The Skinny on Diabetes

Type 1 diabetes is an autoimmune disorder, meaning that the body’s immune system attacks its own pancreas affecting its ability to produce insulin; this usually happens at a young age.  In this case scenario, insulin has to come into your body from outside a good example of which is an insulin pump.  FYI not all autoimmune disorders happen at a young age.

Type 2 diabetes is a different ball game.  Contrary to the popular belief, increased sugar consumption doesn’t cause type 2 diabetes.

Just because type 2 diabetes is linked to high levels of blood sugar, it may seem logical to assume that eating too much sugar is the cause of diabetes.  However, it’s not that simple.  High-sugar diet can increase the risk of developing diabetes but doesn’t directly cause it.  There is no proven link between the two.   By analogy, driving on the road can increase your risk for an accident but a mere fact of driving doesn’t cause it.

What happens with type 2 is that people develop insulin resistance.  Here’s how it works.  When you consume sugar, it attaches to hemoglobin that delivers it to your body cells to be used for energy.  Think about insulin as a key to open the door (of a cell) to let glucose in.  In case of insulin resistance the door won’t open and glucose can’t get in.  As a result, glucose builds up in the bloodstream instead of being absorbed by the cells.

It is believed that excess weight and physical inactivity largely contribute to the insulin resistance.  Genetics play a role, as well.

How type 2 diabetes is diagnosed:  A1C test   A1C test kit

A1C is a widely used test to diagnose type 2 diabetes. It is also called HbA1C or glycated hemoglobin test.  Hemoglobin is a substance found in the red blood cells which carry oxygen throughout your body.  When blood sugar level is elevated, sugar combines with hemoglobin making it “glycated” in which case scenario A1C test shows an elevated number.  This test is being used to show how well your diabetes is being controlled.  Since red blood cells live up to 3 months, this test should be at this interval.   This very test was used to diagnose my type 2 diabetes.

For people without diabetes, the normal range for the A1C test is between 4% and 5.6%.  A1C levels between 5.7% and 6.4% indicate increased risk of diabetes and levels of 6.5% or higher indicate diabetes.  The goal for people with diabetes is a A1C level less than 7%.  The higher the A1C number is, the higher the risks of developing diabetes-related complications.


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1.  DISCLAIMER

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Obesity, BMI and Diabetes

This is a sequel to my previous post, My Opinion About Five Types of Diabetes. Now I will be talking about obesity.

Obesity is traditionally defined as having so much body fat that it has a negative effect on health. Body fat in this context means the one that can be visible from the outside. Generally if your BMI is 30 or over, you’re considered obese, period. Hence your poor health including diabetes, and it’s all your fault.

What else is new?

However, it isn’t that simple. As per Diabetes Daily , the root causes of obesity are diverse and can include the things we can’t control such as genetics or side effects of medications. There are some folks who are overweight but active and eat reasonably sized meals most of the time, versus a skinny person who doesn’t exercise and always seems to be eating junk food. Clearly, the site continues, the causes of obesity are more complex than food choices, and there is no single root of obesity. Too many people misunderstand why we gain weight, stereotype those who have gained excess weight, and give faulty advice on how to fix the situation.

However, as Huffington Post points out, being thin isn’t the same as being healthy. The body fat can be stored inside the body just as well, around the internal organs, out of the plain view. And thin people can still have diabetes, such as for example, Billy Jean King, a pro tennis player with Type 2 diabetes. In fact, type 2 diabetes does happen to the athletes whose BMI is normal.  For example, John Anderson, a life-long athlete, or Jay Cutler, a football quarterback, or Nick Boynton, a pro hockey player.

Meet Team Type 2 diabetes cycling team, founded in 2008.  It is comprised of nearly 100 athletes from over 20 countries and competes in more than 500 international events each year. The team mission is to inspire, educate and empower people affected by diabetes. I bet my paycheck that their BMI is normal and of course, they are not overweight, yet all of them have type 2 diabetes. Go figure.

Will discuss BMI next.  You think it is reliable?  Stay tuned.

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My opinion about five types of diabetes

Think you have Type 1 or Type 2 diabetes? Don’t bet on it. A team of researchers in Sweden and Finland (or in Scandinavia by some sources) recently came to the conclusion that adult-onset diabetes now has as many as five types aka clusters. This somehow has to do with the personalized medicine but as far as I am concerned, it has to do with the diabetes stigma. As if we didn’t have enough of it already.

(there’s also a Type 3 that results from the damaged pancreas. Often misdiagnosed as Type 2).

Here come the Clusters.
Mar 6. Clusters 1 and 2
As you can see, Clusters 1 and 2 combine Type 1 and LADA. The remaining three clusters are all about Type 2.

Mar 6. Clusters 3
Cluster 3 is characterized by insulin resistance, high BMI and a highest incidence of nephropathy (kidney damage resulting from diabetes). Dubbed as Severe Insulin-Resistant Diabetes or SIRD. Well, well, I guess I am insulin resistant but my BMI isn’t high and so far no nephropathy in sight.

The remaining two clusters are rather peculiar as they throw some terms around without much of a detail.
Mar 6. Clusters 4 and 5
Cluster 4 is characterized by obesity, younger age (definition, please!) and not insulin resistant. It is termed as Mild-obesity related diabetes or MOD for short. It is being silent about BG, A1C and such. Hmmm

Cluster 5 is characterized by older age (whatever that means) and modest metabolic alterations. Dubbed as Mild age-related diabetes or MARD. Not a word about insulin resistance, high HbA1C or a neuropathy.

As far as I am concerned, all this is more about attitudes and less about facts. Obesity, younger age and not insulin resistant, in absence of the classic diabetes symptoms this really doesn’t mean much to me. Okay maybe I’m missing something but exactly what is obesity?

In my humble opinion, this new view is one-sided and opens a whole new can of worms. And like I said, more of a stigma. Now NY Post claims that due to this recent discovery, diabetes can be reversed merely by changing a lifestyle and losing weight.  

Wow. How come that pro athletes have Type 2 diabetes? Now all folks that don’t fall into the category of thin, will be poked fingers at and told that they will get diabetes or have it already.   Reebok’s CEO will be happy, no doubt (I blogged about it a couple of years ago) 

To be continued

 

 

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Dealing with Diabetic Neuropathy

I will be talking about my Type 2 Diabetes that I have had for several years. At the time of bringing up the breaking news about it, I was informed that I did in fact had high blood sugar for years, showing on the metabolic panels blood tests done for my RA (rheumatoid arthritis). I had no access to these online and my rheumy doctor didn’t say a word about it, so I didn’t know. Chances are, I was diagnosed late when it finally did happen.

Scroll up to this morning when my legs started trying to kill me. This is known as diabetic neuropathy or nerve pain for short. The cause is commonly stated as high blood sugar but as far as I know, I have never had it high, the last A1C was 6.2, and my fasting numbers are always normal. Besides, I’ve been watching my carbs intake like a hawk. You wouldn’t want to go shopping with me as I always take my time reading Nutrition Panels. The other shoppers just grab their product and go on their merry way but not me.

Usually pain med helps but this time I decided to do without. I stepped into the hot shower and low and behold, the pain was gone. Aw paradise.

The word Neuropathy means nerve damage and it happens due to the BG being elevated over time. Please note, I am not saying ‘high’ but rather ‘elevated’. Both terms especially ‘high’ are highly subjective and can be interpreted every which way. In my opinion, diabetes complications have to do with the length of diabetes rather than with the individual BG levels. Blaming it on the BG levels alone sounds opinionated and judgmental, at least it is to me. But what else is new. Diabetics are traditionally blamed for their condition. Argh.

And once the neuropathy (nerve damage) happens, it doesn’t go away. You just have to deal with it.

Anyway, the pain is gone and I feel terrific. Doing a happy dance.

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What goes up, should eventually come down, or what lowers blood sugar

This is a sequel to my earlier post about blood sugar spikes.

After dolng some research, I came up with a few things that can actually lower blood sugar. The first one is my favorite lol.

1. Household Chores.
Believe it or not, cleaning the house or mowing the lawn can have an added bonus for people with diabetes: it lowers blood sugar. Don’t you love getting your closet organized? (it remains on my to-do list of the next projects). This one can lower your blood sugar so you’ll kill two birds with one stone.

Many of the chores you do every week count as moderate physical activity, with plenty of health perks. Make a point of walking around the grocery aisles or parking farther from the entrance to the store. (I do this often as I want to back into the parking space which is impossible with the sign right smack in the middle in between the parking spaces). Small amounts of exercise add up.

2. Exercise.
Physical activity is great for anyone but for those of us with diabetes it requires some maintenance. When you work out hard enough to sweat and raise your heartbeat, your blood sugar may spike up, but then it can drop. Intense or endurance-type exercise can make your level drop for at least 24 hours afterward. Eating a snack before you start may help. As well as checking your BG before, during, and after you exercise.

3. Sleep.
It is not uncommon for BG to drop during sleep, especially for those of us who take insulin. (I am not on insulin and haven’t had a low fasting number yet, knock on the wood).  It helps to check your BG at bedtime and again in the morning when you wake up.  If you start having lows, a snack before bedtime may help. I usually have a cup of milk and (approx) 2 squares of graham crackers or any other low-carb cookies I have sitting around. This amounts to about 2 carbs. However some folks experience a rise of BG in the morning, so some sources recommend a continuous BG monitor.

4. Alcohol.
This could have a roller coaster effect as alcoholic drinks have plenty of carbs. At first your BG can rise but can drop for as long as 12 hours after drinking. Having your booze with food might help, and of course checking your BG. The ADA guidelines advise no more than one drink a day for women and two for men. The ADA definition of one drink is 5 oz of wine, 12 oz of beer or 1.5 oz of liquor like vodka or whiskey.

5. Heat.
Another roller coaster. The problem is, heat makes your BG harder to control. High temperatures can also affect your medications, glucose meter, and test strips so don’t leave them in a hot car. Test your BG often and drink plenty of water to avoid dehydration. Dehydration can lead to rise in BG and blood sugar becomes more concentrated. Overall, you’d be much safer inside with the AC on when it’s hot outdoors.

6.  Yogurt.
It belongs to the probiotics, the foods that have healthy bacteria. Yogurt can improve digestion as well as help control BG. Plain or light yogurt is your best choice. I usually buy a Greek variety plain, and even then, I take my time to check the carbs content because you never know.

7. Vegan Diet.
The jury is out on this one but some studies suggest that those of us with T2D who switched to a vegan diet – or all vegetable based – had better BG control and needed less insulin. This is possibly due to the fiber content in whole grains and beans that slows down the digestion of carbs. However, more research is needed. I personally don’t know if I ever could switch to the vegan diet permanently. Maybe for a day or two but then I start craving meat which is where my vegan diet ends.

If you think you want to make a permanent switch, talk to your doctor.

8.  Female Hormones.
Another roller coaster. When a woman’s hormones change, her BG follows. Keeping a monthly record of your BG levels might help to get a better idea of how your menstrual cycle affects you. Hormone changes during menopause may make BG even more difficult to control. You may want to discuss a possibility of hormone replacement therapy with your doctor.

9.  Birth Control Pills.
Generally oral contraceptives are safe for women with diabetes, but the types that contain estrogen can affect the way your body handles insulin. The ADA suggests a combination pill with synthetic estrogen.

10.  Glycemic Index or GI for short.
This is a rating of how individual foods raise BG levels. Consequently, the lower the better. For example, beans and whole-grain breads and cereals have a lower GI than white bread or regular pasta. Juice has a higher GI than whole fruit, mainly due to the fiber content. Craving a high-GI food? Eat it along with a lower-GI choice to help control your levels.

I personally never even think about GI as this information isn’t available on the Nutrition Panels, at least not in the U.S.  Can probably find it on the internet but this is a chore considering that I don’t own a smartphone, so can only do the GI research on my laptop when I come home. So I’m only counting carbs and I think it’s enough. Works for me so far.

A word of warning – when comparing Glycemic Index or carbs, keep in mind the serving sizes. Content is based on the Serving Size that varies between the manufacturers.  For example, carbs content per one slice versus two slices can make a dramatic difference.

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After all said and done, the question remains – is sugar bad for you?

If you love sweets, don’t despair. You don’t have to give them up forever. While it’s true that sugar will raise your BG levels more quickly than other carbs, diabetes experts now say that it’s the total mount of carbs that is more important. Keeping your serving sizes small and accounting for the total carbs is the most important.

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Blood sugar spikes – why, oh why

I will be talking about type 2 diabetes that I am more familiar with, since I happened to have it.

As a common belief has it, the only reason for the blood sugar spikes is indulging in sweets. However it’s not that simple. A vast number of other factors can cause it. Even something as trivial as a cup of coffee.

1. Artificial sweeteners.
Many folks with diabetes reach for the diet drinks as a substitute for regular soda or juice because they assume that sugar-free beverages won’t raise their blood sugar. But artificial sweeteners may or may not be completely neutral after all, and the jury is out on this one. A few sites such as Healthline report several studies with mixed and inconclusive results.   The problem is, sugar-free foods might contain sugar alcohols that can increase blood sugar level.  They add sweetness with fewer carbs than sugar, but they may still have enough to boost your BG levels.

2.  Chinese food, pizza, bagels
When you dig into a plate of sesame beef or sweet and sour chicken, it isn’t just the white rice that can cause a problem.  High-fat foods can make your blood sugar stay up for longer.  The same is true for pizza, french fries, and other goodies that have a lot of carbs and fat. The dough and the sauce are the culprits as well.  Bagels for once are packed with carbs, and pizza has a high glycemic index. You might want to check your postprandial (after meals) BG level to know how this food affects you.

3.  Coffee
Can coffee raise blood sugar? It depends. Some studies suggest that coffee drinkers have a lower risk of developing T2D. However if you already have diabetes, drinking coffee can raise both blood sugar levels and insulin resistance. This doesn’t happen with decaf coffee.

4.  Bad cold
Here’s what happens when you have it. Your blood sugar rises as your body works to fight off an illness. Drinking water and other fluids to stay hydrated might help. Beware that some medicines, such as antibiotics and the decongestants that can clear your sinuses, can affect your blood sugar as well.

5. Stress
Overwhelmed or unhappy at work or elsewhere? It takes a toll. When you’re under stress, your body releases hormones that can make your blood sugar rise. This is more common for people with type 2 diabetes. Relaxation techniques can help, such as deep breathing and exercise. Or else, you can always try to change the things that are stressing you out.

6. Meds
Some of them can boost your blood sugar and may even trigger diabetes in some people. Such as corticosteroids commonly prescribed to treat arthritis, asthma and other conditions; diuretics (water pills), some antidepressants, decongestants (cold medicines) and probably more. I believe that my T2D might have been triggered by corticosteroids that I was taking for the Rheumatoid Arthritis back in the day.

7. Alcoholic drinks
Some sources believe that drinking alcohol can spike blood sugar, especially mixed cocktails loaded with sugar, calories and carbs. However, what alcohol does is that it prevents the liver from doing its job which is to store glycogen (stored form of glucose), hence your BG can drop. This can happen within a few minutes of drinking alcohol and up to 12 hours afterward. It’s probably a good idea to wear a diabetes bracelet to alert everyone to the fact that you have diabetes.

8. Hot weather
Remember how hot it can get in summer? You’d know what I’m trying to say if you live in the Midwest USA where we’re right in the middle of a quite cold winter right now and the summer is nowhere in sight.

In the summertime, however, high body temperature can lower blood sugar. On the other hand, folks with diabetes tend to get dehydrated for a number of reasons, and this can raise blood sugar. This can happen if your don’t drinking enough water or when high BG causes polyuria (frequent urination). Dehydration can also lead to heat exhaustion; people with diabetes tend to feel heat more than those who don’t have it.

If you are on insulin, keep in mind that warm skin absorbs it faster, while dehydrated skin, more slowly. It would help to keep your injection site close to the normal temperature and hydration.

Here now, my last fasting number. I don’t check it every morning but when I do, it’s always normal. 91 is super normal for me. As you can see, it was taken at 12:18 pm which is what happens when I am up all night and then sleep til noon. Oh well. Am not complaining about insomnia, though. I am a night owl, feel just fine and full of energy at night. I used to work nights and chances are, my internal clock is still ticking in the same way.

Jan 2 - 91

And that’s all for now. In my next post, will write about what lowers blood sugar.

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Happy New Year!

Happy New Year to all my readers and followers!

20 MS Word - for WP

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Guess who’s calling

Guess who’s calling.  My car registration, that’s who.

A bit of history.  Last year I have traded my old car for the snap orange VW Bug.   Now that the Bug plate stickers are up to expire next month, the time has come to renew them.   I first tried OPlates (online renewal),  only to be told that in the last summer a plate transfer was never completed, therefore my Bug was never registered.  Everything was still registered to my old car that is likely pushing daisies by now.   So I went to the local BMV who basically reiterated what I already knew and requested to produce the title so that we can start from square one.  Inasmuch I didn’t have one with me, I went home to retrieve it.

To be honest, I am the kind that tends to lose car titles.  Not anything else but only this.  With that in mind, I turned everything in the file cabinet upside down, had a vague idea where it could be, and bingo, found it!  Of course, it was sitting in the wrong folder.  Am bringing it to the BMV first thing tomorrow morning.

What I think happened was that someone at BMV checked the wrong box last year.  In hindsight, I should have double checked and read the small print.  But who in the world reads the small print on the car registration after you paid your due by a credit card and receive all the paperwork that you blindly trusted the BMV do it right??  But don’t bet on it.  A lesson learned.

And the good part is, I am single aka happily divorced.  I can’t even fathom what would have happened had I still been married to my now ex.  Most likely we would have gotten divorced anyway, right now, oh yeah over the misplaced car title, so the good thing is, it’s already done and over with (back in the 1990s).   Yay.

Glad I didn’t have any traffic tickets in the meantime.  A cop tells you that by the way, there’s something wrong with your plates — imagine that.

Bug

So much for the calling that WordPress wants us to write about.

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