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Strange Competition in Diabetes: "Are You Type 1 or Type 2?"
Neodiabetics will quickly find that it makes a difference whether you belong to the group of type 1 or type 2 diabetes. "While type 1 diabetes is perceived as an autoimmune disease and thus as fateful, type 2 diabetes is mostly perceived as a result of a lack of discipline and poor self-control, i.e. as self-inflicted", explains the doctor and psychotherapist Christian Tatschl the fundamental problem. That means: Anyone who eats too much and does too little sport is responsible.
Tatschl has specialized in the psychological consequences of obesity and type 2 diabetes and can clearly say: "Weight control and physical activity are not exclusively subject to voluntary control. Genetic, psychological and environmental factors also play a significant role in type 2."
Suggest contributory negligence
Nevertheless: the problem remains. Even medical professionals tend to be prejudiced: once diabetics are treated, people with overweight and type 2 diabetes are often assumed to be poorly adherent to therapy. Perhaps that is why a large survey in the US showed that a significant proportion of people with type 1 diabetes experienced stigma from confusing and associating their condition with type 2 diabetes. In fact, 19 percent of adults or parents of children with type 1 diabetes wanted the disease to be renamed in order to differentiate it from type 2 diabetes.
The strange competition between the groups also exists on another level: Type 1 patients do not want to be compared to type 2 patients and often feel that they are not as disciplined and athletic as necessary. Type 2 patients, on the other hand, are often proud that they do not need insulin, class the insulin-dependent type 1 patients in the vicinity of junkies. Another major problem for overweight type 2 diabetics is that they are asked to eat less, which is a major psychological challenge. Many type 1 diabetics are unaware of these food restrictions; on the contrary, they often consume large portions, and this disproportion creates a kind of envy, because in type 2 diabetics a permanent change in diet requires the avoidance of a number of foods.
Strengths as a strategy
The situation is a dilemma to some extent because, in and of itself, people with diabetes should empower one another. How urgently this is necessary is shown by a Swiss study in which the stigmatization of people with diabetes was examined. The question was to what extent people with diabetes are socially characterized with negative traits and are thus socially discriminated.
Of the 3,347 diabetes patients surveyed, just under a third stated that they had never been treated unequally because of their illness. Slightly more than two thirds have had negative experiences, especially when they have had to inject insulin in public. 55 percent were "looked at in a funny way".
There is also likely to be an image problem with the disease, namely that people with diabetes are old, overweight and therefore diabetic. This picture was confirmed by 48 percent of those questioned in the study. 43 percent said that those around them rated the disease as something "terrible" or that people with diabetes were seen as impaired in their performance. And 40 percent of all respondents assume that they are to blame for their diabetes.
Stigmatizing a disease is in no way beneficial. Not only does it affect emotional and social aspects of life, it also has a negative impact on the management of the disease. Anyone with diabetes knows that discipline plays a key role in this. Women with type 1 diabetes in particular feel that their emotional lives are impaired by diabetes-related stigmatization: 42 percent of the female respondents with type 1 diabetes suffer from feelings such as guilt, shame, criticism, embarrassment or isolation. At 30 percent in men, the emotional impact appears to be less pronounced in type 1 diabetes and people with type 2 diabetes.
More than one in four study participants felt their social life was impaired (type 1 diabetes 22 to 26 percent, type 2 diabetes 23 to 30 percent). Both those with type 1 diabetes (17 percent) and those with type 2 diabetes (22 percent) reported that the diabetes stigma had a negative impact on diabetes management, especially women with type 2 diabetes.
It is also interesting to ask what this type of stigmatization does to those affected: Many withdraw from society and increasingly participate less in social life if they do not feel that they are in good hands there. Anger, aggression, or denial of the disease can also result.
So what it must also be about in the future is well-known general knowledge about diabetes. And there is a lot of catching up to do. 66 percent of the general population (56 percent of whom are health professionals) think that the condition can be completely cured by a healthy lifestyle, and 80 percent still believe that obesity is a disease that a healthy lifestyle completely avoids or prevents . can even be healed completely. (Peter Hopfinger, November 25, 2020)
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