I am a bit disappointed in the response to the first blog on Type 2 diabetes needing their own organization, but just in the comments. The emails were only from one person and not very friendly.
Outside of the need to have an organization for those of us with Type 2 diabetes, I had hoped to get some more objectives and goals that would give us more ideas. So with that in mind, I will attempt to list a few of them and hope that we can draw some responses.
Besides raising funds for research, finding the proper research venues will be a big priority. There seems to be some areas that are coming to light now that may need more exploration that may lead to keys for managing diabetes. Being more accurate in the diagnosis of diabetes should not be overlooked as the ADA has opted to support the A1c test only.
Something will need to be done for educating the medical profession in being more aggressive in diagnosis, early treatment, and follow up. See this for some hope. Patient education also needs to be strongly promoted. I am not sure how this would be best accomplished, but one suggestion would be on line resources. This could be accomplished by having pamphlets or booklets that every doctor or endocrinologist can hand out when diagnosed.
Sadly in need of education are the insurance companies in preventative medicine and early work for patient education, patient followup, and working with other doctors for overall health. This may include, heart disease prevention, sleep apnea, kidney health, neuropathy, eye health, and many other related areas.
Research will need to be done to find out what other people with diabetes want for support, what education they want and need, and what services would better serve them. I suspect some work will be needed with government agencies, medical groups, and diabetes manufacturers of all types.
Because of the problems specific to women and to men, there should be special education and on line help for each. Education will need to be considered for the younger people now being diagnosed with Type 2 diabetes.
Education programs will need to be developed for hospitals and elder-care facilities. This will develop new standards for how patients with diabetes should be treated, allowed to be self-medicated while in these facilities, and procedures for reducing errors in IV solutions and medications. The attitudes of hospitals does need to be adjusted in many situations.
There has to be more objectives and goals. Help!
October 28, 2010
Which sweeteners are you consuming?
When I started this, I had no idea what I was getting into. The way the sweeteners are looked at and discussed varies more than a person might think. Much depends on site objectives and manufacturer influence. Sugar and sweeteners are generally viewed as a poison by some groups, and should not even be looked at for people with diabetes irregardless of type. So those articles have been ignored as I wanted something that made some sense and might be of interest.
While the glycemic index values may vary from what I have located, generally they are within a few points in the sources checked. A few values could not be found and I used (??) to indicate that. The value can also change when processed differently as in pasteurized and raw honey. The GI values listed are therefore only guides and can vary depending on method of processing.
Various sweeteners Glycemic Index Value
Sugar GI 80
Other calorie containing sweeteners:
all have approximately 15 grams of carbohydrates per teaspoon
Honey, pasteurized GI 75
Raw Honey GI 30
Maple syrup GI 54
Pancake syrup GI (??)
Malt syrup GI 42
Karo syrup GI (??)
Corn sweeteners GI 62
Molasses GI 58
Jellies GI (??)
Jams GI 46
Marmalades GI 55
Agave syrup, nectar GI 15
Brown Rice syrup GI 25
Brown sugar GI 64
Fructose GI 22
Lactose GI 46
Glucose GI 96
Blackstrap Molasses GI 55
Stevia – FOS Blend GI <1
Artificial sweeteners GI <1
Name Brands
Aspartame NutraSweet, Equal
People who have a condition called phenylketonuria should avoid
this sweetener.
Acesulfame K Sunett, Sweet One, Swiss Sweet
Sucralose Splenda
Saccharin Sweet'nLow, Sugartwin
Avoid this sweetener if you are pregnant or breastfeeding
Sugar alcohols - These are neither sugars or alcohols, but pure carbohydrates. Examples of common sugar alcohols are maltitol, sorbitol, isomalt, and xylitol and are called “polyols”. There are other manufactured sugar alcohols, but these occur naturally in plants. This article explains more on sugar alcohols.
The key to non-artificial sweeteners is to use in moderation. Overuse of any sweetener is not good for maintaining tight management of diabetes and for many people will cause weight gain.
The above information is knowledge you should make use of when reading labels. While the GI values will not be listed, these are listed here to hopefully give you ideas when you are looking at labels. This article in WebMD may answer some more questions.
While the glycemic index values may vary from what I have located, generally they are within a few points in the sources checked. A few values could not be found and I used (??) to indicate that. The value can also change when processed differently as in pasteurized and raw honey. The GI values listed are therefore only guides and can vary depending on method of processing.
Various sweeteners Glycemic Index Value
Sugar GI 80
Other calorie containing sweeteners:
all have approximately 15 grams of carbohydrates per teaspoon
Honey, pasteurized GI 75
Raw Honey GI 30
Maple syrup GI 54
Pancake syrup GI (??)
Malt syrup GI 42
Karo syrup GI (??)
Corn sweeteners GI 62
Molasses GI 58
Jellies GI (??)
Jams GI 46
Marmalades GI 55
Agave syrup, nectar GI 15
Brown Rice syrup GI 25
Brown sugar GI 64
Fructose GI 22
Lactose GI 46
Glucose GI 96
Blackstrap Molasses GI 55
Stevia – FOS Blend GI <1
Artificial sweeteners GI <1
Name Brands
Aspartame NutraSweet, Equal
People who have a condition called phenylketonuria should avoid
this sweetener.
Acesulfame K Sunett, Sweet One, Swiss Sweet
Sucralose Splenda
Saccharin Sweet'nLow, Sugartwin
Avoid this sweetener if you are pregnant or breastfeeding
Sugar alcohols - These are neither sugars or alcohols, but pure carbohydrates. Examples of common sugar alcohols are maltitol, sorbitol, isomalt, and xylitol and are called “polyols”. There are other manufactured sugar alcohols, but these occur naturally in plants. This article explains more on sugar alcohols.
The key to non-artificial sweeteners is to use in moderation. Overuse of any sweetener is not good for maintaining tight management of diabetes and for many people will cause weight gain.
The above information is knowledge you should make use of when reading labels. While the GI values will not be listed, these are listed here to hopefully give you ideas when you are looking at labels. This article in WebMD may answer some more questions.
October 25, 2010
Hospital Awareness for People with Diabetes
Since the this post, more information keeps coming to light that people with diabetes need to be aware of when entering the hospital. There are some nasty situations that can arise even when the hospital is aware that you have diabetes. The nasty problems are life threatening if the hospital is unaware that you have diabetes.
If you are having an IV(intravenous therapy), please make yourself aware of what will be in the IV. You will want to be sure that dextrose or other sugars are not part of the IV. The IV should be saline, but many are five percent dextrose. For people without diabetes no harm will be done. For people with diabetes, this will play havoc with blood glucose levels (BG) management. Depending on how many you will be given, it could raise your BG to levels higher than manageable immediately, even with insulin, and will require close management for at least 24 hours or more.
So it does not matter whether you are Type 1 or Type 2, be careful of what you are given in your IV's. To assist in maintaining your independence and preventing the inadvertent problems, you should ask your doctor and the hospital administration for release forms to allow you to medicate yourself and to maintain control of your diabetes management. Drives hospitals crazy, but protects them as well as you.
Another area of concern, if you are having any surgeries, will be the medications you will be given (if any), and how they will react with BG levels. There are many medications that can raise BG and you should talk to the surgeons or physicians about your concerns and what medications you may be given.
If enough preparation time, have you doctor find out and discuss the medications you will be given. Be prepared to adjust your insulin needs or oral medications while in the hospital and your doctor can be of great assistance in making adjustments easier to handle. David Mendosa presented the list from Diabetes in Control dot com. This is a very good list to be aware of and use.
If you have surgeries that will involve body part replacements, steroids will probably be involved and this should be known. Steroids will elevate BG levels and for those on insulin, careful watch needs to be done and sometimes extra testing of BG is needed to adjust insulin. Those on oral medications should actually consider using insulin to manage BG levels while on steroids. If staying on oral medications, consult your doctor for dosage and possible addition of other oral medications.
Never be afraid to ask questions and ask for the advice from your doctor or endocrinologist as this assistance may keep you from making some serious mistakes. You may need to schedule another appointment to get this all in, but it will be worth the time and peace of mind for you. If you need to stand your ground, be ready to – it is your health.
This is worth repeating from the previous blog – try to get your medications approved and be prepared to sign any waivers necessary to have them with you. You will still need to guard them carefully. A local legal case brought this home for me. Patient had his medications approved and special warnings put on his chart and records that the medications were to be left with the patient as they were not available in the hospital and patient was allergic to certain comparable medications.
Evening shift nurse thought she knew everything and confiscated his medications and disposed of them in the medical waste. When this was discovered, the patient was suffering from an allergy attack from a substituted medication. When the doctor discovered this and the fact that his medications were gone, at least he had an internal investigation started. Outcome was patient recovered and needed three extra days in hospital at no cost, nurse lost her job, and hospital was out some money in the legal case plus had to replace the destroyed medications.
It is sad that only the bad get the publicity and those that do their jobs do not get the recognition they should. The attitude of the evening shift nurse does happen to be prevalent in more cases than we would like to acknowledge. I am not into speculating what the reasoning for this is; however, hospitals are beginning to slowly realize that with patients who are advocates for themselves, they must listen and facilitate, plus have the nursing staff in full cooperation mode.
The above is all written with the fact that you have knowledge of what is to happen and when. Remember that if you enter the hospital under emergency conditions, then hopefully your spouse, good friend, or other family member can act for you and determine that the above in handled for you. I will mention the limited medical power of attorney again to make sure that those you trust are able to act for you. They must be prepared to act for you and see to your health until you are able to assume that role.
If you are having an IV(intravenous therapy), please make yourself aware of what will be in the IV. You will want to be sure that dextrose or other sugars are not part of the IV. The IV should be saline, but many are five percent dextrose. For people without diabetes no harm will be done. For people with diabetes, this will play havoc with blood glucose levels (BG) management. Depending on how many you will be given, it could raise your BG to levels higher than manageable immediately, even with insulin, and will require close management for at least 24 hours or more.
So it does not matter whether you are Type 1 or Type 2, be careful of what you are given in your IV's. To assist in maintaining your independence and preventing the inadvertent problems, you should ask your doctor and the hospital administration for release forms to allow you to medicate yourself and to maintain control of your diabetes management. Drives hospitals crazy, but protects them as well as you.
Another area of concern, if you are having any surgeries, will be the medications you will be given (if any), and how they will react with BG levels. There are many medications that can raise BG and you should talk to the surgeons or physicians about your concerns and what medications you may be given.
If enough preparation time, have you doctor find out and discuss the medications you will be given. Be prepared to adjust your insulin needs or oral medications while in the hospital and your doctor can be of great assistance in making adjustments easier to handle. David Mendosa presented the list from Diabetes in Control dot com. This is a very good list to be aware of and use.
If you have surgeries that will involve body part replacements, steroids will probably be involved and this should be known. Steroids will elevate BG levels and for those on insulin, careful watch needs to be done and sometimes extra testing of BG is needed to adjust insulin. Those on oral medications should actually consider using insulin to manage BG levels while on steroids. If staying on oral medications, consult your doctor for dosage and possible addition of other oral medications.
Never be afraid to ask questions and ask for the advice from your doctor or endocrinologist as this assistance may keep you from making some serious mistakes. You may need to schedule another appointment to get this all in, but it will be worth the time and peace of mind for you. If you need to stand your ground, be ready to – it is your health.
This is worth repeating from the previous blog – try to get your medications approved and be prepared to sign any waivers necessary to have them with you. You will still need to guard them carefully. A local legal case brought this home for me. Patient had his medications approved and special warnings put on his chart and records that the medications were to be left with the patient as they were not available in the hospital and patient was allergic to certain comparable medications.
Evening shift nurse thought she knew everything and confiscated his medications and disposed of them in the medical waste. When this was discovered, the patient was suffering from an allergy attack from a substituted medication. When the doctor discovered this and the fact that his medications were gone, at least he had an internal investigation started. Outcome was patient recovered and needed three extra days in hospital at no cost, nurse lost her job, and hospital was out some money in the legal case plus had to replace the destroyed medications.
It is sad that only the bad get the publicity and those that do their jobs do not get the recognition they should. The attitude of the evening shift nurse does happen to be prevalent in more cases than we would like to acknowledge. I am not into speculating what the reasoning for this is; however, hospitals are beginning to slowly realize that with patients who are advocates for themselves, they must listen and facilitate, plus have the nursing staff in full cooperation mode.
The above is all written with the fact that you have knowledge of what is to happen and when. Remember that if you enter the hospital under emergency conditions, then hopefully your spouse, good friend, or other family member can act for you and determine that the above in handled for you. I will mention the limited medical power of attorney again to make sure that those you trust are able to act for you. They must be prepared to act for you and see to your health until you are able to assume that role.
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