Personal 10: My struggle with Diabetes (v1.0)

 

Diabetes is an endemic disease and once it takes hold, all you can hope for is keep it under control. There are two main type – Type 1 and Type 2. Type 2 typically sets in as you age. The best way to avoid type 2 diabetes is control your diet and exercise and try to eliminate the risk factors. However, if you evaluate as prediabetic at some age that is the final warning to get your diet and exercise in place. Once you become a full-fledged diabetic, all you can hope for is keep it under control with a combination of diet, exercise, self-monitoring of blood glucose, work on your risk factors, and medication. A diabetic must get a A1C measured frequently (at least once every 6 months) and consult with your doctor to see if any changes are needed. This is crucial.

I have full type 2 diabetes and it is a constant struggle to keep it under control. This was especially challenging during the pandemic. The recommended A1C level is less than 7 for a diabetic, but my last reading was 10.3 in March 2021. I have work to do. My next A1C is due soon. A1C is an indirect measure of glucose levels over a 3-month period.

In the US, 84.1 million people are pre diabetic. 23.1 million people are confirmed diabetic. It is estimated another 7.2 million people are diabetic but undiagnosed. So, this disease is quite common in US. The percentage of Americans with confirmed diabetes has increased over time. In 1958 it was 1%. Now it is more like 8%. This is a commentary on contemporary lifestyles!! Between 30 to 40% of people with type 2 diabetes take insulin.

Diabetes is excess sugar in your blood. There are many organs involved in regulating your blood sugar – the Brain. Muscles, Liver, Fat, Pancreas, Kidney, and the intestines. Some of these increase the level and others decrease it. Long term complications of diabetes include heart attack, stroke, poor circulation, eye disease, kidney disease, and nerve damage. Short term complications are hypoglycemia or hyperglycemia. Some of the symptoms of diabetes include increased thirst, Increased urination, Feeling tired, Blurred vision, more frequent infection, Hunger, and weight loss.

The key risk factors for diabetes are family history, ethnicity, age, high cholesterol, high blood pressure, smoking, Obesity, and sedentary lifestyle. I have most of these risk factors except high blood pressure.

The key oral medications for type 2 diabetes are biguanides (liver), sulfonylureas (pancreas), meglitinides (pancreas), thiazolidinediones (fat, muscle, liver), alpha-glucosidase inhibitors (intestines), DPP-4 inhibitors (pancreas), SGLT-2 inhibitors (kidney), Dopamine receptor agonist, and Bile acid sequestrants. The key injectable medications are GLP-1 RA, Amylin Analog, and insulin. I take Biguanides, sulfonylureas, SGLT-2 inhibitor, and GLP-1 today. Some day I may end up on insulin.

Diabetes is a dangerous disease and should be taken seriously. The long-term consequences are quite severe. I know it is a pain to have such an endemic disease, but there is no alternative but to actively manage it every single day and have your doctor take care of you. Do not get discouraged if you fall off occasionally. Get right back on the saddle!!!

My diabetes may progressively get worse but it is not preordained. The good news is that I don't smoke, drink alcohol, and try to exercise 30 minutes every week day. I try hard to control my diet, although I really love good food. But my genetics is against me. I am not concerned about when I go. I don’t fear death. But I don’t want to burden my wife by getting disabled, and I want to be around to help her as she ages as long as I can. But she will be fine after me.

My take is that the purpose of life, whatever it is, is now complete for me. Now we are on bonus time, to do what we want, with no responsibilities or stress except health, and to live a carefree life. Every day is precious to do with as we please. We have no agenda for the world. There is no need for a purpose.
NOTE Nov 2025: My A1C is now 6.4!! Cool!!