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SLIMMERKIWI's Photo SLIMMERKIWI SparkPoints: (135,793)
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12/28/13 4:06 A



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Russell - I find it very sad that your Dr didn't discuss diabetes or order bloods to check for it given your weight and general health. To me your Dr wasn't fully doing his/her job.

My Dr has checked HbA1c, Thyroid, Cholesterol etc. regularly for 20 years. I have had 3 Glucose Tolerance Tests, too. I ended up borderline pre-diabetic, but that was in the last 2-3 yrs before I started to lose weight. He kept regular checks because I was slowly gaining in weight (got to around 220lb), and the fact that my Dad died having a heart attack (didn't know he had a heart condition) and my mother had a triple bi-pass, and Diabetes ran in my father's family.

Fortunately for me, my bloods (Cholesterol panel and HbA1c) are now perfectly normal, even trending to the lower/normal range. Also fortunately for me, I didn't have to change WHAT I ate. My Registered Dietitian perused some printouts from the SP Nutrition Tracker and just gave me a set calorie to aim for. The weight started coming off then, and the bloods improved. I will add, tho', that she did prescribed Omega-3 Fish Oil to help with the very low HDL, and that is now borderline low.

I think everybody should be pro-active with their Dr. It is in our best interest, and up to us to ensure that we bring these topics up with our Drs so that we don't end up in the situation that Russel found himself in.

Kris



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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,261
12/28/13 12:40 A

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There are now A1c test kits that are sent to a lab where the total cost is under 20 dollars. I believe both Walmart and Walgreens sell one, easy to confirm via internet.
Birgit

You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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SCOTTSMYO's Photo SCOTTSMYO SparkPoints: (254)
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12/28/13 12:25 A

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Hello All,

It's interesting that this topic has come up on these boards as I would like to share my own opinion on the matter.

In reference to this statement:

"Frequently and chronically elevated blood sugars can be a sign of insulin resistance (of muscle cells first). "

I used to believe the same about muscle insulin resistance leading to high blood sugar and fat storage (via gary taubes) but through some rigorous research I have found this to be erroneous.

The reason Blood Sugar remains high after a meal is not because glucose can not get into the cells, but rather because insulin can not stop gluconeogenesis and glycogen breakdown in the liver.

"These results suggest that a low-dose infusion of insulin can lower plasma glucose entirely by reducing glucose production. Since at least 8O°O of glucose production in the fasting state is hepatic'- this strongly suggests that low concentrations of insulin act primarily on the liver by reducing either glycogenolysis or gluconeogenesis or both."

" In diabetics, who are insulin deficient, the restraining effect of insulin on hepatic glucose production is impaired and increased glucose production causes hyperglycemia. The peripheral utilization of glucose in diabetes is similar to that of normal subjects."-http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1604580/pdf/brmedj00125-0013.pdf

One of the main functions of insulin is to partition energy and to switch the flow of energy in our cells after a meal. Insulin acts on cells by increasing the uptake of glucose ( although cells are never fully dependent on insulin because glucose enters cells mainly by facilitated diffusion) and protein, all while halting the breakdown of glycogen, creation of glucose, ketones and fatty acids. When cells no longer respond to these signals, fatty acids, ketones and glucose all become high at the same time in the plasma when they should not be. Essentially Insulin's main job is to direct traffic between our main fuel sources. Fatty acids and Glucose.

Once we understand these simple functions it comes quite clear that insulin resistance can be more closely related to a state where the body is receiving too many fatty acids in a time when glucose should be the main fuel source. Fatty acids build up can then lead too protein mis-folding and subsequent lipo-toxicity leading to beta cell disfunction or as as seen in alcoholics when they develop fatty liver disease due to alcohols effect on VLDL transport and insulin blunting effects.

I have written about this in great detail in the following posts enjoy:

theskinnywhitebuddha.blogspot.com/2013/09/
the-carbohydrate-monster-under-your-be
d_15.html

theskinnywhitebuddha.blogspot.com/2013/09/
the-carbohydrate-monster-under-your-be
d_30.html

theskinnywhitebuddha.blogspot.com/2013/10/
the-carbohydrate-monster-under-your-be
d.html

theskinnywhitebuddha.blogspot.com/2013/11/
the-carbohydrate-monster-under-your-be
d.html

theskinnywhitebuddha.blogspot.com/2013/11/
the-carbohydrate-monster-under-your-be
d_6.html


Thank you,
- Scott











Edited by: SCOTTSMYO at: 12/28/2013 (00:31)
RUSSELL_40's Photo RUSSELL_40 Posts: 16,826
12/27/13 10:24 P

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Algebra, I think we are talking about a small group of people. People that don't go to a doctor regularly. For those who are seeing a doctor already, these tests can be performed by your doctor, with a little insistence. However, for those not seeing a doctor, these simple tests, might let them know they have a problem, and make it MORE likely they will actually go see a doctor. These people would most likely not go to a doctor otherwise, since most people with diabetes do not show any outward effect.

Basically, they don't see a doctor, unless they know they have a problem, and without these tests, they will never know they have a problem.

Of course the doctor is going to run their own tests, but this test is important even for people not going to a doctor. College aged kids are now getting diabetes, but many have no insurance, or would ever go see a doctor. This simple test is an option for those people.

It seems that the argument is testing at home versus testing at a doctor, but in reality, it is testing at home versus not testing. The people testing at the doctor, just need to ask their doctor to run these tests. When you weigh testing with a meter at home, versus just hoping you are not diabetic, the benefit of testing is obvious.

The idea that doing a test at home that millions of diabetics do daily could be dangerous is just silly.The only result that may happen , is they actually decide to go to a doctor to see if they do have a problem.

A1C testing might be better to determine glucose levels over time, but probably too expensive for most. However, you are sending your test kits to a lab, the same as your doctor. There is no " laboratory of erroneous testing ", where they just mess things up.

Once you get the results, you have ranges that let you know if you are low, high, or for most.. in range. If you are low or high, you should see a doctor, re-run the tests, address these issues.

If you are in range, and weren't planning on seeing a doctor for another 10 years anyways, it isn't like the test convinced you not to see a doctor. You weren't going anyways. This fear that this test would cause people to avoid a doctor visit is silly.

"We can't solve our problems with the same thinking we used when we created them "

- Albert Einstein

“Whether you think you can, or you think you can't--you're right.”

- Henry Ford


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ALGEBRAGIRL Posts: 1,767
12/27/13 9:36 P

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'This test could be done by a child. It takes 20 seconds. There is not " interpretation ". If you are over 130, you may be diabetic, if you are over 150, you are. Then a doctor will probably seem like a great idea.'


Reading instructions on a message board about how I can tell if I'm diabetic is a bad idea. You don't think it's 'interpretation' but if you see such a high fasting blood glucose, then a doctor is still going to want to run the lab test, never going by just what you say.

Deciding when you need to see a doctor based on your own judgment of your diabetic condition is still a bad idea. Sounds like this 'do it yourself' thing is what you do before you 'think it's a good idea' to see a doctor and with that I strongly disagree.

Sounds like splitting hairs, but when you are diagnosed diabetic, a testing kit makes perfect sense, which your doctor will support. After all, at that point, you're dealing with another weapon in your arsenal - your insulin.

But whatever test you do has to be repeated by a doctor anyway. He makes the diagnosis. Insurance only respects his opinion. If you are diabetic and don't have insurance, I think that is a problem.

Everything that is done in the lab, coming from a doctor's office is information your insurance company uses to decide what treatments are covered, etc. This is important. A doctor's medical education goes beyond a few tests. When I was a lab student, the only definitive test, which required quite a time commitment, was the 5 hour Glucose Tolerance Test. I doubt some kind of GTT isn't still used for diagnosing diabetes. (I had one when I was pregnant.) The decision to diagnose someone diabetic is not taken lightly.



Edited by: ALGEBRAGIRL at: 12/27/2013 (21:51)
SKIRNIR's Photo SKIRNIR Posts: 5,231
12/27/13 4:11 P

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Surprised a doctor wouldn't automatically check your blood sugar. I mean anytime they do a blood workup, they test blood sugar. Not yearly often times, but at least every two or three years. For me, they will test yearly, as I had the gestational diabetes. When pregnant, they check all women about midway through, if they are doing the regular doctor visit thing during their pregnancy.

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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,261
12/27/13 3:04 P

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Russell,
I can tell that your blood sugars are stable, you are indeed thinking this through very clearly. emoticon
For anyone else reading this: I'm not kidding, by the time my blood sugar levels are higher (but still in the pre-diabetic range) it takes much more effort to think clearly, remember things, understand the relevance of arguments made, not get offended... but these early effects (and there are many others) of pre-diabetic blood sugar levels are so easily interpreted as signs of aging, having too much stress, having to deal with mean or stupid people, having too little sleep, having "hormonal issues", having a lousy job ... but I know that in a significant number of cases these problems in our lives would go away if we got diagnosed and getting blood sugar tested is one of these tests.
Some may think that Russell's experience of a cardiologist not checking for diabetes first is rare and he just had a lousy doctor. That could be, but it could also be that this is typical.
My own experience was similar although I did not get quite as sick as Russell (at least on the outside).
I had hypoglycemic episodes for years while my blood sugars were still in what is considered the normal range (A1c under 5.6) and my physician only recommended that I eat protein with sugar/high carb meals and eat whole grain instead of white flour. That kept the hypoglycemia in check for a few years and then my energy levels bottomed out and so did my mood. In the meantime my thyroid function crashed as well (it has hugely improved since without meds) and I needed to eat every 1-2 hours even after eating protein and whole grains and often needed coffee just to keep going and doing simple chores.
I've always had good medical insurance and someone who is well known and respected in our community as a family physician, a kind and helpful man, but traditionally trained and not knowledgeable about the interaction of diet and exercise. I was never overweight in the last 20 years so the thought that I might be diabetic and/or food/carb addicted did not occur to him at all because he believed that obesity causes type 2 diabetes, not the other way around as I now believe to be the case.
Eventually what saved me was my consistent effort to train for my first half-marathon and finding that my cardio-vascular fitness barely improved, and not for lack of effort on my part as I was very diligent in training for it. My resting pulse was still about 78 months after running my first half-marathon (very slowly), not at all that of an athlete.
Once I read about fuel partitioning and insulin-resistance I understood why neither my heart nor my muscles could function very well. Insulin-resistance caused my muscles and heart to get less than optimal energy in the form of glucose while my fat cells were getting all the nutrition. This caused my to be normal weight but have a ton of belly fat.
Lowering carbs saved my life and also saved my quality of life. I am more fit now than I have ever been with currently only about 30 minutes of exercise per day. Body fat is down from close to 30% 3 years ago to just under 20% now.
Sorry for the long post, it is my story, to sum it up: testing my blood sugar showed me AND my physician (a new one, who is better educated) how to get healthy. At 50 I now have a chance for the second half of my life to be much healthier than the first.
Blood sugar testing was not the only thing but an essential part of this process.

Birgit


Edited by: HOUNDLOVER1 at: 12/27/2013 (15:07)
You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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RUSSELL_40's Photo RUSSELL_40 Posts: 16,826
12/27/13 11:16 A

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I think the #1 reason people have arguments on here is the inability to comprehend English.

No one is recommending self diagnosis. A blood sugar test is a simple procedure that any person can do in 20 seconds, and is accurate. This simple test can let you know if you are diabetic or not. THEN, you should go ask your doctor to run more extensive tests to confirm it. This is not dangerous in any way.

If I missed someone saying we should self diagnose ourselves, then I understand the backlash, but if it happened, I missed it. It seems that a lot of stuff is being inferred, without it being said. We just hear a word or two, and have automatic response that we say, as if it is necessary for us to save others from the perils of discussion. Sometimes, things are just a discussion, and you actually have to respond to what is said.

This simple test would probably let hundreds of thousands of people know that they are diabetic, who are experiencing health problems right now, but are unaware. Sure, we can't force someone to take a test, but barring finances, if a doctor recommended a test, most of us would take it.

The problem is, most doctors never recommend this, unless you come in, complaining of thirst, or craving sugar. I was a 361 lb. heart patient.. ideal diabetic patient, but I found out on my own at a church. Local nurses tested my BP, and blood sugar. My blood sugar was 526. My doctor never suggested any diabetes tests, even though my Mom was diabetic.. all in my chart. I should have been tested immediately. This is a top 3 cause of death, but we don't test for it at all. We tend to find out about diseases, when we go to the E.R., and this is sad. Of the big 3.. heart disease, cancer, and diabetes, diabetes is the simplest to diagnose, and we should be suggesting that everyone get tested at least once a year.. if at a doctor.. awesome! I am not anti-doctor, but the lack of a doctor, should not be a reason not to test.

The idea of testing for this is about as controversial as wearing a seat belt. Not required to get where you are going, but seems like a pretty good idea, and down the road, might be very dangerous.

This test could be done by a child. It takes 20 seconds. There is not " interpretation ". If you are over 130, you may be diabetic, if you are over 150, you are. Then a doctor will probably seem like a great idea. This might help with hypoglycemia too, and the meter can be used multiple times. The test strips have a shelf life though. So you may not be either diabetic, or hypoglycemic, and fall in the sweet spot 80-120 two hours after a meal, year after year, and have no desire to go to the doctor.

Most of us wait for a problem to go see a doctor, so would never get tested, or do a test. This test would solely be a way to learn that you have a problem, and follow up with a doctor. Diabetes is not something you can feel, so you don't know you have it.

The best option of course is to go see a doctor, and get tested yearly, but the reality is, not many people do. his test is done by almost every diabetic daily, and is probably the simplest test you will ever take, and will give you some idea if there is a problem. At most, it would take 10 seconds to explain. I think the problem is, people that don't do it, think it is complicated.

Secondly, if I was stupid, and thought.. Dr. Russell thinks he is diabetic, what would I do? Prescribe myself Insulin, and pills? That's impossible. Your fear of self-diagnosis is unfounded. A regular person can't do anything, even if they think they are diabetic, except go to the doctor. I guess they could switch to the diabetic diet, but that isn't unhealthy for the average person, especially compared to what we normally eat.While I think the diabetic diet is inadequate, it is certainly healthier than the average diet.

So yes, we should all get tested yearly. This isn't a call for you to be a doctor. Just a statement that we should get tested. At a doctor's, if possible.

One of the biggest cost of healthcare is that by the time we diagnose an issue, we are very sick, and the treatment is vastly MORE expensive. If we wanted to cut costs, we would have national health care, with no costs to the patient whatsoever, and pay for it through taxes. yes, at the start we would have tons of tests done, that are not allowed by insurance companies now, but over time, the costs would drop. We have the highest cost PER PERSON in the world, and most countries cover everyone. We don't cover millions, so PER PERSON WHO HAS INSURANCE, we are almost double. Simply finding these problems early with prostate exams, blood tests, and mammograms, would drop the cost around 50 % based on the cost in other countries, many of whom have much better results.

"We can't solve our problems with the same thinking we used when we created them "

- Albert Einstein

“Whether you think you can, or you think you can't--you're right.”

- Henry Ford


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ALGEBRAGIRL Posts: 1,767
12/27/13 3:22 A

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I think a blood sugar test probably is part of an annual physical, but it's not required. Whatever is 'recommended' is not necessarily required. For that matter, what does 'required' mean? As an example, I don't know that a doctor can force a woman to have a mammogram. He can recommend it, have his office schedule it, and maybe the insurance will cover it, depending on the insurance and the reason the doctor ordered the test. If a woman doesn't want to to have a mammogram, she can just refuse to have it.

. My doctor does this: He orders the blood drawn a week before we meet, then we discuss the results at the physical (he sends the results by mail so that I already know them and can have them with me - we're 'on the same page.' )

As far as not being able to afford to go to the doctor, I hope that changes with the new health care legislation here in the States. Paying out of pocket at a drugstore isn't my idea of saving money. The kits are very cheap, the supplies you use to test are not. If you are diabetic, a doctor is going to diagnose you and some sort of insurance is going to have to pay for or help pay for your care. That's where the health care reform should help.

' I find it amusing that a simple call for people to test their blood sugar is met with such backlash. A simple test will let you know that you may have a problem. This is not a bad thing, and suggesting that one does this test, does not imply that they should avoid a doctor's care.'

I think the 'backlash' is about self-diagnosis. You're going to have to see a doctor anyway if you think you are diabetic. The simple test that lets you know if you have a problem is just the lab test (or tests) the doctor orders. But he or she is also going to have to know more about you. It's difficult to persuade someone they have to find a doctor they trust and share their health concerns with a medical professional - if they think this is a matter of 'self-diagnosis' and they save money. If, in addition, they think they probably know better than doctors about treatment, then it's going to be an uphill battle all the way.

If they diagnose themselves and decide they then probably need a doctor, and so THEN they go to the doctor, that's the issue that I see here. There are probably a number of people who will not only diagnose themselves but then prescribe their own diet, monitor their condition as well, thinking that any knowledge a doctor has beyond what they themselves know is probably not worth the money it would cost for visits.

Whatever your diet is, it serves for you to manage your diabetes. I don't think there's a cure with diet. People at WW report that with their weight loss, they have discontinued medication with their doctor's supervision - I think this is just better management, not cures. If these were 'cures' believe me, WW would advertise that far and wide.

Edited by: ALGEBRAGIRL at: 12/27/2013 (04:11)
HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,261
12/26/13 6:30 P

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I think this is not at all about condemning anyone, diabetic or not, it is rather about empowering the consumer of food to learn more about the effects that food has on their body. The more food is available that is processed in any way or grown for taste or ease of harvesting rather than nutritional benefit (fruits and vegetables) the more important it is to learn about the effects that foods have on our body for anyone. Testing for blood sugar is only one piece in the puzzle of many that are helpful. There are also tests for vitamin levels, mineral levels, gluten-intolerance, dairy-intolerance and food allergies that can be the first step to eat in harmony with our body.
Birgit

Edited by: HOUNDLOVER1 at: 12/27/2013 (01:25)
You can talk to God all you want and that's great, but the changes happen when you start listening to him.

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SKIRNIR's Photo SKIRNIR Posts: 5,231
12/26/13 5:19 P

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Russell, I am glad that worked for you, but I still think each and every person is different when it comes to their body, even more so on how their body responds to different foods/carbs. Some have blood sugars that aren't too bad and may be easier to control. Others have blood sugars that just aren't. Some need pills and insulin. Some can do it by diet alone if they have a very strict diet. Each person has to choose for themselves. Yes, doctors and dietitians aren't the best at helping a diabetic discover what diet is best for them, but in the end, no matter what a doctor or dietitian does, the person still has to choose for themselves. There should be more help when it comes to what a diabetic diet should be, IMO, but help that starts where the patient currently is and starts with minor changes that builds and informs. From my experience as gestational diabetic, my dietitian said eat this for breakfast, eat this... but no whys or any such thing. Or protein helps counteract a bit of sugar, etc. Each diabetic has to learn how their body responds, and they can be helped in this process by a dietitian who truly wants to inform. But again, not everyone can do it by pills and insulin alone. As I was gestational diabetic, who has lost 50 pounds getting my fasting blood sugar from about 98/99 to about 85, I will still probably get diabetes as I age. Why? Partly because it is genetic. My brother has it, my dad has it. I have high triglycerides that have come down to close to a normal range, with low HDL, all things that often times go together in genetic diabetes. Don't condemn all diabetics who can't do it be diet alone, please.

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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,261
12/26/13 4:46 P

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Russell,
emoticon emoticon

I'm glad you described a little more about how to test daily blood sugars. I have not done this yet but am planning to just to get a better gauge on which foods increase mine and get to an A1c of 5 or below a little faster.
The process of lowering blood sugars when on medication may need more or less supervision for different people because the changes/improvements can be so quick. But just testing to find out where we are has NO risk factors at all but may save us from future disasters.
Birgit

You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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RUSSELL_40's Photo RUSSELL_40 Posts: 16,826
12/26/13 4:17 P

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As a diabetic, this topic is very interesting to me. I used to keep my blood sugar readings for my doctor to peruse at my visits, and mumble " uh-huh! " every 10 seconds, and tell me nothing.

Not sure about A1C testing, but simple blood sugar testing is quite simple. You just need alcohol wipes, needles, meter, and test strips. Wipe finger, put strip in meter, poke, and place drop of blood on strip tip. 3-4 seconds, and you have your blood sugar. If it is 170, you should contact your doctor for further testing. If it is 80, your probably good. If you are still undecided, I would go to a doctor for a Hemoglobin A1C test.

The idea that you need a doctor to test your blood sugar is hogwash. What you need a doctor for, is if you think you ARE diabetic, meaning it was over 130. Without testing your blood sugars, how would you know that you even need to ask your doctor. It would be great if everyone just got their A1C tested at a yearly physical, but many don't have the money to get the test done. Testing your daily blood sugar is a much cheaper way to rule out diabetes. It may not be the best solution, but it is better than NOT testing, which is what people do now. I find it amusing that a simple call for people to test their blood sugar is met with such backlash. A simple test will let you know that you may have a problem. This is not a bad thing, and suggesting that one does this test, does not imply that they should avoid a doctor's care. If anything, it is more likely that the person, once mad aware that diabetes is an issue, will seek medical help.

As far as " sound science ", and just waiting for experts to change the method of dealing with diabetes, most people don't have the luxury of waiting, especially if they are diabetic. A very high percentage of people are getting minimal results from the " diabetic diet ", and are naturally looking for a treatment that actually fixes their issues. Mostly, this is due to the declining age at which people are finding out they have the disease. A 30 year old might want better results than a 70 year old. My mother just figured she would die before any complications occurred, so she did her best, and didn't worry about it. If you have 40 years to live though, the idea of amputations, blindness, or kidney failure scare you a bit more, since you thought death was decades away.

For those who achieve results on the diabetic diet, hooray for them. The only problem I see, is that most of these people label success as being on pills, and getting under a 7.0 A1C.

So the same doctor who looked at you with pity, and told you that you were diabetic, which was dangerous, never had any intention of fixing the issue. A 6.0 A1C is still diabetic, and comes with all the afflictions I listed, just at a slower rate.

Any low carb dieter who is also diabetic will let you know that they can drop their blood sugars to the same levels as any normal person, and keep them there. It took me 24 hours to get mine down to 90 two hours after breakfast. The day before, it was over 300, but by day 2, I was able to keep it under 100. After 90 days, my Hemoglobin A1C was 5.1. It took a year of low blood sugars for my doctor to take me off the meds, because " low carb won't fix diabetes! " In 4.5 years, my A1C has never been back over 5.4, which is still high, but since 3.5 of them have been without pills, it's not bad.

The problem is goals. My goals are under 5.0, and no meds. My doctor's were pills, then eventually Insulin, and 6.5-7.0. If the goal is so minimal, then you can claim success, and stop looking for better answers, which is what happened. Now, all they are looking for is better pills, not preventing high blood sugars from ever happening.

So, yes, SP has to stick to what is accepted, and us members can't suggest that someone follow other advice, but we all know that there is a better way to control blood sugar than pills, and the " diabetic " diet. The only question is.. How many people will die before someone admits it, and changes what is the current thinking?

With all the issues I had, learning how to eat, with no help from a doctor, I wouldn't suggest that anyone try what I did, but hopefully one day, we suggest lower glycemic carb diets, under doctor/dietitian supervision, and diabetes becomes a rare disease.

Edited by: RUSSELL_40 at: 12/26/2013 (16:20)
"We can't solve our problems with the same thinking we used when we created them "

- Albert Einstein

“Whether you think you can, or you think you can't--you're right.”

- Henry Ford


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ALGEBRAGIRL Posts: 1,767
12/24/13 9:10 A

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I have yet to be able to 'call my PCP'; I always have to actually go to the office to see him!

I got a blood glucose testing kit years ago when a friend of mine was diabetic. Diabetics probably see their doctors more often rather than less often, even with home kits. The reliable kits are reliable enough but no substitute for medical supervision of a true illness, such as diabetes. My friend still had dangerous episodes with wrong doses of insulin, BTW. Such is the life of a diabetic who lets 'some things slide' (she tended to want to have her cake and insulin shots, too!)

'Sound Science' - it's all out there. Not so flawed. Because different researchers pursue different paths to address the same problems is not a sign of flaws. It's a display of the natural search for answers that goes on in labs and clinics everywhere. There is still research on saturated fat and cholesterol.

http://www.ncbi.nlm.nih.gov/pubmed/24363161

http://www.ncbi.nlm.nih.gov/pubmed/24358036
(has free PDF of the study with loads of references)

http://www.ncbi.nlm.nih.gov/pubmed/24346473

(this stuff can come to your inbox every day if you save your 'saturated fat' search on NCBI!)

http://www.ncbi.nlm.nih.gov/pubmed/24342605
(good summary)



Edited by: ALGEBRAGIRL at: 12/24/2013 (09:45)
EXOTEC's Photo EXOTEC Posts: 3,302
12/24/13 8:08 A

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As to "sound science" -- yes, some is exactly that. Some is still based upon flawed foundational research which has since been updated, except to the point that most of the really big specialty groups are highly unlikely to go back and actually say, "gee, we were wrong and have been unintentionally misdirecting you toward unhealthy practices all this time!" Just ain't gonna happen.
Point in case: they're not ever going to change their stance on cholesterol levels and saturated fats... even though cholesterol isn't the problem, it's how we can reduce heart disease (which has never been adequately correspondent with serum cholesterol levels), and the studies on saturated fats were done *without* separation of saturated from trans- (which is where the problem was to begin with) and performed by force-feeding trials with RABBITS. How many carnivorous rabbits do *you* know of? Why wouldn't their serum values be haywire, under such conditions? it's insane.

For the home blood glucose testing meters - I do object to all and sundry simply going out and getting them and providing their own interpretations. You always need the guidance of a skilled professional for that - even if the bottom line is the same, what then? you can't (or shouldn't!) then "prescribe" your own treatment or modification based upon those numbers. That's a sure recipe for disaster, especially where ANYthing hormonal or endocrinological is involved. That entire system is so minutely interconnected you could create far more metabolic disturbance than "simple" sugar dysfunction. Don't go there!
OTOH, most of those meters have a data bank onboard which many doctors will download into your patient file and use those values in their ongoing therapy. If the values weren't valid, I can hardly see any competent physician using them, regardless of where and who performed the POC (in-home) testing. So there's two very valid sides to that discussion.

Even so, I still believe that knowledge is power, and we should be aware and thinking about things like BG. Hopefully we all have PCPs who we can call if we have concerns! that is the true value of home kits - and some are more reliable than others. I feel the BG meters, and additionally the ones with ketone options, are valuable tools, when used in the correct environment. I see no responsible excuse or warning against having that knowledge. Sticking our heads in the sand and hoping Dr. God can just "fix it" isn't fair to them or respectable for us. You wouldn't go along with no oil in your car and just wait for the mechanic to notice it, would you? 'nuff said.

...the problem with people these days is
they've forgotten we're really just animals ...
(attributation forgotten)

We did not create the web of life; we are but a strand in it.
~attributed to Chief Seattle

We don't have souls. We ARE souls. We have bodies.
~C.S. Lewis


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SUNSHINE6442 Posts: 1,873
12/23/13 12:25 P

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I also believe that everyone should get a yearly A1C test which measures blood glucose over a 2-3 month period.

Dr Cederquist is a board certified bariatric physician who specializes in weight loss and weight management. I have heard many of her seminars...she now has a web site that has answers to insulin resistance...and several u-tube videos that explain why yearly testing is important. Very Informative.

Utube.....http://search.yahoo.com/search?fr=mcafee&p=u+tube+dr+cedarquist

stage.drcederquist.com/Insulin-resistance/
Insulin-Resistance-Hinders-Normal-Weig
ht-Loss

www.drcederquist.com/weight-loss-library/I
nsulin-Resistance/index


search.yahoo.com/search?fr=mcafee&p=u+tube
+dr+cedarquist

Why losing weight is difficult...insulin resistance

As recommended by the American Diabetes Association
The great news is now there is an affordable, easy and accurate at home A1C test. It is called the A1CNow by Bayer. This product may be used in your physician’s office as well. So they are saying an at home test is acceptable. Of course you have to see a doctor if you are elevated, that's just common sense, but an at home test could at least provide you with information and speed an appointment to see a medial professional. No one should be against an at home test, especially if one has limited means as it would be a good indicator for one to seek additional help!

www.americandiabeteswholesale.com/bayer-a1
c-now-selfcheck.aspx


Edited by: SUNSHINE6442 at: 12/23/2013 (14:10)
ALGEBRAGIRL Posts: 1,767
12/23/13 12:15 P

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Right back at ya...

And I was wrong about the U.K. planning to reduce sodium. They already did it...
http://www.ncbi.nlm.nih.gov/pubmed/21729460

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12/23/13 11:53 A

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Merry Christmas!

JERF - Just Eat Real Food


I'm a Certified Personal Trainer.

I eat mostly vegetables, fats, meats, some fruit and dark chocolate. Unprocessed and preservative free. And it's changed my life!

5'4"
Goal weight 125lbs
36 years old
2 kids

Keeping my blood sugar levels low on my high fat/ low carb/ moderate protein diet.


Perfection is not attainable, but if we chase perfection we can catch excellence.

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ALGEBRAGIRL Posts: 1,767
12/23/13 11:11 A

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Yes, I know it does take time for substantial change to be implemented. That is why I don't read blogs. I'm willing to wait for the real value to be filtered out from the faux stuff.

I go to NCBI (or rather, NCBI goes to me in the form of a steady stream of emails to my inbox). I'd rather read the abstract, and often the study itself, and not pay attention to the hyperbolic headlines.

NCBI is free to anyone who signs on to use it and every bit of research that is published in scientific journals goes to NCBI in abstract form (and sometimes not that, if the contents are reserved for subscribers of journals, but these instances are few).

So far, the world is lining up pretty evenly to back the results of 'sound science' when it comes to nutrition. I don't see anything on the horizon that will drastically change the way the food pyramid is constructed, for example. Also, what I see is not a problem of taking years to put changes into practice. There are studies pouring out of the scientific community every day, from all over the world. They do pretty much converge on just what we know to be safe and good practice today. And this despite constant challenges taking place in labs and data analysis.

I read recently that the U.K. has put a plan in place to reduce sodium gradually in prepared foods over a set timeline. By doing this, the tastes of those foods will stay acceptable until the tastes have changed. It does take years. And we've known for a long time that excess sodium in the diet causes health problems. This has not stopped scientists from producing data to show that other things impact those health problems more. However, the evidence is heavily in favor of reducing sodium to promote good health.

The data is all there. It's a lot of data.

Which is what you get the benefit of when you visit your doctor. He or she has to 'stay current' in order to stay licensed to practice. Just like a plumber.

I also tested my own blood sugar using one of those kits. I don't recommend anyone using the results to give themselves any information that can't be obtained with more accuracy just visiting the doctor's office. Having had a Glucose Tolerance Test when I had a very large baby (ouch!), I know that even that requires some real medical skill when it comes to interpretation. As I said before, there's no substitute for actually having a doctor's visit and lab results from blood drawn there. Anything you ever find in a home test (and I gave a pregnancy test as an example) has to be replicated in a doctor's office anyway. And giving yourself a 'clean bill of health' with blood sugar results you obtained at home may be just exactly the wrong thing as far as your health is concerned. The same applies to finding 'illness' where there is none. By self-diagnosing. Of course, it's your money, but more important than that, it's your health!

The article you linked to from NCBI was from a public health perspective in 2006. In 2006, my doctor's office did not have a network that linked all patient's records so they are available to any doctor in the practice simply by checking a hand held device. Today, it is standard OP to look at a patient's last 10 years of medical results WHILE talking to the patient in the same medical group. I actually complained that they should have more than 10 years of data right there at their fingertips - I'm so spoiled!

Denmark or Finland (or both, I can't remember) has all of the country's resident's medical histories and test results available to researchers and practitioners. That they are small countries cannot be discounted as a factor in that, but someone had to decide this was a valuable asset when it comes to public health policy. There are some types of information in this country that I don't think we would ever be able to have shared so widely. When the data is there, it's really much easier for a country to see where public health policy is most effective. Change may be initiated much more quickly in other cultures.

What kind of changes are being made, then, when they can be made in the name of public health? That's where I think it's interesting to note that other countries do line up their guidelines pretty much with ours.

Edited by: ALGEBRAGIRL at: 12/23/2013 (11:47)
JUSTEATREALFOOD's Photo JUSTEATREALFOOD Posts: 1,383
12/23/13 10:31 A

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"I also thought there was only 'sound science' when it is being done by researchers and when the results are utilized by health organizations, doctors, nurses, dieticians, nutritionists, and especially government health organizations."


Here in lies the problem, ALGEBRAGIRL. It can take many years before new research is implemented.

"A review suggested that it took an average of 17 years for 14% of original (i.e., discovery) research to be integrated into physician practice."

"Although the progress attained is well known and reported regularly in popular media, evidence summarized here suggests that the discovery of knowledge implies no natural mechanism for deploying it. Years may pass before practitioners adopt new knowledge into clinical or community applications."

www.ncbi.nlm.nih.gov/pmc/articles/PMC14977
98/




I took a month and tested my blood sugars regularly and found the results fascinating. I highly encourage anyone interested to try it.

JERF - Just Eat Real Food


I'm a Certified Personal Trainer.

I eat mostly vegetables, fats, meats, some fruit and dark chocolate. Unprocessed and preservative free. And it's changed my life!

5'4"
Goal weight 125lbs
36 years old
2 kids

Keeping my blood sugar levels low on my high fat/ low carb/ moderate protein diet.


Perfection is not attainable, but if we chase perfection we can catch excellence.

- Vince Lombardi


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ALGEBRAGIRL Posts: 1,767
12/23/13 12:33 A

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Ah, I also thought there was only 'sound science' when it is being done by researchers and when the results are utilized by health organizations, doctors, nurses, dieticians, nutritionists, and especially government health organizations. That's why I was surprised when you referred to 'what you call 'sound science,' as if I was giving it an appellation it does not deserve!



HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,261
12/22/13 8:08 P

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Algebragirl,
I want to make this short. The point was that many scientific findings are later improved upon or even found to be mistaken. For instance when scientists first found out that diabetics can be treated with insulin this was good science. When they discovered that reducing sugar and other carbohydrates in the diet can reduce blood sugar levels, that was also good science. When there is a better answer (and there may already be one but not everyone knows yet) the old answer will still be valid in one sense but it may not be utilized as much any more because a better answer has been found.
It seems to be you introduced the term 'sound science', I did not think there was any other kind, just that science can sometimes be outdated or found wrong.
Birgit


Edited by: HOUNDLOVER1 at: 12/23/2013 (01:57)
You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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ALGEBRAGIRL Posts: 1,767
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'There is no doubt that we need more research on many of these issues, the question is only what those people are to do for whom what you called "sound science" did not work.'

'Sound science' is not in the eye of the beholder. (What I call 'sound science'? Really?)

The organizations that promote health and even government agencies that try to formulate nutritional guidelines are not using 'unsound science' - maybe in your opinion, and you're certainly entitled to your opinion.

Everyone who diets has an anecdote about what worked for them. If you leave the anecdotes aside (including my own journey to near-vegetarianism, which is a story of decreasing glucose and lipid levels!), there's no problem with current nutritional science that I can see. As I've said before, the scientific research community is varied and vast and very active. Take from their results what you will.

'Even sound science is not fool-proof.'
I am going to guess that what you mean is that 'even sound science is no guarantee that what I want x to do will be done for me in y amount of time.' Sound science doesn't have 'fool proof' in it's vocabulary - that term wouldn't even stand up in a court of law, I am guessing. But that's a darned good guess about the law and fools.

What 'sound science' does have to do is run through a gauntlet of peers who test and retest and reframe conclusions until ideas run out of steam or are flat-out refuted.
Scientists working in fields related to nutrition do their work in metabolic units, research labs, computers (metanalyses), and using a lot of statistical techniques that are then scrutinized. And they must pass muster in public evaluations on the editorial page of medical journals where the results are understood.

Someone's particular situation is unique to them. It's their health, not anyone else's. If you think there is one diet that will make you 1) slim 2) non-diabetic 3) less likely to suffer from heart disease and 4) immune to cancer, then you take that chance. For yourself. It's your health.

Even my doctor - whom I ask for advice in those areas (type 2 diabetes in my family, cancer in my family, weight problems, thankfully, no heart disease because cancer gets us first!) would never tell me one diet or restricting one food group is going to do that for me. Which is why doctors will never be out of a job.






Edited by: ALGEBRAGIRL at: 12/22/2013 (18:46)
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12/22/13 4:01 P

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Awareness of blood sugar, A1C and diabetes status is important--but so is having the nutritional tools to be able to do something about it.

I was diagnosed as pre-diabetic about 20 years ago, during the height of the low-fat diet craze. In seeing several different endocrinologists, I was never told to reduce carbs or to see a nutritionist. My diet has always been very healthy--lots of fresh produce and lean meats/fish, beans...as well as lots of rice and pasta. I was a vegetarian for about ten of those years.

It wasn't until I started tracking on Spark and was able to watch what carb consumption did to my weight that I made the connection. I don't restrict carbs very much--about 100 G/day is typical for me--but I try to get most of those from whole grains, veggies and legumes. I limit my fruit.

It works. I went from being borderline diabetic to having a fasting blood sugar of 80 and an A1C of 5.0.

Dances: salsa (standard/LA), casino, rueda de casino, cumbia Colombiana, bachata, mambo, cha-cha-chá, merengue, reggaetón.

Currently learning: Mexican cumbia, danzón, Cuban rumba

Dances to Learn in the future: flamenco, tango Argentino, samba, belly dancing, bhangra, ballroom rumba


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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,261
12/22/13 3:33 P

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Algebragirl,
it seems to me that the "despite trying to follow a healthy diet" is about the people who are using a diet, since they are trying, not about the people who made the diet recommendation.
There is no doubt that we need more research on many of these issues, the question is only what those people are to do for whom what you called "sound science" did not work. Even sound science is not fool-proof. In the end everyone needs to be an advocate of their own health. Relying on the information of a physician is very important when interpreting results, but just as important is picking a good physician and a good nutritionist or dietician. Physicians and nutritionists are not God, and sometimes make mistakes. If in doubt get a second opinion.
If I had not changed physicians I would be on statin drugs and insulin by now.
If strategy A is not working for someone it is better to try another strategy after carefully weighing the potential benefits/risks with professional help and then being brave enough to try something different.
I agree that in some cases the answer may be behavioral, but I also believe that nutritional science is advancing by leaps an bounds at the moment and that many theories that are just being tested right now will be the accepted conventional wisdom in 10 years. Nobody can see the future, so we'll just have to wait and see.
Birgit

Edited by: HOUNDLOVER1 at: 12/22/2013 (15:38)
You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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EELPIE's Photo EELPIE Posts: 2,669
12/22/13 1:55 P

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This is definitely something I would not do myself (test, interpret results). This is something best left to a doctor.

The best exercise in the world is to bend down and help someone up.


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ALGEBRAGIRL Posts: 1,767
12/22/13 1:51 P

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Exotec, I have to point out an important thing about the meters. The meters themselves may be free - the strips that are used, and the solutions that are required to calibrate, etc., are not. This is where the companies make their money. Their business is aimed at diabetics who must know their blood sugars and use insulin. Also, the diabetic must use them - an ideal situation for a company that sells a product.

Looking around at people who are overweight and thinking they must be pre-diabetic is also something that I question. Every person who is overweight may run SOME risk of prediabetes - including a risk of zero. But I don't think it's a diagnosis in itself.

'despite trying (?) to follow a "healthy diet' as recommended by various specialty groups, our government profile, and nutritionists.'
If you mean a specialty group like any specialty group that aims to prevent a disease or condition and also inform the public, sponsor research, and advance scientific knowledge, then don't blame them. Their understanding of science is sound.

I could be mistaken and misinterpreting but 'Despite...' is a word that can be used to deprecate the efforts and ideas of those groups. As in, 'If you follow their recommendations, then, you would be wrong. You are doomed to be a) fat b) diabetic c) a heart attack victim because you are on the wrong path to health.'

Or the word, 'Despite...' can just mean, 'despite the best efforts of these very accomplished and dedicated people to give sound advice...'

In which case, until they come up with something more effective (and my best guess is that the solution will be a behavioral one or economic, not nutritional), and more affordable health care so more people can benefit from public health initiatives, the health of the nation will continue to improve in some areas and decline in others. As does every other country in the world.



Edited by: ALGEBRAGIRL at: 12/22/2013 (14:08)
EXOTEC's Photo EXOTEC Posts: 3,302
12/22/13 1:03 P

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It scares me, too - all the people who may be prediabetic and simply don't know it. Diabetes is surely a life-threatening condition. Look at people around you. How many are overweight, if not obese? A statistic I read somewhere not long ago said about 60% (or more?) people in this country are in one of those categories, despite trying (?) to follow a "healthy diet' as recommended by various specialty groups, our government profile, and nutritionists. Still, our rate of diabetes continues to rise, along with other modern diseases which have been associated with the way we're eating.

Rather than stand on protocol or dogma, I'd prefer to see people take advantage of the free meters for reading blood glucose you can get from many sources. If nothing else, get your PCP to include a HbA1c in your checkups. The ranges listed earlier in this thread correspond to accepted recommendations from the ADA. For anyone in the marginal pool, it would be beneficial to discuss it with your PCP. This is not "medical advice". It's just sound healthcare - and directed toward those who should be making use of it. It could forestall a good amount of potential health issues and heartache if the condition does develop into something more than just a predisposition.



...the problem with people these days is
they've forgotten we're really just animals ...
(attributation forgotten)

We did not create the web of life; we are but a strand in it.
~attributed to Chief Seattle

We don't have souls. We ARE souls. We have bodies.
~C.S. Lewis


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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,261
12/22/13 12:21 P

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Becky,
I understand. I just took a look at the ADA guidelines and found this article which I thought might be helpful to some people. I assume that this is ok to share, if not, feel free to delete the link:
www.diabetes.org/living-with-diabetes/trea
tment-and-care/blood-glucose-control/t
ight-diabetes-control.html


I'd be interested in your thoughts.

Birgit

Edited by: HOUNDLOVER1 at: 12/22/2013 (12:21)
You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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DIETITIANBECKY's Photo DIETITIANBECKY Posts: 26,660
12/22/13 11:58 A

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HOUNDLOVER--
I am glad to hear that you understand our Sparkpeople guidelines for your future posting.
It is great to encourage our members to participate in blood sugar screenings and diabetes prevention interventions. In fact it is fine to even provide the range values when using guidelines from a leading health organization such as the American Diabetes Association.

But further information would be crossing the line into medical diagnosing, medical treatment, medical nutrition therapy, etc....and this is not permitted on this site. One's individual treatment plan should come only from one's health care provider.

Thanks-
Becky

ALGEBRAGIRL Posts: 1,767
12/22/13 12:39 A

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I was reading Skirnir's description of how she ate bran cereal (carbs) and had no problem. Then if she added raisins (carbs), she had a problem. But the bran cereal (carbs) without the raisins (carbs) were OK. I guess it just goes to show that individuals have different experiences.

Edited by: ALGEBRAGIRL at: 12/22/2013 (00:44)
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12/21/13 10:50 P

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Skirnir,
I don't know if type 2 diabetes is always preventable but it should be prevented when possible. Without testing this can't happen as the early symptoms are often not noticed.
Diabetes is most definitely not a death sentence if managed well, but uncontrolled diabetes can be. Even well-controlled diabetes can often affect people's quality of life in a negative way and it is great to prevent it if possible.
The severity of type 2 diabetes often increases over time if not managed well.
I don't think anyone is telling diabetics that their disease is all their fault or that they are responsible for the high cost of health care.
Quite the opposite, this is about empowering people by giving them necessary information through testing to prevent the onset of diabetes and many of the risk factors that come with it if possible.
Sugar and fruit are primarily carbs so if they were causing you problems than carbs were causing you problems.
In fact I believe it is very rare to become addicted to foods that are not carbs. Even fat seems to only lead to overeating if it is combined with sugar as is the case in many processed foods.
Birgit

You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,261
12/21/13 10:28 P

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Becky,
I did read the link you posted and I never said that everyone should lower their A1c level. I was strictly talking about people who have never had their A1 c level checked and who is not currently on diabetes meds or insulin. I know there are situation where I higher A1 c level may be necessary, but for otherwise healthy people my physician gave me the recommendation of shooting for an A1c of 5. I am not saying that this is true for everybody, just that people should get tested and find out where they are at.
Birgit

You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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SKIRNIR's Photo SKIRNIR Posts: 5,231
12/21/13 7:44 P

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I am having a hard time responding to this discussion. But some of it has bothered me a little bit...

1. Diabetes is not solely a preventable, or caused only by what we eat. Yes, one way of managing it, or trying to prevent it is watching what we eat and trying to loose weight. And yes, loosing weight does help avoid it, but it takes time. That is the frustrating part for me. It took me two years to loose 50 pounds. My sugar levels went from the 90s to the 80s during that time. Don't know my H1c levels, as they don't tend to tell me that one when they do a blood workup. While I had gestational diabetes, no one in my family was diagnosed with diabetes, but now, my dad has it, my older brother has it. So it does run in my family, even if when I had it while pregnant, I had no idea it ran in the family. The doctor did suspect it though, as my blood glucose and the cholesterol and triglyceride numbers were all a bit high.

2. Diabetes is not a death sentence. Yes, it is scary to think many have it and don't know it, but there is an easy fix. Testing and learning how to deal with it. Yes, it is something that won't go away. Something you will have to continue to deal with. Many have it and have it rather mildly and it isn't too life changing. Others have much more hard to control forms and that is very tough. I don't want to see people who have diabetes told that it is all their fault. Or they are the cause of our high health care or any such thing.

3. For me, when I had gestational diabetes, carbs were not much of a problem for me. For me, it tended to be sugar and fruit. At breakfast I could have plain bran flake cereal with milk, but add a few raisins, and forget it. Now breakfast was the hardest meal for me to not have high sugars after, as it is the break fast meal that your body isn't as prepared for, I think. I will say the dietician I saw also was crappy working with people. She set all this rules down, but didn't help me to understand it myself. IE diabetes is different for each person. Some, like my husband's father, can be set off more by carbs. The dietician I saw noticed that some people would have a high fat meal and then have high blood sugars the whole next day, that did seem to be true for me. Protein did help counteract a bit the high sugar. IE I couldn't tend to eat ice cream, but I could eat frozen custard, which adds some egg to make it richer. So really a dietician needs to give suggestions, but also help a patient understand the disease, so they can figure out what works for them.


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12/21/13 7:35 P

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Dear HOUNDLOVER--
While I know the intent of your post was to help our members and encourage diabetes screening, I do want you to realize that much of your posting within this thread is crossing the line into diagnosing and medical management of disease. We do "not" allow this on our site. If you take the time to read the link I provided you will see "why" a doctor needs to be involved in interpreting lab values and determine need based on overall healthcare management.
diabetes.niddk.nih.gov/dm/pubs/A1CTest/A1C
_Test_DM_508.pdf


Indicating that everyone should aim for the goal of a lower A1C could be dangerous for some depending on other medical diagnosis. You will see this discussed in the link I shared as well as concern with other situations.

While it is fine to encourage diabetes screening with one's doctor/clinic; I encourage that you leave the interpretation of the lab results and the appropriate treatment plan to the health care provider who has knowledge on the person's complete medical needs.

Thanks
Becky
Your SP Registered Dietitian

Edited by: DIETITIANBECKY at: 12/21/2013 (19:49)
ALGEBRAGIRL Posts: 1,767
12/21/13 5:04 P

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Thankfully, a lot more people should be able to get health care with the legislation recently passed in the U.S.

But - aside from that - if you make a car payment, if you make a rent payment, if you make any kind of payment, you still need to make some room for a payment to a health care provider for medical evaluations and treatment.

Whether a clinic or with some sort of subsidy from a social service agency, it's not something you switch for a 'cheaper' substitute, like self-diagnosis. I recently helped an elderly person navigate the medical care system and it is truly frightening to think what must be even scarier when you are too old and sick to care. All the more reason to bite the bullet and see a qualified practitioner before you are too sick or too far along in whatever ails you!

Ouch. I know it costs. Recently, I have had to pay out of pocket for dental care and visits to the eye doctor. The cost of the eye doctor's evaluation and prescription was not as outrageous to me as the cost of the prescription lenses and frames. As I said to the person in the optical shop, I've paid less for a car!

When it comes to judging who should be considered pre-diabetic, counting someone as 'close' to pre-diabetic is when you might use that much broader range cited in the NCBI abstract I linked to - and that's not a recommendation... just a stab at whatever 'close to' might mean in a health context.

And even then, it doesn't mean much without medical attention over time. In my own case, when I low-carbed, everything was higher... my lipids, my fasting blood sugar... and those results went down as I turned to a more carb-heavy (quite more starchy, actually) diet. But this has all been tracked over time with the medical results from my doctor's office on file with him and also with me (he sends the lab results to his patients so they can be discussed at the time of the annual physical).

It's very individual, diet and health, but doctors deal with individuals.

'Taking steps early' depends on the individual and what the appropriate steps are, given the individual's health, age, gender, etc. I really REALLY would never try to manage my kid's health without a doctor's insights and attention - and when you think about it, it's because your children are precious to you. You should be precious to you, too.














































Edited by: ALGEBRAGIRL at: 12/21/2013 (17:07)
HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,261
12/21/13 4:38 P

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I agree that getting blood sugar tests from a health care provider is the best way to go. But there are millions of people who either do not have health insurance or have reservations going to a doctor or health care clinic. In those cases the at-home tests, which are sent to a lab, give at least a starting point. I compared an at home A1c test with a doctor-ordered one and the one read 5.7 , the other 5.8, a very small margin.
As far as the percentage of people who do not realized their blood sugar levels, it might be helpful to count those people who are not "officially" pre-diabetic but whose blood sugar levels are getting close. I had an A1c test done in 2006 that was 5.3, still in the normal range, but definitely higher than ideal. If I had reduced my carb levels then I may never have become pre-diabetic. But my doctor did not see a problem. This is why I would encourage anyone to take steps early while it's very easy to do so and a moderate reduction in carbs will be all it takes.
Birgit

Edited by: HOUNDLOVER1 at: 12/21/2013 (16:40)
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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,261
12/21/13 4:29 P

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It is scary indeed, and not just because of the number of people who will end up very sick and with a low quality of life, but also because of the overwhelming cost to our health care system that comes from all the consequences of diabetes and it's far ranging consequences. We need our health care system to be able to help people with those diseases that can not be avoided through good lifestyle choices. Preventing diabetes whenever possible or at least managing it well goes a very long way towards making health care affordable for our country. We have a responsibility to ourselves and to the coming generations to keep health care costs from spinning any more out of control. This is an issue where helping ourselves is also helping our country, a win-win situation for sure.
Birgit

You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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DIETITIANBECKY's Photo DIETITIANBECKY Posts: 26,660
12/21/13 3:45 P

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ALGEBRAGIRL-
You are correct...
There is some inaccurate information in the original post.
As the Registered Dietitian for this site, I wanted to emphasize the need to receive testing from a provider; and an approved treatment plan as well based on overall health need.

Becky

ALGEBRAGIRL Posts: 1,767
12/21/13 3:34 P

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http://www.ncbi.nlm.nih.gov/pubmed/23498302

'However, the authors estimate that, among U.S. adults, the top 15% of the nondiabetic HBA1c distribution (HbA1c of 5.7%-6.4%) accounts for 47% of diabetes cases over 5 years, and the top 30% (5.5%-6.4%) accounts for about 70% of cases. Although this clustering of eventual cases at the high end of the HbA1c risk distribution means that intervention resources will be more efficient when applied to the upper end of the distribution, no obvious threshold exists to prioritize people for preventive interventions. Thus, the choice of optimal thresholds is a tradeoff,'



As I've said before, my diet is one big Carb-onanza. But I'm not even in the top 30% (yet!) according to my A1C (a blood test, drawn in the office and sent to a lab). If I were, how would I know if I was in the 70% diagnosed with diabetes over 5 years?

The number of people who prediabetic and don't know it was estimated to be 89% by the CDC.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6211a4.htm

(That's 89% of people who do qualify as 'prediabetic,' not 89% of the population!)

But I don't get how this could easily be half the country. Risk does increase past the age of 45 (yep, I'm in that category) and for women who've had large babies (my son was very large, so my obstetrician ran a Glucose Tolerance Test on me - which I 'passed'). Even if half the country does have risk in their family, plus large babies, plus aging, plus inactivity (huge factor, there), I still don't know that half the country could be prediabetic.

It may sound like splitting hairs, but on the other hand, each individual should know their risk just by having a doctor visit and asking for an evaluation of their own risk.

It's wonderful to know when you have dangerously high blood sugar by testing yourself with a kit and then going to the doctor who will then have your blood sent to a lab and tested again. However, the fasting blood sugar done in a doctor's office (nothing to eat or drink for 12 hours, not even coffee) is accurate and reliable and the A1C done with the same batch of lab tests is going to be covered by insurance. And it WILL be done anyway - no doctor goes by home tests, not even home pregnancy tests - and my doc thinks home pregnancy tests are super-accurate. It's the person doing the tests who's the random variable!

Still, if you think you're pregnant, you do want to run out and buy the test, right? And do it even though you know you're going to be in the doctor's office next week to have your blood drawn for the pregnancy test!

Sorry, Dieticianbecky - did't see that you were posting all that info...



Edited by: ALGEBRAGIRL at: 12/21/2013 (15:42)
DIETITIANBECKY's Photo DIETITIANBECKY Posts: 26,660
12/21/13 2:48 P

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It is scary to think of the number of people who are not aware that they have (or are at risk for having) pre-diabetes or diabetes. Receiving an accurate diagnosis and treatment plan is crucial. This can occur through one's primary care physician, a worksite wellness program, community screening, community clinics, free-clinics, and health departments.

For those following this thread, please utilize the national guidelines for pre-diabetes management and diabetes management. I provide this link for interpretation of the A1C test:
diabetes.niddk.nih.gov/dm/pubs/A1CTest/A1C
_Test_DM_508.pdf


Your health care provider will also be able to provide the plan to best meet your needs---this would involve an appropriate diet, exercise, and medication plan.

Becky
Your SP Registered Dietitian


Edited by: DIETITIANBECKY at: 12/21/2013 (14:53)
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12/21/13 2:46 P

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I get my vitals and such checked annually at my physical and my blood sugar is actually fine. I may be a bit overweight these days but fortunately, I am not concerned about diabetes. And since I am not even pre diabetic, it wouldn't make sense to test my blood sugar daily.

However, it is a good reminder to get things checked annually.



HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,261
12/21/13 1:29 P

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And this question does belong in the nutrition forum because we can have a huge influence on our blood sugar levels with what we eat. But if we don't know we may not make the necessary changes and end up with type 2 diabetes, a disease that kills and maims huge numbers of people every year and reduces the quality of life for even more people.
But first to the reason for testing. The exact numbers vary but, depending on the source, up to 90% of people who are pre-diabetic do not know. That could easily be more than half of the country. The reasons given for this vary as well, with many sources saying that obesity is a major factor, other sources saying that family history of DDT exposure will show effects in the second or third generation, other sources saying the fructose in the diet is the major cause.
Leaving the cause aside, not knowing what our daily and average blood sugar levels are is a very bad place to be. Frequently and chronically elevated blood sugars can be a sign of insulin resistance (of muscle cells first), meaning that the body needs to produce more and more insulin to regulate blood sugar levels. When insulin production in the pancreas can not keep up then blood sugar levels in the blood go up too much. There is more and more evidence that even in the pre-diabetic range there are many negative effects on the body, ranging from short-term memory loss to gastro-paresis, to nerve damage, especially when these levels are high over long periods of time. The brain especially suffers greatly from chronically elevated blood sugar levels but the risk for heart disease goes up hugely, too.
Measuring daily blood sugar levels both fasted and after eating is helpful and can be done with a home kit that diabetics use. It is inexpensive and reliable.
But the other test that does not require daily measuring to be helpful is the Hemoglobin A1c test. This test measures average blood sugars over the period of the last 3 months and is reliable in most cases as long as hemoglobin levels in the blood are normal.
The test kits are available in some drug stores and at Walmart in the diabetes section and are very reasonably priced. For those that have health insurance any physician can do the test as part of standard blood work.
What A1c testing often reveals is surprisingly often that people who are not overweight already have elevated blood sugars. This gives support to the idea that insulin-resistance/diabets lead to obesity, not the other way around.
A normal A1c result would be in the 4's or up to the low 5's in most cases, the pre-diabetic range goes from 5.7-6.4 and anything above that is considered diabetic.
There is a problem with the definition of the pre-diabetic range. It makes people get the impression that anything under 5.7 is ideal. But we don't know in each individual case at what A1c level blood sugars in our body do damage and at what level our pancreas is starting to burn out.
It is somewhat like walking at the edge of a cliff with poor eye sight: we don't want to walk too close to the edge to be sure we won't fall off. Setting a goal of an A1c level that is a little further away from the pre-diabetic range is a good way to be safe and maintain good insulin sensitivity for life.
Early testing, even in children and normal weight people, will assure that elevated blood sugar levels are caught and dealt with early through diet alone while this is still relatively easy and most of the damage can be undone.
An excellent resource on the topic is the book " Dr. Bernstein's diabetes solution", a book written by a type 1 diabetic who has been extra-ordinarily successful in managing his diabetes and who counsels others in what he practices.

www.amazon.com/Dr-Bernsteins-Diabetes-Solu
tion-Achieving/dp/0316182699/ref=pd_si
m_b_1


Our whole family is on the border of being pre-diabetic right now with A1c levels ranging from 5.6-5.8 . I have already lowered my A1 c level significantly through eating a very low-carb diet.
We will all reduce our carbohydrate levels enough to get our A1c level as close to 5 or even in the 4's as we can in the coming year. The exact level of carbohydrates that we can tolerate depend on the person, for me it is 30-40 grams/day, for others family members it may be between 50-80 grams/day. I know the health benefits will be huge.

If you have never been tested, please make this small investment in your health. It may save your life but at least will improve your quality of life in years to come.

Birgit

You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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