From the first moment I discovered I had been diagnosed with DIABETES, I joined a HUGE “club” that has been rapidly expanding since it stopped being a death sentence in the early 20th Century. Currently, there are about HALF A BILLION PEOPLE who have Type 2 Diabetes. For the past 3500 years – dating back to Ancient Egypt – people have suffered from diabetes. Well, I’m one of them now… Not one to shut up for any known reason, I added a section to this blog…
Every month, I’ll be highlighting Diabetes research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: From the discovery of diabetes to the POSSIBILITY of a pancreas transplant...
So, I’m under treatment for my Type 2 diabetes. But I was wondering the other day: “What’s the GOAL of what I’m doing now – watching the diet, monitoring my blood glucose levels, taking Metformin…WHERE AM I GOING?”
As far as I have been able to tell from talking with my doctor and researching my condition for the past year, the “goal” seems to be “Live with Type 2 as good as you can so you won’t get all the complications you can get before you die an early death…”
Given I live in the first half of the 21st Century and we regularly talk about artificial intelligence, smart phones, missions to Mars, private space craft flying to an international space station…where heart-lung transplants (first done here in my home town, Minneapolis) and quintuple heart bypasses are *yawningly* routine…why is our solution for Type 2 diabetes just, “Well, ya got it, so learn to live with it. No pancreas transplant for YOU!!!!”
Hmmm…I’m not sure I’m OK with that any more…
In a 2011 interview for the Arizona Republic newspaper/website, Black American memoirist, poet, and civil rights activist, Maya Angelou said, “If you don't know where you've come from, you don't know where you're going.”
While this is clearly true for her life’s work, it’s also as true and useful an aphorism as it can be. In fact, I can see the straightforward application to my life with Type 2 diabetes.
Most of us know that diabetes is one of THE best known and understood diseases, having been diagnosed originally over 3000 years ago by an Egyptian physician named Hesy-Ra, who documented what we would call Type One diabetes from patients who had frequent urination and along with extreme weight loss. The name originated in 230 BC, by the Greek physician named, Apollonius of Memphis. And in 1675 Thomas Willis, an English physician, added the Greek word mellitus to the word diabetes. This was because those with diabetes had urine that smelled sweet (it also tasted sweet, but let’s not go THERE…)
Then, we reach the 20th Century “Frederick M. Allen was a physician in 1913, who believed that previous diabetic treatments had been ineffective because they attempted to substitute fats for carbohydrates which ended with the patient in a coma and dying! Only a starvation diet that limited the total caloric consumption was effective. Allen found that a liquids-only diet could eliminate glycosuria and acidosis. The diabetic could then begin to eat gradually increasing diets, until sugar again began to show up in the urine. This test would allow him to determine how many calories a patient could safely consume. This was LONG before the discovery of insulin. He also recognized that diabetes was not just a disease that caused elevated blood sugar levels but also problems with metabolism.”
In 1936, two doctors discovered insulin in 1921; the next year, a young boy with Type 1 was injected with it…and “the cure” had arrived. Insulin first came from animals – dogs initially; then cows, oxen, and others in 1936…and this was standard practice.
Until suddenly, in 1982, artificially produced, genetically engineered HUMAN-EQUIVALENT insulin made using yeast cells and E. coli (yeah, the one that can give you horrendous diarrhea…) was approved by the FDA and released for use in the world population of Type 1 diabetics. The treatment for diabetes changed dramatically.
And yet…no CURE. A treatment. Certainly stunning, and yet, what about US? Type 2 diabetics? Insulin RESISTANCE was introduced in 1936. The first line of defense has become Metformin. What is it? “…first described in scientific literature in 1922, it was introduced as a medication in France in 1957 and the United States in 1995. In 2020, it was the third most commonly prescribed medication in the United States”
In two weeks…more about metformin – and some concern a friend of mine pointed out…and the possibilities of an artificial, transplantable pancreas!
Link: https://type2diabetes.com/living/10-facts-history-diabetes, https://en.wikipedia.org/wiki/Insulin, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205949/, https://en.wikipedia.org/wiki/Metformin Image: https://asploro.com/wp-content/uploads/2019/12/Diabetes-Research_Open-Access.jpg
For the first times since I started this column eleven years ago, it’s going to be about me. I was diagnosed with Type 2 Diabetes two weeks ago. While people are happy to talk about their experiences with diabetes, I WASN’T comfortable with talking about diabetes. My wife is Type 2, as are several friends of ours. The “other Type” of diabetes was what caused the death of my Best Man a year after my wife and I got married. He was diagnosed with diabetes when he was a kid. It was called Juvenile Diabetes then. Today it’s Type 1. Since then, I haven’t WANTED to talk about diabetes at all. But…for my own education and maybe helping someone else, and not one to shut up for any known reason, I’m reopening my blog rather than starting a new one. I MAY take a pause and write about Breast Cancer or Alzheimer’s as medical headlines dictate; but this time I’m going to drag anyone along who wants to join my HIGHLY RELUCTANT journey toward better understanding of my life with Type 2 Diabetes. You’re Welcome to join me!
I was diagnosed with Type 2 Diabetes six and a half months ago and have been monitoring, working on losing weight, eating right, and taking my Metformin…
According to the World Health Organization, “The expected values for normal fasting blood glucose concentration are between 70 mg/dL and 100 mg/dL. When fasting blood glucose is between 100 to 125 mg/dL, changes in lifestyle and monitoring glycemia are recommended.” The lowest reading I’ve EVER had since this start was on April 14 – and that wasn’t even QUITE normal, it was 138. So, my glucometer data was ALL in the red and I get constant, nasty notes from the thing telling me my “Blood Glucose Levels have been high the last three times!” Honestly? No matter WHAT I did lowered the levels after fasting.
So, I changed my USER settings to 110-182 mg/dL. I didn’t do it to make myself feel PHYSICALLY better: I’d have changed it to 3000-1,000,000 mg/dL, then! I just got tired of getting beat up by my device, and imagining the people who set these limits look like this: 
I needed a realistic goal; a realistic reflection of my experience with room to grow. So, then, what is the Dawn Phenomenon?
“The dawn phenomenon or ‘dawn effect’ is when your blood sugar spikes in the early-morning hours, usually between 3-8am. The dawn phenomenon is very common among those with insulin resistance, and there are some strategies that may help you reduce your fasting blood sugar. What causes are still unclear, though we know that hormones play a large part. These hormones follow a daily cycle, and increase during our waking hours, starting in the early morning.”
So what do I DO about it? The first thing I saw was this: “Working up a sweat in the a.m. is a good idea for anyone experiencing the dawn phenomenon, too—it can help burn up that extra blood glucose.”
GREAT; but I already do that – I bike between 4 and 9 miles every-other-morning and it hasn’t had ANY effect on my blood sugars – they’re the same whether I exercise or not.
Tick. So, as I am writing this on 5/4/23; tonight I will take my blood sugar before bed and then wake up at 2:30am and take them. By the time you read this, you’ll know the result.
What else? No snacks before bed? Uhhhh…I have my phone alarm set at 7 pm; with the intent of not eating anything afterwards. While I sometimes hit that goal, I sometimes miss it, too. I need to both work harder at meeting the goal and also record what I did. The Mayo Clinic Online says I should: “Avoid carbohydrates at bedtime. Change your dose of diabetes medicine or insulin. Switch to a different diabetes medicine. Change the time when you take your medication or insulin from dinnertime to bedtime. Use an insulin pump to give you extra insulin during early-morning hours.”
I’m going to opt for the first one: Avoid carbs at bedtime.
So: no snacks before bed/no carbs before bed (work harder at this); record my blood sugars before bed and in the middle of the night; (continue to) exercise in the morning.
That’s about it! I’ll let you know how it went.
Source: https://www.virtahealth.com/blog/dawn-phenomenon, https://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/dawn-effect/faq-20057937, https://diabetes.org/diabetes/treatment-care/high-morning-blood-glucose
Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg
