The Sugarless Plum: A Memoir by Zippora Karz

Author:Zippora Karz
Language: eng
Format: epub
Publisher: Harlequin
Published: 2009-12-26T16:00:00+00:00

My dad made an appointment for me with an internist who shared his suite of offices, and I went to see him the day after I arrived. The doctor knew I had just been diagnosed and probably assumed, because of my age and because my blood sugar levels were high, but nowhere near as high as would be expected with uncontrolled type 1 diabetes, that I had adult-onset, or type 2, diabetes. At the time it was not as common as it is now for an adult to be diagnosed with type 1 or for a child to have type 2, which is generally associated with lifestyle—being overweight and inactive. Type 1 diabetes is generally thought of as “child-hood” diabetes, which is usually associated with the image of a slender young child giving herself insulin injections. Type 1 diabetes is caused by an antibody—part of the body’s immune system that makes a mistake and starts attacking the insulin-producing cells, the beta cells, in the pancreas. This is called an autoimmune process (auto = self and immune = infection-fighting system) and is not reversible. People who develop type 1 diabetes have to take insulin for life. Type 2 diabetes means that the body becomes resistant to the effects of insulin, and the body also stops making enough insulin. Most people who get this type of diabetes are inactive and overweight. The treatment starts with weight loss and exercise, then goes to oral medications and may ultimately require insulin. Almost everyone who gets type 2 diabetes has a family history of diabetes, which is much rarer in type 1 diabetes. Nowadays, we know that people can get either type of diabetes at any age, but a slender, athletic person in their twenties almost certainly has type 1 diabetes and requires insulin injections, not pills, for treatment.

At the time, however, it was generally assumed that a diagnosis of diabetes in an adult indicated type 2. This doctor’s treatment of me wasn’t very different from that of the one I’d seen in New York. He checked my blood sugar level but did very little else. He did not, for example, do a test to determine how much, if any, insulin my pancreas was producing. He spent almost no time talking to me, and my brain was so foggy that I didn’t have the wherewithal to ask any questions. What he did do was to prescribe an oral medication that he said would lower my blood sugar levels. As it turned out, the medication was intended for people with type 2 diabetes to cause their pancreas to increase its insulin production; but in type 1 diabetes it can actually be dangerous because it can exhaust the pancreas entirely. And, finally, he sent me to a nutritionist next door, who was now the third person not to explain what was happening to me or why. Instead of teaching me the intricacies of the effects of food on blood sugar levels, and how I could balance food,

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