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Thursday, Dec. 18, 2014

Dealing with diabetes -- it does not get any easier

Wednesday, January 30, 2008

After having diabetes for several months, years, it appears that it would become easier to deal with it and to manage the chronic disease. Apparently, it never gets easy. Diabetes affects each individual in a different way. What might work for one person will not always work for another person.

Readers have expressed to me that they appreciate the columns when I discuss diabetes. More than one has told me that they have clipped the columns out and sent to their brothers. It is for this reason that I have selected this as my subject once again. There is no way that I am any authority on the subject. Instead, I speak from experience of having diabetes and my thoughts on the subject. I continually learn more and realize that there is more learning needed.

Each week more people are being diagnosed with diabetes. There are many who have diabetes and are not aware of having the disease. This increases their changes of having complications. The sooner a person realizes that they have diabetes and to take steps keeping it under control, the greater chance of reducing the complications, which can include death.

Another group is those who are pre-diabetic. These individuals are not diabetic, but most likely they will become diabetic. Many of these may be able to head off becoming diabetic, by weight reduction, exercise and with the proper diet. The number one thing that they need to do is to stop smoking if they are smokers.

As I have often said, everyone should follow the same diet as if they were diabetic. It is not always easy to do, but essential. This means a specific amount of calories designed for each individual and no pie, no cake and no cookies. At the educational program at the Mid-America Diabetes Associates in Wichita, Kan., they said it is OK to have a piece of German Chocolate cake once a year (my favorite) on your birthday.

It was of interest to recently read about one woman saying that those with diabetes should not be referred to as a diabetic. She did not like the term and thought it should not be used. More and more people seem to have a soft skin. I assume that she would refer to a person as the "D" word. Personally, I do not think being referred to as being diabetic is in any way degrading.

Many with diabetes have no problem of keeping their diabetes under control. Others have a great amount of difficulties, experiencing highs and lows in their blood glucose.

Consideration was given to title this column, "The Margin is Narrow." Meaning that for many diabetics it is difficult to getting the sugar glucose level in an area that is not too low or too high. This may be caused by many factors including the medication, the diet and exercise.

When the blood sugar level is too low it is referred to as hypoglycemia. This is usually with a sugar level of less than 70 mg/dl; even below 80 is too low. A mild insulin reaction is when the blood sugars are 60mg +/- down to low 40s. Have been there and have done that -- it is not fun. Fortunately, I have never experienced a moderate or severe insulin reaction, but have known others that have experienced unconsciousness.

Hyperglycemia is when the blood sugar is high. I considered that was when it was really high, such as 400 or more. Here I am thinking that I have never really been hyperglycemia. I am aware of the targets where the blood sugar readings need to be. Still, I have not considered anything higher than those targets being hyperglycemia. I was wrong. That is what I mean as constantly learning.

Looking over information received from the education program from Mid-America Diabetes Associates in explaining hyperglycemia it says, "A blood sugar test of more than 110mg/dl before breakfast is above normal. If your blood sugar is often more than 140 mg/dl after meals or your A1C is more than 6.5 percent it is too high." The after meals are two hours after starting to eat the meal.

With these definitions and standards, yes, too often I am hyperglycemic. Many diabetics are not aware of their A1C, which is an important indication of the blood sugar level. This gives the average blood glucose level for the past 2 or 3 months. Many diabetics are not aware of what their ideal daily blood sugars tests are.

The targets mentioned are standards that need to be met -- at least most of the time. A person should not be frustrated when the targets are not met, but there may need to be an adjustment of some type. These things need to be discussed with your doctor.

While at the education program in Wichita I experienced a low in class. I was checking my blood, when they asked me if I had a low. I did and it was in the high 50s and they would not allow me to move. They gave me two teaspoons of honey and when it did not go up in a few minutes they repeated the honey.

I am now beginning to realize why they were so serious. When the reading gets below 60 mg/dl it is serious. Because a person is not feeling well and wants to come out of it, it is easy to take on too many calories, resulting in a high. Even after getting the sugar level up, it takes awhile to recover from the experience.

The amount of calories, I should be taking after a low of that type is 60 and then checking the blood sugar about 20 minutes later.

One more tip, before exercising check the blood sugar level. If it is below 100 mg/dl, get it up before exercising.

For me and for many others it does not get any easier -- the margin is narrow. It takes discipline. It also takes maintaining a positive attitude.

Leonard Ernsbarger
Leonard At Large