Try to "get closer to tighter control."
We Agree on that one Lizmari!!
God Bless,
Brunetta
Damage is possibly done well before diagnosis … type 2 , may live with diabetes , without a diagnosis for an average of 7 years …Oh, Tim , I just read , what you added .
I am clear…I will continue my best with handling diabetes , to make my life the best for me and those around me , regardless of my genes .
My hubby of almost 80 likely has some " damage " and he does not have diabetes.
As long as you do the best you can, in the end, that’s really what matters, Jennifer…
I am just saying, in as much as we can… (which you are doing, and doing really well, and should not feel badly at all) we need to get as close to control as we can.
We don’t know if we will be unlucky enough to get complications, but what we do know is that the higher the constant blood sugars, the higher the likelihood of getting complications… and if it’s in our power to make some simple changes to lower that, why risk it? (And yes, some people DO risk it… willingly… because ‘nothing bad has happened yet.’ There are plenty of people like this… They are always shooting for 180, whether or not they can easily make a 140… If they even measure their blood sugar, at all… Hell, there’s even a member of our community who’s always shooting insulin, blindly, not even testing to know and see where he’s at… Scary as heck, if you ask me…) That’s the whole point of our care routine… striving to achieve as much control as we can.
Good post but I also think it is dangerous to say this will definately happen or that will definately happen. It scares a lot of people and stresses them out and stress and depression also effect your blood sugars.
From your post, yes, it sounds like blood sugars will always have to be under 100 in order to avoid getting complications. But as I read the stories of the long-termers here - that doesn’t seem to be all cut and dry. Everyone is sooo different and you can’t really say what is or what is going to happen to someone.
When I first found out I had D, I talked to a lovely residency doctor friend of mine whose mom has diabetes, she told me that it takes years and years and years of uncontrolled blood sugar for any complications to start developing. She, for the most part, said that you would have had diabetes for like 20 years and NOT know it (meaning not being on any meds or checking your sugars, trying to control, never having any low numbers, or knowing and just ignoring it etc) for the serious complications to start developing. Even though she is not studying to be an endo, she worked with hundreds of diabetics and did lots of research so I felt pretty comforted by her words since she has the experience. I know i haven’t had this for no 20 years - my guess is a year or two at the most but not no 20! (I have had blood work since at 5 or 10 years prior to this).
This does not mean I don’t try to keep my numbers low - I am lucky to have numbers mostly between 70 and 100 for most of my readings and I have my diet and the Metformin to thank for that. This is before and 2 hour testing. At beginning I had some highs until the Metformin started working its magic, I have had a few 110 to 118 numbers a week ago at 2 hour testing - but I was pre-menustral and I think that was from that (blood come today - numbers are down again). So, I thought I was doin’ pretty good - but now my few higher numbers, even 110 are bad??? So us women may always have some higher numbers because of hormones - we can’t control that - does that mean we are doomed to have our legs cut off one day? Ugh, this is bad thinking.
Also what about those non-diabetics who they say if they eat a big meal may occasionally have a rise to 120? Are they also on their way to definate complications even though they are diabetic?
I do agree we all should keep our numbers as in the normal range as possible. But sometimes I will eat something that one day will give me a nice normal low number 2 hours after and than eat the exact same thing another day and the number will be a little higher. How can I always perfectly control this? I don’t think I can always control it as there are other factors going on in my body that I can’t always control - the chemistry in it changes day by day depending on many different factors… But if I freak out everytime the number isn’t completely perfect that is not good for me either. And sometimes I wonder if the fear and stress that we experience worrying about the numbers is worse than some of the foods we eat. And if doctors really knew everything about this disease and could predict how it will effect everyone in the future exactly based on some high numbers - you would think they would be able to come up with a cure already or at least an ulimate control for all.
Anyhow, just my 2 cents…
I don’t mean to sound stupid but… I’m not sure if I believe this in it’s entirety. Our blood sugars fluctuate every hour. In addition, high blood sugars can be caused by almost anything…
- Stress
- Fear
- Injury
- Surgery
- infections
- Flu
6a. Cold Meds - Sleeping
- Woman’s monthly cycle
- Steroids
- Drugs
- Coffee
- Hormonal Changes
- And a host of other reasons
I really think that this kind of information is can be counter productive, as it can cause people to become either scared, a fanatic, or possibly under-nourish themselves trying to live up to these cookie cutter numbers. I still say life would be easier if we just focused on our A1C. Even the best diabetics with maximum control experience spikes.
I think the point is that target rates given by medical professionals are too high. Targets are just goals & our goals need to be reviewed.
Focusing on A1cs gives a narrow view since it’s only an average. Other than a general overview, they don’t give us enough info. An A1c can look great on paper, but says nothing if someone’s swinging between highs & lows. Take 10 people with exact same A1c & they’ll have 10 different levels of control.
Yes… That is very true too…
Hey John,
Do you have any links to the studies you mention? I’m a bit of a nerd and like to look at journal articles when I can.
Thanks!
Here you go…a good summary and links to articles:
then why do my doctors tell me I am doing great when my aic is 7.3??? obviously it is much over the desired 100…how do I get CGM’s or pumps. How do I get my bg down post meal. my biggest problem.>> I take lantus and novolog. Now totally feeling like I am losing the goal…whew…:BUT I TOTALLY APPRECIATE the information…would like to see source of these stats… would you have an article or link? I would like to place it squarely under my doc’s nose… with a big red READ sign on it. Thanks, Pam
The beta cell toxicity stuff would affect mainly type-2 diabetics. Type-1s and LADAs don’t really have many beta cells left anyway and so it is moot to discuss beta cell toxicity for us. However, it is important to prevent nerve damage. And as long as you can be below 140 mg/dL at the 2-hour mark after meals, your nerves should be fine. I have updated my post with a link to the research.
I just skimmed this link. Fascinating information. Would like to see a follow-up , larger study about the “spikes” and nerve damage…I understand where you are coming from… But diabetes is so individualized , it is hard to say what will or will not happen to all diabetics. So many factors, so much to read and research…
God bless,
Brunetta
Thank You Sweet Robyn , it is wise to stay cool and calm , when one reads about posts , what diabetes can do to us and continue to do the BEST we can , most of the time .
Thanks, John. I was aware of this site but forgot about it, duh.
Sadly, most doctors don’t have particularly high expectations of patients. They’re also justifiably concerned with lows because they could be held liable for lows. Potential long-term damage from highs is not a liability issue. It also takes a lot of time & effort to educate patients to fine tune doses to get better results. Logs have to be carefully reviewed for carb intake, dosing & time of dosing to help target where the problems are. Doctors don’t have time.
To help lower postprandial–lower carbs, adjust insulin, change time of insulin, keep careful records so you can make slow adjustment based on logs.
Your doctor, if he/she agrees, will give you an Rx for a pump & CGM & set you up with training. Check your insurance to see what they cover.
FWIW the complications can develop even with tight control. I’ve probably had average control (7-8) for 35 years. I know back a decade ago I was running highs religiously. Until I learned the carb counting thing I was much more all over the place. My last endo told me that he believes a lot is in your genetics as he informed me that he had some long term diabetics with not great control who avoided complications and some that started getting things after 10 years with rather tight control. If your gonna flip out every time your sugar goes over 140 you might as well call it day. I’ve read an more recent article that stated even the most careful diabetics are only in normal 80-120 range about 30 % of a 24 hour period. I don’t use an endo anymore as I found a local doctor that specializes in diabetes care and she says “do what works best for you”. We are basically our own doctors anyway.
Well this all maybe true, just as It makes sense to me, if a non D never goes above 80’s, then neither should we.
Butt, inorder to Not go above 140 at Anytime, let alone at 1 or 2 hrs takes quite a bit of knowledge and experience…
I have ave staying Under 6% for quite a few yrs, thanks to the newer test meters, being allowed to have 250 test strips a month and the newer Insulins and the Knowledge to go with how to use them… last few yrs been ave 5.8% A1cs using MDI…
But, Just because you have a CGM or even id You test every 2 hrs after meals as I do, I’m lucky to be under 140 75% of the time, but the other 25%, not so much.
Thus Having enough Test strips is in order …like needing from 10-12 a day and you’re talking 300-360 a month… Which for most, ain’t gonna happen…
Then there is the Matter of Weighing all your Food, having the Right Carb Ratios figured out for all the different types of food ( My Ratios are different for different foods)
Then Having a Correction Bolus figured out for when you are at or above that 140 at 2 hrs and then it normally takes another 1-2 hrs for it to take effect…
And with CGMS, etc not being that accurate and very expensive?
I think , with the currrent technology and the limited Amt. of expenses Insurance Companies are willing to spend? Including those On Medicare… It’s not feasiable for the Majority to achieve keeping their BG’s under this # a Majority of the time.
Especially since the vast majority are lucky to have 7% A1c’s , let alone get 5% as we need to have…
And as for Not going to bed when at or above 150? I agree, I strive for my range of 90 at bedtime and am lucky to have that 5 nites our of 7, but the other 2 nites? Not so much
And I think there is too much emphisis on controling our BG’s and not enough on what else causes our “complications”… Since there are other issues at play… But, since Controling our BG’s is about the only thing we can do, that is what we focus on… the rest, as for Gene’s, and our DNA is upto Sceince to solve… we can’t on our own… Our Predessors having T1 and were lucky to ave 175’s all the time at best living 50-75 yrs tells me there are other things at play controlling our destiny…of who gets what and when…and not just having Good BG control…
This is very bad news to me… Not sure how I can keep a 13 year old’s blood sugars in such a tight range… I know I can’t. But will have to modify targets where I can.
Children routinely spike to much higher numbers after eating or during growth spurts. 140 would be considered a minor spike. So I will bang my head against the wall as well. Very depressing news… and I am not doubting the study. Only thing I can do is tighten up on the targets a little when I can. Giving enough insulin to get her to 150 two hours postprandially is the best I can do. I often can and do get her lower but then you are feeding the insulin on board which will bring the numbers back up again. Without a cgms on all the time you can only rely on your formula for covering IOB, such as cover each unit IOB with 8 grams of carbs. Which will raise her back up, briefly, 40 points. With cgms on you can play beat the clock and with cgms on you really can see it is “beat the clock” as you feed carbs and still have two arrows going down. Really, you cannot win… Just have to do the best we can. I do believe damage is done to your body just by virtue of having Type 1; I do not believe it is as simple as keeping good control of your blood sugars at all times… which is impossible to do. There is a lot more at play here. Clearly there are people with very good control who suffer complications and people with moderate or poor control who do not. Must find a cure for this &&&&&& disease.