|This is the Journal of |
<< Round and round and up and down we go again.
Getting to know DAFNE >>
Oh dear. It was all meant to go so well. You do the DAFNE course and then go away and it's easy and you get perfect scores all the time, but no things don't work that way.
I just got the results of a set of blood tests back and the HbA1c result is up. A lot. 7.7%
So the nurse and I try and work out why it's gone like that. I think it's due to the problems I had trying to get the DAFNE methodology to work for me (working out my carb ratios and so on). There was a period over about 4-6 weeks after the course where my numbers were all over but averaging quite high. Also the test will cover the christmas period which is hard to deal with.
The numbers over the last few weeks have got better and are lower (with a lower average bg level) so I hope that the next time I have a HbA1c test it comes out much lower with a more sensible number. Still the doctor wants a word with me about it.
The other things seem fine (kidneys, cholesterol) but the blood pressure is still a bit high. I guess I'll get the dosage of that tablet upped a bit. The only problem is I'm worried that I'm starting to get the 'ace inhibitor cough'. This is a common side effect of these class of drugs and while it's unlikely kill you it can be very very annoying.
Other than that it was the usual lose weight (currently 100.5kg, bmi 30) and drink less (I said I drank up to 40 units a week which is an average of 3 pints of ale a day).
They're promoting a new health drink which lowers blood pressure (if you can stand it)
Beetroot juice, mmmm, sounds lovely
Yea...watch out for beeturia as well! A11454491
Beetroot juice? Ewwww. Well, I hope you can find better ways than that. Tastier ways at least!
Hope it goes better. It seems to be progressing, so I hope the progress continues.
Mine ten days ago (also inclkuding Christmas of course)was 7. The doc sighed and said it wasn't too bad.
Surely beetroot isn't an option for diabetics? For that amount of sugar, I'd prefer a bar of chocolate.
Gung Hei Fat Choi
And a happy new year to you W I hope you haven't overdone it over the new year celebrations.
I expect that the next time I get my HbA1c done it will be a lot better than that. Actually it's unlikely to be the next time as that's next week when I go up to the hospital again. I think I might ask for a chat with the nurse who did the dafne course about it.
I am sourly amused by the way a chap seems to need a degree in biochemistry just to deal with the tests, let alone the condition.
Hoping all is indeed actually very well.
It's advanced psychology that's needed - to deal with the know-it-all doctors, who tend to be particularly dismissive of fat grandmothers. All would seemingly be well if I knocked off the extra baggage. Since I've had it for 30 years,it's very hard to shift, but it would be fractionally easier without the patronising and pitying attitudes that go with the "advice".
Since the professionals have over the years prescribed several drugs that are now on the no-no list (the latest for me was Avandia) I think I know at least as much about diabetes as most of them do.
(The fact that I keep losing and forgetting things is nothing to do with it - you need level blood sugar to keep your brain working and mine still skitters for no reason)
Good luck, Phil and let us know how you get on.
Well I've just got in from seeing the doctor. I was quite a nice appointment, we spent a chunk of time discussing beer and pubs as well as the medical things (he spotted I had listed the latest CAMRA meeting in my diary - it's the only place I look regularly).
Given that my bg readings have been on the whole much more stable and much lower than they were during december soon after the course, we agreed it was probably me adjusting to the new regime of insulin and testing that caused the high HbA1c and to see how it is in a few months time.
While there I've also now got a higher dose of the ace inhibitor to drop my blood pressure a little bit more (it's almost but not quite there).
All in all not too bad I think.
I'd have thought a degree in pharmacology would be useful the number of times a doctors says lets try you on one of these tablets, I think it should work and help you. The last few times I've seen the nurse at the doctors surgery for my diabetes review she's asked if I think I should be on metformin. NO! I have type one diabetes with minimal insulin resistance. I just need to work hard at matching the insulin doses I give myself with the food I eat and then test, test and test some more to make sure I got it right!
I must say I am utterly shocked the nurse asked you SEVERAL TIMES if you should be on metformin. Met is for type II diabetes, for people with TOO much insulin (see, how to remember it? Type one has none, type two has too much). What are they trying to do, hospitalise you?
A friend of my grandfather's in the States, whose pancreas has also completely retired on him, was briefly put on met by a doctor who, basically, saw a fat middle-aged man with low blood-sugar and assumed it was type ii. The friend collapsed in the street, and of course everyone assumed he was having a heart attack and it was HOURS before they worked out what the hey was wrong with him. I mean, it didn't help he'd lost his pancreas to acute alcohol-induced pancreatitis, and he looked exactly like a type ii typical candidate in every possible respect, but your nurse has no excuse at all. I can only assume type ii is becoming so prevalent people are forgetting how very different it is from type i.
I do think that is what it is. The nurse is lovely and I just say no and explain why I think it's not a good thing. I guess she sees many more people with type 2 diabetes at the surgery than the type 1s.
I know metformin can be useful for people with type 1 diabetes but just for the same reason that people with type 2 use it, to reduce insulin resistance. Just because we have to inject insulin doesn't mean we're automatically protected from getting insulin resistance and so a form of type 2 diabetes.
Most of the time when diabetes is is covered in the media it is about type 2 (you know the stories about the impending diabetes epidemic and the various ways to cure/stop you getting it) which isn't surprising when around 90% of people with diabetes have type 2. Adults with type 1 don't fall into the two categories of media consciousness - the supposed fat overweight people with type 2 or the poor little kids who have to be so brave to have several injections a day.
Anyway with all the messages about concentrating on what you eat, being aware of how you feel all the time, having to be slightly obsessive about testing/recording and so on. Is it any wonder why people with chronic diseases such as diabetes go a bit screwy in the head from time to time (something which is not well provided for in all the various bits of medicine trying to manage these conditions).
How are you doing these days Ag? Have the doctors decided if their interventions have worked or are working?
Forgive my butting in.
I'm married to a type II guy, and we never cease to be grateful that he is able to cope on diet control alone.
But that's not the burden of my song. I'm absolutely fed up to the gunwales with medics who pontificate on weight loss, and do absolutely nothing to help. Ask the Practice Nurse 'Oh, it's simple dear. sensible eating and exercise'. She, of course, is as thin as a rail.
Incidentally, have you found that your levels increase unduly with carbs? My Master was advised to have pasta, rice, bread etc, and it was a considerable time before he realised that his levels were always higher after such a meal. Strange.
Hello, don't worry about butting in, this isn't a private conversation, you can't have any of those on here
Oh yes, I know that feeling (as I was told by the practice nurse that my weight had gone up again).
Yup carbs is what makes blood sugar rise. All those things you listed are fairly high in carbohydrate, some of them fast acting carbohydrate which gets from your gut into your blood quicker. I agree with a lot of people with diabetes that a lot of the standard diet advice is wrong given to us is wrong. We're told eat carbs, low fat and moderate protein. This is fine if you're trying to not have a heart attack. Trying to keep blood sugars stable takes much more work than that. Some around advocate a strict reduced/low carb diet for type 2, others are more into the glycemic index approach - eat more of the stuff that breaks down slower to stop the big rises and falls in blood sugar (beans and pulses, 'unrefined' foods and products eg brown rice and granary bread, wholewheat pasta and so on). I guess it probably has to fall somewhere in between those two camps.
The only chance of getting it anywhere near right is to test, test, test and then analyse the results. Testing before and after meals and recording what was eaten to see if that causes problems and so on. I'm sure you've both got a routine that works for you and if it does, hooray! If not we all can use a bit of help from time to time
That's what I'm doing - eating food with low GI, avoiding white bread, potatoes, white rice, white pasta, sweets, fruit-juice, fizzy drinks... I say doing. *ahem*. Mostly doing. I was eating crisps last night.
How am I doing? Well, a lot better since the surgery, as I now have the energy to exercise, and so I do exercise, and I have gone down a trouser-size (yay!) and the GP has stopped advocating metformin and started telling me to carry on. I mean, I never did develop type 2 diabetes, but I am at pretty high risk for it, me and my charming metabolic disorder, so this is all good. Exercise is a brilliant way to control blood-sugar and over-production of insulin, I am repeatedly told - it's almost disappointing to be proving 'them' right.
I have another hospital appointment this very afternoon, to see if anything else has decided to produce the correct levels of hormones too. Bazillions of needles!
(also, it never occured to me you could have both types of diabetes at once! Wow. That would be... complicated).
That is good to hear that things are getting towards what some class as normal
Glad to hear things are behaving better for several of you.
You're absolutely right on all counts. It's February, so I'm feeling sorry for myself. I've just realised I've only done half the number of tests I should've today. This will mean faking three of them. I feel like a five year old.
My hand is sore with the eight pricks a day business. I find if I use any other site it gives a higher reading. I'm sticking needles into my stomach five times a day, but that's fine (apart from the small area I blistered with a hot water bottle)
Sorry for whinge - I find that I'm short-tempered due to fluctuating blood sugar and living alone means I can't let rip with it.
Did you see news of this yesterday?
Every so often it's good to have a bit of a whinge about stuff like this W
I had seen the news about extending the islet cell transplant stuff on the bbc website - http://news.bbc.co.uk/1/hi/health/7238418.stm - turns out the big teaching hospital down the road is one of the centres selected. I'm not sure about it though. You end up stopping taking one set of drugs (insulin) with lots of potential nasty side effects (hypos etc) and start taking another set of drugs (immunosuppressants) with lots of potential side effects and also it probably would need doing again a number of years down the line.
In Sweden, the National Board of Health and Welfare have finally admitted (it takes years for them to change their mind and they are in no way up to date with the latest research) that yes, the old diet recommendations for diabetics were bad and that yes, cutting down on potato and pasta and eating more saturated fat(!) is more sensible.
I have no problems with my blood sugar, but have still cut down on bread, rice, pasta and potatoes and eaten more full fat cheese, bacon etc. And more veggies to replace the rice, pasta etc.
1½ year ago my cholesterol was 5.06. Now it's 4.88.