October 27, 2023 Marathon of hope

Imagine being told by a diabetes specialist that you have type 2 diabetes, and that you’re fat and need to lose weight.

Then imagine hearing that when you are just 20 years old.

For Matt Anderson, now 48, that was exactly how his diabetes diagnosis played out. And, not surprisingly, he didn’t take it well. Says Matt, “That wrecked everything. I was just like, whatever, I’m not going to listen to you. I don’t like you first off—the way you approach me is not right for a kid who just found out he has diabetes and is dealing with weight issues.”

Weighty matters

Most Canadians with diabetes are living with type 2, and are diagnosed only when they reach adulthood, but the condition is becoming more common in kids and young adults. The condition results when your body cannot make enough insulin, or does not properly use what it makes. Insulin is a hormone that helps your body control the amount of sugar (or glucose) in your blood. 

There are many reasons why you might develop type 2, including your ethnic background, a family history of diabetes, and being overweight, as well as your environment, which might make it hard for you to get healthy food or feel comfortable walking in your neighbourhood.

Matt, who lives in Oshawa, Ont., with his wife, Theresa, and three kids, says he has struggled with his weight his entire life. At age 11, he was going to Weight Watchers with his mom. “I probably had diabetes from the time I was 14, but I’ve got a severely underactive thyroid and really didn’t know what was going on with me,” he says. At 16, he was put on thyroid medication and that seemed to help.

However, four years later, while working with his best friend, Matt says, “All I kept doing was going to the bathroom and then drinking more water because my thirst was unquenchable.”

These are two of the most common symptoms you might experience if you have type 2 diabetes, but there are others, ranging from blurry vision to numbness and regular infections (and some people do not show any signs or symptoms).

If Matt’s best friend hadn’t pushed him to go to the doctor, Matt might not have done anything. His mom, whom he had always considered his advocate, had died a year earlier from cancer. Matt admits that at the age of 20 he didn’t really care about his health. And after his family doctor sent him to the diabetes specialist who broke the news, well, he cared even less. “I was pretty bitter at that doctor. My mom had just died and I was trying to find my way, and this guy just approached things with zero empathy. It left a sour taste in my mouth, and I really didn’t start taking care of my diabetes until I had a problem when I was 30 years old.”

Diabetes is complicated

Over time, untreated or poorly managed diabetes can lead to complications that affect your entire body, including blindness, stroke, high blood pressure, mental health issues (also known as diabetes distress), and more.

Although Matt took the oral diabetes medications prescribed by his doctor, he didn’t do much to improve his diet and didn’t do regular checks of his blood sugar levels or his feet—some important steps in good diabetes management.

A visit to the emergency department for a burst varicose vein uncovered a more urgent problem: what Matt thought was just a blister on his big toe (caused by the poor-fitting shoes he wore to play golf) had in fact turned into an ulcer. As a result, the toe on his right foot had to be removed.

What led to Matt’s diabetic foot ulcer was more than just a pair of golf shoes that didn’t fit properly. He had developed nerve damage (also known as diabetic peripheral neuropathy), one of the long-term complications of diabetes. When your blood sugar levels are high for a long period of time, it can damage the nerves that go to your arms, hands, legs, and feet. As a result, these peripheral nerves don’t get the nutrients they need and don’t work as well as they’re supposed to. That means you may not notice cuts, sores, or blisters on your feet, which can then get infected to the point where not even antibiotics will help.

At the time of Matt’s first diabetic foot ulcer, he had a job at a manufacturing plant and had to keep working, even though standing for long periods put pressure on his feet and made his ulcers worse. Since then, he has developed a total of 15 ulcers, all on his left foot. And because the infections, which left him feeling sick with flu-like symptoms for a few days on each occasion, spread to the bone, he has needed about 10 rounds of intravenous (IV) antibiotics—plus four surgeries to shave the infected bone when the antibiotics have not helped the ulcers heal.

“When the infection’s heavy, the pain is like no pain you’ve ever felt before,” Matt says. When the infections are under control, the pain is manageable simply because he no longer has a lot of feeling in his feet.

The value of teamwork

Despite the challenges Matt has experienced, there has been an upside to his diabetes journey. He says, “Theresa and I just said, okay, we have to be positive about everything that’s going on. And we have to approach it from ‘How do we manage this?’ instead of ‘Oh, woe is me.’”

Over the past two years, he has lost about 175 pounds through commitment and hard work that has included joining a weight-loss program and going to the gym daily when he has been healthy. “Diabetes doesn’t give you time off for good behaviour. And that’s the phase that I’m in right now. I’m not getting any time off for my good behaviour, but I’m behaving.”

Matt’s good behaviour also means working well with his healthcare team of pharmacist, wound care doctors, orthotist, family doctor, diabetes specialist and, more recently, kidney specialist. “I didn’t go to the doctor a lot because I had poor experiences before, but I have my one doctor at the wound care clinic who’s like a nice warm blanket. She’s the one doctor who’s just been there and has had empathy and seen what I’ve gone through. We didn’t get along when we first met, but she’s seen me through a lot of things, and has restored my faith.

“I have to trust my team. If I follow what they tell me to do, then it’s going to work for me. It’s how you work with your team. And if you don’t work well with them, why be on it, right?”

A new twist on his diabetes journey

The level of trust between Matt and his team is helping him deal with his latest health challenge: kidney failure. In 2020, when he started what he calls his “weight-loss journey,” he saw positive changes in his physical and mental health until he reached a point when for two months, he could not seem to lose any more weight even though he was still exercising and eating right. He booked an appointment with his doctor in 2022, who sent him for blood work. He hadn’t done that in the previous two years because, he says, “I was feeling great,” and also because Canada and the rest of the world were in the midst of the COVID-19 pandemic.

Matt’s A1C levels (the average blood sugar levels over a two- to three-month period) were great at 7, which is the target for most people with diabetes. The bad news? His kidneys had stopped working, and he needed dialysis. In hindsight, Matt recalls feeling unwell at times but he just kept pushing through it. However, rather than being angry about or defeated by the latest news, he started making plans to take next steps right away. When his doctors did not show quite the same sense of urgency, he let them know he couldn’t—and wouldn’t—wait. “I said to my doctor, ‘What are you waiting for? Put me on dialysis.’ My advocacy genes were going at 150 miles an hour to get this done. If I have to be on dialysis, let’s get ’er going. Let’s move forward. Always move forward.”  

For now, moving forward means dialysis six times a week for six to eight hours a day. He is back at the gym three to four times a week, and says, “I am focused on what I can do, not what I can’t.” Fatigue is a major factor with kidney failure. However, despite the challenges of fatigue, nausea and dizziness, Matt is committed to achieving his weight loss goal, which is important for any future transplant.

The dialysis treatments have affected his blood sugar levels, which now go high. “I’m figuring out my body again and the levels of insulin that I need to take.” His wound specialist has also warned him that the kidney disease means his ulcers will take longer to heal. He recently got a dialysis machine for his home and will soon start night treatments when he’s sleeping so it has less effect on his day-to-day living. “I’m excited because it’s the equivalent of a transplant. So they say. Well, I’m going to believe that positive outlook, and take it as my own.”
 

Lessons learned

Matt is unable to work, which has affected the family income. “When you have diabetes, you have to adapt. You have to be able to get through it,” he says. “But it’s not easy. It’s a lot for me, and it’s a lot for Theresa and our family.”

In the past 20-plus years since his diagnosis, he has learned a lot. “Mine is not a sad story. It’s an all right one. Diabetes is a marathon, and I can’t do anything about that.

“The biggest change I made is when my attitude changed toward my own health care. As my health has gotten worse, my attitude has gotten better. My mental health and my lifestyle are healthy, especially for someone who’s dealing with two chronic illnesses.”

He adds, "Diabetes doesn’t give you the same death sentence as cancer. If you get the same cancer my mom got, now you live [thanks to new treatments], so there’s a cure for some types of cancer. There isn’t one for diabetes.

It’s very easy to support cancer, but diabetes has a stigma. You know, you get diabetes because you eat too much sugar or you’re overweight or you don’t care. Diabetes can eat away at your body slowly over time. That’s why it’s important to support a disease that’s silently hurting people—just as many people as a disease like cancer.

FYI

Open sores on the feet (also known as foot ulcers) are common in people with diabetes. Following a foot care action plan to prevent foot ulcers is vital, since a foot ulcer increases a person’s risk not only for more foot ulcers but for other foot complications such as infections and amputations. Tune into the Facebook Live Foot Care to Prevent and Manage Diabetic Foot Ulcers, in which Matt and healthcare experts talk about this topic.

Did you know?

Diabetes Awareness Month is a time when individuals, community groups and organizations around the globe bring attention to diabetes and urge action to tackle this epidemic that affects 1 in 3 people in Canada. We’re calling on Canadians to show support for people affected by diabetes by spending their time learning more about this too-often “invisible” condition and sharing that knowledge with their communities. Learn more at Let’s Make Time to End Diabetes. #LetsMakeTime #DiabetesAwarenessMonth