Part 2 - Causes
Sunstroke results from a failure in your body's cooling system. When its cooling system fails, your body is overwhelmed by excess heat; this is when sunstroke occurs. Anything that disrupts your body's thermostat can increase the likelihood of sunstroke. These may include such factors as underlying medical conditions, medications, physical characteristics, or age.
Dehydration contributes to sunstroke. Dehydration happens when your body excretes more water than it takes in. For example, increased water loss through excessive urination is a common side effect of caffeine, alcohol, and many prescription and over-the-counter medications. When the water supply in your body is low, cells begin to pull water from the bloodstream, forcing organs to work harder. Dehydration can also affect the skin's ability to cool the body efficiently. The heart must pump an adequate supply of blood to the skin in order for the skin to cool the body. When you are dehydrated, the blood's volume is reduced, so the cooling process becomes less effective. The taxing effect on the body escalates into the symptoms of heat-related illness.
Prolonged exposure to the sun contributes to sunstroke. When body fluids are not adequately replenished, sun exposure can cause rapid dehydration. Even on mild or overcast days, the sun can have dangerous health effects. The heat index is a measure calculated by the National Weather Service. It indicates how hot it "feels" outside in the shade when both the air temperature and the relative humidity are considered. In the direct sun, the heat index rises even higher. The following heat indices are associated with these heat-related conditions:
80°F-90°F: Fatigue possible after prolonged physical activity or sun exposure.
90°F-105°F: Heat exhaustion, heat cramps, and sunstroke possible after prolonged physical activity or sun exposure.
105°F-130°F: Heat exhaustion, heat cramps, and sunstroke likely after prolonged physical activity or sun exposure.
130°F and higher: Sunstroke likely with sustained exposure to the sun.
If heat exhaustion is not promptly taken care of, it can quickly progress to heat stroke. Heat stroke is a more urgent matter and is a medical emergency. Symptoms can include warm, flushed skin, little or no sweating, and an extremely high body temperature. Confusion, loss of consciousness, or seizures may also occur. A call to 911 is the best way to get help fast.
April 17, 2010
April 15, 2010
Heatstroke/Sunstroke - Part 1
This is a large topic, so for simplicity I am dividing it into 6 parts: Basics, Causes, Symptoms, Diagnosis, Treatment, and Prevention.
Part 1, Basics
I live in the north central part of the US, and generally have about four or five months that I need to be concerned about heatstroke. Others have more or less time to be concerned depending on their location.
I had heatstroke as a teenager, but have been able to adapt and have not had a reoccurrence. Yes, I am probably more conscious of what is happening now with that experience.
Summer is the time of year to enjoy being outdoors. When summer arrives here, so do generally high temperatures and high humidity. People with chronic conditions have to be even more careful in the heat than usual, especially with diabetes.
Hot summer weather can cause dehydration very quickly. It is important for everyone to increase their intake of liquids, not just people with diabetes. However, those of us with diabetes, have to know that dehydration can also occur when blood glucose levels are high, regardless of temperature, so when you are outside, it becomes doubly important to increase your intake of fluids.
1. Drink plenty of fluids throughout the day, especially water and even if you are not thirsty. Do not drink sugar-laden juices and sports drinks though -- they can just compound the problem. Beverages containing caffeine in moderate amounts do not seem to affect blood glucose levels. However, consuming large amounts of caffeine over a shorter amount of time seems to raise blood glucose in some individuals.
NOTE: If it is important to replace electrolytes, then some sports drinks may be necessary and extra testing may be necessary.
2. Exercise or do activities that are more strenuous in the early morning hours or evening hours of the day when temperatures are cooler and the sun is not at its zenith.
3. It is also recommended to check your blood glucose levels often when it is hot outside. Both hyper and hypoglycemia can be a problem during hot weather.
Heat stroke is a form of hyperthermia. This means that you have an abnormally elevated body temperature with accompanying physical and neurological symptoms. Unlike heat cramps and heat exhaustion, two forms of hyperthermia that are less severe, heat stroke is a true medical emergency that can be fatal if not properly and promptly treated. I would urge everyone to be aware of this fact alone. A 911 call is important for fast action.
In very dry air, sweat evaporates easily, quickly cooling your body; but in very humid air, sweat does not evaporate. It may collect on the skin or run off your body without affecting your body's climbing temperature.
Extremely warm and humid temperatures can quickly overwhelm your body's cooling system - especially when there is not a breeze. When sweating can no longer keep you cool, body temperature quickly rises, causing the symptoms of heat-related illnesses.
Sunstroke is a type of heatstroke. Heatstroke is a condition that occurs after exposure to excessive heat. In sunstroke, also called heat illness, heat injury, hyperthermia, heat prostration, and heat collapse, the source of heat is the sun. Other types of heatstroke occur after exposure to heat from different sources
Heatstroke, including sunstroke, is considered the most severe of the heat-related illnesses. Heat can have punishing effects on your body. After excessive exercise or physical labor, your body can overheat, and you may suffer heat exhaustion.
Heat cramps occur after excessive loss of water and salt; usually resulting from excessive sweating, or after strenuous exercise or labor. During heat exhaustion and heat cramps, the heat, controlling system is still intact, but can be overwhelmed.
It is necessary to know the signs and symptoms of heat exhaustion, too, since the risk is higher in people with diabetes. If heat exhaustion is not taken care of, it can quickly progress to heat stroke. Heat stroke is a more urgent matter and is a medical emergency.
The body normally generates heat because of metabolism, and is usually able to dissipate the heat by either radiation of heat through the skin or by evaporation of sweat. However, in extreme heat, high humidity, or vigorous exertion under the sun, the body may not be able to dissipate the heat and the body temperature rises, sometimes up to 106°F (41.1°C) or higher.
Again - - A call to 911 is the best way to get help fast.
Resting in an air-conditioned room or another cool place and drinking more water should make you feel better. If you suspect heat exhaustion, call your doctor. He or she may want to follow up with an office visit or other interventions. If the doctor is not available, I suggest a visit to an emergency room.
Those most susceptible to heat/sun strokes include: infants, the elderly (often with associated heart diseases, lung diseases, kidney diseases, or who are taking medications that make them vulnerable to heat strokes), athletes, and outdoor workers physically exerting themselves under the sun.
The summer heat can also be a concern when trying to carry supplies such as insulin, meters and strips with you. Insulated bags with small refreezable gel packs are good for keeping things cool. Keep equipment out of direct sunlight as much as possible.
With some advanced planning and special considerations, summer can still be a safe and enjoyable time of year.
Part 1, Basics
I live in the north central part of the US, and generally have about four or five months that I need to be concerned about heatstroke. Others have more or less time to be concerned depending on their location.
I had heatstroke as a teenager, but have been able to adapt and have not had a reoccurrence. Yes, I am probably more conscious of what is happening now with that experience.
Summer is the time of year to enjoy being outdoors. When summer arrives here, so do generally high temperatures and high humidity. People with chronic conditions have to be even more careful in the heat than usual, especially with diabetes.
Hot summer weather can cause dehydration very quickly. It is important for everyone to increase their intake of liquids, not just people with diabetes. However, those of us with diabetes, have to know that dehydration can also occur when blood glucose levels are high, regardless of temperature, so when you are outside, it becomes doubly important to increase your intake of fluids.
1. Drink plenty of fluids throughout the day, especially water and even if you are not thirsty. Do not drink sugar-laden juices and sports drinks though -- they can just compound the problem. Beverages containing caffeine in moderate amounts do not seem to affect blood glucose levels. However, consuming large amounts of caffeine over a shorter amount of time seems to raise blood glucose in some individuals.
NOTE: If it is important to replace electrolytes, then some sports drinks may be necessary and extra testing may be necessary.
2. Exercise or do activities that are more strenuous in the early morning hours or evening hours of the day when temperatures are cooler and the sun is not at its zenith.
3. It is also recommended to check your blood glucose levels often when it is hot outside. Both hyper and hypoglycemia can be a problem during hot weather.
Heat stroke is a form of hyperthermia. This means that you have an abnormally elevated body temperature with accompanying physical and neurological symptoms. Unlike heat cramps and heat exhaustion, two forms of hyperthermia that are less severe, heat stroke is a true medical emergency that can be fatal if not properly and promptly treated. I would urge everyone to be aware of this fact alone. A 911 call is important for fast action.
In very dry air, sweat evaporates easily, quickly cooling your body; but in very humid air, sweat does not evaporate. It may collect on the skin or run off your body without affecting your body's climbing temperature.
Extremely warm and humid temperatures can quickly overwhelm your body's cooling system - especially when there is not a breeze. When sweating can no longer keep you cool, body temperature quickly rises, causing the symptoms of heat-related illnesses.
Sunstroke is a type of heatstroke. Heatstroke is a condition that occurs after exposure to excessive heat. In sunstroke, also called heat illness, heat injury, hyperthermia, heat prostration, and heat collapse, the source of heat is the sun. Other types of heatstroke occur after exposure to heat from different sources
Heatstroke, including sunstroke, is considered the most severe of the heat-related illnesses. Heat can have punishing effects on your body. After excessive exercise or physical labor, your body can overheat, and you may suffer heat exhaustion.
Heat cramps occur after excessive loss of water and salt; usually resulting from excessive sweating, or after strenuous exercise or labor. During heat exhaustion and heat cramps, the heat, controlling system is still intact, but can be overwhelmed.
It is necessary to know the signs and symptoms of heat exhaustion, too, since the risk is higher in people with diabetes. If heat exhaustion is not taken care of, it can quickly progress to heat stroke. Heat stroke is a more urgent matter and is a medical emergency.
The body normally generates heat because of metabolism, and is usually able to dissipate the heat by either radiation of heat through the skin or by evaporation of sweat. However, in extreme heat, high humidity, or vigorous exertion under the sun, the body may not be able to dissipate the heat and the body temperature rises, sometimes up to 106°F (41.1°C) or higher.
Again - - A call to 911 is the best way to get help fast.
Resting in an air-conditioned room or another cool place and drinking more water should make you feel better. If you suspect heat exhaustion, call your doctor. He or she may want to follow up with an office visit or other interventions. If the doctor is not available, I suggest a visit to an emergency room.
Those most susceptible to heat/sun strokes include: infants, the elderly (often with associated heart diseases, lung diseases, kidney diseases, or who are taking medications that make them vulnerable to heat strokes), athletes, and outdoor workers physically exerting themselves under the sun.
The summer heat can also be a concern when trying to carry supplies such as insulin, meters and strips with you. Insulated bags with small refreezable gel packs are good for keeping things cool. Keep equipment out of direct sunlight as much as possible.
With some advanced planning and special considerations, summer can still be a safe and enjoyable time of year.
March 24, 2010
Defined by Diabetes
Many people with diabetes speak and write about not letting diabetes define them. They go to great lengths to state how diabetes cannot and will not define them and their lives. I sincerely hope that their wish is granted.
I have to admit that I felt this way for a while and I thought I had possibly succeeded. However, after a long look in the mirror, I for one, know that my life now is defined and shaped by diabetes. I write about diabetes and about diabetes service dogs. I spend much of my day reading and researching diabetes, finding topics that I feel comfortable writing about and how diabetes affects me.
Of course, being retired helps me find the time to devote to this and enjoy doing these things. Whether I am able to help people or not, I look forward to sharing information with those ready to learn.
Diabetes has meant adding more doctors for me to see. I occasionally saw a podiatrist for an ingrown toenail or when I had planter warts, but now I see one on a quarterly basis to maintain healthy feet and to catch potential foot problems early. I never had need of an endocrinologist before diabetes, but now I see one on a quarterly basis.
I started seeing a neurologist for sleep apnea and what was neuropathy approximated three years before I was diagnosed with diabetes (should I have known what was coming then?). Now I see him at least twice a year and sometimes more often.
When I was diagnosed with diabetes, I was in the hospital for angina. Therefore, I see a heart doctor at least twice a year. I have always seen a urologist since I was a teenager and was kicked in the groin by a cow; however, now I see him additionally on a regular basis for checking my kidney health.
This year, I am planning on adding an oncologist for possible yearly visits to do a cancer check, partly because of age and family history, but also because I use lantus insulin. I still see my primary care physician on a quarterly basis. I have other doctors and specialists I see on an irregular basis, but in general my doctors are definitely a sign that I am a person with diabetes.
While I could say I don't want my life defined by diabetes, I find it is, and in some ways this definition is a good thing. It has caused me to be more conscious of my health and to be much more proactive in my health care. While some of my doctors may not be overly happy with my being proactive, most are happy and actually talk with me rather than at me. My diabetes has also forced me to be more social in the way I look at things, and more important, more willing to accept changes. While I am still feisty and ill-tempered at times letting my negative side get me into hot water, I am finding myself mellowing and becoming more even in my approach to life.
Diabetes makes me who I am now, and I will not deny this. I must test my blood glucose on a regular basis, both pre and post meals. I will do extensive testing from time to time when I add new foods or want to add new to me foods, and when things seem to be changing for me. I count carbs, do what I am able for exercise (and this is getting better), and take care of myself. I do let my wife help when needed.
When people actually stop and think about it, diabetes does affect the decisions those of us with diabetes make on a daily basis. It affects the foods we choose, which fortunately are more healthy for us than the ones we were eating before diagnosis. It affects the restaurants we patronize, the snacks we eat and to a large part when we eat.
Therefore, by being more realistic, I am gaining better control and not wasting time denying my diabetes.
I have to admit that I felt this way for a while and I thought I had possibly succeeded. However, after a long look in the mirror, I for one, know that my life now is defined and shaped by diabetes. I write about diabetes and about diabetes service dogs. I spend much of my day reading and researching diabetes, finding topics that I feel comfortable writing about and how diabetes affects me.
Of course, being retired helps me find the time to devote to this and enjoy doing these things. Whether I am able to help people or not, I look forward to sharing information with those ready to learn.
Diabetes has meant adding more doctors for me to see. I occasionally saw a podiatrist for an ingrown toenail or when I had planter warts, but now I see one on a quarterly basis to maintain healthy feet and to catch potential foot problems early. I never had need of an endocrinologist before diabetes, but now I see one on a quarterly basis.
I started seeing a neurologist for sleep apnea and what was neuropathy approximated three years before I was diagnosed with diabetes (should I have known what was coming then?). Now I see him at least twice a year and sometimes more often.
When I was diagnosed with diabetes, I was in the hospital for angina. Therefore, I see a heart doctor at least twice a year. I have always seen a urologist since I was a teenager and was kicked in the groin by a cow; however, now I see him additionally on a regular basis for checking my kidney health.
This year, I am planning on adding an oncologist for possible yearly visits to do a cancer check, partly because of age and family history, but also because I use lantus insulin. I still see my primary care physician on a quarterly basis. I have other doctors and specialists I see on an irregular basis, but in general my doctors are definitely a sign that I am a person with diabetes.
While I could say I don't want my life defined by diabetes, I find it is, and in some ways this definition is a good thing. It has caused me to be more conscious of my health and to be much more proactive in my health care. While some of my doctors may not be overly happy with my being proactive, most are happy and actually talk with me rather than at me. My diabetes has also forced me to be more social in the way I look at things, and more important, more willing to accept changes. While I am still feisty and ill-tempered at times letting my negative side get me into hot water, I am finding myself mellowing and becoming more even in my approach to life.
Diabetes makes me who I am now, and I will not deny this. I must test my blood glucose on a regular basis, both pre and post meals. I will do extensive testing from time to time when I add new foods or want to add new to me foods, and when things seem to be changing for me. I count carbs, do what I am able for exercise (and this is getting better), and take care of myself. I do let my wife help when needed.
When people actually stop and think about it, diabetes does affect the decisions those of us with diabetes make on a daily basis. It affects the foods we choose, which fortunately are more healthy for us than the ones we were eating before diagnosis. It affects the restaurants we patronize, the snacks we eat and to a large part when we eat.
Therefore, by being more realistic, I am gaining better control and not wasting time denying my diabetes.
March 21, 2010
Official and Unofficial Types of Diabetes
The American Diabetes Association only recognizes a few types of diabetes. I referred to them and missed a few in my blog of Aug 18, 2009. If I had been on the ball, I would not have missed the article by Dr. Bill Quick of Aug 17, 2009 where he correctly listed them and the subgroups. He obtained his from a posting on the ADA site. The official termination for diabetes includes:
The unofficial types, or what people want you to believe are recognized, are presently listed as two types only; however, several groups and organizations are competing for each type. I have not included what I stated in my previous blog.
Type 3.
Among the groups and organizations that want this unofficial type are some that want to include several of the ADA approved definitions in this to muddy the waters and add to the confusion.
Type 4.
Several groups also want this assigned to their way of classifying diabetes.
What surprises me is that a new unofficial term of prediabetes is not advocated for in my research efforts yet. Yes, I am sure that there are those just waiting to do this and if I have not found it, I will shortly. The ADA has written about it here, but not officially listed it as classification, which may be discouraging some from trying to coop it for their own.
Until the ADA takes a stand and tells individuals, groups, and organizations that they must label their difinitions as unofficial we will continue to have confusion. On this I will support Dr. Bill Quick when he states "In my opinion, anyone using unofficial terminology, such as type 1.5 or type 3, should acknowledge that it is unofficial, and clearly define what they are talking about." Here I would include type four and others that show up.
It is time that the ADA came forward and made a statement about those professing that these types are in existance and clear the air about all these unofficial classifications. The ADA could also comment on the possible types under consideration and let people know that as of yet they are not official. While I do not always agree with the policies and recommendations of the ADA, we do need an official organization to keep the confusion to a minimum.
- Type 1 and this includes LADA (Latent Autoimmune Diabetes in Adults)
- Type 2
- Gestational
- Other specific types and includes several subgroups (which I will let you read for yourself) and includes MODY (Maturity-onset Diabetes of the Young)
The unofficial types, or what people want you to believe are recognized, are presently listed as two types only; however, several groups and organizations are competing for each type. I have not included what I stated in my previous blog.
Type 3.
Among the groups and organizations that want this unofficial type are some that want to include several of the ADA approved definitions in this to muddy the waters and add to the confusion.
- A combination of type 1 an type 2 - autoimmune and insulin resistance in young people and adults. This is a recent development caused by overweight individuals. The following are wanting type 3 for this condition. The group at Battle Diabetes.com, lifescript .com, livestrong .com, and askginny are supporters of this.
- Lack of insulin produced in the brain which seems to lead to Alzheimers and/or dementia. This is supported by the burrillreport .com, inventorspot .com, and new-treatment for diabetes.
- There is some that want the different types of MODY classed as type 3. Some even want the different types of MODY separately typed (3A, 3B, 3C, etc.. These include wikihealth .com and diabetesindex .com.
- Gestational diabetes is another ADA approved that people want type 3 assigned to. Aparently a doctors website is wanting this as is another group.
Type 4.
Several groups also want this assigned to their way of classifying diabetes.
- Gestational diabetes - again someone wants this classed as type 4 and one of these is wikihealth.
- Hypoglcemia - here an individual is the one on the bandwagon and has written a book doing just that.
- Some of the subgroups included in the ADA definition are included by the doctors website as type 4
What surprises me is that a new unofficial term of prediabetes is not advocated for in my research efforts yet. Yes, I am sure that there are those just waiting to do this and if I have not found it, I will shortly. The ADA has written about it here, but not officially listed it as classification, which may be discouraging some from trying to coop it for their own.
Until the ADA takes a stand and tells individuals, groups, and organizations that they must label their difinitions as unofficial we will continue to have confusion. On this I will support Dr. Bill Quick when he states "In my opinion, anyone using unofficial terminology, such as type 1.5 or type 3, should acknowledge that it is unofficial, and clearly define what they are talking about." Here I would include type four and others that show up.
It is time that the ADA came forward and made a statement about those professing that these types are in existance and clear the air about all these unofficial classifications. The ADA could also comment on the possible types under consideration and let people know that as of yet they are not official. While I do not always agree with the policies and recommendations of the ADA, we do need an official organization to keep the confusion to a minimum.
March 14, 2010
Surprises on Diabetes Forums
Sometimes we all have to wonder what is happening. Many of us know that we have to eat by what our meter tells us. We know that the ADA guidelines are there for a reason; however, by using our meter we know that the guidelines are out of our reach, but maybe not for everyone.
Maybe this should more appropriately be titled Move over ADA, the Diabetes Forums will now set the standards. This does not include the smaller forums and those outside the US. They generally have different agendas.
While all forums do a lot of good for people with diabetes - all types - they all have their idiosyncrasies which take some time to adjust to. Some of these are good because they allow for people with different needs and personalities.
For the four largest US Diabetes Forums, the challenge apparently is being in disagreement with the ADA or finding ways to create conflicts. Whether this is intentional or just their aggressive posturing and marketing strategy remains to be understood as the forums are very closed about what they do behind the scenes. However, let the members say too much against the ADA, and the moderators will discourage or stop this by what ever means they feel appropriate.
The large diabetes forums are trying to usurp ADA in the designation of types of diabetes. They do not make any statements that this is an unofficial designation and that the designation is for simplicity. This is important because by their actions they are misleading their members. Unless their members are diabetes and ADA savvy, they will assume the forum they belong to is correct. This applies to type 1.5 (LADA) Latent Autoimmune Diabetes in Adults. The ADA designation is LADA and it is included in the discussion of Type 1.
Three of the four forums has the audacity to label a group of people that do not have diabetes as a Type 3 class. I believe all four do this, but have not found it in the last one. There are many other examples put forth by the forums, but this is a topic for another blog.
This is explained (lamely) as including family members and friends of people with diabetes and caregivers. Offended, VERY MUCH SO! My wife, daughter, and son are also offended, and like myself do not like that my family members are disrespected and stereotyped because people are lazy. It is my diabetes, not theirs. My family respects that I am able to take charge and not force them to be part of my diabetes. I know they would come to my aid if and when it may be needed.
Even some of the bloggers in the Diabetes Online Community (DOC) have classed people without diabetes as Type 3. (same as above). While I can agree the family and friends may be an integral part in the support of family members with diabetes, they should be given the respect they deserve and not stereotyped.
While the ADA is slow to recognize some forms of possible diabetes, I have to wonder where the four diabetes forums have received the authority that they seem to be so willing to flaunt in the face of the ADA.
On March 9, 2010, a question was asked about the policies of one forum. What followed was not the prettiest with members generally on one side and site personnel on the other. It can be found at the first post (link broken) and the topic is locked at seven plus pages. Before reading all of the information, it would be good good to get a different perspective on the topic of resistant starch. While the forum did not say how long resistant starch has been in existence, they presented it as the latest help and miracle tool for people with diabetes. My research is telling me that resistant starch existed before 2004.
Before I get too far into this, I will stop and let Tom Ross finish the topic by referring you to his blog (link is now broken) of March 11, 2010. He has done an excellent job of covering the topic and discussion on resistant starch.
Maybe this should more appropriately be titled Move over ADA, the Diabetes Forums will now set the standards. This does not include the smaller forums and those outside the US. They generally have different agendas.
While all forums do a lot of good for people with diabetes - all types - they all have their idiosyncrasies which take some time to adjust to. Some of these are good because they allow for people with different needs and personalities.
For the four largest US Diabetes Forums, the challenge apparently is being in disagreement with the ADA or finding ways to create conflicts. Whether this is intentional or just their aggressive posturing and marketing strategy remains to be understood as the forums are very closed about what they do behind the scenes. However, let the members say too much against the ADA, and the moderators will discourage or stop this by what ever means they feel appropriate.
The large diabetes forums are trying to usurp ADA in the designation of types of diabetes. They do not make any statements that this is an unofficial designation and that the designation is for simplicity. This is important because by their actions they are misleading their members. Unless their members are diabetes and ADA savvy, they will assume the forum they belong to is correct. This applies to type 1.5 (LADA) Latent Autoimmune Diabetes in Adults. The ADA designation is LADA and it is included in the discussion of Type 1.
Three of the four forums has the audacity to label a group of people that do not have diabetes as a Type 3 class. I believe all four do this, but have not found it in the last one. There are many other examples put forth by the forums, but this is a topic for another blog.
This is explained (lamely) as including family members and friends of people with diabetes and caregivers. Offended, VERY MUCH SO! My wife, daughter, and son are also offended, and like myself do not like that my family members are disrespected and stereotyped because people are lazy. It is my diabetes, not theirs. My family respects that I am able to take charge and not force them to be part of my diabetes. I know they would come to my aid if and when it may be needed.
Even some of the bloggers in the Diabetes Online Community (DOC) have classed people without diabetes as Type 3. (same as above). While I can agree the family and friends may be an integral part in the support of family members with diabetes, they should be given the respect they deserve and not stereotyped.
While the ADA is slow to recognize some forms of possible diabetes, I have to wonder where the four diabetes forums have received the authority that they seem to be so willing to flaunt in the face of the ADA.
On March 9, 2010, a question was asked about the policies of one forum. What followed was not the prettiest with members generally on one side and site personnel on the other. It can be found at the first post (link broken) and the topic is locked at seven plus pages. Before reading all of the information, it would be good good to get a different perspective on the topic of resistant starch. While the forum did not say how long resistant starch has been in existence, they presented it as the latest help and miracle tool for people with diabetes. My research is telling me that resistant starch existed before 2004.
Before I get too far into this, I will stop and let Tom Ross finish the topic by referring you to his blog (link is now broken) of March 11, 2010. He has done an excellent job of covering the topic and discussion on resistant starch.
March 10, 2010
Tips for People with Diabetes
Many people look for or seek rules that they can apply to their diabetes. What they are looking for is the pill or shot approach to cure their diabetes. They have been given the diagnosis and like most expect the doctor to give them a pill prescription or series of shots and they will be back to living the good life. They are looking for the wrong solution because people with type 2 diabetes can vary so much in what their pancreas is producing. For some, their pancreas is producing a good amount of insulin while for others their pancreas in producing a small amount of insulin. Insulin resistance is another factor that will affect how the medications will react for them. Add in other factors such as body chemistry, other ailments, and sleep apnea and you can forget about simple rules.
Below are some tips that may apply, but many people will refuse to follow them.
Tip 1. Relax, you did not develop diabetes overnight. It may take some time to get your diabetes under the control you want. As you become more comfortable with living with diabetes and how it affects your body, you will develop a routine. While diabetes will be in your thoughts daily, it will not necessarily define you. Some people are able to radically change their lifestyle overnight, while others do not find the comfort zone for a few months.
Tip 2. What works for me may not work for you. Diabetes is a very individual disease. We can do a lot of adjusting to try to get the numbers where we want them. No one can say - "do what I do", and you will have the same results. We can only tell you what works for us, but you will have to experiment to find what works for you.
Tip 3. Let you meter tell you what to eat - it should become your best friend. Experiment with different foods and test two hours later to see what your blood glucose reading is. Test a lot the first couple of months and try different foods and combinations of food. Determine the amount fat in your foods to know whether you need to test at one hour and three hours. Eating a meal with more carbohydrates than normal should make you check your blood glucose reading to determine how the foods affect your blood glucose levels. When you have established some good routines and habits, then you may reduce your testing frequency. Be prepared to test more often and make it a habit to do intensive testing when things change or to check for possible changes.
Tip 4. It is all about carbohydrates (carbs). Everyone has to develop his or her own daily carb budget or menu. Then you need to follow it to help keep your diabetes under control. You will eventually develop a plan and possibly some variations. There are some other factors such as lactose intolerance or gluten allergies that can interfere with a person's daily nutrition. Learn how to keep experimenting to develop what works for you.
Tip 5. Diabetes requires a lifestyle change - not a diet - diets fail. It is also not a day or two thing, it is a 24/7 lifestyle change, and we are in for the rest of our lives. The process involves learning everything you can about your diabetes, and everything you can about yourself and your body. Then apply it to your life on a daily basis.
Tip 6. You will make mistakes. We all do, and if you make one, it is important what you decide to do about it, but it is more important what you learn from the mistake. Pick up the pieces, reassemble them, and move on. It is not healthy to become stuck in depression or feel like a failure. We do not fail, we do not blame ourselves, we learn to experiment.
Tip 7. Be flexible, being rigid will break you. Do not become obsessed with numbers - they should become part of routines and goals, but not an obsession. Diabetes can change at a moments notice. What works well today may not work tomorrow. There may be no rhyme or reason to the change, it may change for a reason you can comprehend, or it may simply leave you guessing. Sometimes, you just have to blame the phase of the moon for messing with your numbers and let the stress melt away.
Tip 8. Keep moving! Otherwise they will be throwing dirt on you. Exercise as much as you are able. Park as far from the store as you are able, use stairs when possible, and not the elevator. You need to find the level of exercise that suits you. Some people exercise after every meal, some are not able, it is all part of being flexible.
Tip 9. If you feel like screaming, kicking, maybe saying something under your breath, well, do it! There are times that diabetes can seem overwhelming and nothing is what it should be. As long as you are not screaming at your spouse, the kids, others, and kicking the animals - let it happen. There are times you must get it out of your system.
Tip 10. Do not let denial and small failures derail your control. This will defeat you and allow complications to get a foothold in your life. We are not perfect; however, there is a lot we can do to minimize complications, delay complications, or possibly prevent complications.
Tip 11. Keep a positive attitude. This will serve you well.
Tip 12. Remember the eleven tips and use them!
If you find other tips that work for you and apply to your circumstances, write them down and use them. This is not meant to be all-inclusive. Always be prepared to change your approach and goals as your situation changes.
Tom Ross gave the below answer to a post on dLife diabetes forum when someone was looking for guidelines. This is excellent advice for anyone and ties into the tips above.
Below are some tips that may apply, but many people will refuse to follow them.
Tip 1. Relax, you did not develop diabetes overnight. It may take some time to get your diabetes under the control you want. As you become more comfortable with living with diabetes and how it affects your body, you will develop a routine. While diabetes will be in your thoughts daily, it will not necessarily define you. Some people are able to radically change their lifestyle overnight, while others do not find the comfort zone for a few months.
Tip 2. What works for me may not work for you. Diabetes is a very individual disease. We can do a lot of adjusting to try to get the numbers where we want them. No one can say - "do what I do", and you will have the same results. We can only tell you what works for us, but you will have to experiment to find what works for you.
Tip 3. Let you meter tell you what to eat - it should become your best friend. Experiment with different foods and test two hours later to see what your blood glucose reading is. Test a lot the first couple of months and try different foods and combinations of food. Determine the amount fat in your foods to know whether you need to test at one hour and three hours. Eating a meal with more carbohydrates than normal should make you check your blood glucose reading to determine how the foods affect your blood glucose levels. When you have established some good routines and habits, then you may reduce your testing frequency. Be prepared to test more often and make it a habit to do intensive testing when things change or to check for possible changes.
Tip 4. It is all about carbohydrates (carbs). Everyone has to develop his or her own daily carb budget or menu. Then you need to follow it to help keep your diabetes under control. You will eventually develop a plan and possibly some variations. There are some other factors such as lactose intolerance or gluten allergies that can interfere with a person's daily nutrition. Learn how to keep experimenting to develop what works for you.
Tip 5. Diabetes requires a lifestyle change - not a diet - diets fail. It is also not a day or two thing, it is a 24/7 lifestyle change, and we are in for the rest of our lives. The process involves learning everything you can about your diabetes, and everything you can about yourself and your body. Then apply it to your life on a daily basis.
Tip 6. You will make mistakes. We all do, and if you make one, it is important what you decide to do about it, but it is more important what you learn from the mistake. Pick up the pieces, reassemble them, and move on. It is not healthy to become stuck in depression or feel like a failure. We do not fail, we do not blame ourselves, we learn to experiment.
Tip 7. Be flexible, being rigid will break you. Do not become obsessed with numbers - they should become part of routines and goals, but not an obsession. Diabetes can change at a moments notice. What works well today may not work tomorrow. There may be no rhyme or reason to the change, it may change for a reason you can comprehend, or it may simply leave you guessing. Sometimes, you just have to blame the phase of the moon for messing with your numbers and let the stress melt away.
Tip 8. Keep moving! Otherwise they will be throwing dirt on you. Exercise as much as you are able. Park as far from the store as you are able, use stairs when possible, and not the elevator. You need to find the level of exercise that suits you. Some people exercise after every meal, some are not able, it is all part of being flexible.
Tip 9. If you feel like screaming, kicking, maybe saying something under your breath, well, do it! There are times that diabetes can seem overwhelming and nothing is what it should be. As long as you are not screaming at your spouse, the kids, others, and kicking the animals - let it happen. There are times you must get it out of your system.
Tip 10. Do not let denial and small failures derail your control. This will defeat you and allow complications to get a foothold in your life. We are not perfect; however, there is a lot we can do to minimize complications, delay complications, or possibly prevent complications.
Tip 11. Keep a positive attitude. This will serve you well.
Tip 12. Remember the eleven tips and use them!
If you find other tips that work for you and apply to your circumstances, write them down and use them. This is not meant to be all-inclusive. Always be prepared to change your approach and goals as your situation changes.
Tom Ross gave the below answer to a post on dLife diabetes forum when someone was looking for guidelines. This is excellent advice for anyone and ties into the tips above.
“Any guideline, from the ADA
Guidelines are theory-based. Good diabetes management has to be reality-based. In practical terms, what that means is that you don't ask theADA
Don't focus on theory -- focus on experimentation. Find out what works for you, and what doesn't work for you. Let your meter be your final authority -- if one way of eating doesn't get you good results, find another way.
Normally I would recommend exercising a lot, since that has been so helpful in my case, but your hip problems seemingly would limit your options there. If you can't exercise, you're going to need to be all the more careful about what you eat. Certainly you're not going to want to eat something just because theADA
Guidelines are theory-based. Good diabetes management has to be reality-based. In practical terms, what that means is that you don't ask the
Don't focus on theory -- focus on experimentation. Find out what works for you, and what doesn't work for you. Let your meter be your final authority -- if one way of eating doesn't get you good results, find another way.
Normally I would recommend exercising a lot, since that has been so helpful in my case, but your hip problems seemingly would limit your options there. If you can't exercise, you're going to need to be all the more careful about what you eat. Certainly you're not going to want to eat something just because the
February 11, 2010
Blind Spots - the Good and Bad
I hope that the people at JJSDiabetes will read this. I owe them an apology for posting on their blog. It is clearly marked now that it is for members only. If it was before, I will admit that I did not see it. So I admit to having a punctum cecum (a blind spot).
The topic was about the Lancet Study and while they do say that each patient needs an individual plan, I made a comment about the study being faulty and poorly carried out. My comment is at "Where Are "U"?" which is now several posts down. A second post then offered another study and referred to an article by Janet Ruhl. So now I need to apologize to Janet for getting her dragged into this as well.
Did it end there - no, not by a long way. I received a rather nasty email from the person of the blog. I admit I should not have posted a comment, but it is now the subject of a second post.
I can only pray that this doctor (see his litany of his education in the post) can recover from his punctum cecum and treat his patients with a little concern. My post should not have been published since I am not a member, but the rage shown is over the top. I made a mistake so I have to live with it. Then he does even more by going after Janet Ruhl. I will let you read his response to her article and she did not even post a comment. Enough of this vent. It just reinforces the topic below.
How exciting is the internet? I had been working on this post and pulling ideas from other bloggers and forum members about patient - doctor problems. The above example and the blog by Trisha Torrey from About.com of Jan 18, 2010 worked to bring my thoughts together. Her article is about a problem we all have - a panctum cecum. Then she tied it together with the medical community, and specifically physicians. While I totally agree with her analysis and examples, I want to expand this to include the entire medical community.
This is not to be a put down of the entire medical community; There have been enough problems between doctors and patients with mistakes on both sides to generate a library. Of particular interest was a comment by Trisha Torrey that bears emphasis. When doctors ignore their blind spot (my words), "it's information we patients can use to help our physicians understand why it is they need to think harder. Why they need to rustle up their best practices in differential diagnosis. And why we patients need to hold their toes to the fire."
There are many times on the diabetes forums when we read of patients saying that when the doctor gives them the diagnosis, he gives them a handful of prescriptions, and says they will see you in three to six months or longer. There are other versions about not being given testing supplies, or the worst, watch your sugar and see you in three months (no exact wording of diagnosis even given).
Doctors are busy and set about 15 minutes to see each patient. The doctors often have little or no choice in this as the medical insurance companies often dictate the length of time for which they will reimburse the doctor. This is a practice that needs change from a medical and insurance perspective. When a patient is given a diagnosis of diabetes or any other disease, there should be extra time taken to explain the medicines, the treatment, and the goals that need to be established.
There are those (like me) that think that some of the examples happen because the doctor has not kept up with the developments in diabetes and wants to do some research before the next appointment. Some doctors have a hard time telling the patient the bad news, while others are afraid that the patient will follow their own course of action and not follow their instructions. And this is true for some patients.
Why don't doctors make use of dietitians, certified diabetes educators, other specialists, or refer their patients to an endocrinologist? Some doctors do not have access to these people because of being in small rural areas and too far from these resources. Some think they are the only doctor the patient needs. Others do not want these resources contradicting what they tell the patient and some just don't want to lose the patient.
Some doctors are locked into situations where they are told to work with specialists who will contradict them every chance they can. Then we have the doctors that are confident of themselves, do make referrals, and deal with conflicting advice is a positive manner. Many are understanding of their patients and some actually talk with their patients and not at them. If you are fortunate enough to have one of these rare doctors, treasure them, they are looking out for you.
Dr. Bill Quick suggests is his blog of January 23, 2010 about drug labels that we read the labels and the required FDA enclosures to "wow your doctor at the nest visit with all sorts of trivia you've learned". Yes, he went on to to give some excellent reasons for doing your homework. Then he delivered the best reason - "After all, you're the one who's taking the medication, and you have the opportunity to learn more. Go for it!" Was his humor in order - maybe for some people and some doctors, but for diabetes patients, there has to be some concern if doctors view our knowledge in this manner.
We need to think about our doctors and the lack of information that we are given. Applying the logic of Dr. Quick - the doctor is not the one that will suffer from the lack of advice or giving us poor information, we the patients are the ones who will pay the price, and suffer the complications. Letting our doctors get away with this is not something we should accept. Rather than allowing them to duck their responsibilities, we the patients need to "hold their toes to the fire".
Will Ryan states is his blog that less than half of the people with diabetes are receiving education about diabetes. This is sad. While diabetes has many twists and turns, it is not unmanageable or uncontrollable. No, we are not always in every situation going to have excellent control, but by learning the signs and what causes problems, we can prevent poor control. We can keep the beast under good to excellent control despite our doctors, but their assistance helps even more.
Now while dietitians, diabetes educators, RN's, and any other specialist that is not a doctor, seem to march lock step with the ADA, we need to also hold their toes to the fire. Some of these professionals are realizing that each patient is different and have requirements unique to them; and they are tailoring programs to fit the patient. These professionals respect their profession, honor their jobs, and are those we can rely on and trust. Others unfortunately, will not stray from an ingrained doctrine that is promoted by the ADA and will not hear of any deviation; and they will openly contradict any doctor trying to work with a patient to meet the needs of the patient. They will sabotage the doctors for any number of reason. They are supposed to be professionals, but they take any doctor to task for not sending all patients to them, a remark that the doctor makes and for a host of reasons. Whether these professionals have a "blind spot" is self evident, and they need to change their profession.
Now we come to us - the patients with diabetes. We need to learn that knowledge is power. We have to become proactive in our care. We have to understand how patient empowerment can help us. This means that we need to educate ourselves and learn from every source available to us. We need to know when we make mistakes and admit them. Then we need to learn how to use this knowledge - and not just to "wow" our doctors. Some people have wrongly assumed this means disagreeing with our doctors. No Way! It means intelligently discussing your care and treatment with your doctor(s). It should include finding the right medicine with your doctor to fit your symptoms, body chemistry, and well-being. Not all medicines work for every patient. It will include discussions with your doctor about whether or not meds will be necessary for what length of time, and what the requirements are to be able; if possible, to get off a medicine. It will also include what to do if you experience any of the side effects.
We need to continue our education to be able to maintain control of our diabetes and to know when, outside of regular office visits, to contact our doctor about a problem. We need to learn what factors can influence our control of diabetes. Some of the problems, in no specific order, are - stress and hypertension, sleep apnea, illness, inflammation, certain foods, the use of steroids (prescribed) to treat pain, depression, and many others. These are things that we can learn how to control once we recognize them for what they are. Easy, maybe not, but with the assistance of our doctor and the education we can accumulate, we can exercise some control and get back to nearer normal more rapidly. So for this I will say we need to hold our own toes to the fire as well.
Before leaving this, I must mention a blog on February 9, 2010 by Amy Tenderich about Health 2.0. There is much merit in the discussion she refers to and this should have a place for us in the future. Follow the link she provides for some of the discussions.
The topic was about the Lancet Study and while they do say that each patient needs an individual plan, I made a comment about the study being faulty and poorly carried out. My comment is at "Where Are "U"?" which is now several posts down. A second post then offered another study and referred to an article by Janet Ruhl. So now I need to apologize to Janet for getting her dragged into this as well.
Did it end there - no, not by a long way. I received a rather nasty email from the person of the blog. I admit I should not have posted a comment, but it is now the subject of a second post.
I can only pray that this doctor (see his litany of his education in the post) can recover from his punctum cecum and treat his patients with a little concern. My post should not have been published since I am not a member, but the rage shown is over the top. I made a mistake so I have to live with it. Then he does even more by going after Janet Ruhl. I will let you read his response to her article and she did not even post a comment. Enough of this vent. It just reinforces the topic below.
How exciting is the internet? I had been working on this post and pulling ideas from other bloggers and forum members about patient - doctor problems. The above example and the blog by Trisha Torrey from About.com of Jan 18, 2010 worked to bring my thoughts together. Her article is about a problem we all have - a panctum cecum. Then she tied it together with the medical community, and specifically physicians. While I totally agree with her analysis and examples, I want to expand this to include the entire medical community.
This is not to be a put down of the entire medical community; There have been enough problems between doctors and patients with mistakes on both sides to generate a library. Of particular interest was a comment by Trisha Torrey that bears emphasis. When doctors ignore their blind spot (my words), "it's information we patients can use to help our physicians understand why it is they need to think harder. Why they need to rustle up their best practices in differential diagnosis. And why we patients need to hold their toes to the fire."
There are many times on the diabetes forums when we read of patients saying that when the doctor gives them the diagnosis, he gives them a handful of prescriptions, and says they will see you in three to six months or longer. There are other versions about not being given testing supplies, or the worst, watch your sugar and see you in three months (no exact wording of diagnosis even given).
Doctors are busy and set about 15 minutes to see each patient. The doctors often have little or no choice in this as the medical insurance companies often dictate the length of time for which they will reimburse the doctor. This is a practice that needs change from a medical and insurance perspective. When a patient is given a diagnosis of diabetes or any other disease, there should be extra time taken to explain the medicines, the treatment, and the goals that need to be established.
There are those (like me) that think that some of the examples happen because the doctor has not kept up with the developments in diabetes and wants to do some research before the next appointment. Some doctors have a hard time telling the patient the bad news, while others are afraid that the patient will follow their own course of action and not follow their instructions. And this is true for some patients.
Why don't doctors make use of dietitians, certified diabetes educators, other specialists, or refer their patients to an endocrinologist? Some doctors do not have access to these people because of being in small rural areas and too far from these resources. Some think they are the only doctor the patient needs. Others do not want these resources contradicting what they tell the patient and some just don't want to lose the patient.
Some doctors are locked into situations where they are told to work with specialists who will contradict them every chance they can. Then we have the doctors that are confident of themselves, do make referrals, and deal with conflicting advice is a positive manner. Many are understanding of their patients and some actually talk with their patients and not at them. If you are fortunate enough to have one of these rare doctors, treasure them, they are looking out for you.
Dr. Bill Quick suggests is his blog of January 23, 2010 about drug labels that we read the labels and the required FDA enclosures to "wow your doctor at the nest visit with all sorts of trivia you've learned". Yes, he went on to to give some excellent reasons for doing your homework. Then he delivered the best reason - "After all, you're the one who's taking the medication, and you have the opportunity to learn more. Go for it!" Was his humor in order - maybe for some people and some doctors, but for diabetes patients, there has to be some concern if doctors view our knowledge in this manner.
We need to think about our doctors and the lack of information that we are given. Applying the logic of Dr. Quick - the doctor is not the one that will suffer from the lack of advice or giving us poor information, we the patients are the ones who will pay the price, and suffer the complications. Letting our doctors get away with this is not something we should accept. Rather than allowing them to duck their responsibilities, we the patients need to "hold their toes to the fire".
Will Ryan states is his blog that less than half of the people with diabetes are receiving education about diabetes. This is sad. While diabetes has many twists and turns, it is not unmanageable or uncontrollable. No, we are not always in every situation going to have excellent control, but by learning the signs and what causes problems, we can prevent poor control. We can keep the beast under good to excellent control despite our doctors, but their assistance helps even more.
Now while dietitians, diabetes educators, RN's, and any other specialist that is not a doctor, seem to march lock step with the ADA, we need to also hold their toes to the fire. Some of these professionals are realizing that each patient is different and have requirements unique to them; and they are tailoring programs to fit the patient. These professionals respect their profession, honor their jobs, and are those we can rely on and trust. Others unfortunately, will not stray from an ingrained doctrine that is promoted by the ADA and will not hear of any deviation; and they will openly contradict any doctor trying to work with a patient to meet the needs of the patient. They will sabotage the doctors for any number of reason. They are supposed to be professionals, but they take any doctor to task for not sending all patients to them, a remark that the doctor makes and for a host of reasons. Whether these professionals have a "blind spot" is self evident, and they need to change their profession.
Now we come to us - the patients with diabetes. We need to learn that knowledge is power. We have to become proactive in our care. We have to understand how patient empowerment can help us. This means that we need to educate ourselves and learn from every source available to us. We need to know when we make mistakes and admit them. Then we need to learn how to use this knowledge - and not just to "wow" our doctors. Some people have wrongly assumed this means disagreeing with our doctors. No Way! It means intelligently discussing your care and treatment with your doctor(s). It should include finding the right medicine with your doctor to fit your symptoms, body chemistry, and well-being. Not all medicines work for every patient. It will include discussions with your doctor about whether or not meds will be necessary for what length of time, and what the requirements are to be able; if possible, to get off a medicine. It will also include what to do if you experience any of the side effects.
We need to continue our education to be able to maintain control of our diabetes and to know when, outside of regular office visits, to contact our doctor about a problem. We need to learn what factors can influence our control of diabetes. Some of the problems, in no specific order, are - stress and hypertension, sleep apnea, illness, inflammation, certain foods, the use of steroids (prescribed) to treat pain, depression, and many others. These are things that we can learn how to control once we recognize them for what they are. Easy, maybe not, but with the assistance of our doctor and the education we can accumulate, we can exercise some control and get back to nearer normal more rapidly. So for this I will say we need to hold our own toes to the fire as well.
Before leaving this, I must mention a blog on February 9, 2010 by Amy Tenderich about Health 2.0. There is much merit in the discussion she refers to and this should have a place for us in the future. Follow the link she provides for some of the discussions.
February 5, 2010
Thoughts and a request
Thoughts
The last two days have been interesting and very disappointing! It is interesting that very few type 2 bloggers have made little or no comments about the Oprah and OZ show. Not only did they go for ratings and the sensational aspects, but missed an opportunity to do something positive for people with diabetes.
I have never been a fan of the Oprah show, but she has done some good things, but when combined with a doctor of medicine who apparently can not make a living in medical practice, we get knifed in the back and have to put up with more misinformation for several years.
Request
If you are a person with diabetes (type 2) that is blogging about diabetes - if you are interested in being listed on David Mendosa's web site in the list of Type 2 bloggers (about 1/3 the way down the page) between item 52 and item 53, please send me an email and I will forward your request to him.
I have been encouraging type 2 people that are blogging and have let several months pass, to continue blogging. There are many more type 1 people blogging and we need to continue being represented. There are many good Type 2 bloggers and I want them to succeed.
My email is on my profile page.
Thank you.
The last two days have been interesting and very disappointing! It is interesting that very few type 2 bloggers have made little or no comments about the Oprah and OZ show. Not only did they go for ratings and the sensational aspects, but missed an opportunity to do something positive for people with diabetes.
I have never been a fan of the Oprah show, but she has done some good things, but when combined with a doctor of medicine who apparently can not make a living in medical practice, we get knifed in the back and have to put up with more misinformation for several years.
Request
If you are a person with diabetes (type 2) that is blogging about diabetes - if you are interested in being listed on David Mendosa's web site in the list of Type 2 bloggers (about 1/3 the way down the page) between item 52 and item 53, please send me an email and I will forward your request to him.
I have been encouraging type 2 people that are blogging and have let several months pass, to continue blogging. There are many more type 1 people blogging and we need to continue being represented. There are many good Type 2 bloggers and I want them to succeed.
My email is on my profile page.
Thank you.
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