Lady A is in general good health, but has had some bumps along the road. She is smart and works full- time. She walks a lot, does her own cooking and tries to take care of herself, despite her work schedule being very, very demanding. She was diagnosed with pre-diabetes during a routine health screen. In addition to this, I should mention that Lady A had thyroid cancer, and thus had to have her gland removed. This left her with underactive thyroid for a period of time, followed by hormonal treatment with thyroid hormone. Thus her metabolism bounced around quite a bit for some time, and likely also affected her energy level, made it harder to lose weight etc. When Lady A told me about her pre-diabetes diagnosis, in the midst of all this cancer concern no less, she said to me: “But you know what? I am going to beat this! I don’t want diabetes! I am going to WORK at this, eat right, and lose some weight. I am going to beat this.â And she did. She read about this disease, lost weight and is now totally on the right track.
Now meet Lady B: she has also had some bumps along the road. She was diagnosed with diabetes years ago, but did not fully accept the diagnosis in the past. There was a period of time when she took her medications very infrequently. She suffered a heart attack, but thankfully recovered fully. She has both a glucose checking meter, as well as blood pressure cuff, but she does not use them very often. In fact, she has now decided that she does not want to check any more at all. I am not sure how well she actually takes her medication these days. She has, in the past, not followed diabetic diets very well. She did try to get things under control right after her heart attack, but then stopped trying quite so hard.
Can you guess which woman is in her 30s and which is in her 60s?
The heart attack may have given away the answer, but Lady B is in her 60’s and Lady A is in her 30’s. When I thought about how different these two women have reacted to their diabetes and pre-diabetes, I was struck at the differences. Many people assume that younger folks stay in denial about their diseases and are slow to really get going on treating themselves correctly, while “older, wiserâpeople somehow tend to get it right immediately. But that is not the case sometimes, as in this situation. I am proud to know a woman like Lady A, who has been dealt some bumps early in life, but refused to sit down to them. She has stepped up to the challenges and taken control when she could, and she keeps right on track as much as possible. Seeing people like her in my clinic really gives me hope. Lady B worries me a lot, and I think there is not much I can ever say to change her approach. She has all resources available to her to get this right, but she is not taking full advantage of those. As a result, her diabetes will continue to do its damage for the rest of her life. She has already been dealt a heart attack, from which she was quite lucky to be spared â recall that a number of first heart attacks are fatal. Who knows what may come nextâ¦I hope she changes her approach soon, very soon. Diabetes is not a forgiving disease.
Until next week, stay safe and healthy Vincies. Think on these two ladies, and which approach you think will make your life better.
Anita Ramsetty, MD [email protected]
Medical Director Endocrine Care Group