This page has moved to a new address.

diabetes 24-7

<www.diabetes24-7.blogspot.com>

28 April 2006

Our Bodies and Insulin

As of late, I have been working a lot. Admittedly, this blog has suffered!

Another challenge I faced recently was excruciatingly bad sugars. It was horrendous and frightening. I am a “mum” and I manage a staff at work and I just felt like things were falling apart.

It all started with a little problem that I have had for 5 or so years now called Diabetic Hand Syndrome. Twice a year I receive steroid injections for pain management. My sugars tend to rise a little after the injection, but it is manageable. This time my sugar went up to 27 mmol (multiply by 18 to get mgdl!) It took me six hours to get it down. But things didn’t get better – they were getting consistently worse. My sugars varied from 17 mmol to 13 mmol over a succession of days. 10 was looking pretty good. I was starving myself for better sugars but nothing was working.

Finally I got to see my doctor. My A1c was not affected, but together we couldn’t figure out what was going on with me. Was it purely hormonal – did I have an over-active liver?

I asked my doctor to look at my pump injection sites – sure enough this was the problem. I am suffering from Lipohypertrophy. Here is what my doctor told me:

Lipohypertrophy (which is common and due to fat build up) occurs with all insulins, including aspart and lispro because it is due to the action of insulin on the fat cells. There is no difference between lispro and aspart in this respect. Most people have some degree of liohypertrophy at some stage in their diabetic career, whether on injections or the pump, by the way.

It isn’t that bad on me – in fact hardly noticeable on my stomach area. But there are these little globulars of fat storage sites which I can detect (and I am quite thin.) Hopefully, they will disapear in 6 months or so. I now must use the sites on my lower back or sides, upper legs or even arms! Talk about a human pin cushion!

Things improved in 24 hours. And my trust in my doctor is stronger than ever.

09 April 2006

Diabetes Plague?

In keeping up with my interest in the NY City Department of Health's policy for diabetes survelliance and evaluation for diabetes patients diagnosed and seeking medical care in all the NYC Boroughs, I saw this editorial tonight and thought I would post it. (The original article I posted was on 20 December 2005.) The author of the editorial, Dr. Gerald Bernstein appears to be dedicated to the care of many patients with T2 diabetes and with one quick review of his biography, we can easily comprehend how deep his commitment to diabetes research and furthering diabetes advances in mainstream healthcare. Is his concordance with NYC DoH a reflection of his frustration in dealing with so many poorly cared patients?

Dr. Bernstein even compares diabetes to the plague...seems very extreme, but is it? In modern terminology the word plague is used to describe any epidemic disease with a high death rate which is usually also highly infectious. The Plague specifically refers to the bubonic plague, a disease carried by rats and spread by fleas which killed a third of all humans in medieval Europe.

I think his tone is a bird's eye view into what it must be like for a diabetologist or an endocrinologist in the US - and what he sees everyday. I know that just sitting in any diabetes clinic for one hour is like being in a war zone with bandaged (sometimes bleeding) legs, immobile people in their 40's, 50's and 60's ..., bandaged eyes, people without limbs and finally, tears and frustration. I see the eyes of these patients looking at me - a relatively young woman who looks healthy. Their eyes look right through me begging for understanding and solutions. I am not being dramatic...the emotions are palpable. The faces of diabetes are (often) heart-breaking.

I return home from my quarterly appointment feeling raw from seeing so much pain and suffering for a disease that strikes so quietly yet so insidiously with many serious and horrendous complications! What will be the result of all this media attention? Will all diabetes patients finally have the opportunity to receive the education and care they require?