Читать книгу 1,000 Years of Diabetes Wisdom - David G. Marrero - Страница 10

by Geoff Williams, physician, Rochester, NY

I first met Nancy in 1997 when she came to me as a new patient. She was 50 years old and told me that she had gained 100 pounds after her second marriage. She is now divorced again and working as a secretary at a suburban school district. She was quiet during the interview and would consider each question I asked carefully before answering. She struck me as a kind person. Her medical problems included all the parts of metabolic syndrome (high blood pressure, obesity, elevated cholesterol) and degenerative arthritis. She would often go for long periods of time without coming back, but then would come in for a cold or back pain. I asked her why she wouldn’t come in to see me more regularly, and she said she felt like a failure when she came in, and often she felt she should not come in out of embarrassment.

Her weight continued to climb, reaching a maximum of 274 pounds (BMI of 45 kg/m2) in the spring of 2002. On the day that she came in for a physical exam, I told her I thought that she might have diabetes and asked her to go for a glucose tolerance test. She asked me if I thought diabetes might be reversible. I said that she could certainly improve her diabetes control, if not eliminate the diabetes, if she found a way to be physically active for an hour a day and focus on eating a healthy diet.

Since then she has reported exercising for 30–60 minutes a day and has stayed on her Weight Watchers diet. She has progressively lost 78 pounds, her blood pressure has fallen enough to reduce both of her medications, and she has no sign of diabetes by blood sugar. I asked what made the difference for her to change her life in this way. She said that I had told her that she could do it, but that it would be hard work.

Nancy has truly inspired me as a health care practitioner. She has proved that people can really change their lives based on a positive long-term relationship and continued effort. I am consistently seeing more change in my patients regarding weight loss, increased physical activity, and cholesterol reduction. Remarkably, 2002 is when I read the first studies that diabetes can be prevented with lifestyle change. I believe that much of the failure of my patients in changing their lifestyle was because I didn’t believe that people could do this. Nancy has helped me change my view on that, and suddenly, I see my patients losing weight, exercising, and feeling better about themselves. How much was I getting in their way? How much was I getting in my own way?

I should also note that I began exercising daily on December 9th, 2000, as I was preparing to lecture the first-year medical school class about the benefits of physical activity. I have lost 25 pounds and have kept it off now for almost four years with maintained exercise. Perhaps some of my success has been noticed by my patients and perhaps it is helping my attitude about whether or not they can make these changes.