There's something to be said about being diagnosed at a stage in life where one has memories of family and friends living with diabetes, and how well they have (or have not) managed their condition: we have real-life role-models to help us understand what we can do, and what we can avoid doing, to optimize our health. This is particularly important when we are newly-diagnosed and need to set in place the lifestyle changes that diabetes requires of us.

While I'd known several people with diabetes -- friends, family, and colleagues -- in the forty-two years leading up to my diagnosis, two stood out in particular: my childhood orthopaedist, and my stepmother's father.

"Why these two?" one might ask. "Why not your mother's grandmother, or your father's mother, or even your own mother? You knew these women a lot longer, and a lot more intimately..."

My great-grandmother was a role model in many things, but I did not even know she had diabetes until she was in her eighties at the time. Her insulin and her diet -- what there was of it -- were generally administered by the Home's staff. My dad's mother's diabetes was diet-and-exercise controlled -- which is where I would have expected to be at diagnosis  (rather than immediately given a script for extended-release glipizide) in addition to diet. While both of these women ended their lives with senile dementia, at the time they died, this was not considered to be complications of diabetes. My mother is, like many, a complacent diabetic -- as long as her doctor says she's fine with the current medications, she's not motivated to change her diet and (lack of) exercise patterns.

All of these women were diagnosed after they reached retirement age, giving me the impression that adult-onset diabetes was an "old folks' disease", giving me little from which to develop my own diabetes management style.

While I never had cause to see Dr. Germansky as an adult, I had known he had diabetes for years. Notwithstanding, he had a successful practice; he had studied in Geneva as well as in the United States; he kept up with innovations in the field of orthopaedics; and as far as we could tell, he was always in robust health. He continued practicing even after he had lost one leg to diabetes. From what I was told, he finally retired sometime in his eighties -- only after losing his second leg.

Dr. Germansky showed me that diabetes does not have to be a death sentence.

From what little I saw, my stepfather was the polar opposite. While I later learned that he was more careful in the years following his initial diagnosis, I was first introduced to him some years later -- years after my grandmother was diagnosed with diabetes, and years after he himself had lost one leg to diabetes. Sadly, he was one of those people for whom the loss of a limb resulted in a sort of psychological paralysis -- perhaps today's professionals might diagnose it as unresolved mourning leading to a sort of depression. I saw someone who did not pay attention to diet or to medical advice. I saw him lose his remaining leg piece by painful piece -- and with it, his will to live.

My stepfather showed me that uncontrolled diabetes kills piece by piece -- the same way that cancer kills.

From these two men I learned the importance of controlling diabetes, even when I was still in denial of my own diagnosis. And I learned that negative role models can be as powerful as positive ones, if that fear pushes you in a positive direction.

Rest in peace, both of you; the lessons you taught will not be forgotten.