I’ve made no secret of the fact that I am diabetic. I have type II diabetes. On it’s own, it probably won’t kill me, though it will probably contribute to my death. Whenever that happens. In a review of what my life has been like, and what my personality is, I have no doubt that I will end up dying of something preventable. I’ve no interest in suicide, but that is far from the only ‘preventable’ cause of death. It would not surprise me to find I die in a car accident, or from doing something that I should know better than to do.
Some things that I’m pretty sure will not kill me are alcohol related events (on my part) and I doubt strongly that I will die directly of smoking related conditions, though indirect exposure may have an impact.
Pretty heavy so far eh? Sorry about that, it will get a bit easier along the way.
Back a few years ago, I realized that I weighed too much. I knew well enough that being overweight was a contributing factor to people becoming diabetic (Type II, Type I is a different set of conditions in most cases.) and in as I had lost an aunt and two uncles to the side effects of Type II Diabetes, I took action. Apparently too late. I did loose weight. I went from a high of 260 lb as I weighed myself in the morning, down to a low of 170 lb. One of the things I was hoping to see happen in the process was that I would regain some of my ability to run.
In High School I ran in cross country, and track. I wasn’t very good, but I did run. Running is also one of the things you do when you are in the Army. When I was deployed in Saudi Arabia, I started running around the towers coumpound twice a day. I had hoped that I would continue that once I got back to the states, but ‘life’ got in the way. I did enjoy running though, and when I was running, I would weigh in the neighborhood of 160 to 170 lb.
But as I say, once I dropped down to the 170 to 180 lb, I didn’t regain my running ability. I can jog about half a block, maybe a block or two if I’m not carrying anything, but that’s about it.
Somewhere along the line, my heart lost some capacity for pumping blood. About the same time I was diagnosed as diabetic, I had an ultrasound done of my heart and caratoid arteries, and a stress test, and it turns out that my heart is functioning at about 70% efficiency. I.e. about 70% of the blood is ejected from the main ventrical every time my heart pumps. It compensates for this by pumping at about 20-30 bpm higher than the ‘normal’ resting rate of 60 bpm that most people have. If we do have a limited number of heart beats to live through, I could be said to be getting close to living on borrowed time. However that’s not one of my personal beliefs. Additionally it’s only been within the past 20 years that my heart rate has become elevated, so I should have some time to go.
When the results of the ultrasound came in, my doctor suggested that it looked like I had experienced a heart attack at some point in my life. A normal cause of loss of function for the heart is a heart attack. However after my stress test, my cardiologist (I should set up an appointment with him soon as well) noted that while it’s true that I do have reduced function, he does not see any indications in the ekg or the stress test that it was related to a heart attack. We shall see what comes up after I have a followup with him (or another cardiologist.)
One of the reasons that this is of interest, is that simply because I am diabetic, I have a 50% higher risk of dying of heart failure than people in the general population. Another reason to take interest in this is that one of the varients of one of the medications that I take for Diabtes has been linked to heart failure for people with congestive heart disorders. I am not taking that specific medication, however Actos is in the same family, and while the study did not show a strong corelation for Actos, my doctor is concerned, and I understand that concern.
When I visited my doctor about a month ago, I had been off all medication for the better part of 8 months. My fasting blood sugar reading was 280 by the finger stick test, but the lab test showed a reading of 320. Note that a ‘normal’ fasting reading is under 100 milligrams of glucose per decilitre. Just reading over 120 two times is sufficient for a diagnosis of Diabetes. I don’t think I’ve had 2 fasting readings under 120 in the past month. For the purpose of that statement a ‘fasting’ reading is a reading that is taken more than 8 hours after my last meal. A contributing factor to this situation is that when you have not eaten for some time, your liver goes into starvation mode, and starts converting fat into glucose and dropping that into your blood stream.
As most diabetics know, one of the log term indicators of good control over sugar in your diet is what is usually called an A1C test. The way this test works is that red blood cells are ‘damaged’ by excess glucose in the blood stream. Your bone marow produces red blood cells, and they have a 90 day lifespan in your blood stream after which they are filtered out by your kidneys and ‘pissed away.’ the A1C test takes a snapshot of the damage to the red blood cells in a blood sample, and assigns a ‘damage’ assesment. I am not sure how most people consider the number, but if you think of it as a loss of carrying capacity for oxyogen in a blood cell, we can work with the system. ‘Normal’ blood sugar levels will introduce some damage to the red blood cells, The value is between 5% and 7%. When I visited my doctor, the value their equipment at the clinic was able to report was >14%.
I don’t expect to be getting an A1C evaluation done when I visit the doctor this time. If I do, I do not know if it would be meaningful. Oh, it might show a reading of 12 or 13%, which might back up the testing that I have been doing for myself, but it is not a given. The damage to blood cells over the period of the 2 months prior to my last visit doesn’t ‘improve’, though it should be ‘lesser’. The problem with that sort of an assessment is that it took about 2 weeks for me to get what I would call my daily average under 200. And I still spike over 200 after meals. That may improve depending on the medication that I start taking, but the most promising medications are some that I very likely won’t be getting, as they are the most expensive, and their long term side effects are still unknown. One of those may help with my overnight blood sugar rise, as it basicly tells the liver to hold off on the conversion of fat to glucose. It appears to be doing wonders for the son of a co-worker of mine.
I do wonder at times if having liposuction would help. The logic behind that is that one of the reasons that people become type II diabetic is that fat cells appear to be doing what they can to stay in shape. (I.e. stay filled with fats.) They do this by increasing the bodies resistance to Insulin. (Called obviously enough insulin resistance.) The question becomes if someone looses half a liter or so of fat cells via liposuction, (that’s about a lb of weight, but a quarter of the volume of a 2 liter bottle) does their resistance to insulin go down noticably. The supporting question would be what varieties of fat or other body cells increases the resistance of the body to insulin. If the predominate variety of these cells is those around the abdomen and legs, then a reduction in the number of these cells fhrough liposuction may have a positive influence. On the other hand if it is the variety of fat cells that are within the muscles of the body, then while the total fat cell volume goes down, the percentage of fat cells increasing insulin resistance goes up. I don’t think this would have a specifically negative result, however not having a positive effect would tend to be disheartening to many people.
Am I ‘getting better?’ Well that depends upon what you consider to be ‘getting better.’ I am not expecting science to come up with a magic bullet to cure type II diabetes. The best that I can hope for there is to ‘control’ my blood sugar levels and over the long term hopefully the damage to my body will be reduced. Some of the side effects of diabetes includes taking longer to heal damage to the body. Some damage will not ‘heal’ of course. If you tear a tendon off of it’s bone or muscle, it doesn’t self correct. The best you can hope for is that you get surgury done to reattach the tendon with stitches. However some of the other side effects of normal ‘wear and tear’ to the body do ’self repair.’
As an example, when you work out at the gym, walk or run, one of the side effects of the workout is that in burning the sugar in your blood, your muscles generate lactic acid. This acid ‘damages’ the muscles, which is why a day or two after a heavy workout, your muscles get sore. Likewise most of use experience scrapes and cuts from day to day that scab over and we go on, and a week or so later the scab falls off and we have a light scar there. The effect of Diabetes is that your body’s repair system does not work well in a high sugar environment. So a diabetic with an uncontrolled blood sugar level will spend more than a couple of days with those sore muscles, it may be weeks or longer. Likewise scratchs may never seem to heal up.
One of the first thing that people who have been living with uncontrolled diabetes discover after getting their blood sugar under control is that the scabs that just wouldn’t go away finally do. Doctors and nurses who were working with me when I was first diagnosed with diabetes said that I was going to feel much better. In part this would have been due to muscles finally repairing, but also joints swell as the body works to get the excess sugar out of the blood stream into other places.
My first obvious experience was that I didn’t have to ‘pee’ all the time. But I never really felt bad when I was first diagnosed with Diabetes. At least not in the muscle aches, back aches, joint problems varieties. This time, and a few other times when I know my blood sugar had been elevated for some time, I felt it in my lower back, and I am still feeling issues with one of my arms that I’m expecting to see some improvement over the next month with. Though I will discuss it with my doctor tomorrow.
In the sense of not feeling that pain, yes I am getting better. Still some ways to go, but that is likely to be the case for some time. So my response is ‘Yes, I am getting better.’
I hope you are too.
