More Diabetes Answers

Is The Diabetes Answer Book only useful in the USA?

Not at all.  I grew up in Scotland, and worked as a doctor for many years in cities in Scotland and England with people who had diabetes.  Wherever you live around the world you will have to deal with the same kinds of issues if you have diabetes. 

    When I talk about blood glucose or cholesterol levels in The Diabetes Answer Book or in this blog I will give these in "American" units first and then give the "international" units in brackets afterwords.  I am sure that all of the books that I suggest are available outside the USA.  The websites and other Internet resources should also be available almost everywhere.

Wherever you live, if you have diabetes, or know someone with diabetes then I hope this book and blog will help you.  I will try to answer your questions in ways that will be practical and useful to you.

Am I diabetic or do I have diabetes?

I have many patients who say to me, "I have been a diabetic for fifteen years..." and then go on to ask their question.  but when I speak to them or to any audience about diabetes I never refer to them as being "a diabetic."  I prefer to say, "someone with diabetes."  You may think that this is a trivial distinction but I don't.  Many people, including me, are offended when they hear someone in crutches and leg braces being called "a spastic," and someone who has occasional brain seizures being called "an epileptic."  As far as I am concerned the diseases and problems that you have to deal with every day do not define who you are as a person.  To me, the patients whom I try to help are all interesting and very different people with all sorts of jobs, families, hobbies, and stories to tell.  they just happen to have diabetes as well.  This is a significant burden to add to their lives, but it does not define who they are.  Throughout The Diabetes Answer Book and in this blog I will try to give useful and practical answers to questions that you might have about having diabetes and living with diabetes, but I will not refer to you or anyone else as being "a diabetic."

Plain Language or "Dumbing Down?"

I have been talking to people with diabetes for over thirty years.  Most of them are very smart and ask detailed and thoughtful questions.  They deserve throughtful answers that give as much detail as they need to understand it properly.  Medical terminology can sound complicated and hard to understand.  Lots of words are really long and hard to pronounce.  It is difficult to know what they mean unless you have a Latin dictionary!  But it is usually easy to say the same thing in plain language.  I have tried to do this as much as I can in The Diabetes Answer Book.  Some of my colleagues are experts at talking and writing in "plain language."  I have asked them to look over my answers to help me say things in a way that is easy to understand.  That does not mean that I will make an answer simpler than it really is.  But I will try to use language that is easy to understand.  If you still find my answers to be too confusing or complicated or unclear I invite you to write to me and I will try to explain them better.

Medical textbooks are often written in un-plain language!  It you looked up the cause of type 2 diabetes you might see a sentence like this:

"Type 2 diabetes occurs due to genetically determined amyloid deposition in the pancratic islet cells resulting in progressive detrioration in their capacity for insulin secretion." 

If you understood that, well done!  But if you didn't understand it it does not mean you are dumb.  It is possible to say the same thing in language that most people could understand:

"Insulin is a substance made in your pancreas in special cells called islet cells.  When you inherit the genes for type 2 diabetes from your parents these islet cells begin to fill up with strange stuff called amyloid.  Over years more and more amyloid clogs up the inside of your islet cells so that they make less and less insulin."

Putting it like that is not dumbing down the meaning, just making it easier to understand.  I hope that this approach makes the answers more useful to you.

About the author

    My name is David Kennedy McCulloch.  I grew up in Scotland and obtained my MD from Edinburgh University in 1977.  I did postgraduate training in Edinburgh and Nottingham, in the UK, and was elected a Fellow of the Royal College of Physicians in 1991.  I moved to the University of Washington in Seattle in 1983.  I am a Clinical Professor of Medicine at the University of Washington and have done research on a wide variety of areas related to diabetes.  I have published over 70 peer-reviewed scientific papers.  I also write for UpToDate in Medicine which is an on-line textbook of medicine which is widely used by physicians around the world.  Since 1994 I have been the senior diabetes specialist at Group Health Cooperative, a wonderful health care organization in Washington State.  I work with an energetic team of doctors, nurses, phamacists and nutritionists to help over 25,000 patients with diabetes stay healthy.  I have also been the diabetes chair in several national collaborative efforts to improve diabetes care around the world.  In this work I have worked with teh Institute for Healthcare Improvement, the Bureau of Primary Care and the Robert Wood Johson Foundation.

I live in the Pacific Northwest with my wife, several children and grandchildren.  I have written a couple of adult murder mystery stories and am soon to publish a series of children's adventure stories.  My website is www.davidkmccullochbooks.com .