Friday, February 24, 2017

My Diet

I know so many type 1 people who eat very healthy, low carb meals. That certainly helps with the control of blood sugar levels, but I do not find that to be necessary. For so many years, starting in 1945 when I was diagnosed, I ate anything I wanted as long as it did not contain sugar. My portions could be as large as I wanted. Not eating sugar was my only limitation. My typical day saw me eat hundreds of carbs, many of which were very fast acting. That was poor diabetes management, but my parents and I did not know any better. My doctors knew very little about diabetes back then. I am very fortunate that my diet back then has not caused any serious complications.
At the present time I eat an average of 150-160 carbs per day, and my A1c's have been in the 5.4-6.4 range for fifteen years. Here is a typical day in my schedule:
8:30 AM....A slice of bread (9 carbs) toasted with sugar free jelly (5), a slice of ham, mixed berries (16), a half cup of coffee (2).....total....32 carbs
12:00 noon....A medium size baked potato (30), a pork chop, a small amount of gravy (5)....total....35 carbs
2:00 PM....Before going to the gym for a one hour workout....an ice cream cone (chocolate) with sugar...(25)...only a one unit bolus since I was going to get a lot of exercise
5:00 PM....Five corn chips with salsa (13)
7:00 PM....Pastrami sandwich with mayonnaise, slice of cheese, and slice of tomato... the bread has 9 carbs per slice...(20)....cottage cheese (6)....strawberries (10)...half cup of coffee (2).....total....38 carbs
10:00 PM....My BG was 77 so I needed a small snack....peanut butter and crackers (12)
TOTAL for the day....155 carbs
I never eat anything with sugar (table sugar) unless I am going to get exercise afterwards, or I have a low. I carry a small zip lock bag of jellybeans or skittles with me when I am away from home.
Note: There is really no typical day for my meals, I like a lot of variety so no two days are the same. As long as my diabetes management is stable, I see nothing wrong with that. My A1c is good, and I am not overweight. I like variety in food, TV programs, movies, activities, exercises, and most all things......but not women. My wife is wonderful and I do not need variety there. LOL!!!

Tuesday, February 21, 2017

Commitment

Commitment

In the 1945-1988 years I had only one rule to follow. Don't eat foods containing sugar. My doctors never mentioned carbs. I was very committed to following that rule. I became so used to using artificial sweeteners, that a teensy taste of something containing a lot of sugar was too sweet, and I did not like it. Having only one rule to follow made it easier.

In 1988 I read an article in a magazine saying that diabetics should restrict the number of carbs they ate to help keep their blood tests lower, and more stable. Why didn't my doctors tell me that? That was my first exposure to carbs. Then I found that some carbs acted faster, and others more slowly. I started eating smaller portions of the foods
with faster acting carbs, and I stopped eating some foods. There were more rules to follow, and things became more complicated. Then there was using my first meter in the 1980s, basal and bolus insulins with carb counting in the 1990s, and my insulin pump in 2007. Things were very complicated then. It was so much simpler in my early years to just avoid sugar. It was hard to be committed to having tight control with all these newer rules, and devices to follow. I sometimes wanted to just drop everything, and go back to the old ways. I had no complications despite all the high blood sugar I must have had during my first 40+ years, so convincing myself to follow all the new rules and use the new devices was difficult.
I did not know any other diabetics until I joined some diabetes websites in 2006-2007. That was 61 years after my diagnosis. That turned things around for me. I met so many diabetics like me, and saw they were struggling with the same problems I was having, or had previously experienced. There were so many not taking good care of themselves, and having diabetes related complications. I could feel myself becoming more and more committed to having really great control. I had always worked hard to have good control, but my online experience made me more committed than ever before.

My commitment has led to my having 71 years of type 1 with no complications except some neuropathy, and other minor nerve damage. I do not need any medication for that, and I am very fortunate that having only the "no sugar" rule for so many years has not caused me any major problems.
I am definitely committed to being committed. Perhaps diabetics who are not committed should be committed to online diabetes support groups! :wink:

What does commitment mean to you?

Monday, February 20, 2017

Only In America

Only in America ......do drugstores make the sick walk all the way to

the back of the store to get their prescriptions while healthy people
can buy cigarettes at the front.
Only in America ......do people order double cheeseburgers, large
fries, and a diet coke..
Only in America .....do banks leave vault doors open and then chain
the pens to the counters.
Only in America ......do we leave cars worth thousands of dollars in
the driveway and put our useless junk in the garage.
Only in America ..........do we buy hot dogs in packages of ten and
buns in packages of eight..
Only in America .....do they have drive-up ATM machines with Braille lettering.
EVER WONDER ...
Why the sun lightens our hair, but darkens our skin?
Why can't women put on mascara with their mouth closed?
Why don't you ever see the headline 'Psychic Wins Lottery'?
Why is 'abbreviated' such a long word?
Why is it that doctors call what they do 'practice'?
Why is lemon juice made with artificial flavor, and dishwashing liquid
made with real lemons?
Why is the man who invests all your money called a broker?
Why is the time of day with the slowest traffic called rush hour?
Why isn't there mouse-flavored cat food?
Why didn't Noah swat those two mosquitoes?
Why do they sterilize the needle for lethal injections?
You know that indestructible black box that is used on airplanes? Why
don't they make the whole plane out of that stuff?!
Why don't sheep shrink when it rains?
Why are they called apartments when they are all stuck together?
I like this one!!!
If con is the opposite of pro, is Congress the opposite of progress?
If flying is so safe, why do they call the airport the terminal?

Thursday, February 16, 2017

Type 1 Diabetes, Bone Density

Long Term Type 1, Bone Health Protection
The Joslin Medalist Study has examined more than 1000 people with 50 or more years of Type 1 diabetes. The purpose of the study is to find what makes the medalists different from so many other type 1 individuals who have had diabetes related complications. The study began in 2005, and is ongoing. I participated in the study in 2009. In 2011, I attended a medalist meeting at the Joslin Medical Center. Dr King, head of the project, announced that a large group of the participants in the study have some kind of "inner protection" that has prevented them from having any serious complications with their eyes, kidneys, and nervous systems. He also said that the inner protection does not protect our hearts, and that we should do our best to have good heart health. Many medalists have had heart by-passes. I have been type 1 for 71 years, and except for some very minor nerve damage, including neuropathy , I do not have any of these complications. My heart is also in good shape.
A study of a subgroup of these participants was done at the Bone Density Center of the Mass General Hospital. It was determined that the long term diabetics examined have a protective factor preventing bone health deterioration. The following abstract shows the details of the subgroup study:
Protection from Fracture Risk in Long Term Type 1 Diabetes: 50- Year Medalist Study
HILLARY KEENAN, SARA TUREK, STEPHANIE HASTINGS, GEORGE KING, Boston, MA.
Abstract:
Individuals with type 1 diabetes (T1D) have demonstrated a 12-fold increased risk of fragility fractures over their age-matched peers. As hospitalization for fracture is highly associated with decreased quality of life, morbidity and mortality this is an important, yet little studied diabetic complication particularly amongst those with extreme duration T1D. The 50-Year Medalist Study has extensively characterized over 800 individuals with a mean age of 69 y and duration of 55 y of T1D. Early examination of self-reported rates of hip, vertebral, and wrist fractures show extraordinarily low rates (0.33%, 0%, and 1.7%, respectively) in stark contrast to the 12-fold increase expected. To further examine these findings, 55 participants received DXA scans, 29 females, 26 males with a mean ±SD HbA1c of 7.2±0.8% and 7.0±1.2%, age 62.1±6.5 y and 66.7±6.8 y, and duration of 52.9±2.7 y and 55.8±5.1 y, respectively. BMI for this age group was low with 25.0±5.2 kg/m^2 for females and 27.3±4.4 kg/m^2 for males. T-scores, indicative of risk for fracture, for female 1/3 radius (1/3R) was -1.1±1.3, lumbar spine (LS) 0.1±1.2 and for the femoral neck (FN) -1.3±0.8. For males the 1/3R, T-score was -1.1±1.3, the LS was -0.1±1.9, and at the FN -1.3±0.8, none in the osteoporotic range. Total vitamin D, D2, D3 and calcium did not correlate with T scores among female or male, except for D3 among male and the LS T-score (R=0.5, p=0.03). There was no association of T scores with HbA1c, BMI, age or duration in either gender, p>0.05. As BMIs were low in male and female, the lower than expected risk T scores are likely not due to increase weight bearing as seen in T2D patients. These pilot data demonstrate protection from fracture, and low risk in this group with long term T1DM suggestive of a protective factor preventing bone health deterioration.

Tuesday, February 14, 2017

Diabetic Cheiroarthropathy

I read about a new complication today..."diabetic cheiroarthropathy".

"Diabetic stiff hand syndrome, also known as diabetic cheiroarthropathy, is a disorder in which finger movement becomes limited as the hands become waxy and thickened."

I had carpal tunnel and ulnar nerve surgeries more than twenty years ago, but this stiff hand problem is a little different. I am having carpal tunnel trouble again, in both hands. I may need more surgery, soon.

I have seen discussions abut trigger finger problems. It is very common, and a simple surgery corrects that. I have occasional trigger finger problems. It occasionally occurs when I have very low blood sugar, but it is corrected when my blood sugar is corrected.

"A typical technique for diagnosing diabetic stiff hand syndrome is to hold your hands together, both palms touching.
If the skin and joints of each hand cannot touch each other, or if there is a gap between the fingers and palms, then you should consult your doctor."

More discussion of diabetic cheiroarthropathy appears in the link below.

http://www.diabetes.co.uk/diabetes-complications/stiff-hand-syndrome.html