Are Diabetes Complications Inevitable? Not necessarily...

This is a very personal post, reporting on my own recent reports on three aspects of my health: my eyes, my heart and my other affliction, leukaemia.

I am writing this partly to celebrate but also to motivate any newly diagnosed type 2 diabetics, shocked and scared, who have been warned by their doctors of the inevitability of their diabetes progressing to complications. I suppose some doctors feel they need to do that to scare new people into making lifestyle changes, but too often I find dire predictions of long term complications or heart attacks lead to loss of hope. That can lead to a 'why bother' mentality. 

Please, do not give up. I know managing type 2 diabetes can be bloody inconvenient. You will have to make some annoying changes to your life such as pricking holes in yourself, adding some activity to your day, forever watching what you eat and drink and possibly taking meds and insulin. 

Let me assure you: taking control of your blood glucose levels is worth the trouble. I am just one example of many I read on the better diabetes forums where pro-active type 2s are learning how to take control.

Possibly my continuing story will give you hope.

I was first diagnosed with leukaemia and type 2 diabetes in 2002 at the age of 55. I discovered early I could do nothing at all about the leukaemia; for that reason I concentrated on beating the diabetes. I was thirsty for knowledge. For the first couple of years I spent a lot of time learning from many wise people, mostly on usenet. Some were medical professionals but most were experienced diabetics. I learned something from all of them, even if the main thing I learned was how to tell good advice from bad because, unfortunately, a lot of it was bad. I still believe the best advice was Jennifer’s Test, Test, Test: “Use your body as a science experiment.” 

I tested and experimented to find what worked for me. On usenet over the next couple of years I gradually changed from reader and student to lay advisor, passing on information based on my experience. In 2004 I joined some online forums. In 2006 I started this blog. 

Eventually I wrote a book based on my experience to help any newly diagnosed people who might not be computer-savvy. Of course, as my suggestions for good type 2 management differ significantly from the mainstream there will always be critics. In part this is a response to the critics, describing the results of practising what I preached for the past decade.

Motivation

We each must find our own motivation for maintaining the discipline. For me, it is my sight. Since the day I first learned about the possible complications of diabetes my over-riding motivation has been my vision. I came to accept the possibility of death and I certainly don't want to lose limbs from neuropathy or kidneys from nephropathy, but the thought of living in darkness scared me silly. I have tremendous respect and admiration for vision-impaired people who successfully live with that daily. But I do not want to join them. I am a reader of books, an appreciator of beauty, a user of computers and above all I want to see my grand-daughter’s joy as she grows and learns.

The tests used by doctors to monitor our diabetes such as HbA1c, fasting blood glucose and post-prandial blood glucose are all important but they are really only surface indicators. I use those indicators to set my goals, but they don't directly alert me to dying nerves or optic cells. The acid test is whether complications eventually appear as the years pass. 

Limbs and Kidneys

So far neither blood tests nor physical symptoms, including filament tests by my podiatrist, have indicated any signs of neuropathy or nephropathy. I am hopeful that will continue.

Eyes

I had some good news last month. It is over thirteen years since diagnosis and I had not seen the ophthalmologist since 2010. I had a good report then after a scare in 2006 when he discovered minor scars from healed retinopathy. The scars had disappeared by then. This recent visit was almost identical to that 2010 consultation.

The waiting room was packed. After various eyesight checks on new strange machines by the assistant, then the anaesthetic drops, followed by the dilation drops, then another wait, then more tests on machines, I eventually saw the ophthalmologist. He did a very thorough inspection. He warned me that as I age (I am now 68) I may start developing cataracts but at this stage I had no problems apart from inevitably getting older. I wanted reassurance so I asked specifically about retinopathy, macular degeneration and glaucoma as there is some family history of the latter. He re-inspected carefully. He expressed no concern and no evidence of past damage. Then he complimented me on my "superb diabetes control with respect to eye health". I cannot express in the written word how happy that made me feel. Is there a cloud ten above cloud nine? At his request we then spent a few minutes of his valuable time discussing the Test, Review, Adjust technique.

OK, that covers the ‘opathies. None at all. But there is another lurking danger for diabetics: the heart. 

Heart.

I dropped Lipitor ten years ago; the more I read about statins the less I am convinced of my need for one. My doctor has been polite and patient with me when I have consistently refused a statin for the past nine years despite high cholesterol by official standards. My HDL and triglycerides are fine but my LDL is very high. He suggests that may be because of my low-blood-glucose-spike (which many interpret as low-carb) way of eating. He strongly recommended I have a stress echocardiography accompanied by ultrasound of my heart, mainly to reassure him I am not going to keel over tomorrow. I had those tests last September. First, the gooey preparation and the ultrasound, twisting to awkward positions. Uncomfortable but not painful. Then walking faster and faster on the treadmill, with wires hanging off me, having problems reaching the heart rate he wanted. Eventually we got there. As I cooled down it was fascinating seeing the movies of my own heart pumping away on the playback screen of the ultrasound. 

The cardiologist was very thorough and pleased with the results. It seems my heart and vascular system are in fine shape. No problems at all. I will continue to refuse the statin and eat low-carb, moderate fat, for good blood glucose levels. I no longer care at all what my LDL is.

Leukaemia

 

Finally, although I would like to, I cannot forget my Chronic Lymphocytic Leukaemia sitting in the background like the Sword of Damocles. I make no claims about my diet or lifestyle for that. I’m just lucky I suppose. All of my indicators have improved over the years until almost all are in normal range. I still have hypogammaglobulinemia associated with the CLL but one of the indicators for that, IgM, has crept back into normal range. The IgG and IgA are still low, but oddly I don’t seem to be catching anything despite wandering the far corners of the world since diagnosis. I saw the haematologist quarterly at first, then every four months, then every six, now I waste his time annually.

The haematologist, ophthalmologist, podiatrist (who displays my book at reception and has sold several copies) and my General Practitioner tell me to keep doing what I’m doing. 

That sounds like good advice to me. I will heed it.

Cheers, Alan
Everything in Moderation - Except Laughter

What on Earth Can I Eat? Now out as an eBook!

When I reached my '50s I mistakenly thought that my learning years were long behind me. 

How mistaken I was. My double diagnosis in 2002 led to a whole new world where I was a naïve ignorant student learning about a host of mysterious things neglected from my education in my various earlier stages of life. Things like carbohydrates, insulin, blood glucose, lymphocytes and all that.

Some of those subjects were vital to my continued health. In many of those fields I will be a student for the rest of my life.

Other things I had to learn were less directly important but still necessary to assist my search for knowledge; thus I became net-savvy and learned how to use the web and usenet to get the information I needed. Later, further learning was needed to allow me to find ways to pass on to others the knowledge I had gained. As a consequence I spent a lot of time in 2010 researching self-publishing;. That led to me eventually publishing What on Earth Can I Eat? late last year.

Originally that was going to be the only form of the book, but after publication I received many requests from people to produce an ebook. That involved another learning curve, as I tried to re-work the manuscript for the various e-reading options. I floundered around until I was directed to Smashwords. That made it so much easier.

So now, responding to popular demand, the ebook is out there on the web!

I have to admit I'm still an old fogey and tend to prefer printed books, but for those modern people who prefer to download and read on their Kindle (or any other ebook reader) please click here: What on Earth Can I Eat? Food, Type 2 Diabetes and You. As a service to my blog readers, a $1.00 discount is available if you  include coupon number JP52U when you get to the checkout.

What on Earth Can I Eat? - The Book

Life is full of unexpected surprises. There is no way in the world I could have envisaged ten years ago that one day I would publish a book. Even less credible was the possibility that it would be a book to help people with type 2 diabetes find a way of eating to assist in individually managing their condition.

But that is exactly what I have done today. If you look at the side-bar, there it is. I can hardly believe it myself. How on earth did that happen?

A little over eight years ago I was just like many of the people who are reading this right now. I had just left the doctor's surgery with a handful of diet brochures, a new blood glucose test meter and a new diagnosis of type 2 diabetes to add to my various afflictions. But, unlike many newly diagnosed people, I was determined to conquer this one. I hit the ground running. I started seeking information and I haven't stopped since.

In the eight years since then I have learned from every source I could, commencing with my doctors, dieticians and educators but not limited to those and continuing with usenet and the web. I turned my affliction into my hobby. I learned to use the various medical search engines on the web and subscribed to email alerts from sites such as the New England Journal of Medicine, the American Diabetes Association, Journal of the American Medical Association, Heart, Endocrine Today, Diabetes in Control and many others. I read everything I could find. I learned to understand “Medi-speak” and how to pick a valid research paper from a poor one; and believe me, there are far too many poor ones.

I started on usenet's misc.health.diabetes, back when it was very active (usenet is fading these days), and later added more diabetes groups and web forums. I learned a lot from many good people who helped me. Over time I started trying to help others as they arrived, shocked and scared, on those forums. If their situation sounded like mine and I felt I could suggest a way to help, I did. And slowly, over time, I found that many people started to experiment for themselves using my suggestions and they worked for them too. Often we both learned from the mutual feedback of advice and experiment.

Over time I found that I am a good coach. Like many coaches, I found that some of those I helped achieved better results than the coach. I respect them but I do not envy them, because we each have to choose the right balance for ourselves. I could work harder and achieve tighter goals, but I balance that with my enjoyment of life. My signature on the web is “Everything in Moderation – Except Laughter”. I keep that in mind when making lifestyle decisions. But I never forget that the laughter may become a bit strained if the terrible diabetes complications start to appear in my life. So I try to make sure I work just hard enough to ensure they do not. That can never be guaranteed but after more than eight years they have not arrived yet.

After a while I added other forums and groups to my morning and the number of new arrivals I responded to started to grow, especially on the American Diabetes Association Forum. I found that I was repeating myself daily. So I looked for a way to store the “standard” suggestions and discovered blogging. This blog started in 2006 as a type of archive; a way to give a new person a link to more information without typing it several times daily. Then it started to grow, as I answered more questions and posted some of those answers to the blog.

The book I have published today grew out of that experience, partly to help those who are more comfortable with a book than a computer screen. I finally made the decision to write the book when many of those who had followed my suggestions over the years urged me to write it for their relatives and friends.

That is the story behind the book. I'm a good coach, but not much of a salesman because I tend to be too honest and "tell it like it is".

I do not promise a cure. I don't have a magic bullet. I don't sell herbal mixtures, special potions or promise reversal of your diabetes in 30 days. After buying the book you don't get follow-up mail to buy anything or join a program or start a business. All you get is a book that is easy to read, easy to understand and offers clear and simple ideas to help you take control of your diabetes.

What I can promise is that following the suggestions in my book will help you understand much more clearly the relationship between the foods you eat and the consequences for your long term health. I can teach you a way to find an enjoyable way of eating that suits you. My hope is that this information may help you take control of your own diabetes management, just like many others who have reported back to me, and may help you delay the progression of your diabetes towards those terrible complications.

If you're really quick - you might even get delivery before Christmas :)

Seasons greetings to all. I just received my Christmas present; I hope you receive what you wish for.

Cheers, Alan, Australia