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Experience

Experience January/February 2025

You’re Not Going to Die: My Type II Diabetes Diagnosis

Brian L Tannebaum

Summary

  • Type II Diabetes isn’t just about what you eat, but how much you eat.
  • Lawyers get caught up in deadlines and other obligations and often don’t take care of themselves.
  • Advances in technology, like phone apps, can help you manage Type II Diabetes.
You’re Not Going to Die: My Type II Diabetes Diagnosis
SENEZ/Moment via Getty Images

Jump to:

I didn’t think much of my weight loss, or my excessive drinking of non-diet soda, or even my frequent urination at the age of 34. My wife did, and after sharing her observations, my diabetic mother-in-law said, “Brian may have Type II Diabetes.”

Really?

A doctor ordered a blood test, and on January 19, 2004, Martin Luther King’s Birthday, the day before a big criminal trial, I listened to the voicemail.

“Brian, this is Dr. Pefkaros.”

“I’m sorry to leave this voicemail, but you do have Type II Diabetes.”

“Please call my office as soon as possible.”

I knew nothing about Type II Diabetes, so being the pessimist I am, I told myself I was going to die, at 34.

I called Dr. Pefkaros, who said, with concern, that my fasting blood sugar was 330. A normal fasting blood sugar is 75-100.

“I have a trial tomorrow.”

“You don’t have a trial tomorrow,” he said. “You’ll be in my office at 8 a.m.”

In addition to thinking I was going to die; I was in a battle of doctor versus judge and was only a nine-year lawyer. While death permeated my mind, so did my client, ethics, and contempt. Was I not going to show up to court? For a trial? Apparently.

This was 2004. There was no electronic filing, and it was a holiday. I knew the judge well, but lawyers can’t ex-parte judges. This wasn’t a time when we had everyone’s cell, and I didn’t have the prosecutor’s cell. But I did know the judge’s life partner, also a judge, so I did the only thing I could – I called him.

Of course, he said not to worry and to take care of myself.

The next morning, the trial was continued upon the prosecutor’s request. I don’t know who the prosecutor was in court that day or what conversation took place, but thank you, whoever and wherever you are.

The First Doctor’s Visit

Because I knew nothing about Type II Diabetes other than it had something to do with sugar, I went to the doctor, having not eaten anything since I got the news. Could I eat? What could I eat? I decided the best option was nothing.

I was freaking out.

“You’re not going to die,” Dr. Pefkaros responded when I told him what I was thinking.

He prescribed Metformin, the basic pill for Type II Diabetes, and told me to go to a class where I could learn about my new life with food.

He also discharged me from his practice. Type II Diabetes is an easy diagnosis, but he was a cardiologist and told me I needed an endocrinologist. And for the last 20 years, every 90 days, or so, I’m at the endocrinologist with my latest blood test.

In 2004 I had a blood-sugar meter and stuck my fingers throughout the day. Now I have a sensor, replaced every two weeks. Like I say about all technology - it’s the greatest and worst thing. I get to constantly see my blood sugar and I get to constantly see my blood sugar.

The Type II Diabetes “class,” which was really just me and a nurse, was one of the most important couple hours of my life. My wife and I sat at a table and learned what I should and shouldn’t eat. One of the fallacies about Type II Diabetes is that the basic premise is no sugar – no dessert. The truth is that carbohydrates, or carbs as we call them, is the focus.

The New Diet

I also had to stop certain things I loved. I was drinking cranberry juice daily by the gallon.

I haven’t had a sip of it since my diagnosis, and I don’t drink any juice, ever – even when my blood sugar is low. Mimosas, for me, is a glass of Champagne.

Type II Diabetes isn’t just about what you eat, but how much you eat. It’s all about portions.

“A piece of chicken should be the size of your fist,” I remember from my class.

Thirty days later, I went back to Dr. Pefkaros for a follow-up.

My blood sugar was 103. Perfect.

I was done, I thought. No more high blood sugar readings.

But that’s not Type II Diabetes. This is a chronic disease, and there is no cure. It is forever and requires daily attention. It’s also a roller coaster. What worked one time doesn’t work the same again. Type II Diabetes is affected by food, stress, exercise – everything.

Being A Lawyer With Type II Diabetes

Being a lawyer with Type II Diabetes has unique challenges.

Blood sugar levels rise and fall for various reasons. Some days, I wake up with a good number (under 120), and without a sip of coffee, it shoots up. Other times, I eat something that should raise my sugar, and it doesn’t. Some days, I wake up in the middle of the night because my sugar has dropped.

Sometimes, a lawyer is in court where eating isn’t the norm. What I do is advise judges if I’m going to be in court for hours that I have Type II Diabetes and need to eat occasionally. Of course, there’s always a break or two, but no judge has ever had an issue with me opening a granola bar or other snack and eating at the counsel table - although I’ve never done that without letting the judge know my reasons; otherwise, it looks disrespectful. I have also had juries advised so they don’t think I’m being disrespectful. The need to eat a snack in court is rare, but it’s happened.

There are also scheduling issues that require attention to blood sugar. Sometimes, a lawyer is on the go during the day and doesn’t have time to sit down for a meal. In my briefcase, I always have snack bars and glucose tablets in case my blood sugar drops. I do have to occasionally replace snack bars due to them melting in the briefcase from the warm laptop.

Lawyers get caught up in deadlines and other obligations and don’t take care of themselves as they should. This is where the chronic nature of Type II Diabetes becomes a problem. Elevated blood sugar levels can cause problems throughout the body – permanent problems—and it’s not just feeling lightheaded due to low blood sugar or lethargic due to high blood sugar. Nerve endings become numb, and in the most severe cases – limbs get amputated. Blindness is also an issue. Type II Diabetes affects every part of the body. And that’s why it’s not just an endocrinologist that should be on the list of routine doctor visits. A Diabetic needs to have routine eye and dental exams as well.

Exercise is essential, whatever it is – walking – which I do daily – cardio exercises like cycling, or an elliptical—anything that gets you moving—helps the body process sugar and lower blood sugar levels. Lawyers love to claim they “have no time,” to which I say, wake up 30 minutes earlier or skip that one TV show at night. Exercise is free, as important as anything you are doing to control blood sugar and can replace or reduce the need for prescription medication.

Blood sugar levels should be tested at a lab every 90 days. These labs often open at 7 a.m., which avoids lawyers having to take time during the day, and more importantly, the blood draw requires fasting, so doing it early in the morning, before breakfast, is perfect. The significant advancement in blood testing has come from apps for your phone where you can see the results, sometimes within a day. When I was first diagnosed, I would have to wait for my appointment with my endocrinologist to see my results. Now I know going in what I’m going to be addressing – good news or bad.

The Daily Struggle

A question I get often is whether I know when my sugar is low or high.

Low, yes. High, not always.

A low, for me, makes me a bit shaky, a little lightheaded, and sometimes like a minor headache. Lows should be treated immediately, usually with glucose tablets (which also come in gummy form), or juice. A high reading can be treated with insulin, but that is something to discuss with a doctor to determine dosage and timing.

And yes, I take insulin.

I hate needles, and the first couple of times I had to take insulin were horrific, but like anything else, after daily use for years, I’m used to it. My dentist taught me a great trick for needles – a small shaking of the skin while inserting the needle – you feel next to nothing.

The most important part of the daily struggle of Type II Diabetes is mental health care – meaning learning to be okay with the fact that it’s not always the same. Blood sugar is like the stock market – various factors cause highs and lows. Frustration is part of this, and adjustments are constant.

The Blessing

I know it sounds odd, but I consider my Type II Diabetes diagnosis a blessing.

I now know more about food and how it affects my body than I ever wanted to know. I’m healthier than I’ve ever been—because I’m forced to be. When I was first diagnosed, I spoke to the head doctor at the Type II Diabetes Research Institute, who said, “Stay thin and stay active.” I’ve tried, and at 55, I’ve never felt better. This year, I signed up with a nutritionist, and it was a great addition to my healthcare regimen.

Type II Diabetes is a constant, and it’s a roller coaster. Whether things remain good, or get worse, is up to me, and my age and body. One of those things I can control, and I do my best to stay educated, stay focused, and yes, stay thin and stay active.

I have come a long way from thinking I would die from Type II Diabetes, but the challenge remains to stay thin and stay active. The alternative is irreversible damage, which is not an option for me.

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