Thursday, November 29, 2012

Testing and Logging Data


Just after I was first diagnosed with Type2 Diabetes I began logging all the meals and food I put in my mouth and the results of each glucose test I perform. After 90 days I now have some data I can use to evaluate my progress. For instance:

My normal habit is to only eat one meal per day. I’ve always lived that way and it has never been an issue for me. Diabetes best-practice is to consume three squares a day and this means I need to add both breakfast and lunch.

So…  I started slow by really concentrating on trying to eat lunch each day. The issue is that I have one of those jobs where things get so busy that it is impossible to get away for the time it takes to eat something. From the data I’ve been able to log I can tell that I have been able to eat lunch only 49% of the time for the last 90 days.

10% of the 90 day time period I’ve exceeded my daily caloric intake goal of 1500 calories per day. Not by much but it is exceeded and that’s a fact.

13% of the 90 day time period I’ve exceeded my daily carbohydrate goal of 150 grams per day. Again, not by much but with this disease that might be the difference between sweet blood flowing in my veins and an unhealthy high glucose battery acid mixture...

I know the percentage of time my blood glucose exceeded normal thresholds and because I’ve logged all of my meals each day, by date, I can correlate the higher than normal glucose levels to the meals that I’ve eaten and then eliminate those items that have repetitively caused my glucose to rise.

I have some work to do in order to manage to my goals and hence manage the disease instead of it managing me! 

Gregory

Wednesday, November 28, 2012

Dietician Consult


Consulted with a professional Dietician; who believes that one of the underlying causes of type2 Diabetes may be that the cell receptors are blocked by fat or other impurities in the body. She is very knowledgeable.

She advised me to start a Vegan diet and to maintain this diet for 90 days. In addition, no wheat, no nuts, no sugar-free pudding, no Jell-O, no animal products (dairy, meat), no oils at all, no plain yogurt, a salad a day with fat free dressing, no milk or other dairy products, no creamer for coffee, lots of fiber(beans), sea salt instead of regular salt, low sodium, gluten-free, ground flax seed, a daily protein shake and many other ideas and instructions too numerous to list here.

This will really be a new lifestyle and so we’ve decided to eat up the remaining meat and other non-approved items on the list over the next month as well as create/document a new diet plan over the month of December and then start our new plan on January 1st, 2013.

Happy New Year!  This will be fun. 

Tuesday, November 27, 2012

HbA1c Test


The HbA1c test or as its also known the A1c or Glycated Hemoglobin test is a blood test that shows a person’s average glucose levels over the previous 2-3 months.

This is the test the doctor did when I was diagnosed with Diabetes. You can see from the chart below that anyone with an A1C Glucose percent higher than 6.5 is a Diabetic. The chart came from the National Diabetes Clearing House. I recommend it highly as it is filled with so much essential information. This link is: http://diabetes.niddk.nih.gov/dm/pubs/diagnosis/

 
The goal my doctor set for me at that time was to get my glucose level below 7%.  I’ve been working on that goal for three months. I have logged every bit of food I’ve eaten in that time into an app that calculates and records the carbohydrates, calories, fat calories, &c..  In addition, I’ve logged every glucose test I’ve completed in that time into another app built for that purpose. That app also has a feature that provides one with an estimated HbA1c percent. This morning, my estimated HbA1c was at 6.0! 

A few days ago, I ordered a self A1c test kit for Diabetics off the Internet. You can get these from a number of sources. Some purport to allow you to take the test and get the results immediately while others have to be mailed into a lab and the results emailed or sent via normal post to you within 4-5 days.  The tests range from $19.00 to more than $100.00 depending upon the type and the speed of the results.

The one I ordered was cheaper and requires one to place your blood onto a provided card and then send it into a lab. The results will be emailed to me in 4-5 days and I’ll report the results as soon as I receive them. Once I get the results I'll schedule an appointment with my doctor to have an “official” test and compare the results. I’m hoping I’ve been able to reduce my blood glucose down to the fairly well managed level.

Gregory

 

Saturday, November 24, 2012

My Meter, My Friend

One of the first things I needed to understand after my diagnosis of Diabetes was: “What are the right foods to eat and what should I avoid?”

Upon trying to answer these questions, I read a LOT of seemingly conflicting information.  I was instructed by some websites to completely avoid anything white - white flour, white rice, white tacos, and so on, as well as any kind of “starchy” vegetable such as corn or potatoes. Other information sources clearly showed recipes containing and stated that these foods are okay for diabetics as long as you eat them in moderation and utilize “the plate method” where starches are just a quarter of what is eaten at every meal. In addition, some information sources, state that the Diabetic should eat about 60 grams of carbs per meal. You’ll see websites showing diabetic-friendly meals with low carb taco shells and low carb white bread. I’ve seen some books of Diabetic recipes showing a juicy hamburger on the front cover, topped with kernels of corn. I ask myself upon seeing these, “Can these be truly Diabetic-friendly?” 

For me, the answer is a resounding NO. They are not! How can I say this? How can I know? The answer is of course – my glucose meter.

It doesn’t matter whether you’re pre-diabetic or diabetic or even what type of meter you choose so long as it is as accurate as you can get. What matters most is that you test. Test often and consistently. You have to test in order to get data. You have to have data in order to make informed and appropriate choices. This is your life so don’t stand on the fact that you’re not completely Diabetic yet to avoid testing. It is essential that you understand what foods and activities do to your blood glucose levels AND it is unique for each individual.

I find that it is best for me, that I test in the following manner:
    1.       When I rise in the morning. I test and record the finding.
                 a.  My glucose level should be between 70 and 130. If it is lower, I eat something to get    the sugar level up. If it is too high, I drink a copious amount of water to flush glucose out of my system and exercise to lower the glucose level in my body.  

2.       Before I eat a single bite of food at any meal, I test and record the result.
                  a.       Glucose level should be between 70 and 130.

3.       One hour after eating any food from any meal, I test and record the result.
                  a.       Eliminate any food from your diet that drives your glucose level higher than 140 as a result of this test.

4.       Two hours after eating any food from any meal, I test and record the result
                  a.       Should be lower than 180, however, eliminate any food from your diet that drives your glucose level higher than 120 as a result of this test.

5.       Just prior to finally sleeping for the night, I test and record the result.
                  a.       My glucose level should be between 70 and 130. If it is lower, I eat something to get the sugar level up. If it is too high, I drink a copious amount of water to flush glucose out of my system and exercise to lower the glucose level in my body.  

What I discovered while using my meter, is that rice of any kind; but especially white rice drives my glucose levels through the roof and does so immediately. Before I discovered this via testing, I used to have rice wrapped sushi all the time and white rice with Chinese cuisine foods. I’ve seen Diabetic cookbooks showing a cover photograph of a Chinese meal sitting on a layer of white rice. That may be fine for some Diabetics, bit I no longer eat rice at all because of the impact it has on my Diabetes.

Using the information obtained from diligent, deliberate and consistent testing, I’ve been able to eliminate several items from my diet that the Diabetic books said were just fine; but for me and my body are definitely not. The time it takes to test is nominal and is definitively offset by the wealth of valuable data gleaned from this practice.

For me, the appropriate answer to the questions, ““What are the right foods to eat and what should I avoid?” is that for each Diabetic: ”It depends”.  

I advocate in the strongest of terms that the Diabetic needs to pay more attention to what our meter (our body) is telling us and NOT on what some organization or standard tells us. Do your testing and make your meter your best friend. Trust your body to tell you what you should eat and what you should not.

Gregory

Our First Diabetic Thanksgiving

This Thanksgiving was different than all the others. I went through it as a Diabetic. Actually I went through it twice AND I did just GREAT!

First, my wife and I went to my mother’s house and spent the day with my family. My little sister had flown in from California and was there with her children and grandchildren. We were about 20 people in all and this was a more-or-less traditional American Thanksgiving.

There was Turkey, Dressing (stuffing), green bean and French onion casserole, cranberry sauce, mashed potatoes, white flour yeast raised dinner rolls, spinach salad with mandarin oranges, pies and cakes galore. My wife has made dinner rolls from scratch for years. Most of the family love them and ask for her to make them every holiday because they really are so delicious.

I went through the meal eating a tablespoon each of green bean casserole and dressing; no mashed potatoes or cranberry sauce, a small amount of gravy, more turkey than all the starchy things on the plate except for much more spinach salad than anything else. I used “the plate method” for the most part and even ate a piece of sugar-free apple pie (without eating any of the crust of course). I had nearly all of one of my wife’s luscious dinner rolls. Later, upon testing my blood glucose at two hours afterward, all was well. No spike…   I was elated.

Finally, two days later on Saturday, we had my cousin and his wife over for another Thanksgiving dinner. They’re in their 90’s (he is 93 years of age) and every year we try to ensure they get a good meal and that we celebrate God’s goodness by giving thanks together.

This meal was a Diabetic-friendly meal that my good wife generously cooked. It featured Turkey of course - but it was organic. Instead of mashed potatoes there was cauliflower and also butternut squash. There was a green bean casserole. There was cranberry sauce (Tomatoes was my alternate dish), sweet potatoes and dressing for the non-Diabetics. Unlike any other year, my wife purposely did not include making her famous dinner rolls for this meal (why I love her so much!). Finally, there was a Diabetic pumpkin pie. The recipe is listed below in case you’d like to make it. It was sugar-free and delicious. Again, I tested my blood glucose level two hours after the meal and it was well within normal range! Wonderful!

This holiday I am truly thankful for my family, who cared enough to feature a sugar-free apple pie, for my wife who cared enough not to make her world-famous white flour dinner rolls and to make a simply delicious Diabetic-friendly meal. I’m thankful for our friends and for the information I’ve learned that allowed us to make appropriate choices to manage the disease we must now live with.

I hope yours was as fruitful and delicious.

Diabetic’s Pumpkin Pie
1 baked, cooked 9 inch pie shell
2 sm. Pkgs. Sugar-free instant vanilla pudding
2 c. milk
1 c. canned pumpkin
1 tsp. pumpkin pie spice
¼ tsp. nutmeg
¼ tsp. ginger
½ tsp. Cinnamon

Blend all ingredients in blender until smooth.
Use plain canned pumpkin. DO NOT USE CANNED PUMPKIN PIE MIXTURE.
Pour into pie shell and chill until ready to serve.

Friday, November 23, 2012

Why More People Diagnosed with Diabetes?

Diabetes is reaching epidemic levels in our society. Some of the underlying cause for Type2 Diabetes is probably tied to inactivity and obesity to be sure and certain, but I think this is really just an easy target.

In my mother and father’s day, and even when I was a child, we didn’t have video games or much television and so on. We walked a lot, spent more time outside doing things and so on. HOWEVER, as a child, and in my memories, my Grandfather, Grandmother never did any more physical exercise really than I have done in my life. They never went to a gym because there really weren’t any at that time. I never ever saw any of these people “sweating to the oldies” in any way, shape or form. They also did not have to chop wood to stay warm, carry water to the house nor really go outside to go to the bathroom. These pioneer activities had all been replaced by technology and improvements and were all being phased out.  They had automobiles and used them instead of walking whenever possible. My mother still just putts around all day doing things that she wants to do. She’s never done aerobics, nor anything like that and she’s 86 years old and Diabetes-free.

Kids are kids. What I mean is that when I was a kid, I ran around everywhere and played and jumped at school and at home. Kids today have gymnastics at school. They still go onto playgrounds and play for a period of time every day. They are not completely as active as we were when I was young. People don’t really invest in swing sets like they used to; but the kids do still run and jump.

So why are people getting more of this disease now?  Certainly we have more comfort. We do less and that’s a fact because there is less to do as far as putting around maintaining our homes. We don’t have to maintain everything all the time because we’ve developed solutions and longer lasting materials for our homes and automobiles so that we don’t really have to do that, but food has changed as well and I think that has something to do with this as well.

I continually hear things like “oh we’re all so lazy now.”  But I get to work every morning. I walk from the parking lot into the building. I then walk the entire length of the building to the cafeteria to get coffee and then back the entire length of the building to the elevators. I know that every single day I must walk at least a half a mile for sure. I put around on weekends and walk in the neighborhood. I am not doing any less than I’ve seen my parents and grandparents do for my entire lifetime and yet, I have Diabetes… 

Let me know what you think about why we’re seeing higher rates of Diabetes now.

Creating Order out of Chaos


In order to get a handle on Diabetes and potential complications; you have to read and learn. A lot!

I've pulled together a lot of useful information here. Hope it helps.  

Discovered the National Diabetes Information Clearing House at:
http://www.diabetes.niddk.nih.gov. This site contains a wealth of information.  There are so many great sites packed with great information such as:  http://www.diabetes.org/  and http://www.diabetesdaily.com.  There are a ton-o-sites out there and so I spent the last couple of days reading.

A summary of the disease (Type 2):
Type-2 diabetes is a lifelong illness, which generally starts in middle age or later part of life, but can start at any age. It has a different cause than Type-1: patients with type-2 diabetes do not respond properly to insulin, the hormone that normally allows the body to convert blood glucose into energy or store it in cells to be used later. The problem in type-2 diabetes is not lack of insulin production; most of these patients produce variable, even normal or high, amounts of insulin.

The first stage in type-2 diabetes is the condition called insulin resistance. Insulin helps glucose to enter cells, where it is used for energy. In patients with insulin resistance, although insulin can attach normally to receptors on liver and muscle cells, certain mechanisms prevent insulin from moving glucose into these cells where it is utilized. As a result body starts making more and more insulin and in the beginning, this amount is usually sufficient to overcome such resistance, but during the later phases of the disease the insulin resistance increases in severity and, blood glucose increases, but at the same time the body is unable to use it properly, and the body’s cells are actually starving for energy. Even with increased amounts of insulin the insulin demands of the body is not met because of the increasing tissue resistance. Because the body does not use insulin properly, blood glucose rises above the safe level. The initial effect at this stage may be an abnormal rise in blood glucose right after a meal (called postprandial hyperglycemia). Type-2 diabetes differs from type-1 diabetes in that type-1 diabetes is always caused by the body's inability to make enough insulin.

Type 2 diabetes is the most common form of diabetes, accounting for 90 - 95% of cases. Eventually, the cycle of elevated glucose further damages beta cells, thereby drastically reducing insulin production and causing full-blown diabetes. This is made evident by fasting hyperglycemia, in which elevated glucose levels are present most of the time.
 
Some Facts:
·       13% of adults have type2 diabetes.  About 25-27 million people in the U.S. have type 2 diabetes. 13 million of those are men. Another 30% have pre-diabetes.
·       Even though millions of Americans have type-2 diabetes, only half of these people are aware that they have diabetes.
·       The death rate in patients with diabetes may be up to 11 times higher than in persons without the disease.
·      The occurrence of diabetes in persons 45 to 64 years of age is 7 percent, but the proportion increases significantly in persons 65 years of age or older.
·        People with diabetes are 2x times more likely to develop serious gum disease.
·      Research has shown that diabetic patients have a shorter life expectancy than non-diabetic individuals and that this excess mortality is largely attributable to cardiovascular causes.
·      Diabetes is known to double the risk of heart attacks and strokes, but the new findings show people with type 2 diabetes are also at greater risk of dying from cancer, infection and mental disorders.
·     Even after accounting for other risk factors such as age, sex, obesity and smoking, the researchers found people with diabetes were at increased risk of death from several common cancers, infections, mental disorders, and liver, digestive, kidney and lung diseases.
·       About 60 per cent of the reduced life expectancy in people with diabetes is attributable to blood vessel diseases – such as heart attacks and strokes. Only a small part of these associations are explained by obesity, blood pressure, or high levels of fat in the blood – conditions which often co-exist with diabetes.
·         Diabetes can cause feelings of isolation. Managing diabetes can cause mounting stresses that sometimes lead to poor self-care and feelings of loss of control. Depression can make it difficult to think; interfering with medication compliance and exercise goals necessary to keep diabetes under control. Diabetes doubles the risk for depression. Depression, in turn, may increase the risk for hyperglycemia and complications of diabetes.

Symptoms I was able to find:
·         Increased thirst
·         Increased hunger (especially after eating)
·         Dry mouth
·         Nausea and occasionally vomiting
·         Frequent urination
·         Extreme unexplained fatigue (weak, tired feeling)
·         Blurred vision
·         Itching of the groin
·         Irritability
·         Numbness or tingling of the hands or feet
·         Wounds that don't heal
·         Frequent infections of the skin, gums or urinary tract

Complications I was able to find:
·   Alzheimer's disease
·   Dehydration
·   Diabetic Ketoacidosis
·   Diminished ability to fight infection
·   Eye damage
·   Foot damage
·   Hearing problems
·   Heart and blood vessel disease
·   Hyperglycemia
·   Hyperosmolar nonketotic diabetic coma
·   Hypoglycemia
·   Kidney damage (nephropathy)
·   Nerve damage (neuropathy)
·   Osteoporosis
·   Poor sleep
·   Skin and mouth conditions
 
What can I do to manage the disease? 
(Note, I’m not a doctor so this stuff is just what I’ve found by reading. Any thresholds listed are for me. You'll need to set your own if these are not applicable to you. )
Alzheimer's disease
o   Control blood Glucose levels
Dehydration
o   Drink 8-10 cups of water every day. This also helps flush out the Glucose.
Diabetic Ketoacidosis
o  
Diminished Ability to Fight Infection
o   Continued and consistent use of multi-vitamins
o   Medications as prescribed by doctor
o   Flu shot annually
o   Pneumonia shot annually
Eye Damage
o   The American Diabetes Association recommends that patients with type 2 diabetes get an initial comprehensive eye exam by an ophthalmologist or optometrist shortly after they are diagnosed with diabetes, and once a year thereafter. The eye exam should include dilation to check for signs of retinal disease (retinopathy).
Foot Damage
o   Thoroughly inspect your feet daily
o   Patients should inspect their feet daily and watch for changes in color or texture, odor, and firm or hardened areas, which may indicate infection and potential ulcers.
o   When washing the feet, the water should be warm (not hot) and the feet and areas between the toes should be thoroughly dried afterward. Check water temperature with the hand or a thermometer before stepping in.
o   Apply moisturizers, but NOT between the toes.
o   Gently use pumice to remove corns and calluses (patients should not use medicated pads or try to shave the corns or calluses themselves).
o   Trim toenails short and file the edges to avoid cutting adjacent toes.
o   Well-fitting footwear is very important.
o   People should be sure the shoe is wide enough. Patients should also avoid high heels, sandals, thongs, and going barefoot. Shoes with a rocker sole reduce pressure under the heel and front of the foot and may be particularly helpful. Custom-molded boots increase the surface area over which foot pressure is distributed. This reduces stress on the ulcers and allows them to heal.
o   Change shoes often during the day.
o   Wear socks, particularly with extra padding (which can be specially purchased).
o   Patients should avoid tight stockings or any clothing that constricts the legs and feet.
o   Consult a specialist in foot care for any problems.
Hearing problems
o   Complete and annual hearing test.
Heart and blood vessels and Nerve Damage(neuropathy)
o   Reduction in weight if necessary and maintenance of doctor prescribed weight
o   Reduce/Manage blood glucose levels
o   Protect the heart and aim for healthy lipid (cholesterol and triglyceride) levels and control of blood pressure.
o   Control blood Glucose levels using exercise, diet, medication, regular testing and countermeasures.
§  Test prior to taking a bite at any meal - Fasting levels 70-130
§  Test 1 hour post-meal and eliminate anything from your diet that causes levels higher than 140.
§  Test 2 hours post-meal and eliminate anything from your diet that causes levels high than 120.
§  Test prior to bedtime and supplement with food if blood glucose level below  .
o   Test HbA1C every three months 
o   Control high blood pressure through exercise, diet, and medication
o   Take an aspirin daily. 
o   Get regular medical checkups (every six months).
Hyperglycemia
o   Control blood Glucose levels using exercise, diet, medication, regular testing and countermeasures.
§  Test prior to taking a bite at any meal - Fasting levels 70-130
§  Test 1 hour post-meal and eliminate anything from your diet that causes levels higher than 140.
§  Test 2 hours post-meal and eliminate anything from your diet that causes levels high than 120.
§  Test prior to bedtime and supplement with food if blood glucose level below  .
o   Test HbA1C every three months
Hypoglycemia
o   Control blood Glucose levels using exercise, diet, medication, regular testing and countermeasures.
§  Test prior to taking a bite at any meal - Fasting levels 70-130
§  Test 1 hour post-meal and eliminate anything from your diet that causes levels higher than 140.
§  Test 2 hours post-meal and eliminate anything from your diet that causes levels high than 120.
§  Test prior to bedtime and supplement with food if blood glucose level below  .
o   Test HbA1C every three months 
Kidney Damage (nephropathy)
o   Drink 8-10 glasses of water per day. This helps flush the system of glucose.
o   The American Diabetes Association recommends that people with diabetes receive an annual microalbuminuria urine test.
o   Patients should also have their blood creatinine tested at least once a year.
Osteoporosis
o  
Poor Sleep
o  
Skin and Mouth Conditions
o   Treatment with doctor prescribed skin lotions
o   Brush teeth in the morning and before bed with a toothpaste specifically formulated for gum health.
o   Bath in a barely warm, not hot bath with about 2 cups (500 ml) of baking soda or some Epsom salts added.
 
Can only hope this might help someone out there who needs the information.