On a recent Friday, I went to the lab for a blood draw at my internist's office in Chicago's Southern Suburbs. My phlebotomist-friendly vein popped up reliably. Blood was drawn. My fate was cast.
My doctor, Marwan Baghdan, MD, had ordered the test because my blood glucose levels had been trending up.
The blood test was preparation for a doctor's visit the following Wednesday. My internist had ordered the test because my blood glucose levels had been trending up.
On Sunday, I got a preview of what was to come. I received an email alert from the portal from Advocate Medical Group: my test results were available online. I looked: glucose -- 141.0 mg/dl (Reference Range 65-99) and hemoglobin A1c, 7.8% (Reference Range 4.5-5.6), the latter providing a three-month view of average glucose levels. Three months earlier, my glucose was 126 mg/dl and six months earlier, it was 102. This was my first A1C.
You don't need a medical degree to know what my results mean.
Hello, diabetes
Diabetes at age 69 was the latest stop on my personal health journey, which included a surprise ST-Elevation Myocardial Infarction (STEMI) at age 57 and Gleason 6 low-risk prostate cancer at age 65.
I asked my preventive cardiologist Matthew Sorrentino, MD, of University of Chicago Medicine, if he wanted a copy of my panels and the A1c. "The labs fit the criteria for diabetes. Diet can be very helpful to control this. Let me know if any questions I can help with," he wrote.
Officially, I hadn't received the diagnosis yet.
As a health reporter, I had written about diabetes. My most recent article about research on contact lenses to read glucose levels and avoid the frequent needle stick.
I knew diabetes is a common and growing problem with potentially serious complications if unchecked.
More than 29 million Americans with diabetes, according to the Centers for Disease Control and Prevention. One in four people with diabetes don't know he or she has it. Add to that the 86 million who have pre-diabetes.
When I saw Baghdan, he sensed I already knew the score. Still, he broke the news, gently.
In my experience, some doctors can shine when they have to deliver bad news. Baghdan did.
He was reassuring. He told me he knew, based on previous experiences with the STEMI and the prostate cancer, that I would educate myself and take appropriate steps -- weight loss, improved diet to control carbs and increased exercise -- to control the disease in its early stages and head off complications, including heart and blood vessel damage, neuropathy, nephropathy, retinopathy, foot damage and more.
Diabetes can be a lot to get your head around. You are playing for keeps.
Eating for Life
Baghdan personalized the dietary changes. He said I should eat more like him and reduce the carbs. On occasion, I could, as does he, have some barbecue even though ribs are drenched with sugar-laden sauce. He said I could eat almost anything if I kept track of the carbohydrates and proteins.
Baghdan said the scale was my new friend. It was a way to track my progress. He said food really is medicine with diabetes.
He said some of his patients don't handle diabetes well and get into serious trouble. He knew my health journey well, including Gleason 6 prostate cancer, as well as hypercholesterolemia and a STEMI had been along for most of the ride in recent years.
He said he knew I could be disciplined. I knew I could, too. I lost 40 pounds with Weight Watchers 5 years ago. I used to exercise everyday. But I regained the pounds as life got in the way. Now I had to go all in. My life and health were on the line.
I asked Baghdan about the role of genetics. He downplayed it because genetics is more a disease factor in younger people. I will have my 70th birthday in September.
Still, my father developed type 2 diabetes in his 60s. My brother Steve, who is 3 years younger than me, was diagnosed 15 years ago at age 52. He has controlled his diabetes well.
Baghdan referred me to a diabetes clinic to learn more about diabetes, get instruction from a dietitian and pick up a glucometer.
Steve called to check up on me. He shared his daily meal plans and his strategies to control his carbs and. He substitutes healthier sweet potatoes for white potatoes. He occasionally eats ribs and other seemingly taboo foods. Little tips like these makes diabetes seem manageable.
Steve and I and our wives are going on a 3-week trip together soon. I plan to study at his dining table.
I fully expect to control this with dietary changes and exercise plus Baghdan prescribed metformin (2,000 mg daily) to lower blood glucose levels by improving the way the body handles insulin.
"This isn't a death sentence," my brother stressed. In fact, one friend, who learned about my diagnosis via my Facebook page, said there may be a silver-lining to taking metformin: It's being studied as a life-extension drug.
I told my urologist Brian Helfand, MD, PhD, that I might not be able to go back to our favorite Chicago hot dog joint. "This is terrible. Can you get on track so we can go back to Portillo's?" he said. "The good news is that some reports suggest that diabetes may be protective for prostate cancer -- but maybe because of metformin?"
There will be life after my diabetes diagnosis. And maybe an occasional hot dog.