Guest at the funeral or the three D's

I am 57 and I am going to a family reunion in August of 2010. If you came with me one thing that you would notice is the lack of old people. There will be a few but "few" is the operative word here. You see we don't tend to live beyond the age of seventy.

My aunt Dimple, who passed away a few years back, when she reached seventy one you would have thought she had won the lottery. She was calling all around blathering to anyone who would listen how she had made it.

In my family, we die of stroke, colon cancer and heart attack. What I like to call the three Deaths or three D's, for short. I always wondered why my family was so snake bit then I became diabetic. You would think this wouldn't be such a big surprise, after all I am Black and over fifty. But you would be very wrong. I'm a life long cyclist. I'm very fit. From the neck down, I could pass for a twenty year old. There is almost nothing about me that says, " type 2 diabetes", but I am.

It gets weirder. I am not only a type 2 diabetic but I'm prone to ketosis just as if I were a type 1. If my blood sugars get high my pancreas will simply shutdown and without insulin I could easily die from ketoacidosis much the same as any type 1 would.

This gets even better. If given insulin, overtime my pancreas will recover and I will begin producing enough insulin of my own and go back to being a type 2. The American Diabetes Association has two big classifications for diabetics, there is none insulin dependent and insulin dependent, which we call Type 2 and Type 1. I get to be both depending on which way my metabolic winds are blowing.

The more I learned about Ketosis Prone Diabetes, the more I began to reflect on certain aspects of my life and my family's. Like I said, I'm an avid cyclist and on average I would put 3000 to 4000 miles on the road in any given year. Cyclist get very use to listening to what is going on with their bodies. As we ride our bikes, we have to monitor ourselves and provide food and water at critical moments or we lose all of our energy. This habit of self-monitoring got me to a doctor before my situation got bad. I just didn't feel right.

I had the signs of ketosis: great thirst, tiredness, aching muscles and blurred vision but I didn't see those as important because, ever since my twenties, I've always had those. I would drink until my stomach hurt but I would still be thirsty. I long sense learned to push passed any tiredness or stiffness that I felt and since I've got terrible vision anyway, a little blurriness was no big deal.

Now that I'm diabetic, I look back and see that these things have been with me for awhile. One of the big keys for me was that these symptoms are the symptoms of winter. I'm from Detroit and I still live in Michigan. Michigan weather has been described as 9 months of winter and 3 months of bad sledding. Typically, I would get forced off the bike from late November into early March. During this time, I always lost weight and the previously mentioned symptoms would come marching back. Basically, I felt terrible during the winter months. I solved this problem by becoming a year round cyclist. The diabetes came on strong when I attempted to do a project at home last year and hardly got on the bike.

Here is the last piece of the puzzle. My diabetes is characterized by itching. Suddenly, I get itchy all over my body, if my blood sugar goes above 150. Now that I use a meter, I know that the itching occurs, not when my blood sugar is high, but when it returns to normal. I felt this itching years ago. Like most cyclist, I tend to load up on carbs before a ride to have energy. Carbs, however, drives up blood sugar and I carb loaded like mad before I rode. Always during the ride just when I started breaking a serious sweat, I would get this brief moment where I would feel intense itchy all over but I would ride through it. Strenuous exercise brings blood sugars down. This suggests to me that I've been diabetic since my twenties but due to all the exercise, it never showed itself.

This is where the light comes on. The only way I could be diabetic at that age was because it was inherited. What if my whole family, like me, carried this time bomb in our genes? It would work like this somewhere in young adulthood (When I first started feeling these effects.)our blood sugar begins to move outside of normal range, not much but enough to get us up past the 140 mark where damage is known to occur. I've already mentioned that high blood sugars causes the pancreas to shutdown in KP T2s. The initial part of that shutdown is always the first phase insulin response.

The body has two insulin phases. The first phase occurs when you eat and your blood sugar began to rise. The liver constantly puts glucose into the blood but when you eat something it shuts down and insulin is supplied to blunt the sharp rise in blood sugar. The second phase is the insulin supplied by the pancreas during the daily routine matching the supply of glucose being put forth by the liver.

What if, over time, this first phase slowly began to shutdown? Blood sugars would rise but the second phase over hours would slowly bring it back to normal. The problem with this is that the time above 140 is the point in which damage occurs and the pancreas loses more and more ability to respond. Eventually, a deadly spiral upwards would begin to occur. The more the blood sugar rose, the less the pancreas would respond and so on. Imagine if this process took place over 20 to 40 years. Damage would be occurring across the body. It would feed the formation of cancers and the inflammation of the circulatory system. You would expect to see deaths from heart attacks, strokes and colon cancer which has shown itself to be attuned to fluctuating blood sugars. Guess whose family dies in its forties, fifties and sixties from stroke, heart attacks and cancer?

This, I believe, is the guest at the funeral whose shadow falls across the coffin.

Michael