It's been a busy old time recently, and updates on the blog have taken rather a back seat. Sorry about that!
I realised this week (on Monday in fact) that I had not yet even managed to post an update following my Half Marathon shenanigans in Bath exactly two months ago today. Shocking!
Part of the reason for this post is to say an ENORMOUS thank you to everyone who donated so very generously in support of my race charity Diabetes UK, in fact your generosity was so apparent that I was also able to donate to Medical Detection Dogs (the tiny charity that is able to specially train clever pooches to sniff out hypos and hypers). In total you raised the mighty sum of £685.50, you should feel very proud of yourselves, you rock!
Ready for the off at the Bath Half 2013I had a great time on the day itself. It was bitterly cold at the start where everyone stood shivering for about an hour, but the mood was very cheery nevertheless. It was my first distance race of any kind, and I think I had naively underestimated the experience of running among something like 11,000 other people. It took much longer than I'd thought to find space enough to run at my 'own' pace. I was able to finish the 21km (13ish miles) in 1hr 46 mins, which is just about as fast as I ever thought I'd be able to do it.
I think the D fairy must have been having a day off that day, as my levels were bewilderingly good. The race started at 11am, but even so I reduced my breakfast dose to 90% of normal. Thanks to Artoo I was able to set a TBR which took my basal down to 10% an hour before the start and throughout the run. My levels on the day looked a little like this:
3.00am - 7.3 8.00am - 7.5 Breakfast 9.30am - 7.9 waiting to start 1.00pm - 7.0 Finish! I downed a 60g CHO bottle of lucozade on the way round 2.51pm - 6.8 Lunch
To say I was pleased with those is a bit of an understatement! I wondered at the time if perhaps I should run a half marathon every day?
As is the way of things, it has taken me a fair old while to get the last few donations collected, but the cheques are now on their way to the respective charities. Immediately after the race I'd found myself reflecting on the unexpected enjoyment I'd found in the training, but thought I wouldn't hurry to take part in another event. Then a *very* odd thing happened. Last Sunday was the London Marathon, and I actually found myself thinking, "Well... I wonder if I could...". Encouraged by Dave and his tangerine enthusiasm I have unexpectedly put my name forward for the 2014 ballot. The chances of making it into the event are pretty slim - but it would be an interesting challenge!
The rest of March and April have been a bit of a mixed-bag levels wise. March, and Easter in particular involved quite a few family get togethers and celebration meals which are always fraught with guesswork and wild stab-in-the-dark boluses with all the (lack of) success you might expect. April looked to be a little more settled in patches, but by the end of it a few chaotic days had worn me down, wrecked my averages and SD and I ended the month feeling quite grumpy about the whole unrelentingly inconsistent business.
Part of me thinks I am pushing myself too hard and need to learn to be happier with the successes I am seeing rather than contantly reaching for those elusive 'perfect' days. Many people who have lived with Type 1 Diabetes for any length of time will be familiar with that feeling I think.
I've decided it's time to run a few basal tests during the day just to make sure there is nothing obviously wonky on that score. A tiny dip below 4.0 after the gym has put paid to that for today. Ah well.
Many of you might know that, currently, I work as a cashier for a local restaurant. It can sometimes be a fast paced job, with unique 'diabetes adventures,' as well as unique opportunities to meet people. Sometimes, it's just an opportunity to see people react weirdly to their environments.
Our restaurant isn't exactly a health venue. It's a local fast food type joint, which has at least, some merits: it's privately owned, it makes all of it's food fresh-from-scratch, and since it's family owned, the people are wonderful to work with. For the most part. Every job has it's ups and downs.
I admit I've never been what you would call -- a people person. But I can be a congenial person, and I do love watching people; studying them in their environments, when they think I'm not watching them. Especially as a cashier. Cashiers are like wallpaper to a customer.
One thing which has come as a sort of surprise to me is that most of the people who eat at our restaurant are pretty thin. They'll order the largest thing in the whole joint, deep fat fried, and a trash-can sized cup of soda. Some come and eat this EVERY DAY. Always looking the same weight. Lucky bastards. Then there's the heavy women. They're always ordering salads. A salad, and a cup for water... or a salad, and a diet Coke. And they always look heavy. They never seem to lose weight.
Of course, I don't live with these people -- I don't know what they do or eat when they're not at our restaurant. Who knows if the thin people go running every day, or if the heavier people go eat their entire refrigerators, later. I don't know. But it's a very interesting thing to watch. It makes me feel curious about all the accusations people always have for the obese, like they live, and breathe, fast food... and the level of self awareness some of them must have when they dine out.
And speaking of self awareness... a very curious thing happened to me last Monday. This slender, tall, vivacious looking woman approaches the register, and I happily greet her. She makes eye contact with me, and suddenly, starts freaking out: "Please don't judge me for what I'm about to order because I'm wearing a red dress pin, and I'm about to order really unhealthy food." Quite frankly, I hadn't even noticed the red pin. I was simply more intent on getting her order, and getting it right. I tried to reassure her "Oh, don't worry, it's okay." She looks at me, half smiles, and places her order: two fried items, with a side of fried tater tots, and soda. Then she says "You know, we're allowed to have a treat once in a while." Again, I offer the supportive reply, "Of course. I completely understand." Then she looks flustered, and says "You know what, I'm just going to take it off," as if it were an electronic ankle bracelet, from her local parole officer.
So many responses ran through my mind... like "Lady, I don't give two shits about your damn red dress pin." Obviously, I couldn't have used that one. I smiled warmly, and just offered a light-hearted "Oh, don't you worry yourself about it!," and with a side wink, an "I won't tell."
I also thought... Should I have told her "Hey, I have diabetes. I understand?" I didn't do so... I try not to tell people too much about my private life -- mostly, because I can tell people like that wallpaper feeling when they get their food. (I admit, I don't care too much for knowing people's personal stories when they're just selling me something.) I also thought to myself, "What if she judges me the way she thought I was judging her?" She might think to herself "Of course she has diabetes... look at where she works!" or "look at how heavy she is!" or some other lame conclusion -- as people often love to believe about us people with type 2 diabetes.
But I have to admit, I was quite surprised at her. She felt guilty, from the pin, and it made her aware of her behavior. It was giving her an accountability -- which was only in her mind, really -- but which was a reminder to herself of how she wasn't taking care of herself.
That this woman was embarrassed because of a disease she didn't even have, and of choices she knew were poor, was quite the irony... She may have the option of removing her red dress pin, and ending the stigma, but people who are obese can't easily remove their weight, and put it away, like some sort of suit, and weird fashion statement. We can't easily shut down the stigma, and judgment, others might give us for our condition -- nor can we cure our diabetes with a green salad and a diet Coke. And I sure as heck wish I could 'put my diabetes away,' like some kind of pin, for when I wanted to eat junk... as I'm sure many women with heart disease might wish they could do the same.
And I thought... well, maybe I ought to get a diabetes pin. A pin which always reminds me that I must care for myself. That my health is important... a pin which might make people ask me what it is, perhaps. Blue Fridays is just something meaningless at my workplace, because all my shirts are blue. :-) No one would think to ask, nor could I claim it was 'my choice.' But a blue circle pin, on the other hand... that's a different thing.
A blue circle pin can be awareness, accountability, responsibility, and advocacy. A way to not only remind ourselves of how we matter -- to care for our own bodies -- but to also show others we can do this, and we're not afraid to show it. If I feel bad, on a certain day, I can always take it off.
It's an idea, anyway... Do you feel self conscious in front of strangers when you order junk? Pin, or no pin? Some people always seem to emphasize the diet drink, especially. That's a DIET drink, with the side of fried food. heh We're silly humans, after all.
We're all just so easily embarrassed, I guess.
But perhaps it ought to be a BIG reminder that if we can't handle the imagined stigma of any one disease, even for ONE moment, perhaps we ought to be kind to those who CAN'T easily remove any of their health challenges, like a pin. We need to give others some empathy, some respect, and some space... Especially, when it comes to occasionally letting their hair down, and tasting life.
Dear Beautiful Person (who happens to have diabetes),
Today, you are here. Is there a purpose to your being here? A universal, master purpose? Many claim to have the answer to this, but the honest response is that no one knows. The question is, in fact, irrelevant. You are here. That is a fact. Everything else is just speculation.
It matters not if it's an illusion, a grand plan, a godly design, or a happenchance. You are here.
And while you are here, think upon the magnitude of your existence: The last science knew, the universe was 13.8 billion years old. During much of that time, Earth was a big, hot mess. Life only began to evolve 3.5 billion years ago. Modern man, alone, has only existed for about 200,000 years... and only in the last 30 years or so, have we seen vast improvements in industry, technology, education, science... and medicine.
Medicine.
If you would have been diagnosed with diabetes (of almost any type) back in the 1800s, it was most certainly a death sentence -- if not, a very challenging life.
Insulin wasn't discovered as a treatment for diabetes until the 1920s, thanks to Banting and Best, when many children were literally dying of malnutrition and emaciation. Banting had the heart to insist on not patenting their new-found medicine, so that it could reach as many as needed it.
Metformin was invented in the 1920s as well, and has been used in other countries since the 40s, and 50s. It was not, however, approved in the United States for use with type 2 diabetes until 1994! Yes, that is not a typo. 1994.
Back in the pre-insulin days, starvation was all people knew to do to control diabetes. To eat basically no carbohydrates, or really anything much -- as proteins and fats can also raise glucose (though, admittedly, to a lesser degree). Many simply died because it was so stressful -- or they just couldn't resist pinching food, while no one was watching.
It wasn't until the 1980s when a person with diabetes was able to monitor their levels, independently, and the first glucose monitors appeared. If they had insulin -- that was a good tool -- but if they didn't, all they knew to do was avoid eating sweets. Diabetes has always been with us, at least in the archaeological records, since Egyptian times, and we've known it's a disease about high glucose, but aside from that, there wasn't much monitoring of glucose levels until well into the 80s. Ask anyone who was diagnosed many years ago, and they will tell you stories of urine testing (sometimes, once a month, at a doctor's office), and sharpening and boiling their own needles, for sterility.
In fact... we really didn't know that diabetes was not a disease caused by eating excess sugar and sweets, until at least the early 90s. The other day, I saw a very old VHS tape for an old Vitamix blender I have acquired, and in it, they recommended diabetics substituting honey, in place of sugar. I guess in their minds, anything that was natural sugar, was not really sugar.
And here we are now... 2013. With a variety of different types of insulin, mimicking both basal and bolus outputs from our pancreas, insulin pumps and CGMs to allow us to eat with more freedom and catch hypoglycemic events, the knowledge of counting carbohydrates and the freedom to eat cake, diabetes alert dogs, and glucose meters small, sleek, or indistinguishable from an iPod, small, and painless needles... and on the thresholds of smart insulin, biohub and artificial pancreas options, and noninvasive glucose testing.
. . .
Yes. Diabetes is still hard. But we are blessed to live in 2013, and not 1913. We can see ourselves as the victims of fate, or as the blessed recipients of a grand universal lottery. Think about the kind of life you have the chance to pursue, right now... that you would have never had a chance to pursue back then. Let it sink in -- let it's blessings humble you.
Yes... diabetes can be embarrassing. But all disease is humbling.
Even if you never had diabetes, life is much of an embarrassing process, as well... At birth, and near death... someone has to wipe our behinds. We get old, and lose our good looks... we may get cancer, and lose our breasts, we may get alopecia, and lose our hair... We may be like Farrah Fawcett, and get colon cancer -- colon cancer.
Illness is humbling -- for we have to accept that we are frail, that we get sick, that we get old, and yes, sometimes... that we haven't always done the best to take care of ourselves. But, can you think of anyone who has been perfect -- all of their lives? Always perfect? I know one or two who claim they were -- and you know what -- I honestly don't like them very much. For one, they are liars. They may have read the manual on living, but they haven't actually lived very much. No one learns to ride a bike from reading a book -- and thus it is with living. Some of us just have to fall a few more times, than others... and it is our beautiful, gnarly scars, which make us who we are.
I never thought of Farrah Fawcett as much of a hero -- until her war with colon cancer. And I never thought much at all, about Ryan O'Neal, until his passionate devotion to the woman he sought to wed on her deathbed.
Don't be angry at your loved ones, beautiful person (who happens to have diabetes). It is not a matter of blame. It is not a matter of fault. Don't leave this world, and lose hope... for these massive amount of events I have listed had to have gone through... and for you to be here, in this point in time. Your loved one, well... your loved one simply LOVES you. They are in deep fear because they do not want to be without you -- at least -- not sooner than life will will. Can we blame them?
I was angry once... at my father for (in my own warped perception) not trying harder, at life and circumstance, and God, and you name it. I was once that angry loved one... living in FEAR. Sheer fear. But, you see... for whatever reason, you are here -- in this very moment in time, and a time when you happened to meet your loved one. This is a very precious moment in time... In fact, to quote Lawrence Krauss -- a renowned Theoretical Physicist:
“Every atom in your body came from a star that exploded. And, the atoms in your left hand probably came from a different star than your right hand. It really is the most poetic thing I know about physics: You are all stardust. You couldn’t be here if stars hadn’t exploded, because the elements - the carbon, nitrogen, oxygen, iron, all the things that matter for evolution and for life - weren’t created at the beginning of time. They were created in the nuclear furnaces of stars, and the only way for them to get into your body is if those stars were kind enough to explode . . . The stars died so that you could be here today.”
Is diabetes embarrassing? Well, sometimes... But I am in fact honored to be so privileged to be alive, today... right now... Experiencing this universe, the love of friends, and family... The patter of rain on my window pains, the loving purr of my cat, and the imperfect love and friendship of that idiot that still lives here which I call my husband.
Yes, I am honored... to be living here, and living with diabetes.
One of the wonderful things of having a blog is that, often, people ask you deep questions; deep questions which you may be working towards resolving, yourself... (unbeknownst to the reader) thus, giving one ample opportunities to think "out loud," if one could, on the internet.
I'd like to address one of those questions...
It's a particularly common one. Many people ask me this question, and it's truly one which is bound to come up in a person with diabetes' life sooner or later: "How do I get out of a funk??? Can you point me in a direction to get my eating back on track?"
I think it's safe to say, this question has no easy, or simple answer.
Whenever we get into a funk, we are in many ways, tired of the burden we have to bear. We have to come to grips with that, and acknowledge it, before we can even begin to understand how to fix it. We have to recognize that we are tired... In particular, with type 2 diabetes, we are tired of having to guard against an invisible monster -- who much like the boogeyman under the bed, or inside the closet -- seems as a figment of our own imaginations. That's the big problem with pre-diabetes and type 2 diabetes -- particularly, at the stages where we have no complications, or can manage with just diet and exercise, or even with some oral medications. How does one keep being a lookout for something that never seems to show up? How can one take it seriously? Why does one need to keep taking pills for something that doesn't seem to show up? It seems a bit hard to believe that the minute we stop being a lookout, something will show up. And then... outsiders don't help. They can't see anything serious, either, so many egg us on to just 'enjoy life,' or to quit being 'melodramatic.' "Come on, it's not like you have cancer."
This particular dynamic makes it hard to commit to making serious changes in one's health, particularly when one has had a lifetime of other choices etched into our internal scripts.
We have to recognize that this is real...
Sometimes, we forget that the point of the exercise is NOT the waiting for something to show up -- but to intimidate the something into NOT showing up. It seems as a futile exercise with no rewards. But... if I shine a light in the closet, well, the monsters never materialize. The child never asks "But what's the point of this flashlight? I never see monsters in the closet, so why should I need it?" No. The child merely reasons "the flashlight scares the monsters away, and keeps them from coming." The things we do... the exercise, the diet, the medications. They all come together, in one big, powerful flashlight.
We can change part of our mindset by simply changing how we ask the question.
Now, how sensible would it be... if a person with HIV decided that all their treatments were pointless, because AIDS was not a real threat (somehow)? And we all understand how nonsensical it is for a person with a deep mental health concern, to forgo medications, because they now feel well... But it is, in essence, the same dynamic. We are all fighting to keep something larger, at bay, which is as real as full blown AIDS, or as real as cancer. In fact, it is so real, that diabetes kills more people than AIDS and breast cancer, COMBINED.
Yet, people like to speak of it as if it were a mere inconvenience -- like some kind of bunion on your foot, that bugs you when you walk... when it's more of a darker, more sinister situation. I'll save you the metaphor... I'm sure you don't need it, right now. But I'm sure we've all been there, and thought deeply about the darker sides of diabetes.
We have to recognize that diabetes is scary...
Especially when people are always gracing us with stories of their Aunt Jenny, who lost her foot, or their Uncle Bob, who had to go on dialysis. Diabetes can instill a serious dose of fear into those who live with it, and who struggle holding up that flashlight into the closet -- often making us feel we're doomed into an uncertain future. We get tired, we don't want to face reality, and we get scared into inaction. And it's probably because diabetes is more like an endless night, and the flashlight eventually needs new batteries.
So we fumble.
We fumble, and we won't eat 'right,' or we won't take the god-awful medications, or we 'fudge' the insulin. We want to pretend normalcy, again. We want to believe we live in a world where we are not the ones with diabetes. Or, perhaps, where we sinned and then got diabetes. But... why shouldn't we be the ones with diabetes? Do you know of anyone else more worthy of having diabetes than you, or I? More deserving, somehow? Who had it coming? What makes someone worthy, or not, of having diabetes? Or of having any disease? The answer is nothing. Both birth, and death... happen to all of us. The number one risk factor for getting ill... is living. And if you enjoyed your living, thus far, make peace with it. Don't somehow, 'forgive yourself',' as if you've erred. You haven't. No. Make peace with it. You lived, you loved... and that's what we ALL do. In our own way. Now it's time to live differently. To enjoy differently.
Diabetes is not a judgment on your previous life; it is merely, a different life. In many ways, coming to terms with accepting diabetes, is coming to terms with our own mortality, for managing one, is preserving the other.
And we have to strive to preserve life, to enjoy life. To take life one step at a time.
We have to recognize that it takes baby steps...
It takes baby steps to accept our life, our mortality, and the things we need to embrace to preserve that life. Managing diabetes is an exercise in self-love. And self love is something that takes a great deal of patience, and self-awareness.
There are a few things one can do, such as:
Start small: Seek to make one small change a day, and focus on it for an extended period of time. Perhaps that change can be as small as taking your medications as prescribed, until it becomes an innate habit. Or, perhaps that change can be going out for a small walk around the block, every morning... Maybe even just having ONE meal a day in which you have a non-starchy vegetable. You get the idea...
Work on other projects: Often, when I feel my health life is a mess, I simply go and deep clean the living room, or the bedroom, or the bathroom... or I organize the kitchen. It seems silly, but it often helps give me motivation to take on almost anything -- and put it back in order. Plus, it helps give me some immediate victories to focus on, and not look for the constant 'far away' victory of 'not worsening my diabetes.' In essence, I shift the focus to something else, more immediate. And it's silly, but it helps me feel a bit whole. It's a great big victory when one has cleaned out an entire closet full of junk! So... shift the focus.
Give yourself time off: Diabetes is like a job. Diabetes IS a job. It's a 24/7 job in which you get no time off, and constant worry. You're meant to always watch your health, mind what you eat, and test, test, test... always worried the boogeyman is coming through the door. We tend to get very strict with ourselves -- jump on all manner of fad diets, cleanses, and various things -- because we want to fix the problem NOW. (It's a leftover problem from how we deal with weight, and obesity, and they don't work, and they are wrong.) Look... even skinny people let their hair down once in a while. Schedule one day a week, where you let yourself have some kind of fun, with yourself -- or friends and family -- and look forward to it. You can have a slice or two of pizza... if you like. The world will NOT end, and your foot will NOT fall off.
Do not judge yourself: "I can't believe that wimp's been running that marathon for 10 miles, and he's already tired! Let's berate him until he makes it to the finish line!" -- said no one, ever. Diabetes is a marathon. You're going to get tired, emotional, upset... and sometimes make bad decisions. IT'S OKAY. Tomorrow is another day. Recognize and accept those feelings. DO NOT ABANDON YOURSELF. Simply acknowledge yourself... and see what you learn! Tomorrow is ALWAYS the beginning of a brand new year, not January 1st.
Don't hide: Find a support system. I know... family, and friends, often don't get what we go through. But if you're reading this blog, you're probably already a bit familiar with the diabetic online community. In it, you can find lots of people who like you, and I, are going through this struggle. You can vent to us! We know, and we can relate. There are a lot of places where you can read through people's sincere journeys of struggle, and hope -- or where you can read others' questions, and learn from the responses they get -- even if you want to remain anonymous.
Ponder the benefits: Do you like feeling good? Do you like having energy? Do you like feeling confident that you can set, and complete goals? Do you like not getting sick as often? Do you want to have health and energy for your family? I know I take these for granted more than I would like, and when I do... it's easy for me to get into a funk.
Seek appropriate medical advise: Find a medical team that is willing to work with you, and to educate you. If need be, find a therapist who has experience with patients facing chronic health conditions. Diabetes is very much a psycho-social health condition, as well as a physical ailment. It's very hard to make progress when you work with people who seek to blame you, or leave you off on your own, with few tools to work with. This also goes for managing any side complications you may have, which may add to the burden of diabetes, such as hypothyroidism, depression or carpal tunnel worries. With carpal tunnel, for example, a good doctor can set you up with overnight braces, to keep pain at bay, as well as with a steady Vitamin B6 therapy to help reduce inflammation. Proper hypothyroid medication can also help reduce depression issues. And -- it's important to mention -- that reducing blood glucose levels helps improve ALL of these conditions to some degree, or another.
Seek to learn about 'the funk': There are quite a few resources, available, from persons going through 'the funk,' which can help you be better prepared the next time you feel you might stumble. The goal isn't so much 'averting' a stumble -- but learning from it, and getting back up!
From vlogs, to blog posts... We like to call 'the funk' diabetes burnout.
As a person living through her third year of a type 2 diabetes diagnosis, I am far from being an expert in these topics. I struggle along like a blind man, in a dark room, trying to find a black cat. I have to constantly remind myself that, though I may know how to play the game, I need to actually play the game. I hope that, even with all the things I have said here, just the thought of knowing someone else out there is going through a similar battle... is enough of a wind beneath your wings.
It's certainly given me an excuse to ponder some of these things... a bit more than I would like. :)
I don't think this caused quite such a stir over here as it did with people living with type 1 diabetes in the states, but if you'd like to know a bit more about the spongey thing that might make insulin on demand in realtime and the hoo hah it caused you should probably read this post:
Nature often plays a delicate balance, like these two bugs holding on against the wind, behind these delicate, white blooms. It's a rainy, cold, and wet day, in Iowa. Fall is just around the corner. (September 11, 2008)
One of the biggest challenges, when helping newly diagnosed persons with diabetes, is finding balance in the information provided. Helping create a positive environment, which encourages a person to learn the scope of the disease and its complications, but still keeping their heads above water. No matter the diabetes community -- this is a struggle that I have found almost everywhere. Even in my own diabetes groups.
Whenever I share any information, my hope is for you, the patient, to be able to make your OWN decisions -- and not make MY decisions as yours. I have this crazy idea that, when empowered with basic information, people will tailor their diabetes regimes to their own circumstances, and find balance. That I don't need to tell anyone what to do, and that since this is diabetes we're talking about, what has worked for me... will definitely, and not necessarily, work for you.
The problem is that diabetes is a dick. Diabetes doesn't play fair, and it doesn't give two shits about our feelings. It doesn't. It doesn't care that the news of the things it can do, can scare us, nor does it politely pass us over when we decide to close our eyes against it. So... sometimes, this harsh bit of reality might lead people to behave in one of two ways: either by becoming inflexible with their ideas of control, or by becoming completely lax in their control. Neither of these two ideas is good, even if one of them has much, much better numbers.
Inflexible Control
There's nothing wrong with having tight control. In fact, international diabetic guidelines call for patients with diabetes to aim for postprandial (after meal) numbers which are less than 140 mg/dL at 2 hours. For some time, I belonged to some communities with large numbers of internationals (people in any number of countries, outside the United States) -- and they consistently made their goals to be 140 or less, and never once did I ever see anyone complain about that, or try justify a much higher goal, or A1C, without some serious reasoning behind it. Sure, no one's perfect... but it IS the number they shoot for, so, it is the NORM for the world to shoot for those numbers This is, also, a number which even the American Association of Clinical Endocrinologists endorses. The American Diabetes Association is pretty much alone in their call for persons with diabetes to keep postprandial numbers at less than 180 mg/dL (but even they have this caveat under their goal guidelines: "More or less stringent glycemic goals may be appropriate for each individual.")
The problem is... some people use that truth to assume that everyone must tackle their diabetes in the same way. In fact, some persons are so disturbed by the potential damage of diabetes, that they push for normal, non diabetic numbers, near <90 mg/dL fasting, and <120 mg/dL postprandial. If one can pull that off, that's great. I do it all the time, and I shoot for it... But it's really not something that is ideal for everyone, nor should we expect everyone to easily overcome what we can. We are not all the same. And in fact, the likelihood for complications is also, very strongly determined by genetics. One can have great control, AND STILL GET COMPLICATIONS! So, if someone worked super hard to attain control (out of sheer fear), and they still got complications... what kind of setup for disappointment are we creating? Nothing is truly a guarantee. We do the best we can, and it doesn't really help to overfocus on the axe in the ceiling.
So here, you get people who may be well intentioned, and caring, and wanting to help others achieve control, pushing things like raw dieting, alkaline dieting, paleo dieting, and Atkins or Bernstein dieting, etc. This is not a basic truth a person with diabetes needs to learn. One's chosen diet plan is NOT a basic truth a person with diabetes needs to learn.
Persons with diabetes need to learn:
What diabetes is -- a condition in which the body can't use glucose adequately, because the pancreas has either stopped producing enough insulin (which can be fatal), or has lost sensitivity to it (or sometimes both);
What glucose is -- a type of sugar in which our bodies convert food, to use as fuel for energy. It is NOT the same as table sugar, nor is it exclusively derived from sweets. The body converts ALL foods we eat, from one degree to another, into glucose. 90-100% of carbohydrates, 50% of proteins, and around 10% of fats get converted into glucose. Table sugar and sweets are just another carbohydrate;
What a glucose meter is -- a tool which allows us to measure our blood glucose, and how it is affected by the foods we eat (mostly the carbohydrates we eat), exercise, illness, medication, stress, temperature changes, hormonal changes, etc;
What carbohydrate counting is -- a total, daily, number of carbohydrates we allow ourselves in our diets, in order to control blood glucose levels. We can adjust it in our meals (cut back on it, or add more) based on our glucose meter readings, and divide them up through the day, between three meals, and snacks. We are the most insulin resistant in the mornings, and the most receptive in the afternoons;
What insulin is -- a hormone, which under normal circumstances, is produced by the body in order to help the body's cells and muscle tissues uptake glucose. Insulin takes up glucose found in our blood streams and uses some for immediate energy use, some for energy reserves (like when we need to wake up in the mornings), and some for storing as fat, etc. Insulin itself does not make one gain weight; overeating, and particularly overeating too many carbohydrates, can make one gain weight, because they a.) put too much glucose in the system, and in persons with type 2 diabetes, b.) may lead to too much insulin in the bloodstream;
What insulin resistance is -- insulin resistance is a condition in which the body's cells are not able to bind with insulin, effectively, which would have allowed the entrance of glucose into cells for energy use. The body then finds itself with excess glucose floating around, so then the pancreas produces more insulin to try to take care of the matter. If the excess glucose is not taken care of, again, the pancreas will keep producing insulin. This creates a condition known as hyperinsulinemia -- or excess insulin in the blood stream, which can lead to weight gain, as a lot of that excess insulin tries to manage the situation best by storing that excess glucose as fat. One of insulin's functions as a hormone is to store glucose as fat, for potential energy stores.
What the treatment alternatives are -- which can run the gamut from diet and exercise, to diet and exercise + oral medications, to diet and exercise + oral medications + insulin, to diet and exercise + insulin... but ALWAYS diet and exercise is a requirement for ALL types of diabetics. No exceptions.
Note -- insulin deficiency doesn't just make one
'lacking in energy,' it can also make one dead. It is a
serious condition, not to be taken lightly.
If a person KNOWS how all of these work, then they can decide what to eat. They don't need an extreme diet, "diabetic cookbook," or really, anything else. One counts carbohydrates, one tests pre and post prandially, and one learns from those measurements. "Oh, no! It looks like that plate of whole wheat pasta was NOT a good choice. Maybe I ought to cut back to 1 cup, and maybe add some broccoli, and some chicken on the side... or maybe I ought not eat any pasta, at all." Learning is what we do here. We are little scientists of our own planet. We colonize our OWN planets when we have information.
There are dangers when we tell other people what to eat, or get them to lower their glucose levels too quickly... it can sometimes lead to ketoacidosis, people often have heart conditions, allergies, particular health conditions, genetic high cholesterol issues, other dietetic restrictions they may need to follow in order to manage OTHER conditions... or they might simply be a growing kid, etc. It's truly not up to us to tell people how to eat -- only to give them the basic information so that they can make an informed choice. Honestly, that's a hell of a lot more than most doctors do, right now, for type 2 diabetics.
We blame type 2 diabetics a lot for not taking care of themselves, but we should be blaming many of those people's doctors, instead. If I blindly trusted my doctor, I'd be in no better position than most folks I know... who think they can just pop a pill, and forget about it.
But... unfortunately, a lot of people live this way. "Pop a pill, or take insulin, and forget about it."
Laxed Control
Some folks take on the attitude that it doesn't matter... That because nothing is guaranteed, then nothing matters, at all, so... "please stop showing me that I can get complications, because then why should I bother taking care of myself?" It can become quite hard to educate whoever might be new to the disease. And educate we MUST. We cannot avoid these parts of the disease education.
Diabetes is hard, but maybe we can become a bit self entitled, or spoiled, sometimes? Some persons have real critical conditions -- with no real hope of avoiding some awful things -- yet they still care for themselves. They do so because LIFE MATTERS; our families, and our loved ones MATTER... WE matter... and it's better to be informed, then to be caught off guard. Life just happens to all of us... and that's no reason to live in fear. In fact, I find it helps me live in peace. It just is what it is. Not to be morbid here, but do we honestly know of anyone who, barring some accidental event, is not going to get sick and die? It's just life.
I've also known persons with diabetes who have literally advised others to not bother taking care of themselves because they have spent all their teenage years being a 'bad diabetic,' and now they have none, or minimal complications, to show for it... so that people should have nothing to worry about. I kid you not. People who have advised others "Oh, I was pregnant and had horribly high A1Cs of like 13% or higher, and all my kids were born healthy, so don't worry about it." That is the height of irresponsibility. One person's GENETIC LUCK is not another person's health regime.
That doesn't stop there... it's the same culture who encourages parents to keep kids at A1Cs of 8% or higher, for no real reason. The reasons are mostly a whine -- assumptions of kids rebelling, some references to kid's biology being different which I have never seen any proof for, and wanting kids to be like everyone else.
Listen, don't get me wrong... everyone has the right to pick their A1C goals as they see fit. It's hard for me to comment on many of these issues because I don't have any kids... I don't really have a place of 'emotional authority' in order to appease most people, so that I can give my two cents. But... from what I know about childhood, and coming into one's own adulthood, learning moderation, and learning the discipline to control things like finances, cleanliness, diet, exercise, and emotions happens in childhood. Chronic illness would also fall under that. Obviously, not all children are the same... and some might have some real challenges at keeping a lowered A1C, but truthfully, those are potentially dangerous levels, with some real potential complications. If it's not a paramount necessity to risk it, why do so? Doctors tend to keep kids at high A1Cs, when the circumstances don't call for it, for the same reason they tend to keep type 2 diabetics from access to insulin, when the circumstances DO call for it -- FEAR OF LIABILITY. Fear that people are not smart enough to manage their own kids, without killing them with lows, or manage themselves, and lead healthy lives. There are plenty of kids with A1Cs at the 6% range, and doing just fine. Also, plenty of type 2 diabetics using insulin, and doing just fine.
To be honest, I don't trust anyone's judgement very much, but my own, with this disease, and my own research. I don't. So I respect when people use their OWN judgement, too. But -- they must have ALL the right information to make those judgement calls. And a doctor really needs to prove more to me, than his diploma, to gain my trust. Doctors are just archaic, more often than not, when it comes to diabetic care and knowledge. It's an embarrassment. Don't take my word for it... ask the average person with type 2 diabetes, on the street, or anywhere, what diabetes is, what drives glucose numbers up, and what carbohydrates are... and they WON'T KNOW. They won't know, and they'll somehow think they don't need to test, because some doctor or nurse will have told them it wasn't necessary. Seriously! "Just take a pill..." The IDF has called for persons with diabetes to TEST post meal numbers, as an imperative, to good control... and yet doctors and nurses are telling patients it doesn't matter.
Sometimes... people get burnt out, and I understand that. We all can get burnt out. But there are folks who just don't want to hear about control, AT ALL, nor for people in groups with a goal for education, to teach about the real consequences of diabetes, and the potential dangers of glucose mismanagement... And we just can't educate well, that way.
This IS a chronic health condition. This CAN kill you. This isn't a toe fungus. I'm sorry that it isn't! I wish I could just treat it with some Lamisil, and have it GO THE FUCK AWAY! But diabetes, not type 1 nor type 2, doesn't have a cure. The ugly little critter is just not going to go away, even if I do keep him well confined, and restricted.
These are things we need to impress upon people, sometimes. No, not oversaturate them constantly with it... but with the realities of living with it. Honestly, I just don't know how to candy coat complications, and death. Especially when I had to live through them, with my own father. I guess I'd rather offend many of you with some talk about complications, and the risk of death, then to have you live through what I had to live through.
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So, when it comes to diabetes sharing, and education... I guess what I'm saying is this: a spoonful of sugar makes the medicine go down, but please, do take your medicine.
Give people balanced information, and give them the basics. People will learn what they need to do, and take a hold of their own lives. Some people will never learn, and we can't berate them -- they are responsible for their OWN lives. But, we can't hammer on again and again, with negative data... like alarmist conspiracy theorists. That's what Doctor Mercola does, and I hate that asshole.
Also, let's not settle for living like an ostrich, with our heads in the sand against the storms of reality. The negative data is there, and we must somehow learn from it, make sense of it, and help ourselves find a meaningful, balanced place, where we embrace our lives with diabetes. If I get a complication, c'est la vie. I'll spray paint my mandatory diabetic shoes in neon, hot pink.
So, today, a new diabetes alarmist article is making it's rounds onYahoo! Shine, earning it a Moldy Cupcake Award. The article makes some tremendously sweeping generalizations, about some supposed research from France, showing that diet soda causes diabetes, and that high consumption of sugar causes diabetes.
#1 Where is the link for this research? I'd like to read it for myself, thank you. I don't need someone else interpreting it for me. As readers, and advocates, we deserve to be able to double check your sources.
#3. "Furthermore, aspartame, one of the main artificial sweeteners used today, causes an increase in glycaemia and consequently a rise in the insulin level in comparison to that produced by sucrose." WHERE ARE YOUR SOURCES? Aspartame DOES NOT raise blood glucose. Honestly, I don't know how you dare report that. That is irresponsible journalism. Aspartame does NOT raise blood glucose. It has no calories, and no nutritional value like sugar -- it does NOT raise blood glucose. Some of us who already have diabetes would be in a lot of trouble if it did. Where's your evidence? You have NONE.
#4. The only thing diet sodas have been LOOSELY shown to do is increase the craving for sweet things, in some people, who then go on to overeat, and then could go on to gain a lot of weight -- which if they have the genetic predisposition for getting diabetes -- could lead them to develop the disease. This is not extensive research, nor is it unequivocal. So no. It is an extreme grasping at straws to say that diet soda causes weight gain, much less diabetes. Don't believe me? Ask WebMD!
#5 Why not report on how overconsumption of soda (diet or otherwise) can cause a person to not give its body enough of the proper hydration it needs? How it might make the body 'swell' from dehydration, if one gets severely dehydrated?Oh, here's an idea, why not instead promote moderation??? You fail to see, Yahoo! Shine, that people who are diagnosed with such a life altering, and deadly disease, as diabetes, need transitional foods, and foods that given them a semblance of normalcy. Why? BECAUSE IT IS DAMN HARD, THAT'S WHY! Don't like soda, don't drink it. But don't LIE about it to get readership.
#6 "Type 2 diabetes—which can be controlled by diet and exercise rather than a daily insulin injection ... " Why can't you people ever, at least, talk to a doctor, advocate, or some expert when it comes to describing diabetes? Do you now how simplistic, and moronic, this statement is??? Type 2 diabetes is NOT the same for every individual, and if they are on insulin, it is often NOT because they don't want to follow a good diet and exercise regimen. For many, many people, diet and exercise, alone, are NOT an option! Diabetes is a progressive condition in which treatments often need to be altered or changed, in order to keep up with a failing pancreas... and that includes insulin!And newsflash, I wish it were just one simple daily insulin injection! Obviously, you don't really know much about how a pancreas works, and the amount of insulin (basal, and bolus) that a body needs. No, no, but that's okay. Don't let your ignorance hit you in the ass on your way to misinforming people.
Cite your sources, or don't write an article at all. PROOF, or it didn't happen.
