Last Friday I had the privilege of attending the 6th Annual Education Forum on Diabetes Prevention & Management in Tallahassee, Florida. Throughout the day there was talk about all of the various types of diabetes and their differences, along with the growing number of diabetes diagnoses, the obesity epidemic, the lack of education about the beneficial impact of fitness on the human body, and other topics.
One discussion panel consisted of diabetes educators from rural areas, mostly working with their local health departments rather than a diabetes center of some sort. Each of the professionals shared what their communities were doing to educate people who are at risk for Type 2 diabetes, to help those with any type of diabetes to get the resources that they so desperately need, and to help them navigate the often confusing world of healthcare.
One of the panel members, like so many others that took to the microphone throughout the day, spoke about her personal connection to diabetes and how important it is to her. My ears always perk up when I hear someone sharing their diabetes story. We all have a unique diabetes story, and we find common ground in our shared experiences in living with diabetes on a daily basis.
I heard this panel member trying to share her connection with diabetes from her rural perspective, and her view of the importance of education and helping people to learn the skills they need to effectively live with diabetes. She said, “I understand, because I used to have diabetes, but mine has been resolved. My husband still has diabetes, so it is very important to me.”
I looked up from my iPad, where I was taking notes, and probably had a look of “Huh?” written all over my face. “Used to have diabetes?” I’ve always been taught that there is no cure for diabetes, regardless of what type you have. Sure, there are options if you have Type 2 diabetes, including lifestyle changes and medications, but you still have diabetes even if you are able to avoid medications. Diabetes is a progressive disease, and you have to stay on top of it in whatever way works best for your unique situation. They don’t say “your diabetes may vary” for nothing. For Type 1, there is far less gray area for lifestyle adjustments: Insulin or death, pick one.
At first it agitated me that this woman, a diabetes educator, a representative expert on diabetes in her rural community, was proceeding and educating others with the presumption that diabetes was something that could be “resolved.” To me, that implied that diabetes was somehow the fault of the patient, which is not always true, and certainly is not a fair assumption without looking at many other aspects of the individual’s health. Initially, it felt to me like she was blaming her patients for having Type 2 diabetes, which I do not agree with.
Blame does nothing but remind someone of the circumstances that they are in. Blame looks into the past, not the future, and keeps us focused on what we should have done, as opposed to what we can do now.
I said at first it agitated me, because the more I thought about her words and her perspective, the more I came to realize that maybe her choice of words is a direct reflection of the rural community she is trying to help. Rural communities are often lower income, lower educated, often economically challenged, and without extensive healthcare options within the community area. Given this, for the people with diabetes that she is trying to help, it may be easier and more effective in managing diabetes within the community if they proceed with the idea of:
Losing weight + eating healthy + exercise = diabetes resolved.
As opposed to:
Medications = I have diabetes.
I know this equation doesn’t work for everyone, but I decided to give her the benefit of the doubt, because maybe it works for a majority of the patients in her care. Thinking about it from that perspective, it is certainly a lot easier to inspire people to take care of themselves when they can have a goal of “diabetes resolution.” For a rural community that simply does not have the resources to help every single person with Type 2 diabetes, and the community members themselves may not be able to afford medications, prevention and “resolution” may be the most effective options.
At first I wanted to jump up and say, “There is no cure for diabetes! You can’t give people that false hope! That isn’t fair!” Then I thought about it some more, and even if we find hope and can place our faith in things that under a microscope may not be completely accurate, if it gets us to a better place where less people are dying from diabetes, then I can certainly accept that bigger win in the long term.
It bugs me to hear that professionals are telling people their diabetes can be “resolved”, too. To me, and what I have been through, that is potentially dangerous. If someone is told their blood sugar is normalized, they could either (a) fall back into old patterns, thinking nothing more needs to be done or (b) be fine until an illness unrelated to diabetes strikes. (b) happened to me a couple years ago and it took a long time to get normal blood sugars again. Imagine someone’s surprise who thought their diabetes was “resolved” only to find out it rears its ugly head when you end up with serious illness. (Obviously all talking about type 2, diet/exercise, here.)
The part that I worry about is what if the person does everything they are supposed to and their diabetes doesn’t “resolve”. What if they just give up?
I applaud you for staying composed and listening while considering the patient population.
Even still, I don’t like her choice of words. Period. It doesn’t get “resolved”. It doesn’t “go away”.
I think patients deserve to hear the truth when they attend events like this…even if it’s not exactly what they want to hear.
i had a similar experience last week when a rep from jdrf came to my kid’s school for the fundraising kickoff. she was describing the differences between types 1 and 2 and she really emphasized the fact that type 1s have done nothing to get diabetes, but type 2s typically have brought it on themselves. i understand where she was coming from, and speaking to a room of 6th graders is a different audience than normal, but still, i was really shocked.