Guy's Gotta Talk About Diabetes, Breast cancer, and Alzheimer's

Sunday, April 9, 2023

GUY’S GOTTA TALK ABOUT…DIABETES #8: Understanding A1c – and How To Deal With It…

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!

Yesterday, I had a 3 month check up for my diabetes. Besides blood pressure (good), weight (I’ve lost 7 pounds since I was last weighed!), and my blood sugars (almost always “high”, but there’s a chance I might just have something called “hyperglycemia”. I’ll deal with that later! (Not medically, as a blog post!)

Today, I want to delve more into what exactly my A1c IS.

We’ll start with the “official” definition (aka Wikipedia): “Glycated hemoglobin (HbA1c, glycohemoglobin, hemoglobin, A1C or A1c) is a form of hemoglobin (Hb) that is chemically linked to a sugar. Most monosaccharides, including glucose, galactose and fructose, spontaneously (i.e. non-enzymatically) bond with hemoglobin when present in the bloodstream. However, glucose is less likely to do so than galactose and fructose (13% that of fructose and 21% that of galactose), which may explain why glucose is used as the primary metabolic fuel in humans.”

OK – that’s not terribly helpful. How about someone else? The site EVERYDAY HEALTH, puts it this way: “[The A1c] measures your average blood sugar level over the past three months. Called hemoglobin A1C, or A1C, this test can show you how well your type 2 diabetes management plan is working.”

That seems pretty clear, but HOW does it measure my average blood sugar level? It’s one blood draw! How can it tell how my blood sugars have been for the past THREE MONTHS???

“‘Glycation’ of [many] proteins happens often. When blood glucose levels are high, the glucose attaches to the hemoglobin in red blood cells. When there’s too much glucose in the blood, the more glucose hooks on to hemoglobin in the red blood cells and the higher the glycated hemoglobin.

“Once this happens, it stays that way. When there’s a more than usual amount of this in the red cell, it shows that the cell has been exposed to too much glucose during its life-cycle. A1c is an average of glucose levels during the life of the red blood cells.”

OK. I get how this happens now! But so what? So what if there’s too much glucose attached to the red blood cells in my body? Banner Health has this to say, “High A1c levels mean your diabetes isn’t controlled very well. That can increase your risk for complications, so you may need to be screened for kidney damage, nerve damage, eye damage, and heart disease. Additionally, according to the American Diabetes Association, diabetes is the seventh-leading cause of death in the United States. “It’s worth mentioning that the top six causes of death are all influenced and/or worsened by diabetes, too,” Dr. Bridenstine said.

So what can I do? A1c levels improved significantly after 20 days from start or intensification of glucose-lowering treatment. What are some of those glucose-lowering treatments? We’ll start with natural ways to lower your A1c.

1) Probiotics CAN make a significant reduction in glycated hemoglobin in type 2 diabetics. What are probiotics? Yogurt (avoid ones that are LOADED with sugar! That tradeoff isn’t a good one! Us can sweeten your yogurt with fruit. Unsweetened applesauce is an effective “mixer” for plain yogurt.) Other probiotics (check the labels o make sure the culture is still active/alive!) Different varieties of cheese, kefir, sourdough bread, kimchi, and kombucha. Check the computer for others!

2) Entertain the idea of low carb/high protein meals. Things like lean meats or fish paired with vegetables NOT like peas, beans, carrots, corn, and potatoes. It’s NOT that you CAN’T have them, but you can’t binge on baked potatoes/sweet potatoes and sour cream/maple syrup! By the way, “French fries are NOT potatoes! They are FORMERLY potatoes drowned in boiling oil (used to be an execution sentence! Oh, wait, it is for potatoes. Kills any good the potato had to start with).

3) Water. It’s your friend. Even if you hate it. People my age and my dad’s age didn’t drink water unless they had to. We’d buy Dad a case of bottled water and it would stay unopened for months at a time. I force myself to drink a 1 liter bottle of water (minimal) plus sodas and coffee. Sometimes I drink more water. USUALLY not less.

4) Try to love salads. My wife does NOT. I happen to. HOWEVER, avoid the urge to drown your salad in creamy dressings, then sprinkling with raisins, crumbled taco chips, crushed candied peanuts and walnuts…those are NOT salad! Also, try this: instead of dumping the bag of dressing (or a quarter of a bottle) on your bagged salads, put it in a container and DIP THE FORK into the dressing, then spear your mouthful of lettuce ands… It cuts down on the amount of high calorie, non-food dressings you end up eating, and you might actually taste the mix of lettuce and veggies! Also, try eating different mixes of salads – the grocery store makes it convenient.

5) Exercise. Yeah, I know, me, too: HATE to exercise. I use a trainer for my bike during the Minnesota Winter (usually 4-6 months of snow. Currently, I stopped outdoor biking on November 7, 2022. I started riding again last week on March 27, 2023. (five months of trainer-ing.) BUT, I also did thirteen squats before getting on the trainer (every other day); I also spent a few moments on a balancing disk. I also set up my trainer so I can read while pedaling.

So, the prescription is probiotics, low carb/high protein meals, water, salads/veggies, exercise. I haven’t gotten my most recent A1c back yet, but I’ll add it in when I do!

Source: https://www.dignityhealth.org/articles/7-ways-to-lower-your-a1c-level-even-if-you-dont-have-diabetes, https://www.bannerhealth.com/healthcareblog/teach-me/why-a1c-is-so-significant, https://8fit.com/nutrition/high-carb-vegetables-your-comprehensive-guide/
Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg

Sunday, April 2, 2023

GUY’S GOTTA TALK ABOUT…DIABETES #7: HOW Exactly Do Metformin, Glipizide, Insulin, Ozempic, and Etc…Work Together?

For the first time 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 called Type 1 diabetes. 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! Today: What does Metformin do?

“…metformin reduces blood glucose through inhibition of complex IV activity which in turn leads to inhibition of glycerol phosphate dehydrogenase activity and reductions in glycerol conversion to glucose”.

OK – I need to translate this…honestly, even for me (BS – Biology, MS – Counseling), it seems a bit language heavy!

Metformin – I take four Tylenol-shaped tablets a day. To be honest, it has NEVER brought my blood sugars down to what they are “supposed to be”. They range from the highest overnight fasting I’ve ever had of 205; to the lowest overnight fasting I’ve ever had of 143. The literature indicates that I should be 130 or less. So, is the Metformin doing what it’s supposed to? I don’t know – I’ll be talking with the doctor in April.

“inhibition of complex IV” – This complex is involved with taking energy that’s stored in cells in a sort of “stable” package, and changing it into an active package that the cell can use. The HECK?!?!?!? OK – I’ll break it down. According to Wikipedia: “The molecular mechanism of metformin is not completely understood.” Why does that make me nervous? In addition to a lot of other things, it works on “complex IV (or 4) –mediated inhibition of the GPD2 variant of mitochondrial glycerol-3-phosphate dehydrogenase (thereby reducing glycerol-derived hepatic gluconeogenesis)” SIMPLIFIED translation: it interferes with how the body makes sugar in the liver to dump into the blood. IOW, it slows down the release of glucose from the liver into the blood. Metformin decreases gluconeogenesis (glucose production) in the liver…The average patient with type 2 diabetes produces three times the normal rate of glucose! Metformin treatment reduces this by over one-third.”

Glipizide: “Glipizide sensitizes the beta cells of the pancreas’ insulin response”…

And that means, WHAT? OK, everyone reading this has a pancreas. It sits on top of the stomach and helps you digest food – and it makes insulin. Insulin allows your body to break down “real food” into its pieces, that is into GLUCOSE. “Glipizide makes the pancreas release more insulin to pick up the glucose and either use it or store it. than would be without glipizide ingestion. Glipizide acts by partially blocking potassium channels in the pancreas. The cell depolarizes, opens calcium channels, which encourages insulin release from beta cells (the cells that MAKE insulin in the pancreas.”

Insulin: If you’re a Type 2 diabetic, then by this point, you likely know what insulin is. If you’re new to this, insulin is a hormone (like testosterone, estrogen, adrenaline, melatonin…the list is very long…). If you missed the definition above: “Insulin allows your body to break down “real food” into its pieces, that is GLUCOSE”.

Ozempic®, etc: a HUGE group of drugs used to treat Type 2 diabetes, particularly those of us who are overweight (ie: FAT). Some of the brand names besides Ozempic®: Trulicity®, Farxiga®, Bydureon®, Victoza®, Adlyxin®, Jardiance®, and a host of others – all work in ways similar to Glipizide.

They all are designed to do the following: help the pancreas release insulin when blood sugar levels are high; help move sugar out of the blood and into other body tissues where it is used for energy; and slow the movement of food through the stomach in order to decrease appetite and promote weight loss. (See my post two weeks ago regarding the circus THAT has turned into!)

This gave me a better point of view to what’s happening in my own body as I continue to try and being my blood sugars under control. Hope it helped you, too.

Source: https://medicine.yale.edu/news-article/how-a-widely-used-diabetes-medication-actually-works/
Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg

Sunday, March 19, 2023

DIABETES RESEARCH RIGHT NOW! #4: The Most Effective Weight Loss Wonder Drug Yet About To Arrive and WHAT Does THAT Have To Do With Diabetes????

“Butsch, of the Cleveland Clinic, said he is hopeful insurance companies will cover tirzepatide. “We’re seeing really for the first time highly effective anti-obesity medications,” he said. “The benefit is real.”

“A review published last year in the research journal Obesity found that health care professionals hold implicit and/or explicit weight-biased attitudes toward people with obesity… Bias and stigma about obesity run rampant throughout the medical community…’It’s evident across all health professionals, including physicians, nurses, dietitians and others,’ said Lisa Howley, an educational psychologist and the Association of American Medical Colleges' senior director of strategic initiatives and partnerships.”

Most of you are aware that there’s a current shortage of certain diabetes drugs – because they’re being prescribed by doctors for use as a WEIGHT LOSS drug for people who are NOT diagnosed with diabetes. “The current shortage of semaglutide (Ozempic), an important diabetes drug, has an unusual origin: too many people without diabetes are taking it.”

THE HECK!?!?!?!?!

So, doctors and producers are diverting a medication THAT CAN SAVE A LIFE because certain people are TOO LAZY TO EXERCISE OR NOT STUFF THEIR FACES AT EVERY BUFFET FROM HERE TO ETERNITY OR WANT TO SPEND TWENTY HOURS A DAY NOT WATCHING THE TV THAT’S ON IN FRONT OF THEM WHILE THEY TEXT AND PLAY PHONE GAMES.

Do I sound a teensy bit judgmental here? I am. I feel I’m entitled, though. First of all, I AM one of those who (used to and still DO sometimes) am too lazy to exercise, LOVE to stuff my face at a buffet, I’ve NEVER spent much time watching TV (even when I was single), and I DO text and play phone games while I’m watching TV or a movie…so, I’m not judging from a point of some sense of superiority.

I sound a LOT judgmental…(just so you know, the other blog I write is called POSSIBLY IRRITATING ESSAYS (https://faithandsciencefiction.blogspot.com/), I admit it.

And the fact is that, I sort of get the idea taking care of obesity BEFORE it becomes a true medical condition manifesting as Type 2 Diabetes: “Dr. Holly Lofton, the director of the weight management program at NYU Langone Health, regularly prescribes the new drugs to her patients but many, she says, are denied coverage by their insurance. ‘Patients tell me that it appears to them as if insurance companies want to wait until they get so sick that they have more of a necessity for a medication,’ she said.” It’s not a documented study, but it’s certainly a perspective of people.

A doctor writing on the Health Harvard tells this joke: “Drug ads often urge you to ask your doctor if a treatment is right for you. But we already know a key piece of the answer for Ozempic: if you don’t have diabetes, don’t ask for a diabetes medicine to help with weight loss. There are better ways to get the help you need to reach a healthy weight if you are overweight or obese. Talk to your doctor about a full range of treatment options.” Of course, the “full range of treatment options” means: diet, exercise, and living a healthy lifestyle”.

It's perhaps my jaundiced perception and possibly irritating opinion that Americans (me included), and the wealthiest of other countries around the world), don’t WANT anything that smacks of NOT being able to do whatever they want; eat whatever and however much they WANT, and living HOWEVER THE HELL THEY WANT TO – and then taking a shot to keep them slim and trim and healthy.

I’ll also point out that there have been NO long-term studies of the effects of drugs like OZEMPIC and the newest drug Tirzepatide if it is used for extended periods of time…because as a dieter myself, I KNOW that once we reach our target weight, we throw the lifestyle out the window and we’re soon right back where we started.

“A phase 3 clinical trial found a high dose of tirzepatide helped patients lose 22.5%, Wegovy and Saxenda reduced body weight by around 15% and around 5%, respectively.” Ozempic will help you lose 10%...so what drug will the TARGET MARKET go for? DUH! The one that has the potential for you to drop 52 pounds and only have to get your shot once a week!

My wife however, notes, that when she used Ozempic to treat her Type 2 diabetes, it made her extremely ill.

I wonder why they don’t put that in the actual commercial? Hmmm…probably because showing someone barfing on TV wouldn’t help to sell their product…[Who me? Sarcastic? Not at all!]

Link: https://www.nejm.org/doi/10.1056/NEJMoa2206038, https://www.healthline.com/health-news/diabetes-the-top-discoveries-and-developments-of-2022, https://www.nbcnews.com/health/health-news/weight-loss-drug-affordability-rcna60422 , https://www.health.harvard.edu/blog/what-happens-when-a-drug-goes-viral-202302212892 , https://www.myjuniper.co.uk/articles/expected-weight-loss-on-ozempic#:~:text=About%20a%20third%20of%20people,using%20Ozempic%20for%20weight%20loss.
Image: https://asploro.com/wp-content/uploads/2019/12/Diabetes-Research_Open-Access.jpg

Sunday, March 5, 2023

GUY’S GOTTA TALK ABOUT…DIABETES #6 Part 2: What Do the Numbers On Your Glucometer MEAN???

That’s like asking, “Why do I have to put unleaded gasoline in my car?”

Duh! So WHAT if I put Leaded gasoline in my car, isn’t all gas the same? It’s NOT the same! Here’s a micro-history of why: “In search of cheaper compounds, a gasoline scientist discovered that adding tetraethyl lead (TEL) to gasoline would also increase the octane rating (which determines how violent the explosion of the gasoline is – the more explosive it is, the more power it creates.

NASCAR racecars use “Sunoco Green E15, a 98 octane, unleaded fuel blend specifically engineered for high-performance engines and race cars.” The best you can get at the pump is 91 octane.

Anyway, “At the time adding TEL seemed like the perfect solution because it was cheap and you only needed a very small amount to boost the octane power. However, it immediately released lead into the air as invisible smoke. The inventor nearly died of lead poisoning during his research, which caused significant migraines. During production, it immediately caused worker deaths in production plants.”

The sugar in our blood is what powers our bodies. EVERYTHING we do uses GLUCOSE. It is NOT the same a SUCROSE, which is like the sugar in a cube or that some people spoon into their coffee…

By the way: USING SUCROSE (also known as table sugar) DOES NOT CAUSE DIABETES. Eating Twinkies (which are, admittedly DELICIOUS), but that’s because each Twinkie has 33 grams of sugar in it. NO IDEA how much that is? It’s eight sugar cubes. In each one.

So, what happens then? The sugar (cubed or not!) hits your stomach acid, which tears it apart. Sucrose is a sugar that’s made up of two little hexagram boxes that hold onto 12 Carbon atoms, 11 Oxygen atoms, and 22 Hydrogen atoms. It gets torn by your stomach acid into two hexagram boxes. BUT you get two new sugars from the break up!

One is glucose, which you need to run your body. It has 6 Carbon atoms, 6 Oxygen atoms, and 13 Hydrogen atoms. The rest plus a water molecule, make FRUCTOSE (which is also called “fruit sugar”), and that hangs around for bit then the body lets it go.
Your body can do three things with the newly changed glucose: it can use it right away; it can store it in the liver (there it’s called glucogen and can be changed to glucose again really fast). The last thing it does is gets stored…in my flabby belly!

So we have glucose, now what? THIS is where insulin comes in and can work for you to either store your glucose or use the glucose. In someone whose body works the way it’s supposed to, there’s a good level of insulin in the bloodstream. It’s the way our body works – you get glucose IN, and insulin snags it and gets it to where it’s SUPPOSED to be – muscles for either use or short-term storage; the liver for longer-term storage. Insulin lives in the Beta Cells of your pancreas – it’s a sort-of triangle shaped thing that lays on top of your actual stomach (the ORGAN, not like my jiggle pile of flab!)

So, I’m 12 and I eat my Twinkie. Thirty-three grams of sucrose (plus some more complicated CARBOHYDRATES, which are also broken up into various sugars and eventually end up as sucrose and glucose – the body’s very efficient that way! But THAT’S why eating carbs can also affect your blood sugars!) Anyway, the sugar hits the blood, wakes up the Beta Cells, who send out squirts of insulin. Healthy Beta Cells check the level of glucose every few seconds and adjust the squirts to match the amount of glucose in my blood because...insulin travels through the bloodstream, escorting the glucose and telling a the cell’s “doors” to open to let the glucose in. Once inside, the cells change the glucose into energy to use right then or store it to use later.

That was when I was 12…

At almost 66, my Beta Cells are TIRED. Fact is, most people didn’t do anything bad – it’s just a fact of aging that the pancreas is slower to respond than it was when I was standing on the edge of puberty!

But I’m insulin resistant and that changes how glucose is moved around. My body is no longer able to use its own insulin very well. Glucose can’t enter the cells where it's needed, so the amount of glucose in the bloodstream goes UP. The fancy name is hyperglycemia, we know it as, “Dang! My blood sugar is so HIGH! I gotta test it again.”

When blood sugar levels reach 180 or higher, the kidneys try to get rid of the extra sugar through the urine, stressing the kidneys; which leads to disease. When blood sugar levels are close to normal, it means the body is getting the energy it needs to work, play, heal, and stay healthy. If they’re too high? Lethargy. Slow-down of my body’s ability to heal itself when I get injured or even if I have to deal with something like COVID-19. Continued high blood sugars will ruin my chances of recovering my health and staying healthy as I age…

Resource Data: https://www.forbes.com/health/body/best-glucose-meters/; https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg; One Touch Verio Test Strip: https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcShHtmHsdoaRg877fv-9VN4tmZwWUqQY9BavQ&usqp=CAU
Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg

Sunday, February 19, 2023

GUY’S GOTTA TALK ABOUT…DIABETES #6, Part 1: How My Blood Sugar Tester (aka Glucometer) Works and WHY IT’S IMPORTANT

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!

So, after I started using my blood tester (aka from now on, glucometer) on October 15, 2022; I’m finally starting to understand how it works!

For starters, while your glucometer may LOOK different from mine, they all work on the same principle – using some magical crap inside a plastic box and after sucking a gazillionth of an ounce of blood from my finger, it pops out with a number that’s SUPPOSED to be significant…they can be EXPENSIVE. The cheapest one at my corner CVS is $9.99; the one I got from my clinic/insurance carrier is $109.99. Test strips packs there range from

You absolutely CAN buy one without a prescription from several sources, including your corner drugstore (based on the article referenced below for the TOP FIVE recommended by Forbes: GLUCOMETER: $27.44 (range of $15-$50); TEST STRIPS: $0.31 (range of $0.23-$0.38), though they ranged all the way up to$2.20/strip. MY glucometer’s test strips without insurance, over-the-counter? $1.32/strip

THE HECK!?!?!?!??!

They’re tiny pieces of plastic with a TEENY trough that sucks up an EENSY-WEENSY bit of a blood drop…WTchocolateFudge???

It’s all in how they’re made – and there appear to be several types, but ALL OF THEM do the same thing. I’ll break it down into clear steps:

1) After you prick your finger, you touch the blob of blood to what appears to be a tiny stripe on the end of the test strip (sometimes vertical, sometimes horizontal, depends on the brand).

2) The strip sucks it up because of something called “capillary action” – the stripe is actually a tiny, tiny, rectangular tube. The pressure from the drop of blood forces the blood into the tube. A microscopically small hole on the far end releases the air but is too small to leak blood.

3) Glucose (what your body turns ALL carbs and ALL different sugars into) reacts with glucose oxidase (an enzyme that's found in the tube).

4) The glucose oxidase breaks down the glucose making a new chemical called gluconic acid. [ACIDS can pass electricity. Pure water can, too, because it’s a super WEAK acid. So the pH of gluconic acid is around 4.5. You stomach makes a strong acid which is about pH of 2.5 (the SMALLER the number, the more acidic something is!); old-fashioned car batteries are filled with lead plates and the HIGHLY CORROSIVE sulfuric acid which has a pH of -.7!!!] Anyway, because it’s an acid, electricity can go through it. The more glucose there is in your blood, the more gluconic acid there is, so, the bigger the electrical current produced will be.

5) The glucose meter "reads" this current that correlates with expected numbers that indicate a good glucose level or one that indicates (as in myself) that there is too MUCH glucose in the blood and that the insulin that is in the blood isn’t transporting it to store it mainly in the liver as glycogen. The more gluconic acid, the bigger the current. It then figures out the measurement of glucose in the blood in a two to three digit number. Since I started in October, my lowers was 143, my highest was 229 in January

I get why the whole thing is so expensive…it’s a pretty complicated and impressive job for one tiny little strip, isn't it?

In two weeks, "WHY is blood sugar important?"

Resource Data: https://www.forbes.com/health/body/best-glucose-meters/

Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg; One Touch Verio Test Strip: https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcShHtmHsdoaRg877fv-9VN4tmZwWUqQY9BavQ&usqp=CAU

Sunday, February 5, 2023

DIABETES RESEARCH RIGHT NOW! #3: DIABETES RESEARCH RIGHT NOW! Today – DELAY the Onset of Type 1; Tomorrow...

From the first moment I discovered I had been diagnosed with DIABETES, I joined a HUGE “club” that has been rapidly expanding since t 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: A new drug helps delay the onset of full-scale Type 1 Diabetes by as much as two years…

“Until now, the only real therapy for patients has been a lifetime of insulin replacement. This new therapy targets and helps to halt the autoimmune process that leads to the loss of insulin.” MARK S. ANDERSON, MD, PHD; Director of the University of California – San Francisco Diabetes Center

Last November, the FDA approved the use of a new drug brand named, Teplizumab that has prevented the onset Type 1 diabetes in a unique way.

Rather than frantically trying to replace insulin, this new drug actually targets the CAUSE of Type 1 diabetes – the death of the cells in the pancreas that MAKE insulin.

When I was diagnosed with Type 2 diabetes – and blaming myself for being a big, fat blob, and if I only…Naturally, I started to think about a very old friend of mine, who passed away a little over a year after he was Best Man in my wedding.

He’d been struggling with – and ignoring his Type 1 diabetes (then called Juvenile Onset Diabetes) for years. Ignoring it was what eventually led to his death as he refused to act like there was every reason he could live to a ripe old age – for the sake of his two kids (at the time, one of them unborn!)

He felt crippled by the disease; he felt cheated because, based on the medical knowledge of his condition in the late 1980s, and despite the fact that in 1974, two teams showed that insulin-dependent diabetes is associated with the development of antibodies directed against insulin-producing beta cells in the pancreas – the kind of diabetes once known as Juvenile Onset diabetes was an autoimmune disease.

In this third decade of the 21st Century, we know quite a bit more than we did then. We now know that besides the islet cell antibodies, that were associated with T1D there are four other antibodies connected with the disease.

The number of these five antibodies in total is what causes T1D, and the presence of some of them MIGHT be a cause of Type 2 Diabetes (T2D). The antibodies?

ICA: Islet Cell Autoantibodies (the cells in the pancreas that actually MAKE insulin are called the “Islets of Langerhans”), the body reacting against them, destroying them, is what causes T1D. Besides ICA are the following:

IAA: Insulin Auto-Antibodies
GAA/GAD: Glutamic Acid Decarboxylase
IA2/ICA512: Insulin Auto-Antibody 2, and Insulin C-peptide Antibody512

These have all been identified in patients newly diagnosed with T1D.

Why does knowing this make any difference at all?

Researchers also found out that it’s not JUST the antibodies themselves. It’s HOW MANY types the patient has. They think that once they know what’s there, they can better predict the progression to insulin-dependent diabetes (where you have to inject yourself with daily insulin).

The “red letter day” for the new drug, now called Teplizumab, was a “…trial that showed that a single 14-day dose delayed the onset of type 1 diabetes in children and adults by an average of two years in pre-symptomatic patients.”

AMAZING!!!! If only my friend had lived to today.

Does this have any ramifications to my own T2D? Count on me doing a bit research – and even finding out if T2D is an autoimmune response and if this might work for us…

Link: https://www.ucsf.edu/news/2022/12/424496/ucsf-research-crucial-approval-breakthrough-diabetes-therapy#:~:text=The%20FDA's%20approval%20of%20Teplizumab,a%20lifetime%20of%20insulin%20replacement. , https://www.jdrf.org/blog/2020/12/09/aha-autoimmune-disease/#:~:text=It%20was%20all%20diabetes.,beta%20cells%20in%20the%20pancreas.&text=This%20was%20instrumental%20in%20establishing,T1D)%20as%20an%20autoimmune%20disease. https://pubmed.ncbi.nlm.nih.gov/18176860/#:~:text=The%20first%20antibodies%20described%20in,ICA512)%20have%20all%20been%20defined.

Image: https://asploro.com/wp-content/uploads/2019/12/Diabetes-Research_Open-Access.jpg

Sunday, January 22, 2023

GUY’S GOTTA TALK ABOUT…DIABETES #5: What Does It Mean To “Eat Right” AND WHY IS IT SO FREAKING HARD!?!?!?!?!?!

Sorry for the excessive punctuation marks, but I am so FRUSTRATED!

For example, even when I think I’m “eating right”, when I take my blood sugars in the morning, they STILL show RED!

The only time I get blood sugars where they’re supposed to be is when I fast all day long – like when I KNOW I’m going to Red Robin for supper with one of my oldest friends. Then I have coffee without creamer or Half-and-Half in the morning, just Splenda, and then not eat breakfast and lunch. The last day I did that, my BS (do you experience the same subtle, “I can just ignore my blood sugars because they’re BS” moment that I do? MAN! It’s easy to think that! See, I don’t take insulin yet, and my daily pill regimen is 1 blood pressure pill in the morning, then my cholesterol and my Metformin with supper. My pill box is a little purple thing (with 8 days…don’t try and tell me THAT’S not confusing!) Two of the pills are tiny, of course, the Metformin is the monstrously huge one!)

Anyway, all of the horrific stuff that happens because of Type 2 diabetes – “What KIND of serious problems can insulin resistance (Type 2 diabetes) cause? “stresses the pancreas (where insulin is made) damaging it. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. Diabetes and kidney disease due to diabetes caused an estimated 2 million deaths…” these are all practically invisible to me. I haven’t lost a lower limb – though the fact is that I HAVE seen it. I used to be a Certified Nursing Assistant and as a young man, had no trouble getting a job in a nursing home – because there are a FEW old men in there and they usually deal with female caregivers. They LOVED having me and I learned to keep up enough with sports, hunting, and politics to carry on a reasonably coherent conversation with them. They just liked having a young man around to chat with…One of the men, who was himself still completely “there”, but whose wife had severe dementia, was intelligent, and INCREDIBLY FUNNY. I loved working with him. But once we started to get to know each other, he told my about his wife. He’d chosen to move into the nursing home with her when her medical and health needs got so severe, he simply couldn’t cope with them anymore.

She’d been diabetic most of her life, and eventually had to have both legs amputated below the knees.

So, I KNOW one of the effects. But the others? “stress on the pancreas, damaging it (If it doesn’t hurt, it’s not real, right?)…may cause of blindness (really? In the 21st Century????), kidney failure (I can get one of my kids to donate a kidney!), heart attacks (my Dad had a quintuple bypass when he was like 70 and lived another eighteen years! I’ll just get open heart surgery); stroke – OK, THAT one scares me. Brain stroke can erase a person, creating a true zombie – walking, talking, but the person who used to be in the body is gone…; and lower limb amputation… (“Got it.”). Diabetes and kidney disease due to diabetes cause an estimated 2 million deaths…(and of course, that perennial favorite, “Everybody’s gonna die someday!”)

So, I don’t pay attention because there’s no IMMEDIATE effect on me. I can’t TELL if my pancreas is being damaged, or my eyesight is failing (I’ve had glasses since I was in sixth grade – my eyesight has ALWAYS been failing!), or my kidneys are failing, or I “might” have a heart attack…not of it is immediate.

And I’m not the only one: “Participants’ responses indicated that using healthy eating to control diabetes does not provide immediate, tangible results. Thus, these participants followed their own common sense to guide their diabetes management and improve their health. Clinicians may be better able to help patients eat healthfully if they consider these factors during medical visits.”

So, their common sense is likely as good as mine… “It won’t kill me to eat this one doughnut!” or “If I get a MEDIUM DQ Blizzard, it’s better than getting a large!”

I need to get serious. I mean, ACTUALLY serious. I need to do more than write on this blog. I need to change my life. (“But, I don’t WANT to change my life! I like my life!” to which I will now reply: “You’re gonna get LESS life if you don’t start taking care of yourself NOW!” (Add a foot stomp there at the end. It’s time, Guy, to get serious…)

Resources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3781525/
Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg