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When I was first diagnosed with Diabetes, I started taking a single medication and it seemed to really be helping. However, the first blood test that I took showed that I had high cholesterol/triglycerides (common in people with high blood glucose). As a result, my doctor prescribed me Niaspan (extended release Niacin). Immediately, almost all of the progress I had made since taking diabetes medication disappeared and left me almost in the same place I was before (fasting blood glucose around 300 mg/dL).

I told my doctors of the problem and that I suspected Niaspan as the culprit because I had read somewhere that was a possible side effect. They insisted it was temporary and it would come back down. Almost a year later with no further progress on bringing down my blood sugar, I came across a discussion of a study that suggested that Niaspan increases insulin resistance which results in loss of glycemic control. Finally, after much arguing and attempts to guilt-trip me, they relented and prescribed me a statin instead.

Since switching from Niaspan to Simvastatin, my blood sugar readings have come down dramatically – 168 mg/dL so far this month. This is the lowest average I’ve seen, even pre-Niaspan. I’m certainly looking forward to my next A1C to see if it’s come down from the 8.8% in December.

Some of the trust I had in my regular physician has been lost for two reasons. First, he was not aware of the study and second he had the “I know better” attitude and refused to listen to me as the patient. Not being aware of the study I can forgive, he’s not a specialist in this disease but to not listen to the patient is a serious problem. My physician prescribed additional expensive, no-generic-available medications to treat my still-high blood glucose that most likely occurred because of the interaction with another medication he prescribed. So, I decided it was best to go see an Endocrinologist for a 2nd opinion on my course of treatment.

The appointment with the Endocrinologist went pretty well and she acknowledged that Niaspan can have the effect of increasing insulin resistance in some people. She agreed that the medications I’m taking are the right ones and we discussed some different options for getting off of some of the, assuming that I can meet my weight goals. However, there were a few things that came up that concerned me about her.

First, she said that being overweight causes diabetes. This is a toxic myth because it blames the victim. It sets the expectation with medical professionals who are taught this nonsense that you did something to get yourself into the situation and that you likely won’t do anything to get yourself out of it. I tried to tell her that there is new evidence that points to genetics being the cause of insulin resistance which in turn causes diabetics to be overweight (the more diabetes genes you have, the worse the insulin resistance), but she got the “I know better” attitude with me. Granted, I don’t have a medical degree but I can read and understand things written by people who do. Even I can understand that not all overweight people have diabetes and not all diabetics are overweight.

Second, she told me that I needed to be on a low-carb, low-fat diet. I can only imagine this comes from a) the need to reduce blood sugar through carb restriction and b) the need to reduce cholesterol/triglycerides through fat restriction. However, she stated herself that the high blood sugar is also the cause of the high triglycerides and out-of-balance cholesterol. Studies have shown that when carbs are restricted, the body is forced to burn the excess fat resulting in a better lipid profile without medication or a low-fat diet.

I know this from experience because several years ago, before being diagnosed with Diabetes, I went on the Atkin’s diet after reading his book, lost 60 lbs and my doctor took me completely off all of my cholesterol and blood pressure medications. I didn’t gain the weight back because I started overeating, I gained it back because the diet is unsustainable long-term and I went back to eating “normally”.

On top of all of that, the  diet she suggests doesn’t even make logical sense. How can you restrict 2 of the 3 macronutrients that your body burns for fuel? How can you possibly get enough energy from eating primarily protein without adding either carbs or fat? My experience is that you can achieve low-fat or low-carb but not both.

(Side note: The New York Times had an awesome article about the history of food fads,including the low-fat and low-carb fads, called Unhappy Meals. Go read it and tell me it’s not right on the money.)

To summarize, my frustation boils down to one simple thing. As a diabetic, you start to view food as the enemy. You cannot simply sit down to enjoy a meal and not think about the effects it’s going to have. I was hoping for a little comfort or reassurance that the doctors are on my side – that I’m doing what I’m supposed and they are rooting for my success. Instead, I realize that no one else has my best interests in mind except for me. To them, I’m just the overweight guy who gave himself a chronic disease, but more importantly, is going to help them make their next boat payment.

So, here’s what I’m doing about it. First, I’m taking charge of my medications. I’m no longer going to take medications because the doctor told me to. I’m going to do my own research and I have the means to measure the effects of most of my medications. I’m not going to wait for permission to stop taking a medication. If  I stop and my monitoring shows negative results, I can always start taking it again. I know my own body and I should listen to it.

Second, I joined Dailyburn, a social nutrition and fitness website and I’m loving it. I can track literally everything. Everything I eat, every metric, and every exercise. I can join groups, add friends as motivators, do challenges (e.g. Biggest Loser competition), and find new workouts. I can have my progress and activities posted to Twitter (see my Lifestream). My next goal is to get a Wi-Fi enabled scale that automatically updates Dailyburn with my new weight whenever I step on it.

I know, it’s nuts to share so much information.. but it works better than you would think to keep me motivated and that’s what I need most.

The doctors will send you to the Diabetes education class where you receive very generic and watered down  information. I think I knew more about the causes and treatment of Erectile Dysfunction from watching commercials on TV than I did about Diabetes when I finished the class. The class I went to at the hospital was sponsored by manufacturers of diabetic food products. Guess what their advice was? Yeah, eat expensive special foods for diabetics.

In 2007, I started with a fasting blood sugar of over 330mg/dl when diagnosed then experienced a brief drop to 169mg/dl (7.5% A1c) for a short period. However, for the past year I’ve been extremely frustrated with daily fasting readingss of 220-230mg/dl and my A1c shot back up to 8.8% for my last test in December. All of this despite my efforts to follow a “diabetic diet” and exercise. It’s hard to stay motivated when all of your efforts show absolutely no results!

I came across this website, bloodsugar101.com, a few weeks ago via the discussion forums at Sugarstats (the tool I use to track my blood sugar, doctor visits, etc). As I was reading the site, it was like I was learning about my disease for the first time. Why wasn’t it explained this way in the diabetes education class? Why have I spent the last 2 years feeling like I did this to myself, despite knowing there’s a family history (obesity is a symptom, not a cause)?

I’m happy to report that after following some of the advice on the site and making just a few minor tweaks to my diet, exercise, and medication regimen that  my fasting blood sugar has dropped over 50 mg/dl in just a few weeks. I have not finished absorbing all of the information available on the site or implementing all of the suggestionss, but for the first time in a long while I’m optimistic that I can get control instead of being controlled by it. Yes, I’m motivated again!

I know I have a long way to go. I have get my blood sugar down further and keep it from from spiking over 140 mg/dl at any time in order to avoid doing more damage. I have to break the insulin resistance cycle that is causing my beta cells to work so hard. In other words, I’m shooting for the 5% club.

If you know anyone that is concerned about their blood sugar then tell them about this. If they are diabetic, pre-diabetic, or just have a family history, tell them to read bloodsugar101.com or buy the book.

Now down to the real reason for this post. I received a bit of news this week which I’m not entirely sure how to grok. Although it’s not official yet, it is almost certain that I have diabetes. I guess I’ve been taking it pretty well. I’ve tried to reassure everyone that it’s all going to okay. I’ve told them that I’m not surprised, that I was told I was pre-diabetic in college, that it runs in the family, etc. That’s what I’ve been telling myself as well. I hope it’s the truth and not that I just haven’t had time to really stop and consider what this really means.

Diabetes certainly runs in my family. My grandmother on my mother’s side hid her diagnosis and refused treatment because she spent so many years taking care of her sister with Diabetes and she died before anyone even knew she was diabetic. My grandmother on my father’s side did okay with her condition, but it ultimately caused kidney failure. In the end, she couldn’t do the dialysis anymore and because of her many other health conditions refused treatment and also went on her own terms. However, while this sounds bad, both of them were diagnosed fairly late in life and most of the complications from Diabetes are caused by uncontrolled blood sugar.

The good news is that I’m only 33 and with proper treatment, medication, monitoring, and a few lifestyle changes I should have no trouble living a good long time with this disease. My only concern is how much damage has been done already since I’m afraid I may have ignored the symptoms (even though I knew better) for a long time. What finally made me wake up and smell the artificial sweetener?

I remember sometime between high school and college that I was working two jobs trying to earn money for college and I had a dizzy spell for which my dad had to come and get me because I couldn’t drive. My dad made me see a doctor who sent me for a glucose tolerance test. The test consisted of drinking a sugary drink after fasting and testing blood sugar levels every hour for 5 hours. The test was pretty difficult due to the number of times they had to take blood. The result was that I was that I was pre-diabetic, but I can’t remember ever following up or if there was even anything I could done.

I sort of figured out on my own how to tell when I was going to have a dizzy spell (headache and sweating too) and I would eat something to counteract it before it got bad. I now know this is a symptom of my blood sugar dropping too fast. At the time I had my first spell, I had eaten only a candy bar and drank a coke for my one and only meal of the day. My blood sugar spiked and dropped quickly since I hadn’t eaten any protein to sustain me past the initial quick energy.

Fast forward to just a few years ago when I had a different physician who was actually diabetic. He gave me quite a lecture after a routine checkup where he did tests for blood lipids and cholesterol. He also told me that there were several signs of pre-diabetes. He put me on a low-carb diet, which I did for almost a year and lost 60 lbs. However, it was easier to avoid going to the doctor than realistically sustain a low-carb diet. Even once I regained the weight and was diagnosed with sleep apnea, I avoided the doctor and their blood tests. The reason wasn’t so much that I didn’t want bad news since that would have actually kept me motivated and doing the right thing. It was actually that it is difficult to draw blood for whatever reason. I end up getting stuck 5 or 6 times (yes, I know I’m making excuses).

For the past several weeks I noticed that I was thirsty all of the time. Not just, “oh, I have a parched throat and need a drink of water”, but “I need a drink of water NOW!”. At one point, I was ready to strangle a waitress at a restaurant because she was taking too long to bring my water. Just this past weekend, I had told my wife about the problem and that I should go see the doctor.

I guess I wasn’t taking it seriously enough because on Monday night, I started having chest pains as soon as I sat down to dinner. I’ve had similar pains before, but they always went away within a few seconds. These lasted more than 10 minutes and would not go away. So, I decided it was time to go to the Emergency Room where they did the standard “chest pain protocol”. As a result, the nurse stabbed me four times trying to put in an IV and when he couldn’t get it, brought in another nurse who was not very gentle with shoving an 18 gauge needle into a vein on my wrist.

So, over the course of four hours or so I get two EKGs, two heart enzyme tests, and two shots (and a pill) of blood pressure medicine. The end result is that whatever caused my chest pains (which went away 15 minutes after arriving at the hospital) was not heart-related. However, they told me that my blood sugar was 260. He didn’t say it was high, but when I heard that and remembered the symptoms of diabetes I was having, I looked it up when I got home. The test was done several hours after I last ate and my blood sugar should have been 120 or less. So, it was high.

The next morning (Tuesday) I immediately scheduled a doctor’s appointment to follow up and, of course, by now I’m mostly concerned about the blood sugar. Another test in the doctor’s office shows my blood sugar is 330. A urine test also shows a lot of sugar as well. So, the doctor comes back into the room after all of this with a new glucose meter and medication samples. I would need to come back for a fasting blood test, but the diagnosis is pretty clear. We’re expecting the hospital to call and schedule us for a diabetes information class.

I went back this morning for the fasting blood test which consists of a Hemoglobin A1c test to determine my average blood sugar over the past 90 days in addition to blood lipids and cholesterol. The results of this test will determine the official diagnosis.

At this point, it’s probable that the chest pains were caused by high blood pressure. I’m now taking Altase for that which has the added benefit of protecting my kidneys from high blood sugar (kidney failure is a complication of Diabetes). I’m also taking Metformin to help bring my blood sugar under control. Since then, I’ve taken my blood sugar several times and it’s been doing down.. 327, 220, 202, 179. The target is 70 fasting and 120 two hours after eating.

The best part is that my wife has now become the food Nazi. She’s done a ton of reading and talked to her diabetic grandmother to determine what I can and can’t eat. Not that she’s justified, but it makes me sad that I can no longer eat what I want.

I always decide to start playing a new game right when things become the most stressful in my life. I think it’s because gaming is my stress relief. If there’s no stress, there’s no desire to game. This time it’s Guild Wars. I like to think of it as World of Warcraft with all of the things I hate about WoW removed. Seriously.

It’s going to take me a few weeks to get a new routine going. I had a nice rhythm going which allowed me to get everything done in a week that I wanted to get done. Now new class assignments have sort of screwed that up and it will take a little bit more planning to get the podcast recorded and posted plus have my case studies completed by Thursday when they are due. Don’t forget about reading the chapters from the book and participating in the class discussions about the case studies my classmates post.

My wife has been in two different Emergency Rooms in two days. Once for a bladder infection which we thought had moved to her kidneys and the second time for high blood pressue. The first trip ended with good news on the kidneys, but bad news with the dianosis of an ovarian cyst (the 2nd one for her — the first one removed when she was 15 weeks pregnant with our first child). She was following up on the cyst on Monday whent he Dr. sent her to the ER because her blood pressure was too high.

They did manage to get it down with some new medicine, but the cyst continues to cause her pain. The doctor wants to keep an eye on it to see how it does (grows, shrinks, or stays the same) before scheduling surgery. The problem is that she has to take hydrocodone for the pain and it’s keeping her non-functional most of the time. That means most of the things she normally does around the house falls to me.

*sigh*

I do have some help. Many of the members of our church are volunteering to help chauffer kids around, cook meals, and even help clean the house. It’s just hard for me to accept help from people, especially when it’s so willing offered (if that makes sense). I guess I just feel like I’m taking advantage of people’s generosity.

Next will be better. I hope to finally get my new work laptop and get rid of the piece of junk I’ve been carrying around for 3+ years.