The longer my tenure with diabetes goes, the more I think about the point when it’s all going to catch up to me.  Besides the finger pricks, highs/lows, Endo visits and pump/syringes, I’ve led a pretty normal last 13 years or so with diabetes.  I haven’t let this disease take away anything that I’ve wanted to do.  Each visit with my doctor I hear things like, you’re doing good.  You’re young and have no problems or complications.  I haven’t lost feeling in my feet or lost any sort of vision, which is normally really good.  Nothing so far, nadda, zip.

Eye Exam Tech

A few months ago I went for my regular yearly eye exam.  I’m really not happy with the place I go to, but they seem to do a good job and it’s close and convenient.  It’s the technician that needs to go.  She flat out sucks.  Wouldn’t doubt it if she sucks at life either.  Miserable person who has zero patient manners.  She puts the numbing drops in and then proceeds to put that blue halo thingy directly into my eye ball.  THEN, she gets exasperated when I flinch because something bright and foreign is physically touching my eye.  Go figure, right?

Eye Doctor

The actual doctor that checks my eyes is very good and pleasant.  Year after year, I’ve prided myself on having maintained good eyes and vision.  To me that’s my barometer on how I’ve been managing my diabetes and blood sugars besides my A1c.  This visit was no different in that I have slightly better than 20/20 vision and absolutely no signs of complications in my eyes.  Me = Winning.

Then the doctor drops the bomb… He says right after telling me there’s no problems at this time, “but you’ve recently crossed the 10 year mark with diabetes.”  Me: “Um, what does that mean?”  He said that there usually aren’t any signs of issues with diabetes in the first 10 years of being diagnosed in the eyes for most cases.  It’s more the long term effects that add up over time and will gradually get worse.

What I Heard

I left this exam feeling good that I made it another year (kinda like my 6 month dentist visits) with no issues (cavities).   But this time I was thinking that everything so far didn’t really matter anyway and my honeymoon period was over.  The shit could hit the fan anytime now and it would be all downhill with no way to reverse the effects.  All those visits that I left feeling good were all erased with this one statement by the doctor.

So this begs the question

At what point do all of those 200s, 300s and 400s catch up to you and there’s no turning back?  At what point do you realize and accept the fact that the damage is done, there’s no turning back and you are now a patient with “complications“?

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I want to sincerely thank you for your continued support. This blog is better because of you.

Diabetes Day of Reckoning is a post from: Blogging Diabetes

I was on vacation in Scottsdale recently and after three days of wearing nothing but flip flops and enjoying the resort pool (heavily chlorinated), I noticed my heel hurt quite a bit.  I didn’t think too much of it at first until later on when I fully inspected my foot.  I noticed that the calloused part of my outer right heel had cracked.  I freaked out a bit because I’m constantly going into the pool, playing with my kids around the pool and didn’t want to get an infection.  I did an internet search right away to find out that this issue is called a “heel fissure’” and you can see images of what it can look like below. 

If left untreated, a heel fissure that is deep enough can lead to a serious infection.  I used Neosporin every day, caked my heel in Vaseline each night and covered it with a sock.  It healed and is now better, but it taught me a lesson.  I need to take extra care of my feet to proactively prevent issues like this instead of being reactive.

[source]

[source]

If you have experienced a heel fissure, you know how painful they can be.  Share your thoughts in the comments if you would like to add anything.

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I want to sincerely thank you for your continued support. This blog is better because of you.

Diabetic Complication is a post from: Blogging Diabetes

"Diabetes was the seventh leading cause of death listed on U.S. death certificates in 2006. This ranking is based on the 72,507 death certificates in 2006 in which diabetes was listed as the underlying cause of death. According to death certificate reports, diabetes contributed to a total of 233,619 deaths in 2005, the latest year for which data on contributing causes of death are available." [source]

"Diabetes is the 6th leading cause of deaths in the United States." [source]

What is confusing to me is the definition of diabetes as a leading cause of death.  I could understand that someone with a hypoglycemic or hyperglycemic episode could fall into the diabetes as a cause of death category.  Besides those two categories, I always thought that someone with diabetes dies from a complication of diabetes.  For example, inconsistent blood sugar levels over time can lead to heart disease.  If someone dies from heart disease and has diabetes, are they automatically classified in the diabetes – cause of death category or heart disease? 

I ask these questions because I think we could be over/under stating the diabetes category.  Using the example from above, if someone dies from heart disease and has diabetes, who knows if they would have had heart disease if they didn’t have diabetes.  Some say it’s just semantics, but I disagree.  Is the cause of death subjective to the doctor’s opinion?

Can anyone shed some light on this cheerful subject?

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I want to sincerely thank you for your continued support. This blog is better because of you.

Diabetes as a Cause of Death? is a post from: Blogging Diabetes

Just this year, trying to better manage my diabetes, I got a new bottle of strips.  After one of my episodes previously mentioned, I tested my urine and sure enough, the strip matched to the ‘moderate amount’ color.  Honestly, my very next thought after seeing that there were ketones present was, now what the fu… heck do I do.  Seriously, I had absolutely no idea what it meant other than, this can’t be good.  What I did end up doing was getting my blood sugar down and under control.  I didn’t do anything else specific to treating the ketones.

Recently, I asked the diabetes online community (D-OC) this question: What do you do when you find a moderate amount of Ketones in your urine?  Here are some of the responses that I got. 

• Drink lots of water
• Lots of fluid, give insulin and recheck in 1 hour
• Wash your hands (funny huh)
• Water, correction, call doctor
• Check BG, Water, insulin, relax
• Lemon Water

I checked the American Diabetes Association site for more information.  They basically say to call your doctor if you find more than a trace and they should tell you what to do.  Here is some information from their site about ketones:

“Ketoacidosis (key-toe-ass-i-DOE-sis) is a serious condition that can lead to diabetic coma (passing out for a long time) or even death. Ketoacidosis may happen to people with type 1 diabetes.

Ketoacidosis occurs rarely in people with type 2 diabetes. But some people — especially older people — with type 2 diabetes may experience a different serious condition. It’s called hyperosmolar nonketotic coma (hi-per-oz-MOE-lar non- key-TOT-ick KO-ma).

Ketocidosis means dangerously high levels of ketones. Ketones are acids that build up in the blood. They appear in the urine when your body doesn’t have enough insulin. Ketones can poison the body. They are a warning sign that your diabetes is out of control or that you are getting sick.” [source]

I also checked with the Joslin clinic and they say:

“Drink plenty of water and fluids containing no calories to “wash out” the ketones. Continue testing your blood glucose every 3 – 4 hours, testing for ketones if the blood glucose is over 250 mg/dl. Do not exercise if your blood glucose is over 250 mg/dl and ketones are present.” [source]

In hindsight, the moderate amount of ketones may have been due to the exercising I did just before testing.  If I’m supposed to check my ketones every time my blood sugar is over 250, I may need to order a bit more.  I hope this helps and at least gives you some information about what to do if you ever find ketones in your urine.

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I want to sincerely thank you for your continued support. This blog is better because of you.

What to do about Ketones is a post from: Blogging Diabetes

Disclaimer:  if you suffer from depression, you may not want to watch this video.  If you choose to watch it, you do so under your own discretion.

My intention is not to upset anyone, but just relay the reality of living with Diabetes.  For those with diabetes, I’m sure you can relate.  For those that do not have diabetes, it’s information you may not have thought about.  Part of the goal for this video is to arm the people that didn’t know so they can be more aware of these issues when dealing with their loved ones.  So often I hear and use the phrase “manageable disease”, but reality tells me there will be some consequences down the road.  If you watched the video, my goal and what keeps me going is trying to get as close to 80 as possible.

Being more susceptible to depression means you need to equip yourself with an excellent support system and good doctors.  Don’t stand for mediocre care by your doctor and take charge of your future.  If no one else, you are the best equipped and have the most vested in making sure you get close to 80.

Like what you see?  Subscribe to Blogging Diabetes to stay updated on what’s new with diabetes.

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I want to sincerely thank you for your continued support. This blog is better because of you.

Depression and Diabetes is a post from: Blogging Diabetes

If you haven’t heard yet, Larry lost his battle and passed away on Friday.  My thoughts and prayers go out to him and his family.  By any standards, Larry seemed to be successful in life with five kids, an enormous empire in Salt Lake City, and multiple charities and community service.  But, passing away at 64… That’s entirely too early.  I have no details about Larry’s condition and don’t want to speculate.  However, it kind of scares me to think that someone who was so successful in life, had money at his disposal, and built an empire, couldn’t beat or tame his type 2 diabetes.

So, I now turn to how I opened this post.

• Are you too busy to test?
• Is there too much going on at work to test?
• Too busy to see an Endocrinologist a few times a year?
• Are you embarrassed or feel awkward to test when others are around and might see you?
• Did you forget your medicine?
• Is taking 30 minutes out of your day to exercise asking too much?
• Are you too busy to stop to take your injection before eating?
• If someone was going to bet on you would they take the over or under on age 64?

Sometimes, it’s about the little things that can add up to really big things that matter the most.  Don’t be too busy.

Stay tuned for an upcoming vlog about depression and diabetes.

Like what you see?  Subscribe to Blogging Diabetes to stay updated on what’s new with diabetes.

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I want to sincerely thank you for your continued support. This blog is better because of you.

Too Busy For Your Diabetes is a post from: Blogging Diabetes

Type 2 diabetes is a disease in which either the body does not produce enough insulin or the cells ignore the insulin. Type 2 diabetes is the more common form of diabetes. Although there is no cure for diabetes, there are many means like diet control and exercises, by which the blood sugar levels can be kept in check. If diabetes is not kept in control, it can lead to different complications. Most of these complications are a result of the effect of diabetes on the nerves and arteries. Here are some of the health problems that Type 2 diabetes can cause.

1. Cardiovascular disease and stroke. Type 2 diabetics have two to four times the risk of suffering a heart attack or a stroke. People with diabetes are more likely to have high blood pressure, obesity and high cholesterol. These together with the artery damage caused by diabetes can lead to heart diseases.
2. Kidney disease. Diabetes is the most common cause of kidney failure. Type 2 diabetes can take away the ability of the kidneys to filter waste products. Kidney failure is the last stage of chronic kidney disease and it may require dialysis, artificial blood-cleaning process or kidney transplantation from a healthy donor. 40 % of those who need dialysis have kidney failure from diabetes.
3. Foot Problems. The nerve damage caused by diabetes results in a loss of feeling in the feet. This is called neuropathy. The feet become numb and are not able to feel pain, heat or cold and you may not notice injury until the skin becomes infected. Diabetes also causes the skin at the feet to become very dry. Foot ulcers and calluses may form at the feet and if neglected, these could lead to infection. Poor blood circulation to the feet makes infections difficult to heal. In severe cases, this may lead to amputation.
4. Eye disorders. Diabetes causes many eye disorders by damaging the blood vessels in the retina. The major eye disorders are glaucoma, cataracts and retinopathy. Non-proliferative retinopathy is common and does not require much treatment but in proliferative retinopathy, the blood vessels are so damaged that there is leakage of blood. This condition may lead to blindness if not treated properly.
5. Gum Disease. Diabetics have a higher risk of gum problems. People get gum disease when plaque destroys the gums and bone around the teeth. People with diabetes can get gum disease from having high blood glucose levels for a long time.

Other health problems that Type 2 diabetics risk facing are stomach and bowel problems, where the nerves that trigger normal functioning can become less active causing constipation or diarrhea, and sexual function problems. The nerve and artery damage could lead to impotence. It is very important that diabetics be aware of the health issues that they face. There is nothing to worry, as taking steps to keep diabetes in control will take care of most of these health issues. If you are a Type 2 diabetic, make sure that you take those precautionary measures to keep these health problems at bay.

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I want to sincerely thank you for your continued support. This blog is better because of you.

5 Health Issues of Type 2 Diabetes is a post from: Blogging Diabetes

As I get a little bit older and my family grows, I am thinking more about the long term.  I do think about what will probably happen if I don’t keep my A1c in check. Mostly, I think about these things for my wife and children’s sake.  So… to the point of this post – What money can’t buy?

If you are into sports or in tune with diabetes related news, you may have heard that the Utah Jazz owner, Larry Miller – age 64, just lost both legs six inches below the knee to complications from type 2 diabetes.  Again, what can’t money buy?  Money can’t turn back time and let you have a do-over.  Money can’t bring your legs back or reverse the negative effects from uncontrolled blood glucose over the years.  I have no idea about the details regarding Larry’s control or age when diagnosed.

But I do know that all the money in the world didn’t save his legs.  Yes, it can buy high-end prosthetic legs, but that’s not the same.  He is in my thoughts and prayers.

Larry Miller – Utah Jazz’s Story on ESPN

All that money would buy me a personal chef and trainer to help with my eating and exercising routine.  I’m sure you would agree that having a lot of money would help ease some stress, allow you to work fewer hours and not worry about that $70 CGM sensor that just wouldn’t stay attached.

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I want to sincerely thank you for your continued support. This blog is better because of you.

Something Money Can’t Buy is a post from: Blogging Diabetes

In layperson’s terms, these two supplements could block the negative effects (4 pathways) that one experiences due to high blood sugars (hyperglycemia).  Reread that sentence again…seriously.  Here are the two supplements that were used:

Supplements

1) Benfotiamine (my doctor pronounces it as: ben-fo-tee-a-mean) is a lipid-soluble form of vitamin B-1.

“Benfotiamine is a man-made form of thiamine or B1. Thiamine is a water-soluble vitamin and therefore not as easily used by the body. Benfotiamine is a fat-soluble composition and is better absorbed and utilized. There has been some evidence that Benfotiamine may help relieve the severity of diabetic complications such as retinopathy, nephropathy and neuropathy.” [source]

Wikipedia – Benfotiamine

Cost $23 for a 3 month supply

2) Glucotize

“Glucotize™ is a-lipoic acid, a powerful antioxidant, delivered in a proprietary controlled release formulation developed by Medical Research Institute (MRI; San Bruno, CA). The controlled release formulation was developed by MRI to significantly extend the amount of time a-lipoic acid is present in human plasma. This enables a-lipoic acid to achieve its maximum physiological benefits.” [source]

Cost $54 for a 3 month supply

UPDATE – 1/13/2009 – I just spoke to the company MRI (Medical Research Institute) who made Glucotize.  They told me it is now being manufactured under the name Minus-10 and can be found at your local GNC or online here.

Clinical Trial Lead

The lead in the clinical trial was Dr. Michael Brownlee who is a member of the JDRF International Center of Diabetic Complications Research and holds these positions at Albert Einstein College of Medicine in NY:

• Professor, Department of Medicine (Endocrinology)
• Professor, Department of Pathology
• Anita and Jack Saltz Professor of Diabetes Research

Limitations

Now there were some limitations to the study.  First was the sample size.  The trial was only done on around 10 individuals.  So there’s no telling if the same results will be replicated on a much larger scale.  Also, they don’t know if the dose size was effective or if even both supplements were necessary.  There are some unknowns, but the immediate findings are very positive!

The bad news with supplements and preventative medicine is that in many cases you will never know.  For example, lets say you take these supplements and live until your 80 with minor complications.  You would never know if by not taking them you would have cut-out around 75 with more severe complications.  Maybe, with time, they will be able to test more to determine the effectiveness of taking these supplements.

Recommendation

Don’t take any medication or supplements without the authorization from your doctor.  My advice is to at least talk to your doctor to get their thoughts regarding this trial and supplements.

Other Reading

American Diabetes Association Award Recipient, Dr. Michael Brownlee

JDRF press release about funding the trial

Have you heard anything about Benfotiamine or Glucotize from your Doctor?  If you are interested in this and want to discuss offline, please contact me.

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I want to sincerely thank you for your continued support. This blog is better because of you.

Cure for Diabetes – Next Best Thing is a post from: Blogging Diabetes

If I don’t keep my glucose levels under tight control, I may have blurry vision, be thirsty, urinate frequently, or feel tired.  The worst part is that my body can become accustomed to higher (and lower) average glucose level.  So someone with tight control may feel awful at 200, while another with poor control won’t feel that same effect until about 350.

Diabetes is a silent killer because if you don’t keep tight control today, tomorrow or even this month it may not matter too much in the short term.  It’s a year or maybe not even for 10 years that the poor control catches up with you… when it’s too late.  Once you have the complications from poor glucose control over the years, it’s often too late to reverse the damage done.

As a type 1 diabetic, I have to often tell myself that what I do today DOES MATTER and may go unappreciated because I may not develop the complication that someone with poor control might.  Hopefully, I will never know because if I do, it’s not good and may be too late.  Diabetics would probably keep tighter control if the long-term effects were more immediate and not just years down the road.  That candy or cheesecake that I don’t eat today may just add time on in the end…

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I want to sincerely thank you for your continued support. This blog is better because of you.

Why Diabetes is the Worst Kind of Disease is a post from: Blogging Diabetes