I'm unlearning the shame that came with my diabetes diagnosis
Many of my doctors made me feel diabetes was my fault
This First Person column is the experience of Emily Brass, the host of the CBC podcast Type Taboo: Diary of a New Diabetic. For more information about CBC's First Person stories, please see the FAQ.
I was sitting on the exam table at a walk-in clinic, that crinkly paper beneath my legs. I was there for a fairly minor problem and expected to be done quickly.
But when the doctor came in, his expression was serious. I could tell something was wrong.
"Your blood glucose is high," he said, spouting off numbers that had no meaning to me. I was stunned and probably looked perplexed.
"You have prediabetes," the doctor said. "Do you eat a lot of candy? Soda pop?"
I told him I didn't. I eat mostly vegetarian food, including whole grains, fruit and veggies. Sure, I had some treats here and there and enjoyed a good pub night. But I'd actually just lost 40 pounds.
"Wow, I wonder what your blood sugar was before," he responded, which didn't make me feel better. The doctor gave me a pamphlet and sent me off. I felt blindsided and was still unclear what this really meant.
The pamphlet urged me to eat … well, pretty much the way I already was eating. I was also walking about 90 minutes a day.
In denial
Unsure what else I could do, I went on with my life, mostly forgetting about prediabetes. Looking back, I guess I was in denial.
A year and half later, I moved to Winnipeg. I still didn't have a regular physician, so I visited another walk-in clinic. Again, the doctor's recommendations were to stop eating junk food and lose weight.
I mustered some courage and confessed that losing weight has been a lifelong struggle.
His reaction was to laugh right in my face. My throat got tight, my cheeks started to burn. I felt shocked and ashamed that a doctor found my health troubles amusing.
He handed me a flyer for a weight loss group. I told him I couldn't attend since I work the evening shift. He shrugged and sent me on my way.
Still fuming, I began to wonder if he wasn't acting especially sympathetic because he thought I was to blame for my prediabetes. I started detecting a similar attitude in other places, like movies and podcasts, even casual conversations.
A lot of my relatives are on the heavy side despite being active and eating fairly well. But I've always been embarrassed about my weight, so I mostly kept my prediabetes to myself.
Two years after my initial diagnosis, my prediabetes progressed into Type 2 diabetes. I visited yet another walk-in clinic, where the doctor was busy and gruff. But she asked more questions, prescribed meds and lined me up with a public health dietitian.
Diabetes is a tough diagnosis. There's a good chance it'll shorten my life, and there is no cure. It puts me at much higher risk of kidney disease, stroke, blindness and amputation — all startling and depressing thoughts. I was also mad at myself for not acting with more urgency when I first learned I was prediabetic.
I didn't know how to deal with my sadness and remorse. I also needed advice on staying motivated with treatment and self-care. But I couldn't think of a single person I knew with Type 2 diabetes.
I started doing my own research and was astounded to learn one in three Canadians has diabetes or prediabetes, including an estimated 1.5 million people who don't know. About 90 per cent of people with diabetes have Type 2.
Experience far from unique
I was shocked and outraged! If so many people are affected by diabetes, why didn't I hear anyone talking about it in my circles?
As a journalist, I started doing interviews and learned my experience was far from unique. I spoke with people of all ages from diverse backgrounds. Some are overweight, others have been slender their entire lives. Most have at least one relative who suffered from the disease (including me). Several have had close brushes with death.
Diabetic after diabetic told me they felt that same sense of confusion and shame following their diagnosis. Many said embarrassment and guilt made them hide their diabetes, even from close friends and loved ones.
I've learned the risk factors for Type 2 diabetes are often out of the patient's control. Obesity is a major risk factor for some people. But poverty, colonization and systemic racism can all play a role. So can genes, stress, sleep deprivation — and the way our society is set up.
Like many Canadians, I work a fast-paced but sedentary job and don't have much time to prepare healthy meals. Foods loaded with sugar and white flour are cheap and easy to grab in Winnipeg's downtown core, while fresh veggies are expensive and hard to find.
The city is also car-oriented, with pedestrians and cyclists competing for space on the sidewalks. It's a pretty different lifestyle from that of my relatives just a couple of generations ago in England. They gardened, did physical labour and travelled everywhere on foot and by bike.
I'm battling these obstacles one small, manageable step at a time. I pack a healthy lunch, with more salads and protein. I find ways to sweat more often, adding bursts of jogging into my walks and taking the stairs. I meditate and play music. I found a therapist and a steady family doctor.
It's paying off so far. Within months, my blood glucose dropped to prediabetic levels.
But what helps me most is support. When I told a couple of friends I'd signed up for a 10K for Diabetes Canada, they immediately offered to do it with me. Not only was that a real morale booster, it made me train harder knowing I'd have eyes on me. In six weeks, I went from being able to jog one minute at a time to jogging a quarter of the race — with energy to spare!
Type 2 diabetics need support to get better — not shame. In fact, the biggest predictor of whether a diabetic will succeed at making health changes is whether they have social and family support.
For me, talking about diabetes was tough at first. But with the help of family and friends, I'm moving past denial and grief. I'm embracing the little joys of daily life, from walking in nature to strumming my ukulele. I'm healthier now, and I can feel the difference. In a funny, paradoxical way, diabetes has actually given my life more meaning.
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