When I was diagnosed with type 2 diabetes, I had no idea how long it had been my secret enemy. I was urinating more often, but I attributed that to getting older and, as a male, the enlarging prostate that comes to someone in his fifties. By then, I was already showing symptoms of nerve damage. Again, I thought these were just the natural aches and pains that come with aging. A tell tale sign should have been the weight loss. Although never obese, I had a a few extra pounds on me. Suddenly, it began to fall off without a change in diet. As a matter of fact, my appetite increased. I was almost always hungry. I ate what I wanted, when I wanted to and it made no difference. I went from 185 to 155 pounds in a matter of 6 months. Little did I know then, that a later symptom of diabetes is weight loss. This occurs because I was unable to use my blood glucose for energy, so body fat was burned in an attempt to provide “fuel”. I was suffering from weakness and fatigue and my vision was occasionally blurred.

Below are all of the posts I have written, in chronological order, on what I have been going through and what I have learned. It is here for you to reference. Read it all or just parts that interest you. There are 3 main queries in search engines that usually bring you here and I have links to them and others. Those 3 are Dawn Phenomenon and Somogyi Effect, and what are the A1c Testand the Comprehensive Metabolic Panel with EGFR. Please write a comment if you feel so inclined. I value your experiences and questions. Bear in mind, this is a work in progress, so it is ever evolving with each new entry.

I HATE NEEDLES

When I was young in the late sixties and early seventies, I experimented with drugs. Nothing heavy, mind you, just the simple stuff like marijuana. Back then, the government and police said that marijuana leads to other drugs, such as cocaine, LSD and heroin. It's probably the same message, but I've been out of the loop for so long, I couldn't tell you. What I can say is that I would never do anything with a needle. I hate them. As a kid, I was scared to death when I had to get shots. I could never be a heroin addict. I never wanted to try it anyway. Besides, what good could ever come out of tooth-rotting drugs like the big hits of today, crack, heroin and crystal meth?

I like my KitKat bars, though. Around Halloween, I go buy a bag for the trick or treaters that never come. Oh, I'd better go buy another bag, just in case. I live in a neighborhood where only one kid resides. They tend to go to areas where there are lots of other children walking the haunts. Safety in numbers, I guess. A lot go to malls now, where it's a very safe haven for getting treats. With all these child predators and molesters around, who knows? And because of Disney, there are plenty of hotels. Some advertise to bring your children here. They probably supply candy to their guests to hand out. I know one family that planned to do it that way. In any event, those KitKat bars couldn't just sit there, so I ate them.

As you get older, the little aches and pains associated with aging start to creep up on you. Sometimes, I go for days at a time with a general feeling of malaise. A little tired and achy. I get an occasional sharp nerve pain. Sometimes, my vision will be a little bit more blurry than usual. I know eyes change with age and I started wearing reading glasses a number of years ago, but this comes and goes. I'm more thirsty and urinate more often now. It's been that way for a while. I figured that as a male gets older, his prostate grows and you have to go more often anyway. No big deal yet. I'm not worried about a thing. Besides, I never go to the doctor unless I absolutely have to.

For quite a few years now, my mother has been a diabetic. She takes two shots of insulin a day. It wasn't always like that, but the disease progresses as you get older, especially if you grew up in the era of steak and potatoes. It's tough to break old habits. Fortunately, diets have changed over the years and I have changed with the times. A couple of years ago, I had a case of the hiccups that just wouldn't go away. Finally, I went to a doctor and he ran blood work, an upper GI and chest x-rays. He thought I had a lung tumor but it turned out to be a hernia in my esophagus. Along with a couple of prescriptions, he told me to cut out the starches. My blood pressure and cholesterol levels were a little above normal, but no serious cause for alarm. I dropped from 205 lbs to the "svelte" 165 that I am today. He told me then that my pancreas, liver, kidneys and heart were perfect! My lungs were nice and pink. And I'm a smoker. Of course, he told me to quit. I haven't yet.

My brother Tim is visiting from out of town and staying with my folks. Yesterday morning, my mother made breakfast for us and took one of her twice daily glucose tests. My brother asked if he could take his. His blood sugar level turned out normal at 106. He asked me to take the test. Reluctantly, I agreed. Mine was 200 something. Not good, my mother said. My brother gave me a look of concern. Ah, I'm not too worried about it. OK, we'll check it again before dinner. It was 238. You are a diabetic, my mother told me. She certainly has enough experience to know. This morning, it was 261. On an empty stomach. She's going to make an appointment with her doctor for me to get tested. I've never been a great one for exercise, but this morning, my brother and I took a 20 minute walk. Every morning, I'm going to take a walk and slowly increase the time. I'm going to adjust my diet again and hopefully, I can bring my sugar level down so I won't have to go on insulin. Fat is the real enemy. Cinnamon is supposed to help. I'll do whatever it takes. Diabetes can damage the eyes. It can lead to kidney disease, heart and blood vessel disease and nerve damage (neuropathy). I don't even want to think about going there.

Next time I eat a KitKat bar, I'll eat one instead of five. With my broccoli. And an apple.

Thanks, Tim. It's a great thing you came to visit, as always. Even if nothing was wrong with me.

If you would like more information on diabetes, please click here.

BEFORE THE DIAGNOSIS

"Diabetes is not a disease!"

"Is it contagious?"

The first statement came arrogantly from a friend of mine who thinks I made it up. To him, I was probably trying to elicit sympathy from friends as I sipped on a Bacardi & Diet Coke, my new drink. I knew my days of bellying up to the bar with buddies were coming to an end. His statement was cynical, at best, and, quite obviously, he knows nothing about it. The second question was from an innocent bystander who stepped back upon my pronouncement. Yes - it is a disease and - no - it is not contagious. What I can tell you is that it is often hereditary. My mother has been diabetic for almost 20 years and takes insulin daily. Her older sister is, too. My father has onset. He takes an oral medication. I have researched it over the years because of my mother.

I have no health insurance. My mother tried to get me in to see her primary care physician for blood work and a proper diagnosis. She tried to make an appointment with her endocrinologist, who would not see me without a physician's referral. This was all going to be very expensive. To just peer through the door was going to cost me hundreds of dollars per office visit and a whole lot more for the blood tests. This is money I don't have readily available. I knew I had to do something. I went to a search engine and typed in these four words, "free medical clinics orlando" and came back with a very promising hit,Shepherd's Hope. I went to the website and called the number to explain my predicament. "Yes, we can help you," the woman at the other end told me. They only see those with no insurance.

I had been feeling rundown for some time, at about 93 percent, before that fateful morning I took my first glucose test. I showed many of the signs and symptoms, but was never willing to acknowledge why I was feeling so achy and fatigued. It's not unusual to have this state of denial. I lost 25 lbs in a 6 month period, but I had tried to lose weight anyway. For the next 2 weeks, I took this sugar test morning and night and ran anywhere from 200-370. Not good numbers, and it didn't take a doctor to figure out what my condition was. In the meantime, I've changed my diet and have started to exercise. Some days, I am too weak to. Today, I feel better. Soon, I will take a nice, brisk walk.

When I got to Shepherd's Hope, there were a handful of people waiting for it to open at 6PM. The staff are all volunteers there to help those who can't afford medical attention otherwise. Depending on location, the clinic may only be open one day a week. A woman came out and assigned us all numbers. Some had appointments. We were to write our names and what kind of problem we have. I put down diabetes. When my name was called, the first thing I was asked about was what made me think I had it. I explained. Then, I went into a private room and waited for a doctor. I guess most of the people who go to free clinics are there for the flu or other simple, treatable maladies. Diabetes? I'll bet I was the first one to do that. She knocked. "Come in," I said, "like, I was going to tell you to stay out?" She laughed.

We discussed everything about it. She asked me plenty of questions and I gave her plenty of answers. Do I feel numb here? Tingly there? I told her about the sharp pains I've been getting in my toes, a sign of neuropathy. Mostly, she talked of fatigue. She asked me, if I could, what I would pick my overall average blood sugar level to be during the period of my testing. I guessed around 225. The normal range is around 100 or below, give or take a few. I was well above that mark. She got her stethoscope out and listened to me. "Have you ever had pains here?" she asked, as she pointed to my chest. I had. She said nothing more.

"OK, I cannot tell you that you are, absolutely, diabetic. I am setting you up for some blood work and I can't properly say that until the results come in. I will say that we both know you are and I am going to start you right away on a blood pressure medication, not that it's too high right now, but borderline, yes. Diabetes will bring about all sorts of complications, such as strokes and heart attacks. This is to mostly protect your kidneys from damage. The previous generation of diabetics didn't get this and other drugs you're going to get. Once properly diagnosed, you will also go on cholesterol meds, on top of what your disease is treated with, and regardless of what your cholesterol level is." She wrote a prescription for Lisinopril, an ACE inhibitor. "We have [all donated] new drugs here I could prescribe free, but they are $100 a pop. If we run out, can you afford to stay on them?" No, I can't.

My mother has had a series of mini-strokes. Her kidneys are damaged. I asked her if she had taken any blood pressure meds when she was first diagnosed. She hadn't. This doctor (or Physician's Assistant) knows what she is talking about. I think you can call it preventive maintenance. She was very good, very caring and professional in appearance and demeanor. The next morning, I went to Quest Diagnostics where they drew lots of vials of blood for all kinds of tests, including A1C, which monitors sugar for the 2-3 previous months. I have an appointment with Shepherd's Hope on December 12 to find out the results. I will probably be given prescriptions then to get me on the right path. I will have to find a physician after that. The clinic is not there for continuous care. Right now, I'll take it one step at a time.

I have often read about the benefits of cinnamon in lowering blood sugar levels. My sister-in-law, Lindsay, bought me pills, along with dandelion root tea. So far, they haven't helped. I've always been a firm believer in alternative medicines, and I've been looking at other magic herbs, elixirs and anything else associated with "curing" diabetes. Online, I found out about the remarkable benefits of apple cider vinegar, which, at the same time, will eliminate warts. I read about chromium, the magic of bee pollen, how cranberries help and how just about every natural substance known to man will rid you of this dreadful disease. Cancer, too, probably. I wonder, if I switch to eating nothing but a combination of all of these wonderful things, will I be cured? I think, I'll stick with the conventional for now. Take that, Kevin Trudeau, you huckster, you.

This morning, my siblings told me the best Christmas present I could give them was no present at all, to take what I would have spent on them and apply it towards the medications I will need. They want to see me stick around for a long, long time. Their presents to me will be in the form of money, too. I protested to no avail, but they insisted.

Family, you gotta love them. I feel better already.

Please feel free to ask me any questions. If I don't know, I will do my best to find the answers.

THE DIAGNOSIS

Tuesday night, I went to the clinic for my blood test results and an official diagnosis on the diabetes. Gulp. I was not looking forward to the inevitable bad news. I sat patiently in one of those "holding" rooms the nurse stuffs you in to wait for the doctor. Why does it seem to last for hours before their grand entrance?

"Hello. I am Dr. Chan." That was as friendly as he got. He had the bedside manner of a Gestapo agent. Oh well, perhaps his manner was correct, given the somber news he was about to tell me. He scanned over the report and circled the (Comprehensive Metabolic Panel w/EGFR) glucose number. It was 182. That is the fasting number and 65-99 is what to aim for. He went to the second page and circled the Hemoglobin A1C number. Less than 6 is ideal. Mine is 8.0.

"You are a diabetic." He proceeded to give me strong directives. "You can eat all the fruits and vegetables you want. Do not eat coconut. No butter. Only poly and mono-unsaturated oil. NO SUGAR! Eat more fish. Avoid shellfish. Shrimp. Lobster. Cut all fat off beef. No chicken skin. Drink lots of water."

"What about cheese?"

"Follow this order," he said sternly. "Zero, zero, zero. That means you only eat things with 0% saturated fat, 0% trans fat and 0% cholesterol. Two egg yolks a week only. EXERCISE, EXERCISE, EXERCISE!!! You must eat 3 meals a day. You may have small snack in between." Protein is essential at each meal.

"What about salt?" I never put salt on anything, anyway.

"You don't worry about salt. Why you take Lisinopril?" Lisinopril is a BP med, an ACE inhibitor. "You don't need."

"Kelly, the Physician's Assistant wrote me the prescription two weeks ago when I was here. She told me it was to protect my kidneys from damage. She..."

"It does not help your kidneys. You don't need it."

"What should I do? Should I finish or stop taking it?"

"I don't care. You do what you want."

"But... but?"

"I don't care. You do what you want."

"She also told me I will have to go on a cholesterol drug."

"You may. We see when you come back. OK. Sit on table." He listened to my chest and heart. "We do another blood test. You wait here for nurse." And off he went. She came in a few minutes later and asked how things went.

"Well, he certainly laid it on the line. No messing around with Dr. Chan."

"Nope." She handed me the diagnostic test request for lipids and glucose. Oh, I have to pee when I go. He wants that, too. She gave me a prescription for Glucotrol. Typical doctor handwriting. I have no clue how pharmacists decipher that chicken scratch. Minus the skin, of course. I went across the hall to make an appointment a month from now for those results. It will be up to me to schedule the lab work. They only need a 24-48 hour turnover time. That will be my final visit to this clinic. I will need to find another doctor. For the rest of my life, I will need to take this medicine (or, eventually, insulin), test my sugar twice daily and have the A1C test done every 3 months. The test strips run about a buck apiece. This is not going to be a cheap disease, especially without insurance.

My platelet count is down. The normal range is 140-400. Mine is 102. He wasn't too concerned about that. He talked about my cholesterol level. The ideal number is below 200. Mine is 213. HDL (the good kind) is 41. That's good. LDL (the bad stuff) is 134. Not good. It's supposed to be less than 130. My triglycerides are high. 190. Less than 150 is best. My bilirubin is high. That's got something to do with the liver. Other than that, I checked out pretty good.

Last week, I was IMing with by best and oldest friend. He said it was from all those beers and pizza. Cheap women, too. I told him I haven't had a beer in a long time. Up until today, it was Bacardi & (DIET!) Coke. I typed in that it was from all those years working at the Weiner King, eating all those hot dogs, hamburgers and french fries. Who would think back then that all that junk would take its toll? How was I to know my mother and her sister would get it and be insulin-dependent? That's something we don't think about when we're young. We're going to live forever and never get old. I said it's also from all the trans fat that's in everything today, something food manufacturers have known will kill you for years.

This morning, I popped my first pill. I chose a generic brand because it's a lot cheaper. Glipizide ER 2.5mg. It is an anti-diabetic drug (sulfonylurea-type) used to control high blood sugar in patients with type 2 diabetes. It's meant to stimulate the release of natural insulin. With a proper diet and exercise, hopefully it will work. It's supposed to help prevent heart disease, strokes, kidney disease, blindness, and circulation problems, as well as sexual function problems (impotence). I'm waiting.

A CHANGE IN LIFESTYLE

I just got back from one of my walks. I cannot stress enough the importance of daily exercise. Diabetes is such a debilitating disease. It begins to consume you. God knows how long I've had it. Certainly, it's been a lot longer than when it was officially diagnosed last week and there's no test to determine when it stealthily crept into my life. There are many out there who have no clue what may be lurking under the surface.

This morning, my arms were tingly from my elbows to the tips of my pinkies, all along the lower part. From my knees to my toes, I go from numb to exaggerated bouts of the same thing. Today is no exception. I've felt that way all morning and when I walked, my legs felt like they were made of lead. Sometimes, my toes feel like someone hooked up jumper cables and turned the juice on in quick, stabbing pulses. Then, it goes away. There isn't a day that goes by when I don't feel achy and fatigued. Some days, I have no energy at all. Today, I actually feel better than usual in spite of the numbness. One way to explain the ache is to try to imagine someone taking a knife and scraping the meat off your bones. Perhaps, that description is a little too harsh and I never really feel that bad, but it gives you an idea. At times, my heart pumps so strongly, it feels like it is going to explode out of my body.

Since I began taking the medication, my sugar has slowly dropped. I keep waiting for a small miracle to happen, that I will gain my strength again. I'm sure I will. Little things bother me. Lids on jars that, in the past, were so easy to remove are proving more difficult. Frustrating little things that gnaw at your very fiber. Sugar levels that ran in the 200-400 range are now down to 100-170. 170 is still too high, but it is an improvement. Last night, it was 136. This morning, it was 154. The closer in margin, the better. Saturday night, it was 276 and I have no idea why. That morning, it was 160. I don't think I ate anything wrong. Other diabetics have told me that's one of the strange things about it, that there's no rhyme or reason why your numbers can vary so much. You can eat something one day and repeat it the next and your numbers can be strikingly different.

Every night now, I have to get up about a half dozen times to relieve myself. That's a symptom. Of course, I drink lots of water now. I have to. Life as a diabetic must take on a very regimented structure. I should strive to eat at the same times every day, in spite of the fact that I am always hungry and sometimes nauseous. I should consume the same amount of calories per meal, per day, too. Food groups must be balanced, such as protein at every meal, especially in the morning. Proper sleep is of the utmost importance. Getting up to pee every hour is exasperating and disturbs the natural rhythm of the mind and body.

I can't take aspirin or ibuprofen any more, on account of the Glipizide. One of the warnings is to not take any over-the-counter pain medications without talking to your doctor. Instead, I asked the pharmacist if I could take Tylenol. Yes, you can. I think they know more about drugs, anyway. I also told her what Dr. Chang said about Lisinopril not helping the kidneys. She asked me if he knew what he was talking about. She told me to finish taking it and to demand a refill when I go back again. I said I don't go back for another month and I only have a 2 week supply. Take it every other day, she said. I don't know, maybe Dr. Chang has been in practice too long. Everyone else at Shepherd's Hope has been great, but he was not kind to me. The doctors and nurses there, and most of the other staff donate one night per month from their regular jobs. I don't think pharmacists would contradict a doctor unless they are pretty adamant about it. I started taking it the next day. Soon, I will have a primary care physician. That person will keep close tabs on me and will more than likely set me up with an endocrinologist, who will make sure I am put on the proper path. All diabetics react differently. All need special care.

When I was dealt this hand, it took me a while to adjust to altering my "set in his ways" lifestyle. I always played by my rules. No one ever wants to think they will get permanently sick. Where did I go wrong in life? What could I have done differently? Believe me, those are dumb questions and there is no truth to them. What is true is that I am sitting across the table from diabetes. I will play my cards right. I will keep a close watch on my opponent. I may not always win, but I will never fold. I will not be intimidated. So it must be true with any disease or disability. It's the game of life you're playing and you never let the one sitting across from you get the upper hand.

MY NEW FRIEND

Here is my brand new prized possession. It was my Christmas present to myself, thanks to the generosity of my siblings. It will be my friend for the rest of my life. Or whichever wears out first. Every morning, I will test my blood after a night of fasting, assuming that my last meal was eaten early in the evening. Then, I will test it again, just before I retire for the night. I have been using my mother's kit for the last month and a half. Those test strips run a buck a piece, so that's been $2 a day. Fortunately, Medicare pays for it, but I could not justify continuously using hers. One day, she would have to run out and that wouldn't be a good thing. Plus, when I am up for taking a trip somewhere, I would still have to test myself wherever I am. Medicare does not cover me.

I have been keeping a log of my blood glucose levels for the last 2 weeks. This is something I will have to do for the rest of my life, too. On Glipizide, my numbers have come down, although not to normal levels. Last Friday, I began taking 400mg of chromium picolinate (1)(2)(3)(4), an over the counter nutritional supplement. Since I began taking it, my numbers have come down, but I have no idea if it is strictly attributable to that. I will have to monitor my counts for a considerable length of time to make that determination and there is nothing scientific about it since my diet will vary from day to day. Anyone who considers it should talk to their physician first. Of course, I didn't, but I will when I go to my final visit at Shepherd's Hope clinic. Who knows, I may be told to stop taking it. In the meantime, life goes on and I have pretty much adjusted to my diabetes since the initial shock and denial has finally worn off.

A CHANGE IN DIET AND SHEPHERD'S HOPE

Last Thursday, I went to Quest Diagnotics to have blood drawn for a lipid panel and a serum glucose test. I also peed in a cup for a microalbumin/creatine ratio. Last night, I went to Shepherd's Hope for my final visit to receive the results of those tests.

For the past month or so I have made a concerted effort to alter my diet. For breakfast, I generally eat a veggie burger, an apple and a banana. The burger is not consumed as a substitute for meat. It is a source of protein, which diabetics must have at every meal, and it is easily heated up in a microwave oven. Very convenient. For lunch, I eat a mixed greens salad with fake lobster for protein. Fake crab is often referred to as "krab." I wonder what artificial lobster should be called? Lovster? I am a little more lax around dinner time, but I try not to venture outside of my dietetic parameters. I have been on Glipizide for a month now. I started to take chromium picolinate and magnesium. Of course, I'm taking Lisinopril for blood pressure to protect my kidneys. My blood glucose levels have fallen dramatically. Where I used to range from over 200-400 per day, my levels generally range between around 100-150. That is a very good thing. Remember, normal is 65-99. Interestingly, and in spite of my change in eating habits, my triglicerides went from 190 to 222 from my previous test a month or so ago. Normal is 150 or less. My total cholesterol remained about the same, 213 to 216. It should be less than 200. My HDL (good) cholesterol dropped from 41 to 37. My LDL (bad) remained about the same at 135. The normal number should be less than 130, but for diabetics, it should be below 100. The urine test was done to determine the shape of my liver. No problems there. Less than 30 is the ideal. Mine is 16. The serum glucose test is the same as what I take twice daily when I prick my finger. The first test was 182. Thursday it was 143. That is the fasting number and it must come down.

One thing I have noticed of importance is the way I feel. My strength is returning. Where, on most days I felt achy and weak, I am now the other way around. I'm not ever quite 100%, but clearly a whole lot better.

On my last visit to the clinic, I had the cold and abrupt Dr. Chan who insisted I didn't need Lisinopril. This time, I asked the attending nurse if I could see a different doctor because of what my pharmacist told me about the benefits of that drug in diabetes and that Dr. Chan would not write a new prescription. I got to see Dr. Velez.

Dr. Velez, it turns out, happens to be a diabetic. I found this out incidentally. I mentioned the Lisinopril and what Dr. Chan had told me. That's not really true, he said. I told him that my mother is diabetic and when she went to see her endocrinologist last week, she took my first test results with her. I wrote down the drugs and supplements I was taking. The drugs were fine and the chromium may help reduce sugar a few percentage points, he told her. Dr. Velez asked me who her endocrinologist is and I told him. "He's my doctor, too!" he responded.

Dr. Velez is a very kind and caring doctor. He is also aware of the benefits of chromium picolinate and magnesium. I asked him if they were absolutely safe to take and he responded positively. I asked him about cinnamon and he said he had never heard about that one. I told him my father's doctor told him it was good for the disease. Well, you can't expect every doctor to know everything about every drug and supplement, but I'm sure he'll look into it. I asked him if I would need to go on a cholesterol medication. Yup. No doubt about it. Mevacor 40mg. Knowing that this would be my final visit there and I would, henceforth, have to fend for myself, he wrote me 3 prescriptions, all for 90 day supplies. Through this clinic, for 90 days, I will save a lot of money on the Mevacor. It will cost me $7 per month for the first three months at the Central Florida Pharmacy Co-op. I checked with my pharmacy and their price is $65 for a 30 day supply. Big difference. $21 as opposed to $195. He also scheduled me for more tests to be done in April at the clinic's expense. This will also save me a tremendous amount of money and will include a Comprehensive Metabolic Panel, a Lipid Panel and a Hemoglobin A1C test. By then, I will have already established myself with a primary care physician who would make me take those same tests at my expense.

I really want to thank the dedicated volunteers at Shepherd's Hope for all they have done for me and the many others without health insurance. If not for them, where would I be today? I especially want to thank the doctor I spoke with last night, Dr. Carlos Velez-Munich, who would be my primary care physician if I had health insurance or could otherwise afford all that diabetes entails. He is a very good man.

If you have it in your heart, please contribute to Shepherd's Hope or any type of similar clinic that is there to help those in need who might not be able to afford quality care. They are out there. All I did was Google "free orlando clinics" and up it popped.

PRESCRIPTION MEDS AND SIDE EFFECTS

If you have followed my diabetes posts, you know I am now on 3 prescription medications:

GLIPIZIDE (Glucotrol) for diabetes

LISINOPRIL (Zestril, Prinivil) for blood pressure and, mainly, to protect my kidneys from disease

LOVASTATIN (Mevacor) to lower cholesterol and triglycerides

There are some rather interesting side effects associated with these drugs. If I forget what I'm writing or wander off somewhere, I might not remember why or when I did it. If I get cranky or START YELLING AT YOU, it means I now hate everyone and I want to run you off the road. To keep it simple, these drugs also have overlapping effects, but I will only list them once. Some, I have already experienced. I'm not going to tell you which ones, though, and if you ask, I might break into tears.

• Consipation or stomach pain
• Diarrhea (are these top two just so they can cover their butts?)
• Muscle pain and tenderness
• Weakness (duh... the diabetes made me feel that way)
• Severe fatigue
• Fever
• Yellowing eyes and urine
• Dark urine
• Persistent nausea
• Dizziness
• Headache
• Lightheadedness
• Dry cough
• Blurred vision (again, the disease has alredy caused that)
• Sore throat
• Fainting
• Decreased sexual ability (I don't want to talk about it)
• Rash, itching, swelling
• Trouble breathing
• Vomiting
• Loss of appetite (I wish)
• Easy bleeding or bruising
• Unusual or sudden weight gain (I wish)
• Hypoglycemia (low blood sugar)
• Confusion
• Mental/mood changes
• Chest pain
• Uneven heartbeats
• And, in very rare cases - suicide

In each case, there is a statement that says, "Remember that your doctor has prescribed this medication because the benefit to you is greater than the risk of side effects." I'm trying to explore macrobiotic options. One of the most important thiNs abot tHs florBl gogN roofn jmpofflin gor

I'M LEARNING...

Most people don't understand diabetes. There are plenty of misconceptions out there. Fortunately, I had been researching it for years before I got the disease because my mother has had it for a long time. Of course, there's still plenty for me to learn. I seriously doubt anyone who has it will ever quite fully understand what are the right and wrong ways to deal with it. For example, some things may effect you one day and not the next. Why? Who knows. I am going to try to explain some of the areas that I get questioned on by my friends.

Before I knew I had it, I had been feeling below par for some time. When I realized what I had and was officially diagnosed by a medical professional, it explained why I had mood swings and why I was rather irritable at times. Normally, I've never had much of a temper. One always wants to believe they are healthy and to find out about this can bring you into an emotional quagmire, which I did kind of fall into. It became almost an obsession for the first month and that seemed to be the topic of most of my conversations. Some of my friends started to drift away in fear that, uh-oh, here comes Diabetes Dave again. I noticed it, too, and began to realize I needed to get on with my life. Granted, it can snowball on you. I wasn't feeling well at all and that was compounded by my fear. I believe the blood pressure, diabetes and cholesterol medications have helped me tremendously. My blood glucose levels have come down and I don't feel nearly as achy and weak as I used to. Mentally, I have adjusted as well. I no longer think my life will be cut short. Most people can live long lives as long as they maintain a proper regimen of diet, exercise and monitoring sugar and lipid levels regularly.

One fallacy is that we must give up many of the foods we've always enjoyed eating. Everyone thinks we cannot eat sugar. With proper drugs, there is no reason to stop eating all sugar. Certainly, I'm not going to play a game of Russian Roulette with myself by buying candy and other junk none of us should really eat to begin with. Where I used to do that, instead I eat an orange or an apple. This way, I get natural sugar and nutrition, to boot. Carbohydrates are the real culprit. They raise blood glucose levels. That means a big plate of spaghetti is no longer an option. Neither are many breads, particularly those made with bleached flour. Rice, potatoes, corn and other starchy foods should be kept to a minimum. Instead of eating a plate full of mashed potatoes, I eat less than a quarter. We need good carbs at each meal. Some say to curb fruit and bean consumption because of it, but my first doctor told me I could eat all the fruits and vegetables I want. Beans, too. Eating a diet in carbohydrate-rich foods with low glycemic indices like fruits, beans and oatmeal may reduce the odds of someone getting diabetes. This also has the added benefit of increasing your vitamin, mineral and fiber intake. Protein is very important with each meal. Now, every time I go to the grocery store, I carefully examine the nutritional facts for fat, cholesterol, sugar and sodium content. It's a pain, yes, because many of the things I would like to eat are somewhat suspect. Once in a while, I'll treat myself.

Not all diabetics are on insulin. I'm not. I take a pill. Type 2, or adult onset, means that your pancreas isn't producing as much insulin as it should to properly process sugar in your body. That's where energy comes from. It could also mean that your organs aren't doing the job with the insulin, too. It might be a combination of the two. In type 1 diabetics, the pancreas produces no insulin and the only way to get it is through injections. Ironically, type 2 can eventually turn into type 1 as the pancreas stops producing altogether, but never the other way around. That is the fate a lot of diabetics face and it's not because you're not taking care of yourself, it's just the nature of the disease. It is progressive.

Exercise is of the utmost importance. If you remain a couch potato, your heart, kidneys, liver, eyes and nervous system will begin to fail. I try to park far away from a store so I am forced to walk a greater distance. Every little bit helps.

You don't have to be obese to be a diabetic. I'm certainly not and never was. As a matter of fact, I lost a lot of weight because of it. The most I've ever weighed was 205. I settled in at around 185 for many years. The other morning, I weighed myself. 158. All my friends are really noticing it now. I don't want to lose any more!

Diabetes is brought on by many factors. It could be from a poor diet, especially what's in processed foods today. New York City recently passed a law banning trans fats in all restaurants. Now I know why. You want to increase your chances of getting it? Keep eating those Twinkies. If you ever have felt that smooth grease on the roof of your mouth while eating something tasty, that's the trans fats in action. Remember, trans fats have a higher melting temperature than your body. That means every time you eat something containing it, it solidifies in your system and starts to go to work clogging your arteries and doing other nasty deeds. Long ago, the government gave hydrogenated and partially hydrogenated oils the green light, assuming it was a healthy alternative to the saturated animal fats in other products, like butter. They were wrong. Avoid trans fats at all costs! Studies have shown that vegetarians have a much lower risk of getting diabetes type 2. Lack of exercise will also contribute to greater risks of getting sick. I can attest to that. Remember that genetics play a giant role in acquiring diabetes. If someone in your family has it, there's a good chance you will, too, especially if you don't take care of yourself. Age also increases the risk. People over 45 are more susceptible and the odds go up every year. American Indians, Hispanics and African-Americans are more prone to develope type 2. Everyone should get checked for high blood pressure and blood fats as they age.

Quit smoking! That is something that's weighing heavily on my mind. With every puff, I'm increasing my risks of having heart attacks and strokes. Smokers are more likely to become diabetic than are non-smokers. Alcohol is bad. For healthy people, moderate drinking lowers blood sugar and improves glucose tolerance. There are alcohols diabetics should avoid, like beer and liqueurs. Anything with carbs and sugar. Diabetics who drink are at a much higher risk for eye and nerve damage in the form of neuropathy. No more than 2 drinks a day, if any at all.

Here are some nutritional supplements to take if you have diabetes:

•Alpha lipoic acid

•Chromium

•Evening primrose oil

•Magnesium

•Cinnamon

Always check with your primary care physician before you take any additional supplements. For one thing, there is a chance that something might interfere with other medications. I will continue to study this disease and report anything I find of interest, that I think is truly of benefit. I will not ever write something that could be questionable. I don't care what some of those quacks out there are spewing, there is no cure. It is a lot more controllable if diabetics take very good care of themselves.

THE AMAZING HEALING POWER OF GLUCOBATE

I would ask ALL DIABETICS to go to the Glucobate website and explore a little bit. Browse through the links and testimonials. It doesn't matter which link you click, they're all the same. If you don't go to a link, come back and click Here.

Remember when hucksters would travel from town to town hawking their magic elixirs from the backs of their wagons, barking out that it would cure whatever ails you? Today, they do it on the internet.

There is no cure for diabetes.

DAWN PHENOMENON AND SOMOGYI EFFECT

A very puzzling aspect of diabetes is the contradiction in everything. Glucose levels can bounce around and there doesn't seem to be a clear cut semblance of rhyme and reason to it all. Some people experience weight gain. Some drop pounds. I fit into that category. Sometimes, I'm satisfied with the food I eat. Other times, I cannot satiate my appetite, no matter how much I eat. I have to be very careful with that, too, not just with the types of foods I consume.

A friend of mine works for a bookstore in Winter Park, Florida, called Bargain Books. It was very nice and extremely appreciated when John gave me two books, Diabetes for Dummies and Cholesterol for Dummies. You can't beat good, caring souls. As I was leafing through the diabetes book, I stumbled upon Dawn Phenomenon in the glossary of terms and decided to explore it online. I have this problem and I know many other diabetics do, too.

My blood glucose level is always higher in the morning than it is at night. Why? It doesn't make any sense that an empty stomach level would be higher. My mother has always said that it's a mystery what diabetes does and how the body reacts to it. Everything can flipflop around and doctors don't always seem to have the answers. My father has maintained that what you ate the day before can have that sort of effect on you the next day. Sounds reasonable enough, but then I stumbled upon that phrase. Everyone experiences Dawn Phenomenon, whether diabetic or not. We all have a biological clock. Technically, this one is referred to as Circadian Rhythms and it is rather simple to explain. Your body uses carbohydrates, protein and fat to store energy and during sleep, you use that stored energy to help keep your chemicals balanced. These "macro-nutrients" are converted to glucose stored in the liver and muscles.

Overnight, your body releases some hormones. They come in the form of Growth Hormones from the anterior pituitary gland, cortisol from the adrenal cortex, glucagon from the pancreatic alpha-cells, and epinephrine, otherwise known as adrenalin. These hormones trigger an increase in insulin resistance and add stored or new glucose to your bloodstream. All of this adds up to higher blood glucose levels and a diabetic can have real problems with it.

This activity normally occurs during the hours from 4am - 11am and explains why my sugar is higher in the morning, but what can be done to resolve it? There are different ways to bring that overnight level down and everyone must experiment on their own. One method is to eat a light snack with a slow digesting fat and protein content, such as peanut butter or deli meats and cheeses. The theory is that it holds your blood glucose level high enough overnight to avoid the problem. Some people eat a green apple, such as a Granny Smith or take vinegar supplements to ward off Dawn Phenomenon or Somogyi Effect, which I will try to explain next. Try eating breakfast when you first get up and test your sugar later. There are different things which may or may not work for you. This is not a disease that has any uniformity to it.

Somogyi Effect is often referred to as Liver Dump and usually occurs in insulin-using diabetics and those who go hypoglycemic during the night. When your glucose level drops too low, the liver kicks in and does its best to stimulate and release glucose. One way to try to determine whether you have Dawn Phenomenon or Somogyi Effect is to test your glucose between 2am - 3am several nights in a row without snacking before you retire. If you test normal, it's likely Dawn Phenomenon. If you test low, it could be Somogyi Effect and setting your target number a little higher before you go to bed may eliminate the problem.

I'm going to try the peanut butter (or cheese) snack before I enter the realm of Sleeptown and see if that helps reduce my glucose in the morning. I've been running around 150-160. If that doesn't help, I might have a small (2 ounce) glass of red wine and see what happens. Alcohol lowers blood glucose and it may do the same thing as eating an apple or taking vinegar pills. Who knows? Like I said, it's a very contradicting disease and it could be either Dawn Phenomenon or Somogyi Effect. Certainly, I will talk it over with a doctor, next time I see one.

HELP ME FIND THE ANSWERS

Between my two blogs, I have software where I can cross reference information. This is not for stalking or spamming or for any other seedy reason. I do it because I can get a good grasp of questions posed on search engines and how people are directed to my site. This post is not just dedicated to diabetes because it may help with any sort of medical condition.

The following question really bothered me because I don't know if this person from Decatur, Alabama got an answer that helped and that is only what I want to do here. I wish I could have responded personally, but the information I get does not give me all of the particulars. In other words, I don't know who any of you are and I don't need to know.

I am a diabetic with no insurance.

I am poor and have diabetes.

Where can I get medical help?

I have no health insurance. I did a search for "free Orlando clinics" and foundShepherd's Hope in this area. They got me on the proper path to deal with my disease and I chronicled it here and in ensuing posts. I'm sure there are clinics all around the country that help the poor and/or uninsured. On the federal level, the Hill-Burton Act was passed in 1946 to do just this. My advice would be to go to that site and explore clinics closest to where you live. I would further suggest you first do a search like I did, only replace "Orlando" with your town. If that doesn't work, try using alternative key words along with your search, such as medical or health, like "free health care decatur alabama" until something pops up. If your search yields nothing in your area, go to Hill-Burton and look through these locations.

Here's another popular search:

comprehensive metabolic panel w/EGFR glucose

I have a link on this post that directs you to an explanation of it. Basically, it shows your fasting blood glucose level and will more than likely determine whether you're diabetic or not. Creatinine goes along with that test and is useful in the evaluation of kidney function. This all goes along with

what is A1C test?

which is also linked from the same post. A1C gives a 2-3 month overview of blood glucose levels. Mine was 8.0, which meant I'm diabetic. 7 or below is what you're aiming for.

I get a lot of questions about interactions between drugs, such as

can I take aspirin with Glipizide?

No one on the Internet can make that determination for you. You must ask your primary care physician or specialist about any drug interactions and possible side effects. They alone know about your condition and whether allergies or other things play into the scheme. You might also try asking your pharmacist, since they know what prescriptions you're on. They may give you an answer. I'm of the school of thought that they keep up with drugs more than doctors do, but that's just my opinion. I get the same questions about Lisinopril and Lovastatin because those are the other two pills I take. Ibuprophen. Tylenol. All sorts of questions.

There are many other search questions, too numerous to list here. My advice would be to keep searching, but don't believe everything you read on the Internet. I've read about "Coconut Cures" for diabetes when doctors have told me DO NOT EAT COCONUT! Before I was diagnosed and didn't know any better, I ate a Thai dish that had a coconut milk base. My sugar was sky high later that night. No way will I believe in any sort of miracle coconut cure or whatever else may be lurking out there. As is with any medical condition, all people react differently. There are no blanket cures to be found online, just like not all diets work for all people. Do you really buy into all those diet pill claims you see on TV?

Please, please, if you have a question about anything, e-mail me atmarinadedave@yahoo.com or ask here. I might be able to help steer you in the right direction. I certainly would never, ever steer you wrong.

BENEFITS OF CASSIA CINNAMON AND OOLONG TEA

I ran out of cinnamon capsules last week. My numbers had been running around 120-130 something in the morning. That's somewhat high, but not too bad. Like I've said in past posts, under 100 is ideal. Partially, it's due to Dawn Phenomenon, which I wrote about here. I could probably do a little more work on what I eat and increase my exercising, too. Last night, my sugar was 160. This morning it was 159. I think it's because I've been too lazy to go buy cinnamon.

In December 2003, Diabetes Care published an article on a Pakistani study about the effects of cinnamon on type 2 diabetics. In the study, 30 women and 30 men were broken into 6 groups. Of that, half were given varying amounts ofcassia (cinnamomum cassia), otherwise known as Chinese cinnamon, and the other half were given placebos. The first 3 groups were given 1, 3, or 6 g of cinnamon daily. After 40 days, all three levels of cinnamon ingested reduced the mean fasting serum glucose (18–29%), triglyceride (23–30%), LDL cholesterol (7–27%), and total cholesterol(12–26%) levels, with no significant changes in the placebo groups. Changes in HDL cholesterol were insignificant.

Cassia has a long history as both a spice and medicine. It is the inner bark of a tropical evergreen tree native to southern China and mainland Southeast Asia west to Myanmar. Medicinally, it has been widely used to treat digestive problems, but the most intriguing of all is in the treatment of diabetes. Scientists have discovered that it has insulin-like properties and its active ingredient, called polyphenols (tannins, lignins, and flavonoids), can boost levels of proteins which are crucial to promoting normal insulin signaling processes, a healthy inflammatory response, and increasing glucose transportation throughout the body. Tannins are present in red wines. That may be one of the reasons why small amounts of red wine can be of benefit to diabetics. Cassia might also lower blood pressure, making it potentially useful to those suffering from hypertension. The USDA has three ongoing studies that are monitoring the blood pressure effect.

It seems like a relatively benign form of treatment, although risk factors are always an issue. There haven't been any long term studies done on cassia to make a firm determination. There is concern about the potential for toxic buildup of the fat-soluble components and some European health agencies have warned against consuming high amounts of cassia, due to a toxic component called coumarin. Although not present in large amounts, coumarin has been found to be moderately toxic to the liver and kidneys. It is where warfarin(Coumadin®) is derived (synthetically), so it may have ever so slight anticoagulant properties, as well. I wouldn't worry about it. People have been eating cinnamon for thousands of years and I've never heard of anyone dying from it or causing any type of harm.

There are various forms of cinnamon on the market. You want to buycinnamon cassia (cassia cinnamomum), a close cousin of true cinnamon(Cinnamomum verum, synonym C. zeylanicum), which is native to India and SriLanka. If you can't find it, I think regular cinnamon will do in a pinch. One is just better than the other.

I strongly recommend all diabetics talk to their primary care physician and/or endocrinologist about cinnamon. I recommend this treatment, unless you are allergic to it. If you decide it might help, I'd start with 500 mg per day, gradually increasing, if necessary. I usually take 3,000 mg per day [I have subsequently reduced that amount to 1,000 mg/day]. The original study took 40 days. Those on insulin must be extra cautious because they may have to reduce the amount they take or at least monitor their glucose more often during the day at first.

Another article in Diabetes Care, in June of 2003, suggests oolong tea, a type of tea that is partially fermented during processing that proved to lower plasma glucose in a test of 20 type 2 diabetics who also took hyperglycemic drugs. They were given 1,500 milliliters per day for 30 days. Their glucose fell from 229 to 162 on average. A group not given oolong tea, but water instead, showed no change. Bear in mind, green tea is not fermented at all and black tea is fully fermented. The only problem with oolong tea is trying to find it. It is imperative it comes from China. Also, 1,500 ml is a little over 5 cups, so I'd think about brewing a nice big pot and turning it into iced tea.

You may also find this article helpful. This particular study reviews herbs and dietary supplements for glycemic control in diabetes. Please remember, you can always ask me questions. I will do everything in my power to find the right answers. I'm not a doctor or anything, but I learn easily and well and I know how to weed out improper information.

Well, I'm off to the health store. I want my BG level to go down.

INTERESTERIFIED OIL

I've always gotten along with kids. Years ago, before I became qualified to be considered of grandfather age, many of my girlfriends had children. I used to tell them things while driving along, like, "Do you see that apartment complex over there, called Hidden Pines? Do you know why they call it that?"

"Nope."

"Because they had to tear out all the pine trees when they built it. The trees are all hidden now."

I had plenty of examples like that and many times, they'd pass those little tidbits on to their friends when they'd ride around together. I often wondered aboutHidden Valley. Do you really believe a giant food manufacturing plant is safely nestled inside of a quaint valley, with babbling brooks and birds chirping in the hidden valley trees?

Back to reality. Fats and oils are an important part of the human diet. They contain fatty acids such as linoleic and help metabolize vitamins as well as being a source for calories. They are used to enhance the texture and flavor of foods. All oils vary in their range of melting properties.

Partially hydrogenated oils have been around since the early 1900s. Originally believed to be a healthy substitute for natural fats like butter or lard, it is cheaper to produce, performs better under high heat and has a longer shelf life. Today, we have learned all about how bad these types of oils are for you, even worse than oils found in animal fats and some highly saturated vegetable oils. Years ago, health officials touted the health benefits of partially hydrogenated oil, also known as trans fats, over saturated fat. It took a long time of studying to prove otherwise. I don't adhere to any sort of government plot or conspiracy to fool the masses and make big outfits like Archer Daniels Midland super rich at your heart's expense, but I don't think these mega-outfits care about you, either.

“They did so in all innocence, trying to do the right thing,” Michael Jacobson of the Center for Science in the Public Interest stated. “Everybody thought it was safe. We thought it was safe.”

Today, researchers at Harvard’s School of Public Health estimate that trans fats contribute to 30,000 U.S. deaths a year.

A relatively new oil is over the horizon. Even before I was diagnosed with diabetes, I was carefully examining the ingredients on food packages. Recently, I read something new on one of those labels: interesterified soybean oil. Interesting. What is interesterified? Well, I did some research.

As food manufacturers, bakeries and restaurants move away from trans fats because of laws, such as New York City banning them, and federal labeling requirements, something has to replace it, something with the same flair, flavor and consistency that will keep these goods as close to original as possible. The manufacturing process of interesterified oils is very similar to that of hydrogenated oils - without the trans fats. Wow, lucky us! New & Improved!Now, they can put No Trans Fats on their labels and you'll think it's a healthful product, since partial and hydrogenation have become such dirty words.

Interesterified oils, in plain English, are a combination of polyunsaturated oil and fully hydrogenated oil. Simple enough to read, but a whole lot more complex and controversial than that. Technically, interesterification shuffles the fatty acids that make up each fat molecule. Like partial hydrogenation, which generates unnatural trans fats, it produces some molecules that are rare or nonexistent in nature. Science News describes this process as "...chemically or enzymatically removing fatty acids from fat molecules and transferring them to other fat molecules. Because this process recombines fatty acids randomly, chemical interesterification is sometimes called randomization." The article further states that, "To make a fat with new and useful properties, manufacturers typically interesterify blends of different kinds of fats. These blends often consist of a natural vegetable oil and a solid fat such as fully hydrogenated soybean oil. Full hydrogenation forms saturated fats rather than trans fats, which are products of partial hydrogenation."

A recent study reported perplexing changes in cholesterol and blood glucose concentrations in 30 volunteers in Kuala Lumpur, Malaysia, who had consumed an interesterified-fat–heavy diet. Fasting blood glucose levels were elevated almost 20% after a 4-week period, and was linked to relatively depressed insulin and C-peptide. In other words, interesterified fat was found to depress the level of HDL (good cholesterol) more than trans fat. In addition, it raised blood glucose levels and depressed the level of insulin. This strongly suggests that interesterified fat could lead to diabetes.

By the way, the FDA advised manufacturers, including ADM, that interesterified fats containing a stearate content of greater than 20% may be properly labeled as “interesterified soybean oil,” or “high in stearic acid” or “stearate rich.” Key words to consider on a list of ingredients, especially if you are diabetic.

In the meantime, let's start getting used to dipping our cloned and irradiated lobster in some artificially flavored, drawn interesterified soybean butter. Yum. Is this really what we want our children growing up on? Remember, it took a long time to figure out how harmful trans fats are to the human body. I guess the facts had been hidden in some valley all along, with the pine trees. Interesting, huh?

References:

A Trans Fat Substitute Might Have Health Risks Too http://www.sciencenews.org/articles/20070210/food.asp#how

Stearic acid-rich interesterified fat and trans-rich fat raise the LDL/HDL ratio and plasma glucose relative to palm olein in humanshttp://www.nutritionandmetabolism.com/content/4/1/3

Partial interestification of triaclyglycerols http://www.patentstorm.us/patents/6238926-description.html

HAVE SUPPLEMENTS HELPED?

I have emphasized the importance of periodic tests to check your average blood glucose values, blood lipids (cholesterol and triglycerides), and kidney function. When I got the results back from my most recent tests, done at the end of April, I was very encouraged by what I saw. I switched to a new doctor since then and he hasn't seen the report, but I think he will be impressed too.

From previous tests, my triglycerides dropped from 222 to 128. Less than150 mg/dL is ideal. Total cholesterol went from 216 to123. The normal range is 125-200 mg/dL. My bad cholesterol (LDL) dropped from 135 to 68. The desirable range in diabetics should fall below 100 mg/dL and <70 for those with known heart disease. Unfortunately, my good cholesterol (HDL) also dropped from 37 to 29. It should be > or equal to 40 mg/dL. I don't know what caused that, but I will research ways to improve it. More exercise will help, I'm sure.

Everything on my Comprehensive Metabolic Panel w/EGFR was fine except for my fasting glucose reference interval, which stood at 126. It should range from 65-99 mg/dL. What totally amazed me was the result of myHemoglobin A1c test. Originally, I clocked in at 8.o%, a relatively high number. The non-diabetic range is less than 6.0%. This time, my number is5.5%, an incredible improvement and something I am quite proud to crow about. I attribute this and the other results to several different factors: I am on a prescription medication for blood pressure and to loosen my arteries to protect my kidneys, I take a statin drug for cholesterol, and I take a sulfonylurea medication for diabetes. I do not consume processed sugar and my fat intake is way down. I exercise more than I did before I was diagnosed and I drink a lot less alcohol. I try to eat better overall. Of course, I miss pizza and fried chicken, but hey, you gots to do what you gots to do.

I did a tremendous amount of research on supplements for diabetics, primarily for those with type 2. I really tried to weed out the junk stuff and to make a concerted effort to avoid conflicts with other supplements and medications. Here are the results of what I've found and a list of what I take daily. Bear in mind, I made sure my doctor knows exactly what I'm taking and what his thoughts are on each one. Can I say for sure that these supplements have helped? Of course not. I've only been taking them for a few months. I would have to have similar test results over a much longer period of time to assume otherwise, and my tests may vary as much in myself as they will in any other individual. I would not recommend any other treatment without consulting your own physician first. OK, I do think cassia cinnamon can be a small miracle for people like us.

1.) 2,000 mg cassia cinnamon. This type of cinnamon may help promote sugar metabolism.

2.) 200 mcg chromium picolinate. May help promote insulin effectiveness and regulate blood sugar.

3.) 250 mg magnesium. I take this because of neuropathy. It may help with nerve impulses.

4.) Omega 3 fish oil/alpha lipoic acid. I alternate daily between these two for heart health and to fight against free radicals, plus antioxidant benefits.

5.) multivitamin

6.) 1 gram apple cider vinegar tablet with min. 35% acetic acid.Studies have shown that apple cider vinegar helps control blood sugar spikes in type 2 diabetics.

1.) 81 mg aspirin. Because my doctor told me to.

I take all of these supplements with my evening meal, except for the aspirin, which I take whenever I remember to.

When he looked over my list, he was amazed. He said that the only patients he ever sees that take these supplemental cocktails are diabetics and those with AIDS. Whether they help or not are subject to further studies. He approved most of them in a round about sort of way by checking them off one by one and saying they seem to be OK. He only questioned two of them. Chromium picolinate may alter DNA, but if I'm not thinking about having children at my ripe old age, it should be fairly safe. He takes it himself. His children are grown. He seems to think it might be of more benefit to help ward off diabetes, though. He was puzzled by the magnesium and when I told him it's for neuropathy, he just shrugged. That one, he was less sure of. I wonder what he'll think after reading my test results? I'm running them up to his office this afternoon, but I won't see him again until the middle of July. In the meantime, please discuss these with your doctor before going on any sort of regimen. Just because you read about them here does not mean they are right for you. Besides, I'm still exploring other supplements. It doesn't give me license to eat pizza and fried chicken, either, so watch your diet!

HAVE SUPPLEMENTS HELPED? Hmm...

On Monday, I went to see my doctor. I had some back door work done a little while ago and was diagnosed with diverticulosis. No polyps though, and that's a good thing for a guy who's soon to be 55. I've got to go on a higher fiber diet. That's the good news.

The nurse took a blood glucose test and my sugar came in at 208. That didn't make me, the nurse, nor the doctor happy at all. What happened? Here, I was boasting about my proud numbers in my last diabetes post. My A1c had dropped from 8.0 to 5.5. I have no idea what it would be today and I'm not scheduled for more blood work until the beginning of October. I had been crowing about the supplements I truly felt were working in my favor. Today, I'm not too sure. This afternoon, the magic number was 227. I'm certainly not going to stop taking what I do because he had told me on my last visit that everything was safe, that none of the supplements would harm me. Now, if I run out of something, I won't be so quick to jump in my car to replenish supplies. Besides, everything adds up in cost. I read a lot and listen to plenty of advice from people who have all sorts of natural cures. As a matter of fact, one commenter addressed gymnema sylvestre as an herbal alternative to the prescription drug I take now. It looks promising, but it doesn't come cheap. It's about the same price and until I do further research, I'll stick to my present plan. When I went to pick up some prescriptions recently, I bragged to my pharmacist about my A1c number and how the supplements might have helped. She told me to keep in mind that when I was diagnosed, I stopped eating sugar and that probably had a lot more to do with that number than what I was taking on my own. If I can get my number down to 4.0, then she'll start listening. By the way, she has faith in supplements.

The doctor instructed me to double up on the Glucotrol (Glipizide) XL if my numbers are high. He wrote out a prescription for 60 pills instead of the usual 30. Unfortunately, that also doubled the price. When I tested my sugar last night, I checked in at a much more comfortable 110. The double dose seems to be doing the trick. I took one in the morning and one in the mid-afternoon.

The same person who mentioned gymnema sylvestre also told me about taking niacin to reduce cholesterol. From what I have learned, it does help. Unfortunately, one of the drawbacks is that it has a tendency to raise blood sugar. One of the things of much concern to my doctor was that my good cholesterol (HDL) was very low. Overall, all my choesterol and triglycerides have gone way down from the Lovastain I've been taking, but it seemed to have lowered the good stuff, too. Initially, I was taking 40mg daily, but he reduced it to 20mg. Because of the low HDL number, he decided to take me off straight Lovastatin immediately and put me on Advicor, a combination of 500mg niacin and 20mg Lovastatin. He says this will raise my good cholesterol. Unfortunately, it doesn't come without side effects, some of which can be pretty nasty. It's the niacin. They include feeling flush, itching, tingling, dizziness, rapid or pronounced heartbeat, shortness of breath, sweating, chills, swelling, rashes, abdominal pain, back pain, diarrhea, indigestion, nausea and vomiting. Oh, I did mention high blood sugar, didn't I? About 45 minutes before popping one of these pills, I took a couple of Tylenol to help minimize some of the side effects. Then, I took it, ate a pear and went to bed. I quickly fell asleep and woke up this morning with no ill effects. Maybe, I was a little groggier than normal, a little more light headed, but that was all.

I don't take issue with natural remedies. In many cases, they can be quite effective and beneficial in treating different ailments, but I question their reliability. The FDA does not clinically test supplements for safety, effectiveness and problems if taken in conjunction with other supplements. For example, you shouldn't mix ginkgo biloba with St. John's wort. Sure, the Chinese have been dispensing this root and that herb for thousands of years, but can we say for sure they work better than prescribed medications that have been tested? Without the knowledge of someone well trained, such as a medical doctor, can we be our own physician? If you get a bad toothache, are you going to make tea out of a powdered root or go to a dentist? In many cases, there is no real alternative to traditional treatment. Certainly, in the case of diabetes, every person with the disease has their own fingerprint. Watermelon spikes my sugar. My mother, on the other hand, can eat it and it doesn't bother her the same way. She has been diabetic for 26 years and has been taking prescribed medicines a long time. To think that doctors and pharmaceutical companies have been conspiring with the FDA in order to fool the public is just pure bunk to me. Of course, crooks exist in every profession, but a vast conspiracy? Come on, now. When billions of dollars are pumped into research and development of drugs that are quite effective in the end, what is wrong with taking them? In my case, every prescribed medication has a generic alternative. How is the doctor getting rich off me or the millions of other diabetics taking the same things? It is my decision to ask the pharmacist to give me the generic version and I don't think a doctor would tell a patient you can't do that.

I will continue to explore other treatments and maintain a very open mind, but in the meantime, I will stick with the tried and true. I really don't think I am as qualified as those who have spent thousands of dollars and many years studying to become the doctors and specialists they are. Most pharmaceutical companies offer free medicines to people below a certain income level. Advances in today's medicines are absolutely amazing and I am not going to jeopardize my life because of conspiracy theories. Besides, I think some of the complainers are ones without health insurance. If they had it, they wouldn't have to pay much for their drugs, so they might not be as compelled to seek out alternatives. Think about that next time you bite into your fresh baked cookie made with refined sugar and bleached, enriched flour, something I can't and won't eat anymore.

ODDS & ENDS, BLOOD TEST RESULTS - TAKING THE GOOD WITH THE NOT SO GOOD

ODDS & ENDS

I recently had a discussion with my sister-in-law about one of those mysterious liquid supplements that are meant to cure you of all sorts of ailments. I didn't pay much attention to what it was because I don't believe a cure-all exists anywhere in any form. We read about some never heard of fruit that Amazon natives have been using for hundreds of centuries. We hear it cures cancer, diabetes, hypertension, liver and kidney diseases and bad breath, to mention just a few. Then, and on the other side of the spectrum, we'll learn about all kinds of supplements, each designed to perform a certain function to enhance your life and health. Ginkgo biloba for the mind, for instance. My best advice to you is to not believe everything. For one thing, since the FDA (or any other country's equivalent) doesn't necessarily regulate natural cures, i.e., herbal supplements, how do you know what it will do if you don't let your doctor know first? Every person's body is different. No one pill will work for everyone. Some people have allergies, others don't. Blood types vary. Men and women are different. Men don't suffer from iron deficiencies, for example. Supplements don't always mix well. I've often read to not take St. John's wort with ginkgo biloba. Did you know that? The list of reasons can go on and on and it is impossible to take supplements that promise an eternal life, free of maladies. Besides, my prescription blood pressure medication is derived from snake venom. South American variety. I have a printout that tells me of possible interactions.

"I take Peruvian Ma La Qua Potion every day and I haven't been sick in 48 years." - Ellen B., Baltimore, MD

Do you know Ellen B. or anyone who does? I didn't think so. She doesn't exist, but her fictional testimonial does.

I average anywhere from 80 - 130 visitors a day now on this website. Am I bragging? No. A good chunk of those hits are from people searching for information on diabetes. One such search is on "coconut cures for diabetes" and one of the very first things a doctor told me after being diagnosed with type 2 was to avoid all coconut like it's the plague. I know for a fact that I ate a Thai soup for dinner one night before I was officially diagnosed, but testing my glucose levels twice a day, and my sugar skyrocketed. The culprit? Coconut milk in the soup base.

BLOOD TEST RESULTS

Every diabetic must undergo blood work every three months for the rest of their lives to show how glucose levels are and how your kidneys and liver are functioning. The doctor will prescribe and adjust your medications accordingly. A short time ago, I went in for tests and had a follow-up visit a week later.

"No really bad news to report," my doctor told me soon after he entered the room.

"Good. Then I can leave?"

"No, there are a few things we need to discuss."

The fasting level of my glucose on the morning of my test was 140. That's high. My overall level for that 3 month period was 5.6, up from the previous test of 5.5. Not bad at all (Previous test results and ranges can be found here). He proceeded to double my Glucotrol/Glipizide medication, but, at least, I'm not on Metformin yet. Glucotrol stimulates insulin production in the pancreas. Metformin slows glucose production in the liver. As long as my pancreas is functioning modestly, I'm in better shape overall.

"You know I take cinnamon capsules everyday, right?"

"Cinnamon shows a lot of promise in diabetics," he responded. I used to take 3,000 mg a day, but have since dropped it to 1,000. I give some credit to cinnamon for that 5.6 number.

My cholesterol went up. Originally, I was put on 40mg of Lovastatin. That brought those numbers way down, but at the same time, greatly reduced my good cholesterol, too. He put me on a combination prescription of 500mg Niacin/20mg Lovastatin. This time, my overall cholesterol was 181, triglycerides were 184, LDL was 101 and my good cholesterol (HDL) jumped from 29 to 43. He doubled my medication to 1,000/40. Niacin helps bring good cholesterol up and it did, but 20 mg of the statin wasn't enough to bring the bad back down. One of the unpredictable consequences of diabetes is that medications are constantly adjusted and when you think you've gotten it under control - POW - something else pops up.

"Your urine was very yellow and thick."

"Huh?"

My blood test said TURBID. That means cloudy. My specific gravity was low. He wasn't too concerned, but these might be signs of excreting red blood cells, which leads me to his next discussion.

"I'm a little concerned about your platelet count. It's been testing low, but not too low to warrant further testing at this time. I wouldn't worry about it yet." YET? When a doctor brings up something that concerns him, you tend to get a little bit nervous. "If it remains low or drops, we'll have to set you up with a (bone marrow) biopsy. In the meantime, we'll keep a close watch on that number from now on." My red cell count was low, but he didn't mention it.

"Oh, great news! I noticed that on my last tests, especially since my brother-in-law went through AML (leukemia) and his platelet counts were really bad."

"Well, you don't have leukemia because your other numbers are within range."

"Are there any supplements I can take to increase my platelets?"

"No, but there are prescription medications available. Like I said, don't worry about it yet."

OK, I won't worry, but it will be on my mind. "Does it have anything to do with the diabetes?"

"No. Are you ready for your prostate examination? Remember, we discussed it last time?" Oh, yeah, how could I forget?

It ain't fun getting old. Does anyone know where I can order that Peruvian Ma La Qua Potion?

HOPE FOR THE UNINSURED

Around the end of October of 2006, I bought 2 bags of candy to hand out to trick or treaters. I live on a street where no children reside and we seldom get Halloween visitors. Few came and someone had to eat all that leftover chocolate. It was gone in days. Little did I know that, two weeks later, I would test my blood glucose on a dare and within a month, be diagnosed with type 2 diabetes. I have no idea how high my sugar went from eating that candy, how long I've had the disease or how much damage I've done, but many people could have diabetes or other conditions for many years and not know it. I had symptoms for quite some time and shrugged them off, like a lot of men do. I hate going to the doctor. Constant hunger with a sudden loss of weight, frequent urination and the tingling, numbness and sharp pains in my extremities from diabetic neuropathy were warnings I should not have ignored, but maladies that creep up with middle age and the lack of health insurance were good enough excuses for me to pretend nothing was seriously wrong. Until that day a lancet pierced my finger, those symptoms meant nothing. How quickly life changes. I needed help and I got it, but my thoughts turned to the countless others without health insurance. What about low-income families who don't go to the doctor because they can't afford to? Are they aware there's help out there? There is, but the trick is how to educate them about where to go for treatment.

In the Orlando, Florida area, there are clinics affiliated with PCAN, thePrimary Care Access Network that specializes in health care for the underinsured. There's the Central Florida Family Health Center with locations scattered throughout the area. You pay according to your income level based on the US Department of Health & Human Services' poverty guidelines. For the homeless, there's HCCH, the Health Care Center for the Homeless. Also, try the Florida Association of Community Health Centers.

Thankfully, our community is also blessed with faith-based Shepherd's Hope, nonprofit clinics that provide free assistance in a family-practice setting. Their mission is not one of continuous-care. It is to provide non-emergency treatment to those in need. Presently, there are 8 all volunteer health centers and they are a godsend. Their website states that, of the uninsured population nationwide, 8 out of 10 people are not eligible for government assisted health care plans. Most are hard-working and many work several part time jobs to make ends meet. Putting food on the family table and a roof over their heads are primary concerns and not much is left over.

My advice would be to go to a search engine and explore clinics closest to where you live. I did a search for “free Orlando clinics” and found Shepherd’s Hope in this area. Where you live, replace “Orlando” with your town. If that doesn’t work, try using assorted key words along with your search, such as "medical" or "health", like “free health care decatur alabama” or "free medical clinics philadelphia" until something pops up. On the federal level in the United States, the Hill-Burton Act was passed in 1946 to help you find health care, regardless of your ability to pay. If your search yields nothing in your area, go to the Hill-Burton website and look through the facility locations. Something is bound to pop up.

Through local and national grants, hospitals, pharmaceutical companies and dedicated volunteers, there are countless clinics around the U.S. and throughout the world that are willing to help those in need. Look in the phone book. Call your local government. Ask a friend for advice. All you need to do is seek in order to find and if all else fails, contact one of the organizations listed here. They might be able to steer you in the right direction.

P.A.D. (Peripheral Arterial Disease or Atherosclerosis)

It's been 8 months (Oct. 21, 2007) since I quit smoking and I wish I had stopped after the first puff almost forty years ago. For many years, I have told younger people that if I had my life to live over, the one and only thing I would change is smoking. I never would have placed a lit cigarette in my mouth. Amazingly, after all those years, it wasn't as hard to do, not like I thought it would be. I was terrified of quitting, but I knew the day would have to come. After all, diabetes and smoking do not go hand in hand. My risk of heart attacks and strokes is bad enough with the disease alone. Cigarettes are suicide.

To say I have been naive and stupid all these years is a gross understatement. When young, we think we're going to live forever. All of a sudden, age creeps up on you and you are, well, old. Obviously, genes play a role in what hits you later on in life, but who cares while you still have your youth?

It all started about six years ago with gastroesophageal reflux disease, otherwise known as GERD. I had a terrible time swallowing food at times. I would feel like a grapefruit was lodged in my esophagus and I felt tremendous pain and I would salivate foam. I could not swallow and breathing became difficult. Then, it would go away and I would be terrorized by thoughts of knowing it would happen again. After being placed on Prilosec OTC and now Previcid and/or Protonix, which I take to this day, it never came back. I never knew heartburn could do so much damage. Does smoking have anything to do with it? You betcha! That and other factors like weight and the types of food you eat.

Next came type 2 diabetes and I have no idea how many years I've had it. Doctors say you could be diabetic for upwards of eight years before any symptoms occur. I've written many posts on this disease.

I won't even mention diverticulitis.

Now, I was diagnosed with something else and prescribed a new medication to add to my growing repertoire. Whoopee! For a long time now, while walking, I get pains in my legs, from below the knees down. I can only describe it as very painful and my legs feel like they are made of lead. I pretty much attributed this to neuropathy from diabetes. I do have that problem. For a few weeks now, the tops of my feet have been swollen. I don't want to take chances knowing I am diabetic. We get our feet amputated and I'm not about ready to lower my height by eight inches and hobble around on knobby ankles. I did the smart thing and went to my doctor. After a careful examination of my ankles and feet, he told me the news: Peripheral Arterial Disease or P.A.D.

Whee!

The Peripheral Arterial Disease Coalition website describes it as narrowing or clogging of the arteries due to a buildup of fatty deposits, or plaque. It is otherwise known as atherosclerosis. Without treatment, all sorts of complications can occur, including that scary old amputation word. The main culprit in my case? You guessed it: SMOKING. That and the fact that my mother was diagnosed with it many years ago. I seemed to have been the one sibling ( and I certainly hope it remains that way) who got the most genes from her side of the family. She and her older sister are also diabetic. She apologized for that and I told her she was not responsible for me. I chose to smoke. Yes, she said, but she should have warned me years ago about impending problems. No way is it your fault, I responded. My mother is a very sweet lady.

My doctor began explaining it and gave me some very interesting information I would like to share with you.

"Have you ever noticed that when young people suffer a heart attack, they generally die?"

"Yes."

"And older people can have several attacks and survive?"

"Yes, I never really thought about it, but you're right."

"Well, the mind has a way of adapting itself. In young people, the heart has so many arteries and that's it and when an artery gets clogged, you have a heart attack. In older people and over time, the brain tells the heart to build new arteries around the clogged ones, sort of like a bridge. The same thing happens in your legs and elsewhere. With your disease, it's not quite working the way it should, but fortunately, there are medications that help spur new growth."

"Hmm. I never knew that." Actually, I remembered hearing about the heart thing a while back.

He mentioned some newer and more effective drugs, but since I have no health insurance and will probably never qualify for it again, he prescribed Trental, generic name, Pentoxifylline. It is much cheaper.

"It will work just fine, but don't expect immediate results. I don't think you'll notice a difference for four to six months." That's the pain I feel when walking for extended periods. Exercise, walking in particular, is very important if you're diabetic.

There you have it. Now if my doctor and the specialist I am seeing would just find out why my red cell, hemoglobin, hematocrit and platelet counts are down, I will feel much better. Or, maybe, I don't want to know because I'll surely have to pop even more pills. But, maybe, that will make me feel better, too. Oh, I don't know. I guess all I'm trying to say is if one person puts down a pack of cigarettes or never picks one up, then that's one person who won't have to go through what I'm dealing with.

PLEASE - DON'T SMOKE

DIABETIC NEUROPATHY

One of the many health problems that people with diabetes face is neuropathy pain. It's one of the reasons why everyone today should pay attention to what your body is telling you. Everything I'm going to say here about my past is still very present today, and in some cases, more so.

For several years before I was diagnosed with type 2, I had very sensitive skin from my abdomen down to the tips of my toes. Occasionally, I'd get this piercing, throbbing and burning pain in my toes, too. There's no real way to describe it unless you have felt it yourself because all three of those words are mild compared to the real thing.

I tired much easier. My eyes felt like they were hit by a dust storm but nothing was there. I was constantly hungry, including after eating a big meal. I was thirsty more often and I peed more, too. My weight dropped for no reason as my body munched out on fat to feed itself for energy since my metabolism took a permanent vacation from utilizing sugar to help keep my body active. Meanwhile, I was oblivious to it all because I attributed everything to the aches and pains of growing older. While my family and friends watched me lose 40 pounds in a matter of 6 months, I enjoyed the new svelte me while they worried. No problem, I told everyone, my metabolism is changing for the better. Meanwhile, I was damaging my organs with each passing day, and nothing in the end was for the better.

My skin was so sensitive, I had to be very careful in the shower. The direct flow of water on my mesodermal tissue was painful. The tops of my feet were off-limits because of the excruciating agony from water pressure. I won't even describe the intensity when it hit my you know whats. Direct contact there became an international threat to my manhood.

Meanwhile, like I said, silently, my body was destroying itself from within. Don't get me wrong. I'm not on my deathbed or anything, but there's something I'd like to share with you about a recent experience and it's all about diabetic neuropathy.

To this day, I still feel a constant tingling in my skin. Some days it's more pronounced than others, but it never goes away and most days, I don't pay attention to it anymore. According to the federal government's NIDDK Web site, nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs. Whoopee! Lucky me. Nerves contain a network of cells that carry signals and impulses to the spinal cord and the brain. These are called afferent neurons. They also carry signals away from the central nervous system (CNS), these are called efferent neurons. Enough medical jargon. I just wanted to let you know that along with actually suffering from it, I know a lot about it, too.

Toe Jam

Early one afternoon, a couple of months ago, I needed to go out for a while. I shaved, showered and did my best to make myself presentable to the public. One thing I learned a long time ago was to keep the area between my toes dry so athlete's foot doesn't develop. I have a regular routine where I take my socks and run one of them between my toes in an up and down motion, sort of like buffing the area dry, and that has kept it at bay for years. Then, I carefully take one sock at a time and gingerly place it over my toes and begin the journey up my foot until it rests comfortably and snugly on my ankle. To show you how smart I am, I do the same thing with my other foot with no help from anyone. I even learned how to tie both shoe laces at a very early age and I can still do that, too.

As a creature of habit and being left-handed, I always start with my left foot. Safely, my sock was up and it was time to go to town on my right one. As I placed the sock over my toes and began sliding it up my foot toward the ankle, I felt a little pain in one of my toenails. Bear in mind that diabetics should go to a podiatrist to have their toenails cut, but for $75 a visit, I can do that myself, thank you, and I am very careful to never let my nails grow too long. Yes, I am very careful when I clip them. I stopped, let go of my sock, and rubbed my toe. The pain was brief, I felt nothing askew and I continued the sock's journey on the path to its final destination. The pain was gone. No big deal and I shrugged it off.

I must tell you that I also have PAD in my calves and ankles, so I have to be careful about what types of socks I wear. At the same time it, it reminds you of one of the many other problems associated with diabetes.

I don't remember what I did that day. I probably had errands to run and sometimes, I catch up with old friends at Spatz, the neighborhood bar in Winter Park, where I sip on water with my friends. Watching people drink booze and smoke cigarettes doesn't bother me in the least. Smoking was extremely detrimental to my health and I will never do it again. This month marks 2 years away from the cancer sticks. I only wish I could have patted myself on my back a lot earlier.

Anyway, I got home, went about my business and at bedtime, I sat on the bed, kicked off the shoes and began to unroll my socks; one at a time, starting with my left foot. I told you I am a creature of habit. As I peeled off the right sock, I noticed something immediately. That toe I felt pain in earlier was now coated with dried blood. Hmm. What's this? Upon closer examination, I saw that the toenail was split down the middle up to the root and the right half was completely torn off. Gonesville. I rubbed my toe. How did that happen? How did I not know it?

As you cringe in horror over what I had done to myself, here's the clincher. I didn't even know it. I felt no pain. How's that for diabetic neuropathy? How's that for dying nerves?

You see, it's very important that we take care of ourselves when we are young. Sure, I never thought I'd be in this shape when I should be relatively healthy and carefree at 57, but it does happen. There were signs coming my way I never paid any attention to, like what I described earlier. I was aware that my nails were becoming more and more brittle over time, especially the ones on my toes, but I was stupid or naive or both. My mother has lived with the disease for over 25 years now. Does it run in your family? Think about that food you're eating. Think about my toe.  In 2006, nearly 21 million Americans had diabetes. The number grows by leaps and bounds daily. Do you want to be one of them?