Turn Off the Cruise Control and Grab the Wheel
Type 2 diabetes will not be ignored
By Wil Dubois
Type 2 diabetes is poorly named. When spoken aloud it sounds like "type too diabetes." As in, "Oh, yeah, I have diabetes, too." Or it's just diabetes, too. The word stinks of also, additionally, as well, likewise, and all those other lame adverbs. It makes this form of diabetes sound like a second-rate afterthought of a disease—like ache or tension headaches—not the vicious killer it can be. And believe me, type 2 diabetes is not a disease to be trifled with. It affects more than a quarter of our senior citizens, costs our economy 476 million dollars per day, and lays more than 70,000 of our citizens into their graves every year.
Don't underestimate type 2 diabetes.
Worse yet, don't ignore it.
Maybe type 2 needs a better nickname. Envy the heart attack, medically known as a myocardial infarction, which doesn't sound very scary at all. The advertising agency for myocardial infarction not only staked out the ground "heart attack," but went the extra mile to "the widow maker." Holy cow! No one wants to meet the widow maker! I wonder if we'd do better if type 2 diabetes were known as the Crusher of Kidneys, the Blinder of Elders, or the Sawer of Limbs?
So how is it that such a deadly disease got such a tame reputation? Three words: Medical Cruise Control.
Sam takes his high blood pressure pill, and that takes care of the problem.
Sam takes his cholesterol pill, and that takes care of the problem.
Sam takes his thyroid pill, and that takes of the problem.
I guess we can forgive Sam for taking his diabetes pill and thinking the problem is taken care of. So many other medical problems are fixed by just taking a pill and letting the doctor worry about it, after all.
But now, nine months later, Sam's kidneys are in trouble. Big trouble. What did Sam do wrong?
Well... Nothing. Sam did nothing wrong. In fact, Sam did nothing at all. He just took his pill. And that was his big mistake. You don't turn your back on a mountain lion, they jump their prey from behind.
Type 2 diabetes isn't simple like blood pressure, cholesterol, and thyroid. It's chronic: Meaning it never goes away, even if you try to ignore it. But more ominously, it's progressive: Meaning it gets worse on its own, even when you do everything right. And it has few, if any, symptoms as it grows—until damage is done.
So Sam really can't be blamed. No one told him type 2 diabetes is different from his other ailments.
But you have no excuse. Because you have me. And I'm here to tell you what you need to know. So, as of today, no more Sams. No more ignorance. No more Medical Cruise Control. No more ignoring your diabetes. It's time to be aware that it's not going to go away if you ignore it. It's time to be aware that it'll only get worse over time, and you have to keep tabs on it. It's time to be aware that type 2 diabetes takes some work on your part.
Occasionally my mailbox or follow-the-link browsing will come up with something discussing whether (and if so, when) to ease the restrictions on treatment goals when the patient is elderly, arguing either to favor a higher quality of remaining life (lifestyle choices less limited by chronic illness) or to take into consideration geriatric cognitive decline (aka "senility") and simplify, as much as possible, the regimen. While the goal of medicine is, obviously, not to...