Medical research points us to the right path. Remember, you are at a fork in your road of life as a diabetic. Only you can choose which path you’re going to take. One can lead to a terrible, disastrous, complicated life, but I encourage you to journey on the road to quality living instead.
You may have recently been diagnosed as diabetic or told you’re prediabetic. Or maybe you’re afraid you may be diabetic, but you don’t want to see your doctor and get that news.
Let me tell you a story about someone I’ll call Bill, a diabetic for many years. I had talked to him before about his habits, but he never committed to doing all he could to improve his health. I hope Bill’s story will remind you of the dangers of staying on the diabetic road.
Bill was in his late sixties, way overweight, and had been diabetic for many years. I hadn’t seen him in over a year when he and his wife came from Georgia to the North Carolina mountains for a long weekend and dropped by our house for a short visit. He got both feet planted on the driveway and stood holding on to the opened car door for a few seconds, smiled, and then moved slowly toward our front door. After we settled into the den, he began telling me about his medical problems, which had developed over the past six months. “My legs are my biggest concern.” He pulled up one pants leg to show me how swollen his legs had become.
With my thumb, I gently pressed on the side of his calf. It was like pushing into a thickened sponge. I continued pressing as I watched the end of my thumb sink into the side of his leg. After almost a minute, I told him, “When I remove my thumb, I want you to look at the huge dimple it leaves. It will be the size of a donut hole.” I had a slight smile as I looked up at him. “You know, the size of the hole in all those donuts you like to eat.”
“I don’t eat nearly as many as I used to, Doc. Not since I got started on insulin three years ago.” He laughed.
I removed my thumb and the dimple became evident. It sank a good half inch into the soft tissue under the skin. In years past, I had spoken to him on several occasions about his diabetes. Bill had a pattern. He would be energetic about change for a spell but then go right back to his old habits: not watching what he ate, not exercising, regaining his weight. With the new problem of his legs swelling, I realized this meeting could be the last time I might have the chance to motivate him and explain what would happen if he didn’t make changes in his lifestyle. My approach was more forceful than in previous conversations.
“Your biggest problem is not your legs. Your biggest problem is your heart.”
“Well, that too. My doctor told me it’s congestive heart failure.”
“Exactly. Your heart is so weak it can’t keep your circulation pumping properly throughout your body. Excess fluid is accumulating in your legs. Your heart is failing, and that’s what’s going to kill you if you don’t do something about it. Your diabetes has a lot to do with the health of your heart.” I wasn’t going to sugarcoat what his future looked like if he didn’t change his lifestyle.
“You are on your way out, Bill. Slowly but surely. I can assure you of that. But you can do a lot to extend your time here on earth by many years. We’ve talked about it before, but you’ve gotten yourself on a slippery slope. You started out letting yourself get a little overweight, and then you added more and more pounds. And look at where you are now.”
“I know.” Bill responded. “I’ve lost fifteen pounds in the past two months. You may not believe me, but I’ve cut way down on fried foods. And you know what?” I could tell he was about to brag about himself by the way he smiled. “You know how I love biscuits and gravy? Every morning? But now, I only eat them occasionally—”
“Zero,” I said, interrupting him. “No more biscuits and gravy. You’re at a point in your life where you’re going to have to make some major changes.”
“But my doctor said I could have them once in a while. He talked to me about not eating them every morning for breakfast, although that has always been my favorite. I don’t eat them often, now. Just sometimes on Saturdays.” He laughed and slapped me on my shoulder.
“Okay. Let me ask you a question. If you were sitting here talking to someone who smoked, who had a spot on his lung that could be lung cancer, and you told him he had to quit smoking, do you think it would be all right if he said he would quit except smoking one cigarette every Saturday? No, he would need to abstain completely. You must beat the desire for certain foods. Not only foods that harm your diabetes but those that harm your heart. Diabetes plays a huge role in injuring your heart. That’s why you’re in congestive heart failure right now. You’re not going to die from your diabetes; you’re going to die from your heart problem.
“It takes about two months to beat the desire for a food addiction, like your biscuits and gravy. That takes abstaining completely. Once the desire begins to fade, I guarantee you, Bill, the day will come when you’ll run from those biscuits and gravy because you’ll know what harm they’ll do to you. And if you will follow my advice, the day will come when you’re walking thirty minutes to an hour every day and you’ll have become nice and trim.”
He looked down at his leg. The donut hole had refilled with fluid and was now as swollen as the rest of his leg. He slid his pants leg back down to his ankle before he looked up at me. “Years ago, when we talked about my diabetes, before I had to start taking insulin, you told me I needed to lose weight. We were talking then about what I needed to do for my diabetes. Now you’re saying diabetes affected my heart?”
“Right.” I nodded. “When you think ‘diabetes,’ think ‘heart.’ It’s a double-edged sword, and not many diabetics realize that.”
Bill had no idea about the danger diabetes was to his heart. He didn’t realize that when diabetics come to the end of their lives, more than 80 percent of the time the finale is a heart attack or stroke. Most diabetics like Bill are fighting the battle of diabetes—checking their blood sugar, pricking their finger multiple times, re-gauging the amount of insulin by the amount of certain sugary foods they eat—but they don’t realize the importance of protecting their arteries at the same time. They’re fighting only half the fight in the battle of diabetes. Like Bill, all diabetics need to fight the full fight.
I continued. “Do you know anyone who has had a stroke?”
“I sure do. One of my uncles had two of them. The first one left him unable to use his left arm at all, and he walked funny, but he got around real good with a cane.”
“What about his second one?”
“It killed him.” Bill leaned back on the sofa, shaking his head. “Killed him dead.” Bill’s Georgia accent said it well.
“Was he a diabetic?”
“Yes, he was. But he didn’t take care of himself.”
“So he was overweight like you?”
“Oh, he was a lot heavier than me.”
Bill’s wife decided to chime in. “Bill, he wasn’t that much heavier than you.”
“Did he have high blood pressure?” I asked.
“He took blood pressure pills for years. As long as I knew him, he had to take a lot of medicine.”
I began a sermonette I had preached to him several times in the past. “Bill, after seeing the swelling in your legs, I want to be perfectly straightforward with you. I have known you for many years, and I recall we’ve talked about what you could be doing to improve your health: what foods to eat, an exercise program, reducing your weight.”
“I know, and I really appreciate all the advice you’ve given me. And you remember I started walking every day.”
“That lasted about two weeks each time.” His wife chimed in again.
“I don’t eat anything like I used to. I’ve cut down on a lot of what you told me not to eat—”
“You can’t just ‘cut down,’” I said, interrupting again. “You need to abstain from all the bad foods that affect your arteries. Diabetes harms arteries throughout your body, and you need to do all you can to protect them.”
Bill nodded. “A friend was diabetic, and he lost both his legs. I didn’t know it was because he was diabetic, though. Are you saying that’s why he lost his legs?”
I knew I had his attention at last. “You have congestive heart failure, which means your heart isn’t strong enough to pump your blood and fluids around in your body. Your heart muscle is weak because the arteries in your heart aren’t letting enough blood through to feed those muscles. Your legs look like water balloons, and that’s because your heart is failing. Bill, if you don’t change something, this is going to lead to your death.
“You mentioned your uncle had a stroke. That was because the arteries leading to and the arteries within his brain didn’t let enough blood into his brain to keep it functioning normally. Am I making sense about how important the blood supply to your heart and brain is? Diabetes makes it all worse.”
“I didn’t know that—but if you say so.” He nodded again.
“Well, I’m saying so, and I’m being blunter with you today because I don’t want to lose you. You understand what I’m saying?”
He nodded again, looking more serious.
“Let me give you some things to think about. Did you know you can add years to your life if you’ll change your habits to not only improve your diabetes but to also protect your arteries that supply your heart and brain? It’s estimated that if you take heart disease and stroke together, 84 percent of people sixty-five or older who have diabetes die from some form of heart disease or a stroke. Eighty-four percent. Remember that number, Bill. That’s your destination unless you change the course you’re on.
“Anyone who has diabetes needs to do all they can to bring it under control. I’m not saying you’ll completely get off your insulin, but many diabetics on insulin do get off it, and some even get off all diabetic medication.
“If someone has diabetes, they’re two to four times more likely to die from heart disease than a nondiabetic. Your heart is failing.” I paused to let my words sink in. “And you are still way overweight.”
I looked directly at him. “Weight loss is a must. Bill, it’s do-or-die. Literally. Losing your excess weight not only fights the insulin resistance but also plays a significant role in whipping your heart problem.”
I reminded him about how bad high blood pressure was for him. I pointed out that 80 percent of diabetics have high blood pressure and that it adds to the problem with his heart failing. If you have diabetes and high blood pressure, you have more than a twofold risk of dying from your heart problem than someone who has high blood pressure but is not diabetic.
“Bill, when you were here a few years ago, we talked about the importance of exercise. I remember the next day I watched you walking through the neighborhood for over an hour. Remember?”
“Yes. And you know I lost some weight.” He started smiling as big as possible.
“That lasted about a week, Bill.” His wife was still keeping the story honest. “You didn’t walk any after we got back home, not once.” She sat with her arms folded.
“Do you exercise any now?” I asked.
“About all the exercise he gets now is when he points the remote at the television,” his wife said.
“Here’s the deal, Bill. Exercise of any sort, whether you’re walking or jogging, swimming, or riding a bike, is one of those things you can control. You either exercise or you don’t. Bill, it’s up to you. If you don’t exercise, your insulin resistance is going to become greater and greater. Being inactive is a huge factor that increases your risk of having problems with your heart.
“Right now, your problem is heart failure. Your next problem could be a blockage of your arteries in your heart causing a heart attack. A couch potato diabetic has a higher risk of having a heart attack than one who exercises. Am I making sense to you?”
“You’re scaring me a little bit.”
“One, you’re way overweight. And two, you don’t exercise. You can do something about this, but you must make the decision to do it. You have to want to give the rest of your life more quality than you now have. You have to go beyond the ‘want to’ aspect to a commitment to do everything we’ve been discussing. The one question I have is this: Do you think you can do it?”
“Yes, I can. Where do I start?” Bill’s jovial voice and smile said it all.
“I would encourage you to make exercise the number one goal you make for yourself today.” I looked over at his wife and back to Bill. “She will keep you honest. What do you say?”
“So what’s the most important thing I need to do?” Bill asked.
“Losing weight is the most important, but exercise is so significant in weight loss that committing to exercise five to six days a week is the most important thing you can do to convince yourself that you’re serious about losing your extra weight.”
“Okay. I can at least get started with my walking.”
“I know you can do it. So do it.”
Bill and I went on to talk about good and bad foods to eat and about how his high cholesterol was connected to both his diabetes and his heart. “Bill, what I’m trying to get across is that you can begin taking some steps you haven’t taken in the past, which can reduce your chance of having a heart attack or a stroke and dying earlier than you should.”
“You know,” he quickly said, “for the first time, I think I’m getting what you’re telling me.”
Bill drove away that day knowing a lot more about the relationship between diabetes and his heart, and now you know a lot more about steps you can take that will allow you to live a healthier, more active, quality life. I hope Bill’s story has been a helpful review of some of the main points we’ve been covering. I also hope it will act as one of those triggers that will inspire you to take the proper road to defeat diabetes in your life.
I wish you well on your new journey, and I tell you the same as I told Bill: I know you can do it—SO DO IT!