Sunday, January 06, 2013
1 vs, 2
Nolans 8th anniversary of having Diabetes came and went without notice. At some point that day at work, I remembered, and said something. We have a lot of talk about Diabetes at my work. I am a wound care nurse at a wound clinic. The majority of my patients are Type 2 Diabetics, and a lot of them are Type 1. When people tell me that their Diabetes is the worst thing that every happened to them, I tell them I understand. I tell them about my son. I don't always explain that he has type 1 because people usually ask. They ask his age. They ask how he is doing with it. They ask if he uses a pump, or shots. They always express concern for him, disappointment that this horrible disease could happen to a young child. They all seem to understand that he has the "bad kind"... What I notice the most, is the general concern, the immediate appreciation that they have the "better kind" because they might be able to get away with losing weight and taking pills. I don't experience a lot of sympathy on the flipside. I like to think that Type 1 Diabetes is an entirely different thing than Type 2. Type 2 is genetic, Largely. Not all my patients with Type 2 diabetes are obese. Only about half. Not all my Native patients are Type 2, but most are, thats true. Most of them are not overweight, much to the shagrin of parents of Type 1's everywhere. I used to get really angry when someone would tell me "My dad just found out hes got what your son has". But now, I just nod, and say, "Aw. Im sorry. Its really hard to make lifestyle changes at that age. I hope he does well, and if you need any info, it's all up in me brain.. feel free to pick it." and I let it go. Sometimes I differentiate. Mostly I dont. Why bother. Its a crap disease any way you put it. Its NOT the same, but the manifestations are. The complications, the struggles with insurance, and in a lot of cases, the treatments are the same. I always want to stick up for the Type2's. I feel like the Type1 community kind of hates, or resents them. There are so many Type2's... Gestational, MODY, Type1.5 etc. Some lucky people get both... no insulin and insulin resistance.... Its not all the same.... Except for one thing. Nobody asked for any of it. Not one of us. I think we like to blame the Type2, "you are obese, you kind of asked for it" Yes, obesity plays a part. For sure. But so do processed foods, and autoimmune familial history, and geographics, everything. Its not all about diet and exercise. I have patients who are very active, healthy, and at or below their recommended weight, and still, they found out that they had Type 2 diabetes... Maybe they had it for ten years... or more... without knowing... and then they show up at my clinic because they walked around the golf course with a tee in their shoe and didnt know it a year ago... and the wound will not heal. The point is... I get not wanting your childs Type1 confused with Type2... and its tiresome to have to explain it. But Type1 community... you have to remember that you NEED type2 to exist, and all the other kinds of diabetes that I have failed to mention. If Type1 had to stand alone, and the treatments did not overlap... We would not have the technology we now have... and even if we did, it would NOT be covered by medicare, and the insurance companies would not follow suit. If they werent so worried about having to pay for dialysis for all of those Type2s, stuff just wouldnt be covered as readily. Even though its still hard to get what we want from insurance... Imagine if we were as rare as Type 1 really is. Loads of insurance companies wouldnt even have a policy written for Diabetes if there were no Type2's. All your rinky dink "bc/bs of northern lakes of north dakota valley of the wolves" and "six rivers united health limited foundry of northeast west michigan excluding lakefront areas chapter of health" companies would not cover anything. Nolan was the FIRST type 1 on his insurance policy back in 2006... I had to fight for everything, as the plan was written for Type2's. He had two test strips covered per week. Some electricians made that decision when they purchased the plan. Im pretty sure my picture was hanging in the office at that company, with a check list of the six people that worked there so they could take turns taking my calls. We need each other, Diabetics... We might not all be the same, but who cares. Lets advocate for each other, take care of each other, and be good to one another. After all... thats what humans were put here to do.