Sugar Matters
July 17, 2009
A quick reminder: Diabetes hurts eventually

I know, I know, —everyone is high off the recent Carnival festivities and just slooowly getting back into the swing of things. And now look, I need to drop this difficult topic on you like a bad sore foot. Some things should not be sugarcoated. I was reminded in my own clinic that story-lessons about the seriousness of diabetes are necessary to keep you on course.{{more}}

Meet patient number 1: a gentleman in his 50’s whom I am treating for a thyroid issues, but also has diabetes. It turns out he decided not to follow up with his main doctor about his diabetes while he was seeing me as a specialist for his thyroid problem. When I looked at his lab tests, I pointed out that his diabetes has been worsening over the past year. Has he been checking his blood sugars? No. He was supposed to be following dietary recommendations for his early diabetes, but has he done that? No. His A1C has worsened from 6% in January last year to 6.9% this year. It is not terrible yet but it is going in the WRONG DIRECTION. I started him on Metformin at first, then this visit we added medication for his blood pressure and an Aspirin a day. On questioning he admits he is taking all of his pain pills, (prescribed by another doctor) but sometimes forgets the diabetes medicine. Now he was upset that I gave him more medication. Then I told him the bad news: “Sir, you already have some kidney damage from your diabetes. You are on your way to kidney failure”. Then he started paying attention.

Take note: Even though this gentleman does not have very high blood sugars, he has been ignoring his diabetes for long enough that he already has some early kidney damage. Staying on this course will mean kidney failure in future.

Meet patient number 2: a young woman I discussed previously, who had not been taking care of her diabetes and lost her first pregnancy possibly as a result. She came for a regular appointment. Her blood sugars are still high but better than before. She is, as she tells me, “FINALLY taking the medicines every day.” She laughs and laughs during the appointment, and sometimes I am afraid she is not taking me seriously. Then she stops and looks at me and says: “But you know, I do feel a lot better. I am less tired, and I feel stronger.” She agreed to increase her medication dose and continue watching her dietary choices. This woman is not at her goal, but she is on her way. Thank goodness.

You see, part of the problem with diabetes is that it doesn’t hurt enough. No really, that is a problem. I have lots of patients like the first gentleman who have pain (back pain, foot pain etc) and they make sure they take ALL their pain medication EVERY DAY. But the medicine for their diabetes or their heart, nope, that falls to the wayside. The interesting thing is that being in pain will not kill you, or give you a stroke, or even likely a heart attack. But diabetes will, and it may give no warning.

Remember that-just because you “feel okay” does not mean you can ignore your diabetes. Get to work before diabetes does its work on you.

Until next week, stay safe and healthy Vincies.

Anita Ramsetty, MD
Medical Director Endocrine Care Group
Tel: 843-798-4227