Diabetes, Drinking, and Delusion

“Who me: never!”

Even the most indirect and subtle questions about alcohol abuse or addiction inevitably draw indignant denials. People graduate from social to habitual drinking, oblivious of the developing addiction.

The drinking habit, even if occasional, calls for special precautions in diabetes. Please see my post of December 27, 2006 in this web log.

Are you in danger of drinking more than you should? Visit the following link, which I retrieved earlier today, to check on your relationship with alcohol:

http://www.mayoclinic.com/health/alcohol-use/MH00123

Let me know if you need help to improve your score.

Pre-Conception Diabetes Prevention and Pesticides

The metabolic syndrome, poor dietary habits, family histories, and sedentary lifestyles, are all known risk factors for women to develop gestational diabetes, but do pesticides also play a role? Farm labor and wives of male farmers do occasionally come in contact with pesticide concentrates, drift, and residues, but information on how such exposures impact diabetes is limited. The following link, which I accessed earlier today, is an example of the uncertainty which surrounds connections between pesticides and diabetes:

http://www.nlm.nih.gov/medlineplus/news/fullstory_46736.html

This link is available on the Internet for a limited period of time. Please write to me for the substance of information available on this link if you happen to try and access it after it has been removed.

I think it is best to separate the issues of pre-conception diabetes prevention and exposure to pesticides. Diet and exercise should suffice to keep gestational diabetes at bay, and close monitoring of glycosylated hemoglobin throughout pregnancy will ensure that both mother and fetus stay well.

Pesticide exposure has a number of risks apart from the open question of diabetes, and it is safest if all women of child bearing age avoid contact with these chemical toxins in any form.

Gestational diabetes and pesticide exposure have serious consequences for fetal development. Health literacy about such matters is a crucial part of pre-conception care.

Please mail me if you would like more information about gestational diabetes, pesticide exposure, and how to manage such risks.

You Can Stem the Alzheimer’s Rot in Diabetes

I do not know about you, but I fear old age more than death! It is not just a matter of diabetes. Even my loved ones with normal glucose metabolism should have someone to provide total and loving care, should they live to lose some of their mental faculties.

Everyone needs to know about dementia, because we may be called upon to look after a parent even if we do not suffer from any type of this dreaded condition ourselves. Alzheimer’s is the best known, but not the only form of dementia.

Medical scientists are not yet certain about the causes of various kinds of dementia including Alzheimer’s. There are a few studies which indicate that there may be links with diabetes, but we are not sure of the inter-connections as yet. It is known however, that poorly managed diabetes will damage blood vessels that supply nutrients and oxygen to deep recesses of the brain. It is therefore reasonable to assume that excellent diabetes management will help keep brains in good working condition as we age. Unfortunately, keeping blood glucose under control is not a guarantee against dementia, but it could help to delay onset and progression.

Some amount of loss of mental faculties is normal with ageing. It is therefore nearly impossible to distinguish various kinds of dementia from normal ageing. Experienced clinicians can make informed judgments, especially with the aid of modern brain scans, but only an autopsy can support a confirmed diagnosis.

There is no room for despondency because there is much we can do to manage dementia. Here is an outline of 3 points which you should discuss with your Primary Care Physician, or mail me for individual counsel:

1. Keep blood glucose within normal levels at all times. Monitor your glycosylated hemoglobin every 6 months to make sure that you have your diet/exercise/medication blend just right.

2. Exercise your brain. Nerve tissue is like muscle in the sense that it wastes away if you do not use it. Work on your logic. Write on subjects you know well-even if no one reads it! Learn new subjects. Throw away calculators and do sums in your head. Memorize songs, psalms, or whatever you like.

3. Ask a Psychiatrist to monitor changes in your GAF (Global Assessment of Functioning) every year. This will act as an early warning system, and help you stave off or slow down any type of dementia.

Since there are no firm assurances available in this area, you should be proactive and tell people such as your doctor, close family, and best friends, how you would like to be treated should you develop dementia. Hopefully, such decisions will never have to be implemented, but it is comforting to decide on how to deal with such extreme tragedies on your own, rather than have others think on your behalf

Dementia incidence good rise dramatically as life expectancy grows. It is now possible to live much longer than ever before, even with diabetes. It will pay to be forward-looking, and to prepare for comfortable and dignified life in old age.

A Possible Solution to Insomnia in Diabetes

Juggling with the Glycemic Index of each item of diet is central to managing diabetes. Choice and timing of medicine depends on what you choose to eat, how much you eat, and exactly when. Many complications of diabetes arise simply because patients get tired of diet restrictions, and just eat or drink on impulse. Worse, work or travel may delay a meal, making you vulnerable to dangerously low blood glucose as prescribed medication taken earlier continues to work.

Close cooperation between a diet expert and a patient helps every physician who manages diabetes, to do a better job. A part of meal planning is the quantities and timings of carbohydrate intakes, since they raise blood glucose relatively quickly. I just came across the following link, which suggests that taking some of your carbohydrate quota at night could help you fall asleep sooner:

http://www.medscape.com/viewarticle/552716?sssdmh=dm1.250543&src=nldne

This is merely a preliminary finding, but it fits in with my personal experience that a couple of spoonfuls of rice helps me with some quick shut-eye. I avoid eating the delicious white stuff for lunch on a working day because you never know when the boss drops in and catches you napping at the desk!

Some folks have trouble getting to sleep at night, and many take tablets to help with insomnia. Why not try some rice instead? You have to ask your nutrition expert first though, if you have diabetes!

Sweet dreams!

A Useful Step towards making it Easier to Take Insulin in Time for Diabetes Management

Insulin scores over oral medication for diabetes because it does not have many of the side-effects of the pills we are prescribed for this disease. However, forgetting to take a dose of insulin, or taking too much, has serious consequences. Doctors always worry that patients may suffer the serious consequences of extreme blood glucose level variations due to lapses in insulin medication.

Digital recording of insulin doses and timings go a long way in improving the safety of this hormone administration. A simple but very useful innovation is to allow such automatic recording on an insulin device. Such a product is now available by prescription in the United States, and should soon become standard features on all insulin pens and syringes everywhere in the world.

Ethnic Minorities May Fall Prey to Diabetes Because of Changes in Traditional Diets

It is common knowledge that many processed food brands have unhealthy combinations and levels of saturated fats, sugar, and salt. Some serious diseases of the lowest reaches of the digestive tract are related to reduction in fiber content of modern diets.

These observations relate to mainstream communities in the first world, but what about the poor, displaced, and forced to the margins of societies? Ethnic minorities forced to live in environments alien to their ingrained habits may lose much of their hereditary wellness. Diabetes is one of the chronic conditions with alarming incidence amongst ethnic minorities.

Genes must have something to do with the propensity of Aleutians, Polynesians, Asians, and Africans to develop diabetes, but inappropriate changes in diet may also contribute to the problem. Minor cereals, indigenous varieties of staple grains, and the meat of animals in the wild, may hold keys to good health in descendants of people accustomed to living in harmony with nature.

These thoughts have crossed my mind after I accessed the following link earlier today:

http://www.heraldnet.com/stories/07/01/28/100loc_a1elkside001.cfm

Diabetes Risks of Body Building and Professional Sports

It is strange but true. You would think that superbly sculpted muscles should keep you in the pink of health, but the reverse is true if you use growth hormone products without medical supervision.

Resolve never to take any nutrition supplements except under expert prescriptions, and always buy such products, if you must use them, from legal and responsible sources. A growth hormone may give you diabetes apart from the enhanced physical strength you seek.

Always check to make sure that a person for whom you are responsible has not started an illegal nutrition supplement, if you notice and abrupt spurt in musculature and physique.

Take a look at the following link I accessed today:

http://www.nlm.nih.gov/medlineplus/news/fullstory_45840.html

This link is available on the Internet for a limited period of time. Please write to me for the substance of information available on this link if you happen to try and access it after it has been removed.

It is Easier than You May Think to Make Glaring Mistakes at a Pharmacy When Getting Your Diabetes Medication

“Why are the tablets a new color this time”?

“Hey, this is not my name on the bottle!”

Just one mistake can be bad enough to land you in an emergency room-or worse!

It seems unlikely that pharmacists can make mistakes, but the truth is that it pays for you to double check that the person filling in your prescription has made no mistake. You do not want to be a victim of a spell of absent-mindedness on the part of the staff at a pharmacy, or to pick up someone else’s drugs in a tearing hurry.

Doctors are notorious for bad hand writing so it does help if you have a typed prescription or one printed off a computer file. Do ask your doctor to indicate the purpose of each prescribed drug, should he or she still be in the handwriting era, so that the pharmacist does not palm off something other than what you need, because the written name is similar to something quite different.

It always pays to stick with just one pharmacist, so that the staff gets to know you, and have all your medical details on their computers. Do remember to ensure that a new pharmacist is fully aware of all medications you take and any allergies you may have to certain drugs.

Diabetes is a condition which requires frequent pharmacy visits throughout life from the day that you blood glucose problem is uncovered. You have to make sure that such regular use of the technical service works uniformly to safeguard your health, with ZERO DEFECTS!

Why Eye Trouble in Diabetes Could Signal More Bad News

There is this link I have accessed today, which is worth showing to your ophthalmologist:

http://www.nlm.nih.gov/medlineplus/news/fullstory_45844.html

This link is available on the Internet for a limited period of time. Please write to me for the substance of information available on this link if you happen to try and access it after it has been removed.

Retinal damage is common in diabetes, especially if the condition is poorly managed or if detected late. An annual or even more frequent dilated eye examination is essential for everyone with diabetes in any case.

However, doctors may also use vision trouble in patients with diabetes, to suspect that blood circulation to the far reaches inside the brain could be heading for a crisis. An ophthalmologist may therefore wish to refer you to another specialist just to ensure that everything is ship shape.

Do ask your ophthalmologist, after each visit, if there is any reason to consider a full stroke evaluation. I hope that he or she will feel that there is no such need because you have managed your blood glucose so well, or that further tests by an expert will show that all is well with your capillary circulation.

Good Luck!

Why Self-Gratification and Patience May Beat Drug Treatment of Erectile Dysfunction in a Spouse with Diabetes

Muscular weakness and diabetes of long standing go together. It is not an impossible situation, but contractions as strong as in a healthy young adult are rather unlikely.

Male erectile dysfunction is the most embarrassing manifestation of muscular weakness in diabetes, though older men with normal blood glucose metabolism may also suffer from the condition in some degree.

Drugs to treat male erectile dysfunction have created unusual excitement in patient communities. New medicine discoveries and regulatory approvals have become passé, but the prospect of older men regaining the hard, strong, and sustained erections of their youth, has justifiable allure.

I came across a report today which suggests that men with diabetes can also be treated with drugs for weak erections, but I am not convinced by the findings. But let me give you the link to the report first:

http://diabetes.health.ivillage.com/newsstories/erectiledysfunctiondrugssafeeffective.cfm?general=nl_diabetes

I am uncomfortable with the side-effects reported. We have always known that phosphodiesterase type 5 (PDE-5) inhibitors act by dilating blood vessels, thereby enhancing the flow of blood. This class of drugs carries cardiac risks, and can interfere with a host of other medications as well. Take a look at the following link (also retrieved today):

http://www.fda.gov/cder/foi/label/1998/viagralabel2.pdf

Every spouse or partner contributes to decisions by men to seek drug therapy for erectile dysfunctions. I suggest that diabetes makes the risks of using such drugs less than worthwhile.

There are alternatives to conventional penile penetration whether you have a baby or simple pleasure in mind.

Could Your Job Give You Diabetes?

Job performance, business results, and careers, are not worthwhile if they gibe you diabetes. The adage ‘health is wealth’ may be hackneyed, but it retains all of its relevance!

Take a look at the following link I retrieved a few minutes ago:

http://news.bbc.co.uk/2/hi/health/6390389.stm

Your colleagues at work might need copies of your downloads from the site linked above. Awareness is a cornerstone of health literacy. Note how the referenced article mentions the huge numbers of people who are not even aware that they have diabetes.

Write to me or leave a post here if you have experiences, either as an employer or as an employee, of diabetes due to work related stress. We can make a difference together!

New Insights to Protect Your Children from Diabetes in Future

The growing incidence of type 2 diabetes is a matter of alarm in many countries. The seeds of this avoidable disease are sown in childhood. Poor eating and exercise habits stay with individuals in to adult life. They often result in gestational diabetes and pre-diabetes as well, before full blown type 2 diabetes sets in.

You cannot prevent type 1 diabetes since it is genetic, but once your children are born without such an auto-immune disorder, it is in your hands to raise them in ways that keeps type 2 diabetes at bay.

Waist circumference, blood pressure, and fats in blood, apart from body weight for height, can warn doctors that an individual is at risk of future type 2 diabetes suffering. New research on the metabolic syndrome, which generally precedes type 2 diabetes, suggests that growing children should be monitored regularly for their future risks of developing diabetes.

I suggest that you ask your family physician to assess your children in this respect. Here is a link (retrieved today) to an article which I found most useful:

http://www.medscape.com/viewarticle/552466?src=mp

A Delicious and Filling Snack, with less than 100 Calories per Serving, for People with Diabetes

I could scarcely believe it! Apples I could understand, but cheese and a cracker in a diabetes snack? I have tried it (not the brand though), and found the claims about taste and satiation, which I had heard, to be true. I cannot think of a better way to spend just 60 calories from a daily ration!

Take a look at the following link:

http://vgs.diabetes.org/recipe/viewRecipeDisplay.jsp?SizedRecipeId=865&CategoryID=6

I am happy to say that this post is entirely of my own volition, and I have no commercial arrangement with either the web site owner or the manufacturer of the snack brand.

Enjoy!

Why it may be better to bear the Pain if You Have Diabetes

Visit any waiting room of patients anywhere in the world, and you are likely to find a majority of them with complaints related to pain. This applies to diabetes as well, and patients with this chronic condition often return to physicians with pressing requests to deal with muscular and joint pains.

Pain is also a frequent object of self-care with over-the-counter medications. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) occupy much shelf-space in self-service stores which offer health care products for people to buy without prescriptions. People with diabetes are also free to buy some NSAIDs without medical supervision.

Pain remains a subjective matter, whether or not you have diabetes. No doctor can contradict you if you complain of pain, and almost all will ignore your discomfort if you do not complain. There are no tests for independent confirmation of pain-you have it if you complain, and few will question you if you choose to just grin and bear it!

However, pain with diabetes is not the same as with a person who enjoys normal blood sugar metabolism. That is because diabetes has such a strong correlation with heart disease. There is new information that some prescription drugs may affect weak hearts. There are also possible cardiac implications for people who take over-the-counter (OTC) NSAIDs on their own.

Please discuss the information in the following link with your physician if you have diabetes, and if you also buy OTC products for pain relief, or are on prescription drugs for such a condition:

http://www.medscape.com/viewarticle/552845?sssdmh=dm1.251476&src=nldne

I would be happy if you would resolve to use physical therapy to deal with pain, or just raise your pain threshold. I can help with ways of doing this, if you like.

Osteoporosis Monitoring in Diabetes

Links between diabetes and osteoporosis are unclear, though there is some evidence that women with the type 1variety may be more prone to weak skeletal structures than others with normal blood glucose. (Use the following link, retrieved on March 01 2007, for a well-referenced article on the subject that your physician may want to peruse):

http://www.medscape.com/viewarticle/465736

Some medicines used in diabetes prevention and management may increase the risk of diabetes. Use the following link, retrieved on March 01 2007, for an informative link on the subject:

http://diabetes.about.com/b/a/000064.htm

Osteoporosis monitoring by ultrasound is reliable and convenient. Use the following link, retrieved on March 01, 2007, for detailed technical information on a patented method of osteoporosis monitoring from the junction of 2 bones in the fingers:

http://www.igea.it/eng/diagnostics/dbm.htm

I declare a commercial interest in this system of osteoporosis monitoring, because I use the technology in my practice. However, I have no business links with the manufacturers.

Your physician may recommend DEXA, or another method of osteoporosis monitoring, but this step is important for the overall management of all cases of diabetes.

Let me know if you would like more information on the links between diabetes and osteoporosis, as well as on dietary and exercise guidelines for the prevention and management of osteoporosis.