Happy St. Paddy's Day, Diabetes Community!
While I have only a very small bit of Irish heritage flowing through my glucose-saturated blood, I do get into the St. Patrick's Day festivities each year -- enjoying some Irish beer, feasting on corned beef & cabbage, and this year tuning into our local classic rock station's "St. Petty's Day" all-day block of Tom Petty tunes. Yes, I have my Americanized fun on this particular day (while also keeping in mind important issues like alcohol awareness and drinking with diabetes)!
But on a more serious note, we wanted to offer you a glimpse into the real world of diabetes in Ireland -- with a personal testimonial from this place that so many of us are paying homage to in some form today. We're thrilled to share the story of a fellow type 1 in Ireland named Shane O'Donnell, who's also researching the issue of diabetes disparities in that country and advocating on the topic via the International Diabetes Federation's Young Leaders Program. He's a perfect St. Paddy's Day addition to our Global Diabetes series here at the 'Mine.
So, we hope you enjoy some green fun today, and also take a moment to read what this clever Irish D-peep has to say:
A Guest Post by Shane O'Donnell
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Oh, and in case you decide to Google me: don't confuse me with others who share the name Shane O'Donnell -- like the athletic hurler or the one who works in the medical device supply chain here in Ireland. I can tell you that the analytics are hefty on the amount of times our common name is searched, and guess what...? My name was never so often searched until Shane O'Donnell the hurler broke onto the athletics scene here last year!
I discovered I had diabetes when I was 16 years old. As there was no previous family history, I had been pretty oblivious to the condition up to that point, so the event was naturally a big shock to the system. As I was technically a young adult when diagnosed, I was sent directly to the general hospital by my local GP where I spent a total of two weeks in recovery. I don't remember much from the event, as I was in a pretty advanced stage of DKA.
Not that any of this bothered me at the time. I was actually secretly delighted, not only because of the attention from all the nurses, but also because I was going through a lazy teenage rebellious phase and thought having a chronic illness was just my ticket for getting out of playing any competitive sports at school.
The first day I arrived back in class after my diagnosis, I marched up to my physical education teacher and said: "Sorry, Mr. Brennan, I have diabetes so now I can't do gym anymore," adding that participating might "make my sugars go high or low... or something." Unfortunately for me, it turned out Mr. Brennan was able to list off a wide range of professional athletes/advocates who happened to have diabetes right there and then on the spot! Although my plan didn't quite work out as I had hoped, it nonetheless helped crystalize my attitude toward the condition from that day forward, in that I always tried to see the positive side and never let it stop me doing the things I want to do.
That is not to say that there have not been challenges. I found that maintaining a busy college life while trying to successfully manage diabetes a difficult balancing act. My big passion in life is music and up until relatively recently, I spent a lot of my time gigging around Dublin, which usually entailed late nights and the occasional alcoholic beverage.
Four years ago, after a spate of not so good HbA1C's, my doctor and I decided I might benefit from a switch to pump therapy. The process of obtaining a pump in Ireland can be a frustrating experience. Coverage is particularly low compared to the U.S., and the likelihood of obtaining funding is entirely at the discretion of your local health authority. Thus access is determined by geographic location, rather than the needs of the patient. Luckily, I had a pretty supportive consultant who had advocated on my behalf and was able to obtain a pump for me within a few short months. Going on the pump was one of the best things I ever did. Since starting four years ago, my HbA1C has not risen above 6.7 and I have infinitely better quality of life. One of things I hope to do in the future is to become more involved with my local diabetes federation in campaigning for better access to pump therapy for those who desire it.
In Ireland, we are undergoing a severe economic recession and as a result we are seeing a return to high levels of unemployment and mass emigration, which our country hasn't witnessed since the 1980s. Several successive austerity budgets with severe cuts over the last few years have put huge pressure on our health services. Like the U.S., we have a
tiered health service based on a mix of public and private provisions. While everyone has an entitlement to care under the public system, its funding has been significantly curtailed. So, while we have some of the best trained diabetes specialists and nurses in the world, clinics are often understaffed and overburdened and patients are not getting access to the treatment they need.
The standard of care is much better for those who can afford private health insurance or see their doctor privately, but this option is becoming increasingly less financially viable for most Irish families. All of this can make it extremely difficult for individuals with diabetes to successfully manage their illness on a day-to-day basis. Having said that, access and entitlements to basic medication and monitoring equipment are good in Ireland, and that is something I hope will be safeguarded.
Overall, while I believe that diabetes can bring out both the best and worst in a person, I feel that it has given me a completely different perspective which I might not have gained had my pancreas not decided to kick the bucket all those years ago. For example, I have always felt particularly perturbed by the many myths which surrounds diabetes (both types 1 and 2), and this doubt shaped my chosen career as a medical sociologist.
Three years ago, I was also lucky enough to get a PhD scholarship (sponsored by the Pharma company Merck Sharp and Dohme) to research health disparities in the context of type 2 diabetes. This PhD has given me the opportunity to travel and participate in conferences in the U.S., Canada, the United Arab Emirates, Belgium and Germany. In December, I also had the great privilege of participating in the IDF Young Leaders in Diabetes program, which brought together young diabetes advocates from all over the world. Having never attending camp before and not knowing anyone else with type 1 diabetes, it was a really fantastic experience, and the group that came together transcended barriers in language and culture. I was amazed and inspired by the warmth, energy and enthusiasm of all participants and organizers, and it served to remind me that living with a chronic illness can often be the catalyst to drive people to do truly great things.
As part of my own Young Leaders project, I hope to challenge the widely-held assumption that type 2 diabetes is as a self-inflicted illness arising purely out of the poor choices made by individuals. I am researching how the role that adverse social and living conditions, as well as lack of access to good healthcare, often plays in the onset and subsequent management of diabetes. I'd like to encourage those with type 2 diabetes, many of whom are tired of the stereotypes surrounding their condition, to tell their own story.
I believe those with type 1 diabetes can play a role in this as well. While many of us justifiably resent the association of overindulgence and laziness with our type 1 diabetes, we too often try to disassociate ourselves in ways that end up furthering those stereotypes even more. In doing so, we're attempting to dispel one myth at the expense of perpetuating another. Instead, we should be challenging the stigma around both type 1 and type 2. After all, we have a common set of needs when it comes to equitable and efficient access to medical care and equipment, safe places for exercise, and access to affordable and healthy foods.
Bottom line: Our interests are better served
if we work on this together.
That is my story and what I am working on here in Ireland. And that brings to mind the stereotypical fact that today is St. Paddy's Day, and of course the guy from Ireland was invited to write this. :)
So yes, I have to mention: the whole topic of drinking with diabetes can be a challenge for people with diabetes in Ireland (and elsewhere). I learned a long time ago with diabetes that if you want to drink beer, you've got to play by the rules. So make sure you know how alcohol impacts your diabetes management and, if you're planning to enjoy the festivities, remember to test frequently!
LÃ¡ FhÃ©ile PÃ¡draig Shona Duit (Happy St Patrick's Day, to you!)
Thanks for sharing your story, Shane! May the road rise up to meet you, as you continue your diabetes research and advocate to help dispel the many myths that exist worldwide.