Monday, October 24, 2011

Symptoms of high versus low

I remember when I was first diagnosed as diabetic, about nine and a half years ago, someone (a nurse at the hospital when I was there, I think) telling me that high and low symptoms can be very similar — enough so that you may not know the difference.

Obviously she wasn't diabetic, because while there are some similarities, I've never thought it difficult at all to tell which I am.

Crashing, to me, is perfectly obvious.  I get tunnel vision.  I get shaky.  I can't concentrate.  In short, I feel like shit.

Going high can feel like shit too, but in a different way.  I often get heartburn, a stomach ache, and/or a headache.  Sometimes I feel dizzy (hence the minor similarity to crashing) but it's in a different way than when I'm low.  And if I'm high for a long time, of course, I get dehydrated.  My hands and even my eyes start feeling dry, which is a perfectly miserable experience.

One other symptom of going high that I've noticed is irritability.  It's not like the second my blood sugar goes up, I get grouchy.  It's more like if I'm high over an extended period of time — for instance, if I'm struggling with highs for several days in a row — I start feeling illogically angry about everything.  I've gotten irritable when I've crashed before, but it's rare.  Usually I know I'm crashing right away, whereas I don't always realize I'm high unless I check my blood sugar, so I think that makes a difference.  If I know I'm cranky because I'm crashing, for instance, it's much easier to stop being cranky once I realize the cause.  When I'm high that's a much more difficult attitude adjustment to make.

In fact, that was one of my unknown symptoms in the months leading up to my diagnosis: I was much more easily provoked to anger.  I worked at a preschool at the time, and I had noticed that I was getting angry at the kids more easily when they didn't listen or misbehaved.  I didn't know why it was happening at the time, but I definitely noticed that I was having to work harder to control my temper.

What about you?  What symptoms do you have when you're crashing, and what are your symptoms when your blood sugar is high?

Friday, August 19, 2011

Medical studies: What's in it for me?

I was telling a friend of mine recently that I was going to be participating in another medical study, and I was rather surprised when her response was, "How does this benefit you?"  I've been participating in studies for several years, and I can tell you, that's the first time I've ever received that particular response.

I won't lie.  There are plenty of ways in which it does benefit me to participate in these studies, and that's part of why I do.  I get paid — more for some studies than others — but because I don't get that money until the study is over (sometimes 4 or 6 months), that's not a major deciding factor.  Many of the studies provide my insulin, needles, and test strips for duration of the study, which is a huge incentive for me, especially since my co-pays have gone up.  Sometimes they provide gas cards (usually $20) for every visit you have to make to the doctor's office, which is nice considering the price of gas lately.  Some study participants have to drive a long distance to get to the clinic, but I don't (and my car gets decent gas mileage), so those gas cards generally help to keep me in gas throughout the duration of the study.

I'd be lying if I said these weren't influential reasons why I do the studies, but they aren't the only reasons.  I like being part of the process of new medications and devices coming out.  I've gotten to experience continuous glucose monitors and new insulins this way.  Usually these studies are a ways into the testing, too, so I don't have many concerns for my health and safety, and I can always back out of the study if that changes.  And of course, there is always the satisfaction of knowing that I'm helping these new medications and devices become available to everyone.  It's hardly my biggest reason for doing the studies, but it's still a good feeling.

So I'd say there's quite bit in it for me — but really, do I have to prove that in order for this to be considered a good thing?

Tuesday, July 5, 2011

Diabetes isn't a death sentence

There was an article on USA Today the other day that I really appreciated.  Not only did it specify that it was talking about type 1 diabetes, it also was attempting to dispel one of the fear-inducing myths surrounding diabetes: that as a type 1 diabetic, you are going to die young.

Life expectancy improves for type 1 diabetics

See?  Isn't that beautiful?  "Type 1" clearly specified, even in the title!

The article looks at life expectancies for type 1 diabetics in 2 groups: diagnosed between 1950 and 1964, and diagnosed between 1965 and 1980.  Life expectancy for the first group was 53.4 years, versus 68.8 years for the second group.  Compare that to an average of 72.4 years for the general population.

Of course, the article doesn't address people diagnosed after 1980, probably because none of us are old enough to start dying yet.  (Ha, ha.)  But I can only imagine that our life expectancy has gone up even more, and might even be about equal to the life expectancy of everyone else.  In fact, because having type 1 diabetes makes you so health-conscious, I wouldn't be surprised if our life expectancy is even longer than the general population — we certainly pay more attention to diet and exercise than the average person does!

This just goes to show how much of a difference modern medicine can make.  With modern insulins and glucose meters, pumps, and continuous glucose monitors, we are given such precise control over our blood sugars that we can actually mimic the insulin production of a normal body fairly closely.  And if you keep your blood sugars within normal range most of the time, then theoretically you shouldn't have any of the complication of diabetes that come from having high blood sugar for extended periods of time.  It may take a lot of work, but it's essentially like not having diabetes at all!

Thursday, June 30, 2011

Progress on preventative vaccines for type 1 diabetes

One of the top headlines on USA Today the other day reported mixed results on type 1 diabetes vaccine trials.  One of the trials seems very promising — I don't understand all of this, and by the way the article is written I'm not sure the journalist did either, but it sounds like the vaccine essentially turns the patient's T cells into cells that protect beta (insulin-producing cells) instead of attacking them.  The drug is in phase 2 trials, and so far so good — although it doesn't prevent diabetes, it looks like it can at least delay the failure of insulin-producing cells.

The article also reports on another trial, one that didn't work.  The second trial was also looking for an antigen that would preserve insulin production in diabetics who were just diagnosed.  The article says that the antigen works in mice, but not in humans.

What I find curious is that they are only testing these drugs on people who have already been diagnosed.  Why?  Modern medicine does enable us to identify people who will become diabetic, but aren't yet.  For instance, the children of type 1 diabetics are often tested for signs of an autoimmune response, such as elevated T cells.  I think it would be much more interesting to test these drugs on people who are destined to be diabetic, and see how long the vaccines would hold off their diagnosis.

Tuesday, June 28, 2011

Say which type of diabetes you mean!

If you have read my earlier posts, you know that one of my pet peeves is people — especially journalists and scientists — not specifying which type of diabetes they mean.

Take, for instance, this article on the rapid increase in diabetes cases.  Anyone who knows about diabetes can figure out that the article is talking about type 2, but they don't say it anywhere it in the article — not once.

Now, I don't have anything against type 2 diabetes, and I agree that the rapid increase is alarming.  However, I think it's important to note which type of diabetes you are talking about.  A rapid increase in type 1 cases would mean something very, very different than a rapid increase in type 2 cases.

Wednesday, May 25, 2011

Splitting your Lantus dose

I recently decided to start splitting my Lantus dose.  I tried this a few years ago, before I started doing so many studies, and didn't find it helpful.  Recently, however, I became convinced that I really needed to.  If I took Lantus in the evening, with dinner or shortly before bed, my sugars were consistently very high around dinner and bedtime, and I was at risk of crashing in the wee hours of the morning.  If I took Lantus with breakfast, my sugars were always very high when I woke up — and I'm talking in the upper 200s.  High.

The reason for this is that Lantus isn't perfectly even across the entire 24-hour period.  It has a peak around 2-3 hours after you take it, and tapers off over the last few hours of the 24.

So I started splitting my dose.  I take half with breakfast, and half with dinner.  It works out great because it's not as important that I take it at the same exact time every night, and I'm not having as many problems with highs OR lows.  If you have problems with dramatic swings in blood sugar that you think may be caused by Lantus's peaks and valleys, I highly recommend talking to your doctor about splitting your dose.

Friday, April 22, 2011

Medical studies: Should you participate?

I don't often blog about it, but I participate in medical studies fairly frequently.  I've done one study on continuous glucose monitors, two on new kinds of insulin, and one on a new kind of glucose monitor.

No matter what the study is, I generally enjoy participating very much.  I wish I could say that I do it to help out the study of diabetes and to benefit other diabetics, but I'm afraid I'm not that noble.  Some of the biggest reasons I do it are because I get to try out cool new medicines and gadgets for free, because the studies generally pay for all of my supplies, and because on top of all that, I get paid for it too.  It's not a ton of money, but it's a nice little bonus, especially at the end of a long study.

How much they pay varies from study to study.  I recently did one that paid $100 for just one day.  That made getting up at 5:30am in order to get to my doctor's office by 6am totally worth it!  Other studies may just pay $30 or $40 per office visit, but when you're in a study that lasts for months, that can really add up (and they pay it all at the end).  I was in another study where I got a gas card every time I came in, which was highly appreciated considering gas prices lately, and the fact that I live across town from my doctor's office.

It also varies whether the medicine you get to try out really has any benefit to you.  I didn't get to try out the new glucose meter, for instance, just had to give some blood for testing purposes.  For one of the insulin studies I was in, I was actually randomly put into the control group, so I didn't get to try out the new insulin at all.  (I didn't mind much, though, since they still paid for all my supplies during the study.)  Another study I did, however, introduced me to a fantastic new type of insulin that I will be switching to the instance the FDA approves it.

Finally, not everyone feels this way, but I find the studies to be very interesting.  I like getting to see firsthand the process that companies have to go through in order to gather enough data to submit their medicine or device to the FDA.  I like meeting other people in the studies, both the other participants and the research assistants.  I haven't had the pleasure of knowing other diabetics, so it's always nice to talk to others with the same condition.

My point is, though, that there are a lot of good reasons for participating in medical studies, and not all of them are altruistic.  In my opinion it's well worth asking your doctor's office if they have any opportunities for you to participate in studies, and if not, where else you can check.  It seems like university hospitals have the most opportunities, but some studies will even be advertised on Craigslist!

Wednesday, April 13, 2011

Diabetes book review: Diabetes for Dummies, Mini Edition

iconRecently I bought a Nook, so when I saw the ebook of Diabetes for Dummies Mini Ediiton on sale for only 99 cents, it seemed like a good one to get and review on Proud Diabetic.

First of all, when they say "Mini Edition," they really mean it — the book is only 40 pages long.  It also could be called "Beginner's Edition" or "Intro Edition," because most of it is pretty basic information.  It starts out by explaining what diabetes is — type 1 and type 2 — and then addresses medications, insulin, diet, and exercise for diabetics.

On the whole, I thought this was an excellent ebook for people who were just diagnosed, know someone who was just diagnosed, or just want to learn the basics about the disease.  It's not for someone who knows a lot about diabetes already, and I think there's actually some incorrect information.

A few things I had a problem with:

- The book tries to differentiate between type 1 and type 2 symptoms.  Realistically, high blood sugar is really the main symptom of both diseases (rather than the disease itself, since the body gets there two different ways).  Since both types of diabetes are usually found out because of high blood sugar, the symptoms are more or less the same.  For instance, the ebook lists blurry vision under the symptoms of type 2, when I can tell you for a fact that it happens with type 1 too.  The only symptoms that I think were accurately placed in only the type 2 category are numbness in the extremities (which tends to be caused by long term high blood sugars, and therefore usually isn't present when type 1, which comes on very quickly, is diagnosed) and heart disease (which is I believe a complication because of the combination of long term high blood sugars, and the weight problems usually present in type 2 diabetics).

- The book doesn't seem to know some of the facts about type 1 diabetes.  It claims type 2 is more of a genetic disease, which isn't true because autoimmune diseases are definitely genetic (and because we don't know whether it's type 2 diabetes, or the weight problems that lead to it, that are genetic).  It also claims that there is no way to tell for sure if you're going to get type 1, which also isn't true, because someone with the autoimmune disease will have certain antibodies in their bloodstream.  It also claims that 90 percent of type 1 diabetics became diabetic because of a fever as a trigger, an old theory that was debunked in Dan Hurley's book Diabetes Rising.

- The book sometimes seems rather outdated.  In addition to the fever-as-trigger theory and the apparent lack of knowledge about antibodies and the genetic nature of autoimmune diseases, the book is also shockingly outdated on other things.  For instance, it describes two types of test strips, one that changes color (which tells you your approximate blood sugar) and one that gives you a glucose reading.  Since I have not heard of anyone using the color strips in probably 20 years, I think this is glaring evidence that the book needs to be updated or probably just rewritten altogether, using the newest information.

- The author recommends a diet that is only 40 percent from carbs.  Most studies indicate that high-carb diets are much healthier for you, heart-wise and in other respects as well.  Since modern insulin can do such a good job of managing your sugars, a low-carb diet seems to be rather old-fashioned.  For instance, I eat a very high-carb diet, and my A1c is consistently around 7 (even lower in the last year, because I was doing a study and was on a new insulin, a replacement for Lantus, that is just starting the approval process with the FDA).  I also don't agree with him that low-carb diets make it easier to control blood sugar — I find that hours later, when protein and fats are finally converted into glucose, I end up with a spike in blood sugar if I've eaten a low-carb meal.

In other words, the book is a great intro into the subject, especially for the price, but I wouldn't let it be the final word on anything.

Friday, February 25, 2011

Using technology to manage your diabetes

Yesterday, USA Today ran this article, about how smartphone apps keep health at your fingertips.  I've been using an app to track my blood sugar for at least 6 months now, probably longer, so I found the article especially interesting — even though it didn't mention anything about blood sugar or diabetics.

I use a pretty basic iPhone app, called Glucose Buddy, for tracking my blood sugar.  It was a free app when I downloaded it, but since then they've added a lot of fancy (and, at least for me, unnecessary) features that you have to pay for.  They've also added advertising, which wasn't there before.  However, it is a decent little app and does what I need it to do.  I can input my blood sugar, insulin doses, gram of carbs eaten, exercise, and even (a newer feature, but still free) my A1c.  To review past logs, I have to scroll down a list on my phone.  The graph only shows the high, low, and average values for each day, which is too bad — I'd rather see a graph of all my values for one day — but it's still useful.

Do you use any iPhone apps to keep track of your diabetes?  If so, which one or ones do you recommend?  Please don't forget to include the price of the app, and if it costs something, what makes the app worth getting instead of a free app.

Thursday, February 17, 2011

Energy drinks and diabetes

The other day, this article ran in USA Today: 'Pediatrics' study disputes energy-drink claims.  Essentially, studies are now contesting the claims of energy drink manufacturers, that the drinks provide any benefits for physical and mental performance.  In fact, the study claims that the drinks can cause some serious health problems in kids with other conditions... such as diabetes.

I am curious if other diabetics have had similar experiences with energy drinks as I have.  Caffeine usually causes an increase in my blood sugar, and energy drinks seem to be particularly bad.  Every time I've drank them to try to stay up late to work on a paper for school, or something of the sort, I've ended up with ridiculously high blood sugar.  I suspect it has something to do with adrenaline causing the body to release extra sugar into the blood stream.

What about you?  Have you found that you need to avoid energy drinks, or even that you have to watch your caffeine intake?