Seeing the Signs

Gwen and I went to the third Diabetes class last night, and it was... well, again adequate. They continue to focus a lot on the basics; especially the most important things such as managing hyper- and hypoglycemia. And while I completely appreciate how most people in the class need the repetition, we continued to be a little bored by hearing stuff for the third time.

One interesting thing that we also discussed last night was the impact of stress on blood sugars, and a psychotherapist was there to give us some information about assessing and dealing with our stress. For the most part, though, I handle stress very well. But of course, I've struggled from time to time with the shock and disbelief of the diagnosis, the fear of possible complications, feeling overwhelmed by the changes that I need to make in my life, and the guilt and frustration when I fall off the wagon. But in general, I'm very self-aware, and I don't tend to hold on to or dwell on negative feelings. Plus, I have this blog, GamerChris, and my gaming hobby in general to help me out.

I was also pleased that my weight loss continues to be slow but steady. I lost 2 lbs since last week, which totals to 7 lbs from the start of the program and about 12 lbs since my diagnosis. But as I talk about weight loss, that reminds me of the main purpose that I had for this post, the symptoms that should have led me to seek medical attention earlier.

Seeing the Big Picture of Diabetes Symptoms -

As I've mentioned before, at a previous physical, my blood sugars were in the "prediabetic" range (126 mg/dl if I remember correctly). My doctor and I were mainly working on my blood pressure at the time, however, and neither of us gave the value much attention. Shortly after that appointment, Samantha was born, and I ended up having to cancel the next follow-up because of something or other related to her. It was about 18 months or so before I got back to the Doctor.

On any list of symptoms for type 2 diabetes, excessive thirst and urination are usually at the top. And in retrospect (especially after seeing the drastic reduction in both of these after getting my sugars under control), I certainly had both. But I've always been a thirsty dude, drinking at least 2-3 glasses of beverage with meals and usually sipping on a cup of water all day long, and there was no one point when I noticed a sharp increase. Plus, one of the medications I take for my hypertension is Hydrochlorothiazide, a diuretic. So even when I would get up in the middle of the night sometimes to go to the bathroom, it didn't seem so strange to me (of course, my well-trained bladder from years of critical care nursing probably helped mask the frequency thing as well). Now, however, after having my thirst driven by crazy-high sugars for who knows exactly how long, I'm actually finding it very hard to stay well hydrated.

But the next symptom I should have figured out was unexplained weight loss. With a decrease in effective insulin, your body can't transfer sugar into your cells, and therefore can't use or store energy from your food as well. I definitely noticed this, but frankly, I wasn't too upset by it. And while I'm pretty embarrassed to admit it, I wasn't really aware that weight loss was a common symptom of type 2 diabetes (I thought it was mainly a type 1 thing). So, between not wanting to look a gift horse in the mouth and attributing the loss to another cause (the resolution of an irregular heartbeat that I'd had for about 3 years), I missed this one as well.

The other thing that I can remember as well was an episode of blurry vision that lasted about a week. I was pretty freaked out about it, but couldn't get in to see my Optometrist for several days (by which time it was pretty much cleared up). At the time, he mentioned to me the possibility of a blood sugar spike, so I checked my sugar a time or two at work in the following days, and got readings at or slightly above 100, and therefore attributed the issue to eye strain or something similar. In retrospect, it was probably some freaky sign that my sugars were, in fact, getting more unstable.

And the last symptom that I noticed but ignored is one that you rarely see on lists, a change in bowel pattern. Probably due to the excessive liquids that I was drinking, my poop was looser and more frequent that it had ever been before, and in some ways made me wonder if my weight loss was due to an intestinal issue. It wasn't like diarrhea or anything, however, so I mainly just procrastinated and ignored it.

But as far as the other main symptoms, such as hunger, fatigue, or irritability, I never noticed them at all (but maybe I should ask Gwen about those ;-). At least not that couldn't be attributed to more situational causes (like staying up late to write an entry for my blog or something). And in general, I felt fine right through the day when I found out, even with sugars in the 300's and 400's.

And this is why many people don't seek help for their diabetes until it's often too late. Way too many diabetics get their diagnosis when in the hospital for their first heart attack, or for an out-of-control infection in their foot, or when their kidneys start to go haywire. I mean, I'm a freaking nurse, for goodness sake, and I was able to ignore and rationalize away my symptoms for a year or more because there was no one thing so obvious that I couldn't turn a blind eye to it. The symptoms are subtle, but the complications aren't. Everyone should take their health seriously, see their doctor regularly, and keep an eye on their blood sugars.


Oops, sorry about getting a little preachy there. I looked down and noticed that I was standing on my soap box, but I'll step down now and get on with other things. Have a great day, and take care of yourself!

Treatments and Results

Well, over the last month, my blood sugars have undergone a dramatic transformation. From the 300-400's when I was first diagnosed, down now to the consistently normal range. Just because it's something I wanted to do, here's a couple of charts of what my am (fasting) and pm (after dinner) sugars have looked like:


As you can see, I responded very well to my treatment. Specifically, I started taking 500mg of Metformin at lunch and 15 Units of Lantus insulin at bedtime on 8/18. I increased my Lantus to 19 Units on 8/26, 23 Units on 9/3, and then tweaked it up to 24 Units on 9/11. My Metformin was similar, increasing it to 500mg twice a day on 8/29, 1500mg total on 9/5, and then my final dose of 2000mg a day on 9/12.

For now, it looks like I've got good control. Now if I can just get a handle on my weight loss as well...

Diabetes Class is Underway!

Gwen and I went to our first diabetes class last night... We didn't learn much.

But in the defense of the Lifestyle Center, we weren't exactly the target audience for an "intro to diabetes." As I observed the other people in class, there was a huge range represented. Some were obviously still in the midst of denial and anger about their diagnosis, talking to each other at a break about how they weren't going to hang around for the whole class. Thankfully, they did.

And then there were a few that clearly had no previous understanding of what diabetes really was. Other than the name itself, they didn't have any idea about what a carbohydrate was, or how other nutrients were converted into glucose by the body.

While I didn't learn much new about the pathophysiology of diabetes or the building blocks of a good diet, I did gain a more practical understanding of how this disease ties together so many of us from so many backgrounds. And I feel for those that that have less education, fewer resources, and are generally less empowered to take charge of their treatment and regain control of their lives. As much as I've been rattled and scared by my diagnosis, I at least have the benefit of good information and the advantages to understand it and put it to use.

On a slightly different note, however, I was a little disappointed about my weight last night. While I have by no means gotten my diet under control, I have been eating wayyyyy better than I used to. And I even feel like I've lost some weight in the tightness of my clothes and all. But on the scale, I had lost only about a pound or so over the last two and a half weeks. I'm trying not to be discouraged about it, and I'l chalking it up to the fact that insulin can often cause weight gain. But I certainly don't want that to happen, so I'm going to be trying to continue and intensify my efforts at eating better and incorporating exercise into my routine, and I'll see if that helps by next week.