A good friend of mine was recently diagnosed with Type II diabetes. He’s been ill off and on for almost a year, and lately he has been very ill and it has affected his eyesight as well. The doctors have thrown all kinds of antibiotics and even steroids at him, before finally doing some blood tests and determining that he is diabetic.
Seems when he started having health problems they did some tests and he was ‘borderline’, but they failed to mention this to him. Neither did they tell him to change his lifestyle, although they did make a few suggestions without telling him why.
After telling him the diagnosis, they told him that the damage to his eyesight is permanent. They also told him that he is ineligible for any organ transplants because they don’t allow transplants for diabetics. (Because they have a chronic disease?) This doesn’t make sense to me. I have a very good friend who has Hepatitis C, and he had a liver transplant a little over a year ago. His disease is incurable and will eventually destroy his new liver, but they did the transplant anyway.
Does anyone know anything about this?
learae
This is NOT medical advice. There are too many questions I’d have to ask first. And even then, only a fool renders and opinion without an exam, tests, etc.
Right now, I’m responding because I can ‘hear’ the concern in your post, and it’s hard to ignore that.
I am terribly sorry that your friend has not recieved good patient education. It’s as important as sugar control in managing the many complications of this disease. Also be aware that he needs to find a source that he personally is comfortable with – physician, diabetes counselor, RN…
He may need to seek referrals from friends, if his doctor can’t find someone suitable for him. This is JOB ONE.
Now to answer your questions.
Assuming he has diabetes mellitus (sugar diabetes)…
Based on your brief history I’m guessing he’s 60+, probably overweight (though sometimes a rapid weight loss occurs), probably high blood pressure, maybe high triglycerides and cholesterol as well. I could be way off base, remember I’m only drawing a best guess based on what you told me.
If he’s having vision complications, he’s probably had diabetes for quite a few years, and since you didn’t specify how he’s losing sight - diabetic cataract, retina problems (there are several very different types), glaucoma, etc. - it’s impossible to say if his vision would be much better if he’d be treated a year ago. If his health has been poor for other reasons, as you suggest, they might not even been able to get his sugar under good control by now.
Since you mentioned antibiotics and steroids, I’d guess he had a recent bout of pneumonia. Such infections can throw a diabetic’s sugar wildly out of whack, because the body produces ‘stress’ steroids, which do the opposite of insulin. What is a bad flu for you, may make him severely dehydrated or [or even cause diabetic coma] in a 24-72 hrs
Regarding transplants: Diabetics often have system-wide effects that make them specifically bad candidates for many transplants. They are generally slow healers, have poor circulation, and may have kidney damage, for example. Also major surgery (and most transplants are pretty darn major!) releases the body’s stress steroids (mentioned earlier) which can make the blood chemistry go haywire - a crisis.
In addition to the many effects in the eyes, there are also ‘peripheral’ loss of sensation (meaning hands and especially feet) and other nerve effects.
There are also effects on the blood vessels that result in poor circulation, and increased risk of heart attack and stroke. Damage to the blood vessel in the eye is a major cause of diabetic vision loss
Dietary control, as you noted, is very important, but it is not easy. Make sure to get full advice on this.
Between the poor circulation, poor healing and loss of sensation, it is extremely important that he monitor his feet, and have good- fitting shoes. An injury he might have ignored before could now become very serious.
There’s so much more I’d like to say, but I’m sure you don’t want every possibility, just the ones relevant to his case. For that, he needs to form a good relationship with a local doc, clinic, PA, RN … find one.
Thank you for asking this question. I’m used to thinking of diabetes as being ‘relatively simple’, it’s easy to forget how much info – how many patient’s faces – are behind the answers that pop into my head
Speaking of which. I need to catch a couple of hours sleep
Thank you for your reply. I am deeply concerned about my friend; we’ve been friends since high school and he’s done a lot for me when I’ve gone through some rough patches.
He is only 43. This seems awfully young to have such serious health problems. He is somewhat overweight, but certainly not obese. He doesn’t seem to have been losing any weight, which surprised me since he has been so ill. He hasn’t had much appetite and often skips meals. Recently, he has looked…swollen. Especially around his face. I thought maybe that was caused by the steroids. He has been terribly exhausted…in fact, I gave him a ride to his pickup, (less than 2 miles), a couple of weeks ago, and he fell asleep in my car while he was talking to me. He has been doctoring for the exhaustion and a cough that he couldn’t get on top of.
He is under a lot of stress at his job, compounded by the fact that he has a business of his own to run in his off-time. He is often working from 8am (or earlier) until 2 or 3 am. His blood pressure went up for awhile, but I don’t think he is being medicated for that. I know he had a bit of trouble with his blood pressure when he was younger, but he claimed that he got control of it through his willpower, like he deliberately lowered his blood pressure. I don’t know how he is losing his sight exactly. He told me that he can’t see anything at a distance at all. So, basically his vision is getting worse…like he needs stronger glasses or something.
I really appreciate your comments on this. I guess I never realized how quickly a disease like Diabetes could change a person’s life. And I’d like to think that with a change in his eating habits, and possibly doing more physical things and less of the stressful kinds of work he’s been into, he would get better quickly. Can’t some of these problems turn around. I had always thought that sometimes if you lost weight and became more active you could control your blood suger that way. Is he too far advanced for that?
learae
Try webmd.com, they have tons of great info there on diabetes. There are a few types of diabetes too.
I know a guy who has diabetes, he has a habit of pulling down his pants in front of everyone to inject himself right before dinner 
Learae,
I’m glad he is under a physician’s care. Clearly there are other issues here as well. However, it’s often amazing how a patient’s health (and even their life) turns around as part of the process of getting their diabetes under control. Often, as you note, diet, exercise, etc. can be enough, or at least a major help. And if needed, the pills are usually pretty well tolerated. many people assume diabetes means insulin shots, but that’s rarely needed for Type II (adult onset, insulin resistant; the most common type)
40 is a fairly typical age of first detection. In fact, I originally guessed he was 40-60 for precisely that reason. However for some reason that I don’t recall now, I changed my mind before I submitted. [When will I learn not to second-guess myself?]
Exhaustion, poor diet, etc. can be devastating to a healthy individual. They are harder on a new diabetic. Often diabetics feel as if they are being discouraged from eating everything, but they still need proper nutrition. Fighting fatigue can become a ‘holy war’ that prevents proper rest – especially when there are work problems (which often come with having an unrecognized medical problem).
There are many important psychological elements to diabetes. That’s why I am a big fan of the multidisciplinary approach. Unfortunately, MPSIMS is a far cry from seeing a patient in an office, and addressing their concerns one-on-one. I probably shouldn’t comment any more.
Also, please remember that he may not be sharing all the details of his condition with you. That’s his privilege.
He’s lucky to have a caring friend like you. Keep gently pushing him toward the Patient Education and follow-up he needs, but above all he needs your understanding.
Thank you, KP, I’ll certainly encourage him to find out all he can. He’s told me that he intends to go to another doctor and get a second opinion. He has neglected his health for a long time, so maybe this will wake him up and get him to take care of himself.
Handy, I will try to go to webmd.com and see what I can find. I couldn’t remember what it was called, so I tried webdr.com and I was denied access. So I copied some articles from health.msn.com, and got a lot of info. Thank you for the suggestion, sometimes my mind goes blank, especially if I rely on my memory and don’t write anything down.
Have a great weekend… learae
Please go to diabetes.org. This is the American Diabetes Association website. It will tell you a great deal about diabetes.
Yes, diet and exercise may be able to help control sugars w/o medication. I’d like to stress how important diet is (the dietitian coming out of me) and how it always seems to be the last thing taken care of in regards to diabetes. Diabetics don’t need to buy special foods, or even sugar free foods. They can eat normal, every day foods.
Tell your friend to see a CDE-Certified Diabetes Educator. CDE’s are commonly registered dietitians or registered nurses. At the Wellness Center where I have been working lately, they have a team that consists of nurses, physicians, and dietitians that all work together. See if the local hospital has a program like this, or at least if they offer diabetes classes, most places do.
Good Luck to you and your friend!
I’m not a medical professional and these are only my own opinions and observations:
A swollen face is indeed a classic side effect of steroids; it can happen even on low doses. And corticosteroids cause weight gain even if eating habits don’t change – that is such a prevalent side effect that even cancer patients on chemo gain weight on corticosteroids. Longtime or high-dose steroid use has a whole host of other very nasty side effects – two of which are diabetes and cataracts.
I am not saying that the steroids caused your friend’s problems, but that they are very powerful drugs that can distort or even entirely mask the symptoms of a number of other problems. A second opinion is definitely in order, imho.
Catrandom
Thanks MissMonica7. Shamefully, I never know what CDE stood for – or if I did, I forgot. It may have seemed obvious when it was spelled out.
I’ll keep my eyes peeled for that certification from now on. I’ve seen some ahem “less than fully helpful” clinics out there, but I really can’t keep track of everybody.
I know a guy who has Diabetes & likes to drink a lot of beer. I told him everyone I asked & all the web sites about Diabetes said not to drink alcohol [at least not a lot] and he says baloney. sigh.
For diabetics, drinking alcohol makes your blood sugar drop…especially if you do not eat while drinking. Your liver processes alcohol, and your liver is where glucose is released when you are not eating to keep your sugars normal. The liver can’t do two things at once for a diabetic…it can only process alcohol, and not release stored glucose (glycogen). I’ve heard a true story of a diabetic (i’m thinking type 1) man who died from drinking too much, because he was passed out from the drinking and went into a diabetic coma.
Your friend is taking a huge risk.