Comment by cynicalsecurity | Hacker News Reader

Comment by cynicalsecurity | Hacker News Reader

cynicalsecurity

There is no such thing as "diabetes", people should start distinguishing between type 1 diabetes and type 2 diabetes - they are different diseases. Type 1 diabetes is an autoimmune disease with no cure, not caused by food, lifestyle or weight, and is an absolute living hell; while type 2 diabetes is caused by excessive weight and can sometimes be put into remission or even fully cured through weight loss.

Learn about type 1 diabetes to understand why this distinction matters.

Type 1 diabetes is not caused by food or weight. It results from an autoimmune reaction that completely destroys insulin-producing beta cells. No one understands what causes type 1 diabetes, but generally it's believed to be caused by viruses and infections. Sometimes you can read about "genetic factor", but overall majority of people with type 1 diabetes have no family history of this disease.

The incidence of type 1 diabetes has been increasing in many countries, and researchers do not yet understand why. It most often appears in children and young adults and currently has no cure.

Once again: type 1 diabetes appears to be random and has no cure. It's not caused by food or weight in the slightest. And your life (of life of your child and yours too) suddenly becomes an absolute living hell. Think about it for a second.

For some unknown reason public awareness of type 1 diabetes is hugely limited compared with other incurable diseases. For example, in the UK more people live with type 1 diabetes than with HIV, yet until someone is directly affected, they usually know nothing about this disease. It hits them like a train.

I completely agree.

While the other person replying is not technically wrong about why these things are grouped, it is kind of offensive to sufferers of Type 1.

In one case, a 3yo starts randomly getting sick one day, worse by the day, and will be dead if they don't get a diagnosis soon. From that day forth, their parents need to manage EVERY single bite of food they have, stab them with needles multiple times a day no matter what, and inject them with a insulin - where, if you miscalculate, will cause a seizure within an ~hour and death within a few hours. From a single typo.

Nothing will cure them, their life will be much shorter, filled with work and pain and expense with absolutely no relief, and nothing could've avoided it.

Now compare to Type 2, where you basically cannot get it if you maintain a reasonable diet and a reasonable weight.

Once you start showing symptoms, if you listen to your doctor and reform your diet (particularly with the 5% shock weight loss approach), you will almost definitely avoid it.

You will avoid it for the rest of your life just by eating well, which has the added benefit of extending your lifespan and healthspan and saving you money.

These things have nothing in common, for the sufferer or their family.

By the same logic, there's no such thing as "cancer", a "cold" (or more accurately: upper respiritory illness), or a broken leg, since each of these have many distinct causes.

All models are wrong, some models are useful. And some are based in at least part on historical accident and sequence of understanding. Diabetes (etymology, Greek diabetes, excessive discharge of urine), is one such of these.

Of the multiple distinct types of diabetes currently recognised (types 1 & 2, which you note, gestational, MODY, 5, and possibly several others), there is a commonality of primary symptoms (unregulated, often high, blood sugar), treatments (most must or may be treated with supplemental insulin), monitoring (of blood glucose levels typically by finger stick or CGM, as well as HgA1C for longer-term status and progression), of healthcare providers specialising in the diseases (generally endocrinologists), and of long-term complications: high blood pressure, heart disease and failure, neuropathy, poor circulation, various infections, and often peripheral limb amputations.

Thus the medical literature notes that diabetes is a group of common endocrine diseases all sharing high blood sugar levels, though of distinct types having distinct causes but largely similar treatments.

In the same sense, treatment for a broken leg largely doesn't distinguish on the cause of the fracture (blunt trauma, falls, osteoperosis, gunshot), treatment of respiratory illnesses is similar despite different infectious agents, and cancers, whilst varying greatly in prognosis and treatment, share the commonality of unregulated growth and metastases, with similar end-stage consequences.

All labels and concepts are human constructs to simplify a complex world. Absolutism over definitions tends not to be especially enlightening. Or useful.

I'm not nitpicking. Using "diabetes" instead of "type 1 diabetes" or "type 2 diabetes" really hurts people with type 1 diabetes. It's a dangerous confusion.

By default, people assume "type 2" when they hear "diabetes." They don't understand that type 1 is a completely different disease - and an absolutely terrifying one. Type 1 and type 2 are as different as day and night. It's like having runny nose vs having no nose.

This confusion harms awareness of type 1 diabetes. It undermines the urgency of finding a cure and shifts attention away from type 1.

When people are diagnosed with type 1 diabetes (or, more often, when their toddlers or children are), they get furious that this confusion exists at all - and that they knew nothing about type 1 diabetes beforehand.

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