Boston Mayor Thomas Menino cuts cake during this year’s Boston Harborfest, before his bout of illnesses and Type 2 diabetes diagnosis (U.S. Navy/Wikimedia Commons)
A word of advice for Boston Mayor Thomas Menino from a top specialist: Diabetes is no reason to retire. And another bit of wisdom: When you’re back in the office, schedule exercise into your day as you would a demanding constituent.
Mayor Menino’s doctors disclosed last week that during his recent weeks-long hospital ordeal of infection, blood clot and fractured vertebra, the mayor was also diagnosed with Type 2 diabetes. (That makes him a rarity in American politics; lists of famous diabetics abound, but the only other politician who has been open about Type 2 diabetes that I can find is Mike Huckabee of Arkansas.)
Mayor Menino is now recuperating at Spaulding Rehabilitation Hospital and sounded very much like himself in a recent press conference (Retire? “I checked my retirement. It wasn’t good enough.”) and a public letter about the fiscal cliff. But his ailments triggered calls for him to retire in Boston Globe columns and elsewhere.
‘If you control your blood sugar you can lead an absolutely normal life, and there isn’t anything that you can’t do.’
We’ve written repeatedly about the explosive rise in Type 2 diabetes prevalence, now at 26 million Americans and expected to rise by another 50 percent in the next decade or two.
But I suddenly realized that I didn’t actually understand what it means to have Type 2 diabetes. Both my grandfathers had it. One, a stocky former boxer, was felled by its complications, first knocked down to a wheelchair and then into an early grave. The other didn’t seem bothered by it at all. So how hard is diabetes? Is it in fact relevant to any decision the mayor might make about his next political move?
Dr. Martin Abrahamson (Joslin Diabetes Center)
According to Dr. Martin Abrahamson, chief medical officer of the Joslin Diabetes Center, the answer is an emphatic “No.” I spoke with Dr. Abrahamson just after he gave an overview of the current state of diabetes treatments to some 500 doctors as part of a Harvard Medical School continuing education course. Our conversation, lightly edited:
So we’ve just learned that Mayor Menino has Type 2 diabetes. What does that mean, both physiologically and in terms of — well — living?
Well, it means that his ability to metabolize glucose is impaired, and the glucose levels in his blood have risen, and probably for two reasons: Firstly. he has less ability to dispose of glucose in the cells compared to people who have normal metabolism, and that comes about because the insulin in his body is less effective. And secondly, he is not producing as much insulin as normal people do. Insulin, as you know, is a hormone that pushes glucose into the cells, and the cells use the glucose for their energy on a daily basis. So it means that he has elevated glucose levels.
However, there’s a lot that he can do about it. He can treat his diabetes through a variety of ways, the first of which is modifications in lifestyle, increasing exercise, watching his diet and losing some weight. And second, there are medications that can be taken, either by mouth or injectable ones, that can either help the body use insulin more effectively to dispose of glucose, or enhance the amount of insulin that the body produces to promote glucose uptake into the cells.
So the first-line treatment tends to be lifestyle changes — diet and exercise — and then it sounds like very typically you prescribe Metformin, which is just a pill, right? And then, I believe you said, by about six years out, about half of people with diabetes need insulin? Continue reading →
