Diabetes at the Holidays: Tough Lessons We Learned
Two stories of family health issues that called cultural traditions into question
Hooray! The holidays are here. Like many Americans, we are looking forward to shifting our focus from the divisive election to giving thanks, expressing love and welcoming a new year. When our two families gather, though, there will be sadness, too, as we look around and miss several members who have died prematurely as a result of type 2 diabetes and its complications, like neuropathy, kidney dysfunction, heart disease and dementia.
In sharing our personal stories, we hope to renew the battle against type 2 diabetes in ethnic groups who suffer the disease at higher rates. Because while the U.S. Centers for Disease Control reports that new cases of diabetes are leveling off, this drop is not statistically significant in African Americans or Hispanics.
Irene’s Family: Greeks in America
Irene’s mother was diagnosed with diabetes in middle age, and was initially able to control her high blood sugars by cutting back on sweets and overall food intake. When her father was also diagnosed, the six children decided to pool money to send them to the Joslin Center in Boston to learn more about the disease.
The foods and amount of exercise they got as kids in Greece were completely different from the lifestyle they “enjoyed” in America. Unfortunately, the new habits were hard to break. Both her parents became insulin-dependent.
Burdensome Topics at Holidays
Discussing exercise and medication (especially insulin), testing blood sugar levels and scrutinizing who was eating what burdened everybody at holiday gatherings for decades. They tussled over serving traditional foods like lamb, spanakopita, moussaka, baklava and ravani (walnut cake).
Their father’s care in the nine years of the painful decline leading to his death was particularly challenging because of his excess weight and his increasing dementia, probably due to, or exacerbated by, his blood sugar problems.
Darlene’s Family: African Americans Also Struggling
Darlene’s mother, too, managed diabetes fairly well for a long time by maintaining a healthy weight, taking her blood sugar medications religiously and going to her doctor for weigh-ins and prescription modifications at least twice a year.
Her children learned only when it was too late that her doctor had not been regularly monitoring her blood pressure, kidney function or smoking.
During the two years of her suffering apparent imminent death, Darlene clung to the hope that she could save her mother by donating one of her kidneys. In the process of trying to become a donor, however, she herself was diagnosed with diabetes and morbid obesity. Her brother was also diagnosed with diabetes,and her sister with kidney cancer.
Her ‘Drastic’ Choice of Gastric Bypass
Hope for a family donor died shortly before their mother did. Her last request was that Darlene lose weight. At that point, and in fear of herself dying a premature death, Darlene made what many may consider a drastic decision — to have gastric bypass surgery. She lost over 100 pounds and no longer lives with diabetes or its co-morbidities.
Preparation for, and recovery from ,the surgery gave her time to learn about proper nutrition and to reflect on her family’s medical history. Now, she knows how to prepare healthy meals that at holiday time can include some traditional African American foods like ham, collard greens, yams, macaroni and cheese and sweet potato pie.
Gastric bypass surgery, of course, is not necessary or appropriate for everyone. Many of us at risk need to remember that even a small drop in body weight and a moderate amount of regular exercise can reduce the risk of developing type 2 diabetes. Smokers should do everything they can to quit. The trick is not to develop diabetes in the first place.
Treating ‘the Whole Person’
However, if you or someone you love is living with diabetes, insist that doctors treat the whole person. That means giving attention to healthy body weight, good nutrition and exercise, and regularly tracking blood pressure, kidney, liver, heart, sight and cognition status.
Help them in their daily lives by voicing positive messages and offering healthy alternatives: your company for a walk instead of sitting together in front of the television; a dish or dessert prepared with no added fat or sugars, instead of traditionally; served portions instead of self-service. Before holiday parties or meals, develop and share a plan for how to handle the many foods on offer.
Making Healthy Changes
In truth, we ourselves find none of this easy, and unfortunately, we learned these lessons the wrong way through mistakes with our parents. Going forward, we encourage each other and split one sandwich when we go to lunch.
As for the holidays, we’re pledging to bring a healthy alternative to parties we attend, to enjoy our favorite traditional foods in small portions and to walk before and after main meals.
We can’t change the ethnic identities and family histories of diabetes that put us at higher risk, but maintaining a healthy weight and getting 30 minutes of aerobic exercise a day are under our control and have proven to help prevent type 2 diabetes.