Wednesday, June 18, 2008

Which type of diabetes do you mean?

This morning on Colorado Public Radio, I heard a story about how diabetes and depression often cause one another. They didn't say which type of diabetes they meant, and although I knew they were most likely talking about type 2 diabetes (since the probability of depression causing an autoimmune response is pretty slim), it irritated me that they wouldn't say the words "type 2."

I couldn't find a link to the radio story on NPR, but I did find it on the Washington Post: Diabetes and Depression Go Hand-in-Hand. (Please note that this story does clearly state that they're talking about type 2 diabetics — it was only the NPR radio spot that did not specify which type they meant.)

It really annoys me when the media fails to specify which type of diabetes they're talking about. The two types of diabetes are actually very different — the diseases aren't related at all, even though the end result (too much sugar in the bloodstream) is the same. Type 1 diabetes is the inability to make insulin, because the body's immune system decided to go postal on its pancreas, while type 2 diabetes is the inability to use its own insulin, usually because age or obesity has caused insulin resistance in the body's cells.

In type 2 diabetes, a connection with depression makes sense, because depression typically makes people more sedentary and less willing to exercise, which in turn can exacerbate diabetes. And on the flip side, people who have been diagnosed and are being treated for type 2 diabetes could feasibly be more susceptible to depression, because of the stigma on diabetes in our society.

On the other hand, if the connection were with type 1 diabetes, it would have much more serious genetic and scientific implications. Right now we know that an autoimmune response is what triggers type 1 diabetes — the body's immune system decides to attack the insulin-producing cells of the pancreas, eventually killing enough of the cells that the organ can no longer keep up with the body's insulin needs. The autoimmune gene is hereditary; so far, though, scientists don't know what triggers the autoimmune response. If the study had been on type 1 diabetics, it would have meant that a possible trigger — depression — had been found.

But the study wasn't on type 1 diabetes. It had nothing to do with type 1 diabetes, but because that wasn't clearly stated in the story, some listeners could have drawn the wrong conclusion. So, when you're talking about something — such as depression — being connected to diabetes, you really need to specify which type of diabetes you are talking about, as the connection can have far different connotations for each type!

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