Who In The Forum Is Diabetic ???

[JeffH]

Amazing! For gawd's sake we got better medical care 40 years ago than we do now!!! At least in my experience!

You are right. Now when you go to the hospital, (if you can even get in a hospital) you are taking your life into your own hands. I know of so many people that have gotten really sick from being in hospitals.

JeffH

[GuyK]

Maybe -- I just finished reading a rather interesting book: Complications, by Atul Gawande. Dr. Gawande is a general surgeon at Mass General and this book covers some of his personal discoveries (for lack of a better phrase) about the medical field during his residency.

Towards the end of the book, he talks about the overall change, in health care, from doctor-led decision making to patient-led decision making. I was surprised that it kind of all boils down to a single doctor (who wrote a book) that drove this process many years ago.

I don't have the book with me right now, but I did make note of an excerpt that I thought would be a good idea to print here. The upshot of it all comes down to "taking charge of one's own therapy".

So, I'm not sure 40 years ago was better (I was just a little kid back then!) -- doctors definitely worked to keep their patients ignorant back then. Now at least we get to be part of the decision process, if we choose to.

Guy

[Sleepdiva]

Hi, I am diabetic and am on an insulin pump. I've been diabetic for 12 years. I have other medical issues also and of course sleep apnea. I go to the dr. for the correct pressure on my c-pap next week, which was a long awaited appt. I feel I have a very good diabetic education and I have learned and will never stop learning about it. Every day is different as well as every night with sleep apnea. I was educated at the local hospital and at Joslin center for diabetes. Being on the pump you have to know all there is to know.

I've learned a lot about sleep disorders, since I've been to the sleep lab 8 times and still have more to learn about SA. I hope you get the education or your questions answered that you are seeking. In my opinion there is no cure for either but they can be controlled.

[GuyK]

This is the post I just added about the book "Complications":

viewtopic/t38284/Complications--Atul-Gawande.html

Guy

[Grems4ever]

Well, I've been pre-diabetic for the last 17 years with brief surges into the "uh-oh" zone on a few occasions. Education? What education? Everything I've learned has been learned on my own. I've asked for assistance, but my HMO won't pay for anything until I'm "officially" diabetic.

Yes, this is exactly how my OSA is handled.

Thank God for forums like this one.

David

[Debjax]

I knew I was in for trouble with my primary care doctor when he saw an A1C of 5.9 (high side of normal range) and said, "look, you're no longer diabetic!" I guess I can just run right out and eat a pound of M&M's then, right? (that was one of those things I wished I would have said).

Which is why you should be seeing an endocronologist. Ours sees my husbands A1C at 5.5 and tells him "you are managing your diabetes very well, keep it up" There is no "you are cured", there is continued management of a chronic disease and proper followups...he must see an opthomalagist once a year, the podiatrist at least twice a year.

[jnk]

Who In The Forum Is Diabetic ???

.

I'm "pre" at 120 fasting glucose and a family history (grandmother, uncles, sister). So just give me a few more years, Slinky, and I'll let you know if I get any education.

[gasparama]

Who In The Forum Is Diabetic ???

.

I'm "pre" at 120 fasting glucose and a family history (grandmother, uncles, sister). So just give me a few more years, Slinky, and I'll let you know if I get any education.

Have you had a 3 hour glucose tolerance test or maybe had your HA1C checked? If you are fasting at that level, you could be running dangerous levels during the day. Type II's often go years undiagnosed due to a fasting level under 126.

[gasparama]

I've been a Type II for 19 years with no complications. I pretty much educated myself and trusted very few of the doctors and other health educators. I recommend that all diabetics read Dr. Bernstein's book or go to his website. So far, my eyes and feet are in such good condition that I have to see the specialists only once a year. I had a heart cath last September and the arteries were pronounced very healthy. I am a very fortunate person to have had the help that I needed. For years there was an excellent mail list whose chief poster was a retired electrical engineer who educated us so well and raised my desire to control this disease. He became quite irritated with us at one time and quit posting causing the list to eventually ride into the sunset.

[jnk]

. . . Have you had a 3 hour glucose tolerance test or maybe had your HA1C checked? If you are fasting at that level, you could be running dangerous levels during the day. Type II's often go years undiagnosed due to a fasting level under 126.

Thanks, gasparama. I will bring both of those up to my doc.

All my blood-workup numbers improved with my last physical (after 6 months of PAP) except my fasting glucose test number. Hopefully my changes in diet and increased activity will get the number down as my weight goes down. Although, when I met with a dietician a while back who looked at my family history, my medical history, and me, she shook her head and said "we may have to adjust our goal from preventing DM to simply delaying it." I appreciated her honesty. Oddly enough, it has motivated me to work harder.

[Goofproof]

A little more on my 20 year battle with diabetes, I was never given the test for diabetes, I went to the doctor because I knew I had it due to most of the symptions. A friend had it and we tested on his machine, the reading we got was HHH, looked it up, and it stood for out of range too high to read. the meter went to 600.

I went to my doctor I later fired, he took the same meter test in the office and got on the phone to the hospital. I ask him what he was doing, he said he was getting me a room, I told him to stop, I'd be at work 40 miles away in two hours. He ask me where to sent the meat wagon, I said send the cold one. I soon started treatment with the VA, for 10 years, but didn't have any success until going on insulin.

Now since the by-pass and not being able to be active I have to take 200 units daily just to get to A1C of 5.5, the best I've been in 20 years, I eat 1/3 the food I did when working, but I can't even burn that off now. I have a cup of coffee with milk a piece of toast and butter with a little jelly, and two slices of bacon, for breakfast, that required 55 units of insulin and 6 hours to burn off.

Sugar isn't the problem with diabetes, it's everything that you eat, in the end it all raises your sugar level. I think for some of us, even breathing raises it. The problem that comes with diabetes, is controlling when foods convert to sugar, some convert fast others slower, and some even slower, it's the volume of foods you eat and how you mix them. You have to try to get a level conversion over the time between meals and also match the insulin rates to thelevels needed to use the fuel. It's never easy, it's like quail hunting with a rifle. Each type of insulin has different rates of use by the body. I mix the two I use trying to meet my need at the time, it can be a rollycoaster ride. While I was in the hospital, they control your food intake and every 3 hours your insulin is checked, I had the worst treatment in their care that I had in years. The doctors and staff know nothing about diabetes treatment in the real world, I had to hide food, to keep from having a severe low event, what a rollycoaster ride, if I was too sick to control it I would have been in trouble. I don't believe in a controlled diet, to many things in my life aren't under my control, I try to eat what I like and control portions it a level I can manage, and I deal with it. Just like I do with my XPAP treatment, I use the input from my testing equiptment to make my own informed decisions. Jim

[kebsa]

I was diagnosed with type 2 diabetes 5 years ago but only because i had virtually self diagnosed and needed official confirmation. I am an RN and for much of my practice i was involved with newly diagnosed diabetcis (inpatient rather than outpatien dx). Obviously i did not recieve a great deal of education as it was deemed to be redundant. Generally though our newly diagnosed diabetics recieved regular meetings with a dietician, diabetes educator until it was clear that they were comfortable after which it was reduced to just periodic perhaps 6 monthly or evn 12 monthly depending on the severity of their conditions (type one or type 2 etc). The rest of the time the persons family practioner monitors it.

the patient generally monitors their blood 4 times per day, more frequent if they are ill as this will affect evn good control, the family Dr will do a test called a HB A1c that is able to provide a very accurate assessment of how good their control has been over the previous 12 weeks. The patients are encourage to make sure that there machines are accurate by continuing to tests themselves and by also doing control tests on their machines- sometimes they do this by purchasing the control solutions them selves other times if finances do not allow for that they bring the machines to the diabetes centre at their public hospital

karen

[GuyK]

I knew I was in for trouble with my primary care doctor when he saw an A1C of 5.9 (high side of normal range) and said, "look, you're no longer diabetic!" I guess I can just run right out and eat a pound of M&M's then, right? (that was one of those things I wished I would have said).

Which is why you should be seeing an endocronologist. Ours sees my husbands A1C at 5.5 and tells him "you are managing your diabetes very well, keep it up" There is no "you are cured", there is continued management of a chronic disease and proper followups...he must see an opthomalagist once a year, the podiatrist at least twice a year.

That's the laugh -- he is an endocrinologist!

(for a multitude of reasons, I'm no longer his patient)

Guy

[Janknitz]

Now that I know how the sausage is made I have to say Diabetes education in the US is pretty piss poor. Doctors, nurses, Diabetes educators get their training in Diabetes “management” from Merk, Glaxo Smith Kline, Kellogg’s, Coca Cola, and M&M Mars. I’m not being facetious, these are companies that sponsor the continuing education programsAmerican Diabetes Association, the Association of Dietetics and Nutrition (formerly the American Dietitians Association), and other Diabetes professionals.

They push the grain heavy USDA food pyramid (now morphed into “My Plate” and a philosophy of “eat up and shoot up”. They teach telling carbohydrate intolerant people that they shouldn’t be “deprived” and to go ahead and eat those sweets, drink that soda (moderation, please) pasta, and bread because “you can cover it with medicine”. Ever take a look at a Diabetes magazine? Full of carb-heavy recipes and ads for oral and injectable diabetes drugs, meters, painless syringes and lancets. Plus wheelchairs walkers, canes, and walk in bathtubs for when (not if!) they amputate your foot. One thing literally feeds the other.

To ad insult to injury, Medicare and other insurers now say that type iis only need one test strip a day-Let’s make sure you don’t see the blood sugar spike the banana cake recipe in the Diabetes magazine (hey, “it’s healthy”, they replaced the fat with applesauce, and added a cup of whole wheat to the batter ). At least with CPAP we get data all night, not just the first 10 minutes of usage.

People who follow these guidelines suffer from progressive illness. Ever higher weight, blood glucose and A1C, vision loss, amputation, kidney disease, stroke, heart attack and dementia. As predictable as those magazines making sure you don’t miss the chocolate cake.

There is a better way, just as renegade as taking charge of your own CPAP data and treatment. It can halt Diabetes progression and some believe even reverse it. But don’t expect to be told about it by your KFC trained Diabetes professional.

[ShiftWorker]

Hello,
I was diagnosed as "Pre" at the same time i was checked for OSA, this was in 2010. i was told at that time to go on a diet.
After getting good insurance in 2012 I had a sleep study titration test and given a basic cpap set to 20 cm H2O. I was not compliant and didnt even try. Later that year after an A1C I was told that I had type II and to monitor my blood sugars. then in November 2016 I went into AFIB. at that time I became very serious about getting my CPaP therapy going, Six "Titration" studies later I am on an ASV machine and after almost four months am able to get more then 4 hours of sleep! And I feel so much better! During one of my follow up visits with my Cardio Electrophysiologist she referred me to an Endocrinologist, I have been to one hour long class and an hour long session with an Educator in addition to my first 45 minute long first visit. My A1C went from 7.6 to 5.7 because of this education and I started daily injections of Victoza.
I wish I had asked about diabetes education sooner!
Robert