Paul Floats on Air

My type 2 neighbor Paul, whose pessimistic outlook I wrote about recently, is a new man.

He went to an endocrinologist a few days ago to discuss a long list of questions, fears, and  concerns about his condition. Is his A1c low enough? Too low? Could he be headed for sudden death by hypoglycemia? Should he be taking a sulfonylurea?

His wife says that when returned, his face was that of a man who has just had a huge weight lifted off him.

Why the transformation?

Well, the endocrinologist listened patiently and intently to Paul, then told him some reassuring things:

Paul had gone into the consultation with an A1c of 6.0. The endocrinologist, noting that Paul is 69 years old, told him that his A1c was excellent and that he shouldn’t try to lower it any more. He said the current consensus is that older people just don’t need to aspire to the level of control that younger type 2s are encouraged to pursue.

He advised Paul to quit taking metformin. His reason? It wasn’t because metformin isn’t a great drug—it is. But it gives Paul stomach aches, and given his current level of control may not be at all necessary. He told Paul to track his metformin-free numbers and see. If those numbers stay low, no loss.

The most important thing he told Paul was that “diabetes” describes a disease but does not describe the great range of individual variations among those who have it. Some, like Paul, who’ve had diabetes for years can, with a focused effort, quickly achieve an extraordinary level of control.

Others, although extremely determined and motivated, find that no combination of diet, exercise, and oral medications seems to work at decisively lowering their A1cs. Although scientists now understand the processes of diabetes more than ever, they still can’t say why each individual with the disease can respond so differently to therapy.  

And that’s the rub. There are times when no matter how dedicated we are to doing all the right things, our bodies have other plans. We humans may all come with a basic design and components, but there’s almost infinite variation among us in the small details. Our ability to deal with diabetes is a luck of the draw over which we have no control.

Which is why I’m glad for Paul, although my journey has not gone as smoothly as his. It’s human nature to cheer for the ones among us who do unexpectedly well. Watch the faces on audience members when a contestant on a game show like Wheel of Fortune wins the $100,000 prize.

If they can be happy for a stranger who’s been struck by great fortune, I figure I can be happy for my friend.