COFFEE, CAKE & STARBUCKS

The Lunch Rush Hour has ended in Midtown.
I arrive and take my seat at the Starbucks along the Great Window that faces the passing of people.
The Air-Conditioner provides a comfort level mixed with the Chocolate Cake Doughnut and Sumatra Coffee that will "fix" my Hypoglycemia.
My earphones play Dylan's, "Desolation Row" as I look at all the Hominid passings from the Large Starbuck's Window.
Virtual Reality at its Finest Hour

HAIKU

Hot days and nights
No Wind
Sticky sweat with Glucose lays on skin.

FINALLY!! DIABETES SOFTWARE FOR MAC OSX USERS

As most of us know by now, there is almost ∅ amount of Diabetes related software for Mac Users, which is why I was elated upon coming across
Diabetes Logbook X 1.0b5 - Track and report diabetes related events. Since Mac does have the "best" Graphics available, why not take advantage of this feature that Developer Paul Nesfield from UK has provided. The Application is a Log Book for all T1DM persons where you can input Glucose levels, Insulin amounts, Carb. numbers, Medications (in addition to Insulin) taken, Ketone data and "Notes" regarding any Problems. It is however formatted in 24hr rather than 12 hr time (which is no big deal). It has a color code that lets you visual "see" your results in the Log Reports that are generated from 7 days to 12 months. One can also "Import" and "Export" Data. Everything is very well done. What I personally would like to have as a possible "Update" is the availability of a scatter and simple line graph as well. Currently the only representation besides the numbers Data is horizontal Bar Graphs in the Report Section. BTW this is a "Freeware"/"Donationware" which is of additional benefit to many. However, since this is a Freeware and Paul Nesfield did take the time to put all this together and make available, why not "Donate" what you are able to offer. He and the Wife must now put the energy, time and anxiety (as we all know) in the caring of their wonderful 6½ yr. old son who was diagnosed w/T1DM 3 years ago. Donations will be going to The Diabetes Association of UK.

MOMENT OF JOY

Sitting on the bed on a hot Summer afternoon with my cats who have saved my Life many times.........as we eat yogurt with blueberries together......

OPPRESSIVE HEAT OR SUMMER IN THE CITY

Do any of you with T1DM also feel extremely uncomfortable during the hot/humid Summer Days? I do know, that those with Autonomic Neuropathy because of T1DM do have difficulty in their bodies "cooling down" and adapting well to hot weather.

TYPE 1 & TYPE 2 DIABETES TOGETHER

According to Professsor Francine Kaufman, Director of the Centre for Diabetes, Endocrinology and Metabolism at The Childrens Hospital, Los Angeles, California there now exists an increase in the onset of both T1DM and Type 2 Diabetes in children. What is unusal, is that both diseases exists together in the same child. Type 2 is for the most part obesity related and can be "prevented" with good and healthy Lifestyle habits. Here is a copy of the article which I hope you will find interesting.'Double diabetes' appearing in kids

[Posted: Mon 29/05/2006]

When a child or teenager develops diabetes, it is relatively easy for doctors to distinguish whether they have type 1 or type 2. However new research has found that some young people have elements of both kinds of the condition - a phenomenon known as 'double' or 'hybrid' diabetes.

Current figures show that both type 1 and type 2 diabetes are on the increase in children and teenagers. The overall prevalence of type 1 diabetes among children under 15 is increasing by over 3% every year, while in children under the age of four, it is increasing by more than 6% a year.

Meanwhile, over the last 10 - 15 years, there has been a increase in the incidence of type 2 diabetes in young people worldwide. This has largely been obesity-driven.

Writing in the International Diabetes Federation's magazine, Diabetes Voice, diabetes expert, Professor Francine Kaufman, said that while it is usually easy to determine what type of diabetes a young person has, 'in some instances, it is not quite so clear'.



While there are a number of differences between the two types of diabetes, Professor Kaufman pointed out that with type 1, the 'hallmark' is the presence of antibodies which attack the insulin-producing pancreatic beta cells.

The hallmark of type 2 meanwhile is the combination of insensitivity to insulin and the body's continuing ability to make the hormone, although not enough to overcome the body's insensitivity to the action of insulin.

"Double diabetes suggests that elements of both type 1 and type 2 diabetes co-exist in the same person...Blurring the issue further is the fact that people with type 1 have family members with type 2 and vice versa. This means that a considerable number of people may be at genetic risk for both kinds of diabetes", Professor Kaufman said.

She pointed out that at the time of diagnosis, the doctor should of course attempt to determine which type of diabetes is present. However if the type cannot be determined initially, 'the young person should be started on insulin therapy while waiting for test results that hopefully will clarify the situation'.

For people with double diabetes, it is likely that they will need both insulin and oral diabetes medication, she said.

"We need to learn more about this relatively newly recognised condition. Since the emergence of double diabetes seems to be linked to the epidemic of obesity in young people, our focus should be on how to prevent childhood obesity as a primary means of reducing the emergence of this potentially devastating condition", she added.

Professor Kaurfman is the head of the Centre for Diabetes, Endocrinology and Metabolism at the Childrens Hospital, Los Angeles, California.

THE HIDDEN SECRET THAT ISN'T ALWAYS REVEALED

All of us know that it is of prime importance to keep our HgbA1C's in great numbers as well as the day to day readings of our glucose levels. What is not (unfortunately) discussed is how to avoid the MANY complications that affect people with T1DM no matter how great the glucose numbers are. The problem is in the LONGEVITY of the Disease. That is the issue at hand. There was a time when mortality age levels were low in comparison to today. Hence the diseases and health problems that most people now encounter were never around before. One of the many many problems with T1DM is that (obviously) it is not just about SUGAR as the villain. T1DM also raises inflammatory levels in ALL of us(T1DM), which in turn makes for susceptibility towards things such as Coronary Artery Disease and various Neuropathies. These things most Physicians usually do not discuss with their Patients other than give them referrals and limit their time to Insulin/Glucose Maintenance. How unfortunate and another example of overspecialization, time constraint and the business of Medicine. The nature of the Beast is that it is not as simple as it appears. TRAGIC!!!!

ADDENDUM TO FAT PEOPLE=FAT PETS

This is pretty much an addendum to a previous posting about obesity in animals causing Diabetes. I have recently come across more information regarding this problem. The conclusions are self-evident. Another example whereby people do not take responsibility for the good health of themselves, their children and their pets. There always exits cause and effect relationships. Enjoy the read:PET DOCTOR
Middle-age thirsty cat tests positive for diabetes
Dr. Michael Fox

Dr. Michael Fox/PET DOCTOR

Q: My cat started drinking and urinating a lot more than usual. She seemed weak and walked differently, as if on her heels. I thought it was her kidneys giving out and was in shock when the veterinarian tested her positive for diabetes. She said this is common in middle-age cats and dogs. Please spread the word.

A: Your veterinarian is correct. Type 1 diabetes mellitus is common in middle-age and older dogs and cats. It is often associated with obesity. Complications include cataracts in dogs and fatty liver disease in cats. Acetone may cause the breath to smell sickly sweet. Cats develop a down-in-the-heels (plantigrade) stance.

Early signs include increased thirst, urination, hunger and muscular weakness. Secondary infections due to immune-system impairment are common, in the skin, ear, urinary tract, prostate and respiratory system.

Regular blood tests, insulin injections and a special diet high in fiber and complex carbohydrates (and low in fat) are called for. High-sugar, semi-moist cat foods and dog foods must be avoided, even in healthy cats and dogs.

The high prevalence of diabetes and all of its serious complications in dogs, cats and people is reason for concern. In many instances, proper nutrition early in life -- no junk food (and sugar-laced cereals, candy and sodas for kids!) would save many lives and prevent much suffering.

GLUCAGON REALLY WORKS!!

Last evening as I was seated at my computer, the font size appeared very small on my monitor. That was strange, since I had not changed them at all. I enlarged my page, but still was unable to read the print. Since it was my usual time to check my glucose readings, I inserted the strip and got a ☞34mg/dl☜ reading!! I began to think to myself, how was it that I was still conscious? There was no dizziness only an inability to focus clearly. I immediately went to my refrigerator and quickly took out my Glucagen HypoKit. Inserted the sterile water into the glucose powder and injected into my muscle after the solution was shook. The great thing about the Glucagen Kit was that it began to work within 5-10 minutes and when I checked my glucose at that time it nicely climbed to 160mg/dl. Much better than when I would treat my low blood sugars with soda or sweet carbs and end up with my glucose rising to the other extreme (rebound) of 200-300mg/dl. This Kit is great because it raises the blood glucose quickly without rebound. Normally I would have eaten something sweet, but my numbers were too low and I had a feeling that they were falling too rapidly.
BTW, I do not work for the company.

HYPOGLYCEMIA AT MY PHYSICAL THERAPY

This morning while I was at my Physical Therapy appointment with my Therapist, B.....I started to perspire. Experienced in the nuances of hypoglycemia, I tested my glucose and got a 42mg/dl. I showed B the results on my meter and began to ingest six sugar packets. I told her that I would be alright, but wanted to inform her ahead of time in case I was not. The irony with all this was that here I was being treated for a post fractured wrist because of hypoglycemia about two months ago and now I am again experiencing another bout with severe low blood sugar, but this time within the confines of Hand Physical Therapy. I proceeded with the proscribed exercises and when I left after about one hour, I again checked my glucose and got a repeat 42mg/dl......How strange!! It is as if the sugar ingested had no effect, or that the physical therapy for my wrist, reduced my blood sugar even further, or (and this is the one I think is correct) my glucose was dropping so rapidly and quickly,,,,,that the six packets of sugar was just enough to hold it at the same original level. I should have taken the cookies she originally offered, but even better, drank a sweet beverage which I should carry.

TYPE 1 DIABETES GETS SHORT- SCHRIFT

At my Primary Care Physician's office there are a number of R.N.'s who give classes to those with Insulin Resistance Disease(Type 2 Diabetes) to help provide better management. I met one of these nurses in the elevator today and asked her whether her patients were compliant or non-compliant? She did not know who I was, so I told her that I had Type 1 Diabetes and find that people with T1DM are usually better motivated, knowledgeable and compliant compared with Insulin Resistant Disease. In addition, I said that we for the most part do not have a "weight problem". I went on to tell her that when I was being treated by Fellows in the Endocrinology Department at that hospital that advertises, "don't you deserve this level of care", they (the Fellows) had a mind-set and disposition into just treating Insulin Resistant Disease(Type 2 Diabetes). In so doing, people with T1DM were at a disadvantage and getting "short-schrift". All she said was that most of Diabetes (90%) is of Type 2 and so Physicians will orientate themselves in that direction. This is what I propose:
1. People with T1DM should be treated by Clinical Immunilogists rather than Endocrinologists, since T1DM is "Auto-Immune" in etiology and a mind-set/bias appears in those Physicians who are trained in Endocrinology to just "handle" Insulin Resistant Disease.
2. A new medical nomenclature should be established where those with Insulin Resistant Disease should no longer be called Diabetic or having Diabetes, since it takes away from the true meaning of the word in those with T1DM as well as the fact that these are distinctly TWO DIFFERENT DISEASE ENTITIES.

IN THE ARMS OF AN ANGEL

The other day, as I was on the 51st Street Subway Station preparing to go to Farmer's Market, I felt the common signals of Hypoglycemia. I sat down on the wooden bench and prepared to open my "trusty" sugar packs. As I was doing this a woman who was dressed up as an Angel (Wings included) began singing in a beautiful and deep operatic voice, "In the Arms Of An Angel". It was beautiful but profound as well, given the juxtaposition of the situation I was in. The train arrived at the station, the song was over and my Hypoglycemia was attended to with the help of the Arms Of An Angel.

HAPPY EASTER/HAPPY PASSOVER

At the start of these Holidays, it is important for all of us to remember that in spite of having a Chronic Illness, we still are part of an Energy that is greater than that illness. I have selected this Prayer and Meditation for All:MEDITATIONS AND PRAYERS LED BY THE HOLY FATHER POPE BENEDICT XVI ON GOOD FRIDAY 2006

COMPOSED BY Archbishop ANGELO COMASTRI Vicar General of His Holiness for Vatican City President of the Fabric of Saint Peter's

•We have lost our sense of sin!
Today a slick campaign of propaganda
Is spreading an inane apologia of evil,
A senseless cult of Satan,
A mindless desire for transgression,
A dishonest and frivolous freedom,
Exalting impulsiveness, immorality and selfishness
As if they were new heights of sophistication.a

Lord Jesus,
Open our eyes:
Let us see the filth around us
And recognize it for what it is,
So that a single tear of sorrow
Can restore us to purity of heart
And the breadth of true freedom.
Open our eyes, Lord, Jesus!

•Surely God is deeply pained
By the attack on the family.
Today we seem to be witnessing
A kind of anti-Genesis,
A counter-plan, a diabolical pride
Aimed at eliminating the family.

There is a move to reinvent mankind,
To modify the very grammar of life
As planned and willed by God.

But, to take God’s place, without being God,
Is insane arrogance,
A risky and dangerous venture.

May Christ’s fall open our eyes
To see once more the beautiful face,
The true face, the holy face of the family.
The face of the family
which all of us need.

•Lord Jesus,
Purity has everywhere fallen victim
To a calculated conspiracy of silence: an impure silence!
People have even come to believe
A complete lie:
That purity is somehow the enemy of love.

But the opposite is true, O Lord!
Purity is necessary
As a condition for love:
A love that is true, a love that is faithful.

In any event, Lord,
If we cannot be the master of ourselves?
How can we give ourselves to others?

•Everything seems over,
The wicked seem to triumph,
And evil appears more powerful than good.

But faith enables us to see afar,
it makes us glimpse the break of a new day
On the other side of this day.
Faith promises us that the final word
belongs to God: to God alone!

CHOCOLATE BROWNIE RECIPE

Ok, this recipe is for Megan, the Chocolate Goddess, and others who eat, enjoy, and relish in great food and desserts. It does not matter that you have Diabetes, Life is still to be participated in and enjoyed.
RECIPE:Chocolate Brownies
INGREDIENTS:
1. 6 large Eggs at room temperature
2. 1 ½ lbs. Good Quality Chocolate(should be semi-sweet or bittersweet or a combination). Chocolate is like coffee.Everyone has their own particular likes as to preferring strong/earthy coffee or more of a medium blend. The same holds true of Chocolate. Both Chocolate and Coffee are related cousins regarding their bean.
3. 2 C Sugar
4. 1 t. Baking Powder
5. 2 T Vanilla Extract
6. 8oz. (½ Lb) Sweet Butter Softened at Room Temperature.
7. 3 C Walnut Pieces(broken Up) (Optional)
8. 3T Expresso Powder
9. 2 T Bourbon (Optional)
10. 1 ½C Sifted Flour
11. ½ t Salt

Preheat Oven to 350F at least ½ hr. before baking. Sift the Flour and baking Soda together in a bowl. Add ½ t Salt and mix together. Melt the chocolate(first cut into small pieces) with the butter in a Double Boiler or use a metal bowl over a saucepan of simmering water.You can add the Expresso Powder if you want a Mocha Flavor added to the Brownies. I did and it tasted great. Do not get any water or steam into the Chocolate. Chocolate is very sensitive to heat and MUST BE melted slowly as you stir the bowl with a Spatula(I use a Rubber/Plastic Spatula that can withstand the heat). Keep stirring until the Chocolate& Butter have mixed together and melted. Remove from heat. In your mixing bowl, beat eggs with your Paddle Whisk and slowly add Sugar. Beat at Medium Speed till the Egg Batter has lightened and thickened. Add the Melted Chocolate/Butter Mixture which should be cooled down to the Egg&Sugar Mixture in your mixing bowl. Take your
Spatula put it into the mixture (Machine is turned off) and give it a couple of quick turns from the bottom and sides.Next, add the flour on low speed till incorporated(do not overmix). Remove bowl and stir again with your Spatula......Add Bourbon if desired. Also add Walnuts, but they also can be left out. The Walnuts should be preheated a little in a cookie sheet to bring out their flavor(DO NOT BURN OR OVERCOOK THEM).
I used a Pyrex Rectangular pan that measured 9 ½ X 13 ½. Make sure that you completely butter the pan all around as well as the bottom before adding the Brownie Mix. Smooth the top after all the mix has been poured into the pan. BAKE FOR ABOUT 50min. But you must test to see if the Brownies are done by inserting a toothpick or any other long object into the pan.If some chocolate adheres to the toothpick, they still have to bake more. At this point check for doneness every 10 minutes. DO NOT OVERBAKE. Take out of oven and cool to room temperature. Then refrigerate. Brownies always taste best the NEXT DAY after they are cooked. When you take them out of the refrigerator they will be hard. That is OK....Just leave them for a while at room temperature. Cut into slices for yourself and/family or/and friends. You can serve them with berries, whipped cream or powdered sugar in top. Don't forget the Insulin Shot. Enjoy!!!!!

CHOCOLATE BROWNIES: YUMMMMMM

I just finished making chocolate brownies using all natural ingredients, of course. The new cure for Diabetes........just kidding. But definitely will make you happy by letting it swirl around your mouth as you bite into the soft chocolate while it travels down slowly within the bottom recesses of your being. Eating a good chocolate brownie is a lot like having a good love experience. Both are to be enjoyed slowly and intensely without guilt.
The brownies are now resting and cooling before I will refrigerate them and prepare for tomorrow's relish. If they are good, I will share the recipe with all of you. Before consuming, prepare for a insulin to carb ratio, since it will be treated like any other carbohydrate.
By the way, lots of good quality chocolate is needed (I use 1½ pounds of chocolate).

HYPOGLYCEMIA IN TRADER JOE'S

I just got back from that great food store, Trader Joe's. While in the store that just opened here in Manhattn, I began to feel as if I was about to blackout and lose consciousness. I immediately searched my pockets for anything sweet and found coffee sugar packets that I sometimes carry with me. There in the middle of Trader Joe's I began to dump about six packets of sugar down my mouth with my head back so as to take it all in. The security cameras in the store must have thought I was an unusual sight to behold. What I ask you could be more of an irony? To be surrounded by great and unusal foodstuff from around the world while I am about to go under from an Insulin Reaction.Lucky there was also a "Sample Bar" in the store where I availed myself of 5 small (finger size) barbecued chicken sandwiches. By the time I got to the cashier with my shopping wagon (15 minutes later) I was OK. Carbs and sweets to the rescue again!!

OVERWEIGHT PEOPLE=OVERWEIGHT PETS

It is amazing but not unique to New York City where there is always visual stimuli present, that there always seem to be an obese man or woman walking down the street with their dog who also is obese. I am an "Animal Rescuer" and find it very sad that the pets people have are totally dependent on the care that they receive from whoever cares for them. The problem being in the kind of care that they receive, which in this case, is poor and destructive care to the health of the animal. In spite of there being numerous variables responsible for the rise of Insulin Resistance Disease(Type 2 Diabetes),overeating is a major contributor. People would rather eat foods high in carbohydrates, fats and other types of "junk" because as they reason, "I just can't help myself and it tastes good". These same irresponsible people use similar faulty logic with their pets(cats or/and dogs) by giving their animals too much food to eat. As most of us know, dogs and cats also develop Diabetes and have to be treated with insulin. They are subject to the same complications as their human counterparts such as heart disease, kidney disease and other awful neuropathies. If the owners of pets have no self-control, self-respect for their bodies, they should not pass this horrible behavior to their pets. Their animals are TOTALLY dependent on their caregivers. It is not fair to these animals because they have people taking care of them who do not know what they are doing. All of them will tell you that they 'love their pets'. However creating an illness in your pet that results from overfeeding and obesity is hypocritical and nothing to do with Love. These same people often overfeed their children as well creating more Diabetes or and Heart Disease now or for later in life.
I have had animals in the past and have them now as well. They are not overweight because I do not and have not overfed them. My animals (cats) have saved my life by helping to restore consciousness in me while in severe hypoglycemia as well as alerting me to my having low blood glucose(another story for another time).

POST BRONCHITIS

A bout with Bronchitis which lasted for two weeks is finally over minus 10lbs of body weight because of not being able to or wanting to eat anything. I guess that takes me out of the "running" to be eligible to use Exubera (Inhaled Insulin). As I previously posted, "those with any respiratory problems such as Asthma, Bronchitis as well as Smokers are not candidates for Inhaled Insulin". Anyway, it was really created for those with Type 2 Diabetes who are afraid or do not want to use a needle with syringe to inject themselves for better Diabetes management/control. As we all know, in terms of "dollars & cents", Type 2 Diabetes is a larger cash flow market than Type 1 Diabetes which is about 10%. Another example of R&D being tipped in favor of those with Type 2 Diabetes since there is more money to be made.
The irony behind all this, is that Type 2 Diabetes is "PREVENTABLE". Type 1 DM is not.

SOMETIMES THE "OLD" IS BETTER THAN THE "NEW"

The Lancets used for the necessary testing of Blood Glucose are getting better and better. There now exists on the Market a Lancet that is 33Guage (very sharp and thin). This is all very good if you are newly diagnosed with Diabetes, a young child/infant/baby or someone who still has "Virgin Skin". If on the otherhand, you have had Diabetes for a long time (I have had Diabetes since I was 6), do a great number of "Finger Sticks" and have developed scar tissue, then the "New & Great 33 Guage Lancet" is not for you. The first time I had tried one, it did not even penetrate and was not even felt. There is logic within Diabetes. The more frequently that you use sites(no matter how much rotation you do) you will inevitably develop underlying scar tissue at the point of impact, preventing very thin lancets from drawing blood. One way around this is to have a Lancing Device that has greater depth and a higher degree of force. Sounds like a Bow and Arrow to me.
So I am very happy to be able to use the 31 Guage Lancet which is able to penetrate through the tissue with just enough force.

JUST BACK FROM THE E.R.

I just got back from the E.R. after yesterday's battle with HYPOGLYCEMIA. After my neighbor called 911 at 2:00AM because I yelled at her to do that, since I was on the floor of my apartment thrashing about with the Forces of Life and Death. The Paramedics arrived and asked if I wanted to go to the hospital. Since I had drunk a good quantity of Maple Syrup and my Blood Sugar was now 65mg/dl where previously it was 40mg/dl. I decided against going to the hospital. They would have given me Glucose I.V. and taken my blood. These things I was doing myself minus the Glucose I.V.
What happened was when my BloodSugar was 40mg/dl, I decided to make Crepes with Maple Syrup to raise it up. However, Time was not on my side. Yes, I began eating the Crepes w/Maple Syrup, but next found myself on the Kitchen Floor with my plate smashed doing battle with the Forces of Life & Death from the Hypoglycemia. It must have gone down to about 20mg/dl. Since I now have Hypoglycemia Unawareness, the Falling of my BS is very quick,
Before the Paramedics left, I tested my Glucose and it was now 86mg/dl. We all felt assured that things were OK. However, an hour later my L Hand began to swell. I immediately put ice compresses on it and knew that it was related to the Fall. Since the EMT people had already left, I decided to go to the E.R. in the morning after sleep.
While waiting in the E.R. Waiting Room I heard someone coughing and sneezing. I turned in the direction and again saw that the simple implement of a tissue or handkerchief was not used to cover the nose and mouth. The person looked like a Fellow American. So it shows, that All People,including Americans (based on my comments of yesterday in the TUBERCULOSIS article) can display low class, base behavior, not caring about others or themselves.
Back to the E.R. The results of the Xray revealed a fracture of the Radius on my L Hand. So I have to wear a Soft Cast for about 6 weeks. The irony about all this as I told my Physician and Nurse is that all the long years I spent in Martial Arts, I never incured a Fracture, However my Battles with staying Alive from Hypoglycemia related to Diabetes caused more Pain (Emotional & Physical) as well as Fractures in comparison.
Eventhough I ended up staying 8 hours in the E.R. from 4:00PM to 12:00AM, Dr. Kaplan who was the E.R. Attending and Dr. Gulotta , the Orthopedic Resident were great as were Thomas and Mei my E.R. Nurses.