December 6, 2014

Have Diabetes – Be Cautious of Electric Blankets

Yes, please be cautious! Why? If you have had diabetes for a few years or developed neuropathy before your diabetes diagnosis, you may have problems detecting if the blanket gets too hot. Burns can happen according to M. Regina Castro, MD at the Mayo Clinic.

Dr. Castro says, “Over time, excess blood sugar can injure the walls of the tiny blood vessels (capillaries) that nourish the nerves. This can cause tingling or numbness that usually begins at the tips of the toes or fingers and over a period of months or years gradually spreads upward. Left untreated, it's possible to lose all sense of feeling in the affected limbs.”

The above means you may not be able to sense if an electric blanket or heating pad is too hot. Burns can happen from these and can be very painful. Neuropathy can also make it difficult to tell if bath water is too hot.

If you do not have neuropathy, it is still good to be careful if you have diabetes as about 66 percent do have it. I like the suggestion Dr. Castro gives. She says use the electric blanket to warm up the bed before bedtime. Then turn the blanket off or remove it from the bed before you climb in.

December 5, 2014

Collect Family Health History

As important as family health history is, I still do not understand why the Health and Human Services Department and the Acting Surgeon General Boris D. Lushniak, MD has to wait until just before Thanksgiving to make their announcement. Yes, last Thanksgiving was the eleventh annual Family Health History Day. Over the holiday or at other times when families gather, Americans are encouraged to talk about and keep a record of the health problems that seem to run in their families.

Because this blog is about diabetes, and too often families want to keep this a secret, this is even more important to talk about this. This was driven home in April this year when after an intervention with James, he discovered that diabetes was in his family history. He was not aware of this. In talks with him later, he said this was probably why he had probably been too heavy into denial and why it was difficult for him to accept that he had diabetes.

This is a reminder for everyone to ask firmly, other family members what is in their health history that could be important to other family members. I know what this was like as my mother's family had the secrecy. If it had not been for my father, I may have never known about diabetes being in my family. Granted, two of mother's sisters did confirm this several years later when I asked, but they did not offer the information.

I would say that you should ask for anything that might be in the family medical history as this could be important in the future and if a doctor knows your family history, it could quite possibly save your life. I was fortunate that I did not have to ask too forcefully, but I know a few friends that had problems obtaining medical history from their families. One of them had recently been diagnosed with a rare disease and he had no medical history for either side of the family. Finally after telling an uncle on his father's side about what he had and why he was asking, he was able to get a complete history.

When he gave the history to his doctor, his doctor said he had one test to do and if he was right, he would have a corrected diagnosis in a week. When he heard from the doctor, it was a corrected diagnosis and not a rare disease, but a fairly common one that was related.

I have not used the link provided, but I give it to you for your consideration.

December 4, 2014

Summary of Lessons, New to Type 2, Part 16

This ends the series. Hopefully you have gained some insight into managing your type 2 diabetes and to improve your diabetes management.

Lessons for People New to Type 2 Diabetes, Part 1 - Diabetes rules, Lessons in diabetes

Lessons for People New to Type 2 Diabetes, Part 2 - Diabetes grief, Diabetes support groups

Lessons for People New to Type 2 Diabetes, Part 3 - Care of testing supplies, Hand washing, Testing

Lessons for People New to Type 2 Diabetes, Part 4 - Food plans

Lessons for People New to Type 2 Diabetes, Part 5 - Exercise

Lessons for People New to Type 2 Diabetes, Part 6 - Diabetes knowledge, Learning styles, Variables

Lessons for People New to Type 2 Diabetes, Part 7 - Diabetes learning, Reading sources

Lessons for People New to Type 2 Diabetes, Part 8 - Food plans

Lessons for People New to Type 2 Diabetes, Part 9 - An intervention, Natural substances

Lessons for People New to Type 2 Diabetes, Part 10 - Dental care, Eye care, Hearing care

Lessons for People New to Type 2 Diabetes, Part 11 - Foot ulcers, Leg sores

Lessons for People New to Type 2 Diabetes, Part 12 - Depression

Lessons for People New to Type 2 Diabetes, Part 13 - Complications, Medical alert jewelry

Lessons for People New to Type 2 Diabetes, Part 14 - Diabetes support, Self-sabotaging behavior, Bad habits

Lessons for People New to Type 2 Diabetes, Part 15 - Video Apps, Charges for education

This in no way is a complete listing of topics important for newly diagnosed people with type 2 diabetes to learn. Even the people that have assisted me in gathering information agree and will be looking for more ideas. We would welcome ideas from readers and will add a new series when we have collected more topics.

The links in the Part number will take you to the blog.

December 3, 2014

Lessons for People New to Type 2 Diabetes, Part 15

This will be the next to last blog in the series. After checking the mySugr website a little more thoroughly and looking at the Facebook page, I know that I will not join. Then another blogger had this to say and a different approach to the website. This is how I learned that the site was selling apps to view the videos that were beyond the free introduction videos. This was when I stopped doing more searches.

The following is what I learned on their Terms of Service. I will quote some of this for your information.
3. Downloading the Apps
mySugr offers Apps to the client, namely software that can be downloaded onto his end device. The conditions for downloading the app will be shown on the screen of the end device. The App is necessary in order to use mySugr’s services. The client acquires a non-exclusive right without temporal and geographical restrictions to save a copy of the App for his own purposes on his end device. Updates to the App must be expressly agreed to by the client; such consent may also be provided in advance. The Apps, in their entirety, are owned by mySugr and protected by copyright.
4. Contract for services
Upon registration, the client makes a binding contractual offer which can be accepted by mySugr by activating its services. During the registration process the client must make his name and email address known. The activation takes place via a confirmation email from mySugr, whose instructions are to be followed by the client. mySugr is authorised to refuse the client’s offer without having to provide any reasons.
5. Right of withdrawal
Once activation has been initiated mySugr shall begin executing its services within a maximum of 12 hours. At the time of the activation there is no right of withdrawal (§ 5e Consumer Protection Act, § 5 f Clause 1 Z 1 Consumer Protection Act). In accordance with the regulations of § 5 e Consumer Protection Act the client has the right to withdraw from contracts within seven working days after receiving the goods / from the date of the contract in the case of service contracts. Saturdays do not count as working days. No justification must be provided for the withdrawal and it must in writing; timely dispatch suffices to meet the deadline.
6. Services
Continuously using the services allows the client to gather or get information on his diabetes disease; the services should help increase the client’s awareness. Analysis of the data gathered in this way is the responsibility of the user and his doctor. mySugr expressly indicates to the client that the App cannot replace a medical consultation. mySugr always recommends discussing any questions concerning the disease and its therapy with a doctor. The services are not a recommendation. mySugr does not draw any conclusions from the data results that the client has collected and makes no recommendations.
7. Payment
The usage fee or purchase price shall be calculated by the Online Store. The usage fee or purchase price is payable with immediate effect.
The price information concerns monthly usage charges. Monthly usage charges are due, so long as not otherwise agreed, on the first of every month in advance.
The Online Store shall send the client a receipt which lists the product, the price and mySugr as seller. The purchase and payment process shall take place via the client‘s Online Store account. The Online Store’s GCU, over which mySugr has no influence, apply.
Suspended access due to non-payment:: mySugr retains the right to suspend a client’s rights to the services in instances of non payment or partial payment. The client’s obligation to pay a usage charge remains unaffected.
8. Duration
Unlimited duration: Unless a limited contractual period is indicated on the screen, it is agreed that the provision of services will run indefinitely. A contractual relationship concluded for an indefinite period can be ended by either party by giving 14 days notice.
Limited duration: Prior to the end of a limited contractual period, the client shall be informed of the possibility of an extension. The contractual period will not be automatically renewed. There is no valid future legal claim for free provision of services over a fixed contract period. mySugr reserves the right to revoke such a free subscription at any time.
Free services: mySugr reserves the right to limit free of charge services, to cease them or to make them payable.
9. Availability
mySugr shall perform all services in accordance with the existing technical, economic, operational and organisational possibilities. As a result, mySugr provides no guarantee in connection with any interruptions, disruptions, delays, cancellations, failed transfers or storage failures related to the use of services or communication with the client.

3. Right of Withdrawal
1. According to § 5 e of the Consumer Protection Act, the user has the right to withdraw from a contract within 7 days, starting from the date upon which the goods were delivered to the user or, for service contracts, from the date the contract was concluded. Saturdays are not working days. No reason must be given for the withdrawal but it must be made in writing; timely dispatch suffices to meet the deadline. There is no right of withdrawal when goods are electronically sent as data. In addition, the right of withdrawal does not apply to the delivery of audio or video recordings or of software, where the user has unsealed the delivered data media.
2. In the event that the user exercises the right of withdrawal, he must return the goods if it is possible to send them by post. In this instance the user bears the costs of returning the goods.”

You are welcome to read the entire terms of service on the website.

December 2, 2014

Lessons for People New to Type 2 Diabetes, Part 14

Think about support for the person with type 2 diabetes. This topic is somewhat difficult for many people with diabetes. Not every family is supportive. Blame this on the invisible nature of diabetes. Often teenagers do not understand that a parent has a disease or the hear amputation stories from their friends and believe that you will soon be having that happen to you. The younger children cannot comprehend because they do not see any visible difference in the parent.

This blog shows what can happen when parents know their children well enough to prevent problems until they were older and then drop the news on them. Yes, every family is different. Thought is needed in the method used to discuss a diagnosis with them. This blog discusses a study and what the people with diabetes feels his or her family thinks about their diabetes. This blog covers some useful tips for the person with diabetes and how to manage some situations.

Fortunately, none of our support group members has had support problems. Several of the members know other persons with diabetes that have had family problems and even two that ended in divorce when the spouse would not believe that the other spouse could manage diabetes. Both members believe that the spouse was looking for a way out of the marriage and the other spouse having diabetes gave them that out by developing diabetes.

Self-defeating, self-sabotaging behavior must be human nature or it wouldn't happen with such regularity. No, I am not talking about mistakes, errors, or falling off the wagon in diabetes care, but doing things that are self-sabotaging to your diabetes management. Some of the self-sabotage behaviors include procrastination, self-defeating behaviors, fear, and perfectionism. These were in my blog of August13, 2014. After denial, these behaviors do more damage to managing diabetes than any other activity.

Having said that, bad habits can also do a lot of damage to your diabetes management. Some bad habits are worse than others, but are still bad habits to avoid. A listing of these from my blog on April 29, 2014 include:

  1. Not tracking your blood glucose
  2. Sloppy carb counting or not correctly recording the carbs consumed
  3. Binge eating
  4. Skipping meals
  5. Emotional eating
  6. Avoiding fish in favor of red meat

Completing the list from my blog on April 28, 2014 are the following:

  1. Not learning from mistakes
  2. Saying that the doctor did not say anything about this
  3. Over indulging your sweet tooth

Of these, I hear “Saying that the doctor did not say anything about this” probably more that anything. I admit I do not understand why this seems to be a favorite way that people use to avoid doing something they should be doing.

Now that we are in the holiday season, binge eating, and emotional eating come to the front and these bad habits do a lot to upset the good diabetes management we are accustomed to doing. We are already seeing many people writing about this and encouraging people with diabetes to maintain the good habits, especially during the holiday season. I can only say that we should do our best to maintain control of our diabetes management. Otherwise, the holidays may not be as happy as we want them to be.

December 1, 2014

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.

November 30, 2014

Lessons for People New to Type 2 Diabetes, Part 12

Do you know and understand depression. If you are new to diabetes, this should be on your list of topics to learn about. Since diabetes is a 24/7/365 disease, depression will eventually catch up with you. Yes, a few people can avoid this, but even one person I know finally admitted that depression had caught her off guard and it took a few days for her to realize what had happened. She has had diabetes for over 12 years and was not happy about having even this mild case of depression especially the way it happened.

A.J said that my blog here on interventions – understanding depression helped him and recently he needed to have Jerry read it and several other blogs to help him conquer his minor depression. Those of us in our support group have been excellent learners and we work with each other to help when we have depression. We know we can count on our members to talk about it and this talking helps us through the tough times and gets us back to the positive and happy side.

This is one reason I have been able to do the blogs in this series. A.J, Allen, Barry, and Ben have been exploring the topics and pulling other blogs together for me to write about. Often they suggest thoughts and ideas to include. Even Barry and Ben's sister, Sue, has asked that I include certain women's issues, but would understand if I did not feel like writing about them. She said having diabetes when entering menopause can make some women more susceptible to depression. She said that their cousin was having these problems and was thankful for all the information we had supplied her for her cousin to read and talk about with her. She had been diagnosed with type 2 diabetes shortly after she started menopause. She had depression and her blood glucose readings were difficult the manage at the same time.

Mild depression is often not even paid attention to as a health problem. Many doctors just prescribe an antidepressant and often for too long a period. Depression and diabetes seem to feed on each other and many doctors treat both at the same time and do not follow up to be sure that both are managed properly. A good doctor will treat each separately and make sure that both are properly treated. Some will even recommend seeing a therapist to make sure that the depression is handled properly.

If not treated properly, mild depression can become severe depression and this will lead to unmanaged diabetes. Yes, I am aware of the resistance people have to therapists – they don't like this because they are all wrapped up in the myth that people that say this imply that the disease is “all in your head.” The fact that people with diabetes get depression and often suffer from stress, makes this even more important. Both can make diabetes more difficult to manage and by talking to a therapist can often help reduce stress and make depression more recognizable and easier to get past mild to moderate episodes of depression.

Approximately 67 percent of people with diabetes develop mild to moderate depression and about 19 percent develop severe depression. If this does not give you concern, it should. Depression that lasts for several weeks can undo good diabetes management and encourage the development of some complications. Please get depression taken care of and don't let it ruin you diabetes health.