Case #22: Mila

Summary

Symptomatic: A Medical Mystery Podcast - Episode 22: Mila

Introduction

In episode 22 of Symptomatic: A Medical Mystery Podcast, host Lauren Bright Pacheco delves into the compelling and emotional journey of Mila Clark. Diagnosed at an unusually young age with type 2 diabetes, Mila's story highlights the struggles of misdiagnosis, the stigma surrounding chronic illness, and the resilience required to seek accurate medical care. This detailed summary captures the key points, discussions, insights, and conclusions from Mila's episode.

Mila's Background

Mila Clark is portrayed as a vibrant and driven individual whose passion extends beyond her professional life. "Mila's energy is unmistakable. She's driven, always one step ahead, and her passion for her work is contagious," Lauren Bright Pacheco describes (00:53). Outside of work, Mila is an avid gardener. “I am a total plant lady, so I love being out in my terrace garden... I love being out in nature despite the fact that I live in, like, the fourth largest city in America,” Mila shares (02:00).

Her deep-rooted connection to nature traces back to her childhood, spending significant time with her grandmother tending to a giant mint bush. These fond memories underscore her nurturing and attentive personality (02:39).

The Onset of Symptoms

Mila began experiencing troubling symptoms around the age of 25. Initially dismissing them as mere signs of stress and a demanding job, she felt constantly tired, thirsty, and unwell despite maintaining a healthy lifestyle. “I was in the best health of my life physically, but I just feel awful. I feel really tired all the time,” Mila recounts (05:07). Her partner, recognizing the severity of her condition, urged her to seek medical attention (06:08).

Struggle with Diagnosis

Mila's first visit to the doctor led to an alarming discovery: her blood sugar levels were dangerously high. “Your blood sugars are extremely high. They are through the roof,” the nurse informs her (10:12). Shocked by the diagnosis of type 2 diabetes at such a young age, Mila felt judged and misunderstood by her healthcare provider. “This is a lot of judgment... I had all of these questions, but I felt too ashamed to ask them in that moment,” she admits (11:14).

Her initial efforts to manage the condition were strenuous but ineffective. Despite rigorous exercise and meticulous tracking of her diet, Mila's A1C levels barely dropped by 1 percentage point after three months, leading her doctor to question her adherence to the treatment plan (16:44). This skepticism exacerbated Mila's feelings of frustration and shame.

Impact of Misdiagnosis

Over the next few years, Mila's struggle intensified. Misdiagnosed with type 2 diabetes, her treatment efforts were in vain, leading to worsening health and mental exhaustion. “I was at the point where I'm worse, working my hardest... I was exhausting myself and not eating enough,” Mila explains (15:54). The social stigma surrounding her condition manifested in hurtful comments and misunderstandings, further isolating her (18:48).

Correct Diagnosis and Relief

Determined to find answers, Mila sought a second opinion from a specialist endocrinologist, Dr. Artie Thangadu. Through comprehensive testing, Mila was correctly diagnosed with Latent Autoimmune Diabetes in Adults (LADA), a slow-progressing form of type 1 diabetes (27:32). This revelation provided the clarity she desperately needed. “When I learned that the way to get your diagnosis confirmed was a blood draw like I had taken a million times, I was so mad because I was like, just double checking could have changed the trajectory of my health overall,” Mila reflects (30:12).

Building Community and Advocacy

Embracing her new diagnosis, Mila launched "Hangry Woman," a blog and social media platform to document her experiences and connect with others facing similar challenges. “I have found that I'm not alone... they're just looking for somebody who understands and who's not going to judge,” Mila shares (34:32). This community has become a source of support and accountability, helping Mila navigate her condition while empowering others to seek the help they need.

Future Hopes and Conclusion

Dr. Thangadu emphasizes the need for a more empathetic and patient-centered approach to diabetes care. “I hope that we move to a more empathetic, patient-centered approach to diabetes with more access to specialists,” he states (36:43). Mila echoes this sentiment, advocating for individuals to fight for their health and seek multiple opinions if necessary. “Fight for yourself... don't stop pushing,” she urges (37:42).

Mila's story is a powerful testament to the importance of accurate diagnosis, the impact of medical stigma, and the strength found in community support. Her journey from misdiagnosis to advocacy offers valuable insights into the complexities of chronic illness and the relentless pursuit of health and well-being.

Notable Quotes

• Mila Clark (00:09): "I was really confused, and I was like, I don't know what just happened, but I know that's not normal."

• Lauren Bright Pacheco (00:53): "Nearly half of all Americans suffer from some chronic illness, and many struggle for an accurate diagnosis."

• Katie (03:31): "We've just lived so close that it's almost like we're siblings."

• Mila Clark (17:44): "You are not doing what you're telling me you're doing."

• Dr. Artie Thangadu (28:14): "Diabetes is the most expensive chronic condition that we facing as a country."

• Mila Clark (37:42): "If something feels off, it's probably off."

Conclusion

Mila Clark’s episode on Symptomatic sheds light on the often-overlooked challenges of chronic illness misdiagnosis and the enduring human spirit required to overcome such adversities. Her advocacy through "Hangry Woman" not only provides her own solace but also serves as a beacon for others navigating similar medical mysteries. This episode underscores the critical need for empathetic healthcare practices and the profound impact of community support in managing chronic health conditions.

Transcript

[Lauren Bright Pacheco]

Ruby.

[Mila Clark]

I was making myself breakfast and I fainted. And I kind of like came to. I was really confused, and I was like, I don't know what just happened, but I know that's not normal.

[Katie]

She was doing all the right things health wise, but went through years of struggling that she probably didn't have to.

[Dr. Artie Thangadu]

She had no weight to comprehend what she had to do for her disease that affects every minute of every day.

[Mila Clark]

And I'm like, I failed. I don't know how much harder I could work. The only thing that I could do is, like, be in a different body.

[Lauren Bright Pacheco]

How terrifying would it be to fight an unknown enemy, one you didn't recognize and didn't see coming? What if that enemy was coming from within? A disease that even doctors couldn't identify? Nearly half of all Americans suffer from some chronic illness, and many struggle for an accurate diagnosis. These are their stories. I'm Lauren Bright Pacheco, and this is symptomatic. Mila's energy is unmistakable. She's driven, always one step ahead, and her passion for her work is contagious. Her natural confidence and ability to connect with others proved invaluable when she faced daunting health challenges. Tell me a little bit about yourself outside of work. What are your passions?

[Mila Clark]

I am a total plant lady, so I love being out in my terrace garden. I live in the middle of Houston, Texas, so we're right in the center of the city and I miss my greenery. So we have like a little composting bin outside on our deck and we grow some of our own produce and some of our own food, just as something that we found was actually really simple to do and really gratifying when it comes to cooking and eating. And so I'm just like a nature person. I love being, being out in nature despite the fact that I live in, like, the fourth largest city in America.

[Lauren Bright Pacheco]

Have you always had a green thumb?

[Mila Clark]

I have. Both of my parents were working parents. They were both immigrants from Jamaica. And so I spent a lot of time with my grandmother when I was younger. Like, one of my most vivid memories of childhood is going out with my grandma to go to our mint bush. We had this like giant mint bush. It was probably like 9ft tall. And we would pick out mint leaves for our tea and we would sit and have tea in the afternoon and talk. So if you can imagine, like five or six year old Mila sitting with her grandmother just like having a cup of tea and talking, it's like one of my favorite things.

[Lauren Bright Pacheco]

Fond childhood memories wouldn't be complete without Mila's best friend, Katie. They first met in middle school as friends in passing. But by high school, their friendship deepened. Over time, they grew inseparable, sharing life's ups and downs together.

[Katie]

We were sitting there at yearbook, and we were on our computers next to each other.

[Mila Clark]

We were journalism nerds. And so in our senior year, we're so excited to be editor in chief and layout editor.

[Katie]

And we realized that we were both going to the same university. And we were like, oh, do you need a roommate? And we said, yeah. And it was just the easiest decision. That kind of gave us a good platform and foundation for our friendship now is that we've lived together, we've seen it all, we've done it all. Like, we've just lived so close that it's almost like we're siblings.

[Mila Clark]

We jokingly say that we're always on the same wavelength and we're always reading each other's minds because we're almost thinking the exact same thing at the exact same time. We have grown so close that we really consider each other sisters. I don't even tell people like, oh, that's my best friend Katie. I say, it's my sister.

[Lauren Bright Pacheco]

Now, for somebody who hasn't met Mila, how would you describe her and her personality?

[Katie]

She is so free spirited. She's creative and driven, and if there is something that she is interested in, she will stop what she's doing and just investigate and dig in. And she wants to know everything. She wants to help people. She's very generous with her time, sometimes to a fault where, you know, it's, let's take care of yourself before you help others.

[Lauren Bright Pacheco]

Mila quickly realized she needed to focus on herself when she began noticing subtle signs that something was off. Katie and, as always, was there from the start. Witnessing the onset of symptoms that would mark the beginning of a new chapter in Mila's life.

[Mila Clark]

I was about 25 when I first started to notice some of my symptoms. And it really, for me, was something that I sort of brushed off. I was thinking, I'm young, I work out almost every day. I'm pretty conscious about what I eat. I don't drink. I'm in probably the best health of my life physically, but I just feel awful. I feel really tired all the time. I feel like I just don't have any energy. And that, to me, felt really odd and really strange. And I remember ignoring those feelings for a long time.

[Katie]

She was working a really stressful job, so I think that was a really easy way to kind of write it off as, oh, I'm just becoming into myself as an adult. Like, it's stressful, I'm tired. So it's really easy to chuck all of the things up to that, you know, and even doctors, when she would go just for like a normal checkup would be like, yeah, get some more sleep, get some more exercise.

[Mila Clark]

At the time, I was in my first real job out of college, and I was dragging myself through working 50 or 60 hour weeks at times, and I probably need to take a vacation, I probably need to drink more water, just take a little bit more care. And my partner at the time was really adamant, like, this is not normal and you probably need to go and see someone, at the very least to go get a checkup and see what's going on.

[Lauren Bright Pacheco]

Mila was drawn to her work at a nonprofit focused on community development initiatives, where she tackled disaster recovery, health care access, and immigration logistics. She faced these challenges during one of Houston's most devastating events in recent Hurricane Harvey, which brought 52 inches of rain and widespread destruction.

[Mila Clark]

We were running one of the biggest shelters in the city, and that required getting information out so that people knew where they could go, how they could be helped, what they could do if they just lost everything. And so it was a really, really stressful time. And I was the only one on the team doing social media, so I was working around the clock. And in that time period, we're getting hundreds of messages every 15 minutes about where people should go, what they should do, and I am having to hop on that crisis response. And so my job was like that all the time.

[Lauren Bright Pacheco]

So you're on call basically 24 7, reacting in real time to crisis, which put your life in crisis, I'm sure, pretty much.

[Mila Clark]

I felt often like I could lay down and sleep for 24 hours and I would wake up and I would still be tired. No amount of rest or sleep felt like it helped me stop being tired. And then I was also experiencing a lot of physical symptoms. So I was extremely thirsty and I could drink like 2 gallons of water a day and still not feel like my thirst was quenched. I was losing weight pretty rapidly in mass amounts over time, and I at the time was like, well, this is good, because, you know, every woman is like, you know, I'm losing weight, I look good, I'm fine, but I felt awful. The other thing that I kept noticing was that when I would sleep, I would wake up, like, drenched in sweat, my entire body. And I was just like, maybe it's anxiety. You know, I kept thinking, like, if I wait long enough, it'll pass. It'll just go away, and I'll be fine.

[Lauren Bright Pacheco]

There is a kind of denial that's easier than proactively seeking answers where you decide, I'm healthy, I am doing the best I can, and this will pass. What for you was that wake up call of something's really wrong. I have got to see a doctor.

[Mila Clark]

I was in the kitchen cooking one day, and I was by myself, and I fainted. And I came to, I woke up, I was really confused, and I was like, I don't know what just happened, but I know that's not normal. And so I told my partner about it, and he was like, book the appointment, take the day off of work, go to the doctor and get checked out. Because that's really scary and, like, it's not okay that that's happening to you.

[Lauren Bright Pacheco]

Yeah. And so tell me your first experience with going to the doctor and trying to explain what's going on.

[Mila Clark]

So I walked into the doctor's office and explained to him my symptoms. I told him about fainting in the kitchen. I told him about just how I was feel overall. And he said, okay, well, it doesn't look like you've had blood work done almost ever as an adult, so let's start there and kind of get the baseline and see what's going on. And that same afternoon, I get a call back from the doctor's office, and I missed it. But I don't think that they call you if everything is okay. I was a bit nervous and anxious to make the call back, and when I did, I talked to the nurse who had looked up my chart, and she said, your blood sugars are extremely high. They are through the roof. It is at a dangerous level, and you need to come back to the doctor's office immediately so he can walk through treatment with you. And so at that point, I had no idea what it was. And I heard high blood sugar, and I was just like, I don't even know what that means. Like, I don't even know how I would know. My blood sugar's high.

[Lauren Bright Pacheco]

Mila spent the night grappling with a heavy sense of uncertainty, her mind racing with questions. What could be wrong? What could have caused all this? What is she supposed to do now?

[Mila Clark]

And so I rebooked an appointment for the next day and sat down with a doctor, and he tells me, you have type 2 diabetes and this should not be happening to you at this age. And this means that you are not doing the things that you are supposed to do to live a healthy life. And I was just like, this is a lot of judgment, but also, like, you have not even explained what this means to me, and I have no idea what you're talking about or how this even comes up or how you even determine this result. And so the first conversation that I'm having about diabetes with this care provider is about amputations and about potentially losing my kidneys and having to go on dialysis and all of these things that are, like, so shocking and scary. And I walked out of there thinking, like, am I going to die today? Like, I had all of these questions, but I felt too ashamed to ask them in that moment because I was like, well, he's literally telling me that I have, like, ruined my body and ruined my life, so I don't really know where to go from here. I just started bawling because I was so scared and frustrated.

[Lauren Bright Pacheco]

After she was diagnosed, initially, she said that you were one of the first people she called. Can you just tell me about that phone call and what you felt the need to convey?

[Katie]

I was like, I don't think that that's a condition that you get when you're in your 20s. You either have it when you're a little kid. Type one or older people usually are diagnosed with type two. That's weird. You're 26. Like, how is this just now happening or happening already? And so I was like, I don't know. That seems, like, not right, you know? And she's like, well, that's what the doctor said. So, you know, it's probably true.

[Lauren Bright Pacheco]

Mila left the doctor's office with a handful of brochures and a deep sense of shame. Her blood sugar levels were nearly double what they should be. She recalled watching her mom managed diabetes with insulin injections and a careful diet. Suddenly, everything became clear.

[Mila Clark]

I was just like, I've ruined my life, and now I don't know what to do, and I don't even know where to start and how to make this better. I'm just terrified about all of the outcomes that my doctor has told me. Like, this is what's going to happen to you because of where you are with your blood sugars. I just felt really by myself, and I felt like I couldn't quite express what I was feeling, But I knew that I wanted to write it down, and I knew that I wanted to kind of document what I was going through. And then I also wanted to find people who were like me.

[Katie]

And so she started hangry Woman, which is her blog and YouTube channel and Instagram and everything to create content to document and also like, for her own accountability, her lived experience with diabetes.

[Mila Clark]

I was wondering, like, how do other people my age balance and manage this? There are millions of people living with diabetes. I'm sure somebody is my age and I can find them and meet them.

[Lauren Bright Pacheco]

On that note, being a self proclaimed journalism geek and a communications gal. The hangry woman, where did the name come from?

[Mila Clark]

So the name came from my partner because one of the side effects of having diabetes is being hangry. It's like needing and wanting to eat because your cells aren't absorbing the glucose from your bloodstream. And so I, in the early stages of my diagnosis, was quite cranky all the time. And so my partner at the time had said, yeah, you're just like such a little hangry woman. And I was like, that would actually be just like a really funny name.

[Katie]

And she got a lot of positive feedback from that, but also there was a lot of negative feedback. And you know, you can't judge a person by the way they look, but people on the Internet do. So to put herself out there in such an intimate way like your health, your numbers being so public is brave.

[Lauren Bright Pacheco]

With the diagnosis in hand, Mila finally had a path forward. Supported by a growing community desperate for results, she threw herself into the fight. With determination and focus. I can tell what a positive driven, go getter mentality you have. So you set out to be the best type 2 diabetes patient ever. And what happens?

[Mila Clark]

Basically, it gets worse. And so I am at the point where I'm worse, working my hardest. I'm working out twice a day, running, walking, biking, skateboarding, like doing everything, getting active, being outside, and also changing my diet. And I was exhausting myself and not eating enough. I wasn't giving myself enough energy to get through the day. I was still just as tired, just as thirsty, just as sweaty. And then I went back for my A1C results three months later from my initial diagnosis and my A1C had dropped by 1 percentage point. And I'm like, I failed. I don't know how much harder I could work. The only thing that I could do is like be in a different body.

[Lauren Bright Pacheco]

The A1C test, also called HbA1C, measures your average blood sugar over a two to three month time span and is key for diagnosing and managing diabetes and prediabetes. MILA's slight 1% drop is now making her doctor skeptical. Back in the office, Mila is under scrutiny.

[Mila Clark]

My Doctor said, clearly you are not doing what you're saying you're doing, because if you're coming in here with your blood sugar logs that say one thing and your A1C says something else, you are not doing what you're telling me you're doing. And I was like, I promise I am. Like, I have my. My fitness pal log here. You know, you can see everything that I'm doing. Everything that I'm eating, I'm tracking to my detri. It's so frustrating and so triggering and alarming to have to track every single thing you eat, have to prick your fingers five or six times a day to draw blood to get your readings, like, I'm doing the work.

[Lauren Bright Pacheco]

Well, there comes that shame and guilt, you know, implying that you're not being honest as to the actual steps you're diligently taking, what went through your mind, your body?

[Mila Clark]

I think I was just angry, to be quite honest, because I felt like with everything else that I had ever done in life, I put in the work, and I get a good result, and I was doing everything that I thought I knew how to do. And then I got the result back, and it was disappointing.

[Lauren Bright Pacheco]

After seeing little improvement, Mila started medication to lower her blood sugar. The medication only managed to drop her blood sugar by one more percentage point. Six months after her diagnosis, her levels were still not within a safe range. As the months turned into years with little improvement, Mila not only faced physical challenges, but also began internalizing the stigma surrounding type 2 diabetes. Three months later, her levels had only dropped by another 1%, still far from safe.

[Katie]

I think we were ordering pizza, and this. This person who isn't an acquaintance, not anyone close to her, said, really, in a snarky tone, are you sure you should be eating that? And both of us whipped our head around, like, did you just really say that? Like, first of all, I don't think anybody should be commenting on what anybody else is eating, period. I just couldn't believe the audacity of it. And I don't exactly remember what happened, but I remember that Mila's attitude towards that moment was, like. It was shock. But I can only imagine how hard that is to be already so concerned about all of your data, all of your numbers, all of your blood sugars day in and day out. That person doesn't know if she ate nothing for breakfast and a salad for dinner. And this is what she's calculating to eat for lunch because she knows that she's out.

[Mila Clark]

Katie was probably, like, the most supportive person that I could ever interact with in that moment because she gave me understanding and kind of like hyping me up like a best friend does.

[Lauren Bright Pacheco]

Mila recalled another time when she tried to discreetly take her insulin while out to dinner, only to be accused of doing drugs at the table. Sadly, this was becoming her reality. Living with type 2 diabetes, endocrinologist Dr. Artie Thungadu strives to holistically understand her patients. Recognizing the effects of diabetes go far beyond physical symptoms. Do you remember when you first crossed paths and your first impressions of Mila?

[Dr. Artie Thangadu]

Yeah. So I had been following along her journey on social media for a long time, probably before she ever knew who I was. She so poignantly and clearly and honestly describes the patient experience. And as a physician, I just feel like that is so valuable and important for us to see because the way our healthcare system is now, there's this huge divide between doctors and patients, and the time to build a relationship in the traditional healthcare setting just isn't there. She just so clearly tells her story openly and honestly. And so it was several years ago that I had heard of her, and then we were able to work together.

[Lauren Bright Pacheco]

After four years of trials, setbacks, and frustration, Mila was still searching for a treatment that could bring real results. Relief. From battling dangerous blood sugar levels to dealing with the social stigma of type 2 diabetes, she had fought hard every step of the way. With no clear solution in sight, Mila was growing desperate.

[Mila Clark]

I know it wasn't like intentional ridicule, but it felt like ridicule. It felt like I'm walking into this situation where I know I'm just going to be berated because my number is not good enough. And so here I am thinking like, okay, this is exhausting, but I'm working so hard and I'm doing this, and then I go and it's 1% lower. In that moment, I felt so almost embarrassed, and I felt stigmatized.

[Lauren Bright Pacheco]

We'll be right back with Symptomatic A Medical mystery podcast.

[Katie]

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[Lauren Bright Pacheco]

Now back to Symptomatic A Medical Mystery podcast. Mila initially dismissed her exhausting and debilitating symptoms as mere work stress before being diagnosed with type 2 diabetes at an unusually young age. Determined to lower her blood sugar levels, which were nearly double the normal range, she became obsessive. She worked out several times a week and meticulously tracked what she ate, but Nothing lowered her A1C levels more than a couple of percentage points. Four years into her quest for relief, Mila had pushed her commitment to the extreme.

[Mila Clark]

There was one point where my A1C numbers were better, but my health was not. And it was this point where I basically stopped eating because I was like, this is the only thing I know how to do, and it's the only thing that I feel like is going to work. And when I don't eat, my blood sugars are in perfect range, so maybe that's what I need to do. And I was literally, like, malnourished. Like, I wasn't getting enough food, I wasn't getting enough energy. I was only drinking water or tea or coffee, and my brain was just in a tailspin, like I couldn't function.

[Lauren Bright Pacheco]

What did you decide you were going to find when you set out to find a new doctor?

[Mila Clark]

I know that if I find someone who looks like me, they will listen to me and they will be more likely to understand where I'm coming from, to understand my culture, to understand where I am and what I've been doing. And my doctor said, what did you do? Like, this is a drastic change. And I said, well, I'm not eating anything. And she was like, anything. And I was like, I mean, water, ice, coffee. And she was just like, no, no, no, no, no, no.

[Lauren Bright Pacheco]

Was there at any point that you thought maybe this isn't the right diagnosis?

[Mila Clark]

I didn't, but my doctor did. She was incredible. Once I brought my whole encyclopedia of Mila's diagnosis to her, and I said, this is the story. This is what's happening. We tried a couple of different treatment options, and they didn't work. And there was a point where she said, I think I might be at capacity with you. And that's not because of you. It's because I don't think that I know enough to correctly provide you a treatment plan. And I think that you need to go see a specialist so that we can get more information, we can understand where you are and they can give you a treatment. And she was like, I am happy to manage treatment with you. Once a specialist really lays that out.

[Lauren Bright Pacheco]

The doctors willingness to listen to Mila's story, acknowledge the limits of their expertise, and still take charge of her treatment gave her the confidence she needed. For the first time, Mila felt she had found the right connection to finally get some answers. She was referred to a new endocrinologist to review her entire symptomatic record.

[Mila Clark]

I was able to explain I have this really long, almost five year history of having type 2 diabetes. And I have tried oral medications, I have tried not eating, I've tried eating basically only lettuce. I have tried exercise. I've tried everything that I know how to try and I am still not getting better. My A1C is still not in the range that it needs to be. And I am so frustrated. And so he asked me, you know, well, what's frustrating? He was so great about just like asking me questions as a human being rather than staring at my chart. After I told him everything, he asked me, when you were initially diagnosed, did they confirm your diagnosis? And I was like, I did not know that you could confirm it. I just thought you get a number and you know whether you're in range or not, if you have diabetes or not. And he said, no, it's pretty odd and off for you to have a type 2 diabetes diagnosis even though you have a family history. It's strange for your age. And so I want to confirm your diagnosis. And he said, I don't think that you have type 2 diabetes. I think that you have something else.

[Lauren Bright Pacheco]

Mila specialist ordered a blood panel test for four specific auto antibodies that appear in response to high A1C blood sugar levels. This test helps determine the type of diabetes a person is dealing with and would provide Mila with the clarity she'd been seeking for years.

[Mila Clark]

I get the results back about a week later and it turns out that I have what's called lada, latent autoimmune diabetes in adults. It's a slow progressing form of type 1 diabetes.

[Katie]

She was actually at my house and she opened her phone when she got the results of the labs, when she got rediagnosed and that she did have the beta cells that prove that she doesn't have type two. And I could just see the relief on her body, like, shoulders drop. And it was just so frustrating because she went through years of struggling that she probably didn't have to, but also just so satisfying that like, okay, well, now at least I know, and I can probably change my treatment plan in order to actually start seeing progress.

[Lauren Bright Pacheco]

The exhausting commitment to treatment, the stigma, the mental roller coaster. Mila's entire understanding of her health had been flipped upside down by this new diagnosis. Dr. Ardi Thangadu, the endocrinologist Mila had worked with on diabetes education campaigns, explains the various types and treatments of diabetes.

[Dr. Artie Thangadu]

We are learning that there are types of diabetes that we haven't even discovered yet. Diabetes is a complicated diagnosis. The two most common ones that we hear about are type 2 and type 1. Type 2 diabetes is more connected with metabolic syndrome, lifestyle related, but there are huge genetic factors. It's not like people are choosing to have diabetes. Right? And so type 2 diabetes is caused by insulin resistance. So the blood sugar gets high and that can wreak havoc on basically all of our organs, our heart, kidneys, nerves, feet, eyes, things like that. Type 2 is usually a more gradual onset, and if treated well and early, it can actually be put into remission. So that is the most common type of diabetes. And type 1 is autoimmune diabetes, Usually where the body has seen the insulin producing cells in the pancreas as other and it targets those and destroys them. So the body doesn't produce any insulin at a certain point. And for these patients, they usually present fairly acutely. Sometimes they end up in the hospital with a very, very high blood sugar and they need insulin to survive.

[Lauren Bright Pacheco]

That's a great breakdown of type 1 and type 2 diabetes as we often understand them. So what specifically is lada?

[Dr. Artie Thangadu]

With latent autoimmune diabetes of the adult, it's a little bit more gradual, and so there's a lot of room for misdiagnosis with type 2. And then it just continues to progress to the point of enough beta cells being destroyed, insulin production being low enough that patients end up on insulin within the couple of months as opposed to a couple of weeks.

[Mila Clark]

When I learned that the way to get your diagnosis confirmed was a blood draw like I had taken a million times, I was so mad because I was like, just double checking could have changed the trajectory of my health overall. And I'm so lucky because over that time I didn't go into diabetic ketoacidosis, which is when you don't have Enough insulin in the body, your blood turns into acid. It's the way that most people get diagnosed. I didn't have to go through that. I don't have any major complications of diabetes at this point, but I could have. I'm just lucky that my doctor knew what Lada was and that he suspected it from what I told him.

[Lauren Bright Pacheco]

Oh, my gosh. So at that point, for one sixth of your life, basically, you have been disappointed, diligently trying to treat something you didn't have.

[Mila Clark]

Yeah. And that was mind blowing to me. I think a lot about the time period that I went through in terms of being diagnosed. And I wonder a lot if I hadn't walked into the doctor's office as an overweight black woman with a family history of type 2 diabetes, would they have asked different questions to make sure that I got the right diagnosis the first time? Or did I just walk in looking like every patient that they have ever seen who lives with type 2 diabetes? They said the numbers match up. We don't really have to check.

[Lauren Bright Pacheco]

In the case with Mila, because she was diagnosed early to mid-20s, automatically they went to type two. Is that a common misconception? Because we've spoken about one and two, but there are other types.

[Dr. Artie Thangadu]

So if someone came to my office and they had diabetes in their early 20s, there is no way type 1 would not be on my radar because type 2 diabetes is slow and progressive. And so, unfortunately, in Mila's case, and I don't agree with these things, but she had a lot going against her. Right. She had race going against her body, habitus going against her, and gender going against her to get great healthcare. I think we know that certain racial populations, women, women of color, don't get the same healthcare as our male counterparts, our white male counterparts. And so, unfortunately, she was in a situation where we, as a healthcare community, don't do the best job.

[Lauren Bright Pacheco]

Mila finally had the correct diagnosis, offering her both relief and a clear path forward. She began with manual insulin injections before eventually transitioning to an insulin pump for greater control over her blood sugar levels.

[Mila Clark]

Personally, it was finally that breath of fresh air. And I, over time, built the confidence to be like, okay, I'm cool with wearing a device. I have my watch on that, like, displays my glucose numbers, and so I can, like, see what's going on and see how I'm doing and where I need to take breaks. And I feel like, personally, it's made me slow down a lot, and it's made me take so much better care of Myself, because I feel like I can actually live a relatively normal life and not have to struggle with eating or with over exercising or with like the shame of feeling like I have failed. And I actually just like, I get to live. And that's pretty cool because I think about like that five year period where I was not living. I was a shell of myself. I don't feel like I had like enough energy to just be myself.

[Lauren Bright Pacheco]

But you seem to have pulled some energy from the community you created with Hangry Woman. What has been so rewarding about that outreach and response?

[Mila Clark]

I think the best part has just been that I personally have found that I'm not alone. And I have found that other people are dealing with a lot of the same things and they're dealing with it in a silo because they maybe don't have a friend like Katie that they can talk to or a family member who gets it, or they feel that same exact stigma. And they're just looking for somebody who understands and who's not going to judge and who can really just like, help them grab their bearings. And I think one of the, like, best things that ever came out of creating Hangry Woman is the community that I have.

[Dr. Artie Thangadu]

It's connecting the dots. And her story, it totally sucks, but she has used it to propel her own life forward and she's also been such a vocal advocate for this. And so social media is so great in that way that there's a whole type one community. And I know that they hate on doctors all the time, but I still love that there's a community out there supporting each other who are living with this day in, day out and giving each other tips and tricks and support and stuff like that. So, yeah, it's just amazing to see the level of advocacy that you can really do for free now.

[Mila Clark]

I do all this myself and sometimes I'm like, why do I even do this? Like, it doesn't even make a difference to anybody. And then I get a message and I'm like, okay, no, I'm doing the right things for the right reasons. And if somebody can walk away with a diabetes diagnosis and they can feel excited about the future rather than dreading what the future holds, then it's all worth it.

[Katie]

She gets these stories back from people that, you know, the fact that you shared this post or you this video or this Instagram story is what made me go ask the doctor about my own symptoms. And I got diagnosed and now I have knowledge and stories like that are really like, what keeps her going and makes her feel so proud of herself for continuing to post.

[Lauren Bright Pacheco]

What do you hope for the future of diabetes treatment?

[Dr. Artie Thangadu]

I'll say my biggest overarching hope because we could get really nitty gritty here. But I hope that we move to a more empathetic, patient centered approach to diabetes with more access to specialists. And my hope is to make endocrinology a field that is desirable for clinicians to go into and physicians to go into so that we can truly utilize our expertise to treat the most pressing chronic condition of our time. Diabetes is the most expensive chronic condition that we facing as a country. It is so prevalent. So I hope that we recognize the importance of diabetes to people's lives, to the economy, and we treat it in a specialist, forward manner that is patient centered.

[Lauren Bright Pacheco]

Mila, what do you want people to take away from your story?

[Mila Clark]

Particularly, I think really it's to fight for yourself and if, if you feel like something is wrong, yes, your physician and your care team are experts, but you live in the body that you live in every single day and pay attention to those signs. And even if it's frustrating, don't stop pushing. Hopefully pushing gives you an answer in less than five years. But if something feels off, it's probably off. And it's okay to say I disagree and get another opinion and get another opinion and get another opinion until either it's confirmed for you that you are where you are or that it really changes the trajectory of what your health looks like and you get to be in a better place because of it.

[Lauren Bright Pacheco]

You can find more on Mila's story, her online community and many delicious [e-mail] in honor of World Diabetes Day on November 14, check out worlddiabetesday.org to learn how you can can support and advocate for diabetes awareness every day.

[Mila Clark]

My name is Mila Clark and I was misdiagnosed for five years and I was re diagnosed and properly diagnosed with latent autoimmune diabetes in adults or LADA, a slow progressing form of type 1 diabetes.

[Lauren Bright Pacheco]

Next week on Symptomatic, we're back with another edition of Symptomatic House Calls. For this house call, we are revisiting case number 13, Alicia from season two. For those who haven't heard this episode, a quick spoiler alert. Alicia was diagnosed with plaque psoriasis, a chronic autoimmune condition that causes thick raised patches of skin. Join us as we catch up with Alicia to hear her latest life updates and learn how she's continuing to manage her plaque psoriasis.

[Mila Clark]

Self esteem, it comes Confidence and self worth are universal themes that you really have to focus on in your life outside of chronic illnesses. It's just so imperative to have that love for you and confidence for yourself day to day.

[Lauren Bright Pacheco]

As always, we would love to hear from you. Send us your thoughts on this episode or share a medicine mystery of your own@ symptomaticheartmedia.com and please rate and review Symptomatic wherever you get your podcasts. We'll see you next time. Until then, be well. Symptomatic is a production of Ruby Studio from iHeartMedia. Our show is hosted by me, Lauren Bright Pacheco. Executive producers are Matt Romano and myself. Our EP of post production is James Fox Foster, our supervising producer is Ciara Kaiser, our writers are John Irwin and Diana Davis and our editor is Ciara spreen.

[Katie]

Join me, Dr. Panico with Cyndi Lauper and chef Michelle Bernstein to talk about plaque psoriasis and psoriatic arthritis, the potential connection and risk of developing permanent joint damage.

[Dr. Panico]

Cosentyx Secukinumab is prescribed for adults with moderate to severe plaque psoriasis 300mg dose and adults with active psoriatic arthritis 150mg dose. Don't use if you're allergic to Cosentyx before starting, get checked for tb, serious allergic reactions, severe skin reactions that look like eczema and an increased risk of infections, some fatal have occurred. It may lower your ability to fight infections, so tell your doctor if you have an infection or symptoms like fevers, sweats, chills, muscle aches or coughs. Had a vaccine or plan to or if IBD symptoms develop or worsen. Learn more at 1844cosentyx or cosentyx.com Cindy.