The late-night spoons of ready-made frosting were the best. The preteen thrill of sneaking downstairs to the fridge and plunging a spoon into an open can of sweet and creamy vanilla sludge made the treat all the sweeter as it melted over my tongue and then slid down my throat.
My parents caught onto my clandestine snacking. My pediatrician had already warned my parents to rein in my eating habits and my growing belly. Dad—who overindulged without shame in the light of day—teased me about it. Mom had even made me wear a snap-on modesty apron below my bikini top to hide the pooch.
So with the typical ambivalence of a tween girl, I felt both exposed and defiant. I plotted my next secret rebellion: lifting sugar packets from the table at restaurants when no one was looking, excusing myself to go to the restroom and, once safely hidden in a stall, pouring the crystals down my gullet. The seediness of the location made it feel all the more right.
From Defiance to Denial
My love affair with sugar was deep, unruly and destructive. Over the years, as my weight fluctuated, the affair would lure me into unhealthy and frequent transactions with “the Carrot Cake Man” of Philadelphia (his bakery was just down the street from my home!) and convince me that it was totally healthy to eat a massive slice of Mississippi mud pie in one sitting, as long as it was vegan. Even co-editing a book with the words Choosing Health and Wellness in its title and a chapter on “Recognizing and Preventing Diabetes” couldn’t break up the affair. Sugar has the power to make hypocrites of us all.
Eventually I developed a pretty healthy lifestyle in order to control another health condition that I could not ignore: high blood pressure. I avoided most dairy items and fried foods, as well as sodas and sugary drinks. I even ran in the park a couple of days a week.
Then came a series of life-altering breakups. The first happened to my marriage, an upheaval that robbed me of sleep, sending me to the doctor in search of relief. She required me to go through a complete, standard physical exam, and then called me with the news that finally forced me to separate with sugar, too: I was within a hair’s breadth of becoming diabetic.
The evidence was the results from an A1C test, one of several that reflect one’s blood sugar level. A normal reading is below 5.7. A reading of 5.7 to 6.4 is considered prediabetic, which means that, like more than 1 in 3 Americans, you have a high risk of developing diabetes. Above that, you are diabetic. My reading was 6.3.
“Shock” is an inadequate word for what I was feeling. I had never had a prediabetic result that I could remember. Sure, I knew that African Americans are at a higher risk of developing Type 2 diabetes, the most common type, in which the body doesn’t use insulin properly to move glucose (sugar) from the bloodstream into the body’s cells. (With the rarer Type 1 diabetes, insulin is not produced at all and must be injected.) I knew that I had high blood pressure, another risk factor, though it was being managed. I even knew I had relatives with Type 2 diabetes—yet another risk factor. So why had the doctor’s diagnosis blindsided me?
It was because I had gotten the message from doctors and health organizations that people get diabetes when they indulge in an unhealthy lifestyle. Any black woman who consumes health information is likely to know that we have been singled out as the group with the highest rate of overweight or obesity in the U.S., exceptional for the wrong reason in a society where thin is in.
The diagnosis made me feel like the 11-year-old in the apron bikini pouring sugar down her throat all over again. Having a grandmother and an uncle who had developed diabetes in midlife was reason enough, said my doctor, interrupting my reverie. She advised me to cut back on sugar and food with high glycemic loads that could cause my blood sugar to spike quickly, such as complex carbohydrates (also known as starchy foods). I was to replace them in smaller portions with fiber-rich, low-glycemic–load foods that are digested more slowly, and then come back in a month to see if I should be put on medication to avoid developing full-blown diabetes.
Redefining a Healthy Lifestyle
As I left her office, the specter of amputated limbs, blindness and painful neuropathy—all complications of diabetes—haunted me. Oh no, I thought. That will not be me.
Desserts (yes, all desserts) and energy bars were replaced with homemade dried-fruit-and-nut trail mix and vegan fruit smoothies. As my palate adjusted to less sweetness, I stepped down to healthier fresh fruit, which, in moderation, is now the only type of dessert I have—except my once-yearly vegan birthday cupcake. Juicing, which concentrates sugar, is out. I don’t miss it. Whole fruits and vegetables are better, and tasty when your palate is no longer stunned by sugar.
Proper portion control with complex carbs rather than simple carbs was the bigger challenge, because they were the real trigger foods for me. Remember the old saying, “You can’t just eat one potato chip; you have to finish the whole bag”? That was me with white rice, regular pasta, noodles, potatoes and any kind of chips. I switched to smaller portions of the whole-grain versions, which made me feel full a lot sooner anyway.
Meanwhile, I had cranked up the twice-weekly running habit with a lifelong dream in my sights: to run the New York City Marathon.
Little more than a month later, I came back to the doctor. After a brief examination, during which she noted that I had lost more than 5 pounds, she said that nonetheless she would put me on medication to prevent diabetes. Most people can’t move the needle in such a short time, she explained. “Test my blood sugar first,” I insisted.
When the results came back, it was time for the doctor to be shocked. My A1C was within normal range, and it has been ever since. Within six months, I would lose another 20 pounds. Within two years (and newly divorced), I ran the Chicago Marathon and, a year later, the New York City Marathon.
Five years since my prediabetes diagnosis, I still have normal blood sugar readings, a continued passion for running, and a clear understanding that I simply have to work harder than others to stay healthy and avoid diabetes. It’s simply in my makeup, as it is for many other black people.
Getting past the feeling of being shamed came with having a frank conversation with my physician that went beyond “lose weight” to here are your numbers and the steps tailored to your life and physiology that you can take to improve them.
That customized approach is key. “There’s not one diet that is appropriate for every person with diabetes,” or prediabetes, explains William T. Cefalu, M.D., chief scientific, medical and mission officer at the American Diabetes Association. “It needs to be a flexible nutrition plan, and it needs to be tailored to the individual’s needs, their activity—and, basically, what works for that patient.” For some, medication is also necessary, he added.
As I had been, 90 percent of prediabetic people are unaware of their condition. With so many people at risk, I recommend that anyone reading this educate him- or herself at DoIHavePrediabetes.org or Diabetes.org. There’s no shame in it—only the risk of having a tawdry rendezvous with better health.
Sheryl Huggins Salomon is senior editor-at-large at The Root. Follow her on Twitter.