LET'S TALK PERSONAL
YOUR PERSONAL SELF MANAGEMENT OF YOUR
DIABETES
QUESTIONS AND ANSWERS
Send your questions to: mailto:diabetes@starterkithaven.com
Question for January 24, 2002
Sheila Foy de Frausto wrote:
I was
dx in June of last year - with 500 fasting. I was having all the symptoms
but was clueless. Selective blindness I guess. Over the next three
months, while I was REALLY doing all that I was supposed to my sugars went
slowly down to normal and I lost 24 lbs. Then my Dr. gave me metformin tablets
and I started with a horrible right-now diarrhea problem - that continued
even after I stopped taking the metformin.
I could not leave my home for the next two and a half months - literally. Nothing stopped it and I went thru all the pharmacy had to offer. Then after hours and hours on the net investigating I came across an article about nitrous oxide, and started taking it twice a day - problem resolved - I am not 100 % cured but at least 80% better -THANK THE GOOD LORD !
All this time my sugars were with in the normal range but I
was not loosing any more weight - which was weird considering the
runs. Since I do not have any kind of insurance the test strips are quite
expensive for me and since my results were
always good - maximum 113 fasting
and max 147 post prandial - I stopped testing for three weeks. ( was not
at
home for this time and did not take the meter with me )
When I came back I started testing again and I was ok - 109
fasting. Then two days later I had a fasting of 139 - which scared
me. I was eating the same - almost no simple carbs, lots of complex carbs
and not a lot of meat. I had gained 2lbs. on the trip but lost them in the
first week home. My sugars have been about 40 points higher than
expected and I
was getting really concerned.
I have an older meter, the first that was donated to the cause, a glucometer 4 by bayer which I took out of hiding and when I tested with it the first time it gave me 106 vs 145 on the one touch basic I had been using. On a fasting 106 Vs 145 is a BIG difference. One is fine and the other is very worrisome.
Here are the test results I have gotten over the past
few days: fasting - OT 145
- Bay 10660 min post OT 170
- Bay 161120
min post OT 143 - Bay 128 120
min
post OT 149 - Bay 122
fasting
OT 138 - Bay 109
What is frustrating as all get out is the fact that there is
nothing uniform about the readings - they go from a difference of 39 to 9
points. I changed from the Bayer meter to the One Touch because of the
cost of the strips - the Bayer ones are 2 x the cost of the One touch. When
I started with all this I took both meters to the lab with me when I had
lab work done and with the same blood sample got readings with 20 point
differences - the bayer being closer to the lab results. The lab is not
100% reliable either - on the same blood sample I have had 20 points
differences between labs. I am trying, with much effort, to have a tight
control. I feel so frustrated that I cannot really know where I am - - 106
is good - 145 is to high. Up till now I have controlled with diet
and ( I have to admit ) very little exercise - the DR. wants to give me
medication but I
would rather try and keep a tight control the way I
am. ( I am already spending to much money on medication ! ) My
Dr.
seems uninterested in my problem - he says I am doing great but I get the
feeling that he has no experience in
people who want to have tight
control.
I show him my numbers but he hardly looks at them. He is
intrigued with the fact that I stopped losing weight when the runs
started. I have hypothyroidism and asthma also and I know that has
something to do with all of this too but he shrugs it off. I have learned more
from the net than anything he has told me - I take articles to him but
since they are in English he
doesn't look at them either. ( I live in a
tiny town in the middle of Mexico ) Am feeling very frustrated and gloomy
- any
light you could shine on this would be greatly
appreciated
==========================
Sharon Truax's answer......
Hi Sheila,
The first reason that your blood sugars went
back up is because you went off the metformin. I understand why you did
it, but that is the reason your blood sugars are starting to go back up.
Metformin works on the morning blood sugars by stopping your liver from putting
out excess sugar during the night.
I am not familiar with the Glucometer meter you are speaking
of. It must really be old. I assume that the test strips have not
expired. I would go by the One Touch readings as I think it is the newer
of the two. The other factor is if the glucometer model is using plasma or
whole blood readings. You might find this link helpful:
http://www.mendosa.com/meters.htm
As
far as the weight goes, you did not say if the weight you lost brought you to
your target range. Do you need to lose a lot of weight? Exercise will
definitely help. It makes your cells very sensitive to insulin.
Weight loss plateaus often last a long time, and then you start losing weight
again. Your body is just trying to adjust. Most doctors don't know as much
about diabetes as they should. So that is why they show little or no
interest in your glucose readings. Next time he shrugs
off your record
book tell him "Look, I have been sticking my fingers, which really hurts, so I
can control this disease better. The least you can do is spend some time
looking at my results." This will probably get his attention.
Wish
I could be of more help. I really think the problem is the lack of
metformin. There are many other excellent diabetes medications you can
try. Or, start exercising and see what happens.
Hope this helps,
Sharon Truax, RN,CDE,OCN
http://www.mydiabetesed.com/
When I first requested questions I received this question from a subscriber and I was out of town and tried to forward it to my mail e-mail it disappeared into cyber space. I remember the question, just not the person that sent it.
Question #1
He question was regarding the numbness and tingling in the legs and feet.
Sharon's Truax's Answer:
This is in response to a question about numbness and tingling in
the
lower extremeties (legs and feet).
This is called peripheral neuropathy. It is a type of nerve damage caused by uncontrolled blood sugars.
I truly sympathize with anyone who has it. It is extremely
painful. Now for the good news. In this
particular case, pain is
a good thing. As long as you still have pain, we know that the nerves are
still working.
So the neuropathy can usually be reversed and the symptoms
alleviated with good glucose control Now for the
bad news (and there
always is), when good glucose control is maintained, the pain often gets worse
before it gets
better.
But, remember, it does get better, and is often gone for good.
There are also medications that will help with the pain.
You can
always use tylenol or ibuprofen. These medications often help in the
beginning, but don't do much when the neuropathy gets worse.
The other oral medications are by prescription only. They would include medications like Elavil, Tegretol, and Neurontin, to name a few. Most of the medications used to treat peripheral neuropathy are mainly used for other things such as depression and seizures.
They found that people with diabetes that were on these medications had relief from their pain. So physicians started using them for pain control.
Lastly, you can use an over the counter cream called Zostrix or capsaicin. This cream needs to be applied to the affected area every day. It often takes 6 weeks before relief is felt. But I have had many patients tell me that it does work.
One word of caution...when applying it, be sure to wear
gloves. Capsaicin is made from chili peppers. If you were
to
apply the cream and then touch your eye or some other sensitive part of
your body, it would burn terribly.
Hope this answered your question.
Take care,
Sharon Truax,
RN,CDE,OCN
http://www.mydiabetesed.com/
Question #2
Subject: How does alcohol abuse affect diabetes?
I
have a friend who was just recently diagnosed with
diabetes in the last five
months. I think the oral
medicine that he takes twice a day is gloucocheck.
I
didn't spell this medicine right, but it is a new
medicine that combines
two of the most popular oral
medicines used for diabetes!! My question is
regarding
alcohol. I think my friend is an alcholic as he drinks
between 4
to 6 or more beers every day. How will this
affect his diabetes? His doctor
told him to limit
himself to two beers a day, but he does not do
it!!
Also, he does not do his blood sugar tests either. I
think this
amount of beer consumption will affect my
friend's diabetes adverserly. Am I
right?? I have
tried to talk to him about changing his
self-destructive
behavior, but he refuses. What
complications is he likely to experience if
he
continues drinking this much beer every day?? His
blood sugar was over
200 when he was diagnosed and he
had lost 27 lbs and had extreme thirst. He
is 47 years
old, and claims not to have diabetes in his family. He
weighed
225 and then went down to 198, and now is back
to at least 205 lbs and is 5'
10" tall (medium frame).
He doesn't really do any exercise, but does
walk and
climb at work. He's an airplane mechanic. Therefore,
he doesn't
really get much aerobic exercise!! Thanks
for your help.
Sincerely,
SG
==========>>>>>>>>>><<<<<<<<<<==========
Sharon Truax's answer
Dear Sharon, (all these Sharon's are confusing - this Sharon is
the one answering the question)
Before I get started, I need to commend
you for being such a good
friend. I hope your friend appreciates
you.
Now on to the answers. The medicine your friend is taking is
called
Glucovance. You are correct; it is a combination of Glyburide
and
Glucophage, two very popular diabetes medications. These
medications
and alcohol do not mix. In order to understand why, you
need to know
what diabetes is and how these medications work.
A couple
of things are happening when you have type 2 diabetes; you are
either
not making enough insulin (a hormone that moves the sugar that is
in your
blood stream into your cells) or your cells don't like the
insulin that you
make (this is called "insulin resistance"). Insulin
works like a key to
unlock your cells. When this lock and key mechanism
works properly, the
food that you eat (which after it is digested is
broken down into sugar)
moves out of your bloodstream and into your
cells. When the lock and
key mechanism doesn't work properly the sugar
stays in your blood stream and
your cells start to starve. This is
diabetes.
Glyburide works by
"pushing" your pancreas (where insulin is made) to
produce more insulin. So,
when Glyburide is doing it's job, a person's
blood sugar should go
down. That's a good thing.
When you have type 2 diabetes, your
liver often "puts out" to much sugar
into your blood stream. It does
this for a reason. As I stated above,
often when you have type 2
diabetes, your cells are very resistant to
the insulin that you make.
So your body compensates by making twice as
much insulin, hoping that some of
it will work. Your liver notices that
you have twice the amount of insulin in
your blood stream and thinks
that your blood sugar level is going to go too
low (remember, insulin
moves sugar out of your blood stream and into your
cells.). So it start
producing sugar and sending it out into the blood
stream, and your
blood sugar ends up going even higher.
Glucophage stops your liver from
producing and sending out sugar.
Are
you still with me? Now on to the alcohol problem. As you
probably
know, your liver removes alcohol from your system. This is the
root of
the problem. His liver will be so busy removing the alcohol, that
it
will forget to keep his blood sugar normal. So his blood sugar will
go
too low. This is called hypoglycemia and is a very dangerous
condition.
If your friend is drinking, he probably won't notice his blood
sugar
dropping, and this can lead to unconsciousness, seizures, and
even
death. If your friend read the insert on his medication, he
already
knows this. It states that "no drinking is allowed." He
is playing
"Russian roulette" with his life. If he is an alcoholic (and
I agree
that he probably is) it will be very difficult to convince him of
this,
even if he reads it for himself. Most people don't think drinking
beer
on a daily basis is considered alcoholism. You and I both know it
is.
So, what to do? Give him this information and encourage him to
quit
drinking (you are already doing that). Of course, you can also
give him
this little bit of information too. If he is driving, has a
low blood
sugar reaction and has an accident, he can lose his driver's
license.
Even if he hasn't been drinking. This is a reason to start
testing his
blood sugar. You can also try this one...drinking alcohol
can lead to
impotence. Diabetes can also lead to impotence. Put
them together and
he will surely be impotent. Or this one...alcohol is
very high in
calories. This is the reason for the "beer gut".
If
he insists on drinking, please make sure he does not drink alone.
Someone
else might notice that his blood sugar is going to low (the
symptoms of low
blood sugar are confusion, cold clammy skin, weakness,
headache,
irritability, shaking or trembling, a fast heartbeat,
etc.--and yes I know,
it sounds like he is drunk) and can at least get
him something to
eat. Also, he should eat if he is going to drink.
Yes, it will increase
the amount of calories he is taking in, but it
will also keep his blood sugar
normal.
As far as the exercise goes, he knows what he should be
doing. Getting
him to do it is another thing. When you find the
magic words that can
motivate him, please let me know. We could both
make millions.
Once again, I admire your concern. We should all be
blessed with
friends like you. Last, but by all means not least, I will
say a prayer
that your friend realizes how very precious life is, and gets
his head
"screwed on straight".
Take care,
Sharon Truax,
RN,CDE,OCN
http://www.mydiabetesed.com/
==========>>>>>>>>>><<<<<<<<<<<===========
This is the Sharon that ask the question (this is her remarks to the Sharon that answered the question)
Dear Sharon: Thanks so much for the information!!
I
understand all the information that you sent!! You
really wrote it in a
very understandable format!! My
friend is very resistant to any advise
concerning his
diabetes and alcoholism. In fact, he is still in
denial
about his diabetes and alcoholism. I can't make
him believe anything about
either of those topics. I'm
not even sure that he is taking his
medication
regularly. As a result of my concern, he doesn't want
anything
to do with me. I'm sad for him, but I guess I
will know that I have tried my
best to help him. I do
love him, but must go on with my life without him,
as
I will continue to suffer more heart ache seeing him
continue to
destroy his health and possibly his life
as you indicated. Thanks again for
your help!! It has
meant so much to me!! My father was an
alcoholic
also,(although he did not have diabetes), so I am well
aware of
the problems concerning alcholism. In a way,
I guess I have been in denial,
since I met my friend
five months ago. I did not want to admit that he
was
an alcoholic and risking his health and life, either.
I just wanted to
go on with him, blinded by love.
Again thanks for your help in helping to
realize that
this relationship is not healthy for me. I do not
drink at
all, and I am a very health conscious person.
I have been a social worker for
31 years and I've seen
what alcoholism can do to individuals and
their
families. Yet when I believed that I was in love with
someone, I
chose to ignore the signs alcholism!!
Thanks for helping to wake me up, and
not a minute too
soon!! I can't thank you enough for your help
in
answering my question!!!
Sincerely,
S G
That's all the questions for now - We will update them as they come in. Let us know if this helps you in any way.
Sharon Lambkin
Publisher
e4u
Newsletter
http://starterkithaven.com