Saturday, May 26, 2012

Rethinking Type 2

I just watched a YouTube video of a Barbara Walters show with Paula Deen as co-host, and Dr. Jeff Nathan and young Misty Ayala as guests. You can see it at
First off, Dr. Nathan DID distinguish between Type 1 and Type 2 very clearly, and to me, it was obvious that when he was talking about lifestyle changes and about Misty, that he was talking about T2. My only real complaint is the label "the Fat Show", simply because the real problem with merely correlating T2 with obesity is that it doesn't HELP anyone. Telling people they're fat when they know perfectly well they are, and already feel guilty and ashamed about it is not really helpful. Seems to me that the issue is not whether people with T2 are fat, but understanding that metabolism is complicated, poorly understood, and very hard to regulate when it's malfunctioning. And there is increasing evidence that T2 is NOT a merely a disease of pancreatic malfunction, but a panoply of metabolic dysfunctions. The fact that Misty was able to come off Metformin, and get good control of her diabetes while remaining obese points very clearly to the fact that obesity is not the CAUSE of T2, but more likely a result of metabolic dysfunction, whose mechanism is not yet fully explored. I think this is what T2s are trying to say when they object to the linking of T2 and obesity. And it seems like many people are plugging their ears and singing lalala when T2s try to make this point.

One of the things I am working hard on is NOT to take it personally when the media is clearly talking about obese T2s. I know that T1s get upset when they are ragged about why don't they clean up their diet, etc. by people who really don't know anything about diabetes, but it's JUST ignorance, and we really need to learn to let it roll off our backs. In my mind, it's just about the same as when people tout miracle cures for ANY disease. I do have my own personal crap detector (AKA Snopes) in my brain, and I'm really working on learning to use it more automatically. The real issue is to call out the bullshit when appropriate and to be able to distinguish when it IS appropriate. When your best friend tells you that your diabetes could be cured if you'd eat less, call them out on it, and when the media fails to clearly distinguish between the types, send out answers and press releases, but when the media IS appropriate, even if not perfect, as I thought this show was, I think they should be applauded for it, not criticized.


  1. I agree Natalie, he did explain the difference very clearly. I don't expect anyone to keep saying Type 2 every time the word diabetes comes out of their mouth as long as they are clear the first time which type they are talking about. I didn't like the name of the show either.

  2. Thanks for the thoughtful post, Natalie. I think you're absolutely right: We need to stop taking it personally. And look at things out of a broader D-community lens, rather than our own individual lens. That's the only way we can grow and strengthen ourselves as a community.