Long-Term vs. Near-Term Thinking – A Type 2 Diabetes Perspective

Society has many myths and misconceptions about people with diabetes. But even our own community can have some rather interesting “prejudices” about what diabetes is like for other people. After an article on a so-called “Civil War” between type 1 and type 2 diabetes appeared in the Chicago Tribune last fall, we at the ‘Mine decided to start sharing some personal stories of people living with type 2 diabetes, in order to better understand this complicated condition. Today, Bob Pedersen, a blogger diagnosed with type 2 in June 2008, shares his struggles with this disease, and how he’s altered his mentality to better cope with it.


A Guest Post by Bob Pedersen

People with diabetes should know better than anyone that there is no “one-size-fits-all.” People with type 2 diabetes are a very diverse group with regard to how the disease is treated and how it impacts them. Possible treatments include control solely through diet and exercise, a range of oral medication options, injected medications, medications supplemented by basal insulin, and full insulin dependence — not to mention the possible combinations of these. We differ in how subject we are to trouble with high and low blood sugars and how difficult it is to get back within range.

People with type 2 may be otherwise healthy, may be dealing with one or more of the other conditions that like to hang out with T2, or may experience other health problems. And of course, folks with T2 may experience any of the complications that can result from chronically high blood sugar — in fact, type 2 is sometimes not diagnosed until complications have already appeared.

For me, I’m currently able to achieve pretty good glucose control with oral medications. I’ve not been dangerously low yet, though I’ve been frightened a couple of times, and I don’t usually get very high without a pretty serious error in judgment. But that’s only the case right now: because type 2 diabetes is progressive, it’s probable that control will someday be more difficult to maintain. I will then require more aggressive treatment, and then perhaps need more aggressive treatment than that. It’s possible that I will someday need insulin as much as my type 1 friends do.

“Please, folks. Be gentle with each other. This disease is tough enough.”

— from Bob’s blog

Because of Type 2′s progressive nature, my life with diabetes can be thought of as being more about future control than my numbers in the present. The hope is that I may be able to slow the progression of my disease as well as reduce the risk of future complications. And the main tool I have to do that is lifestyle change.

Although many people diagnosed with type 2 bear no resemblance to the overweight-and-under-active picture many people have, I very much do. Not only am I seriously overweight, but I had been so for over three decades at the time I contracted diabetes. And, though I quickly learned that I’d be greatly benefited by making big changes in what I ate and how much I exercised in order to reduce the insulin resistance that is the chief feature of type 2, I found myself unable to make those big changes in any lasting way. In fact, perhaps due in part to my medications, I actually gained weight after diagnosis.

For my first two years with diabetes, I felt that I was failing in the long-term aspect of management. Then, about a year ago, I found I had had enough of the pain those feelings brought me. Since I couldn’t change my body, I changed my mind. I put away my bathroom scale and decided that my goal would not be to become slender but instead to become the healthiest fat man in town. I stopped berating myself when I ate something “bad,” but instead began to respect my body’s needs and find healthier ways to meet them. Over time, I found ways to eat a good breakfast, take my medications as prescribed, and even get in a bit of regular exercise.

I’m still a long ways from making all my choices in the best way. But small changes are adding up. My doctor and I are both happy with my A1c, and other indicators important in my situation have improved significantly. As of my last checkup, I’d even lost some weight. But, whether that weight loss proves lasting or temporary, the most important thing is that I am healthier in body and more peaceful in mind.

Yes, type 2 covers a very wide range of personal situations, and the progressive nature of type 2 means that my own situation is subject to change. But whatever my T2 future may bring, I’m reasonably comfortable that I’m doing what I can to help that future be as healthy as possible. That’s the best any PWD can do.


You can also follow Bob on Twitter at @rpederse.