Diabetes Organizations Contribute to Complications

Yes, I am making this accusation and it makes sense to me. Why else would people of importance in the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE) speak so confidently about type 2 diabetes not needing to test regularly and to rely on their A1c results only.

Dr. Robert Ratner, past chief scientific and medical officer of the American Diabetes Association and Alan J. Garber, M.D., Ph.D., Professor of Medicine, Biochemistry & Molecular Biology, and Molecular & Cellular Biology at Baylor College of Medicine, Houston, Texas are both recipients of money from Big Pharma. I also have to wonder if they also receive large sums of money from Big Food, Big Agriculture, and Big Chemical. These two doctors and others within these organizations received big sums of money to limit what most patients can do. To date we have not heard from the new officers in the ADA or AACE.

This is why they insist that we do not test to make the complications happen. This in turn is a favor to the rest of the doctors to give them patients to treat. It is a shame that the insurance industry has to go along with the pronouncements of these doctors, but they are in the business of showing a profit. Therefore, their leaders are more than happy to limit testing supplies. What they do not realize is that the complications will cause greater expenses in the future than the test strips will cost now.

This is part of the reason I have such a dislike for the people in the ADA and the AACE that are in a position to influence guidelines and position statements. This in turn affects most of the actions of other healthcare professionals in the American Association of Diabetes Educators (AADE) and the Academy of Nutrition and Dietetics (AND). This is also the reason most of their members do not talk about testing or promote testing.

This leaves people with type 2 diabetes who cannot afford extra test strips, managing their diabetes in the dark without the means to use testing supplies that will aid them in more efficient diabetes management. These patients will not be able to determine the most reliable time to test postprandial and often find it impossible to test in pairs to help them decide how a meal affects their blood glucose levels. Those of us that have been able to do this have found that we are better able to manage our diabetes.

We have found that by reducing the number of carbohydrates consumed, we are better able to manage our diabetes. Yet both members of the AADE and AND continue to promote carbohydrates and reduced fat and this makes diabetes management more difficult for most people with diabetes. Yes, the ADA has opened the door for low carbohydrate consumption, but the members of these organizations have yet to put this into practice. Maybe the officers have accepted this, but the general membership still follows the old guidelines and the two organizations have not produced new position statements to affirm to the membership the acceptance of anything but the prior guidelines.

All of this creates an uphill battle for people with diabetes that desire to manage diabetes at a level to prevent complications. It is still possible, but takes more effort and education, which most with type 2 diabetes do not receive. Most are required to self-educate to be able to manage their diabetes.

Diabetes Complications and Preventing – Part 2

Eye Damage (Diabetic Retinopathy)

To protect your vision, see an eye doctor at least once a year. He should dilate your pupils while you're there. People with type 1 diabetes who are older than 10 should start these visits within 3 to 5 years of diagnosis. If you have type 2 diabetes, make an appointment as soon as you’re diagnosed. If you have problems, you’ll need to go more often. If you get pregnant, schedule a comprehensive exam during the first trimester and a follow-up later in your pregnancy.

Gastroparesis

Diabetes can damage the nerves that control your stomach so they stop working properly. Known as gastroparesis, this condition causes it to take too long to empty. That makes it hard for you to manage blood sugar levels. Sometimes a change in diet can help. There are medications and other treatments, too.

Erectile Dysfunction

Diabetes makes men more likely to get erectile dysfunction or become impotent. Sometimes all you need to do is adopt a healthier lifestyle, quit smoking, exercise regularly, and reduce stress. It's important to talk to your doctor about these problems. He can suggest medications or remedies like a vacuum constriction device and other products.

Skin Problems

Many people with diabetes will have a skin condition related to it at some time in their lives. The sugar in your blood provides a perfect breeding ground for bacteria and fungi. It also lowers your body's ability to heal itself. Fortunately, most of these problems can be prevented and treated if caught early on. If you have type 2 diabetes and don’t take care of yourself, a minor scratch could turn into a serious infection.

Infection

Type 2 diabetes slows your body's ability to fight infection. High sugar levels in your body's tissue means bacteria grow more easily and infections set in more quickly. Common sites for them are your bladder, kidneys, vagina, gums, feet, and skin. Early treatment can prevent serious complications.

Dental Problems

The less controlled your blood sugar is, the more likely you’ll have problems in your mouth. That’s because the disease harms white blood cells, which are your body's main defense against oral infections. Brush, floss and rinse with antiseptic mouthwash each day. See your dentist for regular cleanings and checkups.

Diabetes Complications and Preventing – Part 1

How to Prevent Diabetes Complications

If you have diabetes, you spend a lot of time keeping it under control. That’s good because it can cause a lot of complications that can affect nearly every organ in your body. Learn what you can do to prevent these problems.

Heart Disease

This is one of the most common diabetes complications. In office visits, your doctor may do tests that screen for heart disease to help you prevent serious problems. At every visit, he’ll check your blood pressure. He’ll probably test your blood for cholesterol level and triglycerides at your first visit. And he should do an EKG as part of a complete medical record. Learn more about your risks for heart disease. Does it run in your family? Do you smoke? Make a prevention plan that includes weight loss, regular exercise, and stress management, as well as keeping your blood pressure, cholesterol, and triglycerides at normal levels.

What Are the Complications of Diabetes?

Stroke

Symptoms of a stroke include:

• Sudden weakness on one side of the face or body
• Numbness in the face, arm, or leg
• Trouble speaking
• Trouble seeing
• Dizziness

If you have any of these, see a doctor immediately. He may refer you to a neurologist or other stroke specialist.

Kidney Disease (Diabetic Nephropathy)

If you have diabetes, get your urine tested every year to look for kidney disease. Your doctor should do a creatinine blood test to check how these organs are working. He’ll also check your blood pressure regularly. It's key to slowing this disease. Your reading should be less than 130/80.

Nerve Damage (Diabetic Neuropathy)

Over time, diabetes can cause nerve damage. You might feel numbness, burning, or pain in your hands, feet, or legs. If your skin loses feeling, you may not notice small wounds that could grow to become bigger ones. Check these parts of your body daily for redness, calluses, cracks, or other damage. If you notice any of these symptoms, tell your doctor right away.

Complications of Uncontrolled Diabetes

It can take work to get your diabetes under control, but the results are worth it.  If you don't make the effort to get a handle on it, you could set yourself up for a host of complications. Diabetes can take a toll on nearly every organ in your body, including the:

• Heart and blood vessels
• Eyes
• Kidneys
• Nerves
• Gums and teeth

#1. Heart and Blood Vessels Heart disease and blood vessel disease are common problems for many people who don’t have their diabetes under control. You're at least twice as likely to have heart problems and strokes as people who don’t have the condition are.

Blood vessel damage or nerve damage may also cause foot problems that, in rare cases, can lead to amputations. People with diabetes are ten times likelier to have their feet and legs removed than those without the disease.

Symptoms: You might not notice warning signs until you have a heart attack or stroke. Problems with large blood vessels in your legs can cause leg cramps, changes in skin color, and less sensation.

The good news: Many studies show that controlling your diabetes can help you avoid these problems, or stop them from getting worse if you have them.

#2. Eyes Diabetes is the leading cause of new vision loss among adults ages 20 to 74 in the U.S. It can lead to eye problems, some of which can cause blindness if not treated:

• Glaucoma
• Cataracts
• Diabetic retinopathy

Symptoms: Vision problems, sight loss, or pain in your eye if you have diabetes-related eye disease.

The good news: Studies show that regular eye exams and timely treatment of these kinds of problems could prevent up to 90% of diabetes-related blindness.

#3. Kidney Disease Diabetes is the leading cause of kidney failure in adults in the U.S., accounting for almost half of new cases.

Symptoms: You might not notice any problems with early diabetes-related kidney disease. In later stages, it can make your legs and feet swell.

The good news: Drugs that lower blood pressure (even if you don't have high blood pressure) can cut your risk of kidney failure by 33%.

#4. Nerves Over time, high blood sugar levels can harm your nerves. As many as 70% of people with diabetes get this type of damage.

• Peripheral diabetic neuropathy can cause pain and burning or a loss of feeling in your feet. It usually starts with your toes. It can also affect your hands and other body parts.
• Autonomic neuropathy stems from damage to the nerves that control your internal organs. Symptoms include sexual problems, digestive issues (a condition called gastroparesis), trouble sensing when your bladder is full, dizziness and fainting, or not knowing when your blood sugar is low.

The good news: You have many options to treat your pain. The doctor might prescribe an antidepressant, a medication that stops seizures (called an anticonvulsant). He could also give you drugs that go on your skin, like creams or patches. He might suggest you use a device that stimulates your nerves called TENS (transcutaneous electrical nerve stimulation).

#5. Teeth Having diabetes puts you at higher risk for gum disease.

Symptoms: Your gums might be red and swollen and bleed easily.

The good news: If you keep your blood sugar under control, visit your dentist regularly, and take good care of your teeth each day by brushing, flossing and rinsing with an antiseptic mouthwash. In doing so you can avoid gum problems and tooth loss.

Take Charge of Your Condition  Some people have to make only small lifestyle changes to keep their blood sugar under control to reverse a diabetes complication. Others need medications to stop them from getting worse.

Treatment of complications focuses on slowing down the damage. That may include medication, surgery, or other options.

The most important ways to slow diabetes complications are to keep your blood sugar levels under control, eat right, exercise, avoid smoking, and get high blood pressure and high cholesterol treated.

Diabetes 'Experts' Forcing Complications on Patients

Yes, I am making this accusation and it makes sense to me. Why else would people of importance in the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE) speak so confidently about type 2 diabetes not needing to test regularly and to rely on their A1c results only.

Dr. Robert Ratner, chief scientific and medical officer of the American Diabetes Association and Alan J. Garber, M.D., Ph.D., Professor of Medicine, Biochemistry & Molecular Biology, and Molecular & Cellular Biology at Baylor College of Medicine, Houston, Texas are both recipients of money from Big Pharma. I also have to wonder if they also receive large sums of money from Big Food, Big Agriculture, and Big Chemical. These two doctors and others within these organizations received big sums of money to limit what most patients can do.

This is why they insist that we do not test to make the complications happen. This in turn is a favor to the rest of the doctors to give them patients to treat. It is a shame that the insurance industry has to go along with the pronouncements of these doctors, but they are in the business of showing a profit. Therefore, their leaders are more than happy to limit testing supplies. What they do not realize is that the complications will cause greater expenses in the future than the test strips will cost now.

This is part of the reason I have such a dislike for the people in the ADA and the AACE that are in a position to influence guidelines and position statements. This in turn affects most of the actions of other healthcare professionals in the American Association of Diabetes Educators (AADE) and the Academy of Nutrition and Dietetics (AND). This is also the reason most of their members do not talk about testing or promote testing.

This leaves people with type 2 diabetes who cannot afford extra test strips, managing their diabetes in the dark without the means to use testing supplies that will aid them in more efficient diabetes management. These patients will not be able to determine the most reliable time to test postprandial and often find it impossible to test in pairs to help them decide how a meal affects their blood glucose levels. Those of us that have been able to do this have found that we are better able to manage our diabetes.

We have found that by reducing the number of carbohydrates consumed, we are better able to manage our diabetes. Yet both members of the AADE and AND continue to promote carbohydrates and reduced fat and this makes diabetes management more difficult for most people with diabetes. Yes, the ADA has opened the door for low carbohydrate consumption, but the members of these organizations have yet to put this into practice. Maybe the officers have accepted this, but the general membership still follows the old guidelines and the two organizations have not produced new position statements to affirm to the membership the acceptance of anything but the prior guidelines.

All of this creates an uphill battle for people with diabetes that desire to manage diabetes at a level to prevent complications. It is still possible, but takes more effort and education which most with type 2 diabetes do not receive. Most are required to self-educate to be able to manage their diabetes.

Lessons for People New to Type 2 Diabetes, Part 13

The last topics can be real problems for people new to diabetes. The first reference is my blog on the summary of diabetes basics which will take you the topics you may wish to read. It even has many of the topics covered in this series.

If you are new to diabetes, learn about hypoglycemia and hyperglycemia. I know many people will say that people on most oral medications, except the class sulfonylureas, do not have to worry about hypoglycemia and in general they could be right. But add insulin or some of the other injectable medications to just about any oral medication without a reduction in oral medication dosage could cause hypoglycemia. If you are on insulin, hypoglycemia is a real and dangerous possibility.

Hyperglycemia is the unreasonable elevated level of blood glucose and if your blood glucose does not stay elevated for an extended period, you may not have any adverse results. However, if the level remains elevated for several weeks, then you will be promoting the complications of diabetes.

Both hypoglycemia and hyperglycemia can both be the cause of death if diabetes is not managed. Hypoglycemia, if severe, is the cause of more deaths, but hyperglycemia, if not managed, can also cause death.

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 affects the eyes, neuropathy affects the nerves, nephropathy affect the kidneys, and deafness affect the small blood vessels in the inner ear.

Medical alert jewelry is something many people with type 2 diabetes just do not want. This I do not understand. Some on insulin do have the jewelry and are happy they do. However, most on oral medications do not because they don't see the necessity. If you are involved in an accident, at work or in an automobile, think of what might happen if you are unable to speak for yourself. Oh, you don't think any harm will happen. Well, guess again, as the emergency medical technicians may just hook you up to an IV containing glucose and your blood glucose may rise significantly. What may happen if you are unable to speak for yourself for a week or longer?

I wear a necklace with my information on it. I have had to show it only once and that was overseas. Once they looked at it, there was no further problems. I have heard some horror stories about people with type 2 diabetes being involved in auto accidents that did not have diabetic or medical alert jewelry and were harmed because of this.

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