Carlos Gonzalez was first told he haddiabetesin an ambulance after a car crash. An ETM ran routine postcrash blood tests which showed not only thatGonzalezhad high blood sugar, but that he also had a buildup of acid in his blood that results fromdiabetic ketoacidosis—a serious complication of diabetes. To confirm this finding, ER doctors then ran anA1C test, which measures average blood sugar levels over the past three months. A healthy A1C is below 5.7%. Anything above 6.5% indicates diabetes. Gonzalez’s was 14%—and he was subsequently diagnosed with type 2 diabetes. “They didn't know how I managed to live this long like that,” he remembers. “It was one of those things where you don't realize you’re sick until somebody tells you you're sick.”
When we digest food, the body breaks down carbohydrates into glucose that is then absorbed into the bloodstream. As blood sugar levels rise, our pancreas releases insulin, which is like a key that opens the door to the body’s muscle, fat, and liver cells so that glucose can enter them and be used as energy. People withtype 1 diabetesmake no or very little insulin, so they don’t have a key (or enough of that key) and need insulin injections to open the door. Type 2 diabetics have a key that doesn’t work correctly. “Either way, our body continues to try to break down food into energy—particularly carbs into sugar—but our body isn’t using it properly. So it stays in our blood,” explainsLori Zanini, a California-based registered dietitian and certified diabetes educator.
Prior to his diagnosis, Gonzalez would typically down a few peanut butter and jelly sandwiches, half a bag of chips, and cookies and milk after work. He was always tired and was urinating a lot—twocommon symptomsof high blood sugar. He had dated a type 1 diabetic and his grandmother has type 2. But he never suspected he might have diabetes himself.
Retired restaurateurIna Pinkneyalso discovered she has type 2 diabetes following an injury. Healing at home from a broken leg, she couldn’t figure out why she wasn’t losing weight. “I was eating very little, based on my normal intake,” Pinkney remembers. “I just couldn't understand.” Only when her physician asked if she was drinking a lot of water did she connect her constant thirst with insulin resistance.Constance Brown-Riggs, a New York–based registered dietitian and certified diabetes educator, says this scenario is common. “If someone is experiencing symptoms, they’ve had diabetes for quite some time,” she says. “That's part of the problem.”
After his diagnosis, Gonzalez started insulin injections. Pinkney was prescribed medication to lower glucose production and improve insulin sensitivity. They were both also advised on how to adjust their diets. “With a lot of medical diagnoses, we cannot self-manage. If we have cancer, we can’t administer our own chemo,” Zanini points out. “But with type 2 diabetes, there’s so much we can do by ourselves that will control our outcome. That can be overwhelming in the beginning. But as people learn how much they can do, it ends up being empowering.”