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Thursday 8 November 2012

Laying Blame: Why Do People Get Diabetes?

Alex O’Meara | June 12, 2012


People get diabetes because they’re fat. They get diabetes because they don’t exercise. They get it because they’re lazy and they lack discipline in controlling their appetites. They get diabetes because they’re out of shape slobs. People get diabetes because they deserve it.
 
Most people won’t say this to your face, but that doesn’t mean they’re not thinking it. The extent to which people believe that diabetes is the fault of the diabetic became very apparent, recently, after a finger pointing exchange about blame for the condition by two celebrity chefs. And what that reveals is an underlying societal discrimination of diabetics that could cost people their lives.
 
In January celebrity chef Paula Deen revealed she had type 2 diabetes. The creator of a hamburger featuring doughnuts in place of a bun was met with a backlash of blame. She was drawn into a kafuffle with fellow celeb chef Anthony Bourdain when he said he thought it was in “bad taste” for Deen to be dishing high fat Southern cuisine while she had diabetes and had not told the public about her condition. The implication was that Deen’s recipe for loaded mashed potatoes was the food equivalent of a loaded gun because, clearly, eating such rich foods leads inevitably to diabetes.
 
“People out there with diabetes haven’t chosen this,” Deen said in response to Bourdain’s comment. “It’s not their fault. So many things play into whether or not you get diabetes. I thought [what Bourdain said] was very, very cruel.” (prevention.com)
 
And that’s when it got ugly. That was when people stepped up and, from behind their anonymous postings on blogs and Internet sites, laid the blame where they believe the blame belongs.
 
“Look people, there are consequences for what you put in your body,” an anonymous poster wrote on thestir.com in response to an article about Deen and how much responsibility she should shoulder for her condition. “This isn’t some autoimmune disease. It won’t ‘just happen no matter what you do.” If you are taking dietary and/or health advice from a woman who ate herself into obesity, you deserve what you get.”
 
There’s that word: deserve. The “they deserve it” argument isn’t new to healthcare. People who smoke cigarettes deserve to get lung cancer. Gay men who engage in unprotected sex deserve to get AIDS. Overweight people deserve to suffer heart attacks. The “they deserve it” argument, however, is more than just an opinion about Old Testament retribution for lifestyle choices.
 
In the cases of AIDS, lung cancer, and heart disease, more people died and got sick than otherwise might have because the idea that they deserved to be sick was accepted on a mass scale. That institutionalized belief in blame restricted funding, which hampered research, which, in turn, cost lives.
 
As an example, President Ronald Reagan spoke about AIDS for the first time in 1987, more than six years after the virus was first identified. Between 1981 and 1987 almost 60,000 people had acquired the virus, and almost 28,000 had died. If Reagan had made a speech about the need for AIDS research and treatment in 1982, how many people’s lives may have been significantly extended through research into creating more effective medications?
 
With diabetes, we’re in 1981. Paula Deen helps provide another example of how thoroughly accepted it is to casually blame diabetics for their diabetes. When Deen was poised to reveal she had diabetes, ABC News previewed her announcement in a story called: “Paula Deen to Confess She Has Type 2 Diabetes.”
 
Confess? Don’t people typically “confess” to something they’re guilty of, something they’re to blame for?
 
While it might seem silly to think the name of an ABC News story is a cultural bellwether, it’s not once you look at some numbers that are representative of overall research spending. In 2006, according to the New York Times, the United States government spent ten times more, per patient, researching cancer than researching diabetes. This despite the fact that the number of people with diabetes is on the rise, while the number of cancer patients is falling.
 
One way to explain that disparity is that most people simply don’t believe diabetics deserve more investment in a cure. After all, they’re already getting what they deserve.
 
For more from Alex O’Meara see his essay Curing Diabetes: Would I Do It Again?
 
 
Alex O’Meara is the author of the book, Chasing Medical Miracles: The Promise and Perils of Clinical Trials. For more about Alex visit alexomeara.com. For further reading on clinical trials in general and on diabetes.
 
Alex O’Meara is a regular contributor to ASweetLife, he writes the blog The Other Side of Diabetes.