Last week, I was crossing Germantown Avenue in Philadelphia when I noticed a large man toting a bag of burgers and fries limping beside me. On his right foot, he wore a huge surgical boot. As we reached the opposite sidewalk, I nodded at the boot, telling him I empathized with his situation: I had worn a similar boot for a broken foot over a hot summer a few years back.
“No fun,” I told him.
“Mine’s not broken,” he said. “It’s gone.”
“I’m so sorry,” I said. “An accident?”
“Type 2 diabetes,” he said. “First my toes, then the foot.”
Although it was a sunny June day, I shivered. Losing a limb to type 2 diabetes is far less common than it once was thanks to advances in both caring for the condition and improved surgical techniques. Teams of neurologists and surgeons work together to save rather than amputate.
Yet in cases where diabetes goes unchecked, amputation is still possible. People who live in denial of their disease, inequities in health care, lack of access to healthy food, unsafe neighborhoods where exercise is difficult or impossible, costly drugs, and a host of other social problems can make treating type 2 diabetes to prevent complications like amputations, heart disease, or loss of vision a difficult proposition.
All of which I left unsaid.
Instead, the man and I exchanged small talk. We chatted about the unseasonably warm temperatures, the results of a recent local election: neighborly odds and ends. But the more we spoke, the more I debated: Should I mention that the bag of greasy burgers and fries might not be the best type 2 meal for someone with serious blood sugar issues? Should I share how I had switched to a pescatarian diet a few years back and lost 20 pounds, improving my sugar along the way?
Or should I continue chit-chatting until we parted?
It wasn’t the first time I’d faced such a dilemma. Although I’m not a medical expert, I have spent years studying, thinking, and writing about type 2. Yet I’ve learned not to offer unsolicited advice because it often doesn’t go well.
There was, for example, my sibling with type 2 who has gained 50 or more pounds. When I told her I read that even 10% off her weight might lower her blood sugar, she told me she didn’t need lectures. Then, there is a dear friend who refuses diabetes medication because she doesn’t feel ill. “Pills are for sick people," she says.
I’ve tried to explain how diabetes doesn’t always come with symptoms even as it creates serious complications, but she simply smiles.
“I’m good,” she says.
On the corner, the man -- Charlie -- and I finished our conversation. He offered his hand.
“Really good meeting you,” he said. “Thanks for stopping to talk.”
“You know,” I began. I have type 2 diabetes, too, I wanted to say. But the words stayed in my throat.
“Take care,” I told him. “And have a wonderful day.”
Photo Credit: Compassionate Eye Foundation / David Oxberry / DigitalVision via Getty Images
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