Type 2 diabetes diagnosis: 6 months later
NEW YORK I was sitting in my recliner watching TV on a sunny Sunday morning in June when my doctor called. I had been to see him that Friday for a checkup; he was passing on the alarming news that my blood glucose was over 300 mg/dL - about triple that of a healthy person.
"Whatever you do, don't eat anything sweet," he warned, after we made plans to have me see an endocrinologist that week.
After he hung up, I reviewed what I had eaten that morning: a latte from the French bakery down the street, along with a chocolate-almond croissant dusted in powdered sugar with two seams of rich dark chocolate inside. I had also polished off a pair of half-empty sorbet cartons in my freezer -- you know, to clear the decks for the coming week.
Sugar was pretty much all I had eaten that morning.
I spent the rest of the day googling the obvious likelihood that I had probably joined the ranks of 25.8 million Americans with diabetes. That's 8.3 percent of the U.S. population, according to the American Diabetes Association, and an estimated 7 million of those people don't even realize they have the disease. The ADA estimates another 79 million Americans are pre-diabetic -- which means they're well on their way to joining the club if they don't make lifestyle changes.
Taken together, that's more than 30 percent of the U.S. population that is diabetic, undiagnosed, or pre-diabetic, according to the ADA.
When I saw the endocrinologist two sugarless days later, my blood glucose was at 250 mg/dL -- still way too high. Another test of long-term control of blood glucose levels also had super-high levels.
A normal blood glucose ranges from 70 to 130 mg/dL before a meal to less than 180 mg/dL after a meal, according to ADA.
It was official: I was a Type 2 diabetic. My new endocrinologist gave me a blood monitoring kit, a couple of prescriptions and an admonishment to see a nutritionist. I was on my way into a new phase of my life.
The six months since my diagnosis have been an unsettling time -- a gut check of how much discipline I have; a daily test of my commitment to get healthier. I've had to readdress my relationship with two of my comrades-in-arms of middle-age, gluttony and sloth. I've spent a lot of time reading about what exactly diabetes is, and the pernicious effect it has on the entire body -- eyes, kidneys, liver, heart, blood vessels, nerve endings, feet, penis, skin.
As someone who has been prodigiously healthy all his life, it's been a sucker punch to be suddenly saddled with a chronic condition. I'm angry that I'm taking pills that have distressing side effects like flatulence and diarrhea. I'm secretly hoping that if I can drop a lot of weight, this will all go away -- which may or may not be in the cards.
I don't know why I was so shocked at this diagnosis. Both my father and maternal grandmother had developed Type 2 diabetes late in life -- but much later than myself at a mere 54 years.
In recent years the warning flags at my annual checkups had been more about high cholesterol and obesity. I remember a few years back listening to my doctor give me this and that result, and then asking him something like "Yes, but other than the weight, I'm in pretty good health, right?" To which, I'll never forget, he looked me in the eye and yelled "You're too fat!"
But high blood sugar was not on my radar, other than as a general issue that might crop up in my old age.
My symptoms, in the months before this checkup, were classic signs of the disease: unusual thirstiness, frequent urination. I had been getting up to go in the middle of the night, which I never did before. My kidneys seemed a little off their game. I now know that when you have excess sugar in your blood, your kidneys have to work harder to clear it. Of course that's just one of the many damaging effects from excess sugar ripping its way through your system.
I was overweight and felt sluggish -- but that was nothing new. I figured that's just how you felt when you're middle-aged and heavy. That's how we roll in fat America.
In addition to the pills, my days now include a pinprick, a drop of blood and a number on a tiny digital device that tells me whether I've been a good boy or not.
I had first learned about blood glucose monitoring in 2006 when my father was dying of pancreatic cancer, and I took time off from work and went to Arizona to help. A home nurse showed me how to do it and I took charge of pricking my dad's finger each day, dipping the testing strip in the drop of his blood and reading the results on the little screen.
I remember one time my father's blood sugar was over 300, which I duly reported to his doctor. I will always remember the kind way his doctor looked at me and said, "Yes, that's bad. But that's not what's going to kill him."
And so it was.
I learned testing your blood is easy. The monitoring kit comes with a little needle device that you can set for the slightest of punctures and you don't need much blood at all.
At CBSNews.com we have tools that tell us the real-time traffic for any story or video on the website. Blood glucose monitoring is the same thing -- it's real-time information on how you're doing with your diet and exercise.
If you, like me, believe that knowledge is power, than the glucose monitoring device is a powerful tool.
The last six months since my diagnosis have been a tale of two halves:
- The first three months I was so freaked out by the diagnosis that I was eating the perfect diabetic diet: A lot of salad and vegetables, lean proteins, low carbohydrates and very little sweets. My blood sugar numbers quickly improved.
- The second three months however have been more exploratory: how much can I get away with? How many sweets can I let back into my life without going overboard? What are the trade-offs?
I have dieted many times in my life and know that I can observe a strict regime for a while. I also know there's a certain point where you begin to lose your willpower if you're not eating at least some of the things you love.
A popular nutrition technique for diabetics involves drawing an imaginary line down the middle of your plate. The half to the left of the line should be all greens, salads and vegetables. The other half of the plate, on the right, is divided in half horizontally -- with a lean protein in the top quarter and a low-glycemic carb like sweet potatoes in the bottom quarter.
I have found the perfect diabetic dinner to be grilled salmon with a salad and vegetables. I say "perfect" because I've found, via the blood glucose monitor, that I can also add on a cup of frozen yogurt and still hit acceptable blood levels two hours after the meal.
Perversely, the successes I've had -- based on the blood-sugar readings -- have let me fall back into some bad patterns. No, I don't eat the whole carton of Haagen-daz in one sitting, as in days of yore -- but I will eat half of it. But not that often.
I am very proud, however, of a lifestyle change I've made with the help of an iPhone app and an exercise buddy. I am walking: I walked 55 miles in November; 75 miles in October; 85 miles in September ( I did a lot of hoofing on vacation in Montreal); 65 in August; 55 in July.
I am a goal-oriented person. I want my gold star for performance. Having a GPS walking app that tracks my total mileage makes it more fun for me. I set a goal each month and try to hit it. It's a little colder now, so it's not realistic to shoot for as many miles as during the summer. Having a walking buddy helps you commit to getting out of bed on lazy weekend mornings; I highly recommend it.
So here I am, six months after getting my diagnosis. I've had some positive responses -- and some lapses. If I had to give myself a grade for how I've responded in the past six months, I think I earned a "B-". The walking was a huge change for sedentary me. I've adjusted my diet a lot. The other night I had fish and chips, and subbed salad for the chips. I really wanted those chips, but I subbed salad. On the downside, fried fish is not the greatest meal because fried foods elevate your blood sugar and make it stay high for a longer period of time.
I'm hard on myself in that I have not lost the weight that I wanted to. When I got the news in June I weighed 238 lbs.; six months later I weigh 235 lbs. Three pounds in six months is not a game changer. I could tell you that I feel a little firmer in my thighs and butt from the walking, and that my pants are a little looser. But for a 6-foot-tall man, I should be closer to 200 lbs.
So there's room for progress on the weight-loss campaign. I blame my buds gluttony and sloth. I tried to kick them to the curb. But like most pimps, they're hard to shake loose. They hang around.
- 371 million people have diabetes globally, about half undiagnosed
- Rising Type 2 diabetes rates linked to increases in high fructose corn syrup consumption
- Lifting weights may protect men against Type 2 diabetes
- CDC: Less than half of Americans get enough physical activity
When I told friends about my diagnosis, a common reaction was a look of concern and "Oh, I'm so sorry."
I quickly realized that I didn't see my situation in those terms. The fact is, I feel much better now than I did six months ago. My kidneys feel better; I'm not getting up in the middle of the night. Whether from the pills or the walking, I feel peppier.
I've gone from a bleary state of feeling that something was not right to a clear-cut proposition: If I value my health I will take certain steps -- and if I don't, I won't.
I would highly recommend to anyone reading this piece to go get checked out whatever little thing is worrying you in the back of your mind. If it's nothing, then you don't have to worry about it anymore. If it's something, then you have concrete choices, options and decisions to make. I think that's preferable to nebulous unease.
Because if there's one thing I believe more than anything else in life, it's this: knowledge is power.
If you've read this far, you must have some interest in diabetes. Will you share your experience and insights in the comments area below? I'm especially keen to hear from anyone who has gotten off the pills completely.