I’m hopeful some people can help me. My husband was diagnosed with type 2
in November 1994 at the age of 33. He is of average weight. He is taking
the max amount glucophage and 2.5 mg. of glucotrol. He is sensitive to
insulin; his BG plummets with as little as 2 units. Last holiday season,
he was so newly diagnosed, that he was experimenting with treatment. I
feel like this is the first time he’s really on a regime.
My concern is this. He is nervous about all social situations this
season. He really eats at regular times. He is prone to hypoglycemic
episodes if he waits too long to eat. Usually by the time he feels it
coming on, it’s too late. . . he treats it but his liver generally is
kicking in some glucose on top of this (our educated guess). So, timing
dinner reservations, etc. has been a nightmare. He eats dinner at 6:30 pm
pretty much precisely every single day. This is not always possible in a
restaurant situation or when dining with friends. he feels he is "putting
people out", but he knows how serious this is too. It’s easier to "avoid"
then deal with this. However, I don’t want to sit home all through the
holidays. Plus, we are going to a lovely restaurant on Friday for my
birthday where meals tend to take a while. We RARELY go out because of
this problem.
I don’t know what to do. I’m sure others out there have found ways to cope
with this. . . slow waiters, busy holiday season, etc. Also, there’s the
issue of eating at other people’s homes. . .things do happen.
Thanksgiving at his sister’s was 1 hour later than planned. . .although
she did her very best. The turkey did not cooperate.
Any advice? Should he take a swig of juice if the wait gets too long?
Then, he really has to watch what to eat at his meal? I really would love
some help and ideas. Thanks in advance.
Patricia
Patricia
I was concerned about my "violent" swings in blood glucose when
I was first diagnosed with diabetes. A couple of diabetic
friends told me their "swings" moderated after they’d had the
disease a few years, and that’s what happened to me too.
I carry "ritz" crackers or "graham" crackers with me everywhere
I go and use them to munch when I’m in a late-for-dinner
situation. I rarely seem to need them UNLESS I have neglected
to bring them along, when of course I seem to get in trouble.
I also carry a small plastic container or 2 full of good old
nasty white table sugar. I never seem to eat the sugar unless
I’m REALLY in trouble whereas if I keep sweets or snacks I like
I DON’T "keep" them, I get into them and eat them prematurely
and unnecessarily. The containers that my glucose test strips
come in are what I use for sugar containers, they are small and
can be kept unobtrusively in a coat pocket etc.
I’ve been diabetic for more than 10 years now and I still find
myself forgetting to keep such supplies in EVERY vehicle I ride
in, or a often-worn jacket, despite the fact I always take
insulin supplies with me.
I also keep a diary of my injections, reactions, sicknesses,
basic summaries of what I ate that day vs. what exercise I got,
which often comes in handy when I check my bg at bedtime and
find I’m way over the limit. If I can find a similar situation
in my diary I can get a good guess as to how much R insulin to
take to lower the blood glucose while still (hopefully)
allowing me to get a good night’s sleep. As your husband gains
more experience he will be better able to guage and guess his
needs for odd mealtimes, pigout sessions, etc, as well as stay
prepared for the inevitable unexpected drops in bg levels.
—
*********** Jim Devenport WB5AOX **************
* PO Box 445, McIntosh NM 87032 *
* http://nis-www.lanl.gov/~jdport/ *
***********************************************
My eleven year old son has Type 1 and one of the first things
he was told by his team educator was to always carry a pack of
life savers in his pocket. This has come in handy on more than
one incident. He does get tired of us asking everytime he goes
out if he has his life savers. When we eat out we try to find
those restaurants who either have a salad bar or a buffet line
so even if some of us want to order off the menu he can begin
with his salad almost as soon as we sit down. Eating out has
certainly proved to be one of our biggest challenges. Good
Luck.
Paula Carr
In article <49fm0u$…@newsbf02.news.aol.com>, tri…@aol.com (TRICI N) writes:
=I’m hopeful some people can help me. My husband was diagnosed with type 2
=in November 1994 at the age of 33. He is of average weight. He is taking
=the max amount glucophage and 2.5 mg. of glucotrol. He is sensitive to
=insulin; his BG plummets with as little as 2 units.
He might want to experiment with timing of injections. If his diabetes is
characterized by impaired early-phase insulin release, and he injects at such a
time that the insulin doesn’t take effect until his blood sugar level has
already increased substantially, then that might explain the apparent insulin
sensitivity (basically, the action of the injected insulin permits glucose
metabolism, triggering a massive late-phase insulin release, so the BG isn’t
really plumetting with 2 units of insulin: it’s plumetting with the 2 units he
injected plus the considerably larger amount his body releases in response),
and there’s a chance that, by injecting earlier, so that the insulin begins to
take effect before the blood sugar spike, the apparent sensitivity could be
avoided. He should, of course, discuss the idea with his doctor before trying
it.
—————————————————————————
I try very hard to say exactly what I mean. I’d appreciate it if you’d
bear that in mind and not try to "interpret" my posts to fit your own
preconceived notions if I’m posting in a serious thread. Remember: If you
throw a strawman into a heated debate, flames are likely to be the result.
I agree 100% about the purpose of the survey. They try to make it sound
like it is for scientific uses but when you look closely you find it is
actually from B-D. I was taking a course in market research last year and
called B-D looking for Martha to ask some questions. I was switched to a
number of people and finally got to the area where she works (I think she
is a real person). I explained that the survey made it sound like the
info was for scientific research and I wanted to use it for a course I was
taking at Rochester Institute of Technology. They refused to give me any
info and said it belonged to the sponsors of the survey and was for their
use only. I read her what the intro on the survey said and stated it
sounded like it was for sci purposes and I planned to use it in my paper.
She said sorry, no way. Oh well, it was at that point I realized I had
just entered myself into B-D, BMD, and Lilly’s market research database.
My prediction is they will attempt to use B-D’s micro collection equipment
and BMD’s dry technology to come up with competion to Bayer/Technicons
capilary HBA1C product. Now they know who to market it to (smart
marketing ploy, lousy PR move).
If I had only realized that up front I wouldn’t have wasted my time!
Maybe if they read this we can see the results published in ADA Forcast!
In article <1995Nov28.231006.7…@lafn.org>, ar…@lafn.org (David Cohler)
wrote:
- Hide quoted text — Show quoted text -
> I dunno about the rest of you who may have received the latest so-
> called "PACE" survey form from BD, but I am irked at what looks to
> be more like a marketing ploy than a sincere effort to propagate
> accurate info about maintaining good bg control.
> The cover letter, from "Martha Griffin, Diabetes Care Specialist,"
> evidently an employee of BD, states categorically that "People
> with diabetes should take (an Hb1AC — glycolsolated hemoglobin —
> test) three to four times a year." She neglects to mention that
> the test, while indeed an excellent indicator of overall bg
> control, is nonetheless *absolutely unnecessary* for diabetics
> whose control is good (as measured by frequent home monitoring)
> and who are thus on the right track without it. For such people,
> just one A1C a year might be defendable, but three or four is an
> absolute waste of resources. Griffin further urges all diabetics
> to ask their doctors about the test — as if MD’s didn’t know
> about it already. The effect of this hectoring is to get doctors
> to prescribe tests which may be totally unnecessary, and thereby
> to put more money into the pockets of various product and service
> providers — the ripple effect of which is to drive up health care
> and insurance costs.
> The "survey" itself (which is actually a thinly disguised attempt
> to gather marketing info) asks 9 questions about various aspects
> of bg control — including, of course, what products you use.
> Some of the questions appear to have been written by nondiabetics.
> For example, question #7: "How many times a day do you inject
> insulin?" The checkbox answers are limited to "1," "2," "3," and
> "4 or more." It apparently did not occur to the questioner that
> "As many as necessary to maintain good control" is a probable (and
> possibly the best) answer. Ditto for the question, "How often do
> you test your blood sugar?" "As often as necessary" is *not*
> among the optional answers.
> Well, look, the sponsors of this mailing (BD, Lilly, & Boehringer
> Mannheim) make excellent products for diabetics. But I resent
> their blatant effort to boost sales via a marketing ploy they
> choose to call a "National Diabetes Care Survey." I wish they had
> spend the money on *product* R & D instead of on marketing R & D.
> —
> David Cohler, South Pasadena
In article <1995Nov28.231006.7…@lafn.org>,
David Cohler <ar…@lafn.org> wrote:
>The cover letter, from "Martha Griffin, Diabetes Care Specialist,"
>evidently an employee of BD, states categorically that "People
>with diabetes should take (an Hb1AC — glycolsolated hemoglobin —
>test) three to four times a year." She neglects to mention that
>the test, while indeed an excellent indicator of overall bg
>control, is nonetheless *absolutely unnecessary* for diabetics
>whose control is good (as measured by frequent home monitoring)
>and who are thus on the right track without it.
Don’t forget that *many* of the diabetics out there are not
undergoing what some call "intensive therapy". The reasons
why they aren’t are wide and varied, but a significant chunk
could benefit from a Hb1AC.
How frequently would you have to test to make the HB1AC test
absolutely unnecessary? Many diabetics who check their
blood sugars religiously 4 times a day will rarely check their
blood sugars at other than before meal times, while the large
spikes in blood sugar most likely take place between meals.
The A1C number is a convenient quick test that says something
about the overall average level, instead of the levels at the
before-mealtime tests that are most often done. It’s not
a full replacement for individual blood glucose measurements,
though.
> For such people,
>just one A1C a year might be defendable, but three or four is an
>absolute waste of resources.
Once a year is something I could live with. My doctor would
probably prefer to have it done more often, though.
> Griffin further urges all diabetics
>to ask their doctors about the test — as if MD’s didn’t know
>about it already.
Many GP’s (again, not all diabetics are under intensive treatment
and many don’t even see an endocrinologist regularly) probably don’t
know about the A1C test, or how to use it.
> The effect of this hectoring is to get doctors
>to prescribe tests which may be totally unnecessary, and thereby
>to put more money into the pockets of various product and service
>providers — the ripple effect of which is to drive up health care
>and insurance costs.
I believe the lab charge for a A1C test is about $20-$30;
depending on exactly what sort of home blood glucose strips are
being used, this would pay for fifty or so home glucose
tests at random times to come up with the same average that the
A1C measures. Whether those fifty extra tests
would be of the same use as the A1C is something that probably
depends on the doctor and patient.
Tim. (sho…@altair.krl.caltech.edu)
In article <1995Dec4.154001.27…@lafn.org>,
David Cohler <ar…@lafn.org> wrote:
>In a previous article, sho…@altair.krl.caltech.edu (Tim Shoppa) says:
>>>How frequently would you have to test to make the HB1AC test
>>absolutely unnecessary? Many diabetics who check their
>>blood sugars religiously 4 times a day will rarely check their
>>blood sugars at other than before meal times, while the large
>>spikes in blood sugar most likely take place between meals.
>Well, then, they are checking their bg’s at the wrong times. The more
>useful measure is 1-2 hours *after* a meal.
It depends what you’re using it *for*. For long-term planning and
checking your current regimen, yeah. For short-term, "how much insulin
do I need for *this* injection?", before meals is more useful.
Rachel
–
Rachel Meredith Kadel or, for the adventurously inclined, Bean-na-Sidhe
rka…@fas.harvard.edu
Honorary Fellow of Brad’s School of Piano Tuning and Bible Technology
In a previous article, lfraz…@erols.com (Larry Frazier) says:
>Sound like you’ll be entered into the marketing database and targeted
>for mailings etc. later. Keep this information private.
>If you are doing frequent BG monitoring, the A1C may not be as important.
>It is however valuable to doctors, because people naturally try to become
>more careful about control when expecting to visit the doctor soon. I
>used to become more "complient" with doctors orders when a visit was due.
>The A1C gives the physician a two month overall view of patients
>condition, not just the careful tweaking the patient did for a few days
>to get a good "fasting BG" result.
Another example of what happens when people lift quotes out of context.
By the time the 3rd or 4th person chimes in, the intent of the original
post becomes completely distorted. All I said was that it is incorrect
to tell *all* diabetics, regardless of type or degree of control, to have
three or four A1C tests a year. No one disputes that it’s a valuable
test for doctor and patient alike. But it is by no means required if
doctor and patient are satisfied about degree of control without it. And
for BD, Lilly, and Boeringer Mannheim to say otherwise is a marketing
ploy having nothing to do with good medicine.
–
David Cohler, South Pasadena