We have seen from the last talk about Diabetes that it is a very complicated disease, which is present over the whole world. Once someone has Diabetes one cannot get rid of it. The goal is not cure but controlling the side effects of the disease. The key question is how can we control the side effects of Diabetes? Other important questions are related to treating the main side effects of Diabetes, namely to the organs of the eye, kidney, heart and blood vessels and the nerves of the body, especially the legs.
Many people in China have Diabetes. Further as the Chinese people have a more affluent society, they appear to be doing what the rest of the world is doing; i.e. exercising less and eating more both of which make Diabetes worse. However, the major reason for major growth of Diabetes in China is the rapid aging of its population. This aging population will be the major challenge of Diabetes to the nation of China.
Ma Hai Long was a forty-two year old woman who had just been diagnosed with Diabetes. She actually did not feel bad at all. She was diagnosed when she went to the doctor to be evaluated for some pain in here chest. The chest pain turned out to be nothing. However, her doctor did some blood work, which showed a high blood sugar, and the repeat fasting blood sugar was also elevated. The blood sugar was not too elevated but she clearly had a high blood sugar. The doctor referred her to a specialist in Diabetes.
Ma Hai Long was very concerned and talked to many of her neighbors. She found out that many of them either had Diabetes or had other friends or relatives who had Diabetes. They encouraged her to go see the Diabetic specialist. When she went to see this specialist he told her just a few very important things. First was that Diabetes was not curable. Second, he told her that recent studies in 1992 and 1994 showed that though Diabetes cannot be cured it can be controlled. Further, if the blood sugar level can be controlled to normal, she was told that the risk of kidney, eye, artery, heart and nerve damage can be reduced as much as 60%. Ma Hai Long was very encouraged.
Diabetes is a very major disease. However, Diabetes is not the cause of sickness and disease. The real cause of sin and illness in the world is sin. The Bible says, ‘all have sinned and fallen short of the glory of God (Romans 3.23). The Bible say in the book of Genesis, which is the first book of the Bible and talks about the beginning of the world, that when man sinned disease and sickness entered into the world. This is important because it shows that sin and not Diabetes is the real cause of disease and sickness in the world. If this is the case then dealing with sin is far more important than dealing with Diabetes. Though helping people with Diabetes is important. However, what are the results of sin in this world?
The Bible says ‘the wages of sin is death but the gift of God is eternal life through Jesus Christ our Lord (Romans 6.23). What does this mean? Each of us receives a wage or income when we work. The wage or income of sin is death. Some may say that is not too bad. However, the Bible says that the result of death is not the end of life. The Bible speaks of a life after we die, eternal life or eternal living death or hell. The Bible tells the following story:
“The kingdom of heaven will be like a man going on a journey, who called his servants and entrusted his property to them. To one he gave five talents of money, to another two talents and to another one talent, each according to his ability. Then he went on his journey. The man who had received the five talents went at once and put his money to work and gained five more. So, also the one with the two talents gained two more. But the man who had received the one talent went off, dug a hole in the ground and hid his master’s money.
After a long time the master of these servants returned and settled accounts with them. The man who had received the five talents brought the other five. ‘Master,’ he said, ‘you entrusted me with five talents. See, I have gained five more.’
His master replied, ‘Well done, god and faithful servant! You have been faithful with a few things; I will put you in charge of many things. Come and share your master’s happiness!.’
The man with the two talents also cam. ‘Master,’ he said, ‘you entrusted me with two talents; see, I have gained two more.’
His master replied, ‘Well-done, good and faithful servant! You have been faithful with a few things; I will put you in charge of many things. Come and share your master’s happiness!’ Then the man who had received the one talent came. ‘Master,’ he said,’ I knew that you are a hard man, harvesting where you have not sown and gathering where you have not scattered seed. So I was afraid and went out and hid your talent in the ground. She here is what belongs to you.’
His master replied, ‘You wicked, lazy servant! So you knew that I harvest where I have not sown and gather where I have not scattered seed? Well then, you should have put my money on deposit with the bankers, so that when I returned I would have received it back with interest.’
‘Take the talent from him and give it to the one who has ten talents. For everyone who has will be given more, and he will have an abundance. Whoever does not have, even what he has will be taken from him. And throw that worthless servant outside, into the darkness, where there will be weeping and gnashing of teeth (Matthew 25.14-30).’
What does this story mean and does it relate to Diabetes? First, the main point of the story is that of ownership and responsibility with what we have been given by God. Some of his have been blessed with a lot of money from God. Some of us have been given great talent, like playing the piano or violin or a sport. Some of us have been given a great place in life, like being president of a company or major of a city. Some of us have been given great health in life.
Some of us have been given disease and illness. However, regardless of what God has given us we are responsible for that gift of life. This is the main point of this story. However, another main point of this story is that those who ignore the gifts God has entrusted to them is in danger of being thrust forever, after they die, ‘into the darkness, where there will be weeping and gnashing of teeth.’ This is an eternal darkness. This is the result of sin. Sin is simply ignoring what God wants us to do. As is the case in this story, God clearly gives us responsibility and instructions. Ignoring these responsibilities and instructions carries with it severe eternal consequences.
However, we can learn to treat our Diabetes well. How do we do this? There are several primary ways to do this. First is the use of diet and exercise. This is the most important way to control Diabetes. How is this done? First, is to cut back to the total amount of food eaten to between 1500-1800 calories per person per day. This is probably less than most people eat but it is enough to live on. Eating smaller amounts at meals, eating less fat, drinking less alcohol and eating more fruits and vegetables can primarily do this. Second, is to exercise more. One should at least walk or run or ride a bike 20-30 minutes 3 times a week to have benefit. Also one should also work hard to loose weight. Excess weight can cause one to become a Diabetic more easily.
After controlling diet, exercising and loosing weight medical treatment can be used. More advances have been made in medical treatment of Diabetes in the 1990’s than in any other decade of the past several 100 years. Thus this is a good time for Diabetics to be alive. There are two main medical treatments, which can be offered. First are pills, which can be taken for Diabetes to control the blood sugar. Your doctor will know which pills are the best for you. Second, is Insulin. Insulin is more commonly used for children with Diabetes. However, adults may also use Insulin as well for controlling their Diabetes, though Insulin is used less regularly with Adults with Diabetes. Often a patient may take one or more medicine for controlling their Diabetes. Patients may also take pills and Insulin together to control their Diabetes.
There are several laboratory measurements, which may be out of a normal range at the time of the diagnosis, which is important to evaluate. Patients with Diabetes are more prone to heart disease and strokes. Thus it is important at the outset of the diagnosis of Diabetes to check a person’s cholesterol. If the cholesterol is elevated, then it needs to be treated as well as the blood sugar.
Lowering this cholesterol will help lower the chance that Diabetes will cause heart attacks or strokes.
A second laboratory value is protein in the urine. All persons have a small amount of protein in their urine. They cannot see this protein, but it is there. Over time, Diabetes can have a significant effect on the kidney if the blood sugar is not controlled. The result of this effect is that over time the kidney will start ‘leaking,’ larger amounts of protein. It is this leaking of protein which is the problem. The average person in the world will progress to total kidney failure after 9 years after starting to leak protein in their urine, i.e. from their kidneys. Can this be prevented and treated, i.e. this spilling of protein in the urine? Yes it can? By controlling the Diabetes to normal the chance of a person getting kidney damage from Diabetes is significantly reduced. Second, if even after a patient gets kidney damage from Diabetes and protein spillage, if the Diabetes is controlled to normal then the progression of that kidney damage is also reduced.
There is also some other medicines which can be used to prevent the progression of kidney damage in patients in Diabetes. You can ask your doctors about these medicines. These medicines are currently available in China.
Finally, Diabetes can affect the nerves in the legs so that a person with Diabetes cannot feel if they get burned. This is a very serious problem as many Diabetics in the world, China included, have this problem and in time it can lead to leg amputations. What can be done? Again, controlling the blood sugar to normal is the most important thing to do whether by diet, exercise or medications.
Let us go back to that story in the earlier part of this broadcast. How, can one not be cast into eternal darkness? That is a very good question. First, the Bible says, ‘for it is by grace you have been saved through faith, this not from yourselves, it is a gift of God, not by works, so that no one can boast (Ephesians 2.8,9). A man named in Paul wrote this about 2,000 years ago. What does this mean? We are saved from this eternal darkness and hell by a gift from God and this gift is faith. There is nothing we can do to earn this gift. It is because of God’s grace. Grace is simply God’s unmerited favor. The Bible in another place says, ‘for God showed his love for us in that while we were yet sinners Christ died for us (Romans 5.8).’ Even while we did wrong and went against God he still loved us and wanted to save us from our sins. What an amazing story! What a great love for us!
What can we do about this? We can respond in faith to what Jesus Christ did for us on the Cross, when he died to bear our sins so that we might have eternal life. He took these sins upon us so that we would not be thrown into eternal darkness. What can you do right now? You can pray the following prayer: Dear Lord, I know that I have done wrong and am a sinner. I know I have deliberately gone my own way. I believe that Jesus Christ died on the cross to take my sins and the sins of the world upon himself and that he rose from the dead to show that he has conquered sin and death. I repent of those sins and ask you to come into my life and live. If you have prayed this prayer then you are a child of God and will live forever. Congratulations.