The Message of Diabetes

by Wendy Kagan and illustrations by Annie Internicola, May 28, 2011

Bill Pfleging arrived somewhat suddenly—and altogether accidentally—upon his diagnosis for type 2 diabetes. In a haze of pain, the 56-year-old Woodstock resident was admitted to Kingston Hospital in the spring of 2008. After running some tests, an emergency room doctor identified the source of the agony: a kidney stone. Pfleging was told it would pass in about 48 hours. “And by the way,” the doctor added on his way out the door. “You’re also diabetic.” His tone was lackadaisical—but his words hit Pfleging with machete-like force. Both Pfleging’s mother and grandmother had died from complications of type 2 diabetes. For Pfleging, “It felt like a death sentence.” He left in shock—but ready to make some radical changes that would turn his life around and set him squarely on the path to health.

Many type 2 diabetes diagnoses come in just this way—inadvertently exposed by blood work from a separate medical event. Diabetes can enter a life silently, lurking for years before an onset of symptoms such as excessive thirst, increased hunger, and frequent urination. By the time symptoms appear, it’s likely that high blood-glucose levels have wreaked some havoc on the body’s delicate latticework of cells and tissues. But whenever the diagnosis arrives, it’s always a wake-up call. The message is firm and clear: You must change your diet and your lifestyle. If you don’t you’ll face an uncertain future, and increased odds for complications ranging from kidney failure and heart disease to amputations and blindness.

A dazzlingly large number of people are receiving this message nowadays. An estimated 27 million Americans have diabetes, and another 65 to 70 million are prediabetic. One out of three people born today will develop diabetes. And according to a University of Chicago study, the incidence of type 2 diabetes in the U.S. will double in the next 25 years. Around the globe the statistics are not much better, but it is the American way of life—an exported culture of Big Gulp sodas, supersized meals, and sedentary habits—that’s largely to blame.

Yet there’s good news, too. The complications of diabetes are largely preventable, and the conscientious patient can live a healthy life for many years through careful adjustments to diet and lifestyle. If type 2 diabetes is caught early enough, as it was with Pfleging, its status can even be reversed, with blood sugar levels returning to normal after a few months of dedicated, boot-camp-like change.

Goodbye, White Bread
When Pfleging arrived at Kingston Hospital, his blood sugar was hovering at 250—well above the normal range of under 120. A hemoglobin A1C test, which reveals blood-sugar levels from the previous three months, confirmed a diabetes diagnosis, and Pfleging’s family doctor wanted to start him right away on oral medications to control the problem. But Pfleging resisted. “I knew that if I went on meds, I wouldn’t change my eating habits,” he said. Since Pfleging wasn’t having any symptoms yet, his doctor agreed to a little experiment: He would let his patient give diet-modification a try.