My Immune System Killed My Pancreas! 💀

You guys! I JUST realized March is Autoimmune Disease Awareness Month! 

I’m not sure how I never came across this before, but I am glad I did. I am living with not one, not two, but three autoimmune diseases. As most of you know at this point, I was diagnosed with type 1 diabetes at the age of 11, which is an autoimmune disorder. I have always been a huge advocate for diabetes awareness. Living with Type 1 Diabetes, (T1D) I get ALL of the ignorant comments from well meaning people: 

“Did you get diabetes from eating too much sugar?”

“Should you be eating THAT?!”

**Looks me up and down** “You don’t LOOK diabetic”

“Oh, you have to take insulin. Do you have the bad type of diabetes?”

“Your blood sugar is high. What did you do wrong?”

And that's just a few. To clear things up, T1D is an autoimmune disease where the immune system gets confused and attacks the pancreas, killing off the Beta Cells that produce insulin. Sugar did not trigger this. A certain weight or body type does not trigger it. What happens in our bodies is completely out of our control. Some think some sort of infection triggers the immune response. Regardless, once the Beta Cells are dead, there is no bringing them back. No, cinnamon will not cure my diabetes, thank you very much. Without functioning Beta Cells, the body cannot produce insulin, leading to elevated glucose levels. Chaos ensues from there until the person is placed on insulin therapy FOR LIFE.

So that is T1D in a nutshell. Of course there are a lot more layers to it, but I think for the average person it helps to gain an understanding of the epidemiology of it. A lot of the misconceptions about diabetes (both Types 1 & 2) are spread through inaccurate representations in popular culture & social media. The trope of the lazy, gluttonous individual GIVING themselves diabetes couldn’t be further from the truth. What’s more, that narrative is DANGEROUS. It puts undue blame on the person, which can lead to feelings of hopelessness, frustration, and shame. I don’t know about you, but it is pretty hard to find the motivation to take care of myself when I feel like a worthless P.O.S. 

Type 2 diabetes (T2D) has a huge stigma around it as well. While it isn’t thought to be an autoimmune disease like T1D, it occurs when an individual's pancreas can no longer keep up with the insulin demands of the body. That can happen for a lot of reasons, many of which have nothing to do with weight or food. Genetics play a huge role, as well as race and socioeconomic status. Another factor I don’t feel is discussed enough is mental health. If someone is in the throes of depression or addiction, everything else, even healthy behaviors, tend to fall low on the priority list. In my current job, I’ve seen many patients diagnosed with T2D after entering treatment. Often, their addiction (be it alcohol or other substances) puts a strain on the individual’s pancreas, like in chronic pancreatitis. 

I often wonder how much these factors are taken into consideration when someone shames an individual struggling with diabetes, type 1 or 2. Do they think about all the other things going on in that person’s life? It frustrates me to NO END how individuals are often blamed for their health issues. I NEVER was fond of the term “Non-compliant” either, because it’s just a lazy way of writing the patient off. 

For a time I worked in an inner-city diabetes center. On top of educating the patients, a good portion of my days were spent trying to find insulin and other medication at a discount, through coupons, vouchers, etc. for my patients who couldn’t afford it otherwise. Or helping them apply for Food Stamps, because it is hard to eat fruits & vegetables without an income. I often felt like a social worker, trying my best to advocate for my patients and get them the resources they so desperately needed. 

For me, I always try to ask why? Why can’t the person take their insulin as scheduled? Is it because they can’t AFFORD the insulin? It is pretty hard to take insulin you don’t have the money to buy in the first place. Why are their eating patterns inconsistent? Maybe because we live in a society that tells them they are less than because of their disease? Maybe they self-soothe with food in the middle of the night, struggling to work through their depression while trying to manage their diabetes? Why is my patient’s Hba1c (average blood sugar over the past 3 months) so elevated? Maybe she is withholding her insulin in an effort to make herself small, which is an eating disorder known at Diabulimia. You don’t know what is going on, unless you ask why. Just talking at them, and giving them a handout isn’t going to change their behaviors.

More people, including health care professionals, need to start asking why? The answers you get will surprise you. So the next time you or someone you know is struggling with diabetes, be it type 1 or type 2, remember they are more than just their diabetes. Look at the WHOLE picture, with compassion and empathy.