I saw one of my favorite patients today. He is a 30-something-year-old guy with a history of diabetes for the last seven years who has been doing a great job over these last few years of keeping his diabetes very well-controlled. He takes his meds on time, calls in for refills when they start to run out (a rarity not to be underestimated among patients!), and has been very compliant with his routine visits. Like any diabetic, despite maintaining a good diet most of the time, he occasionally gets tempted by very sugary and starchy foods, but for the vast majority of the duration of his chronic illness he has done a great job of showing restraint.
This visit, however, he had news for me. Apparently a new bakery moved in next door to where he worked, and he fell under the spell of some tantalizing cakes they made. Initially he did not even notice the cakes. Then one day he had to go in for a non-food related reason and his interest was slightly piqued. Soon things escalated to the point where almost every day he would walk in and ask for a tiny sample of a cake. That was a few months ago. These days he was at the point where he'd ask for a slice on a daily basis. He still took his meds; he still measured his sugars; but now he was also having a generous slice of cake ... and frequently too.
So he finally succumbed. Despite his initial strength, his many years of good diabetic control, and full awareness of the consequences, he bought an entire cake and went home to eat it. Not just eat it ... scarf it down. From what I hear, he really enjoyed it. It seems that before this bakery, he had not touched cake in many years. And now, he tells me, he splurged three nights in a row, one cake each night.
After this encounter, I couldn't help but think why is it that the best things in life have the potential to be the most dangerous? Not only are they not free as the adage suggests, but they really are the most harmful, whether physically or emotionally or financially. I am not only referring to sugar, salt, fat, and other tasty foods, but other entities in life as well (e.g. excessive money, extreme sports, a neighbor's wife.) Our brains seem naturally wired to crave that which is bad for us. Or maybe it's just we covet that which we can't have. I don't see how this helps with natural selection. In fact, I bet some grand designer up above designed this system intentionally and must love observing us.
Back to my patient, he has now radically thrown off his blood sugar readings and who knows what sort of complications he may face down the line. He is regretful, although he really did enjoy it in the moment. He claims he will be back to good behavior, but we shall see.
Anyway, I don't know why I even wrote this entry.