Have diabetes and fed up with people who don't have diabetes 'sticking their oar in' whether in a kind meaning way or not? Yeah, so was Dr Polonsky and he came up with some diabetes etiquette which I am happy to share with you. Feel free to share with your non diabetic friends :)

Here are Dr. Polonsky's 10 etiquette tips for people without diabetes, written from the perspective of someone with diabetes:

• 1 - DON'T offer unsolicited advice about my eating or other aspects of diabetes. You may mean well, but giving advice about someone's personal habits, especially when it is not requested, isn't very nice. Besides, many of the popularly held beliefs about diabetes ("you should just stop eating sugar") are out of date or just plain wrong.
• 2 - DO realize and appreciate that diabetes is hard work. Diabetes management is a full-time job that I didn't apply for, didn't want, and can't quit. It involves thinking about what, when, and how much I eat, while also factoring in exercise, medication, stress, blood sugar monitoring, and so much more - each and every day.
• 3 - DON'T tell me horror stories about your grandmother or other people with diabetes you have heard about. Diabetes is scary enough, and stories like these are not reassuring! Besides, we now know that with good management, odds are good you can live a long, healthy, and happy life with diabetes.
• 4 - DO offer to join me in making healthy lifestyle changes. Not having to be alone with efforts to change, like starting an exercise program, is one of the most powerful ways that you can be helpful. After all, healthy lifestyle changes can benefit everyone!
• 5 - DON'T look so horrified when I check my blood sugars or give myself an injection. It is not a lot of fun for me either. Checking blood sugars and taking medications are things I must do to manage diabetes well. If I have to hide while I do so, it makes it much harder for me.
• 6 - DO ask how you might be helpful. If you want to be supportive, there may be lots of little things I would probably appreciate your help with. However, what I really need may be very different than what you think I need, so please ask first.
• 7 - DON'T offer thoughtless reassurances. When you first learn about my diabetes, you may want to reassure me by saying things like, "Hey, it could be worse; you could have cancer!" This won't make me feel better. And the implicit message seems to be that diabetes is no big deal. However, diabetes (like cancer) IS a big deal.
• 8 - DO be supportive of my efforts for self-care. Help me set up an environment for success by supporting healthy food choices. Please honor my decision to decline a particular food, even when you really want me to try it. You are most helpful when you are not being a source of unnecessary temptation.
• 9 - DON'T peek at or comment on my blood glucose numbers without asking me first. These numbers are private unless I choose to share them. It is normal to have numbers that are sometimes too low or too high. Your unsolicited comments about these numbers can add to the disappointment, frustration, and anger I already feel.
• 10 - DO offer your love and encouragement. As I work hard to manage diabetes successfully, sometimes just knowing that you care can be very helpful and motivating.

A new diabetic drug scare - sulphonylurea increases the risk of heart disease. Well, hello!!! Diabetes increases the risk of heart disease and of losing eyesight and amputation and stroke. The bloody disease is far worse than the cure.

Mind you, quite please I am not taking it at the moment I am on Metformin and Vildagliptin, how long before they say that vildagliptin causes problems and withdraw that?

There is a story in the NHS here, and it has links to the daily telegraph and Daily Mirror stories.

And in the UK they have stopped our strips for monitoring. Utter Madness. The following came from Diabetes Health.

Never a "Duh!" Moment: Study Confirms That Self-Monitoring Improves Patients' Response to Diabetes

Patrick Totty
Oct 13, 2009

"Self-monitoring blood glucose" (SMBG), a staple in the lives of most people with diabetes who take insulin, involves consistently monitoring and recording blood glucose levels before and after specific activities, such as eating, exercising, sleeping, and taking insulin. By observing the effects of certain foods and activities on their blood glucose levels, patients can learn exactly what works to raise or lower them. Thus, SMBG affords a kind of "fine tuning" approach to diabetes that empowers patients to adjust their medicine, modify their behavior, and manage their disease without always needing expert intervention.

So it's hardly surprising that an international study sponsored by Roche Diagnostics has confirmed that SMBG is a useful tool.

The study, published by SAGE Publications in The Diabetes Educator, looked at the SMBG practice of "paired testing," in which people with diabetes measure their blood glucose levels before and after specific activities to see how modifications in those activities might lead to better BG management. The researchers, located in five far-flung locations-Los Angeles, London, New Delhi, Singapore, and Washington, DC-found that SMBG is helpful to patients because it increases their sense of control and provides nuanced information that allows them to finely hone their diabetes management.

The researchers also looked into the possibility that non-insulin-taking type 2s could benefit from SMBG. Because about 40 percent of type 2 patients are treated with oral drugs or through diet, constant self-monitoring of blood glucose has not been thought to be necessary. Even type 2s who take a combination of oral medications and a daily dose of long-acting insulin are not required to take anywhere near the number of self-administered BG tests that SMBG usually calls for. Given the depth of information and sense of control that SMBG affords, however, even type 2s who do not use insulin may soon hear their healthcare professionals recommending SMBG as part of an aggressive approach to managing type 2.

Another great peace of news for us diabetics. When is a HIP replacement not a HIP replacement ? Read on, this great article came from www.diabeteshealth.com

One thing that really frustrates people with diabetes mellitus is the biopharma industry's focus on treatments rather than cures. A cure is what the diabetes community wants, not another band-aid. So the existence of a biopharma company that calls itself "CureDM" is promising, and its first product, Pancreate, seems to be on its way to fulfilling that promise.
CureDM started with the information that in most cases, the mass of pancreatic islets drops by 80 percent in type 1 patients and 50 percent in type 2 patients. They also knew from recent research that the adult human pancreas contains an abundance of pancreatic progenitor cells. Like stem cells, progenitor cells have the capacity to differentiate. Unlike stem cells, however, they are not able to become any type of cell. Instead, they differentiate only into their "target" cell, in this case, islets.
In adults, however, pancreatic progenitor cells rarely make the change into islets. Under normal conditions, islets differentiate only during fetal development, when the pancreas is first powering up. When islets do form in adults, it is usually in response to pancreatic injury and stress.
Scientists knew this fact way back before insulin was discovered, when surgeons performed partial pancreatectomies on children with diabetes in hopes of triggering islet regeneration. Rather than hacking off pieces of pancreases, however, CureDM turned to the modern study of genes, called genomics, and proteins, called proteomics. Using these approaches, they were able to identify the key that unlocks the pancreatic progenitor cells, causing them to differentiate into islets. That key is Human proIslet Peptide (HIP), christened Pancreate by CureDM.
HIP is a peptide, or small piece of a protein, made of 14 amino acids (the building blocks of proteins). It is a segment of a large protein that is created by a gene called regenerating islet-derived 3 alpha, or the REG3a gene. HIP stimulates the pathways that cause adult pancreatic progenitor cells to differentiate into functioning islets, fully equipped with alpha, beta, gamma, and delta cells. Because of the scarcity of the REG3a protein after fetal development, CureDM believed that a lack of HIP was the critical element preventing new islet formation, or neogenesis, in adults.
CureDM discovered that the sequence of amino acids in HIP is very similar among many species. When they made a three-dimensional model of the human REG3a protein, they found the HIP part is exposed on the outer surface of the protein, not folded deep within it, making it available to bind with the other proteins that go on to stimulate islet differentiation. And CureDM has successfully stabilized HIP to improve its availability in the body. Recent studies indicate that the dose of HIP required to stimulate islet neogenesis may be 100 times lower than the concentration required by naturally produced HIP.
So far, HIP has been producing some hopeful results. In cultures of human pancreatic ductal tissue, treatment with HIP increases insulin secretion four-fold. In diabetic mice, it triples the number of islets, essentially reversing the disease. Diabetes-related biomarkers normalize in as few as 10 weeks, and diabetic animals no longer need extra insulin after only 21 days of treatment.
CureDM is currently completing the toxicological studies required before filing an Investigational New Drug application, or IND, for Pancreate. An IND is a request for permission from the FDA to administer an investigational drug to humans. The company expects to begin clinical trials in both type 1 and type 2 diabetes in early 2010.

One in three people with type 2 diabetes are given medication too soon, instead of being urged to eat better and do more exercise, a study suggests.

The latest report that I saw suggests that Doctors are too quick to put us Type 2 diabetics on tablets (see here) . Well now I think that reports like that are very worrying, not because of the suggestion that they make, but worrying because the suggestion is misleading and the study poorly scoped.

It is reported that some people have Type 2 diabetes for years without knowing. How can that be I wonder? For me the disease came on very quickly, in December a full medical showed no illness and just a few pounds overweight, by the following June I was in full blown Type 2 and, according to my hurredly taken blood tests, only a few weeks away from hospitalisation. In the early months of the onset I increasingly felt 'old', my energy waned, my concentration was lacking and my thirst grew beyond belief. By June it was obvious to me and to my family that there was something seriously wrong. I could not have lived with that medical knowledge for years, in fact I couldn't have coped any longer. I put off going to the doctors for at least a month, even though I knew I shouldn't. I was scared to be told what I had, I wouldn't even look the thing up on the internet. Eventually I had no choice, I could not live any longer the way I was.

At the Doctors, armed with blood tests showing a skyhigh HbA1c and the records of how I ate and what I ate, my GP had only one option. Tablets. He told me that lifestyle was something I needed to look at but that a visit to the dietician was probably a waste of time, my diet was already very good. He put me on metformin, statins, aspirin and perindropril and signed me off work for a month.

In the few months since my full medical, my BP had gone from 140/80 to 200+/100, my cholesterol had gone from around 4.5 to 11 and my blood sugar was 'dangerous'. A lifestyle change by Jogging around the streets and eating more fruit and less fats was absolutely NOT going to sort out my Type 2. No way. Yet I am in the South West, I am one of the statistics in the study, the study that says Type 2 diabetics are given tablets too soon. From what I can discern, the study looked only at time from diagnosis to medication. A true scientific study should have taken many other factors into account, the levels of key indicators, the speed of onset, the existing dietary and motory habits of the patient.

I think that this study is poor, and I think this type of headline maligns the GP. My GP was excellent and did exactly the right thing for me. He is in the South West, the area covered by this report. The reporting of the frankly poor study should have given a balance, should have examined the assertions and perhaps spoken to some GP's for their opinion.

Not impressed, yet again. BBC I expect better quality reporting from you.
Rant over.

Yet again poor reporting on a major

I was sent this news report today. I am not sure of the web source, if I can find it I will append it and reference it properly. I can say that I am totally at one with this, I have so struggled with memory loss since I became diabetic, and I can assert that when I was unregulated, my blood sugar I mean, my memory was terrible and contributed to my eventually losing the job I loved. My memory is better now, but nowhere near as good as it used to be. I am trying to keep my brain exercised - but it is so tiring.

Blood sugar control linked to memory decline, study says
Spikes in blood sugar can take a toll on memory by affecting the dentate gyrus, an area of the brain within the hippocampus that helps form memories, a new study reports.
Researchers said the effects can be seen even when levels of blood sugar, or glucose, are only moderately elevated, a finding that may help explain normal age-related cognitive decline, since glucose regulation worsens with age.
The study, by researchers at Columbia University Medical Center and funded in part by the National Institute on Aging, was published in the December issue of Annals of Neurology.
"If we conclude this is underlying normal age-related cognitive decline, then it affects all of us," said lead investigator Dr. Scott Small, associate professor of nememory lossurology at Columbia University Medical Center. The ability to regulate glucose starts deteriorating by the third or fourth decade of life, he added.
Since glucose regulation is improved with physical activity, Small said, "We have a behavioral recommendation — physical exercise."
In the study, researchers used high-resolution functional magnetic resonance imaging to map brain regions in 240 elderly subjects. They found a correlation between elevated blood glucose levels and reduced cerebral blood volume, or blood flow, in the dentate gyrus, an indication of reduced metabolic activity and function in that region of the brain.
By manipulating blood sugar levels in mice and monkeys, researchers said, they tried to confirm a cause-and-effect relationship between the glucose spikes and the reduced blood volume, Small said.
Bruce McEwen, who heads the neuroendocrinology lab at Rockefeller University in New York and was not involved in the research, said the study's findings were "compelling," with important implications not just for the elderly but for the growing number of overweight children and teens at risk of Type 2 diabetes.
"When we think about diabetes, we think about heart disease and all the consequences for the rest of the body, but we usually don't think about the brain," he said. "This is something we've got to be really worried about. We need to think about their ultimate risks not only for cardiovascular disease and metabolic disorders, but also about their cognitive skills, and whether they will be able to keep up with the demands of education and a fast-paced complex society. That's the part that scares the heck out of me."
Previous observational studies have shown that physical activity reduces the risk of cognitive decline, and studies have also found that diabetes increases the risk of dementia. Earlier studies had also found a link between Type 2 diabetes and dysfunction in the dentate gyrus.
Sheri Colberg-Ochs, an associate professor of exercise science at Old Dominion University in Norfolk, Virginia, said her research has found that regular exercise, even light physical activity, can offset the potentially negative effects of Type 2 diabetes on cognitive function. It is not clear what the mechanism is, she said, but may have something to do with the effect of insulin.
"This new study is interesting in that it allows for a greater understanding of which region of the hippocampus is likely most affected by poorly controlled diabetes," she said.
But the elevations in blood glucose seen in the new study are more subtle and would not be considered a disease state, Small said.
"It's part of the normal process of aging, much like wrinkling of skin," he said. "It happens to all of us inexorably, and it worsens progressively across the life span."

Well that was a surprise. I've just appeared on the BBC website (click here). It follows an interview I gave the BBC ages ago and I had almost forgotten about it, and then today I had a very nice comment from Stuart Diamond on my entry from a few days ago. It reminded me that a few times in the past I have a had blood tests done, usually on a precheck prior to going into hospital, and they had suggested diabetes and referred me to my GP for a thorough check up. So I would go and have a check up, and no diabetes found. Not forgetting that I had an annual medical at work that included blood checks, I was supposedly diabetes free for many many years.
But now I wonder.

I wonder if my diabetes was 'waxing and waning' somehow.

I wonder if we need a better way of checking.

Anyway, I still eat healthy, I am still relatively sedentary, but do what I can. I have just built lean to and am now removing a huge old tree and preparing land for growing vegetables. I am not a couch potato, but it just takes me a lot longer to do things than many other people. I refuse to give into my arthritis and I refuse to give into my diabetes.

And people still label me as a glutton because I am diabetic. In response I mentally label them as ignorant. Perhaps I am just as bad as they are.

Blood Sugar Testing - If, like me, you are Type 2 Diabetic, you will probably have had your testing strips stopped by your local Medical practice - it may well be a simple cost cutting exercise, but in the long term it is an action that may well cost the NHS even more.

Accord undertook a study into type 2 diabetics in USA and Canada and found that intensively targeting blood sugar to near-normal levels in adults with type 2 diabetes ... does not significantly reduce the risk of major cardiovascular events, ... , but increases risk of death, compared to standard treatment.

The study set two strategies for diabetic control, one aggressively targeting A1C to less than 6 percent – similar to that found in adults without diabetes, and one aimed at lowering blood sugar levels to an A1C of 7 to 7.9 percent – a target similar to what is achieved, on average, by individuals treated for type 2 diabetes in the United States.

Other earlier medical trials have shown that lowering A1C to around 6 or better reduces the risk of retinopathy or neuropathy and thus reduces the risk of blindness or amputation. However, and this is a BIG however, the ACCORD trial suggests, (at least to me) that this is at the expense of increased risk of death, compared with and A1C of around 7. In the detail of the study, I believe that the increased risk is linked to Hypo's.

I believe that this means that improved understanding of blood glucose levels is absolutely essential for diabetics, and as such testing needs to come high up the agenda list, not removed completely. SO come on NHS, get us diabetics testing again!! Then we can know for sure if we are dipping towards Hypo's - sometimes I don't get the symptoms even though my glucose levels are very low. I think that means that I am one of those people that will go into hypo shock without realising it is coming. Now I am beginning to think to myself that I am probably going to worry myself into a heart attack and thus 'prove' the study results.



ACCORD - Action to Control Cardiovascular Risk in Diabetes is a study into why patients with type 2 diabetes mellitus die of cardiovascular disease (CVD) at rates two to four times higher than non-diabetic populations of similar demographic characteristics.

ACCORD

Sponsor: National Heart, Lung, and Blood Institute of the National Institutes of Health Studied: 10,251 patients in the USA, Canada

The following is taken from a press release on June 6th 2008.
ACCORD Clinical Trial Publishes Results --

A Therapeutic Strategy Targeting Blood Sugar to Near-Normal Levels Does Not Reduce Cardiovascular Events But Increases Mortality in Persons with Diabetes at High Risk

Intensively targeting blood sugar to near-normal levels in adults with type 2 diabetes at especially high risk for heart attack and stroke does not significantly reduce the risk of major cardiovascular events, such as fatal or nonfatal heart attacks or stroke, but increases risk of death, compared to standard treatment. Researchers from the ACCORD (Action to Control Cardiovascular Risk in Diabetes) clinical trial compared a medical strategy aimed at near-normal blood sugar levels – below current recommendations -- to a strategy to reach more standard blood sugar levels. Supported by the National Institutes of Health, the study evaluated the effects of intensively targeting blood sugar control among adults with established diabetes, high blood sugar levels, and pre-existing heart disease or at least two cardiovascular disease risk factors in addition to diabetes.

The first published results of the ACCORD trial of over 10,000 participants appear online in the New England Journal of Medicine (NEJM) today and will be in the June 12 NEJM print edition. The results are being presented at the American Diabetes Association's 68th Annual Scientific Sessions in San Francisco on June 10.

In February, the NIH's National Heart, Lung, and Blood Institute (NHLBI) stopped the intensive blood sugar strategy after an average of 3.5 years of treatment, instead of the planned 5.6 years, due to safety concerns. The intensive strategy group had a 22 percent higher risk of death – or 54 more deaths -- compared to the standard group. The increased risk began emerging within 1 to 2 years after the strategy began to aggressively lower the participants’ blood sugar levels. All participants now follow a medical strategy to reach the standard blood sugar levels while other components of the study continue.

"ACCORD is providing important evidence to help guide treatment recommendations for adults with established type 2 diabetes who have had a heart attack or stroke or who have two or more risk factors for cardiovascular disease in addition to diabetes," said NHLBI Director Elizabeth G. Nabel, M.D. "For these individuals, intensively lowering blood sugar to near-normal levels appears to be too risky."

The researchers caution that the results might not apply to patients who are at lower risk of cardiovascular disease than the ACCORD participants or to patients with more recently diagnosed type 2 diabetes. On average, ACCORD participants had been diagnosed with diabetes for 10 years at enrollment.

ACCORD's ongoing studies of the effects of aggressively lowering blood pressure and treating multiple blood lipids (cholesterol and triglycerides) in high-risk diabetic patients are expected to continue through June 2009.

"Adults with type 2 diabetes are two to four times more likely than adults without diabetes to die from heart disease, so identifying the safest and most effective ways to help them lower their risk of heart disease, stroke, and death is critical," Nabel noted. An estimated 21 million Americans have diabetes and 284,000 die from it each year. Sixty-five percent of deaths in persons with diabetes are from cardiovascular causes.

Conducted at 77 sites nationwide and in Canada, ACCORD randomly assigned 10,251 participants between the ages 40 and 79 (average age 62) to standard or intensive blood sugar treatment goals. Therapy in both groups included patient education and counseling, and treatment with any of the major classes of Food and Drug Administration-approved diabetes medications, as prescribed by their study clinician: metformin, thiazolidinediones (TZDs, primarily rosiglitazone), insulins, sulfonylureas, exanatide, and acarbose. Combinations of medications could be used as needed to reach the treatment goals.

Hemoglobin A1C levels, a standard measure of average blood sugar levels over the preceding two to three months, were used to monitor participants' blood sugar. The standard strategy group (5,123 participants) aimed to lower blood sugar levels to an A1C of 7 to 7.9 percent – a target similar to what is achieved, on average, by individuals treated for type 2 diabetes in the United States. The intensive strategy group (5,128 participants) had an A1C blood sugar target of less than 6 percent – similar to that found in adults without diabetes. To join the study, participants needed to have an A1C level of 7.5 percent or higher; at study enrollment, one-half of the participants had an A1C level over 8.1 percent.

Half of the participants in the standard strategy group achieved an A1C less than 7.5 percent, and half of the intensive strategy group achieved an A1C less than 6.4 percent. On average, participants in both groups achieved these levels within the first year of the study and maintained them throughout the study.

After an average of 3.5 years, 257 people in the intensive strategy group died, compared to 203 participants in the standard strategy group. This difference of 54 deaths resulted in a 22 percent increased death rate in the intensive group. Causes of death were similar in each group, with about half from cardiovascular conditions, such as heart attack, sudden cardiac death, stroke, or heart failure. However, the intensive group had 41 more cardiovascular deaths than the standard group, resulting in a 35 percent higher cardiovascular death rate.

"Despite detailed analyses, we have been unable to identify the precise cause of the increased risk of death in the intensive blood sugar strategy group," noted lead author Hertzel C. Gerstein, M.D., M.Sc. "Our analyses to date suggest that no specific medication or combination of medications is responsible. We believe that some unidentified combination of factors tied to the overall medical strategy is likely at play." Gerstein holds the Population Health Research Institute Chair in Diabetes and is director of the Division of Endocrinology & Metabolism and Diabetes Care and Research Program at McMaster University and Hamilton Health Sciences, Hamilton, Canada.

To meet their more aggressive targets, participants in the intensive group used more medications, were more likely to use combinations of medications, and changed medications and/or doses of medications more frequently than those in the standard group. For example, 52 percent of participants in the intensive strategy group were on three oral medications plus insulin compared with 16 percent of participants in the standard strategy group. The intensive strategy was associated with more adverse side effects from medications, hypoglycemia (low blood sugar) events, weight gain, and fluid retention.

The researchers also studied whether participants' characteristics at enrollment had an impact on their outcomes. They compared persons with and without existing cardiovascular disease, women and men, those older and younger than age 65, those with A1C levels lower and higher than 8 percent, and white and non-white participants. Death rates were consistently higher in the intensive strategy group regardless of baseline characteristics. However, compared to participants in the standard group, those in the intensive group who began the study with no history of heart attack or stroke, or with lower blood sugar levels (A1C level 8 percent or less) had fewer combined cardiovascular events – fatal and nonfatal heart attacks or strokes – during the study.

The increased risk of death from the intensive strategy surprised researchers and other experts because earlier studies had shown that blood sugar at near-normal levels was associated with lower cardiovascular disease risk in people with type 2 diabetes. However, these were observational studies, rather than randomized clinical trials, as they did not test treatments to reduce blood sugar. In addition, intensive blood sugar control has been shown in clinical trials to reduce microvascular complications from diabetes – including eye, kidney, and nervous system diseases – in people with type 1 or type 2 diabetes, and to lower cardiovascular disease risk in people with type 1 diabetes. However, the levels tested in other studies were not at as low as the level targeted in the ACCORD intensive treatment group.

The American Diabetes Association's clinical guidelines recommend that most people with type 2 diabetes reach and maintain an A1C of less than 7 percent. The guidelines also state that treatment should be individualized. For example, a less stringent A1C goal should be considered for people with severe or frequent low blood sugar or with other medical conditions.

The more I think of the events recently where I was offered a position in a local company, only to have the offer withdrawn a few days later, the more ridiculous it sounds. I was offered the position by a Director, after the position had gone through the companies HR department and had then been passed to a recruitment agency. After being interviewed by the agency and then by a manger in the company, I had my session with the director, during which I discussed my medical condition of diabetes, and the Director showed no concern at the time and the position was subsequently offered.
Now the offer was withdrawn a few days later and the reason given was that the US arm of the company had not given approval for the vacancy. I find it incredible that a company the size of the one that I am talking about can require overseas approval for local junior positions. I even offered to work as a team member with a view to getting the Supervisory role if and when it was approved, this was not acceptable. May be it is paranoia, maybe not, but I really cannot believe the reason I was given. It feels to me much more like second thoughts after considering my health situation.
Well that is their loss. They have lost some one vastly over experienced to do the role, who would have been a great asset to the company, and who was looking to stay long term and establish a new career.

I am now attending my local pain clinic at the hospital and going through various ways of better dealing with chronic pain. You might think that having had constant pain since being a teenager, I would be well versed with dealing with it by now, but I still think that there are new tricks to learn, and I am not an old dog yet!

DIABETES TYPE 2 - A REFRESHER

I thought it worth a quick overview and refresher on type 2 diabetes, you may have just been diagnosed and wonder about it, or a friend or co-worker may have just told you that he/she has it.


Diabetes is a CHRONIC disease, which basically means long lasting. It has NO CURE, treatment is mostly to mitigate the side effects which most likely would lead to premature death if untreated. Diabetes is typified by a metabolism that is awry and also abnormally high blood sugar levels. It is caused by too low levels of insulin in the body. In Type 1 diabetes the pancreas stops producing insulin, in Type 2, the body becomes resistant to insulin and the pancreas simply cannot produce enough insulin.

Main symptoms are high blood sugar levels which cause increased urinating and blurred vision, dehydration caused by increased urinating leading to an abnormally high thirst, tiredeness or lethargy and an unexplained weight loss.


Diabetes Type 2 can go on to cause many ACUTE complications such as a doubled risk of heart and other cardio vascular problems, hyperglaecaemia, renal failure, optical (esp retina) damage, nerve damage.

CardioVascular problems affect the arteries and veins, and as this system is the most important 'bit' of our system that keeps us alive, any risk to it needs avoiding. Untreated Diabetes Type 2 is a very large contributor to CV problems. CV problems can lead to death. It is vital to keep blood pressure down ( I am advised 130/70 is my target, scarily I did get to 200/100 when my diabetes first struck), keep cholesterol levels down ( I am advised to get mine down below 4, it was well over 7 when diagnosed, had previously been as high as 11), and even more importantly, do not smoke. (I Don't, so didn't need to give up).

Hyperglaecaemia or a HPYER (not to be confused with HYPO which is a predominantly Type 1 issue), is also known in America as HONK (hyperosmotic non-ketotic acidosis (HONK)), typically requires the blood sugar to be over 33mmol/l (mine was at 27 when I was diagnosed). As I understand it you get into a cycle of increased urination which causes increased dehydration and (strangeley) increased urination ..... Leads to Myocardial Infarction, Stroke, Thrombosis, Motor Impairment, Focal Seizure, can lead to death.

Renal failure or Chronic Kidney Disease caused by untreated Diabetes Type 2 causes a loss of kidney function (Dialysis for the rest of your life) and development of cardiovascular disease which we have already seen can lead to death. It is important to reduce alcohol levels (if you drink a lot), and also not to drink too much water (which can bring its own complications)

Retinal damage ( AKA Diabetic Retinopathy) is caused by the growth of poor quality blood vessels in the eye and can lead to blindness.

Nerve damage (AKA Diabetic neuropathy) can lead to severe complications starting at limb extremities. Healing time can be poor, and simple cuts or small wounds may be become infected, leading to gangrene and amputation. Loss of sensation or tingling (pins and needles) can be an early symptom.


I AM NOT A MEDICAL PRACTITIONER, so if you suspect that you are diabetic, or have any of these symptoms, then for goodness sake, go and see a doctor and get proper treatment.


My boss when I told him that I had diabetes, said "oh thats easy, just ease up on the sugar" I think that was an "Ignorant and foolish comment from someone who should think before commenting" (That is the polite publishable comment, at the time I just thought 'stupid p**t'.

At the moment, it cannot be cured, you cannot just get a Pancreas transplant, because it is often not that you are not producing insulin, but rather have become resistive to it. The Pancreas might be the only bit that doesn't need changing. I did read an article ( I forget where) that suggested that the problem may be in part of the small intestine which may be producing an unknown hormone that counters the effects of insulin. This is as a result, I believe, of gastric bypass ops in morbidly obese people, over 50% of which go on to no longer have diabetes. As far as I know there has been no clinical study that has lead to a definitive statement that leads to a cure for Type 2 Diabetes.

THE MOST IMPORTANT THING is that if you get it under control, and that has to be with the aid of a practising doctor, the complications lessen and the risks become manageable. You still need to be careful of course, see an opthalmist and podiatrist regularly for checkups (apparantly the feet and eyes are the furthest reaches of the CV system and the first to show symtoms). You need to get your meds right - too much diabetic medicine can cause a HYPO (two little glucose) and coma, too little can cause a HYPER (see above).

When you are diagnosed you may be put on STATINS and ASPIRIN straight away, Statins will help reduce cholesterol and low dose (typ 75mg) of Aspirin to reduce the risk of developing blood clots. Depending on other factors, you may be advised on diet and exercise, and you may be given medication, such as METFORMIN to control your diabetes.

YOU CAN LIVE WITH DIABETES, IT IS NOT A DEATH SENTENCE. (Did you know that being born is the only actually guaranteed death sentence?). You must take control of it and not let it control you.

I have been interviewed at Dipex and you can see my thoughts in full there. (LINKed on this page). Your doctor must be your first point of call, but I am happy to discuss further with you, or your loved ones, co-workers etc if you want, just contact me. Hopefully you know a bit more about diabetes, and hopefully you will also have searched online for more info on diabetes. For me the biggest gripe is that most people still think of it as a fat persons disease. True fat people get it, but i'm not fat and I got it. There is more to diabetes than just overeating! There can be so much more to life if you don't give in to diabetes.

Well now, sometimes things seem so obvious that they don't get told, and then when they are reported as news it seems like 'non news. The BBC have a report on their site (CLICK HERE) about the MED Diet and how it may help prevent type two diabetes. Now I know that the testing was not really a map onto real diabetic age groups, but, has no-one read the report that I read about a year ago about how much lower the incidences of type 2 are in some areas of the med? I wish I could find the original report. It didn't really help me, I am not fat, have a lot of fruit and olive oil in my diet yet I am still Type 2. But then those of us that are the exceptions probably prove the rule.

I have been lined up for an interview with a reporter from the beeb because of my 'Its not just a fat persons disease' stance, so I will hopefully be able to balance the views a little.

Another of the so obvious it didn't need saying until someone said it was on another report I saw at the BBC website (CLICK HERE) As we get older we need more care, especially us diabetics, and we are not, aparantly, getting the right care. It seems that we get more frail as we get older (der!) and perhaps diabetes causes an increased fraility. Hello, it's a chronic condition, just ask a diabetic how they feel. I recall that when the diabetes came on, I have never felt so ill and so old. In fact, looking back, the clues were there. In the 12 months prior to it 'coming out', I was beginning to really 'feel my age'. Now that I am stabilised and living with 20 odd tablets a day, I actually feel like I did 10 years ago, so that 'feeling your age' thing is a load of old tosh.

AND FINALLY, well I guess that I am better off having changed from the aspartme laden diet colas to the Sainsbury's cola which doesn't use aspartme, but my urine is a lovely shade of burnt umber now!

We are back from the holiday on the Island of Manhatten and back with the Islets of Langerhans. Interesting read on Diabetes Self Testing here. It also explains, perhaps, why my GP practice is discouraging the practice of self testing, and has taken the strips off my repeat prescription list.
When I was newly diagnosed, I found self testing hugely helpful in understanding my condition and what effects various foods had on me. I tested myself before every meal and two hours after I had eaten. By keeping a log in Microsoft Excel it was easy to turn the figures into a graph which gave a very visual representation of what was going on. When my GP changed my medication, the effects could be seen on the graph, when I 'sinned' foodwise, the effects could be seen. Far from leaning me towards depression, the practice of self testing helped me understand and come to terms with diabetes.

Now I only self test 2 or 3 times a week, just to make sure that I am still well in control. The biggest lesson I learned? That white bread is a no go area for me as a diabetic. Brown bread is typically half the sugar of white bread, and lowers my blood sugar by around 1 point compared to white.

A few new diabetes related news items I spotted.

This first one talks about vitamin supplements, look here, and suggest that low levels of vitamin B may be a factor in the complications that can result from diabetes. Apparantly diabetics have alow level of thiamin in their blood. The same thing is also covered here

The second article, here, talks about bones. Professor Karsenty said: "The discovery that our bones are responsible for regulating blood sugar in ways that were not known before completely changes out understanding of the function of the skeleton and uncovers a crucial aspect of energy metabolism. You need to read it.

“What the public needs to know,” Dr. Guallar says, “is that most people in the have adequate selenium in their diet. Moreover, taking selenium supplements on top of an adequate dietary intake may cause diabetes.”

Selenium rich foods include shrimp, crab meat, salmon, halibut, brown rice, light chicken meat, and pork. Brazil nuts from selenium rich soil are one of the foods that contain the highest level of selenium.

A scientist affiliated with foodconsumer.org suggests that just one dose of selenium supplements in the study can not rule out other positive effects associated with other usage levels. He says selenium is an important micronutrient. But like many others, too much of a good thing can be bad. He suggests consumers should follow a nutritionally balanced diet to prevent chronic diseases such as cancer and diabetes.

So concludes a report that shows a group of people taking selenium supplements had an increased take up of Type II Diabetes, compared to those in the control group that tool placebos.

Read the article HERE .

Who would have thought it? The Gila Monster has a feature that helps us diabetics?

The drug is the first incretin memetic to be approved and works by mimicking the action of naturally occurring human incretin hormone, glucagons-like peptide-1 (GLP-1).

Byetta has been shown to stimulate insulin secretion only when blood sugar is high, and can even restore the 'first-phase' insulin response, an activity of the pancreas' insulin-producing cells that is lost in patients with type II diabetes.

Now is that bloody magic or what? Of course now I am worried that they are going to have to trap and kill a load of lizards just to help me.

So the latest thing seems to be, don't give us drugs to manage diabetes, make us change our lifestyle. Here are a couple of news items I picked up on recently:
CBS News Report
and
BBC News Report

Interestingly, I am NOT overweight, I don't eat unhealthily and haven't for many years, yet I am Type 2 diabetic. I have been told that I HAVE the illness and it won't go away, it cannot be cured. The tablets, and I am on avandamet as it was the one that eventually managed to get my blood sugars down below 7.0 (most of the time), keep me in check, they help regulate my body, they do not provide a cure. My question is, who are these people at the Mayo clinic talking about? For me, these tablets do not prevent Diabetes, they help control what I have. Are they advocating that I stop tabletting and adopt lifestyle changes in order to keep my blood sugar down? But I already have it, so, are doctors prescribing these drugs to patients who haven't got Diabetes, but might get it because they are fat / overweight / inactive ? I don't understand.

Another intersting story on the genes front emerged this week:
http://www.chinadaily.com.cn/world/2007-04/28/content_862461.htm

I quote "Despite its growing global prevalence, the disease's underlying causes have been only minimally understood, restricting treatment and prevention efforts." from the above source. MINIMALLY UNDERSTOOD. I read that after I was still seething about the Mayo professors and their apparant generalisation that type 2 diabetics are overweight and immobile.

More and more I feel like a leper, perhaps I ought to get some T SHirts printed up with 'It's in my Genes'

Scientists say they have mapped the most important genes that put people at risk of type 2 diabetes, offering hope that a test could be delivered.
The findings could explain up to 70% of the genetics of the disorder which affects over 1.9 million UK people.
Family history is a major risk factor for the condition, along with obesity.
See http://newsvote.bbc.co.uk/1/hi/health/6342855.stm for more

and

More evidence has emerged suggesting a link between pollutants found in oily fish and type two diabetes.
An international team found high levels of persistent organic pesticides (POPs) in the blood correlated to insulin resistance, a precursor to diabetes.
see http://news.bbc.co.uk/1/hi/health/6544709.stm

Interesting that as a man at under 16stone (ie under 98Kg) and at 6'2 " tall, I am in no definitiion obese, yet nearly everything i read points to obesity being the major contributing factor to beming type 2 diabetic. Indeed when I went to the Diabetics Session run by my local Health Authority, i was the thinnest person there, yet I now feel 'fat'

It is depressing

An update on the meds. After 4 weeks on the Avandamet I had gained over a stone in weight, pushing me over the sixteen stone and adding over 2 inches to my waist. Apart from the fact that trousers don't fit and shirts are tight, the biggest threat to my health is, according to my diabetic specialist nurse, the extra weight around my abdomen. It is this weight in particular that seems to affect the ability of the body to produce sufficient insulin and to deal with the sugars in the system. It seems strange to me that the very drug that is supposed to resolve my diabetes problem is actually exacerbating it.
My GP has prescribed Xenical (120mg orlistat) alongside the avandamet to help me lose weight. After taking it for two weeks, I haven't lost weight, but I have seemingly stopped putting it on. I have stablised at 16s 2ib and a 39" waist. That is over a stone heavier than I want to be, and 2 inches more around my waist than is healthy or advisable.
What at first I put down to the xenical, i.e. an absolute need to be no more than 3 paces from a toilet, I now suspect was food poisoning. Two days after starting the xenical I was suffering greatly from the gallops (actually, more of a slow knees together shuffle, in a quick sort of way), and I strongly debated whether I would be able to cope with xenical, but that only lasted around 48 hours, and now I am back as I would normally be. With the violent lower gut / stomach pains I had as well, I am now more inclined to put that down to a gut infection of some sort.
Ongoing I have blood sugars averaging at 6.9 around 3 hours after food. My BP is averaging 150/90 and I have no energy, absolutely no energy to do anything. It is a struggle of willpower to get up and go to work. By midday, I am absolutely wasted, and I am in trouble if this is the long term future for me. Right now, I don't even have the energy to write, hence the authoring has slowed down to a virtual stop. My mind is still active, I just really can't be bothered to type much.
So it seems that I shall need to review my meds once more when next I see my GP.