I went home to Denver last week for a stay with my parents for Thanksgiving and was suddenly inundated with diabetes facts. (My wife, Sue, was in Toronto at a conference and didn’t join me.)

While planning the menu for Thanksgiving dinner I learned that my second cousin has been diagnosed with slow-onset type 1 diabetes. Her mother (who is not genetically related to me) also has it. Thus, I don’t think the disease will affect me.

However, I also learned that my father has been diagnosed with type 2 diabetes. He monitors his glucose level one day each week and records it in a notebook. He takes medications (I didn’t ask which ones) and has made minor adjustments to his diet. The diagnosis was made a few years ago, but he never told me. But now I know why my mother switched from serving white rice to brown rice a few years ago. (I’m sure eating brown rice with a Japanese meal is considered a form of Shinto blasphemy.)  I wonder if I had known of my father’s diabetes and told the transplant hospital about it, if that would have made me medically unsuitable to be a kidney donor?

Then, while surfing the web at my parent’s house, I saw an article by Hanna Rosin in Slate Nov 2010 in which she describes her life with slow-onset Type 1 diabetes. In the article, she is upset that needing to monitor her glucose level has made her an obsessive self-quantifier. She goes on to discuss how little is known about the relationship between blood glucose level and cardiovascular disease.

Finally, when I came home, Sue left an article she had clipped from the Nov 23 Globe and Mail on how politics affects the diagnosis of diabetes. Blood tests are used to diagnose diabetes. Both the U.S. and Canada use the overnight fasting glucose test and both use a result above 7.0 millimoles per liter of blood to make a diagnosis. However, in January 2010 the U.S. added the hemoglobin A1C test to the diagnostic list. Now, in the U.S., a HbA1C level greater than 6.5 percent also means you are diabetic. This means more Americans will be diagnosed as diabetic than Canadians. This means more Americans will be treated, changing their diets, monitoring their glucose levels, and taking medication to control their blood pressure. Who knows if, and how, this will affect medical outcomes and total medical costs in the two countries.

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