" 'Roid Rage" : A Personal Perspective

As I mentioned in the initial post of this blog, I share Diabetes with those folks we speak of in this Sugar Free Surgery Blog, albeit mine is type 1 vs. the type 2 that is the predominant type for the obesity related surgery discussion.

I am blessed to have had excellent control throughout my nearly 30 years of disease, but have had some significant challenges of late.

I have had a recent recurrence of a painful condition called Brachial Neuritis, which causes sporadically intense pain along the Brachial Plexus. It can last for weeks, and then is followed up by a few months duration of weakness to segmental aspects of the muscles effected by the demyelinating process that created the pain initially.

In any event, the treatment now is a series of 1 G IV infusions of Methylprednisolone which obviously gives rise to a 24-48 hr period of significant disruption to my normal blood sugars, mandating significantly more vigilance than usual. Diabetics, (especially ones that are in good to tight control) as you likely are aware, are dedicated creatures of habit, often out of necessity. With a brand-new set of rules as far as coverage scales and atypical responses to typical CHO loads, it can get dicey, and quick. I haven't seen readings like today's (over 330) thankfully, in a long time!

It just got me thinking.

I know, and I am sure you do as well, many Diabetics as patients (talking T2DM now) that essentially live by how they feel. Even though they may feel the relatively acute difference of a 65 reading vs. a 250 reading, when they exist in the range of 180 (maybe a good day) to the 300's (as a patient told me recently, her averages before surgery), they are re-establishing what feels normal to them. They often sense a powerlessness about trying to get any better control than they have, and while as their frustration turns to indifference, they still may not feel all that bad.

Add to that the component of maxing out medical therapies, and their inability to lose weight , and/or eating “correctly” for nutrition / weight / and glycemic balance, it with sustained hyperglycemia it truly becomes not a matter of if there will be a problem, but when a related comorbidity irreversibly effects their current level of health.

I suspect you don't need a reminder, but 4 of the top 10 causes of death in the US are related closely to Diabetes. Oh, and by the way, you an add at least one more to that list of 4 (Cancer), to make 5/10 as obesity-related causes of death as well.

Keep that in mind as you see that poorly controlled, obese Diabetic this week in the office. If they applied for life insurance this week, guaranteed that the insurance agency most certainly would.