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[Guest guest]

Hi, my name is Thala and I was diagnosed Tuesday 3/23/04 with

diabetes. I had been out of the country in Baja and thought I was

dehydrated. I drank about 8 16oz bottles of water a day and was still

thirsty. I got real dizzy, then my eyesight got bad, that happened

on Weds. and I did not get home until the following Mon. and the Dr.

on Tuesday. I am on a pill twice a day and a shot at night but my

blood sugar is not coming down very fast. Does anyone have any

information for me that may help it drop faster. Thanks so much for

any advice offered. Thala

[Guest guest]

Thala Vance wrote:

>Hi, my name is Thala and I was diagnosed Tuesday 3/23/04 with

>diabetes. I had been out of the country in Baja and thought I was

>dehydrated. I drank about 8 16oz bottles of water a day and was still

>thirsty. I got real dizzy, then my eyesight got bad, that happened

>on Weds. and I did not get home until the following Mon. and the Dr.

>on Tuesday. I am on a pill twice a day and a shot at night but my

>blood sugar is not coming down very fast. Does anyone have any

>information for me that may help it drop faster. Thanks so much for

>any advice offered. Thala

>

Sorry to hear about your diagnosis. The vision problem should

revert to normal as soon as you get control of your blood glucose (BG).

Tell us what pills and doses you are taking and tell us about

your shot.

Has your doctor provided you with any instructions about what to

eat? What kind of diet are you following? What are you eating? Do

you exercise?

When do you test and what readings have you been getting?

Edd

[Guest guest]

Thank you for your reply. I am taking Diabeta 2.5 mg twice a day,

Lantus 100u m/l at night 20 units. My diet is very simple, eggs,

toast, strawberries for breakfast. Tuna salad and an apple maybe a

cracker for lunch, meat, salad, vegetable for dinner. This morning

my reading was 247 before breakfast. My exercise is going to a

personal trainer twice a week prior to this disaster, and cycling at

home a couple times a week or walking. I have a total knee

replacement so the walking isn't great because I need a second knee

replacement and yes I am overweight. At this time I must have a

virus because I have a horrible cough and my husband has a sore

throat. I had three steroid epidurals which I understand could have

brought this on, I was getting my blood checked once a month prior to

this episode and I was still normal but borderline. If you have any

suggestions to help me lower my readings I would appreciate it, as

for exercise right now, I just feel too ill. Thala

[Guest guest]

Thala Vance wrote:

>Thank you for your reply. I am taking Diabeta 2.5 mg twice a day,

>Lantus 100u m/l at night 20 units.

>

An unusual therapy. Generally, insulin and insulin stimulating

pills are not used at the same time. Lantus is one of the newest

insulins and is a good basal insulin. It's often used in conjuction

with Humalog or Novalog, short acting insulins to cover meals. You

would inject Humalog immediately before a meal and it would be active

for about 2-4 hours, roughly the length of time it takes to digest your

meal. This is the closest imitation of our own pancreas that medical

technology now has to offer us (well, short of getting an insuln pump, I

suppose).

Diabeta (glyburide) as a fairly long acting drug. It has a

half-life of 10 hours, so every 10 hours, it reduces in strength in your

system by half. Taking it in the morning would tend to cover you

nearly half a day. It's sort of taking another basal insulin. The

problem here is if you take enough to keep your after meal readings

properly low, then it would make you hypoglycemic the rest of the day.

You're already injecting insulin, but I don't know how happy you are

about that. With Humalog/Novalog, you'd have to inject an aditional

time for each meal. That would give you better control, but perhaps

you'd hate those additional injections. In that case, there are a

couple of different pills, which would work similarly. Prandin and

Starlix are drugs which stimulate insulin production, but only briefly.

They are the pill equivalent of short acting insulin. They are taken

immediately before eating and are used to cover the the insulin needs of

just that meal. The Lantus would continue covering your basal needs for

the entire day.

I seem to be rambling on and on here. These are issues you need to

disuess with your doctor, of course. It might be interesting to learn

his reason for putting on this unusual mix of pills and insulin. There

are some other pills which work differntly which could also help you

lower your readings.

>My diet is very simple, eggs,

>toast, strawberries for breakfast. Tuna salad and an apple maybe a

>cracker for lunch, meat, salad, vegetable for dinner. This morning

>my reading was 247 before breakfast.

>

You've been diagnosed so recently, that you've probably not had

any dietary counselling. The really sharp doctors schedule their new

diabetics to meet with a dietian. The diet you eat is a major part of

controlling our readings. Briefly there are two major schools of

thought on the diabetic diet. You'll find everyone has diet advice,

but just about everyone falls into one of these two schools. The

American Diabetes Association (ADA) promotes our eating the same

" healthy " diet that non-diabetics eat. This diet is relatively high

in carbohydrates, and it's is the carbohydrates in our diet which raise

our blood glucose levels. The ADA recommends this diet and assumes we

will get enough exercise and take enough medication to bring our

readings to desired levels. The other school is championed by

K. Bernstein, M.D. who recommends mimimizing our carb intake to prevent

our readings from going up in the first place. This minimizes the

amount of medication we take. I have a long post which details the

reasons or each approach, but perhaps we can save that for another time.

But when looking at the diabetic diet, it is the carbs that we

consider first. For a new diabetic, you seem to be eating fairly

well. The strawberries are low carb for fruit. So are eggs. The

toast would be problematical, but that depends on how many slices, I

suppose. So your breakfast looks fairly good. Fruit is always

promoted as " healthy " for non-diabetics, but to us, fruit is full of

carbs. Fruit juice is little more than sugar water. But a single

apple is reasonable. You mention vegetables. Depends on which

vegetables. The " white " vegetables are often problems. Bread,

grains, rice, potatoes, pasta etc. tend to be high in carbs and problems

for us. Cauliflour is white, but is low carb, so it's an exception to

the " white " rule.

Many diabetics tend to follow low carb diets like Atkins or South

Beach. Those diets tend to be very helpful to diabetics, although they

were designed for weight loss. Dr. Bernstein has designed a low carb

diet expressly for diabetics.

Your fasting reading of 247 tells me, first, that you are testing

before breakfast and that's good and second, you're way too high, which

explains why you're here asking for help which is the correct thing to do.

>My exercise is going to a

>personal trainer twice a week prior to this disaster, and cycling at

>home a couple times a week or walking.

>

This is excellent. Exercise is important for diabetic

control. This will do just fine.

>I have a total knee

>replacement so the walking isn't great because I need a second knee

>replacement

>

Sorry about that.

>and yes I am overweight.

>

We are all overweight, at least 80 - 90% of us. Some of us,

like me, are down right fat. We're in the majority here, so you can

relax. I'm sure everyone will tell you to lose weight, or perhaps that

losing weight will cure your diabetes. Losing weight, at best, is slow

and generally only temporary. You can achieve good diabetic control

without losing weight. You have a lot to learn about being diabetic

and some probably uncomfortable adjustments to go through. I recommend

you work on gaining diabetic control for now and worry about losing

weight after you reach your diabetic goals. High blood sugars are

damaging, and you want to avoid damaging yourself over the months it may

take to reach your goal weight.

>At this time I must have a

>virus because I have a horrible cough and my husband has a sore

>throat.

>

Infections of any kind can raise your bgs (blood glucose),

including cold or the flu. This may be part of the reason your

readings are so high right now. Often we can anticipate coming down

with something, even before we feel any symptoms, because we see an

increase in our BGs. You'll get over your cold and your numbers should

come down some.

>I had three steroid epidurals which I understand could have

>brought this on,

>

Right. Steroids can raise blood glucose levels and long term use

of steroids can even cause diabetes. Type 2 diabetes is a genetic

disease which is often triggered by some traumatic event, disease, car

crashes, or some serious stress.

>I was getting my blood checked once a month prior to

>this episode and I was still normal but borderline. If you have any

>suggestions to help me lower my readings I would appreciate it, as

>for exercise right now, I just feel too ill. Thala

>

There are three methods to control blood glucose levels.

Exercise, diet, and medication. For most of us, some combination of

those three things will give us control. For now you're feeling too

crappy to exercise. Your diet doesn't seem unreasonable, but watch

your carbohydrates. Stay away from the " white " ones, starches. For

the moment, try to eat as low carb as you can. That should help. That

leaves medication. Your doctor has just started you on meds, so he's

undoubtedly started you on a low dose and plans to increase your doses

until you achieve control. This is called titrating the dose. You

might give him a call and tell him you have terribly high numbers and

ask him to increase your meds. In the short run, that seems like the

quickest fix. I doubt your doctor would be interested in talking

about changing your medications over the phone, but he may be amenable

to increasing doses. A bit of caution here, you'll need to take into

account that your numbers may come down somewhat by themselves as your

cold improves.

Stay hydrated. That'll be good for you cold, but it will also help

lower your BGs a little bit. If you feel well enough to to some

light, easy, gentle walking, do that. Test before and after to see

what your numbers are. When your numbers are up around 250, exercise

is often not recommended, because it can sometimes actually make your

numbers go up. Walk, test. If your numbers, don't come down, then

stop walking.

You should be testing after meals. Testing at the 1-hour or 2-hour

mark after a meal, will help teach you which foods drive your numbers up

and which foods are more easily tolerated. It's not just sugars, it's

all carbohydrates. Ideally, you should shoot for about 140 2-hours

after a meal. Morning readings should be around 110.

Has your doctor scheduled you for a class on basic diabetic

training? This is usually done with a Certified Diabetes Educator

(CDE). This person is sometimes also the dietiian you meet with. The

sharp doctors schedule this, but commonly it's not done. If your

doctor fails to do this, then seek out training youself if it's

available at a hospital near you. And stay in touch with this group,

where you can get many answers.

Here is information about the Diabeta you're taking. It's a bit

technical, but worth reading.

http://www.rxlist.com/cgi/generic/glybur_ids.htm

A couple of worthwhile books to learn about diabetes:

_The First Year: Type II DiabetesZ, by Gretchen Becker. Easy

reading. Humorus. Good basic introduction.

_Diabetes Solution_, K. Berstein, MD. A harder read.

Good boot camp manual for diabetes. One chapter covers his low carb diet.

http://www.diabetes-normalsugars.com/index.shtml

Hope you feel better soon.

Edd

[Guest guest]

> Hi, my name is Thala and I was diagnosed Tuesday 3/23/04 with

> diabetes. I had been out of the country in Baja and thought I was

> dehydrated. I drank about 8 16oz bottles of water a day and was

still

> thirsty. I got real dizzy, then my eyesight got bad, that

happened

> on Weds. and I did not get home until the following Mon. and the

Dr.

> on Tuesday. I am on a pill twice a day and a shot at night but my

> blood sugar is not coming down very fast. Does anyone have any

> information for me that may help it drop faster. Thanks so much

for

> any advice offered. Thala

I hate to tell you that it takes time for the blood sugars begin

showing improvement as it is a balancing act with eating habits,

exercise and meds. I have been a t-2 for over 35 years and it was

rather easy for me at first because I did it with eating control and

lost 55 pounds but then it progressed to a point (5 years) and I had

to start on Insulin therapy which has since increased from 1

shot/day to 4 shots/day using Lantus and Novalog and also taking

Actos. I now have an HbA1c of 6.3. I have lived a very productive

and fun life playing golf and traveling all over the world. May I

suggest that you ask to see an Endocrinologist, also an

Opthalmologist and a Podiatrist even though right now you may not

need the latter 2. Also have a RD help you plan your eating habits

and if available obtain the advice of a CDE. Also join the American

Diabetes Association and subscribe to the Mag Diabetes

SelfManagement. Joining this group was a good step and do research

on the web.

Good luck & God Bless