Early detection and healthy lifestyle are the keys to fighting back.
with Amy Tenderich
Editor's Note: While this columnist is no longer writing for dLife.com and we have ceased to update the information contained herein, there is much to be read here that is still applicable to the lives of people with diabetes. If you wish to act on anything you learn here, be sure to consult your doctor first. Please enjoy the column!
March 2008 —For a project I'm currently working on, I've had to face one of my biggest fears with diabetes: long-term complications. I've interviewed dozens of experts and patients about risk of – and life with – cardiovascular disease, diabetic retinopathy, kidney disease, neuropathy, and even sexual dysfunction. It's been frightening, and fascinating, and hopeful at the same time.
What's impressed me the most has been the spirit of so many people affected by diabetic complications – their incredible fortitude and willingness to help others. For me, hearing their stories finally abolished the "blame factor," that subconscious tendency to believe that if someone has complications, it's their own fault for not taking proper care of themselves. "How could they allow themselves to reach such a state?" It's really not that simple. In fact, I've learned a number of important lessons that have changed my view of complications forever. I share several with you now, in no particular order:
Lesson 1: Now is the time.
Many people who live with complications today spent a lifetime struggling to maintain steady blood glucose control with only the most primitive tools: huge glass syringes that required boiling, beef and pork insulin that took an hour to kick in and then packed a wallop when it did, and once-weekly urine tests to check sugar levels.
"We didn't even have glucose meters. We didn't have tools for early detection. When I was diagnosed, I was already spilling 40 grams of protein into my urine – where it should be under 30 grams. I was already developing kidney disease," says Shawn Faulk, who's had diabetes since she was 12 years old. She's now 50 and a CDE at Sharp Healthcare in San Diego, CA.
Despite having experienced eye and kidney disease, gastroparesis and neuropathy, she can barely express how thankful she is for recent advancements in diabetes care.
New laser treatment saved Faulk's eyes a few years ago when her retinopathy went into advanced stages. She had a double kidney and pancreas transplant in 2000, and has actually been off insulin for the last seven years. As long as the transplanted organs keep working, she's essentially "cured." Her existing complications won't disappear, but the treatments available today can stop them from progressing.
"If you've got one complication, you have to target more tight glucose control. You don't want to have another. We're so lucky now that we can stop the progression to blindness and other damage, due to the great treatments we didn't have in past," she says in a grateful tone.
Lesson 2: Developing one or more complication(s) is not the end of the world.
We kind of tend to think that developing complications is "the end of the line." Well, I've discovered that many, many diabetes veterans out there live very active and happy lives despite the complications they've endured.
"You've only got one life, so you may as well be happy and enjoy it," says Chris Stiehl, who's had type 1 diabetes for 48 years and has experienced nearly every form of damage that diabetes can do, including kidney failure, eye disease, loss of feeling in his limbs that led to partial foot amputation, high blood pressure, and gastroparesis. Still, he is happily married, a busy father, and runs a market research consulting company in San Diego, CA.
"I just got back from exercising at 24-Hour Fitness," he told me. "With a partially amputated foot, balance is hard. Lots of things are hard. But you just have to have the motivation. I tested my blood pressure before and after, and I could see the direct impact. It's lower, and that's very empowering."
Like many of us with non-insulin-dependent type 2 diabetes, my biggest diabetes expense is test strips. In theory, test strips are covered by my insurance — but not nearly enough of them, and not for a device small enough to fit in my pocket. This means that if I want to have the option of testing when I want, where I want — or in more doctor- and road-safety-compliant terms, when and where I need to test (there has to be some proportion of...