The worst type – by Helen May
I neither hide nor advertise that I have diabetes. As a result, it sometimes just pops into conversation. For example, I was recently explaining to my hairdresser that I wouldn’t be going to the gym that day because I was feeling less energetic than usual as a result of having a flu jab which I am entitled to it because I have diabetes.
ASIDE: Don’t forget to get a flu jab. In my early diabetes years, I was not aware I was entitled to a free jab and, even minor flu made my diabetes difficult to manage. The only time I have experienced a significant reaction (although it was not major) was when I also had a pneumonia vaccination. And, as the flu strain varies each year, the vaccination is different. So, I would not make a judgement call based on my experience of a previous flu jab.
My hairdresser was surprised to hear I have diabetes. This is a common reaction. Probably because I do not match the expected stereotype of someone with diabetes as I am very active. Another common reaction is a flow of questions:
- do you have to inject every day?
- how long have you had diabetes?
- which type do you have?
- is that the worst type?
The last question is the one I find hardest to answer. Partially, because I cannot talk from personal experience and, partially, because I don’t think there is a worst type. My usual answer is to explain that, of the two main types of diabetes, Type 1 does not produce insulin and Type 2 do not use insulin efficiently. Then, I leave the questioner to decide.
There are many ways to consider what makes one condition worse than another: the physical consequences, the treatment, the length of the condition and the mental impact.
The physical consequences: higher risk of heart disease, kidney problems, neuropathy, retinopathy, to name a few: are risks for both Type 1 and Type 2. So from this perspective, there is definitely no worst type.
For Type 1, the treatment is injection (or pump). Although this is inconvenient and subject to mistakes, personally, I do not find this a big problem. But, if you have a needle phobia, low pain threshold or struggle to calculate the required insulin dose,injecting insulin is a big problem. To my understanding, treatment of Type 2 is more complex: it may be treated with diet which could be difficult to follow; it may be treated with tablets which could have some side effects; it could be treated with insulin. So, for me, treating Type 2 would be worse.
Typically, Type 1 is diagnosed at a younger age than Type 2. As there is no cure, you are likely to have Type 1 for longer than Type 2. Does that make Type 1 worse?
Finally, there is the mental impact. Knowing you have a chronic condition is very likely to have an impact on the way you feel. There are days when you want to be like everyone else: leave your needles behind, exercise without worrying about hypos and eat without carb counting. The opinion of others impacts how you feel: there is a stigma associated with diabetes, especially Type 2, because some think you have bought it upon yourself. In this regard, I imagine it is worst to have Type 2.
There are, of course, other types of diabetes. Some of the risks, treatment and consequences are similar. Considering these, adds another dimension to the question: is it worse that few people have the same condition as you?
So, what is the worst type of diabetes? If I was forced to answer, I would say either “it depends on the person”, or “neither”. Am I sitting on the fence?