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Life With Type 2 Diabetes: Too Good to Be True

I’m not sure whether what I’m about to describe is a blessing or a curse. But it’s something I run into with almost everybody I know, myself included: the inability to see our luck or good fortune as clearly as others see it.

I just got back from walking my doofus boxer Baxter, a route that often takes me past my neighbor Paul’s house. I’ve written about Paul before: He’s a 70-year-old type 2 who’s one of the most fortunate people with diabetes I’ve ever encountered—except he believes that numbers I and almost every other type 2 on earth would consider fantastic are really a sign that he’s in danger of going to sleep one night soon, falling into terminal hypoglycemia, and never waking up.

Keep in mind that Paul has yet to take any of the drugs that we type 2s have been gobbling down or shooting for years: metformin, sulfonylureas, GLP-1s, DPP-4s, insulin, SGLT-2s—zilch. The closest he comes to any medication is a Glucerna bar he consumes before bed lest he plummet from his usual pre-sleep BG number of 95 into a coma. The bar keeps him pretty steady, because he usually wakes up at 99 or 100.

An endocrinologist I highly respect once told me that her mission in life was to get people like me down to a consistent 100 in our blood glucose readings. She would have considered hers to be a life well lived if she could do that, she said. The rub, of course, was that so few type 2s could ever get down to a consistent number that low.

But Paul can.

Even so, he is a total worry wart. He thinks that a 95 is perilously close to a 70, and that his pre-bed readings are really paper-thin margins separating him from oblivion. It doesn’t matter that his numbers, low as they are for a type 2, technically qualify him as a pre-diabetic. As far as I know, nobody has yet to die from pre-diabetic hypoglycemia.

It also doesn’t seem to matter that he has stumbled onto a routine that is working incredibly well: Go to bed with a good number like 95; maintain that number with a diabetic bar that keeps BG levels steady through the night; awaken at pretty much the same number you went to bed with eight hours before.

In my world, that counts as a near wonder. In Paul’s world, though, the effectiveness of his routine and his amazing non-medicated numbers, despite having had type 2 for years, don’t count. In his mind, the reality of how well he’s doing is trumped by the incredibly remote possibility that he’ll go to bed one night and his Glucerna bar and his body’s own warning system will fail him completely, his numbers will plummet catastrophically from 90 to 30, and we’ll all soon be talking about him in the past tense.

It doesn’t matter how much I try to reason with him about this, the fearful and irrational side of him has him in its grip.

But in thinking about it afterwards—Paul always gets me to thinking—I begin to see that maybe Paul’s attitude is a very unconscious mix of gratitude and fear. The gratitude is that he does realize, even if he won’t admit it, how extremely well he’s doing. The fear, I think, is that deep down he doesn’t want to tempt whomever or whatever is smiling on him to take away his good fortune. Appearing to be taking it for granted could be seen as taunting the gods, or Fates, or karma into administering him a mighty slap.

So maybe there’s no either/or here, but more of a both/and: Paul’s attitude is blessing and a curse. But it’s one that lets him balance his quiet elation and overt worry wart-ness in a way that keeps mischievous forces at bay.

 

 

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