When I came across this (link now broken - area deleted from site), I needed to rein in my anger level. I am not surprised at the position taken, but some RD/CDE's (Registered Dietitians/Certified Diabetes Educators) just don't understand that when they give advice, they need to be more careful and sensitive to the person needing the advice. Many just state the old ADA position and leave it at that. Plus diabetes forums are a poor place to give dietary information, like carbohydrate advice, especially when what works for one person, may not work for another person, nor meet the dietary needs.
This then makes many people upset and sometimes very disrespectful of the “Title” of the person giving the advice. We know that there is a lot of education behind the title; however, the insensitivity with which advice is given leaves a lot to be desired.
While I have written about this problem before, people need to learn that asking for dietary and nutritional advice on a diabetes forum will often result in advice that may not work for them. Normally the recommended amount of carbohydrates is too high and people want to believe this, but soon discover that the recommended amount is above the level they can tolerate and still manage their diabetes.
I will admit that I am very distrustful of RD's, CDE's, and other titles that participate on diabetes forums recommending how many carbohydrates people should eat in a 24 hour time. I very seldom see recommendations below 200 grams of total carbohydrates. If you are testing before meal and after a meal (1.5 to 2 hours) with a difference of 40 points or less, then your body can tolerate that many carbohydrates. If the difference is greater, then you should seriously consider reducing the amount of carbohydrates.
I realize that this is mostly volunteer work for these RD/CDE's and therefore we should not expect more salient and sage advice. I also know that most diabetes forum members are looking for quick solutions for carbohydrate numbers.
Now dare I mention that carbohydrate numbers are not the end-all to management of diabetes? I wish this could be so as then life could be so much simpler as some RD/CDE's would like us to believe. While those of us with diabetes need to count carbohydrates and they help determine our meter readings before and after meals, too often they do cause us to forget to balance our nutritional intake of foods.
Many people often end up lacking essential nutrients and trace elements in what we eat because we concentrate too much on just the number of carbohydrates. We also need to remember our vitamins, minerals, and certain trace elements that make up a our daily needs. Without them, we end up with other illnesses, health problems, and we constantly are battling other wars with management of our diabetes because we neglected them.
Diabetes management does need vitamins, minerals, and trace elements to be effective. Often because of carbohydrate management, we need supplements to balance what our bodies need. Just a few that come to mind include vitamin B12 for those that have been on metformin for extending periods. Vitamin D3 for those who do not get outside enough or don't include foods high is this. There are others and especially trace minerals are often lacking from our daily nutritional intake.
While I will be the first to admit that nutrition is something that I often neglect. I am working by having more tests done to determine what I am missing, and adjusting my eating habits or by taking supplements to cover the areas that I am short in my nutritional food intake. Because the quantity of carbohydrates is important in my management of my diabetes, I will continue to count them, but I am striving to include more foods high in vitamins, minerals, trace elements, and other vital nutrients important to my health.
The last point is the caloric intake in the foods we eat. Often the carbohydrate amounts are too high for some individuals and the calories are too high to assist people in losing the weight new diagnosed people often need to lose. This is why we need to consider the ratio of protein, fat, and carbohydrates that is optimal for each person.
September 18, 2010
September 17, 2010
Natural treatments for diabetes. (Not a cure) Part 1
The following information is for your reading and is not a cure. I am not endorsing any of these herbs, supplements, or natural remedies.
I am constantly seeing information about this or that natural remedy or supposed cure for diabetes, but I am getting so tired of the emails and constant bombardment by snake oil salespeople and their instant cures. Their constant stream of lies and enticements are indeed interesting, but under analysis are so false and not based on any form of scientific evidence. The supposed endorsers are so obviously paid to say what they are told, that you can't trust them.
In these cases I will fall back on the saying that a fool and his money are soon parted. Before I get carried away venting about these crooks (and some are doctors that should have their license pulled), I would like to cover a few items that may help those with diabetes. I say may, because many people do not derive any benefit, but a few do receive short-term benefits. I am not sure why, but there may be something in their body chemistry that was needed which the supplement, vitamin, or herb supplies to restore some balance, thus the short-term benefit.
Some items are said to have longer benefits, but there are no studies to prove this or scientific evidence to support these claims. What studies exist for some of the following items are either poorly designed, not all that conclusive, or done with such a small sample of people that it makes them suspect. Most of the natural remedies do not get much financial support for studies because there is little profit to do so.
This is important!!! WARNING If you are taking supplements or anything that is not prescribed by the doctor, please make sure that the doctor is informed. Some of the supplements when taken with oral medications and/or insulin can cause hypoglycemia or have toxic results, even cause death.
This is important enough to tell you to maintain a Supplement Diary of every herb, vitamin, and supplement you are taking and give a copy to your doctor. I am aware that many people do not feel this is important, but the consequences for persons with diabetes can have severe medical implications.
Of the items covered in this blog, I use vinegar, cinnamon, and magnesium, but not as supplements. I just use them as they come to me in different foods or as part of a recipe. Yes, I do seek out the foods rich in some of these items, especially the magnesium.
Vitamin K:
A Dutch study has found that Vitamin K (K1 and K2) may have lowered the risk of getting type 2 diabetes. Like so many studies, they want more studies and say nothing about being any help for those of us who already have type 2. About all the study is good for is disputing the American minimum daily requirement.
Vinegar:
I will refer here to a previous blog about vinegar. I have not seen or found any more than I have referenced in that blog.
Cinnamon:
I will admit that more studies are emerging that show cinnamon has some benefits. This 12 week study only involves 22 people. I am not sure that this gives enough conclusive evidence to prove real benefit, but the different studies are continuing to add to the body of evidence for this spice. Another blog about another study appeared on October 10, 2006 with 60 men and women. No one has yet determined the length of the benefit on cinnamon, just the short-term benefits for small numbers.
Chromium or chromium picolinate:
One of the more (to my understanding) beneficial supplements is chromium, there are some health warnings about chromium picolinate. While this is a trace element that has an effect on insulin production, many people are overdosing with this supplement and may be causing some harm to their systems. What is it that people do not understand about the word trace element. Only a small amount should be used and probably not on a consistent basis. This article is very informative and clearly states that little information is available on the safety of chromium. Other studies have not confirmed the benefits.
Ginseng:
The North American ginseng shows in the studies to be the best form of ginseng for benefits for those of us with diabetes in that it may improve blood sugar control. While again, not enough studies have been done, there are indications it may have some benefits.
Magnesium:
Studies here do indicate that low magnesium levels may make blood glucose control more difficult and that proper levels may help with insulin resistance. A fellow blogger has written a blog (sorry, link is broken) about magnesium and you should read it and the comments.
This mineral comes with some warnings about over use and the side effects that it can cause. There are also some problems with heart medications so use only under a doctors supervision.
End of Part 1 of 4.
I am constantly seeing information about this or that natural remedy or supposed cure for diabetes, but I am getting so tired of the emails and constant bombardment by snake oil salespeople and their instant cures. Their constant stream of lies and enticements are indeed interesting, but under analysis are so false and not based on any form of scientific evidence. The supposed endorsers are so obviously paid to say what they are told, that you can't trust them.
In these cases I will fall back on the saying that a fool and his money are soon parted. Before I get carried away venting about these crooks (and some are doctors that should have their license pulled), I would like to cover a few items that may help those with diabetes. I say may, because many people do not derive any benefit, but a few do receive short-term benefits. I am not sure why, but there may be something in their body chemistry that was needed which the supplement, vitamin, or herb supplies to restore some balance, thus the short-term benefit.
Some items are said to have longer benefits, but there are no studies to prove this or scientific evidence to support these claims. What studies exist for some of the following items are either poorly designed, not all that conclusive, or done with such a small sample of people that it makes them suspect. Most of the natural remedies do not get much financial support for studies because there is little profit to do so.
This is important!!! WARNING If you are taking supplements or anything that is not prescribed by the doctor, please make sure that the doctor is informed. Some of the supplements when taken with oral medications and/or insulin can cause hypoglycemia or have toxic results, even cause death.
This is important enough to tell you to maintain a Supplement Diary of every herb, vitamin, and supplement you are taking and give a copy to your doctor. I am aware that many people do not feel this is important, but the consequences for persons with diabetes can have severe medical implications.
Of the items covered in this blog, I use vinegar, cinnamon, and magnesium, but not as supplements. I just use them as they come to me in different foods or as part of a recipe. Yes, I do seek out the foods rich in some of these items, especially the magnesium.
Vitamin K:
A Dutch study has found that Vitamin K (K1 and K2) may have lowered the risk of getting type 2 diabetes. Like so many studies, they want more studies and say nothing about being any help for those of us who already have type 2. About all the study is good for is disputing the American minimum daily requirement.
Vinegar:
I will refer here to a previous blog about vinegar. I have not seen or found any more than I have referenced in that blog.
Cinnamon:
I will admit that more studies are emerging that show cinnamon has some benefits. This 12 week study only involves 22 people. I am not sure that this gives enough conclusive evidence to prove real benefit, but the different studies are continuing to add to the body of evidence for this spice. Another blog about another study appeared on October 10, 2006 with 60 men and women. No one has yet determined the length of the benefit on cinnamon, just the short-term benefits for small numbers.
Chromium or chromium picolinate:
One of the more (to my understanding) beneficial supplements is chromium, there are some health warnings about chromium picolinate. While this is a trace element that has an effect on insulin production, many people are overdosing with this supplement and may be causing some harm to their systems. What is it that people do not understand about the word trace element. Only a small amount should be used and probably not on a consistent basis. This article is very informative and clearly states that little information is available on the safety of chromium. Other studies have not confirmed the benefits.
Ginseng:
The North American ginseng shows in the studies to be the best form of ginseng for benefits for those of us with diabetes in that it may improve blood sugar control. While again, not enough studies have been done, there are indications it may have some benefits.
Magnesium:
Studies here do indicate that low magnesium levels may make blood glucose control more difficult and that proper levels may help with insulin resistance. A fellow blogger has written a blog (sorry, link is broken) about magnesium and you should read it and the comments.
This mineral comes with some warnings about over use and the side effects that it can cause. There are also some problems with heart medications so use only under a doctors supervision.
End of Part 1 of 4.
September 14, 2010
Mayo Clinic has entered the Social Media Arena
This is a big one folks! I don't normally follow the Mayo Clinic that closely, but I do read one area, the Expert Blog under Diabetes.
On Monday the 13th, Scott Johnson wrote about the Mayo Clinic entering the social media. This link takes you to it. Thank you Scott. And they are not doing social media small time. This is big time!
Now I want to hear what the doctors have to say. Most will ignore you while they grimace big time. They don't want to hear it. Now they had better listen when the Mayo Clinic gets running full time and full out. Their mission statement is pretty bold and all encompassing.
The official opening is scheduled for September to coincide with Mayo's hosting of its second Social Media Summit in collaboration with Ragan Communications, September 27 to 29 at the Mayo Clinic's Jacksonville, Florida campus. However, it is up and usable now.
This is one website that I will need to check on a regular basis as there are many directions it could expand. Take time to explore the home page and what they are already involved in on YouTube, Twitter, Blogs, Facebook, and other areas. This is below the video. Explore the entire website!
On Monday the 13th, Scott Johnson wrote about the Mayo Clinic entering the social media. This link takes you to it. Thank you Scott. And they are not doing social media small time. This is big time!
Now I want to hear what the doctors have to say. Most will ignore you while they grimace big time. They don't want to hear it. Now they had better listen when the Mayo Clinic gets running full time and full out. Their mission statement is pretty bold and all encompassing.
The official opening is scheduled for September to coincide with Mayo's hosting of its second Social Media Summit in collaboration with Ragan Communications, September 27 to 29 at the Mayo Clinic's Jacksonville, Florida campus. However, it is up and usable now.
This is one website that I will need to check on a regular basis as there are many directions it could expand. Take time to explore the home page and what they are already involved in on YouTube, Twitter, Blogs, Facebook, and other areas. This is below the video. Explore the entire website!
September 13, 2010
More of Dangerous Myths – Myths Part 3
Some of the most dangerous problems happen to those who will not use insulin because they have heard some of the lies put forth by the people against insulin. Others originate from people who associate insulin with problems a relative had because of poor or no diabetes management.
These lies are:
1. Insulin causes blindness, amputations, and kidney failure.
2. Insulin causes sterility and sexual dysfunction.
3. Insulin use is the beginning of the end.
4. Insulin is toxic.
5. Insulin use will label me as a drug addict.
6. Insulin causes weight gain.
7. Insulin use will cause insulin shock (now termed hypoglycemia).
8. Insulin use is an inconvenience.
9. Insulin use is resisted by physicians and patients.
What causes items 1, 2, and 3 above is poor to no management of diabetes. Many people that do not manage their diabetes can have blindness, amputations, kidney failure, sterility and sexual dysfunction, and be near the end because they have not controlled their diabetes. Those that tightly manage their diabetes can live long and often healthier lives, with or without insulin.
Insulin is not toxic for the majority of people. However, some people do have allergies to some insulins. This is the only time insulin can be considered toxic.
Number five generally is not a problem; however, I have been questioned by the police about my use of syringes. Fortunately I had the insulin there and the pharmacy RX on the box and after checking, the officer was very polite.
Number six is difficult as initially the increased control insulin can give causes for some weight gain as the cells can now utilize the glucose. However, it is important for for those starting insulin to meet with a dietitian that understands diabetes and can provide guidance in nutrition and food choices. They also need education on counting carbohydrates and adjusting insulin to carbohydrates to prevent hypoglycemia.
This is also how to prevent number seven from occurring. Also the education needs to include the warning symptoms of hypoglycemia and how to test and resolve the problem with the appropriate glucose medication or other fast acting foods, mostly fruit juices.
Number eight can be a problem if you let it be a problem. It does take some adjustment and possible change in environment to manage your diabetes, but your health is more important than an inconvenience. Just remember that preventing the complications of diabetes is worth the effort.
Number nine is true because many doctors and patients resist the use of insulin for various reasons or myths. Often the doctors go along with the threat idea because patients will more readily follow the oral medications route. Often the doctors do not want to spend the time to educate their patients on the use of insulin and are worried about hypoglycemia becoming a problem on insulin.
Sometimes the doctors know that their patients cannot afford the cost of insulin. But most doctors and patients do not take into account the true cost effectiveness of each treatment. Not only are some of the oral medications costly, but the success of oral medications is not always the best when compared to insulin. Also, not everyone can get excellent control with oral medications. A few medical professionals are also not aware that some oral medications when used by themselves or in combinations will cause hypoglycemia.
For me, insulin is the only way that I will probably be able to retain some insulin production from my pancreas. Many people that go the oral medications route only, end up with a pancreas that wears itself out and can no longer produce insulin, forcing the use of insulin. I know that mine still works and that I have to be very careful when I have been able to exercise, or have had to work extra when moving from one apartment to another. I know that I will go low, need to test more often, and reduce the amount of insulin drastically for several days or even a couple of weeks.
I have also found out in the last month what an illness can do to me. I have needed to reduce my insulin usage and now that I am spending time bicycling regularly, I have needed to reduce my insulin further as my pancreas is almost producing more than I can use. A fine turn of events for me, but not one I expected as I still have to lose much more weight, but I will take what I am given. My insulin resistance has obviously dropped, but that could return at any time. So in the meantime, I am testing more often and enjoying life.
There are many more myths, but this will be the last in this series for now.
Articles used in the above:
Site 1, Site 2, Site 3. Sorry - the links have been broken - discovered 8/8/14.
These lies are:
1. Insulin causes blindness, amputations, and kidney failure.
2. Insulin causes sterility and sexual dysfunction.
3. Insulin use is the beginning of the end.
4. Insulin is toxic.
5. Insulin use will label me as a drug addict.
6. Insulin causes weight gain.
7. Insulin use will cause insulin shock (now termed hypoglycemia).
8. Insulin use is an inconvenience.
9. Insulin use is resisted by physicians and patients.
What causes items 1, 2, and 3 above is poor to no management of diabetes. Many people that do not manage their diabetes can have blindness, amputations, kidney failure, sterility and sexual dysfunction, and be near the end because they have not controlled their diabetes. Those that tightly manage their diabetes can live long and often healthier lives, with or without insulin.
Insulin is not toxic for the majority of people. However, some people do have allergies to some insulins. This is the only time insulin can be considered toxic.
Number five generally is not a problem; however, I have been questioned by the police about my use of syringes. Fortunately I had the insulin there and the pharmacy RX on the box and after checking, the officer was very polite.
Number six is difficult as initially the increased control insulin can give causes for some weight gain as the cells can now utilize the glucose. However, it is important for for those starting insulin to meet with a dietitian that understands diabetes and can provide guidance in nutrition and food choices. They also need education on counting carbohydrates and adjusting insulin to carbohydrates to prevent hypoglycemia.
This is also how to prevent number seven from occurring. Also the education needs to include the warning symptoms of hypoglycemia and how to test and resolve the problem with the appropriate glucose medication or other fast acting foods, mostly fruit juices.
Number eight can be a problem if you let it be a problem. It does take some adjustment and possible change in environment to manage your diabetes, but your health is more important than an inconvenience. Just remember that preventing the complications of diabetes is worth the effort.
Number nine is true because many doctors and patients resist the use of insulin for various reasons or myths. Often the doctors go along with the threat idea because patients will more readily follow the oral medications route. Often the doctors do not want to spend the time to educate their patients on the use of insulin and are worried about hypoglycemia becoming a problem on insulin.
Sometimes the doctors know that their patients cannot afford the cost of insulin. But most doctors and patients do not take into account the true cost effectiveness of each treatment. Not only are some of the oral medications costly, but the success of oral medications is not always the best when compared to insulin. Also, not everyone can get excellent control with oral medications. A few medical professionals are also not aware that some oral medications when used by themselves or in combinations will cause hypoglycemia.
For me, insulin is the only way that I will probably be able to retain some insulin production from my pancreas. Many people that go the oral medications route only, end up with a pancreas that wears itself out and can no longer produce insulin, forcing the use of insulin. I know that mine still works and that I have to be very careful when I have been able to exercise, or have had to work extra when moving from one apartment to another. I know that I will go low, need to test more often, and reduce the amount of insulin drastically for several days or even a couple of weeks.
I have also found out in the last month what an illness can do to me. I have needed to reduce my insulin usage and now that I am spending time bicycling regularly, I have needed to reduce my insulin further as my pancreas is almost producing more than I can use. A fine turn of events for me, but not one I expected as I still have to lose much more weight, but I will take what I am given. My insulin resistance has obviously dropped, but that could return at any time. So in the meantime, I am testing more often and enjoying life.
There are many more myths, but this will be the last in this series for now.
Articles used in the above:
Site 1, Site 2, Site 3. Sorry - the links have been broken - discovered 8/8/14.
September 8, 2010
Medic alert jewelry – pros and cons
In my previous blog about whether to wear medic alert jewelry, I said the pros and cons were for another blog.
As with any jewelry, you should consider your lifestyle and how often you have accidents with your jewelry. Medic Alert jewelry fits the same criteria. Find something that is practical and fits with your lifestyle.
Bracelets
– pros – can be worn on either arm, some even wear them as ankle bracelets. Some models are very stylish while others can be over the top depending on your budget.
- cons – people do catch them on things and they do come off at inopportune
times.
Necklaces or Dog tags
– pros – many men find necklaces more acceptable as they are covered by clothing and for some dog tags fit the bill.
- cons – while most will break if caught on something, but they can leave nasty scars.
Cards
– pros – easy to carry, can easily be updated.
- cons – easily lost, misplaced, stolen.
Shoe tags
- pros – may not be as noticeable, pant cuffs may cover.
- cons – can easily be lost, removed, or stolen.
Sports bands
- pros – see bracelets for pros and cons.
Watches
- pros - are practical and many of us do wear them.
- cons – are more expensive than many of us can afford to wear.
The above are just six of the possibilities. With Medic Alert, a card comes with any piece of jewelry so it makes sense to use them both.
One caution for those wearing necklaces – they must be removed by personnel administering a defibrillator. This must be done to prevent burns as well as other metal worn as part of clothing. Yes, women, I am talking about under-wire bras.
Other than those that believe big brother is watching and will never use an medical microchip, they could become a good thing for people with chronic diseases. The information could be stored and retrieved by readers. One problem is that many companies will want a piece of the action and their microchips will be encoded slightly different from another company so they can also sell their microchip readers. This will need federal regulation to prevent this from happening. Imagine a person from the East traveling to the Southwest part of the US and needing medical assistance, but the reader used there does not read to microchip from the East. Not good.
I personally would not like to see federal regulation, but our companies have a big habit of trying to be competitive and want to dominate the market and not cooperate when it comes to health care or assisting people with chronic illnesses. If they could cooperate, it could be good for all parties.
Another idea I mentioned is a sticker that could be displayed in a vehicle window or have a symbol on the license plate. This could be a large help to our police in knowing that something could be wrong.
An idea that I want to explore is a decal or sticker that could be placed where it would not be missed just inside the apartment and or the same for the main entrance to a house.
As with any jewelry, you should consider your lifestyle and how often you have accidents with your jewelry. Medic Alert jewelry fits the same criteria. Find something that is practical and fits with your lifestyle.
Bracelets
– pros – can be worn on either arm, some even wear them as ankle bracelets. Some models are very stylish while others can be over the top depending on your budget.
- cons – people do catch them on things and they do come off at inopportune
times.
Necklaces or Dog tags
– pros – many men find necklaces more acceptable as they are covered by clothing and for some dog tags fit the bill.
- cons – while most will break if caught on something, but they can leave nasty scars.
Cards
– pros – easy to carry, can easily be updated.
- cons – easily lost, misplaced, stolen.
Shoe tags
- pros – may not be as noticeable, pant cuffs may cover.
- cons – can easily be lost, removed, or stolen.
Sports bands
- pros – see bracelets for pros and cons.
Watches
- pros - are practical and many of us do wear them.
- cons – are more expensive than many of us can afford to wear.
The above are just six of the possibilities. With Medic Alert, a card comes with any piece of jewelry so it makes sense to use them both.
One caution for those wearing necklaces – they must be removed by personnel administering a defibrillator. This must be done to prevent burns as well as other metal worn as part of clothing. Yes, women, I am talking about under-wire bras.
Other than those that believe big brother is watching and will never use an medical microchip, they could become a good thing for people with chronic diseases. The information could be stored and retrieved by readers. One problem is that many companies will want a piece of the action and their microchips will be encoded slightly different from another company so they can also sell their microchip readers. This will need federal regulation to prevent this from happening. Imagine a person from the East traveling to the Southwest part of the US and needing medical assistance, but the reader used there does not read to microchip from the East. Not good.
I personally would not like to see federal regulation, but our companies have a big habit of trying to be competitive and want to dominate the market and not cooperate when it comes to health care or assisting people with chronic illnesses. If they could cooperate, it could be good for all parties.
Another idea I mentioned is a sticker that could be displayed in a vehicle window or have a symbol on the license plate. This could be a large help to our police in knowing that something could be wrong.
An idea that I want to explore is a decal or sticker that could be placed where it would not be missed just inside the apartment and or the same for the main entrance to a house.
September 7, 2010
Open request to all type 2 people
As of now I have published all that I have permission to publish. I wish more would have responded to my request to publish their information. I will not publish without permission. I still have a lot of requests out and will continue requesting if I find new sites. Information will be added as I get it plus new URL's will be added for people.
I am not sure why people have not responded, either they have very tight control on their email and my emails were routed to spam, or have chosen not to participate. At some future date I may list the URL's only without any other information, but I really don't want to do this.
If you have been missed, are a person with type 2 diabetes, and want to be included, please go to my blog profile page and email me.
If you can help, please let me know. The lists are presently all here.
I am not sure why people have not responded, either they have very tight control on their email and my emails were routed to spam, or have chosen not to participate. At some future date I may list the URL's only without any other information, but I really don't want to do this.
If you have been missed, are a person with type 2 diabetes, and want to be included, please go to my blog profile page and email me.
If you can help, please let me know. The lists are presently all here.
September 3, 2010
To wear or not to wear a medic alert ID
Many people on the forums are asking about wearing a medic alert bracelet or carrying a medic alert card.
First, there is nothing that requires that you wear anything. Now that I've written that, I would like to give you a few reasons for wearing one.
Every day, somewhere in the USA, an officer of the law stops someone that appears or acts like they have had too much to drink. While many are overly full of the spirits, some are having hypoglycemia. Since the symptoms are very similar, erratic driving, slurred speech, etc., they often get locked up in the local jail. Some have problems and actually go into a diabetic coma, a few die, and others are able hang on until someone recognizes that they have hypoglycemia and they get treatment. Not the outcome that is desired for all concerned.
To begin with, people should test their blood glucose (BG) before turning the key in their car. If they are below a certain number, they should take a glucose tablet or more and retest at 15 minute intervals. When the BG is at an acceptable level, then they can drive. The only people that should be exempted from this requirement are people that are able to control their diabetes with nutrition and exercise or that the doctor has given a written permission to drive without testing because the medications they are on will not cause lows – which are very few. Many or in reality most oral medications can and will cause hypoglycemia especially when in combinations. Insulin will cause hypoglycemia.
A few states are starting to recognize this problem and are treating these people like drunk drivers and fining them and suspending their drivers licenses. I honestly hope more states follow suit. There are far too many accidents resulting in deaths caused by people with hypoglycemia. And we should take this seriously.
Now, I have to attack our insurance industry for their restrictions on covering testing supplies. People that drive a lot, should not need to be afraid of testing as often as needed nor have constraints from an insurance company that because they are people with type 2 diabetes, they should only be allowed to test twice a day. If they are on oral medications that can cause lows, they need to test more often. Of course if they are on insulin, they are allowed more testing supplies, but this still may not be enough if this person does a lot of driving. This is where a doctors orders should be allowed to increase testing supplies when needed and insurance companies should allow for these cases.
This is probably one of the biggest reasons to wear a medic alert bracelet. Some will say necklace, and others will say carry a card. A few will say that they want tattoos with the information in them. Another item to consider is a medical identification microchip as is being promoted in some parts of the country. All are reasonable and all should be considered and even in possible combinations. There are pros and cons for each, but this is a topic for another blog. I would also suggest that a medic alert sticker should be available for motor vehicles that would be visible to law enforcement.
The State of Iowa at their Police Training Academies does cover many of the medical topics since our state trains them to be first responders for all 911 situations. Hypoglycemia is one of the topics covered as is hyperglycemia.
In my talks with the local police department and ambulance service manned by Emergency Medical Technicians and paramedics, all have been in agreement that they look for medic alert bracelets, necklaces, and cards. Normally the police are first on the scene and if the patient is conscious they ask questions and if unconscious, look to get information as quickly as possible from medical alert jewelry and contact sources as rapidly as possible. This way when the paramedics, (EMT's) arrive, they have as much information as possible for them to better preform their duties.
They are trained to look for glucose tablets, orange juice, or other items that can quickly raise blood glucose or be prepared the inform the EMT's that glucose need to be administered with the IV. But they cannot do this unless they have the medic alert information available. They even suggest having medical data in the refrigerator in plain view as some people have had.
It is surprising how many people with diabetes do not even consider wearing medic alert jewelry and won't. Probably because they are wanting to be private about their diabetes. I say that this is a poor reason and you life may depend on people being able to get information quickly when it may be your life that is at stake.
I have been wearing a necklace with information on a pendant, but after reading more in preparation for this blog, I am going to get a medic alert bracelet and get registered with Medic Alert Advantage program for $30 per year with a $9.95 initial set up fee. I am not sure which jewelry I will select yet, but this is on my to-do-immediately list. I do encourage everyone with diabetes to do the same. It could be a lifesaving move. There is other medical alert jewelry, but none is part of the system by Medic Alert Organization.
You need to talk to your local ambulance service and police department in your state to find out how they handle these situations. It could save your life.
First, there is nothing that requires that you wear anything. Now that I've written that, I would like to give you a few reasons for wearing one.
Every day, somewhere in the USA, an officer of the law stops someone that appears or acts like they have had too much to drink. While many are overly full of the spirits, some are having hypoglycemia. Since the symptoms are very similar, erratic driving, slurred speech, etc., they often get locked up in the local jail. Some have problems and actually go into a diabetic coma, a few die, and others are able hang on until someone recognizes that they have hypoglycemia and they get treatment. Not the outcome that is desired for all concerned.
To begin with, people should test their blood glucose (BG) before turning the key in their car. If they are below a certain number, they should take a glucose tablet or more and retest at 15 minute intervals. When the BG is at an acceptable level, then they can drive. The only people that should be exempted from this requirement are people that are able to control their diabetes with nutrition and exercise or that the doctor has given a written permission to drive without testing because the medications they are on will not cause lows – which are very few. Many or in reality most oral medications can and will cause hypoglycemia especially when in combinations. Insulin will cause hypoglycemia.
A few states are starting to recognize this problem and are treating these people like drunk drivers and fining them and suspending their drivers licenses. I honestly hope more states follow suit. There are far too many accidents resulting in deaths caused by people with hypoglycemia. And we should take this seriously.
Now, I have to attack our insurance industry for their restrictions on covering testing supplies. People that drive a lot, should not need to be afraid of testing as often as needed nor have constraints from an insurance company that because they are people with type 2 diabetes, they should only be allowed to test twice a day. If they are on oral medications that can cause lows, they need to test more often. Of course if they are on insulin, they are allowed more testing supplies, but this still may not be enough if this person does a lot of driving. This is where a doctors orders should be allowed to increase testing supplies when needed and insurance companies should allow for these cases.
This is probably one of the biggest reasons to wear a medic alert bracelet. Some will say necklace, and others will say carry a card. A few will say that they want tattoos with the information in them. Another item to consider is a medical identification microchip as is being promoted in some parts of the country. All are reasonable and all should be considered and even in possible combinations. There are pros and cons for each, but this is a topic for another blog. I would also suggest that a medic alert sticker should be available for motor vehicles that would be visible to law enforcement.
The State of Iowa at their Police Training Academies does cover many of the medical topics since our state trains them to be first responders for all 911 situations. Hypoglycemia is one of the topics covered as is hyperglycemia.
In my talks with the local police department and ambulance service manned by Emergency Medical Technicians and paramedics, all have been in agreement that they look for medic alert bracelets, necklaces, and cards. Normally the police are first on the scene and if the patient is conscious they ask questions and if unconscious, look to get information as quickly as possible from medical alert jewelry and contact sources as rapidly as possible. This way when the paramedics, (EMT's) arrive, they have as much information as possible for them to better preform their duties.
They are trained to look for glucose tablets, orange juice, or other items that can quickly raise blood glucose or be prepared the inform the EMT's that glucose need to be administered with the IV. But they cannot do this unless they have the medic alert information available. They even suggest having medical data in the refrigerator in plain view as some people have had.
It is surprising how many people with diabetes do not even consider wearing medic alert jewelry and won't. Probably because they are wanting to be private about their diabetes. I say that this is a poor reason and you life may depend on people being able to get information quickly when it may be your life that is at stake.
I have been wearing a necklace with information on a pendant, but after reading more in preparation for this blog, I am going to get a medic alert bracelet and get registered with Medic Alert Advantage program for $30 per year with a $9.95 initial set up fee. I am not sure which jewelry I will select yet, but this is on my to-do-immediately list. I do encourage everyone with diabetes to do the same. It could be a lifesaving move. There is other medical alert jewelry, but none is part of the system by Medic Alert Organization.
You need to talk to your local ambulance service and police department in your state to find out how they handle these situations. It could save your life.
August 29, 2010
Pre-diabetes vs what?
Some bloggers have done an excellent job of defining pre-diabetes. Our professionals have said that 126 and greater is diabetes and 125 and lower is pre-diabetes. This makes for a good reference point; however, I am not willing to accept that the numbers are right or wrong.
Many doctors are doing us a disservice when they do not investigate further. Tom Ross got me to thinking in his blog of Aug 16, 2010. My thoughts before were - either it is or it isn't diabetes. I still cling to this because I do not like what our medical community is doing with the term pre-diabetes. Patients are not being properly informed nor educated about what to do to prevent or at least delay for the short or long-term, the progress of diabetes.
At the same time, Tom is right that being arbitrary does nothing to improve the situation as both do have problems with blood glucose control or a pancreas that is not able to react properly as it needs to.
A large problem is that our insurance will not cover anything that is less than 126, but will at 126 and above. To them if you are below 126, you do not have diabetes and therefore most insurance companies will deny your claims. But that is fodder for another blog.
Bob Pedersen does very well to lay out his case. He does not accept the analogy some have loosely used about the woman being a little bit pregnant and applying this to diabetes. I like the analogy and I will use it as I believe above 100 to be indicative of diabetes.
Michael Hoskins does not like the term “pre-diabetes” and I agree with him. Why? The medical community is too quick to use terms that let themselves off the hook for not following recommended procedures. This is where Tom's line of thought becomes important. Arbitrary values often miss the underlying problems that our pancreas is having problems that need to be addressed. And our medical community does little to address this issue other that saying that below 126 you have pre-diabetes and often leaving the patient to wonder what that means.
They leave the doctor's office wondering just what the doctor was talking about and why if it is serious, didn't the doctor issue a prescription to help control things or give them more information to make a sound decision of their own about halting the progression to diabetes and larger future problems.
To many the term pre-diabetes is more descriptive that “borderline diabetes” and I have no quarrel here. I will continue to disapprove of the term pre-diabetes and hope that another term, label, or description will evolve that defines the area that means that diabetes is likely and causes doctors to better inform their patients about the seriousness of their medical status.
Now with this written, we should all take the time to read a book by Gretchen Becker titled “What You Need to Know to Keep Diabetes Away – Prediabetes”. She writes an excellent discussion of diabetes and why we get it or don't, and why we should take the steps necessary to prevent diabetes from developing. If you are likely to get diabetes, Gretchen tells us what to do to postpone it from developing or to do for early control to delay the onset of complications for many years.
After reading Gretchen's book, if you decide to use the term Prediabetes, then I will say that you at least have a more thorough understanding of the term.
Even more important is Dr. Bill Quick's blog published August 22, 2010. In it he discusses the various medications being studied for use to treat prediabetes. As of then, there are no medications approved by the Federal Drug Administration (FDA) for the treatment of prediabetes.
Dr. Quick uses the term “off label” to describe the use of diabetes medications being used by patients before diagnosis of diabetes that insurance does not cover and therefore is at the patient's expense. These medications are also not approved by the FDA for use by these patients. His blog is worth reading.
So while the term “prediabetes” is not an official designation by the American Diabetes Association, it is appearing more and more in blogs, articles, and print both on and off the internet. Either the ADA should recognize this term or preferably designate another term which reflects the seriousness of those that are not classified as type 2 diabetes.
Tom Ross is correct in his analysis that below 126 blood glucose readings do indicate cause for concern as the pancreas is not functioning like it should and this needs to be taken seriously.
I am feeling much happier after the article from the August 25 issue of WebMD. The term prediabetes has been discredited by a consensus panel of diabetes experts. I know that this is not the end of the discussion, but the new approach recommended does make good sense. However, the author of the article does not agree and several of the comments agree with him.
I have a feeling that this debate will continue for some time until the American Diabetes Association starts exercising and gets off their lazy sedentary backside and makes a decision. They do not realize how many doctors are not taking numbers below 126 seriously. It is no wonder the patients don't understand.
Many doctors are doing us a disservice when they do not investigate further. Tom Ross got me to thinking in his blog of Aug 16, 2010. My thoughts before were - either it is or it isn't diabetes. I still cling to this because I do not like what our medical community is doing with the term pre-diabetes. Patients are not being properly informed nor educated about what to do to prevent or at least delay for the short or long-term, the progress of diabetes.
At the same time, Tom is right that being arbitrary does nothing to improve the situation as both do have problems with blood glucose control or a pancreas that is not able to react properly as it needs to.
A large problem is that our insurance will not cover anything that is less than 126, but will at 126 and above. To them if you are below 126, you do not have diabetes and therefore most insurance companies will deny your claims. But that is fodder for another blog.
Bob Pedersen does very well to lay out his case. He does not accept the analogy some have loosely used about the woman being a little bit pregnant and applying this to diabetes. I like the analogy and I will use it as I believe above 100 to be indicative of diabetes.
Michael Hoskins does not like the term “pre-diabetes” and I agree with him. Why? The medical community is too quick to use terms that let themselves off the hook for not following recommended procedures. This is where Tom's line of thought becomes important. Arbitrary values often miss the underlying problems that our pancreas is having problems that need to be addressed. And our medical community does little to address this issue other that saying that below 126 you have pre-diabetes and often leaving the patient to wonder what that means.
They leave the doctor's office wondering just what the doctor was talking about and why if it is serious, didn't the doctor issue a prescription to help control things or give them more information to make a sound decision of their own about halting the progression to diabetes and larger future problems.
To many the term pre-diabetes is more descriptive that “borderline diabetes” and I have no quarrel here. I will continue to disapprove of the term pre-diabetes and hope that another term, label, or description will evolve that defines the area that means that diabetes is likely and causes doctors to better inform their patients about the seriousness of their medical status.
Now with this written, we should all take the time to read a book by Gretchen Becker titled “What You Need to Know to Keep Diabetes Away – Prediabetes”. She writes an excellent discussion of diabetes and why we get it or don't, and why we should take the steps necessary to prevent diabetes from developing. If you are likely to get diabetes, Gretchen tells us what to do to postpone it from developing or to do for early control to delay the onset of complications for many years.
After reading Gretchen's book, if you decide to use the term Prediabetes, then I will say that you at least have a more thorough understanding of the term.
Even more important is Dr. Bill Quick's blog published August 22, 2010. In it he discusses the various medications being studied for use to treat prediabetes. As of then, there are no medications approved by the Federal Drug Administration (FDA) for the treatment of prediabetes.
Dr. Quick uses the term “off label” to describe the use of diabetes medications being used by patients before diagnosis of diabetes that insurance does not cover and therefore is at the patient's expense. These medications are also not approved by the FDA for use by these patients. His blog is worth reading.
So while the term “prediabetes” is not an official designation by the American Diabetes Association, it is appearing more and more in blogs, articles, and print both on and off the internet. Either the ADA should recognize this term or preferably designate another term which reflects the seriousness of those that are not classified as type 2 diabetes.
Tom Ross is correct in his analysis that below 126 blood glucose readings do indicate cause for concern as the pancreas is not functioning like it should and this needs to be taken seriously.
I am feeling much happier after the article from the August 25 issue of WebMD. The term prediabetes has been discredited by a consensus panel of diabetes experts. I know that this is not the end of the discussion, but the new approach recommended does make good sense. However, the author of the article does not agree and several of the comments agree with him.
I have a feeling that this debate will continue for some time until the American Diabetes Association starts exercising and gets off their lazy sedentary backside and makes a decision. They do not realize how many doctors are not taking numbers below 126 seriously. It is no wonder the patients don't understand.
Subscribe to:
Posts (Atom)