By: Patrick Totty
My down-the-street neighbor, Paul (not his real name), has type 2. We often stop to talk about our numbers, our latest visits to the endocrinologist, and our concerns.
We look a lot like each other–I’m a few years younger than Paul, but we’re both the same height, weight, coloring, and body shape (OK, my pot isn’t as big as his). We both wear paisano-style wide-brimmed hats when we’re out walking, so neighbors sometimes mistake one of us for the other.
But the similarities between Paul and me end there. In our many talks about type 2, I’ve come to realize that Paul is a glass-half-empty person while I’m a glass-half-full person. He came very late to taking any sort of drug for his diabetes, only starting on metformin and a sulfonylurea late last year. His numbers plummeted immediately, quickly reaching dangerously low pre-sleep levels in the 60s. He rightfully fretted about going to sleep one night and not waking up.
So Paul experimented with his doses as well as the medicines themselves. He ended up stopping both drugs and saw that, with increased exercise and judicious eating, his numbers still averaged below 120 mg/dL throughout the day, with fasting around 90 and pre-bedtime around 110.
I told him that he was extremely lucky to have such relatively low and benign numbers this late in the game. The fact that he was achieving pretty good control with no drugs told me that if and when he did need to take them, they would work very effectively because his body wouldn’t be habituated to them.
But as I said, Paul is a worrier. He decided that a 110 mg/dL blood sugar level just before bed was a sure invitation to a drop into fatal hypoglycemia. Sometimes he’d report awakening that day with a fasting of 85 or 90 and declare that it meant he’d just experienced a near brush with death.
When I tell him that I would kill for some of his numbers (I’m on 30 units of basal insulin daily and wake up with a fasting number of 110 to 120), it makes no impression on him. He’s still fixated on his fear of sudden death in his sleep.
No matter how much I’ve tried to get him to understand his numbers, in terms of what’s truly dangerous and what’s exemplary, he still frets. It’s his nature, and there’s nothing I can do about it except to encourage him to explore and learn as much as he can about type 2.
Fortunately, Paul is a former computer programmer, so there’s a scientific streak in him that I can appeal to: “Paul, set up this sequence of tests for your numbers. Keep these records. Watch for a pattern. Take into account that there will be variables, such as unexplained spikes. But even those can assume a pattern if you track them long enough.”
All of this is to say that one thing having diabetes teaches you is that every person who has it brings a different outlook, expectation, and motivation to it. What seems obvious to me may not be to another, and vice versa. Paul thinks I’m not serious enough about my disease while I think the opposite about him.
But, we take that into account with each other. We’ve agreed that we have different points of view on type 2, and that in between discussing what we’re doing and thinking about it, we’re enjoying the heck out of each other’s company. When I walk my doofus boxer, Baxter, past Paul’s house I always make sure to slow down, just in case his garage door is open and he’s working on some project. There’s always the possibility of a good conversation there.