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Thread: The Big 'D'

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    The Big 'D'

    Hey everyone. I am kind of bummed right now.
    I was told a few months ago that I was at risk of developing pre-diabetes and that the doctor would be regularly monitoring my blood. I have been visiting the dietician and I think I actually tried to follow her advice for a few weeks.

    So I went for the now routine bloodwork one morning last week then went to work.
    I got a call a couple hours later from my doctor: "You need to come to the hospital." "I'll come right after work," I replied.
    "No. Come right now."
    Turns out my fasting blood glucose was at 26 mmol/L (normal is between 4 and 7). I spent four days in the hospital and am I now take several different pills a few times a day and a shot of slow-acting insulin before bed. It all made sense when he told me - I had been peeing every 2 hours like clockwork (usually I go between 5 and 7 hours) and my vision was getting a little blurry (I had made an appointment with the eye doctor which I cancelled because I was in the hospital)

    I know this story is not unusual around here, but I didn't expect it to happen to me. I am only in my mid 30s. I stay active, commute 14km to work semi-regularly, go on fast group rides regularly, and do longer rides as often as I can. I even rode my bike to the hospital to get my diagnosis for christsake!
    I am overweight - 270 lbs - but with my build and height I figure my ideal weight is around 240 lbs.

    A compounding factor is that I have also recently started having attacks of gout in my left foot and this puts the kibosh on some of my winter plans... I have been teaching kids cross-country skiing for the past few years, which I had to bow out of, and I was going to get a new set of snowshoes to spend more 'quality' time with my wife. I can still ride (I have my winter bike always at the ready), but I don't want to burn myself out on riding before spring as I have some events and goals to meet for my riding this coming summer.

    Now I know this is not a death sentence, and I have made strides in the past week that may be the foundation for real and positive change in my life, but it is a real bummer for me.

    SO I am wondering: does anyone else have diabetes stories of hardships and/or triumphs to share? They say misery loves company, right? I would love to hear how some of you have dealt with the diagnosis and how your life and health have changed.

    -self-pityingly yours, Lar

  2. #2
    Fat Guy Rolling dcrowell's Avatar
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    Scary! On the bright side it was checked and dealt with before it harmed you badly.

    Diabetes runs in my family, but AFAIK I don't (yet) suffer from it. I just had blood work this morning, so I may get a call like yours tomorrow. <eek!>.

    Just think of it as a wake-up call. Also, ask your doctor what your ideal weight should be. You might be surprised... really surprised.
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    Carpe Velo Yo Spiff's Avatar
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    No hardships here, I'm afraid, but I need to be wary. I was told by my doctor that I am "mildly diabetic". Reading up on the subject suggests to me that I am actually in the pre-diabetic stage. I think my doctor does not make that distinction. To her, you either are or aren't. I was able to get it down to the normal range by my first follow up. Eating better was the main thing that did it, but riding the snot out of my bike, and losing weight was a help as well. Blood pressure took some more work, but it's now down to either the target 120/80 or just a touch over that (seems to vary depending on how much I've gotten out and exercised recently) Sounds like you are doing everything right.
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    Quote Originally Posted by Yo Spiff View Post
    No hardships here, I'm afraid, but I need to be wary. I was told by my doctor that I am "mildly diabetic". Reading up on the subject suggests to me that I am actually in the pre-diabetic stage. I think my doctor does not make that distinction. To her, you either are or aren't. I was able to get it down to the normal range by my first follow up. Eating better was the main thing that did it, but riding the snot out of my bike, and losing weight was a help as well. Blood pressure took some more work, but it's now down to either the target 120/80 or just a touch over that (seems to vary depending on how much I've gotten out and exercised recently) Sounds like you are doing everything right.
    When I first went to the doctor regarding the gout, they took my blood pressure and it was like 148/37 or something, and that freaked me out a bit... but the nurse figured it was likely just form the pain and the stress of being in the hospital. My BP was checked regularly while I was in the hospital and it is back to normal.

    I, too, am hoping to use mad amounts of exercise and healthy eating to help control mine. THe dream would be to get rid of it altogether, but I will make the changes first and take whatever benefit or help I get.

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    Quote Originally Posted by dcrowell View Post
    Scary! On the bright side it was checked and dealt with before it harmed you badly.

    Diabetes runs in my family, but AFAIK I don't (yet) suffer from it. I just had blood work this morning, so I may get a call like yours tomorrow. <eek!>.

    Just think of it as a wake-up call. Also, ask your doctor what your ideal weight should be. You might be surprised... really surprised.
    Good luck on not receiving that phone call!

    Yeah, I am happy I had only just begun having mild symptoms and it got caught. As of right now my sugar is in the normal range (I think I was actually mildly hypoglycemic when I got home - good thing I got a ride form a friend and didn't try to bike home).

    I am going to see my doctor next week so I will ask him! Somehow I never thought to do that. Do you know if health care professionals generally calculate it somehow or do they take it off a chart like a BMI index?

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    Senior Member Ursa Minor's Avatar
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    I'm sorry to hear you got diabetes. My story is sort of similar: last May i was 352 pounds drinking 10 beers a day and no exercise.
    I happened to check my blood sugar and found it was high 160-190 all day for 3 days running. That really scared me so I changed my diet
    to eliminate all high glycemic foods. That helped some bs dropped to 140-170 still high. So I quit drinking (sigh) and bought a stationary
    bike for exercise. Started real slow on the exercise 5 mins every other day on the lowest setting. Within 2 weeks my blood sugar
    was in the normal range and has stayed there. So far ive lost 91 pounds and am in training to do a 50 mile bike ride on March 10.
    For me the diabetic problem was the best thing that ever happened to me since it made me change my lifestyle.

    Good luck man I'm praying for you.

    Charlie
    Grimly determined to have fun.

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    Carpe Velo Yo Spiff's Avatar
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    When I was in the Air Force, they used a chart, but then a few years afterwards, they went to a body mass index, and used a pair of fat calipers to figure it out. I was always pushing the limit. Here's what I looked like when I was on the AF's "fat-boy program" in '84. I don't think their system worked to my advantage.
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    Quote Originally Posted by Yo Spiff View Post
    When I was in the Air Force, they used a chart, but then a few years afterwards, they went to a body mass index, and used a pair of fat calipers to figure it out. I was always pushing the limit. Here's what I looked like when I was on the AF's "fat-boy program" in '84. I don't think their system worked to my advantage.
    Pretty far-out Chevette, man! I have a friend that quite recently bought an '82 CHevette with ~2000 miles someone had in storage.

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    Quote Originally Posted by Ursa Minor View Post
    I'm sorry to hear you got diabetes. My story is sort of similar: last May i was 352 pounds drinking 10 beers a day and no exercise.
    I happened to check my blood sugar and found it was high 160-190 all day for 3 days running. That really scared me so I changed my diet
    to eliminate all high glycemic foods. That helped some bs dropped to 140-170 still high. So I quit drinking (sigh) and bought a stationary
    bike for exercise. Started real slow on the exercise 5 mins every other day on the lowest setting. Within 2 weeks my blood sugar
    was in the normal range and has stayed there. So far ive lost 91 pounds and am in training to do a 50 mile bike ride on March 10.
    For me the diabetic problem was the best thing that ever happened to me since it made me change my lifestyle.

    Good luck man I'm praying for you.

    Charlie
    I feel like I was training for the bad-eating olympics, but you sure had me beat in the beer category! I usually ate a big bag of chips and washed it down with 2 or three beer. I was usually exercising but I guess the bad diet was harming me more than my weight let on.

    I am hoping that this scare will light a fire under my ass and get me back into shape, too. I have dreams of conquering the largest hill in the area and hanging with the lead pack in the gravel road race coming up in a few months.
    Good luck with the march ride! The hardest part is getting on the bike at the start!

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    Quote Originally Posted by LarDasse74 View Post
    Now I know this is not a death sentence, and I have made strides in the past week that may be the foundation for real and positive change in my life, but it is a real bummer for me.
    You're kidding, right?

    I've been a Type 1 (insulin-dependent) diabetic for the last 30 years. For the majority of that time I've been tethered to an insulin pump 24x7x365 and checking my blood sugar 5-10 times/day. Still, it always amazes me that people make such a big deal about diabetes. Yes, it's a chronic condition that requires treatment. So what? I honestly can't remember the last time that I thought diabetes had an impact on my life... and the form I have is generally to be the more problematic of the two.

    As a diabetic, I have: climbed Mt. Kilimanjaro, seen more of Africa in person than you've seen on Wild Kingdom, ridden my bike from San Francisco to Los Angeles, had lunch with Chuck Yeager and Olivia de Havilland, spent more time racing motorcycles around racetracks at 100+mph than you've spent reading Cycle World magazine, been a member of a championship winning marching band, learned and forgotten more math than most people ever know, rock climbed routes up to 5.10c in difficulty, TIG-welded my own bicycle frame, and had my passport stamped in countries that no longer exist.

    I say these things not to impress you but so you'll know: diabetes is only a limitation if you try to ignore it. Understanding and managing the disease is really pretty simple, though it may take some time to make the necessary adjustments to your lifestyle. If you follow through with the necessary education and treatment I think you'll find that there's little, if any, impact on your life.

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    Quote Originally Posted by sstorkel View Post
    You're kidding, right?

    I've been a Type 1 (insulin-dependent) diabetic for the last 30 years. For the majority of that time I've been tethered to an insulin pump 24x7x365 and checking my blood sugar 5-10 times/day. Still, it always amazes me that people make such a big deal about diabetes. Yes, it's a chronic condition that requires treatment. So what? I honestly can't remember the last time that I thought diabetes had an impact on my life... and the form I have is generally to be the more problematic of the two.

    As a diabetic, I have: climbed Mt. Kilimanjaro, seen more of Africa in person than you've seen on Wild Kingdom, ridden my bike from San Francisco to Los Angeles, had lunch with Chuck Yeager and Olivia de Havilland, spent more time racing motorcycles around racetracks at 100+mph than you've spent reading Cycle World magazine, been a member of a championship winning marching band, learned and forgotten more math than most people ever know, rock climbed routes up to 5.10c in difficulty, TIG-welded my own bicycle frame, and had my passport stamped in countries that no longer exist.

    I say these things not to impress you but so you'll know: diabetes is only a limitation if you try to ignore it. Understanding and managing the disease is really pretty simple, though it may take some time to make the necessary adjustments to your lifestyle. If you follow through with the necessary education and treatment I think you'll find that there's little, if any, impact on your life.
    Thank you for putting it in perspective. I am aware that my diagnosis is very minor compared to many other conditions, and even compared to many others with diabetes, esp. with type 1. Like I said, it is a 'bummer' - meaning not that it is terrible or tragic, but that it is a bit of a nuisance, and that I am feeling sorry for myself.

    While I was in hospital the nurses were telling me all sorts of horror stories about amputations and early deaths, but made it clear that those things are much more likely to happen to people who, like you said, try to ignore it.

    I am also coming to grips with the fact that my bad habits were also me sitting aroaund feeling sorry for myself and taunting bad health to see how close I could get it to come, and that I need to pull my head out of my arse and treat my body right if I want to see the world and have some of the adventures you speak of and that I want to have. Even with being diagnosed my habits would have spiralled me further into poor health in some other way. I don't believe diabetes will nave no impact on my life - but whether it is a positive or negative impact is up to me now.

    Thanks again!

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    Type 1 you're stuck but with Type 2 can you not work your way out of it? I don't know what the odds are or how realistic it is - just thought I read that somewhere. I hope so.

    Unless you're Andre the Giant, your ideal weight is probably not 240. You must be using the same mental chart that I've been using all these years.

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    Quote Originally Posted by TrojanHorse View Post
    Type 1 you're stuck but with Type 2 can you not work your way out of it? I don't know what the odds are or how realistic it is - just thought I read that somewhere. I hope so.

    Unless you're Andre the Giant, your ideal weight is probably not 240. You must be using the same mental chart that I've been using all these years.
    I certainly hope I can at least get off the insulin with exercise and better diet, but there are no guarantees. Even if it was guaranteed that I could with lifestyle changes, there is no guarantee I will be able to make and maintain the lifestyle changes.

    You are probably right about my weight. We shall see.

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    I've spent quite a few years around 250lbs and when I started cycling to lose weight, I thought for sure that the BMI thing was way off and at 210 I would look healthy and normal. Right now, I'm at 215 and there is no way that five more pounds will make the rest of this go away. Going by BMI, I'll be in the normal range once I reach 175. That's starting to sound much less ridiculous, even with copious amounts of muscle like I have from previously being a powerlifter.

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    Hey, Joe! Long time!
    on light duty due to illness; please contact my assistants for forum issues. They are Siu Blue Wind, or CbadRider or the other 3 star folk. I am currently at home recovering from a couple of strokes. I am making good progress, happily.


    . “He who fights with monsters might take care lest he thereby become a monster. And if you gaze for long into an abyss, the abyss gazes also into you.”- Fredrick Nietzsche

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    http://www.diabetes.ca/

    http://www.diabetes.org/

    The first link will direct you to the Canadian Diabetes Association. Through it, you'll find local resources, ways to get involved (fundraising events through cycling, running, etc).

    The second link will direct you to the American Diabetes Association. Through it, you'll find tons of useful information - way more than the Canadian site. There are ways to get involved there, too. Some of those events might be closer than the Canadian events.

    A diabetes diagnosis is not a death sentence if you catch it in time. I ride with the NC ADA Chapter, and know several type 1 diabetics who can ride me into the ground. For some inspiration, check out Tony Cervati's blog at type1rider.org.
    DFL > DNF > DNS
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    Quote Originally Posted by JoeMetal View Post
    I've spent quite a few years around 250lbs and when I started cycling to lose weight, I thought for sure that the BMI thing was way off and at 210 I would look healthy and normal. Right now, I'm at 215 and there is no way that five more pounds will make the rest of this go away. Going by BMI, I'll be in the normal range once I reach 175. That's starting to sound much less ridiculous, even with copious amounts of muscle like I have from previously being a powerlifter.
    I just looked up the BMI calculations and I should be around 210 lbs. I remember the last time I was 210 lbs and I guess I was not unhealthily skinny... I got down to about 190 lbs for a while and that was too small. I am sure I have gained some muscle since then (that was when I was 20 years old). I will see what I can do.

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    I'm a type II who is insulin dependent now thanks to stupid life choices I made in the past. I was diagnosed diabetic in 2003 and figured as long as I took my meds it would be ok. Lack of exercise and poor diet added up to being on 60 units of long acting insulin a day.

    Last June I decided I'd had enough of being 250+ pounds. I decided it was high time to kick diabetes square in the teeth. Eat less, exercise more became something more than I just heard in my doctors office, it became my wife and I's lifestyle. Since June 1 of 2011 I've dropped over 56 pounds, I've lowered my insulin dose from 60 units down to an average of 10 units or so.

    My decision point was watching a co worker who is an uncontolled diabetic who is about ready to loose his feet. I looked at him and saw what my future might hold. I figured life is what I make of it, either get busy living or get busy dieing. Personally, I chose to get busy living.

    Semper Fi

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    I know how you feel. I've been there too.

    I've been diabetic since (at least) November 2005. Was put on oral medication when first diagnosed, but was switched to Victoza injections and the Byetta injections about a year ago. Got lots of advice, but didn't follow much of it, so my blood glucose numbers were always higher than they should have been.

    Well, back in mid December, I got up one morning not feeling too well; dizzy and light headed...sure signs that my number was high. Took my shot and headed off to work. The further the day progressed the worse I felt. It was getting difficult to stay on my feet (my job pretty much has me on my feet 8 to 10 hours a day) and I could barely see straight. It finally all came crashing down on me when I fainted. Came too with a bunch of paramedics hovering over me, telling me my blood glucose number was 485 and that I was getting a trip to the hospital. By the time I got there my number was up to 496.

    To make a long story short, my doctor put me on Lantos insulin along with the Byetta I was already doing. Since then I've been a lot more serious when it comes to taking care of myself by taking my medication regularly (something I wasn't doing before), eating less and exercising more. It has paid off. back on December 20th I weighed 250; as of this morning I weighed in at 241.

    You mentioned that you've been laying a new foundation the last week or so. That's good. Keep at it and you will see success, just like I'm starting to. Diabetes is a *itch, but I'm finding out that if you take it seriously day by day, you can come out on top in the battle.

    Quote Originally Posted by LarDasse74 View Post
    Hey everyone. I am kind of bummed right now.
    I was told a few months ago that I was at risk of developing pre-diabetes and that the doctor would be regularly monitoring my blood. I have been visiting the dietician and I think I actually tried to follow her advice for a few weeks.

    So I went for the now routine bloodwork one morning last week then went to work.
    I got a call a couple hours later from my doctor: "You need to come to the hospital." "I'll come right after work," I replied.
    "No. Come right now."
    Turns out my fasting blood glucose was at 26 mmol/L (normal is between 4 and 7). I spent four days in the hospital and am I now take several different pills a few times a day and a shot of slow-acting insulin before bed. It all made sense when he told me - I had been peeing every 2 hours like clockwork (usually I go between 5 and 7 hours) and my vision was getting a little blurry (I had made an appointment with the eye doctor which I cancelled because I was in the hospital)

    I know this story is not unusual around here, but I didn't expect it to happen to me. I am only in my mid 30s. I stay active, commute 14km to work semi-regularly, go on fast group rides regularly, and do longer rides as often as I can. I even rode my bike to the hospital to get my diagnosis for christsake!
    I am overweight - 270 lbs - but with my build and height I figure my ideal weight is around 240 lbs.

    A compounding factor is that I have also recently started having attacks of gout in my left foot and this puts the kibosh on some of my winter plans... I have been teaching kids cross-country skiing for the past few years, which I had to bow out of, and I was going to get a new set of snowshoes to spend more 'quality' time with my wife. I can still ride (I have my winter bike always at the ready), but I don't want to burn myself out on riding before spring as I have some events and goals to meet for my riding this coming summer.

    Now I know this is not a death sentence, and I have made strides in the past week that may be the foundation for real and positive change in my life, but it is a real bummer for me.

    SO I am wondering: does anyone else have diabetes stories of hardships and/or triumphs to share? They say misery loves company, right? I would love to hear how some of you have dealt with the diagnosis and how your life and health have changed.

    -self-pityingly yours, Lar
    Never too soon to start training for the 2015 Chicagoland Tour de Cure... http://main.diabetes.org/goto/Adams_TdC_Page


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    Quote Originally Posted by dave5339 View Post
    I'm a type II who is insulin dependent now thanks to stupid life choices I made in the past. I was diagnosed diabetic in 2003 and figured as long as I took my meds it would be ok. Lack of exercise and poor diet added up to being on 60 units of long acting insulin a day.

    Last June I decided I'd had enough of being 250+ pounds. I decided it was high time to kick diabetes square in the teeth. Eat less, exercise more became something more than I just heard in my doctors office, it became my wife and I's lifestyle. Since June 1 of 2011 I've dropped over 56 pounds, I've lowered my insulin dose from 60 units down to an average of 10 units or so.

    My decision point was watching a co worker who is an uncontolled diabetic who is about ready to loose his feet. I looked at him and saw what my future might hold. I figured life is what I make of it, either get busy living or get busy dieing. Personally, I chose to get busy living.

    Semper Fi
    Thanks for the reply.
    I am currently on 28 units of Lantus slow acting insulin.

    It is pretty crazy how hard it is for some people to make the necessary lifestyle changes to stay healthy. Only time will tell if I can do it, but I am quite hopeful.

    My grandmother was diagnosed type 2 in her mid fifties, a couple years before I was born. I only knew this because all us kids watched he take her insulin, and she let us lance our fingers and test our blood with her equipment (I don't think Grandma was in a high risk category for HIV ). She ate and drank everything all the other adults did, but in a slightly more moderate way, and lived to a ripe old age and died of an unrelated hear attack. She got an infection and lost a toe in her late 70s, and her vision was failing by the time she reached 80, but otherwise she was healthy. I am plan to use her as a role model for how to live with type 2, although with more exercise (although grandma walked a lot).

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    Quote Originally Posted by IndianaRecRider View Post
    I know how you feel. I've been there too.

    I've been diabetic since (at least) November 2005. Was put on oral medication when first diagnosed, but was switched to Victoza injections and the Byetta injections about a year ago. Got lots of advice, but didn't follow much of it, so my blood glucose numbers were always higher than they should have been.

    Well, back in mid December, I got up one morning not feeling too well; dizzy and light headed...sure signs that my number was high. Took my shot and headed off to work. The further the day progressed the worse I felt. It was getting difficult to stay on my feet (my job pretty much has me on my feet 8 to 10 hours a day) and I could barely see straight. It finally all came crashing down on me when I fainted. Came too with a bunch of paramedics hovering over me, telling me my blood glucose number was 485 and that I was getting a trip to the hospital. By the time I got there my number was up to 496.

    To make a long story short, my doctor put me on Lantos insulin along with the Byetta I was already doing. Since then I've been a lot more serious when it comes to taking care of myself by taking my medication regularly (something I wasn't doing before), eating less and exercising more. It has paid off. back on December 20th I weighed 250; as of this morning I weighed in at 241.

    You mentioned that you've been laying a new foundation the last week or so. That's good. Keep at it and you will see success, just like I'm starting to. Diabetes is a *itch, but I'm finding out that if you take it seriously day by day, you can come out on top in the battle.
    Thanks 1,000,000 for sharing.
    Your story reminds me a lot of my buddy's dad - type 2, but eats badly and only takes his meds properly when his wife, a nurse, forces him to. My buddy told me he fainted a couple of months ago and got a head injury and I suspect it was a similar situation to you.

    You stick with it, too, buddy! You're worth it!

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    Wow, there's some real motivation in this thread.
    2000 Bianchi Veloce, '88 Schwinn Prologue, '88 Trek 900, '92 Trek T100, 2000 Rans Tailwind

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    Quote Originally Posted by IndianaRecRider View Post
    Well, back in mid December, I got up one morning not feeling too well; dizzy and light headed...sure signs that my number was high. Took my shot and headed off to work. The further the day progressed the worse I felt. It was getting difficult to stay on my feet (my job pretty much has me on my feet 8 to 10 hours a day) and I could barely see straight. It finally all came crashing down on me when I fainted. Came too with a bunch of paramedics hovering over me, telling me my blood glucose number was 485 and that I was getting a trip to the hospital. By the time I got there my number was up to 496.
    I'm curious: did you check your blood sugar before taking your shot? You don't mention it so, given the outcome, I'm assuming you didn't?

    Incidents like this are completely preventable... if the patient receives the right education and tools for preventing them. Sadly, the more I talk with Type 2 diabetics the more I become convinced that they're living in the dark ages with respect to treatment strategies. As a Type 1 diabetic, in a case like yours I would have tested my blood sugar (with a glucose meter), given myself a shot of fast-acting Humalog insulin, and had my blood sugar back to normal within 1-2 hours. I'm surprised that more Type 2 patients aren't taught how to use fast-acting insulin's like Humalog and NovoLog to quickly address high blood sugar...

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    Quote Originally Posted by sstorkel View Post
    I'm curious: did you check your blood sugar before taking your shot? You don't mention it so, given the outcome, I'm assuming you didn't?

    Incidents like this are completely preventable... if the patient receives the right education and tools for preventing them. Sadly, the more I talk with Type 2 diabetics the more I become convinced that they're living in the dark ages with respect to treatment strategies. As a Type 1 diabetic, in a case like yours I would have tested my blood sugar (with a glucose meter), given myself a shot of fast-acting Humalog insulin, and had my blood sugar back to normal within 1-2 hours. I'm surprised that more Type 2 patients aren't taught how to use fast-acting insulin's like Humalog and NovoLog to quickly address high blood sugar...
    For me there was never any mention of fast acting insulin, but I was told to test my blood whenever I thought it might be necessary. I also spent an hour a day while I was in the hospital discussing strategies for coping and developing a routine. I was in a small rural hospital where they seemed to have a lot more time to deal with individial patients than a lot of other hospitals I have seen... well at least the nurses and other care-staff do, not so much the doctors who are run off their feet.
    It hasn't happened yet, but I think they told me to go to the ER if my glucose numbers are out of whack. This is likely where the decision to give me fast acting insulin would be made.

    And every day I thank the flying spaghetti monster for socialized medicine!!!111

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    Quote Originally Posted by DCB0 View Post
    For me there was never any mention of fast acting insulin, but I was told to test my blood whenever I thought it might be necessary.
    You should test your blood sugar regularly, not just when you think it might be necessary.

    I also spent an hour a day while I was in the hospital discussing strategies for coping and developing a routine.
    And yet you still seem unsure about what to do if your blood sugar is above 250 mg/dL. You must know this if you want to avoid potentially severe complications down the road.

    It hasn't happened yet, but I think they told me to go to the ER if my glucose numbers are out of whack.
    This sounds like poor advice to me. You should consult with your doctor and make sure that this is his intended treatment plan for high blood sugar. Personally, I'll suggest that knowing how to use a 10-cent syringe and $20 bottle of insulin is a better treatment option than racking up multiple hours in the ER and a large medical bill...

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