Introduce yourself

[Gina]

Tell me a little bit about yourself!

[Jon Schlaman]

So at this stage, can diabetes be prevented, or just postponed?

[tmana]

It's to some degree a matter of semantics whether one has "prediabetes" or "diabetes" at that stage. And it's a matter of semantics as to whether someone maintaining normal blood glucose levels using ILM alone has "beaten diabetes" or "no longer has diabetes" or whatever. I've been told it's somewhat like virginity: once you've done it (been diagnosed with "pre-diabetes", "borderline diabetes", or "diabetes), you can never go back to being "non-diabetic".

Semantics notwithstanding:

Whether or not the condition progresses further, or can be made to regress, depends upon the causes and effects of the individual's hyperglycemia, how much beta cell function remains at time of diagnosis, and the person's commitment to intensive lifestyle management.

I have been led to understand that regardless of "type", the clinical milestones of diabetes diagnosis do not appear until beta cell destruction is greater than 50%. (I am not completely convinced this is true, but...)

"Pre-diabetes" and "borderline diabetes" are both terms used exclusively in relation to Type 2 (insulin-resistant diabetes, impaired-glucose-tolerance diabetes, and/or diabesity).

In "pre-diabetes" or "borderline diabetes", we are talking about blood glucose levels that are already elevated ("normal" fasting glucose is < 100 mg/dl). Because of this, one might presume that some beta cell damage has already occurred (I think the benchmark is something like 20-30%). This is one of the theories behind diagnosing "diabetes" at 110 mg/dl fasting blood glucose, and commencing metformin immediately. However, in T2 there are several potential causes for hyperglycemia, not all of which indicate beta-cell malfunction or destruction.

When one is obese, hyperglycemia can arise from simply having too many cells, excessively large adipose cells, and/or too many miles of circulatory system for the beta cells to produce as much insulin as the body needs (think of it in terms of "supply and demand", and you have a larger population demanding insulin than your body can supply). If this supply-demand mismatch is caught early, before significant beta cell death has occurred ("the poor things are worked to death!"), then caloric restriction, a low-GI-diet, and/or weight loss can reduce insulin demand to meet the body's ability to supply it. In those cases, one can maintain a "normal" (normoglycemic) lifestyle for many years -- perhaps a lifetime -- without resort to pharmaceutical assistance. Some consider this "beating diabetes" or "avoiding diabetes"; others consider it "controlling one's diabetes".

If the "pre-diabetes" is caused by insulin resistance (usually a result of malformed insulin or more frequently, unresponsive receptor sites), then decreased insulin demand may not relieve the load on the insulin metabolism sufficiently to return it to "normal". If that is the case, then there is a high likelihood that the condition will progress. However, if insulin reception is impaired by high levels of abdominal-adipose hormones, then weight reduction and maintenance should restore normoglycemia.

Again, nomenclature is a semantic issue... but whether or not the condition will progress depends on the person, the underlying reasons for the initial presentation of hyperglycemia, and where applicable, the person's commitment to intensive lifestyle management.

[Sugar Plum]

Blood and urine test during a routine annual physical. I was careless for years. Yummm to creamy macaroni & cheese, bagels w cream cheese, dessert, potato chips, etc. Especially Gatorade. I drank it like a fish for over a year. I didn't know how to read nutritional labels then. And lack of exercise. I've since lost over 30 pounds and I run most mornings, around the block or 7 or 8 blocks, depending on how much time I have. I feel great! I got rid of most of my old clothes and bought too much on eBay. I'm now possessed on eBay! Prediabetes leading up to Type II diabetes is plain carelessness on the part of most people who eat too much and don't have an exercise plan. I've really learned my lesson and felt punished. Now I'm normal but I have to be cautious for the rest of my life. Sort of like a life sentence with parole now and then ( treats on occasion ). My doctor laughed when I complained about that. Now I've lightened up about all this, and stick to my diet and exercise. This is my new lifestyle and it's working out very well for me. I'm very happy for you and your family. It's such a relief that your son finally has his pump, and that he's doing well. Type I diabetes is something that happens. Type II can be prevented. I believe that there will be a cure for Type I. Treatment has come a long way. Good luck and keep us posted.

Sugar Plum

[Sugar Plum]

Blood and urine test during a routine physical exam. I got careless with food, and lack of exercise helped me to gain weight. I've since lost over 30 pounds and I feel great! My doctor and dietician are a great help. Now it's a life sentence for me with day passes, such as treats on occasion. No more piles of cookies after supper every night. Maybe ONE cookie. Diet cola and maybe a little chocolate. They say dark chocolate is good for the heart. Well, a little bit for a treat anyway.

[Sugar Plum]

Hi, I'm Sugar Plum (not my real name). I got my blood sugar under control and lost over 30 pounds, so now I'm normal with a life sentence to be cautious due to my carelessness with food and lack of exercise. I'm currently taking ballet and having a great time with it. It's a very graceful dance, though we're not dancing yet. I'm thinking about going into hip hop because it's more strenuous and hopefully not too difficult to keep up with. I'm not very coordinated, especially in a class setting. Perhaps my doctor will scrap the idea that I should get a glucometer. Kind of scary for me: the testing after meals, and lancing myself. I don't know if I can 'do' that to myself. After I lose a few more pounds I'll make an appointment with him, and perhaps my dietician as well. Wish me luck!

[Sugar Plum]

Sorry I posted three time about myself. I'm not full of myself. I though my previous postings didn't work. I'm not very computer literate, and I don't mean to repeat myself.

[Lindsay]

Hi! I'm Lindsay and I'm a 26-year-old living in DC. I was diagnosed with Type I diabetes when I was 13--so I've been dealing with this half of my life. I've been on an insulin pump for the last four years and I like it. My best H1c was my most recent--7.1. I'd really, really like to bring it down but I have a pretty intense sweet tooth and a difficult time cutting back on foods I like. I've done a much better job in the last year but and still definitely looking for tips about how to make foods taste good on a limited diet. I love to exercise but do it only as regularly as my busy life allows. I have a super supportive partner who helps me manage my care. And I'm so glad to have found this site!

[Sugar Plum]

Hi,

I'm Sugar Plum and I've discovered that boiled vegetables taste pretty good without the butter and salt. I find that I enjoy the taste of the pure food: for example, carrots and broccoli tastes sweet without anything added to it. Even the broth is sweet. It would be better to steam the vegetables, though. That way vitamins are not lost when it's boiled. If you want flavor, try different herbs. You can even buy vegetable flavorings without the added salt. Try your local health food store. The staff there are usually very helpful, and you get the attention you need there as opposed to grocery stores where the staff are always too busy to answer questions (not that they can really help you ). Have you tried sugar free Jello Brand pudding? They come in chocolate, caramel, and vanilla flavors and have only 60 calories per cup. There is also Jello Brand jello that is sugar free. I've discovered sugar free cookies in regular grocery stores. I know that it's the carbs that you have to watch for, but I figured that it's not necessary to add sugar when artificial sweeteners can be used. You live in the United States so your groceries store would have a larger variety of sugar free foods than Canada, which is where I live. As for exercise, I run a little almost everyday. Sometimes I run around the block, and when I have more time, I run about 7 or 8 blocks. I might even use the gym in my building. I'm also taking ballet once a week and I find that the exercises are excellent to do on my own. There is a book titled Fit For Life by Marilyn and Harvey Diamond. It teaches food combining that makes a lot of sense. I believe that people with diabetes can work it into their diet. I was going to a dietician for about 9 months and she explained that it's possible to live well by eating according to a person's height and frame and level of exercise activities. Good luck and keep us posted. We want to know that you continue to make changes for the better.

[Gina]

i love veggies with nothing on them as well! Thanks for coming around sugar plum! your input is really useful!

[Lisa Lagarde]

Hello,

I am Lisa and my 15 year old son has type I. He was at the Dr. today and tested at over 14 A1C! Yikes! This has been such a problem for him since he was diagnosed. I read a lot of great things from people who are doing well and it makes me hopeful..... Anyone out there with advice for me. Have a similar situation?

[Jon Schlaman]

Hey Lisa, my son is 17 and his A1C has been between 11 and 14 since he was diagnosed 10 years ago. I have been pulling my hair out for years trying to figure out a way to get it down and nothing seems to work. I think the teenage years are particularly hard to manage. I am not saying it is ok, but I am saying that you are not alone. The insulin pump helped some, but I think most of the problem is just trying to get a teenager to take diabetes seriously.

[Big Al]

Hi everybody. I am Alan and I was diagnosed with diabetes about a year ago. I am a 47 year old that has been happily married for 26 years and have one son. My doctor initially put me on Humalog mix 75/25, a dosage of only 12 units per day, and after about 10 months I have been able to drop the shots and move to Metfromin Extended Release. 2 pills a day, 500 mg pills. Started off taking both in morning, noticed my fasting sugars were starting to rise a little, and switched to one pill in the morning, one in the evening and things have gotten back to where they were before the switch to pills. Still working on exercising more, and losing more weight which should help me even more.