Short stories, Travel and Health Information
One of my patients has recently become Diabetic.
Having recently diagnosed him with diabetes, I as his family doctor decided against immediately prescribing medication for him – because I knew this would give him the wrong impression that all he had to do was take the pills every day and he would be cured. I elected instead to tackle this problem in a more effective way. After all, he is the one with diabetes, not me – so it would be counter productive for him to think that I as his doctor was responsible for “curing” his diabetes.
I explained to him that in very simple terms, Diabetes is a matter of Imbalance. It is the result of a discrepancy between the sugar and sugar-producing foods a person consumes – and that person’s ability to utilise and/or store this sugar. If more sugar is taken in than is used up or stored, then the extra glucose spills over into the blood – and gets into all the body’s organs where it starts to cause damage.
So instead of just writing out a prescription, I measured his weight, waistline and blood pressure – and suggested he come and see me the following week with his wife. Before that visit, I asked him to do three things:
When he returned with his wife about ten days later, bringing an accurately maintained record of food consumed and blood sugar readings (after all, he IS a conscientious accountant by profession!) it was easy to show him how his high blood sugars were related to the type food he ate, and (even though he had not been able to walk every day) how the glucose readings were usually lower if he had done his “exercise walk” the day before. After he digested this information, I gave him a few tips about how he could select foods and times of eating that would not put his blood sugar up excessively, encouraged him to continue walking as many days of the week as he could, referred him and his wife to a dietitian for advice – and prescribed him a small dose of a medicine called Metformin to be taken each day with his evening meal.
The purpose of asking him to come and see me with his wife, I told them, was because it was HIS responsibility to manage his diabetes, and I was sure that his management would be more effective if he could enlist her help in this task.
I arranged to see him again (with his updated record books – one for Blood sugar readings and the other his food diary) after a month. When he returned, his readings on the whole were good – and when I repeated his blood tests two months later, all his measures of diabetic control were excellent.
I commended him for his efforts, and asked him how he had managed to be so disciplined.
“It’s not me who should get the credit, Doc” he admitted, “it is my wife who should be given credit for this. After you involved her in managing my Diabetes, she watches what I eat like a hawk and makes sure I make the time to exercise at least four times a week. When we go out for dinner, she always serves me before she serves herself. Everybody says how lucky I am to have her do this, but I know that it is to make sure I don’t eat what I shouldn’t. Even if I occasionally try to serve myself a large helping of cake or ice cream, she does not say anything – she just gives me That Look, and so I serve myself a small piece or take some fruit instead. I call her my Diet Police – and it is because of her that I have been able to manage my blood sugars so well.”
Then he smiled. “You know, Doc – wives are very useful people, even if we don’t always like to admit this!”