Recently, the Australian of the Year was announced. This year, the gong was awarded to Dr James Muecke, an eye surgeon from South Australia, who was acknowledged for his work raising awareness of type 2 diabetes and its links to preventable blindness.
I didn’t really know of Muecke before the announcement, but clearly, he is very accomplished, and his work reaches beyond Australia’s borders. He co-founded social impact organisation, Sight for All, which raises funds to deliver vision-saving programs and eye health projects to people in under-resourced countries.
However, it is Muecke’s work in linking type 2 diabetes and blindness that received the majority of the media coverage, with (as can always be relied upon) some pretty average reporting. Interviews with and soundbites from the newly crowned Australian of the Year did focus on a simple and incorrect equation of sugar equalling diabetes, and this certainly did seem to concern a lot of people responding to what they were seeing online.
I sighed as I read through a lot of that commentary, dismayed as the calls to differentiate between the types of diabetes drowned out Dr Muecke’s award, with repeated bleats that ‘Sugar didn’t cause my/my child’s type 1 diabetes’.
Sugar didn’t cause anyone’s diabetes – it’s just not that simple. I appreciate wanting people to understand that drinking too much Coke isn’t why type 1 diabetes develops. But equally, I want people to understand that it isn’t why type 2 diabetes develops either.
Asking for clarification of the different types of diabetes isn’t always necessary because it doesn’t always matter. You bet that it does matter at times, but other times, it really doesn’t.
We see this time and time again. Think about the time that café in Sydney thought they were being cute by calling a dessert ‘Diabetes’, or the time that guy on that UK cooking show referred to something as ‘Diabetes on a plate’. Was this really the time to get all uptight because the difference between type 1 and type 2 diabetes were not specified? Were the calls to stop stigmatising type 1 diabetes by not clarifying that ‘our’ diabetes isn’t because we ate that dessert? Does it matter in these moments if the person stigmatising and misrepresents diabetes doesn’t point out which sort of diabetes?
It really doesn’t. If the dessert was called ‘type 2 diabetes’ or the recipe was ‘type 2 diabetes on a plate’, it still would have been wrong. It still would have been stigmatising.
And yet, every time another lousy comedian, or celebrity or chef makes a diabetes joke, or the media gets diabetes wrong, or the Australian of the Year explains diabetes in the wrong way, the predictable cries, and rapid soundbite responses only feed into the stigma, prejudices and misconceptions of type 2 diabetes.
We can do better – we need to do better. And we can, by being more thoughtful in our response to correct people getting diabetes wrong.
I should point out that this goes beyond people with (or parents of children with) type 1 diabetes. Lots of other diabetes stakeholders get into it too. Some health professionals trip over themselves in their endeavour to speedily demand clarification of type, (even when it is not necessary). This has always left me somewhat befuddled and wonder if they think this will win them brownie points with the cool kids on Twitter. Surely HCPs working in diabetes understand that sometimes putting ‘type 2’ before diabetes is not actually rectifying what is factually incorrect in the original statement. And that should matter, a lot more than the ‘likes’ from the type 1 diabetes Twitterati they seem so eager to impress!
We can get it right, and get it right quite easily. When the Australian of the Year announcement was made, the comms team at Diabetes Australia absolutely nailed the messaging, striking a balance between commending Dr Meucke for his award, acknowledging how wonderful it was to see the Australian of the Year platform being used to highlight the link between diabetes and diabetes-related eye disease (with a plug for KeepSight!), and adding a note to clearly and eloquently explain the complexities of type 2 diabetes, the role that genetics and other non-modifiable risk factors play in its diagnosis, and reminding people that type 2 diabetes is not caused by eating sugar.
I think the team got it right – the information was correct and accurate and did not in any way add to the stigma of diabetes. (Disclaimer: I work for Diabetes Australia and I’m talking about my colleagues. Whilst I sometimes work with the comms team, they are all far smarter and better at communicating than I could ever hope to be. Which is possibly why they won’t let me near any of our socials. That, and they worry I’ll swear, or share an Effin’ Birds cartoon…)
Each type of diabetes – and there are many! – has its own complexities and some of the time we need to make sure that it is clear which diabetes we are talking about. But next time you find yourself about to take to the keyboard to correct some misinformation, ask if you are actually adding to that misinformation. And if you see someone demanding such clarification, ask them if they are aware they are contributing to type 2 diabetes stigma. Because I think a lot of the time that is exactly what is happening.

Complete digression, but the title of this post reminded me of these books, which anyone who has been around kids in the last 15 or so years would know about!
7 comments
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February 3, 2020 at 4:42 pm
Min
Oh god, I’m confused how I am meant to behave about having type 1 diabetes and whether it is rude to mention that or whether it is rude to correct people weekly with attacking attitude that you do not get diabetes from eating pavlova or mixed lollies? And I was absolutely going Huh the Australian of the year works on type 2 diabetes eye disease apposed to diabetes eye disease? I sat there scratching my head thinking I am sure both type 1 and 2 have the same eye diseases, as I have type 1 and have had laser treatment for retinopathy twice. I think diabetes does the same damage to eyes whether your a one person or a twoperson in my logic? All the same good job Australian of the year, clap clap!.
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February 3, 2020 at 7:33 pm
Alex Erskine
Somewhat off topic, but there were reports of a cafe in Ireland that called its desert “Brexit”. Asked what it was, the chef said it was really an Eton Mess.
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February 4, 2020 at 5:58 pm
Min
Cracking up at you Alex!
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February 4, 2020 at 12:31 am
T
The “diabetes type” behavior dilemma might be analogous to the social psychology explored in this article curated from _The Atlantic_ https://getpocket.com/explore/item/why-women-sometimes-don-t-help-other-women
That said, a number of adult DOC members with T1 have had issues with access to appropriate care because of the inaccurate trope that all adult PWD have T2, and have HAD to specify T1, over and over, to get access to insulin. (Note that there are many T2PWD who ALSO require exogenous insulin, often in much larger amounts than their T1 compatriots.) Still, there are so many unidentified subtypes of both T1 and T2 that I consider those labels largely irrelevant.
I suspect one of the origins of equating sugar consumption with diabetes may be related to the effects sugar consumption has on blood glucose levels and metabolism, and “diabetes diets” that have restricted sugar and/or carbohydrates for that reason. (There is also a school of health thought that the glucose spike of eating a lot of sugar at once causes an insulin flood that worsens long-term glucose tolerance, one of the primary hallmarks of T2 diabetes syndrome. “Eating sugar causes diabetes” is social shorthand for that theory.)
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February 4, 2020 at 5:39 am
G.M. Bunyan
That really is a great post Renza. Perfectly pitched! Effin Bird alright! The Comms team must just be jealous they can’t fall back on that cartoon series. Chrz Gordon
Sent from my iPhone
>
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February 4, 2020 at 1:09 pm
Rick Phillips
Hey Disney caused my diabetes I will not rest until it is a recognized cause. I mean why not? If sugar causes diabetes, why not Disney? Yeah I said it.
#DisneyGaveMeDiabetes and
#DisneyOwesMeAVacation
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February 7, 2020 at 12:10 pm
JT
So if PWD could create a billboard campaign how NOT to add to the stigma, what would it say?
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