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Advocacy is a slow burn. I say those words every day. Usually multiple times. I say it to people with diabetes who are interested in getting into advocacy, not to scare them off, but so they understand that things take time. I say it to established advocates. I say it to people I work with. I say it to people in the diabetes world who want to know why it takes so long for change to happen. I say it to healthcare professionals I’m working with to change policy. I mutter it to myself as a mantra.
Slow. Burn.
But then, there are moments where there is an ignition, and you realise that the slow burn is moving from being nothing more than smouldering embers into something more. And when that happens I can’t wipe the smile of my face and I start jumping up and down. Which is what I was doing in my study at home at 2am, desperately trying to make as little noise as possible so as not to wake my husband and daughter who were sounds asleep in other rooms off the corridor.
The World Health Organisation conducted the first of its two focus group sessions for people with diabetes yesterday (or rather for me, early this morning), and I was honoured to be part of the facilitating team for this event. In the planning for the questions that would be discussed in the small break out groups, the WHO team had gone to great pains to workshop the language in the questions so they were presented in a way that would encourage the most discussion possible. That was the start of those embers being stoked.
I think that the attention to how we framed the discussion points meant that people thought about their responses differently.
The topics last night were about barriers to access of essential diabetes drugs, healthcare and technology. Of course, issues including affordability, health professional workforce, ongoing training and education were highlighted. These are often the most significant barrier that needs to be addressed.
But the discussion went beyond this, and time and time again, people identified stigma and misconceptions about diabetes as a significant barrier to people not being able to get the best for their diabetes. It certainly wasn’t me who mentioned language (at least not first), but communication and language were highlighted as points contributing to that stigma.
This recurring theme came from people from across the globe. It was mentioned as a reason for social exclusion as well as workplace discrimination. There was acknowledgement that perceptions of diabetes as being all about personal responsibility has affected how policy makers as well as community responds to diabetes – how serious they see the condition.
In the discussion about diabetes-related complications, the overall language had been changed from ‘prevention’ to ‘risk reduction’ and this was recognised in many of the discussions as a far better way to frame conversations and education about complications. This isn’t new – it was a recurring theme when a focus in the DOC was the hashtag #TalkAboutComplications. I wrote and co-wrote several articles about it, including this piece I co-authored with the Grumpy Pumper for BMJ.
The direction the discussions took were a revelation. No. It was a revolution!
So often at other events and in online debates when language and communication has been raised, conversation has been stalled by people pushing agendas about wanting to be called ‘diabetic’, as if this is the first and only issue that needs to be resolved. That didn’t even come up last night because the people who were highlighting the implications of language understood that when you look at the issues strategically and at a higher level, those details are not what matters.
What matters is looking at Communication with a capital C and understanding its influence. It elevated the discussion so far above the ‘it’s political correctness and nothing more’ that it would have been ridiculous to drag the discussion back to that level.
For years, there has been push back regarding communication because people have not stood back and looked at impact. That has changed.
When I wrote this four years ago highlighting that diabetes’ image problem diabetes – all those misconceptions and wrong ideas about the condition – has led to fewer research dollars, less understanding and compassion from the community, more blame and shame levelled at individuals … it was to emphasise that the repercussions have been significant.
Thankfully as more people started stepping back and considering big picture – health systems, policy, community education – I could see that there were shifts as some people stopped talking about political correctness and started asking what needed to be done to really move the needle. It seems that’s where the very, vast majority of people were during the WHO focus group
This diabetes #LanguageMatters movement stands on the shoulders not of the people who have elevated the issue in the last ten years (although those contributions have been massive!) or the position papers and guidelines that have been published (although those have certainly aided the discussion in research and HCP spaces), but rather, the people in the diabetes community who, for years, knew that language and communication was a driving factor in our care. People like those in the (Zoom) room yesterday.
Looking for more on #LanguageMatters
Click here for a collection of posts on Diabetogenic.
The Diabetes Australia Language Position Statement (Disclosure: I work at Diabetes Australia and am a co-author on this statement.)
The Diabetes Language Matters website which brings together much of the work that has been done globally on this issue. (Shout out to diabetes advocate Jazz Sethi for her work on this.)
DISCLOSURE
I was invited by the WHO Global Diabetes Compact team to be part of the facilitators at the Focus Group on Advancing the Lived Experience of People Living with Diabetes. I am happily volunteering my time.
It’s International Women’s Day and I want to it yell from the rooftops and celebrate the incredible women diabetes advocates who continue to lead and chart paths that are pioneering and innovative. But in equal measure, I want to crawl into a cave and return out of it once the performative platitudes are over.
And yet, I can’t go without acknowledging it, because there is literally one day a year when women are centred and even then, we must defend our right to a day that highlights the centuries of systematic inequality that entrenched misogyny has afforded us, and answer the inevitable question: ‘WhY iSn’T thErE an InTerNaTiOnaL Men’S DaY?’ (There is. It’s in November. Put on your own morning tea.)
We’re seeing more and more women talk about how they feel targeted and unsafe in all spaces – on- and off- line. It’s not because this is suddenly ‘a thing’. Rather it’s becoming more acceptable to talk about it and to call it out.
Which is what I do.
Last year, I wrote about an event I’d facilitated women and diabetes. When I linked to the post on twitter, I was accosted for my take which dared to suggest that misogyny contributes to so many women’s health issues being under researched and rarely discussed. And then I was told off for not crediting the men who had discovered insulin.
Getting #NotAllMen’d and attempting to centre men on a post about the prejudice women experience in healthcare did drive home my point, but really, it was completely unnecessary. And downright exhausting too.
Also last year, in preparation for a presentation about diabetes and menopause, I asked the DOC if they routinely had discussions with healthcare professionals about menopause and diabetes. I had naively thought that it would start a conversation with women in the community. Instead, I had some bloke have a go at me for not promoting low carb diets and topped it all off with a demand that I don’t talk with my peers about menopause because I have no health professional training.
Again, exhausting. But also, it’s just what women have come to expect. Being mansplained menopause or told that my own analysis of entrenched misogyny is wrong is simply part and parcel of being a woman who dares speak up.
Most recently, I’ve been dealing with some pretty damn pathetic anonymous trolling which is hurtful and ludicrous. Someone is so unimpressed with me they have felt the need to repeatedly let me know and inform me it’s why they refuse to support Spare a Rose, and that I need to stop suggesting that it is the only way the diabetes community can help people with diabetes in Ukraine. I’ve checked. I’ve not said that. Not once. So I’m not sure why anyone is going out of the way to deliberately highlight that no one must support the campaign. It’s not lost on me that of the coordinating group of this community initiative, I am both the only woman and the only one being targeted.
There is more to those messages though. There is also this: ‘You do nothing other than self-promote … and amplify yourself.’ I wonder how many men who share their work, tweet what they’re up to, feel proud of what they have achieved are accused of this. Because it has been a recurring theme throughout my career. That and being called words like strident, and being told that I should be reined in.
I don’t feel special here. There are many women who have had similar experiences. I could have just ignored those messages, or stewed away quietly. But I have chosen to share them and I do so knowing there is a snowball effect in play. Undeniably, it’s easier to pop your head above the parapet when you know there are others out there too. When we recognise our own difficult experiences bravely shared by others, we find it easier to bravely step up too.
I know this, because I spend a lot of time reaching out to thank women who have shared their story. And every single time I’ve ventured to share the gendered crap I’ve dealt with, I’ve had dozens of women send me a DM to tell me their experience is similar. Sometimes, we privately share who is the behind our experience, and it is remarkable just how often the same names come up. And it is also remarkable just how often those men claim to be allies. Those same men who can’t help but refer to people like me as angry women. Is it important for them to point out my gender when they’re having a go? Apparently, yes.
I am more than happy to be called an angry woman, a strident woman, an irate feminist. I will wear those labels as badges of honour. Because I know this: If you see and hear woman calling out the crap and respond by calling us angry women, you have played your cards and they show us that you are a misogynist. You are showing how you can’t handle strong women. And you are speaking when you should be listening.
There are some far more celebratory IWD posts on diabetogenic, and I encourage you to read them because the women acknowledged deserve the recognition.
Usually, as February comes to a close, there is a flurry of excitement in the diabetes online community as the final tally for the annual #SpareARose campaign is announced.
This year is different. With war breaking out in Ukraine, it didn’t make sense to end the campaign at the exact moment that many in the diabetes community were wondering how to help our brothers and sisters affected by the war.
And so, after a frantic 24 hours of emails, text messages, phone calls and people doing things, #SpareARose for Ukraine was launched.
It’s live. Right now. And you can be part of it.
The colours may have changed a little, but the campaign remains that same: a donation – not matter how big or small – will help people with diabetes living in challenging situations. All funds are donated directly to Insulin for Life, a charity that has years of experience working providing insulin and diabetes supplies to under-resourced countries and responding to emergencies. This is an emergency.
Insulin for Life will be earmarking funds donated in March for their efforts supporting people with diabetes affected by the war in Ukraine. They are part of an international consortium, with partners in Ukraine, and they have supplies ready to go if, when and where they are needed.
You can help by sharing details of how to donate to #SpareARose for Ukraine with your networks. Speak with your workplace to see if they will support the campaign by matching employee donations. You can connect with the campaign online (Twitter, Facebook, Instagram) and share what we’re posting. Remember to share outside as well as within the DOC to reach as big an audience as possible.
And, of you can, you can donate.
#SpareARose for Ukraine builds on what has always been a community campaign. It was started by diabetes advocates, it continues to be coordinated by diabetes advocates, all on a volunteer basis. It is underpinned by the philosophy ‘BY the community, FOR the community’. Please support any way you can.
I was interviewed for an article last year and loved the copy they came up with, but it was the heading that got me. ‘Living a Life of Advocacy’ it screamed at me bold text, perfectly popping out from the hot pink background of the photo they’d selected to accompany the article.
The photo is from a while ago now. It was 2013, and I was on a stage in Paris where I’d been invited to give a keynote at Doctors 2.0 – a digital health conference that brought together people using, developing and constantly thinking about digital health solutions. I look at that photo and love the action shot of me mid-sentence, one hand holding a microphone, the other waving, because of course.
But I also know that at the time I was about 10 weeks pregnant and behind the confidence I projected on that stage, I was terrified and anxious. It was a terrifying time as I balanced wanting to be the best advocate I could while also wanting to bunker down back home, wrap myself in cotton wool and do nothing but protect the baby I was growing.
As I spoke about how digital solutions bring together a diabetes community from across the globe, I didn’t know that a mere four weeks later, while in New York, I would miscarry my much-wanted baby. I didn’t know that I was about to face the most challenging and emotionally traumatic period of my life. I didn’t know that, because all I thought about in that moment as I was on that stage with the hot pink background, was how important being there was – people with diabetes on stages as equals with health professionals, disrupters and industry. It was big!
Living a life of advocacy. All while almost being afraid to breathe because I was worried that every jolt, every movement, and the active way I present was endangering the baby. No one else would have known that was going on. There was one person, and one person only, at the conference who knew I was pregnant, and she was sitting next to me on that stage. I figured that I needed a friend with me if something went wrong. No one else was knew, and no one – no one – knew how afraid I was.
In a recent podcast interview, I was asked where this advocacy drive came from. Without missing a beat, I answered that it was in my bones. Because it is. My mum, the trade unionist, had me at protests while I was still in a pram. I went to university to study music, but it makes perfect sense to me and those who know me that I’ve wound up doing what I do, being who I am, advocating my way through my days. In my bones.
But that doesn’t make it easy. It doesn’t stop the burnout from it, or from feeling overwhelmed. And when it’s diabetes that is the focus of those advocacy efforts, while at the same time, I spend so much time focusing on living with diabetes, there’s a weight that seems compounded. It is heavy.
Last year, almost 12 months ago to the day, someone decided to email me about Spare a Rose, reaching out through my blog and, with nothing better to do, thought they should let me know that no one cares about the campaign, and that I should understand what people think about me (which wasn’t much, apparently). It was shitty, it was unnecessary. It was unnerving. After the third or fourth one of those emails, I decided to share one on Twitter. I had no idea who it had come from, but I figured that whoever it was would see my tweets and understand just how upsetting it all was.
It did the trick because it was the last time I heard from my anonymous critic. At least, for the 2021 campaign.
Alas, a week into February 2022, old mate was back, this time with a comment on my blog post about Spare a Rose. I’m guessing it’s old mate – I could be wrong, because who knows when people won’t put their names to things, but the sentiment was the same. It has the same hits as last year. It’s cruel and unnecessary and, once again, has completely rattled me.
It confuses me beyond belief that of all the advocacy issues I’m involved in, it’s the one that literally is saving the lives of other people with diabetes that was the reason someone thought they would take the time to message me. I mean, I get my fair share of criticisms about language, and other topics that are not everyone’s cup of tea. But surely if there is one thing we can all agree on, it’s that a campaign that is saving the lives of people with diabetes in under-resourced countries is not controversial.
Surely.
It all feels so, so heavy.
I know I’m not alone. I know it is a side effect of advocacy. I look to advocates in the diabetes world and I am in awe of what they do.
I am in awe of people advocating to healthcare professionals to be more mindful and thoughtful of the way they interact with people with diabetes.
I am in awe of people who work in industry, invading that space, gaining employment and while they are there, building a career that is forged in advocating to create devices, and device adjacent materials to make diabetes better, easier – and those devices more relevant.
I am in awe of people advocating about the injustices of insulin pricing and access, because they want to change the paradigm that means that some people simply cannot access the very drug they need to stay alive.
I am in awe of people who advocate quietly for years, and make big change by doing small things, over and over and over again.
I am in awe of advocates who have not waited, and instead, built solutions to make their lives easier and less burdensome and then – once they had worked it all out – made it free and available to anyone else who wants to benefit, and then remain there to support them.
I am in awe of creative people who use art, poetry, drama, comedy, music, as advocacy tools to show people how diabetes impacts everyday life and to change how the world sees those of us living lives of diabetes.
I am in awe of the work all these advocates do, and I wonder if they’re also feeling that physical weight that comes from their advocacy.
Do they feel that pressure coming from all different directions, weighing them down from above while also feeling as though it is crushing them from the sides? Do they feel overwhelmed?
I do. And it really, really is heavy.
February 1 and Spare a Rose. The two go hand in hand in my mind. It’s when the diabetes community comes together to support a campaign that gives back in the most fabulous way. For anyone who is new here, or who isn’t sure why the DOC takes on a fetching red hue for the month of February, let me explain.
#SpareARose is a beautifully simple idea that asks people to forgo one rose in the bouquet to their love on Valentine’s Day, and instead, donate the saving from that one rose to a charity that supports people with diabetes in under-resourced countries. That one rose (about $5/£5/€5) covers the monthly cost of insulin.
Since 2013, the campaign has been known as Spare a Rose, Save a Child, and the charity that has received all donations has been Life for a Child. Over those nine years, the diabetes community – people with diabetes, people affected by diabetes, diabetes organisations and diabetes industry – has raised close to US$400,000, providing months and months of insulin to children in under-resourced countries. Plus, it’s raised the profile of the charity. Back when it started, very few people in the diabetes community knew about Life for a Child. Now, it’s supported financially by many, and recognised by even more.
For 2022, the campaign is doing something different and broadening its outlook to support people with diabetes diagnosed as adults, or who ‘age out’ of programs that have an upper age limit. Life for a Child supports people up to the age of 26 years. But of course, type 1 diabetes is for life, as is the need for insulin, diabetes supplies and healthcare.
With this in mind, #SpareARose has changed to Spare a Rose, Save a LIFE to recognise how the campaign will be helping adults with diabetes now, and the new charity partner – Insulin for Life.
Insulin for Life is a global charity and supports people with diabetes in many of the same countries supported by Spare a Rose. It’s so wonderful to know that these people will continue to receive insulin and other diabetes supplies, even once they hit 26 years of age, and beyond. You can read more about the important work done by Insulin for Life here.
Despite these changes, the campaign remains the same. One rose = one month of life. It’s a fabulously simple equation. What also remains the same is that it is a campaign BY the community, FOR the community. Every single person in the Diabetes Online Community can be a part of #SpareARose. We’ve seen tweetchats hosted by people across the world, we’ve seen fun challenges on twitter (remember #SpareAFrown?), we’ve seen videos and vlogs and lots and lots of blog posts. #SpareARose is on Twitter, Facebook and Instagram.
Of course, it’s not just financial contributions that make #SpareARose the success it is. It’s also about the community raising its voice to a veritable roar, and elevating the campaign and its charity partner. If you can donate, please do. If you can share, please do. Every time you share, someone might be click on the donate button, or the share button.
#SpareARose to Save a Life. Is there a more meaningful gift to make in the name of a loved one, a friend, a colleague, or in your own name? I really don’t think so.
DISCLOSURE
I’m so honoured that I get to be involved in this campaign by sharing and promoting it as widely as I possibly can. I have spoken about #SpareARose across the globe and written dozens of pieces to raise awareness of this fabulous grassroots campaign, and anyone and everyone can do the same thing. Really, I have no disclosure. I volunteer my time, along with a number of other diabetes advocates from around the world who drive socials to talk up #SpareARose. We also work with diabetes organisations and industry to encourage donations. If you would like to get involved, please reach out. The more the merrier!
Christmas eve and Melbourne is turning it on. Gorgeous sunshine and divine mid-twenties temperatures. It seems perfect and would be if it weren’t for the C word’s new O variant that is looming heavily. I went to the Queen Vic Market this morning with my sister for our traditional oyster breakfast, and kept having to talk myself off the ledge of overwhelming anxiety at the thought of being amongst far more people than I’ve grown comfortable.
But amongst it all, Christmas is here. A huge jar of buttery shortbread stars sits on the kitchen counter, grabby hands reaching in anytime we walk by. Crostoli have been made, eaten and more made. The Christmas tree is decked and glittery, wrapped gifts strewn. There is freshly assembled tiramisu in the fridge, time doing its magic so that when it’s served up tomorrow, it will be a perfectly pillowy delight of coffee and mascarpone. There is lasagna ready for this evening’s small gathering here. Tomorrow will see another two family get togethers and Boxing Day will be the final of the family assemblies.
I feel oddly relaxed, which is lovely because often at this point of the game, I’m a stressed mess with a list the length of all the versus of the 12 Days of Christmas, wondering where I can still find wrapping paper, and hopeful that the local bookshop will still be open for those last minute presents I forgot.
And so, I’m signing off for a few weeks as I enjoy some time off, dappled sunshine to light my days, memories to be made with my beautiful family, a new kitten cuddle, pups to take to the park, friends to hang out with, including some I’ve not seen in two years who somehow miraculously booked tickets on flights that actually made it to Australia. There will be walks along the beach, afternoons languishing on the back deck with my Christmas books (presumptuous of me, but it’s a good bet), outdoor tables at cafes where I’ll sit for hours, alternating between hot and iced lattes, and lots of food. And as little time as possible dedicated to dealing with diabetes, because I am so lucky that Loop has been part of my life
Two years ago, I was wrapping up one of the busiest advocacy years I’d ever had. My passport had been stamped well over twenty times as I flew in and out of countries across the world, presenting, running workshops, sitting in ad board meetings, fighting the good fight. It was exhilarating, exhausting, exciting. And 2020 started off in the same way. Until the world changed. But the advocacy efforts haven’t stopped. In fact, this year was probably my busiest ever. 2022 is already shaping up to be just as involved as this year, more so probably. I’m already scared to look at some months on my calendar, as dates are filling fast. I wouldn’t want it any other way. But that’s next year.
Thanks to everyone who has stopped by this year. I’ve had the most gorgeous messages from people – words of support, asks for help, messages of solidarity. I’m always so grateful to people when they reach out. And I’m grateful to everyone who has taken the time to read my words. I’ve always said that hearing the stories of others helps me make sense of my own diabetes. I hope that perhaps my stories here have helped others in similar ways.
And so, there is only one thing left for me to do before I close my MacBook and let the battery run flat over the next couple of weeks. And that’s make a donation to Insulin for Life’s Secret Santa campaign. Thanks to everyone who has already donated to #IFLSecretSanta this year. Hundreds of dollars of donations followed my earlier post about it. If you’ve been meaning to make a donation, please do. It is truly one of the most important things you can do at this time of the year.
I’m dedicating my donation to diabetes friends who have been incredibly important to me over the last year. Peer support continues to be a cornerstone of my diabetes management – I can’t see that changing any time soon. And I can’t see a better way to say thank you to those who have helped me by supporting a charity that helps others with diabetes.
Last year, facing the first Christmas in the times of COVID meant that for many people, celebrations were very different to other years. Our huge Italian family gatherings were put on hold because the idea of sharing food around a table, sitting in close proximity, and basically bringing together thirty or so loud Aussie-Italians, all shouting, because we all believe we need to be heard over everyone else, was considered not especially COVID-safe. Instead, we met in parks for catch ups, physically distanced and masked up.
We also waived gift giving for the year. Instead, I made donations in the names of all my cousins’ kids, and for the Secret Santa gifts we (thankfully) didn’t have to buy. (I remain especially Grinch-like about this particular Christmas activity and you can read all about why here.)
Charities are continuing to do it tough. Not only are fewer people able to donate, but more and more people are relying on their services to get through.
Insulin for Life is once again running its Secret Santa campaign and what a great way to share some love this festive season! All donations make a difference, but to give you an idea, if you can spare $5, you’ll be providing a week worth of diabetes supplies – insulin, syringes, and glucose strips – to someone with diabetes in an under-resourced country.
There’s lots of information available on the Insulin for Life website, but this one statement certainly brings home just how dire the situation is for so many of our diabetes brothers and sisters around the globe: For every two people alive with type 1 diabetes, one person has died prematurely due to lack of basic care.
Let me just share that again: For every two people alive with type 1 diabetes, one person has died prematurely due to lack of basic care.
Even though I have been volunteering for years now for different diabetes-related charities that support people with diabetes in under-resourced countries, I haven’t become immune to feeling shock when I see the stark truth written out in such simple terms.
Every single person can make a difference and improve the situation for people with diabetes in these situations. Donating is not possible for everyone, but there are other ways to help. If you are on social media, you can amplify the cause and share this blog post, or the donation link with a few words explaining how impactful donations can be (use the hashtag #IFLSecretSanta). You can organise a fundraiser at work, school or with friends – doing the legwork to make things like that happen are important and make a huge difference too. You could do a Facebook or Instagram fundraiser. You can pass a hat around at Christmas drinks and ask people to throw in any loose change they have. No amount is too small. Every contribution matters.
I was just chatting with some of the amazing people from the Insulin for Life team, and I was thrilled to hear donations are already coming in from the community. Of course, I’m not surprised. The diabetes community has always been amazing at giving back, as evidenced by the amazing efforts seen over the years with Spare a Rose.
Insulin for Life’s Secret Santa campaign is just getting started. Last year was the first year, and the community stepped up. And in 2021, even after the absolutely horrendous year so many have had, there are people in the DOC showing up to support the campaign once again. That’s what this is all about. It’s what it’s always about.
Why does everyone want to cure diabetes? I mean, I think it would be GREAT if someone truly managed to cure it PROPERLY. But in lieu of that, everyone with internet access, a Canva account, and their finger on the pulse of the latest superfood (which, when said superfood is a legume it actually is a pulse), is out there busily curing diabetes with whatever snake oil concoction they can come up with. (At this point in time, I am going to take a MASSIVE diversion and say that Snake Oil is a thing and it is sold by a woman named Caroline Calloway who is a scammer and all that is wrong with the idea that we need ‘influencers’ in our life, and I would urge you to NOT pop her name into a Google search right now, lest you want to lose the next five hours of your life, and destroy a few brain cells while you are at it.)
Anyway, where was I? Yes, scam diabetes cures. Scamabetes cures.
Lucky for me, I get at least half a dozen diabetes cures delivered directly to my inbox each week. By lucky, I mean, I wish the fuckers would all leave me alone, but that’s not happening.
On days where I don’t get cures in my inbox, I get invitations to conferences that aren’t real, or asked to write for imaginary medical journals. The positive is that it makes me feel as though I am highly sought after, and people desperately want to hear from me. The negative is that they’re all a con, and that rather than thinking I’m somewhat brilliant, these scammers are hoping that I’m somewhat gullible.
The scamming is real in the cure diabetes world, and it never ends. Just at the point where you think it’s been rather quiet in the dodgy-cure entrepreneur corner of the globe, there is suddenly a concerted effort to get you to drop some coin on a turmeric and kale chai teatox for the low monthly price of $39.99 plus tax. What have you got to lose?
How the fuck are we meant to navigate our way through it? Twenty-three years in and being a sceptic with a healthy dose of mistrust in strangers approaching me online asking for money and promising me the world has served me well. I start from a position of disbelieving pretty much everything, which has been super useful in the last two years if you think about the rubbish that people (looking at you Clive Palmer) have claimed to be cure-alls. When future Lin-Manuel Miranda writes a musical about the COVID years, there will be a song dedicated to Ivermectin, drinking bleach, and that weird light thing that Pete Evans was trying to sell us for a cool $15K, and a story of vax-crossed lovers where an AZ and Pfizer jabbed couple try to overcome their differences, succeeding only when they are both boosted with Moderna.
Promises of diabetes cures prey on the vulnerable and the scared. It’s abusive and mean. If diabetes could easily be cured, WE ALL WOULD BE CURED, because I’m yet to meet anyone who wants to live with a lifelong chronic health condition, no matter how much they seem to have their shit together.
If it were as simple as eating a cucumber (looking at you, whichever Kardashian made that outrageous claim), I’d be living on cucumber granola for breakfast, cucumber sandwiches for lunch and having a liquid dinner of cucumber mojitos, and snacking on cucumber dipped into tzatziki. All. Day. Long. And I bet everyone else with diabetes would be too, because even if we all got sick and tired of cucumbers by day three, it would still be a shedload better than dealing with diabetes. Wouldn’t it? Yes. Yes, it would.
In times where it is so easy to spread misinformation as gospel, people with diabetes are taxed with even more. On top of doing the task of one of our organs, do impressive maths calculations throughout the day, act as a multidisciplinary medical team for ourselves, employ some damn impressive detective techniques, and be the most efficient executive assistance in the known universe (all before lunchtime), we also need to sort through the constant stream of information, picking out the trash, and staying on heightened alert. Even though we would probably really like some of those pseudo-science promises to work…even just a little bit.
As I was writing this today, my email pinged and there waiting for me was some ‘research’ (a term here used to mean ‘made up stuff’) suggesting that my diabetes could be cured by taking a daily supplement in a convenient, once-a-day tablet. But wait! There’s more. I could take advantage of the cyber-Monday special and get an extra 23% (random number) discount, if I locked in a twelve-month subscription contract. For the record, even with the discount, I’d be out of pocket for this scam product USD$647 per year. Each ‘film-coated’ tablet contains, cinnamomum cassia, garcinia gummi-gutta, chromium hexahydrate, zinc citrate, glutamine, gymnema sylvestre and citrus extract.
I hit the unsubscribe button, blocked the sender. And instead of ordering that veritable shit salad of ingredients, decided that a better way to ingest citrus extract would be to make some lemon bars, and cinnamon via an apple cake. The rest of the stuff sounds made up and absolutely not likely to make my beta cells start making insulin again.
And so, I donated some of the USD$647 I just saved my not getting swept up in this scam to Insulin for Life. Because you know what? The stuff IFL is giving to people with diabetes in under-resourced countries is something that really works and is really essential. And absolutely, completely and utterly not a scam.
You owe no one.
You owe no one involvement in diabetes awareness activities.
You owe no one Twitter fury and outrage when diabetes is misrepresented.
You owe no one a decision to jump on a bandwagon just because everyone else is.
You owe no one your loud voice, your quiet voice, your whispered voice.
You own no one involvement in their diabetes advocacy efforts.
You owe no one blue eye shadow, blue nail polish or blue hairspray.
You owe no one reminders that diabetes doesn’t stop you.
You owe no one explanations for how you choose to advocate or the causes you choose to support.
You owe no one for the type of advocate you are.
You owe no one reasons for who you decide to work with; and who you decide not to work with.
You owe no one.
You owe no one hope.
You owe no one justifications for the technology you choose, or don’t choose.
You owe no one a podium.
You owe no one details for why you are at a conference, a dinner, a meeting, talking diabetes.
You owe no one the right to uses your diabetes as a teaching moment.
You owe no one marathons or mountain climbs or channel swims in defiance of diabetes.
You owe no one your time to just read their blog post, join their support group, sign their petition.
You owe no one a cheer squad.
You owe no one the words and language you choose to use to help make sense of your diabetes.
You owe no one an insight into your diabetes management, your HbA1c, your CGM curve.
You owe no one.
Except.
Maybe…
You owe yourself love and kindness and reminders that on days when diabetes feels too hard, too big, too sad, too … everything … that doing what you can is enough. You owe yourself room to breathe. You owe yourself space to step back and space to step up. You owe yourself pats on the back and high fives. You owe yourself flowers. You owe yourself the freedom to do diabetes your way and in your own time.
You owe yourself. And no one – no one – else.
Over the last two days (or last two middles of the night if you’re perpetually in the wrong part of the world as it seems I am), I participated in the excellent first World Health Organisation Global Diabetes Compact Forum. (You can read the Compact which was launched earlier this year here.)
Once again, the WHO team had brought together stakeholders, including diabetes advocates, from across the world to talk about some critically important challenges facing people living with diabetes. These included access to insulin, research and innovation and prevention, health promotion and health literacy. The Forum was definitely not a ‘sit and be lectured to’ event. It was interactive, with everyone having the opportunity to participate and share their experiences and perspectives. The chat function was open and there was a constant stream of engaging, energetic discussion and sharing.
The final session was about prevention and in his introduction, James Elliot, who expertly moderated the event, laid the foundation for the discussion. As with the previous sessions, there were no pre-conceived ideas or narrow focus about the topic.
Prevention isn’t just about prevention of type 2 diabetes. There is a lot of work also going on looking at prevention of type 1 diabetes. And also, once living with diabetes, looking to do what we can to prevent diabetes-related complications.
When I spoke, the first thing I wanted to highlight was the problem I feel with the word prevention, and I revisited previous discussions in which I’ve been involved which highlight the struggle I feel with the word prevention. For too many people it is a word that offers a promise – a promise which guarantees that we can prevent aspects of diabetes that are often well beyond our control. I presented my case for instead focusing on how reducing risk is a far more accurate description of what efforts are truly about, a perspective that I have noticed is being used more and more.
The discussion pivoted to being about complications and associated stigma. Thankfully, this is not the start of the conversation about diabetes-related complications and the way people see them. When I wrote this piece back in 2013, I wrote about the way complications were presented to people with diabetes and how non-modifiable factors such as genetics, are rarely part of the conversation. There seemed to be a very one-dimensional presentation of diabetes-related complications: ‘take care’ of yourself, and you won’t get them.
With communication around complications starting to be included in the language matters movement, I could see that too many people had been told that over-simplistic tale.
It all got taken up a very significant notch when there was a concerted effort in the DOC to encourage dialogue about diabetes-related complications in a non-judgemental and safe way. Suddenly, we were seeing the hashtag #TalkAboutComplications accompany people’s stories, or questions others might have. This led to a real shift, as more and more people shared their experiences, with many saying that it was the first time they had seen others being so open about what was often considered a taboo topic. Starting to peel away the shame and secrecy of what can be a scary part of life with diabetes allowed many people to seek support from peers and help from health professionals.
The legacy of the #TalkAboutComplications idea is that is that there are far more conversations today about diabetes-related complications. There is also a plethora of blog posts, podcasts, journal articles and conference presentations about the topic. I know that there is still significant stigma that we need to chip away at, but actually being able to easily find places online where conversations about complications are normalised and being part of those conversations is contributing to reducing that stigma.
The session at the Global Diabetes Compact Forum was terrific because it tied together diabetes-related complications and stigma. With the theme of access this World Diabetes Day, perhaps we need to think about what that means when it comes to diabetes-related complications. While we absolutely do need to think about all factors at play when it comes to the development of complications, we also need to acknowledge that access is a factor when it comes to outcomes. Access to the right information, including information about risk reduction, access to insulin, access to glucose monitoring devices, access to complications screening, access to early diagnosis and treatment, access to peer support, access to stigma-free treatment, access to mental health support…all these have the very real potential to influence outcomes.
Diabetogenic 