Hey fam, today we're talking CONTROL, COMPLIANCE, and ADHERENCE in diabetes management: an #NDAM thread 💙💙💙
People with diabetes, from the time of diagnosis on, get bombarded with questions like, "How do you control your blood sugar?" and "is that [a blood sugar reading] good? is that bad?"

( #T1D, #T2D, #LADA fam–– chime in here! help me gather examples)
Even worse than those questions are the instances in which we're dehumanized by medicine. We're called "noncompliant" or "nonadherent," both of which refer to a collection of assumptions:
––that we know how to manage our health (so, so many people receive subpar care...
...including folks with T2 and #BIPOC)
––that we have ALL THE TOOLS to manage our health, like health insurance, $$ for insulin and supplies, access to fresh produce and other healthy foods, etc.
––that we have the SUPPORT to manage our health; many spouses, parents...
...friends, employers, and teachers do not make any effort to accommodate diabetes.
––&finally, that because we have total access to knowledge, tools, and support, if our health is out of wack it's because we're LAZY or APATHETIC.
When medicine calls us "nonadherent/compliant" they're quietly calling us lazy, apathetic, and morally bankrupt for failing to manage our health better.

Moral judgement based on assumed agency/ dominion over one's body has a name––healthism–– and it saturates endocrinology.
Current diabetes care hangs on "self-management:" the ability to control blood sugar through insulin dosages, nutrition, and exercise. "Good" self-management means "good" control and "adherence" or "compliance." Bad means the inverse.

Thing is, diabetes isn't controllable.
Sure, we say it is. We say we manage our blood sugar. But I can do everything right and only get the "good" number half the time. Yesterday's thread on glucotoxicity is a perfect example of this:
8/ https://twitter.com/RenegadeLib/status/1326200782853705730?s=20
Internally, we deal with stuff like glucotoxicity, where our bodies LITERALLY STOP USING INSULIN CORRECTLY FOR A HOT MINUTE.

Externally, we deal with #unemployment that creates lapses in health insurance. We live in imperfect homes, full of imperfect people.
We work in imperfect, #ableist and #racist and #sexist spaces. Those spaces cause us stress, and that screws with our health.

We live beneath the poverty line, and still fight for #insulin4all while we ration.

We live in food deserts and subsist on processed food.
Notions of compliance, adherence, and control our context. The expectations they represent are based on the BEST CASE SCENARIO (read: privilege).

&any less than perfect and medicine calls our health uncontrolled, us noncompliant or nonadherent.
When our doctors think we CHOOSE to feel nauseated all the time, they tell us they're not safe, that we can't be fallible with them––&truthfully, that's the worst part of the whole linguistic tic.

Bc if we have to battle insurance, or a pharmacy, who do we HAVE to turn to?
Medicine–– endocrinology, etc.–– have made themselves our emotional abusers by labeling us noncompliant.

We need them for us to stay alive, we need their help
&bc we need them, they can treat us however they want.
&they've made us the villains in our own #diabetes stories.
You can follow @RenegadeLib.
Tip: mention @twtextapp on a Twitter thread with the keyword “unroll” to get a link to it.

Latest Threads Unrolled:

By continuing to use the site, you are consenting to the use of cookies as explained in our Cookie Policy to improve your experience.