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Janknitz wrote:I have to say Diabetes education in the US is pretty piss poor.

ShiftWorker wrote: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

Hmmm? Seems to be a contradiction here?

Not contradictory--inconsistent! Shiftworker's providers are rare gems indeed.
My "training" was an hour-long class held in the clinic break room,
centered around the sacred food pyramid.
---right next to two vending machines--filled with nothing but high carb selections.
The brochures I was given were compliments of one pharma company or another.
One could easily see which gods they worship.
When I was in the hospital, they gave me MASSIVE quantities of carbs, which I sent back.
My family brought me healthy food from outside.
After my stay, I filed a complaint--FWIW.

I just ran across this thread and am a Type I diabetic diagnosed 20 years ago. I'm fortunate to have excellent Endocrine and diabetes care, education and treatment at a major teaching hospital. My CDE is a Type I diabetic and has been since childhood, so, I'm quite lucky. She can really relate.

I've been on CPAP for about 3 years. My, oh my, how times flies! lol I'm on daily injections, but, do wear a Continuous Glucose monitor (Dexcom), so, I'm using lots of equipment each day with my CGM, Accu check Pro meter for calibrating CGM, and ResMed 10 CPAPA. In my spare time, I have a full time profession and am preparing to embark on a new part-time profession. lol I'm serious.

I don't think that people get how much time, energy, thought and money goes into managing diabetes. At least Type I. I don't have any experience with Type II.

My great aunt was Type I, as well, and she lived into her 80's with no loss of vision, organs or limbs. And she maintained a sound mind until the end. This was a lady who was diagnosed in the 1950's, when there were no at home meters to test BS and the patient just had to guess what it was. The needles were gigantic back then too. So, she's my role model and I think of her when I start to feel sorry for myself. lol It gives me a fresh perspective.

Type 2 Diabetic, diagnosed 18 years ago or so, and probably had it for a few years before that. A1C was something like 13 if I recall. Have been through major weight loss, fitness training, and a number of different drugs like Prandin, Actos, and am currently using metformin as well as a rapid insulin with meals and a long acting insulin twice a day. Since going on CPAP treatment my CA events have increased. Now I am a bit worried about autonomic nervous system damage from diabetes possibly being related to the central apnea. I guess time will tell if it start to increase, or reduces with treatment time.

Ron AKA wrote: ↑

Tue Apr 03, 2018 2:25 pm

Type 2 Diabetic, diagnosed 18 years ago or so, and probably had it for a few years before that. A1C was something like 13 if I recall. Have been through major weight loss, fitness training, and a number of different drugs like Prandin, Actos, and am currently using metformin as well as a rapid insulin with meals and a long acting insulin twice a day. Since going on CPAP treatment my CA events have increased. Now I am a bit worried about autonomic nervous system damage from diabetes possibly being related to the central apnea. I guess time will tell if it start to increase, or reduces with treatment time.

Ron, you might want to start a separate thread and post your Sleepyhead results. Folks here who know how to read the charts might be able to help you with those CA events. I find that I get increased CA events periodically and then they go away. In my case, I think it's the RLS waking me up at night, so turning probably causes them. A simple google search shows that diabetes can affect lung function, but not sure that equates to CA events. This was a more recent study, but it's just one study. https://www.sciencedirect.com/science/a ... 3813001441. Yes, I'm diabetic as well, but only had it since 2010. Highest A1c was 7.2, so nowhere near yours!

SewTired wrote: ↑

Tue Apr 03, 2018 2:49 pm

Ron AKA wrote: ↑

Tue Apr 03, 2018 2:25 pm

Type 2 Diabetic, diagnosed 18 years ago or so, and probably had it for a few years before that. A1C was something like 13 if I recall. Have been through major weight loss, fitness training, and a number of different drugs like Prandin, Actos, and am currently using metformin as well as a rapid insulin with meals and a long acting insulin twice a day. Since going on CPAP treatment my CA events have increased. Now I am a bit worried about autonomic nervous system damage from diabetes possibly being related to the central apnea. I guess time will tell if it start to increase, or reduces with treatment time.

Ron, you might want to start a separate thread and post your Sleepyhead results. Folks here who know how to read the charts might be able to help you with those CA events. I find that I get increased CA events periodically and then they go away. In my case, I think it's the RLS waking me up at night, so turning probably causes them. A simple google search shows that diabetes can affect lung function, but not sure that equates to CA events. This was a more recent study, but it's just one study. https://www.sciencedirect.com/science/a ... 3813001441. Yes, I'm diabetic as well, but only had it since 2010. Highest A1c was 7.2, so nowhere near yours!

I'm not too worried about it at this point. Here is an article that concluded diabetics with diabetic neuropathy had double the risk of developing sleep apnea syndrome, compared to diabetes without neurophathy.

DN & SAS Relationship

I had zero training at all. I was given a prescription for insulin and told to take 60cc at night of the long acting, and 40 of the short acting before meals. Then told that if my blood sugars were high after a meal to give myself another dose. Zero.

I had to go online and really research. Even with a strict diet and a shit ton of insulin I was never able to get my diabetes under control. Then I had weight loss surgery and lost 165 pounds. The diabetes was gone before I had even lost a single pound. I have not needed insulin since the day after my surgery. That was nearly 6 years ago. Weight and diabetes are both still gone.

Diabetes education in this country is scary at best. I was in the hospital 3 separate times with blood sugar levels over 700 and a fourth where it was over 1000. They still never bothered to actually set me up with a diabetes educator or any kind of class. But they sure did run their judgmental mouths and treat me like shit for not being able to keep it under control.

jennmary wrote: ↑

Tue Apr 03, 2018 10:15 pm

The diabetes was gone before I had even lost a single pound. I have not needed insulin since the day after my surgery. That was nearly 6 years ago.

This is so interesting, Jennmary.
What explanation did the doctors give for this?

I'm not diabetic or pre-diabetic, but am very curious about the connection between diabetes and OSA and wonder if there is a relationship between them or if they just happen to co-exist in some people.

Diabetes Type II can be reversed and Type I managed so that the diabetic complications are minimal:

http://www.diabetes-book.com/
http://www.phlaunt.com/diabetes/18217337.php

See also https://www.virtahealth.com/research (Peer reviewed studies with essentially the same dietary approach Dr. Bernstein recommends but with an online support model)

Arlene1963 wrote: ↑

Wed Apr 04, 2018 4:52 am

jennmary wrote: ↑

Tue Apr 03, 2018 10:15 pm

The diabetes was gone before I had even lost a single pound. I have not needed insulin since the day after my surgery. That was nearly 6 years ago.

This is so interesting, Jennmary.
What explanation did the doctors give for this?

I'm not diabetic or pre-diabetic, but am very curious about the connection between diabetes and OSA and wonder if there is a relationship between them or if they just happen to co-exist in some people.

They don't know yet and are trying to figure it out. It interrupts the insulin resistance. Your islets that have been destroyed won't come back (so no go for type 1 or 1.5). However, many folks with type 2 produce plenty of insulin, so their islets are still there - just whatever causes the insulin resistance is gone. But yes, even when weight isn't considered, diabetics between 40 and 65 are more likely to have OSA than non-diabetics. For the over 65 crowd, they haven't really seen any differences because I'm guessing non-diabetics catch up with older muscles and stuff.

Jennmary, I assume that you are not with Kaiser. They just about browbeat people into diabetic education. While the diabetic education is maybe not what I agree with, it's better than what you got by a long shot. I followed Dr. Bernstein's type of method for some years and it was great. Unfortunately, ever since I had cancer surgery, it's been an up and down thing. Anyway, I'm happy to read of your success!!

Janknitz wrote: ↑

Wed Apr 04, 2018 1:16 pm

Diabetes Type II can be reversed and Type I managed so that the diabetic complications are minimal

The only problem is that the so called "Dr" Bernstein is quack.

I’m not diabetic but I am hypothyroid. That means my thyroid is under active. I’m on a little blue hormone pill for it.

SewTired wrote: ↑

Wed Apr 04, 2018 5:10 pm

They don't know yet and are trying to figure it out. It interrupts the insulin resistance. Your islets that have been destroyed won't come back (so no go for type 1 or 1.5). However, many folks with type 2 produce plenty of insulin, so their islets are still there - just whatever causes the insulin resistance is gone. But yes, even when weight isn't considered, diabetics between 40 and 65 are more likely to have OSA than non-diabetics. For the over 65 crowd, they haven't really seen any differences because I'm guessing non-diabetics catch up with older muscles and stuff.

Thanks SewTired!

I was especially interested to read that Jennmary's glucose levels returned to normal prior to weight loss and immediately after the procedure.

I did some research yesterday and found this article in "Diabetes Care" published in 2011

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632208/

"Studies have shown that return to euglycemia and normal insulin levels occurs within days after surgery, long before any significant weight loss takes place. This fact suggests that weight loss alone is not a sufficient explanation for this improvement. Other possible mechanisms effective in this phenomenon are decreased food intake, partial malabsorption of nutrients, and anatomical alteration of the gastrointestinal (GI) tract, which incites changes in the incretin system, affecting, in turn, glucose balance. Better understanding of those mechanisms may bring about a discovery of new treatment modalities for diabetes and obesity."

I had no idea that this was the case and have certainly learned something new.

Fung has an interesting take:

-- https://www.youtube.com/watch?v=DXfdhyh7hNk

-- https://idmprogram.com/bariatrics-surgi ... ing-t2d-6/

-- https://www.dietdoctor.com/bariatric-su ... -treatment

I can't imagine how cutting down on putting food in your gut could help blood sugar levels....

WARNING: This was satire, Of Course, it helps your blood sugar, to limit the intake of food and drink. Jim