Diabetes monster bites again!

Diabetes Advocacy Self Advocacy
1

Well,

Not a good day for Buckley!

Started off well, got my lab results from my last HbA1c 5.9%, first ever foray into the 5% club, this was after a pump malfunction and resultant ketoacidosis several weeks ago which caused a long wave of high blood sugars. So the 5.9% was a nice surprise.

So I stand there being self congratulatory "Well done Buckley, you've got this diabetes thing licked,see all the effort over the years has paid off blah blah, you are walking, talking artificial pancreas of a man"

I look down to see a letter on my door matt,

"Dear Mr Buckley,

Unfortunately your recent diabetic eye screening has indicated Diabetic Maculopathy, further tests are required, potential treatments included laser therapy, injections may need to be discussed etc."

Back down to earth with a bump!

Eye site complications are one of my biggest motivators for tight control so to say I'm abit annoyed is an understatement.

I sat with the technician who did the tests two weeks back and we looked through the images of the back of my eyes together, they looked fine, previous early retinopathy had healed was no longer visible.

The tech even stated they were the healthiest eyes he'd seen on a long standing type in a while. Vision was fine, could read the smallest letters on the snellen chart easily.

No bleeds, no floaters, just a minute dot of what looked like exudate and the sheen that young people have in images of the eyes had faded quite markedly from last year, so I left feeling a little old, mourning my wasted youth, but certainly not fearing diabetic maculopathy.

I really wasn't expecting this letter! I'm hoping it's nothing too serious and they are just being proactive as I know the screening programme here is top notch.

Anyway screw diabetes, my fault for letting my guard down!

Some questions for you guys though.

I'm 31,devastatingly handsome,modest,control is pretty tight. Postprandial/standard deviation could be tighter. Intend to get a CGM and play around with bolus timings to improve here.

Type 1 for 20 years, teen years were rubbish, always took my jabs, tested once a day, average HbA1c 7-8.5. 8 years ago, I started reading Bernstein and Schneider, got a pump 4-5 years ago, grew up HbA1c has been great for the last 7 years.

I'm pretty active, do my 300-400 minutes of cardio a week, resistance exercise four times a week. Resting heart rate is around 50bpm

Eat pretty clean, only issue I seem to have is my blood pressure is a higher than I would like, Stage 1 hypertension a few times during the days 130/90-150/85 quite often. Other times it's fine.

I know high blood pressure is a risk factor for maculopathy, so other than low sodium, exercise, what else can I be doing to lower my blood pressure.

Should I really be considering blood pressure medication at my age?

Could it be genetic?

I do find the world an infuriating place, perhaps mindfulness meditation or joining the priesthood?

Any advice greatly appreciated.

B

2

I take Lisinopril, I have for years, buying the "perhaps it reduces your risk of kidney damage...". When I was heavier, c. 2004, my BP reached something like 180/100 but I lost weight and it seems to run about 120/70 these days which seems ok, although still taking the Lisinopril.

I've had pretty tight control since 2008, or even a bit longer than that, am 47 and have had T1 since 1984 and had 3 bleeders at my last ophthalmologist appt. Actually, they saw them at the optemitrist I'd gone to the year before and said "go see a specialist" and I asked them "what would they do?" to which the optometrist said "nothing" so I figured I'd get around to it and went about a year later. The opthalmologist also said "well, 3 way off the macula like that, we don't do anything. If there were like 100, we'd do something, laser it but not for 3." I asked her if I should eat kale or spinach and she said "well, yes, because they are good for you but that doesn't do anything for this..."

Good work on the A1C mate!!

3

I've dropped about 25kg weight over the last few years, body fat is quite low at around 15%. But still a big guy at 190cm/95kg. Hmm maybe I should get to running more and attempt to lean down further drop some size...

I'm completely ignorant when it comes to blood pressure meds, they seem to get quite a poor press due to side effects. I'd have no issue taking them if they helped lower my blood pressure though. So I might have the discussion with my GP.

4

I wouldn’t delay treating hypertension; it’s not worth the risks and further complications to do so.

5

Agreed GP appointment made.

6

So I started on 10mg of lisinopril yesterday blood pressure was 110/72 this morning! Down from 156/93 the day before.

Probably should have started a while back I think.

Did you notice any side effects when you first started, what dose do you take?

7

Hi Buckley,

Sorry you had that news I would get another opinion about your eyes before doing anything. I take losartan daily to prevent kidney damage even though I have good bp. I would definitely go on a bp med if you have hypertension. Diet and salt reduction aren't enough and we are at risk for a lot even without high bp. My eye doc(retinology and D specialist) checks bp at her office each visit. I think one of the doctors I saw said bp meds won't help eye problems as much but I don't see why it wouldn't, that doesn't make sense to me. I don't seem to have bad side effects from losartan and it doesn't seem to have any effect on my bp, like lowering it, which is good since mine is normal most of the time even when I'm stressed or have high bg.

8

I’ve done 10mg for years and don’t notice any side fx.

9

Hi,

Yes I started on 10mg of Lisinopril on Friday 13th ;) no side effects that I can notice. Although I feel alot more relaxed and have been sleeping straight through the night, usually I wake up every 2-3 hours without fail. Probably psychosomatic!

Average blood pressure based on 3 test a day over the 3 days is 110/70 so it works.

I am awaiting a referral to a specialist, I'm hoping the letter was just a generic one they send out regardless of severity. I've had a similar letter before and that was a small bleed which has since healed. So fingers crossed it's nothing serious.

10

Just started on the same, already but my average blood pressure down to 110/70. So seems to be good stuff.

Dr's are being quite thorough and requesting I submit for an ECG, provide a 24 hour urine sample and two lots of blood tests! Wanting to rule out some sort of adrenal tumour..

I need to go to one of those stress reduction anger management junk yards where you can just smash on cars with sledge hammers and baseball bats for an hour :) That or find enlightenment.

11

Yoga is great for that Buckley! We've had classes at work for a couple of years now and I'd gone to a few other places and always feel better after a session. I've had 3x out of body experiences in Shavasana at the end of class, 2x outer space and one cookies and cream.