DIABETES IS THE NEW AIDS

Diabetes is the new AIDS. I’m going to make an argument supporting this assertion, which is triggered by the desire of some jurisdictions to list everyone who has the condition, regardless of whether it is controlled and without knowing the cause. Their position is that since uncontrolled diabetes leads to very expensive problems that require radical treatment like amputation of feet or renal dialysis and since (they assume) the main body of victims are poor people or people who otherwise neglect proper compensation for diabetes, then the cost for all this treatment becomes a public expense, so the authorities should find out who these people are and “guide” them through counseling about prevention.

So, here’s what I see:

1. First, the stigmatization of the persons involved. These people are not gay, but they’re poor and fat (the assumption is) and therefore have no rights. (Many people, asked whether they would rather be buff and gay or fat and poor, would have to think it over -- like Jack Benny considering “your money or your life.”)

2. Once people are identified, laws and requirements can be imposed. Already diabetics can be passed over for jobs or for health insurance, on grounds that they are too expensive and their condition might impair their thinking or performance. It’s a bit like being epileptic. And when people like the former governor of South Dakota use diabetes as an excuse for auto accidents, they encourage that thinking.

3. Diabetes is a wonderful marketing tool. If not inventing new wonder drugs, resourceful people can market membership in an organization like the ADA, which can then sponsor advertisements for special foods, shoes, and so on. It’s as big as Weight Watchers, at least. A mailing list of potential clients is worth enough bucks to likely overwhelm the need for privacy.

4. Once the demographics of diabetes are “proven” to be predominately Indian, Mexican, old, poor, fat -- in short, "other" or at least "not me") it becomes very easy to blame the victim. They are “sugar pigs” who can’t control themselves or follow simple instructions such as “eat high quality food” or “get lots of exercise.” This relieves the authorities of inquiring into the possibility of industrial contamination from plastics or food ingredients or feed lot “meds,” etc.

5. The basis of Type 1 Diabetes is clear: failure of the Isles of Langerhans to produce enough insulin or ANY insulin, sometimes due to the Isles being altogether missing. Success in understanding and compensating was brilliant. But the basis of Type 2 Diabetes is unknown. The research is only beginning to get below the surface, detecting “new” kinds of diabetes so there are several different versions of “Type 3” diabetes from gestational to brain insulin production, possibly keying into Alzheimers. No one wants to say “prion.” Many are now persuaded to say “metabolic syndrome,” meaning that blood sugar feedback loops are linked to lipid management and blood pressure, suggesting a common cause somewhere deep in the body’s “symphonic” system. Vitamin deficiencies, exposure to radio waves, genetic mutations, and so on present such a plethora of possible causes that it’s hard to keep order.

6. Doctors are not at all sympathetic to the management of diabetes. Their theories don’t work, their meds have strange consequences, the amount of explanation and “talking therapy” that is needed turns them off, the patients are not upscale or even grateful, and checking feet seems like nurses’ work.

7. This has encouraged people to form blog communities, support forums, and other “horizontal” ways to work on the problem. They have learned to bypass the doctors by using home meters or going directly to labs. This makes the doctors more insecure and irritable, which pushes the people back to their peers.

8. A certain amount of fatalism sets in. “There’s no use in trying, because I’m doomed.” Then avoidance, procrastination.

9. Helplessness soon follows. Inertia, resignation. “If I’m going to die anyway, I might just as well...”

10. The enormous social importance of food in our lives is VERY hard to handle. Birthday cakes, wedding cakes, Christmas cookies, Halloween candy, Valentine chocolates and friendship coffee klatches are the ways we structure and commodify our symbolic lives. “Taking lunch,” having “power breakfasts,” are the least of it. Your gramma wants to fix your “favorite food,” which his not likely to be diabetic friendly. It’s such a temptation to eat all that stuff and then medicate to compensate, instead of cutting waaaaay back on the food and training oneself to eat a different way.

And so secrecy, denial, failure to address the problem.

But what’s worse is that the right amount of money in the right sort of places is withheld. We do not need “no-fat Twinkies.” We need someone willing to go around small towns and reservations taking blood pressure and washing feet. We do not need research on how to produce no-calorie food, we need food distribution networks that are trustworthy and chemical-free.

I’ve come to hate and fear lists of “deficient” people, because they so often are just pass-throughs for mega-corporations, like the Medicare drug bill, so that the government will pay for stuff that is later discovered to be ineffective or dangerous (like many diabetes drugs). And because they are used to pass draconian laws, like requiring people to buy health insurance or publicly register as sex offenders. I can imagine quarantines, sequestration, putting people on reservations (Indians are already conveniently there, just as many ghetto dwellers are black and red-lined). Once the authorities have control of people, as they do prison felons, they can control what’s eaten or how much exercise one can perform. Is it too sci-fi to imagine institutions where diabetics are confined, as TB patients were once, forced to eat “healthy food” and marched around a yard? Don’t we already do that with fat camps for kids?

Of course, once the government is involved, they’ll look for the cheapest way to manage and if it’s outsourcing we may all find ourselves eating All-Bran noodles in China before our morning march.

Scared? Disgusted? Think I’m making it up? Watch the newspapers. Backlash? Bring it on.