Sarah Howard
Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.
Sarah and her husband live in NYC with their cat Gracie. In her spare time, she enjoys doing comedy, taking dance classes, visiting art museums, and exploring different neighborhoods in NYC.
In my personal experience as a RN, CDE, DCES, and long -time T1 PWD, I have encountered many people in the general population who are uninformed & confused about the difference between Type 1 and Type 2 diabetes, pre-diabetes and/or insulin resistance. True – all forms of diabetes impair the physical body’s ability to produce and/or utilize insulin effectively to maintain homeostatic blood glucose levels. Sadly, this general lack of knowledge to differentiate diabetes type is prevalent even amongst people working in health care professions, including doctors and nurses. Not all persons with diabetes fall into the same category. There are nuances of diabetes that must be considered – especially when weighing a proper diagnosis of T1 or T2 diabetes. Manifestations of T1 diabetes in most cases is usually fairly sudden with acute symptoms of severe hyperglycemia and is pretty straightforward, unless the PWD is an adult being mistakenly treated for T2 and they actually have LADA. LADA can be a more gradual process and because it is still a fairly new concept to many health care providers, it all too often goes unrecognized and is an underutilized diagnostic consideration amongst many primary care providers. With an obesity epidemic occurring worldwide in many countries, more and more kids under the age of 18, and as young as 6 to 8 years old, are being diagnosed with metabolic syndrome insulin resistance that if left unaddressed and untreated can gradually lead to T2 diabetes. As such, T2 diabetes is a very different disease process from autoimmune driven insulin deficiency seen in T1 diabetes. T1D was formerly known as juvenile diabetes. But as we now know, not all T1 PWDs are diagnosed as children. And children with T1 diabetes grow up to be adults with T1 diabetes. And T1 diabetes does not change into T2 diabetes when T1 children reach adulthood. Nor does T2 diabetes turn into T1 diabetes – even if/when the T2 PWD requires insulin. Truth be told – onset of diabetes no longer fits into any one age category to make assumptions about what type it is. IMHO, it can be better characterized and understood as insulin deficient or insulin resistant, with an age of onset qualifier – such as juvenile or adult onset T1 diabetes; or juvenile onset insulin resistance or a confirmed diagnosis of T2 diabetes in youth. These considerations are important to make an appropriate determination between T1 diabetes and T2 diabetes.
I said 25-50% know the difference, but I’ll also say that they don’t know much about either disease unless they have a family member or close friend who has either Type 1 or Type 2 diabetes. There seems to be a total lack of differentiation when diabetes is discussed on news shows that are trying to educate the public about diabetes.
I have read both Connie and Bonnie’s comments and completely agree. I have been a Type 1 for over 45 years. Last year I had a severe accident in my bathroom wherein I broke my left ankle and the lower leg. I had to keep reminding hospital staff that I was a T1 Diabetic and pointed to my wrist bracelet that I was. I was appalled that the Nurses who attended to me had no idea of the difference. Between the two. My family member remembered to bring my diabetic kit with me. She knew I was very reluctant to go to emergency without it from a past bad experience. I strongly urge all T1’s to have a complete kit ready before going to hospital especially emergency. If you wear an insulin pump well then the danger increases.