July 10, 2012

Back to Diabetes Basics – Part 5

Diabetes Complications

Complication don't cause themselves. Poor or no management of diabetes – meaning not testing, not losing weight, not eating healthier, not making other lifestyle changes, and no blood glucose management is what causes the complications. So what are the complications?  Retinopathy, neuropathy, nephropathy, atherosclerosis, and deafness are the most common, and many don't include deafness. The first three and deafness are grouped together under the term microvascular complications because they result from damage to the small blood vessels. The macrovascular complication is atherosclerosis, which is caused by damage to the large blood vessels.

Retinopathy causes damage to the retina, which may lead to poorer eyesight or blindness. Neuropathy causes damage to the nerves, which cause pain and can be more than annoying pain. Nephropathy causes damage to the kidneys or increased renal problems leading to kidney failure or chronic kidney disease (CKD). Deafness or hearing loss is caused by the eardrum losing the ability to transmit sound because of short blood supply. Atherosclerosis can lead to heart attacks, stroke, or poor healing of wounds in the feet and legs. This is the cause of amputations.

These are the reasons those of us that blog about diabetes for people with type 2 diabetes discuss this so often. We are encouraging you to manage your diabetes by maintaining your blood glucose levels at or as close to normal as possible to prevent the complications from starting. The closer your A1c is to 7.0 percent or above, the greater the chances are for the complications developing. That does not mean that people with A1c's of 6.0 will not develop complications, just that their risks are smaller and increase the closer to 7.0 they become. Above 7.0, the risk of complications rises dramatically as A1c's goes up.

That does not mean that once you have an A1c above 7.0 that you give up. By managing your diabetes more carefully and bringing the A1c back to 6.0 or lower, you can stop the complication from progressing or slow it dramatically. Damage will still likely have been done, but if stopped or slowed, you may not notice any change and if early enough your body may be able to heal the damage. Continued forays above 7.0 may mean that the damage will become worse and your body may not be able to heal or repair the damage. Keep a positive attitude about managing your diabetes and work to manage your diabetes and not diabetes managing you.

Diabetes Myths

Diabetes myths are a dime a dozen and I keep hearing about them again and again. Why people have to believe them is not something I understand. I was not exposed to many of them until after I had diabetes for a year and had been on insulin for about as long. I knew immediately when confronted with them by a person that is no longer a friend that there was little or no truth in what he was telling me. In an hour, I lost track of the number of myths he was repeating and finally had to ask him to leave.

That evening after cleaning up after my evening meal, I did go on the computer looking for some of what this person was telling me. Even then, there was not a lot of information about some of what he said. I started looking on David Mendosa's website, but even he did not have a lot in December 2004 about what we refer to now as myths. I did locate this item and it got me started looking for more. Eventually I did find a site that today no longer has the page David wrote about, but back then, it was as David described it, “While several Web sites around the world have a page like this, Diabetes UK's is the best and most authoritative of any that I've seen.”

I now wish I had copied the page, as I am no longer able to locate it. They covered a lot of myths and then gave an authoritative explanation. There were sites that listed myths with no explanation, but many were like or similar to things my visitor had sought to enlighten me. The following evening, he returned with a fresh list and wanted to educate me with his diabetes knowledge. I patiently informed him that these were myths and had no basis in fact or scientific evidence. He went ballistic on me and said I did not know what he was talking about and if I truly had diabetes, I would understand what he was saying. With that, I walked him to the door and informed him that I had diabetes and was on insulin. “Oh,” he said, “I did not know you were that close to the end.” I then told him to leave and never come back if he was going to talk about diabetes.

I have also blogged about diabetes myths. Rather than repeat them, I will link them and let you read them - Blog 1, Blog 2, and Blog 3. Another blog that talks about a myth here and then this one on insulin and weight gain which is often a fact for many people, unless they are aware of the things to do right and prevent this from happening. One myth that I find little to support was told to me by a diabetes educator and it was that type 2 people could not see an endocrinologist. Funny, I see many type 2 people having appointments with an endocrinologist.

Diabetes Scams and Scammers

Diabetes is ripe with scams and scammers. To get you started, read this article by David Mendosa. In the article, the government list no longer is a valid link, but David did list some of them and I don't know if they all work, but I like the list just for show of the types of sites trying to scam us. Many more have appeared since David wrote this in October 2006. Some sites are very slick in their design and enticing to any readers they can lure to their sites. I have had several email me in the last year wanting me to advertise their products. After a thorough investigation of their site and the claims some make, I can see right through the scam or falsehood, if you will allow.

I am unlike David and I will not even give you a link to any scamming site as I will not give them any notice since they do not deserve being noticed. Yes, I could educate you by listing them, but I don't need the hate mail several of them are well known to retaliate. There would still be readers that would fall for some of the information so I feel better not listing them.

If you think these are the only types of diabetes and other scammers, guess again. Tom Ross has a blog here that uncovers some that are involved in research and scamming funds to do research. I was almost in disbelief, but after checking with a couple of sources within the pharmaceutical industry, they confirmed this blog, but would not be specific about what had been done.

Food for Diabetes Patients and Introduction to Glycemic Index

This is not a topic to be taken lightly by people with type 2 diabetes. However, the one comment I get all too frequently is, “the doctor just told me to eat more healthy,” or “my doctor said nothing about what foods to eat or not eat.” I often have to wonder if this is selective hearing, or the doctor really did say nothing. I know many doctors are not knowledgeable in nutrition for people with diabetes so this is possible. I also know some people bypass the appointments for a class in nutrition and feel it is too late for them to change. Unhappily their A1c results are reflective of their habits – above 8.0 and often much higher.

Even though I am a little over expressive in this blog on diabetes diet, it still covers some important points. Another blog is here. I have mentioned the glycemic index for foods. The best reference is here in the books blog, The New Glucose Revolution, New York, Marlow & Company, 349 pages, by Dr. Jenny Brand-Miller, et al. It is in a sense the best available currently.

Do take time to study the glycemic index tables for foods. Do not believe these are gospel because the index is determined by testing normal people and not people with diabetes. Do use it only as a guide for determining which foods may rapidly raise your blood glucose. By using your search engine, there are many available (key words – glycemic index). Table sugar has a glycemic index of 80, so compare that to the white potato.

My words of warning are good, and a guide is what it should be. It is not about complete food nutrition and is good for giving you guidance to foods that will not spike your blood glucose levels.

Series 5 of 12

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