December 25, 2010

Medically Induced Diabetes

What is this you say? Why would anyone allow diabetes to be induced. It is one of the types of diabetes that is recognized by the American Diabetes Association (ADA). I feel that there is one exception that is not officially recognized by the ADA, but still exists in daily life.

I will start with the not recognized diabetes which I will emphasize is not considered by the ADA. This is when an accident happens which severely damages the pancreas making it incapable of insulin production. This does not happen that often, but there are a few individuals in this unofficial category.

The medically induced is simply called – Drug- or chemical-induced diabetes. There are apparently many drugs that can impair insulin secretion, but not cause diabetes by themselves. These drugs can start diabetes in people with insulin resistance. When this happens, the classification is difficult because the sequence or importance of the beta-cell dysfunction and insulin resistance in unknown.

Some toxins like Vacor (a rat poison) and intravenous pentamidine can destroy pancreatic beta-cells, but these are rare. There are many drugs and hormones that can affect insulin action. A list (see here) in table one is not all-inclusive, but includes the more commonly recognized drug-, hormone-, or toxin-induced forms of diabetes.

When I was told recently that a friend had medically induced type 2 diabetes, I had to look this up. There is only a classification of medically induced and no type associated with it. I am not going to debate this until the ADA does more clarification or assigns a type. Then there is diabetes resulting from prescription steroids.

Medically induced diabetes is still diabetes and must be treated as such. Some are treated with oral medications and the rest with insulin depending on the damage done to the pancreas. Most of the few that have accident caused diabetes are on insulin.

Read the ADA definitions here.   This definitions for the above discussion are about one-third to one half way down the page.

December 22, 2010

Learn How to Manage Holiday Stress

Many people are telling us how to minimize the stress of the holiday season. Some are excellent, some are okay, and others almost seem to create more stress than help reduce stress. I am looking as this as a person with diabetes. What works for some may not work for all us. Stress makes management of blood glucose levels more difficult.

This article fits and includes many of the criteria for reducing stress. The most important point is not forgetting to take care of ourselves. There are many points that can be included in taking care of ourselves. These also work for minimizing depression. Learn to manage your diabetes routine and expectations to make the holidays enjoyable.

Make sure that you maintain a good sleep schedule. This means not shorting the amount of sleep and getting the eight hours needed each night. Sleep deprivation is a negative factor in managing your blood glucose levels and can make it more difficult.

Avoid overeating or loading up on carbohydrates. This will force blood glucose management out the window. Know you limits and stick to them. If you must have the extra piece of desert or extra serving of your favorite food remember to plan for some exercise before eating and some light exercise after eating to help burn the extra carbohydrates. Those of us on insulin have a much easier time, but we still need to be careful of the extra carbohydrates.

This is important – know your limits. Avoid family gatherings that include airing family issues and grievances. It is often better to miss these gatherings than feel resentful for days afterward. It is better exercising restraint beforehand than dealing with problem relatives and letting them raise your blood pressure.

Rather than staying late at gatherings, leave early when necessary to allow yourself some time unwind and relax before bed time. Allow time for taking a walk if possible or other types of exercise. Take a good hot shower or soak in the tub to wash the day's stress away. In other words, take care of yourself first and don't let little things become mountains.

Learn to budget your time and patience for the holidays to get the most enjoyment out of them for you. If you have something that reduces the stress for you, do it. You are worth it!

I cannot leave this without adding another reference that may reduce the food stress for the holidays. Even though the author does not have diabetes, he knows how to adapt for diabetes. His blog has a practical way to handle the eating stress many of us feel during the holidays. Though he probably was not thinking stress, his blog has some excellent tips. I use many of them, but never thought of them the way he presents the ideas.

Happy holidays!

December 21, 2010

Seasons Greetings



To all my readers

May you have a happy holiday season


Have a Merry Christmas!

and

A Happy New Year!


The blog will continue during the holidays. I wanted to take this opportunity to greet everyone and wish you happy holidays.

December 20, 2010

New Vitamin D Standards

Once in a while, I seem to do something right. When the first information came out on the new standards for vitamin D from the Institute of Medicine (IOM) I wanted to scream. To me they seemed to be missing the point and I thought maybe I should not write about this and set it aside. Now about three weeks later, I am glad I did not throw this reference away.

After reading several other blogs by doctors, I know as a patient that I am not out in left field for wanting to believe that many people that I like to read their blogs could not be wrong for as many years as they have been doing this. So hopefully I will not mess this up in the explanation.

First, I have been reading David Mendosa for several years and he is not bashful in recommending high quantities (International Units - IU) of vitamin D. He does tell people to find their own levels and not necessarily follow his example. Several others who shall remain nameless take Vitamin D, but not quite as high IU. Now the IOM has just raised the recommendation. The recommendation is here and because I now understand what they have done, I am still upset. The IOM level is still only a maintenance level to prevent deficiency only.

Doctor William Davis did an excellent task of pointing this out and referring to another Doctor about the topic of vitamin D. Dr. Davis also refers to another website about vitamin D. So like me, you have your reading ahead, but I feel that you will better understand the need for vitamin D and the levels suggested.

I am not sure of where to suggest starting your reading, but I would start with the recommendation above and then read three of the blogs by David Mendosa. Blog 1, Blog 2, and Blog 3. Or if you want to read more later go to the main site and use the search tool that he has on his time and type in vitamin D.

Next I would suggest reading the blog by Dr. Davis here. Then follow the links he has in this blog. Finally, read this by Dr. John Cannell.

I have to appreciate these bloggers for using common sense in recommending higher levels of Vitamin D that the IOM. It is discouraging to realize than the IOM just recognizes the minimum levels to prevent deficiency and not giving us levels for optimal health which could be set as a range – deficiency prevention to optimal health.

I find that the doctors recognize that about 30 minutes in the sun gives us about 10,000 IU of vitamin D. They also recognize that vitamin D is a hormone that was miss identified but important enough that the term vitamin has been left in place. So when they mention taking 5000 IU this is not out of line.

However, most physicians only see the recommendations of the IOM and get upset with us when they find out the number of IU we are taking. I do feel fortunate that my endocrinologist is knowledgeable and even suggests higher levels during the winter that I am currently taking.

I suggest bookmarking the reference links if this topic is of interest to you. Links in other blogs mention above but not listed by me yet include: link 1 and link 2.