World Diabetes Day, and Four Years of Living with Diabetes

Hello sweet peeps! It's about that time of the year again! Diabetes awareness month is fast approaching... and with it will come another year of living with diabetes, for me. November 17th will mark my four year anniversary of living with this insidious disease.

What will you do for diabetes awareness month? Will you wear a diabetes awareness pin? Will you hand out fliers, or educational materials? Will you donate money to the cause, or participate in a walk? Will you help the International Diabetes Federation light up a building blue? There are so many things we could do. I was considering making little educational booklets for the recently diagnosed type 2 diabetic, being as there is often so little information given to patients. This might take me a little time, and expense... but it's a goal I have. 

November is also a month in which I contemplate my life with diabetes: Where am I? Where am I going? Am I where I want to be? What have I learned about myself. 

Through my four years of living with diabetes, I've gone through several approaches as to how to manage and cope. From stricter, to less so, to more of a balanced and moderate approach. I've had to sit down and think long and hard about my attitudes toward food, weight loss, and how I was emotionally comforting myself. For a while, I practiced extreme low carbing, and realized it was not the best approach for me: it was not financially doable, plus it was also not realistic as to enjoying life with others in social situations. And well... I just dislike almond flour and excess fat. Now, I love the approach of eating with awareness, or intuitive eating, but I must be aware that as a person with diabetes, I must mind my level of carbohydrate consumption, as well as some of my calories, so I still needed to put some limitations on myself. 

So far, I've come to a place where I practice a sort of hybrid of both: I try not to eat more than 400 calories per main meal (I'm only 4'9... I really don't need that many calories), and then I eat my meals with awareness, so I may not end up eating that whole meal, if I don't feel like it. I can be one of those people who eat distractedly, or emotionally, so if I 'fail' to stop where I want, at least I won't have eaten a lot more than 400 calories in one sitting meal. If I am physically hungry and need more food than this, I'll eat it. I try to do this approach of mindful eating when I'm in restaurants, too. If I can, I will order less of the regular portion, or box away half of the portion, etc., adding veggies or side salads, helping to balance things out, as well. I generally don't like to take portions home.  

I've started trying to cut ties with certain foods, not because I can't have them, but to reduce my cravings for them, while increasing my appetite for others. It has given me quite a bit of freedom in my walk with diabetes... leaving some foods to rare occasions. I won't say what these foods are: I think that's irrelevant, really. What those foods are, could be different for everyone. It's the concept that matters. 

I am fortunate right now, that I have a very physical job at a restaurant, and I get quite a bit of exercise running around a busy dining room all day, and often lifting heavy things. I should add more physical activity to my life, though, as I go along. And this won't be too difficult to do. I just need to schedule it in, and go do it. 

Pacing myself with weight loss has also been another big lesson. When I first was diagnosed with diabetes, I was in such a hurry to lose weight and be healthy -- I was so scared of this disease. I did manage to go from 243 lbs down to 170, which was a great accomplishment, but it left me feeling tired, deprived and trapped by having diabetes. It made me burnt out. Eventually, I yo-yo'ed a lot with my weight, gaining and losing weight quite a few times, up to reaching 226 lbs again. I am now, presently at 183 lbs... and losing slowly, and as peacefully as possible. Even us advocates need to be reminded that this is not a sprint, but a marathon; that we need to pace ourselves along the way. Love ourselves along the way. It is hard to feel much love for life, ourselves, or any peace with diabetes, when one is pursuing strict, short term solutions, to long term problems. This rocky relationship brings moodiness as well; depression, anger, eventual high blood sugars, and further uncontrolled emotions.  

Diabetes has been for me then, a deep exercise in introspection: a deep learning to pay attention to my needs, to want those things I'm doing for myself, to love and desire to be healthy, and in good spirits. It is the courage to look at what we want in the face, versus what we need... and to turn what we need into what we want.  

Temptation Wears a Red Dress Pin

Many of you might know that, currently, I work as a cashier for a local restaurant. It can sometimes be a fast paced job, with unique 'diabetes adventures,' as well as unique opportunities to meet people. Sometimes, it's just an opportunity to see people react weirdly to their environments.

Our restaurant isn't exactly a health venue. It's a local fast food type joint, which has at least, some merits: it's privately owned, it makes all of it's food fresh-from-scratch, and since it's family owned, the people are wonderful to work with. For the most part. Every job has it's ups and downs.

I admit I've never been what you would call -- a people person. But I can be a congenial person, and I do love watching people; studying them in their environments, when they think I'm not watching them. Especially as a cashier. Cashiers are like wallpaper to a customer.

One thing which has come as a sort of surprise to me is that most of the people who eat at our restaurant are pretty thin. They'll order the largest thing in the whole joint, deep fat fried, and a trash-can sized cup of soda. Some come and eat this EVERY DAY. Always looking the same weight. Lucky bastards. Then there's the heavy women. They're always ordering salads. A salad, and a cup for water... or a salad, and a diet Coke. And they always look heavy. They never seem to lose weight.

Of course, I don't live with these people -- I don't know what they do or eat when they're not at our restaurant. Who knows if the thin people go running every day, or if the heavier people go eat their entire refrigerators, later. I don't know. But it's a very interesting thing to watch. It makes me feel curious about all the accusations people always have for the obese, like they live, and breathe, fast food... and the level of self awareness some of them must have when they dine out.

And speaking of self awareness... a very curious thing happened to me last Monday. This slender, tall, vivacious looking woman approaches the register, and I happily greet her. She makes eye contact with me, and suddenly, starts freaking out: "Please don't judge me for what I'm about to order because I'm wearing a red dress pin, and I'm about to order really unhealthy food." Quite frankly, I hadn't even noticed the red pin. I was simply more intent on getting her order, and getting it right. I tried to reassure her "Oh, don't worry, it's okay." She looks at me, half smiles, and places her order: two fried items, with a side of fried tater tots, and soda. Then she says "You know, we're allowed to have a treat once in a while." Again, I offer the supportive reply, "Of course. I completely understand." Then she looks flustered, and says "You know what, I'm just going to take it off," as if it were an electronic ankle bracelet, from her local parole officer.

So many responses ran through my mind... like "Lady, I don't give two shits about your damn red dress pin." Obviously, I couldn't have used that one. I smiled warmly, and just offered a light-hearted "Oh, don't you worry yourself about it!," and with a side wink, an "I won't tell."

I also thought... Should I have told her "Hey, I have diabetes. I understand?" I didn't do so... I try not to tell people too much about my private life -- mostly, because I can tell people like that wallpaper feeling when they get their food. (I admit, I don't care too much for knowing people's personal stories when they're just selling me something.) I also thought to myself, "What if she judges me the way she thought I was judging her?" She might think to herself "Of course she has diabetes... look at where she works!" or "look at how heavy she is!" or some other lame conclusion -- as people often love to believe about us people with type 2 diabetes.

But I have to admit, I was quite surprised at her. She felt guilty, from the pin, and it made her aware of her behavior. It was giving her an accountability -- which was only in her mind, really -- but which was a reminder to herself of how she wasn't taking care of herself.

That this woman was embarrassed because of a disease she didn't even have, and of choices she knew were poor, was quite the irony... She may have the option of removing her red dress pin, and ending the stigma, but people who are obese can't easily remove their weight, and put it away, like some sort of suit, and weird fashion statement. We can't easily shut down the stigma, and judgment, others might give us for our condition -- nor can we cure our diabetes with a green salad and a diet Coke. And I sure as heck wish I could 'put my diabetes away,' like some kind of pin, for when I wanted to eat junk... as I'm sure many women with heart disease might wish they could do the same.

And I thought... well, maybe I ought to get a diabetes pin. A pin which always reminds me that I must care for myself. That my health is important... a pin which might make people ask me what it is, perhaps. Blue Fridays is just something meaningless at my workplace, because all my shirts are blue. :-) No one would think to ask, nor could I claim it was 'my choice.' But a blue circle pin, on the other hand... that's a different thing.

A blue circle pin can be awareness, accountability, responsibility, and advocacy. A way to not only remind ourselves of how we matter -- to care for our own bodies -- but to also show others we can do this, and we're not afraid to show it. If I feel bad, on a certain day, I can always take it off.

It's an idea, anyway... Do you feel self conscious in front of strangers when you order junk? Pin, or no pin? Some people always seem to emphasize the diet drink, especially. That's a DIET drink, with the side of fried food. heh We're silly humans, after all.

We're all just so easily embarrassed, I guess.

But perhaps it ought to be a BIG reminder that if we can't handle the imagined stigma of any one disease, even for ONE moment, perhaps we ought to be kind to those who CAN'T easily remove any of their health challenges, like a pin. We need to give others some empathy, some respect, and some space... Especially, when it comes to occasionally letting their hair down, and tasting life.

Awareness, Acceptance, and Perseverance

I really hate year end resolutions. Call me a little full of myself, perhaps, or a little 'pessimistic' if you want, but I find it beyond silly how people don't realize they're being played like puppets, every January. I mean, really? Come on... How can you not tell?? You can't seriously believe you can get on a cereal diet, a milk shake diet, a soup diet, a sprinkle crap on your food diet, a yogurt diet, smoke water vapor cigarettes, etc, and think that all your weight/health issues, whatever else, will magically just melt away... Or paying $200+ for some incredibly UNREALISTIC exercise regimen with some guy, ripped beyond belief, who probably DOES NOT use this video at home, and spends 20 hours at the gym, every day, GETTING PAID to be there.

What's worse... is that people have changed the 'motto' from "resolutions," to "goals," thinking that by changing the name, and breaking down the resolution into goals, this is somehow going to help. Or... giving it silly acronyms to make it easier to remember, or deal with. People, please! Your life is NOT an acronym. I can't even remember what DSMA stands for, half the frigging time! SMART goals my ass! How about actually being SMART about how putting ourselves on the spotlight has never worked for anyone? Spotlights are for people who pretend: Actors.

Let me see, how can I describe it a little better for you... I remember when I was 7 years old. The weight issues related to my PCOS had been taking quite the foothold in my body, and clothes were really not fitting me so well. I remember visiting shops looking for a First Communion dress, with my mother... and she'd openly, loudly, complain to the store clerks how she was tired of me being so overweight and me not being able to fit into things. Then, of course, the clerks would chime in... sharing some nonsense, or unhelpful comment or another... like "Honey, your mom wants to be able to dress you like a little princess, so you need to stop eating, okay?"

I am sure you have your OWN equivalent of being embarrassingly put on the spotlight.

Well, when you embrace a new year's resolution, goal, or what have you, you are doing THE SAME THING to yourself... It's very similar to you putting yourself on the spotlight, to either your own self perceptions, or the whole world: they'll constantly ask you how your goals are going, if you've stayed on them, if you've cheated, try to get you to cheat, or POLICE your behavior as much as they can because they will all see themselves as IN THEIR RIGHT to come and make sure you are being a GOOD GIRL. What's worse is that you end up feeling like hell, or embarrassed in front of others, when you do stumble, and ruin that "perfect" new year slate.

Let me suggest to you... an alternative: Living life... with a little awareness, acceptance, and perseverance. 

Greaaaaaat, another empty motto, you might think.

Except... It's not a motto.  It's reality. If you stop, and pay attention, life's themes sort of start revealing themselves to you, one at a time. Yes. Life has themes. And those themes require, you guessed it... awareness, acceptance, and perseverance.

If you are binging, ignoring your diabetes, if you are... smoking, not exercising, or whatever else that binds you... Those behaviors are NOT your themes.  The themes are the underlying attitudes, and 'truths' you have allowed yourself to believe ABOUT yourself and life, which are enabling your behaviors.  And you can't fix those on any given 1st of any January, on any given year. It is SILLY to try to spend all kinds of time mopping the basement, if you don't first fix the leaky pipe.

If we are not aware of our themes, we can't fix them. In order to effect positive change, in our lives, we need to have an ongoing awareness, and an ongoing dialogue with ourselves, and an ongoing acceptance. Do NOT abandon yourself. 

We need to come to points, and places, where we accept our emotions, and try to help our inner persons cope with WHY we feel those emotions. I'm not talking about silly little 'goals' here, like "I resolve to put the toilette lid down, every time, from now on..." I am talking about the things that form, and shape, and cement our daily lives... into the WHO we are, right now... and tomorrow. 

If we don't know our themes, we can break that resolution down into 20,000 goals, and we are still destined to FAIL and be right back at square one, next January. I KID YOU NOT.

Listen to me, here, people...

• Your internal dialogue... is not to be shared with unhelpful people. This conversation is between you, and yourself, and perhaps the 20,000 other people who might read your blog (God help me). 
• Your internal dialogue has no beginning, and it has no end. It is happening right now, as we speak, yet you may go about your daily life ignoring it.
• Your internal dialogue is about perseverance... but once you learn a truth, you cannot unlearn it. It's like reading a book. Once you learn a deep truth about yourself, well... there's no turning back. It sort of magically sets you free... (I used to love Burger King. Burger King gives me EXTREME gastric upset, probably the equivalent of ten Metformin pills. After 4 or 5 episodes of this, I can guarantee you I shall NEVER unlearn this. It is NEVER up for debate.) 
• EVERY day is a new year. Seriously. On any given day, you can say to yourself... "A year from now, I'll wish I would have started today." There is no reason to assign yourself a magical start date to pass/fail yourself like a child needing approval from Mrs. ShameMyself. 
• A new year is NOT meant for these things! A new year is meant for you to EXAMINE your life: the things you are thankful for, the blessings you have been granted (by life, God, however you see it), and the LESSONS you learned from your trials and challenges, and your mistakes. YES, YOUR MISTAKES. Be thankful for those mistakes.Those lessons are probably the things that will help you with your life themes! Those lessons have already changed, and shaped your life and behavior, for a better 2012, without pre-assigned resolution. If you resolve to do anything, anything at all... Resolve to really EXAMINE your life with some amount of prudent, sober acceptance, every new year's eve. Heck, EVERY DAY. 

Life is not about those boxes people want to put us in. Don't be the idiot debating whether the glass of life is half full, or half empty... when there's obviously more in store, in the fridge. 

The Greatest Lesson You Will Ever Learn

I don't recall exactly how I got there...

But I think it was just one of those "I'm really unhappy with my body, so I'm just going to go on another diet," kind of moments. However it happened, I had been referred to a nutritionist, or dietitian, or whatever the heck she was, by my Primary Care Provider (PCP) at that time. (My PCP... a man who never cared to talk much about certain things. Including, telling me my blood sugar was high.) 

I sat there, waiting in an office... in the usual weirdness of waiting for one of these folks. Fake plastic foods lining wall to wall shelving, and giant tomes and texts which I am not entirely sure had ever been read. This office was the size of a small bathroom, sterile, and with dark wood paneling to boot. A large, round table, took up most of the room, while a cluttered desk sat at it's opposite. 

"So, what exactly is it that you want?" -- says the woman... doctor, who? I am not sure. She's wearing a white lab coat, and it's making me rather uncomfortable. I thought this woman was just going to help me find a diet plan... why is she being so curt? And why the heck is she wearing a lab coat? You don't need a lab coat to write a frigging diet plan!!! Rather shocked, I explain to Doctor Who that I want to lose weight, that I am not happy with my body, and it's time I got things figured out, with a little help. 

Doctor Who stops to take a very long, stern, look at me. She demands to know what my life is like, and what I do. Of course, at the time (2002), I was in employment limbo -- much like I am now. I lived with a large, religious family, active in the local college campus community, and I minded their kids in exchange for housing. I lived in their basement. Their dark, dank, gloomy, depression fit inducing, basement. I also worked a minimum wage job, with grueling physical labor, and even more tedious hours. I was at great odds with myself, and with my faith, and to top it off, the family and church I belonged to at that time were extremely controlling, and extremely judgmental. One of those types of churches that need to know and control every single aspect of your life, from what to study, to whom to marry. How I got to be in that state, however, is a story for another day.

"I am NOT giving you a diet. You don't need another diet," said Doctor Who, in her Indian accent... really without knowing much about me. "Then...? What am I supposed to do? I mean, I AM paying to be here, after all..."  Her features soften, only for a moment, just enough to tell me that I have an eating disorder.  "A what??" ... "Yes, an eating disorder. You don't need another diet, and I'm not going to give it to you." 

Stunned, I just sat there.  I'm nowhere near skinny enough to have an eating disorder; in fact, I'm quite overweight, even obese. Morbidly obese. (By the way, thanks for that, Polycystic Ovarian Syndrome.) 

She hastily draws up a chart ...  

Explains to me I am living in a vicious cycle, and gives me four rules.  

1. Eat only when you are physically hungry.
2. Eat ANYTHING you want.  Anything at all.
3. Eat only until you are satisfied, not full. 
4. DO NOT SKIP MEALS. 

She then asks that I buy the book Breaking Free from Compulsive Eating, by Geneen Roth, and sends me on my way, though not before telling me that "... but even that won't work, because you're too busy right now, to focus, and need to wait until you're at a better place to make some changes." 

Oh. My. God. Who the hell does Doctor Who think she is? I *payed* her to do what she went to college to do... GIVE ME A DIET PLAN.  And instead, she gives me a frigging book review, tells ME that *I* have an eating disorder, and spits me out of her office, just like that! How dare she?!?! &$^#^%$@!!

Of course... She was right.  She was a total bitch about it, but she was right.  

Through much tracking, and tracing, I eventually found the book... because of course, it wasn't an easy off-the-shelf kind of book, either. It was an old 80's book, and it sat on my shelf gathering dust for a good while before I decided to finally crack it open, sometimes just chancing upon segments, and paragraphs, before having the courage to actually read it cover to cover. 

Now, this is NOT one of those moments where I tell you I've lost a gazillion pounds (which, at times, I have...), and Oprah comes and finds me, and hosts me on her show... or Dr. Oz... or whatever other idiot flavor of the month happens to be. I am still fat. I still binge. I still get up, gather up the pieces of ME, and keep going.  

This is NOT the time when I tell you that that was the most inspirational book of my life; it wasn't. In fact, it's probably one of the cheesiest books I've ever read (and please, never read it while drinking anything... much less soda of any kind).  

But it is the time when I will tell you that I learned what was probably the MOST important lesson of my life... and what should probably be the most important lesson of YOUR life. 

NEVER ABANDON YOURSELF. 

It doesn't mean you are perfect, and will always follow the rules. It doesn't mean you are only relying on yourself. It doesn't mean you won't ever become depressed, nor sad... nor compulsive. It doesn't mean that you need to find 20,000 inspirational post-it notes for your bathroom, either.  

What it does mean... is that whatever you experience in life, or whatever it is you choose to do... BE THERE with yourself. Actively keep yourself company. Be conscious and aware. Acknowledge yourself. 

Acknowledge and OBSERVE from a non-judgmental place the rhythms and intricacies of your emotions... just observe them. No need to judge them. Turn off the TV, and step away from the electronic gadget.  

Do not run away into the occult recesses of your mind while you... ______________. (Enter favored compulsive behavior here, including, not taking care of one's Diabetes.) Acknowledge what it is you need, and seek, and GIVE it to yourself with the REAL DEAL. Not a substitute. 

Know that whatever it is we do, we do it for a reason... seek to LEARN those reasons. 

Allow yourself to be human, and just learn. Learn from the moment. Learn about YOU. Take life... one second at a time. Life will never be easier, or less complicated, like Dr. Who suggested, so just start TODAY. Start with one moment. One action. 

Consider the power of one snowflake... one snowflake every second can lead to a perfect Winter storm. This is YOUR storm. 

A Call to Change: Revamping Type 2 Diabetes Awareness

Every November is sort of bittersweet, for me.  In one way, I am very excited -- the unity, love and compassion of many, just pours over in our communities.  It is a huge opportunity to spread a bright blue beacon of awareness across the world. It's almost like Christmas time... Diabetes style.

In another way, Diabetes Awareness Month is very frustrating to me... because it is, in many ways, National Recrimination Month.  I can conspiracy-theory-spin this all the way to the bank, but I won't... Instead, I'll just share a few simple truths with you:

1. Type 2 Diabetes Awareness, largely focuses on telling people that their Diabetes is preventable, and that 80-90% of the cases could have been avoided.  Now, I'm curious... did anyone send you a survey, or knock on your door asking you how you got your diabetes? Did they ask you what medications you take, what other illnesses you have, or come over and take blood samples from you? No? Oh. Well... That's because when people are throwing that statistic around, they are usually mentioning either of these two studies... (Most people, or organizations, WON'T EVEN REFERENCE THEM. I had to dig DEEP just to find these two.)
• Diet, Lifestyle, and the Risk of Type 2 Diabetes Mellitus in Women: Frank B. Hu, M.D., JoAnn E. Manson, M.D., Meir J. Stampfer, M.D., Graham Colditz, M.D., Simin Liu, M.D., Caren G. Solomon, M.D., and Walter C. Willett, M.D. N Engl J Med 2001; 345:790-797. September 13, 2001. http://www.nejm.org/doi/full/10.1056/NEJMoa010492#t=articleDiscussion
• Lifestyle Factors and Risk for New-Onset Diabetes: A Population-Based Cohort Study. Jared P. Reis, PhD; Catherine M. Loria, PhD; Paul D. Sorlie, PhD; Yikyung Park, PhD; Albert Hollenbeck, PhD; and Arthur Schatzkin, MD, PhD†. http://www.annals.org/content/155/5/292.abstract 

Now... what's wrong with using this to badger people with diabetes? Well, for starters, these types of studies are OBSERVATIONAL studies.  Meaning a.) they rely largely on demographic data from participants, and not on laboratory studied, measured, clinical data,  b.) they make assumptions on what a healthy diet means, b.) they rely on anecdotal testimony on what participants may claim are their risk markers for a family history, c.) they do not account for racial, or ethnic risk markers, d.) they use limited populations of people that may or may not represent the overall population, in certain circumstances (like ALL nurses, which their occupation already may put STRESS as a HUGE factor in diagnosis.), e.) they don't tell how many of the total participants in the studies were actually overweight or obese, regardless of diabetes development, f.) they control for common things, like metabolic syndrome, but not for other critical factors, such as different illnesses, medications, pollution, toxins, etc., g.) They assume things like high triglycerides, high cholesterol, and high blood pressure, are ALL preventable things (completely ignoring their genetic components), and what's worse... h.) These studies assume that because the rest of the people were able to, somehow, avoid getting Type 2 Diabetes... that those people who did get it, should have been able to avoid it, too! I think that it's very evident that we are all UNIQUE, as our fingerprints, and that unless we were able to magically step back in time, and redirect those people who got Type 2 diabetes, we will never truly be able to tell if they could have prevented their illness just by comparing them to other strangers! That's like saying I could have avoided getting late to work, like 'Jenny did,' without taking into account a.) my car breaking down, b.) people having an accident and blocking the main roadways, c.) tornado warnings being issued, etc., etc. These studies tell you NOTHING about these people other than many of them have a poor diet, like MOST Americans do.  Yet MOST Americans will NOT develop Diabetes.  These studies will NOT tell you anything about the chemistry inside these people's bodies, or even WHY they might be overeating, or addicted to nicotine, or alcohol.  As discussed in my About Diabetes post, Type 2 Diabetes is a HELL of a lot more complicated than these simplistic studies.  

I am SICK and TIRED of hearing this old line used to badger poor people who got a disease they DIDN'T WANT.  NO ONE wants Diabetes.  NO ONE. While I can't say that there aren't folks out there, in the world, who love food... or love to pig out, or drink, or smoke, for the sake of doing these things... I can tell you that that is HARDLY an excuse to say everyone else who developed a disease was EXACTLY LIKE THAT. What's worse are the George Burns of the world who smoked till they were 100, and had NO PROBLEMS ever with lung cancer, or the Manuel Uribe's of the world, who weigh in around 1,000 lbs, and have no high blood pressure, no high cholesterol, no triglycerides, and no diabetes. Healthy eating and exercising can benefit EVERYONE, and they are ways to help us EXTEND our chances for good, overall health, and have more energy for life... but they are not a passport to a disease free life.  I recall a next door neighbor, from my childhood... Jogged every day, very fit, and thin... Died at 42, from a sudden heart attack. No family history.  His dad, by contrast, smoked like a chimney ALL HIS LIFE and didn't die until well into his old age, when he actually presented complications. Diet and exercise will NOT 100% prevent anyone from getting Type 2 Diabetes, nor should it be presented that way.  Am I saying we should push the lottery of life? NO.  No way in hell.  But what I AM saying is that telling people they could have avoided giving themselves a disease is a.) Unhelpful, and b.) Not the complete picture of things, and probably, very untruthful.  
2. Awareness focuses on telling people THEY need to take action in getting tested, and finding out that they have this chronic condition. Now, don't get me wrong... I agree with this.  I agree that we need to take action, and we need to get a hold of our health... but I agree with it, mostly because doctors are NOT doing their part.  And this is where awareness fails.  Awareness should not rely on going around, scaring people, telling them they need to get tested. (Many people won't... they don't want to know... hey, it's scary... I don't blame them!) Awareness should rely on empowering doctors, urging them to continuously educate themselves about Diabetes, and giving them the tools to help, and empower persons with Diabetes, in a welcoming, and nonjudgmental environment. If this is such a dangerous disease, why aren't doctors being sent to more intensive training to learn, and deal with this condition? Why is my PCP so ignorant that she had to go get herself on the ADA website to find out information to "give me," on what to do?! I can do that myself, thank you very much! (And it sure as hell WON'T be from the ADA site!) If this is such a dangerous disease, why is a fasting blood glucose, or even an OGTT for those at high risk, NOT part of an annual physical? Why do people need to know that they need that, in order to demand it? Why can't a doctor know? 
What's worse is HOW a diabetes diagnosis just keeps getting delayed, and delayed because of old, and tacky, ADA guidelines. Patients are not given proper follow up testing, told they have "pre-diabetes," not told they need to make any changes, not referred to any certified diabetes educators, or registered dietitians, and not given tools to monitor their condition.  In short, they are told they have NOTHING to worry about.  To just lose some weight, and they will be fine.  Most of these people are ALREADY diabetic, and don't know it.  By the time the average person gets diagnosed with "Pre-Diabetes," they've already reached a 40% loss in beta cell function. (http://diabetes.diabetesjournals.org/content/52/1/102.full) By the time they are diagnosed with Type 2, an 80% loss in beta cell function. (http://www.dlife.com/diabetes/type-2/diabetes-causes/garnero_0608)
3. Awareness focuses mainly on telling people with Type 2 Diabetes that they need to take care of themselves, and they need to test.  I couldn't agree more! *clap* *clap* This is the truest thing that anyone can say about Diabetes (of any type), really.  It might seem hard to imagine that I, or anyone else, would have a problem with this... what could possibly be wrong? Well, the problem is similar to telling your spouse they need to go do the grocery shopping (for the week), and giving them only $20 to do it with. Huh? I'll spell it out for you... :)  Insurance companies will NOT HELP people with Type 2 Diabetes; they are of the view, and the assumption that because most of us will not immediately die from high blood sugar, that we do not need to test as often. This means that if you have "Pre-Diabetes," you are likely to be given 0-1 test strips (a day!) to test with; if you have Type 2 (anywhere from 2-4), depending on what medications you use... with 1 generally used for those not on medications, and 4 being used for those on insulin.  If you are a newly diagnosed person with diabetes who does NOT know how their diet affects them, 1 strip isn't going to be of much help.  Much less 0. You have to know at least two parts of a mathematical equation, to be able to come up with a conclusion of some sort (ie, because my fasting blood glucose before a meal was X, and my postprandial was Y, then I know the amount of carbohydrates I had raised me Z glucose points.) But if you only have X, or Y, by themselves, that doesn't tell you much of anything.  And if you have nothing, you're pretty much going on exactly that... nothing. Almost every informational pamphlet out there, on Type 2 Diabetes, urges people to test before and after every meal, at rising, before going to bed, and before or during exercise, and at times of illness.  Now, do the math with me... how many strips does that add to? ... Yeah, a heck of a lot more than 1. Insurance companies claim that the costs of covering these strips is too much, yet... they do not factor in the costs of complications from poorly controlled blood glucose, nor do they seem to want to listen to how much money they could actually save if they actually taught people how to monitor their blood glucose and make meal decisions based on their numbers.
4. Awareness focuses on telling people they need to go talk to a Certified Diabetes Educator, Registered Dietitian, or Endocrinologist.  Yet, for a Type 2 Diabetic, insurance will SELDOM cover these specialists as they deem them unnecessary, and unjustifiable.  Diabetics are left to the care of very many ignorant PCPs, APs, and even RNs, or LNs, with their OWN ideas of what diabetes is.  What's worse, is that NONE of these people seem to understand that Type 2 Diabetes is a progressive illness in which our bodies will not be able to metabolize carbohydrates properly... We are ALL different in our progression (and the damage in our systems), and telling a person to eat X amount of carbohydrates, at meal times, without instead... letting them learn what number is appropriate for them based on their glucose responses, their overall health feeling, and appropriate medication levels, is setting up MANY people for failure.  This is where the conspiracy theorist in many wakes up, because keeping people on so many carbohydrates with the excuse of "your brain will starve," keeps a lot of diabetics on MANY medications, some very dangerous, bringing about many unnecessary complications at an early period of progression.  What's worse is that doctors not up to par with the latest in medical research will keep Type 2 Diabetics from access to insulin, sometimes until terrible, and unnecessary damage has occurred, from the complications of high blood glucose. Studies have shown that early insulin intervention is NECESSARY in Type 2 Diabetics. (http://clinical.diabetesjournals.org/content/27/2/60.full)  
5. Awareness focuses on telling Diabetics they need to keep their blood glucose numbers steady. Yet another gem of wisdom here.  I couldn't agree more, again, frankly... "But why is this so wrong, Liz? You must be off your rocker..."  The problem here is that Diabetes advisory organizations do NOT agree on blood glucose target goals, and often use poorly done studies (like the ACCORD study) to justify that diabetics (of all types, without respect to good health), stick to higher blood glucose numbers that can lead to complications later down the road.  Frankly, the American Diabetes Association is the ONLY organization recommending such high blood glucose goals as being at 180 or lower, 2 hours after a meal! Everyone else recommends around 140 mg/dL.  Why are we relying on these people, and not on the American Association of Clinical Endocrinologists, for example? I can't tell you the answer to that one... I can surmise they channel most of the research funding money, and think many of us can't do it. We can't and won't take care of ourselves, to better levels... It's too hard.  While some, may, indeed have health challenges keeping them from tighter goals, I do think those are personal decisions that need to be made with one's medical team, and not as general blanket goals espoused by guideline organizations.  Again, the conspiracy theorist in me, would tell you that because the ADA has a LOT of conflicts of interest with big pharma (and this was documented through a recent Mount Sinai research study), then they get some type of financial, monetary kick back from many of us being on pills.   (http://www.ama-assn.org/amednews/2011/10/24/prsc1025.htm) 
6. By far... what I dislike the most about Type 2 Diabetes, in regard to Diabetes Awareness  Month... is that they NEVER talk about finding a cure.  This hurts me deeply... because NO, diet and exercise won't make this thing go away, and for many of us... like my father... they are not even guarantees of having good control. My father lost his battle to Type 2 Diabetes on 05/05/2003. During the last few years of his life, he endured kidney failure (we dialysed him at home), blindness, neuropathy (both peripheral and autonomic), coronary heart disease, dementia, stroke, and gangrene. He passed away at the operating table, from respiratory failure, as he was awaiting surgery for a leg amputation.  His diabetes simply took a very brittle turn for the worst... I've never known someone that took better care of themselves.... He was President of the Puerto Rican Olympic Cycling Federation and Skating Federations, as well as President of the Puerto Rican BMX Associations.  A coach, and a huge supporter of active youth, and athletics.  He got me my first BMX bike when I was just 5 years old. 

My father, near diagnosis.

My father, 10+ years after diagnosis 

My father in his last years.

EVERYONE deserves a cure.  Everyone deserves a dad, or a loved one, to come home to... Spend Christmases with... and walk them down the isle. Everyone.  You owe it to me, ADA.  You owe it to EVERY person with Diabetes, of EVERY type.  

It's time you get off your sofa, stop pigging out on chips and soda bought with big pharma money.. AND FIND A CURE.