“Here’s How I Knew I Had Diabetes”: One Patient in “Perfect” Health Shares Their By-Chance Discovery
Updated: Jun. 25, 2024
It's been reported approximately 7 million Americans have diabetes and don't know it. This patient's story illustrates why it can be dangerous to assume only people who are inactive or overweight are at risk for Type 2.
Data cited in 2022 suggested that greater than one in five individuals who have diabetes don’t know it. “Patients may have no symptoms at all when their sugars are only slightly elevated,” says Sarah Rettinger, MD, FACE, a board-certified endocrinologist at Providence Saint John’s Health Center in Santa Monica, CA.
There’s often a stereotype that type 2 diabetes only occurs in people who are overweight or sedentary, but this is one of the common diabetes myths. Dr. Rettinger explains that type 2 diabetes is caused by a complicated interaction of genes and environment. Type 2 diabetics often first experience insulin resistance—meaning their cells do not respond well to the insulin the pancreas is making. The Cleveland Clinic explains that insulin is a hormone that moves the sugar from your blood into your cells to give you energy—but when this mechanism isn’t working properly, that sugar builds up in your blood. In response, insulin levels may climb quite high, especially in the early stages of the disease. Eventually, a patient’s pancreas may be unable to keep up with the amount of sugar in the blood, and insulin secretion from the pancreas goes down.
“Most often,” Dr. Rettinger says, “the progression from pre-diabetes to diabetes takes many years—so getting your HgbA1c, sometimes referred to as your A1c, checked every three years would find diabetes in its earliest stages,” she says. In 2024, the CDC stated what the following A1C ranges indicate:
- “Normal” (healthy) A1c = below 5.7%
- “Prediabetic” A1C = 5.7-6.4%
- “Diabetic” = 6.5% and above
Dr. Rettinger notes this disease should be on everyone’s radar as the consequences can be severe. Complications of uncontrolled diabetes include nerve damage, pain or numbness in the hands and feet, kidney disease, vision problems, heart disease and strokes. “By the time patients have higher blood sugars,” Dr. Rettinger says, “they may feel thirsty, hungry, and may be urinating excessively. Some patients lose weight without any change in diet and exercise.”
“Diabetes is a progressive disease even in patients with excellent lifestyles,” she says. “When patients get regular checkups, we can also detect the early signs of complications, often slowing down or reversing the problem.”
One of these patients is Jack Dunham, a 76-year-old retired purchasing manager who lives with his wife Jodi in Denver, CO. Here, Dunham shares his story of how he was blindsided by his diagnosis and how he’s learned to manage it over the past two decades since a young doctor in training first suggested a last-minute A1C test.
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By Jack Dunham, as told to Charlotte Hilton Andersen
In 2004, I showed up for my annual checkup expecting it to go just like every other checkup had gone for the past 56 years: Perfectly. I’ve been blessed with overall great health my whole life. I was not overweight, and as a former college athlete, I kept up my fitness level. Sure enough, my doctor did all his pokes and prods and pronounced me “fit as a fiddle.”
I was getting ready to leave when he casually asked if I had been experiencing any new symptoms since my last checkup. I mentioned that maybe I was a little more tired than usual, and maybe a little thirstier, but otherwise I felt great. He joked perhaps that was because I kept playing basketball with high school kids, and maybe it was time to play with people my own age. I was proud of my ability to keep up with the younger guys, and I probably would have just left at that point, except that a student who was shadowing the doctor that day stopped both of us.
“Maybe you should order some blood work and just check his blood sugar,” he suggested. The doctor and I both shrugged. Why not?, I figured. I was sure everything would come back just fine.
I had lab work done, and then came the news: “Well Jack, you have diabetes,” the doctor said, just as matter-of-fact as he’d been moments earlier.
My first instinct was to argue. “Of course I don’t have diabetes!” I said. “You just told me that I’m fit as a fiddle!”
He replied that I was showing a blood sugar level of nearly 400. “Plus, your A1C is above seven. By definition, you have type 2 diabetes.”
I was in shock. “Are you sure I don’t just have pre-diabetes?” I asked.
He was sure, he answered.
He then wrote me a prescription for metformin, a medication used to manage blood glucose, as well as a referral to a dietitian. I hadn’t seen any of it coming, and I’ll admit: It scared me.
Diabetes often has no symptoms at the beginning
As my wife and I drove home, she had to keep repeating what the doctor said because I just couldn’t process it. How could I possibly have diabetes? Other than some slight fatigue and thirst, I hadn’t experienced any symptoms. I would later learn that diabetes is called a “silent killer” because it’s common to have no symptoms.
It soon occurred to me that I was lucky they’d caught it when they did because I never would have gone to the doctor based on those hardly notable symptoms.
Once I’d accepted my diagnosis, I realized that it probably shouldn’t have been as much of a surprise to me as it was. Both of my siblings have diabetes, and my father had it as well. Also, in addition to playing sports like a high-school athlete, I’d been eating like one, too. All my life, I’d been able to maintain my weight and still eat whatever I wanted—and what I wanted was junk food. Once they built an In-N-Out Burger near my home, I was a regular visitor. I also enjoyed sodas and sugary drinks daily. Plus, I had a killer sweet tooth.
In hindsight, the really surprising thing was that I hadn’t gotten diabetes sooner.
My diagnosis really shook me up, and I was determined to fix my eating habits. I lost 20 pounds in a couple of months. Now I was down to the weight of my younger years, and I felt great.
But then, I had to learn another hard lesson: You can’t really cure type 2 diabetes. This wouldn’t be a situation where I could just diet hard for a few months. I would still need to stick with the healthy changes and, in my case, also would have to stay on my medication and be vigilant about watching my blood sugar…for the rest of my life. This was a hard pill to swallow at the time, but what choice did I have? It was literally a life or death decision, and I chose life.
Living with diabetes
I’m now 76 years old, and have 20 years of experience managing diabetes. I wish I could say I’ve handled it perfectly, but I still love fast food, and occasionally my weight and blood sugar levels have both crept up to show it.
But a few years ago, I had a scare with my heart that made me realize I needed to be more vigilant. Diabetes can increase the risk of heart disease, so my doctors were clear about what I needed to do. I started Weight Watchers, which did help. I still make it a point to exercise every day.
But you can’t out-exercise a bad diet. So recently, my doctors added injectable semaglutide to my metformin regimen, and that’s made a huge difference in minimizing my appetite and cravings to help me lose those extra pounds once more, and regulate my blood glucose.
What I wish I’d known 20 years ago
Looking back, I wish I’d known that you don’t have to be overweight to get diabetes. I also wish I’d been regularly screening my blood sugar from an earlier age. I shouldn’t have waited until my mid-50s to get that checked—if I had, I might have been able to catch it earlier so that I wouldn’t need medication for the rest of my life. I advocate that everyone should get regular screenings for type 2 diabetes and clean up their diets, even if you think you’re at a healthy weight.
But perhaps the best thing that I’ve done to help manage my illness is finding a social way to exercise. I’m part of a pickleball group called the Polar Bears, and we are on the court every single day, no matter how cold or hot it gets here in Colorado. (That’s me holding the sign in the photo.)
I also regularly play tennis and basketball and ride my bike. These activities keep me active, not just in my body but also in my mind and spirit. One of the greatest risks as we age is isolation and loneliness, and these folks, along with my wife, keep me happy and healthy—a state I hope to stay in for another 20 years.
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Originally Published: June 25, 2024
