Interesting Comment Made By My Doctor

[VersatileBreeder]

The other day when I saw my ID doctor, he made a comment that surprised me. When I was asking him about the effectiveness of the new HIV drugs out there as well as how "chronic" HIV is exactly, he responded with, "with the sophistication of the new drugs out, if someone told me I had to choose between having diabetes and HIV, I would be hard pressed to choose diabetes."

His comment somewhat surprised me but also kind of made me feel better. What do you guys think of that? Do you think it's kind of a stretch? Or would you agree with him there?

[fillmyholeftl]

Knowing his experience & background as I do...I would think it's a pretty valid comment. I don't think he was giving "lip service" to make you feel better at all.

The other day when I saw my ID doctor, he made a comment that surprised me. When I was asking him about the effectiveness of the new HIV drugs out there as well as how "chronic" HIV is exactly, he responded with, "with the sophistication of the new drugs out, if someone told me I had to choose between having diabetes and HIV, I would be hard pressed to choose diabetes."

His comment somewhat surprised me but also kind of made me feel better. What do you guys think of that? Do you think it's kind of a stretch? Or would you agree with him there?

[Blueyedsoul]

Poptronic: I have a friend/colleague who is an ID (with a PHD from USC and an MD from Stanford). In passing once when we have chatted, he echoed this sentiment. He was more concerned about my blood sugar levels, rapid weight gain and knowing my family's bought with Diabetes. I personally, have watched men in my family endure the slow agonizing death through amputations, loss of eye sight, kidney failure after countless hours of dialysis. On the flip side, I/we have seen the advances in HIV research treatments. In turn, an HIV+ diagnosis is no longer a ticket to meet your maker.

[mike_thieriot]

That depends on the specific case of diabetes, really. At least with diabetes, there is one treatment that can sometimes cure it, namely the Edmonton protocol (basically an islet transplant).

[mike_thieriot]

Poptronic: I have a friend/colleague who is an ID (with a PHD from USC and an MD from Stanford). In passing once when we have chatted, he echoed this sentiment. He was more concerned about my blood sugar levels, rapid weight gain and knowing my family's bought with Diabetes. I personally, have watched men in my family endure the slow agonizing death through amputations, loss of eye sight, kidney failure after countless hours of dialysis. On the flip side, I/we have seen the advances in HIV research treatments. In turn, an HIV+ diagnosis is no longer a ticket to meet your maker.

Not knowing much about diabetes, how is that possible? I thought that as long as you maintain as close to the same levels of insulin as a healthy person, there's no difference?

[VersatileBreeder]

Well, the reason his comment shocked me is maybe because I haven't seen the darker side of diabetes. I have an uncle (not blood related uncle) who has diabetes. He takes a shot of insulin every day, but I don't think he has ever suffered from any significant health detriments. Not to sound like I am trying to make light of diabetes (I know it can be very bad for certain people), but I always thought for the most part, it is pretty manageable. But of all people, to come from an infectious disease doctor? Implying that diabetes is WORSE than HIV? I just would have never expected that.

[wood]

That depends on the specific case of diabetes, really. At least with diabetes, there is one treatment that can sometimes cure it, namely the Edmonton protocol (basically an islet transplant).

Ive read about this, and its not really a cure perse, but more of a long term treatment, that delays insulin therapy for an extended period of time.

as far as the diabetes vs HIV argument, I dont wait either, but I see why the ID doc said what he did. Diabetes is a day to day managed condition whereas HIV is now something that gets managed every 4-6 months only via blood tests, and a pill or two a day.

[bearbandit]

I'll believe in the diabetes/HIV comparison the day a diabetologist turns round and says "it's not so bad, a bit like having HIV, really"

I got diabetes as a result of early HIV treatment (two drugs that are barely used and the other at an eighth of the dose it's now used at). It might be that I've lived with HIV for far longer (34 years) than diabetes (10 years) but I'm far more attuned to what HIV can do to me than I am to what diabetes can do. For most of last year I walked around with my blood glucose several times higher than it ought to be because I couldn't eat properly and was using nutritional supplements. No wonder I couldn't pass a settee without it mugging me for a nap or concentrate on what I was doing.

Doctors who use the HIV/diabetes comparison are being lazy: they are two very different conditions and progression of each is also very different. But for the record, if I could get rid of just one of them, it would be the diabetes.

[rawTOP]

Well, the reason his comment shocked me is maybe because I haven't seen the darker side of diabetes.

When I was a kid there was a woman at church who was blind from diabetes. We'd go over to their house pretty frequently and she'd cook for us. As she was going blind she learned the position of every ingredient in her kitchen - it was pretty amazing. Her bread pudding was incredible. She even had a kitchen fire at one point, and managed to put it out herself (though she called the fire department to make sure it was really out). After a while the swelling in her legs got really horrible and disgusting.

A few years later, different church, I had this woman who was like a big sister to me. She and her husband would take me on vacations with their family, etc. She had Type 1 diabetes. She was constantly checking her levels and giving herself shots. It was a ton of work on her part - definitely not easy. But I think she was scared shitless of going blind, etc.

So yeah, there's definitely a dark side to diabetes. I think it's gotten easier since the 70's/80's when I was around it, but I imagine it's still pretty rough.

[whtbbcumhole4blk]

The doctor I saw this week made a similar comparison, though not so starkly. Saying basically HIV is a manageable condition like heart disease or diabetes as long as I take my medicine and have my levels tested regularly.

She's fairly young, probably 5-10 years younger than I (36). Maybe it's a generational thing?

As we were wrapping up the consultation, she commented that I was one of the most well adjusted patients she has seen in a while. I guess having known people for years who are living with HIV (20+ year survivors, one of which is a former roommate now in his mid 60s) has helped lessen the blow and fear of what it can do to me.

[NYCBearpig]

Runs in my family, as does heart disease, so my regular bloodwork includes these other markers.

[bearbandit]

I think the idea comes from the fact that the general public think that diabetes is simply a matter of taking you insulin/your pills/or sticking to your diet and you can live a normal life. They're trying to project a similar image onto HIV. Wrong in both cases. Many of us know someone who was diagnosed with HIV late and has had appalling health problems since. Similarly, I spent much of last year zoned out and asleep because my blood sugar was out of control, but allowing that lack of control was the only way I could get enough calories into myself so that I didn't waste away. Both HIV and diabetes have their dark sides. With both it's a question of early intervention before too much is done. And unfortunately comparatively little is known about co-morbidity of HIV and diabetes.

Blood glucose should be part of any HIV blood workup because there's still the (admittedly slight) possibility of the ARVs causing diabetes.