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If only I had known then what I know now

Marta is living with type 2 diabetes. Her heart attack at age 48 completely transformed the way she was looking at her life with diabetes and high blood pressure. In this interview, she shares her journey and explains what she did to regain balance, happiness and a productive relationship with her doctor.

“Experiencing a heart attack at the age of 48 really scared me. I was lucky that my doctor stood by my side, explained the treatment options and took proper care of me.”

-Marta, type-2 diabetic

Diane: Thank you for taking the time to talk to us today. First off, please tell us something about yourself.

Marta: My pleasure. So, I’m Marta, I’m 57, and I live in Prague with my husband and two teenage daughters. I run a small tailor shop where I do all sorts of clothing-related services. I also live with type 2 diabetes, which I guess we’ll talk more about.

Thank you. Yes, let’s just dive in. Please help us understand your history with diabetes better and your health in general.

As a young person, I didn’t have any health complications at all, but my first pregnancy took a heavy toll on my health. I was very sick, and the tests showed that my blood sugar was too high. I was diagnosed with gestational diabetes, which is a variant of diabetes that sometimes occurs during pregnancy1. I began seeing a diabetologist every six months. I received treatment for high blood pressure and cholesterol, and then for a long time I seemed to be doing fine.

Then what happened?

In short, stress happened. If your condition means that your blood sugar is generally high, then stress can be really bad for you2. In my case, the stress was a result of being laid off from work. I was working as a seamstress, and by this time I had had my second daughter. In hindsight, adding unemployment to the challenge of raising two daughters – and then starting my own business – was probably too much. That was when I got diagnosed with type 2 diabetes.

“You could say I had to learn about the increased risk of cardiac events the hard way.”

-Marta, type-2 diabetic

Can you give us a sense of what your life was like when you were diagnosed? When were you diagnosed, and what was your relationship with your doctor like at the time?

I was diagnosed with type 2 diabetes 12 years ago. I began seeing a specialist who prescribed pills and recommended a diet3. I focused on living my life and didn’t add any major changes to my lifestyle. At that time, I knew that diabetes could cause problems in the eyes and feet, but I had no idea that it can also cause heart attack and stroke4. My doctor didn’t tell me this, and looking back I wish he would have. You could say I had to learn about the increased risk of cardiac events the hard way.

So, you only learned about comorbidities related to diabetes when they actually happened to you? Didn’t your doctor tell you anything about this before?

It’s true! My doctor and I never had an open conversation about diabetes complications or increased cardiovascular risks until reality suddenly hit me like a bolt from the blue. Looking back, my diabetes management should probably have been adjusted years prior. I remember it happened on my 48th birthday. In the morning my husband, my friends and I joined a dance competition with other people in our age group. However, what could and should have been a lovely day took a turn for the worse and ended dreadfully. After dinner, instead of going to bed, I had to be taken to the hospital, where I was diagnosed with a heart attack. I sometimes think that if only I had known then what I know now about diabetes complications, then maybe my heart attack could have been prevented – through changes to my lifestyle and my diabetes treatment and management.

“If only I had known then what I know now about diabetes complications, then maybe my heart attack could have been prevented.”

-Marta, type-2 diabetic

And how did this experience affect you long-term? Did it change you in any way?

It did. First of all, experiencing a heart attack at the age of 48 really scared me. I know I was lucky to receive good information about treatment options, but still, coming home from the hospital I was so worried about myself that I almost couldn’t do anything! So I started gaining weight, and it took me a while to realise that this was not a good thing. I think what I needed was encouragement – some new motivation. I needed someone to help me see that there were things I could do (and do differently) which would help me. So I looked around for a new doctor and was fortunate enough to find someone capable and helpful. My new doctor turned out to have a lot of useful advice for me, both regarding my diabetes treatment and lifestyle management. I gained a new perspective on myself – and a feeling of hope.

Did the new treatment and lifestyle management have a desirable effect on you?

They did! I’m so grateful for my doctor’s suggestions because the  new treatment combined with lifestyle changes make me feel a lot better. And on top of that, I’ve managed to lose weight. My blood sugar levels and blood pressure are also closer to where they should be. Back when my health was getting out of control, I had to give up dancing with my husband, although I loved it. The good news is that these days I’ve taken up swimming, and it’s really working for me.

“Try to be completely transparent with your doctor. The more he/she knows about your condition, the better their chances of foreseeing some medical issue and addressing it in time.”

-Marta, type-2 diabetic

Have you got any advice for people who are living with type 2 diabetes and high blood sugar, and who may be worried about cardiac events?

Absolutely. Talk to your doctor often, and “help” him/her help you. A great way to do that is to find out which questions and topics are particularly relevant in your situation. Make a list of what you want to ask before going and use your list when you sit down with your doctor. Try to be completely transparent with him/her. The more your doctor knows about your condition, the better his/her chances of foreseeing some medical issue and addressing it in time.

Any advice about lifestyle and what to do about diabetes symptoms on a day-to-day basis?

To manage your type 2 diabetes well, not only do you need to take your medication as instructed, assuming you’ve been prescribed medication. I would also strongly recommend you to try to get a little physical activity every day (a walk, a swim, a ride on the bike). Having regular habits and routines can help with this and may have a stabilising effect on your blood sugar in the long run. It’s all about finding out what works for you in your life. Let me also mention that it’s a good idea to eat a healthy, varied diet – every day. I recommend avoiding processed foods, too much salt, red meat and alcohol. And finally, if you are a smoker, you really should look for ways to stop.

“Sticking to regular habits is something I’m still working on. I’ll get there eventually. There’s always a new day tomorrow.”

-Marta, type-2 diabetic

Has taking this advice helped you personally, Marta?

Oh yes, definitely. Now, I am someone who has no problem sticking to a healthy diet, but I still struggle a bit with regularity. Improvising and having irregular habits can be risky, so be careful about deviating from your daily routines if they are helping you. In my case, my work sometimes means that I can’t prioritise getting my lunch when I most need it. That is perhaps why, despite following a healthy diet, I have had some difficulty keeping my weight down. So that’s something I’m still working on. I’ll get there eventually. There’s always a new day tomorrow.

Thank you so much, Marta, and I wish you all the best!

You are very welcome, Diane.

If you would like help with which questions to ask your doctor, then download the conversation guide.

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References
  1. Committee ADAPP. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2024. Diabetes Care. 2023;47:S20-S42. doi: 10.2337/dc24-S002.
  2. Surwit RS, Schneider MS, Feinglos MN. Stress and diabetes mellitus. Diabetes Care. 1992;15:1413-1422. doi: 10.2337/diacare.15.10.1413.
  3. Committee ADAPP. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2024. Diabetes Care. 2023;47:S158-S178. doi: 10.2337/dc24-S009.
  4. IDF Diabetes Atlas Report, 10th edn. http://www.diabetesatlas.org/ Last accessed: December 2023. http://www.diabetesatlas.org/ Last accessed: August 2023.

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