Someone I know, according to the email I received this week, must now give himself insulin injections, possibly daily.

My immediate response was not one of surprise or shock. I’ve been expecting this for years. And when I receive an email, a few years down the road, denoting the next stage of the disease, I won’t be the slightest bit surprised then either.

My lack of surprise is because this is simply just the next step. He was diagnosed with adult-onset diabetes a number of years ago. He was given dietary advice, but like a disturbingly large number of people his age, he decided that it didn’t really apply to him. He was given pills and strips to monitor his blood. I can only assume he has been taking the pills, but he certainly hasn’t been monitoring his blood sugar – in fact, any time any of us ask him about it he gets mad and changes the subject. And now the diabetes has gotten bad enough that he will have to start giving himself insulin shots.

I am angry about this – angry and frustrated. I realize that as adults, we all have a certain amount of freedom that we are allowed to take with our own health. After all, I weigh about 30 pounds more than I should, so I’m certainly no paragon of health and nutrition virtue. But I am trying – trying to eat healthy, trying to exercise; trying to pay attention so that I won’t have to deal with the extra pills and aches and pains and problems that plague those who are my age and older. And because of this I know how easy it is to make the few minor changes in diet and activity that are necessary to make a difference. This isn’t to say that I don’t occasionally crave my old high-fat diet, or that I don’t occasionally decide that my need for a double cheeseburger far outweighs my need to shake those extra pounds. But overall, the changes are sticking, because it’s important to me.

I am angry because he knows better – he and everyone else I’ve watched go through this. The information is out there – they have been told and told and told what they should be doing, but they cover their ears and refuse to listen. My grandfather had adult onset diabetes and dealt with all the myriad of problems associated, including cataracts, because he refused to take it seriously. A friend’s mother is facing kidney dialysis because she was diagnosed years ago and refused to take it seriously. The facts are staring all of them in the face, but yet they blindly keep on doing what they’ve always done, refuse to make any more than a token effort to incorporate those simple little changes the doctors request, and let all the nasty side-effects happen to them. Yes, I said LET. In most cases this condition can be treated by lifestyle changes alone. In some cases, they might still have to take pills, but usually, if they catch it early, and pay attention, and do what they’re *told*, people can avoid what my grandfather went through; what my friend’s mother is going through; what someone I know is facing right now. They make the choice to *let* it happen because they can’t be bothered to make the effort to change.

I am angry because, despite everything, I know that the chances of him actually taking this really seriously, even with the insulin shots, are slim. I know this because I know him, and I know too many others like him, and they just can’t see why they should care about it until it’s too late. I am angry because it doesn’t matter what I do, or anyone else who is close to him and cares about him, or even the doctor. Ultimately, the decision to take care of his own health is up to him, and by the time he finally wakes up and realizes how serious this is, it might be too late.