Tikkabik

So about three years ago I was diagnosed with Type 2 Diabetes -- adult onset, in other words: The kind fat people with poor diets and little exercise are prone to. Unfortunately, I've had an on-again, off-again relationship with my doctor, so my treatment for it hasn't been nearly as consistent as it should have been. In fact, I haven't been taking any medicine (or seeing a doctor regularly) for a while. What I was taking would occasionally make me queasy and lightheaded, because it could actually cause my blood sugar to drop below where it should have been.

Anyway, I decided to take matters into my own hands earlier this summer and made an appointment with an endocrinologist referred to me by my medical insurance provider. I had the appointment earlier this week. I'm back on medicine and have a plan of action to implement over the coming weeks.

Insulin is a pretty important hormone produced by your pancreas. It helps your body regulate the storage and consumption of your blood glucose. With Type 2 Diabetes, your body has trouble making proper use of insulin, so you can't regulate your blood sugar as well as normal people (this is different from Type 1/Juvenile Diabetes, which is where your pancreas is wonky and doesn't produce enough insulin to begin with). The net result is that you end up peeing a lot, feeling like you're walking through mud, and are prone to a whole shitload of side effects: Blindness, numbness in your extremities, heart disease, stroke, infections. In my case, years of a sedentary lifestyle, correspondingly poor physical condition and a wretched diet high in carbohydrates put me at very high risk. It's a triple threat, like having unprotected sex with heroin-addicted third world prostitutes.

Interestingly, though, there are plenty of people walking around that are heavier than me, who eat worse than I do, who have acceptable blood sugar levels -- even if they're at high risk for future complications in their life. So understanding why my body is doing what it's doing is important, and that's something that's frankly beyond the domain of a "normal" general practitioner. That's what interested me in meeting with an endocrinologist: This is their specialty.

The meeting went well. I like the woman's bedside manner and she's got an efficient and friendly (albeit busy) practice that's not too far away from where I live. She's interested in why I'm diabetic too, as I'm still pretty young for this problem -- so she's ordered a battery of blood work that I'll have to do soon, testing just about every fluid that comes out of my body to see what exactly what is working and what isn't.

The good immediate news is that I'm going to be using different medicine than I did before, which should make me less prone to some of the problems I had before. Previously, the medicines I used had two effects: One raised my basal insulin level, and the other reduced my body's resistance to absorbing insulin. Raising my basal insulin was what would occasionally give me the shakes. This time around I'm taking the same drug I did before to reduce my body's insulin resistance, but instead of the basal drug I'm taking a different one that actually blocks your liver from producing glucose. There's a nice side effect, too -- it can cause your blood fat levels to drop, possibly helping with some minor weight loss.

My old doctor forbade me from going on a trendy low-carb diet, as well. I'd had it drilled into my head that those things were bad for diabetics. Turned out he (well, more specifically, the nurse practitioner in his practice) was wrong -- the endocrinologist said that low-carb diets are not bad at all for diabetics, though Atkins -- at least in its original saturated fats-rich form, isn't something she recommends. She said that some of her patients have had really good luck on South Beach, so I'm looking into it.

"Carbohydrates are the enemy," she said. More than once.