Monday, March 12, 2018

Prevention is Hard: The story of a glucose monitor

When I was pregnant at the age of 22 I had gestational diabetes.  They told me that it goes away most of the time after delivery, and it did. It came back 5 years later with my second pregnancy but went away again.  However, I started having higher glucose tests at my check ups than I had post pregnancy before, and when I had my third child in 2002, the diabetes stuck.  A lifetime of preventing pre-diabetes from becoming full-fledged diabetes began about a year later, and I have been swimming upstream against a health care system that refuses to prioritize prevention ever since.

During my 3rd pregnancy I was given a glucose monitor.  This is an amazing little device that tells you what your glucose levels are any time you prick your finger and feed it a drop of blood.  It's used to monitor sugar levels for the purpose of learning how to control them.  It was very hard to get one a year after I had my baby.  I wished I had kept the one I had during my pregnancy, but I thought the diabetes would go away.  I probably wouldn't have been able to get the lancets and tests strips anyway though.  As I watched my glucose levels rise and fall at appointments from 2003-2009, I asked several times for a monitor but was told it "wasn't necessary at this time."  In 2009 my A1C* went over 6.

I was determined to beat the evil diabetes and knew from pregnancy that I had the willpower to control it with diet and exercise. I read everything I could find about nutrition and glucose. I lost 40 pounds in 3 months and kept it off for over 5 years.  My glucose stayed steady at 5.  In 2014, I started gaining weight but couldn't figure out why. Over the next 2 years I gained about 30 pounds, kicking and screaming all the way.  I thought it was the infamous "metabolism" slowing down as I aged, but it turned out to be a non-functioning thyroid covered with polyps that may or may not be cancerous,  which I had hastily removed. 

It wasn't until 2016 when my A1C went over 7 that my insurance finally approved nutrition education that I no longer needed because I could have by then taught the classes. I asked for a glucose monitor again but they told me to "just go to the classes" because "the key is eating the right foods." I told them I was eating the right foods. They were skeptical. I asked if the thyroid problems could be causing my high glucose levels. They said no.  This turned out to be false. 

In 2016 I started seeing a glandular disease doctor to monitor my thyroid medication.  He became very interested in my diabetes problem and told me I needed medication.  I told him I could control it without medication and he told me all about how my organs and my eyesight would suffer if I didn't follow his advice. I drove home feeling defeated. I had lost the battle.  I was officially diabetic.

I had two choices:  Give up, take pills and go eat ice cream, or go see a different doctor.  I chose door number 2 and finally! found a doctor who gave me a glucose monitor.**  From February 2017 to June 2017, I lost 30 pounds and my A1C went from 7.1 to 5.3.  My doctor was so excited that she could not stop smiling. Seriously, she was just gleeful.  I don't think they see a lot of diabetes reversal.  I told her it was all the monitor. It is the missing piece in the Glucose Wars because it gives you the intel you need to understand what effect any food you ever eat has on your body.  It also helps me see the relationship between food and exercise.  For example, I can eat ice cream*** and then go for a walk and then test my levels 2 hours later.  If I test high I either ate too much ice cream or didn't walk long enough, or a combination of those factors that I can play with next time.  I can also monitor the effect my weight has on glucose levels.  I know that if I go over 150 lbs, my glucose levels will go higher than if I stay under 150.  It's a very powerful tool.

If I'd been able to get a glucose monitor in 2009, this would be a very different story.  I don't think  my A1C could have ever gone so high.  I honestly don't understand the reluctance to give them out, and it wasn't just the insurance - the doctors weren't supportive either.  Everyone was far more interested in prescribing medication that chemically lowers glucose - medication that can have the some of the same side effects that my doctor told me would happen if I continued to refuse medication! How freaking confusing.

I know the journey isn't over.  Stress can cause my glucose to rise even if I am doing the right things with food and exercise.  I saw that when I had the thyroid problems.  And controlling my weight is hard too, which probably does have something to do with metabolism over the age of 50.  But I feel that much more confident in my ability to win the war, now that I have the right tools.   The moral of this story is that prevention may be hard, but not necessarily for me now.  

*A1C is the number that measures your average glucose over the paste 3 months
**and an insurance company!
***it's usually not ice cream, it's way more likely to be mac-n-cheese or a hamburger

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