After All These Years
Dr. David Reiss had never heard of diabetes until age 16, when he found out he had type 1 during his college physical exam. He rebelled and refused injections for a year, but by then there were ketones in his urine and he had no choice. That was 42 years ago, when people gave themselves just one injection a day.
There was no home monitoring; instead, Dr. Reiss went to his doctor for a blood test every three months. The day before a test, he would be very careful about what he ate because he wanted to “do well on the test.” A few days after the test, he’d receive a letter in the mail stating that his blood sugar was too low or high and telling him to raise or lower his single daily shot of lente insulin by a few units.
Diabetics Don’t Tell
Dr. Reiss didn’t like to tell people that he had diabetes. He would occasionally tell a girl he was dating, and the next thing he knew, her parents wouldn’t let her go out with him. He doesn’t advertise it now, but he doesn’t hide it either. He says, “I just don’t care like I used to.”
After college Dr. Reiss pursued his medical education, in Mexico first and then at the Joslin Center and in New York. He says that while training at the Joslin Clinic, “I had myself phenotyped and found that I’d inherited the gene for diabetes from my mother. She always blamed herself because she didn’t breastfeed me as an infant.”
In 1980, he moved to California, where he’s been with Kaiser ever since. From 1980 to 1997, he was the only endocrinologist for all of Orange County. Since then two more have been hired, but the shortage is still acute.
On the Pump
About eight years ago Dr. Reiss went on the pump, after resisting previously because he thought it would feel “like a ball and chain.” He’s on the Paradigm MiniMed pump now, and he loves it. He tried their sensor, the one that links to the pump and reads off the blood sugar every five seconds, but it wasn’t accurate enough for him.
Currently he recommends either the Animas or the Medtronic pump to his patients, but not the sensor with the pump. He uses fingersticks, pricking his fingers 15 times a day, because they meet his standard for accuracy.
With regard to complications of diabetes, Dr. Reiss says ruefully, “You name it, I’ve had it.” He attributes his problems to the ignorance and lack of technology that prevailed when he was younger. If they’d had A1c’s and home monitoring, he says, if they’d known good control made a difference…but they didn’t know. He doesn’t doubt that if “we knew then what we know now,” he’d be a much healthier man.
He’s still going strong, nevertheless. He works out every single day and looks robust, much like the pull-up and push-up champion that he was in college. His wife is a gourmet cook, and he eats healthy meals. He tells his patients to judge by the color of the food: If it’s bright red, green, orange, yellow, it’s good; if it’s drab, pale and washed out, be careful. “Watch the quality and limit the quantity, and exercise every single day,” he says. His A1c is 6.9%
Dr. Reiss isn’t optimistic about a cure. He notes that about twenty years ago, he was constantly hearing that a cure was due within five years, but nothing ever materialized. He thinks the drug companies are “making a heck of a lot of money on diabetes.” There are much better treatments now, he admits, but regarding a cure, “they haven’t gone anywhere near where they could have gone.”
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