Diabetes' civil war

Laura Fitzgerald, 21, was diagnosed with Type 1 diabetes when she was 6 years old. She must inject herself with insulin daily. (E. Jason Wambsgans / Tribune)

It's possible for Type 2's to reduce their insulin resistance, usually through lifestyle changes such as diet, exercise and medication. In some cases, they can reverse the onset of diabetes altogether, if it's caught early.

Those genetically predisposed to Type 2 may even be able to stave it off.

"There's a lock and a key," said obesity specialist David Edelson, an assistant clinical professor of medicine at Albert Einstein College of Medicine of Yeshiva University in New York. "The key is a bad lifestyle that leads to weight gain around the gut."

The fact that many people assume that Type 1's also can do something to avoid getting diabetes is a sore spot.

"Type 1's clearly can feel like victims and say that Type 2's could have prevented it," Edelson said. "And to certain extent they could be right. It's a disease of bad lifestyle. My Type 1's work out fastidiously and watch their diet. If my Type 2's did what my Type 1's do, they'd probably cure themselves."

For Prairie Grove's Karen Ewert, both the diagnosis of Type 2 diabetes and her exercise plan have been life-changing.

"I feel better and I'm losing weight," said Ewert, who has family members on both sides with Type 1 and Type 2 diabetes. She works out with trainers five days a week, does her own cardio workouts and follows a dietary plan that includes frequent small and healthy meals.

"Controlling my blood sugar with diet and exercise only is my goal," said Ewert, who is currently on medication.

Competition for research funding also causes tension between the two camps, said Ryan Luce, the cofounder of corengi.com, a Web site aimed at helping people with Type 2 learn more about clinical trials.

Not surprisingly — since Type 2 diabetes is more common and has more treatment options — there are three times as many clinical trials for Type 2 as for Type 1 on the government's Web site, Luce said. For industry-sponsored trials, the ratio is 5 to 1.

More than 23 million Americans have some form of diabetes. Between 90 percent to 95 percent of the cases are Type 2, though some people have features of both, meaning both insulin resistance and autoimmunity, said Dr. Judith Fradkin, the director of the division of diabetes, endocrinology and metabolic diseases at the National Institutes of Health.

By 2050, health officials fear that as many as one in three U.S. adults could develop Type 2 diabetes because of the aging population, growth in high-risk minority groups and the extended lifespan of people with diabetes, according to an analysis by the Centers for Disease Control and Prevention. One in 10 U.S. adults has diabetes now.

Anxious to change the course of the disease, public health officials are aggressively preaching prevention. But the message applies only to Type 2's; so when Type 1's hear Dr. Mehmet Oz talking about "preventing diabetes" on "The Oprah Winfrey Show," they say it perpetuates the notion only one kind of diabetes exists.

"There is underlying resentment because Type 1 never goes away like Type 2 can and often does," said Natalie Kolok, cofounder of parentingdiabetickids.com whose 9-year-old twins have Type 1.

She sees a rift between the two sides and wants it to "widen into a chasm" to help create clarity.

"We just want people to understand the differences so they don't treat our children as if they have Type 2 and that it could have been prevented," said Kolok, of Burlington, Vt.

Greenberg, based in Brooklyn, N.Y., thinks a name change is worth fighting for, especially since Type 1 diabetes often comes on in childhood and "when children hear 'die-abetes,' all they think is that they're going to die," she said.

She proposes "betasin" — as in, "isn't it a sin my beta cells (in the pancreas) gave up?" — or "mellitus," the second half of the full name of the disease, which is "diabetes mellitus."

Hashemi-Rad, of Tonka Bay, Minn., said she doesn't really care what it's called; she just wants people to understand that she didn't get diabetes because of what she weighed before her diagnosis and that managing Type 1 diabetes is emotionally and physically draining.

When people tell her, "Oh, it's too bad your parents fed you so much sugar" or "If you just follow this diet you can stop taking insulin!" her anger rises to what she called "ridiculous levels."