Thoughts on Diabetes

I have diabetes. I've probably had it for most of the past 20 years, but I've only known about it since early 1996 - just 11 years ago.

I didn't know I was diabetic for the 8-9 years prior to that because my doctors during that time didn't think I really was. If anything, I was "boarder line diabetic" - flunking my glucose tolerance test (fast for 12 hours then drink a high-glucose drink, before, during and after which they'd take blood samples) the first time, then pass it the second time.

This was before the invention of the HbA1c test that measures the "sticky" sugars stuck to red blood cells. It takes advantage of the fact that the blood cells have a life cycle of about 120 days - so the amount of glucose stuck to them on average gives an indication of how much extra there has been in the system over what the body's insulin has allowed/helped into the cells for fuel.

At the time, I had been suffering from some minor infections near my fingernails that normally would have lasted a few days, but in this case had lasted over a month. That was why I had visited the doctor at that time in early 1996.

He said "the good news is your infections are nothing to worry about... the bad thing is that the reason you're not healing is that you are diabetic." As a GP, he had a number of things to tell me, but he handed me on to an internist for more in-depth work-up and I'm eternally grateful for that. My new specialist friend, and I class him now as a friend, was brutally honest to me about what my affliction meant then and could mean in the future.

He told me that he expected me to be dependent on insulin injections within 10 years.

He told me that I should watch for "tingling" in my feet and hands - and that that was a sign that I might lose limbs.

He told me that I would probably end up with high blood pressure and might die of a stroke.

He told me to watch for diminished sexual abilities - not needs/wants, but the ability to perform when I really wanted to.

He told me to lose 50 lbs and keep it off - I was 245 at the time and I'm 6'4" - with a "best-weight" of around 195-200.

And I believed him.

I lost 40 lbs in the next 6 months.

I stopped drinking anything but water, coffee, dry red wine and at that point, artificially sweetened drinks, with some beer thrown in on occasion. In 2000 I quit diet drinks cold-turkey, but that's another story.

I stopped eating at smorgasbords - I stopped going to all-you-can-eat anythings. I stopped ordering the biggest steaks on the menu and started ordering the smallest but best, and eating the green and yellow veggies first and almost no starch (not none!) but eating that last in any case.

I started eating on a schedule - 3 meals a day, all within about an hour of the same time each day, 7AM, noon, 6PM - with the very occasional snack near bedtime. No more mid-day donuts.

I started drinking coffee when I was hungry between breakfast and lunch, and nuts between lunch and dinner, with cheese before bed.

I stopped having burgers at fast food places. I started frequenting Mexican fast food if I had to have something fast. In fact I started eating at Mexican restaurants a lot more than I had. Real cheese, fresh vegetables and greaseless meats make a big difference; so does the spices but again, that's a different story.

I started walking or riding a bike for at least 15 minutes a day - hard - with many weekends including an hour or more of one or the other, or in Winter, skiing, and in Summer, swimming.

It took over 5 years for me to stop being hungry between meals - and in fact this didn't happen until I gave up soft drinks completely in 2000.

It took over 5 years before I could go a couple of days without exercise and not have it literally hurt; in my fingers and other joints.

I've gone from up to 6 Metformin (500mg) a day to where I generally have 3-4.

I've gone from using my blood-glucose meter religiously to where I have not used it in over a year.

For the past 3 years I've been stable at 200 lbs.

It is now almost 12 years since I was diagnosed and the last time I talked to my internist he said it is likely at least another 10 years before I might need to inject insulin. Neither of us think I'm cured - in fact I know I'm not because I can feel what falling off my normal diet does to my brain and body, that's how atuned I've become to it. I know when my sugar is out because my brain slows down and my eyesight (one of the better things about my body) gets less than perfect.

This weekend I hope I scared a friend of ours enough that she will take the potential consequences of her diabetes seriously enough to change her habits. She ordered French Toast with syrup for brunch while I had an omelet with no side of potatoes.  She says that's the last French Toast for her - in fact wanted to take a picture of it to remember it by. All in the name of keeping her feet because she'd been complaining that she'd been diagnosed with "diabetic feet" - hot sweats at times and pins-and-needles at others; a sure sign that her sugar has been out enough to do damage to her nerves in her feet - and the first sign that she may end up losing them sooner rather than later.

I've watched others who started out the same as me - borderline - end up in hospital with all manner of complications in less time than my doctor gave me to end up on the needle. People who simply thought that the pills their doctor gave them were enough, and that they didn't have to change their life style. Instead, now they have to go through physical therapy and learn how to walk on a prosthetic - or use a wheel chair.

Not for me - I saw the future and said no, not me.

Diabetes is a wakeup call to change your style of living. I used to eat everything on my plate - and go back for more. I used to eat a whole large pizza at a sitting and wash it down with multi glasses of pop. I used to go days without eating anything but burgers from various fast-food places, and I used to go months without any more exercise than walking from my car to my office - and I had the closest parking spot to the door.

Whether diabetes will ever be truly cured isn't known. Certainly type 2 is more than  just a weak set of islets on the pancreas, it is also insulin resistance due to other factors; lack of exercise, excess weight/fat, and who knows what else. There may never be a single "cure" for type 2. No matter, in the mean time we have to survive it and live to enjoy ourselves and our lives and those around us.

Deciding that I was going to change and do my utmost to live without injections - which also meant not losing body parts and turning into a vegetable - meant changing the things I did on a daily basis. What it did not mean was stopping enjoying life, eating, work and play. In fact, it actually made all of them better because now I think about what I'm eating and work at enjoying it, I do more and more variety of things, and I have an excuse to not get so bogged down in my work and other commitments that I can't take time for myself and my health. I actually use my diabetes to make sure I don't end up crippled - and so that I enjoy life daily instead of just some weekends and maybe on vacation.

What having diabetes doesn't mean is that I deprive myself of anything. I've stopped craving sweets because I no longer have anything sweet in my daily diet, but that doesn't mean I never have a sweet. I had a sweet desert with my dinner at a restaurant last Friday. It sat on top of my small filet steak and vegies main course - and was washed down by far too much red wine, but because I've been good and kept my sugar in check for so long, that one desert (last one was over 2 months ago) probably won't even show up on my next blood test. Last one was 5.7, and 10 years ago I was 8-9 average with spikes to 14.

It is possible - but you have to work at it every meal of every day.