Re: Question on short term high readings/exercise

[Guest guest]

Thanks Ted,

This does make me feel a bit better. I was exercising directly after meals when

I was getting better readings. Then I was told on a list to wait 30 to 60

minutes after eating to exercise. So I waited 30 and started getting higher

numbers (just thought of that fact this morning). Maybe the fact that I'm thin

(down to 105) means my metabolism is very fast and I need to exercise right

after I eat to " get " that sugar burned up before it hits my system? Just a

thought!

Sandy

Re: Question on short term high readings

It takes about 4 hours for serious glycation to take efffect from a high bg.

Short term highs

shouldn't be a problem.

Ted Quick

[Guest guest]

In a message dated 1/5/2006 11:36:41 AM Eastern Standard Time,

whimsy2@... writes:

> Is it the thought of using insulin that's scary for you? It seems to be,

> for most people. But from the standpoint of someone who's been using it for

> 7-1/2 years, I can tell you, it's no big deal. It doesn't hurt to inject at

> all with today's super-fine needles.

You wrote an excellent summary, Vicki, and I agree with you.

I wonder why some people are afraid of needles. Is it because of the

inoculations we had as children or is there some other factor?

When I first tried insulin I wasn't worried about the slight twinge when the

needle penetrates skin, but I was very concerned about the possibility of low

BG. I used a small dose of insulin and several test strips. As I gained

confidence I gradually increased the insulin dose and used fewer test strips.

Today, I know how much insulin to use to get the results I'm after, without

having

low BG.

We are fortunate to have easy access to meters. It must have been very

difficult, if not impossible, to get the proper insulin dose, before the advent

of

meters for home use.

Paice

www.dapaice.com

" Click on Potpourri for diabetes tests. "

[Guest guest]

Sandy...please excuse me if I already questioned you on this -- I read a

LOT of email on my 3 diabetes lists and often forget who said what --

but the fact that you're thin could indicate you're not type 2 but LADA.

The vast majority of type 2 diabetics are " apple shaped, " which, at 105,

you probably aren't.

Just in case it didn't come up, I'm going to append a brief definition

of LADA. Tell me if any of this fits.

LADA = latent autoimmune diabetes in adults

LADA is a form of autoimmune diabetes that starts in adulthood instead

of childhood. It is nothing more than type I diabetes (IDDM) starting

slowly after the age of 30-35.

In general, LADAs are not overweight, have no family history of NIDDM,

may or may not have a family history of IDDM, do not put on weight at

the time of the diagnosis (as a matter of fact, some of them may even

lose weight at that time), and they tend to have higher BGs from the

beginning.

Doctors may try to control LADA with diet, but within a short period,

from months to a few years, metabolic control fails. BGs start going up,

despite good diet and weight control, and they soon require insulin.

Oral agents may be tried first, but subsequent progress to insulin

dependency may be quite rapid.

The mechanism of DM in LADA is mostly the failure of the beta cells in

the pancreas to secrete insulin.

In the past, some of these patients were considered to have " primary

failures " to oral agents because they did not respond to them or they

respond for a short period of time.

Studies have shown the presence of markers of autoimmunity in LADA

patients. The markers of autoimmunity that can be found in a person with

LADA are the classic islet cell antibodies, or more precisely anti GAD

antibodies, which can be found even more frequently.

15-20% of all diabetic adults may have LADA, and LADA may constitute as

much as 50% of non-obese adult onset diabetes. This form of diabetes is

sometimes known as " Type 1 1/2 " .

LADA patients can be very confusing to doctors who are not aware of this

possibility. The patients with LADA may look exactly the same as

patients with NIDDM, and it becomes frustrating trying to control the

BGs with diet and pills. The doctors may blame the patient for not

following the diet well, or for not taking the pills as they should. The

truth is that the islets of Langerhans are slowly being attacked by the

autoimmune process and stopping their secretion of insulin.

In children, the autoimmune process is more acute and " explosive " with

symptoms presenting over a short period of time and being more severe

(thirst, urination, hunger, decreased weight). In adults, the autoimmune

process that destroys the islets of Langerhans seems to be slower, and

the decline in insulin production appears over several months instead of

several weeks.

As soon as the diagnosis of LADA is made, it is better to start insulin

right away. Putting the beta cells to rest by giving insulin exogenously

and normalizing the BGs is good for the beta cells. It prevents the

exhaustion of the beta cells, and it seems to decrease the autoimmune

attack on the islets.

Vicki, diagnosed LADA 8 years ago at age 60

Re: Question on short term high readings

>

>

> It takes about 4 hours for serious glycation to take efffect from a

> high bg. Short term highs

> shouldn't be a problem.

>

> Ted Quick

>

[Guest guest]

Hi Vicki,

Yes I read that part of your email when I first joined. ly, it scared me

and I didn't like it and still don't. I did ask my doc about it, he didn't

think that I had that - but I don't know how one would tell for sure?

I lost 25 pounds over the last year and was borderline (115) fasting last

August. My dad has diabetes 2 diagnosed late in life in his 70s. Losing weight

is also a symptom of Type 2.

So I don't know. I am barely hanging on with thinking I'm type 2 and if I'm

LADA, that just scares me even more. I will take your email to my doctor at my

next visit in a few weeks and ask him to read it and talk to me about it. His

office is very progressive - has their own research department so I will see

what he thinks.

Sandy

Re: Question on short term high readings/exercise

Sandy...please excuse me if I already questioned you on this -- I read a

LOT of email on my 3 diabetes lists and often forget who said what --

but the fact that you're thin could indicate you're not type 2 but LADA.

[Guest guest]

Sandy,

This makes sense and I had never really thought about it before. No

matter what one tells you, we always have to go by what our body/meter

says. You may have other endocrinological issues that we don't. You

know your body better than others. Follow your instincts. Otherwise it

does get pretty confusing.

> Maybe the fact that I'm thin (down to 105) means my metabolism is very fast

and I need to exercise right after I eat to " get " that sugar burned up before it

hits my system? Just a thought!

>

>Sandy

>

[Guest guest]

Hi, Sandy...sorry, I didn't mean to scare you. From my point of view,

knowledge is power.

Is it the thought of using insulin that's scary for you? It seems to

be, for most people. But from the standpoint of someone who's been

using it for 7-1/2 years, I can tell you, it's no big deal. It doesn't

hurt to inject at all with today's super-fine needles. And you can gain

excellent control with insulin if it's used correctly. Most doctors

prescribe a " standard dose " which rarely works. However, matching

insulin to carbs eaten, as pumpers do, with multiple daily injections

(MDI) works most excellently, once you determine your insulin to carb

ratio. And there are many here who have done this and are willing to

offer advice.

What's really scary to me is the thought of reaching my old age without

all my body parts in good working condition - a state that far too many

poorly-controlled diabetics reach, alas.

What used to also really scare me was the thought of having to deal with

calculations all the time; I'm severely math impaired. However, I'm

pleased to say that I even got past that one! And my A1Cs have been

consistently under 6 for the last 7 years now.

Vicki

Re: Question on short term high

> readings/exercise

>

>

> Sandy...please excuse me if I already questioned you on this -- I

> read a

> LOT of email on my 3 diabetes lists and often forget who said what --

> but the fact that you're thin could indicate you're not type 2 but

> LADA.

>

[Guest guest]

Well - I'll let you know if my numbers get any better over the next couple of

days than the last few days where they started inching up doing the exercise 30

to 45 minutes after eating. In the beginning, I was doing it directly after

eating and my numbers were better. Might not be the case, but will find out.

Sandy

Re: Re: Question on short term high readings/exercise

Sandy,

This makes sense and I had never really thought about it before. No

matter what one tells you, we always have to go by what our body/meter

says. You may have other endocrinological issues that we don't. You

know your body better than others. Follow your instincts. Otherwise it

does get pretty confusing.

[Guest guest]

Hi Vicki,

I know you were only trying to help. I've come to really like this forum the

best. The shots don't bother me (i don't think!) I give them to my horses all

the time. I have lots of loose skin on my belly from 2 kids - about the ONLY

spot on my body now that has loose skin though!

What scares me is (and maybe this is not true as you all just had this

discussion) that I thought Type 1's die earlier, have more complications and are

harder to control. AND all these different insulins and dosages and readings

that you have to keep track of is completely mind boggling! I barely have time

to do my work now just doing all the exercise and new cooking!

Is there any test or 100% way of knowing if you are LADA? I asked my doc about

the C-peptide test and he said he could tell from my other labs that he didn't

need to do that particular test (if I remember right).

Sandy

Re: Question on short term high readings/exercise

Hi, Sandy...sorry, I didn't mean to scare you. From my point of view,

knowledge is power.

Is it the thought of using insulin that's scary for you? It seems to

be, for most people.

[Guest guest]

Hi, Sandy...you're the victim of bad information.

The only reason type 1s on insulin die earlier is because type 1s have

had diabetes a lot longer than type 2s and very few type 1s are or have

ever been tightly controlled; therefore their BGs have been higher for

longer and they accumulate complications. It's as simple as that. It's

not insulin that makes them die earlier; it's poor control over a longer

period of time.

Insulin, dosed properly, will prolong the healthy life of diabetics.

Unfortunately, very few doctors know how to prescribe insulin properly.

They assume patients want to take as few shots as possible and very

often prescribe once-a-day shots at a set dose, which rarely, if at all,

works well. Further, they often prescribe older insulins, such as

regular or NPH, which are known for their irregular action curves and

which often cause hypos instead of the newer, more efficient insulins.

Sometimes they prescribe a mixed insulin, which rarely works optimally.

The proper way to dose insulin is MDI, multiple daily injections, with a

fast-acting insulin such as Humalog or NovoLog, taken directly before

meals and based on the amount of carbs eaten at that meal, as well as a

longer-acting insulin such as Lantus, to cover between meal BGs. It

takes some experimentation to get the correct insulin-to carb ratio and

very often it may be different for each meal, but the results are well

worth it.

All the calculations sound daunting but as a math impaired person, I'm

here to tell you that after a while it becomes no big deal. And the

results of tight control -- no complications -- are well worth the

trouble!

As far as your second question, yes, there is a definitive test for

LADA; it's called the GAD (glutamic acid decarboxylase)antibody test.

It's not a standard test and your doc may not even be familiar with it.

However, it will tell you definitely if you're LADA. When I had mine,

the result was 34.28 and lab normal was 0.00 - 1.45. Bingo! LADA.

I think you should definitely request this test,

As far as the time and effort required -- well, I'm an extremely busy

lady, too. I have a fulltime job. I exercise every day. I'm a quilter

and involved in several quilting projects at any given time and I'm on

the board of one of my quilt guilds. (meaning: meetings! plus

associated board-related activities). I do some volunteer work too, as

well as spend at least an hour a day reading and responding to diabetes

lists online.

I have to admit, I do have to get up at 5:30 a.m. in order to accomplish

all this...but I guess one of the nice things about being a senior

citizen is that I don't require as much sleep; 7 hours a night works

just fine for me. And I do like early mornings.

Vicki

Re: Question on short term high

> readings/exercise

>

>

> Hi, Sandy...sorry, I didn't mean to scare you. From my point of

> view,

> knowledge is power.

>

> Is it the thought of using insulin that's scary for you? It seems to

> be, for most people.

[Guest guest]

HI Vicki,

Well that was informative. I have printed it out.

So if I got such a good response - at first to no meds with just a change in

diet for the first week, then an even better response to meds, I could still be

LADA?

Hmmm - the hard part is I just got this new doc who seems very well informed.

Since I " m just learning, I would feel a bit odd going in there with a printout

from a yahoo email group telling him that I want this test and then if we decide

I need insulin, I'm actually supposed to tell him which kind I want? Is that

what everyone on this group who learns this does - just disagree with the doc

(if in fact he was to prescribe an " older " insulin) and tell him what you want

even if you aren't positive what is needed? Just seems funny to start

dictating what I want when I could be jumping the gun and not need the test. I

imagine this test is expensive and I have an HMO - not real sure unless there is

a valid reason, that my doc could prescribe it and they would pay for it.

I will ask him about it though.

How do you calculate perfectly every carb you eat? Gosh that would drive me

crazy. I can judge when I eat a meal - say 10 to 15 carbs or something but to

know exactly would be really hard I would think.

Sandy

Re: Question on short term high readings/exercise

Hi, Sandy...you're the victim of bad information.

[Guest guest]

At 03:05 PM 1/5/06, Sandy wrote:

>Hmmm - the hard part is I just got this new doc who seems very well

>informed. Since I " m just learning, I would feel a bit odd going in there

>with a printout from a yahoo email group telling him that I want this test

>and then if we decide I need insulin, I'm actually supposed to tell him

>which kind I want? Is that what everyone on this group who learns this

>does - just disagree with the doc (if in fact he was to prescribe an

> " older " insulin) and tell him what you want even if you aren't positive

>what is needed?

Absolutely. It's your body. You're the one who will have complications, not

the doctor. Also, if you know that the older insulins aren't good, you'd

also have the names of the newer ones so you could say what you needed.

8-) There are many well-informed people on this list, and they are

speaking from their personal experience or research.

>Just seems funny to start dictating what I want when I could be jumping

>the gun and not need the test.

Well, you'd need to get the test first . I must say that when you described

your initial symptoms and your weight and your weight LOSS (I think most

type 2's gain weight or are already heavy or apple-shaped) I immediately

thought of LADA.

sky

[Guest guest]

Thanks Sky,

I have typed up a letter to my doctor (I can definnitely think and type better

than when I'm in the doctor's office) so I'm going to send it to him and request

this test along with my next A1c. Hopefully he will agree. I swear I'm going

to drive my new doc crazy with all my questions and demands! But I know, we

have to if we want to be in control. I also told him my concerns about being

on Amaryl which wouldn't be optimal if in fact I was LADA. He wanted to put me

on Actose or Avandia if I couldn't do diet along after taking me of Amaryl. All

the drugs bother me !

Sandy

Re: Question on short term high readings/exercise

At 03:05 PM 1/5/06, Sandy wrote:

Well, you'd need to get the test first . I must say that when you described

your initial symptoms and your weight and your weight LOSS (I think most

type 2's gain weight or are already heavy or apple-shaped) I immediately

thought of LADA.

sky

[Guest guest]

In answer to your first full paragraph question, yes, indeed. It just

means you still have some betas left. If you're LADA, eventually they'll

poop out then you'll need insulin absolutely. With no help at all from

your pancreas. This process can take months to years. Better to save the

betas and start insulin

early if you're LADA . That's why it's good to have the GAD antibody

test.

Vicki

Re: Question on short term high

> readings/exercise

>

>

> Hi, Sandy...you're the victim of bad information.

>

[Guest guest]

As a senior citizen, I need more sleep, not less! Or maybe I just enjoy

sleeping, LOL. I don't do early mornings, now that I don't have to. I

stay up late and get up late, like 10 or 11. It seems that I need about

9 hours of sleep. Maybe having rheumatoid arthritis has something to do

with it because RA causes fatigue.

Sue

>

> I have to admit, I do have to get up at 5:30 a.m. in order to

> accomplish

> all this...but I guess one of the nice things about being a senior

> citizen is that I don't require as much sleep; 7 hours a night works

> just fine for me. And I do like early mornings.

[Guest guest]

Maybe it's just attitude.

I consider sleeping a waste of time although I recognize its importance.

But I like to Accomplish Things and outside of replenishing my energy

source, sleep doesn't seem to accomplish anything. I can think of much

better things to do with my time. All those books to read! All that

music unheard! All those quilts to make! All those diabetics out there

who need help and encouragement! Etc, etc.

Vicki

Re: Question on short term high

readings/exercise

> As a senior citizen, I need more sleep, not less! Or maybe I just

> enjoy

> sleeping, LOL. I don't do early mornings, now that I don't have to. I

> stay up late and get up late, like 10 or 11. It seems that I need

> about

> 9 hours of sleep. Maybe having rheumatoid arthritis has something to

> do

> with it because RA causes fatigue.

> Sue

>

>

>>

>> I have to admit, I do have to get up at 5:30 a.m. in order to

>> accomplish

>> all this...but I guess one of the nice things about being a senior

>> citizen is that I don't require as much sleep; 7 hours a night works

>> just fine for me. And I do like early mornings.

[Guest guest]

Beverly, the needles used for injecting insulin are super fine. They're

not like the ones used in the doctors' offices for shots - really!

Also, the best place to shoot insulin is in the belly and there are

very, very few nerve endings there. So the combination of super fine

needles and very few nerve endings makes for truly painless insulin

injections.

Anyone here who takes insulin will attest to that. Even some who were

needle-phobic before starting insulin.

Vicki

Re: Question on short term high

> readings/exercise

>

>

>

> I wonder why some people are afraid of needles. Is it because of the

> inoculations we had as children or is there some other factor?

>

[Guest guest]

It sounds to me like Bev is not so much needle-phobic as she has a low pain

threshold ( is this the right term for someone who finds every little bump

painful.) My mother was like this, and things that we would brush

off(bumps, bruises, needle pokes) would hurt her for a good while, give her

big bruises that would hang on. She didn't make a big deal about it, but

she sure didn't like it either.

Jo in MN

Re: Question on short term high

> readings/exercise

>

>

>> I can't speak for anyone else but my fear of needles is because

>> they HURT. It usually takes 3-5 hours before I quit feeling the pain

>> of a shot or blood draw and 2 days to a week for the bruise to go

>> away. When I do a finger test it takes 1-2 hours for the pain to stop.

>> If all you have is a slight twinge you are very lucky. I have pain.

>> Some people are more skilled and it hurts less but it always hurts.

[Guest guest]

It could be she has a low pain threshhold, but unless she's built

different from the rest of us, she still has less nerve endings in the

belly, smile.

Vicki

Re: Question on short term high

>> readings/exercise

>>

>>

>>> I can't speak for anyone else but my fear of needles is

>>> because

>>> they HURT. It usually takes 3-5 hours before I quit feeling the pain

>>> of a shot or blood draw and 2 days to a week for the bruise to go

>>> away. When I do a finger test it takes 1-2 hours for the pain to

>>> stop.

>>> If all you have is a slight twinge you are very lucky. I have pain.

>>> Some people are more skilled and it hurts less but it always hurts.