Type 1 in a Type 2 World
What not to say to someone with type 1 diabetes.
Source of Stigma
That fact -- the obesity-diet-exercise connection -- lies at the heart of the battle over type 1 vs. type 2. Many people with type 1 diabetes feel that they're being unfairly stigmatized as having brought on their disease with an unhealthy lifestyle.
Wendy Conway's daughter, Abby, was diagnosed with type 1 diabetes one month after her fourth birthday. Like Andrea Kolligian, they've heard a lot of judgmental messages about weight and lifestyle. "There are a lot of assumptions," Conway, who lives in Boston, says. "When people find out she has diabetes, they say ‘Oh well, she's not heavy,' or ‘Did you give her too much sugar?'"
"I have had people to this day tell me what I should and should not eat," says Susan Manser of Manchester, Conn., who was diagnosed with type 1 diabetes at age 4. Her twin sister, diagnosed a day before Susan, died of kidney failure in 1993. "They tell me I am cheating, but they do not realize I use an insulin pump," Manser tells WebMD in an email. "I count carbs. I watch what I eat and work with my endocrinologist to ensure I am doing all I can to stay healthy."
In spring 2010, an article on the Diabetes Health web site, "What People with Type 1 Diabetes Can Learn from Type 2s," sparked a firestorm of controversy, with many comments in response. Author Clay Wirestone wrote that, "in weaker moments," people with type 1 diabetes "look down your noses" at those with type 2. He suggested that type 1s, who must control their disease with insulin, should devote themselves to exercise and a healthy lifestyle in the same way that type 2s must do.
The resulting debate included people with type 1 and type 2 declaring that they were tired of being misunderstood and having others assume that they got their disease by being lazy and eating badly.
Frustrated though she is by the assumptions that Abby has to deal with, Conway understands the anger people with type 2 feel as well. "It's a stigma for them too. People think that they're lazy or eat too much. While that can be true, in many cases, it's not, because there's a big genetic factor with type 2, more than with type 1," she says. "And some people work very hard to lower their weight and change their diet, and still can't reverse their disease."
Perhaps no one understands the push and pull between type 1 and type 2 better than Michelle Chase of Boston, who has type 2 diabetes and has a 24-year-old son with type 1 diabetes. In an email, Chase tells WebMD that people tend to assume that her son has type 2 diabetes and that a bad diet caused it.