NR* an ex-athlete, 60+ year old ex-consultant was diagnosed with diabetes 23 years ago. While his diabetes is under control with oral medication, his journey has been replete with ups and downs. In this article, he shares the highlights of his journey, his current state and set of actions, with special focus on his challenges with his emotions and how they impacted his ability to act constructively.
Trigger Warning: Some parts of the narrative may be triggering for some persons with diabetes or their family caregivers
I have been a diabetic for 23 years, and I have mostly been in some sort of denial. I hope that my sharing this helps others. When I started writing, I could not remember many milestones and event sequences. My wife helped me fill the gaps since I had suppressed the more painful parts.
My background
I am now in my mid-sixties. I was studious in school, slightly short and plump. In college, I engaged in sports, and became obsessed with them. I grew taller (5’ 10”), and became very fit, weighing around 60 Kg in my last year of studies. I have been a vegetarian (with dairy and occasional eggs) all my life.
I started working in Bombay, got married, and we moved to Delhi in mid -1980s. From mid-1990s, I worked as a consultant, and travelled a lot (in India and abroad). In 2004, we moved to Bangalore. I reduced my workload in my mid-50s, and coasted towards retirement (with minimal new learning). In 2019, I began phasing out work and then retired.
Some lifestyle highlights and early warnings of diabetes
When I started my career, my weight was around 62 Kg. Exercise reduced significantly (mostly only walking), once I started working. One year in Bombay followed by a year in Europe - low exercise, reduced sleep, loneliness in an unfamiliar society, unhealthy food (cheese, pizzas, etc) – and my weight reached the mid-seventies. This poor lifestyle continued on returning to India.
Work-related traveling increased around the mid-1990s. My sleep and diet became even worse. Food was mostly in flights, hotels and client offices, and at odd times. Exercise by now was almost zero. My weight ballooned. My family and GP warned me about possible diabetes. I also had other indicators that I sort of noticed and ignored – like slow healing of wounds.
Diagnosis of diabetes
In 1999, my weight was 80 Kgs and I was always thirsty and hungry. I drank a lot of water, sweated a lot, and lost several kilos - without changing diet, exercises, etc. One night, in a hotel, I could not see for some time, and got scared. On returning home, I got a blood test done, as recommended by my wife. My fasting sugar was over 300. The lab chief insisted that I go immediately to a nearby doctor, who considered insulin, but prescribed tablets.
Timeline of my diabetes and experiences with doctors
- After the diagnosis, my blood sugar normalized quickly with tablets - these were phased out in a few months.
- In 2000, my regular blood tests (as suggested by the doctor) showed that my diabetes had returned. I consulted a well-known endocrinologist – who prescribed tablets. He said the medications can reduce depending on the control. I exercised more, but did not control my sleep or diet. Weight reduced to 75kg, but I could not lower it further. Travel remained high and schedule was irregular.
- We moved from Delhi to Bangalore in 2004. I started consulting another well-known endocrinologist. After some years, this doctor became ineffective - less concerned about my HbA1c (7.5-8%) or my weight (73-75kg), and kept saying “it anyway gets worse”. But I was in a comfort zone, and did not change my doctor. Meanwhile, my habits remained irregular and stress on personal front increased - I repeatedly skipped tests and doctor visits.
- By 2018 my HbA1c was usually above 8. I switched to a diabetes clinic for a one-year package, my weight came down to 65 kg and HbA1c came down to 7% in months.
- In 2019, I moved to a GP (with specialization in diabetes), to cover myself for aspects like immunization and overall health.
- At present, mid-2022, I am on metformin and sitagliptin tablets for my diabetes. My weight (63-64 Kg) is in the ideal range, and other parameters are fine.
One experience across doctors is that they explain things only when asked specific questions. Most explanations are standard and not tailored to my situation/ needs. They follow standard protocols. They convey that things will get worse and seem surprised that I am not already on insulin - making me feel that I have done my best.
My emotional attitude and approach towards diabetes.
Before my diagnosis, I ignored my declining fitness, increasing weight, and advice received.
Then came the diagnosis. From then and till very recently, I viewed my diabetes with resentment. I was unwilling to talk about it, understand it better, or make lasting lifestyle changes. I made sporadic changes, achieved some benefits, then reverted to old patterns, and never tackled my emotional acceptance issue. To elaborate:
Anger: I would get resentful and angry at any discussion about diabetes. I sometimes stopped eating or I would burn food and eat charred food saying “food is my enemy.” I raged at my wife if she mentioned my diabetes.
Fatalism: Narratives like ‘things will anyway deteriorate’, were embedded. Even when I got significant reversals through specific actions, I ignored them, slipped to old habits and the diabetes bounced back.
Rebellious attitude: For example, I never liked gulab-jamuns or rosgullas, but after getting diabetes I would eat them – thinking “why the hell should I not eat them?”
Avoided lifestyle changes and blamed my situation: I was not willing to make significant, long-lasting changes to my habits and lifestyle, feeling that many things were outside my control. I forgot that I had transformed myself to a very fit person in college, while living in a hostel. I could have changed many aspects - carried healthy snacks, selected flights that helped better sleep and exercise, specified my meal preferences to clients. Instead, I wallowed in self-pity.
Became a stuck record: ‘more exercise, less food, reduce weight’- Even after my weight reached the ideal range, I insisted on exercising more and eating less. This stressed my body and worsened my sugar levels.
Extreme Fear: I was in extreme fear of consequences - body parts decaying as the disease progressed, visits to ICU, etc. This paralyzed me internally, while I pretended to be ‘cool’.
Related Reading: What is Diabetes Distress
When I would mention my diabetes to friends and they would disbelieve, saying I was too energetic and fit (though I was overweight) or share horror stories from their personal lives. I would feel either smug or despondent. I started avoiding discussing my diabetes with others.
My wife often told me to be serious - tests, doctor visits, self-education, lifestyle changes. I pushed her away, sarcastically. I pretended that whatever I did for diabetes was only for her, not for myself. I said she was interfering. Once, after a bad HbA1c report, when she was worried - I told her loudly - in a public place - “it will be my leg that will be cut, not yours.”
I did not join any forums, because they seemed depressing. I did not consider counselling.
I did nothing about my emotional state even though I knew it was making my diabetes worse.
A gamechanger - exposure to a reversal program.
Around 2019, my wife told me about a diabetes reversal program. It was exciting and hope-generating – with multiple types of actions and step-by-step guidance. I adopted some recommendations - these were not too unpleasant or restrictive. Benefits became visible within a week - then I slipped, and the sugar readings went back to old values.
My adopting the protocol, improving, and then giving up happened twice, slipping both times ‘one short-cut at a time’.
To share a couple of examples
- I had to take a particular type of smoothie every morning. After a few days, I thought - let me eat the vegetables and fruits instead of churning them together. Next slippage – I started eating the ingredients any time of the day (instead of morning). Then, that too stopped.
- I used to eat a mix of 3 different sprouts every day. Then I started eating only one type of sprouts; then decided I could eat the soaked or partly sprouted lentil instead of letting it sprout fully. After some time, without any explicit decision, I had given up the full protocol.
- It was somewhat like the ‘boiled frog’ story.
My current state and most recent experience.
After years of evading tests and doctors, around 2019, I implemented some actions more consistently:
- Home blood sugar readings, at least 3 per day out of 6 (before meals and 2 hours after)
- Monthly HbA1c (though doctors recommend quarterly), to detect any sugar control problem early.
- Sleeping early and getting out of the bed only after 7.5 hours.
- Do exercises – morning and evening
Some months ago, I decided to exercise even more and eat even less. Home sugar readings stayed the same, but the HbA1c went up to 7.3% (from 7.0%) in a month. This HbA1c was inconsistent with my home readings, which were usually in the non-diabetic range.
Based on my wife’s suggestion, I took additional home readings for three days to debug this. My sugar was higher at 3 and 4 hours after a meal compared to 2 hours (it should have reduced after 2 hours). Also, the sugar went up around midnight, and remain high till 3:00 AM. This explained my elevated HBA1c.
My wife reminded me of the discarded Diabetes Reversal Program – the one I had adopted in 2019 (with smoothie, sprouts, etc.). I tried it for a few days and saw a marked improvement in sugar levels. The learning was - just doing more exercises and eating less, is detrimental beyond a point – one has to maintain a balance, reduce ‘stress’ (physical and emotional) and also pay attention to the variety and timing of the diet and exercises.
I talked to the doctor after my 7.3 HBA1c reading and a few days of my experimentation. Based on the HbA1c, he wanted to change my medications, but I explained my multiple home readings and experiments. He sounded sceptical, but agreed to wait for three months.
I adopted my own ‘mini-reversal’ protocol, after re-educating myself.
- Added 10 minutes of full-body exercises (mix of flexibility, aerobics and light weights) - 2 hours after each meal, and reduced my morning exercise (mainly jogging and walking)
- Drank a smoothie before morning exercises (vegetable + fruit + spices)
- Reduced grains and dairy significantly
- Started requesting my body – liver, pancreas, cells, digestive system, etc. - to function well
In one month, my HbA1c dropped from 7.3% to 6.8% (without changes in medications).
To sum up my learnings
Looking back, I should have taken better care of my weight and fitness after college and listened to well-wishers. I should have invested in educating myself about diabetes. Adopting unhelpful emotions, self-talk, and attitudes made it worse. Like “Once a diabetic, always a diabetic”, “Things will anyway deteriorate”, or my childish rebellion.
I could have made some changes even before retirement, with negligible impact on my career. These include things like slightly reduced workload, assignments in and near my home city, flights that allowed me better sleep, mild exercises at home and hotel rooms (and not using dark roads or closed gyms as excuses) and better planning and control of diet even while travelling or at client sites. I did not do this.
I am now working on my attitude - removing anger, despair and rebellion. I shall remind myself – ‘reversal is possible.’
I plan to remain regular with medical tests and consultations, and understand my body better. To make sure I don’t overdo the changes, get overwhelmed and then start slipping, I shall make only a few simple, sustainable changes at a time, check the results, then decide the next steps. I will review my protocol implementation daily. I will consider finer aspects like timings and mix of food and exercise.
I understand now that what is suitable at one time may not be useful later (e.g., weight loss is useful only up to a point). That applies even to reviewing whether my doctor continues to suit me.
I am moving out of my ‘set’ zone of actions and mindset, and adopting a positive, open attitude, seeking input and willing to act on multiple fronts.
* Anonymised on request
Related Reading: Aubrey shares his experience of diabetes control and remission
