I started putting my little journal online to share with others my thoughts and what I have learned about living with this disease. I will try to post a new entry on a regular schedule but as with everything in life, sometimes things happen. Each time, I will talk about something different to keep things fresh and not boring for you all.
June 3rd, 2016 Father's Day
Father’s Day i
s just around the corner. It is a day to celebrate Dads and it has been around for a long time. In some countries, there are religious overtones as to when it is celebrated. Almost every country in the world has a special day to celebrate Dads.
In our household, it is a simple affair. Whether it is a dinner in a nice restaurant or a backyard barbeque, we follow the same simple rule mentioned in my other blogs: moderation. Moderation is the key to managing my diabetes. We try not to stuff ourselves when we go out, or my wife makes simple yet delicious and nutritious meals for the family.
With backyard barbeques, meat comes to mind. How can one not enjoy the simmering flavors from a hot grill? Hot dogs, steaks and hamburgers are the most favorite grilled food. There
are many healthy reasons why grilling is healthy and benefits diabetics. First, fats drip off leaving less fat on the food. Second, the high heat from the grill is effective in sealing moisture and keeps food tender. This minimizes the need to add oils or butter to the food. In that effect, there are fewer calories. Third, vegetables retain more vitamins and minerals when cooked quickly in a grill.
Remember that cooking on a grill is not necessarily very healthy. Studies have shown that fat dripping into hot charcoal generates chemical reactions producing gases that may be carcinogenic. To avoid some of the negatives of grilling, my wife marinates the meat before putting in on the grill. This is her secret recipe. We did not know until recently that studies and research have shown the health benefits of marinades. Marinades containing garlic, honey, turmeric, and other herbs help overcome the negative effects of gases generated from fat falling down onto the charcoal. Studies also seem to suggest that the less time meat is on the grill is better for reduces the amount of potentially harmful gases.
Using a slow cooker to tenderize the meat is another technique my wife uses to help minimize the amount of time is on the grill. Once the meat is tenderized in the slow cooker, she puts the meat in the grill to give it the charcoal flavor. The bottom line is this: Marinate the meat or tenderize it first on a slow cooker to minimize the exposure to gases created by grilling. And of course, do not overeat or drink too much. Happy Father’s day to all dads around.
May 27th, 2016 Tracking Your Progress
Know Your Body
You are the one that knows your body. You know how you feel and you know what the medications do to you. That is the reason why it is very important to keep track of vital data about your diabetes.
This is what I normally do. I take my glucose reading every morning before breakfast around 8 AM. The typical level for me is less than 120 mg/dl. I then eat breakfast and take my medications. If the reading before breakfast is over 120 mg/dl, I take another reading before eating lunch at around 1 pm. Under normal conditions, it would be under 110 mg/dl. I would then eat lunch. If the reading before lunch is higher than 110 mg/dl, I take another reading before dinner at around 7 pm. Most of the time, I take 3 readings daily.
After each reading, I would log the results in my logbook, such as the one shown on the download. Recently, I started using the Health App in my iPhone. This neat and simple application allows me to track all the information shown in the log more easily. An image of the app is shown.
Once you have a reliable record of your glucose and blood pressure readings, it is very convenient to show it to your doctor for him to help manage your health and keep you well.
Click here to download the Glucose and BP Log Chart
For blood sugar, I collect the following information:
Date- Time
- Blood sugar level
For blood pressure, I store the following information:
- Date
- Time
- Systolic
- Diastolic
- Heart Rate
Using Excel or other tools, I calculate the minimum, maximum, average readings for Systolic, Diastolic and Heart Rate.
If you would like a copy of the logbook, please refer to the top of the page. It will be downloaded as a pdf file.
May 11th, 2016 No Need For All The Pills
There are many ways to get beneficial supplements w
ithout swallowing a bunch of pills. Foods like bitter-melon, which has insulin-like properties that are supposed to reduce blood sugar for diabetic patients. Bitter melon is a tropical and sub-tropical vine grown mostly in Asia, Africa, and the Caribbean. It is edible but very bitter as per its name. My wife incorporates bitter melon in her cooking by stir-frying it with beef, chicken or shrimp. I would say that bitter-melon is an acquired taste because of its bitterness. When cooked properly, seasonings masks its bitterness and the dish becomes delicious and dietarily beneficial. There are pills as well as teas that many people consume on a regular basis to help control their blood sugar. Bitter-melon is one of the many supplements claimed to have beneficial effects for diabetics. {To get a copy of her recipe, make a request by sending me a comment or email at fred15440@msn.com}
Another good food to help with your daily fight against diabetes is cinnamon. A friend of mine swears by cinnamon pills. Cinnamon is a spice scraped from the inner bark of trees originally grown mostly in Sri Lanka, China, India, and Ethiopia. There are different dosages available at stores. The most common one is a 500-milligram pill. I take two pills every day. Since we like the flavor of cinnamon, it often ends up in my wife’s baking such as in an apple pie.
Omega-3 fatty acids are usually associated with salmon and other oily fish. If fish is not to your liking, supplements are available. There are other sources such as flaxseed oil, walnuts, almonds, pistachios, and dark leafy vegetables.
These are just three examples of 
many supplements available in the market that diabetics take to help control their sugar levels. But are they effective?
So what is the bottom line to all these? First check with your doctor. If you are going to take these supplements, be sure that your blood work includes liver and kidney functions for these are the organs most affected by any medication.
Some are so convinced on the positive effect of these supplements. This may be true. After all, only you can fully assess the effect of any medication (or supplement) you take.
March 15th, 2017 Doctor Visit
I just came back from my doctor. I see him every 4 to 5 months. Good news from the lab work. My A1c is down!. This is the number that we monitor closely. In June 2017, my A1c was 7.2 it crept up to 7.6 about a year later. Now it is down to 6.8. This is wonderful for it showed a downward trend. We hope that the trend continues. The A1c number is one key information a diabetic needs to remember. This number is key to managing diabetes. Keeping this number to lower than 6 is the magic number. From the chart below, I am still in the high (red) range. My doctor is working with different medications to keep my A1c numbers within the target “green range”.
A1c test results over approximately 3 years
During this recent visit, I also learned that I lost weight. The doctor said that losing weight helps manage my diabetes. In the last 6 months, I lost about 8 pounds, bringing my weight to 163 pounds. At 5 feet and 10 inches, my BMI (Body Mass Index) is 23.4. This is within the normal range of 18 – 25. If I lose another 5 to 10 pounds that would be great!
Oh, I need to mention that my diabetes medication includes Metformin and a family of products called liptins (linagliptin, saxagliptin, sitagliptin). More information on these medications can be found in my blog roll.
April 27, 2017, Progress with New Medication
After my doctor's visit last month, I was so happy with the progress I made regarding my blood sugar level and my weight. Since then, I have lost a few more pounds. That is the good news. With all the good news, what is raising my concern is my daily blood sugar level. Prior to the last doctor's visit, the daily average was in the high teens. Now, it appears to be creeping up to the 120 range. Not good. My doctor asked me to take one of the newer medications together with my Metformin (1000 mg in the morning and at night). I started taking Janumet (50 mg combined with 1000 mg of Metformin) in the morning and take my regular dose of Metformin at night. So, one month later, my blood sugar level seems to be higher. I do not know what is causing this, because I do not think anything else changed (diet, exercise, etc.). Is it the medicine? Is my metabolism changing? Am I getting older?
My next lab test for my A1c will be next month, so we will see. After the lab test, I am scheduled for a doctor's visit. I will just wait and see what happens, or what he will say. I just hope that my A1c trend continues as it has been doing as mentioned in my previous month's post. But time will tell. Stay tuned....
July 6, 2017, Latest Blood Work and Doctor's Visit
My doctor was very pleased during this visit. He declared me his model patient. Why? Because today, the blood work showed that my A1c dropped to 6.4% from 6.8% on my last visit. My Lipid panel shows total cholesterol total is 137, HDL is 67 and LDL is 58. My weight dropped down to 158 pounds. Over the last year, I shed close to 15 pounds. These numbers are very good and show that my diabetes is under control. My doctor wants me to be very mindful of my weight and A1c. This is the advice he gives all his patients. (He specializes in Internal and Geriatric Medicine).
What do all these mean? I was told that decreasing A1c from 8% to 7% may reduce the risk of eye, kidney and nerve damage by 37%. That is a very sobering thought. An A1c between 6% and 7% shows that glucose is under control. Higher than 7% is an indication of out of control levels. For sure, the lower the A1c is, the better.
My current medication for diabetes is as follows: Janumet 50/1000 (a combination of 50 mg of Januvia and 1000 mg of Metformin) in the morning and another 1000 mg of Merformin XL in the evening. My cholesterol is controlled by 10 mg of Atorvastatin in the evening. Also taken in the evening are 50 mg of Losartan and 5 mg of Amlodipine. These medications I have been taking for over 6 months now and seems to be working well for me.
Diet has played a very important role in my weight control. Lower the carbs. Pasta, bread, and rice are some of my favorite dishes. Total disaster for a diabetic if eaten in large quantities. As I mentioned in my previous entries and blogs, moderation is key. It is difficult to stop eating this wonderful food. Just eat less of it. And that is what I have been doing. Oh, there is another thing I forgot to mention. I try walking at least a mile 5 to 6 times a week.
My diabetes will be with me for the rest of my life. It could kill me over time if I am not compliant with my medications. If I do not control my food intake and eating habits, if I do not exercise, my A1c would be out-of-control and complications from diabetes could arise.
November 10, 2017, Four Months Later
I visit my primary doctor every 4 months or so. Wonderful news again. My A1c went down from 6.4% to 6.2%. My weight went up to 162 lbs from 158 the previous July. So why is my A1c going down when my doctor told me that weight is one of the factors in bringing down A1c. The only thing that did not change is my medication. Since I gained 4 pounds during this visit, it is an indication that I have not followed regimen. I think in the last four months, I ate too much carbs! Ouch!
The good news is that the overall lab work is positive. I am still with the same medication. I hope that when I visit my doctor in March 2018, I will continue to have continued success in controlling my diabetes.
August 4, 2018, Nine Months Later
As I have discussed in my previous journals, I am very consistent with my visit to my primary doctor. At least every 3 to 4 months, I see my primary doctor and regularly get my blood work. I am happy to report that my diabetes is very much under control. My A1c is below 7.0%, my cholesterol levels are normal. My doctor jokes that if all of his patients were like me, he would not have a job. Part of the reason that all my blood work is within range is that I am very religious with my medication. Bottom line, I follow all the doctor's orders.
I hope that in the months ahead, I remain healthy with all my lab work numbers stay within range. Stay tuned….
September 3, 2018
It is tough when age catches up with you. My doctor recommended that I have a colonoscopy. It has been over 10 years since I had one. The memory of that experience still lingers in my mind. I remember how I had this giant jug of a god-awful tasting liquid I had to drink in order to flush me clean for the procedure. The procedure itself is painless. It is the prep work that is terrible. That was over 10 years ago. When my doctor asked me to see a gastroenterologist, I hesitated for the longest time. I kept postponing it, until finally, he said, I have to do it!
Well, I did. I made an appointment and received the prescription. It turned out that it was not as bad as I had thought. Thanks to modern science, the prep process now is a lot easier. The bottom line is I have to drink 16 ounces of the medication within an hour. The following hour, I had to drink another 16 ounces of plain water, also within an hour. This has to be done about 8 to 12 hours before the procedure. And oh, I forgot. I this point, do not eat anything – just clear liquids such as soup. So here I am starving and living in the bathroom while the medication takes effect. Now the bad part is that I have to repeat the process 4 hours before the colonoscopy.
The procedure was completed without any complications. After speaking to the gastroenterologist and the anesthesiologist briefly, they initiated the process and before I knew it, I was in the recovery room. The entire procedure took about 45 minutes and I was asleep all the time. In the recovery room, I spoke to the doctor who was happy to inform me that they found no anomalies in my intestines and I should be good for another 10 years. Hopefully, by that time, the preparation would be even simpler and less miserable.
November 12, 2018, Dangers of being alone
For people living alone or are left alone by themselves most of the time and you are a diabetic, danger lurks. What if you fell and incapable of getting up? This problem could be made worse if the individual is not mobile, such as being in a wheelchair, walker or cane. I know of an elderly person who fell beside his bed and could not get up. His family found him on the floor. He has been there for hours because the family was at work. He was hungry and dehydrated. Fortunately, he did not break any bones. But what if the family member did not show up for a longer period of time? The consequence could be a lot worse. And of course the older the individual is, the more problems could arise.
Millions of individuals in the United States, more so around the world, are impacted by a fall. Unfortunately, in the US alone, up to 25,000 of these fall events result in death. Of those that survive the fall, many suffer from hip fractures. As we all know, hospital stay and procedures are so expensive. These numbers came from medicalalrert.org, an organization “dedicated to the improving of the lives of older adults through assistive technology”. In the site, one can explore the various technologies available to the elderly that could make their lives safer and giving the family security and worry-free, knowing that their loved ones are cared for.
With modern technology, problems with falling can be mitigated. There are devices that can quickly call for assistance in the event of a fall. The options are now many. Lives can be saved by a quick response to an emergency. In some cases, it has to be triggered by the individual wearing or have access to a system that summons help. In others, the individual is in communications with the dispatch office.
With today's available technology needless distress and expenses can be avoided.
December 1, 2019, Update after just over a year
It has been over a year! How time flies! I have not posted anything in my Journal for many reasons. I cannot really pinpoint one single reason. The bottom line is many events transpired over the last year. Fortunately most of them good. My blood work continues to be good for cholesterol, HDL, LDL, liver function, etc., but something is trending the wrong way. It is my A1c. Yikes. Hemoglobin A1c is one reading I (and my primary physician) has been watching over. Well, sad to say, it has been creeping up. This is how it has trended:
- October 2017 6.2
- March 2018 6.5
- June 2018 6.5
- November 2018 7.1
- May 2019 7.3
- August 2019 7.4
I have been taking the same medication. The only difference is that I gained weight. I would like to believe that is the reason. In October 2017, I tipped the scale at 158 pounds. I am now 10 pounds heavier. Lots of work to do ahead of me. The next blood work is at the end of this month. Stay tuned…
December 8, 2019, Restful sleep and my Glucose reading in the morning
In addition to the Hemoglobin A1c readings, I also noticed that my daily glucose readings have been creeping upwards. In previous years, my Glucose Plasma reading was in the 110 to 120 mg/dl. Recently, this range of reading was is atypical. I take a reading half an hour after I wake up in the morning and it now ranging between 130 and 150! And of course, this affects my Hemoglobin A1c. My diet remains the same, my exercise level has not changed, but what I now suspect is that I am not fully rested when I sleep at night. In the years past, I had a better sleep pattern than now. I have been reading up on this, and I am not sure if I have a sleep issue. I need to research this topic better. There may be some underlying issues with my sleep pattern that has contributed to the increase in my Hemoglobin A1c.
December 15, 2019, Bloodwork Results
Whew!, my A1c did not go up as I expected. It did not go down either to my disappointment. I was able to maintain it at 7.4, the same reading from August 2019. Unfortunately, I was not able to go to my scheduled visit with my primary doctor due to schedule conflicts. I will see him in March 2020. In the meantime, I will work on losing weight (back to around 160 lbs) from my current 172 pounds. Being 10 to 12 pounds lighter should help reduce my A1c. I was down to around 160 pounds when my A1c was 6.2 in October 2017. Cross my fingers!!
December 30, 2019, Sleep and its Effect on my Glucose Readings in the morning
Several, weeks ago, I brought up my observation between my sleep patterns and my Glucose readings in the morning. I have been doing some research on this and found that there could be a relationship. In reviewing the material from Webmd in their article, “How Sleep Affects Your Blood Sugar”, they are saying that with diabetes, one needs at least 7 hours of sleep at night. This may be the situation with me since there are times that I wake up too many times at night and do not get a good rest.
In addition to the Webmd article, I learned that many factors can affect your sleep. The National Sleep Foundation has a good article on the relationship between diabetes and sleeping. This also confirms the article from Webmd. Having said that, I found another resource discussing how a good mattress can help one sleep better. The Sleep Help Institute is a resource one can get additional information on ways to get a good night's sleep. They have several articles on ways to Improve your sleep, including finding the right mattress. This is a new discovery to me, and I will follow this up in my future blogs.
January 11, 2020 Staying Healthy
As we are now in the new year, a new decade, I wish everyone good health and success in the years to come. One of the articles I mentioned in previous entries is staying healthy. But how does one stay healthy? If we can manage our weight, eat right and follow what the doctors tell us, most of us will probably be able to maintain a healthy lifestyle. For this post, I am lucky enough to have Jennifer McGregor who wrote a contributing article for this post. Her entire article is shown below. The article clearly reminds us of the steps we need to stay healthy. This is very true for individuals suffering from diabetes who struggle every day to maintain their weight and eat right.
“How to Make Health an Everyday Habit with Simple, Affordable Steps by Jennifer McGregor
If you’ve been wanting to get healthier lately, you’re definitely not alone. According to recent survey results, health and fitness goals top the list of most common New Year’s resolutions each year. However, gym memberships and protein powders can be expensive, and all those yoga class fees add up over time. It can feel overwhelming trying to stick to a healthier routine when you’re also worried about breaking the bank.
Luckily, head-to-toe health might be more achievable — and more affordable — than you may think. So, here are some easy, budget-friendly health and wellness strategies that you can incorporate into your everyday life starting right now.
Boost Your Confidence
When most people think of health, chances are they picture physical health, weight loss, and athleticism. Sure, each of those factors are important. However, our mental and emotional health is equally crucial to overall well-being. One way you can improve your mental health is by practicing emotional hygiene, which involves reducing feelings of shame and loneliness.
Additionally, you might work to improve your confidence and self-esteem. According to the National Alliance on Mental Illness, low confidence is a leading cause of mental and emotional health conditions such as anxiety and depression. To boost your confidence, try practicing more positive self-talk. If you’re struggling with self-talk or suspect you might be depressed, talk to a licensed professional. There are many therapies, including cognitive-behavioral therapy (CBT), that can help get your confidence back on the right track.
Hit the Road
If you’ve been feeling stressed or overworked lately, it might be the perfect time for a vacation. Your travel bug is good for more than just sightseeing; studies have actually linked travel experiences to increased mental and emotional health. According to travel blogger Jamie Strand, taking that vacation not only boosts your mood, but doing so can also bring physical health benefits. For instance, walking the beach or heading on a guided hiking tour will provide a healthy dose of physical activity. Meanwhile, trying new foods in your chosen destination can encourage you to make thoughtful food choices.
Make Health a Habit
The last piece of everyday health advice can sometimes feel the most daunting. If possible, try to make health a habit by prioritizing your wellness each and every day. The first step can be as simple as paying attention to what’s happening within your physical body. You don’t have to change anything; just notice what you feel. If you’re experiencing any pain, Curable recommends taking a few deep breaths and noticing the pain. Where is it coming from? Is it sharp or dull? If you have chronic or long-term pain that isn’t responding to treatments, you might try meditating to help cope with your symptoms.
Once you’ve found healthy habits that work for you, you can stick to them without spending a fortune. In addition to shopping the sales at your favorite stores, turn to an aggregate site like Rakuten for deals and promotions on the self-care items you need. You can also refer to the Rakuten Smart Shopper blog for more lifestyle tips and ways to save money on your purchases.
Simple habits, such as eating a balanced diet, exercising, and getting enough sleep, are cost-effective ways to focus on your overall health. Rather than trying to incorporate too many healthy habits at once, gradually introduce one healthy habit at a time. After all, you’re building skills that will last you a lifetime.”
May 15, 2020 Continuous Glucose Monitors
Tired of daily (or more times per day) pricking of fingers to draw blood? That could be a thing of the past. With Continous Glucose Minors (GCM) no pricking is required. Products like Dexcom (www.dexcom.com) or FreseStyleLibre. Libre are some of the ones you see advertised. These monitors have a sensor and transmitter that provides for multiple reading of blood glucose without pricking your fingers. Instead of pricking your finger once, twice, or more times per day, the CGM systems let you obtain a reading as many times a day as needed. Painfree and convenient. Why is this important? In a recent article in India studies have shown that Time in Range (TIR) is a significant breakthrough in diabetes management, and could be a ‘game-changer'. Why so? Well, consider this. If you prick your fingers once or twice a day, it is possible to get a normal reading, but during the rest of the time, blood sugar could spike up and down. In other words, a diabetic person could have an acceptable reading during the time the finger is pricked, but for the rest of the day, the actual reading could be much higher or lower. A CGM could help individuals manage their sugar levels during the day by using the system to get a reading anytime for them to act accordingly.
This sounds like very good news. The bad news is that in general, most insurance will not pay for it unless one is on an insulin regiment. I tried to go thru with my Medicare program and was told that I could not qualify for insurance coverage because my diabetes is controlled with pills that I take. The cost of the sensor is around $70 with insurance, but the transmitter component lasts anywhere from 7 to 14 days. The transmitter component could cost $30 to $40 per month with insurance. The website mysugr.com has a good article on the cost associated with using a CGM.
June 21, 2020 COVID Pandemic
The new normal is upon us. With the pandemic raging and what appears to be no end in sight, life for most if not all will change. Reports of ever-increasing numbers of positive cases, and sadly, deaths, it is time for diabetics and non-diabetics to rethink their lives. Diabetics are one of the population segments susceptible to this deadly disease. It is not going to be the same for years to come.
Recently, an article authored by Sheila Johnson advises all to exercise caution in her article “Despite Loosened Restrictions, Caution Still advised as Pandemic Grows“. This collection contains numerous tips and advise on dealing with our new normal. Her article is shown below:
“As the pandemic spreads, our new normal continues to shift. And with changes happening day to day and summer on the horizon, there’s still some confusion for many people when it comes to what they should and shouldn’t be doing right now. It’s true that many states are loosening restrictions, but vigilance remains critical, especially for those with underlying health conditions like diabetes, lung disease, asthma and heart disease, to name a few.
Staying safe and healthy means getting the right information, sticking to hygiene protocol and limiting exposure to the public, even if stay-at-home orders have been lifted in your area.
The Basics
Let’s start with the most essential information currently available for COVID-19.
- How Quickly Is The Coronavirus Spreading State By State?
- Does Warm Weather Slow Coronavirus?
- COVID-19: Who's at higher risk?
- Chronic Illnesses Don't Just Stop Because There's a Pandemic
- Coronavirus disease (COVID-19) Advice for the Public: Myth Busters
Common Sense Precautions
At the moment, there is no vaccine or treatment available for COVID-19. The best way to stay healthy is to take practical measures.
- How to Reduce the Spread of Coronavirus
- 21 Ways to Disinfect Your House During the Pandemic
- COVID-19 Cleaning and Safety Products You Can Make at Home
- Consider Having Furniture Cleaned to Boost Germ Removal
To Go or Not to Go?
Ideally, if you have an underlying health condition, you should be staying at home and limiting contact with others. However, if that’s not realistic for your lifestyle you can still find ways to stay safe and healthy when you have to go out.
- How to Stay Safe at the Grocery Store During Coronavirus Outbreak
- Look to Grocery Delivery to Avoid Exposure
- Why It's Not Okay to Take Small Social Risks During the Pandemic
With lockdowns easing across the country, it can be easy to assume the worst is over, but the fact remains that people with chronic illnesses should continue to practice cautious behavior. There is no rhyme or reason to when this virus will end, and your safety and health are paramount. Continue to stay informed and prepared, keep in touch with your doctor, and look for ways to keep your stress levels to a minimum.”
July 31, 2020 Lab Work
In preparation for my next doctor's visit in August, I am very pleased with the results, mainly because my A1c curve is going down.
Here are my 2-year A1c results:
- 6/2018 6.5 Very good!
- 11/2018 7.1
- 5/2019 7.3
- 8/2019 7.4
- 9/2019 7.4
- 7/2020 7.0
I am sure my doctor will be happy to see this 0.4 drop in 10 months. All my other test results, cholesterol, kidney function, urinalysis are in the normal range. My worry has always been my A1c. In 8/2015, it went to as high as 7.6, and over the next 3 years, it kept going down until it reached its lowest point in 6/2018 as shown in the table above. Then, it started creeping up to its highest point, 7.3 in just around a year. Now it is going down and I want to keep this downward trend. Next post, I will discuss what I think was a major contributor to this trend. Stay tuned!
August 20, 2020 Doctor Visit
It was my regularly scheduled doctor's visit last week, but nowadays nothing is regular or normal. It was a teledoc discussion with my doctor. The good news is that all my blood work are good. Cholesterol, Kidney function, Urine, the whole metabolic panel. He was very happy to see that my A1c dropped from 7.4 to 7.0 in 10 months. Two reasons I could offer. One is I lost weight. In the last 3 – 4 months of the pandemic, I lost almost 10 pounds. I just ate less – no going out to restaurants to eat, not fast foods, etc. My wife has been preparing our meals, and she makes them heart-healthy. Besides, I also cut down on extra servings – rice, potatoes, etc. n preparation. So if you ask me, this pandemic has helped improve my health. The other reason is the meds that I am taking. I have been taking 1000 mg of Metformin twice a day plus 5 mg of linagliptin (Trajenta) and a similar branded family of liptin medications (Januvia, etc.). He prescribed a combination of liptin and flozin family of products (Jardiance, Glyambi). We will see how this goes. Stay tuned to my next doctor's visit.
September 24, 2020 Friend with Continuous Glucose Monitors (GCM)
I have always been fascinated with the new technology to track blood sugar. Yes, I truly believe that CGM is here to stay. In my May 15, 2020 post (see above), I discussed the benefits of CGM. Unfortunately, my understanding is that few insurance companies would pay for it unless you have a fairly serious condition with Type II Diabetes. Because my diabetes is fairly well controlled, my insurance company and Medicaid will not pay. Sad news, and I am truly tired of pricking my fingers. Although my prescription calls for pricking my finger once a day, sometimes I do it multiple times. My A1c is around 7 and my blood sugar in the morning before breakfast is between 110 and 120 mg/dL.
A friend of mine recently was approved by his insurance company for a Dexcom G6 unit. After a few days of tweaking and adjustments, it is finally working for him. There were initial “installation” issues with the transmitter not working and after consultation with the Dexcom support staff and his endocrinologist, it is now working well for him. Since the unit monitors blood sugar, one can easily see how the sugar level tracks over time. For example, when he eats, you can immediately see the effect of the food intake. This is the same for his insulin intake.
Prior to the CGM, he would prick his finger several times a day, but it does not show the trend and spikes in blood sugar levels. Spikes in the level are not good. Warning signs can be set based on the upper and lower bounds prescribed by the doctor. In his case, the range is between 70 and 200 mg/dL. Anytime the blood sugar level is outside of these limits a there is a warning sound. The unit comes with its own recording unit, but an iPhone can be paired with the Dexcom transmitter and he does not have to carry around with him the Dexcom unit.
So I had a chance for a closeup look at the unit's operation. There is a sensor (unfortunately has to be replaced every 10 days) that he applies in his abdominal area. The sensor has an adhesive that provides a strong bond to the skin. There is a special device that installs the sensor, and it is a single-use only. On top of the sensor is a special mounting plate where the transmitter is installed (the transmitter has to be replaced every 30 days). The transmitter is essentially a Bluetooth device that is paired with his iPhone. The blood sugar levels are sent to the phone and it can also be shared with his doctor.
The unit is a marvel of technology. I am looking forward to the day that this device would be more readily available. In the meantime, I will continue to monitor my friend's use of CGM, and I continue to post his progress (and success with the unit).
November 30, 2020 Sleep and Diabetes
Almost a year ago, I posted an article about sleep and its effect on glucose readings in the morning. I recently ran into another source discussing the effect of sleep on diabetes.
A CDC report shows the prevalence of diagnosed and undiagnosed cases of diabetes in the American population – 34.2 million people of all ages or 10.5% of the US population had diabetes. A whopping 26.8% of adults aged 65 years or above have this disease. Another source (mattressadvisor.com) pointed out that over 1.5 million Americans are diagnosed with diabetes each year, 86% of them experience a major sleep disorder. This is a huge number. According to this article:
“Diabetes and poor sleep are closely intertwined. When we sleep, our blood sugar levels rise. Our bodies produce insulin to bring our glucose levels back in check. When we don't get enough sleep, over time, our bodies begin to lose their sensitivity to insulin, and we become at risk for developing type 2 diabetes. Diabetics either do not produce enough insulin or are resistant to it. For them, a sleep deficit can be especially concerning. Poor sleep is so prevalent among Americans that the Centers for Disease Control (CDC) call insufficient sleep a public health epidemic.”
I did not really pay much attention to sleep and its effects on my diabetes. While my diabetes is under control with medication only, this is new knowledge from the article is an eye-opener. I often wonder why sometimes in the morning, when I wake up my blood sugar is high. I always attribute this to my either eating too much the night before or having an extra bite of dessert. When I look back, I now remember that whenever my morning readings are high (between 125 – 140 mg/dL), I did not have a good sleep the night before. The same article pointed out that in a study of over 4,000 people, there was a correlation between sensitivity to insulin and number of sleeping hours (6 hours or less). In other words, not enough sleep could make one more susceptible to getting diabetes. Or if you already have diabetes in could cause swings in your blood sugar levels.
Fortunately, I do not have sleep apnea (known as obstructive sleep apnea or OSA), but for folks with this disorder, studies have shown that OSA impairs insulin sensitivity and glucose tolerance. I strongly suggest that if you have this condition a medical consultation should be considered right away, before the condition causes more serious effects on the body.
I strongly recommend reading the article on the mattressadvisor.com link to learn and understand the effects of sleep on diabetes. And of course, a good mattress could be a big help in improving one's sleeping habits.