As a Type A Diabetic, I am always armed with a CGM (aka continuous glucose monitor aka carbohydrate translator device). Unfortunately, I am also part of the ~10% that has developed an allergy to the adhesive Abbott Labs uses to keep my CGM firmly attached to my skin. So I went to a doctor to get a remedy to clear up the chemical burn that I had developed. During this appointment, he said to me “You know, as a diabetic, these things will take longer to heal.”
Boy, did I give him the Type A Diabetic treatment.
“Help me understand what you mean by that,” I said. “What part of my 105 mg/dl average glucose levels over the past 3 months would create the physiological dynamics that would impair my body’s healing abilities?”
Now, before I share his response, I want to provide some quick context: He’s a good doctor. He’s an intelligent systems thinker who doesn’t just dole out drugs to solve problems. He is conservative in all the right ways. Yet his response was disheartening to me: “Diabetes is a disease, Jon, and you need to come to grips that this will impact your health.”
He (correctly) identified my resistance to being labeled and categorized as someone in a disease state. As a Type A Diabetic, my conviction is that while I certainly have the underlying conditions that can create a diabetic state, I am able to mitigate these fundamental conditions using a variety of techniques to bring my body into glucose equilibrium, which lifts my body out of a diabetic state and into a healthy, balanced state (at least when it comes to glucose levels!).
Armed with my Type A Diabetic conviction, I retorted that he would have to do better than to throw labels at me as a way to escape the raw facts that my body had similar glucose levels as any other gluco-normal human being, and challenged him to explain to me precisely what physiological dynamic that included normal glucose levels would lead to slow healing of wounds.
He nodded and moved on. I’m not going to lie – I felt slightly vindicated.
This is just one story of many that I’ve experienced in the same vein. When I post questions similar to this on diabetes forums online, I am inundated with similar (tribal-laden) responses like “we diabetics don’t heal as fast as normal people.” I am having a difficult time putting into words just how unfortunate I find this common way of thinking is. Suffice it to say, it’s not just inaccurate, it’s deflating… and to an extent, dehumanizing. That said, it’s quite true that for many with insulin disorders, some damage is done to the system before the condition is properly diagnosed and, importantly, managed well. As a result, there will be plenty of people with insulin disorders who will — and do — suffer from complications due to prior glucose toxicity.
Nevertheless, my doctor knew my history with diabetes. Based on this knowledge of my particular situation, he would likely have known better as to not conflate generic disease-related complications with my specific situation. I am convinced that if the term diabetes wasn’t used to describe every person with an insulin disorder, he would not have so easily jumped from the world of “diabetic complications affect all diabetics” to my specific situation.
It’s true – you can have an insulin disorder while also being in near-perfect physiological health.
So, let’s put an end to brands and unhelpful labels in medical conditions. Let’s remove “diabetic” from “diabetic complications” and refer to them in a more accurate, helpful, and descriptive fashion. We need to be more descriptive and use less marketing:
Anything considered a diabetic complication should be referred to as a complication due to glucose toxicity.