A Burden Too Heavy: Living well with Diabetes
Patient: She was just 33, with an only child, a 17-year-old son, which meant that she was married in her teens.
Her Problems: Diabetes, Hypothyroidism and Diabetic Kidney Disease worsening chronic kidney disease, early renal failure, anemia and high blood pressure. A struggling heart and liver caused accumulation of fluid around the body.
Patient's Story
I could see she was tired of the heavy burden she had been carrying for so long. There was no ‘Sumai Thangi’, to which she could transfer the burden, rest and recover.
Diabetes struck early in her life, almost a decade ago. So did hypothyroidism, heralding the entry of two endocrine disorders into her life. Predictably diabetic kidney disease arrived, worsening inexorably to chronic kidney disease and early renal failure.
As the kidney began to fail, it could not produce erythropoietin required to stimulate the bone marrow to produce oxygen-carrying red cells, leading to anemia. Her worry did not stop there. The failing kidney pushed up her blood pressure. The heart then began to struggle. The liver also began to suffer from Fatty Liver of Diabetes, now called Metabolism Associated Steatotic Liver Disease (MASLD) and related Hepatitis (MASH). She became breathless, fluid accumulating around her heart and lungs.
Looking at her, sitting on her bed, bending her knees, and cheerlessly looking at the world around her, you would not guess the weight of the burden she was carrying.
Outcome
She thus became the victim of Cardiac-Renal- Metabolic (CKM) disease, stemming from Diabetes. She would need careful hand – holding from specialists- Cardiologist, Diabetologist and Nephrologist. Recovery may take several years, and she would need such coordinated care lifelong to keep her safe from the heavy physical and emotional burden of her illnesses, so that she can look forward to living a stable with her family .
