It’s sometimes fascinating, living with chronic medical conditions. Note that in a medical context “chronic” refers to “long-term” rather than “severe”. It can be a mental challenge, and admittedly “fascinating” is not a term that everybody would choose for it.
It’s all about probability
With diabetes in particular, we often hear about it putting us at higher risk of all sorts of health complications. In fact, the language sometimes used makes it easy to think that it’s just a matter of time until you “will” develop these problems.
So when we notice something not quite right, it’s easy to think it’s because of our diabetes. Yes our diabetes is sometimes involved, but it’s not that simple!
It’s very frustrating when medicos leap to conclusions like that (especially if they end up being wrong). But there’s also a risk that when we ask about it in the echo-chambers of peer support groups, sometimes others will convince us that it’s due to our diabetes.
We are all individuals
We do have a lot of things in common of course, but we’re not all the same. Some of our health complications do end up being related to our diabetes. But it’s not automatic.
In my own case I’ve had type 1 diabetes since 1982, and although my HbA1c has for several years been in the range of someone without diabetes (largely thanks to my closed-loop system) before that it jumped around at higher levels. While I feel very comfortable that my current BG levels are not a cause for concern or elevated risk, I really don’t know what my earlier history means. I don’t know what all the other environmental and genetic risk factors are either.
I’ve had a few things come up which have clearly reminded me that “it’s not always diabetes“:
About 20 years ago I was diagnosed with bursitis in one shoulder joint. At the time no-one mentioned “frozen shoulder”, but with all the talk of it online these days I’d probably be thinking that it was going to be a major problem and due to my diabetes. But at the time the doctors I saw hardly mentioned it. We did discuss the option of steroid injections, but the doctors saw that as not the first resort. In the end a combination of anti-inflammatories, physiotherapy, and most-importantly a change in pillow height managed to eventually resolve the problem.
I’m certainly not saying that this would be true for everyone else, but I’m conscious that with today’s social-media storms I would probably be going into things feeling damned to steroid injections, possible surgery, and probable recurrence.
It hasn’t recurred in the years since.
Recently I noticed that the joints in one of my “pinkie” fingers weren’t able to straighten completely.
Dr. Google would have me believe that this is the onset of “diabetic hand syndrome”, and could end up with things like Dupuytren’s Contracture and/or “trigger finger”. But I’ve had doctors shake their heads at that.
I was talking to my GP about this and she commented that she’d recently seen seven different patients with “trigger finger”, and none of them had diabetes.
Yes statistically many people with trigger finger do have diabetes, but many don’t. Having diabetes (especially having chronically elevated BGs) does increase the odds, but there are many other factors at play too.
After ultrasound and X-ray of the area, doctors (including my endocrinologist) have decided that my diabetes probably has no relationship with this tendon injury, which probably stemmed from a subtle/unnoticed hand injury in the last years.
Luckily the finger is still able to operate and has plenty of strength so it’s not really affecting me yet. It doesn’t get in the way of my photography work. We will of course take care of it to preserve function for the coming years, but at least I don’t have a “diabetes cloud” hovering over it.
Retinopathy and other eye damage is another big topic of concern to people with diabetes, and I’ve been having regular examinations with an opthalmologist for many years.
Through this we did find and start treating a non-diabetes issue in one of my eyes years before I would have otherwise found it. So I think I can say that my eyes are in better condition than they would have been without diabetes.
It’s not always diabetes
Of course I can’t say that nothing is due to diabetes. In many cases it’s definitely implicated. But not always, and I think we need to be careful to not always assume that it is.
I guess I have been incredibly lucky with these experiences, but of course they’re not an exhaustive list of my medical conditions. As I get older I seem to interact with new specialists almost every year (sometimes for short-term investigations, sometimes “chronically”). But I hope that’s more to do with me getting older than it has to do with me having diabetes.
It’s not always COVID either
Recently I’ve been run down by a cold. I have already had my first COVID and flu vaccinations for this year. But this took hold in my sinuses, tried to creep down my throat, and then I developed conjunctivitis at the same time. The conjunctivitis symptoms leant towards a virus instead of bacteria, but the doctor I saw couldn’t be sure. We did start with antibiotic eyedrops anyway. Obviously I couldn’t attend my job at a healthcare facility the next day.
So of course I got tested for COVID again, hoping that wasn’t it. And then as usual I had to isolate until we got the results. With all the worry about the pandemic it’s very easy to worry yourself into a corner thinking that everything points to COVID.
But just as “it’s not always diabetes“, it occurred to me that “it’s not always COVID” too.
It was a very tempting thought though, especially when feeling very run-down and sick.
Then on the day I got the (negative) test result I also found that the eye drops seemed to having good effect on the conjunctivitis (meaning it was probably bacterial). That was a good day! The head cold broke soon after.
2 thoughts on “It’s not always diabetes”
Very interesting logical writing David
After my children heard me in a rather elevated telehealth consult recently I explained to them how frustrating I found it that doctors always blamed my diabetes for everything but sometimes IT WAS JUST A SORE FOOT! They got this concept, and my frustration, more than any Dr I’ve seen..they’re nine! (Yes, I’m very quietly hoping they’ll choose endocrinology as career! ?)