What is type 1 diabetes and what causes it? It is an autoimmune disease in which the human immune system attacks its own beta cells in the pancreas, which are responsible for producing insulin. Type 1 diabetes is not caused by excessive consumption of sweets, a poor diet or lack of exercise. It is diagnosed in infants and older children who are not obese, but rather slim and athletic.
During the preschool and school years, the parents of children with type 1 diabetes come up against a wall. It is built from a lack of goodwill, teachers’ enforcement of the law and ordinary human indifference. Getting rid of the “problem” by sending a child to another educational institution is an everyday reality for children with type 1 diabetes and their parents. Doors bearing the message “we do not want you because you have diabetes” are not uncommon. There are exceptions, however: teachers who take on the challenge, “Type 1 diabetes versus the teacher.” They learn about the disease and, with a little goodwill and empathy, release parents from having to camp out in preschool and school corridors, while creating conditions for the ill student to develop normally among peers.
To ensure full care for a person with an incurable illness—in this case, a child—the legislature has made it possible through a disability certificate containing a whole range of criteria. “Type 1 diabetes versus disability assessment”—that is a problem in itself. Comparisons detached from reality with healthy peers, often made by doctors without diabetology specializations, are harmful and discriminatory. The absence or removal of point 7 in a disability certificate (point 7—“the need for constant or long-term care or assistance from another person due to a significantly reduced ability to live independently”) prevents parents from ensuring their children’s safety and from helping them learn about the disease during childhood or at an early stage after diagnosis. The assessing physician decides on behalf of the parent, on the basis of records and a several-minute interview, without evaluating the actual situation. The fact that a person with diabetes can put on their shoes, wash themselves or eat a meal just as their peers do does not mean that an hour later, during severe hypoglycemia (low blood glucose), they will be able to do so. Diabetes disqualifies assessors who abuse their discretionary authority against children with type 1 diabetes through their superficial and erroneous assessments, as demonstrated by frequent appeals to higher authorities and courts.
“Type 1 diabetes versus politics”—where should one begin and where should one end? Children with disabilities are a “problem,” and children with type 1 diabetes are the proverbial fifth wheel on this problem-laden wagon. The 500+ program cannot be used to finance a child’s disability, yet unfortunately this is the case in many instances. Parents who love their children with disabilities are burdened with the lack of funds in the budget. They are willing to give everything and go into debt to help their child. A package of five cartridges of the insulin necessary for life costs at least 40, 50 or 70 zlotys; continuous glucose monitoring (partially reimbursed under the Ministry of Health regulation from 1 March 2018) is available only to selected patients; disposable needles for insulin pens and lancets for lancing devices are fully paid for, and so on... How much, in the eyes of lawmakers, is the life of citizens worth—in this case, the lives of people with diabetes? Adult people with type 1 diabetes hold a special place in government austerity plans, because they are deprived of almost everything, with only minor reimbursement exceptions. Today’s children are growing up and will add to the group of adults with type 1 diabetes. What plans for the future does the ministry responsible for public health have? People say it is better to prevent fires than to put them out. A statement more consistent with the ministry’s current policy would be: wait until it burns down and then sweep it away... Saving money at the expense of human health is barbaric and calls the democratic state governed by the rule of law into question. One cannot fight for unborn life while saving money on the health of those already living.
People can be both friends and enemies to one another. Divisions also exist among people with diabetes, and with a broader perspective they can be reduced. The fact that someone has mastered the subject of diabetes does not mean that everyone is physically or mentally able to master it to the same degree. The fact that some people have personal and financial support does not mean that everyone lives at that level. The fact that an adult with diabetes did not have today’s therapeutic conveniences in childhood does not mean that current young patients should not be able to benefit from them. Diabetes tramples people, destroys their closest surroundings, and causes discrimination and stigmatization. It is a struggle for life and survival. Despite all the difficulties that type 1 diabetes brings, young patients achieve tremendous success in sports, technical fields and the visual arts. Defying the disease, they boldly show their strength and endless will to fight. Do not be afraid of diabetes; respond to the needs of people with diabetes. Any child can develop type 1 diabetes. Do not remain indifferent—take an interest in this disease, because you may one day save the life of a person with diabetes.
Witold Fydrych
(“SŁODKA JEDYNKA” Association).