THE TRUTH BEHIND HbA1C

Most of us with Type 1 Diabetes are familiar with HbA1C. This test shows a 6-12 week pattern of blood sugars and is widely use as a predictor and evaluation of "how well the patient is doing" by the Medical Profession. Basically, Glucose binds with the protein Hemoglobin to give us glycosilated hemoglobin. It is now generally felt that those with Diabetes should have a HbA1c of 7% or lower, but not higher since that would mean poor control with "high blood sugars".
The thing that is wrong with this type of test to be used as a Predictor of Control is that the person could have very high blood sugars (300mg/dl and above) for 2 weeks and then have very low blood sugars 50 and below( as in the case of Hypoglycemia) for the remaining balance of the month or two.
Since HbA1C shows a median or average of the numbers.....the percentage might appear as a HbA1C of 7% and the Healthcare Providers are saying "how great and what a good job you are doing" to the patient. In reality however, the person's blood sugars are fluctuating between extremes and while the HbA1C shows "good numbers", the reality is not very good. Again keep in mind that the only thing that is measured, is the average of all the numbers and not the fluctuations that can and does occur on a daily basis.

INHALED INSULIN......BIG DEAL/SO WHAT?

The approval for Inhaled Insulin by the FDA is now going to get the "Madison Avenue Marketeers" going full steam probably with the support of some Diabetes organizations and hospitals/clinics. In reality, Inhaled Insulin is geared for those (Type 2 Diabetes) who have fears and hesitancy in taking insulin(injecting) for good Diabetes control. Dollars & Cents, it is a huge market, with about 90% of people with DiabetesType 2 as potential buyers. It will by all accounts be more expensive than vial insulin already available . In addition, it is not recommended for those who have asthma and other respiratory problems such as bronchitis. It is also not recommended or children.
This Fairy Tale, is but yet another method for taking insulin, nothing more and nothing less. Where are all the new products/inventions for Type 1 Diabetes? I'll answer that, "they are on the back burner, because Type 1 Diabetes is not as profitable as Type 2 and there is a greater monetary market potential and volume for healthcare as regards Type 2 Diabetes". This is another reason why we (Type 1 Diabetes) must be our "own Doctors" and never give up on ourselves. I have no fear injecting insulin. My big fear however is meeting up with mediocre healthcare personnel who know nothing about Type 1 Diabetes.

INHALED INSULIN

Let us celebrate!! Another star for progress in the management of Diabetes. No cures, no cures.....but lots of glucose meters,lots of insulin pumps, lots of various insulins, lots of sharp needles (31G) and lots of congraulations to be had. This all points out to where on the "Time Continuum Line" you are on. As all of you know, 100 years ago, short acting insulins, let alone disposible syringes and meters were totally unheard of and unavailable. The way people with Diabetes managed their disease was with food and starvation. I am in no way implying that all these "devices" do not make the management and life easier as far as having Diabetes is concerned, but I also know, that sometime later/later☞☞ because of the "Time Continuum", the word Cure will have a greater meaning for those with Diabetes.

WHAT SEAT ARE YOU IN?

In Type 1 Diabetes, it is most important to instill in the patient(person) the foundation for education, care and responsibility for good management. This can be made possible by having good Endocrinologists available who are more interested in Type 1 Diabetes than Thyroid Disease or Type 2 Diabetes(Insulin Resistant Disease), as well as having the opportunity to avail themselves of Certified Diabetes Educators and other Healthcare providers.
From the age of 6, I was fortunate enough to meet Physicians who stressed and encouraged my "taking care of myself and in learning as much as possible about the illness so as to become responsible for day to day living with Diabetes". This responsibility is a necessary part for the patient who is the one managing his/her illness 24/7.
I use the analogy of the Driver's Seat. You and your Physician as well as other Diabetes related Healthcare providers should both be sitting in the front seat of the car with the Physician at the wheel. Never sit in the "Passenger's Seat". You have the responsibility and duty to make decisions regarding your care along with your Physician and others.
When you choose to seat in the "Passenger's Seat" you have given up your autonomy. Not very good for ideal Diabetes Management.

HOW TO PREVENT/REDUCE CLASS 5's

Class 5's is not going back to the Fifth grade, it is however how to reduce the number of dental caries that may result in sugar intake to correct hypoglycemia.
As most of us know, that the fastest way out of low blood sugars(hypoglycemia) is to ingest something very sweet. This could take the form of any liquid such as colas, honey, maple syrup and many others. Unfortunately when we are in the middle or beginning of a hypoglycemic reaction we are not thinking about our teeth or even about what to wear the next day. Our attention is (and should be) very focused on attending to our problem and how to resolve it. If we take a beverage or any other liquid, it will not only restore our blood sugar levels to where we can function again, but a "sticky" residue from the liquid will be left on our teeth. This residue usually adheres itself to the anterior(front) layers of the enamel between the gum and tooth at the margin. If allowed to remain....it can and often does create a dental condition called, "Class 5 Caries".It is the concentrated sugar that creates this condition, and the baseline of the gum is an attractive place for caries to feed on if anything sweet is found there. I found for myself, the best way to prevent this or/and reduce the number of caries is to rinse vigorously after you are feeling better or wisely, brushing your teeth. Afterall, who wants to return to the 5th Grade?

COCONUT CAKE w/A CHOCOLATE GANACHE COVERING

On the weekends, I like to go to Farmers' Market here in NYC. I usually pick up what is in season and today was no exception. I always however pick up fresh chicken and eggs (for my baking and breakfast) so that I would have them on hand for the week. My "Poultry & Egg Vendor", is a great person and will always go out of his way to make sure that eggs and chicken are put aside for me. In turn, I will bake various desserts and cakes for him and his family. I decided to bake a coconut cake with a ganache spread to it. The combination of chocolate and coconut is great.
So I got on the subway with the cake and my large LL Bean canvas boat bag that I usually fill up from the market. When I arrived about 1 hour later, I saw an empty space where his stand usually sits. I asked the Vendor next to him as to what happened? She replied, "his truck broke down on the way to the market". Feeling a little disappointed and still carrying a great coconut cake with a ganache cover, I looked around to see if I could give the cake to anyone else in the market. I decided that I would not. So, I bought some apples and potatoes before I took the subway back home. On the subway, I started to feel a little lightheaded. Since I always carry my meter with me (Freestyle Flash) in a pouch clipped to my belt, I tested my glucose as the train headed north. Sure enough, my blood sugar was 36mg/dl. I looked in my jacket for any "sweet" things and found 3 packets of sugar (coffee packets) and immediately swallowed them. A half hour later, I checked my bs again, and it was still low at 40mg/dl. I looked in my canvas boat bag and saw the box which contained the great cake that I was unable to give as a present to my Vendor and decided that, "this would be a great way to get out of my hypoglycemia". In New York City, people as a rule do not look at others too much, since so many things and behaviors are always seen and nothing is "new". I opened the box and proceeded to cut the cake. The chocolate ganache gave way as butter would, and since the cake was so fresh it cut straight through with one slice. The best part was putting it into my mouth and eating it as I rode home. I did feel better after eating a slice of the cake and I was happy at the same time. Ode to Coconut Cake with Chocolate Ganache!!

LIFESTYLE CHANGES
It is amazing that so many people would rather continue with negative Lifestyle habits than change them for a much better quality of Life. Take the case of the French woman with the facial implant. She is now back to her previous habit of smoking cigarettes. This behavior can lead and often does to poor healing by "upsetting" the blood flow to her face as well as "interfering" with foreign tissue acceptance. It is the same with Diabetes.....It is not only in taking the correct amount of insulin on a daily basis, but it is also eating healthy, exercising and allowing "positive energy" into your life. This positive energy can be in the type of friends you associate with, the type of job you do, how much sleep you get, what kind of food you are putting into your body, how you deal with stress, doing things that "really" bring pleasure and not becoming obsessed with Diabetes by identifying with the illness(Diabetic).

THE FIVE ELEMENTS

Last night I dreamt of my "departed" Sifu(Teacher) who taught me Kung Fu.
I was in the class practicing and doing the 5 Element Form in his presence. The Five Elements are the basis for Traditional Medicine and Martial Arts within China. A fusion of Body & Mind. It is the Foundation of what the Universe is composed of and everything inclusive as well.
When I awoke, my bs was 72mg/dl......Even in sleep, the body/mind is filled with Life.

HOW TO (easily)UNDERSTAND THE STOCK MARKET
The Stock Market is like making love....It goes Up & Down. When It goes up, everyone is happy and when it goes down, people are besides themselves, befuddled and betwixted. But like all in Life, "what goes up, must come down" or priapism develops.

WAKING UP
My cats get up at day rise, which here in NYC is about 6:00AM these days. When I am still asleep they become concerned as to my safety. They have on many occasions been able to detect low blood sugar levels within me and have all "rescued " me by various means to enable me to "wake up". This morning was no exception. My Alpha male cat, Willie hopped onto the bed and used his head to nudge my arm to move as well as using his head to push my face. In addition, he knocked down my alarm clock......All these actions as well as Sammy's loud verbalizations and Sara's licking of my nose succeeded in waking me up. My blood sugar was 72mg/dl..........Time for a great breakfast of noodles, eggs and fresh coffee made the best way☞French Press.

THE AGONY & THE ECSTASY

This morning I awoke screaming in pain. I do not know if any of you have ever experienced this problem, but my calf muscle cramped up on me. The tightness (constriction) produced such pain as to warrant the scream. Since I live in an apartment in New York City where the walls are very thin, my neighbor must have thought that I was experiencing profound and intense orgasm. Both verbal expressions are very similar. I take this phenomenon to be a calling from G-D, since upon waking up and checking my blood sugar(bs) I found it to be 40mg/dl.
G-D always has a way of making his presence known so we may do the correct thing. The correct thing was to intervene so that my life would be saved.

TYPE 1 DIABETES

I first want to make it abundantly clear that this site is devoted to people with Type 1 Diabetes. There is a huge difference between Type 1 Diabetes and (the other illness, which should be called and is called in some small Medical circles, Insulin Resistance Disease). As "We" all know, Type 1 Diabetes has a different etiology, different prognosis, different complications although the "other illness" does share in some of the same complications, different methods of treatment. In this too, the only similarity is the taking of insulin. There are many other "Differences", such as motivation and identity with the illness. People with Type 1 Diabetes are usually more motivated and more fine tuned in identifying the illness as an addition to many other things that make up "who they are". This is not political correctness, but common sense. It is unfortunate that the vast amount of people within the Medical Community have not yet made that distinction. Go to any hospital in any city and you will hear people with Diabetes referred to as "The Diabetic". Not only are they in error in doing this(people are more than their illness), but they are usually referring to the other illness (Insulin Resistance Disease aka Type 2 Diabetes). To respect ourselves, NEVER refer to who we are by our Illness(Diabetic), Whenever anyone in the Healthcare community calls us "Diabetic", we should correct them by saying, "I HAVE DIABETES, I AM NOT A DIABETIC", If they do not understand this, it is time to look for a new Healthcare Provider. Remember, that you are your own best Doctor when it comes to taking care of your Diabetes. Who knows your Body/Mind better than you?