Alma Ambrosio - Type 2 Diabetes
Alma Ambrosio loves life, lives every day to the fullest and believes in taking things in stride. So, when she faced two challenging health problems, Alma’s spirit for life did not waiver.
In 1998, Alma took a terrible fall in her home while stepping out of her shower stall. She ignored the pain she felt in her ankle and the black and blue color of her foot until a friend who is a physician persuaded her to visit her primary care physician. Her PCP sent her directly to the emergency room where evaluation led to her admission to the hospital. She was diagnosed with cellulitis, an infection of the skin and underlying tissue. Fortunately, Alma was put on antibiotics and recovered, but her stay in the hospital led to the discovery of another health condition.
While in the hospital for her cellulitis, blood sugar tests showed Alma's levels to be elevated, so a further examination was conducted. The exam led to a diagnosis of type 2 diabetes for Alma, so she was prescribed an oral medication and given a glucometer to test her blood sugar at home.
“I was not angry or upset at the diagnosis. I was familiar with diabetes since it has run in my family. My two cousins and aunt had the disease.”
Initially, Alma's PCP helped her manage her diabetes. As time went on, her blood sugar did not improve so her PCP referred her to Dr. Nazanene Esfandiari, an endocrinologist in the U-M Metabolism, Endocrinology and Diabetes Division. Esfandiari began monitoring Alma closely. During the next two visits, Esfandiari noticed Alma’s level from her A1c test results were increasing. The A1c test - also known as the glycated hemoglobin test or HbA1c - gives diabetics their average blood glucose control for the past two-three months. On the third doctor’s appointment, Esfandiari demanded Alma go on insulin – news Alma was devastated to hear.
“I hated the thought of insulin injections, but it was necessary to decrease my blood sugar levels. So, I take one injection of long acting insulin in the evening before I go to bed and it does not hurt at all!”
An avid traveler, Alma has visited nearly 60 countries since 1988. She was afraid that being reliant on insulin would make traveling cumbersome or prevent it all together. But she quickly learned this was not the case.
“Traveling is not a problem. I take all my supplies and when I eat out, I choose healthy options. I find a lot of other type 2 diabetics stating they cannot travel due to their disease, but this is not true. Diabetes will not keep me at home.”
Those who suffer from type 2 diabetes will naturally begin losing their ability to produce insulin and, overtime, may need different treatments to control their blood sugars. For example, one may be able to manage their disease through diet and exercise alone. As time goes on, an oral medication or even insulin may be prescribed as insulin production decreases. No matter what your treatment is, it is vitally important to maintain normal blood sugars.
While the exact cause of type 2 diabetes is unknown, factors such as age, sedentary lifestyle, excess weight, heredity, or ethnic background are all factors that can increase someone’s chances of developing the disease.
In Alma’s case, the disease runs in her family, she is in her early seventies and, at the time of diagnosis she was overweight.
“When I was in my forties I was very physically active. I would swim or jog everyday. However, as I got older I exercised less and less and did not pay much attention to my diet. So I began gaining weight.”
A few years after the diagnosis, Alma was managing her diabetes and taking better care of herself.
“I began walking every morning, attending U-M aerobic classes and paying close attention to what I was eating.”
In 2001, Alma faced another health scare - this time during one of her trips abroad.
“My friends and I were walking up a long hill in Finland. I had to stop to catch my breath several times and my chest felt like it was burning.”
When she returned home she visited her PCP who performed a stress test. Her PCP referred her to a cardiologist at the University of Michigan. She was told she would need a six coronary heart bypass graft - a form of heart surgery that redirects blood around clogged arteries to increase blood flow and oxygen to the heart. In Alma’s case, six of her coronary arteries (and their main branches) were blocked.
While this procedure did not affect her diabetes directly, it did result in some minor changes to her diet.
“As a diabetic, I had to watch the amount of carbohydrates I ate. After the coronary procedure, I had to watch the amount of fat I ate. A low carbohydrate, low fat diet was difficult at first. But I have tailored what I eat to only include good fats and low carb options. For breakfast I have skim milk, a half of a banana, whole wheat cereal and flaxseed. For lunch and dinner I eat mostly salads and I make sure I get six servings of fruits and vegetables each day.”
The heart condition has not affected her travels either.
“A friend of mine questioned whether or not I should be traveling with my heart condition and diabetes. But there isn’t anything that would keep me from it. I figure if I die on a trip then at least I was doing something I love! Plus, I could never dream of sitting at home and doing nothing. That’s the way I look at it.”
Alma has trips to Honduras, Guatemala, Belize and Mexico planned for the near future.
Alma relies on prayer and a good attitude to keep her strong.
“I have learned to let go and let God handle things. I believe there are reasons why things happen so I just roll with the punches that life hands out.”