Question:
I have had a hx of high cholesterol, 215-268 with a rato that ranges from 5.1-7.1. I had controlled it with Niacin I thought, and hadn't had a physical for several years. Recently, at about 25 LBS overweight, I finally decided to go for a physical. I had put it off as I wanted to lose weight to get life insurance and my weight never came off but I never really worked hard at it. I was horrified at my physical to learn that my Cholesterol was at about 275, triglycerides at about 220, LDL was at about 190, HDL 48 and my ratio was about 6.1. Also my blood sugar was about 175. When I did the A1C test it came back 9.1. The doctor put me on glucophage and zocor. The questions are: 6) Is it a foregone conclusion that I am diabetic or could it be a function of my weight? In the past when my weight went down, so did my cholesterol numbers. 7) I am reading that Diabetes can be reversed with diet and exercise but some physicians say that in theory it can never be reversed. 8) If one is genetically predisposed to diabetes, would it develop even for one in good shape with lots of exercise. What I am wondering is if I definitely brought it on myself . In other words, had I exercised and been at a decent weight is it possible that I would have never developed it or would the onset just have been forstalled? 9) If one monitors and controlls their diabetes, can they live just as long as anyone else without any complications? 10) Is it better to be off of medication and try to deal with it with diet and exercise first? 11) Anyone have any experiences getting life insurance with controlled diabetes and if so how much is it compared to someone who does not have it? 12) I am using KetoDia Sticks to generally check my ketones and glucose. Should I invest in a glucometer and if so which one? 13) I will be visiting the MD for the first time post glucophage in a few weeks. What type of reduction in numbers should I be looking for? 14) Should I get a consult from a endocrinologist? Thanks for all of your support. I am very new to this. Any good books to read?
Answers:
"Michael Roback" <roback~earthlink.net wrote in message news- :kbbLa.68704$Io.6433171~newsread2.prod.itd.earthlink.net... I have had a hx of high cholesterol, 215-268 with a rato that ranges from 5.1-7.1. I had controlled it with Niacin I thought, and hadn't had a physical for several years. Recently, at about 25 LBS overweight, I finally decided to go for a physical. I had put it off as I wanted to lose weight to get life insurance and my weight never came off but I never really worked hard at it. I was horrified at my physical to learn that my Cholesterol was at about 275, triglycerides at about 220, LDL was at about 190, HDL 48 and my ratio was about 6.1. Also my blood sugar was about 175. When I did the A1C test it came back 9.1. The doctor put me on glucophage and zocor. The questions are: Hi there Michael, Welcome to the group. This is a very long list of questions, and I sure don't know the answers to all of them. So what I'll do is answer as best I can the ones that I know a bit about, and leave the rest for either someone else to tackle, or as unanswerable. Just keep in mind that NONE of us are experts, but collectively, we have a lot of experience and knowledge between us, that may very well be of help to you. Think over the answers carefully, and choose those that work for you. ("Working" for you means that the suggested strategy WORKS, ie improves your health status.) It may not always be what you wanted to hear though! Which leads us to your first question. 1) Is it a foregone conclusion that I am diabetic or could it be a function of my weight? In the past when my weight went down, so did my cholesterol numbers. You have diabetes. Diabetes and being overweight are linked. Which came first is still unanswerable. They promote one another in a vicious cycle. Your A1c was 9.1%. Your random blood glucose (bg) test at the doctor's was , <about 175. It can be controlled, it can appear to be in "remission", but once you develop frank diabetes, it's always there. To date there is no cure. Additionally, the high triglycerides, the poor cholesterol ratios are all indicators of insulin resistance, the definitive symptom for a dx of Type II (T2) diabetes. You had the insulin resistance before you developed diabetes, and at that stage, yes, one CAN hault the progression to frank diabetes, but once the hyperglycaemia has permanently damaged the beta cells in your pancreas, the pancreas will never handle your bg for you like it did in the past. There are studies ongoing to see if this state of affairs can be remedied, but so far they're just hopes and speculations. Gaining good control, however, of your bg levels, will also probably lower your weight, improve your cholesterol profile and lower your insulin resistance. For most T2's, getting back to non-diabetic levels in these things is our major goal. 2) I am reading that Diabetes can be reversed with diet and exercise but some physicians say that in theory it can never be reversed. What I said above. There are three strategies that can be employed to achieve good control of your diabetes. 1. Medication - oral meds, and/or insulin. Your doctor has already started on this, and is the person one looks to for help and advice. Different meds often work in quite different ways, and you will need to become familiar with each one you take, and how it works in your body. 2. Diet. What you eat, and how fast the glucose from that food enters your blood stream is extremely important. High blood glucose (hyperglycemia) can act as an inflamatory in your system, and some foods help reduce this affect. Others lower cholesterol and reduce LDL and increase HDL. This of course is in your hands. Dieticians can offer ideas and suggestions, but you'll find that most of us rely on our meters, and new understandings on nutrition, to work out what we should eat to achieve the goal of optimum health. 3. Exercise. Muscles use glucose to function, and when one exercises, they can actually "take up" glucose from the blood even without needing insulin! What's more, exercise builds more muscles, thus enhancing this effect. There are two kinds of exercise the aerobic kind (walking running, cycling etc), and the anaerobic or resistance exercises, (body building stuff). The first is the best for your cardiovascular system, the second for improving glucose up-take. Doing both is a great idea. Quite a few of us here are now controlling our diabetes with diet and exercise alone, (including me), but only after applying the diet and exercise WITH the meds, and gradually reducing the meds as we gained the desired level of control. The general opinion is to achieve good control before considering quitting the meds. 3) If one is genetically predisposed to diabetes, would it develop even for one in good shape with lots of exercise. What I am wondering is if I definitely brought it on myself . In other words, had I exercised and been at a decent weight is it possible that I would have never developed it or would the onset just have been forstalled? For a T2, the answer is "Probably". There are always exceptions. In a way, if one is genetically predisposed, the onset can be "forestalled" indefinitely! Still one must pay attention to the exercise and diet, and keep that weight off, to achieve this state. 4) If one monitors and controlls their diabetes, can they live just as long as anyone else without any complications? Perhaps. Some damage to your various body systems has already been done by insulin resistance and intermittant hyperglycemia about ten years before diagnosis of frank diabetes. What's more, it can be hard to determine how long the diabetic condition has been present, undetected. The sooner one gains good control, the better the chances of limiting or preventing the complications. Most of the members of this group are definitely not your average diabetic. We like to strive for as close to non-diabetic numbers as possible, and look after our health more aggressively than most. 5) Is it better to be off of medication and try to deal with it with diet and exercise first? Depends. I personally think the best approach is first gain the control, and then consider going med free. High blood glucose levels are the biggest threat to your future health. BTW, an A1c of under 6% is considered the goal in most cases. 6) Anyone have any experiences getting life insurance with controlled diabetes and if so how much is it compared to someone who does not have it? No comment. I live in Australia, and have no idea what may apply where you live. Life insurance has not been of concern to me. I guess it would depend on the insurance company's requirements. 7) I am using KetoDia Sticks to generally check my ketones and glucose. Should I invest in a glucometer and if so which one? Absolutely! Get a meter! The KetoDia sticks only measure glucose in the urine, which only shows up when blood levels of glucose exceed the renal thresh-hold. That's usually way too high for what we are endeavouring to achieve. Again, opinions vary about which meters are the best. Everyone has their favourites, for different reasons. In the US, a common reply would be "Whatever your insurance company will cover". Those with no insurance want the one that has cheap, readily available and reliable strips. In Australia, there are only a few on the market, and all of them are equally good. The thing about having a meter, is that you can then monitor what different foods do to your bg. One tests just before eating, and 2 hrs after the first bite. You'll be able to see just how that meal, and those foods, affected your bg. If you go to our web page, you can read Jennifer's advice to newbies for more detail about this. I strongly recommend you do so. The URL is: http://www.alt-support-diabetes.org 8) I will be visiting the MD for the first time post glucophage in a few weeks. What type of reduction in numbers should I be looking for? Glucophage (metformin) takes around 3 weeks to start showing results. Any lowering of your overall levels is a good result. What you are looking for is a downward daily trend, even if it is only small. Metformin is often accompanied by varying degress of gastric distress, which gradually recedes, so doctors often start patients on the lowest dose, and increase it gradually till the desired bg lowering effect has been achieved. One of the nice things about metformin is that it is unlikely to cause a hypo, it works by reducing insulin resistance, rather than by increasing insulin production, so is one of the safest meds to use. 9) Should I get a consult from a endocrinologist? Depends if you feel you need it. If you are unable to obtain good control, or are unhappy with your current doctor's approach, you may wish to see one. Many doctors refer their patients to one initially anyway, with 12 monthly check ups afterwards, if all is going well. Thanks for all of your support. I am very new to this. Any good books to read? Yes there are, and some good sites on the internet as well. Just brouse for "Diabetes". With books, check out your local library for up-to-date recent publications, and see which ones you like the best, before laying our money on one. You *are* going to have lots more questions, and we will be interested in your progress. I look forward to hearing from you again. Till then, All the best, Annette T2 for over 27 years, 63 yo, controlled by diet and exercise only. --- Outgoing mail is certified Virus Free. Checked by AVG anti-virus system (http://www.grisoft.com). Version: 6.0.493 / Virus Database: 292 - Release Date: 25/06/03
Answers:
On Sat, 28 Jun 2003 07:10:08 GMT, "Michael Roback" <roback~earthlink.net wrote: I have had a hx of high cholesterol, 215-268 with a rato that ranges from 5.1-7.1. I had controlled it with Niacin I thought, and hadn't had a physical for several years. Recently, at about 25 LBS overweight, I finally decided to go for a physical. I had put it off as I wanted to lose weight to get life insurance and my weight never came off but I never really worked hard at it. I was horrified at my physical to learn that my Cholesterol was at about 275, triglycerides at about 220, LDL was at about 190, HDL 48 and my ratio was about 6.1. Also my blood sugar was about 175. When I did the A1C test it came back 9.1. The doctor put me on glucophage and zocor. The questions are: 1) Is it a foregone conclusion that I am diabetic or could it be a function of my weight? In the past when my weight went down, so did my cholesterol numbers. Obesity and high cholesterol go hand in hand. Obesity may trigger diabetes. 2) I am reading that Diabetes can be reversed with diet and exercise but some physicians say that in theory it can never be reversed. Once a diabetic, always a diabetic. 3) If one is genetically predisposed to diabetes, would it develop even for one in good shape with lots of exercise. What I am wondering is if I definitely brought it on myself . In other words, had I exercised and been at a decent weight is it possible that I would have never developed it or would the onset just have been forstalled? Stress can also cause diabetes. 4) If one monitors and controlls their diabetes, can they live just as long as anyone else without any complications? No real way of knowing that answer. Diabetes affects each of us differently. With tight control some may never experience the nasty complications, while others will experience the complications. No real way of knowing. 5) Is it better to be off of medication and try to deal with it with diet and exercise first? Your doctor is the best judge of that. You should be aware that a lot of medical professionals are totally out of sync with the latest treatment of diabetes. Your medical practioner should treat your diabetes with aggressiveness. Some doctors/nurses think that a BG of 200 is fine. Keep those BG's as close to non diabetic numbers as possible. If you see a dumbshit doctor/nurse with a cavalier attitude, find a different medical team immediately. It is your life you are playing with. 6) Anyone have any experiences getting life insurance with controlled diabetes and if so how much is it compared to someone who does not have it? Getting insurance with diabetes is almost impossible. Your state DMV may require you to disclose if you have diabetes when you renew your drivers license. 7) I am using KetoDia Sticks to generally check my ketones and glucose. Should I invest in a glucometer and if so which one? Keto sticks are yesterday's technology. Yes get a good BG meter. Try to get a FREE meter from your doctor, clinic, hospital, etc. Try to get an Accu-check, One Touch Ultra, Freestyle, or Elite XL at no cost to you. The meters are way overpriced, try not to pay for a meter. If you have no insurance and can't get a free meter, get Walmart's Relion meter for $8.88 and 100 sticks for $42. It is the cheapest on the market and is very reliable. I've used it for the past year. Whatever you do, avoid Lifescan's One Touch Basic meter. It is an outdated, unreliable, unstable piece of crap. I made the mistake of purchasing a whole bunch of OTB sticks from Walmart since they had a huge price mark down on them. The meter is erratic and has a lot of misfires. A waste of precious financial resources. EBay.com and Walmart are probably the best places to get BG sticks at a cheap price. Look out for scams on EBay. Somebody posting this morning that Bristol Meyers Squibb is doing a study on Type 2's. Diabetic supplies and tests are Free. Call 1-877-355-8877. Not sure what it is about. Just an added bit of info for you. 8) I will be visiting the MD for the first time post glucophage in a few weeks. What type of reduction in numbers should I be looking for? Try to get BG numbers as close to non diabetic numbers as possible. Since you have cholesterol problems I assume you have blood pressure problems. I also suggest you invest in a home BP monitor. You can get Walmart's Relion BP monitor for about $45. I've used it daily for the past year without incident. To record BG's and BP values, see Sig. It's Free. The software's greatest asset is graphing and printing to paper. Good luck. _____________________________________________ http://www.tcainternet.com/retired/index.html
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This post not CC'd by email On Sat, 28 Jun 2003 07:10:08 GMT, "Michael Roback" <roback~earthlink.net wrote: I have had a hx of high cholesterol, 215-268 with a rato that ranges from 5.1-7.1. I had controlled it with Niacin I thought, and hadn't had a physical for several years. Recently, at about 25 LBS overweight, I finally decided to go for a physical. I had put it off as I wanted to lose weight to get life insurance and my weight never came off but I never really worked hard at it. I was horrified at my physical to learn that my Cholesterol was at about 275, triglycerides at about 220, LDL was at about 190, HDL 48 and my ratio was about 6.1. Also my blood sugar was about 175. When I did the A1C test it came back 9.1. The doctor put me on glucophage and zocor. The questions are: 1) Is it a foregone conclusion that I am diabetic or could it be a function of my weight? Yes ... though officially one need TWO fasting blood glucose tests over 126. 126 looks like a funny number to choose but it is simply 7. mmol/L expressed as the US 126 mg/L. The reason for that is to avoid false diagnoses due to something like an infection or steroid drugs. In the past when my weight went down, so did my cholesterol numbers. Quite but irrelevant. Some of beta cells in the pancreas died. Died means dead. Resurrection isn't sufficiently common as to form a basis for reasonable hope. 2) I am reading that Diabetes can be reversed with diet and exercise but some physicians say that in theory it can never be reversed. Well some people aren't telling you it straight. The symptoms can be ameliorated. The beta cells that died don't spring back to life but we learn to live with the ones that aren't dead. 3) If one is genetically predisposed to diabetes, would it develop even for one in good shape with lots of exercise. What I am wondering is if I definitely brought it on myself. In other words, had I exercised and been at a decent weight is it possible that I would have never developed it or would the onset just have been forstalled? Oh, it is quite possible that you might have delayed the onset until after you died of some thing else. Some countries had very low incidence of diabetes. With shifts to Western diets their rate of T2 diabetes has increased. Now it stands to reason that the population of these countries has not changed significantly so the most probably reason is a change in diet and exercise level are responsible. As to whether discovering whether you are personally responsible for the onset of the disease ... that sort of strikes me as futile. There are two possibilities you were ... you weren't. In either case you must deal with the diagnosis. Dealing with guilt on top doesn't seem productive to me but hey ... each to his own. Let me ask you a question "If you feel responsible ... will it motivate you to control your diet more strictly and exercise more regularly." If the answer is "Yes" then you had better feel responsible in the first degree. 4) If one monitors and controls their diabetes, can they live just as long as anyone else without any complications? The chances get better if you do. That is far as the promises go. Personally I am banking on the hypothesis being correct. Now let me share someone weird with you. Countless people have come here with a diagnosis of T2 diabetes. For years they have been sort of half way unwell, not enough to attract urgent medical attention but hey the signs were there, fat belly, a bit of breathlessness and one hell of a lot of rationalisation. Now comes the weird bit, when diagnosed with T2 diabetes there was a dramatic realisation of the consequences of not bringing the disease process under control. It has been the turning for countless lives. Diet plus exercise, some medication and the person has gone on to be healthier than they ever could remember being. 5) Is it better to be off of medication and try to deal with it with diet and exercise first? Get control first by whatever means. Take a serious look at where you are at. Even with drugs to lower cholesterol it is only since the advent of statins that it has been possible to unequivocally improve life expectancy by lowering cholesterol. Before that it was known that lower blood cholesterol corresponded to better life expectancy but the cholesterol lowering drugs and diet were insufficient to actually improve life expectancy. IMHO be grateful you are alive today an not say twenty years ago. 6) Anyone have any experiences getting life insurance with controlled diabetes and if so how much is it compared to someone who does not have it? Sorry I live in New Zealand. 7) I am using KetoDia Sticks to generally check my ketones and glucose. Should I invest in a glucometer and if so which one? Glucose testing of urine is misleading. Glucose doesn't spill into the urine until the blood glucose levels are way to high to be safe. 8) I will be visiting the MD for the first time post glucophage in a few weeks. What type of reduction in numbers should I be looking for? Think Fasting 100 1 hour under 140 2 hour under 120. 9) Should I get a consult from a endocrinologist? In NZ that doesn't happen until the first line treatment from the GP has failed. As it happened I dropped my A1c from 9.6 to 5.8 in two months so I have never seen an endocrinologist. Thanks for all of your support. I am very new to this. Any good books to read? Ever seen those Kung Foo movies where they have rules Rule One ... Blah Blah Blah Rule Two ... read rule One. In this case read Annette's reply. Rule Three ... read Jennifer's advice to newbies. Rule Four ... use the interloan facilities of your local library to get a copy of Syndrome X by Jack Challem or "You could have Syndrome X" by Dr. Sandra Cabot. OK it is a bit of history lesson now but will answer a lot of your question in more depth. Best wishes. -- Quentin Grady ^ ^ / New Zealand, #,#< [ / \ /\ "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin
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Michael Roback wrote in message ... . . .(snip). . . I was horrified at my physical to learn that my Cholesterol was at about 275, triglycerides at about 220, LDL was at about 190, HDL 48 and my ratio was about 6.1. Also my blood sugar was about 175. When I did the A1C test it came back 9.1. The doctor put me on glucophage and zocor. The questions are: 1) Is it a foregone conclusion that I am diabetic or could it be a function of my weight? In the past when my weight went down, so did my cholesterol numbers. 2) I am reading that Diabetes can be reversed with diet and exercise but some physicians say that in theory it can never be reversed. 3) If one is genetically predisposed to diabetes, would it develop even for one in good shape with lots of exercise. What I am wondering is if I definitely brought it on myself . In other words, had I exercised and been at a decent weight is it possible that I would have never developed it or would the onset just have been forstalled? 4) If one monitors and controlls their diabetes, can they live just as long as anyone else without any complications? 5) Is it better to be off of medication and try to deal with it with diet and exercise first? . . .(snip). . . Many, many questions, but that's good. You are concerned and are thinking about it. Diabetes is a disease in which the patient must do most of the work. Dumb, happy, and complacent is a recipe for painful death in our club. Worried and anal-retentive means a longer, happier life with less chance of complications. Unfortunately, the answers to many (but not all ! ! !) of your questions are the "bad news" answers. Most of us have slightly different interpretations of the state of diabetic art so the answer to any individual question could vary, but in general, you have joined our club. My viewpoints are presented below. 1. Your HbA1c of 9.1 correlates with an average blood glucose (bG) of about 245 over the last few weeks and months. That's very high. You have been "controlling" your bG by dumping glucose in your urine. That's very bad. 2. You may feel "sorta well" right now but you are very sick and it's time to take serious action. Take a look at "The Progression and Natural History of Type 2 Diabetes" at http://www.medscape.com/viewprogram/145 Make certain you understand Slides 6, 9 and 10. You have been in "medical trouble" for several years. 3.Your sky-high LDL and triglycerides are "markers" for the Insulin Resistance which causes Type 2 diabetes. They are markers for the damage to the arteries which causes Type 2 diabetics (T2) to be at high risk for premature heart attack. The anti-Insulin Resistance meds metformin (Glucophage) and Actos reduce are anti-heart attack meds for T2 because they reduce levels of circulating insulin and reduce LDL and triglycerides. Zocor merely controls cholesterol. You need both types of med. 4. Your goals are: a. HbA1c below 6.5 b. Fasting bG below 125 mg/dL c. bG at 2-hours-after-eating at 140 or less d. blood pressure at 130/80 or less, preferred below 120/80 e. Total cholesterol below 200 f. LDL below 130, preferred below 100 g. Triglycerides below 150, preferred below 100 h. Triglycerides/HDL ratio below 3.0 You take as many different meds, and engage in as many lifestyle changes as needed to meet your goals. The better you meet your goals, the better your life. Anal-retentive is a compliment to a diabetic. 5. The most powerful attack on your T2 will be lifestyle changes. They are: a. Lose fat lb b. Gain muscle lb c. Exercise vigorously and regularly, the more vigorously and more regularly the better. A 2-mile walk each day is a start. 6. Type 2 diabetes is a genetic condition. It is cued by insufficient exercise and excess body fat. How "insufficient" the exercise and how much "excess" the body fat seems to be an individual matter. If you had picked professional marathon runner, mountain sheep herder-on-foot, or Step Aerobics instructor as careers, you had a good chance of avoiding the disease. Otherwise, who knows. . .Ask your genes how you could have avoided it. That's a serious answer, not a joke. Of course jokes and a sense of humor help right now. Some of our answers and some of your reading may leave you feeling like you've been punched in the stomach. 7. The basic T2 training course takes 10-classroom hours spread over 3 days at our local hospital. You have a lot to learn. 8. Keep coming back. Reading the Diabetes Usenet groups (alt.support.diabetes and misc.health.diabetes) every night has resulted in significant improvements to my health and quality of life. I am sure it has lengthened my potential life span. 9. Sorry about the sloppy writing and rambling. I miscalculated last night and this morning. My bG is below 70 right now and I am a bit dopey. I hope you memorize that and think about it in days to come. A bG below 70 is not good, but having the tools to be able to approach it is. Good Luck. Regards Old Al
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As everyone says here, "Welcome to the group that no one wants to join." You have heard some great answers to your questions. I can't add too much more factual information. I can tell you that taking this illness seriously and making the changes in your lifestyle necessary to control it will make a difference in your life. I was diagnosed with an A1c of 10.8. I followed the advice here and reduced it to 5.4 and got my cholesterol #'s back to normal withing three months. However, it's not a one-shot deal. Now the work comes that I have to keep them there. I started out with meds and am gradually dropping them as I gain more control. Meds are a tool and needing them doesn't make you inferior to people who control with diet and exercise alone. The main point is to find a medical team you trust and to take control seriously. Keep posting. It makes a difference. c "Michael Roback" <roback~earthlink.net wrote in message news- :kbbLa.68704$Io.6433171~newsread2.prod.itd.earthlink.net... I have had a hx of high cholesterol, 215-268 with a rato that ranges from 5.1-7.1. I had controlled it with Niacin I thought, and hadn't had a physical for several years. Recently, at about 25 LBS overweight, I finally decided to go for a physical. I had put it off as I wanted to lose weight to get life insurance and my weight never came off but I never really worked hard at it. I was horrified at my physical to learn that my Cholesterol was at about 275, triglycerides at about 220, LDL was at about 190, HDL 48 and my ratio was about 6.1. Also my blood sugar was about 175. When I did the A1C test it came back 9.1. The doctor put me on glucophage and zocor. The questions are: 1) Is it a foregone conclusion that I am diabetic or could it be a function of my weight? In the past when my weight went down, so did my cholesterol numbers. 2) I am reading that Diabetes can be reversed with diet and exercise but some physicians say that in theory it can never be reversed. 3) If one is genetically predisposed to diabetes, would it develop even for one in good shape with lots of exercise. What I am wondering is if I definitely brought it on myself . In other words, had I exercised and been at a decent weight is it possible that I would have never developed it or would the onset just have been forstalled? 4) If one monitors and controlls their diabetes, can they live just as long as anyone else without any complications? 5) Is it better to be off of medication and try to deal with it with diet and exercise first? 6) Anyone have any experiences getting life insurance with controlled diabetes and if so how much is it compared to someone who does not have it? 7) I am using KetoDia Sticks to generally check my ketones and glucose. Should I invest in a glucometer and if so which one? 8) I will be visiting the MD for the first time post glucophage in a few weeks. What type of reduction in numbers should I be looking for? 9) Should I get a consult from a endocrinologist? Thanks for all of your support. I am very new to this. Any good books to read?
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I will answer as I remember the questions. Yes, do invest in a meter or better yet get one free, Call roche and ask them for a accuchek compact and they will send it to you for free and it will be the strips that cost the money, Hopefull yu are covered with insurance. No diabetes cannot be reversed, It can be controlled as a regular person,. but eat that big piece of cake and you will see how quickly your sugar rises. With an A1c of over 9, there is not doubt, you are unfortunately a diabetic, Losing weight wont make diabetes go away, but it will give you a better handle on the disease. I imagine diet and exercise alone would be an ideal world, but this is not an ideal world so if you need to take meds,. you need to take them at least until you are in good control and have lost the weight, Even then you might not be able to do it. About the cholesterol and tris, I find it went hand in hand with diabetes, I had cholesterol of over 450 and triglyceriudes of 1800, that is not a typo. Today my cholesterol is l42 and tris of about 150 so it can be done, I am on lipitor but to have dropped over three hundred points will keep me on it. Jennifer should be here with advice to newbies and it is the best you can get, So , let me officially welcome you to our home for diabetics, Sorry you have to come here, but now that you have, this can be a world of support and knowledg if you choose to avail yourself of it. You want information and that is a step in the right direction. Loretta -- In tribute to the United States of America and the State of Israel, two bastions of strength in a world filled with strife and terrorism.
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"Michael Roback" <roback~earthlink.net wrote in message news- :kbbLa.68704$Io.6433171~newsread2.prod.itd.earthlink.net... I have had a hx of high cholesterol, 215-268 with a rato that ranges from 5.1-7.1. I had controlled it with Niacin I thought, and hadn't had a physical for several years. Recently, at about 25 LBS overweight, I finally decided to go for a physical. I had put it off as I wanted to lose weight to get life insurance and my weight never came off but I never really worked hard at it. I was horrified at my physical to learn that my Cholesterol was at about 275, triglycerides at about 220, LDL was at about 190, HDL 48 and my ratio was about 6.1. Also my blood sugar was about 175. When I did the A1C test it came back 9.1. The doctor put me on glucophage and zocor. The questions are: 1) Is it a foregone conclusion that I am diabetic or could it be a function of my weight? In the past when my weight went down, so did my cholesterol numbers. You are diabetic. 2) I am reading that Diabetes can be reversed with diet and exercise but some physicians say that in theory it can never be reversed. Can't be reversed. Can be controlled. Now there are specific situations where diabetes *can* go away. But in these cases, the diabetes was caused by taking certain medications, such as steroids. And there has been recent debate about the thyroid/diabetes connection. 3) If one is genetically predisposed to diabetes, would it develop even for one in good shape with lots of exercise. What I am wondering is if I definitely brought it on myself . In other words, had I exercised and been at a decent weight is it possible that I would have never developed it or would the onset just have been forstalled? I was in good shape and got lots of exercise when I got GD (gestational diabetes). Did I forstall my diagnosis? Maybe. My brother was diagnosed at a slightly younger age than I was. But the part about exercise and decent weight do not necessarily go hand in hand. There is one school of thought that says the insulin resistance caused by diabetes is what causes the weight gain. 4) If one monitors and controlls their diabetes, can they live just as long as anyone else without any complications? Maybe. Unfortunately, there is no way of telling who will get the complications and who won't. Some people do everything they're supposed to and still get complications. Yet still others do not control their diabetes and somehow manage to escape complications. 5) Is it better to be off of medication and try to deal with it with diet and exercise first? No. Use the medication if you need it. And some medications (like Glucophage) are good to be on because of the protection they give to the heart. 6) Anyone have any experiences getting life insurance with controlled diabetes and if so how much is it compared to someone who does not have it? Don't know about that. 7) I am using KetoDia Sticks to generally check my ketones and glucose. Should I invest in a glucometer and if so which one? Useless except for ketones. And you probably don't need to check those unless you are on a really low carb diet. If glucose reaches your urine, that means it was in your blood some many hours ago and you were way out of control. Means nothing at the time you pee it out. A meter is the only way to know how your control is. 8) I will be visiting the MD for the first time post glucophage in a few weeks. What type of reduction in numbers should I be looking for? Glucophage can take several weeks to kick in. You might be on a starting dose right now. Ideally, you should be at <110 fasting and <140 at two hours after eating. Some people go for <140 at 1 hour after eating and <120 at two hours after eating. But with no meter, you have no idea how you are doing. 9) Should I get a consult from a endocrinologist? If you feel your Dr. is not capable of treating your diabetes. My GP refuses to do anything with my diabetes aside from ordering lab tests and refilling prescriptions. I do also have a thyroid problem and that complicates things. I see an Endo. Thanks for all of your support. I am very new to this. Any good books to read? The best one I've found is the American Diabetes Complete Guide to Diabetes. -- Type 2 http://users.bestweb.net/~jbove/
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Michael Roback wrote: 2) I am reading that Diabetes can be reversed with diet and exercise but some physicians say that in theory it can never be reversed. I think this is the bottom line. By the time the typical Type 2 diabetic is diagnosed, he's lost 80% of his beta cells. You can take medication, and get plenty of exercise. You can control your diet and do everything right and be well controlled, but you can never bring those beta cells back to life. You have to ask, what does "reverse diabetes" mean? If it only means controlling your diabetes, then, yes you can. But if you mean going back to the good old days when you weren't diabetic, then I'd have to say you can never bring those beta cells back to life. For what it's worth, there is ongoing research is ways of transplanting or infusing new beta cells into our old diabetic bodies. If any of those techniques are brought to a practical reality, then perhaps we will be able to go back to the good old days. E
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Michael... Welcome. You've asked all the good questions. Questions most of us asked ourselves right after dx. You've started down a trying path in life, but rest assured you've got a lot of company! Here's where I net out on your queries: 1) Is it a foregone conclusion that I am diabetic or could it be a function of my weight? In the past when my weight went down, so did my cholesterol numbers. It's pretty much a done deal. Some people find that their BG (that's blood glucose) somewhat normalizes with weight loss. Others don't. BUT, even if it normalizes, that doesn't mean you're "cured". It means whatever you're doing to maintain that weight loss (food/exercise/meds) is what's controlling your diabetes. Controlled not cured. Sorry. 2) I am reading that Diabetes can be reversed with diet and exercise but some physicians say that in theory it can never be reversed. Reversed is an imprecise word. If they mean 'cured', then no, right now there is not cure. If they mean controlled, well hell yes. That's the primary goal! 3) If one is genetically predisposed to diabetes, would it develop even for one in good shape with lots of exercise. What I am wondering is if I definitely brought it on myself . In other words, had I exercised and been at a decent weight is it possible that I would have never developed it or would the onset just have been forstalled? Well... the real bottom line is, no one knows for sure. Perhaps you could have forestalled it until old age got you first, perhaps not. But the other side is, what good will the answer to that question do you? You've got diabetes now. If you're looking to beat yourself up and feel guilty, don't. None of that will do you any good. Shame and guilt are two of the most toxic emotions we have. In the vernacular: "Don't go there". 4) If one monitors and controlls their diabetes, can they live just as long as anyone else without any complications? Hopefully so. You've entered a gambling game. Most of us here are betting that with tight control we can hold back the complications. Most studies suggest that. In any case, it can't hurt! And if you refer back to your question #3... You do have the gift of a second chance here. If you do keep your BGs in line, exercise and stay as a controlled diabetic, you're giving yourself the best odds to live a long, healthy, diabetic life. 5) Is it better to be off of medication and try to deal with it with diet and exercise first? It's better off to get your numbers in control first, by all means necessary. Then you have the "luxury" of reassessing your game plan. Maybe you won't need meds forever, but don't waste time with high BGs trying to find out. 6) Anyone have any experiences getting life insurance with controlled diabetes and if so how much is it compared to someone who does not have it? I don't have an answer to this one. 7) I am using KetoDia Sticks to generally check my ketones and glucose. Should I invest in a glucometer and if so which one? That's pretty outmoded technology. Also, by the time glucose is in your urine, it's been in your blood long enough and high enough to do damage. A meter is a wonderful thing. It will become your best friend. But don't buy one. You should be able to find a deal to get one free. It's the strips they make their money on, and every company would like you to use their meter and buy their strips. I would hazard a guess that if you called up some meter companies and said you were a new diabetic and would like to try their meter and get your doc to prescribe strips, they would RUSH you a meter in a nanosecond. As for that, many here, including myself, like the One Touch Ultra. Another good brand is the AccuChek. If you don't have health insurance, the Walmart Relion brand has the cheapest strips, when it's coming out of your pocket. 8) I will be visiting the MD for the first time post glucophage in a few weeks. What type of reduction in numbers should I be looking for? A few weeks may not be enough to see a change. Especially if all you're doing is taking the pills and not much else. Diabetes needs a three pronged attack. Meds / Food / Exercise. What are you doing about the other two? 9) Should I get a consult from a endocrinologist? Some say yes, some say not needed. See how your regular doctor handles things at your next visit and go from there. Thanks for all of your support. I am very new to this. Any good books to read? Oh yes, the best of the best is Gretchen Beckers First Year Diabetes book. You can get it at most book stores, Amazon, and sometimes it shows up CHEAP at www.half.com. Michael, you'll be fine. I can tell. The successful newbies are the ones who ask all the questions ; ) Now, here's the advice I give all newbies, it can help you start finding your own path: Sounds like you're planning a move to take control of your diabetes... good for you. There is so much to absorb... you don't have to rush into anything. Begin by using your best weapon in this war, your meter. You won't keel over today, you have time to experiment, test, learn, test and figure out just how your body and this disease are getting along. The most important thing you can do to learn about yourself and diabetes is test test test. The single biggest question a diabetic has to answer is: What do I eat? Unfortunately, the answer is pretty confusing. What confounds us all is the fact that different diabetics can get great results on wildly different food plans. Some of us here achieve great blood glucose control eating a high complex carbohydrate diet. Others find that anything over 75 - 100g of carbs a day is too much. Still others are somewhere in between. At the beginning all of us felt frustrated. We wanted to be handed THE way to eat, to ensure our continued health. But we all learned that there is no one way. Each of us had to find our own path, using the experience of those that went before, but still having to discover for ourselves how OUR bodies and this disease were coexisting. Ask questions, but remember each of us discovered on our own what works best for us. You can use our experiences as jumping off points, but eventually you'll work up a successful plan that is yours alone. What you are looking to discover is how different foods affect you. As I'm sure you've read, carbohydrates (sugars, wheat, rice... the things our Grandmas called "starches") raise blood sugars the most rapidly. Protein and fat do raise them, but not as high and much more slowly... so if you're a T2, generally the insulin your body still makes may take care of the rise. You might want to try some experiments. First: Eat whatever you've been currently eating... but write it all down. Test yourself at the following times: Upon waking (fasting) 1 hour after each meal 2 hours after each meal At bedtime That means 8 x each day. What you will discover by this is how long after a meal your highest reading comes... and how fast you return to "normal". Also, you may see that a meal that included bread, fruit or other carbs gives you a higher reading. Then for the next few days, try to curb your carbs. Eliminate breads, cereals, rices, beans, any wheat products, potato, corn, fruit... get all your carbs from veggies. Test at the same schedule above. If you try this for a few days, you may find some pretty damn good readings. It's worth a few days to discover. Eventually you can slowly add back carbs until you see them affecting your meter. The thing about this disease... though we share much in common and we need to follow certain guidelines... in the end, each of our bodies dictate our treatment and our success. The closer we get to non-diabetic numbers, the greater chance we have of avoiding horrible complications. The key here is AIM... I know that everyone is at a different point in their disease... and it is progressive. But, if we aim for the best numbers and do our best, we give ourselves the best shot at heath we've got. That's all we can do. Here's my opinion on what numbers to aim for, they are non-diabetic numbers. FBG under 110 One hour after meals under 140 Two hours after meals under 120 or for those in the mmol parts of the world: Fasting Under 6 One hour after meals Under 8 Two hours after meals Under 6.5 Recent studies have indicated that the most important numbers are your "after meal" numbers. They may be the most indicative of future complications, especially heart problems. Listen to your doctor, but you are the leader of your diabetic care team. While his /her advice is learned, it is not absolute. You will end up knowing much more about your body and how it's handling diabetes than your doctor will. Your meter is your best weapon. Just remember, we're not in a race or a competition with anyone but ourselves... Play around with your food plan... TEST TEST TEST. Learn what foods cause spikes, what foods cause cravings... Use your body as a science experiment. You'll read about a lot of different ways people use to control their diabetes... Many are diametrically opposed. After awhile you'll learn that there is no one size fits all around here. Take some time to experiment and you'll soon discover the plan that works for you. Best of luck! Jennifer
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"Michael Roback" <roback~earthlink.net wrote in message news- :<kbbLa.68704$Io.6433171~newsread2.prod.itd.earthlink.net... Thanks for all of your support. I am very new to this. Any good books to read? I recommend "Dr. Berstein's Diabetes Solution" Apparently there is an updated version coming out this summer. You can visit his web site at http://www.diabetes-normalsugars.com/index.shtml and read samples of his book
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"Quentin Grady" <quentin~paradise.net.nz wrote in message news:dlrqfvsu2v672gn8ig8lk2ohc1hp39mptq~4ax.com... This post not CC'd by email Ever seen those Kung Foo movies where they have rules Rule One ... Blah Blah Blah Rule Two ... read rule One. In this case read Annette's reply. Hi there Quentin, I'm not sure about what you meant. Blah, blah, blah? Who, me? :-D Annette One does what one can. --- Outgoing mail is certified Virus Free. Checked by AVG anti-virus system (http://www.grisoft.com). Version: 6.0.493 / Virus Database: 292 - Release Date: 26/06/03
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Hi_Therre wrote: Try to get a FREE meter from your doctor, clinic, hospital, etc. Try to get an Accu-check, One Touch Ultra, Freestyle, or Elite XL at no cost to you. The meters are way overpriced, try not to pay for a meter. If you have no insurance and can't get a free meter, get Walmart's Relion meter for $8.88 and 100 sticks for $42. It is the cheapest on the market and is very reliable. I've used it for the past year. If you'd rather not spend a lot of time tracking down a free meter or wait till you see your doctor again you can also usually buy a meter and get a rebate or buy a bundle with a bunch of test strips and come out pretty well. These offers change all the time so go to a discount store and check out the current offers. I got an emergency replacement One Touch Ultra for about $8.00, after rebate at Wal-mart. I only got the Ultra because mine died, I had a lot of strips with me and I was traveling, eating out and didn't want to wait for a replacement ( which was overnighted to my home, free of charge). -- K'neH'a'Iw Uncloaking, Shields Up.
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Hi_Therre wrote in message ... . . .(snip). . . Your doctor is the best judge of that. You should be aware that a lot of medical professionals are totally out of sync with the latest treatment of diabetes. Your medical practioner should treat your diabetes with aggressiveness. Some doctors/nurses think that a BG of 200 is fine. Keep those BG's as close to non diabetic numbers as possible. If you see a dumbshit doctor/nurse with a cavalier attitude, find a different medical team immediately. It is your life you are playing with. . . .(snip). . . It sounds like Bruce is trying be funny, or is way too cynical with his "dumbshit" comment. Unfortunately, he's just being succinct and accurate. There are a potful of medical personnel who fit this description. In general, they are following obsolete therapies. "Best Available Therapy" for diabetes was revolutionized in the mid-1990's. Unfortunately, a lot of doctors and nurses are still following the guidelines in their old medical textbooks. If you run into one of these situations and are not paying attention or are too timid to object, you are condemning yourself to tragedy. Regards Old Al
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Annette wrote in message ... "Quentin Grady" <quentin~paradise.net.nz wrote in message news:dlrqfvsu2v672gn8ig8lk2ohc1hp39mptq~4ax.com... This post not CC'd by email Ever seen those Kung Foo movies where they have rules Rule One ... Blah Blah Blah Rule Two ... read rule One. In this case read Annette's reply. Hi there Quentin, I'm not sure about what you meant. Blah, blah, blah? Who, me? :-D Annette You seem to be on a roll lately, "Furstest with the bestest"* when it comes to replying to new folk. I find myself replying. . ." . . .and see Annette's post" Must be the Oz time difference. Regards Old Al (*for you non-U.S. folks, that's a play on a famous U.S. civil war quote by Nathanial Bedford Forrest: "Furstest with the mostest")