Do You Know This About Diabetes?

Many of the people I correspond with and those members of the support group I belong to know most of this information and many other points. Yet, many people are not familiar with some of this information while others ignore any information about diabetes until it is too late.

Most of the following can be found in reading this.

#1. About one quarter of people with diabetes, don’t know they have it. This is unfortunately true and approximately seven million people have no idea they have diabetes. I would urge people that think they have risk factors and relatives with diabetes to be checked regularly at their doctor's office.

#2. You can reduce your risk of developing type 2 diabetes by losing a moderate amount of weight. If you are overweight, consider losing about 10 percent of your body weight. Exercise is one lifestyle change that is not easy, but losing a few pounds by walking, swimming, or dancing almost every day can help in preventing diabetes. If you have risks, talk to your doctor and make sure he understands you are sincere in your desire to prevent diabetes.

#3. Insulin isn’t just for people with Type 1 diabetes. Right, approximately 30 to 40 percent of people with type 2 diabetes are using insulin. If you are moving from oral medications to insulin, this does not mean you have failed. Fact is, the sooner you start insulin, the better you will be able to manage your diabetes. A popular myth is that starting insulin means you are near to going blind or about to lose a foot. Doctors promote this because they don't know insulin and are afraid of hypoglycemia.

Insulin is the most effective treatment for diabetes and if you keep an open mind, you should be better able to manage your diabetes. If your doctor will not prescribe insulin or says you are failing on oral medications, then it is time to change doctors.

#4. Diabetes is a leading cause of blindness in American adults. I wish this wasn't true for so many people. This happens because people with diabetes do not have a dilated eye exam every year or as often as your eye doctor recommends. It is not recommended to use the eye clinic at your local mall or retail store. If you have retinopathy or diabetic macular edema, there are effective treatments to prevent it from becoming worse.

#5. Bariatric (weight-loss) surgery is a highly effective treatment for Type 2 diabetes. I am not encouraged by this and have a difficult time even including this as there is so much they fail to tell you. Once you have the surgery, you have to eat such small amounts of food that many people cannot do this. When people are unable to lose weight and all others attempts have failed, bariatric surgery is certainly an option. There are definitely risks to this surgery and people with type 2 diabetes can only expect a remission for an undetermined amount of time and not a cure of their diabetes.

#6. An “artificial” pancreas should soon be available to help people with Type 1 diabetes more easily manage their condition. For people with type 2 diabetes, this is probably one device that will not be available to you. And if you are on Medicare, don't expect to receive one of these tools that type 1's will receive until they turn 65.

#7. Medical providers and the related professions advocate a 'one-size-fits-all' way of treatment. The harried doctors of today do not have time to individualize treatment and if something does not fit their thoughts, you will be told 'it is all in your head', or you will be referred to another doctor. Doctors are so afraid of hypoglycemia that they will accuse you of failing and threaten you with insulin to keep you on oral medications. These doctors are wrong in so many ways that you should be afraid of them. Insulin should never be a medication of last resort for excellent diabetes management.

I could really use a rant, but I will end this here before I say something I will regret later.

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

What Is So Discouraging About Diabetes Forums

I am talking about diabetes forums in general and not pointing out any particular forum. Diabetes forums can be a source of some valuable information – when people do not take offense to the information given. What people need to understand, but seldom do, is there are many ways to approach any given topic and you will find many of them in answers to some inane questions.

On several of the forums lately, there have been some excellent questions and many equally good answers. However, for three questions on three different forums, the persons asking the question were looking for answers they thought they should see. When the answers were not what they were looking for, they dropped out of the discussion. All the questions were for people with type 2 diabetes

Two of the questions were about carbohydrates and fat content of foods. They were looking for confirmation of some information they believed in and that is promoted by the American Diabetes Association. This did not happen; all answers were low to medium carbohydrate and medium to high fat answers. The original posters came back with the studies have shown that fat was bad for us and whole grains were good for us. None of the responders agreed and so the discussions ended on both forums.

The third forum had a question about insulin and when to go on insulin. I thought this could be an interesting discussion, but for every answer, the original poster would ask about another insulin myth. There were some good responses, but the person was not convinced. Finally, one person listed many of the insulin myths and the correct answers to them. This infuriated the original poster and she said there had to be some truth to the myths. She then stated that was the reason she would avoid insulin as long as she could as insulin was only for people with severe complications and near the end of life.

I had not participated in the discussion about insulin since the other answers were good and to the point. The last statement above is the myth to end all myths. This is because insulin for people with type 2 diabetes is thought to be the treatment of last resort. Many doctors and most type 2 patients hold this to be true. By doing this, they are diminishing their quality of life and their lifespan by possibly years if not a decade, or longer.

People with type 2 diabetes should become knowledgeable about insulin and the myths so they can understand the value of insulin and how it can enhance their life and prevent the complications from gaining a foothold in their lives. I have now been on insulin for a full eight years and am very happy that I have this medication to hold the complications at bay. Yes, I have neuropathy, but I had this several years before the diabetes diagnosis. I can say that it has not gotten worse since diabetes and going on insulin.

So if you are an active participant on any diabetes forum, be aware that many that come to the forums do so only for confirmation of what they believe and not for the truth. They believe in many of the myths about diabetes and are fearful of insulin. Some are more fearful of the needles, but they can learn to overcome this. Insulin can be a very powerful tool in the battle to manage diabetes. There is a need for education, but the information is available, whether in printed form, or online.

Do You Feel Guilty About Diabetes?

Are you buying into the myths often laid on us by the medical profession, friends, and family? This is easy to do, but you must not. First, understand that diabetes is not your fault. I have said this before and some need a constant reminder of this. Then be sure you are living in the present as the past is exactly that, the past.

Being able to manage diabetes is now your goal. This is a task that requires attention 24/7/365. There is no vacation and this does present challenges for some. There can be good and bad times, as well as days that can be planned when you can treat yourself to some relaxing time.

People with Type 2 diabetes often give up for several reasons. Often they are tempted and do give in to these temptations. Others get discouraged because they don't obtain the results the doctor had told them to expect. Some believe in the myths about diabetes and therefore do not challenge themselves to do many things that may help them in their management of diabetes. Still others do not follow the instructions of the doctor and wonder why they are not getting better.

A difficult truth for many is there are few people with Type 2 diabetes that can measure their results to another person's results. Therefore, you must become your own science experiment and find out how your body reacts to different foods, different medications, and different levels of exercise.

If you are looking for other views, two bloggers have something to say. David Spero has a blog here about this subject. And Pine Pienaar has has other suggestions here.  (The last link is broken - no fix found.)  They both have good points and I enjoy reading both.

If you have gotten past the initial shock, anger, and denial, the next step is gaining the knowledge you need to manage diabetes. There are many excellent books and web sites available that can give you much good information. Just a word of caution, there are some very unreliable websites that promise cures, but they are after your money and will promise most everything to get you to pay it over to them.

There are many studies out that criticize many of the sites for their unreliable and misleading information. Just use extreme caution and I have many sites listed in other blogs. A few are blog 1, blog 2, and blog 3.  When you find something you like or that you find useful, bookmark it to have it for reference. If something does not work for you, discard it and move on. Occasionally some ideas will work in the future.