Defined by Diabetes

Many people with diabetes speak and write about not letting diabetes define them.  They go to great lengths to state how diabetes cannot and will not define them and their lives.  I sincerely hope that their wish is granted.

I have to admit that I felt this way for a while and I thought I had possibly succeeded.  However, after a long look in the mirror, I for one, know that my life now is defined and shaped by diabetes.  I write about diabetes and about diabetes service dogs.  I spend much of my day reading and researching diabetes, finding topics that I feel comfortable writing about and how diabetes affects me.

Of course, being retired helps me find the time to devote to this and enjoy doing these things.  Whether I am able to help people or not, I look forward to sharing information with those ready to learn. 

Diabetes has meant adding more doctors for me to see.  I occasionally saw a podiatrist for an ingrown toenail or when I had planter warts, but now I see one on a quarterly basis to maintain healthy feet and to catch potential foot problems early.  I never had need of an endocrinologist before diabetes, but now I see one on a quarterly basis.

I started seeing a neurologist for sleep apnea and what was neuropathy approximated three years before I was diagnosed with diabetes (should I have known what was coming then?).  Now I see him at least twice a year and sometimes more often.

When I was diagnosed with diabetes, I was in the hospital for angina.  Therefore, I see a heart doctor at least twice a year.  I have always seen a urologist since I was a teenager and was kicked in the groin by a cow; however, now I see him additionally on a regular basis for checking my kidney health. 

This year, I am planning on adding an oncologist for possible yearly visits to do a cancer check, partly because of age and family history, but also because I use lantus insulin.  I still see my primary care physician on a quarterly basis.  I have other doctors and specialists I see on an irregular basis, but in general my doctors are definitely a sign that I am a person with diabetes.

While I could say I don't want my life defined by diabetes, I find it is, and in some ways this definition is a good thing.  It has caused me to be more conscious of my health and to be much more proactive in my health care.  While some of my doctors may not be overly happy with my being proactive, most are happy and actually talk with me rather than at me.  My diabetes has also forced me to be more social in the way I look at things, and more important, more willing to accept changes.  While I am still feisty and ill-tempered at times letting my negative side get me into hot water, I am finding myself mellowing and becoming more even in my approach to life.

Diabetes makes me who I am now, and I will not deny this.  I must test my blood glucose on a regular basis, both pre and post meals.  I will do extensive testing from time to time when I add new foods or want to add new to me foods, and when things seem to be changing for me.  I count carbs, do what I am able for exercise (and this is getting better), and take care of myself.  I do let my wife help when needed.

When people actually stop and think about it, diabetes does affect the decisions those of us with diabetes make on a daily basis.  It affects the foods we choose, which fortunately are more healthy for us than the ones we were eating before diagnosis.  It affects the restaurants we patronize, the snacks we eat and to a large part when we eat.

Therefore, by being more realistic, I am gaining better control and not wasting time denying my diabetes.

Official and Unofficial Types of Diabetes

The American Diabetes Association only recognizes a few types of diabetes.  I referred to them and missed a few in my blog of Aug 18, 2009.  If I had been on the ball, I would not have missed the article by Dr. Bill Quick of Aug 17, 2009 where he correctly listed them and the subgroups.  He obtained his from a posting on the ADA site.  The official termination for diabetes includes:

1. Type 1 and this includes LADA (Latent Autoimmune Diabetes in Adults)
2. Type 2
3. Gestational
4. Other specific types and includes several subgroups (which I will let you read for yourself) and includes MODY (Maturity-onset Diabetes of the Young)

If I have missed something recently published, please let me know.

The unofficial types, or what people want you to believe are recognized, are presently listed as two types only; however, several groups and organizations are competing for each type.  I have not included what I stated in my previous blog.

Type 3. 
Among the groups and organizations that want this unofficial type are some that want to include several of the ADA approved definitions in this to muddy the waters and add to the confusion.

• A combination of type 1 an type 2 - autoimmune and insulin resistance in young people and adults.  This is a recent development caused by overweight individuals.  The following are wanting type 3 for this condition.   The group at Battle Diabetes.com,  lifescript .com, livestrong .com, and askginny are   supporters of this.
• Lack of insulin produced in the brain which seems to lead to Alzheimers and/or dementia.  This is supported by the burrillreport .com, inventorspot .com, and new-treatment for diabetes.
• There is some that want the different types of MODY classed as type 3.  Some even want the different types of MODY separately typed (3A, 3B, 3C, etc..  These include wikihealth .com and diabetesindex .com.
• Gestational diabetes is another ADA approved that people want type 3 assigned to.  Aparently a doctors website is wanting this as is another group.

It is interesting how these groups are also trying to get acceptance for their way of classifying diabetes.  It seems that stepping outside ADA is a popular thing to do by various groups.

Type 4. 
Several groups also want this assigned to their way of classifying diabetes.

• Gestational diabetes - again someone wants this classed as type 4 and one of these is wikihealth.
• Hypoglcemia - here an individual is the one on the bandwagon and has written a book doing just that.
• Some of the subgroups included in the ADA definition are included by the doctors website as type 4

The confusion by many individuals is understandable with all the different websites each claiming that their classification is what you should assume is correct.  It seems that many want to be credited with naming the types of diabetes. 

What surprises me is that a new unofficial term of prediabetes is not advocated for in my research efforts yet.  Yes, I am sure that there are those just waiting to do this and if I have not found it, I will shortly.   The ADA has written about it here, but not officially listed it as classification, which may be discouraging some from trying to coop it for their own.

Until the ADA takes a stand and tells individuals, groups, and organizations that they must label their difinitions as unofficial we will continue to have confusion.  On this I will support Dr. Bill Quick when he states "In my opinion, anyone using unofficial terminology, such as type 1.5 or type 3, should acknowledge that it is unofficial, and clearly define what they are talking about."  Here I would include type four and others that show up.

It is time that the ADA came forward and made a statement about those professing that these types are in existance and clear the air about all these unofficial classifications.  The ADA could also comment on the possible types under consideration and let people know that as of yet they are not official.  While I do not always agree with the policies and recommendations of the ADA, we do need an official organization to keep the confusion to a minimum.