I was diagnosed with type 2 diabetes in 2011. I had a routine physical, I got my bloodwork results in the mail, I knew what to look for. And I knew it was probably coming.
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SPOKESPERSON
You know who Paula Deen is. She’s the not-thin Southern lady who has a restaurant and cookbooks and some TV shows and lines of cookware and housewares and clothes. The one who makes Food That Is Bad For America, who is hilarious to watch when she’s on Craig Ferguson’s show. It turns out she’s had type 2 diabetes for years, and she’s coming clean about it because she’s landed an endorsement deal with Novo Nordisk, a pharmaceutical company that makes the diabetes drug Victoza.
This makes my head explode. Yours too, maybe. But I’ll wager my blast pattern is different.
BACKGROUND
I was diagnosed with type 2 diabetes in 2011. I had a routine physical, I got my bloodwork results in the mail, I knew what to look for. And I knew it was probably coming.
I had gestational diabetes in 2000. Gestational diabetes is otherwise known as Type 2 Diabetes That Goes Away When You Expel A Fetus – and my odds of getting Non-Fetus Expellation Related Type 2 Diabetes went up sevenfold after GD, according to the National Institutes of Health. Bonus: I had insulin dependent gestational diabetes. I had to inject insulin once a day for the last month I was pregnant. That was practically a VIP invitation to…to…
THE NAME
Type 2 diabetes should have a different name. To put it far too briefly, type 1 diabetics’ bodies can’t make enough insulin to manage their own blood sugar. Type 2 diabetics’ bodies give insulin the finger until the pancreas says “You know what? Fuck this,” and gives up.
I’ve spent some time trying to come up with a new name for type 2 diabetes. It hasn’t been easy. You can’t name it Fatty Fatterson Disease or The Obesity Apocalypse or God Sorting Out First World Consumerism because type 2 diabetics come in all shapes and sizes, and not all fat people have it, even though, as it happens, I am a fat woman who does.
As a result, renaming type 2 diabetes requires some deeper thought. Type 2 sucks — but it doesn’t suck as much as, say, cancer. You can’t name it after people who suck but not as much as cancer sucks, because then people will think Kim Kardashian has type 2 diabetes…and if she does, she’s keeping it to herself for now. You can’t name it after a body part, because so many are implicated. Ask any physician to finish the sentence “Type 2 diabetes is a disease of the ________.” and you won’t get the same answer twice.
My current favorite name for type 2 diabetes is Six Years Off. That’s how much an average Type 2 diabetic’s lifespan is shortened, according to this study. But that, understandably, creeps some people out. So until this gets dealt with by a UN committee, I mostly call Type 2 diabetes The Reason I Don’t Eat Your Blueberry Muffins, Even Though You Have Assured Me They Are Healthy. And even that doesn’t work, because some type 2 diabetics do eat them. Do you see why this is taking me so long?
YMMV
So. I have an epidemic-level disease that has a bad name. But what does that mean, exactly?
For me, it means that I am urged to do things like get flu shots, get referrals to other medical specialists, go to diabetes education sessions, take statins, and take high blood pressure medication when my blood pressure is not high by normal standards. For me, it means that I take 500mg of a generic drug called metformin every morning, for which I pay $14 a month. It means I check my blood sugar often enough to have a little black zippered case that sits on my kitchen table. It means I exercise more than I used to, and I eat differently than I used to. For me, for now, it means these things alone are enough to keep my Six Years Off under control. And in the world of Six Years Off, I am quite fortunate.
Other type 2 diabetics are not as fortunate as I am. Victoza, the type 2 diabetes medication that is now on Paula Deen’s list of endorsements, can cost $500 a month if it’s not covered by insurance – and often, it isn’t. Overall, the CDC estimates that diabetics’ healthcare expenditures are, on average, 2.3 times higher than nondiabetics. Drugs like Victoza are only part of the reason why.
For all of us type 2 diabetics, the disease means we might lose a foot or a hand or eyesight or six years or a heart. Even if we tried everything we could to stop it from happening.
It sometimes means people think we had it coming.
BLAME
Six Years Off is exacerbated and diagnosed through high blood sugar. Eating foods that are high in simple carbohydrates elevate blood sugar. Foods that can be high in simple carbohydrates include white bread, soft drinks, cereals, juices, and milk. Other types of foods with carbohydrates can affect blood sugar as well. Foods that are never high in simple carbohydrates include meat, eggs, butter, and cheese.
Even before her diagnosis came to public light, Paula Deen took a lot of shit for the stuff she cooked. Every article since her announcement (and all of the ones before) mention examples of her cooking, because it’s pure food porn. Nearly every article mentions butter and bacon as the culprits for diabetes. Articles that mention Paula Deen’s donut hamburger focus on the hamburger.
Those articles should focus on the donut.
LUNCH
The amount of carbohydrate in food, or how it affects each Six Years Off, is not always synonymous with our country’s perception of what is healthy.
Foods I usually turn down include pizza no matter what’s on it, rice, pasta, bagels, muffins, potatoes, cherries, regular beer, and most things with sauce where I haven’t read the label or watched it being made. I eat meat of all kinds, and fish. I eat eggs. I also eat vegetables – lots and lots of them – but not much fruit.
The RDA for carbohydrates is about 300 grams. Most of the time, I’m at about 100.
With Six Years Off, there is nothing that goes into my mouth that I don’t think about before I put it there. Nothing. If you see me drink a beer or eat a bagel, know I have done a fair amount of mental weighing of the issues at hand.
You should probably also know that if type 2 diabetes eating plans were global spirituality, I would be a member of a large and prominent cult. The American Diabetes Association does not recommend eschewing carbohydrates to the degree that I usually do. But I am reasonably happy with my path, because I am very happy with my results. And for now, it only costs me $14 a month.
As I write this, I’m eating baby spinach out of a bag. I dip it in blue cheese dressing that I’ve poured into one of the little cups my (preteen, non-diabetic, non-obese, because I know you’re wondering) daughter used to eat Cheerios from as a toddler. The blue cheese dressing has bacon in it. I don’t know how much fat is involved, but I do know this dressing has somewhere between zero and one carbohydrate per tablespoon.
I know how many carbohydrates are in lots of things. Go on, try me. Cottage cheese? About 20g for a regular size tub. Sliced bread? It varies, but usually between 10 and 40g a slice. That’s a pretty big spread, by the way, and there’s no way to know for sure unless you actually read the label. Two tablespoons of chocolate chips? 18g or so. A liter of Diet Pepsi? Zero. Sugar free candy? Not much fewer than regular candy, not worth it. String cheese? Less than one per stick. I fucking love string cheese.
THE PROBLEM
It pisses me off that Paula Deen takes shit for her type 2 diabetes. Paula Deen, according to her own website, knows a thing or two about grief, poverty, and mental illness. Paula Deen came to her success during an era where mental health treatment was costly, full of stigma, and sometimes terrifying in what it could do to patients and their families. It’s not hard to imagine choosing addiction instead. It’s not hard to imagine choosing food addiction, which, unlike other types of addiction, allows one to continue functioning in the world as a responsible human being even while you’re being judged by others. That this choice ended up lucrative for her is not unheard of, either. Would Robert Downey, Jr. be as interesting without his backstory? (Or Anthony Bourdain, for that matter?)
At the same time, Paula Deen really pisses me off.
Imagine you are a successful, famous person for whom money is no longer a problem, and you are diagnosed with a chronic disease that, according to the Centers for Disease Control, affects 8.3 percent of the American population. In addition, it’s estimated that over a third of the population is pre-diabetic. And on the American causes of death hit parade, diabetes is Killer Number Seven. (Which might be even catchier than Six Years Off, actually.) Now, imagine that you famously live in a certain state, and it’s a state where private insurers can deny coverage to Type 2 diabetes patients. And that the advocacy group for this chronic disease, the one that works on health care reform in this area, could probably use some star power.
What do you do with all of that? If you’re Paula Deen, you ink a deal with Novo Nordisk to promote a drug that you yourself would probably not have been able to afford thirty years ago.
For the record, I’m not thrilled with Wilford Brimley, either.
EASIER
I don’t eat at night anymore, but I’m still a nightowl. Sometimes I watch Adult Swim on the Cartoon Network. One of the perennial commercials between Metalocalypse and Moral Orel and King of the Hill is The Diabetes Care Club. A couple that’s older than I am tells me that I don’t have to stab my fingertips anymore! There’s a new method of testing my glucose that’s nearly painless! They don’t say what it is, but I know because it is now my business to know these things! It’s stabbing my arm!
Here’s the truth: Testing glucose hurts less than a bad paper cut. If stabbing your fingertips hurts that much, you might want to work on technique before you get a brand new meter. Oh, and what you need is a new lancet…not a new meter. The meter reads the test strip. The lancet stabs.
Self-mutilation is easily the part about Six Years Off that freaks other people out the most. People get visibly uncomfortable when I bust out my little kit with the lancets, and they look away when I cock the spring mechanism before I bring it down on the side of my pinky (see above: technique). God, I hope I never have to do that, they think.
The paying attention to everything you eat, the exercise, the physicians, the expenses, the fear of what the future might bring. None of it seems as bad as sticking yourself with a lancet.
I know that’s how people think. I used to think that way myself.
“Fuck you,” I say to the old couple, every time. If I wake up my husband, he knows it’s just the Diabetes Care Club. And he goes back to sleep.
