Blackouts and Basics

I’m afraid I’ve left it a bit late to post today, I work from 5:30 until 11:30 pm, which means (although I like it) sleeping until around 4:00pm because I have to squeeze in work before my insulin, that is Humulin(TM) starts to peak (in 7 to 8 hours, but the timing always varies. (Important Digression; main thread continues below) And I have to let the Humulin(TM) get going in my system for at least an hour, so it’s at least somewhat active soon after eating, waiting most of the hour to eat, if eating is at all possible [checking the log, I see I ate breakfast (2-5 oz. of a pasta, vegetable, meat mix, I eat at least twice a day, to minimize variables) every day this week, m-f, which means I began every day with a normal or near normal blood sugar. That’s a pretty good week, because reaching euglycemia, or normal blood sugar at least once every day will ensure you will not experience (with the exception of unusual circumstances, such as illness) ketoacidosis, period. This is one of the pillars of my technique: GET TO NORMAL EVERY DAY)

I can’t stress this enough, the only target for your blood sugar is normal blood sugar. This is the only way to avert complications down the road. The downside to this is that You will experience hypoglycemias. I know, even for those receiving adequate warning, reactions can be terrifying,  Twenty seven years ago, in between school I worked with a lady who remarked on the equanimity with which I endured and remedied insulin reactions. She told me her diabetic husband was terrified of them. Her husband was a very large, strong and thoroughly imposing guy and you wouldn’t expect that sort of response, so I know how scary insulin shock can be. Think how bad it is for someone who can’t tell, most of the time, that it’s even happening!  I see doctors, who are trying to help their patients avoid these events, encourage patients to maintain their sugar at what I consider alarmingly high levels. My friend Fred, with a diabetic daughter, told me that once at a support group meeting, he was talking to a woman who said her sugar hadn’t been under 200mg/dl in 6 months. I was horrified, I said ‘Fred she needs to be under a doctor’s care!’ He replied, ‘What are you talking about, Mike? She IS under a doctor’s care!”

The problem is, in a few years, she’ll be experiencing gradually increasing complications, cardiovascular and renal (kidneys). Her eyesight will be rapidly deteriorating (I’ll show you how to prevent that later) and she’s going to end up blind, ischemic (interruptions of blood supply) and on dialysis. THIS IS NOT A GOOD TRADE-OFF! Hypoglycemias can, in most cases, be dealt with easily and quickly (although for the elderly patient, already advanced in years, the equation might be re-examined), and this is a much simpler and easier process than living on dialysis or being blind, Then, of course there are the other commonplace results of perpetual high blood sugars, such as  losing limbs, not fun.

(This is not intended to be unfairly critical of doctors. By far, most doctors are very hardworking and immensely compassionate, especially my last three doctors, people. They’re in a hopeless position, trapped between loyalty to their patient and the draconian dictates of “managed” care accountants.

On top of that they’re being lied to, yes, I said it, by pharmaceutical drug dealers interested only in perpetuating, not curing conditions which garner them billions every year. Rezulin (troglitazone) springs to mind, the TZD (thiazolidinediones: http://en.wikipedia.org/wiki/Thiazolidinedione) medication, reported on by 60 Minutes, in which pharmaceutical representatives state that when briefing doctors on Rezulin, if asked about  possible adverse effects, they were instructed to ’steer the conversation to another topic.’ Rezulin killed at least 63 people, although I’m pretty sure NPR revised that number upward more recently.    http://www.yourlawyer.com/topics/overview/rezulin)

Thread Coninues:– because that is when most of my hypoglycemias or blackouts occur, although they can and have occurred pretty much every hour of the day. Naturally, they tend to correlate with the rise and fall of the insulin activity. Anyway, I’m awake all night and  had a friend come over, I hadn’t entertained in a long time, so with one thing and  another, it’s already bedtime. But I would like to at least post links to some of the articles I’ve been collecting over the last 8 years, if I can figure out how, hang on. Also, I wanted to mention some of the other topics I intend to discuss, including the structure of insulin, why Humulin(TM) is NOT insulin, the role of Big Pharma in the selection and editing of research on a number of products, including insulin and the relationship between Humulin(TM) and osteoporosis     (Daniels, Stephen R. M.D. , Ph.D. The Journal of Pediatrics, Vol. 144, Issue 1, Jan. 2004, page A3 — “Type 1 Diabetes and Osteoporosis”). At the same time, along, hopefully, the left edge, I’ll post the hourly log, I keep every day, and have for nine years, since shortly after I was forced to go to Humulin(TM). One of the purposes of this blog is to shed light on the existence of persons living with Hypoglycemic Unawareness (from now on, I’ll just type ‘HU) and having to depend on a synthetic drug which behaves for over 10%  of the people using it, extremely erratically, causing blood sugar to skyrocket even without food and nearly always after a very small amount of food, then plunging precipitously with the space of minutes to an hour. Source:(http://members.tripod.com/diabetics_world/symptoms_of_synthetics.htm) That is, except for the days when it doesn’t do that

There will be criticisms of the technique described, I know, because of my nearly exclusive use of reagent strips for estimated blood glucose measurement. I yield willingly to these anticipated critiques, I would love to be able to use one of my many glucometers whenever I liked, but the cost of strips is prohibitively expensive for a person who, because of his condition, has to work a little more than part time (up to 30 hours/week so I can get back before the peak gets going).  Also, digressing again for a moment, sometimes it’s not necessary to know exactly where your blood sugar is as long as you know it’s still high, and you need to wait to eat, or it’s not above normal and you CAN eat. People are far more likely to check their sugars more often if all they have to do is pee on a strip. Guys of course have an advantage.    (Insert: I would like to stress that the data I get from reagent tapes is carefully phrased, the color ranges are assigned values which have been repeatedly correlated with one or more (occasionally) glucometers. The data extracted from reagent strips is limited to “110mg/dl or lower” to “160 mg/dl or higher”  or points in between. Also, after years of experience, I can estimate correctly to within 10 milligrams (mg) blood sugars up to 200mg/dl (deciliter or one tenth of a liter). Again I would use a glucometer more often, especially during the peak, if I could afford the test strips. Because of the rapid change in glucose level around the activity peak, when it’s most effective, the 15 minute minimum delay of the reagent reading (only reflects averaged blood glucose for the period since last urination no closer than fifteen minutes earlier–you pee on the end of the strip) blood sugar can drop very low while waiting for the urine to clear. At times like that a glucometer strip is the way to go with a current reading of blood glucose.  On animal insulin, I worked full-time almost exclusively for over twenty years, starting out as a clerk in a bookstore, then manager, then owning my own ten years in, eventually selling the last one, after I started waking up on the floor, confused and missing  a couple of hours (during the first six months I spent on Humulin(TM), before I switched myself back, and all the aforementioned symptoms ceased).  One of the best sites on the web for more information about all aspects of adverse reactions to insulin, including scientific studies, personal accounts and news about diabetes in general, is the website, founded by the late David Groves, who was experiencing the same symptoms I do, but many years earlier, called the Diabetic International Foundation, here is a link to their main page. Theyve been working on this page for several years now, but if you click on ‘the old table of Contents’ link, and scan the long list of articles, you’ll find a great deal of fascinating and infuriating material:

http://members.tripod.com/diabetics_world/

I don’t think these are displaying as links, so you may have to drag, copy and paste into the address bar, I’d open a new tab so you can flip back and forth.

Before I go, I want to post another very valuable link:http://www.childrenwithdiabetes.com

That’s the main site, but here is the page with the Daily News Summary, all the research published that day on diabetes. Scan it, just to get an idea of what’s available:

http://www.childrenwithdiabetes.com/d_0j_200.htm

This is an immensely useful site for anyone researching diabetes, and they’ve kept it up for years. This is a daily log of basically all the published research on diabetes every day for that day.  Statistical extrapolations may also be performed on this database of research, for example, as far back as this log ran, when I first accessed about six years ago, which was the mid 90s, there were, at that time, only two studies (I believe, it was a long time ago, but that was pretty much it) on hypoglycemic reactions, as Humulin(TM) permeated the market, the number of log entries concerning hypoglycemia steadily increased. The correlation is clear.

The entire Children With Diabetes site is well worth a look, especially for families with diabetic children. Will return…

A Diabetic’s Story

7/18/08

(Before we get going, let me first say I am not a doctor and I have had no formal medical training. Nothing you read here should be construed as traditionally informed medical advice. Any inferences are made solely by the reader and any action taken by the reader is entirely that person’s responsibility. Everything I say here is based entirely and solely on my own experiences and research, for which I will, as much as possible, cite my references. Also, it should be noted that the commercial insulins referred to herein are all trademarked products, and if you don’t see a trademark insignia, it should be assumed to be present. I also want to point out that even for a non-diabetic, I am in excellent health still, showing almost none of the usual complications of diabetes, such as retinopathy, the uncontrolled growth of blood vessels over the retina which is the reason diabetes is the leading cause of blindness in the US. This is my 1st blog and it is presently under construction, so please bear with me. In the near future I intend to post a photo of myself, showing as much skin as possible, so you can see for yourself what kind of shape I’m in. I am also going to detail how to prevent retinopathy and other measures for maintaining health, particularly beneficial for diabetics, but also for the general public. It will take probably a few weeks to get it all together.)

My name is Michael Damian Dana, I am now 52 years old. I was diagnosed as a type 1 diabetic (juvenile onset) in June, 1974. This was almost immediately before starting college, and I pretty much ignored the condition, save for taking my daily insulin injections each morning. I was given no further instructions beyond that, and I ate almost anything I wanted, with the sole exception of avoiding sugar. Amazingly, it was three years before I ended up in DKA (diabetic ketoacidosis). I had actually stopped taking shots for several weeks, the previous year, while I backpacked much of the southern end of the Appalachian Trail, from Georgia to Virginia, believing that the exercise I was getting every day would allow me to do this, as indeed, it did. I resumed shots, with no complications, when I reached my destination, visiting close friends in Glasgow, Va. Although a year after being diagnosed, I’m now fairly sure I was still in the “honeymoon” period,” that often follows the initial diagnosis, which allowed me to be more relaxed than I could be thereafter in following the usual treatment guidelines. Also, in college, I was studying martial arts three nights a week, taking archery, some dance and riding a bicycle as my principal means of transportation. So I was getting plenty of exercise. This was probably what allowed me to eat large quantities of food daily, without causing extreme sugar ‘excursions,’ as high blood sugars are referred to in the textbooks. That is not to say that they didn’t occasionally happen, but when I felt my sugar to be high, I would stop eating for a few hours, until my insulin caught up with my sugar and brought it back down. Taking care of low blood sugars was even easier, since I would quickly start experiencing the symptoms of insulin shock when my sugar dropped below 90, in plenty of time to eat some sugar or sweet food. (This is no longer the case for me, and this insensitivity to low blood sugar, called “hypoglycemia unawareness” has been one of the worse consequences of Lilly’s decision to stop making animal insulins.) During this time, my doctor at the time had not informed me there were more varieties of insulin than the 24 hour NPH (from beef and pork insulin) I was taking, probably believing that since I was doing fairly well, making me aware of faster-acting insulins, such as Regular insulin (now no longer available) which onset, peaked and offset in only 3 hours, would only result in complications.

Inevitably, this caught up with me and in spring 1977, I had my first (and last) experience with acidosis, an elctrolyte imbalance caused by the metabolism of fat for fuel by the body’s cells as a result of being unable to access the blood glucose normally used for energy. After a period of time, usually (but not always) a few days, this typically results in coma or death by cerebral edema, or swelling of the brain. While the condition progresses, the brain is unable to properly receive or transmit signals, and let me tell you, this is a truly terrifying experience. You know something’s badly wrong, but you can’t think well enough to understand what it is or take action ( like taking more insulin) to remedy it. The night this happened, I was eventually able, with my roommate’s help, to telephone my doctor and ask him if I should take more insulin. He agreed, although I now know it was probably more as a psychological aid than anything else, since the 24 hour NPH insulin would do very little to relieve my immediate condition, taking 1.5 hours to onset and not peaking for 8 hours, by which time I would see him, as I did the next morning. Fortunately, his office was only a short walk from my apartment and I was there as soon as it opened. He immediately reserved a hospital bed for me, and my roommate took me there that afternoon. With the appropriate insulin, he quickly brought down my sugar, but kept me there several days for observation.

While I was there, my food intake was measured and it turned out I was eating more than 2,500 calories a day. This may not be that much for a large person, but I’m only 5′3″ and at that time even skinnier than I am now. For more than the last twenty years, my daily caloric intake has been only around 900 calories, and after the substitution of Humulin (TM) for insulin, often far less. My weight, however has remained fairly constant, now, 128 lbs, and at that time, 115lbs.

(One of my science heroes is the late Dr Roy Walford [http://en.wikipedia.org/wiki/Roy_Walford], whose research into gerontology, the study of aging, led me in the mid 80s to drastically reduce my caloric consumption. This reduction in food intake is one of the things that has kept me so healthy, and I believe, although I can’t yet prove, is one of the main reasons my hair is still very dark, as a result of the reduction of free radical generation). Hey, I just looked it up, and it seems I’m not alone in that opinion, check out this site:http://ask.yahoo.com/20020926.html

I was released from hospital a few days later, having been informed by doctor about the existence of fast-acting insulins, and Lente insulin, also a 24 hour activity cycle, but which allowed me to mix, if necessary, Regular and Lente in the same syringe. It was at this time, I began looking for my own answers about my condition, and I found them! Over the next few years I came to conclusions, sometimes not shared by doctors, which allowed me from then until animal insulins were removed by Lilly and Novo, the only two major manufacturers of insulin worldwide, to keep my sugar so closely under control, that when, in 1996, I was given my 1st HbA1c test (glycosylated hemoglobin, a marker indicating the attachment of sugar to hemoglobin molecules, itself  not immediately dangerous [see 'Glycosylation Reconsidered' below], but which act as a marker for the control of diabetes) the doctor who examined me was amazed to find it was only 4.5%, when the normal, non-diabetic level is 4%. The word he used was ‘astonishing’. Even now, the ADA (American Diabetic Association), only recommends it be kept under 7%, in my opinion, way too high. I did discover, a few years ago, a (then) small company in England, where I was born, CP Pharmaceuticals, which continued to make animal insulins. They have since been bought out by an Indian (I believe) company and are now known as Wockhardt, UK. (http://www.wockhardt.co.uk/). Unfortunately, the US government has thrown up immense roadblocks to the importation of animal insulins from overseas (and even Canada), at at last count (this is some years ago) less than 50 of the tens of thousands of type 1 diabetics in this country that need animal insulin, have actually been able to import it. (Megan Romano, Genewatch magazine, 2003: http://www.gene-watch.org/genewatch/articles/16-6romano.html.

(9/5/08 I’ve posted these links and others to follow, in the blogroll at top right)

I’m going to stop now and go to bed, but I’ll pick this up again tomorrow. In the days to come, I intend to create sidebars devoted to particular topics, with links to sites, both scientific and personal, that will provide shortcuts to essential articles.  I will also state the four essential principles I believe will allow most or all type 1s to maintain their health, it’s just too late right now. This isn’t just for diabetics, anybody can benefit from these practices. One of them is the means of preventing retinopathy, another is the cure for osteopenia/osteoporosis (without having to pay for a biophosphonate such as (TM) Fosamax, a hideously expensive, and basically unnecessary moneymaker for Big Pharma ( the collective name given to the united organization of pharmaceutical companies). ( I was diagnosed with osteoporosis in 2001, saw a specialist who assured me I would develop a hump (and he was a very good doctor and person, no criticism of him is implied, he just said what he’d been told was true), and yet not only do I not have a hump, but was able to replace about 4/5 of the spinal disintegration I had experienced, that is regained 2.5″ of the 3″ I had lost in height! More will follow, stay tuned.