Robert A. Hayden, DC, PhD
Mr. Gardner came to our clinic for a physical exam, but he left to begin a new phase of his life journey. He sought none of this when he made an appointment, but the information we discovered during his examination would affect every aspect of his existence for the rest of his days.
I spend a lot of time both in and outside the clinic doing physical exams for drivers who are regulated by the Department of Transportation (DOT). Many of these physical are done on candidates for one of three trucking schools, although we have many clients who send drivers to us for this purpose. The trucking schools' student rosters swell whenever another industry goes out of business, so it has been brisk work recently.
Mr. Gardner provided a urine specimen that we analyzed in accordance with the procedures prescribed by the DOT for these physicals. One of the tests performed was a urine glucose level, and it was up to the maximum amount measured on our instrument.
Sure enough, he reported that his mother and two siblings were diabetic.
He had lost about twelve pounds in the past month without dieting. He was thirsty and having to go to the bathroom more often to urinate. He was about thirty pounds overweight, and craved chocolate ice cream. All of these are signs of diabetes, and his was a classic case.
This was more than a pothole on his road to a new career. His understandable initial anxiety was met with calmly presented information and alternatives. We referred him to his personal medical doctor to rule out diabetes.
The first step is a fasting blood glucose test. Mr. Gardner was sent to the lab early one morning before breakfast. The glucose was significantly elevated, confirming the disease at work.
About one to two of every twenty candidates I examine must be referred to medical providers due to previously undiagnosed diabetes. The disease is running rampant in our overweight society.
According to the American Diabetes Association (ADA), seven percent of Americans are diabetic, or almost 21 million children and adults, one-third of whom do not realize they have the disease. There are 54 million others who are in a pre-diabetic state. With this large prevalence, it is no wonder that so many of them turn up during physical exams.
Diabetes is a condition in which the body lacks insulin, a hormone that facilitates the transmission of glucose into cells. There are two types of the disease, depending on the amount of insulin the body secretes.
Type I diabetics do not produce insulin. They require insulin injections to survive. The DOT does not allow Type I diabetics to drive, so this would prove bad news for Mr. Gardner, who needed to go to work to support his family after his company moved to Mexico. Fortunately, only 5 to 10% of diabetics have this variety of the disease.
Most new diabetics are Type II. In this case, the body makes insulin, but does not utilize the hormone properly, and it is secreted in insufficient amounts. Some of these can be treated with diet alone, with reduced intake of carbohydrates and weight reduction. There are some Type II diabetics who need oral medication that will stimulate insulin secretion, called antihyperglycemics.
With so many diabetics in America, and with even more in a pre-diabetic state, the chances are excellent that either you or someone you know well will be seriously affected by this disease. What are the warning signs? How do you know if you have this condition or its precursor?
Look for an increase in appetite. Hunger is a normal phenomenon, but when your blood glucose is too high, you cannot get the nutrition to your cells. You will be inordinately hungry because your body cannot satisfy its needs.
You will lose a lot of water because the glucose that is filtered through the kidneys pulls water with it. Look for an increased frequency of urination. Along with this, as you might guess, you will be very thirsty because you will try to replace all the water you have lost.
Because your body cannot nourish itself properly with sufficient insulin, you will feel tired and irritable. You may have some problem concentrating or staying awake. Your vision may blur somewhat.
Another trend you may notice is the loss of weight without dieting. While this may seem a happy and gratuitous process, it is due to the fact that your body is trying to survive by breaking up fat stores within its cells to compensate for the fact that it cannot get the glucose from the blood stream into the cells.
A family history of diabetes should cause you to be even more aware of the signs and symptoms above. You are also more at risk if you are African American, Hispanic, native American, native Hawaiian, or Asian. If you are obese, you have more chance of developing diabetes at some point in adulthood.
Mr. Gardner went to his physician and returned with a diagnosis confirmed of Type II diabetes, a diet plan, an exercise regimen, a prescription for his medication, and a new attitude for self-care. Though he was not known for his health habits before that day, he would become an example of determination that characterizes those who thrive despite the disease. He passed the rest of the physical and was granted a medical examiners' certificate that allowed him to go on to school. He will finish school soon and take his choice of many job opportunities, as qualified truck drivers are scarce nowadays. He will provide for his family well, and they will be secure.
More importantly, Mr. Gardner is on his way to better health. He will learn more about how to care for himself as he continues this new leg of his journey. He will feel better, look better, and actually be better. And that is sweet, don't you think?
(For more information on diabetes, check out www.diabetes.org, the ADA's web site./RAH)