The Stages of Diabetes

Patient Expert

Most of us are familiar with the Elisabeth Kuebler-Ross's Stages of Grief: Denial, Anger, Bargaining, Depression, and finally Acceptance. Some people have suggested that you go through the same stages when you encounter other challenges, like diabetes.

Perhaps some people do, but I didn't. I've had type 2 diabetes for 16 years now, and I think this would better describe my journey: Shock, Obsession, Normal, Ho Hum.

Shock. Yes, the diagnosis was a shock. My mother had been diagnosed in her 60s, and I knew the disease was inherited. But then she lost a lot of weight and said she didn't have diabetes anymore and her doctor wondered if she'd ever had it, so I stopped being vigilant. Hence the shock when I was diagnosed.

But I was never in denial. I knew I had it even before the first lab tests came back, because I'd been thirsty and peeing a lot, and a home test for urine sugar I'd gotten after my mother's diagnosis came back positive.

I was never angry. I didn't say, "Why me?" I had a good friend who had died of a brain tumor at 50 and a high school classmate who had died of cystic fibrosis as a young mother, so who was I   to complain about a chronic disease that could be controlled. In fact, as acquaintances came down with various medical problems and I seemed totally healthy, I often thought, "Why not me? Why am I so healthy when my friends are so sick?"

Obsession. Instead of trying to bargain with fate, which I knew was pointless, I became obsessed with diabetes. I joined online discussion groups and read scientific papers about diabetes, trying to learn as much as I could about the condition. Because I had a strong science background (I had been a PhD candidate in biology), I found the science interesting even when it had no practical application.

As a result of that obsession, I wrote a couple of books, The First Year: Type 2 Diabetes and a book on prediabetes, as well as co-authoring a book on what I felt was the healthiest diet for someone with type 2, a low-carb diet that emphasized real foods and fiber as well as limiting carbs (The Four Corners Diet). Later I began blogging about diabetes.

Normal. With more time, I became accustomed to having diabetes. It began to feel normal. I maintained a low-carb diet and no longer had much interest in carby foods, with the exception of fruit. At one point I tried some bolus insulin in the hopes I could occasionally eat things like bread. When I did, I realized I no longer particularly liked bread. So I abandoned that approach.

I do eat small amounts of berries and the occasional slice of peach or other fruit cut up into homemade kefir, which spreads the flavor around. Eating a whole peach no longer sounds enticing. The first bite or two would be good. The rest would just be a form of "cleaning your plate."

Ho Hum.  With even more time, I've realized that the diabetes is just a minor part of my life. I've reached an age at which almost all my contemporaries have some kind of medical problem or other. Some are crippled with arthritis and can't walk without a walker. Some are getting joint replacements. Some have cancer. Some are losing their vision to nondiabetic diseases. Some have had heart attacks. Some have MS. Some have Alzheimer's. Some have lost spouses. Some are dead.

Compared with all that, having a controllable disease like diabetes that forces you to eat a healthy diet and get regular exercise, both of which make you healthier in the long run, seems pretty trivial. Of course, had I gotten diabetes in my 30s, I'd still be relatively young and perhaps resentful of the fact that I had to limit my diet when my friends did not. Or maybe not. I'll never know.

So if you've recently been diagnosed, hang in there. Yes, it's difficult at first. But it does get easier with time. At the present time, diabetes is not curable. But, unlike so many other diseases, it's controllable. Controlling does require knowledge and some effort on your part, sometimes major changes in the way you eat. But the new way of eating will eventually become a habit you won't pay much attention to.

In the meantime, it helps to connect with others who share the condition, either in person or online, to share coping skills. With time you won't need all that support, but then you can help other newbies in this quest for a better life.