We continue with our new series on life around the globe with diabetes! Our first feature was an English PWD living in Spain. Today, we introduce you to Anke, a kindred spirit from Germany who has some pretty unexpected revelations about diabetes in her country.
A Guest Post by Anke Troeder
I’m a college lecturer for public speaking and presentation skills at a small college in northern Germany. I was diagnosed in 2005 at the age of 45 with Type 1 (or LADA?) and a few other autoimmune and food disorders that make life a little tricky. Most things that are good for diabetes are off-limits, for one reason or another, like beans, or many greens.
My corridor for food has grown excessively narrow and sometimes I find myself wishing it was only diabetes I had to deal with. That is when I go and photograph food and write in small white circles into my weblog until all colors and numbers make sense again.
I have always felt weblogs are the most polite way of feeling sorry for yourself.
The first real difference between Germany and elsewhere I can think of is that we work out carbs in Broteinheiten (literally translated as units of bread). 10-12 carbs are 1 Bread Unit or BE. It’s an easy way of learning your food. 1 small apple/potato = 1 BE. It’s like metric and imperial. Whatever you grow up with comes easy.
Germany is roughly the size of Texas or Italy, but it actually ranks first with all things diabetes:
7.5 million diagnosed cases make it top of the list in Europe. I am sure the Germans’ love for meat, potatoes, rich cream cakes, curry wurst, and more recently pizza, and döners plays a huge part here. We simply have not enough coastline, I often think. Coastlines are great for waistlines.
The D-pattern is the ubiquitous 90% T2, 10% T1/LADA, all rising. When I was diagnosed, there were around 100,000 type 1s. Now it is closer to half a million. One is not the loneliest number anymore. Join the club.
Germany needs to rethink much, and learn fast.
A recent survey stated that a large numbers of younger Germans don’t know how to cook. Considering the fact that food is one of the most important tools to tackle diabetes, this is extremely worrying.
Earlier this year, the food industry lobby stopped a scheme called Food Traffic Light. It was meant to educate customers with an easy code of red/green/yellow dots about the content of packed food items beyond the small print: Fat, protein, carbs. Oh well. You can still get the app, though.
Germany has the highest number of amputations in Europe with 60,000 per year. 70% of those are people with diabetes, mainly type 2. Undiagnosed cases of diabetes are estimated at over 3 million. Numbers looming in the dark. Teeth clenched. Ready to attack.
Germans are a pretty organized bunch, though, and have organized diabetes, too. There are at least five major diabetes societies and organizations, one even caters to international travelers.
All in all, Germany is a pretty decent country to have diabetes in.
With private health insurance that is, at roughly US $800 per month, if you are a type 1/LADA like me. I can choose doctors. I can change doctors. I get longer face time. Lucky me! Even if there are months when I need to pay a thousand dollars in advance and wait nervously to be reimbursed…
National health care works like a large community. Everyone chips in, everyone takes out. The state tries to make ends meet. Meet diabetes test strips.
In February 2011, some 100 people demonstrated in Berlin against a pending health care decision: test strips for type 2s that do not use insulin may not be reimbursed anymore. As one spokesperson said: “It’s just some kind of leisure time activity, this checking numbers.”
Hell. Understanding the numbers we live by is empowerment.
Other discussions involve no more analog insulin for type 2s. As if. Again, lucky me. My wonderful doctor whom I see every few months resides 300km from where I live now, but every time I leave it is with a smile on my face. He does not work with guilt, and all of you know how much guilt is part and parcel of diabetes. Even if it just over a glass of wine, or a piece of cake.
I have met other doctors, and have left their offices crying and depressed for days on end. The diabetes police too is an international task force, I guess.
One last gray figure for closure: One in four people in a residents’ home in Germany has diabetes.
That’s what I am afraid of, when I need to force myself back towards the light after another 4am hypo: Living in a home, dependent on others, and most of all dependent on their food choices and the way they cook.
I still love food. No matter what. I may have given up on high heels and tight black dresses, but I still go hunting for good food these days, what’s available that’s light.
Recently I have re-discovered rutabaga and parsnips as great fillers. Lovely, slow, golden carbs. Easy to bolus for. Great food for thought. I live in the city of roots and roses. I might as well make use of that.
Lovely post. Interesting to see yourself reflected in another cultural mirror. Shocking tho if I read the quote correctly that “One in four people in a residents’ home in Germany has diabetes.”
Anke,
Thanks for the post. Interesting and disturbing. I would really like to have some of my “leisure time” shifted from stabbing my fingers to walking on the beach!
Fair Winds,
Mike
Thank you for your kind comments and wishes.
The numbers are indeed disturbing, and I must admit I was not aware of that myself until I checked the latest official statements for this post.
Take care.
Thanks for sharing your perspective. I was expecting to hear that the Germans diet was better — maybe just because it’s European. But, I guess everyone is catching up with America’s bad habits…
What a great post, and thank you so much for sharing that German perspective with us, Anke. I’m a huge fan of German food (and beer) myself, but had no clue about the variance in measuring carbs and all of that. Those numbers are disturbing, as you say, and it sounds like Germany is a part of this as so many places globally are in changing our way of thinking.
Thank you for your insight into Germany and diabetes treatment. I worry that eventually those types of initiatives (no testing for Type 2 nor analog insulin) may find their way here to the US, what with healthcare as it is…
I also worry about us long termers and who will help in our golden years. The thought of being in a home and dependent on others is disturbing to me. Even in health care facilities, diabetes is poorly understood, especially insulin dependence and Type 1.
Thank you for taking the time to write! The statistics you quote are saddening. But what really disturbs me is the discrimination against Type 2 — as if their disease was somehow “milder” than Type 1. I just read that 30% of Type 1′s, but 40% of Type 2′s get kidney disease. Just where is milder in this equation? One of the things we need to do in this country, and you need to do in Germany is increase advocacy for Type 2′s — Type 1′s pretty much have their act together (they have to!), but in Type 2′s the ignorance is generally appalling (except for those who are on the internet, who are generally very motivated and try very hard). Best of luck to the diabetics in Germany, and keep up the good fight!
Hmmmm….National Healthcare telling people that testing blood glucose is a leisure activity and not allowing test strips. Sounds like Healthcare RATIONING to me and is what ALWAYS happens under a national healthcare. It has to. Let’s pray we don’t end up like that. Repeal Obamacare and let’s get some REAL reform done that will free up this rediculous system we have now.
“But, I guess everyone is catching up with America’s bad habits”…?!!
Yeah, Now is the time for America to catch up with Europe’s bad habits of socialized medicine so we can ration test strips and insulin for type 2s…NOT!!
Give me a break Roselady! Are you really so uninformed that you think America is the bad guy?!
Good post, Anke, thanks.
I live in Hamburg and was just told I get 50 testing strips for 3 months and to only test once a week. Just don’t know what to do
Hi, I stumbled upon this while searching for some information on whether glucose jelly beams are available in Germany. Here in Australia, pharmacies sell them for diabetic and hypoglycaemic patients when they crash… Is there any such product in Germany? They are almost purely glucose, and are very different from regular confectionary…
Thank you in advance
I was doing some reseach on diabetes in different parts of the world, I can see in germany you also have a huge increase in diabetes, in 2003 when I statrted to look at figures and said
that diabetes in england could reach 5, million they thought I was an idiot, but it appears this is all to fast slowly but surely
comming true, I based my figures on yearly rises, over the last decade we have seen gigantic jumps in percentage
of diagnosis, it is becomming an epidemic condition, takes
much of the health care resources, I am hoping soon there will
be a cure, beter drugs are now becomming available, I wonder
what the situation will be like in 20 years, curable I hope
I was just doing some research on german hospitals, with the web cam it makes all things possible, it is clear treatment in germany is at a very high standard, probably the best in europe, I do of course have some reservations about the diabetic care is heading in the UK, in fact those with type 2, diabetes not on insulin do not get meters or test strips they have to buy them, we have a number of high cases of diabetes
where I live in EA, some time a go they suggested the cause may be genetic and a result of proximity breading, I decided to
do my own research, and found this was not the case, I found that many people with the condition had moved into the area within the last hundred years from other parts of the UK, it proved this therory to be unreliable, also investigations into background and ancestry proved this to be none conclusive, My grandmother ran a grocers store in the 60′s, we got to know everyone in the community in those day’s as there were
very shops and no supermarkets, diabetes then was very rare
indeed, it was also unheard of in schools, or extremely rare,
with just the very odd case, of course in those day’s diet was
very different, we only ate three meals per day, there was not
so much processed food, but lots of fresh vegtables, fish and
meat, people did not eat,sweets and fast food like they do today, I have been looking at diabetes from the ground level,
i hold the veiw, the causation is in fact food, or chemicals in
food, I would not discount, that a person who has deveolped
diabetes could transfer it genetically once the condition is already established, however I would despute the findings of there being an ancestry genetic causation of the condition in
everyone, this is a nonsense, the fact is we are seeing an
explosion of the condition, in the UK and Germany with all
beit similar statistics, one can only hope science will soon find
a cure for this condition, it has long term implications to the
economy which must not be ignored or underestimated.