By Hollie Lemons

17 years ago I went on my first date with the man who is now my husband. When it was time to go our separate ways, after hours of conversation, he asked for a moment so he could give himself a shot. This took me off guard, but I don’t think I showed it. He then explained that he has type 1 diabetes.

I had heard the term diabetes before, but was very ignorant on the subject. I had never really known anyone with the condition, nor had I ever read anything about it. Even so, I thought I knew. I mean, you read snippets here and there, or your grandmother tells you she has it. It’s something that older people get, right? It’s something that overweight people who don’t take care of themselves get. At least, that’s what I thought—just like so many others.

Most of the public is probably aware of gestational diabetes. But what I’m talking about is type 1 and type 2 diabetes, which are both chronic illnesses. Type 2 diabetes is more common and is what most people think of when they hear the term ‘diabetes.’ In this case, the body typically becomes resistant to the insulin that is produced. This is sometimes followed by a decrease in insulin production from the pancreas as time goes by. Type 1 (formerly known as juvenile diabetes) is a different story, though. With type 1, your pancreas does not produce any insulin, or so little that it is ineffective.

Type 2 diabetes can come on naturally in a person’s body through genetics or aging. Yet 85% of type 2 diabetics develop the condition due to being overweight. Type 1, though, is not brought on by diet, physical activity, or anything that a person may choose to do. Type 1 occurs strictly because of genetics or because the body has simply decided that that the pancreas will destroy the beta cells within it.

Although some type 2 diabetics will require insulin, most can be treated with oral medication. On the other hand, 100% of type 1 diabetics will need insulin therapy to live. This means that if insulin is not available to a type 1 diabetic, they will not survive.

In addition to insulin therapy, a type 1 diabetic will need to watch their diet, limiting sugar and carbs, and making sure they take care of their bodies. Keep in mind, though, that even the ‘best’ diabetic will still have bouts of high and low glucose throughout the day.

You have to be careful with the lows because glucose is something many organs need for survival. This includes the brain, which is why anyone with hypoglycemia usually starts having neurological symptoms before anything else. It may start with a headache, and progress to light-headedness and make them feel like they want to pass out. If the glucose keeps dropping, it could eventually cause brain damage and even death.

High glucose is also a problem, as it will eventually lead to problems throughout the body. Chronically uncontrolled glucose can cause organ damage and neuropathies in many places, most often the feet, hands, eyes, and kidneys. If glucose gets too high in a short period of time, you might see DKA (Diabetic Ketoacidosis) or HHNK (Hyperglycemic Hyperosmolar Nonketotic Coma). If not treated quickly, it can cause permanent damage and eventually death.
My husband was diagnosed with type 1 diabetes when he was 12 years old. Since then, he has also been diagnosed with hypertension, gastroparesis, diabetic retinopathy, and stage 3 kidney disease, In the past few years, he has had a heart attack and a minor stroke. Every time something has occurred or been diagnosed, we were told by the doctors that it was a complication from diabetes. Every time.

My reason for writing all of this is to maybe help educate some on the differences between type 1 and type 2 diabetes. If you go to Google right now and type in ‘diabetes’, you will find that most articles don’t specify which type they are writing about. If you type in ‘living with type 1 diabetes’ you will find that most articles are geared towards teenagers or younger children.

These are all misleading. Type 1 diabetes doesn’t go away when you are an adult. The articles geared towards children are very deceiving and do not explain how your life and body will change over time. The articles that do not distinguish between type 1 and 2 give an incorrect impression and teaching of both types.

Most people believe that adults with diabetes only have type 2, and are not aware that there is even a difference. Because of this, they assume that what is being written and shown about diabetes applies to all adults. I was once sitting in a waiting room that had the news on the TV in the corner. There was a small bit about how gastric bypass surgery can help diabetics. Never once did they say that it was for type 2 diabetics, who most likely developed the disease because of their weight.

I suppose one of the reasons it bothers me is because when people are uneducated, they assume rather than ask. I can’t begin to tell you how many times my husband and I have gotten rude comments from people when they find out he has type 1 diabetes. Usually, the first question someone will ask me is, “Is he fat?”. As I’ve already explained, a type 1 diabetic’s weight has nothing to do with their condition.

When you try to explain it, they will actually argue with you and tell you that you are wrong. They do this because they have read something in a magazine or saw something on the news which did not specify that they were reporting on type 2 diabetes. They tend to repeat that a diet of cucumbers or a specific type of tea will cure him. Obviously, this is not the case.

But I think the reason I have issue with it the most stems from some of the visits to the emergency room. We always specify that he has type 1 diabetes, but are still asked questions that do not apply. Nurses have asked “what pills are you taking to treat it?” And sometimes we get blank stares as if this is something new to them.

It is very disconcerting to me when his nurse is asking questions like this or they are honestly confused about it. Type 1 diabetes is not a newly discovered condition. And neither is the differentiation between type 1 and type 2. The fact that someone who is treating him is so uneducated on it, does not sit well with me. Honestly, it makes me angry.

When he finally got his insulin pump, that seemed to confuse the nurses even more. We were asked “what is that?” and “how do you use it?” Now, these may seem like innocent questions, but they are not ones that his nurse should be asking. Insulin pumps have been available to the general population since the early 1980’s and should not be in the realm of the unknown to any medical professional.

It occurred to me, though, that this was not their fault. It is all caused by a lack of education in our medical community. Nurses will deal with many more type 2 diabetics on a normal basis. While they are not educated on type 1 as much as they should be, it also doesn’t help that they will see so few of them. Naturally, the information may start to fade from their mind.

Of course, I know that this is not a problem with all nurses. We have had some amazing nurses that were very understanding and helpful. But I cannot stress how important it is that everyone be well informed on type 1, as well as type 2. There are new developments all the time, and there is new technology every year. Without the proper knowledge on the subject, you will not be able to treat your patients effectively.

This article does not go into the details, cost, or emotional toll that any type of diabetes will take on a person. I strongly recommend that you research the topic and learn what you can so that you will be an effective part of your patient’s treatment and well being.