Re: Another diabetes complication

December 4, 2000

" Susie M. " wrote:

>

> Dave O. wrote:

>

> << " s wife was on insulin during her clinic treatment when the

> glucophage was discontinued. >>

>

> I hope I'm not putting words in his mouth, but was wondering about

> diabetics who don't wind up in a hospital setting. Are all of us who use

> Glucophage supposed to keep insulin and needles around, and learn how to

> inject ourselves, in the event we become ill and heed the warning to

> discontinue Glucophage? Or do just discontinue it and let our readings soar

> temporarily?

I think that in the case of severe infection we should communicate with

our physician, and make decisions after consultation.

IIRC, you don't take Glucophage ala prescribed regimen. I.E., BID or

TID, but based on the way you eat. I understand the way the drug works

is to establish a level of drug in your body, and then to maintain that

level, not up and down. I realize also that it was prior to you getting

insurance.

--

Dave - 1:43:41 PM

T2 - 8/98 Glucophage, Precose

-

Davors Daily Aphorism:

Dumb luck beats sound planning every time. Trust me.

--

Visit my HomePage:

http://dorcutt.homepage.com

December 4, 2000

In a message dated 00-12-04 20:24:16 EST, you write:

<< for hypo I get freezing cold

carol >>

interesting! V.

December 4, 2000

In a message dated 12/04/2000 10:14:03 PM Eastern Standard Time,

whimsy2@... writes:

<< << for hypo I get freezing cold

carol >>

interesting! V. >>

Before my surgery for crohns disease I used to get freezing cold just before

my fever spiked at the beginning of the flare-ups.

BG's. were high even then, but I was told(stupid me!!!) didn't matter it was

only from the prednisone so no treatment was needed. LOL

carol

December 4, 2000

Carol, hi. I wasn't dx with diabetes until Sept. 2000, but had an ulnar

shortening done Dec.98.{that is were they cut out an inch of bone from the

smaller forearm bone}It should of taken only 3 months for the bone to heal

but took almost a year. Also I had a number of infections the last 18

months. At times I had bone infections so bad the infection would bore to

the surface of the skin. Since getting my sugar down it has really cleared

up alot. My arm and hand are no longer green. D.J.

Re: Re: Another diabetes complication

> In a message dated 12/04/2000 2:39:23 PM Eastern Standard Time,

> lists@... writes:

>

> << What I didn't realize before

> was that an increased susceptibility to acquiring infections due to

> impaired lymphocyte function was a diabetes complication. >>

>

> This is true, my ulcer sores were being treated a GI problem, now that its

> being treated as a DM problem, its healing. I'm told it takes a few months

to

> heal completely from other people with diabetes and crohns that have

> ostomies, but that really doesn't matter, I had sores on my lower legs

too,

> now I keep bg really low all the time, that disappeared.

> carol

>

> Public website for Diabetes International:

> http://www.msteri.com/diabetes-info/diabetes_int

>

December 4, 2000

Carol, hi. I wasn't dx with diabetes until Sept. 2000, but had an ulnar

shortening done Dec.98.{that is were they cut out an inch of bone from the

smaller forearm bone}It should of taken only 3 months for the bone to heal

but took almost a year. Also I had a number of infections the last 18

months. At times I had bone infections so bad the infection would bore to

the surface of the skin. Since getting my sugar down it has really cleared

up alot. My arm and hand are no longer green. D.J.

Re: Re: Another diabetes complication

> In a message dated 12/04/2000 2:39:23 PM Eastern Standard Time,

> lists@... writes:

>

> << What I didn't realize before

> was that an increased susceptibility to acquiring infections due to

> impaired lymphocyte function was a diabetes complication. >>

>

> This is true, my ulcer sores were being treated a GI problem, now that its

> being treated as a DM problem, its healing. I'm told it takes a few months

to

> heal completely from other people with diabetes and crohns that have

> ostomies, but that really doesn't matter, I had sores on my lower legs

too,

> now I keep bg really low all the time, that disappeared.

> carol

>

> Public website for Diabetes International:

> http://www.msteri.com/diabetes-info/diabetes_int

>

December 4, 2000

Thornton wrote:

I wonder if Susie missed the fact that your wife was hospitalized due to

reaction to a penicillin-type product, instead of poor diabetic control

because she's on the road?

>

> It is not really fair to apply the attribute " accurate " to subjective

> terms like " lopsided " and " balanced " . I withdraw the word " balanced " ,

> which I included really only to get you going, which I admit is also

> not fair, sorry.

>

> > I would think that increasing her Glucophage

> > to the max. - 2,550 mg a day - during times of

> > medication- or stress- or infection-induced

> > hyperglycemic episodes would be helpful.

>

> No thank you, Susie! Under those conditions, it is mandatory to

> suspend treatment with Glucophage altogether - read the package

> insert! That is just my problem - do I have to be prepared to

> switch to full insulin control during those times or is there some

> other useful strategy?

>

> > We have been told in the U.S. that the

> > " minimum effective dosage " of Glucophage is 1500 mg.

>

> That is quite obviously a mistake. Since they recommend starting

> dosage at 500 mg/day and working up from there, they must expect that

> 500 mg/day could, under some circumstances, be an " effective dose " -

> and it is.

No , it's not a mistake; they recommend that because to start at

1500mg right off the bat tends to create severe gastric problems. They

(my doc included), started me on 500mg the first week, 1000mg the

second, working up to the 2250mg that I'm at now. I avoided the

problems.

I will concede that 500mg does work for some super-sensitive

individuals.

>

> > Do you suppose that would be because our diet

> > is higher in carbohydrates than yours?

>

> I don't use the word " diet " very much, except perhaps in the

> term " fad diet " , referring to the recommendations of Atkins,

> Bernstein, et al., especially when I am in a fighting mood.

>

Careful, she's been known to put truckers up against the wall...

--

Dave - 3:18:43 PM

T2 - 8/98 Glucophage, Precose

-

Davors Daily Aphorism:

I don't think, therefore I am not.

--

Visit my HomePage:

http://dorcutt.homepage.com

December 4, 2000

I get the hot flashes with a hypo, like Vicki. It starts to happen around 70.

The first time it happened I thought " Dang hormone therapy! It's not working! "

Re: Another diabetes complication

In a message dated 12/04/2000 8:19:10 PM Eastern Standard Time,

whimsy2@... writes:

<< does everybody feel this? when my bg is starting to rise, I feel really

hot,

like hot flashes. >>

No, that's what happens to me when I get hyPOglycemic - like when I hit

about

40 I get hot and sweaty. (Haven't done that for a long time tho, thank

goodness!) >>

for hypo I get freezing cold

carol

eGroups Sponsor

Public website for Diabetes International:

http://www.msteri.com/diabetes-info/diabetes_int

December 4, 2000

I get the hot flashes with a hypo, like Vicki. It starts to happen around 70.

The first time it happened I thought " Dang hormone therapy! It's not working! "

Re: Another diabetes complication

In a message dated 12/04/2000 8:19:10 PM Eastern Standard Time,

whimsy2@... writes:

<< does everybody feel this? when my bg is starting to rise, I feel really

hot,

like hot flashes. >>

No, that's what happens to me when I get hyPOglycemic - like when I hit

about

40 I get hot and sweaty. (Haven't done that for a long time tho, thank

goodness!) >>

for hypo I get freezing cold

carol

eGroups Sponsor

Public website for Diabetes International:

http://www.msteri.com/diabetes-info/diabetes_int

December 4, 2000

<< That is quite obviously a mistake. Since they recommend starting

dosage at 500 mg/day and working up from there, they must expect that

500 mg/day could, under some circumstances, be an " effective dose " -

and it is. >>

This is of interest to me too, . Dave O. says we need to take at least

1500 mg daily, regardless of the content of our meals. Don't you think that

initial dosage is not really intended to be fully effective, but is

recommended to minimize gastrointestinal upset?

Susie

December 4, 2000

Thornton wrote:

<< Where on earth did you get that one from, Susie? Who is the genius

that is pretending to be able to decide what is natural and what is

unnatural? The whole of evolution depends on mutations - that's the

way it works. If 85% of us are born in that condition, whose genes

are serving as a reference in order to be able to call it a " variant " ? >>

It's a study I posted to the group just recently. And I agree with you.

That's why I put " gene variant " in quotation marks.

Susie

December 4, 2000

Dave O. wrote:

<< I wonder if Susie missed the fact that your wife was hospitalized due to

reaction to a penicillin-type product, instead of poor diabetic control

because she's on the road? >>

I was referring to 's wife's visual problems as an indication of

complications.

<< Careful, she's been known to put truckers up against the wall... >>

I saw the doctor today. It was very cool. When he asked me how I controlled

my diabetes, I stammered and stalled, and finally said, " Uhh - low-carbing? "

And he shot right back, " That's very good! " Later, as he was checking my

physical strength, he said, " I hope you never get mad at me! "

Susie )

December 5, 2000

Thornton wrote:

<< What I didn't realize before was that an increased susceptibility to

acquiring infections due to

impaired lymphocyte function was a diabetes complication. >>

I didn't know that, . I had thought it was primarily due to impaired

circulation.

Susie

December 5, 2000

Carol wrote:

<< does everybody feel this? when my bg is starting to rise, I feel really

hot,

like hot flashes. >>

I have heard it said that insulin and adrenalin are first cousins; one will

accompany the other. That is the reason, they say, that elevated insulin

levels overnight can cause a pounding heart, restless leg syndrome,

nightmares, night sweats, etc. My diabetic mother and sisters frequently

complain of feeling hot, and their pulse is often 95-100 at rest. One sister

(not yet diagnosed) reports, " When I drink Coke at night, I ride my bicycle

in the bed. "

Susie

December 5, 2000

That is the reason, they say,

> that elevated insulin

> levels overnight can cause a pounding heart,

> restless leg syndrome,

> nightmares, night sweats, etc

---

That describes me when I am in a low state, all except

nightmares. The heart pounding is the worst.

Lily

__________________________________________________

December 5, 2000

In a message dated 00-12-05 15:38:42 EST, you write:

<<

The alternative way is to emphasise the " quality of life " aspect and

adopt the attitude that a diabetic with good control is, in fact,

just as healthy as most of the other folks walking about with all

kinds of diagnosed and undiagnosed chronic illnesses, either already

there or on the way. >>

Works for me, . But it does take constant vigilence. Vicki

December 5, 2000

In a message dated 00-12-05 15:50:40 EST, you write:

<< Neither of us ever had gastric symptoms from Glucophage.

>>

Neither did I, and I was up to 2500 mg. per day. I quit taking it when I

started on insulin. Vicki

December 5, 2000

> I have also started taking my temperature

> every time that I take my blood sugar readings

> and I record it right along with the BG's

I am just beginning to think about the tips that Carol just gave -

the ones about using only liquid soap in a dispenser and only having

paper towels in the place. This will mean having to archive

our " collection " of hotel towels but hygiene comes first. I am just

worried that we will end up every morning scrubbing-up like surgeons

and walking about in face masks and disposable gowns and caps!

The clinic atmosphere with blood pressure and blood glucose measuring

equipment, thermometers, tablets, ointments, etc. lying around will

surely get us into a " being sick " state of mind that I would really

like to avoid if I can. It is hard to know where to draw the line -

there has to be one somewhere. If I had the money I would probably

finish up like with his very own private medical staff -

if I had the luxury penthouse apartment to go with it!

The alternative way is to emphasise the " quality of life " aspect and

adopt the attitude that a diabetic with good control is, in fact,

just as healthy as most of the other folks walking about with all

kinds of diagnosed and undiagnosed chronic illnesses, either already

there or on the way. That might not be a good idea, however.

December 5, 2000

> No, , I think they suggest 500 a day

> to start because of the possibility of gastric

> symptoms which can occur with Glucophage. By

> starting low and working up this can possibly

> be avoided. At least that's what my doc told me

> when I started it.

I must admit that I hadn't thought about that possibility, Vicki. I

remember that I was on 500 mg unsuccessfully for many months before

it was upped to 2 x 500 mg/day. My physician told me at that time

that if that didn't work, he would put me on insulin as 1500 mg

Glucophage per day was too risky (and I have no kidney problem). I

understand that the problem is not that you get a reaction from

taking a higher dose but that after a time the higher dose will

eventually cause Glucophage to fail altogether and you have to move

to some other oral medication anyway. The philosophy over here seems

to be to keep the dose as low as possible, supplementing with a low

dose of a sulfonylurea if necessary, in the hope of postponing total

failure for as long as possible.

My wife is well adjusted on an 850 mg Glucophage split in half, one

half taken in the morning together with 0.5 mg Amaryl and the other

half in the evening. We have tried a wide range of other combinations

and doses but the one she is on now gives the best results for her.

Neither of us ever had gastric symptoms from Glucophage.

December 5, 2000

> This is of interest to me too, .

> Dave O. says we need to take at least

> 1500 mg daily, regardless of the content

> of our meals. Don't you think that

> initial dosage is not really intended to

> be fully effective, but is recommended to

> minimize gastrointestinal upset?

Well, now - I don't think that the medication dose prescribed over

here takes account of the content of meals. The approach seems to be

to start off with 500 mg and stay on it for a few months and watch

the HbA1c. If that does not fall, the dose is upped to 1000 mg for a

few months and again the HbA1c is watched. If it falls then we stay

on that dose; if it doesn't fall we are put onto insulin. Don't

forget that the treatment goal for metformin as defined in the safety

study was to reduce the HbA1c linearly to below 7% within 2 years at

the most without ever once showing a positive trend. Any increase in

HbA1c during the 2 years was to be reason for cessation of the

metformin treatment.

I am wondering if the Glucophage sold over here is the same as the

kind sold in the US. Our Glucophage has a barrier to prevent the

mouth and gullet coming into contact with the metformin and to let it

out slooooowly when the barrier dissolves in the gastric juices.

Could that be saving us from the " gastrointestinal upset " ?

December 5, 2000

Thornton wrote:

<< If I had the money I would probably finish up like with his

very own private medical staff - if I had the luxury penthouse apartment to

go with it! >>

And don't forget the Kleenex boxes to wear as slippers! )

Susie

December 5, 2000

, I get boil-like sores and have for several years. The 6 months before

diagnosis, I also noticed I started getting these big pimple-like boils on

the back of my neck. My brother, diagnosed 5 years ahead of me, also has

these. My doc gave me an anti-biotic wash to use on them.

*sigh* Judith

Another diabetes complication

>I am also left wondering - has anybody on this list:

>- observed the appearance of boils or other skin infections?

December 5, 2000

, I don't take my temperature ALL OF THE TIME. I have only been taking

it during this siege with the flu. The doc always wants to know if I'm

running a temperature when I call in to let him know that I'm still alive

and kicking and give him my weekly BG readings. I'm really not a " health

nut " , but just a diabetic trying to beat this darned old flu bug. I'm much

better now but still coughing and sneezing and staying in isolation. I sure

don't want anyone else to catch it from me.

Tootie