November is National Diabetes Awareness Month (for a full explanation on the types of diabetes and further information on statistics quoted, please visit www.diabetes.org).  It’s worthy of awareness because in 2012 almost 30 million Americans had some form of diabetes and 86 million over the age of 20 were thought to have pre-diabetes.  The most common form of the disease, Type II Diabetes may be prevented with early lifestyle changes in diet and exercise.  In recognition of this disease, the following is a blog post I wrote last year.  The published title was “Your Mileage May Vary.”  If you or someone you love suffers from this disease, be kind and gentle with yourself/them and take one day at a time.

As a person who was diagnosed with Type II Diabetes over a decade ago, I have not always practiced “awareness”.   My diagnosis which came after a very stressful job and location move, sent me into a spiral of shame and self-blame.   Diabetes ran in my family and I saw the consequences of the disease.  Complications from diabetes and heart disease led to the death of my godfather and my mom’s brother, my Uncle Tom.  Although, he never carried the excess weight that I do, he loved his desserts just as I do.   After his diagnosis, I remember being very concerned for his welfare as he continued to enjoy the elegant desserts that he made himself.

Flash forward a few decades and I, too, sometimes forget my diagnosis and see the fear in some family members eyes as I eat with abandon.  There are many judgments around Type II as it’s considered a “lifestyle” disease.   I know this from first hand experience.   Privately, in addition to my sweet tooth and my love of cooking, I blamed my globetrotting career with way too many gourmet business meals as critical legs on my itinerary to my Type II destination.  Food was a big part of how I socialized, and I didn’t want to give up the lifestyle I loved.    As I gradually let people in my workplace know about my diagnosis, one strong, lean, healthy individual bluntly told me, “You know you did this to yourself.”  He was clearly commenting on the extra weight I started carrying around when my month long starvation diets and marathon gym sessions no longer yielded the same pound melting results that I enjoyed in my 30s and 40s.

Although I didn’t admit it to many, the disease terrified me.  My diagnosis brought back memories of my Uncle Tom who first had a heart condition in his 50s followed by a diabetes diagnosis.   After watching his health decline, I was sad when he died in his mid 60s, prematurely.    I silently hoped my shared love of sweets would not lead me to an early death.   As part of dealing with my diagnosis, my doctor sent me to a diabetes education class, a nutritionist and I re-ignited my dormant gym routine.   I read everything I could get my hands on.  With focus and awareness, my weight came off and my glucose readings improved after a few months.  Since, I was managing the disease with oral medications, I often forgot I had the disease.  Over time my old habits crept back in, I became less aware and I ignored my diagnosis.

Part of the reason for my cavalier attitude was that most days I felt fine.  But, I knew I wasn’t as fine as perhaps my finest.    And, my subconscious knew that feeling fine today might not shield me from potential major life-altering complications that were attributed to unmanaged diabetes.   My quarterly check-ins with my doctor and daily finger pricks allowed me to track my glucose level.  Understanding the level of glucose in your blood is an important measure of how well you are managing the disease.  When the glucose number went up, so did my fear and vow to relearn a healthy lifestyle.  So straddling my unspoken fear and a desire to live “normally”, I continued to experiment with my diet and research options to feel “finer”.

There are so many resources to choose from and many with conflicting guidance.  One of the best books I read after my diagnosis which helped to shift my judgmental attitude toward the disease was written by a Type II diabetic after her diagnosis.  In her book, The First Year: Type 2 Diabetes: An Essential Guide for the Newly Diagnosed,  (an updated edition was just released in October 2015) Gretchen Becker, points out in her first chapter – “Its not Your Fault”.    Ms. Becker helped me through my self-blame shame.   Her research found that while diabetes and obesity appear linked it’s not clear whether obesity causes diabetes or the reverse.  She points out that if you do not have the genetic predisposition for diabetes, you won’t get diabetes.   Also, not all Type II diabetics are overweight.  In addition to lack of exercise and diet, stress can also have an impact on elevating blood glucose levels.   This assertion certainly, helped me take a more positive approach to experimenting with what worked best to manage my disease.

I believe it was from reading Ms. Becker’s book that I learned much of the medical and wellness advice out there may not be applicable to my situation.  One phrase that I’ve retained from my early research is “Your mileage may vary.”   To me this meant, to really know what works best, you need to practice awareness and observe what patterns offer you your best mileage per day.

Knowing what diet or exercise regime works best is really about you developing awareness of how you feel and what things impact a change in your blood sugar readings.  In my case, I have learned that stress can have as big an impact and sometimes more than poor dietary choices.  I’m not suggesting that I can eat with abandon if I’m stress free, but I have noticed that a higher carb, whole food based diet on a Yoga retreat in Mexico resulted in better glucose readings than observing a similar diet at home.  Additionally I’ve also had excellent results with a very low carb almost paleo diet, which my nutritionist who advocates the American Diabetes Association guidelines strongly objected to.   At the end of the day, I’ve learned its all about moderation.

My resolve for this month is to continue to cultivate awareness for what works best for my diabetes management.    If you don’t have a genetic pre-disposition for diabetes but know someone who does, encourage them to cultivate self-awareness to make good choices.   Asking them to notice how they feel when stressed, eating or exercising is more helpful then telling them what you think or read they should be doing.  Remember, we are all different makes and models and as a result, “ your mileage may vary.”

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