Sunday, September 30, 2007

Diabetes is just a pain in the ass.

This pretty much describes me:

For some people with diabetes, the burden of adhering to their daily care regimen nearly equals that of their diabetes-related health complications, a U.S. study finds.

University of Chicago researchers conducted interviews with more than 700 adults with type 2 diabetes.

As reported in the October issue of Diabetes Care, some patients said the inconvenience and discomfort of having to take numerous medications each day, carefully monitoring their diet, and getting the required amounts of exercise had a major impact on their quality of life.

I have written about my illness previously, and this is a typical day:

Each day, a typical diabetes patient takes many medications, including two or three different pills to control blood sugar levels, one or two pills to lower cholesterol, two or more pills to reduce blood pressure, and an aspirin to prevent blood clots. As the disease progresses, the number of drugs increases and often includes insulin shots, according to background information in the study.

From 12 percent to 50 percent of patients interviewed said they were willing to give up 8 of 10 years of life in perfect health to avoid a life with diabetes complications, but between 10 percent and 18 percent of patients said they were willing to give up 8 of 10 years of healthy life to avoid life with treatments.

I emphasized that last part because that's precisely how I feel.

The only thing I can eat without remorse or reservation is vegetables. Not fruit -- even watermelon spikes my blood sugar. Forget pineapple or strawberries. Red meat slams my cholesterol, and alcohol sends my trigylcerides into the ozone.

So how would YOU like a nice salad for breakfast this morning?

The decisions you make three to five times a day about what to put in your mouth have, for me, those afore-mentioned "long-term implications" under consideration: shall I have the salmon or the filet? The sandwich or the salad? The mocha Frapp or the tea?

No pasta. No bagels. No soup (too much sodium). Nothing fried. One glass of wine or one beer, period. Walk for twenty minutes, minimum, after dinner every single evening. Don't forget to pack both meds and healthy snacks every time you leave the house, lest you go hypoglycemic. Despite tight control of my blood glucose for the past few years, I still experience one of these episodes about once or twice a month.

Forget about Italian food. Pass on the Chinese takeout. La comida Mexicana is off the menu as well. Can have some sushi (sashimi obviously being the wiser choice). Mashed potatoes? Very funny. Rice? Ha ha. Corn? I don't think so. Whole grains -- complex carbs also including beans, for example -- are better than the bleached, refined ones, but not by much. Bread, chips, crackers, pastry, cake, cookies, ice cream? Pizza? A cheeseburger and fries? Are you nuts?

I didn't have bad eating habits before my diagnosis; I ate only a little red meat even when I was 20-something. I always liked all kinds of fish. I stopped drinking cow's milk (me soy guy) decades ago. As in two decades ago. No sodas for at least as long a period of time. I was also moderately active or more all of my life, playing sports as a kid, climbing and hiking with the Scouts as an adolescent, intramural basketball and softball in college, and so on. Throughout my thirties I took vitamins and supplements and was in the gym four days a week for an hour lifting, followed by another half-hour of aerobic activity. Now, once I tapered off and then stopped altogether about five years ago, I quickly gained 25 pounds. And became diabetic.

There was no history of the disease on either side of my family, and no incidence of heart disease either (sometimes diabetes goes undetected in individuals for years until they experience a cardiac event -- or a stroke, for example). Can't blame it on the genes. Can't find much of anything to blame it on, really; I just got lucky, I guess.

So anyway, it's just a drag when you're out with friends and everybody else is having the fajitas or the fettucine alfredo or the Philly cheese steak and you're having the grilled chicken salad (not the Caesar and no ranch dressing) for the tenth time that week.

Is an occasional guilty pleasure worth the risk of onset of failing kidneys -- or reduced vision or an amputated foot -- a few years earlier than perhaps it would have occurred?

Sometimes it is, yes.

How much of life is really worth living if you have to deny yourself virtually everything that makes it worth living in the first place?

So once in a while -- not very often, and certainly not as often as I would like -- I have the nachos or the pasta or the fried rice, and take extra medicine, and don't fucking worry about it.

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