Taking Control of Diabetes

One of life’s mysteries is how suffering can transform an ordinary human life.

Some people call it breaking through to higher ground. Or claiming victory from defeat.

Most of us don’t know what to call it because we haven’t been there. Here’s the story of someone who has.

Steve Edelman was 15 when his symptoms first hit: fatigue, excess thirst and urination, a scab that wouldn’t heal. Then he lost 20 pounds. The final clue was his blood sugar: sky-high. He had juvenile diabetes (now called Type I diabetes).

Edelman’s pancreas, for unknown reasons, had quit making insulin. Bottom line: In order to survive, he would need insulin shots for the rest of his life.

For the next several years, Edelman was assigned to a doctor who was not a diabetes specialist. As he recalls, every appointment was the same. On the morning of the visit, he gave urine and blood. Awhile later, the doctor would call him in, glance at his results and say something like, “Steve, you’re doing fine. I’ll see you next time.”

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Finally, Edelman, now a college student in premed studies, grew suspicious. Yes, he had dodged diabetic coma. But he also knew his insulin dosing and blood sugars were far from ideal. And so he concocted a test for himself and his doctor. On the morning of his next appointment, he stopped by a doughnut shop and downed five sugar-laden time bombs.

A few minutes later he checked his urine with a chemical strip. The strip turned coal black, indicating, as he suspected, that his blood sugar was through the roof.

Back at the doctor’s office, it was business as usual. He gave urine and blood. He flipped through magazines in the waiting room. Finally, his doctor called him in and repeated his now-familiar line: “Steve, you’re doing fine. I’ll see you next time.”

But there was no next time because Edelman never went back to see him again.

The next jolt came in 1980 when Edelman was in medical school and he heard a simple statistic in a pathology lecture: 50% of Type I diabetics will die of kidney failure within 20 years of their diagnosis. To most of the class, it was one more fact to memorize. But for one student, it was a wake-up call.

During his early, lackluster treatment, Edelman figured he had already used up seven or eight years of healthy kidney life. Now that renal meltdown loomed, he was past denial. Consequently, two years later when insulin pumps and home glucose monitoring arrived on the scene, no one had to twist his arm. He was ready to fight his disease with any tool available.

I met Edelman during his internal medicine residency. At the hospital where we both worked, his pranks and wild hair were legendary. But behind his comic personality lay empathy and zeal, especially for patients suffering from diabetes. In fact, he kept a list of their names with him at all times. He had already begun his personal campaign to educate fellow diabetics. Why?

Because by then the research data were unequivocal. Lower blood sugars equaled less long-term damage, including blindness, kidney failure, nerve injury and amputation. No matter what age diabetes hit.

Edelman’s campaign continues. After years of specialized training in diabetes, he now works as an associate professor, researcher and clinician at the UC San Diego Medical School and San Diego’s Veteran Affairs Medical Center.

Throughout his career, he’s never stopped preaching his basic message to diabetics: You can take control. To spread the word, he’s even created a nonprofit organization that hosts diabetes health fairs around the country.

By the way, this isn’t a fairy tale. No one, including diabetic doctors, escapes the long-term ravages of abnormal blood sugar. Recently, Edelman has suffered eye hemorrhages, reduced sensation in his feet and some kidney damage. But one thing is sure. After relying on insulin for almost 30 years, those complications are small potatoes compared with what might have been if, years ago, he had not taken ownership of his disease and his health.

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For more information on upcoming diabetes health fairs, please consult https://www.tcoyd.org, call (800) 998-2693 or write to Taking Control of Your Diabetes, 1110 Camino Del Mar, Suite C, Del Mar, CA 92014. The next local conference is scheduled for Saturday at the Long Beach Convention Center, 300 E. Ocean Blvd., Long Beach. 7:30 a.m.-5 p.m. Advance registration, $40; on-site admission, $45.

* Claire Panosian Dunavan is a Los Angeles internist and infectious disease specialist. Reader comments are welcome at cpanosian@mednet.ucla.edu.

* The Doctor Files runs the fourth Monday of the month in Health.