DNA, diabetes and family destiny

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The Cabrera family say their goodbyes after an evening of discussing their diabetes complications in their late parent’s house. (Kristen Cabrera/WHYY)

The Cabrera family say their goodbyes after an evening of discussing their diabetes complications in their late parent’s house. (Kristen Cabrera/WHYY)

Ever since I can remember, my father has had diabetes. Pricking his finger and checking his blood sugar is part of his morning routine.

I was raised in the Rio Grande Valley — about five hours south of Austin, Texas. It’s an area on the Texas/Mexico border that is almost 90 percent Hispanic.

All seven of my dad’s sisters and brothers were diagnosed with Type 2 diabetes. I talked with four of them.

Macario Cabrera Jr. was diagnosed in 1992.

Blanca Cabrera was diagnosed in 1999.

Arty Cabrera was diagnosed in 2000.

Adam Cabrera  was diagnosed in 1996.

My father, Aaron Lee Cabrera, is the oldest. He’s 61, and was diagnosed with diabetes in 1996.

The other siblings are Tio Edgar, who’s had diabetes for 18 years. My Tia Yvette had diabetes for 10 years. But back in 2014 she had weight loss surgery, and doesn’t have it anymore. Carrying extra weight or being obese are big risks for diabetes.

Tio Eliud, the baby brother of the bunch, was diagnosed in 2002 and lived with it for five years before he died of colon cancer.

Honestly, no one in my family knew about the connections between colon cancer and diabetes. But one study found that patients with diabetes and colon cancer have shorter lives — by about five years— than people who have colon cancer, but no diabetes.

“It’s funny listening to all my brothers and sisters because it’s like we all got diagnosed around the same time,” my dad says.

The American Diabetes Association recommends most people get screened around age 45. In my family, people typically get diagnosed around age 37.

Being Hispanic is a risk factor for diabetes. But being of Mexican descent, like we are, is an even higher risk. That’s not the only pattern that I noticed. My aunts and uncles experienced a lot of the same symptoms.

Junior and Bianca both described bleeding from their eyes, and so did my dad.

“Now I’ve also got diabetic retinopathy,” he says. “It’s like when your blood vessels are bursting in the back of your eyeball.”

As a family, we are all pretty used to dealing with the many complications that come with diabetes. Still, it’s a scary thing to know your father is bleeding from his eyes. And we really weren’t prepared when my grandmother’s health started spiraling after one small cut.

“She had a fall and cut her toe,” my dad remembers. “We didn’t know she cut her toe when she fell.”

The wound got worse and worse. It began to sink in for my dad and the rest of family that this was really serious. The daily drop-ins at the doctor’s office wouldn’t be enough to take care of her anymore. She was going to need 24-hour care in a nursing home.

One week, she fell three times.

“We had to call EMS because we could not lift her up, she was so heavy,” my dad says.

“She was pretty close to 300 pounds. And her doctor came in and they decided they’re going to really need to amputate some toes. So after a week, maybe two weeks, they saw that her gangrene had not stopped and so they figured they had to remove her left leg up to her knee, and that’s what happened, eventually.”

Blanca remembers being really uncomfortable about the amputation.

“I work at the hospital and I had to ask the doctors, ‘Do not let me see mom’s foot.’ Ugh it just, it scares the crap out of me.”

My dad says that watching his mother go through all that taught the whole family a lot.

“We all know that we don’t want to go down that path. As we saw how Mom suffered, and that’s agonizing.”

My aunts and uncles each have their own questions about what happened for my grandmother.  Adam wonders why she went through such an ordeal.

“She had help with her insulin, but she wasn’t very active,” he muses.

Blanca doesn’t understand why things changed for her so quickly. “See, years before she used to walk,” she says. “I don’t know what happened. One day she just stopped.”

“Mom went down hill really after Eliud died,” says my dad, and Junior agrees with him.

“She didn’t care after that,” my dad says.

Ultimately, my grandmother’s complications lead to heart failure. She died in January of 2016. Her death affected all of us.

I wonder if her passing has been a warning to my aunts and uncles: Take control of your diabetes.

“Seeing what Mom and Dad were going through, it was hard,” Blanca says. “And it was very depressing I guess. And I guess because of that I wasn’t taking care of myself. So now that Mom and Dad are gone and they’re in a much better place, now I have to focus on me.”

“We’ve even talked about it,” my dad says. “For me, personally and what I heard from my brothers, we’re just exhausted. We’re so tired. I wish I had more energy.”

I’m hoping our family talk helped everyone connect the dots a bit.

Caring for yourself— your body, your emotions — it all matters when you are trying to live well with diabetes.

I definitely see some of our family patterns in me: Years of morning breakfast tacos loom over me. I’m overweight. I’m heading into my 30s. I don’t ever really exercise.

But I don’t want my DNA to control my destiny.

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