There are many misconceptions and misunderstandings about Type 1 diabetes. In honour of World Diabetes Day (November 14), here are 14 things that I wish everyone knew about Type 1 diabetes.
1. Type 1 diabetes is an autoimmune disease, just like multiple sclerosis and rheumatoid arthritis (among many others). In Type 1 diabetes the immune system attacks and destroys the insulin-producing cells in the pancreas. There is no way of preventing Type 1 from developing.
2. There is no cure for Type 1 diabetes. Insulin is not a cure. Without insulin, people with Type 1 die, and ninety years ago--before insulin's discovery--it was a universally fatal disease. Insulin allows people with Type 1 to stay alive, and that's it.
3. Type 1 diabetes is a continuous balancing act. Imagine trying to manually control your temperature or heart rate all day, every day. It must respond and change throughout the day, but not too high or too low or you die. That's exactly what people with Type 1 are doing with their blood sugar.
4. Type 1 diabetes requires constant vigilance. There are no days off and no vacations, ever. Times when most people get time off—like parties or when they're sick with the flu—are times when people with Type 1 have to work twice as hard to stay safe.
5. Type 1 diabetes takes a lot of work. It's not only the blood tests and a healthy diet. Someone with Type 1 makes a diabetes-related decision every couple of hours throughout the day, and often several times during the night as well.
6. Type 1 diabetes is serious. Out of the dozens of diabetes decisions made during each day, it takes one wrong decision (or one wrong guess) to end up in a life-threatening situation. And that's not even counting the long-term complications all people with diabetes are at risk of developing.
7. Controlling Type 1 diabetes is largely guesswork. It is virtually impossible to take account of every factor that influences blood sugar, many of which—hormones, stress, even weather—people have little to no control over. Having "perfect" blood sugar control is impossible.
8. Someone with Type 1 diabetes can do everything "right" and still have high and low blood sugar levels. Even a blood sugar that is wildly out of range may not be anyone's fault and may have no known cause. And these "random" blood sugar levels are routine—not extraordinary—occurrences.
9. Type 1 and Type 2 diabetes are completely different diseases. They share a name and high blood sugar as the primary symptom. They are challenging in different, though occasionally similar, ways. But the genes, cause, often treatment, and definitely cure are vastly different.
10. Exercise takes a lot of effort for people with Type 1 diabetes. Going for a run or a swim may take literally hours of preparation and follow-up monitoring and food and insulin adjustments to manage blood sugar levels. Exercise is good, but it's not as simple as it may appear.
11. People with Type 1 can eat anything, but it may take an incredible amount of work. Like exercise, it may take hours of monitoring and dosing insulin after certain foods. Sometime people may feel like putting in this effort to eat a treat, and sometimes they may not feel like doing it.
12. People with Type 1 diabetes require nutritional information for foods. It is required in the same way that people with food allergies require ingredients before they can eat. Without it, people with Type 1 are making a wild guess about how much insulin they need to take.
13. The insulin pump is just another (more precise) way of delivering insulin. It does not automatically regulate blood sugar levels or insulin. It requires constant programming and monitoring, and only delivers what the user manually programs to be delivered.
14. Type 1 diabetes is often as much an emotional struggle as a physical one. Imagine taking a lifelong course you didn't want to sign up for, working hard at it every day, and only getting a C on the exam. Then repeating it all again next semester, forever. That's what Type 1 often feels like.