Mr Mac had diabetes

And his diagnosis is freaking me out.

He's got it pretty mildly right now. To the point where his doctor just wants him to monitor his blood sugar levels twice a day and see a nutritionist.

To me, it's a sign he's in decline. I have been worrying very much about a heart attack given his weight, his cholesterol and his family history but now he has sleep apnea, high cholesterol and diabetes. I think of that as the Morbid Obesity Triad.

He is talking about exercising again. I'm trying to get him to go out with me sometimes. Like when I go running, he can go walking. If we time it right, we can start and end together.

I'm still very worried because I see diabetes as the first step towards all sorts of health problems such as wounds that never heal, blindness, getting legs amputated, etc.

You are absolutely correct to be worried about him. I had all those risk factors and decided to have surgery, because I was more afraid of severe sleep apnea and diabetes, than I was of having the surgery. I was pre-diabetic, but headed towards diabetes, and saw my father go through it. I didn't want anything to do with it. I am a RN and have seen the devastation that diabetes can wrought.

Would he consider surgery? If he lost just 10 % of his weight, his numbers would improve, as well as the level of risk. Studies have shown that just 10% weight loss can have a positive influence on Type 2 diabetes and cholesterol levels.

Take Care, Marie.

Gail

Gail, I've seen that study...while WLS absolutely has a positive effect, just losing weight doesn't always. I lost over 40 lbs at one point and still was on an insulin pump and my use of insulin went up instead of down. I lost from 245 down to 185 at one point and it rose instead of going down. And most of the people I know on the list I mentioned (well over 2000) don't go down unless they lower their carb intact even if they do not lose weight.

Liz

 I don't think small decreases in weight can help everyone, but it can help those with pre-diabetes and/or early Type 2 diabetes. Usually, decreases in weight, along with lowered carb intact can help to lower triglycerides and cholesterol levels. Not always, since family history and other environmental factors come into play. There are exceptions to everything, but weight loss and lowered carb intake can make a difference.

WLS was truly a gift for you, since it seems like you had a very brittle type of diabetes.


Gail

My diabetes was stable thanks to being on an insulin pump...had I relied just on insulin shots, I would have been up and down.

Now stable doesn't mean perfect control...that was part of the issue the last two years. I was running over an 8 a1c the last two years but didn't go too low or too high within that range...it just wasn't budging.

But stable also means I wasn't brittle, just had a LOT of insulin resistance. Now my stepdaughter who is a type 1 would be considered brittle cause she has wild swings in her blood sugar readings.

So, the pump helped to keep you stable.  Would a pump help your stepdaughter's diabetes to be more stable?

Unfortunately she is already on a pump and has been longer than I was. What WOULD help her is watching her carb intake...She thinks the pump gives her license to eat as she wants.

Unfortunately, many people who have diabetes think that way. They just give themselves more insulin to cover the carbs. I have a friend, whose sister operates that way. The more carbs they eat, the more insulin they take.

I'd be worried too...but there are things you can do to help him besides what you are doing now. The best way to keep your A1C under control is to know what foods push him high and that means a rigorous testing when eating anything besides meat (protein) or fat.

How to test any food that has carbs in it...
Test prior to eating.
Test again at each of these marks: 30 mins, 1 hr, 2 hr, and 3 hr.

The highest point after the meal should be no more than 20 points higher than the pre meal test. So if you test 120 pre-meal, the highest you should go is 140 in the three hours after. Some people have a delayed response which is why you add the 3 hour mark.

You can monitor twice a day and still have full blown uncontrolled diabetes. You have to test after meals. And most nutritionists will tell him to eat a diabetic diet (btw, there is NO such animal). All except one "diabetes" diet is heavy on grains which translate into sugar in the blood.

Start reading labels for carbs, not net carbs, but total carbs. Sugar isn't the only culprit as carbs turn into sugar in your system and white/starchy carbs are higher in sugar than green leafy ones.

You can either learn the list that most of the well controlled diabetics I know follow: http://www.diabetes-book.com/readit.shtml Chapter 9 & 10 or get a copy of the glycemic index.

I'm still very worried because I see diabetes as the first step towards all sorts of health problems such as wounds that never heal, blindness, getting legs amputated, etc.

While those are issues, the biggest problem is not the triad of issues that can plague a diabetic (peripherial neuropathy, eye problems, or kidney issues) but what diabetes can do to your heart.

And there is a place to find out all kinds of information...a yahoo list that I belong to that is owned by an endo out of Boston. He ran it on a Lehigh listserv for years before having to move to yahoo. You can find it here: http://health.groups.yahoo.com/group/diabetesworld/ It's not just for diabetics but for their loved ones/support system as well. I've been a member since 1999.

I hope he gets it back under control soon.

Liz

He won't consider surgery. He's deathly afraid of hospitals and surgery. Maybe this will be the item that pushes him over the edge but I suspect not.

He's supposed to measure when he wakes up and after eating dinner. I can mention he should measure before dinner too but I know from past experience he will blow me off if his doctor tells him something different.