As a child growing up in India, it was common to hear elders on both my mother’s and father’s sides talk about their diabetes and their high blood pressure. I used to overhear conversations about stents, angioplasty, and blockages during family get-togethers. My father took pride in helping his friends measure their blood pressure. At the time, I hardly knew what any of these terms meant; I never imagined that I would have to deal with some of these conditions myself. I had always thought of these problems as problems related to older people, and assumed that they were of no concern to a man in his 30s or 40s. However, fate necessitated that I learn and understand all these terms intimately.
I did not realize at the time, but the very first signs of my predisposition to diabetes surfaced in my mid-twenties during a free employee health checkup when lipid panel results revealed that I had elevated triglycerides, a possible sign of metabolic syndrome. A primary care doctor I consulted simply put me on cholesterol-lowering medication and advised me to take it for life. I remember thinking “It is just one small pill, which is nothing compared to the large number of pills my father takes on a daily basis. My affliction must be pretty minor.” Starting on a plan for “medication for life”should have given me pause, given that both my parents were diabetic, but it did not. My life at that time did not indicate illness in any discernible way. I was young, active, excited to be married and to be parenting a beautiful new baby. I had a great job and life was good.
Seven years later at my annual health checkup, I mentioned to my doctor that my eyes were having trouble focusing in the mornings. He asked me to get blood work done. Results showed elevated A1c which is a measure a of a person’s average blood glucose levels over the past few months. I was officially diagnosed with diabetes! My diagnosis should not have come as a shock. After all, diabetes was in my genes. Yet, I found myself pulling over to the side of the road to catch my breath when I heard the news from my doctor’s office. Images of my father struggling with his insulin injections and the mounds of pills that he had been taking for half of his life swirled through my head, and I was shattered. How could I have type 2 diabetes at the age of 33? I was put on prescription medication that soon caused episodes of hypoglycemia. My concerned wife convinced me to get help from an endocrinologist who helped with medication management and I was able to regain some control over my life.
That was ten years ago. Over the course of a decade, as work and stress increased, I could not maintain a regular fitness regimen and exercised sporadically. I continued to gain weight and my A1c slowly began to rise. Long hours at a demanding high tech job, plus family responsibilities sent stress levels through the roof. There was no special diet except a superficial avoidance of sugar and sweet treats. I was on the typical Indian “rice and chapati-centric” meal plan. It was the perfect storm and my diabetes flourished.
I knew I needed to get control of my diabetes and invest in my health, not only for myself, but also for the sake of my wife and daughters. I made a commitment to see an endocrinologist every three months and a cardiologist once every year. Still I could not keep my A1c in check. Two years ago, my medication was increased to the maximum allowable dosage. I was exercising regularly and felt strong and energetic, but my blood test results still did not show any signs of improvement. In desperation, I turned to the Internet and the library for help. I read all there was to read on pre-diabetes, insulin resistance, and type 2 diabetes I learned more about the importance of diet and exercise for those with this metabolic disease. I read about insulin and how it works, about cortisol, ghrelin and glucagon. I even read a few books on diabetes management. I gained significantly in knowledge, but could not put all the disparate information together into a regimen that I could maintain. I tried techniques like intermittent fasting, a diet avoiding sweets completely and another diet with less than 100g of carbs per day. These had good short term results, but I just could not sustain these diets in the long term. . I was overwhelmed and frustrated.
It was at this time that my cardiologist recommended the South Asian Heart Center at El Camino Hospital. At first, I enrolled in the Center’s AIM to PreventTM program and learned about the specifics of my personal condition. I was happy to find experts who presented information about type 2 diabetes in a way that I could understand, accept and utilize. The program helped me understand my diet and choose my foods mindfully. Last year when the Center launched a new program called STOP-D to stop diabetes before it starts, I was among the first to register. STOP-D, a structured, culturally adapted program based on proven national diabetes prevention curriculum was just what I needed. I learned the science through webinars and workshops led by experts, and benefited from personalized lifestyle coaching. My peers and I shared recipes and achievements, and motivated each other to stick to the program. I not only focused on the obvious – exercise and diet – but also meditation and sleep, which turned out to be just as important. In the one year on STOP-D, I have picked up actionable tips and tools on diet and exercise, stress reduction and more that have become part of my daily life.
I grew to appreciate vegetables, even salad, and stopped eating a lot of rice. My eating habits now are very different from the diet that I grew up with in Hyderabad, India. I have a sweet tooth and I soon devised ways to avoid temptations in the office lunch room. I discovered that not only the quantity, but the quality of food and my interaction with food matters a lot. My heart health coach constantly encouraged me by setting up little challenges to take me to the next level.
The Center’s focus on sleep led me to investigate the reasons for my inadequate sleep patterns. I now use a machine to treat my sleep apnea and am getting a full night’s sleep for the first time in years. I used to think that meditation is quackery but my coach gently wore down my resistance. I tried it and was amazed to find it clarified my thought process, helping me decompress and think through challenging choices.
Over the course of this program, and with the support of my family, I have learned to exercise sustainably, eat right, and reduce stress with proper sleep and regular meditation. I’ve lost weight and my A1c level has dropped from 6.8 to a pre-diabetic level of 5.7. Now I understand that, for me, as for so many others, that medication alone is not enough. I needed a structured lifestyle program too. I am glad I made this investment in my health so I can take care of my family, now and in the future.
Sajjad Lateef a 44 year old father of two, is a technical product manager at Illumio in Sunnyvale, California.