One of the hardest parts about type 2 is the jokes.
There are different types,
There are jokes about T2 by T2s for other T2s, both lighthearted and gallows humor, and that’s where all of the fun ends.
There are jokes by T2s at their own expense which hurt by proxy. There are jokes about the disease made by comedians which moralize or take aim at us, and there are jokes about obesity or sugar intake which both do and don’t actively target my demographic but identify and transform it into a punchline all the same.
I’ve seen young people in online communities confess that they prayed their diagnosis would be type 1 because even at 17 years old they’ve already been exposed to enough of the stigma to be preemptively ashamed of themselves.
I’ve seen other T2s express self-hatred for their condition, sharing deep-seated self hatred and regret for not being able to summon the will or motivation ex-nihilo to just cold turkey all the bad habits and make a perfect 180 turn, suggesting they believe somehow they should be able to do just that.
I’ve seen many memes, reddit comments, and even a professionally produced comedy series for youtube where other types of diabetics refuse to defend type 2s, choosing instead to deflect or even actively stigmatize us for even sharing the nomenclature with their disease which they view as morally superior or even sympathetic where it’s implied or expressed that T2s deserve their fate, we deserve the stigma.
I do not deserve blame. I refuse to make that conclusion. My family history proves it, and even if it didn’t, the wide array of genes that cause predisposition and the ultra-processed food complex would give perfectly exculpatory explanation just the same. Modern life is broken, and never before in the history of man-kind has there been a need at scale for people to actively fight the prevailing lack of access and motivation to exercise. The jokes are about sugar, but sugar is nowhere near new. Office jobs are new. The ‘bliss point’ (I encourage you to research this topic) is new. The widespread occurence of obesity in the poorest among us is new.
There are underweight people who are diagnosed with type 2 diabetes mellitus. There are severely obese people who are never diagnosed. Among the many physiological reasons some are worth highlighting: hormones and types of adiposity.
If you have low food noise (caused by inherited hormonal deficiency or sensitivity), but you also never exercise and choose nutritionally deficient foods, you will become “skinny fat”. You will have little noticeable subcutaneous fat and you will have a high fraction of visceral fat, the type that surrounds the organs of your GI tract and creates insulin resistance.
Insulin resistance leads to spiraling insulin demand and eventually deficiency, and this is the physiological process or ‘etiology’ of type 2 diabetes mellitus.
If you have very high food noise, but you choose relatively healthy foods and you work a meaningfully physical job, you can become obviously overweight without the adipose tissue collecting around your organs. You can avoid insulin resistance but it seems from what I read that every doctor will be surprised when your A1c is normal. Even after all the education they recieve, the prevailing pattern means even healthcare professionals still fall for the mental heuristic of ‘obesity = type 2’.
This disease is epidemic for reasons that exist outside of individual’s control. Poeple have not suddenly become more gluttonous by fraction. Instead, gluttony has likely persisted at a normal, physiologically unavoidable rate while the food environment around it has changed radically, faster and faster as technology forms a never-ending positive feedback cycle tearing us away from the physically demanding agrarian work that enabled the very same technological civilization
T2 begs for your understanding, but because people would rather think fast than slow, because we would rather blame someone for their condition and imagine that we do not deserve such a fate and that is why we don’t suffer it, there is no chance that the moralizing jokes aimed at the obese or eating disordered stop. And because in recent years (in my expeirence) directly joking about obesity and eating disorders has been recognized as harmful (the way it always should have been) for some time now to come those same jokes will be smuggled into the cultural commentary unde the guise of and at the expense of type 2.
So here I exist, having lost 120 lbs, having changed my whole life slowly and carefully to regain and preserve what pancreatic function I can. And what’s my reward?
I find out a real fraction of doctors refer to my demographic collectively as “HONDA”s, or ‘Hypertensive, Obese, Non-insulin Dependent Assholes’ or some slight variant of the term, referencing the older “non-insulin dependent” terminology rather than type 2, showing the age of this acronym.
I hear jokes about type 2 diabetes from the most wholesome youtuber I follow, a guy with no political or hot takes whatsoever who just shares the american national parks and his van build and life with his cats.
I encounter other diabetics who are actively hostile, angry and moralizing when I just try to find solace in my own demographic’s online support groups because the recommendation algorithms have no discrimination between types of diseases.
And I don’t get to eat the popular snacks available at every cash register I visit, even sitting there taunting me when I go to the pharmacy to pick up medication.
I should love being a type 2 diabetic. This disease has turned my life around and given me a new profession to pursue.
But as Sartre so astutely wrote “Hell is other poeople.”