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TYPE I DIABETES

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About 1,4 million Americans suffer from insulin-dependent diabetes. The problem is usually discovered when the condition is very serious. It often begins quite suddenly. The person may feel fine, and then, with hardly any warning, falls so seriously ill that emergency hospitalization may be necessary.
At first, a person may overlook some of the symptoms of diabetes or think they are due to something else. Reaching for that extra bottle of Coke, one might think, “It certainly is hot today!” A person with a sudden need to urinate more than usual might pass it off with the thought, “I shouldn’t have had that extra glass of milk before bedtime.” If a child suddenly begins wetting the bed, parents are more likely to wonder about emotional problems than to suspect diabetes. Taken together, though, these symptoms spell out a very clear warning. Since each of us has about one chance in five of developing diabetes at some time in life, it is a warning we should all learn to read.
Who Gets Type I Diabetes?
Although Type I diabetes usually first appears in children, teens, or young adults, it can occur in tiny babies or in middle-aged or older adults. It strikes both sexes and is found equally among males and females. It is rare among Asians, Africans, and Native Americans.
What causes diabetes? Why can’t the body handle the sugars it needs to provide energy? What other effects does the disease produce? Before examining what goes wrong in the body of someone with diabetes, we need to know something about how the healthy body works.
The Factory Inside Us
Your body is a miniature chemical factory. While you sit reading this book, countless numbers of tiny production lines are busily turning out the chemicals you need to breathe, read, turn the page, and think.
Like any factory, the body needs fuel and raw materials. The foods we eat supply them. Starches, such as those found in potatoes and bread, are digested into sugars, which can pass easily through the walls of the digestive tract into the bloodstream, and then into the body cells. (Both starches and sugars belong to the group of foodstuffs called carbohydrates.) Proteins, the main ingredients in meat and fish, are digested into smaller units called amino acids. Fats and oils are broken down into their component parts, called fatty acids and glycerol.
All three types of foodstuffs—carbohydrates, proteins, and fats—can be used as fuel by the body. But if there is enough sugar available, the body will generally use that as fuel in preference to proteins and fats. Proteins are the main building materials of the body; they form the bulk of muscles and skin. The brain, nerves, and other body tissues contain large amounts of fats.
Generally the body uses what food it needs and stores any extras. Sugars are stored in the liver and muscles in the form of a starch called glycogen. Proteins may be changed into sugars or fats for storage, or may be broken down and sent out of the body in the urine. Fats are stored in “fat depots” in various parts of the body, for example, the belly and buttocks. If food does not contain enough materials to support all the body’s activities, the body will live off its reserves, drawing out sugar from the glycogen in the liver and muscles, then taking fat from the fat depots, and, if necessary, even pulling proteins out of the muscles.
Scientists call the sum total of all the chemical reactions that go on in the body metabolism. Chemicals called hormones act on each other and on the cells of the body to control the body’s metabolism. Hormones are produced by the body’s endocrine glands, which send their secretions directly into the bloodstream to coordinate many activities in the body.
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Posted by admin on June 15th, 2011 :: Filed under Diabetes

DIABETES: LIFE GIVES YOU NO TIME TO REHEARSE

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Once when I was talking with Al Sanders on one of his “Vox Pop” radio broadcasts, he quoted something from Ashleigh Brilliant that I often say: “My life is a performance for which I was never given any chance to rehearse.”* Then he asked, Why do you say that?”
I told him this: “Suddenly life has happened. I didn’t have any chance to prepare for the four tragedies that hit our family over a period of nine years. But I believe that when I talk to you now, I have credentials because I’ve been in the pits. I’ve been through the tragedies, but now I’ve got a lot of joy. I want to inject that joy and humor and hope into the people who are listening.”
Every day is so precious, we have no time to waste. Some days may bring pain, but we always have a choice between misery and joy. The secret is to live one day at a time and to make the right choices as you go along. Ralph Waldo Emerson was a wise thinker, and one of the best pieces of advice he ever gave the world was this:
Finish every day and be done with it. You have done what you could. Some blunders and absurdities no doubt have crept in; forget them as soon as you can. Tomorrow is a new day; begin it well and serenely and with too high a spirit to be cumbered with your old nonsense. This day is all that is good and fair. It is too dear, with its hopes and invitations, to waste a moment on yesterdays.
Л few weeks ago I was chatting on the phone with Dr. WaIter Martin about some problems I was having getting books sent to Canada where I was to speak at a Bible conference. I had been in his Bible class for years, and he had written I he introduction to my first book, Where Does a Mother Go to Resign? Over the years his tapes have also been such an encouragement to me. He gave me some pointers about how to solve the book-shipment problem, and then, since I knew he had diabetes, I shared with him that I, too, had been diagnosed as having diabetes. When I joked about our probably never having to end up in a rest home, he laughed and said, “That being the case, perhaps I should sell my interest in a rest home hack East.” We laughed some more, and I told him about this very book, which I was in the process of writing.
Ten days after our phone conversation, Dr. Walter Martin was singing praises around the throne of God. A sudden, unexplained heart attack and he was gone! Life is so fragile for all of us. How important to make decisions that count for eternity! Eternity is waiting for all of us, but if we can accept the pain that comes in this life and choose to react positively, we can avoid misery. We always have the option to choose JOY!
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Posted by admin on May 7th, 2011 :: Filed under Diabetes

THE G.I. FACTOR: ANSWERED QUESTIONS

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What sort of variation do we see from day-to-day and between people?

G.I. values show a certain degree of variability, both from day to day and between people. In non-diabetic subjects, the average day-to-day variation is 22 per cent (ie the G.L value varies by an average of 22 per cent). In people with type 2 diabetes, it is 16 per cent, but in individuals with type 1 diabetes, it is as high as 30 per cent. This means we should not expect to see precisely the same blood sugar levels after one particular food from one day to the next.

As is the case with any biological response there is quite wide variation between subjects ie the G.I. in one person may be double that in another. However, it is dear that subjects tend to ‘track’ well, giving high or low or intermediate responses on a consistent basis. In practice, therefore, foods will show the same ranking in terms of G.I. factor in different subjects.

Why are there different G.I. values for the same food in different publications?

In some instances, there is a difference between two results but it is small and not statistically or biologically important. For example, G.I. factors of 70 and 80 for white bread are not considered very different. The difference is within the error of the methodology. A difference of 20 units, say 60 and 80, is considered important in a clinical sense and is usually statistically significant as well.

There may also be differences due to variations in the food itself. Rice is a good example of this. Genetically determined differences in the amylose content of rice means that different varieties of rice have very different G.I. factors. Basmati rice has a low G.I. factor and Calrose rice has a high G.I. factor. In the early days of G.I. research, the variety of rice was not specified.

Again, the same food processed in different ways can produce very different G.I. factors. Breads containing a lot of intact whole grains will have a lower G.I. factor than normal soft white sandwich bread. Packaged breakfast cereals, on the other hand, are processed in similar ways all over the world and their G.I. factors are very similar in Canada, Australia and elsewhere.

A third reason for the differences is the use of two reference foods, bread or glucose. However, it is easy to convert from one scale to the other using the factor 1.4 (equals 100/70). For example, if the G.I. factor of a food is 80 when bread is the reference food, its G.I. factor on a scale where glucose equals 100, is 80 divided by 1.4 (equals 57).

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Posted by admin on May 8th, 2009 :: Filed under Diabetes
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DIABETES IN CHILDREN AND YOUNG PEOPLE: SOCIAL QUESTIONS

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Sometimes friends ask me to stay on for a meal at night after school, but I can’t because of my evening insulin dose. It is too far to go home just for an insulin injection.

Don’t let your diabetes routine spoil things for you. What are the options?

1.     Miss out on your evening dose that night. If it is a small dose and you are careful with what you eat and pretty accurate this might be all right. Check your blood glucose when you get home, and if it is high give a small dose of quick acting insulin before supper.

2.     Refuse the invitation and go home for insulin. Not a good idea. Even if you didn’t want to stay you shouldn’t use diabetes as an excuse.

3.     Ring up your parents and ask them to drive over with your insulin and syringe. This would answer your problem but would it be fair to ask? Only you (and they) could answer this.

4.     Stay for the meal and plan to have a modified dose of insulin when you get home. About two thirds of the usual dose at supper time would probably cover you satisfactorily, but check your blood glucose. You could need a little more of the quick acting insulin if it is high. I favour the fourth option but discuss it with your parents when the occasion arises.

I am going on a school camp. What should I do about blood tests and insulin?

The best way to enjoy your camp is to make sure you don’t have a hypo, or let your diabetes get out of control. Be prepared for activity, perhaps delayed meals and unusually late nights.

Take a good supply of syringes, an extra bottle of each insulin (in case of accidents) blood testing strips, urine-ketone strips and a good supply of carbohydrate exchanges, such as dried food, barley-sugar, other lollies and biscuits. It may be best to take the blood testing strips that don’t need a meter (BM Test Glycemie 20-800 or Glucostix).

Make sure a responsible adult knows about your diabetes and what to do if you have a hypo.

Make sure that your friends know that you will need insulin injections and may need extra food or sugar.

Divide your supplies of insulin and syringes into two packs. You carry one and a responsible friend or adult carries the other. A lost pack could otherwise spoil the camp.

Discuss what to do about blood tests and insulin in advance with your doctor. Here is my suggestion: Do a blood test when you get up. If it is low have some sugar at once while waiting for breakfast. If it is high and you don’t feel well check for urine-ketones. You could need extra quick acting insulin if ketones are positive but check in advance with your doctor how much you would give.

Otherwise have a slightly reduced dose of insulin because you will probably be pretty active at camp and need less insulin because it works more efficiently this way. Have extra carbohydrate during the day if you are very active, especially hikes or swimming.

If a meal is delayed have one or two exchanges at the usual time while you wait for the meal. Have your evening dose of insulin just before the evening meal, but reduce the dose to prevent a night time hypo.

Do a blood test before you go to bed. If it is low have an extra starch exchange to make sure that you don’t become hypoglycemic during the night.

With these precautions you should have no trouble – and your parents won’t need to worry about you either.

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Posted by admin on April 28th, 2009 :: Filed under Diabetes
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