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Carol Forsloff - As a diabetic, diagnosed with the disease at age 66, I was surprised and saddened when I heard my doctor describe my condition, then learned over time about its negative impact from experience and research. The progression of the disease is what makes diabetes insidious, difficult to manage and sometime leads to early disability or death; and the understanding of what that progression means could change medical costs and the human toll that diabetes takes on individuals and families.
Diabetes is described as a
progressive disease by the medical profession. New treatments hold promise for reducing effects of the disease and even its potential onset. By the time an individual is diagnosed with diabetes, however, the individual often has already had years of suffering its consequences. Family and friends can be included in that suffering as well, because diabetes negatively influences behavior and mental functioning as well as physical conditions.
Despite the fact there is evidence doctors have known for three hundred years that diabetes can influence emotions, most people think only about how it relates to sugar intake and what the physical issues might be in relationship to the disease. We read about heart attacks, stroke, blindness, amputation, and other disabilities as well as dramatic weight gain and loss, but seldom do we learn about how diabetes affects feelings, behaviors and attitudes.
That angry man in line at the grocery store may be experiencing a “sugar episode.” Research has shown that Type A individuals have higher glucose levels than the “B” personality types. As the diabetes disease progresses slowly over time, it can begin to
influence emotions before the diagnosis. Behavior of the diabetic is often misunderstood by others, as we might respond negatively to that angry man at the grocery store as simply being impatient and self-centered. But anger, depression and stress are exacerbated by problems with glucose control, even before a formal diagnosis of the diabetes. After the diagnosis, sufferers of the disease often drift further into depression, especially as the body changes and medical concerns increase. The manifestation of that depression is often the depression turned inside out to anger.
Many diabetics don’t know they have the disease because for some people the symptoms go unnoticed for many years or are diagnosed as evidence of some other condition that might be short-term and unrelated to the disease itself. My doctors diagnosed me as having a rheumatoid-type condition because of complex muscle aches and fatigue. Flakey skin was a dermatologist’s concern, with prescriptions for various ointments and lotions to calm infected areas on scalp and face. Falling asleep after meals was disregarded entirely as a symptom of nothing more than doing too much. Frequent infections, especially after surgeries, simply were treated episodically as opposed to viewing them as early symptoms of diabetic progression. Some of these conditions started in my early twenties, causing infected nails, unexplained fatigue, and a raft of medical conditions, now seen as part of the progressive disease of diabetes but viewed at the time by friends, family and physicians simply as behavior related to some situation or event. But these are the
early signs of the disease, especially when they become progressively worse, even with care.
Unless someone has a family member with diabetes, the disease may not be acknowledged as a possibility when certain symptoms develop. In my case, the catalyst for diagnosis came during a period of severe headaches and fainting. By that time it was clear from tests that I had diabetes. There was no record of a family member having the disease, until an investigation found a close relative had died, exhibiting for years the symptoms I have had. That relative was my Mother, an individual with a mental health condition that overrode almost every other medical evaluation made, so her symptoms were simply treated at the time, but not as symptomatic of the disease of diabetes.
Experts tell us those folks who observe changes in physical or mental condition, even small ones over time, can find it helpful to begin prevention of diabetes early by beginning dietary changes and having a fasting blood sugar test at regular intervals. It is that prevention, or early detection, that makes a difference in how an individual will fare with the disease. It means that even those folks without a family member having the disease, or even with symptoms that may seem simple at the time, need to be examined by the patterns that present not just at the time of a doctor visit but over a period of time. as potentially predictive of the progression of disease. Interrupting that progression early can make a difference both in health care costs and the welfare of the diabetic in the long term.
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