The Smallest Minority on earth is the individual. Those who deny individual rights cannot claim to be defenders of minorities. - Ayn Rand
Don't believe your labs. Do NOT go on any drugs unless your sugar is WAY high (12 hour fast with sugar over 140 three days in a row).
Get a glucosimeter now. Test yourself when you wake up, then before breakfast, then two hours after breakfast, then two hours after lunch, then two hours after dinner, then before bed.
Log EVERYTHING for two weeks.
THEN go back and talk to your doc again.
Type I (insulin dependent) or Type II (pills)?
On the bright side, you get a good excuse for all the heroin needle tracks... /gallows humor
God-willing, everything turns out okay, Kevin.
Kevin, I've been Type 1 diabetic for 24 years. I've been on a multiple daily insulin injection regimen since day 1.
Data, man, data.
Get thee an Accu Chek Aviva glucometer pronto, and tell us what it says. Like Chris Byrne, I'm interested in what it says two hours after eating regular meals, and most especially, what it says when you wake up in the morning.
Hype tracks only come from dirty needles or bad shooting conditions. Smart IDDMII's know how to get good works and keep it clean.
All dark humor aside, it's not the end. In fact, it can be a new beginning, if you treat it right. Hang in.
Type II. My blood yesterday morning at 6:30 AM registered 160 apparently. For the last several years it's been around 102 or so. Dr. is asking to see if the lab can use what's left of the sample for an A1C test.
Picked up a glucometer on the way home. 5:00PM: 116. Ate dinner (including some rice). Two hours later: 162. We'll see what it is tomorrow at 5:30AM.
I have an appointment to see the Dr. again in two months. Until then I'm doing nothing but changing my diet and activity level and monitoring my blood glucose. No drugs.
The problem is, with AIP I have to maintain relatively high blood glucose levels. As I understand it, the excess porphobilinogen enzymes in my blood bonds to the glucose molecules and is then carried out of the body in my urine. If I don't maintain a (relatively) high blood glucose level, the PBG builds up until I have an acute attack, which (as I have grown older) have gotten to be most unpleasant. There was a study done some time back that I read about where 500 Scandanavians with AIP were tracked for several years. Something like 49 of them developed Type II diabetes. These 49 never had another AIP attack.
I'm doubtful that the trade-off is a good one, though.
I got diagnosed with Type II about two weeks ago, I was running about 300 on my blood sugar, seems like I'd had it for several months now.
"I'm doubtful that the trade-off is a good one, though."
So, would you prefer the noose or the garrote?
Damn, but that sucketh greatly.
The key then, methinks, is to monitor your A1C. The goal is to keep the A1C results below 7.0, and only the A1C test can tell you what it really is. Mine has averaged 6.2 since I began recording the results, which was in January of 2004.
Go see http://www.quickmedical.com/metrika/ This is a kit which contains a meter, ten or twenty test cartridges, and instructions. It's intended for clinic use, but I've bought it for years. The cost per test, net, runs around $12 or so, and takes only about ten minutes.
It pays off. My optometrist, who captures a yearly Optomap image of each retina, stated a few weeks ago that I am the only diabetic he has examined who has had it as long as I have without showing any sign of a retinal hemorrhage.
As Red Green says, "I'm pullin' for ya. We're all in this together."
This just appeared on Instapundit:
I can't vouch for it, as this is the first time I ever heard about it.
But, we find this in the "Frequently Bought Together" section of that page:
I have a copy of the original edition of Bernstein's book, and I recommend it highly. The one listed is "revised & updated", so I just might order both and get free shipping.
I just ordered the book that Instapundit pimped (bought it used), then came here and saw this. Uh, both of your links go to that book, not one by Bernstein.
Type II, I have been told, for... 6 to 8 years. They initially used insulin, but I am not good with eating or dosing. Went to pills, didn't affect it, stopped. Things smoothed out. Then I tried to quit chew, stupidly went to hard candies. The number jumped to over 600... insulin again. Dropped to below 60 every few days, quit that, tried pills, didn't work. Quit all of it, been "clean" for 4 years. Eyes have improved 3 times, no bleeding seen in them, no problems, usually about 200 when checked now. It really hasn't affected me, so far. It might, will, whatever. I do not have what it takes to tend the thing. I am eating better, in my own home, that may have some effect. Anyway, I am not sure they really know what diabetes is. That's all I am saying. Good luck with it.
Take care of yourself, man.
Sorry to hear about the diabetes, Kevin; but I'm glad you're trying to manage it through lifestyle first. I've heard many testimonials from people who've completely turned adult-onset diabetes around through diet and exercise.
It's all about the numbers. I was diagnosed type 2 eight years ago. I take pills. I'm a relatively poor example about diet/exercise (I have many other health issues), but hang in there. Pay attention to how you feel. ALWAYS have some candy with you, if your blood sugar drops. At rest, I can feel when mine goes below 65, 60. Only had one serious drop in 8 years.
I'm sorry about the diagnosis, Kevin, but you have some knowledgeable people in your corner.
I was diagnosed just over a year ago.
Started on 3 Metformin a day and 10ml of injection.
Also started Nutri-System's D plan to lose 50 lbs. Got my numbers under control almost immediately and had to drop the third pill in less than a month.
Lost the 50lbs and shortly after that my job. About six weeks after that they called me back in for another followup - the Nurse Practicioner couldn't believe my numbers had improved so radically (A1C from 11+ to 5.1 in six months). Right about then I learned that I was apparentlly right that the building I worked in was posioning me because all of a sudden I wound up being unable to keep my glucose levels up enough and getting meds dropped. First dropped on one pill + shot, then lost the shot, then the pill. Now I just keep eating the way I learned to while on the Nutri-System D plan and checking my sugars (once / day + occasional spot check).
Travel tip: if you forget your meter, or have something else happen to it, go to a drugstore and get the little 'True2Go' meter that fits on the top of the test strip vial. $10 for the starter kit that includes 10 test strips and the company will send you back the $10. I've got one as my 'travel / backup' meter and if necessary I'll add another without hesitation. Whole kit fits easily in your shirt pocket, it uses a very small sample and the strips are about the cheapest available (good because only the bits for my primary meter are covered by my insurance). Just like with other things, "One is none, two is one."
Glucometers are cheap, even for the very good ones. As with razors and blades, they extract your money via the disposable strips. It's amazing how they nearly all cost the same per test.
There are strips that are significantly cheaper than a buck per test, but my own testing shows the cheap ones to be quite non-repeatable, particularly the "Reli On" house brand by Walmart. That's why I recommend the Accu Chek Aviva. Retail, the strips for it are a buck or so each; through my insurance, they are 30 cents each.
You've already recieved good advice, now just bear this in mind: The American Diabetes Association is trying to kill you. Recommending that type II diabetics make starch the primary calorie source of their diets is like recommending that alcoholics have vodka for breakfast.
Carbohydrates of one form or another are more than half of my caloric intake.
I had an "almost" heart attack five years ago at age 52. "Almost" means only that my heart suffered no muscle damage; I received nitroglycerin spray to relieve the symptoms within 45 minutes of their onset. A triple coronary bypass worked extremely well to fix the specific cause, and felt like putting a turbocharger on a lawnmower.
Unfortunately, it runs in the family. My brother had a double bypass at age 46, and my father died of a massive heart attack at age 45. Diligence is worthwhile.
Coincidentally, I had a routine three-month checkup only this afternoon with my cardiologist. He told me that he has only five or so other patients who have responded as well I have by controlling risk factors. My total cholesterol measured 123 via a home test that I took last night.
Five years ago, he heard my history and my family's history, and then strongly recommended that I avoid a high protein diet and (of course) keep my fat intake down. "Strike a balance" was his suggestion. Humans are omnivores, and I should not behavor otherwise.
Today, I told him what my optometrist said, which was, as I related yesterday, that I am the only diabetic he has examined who has had it as long as I have without showing any sign of a retinal hemorrhage. My cardiologist commented that good blood sugar control and low cholesterol are synergistic toward preventing vision problems, particularly macular degeneration and retinal hemorrhaging.
Dr. Bernstein recommends a high protein, low carbohydrate diet. It worked for him, but it didn't work for me. I tried it after reading his book, long before my heart acted up, and despite having good blood sugar control, I felt awful. When I went back to what worked for me, I went back to feeling normal. I recommend his book because he gives considerable insight into the mechanics of diabetes and methods of controlling blood sugar.
So, if you have diabetes, I suggest using what works for you. Diabetes is serious, it is relentless, and it is aggravating enough to deal with. Don't handicap yourself by doing what you hate, just because it works for someone else. I follow that advice myself, and it seems to be working well.
You're also a type I, which makes a fairly major difference in the origin and treatment of the problem. Most type IIs came by it through progressive overload, as it were. Downregulated insulin sensitivity is a much different problem than total lack of endogenous insulin though the same hyperglycemic result is achieved.
Not everybody needs a low-carbohydrate diet or even does well on it, as you've pointed out. However, when the explicit origin of a problem is downregulated insulin sensitivity due to too much insulin needed to handle the carbohydrate intake over years, requiring less insulin production due to less starch doesn't strike me as a neutral "six of one, half a dozen of the other" option.
Of course, the porphyria does make for an interesting-in-the-curse-sense variable.
You're right, but it goes further. Even type I diabetics develop insulin resistance. Am there, am that.
The mechanism of insulin resistance, as I understand it, is that a steady diet that puts more glucose into the bloodstream than the body needs results in cells that revolt, in effect saying, "Enough already." The cells respond by reducing the number of receptor sites where insulin binds to the cell walls to allow glucose to pass through. That is what insulin is for. Because insulin has fewer receptor sites to bind to, insulin is less effective at passing glucose from the bloodstream into the cells, and so blood sugar rises. The type II body produces more insulin and the type I increases dosages, all to counter the higher blood sugar level, and the problem is described as "resistance to insulin".
Cells which are so overloaded convert the glucose into fat for storage. Thus, a spare tire about the gut is an insulin resistance meter. The bigger it is in proportion to the rest of the body, the greater the problem is with that individual. This is true for non-diabetics, also. The non-diabetic with insulin resistance simply isn't quite over the cliff yet.
For type I's, it is a vicious circle. Insulin resistance leads to larger doses, which leads to episodes of hypoglycemia that are deeper and last longer, which leads to carbohydrate intake to relieve hypoglycemia when it happens, which leads to greater conversion of glucose to fat, which leads to greater insulin resistance. It's like living on a roller coaster that makes several runs every day.
This explains why losing weight tends to reduce the insulin dosages for type I's and improve blood sugar control for type II's, and THAT is the lesson to learn from Bernstein's book. All else is how to get there.
I keep trying.
You need to have 5-6 small meals / day every three hours, fresh fruits and vegetables and lean protein (chicken, fish, eggs) only, no sugars, starches, or alcohols.
Then workout 6 days/ week for 15 minutes each day.
M/W/F - run as far as you can in 15 minutes (as fast as you can, not an easy jog).
T/Th/Sa - do 30 minutes of yoga, Yeah it's for queers and hippies, but health benefits are real. Just find a video on yourtube and follow along rather than go to actual classes.
Also take 1-3 grams of vitamin C and have your vitamin D levels tested to make sure you are in the normal range (most diabetics are not, to the detriment of their insulin sensitivity).
I played rugby on the US national team and at my peak my stats were:
Of course I did a different workout (same diet), but that workout above is best for controlling blood sugar.
Sorry to have to welcome you to the club, Kevin.
If I might add to the generally excellent advice, a full blood work up to determine your vitamin deficencies (there seems to be a strong coorelation between that and adult Type II onset) and a rigorous avoidance of carbohydrates in your diet will go a long way toward controlling the disease without excessive drug requirements. From personal experience, this is a reasonably edible alternative to raised bread: www.flatoutbread.com
Can't overemphasize what Doom said above about the eyes, get your's checked STAT. I've had three partial retinal detachments surgically repaired in the last few years. An experience to avoid if you can ... :)
On a more positive note, once you do stabilize there's no reason for you to curtail your activity levels because of a blood sugar imbalance. I've returned to regular Krav Maga training this year and still shoot indoors (fairly) regularly without ill effect. As Chris Byrne said, first find out where you are, then give yourself the time your body needs to attain your level of equalibrium.
Best of luck.
I've had my eyes checked annually since I was 19 - full visual field test, retinal photographs (a torture that they should use instead of waterboarding, I think), the whole nine yards.
I've just started monitoring my blood glucose, and changing my diet.
This is going to be interesting, anyway.
Oh, and for some reason "Guest" is me, Kevin. I posted this comment from my EeePC. I guess I have to finish setting up everything after I switched OS's to Ubuntu.
"... a torture that they should use instead of waterboarding, I think ..."
It USED to be torture, Kevin. It isn't anymore. Find an optometrist with an Optomap machine, or convince yours to get one.
The machine is a big, white box with a hole you look into. A technician positions your head while looking at a monitor to get it positioned just right, then a green light flashes and a photo of your retina is made.
The good news is: 1) no dilation is required; and, 2) the green light is not bright; there is no painful, white, nuclear explosion of light inside your eye, as the old technology required.
The photo produced is very high resolution, allowing the good doctor to zoom in on tiny details all over the retina, annotate it for future comparison with next year's photos, and so on.
Had it done two weeks ago. Piece o' cake.
I've been going to the same opthamologist for 29 years. She upgrades to the latest technology on a fairly regular basis. I think she has this machine and uses it to check the relative thickness of the retina, but she still dialates my pupils and then photographs and personally examines my retinas each and every year.
Sorry to hear your diabetes diagnosis. I would highly recommend you go Primal- it will help your diabetes immensely. Start here:
Sympathies Kevin. I have known a number of diabetics of both Types, and we have a Type 1 in the family.
I should guess you will see this as a problem to be tackled and not to be denied. Gives you the best chance of reducing the problem to mere condition.
It seems to me that all the technicalities are covered by the previous posters. All you need from your doctor is advice, not instruction.
A follow up bit occurred to me:
Treat your diabetes like your reloading. All you need to do is track the numbers and find out what works best for you and then stick with it.
That's what I'm working on. I have to develop a baseline first, so I'm monitoring blood glucose regularly.
Kinda fascinating, actually.
OK, for anyone interested, there has been some good news. My A1c test came back at 6.5. The Dr. said to work on exercise & diet, and come back in four months instead of two. He wants to see my A1c in "the low 6's" by then.
So I'm diabetic, but mildly, and it looks like diet & exercise will be all that's required, at least for now.
UPDATE: This is interesting. To me at least.
On the one hand, if you, in effect, use mild diabetes to control porphyria, you run the risk of controlling diabetes too well. On the other hand, an A1C score of 6.5 is very good.
So, it ain't TOO broke yet. Careful you don't fix it.
It's all about blood sugar, so go for the low glycemic foods. Basically a lot of people eat food that was designed to bulk-up cattle - white, wheaty, and sugary foods. Stuff that turns into sugar the moment it hits the bloodstream (or nearly) is fine if you have the activity and metabolism of an 18-yr old, but after 40 it doesn't look/work so great when you have the metabolism of a sponge - you get all spongy. When you examine the types of food that produce fast sugar (high glycemic index) and take them off the list you still have a lot of yummy tasting stuff like bacon and sausages.
Check out http://www.glycemicindex.com/ and http://www.gilisting.com/ Here's a chart: http://www.carbs-information.com/glycemic-index-food-chart.htm
DirtCrashr's spot on - diet is the key.
Like I said, Nutri-System's Diabetic plan is great for anyone newly diagnosed who needs to lose at least a little weight. It not only gets your numbers under conrol immediately, it teaches you what and how to eat. Gives you some time to find the diabetic cookbooks with recipies you like, the 'safe' foods, etc..
BTW, the Glucerna bars and the Extend bars are pretty good and also keep your sugars under control. You'll find - if you haven't already - that you must eat on schedule, whether you feel hungry or not.
Yeah, since I picked up the glucosimeter and modified how and what I eat, it's been fascinating watching the roller coaster that is my blood sugar level. I do know one thing: I feel crappy when it hits 79.
I do know one thing: I feel crappy when it hits 79.
You know you're in real trouble when you no longer notice it blowing through 70 headed South. I've helped out a guy I work with more than once when he went under 40 - and was all set to just keep on working. Sorta ...
Good to read you seem to have caught things early.
It feels awful when it's low.
If you depend on insulin injections, being low is a daily roller coaster, and your body will learn to tolerate it better. Will Brown is right; tolerating hypoglycemia better can make it less noticeable. The trick is to detect it and correct it before it hurts you.
In that regard, I am quite fortunate in several ways. When mine gets low, I usually know because of the symptoms it produces, and I'm fairly good at predicting what my glucometer will read (usually within 5 - 10 points). My great fortune is that I function quite well (that is, the same as if it were normal) despite feeling awful, even when it is as low as 50. Below that, I put the tools down, as it were, and wait it out. My primary symptom at 35 or so is profuse sweating, and I've measured it at 22 ONCE (not intentionally, mind you, but such things can happen).
The difficulty is that it can drop VERY quickly, and if I'm quite active, particularly in the heat of the summer, fatigue, heat, and the sweating it produces can mask it. Conversely, if I'm quite still, such as sitting in a cold hunting blind, it can drop slowly with very few symptoms.
My description of managing type I treatment is that it is like trying to keep a three-legged stool both level and at the correct height. The height is blood sugar and the level is the rate of change. The three legs are food, insulin, and activity. Food intake lengthens one leg while hunger shortens it, activity shortens one leg while sloth lengthens it, and insulin shortens one leg and then lengthens it along a time-dependent curve. Taken this way, the three legs are remarkably independent, and one can anticipate hypoglycemia by considering the interaction of all three legs.
So, you have to learn the signals that YOUR body sends you, and your body will not necessarily respond as the books say or as others do. It is relentless, but it's tolerable and manageable.
My sister used to get hypoglycemic, and she turned into a freaking rage-filled monster screaming at people...we tried family counseling because it seemed like a case of periodic psychotic episodes back in the mid-70's. Not a fun place to be.
Welcom to the broken pancreas club. I have engineered sugars to bake with that my diabetic mom couldn't dream of (I have chocolate milk several times a week with everything but the guargum ;) I have needles I honestly can't feel almost half the time (Ok not for the tests yet but certainly on the Lantos pens) and I have 20 years of medical research mom didn't enjoy that has most likely eliminated the eye problems (lutein, lycopein) the heart problems (exercise, it's the new lipitor) and the sugar swings (if I needed one I'd have a coupled meter/pump). Keep your A1C low and don't worry about the rest.