Diabetes Awareness Month: Illuminating the Invisible Illness

Cartoon by Lianna Maley.

It is no secret that insulin is incredibly expensive, with newer versions retailing between $175 and $300 a vial, but what is a vial of insulin? How many vials does a diabetic need to survive? 

It’s not a difficult task to post an infographic on one’s Instagram story saying insulin is the 6th most expensive liquid in the world, but could the same person explain what insulin does? Or what the difference is between type one diabetes and type two?

November marks National Diabetes Awareness Month, as diabetes organizations across the country aim to raise awareness and take action as a community to find a cure. This November, the Oracle has decided to join in and spread awareness on this invisible illness. 

Over 34 million Americans live with diabetes, approximately 1.6 million with type one and the remainder, about 90-95%, with type two.

Type one diabetes occurs when the immune system essentially attacks itself by attacking the insulin-producing beta cells in one’s pancreas. The trigger for this attack is still unknown, however, many scientists believe it is caused by genes and environmental factors like viruses.  

Type two diabetes — the most common form — can be caused by several different factors. Type two diabetes often begins with insulin resistance, the pancreas produces insulin normally, but one’s body is unable to move glucose into the cells. The pancreas will, at first, create more insulin to counteract the resistance, but eventually the cells cannot keep up and the insulin production slows. This is called prediabetes; where a person’s blood sugar level is higher than normal but not high enough to be diagnosed with diabetes. If insulin production continues to decrease while resistance increases, it becomes type two diabetes. Most often, type two diabetes is associated with variables like weight and ethnicity. 

Cause isn’t the only major difference between the two types: so is management. 

The average non-diabetic is able to regulate their blood glucose levels through the hormone insulin and remain at a steady level of 80-100 mg/dl. The beta cells in a non-diabetic maintain this steady level by 

taking away proteins that make the blood sugar go up and increasing glucose storage, which means it doesn’t go into your blood. 

For people with type one diabetes their blood sugar must be regulated manually. This is done through the use of short-acting and long-acting insulin. A blood sugar level without the beta cells regulation can be affected by almost anything but primarily: food, activity, stress and illness. It is the job of a diabetic to give the correct amount of short-acting insulin to ensure a steady blood sugar. 

Those with type two diabetes are still able to produce insulin; doctors recommend dietary changes, increasing physical activity, losing weight and the use of some oral medications or insulin therapy.

One of the common misconceptions about diabetes is that it is caused by eating too much unhealthy food or being overweight. For type one diabetes, and at times for type two diabetes this is not the case. 

But it is no wonder that people think this when some of the most popular songs like Cardi B’s “WAP” and Tyler, The Creator’s “A Boy is A Gun” have lyrics like, “I let him taste it now he’s diabetic,” and “Boy, you’re sweet as sugar diabetic to the first degree,” respectively. 

Developing type one diabetes isn’t related to being overweight, and a diabetic can just as easily eat anything that a nondiabetic can as long as they give themselves the correct amount of insulin that a nondiabetic would naturally produce.

A staff member at the Oracle, received a message when asking for assistance doing a project on type one diabetes, it read, “hiya! i’m not diabetic so idk how much help i can be but an idea you could do is maybe photograph someone taking their insulin or for example if they can’t eat a certain food (I read on google flavored coffee and pasta but i’d fact check with someone) you could have them pose with their hands on their hips looking frustrated outside of starbucks.”

The Mount Sinai website has a page dispelling many myths that are often associated with diabetes like the one received in the message above:

“Myth: I will likely develop diabetes because I am overweight. Fact: It is true that excess weight increases your chance of having diabetes. However, many people who are overweight or obese never develop diabetes. And people who are normal weight or only a little overweight do develop diabetes.”

“Myth: I was told I have diabetes, so now I’ll have to eat a special diet. Fact: People with diabetes eat the same foods that everyone eats. In fact, The American Diabetes Association no longer recommends specific amounts of carbohydrate, fat, or protein to eat. But they do suggest that people with diabetes get their carbohydrates from vegetables, whole grains, fruits and legumes. Avoid foods that are high in fat, sodium and sugar. These recommendations are similar to what everyone should be eating.”

So before joking around saying “you’re going to give yourself diabetes,” when you see someone eating candy or drinking soda, just know there is no giving yourself diabetes, especially not by drinking a can of soda.

With insensitive jokes on top of tracking your blood sugar levels, dosing insulin and planning days around your blood sugar, diabetes becomes incredibly emotionally draining and overwhelming. All effects of the disease that go without being seen.

This is life with an invisible illness.

“The internal battle you’re fighting takes mental and physical energy and just going through daily tasks can be debilitating. However, those looking at you may have no indication you’re suffering, let alone that you have a chronic disease. You suffer from an invisible illness,” describes Northwest Primary Care.

No wonder depression and diabetes are clinically linked together. Around 10% to 15% of all people living with type one or type two diabetes also experience depression, according to WebMD. 

“What you may not understand is this: diabetes is not as simple as simply doing a blood sugar test, accompanied by an insulin injection or the touch of a few buttons on an insulin pump. Diabetes is like I’m running a race with a weight belt on. The course is the same and it has hills and valleys just like for everyone else, but every step, every moment and every time I push myself to the max, I have to work a little harder than everyone around me. It’s a constant weight on our shoulders that for most diabetics will never go away and is sometimes difficult to manage and live with,” writes type one diabetic Shelby Farrell.

“We’re allowed to have good days and bad days; just like everyone else. We just need to be prepared. Even on our bad days, we are still diabetics. We still have to stop and test our blood sugars and give insulin,” Farrell said.

Just because it is hard to see and so commonly joked about doesn’t excuse ignorance.

Yes, November is Diabetes Awareness Month but that doesn’t mean that awareness of this debilitating disease should begin and end during these 30 out of 365 days of the year.