For 30 years, endocrinologist Dr. Usman Ahmad has been treating people with diabetes.

Five years ago, he became one of the treated.

Dr. Ahmad, the director of the Lions Diabetes Center at UPMC McKeesport, was careful not to treat himself because, as he put it, physicians completely lose objectivity and are the worst patients.

"When we have a little cough, we think we have lung cancer," he noted. "When we have lung cancer, we think it's a mild bronchitis."

So that first morning when he confirmed his suspicion that his blood sugar levels were elevated, Dr. Ahmad took a deep breath, sat down and prayed, "God, give me the strength to be a good patient." Then he contacted a colleague to be his diabetologist and scheduled his first appointment with a diabetes educator.

Since then, "I have been a very, very good patient," he said. "I have done everything that I preach to my patients on a daily basis."

That means Dr. Ahmad sees his doctor every four months and keeps a close watch on his A1C, a blood test that reflects average glucose levels over many weeks. Although he knows diabetes "inside and out" and teaches students to specialists both locally and nationally, he defers to his doctor's judgment.

"I am allowed to discuss different options, but I will never ever take action without explicit approval of my physician," Dr. Ahmad said. "That probably is the single most important thing that will help me stay healthy."

Employing a "don't flaunt, don't hide" philosophy in his practice, he neither routinely tells his own patients that he, too, has type 2 diabetes, nor hesitates to share his experience if he thinks it will help. He knows firsthand now how challenging it can be to live with the condition.

"I had to learn, I used all the different syringes, I used pens, I experienced hypoglycemia," Dr. Ahmad said. "I became more knowledgeable in different ways."

His sugar was so high when he was diagnosed that insulin injections were the only appropriate treatment. After several months, he was able to switch to pills to control his blood glucose.

Dr. Ahmad, 62, of Churchill, wouldn't have predicted three decades ago that he himself would have diabetes, even though his father and two maternal uncles did. But in addition to a possible genetic predisposition, immigration to the United States from Pakistan may have played a role in his development of diabetes.

People from the Indian subcontinent, comprised of India, Pakistan, Bangladesh, Sri Lanka and other South Asian nations, are at greater risk for getting type 2 diabetes, even when they don't meet North American criteria for overweight or obesity.

When Dr. Ahmad, who was an inch shy of 6 feet tall, came to this country in 1969 as a medical intern, he weighed about 160 pounds and had a flat, even sunken, belly. During the next 15 years or so, he gained about 18 pounds. His body mass index, or BMI, was still less than 25, the threshold to be considered overweight.

Still, "the latest scientific research in the last decade has told us that bulging belly is directly related to heart attack, heart disease and stroke," Dr. Ahmad said. "So even though I might be under 25 BMI, the belly is bad news. Watch your belly even if you don't want to step on a scale or do this measurement for your BMI."

Lifestyles are changing in the subcontinent and high-fat foods that used to be cheaper and more available in Western countries are becoming more commonplace, he added. Also, exercise and activity, when it occurs, tend to be structured in the West, rather than part of an ordinary day.

"The message for the subcontinent population is, look at your genetic history and look at your weight and activity," Dr. Ahmad said. Taking an old-fashioned approach to eating and exercise might be correct from the perspective of genetic heritage.

Dr. Ahmad's grandfather told him stories about walking eight miles in about 90 minutes, each way, to attend his paralegal classes. "He died when he was coming back from work at age 81," Dr. Ahmad said. "He was hit by a car driven by a drunk driver."