Pre-diabetic? Don't Be in Diabetes Denial

Diabetes in My 50s Now What

The trajectory of emotions I experienced

Giulio Bonasera Okay, so the question and exclamation marks in the title suggest that perhaps this diagnosis came out of the blue and wasn't expected. False. I had several “prediabetic” bloodwork results and enough lay knowledge of medicine to know that I was at risk — dietary habits, overweight, age … a lot more “yes” boxes checked than I care to admit. Nonetheless, when you first hear those words, it's shocking and terrifying … and yes, surprising. I passed all of the “So you think you might have diabetes?” magazine quizzes with flying colors, having none of the traditional, early symptoms of the disease. (Read next part with a voice full of dismay:) “But I thought the PRE in meant it didn't necessarily ever have to develop into the full-blown thing” or “But no one in my family is diabetic” or “But I JUST had cancer … now DIABETES? OK — I admit that last one is simply ridiculous. But diabetes denial is a real thing. And then there's the way I found out. Step 1: Yearly routine checkup. Join my practice's nifty new online patient portal because I'm SO computer savvy, read the results on my own, overreact and panic. Step 2: Dr. Google. What? Come on, you know you'd do that, too. That's where I found out about the real phenomenon of diabetic denial. Step 3: Text (see? tech literate) my third-year resident daughter (surgical resident at Johns Hopkins). Answer: “Mom. I'm a urologist. Talk to your doctor." Step 4: Make an appointment with my doctor. So, after panic, Google, daughter … I made (and kept) an appointment with my doctor to discuss what comes next. Although the shock had dulled some, it certainly had not worn off. Partially that was due to my doctor's overall vagueness during “the talk.” I can't blame her — I'm sure tossing around a diagnosis such as diabetes isn't her favorite doctor task. She continued to skirt around the issue of “the word that shall not be mentioned.” She said technically I would need one more blood test to confirm a true diagnosis of diabetes but that it was all a matter of semantics at this point and we should begin treatment as if I had it. She said she wanted me to consider starting Metformin, a diabetes drug. She suggested nutritional counseling. She asked if I wanted a follow-up appointment in three months. I suggested six weeks. Even though my head was swimming in a myriad of thoughts, I was entering my proactive stage. My early denial-ish behavior had changed to me wanting to know everything I could to see what I could to or even to reverse it. I knew this was game time — no more maybes, ifs or pre about it … I HAD DIABETES and I HAD to take the bull by the horns. I wanted to learn all I could and be the model patient. But just as grief has its stages, new diagnoses seem to have their own trajectory of emotions. Let's recap where I've been in my head thus far: STAGE 1: Diagnosis STAGE 2: Denial STAGE 3: Zealous acceptance and overcompliance And the next stages in the process: STAGE Denial Part Deux: Maybe-I'm-overreacting and this-isn't-the-big-deal-I'm-thinking-it-is-stage. After all, this was a relatively new doctor for me and it was not the first time this doctor seemed to me to be medically aggressive testing and treating. Can you guess the next stage? STAGE Super-denial: Did I really hear the diagnosis correctly? Maybe more testing should be done. Aren't second opinions encouraged? My diet isn't THAT bad. (This has historically been a favorite stage of mine to linger in when confronting major change of any sort.) STAGE Full Circle: Resembles the Proactive Stage but with more sound, logical reasoning. Let's first call the insurance company to see if nutritional counseling is covered. Then call the local diabetes center, where the kind and competent nurse on the phone did not struggle with tough loving the word diabetes and my definitive diagnosis. Do some preliminary research about basic lifestyle changes I can easily implement. Join some Facebook support groups. Admittedly, this would not be the first time in my life when all or nothing thinking got me into trouble. I'm much better off once I hit STAGE Full Circle — taking baby steps, dipping the proverbial toe in to test the waters. So call it what you will — a grieving process of sorts, the fact that no one really likes change, the “why me?” phenomenon or simply getting old stinks … I knew I needed to move past the labels, past the stages, past the fear. Indeed, I owed it to myself to allow myself to go through the different phases — I needed to — but now it was time to get serious and get to work. No one is going to take care of my health better than I am. While it's okay once in a while to have a pity moment (no time for a full-blown party) — after all my parents and brothers led similar lifestyles but didn't face diabetes and I think 54 seems a bit of early unfairness — I can't afford to wallow for too long. So, whether I seek assistance from my doctor, advice from the internet, or compassion from my daughter — the real work — educating myself, changing my habits and regular monitoring are all mine. I'm ready. UPDATE: I'm doing well on Metformin, for which I feel fortunate, because many people suffer negative side effects and have to discontinue it. I've lost four pounds — not a milestone, for sure, but a start. I've reduced my diet cola intake dramatically — in addition to just not being good for you, there's a diabetic connection — in favor of water. And the diabetes diagnosis has led me to take charge of other health issues that needed addressing – the year-late mammogram for one. Still not having any outward symptoms can be frustrating and makes it more difficult to say no to the occasional tempting pastry, even though I know the numbers don't lie. Taking charge now could mean avoiding glucose monitoring, insulin and a whole host of much more serious symptoms. While I'm not sure I've yet entered the stage where I think of this disease as a “blessing,” I do feel a sense of gratitude that I'm counting on to keep me moving in the right direction. Bloodwork in a month, taking those nutrition classes, and the journey continues — for what I hope is a long lifetime.

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