Sugar Turned On Me

Today, my wife asked if it was okay to put some measurements of me online (I’m looking for a gently pre-owned Utilikilt). I said it was okay, but wasn’t sure why she’d felt the need to ask. She wondered if I’d mind that the world know that I have a 38″ waist.

This got me thinking.

One of the peculiarities about the human condition is that things which should be simple statistical facts often come with stigma. The come with pride, too, sometimes but in the end, things like weight, height and proportion are just numbers. Numbers that change at that.

I appreciate her concern and don’t fault her for asking. Most people would consider such a thing a personal detail and the sort of thing that one should be able to control access.  But some things I can’t afford to be shy about.

There are numbers that I might endanger myself if I ignore or try to hide, like my blood glucose and my weight. They are nothing about which I should be ashamed; I take responsibility for them, but I don’t think that they are comments on my character. The numbers only matter inrelation to other number, really, so why should I worry about them?

I’m 5′7″, 200-210lbs. My last A1C was 5.7 and my blood sugar this morning was a glorious 88, the lowest number it’s been in months. I fear none of these numbers and even when they have been higher (except for height, which pretty much just stays there) I have never felt that they were  score or that somehow indications of failure. They are just numbers. Saying them aloud will not hurt me.

Keeping them to myself, though? That just might.

In part two of the fact finding mission begun yesterday, I went looking for studies about vinegar and diabetes. To recap, I found someone saying they’d lowered their blood sugar with vinegary pickles and garlic before bed. While the garlic may have had no real effect on his glucose levels, information I found suggests that the vinegar might.

Vinegar is acidic and the acetic acid in vinegar may be able to effectively lower the glycemic index of foods. This means that the spikes after meals will be lower. People who use vinegar before meals also report they feel more full afterward, helping with overeating.

At least one study was done where subjects, none of whom were diabetic, were given bread soaked with apple cider vinegar before meals. The ones who were given the bread had lower numbers than those who didn’t.

The recommended dosage comes out to around two tablespoons. This can be taken straight or mixed with a little water and/or honey. If you’re going to try this, please tell your doctor first. Some people have had averse reactions to drinking vinegar and there is some connection between using vinegar and damaging the enamel of your teeth over time.

I don’t know that I’ll be jumping into the vinegar pool anytime soon, but it’s good to know that there is some basis to the rumor. Diabetics need all the help they can get and knowing you might already have said help in your pantry is good, good thing. So for those who are willing to try it, good luck, pinch your nose and hopefully you’ll see those numbers drop.

By many accounts, I’m a pretty laid back guy. When I find myself bickering, I usually have to take a step back and ask myself what the cause is and if there are any outside influences to my demeanor. Recently, due to some conversations where I was a lot shorter tempered than I should have been, I wondered if one outside influence might lie in diabetes.

The American Diabetes Association lists irritability as a symptom. Separate studies have been done for both Type 1 and Type 2 diabetes to see if they effect moods. Results showed that there were correlations between hypoglycemia and memory as well as between hyperglycemia and aggression.

Depression also accompanies getting diagnosed. This is true for most chronic illnesses though, so no big surprise.

What information I found pointed out that one’s sugar needs to be significantly out of whack for it to affect your moods. Some people were suggesting that your blood sugar would need to be in the over 180 range before you’d start seeing problems. I’m willing to bet, in my very not at all an expert opinion, that lesser numbers will still effect your moods, but more exasperating minor issues rather than creating them all on their own.

I have yet one more reason to keep a blood sugar diary again, to track my blood sugar vs. my moods. This is recommended to get a more concrete picture of what your diabetes is doing to your state mind. But even before I start, it’s nice to know that I’m not crazy; there really is a connection.

Item the First:
Aspirin can help with heart health. People who take aspirin regularly have a lowered risk of heart attack or stroke. If you didn’t already know this, then Bayer is not spending enough on TV commercials.

New research shows that people who have no heart disease, however, show no added benefit from taking aspirin regularly. In Britian, doubt is rising that diabetics and people in other high risk groups  should take regular doses as a preventative measure.

But don’t just take my word for it: Diabetes Aspirin Use Questioned

Item the Second:
Saying that diabetics benefit from controlling their blood sugar is kind of like saying that hungry people benefit from eating. A study released in early September of 2008 elaborates on the obvious by showing that Type 2 diabetics who keep their blood sugar under control in the first 10 years of discovering they have the disease significantly lower their risks of heart disease, eye disease and kidney damage.

Additional words about this subtle but interesting discovery are to be found here: Blood-sugar control lowers diabetics’ risks.

Item the Third and Last:
Type 1 diabetics know better than anyone about the irritation of having to stick yourself with sharp objects multiple times a day. In a development that might keep save those with Type 1 some suffering as well as give them the opportunity to tell people that they are cyborgs, doctors have developed implanted monitors, worn under the skin. Using such a device on a constant basis has shown promise in better keeping their diabetes under control.

The salient facts can be found here: Under-The-Skin Blood Sugar Monitor Boosts Diabetes Control.

The past 24 hours have been an interesting ride, and I’m not talking about the Biden/Palin debate or the $700 billion bailout. It’s much more personal, red and sticky.

Since my diagnosis, my blood sugar has remained reasonably stable. I get a few spikes here and there and they concern me. Sometimes my blood sugar even stays high for a while. But last night, I was doing not much of anything, just shopping for groceries, and I bottomed out.

I’d been fine all night but suddenly, it was hard to concetrate. Then there was the mild headache. I was thinking many thoughts but not able to follow through on any of them. If I’d not had a list to go by, I don’t think I’d have been able to get through my shopping. I was going to have dinner when I headed home, but decided to grab a single serving chocolate milk to boost me up a hair.

When I got up this morning, after too little sleep and a reasonable dinner, I had a blood glucose of 120. This is about 10 or 12 points higher than it’s been lately. Then I had breakfast. By lunch, I was having the headache again. My blood sugar was only 90, well within normal limits, but I was back at the place I’d been about 12 hours before.

There are people who have it much worse than this and on a more frequent basis. It’s not that the number concern me all that much, it’s that it’s a hard shift to get used to. I’m diabetic, so I expect my blood sugar to be high now and again. The crashing is what I wasn’t prepared for, having to eat because I can’t think straight.

And what’s worse is that other than getting about an hour’s less sleep than usual, I did nothing all that different from the night before or the one before that.

I’ve heard other diabetics talk about the Diabetes Fairy, a capricious being that brings us our blood glucose readings from day to day. Sometimes she likes us, and sometimes she doesn’t.

Today, she gave me tickets to a roller coaster, which might be fun if I’d wanted to go on a ride, but is no fun if you just wake up and find yourself about to go over that first hump.

Can’t I just switch to the teacup ride again?

I’m a big fan of paraphernalia. Not just the word, even though it’s fun to say, but the whole of accessories that go with any hobby or lifestyle. In the case of being diabetic, that’s my blood sugar monitor.

I only have experience with two blood sugar monitors. Were it not for an insurance snafu, I’d have experience with only one. The good thing is I’m not unhappy with the one I use now. It’s called the One Touch Ultra Mini from Lifescan.

The name makes it sound like a brand of tampons, but that aside, it’s worth a look.

First off, the price is right at under $20.00. The basic package includes the monitor, their lancet device, lancets, a spiffy carrying case, some fluid for testing strips and little booklet that discusses how to live as a diabetic. No actual strips though.

One of it’s selling points is that it’s small, about four inches long. With or without the case, it’s convenient to carry. Between this and the price, it makes a good backup monitor for travel. It even comes in four colors, which depending on your opinion of accessorizing medical equipment, could be either a plus or a minus.

It stores your past 50 results. It’s got no other tracking features, but that’s the trade for it’s cost and size. It’s error messages are pretty straight forward. It and the lancet device are also set up for alternate site testing (I’ve only done that once, but the results were satisfactory).

The strips The Ultra strips come for about a dollar a strip before insurance, which seems about typical. The drop of blood required isn’t large, the usual pin head size. They’re coded strips which I’m less fond of, but more on that later.

The Lancet device, pictured above here, is pretty good. Adjusting it for a deeper or shallower poke is easy and the cocking mechanism is straight forward. I use it with bargain lancets and have never had a problem.

I’ve not done any in depth accuracy testing with it, like testing against other monitors, but I’ve been satisfied… mostly. Once, I had a batch of strips that returned a consistently 10-15 point higher result than I was expecting. The batch of strips tested normal, so it could have been coincidence but my readings went back to normal when I bought the next batch. The only other time I’ve gotten a questionable result was when I gave it an almost too small sample and it was 40 points different than when I tested again with a new strip and proper blood dot.

While I use it as my main monitor, I’d recommend it to others as a backup without reservation and a main with only a couple of caveats.

When I started this blog, I had visions of medical companies sending me samples of their wares and reviews like this being a regular thing. Until then, I’m happy with my little informative vampire. But I’m staying away from the lime green version.

I mean… seriously? Lime green?

As a vegetable, it took me a while to warm up to broccoli. Like most people, I first only enjoyed it doused in cheese or ranch, then later steamed and seasoned and only recently raw. Now I find it a wonderful dipping tool for hummus.

There may be reason for me to go grab more broccoli, that being that research is showing it may reverse damage to blood vessels caused by diabetes.

The basics, if they can be called that, go something like this: There are molecules in your body called reactive oxygen species. They are a natural byproduct of your cells metabolizing nutrients and they have functions in the immune system and healing. But like many things in the body, it’s all about balance because they also have a function in telling the cells in your body when they should die. Have too high a level of them in your system and cells start getting damaged.

Hyperglycemic folks such as my self often have damage to their blood vessels due to complications from their disease. Damage to blood vessels lead to heart disease which leads to very bad things.

Now enters broccoli which has a compound in it called sulforaphane which has already been studied as a cancer preventative. The broccoli study has shown that sulforaphane reduces reactive oxygen species which helps the body repair damage to blood vessels caused by hyperglycemia which then lowers the risk of heart attack and stroke.

Got it? Good, there will be a quiz.

The research is ongoing, so don’t take this as a proclamation from the heavens or anything. Further studies may further quantify the extent to which broccoli may help with heart disease as well as determine if other sources of sulforaphane like cauliflower, cabbage, boy choy and other vegetables produce like results. Do your research before any radical changes to your diet.

Me, I don’t need much of an excuse to eat broccoli. If you do and you have diabetes, you may have just found one.

The BBC Article on Broccoli and Blood Vessels
Wikipedia’s article on reactive oxygen species
Wikipedia’s article on sulforaphane

There are times where I feel like I’m a poser diabetic. My case is pretty mild and what I need to do to keep it in check is pretty trivial. I don’t feel any different than I did a year ago (well, maybe a little more energetic). There’s no visible signs of my disease. At times I’ve even wondered if my doctor told me I was diabetic just to make me stop downing three Baconaters a week.

I might have not changed my life at all except there were these numbers. Like 450, which was my triglycerides which made my  bad cholesterol numbers incalculable. Then there was 6.5, which was my A1C, a number that I didn’t even know could be measured before I was told it was confirmation that yes, I was diabetic.

Last week, I wrote that I’d gotten a little scared by my daily blood sugar measurement being at 120 and a nice lady responded encouragingly that the number wasn’t that high. I’m thankful for the consolation, though in truth I already know that I’m dealing with much less of an issue than some others. The only reason it made me concerned is that it was bookended by two days of 100 mg/dl. I have a good number of days were my blood sugar is only two digits, so a 20 point deviation is a big deal to me, even though I know there are people who are happy when theirs is below 300 on a given day.

Despite my diagnosis, I consider myself lucky. I think my problem got caught early on enough that I have a good chance of minimizing it’s impact on my health and on my life. The temptation is to think that because my case is mild, I don’t need to worry about it. But I’ve got these numbers and that’s enough to keep me honest.

In three months, I dropped my triglycerides to 175 and my A1C to 5.7 and I’m really happy about that. It would be easy to let myself think I’ve gotten this licked and in another three months be back to my old diet, putting myself at risk. But in this case, it’s good for me to take great care of small things and up my chances I’ll be around to see retirement.

Diabetes, after all, is serious business.

I’d like to ask, for my perspective and for the perspective of anyone who might be reading this that if you know what your blood sugar was this morning, reply with it. It might help someone like me understand how good we’ve got it… or where but for the grace of the gods we might go. Thanks. 

I had a checkup last week and my doctor was happy with my numbers. After three months of lifestyle changes, I got the official nod that my numbers were looking much better and that I was controlling my blood sugar. It was a good thing to hear, a validation for the efforts I’d been making. My blood sugar appeared to be getting under control.

Then came yesterday. My blood sugar was 120. As in twenty points higher than it needed to be for a fasting result.

I went over what I’d eaten the night before and double checked in my head that I’d not gulped something down for breakfast and forgotten about it. Nothing obvious culprit appeared. I went over other factors and then did a web search to confirm what I thought was giving me the unwelcome boost. It took but a few moments to confirm.

Stress.

That morning I’d been thinking about monthly bills, a vacation my wife and I are taking, events we wanted to do next year and the anemic state of my bank account and all were adding up to a bit of panic. Apparently, your body deals with such freakouts the same as if you were in the woods, facing down a dozen hungry wolves. Your fight or flight response kicks in. Your body demands fuel so you can run screaming. As a result, your blood sugar goes up.

Now most of us don’t have to face down hungry wolves, but we do have enough to concern us that it’s not hard to get stressed out on a regular basis. Knowing that stress is demonstrably effecting your health may even give you more to stress about. But worry is concern without action. It’s a waste of effort. While that may be difficult to remember in the midst of one’s gloom, it’s the truth.

Today I’m in a better mood and despite having a much more sugary menu last night than the one previous, my blood sugar was at normal levels. While I’m not 100% stress free, I am doing better.

Here’s some things I can recommend to help banish the stress when it hits you:

1. Don’t keep it to yourself - Talk to someone about what’s going on with you. The outside perspective can lead to solutions you might have missed because you’re a bit to clouded. Also, once you’ve spoken your problems, the sometimes seem smaller out in the open than they did trapped in your head.
2. Remember to Breathe - Worry shows in your body. Sometimes making a conscious effort to relax the body helps the freak out dissipate. Ten deep breaths is usually all it takes to aid a new perspective.
3. Escape - Go walk around the mall. Watch a movie. Take ten minutes to sit outside and stare at the sky. Do something to hit the reset button in your head. While too much escapism is a bad thing, a little when your hands are shaking can mean the difference from feeling trapped to feeling okay.
4. Make a Plan - I know my biggest source of stress comes from not knowing where I stand, not knowing what I’m going to do. Even if it’s just a skeleton of an idea, write down what’s hurting you and then write down what you can do about it. Get creative. Take back your life.
5. Count Your Blessings - The irritants in our lives are more often than not more noticeable than the comforts. By taking the emphasis off what’s troubling you and focusing on the good things in your life, I find that things soon get put in perspective.

I can’t guarantee that what works for me will also work for you. But I do believe that when all goes to hell, there are are always ways get back out.

Listen to your body. Clear your mind as needed. Remember that no matter what’s going on the sun will rise tomorrow, someone is likely to have been in the place you’re in now and in the end… it’s really going to be okay.

I collect swords. I’ve taken classes to teach me how to use them. I keep them hanging on my walls, tucked into corners and resting next to my bed. I admire the simple beauty of them, the efficiency of a sharp piece of metal designed to interrupt integrity of the epidermis. I’ve never feared them.

And yet, a needle less than an inch long intimidates me.

Part of being diabetic is sticking yourself, drawing that tiny crimson dot that your digital vampire, i.e. the ever present monitor, requires to let you how your blood sugar is doing that day. It’s one of the simple facts you accept the moment you start dealing with the disease. You will bleed every day, sometimes many times a day, from now until your blood flows no more.

For some, I imagine this is an easy reality to accept. My wife was fascinated by the concept. I’ve spoken with others who say it’s no big deal and feel no pain in the process.

That’s not me. The first time I took my blood took 2 testing strips, 3 lancets, and 30 minutes. I sat there, trying to press the button on the lancet device while the subtle pressure required to trigger it seemed more force than my fingers were capable of producing. I could feel the blood drawing back towards my heart, my body unwilling to co-operate as I performed this unnatural act. I had to insert the strips into the monitor more than once as the device timed out and turned off waiting on me. When I tricked myself into pressing the button, I flinched and just put a tear in my skin that produced little result. I the repeated the process, the anxiety no less the second go round, and at last yielded the desired sample, feeling as if I’d just performed minor surgery.

Knowing that in the long run this wouldn’t do, I asked around. After much trial and error, talking with friends and getting pointers, I’ve worked out the following tips:

1. Before the poking, shake your hand like it was wet and you were trying to fling water off. This will get blood into the fingertips.

2. Use the side of your finger. The pad will be more sensitive and will make typing hurt.

3. Most lancet devices are adjustable, allowing you to make the needle penetrate deeper or shallower. Remember your pinky isn’t going to require as deep a poke as your middle or ring fingers.

4. Change fingers every couple of days. I personally don’t take blood from the same side of the same finger more than 3 days in a row. Take blood from your index finger last as you use it more.

5. If blood doesn’t come out immediately, don’t worry. Just massage the area a bit. If you do that and not much comes out you may be pressing too hard. Stop, let blood come back to the area and massage it a little more.

6. Keep in mind that you’re going to need to dispose of something sharp. Most lancets come with a cap or something to put the needle into after use, but you may want to keep an empty water bottle or something similar to have as a “sharps” container.

I’ve gotten my blood draws down to a quick few moments now. It is something you never think you’ll get used to, but you do. Just load the device, put it to your skin, look away if you have to, and click… it’s done.