T1 and T2--would love your opinion =)

General
1

Hello All!

So I was reading a post about "what is the most annoying thing someone has said to you about diabetes?". This made me remember about a person I had talked to last week--

I was out with my friends and ordered something to drink. I told him "diet" and to please make sure it is diet because I am a diabetic. The man asked if I was type I or type II. I answered that I was type I. He said, "Well, at least you aren't type II. That's the bad one, right?". I looked at him kinda wierd. I said, "I am type I, I have to take insulin". He then relied, "Oh, so you DO have the bad type...". What does he mean by "bad"? Is it bad to have to inject insulin? I guess I just don't understand why people think one is worse than the other. Could it be because type II can sometimes be managed with diet and weight loss and type I has an indefinate outcome to taking insulin for the rest of my life? Is T1 harder to control than T2?

I was just kind of confused. Maybe it's because I am having success with my management and numbers since I've been diagnosed that I don't think T1 is that horrible. I mean, don't get me wrong, a person with T1 definately needs determination, patience and courage to take this disease on, but...I don't know. I guess I've only had this since October 2010, so I have a long way to go; I'm sure there will be frustrating and trying times. I'm guessing that this guy thought that T2 was better because it usually requires taking a pill, whereas T1 involves a needle...oooo! Scary!! hehehe

 

What do you think??

--Kelly

2

I'm Type 1, and I have my numbers managed pretty well, but I could do without the unpredictability of the whole disease. I wouldn't wish the blood sugar rollercoaster that happens onto anyone. T1 is much worse in my opinion.

3

[quote user="Kelly"]Could it be because type II can sometimes be managed with diet and weight loss and type I has an indefinate outcome to taking insulin for the rest of my life?[/quote]

I think you got it right, there.  Plus, it's probably viewed as worse than it currently really is because treatment used to not be nearly as good.  Remember Steel Magnolias?  While wayyyyy over dramatized and a little out of date even when it was released, it wasn't fabricated (in fact, she was based on the playwrite's own sister).  The fact is that type I was probably a lot more volatile to live with before thingsa like home glucose testing and rapid-acting insulin became available.  And once upon a time, there was only one kind of insulin, regular, which meant they couldn't imitate the pancreas's continuous "basal" release of insulin like we can with either a pump of long-acting (or intermediate-acting) insulin.  And before that, before they could extract insulin from animals, this disease was a death sentence.

In the meantime, some people with type 2 (but not all!) can control their blood sugar through diet and lifestyle.  And of those who can't, most can deal with it through oral medication (until, eventually, their pancreas wears out and they need insulin).

So, I'm not surprised that people see type 1 as "the bad diabetes."  Not only are msot peopel horrified by the whole shots-of-insulin-for-the-rest-of-your-life thing, but the disease has a history that is far, far more grim than it's present and future.  But type 2?  Eh, those people can just go hop on a bike, right?  (Yeah, it's that simple, sure.)

I really liked the perspective of my very first CDE.  Since I was 30, my GP and I were assuming that test results would reveal I was type 2.  Scared though I was, I held up hope while waiting for those test results.  Even if they started me on a medication, my plan was kick my ass into gear, exercise, eat low carb, and control my diabetes through lifestyle if at all possible.  I was going to take control!  But when the results came back showing likely type 1, and the doctor prescribed insulin and was explaining what to expect at the insulin therapy class she was referring me to, I felt control slipping away.  There was nothing I could do.  I would always need insulin.  I would always have diabetes.  Nothing I could do would change that.  (And yes, I knew that people who control T2 diabetes through lifestyle still have diabetes, but I wasn't being logical at the time!)

I was terrifed.

But when I sat down to talk to my first CDE, she started off by saying, "I have type I diabetes, and I have all my fingers and toes.  I've never had a single major complication.  You can do this.  As far as I'm concerned, you're lucky it's type I."  (At this point, I interrupted her with a very skeptical, "Really?")  "Yes, really.  I say that because most people who get type 2 walk around with the disease for years before finding out, and the high blood sugar is causing irreparable damage to their bodies.  But with type 1, you find out almost right away and you can start doing something about it and probably avoid those complications."

Suddenly, I felt like I had some control back.  My own view that I had "the bad diabetes" shifted a little.  And since then, I don't think of it that way.  I have some things a lot harder than a type 2 would, but they have some things harder than I do.  It's all a trade off.  Neither of these are the "good" kind of diabetes!!!

Jeez.  *steps down from soapbox*

4

Well said, Elizabeth! Finding out fast was a shock, but also a good thing....walking around for years and years having damage done is no good. You totally hit that nail on the head!

Gosh, that's funny, because I was actually hoping for a T2 diagnosis when I was sitting there in the dr's office too. **I guess I answered my question right there, huh? I WANTED the T2 diagnosis because I thought it was the "better one" ....DERR!! hahaha** They told me even before the tests came back that I was a T1 because my BS was wayyy too high to be T2. Then they whipped out the Humalog pen and needles and said "roll up your shirt, I'm going to go through insulin injection instructions with you, we have to start this RIGHT AWAY". I'm thinking....WTF!! I have to put what... where? I had to count myself down about 5x before I actually did it. BUT I DID IT.

I felt a lot better when my CDE told me that taking insulin is not that bad. She said that insulin is like the 'Cadillac' of diabetes medications--it's made by the body naturally, so you don't have to worry about creepy side effects (well, except the good ol' occassional hypoglycemia... ), whereas with, for instance, Metformin, Glucophage, etc., can cause headaches, edema, cold-like or flu symptoms, metallic taste, nausea, constipation, diarrhea, sensitivity to sunlight, etc, etc, etc. Yeahhhh....I'll take the insulin, thank you.

I guess a person has to have diabetes to actually know, huh? But I agree, neither one is the "good" one. I'd rather have neither, but it just IS....and I'm okay with that =)

5

Jason-

Off topic, but is that Target Field in your picture?  (Go Twins!)

6

Kelly,

I think the hardest thing about having t1 is the misconceptions non-diabetics have about it.  Most people I've met think t1 and t2 are the same and that the only difference between the two is the age at which you were diagnosed, t1=younger, t2=older.  I had someone tell me recently that it probably wasn't too bad having diabetes, since I could control it by just eating good.

I think both t1 and t2 suck, but I'd rather have the option of taking a pill to control it. With t1, that will never be an option!

 

7

Kelly, I have seen this discussion so many times on many diabetes sites. When there are both T1's and T2's present, it can become a war between the two types. I am glad we are all one type here, and we are all on the same side. I don't believe there is a good type and a bad type. Both types can be very well controlled if the appropriate steps are taken and proper diabetes management is accomplished. Both types can be bad if there is denial and no attempt is made to have a controlled diabetic existence. I accepted my diabetes when I was 6, and am very healthy after 65 years of type 1.

 

8

Elizabeth, I enjoyed your post. You should get on your soapbox more often. You are correct about type 1 having been more volatile during the early years after the discovery of insulin in 1921. It is amazing that there are so many long term diabetics who were diagnosed more than 50 years ago, and are alive and well now. I was diagnosed in 1945 and am very healthy, except for some minor nerve damage. William Rounds was born and diagnosed in 1923, the same year insulin was first sold. He is still living, after 87 years with type 1.

I agree that a type 1 is much more likely to know about having diabetes soon enough that good control is more likely to prevent complications. That is the way it has been with me, however, my parents had to take me to four doctors before they found one who diagnosed me. I had all the classic symptoms, but the first three doctors did not have a clue.

Neither type has to be bad, but so many diabetics ignore their diabetes and have a miserable, and abbreviated life.

9

People think Type I is the bad kind because you have to give your self shots ( or used to before the pump ).  That's it.  It's a pretty creepy thought to someone who has never done it before.  I know it was for me.  But I got used to it. As would they if they had to ( but they don't, so they're freaked out about it ).

10

Elizabeth, great post!  I am so grateful to have been born when I was.  I know that it is possible to still be alive today even if you have lived with T1 before reliable testing and insulin were developed, (which, btw, is amazing and commendable in my opinion), but those years did take their toll on others who weren't so lucky.

Another reason that I think the guy at the restaurant may have thought you had the "bad kind" is because of the general population's attitude regarding insulin.  As we all know, the incidence of Type 2 in this country has reached an epidemic.  Type 2's are initially treated with oral medications, but if they start becoming ineffective in controlling blood sugar levels, doctors often prescribe insulin.  However, many doctors use insulin as a threat, as in "if you can't control your blood sugars, you are going to have to go on insulin!"  Many Type 2's that I know have had this experience with their doctor.  Essentially, by using insulin as a threat, the doctors are suggesting that not being able to control blood sugars with oral medications is a failure on the part of the patient, and insulin is the punishment.  What really sucks about this is that the eventual need for insulin in many Type 2 Diabetic patients would have been an inevitable part of the development of their disease and something they had little control over, rather than something they caused by negligence.  And what sucks even more is that there have been recent studies that suggest that the early introduction of insulin therapy in Type 2 Diabetics can preserve beta cell function, I'm assuming by reducing the stress on the T2's own pancreas. So doctors should really be talking about insulin in a positive way, not a negative one.

The unfortunate side effect of all of this for Type 1 Diabetics is that now insulin is beginning to be viewed as something that is only needed in cases where someone was extremely negligent and didnt't take care of themselves, when obviously, that is DEFINITELY not the case for us, and is not even really the case for lots of Type 2's.

Molly