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