Diabetes: the burden of a diagnosis

Having close family members, such as parents and siblings with type 2 diabetes, increases the risk of developing it. For years I walked the fine line between prediabetes and diabetes, watching my diet, exercising regularly, and even taking Metformin to decrease my risk. So when my A1c returned at 6.9% (type 2 diabetes is diagnosed at 6.4%), I went straight into denial and remained there for a few months. I’m a diabetes educator, I teach people how to manage their diabetes. I’m passionate about helping people care for themselves and preventing the long and short-term complications associated with diabetes. I impart knowledge without judgment and with an understanding of the factors that challenge the self-management of persons living with diabetes and other chronic illnesses. I thought I was already making a substantial contribution and did not know I needed to add my testimonials. However, to remain honest, authentic, and, most of all, humble, I must accept and admit that I have type 2 diabetes. Let me share why it is so difficult to handle this diagnosis. 

The Type 2 Diabetes Stigma

Because there are some modifiable risk factors, it is often believed that persons living with type 2 diabetes could have prevented it. Persons who receive the diagnosis are frequently stigmatized. We are labeled as lazy and obese. People often state that it is our fault for causing the disorder. Persons living with type 2 diabetes are often treated with less respect and empathy from healthcare professionals, especially in acute care settings. The consensus is that we could have prevented getting the disorder by eating better and exercising. While diet and exercise are modifiable risk factors for type 2 diabetes, they do not tell the entire causation story. There are several non-modifiable risk factors that, as suggested, cannot be modified and is no one’s fault. Insulin resistance is a part of my genetic makeup, and my race, gender, and age also contributed to my risk factors. Type 2 diabetes is a complicated disorder involving multiple core defects, from beta-cell failure in the pancreas to insulin resistance in the liver muscle and brain. Aiding in the stigmatization of type 2 diabetes are the disease exacerbations that require costly emergency department visits and hospitalization. It does nothing to reduce the shame when diabetes is associated with worse outcomes and fatalities in persons with the most significant illnesses such as kidney disease, cardiovascular diseases, and now Covid-19.

Covid-19 and Diabetes

There is a strong link between blood glucose and Covid-19 outcomes. Studies are showing that persons with hyperglycemia (high blood glucose) have poor Covid-19 outcomes and increased fatality. Ok, did anyone notice that the sentence reads hyperglycemia and not diabetes? Now I know that having high blood glucose implies diabetes, but it does not mean that everyone with diabetes maintains higher than normal blood glucose. It’s important to note that well-managed diabetes is not associated with poor outcomes and fatalities in kidney disease, cardiovascular diseases, or Covid-19. Persons who maintain fasting blood sugars below 130, postprandial (after meals) blood sugars below 180, and an A1c below 8%, or 7% in younger, healthier persons, should not have to fear worse outcomes and fatalities with Covid-19 or any other disease. My message to you is to manage your diabetes, if your numbers are higher than the above mentioned, make an appointment with your doctor.

Discussions to have with your Healthcare Provider

  • Discuss with your healthcare provider whether you are receiving the optimal treatment for your diabetes; ask about the type of medications you are taking.
  • Persons with type 2 diabetes have insulin resistance, and if you are taking insulin, you should ask to be prescribed a medication to help your body absorb the insulin.
  • Ask if you are on medication to protect your kidneys and one that protects your heart.
  • Speak to a diabetes educator, a dietitian, and or fitness specialist if available.
  • Get all the help you can to set achievable self-management goals. Enlist your family and friends’ support in helping you eat healthier and increase your activity level.

You may not have been able to prevent diabetes, but you sure can determine how you live. Diabetes is not a death sentence, just a wake-up call.

Photo credits: Mykenzie Johnson on Unsplash

10 thoughts on “Diabetes: the burden of a diagnosis

  1. This article is very informative, Angela. As someone who was diagnosed with diabetes and who has been managing this disease reasonably well for many years, I did not quite understand why I was at risk for contracting Covid-19. I now have a better understanding going forward, and am also now aware of some of the issues that I need to discuss with my doctor at my upcoming appointment next week.
    Thanks for shedding light on what could potentially be a confusing and anxiety-causing condition at a time when we have more questions than answers.
    Keep up the good work!

    1. Thank you, Carrol!

      We appreciate your feedback and knowing that you found the article helpful. It is vital to our community’s health and well-being that we spread some truth amidst all the noise and confusion. Please note that the problem is not that hyperglycemia increases the risk of contracting Covid-19, but that hyperglycemia contributes to worse outcomes and increased fatalities in persons that do contract Covid-19.

      We here at PEEPS wish that you continue to live well with your diabetes, and have lots of resources to support you in your effort.

  2. Very informative article. Opening up about your personal journey with Diabetes allows those that come to you for help feel comfortable to open up about their struggles with no judgment.

    1. Thanks, Mattie, I agree with you.

      I knew I had several of the non-modifiable risk factors for type 2 diabetes but was still shocked to receive the diagnosis. However, I am excited to discover how this added dimension will enhance my role as a Certified Diabetes Care and Education Specialist. I plan to walk my talk, share my journey, and spread the message that we can live well with diabetes.

  3. Angella great article. A very informative personal account gives me insight into some of my patients. As a pharmacist, this definitely gives me a perspective to consider when counseling my type 2 diabetic patients. There is an article in Medscape that also references the Wuhan study and the link between hyperglycemia and COVID-19 death. Thank you for writing this article because with or without a diagnosis of diabetes we all need to be aware of the role hyperglycemia plays in COVID-19 outcome.

    1. Thanks, Deborah,

      We here at PEEPS appreciate that you took the time to leave us your feedback. We are committed to providing excellent content that is relevant to those seeking to improve the health outcomes of persons living with diabetes.

  4. Great article! Thanks for sharing your personal journey Angella, I am sure it is not easy journey but I believe sharing your testimony has helped a lot of people. Also it is a good reminder for me to be careful not to stigmatize individuals with diabetes, sometimes there are risk factors that are not modifiable and we do not know where each individual is at in their journey. Looking forward to reading more articles.

    1. Thank you, Jayce,
      While I must admit that it was a difficult process coming to terms with my type 2 diabetes diagnosis, I have since accepted it as an opportunity for me to “walk my talk.” As a diabetes care and education specialist, when I say to my patients, “I know what you are going through,” I can do so from experience. The ability to connect on a deeper personal level can only strengthen my commitment to providing education, care, and support to persons at risk for and living with diabetes.

  5. I think this is beautifully outlined and explained in uncomplicated, understandable language. Thank you for showing the correlation between diabetes and Covid 19. Even though almost everyone keeps repeating the fact that Covid 19 is very detrimental to the health of people with underlying conditions – diabetes being one of those, I have never fully grasped the connection, meaning, the exact “modus operandus” of this virus in the system of people with diabetes. This article has totally clarified that confusion and now I can equally explain same to someone else. That is amazing in itself. Not to mention the very useful and apt probable questions that a diabetic should be asking the doctor in order to stay on top of/ahead of their game in the fight to beat this condition called “Diabetes” and to stay healthy for a long time to come. Thank you so much, Angella.

    1. Thank you, Ocha,
      I appreciate your feedback. We must make the distinction between diabetes and hyperglycemia, particularly when identified as a risk factor for poor health outcomes. Persons living with diabetes need to know that if they adopt the recommended self-care regimen and maintain their blood sugars within their target ranges, they can have excellent health outcomes. Also, in an effort not to label persons by their disease, we now use the term” persons living with diabetes” instead of referring to them as “diabetics.” Thanks again for taking the time to respond to this article.

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