Diabetes Wake-Up Call

Fast food was a mainstay before his diagnosis, 
but Josh and his wife, Rachel, now do more 
meal planning for cooking at home. 

Josh Smith is determined to become the picture of health. At 34, he closely watches his diet, keeps his daily meal carbohydrate intake below 60 grams and has begun exercising. He weighs 247 pounds, is working to lose more, has a near normal blood sugar level and has lowered his blood pressure to 138/86.

A year ago, his path was quite different. At 6-feet tall and 349 pounds, he was on track to possibly die from a heart attack or stroke. Combined with a family history of high blood pressure and diabetes, Josh’s outlook was dire if he did not seek treatment.

On April 21, 2021, treatment came suddenly — through Josh’s emergency visit to North Kansas City Hospital. Not feeling well all day, he checked his BP, which was high. “I went to the ER thinking I would get medication and go home,” said Josh, who lives in the Northland with his wife, Rachel. “The ER doctor said, ‘How long have you had diabetes?’ I had no idea I was diabetic.”

He thought his fatigue and increased thirst — telltale signs of Type 2 diabetes — were brought on after a bout of COVID.

In his four-day hospitalization, he met with a diabetes educator; went on IV insulin for his diabetes, for which his blood sugar level was twice the normal; and began taking medicine for his high BP, which was 209/115.

He went home with a new attitude. “My diabetes diagnosis was a shock,” Josh said. “I knew I needed to change my lifestyle. There wasn’t another option. I was 33 years old and wasn’t going to let this take me.”

Once home, Erika Busby, BSN, RN, Meritas Health diabetes nurse educator, reached out to Josh. One of nine MH care coordinators, Erika works with patients to help them manage their diabetes. “Erika has really helped me. She has shown me I can do more than what I originally thought I could. I also could not do this without the support of my wife, and together we cook more meals at home,” said Josh, whose meals before his diagnosis were oftentimes fast food with as many as 200 carbs.

After coming off an injectable insulin, Josh transitioned to an oral drug combination that helps control his high blood sugar, which he tracks through continuous glucose monitor. He also takes BP and cholesterol medications.

Erika applauds Josh’s success. “Josh has taken what I have taught him about diet, exercise and lifestyle changes to heart,” Erika said. “He is very positive and told me, ‘I don’t know why people think this is so hard. All you have to do is put your mind to it.’”

He also sees Carolyn Coyle, MD, family medicine physician with Meritas Health Vivion. “Erika’s tremendous guidance combined with Josh’s grit have made this a success story,” Dr. Coyle added. “We will continue to monitor him closely because it can be hard to sustain such a radical change, but Josh is very determined.”

His success motivates Josh. “I now have more energy and feel a lot better. I want to lose 30-40 more pounds and build muscle mass,” Josh said. “I never knew I felt bad until I started feeling better.”