Beyond blame

Last month's issue included an article about diabetic ketoacidosis in children. In response, we received a letter from a reader who expressed concerned that it was perhaps not quite clear enough in the article that type 1 diabetes, which is by far the most common in children, is not associated with lifestyle factors such as diet or exercise, and felt that mention of any such factors may imply blame. We are working to clarify those points.

However, even where lifestyle factors do play a role, such as in type 2 diabetes and other long-term conditions, the important message of lifestyle changes for prevention and management may inadvertently carry a subtle undertone of blame; that had we eaten differently, moved our bodies more, smoked and drank less, perhaps we would not be sick. However, we know how complex, numerous and varied the reasons and factors behind illness are. We also know that people who regularly exercise, eat nutritious food and have never smoked a day in their life still receive such diagnoses.