My mother was not a hoarder.  In fact, if there is anything that is the opposite of a hoarder, that is what my mother was.  She threw away everything.  Therefore I don’t have much stuff from my childhood.

But I do have my report cards.  All of them starting in first grade.

So what does this have to do with Diabetes?

My 1st Grade teacher wrote a comment that I had a hard time accepting mistakes and always blamed them on someone or something else.

Fast forward to Type 1 Diabetes.  I do fine with comorbidities.  Those are the things that go along with Type 1 Diabetes but are not caused by diabetes.  I have hypothyroidism.  It is not a result of abnormal blood sugar, but rather the same autoimmune process that destroyed my beta cells.  It is something that I could have done nothing to avoid. It is not my fault and I accept it openly and without guilt.

Similarly I have an autoimmune form of arthritis.  No guilt.  You can’t blame me.  It’s a result of my rogue immune system.  Same with a skin condition I have that comes and goes.

I am on my third frozen shoulder and that enters the murky area between complication and comorbidity.  The exact cause of frozen shoulder is not known.  One theory for why people with diabetes get it at a higher rate than the rest of the population is that high blood glucose causes an abnormal thickening of the collagen and fibrous material in our tendons and ligaments.  But other conditions such as age, hypothyroidism, Parkinson’s disease, and having a recent shoulder injury are culprits in the onset of this painful condition.  Ironically two of my frozen shoulders have come during periods when I had extremely low A1c’s, so there is definitely more to it than BG levels.  But at the same time I could never argue that I have normal blood sugar so the collagen theory makes sense.

Currently I have none of the complications of Type 1 that are commonly considered to be the result of high blood sugar levels.   No kidney disease, no retinopathy, no neuropathy.  Ha!  I’m free of complications and nothing is my fault.

The problem with that logic is that if you turn it around, you point your finger at those with complications and say it was “their fault.”  We all know how hurtful and untrue that remark is.  And as hard as I work to control my diabetes, I don’t know that one of those things won’t be on my plate next week.

Diabetes does not play fair.  For whatever reason, some people get multiple complications and others seem to remain relatively unscathed.  Sure, studies show that lower A1c’s increase our odds of good health and that gives most of us motivation to fight the diabetes battle every day.  But good A1c’s are not a guarantee against complications and diabetes does not sign a contract promising good outcomes for every individual.

So where am I when it comes to blaming other things and other people?  I have come a long way since 1st Grade and work hard to accept responsibility where appropriate.  The idea that comorbidities are easier to accept than complications is still part of me even though intellectually I think it is mostly a meaningless distinction.  When my rheumatologist confirmed in May that I was indeed dealing with frozen shoulder again, his first question was “What is your A1c?”  I was surprised that my first reaction was being defensive that he thought it was “my fault.”

This post has become riddled with terms such as comorbidity, complication, fault, blame, responsibility.  Those are words that never leave our Type 1 brains.

One of the best discussions about the line between blame and responsibility was in a 2/25/13 post by George at Ninjabetic.com.  You should read the whole post, but what has stuck in my head are these words:

“Sometimes it is good to remember that this stuff is my responsibility but not all my fault. That is the difference. It’s not my fault that I have diabetes. It’s not my fault my body doesn’t do what it’s supposed to.

But to not take care of my responsibilities and to allow bad things to happen to my body because of negligence is my fault.

The line is thin but there is a difference between the two.”

Thanks to George, there is not much else to say on the subject.