Type I vs. Type II: Why Are We Competing?
If you've already read my article Type I: The Forgotten Diabetes, I spell out how Type I diabetes has become the red-headed stepchild of the diabetes world. We know it's there, but it just isn't worth getting to know anymore.
This is in comparison to the storm that is Type II diabetes. Almost 1/4 of the USA is dealing with or on their way to dealing with it. And with its connections to a bevy of other conditions like heart disease and obesity, it has monopolized the attention of the research community.
This has led to some derision between diabetics. Type 1s, painted as having no influence over how they got their condition, feel neglected for losing their due research to the Type IIs, who are painted as having their condition because of poor lifestyle habits.
I.e. They chose to live that way and knew the risks and they didn't change. They deserve what they get. I, the type I diabetic, have been trying to do the right thing my whole life! I don't have a choice but be healthy! Why do THEY get meds and headlines??
I'm not here to paint either group as the villain. The selfish, helpless Type 1s playing victim versus the stubborn, sedentary Type IIs who can't get out of their own way.
There are underpinnings of truth to both accusations.
Type Is (myself included) were given the "No cure, bad luck" spiel from Day 1. And whether your Day 1 was in 1975 or last month, it's still the same spiel. In an age where there's a new iPhone every 6 months and billionaires going to space, how do we not know something new?
Type IIs are victims to society's dislike of overweight, self-indulgent and undisciplined people. Because, as we're led to believe, you can only be overweight and unfit if you're dumb and lazy. Right?
Let's inspect both takes:
Before any Type I reading this gets the uppity urge to scoff at those idiot doctors and fat, lazy Type IIs, the person I'm asking for new information from is you. Look in the mirror. How do you not know anything new about your condition? When was the last time you googled diabetic research articles? There is no one else more invested in a cure than you. Why would you not capitalize on that kind of energy? Don't play dumb either. We've become helplessly complacent doting on the ever-elusive call to come into the doctor's office and be cured. In what world is that how things would play out?
The medical community has become an abusive parent and diabetics the dependent child. Yes, they serve a vital function. No prescriptions, we die. Counsel and advice for those new to treating themselves? It is so important. But why do we go back looking for more? Does anyone else feel like they've been knocking on the metaphorical door for a long time without an answer? Why do we still knock? Could it be we're at the wrong house?
I'll hold myself accountable first and foremost. I've been diabetic for 21 years, 18 of those years have been like most of you out there now: "OK, what can I do to best manage but still have fun and not feel terrible?"
And while I can't say specifically what brought me to do it, one day I came to the realization that I didn't want to wait anymore. I googled some and found a few interesting articles. Things I had never heard about. I brought it to my endo's attention:
"Well, the research is not very robust."
"Rat models don't always have great conversion to human models"
"I just don't want to give you a sense of false hope"
Doc, I need false hope. Give me whatever type of hope you got. We have been shit outta luck for a long time, give me the tiniest trace of a lead and I will do the work.
And for the Type IIs running a pharmacy out of your medicine cabinet, you are drowning in a sea of inflammation and misinformation. The degree of self-delusion occurring in the realm of Type II diabetics is unnerving. To think a "lifestyle" disease can’t be set to rest with a few pills?
But Bowie, my doctor says... Aren't they supposed to know?
It pains me to imagine all of the people sitting in their endocrinologist’s office talking about how they feel like they’re running out of options. The 2nd, 3rd and 4th medications aren’t quite doing the trick. You still aren’t sleeping well. You’re a moody mess after your meals. Your doctor looks at you straight-faced and says “Let’s see if upping your doses does the trick.”
Sure, doc. Let’s do that.
Maybe the 5th pill does the trick. Free at last! Free at last! You’ve finally got things under control. And nowhere in this beautiful world of ours is anyone there to yell at the top of their lungs “THIS IS NOT WHAT UNDER CONTROL LOOKS LIKE”.
Let’s be clear: You are OUT OF CONTROL and on 5 medications to keep the fucking lid on.
Type II diabetes has been reversed before. It's been done. Bariatric surgery has been the most widely documented method but sustained weight loss by diet and exercise has done it, too. But I don't think a lot of Type II diabetics know that. Do you?
If you told a Type I diabetic they needed to tattoo their mom's lips on their forehead, you'd find me in the tattoo shop today. So for my Type II diabetics, if you knew you could, would you?
Everyone has heard the inspiring stories of people told they have pre-diabetes and that they are "headed down the wrong path of health". They join a gym, double down on a healthy diet, and they come back looking great and not pre-diabetic anymore. How is that same logic not used for Type II diabetes? As if there's an imaginary line of no return.
Am I being dramatic? Maybe.
But I'm also right.
Type Is, if you weren't so consumed with being a diabetic and getting jealous of Type IIs, you'd see that the answer to your condition is in the literature about their condition.
Type IIs, you've got 25 different medical conditions to manage. Pick 1 to focus on. Go for a walk everyday without exception. Take just 1 of the things you know you shouldn't be eating, and don't eat it. I guarantee more than just the 1 condition will begin to improve.
We need to be working together on this. We're not nearly as far apart as we're made out to feel.
We can do this.