Miss Manners – still wrong.

Sorry, Miss Manners initial response to the person with diabetes asking about testing his blood in his seat was wrong, especially if written by a PWD. No amount of parsing will change that. And shame on Nick Martin, Miss Manners’ son and person with type 1 diabetes, for not giving full disclosure in the column. A disservice was done to people with diabetes everywhere. Rather than acknowledging this, excuses were made. Nick Martin admits to being able to dose in the dark, to test without others knowing, to being discreet… after the column was published. Most PWD do this regularly but sometimes it is just not possible. There was little or no recognition of the difficulties of a life with diabetes from this type 1. An opportunity to raise awareness of the plight of people with diabetes was lost, yet again! Rather than an apology from a person who knows the difficulty of living with diabetes in public a defense was given. Not very mannerly!

Dear Miss Manners,

In response to the answer in your February 18, 2014 column to the person with diabetes, I must say you have little or no understanding of people who try to control their blood sugar minute by minute, hour by hour, day by day, week by week, month by month, year by year throughout their lives.

I try not to allow my 24/7/365 condition to disturb the perfect world you would like to have. The world where there is no tolerance for imperfection, the world where rules of etiquette prevail over all else. Even though I am a considerate, thoughtful and polite person I have been burdened with the task of controlling my blood sugar no matter where I am or what I am doing. Allow me to enlighten you as to what living with diabetes really means.

It can mean, for example, that the seat belt light is lit on the flight I am on and I feel a little light-headed and shaky. I can’t immediately be sure if this is because I am nervous about our impending departure or if I am getting hypo-glycemic. The only way to be sure is to administer a finger-stick blood test in my seat. If your rules of perfection prevailed I would wait until after take-off and then after the fasten seat belt sign has been turned off. At this point, perhaps a half an hour or more since my initial symptom, I am to calmly & with dignity, walk to the rest room. If it is not occupied, I should enter and administer a blood test in an environment that is rarely clean. How quaint that you haven’t the slightest awareness that if I ignore my hypo-glycemic symptoms for that amount of time we will all hear on the nightly news how a sick passenger caused a monumental delay at one of our nation’s airports and had to be removed from the plane by ambulance and nearly died, or did die, from severe low blood sugar. It has always been my own policy to do what I need to do, when I need to do it and politely engage those curious eyes with some words of wisdom or an informative conversation if they are so inclined. I will never hide my diabetes. It is an integral part of many, many people’s lives and it should be acknowledged and seen for what it is; a condition that requires constant attention.  Diabetes is a condition that must be integrated into everyday life and dealt with at a moment’s notice, often without warning.

How utterly ignorant that one would expect a relentless unforgiving condition to be managed in a way that keeps it invisible to the general public so as to not offend anyone. Well, Miss Manners, I and the three million or more people with type 1 diabetes are greatly offended by the burden that has been placed upon us involuntarily. The burden to administer 6 to 10 finger stick blood tests a day. Blood tests before every single thing we eat. Blood tests 2 hours after we eat. Blood tests before we go for a walk or a drive or to the gym. Blood tests when there is a doubt of whether what you are feeling is hypo-glycemia or nerves or nausea or just plan not feeling right. We people with diabetes that use injections as our method of desperately trying to control our condition are greatly offended by having to inject insulin into our abdomen, arm, thigh or butt before every meal. We who use an insulin pump are offended by having to constantly program an insulin dose before eating and to stop everything every two or three days to self-administer an invasive medical procedure to refill our insulin supply and move our infusion site to avoid infection. Did you know, Miss Manners, that some of us also have a continuous glucose monitor that we must attach to ourselves through another invasive procedure and that must be changed every seven days? Do you have any idea whatsoever, even with all these advanced invasive technological wonders, how nearly impossible it is to maintain a blood sugar close to what your proper and inoffensive pancreas can do without offending anyone. Do you have a clue, Miss Manners?

Clearly, you do not. Allow me to offend you further; I am of the opinion that with nearly 27 million people in this country battling either type 1 or type 2 diabetes that we need to bring diabetes management out of the rest rooms and into your face. If you and people like you, do not see the dire need to control a medical condition that kills someone every 8 seconds and costs our society upward of 245 Billion dollars a year, then you need to see, first hand, the devastating personal toll this condition has on people just like you. Polite, dignified, thoughtful people who would rather do a blood test in public than bring an entire plane full of people to a most inconvenient delay.

You, Miss Manners have done the 27 million people with diabetes in this country a grave disservice. You have perpetuated the idea of shame for people who, for the most part, achieve great things such as being productive workers, creating families and contributing good things to society in spite of a condition that is a full time job in and of itself. We await your apology.