For the past few weeks, for some reason, my email box has been full of letters from people who are desperately hoping that they have diabetes. They don't. In fact, most of them have blood sugar numbers you and I would kill for. When I explain this, they come back saying, "But my mother had diabetes" or "But when I ate an entire chocolate cake my blood sugar rose a whole 30 points. And my fasting blood sugar the next day was 98. That can't be normal!"
Before you dismiss these people as garden variety hypochondriacs, let me explain what's going on.
All these people do have something wrong with them--usually something quite painful or very disturbing. They've been to doctor after doctor who have given them the usual ten minutes of bored attention and then sent them off with a shake of the head or an order for lab tests that come back, almost invariably, with normal values, usually because they are ordering only the standardized tests that turn up the most common medical problems.
So these people email me because they are desperate. They're in pain. Their symtoms are making it hard to go about their daily lives. They've been trolling the internet, scanning for anything that mentions these symptoms, looking for relief, and invariably they end up reading about diabetes because diabetes causes such a wide variety of symptoms. Tiredness, painful feet, stomach pain, ulcers, blurred vision, kidney pain. You name it, someone with diabetes will develop it and post about it somewhere.
So that is why when these people who need help read that doctors do a very poor job of diagnosing diabetes a light goes off in their minds and suddenly they're filled with hope. Maybe that is what is wrong with them, diabetes, and if it is, then there's hope, because once they have a diagnosis they can treat it.
So they email me and I send them off to test their blood sugar, and almost always, when they respond, I have to deliver the news that their blood sugars are completely normal. Whatever is wrong with them, it isn't an obscure, difficult-to-diagnose case of diabetes. Their fasting sugars are under 100 mg/dl. Their sugars don't go over 120 mg/dl after meals. Diabetes is not likely to be causing their symptoms.
You'd be amazed how many people find this upsetting news. They write back to me begging me to consider this or that extra fact. Maybe it isn't diabetes but pre-diabetes. Maybe they hadn't eaten enough carbs when they tested their sugars to be sure. They went low on their glucose tolerance test, isn't that a sign of something?
When I tell them, no, it isn't. They can get testy. I get tempted to tell them to go away because there are dozens of people with diabetes who also need help, and they are taking up my time, but I don't. Because I've been in their shoes--trying to get help for some devastating symptom that doctors wouldn't take seriously and checking out anything that sounds like it might help. I know what a poor job most doctors do diagnosing anything that isn't one of the 85 common conditions they studied in med school.
But there isn't much I can do for them, and I also tell them that whatever is wrong with them, they should rejoice that they don't have diabetes. Because as most you reading this know, even after they diagnose it, most doctors do a lousy job of treating diabetes.
But taking in all these people's miserable experience with doctors who won't diagnose painful conditions, and adding in my own experience with the same, I have to wonder: Why is it that the most sophisticated artificial intelligence systems in the world are devoted almost exclusively to delivering spam that is tailored to your tastes, instead of helping you find out what's wrong with you so you can fix it?
Don't all answer at once. I know it isn't quite that simple.
But if you are one of the masses of people with uncommon, painful, worrying conditions, don't give up. Keep reading and researching. Eventually you may come up with something that should point you in a good direction, and even if you can't go back to your doctor--or a new one, preferably young, recently trained, still enthusiastic, and hungry for new patients, and demand the tests you need to sort out what is going on with your body.