Diabetes Letter
I have received a copy of the diabetes consultant's letter. I had to look up some of the terminology and the number ranges. It basically says to increase my metformin from 1g twice a day to 1g three times a day, and to add 40mg of gliclazide. The gliclazide can go up to 160mg twice a day. But if that doesn't help, because of my BMI being so high, he would want me to go on GLP1 analogue therapy. Form the briefest of Google searches, that's a med that makes your insulin respond better to the glucose in the bloodstream, makes the liver not release sugar when it's not needed, and makes the digestive system digest food more slowly.
It also says that there are early signs of possible kidney damage. eGFR is under 90. It should be between 90 and 120, I think. Under 60 is serious, under 15 is pretty much failure. ACR is slightly elevated at 7.73. If it remains under 15 on two occasions I need to be referred to nephropathy clinic (kidney specialists).
Also with a BMI at 41.2 he really wants to get me on Orlistat, first to reduce and then to maintain lower body fat.
I'm glad the letter contains details and numbers, even if it did require 10 minutes on Google just to understand it. But also it's a very frightening thing. I have a lot of illnesses, but the two most likely culprits for getting me in the end, as of right now before they diagnose the next 5 things, are either heart failure or diabetic kidney failure. Heart failure because so many of my family have died young of sudden, unexpected heart attacks in otherwise healthy, fit adults. I have had them check my heart out thoroughly, and they've found nothing at all wrong. But the Healthy Routes test puts my heart health as that of a 61 year old, so I don't stand much of a chance if I have an attack. My dad, and many other diabetic family members, have basically had 30 years after diagnosis of diabetes before their kidneys gave out. In most cases their hearts couldn't cope at that point, either with the kidney failure itself or with dialysis. One lived a further 10 years on dialysis. I was diagnosed at 35. That means 65. Medicine is constantly making advances, but on the other hand they didn't have signs of kidney problems this soon after diagnosis.
Maybe I'm just being morbid or alarmist, but it feels like an early warning of the beginning of the end. Days like this make me want to pack in trying so hard, putting up with stuff, striving constantly, the physical pain and bone-deep weariness and all the little things I have to do, moment by moment, decision by decision just to make it through a day, all the juggling between spending time on myself to be well and spending time on my family, who need me, trying to show my kids how to contribute something positive to the world in whatever way you can. I could just lie down in bed and never get up. I know people who have done it. People think I don't have it in me to do that, but I do, I just try bloody hard not to let them see that side because it would do no good. I wouldn't have to try any more.
But days like this also remind me how much I love life, how much I really, truly, never could lie down and give up like that, all I have to live for, all the things I'm needed for and could never provide, the burden I would become, all my ambitions I would never achieve, how much of other people's lives I would miss, especially the kids, all the random things that only happen to me that would therefore happen to nobody.
Either way, it's frightening.
It also says that there are early signs of possible kidney damage. eGFR is under 90. It should be between 90 and 120, I think. Under 60 is serious, under 15 is pretty much failure. ACR is slightly elevated at 7.73. If it remains under 15 on two occasions I need to be referred to nephropathy clinic (kidney specialists).
Also with a BMI at 41.2 he really wants to get me on Orlistat, first to reduce and then to maintain lower body fat.
I'm glad the letter contains details and numbers, even if it did require 10 minutes on Google just to understand it. But also it's a very frightening thing. I have a lot of illnesses, but the two most likely culprits for getting me in the end, as of right now before they diagnose the next 5 things, are either heart failure or diabetic kidney failure. Heart failure because so many of my family have died young of sudden, unexpected heart attacks in otherwise healthy, fit adults. I have had them check my heart out thoroughly, and they've found nothing at all wrong. But the Healthy Routes test puts my heart health as that of a 61 year old, so I don't stand much of a chance if I have an attack. My dad, and many other diabetic family members, have basically had 30 years after diagnosis of diabetes before their kidneys gave out. In most cases their hearts couldn't cope at that point, either with the kidney failure itself or with dialysis. One lived a further 10 years on dialysis. I was diagnosed at 35. That means 65. Medicine is constantly making advances, but on the other hand they didn't have signs of kidney problems this soon after diagnosis.
Maybe I'm just being morbid or alarmist, but it feels like an early warning of the beginning of the end. Days like this make me want to pack in trying so hard, putting up with stuff, striving constantly, the physical pain and bone-deep weariness and all the little things I have to do, moment by moment, decision by decision just to make it through a day, all the juggling between spending time on myself to be well and spending time on my family, who need me, trying to show my kids how to contribute something positive to the world in whatever way you can. I could just lie down in bed and never get up. I know people who have done it. People think I don't have it in me to do that, but I do, I just try bloody hard not to let them see that side because it would do no good. I wouldn't have to try any more.
But days like this also remind me how much I love life, how much I really, truly, never could lie down and give up like that, all I have to live for, all the things I'm needed for and could never provide, the burden I would become, all my ambitions I would never achieve, how much of other people's lives I would miss, especially the kids, all the random things that only happen to me that would therefore happen to nobody.
Either way, it's frightening.