August 12, 2013

Staying Positive with Diabetes

I cringe when I read blog titles like this “Five Big Diabetes Fears—and What to Do About Them.” Yes, I know, writers prerogative to bring readership, but I still cringed and went on to something more positive to read, which there were a few articles and blogs. I did not need to do much searching. I discovered some positive or what I would term semi-positive news on Medscape titled “Diabetes Not Linked to Dementia.” This does not agree with many previous articles saying that there is a link to Alzheimer's disease, but this study seems very sure of itself.

After reading several more semi-positive articles, I decided to return to this negative blog. I will take the five supposed fears and see if I can make something positive out of them.

#1. Low Blood Sugars This is the one that can cause the most fear for some people. Since I am an insulin dependent type 2, why does this not create fear for me you may ask. Probably because I have not had that many severe episodes of hypoglycemia – only two that were below 50 mg/dl, one at 48 and another at 42. I was able to recover very fast with glucose tablets and did not worry further. Yes, I have had another couple of episodes below 60, but at 58 and 59, I never was overly concerned.

I do understand type 1 people getting concerned when they “rage bolus” with their pumps and don't know how much insulin they may still have had in their systems. I read several type 1 bloggers that seem to be on a yo-yo string of highs and lows in a day and that would scare the dickens out of me. This is why I will stay with my multiple daily injections and think nothing of it.

I have been fortunate to have been supplied with one of the best names in test strips and the meters to compliment them. My episodes of hypoglycemia mentioned above have come when I inject my short acting insulin too close to the last injection of the long acting insulin. I normally realize this as soon as I have put the syringe down and then I take immediate action to prevent the oncoming hypoglycemia. I start testing in the next 15 minutes and repeating at 15-minute intervals. Once I know that a low is happening, I start taking my glucose tablets. I repeat this until the trend is back to the positive side and continue until I am back above 70 mg/dl.

Only one time did I get the shakes so bad that I had trouble wicking the blood into the test strip. Once I drop near 65 mg/dl, I start sweating profusely and I reach for the meter and test strips and start testing. Most of the time, I can correct it with one 15 gram tablet of glucose. But be careful as there are several different types of tablets – from 4 gram to 15 gram tablets. I have been able to locate 15 gram tablets and prefer using them.

#2. Microvascular Complications This is no longer for most people a concern because of our equipment that we have available today. Yet, I look at those that are not managing their diabetes and wonder if they aren't having some real fears. Most type 1 people are trained how to manage their diabetes, as are most type 2 that use insulin. The microvascular complications of loss of sight, nerve pain, and kidney disease are often not a problem for these people unless they are not managing their diabetes.

Now I would be remiss in not being concerned about the type 2 people on oral medications. These are the people that our “experts” degrade and say they should depend on their A1c results for knowing how they are progressing in their diabetes management. Talk about the blind trying to lead. They are slowly forcing these people with type 2 diabetes into the dark because they have no idea of how they are managing their diabetes until they receive their A1c results. Many still don't know because their doctors don't tell them what the results are.

Recently, I was not aware of the panic in our support group when one of Barry's friends came for a visit. He and Barry had been talking about diabetes, but not being very specific. Then the second day Barry asked his friend what has last A1c had been. His friend said he did not know as the doctor had not told him. Barry said the only comment he could remember was something to the effect of watch what he was eating as it was creeping back up. I had been out of town that day and several had been called to see if they could locate an A1c test as the local doctor was out and had not received his order yet. When they finally called me, I was able to stop on my way home and found an A1c testing kit. More about this in another blog.

#3. Macrovascular Complications This is more of a concern than many will admit. Anyone with diabetes is at an increased risk for heart problems, but we still need to be concerned as most doctors shove statins and other medications at us and fight to keep us on them. Why the author did not cover the one area of greatest concern is beyond me. We all need to be aware of atherosclerosis. This can cause poor healing of wounds in your legs and feet. This is the cause of most amputations because they become infected and even more difficult to heal.

#4. Food Changes Many people get all tangled up in the panic panel on this one. Most are type 2 people on oral medications are not given the testing supplies necessary to help them discover what the different foods do to their blood glucose levels. By testing and eating to their meter, they could discover what foods to curtail, eliminate, reduce in quantity, and which they are able to consume in their meal plan. Since there is no specific diabetes diet, food plan, or even guidelines, many people return to eating what they had been eating and away goes their diabetes management.

Each person needs to determine what their bodies can handle and by using their meter can develop a food plan that allows them to manage their diabetes. In this determination, what another person is able to consume may not be what they are able to consume. I will always urge each person to see if their doctor will attempt to get approval for the first six months to be allowed extra test strips or if they are able to purchase the extra.

People on insulin would be better served by finding out what they are able to include in a balanced meal plan and what their meter tells them as well.

#5. Medication Issues Many people become highly agitated when they are told they must take insulin or a pill to help manage their diabetes. Those with type 1 diabetes must inject insulin and they have no choice if they wish to live. Yet, many people with type 2 diabetes, take the prescriptions, stuff them in a purse or pocket, nod to the doctor and as soon as they are outside, head for the nearest health food store, or natural supplement shop and spend money by the fist full for something “natural” that the sales clerk recommends.

What they don't admit is that they have substituted one medication for another medication. Unfortunately, the natural medications will not help them make any improvement in their diabetes and they may or may not return to their doctor until they start to develop some of the complications. But they don't care, they haven't taken any of the prescribed chemicals, so they are happy. I can only say, good luck and don't complain when the complications start.

Then I haven't mentioned those with literacy problems and can't follow medication directions and wonder what is happening when the doctor asks if they have been taking their medications because of little or no improvement in their A1c levels. Most doctors are not working to help those with any type of literacy problems.

In addition, please read these two blogs. The first is about what you need to know immediately after diagnosis and the second is about the best level of blood glucose management.

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