Bamboozled!

I approach this topic reluctantly, but while discussing diet and food intake, I think I would be remiss not to discuss alcohol on some level. Several people who have passed through my life have been alcoholic, some recovered, some not, and some who have fallen down those twelve steps. A couple people in that last category are among those no longer in my life who I miss the most, so the subject can be somewhat loaded for me as I was not able to help people no matter how much I sincerely wanted to and tried.
I am not judgmental about alcohol use. I drink on occasion but can take it or leave it. I felt a certain propensity towards becoming an alcoholic that I have successfully resisted since that first bottle of blackberry brandy in the woods behind the house at age 15.
The diabetes itself, I think, can increase the propensity. Most diabetics are not consistent in temperament. We can be prone to depression and suffer hormonal changes to our biochemistry. This brings certain vulnerabilities to alcohol dependency or abuse that anyone can suffer. so diabetics who feel these daily desires may not be able to deny inappropriate use of alcohol as non-diabetics.
I do not think diabetics need to totally avoid alcohol or can never safely drink. Health benefits such as found in wine usually apply to diabetics. With wine, the diabetic must remain self aware as the grape source of wine can elevate sugar levels with fructose. Moderation with alcohol should always be followed.
A second hand concern was the core of my perceived need to address alcohol. Just as my experience with low fat milk elevating my sugar level more than whole milk, a diabetic friend tells me that light beers raise his sugar more than regular beers. I never acquired a taste for beer, so do not know how they achieve the reduced fat and/or calorie effects in lute beer. Strictly in a blood sugar effect, I say diabetics need to pay attention to their beer drinking.
Most of my drinking experience is with hard liquor. Basic straight alcohol–rum, gin, vodka, whiskey, etc–will lower blood sugar. But as most of the straight hard stuff is often mixed with fruit juices or liqueur varieties, this effect can be easily overridden or overlooked. Liqueurs contain sugar. contain sugar from their manufacturing and processing. Brandy and Schnapps will often have sucrose added on top of natural fructose.
The effect on sugar levels can be very inconsistent, depending on so many factors that diabetics need to be self analyzing. A shot of vodka will lower blood sugar. A screwdriver (vodka and orange juice) may have the two sugar influences cancel each other out over time, but from my experience he orange juice sugar will take effect first and be lowered by the sugar reducing alcohol. A Fuzzy Navel, which is made with orange juice, vodka and Peach Tree Schnapps, will raise the sugar. How much this effect happens depends on prior consumption sugar levels, and whether the last meal contained a lot of carbs or not, and the proportions in the drink consumed, and activity level.
There’s a lot of variables that are just harder to track with any temporary mental impairment brought by the alcohol consumed.
Diabetics are wise to avoid most alcohol, but drinking always pares down to personal choices and comfort levels, so give this opinion without judgment. The important thing, as with anyone, is to drink responsibly.

Milking the Diet

Cow’s milk has always been a major part of my diet, both as the base in which to eat cold cereal and on its own.
My body can be pretty primal. I don’t fight cravings, and any serious problems with bones or teeth or other problems such as a traumatic toenail injury will make me crave milk. During a time when a low level tooth infection went undiagnosed and treated, the milk craving was at an extreme. I would stop and buy two gallons at 7-11. I would swig from the gallon before driving the six blocks home. When parked, I would swig some more then walk up the two flights. I’d swig some more before putting the two new gallons in the fridge. The gallon I’d be drinking from could be more than half gone before it ever hit the fridge.
My doctor told me this was diabetic thirst. I know better. Milk doesn’t quench thirst; it usually coats the tongue and throat and increases thirst. Those times I have diabetic thirst, only water satisfies.
I never noticed any changes as the milk addictions came and went. About the time I gained a roommate, I switched from whole milk to the "healthier" 1% low fat milk. That was just easier than arguing for what I liked better. I also did not notice any change in my sugar during the time of the change. The 1% habit remained for years.
What has become apparent is that my body cannot metabolize the 1% as well. I’m not talking about lactose intolerance. Low fat milk raises my sugar more than whole milk does.
Shooting up extra insulin after a milk binge could not compensate when I indulged the cravings. When the ankle collapsed due to the Charcot Foot, my milk cravings were at a new high. The night I went into the hospital for the sudden toe infection had been a high milk night. I had eaten little throughout the day, a reasonable dinner, then about a half gallon of 1% before going into the hospital. Having become aware that milk was contributing to higher sugar levels, I had shot up before leaving.
My sugar was still in the 600’s when they tested in the hospital, and I could feel the insulin dose doing nothing.
I’ve since gone back to whole milk. The roommate mostly stays with 1%, but he has always been inconsistent about that and often eats cold cereal with ½ and ½ poured over it.
My sugars have felt better since I made the switch. 1%^ milk actually raises my sugar more than a glass of Kool-Aid will. Whole milk gets absorbed by my body in a more measured way, without absolute sugar surges.
I don’t claim to understand this. Low fat salad dressings definitely have added sugar. Low fat milks do not. Something about the low-fat process changes the milk’s biochemistry and how my diabetic body reacts to it.
This effect as observes in a "whole food" form reinforces my theories that "healthy" dietary changes can be beneficial to the normal dieter but catastrophic to diabetics. Our bodies metabolize changed foods in some fundamental and often unexpected ways. Diabetic diets are best in avoidance of pre-prepared and processed foods. As that can never be fully avoided in this day and age, we need to watch what we eat and what effects any change may bring.
The lower fat and reduced cholesterol benefits don’t amount to much if our blood sugar is always higher for the change.

Splendid Equality

Here’s a natural bridge from the last post about sodas. I stated how I did not like the aftertaste of soda varieties sweetened with Splenda©. It tastes like sugar soda to me.
I don’t use Splenda, but have stuck with Nutrasweet as an artificial sweetener, in soda, coffee or any other things I feel the need to add an artificial sweetener. I like the taste and am used to it. If in a restaurant where the options are only Splenda or saccharine-based Sweet-n-Low, I will use Splenda.
But I would never allow myself to use Splenda regularly or habitually. This is a precaution based on the processes of my brain I call logic. I have not specifically researched this independently or for this post. My declining eyesight does not really allow me to research it now.
Here’s my precautionary logic:
Splenda is made from true sugar. It was modified to be a no- or low-calorie sweetener that tastes like real sugar. It did succeed in that, as my dislike of Diet Coke with Splenda demonstrated to me. I have no doubt that this is a great product for dieters.
I am not convinced it’s a good idea for diabetics, whether childhood or age advanced. Splenda, as a modified sugar, seems very likely to be processed by the body as sugar. Diabetics may benefit from the reduced calorie aspects, but could easily find that Splenda would raise their sugar as much as real unmodified sugar does.
I never tried Splenda to know if it would have such an effect on me. I saw no reason to risk this and still don’t.
You can call me paranoid, or cite studies that say Splenda is perfectly safe for diabetics. I will still stick with Equal.
Splenda is a new product, so may have effects not yet realized, or, worse, have effects that are being concealed. I do not know if it was ever specifically tested with diabetics. I would assume that any such tests were carried out by the manufacturer and spun to say what the manufacturer wanted without any outright lies.
This same logic, based on a general understanding of basic sciences, kept me from any temptation to try inhalable insulin, which was very shortly pulled from the market for causing lung cancer.
Just as I never thought inhaling a hormone was a good idea, I just don’t see any wisdom of diabetics habitually consuming modified sugar.

Drink Coke, Soon Croak

The last absolutely forbidden food to me is sugared soda. I learned this at 15 ½ years old in my driver’s ed class. My sugar was down, and I drank a quarter to a third of a friend’s can of Coca-Cola. By the time I was home, I was feeling ill from high sugar.
The effect was so pronounced that nearly thirty years later, I cannot comprehend why any diabetic would knowing consume sugar soda. In general, diet sodas are readily available almost anywhere, and the quality of the product has skyrocketed since the advent of Diet Coke n the mid-1980’s. Even with those who are allergic to the phenylamine in Nutra-sweet, the damage sugar soda will do to a diabetic body does not come close to compensating for the allergy.
I seldom order fountain soda in restaurant due to the risks associated with server error or the kitchen staff accidentally hooking up the wrong syrup bag to the diet spigot.
I can drink Kool-Aid. I can drink a restaurant brixed lemonade if my sugar is lower to begin with. Both will raise my sugar, but not to drastic levels. I cannot drink sugared soda under any circumstance.
Not all sugared sodas are the same. Caffeinated varieties such as colas and Mountain Dew contain more sugar than other varieties. Sprite or 7-Up have less sugar than Coke. Ginger le still has even less sugar than lemon/lime, but why would you drink it at all? It’s absolutely empty sugar than can overwhelm your system before you know it.
Tab stick urine sugar testers can be used to determine that you have indeed received diet soda in restaurants. If what you are served tastes like regular soda, it is best to return it and have it removed from the bill and drink water with the meal. Any other action can and usually will amount to an argument with the server that neither side can win, An error could have been made in the syrup bag, and even if fixed, sugar syrup may remain in the line.
If you are a Type 2 who doesn’t like the "aftertaste" of diet soda, you just need to make a longer adjustment. Switch to the diet of a different flavor or brand of soda and drink that exclusively for about a month. Then switch to the diet variety of "your" soda and the particular aftertaste will not be as noticeable. If still available, Splenda varieties of soda will have a very similar aftertaste to regular sodas. After forty years of diet soda, I don’t like the aftertaste of regular sodas, or their Splenda counterparts. This gives me innate understanding of Type 2 diabetics who have difficulty to this particular change necessitated by a new condition, but I still have no sympathy on that one. I am no fragile diabetic and can eat almost anything in moderation, but sugar soda always makes me ill.

Diet at Fruition

The talk about the dangers of fruit pies to dieters and diabetics alike emphasizes one point of the "diet series" posts. Some things that are good for dieters are not so good for diabetics. Fruit. These are healthy foods with many benefits, but can easily be eaten into excess. Many menus or meal plans that diabetics receive from dieticians have the impractical inclusions of half a piece of fruit just for this reason. For all the health benefits, fruit contains a lot of natural sugars and can quickly throw diabetics out of whack. Diabetics are often advised to six to twelve servings of fruits and vegetable per day. The emphasis on such plans is to the vegetable, which should be roughly a ration of 2:1.
Diabetics should choose fresh fruit sources. As sweet as fruit is, most "prepared" forms have added sugar. The combination of sucrose and fructose can easily overload the system.
Canned fruits should always be checked and preference should be given to varieties with no sugar added. Apple sauce should always be analyzed for added sugar.
Jellies and jams are usually loaded with sugar and should be used sparingly, if at all.
Fruit juices, particularly "cocktails" also need close examination. Even without added sugar, juice can be high in sugar, particularly grape and orange. Properly made Tang actually has less sugar that whole and pure orange juice. Tang will provide Vitamin C, but not potassium and other benefits of orange juice.
The 100% "pure" Juicy Juice is typically one of the best alternatives, especially the varieties that mix lower natural sugar fruits with the higher. Cranberry juices almost always have sugar added.
As much as I would love to be more precise, my vision is no longer cable of label and ingredient comparison, even online. Fruit is an excellent option for dieter as the water based fructose generally pisses out of the system effectively, and an excess ill often trigger other bodily purges. Diabetics, however, need to limit and monitor consumption in the goal of keeping sugar levels down. This can be easy to forget when dealing with something so healthy.

Bye Bye Miss American...

There’s been some minor doubt or scoffing about my reports of the effects of kids’ cereals from adult cereals. I’m just reporting the effects of my body from different foods. Basically, kids’ cereal will push my sugar up sooner and the influx of raw sugar will be affected More quickly by insulin and activity. Adult cereals also contain raw sugar, but in more of a balance with carbohydrate sugars and often fruit sugars. Even a basic healthy cereals such as ice Chex will spike my sugar about the same as a pre-sweetened cereal, but the high effect will hit later from consumption.
I’ve never doubted this or thought more deeply about it because it is consistent with the reasoning of my second group of "forbidden" food, the stuff I can’t eat under any circumstances.
This group is fruit pies. I learned of this incompatibility to my system during my teen years. To counterbalance a low sugar episode, I ate a Hostess apple pie. It did lift my sugar. And it kept lifting my sugar. On the inside of an hour, was feeling excessively high sugar and needed to shoot up. Those roller coaster rides of highs and lows in short times are some of the most difficult days to deal with.
I am no fragile diabetic, and my readers should keep that in mind when applying my reports to their own conditions. My body handles raw sugar fairly well.
Most fruit pies contain real sugar. Often, they contain brown sugar as well. My body’s problem with these food, including nut pies, is beyond the basic sugar. On top of any sucrose forms, these are naturally high in fructose from the filling, be it apple or cherry or blueberry. Nut pies such as pecan will add other forms of complicated sugar, and are also inedible to me. And on top of raw sugars n the fillings and the fructose or nut sugars, the crust will often contain raw sugar on top of the carbohydrate sugars. Pies essentially become a source of multiple forms of sugar all consumed at once. This mix overloads the system, and when eaten as a dessert, is adding to any raw and complex sugars eaten with the main meal. I can handle moderate amounts of fruit jelly on toast or a bagel, but fruit pies are dangerous for me, often with effects not just excessive, but unpredictable.
The effect of that Hostess pie is still with me nearly thirty years later. As un-American as it sounds, I detest apple pie. Even the smell can be nauseating to me. I still like raw apples, but even non-pie bakes of stewed and sugar apples carries a taste with a severe negative association. I can enjoy gourd pies and custard pies, but all fruit and nut varieties hold zero temptation for me. I know they will get me sick by overload. Few fruit based deserts hold temptation for me.
I’ve never gotten overloaded on adult cereals. But compared to the "empty" sugar of kids cereals, the sugar content in the healthier cereal varieties can have complicated processing by the body
Fruit pies are best avoided by dieters and diabetics alike.

Mallowed Out

While I have never been a home blood sugar tester and have no intention of ever becoming one, I have always paid attention to what excesses and cheats of the diabetic diet that disagreed with me or caused unanticipated problems. I don’t eat those things that are so disagreeable.
There’s some surprising things can eat, in moderation or on occasion. Jellies and jams are the most surprising thing, but eating such things several days in a row will make a cumulative effect that will have me feeling poorly before long. I limit myself in such things. While can eat almost anything in moderation, there are things I just accept as inedible.
The first is marshmallows. They are high in raw sugar, which should pass through the system quickly as if eating raw table sugar or Skittles or other hard candy.
The other ingredients prevent this.
The effect of marshmallows, wither in packaged form or the dehydrated varieties found in cocoa or cereal, gum up my system. I’m not talking in a bad bathroom sense, but in my body’s overall capacity to process or metabolize food. The sugar in the marshmallows will stay with me longer, and in an effect that can last for several days, anything else I eat will remain in the system and keep my sugar elevated. This effect can last for several days.
This is easily enough avoided for me. No fluff on a peanut butter sandwich, no Lucky Charms or Boo-Berry cereals, no raw marshmallows, no Rice Krispies Treats. The last mistake along these lines was a variety pack of chewy granola bars that had S’mores varieties in the mix. Just one of those granola bars had the sugar feeling high for a few days. Eating it was not a willful disregard for my own health, but something I couldn’t tell due to blindness. I am typically careful about what foods I bring into the house.
Gelatin-based foods can also have this effect, but, judging from my experience, not as reaction to small quantities as marshmallows. I can cheat or use gummy bears medicinally, but in trace amounts. Fruit roll-ups and similar snacks will also gum me up inn excess. I’ve stopped giving in to the temptation of Jello at Chinese buffets and actually find the sugar free varieties to be just-fine alternatives. That’s far preferable to overdoing the traditional sugar version. I found the moderation of jello to be a sometimes difficult control as the problem is with the gelatin and not the sugar. The gelatin in even a sugar free dessert can react to the other sugars eaten, and stay in the system for a couple days and cause problems with foods eaten later.
An advantage to having developed diabetes at the age of four is that I am fairly accepting of the foods I just can’t eat. While I can handle occasional moderate amount of gelatins, my body can’t handle marshmallows in any quantity.

Cereal

It’s not just for breakfast and has been the staple of my diet for my entire adult life. There’s a great variety available, almost all of which are well fortified with vitamins and minerals. The per serving cost is reasonable, and it takes less time to prepare than to eat.
The habit for me was probably introduced during the sixth grade hospitalization, when cereal was not just for breakfast but also a recommended evening snack.
Part of my problem with cereal is that I do tend to eat too much at a time. I don’t add the recommended serving to a recommended amount of milk, but mix in the bowl according to how much the cereal will float and overflow. When I eat the cereal totally out of the milk, I will add more cereal to the remaining milk, again and again until gone.
I time when I eat adult or kids’ cereals. I try tp keep sweeter cereals to earlier in insulin cycles or when the sugar is actively low. This will counterbalance the sugar surge of Fruity Pebbles. That said, I have noticed that less sugary cereals will also give a sugar surge, but they do so later, more from the combination of carbs and sugars than from sheer sugar. Rice Krispies, Corn Chex or Rice Chex will surge my sugar about the same as Trix or Frosted Flakes, but will do so later than the sweeter cereals, s such, I will often hit a second sugar low when the sugars of the sweeter cereals passes, but more "age appropriate" cereals will give a surge so much later that eating something else hours later creates a bit of an overload.
Raw sugar with little else hits faster but burns out faster. In many ways it’s easier to keep track of rawer, simpler sugars than a mix of sugars and more complex carbohydrates. Do not discount the sugar content of even diabetic-friendly cereals. Rice Krispies ingredients reveal rice then three different forms of sugar–regular sugar, corn syrup and malt flavoring–as almost the sole ingredients, and if they used sugar rather than corn syrup, sugar would probably be the primary ingredient.
So while much of my diet derives from these products, I often need to remind myself about the importance of moderation with any dietary source, and I need to pay attention to the effects of new varieties.

Old Advice

Decades ago, the Providence Journal ran a syndicated column by a Dr. Donague. I may be spelling that wrong; his column may still be one of the Journal’s features, but I wouldn’t be able to see that for myself; I don’t remember the doctor’s first name, but he was not the television host of the late 1970’s on.
I remember a column from some twenty to twenty-five years ago in which he addressed a letter writer who wrote in to complain about a diabetic’s self management. The problem was that the diabetic was using sugar in hir coffee and the non-diabetic friend with limited knowledge of diabetes management, thought the diabetic’s practice was unacceptable.
Dr. Donague’s response defended the "bad diabetic." I remember this because it matched or shaped some of my self management, which always held me in good stead until I started actively seeing a doctor.
Managing the insulin is a series of checks and balances. Once the daily dose of insulin is taken, it is in the system and can cause difficulties for the diabetic if not balanced out with food.
The preferred practice for diabetics is to eat multiple small balanced meals each day to equalize absorption of the time release insulin. This is not always practical or possible for the diabetic to do.
Dr. Donague did not recommend "shortcuts" such as taking sugar in coffee to absorb insulin, any more than he would have recommended Skittles candy or glucose tablets. He merely explained to his readers some of the balancing act diabetics face and that all sugars are not to be avoided at all times. Sometimes they are needed to regulate the sugar.
The problem with a sheer sugar boost, according to Dr. Donague and me, is that the diabetic gains no nutritional value for the intake of raw sugars.
While I have had phases of quick and convenient intake to resolve an insulin spike, I have made efforts to maximize nutritional sources with this. My at home remedy is typically kids’ cereals. Froot Loops and Cap’n Crunch are high in sugar that will resolve and insulin surge quickly, but in addition to the sugar boost, cereals are fortified with necessary vitamins and minerals. On-the-tun solutions include Pop-Tarts for the same reason. When driving, I often had a box of cereal in the car to snack on.
There are actually few foods I would not eat, and all of those were for effects on my sugar that I felt outweighed any potential enjoyment from the consumption. As a "medicine," those sweet foods caused more side effects than they resolved.
I had several specific points of bringing up the old article by Dr. Donague. The first is that no matter how well intentioned the input or correction of family and friends on adult diabetics, unwanted advice can be annoying. This is especially true when the advice stems from the broadest general Knowledge but a lack of specific education of the intricacies of diabetes. Diabetics can consume almost anything, but in moderation only and with attention to the blood sugar effects.
The more personal point: I may actually know what I am talking about, even when my words or actions run contrary to the most black and white aspects of the disease management.
Future posts will explore my personally "forbidden foods."

Waiting

I can’t hide the fact that I am blind anymore.
The Charcot foot has stabilized, but the vision has gotten worse. Not enough light is always too dark, too much light is a hazy bright blur, and just the "right" amount of light leave everything backlit and in indiscernible shadows.
The range of vision is one to two feet, depending on lighting, and usually without the ability to discern fingers unless there is a sharp background. I can’t see well enough to recognize people by sight at any distance. I’ve always been good with voices and other cues, and try to stretch those abilities as best as I can.
I adjust as I stare at the computer, but looking away makes everything worse, and stepping away will often leave me unable to refocus on the bright screen. Most often, light hurts. As I physically tire or exert, my vision also diminishes.
Things have gotten worse month by month. So take out the violin...
And crash it into my skull.I say this to be informative to the people who watch me walk like a crippled great-great grandpa and turn to a caller with that blank blind look in my eyes. I’m still doing everything I can, with the acknowledgment that what I can do is lessening almost daily. I can do less and do everything more slowly. I’ve been trying to accept the new, ever increasing limitations and to stop pushing myself.
For lack of choice in my life, I am learning to relax.
I’ve made progress on completing things that have been on hold in the three-plus years since the Cialis-induced blood hemorrhage. I’m looking to complete final things so I can turn over my responsibilities in an orderly and accessible manner. The more I complete, the better relax. The time for waiting in hope that tomorrow or next week or next month may be better is over.
There’s another procedure in January, and there is some hope of improvement after that. Things may be clearer if the worsening situation is the result of the vitreous being dirty.
Until then, I am waiting and deferring many other decisions.
People have noticed by this blog and in person that I am not talking as hopefully as I had been. This isn’t a matter of giving up, but a matter of perspective. I’m all for optimism, but I am more for realism. I’m finding the balance between the two and holding on to each.

Getting Sauced

Ketchup is a source of high sugar that dieters and diabetics alike can easily overlook. Its healthier relatives of tomato sauces, whether for pizza or pasta, can also be another high sugar content source. Sauces, however, have more variance in sugar content from vendor to vendor.
I have little direct experience with jarred or canned sauce for home consumption. In addition to being leery of sugar content, many tomato sauces contain pieces of things I don’t like and won’t east, including onion in any form or pieces of peppers or tomatoes. I find it easier to make my own sauce from a tomato paste base and mixed with meats, vegetables and herbs. I do not add any sugar or salt to the pot, though I will salt it on the plate.
Tomatoes are acidic, so sugar is usually added to counter-effect the natural acids. Most grocery-bought sauces will contain some sugar. The FDA requires ingredients to be listed from most abundant to least, so it is best to choose brands by the most ingredients before sugar. Monitoring blood sugars after the meal is also advisable. Sauces sold in cans with tomato pastes, purees and pieces often are very straightforward and plain. These products, with makers such as Hunts, Contadina and store generics will usually have less or no sugar and can be seasoned to taste. Jarred sauces such as Prego, Ragu and Aunt Millie’s, sold as the "flavor" brands, will have more sugar.
Restaurants are harder to plan. Some chains may use basic foodservice packaged varieties of common brands, but these may also be labeled for specific chains so even the employees may not know. Many of the pizza chains have their own secret house recipes. These are also generally make offsite and shipped in gallon cans or five gallon bags. I worked for the New England chain Papa Gino’s and never felt as though my sugar was higher. I did notice when working in a mall that Pizzeria Regina lunches always shot my sugar higher than it should have been after a reasonable meal. As you cannot be sure of the accuracy of what most employees will tell you, it is best to avoid other sweets when eating Italian out and paying attention to your sugar levels afterwards. Avoid the places that raise your sugar and frequent those that do not.
You may find your prefer the higher sugar recipes . That’s okay, in my opinion. A successful diet is one you can maintain permanently, and avoiding all sugars all the time is not possible for most people. The important thing is to know what you are consuming and how it affects your body and knowing when you need to compensate. A carb-rich plate of pasta is an important thing to track as a sugary sauce will spike your sugar sooner and the pasta carbs will keep the levels elevated.

Covering Condom’s...

Condiments, that is.
Like the low fat varieties of salad dressing or even the vinegarettes that can have major unrealized sugar content, condiments are typically the biggest source of unrealized sugar intake.
Ketchup/catsup is really one of the worst things a diabetic can casually eat. The sugar content exceeds orange juice, and, depending on the manufacturer, can contain multiple sources of sweetener such as both raw sugar and corn syrup. Manufacturers like mixing these two types of sweeteners in all sorts of products to make the taste sweeter without having to list a single sugar ingredient higher on the ingredient list. The United States Food and Drug Administration requires ingredient lists to be ordered from highest content to lowest, so dividing sweetener between multiple sources can be a deceptive way of "reducing" sugar content.
Barbeque sauces should also be reviewed before consumption. Typically, the spicier the condiment, the less sugar it will have, but particularly with barbeque sauces, the ingredient lists must be checked for sugar, brown sugar, corn syrup, honey, molasses and maple.
Mustards also follow this trend. A "mild" mustard will almost always have more sugar than a naturally hot mustard.
Restaurant "special" sauces should always be suspect, not just for sugar, but also for salt.
Steak sauces and marinades should also be checked before consumption.
I’m not advocating bland diets of plain food. By my experience, here in America, if something "needs flavor," chefs add sugar or salt or onions and think things much improved. I just hope to help diabetics and dieters be more informed in their choices and to think twice about their decisions. I don’t find catsup to be an enjoyable enough addition to anything to use it. I use barbeque as a more flavorful replacement, but have noticed that some push my sugars up higher than other.
All condiments from relish to basic salt should be checked for sugar. We are so familiar with these products that we may take them for granted and discount the things hidden within.

Mono Sodium Glutamate

The third "unknown" pratfall of salad dressings is mostly but not exclusively a danger of Ranch dressing, including the "original" by Hidden Valley. Almost all varieties of Ranch dressing include MSG.
MSG stands for Mono Sodium Glutamate. The average person can think this is a danger exclusive to Chinese food; that is far from the truth. Breaking down the name Mono Sodium Glutamate can leave us with a rough translation as "One Salt Sugar compound." "Glutamate" shares roots with glucose. This is a chemical compound of intense salt and sugar. I’ve seen MSG sold as a spice. It’s a white powder that makes food more "American" by adding both salt and sugar in forms that do not have to be specifically listed in ingredients. Despite the fact that MSG induces headaches in many people, the FDA does not require the ingredient to be bold in the contents list as true allergen foods must be.
I actually have a pretty good diet, blood sugar levels aside. I am one of those who discovered my problem with MSG by the resulting headache.
Any Asian restaurant that states "no added MSG" is telling you that their food has MSG from the vendor. American Chinese food is actually much sweeter than true native cuisine. Many restaurants no longer use MSG, but it is safer to always ask. I found that most hold outs of MSG use are kiosks of Asian food in malls rather than true sit down restaurants.
Unfortunately, MSG is much more common than that. Here’s a partial lost of things I discovered through the illness derived from having eaten the wrong thing.
The Ranch dressing sold in the produce section of better super markets is the only Ranch I have found without MSG.
Regular Kraft dinner does not contain MSG. Kids’ varieties, even by Kraft, do have the compound. Most generic and lesser brands also contain MSG.
Most chip dips contain MSG.
Seemingly all Hillshire Farms sausage products contain MSG.
Cheese doodles, whether puffy or friend, contain MSG.
Spreadable cheeses are more likely than not to have MSG.
While more vendors and manufacturers are making the switch away from SG, it is better to assume that most soups and broth, particularly chicken varieties, contain MSG. It seems most prevalent with chicken varieties, and companies such as Progresso are labeling the changed formulas with prominent "no MSG" labels. Broth and bullion needs to be specifically checked before use.
Most dry soups including Cup o’Noodles and Ramen are huge MSG sources.
Convenient pasta pouches such as "Pasta Sides" and Hamburger Helper contain MSG.
Crackers, popcorn and snack chips in cheese flavors are likely to contain MG. Labels need to be read carefully. Check non-cheese varieties on any brand or line that you discover MSG in the cheese flavors.
MSG headaches are crippling to those prone to them. If you discover you’ve eaten something with MSG, I advise preventative aspirin as soon as possible and to intake as much water as possible to prevent the salt from dehydrating you.

Dressed for Unsuccess

Low fat diets can be dangerous to diabetics due to the addition of sugar to many low fat products. This does extend beyond foods labeled as low fat varieties. Last time out highlighted low fat dressings. The modern popularity of vinegarette dressings is another trail of the low fat craze, but many of these varieties are advertised as naturally low in fat but not as a "low fat" alternative.
The vinegarette dressings are lower in fat because they do not mis vinegars with oils as much as traditional Italian dressings do. Very often, they are high sugar options.
Raw sugar is often added to balance the bite of vinegar. Particularly in fruit flavors of vinegarettes, the sugar content can be particularly high. Diabetics and "healthy" dieters alike need to read salad dressing labels carefully. That salad that was chosen as a healthy alternative to an earnest diet can be an unrealized source of high sugar intake.
Sugar in salad dressings may be unavoidable, but careful label review can minimize the unwitting intake of excess sugars. The safest bet is plain old oil and vinegar, but that can get boring fast. The key to success is moderation. As diabetics are "supposed" to make each meal half fruit and vegetable, salads are an important staple to success, but extra attention is required to what is put on the salad.
If I was whole and capable, I would provide research and label comparisons. My eyesight has nowhere near enough capabilities for me to do that any more, so that extra effort has be put in by those truly interested in what they are consuming.

Low Fat, High Sugar

In almost all cases, it is advisable for "healthy folk" to follow diabetic diets. Diabetic diets emphasize a balanced healthy diet. The reverse is not true. Diets for the general population typically are geared for weight loss, the quicker the better. Instead of emphasizing balanced, sustainable diets, they encourage the avoidance of certain foods or food classification, and this is seldom any healthier than bulemia.
One food diabetics need to avoid at all times is low fat or non fat versions of foods. In removing fat content, the manufacturers need to make the products taste good. The easiest and most frequent way they do this is by replacing the reduced fat with sugar.
One statistic I like to cite long after I have forgotten the source is that obese women consumer the most raw dietary sugar via low fat salad dressings. Obviously, diabetics and dieters alike should read labels carefully. What is being saved in low fat varieties may be providing excesses in other areas. Diabetics need to eat to avoid sharp and sudden rises and falls in their sugar levels, so obviously low fat but high sugar options are typically counterproductive to those goals.
Something seems to counteract most healthy choices as widening American population pursues lower fat diets in haphazardly convenient ways. E get information from people trying to sell us something. We embrace ground turkey as a low fat alternative to ground beef without realizing that turkey contains a much higher cholesterol content. They get you coming or going and prey on our choices for convenience.
The best diets are the ones you can consume for the rest of your life, not some fad that will be broken in a matter of weeks.

Excuses...

The blog has been neglected lately for a few reasons that accumulate enough to come across as excuses.
First, and always best, is that my eyesight continues to deteriorate. Everything’s harder for me, including the computer, and I can spend less time on here before my eyes just burn out.
That burning out limitations works a few other ways too. I am, eleven months after the reattachment surgery, still on four different eye drops, and some recent events temporarily necessitated a fifth. The drops greatly reduce my vision for a few hours afterwards.
Despite the fact that I am really and truly disabled, I have not yet divested myself of all old responsibilities and some of those became quite taxing over the last couple weeks. Things seem to be under control again. I impressed even myself with some of the things I can do blind and am grateful for the lesson that I could still do some things. But the other side of that coin is that I know I don’t want to be doing most of those things. The effort just takes too much out of me.
The last excuse is my favorite. I submitted a shelved novel to a publisher and got a nibble. There’s promise and potential but far from any type of guarantee, but such a chance needed to be pursued. Again, my functional computer time is physically limited and the holdover responsibilities interfered even with the full writing goal, but I got "a more traditional synopsis" out tonight, so can eke out some time to resume posts.
I will be turning back to general diabetic issues of diet.

Diet Differences

Popular or common use of the term "diet" does not fit exactly to "diabetic diet." The general term among non-diabetic populace carries an indication that the diet can be ended or suspended at any time. Diabetics just can’t do that. Every sugar spike, no matter how temporary, adds to the debilitating effects than can plague diabetics.
Diabetic diet must become a lifestyle change of healthy eating and exercise. The diabetic cannot take a week off from the diet. Upon diagnosis, the diabetic must cat back and cut out of their diets and routines. Forever.
That Boston Creme donut enjoyed once a week? Gone.
Diet soda is no longer an option, but the necessity of soda.
McDonald’s is a place that should never be entered again.
"Healthy" people wanting a diet routine could do well to look at diabetic allowances and routines. Diabetics cannot base their diets of fat cutting, calorie counting weight loss "tricks." Too many of those options just are not healthy.

Looking Ahead

The blog has slowed down a bit, just like most aspects of my life have, for the same reason: I’m not seeing as well, with a marked decrease in vision even from one month ago. My rested, strongest vision doesn’t last under much exertion, and real functional time I have is even more limited. More disabled, you could say. Even as I have completed and/or pared down my responsibilities, more things have arisen from those that remain to have kept me busier with less ability.
With the accounts of low and high blood sugar done, I am proceeding with the next phase of direction for the blog, matters of diet. The forthcoming posts will focus on both diabetic and general population diet, how those things can be incompatible, and things diabetics specifically need to keep ion mind, most of which can be useful for non-diabetics to know.
I do thank those who are known to me and strangers who have been keeping up with the blog. I’m limping along through life right now. When I have adjusted to my once again newly diminished status quo, I’m hoping to deal with issues of the blondness more directly, and hopefully with touched of humor that many readers look forward to.
In the meantime, I do hope the forthcoming dietary issues offer information of value to the general readership and those who stumble upon the blog through other sites and sources.

Big D's

Scientists actually know precious little about how the brain works. Intricacies of memory and thought often baffle the researchers. I understand the basics enough. As a science fiction writer I know generalities and specific details about many things, enough to give advance thought and theory but not an expert unless I specifically research a topic and I can often forget the specifics. My mind is limited and usually stretched too thin across too many things.
I understand the chemical imbalances of depression and when the depression is emotional. For months now, as the eyesight has been steadily deteriorating, the depression has gotten worse, with definite biochemical interaction to the despair of my situation.
My mind works by association, I pay attention to assorted random things and have made definite connection between lifelong cycles and my changing situation.
Constant lower sugar levels bring on a biochemical depression. This is now constant low sugar; the A1C numbers will still be higher than any level that any doctor will find acceptable.
I heard a news bit more than a decade ago and putting it into practice seems to have lent weight to the theory that fish and seafood acts as a natural antidepressant. It doesn’t cure me, but I do just feel better the day after eating scallops or whitefish or a tuna sandwich.
All of these fish sources male ,e dream. I am one of those who normally does not remember dreaming, but have never denied that I do. I have vivid dreams the nights of fishy meals. It took a year or so of my time traveling to England on business to realize that I was dreaming due to regular fish intake, not because of a tendency to eat hot custard deserts while there. My roommate always has vivid dreams when he has done a routine trip to Maine. He thought something about being in Maine made him dream, even when he returned that same night. I realized that his typical Maine lunch of seafood (usually tuna) was the true cause. He has no depression or dream issues otherwise.
I have come to believe that people who do not remember dreaming are more prone to depression. More recently, I’ve come to theorize that Vitamin D plays a major role in the chemical equation. The core of the belief if seasonal depression. Less sunlight, less Vitamin D, more depression.
In the last year and a half, as my mobility has decreased, my Vitamin D level has fallen from normal healthy levels above 25 to "insufficient" at 20 and finally to "deficient" at 13. I can’t see where I’m walking and can’t walk where I’m seeing. I don’t leave the house as often. It’s too much effort for too little result. There can be stretches of days where I just don’t leave the house and get no direct sunlight.
Vitamin D can’t be effectively gotten through diet. Sunlight or supplement is essential. Milk actually does not have enough. Online research indicated that the only equal is two servings of fatty fish per day. Besides lacing variety, such a diet can raise big stinks. Lack of vitamin D can produce bone problems, but also result in a variety of other debilitations, including muscle atrophy. I’m sure it has also contributed to the severity of the depression.
I’m taking the supplements as well as an antidepressant.
I’m still trying to pull myself back up.

Physical Low

When I don’t get frustrated or simply wake up with the buzz of low sugar level and insulin shock, certain physical conditions are evident. Keep in mind that this is not a comprehensive list of all symptoms that can occur, but the physical symptoms that usually hit me.
If I have eaten within a few hours of the sugar level dropping, one of the first physical symptoms is flatulence. I control this when I can, but that’s not always comfortably possible. What I ate makes no difference. This does not happen when my stomach is bare empty. This effect happens most often when the sugar drops due to increased physical activity rather than just not having eaten enough.
I will get tingly, especially in hands and feet, an itchy hot feeling.
I get hot and usually sweat. This is often the first symptom to subside with food as blood goes to the belly. I normally get cold after eating if it is under about 60 degrees F or less, and things have been that way since the 1990s.
I get weak and light headed. These days, this aspect will include vertigo. As some of the medications I am on and the eye problems themselves can cause vertigo, I am not sure to what extent the change in Wal-Mart’s ReliOn Insulin causes this specific problem.
Generalized shakiness will overcome me. More often than not, motor control diminishes.
There is a panic sense of urgency. When the sugar starts to fall I can put off resolution, but once a critical level is reached nothing can distract from the need. At advanced stages of low sugar, this does not become a short temper issue, but an exclusive focus on eating to ignorance of all other factors. I totally disconnect from anything else until the blood sugar levels rise.
Overall, it is a very weak and vulnerable feeling.
I have never had fainting spells or passed out due to the sugar being low. This may very well be because the sugar drop is typically a relative fall to where my sugar had been rather than a sheer drop to a home meter test number of 70 or less. While working on trying to get the numbers down last summer, I often let the low sugar feelings stretch out. That did not seem to work. Even as I felt everything was lower, the A1C remained high. There’s been considerable drug interaction in the past ten months, and my disabilities have had other effects that I should have anticipated....

Relative Lows

In talking about the feelings of low sugar, I need to put out the reminder that with my system, it is a matter of relative lows. My numbers run consistently high, but almost daily I feel the effects of lower-than-it-should-be levels. These hit me at home meter testing numbers that would suggest it impossible for me to have low sugar or insulin shock sensations.
In feeling out symptoms over the past twenty years and more, I operated on not letting myself feel high. It’s an uncomfortable feeling, and more importantly, all the complications of sugar come from the sugar being too high. To me, a daily low was a good sign overall.
Most often, the low hits when the first spurt of time release insulin kicks in, usually three to four hours after taking the morning dose. I have found this to be an almost unavoidable and inescapable part of the day, whether twenty years ago or today. I used to take my coffee with extra sugar just to beef up against the coming low. These days I will try to eat full meals; a truly full meal will overcompensate, making the sugar feel higher for a short time, even more than the sugared coffee ever did. Eating in short grazing spurts often will not fully ward against the coming low, and has the effect of expanding the stomach. When eating multiple small meals as a diabetic should, I am usually hungry all day. The likelihood of overeating at one of those multiple mealtimes increases.
The many meal day is difficult to follow through with. I’m almost always home now, but the preparation of six meals a day can absorb enough time that nothing else gets done. A day with errands can completely shatter the plan. Especially with other people always driving, there is an unstated pressure to get done what the help is helping with, to the expense of following meal planning. In working times, this was often more difficult, because everyone wants any "perk" granted to someone else for whatever reason.
A busier or more physical workday than normal can also wreak havoc into the blood sugar balance. The unexpected exertions will absorb the food intake faster and leave the body wanting. Supervisors or coworkers can be very quick to raise speculation of laziness when the body’s reserves get used up and further nourishment is required. Whether working low end or respectable jobs, I always gave everything I had when I had it. This almost never seemed enough to compensate for genuine times of need. Too often, the end result was political workplace failings. Too often, I would push past the physical limitations, which exposed the psychological failings of the condition. This has cost me several jobs over the years. The best recourse was to work independently whenever possible, so I could surge ahead when able and recharge when necessary.

Feeling it Out: Low Life

The confusing contrast between my blood sugar numbers and how it feels is that the numbers are high but the feel is most often low. Think the numbers crept up over time, despite the daily critical lows and my habit of not letting things remain at high feelings.
Admittedly, my system was poor blood sugar control, mostly because I was always reacting to the sugar rather than actively managing it. I still tend to do this. The diabetic recommendation of stopping to eat small meals six to eight times per day is not practical and not one employers would ever favor.
I maintain those bad habits. Even when trying to "live better," I revert to the old ways without noticing. I’m Type A personality with some level of attention deficit disorder. Get too engrossed in what I am doing and want to get just one more thing done before I eat. I lose track of time when I get absorbed in what I am doing. Stopping to eat seems counterproductive, inefficient, and can be interpreted as a form of lazy slacking to coworkers.
The dangerous result of waiting for signs of low blood sugar before eating is a tendency to overcompensate and eat too much. This can create a roller coaster effect of highs and lows. When control any urges to overcompensate, I sometimes stay at a perpetual low throughout the day and can’t seem to raise the sugar level to a healthy feeling
In the days of pork and beef insulin, they physical symptoms of low sugar would give me clear indication that I needed to get something in my system. Those days are long gone to the interests of the pharmaceutical companies’ manufacturing agendas. The humulin varieties, perhaps because they do work in the body more like "real" insulin, show their first signs in me through mood.
Contrary to the impression other people get, (in part because I don’t often take shit that happens because someone else just wants to dole out shit for the sheer love of shit or self-centeredness at other peoples’ expense,) I don’t have any anger management issues. Things that would get other people angry are things I can deal with in a level-headed, often stoic way. I’m actually good to have around in a crisis.
Frustration is something else entirely. I do have frustration management issues, and I cannot hide these when my sugar levels are down.If I print a novel manuscript and realize the ink ran out and most of it has to be reprinted, I would sigh "Oh, damn it," and get to work on changing the cartridge and reprinting. No emotional reaction. But if I have been typing a manuscript for too long and the sugar has fallen, every successive type I make because a point of frustration. The repetition builds, and with it, the frustration. The reaction is not Oh, damn." There’s a horrible biochemical reaction and I become insane. The "damn" becomes shouted streams of language that would make sailors and the dockside whores who service them blush. If I get stubborn and stupid and insist on finishing what I was doing before eating, I can turn violent against inanimate objects or myself. Somehow, I have a very solid mental block against turning this on other people or the innocent cats that reside with me.
This ends when I eat, but if I really lose control, guilt shame and embarrassment will linger and trigger a depressive state that may last a day or two, until the next too-low moment.
Even in the low sugar state, a major crisis will not affect me, although I am more vulnerable to people who may want to instigate because the repetitious frustrations trigger something different in me. The sugar is the key factor to that, but I do not deny that there’s some otherwise hidden character flaw involved.
Without frustrations, the dropping sugar level will proceed to the physical symptoms without the psychotic interlude.

Feeling it Out: Mid Life

My experience of watching other men deal with their mid life crises had provided me experience than just with my father, who is the type who would probably deny ever having had a mid life crisis. Fathers, bosses, mentors...most ruined things for themselves in one way or another. I sought to avoid that.
I had that "what to do and how to get there" life crisis early, at high school rather than college age. It’s no surprise my mid life crisis came at 36 rather than in my 40’s. It was mild. I developed an uncharacteristic infatuation that I could not make develop. I regretted having little financial savings. I listened to other people who told me I should be taking care of myself better health-wise.
At 43, I am still shunned by the former object of my affections. My main means of savings is still home ownership and equity–always iffy in this economy. And now I am not only disabled but feel like crap.
My diet had never been bad. The sole dietary change I made was switching from real sugar to Equal in my morning coffee. I had developed the sugar habit to boost my sugar in the days when I could not actually afford to eat anything for breakfast. That had changed. The other significant change when I started "taking care of myself better" was following my GP’s guidelines of taking a much higher insulin dose at night. It made sense to me as I knew by feel that overnights were the main time I sugar would rise to uncomfortable levels.
My sugars did lower, although never to the A1C numbers my doctor wanted to see. I was no longer getting up in the night to go pee. Instead, I was not able to sleep because the sugar levels felt too low. Too high, and I don’t get good sleep because I’m off to the bathroom a few times each night. Too low, I just can’t actually fall asleep.
I still seldom find that right balance.
This past spring and summer, I made a renewed effort to get my sugars lower, no matter how I felt. The inflamed Charcot foot had further impeded my circulation enough to cause the quick and massive infection that almost cost me a toe. The night of that hospital admittance also emphasized one particular problem food that raises sugars beyond expectations. (Low fat milk, which I will address in detail before long.) I succeeded, and am feeling so much worse for it.
Here’s how the diabetic things feel these days.
My blood pressure went back to normal levels when the Charcot inflammation subsided. The reduced swelling is probably more of a by product of the prednisone I still must drop into my eye than true healing. The foot is stable, but the Crow boot is a permanent fixture due to the ankle collapse suffered from the reduced circulation. I have frequent vertigo issues, which is probably a combination of the eye maladies and reaction to blood pressure medication meant for a worse situation than I am now in. Any of the four to five eye drop medications may also play into the vertigo.
My eye is a mess and my vision is getting worse. The strobing light exams contribute to this. The eye drops reduce vision at least temporarily when taken. Debris may be built up in the silicone oil that still remains in my eye. Light sensitivity is still blinding, darkness vision is non-existent, and the "retinapathy veil" grows darker. On doctor’s instructions, I had stopped the eye pressure drops when the pressure was good, and it re-rose to scary levels, so those drops are to be continued indefinitely. The prednisone still gives stomach problems, but not as severe as they were last winter.
Long story short, I’m the mess I had sought to avoid ever becoming after re-examining life in middle age. Maybe that "male menopause" just can’t be avoided.

Feeling it Out: High Life

My GP doesn’t fully understand the quirks and nuances of my sugar levels, and that seems to permanently maintain our lack of consensus on treatment. I do try to go along with his recommendations, but for me, it is more important to feel good than to be good according to numbers.
I feel good and function when my A1C runs towards 14, double the guidelines. Standard home testing numbers have run at 400 and I have felt a relative low in the blood sugar.
This isn’t normal, and I know it.
I do not let the sugars linger at levels that feel high. If I start peeing too much or get the heavy "clunky" feeling of high sugar, I take more insulin, without hesitation.
I’m not recommending this high life, but am just accounting for the slow rise in my numbers over a period of years, with note that my body adapted well to it.
Periods of sincere attempts to manage more according to my doctor’s wishes ushered in periods of not feeling well. The lowered numbers always seemed to usher in other problems, including the problems that now have me permanently disabled. I do not believe it just "caught up with me." I think the changes made me a "fragile" diabetic. The timing of bodily changes to the development of problems that led to other problems was too exact. For all the "typical" connections between the things that have afflicted me and being diabetic, none of my problems spontaneously "combusted." All of them had catalysts that can be traced outside the diabetes.
I’d love to feel healthy again, but I am too much of a realist to entertain pipe dreams. The damages are now done and there is no going back.
I talk with other diabetics I know, whether Type 1 or 2. I have yet to meet anyone who maintains proper numbers–A1C >7 and home testing at 120–who actually feels good. Most seem to get more discouraged by berating from doctors and caregivers when they can’t get their numbers to those levels. Those that do don’t feel good when or if they get there.
Average people in diabetics’ lives just don’t seem to get the delicacy of the balance.

The Stable System

My "lack of control" regarding my blood sugar developed over years. At the point of "taking care of myself better" circa 2005, I had stable but definite signs of old diabetic damage. Diabetes effects became opportunistic in the face of other problems that developed independently. Throughout those years I had a stable situation that resulted in good health, at the very least as defined by how I felt.
Those years of being a "better" diabetic–never a good diabetic–destabilized me. I have not felt healthy since.
I know this sounds like a load of bull poop. I can’t count how often I am told I am wrong about how I felt and how I feel. I am told that what I report just isn’t possible.
I don’t think it’s that impossible, and I can explain it with knowledge of another hobby I have mostly had to give up to being blind.
If you set up a new tropical fresh water fish tank, you have to create specific conditions that the fish find comfortable. Otherwise, they die. There’s things you shouldn’t put in the tank, there’s things you can’t put in the tank, and things you can’t put in together. There’s some fish such as tiger barbs that thrive in a new tank while your desire for something like neon tetras must wait until the tank’s enclosed system ages. You set the tank up successfully and get it off to a good start.
Time passes. Your diligence fades and you pay less attention to the tank’s ongoing water conditions. The fish in the tank continue to thrive with minimum care of filter cartridge changes and daily feeding. You stop testing the water. Some fish die by attrition. You get more of the same to maintain a school, and they die off quickly. Testing shows that the water is not healthy for the fish. You effect changes to accommodate new fish you want to add, and the changes kill all the old fish that were thriving in the "unhealthy" water. Because the bad changes had happened over time, the old fish adjusted to it.
My body was an enclosed system thriving under bad conditions. The changes I made under my GP’s guidance were textbook and statistical moves towards the way things should" be and they massively disrupted my thriving unhealthy system. The chain of events of unintended consequences directly led to the loss of the good eye and the Charcot foot.
My impossible desire isn’t going back to not taking that dose of Cialis, but going back and never putting myself under care and making those efforts to "take care of myself better." I never needed boner pills when I "wasn’t taking care of myself." Every other function worked better back then too.
My GP says that it all just caught up with me. I find the timing of the decline too perfectly coincidental to believe anything other than that the GP’s statement is just more bull poop.

Relativity Theory

I generally feel very stiff at the times when my body is feeling high sugar. I say this with the acknowledgment that strictly by testing numbers, my sugar is always high. By functionality and my body will frequently disagree with testing results. This is a phenomenon of relative highs and lows. I do not home blood test. As I learned more about the home testing process as my GP tried pushing it on me, I was not able to get satisfying answers to what I should do if my body said my sugar was low and in need of food but the numbers ran in three- or four hundreds.
This happened in my GP’s office a number of years ago. He was doing the usual rant on higher sugar. I told him normally my sugars felt healthy to low and that in fact I was in an insulin peak that very moment and needed to eat. He had an assistant do a home test. My sugar was in the 400’s.
I asked how could be having the feelings of excess insulin. He only shrugged. I could only shrug at his questions. I was not exaggerating how I felt or making anything up. I had to eat something before I could feel comfortable driving home.
As my GP had no answers, I turned to the internet. The disparity was a general theory of relativity. For good or bad, I took the situation as reinforcement of my own theory of self management. My doctor considers it rationalizing my own recklessness. He does not understand how I have never been in a coma. He will not consider causes other than my "poor sugar control" for any malady or complaint that can overlap with diabetes.
I face my own experience. While I was an "uncontrolled" diabetic, I had no effects that could be attributed only to the diabetes. Some things, such as periodontal problems and the loss of vision in the right eye certainly resulted from diabetes being opportunistic of other problems, but no condition spontaneously began without influence from factors outside the diabetes. That has not remained true in the time since I have been "taking care of myself better."
Here’s my train of thoughts on this.
My baseline number may be at 450, a blood sugar number that should have other people in a coma but at which I was healthy and strong. A "good" diabetic has a baseline of 120 but home testing numbers. We take our insulin. The insulin peaks and lowers our respective blood sugar numbers by 40 points. I drop to 410 and the goodie drops to 80. My change was under 9% while the goodie suffered a 33% drop in sugar level. We’re both feeling the effects of low blood sugar, including the sweaty panic. We overcompensate, raising our blood sugar by 70 points. My new change from 410 to 480 is 17% while the goodie caused a whopping 87% change from his low of 80.
The percent of change is far more drastic to the good diabetic than to the surly bastard that is me. By these numerical statistics, the healthy diabetics are comparatively fragile diabetics.
I am not advocating that diabetics intentionally raise their numbers to levels that could kill them. My "lack of control" developed over years. At the point of "taking care of myself better" circa 2005, I had stable but definite signs of old diabetic damage and some of these became opportunistic in the face of other problems that developed independently. I had a stable situation that resulted in good health, at the very least as defined by how I felt.
Those years of being a "better" diabetic–never a good diabetic–destabilized me. I have not felt healthy since.

Intensity of Feelings

(Feeling it Out: The High Sugar, Part 2)
Unquenchable thirst and heavy urination are the most obvious feelings and signs of high sugar, but far from the only ones.
I generally feel very stiff at the times when my body is feeling high sugar. I say this with the acknowledgment that strictly by testing numbers, my sugar is always high. As discussed in the posts, the numbers and my body feeling can be contradictory. When faced with a decision over the contradictions, I would always choose to listen to my body’s demands.
When I eat dinner towards the end of my insulin cycle, my body can react quickly. I reasonable meal without a lot of sugar content can cause an uncomfortable spike in blood sugar levels, and the urination cycle will often not be the first or most apparent sign.
My ankles get particularly stiff under those circumstances. It can trigger what has been dubbed by pharmaceutical companies looking to push drugs as "restless leg syndrome." Food is in, the sugar goes up, the blood thickens, and circulation reduces. I feel no need to test when this happens. It’s easy enough to think what time it is now and when I took the last dose of insulin. The stiff ankles will always trigger after a meal consumed about 11 - 14 hours after the insulin dose, even when I have eaten very little throughout the day. When the insulin has been absorbed, it is gone and any intake will trigger a blood sugar spike.
I react by taking my evening dose of insulin. I don’t advocate that other diabetics avoid home testing because I understand the danger of the advice when misapplied. I, however, pay attention to the situational factors of my day and their effects on my diabetes.
For me, high sugar feel somewhat different when it is high from food or sugar excess than when the spike comes from the insulin having just run out or been absorbed.
High sugar from the insulin petering out is a vague discomfort. The stiffness is pronounced in the ankles and a more distant feeling elsewhere; it’s almost something that has to be specifically considered than something that would be readily noticed on its own. Thirst will not be automatic, but the tongue just doesn’t taste right and may feel thick on the surface.
I feel more intense when the sugar rises due to actual excess or having eaten something better avoided. The ankle ache won’t be a dull stiffness, but outright "cramping" pain. The overall stiffness will also have intensity enough that motor control may diminish. The tongue may taste fruity and overly sweet in that way that produces the fruity breath that is an indication of diabetes. As a child, I used to look at that last sign as a curse of how my own body would betray me to others.
These signs will usually affect me before the thirst and urination cycle begins.
I pay attention to these signs. I shoot up at first opportunity. The side effects and debilitating conditions that accompany diabetes occur from the sugar being too high. It always made sense to me not to let those feeling linger. Those aren’t comfortable feelings anyway, so I deal with them at first opportunity. Regular insulin will begin improving the feelings almost instantly.
I do not let high sugar feelings remain for long, but in years of effort, I have not been able to rectify the feelings with numbers my doctor feels comfortable with.
Whose feelings should I prioritize, my doctor’s or my own?

Pissing the Days Away

(Feeling it Out: The High Sugar, Part 1)
The most obvious sign of high sugar is the most obvious symptom of the onset of juvenile diabetes itself the insatiable thirst and frequent to constant urination. This makes sense with basic understanding of how the body works. The body senses the excess sugar as waste material that must be purged. It makes you thirsty to give itself the raw material of water to ease and speed the removal. In Type 2 onset, this is also present as a condition and symptom, but less prominent. Not being able to sleep through the night without a need to get up and pee is one of many subtle signs.
With some but surprisingly little exaggeration, when my sugar is really high–and I do not let it stay that way–you could pretty much stand me over a toilet with a garden hose to my mouth. At a critical high I remember (caused by having forgotten to take the insulin before work and not realizing it until after having eaten) I had to go every fifteen minutes. I’ve had nighttime surges that had me awake more frequently than every hour, and more frequently than every half hour if unable to get fully back to sleep in between trips.
This is not a comfortable situation. I do not hesitate to shoot up to resolve the problem. If I get up a second time in the night ro pee, I shoot up no matter what. Often I shoot up if I wake at all without having an "innocent" cause such as having drank a lot just before bed. Most of the time, barring other issues such as insomnia, I sleep through. I feel healthy when I do that.
This is part of the very difficult balancing act. Other people often do not understand the true difficulty involved in "controlling" the blood sugar and maintaining balance.
If my sugar is too low, I cannot sleep at all. A night of higher sugar does not provide restful sleep. For purposes of sleep "normal" hours in duration and the actual time, I rest best when the sugar is starting at (by feel) a somewhat elevated level but is on the way down. Daytime function can also feel best under those circumstances.
Most of my sugar control problems have been the at night, either too high or too low, one extreme or the other.
Because I have managed by feel rather than testing numbers for so long, I tend to notice changes in my system rather then effects on numbers. One of my HP’s weaknesses is a tendency to blame any symptom on the sugar instead of other possible factors. Prozac acts as a diarrhetic on my system, creating excess urine from the amount of water taken with the pill. My GP waved that off as urination due entirely to high sugar. My body says otherwise in function, particularly as that first draining after a Prozac pill tends to be very foamy.
While the thirst and urine cycle is the most obvious sign, I always note that diabetics can get thirsty or piss more for other reasons. A handful of pretzels can trigger great thirst for the salt but not actually raise the blood sugar. Diet soda can be a diarrhetic, causing urination in quantities beyond the amount of fluid consumed.

Blood Sugar Downer

The change in Wal-Mart generic insulin manufacture has brought more frequent periods of discomfort with "low" sugar levels. I use quotes on "low" as acknowledgment that this is by feel, not by blood testing numbers.
Overall the sugar has felt lower with the Novolin than it had been with the Humulin formula. Since the toe problem that landed me in the hospital in the spring, I was making a concentrated effort for an overall lowering of the blood sugar. The change in insulin seems to have made a sharper change in that direction, unfortunately at a time when I was looking to slowly raise it again so I would feel overall better health.
People, including my GP, do not understand that last statement. Diabetics do. I do not feel as good when the sugars are lower. Diabetics who are good doobies and paint by numbers also report that they feel less well when their sugars are at better numbers. I’m still waiting for that lucky day when I meet a doctor who understands that how a patient feels is somewhat more important than what test numbers statistically say about their health. At least two of the three other diabetics with whom I have most recently spoken with in general terms report that they primary care givers and/or diabetic specialists have railed against missed target numbers without regard to how the patients were actually feeling, so I am not holding my breath on meeting the more compassionate and logical doctor. Both of those acquaintances were discouraged that no effort seems enough.
I have never recovered the feelings of wellness and functionality I possessed prior to "taking care of myself better." By the full chains of events, I would not be blind nor crippled by the collapsed ankle via Charcot foot if I had not started taking care of myself better. I My numbers had risen again and things got better, but never back to where they had been, even discounting the blind thing and the cripple thing.
I did make a renewed effort on my own after this spring’s hospitalization. The Charcot foot had nearly totally impeded circulation in the foot, allowing for the sudden infection and almost instantaneous gangrene and the collapse of the bone structure that has permanently impaired my ankle. My largest steps were to eliminate as much of the big (and hidden) source of sugar in my diet as possible, and letting my sugar levels stay at critically low feeling longer than I usually would.
I don’t need an A1C test to know I have succeeded. I don’t feel as well as I did prior to the hospitalization. Fatigue is constant. When the sugar hits a low feel level, the physical symptoms hit much sooner after the temperament issues than they used to. Those temperament issues are more severe and the "calm" times between are periods of severe depression that is biochemically impacted beyond the constant "useless gimp" feelings that are situational depression that anyone would feel in my situation. My thoughts are usually slower. I tire more easily. Stamina is gone. Neuropathy burns are more frequent. The depression had reached such an abyss that I found no choice other than to resume antidepressants.
Does this sound like healthier living?
It sure don’t feel like it.

Feeling it Out: Wal-Mart Generic Insulin Change

With a few more weeks of (mostly) twice daily dosages under my skin, I think there are larger differences to the Novo Nordisk manufactured Novolin from the generic it replaced, Eli Lilly Company Humulin. I report these changes from feel, not from home monitoring of blood sugar numbers. I am also talking about the time release "N" variety and have not begun using the instant "R."
The Novolin seems to peak less often in the day. The humulin would spurt in several times over twelve hours and then it was just gone, fully absorbed and needing replenishment. The Novolin peaks are stronger than the humulin peaks. This makes sense with the lesser frequency of peaks.
The first surge is strongest and is not always easily leveled.
The Novolin lasts longer than the 12 hours I was used to with the humulin. That strength of the first peak after the injection may be that the first of the latest injection is combining with the last of the prior injection.
The change has brought more frequent periods of discomfort with "low" sugar levels. Overall I feel that the sugar is lower than it had been with the humulin formula. Since the toe problem that landed me in the hospital in the spring, I was making a concentrated effort for an overall lowering of the blood sugar. The change in insulin seems to have made a sharper change in that direction, unfortunately at a time when I was looking to slowly raise it again so I would feel overall better health.
Diabetic patients do need to watch themselves more closely when adapting to the new generic.

Anniversary

My quirky mind works by association. Prior to 2009, October 6 was always my "un-birthday," the date of turning age + half. Don’t ask me why this was always so; I barely acknowledge my actual birthday.
Since 2009, 6 October has been and probably always will be the anniversary of the blood hemorrhage that made a sometimes uncomfortable life into something perpetually difficult.
I’ve been in a deep "melancholy" state of late as it is. The blog post records acknowledgment and lets me move on with the day, with my life.
Don’t ask me how I’ve done this through these bleak and darkening three years. Many times I would find myself completely unable to answer.
Today it will be concentrating on getting a fiction story or two out to editors for submission before the glare of the TV used as a computer monitor overwhelms my vision. I don’t submit stories often any more; the task is impeded by the vision and always takes time from everything else.
Perhaps that feeling of so many things left undone is the fuel I use to propel myself forward. I don’t want to look too deeply, though. The blur frustrates me when I look too hard at anything, and I am afraid the charm will lose its magic if I try to understand its workings.

Untested Theory

I do not test my blood sugars for reasons that make logical sense to me, including the hastening of neuropathy problems in the fingers and moral outrage that pharmaceutical companies’ financial interests take priority in this country over the long term interests of patients. Other alternatives exist but are suppressed for the profitability of test strips and lancets. I am not alone in this; one of the doctors I saw about a specialized problem in the past year is a Type 2 diabetic who also does not home test. Like me, he relies on A1C tests to gauge his progress or lack thereof.
Readers, however, should keep in mind some things about this (non) practice. The first is that I fell into it out of necessity during financially destitute times, not an intentional rebellion from the inescapable status of being diabetic. I had been diabetic for fifteen or more years by that time and paid attention to what my body would tell me.
Non-testing could be dangerous to those who can’t or won’t pay attention to their bodies’ telltale signals and I do not advocate the practice even while discussing it. Knowing the signs can take time, so newer diabetics need to go through the regimen up until a time that other home testing alternatives are made available.
I stopped even urine testing due to financial constraints sometime around 1989 to 1990 and managed the sugar by feel. One key aspect of this, something I had to "unlearn" from prior diabetic education and parental control. In that abandoned approach, the theory impressed on me was that the insulin was taken only at certain times and the rest of your life was to be planned around that until the nest scheduled dose. I think most people can imagine the post high school difficulties in this, with college schedules and variable work schedules. Employers certainly understood it: I had been told outright in 1987 that I would not have been hired if the boss had known I was diabetic. Wonder how many bosses since just never said so outright after such statements became illegal.
The new approach I adopted was to react to what my body told me. This is not just a matter of eating when my body said it needed food, but shooting up with more insulin if my body said it needed that. This had not been an approved method of treatment growing up. Starving the patient was the directive on food, and taking insulin outside the approved times was also not allowed. This mentality left me with long stretches of feeling uncomfortable and probably triggered some aspects of old bodily damage.
My refusal to test my sugars outside occasional A1C lab tests (the same method that doctor I mentioned uses) does not equal not taking care of myself or emotional denial of my condition. I feel uncomfortable whenever the body feels that the sugar is too high or too low, and will make efforts to moderate extreme feelings.
But as I managed by feel for more than two decades, my body diverged entirely from the medically approved number scales of any blood testing. I feel good at what are considered to be horrifically dangerous numbers. Any and all efforts to control the sugar by the numbers has resulted in the manifestation of side effects and complications. I felt healthier when I was a purely "bad diabetic" by professional standards. In the decades of no testing, even by A1C, my body regulated itself to a place it wanted to be and I could fully function in every way, but the numbers rose to levels that make my GP wonder why I had never been in a coma. I had managed by feel and in light of the problems that have developed as a result of "taking care of myself better," I wish I had stayed with the "lifestyle" that had worked so well for me for so long.

Burns and Blood

It’s easy to confuse the specifics among generalities and similarities. I have caught myself doing this recently in causes and effects within my legs. I don’t think aspects of this mistake hit the blog, but it’s better to be clear.
A diabetic is inclined to have many problems with their extremities. My earliest side effects of being diabetic related to my legs below the knee. My lower legs easily cut or scrape with the slightest aggravating touch. These minor mishaps generally heal well but do scar easily. The other longstanding sign is caused by my good habit of protecting my feet with constant covering of quality socks. I should all along have been using socks that did not constrict around my ankles as much. I should have been choosing socks with less upper elasticity. The tighter socks had a tendency to rub constantly on my legs. My legs could rival the hairiness of a spider’s legs, except that socks tend to shear away hairs along the lower shins and ankles. The natural indent behind the knobby bone of the ankle maintains a tuft of hair because the socks stretch over the area rather than rub against it.
These quirks result from diabetics’ reduced circulation. Neuropathy is a completely different affects the same areas as reduced circulation, but is a completely different thing. Neuropathy is a condition of the nervous system. Circulation is blood flow. Reduced circulation hinders the main function of the blood stream: delivering oxygen throughout the body.
Neuropathy causes different problems. Usually the first sign is reduced sensations of touch and feeling. The diabetic may not feel minor cuts or other injuries to the feet and lower legs and the hands. This can be dangerous as unknown injuries will remain untreated. The poor circulation conspires with the neuropathy to raise these risks of infection and gangrene, as I perilously learned last May, as recounted in most of the entries under the "Sturdy Hospital" label.
The second most common sign of neuropathy is burning sensations. This generally occurs as the problem advances. It feels as though someone took a wooden match, lit it, then pressed it against my skim. The burns may throbs. I never had this problem until after "taking care of myself better" by working with my GP starting in 2005.
The burns will often throb in time with my pulse, and may synchronize with points of pain in different locations. The pain is not generally constant, and occurs more often at night. It can manifest from the toetips and up the legs to the waist.
My sugars have been up and down over the past few years in self-comparison. Oddly enough, I feel the burns when my A1C blood tests are higher.

Post-op Pattern

The retina reattachment procedure did not go as well as either my eye doctor or I had hoped. I dealt with that disappointment OK, all things considered.
I noticed a pattern that is giving me reason to look at things more deeply, so to speak. I have noticed a definite pattern that my eyesight gets worse. When it recovers from the visit, it does .
My theory is the light sensitivity effect. Glare is worse, sensitivity to light is worse and darkness vision is worse, all worse aftert each exam.
In these visits, they are dilating my eye and strobing the eye with very bright light. This is how the doctor is able to see the retina to note changes. I think this has the same damaging effect as staring at the sun.
I don’t see the point of going to the doctor–even this very good doctor–to be told I can’t see.
The eye is unstable, and the condition is currently made worse by the resumption of eye drops for eye pressure and the report of a cornea scratch. There’s more to the latter, and those have the texture of anchovy paste and the effect of making things worse.
I still have a procedure to go. The center of my eye is filled with silicone oil, which is meant to keep pressure on the retina to keep it in place.to be drained. My realistic hope is that the oil has gotten clouded over time and that the procedure will ewatore some acuity.
Other things to hope for are just not realistic. For me, realism always trumps optimism. The doctor wants to continue waiting before changing the silicone oil. If it is potentially creating a glaucoma problem, and if my vision worsens every time I am examined, we’re crossing the threshold of the treatment being worse than the disease.

Kidney Pie

Kidney disease as part and parcel of the entire nightmare of diabetes is easy to understand with a little knowledge of how kidneys work. In essence, they are filled with blood vessels.
Learning that simple fact also tied the connection between blood pressure and kidneys in my brain. I had not been able to grasp the logic of the kidney-blood pressure correlations even asking questions of doctors. I knew that blood pressure medications are usually also beneficial to kidney health.
The tiny blood vessels within the kidneys act as the actual filters for waste products in the blood. The kidneys expel the waste through urine.
Those facts make a lot of the diabetes connections self evident to me.
The primary symptom of high blood sugar in diabetes is severe thirst and frequent urination. The kidneys sense too much waste sugar and make you thirsty to give them the fluid they need to expel the waste at peak efficiency.
Constant high blood sugar damages blood vessels. This damage is most apparent in retinapathy and circulation. Kidneys follow closely behind these problems. Knowing that the blood vessels in the kidneys are tiny makes it quite understandable that they can be damaged easily.
High blood sugars thicken the blood. The thicker blood passes less easily, especially through smaller vessels. Like Coca-Cola that was wiped but not washed from a surface, the blood becomes sticky, and this further reduces the blood’s ability to pass freely. The smaller vessels and passageways clog. Weaker blood vessels can break, restricted vessels can increase blood pressure, and smaller vessels will clog or reduce circulation, which deprives body parts of needed oxygen.
Constant high blood sugar overworks the kidneys on a regular basis and thus can hasten damage just by effectively wearing out the kidneys with overwork. The waste products that the kidneys remove from the blood slide through "filter holes" in the kidney. The waste stays molecularly smaller than protein and healthy blood cells. Overwork of the kidneys essentially enlarges the holes over time and allows good protein molecules to pass into the urine.
The lab test for kidney function and performance is usually a simple test. The lab checks for amounts of protein in the urine. The kidneys are supposed to filter waste but retain protein. The presence of protein in the urine indicates a problem. This really is the best way to determine kidney problem at a stage where further development of the problem can be kept in check.
Other "early symptoms" of kidney disease are vague and overlaps with too many other potential problems with the body. The overlap is also high with other symptoms that diabetics may feel on a daily basis without kidney problems. These general symptoms include fatigue, poor appetite, poor concentration, insomnia or other sleeping difficulties, general weakness, and upset stomach.
The best preventative maintenance for kidneys is to drink a lot of water regularly, not just when your body says it’s thirsty.