Thursday, May 16, 2013

diabetes is not my fault

I already posted some of this on facebook, but then realized I have a lot more to say. So here is my original post:


I am so tired of reading things that imply or claim that people with type 2 diabetes become diabetic because they are or were overweight. This is oversimplified and adds blame and shame to an already upsetting and frustrating disease. Perhaps more people should read this fact from the American Diabetic Association...

Fact: Being overweight is a risk factor for developing this disease, but other risk factors such as family history, ethnicity and age also play a role. Unfortunately, too many people disregard the other risk factors for diabetes and think that weight is the only risk factor for type 2 diabetes. Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.

And here is what I want to add: 

I have never been 'skinny'. Aside from the year I had mono, I have probably never been the correct weight for my height on a chart. But I have been fit and active most of my life. With the exception of a few years while having kids and working multiple jobs, exercising and sports have been a priority for me. And most days I manage to eat right. 

Nevertheless, a few years ago, I went to the doctor complaining of a pain in my side. He listened to my symptoms, then checked my blood glucose levels. My fasting blood sugar level was something like 290 (120 is normal), so he told me I probably had diabetes. I mentioned I had eaten several cookies before bed the night before. He quipped, 'It would take more than a few cookies to get a reading like that.'

A few days later he called my cell. I answered, he asked what I was doing. Odd, I thought. I was driving, I told him, so he asked me to call him back. My heart sank and my stomach knotted up. Cancer is prevalent in my family. Rational or not, it has been a persistent worry.

I called him back the minute I got home, prepared for the worst. He told me I had type 2 diabetes. I was relieved. A little annoyed perhaps, but mostly relieved. I didn't have cancer! 

Diabetes was familiar to me. My dad had diabetes for about 20 years before he died. Many of his siblings had diabetes and lived a long time. My oldest brother developed diabetes around my same age, my younger brother was diagnosed a year or two before me, my mother was diagnosed a year or two before that, and one of my sisters had been 'borderline', like me, for awhile. I had even had gestational diabetes myself, twice. So bring it on!

I started taking Metformin, to help restore the way my body turned food into energy, and read everything I could find on controlling diabetes.

Although I was already running several days a week, I was only running three miles a day. With the help of a running partner, I bumped up to four days a week and ran a 10k (6 miles) within six months. Two months later, I ran my first half-marathon (13.1 miles). I cross-trained with biking and walked on my 'rest' days. 

I became obsessed with counting calories and carbs; myfitnesspal was my new best friend. I had lost ten pounds from my heaviest weight before being diagnosed. With concentrated efforts, I lost nine more and then stopped. I increased my exercise and decreased my calories, but the scale wouldn't move. After the half-marathon, I gained four pounds. I increased my exercise and decreased my calories; the scale didn't move. Winter came and I gained five pounds. No matter what I did, the scale wouldn't move. 

I went back for checkups; my cholesterol was high, my blood pressure was high and my weight was 'overweight' on the chart. The doctor told me I needed to lose weight. My father-in-law (a retired doctor), told me I needed to lose weight. I was angry and upset. 

I read more articles, more blog posts, more study results. The more I read, the more discouraged I got. I started to think having diabetes was my fault. One man claimed to have cured his diabetes by following The Paleo Diet. Another article linked diabetes with Alzheimer's, citing the over-consumption of sugar as the "cause". It would seem, from the majority of literature I read, that I was sick because I was fat. I wasn't doing enough...

Spring came and I lost my winter weight, but I wanted to get back to my lowest point; even more, I wanted to lose enough weight to fit on the doctor's chart. I thought this was the only way to prove to myself that I didn't deserve to have diabetes.

At some point, I went too far. I realized this when I ran 8 miles one morning after eating very little the night before. I had eaten nothing before the run, and only a few Sport Beans during the run. I had started drinking as little as possible too, as a good, long run without water could easily make me two pounds lighter on the scale. Since I typically burn at least 100 calories per mile, it is likely my blood glucose levels were dangerously low. Unfortunately, when my levels are low, my thinking becomes muddled. I didn't eat much after my run, because after noting I had burned about 900 calories on my run, I got this number stuck in my head as the total number of calories I could consume that day. I ate a small snack and took a nap. 

With great difficulty, I dragged myself out of bed a couple hours later. Fortunately I went to a party, where I told a friend and running partner how tired I had been the past week. A dietician, she suggested it could be my diabetes. Light dawned. I hadn't been eating enough. I ate a cupcake. And a cookie. Within fifteen minutes I felt more energetic. I went home and ate whatever came to mind. The difference was incredible!

I stopped tracking calories and maintained the same weight. By chance, I visited a nurse practitioner when my regular doctor called in sick. He told me I wasn't fat. He told me the diabetes wasn't my fault. He told me my cholesterol was high because the sugar in my blood wasn't finding its way into the cells where it belongs. He told me I should take medication for it, but it wasn't imperative now; he would tell me when it was. Later, he told me my blood pressure was too high, despite all the running; another side effect of diabetes that wasn't my fault. I had to start taking medication for it, he said, 'I know you don't want to, but it's time.' He reiterated that I was healthy and fit. That I was doing everything right. That I was not at fault. The relief was so great, I cried. 

I'm still working through my tendency to obsess: to blame myself for the state of my health; to push myself until my body starts to break; to worry my kidneys, my heart, my eyes will fail; that I will abandon my children and spouse. But I am starting to come to terms with my disease. And to accept my body, and appreciate all it can do, even if it doesn't fit on the charts. 

On the up-side, I don't worry much about cancer anymore. Now if I could just get rid of that pain in my side...