Fighting misperceptions of diabetes in the mainstream media seems to be a losing battle sometimes. Case in point: this recent story in Women's Health magazine about a "new wave" of fit and trim young American women developing type 2 diabetes — a condition they're calling TOFI (thin outside, fat inside). What a load of crap!
The article is about a "rarefied yet growing group of 20-30 year-old women developing type 2 though they are thin — it's about how unhealthy they eat."
This is just so typical of a health/ beauty/ women's fitness glossy magazine looking for another eyebrow-raising headline. The reaction they're after: What?! I'm subsisting on snack foods, salads and aerobics, but that big, scary diabetes might get me anyway?!
Geez, who wouldn't stop to look at their photo of the supermodel injecting herself...?
Here's what's fundamentally wrong with the story, as pointed out by friend and leading CDE and author Hope Warshaw:
1) It is highly likely that these women have LADA, a form of type 1 diabetes in adults, and just haven't been diagnosed properly!
2) By not researching and revealing this, the magazine is essentially "looking for a needle in a haystack when we've got millions of people who need solid info on 'real' types of diabetes."
In other words, it's media sensationalism doing its typical damage — misinforming by not telling the whole, true story, while hyping up some minor and dubious detail. Ugh.
I find it ironic that a story like this should appear just weeks after the Diabetes Advocates group announced a new "Assistance in Accurate Reporting" program to help the media get it right.
"Our goal is to stop being reactive and start being proactive," fellow D-blogger and organizer Kelly Kunik said in the announcement release. "When a story with incorrect information is published, the damage is done. By making ourselves available to media and entertainment outlets, we are seeking to be part of a solution."
But it's near-impossible to be proactive when you just don't know these stories are in the works.
I pinged Kelly, who's lived with type 1 for almost 35 years, for reaction on this one. She says, "It is not made clear in the article if TOFI is a medical term or a term used in convenience without clarification as to the medical meaning. I am unsure as I have not heard it in all my years prior to this article... That being said, I do believe that this article is an example of the media not getting all the diabetes facts before they go to print."
Buried about 3/4 of the way through the Women's Health article, they do admit that "many of the slim women diagnosed with type 2 may not actually have that disease. Rather, they could have an undiagnosed case of type 1." But this sure ain't the message that bangs the reader over the head here.
I also pinged some medical experts, to be sure we PWDs are not overreacting to this story.
Legendary CDE and author Gary Scheiner writes to me:
"I agree with you, Amy. This article appears to be very misleading. It is extremely rare to see insulin resistant type 2 diabetes in women like those portrayed. When it does occur, there are usually contributing factors such as a significant family history of type 2, prednisone or cortisone use, post-pregnancy effects, or as you indicated, LADA. Type 2 in young, fit people is hardly the epidemic they describe. We're better off focusing on where the epidemic truly lies."
Endocrinologist Jen Dyer, also know as EndoGoddess on Twitter, had this to say:
Without really knowing the medical facts, speculation about 'eating bad' is inappropriate. In fact, just sensationalism without a true epidemiological study. However, epidemiology studies are confirming more cases of both type 1 diabetes and type 2 diabetes in kids and young people, this is a fact.
The most likely medical possibilities:
1. Early LADA (would most likely have blood tests positive for type 1 diabetes antibodies like GAD65, islet cell antibodies, ICA512)
2. Or, perhaps a rare condition called MODY (there is an available molecular gene test on the blood to confirm one of the 6 types of MODY)
3. Or, IF the girls are Asian or Asian Indian, they could have type 2 diabetes with only a small amount of weight gain as the genes for type 2 diabetes do seem to have a higher penetrance in this ethnicity (i.e. don't have to gain much weight to get type 2 diabetes)
"Yes, there is much more utility in telling people who are at risk to check their diabetes risk factors than worrying people who are at low risk."
Right. Utility. That's what pseudo-medical stories about diabetes should be aiming for, correct? Helping people who need it, rather than throwing yet another albatross around the neck of these poor young yuppie women, probably already obsessing about their weight and health.