We continue with our new series on life around the globe with diabetes! Our first feature was an English PWD living in Spain. Today, we introduce you to Anke, a kindred spirit from Germany who has some pretty unexpected revelations about diabetes in her country.
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A Guest Post by Anke Troeder
I'm a college lecturer for public speaking and presentation skills at a small college in northern Germany. I was diagnosed in 2005 at the age of 45 with Type 1 (or LADA?) and a few other autoimmune and food disorders that make life a little tricky. Most things that are good for diabetes are off-limits, for one reason or another, like beans, or many greens.
My corridor for food has grown excessively narrow and sometimes I find myself wishing it was only diabetes I had to deal with. That is when I go and photograph food and write in small white circles into my weblog until all colors and numbers make sense again.
I have always felt weblogs are the most polite way of feeling sorry for yourself.
The first real difference between Germany and elsewhere I can think of is that we work out carbs in Broteinheiten (literally translated as units of bread). 10-12 carbs are 1 Bread Unit or BE. It's an easy way of learning your food. 1 small apple/potato = 1 BE. It's like metric and imperial. Whatever you grow up with comes easy.
Germany is roughly the size of Texas or Italy, but it actually ranks first with all things diabetes:
7.5 million diagnosed cases make it top of the list in Europe. I am sure the Germans' love for meat, potatoes, rich cream cakes, curry wurst, and more recently pizza, and dÃ¶ners plays a huge part here. We simply have not enough coastline, I often think. Coastlines are great for waistlines.
The D-pattern is the ubiquitous 90% T2, 10% T1/LADA, all rising. When I was diagnosed, there were around 100,000 type 1s. Now it is closer to half a million. One is not the loneliest number anymore. Join the club.
Germany needs to rethink much, and learn fast.
A recent survey stated that a large numbers of younger Germans don't know how to cook. Considering the fact that food is one of the most important tools to tackle diabetes, this is extremely worrying.
Earlier this year, the food industry lobby stopped a scheme called Food Traffic Light. It was meant to educate customers with an easy code of red/green/yellow dots about the content of packed food items beyond the small print: Fat, protein, carbs. Oh well. You can still get the app, though.
Germany has the highest number of amputations in Europe with 60,000 per year. 70% of those are people with diabetes, mainly type 2. Undiagnosed cases of diabetes are estimated at over 3 million. Numbers looming in the dark. Teeth clenched. Ready to attack.
Germans are a pretty organized bunch, though, and have organized diabetes, too. There are at least five major diabetes societies and organizations, one even caters to international travelers.
All in all, Germany is a pretty decent country to have diabetes in.
With private health insurance that is, at roughly US $800 per month, if you are a type 1/LADA like me. I can choose doctors. I can change doctors. I get longer face time. Lucky me! Even if there are months when I need to pay a thousand dollars in advance and wait nervously to be reimbursed...
National health care works like a large community. Everyone chips in, everyone takes out. The state tries to make ends meet. Meet diabetes test strips.
In February 2011, some 100 people demonstrated in Berlin against a pending health care decision: test strips for type 2s that do not use insulin may not be reimbursed anymore. As one spokesperson said: "It's just some kind of leisure time activity, this checking numbers."
Hell. Understanding the numbers we live by is empowerment.
Other discussions involve no more analog insulin for type 2s. As if. Again, lucky me. My wonderful doctor whom I see every few months resides 300km from where I live now, but every time I leave it is with a smile on my face. He does not work with guilt, and all of you know how much guilt is part and parcel of diabetes. Even if it just over a glass of wine, or a piece of cake.
I have met other doctors, and have left their offices crying and depressed for days on end. The diabetes police too is an international task force, I guess.
One last gray figure for closure: One in four people in a residents' home in Germany has diabetes.
That's what I am afraid of, when I need to force myself back towards the light after another 4am hypo: Living in a home, dependent on others, and most of all dependent on their food choices and the way they cook.
Recently I have re-discovered rutabaga and parsnips as great fillers. Lovely, slow, golden carbs. Easy to bolus for. Great food for thought. I live in the city of roots and roses. I might as well make use of that.