Wednesday, July 26, 2023

Keep Me In The Loop

The T Slim X2 insulin pump showing control IQ in use

Type 1 Diabetes tech can advance pretty quickly. Even access to it, in some areas, has greatly improved in recent times and for that we have much to be grateful for. Of course, there is far more to do than has already been done. There are many who struggle to access some very basic things and, in the UK at least, a yawning disparity in care is obvious between areas. If the playing field will ever be levelled is debatable. With my most optimistic hat on, it seems certain to be a drawn process, as with many aspects of NHS care.

Yet! We continue to advance diabetes care in the UK (probably beyond) thanks to a little thing called "Peer support" Actually, it's not little at all. In terms of numbers, the peer support groups both online and in person, have grown enormously over the last few years. Indeed, you'll see diabetes-care-engaged HCPs communicating with these groups, recognising their importance, referring patients, etc. 

For me, it's not little at all in terms of the impact on my health and life.

Back in 2017, I had recently reached a "milestone age" and after going through a great deal of diabetes related issues I thought it was time to get to grips with my T1D. The story is long and rather dull, in short it involved creating social media and forum accounts, sharing, learning and trying to be the best diabetic that I could be. I anticipated that I'd be largely on my own, that I'd pick up a few useful tips among the keto scams and cinnamon cures. I was wrong, I was definitely not on my own.

If you arrived here via Twitter, there is a great chance that you already know about #GBDoc. It is a tremendous community, run entirely by volunteers who just want to learn and stay well as much as everyone else. I mention the hashtag often and I do promote the community when the opportunity arises. I don't run it or have any influence in what happens. I'm a volunteer, learning, trying to stay well and hopefully assisting others in the same.

I try to give as much as possible to my peers within #GBDoc because since day one I have been inundated with kindness. Sure, as with any community, there will be disagreements and people will come and go. Yet, the core of #GBDoc has remained and from everything I've read and learned, I believe the community has evolved into a more inclusive, community driven, place rather than the individually run entity it once was.

In the last six and a half years, I have met hundreds of community members in person. I'm very likely to meet hundreds more. Each time, it was a delight. I love to learn about others, to talk, to laugh and to share experiences. From the hundreds, I have close bonds with many people who are now incredibly good friends. If you enjoy socialising then #GBDoc can certainly improve that aspect of your life!

Let's focus on the direct impact that peer support has had on my health. In 2017, I was finger pricking and injecting and that was the extent of my T1D management. Today, I write this blog post as somebody who is using Hybrid Closed Loop to manage my diabetes. Essentially, an insulin pump is communicating with a CGM to make frequent adjustments to my insulin dose without my input, aside from entering carb counts and other very minimal-effort engagements (see the photo used for this post). If you don't have T1D, your pancreas does a similar job, but this is not an artificial pancreas. I'll blog more about HCL in a week or two. 

HCL is the latest development from my accessing of the peer support in #GBDoc. Before that, there have been many other examples of help from the community members. Items include:

- A donated insulin pump
- Many donated insulin pump consumables
- CGM transmitters
- CGM and Flash sensors
- Ketones test strips
- Glucose drinks
- Sweets, chocolates, lots of coffees!

The last one might not be hugely impactful on my diabetes management, but it helps and they were much appreciated! I didn't ask for any of those items. Various individuals took it upon themselves to offer their time, energy and money to help me. The physical items are one thing, the enormous amount of education is something else. There really is no better place to learn about T1D than from those who live with it. Every little snippet of info, every little trick, hack, guidance and signposting is a little bit more ammunition to go to war with. Over the years, I've absorbed it all. It feels like I've studied for a medical degree in some respects.

Of course, I do what I can to give back. "Pay it forward" is the often used term for a good deed. I won't list my involvements in diabetes related initiatives in this post. This post is about the others who do wonderful, kind, things for people without really realising the positive impact it can have. You are saving lives, prolonging lives, improving lives. I don't write that sentence flippantly. I truly believe it. You may never be officially recognised, but I see you. Thank you.

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Sunday, July 9, 2023

Combating Stigma in Diabetes Online Content


In today's digital world, the internet has become a significant source of information and support for individuals with chronic conditions such as diabetes. However, despite its many advantages, the online sphere is not immune to the perpetuation of stigma and misinformation surrounding the condition. You may have read a lot about stigma via your social media platforms of late. I apologise if my own content has been focused on that subject. However, I do believe it is a hugely important issue and one which can be addressed within the general population. I understand that to many of you stigma is not the most exciting subject to read about. Indeed, some of you may have never experienced stigmatising content. Stick with me, have a read, it will only take a few minutes.

So, we know that diabetes is a chronic condition that affects millions of people worldwide. It is characterised by the body's inability to properly regulate blood sugar levels. Unfortunately, diabetes is often associated with stereotypes, misconceptions, and blame. Stigma arises from these preconceived notions and societal attitudes, resulting in discrimination, shame, and psychological distress for those living with diabetes.

The internet has revolutionised the way we access and share information. It offers a wealth of resources and online communities, such as #GBDoc, that can be immensely beneficial for individuals with diabetes. However, the online sphere is also a breeding ground for stigma and misinformation. Many platforms lack proper oversight, allowing harmful content to spread unchecked. As a consequence, diabetics often face an uphill battle in navigating the online landscape, leading to increased anxiety, self-stigmatisation, and poor mental health.

Stigmatising content can have severe consequences for individuals with diabetes. It not only perpetuates harmful stereotypes but also hinders our ability to manage the condition effectively. Stigma may discourage individuals from seeking necessary medical care, adhering to treatment plans, or even disclosing their condition to others. Consequently, this can lead to poor glycemic control, increased complications, and a diminished quality of life.

To combat stigma effectively, it is crucial to empower individuals with diabetes through education and awareness. Creating and promoting online content that accurately represents the realities of living with diabetes can play a pivotal role in challenging misconceptions and dispelling stereotypes. At #GBDoc, we recently launched the #StopTheStigma campaign to do precisely that. By providing evidence-based information, sharing personal experiences, and embracing empathy towards others, we can reshape the narrative around diabetes and create a more inclusive online environment.

Online communities such as GBDoc can serve as a lifeline for individuals with diabetes, offering support, validation, and a sense of belonging. These communities should prioritise the creation of safe spaces that are free from stigma and judgement. As a volunteer, I work hard to ensure everybody feels safe to engage in and express themselves in the communities that I am a part of. If you notice or experience otherwise, just let me know.

Healthcare professionals CAN play a crucial role in combating stigma surrounding diabetes. By staying updated on the latest research, guidelines, and treatments, they can provide accurate information to their patients and the general public. Sadly, there are some HCPs with a different agenda. I strongly encourage diabetics of any type to avoid engaging with or acknowledging HCPs who are promoting diets or lifestyles via a subscription based service. There are a few of those guys kicking around, even in the UK!

Additionally, healthcare professionals can actively engage with online communities, offering expert advice, clarifying misconceptions, and addressing concerns. By bridging the gap between medical knowledge and the online sphere, healthcare professionals can become allies in the fight against diabetes stigma.

Despite it being 2023 and despite many words of advice and correction, stigma surrounding diabetes persists in online content today, creating barriers for individuals seeking support and information. However, by recognising the impact of stigma and actively working to combat it, we can create a more inclusive and supportive online environment for individuals with diabetes. Through education, empathy, and the promotion of accurate information, we can break down barriers, empower those affected by diabetes, and contribute to everyone's overall well-being.

I'd like to ask you all to share your experiences of stigma on your social media accounts. If you can, post that content where people could benefit from learning about stigma (where people without diabetes might read it) and use the hashtag #StopTheStigma. Raising awareness has the greatest impact among the unaware.

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Friday, June 23, 2023

Dexcom One CGM - In Review


It's been a number of years since I last used a Dexcom CGM. In 2018 and 2019, I used the Dexcom G5 followed by the G6 and my experience was "patchy" for various reasons. So, it was with hesitancy that I accepted the Dexcom One "Starter Pack" during my latest diabetes review appointment. It was offered to me following the sharing of my experiences of Freestyle Libre 2.

Firstly, how wonderful to have a choice of blood glucose tech. I know most areas in England and Wales are offering a choice of Libre 2 or Dex One yet many are still finding it difficult to access one or the other - mostly Dex One - at the time of writing this blog post.

The Starter Pack contains everything you need for 10 days CGM use - 1 transmitter and 1 sensor. You'll need to install the Dexcom app on your phone and create an account if you don't have one already. Then, you're ready to go!

You'll need to "pair" your phone with your Dexcom One transmitter. Pairing is a simple process, just follow the steps on your phone screen. Once you are paired up, you can insert the sensor using the single use applicator. By the way, be sure your phone is compatible with the CGM. Dexcom will have a list of compatible handsets on their website. 

The sensor applicator looks and feels a little like a computer mouse. There is one orange button to insert the sensor under your skin and a small protective orange strip to cover it. You'll need to snap that off before you press the orange button. You'll also need to remove the two slips of paper that cover the sensor adhesive area. Once the paper is removed, hold the applicator against your skin and press the button. Sensor inserted! Just ease away the applicator and dispose of it as best as you can. It's a pretty chunky lump, making recycling difficult. Some have suggested breaking it up with a hammer to make recycling easier. I think Dexcom could do a lot more to be planet friendly, here.

Before you go waving a hammer around, pop the transmitter into your sensor. Next, follow the app instructions to begin the warm up process. If you've never used a Dexcom CGM before, then get ready for a wait. The Dexcom One takes 2 hours to warm up so, maybe don't do this right before bed.

The warm up process was problem-free and BG values began to appear. The first few readings were pretty close to my actual blood glucose. "Great!" I thought, until my BG dropped so low that numbers became letters on the Dexcom app. However, I wasn't hypo. Things didn't get any better for a good 6 hours, throughout that time I remained outside of the hypo zone. I decided to let the CGM "bed in" and, erm, go to bed.

I don't know if it was just really tired from sitting in a box on my living room floor for a few days, but the rest seemed to do the CGM good! Fasting BG in the morning was very close to the Dex One number, which was also very close to the Libre 2 number (I'm wearing both devices at the same time). 

Heading towards 7 days with Dex One, I've become comfortable with it and I have begun to trust it. Compared to Libre 2, it has been closer to my actual BG for more of the time.... just! The difference between the two is very minimal for me. L2 is reading a little lower (it usually does) than Dex One, but not by worrying amounts. 0.5 mmol perhaps as an average.

Accuracy aside, the Dexcom One app is a very stripped out affair compared to LibreLink. It will offer some eA1c info via Clarity and some Time In Range data, but there is no place to leave notes and no way to screenshot the app. Read this in your best Nick Jonas voice - No screenshots? Really?! Some of you are going to suggest using third party apps and you're right. You can screenshot and note leave using different apps. However, I'm not a fan of unofficial apps when it comes to my data, support, security, yada yada. Also, the tech newbies don't want to be overwhelmed by having to install multiple apps to do things they could do with one app on LibreLink. I'm not a newbie, I'm just big hearted and I care about the people who are.

The app is my only gripe, really. Yet, it works and how often am I going to leave passive-aggressive notes about the sensor accuracy? Do I really need to screenshot my BG to encourage keto diet zealots to question how long I'll be keeping my toes with those numbers? Maybe not. I've drifted off track. My gripes aren't a big deal. They're little annoyances. The important thing is the CGM works well. At least, after the first 6 hours.... 8 hours if you include the warm up. Yeah, that first day is pretty annoying. I can accommodate that, though.

What else? 

- It's ergonomic. No sharp edges to catch on clothes, bed sheets, other humans, etc.
- It's simple to set up. Minimal steps and great on-screen instructions.
- Satisfactory accuracy vs Libre 2.
- 10 day wear isn't wonderful. That's 3 sensors per month vs the near 2 for Libre.
- 90 day transmitter usage is... okay... remember GlucoMen Day have rechargeable transmitters that last for 5 years.
- Waste could be better. That big lump of applicator, 3 times per month. Eeek.

That's about it. Soon, I'll need to make a choice for NHS purposes. Dexcom One or Libre 2. Which one do you use? Have you been given a choice?  

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Monday, June 5, 2023

1 Hour of Diabetes Stigma


So, the title of this one doesn't sound like a barrel of laughs. I know, I know, stigma and diabetes gets more airtime than Phillip Schofield and a full hour of it? Relax! Unless you're really slow at reading, this blog post will not take an hour to get through.

We're all good now, aren't we? Cool. 

A few weeks ago, I asked a question on Twitter along the lines of "Have you ever searched 'Diabetes' on Twitter?" A simple question. Some of you actually did that, some of you knew what I was getting at - It's horrendous. 

Stigma comes in many forms, of course. Some of it is well meaning "advice", some of it is terrible, upsetting, bullying, stigma breeding trash that really has no place on any platform. Yet, it's 2023 and here we are, social media is a heaving cesspit of diabetes stigma. A wall to wall misinformed, Facebook researching, pile of turd.

I'm not happy about this, can you tell?

So, to fuel my fires further, I performed the Twitter search for "diabetes" once again, yesterday. I decided to check the latest tweets, the tweets from the last hour. Of course, you might perform this search after reading this blog post and find entirely different results. However, for the purposes for this blog, I'm going to show you nine tweets which were sent in that hour.  On average, that's a tweet every 6 and a half minutes.

Ready? Deep breaths. Let's start with this cracker:


Diabetes in a cup. Your number one, alongside 'Diabetes on a plate', in Diabetes Stigma Bingo. Ooh, this is so tiresome and it's been repeated a million times. "Sister" was probably trying to be witty. 1985 left a voicemail, they want their diabetes joke back.


Mild diabetes. What? Mild diabetes? Loverboy got lucky with a mild dose. I've had the severe version for 38 years. Still, great that he warned us about this rather unusual way of getting diabetes - from watching a Ben & Jerry's TV ad'. Is nothing safe?! 


Looks like diabetes. Nope, it doesn't.


All Y'all diabetics, y'all. Fortunately, he clarified that cookies giving people diabetes was just a joke. All fine and not be blind at all... y'all. 


So sweet! Diabetes stigma bingo is back with this classic. I don't know what was so sweet. Maybe it was an ableist piece of trash falling down some stairs into a pile of horse manure?


Diabetes. Great try, DJ! You're wrong, but for trying so, so, hard to be funny you win a Donut. Oh, wait!...


Type Socks. I think this is my favourite one. Veinexes keeps those socks on despite it meaning getting diabetes. I like warm feet in bed, but i'd probably pass on toe comfort to be diabetes free. Still, now we all know the true cause of diabetes. Scientists, you can work on something else.

*Update. This looks like a typo/autocorrect of the word because or cos. The reply makes more sense when read that way. 


Cosmic Diabetes. Far out, dude. Diabetes from across the galaxy. Alien diabetes is probably easily managed with a ketogenic diet, lots of cinnamon, praying and an anal probe.


DiAmazonetes. Bernard, here, absolutely soiling himself laughing at his own gag. Ah, Bernie you old rogue! You cheeky, ableist, stigma breeding, piece of... IBS kicking in again. 

Alright, that's enough. Most of these idiots probably didn't mean any harm, they're just... idiots? Although, I'm not sure about the socks person - that's really freaked me out. I love socks. I should really end this post with a serious point. I think you've understood my point. That's a lot of stigma in a short space of time from various different idiots. 

Can it be stopped? No. At least not until there is proper regulation of social media (one person, one account, verified with ID, additional accounts listed openly). That would reduce the other horrible hate tweets, too. It would also reduce tweet impressions and hurt the income stream of the platform. Hmm, a tough one. Reduce harm and revenue or continue with the status quo. How important is money over human well being? Over to you, Elon.

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Sunday, May 21, 2023

The Darkest Hour


Mental Health Awareness week is coming to an end and, for the first time really, I've been quite active about raising awareness of mental health issues on social media. During the last week, I have read about the issues faced by others within the diabetes community. I have also had several conversations with fellow diabetics about their mental health and shared my own thoughts in turn.

During a couple of conversations, diabetes related complications became the subject. It seems very reasonable to be fearful or anxious about complications, whether you've experienced them personally already or you've simply heard about them - yet managed to stay complications free. These particular conversations were on a mentor to mentee basis (I help to mentor a handful of people living with T1D) and so it wasn't appropriate for me to use that time to fully open up about my experiences. Some of my mentees pay for my time and it's important to focus on their issues, rather than drift off into my experiences. However, as we touched on some aspects of mental health in relation to diabetes complications the memories came flooding back.

Before we tuck into the main course of this blog post, I'm going to put a trigger warning here. Below, I will be writing about diabetes related complications, depression, and suicide. So, if you're upset by those subjects or they trigger you in a negative way, then please close this window and drop by again later for another blog post. Thank you.

Type 1 Diabetes had never really impacted upon my mental health. I'd had the condition for around a quarter of a century, from childhood until my early 30s, and although it was a massive annoyance and it nearly killed me a couple of times it wasn't affecting my life much. I'd been married, had two children, I was working for a TV channel in London, drove a fancy car, and I was flying around Europe to play poker tournaments. Much more was going on at that time, too! Needless to say, I was enjoying life and I didn't have much time for diabetes. My autobiography will tell you about that time.

Diabetes got angry at my ignoring of it. It'll do that, it's very needy. As my vision began to change, as little black dots appeared, as things became more and more blurry, I knew that I couldn't keep my head in the sand forever. I'd already been diagnosed with retinopathy at that stage. If you've read my previous blog posts on the subject, you'll know the story from then on. 

What I haven't ever spoken about is the affect that this period had on my mental health. Sure, I've joked that it was "a pretty dark time" but that's about it. The truth is that it was a terrible time. Once the initial feelings of anger, self-pity and guilt had subsided, I felt an overwhelming sense of hopelessness and that didn't disappear very quickly at all. It took many operations and around 18 month - 2 years of my life until I found some hope again. 

The title of this blog is The Darkest Hour. When I think of this time, many hours were dark (stop with the puns!) yet there was one particular time when I had firm plans to end my life. I am sorry to my friends and loved ones if reading that upsets you. The time frame is a little hazy, but it was around a year into my life as a very, very, visually impaired person (almost entirely blind). I'd had several operations on one eye with very limited success and no "work" had taken place on the other one at that stage. I considered what the future held for me, what had been, what I'm currently missing. A spiral of depression began and I became comfortable in planning my demise. So much so that I told a trusted person of how long I'd be waiting before calling it a day. That time was approx' a month after my next operation. I figured I'd give some time for things to settle down after the op, talk to my surgeon about what could be done from then on, and if the situation was to stay the same then I'd go through with my plan. 

Losing my sight was devastating, but it was also the fact that it was happening to me in my 30s. I imagined what might happen in my 40s, 50s and beyond. I had no intention of slowly decaying and putting my family under the stress of witnessing that and caring for me. I won't be writing about my plans to die in any detail in this blog post or anywhere else. I'm absolutely not here to put plans into heads.

I'm still here, in my 40s, so you already know that things changed for me. I remember that day as clearly (pun?) as any in my life. After getting the thumbs up from my surgeon, I could look my children in their faces and see their eyes and their smile. Everything changed. Oh sure, I've made monumental balls ups of many things since that day in 2012, but I've become more appreciative of life, more understanding of the desperation felt by others when life becomes intolerable, more respectful of diabetes and more engaged about my own health.

So, here's a thing; I was wrong. Wrong to make plans to end things, but in hindsight I understand why I was in that position. What I needed was support to help me deal with the devastating news and the long period of time as a severely visually impaired person. What I got was a meeting with a blind persons charity, in the eye clinic waiting room, surrounded by many other patients. That was followed up with a home visit to ask what I needed in a practical sense for living at home. I was given a talking blood glucose meter. Cool, thanks. No psychological support was offered.

I feel very lucky. The brilliance of my surgeon saved my sight and, in the process, my life.

I've been wondering how to end this blog post without sounding patronising and without doing the "My DMs are open, message me if you want to talk" virtue signalling nonsense. How about this:

If you're in a bad place with your mental health, diabetes related or otherwise, hold on. Life is long and sometimes things can take what seems like ages to change. You may feel that change is impossible, even if change means you must adjust to new circumstances, but it will happen and you can adjust. Seek the right help to support you. You'll need professional organisations and possibly psychological help. Be honest with your family and trusted friends.

You might also benefit from just talking. There is no shame in feeling depressed, anxious or even suicidal and when it comes to diabetes, we got you. I got you.

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Monday, May 8, 2023

It's Complicated

 


A lot of subjects revolve around Type 1 Diabetes. Many of those are routinely spoken about at your clinic appointments, with your peers, on social media, etc. That's a great thing! Reading about some diabetes related subjects might help you with your own management or, if you decide to verbalise your own experiences, you could be helping others. It's a win-win situation as far as I am concerned. 

I know some will have issues in reading or hearing about the scary aspects of diabetes. I spent a good part of my life avoiding those subjects at all costs. Even when one of the most scary, diabetes related complications, came to visit me personally I decided the best course of action was to put my head in the sand. That was a poor choice, of course.

Living with type 1 diabetes can be challenging, and there are several potential complications that can arise as a result of the condition. I believe that it's important to talk about these complications openly and honestly, without blaming or shaming people with diabetes. Stigmatising language and attitudes can be harmful and can make it more difficult for people with diabetes to manage their condition.

Let's take a look at some of the most common complications associated with type 1 diabetes:

- Diabetic ketoacidosis (DKA): DKA occurs when the body starts breaking down fat for energy instead of glucose, leading to a buildup of acids called ketones in the blood. This can be a life-threatening condition if left untreated.

- Hypoglycemia: Hypoglycemia, or low blood sugar, can occur when a person with diabetes takes too much insulin or skips a meal. Symptoms can include shakiness, dizziness, confusion, and even seizures. We talk about hypos within the diabetes community quite often yet, still, some find the subject embarrassing.

- Neuropathy: Over time, high blood sugar levels can damage the nerves in the body, leading to numbness, tingling, and pain in the hands and feet.

- Retinopathy: High blood sugar levels can also damage the blood vessels in the retina, leading to vision problems and even blindness. I know this particular one very well. 

- Nephropathy: Diabetes can also damage the kidneys, leading to a condition called nephropathy. This can progress to kidney failure, which may require dialysis or a kidney transplant.

It's important to note that not everyone with type 1 diabetes will experience these complications, and managing blood sugar levels can help reduce the risk. However, even with the best management, complications can still occur. That's why it's essential to have open and honest conversations about these potential complications and provide support to those who are managing the condition.

Unfortunately, people with type 1 diabetes often face stigma and blame for their condition, which can make it even more challenging to manage. Some people may assume that diabetes is caused by poor lifestyle choices, such as eating too much sugar or not exercising enough. However, this is not the case with type 1 diabetes, which is an autoimmune condition that cannot be prevented or cured.

Stigmatising language and attitudes can make people with type 1 diabetes feel ashamed or embarrassed about their condition, which can prevent them from seeking the help they need. It's important to talk about type 1 diabetes in a way that is respectful and understanding, and to avoid placing blame or shame on people who are managing the condition. 

There is often much talk between diabetics about the language used about our condition. Even the use of the word "diabetic" causes some to feel uncomfortable, much as the clumsy "PWD" does. I've repeated this many times previously; We're all very different. The use of some words and phrases doesn't cause me any upset and I believe that to be commonplace among other diabetics. 

What does cause me upset is the stigma surrounding complications. And not just because I've lived through several different eye problems. Indeed, I haven't felt stigmatised in any way for my diabetes related complications, but I know that others have and I know that many others fear talking about their own complications due to the reactions of others. That needs to stop. 

Through my own engagement with the online diabetes communities, I've learned much about my T1D. I've improved my diabetes management and probably given myself a much better long term outcome. If we open the door to discussing complications, normalise the subject, provide support through communities and peers as well as directly in clinic, then I firmly believe we can lessen the severity of complications in many. Why? because fewer will think twice before asking a question online, fewer will be worried about approaching their doctor for advice, the early stages of complications can be picked up on and stopped or slowed down before they become severe.

So, if you've got complications concerns, a question, experiences to share, etc then hit your socials. There are many who will support you and benefit from your engagement. If you experience negativity, use your mute or block buttons. 

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Wednesday, April 5, 2023

Diabetes Abuse

 

Living with diabetes can be a challenging experience, and connecting with others who understand what it’s like can be incredibly beneficial. However, as with any community, there can be issues that arise, including abusive behaviour. Unfortunately, even within the diabetes community, there are people who engage in abusive behaviour towards their fellow diabetics. This can take many forms, from bullying and shaming to outright harassment and intimidation.

It’s important to recognise that abusive behaviour is never acceptable, regardless of who is engaging in it or why. No matter how frustrated or angry someone may be, it is never okay to take that out on another person, especially someone who is dealing with the same struggles that you are. In fact, engaging in abusive behaviour towards other diabetics is particularly harmful because it can undermine the sense of community and support that is so important in managing diabetes.

Here are some of the reasons why it’s essential to not accept abusive behaviour within the diabetes community:

• It undermines the support system

One of the most significant benefits of the diabetes community is the sense of support and understanding that it provides. When you connect with other diabetics, you can share your experiences, exchange advice and tips, and find comfort in the fact that you are not alone. However, when abusive behaviour is present, it can erode that sense of support and understanding.

People who are subjected to abuse may feel isolated and alone, as if they have no one to turn to who will understand what they are going through. This can make it more challenging to manage diabetes, as the support that they would usually rely on is no longer available. It’s essential to create a safe and supportive environment within the diabetes community to ensure that everyone feels comfortable seeking and offering support.

• It can have negative mental health consequences

Abusive behaviour can have a significant impact on mental health. For people with diabetes, who already have to manage the stress and anxiety that comes with living with a chronic condition, this can be especially harmful. Abuse can lead to feelings of shame, guilt, and worthlessness, which can exacerbate existing mental health issues or even lead to the development of new ones.

It’s crucial to prioritise mental health within the diabetes community, and that means not accepting abusive behaviour. People with diabetes need a supportive environment where they can feel safe discussing their struggles and seeking help when they need it. If abusive behaviour is present, it can make people feel even more isolated and alone, which can be detrimental to their mental health.

• It perpetuates harmful stereotypes

Unfortunately, there are still many harmful stereotypes and misconceptions about diabetes. Some people believe that diabetes is a result of poor lifestyle choices, and that people with diabetes are lazy, unmotivated, or lacking in willpower. These stereotypes are not only untrue, but they are also harmful and can contribute to the stigma that people with diabetes face.

When people within the diabetes community engage in abusive behaviour, they are perpetuating these harmful stereotypes. By shaming or bullying other diabetics, they are essentially saying that they believe these stereotypes are true, and that people who struggle with diabetes are somehow to blame for their condition. This can be incredibly damaging, both to the individual who is being targeted and to the community as a whole.

• It creates an unsafe environment

Abusive behaviour can create an unsafe environment within the diabetes community. People who are subjected to abuse may feel uncomfortable attending diabetes-related events or engaging with others in the community. They may feel that they are at risk of being targeted again, and that they have no recourse if that happens.

Creating a safe environment within the diabetes community means ensuring that everyone feels comfortable and supported. No one should feel as though they are at risk of being targeted or harassed. When abusive behaviour is present, it can undermine that sense of safety within the community.

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