I had my regular check-up with my endocrinologist this morning. Last week, I had a fasting blood test, and today we met to talk about the results. Before talking about the results, however, I tried to convince my endo to minimize fasting blood tests (I don’t like skipping breakfast, even if it’s just once every three months), but he likes to check my cholesterol level and other conditions that require a fasting blood test. I tried before but he gave in only one time, with the excuse that he wanted to know what my two-hour post-breakfast BG level and non-fasting cholesterol level were like. Just once. Today, I don’t think I convinced him to do away with fasting tests.
Anyway, my appointment with him was uneventful as everything was absolutely fine. How exciting is that? But, to my endo’s credit, what could have ended in five minutes was extended to more than half an hour, as he spent time to explain one of the tests, my fasting insulin level. He was pleased that my fasting insulin, my fasting BG (mind you, after showering, dressing up and going to the doctor’s office) and A1c were within the normal range (some, on the low end). If it weren’t for the fact that my previous tests consistently showed that I’m T2D, I could have been diagnosed with another type of diabetes.
My endo again brought up the possibility of reducing my metformin. I’m on 1,000 mg of metformin and he wants to reduce it to 750 mg. I had to remind him that we tried that before and I was not very happy as it required me to reduce my carb intake and live in what for me was absolute misery. I have no desire to be medication-free if it means a poor lifestyle for me. So, he agreed to keep my metformin level as is since (a) my A1c is at the low end of 5%, (b) my fasting insulin level is low, (c) my fasting BG is in the non-diabetic range, (d) I haven’t gained weight since 3 months ago, and other factors (he listed them down as if to convince himself that I really did not need to reduce my metformin dosage).
After we discussed my medication and my next tests (I’m due for annual checks), he inquired about how I was dealing with the weather, eating challenges and other difficulties I may have faced in the last 3 months since we saw each other. And I knew he was listening because he was taking down notes and asking questions. Before I left, he reminded me of some of the things I must watch out for vis a vis metformin (such as stop taking it if I’m having very high fever and the chill, or if I’m vomitting, or if I’m suffering from food poisoning), and to keep hydrating myself as it’s still hot and humid in Tokyo.
When I filed away my copy of my recent tests tonight, I noticed that this month marks my 6th year diagnosis as a T2 diabetic. After consulting my journal, I can confidently tell you that I’ve come a long way. In September 2007, my A1c was 6.8% (that, together with an FBG of 161 and a previous random BG test that yielded 218, sealed my diagnosis as a T2 diabetic). Six years later, my A1c is 5.3% and everything else is within a normal person’s range (in fact my doctor told me that I’m healthier than most of his non-diabetic patients).
I wish I can say that the past 6 years went by in a breeze but I’d be lying. The first 12-18 months was a period of discovery, not just how to live with T2 diabetes but a discovery of myself. The most important thing I discovered was that the secret to living with diabetes is not just to find the right diet (which most newly diagnosed diabetic and even long-time diabetic focus on), but to figure out how one wants to live. I experimented a lot to figure this out. If we don’t know how we want to live, we can’t settle on a lifestyle that we will be satisfied with, which only leads to a miserable existence.
Another lesson I learned is that while we can learn from other diabetics’ experiences, what works for them may not work for us and vice versa. Your Mileage May Vary (YMMV). Your Diabetes May Vary (YDMV).
The third lesson, which I find to be one of the most difficult, is to learn to respect other diabetics’ choice, to not preach, and to not judge others simply because their choice is different from mine.
The fourth lesson I learned is that while it’s not good to preach, it is also important for diabetics, especially T2 diabetics (there are not enough bloggers and DOC participants), to share their experiences and difficulties, to let their voices be heard, and to fight the perception that we deserve our diabetes and that we brought diabetes unto ourselves.
Another important lesson I’ve learned is to not be cynical and to give everyone the benefit of the doubt.
I must say that even after six years, I still have a lot to learn. I’m learning from the DOC, whether it’s through someone’s blog, or through a diabetic board, or twitter, or advocacy sites. I’m glad of the advancement in technology that enable people from different parts of the world to interact and exchange information. I’d be so lost without the Internet.
Today, I look forward to the challenges and humbling lessons that this chronic condition will bring in the coming years. But wherever diabetes takes me, I have no doubt that I’ll conquer it and be on the winning side.