Need help navigating life with diabetes? You can always Ask D'Mine! Welcome again to  our weekly Q&A column, hosted by veteran type 1, diabetes author and educator Wil Dubois. This week, Wil explores the impact of diabetes "awareness" efforts, and also the woeful food options available to diabetics living on the street.


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Ruth, type 1 from Ohio, writes: Wil, you've been living with diabetes personally and professionally for a while now (how long exactly, I'm not sure). But you know the deal. So, what's your take on how diabetes awareness has changed over time? Has awareness improved or not? I would love to get your perspective on it.

Wil@Ask D'Mine answers: I've been part of the D-club for 11 years this fall. But because it's 24-7-365, it feels like a hell of a lot longer. It's really more like dog years, isn't it? In dog years, I've had diabetes for 57 years, 10 months, 14 days, 19 hours, 28 minutes, and seventeen seconds. Or something like that. (Hey, in dog years I'm a Joslin medalist!)

Actually, I don't even recall my diagnosis date. Having been miss-dx'd as a type 2 initially, I wouldn't even know which anniversary to celebrate: the welcome to diabetes one, or the welcome to the more complicated diabetes one.

One truth that I can share from observing this Diabetes World during the past decade-plus, though: D-Awareness has skyrocketed— just not for the reason you might think. In 2003, a year after I joined the club, stats tell us that 18 million Americans had diabetes. That was 6.3% of the population at the time. Now, a decade later, we probably have 26 million or so (it takes a few years to work out the numbers), and a greater percentage of the population is affected, probably around nine or ten percent. Diabetes isn't just growing because the population is growing, a greater percentage of the population are becoming members of our club, too.

So I can say with absolute certainty that eight million additional people are more aware of diabetes than they were a decade ago. And because very few American diabetics are hermits (although exact data on this doesn't seem to be available), we can safely say that the loved ones of those eight million are also now more aware.

But what about the awareness of people not touched by diabetes?

Has that improved? Not that I can see, but others' opinions may vary.Awareness Med

There's one exception, in my eyes. I think Americans are only aware of diseases that personally affect them or their loved ones. The exception to this rule is breast cancer, which thanks to the Pink Ribbon, boasts a thin level of awareness higher than you'd expect given the prevalence of the disease. Everyone knows the Pink Ribbon, while few people know the Blue Circle of diabetes—and breast cancer is only about 1/10th the patient "size" of diabetes. But I say "thinly" aware because I don't think most of the Pink Ribbon crowd has a particularly great understanding of breast cancer's reality.

So I don't really think D-Awareness is growing in the general public in a significant way, beyond the fact that it's simply touching a greater number of people and a greater percentage of our population. Of course the "epidemic" of diabetes is now more and more frequently talked about in the general press, but I see that much of this media coverage of diabetes is still simplistic, and the "facts" are often just plain wrong. That said, I'm not sure it would matter anyway. Even if the facts were 100% right, the "news literacy" of our population is quite low, and most people who bother to watch or read the news retain very little of what they see, hear, or read.

Beyond that, let us not confuse awareness of diabetes with understanding diabetes.

Of course, media is only one of the two columns that support the roof of public opinion. The other is entertainment, and when was the last time Hollywood got diabetes right?

So while all of that talk about D-awareness in the news-reading population is depressing, I do see one bright ray of sunshine. I think that, thanks largely to social media, people with diabetes are better aware of their own illness, better informed about treatment options, and more empowered in dealing with it than ever before. People with diabetes have long been complaining about media misinformation, but only in the past several years have patients been able to educate each other on the reality of this illness through social media.

Will the growing power of social media eventually change mass media coverage of diabetes and enlighten Hollywood? Maybe. Social media has toppled tyrants, after all. But can it change Hollywood and the apathetic, overworked, overstimulated, and generally selfish American public?

I think tyrants are easy fodder by comparison.


An email from a colleague on the east side of my state: The reason for this e-mail is that I ran into a homeless diabetic. He is at a healthy weight and takes care of himself as best as he can. But he mentioned that it was hard to get healthy items to eat at the food banks. Have you ever built food bags for the homeless that are diabetic? Most of the bank items are high in carb, salt, and fat. Yikes...... 

Wil@Ask D'Mine answers: This is one of the things I hate about checking email at work: I can't reach for a glass of Buffalo Trace when I need it. Homeless, dependent on food banks, and diabetic. Could that suck any worse? (See our report on homelessness with diabetes from last winter.)

I have patients living with no electrical power. I have patients living with no water. I have people living in shacks that are only slightly better than cardboard boxes, and others in rodent-infested houses that you'd be terrified to set foot in. For a time I had a family of four living in their car under an overpass. But I don't have a single genuine shopping-cart-pushing homeless patient in my panel. Thank God.

So where to even begin? Food bank 101: Most donated food comes from grocery suppliers and grocery chains. It's short-dated overstock. The range of foods our state bank sends up to my community is mind-boggling. And scary. Sixteen-inch pecan pies. Wonder BreFood Donation Boxad. Chocolate milk. Party-platters of cherry turnovers. Yeah, sometimes we get fresh carrots, but more often than not, the food is high-carb, highly processed, and highly preserved. Not exactly healthy, but eating it sure beats the hell out of starving to death.

Actually, not very many people in our country really starve to death, but something much more sinister is going on. The polite term for choosing between feeding your children and paying the electric bill is "food (in)security." Nationwide, 23% of children live in homes where there is not enough food for the family. Where I live it's worse. One in three kids living in my state suffered food insecurity last year.

But back to food banks, I'm sure different areas do it differently, but here in northern New Mexico, local food bank volunteers take everything that comes up in the eighteen-wheeler from Albuquerque and swiftly re-package it as equally as possible into 75 or so boxes for our 75 or so families in the greatest need. Each box is pretty much identical to every other box. It's "fair," and while not as appropriate as trying to match the food to the families, it is efficient—and there's only so much time you can ask volunteers to donate.

Still, what I suggested to my colleague was to try to get the food bank folks to let her customize a box for the homeless diabetic, rather than giving him the standard box. Homeless diabetic guy doesn't need the sixteen-inch pecan pie, but maybe he could use an extra can of Vienna sausages, or whatever.

The worst part of this whole thing (yes, it does get worse) is that what little fresh food there might be will do a homeless diabetic precious little good. The majority of the citizens at the brink of starvation or malnourishment in our country at least have refrigerators ... and TVs. But the homeless do not have refrigerators, or ovens or stoves. The truly homeless have no way to keep fresh food fresh, or to prepare it.

Homeless with diabetes. It makes our fights with our insurance companies, battles with depression, carb-counting woes, and meter accuracy issues all look pretty lame by comparison.

Homeless with diabetes. I'm pretty sure it doesn't suck worse than that.



This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.



Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.