Some Notes on Type II Diebetes

August 20, 2006

I received the bad news the first of March of 2004. I am still sorting out this unwelcome intrusion into my otherwise fine life! And the whole process will probably take quite a bit longer. But this is what I have learned so far.

Not the End of the World

But you can see it from here on bad days. There MUST be changes, but they have not been that bad for me. My biggest problem is taking my blood sugar readings. There will be much more about that further on. The internet is not much help. The first place most people stop is the American Diabetes Association web site. It is not worth even a cursory look. There is no helpful information there. All they want to do is sell books. They are also heavily into the Blame Game. If you have type II, it is your own damn fault according to this most fashionable theory espoused by most everyone in the US. It ignores the fact that there is a genetic component that cannot be willed away. In my case I was 5' 9" weighing 167 pounds with a very active exercise program. So I have no use for the Blame Game establishment, which is rampant in the US.

Sadly there is much more money to be made treating the effects of this disease. The New York Times carried a long series on diabetes in the first part of January, 2006. In that they note that Medicare will not pay for a $150 visit to a podiatrist to help prevent damage to diabetic's feet, but they will pay $30,000 to amputate the same person's foot. This is just plain WRONG!

The most important thing you can do is find someone who is in the same boat. There is so much to assimilate and frankly the medical community can't help. My doctor has no idea how one takes their blood sugar readings... somebody else always does that. I asked several times for a diet, but never recieved one. I later learned that would be a not worth the paper it was written on. Our medical establishment does not have any interest in or really knowledge of the glycemic index of foods. You have to go to some other country for that information.

The basic change in your diet will be to not consume any prepared foods. Especially prepared foods in the US which have at least 50% more sugar in them that the same brand sold in any other country in the world. Our food companies are very much part of the problem. You have to generally stick to meals prepared from fresh ingredients.

The biggest problem with diabetes is that the real problems appear 5 to 20 years after onset. It is easy to get suckered into not worrying too much about it. Eye problems are especially worrying for me. It is very important to work as hard as you can to control it. I have read a number of encouraging articles about people who have successfully staved off the complications of diabetes. They were VERY diligent. One person limited himself to one piece of bread a day. PERIOD. I should be that diligent!

Precursors to Onset of Diabetes

The classic precursors to diabetes are shoulder problems and foot problems. I had both. I think the foot problem is much more diagnostic. The balls of my feet felt oddly thickened. There was less feeling as well. The poditrist described it as feeling like your socks are wadded up and that is as good a description as any. When this starts, your blood sugar readings will not alarm your doctor. So this is a good indicator for diabetes onset.

I had shoulder problems 3 or 4 years before diabetes onset. Bursitus was the diagnosis, but there was some communications problems that may be caused by the lack of clearly defined symptoms.

An unusual tiredness is what tells you diabetes has arrived. I was feeling tired for months before the diagnosis. At 62 I assumed it was old age. Don't make that mistake. See your doctor and get a blood test! Now that I am regularly checking my blood sugar, I can tell the difference between a blood sugar reading of 125 and a blood sugar reading of 100. The lower reading gives me noticably more energy than the higher one.

Foods

According to the American Diabetes Association, I was eating a perfect diet when I was diagnosed with Type II diabetes. This was especially confusing. Then my Venezuelean friend pointed me to the University of Sydney (Australia) study of Glycemic Indices for food. And this told me that I was eating ALL the wrong things. Baked potatoes are actually worse than eating sugar by the spoonful. You need to retool diet using Glycemic Indices. Unfortuantely all of the studies are done over seas and the results are different than for the same prepared food sold in this country because there is so damned much more sugar in our prepared foods. It leads me to think that the reason no one will talk about Glycemic Indices in this country because all the money is invested in creating prepared food with terrible Glycemic Index values.

Click Glycemic Index

There are some surprises. Peanut M&Ms are okay as is ice cream. But you need to be eating premiem ice cream to get good Glycemic Index values. Anything with vinegar in it will be better. In general, you have to look at the whole package instead of the individual components. That is why it is important to have a good food list. You will find many on the internet, but they all seem to derive from the University of Sydney's work. So you might as well go to the source. Personally the loss of bread from my diet was the worst blow. I have found a 100% Whole Rye bread that Trader Joe's here in Ohio. They are not a national chain, but this bread is probably available in other stores of that type. It is great toasted with melted cheese on it. And it is okay for sandwiches, but real bread it AIN'T! I was also upset losing stewed tomatoes from my diet, but Hunt's has a balsemic tomatoes in a can that don't seem to increase my blood sugar. Again the vinegar cuts the index sharply.

The South Beach Diet is a new diet that does include the Glycemic Index into its food consumption plan. This is a start. But this diet is a very tough one to follow and it removes as much fat as possible as well. This is what I probably should be following, but I have not gotten there yet. And as a result, I have gained at least 10 pounds since I was diagnosed.

The Trader Joe's food stores are the best place to shop here in Ohio. They have fresh, high quality food for remarkably reasonable prices. Their selection for nuts is awesome and their prices are the lowest anywhere. I would take a close look at Wild Oats, if there is one near. I don't think their prices match Trader Joe's, but their quality certainly does.

Cinnamin has positive effects on my blood sugar readings. I try to take more than half a teaspoon in sugar-free applesauce each day. It doesn't sound like much, but a little bit of this stuff goes a long way!

Blood Sugar Readings

This was the toughest thing for me to do. I hate needles, period. It took me nearly a year to embrace the notion of regularly taking my blood sugar. This was part of my denial process. I did finally start taking detailed notes and have learned a fascinating amount of information about blood sugar readings: It took nearly nine months to find an effective way to take my blood sugar readings. Here is the step by step process I use:
  1. Wash hands with anti-bacterial soap and dry with paper towel
  2. Prepare the sticker with a new dart. The One Touch sticker set 2 steps from maximum gives the least pain and reliable blood flow
  3. Prepare the reader, but do not start it. The Accu-Chek reader takes the least blood and is the easiest for me to use.
  4. Place the reader on the edge of a table
  5. Clean an area on one side of one of my thumbs with an alcohol pad
  6. Use a hair drier to dry the thumb and apply heat to the entire arm. Use high setting. Applying heat causes blood to flow to that area.
  7. Push blood toward the area you will stick!
  8. Press sticker to side of the thumb and release dart... no flinching!
  9. Use your other hand to squeeze out enough blood... manipulationg the skin but never touching the blood bead!
  10. When the bead shows signs of growing large enough, start the reader. There is a time limit and it saves money to not even start it if there is no action... sometimes it happens.
  11. When there is enough blood, use both hands, steadying them on the table edge to touch the blood bead to the channel of the reading strip.
  12. Do NOT allow your skin to touch the strip. The manuals and tv ads show this happening freehand. That does not work for me at all.
  13. I have successfully smeared blood when it didn't quite take, but the manual says to never do that... but damned if I am going to waste a sticking event!
  14. I hold my breath as the damned reader does its thing, but I don't think it helps that much.
  15. Use the alcohol swab to clean the stuck place.
  16. Remove the used dart immediately... this is fairly new for me, but it saves me real trouble the next time I take a reading.

The important thing is to take blood sugar readings regularly. Twice a week works well. People who take the readings regularly control their blood sugar much better than those who do not.

Exercise

Everyone will tell you that exercise is important for controlling diabetes. But it is also important to improve your blood circulation. Blood circulation problems cause the most damage to your body. I exercise every day but Sunday as part of my morning routine. On days when I take a blood sugar reading, I exercise after the reading. It takes at least 10 minutes to enlarge your veins and arteries. This is why the first 8 minutes or so of running is always the toughest. Most people get a 'second wind' at about 8 minutes. This is actually your cardiovascular system enlarging to handle the increased blood flow. On days that I do not have time for exercise, I do 10 - 12 minutes of meditation as soon as possible.

I have continued to bike long distances without any ill effects so far. I go the Ohio GOBA ride for a week each June and last fall I rode the 80 mile Greenbriar trail in West Virginia in one day.

Feet

Your feet really take a beating because they are the furthest from your heart. After exercising each morning, I take a bath. A shower won't give your feet the soaking in warm water that they need. And it is very hard to scrub your feet in the shower. I use a rounded pumice stone on the bottoms and sides of my feet with each bath to promote circulation and to keep the calluses under control. Those calluses are another feature of diabetes.

An amino acid, L Arginine, can be taken to improve blood flow. This makes a big difference in the pain level that I began experiencing about two years after my diagnosis. This is a short lived effect and you can take three of these a day if you need to. I find the pain is associated with long hikes or bike rides. Taking one pill before starting will eliminate the pains I currently experience.

Good shoes are a must. I generally wear LL Bean Cresta hiking boots when hiking. For teaching I wear LL Bean Day Hiker boots when I will be on my feet long periods of time. Spenco inserts are also a must. Replace whatever flimsy insert with a heavy duty Spenco one. And you should not wear a pair of shoes for more than one year. The mid-sole loses it's ability to cushion your feet after one year. I do stretch this a bit, but not as much as many of my friends may think. I also wear good European walking shoes for a mixture of walking and sitting. Good means a full price well over $100. Your feet will tell you when you are not taking care of them. Heed what they tell you.