Matt, whose long-time dream had been to join the Peace Corps, came to me for the organizationís required physical. During the exam Matt complained that he had been drinking more water and urinating quite often. Since he was only 23, he did not understand why he needed to go to the bathroom several times each night.
I drew a blood sugar blood test, which was 590. That was so dangerously high I admitted Matt to the hospital and started immediate infusion of intravenous insulin. He did not respond very well, so I consulted an endocrinologist who also had problems controlling Mattís diabetes and ended up giving him higher doses of insulin than he had ever given a patient before. At one point Matt was taking 90 units of insulin in the morning and at night. A normal dose would be around 10 units.
After Matt finally stabilized and left the hospital, I suggested that he make lifestyle changes while still taking insulin. He began working out, eating food that would not spike his blood sugars, and taking mineral and antioxidant tablets. Matt was dedicated and did well in staying with his program. His weight started to fall and gradually he decreased the amount of insulin. Month after month he improved.
Four months after his visit for the physical, Matt came into my office and informed me that his blood sugars were normal and that he wasn't taking any insulin. Knowing his history, I really didn't believe him. So I checked his fasting blood sugar and the result was 84. I then challenged him with a sugar load and checked his blood sugar two hours later. It was 88--within normal limits. His hemoglobin A1C was 5.4, which also was normal. He was no longer diabetic.
I then had the difficult task of writing a letter to the Peace Corps, explaining that Matt was in fact at one time an insulin-dependent diabetic but now was no longer even diabetic. I feared that even the good report might disqualify Matt and end his dream of service. The Peace Corps repeated his blood work and concluded, too, that he was no longer diabetic.
Matt joined the Peace Corps and now works in Africa. The last time I checked, it had been two years since that original diagnosis, and he was continuing to do well. The Peace Corps flies him out of the bush to a hospital every six months for tests to be sure his blood sugars remain normal.
Ray Strand, MD