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Hey guess what! I was distracted from my reading by the tiny print on the right side of the page when I noticed that we were listed as a Notable Board! Thanks to all of you who have made this a successful board launch over the last month!

On a personal note, I go see the doctor on Tuesday. 6 months ago he put me on twice a year visits instead of quarterly. Now we get to see if I could hold the fort down BG wise. Not great that the tests are coming after steak, hot dogs, ribs, and apple cobbler!

Happy 4th everyone!
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Hi Fuskie!!!

I'm really surprised we don't have more traffic here. There a lot more diabetics around than this board shows. Maybe the notable staus will bring more in.

Apathy4All

PS I'm one of those that has higher blood sugar (more than I'd like) in the morning and it's confusing the heck out of me. The adrenaline explaination seems plausible. Also recently had a physical and my doctor was praising me for my hemoglobin A1C results. Still confusing.
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Hello FuskieFool and all board members. I saw this on "notable boards" and didn't realize it was here. I've read the last 30 or so posts and noticed some minor misconceptions that I might be able to help with.

I am an Internal Medicine physician in an area of the country where diabetes (Type II) is so rampant it makes up about 50% of my practice. I treat a LOT of Type II diabetics and diagnose or am referred 2-3 new diabetics every week. I'd be glad to give input if wanted and as time allows.

A couple of things to think about first. "Type I" and "Type II" diabetes are just names the definitions of which have changed over time. Type I is typically a child or young adult but can be of any age (I've diagnosed 80-year olds with Type I). The pancreas' beta-islet cells no longer produce enough insulin to control blood glucose levels - these people always require insulin. Type II is more complex physiologically with carbohydrate intolerance and/or insulin resistance and the disease more responsive to a variety of treatments including diet/exercise, oral meds and/or exogenous insulin. Type II's are not all middle-aged, obese people and many are young and of normal weight. Why it develops is not known.

The Hemoglobin A1C ("A1C") blood test, expressed as a percentage, gives your doctor an idea what your average blood sugar level has been over a 3 month period of time. Goal A1C's are 7% or below (7% being roughly about equal to a blood sugar of 140 and going up or down about 20 points for each percentage point higher or lower). Personally, I shoot for as close to 6% as possible in my patients to help minimize long-term "target-organ" damage. Always record your blood sugar readings in a log or on a piece of paper with the time of day of that reading and bring it to your doctor visits so he/she can suggest modifications of therapy as may be needed.

Hope I can be of some help.

ab

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ab: The Hemoglobin A1C ("A1C") blood test, expressed as a percentage, gives your doctor an idea what your average blood sugar level has been over a 3 month period of time. Goal A1C's are 7% or below (7% being roughly about equal to a blood sugar of 140 and going up or down about 20 points for each percentage point higher or lower).

Acouple of questions.
1. My hemoglobin A1C is very good (4.7) but I have read that it is also very important to keep the blood sugar as near constant as possile over the day. This is where I have a bit of trouble. Your comments on How important it is to try to maintain a steady level over the day would be much appreciated. I tend to have spikes up to 170 a couple of hours after eating.

2. Do artificial sweeteners affect blood sugar levels? I've been trying to find hard info on this with not much luck.

Thanks in advance.
Ted
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1. My hemoglobin A1C is very good (4.7) but I have read that it is also very important to keep the blood sugar as near constant as possile over the day. This is where I have a bit of trouble. Your comments on How important it is to try to maintain a steady level over the day would be much appreciated. I tend to have spikes up to 170 a couple of hours after eating.

Sure, if you could keep your sugar under 140 all the time it'd be great, but also kind of impractical. It is expected that your sugar will go up after a meal with carbs, the degree and duration depending mostly on your body's response and medication type and perhaps dosage time. 4.7% is as good as it gets and I wouldn't be surprised if you were frequently in the 60's and 70's.

2. Do artificial sweeteners affect blood sugar levels? I've been trying to find hard info on this with not much luck.

They shouldn't. Sweet-N-Lo, Nutrasweet and Splenda should all be okay.

ab

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ab, Thanks for the information! I find I generally start feeling strange and uncoordinated when I get down to about 65 so I try to avoid going that low. Matter of fact, that's how I usually notice that I am too low. (Forgot to mention I'm type II, using Glipizide and Actos)

Thanks again,
Ted
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My A1C has been running around 4.8 for my last three quarterly check-ups. I stopped my Actos as soon as I consistently got my Blood sugars under control with diet, because it was causing my numbers to fall to far, too fast.

If I didn't eat every 4 hours, I would get nauseous, dizzy, and break out in a sweat. Once, while waiting to meet dh for dinner, I passed out at the mall. Not fun. I am now on 500mg of Glucophage twice a day. I was thinking of speaking to my doctor about discontinuing that as well, and controlling entirely by diet.
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Doc, without seeming like preying on your professional expertise, I would love it of you trolled around here now and then and maybe debunked some theories or offered some suggestions. I think a lot of people here would just appreciate knowing that they are not going crazy with some of the wiered "complex" effects of diabetes that they encounter.

I for one was planning on asking my doctor on Tuesday during my physical whether I am imagining a link between high morning readings 140-160 around 8:30am and a general fatigue that makes it hard to wake up in the morning.

Or am I just lazy?
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I for one was planning on asking my doctor on Tuesday during my physical whether I am imagining a link between high morning readings 140-160 around 8:30am and a general fatigue that makes it hard to wake up in the morning.

140-160 shouldn't make you fatigued. Sleep apnea, thyroid and anemia are just a few of the possible medical reasons in addition to diabetes concerns you might bring up with your doctor.

Not depressed are you?

ab

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Pebbles--

>>I am now on 500mg of Glucophage twice a day. I was thinking of speaking to my doctor about discontinuing that as well, and controlling entirely by diet.<<

You're definitely going in the right direction. I've been off my Glimepiride (Amaryl) for 13 months now, with diet and exercise...and with my physician (who also has me on a formal, medically-supervised weight loss program; I've lost 104 pounds so far, but still 99 to go) reasonably happy. My HbA1c's, WITHOUT meds, at 4.5 to 5.5%, are the better than they ever were, WITH meds.
One key points, IMO:
It's NOT just 'diet'; but diet AND EXERCISE. Diet, alone, with rare exceptions, will not, for example, increase insulin tolerance (which is what your Glucophage is doing chemically)...whereas exercise is proven to. You got to improve both. And, in the end, it has to be every day.
As my doctor reminded me last week, when I asked him why, for example, he didn't have C-reactive protein tested for during my quarterly blood work, his response was: "Because the main reason for that is to test for risk of heart disease; BUT AS A DIABETIC YOU ESSENTIALLY ALREADY HAVE HEART DISEASE, so there is no point in doing it". This goes along with the ADA assessment that each Type II diabetic should basically behave as if you've already had one heart attack.

good luck...and keep at it! It's worth it.

JP
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"Because the main reason for that is to test for risk of heart disease; BUT AS A DIABETIC YOU ESSENTIALLY ALREADY HAVE HEART DISEASE, so there is no point in doing it". This goes along with the ADA assessment that each Type II diabetic should basically behave as if you've already had one heart attack.

How curious! I've only recently (last year) been confirmed as diabetic, but I've been told that the diagnoses generally means I've been for as long as five years before. And within the five years before I've had chest pains and chronic edema and when I saw my doctor about it she just blew it off as indigestion.

So I should just assume that I probably also have heart disease and take care of myself based on that assumption?
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