Diabetes

[EeyoresButterfly]

Sorry I haven't been on in awhile. This semester has kept me extremely busy. I was wondering if anybody here knows about diabetes. I have a ton of questions that I am looking for answers to and was hoping to find a voice (or two or three) of experience.

[Princess Susi]

Well, what do you want to know, anything specific? There are some great sites online like WebMD and others that have all the symptoms and things that can happen and how to control it. I could write a book about it here for you, but are there any particular points of interst you need to know?

We can start with some basics. Diabetes is a disease of the Pancreas. It creates a problem of not enough insulin to use up the sugar in the cells. If you get an overabundance of sugar in your body, you have problems.
However, nowadays, diabetes does not have to be treated with insulin shots neccessarily. It can be controlled with diet in some cases, and pills in others. There are 2 main types, Diabetes 1, you are born with a faulty pancreas that does not produce enough insulin, and Diabetes 2 in which a person can develop it from being overweight, pregnancy can bring it on, and other factors can also cause it. This type may resolve on it's own as in the case of gestational diabetes (pregnancy,) USUALLY.
That is the basic of what it is.
sues

Check these for a good basic overview:

http://www.diabetes.org/homepage.jsp

http://diabetes.webmd.com/

[DisneyMom]

So what do you need to know?
Diabetic Nurse here.....

I became diabetic when a small piece of a gallstone blocked my pancreatic duct causing severe inflammation and destruction of the pancreatic cells about 5 years ago.

[Princess Susi]

There is your expert!

[EeyoresButterfly]

Okay, here it goes:

1.) At what point during the diagnosis did the doctor recommend and endocrinologist? The nearest one to me that my insurance covers is a two hour drive from my university.

2.) What should I expect from the dietician? I hear a lot about carb counting, how does that actually work?

3.) What is considered low? What is considered high? (Premeal/Postmeal)

4.) What do diagnosis and treatment typically look like?

[DisneyMom]

Okay, here it goes:

1.) At what point during the diagnosis did the doctor recommend and endocrinologist? The nearest one to me that my insurance covers is a two hour drive from my university.

2.) What should I expect from the dietician? I hear a lot about carb counting, how does that actually work?

3.) What is considered low? What is considered high? (Premeal/Postmeal)

4.) What do diagnosis and treatment typically look like?

OK.....
1) I'm assuming that you are a newly diagnosed pre-diabetic/diabetic, but your sugars are being controlled by diet for now(since you do not mention being on any meds yet). Depending on what your blood sugar testing is showing/age/weight/activity level, the Doctor or dietician may recommend a NCS diet(no concentrated sugars),or a diet with specific calorie recommendations such as a 1200,1600,or 2,000 calorie ADA. ADA stands for American Diabetic Association.
2) The Dietician will give you instruction depending on the diet recommended regarding basic nutrition and the Diabetic exchange system-or not. I guess it depends on how much time they alot to a patient, but they will start very basic and add details as the patient is ready to absorb them. The Diabetic exchange system outlines what equals a "Starch" , "Meat", "Milk", "Vegetable"
serving of a variety of foods and the meal plan will say how much you are alotted for meals and snacks depending on the calories you are allowed to have each day. Someone like you will be able to understand it, but that doesn't make it easier to adapt to everyday, so the dietician may give you more like "guidelines". There is such a variety of foods, and let's face it, most of us eat out or have pre-prepared foods frequently, that breaking it down into components becomes time consuming for anyone but an expert. CARBohydrate counting is the amount of carbs a serving of any food breaks down into in its more simple form in the body. Virtually everything breaks down into the glucose molecules that fuel our bodies.....
3) low and high numbers are averages, but if you are diabetic, your personal low and high will be different than a "normal" person's....before meals less than 70 is too low for me, and the doctor recommends I try to maintain less than 160 2 hours post-meal. Your doctor can give you his idea of what is appropriate for you.
4) treatment depends on how far progressed your diabetes is....The oral medications I take now have changed. I was doing well on them (while eating
pretty much what I wanted) but I regained the weight I lost and now meds have altered and doing better now (but med side effects are a pain). Some people require insulin, but the types and dosages are individual. Did your doctor give you a blood sugar monitor? Insulin dosages vary for many people based on the readings, and vary meal to meal. it is important to check your blood sugar according to MD instructions,and the doctor will tell you to report certain highs and lows to them (below 70 or higher than 200 is considered reportable, but the Doctor will be specific to you).
I'm not an expert, but definitely have experience..... ;)

[DisneyMom]

As for endocrinologist, not sure if you need one or not, and if your health care plan recommends or pays for one. I would guess that your MD knows what is needed for your treatment, and you may not need a specialist, but that is only a guess.

[EeyoresButterfly]

Thanks for the info. I'm in the diagnosis stage right now, found out on Wednesday that I am either prediabetic or in the early stages of diabetes. This week is information gathering. Had to have the full blood panel done and I'm testing my blood sugar several times a day. Next week I have a follow up to proceed from there and next Friday is the dietician appointment. I'm doing Weight Watchers and the doctor said that Weight Watchers and what the dietician will recommend are not incompatible. I'm just trying get as much information as possible so I know what to expect and which questions to ask.

It's been a long ride. (sorry, sort of venting now.) For a year or so I've been having problems with my blood sugar suddenly plummeting. I tried going to the health center on campus last year, and it was a wretched experience. They told me to fast andthey would do a fasting blood sugar, but the NP didn't do any tests. She blew me off, told me it was nothing, and essentially made me feel like an idiot. It's been getting worse, but I kept letting it go on. Some friends over on another board convinced me it was time to give it another try, so I drove the 45 minutes to the nearest place my insurance covers. It was a complete 180 from my experience last summer.

The doctor and nurses were very nice. I got in the same day I called and was very surprised they took me seriously after what happened last summer. I dang near cancelled the appointment of fear of being made to feel like an idiot again, now I'm glad I didn't. They tested my blood sugar and it was fairly high. The doctor gave me a meter on the spot, and made the appointments for the blood work, dietician, etc. I think at this point she is leaning more toward prediabetes because of the sudden dips in blood sugar. What irritates me is that this could have been taken care of a year earlier, but it wasn't. Because of that one NP, I was terrified to even try again, even though I knew something was wrong. I'm just glad to finally be getting answers.

[felinefan]

I think that nurse practitioner should be reported. What if you let it go longer, and you ended up with major preventable health issues? It was her responsibility to test you, she had no business blowing you off. Hope you get better soon, and that this is only temporary.

[DisneyMom]

It is good that you found out now. Many people don't know that they are diabetic until they have a complication like having a retina detach. It sounds like you might be able to control your diabetes with diet, that would be good.
The longer you can go without meds, the better, but even if you do have to take something, it is not a sign of failure. Keep us updated.