Diabetes Self-Management Blog

It’s snowing. Again? Still? I’ve lost track. Unlike a couple of weeks ago, when we got back-to-back major snowfalls and sub-zero temperatures, we’re just getting a little bit of snow every day (after day after day after)…

All of that snow and melting and refreezing is keeping me indoors because it tends to make the ramp slick. I can get down OK; it’s getting back up that’s the problem. One day I kept myself occupied by making a huge pot of vegetable-beef soup that sat on a back burner and simmered all day as I added this vegetable and that.

Then there was the day I talked to somebody about answering some questions for a blog entry. I sent the questions, but haven’t heard back.

So I went looking for something else. A couple of weeks ago, I wrote a blog entry that mentioned research finding that people with Type 1 diabetes were living longer.

But what about Type 2? As it turns out, I finally found something. Sadly, the news was not as positive. Cutting to the chase, researchers found that having Type 2 diabetes increases by twofold your chance of dying when compared to people without diabetes. (No, that isn’t the reason it’s called Type 2.) Cardiovascular disease is the main cause of death, followed closely by stroke.

To reach that conclusion, researchers digested the information found in 35 studies involving 220,689 subjects with an average follow-up of 10.7 years that were published between 1990 and 2010 and covered several countries.

What is it with Type 2 diabetes? Why are our chances of dying two times that of those who don’t have diabetes?

For one, lack of a timely diagnosis. Authors of the research note that “50% of people [have evidence of] complications at diagnosis.”

Type 2 is sneaky. It slips in on cat’s paws and settles in quietly while orchestrating a bit of beta cell dysfunction here and rising blood glucose there, while the insulin your body produces is either insufficient or fails to work properly.

So then you have a heart attack or a stroke and find out you have diabetes. You’ve probably had diabetes for years. Don’t sweat it, though: Diabetes only affects the parts of your body that have blood flow.

Perhaps you even knew you had Type 2 diabetes, but didn’t understand how it worked. An ophthalmologist I know once told me he would find retinopathy in a patient’s eyes and ask, “Has anybody ever told you that you have diabetes?”

“Yes,” the person would respond, “but I took some pills and it went away.”

No, it didn’t. Diabetes of all types is a chronic condition, meaning you’ll have it — and need to take care of it — for the rest of your life. It isn’t the same as an acute illness, like a cold or the flu, where you may or may not take medication and it goes away.

Some doctors don’t seem to understand how it works. A man I know had diabetes, his doctor prescribed medication, and then, when his blood glucose went down to normal levels, told him he didn’t have to take the medicine any more. His sister, who is a CDE, had a fit! And, yes, his glucose went right back up.

Some doctors may not keep up with standards. Take my husband’s former doctor, for example, who once said: “Oh, look. Your sugar is 140 [mg/dl]. We’ll have to keep an eye on that.” Nope. It was a fasting level. A fasting level of more than 125 mg/dl is full-fledged diabetes. You noticed I said FORMER doctor?

Hubby’s HbA1c has been creeping up, but his current doctor is still putting off adding antidiabetes medication. Which can be another problem. I don’t agree that people’s glucose should creep up for a while before they’re brought back under control.

I also don’t agree with doctors who threaten people with insulin. (“If you don’t start complying, I’m going to have to put you on insulin.”) Insulin is good. It’s taken in small amounts via a needle that’s smaller in diameter than a human hair and injected into the fat layer. It isn’t a medication, by the way: It’s a hormone that everybody needs. Taking insulin does not mean your diabetes is worse. It just means that your Type 2 diabetes is progressing — as it does — and you need something more or different to help you maintain control of the diabeastie.

If you are one of the people who already has complications, is it too late? Maybe not. Good control can help delay or reverse symptoms. For that, you need diabetes self-management education. And not the kind a doctor gave a friend’s son: “You have diabetes. Watch what you eat.”

It may be easier to go along with not knowing anything and not fighting to keep your glucose under control as much as possible. But you need to learn all you can. Because, unfortunately, while you’re busy ignoring diabetes, it isn’t ignoring you.

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