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TRYING TO AVOID DIABETES COMPLICATIONS

The Diabetes Health magazine published an article stating that diabetics should maintain a good BG average and A1c, and avoid a roller coaster type of control. The roller coaster type of control involves having many highs and lows, and that would involve data widely scattered above and below the average. Blood sugars that rise and fall on the path of a roller coaster are a shock to the body. Experiencing this shock over a long period of time can lead to diabetes related complications, even if the A1c is good. I will demonstrate with two examples.

Patient 'A' has test results 40, 55, 65, 100, 135, 145, and 160. The average is 100, but there are numbers that indicate unhealthy highs and lows.
Patient 'B' has test results 72, 80, 94, 100, 106, 120 and 128. The average is again 100, but the data is more closely packed, and none of the numbers are undesirable. Patient B is experiencing much better control, and is much less likely to have diabetes complications.

The purpose of this discussion is to discuss the fact that a very good blood sugar average can still involve diabetes complications if there is a significant number of highs and lows over a long period of time. Don't rely solely on a blood sugar average and A1c. Try your best to avoid so many highs and lows. A good average accompanied by a stable control is the best way to avoid complications. Proper dieting and well chosen exercise routines can help very much in avoiding the highs and lows.

I had A1c's less than 6.0 for several years, but had the beginning stages of neuropathy and retinopathy. My control had been tight, but it was necessary to make it even tighter. I stopped having so many highs and lows and after a few months had passed, the retinopathy disappeared. The neuropathy is still present in one foot, but I rarely experience any pain. If I have high blood sugar for several hours there is sometimes mild pain during the night. I have been a diabetic for 66 years, and have not had any serious complications. I want to keep it that way!!
 

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Don't get me wrong Richard, I'm glad you are on very tight control, but even you will run into problems some day thats life, sounds like to me you are letting the Diabetes run your life.

What do you class as serious complications
 

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I am one who believes in tight control, too. Since I rarely go lower than 90 I never have a lot of lower bgs to average out higher ones. So I try to keep bgs between 90 and 120. I'm hoping this is enough to prevent complications in the future.
 

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you will run into problems some day thats life
Why is this true? My understanding is that diabetic complications come from high bg, full stop; if you tightly control your bg (A1c below 6 and no spikes over 140), you shouldn't have complications. This is wrong?
 
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I don't believe it's wrong, WV Mom, I think it's a very practical way of dealing with a situation that can get out of hand way too quickly if ignored. If we don't take responsibility for our own sugar levels, nobody else will.

Richard is not just lucky; he will be the first to tell you he has encountered a few snags in his lifetime, but he has taken the trouble & done the research to find solutions and incorporate them into his routine. I do not believe in "that's life". I believe life is what you make it. If we insist on continuing our merry unfettered way, then we'd better prepare to go blind and hobble around on stumps.
 

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Don't get me wrong Richard, I'm glad you are on very tight control, but even you will run into problems some day thats life, sounds like to me you are letting the Diabetes run your life.

What do you class as serious complications
More to the point, what do YOU consider serious complications, Will?
 

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Discussion Starter · #7 ·
Will, diabetes does not run or ruin my life. With my good control and no complications I have run diabetes OUT of my life, at least it seems that way.

If diabetics deny or ignore their diabetes, then complications are highly likely to occur. Under those conditions they have indeed let their diabetes run their lives. Diabetes is the leading cause of blindness, and amputations in the US. It is also one of the leading causes of kidney failure. (Maybe it is the leading cause of kidney failure, does anyone know?) The leading cause of death among diabetics is heart disease. It is the number seven cause of death in our country.

Don't let your diabetes run your life, Will. YOU run your own life and don't let diabetes stop you in any way.
 

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I believe you can choose to have a healthy life even if you are diabetic. Of course that mean you cant just live your life like you did before D and eat and drink whatever you want.
Or you can choose to live your life exactly as you did before D and just ignore it, but usually you put yourself in a high risk for getting complications.
And you can have bad luck even if you really try to live healthy.
I was diagnosed with Polyneuropathy last week although I do my very best to control my BG.
I was told since I have hypothyrodism, psoriasis, diabetes and is really, really low in vitamine D I would have had extremely much luck if I were able to avoid this complication even if my A1c has been fine after the first month were I got A1c down from 12,6 to 6,3.
 

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I definitely agree with "no highs and no lows" (it's in my signature after all), but doubt if that is sufficient to prevent complications and I want to do more.

The agent of complications is glycation. High blood sugar causes glycation. However a much more potent agent of glycation is methylglyoxal which does its dirty work WITHIN the cells (so measuring circulating MG is probably irrelevant). I believe this is why the body responds to too much glucose with insulin resistance.

Methylglyoxal is a by-product of the SUCCESSFUL utilization of glucose within the cells. As such, the amount of MG present is directly proportional to the amount of glucose successfully metabolized. What we measure with our meters is the amount of glucose NOT (or not yet) successfully metabolized.

For some reason, those of us with the "predisposition" to diabetes either produce more of it than others, are unable to purge it effectively or are more sensitive to its damaging effects - or some combination of those three.

Anyway, since MG is a much more potent glycating agent than high blood sugar, the body opts via insulin resistance to refuse much of the glucose - at the same time sending a signal that you need to quit dumping so much into your blood and find other sources of fuel.

So, my objective is not just reducing blood sugar ("overflow") but more importantly reducing the total amount of glucose I am processing. I can actually get slightly lower numbers by processing a little more glucose but I don't believe it is better.

If I eat a little more glucose producing foods regularly, my pancreas gets stimulated and I usually go to 73 - 83 waking and between meals. But when I am on my "optimal" diet, in full ketosis and procesing as little glucose as possible, my fasting tends to average closer to 90.

As much as I love little numbers like 73, I believe this is a better scenario. It seems that my body adjusts to the tiny amount of incoming glucose and learns to "conserve" a little better in case of sudden need (by those 5% of cells which can only use glucose).

So, it is my belief that the way to prevent complications (and progression) is to minimize TOTAL glucose, not just the measurable overflow - which of course is the FIRST step.

And I don't believe that complications (or even progression) is "inevitable". I hope to give a positive report on that in 20 years or so!
 

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Salim, I have noticed the same thing. If I choose to eat sprouted grain bread or a few more carbs it will force my pancreas to produce more insulin giving me lower bgs. But like you I am not sure this is good. By not eating these things my fasting stay in the 90-100 range and stay there most of the day. My highest numbers of the day are usually late morning from hormone production.
 

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Yup. Isn't it great that we have this opportunity to share things like this? I suspect that overall my average is probably as good or even better when on my "optimal" plan, but I haven't gotten enough measurements to be sure yet. It does seem like when it only goes down to 90 instead of 73 it doesn't go as high PP, either.

I noticed you talking about being in a very narrow range and I suspect that may be a better condition than the lowest possible numbers. This would be true if my theory is correct that MG is more damaging than BG, within tolerable numbers of course.


Salim, I have noticed the same thing. If I choose to eat sprouted grain bread or a few more carbs it will force my pancreas to produce more insulin giving me lower bgs. But like you I am not sure this is good. By not eating these things my fasting stay in the 90-100 range and stay there most of the day. My highest numbers of the day are usually late morning from hormone production.
 

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I live between 70-90, seldom go past 100. on rare occasions. I also read a good bit about MG and glycation in general. I was taking a supp. L-carnosine which is suppose to prevent glycation. Need to redo my CHL to know if it has worked or not. I also believe complications are a result of lack of control and or high insulin levels along with high BG levels.
 

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For some reason, those of us with the "predisposition" to diabetes either produce more of [methylglyoxal] than others, are unable to purge it effectively or are more sensitive to its damaging effects - or some combination of those three.
So I go to research this, and one click leads to another, and next thing I know, I'm staring at the Amadori rearrangement, which I had to memorize a zillion years ago to understand carbonyl-amine browning, or "why baked bread gets brown."

There's a joke in here somewhere, but I can't quite find it. The Amadori rearrangement occurs within baking bread. The Amadori rearrangement occurs within our bodies. We're like big loaves of bread. We can't eat big loaves of bread.
 
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Greetings, All! Dwayne, here!

You all add interesting perspectives; but all my complications are already out-of-control - including my roller-coaster blood sugar levels! Eat this, eat that ... that's what you really need. I can't eat anything fibre, low-carb, or raw - that I used to enjoy eating before; and it is all because of the way my diabetic neuropathy has spread throughout my body and all its systems. My bowels are so messed up, I need to take 4 different stomach pills just to keep food down, and get it processed through my body. Then there is the adventure of whether I'll even be able to swallow it - no matter how well I chew it, or how long I blend it - Since the neuropathy keeps screwing-up my epiglottis; so I don't end-up choking on something as basic as my own saliva! Plus we have the neuropathy creeping into my brain, now; so - at age-50 - I am showing signs of early dementia. Not to mention how the neuropathy is affecting my already advanced kidney disorder, my aschemic heart disease, my cardio-vascular disease; plus the general pain it adds to my arthritis (throughout my body) and the scoleosis that has twisted and compacted the lumbar section of my spine into something resembling a twisted, knotted, wrung-out towel. I can barely eat; and what I eat, I have little appetite for. I can barely move, without falling down from my legs/hips not obeying my brain; or from my chronic dizzy spells - the deterioration of my mobility has increased faster and faster, over the past 3-5 years, than the doctors can keep up with.

I'm terrified of needles; but need to take large doses of insulin 4-times/day. I have several other anxiety and PTSD-related diagnoses; and have suffered chronic headaches (3-4 different kinds) since the age of 5.

But I get up; and work my way through each new day of pain, because that's the only way I know how to do it. And, I'm not saying, none of the rest of you have it hard, either (also?) ... anyways, I'm just adding my perspective.

So.... now, how was your day?

Dwayne
 

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Dwayne: Wow. Sorry to hear your story, but sure puts anything I could possibly go through in perspective.

This whole discussion is really interesting. Reminds me of the arguments about exercise: Which is better, continuous light-to-moderate exercise, or long days immobile at a desk followed by marathons at the gym?

Also, it's something I've been wondering about. Back in June I was freaked out because I had bouts of reactive hypoglycemia. I've since discovered that my BG won't go below 70 (or maybe 67 at the lowest), so there's no need to freak out, but I did wonder how healthy those roller coaster rides could be.

Now I'm low-carbing it. I rarely have a spike followed by a crash anymore; the fat keeps things level. Unfortunately, it often keeps things high; if I go to 180 or 200, it will stay for 2-3 hours and not get back below 100 ever.

So I wonder which was best for me. I feel much better eating as I am and don't fall asleep due to sugar/carb overload anymore, but rarely see fasting below 100 anymore.

I guess time will tell.
 
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Mar2a: Wow, back! - lol ... For some reason, I was leading myself to believe that this was a site for Canadian diabetics. But I didn't understand anhything you shared about your readings, because they are, obviously on the American scale. But, good luck with the whole diet aspect of your post. Like I said, the neuropathy controls my bowels, therefore, what I eat. It's all white bread and mashed carrots or potatoes for me. The occasional bowl of oatmeal, if it's not too lumpy, sometimes gets through, too.

Dwayne

Mar2a said:
Dwayne: Wow. Sorry to hear your story, but sure puts anything I could possibly go through in perspective.

This whole discussion is really interesting. Reminds me of the arguments about exercise: Which is better, continuous light-to-moderate exercise, or long days immobile at a desk followed by marathons at the gym?

Also, it's something I've been wondering about. Back in June I was freaked out because I had bouts of reactive hypoglycemia. I've since discovered that my BG won't go below 70 (or maybe 67 at the lowest), so there's no need to freak out, but I did wonder how healthy those roller coaster rides could be.

Now I'm low-carbing it. I rarely have a spike followed by a crash anymore; the fat keeps things level. Unfortunately, it often keeps things high; if I go to 180 or 200, it will stay for 2-3 hours and not get back below 100 ever.

So I wonder which was best for me. I feel much better eating as I am and don't fall asleep due to sugar/carb overload anymore, but rarely see fasting below 100 anymore.

I guess time will tell.
 

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It's all white bread and mashed carrots or potatoes for me. The occasional bowl of oatmeal, if it's not too lumpy, sometimes gets through, too.
Some of the low-carbers on another forum talk about "fake" oatmeal: basically 1/4 cup of almond flour (or almond meal) and 1/4 cup flax, with artificial sweeteners, if needed.

I didn't realize this board was mostly Canadian! I recognized a number of names I see on other boards and even though I know that there are a lot of Canuks there, I just figured it was a mix!

I'll convert the numbers in a sec and post them, ok?
 

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Dwayne said:
Mar2a: Wow, back! - lol ... For some reason, I was leading myself to believe that this was a site for Canadian diabetics. But I didn't understand anhything you shared about your readings, because they are, obviously on the American scale. But, good luck with the whole diet aspect of your post. Like I said, the neuropathy controls my bowels, therefore, what I eat. It's all white bread and mashed carrots or potatoes for me. The occasional bowl of oatmeal, if it's not too lumpy, sometimes gets through, too.

Dwayne
This site is actually based in the UK, but there are wonderful folks here from around the world.

Sent from my iPhone using Diabetes
 

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I've since discovered that my BG won't go below 70 (or maybe 67 at the lowest
70 mg/dl = 3.89
67 mg/dl = 3.7

Now I'm low-carbing it. I rarely have a spike followed by a
... if I go to 180 or 200, it will stay for 2-3 hours and not get back below 100 ever.
180 mg/dl = 10
200 mg/dl = 11.1
100 mg/dl = 5.6

...rarely see fasting below 100 anymore.
100 mg/dl = 5.6
 

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This site is actually based in the UK
No problem. I speak UK :) My husband is from England. We'll be going over there for the holidays. I like going into shops (see, I used the British word instead of "stores"!) to see how things are different. This time when I go to Boots to get my Ibuprofen gel, I'll see what's on offer for diabetics.
 
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