I was in suburban Chicago recently one morning, hoping to get something to eat for breakfast. I’d heard that the Panera chain was now serving breakfast that you could order any way you wanted. It’s called “Panera Bread,” but I thought I’d give it a try, as I’ve safely consumed their salads in past.
At the counter, I placed my order for 3 eggs over easy, sausage, and bacon—not perfect, given our inability to scrutinize foods and ingredients in such places, but I was willing to try. Obviously, I turned down the breads/toasts that were included. The middle-aged Hispanic woman behind the counter raised her eyebrows and asked, “Why no bread?”
I replied simply, “Bread makes you fat and diabetic. I was a type 2 diabetic 25 years ago. I’m not anymore.”
“Really? I am diabetic, too, but I cannot give up my tortillas.”
A brief, casual encounter, but I am nonetheless always surprised by such responses based on comfort and habit, people who are unwilling to leave their comfort zone. We all know what a future of type 2 diabetes looks like:
- Marked increase in heart disease, heart attack
- Increased risk for stroke
- Peripheral vascular disease
- Diabetic retinopathy and cataracts
- Kidney disease and failure
- Peripheral neuropathy
- Foot and leg amputations
- Increased risk for dementia
- Life shortened by about 8 years
- $10,000/year added healthcare costs
It also makes me wonder if people who provide such responses really understand the gravity of their condition, or maybe choose to ignore it. During my over 30 years of cardiology practice and training after medical school, I witnessed countless people with kidney failure from diabetic kidney disease, often resulting in dialysis, a miserable experience; thousands of strokes and heart attacks; oodles of peripheral neuropathy with loss of sensation and chronic pain, resulting in gangrene and amputations; and, of course, I’ve seen many, many diabetics experience premature death.
We all recognize that the wrong response to an encounter like the one above is to press hard and try to persuade someone that they are throwing their health and life away for a disease that is nearly always completely reversible back to normal, or at least minimizable. I believe that all we can do is set the example of health and answer the occasional question, hoping that each person hears the same message from others as more and more people realize that type 2 diabetes is an easily reversible disease.