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I’ve been interested to read a few things lately on Twitter about the DOC not being a particularly welcoming environment. I am both saddened and surprised to hear that some feel that way, because I have always found the community to be very, very supportive and welcoming. Perhaps I am fortunate, or perhaps I have just found – and engage with – people who are friendly and happy to embrace new people in the community.

I’m unsure if feeling unwelcome is because there is a sense that the community may be a little like a high school clique. There are people who have known each other many years in this space, so they have a comfortable and easy banter as they share stories and inside jokes. I know that when I started, I was worried about that, but anytime I tried to engage, I found nothing other than friendly responses.

When I first walked into the DOC playground a few years ago now, I was considering starting a blog after years of reading what others were saying about their lives with diabetes. I’d lurked around a few online platforms to see how people interacted and what people said.

Then, one day, I decided I would join a tweet chat, and I tentatively said ‘hello’ to the #DSMA world. The rest is history and now I am a regular contributor and participant – both online and off – in the community.

But it did take me a while to understand the lay of the land and to get a handle on online communication. Trying to adequately put across a point in 140 characters or fewer leaves little room for qualifying comments, so often it’s only the bare bones that can be offered. This can sometimes leave people feeling a little taken aback at the directness of discussions.

I am, by nature, very direct. I take the ‘tell-me-what-I-need-to-know-and-leave-it-at-that’ approach, so Twitter is a perfect platform for me. Say what I want and get out! But I know that sometimes, I come across as being very direct; some may even say confrontational. People who meet me after having only engaged on Twitter say they are surprised that I am a lot warmer in real life that online. (I never know whether to apologise or say thanks to that…)

I had to learn that just because people had differing opinions didn’t mean that they were attacking me, or that I wasn’t welcome in the discussion. In fact, some of the people I respect most in this community are people who I don’t usually agree with. They challenge me to think about things differently and to step out of my comfort zone. I’ve engaged in some really robust and heated discussions about different aspects of diabetes. As long as it is done with respect, (and an understanding that an opposing opinion isn’t a character flaw!), I’m happy to not agree.

And, possibly most importantly, I learnt that I didn’t need to love everyone in the community. I’ve written about that before, and how it came as a huge relief when I realised that I wasn’t going to be friends with everyone; there would be some people I just didn’t really feel any connection to – just as there are many who don’t gel with me.

The DOC is a big community; there are many of us. And when there is a community, there will always be people who are more vocal and more active. But they are not the only people in the community. It really does come down to finding people where there is some sort of synergy, or some way to connect. Just like in real life!

So what’s the take away from this? I hate for people to feel that they can’t be part of the community because they have a different view to others. I have not come across another person in the DOC who I agree with all the time.  But equally, I’ve not ever had someone attack me for having a different opinion to them. (Trolls excluded in that last comment, because trolling is attacking and just not necessary.)

I guess the struggle is that when you have a lot of very passionate people given a microphone and a stage, we get very, very worked up at times and defend our position fervently, challenging those who don’t agree, building alliances with those who do. We can be a vocal bunch, we like to be heard and listened to, and we want to defend, defend, defend what we say. I am guilty – if that is the right word – of being and doing all these things.

But I genuinely do want to hear from everyone. I don’t have to agree, or even like, what you are saying, but I want to hear it. Any community is stronger with diversity of opinion, experience and outlook. And the community is weaker when people do not feel that they are free to share their thoughts.

I had a call the other day from one of my favourite diabetes HCPs who is writing about diabetes and female sexual health. I wanted to shout ‘Halle-fucking-luiah!’ but didn’t because I am polite and never swear.

Anyway. The reason I was so excited to hear this is because when it comes to diabetes and sex, women rarely get a look in. Let me reframe that. When it comes to information about diabetes and sexual health, women rarely get a look in. (Hopefully women with diabetes who are wanting sex are getting plenty of looks in…so to speak…Yeah, this is not going to be awkward at all, is it?)

When talking about the complications of diabetes, erectile dysfunction*** frequently is mentioned. It is actually one of the things that often get men to the doctor because, well, because…erectile dysfunction. There is information about it and it is a well acknowledged complication of diabetes in men.

But women also report problems with sexual function, yet there is very little information about it and it is spoken about very, very rarely. Or, when it is, it’s discussed around changes in sexual function relating to menopause, which may be an issue for all women – diabetes or not. I guess the thinking is that ‘this is when it is likely to be a problem, so let’s talk about it now’, which doesn’t really help those who may have concerns with sex and sexual function earlier than menopause.

So today, let’s talk about women’s health and diabetes – all of it, including the sex stuff.

(For the record, there is no kissing and telling in this piece. There will be no personal sharing of sex stories. This is for everyone’s benefit! Plus, I learnt that it is not cool to discuss my sex life in a public forum after I once mentioned in a talk to a group of first year med students that I hypo pretty much every time after sex, and then made some silly comment about it being because my partner was so good in bed. This would have been fine if it all stayed in the room. The next night, when out for dinner, a group of Uni students came up to me and told me that they had been at my talk the day before and it was great. Then they looked at my husband who was innocently eating a plate of pasta and one of them said ‘Well done, mate.’ I was mortified. Anyway, let’s move on…)

So, what is out there now for women who want some information about diabetes and sex? Well, while working at Diabetes Victoria we developed a nifty and gorgeous looking booklet which talks about contraception choices. It’s called Sexual Health and Contraceptive Choices for Young Women with Type 1 Diabetes, and I can’t for the life of me find it online, but if you can get a copy, it’s terrific!

There are also some great Australian resources available on diabetes and pregnancy – both for women with type 1 and type 2 diabetes – which provide information about pre-conception planning as well as what happens after conception, during the pregnancy, during delivery and post-partem.

There is some (limited) information about diabetes and breastfeeding. (So wish there had been more eleven years ago because, seriously, I bumbled my way through for almost 24 months and it was horrid at times, diabetes-wise…)

But where is the stuff about everyday diabetes and women’s health and sex – not necessary tied up with trying to get pregnant. (We’ll ignore the ‘tied up’ comment there, okay?)

On the day I was diagnosed, a lovely diabetes educator told me that sex is exercise. Exercise often causes hypos. Hypos are not fun. Not fun kills the sex stuff. Moral of story – keep jelly beans beside bed. I was terrified that I was going to pass out during sex and that it was going to be unpleasant for everyone involved. (Not that there would be a cast of thousands…)

Yawn – it was boring information and it made me think that in future, sex was going to very unsexy. What I wanted to hear was ‘you absolutely can still have sex and, if you want to, you absolutely should. There are some things you might want to consider such as the possibility of going low… I’m talking about your blood sugar, get your mind out of the gutter, Renza, and wipe that smile off your face… so Nutella body paint is a good idea.

Now that would have made me smile, think of Nutella as a medical necessity and therefore how diabetes now justified me keeping a jar of Nutella by the bed. And on the kitchen table. In the bathroom… basically anywhere! As an emergency contingency, of course.

No one ever spoke to me about what orgasms may do to my BGL. Nor was I told much (in fact, anything!) about how high BGLs might impact on sexual function.

And then there is the minefield that is body image and diabetes, and thinking about how we feel about ourselves and its impact on how much we want to have sex. Or how it makes us  feel when we are actually having sex.

Plus, the visible signs of out so-called invisible illness impact on how we feel about undressing in front of someone. I have scars all over my abdomen and hips from heeling pump sites. There is usually a CGM sensor strapped to my arm and a pump cannula in my tummy or hip. There are dregs of tape from old sensors and sites and sometimes tiny bruises. There are tubes and a little vibrating machine (pump, people…I’m talking about my pump).

All of these things point to the fact that I am not perfect and that my body is not perfect and that I need devices and drugs to keep me ticking along. This makes me feel crap at times, wonder what my partner is thinking and want to hide all the reminders that I am not a perfect woman away. This sucks even in my situation where I am married and have had the same partner since diagnosis. Add to that the idea of exposing and explaining all this to someone new and you bet that will impact on how one feels about one’s body and the very idea of sex.

I remember being warned a million times about how women with diabetes MUST PLAN PREGNANCY. And this is excellent advice. However, it made me so terrified of getting pregnant with a sub-perfect A1c. I learnt that fear is an absolute libido-killer. Even when pregnancy would have been welcomed, I was terrified to fall pregnant before I’d been given the green light by my endo.

…which for a while made me feel like there were more than just the two of us in the room trying to make a baby when we were…well…trying to make a baby.

My diabetes loomed overhead, and every moment, I was petrified of my BGL. I started pondering ridiculous things like ‘If I conceive right now and my BGL is not in range, what will that mean? Is it possible that my baby may not have eyelashes if that happens?’ Way to go being drawn out of the moment and into a weird space of imagining babies without eyelashes and how they would hate me forever and ever, and never be able to wear mascara.

So, who do you talk about if you want to have a chat about diabetes and sex? I have never ever been asked about my sexual health from any of my healthcare professionals. Of course there have been discussions about contraception and pregnancy planning and actually being pregnant. But no one has ever said ‘Does your diabetes in any way impact on how you feel about sex? Or do you think diabetes might impact on actually having sex?’

For the record, (and this is a personal bit), I did find that my attitude to sex changed after I was diagnosed. I am sure that was connected to how I felt about my body, so there was some psychological stuff I needed (and continue) to work through, but there was also a noticeable difference in actual function and how I felt. I couldn’t find any information about it, so naturally, thought it was just me.

Of course, it wasn’t. And as soon as I spoke to a group of women the same age as me who were all experiencing similar things, I felt heaps better. But it took me a long time to find those women and feel comfortable speaking about it (yay for prosecco!).

I don’t really have any answers in this, but I wanted to write to start a discussion. I know of many women who say that they believe diabetes has an impact on their sex life – both physically and emotionally. Also, I have come to understand that if it is an issue for one, it is usually an issue for many. Anything anyone want to share? Feel free to do so – anonymously if easier.

***LANGUAGE DIGRESSION

Erectile DYSFUNCTION? Can we please come up with a different term for this? Dysfunction sounds like failure – or at least like a penis has failed. It has not.

She called me because someone had told her to get in touch. ‘Speak with Renza. She gets it.’ Is what she was told. She we organised a time to meet and over coffee we talked. And she searched my face for reassurance as she told me how scared she was feeling.

When I meet someone who has recently been diagnosed with diabetes, I say very little. I listen. I ask questions and gently try to find out what is going on in their head. I don’t say much about my own diabetes, because I don’t want to imprint my experience in their mind. Everyone feels different at the time of diagnosis and working out exactly what they are feeling needs some time.

I listen and sit there quietly and try to reassure and be positive. I nod a lot, and let them talk and vent and, if they need to, cry. Usually people cry. And I let them know it is okay. I did all of this with the woman who called me. She did cry and she did vent. And then she cried some more. And I said hardly anything.

But this is what I wanted to say:

  • It is okay to feel scared and uncertain. Or angry. Or completely and utterly ambivalent.
  • Because, you see, there is no right way to feel right now – or ever – about living with diabetes. And equally, there is no wrong way to feel.
  • You don’t have to work this all out this week. Or next week. Or next year. In fact, you never have to work it out.
  • But do work out what you can manage today and do that. And whatever it is, it’s enough. It. Is. Enough. And well done you for doing it!
  • Find your tribe. In fact, this is what I want you to know more than anything. Others who are also ‘doing diabetes’ will help you make sense of this new world. You have to be ready to do that, but do be open to the idea. I wish that someone had introduced me to others with diabetes when I was first diagnosed. It took me over three years to meet another PWD and I felt so alone in those three years.
  • And when you do meet people, don’t think that anyone has this diabetes thing worked out completely. Even those who say they do…
  • …because, there is always more to learn, which is daunting and exciting in equal measure.
  • I promise you – whatever you are feeling, whatever you are thinking, someone has had that same feeling and same thought. You are not alone. (Reading diabetes blogs will prove that to you!)
  • Diabetes may feel like it is about to take over your life and it probably will for a little bit. And there may be times that it does again. But it will not define you for the rest of your life or determine who you are. It can be as much or as little of your identity as you choose to let it.
  • You will be okay. You will be okay. You will be okay. (And, yes, I am saying that for your benefit as much as my own!)
  • There will not be a cure in the next five years. Or even ten. I am not saying that to be pessimistic, I just want you to understand that hope is really important in living with diabetes. But unrealistic expectations that won’t come true are not going to give you that hope; they will destroy it.
  • Ask questions. All of them! You may not like the answer (i.e. see previous dot point), but ask anyway. You will be amazed at the things you learn.
  • Your diabetes; your rules. This will become more and more apparent the longer you live with diabetes. You don’t need to explain, apologise or justify anything you do to manage your diabetes. Ever.
  • Anyone who makes you feel crap about your diabetes – whether it be the fact you have diabetes, or how you are living with it – needs to fuck off. (And if you can’t tell them that, find someone in your tribe who can! I am happy to be that person. Truly! I have the mouth of a trucker and I’m not afraid to use it.)
  • Right now, this probably seems like it is the worst thing that will ever happen to you. This may sound odd, but actually, I hope it is. Because I know you can get through it.
  • You will laugh again. And smile and feel light. You will not think about diabetes for every minute of the rest of your life. It will be there, but it does not have to rule your very being. It certainly doesn’t rule mine. You will learn where to place it in your world, and that is where it will sit.
  • You do not need to feel grateful that you have been diagnosed with diabetes and not something else. Because it does suck. It’s good to remember that and say it every now and then. Or shout it out. While drunk.
  • Go buy a new handbag. Trust me! If you want, I can help you to justify it as needing a new bag to cart around all your diabetes crap, but just do it for yourself. And while you’re at it, a new pair of shoes. Just because!
  • Call me. Anytime. If you want. Only if you want. And even if it just to hear me tell you that you will be okay.

But I didn’t say those things. I only said this: You will be okay. I know this to be true because you are strong and resilient and capable. I know this to be true because many others have walked this path and worked out how to make it okay for them. You will do that too. It will be okay for you.

And I hope that was enough. Or, at least, enough to start with.

Last night, I was the ‘here’s one we prepared earlier’ on a panel discussing CGM technology. The audience was all healthcare professionals – mostly DEs, but some dietitians, RNs and also a GP-in-training (so much yay to him for coming along!).

I love being in the room for these events! I wrote about my last experience giving the same talk here. I cannot speak highly enough of the two experts on the panel last night. Dr Peter Goss – who spoke at the last one of these events – is what I would call a disrupter in the diabetes healthcare space and, honestly, all the power to him. He may ruffle some feathers with his sometimes unorthodox approach, but it is undeniable that he is a champion for kids and teens (and young adults) with type 1 diabetes. Also on the panel was A/Professor David O’Neal who is best described as a truly awesome endo (I have heard that from every single person I know who sees him as their endo) and an absolutely brilliant mind. His expertise in diabetes tech is second to none and he is genuinely interested in how the technology can safely, efficiently and effectively be incorporated into the lives of people living with diabetes.

I know that all sounds rather effusive. But I need to point out that they are remarkable. And that they are the sorts of HCPs you want on your side if you are a person with diabetes.

Because now I am going to talk about language and why I pulled them up a little bit after we all did our presentations and sat on the stage ready to answer questions from the audience.

As happens frequently when I am in the room with a group of healthcare professionals, the conversation turned to language. Okay, I made that happen. In fact, the words I used were ‘I’m going to hijack this conversation because we really need to talk about language here.

One of my biggest pet peeves is the jokey, and somewhat snide, comments made about people with diabetes making up numbers in their diabetes log books. Because, it’s not a joke. It’s not something for HCPs to roll their eyes over and dismiss as ‘non-compliant’ behaviour.

The word that was used for PWD who make up numbers in their books was ‘fakers’. I cringed the moment I heard the word. And cringed even more at the audience’s response – laughter, heads shaking from side to side and knowing looks. I looked around the room and knew that we would be talking about this later on in the evening!

As I pointed out when the panel was seated on the stage, I absolutely did this. And I was incredibly good at it – different coloured pens, splotches of blood on the pages, dog-eared corners of the book. Once, I even splattered a few drops of juice, because on that particular page, I was having a lot of lows and I thought the juice would make it look more authentic.

Now, let’s all just remember for a moment that I was diagnosed as an adult. This wasn’t insolent teenager behaviour. This was a woman in her mid-twenties who was terrified of disappointing and being judged by the HCP to whom she would be handing the grotty book and its made up numbers.

I told the room my story of this last night and there was laughter – because the way I spoke about it was amusing. It was a cheeky anecdote. But at the time, it wasn’t funny. I was scared, I hated checking my BGL, I was paralysed by numbers that didn’t make sense and I didn’t know what to do about it. So I lied. Of course my HCPs knew that. And I knew my HCP knew.

But the question is about WHY people do this. The discussion needs to stop being about diabetes at that point, because really, managing BGLs and most other diabetes tasks is not the issue here. The issue is distress, anxiety, fear. And, in my case, I felt desperate.

One of the panellists made the point that the reason that he brought it up was because HCPs need to know what to do when someone is ‘faking’ their numbers. He’s right. I completely agree. And then there needs to be understanding of how to approach it, which is likely to be different with each PWD.

For me, it took until I found a HCP who I felt I could trust – one who wouldn’t judge the numbers that were out of range (which one HCP always circled in red pen, making me feel even more like a delinquent adolescent) – and was interested in knowing what was stopping me from feeling able to check my BGL.

When we worked through that, I was better equipped to not only regularly check my BGL, but also to deal with the numbers and act upon them. I came to understand that a number was nothing more than a piece of information that I could use to make a treatment decision – not an indication of me being a good or bad person.

Language does matter. And words count for a lot. Using the word ‘faker’ in this context is loaded with judgement and accusation, and even if that is not the intention, it made me – a person with diabetes – feel very uncomfortable. But mostly, it fails to consider the real problem at hand which is not that a PWD is making up numbers in a book. It is why they feel the need to do that.

I woke up today to feeds full of tech – diabetes tech. Plus I seem to be reading heaps and talking about not-so-new, but still awesome tech-y stuff.

Diabetes technology has been on my mind a lot lately (as well as on my body). Mostly, I have been thinking of the evolution of how dtech moves from being a niche market embraced by only a few, to becoming mainstream.

Back in 2001, those of us using pumps were seen as leaders in the dtech area. Many diabetes HCPs had never even seen a pump and certainly were not comfortable encouraging people to use them. The only reason I started using this technology was because I met someone using one at a diabetes event and asked her. I then spoke with my endocrinologist who was incredibly dismissive, labelling the technology as dangerous. I interviewed for a new HCP team to find people who were more willing to embrace technology.

The same thing happened when CGM was launched here.

And the same with new and different other devices. iBGStar, Libre, diabetes apps – most often, the interest is led my people with diabetes who force the establishment to catch up and get on board.

And I think it is still happening. Here are some things that are being spoken about by patient advocates A LOT. How many of your diabetes HCPs would know about the current state of play in the space? Next time you see them, why don’t you ask?

TANDEM

Makers of very cool (and, frustratingly, unavailable here in Australia) t:slim insulin pump, Tandem Diabetes Care, has joined forces with digital health company, TypeZero Technologies. Yesterday’s announcement explained that the two have entered into an agreement whereby the next generation t:slim pump will integrate TypeZeros’ artificial pancreas technology.

More here.

BIGFOOT

#IBelieveInBigfoot even more after news today from the start-up that they have commenced clinical trials of their smartloop automated insulin delivery system. BigFoot Biomedical is hoping to commercialise their product by 2018. That’s way less than 5 years, folks!

More here from the team at Diabetes Mine and here from the team at ASweetLife.

FDA votes on CGM

Looks like our Dex 5-wearing friends in the US will soon have the same classification on their devices as us here in Australia (and in Europe) with the FDA voting to revise labels to support treatment decisions based on CGM data without confirmatory BGL checks.

The live tweeting from the FDA Panel hearing was interesting with some really valuable and insightful comments from patient advocates. (And can I just say how refreshing it is to see that advocates were given such a huge opportunity to speak here?!)

Some interesting discussions on the interwebs as the vote was announced (and in the lead up too). Not everyone is as excited by this development, or on the same side of the advocacy fence, with some claiming that they don’t have the same faith in the tech and fear that access to BGL strips will be removed.

For what it’s worth, my experience with this technology – and using it as classified – has been nothing but positive. The accuracy of the system is, for me, undeniable and I trust it implicitly to treat both high and low BGLs without doing a confirmatory blood check.

And I have also written before that I have used my CGM ‘off label’ for some time – even before the G5 – and am confident in saying I know I am not the only one. This seems like an example of the regulators finally catching up to the reality. Welcome to the party, guys!

More about the FDA vote here.

GONG FOR ED DAMIANO

Congratulations to Ed Damiano who was awarded Boson University’s Innovator of the Year for 2016.

Ed was recognised for his work in developing the iLet Bionic Pancreas.

More here.

WHAT THE HELL IS #OPENAPS?

Someone asked me this the other day – actually using those exact words. I bumbled my way through an explanation and after about 60 seconds remembered THIS piece by Dana Lewis.

Have you had a discussion about this with your (or any) HCPs? And if so, what have they said? Most HCPs here I have spoken to either do not know about it at all, or are very dismissive of it.

It seems that there are a lot of people in the DOC who have kept across the ‘movement’, but not a whole lot of break-through in more traditional corners.  As is often the case, I suspect that the way, it will be PWD who drive that.

IN MELBOURNE?

Check out this tech event: Translating type 1 diabetes technology into the everyday. It’s free and there is lots on the agenda.

 

 

Some people may have seen news reports yesterday about changes to access of blood glucose strips for people with diabetes in Australia. Some reports were a little light on detail (and by ‘light on detail’ I mean ‘incorrect’) and there has been a lot of discussion on SoMe with people trying to get the facts and work out what it means for them.

This information on the Department of Health’s website gives all the details to date.

Following the news piece, quite a few people have been in touch asking me if I can provide some clarification. I have no details other than what has already been announced publicly. When the announcement was made last year, I wrote this piece about it, so for some background of the issue – and my take on it – have a read.

But what does it mean TODAY for people with diabetes in Australia?

  • These changes DO NOT affect people with type 1 diabetes or insulin-treated type 2 diabetes.
  • No one should be denied access to BGL strips today, tomorrow, next week or next month. While the change in policy took effect from 1 July 2016, an initial six-month supply has been automatically granted to all NDSS registrants with non-insulin treated type 2 diabetes. This means the earliest anyone may be affected by the changes is 1 January 2017.
  • Further information will be coming, so keep an eye on the NDSS and Department of Health websites.
  • Speak with your HCP about the changes if you are concerned about how this will affect you and your diabetes management.

I know that many of us are feeling a little confused about diabetes supplies at the moment with the recent changes in how we access our consumables, and this seems to just be another change we need to deal with.

And as with all change, there is often a lot of speculation and misinformation being shared around. The sensationalist nature of yesterday’s reports did nothing to allay any of these concerns and only fuelled the fire of uncertainty. And is yet another example of poor reporting of diabetes in the media.

I’m almost ready to take a deep sigh of relief, because National Diabetes Week is almost over. It’s been a busy week – it always is. I’ve been working for diabetes organisations for a very long time, and have seen quite a few national campaigns, including some of which I was very, very critical. (Just ask the Comms Manager I worked with for over 10 years who had to deal with me complaining a lot!)

But today, I am writing only of this year’s campaign, which has highlighted the need for a National Diabetes Amputation Prevention Strategy. The campaign has not pissed me off which is a pleasant surprise for everyone who has to work with me. I don’t think it is a scare campaign. I don’t think it is graphic and gory. And I don’t think it is laying the blame for developing diabetes-related complications on people with diabetes.

On Sunday, within hours of the launch, the criticism started. I posted this on my FB page, and my frustration is pretty apparent.

Throughout the week, in between doing interviews trying to raise awareness of diabetes and why it is really crap that each year 3,740 have diabetes-related amputations that could have been prevented, I have read many comments about the campaign. A lot of them – in fact the vast majority – are really positive. Many people understand the complexity of communicating a really difficult message to a very diverse audience. But not all of them.

I have never subscribed to the idea that everyone needs to have the same opinion. And I have never ever shied away from people criticising me or the work I do. I like robust discussions, especially if they are respectful and that everyone is open to considering – not necessarily agree though – with all sides to the debate. (Unless we’re talking vaccination. Then there is only one side.)

But I what I absolutely despise is that any time diabetes is in the media and someone doesn’t like the angle, because what is being discussed is not relevant to them, or they don’t like the message, they respond with immediate outrage and negativity and refuse to consider other positions. This is not just a diabetes thing – social media outrage is the default position for many – hell, I’m guilty of it too. But often with the outrage comes assumptions and the perpetuation of misconceptions about diabetes.

In my capacity as an employee of a diabetes organisation, I have read the comments and not replied. That includes to the direct messages I have received on Twitter and Facebook and email that have been personally attacking and have called me some pretty choice names. (There is no denying the power of deleting and blocking!)

But today, I thought that here, I would put down my responses to some of the comments I’ve seen online. (Please remember that this is my blog and all opinions are mine. Nothing I have written here necessarily reflects the thoughts of the organisation I work for.)

  1. The campaign is not relevant to people with type 1 diabetes.

Of course it is! You have diabetes – any type – and you are at risk of complications. That’s the reality. It’s unpleasant; I hate thinking about it; it terrifies me.

Here is what denying this reality does: it adds shame and stigma to those who do live with complications. Had a limb amputated? Well, obviously it’s because you didn’t look after yourself and are not a diabetes superhero like me.

  1. Type 1 and type 2 diabetes are not the same thing.

Yeah, I know. I get it – they are two different conditions. Sometimes though it’s not relevant to differentiate. 4,400 people have diabetes-related amputations each year. Some are type 1 and some are type 2; some are men and some are women; some are older and some are younger. They are all people and they all have diabetes.

  1. People already diagnosed with diabetes know what happens if their condition is not well managed.

Absolutely not true and a dangerous idea to perpetuate. And this sort of comment is a brilliant example of not being able to look outside your privilege bubble.

If you are in a position to know a lot about your health condition, have access to specialist care, have wonderful support around you, (or know where and how to access support), can afford the latest treatment and technology and are managing really well – that is fantastic. I am one of those people and I know how lucky I am. But many people do not. If you are sitting on the end of a computer, complaining on Facebook and/or blogging about your experiences, you are privileged.

If you are one of those people and think everyone else is just like you, you are wrong and I would really urge you to maybe look beyond the Facebook page where you do your bitching and moaning.

Also – what is it saying to the people who have done everything ‘right’ and still have developed complications?

  1. People with type 1 are well aware – it’s people with type 2 that have no idea what they are for if they keep mismanaging their health.

Really? Just wow! Let’s break this into two sections:

  • It’s a mighty big assumption to make that all people with type 1 are aware, capable and well-informed of their condition. It’s also incorrect. And it says that we don’t need to be focusing on people with type 1 because we are all clever clogs and know everything!
  • The idea that it is only people with type 2 diabetes who have no idea is wrong and also really stigmatising. And it shows a complete and utter lack of understanding about type 2 diabetes and those living with it. Maybe that campaign about the different sorts of diabetes needs to start from within the diabetes community first. How can we expect people completely unaffected by diabetes to know the facts of those of us in it are so ill-informed at times?
  1. What would you know? You don’t live with diabetes.

Hi. I’m Renza (or Brenda, Peta, Wenzer). Here is my blog about living with diabetes.

One of the things I have come to learn is that there is no way that a single diabetes campaign will appeal to everyone or be relevant to everyone living with the condition. And that there is no making all people happy all of the time. In the spirit of this piece of advice, I am calling the week over and putting it in the vault. Have a great weekend everyone!

 

The new Prime Minister of Britain has type 1 diabetes. I am sure that you have heard this about her, possibly mixed up in the commentary about her hair and shoes. (Which is, of course, THE most important thing about a woman who has become one of the most powerful leaders in the world and absolutely what we should all be talking about. Ugh!)

Pretty much everyone I have ever met has informed me that the new PM has type 1 diabetes. I have had calls, emails, Facebook posts and texts from people excitedly telling me that Theresa May is just as pancreatically-challenged as me! Many have asked if I am excited that we have a new pin-up gal for ‘our cause’.

I’m not commenting on May’s politics – that is actually totally irrelevant to how I feel about having a world leader with type 1 diabetes.

Here is what I would love to see about Theresa May’s own diabetes. Very little. Because I don’t want her type 1 diabetes to become a focus. I don’t want type 1 diabetes to be ‘blamed’ for questionable decisions, political gaffs, or the fact that she fell asleep in parliament last week.

Because people without type 1 diabetes make bad decisions all the time. And people without type 1 diabetes make political gaffs. (Barnaby? David? I’m looking at you two…) And people without type 1 diabetes fall asleep in parliament because often there is a man in a suit speaking in a monotone about something possibly rather uninspiring. For a very, very, very long time.

In the same way that every move AFL player Paddy McCartin makes is scrutinised from the position of his defective beta cells, I fear that may be the case for Theresa May.

A world leader with type 1 diabetes is brilliant because it can show people that diabetes need not be a barrier to being at the top of your game. We all love a story like that!

But being the excuse for any negativity – or becoming the focus of her time as PM? That can do ‘our cause’ more harm than good.

Related – but not really

Discussions about Theresa May have included me saying: ‘Well if Jed Bartlet can be President of the United States of America with MS, Theresa May can be PM with type 1.’ I had to be reminded that Jed Bartlet is not real – and no matter how hard I hope and wish for it to be true, it never will be. Damn. 

The contradictions in diabetes are complex and confuse my little mind sometimes. Today is one of those days.

Getting the message that diabetes is serious – and needs to be taken seriously – is sometimes messed up in our determination to show that diabetes won’t stop us from being superheroes. In our proverbial capes*, we do amazing things; we are brilliant; we advocate; we inform. All while pretending to be a pancreas.

We use language that empowers us and makes others see us as forces with which to be reckoned. I say I live with diabetes (often saying I live well with diabetes, never struggle with it. I refuse to even suggest for a minute that I am suffering with or from diabetes and will correct anyone who suggests otherwise.

But is that undermining the seriousness of it? And is it ignoring the days where it does seem like a battle – and an uphill one at that.

I refer to diabetes as a condition, never a disease. Is that the right terminology? And why do I do that?

According to this piece at Health Writer Hub a disease is an …’ abnormality in systemic function…that causes both physical and emotional signs and symptoms’. A condition is …’an abnormal state of health that interferes with the usual activities or feeling of wellbeing’. Both are actually correct when talking about diabetes, and yet I (and many others) object to using the term disease.

Perhaps we don’t want to be thought of as ‘diseased’ or as if there is something wrong with us and ‘disease’ does suggest that.

We want people to think we are superheroes who manage to not only thrive and excel with the condition (disease?) we have been dealt, but also demand that they don’t think of us as any different to everyone else and are given the same opportunities and choices.

Are we doing ourselves a disservice by appearing so ‘in control’ and, dare I say it, ‘normal’, when there is truly nothing normal about having to pretend to be an internal organ, day in day out?

I don’t for a minute want to stop being the empowered, confident, secure and capable person I am. But sometimes I do feel that in all my cheerleading efforts, I sometimes forget – or rather refuse to admit – that it can be tough.

And mostly, I wonder, and fear, that if we all are making diabetes look so easy to manage and impact us in such insignificant ways, do others not see and understand the urgency that we feel every single day in our desire to make things better? Who needs a cure if we look so bloody happy and competent with our little condition?

*I totally do wear a cape! 

Today I attended the Victorian Kellion Victory Medal Award Ceremony. There before me, sixty-six people were awarded medals for having lived with diabetes for 50, 60, 70 and 75 years.

I write about this event every year, and each year, I write about how much hope and inspiration I feel while sitting in the room.

Because it’s true. I walk away from the Kellion awards full to the brim and amazed at what these people have achieved. I’m never sure if it is despite or because of their lives with diabetes that I feel this way. But, undeniably, it is a special day.

Frequently the stories are the same – a shock diagnosis, sometimes a misdiagnosis. Many are unable to pursue their chosen career, especially in days where teaching or nursing were not possible vocations for people with type 1 diabetes. Many spent a lot of time in hospital as they adapted to their post-diabetes-diagnosis life. And many reminisce about injecting into an orange, which apparently was the done thing for a newly diagnosed person 75 years just as it was 18 years ago when I was diagnosed – and still today!

And they share tales of brutal management instruments and tools that in equal measure terrify me and make me glad of the time I was diagnosed.

The hope exists for me because when I look around the room, and I listen to the stories and I speak directly to the recipients and their families as they proudly hold on to their well- earned medals I don’t see diabetes. I see people.

They don’t all claim that diabetes has been fun or that it has been a breeze. In fact, some of them are really open about just how tough it has made their life. But even those who say they have really struggled, still do not believe diabetes has been the single most defining aspect of their life.

I’ve always said that I wish all newly diagnosed people could meet a Kellion medal so they can see that everything will be okay. But I think that was a little naïve of me and actually undermines just what it has taken for these people to be standing there in front of us, accepting their medal. And it also suggests that diabetes hasn’t actually had some sort of impact on their lives.

These are ordinary lives made extraordinary by diabetes. And while their achievements are not there for my benefit, I am so glad that I get to hear their stories.

Source - @DiabetesVic

Source – @DiabetesVic

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