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Type II Diabetic Marathoner. An oxymoron? No.

While anecdotal (what I call "n of 1") stories can't be used to make broad generalization, they can be used to enrich understanding of complex situations. Take the example of diabetes. The "generalization" (which certainly has great truth to it) is that our current lifestyles and diet are inconsistent with what what our bodies evolved to need to thrive. But it is an oversimplification to say everyone with a chronic illness like diabetes is "at fault" for their disease.

So, here is the "n of 1", illustrative story of the marathon runner..

There is a gentleman I know from my running club who is a Type II diabetic. We're in a marathon training program together and he has ran over 15 marathons in his life, plus many more 1/2 marathons and other relatively long disease races. He trains consistency and makes great times.He is trim and fit and follows a careful diet that most people would only aspire to.

He is also a Type II Diabetic - diagnosed in his early 20's. 

In his case, the genetic component of the disease is clear: both parents and 3 grandparents have diabetes. They are of Indian (from India) descent, where these strong genetic components of the disease are commonly found. He himself was born and raised in India. Though a clear, and extreme case, his situation points out the fact that there isn't always an easy way to place blame for diabetes. Yes, personal accountability for managing the disease is critical. (In his case, his careful medication schedule, three blood glucose checks per day, careful diet and exercise plan has allowed him to maintain a low HbA1c, which indicates great diabetes control). But "blame" for the disease can be misplaced.

Why does this matter? It just means it is important to not assume that a diabetic isn't trying to be healthy or control their disease. It means assuming that it is very hard to manage the disease. And, it means that effective supporting programs must go beyond general education and periodic interventions. Real-time interventions and customized one-on-one support are required on an on-going basis to truly teach, and motivate, a diabetic to achieve control and good health.

Rebecca Dubowy, Chief Medical Officer



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