What physician has not stifled a groan when a patient presents with a chief complaint of “I just don’t feel right, Doc.” About this time last year, I had that “not quite right” feeling and vague, seemingly unrelated symptoms … sweating, mid-morning headaches, and frequent feelings of hunger, which I was accustomed to satisfying with a muffin. I began to diagnose myself. No chest pain — hence, no myocardial infarction. No asthma. No history of hypertension or coronary artery disease.

Rather than calling my primary care physician as I should have, I ordered a few standard lab tests. To my utter astonishment, my fasting blood sugar was just over 100.
I made an appointment with my PCP. After a thorough workup, he informed me that I have what we now call pre-diabetes.

He also gave me my new marching orders: I had to lose 5% of my body weight by reducing my carbohydrate intake to 60 gm a day. No small feat!
I consulted a PhD nutritionist who just happened to make house calls. Taking inventory of my refrigerator and kitchen cupboards, she was appalled. Once she explained the error of my ways, I felt pretty sheepish.

I had been avoiding fatty foods by eating more of the “bad” kind of carbohydrates, especially those with innocent looking labels like “low fat.” And I hadn’t been paying sufficient attention to my protein intake.
Suddenly, I understood what was causing my symptoms. My diet and eating patterns created a scenario in which my body was alternating between hypo- and hyperglycemia and, more than likely, hypo- and hyperinsulinemia.

As a result of my personal experience, I have a new appreciation for how complicated and downright scary it is to manage diabetes — knowing that, unless I do things differently, my condition will deteriorate.
To date, therapy for patients with pre-diabetes is limited to weight loss and carbohydrate restriction. The insidious onset of this disease and its potentially devastating health and economic impact should drive additional studies that look at its full scope.

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