I do not control which ads are displayed by Google Ads nor do I endorse the products advertised. Ads claiming diabetes is curable or reversible should be ignored.

Sunday, December 28, 2008


I find it inspirational to read the success stories that others post in the various forums I read. Some are spectacular, some seem ordinary until you read between the lines to see the courage, determination and character that led to success. To me they are all illustrations of ordinary people who have decided to become extraordinary when they decided to take charge of their own future. I posted these stories previously:

xita's Story

Jennifer's Story

Good Advice, Bad Advice - Nicky's Experience


Here is another, from nanna2six. That nick implies lots of other happy stories too. She originally posted this on the ADA Forum.

I would be delighted to help someone else.

When I was diagnosed in April 2008, I wasn't sure where to start. I went in for my annual exam, on a Friday, on the following Tuesday the nurse called and said I needed to repeat my glucose test because it was a "little high". I said how high? She said 289. I repeated the fasting glucose, I work at a hospital, so this time I had the blood drawn there (to keep from missing so much work), it came back 269, the nurse called again and said the doctor wants to see you Friday morning. I already knew, so I was sort of prepared (not really) but as much as possible.

I give credit to my doctor because he took quite a bit of time going over things with me. He started me on Metformin 500 mg, over the next few weeks, he increased it until I am now taking Met 500 mg with breakfast, and Met 1000 mg with dinner. So over that first week end...I was lost.

The only thing I didn't agree with my doctor about was that he told me that until I went to Diabetes Education class...I could drop by the office once a week and have my finger stuck??? I bought a meter on Saturday morning. By Saturday evening I had found this message board...but because I had been all over the internet, I couldn't remember how to get back to it. So it took me a couple of days to find it again.

I started reading and I have been reading since then. I am by nature a quiet person...I listen more than I talk. From reading, I learned to start MOVING! I get to work 30 minutes early...so instead of reading...I started walking. My first attempt was this big hill, it took me about 3 days before I could get all the way to the top LOL, then I stopped noticing the hill and I started going around the block, I am now at eight blocks before work. I also walk at lunch time, my lunch is usually something that I can carry, don't need a knife or fork kind of meal, then I walk about 7 blocks to the bus stop after work. NO, I don't walk after I get home.

But the most drastic change is what I eat. In my D class, I was given a meal plan that said I could have 60 carbs a meal (NOT!). From THIS BOARD and the people here, I learned that I had to find out what my body could handle and it was not 60 carbs a meal. I eat approx 15 plus for breakfast. I didn't use to eat breakfast at all, but since I had meds to take, and I was told I need breakfast I do. At lunch and dinner I eat between 30 at the most 45 (not too often) of carbs. I drink lots of water.

I have lost 26 lbs, since April, but 36 lbs total since my last Dr visit which was for an unrelated issue in October 2007. I would love to help someone. I don't want to forget to say that the only way to find out how food effected me was to test almost all the time. I wasn't told that in D class either...just to test as soon as I got up each morning, nothing about before and after meals.

I have a friend that is also D, but she is totally noncompliant...does not care. I just thought that if I can't help her, and I see her most days....but I will become more active on the boards. I hope this tells you a little more about me.

Thanks for your permission to post another inspirational story, nanna2six. I'm sure that you have already helped others.

Cheers, Alan

Everything in Moderation - Except Laughter

Wednesday, December 17, 2008

Smoking and Diabetes

So, you're a smoker and you've been diagnosed with type 2 diabetes. And you're sick of people telling you to quit? Yeah, I know. Been there, done that. In 2001 I finally succeeded in quitting after nearly forty years of forty-a-day. As an ex-heavily-addicted smoker, I know how hard it was to give up. There were few people I detested more when I smoked than ex-smokers who would say "I just decided to stop - it's just willpower." Yeah, right. Idiot.

So why should you?

Well, I presume you're reading here because you have diabetes and want to avoid the usual complications. That word doesn't really seem nasty enough to cover heart disease, kidney failure leading to dialysis, blindness or salami surgery, does it? So, to try to avoid those you are testing your blood glucose levels, changing your menu, doing some extra exercise and learning everything you can to give yourself a chance of a more enjoyable, longer life. Great stuff - you are doing the work and deserve the rewards.

But you still smoke? It's time to think about that.

Usually, scare stories only provide partial help - but I'll pass these on anyway. Because I don't want to hear from anyone, anywhere, claiming that smokes aren't harmful to a diabetic.

Start by doing a simple google scholar search on "smoking and diabetes". The references at the foot of this article are a small sample of the 283,000 hits. Just one small snippet among many: "Particularly, survival of smokers with diabetes on hemodialysis is abysmal."

I first discussed this in 2005 on alt.support.diabetes. A friend of mine, Annette, responded with this interesting, but alarming, comment:

"Here are a few interesting tit-bits about tobacco use and metabolism to add to the list. I discovered some during my look at cyanide in plants and how the body detoxifies itself from this potentially deadly poison.

Tobacco contains a VERY high level of cyanide. Workers who handle and process the leaf have been fatally poisoned just through skin contact with the leaf.

I have read that people who smoke or use tobacco have been found to be consistently deficient in Vitamin B12. This vitamin is the body's main line of defense against the chronic low-level state of cyaniditis. It gets depleted by having to de-toxify the cyanide that keeps coming in all the time. After all there are small amounts of cyanide in most of plants we eat. Fine, unless you smoke. Diabetics are particularly likely to have sub-optimal levels of Vit B12 anyway, especially if they use that otherwise helpful med, metformin. So that's a double whammy. Even supps have a hard time keeping up the supply.

Cyanide binds strongly to the iron in the body, which then lowers the uptake and presence of oxygen in the blood and cells. That's why it can kill so fast. No oxygen! Smoking contains carbon monoxide, which also replaces oxygen in the blood. Breathe in enough, and that will cause death too. Same reason. Cigarette smoke lays down "soot" in the lungs, as well as being carcinogenic. So less oxygen is being absorbed by those wonderful "ventilators". A triple whammy!

Now the body does fight bravely to deal with these assaults. It tries to "wash" the offending soot out of the airways with mucous, hence the classic "smoker's" cough. It tries to detoxify the cyanide, hence low levels of B12 that are needed elsewhere. It does it's best to kill cancerous cells, but of course can simply fail to handle such a constant intake of carcinogens, and cancer can get the better of all it's efforts. Finally, the lungs endeavour to correct the lack of sufficient oxygen for normal metabolism, and stretch so as to increase the amount of air taken in with each breath. Long term though, they gradually lose their elasticity, like worn out elastic in waist bands, and can no longer function effectively. I'm not surprised that smoking raises the risk of heart attacks. Every living cell in our bodies need oxygen, those hard working muscles in the heart in particular. But if none of the above get you, the emphesema will.

Just one more tip to close off. I'm not cogniscent of why, but smoking definitely has been shown to raise insulin resistance. If you decide to quit, keep an eye on your bg levels (especially if you are a T2). The insulin resistance can improve so rapidly, you may find yourself suffering from a hypo!

Good grief, you may even be able to drop all your oral medications, enjoy exercise, and find bg management a breeze. It's that much of an influence."

You already know you need to quit, but if you need further convincing browse through the references below. I've checked that all the links still work if you want to read deeper.

For the sake of those who love you , even if that's only you, quit. I know it's not easy, but it will be worth it.

Cheers, Alan
Everything in Moderation - Except Laughter.

Further reading:
Cigarette smoking and health. American Thoracic Society Cigarette smoking remains the primary cause of preventable death and morbidity in the United States.
Preventing cardiovascular events in patients with diabetes mellitus. Abraham WT.
Smoking is known to be particularly dangerous for those with diabetes, and it is important for health care providers to help their patients stop smoking.
Effects of smoking on systemic and intrarenal hemodynamics: influence on renal function. The mechanisms of smoking-induced renal damage are only partly understood and comprise acute hemodynamic (e.g., increase in BP and presumably intraglomerular pressure) and chronic effects (e.g., endothelial cell dysfunction). Renal failure per se leads to an increased cardiovascular risk. The latter is further aggravated by smoking. Particularly, survival of smokers with diabetes on hemodialysis is abysmal.
Effects of cigarette smoking, diabetes, high cholesterol,and hypertension on all-cause mortality and cardiovasculardisease mortality in Mexican Americans. The San AntonioHeart Study
After adjustment for sex, age, and socioeconomic status in multivariate analyses, current smoking, diabetes, high cholesterol, and hypertension were positively associated with all-cause mortality and cardiovascular disease mortality in Mexican Americans. Overall, these risk factors accounted for 45% of all-cause mortality and 55% of cardiovascular disease mortality in this ethnic group.
Smoking, diabetes and hyperlipidaemia. Mikhailidis DP, Papadakis JA, Ganotakis ES.
Department of Chemical Pathology & Human Metabolism, Royal Free Hospital & School of Medicine, Univ. of London, United Kingdom.
The epidemiological evidence linking smoking with insulin resistance is considerable. This evidence is even more convincing because there is a dose response relationship between smoking and the risk of non-insulin dependent diabetes (NIDDM). Similarly, there is a time-dependent decrease in risk of NIDDM for those who quit smoking.
Insulin resistance (in the form of impaired glucose tolerance, IGT) may precede the development of NIDDM. There is a biochemical basis for the smoking-IGT/NIDDM relationship. Smoking increases the risk of developing diabetic complications like nephropathy, neuropathy and retinopathy Smoking is also an independent risk factor for myocardial infarction and all-cause mortality in NIDDM. Smokers are both insulin resistant and lipid intolerant.
Smoking and diabetes D Haire-Joshu, RE Glasgow and TL Tibbs
There are consistent results from both cross-sectional and prospective studies showing enhanced risk for micro- and macrovascular disease, as well as premature mortality from the combination of smoking and diabetes.
Smoking is associated with progression of diabetic nephropathy
RESULTS--Progression of nephropathy was less common in nonsmokers (11%) than in smokers (53%) and patients who had quit smoking (33%), P < 0.001. In a stepwise logistic regression analysis, cigarette pack years, 24-h sodium excretion, and GHb were independent predictive factors for the progression of diabetic nephropathy.
The Effects of a Smoking Cessation Intervention on 14.5-Year Mortality
Intervention: The intervention was a 10-week smoking cessation program that included a strong physician message and 12 group sessions using behavior modification and nicotine gum, plus either ipratropium or a placebo inhaler. Results: <snip>Differences in death rates for both lung cancer and cardiovascular disease were greater when death rates were analyzed by smoking habit.
Getting to Goal in Type 2 Diabetes: Role of Postprandial Glycemic Control
Slide 9. MRFIT: Impact of Diabetes on CVD Mortality These are data from the Multiple Risk Factor Intervention Trial (MRFIT) study, where people with and without diabetes were classified as having: no risk factors at all, only 1 risk factor, 2 risk factors, or all 3 risk factors. Risk factors were hypertension, hyperlipidemia, and smoking. For any given number of risk factors, the chances of getting cardiovascular disease are markedly increased in people with type 2 diabetes. This increased risk is related to hyperglycemia.