Letters to the Editor
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countrygirl
you are very generous in your apology. i probably blew a little too hard myself.
there is a wierdness about diabetes-- it erupts, for instance, when a simple "boo-boo" morphs into serious trauma. before diabetes, if i mashed a couple of toes i simply stuck them into roomy shoes and at most limped around a couple of days until i was better. no more. i jammed two toes, ignored the problem (what problem? i stubbed my toe!) until i was hospitalized for ten days for infection, septicaemia, a foot ulcer, uncontrollable blood sugar, etc. the docs even rumbled about amputation. i was sent home on crutches, thankfully still intact. it was the first time i was hospitalized as a consequence of diabetes, but not the last.
people who are poor or uninsured or lack a competent caregiver at home are sh*t out of luck.
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A good article with inaccuracies
My heart truly goes out to all the women struggling with a desire to control their weight, especially those with diabetes. If you're reading this, please accept those parts of yourself that you reject. PLEASE... You are worth it. I promise. I'm sorry you haven't had the right examples to guide your relationship with your body.
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With regards to the article:
1. Insulin doesn't automatically cause a person to gain weight. We all produce/release/use insulin on a daily basis and if it's properly administered in a diabetic it acts in the exact same way as it acts in a non-diabetic's body. This factual error gives diabetics even more of an excuse for not taking insulin. Fabricating this catch-22 (take insulin and gain weight or skip insulin and lose weight) for the sake of the story is not only unnecessary but it's also irresponsible journalism as well.
2. A1C tests are given as needed (usually quarterly), and they give a summary of the last couple months of testing.
3. Blood tests, likewise, are not something to be done 4 times a day, but also as needed, which can be anywhere from 1-12 per day.
These are just some of the inaccuracies I remember off the top of my head. It sounds like poorly informed patients were consulted as expert witnesses.
The rest of the article, which highlights the incredibly strong social forces that can bring about such a sad situation, is commendable.
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Insulin and Weight Gain
To those of you who keep commenting that insulin does not cause weigh gain in and of itself are missing the point that Ms. Bauer is trying to make. When insulin is withheld for such a length of time and then reintroduced, it does cause a dramatic weight gain (commonly referred to as water weight). If you have never been through this process then you wouldn't have any idea about it - And so you are speaking about something for which you have no expertise yourself.
This is one of the reasons that Diabulimics have such a tough time in recovery. Have you every gained 10, 15 or 20 pounds in one week? I have. It is miserable and in many cases Diabulimics revert right back to omitting insulin. It takes months for your body to adjust back to normal. Doctors don't expect this and tell you that there is nothing they can do. Fortunately, Endocrinologists and Eating Disorder professionals are starting to understand this phenomenon and are finding ways to help girls and women deal with it. Your comments certainly aren't helping.
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Gratified. Horrified. Annoyed. Troubled. Relentless.
So many thoughts whistling through my head upon reading this article…
My type 1 diabetes was diagnosed when I was 7 – in 1961. (I believe it was the result of an autoimmune response by my body to an extremely severe case of German measles.) In the ensuing 46 years, I can’t even calculate how many times I’ve heard “the cure is around the corner” and “we’re making such great strides!” It is impossible not to be cynical at this point about that rubbish. The medical community and the community of “professional diabetics” need to stop insulting our intelligence and get off their asses. Now.
The trick is to remain cynical and yet not give in to it, not get thoroughly depressed. And that can be quite a trick sometimes. It’s not hard to fathom why there is such a high incidence of clinical depression in people with diabetes.
It’s gratifying to read an article like this that – despite its several factual errors, which have been noted – focuses specifically on type 1 DM (diabetes mellitus), because we are in the minority – not sure of the exact stats, but in the U.S. it’s something like 1.5-2 million type 1s vs. 20+ million type 2s. As a result we tend to get significantly less “play” in the discussions about diabetes. The potential devastating effects of all kinds of diabetes are ghastly. But let us be clear: type 1 and type 2 are two completely different diseases. And to be honest, it is a huge irritant when the two are conflated.
It’s horrifying to read this article because it brings back such intense memories of my own forays into diabulimia, starting when I was a freshman in college, in 1972. That was long before there was a name for it, as far as I know. That was also long before the advent of home glucose monitoring (though we did have disposable syringes at that point, so some “progress” there!). It was easy for me, in college 500 miles away from home, to disguise what I was doing, to hide it from my parents. While other girls were comparing notes on how easy it was to be bulimic (eat what you want, throw it up, lose weight!), I was eating whatever I wanted and could keep it down, and was rail-thin. Pretty fabulous. When I was a freshman, after weeks of little insulin and vast quantities of food, I ended up hospitalized in nearly fatal diabetic ketoacidosis, with bG levels so high that major organs began the process of shutting down; other horrors ensued. It would be salutary to say that I learned my lesson and was The Good Little Diabetic Girl from that point on, but as others here have pointed out, youth believes, and always will believe, that it is immortal. The behaviors continued for some years but I’d learned enough not to let them get to such a point again.
And fortunately I eventually turned my back forever on those behaviors.
Often it is difficult not to fantasize about having just one day of vacation with no consequences from this monster. One day without obsessing about numbers, amounts, calculations, the unending walking of the tightrope that is life with type 1 DM and being on insulin. Am I too high? Am I too low? I need to get in my car to go to an appointment – is my bG okay, or do I need to bolus, or do I need a snack? Can I eat this 20 grams of carb without blowing my bGs to hell, or should I bolus maybe ¼ or ½ of a unit for it? But I’m going to go for a walk, so maybe I shouldn’t bolus at all. Should I set my alarm tonight for 2 a.m. so that I can check my bG to make sure I’ve not gone too low – or too high? Why is my bG so high all of a sudden? Could that one gingersnap and the two lifesavers have done it, or is my insulin pump infusion site somehow at fault? Maybe my insulin is old and I just lost track of the date I started using it. Should I take out this new infusion site and start all over? If I get in my car to drive somewhere and forget to bring my testing kit with me, or some backup insulin, and my pump malfunctions, will I be truly endangering myself – or perhaps someone else? It is relentless, the process.
It’s pointless to wish for something different. This is what it is. But oh! That desire for freedom sometimes feels overwhelming. I think it wouldn’t be human to feel otherwise. A happy time for me is when I can disconnect completely from my pump and go for a long hike with my dog. And yet it feels a little scary, too, to be without my pump. It is a true love/loathe relationship. As is the relationship with insulin: a blessing and a lifesaver, and a curse because it is often so damn hard to know what to do or how to do it or how to fix what you might have guessed incorrectly at, even with supposedly the best tools at one’s disposal. Even the seemingly most minor error can end up causing catastrophic consequences. It is endless, the process.
When I think of what a sickening blow it was to my dear parents, brother, and sister, when they were informed of my diagnosis all those years ago, and how wonderful and loving they were, and always have been, it troubles me no end to read of the reaction by Katie’s parents. I can’t even imagine how shattering that was for her. It boggles.
Sadly, the quest by young woman for “the perfect thin body” is an age-old one, and it continues. I’m hugely grateful to have escaped it and to have the battle scars and war stories to prove it.