Disaggregating diabetes

Abstract

Interest in disaggregating diabetes into numerous subtypes is growing as patients and providers recognize the limitations of standard diabetes typologies. As anthropologists, we draw attention to how ‘subtyping’ may reduce stigma derived from the connection between obesity and ‘type 2 diabetes’. We highlight the complexities that drive diabetes and argue that an exclusive or dominant focus on diet and obesity obfuscates other underlying risks. Yet, we warn that subtyping may promote unnecessary pharmaceuticalization, especially for other subtypes of diabetes that may be associated with stress and inflammation. We call upon providers to continue to closely attend to patients’ lived experiences. While we recognize the shortcomings of the existing classificatory scheme, patients’ outcomes and prognoses are often more closely connected to the social and medical support they receive than to the underlying metabolic classification.

Diabetes

“…[9] This entry focuses on type 2 diabetes due to its overwhelming global prevalence and due to the biomedical focus on solely individual behaviours. Diabetes is commonly known among biomedical healthcare providers as the 'lifestyle type' due to its association with overconsumption and sedentary behaviours, which are generally blamed on individual patients (Carruth et al 2019;Yates-Doerr 2011). However, this framing ignores the social, economic, and political contexts that impact the diabetes experiences of many patients.…”

“…Unfortunately, most diabetes itself is rather less colourful, albeit equally dangerous if left unchecked. Diabetes is a chronic disease characterised by high glucose due to the body's inability to produce and/or process insulin, a hormone that helps the body use energy (Carruth et al 2019;Mendenhall et al 2010;Schoenberg et al 2005). People are clinically diagnosed with diabetes if their fasting glucose blood test levels are over 126 mg/L or have a three-month average hemoglobin (HbA1c) level of at least 6.0%.…”