[JenAjd]

Originally Posted by Ohiogirl

What's the difference between the A1C reading and the glucose level reading on a glucose meter?

Great question!!! I know I've been told this...but it slips my memory and I'd love to see an answer.

My daily numbers have been great lately. I do alot of pool-walking and have to think this helps. I try to eat moderately as well. I was doing that before my diagnosis last summer but the exercise too is "key" to this disease. I've seen too many people who've had the side-effects of retinopathy, nerve damage, heart issues and more....so gotta keep on keeping on with doing what's right for control.

[springfield]

Your daily tests tell you how your body is using or not using the glucose at the moment of the test. Your cells need this glucose to survive, it is the fuel. If you are diabetic, the "key" doesn't work correctly to let the glucose get into the cells to do its job and builds up in the blood since the cells aren't able to use that fuel.
The a1c test tells you how your body has used glucose over a 3 month period.
Both tests are helpful. The daily tests help you learn how your body responds to different foods and amounts of food. The A1C is the average.

I found out that your body can take glucose from the liver if it detects a lack in order to protect vital organs like your brain. Sometimes my readings are highest in the morning because the body took it from my liver to protect, I hope,my poor little brain. If I have some protein before bed, it seems to help carry me through the night better.

[2BNTV]

Originally Posted by mikeod

2BNTV. You are so correct. In my years of working with diabetics, I had to keep reinforcing that they were not on a diet, but were changing their eating habits PERMANENTLY. Most told me how difficult it was for them initially. But after a while, different for each person, it became almost automatic, and they were much more comfortable with the changes.

One humorous memory I have is the patient who was concerned because his 50th anniversary was upcoming and he knew there would be a cake. He was afraid of eating any cake, but didn't want to not celebrate with his wife. I told him to have a small piece of cake, but watch his other food intake. Diabetes involves choices. If you're going to eat one thing that could elevate your blood glucose, eliminate something else so that your overall intake is not much different from normal. I had a patient that liked to eat potato chips watching football and rebelled at eliminating them. We discussed it with his dietician and came up with the solution to measure out a small bowl of chips (He used to have the whole bag by his chair) and eliminate something else during that day. He did well.

BTW, I am not a dietician, but worked in a multidisciplinary setting for diabetics and met regularly with all the other people involved in diabetic care. My involvement was evaluating retinopathy. In most cases, I could tell how well they were controlling the disease by how much retinopathy I saw. And what I saw in the eye was happening all throughout the body.

Another aspect to diabetes control is that everyone's control is personal. I can't count the patients who complained that their physician was pushing them to improve their control when they had a friend or neighbor whose physician was happy with a higher A1C. They did not realize that there is a balancing act with control and cardiovascular complications.

mikeod:

I remember when I was first diagnosed with diabetes, the nurse practicitoner thought I would not take diabetes seriously as she said that 99% of the patients she saw would not hear of changing their eating habits. Their response would be, "just prescribe me a pill to take', because I am not going on a diet. Not a diet but 'lifestyle change".

It's ok to cheat a little assuming one had their diabetes in control but in moderation. I tend to look at processed foods, candy and anything bad for a diabetic as poison. Since I have been selecting the healthier foods, (four years), the foods high in sugar content don't taste good to me.

I am vigilant in selecting foods that don't have a higher fat content, (30% fat for every 100 calories max = 3 grams). I have the type of diabetes that is affected not only by sugar but the fat content. I generally don't try to eat anything that more than 10 grams of sugar. This also means if I were looking at a label and the contens were 8 grams of sugar per serving, I would also look to see if the contents were more than one serviving.

I will make an effort to look of the list of things I consume that work for me to see if others might benefit from it. I'm not a doctor and everybody is different.

I am concerned about my eyesight going forward as I don't want to get macular degeneration or any other condition.

I agree this is a disease where you can't tell what is going on inside your body so vigilance is mandatory to stay healthy - IMHO. I feel better than when I first diagnosed and I will work hard to fight all the various ways diabetes can affect one's body.

I apologize to everyone is this sounds like a sermon but it is a subject close to my heart. My immediate family has either died or it adversely affected by this insideous disease. my brother just had a heart attack on Dec 30, 2010, and the doctor said that he had a diabetic heart although his blood work never showed he had diabetes. I don't understand how that can be so.

Best Wishes to all to stay healthy and happy.

[Freeda]

I don't agree that diabetes is inevitably 'incurable'; and I wanted to speak up because I think people should be given that hope rather than just hear that there is no hope. It is true that there is no medical 'cure'; but then that is true for most medical conditions; medical approaches control the disease symptoms or in some cases its speed of progression, but they are rarely a 'cure' for the underlying condition; (just as putting sound-proofing material under the hood of a car engine is not a 'cure' for the knock in the engine).

However, the body, namely, the human cell, has an inherent ability to heal itself, given the right tools; and not only of diabetes but of many degenerative diseases; even many infectious diseases. It is only the functions within the cell, itself, that, by normalizing, produce, by definition, a 'cure'; that is, a 'healing', and an end of the abnormalities of function within the cells that lead to symptoms and signs that, collectively, are assigned a name, such as diabetes (or high blood pressure, arthritis, asthma, etc). Not only can cells regain better function, but all cells, as they age and eventually die, are constantly generating new versions of themselves; and a newer cell can, when the body is properly cared for, function better than that which served before it. This is the miraculous nature of how the human body was designed. It is truly, inherently, capable of 'miracles'; but they need our help in order to occur.

An analogy is that a car that requires premium gasoline will not run or sound 'right' when regular gasoline is used; but the problem is not the car - the car itself is not 'broken' (at least, not for a while); when properly fueled with high test, the car once again runs normally. Trying to 'adjust' the engine to make it run 'right' with the incorrect fuel would be a medication-type approach; providing the correct type of gasoline would be a natural 'cure' to make the engine run correctly.

A year and a half ago my husband completely reversed his type 2 diabetes, and all of its related symptoms, with a very low-glycemic diet, supplements, and regular moderate exercise (just taking brisk walks). I know that others have been able to do the same. He never started the insulin or pills that were initially recommended; and it was in the thought of having to take medication on a chronic basis, which he found so repugnant, that he found the motivation to change how he was living; and upon diagnosis his blood sugar had been around 360; nearly at coma stage.

The earlier one starts lifestyle changes upon diagnosis (or upon 'pre-diabetes' diagnosis), I think the better the chances of healing oneself.

[Russ_Boston]

I caution against the word 'cure' here.

Type II can be battled, very successfully, with lifestyle changes. Many times to the point that no medications or insulin are needed. I've seen it done.

But the patient can NEVER let their guard down. Once you are insulin resistant you will always be. You need to constantly monitor your glucose intake and your body's reaction.

But I applaud anyone who tackles this horrible disease head on!

[Mikeod]

With all due respect, your husband did not "cure" his diabetes. He is managing it, and very successfully as well. I applaud the effort. If more type II diabetics would exert the same effort, more (but not all) could reduce or eliminate their need for pharmaceutical assistance in managing the disease. What do you think would happen to your husband's blood sugar if he returned to a "normal" diet that other people tolerate without problem?

Look at it this way. A person leads a normal life with a normal diet. At some point, the body's ability to process/utilize carbohydrates is compromised. Cells that normally perform that function are not functioning adequately. Those cells are replaced over time by the process of mitosis where the original cell splits into two cells, each one inheriting all the characteristics of the original cell. If the original cell is malfunctioning, the two resulting cells will also. The original cell is not replaced by a new cell that is fully functional. If that were the case, there would be no kidney disease, no liver disease, no macular degeneration, etc.

Now, if you are referring to stem cells, that is an entirely different story. That is something introduced to the organism from outside, and not an organism "healing" itself.

Again, I commend your husband, and wish more of the diabetics I saw had his dedication. I would have had to tell fewer people that their eyes were failing because of their diabetes.

[Freeda]

I agree that once someone reverses an illness like diabetes, it is not as though they are 'cured' in the sense that they can resume a diet of french fries, cake, and coke (3 of my husband's former favorites); my husband will always need to eat and live healthfully (but actually, that is how all of us should be eating and living, whether we have a disease condition or not), as he mostly does now; if he does not, he very well would probably become a diabetic again (but so would I, likely, if I continually ate like that); but that does not mean that he has diabetes now; he does not meet the definition, any longer. He has resumed having normal blood testing, and no longer has the sweats, leg cramps, blurred vision, or other signs/symptoms of diabetes.

Also, the insulin receptors, like other tissue, can (since all tissue is made up of cells) return to normal function. It is their oxidation (akin to 'rusting') that is the principle reason for insulin resistance; so over time it is possible to reverse insulin resistance. Dr. Ornish's book, Reversing Heart Disease, years ago conveyed many of these same principles.

The notion that our body, once 'damaged', is like a cracked china dish that can never become normal again is a dangerous one because it discourages people from being motivated to regain their health, as opposed seeing themselves as having, at best, a life of being resigned to 'dealing with' a health problem.

[Freeda]

Originally Posted by mikeod

What do you think would happen to your husband's blood sugar if he returned to a "normal" diet that other people tolerate without problem?

Look at it this way. A person leads a normal life with a normal diet. At some point, the body's ability to process/utilize carbohydrates is compromised. .

I think it depends on what you mean by the 'normal' diet. It you mean, and I think you do, the 'usual' diet of the industrialized, Westernized world, consisting so largely of high-glycemic (which induce food cravings) foods, and unnatural and processed foods, and food-'like' substances, then I would say that that 'usual' diet is the primary reason for the growing epidemic, and future increasing epidemic, of diabetes and pre-diabetes, and overweight conditions in all age groups, which is the greatest health tragedy of all time. In other words, that 'normal' diet is the very REASON why, as you stated ... 'at some point, the body's ability to process/utilized carbohydrates is compromised..' It is no coincidence; our bodies are not 'engineered' to at some point in our lives develop diabetes for no reason. What may be the 'usual' diet, as discussed above, is by no means a 'normal' diet, ie, in the sense of being a diet that is suited to our body's needs.

I don't agree that anyone can 'tolerate' the 'usual / normal' unhealthy diet indefinitely, and cavalierly, without developing, sooner or later, related health problems; it is just a matter of time for most people who eat unhealthfully too much of the time; many will be (and often are, unknowingly) prediabetic for years before developing full blown disease.

I am very interested in longevity, and in talking over the years to many very aged people, 90 or older, who are still healthy, I don't meet any that are grossly overweight, who have diabetes, or who consume alot of unhealthy foods; and, frankly, few of them are from the medical industry (nor from my first career field, law - where the high stress level, and its effect on other lifestyle choices, is a factor weighing against longevity). I hope to be one of those long-lived people some day, so I love to learn from them.

[Mikeod]

I purposely avoided using the phrase "normal American diet" in my response to you for those very reasons. I agree that such a diet generally puts people at risk for various health problems. However, I don't have to look far for examples of people who, for some reasons, probably genetic, have tolerated such a diet without problems. My FIL passed away at 97, his mother and grandmother passed at 97/98. Their diet included plenty of foods we would consider unhealthy. Fried chicken in lard, steaks sauted in butter, french fries, white bread, and few fruits and vegetables or whole grains. No diabetes, no heart disease, no cancers, etc.

When we had a patient who achieved normal blood sugar levels through lifestyle modifications, we consciously told them they were still a diabetic. We did not want to convey the impression they could lessen their efforts and wanted to encourage them to keep follow-up testing at home and in clinic. I think Russ said it best. Consider a diagnosis of diabetes like alcoholism. Even though an alcoholic is sober, it doesn't mean they are no longer an alcoholic. A diabetic is a diabetic because their body can no longer process carbs normally. Even if they are managing the disease to keep their readings at a normal level, they are still, and should always consider themselves, a diabetic. This does not remove hope, but reinforces the need to be continuously vigilant.

[Freeda]

Originally Posted by mikeod

A diabetic is a diabetic because their body can no longer process carbs normally.

We seem to be mostly in agreement; some apparent differences are perhaps more a matter of semantics. And I wish I could have talked to your relatives to learn about how they had lived; as you point out, there are probably exceptions to every 'rule'. I just don't want to have to count on being one of the 'exceptions' when it comes to living a long life; so I'm interested in what the similarities are among long-lived people.

But I don't agree with the statement I quoted above; simply because I think that what leads to diabetes is years and years of asking our body to process carbohydrates to an abnormal extent - and eventually this is what wears out those functions of the body. In other words, the body eventually can no longer perform the abnormal processing of carbs that the modern industrialized diet requires; and that is what causes one to become a diabetic.

I think that a diabetic can still process carbs normally - it's just that processing carbs normally means, to me, consuming healthy carbs, in the first place (as well as healthy proteins and fats). Even a diabetic can process healthy carbs in reasonable amounts, and that is what is 'normal' (though perhaps not 'usual'), and is what our bodies were designed to be able to do. What a diabetic CANNOT do is continue processing abnormal, high-glycemic carbs, which cause sharp spikes in blood sugar.

I think of diabetes as different from alcoholism, since it is my understanding that alcoholism is an innate trait, perhaps genetic, but inborn; I don't think it is acquired through lifestyle choices. I don't know alot about that, but that is my understanding.

Diabetes (type 2), by contrast, is an acquired condition, from lifestyle choices. (I realize that some people disagree and think that it is genetic, and perhaps it is, for some people). I think diabetes is more like a smoking, than like alcoholism. A person who has ceased smoking is not still a smoker -they are an ex-smoker. Just as with time, the lungs eventually reverse the damaging tissue effects of smoking, the same thing happens, over time, with diabetes and insulin resistance, when a person ceases the conduct that causes diabetes.

Just as an ex-smoker will cause themselves new lung damage (just as will someone who is new to smoking) if they start smoking again, a person who was once a diabetic can cause themself, through adopting unhealthy habits again, to develop the condition again, and have the wild blood sugar swings, insulin resistance, and the resulting bodily symptoms and, eventually, other organ damage from diabetes. But an ex-smoker who has stopped long enough for their lung tissue to regenerate to healthy tissue again, and a diabetic who has been of normal blood sugar findings, and free of symptoms, and who has reversed insulin resistance - and, yes, this can be achieved over time -are merely an ex-smoker and an ex-diabetic; and yes, either of them can become a smoker or a diabetic again - just as can someone who has never been a smoker or a diabetic.

I just disagree with the idea that 'once a diabetic, always a diabetic', since, while I can see the point that has been made that this 'label' might 'scare' some people into maintaining better health habits, it might also, for some people, be a source of discouragement of efforts to improve.

There are specific diagnostic criteria for diabetes, and those who do not any longer fit the criteria should not, by definition, be labeled a 'diabetic' any longer. (Not that they have 'immunity' from future recurrences of the condition if they resume old habits).

[Mikeod]

"Diabetes (type 2), by contrast, is an acquired condition, from lifestyle choices."

From my training and 20 years of working with diabetic patients, I have to disagree entirely with that statement.

There is no doubt that lifestyle choices can be a significant risk factor for developing type II diabetes. But it is not the only factor. If your statement is correct, everyone who is obese will become a diabetic. Everyone who leads a sedentary lifestyle along with an "unhealthy" diet will become a diabetic. And that does not happen. My patients came from all walks of life. Athletes, laborers, law enforcement, office workers, retirees, etc. They were of varying stages of fitness, various diets, various ethnic groups. They were a subset of my other patients in every way.

It is not my goal or intent to change the way you think about diabetes. This a popular message board and many people, diabetics and non-diabetics alike, will read what is posted here. Because I have observed diabetics who have excellent control still experience the microvascular effects of the disease, I and the team I worked with found it best to consider our diabetic patients to be diabetics forever.

The best to you and your husband. I wish you well.

[Russ_Boston]

Originally Posted by mikeod

I and the team I worked with found it best to consider our diabetic patients to be diabetics forever.

That is what I was trying to say but you said it better. Thanks!

[2BNTV]

I am not a doctor. Please consult your doctor with any concerns about the right course of action for you.

These are my observations as I understand them:
1. Diabetes are genetic if family has a history.
2. Slender people can have diabetes, (Mary Tyler Moore had it at age 19). It's not always a function if you don't eat well and in the right amount of food.
3. There is junvenile diabetes.
4. Once your diagnosed with diabetes, you can work to control it with healthy eating and exercise. My doctor said even if the blood levels don't say your in a diabetic range anymore, you still are a diabetic. You may be in control of your diabetes which is the best option.

My point of view is this:
1. You can work to control your diabetes or it will control you with the various maladys that come with it. I prefer to control it.
2. By posting what has been my experiences, I was hoping that others would know there is hope if you are diligent in your eating choices and exercise habits in bringing it under control and not suffer the possible damaging effects of this disease.
3. I was not trying to spread fear as some medical profesionals will inadvertenly do when explaining how this disease works.
4. I feel better now because I am eating more healthy than ever before, so getting the Diabetes diagnoses was a good thing for me.
5. Every person is different as should follow the advice of their doctor to do whats right for them to keep healthy.
6. I think of a "lifestyle change" in terms of my eating habits is positive thinking because when I think of "diet", I think of I'm depriving myself of something I want to eat.

The "alcoholic" analogy came from my doctor. I understand it to mean that an "acoholic" can become sober and gain control by not drinking but he/she goes back to drinking, their life will be out of control. The statement had nothing to do with "alcoholism" as a disease but what is needed to bring it under control. Same for a diabetic.

Longevity reminds me of the old Abbott and Costello joke when they were placed in front of a firing squad. The officer asked Lou if he had any last wishes. Lou Replied,"I want to die of old age".

I have the utmost sympathy for those people who have had received a diabetes diagnoses that need to take medication and suffer from the effects of this disease. I wish everyone well.

Diabetes is an epidemic in this country. We shouldn't be afraid of it but we shouldn't dismis it lightly.

Russ_Boston - But I applaud anyone who tackles this horrible disease head on!

I would like to be counted as one of the people who has met this head-on.