Wednesday, November 17, 2010

Reviews of diabetic cookbooks

I'm not much of a fan of the low-carb diets that are promoted for diabetics, but I do realize that having type 1 is a bit different than having type 2.  Whatever type you have, though, this article has a few suggestions for holiday meals, based on some of the top diabetic cookbooks:

Holiday dishes fit for a diabetic

The white bean and tomato soup sounds especially good right now, with colder weather setting in!

My husband is a vegetarian and I consider myself a flexitarian, so I don't really eat a lot of meat around the holidays, even when we celebrate with meat-eating family members.  No big loss to me, as I never really did like turkey.  What about you?  What do you usually eat around the holidays?

Friday, November 5, 2010

How to prevent insulin injections from hurting

The other day I wrote about an article in USA Today, dispelling some of the myths surrounding diabetes.  In addition to the 5 myths debunked in the article, the article started with a 6-question quiz to test the reader's knowledge about diabetes.  One of the questions was about whether insulin injections should hurt — the quiz said no.

I was amazed at how many people took exception to that in the comments.  A whole lot of adults started whining about needles hurting them, as one commenter put it.  The thing is, I agree with the author of the quiz — with the advancements in medical technology, injections don't hurt if you are doing them right.  The needles are 30 gauge or smaller these days, and shorter than a centimeter.  I take between 5 and 8 injections every single day, and I hardly even feel them unless I do something wrong.

The vehemence in the comments made me wonder how many people don't know how to properly give themselves an injection.  Many of these people said they had been diabetic for many years, and that's how they know it hurts.  But that just makes me wonder whether they have seen an diabetes educator since the early days of their diagnoses, to make sure they are injecting themselves properly and using the most modern technology available.

I am not a diabetes educator by any means, but I can offer some tips from my own experience.  Here is what I would recommend:

1. Make sure you are using the smallest needles available.  With an insulin pen delivery system, you should be able to get ultra fine short needles, which are 30 or 31 gauge, and about a centimeter long (if not shorter).  These are the needles I use, and I can tell you, I hardly feel them.

2. Choose your injection sites carefully.  There are certain, more sensitive spots you should avoid.  I like to give myself injections in the backs (the fleshy part) of my upper arms, the sides of my stomach, and sometimes my inner upper thighs.  However, I was once warned by another diabetic not to give myself an injection too close to my belly button, because it can hurt pretty bad there.

3. Rotate your injection sites every time.  I have noticed that if I give myself an injection in a spot that has been used too much lately, it will burn like the dickens — but that doesn't mean that injections hurt.  It means I made a bad call.  Your educator should tell you to rotate your injections every time, and this is one of the reasons why.  (The other reason is because that spot will develop scar tissue that prevents the insulin from absorbing in your system correctly.)

I typically rotate back and forth between both sides of my stomach and both upper arms.  However, just that much rotation isn't enough.  You have lots of room on your tummy for those tiny little shots — use it!  When you rotate back to your stomach, move your shots around so that you aren't injecting on top of last night's or that morning's shot.  I vary my shots up and down on my upper arm and tummy, and further in and out from my belly button.  Every square inch is a different injection site.  There are many more injection sites on your body when you think of it that way, and very little reason why you ought to be causing yourself pain by injecting in the same place twice in too short a time.

4. Inject large amounts of insulin slowly.  If you have a larger shot to give yourself — i.e., 15-20 units or more — it tends to sting if you shove it all in too fast.  That is because your cells are having to essentially stretch to make room for all the insulin.  Again, this is completely avoidable.

If you use a vial and syringes, you will have an easy time adjusting the speed at which you inject the insulin.  Instead of depressing the plunger all at once, just do it in increments, a few units at a time.  If you are on insulin pens, not all the pens allow you to do this — with Lilly pens, you just press the button at the end of the pen all the way in to inject the insulin.  With other brands, however, the inner workings of the pen turn unit by unit as you press the button, allowing you control over how fast the insulin is injected.

These are a few of the tricks I have found work well to keep my insulin injections painless.  Like I said, I inject myself a minimum of 5 times a day, and rarely ever feel any pain — rarely ever feel anything at all, even!  If you have anything to add, please feel free to add it in the comments.  I don't think anyone in this day and age ought to walk around thinking that it should hurt to give yourself insulin!

Wednesday, November 3, 2010

Setting the record straight on diabetes

USA Today ran a great article recently on diabetes: 5 myths about diabetes.  I love these kinds of articles, because they dispel the myths that are often repeated even by the media, but unfortunately they are few and far between.

If you read the article online, it starts out with a 6-question quiz about diabetes.  If you have the disease and have a good handle on it, most of the questions should be easy.  For instance, we all know that eating right as a diabetic isn't expensive, and most of us know that you can get diabetes even if no one in your family has ever had it.

The article dispels some of the more critical myths, in my opinion.  For instance, it completely debunks the idea that diabetics can't eat anything with sugar in it.  In explanation:

"We know now that table sugar doesn't raise blood sugar any more than other starches, like a baked potato, rice or bread," says Elizabeth Kern, director of the diabetes program at National Jewish Health in Denver.

I think there is still evidence that certain carbs raise blood sugar faster than others, but if you are aware of that, take the right amount of insulin, and monitor your blood sugar a handful or so of times a day, it won't be a problem for you.

The article also talks about how having diabetes doesn't automatically mean you'll have other complications such as blindness and kidney failure.  Those complications are associated with untreated diabetes, so the article stresses the importance of proper treatment.

The final myth the article debunks is the idea that having diabetes will limit your career choices.  It shouldn't — we have the ADA for that, though apparently military colleges can still deny anyone with diabetes.  (WTF?)  You may have to fight for it — my last employer tried to cover less of my health insurance premium than my non-diabetic co-workers, so I had to contact a lawyer — but having diabetes shouldn't have an impact.

In regards to this last one, I think that sometimes the only impediment to someone's career is actually in their head.  I have heard diabetics complain about how crashing wipes them out, rendering them unable to come to work on time, or stay at work if they are already there.  Crashing happens, but it shouldn't frequently happen with enough seriousness to impact your work performance if you take good care of yourself.

Can you think of other negative myths about diabetes that you would like to set straight?

Monday, November 1, 2010

Prevalence of diabetes going up

There was a scary article the other day about the rising prevalence of diabetes:

Diabetes may affect as many as 1 in 3 Americans by 2050

Really?  A third of the population?  That is INSANE.  C'mon people — lay off the fast food and the soda, and get off the couch once in a while!

Of course, I know that not all type 2 diabetics (what the article is primarily talking about) are diabetic because of diet and lack of exercise.  But those factors are responsible for many cases of type 2 diabetes, and certainly for much of the rise in diabetes.  Our American lifestyle has got to change, and fast, if we don't want a third of our population to be diabetic in 40 years.

Friday, October 29, 2010

Service dogs for diabetes?

Service dogs are used for a number of odd things.  For instance, I've read about service dogs being used to detect a seizure coming on — I guess they can smell the difference in the person.  Heaven knows how you train a dog to do that!

I've always wondered whether dogs (or other animals, for that matter) can smell the difference in a diabetic who is crashing.  Do my dogs know that something isn't right with me, even if they haven't been trained to do something about it?  Furthermore, does my horse know if I'm riding him and my blood sugar goes high or low?

I guess dogs at least can sense it, according to this article about service dogs used for diabetic patients:

Dogs alert diabetes patients when blood sugar is off

I think the idea of a service dog for this is fascinating.  The only thing I don't like about the article is the big deal it makes about this little girl crashing.  Seriously, she is crashing more than 6 times a day?  And is "knocked out for an hour" every time?  And her parents had to check on her to make sure she hadn't gone into a diabetic coma during the night?

I am coming to realize that the media likes to exaggerate the dramatic moments of diabetes, and is probably eager to use someone as an interview subject who embodies the drama they are looking for.  Because really, most diabetics, if they are in good control, shouldn't crash that often or be at risk a diabetic coma every night.  And hey, it's not like you should have to need the dog's detection skills 6 times every day in order to deserve a service dog.

But I am getting away from what I am most interested in, which is: Do any diabetics out there have pets that respond to your low blood sugars in some fashion?  I'm talking about just regular pets here, not trained service dogs.  Have your cats, dogs, or other animals ever indicated that they know when you are crashing?

Wednesday, October 27, 2010

Cholesterol medication time?

When I went into the doctor last week, I discovered that my cholesterol has gone up again.  My LDL is up around 130-140 again.  I think this is probably because I stopped drinking grapefruit juice months ago — I think the grapefruit juice was responsible for bringing down my cholesterol over the past few years.

My doctor is taling about putting me back on Lipitor, but I told him I want to try drinking grapefruit juice every day again first.  He wants to recheck my cholesterol again next time I'm in, in 3 months.  Even if my LDL is still around 130, however, I plan to tell him I won't take Lipitor again.  Like I've said before, I don't believe I am truly at risk for a heart attack — I am healthy, active, and eat pretty well — and if I weren't diabetic no one would care about my LDL being around 130.  If it keeps going up, of course I will reconsider, but I just don't feel that an LDL of 130 is worth risking the long-term effects of being on Lipitor for the rest of my life.

Sunday, October 3, 2010

A scary finding about exercise

I am aware that as an active diabetic, I am not the norm.  I ride my horse several times a week at the very least, and my husband and I take the dogs for a brisk walk nearly every Saturday and Sunday.

As it turns out, it sounds like I'm not the norm for the average American, any more than I am the norm for the average diabetic.  A national telephone poll found that only about 5 percent of those called had exercised in the last 24 hours.  The majority of people polled had done nothing more active than food and drink preparation.

Yikes!  What kind of country do we live in, that the height of our daily activity is standing in the kitchen, making ourselves something to eat or drink?  I don't expect everyone to ride a horse every day, or even to go to the gym (I hate gyms).  But for heaven's sake, how hard is it to take the stairs at every opportunity or take a walk on your lunch?

What do you do to try to get some exercise throughout the day, and what could you do to improve your activity levels?

Thursday, September 23, 2010

Would you trade your heart for normal blood sugars?

The increased risk of heart attack is one of the biggest incentives for diabetics to closely monitor and control their blood sugars. So why would you want to take any medication that makes it more likely that you'll have a heart attack, even if it does do a good job of lowering your sugars?

That's what I don't understand about why the FDA has chosen to keep Avandia on the market. The increased risk of heart attack is documented, so why would they allow the company to continue selling the drug, even if it is on a more restricted basis?

I wouldn't be surprised if someone is pressuring the FDA to keep the drug on the market...

Monday, September 20, 2010

Being diabetic BEFORE Lantus

I got an ugly look recently at what it used to be like to be type 1 diabetic.

On Friday, for a study I am participating in, I was put on an older 12-hour insulin called NPH. I've heard that when Lantus replaced these older long-acting insulins, they revolutionized the way a diabetic lives, but I had no idea how true this was until this weekend. I was diagnosed shortly after Lantus came out, and never had to use anything else.

Well, let me tell you, NPH sucks. This is why diabetics didn't used to be able to delay or skip meals! Good heavens. I fight crashing from lunchtime until well after dinner, but when I wake up in the morning, my blood sugar is sky high. I rarely ever have readings over 400, but I've woken up with my blood sugar that high two mornings in a row now.

It is destroying my life. I have to snack and purposely run my sugars high, so that I won't crash while I'm doing something like riding my horse. Then I feel like crap all the next morning while my blood sugar comes down from its ridiculous high.

Luckily, I'm only on NPH for a week, and let me tell you, I can't wait to get back on a real long-acting insulin! If you still take NPH — and I know there are type 1 diabetics out there who do — do yourself a favor and ask your doctor about switching to Lantus and a short-acting insulin such as Humalog. You'll be amazed at the freedom you get from more modern insulins.

Tuesday, September 7, 2010

Avoiding too much medication

One of my big beefs is how much medication we, as Americans, take. It actually made top headlines the other day, too: Prescription drug spending doubled in less than a decade.

Now, obviously part of this has to do with out-of-control health care costs. The cost of prescription drugs is rising rapidly.

But part of it also has to do with how many more drugs we are taking now. For instance, the percentage of people who took five or more drugs in the past month doubled as well, from 6 percent to 11 percent in 10 years. (Increases in those who took one or two drugs in the last month are more modest, but when you think about what this means in terms of the big picture, I think it's still pretty alarming.)

Why are Americans taking so many more drugs now? The most commonly used drugs are what you might expect: statins, antidepressants, and for children and teens, medications for asthma and ADD/ADHD.

I personally feel that as a society, we are overmedicating ourselves. Now there is a fine line to draw between what is actually needed, and what is too much. For instance, I really do need insulin, because my body no longer makes it (or at least not enough to keep me alive). A cancer patient really does need chemo, and someone who has had an organ transplant really does need the medications that keep his body from rejecting the new organ.

(You'll have to forgive me if there is a medication you really need that I haven't mentioned. I don't pretend to know much about other diseases, even if I know a lot about my own, and I'm sure many people are the same way.)

But where to draw the line? Do we medicate little Johnny to keep him from acting out in class, or do we try harder to work with him? Do we give someone statins to keep their cholesterol low, or do we encourage them to improve their diet and their lifestyle? Isn't the route of less medication, if it's available, always the healthier choice?

Friday, September 3, 2010

How empowered are you?

There was an article on that I found encouraging: More 'empowered patients question doctors' orders. Apparently it is becoming increasingly more common for patients to do their own research, and want to have some input in their treatment.

The article talks about how people's attitudes and involvement in their own health care have changed over the years, as out-of-pocket costs have gone up — and as information has become easier to come by. For instance, one source mentions longtime diabetics who don't know what an A1c is or why they need it.

Doctors seem to disagree as to whether this is a good thing. Some doctors don't like it, while others — such as the one who talked about diabetics not knowing about the A1c — think it's a good thing for people to be more interested in their own health care.

I've talked before about my decision to get off Lipitor, which was made independently of my doctor. I've also talked about my first doctor, whose overbearing and accusatory bedside manner convinced me to switch. Clearly I am one of those "empowered" patients. However, I also know many people who seem to accept their doctors' orders blindly.

Where do you fall on the scale?

Wednesday, July 21, 2010

Obesity surgery controversy

I recently blogged about my thoughts on Dan Hurley's Diabetes Rising, a fantastic book about the history, present, and future of diabetes. The one thing I noticed was that he was somewhat noncommittal on whether he attributed type 2 diabetes to diet — he claims early on that it's not as simple as that, but later in the book, he does a great deal of talking about an area of the country with the highest incidence of the disease: the number of fast food restaurants there, the lack of health education, etc.

Anyway, one subject he talks about that I didn't mention in my last post about the book was obesity surgery as a cure for diabetes. There are two types of surgeries — one that makes the stomach smaller, and one that bypasses part of the intestines. He follows a guy who has both surgeries, and almost immediately the patient goes off his diabetes medications, which hadn't been working very well. It is a miracle cure for him.

Well, this obesity surgery has come into the news as a treatment for diabetes. Although Hurley writes about it very positively, I have mixed feelings. Sure, there are probably people who biologically need it in order to control their weight and their diabetes. But I also fear that type 2 diabetics who could be helped by diet and exercise, won't try to live healthier lifestyles, because it's so much easier just to get the surgery and be done with it. I also worry that people who haven't developed type 2 diabetes yet, but are perhaps prone to it, will not try as hard to watch their diet or stay active, because hey — what's the point? If their lifestyle starts to affect their health, they just have to get a quick surgery, and ta-da — all better!

What are your thoughts on the issue?

Sunday, July 18, 2010

Diabetes Rising by Dan Hurley

iconI recently read Diabetes Rising by Dan Hurley, a book that takes a harsh look at the rise in diabetes and what is (or isn't) being done about it. Most of us have heard that type 2 diabetes is on the rise, which we blame on the poor American diet. We also know that 9 out of 10 diabetics are type 2, which those of us with type 1 diabetes tend to think puts us in the clear. Ours is considered a genetic disease.

But Hurley turns that theory on its head in his book. First of all, he talks about how the incidence of type 1 diabetes is going up remarkably quickly. Some people would say that's because of medical advancements — e.g., we know what it is now, people can survive long enough to pass the genes on to their kids, etc. — but Hurley goes through a whole list of factors that have been shown in studies to increase the likelihood of someone developing type 1 diabetes.

For example, an increased chance of developing diabetes is linked to:

* Wealth - Statistics show that children from wealthier families are more likely to develop diabetes.

* Milk - Babies who are nursed for the first year are less likely to develop diabetes than babies who are fed formula. There is a theory that until a certain age (6 months? I can't remember what he said) our children's bodies are not made to digest any protein other than what is in our own breast milk, and feeding babies with formula — which is made from cow's milk — makes a child more likely to develop diabetes later on.

* Lack of sunlight/vitamin D - Diabetes rates are highest in the northeastern U.S. and northern countries where kids don't get a lot of exposure to the sun, and a study in Europe (Sweden? Finland? I can't remember where) showed that vitamin D supplements decreased the risk.

I think there were others, but these are the ones I remember offhand. Hurley also discussed one man's theory that type 1 and type 2 are not, in fact, different diseases — that type 2 is simply what people prone to diabetes develop when they don't get type 1. The chapter describes it better than I ever could, but basically, people who have type 2 also tend to have the antibodies that cause type 1 (autoimmune) diabetes, and people with type 1 also tend to have resistance to insulin. The thought is that, whatever the trigger is, if you develop diabetes early in life, it shows up as an autoimmune response, while later in life it shows up as insulin resistance.

Hurley also spends a great deal of time talking about scientific advancements for treating diabetes, versus advancements for curing diabetes. He points out that more of the effort is focused on treatments than cures, presumably because there is more money in treating it than in curing it. He also discusses non-biological cures, such as combining pump and CGM technology to create an artificial pancreas. The FDA won't approve such a device, because it claims that a human needs to be involved in making decisions about treatment, but Hurley has participated in studies on such software and says that it is far more accurate than any human could ever be.

The history of diabetes treatment is also pretty interesting. The "tight control" era is a fairly recent phenomenon, made possible by the small miracle we call a glucose monitor. Insulin, on the other hand, has been around for nearly a century — although not nearly as effective or as precise as it is now.

I highly recommend Diabetes Rising for any diabetic, anyone who has diabetes in the family, or — heck — anyone who knows a diabetic. It is fascinating stuff, written in a fairly brief but engaging format — an easy, interesting read for anyone who is invested in the subject.

Thursday, July 8, 2010

More on Colorado's high-risk health insurance pool

In my last post, on Colorado's new health insurance program, I mentioned that I didn't know how the new program differed from CoverColorado, a state program already in existence to provide health insurance for people with pre-existing conditions.

I have my answer now, thanks to this article:

Ritter details Colorado's new high-risk health-insurance pool

The difference is that people in the new program won't be paying any more than normal, healthy people would pay for health insurance. CoverColorado, on the other hand, charges people about 130 percent of what a healthy person would pay.

Another way the new program differs is that people have to have gone without health insurance for at least six months in order to qualify. That eliminates all of the people in the CoverColorado program. Essentially, what this new program does is target the people who couldn't afford to pay higher than market rates for health insurance — even CoverColorado rates.

Tuesday, July 6, 2010

Health reform starts to go into effect

Today is a big day in Colorado. Today our state launches a website to help Colorado residents get health insurance until certain provisions in the health reform bill go into effect.

New Colorado health plan to cover those with pre-existing conditions

The program seems to be based on a state program that already existed: CoverColorado, which allowed people with pre-existing conditions to buy health insurance. I'm not sure how the new program differs.

The state program, a collaboration with Rocky Mountain Health Plans and the state's high-risk insurance pool, CoverColorado, will offer coverage to people who have been uninsured for at least six months and have been denied coverage because of a medical condition.

Colorado officials are keeping many details quiet until Tuesday, but the U.S. Department of Health and Human Services said monthly premiums for the Colorado program will cost from $120 to $551 with a $2,500 deductible.

Interestingly, when I looked into CoverColorado in early 2005, there was no requirements about how long you'd been uninsured. Also, I believe the monthly premium for me — with my type 1 diabetes — fell within that range. The only thing I seem to remember is that I would have received a discount, since I made under a certain amount. But it was still several hundred dollars a month.

The actual deadline for individual states to implement this type of program was last Thursday, but apparently Colorado is still ahead of many other states. I suspect that having a similar program already in place made it easier to meet the requirements.

The health care bill's regulations prohibiting companies from denying people with pre-existing conditions won't go into effect until 2014, so the state programs are supposed to help people out in the interim. Hopefully, for the sake of people with diabetes and other pre-existing conditions, the rest of the states will get their acts together soon.

Advances made in diabetes treatment

I haven't blogged in a while, and I have more to talk about, but I wanted to start with two articles I found, announcing advancements in diabetes treatment.

Experimental vaccine targets type 1 diabetes in children

The point of this vaccine is to preserve remaining pancreatic function, not to cure diabetes. The vaccine is to be used to prevent children with type 1 from losing any more insulin-producing cells. It can also be used to prevent high risk children from developing diabetes.

The article states this pretty clearly, so I don't understand why they've made this statement:

"If the clinical trial for a vaccine called Diamyd is successful, diabetes patients may never need another insulin injection."

If all the vaccine does is stop the autoimmune response from destroying any more islet cells, how is it going to change how much insulin kids currently need to take? If they are already taking insulin, that isn't going to change. Duh.

It's exciting to be able to prevent the autoimmune response, but hey, let's recognize this for what it is. It's not a cure for people who are already taking insulin — it's preventative for kids and people in the early stages so that they don't have to eventually take insulin.

Progress made on artificial pancreas for diabetic patients

This article suggests a discussion that I've been wanting to have after reading Diabetes Rising, so I'll save some of my thoughts on this for later. As a quick preview, though, in the book the author talks about a study he did to try out an artificial pancreas — a computer-driven system that tested blood sugar and delivered insulin every 15 minutes, more like a health pancreas would do. It effectively prevented any highs and lows in blood sugar, but at the time, the FDA wasn't allowing a computer to make decisions about how much insulin a person should be taking. This article predicts that in a few years, the technology will be made available to the public. I sure hope so!

Wednesday, May 19, 2010

Speaking of the pill...

I had a really scary hypoglycemic event the other night. And I mean, really scary — as in, the second lowest I've ever crashed.

I woke up and realized through a nightmarish fog that I was crashing. I think I'd been having nightmares, which often happens when I crash, and I was having a hard time waking up from them. I had the sensation as I was waking up of them still clinging to me like cobwebs.

When I checked my blood sugar, I found it to be 27 — the second lowest reading I've ever gotten. My lowest ever was 26, and that was six years ago! I am pretty sensitive to the symptoms of crashing, so I typically catch it by the time I get into the 50s or, at the lowest, the 40s. You can imagine, then, how I felt at 27.

I drank some juice, and then ate some Gushers and some sweet pickles. I was really hungry and it took restraint to stop at that, when I wanted to stuff my face with anything I could find. Even so, I woke up the next morning at 177, surprisingly low considering everything I ate before going back to bed.

I used to feel very tired the next day after a nighttime low, but I normally don't anymore. I think it's because, now that I work from home, I get more (and better quality) sleep than I used to. I can sleep in the next morning after crashing if I need to, and that makes a big difference. This time, however, even getting up at nearly 9am the next morning I felt very drained and tired. I lasted until the afternoon (almost crashed again around mid-day) before finally taking a nap.

For the longest time I couldn't figure out why I had crashed so dramatically. I had been just over 200 at bedtime, and took a single unit of fast-acting insulin to correct, which shouldn't have had such a drastic effect. Finally I realized that I had forgotten my birth control pill the previous night. Without my pill, I had four units too much long-acting insulin in my system, which sent my blood sugar plummeting. I've done that before, but never with such a terrible low as a result, so I am pretty sure I will be more careful about remembering my pill from now on!

Sunday, May 9, 2010

50th anniversary of the pill

Today makes exactly 50 years since the pill was approved by the FDA. The anniversary made a few headlines, together with a discussion on how the pill has changed women's lives.

As a diabetic I have a slightly different perspective. Every month during my period, when I take the little blank pills, my insulin needs drop: I have to take 4 units less of my 24-hour insulin during that week. It's always about the same, too, even if my insulin needs fluctuate the rest of the month — if my basal shot goes down to, say, 17 units from 18, I'll need to take 13 units instead of 14 during the last week of the pill.

I have always been on some kind of contraception since I was diagnosed. At the time of my diagnosis, I was on the Depo-Provera, but I switched to the pill soon afterward. I did find that my 24-hour insulin needs were more constant on the Depo-Provera, most likely because the pill causes changes in the body's hormone levels, and hormones tend to block the effectiveness of insulin. (I also think that's why I take less insulin during the week when I'm taking blank pills.)

I'm interested in hearing from other diabetics. Do you take the pill or do you use another form of birth control? If it is the kind that tinkers with your body's hormones, how do you find it affects your diabetes?

Thursday, May 6, 2010

Attention diabetics: Cinnamon doesn't work!

I can't be too critical of taking supplements, since I do try to drink 8 ounces of grapefruit juice every day to lower my cholesterol, but I am deeply skeptical of anything that comes in a supplement form. It's just basically companies capitalizing on this finding or that finding by packaging and selling "good health" like snake oil. Many foods have health benefits, but eating whole foods and taking a pill are two different things. Since we don't always know what it is in a certain food that is good for us — or if it's actually a combination of more than one thing, acting together — the idea that we can cram good health into a little plastic capsule is ludicrous.

Take cinnamon, for example. It has long been claimed that cinnamon helps to lower blood sugar, and while that sounds like a fine excuse for enjoying a little cinnamon and sugar on your toast, many supplement nuts pop cinnamon capsules like Valium.

Well, the claims weren't actually backed up by solid research — apparently there were a lot of conflicting findings, and the studies on cinnamon tended to be too small to make any good conclusions. Finally someone did a large study, however, and found that cinnamon has no effect on diabetics' sugars.

I'm sure there will be people who stubbornly insist that cinnamon works, and if you want to continue taking it, more power to you — as long as you eat right and exercise as well. There is simply no substitute for a low fat, whole foods diet and an active lifestyle!

Monday, May 3, 2010

Drugs don't lower heart attack risk in diabetics

I wasn't aware of the findings of this study when it came out, but apparently drugs to lower blood pressure and cholesterol don't actually reduce the risk of heart attack in diabetics. Heart disease is a major risk for diabetics — more than twice the risk than for a non-diabetic. (I personally think this statistic is skewed by the prevalence of type 2 diabetes — I am willing to bet the risk is lower for type 1 diabetics, and probably related more to the lifestyle problems that tend to occur with type 2 diabetes, such as poor diet and lack of exercise.)

Some of you may remember when I stopped taking Lipitor a couple of years ago. My cholesterol has been fine without it — a little higher than the target numbers for diabetics, but not high enough to warrant subjecting my body to a drug with potentially harmful side effects, in my opinion.

You'll notice though that the article has a quick disclaimer that diabetics shouldn't stop taking their medication without consulting their doctor first. While I do agree that you should never make major changes to your diet or treatment regiment based on one article, I also think that well-informed and educated people do have the right to make a decision without their doctor, if said doctor is stuck in the Dark Ages.

Wednesday, April 28, 2010

Still a good thing to lower blood sugars...

I didn't know this, but apparently there was some suspicion that lowering blood sugars too aggressively in type 2 diabetics actually could cause diabetes-related deaths. Turns out it's not true, anyway:

Rapid lowering of blood sugar not linked to diabetes patients' deaths

So, yes, it's still a GOOD thing to aggressively try to lower your blood sugar. Big surprise!

Monday, April 12, 2010

How other medications affect your blood sugar

I recently had an infection in my hand where I burned it, which you can read more about here. Long story short, I ended up with prescriptions for antibiotics and steroids (to reduce swelling, as it was puffed up to nearly twice its size).

I noticed while I was reading through the information on the drugs that the steroids were said to raise blood sugars. Turns out that is an understatement. My sugars have been running in the 200s and 300s since I started the prescription, especially in the mornings (since I take 2 pills at night). My vision has been very blurry as a result — the worst I've experienced in quite a while. It's all very frustrating and disorienting... And this is with me checking my sugars before every meal.

Diabetics are often told that when we are sick, it is important to check our blood sugar frequently and correct as necessary. Certainly the stress our bodies are under when we are sick or injured is plenty to send our blood sugars up into the ozone, but I haven't often run into medications that do that. (Energy drinks, yes, but that's another matter entirely.)

It occurs to me that it might be nice to make a list of medications that tend to raise or lower blood sugars. What medications have you found will mess with your sugars?

Tuesday, March 30, 2010

Fallout from the passed health care bill

Since the health care bill passed, there have been a lot of headlines — some grumbling, some praise, and some political posturing from politicians and insurers alike.

In one particularly scary headline, the health insurance companies claimed they had found a loophole and were therefore not going to comply with the requirement that they immediately start covering children with pre-existing conditions. This ought to show how blatantly evil the insurers are, that they would flat-out state that they weren't going to cover sick kids! I mean, how heartless can you be?

Luckily, the White House was able to put enough pressure on them that they changed their tune:

Insurers to Comply with New Rules for Children

In other news, a measure was just passed to alter a few parts of the health bill:

It also eliminates special deals, such as $100 million to help Nebraska pay for its share of Medicaid, the joint federal-state health program.

In addition, the reconciliation bill will change the way college students borrow money from the government. Previously, government-sponsored student loans were issued by banks, which contributed to a lot of students' confusion as to whether their loans were from the government or from the bank. Banks were basically taking advantage of the government-back student loan program to sell students on more expensive, private loans. That will end now, as the reconciliation bill takes government backed loans away from the banks — from now on, students will get their loans through the schools, eliminating confusion and saving the government a lot of money.

I'm not really a fan of bills that contain a little bit of everything, because I think they tend to confuse the issue. Even if the student loans stuff has nothing to do with the health bill, though, in this case I think it's a good thing!

Tuesday, March 23, 2010

Health care bill passed!

I meant to blog about this sooner but I have been too busy to get it done. It seems President Obama's renewed attempts to push the health care bill worked, because it passed on Sunday and was signed into law today! Here's an excerpt:

The package of changes would provide coverage to 32 million people through Medicaid, subsidies to families and tax credits to small businesses that can't afford to cover their workers. It would pay for the expansion with the Medicare cuts, new taxes on upper-income workers and expensive insurance plans, and fees on the manufacturers of prescription drugs and medical devices.

It also would prohibit insurers from denying coverage based on pre-existing conditions, dropping people when they get sick and limiting lifetime benefits. Children could be covered on their parents' policies up to age 26, and seniors would receive improved coverage for Medicare prescription drugs. Most individuals would be required to have insurance, and businesses with 50 or more employees would have to provide it or pay a fee.

Sounds pretty good to me, particularly the part where insurers can't deny coverage based on pre-existing conditions. There seem to be a lot of people who don't support the bill, though. Just today I was told that the law already protected me from being denied coverage for a pre-existing condition. Um... no. It didn't. Trust me, I know — I've been turned down by the health insurance companies before.

The bill also prevents the health insurance companies from dropping you once you get sick, which is a huge deal. Kids will be able to stay on their parents' insurance until age 26, too, which is important considering how few kids get settled in life by age 19. And — very importantly — the bill puts a limit on how much insurance companies can charge you in premiums for an individual (non-group) plan if you have a pre-existing condition.

Here is a good explanation of all of the benefits of the health care bill. And another article, in which the NYT answers readers' questions about the health care bill. And finally, a side-by-side comparison of the health care bill that passed with the original House and Senate bills.

I really think that if people would stop freaking out about the cost (which really isn't that bad, since they are cutting unnecessary spending on Medicare and increasing taxes on the wealthy to pay for it), they would find that this benefits them far more than it hurts anyone.

Monday, March 8, 2010

A new push for the health care bill

It feels like it's been a while since there was any talk about a health care bill. I don't like this blog turning too political — though of course it's impossible to talk about health these days without getting at least a little political — but I think it deserves at least a mention.

President Obama is really pushing hard now for the health care bill that gets passed. The message he is sending is that he doesn't care what happens in the next election, or the next, or the next, as long as Americans are guaranteed health care from here on out.

Obama Warns Democrats of Urgency of Health Bill

It's short-sighted in some ways, but in other ways, he's right. What other items on the Democrats' agenda are anywhere near as important as the health of our citizens?

Thursday, February 25, 2010

Switch completed!

Since Blogger is no longer supporting publishing via FTP, I've switched my blog over to Custom Domain publishing. None of the URLs should change, but please let me know if you find something that doesn't work quite right!

Switching to Custom Domain

Blogger recently announced that they'd be discontinuing FTP publishing. This has thrown a bit of a wrench in the works for me, as I've been using FTP since the very beginning, and I happen to love it. There are a few things I need to figure out about publishing via Custom Domain, so expect a bit of trial and error over the next few days. Bear with me please!

Monday, January 25, 2010

Fluctuating insulin needs

One of the most difficult things I find with having type 1 diabetes is unexpected changes in my insulin needs.

I've been dealing with this recently. Just a couple of months ago, my sugars were running high quite frequently, especially in the evenings. My doctor was recommending more and more insulin to compensate at dinner.

Then, suddenly, my insulin needs suddenly reversed course. I started crashing all the time and had to back off my once-a-day Lantus dose by several units.

Now I'm taking one unit less of my daily Lantus than I used to, but I'm no longer having the same problem with the highs. In fact, my sugars have been under great control, so why am I complaining?

The hardest part of this kind of thing is trying to figure out something that often has no rhyme or reason to it. I have a guess at what could have caused part of the change, but not all of it. I went through a 2- or 3-week period where I wasn't riding my horse, and it was shortly after I started riding again that I started crashing all the time. However, this doesn't explain why I'd been struggling with highs for a month or longer, as I was riding regularly during part of that period.

Whether or not you can find an explanation for abrupt changes in your insulin needs, one thing is for sure — having diabetes requires a lot of vigilance.

Tuesday, January 5, 2010

Dan Hurley and 'Diabetes Rising' on NPR

I haven't posted to this blog in quite a while, I guess partially because I have barely had time to check my sugars, let alone think about diabetes for long enough to write a blog post about it. Between the holidays, a sick cat, and a few other contributors, I have been quite busy.

But today I saw a story on NPR that made me want to come over here and blog again: Despite Advances, 'Diabetes Rising'

It's a promotional story for a new book about the increase in diabetes, written by a type 1 diabetic and an investigative journalist. The radio story lasts for about 30 minutes, but I took notes, so I'll highlight what I thought was noteworthy:

A few of Hurley's quotes:

Diabetes is a "disease of modern culture."

"The world we're living in is a diabetes machine," referring to aspects of the American lifestyle, which seem to contribute to a higher incidence of both type 1 and type 2 diabetes: lack of activity and exposure to sunshine, pollutants, etc.

Apparently diabetes (both types) is increasing faster than obesity itself, indicating that obesity isn't necessarily the only cause. According to Hurley, in children born in 2000, a third of the boys and 39 percent of the girls will be diabetic.

He talks about the difference between type 1 and type 2:
- Type 1 is an autoimmune disease that results in a dead pancreas and no insulin production: "There's no diet that will save you."
- Type 2, although it has been seen as a condition that results from age, inactivity, and poor diet, is now being seen in younger people, even children, and in people who are not actually overweight.

A brief mention is given to what Hurley calls "diabulemia," which he says occurs in about a third of young women who are insulin dependent: They actually stop taking their insulin in order to lose weight. Scary!

He is also very clear that there is NO SUCH THING AS PERFECT CONTROL. "We need to accept that we are human beings, and we were not put here to control our blood sugar, and we do the best we can." Doctors need to understand that "we've got more important things to do with our life than stare at our blood sugar all day."

He also talks about the artificial pancreas — basically a combination of insulin pump and continuous glucose monitor — and the frustrations in the medical industry as to why the FDA won't approve such a device. "It's entirely doable, all the products exist, all we need is some final testing and get the FDA to wake up."

Finally, a listener sent in an email about how the medical industry seems to have backed off of the idea of finding a cure, and questions whether that's because they benefit more from treating diabetes than from curing it. While Hurley doesn't think they are intentionally keeping people sick in order to make money off of them, he does say "they want to make money. They need to make money — that's their job. But it's the job of people with diabetes to demand harder work and the kinds of research that will get us to a cure."

Hurley doesn't seem to think that cure is likely to be biological just yet, by the way — he thinks a "computer cure" (i.e., the artificial pancreas) is much more attainable.

Finally, he also commented on how much we as diabetics have to spend on health care — it's "just obscene," he says, stating that he doesn't think it has to cost this much.


Although the radio spot talked about diabetes in a more general sense, the book itself sounds like it is tackling the question of why diabetes is becoming so much more common. I've put a hold on it with my library (it's on order), so as soon as I read it I'll be back with a little more on the subject.