Death by cake

  It's ridiculous to think that someone would die by cake, but it happened.  Marie Antoinette, a woman born of great privilege (thus a whole lot of unintentional ignorance), was beheaded because of her supposed "let them eat cake" response to the citizens plight of starvation

  The other is likely to be me--also, a woman born of privilege and struggling with unintentional ignorance (truly sorry to those I have offended...)

  I don't know how it happened, but during pregnancy, I suddenly became insulin resistant and it never went away.  My sugars would shoot up even with one bite of bread.  No one in my family had diabetes that I knew of.  How could this be when I often had low blood sugars and would pop in a candy to prevent the cold sweats and shakes from seeping in.  I was on the thinner side and played sports all my life.  Don't get me wrong, I did love sweets.  I could wipe out a whole pack of oreos in 2-3 days all by myself, eat a dessert after every meal, have two cupcakes at a time (maybe a third later in the day), and not particularly gain weight.  I'm thin, I work out, no one in my family has diabetes, and my a1c right before pregnancy was a 4.9 even with all the occasional junk I ate--what were the chances?

  There are days I feel woe and dispair.  Actually, I feel it everyday.  It has gotten less intense now that it's been over a year, but there is still struggle since I face 3 meals a day.  I wish I could just have rice or noodles, something on the side, and call it a day.  But instead I need to fill my belly with protein and endless greens to feel somewhat satisfied and full.  A sandwich shouldn't be something to fear.  On days I am hormonal or particularly sad, I wish I could just have a cupcake.  How easy it would be to make a huge batch of pasta and have it for dinner for the three of us...but I have to make separate meal for myself.  Eating out frightens me in that I have to see if I have the opportunity to walk quickly or jog shortly after having a somewhat carby meal to bring my sugars down.  I have to run at least 30-40 minutes to keep my sugar ranges somewhat in check if I eat a bowl of ramen.  I wish Alex, friends and family wouldn't have to consider my dietary restriction when choosing a restaurant.  It's ironic (sheesh even after that whole CRVO debacle) that I am a doctor who is well aware of what diabetes can do to a person--it doesn't matter how bad your sugar LEVELS are, it matters how LONG you've had it.  I've seen patients with great a1c and fasting numbers but they've had diabetes for 20 years and they are starting to go blind in one eye and their skin is a mild dull brown color with some neck tags.  Holy moly, I'm only 33!  What am I going to look like when I am 50?  Will I make it to 70 even?

  I know how I'm going to die. 
  It's either going to be by:
  1. a long suffering from the slew of comorbidities that the diabetes gift package comes with like heart disease, stroke, high blood pressure, blindness, kidney failure, gangrene limb amputation
  2. cancer
  3. the other c-word: cake

  Should the quality of my life significantly decrease and I cannot take it anymore (oh and I am confident Alex and Nat can take care of themselves somewhat when I'm gone), I will have a three day parade of where I eat delicious starchy and sweet things with loved ones. I'll have bowls of white rice with marinated crab, some pho, some ice cream, some pastries (perhaps jet to France on one of those days), some bread and jam, some mangos and fruits, sample as many slices of cakes as I can, dozens of cupcakes, bags and bags of oreos, and perhaps a boba.  Nah not boba, not a big fan.  Then my body will go to ketoacidosis and I will sign a waiver to let me die when I become unconscious by it.

Death by cake:
1. Marie Antoinette
2. Sandra Lee Juhn