Keep asking yourself, "Why?"

I have a vivid memory of a nice dinner my now ex-husband Brian, my daughter Audre, and I had together several years ago.  At the time, it was a fun, family meal, we were all happy and enjoyed each other's company and the food we shared.  Audre would have been about 3 years old, coming into her intelligent and fun-loving personality.  But looking back on it now, I see a much more grim picture that invokes feelings of disgust.

The meal took place at McDonald's.  In rapid succession I ate 2 Big Macs, an extra-large serving of fries, a 44oz cherry coke (with a refill), and apple pies for dessert.  I have vague recollections of finishing Audre's uneaten fries, and we may have also shared a 10-piece Chicken McNugget.

At the end of the meal, I was still hungry.

Tipping the scales at 300lbs with enough fat stores to survive a worldwide famine, having ingested enough calories to feed a village for a week, and my body was still screaming, "Please, sir, may I have some more?".  Breaking down the fog of nauseous hindsight, I can't help but wonder... Why?

I have often questioned whether I have diabetes.  My blood sugar was checked in May of 2003 and I remember it being around 200mg/dL.  I had no idea what that meant at the time, except that it wasn't good.  I had eaten some oatmeal for breakfast that morning, but by standards now I was pre-diabetic if not diabetic.  In type 2 diabetes, the hormone insulin can't do its job very well.  Its most important job is to serve as the key opening the lock on glucose (sugar) transporters on most cells in the body, to allow glucose from the blood into the cell.  In type 2, the keyhole becomes distorted so that insulin cannot fit into it, and glucose builds up in the blood (hyperglycemia) and starts to damage smaller blood vessels and capillaries especially in the eyes, kidneys, and extremities.  On top of that, the cells are deprived of glucose (their preferred fuel for energy) and start sending out S.O.S. messages to the brain that they're starving, even if you've just eaten a McDonald's buffet with several buckets of pure sugar-laden soda.

9 years later and after losing 120 pounds, regaining it, and losing it again, my blood sugars were last hanging out with a HbA1c of 5.5.  Although I still occasionally have slightly high fasting blood sugars, this puts me into the "normal" category -- even though you technically can't "cure" diabetes, just control it.  One of the secrets the doctor doesn't specifically tell you is that there's a back door to get glucose from your blood into your starving cells: Exercise.  During exercise, a different glucose transporter on cells gets opened to allow glucose to come in without needing insulin to unlock it.  Your cells get fed, glucose doesn't build up in the blood, and everyone is happy again.  A balance still needs to be maintained between what you eat (how much glucose / sugar / carbs), when you eat (regular small meals!) and how much you exercise (plus what kind of exercise and intensity), but the jist is, exercise is good for you, folks.  And not just in that, "oh, just diet and exercise" way your doctor may casually remind you to do but not really believe you'll do it.  When you do it and stick with it almost every day, it works.  On days I don't get in a good sweaty, heart-pumping workout, I feel hungrier.  My cells start screaming for fuel.

For those of us who are insulin resistant or have type 2 diabetes, we should start asking why we always feel hungry, and listen to what your body is really trying to tell you.  If you've already eaten, your cells may be screaming, "Go for a walk!" instead of telling you to reach for that next Big Mac.  Speaking of which, my cells are telling me I should go to the gym right now.