Stress and Blood Glucose Levels.

Stress, like blood glucose spikes, has an insidious effect on the body. I am not qualified to go into the biological aspects of stress, but over the past three weeks I have certainly been forcibly made aware of the physical and mental consequences.

I have also been reminded that I have not cured my diabetes over the past decade; at best I have maintained good control. Control which can swiftly degrade under stress.

I post my story partly as an explanation to the people on various forums who may have wondered at my absence over the past month, and also as an example to others undergoing stress to reassure you that you are not alone, we all experience our own personal tragedies and stresses. I am not looking for sympathy, I have already received a great deal of support. My intention is to show that this can happen to anyone. If your numbers are rising when under stress, the cause is not always poor diet or inadequate medications. Resolving or dealing with the causes of the stress are just as important.

To set the scene, my usual fasting blood glucose over the past few years has been in the range 5.5(100) to 6.5(117). I suffer from Dawn Phenomenon so I am reasonably happy with that. My A1c has been in the low 6% range. In contrast, for the past two weeks I have not seen a fasting blood glucose under 7.5(135) and if my A1c was tested right now I doubt it would be under 7%.

Physical stress.

Three weeks ago I was cooking sausages on the barbecue raising money for our local Neighbourhood Centre, something I have done twice a month for several years. After cooking several hundred sausages I had to empty the hot drained fat container and carelessly spilt some on my hand, mainly my right index finger. The doctor said it was second and possibly third degree burns. That placed my system under some stress as it slowly healed; I took the final bandages off yesterday, but I am still applying ointments. At least I can type with two fingers again. I noticed that my fasting numbers immediately rose about a mmol (18mg/dl) – and stayed up.

Financial stress.

Just before I burned my hand I arranged tradesmen to renovate my bathroom. Plumber, carpenter, tiler etc. I am an experienced home handyman so the budget was based on doing most of the preparation work – removing old tiles, shower screens, cabinets etc – myself. Suddenly all that had to be done at tradesmen's rates. The budget has blown out.

Personal stress.

About three years ago my younger brother was diagnosed with cancer. Over the next couple of years he underwent chemo but made the wise decision to spend as much time as he could travelling with his family and enjoying life between chemo sessions. He did not change his bright, happy character at all.

Three days after I burned my hand my brother's wife rang to say we needed to go to the hospital, two hours away. When we arrived it became clear he would not be leaving hospital alive. We stayed for a couple of days, then returned home. On return we received an email that one of my wife's best friends had died in hospital, also from cancer.

Four days later my brother's pain left him. Two days later we attended my wife's friend's funeral. Two days ago we went to my brother's funeral. Some time during that period we discovered that the bathroom renovation required more extensive work than we first realised. It didn't really seem that important now.

This morning my fasting blood glucose was over 8(144). However, my bandages are off, I will continue to grieve but the worst is over, and today is a new day. In reviewing the past few weeks I realise that I also let my usual dietary regimen slip. Not surprising, but that is something I can change.

It's time for me to begin again, testing, testing..

I know that there will be people reading this who are going through situations far worse than mine. I hope that my story helps a little by letting you know you are not alone.

Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter 

For UK Type 2s: A Petition to Make Test Strips Available to People With Type 2

This is a brief but important post. I know I have some readers in the UK.

For those not aware of it, test strips are severely restricted for type 2s in many NHS districts. The terrible paper by Farmer et al back in 2007 is often used to support this. I comment on a later paper citing that one here: Is Testing Worthwhile? 

This excerpt from a recent speech by the head of the NHS suggests there may be a brief opportunity to get this changed. 

After the expected introductory words this appears:

"I went to see my GP, they did all the stuff, they said, yes, you've got diabetes. It's quite a difficult thing, I think, particularly for someone, a healthcare professional, someone who has worked in the NHS, to kind of reflect on that and say, right, I have an illness now, a condition which could involve me losing my limbs, my kidneys packing in, having a heart attack and probably dying of a stroke."

  If you read it you'll see why I left out the next sentence. Then he says:

"one of the things they gave me was a monitoring machine, so I take my blood glucose levels four times a day and I have a little chart that I put them on. Now I'm not a stereotype here, but give me a chart and a target and a trajectory and I'm absolutely -- I'm absolutely with you. They could have designed -- they could have absolutely designed that interaction for me and I have been absolutely at it since then."

A friend of mine who runs a UK forum has started a petition to Sir David. I invite UK readers to read it; if you agree, please sign it.  

Click here: David Nicholson, Chief Executive of NHS England: Make blood glucose test strips available to people with T2 diabetes 

There is a short window of opportunity. He retires from the post in a few months.

Cheers, Alan
Everything in Moderation - Except Laughter. 
There is nothing I could eat I like more than my eyes.

George's Story

Here is another inspirational story from a cyber-friend who posted this on the ADA forum recently. I asked his permission to post it here because I believe our success stories help others, especially newly diagnosed people who fear an unknown future.

My Story: Lucky to Have Diabetes

 

Hi. I am George_M. What follows is my story, and why I feel so lucky to have diabetes.

In August of last year, I was feeling like I had been blessed with a wonderful life. After a disastrous first marriage, I had found the woman of my dreams, and we had enjoyed 23 years of happiness together. My life had its full share of bumps in the road, but those all seemed behind me now. After many years of working 60+ hour weeks, my wife and I were both retired. We had the time and sufficient retirement income to care for our needs and some of our desires. We had a long period of caring for her mother, which was very difficult and emotionally exhausting, but her mother had passed away peacefully at age 95 a few months before. We were able to indulge our joint passion for traveling to interesting places.

I get an annual physical exam. The last two had been OK, nothing much to worry about. Triglycerides and cholesterol were somewhat high, and my doctor advised me to cut fat out of my diet. And, oh, one other little thing. My fasting blood glucose in 2010 was 99. In 2011 it was 101. My doctor said that was getting somewhat high. If it went up more she would diagnose prediabetes. She said I should lose weight.

I was normal weight for my first 50 years, but weight had definitely become a problem for me the last 20 years. I gradually put on 140 pounds over 10 years. I lost that all in one year on Weight Watchers, then gradually put it all back on over the following 10 years. I was constantly very hungry, even an hour or two after eating a very large meal. Now the doctor was telling me to lose weight. Well, OK, I would try.

Then, about two months later, the most miraculous thing happened! I started to lose weight, without any particular effort! I lost about three pounds per month, for 10 months. This is great, I thought, my doctor will be very pleased. I figured my body must have changed as I got older and was naturally shedding weight.

Then I went in for my annual checkup in August 2012. The doctor listened to my heart and lungs, said how pleased she was about the weight loss and sent me to the lab to have blood drawn. A couple of days later, I got an email from the hospital that my lab test results were available. I logged on. Most of the tests were about where they had been the year before. But my fasting blood glucose was 235. The lab put a note in the report that they assumed the test was not fasting. The problem was, I knew it was a fasting test.

What did this mean? I did some research on the internet and found out that I had type 2 diabetes. How could this be? There was no diabetes in prior generations of my family. My brother has type 2 and is on insulin, but he had been exposed to Agent Orange in Vietnam, and the government says that if someone who was exposed to Agent Orange develops diabetes, the presumption is that it was caused by the Agent Orange. I had not been exposed. How come I had diabetes? And what happened to that prediabetes, where I could know that this was serious and make some changes to keep it at bay?

A couple of days later, I got a phone call from my doctor’s secretary. She said my fasting blood glucose was high, that I should avoid sweets and cut back on starches for the time being and come back in two more weeks to repeat the tests. By this time, my head was spinning. Did this mean I couldn’t travel anymore? Would I need insulin right away? What about amputations? Blindness? Kidney disease? Heart attacks and strokes? My brother has had two strokes due to his diabetes and needs assisted living, and I have to handle all his financial affairs because he is unable to. Would I end up like that shortly? I felt like the bottom had just dropped out of my life and I was falling.

Then I found the forum section of the American Diabetes Association website. There were many people there who were handling their diabetes successfully, and they were going on to live pretty normal lives despite diabetes. Two of them, LizzyLou and Alan_S, had taken the time to set up blogs where they have a huge amount of information about diabetes and how to live with it. I spent several days reading and digesting that information, and also reading threads on different topics on the type 2 forum.

At my follow-up visit, the lab drew more blood. I had changed my diet quite a bit, so my fasting blood glucose came back 156, but my A1C was 10.1. This only told me what I already knew: I had diabetes. My doctor referred me to a nurse practitioner and a nutritionist. She also wanted to prescribe Metformin ER, 500 mg twice a day. I thought I would be able to get my blood glucose down with diet and exercise, so I resisted the Metformin. We compromised on one 500 mg pill per day.

The visit with the nurse practitioner went OK, although I had the impression that I knew more about diabetes than she did. The nutritionist advised a diet with 240 to 300 grams of carbohydrates per day. I told her that I was already eating a diet with about 20 percent of those carbs, and I was doing quite well on it. She warned how bad that diet would be for me, and I went on my way.

When I reduced the carbs in my diet, the huge raging hunger that I had been experiencing for the last 20 years went away. I became mildly hungry sometimes and moderately hungry for an hour or so before meals. This made losing weight much easier. When I was diagnosed, my doctor told me to lose 90 to 100 pounds (in addition to the 30 pounds I had lost without trying before diagnosis). In just over seven months, I have lost 75 more pounds. My triglycerides and cholesterol have come down, despite doing the opposite of what my doctor had told me to do to bring them down—eating a higher-fat, lower-carb diet. I had been exercising almost every day (mostly walking) for the past 10 years, so I just became more consistent doing that. This is what works for me.

I wrote my relatives to tell them that I had diabetes and that there was a strong genetic link. My only other sibling, my sister, wrote back that she had prediabetes, that she was taking Metformin and that her latest A1C had gone up to 6.5. All of us either had diabetes or prediabetes.

I did want an endocrinologist who specialized in diabetes to treat me. There were a few little things in my past that might have been warning flags, had I only known. I didn’t like the feeling that I should have known more and done things differently, and I didn’t want to be having those same feelings in 10 years about what I was doing today. I did some investigating, picked a great endocrinologist and made the next available appointment for about six months after diagnosis. When I answered her questions about what I was doing, her eyebrows went up. “Where did you learn all that?” she asked. I told her about the Association’s website. She said “That’s amazing. Normally, I have to tell my patients to do all these things you are already doing. I have to argue with some of them. You are already doing those things.”

I spent a month or so just reading on the Association’s website. I felt it was time to try to repay the enormous debt that I owe to the many people there who have helped and befriended me—by trying to help others who are not as far along the path as I was. I have been doing that for about six months now, mostly trying to offer encouragement and telling others what has worked for me.

I am 69 years old, and many of my friends are about my same age. We are all starting to develop medical issues. I have friends with Parkinson’s disease, cardiovascular disease, crippling arthritis, multiple sclerosis and other serious conditions. I got a disease that made it both necessary and much easier to lose weight, exercise and lower my cholesterol, blood pressure and triglycerides. My disease has not imposed any serious limitations on my life activities yet, and I hope to have many more years before it does. Unlike many other diseases, what I do can have a big impact on how my diabetes goes, so I get to be largely in control.

And that is why I feel lucky to have diabetes.

Thanks George.

Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter