November is Diabetes Awareness Month, which includes World Diabetes Day today, November 14. Although many people are already aware that diabetes exists, few people know the real struggle that is being a diabetic. This is primarily due to a history of demeaning jokes that don’t apply to all diabetics.

The year is 2006. Random teenagers and immature adults find a commercial from 1999 and decide that it’s worthy to become an internet meme. Wilford Brimley is a popular actor who is well known for his acting on the show The Waltons.

Probably more recognizable for younger generations, he is also known for having been in a Liberty Medical video explaining his life as a Type 2 diabetic. Unfortunately, he didn’t properly pronounce diabetes, and as the internet always does when people slightly mess up, they added autotune and edited the video in loops. Years later in 2017, we still feel the after effects that this meme has made.

On the comments of food videos or photos on instagram, there is almost guaranteed to be a barrage of “diabeetus” jokes, suggesting that everyone who is diabetic became that way from eating one sugary treat. However, the reality is that not even Type 2 diabetics contract diabetes from eating one meal.

Diabetes is a disease that is caused by a malfunctioning pancreas. For people with Type 1, this malfunction is a total lack of insulin production that is inherited genetically.

Basically, when these people eat, their body doesn’t release the necessary hormones to break down the glucose (sugar) or carbohydrates they’re eating and instead these sugars get built up in the bloodstream.

This is an autoimmune disease, meaning that it causes the immune system to attack perfectly healthy cells. The treatment for Type 1 diabetes is repeated insulin injection before meals and after meals and at night and in the morning and basically any time that blood glucose levels begin to rise.

If they are unable to get insulin into their system quick enough, they risk going into DKA- diabetic ketoacidosis. This is when the body doesn’t have access to sugar for energy so they begin to break down fat and muscle instead, releasing the fatty acids “ketones” into the bloodstream, causing a complete imbalance that can cause coma or even death. In contrast, when blood glucose levels start to fall, it’s a race to be able to eat something with fast acting carbs that will hit your system before you dip too low and risk having seizures, and eventually, death. This disease has a harsh balance between living, dying, and surviving.

Type 2 is primarily diagnosed after repeated and excessive eating of unhealthy foods without exercise. For these people, their pancreas continues to produce insulin at the beginning, but their cells don’t allow for the insulin to enter from the blood stream.

This can be treated by injections of even more insulin to force the blood glucose levels down, but this eventually causes the pancreas to shut down and stop producing insulin. Their blood glucose levels have extremely similar experiences as people with Type 1.

The one lucky part of Type 2 is that although it can be passed on genetically, if the people diagnosed with Type 2 make efforts to eat right and exercise, it can delay or prevent the disease from worsening. In the past, this was considered a metabolic disease, but because of the genetic factor and new found research, scientists are beginning to consider calling it an autoimmune disease as well.

“I was diagnosed with Type 2 back in 2014,” student publications teacher Tom Hayes said. “I changed my diet, starting exercising daily and I lost 35 pounds and my numbers (diabetic) numbers went down. I still treat it (diabetes) with medication, but I feel better. Being diagnosed with diabetes kind of shook me up and reminded me of the importance of taking care of yourself.”

If you fear you may be diabetic, go to a doctor immediately. Catching the disease early allows for you to begin treating it as soon as possible and prevents extreme long term effects including damage to blood vessels in appendages, eyes, and nerves, causing other complications like necessary amputation and neuropathy.

Feet are extremely worrisome for people with this disease because the nerve damage that can occur, even in diabetics who devote their life to managing their illness correctly, can cause irreparable damage and pain. Not to mention that for many people with this disease, life is misunderstood and difficult to explain to other people who just continue to joke that eating a donut will cause this disease. It’s been reported that over one quarter of Type 1 diabetics have suicidal thoughts or attempts, and a little over one tenth of Type 2 diabetics having them as well.

So next time you decide to roam the internet in search of a place to make a joke about a disease that affects over 350 million people worldwide and causes the death of 3 million annually, take a second to think about the people who are dealing with this disease everyday.

Think about the five year old boys who were diagnosed young and have to deal with needle pokes to the finger every day to check their blood glucose levels, think about the mother who struggles to make ends meet and keep their children happy while also staying alive, think about the man who doesn’t make enough to pay for the insurance necessary to supply him with his supplies to stay alive but who makes too much to qualify for free or reduced insurance. Think about them, and think about what you’d say to them if you were standing in front of them.