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April 10, 2013
“A rose by any other name would smell as sweet,” says Juliet to Romeo in the famous play, suggesting that names are insignificant and that we should pay attention only to the person or thing behind them. In the real world, of course, names can matter a great deal — just ask any politician who has supported the “estate tax” or opposed the “death tax,” to name just one example. When it comes to describing medical conditions like diabetes, there might not be quite as much controversy as in politics. But a recently started online petition shows that many people are unhappy with the names Type 1 and Type 2 diabetes, believing them to be confusing and not descriptive enough.
The petition at change.org, started by two mothers of sons with Type 1 diabetes, asserts that media coverage of diabetes often fails to differentiate between the two most common forms of the disease (less common forms include gestational diabetes, MODY, and LADA). These mothers write that especially due to the alarming incidence of Type 2 diabetes in children, but also in adults, Type 2 diabetes has almost completely pushed Type 1 diabetes out of general public awareness. This, they write, results in many adults taking Type 1 diabetes in children less seriously, not realizing that it can quickly lead to life-threatening situations (most notably hypoglycemia as a result of injected or infused insulin). They note that historically, the terms “juvenile diabetes” and “adult-onset diabetes” made confusion less likely, since even people with no education on the topic realized they were completely separate conditions. Only after “juvenile diabetes” started to appear more and more often during adulthood, and “adult-onset diabetes” appeared in children, did the terms “Type 1″ and “Type 2″ gain widespread use.
The petition goes on to claim that both people with Type 1 diabetes and those with Type 2 could benefit from a name change that provides more of a description of each condition. Right now, it claims, many people attempt to keep track of the two conditions by thinking of Type 2 as “earned” diabetes, brought on by poor lifestyle choices, and Type 1 as “bad luck” diabetes. In reality, of course, there is a clear genetic component to Type 2 diabetes, and the petition claims that a descriptive term such as “insulin-resistant diabetes” would help discourage the public from blaming the victims by focusing on the biological nature underlying the problem. Similarly, it claims, a term like “autoimmune beta cell apoptosis diabetes” could help the public understand what is happening in Type 1 diabetes.
As of this writing, the petition has been signed by nearly 2,000 people worldwide, short of its goal of 8,000 but not hopelessly so, given that it has been online for less than two weeks. The petition has the support of several doctors, including Dr. Camillo Ricordi of the Diabetes Research Institute (which supports mostly Type 1-focused diabetes research). The petition is addressed to leaders of the American Diabetes Association, the National Institutes of Health, and the International Diabetes Federation.
What do you think — are the names “Type 1″ and “Type 2″ confusing or not specific enough? Do the names imply, as some people have asserted, that one type is more severe than the other? Do you think safety concerns about how adults might react to children with Type 1 diabetes — if they mistake it for Type 2 — are legitimate, or probably exaggerated? Have you had to explain your type of diabetes to confused friends, coworkers, or relatives? Do you think new names would be even more confusing? Leave a comment below!
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