[acb-diabetics] type 1 can learn fromr type 2

Fri Apr 23 01:30:59 GMT 2010

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What People with Type 1 Diabetes can Learn from Type 2s

Clay Wirestone 

Apr 19, 2010 

Admit it, 

Type 1s

. In weaker moments, you look down your noses at the 

Type 2

 diabetics. You know that their disease can result from poor lifestyle
choices. You know that their treatment regimen, compared with yours, is
simple.

And you're really tired of folks telling you: "Oh, my grandfather had
diabetes, too!"

"It's almost like sibling rivalry," says diabetes educator and author
Constance Brown-Riggs. "People with 

Type 1 diabetes

 feel that those with Type 2 get all the attention. People with Type 2 feel
that Type 1 diabetes is 'really bad diabetes.' "

But clinicians such as Brown-Riggs and diabetics themselves point out that
both types hold similar challenges and consequences. As a matter of fact,
Type

2 diabetics sometimes outperform their Type 1 brethren.

Impossible? Far from it.  The best-controlled, most-motivated Type 2s have
lessons for all of us - Type 1s and even other Type 2s. Here are a few.

Taking a wake-up call

Type 1s know their disease isn't their fault. Type 2s don't have that
reassurance. But that means some take their diagnosis as a serious
motivator.

Brown-Riggs told me, "I have one women in my practice that was diagnosed
with type 2 about eight years ago. She absolutely took her diagnosis as a
wake-up

call. She carefully plans her meals, counts carbs, 

exercises

, monitors blood glucose and maintains regular contact with her health care
team."

With that work, the woman is able to manage her illness without medication.

Brown-Riggs's patient understood that she got herself into this situation
and it was now her job to get herself out of it. For Type 1s, the diagnosis
is

permanent. But that doesn't mean they can't learn from the best Type 2s and
realize that the key to success isn't a particular device or nutrition plan.

It's their own willpower.

To the treadmill

You can rededicate yourself to the basics, but where do you start? Why not
diet and physical activity?

For Type 1s, diet lessons can fade into the background after years or
decades with the disease. Why not take some extra 

insulin

 and eat an extra doughnut? Brown-Riggs has seen the direct consequences of
this thinking: fatter Type 1s.

"I just saw someone in the office today - type 1 and obese," Brown-Riggs
said. "So clearly the conversation revolved around weight and lifestyle."

Type 2 diabetic and stock car racer Richard Palasik finds himself routinely
checking nutritional information on packages at the grocery store. He points

to obesity as a challenge not just for diabetics, but for our culture.

"Obesity is almost the norm," he said. "Not the rarity."

For Type 2s, connections between weight, exercise and their illness are
crystal clear. They can't afford to discount them. So if you're a Type 1 who
manages

fairly well with insulin but sticks to the sofa -- get a move on! Those
pounds aren't going to lose themselves.

No change is too small

Type 2 patient Barbara DiRisio exercises at least five days a week and takes
her oral medication faithfully. Since her diagnosis in 2001, she said, "I
have

only missed my pills perhaps twice a year."

But DiRisio offers another tip, one that might be easy for Type 1s to
dismiss: "I never drink fruit juices or colas," she said. "Only diet cola."

Type 1 diabetics surely know not to drink sugared sodas. But how many other
small changes do we miss? DiRisio, a Type 2 diabetic since 2001, has
improved

her health in a simple, direct way.

Do we take the stairs at work rather than the elevator? Do we remember to
check our 

blood sugar

 that extra time when we're unsure? Do we, like stock car racer Palasik,
make sure to inspect the labels on food we buy?

When when we make these small things habits, we can improve overall diabetes
control and health.

Head back to class

Type 2 diabetics may not have dealt with their disease as long as many Type
1s, but that means they can have an educational advantage. Once diagnosed,
many

Type 2s go to sessions with a diabetic educator. They learn about healthy
practices. They get handouts.

Depending on a Type 1's level of engagement, years may have passed since a
session with a diabetic specialist. And like most areas of medicine, the
diabetes

field doesn't stand still. Brown-Riggs said she often has to bring Type 1s
up to date with the latest research and information - if they even had the
knowledge

to begin with.

"Many that have had diabetes for years have had no formal education," she
said, "particularly when it comes to nutrition."

Ultimately, extra communication with professionals can only help your
control. Having to explain yourself to someone can be a powerful motivator.

Catch some Zs

Author John Hedtke connects his 

Type 2 diabetes

 diagnosis with a lack of sleep. "I was working a full-time job and writing
books in the evenings, shorting myself on sleep pretty constantly for years

at a time," he says.

According to the National Sleep Foundation, more and more research makes the
same connection. Lack of sleep equals high blood pressure, obesity and Type

2 diabetes risk.

Type 1s already have their diagnosis, but the applications are clear
nonetheless. High blood pressure and obesity complicate diabetes management.
Reducing

or preventing both improve blood sugars and overall health.

Hedtke has also found, firsthand, that no change is too small. "I'm actually
napping more and working only one full-time job at a time," he said.

-- Don't let it slow you down

Yes, managing insulin-dependent diabetes takes time, energy and effort. But
Type 2 diabetics have something else to teach: Don't let the disease become

your life. Make it another part of who you are

That's what Palasik has done. He's the crew chief with California's Desert
Dingo Racing, which runs the official World Diabetes Day off-road race car
and

competes in the Baja 1000. He's taken the wheel of the team's stock
Volkswagen Beetle.

"I don't let the disease stop me doing what I want to do or hamper me in any
way," Palasik said. The strenuous effort of desert driving makes his blood

sugar rise, so he makes adjustments before each race, often giving himself
extra insulin.

"You don't have to let it define you," he said. "Just follow the rules."

Type 1 and Type 2 diabetics may never be on exactly the same page. The
difference are real and profound. The average age of diagnosis. The
treatment regimen.

The long-term prognosis.

But the epidemic of Type 2 diabetes means that more people than ever are
learning about the disease and that more education and treatment is
available now

than ever before. Not everything can work for both groups. But much can.

"It's just not as cut and dry as it use to be," Brown-Riggs said. "Which is
actually good news."

Self-care Behaviors

Dietician and certified diabetes educator Constance Brown-Riggs' new book,
The African American Guide to Living Well with Diabetes, comes out in July.

She points out that despite the big differences between Type 1s and Type 2s,
"self-care behaviors are the same regardless of what type of diabetes an
individual

has." She lists seven categories:

list of 7 items

1. Healthy eating 

2. Being active 

3. Monitoring 

4. Taking medication 

5. Problem solving 

6. Reducing risks 

7. Healthy coping 

list end

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Categories: 

Blood Sugar, 

Community, 

Exercise, 

Type 1 Issues, 

Type 2 Issues

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Patricia Wolf

Type 1 since 1944

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