November 18, 2008

Diabetic? Who cares?

Hear no diabetes, speak no diabetes, get photo from Flickr.

According to the CDC, 1/4 of Americans have prediabetes and don't know it.

Wait a minute. Back up and read that again. 1 out of 4?

Here's another statistic. The rate of people who already have diabetes has gone up by 90%. And WebMD says that may be an underestimate. (They also say the number of people who already have prediabetes is 1 out of 3.)

Type II Diabetes: easy to control, dangerous to ignore

Even though yes, I know, there are tons of people out there who are either at risk or already have the disease and don't know it, this still surprises me.

The trouble is that if you're reading this post, you probably are not one of the people with prediabetes, because you are interested in regular exercise and a healthy diet. But I will guarantee that someone you know -- maybe someone you love -- is one of the statistics.

I mean, damn! In the early stages at least, prediabetes and Type II diabetes are easily controllable disorders. And they can be controlled by the individual; it's not a situation where you have to put yourself in the hands of others and take a bucketful of weird and expensive drugs with powerful side effects.

People who know better and don't bother

It's frustrating. As an example, take this guy I know. Extremely well-educated (well, I assume lawyers are educated, they sure know a lot of words I don't) so you would think he could bother to read about the risks of Type II diabetes, you would think he would bother to find out the minimal steps necessary to deal with the condition. The only concession he made to his condition was to take his medication. (Yes, he did switch to lite beer, and he did minimize the amount of red wine to a couple of drinks a night, but I don't call those concessions.)

The thing is that Type II diabetes is one of those diseases that you CAN do something about: diet and exercise and (definitely 3rd in the list) medication can control the symptoms and progression of the disease.

So why are there so many people out there who can't be bothered?

Diabetes doesn't go away if you ignore it!

My anger in this case is all the stronger because if you don't take care of the situation, You Get Worse. Diabetes leads to serious and irreversible problems, especially when you combine it with alcohol. This lawyer is now forced to listen to doctors use phrases like "poor prognosis" and "experimental studies." His younger daughter is seventeen, and he'll be lucky to see her graduate from high school.

I don't know how (or even if it's possible) to get someone to listen when they're risking their life through sheer inertia. Maybe this post will help someone to become 'scared straight' or whatever.

Someone to talk to about diabetes

MyHealthVillage is hosting a series of diabetes chats, starting tonight.

The Chats will be hosted by Cindy Sears (RN, CDE) -- diabetes educator with years of experience working with persons with diabetes at Capital Regional Medical Center and private physician practices in Missouri, who has participated in a research study for rural primary care practices funded by the Missouri Foundation.

To participate in the diabetes chats, simply go to and join the Chat on any of the following dates and times.

Tuesday, 11/18 at 8 p.m. ET -- Insulin Myths and Realities

Thursday, 11/20 at 1 p.m. ET -- Medication Know-How

Friday, 11/21 at 11 a.m. ET - Pondering Privacy

Tuesday, 11/25 at 8 p.m. ET -- Here Come the Holidays!

Okay, end of rant

This post was me ranting because someone I know is dying and it could have been avoided. It is inexpressibly frustrating to not be able to help with something like this.

I can't be the only person with friends or family who are digging their grave with their teeth, as it were. Anyone have any good suggestions on how to handle the frustration? I don't think there's much we can do to help people who don't want to change.


  1. I'm in the same boat, with someone I know and love. I don't think there is anything much to be done; certainly any attempts I make just get interpreted as nagging, however gently I try to mention subjects like quitting smoking or taking exercise. I suppose, ultimately, we have to respect the personal choices people make - and if we always agreed with them, there wouldn't be any need for that respect!

  2. Although I'm not disputing that diabetes can be terribly devastating, these sort of statistics bother me. Currently diabetes affect roughly 8% of the population; to say that another 25% are on the cusp seems like an astronomical jump. What are the "normal" data based on, anyway? I'm not 100% sure, but in looking at the blood sugar ranges it seems like they're lower than they were a few years ago--similar to how the BMI charts were arbitrarily changed.

    Diabetes has become so inextricably linked with weight (rather than genetics or lifestyle independent of weight) that I'm always skeptical of statistics that play into the ZOMG OBEEEEEESITEEEE AND DIABETEEEES!! panic to such an extent. Certainly people should take care of themselves, but scaring people about it seems counterproductive to me--because it can trigger disordered eating behaviors that are just as unhealthy as having borderline diabetes.

    (Again, I'm not minimizing the problem of diabetes--my dad is diabetic, my aunt died from related complications, and so did my best friend's dad. I get my blood sugar tested yearly. It's something to be aware of for certain.)

  3. My grandmother is in the same boat. She takes a tub full of medication that i have to get for her every month from CVS. I tried to get her to just walk around the block, and always scold her for eating sweets, but she just doesn't listen.

  4. Unfortunately someone very close to me I fear is heading down this path. He is only twenty five years old, but overweight AND a smoker. Unfortunately there is only so much I can do in setting a good example and making recommendations without bordering the line of pushy and annoying. I'm dreading that it may take something drastic to see any change in him, but I sincerely hope it doesn't come to that.

  5. It's the joy of people being in charge of their own behaviors. There's nothing you can do unless they ask you for help. It's their life and their choice, which is a lesson I struggle with but try to keep in mind. You see it all the time...I have several loved ones that smoke cigarettes, or are cancer patients (not the same peopel) that don't take their treatment on a regular basis, friends that don't eat at all and some (like me) that eat too much. You can't control other people. As long as they know what they should be doing, then all you can do (if you still want them in your life) is accept them for all of their faults and try to be there for them when you can or when they want help. Just like I'd hope that they'd do for you.

  6. My MIL was diagnosed with Type II a few years ago. One day after a Southern fried dinner and cheesecake for dessert, I said something about going for a walk. She mentioned that it would probably help bring her blood sugar down. I asked her if walking really helps and she said, "yeah it helps a lot, but I never do it." My jaw dropped and I thought to myself, "why the hell would you NOT walk if it will help keep your potentially debilitating disease in control??????" I think she's in denial about the whole thing, really.

  7. I know your frustration. I have a number of family members with health problems that can be directly related to poor lifestyle choices. And although it does make you want to pull your hair it, it is ultimately their decision. However, one of my close family members recently had a pretty serious health scare and she's totally turned her health around by limiting alcohol, walking regularly and making better food choices.

  8. The tide will not be turned :-(

    Denial, it's not just for breakfast anymore.

  9. I have a very long line of diabetes in my family. All type 2. I worry that I will get it practically every day. My parents both have it and so did my grandma. They are all obese and do not excercise. I excercise and try really hard to eat right...although it isn't always easy. Do you think some of it is heriditary? I kind of wonder sometimes because I am overweight..if I am predisposed?

  10. Great post! Diabetes (type II) runs in my family and I have seen the consequences of uncontrolled diabetes. They are ugly and so destructive! Thanks for the great reminder! Now, will you call my mother??

  11. Don't forget that a lack of sleep also plays a crucial role in diabetes - it's not all about weight and what we eat. Researchers at the Sansum Medical Research Institute wrote a whole book about this called 'Lights Out.' And while I can't bring myself to buy all they write, I've seen enough research on our sleep debt (we're now sleeping an average of 2 hours a night less now than 2 decades ago) to be convinced it plays an enormous role in diabetes.

    In addition - stress changes the way our bodies handle and manage our blood sugar. And I don't think many people would dispute that stress levels have gone through the roof.

  12. That's a crazy big amount. Another post about symptoms of prediabetes/warning signs? :)

  13. As someone who once WAS pre-diabetic, these statistics do not surprise me. I think the problem is the "warning signs". Besides the obvious over weight issue, the #1 sign is being constantly tired, yet having trouble sleeping. Really? In this day and age who doesn't fight that problem on a regular basis even without the diabetes issue. Stress and a hectic lifestyle just help hide the symptoms.

    Convenience foods and people refusing to learn to cook for themselves when they can hit fast food for what they think is less money all just pile on to the problem.

    And it runs right down the same line as substance abuse. The person has to want to help themselves. You cannot force it on them.

    Type 2 runs in my family. We're also notoriously great sleepers. When I started having problems with my energy and sleep cycle I went to the doc. I was smack in the middle of pre-diabetic indicators. A quick jaunt down the South Beach to wean myself off my beloved pasta and garlic bread (really, I was eating that stuff like 4 times a week - left over habit from my frugal college days!), and my #'s came down. Everything in moderation these days. And I'm a better mama and happier person because of it.

  14. This is a sad post to read.... Your friend's decline must be very painful for you and your friend's loved ones to watch happening.

    Having been on both sides of the destructive-behavior fence, I have to agree with Diana that---once the person knows the basic facts---it is entirely up to them to change, to take the physical steps to make things better. Someone I love smokes and I hate it but nagging has gotten me nowhere. I know he will have to decide and quit on his own. My impotence in this area is frustrating! I believe the 12-steppers recommend "detaching with love" or something like that in these cases.

    People are complicated and baffling and frustrating sometimes! (I fit into that category, too, btw.)

  15. I have no idea why anyone would deliberately fail to take the simple steps that would keep early-stage diabetes in control. A friend's father lost his feet, then his legs, then his eyesight to diabetes. Last year, he died.

    I just hope that at the end, he still felt that eating crap food and sitting on the sofa watching TV was worth it. We all have our priorities, and sometimes those priorities are deadly.

  16. "The trouble is that if you're reading this post, you probably are not one of the people with prediabetes, because you are interested in regular exercise and a healthy diet."

    While you would think this, it is not necessarily true. Sometimes excercise and eating well don't prevent it either, although they make your chances a lot better!

  17. I'm sorry that you're hurting over your friend's decline. When the people we love don't look after their health, they're doing more damage than just to themselves. Often it takes a major scare for them to try to turn things around. Better than nothing, but just not good enough.

  18. "Probably" not one of those people with prediabetes

    You can get diabetes or be prediabetic even if you're careful. What pisses me off is people who aren't careful, and don't care, but at the same time they don't really want to die.

    Had a brother who smoked cigarettes all the way through his chemotherapy treatments. Same sort of thing.

  19. I don't know the reasons for the increase in the rates of diabetes, but it's such an incredibly huge jump that it got my attention.
    I would love to think the statistics are exaggerated :(

  20. I don't know much about Diabetes. Whenever I hear the word though, I can't get Wilford Brimley out of my head saying "diabetes" in that old timey, mispronunciation way like "dia-beat-ESS". Funny dude.

  21. It is such an insidious disease and preventable for so many people AND children, not to mention crippling our health care system. Ugh.

  22. My mom:Type 2 diabetes took both her legs,her kidneys,and contributed to I-don't-know-how-many strokes.

    Yes, she was overweight and did not exercise, but her father was a Native American. Native Americans are genetically predisposed to type 2 diabetes. My mother's brother also had type 2 diabetes. He DID exercise (sports and a physically active job) and was never overweight.

    I'm sure my mother's lifestyle did not help her diabetes, but I am convinced that it did not CAUSE her diabetes.

    I am very sorry I nagged her so much about her weight and lack of exercise. The nagging did not help her health and did hurt her feelings and our relationship.

    If I had it to do over again, I would not nag her or act is if my love for her was conditional on her "doing the right thing". I wish I would have simply loved her.

  23. You earn type II diabetes.... I think too often we think ignoring something will make it go away. On the reverse side, I know a lady who was completely diabetic. She lost over 100 lbs, got into daily strenuous exercise, watched her diet and voila. 1 year later, her blood sugar is stable with NO meds. Kudos.

  24. My mother-in-law died from complications from diabetes when she was 59. She didn't take care of herself before, and she certainly didn't take care of herself AFTER her diagnosis. She had a lot of dementia at the end...I met her only once about 6 weeks before she died.

    And now I have a friend, age 32, who has been diagnosed. She is at least 100 lbs, maybe more, overweight. She doesn't ever exercise. I want to help her - I have an uncle who, through diet & exercise, got to a point where his diabetes could be managed without medication. I'm afraid that my friend, who refuses to make diet & exercise a priority, is jeopardizing her chance at a long & healthy life.

  25. A question they may need to ask themselves is why are they using certain foods, habits and/or alcohol. As most things in life that you want, it's the why you want it. What is it filling for the person. If they feel they need it or deserve it then it will not change. Learned a long time ago you can not change someone, they have to want to change and even then there can be back sliding. Best wishes for your friend. Hope the answers click and there is a turn around in thoughts on the subject.

  26. Great post. I had my 2-hour fasting test done about a year and a half ago and was diagnosed as pre-diabetic.. Like one of the posters, I was skeptical and complained about moving goalposts, overdiagnosis, &c. Looking back, it was denial. I was fat, and while I was more active than many people my age, it wasn't enough. After a bit more waffling, I got serious, lifted weights, started running, watched my diet -- and a year later my numbers were normal again. I just realised I did NOT want to be sick.

  27. I'm amazed at people not willing to change...if someone told me "do this or you'll have a shorter life, poor health and feel lousy"...and all I had to do was eat better and exercise more?

    I hope my loved ones would beat me around the head a few times if I tried to rationalise that away.

    DIabetes is a scary many people don't even try and eat wholesome ehalthy foods anymore...I'm sad to say the 1 in 4 number didn't surprise me...

  28. Sometimes people aren't motivated until they are on their death beds. My BIL has been diagnosed as pre-diabetic and he eats crap all the time. Diabetes killed both his grandparents. His mom died of cancer before diabetes could kill her.

    I don't think people take illness seriously until it costs a limb, their eyesight or their life. By that time it's too late.

  29. So sad. I have known people who were in danger of and eventually lost limbs (feet) from type II diabetes. They had room to make improvements in their diets, but they didn’t want to give up the sugar, carbs, alcohol, fast food, sodas and God knows what else. I don’t understand it either.

  30. I hear ya....a relative has finally taken steps to exercise, eat better and lose weight since her Dr. diagnosed her with pre-diabetes. SHe is doing much better so I do try not to nag. It's just hard when it's someone you care about!!

  31. very scary! I had gestational diabetes with the twins and had to do insulin shots twice a day. I was pre-diabetic 7 months ago.......but after losing 70lbs my sugars are normal :)

  32. My ex was ecstatic when he finally got his handicap placard, because he hated walking. He always had to circle a parking lot to get the closest spot. I was the opposite, I walked every chance I got (I was a lot younger too). He was also overjoyed to find out he was a diabetic, and immediately surrounded himself with even more boxes and barrels of cookies, chocolate, candy, sugared fruit juices and the like. He'd take his Glucophage and do a finger test, and he'd have a healthy dinner, but talk about blatant self sabotage! Long after we parted, going to the hospital seemed to be like going to a resort for him, because he could get attention. He figured the dr's and pills could fix everything that broke. He's dead now, almost a year ago, but somehow made it to 83.

    It pisses me off how much people not taking care of themselves has increased the cost of health care and /or made it impossible now to get coverage, unless you're really poor, then people like me who can't afford a dr. visit ourselves subsidize the cost of their care through our taxes.

    Some people have a psychological disorder to do self harm in order to have medical drama to get attention, some are in denial or are just lazy, or have a "tomorrow, I'm too busy today" attitude, some apparently have an outright death wish.

    I have a mom who weighs 100 pounds, barely eats yet drinks an incredible amount of alcohol every day, smokes, and won't walk around the block. I can't do anything but clean up the mess when the time comes that she can't care for herself anymore.

    I am sorry you are going through this. It is so frustrating! But yeah, the "detaching with love" process mentioned above is about all you can do.

  33. I just wanted to share a brief word of encouragement to all of you who have mentioned personal struggles with diabetes or struggles with family members who have the disease. My mother, who was an insulin-dependent diabetic on too many medications to remember, and I used to get into the biggest fights over things like coconut cake when I was a teen. She felt smothered by my comments and concern, while I feared that she would have to go to the hospital again after a holiday meal because she wasn't paying attention to the fact that she was sick. It's hard to watch the people you love make choices that could ultimately kill them. Some of you mentioned having lived through that very experience. I am sorry for your pain and loss.

    In an effort to encourage my mom, I began a fairly strict diet and exercise regimen and hoped that she would be motivated by my progress. Well, it took almost a year, but she woke up one day realizing that not only was she sick, but that she was continuing to MAKE HERSELF SICK by ignoring the disease. With the help of a trainer, some like-minded individuals and some nutrition classes, my mom turned her life around.

    In only 6 months, my mother lost more than 35 lbs. That wasn't her victory, though. Her real victory was ending the nine and a half years that she was dependent on insulin to survive! Her doctor commented that she sees an average of 600 patients a month and that my mother is the only patient she has ever taken off of insulin. She said she believes it is because people do not believe that they can do anything about the disease, they are embarrassed by their "lack of self control," or they simply do not want to be told what to do. Well, my mother is proof that you CAN do something about diabetes and it is within your power to do it! Six months. That's roughly 1% of her entire lifespan.

    Take heart. There is hope. I hope that my mother's story will encourage those of you who are struggling. There is often little that we can say or do to encourage diabetic family members and friends to fight. In my mom's case, she wouldn't hear it because we (the rest of my family) "just couldn't understand." Well, my mom understands your family and friends' predicament. She will tell you that it is not easy, but she will tell you that it is worth it. She saved her life. I hope that her story inspires others to fight back, to fight hard and to save their own lives.

    **On another note, World Diabetes Day took place last week (on November 14). This year's focus was on children with diabetes, but the information and awareness brought about is so important, I thought I should pass it along.

  34. As with those who want a magic pill for weight loss, many want to be able to do whatever they like with food and exercise, and get the medical community to give them a magic pill to make it all go away.

    Until they learn that the only magic pill is personal responsibility, it will not change.


  35. Until they learn that the only magic pill is personal responsibility, it will not change.

    I like that comment!

    Five years ago my mother was diagnosed with Type 2 diabetes. The irony is that while I have been significantly overweight or obese from childhood, she has never had a weight problem, so never thought it could happen to her. After her diagnosis, I lost 90 pounds by following a healthy low-GI diet and started working out really hard.

    Yet my mother bitterly resents the fact that it is she, not me, who has diabetes and has *never* mentioned my weight loss!

    I know this is a somewhat contrary comment, but I'm mentioning it because family dynamics can be very complex.

  36. The problem is getting people to pay attention to their diabetes when it is mild. My own family says, "Oh so an so's sugar is 400 and mine is only 175." The only stages where you can really turn it around is the early ones. Once your blood glucose is sky high, you have pretty much turned the corner.

  37. Check out the trailer for Simply Raw: Reversing Diabetes in 30 Days.

    Wonderful documentary film that chronicles six Americans with "incurable" diabetes switching their diet and getting off insulin.

  38. I, too, am in the same position. My step mother has lost one leg and most of her foot due to diabetes. She also has had quadruple bypass surgery and yet she still smokes and refuses to change her diet.

    My sister is 21 and is 2 or 3 times what she she weigh and she also refuses to exercise or change her diet.

    It's extremely frustrating to have people in your life that you care about who just don't take heed to the warning signs. The best thing I can think of is to keep trying and just take care of yourself.

  39. You're right. It's almost impossible to help people who don't want to change.

    Great post.

  40. Great post - I totally share the frustration, especially when parents choose to feed rubbish food to their children - but that's another rant...

    In terms of helping - there are two situations here really (IMHO).

    1) A person you know but is not a close friend - i.e. you don't keep in touch often, and they don't care too much about you.

    In this case, as cold as it sounds you can't do much if they're not interested. In fact they have to be much more than that - they have to want your help...

    2) The second situation is when a person you love (and I don't use the term lightly) is "risking their life through sheer inertia" (that's such a powerful statement BTW).

    Here you have no choice but to try to help. My practice is to usually be cruel to be kind, but not too cruel, as you want to make an impact, but you don't want them to switch off.

    The thing is, that you need to find their 'trigger' - the one thing that matters to them so much, that if they lost it, it would hurt worse than death...

    It is a different trigger for everyone. It is usually hard to dig out. It may cost you the friendship (in the short term). But if it is the real trigger - it would save them...

  41. Whether it's diet or exercise or what have you, people have to really want to change. And the problem is that in the initial stages when it's first diagnosed, they don't have as much motivation, because the symptoms aren't quite so bad, and they can justify it by saying that it's just the disease and they can't do anything. And by the time they get to the point where they want to change because of the really bad consequences, then it's nigh impossible to make as big an impact. Kudos to all those who've turned their lives around, and good luck to those who haven't!

  42. Crystal said, "the only stage in which you can really turn it around is in the early stages."

    I love the stories of people who saw the light and made lifestyle changes and got off of oral meds and/or insulin.

    However, some people with diabetes (PWDs)reach a stage of nearly-complete pancreatic exhaustion.

    Even if that person becomes a true-believer in regards to eating well and exercising and really walks the walk, these people may never be able to get off of medications.

    As wonderful as it is to get off of medications, that should not be the only measure of success. PWDs who start taking good care of themselves at any stage of the disease deserve to be called a success.

  43. Very informative and very true. For as serious as diabetes is, I would think that people would want to avoid it at all cost. I agree with your post 100% because I know several people with type 2 diabetes who just are not that concerned about it. It's shocking to me!

  44. Great Post. It is unbelievable that 1 out of 3 people have pre-diabetes. There are just so many people out there who take the simplest life saving tasks (such as healthy nutrition and exercise) and make them negligible.


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