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Is anyone here a brittle? Has anyone here been on the pump? Does

anyone here have diabetes bad enough that they are considering the

islet cell transplant or had any kind of pancreatic surgery? Thank you-

Kat

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Yes, my Uncle, 73, is a brittle. If you mean your bg can swing from

low to high, or vice-versa, then yes. We thought it was stress

related, but he has it happenning since the stressors have left.

>

> Is anyone here a brittle? Has anyone here been on the pump? Does

> anyone here have diabetes bad enough that they are considering the

> islet cell transplant or had any kind of pancreatic surgery? Thank

you-

> Kat

>

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Hi Kathleen,

I am on the insulin pump. I have been for a bit over 2 years now. I am getting

better numbers now then when I was on MDI's. Yes, with the pump it makes

bolusing too easy, but it also makes it easier to count carbs, cough, when done

right, and its easy to just take the pump out of your pocket and press some

buttons and press enter. It can be a nusiance in a few ways though. One, is

that you have to keep loading the insulin cartridge every 3-4 days, it uses

batteries, an alarm can go off when there is an occlussion or its low on

insulin, etc.

Are you interested in becoming a pumper? There is a good site you can go to "

http://www.insulin-pumpers.org

At the moment, I am not considering any type of transplants. Its too risky,

but with technology, this type of operations can change.

Kathleen Cowart katseye1969@...> wrote:

How does your Uncle control his brittle?

I am asking if anyone is on the insulin pump and if anyone is considering the

islet cell transplant to cure their diabetes.

the

>

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Thank you , I just got off the pump. I am not real interrested on going

back on it. I got off mine in Dec after my Whipple. I am either going to do a

whole organ or islet cell xplant. Dr Sutherland in MN has been doing them for

over 30 yrs, he did my Whipple. He is the only one I would go to for xplant. The

pig cell stuff looks promising...I was not on the traditional pump you are on.

Mine was hooked up through my TPN, so it was all automatic. I didn't have to do

anything. I don't like tubes in my belly, I tend to yank those out...that's the

main reason why I don't want back on the pump. How do you feel about it

personally? I mean, when you look at yourself in the mirror, how does it make

you feel? I hated my drain tube. Hated it. That's the thing that freaks me out

about your kind of pump...I guess I am more interrested in what the pump is like

for you emotionally. Thanks.

Nodge misguided_mortal_1970@...> wrote:

Hi Kathleen,

I am on the insulin pump. I have been for a bit over 2 years now. I am getting

better numbers now then when I was on MDI's. Yes, with the pump it makes

bolusing too easy, but it also makes it easier to count carbs, cough, when done

right, and its easy to just take the pump out of your pocket and press some

buttons and press enter. It can be a nusiance in a few ways though. One, is that

you have to keep loading the insulin cartridge every 3-4 days, it uses

batteries, an alarm can go off when there is an occlussion or its low on

insulin, etc.

Are you interested in becoming a pumper? There is a good site you can go to "

http://www.insulin-pumpers.org

At the moment, I am not considering any type of transplants. Its too risky, but

with technology, this type of operations can change.

Kathleen Cowart katseye1969@...> wrote:

How does your Uncle control his brittle?

I am asking if anyone is on the insulin pump and if anyone is considering the

islet cell transplant to cure their diabetes.

the

>

---------------------------------

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I don't mean to sound stupid but what is a " brittle " and what is

a " whipple " . I'm sure these are things that I need to be made aware of.

> >

> > Is anyone here a brittle? Has anyone here been on the pump? Does

> > anyone here have diabetes bad enough that they are considering the

> > islet cell transplant or had any kind of pancreatic surgery? Thank

> you-

> > Kat

> >

>

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" Brittle " means a brittle diabetic and the whipple has nothing to do with

diabetes. The whipple is a procedure where they remive 1/2 your stomach, 1/2

your pancreas, your small bowel and biliary. It is typically done for pancreatic

cancer and severe chronic pancreatitis. Because the islet cells are in the tail

of your pancreas, generally speaking the Whipple does not effect diabetes.

However, in my case it did. So I am now thinking about a transplant. If you are

diabetic, you need not concern yourself at all with the Whipple.

Marie awendela@...> wrote: I don't mean to sound stupid but what

is a " brittle " and what is

a " whipple " . I'm sure these are things that I need to be made aware of.

> >

> > Is anyone here a brittle? Has anyone here been on the pump? Does

> > anyone here have diabetes bad enough that they are considering the

> > islet cell transplant or had any kind of pancreatic surgery? Thank

> you-

> > Kat

> >

>

" Success is to be measured not so much by the position that one has reached in

life as by the obsticles which he has overcome " . -Booker T. Washington

http://www.cafepress.com/kathleensart

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Thank You:)

> > >

> > > Is anyone here a brittle? Has anyone here been on the pump?

Does

> > > anyone here have diabetes bad enough that they are considering

the

> > > islet cell transplant or had any kind of pancreatic surgery?

Thank

> > you-

> > > Kat

> > >

> >

>

>

>

>

>

>

> " Success is to be measured not so much by the position that one

has reached in life as by the obsticles which he has overcome " . -

Booker T. Washington

>

> http://www.cafepress.com/kathleensart

>

> ---------------------------------

> Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls.

Great rates starting at 1¢/min.

>

>

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Hi Kathleen,

I have the Animas 1200 pump and I use the Disetronic Rapid D's for tubing

and insert. Actually now its called Accu Check Rapid D's. It has its ups and

downs for sure. I also tend to accidentally yank out my insert and then I have

to get another insert since it loooses its stickyness once its pulled out. I

can not stick that needle back into myself. I have tried. Then there are during

the nights when I somehow make a funny move in bed and my site gets yanked out.

It wakes me up. OUCH. When I look myself in the mirror skyclad and see that

inserter sticking out my belly like that, even when I unhook my pump, I feel

like an alien, or some sort of lab experiment gone awry. Other then this I

have no problem with it. Its just something I have to keep an eye on.

What are Whipple and TPN? I never herd of those. I may know TPN but I dont

know what it stands for. Could it be total Parenteral nutrition?

Kathleen Cowart katseye1969@...> wrote:

Thank you , I just got off the pump. I am not real interrested on going

back on it. I got off mine in Dec after my Whipple. I am either going to do a

whole organ or islet cell xplant. Dr Sutherland in MN has been doing them for

over 30 yrs, he did my Whipple. He is the only one I would go to for xplant. The

pig cell stuff looks promising...I was not on the traditional pump you are on.

Mine was hooked up through my TPN, so it was all automatic. I didn't have to do

anything. I don't like tubes in my belly, I tend to yank those out...that's the

main reason why I don't want back on the pump. How do you feel about it

personally? I mean, when you look at yourself in the mirror, how does it make

you feel? I hated my drain tube. Hated it. That's the thing that freaks me out

about your kind of pump...I guess I am more interrested in what the pump is like

for you emotionally. Thanks.

---------------------------------

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Hi , Yes, TPN is juat what you said, tube feeding. The whipple is a

surgery they do in transplant centers because it is the most major surgery done.

(not for diabetes) They remove 1/2 the pancreas, 1/2 the stomach, the small

bowel and biliary. You have to have one or more drain tubes hanging out of your

belly for a long time. Drain tube with a bulb, called a JP, short for

-Pratt. So after that, I don't do well with tubes. Liek you said, I too

felt like an alian and I was always having to pin my bulb in the right place.

Eventually I got decorative bags to put " Marvin " in os no would have to look at

him. As dumb as it sounds, I just don't want to do through that agian. Though,

my diabetes is becoming brittle pretty quickly since my whipple, So I thinking,

if I do the islet cell I will need the pump agian, but if I get a donor

pancreas, I should be good. It's something they don't know until

transplantation. I am not sure how mentally prepared I am for that kind

of pump. I won't have the luxery of a picc line this time. I will be eating

real food and on a regular pump like you have. I don't know what I think about

all of that. I just know how I felt when I looked in the mirror and showered,

etc. To me, that's what's matters, how you really feel about it emotionally and

mentally. Thank you for sharing with me, I appriciate it. Take Care, -Kat

Nodge misguided_mortal_1970@...> wrote: Hi Kathleen,

I have the Animas 1200 pump and I use the Disetronic Rapid D's for tubing and

insert. Actually now its called Accu Check Rapid D's. It has its ups and downs

for sure. I also tend to accidentally yank out my insert and then I have to get

another insert since it loooses its stickyness once its pulled out. I can not

stick that needle back into myself. I have tried. Then there are during the

nights when I somehow make a funny move in bed and my site gets yanked out. It

wakes me up. OUCH. When I look myself in the mirror skyclad and see that

inserter sticking out my belly like that, even when I unhook my pump, I feel

like an alien, or some sort of lab experiment gone awry. Other then this I have

no problem with it. Its just something I have to keep an eye on.

What are Whipple and TPN? I never herd of those. I may know TPN but I dont know

what it stands for. Could it be total Parenteral nutrition?

Kathleen Cowart katseye1969@...> wrote:

Thank you , I just got off the pump. I am not real interrested on going

back on it. I got off mine in Dec after my Whipple. I am either going to do a

whole organ or islet cell xplant. Dr Sutherland in MN has been doing them for

over 30 yrs, he did my Whipple. He is the only one I would go to for xplant. The

pig cell stuff looks promising...I was not on the traditional pump you are on.

Mine was hooked up through my TPN, so it was all automatic. I didn't have to do

anything. I don't like tubes in my belly, I tend to yank those out...that's the

main reason why I don't want back on the pump. How do you feel about it

personally? I mean, when you look at yourself in the mirror, how does it make

you feel? I hated my drain tube. Hated it. That's the thing that freaks me out

about your kind of pump...I guess I am more interrested in what the pump is like

for you emotionally. Thanks.

---------------------------------

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My Uncle is retired RN, he says a person can't control being brittle,

thats why it is so dangerous. He said all you can do is be prepared in

case it does happen. WHich for him could be 2AM or while we are

driving down the highway. He ALWAYS has the sucrose tabs, and we are

constantly hitting the nearest store for candy. His sugar can race

from 105 to 420 just out of the blue. I --think-- he said he is

allergic to his own insulin. ?? I am not an expert on technical

stuff. I just live with it.

As far as the pump, my own personal experience is they are creepy. I

saw a guy go into convulsions after his sugar bottomed out in public,

and while having a grand mal seizure, his pump was flailing about. So,

my experience was negative. The guy admitted he neglected to eat.

Hmmm, I never have THAT problem. I just cant stand the thought of

anything staying stuck in my stomach.

My sister's husband (a Type I diabetic) has had two transplants. One

to get off dialysis, which was successful and one pancreas (?) to stop

being diabetic. His body rejected that one.

It can be rough living with this challenge. But having knowledge is

your best weapon.

>

> How does your Uncle control his brittle?

>

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I realize being brittle means you can not control your BS, Is he in the pump?

does he self inject? Is he on the pill? That is what I meant by " control " . How

is your cousin doing with the donor pancreas?

redbird4848 redbird4848@...> wrote: My Uncle is retired RN, he

says a person can't control being brittle,

thats why it is so dangerous. He said all you can do is be prepared in

case it does happen. WHich for him could be 2AM or while we are

driving down the highway. He ALWAYS has the sucrose tabs, and we are

constantly hitting the nearest store for candy. His sugar can race

from 105 to 420 just out of the blue. I --think-- he said he is

allergic to his own insulin. ?? I am not an expert on technical

stuff. I just live with it.

As far as the pump, my own personal experience is they are creepy. I

saw a guy go into convulsions after his sugar bottomed out in public,

and while having a grand mal seizure, his pump was flailing about. So,

my experience was negative. The guy admitted he neglected to eat.

Hmmm, I never have THAT problem. I just cant stand the thought of

anything staying stuck in my stomach.

My sister's husband (a Type I diabetic) has had two transplants. One

to get off dialysis, which was successful and one pancreas (?) to stop

being diabetic. His body rejected that one.

It can be rough living with this challenge. But having knowledge is

your best weapon.

>

> How does your Uncle control his brittle?

>

" Success is to be measured not so much by the position that one has reached in

life as by the obsticles which he has overcome " . -Booker T. Washington

http://www.cafepress.com/kathleensart

---------------------------------

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No, brittle, as I am using the term, means his blood sugar can go from

400 to 40 in no time flat. He eats right, takes right amount of

medicine and is not a couch potatoe. We can eat sensibly- and an hour

later my sugar is starting to soar and out of the blue, he starts

having low blood sugar. BTW, he is on pills, not insulin. He is not

overweight and prefers insulin. That is what brittle means. This does

not happen all the time.

My brother in law who had the pancreas transplant is fine, although his

body rejected the pancreas. We tease him because his kidneys came from

an african american woman. You know Indians like to tease.

>

> I realize being brittle means you can not control your BS, Is he in

the pump?

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No, he is not on the pump. He takes pills, but I don't know the names.

>

> I realize being brittle means you can not control your BS, Is he in

the pump? does he self inject? Is he on the pill? That is what I meant

by " control " .

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Hi Redbird. I am a type 2 diabetic. I am on a pump. It became necessary when

my pancreas stopped producing insulin after 23 years on diet and exercise

then medicine. I was Dxed in 1982 at 42 years of age. I was injecting 7 or 8

times a day. I was like you, I thought that I could not live with a pump

tied to me 24 hours a day. It is amazing what I can do when I have to. The

positives with the pump out weigh the negatives. I can now eat anything I

want to, even though I still stick to a diabetic meal plan. I can go all day

without eating anything, and not have any problems. I have an A1c of 5.4 to

5.8%. I still have to test my BG 12 times a day. I am very insulin

resistant. I started on the pump with 1 unit of insulin to 1.5 mg/dl BG. I

am now up to 1 for 6 mg/dl BG. I am living much better since I went on the

pump. I have been on insulin for 2 years and the pump since Nov 2005.

Keep an open mind and things tend to work themselves out.

S Wilkinson,

Rome, New York

Re: Brittle and the pump, etc

My Uncle is retired RN, he says a person can't control being brittle,

thats why it is so dangerous. He said all you can do is be prepared in

case it does happen. WHich for him could be 2AM or while we are

driving down the highway. He ALWAYS has the sucrose tabs, and we are

constantly hitting the nearest store for candy. His sugar can race

from 105 to 420 just out of the blue. I --think-- he said he is

allergic to his own insulin. ?? I am not an expert on technical

stuff. I just live with it.

As far as the pump, my own personal experience is they are creepy. I

saw a guy go into convulsions after his sugar bottomed out in public,

and while having a grand mal seizure, his pump was flailing about. So,

my experience was negative. The guy admitted he neglected to eat.

Hmmm, I never have THAT problem. I just cant stand the thought of

anything staying stuck in my stomach.

My sister's husband (a Type I diabetic) has had two transplants. One

to get off dialysis, which was successful and one pancreas (?) to stop

being diabetic. His body rejected that one.

It can be rough living with this challenge. But having knowledge is

your best weapon.

>

> How does your Uncle control his brittle?

>

Diabetes homepage: http://groups.yahoo.com/group/diabetes/

To unsubscribe to this group, send an email to:

diabetes-unsubscribe

Hope you come back soon!

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Kathleen,

Noticed that Dr. Sutherland did your surgery. From the it's a small world

department I met Dr. Sutherland's son Rick when he sold beer and I sold

peanuts as a vendor at the Metrodome. Rick helped me understand the

vending process while being sympathetic about my type 1 diabetes.

Kind regards, Tim

Kathleen Cowart katseye1969@...> wrote:

Thank you , I just got off the pump. I am not real interrested

on going back on it. I got off mine in Dec after my Whipple. I am either going

to do a whole organ or islet cell xplant. Dr Sutherland in MN has been doing

them for over 30 yrs, he did my Whipple. He is the only one I would go to for

xplant. The pig cell stuff looks promising...I was not on the traditional pump

you are on. Mine was hooked up through my TPN, so it was all automatic. I didn't

have to do anything. I don't like tubes in my belly, I tend to yank those

out...that's the main reason why I don't want back on the pump. How do you feel

about it personally? I mean, when you look at yourself in the mirror, how does

it make you feel? I hated my drain tube. Hated it. That's the thing that freaks

me out about your kind of pump...I guess I am more interrested in what the pump

is like for you emotionally. Thanks.

Nodge misguided_mortal_1970@...> wrote:

Hi Kathleen,

I am on the insulin pump. I have been for a bit over 2 years now. I am getting

better numbers now then when I was on MDI's. Yes, with the pump it makes

bolusing too easy, but it also makes it easier to count carbs, cough, when done

right, and its easy to just take the pump out of your pocket and press some

buttons and press enter. It can be a nusiance in a few ways though. One, is that

you have to keep loading the insulin cartridge every 3-4 days, it uses

batteries, an alarm can go off when there is an occlussion or its low on

insulin, etc.

Are you interested in becoming a pumper? There is a good site you can go to "

http://www.insulin-pumpers.org

At the moment, I am not considering any type of transplants. Its too risky, but

with technology, this type of operations can change.

Kathleen Cowart katseye1969@...> wrote:

How does your Uncle control his brittle?

I am asking if anyone is on the insulin pump and if anyone is considering the

islet cell transplant to cure their diabetes.

the

>

---------------------------------

Groups are talking. We´re listening. Check out the handy changes to Yahoo!

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Guest guest

My sons's former German teacher is type 2 and he uses an insulin

pump. He says he loves it. It makes his life easier.

> >

> > How does your Uncle control his brittle?

> >

>

>

>

>

>

>

> Diabetes homepage: http://groups.yahoo.com/group/diabetes/

>

> To unsubscribe to this group, send an email to:

> diabetes-unsubscribe

> Hope you come back soon!

>

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Guest guest

Wow, your A1C says it all. That is great. You are right about the

necessity of keeping an open mind.

Unfortunately, I get my meds/supplies from IHS, and they are famous

for having " leftovers " from other medical/pharmaceutical companies.

Most of the pills ya'll talk about here, I have never heard of.

IHS (in my area) definitely does not have the pupm available.

> >

> > How does your Uncle control his brittle?

> >

>

>

>

>

>

>

> Diabetes homepage: http://groups.yahoo.com/group/diabetes/

>

> To unsubscribe to this group, send an email to:

> diabetes-unsubscribe

> Hope you come back soon!

>

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Kathleen,

I applied directly to the U. of M. Islet of Langerhans

transplant department. Feel fortunate to be so

healthy.

My lone complication after 37 years is hypoglycemic

unawareness.

Never heard of Anne Marie.

Tim

--- Kathleen Cowart katseye1969@...> wrote:

> Tim,

> YOU ARE KIDDING ME!!!! What type of xplant were

> you looking at doing? My buddy just did the TP/ICT

> and he is over 50. True, whole organs are different

> and they generally do not like to do them over 50

> yrs of age...My grandfather had one and I know he

> was over 50 because I was an adult when he got his

> liver..how weird...Did you go through Ann Marie?

>

> Tim snikpoh8@...> wrote:

> Kathleen,

>

> Glad I have a sense of humor. When applying for a

> transplant

> four years ago The U. of M. told me I was " too

> healthy. " Now at 52

> am told I am too old, too great a risk for a

> transplant. You gotta laugh.

>

> Tim

>

> Kathleen Cowart katseye1969@...> wrote: Tim,

> That is so cool. Doc S is the best. He will do my

> xplant too if I decide to go through with it. He is

> really awesome. He amazes me..he has dedicated his

> entire life to find the cure for diabetes..which he

> has done..and through his progress has also found

> ways to help pancreatits patients. He is a wonderful

> human being..a pleasure to be around. Take it easy,

> Kathleen

>

> Tim snikpoh8@...> wrote: Kathleen,

>

> Noticed that Dr. Sutherland did your surgery. From

> the it's a small world

> department I met Dr. Sutherland's son Rick when he

> sold beer and I sold

> peanuts as a vendor at the Metrodome. Rick helped me

> understand the

> vending process while being sympathetic about my

> type 1 diabetes.

>

> Kind regards, Tim

>

> Kathleen Cowart katseye1969@...> wrote:

> Thank you , I just got off the pump. I am not

> real interrested on going back on it. I got off mine

> in Dec after my Whipple. I am either going to do a

> whole organ or islet cell xplant. Dr Sutherland in

> MN has been doing them for over 30 yrs, he did my

> Whipple. He is the only one I would go to for

> xplant. The pig cell stuff looks promising...I was

> not on the traditional pump you are on. Mine was

> hooked up through my TPN, so it was all automatic. I

> didn't have to do anything. I don't like tubes in my

> belly, I tend to yank those out...that's the main

> reason why I don't want back on the pump. How do you

> feel about it personally? I mean, when you look at

> yourself in the mirror, how does it make you feel? I

> hated my drain tube. Hated it. That's the thing that

> freaks me out about your kind of pump...I guess I am

> more interrested in what the pump is like for you

> emotionally. Thanks.

>

> Nodge misguided_mortal_1970@...>

> wrote:

> Hi Kathleen,

>

> I am on the insulin pump. I have been for a bit over

> 2 years now. I am getting better numbers now then

> when I was on MDI's. Yes, with the pump it makes

> bolusing too easy, but it also makes it easier to

> count carbs, cough, when done right, and its easy to

> just take the pump out of your pocket and press some

> buttons and press enter. It can be a nusiance in a

> few ways though. One, is that you have to keep

> loading the insulin cartridge every 3-4 days, it

> uses batteries, an alarm can go off when there is an

> occlussion or its low on insulin, etc.

>

> Are you interested in becoming a pumper? There is a

> good site you can go to "

>

> http://www.insulin-pumpers.org

>

> At the moment, I am not considering any type of

> transplants. Its too risky, but with technology,

> this type of operations can change.

>

>

>

> Kathleen Cowart katseye1969@...> wrote:

> How does your Uncle control his brittle?

>

> I am asking if anyone is on the insulin pump and if

> anyone is considering the islet cell transplant to

> cure their diabetes.

>

> the

> >

>

> ---------------------------------

> Groups are talking. We´re listening. Check out

> the handy changes to Yahoo! Groups.

>

> [Non-text portions of this message have been

> removed]

>

> " Success is to be measured not so much by the

> position that one has reached in life as by the

> obsticles which he has overcome " . -Booker T.

> Washington

>

> http://www.cafepress.com/kathleensart

>

> ---------------------------------

> How low will we go? Check out Yahoo! Messenger’s low

> PC-to-Phone call rates.

>

> [Non-text portions of this message have been

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>

> ---------------------------------

> How low will we go? Check out Yahoo! Messenger’s low

> PC-to-Phone call rates.

>

> [Non-text portions of this message have been

> removed]

>

> " Success is to be measured not so much by the

> position that one has reached in life as by the

> obsticles which he has overcome " . -Booker T.

> Washington

>

> http://www.cafepress.com/kathleensart

>

> ---------------------------------

> Do you Yahoo!?

> Next-gen email? Have it all with the all-new Yahoo!

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> [Non-text portions of this message have been

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>

>

>

>

>

>

> " Success is to be measured not so much by the

> position that one has reached in life as by the

> obsticles which he has overcome " . -Booker T.

> Washington

>

> http://www.cafepress.com/kathleensart

>

> ---------------------------------

> Yahoo! Music Unlimited - Access over 1 million

> songs.Try it free.

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> [Non-text portions of this message have been

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So what does brittle diabetic mean?

Kathleen Cowart katseye1969@...> wrote:

" Brittle " means a brittle diabetic and the whipple has nothing to do with

diabetes. _,_._,___

__________________________________________________

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" BRITTLE " DIABETES

by J. Nebergall, PhD

One of the most prominent features of diabetes is its uniqueness. No two

diabetics respond in exactly the same way to their food, insulin, or

exercise, and no two individuals, even if they show the same glucose test

results, will experience precisely the same complications. The disease is,

by definition, unpredictable. Still, making allowance for surprises, we know

the effects of more insulin, less insulin, more exercise, less exercise,

more food, etc.

For most diabetics, most of the time, the " rules " work. " If I do this, or do

not do that, I can expect this result. " But there is a body of individuals

for whom the rules do not appear to apply, and to them is often applied the

adjective " brittle. "

The problem becomes separating the truly " brittle " diabetics from the

non-compliant, the poorly-controlled, or those whose unstable sugars have

other explanations. Some have insisted that if all diabetics diligently

practiced " tight control " (as described by the DCCT), none would be

" brittle. " They're partially right; the numbers would go down, but some

diabetics can do everything right and still remain " brittle. "

These are the diabetics, even practicing tight control, whose blood glucose

level " over-reacts " to minute changes in diet, exercise, and/or insulin.

These individuals experience unpredictable rises and swoops in blood

glucose, within very short periods, as the result of very small departures

from schedule. Small changes " break " their control, and they are thus said

to be " brittle. "

If you are practicing tight control, are in good compliance with your

schedule, and are still experiencing rapid, out-of-proportion blood glucose

changes, talk to your doctor. You (or more correctly your diabetes) may be

" brittle, " but your instabilities may well be a sign of some other problem.

Maybe You're Not Brittle

Many diabetics whose sugars seem to run unpredictably, " all over the map, "

have heard their diabetes described as " brittle. " Sometimes it is; but there

are other possible explanations, such as the dawn phenomenon, and the

Somogyi Effect. If your sugars are unexpectedly high in the morning, one of

these may be the explanation.

We all have our normal " sleep cycles. " When the human body becomes used to a

schedule, it releases hormones, including glucagon, into the blood on

schedule, to help you wake up. Your sugars rise, in the expectation of

activity. How many times have you opened your eyes, looked at the alarm

clock, and found it was one minute short of going off? That hormone and

blood sugar rise is the dawn phenomenon. It is very normal, and perhaps your

morning glucose monitor test is catching it.

Problems come either when this response, the dawn phenomenon, fools you into

thinking you need more insulin, when you don't, or when it gets out of hand,

excessive, requiring you to readjust your diet/medication balance.

There is also the Somogyi Effect (named for the researcher who first

described it in the 1930s). Your body naturally seeks balance, what the

doctors call homeostasis, in all things, including blood glucose. After you

eat, a healthy, non-diabetic pancreas will secrete more insulin, to bring

the numbers back down. If you have a " low, " your liver will release stored

glucose, to bring you back up. But this " rebound " is imprecise; and when you

have a low, and your body rebounds, it'll often take you way up into the

high range. Then, if you happen to test your blood sugars, you'll see you're

high, get worried, and perhaps add more insulin to bring your numbers back

down. BUT--you're only high because you're having a rebound from a low, so

that extra insulin just points you back into another low, which will likely

trigger another rebound, making you think you're high again... You're not

brittle; you're in the midst of the Somogyi Effect!

So what should you do about this vicious cycle? Slow down, and do some

tests. Are you having unrecorded night-time " hypos? " If your early morning

high is regularly preceded by a night-time low, treat the cause of that low;

perhaps you need to lower your afternoon insulin dose, and/or add a bedtime

snack. If you can eliminate the " low, " you'll eliminate the body's rebound.

You may need less insulin.

If your sugars are not running low at night (and a week's late-night tests

should let you know), but you're too high in the morning, it could be the

dawn phenomenon, and if it is, you may need more insulin. You can see how

important it is to tell which phenomenon you're dealing with.

Real " brittle diabetes " doesn't follow patterns. Individuals who'se diabetes

is " brittle " experience unpredictable, out-of-proportion rises and swoops in

blood glucose, within short periods of time, as a result of very small

deviations from schedule. Talk to your doctor, and to your health care team.

They should help you set up an individualized testing program that will

reveal what's going on--and then give you the tools to deal with it. Good

luck!

S Wilkinson,

Rome, New York

Re: Re: Brittle and the pump, etc

So what does brittle diabetic mean?

Kathleen Cowart katseye1969@...> wrote:

" Brittle " means a brittle diabetic and the whipple has nothing to do with

diabetes. _,_._,___

==================snip=============================

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Brittle is actually an old term that isn't used much anymore, and now mostly

by the older generation that was around when it was used. And it was always

used in a confusing manner. A lot of folks used it as another name for

Insulin Dependent Diabetes Mellitus (also called juvenile or Type I

diabetes). Other people used Brittle to mean a diabetic who's sugar was not

in control (usually due to not taking their insulin regularly). Still others

used it to mean a diabetic whose diabetes was difficult to control, even

when they were following procedure. It's the last use of brittle that is

probably still in some use today.

- Walter

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,

Thanks for the info. I wasn't exactly sure what a " brittle " was.

Although it doesn't apply to me, it's nice to know. The " Dawn

Phenomenon " seems to fit me to a " T " . My BG is always higher in the

morning even if I eat a small snack before bedtime. I did notice

however, I sometimes wake up @ 3 or 4 a.m. and my bg's will be high

then. I've learned that if I eat a small snack and go back to sleep

that my bg's will actually be lower @ 7 a.m.

Before this group I did't eat the snack, I'd just stay up because I

couldn't go back to sleep. I almost never feel hungry and because

my bg's were high I didn't think I should eat yet.

Marie

> " Brittle " means a brittle diabetic and the whipple has nothing to

do with

> diabetes. _,_._,___

> ==================snip=============================

>

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Thanks, . This was very helpful.

S Wilkinson jwilkins@...> wrote:

" BRITTLE " DIABETES

by J. Nebergall, PhD

_,_._

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