15 - DIABETES & ME,
Many have asked about how I manage my Diabetes.
The question is I know so much about diabetes, so where do I begin.
I did not know anything about diabetes besides it was elevated sugar levels in the blood until I met my Wife Mithu in 1978. She was 21 then and had been a Type-1 diabetic from age 13. To this day we keep speculating the causes which could have been a viral infection, reaction to an asthma medication called Tedral which was prescribed to her but was pulled out of the market in 1993. I became an instant carer monitoring her insulin injections and food and exercise routines. I was playing the role of the security guard and Mithu cheating and getting caught. In the 80's we had to depend totally on doctors to manage diabetes. there were no blood testing strips. Only Ketodiasticks to test sugar in the urine which was not much use as the event had already occurred and sugar was being excreted through urine.
So even before we got married we were fighting like husband and wife and decided to make it official in 1980 :-) On 29th October we celebrated our 41st wedding anniversary with a big fight. BY the way I only fight with people I care about. Others are not worth my time.
Every time we disagreed on Diabetes, Mithu's way of attacking me was "How would you know because you are not a diabetic?"
So in 2003 I satisfied the criteria by becoming a diabetic myself
There was no diabetes in my family even to this day and it was not my life style or Diet. I had to be different to most. I will explain later
Do you know the history of Blood testing machines for sugar ?
Briefly Bernstein was an Electrical Engineer who became a Type 1 Insulin dependent Diabetic as a teenager and realised his endocrinologists knew very little about diabetes just drug pushers and had to take charge of his Diabetes if he was to continue living
He had to do something so he joined and studied medicine and also specialised as an Endocrinologist. Just around that time a small company called Ames Reflectance meter I think designed and manufactured the blood testing kits.
The Ames Reflectance Meter was the first blood glucose meter. It allowed patients with diabetes to self-monitor their blood glucose levels.
The Ames Reflectance Meter was developed in 1970 by Anton H. Clemens. It had a needle that indicated the intensity of blue light reflected from a paper strip, called Dextrostix. The meter gave a quantitative number that was correlated with glucose levels in blood that the Dextrostix was exposed to.[1]
The Dextrostix was developed about a decade earlier. It was a paper strip with chemistry immobilized onto it. When the paper strip was dipped into blood, it changed color to a shade of blue. The exact shade of blue was dependent on the level of glucose in the blood.[2]
The meter weighed about 3 pounds and sold for $650. It was initially marketed to physician's offices, not patients.
One man with diabetes, Richard K. Bernstein, managed to buy one because his wife was a physician. He used the machine to map out the daily fluctuations in his blood glucose levels. This knowledge allowed him to manage his diet and insulin injections better to maintain steady, normal blood glucose levels.
The Medicos and FDA wanted only the doctors to manage patients Blood sugars and use the blood testing machines. Bernstein waged a war with the medical profession arguing that BSLs should be managed each and every day and only a patient can do that seeing Doctors once in three months was not the way to Treat Diabetes and he won and you and I can have a little Accucheck machine at home to get spot sugar levels in the blood. We now also have Oxymeters invented by Engineers.
You know my wife Mithu is a Type one Diabetic since age 13. In 1980 I accompanied her to see her endoctrinologust Prof.Warren Kidson and sat there quietrly listening to him giving her sermons about maintaining a strict blood sugar level regime of between 5 and 6. When he was done I said "Doc I have a question for you ?"
As a structural Engineer when we design structures say the beams of a Bridge we calculate the Dead load and max anticipated Live load say from semitrailers to army tanks so bridge does not collapse under this odd unprecedented load. "So what are you getting at" Dr Kidson asked. I said doc after calculating the absolute max load we multiply it by 1.5 which is a factor of safety.. Blood sugar will not stop as a desired point it will go up or keep going down. There is notthing to stop BSL at 5.0. as you are advocating. If You aim at 5.00, may be the insulin is too much and BSL will drop top 2.5 causing a massive Hype and sugar will be consumed and BSL will shoot up to12.0.
So Doc Kidson, Imagine a simple Pendulum, can you control its amplitude. How far it swings and how long it gets to lose the momentum is a question of Mathematics. So Doc in order to maintain reasonable safe BSL without Hypos and Highs if a Patient aims at Blood sugar levels between "9.0 and 5.0 the average could be an optimal 7.0 would it not ??... This discussion was in 1980.
He did not ridicule me but said you logic makes sense and we left the clinic
Dr Kidson has published many many papers of Blood sugar management and today Doctors will tell you that a HBa1c, which is a Three month average of between 6.00 and 7.5 is safe.. The Good thing about Dr Kidson was he was a Genuine Doctor who cared for Diabetics
So Friends if you or some one ion the family is a Diabetic and use Blood testing machine at home like the Acucheck that I use
then Please remember to Salute Dr Burnstein an Electrical Engineer who became Doctor to force medical Practioners to allow Patients to monitor the sugar levels on a daily basis
There is one tonne of Information Of Dr Bernstein and His University and his diabetic diet etc for those of you who may be inclined to find out More
My story Briefly:
My Blood sugar levels were on the rise in 2003 si my GP sent me to an Endocrinologist who diagnosed it as Type 2 Diabates and prescribed Diabex (which is Metformin) started off with 500mg at dinner and ended up with 1000mg Three times a day and i would still waking up with a fasting blood sugar of 9 0r 10 and my weight had gone up from 80kgs to 95 kgs So I decided to see another endocrinologist who immediately put me on Fast Acting Insulin
I took just 3 units of Insulin and had a Massive hypo as I was driving. By year 2015 I was on fast acting insulin three times a day of 30 Units ( enough to kill a horse) Plus 50 Units of Long acting Insulin morning and evening. My weight soared to 110 kilos and all that the endocrinologist was doing was increasing my insulin intake. None of the doctors amongst my family and friends could help.
So in distress I turned to a Diabetes Forum and patients there in the forum asked many questions about my diet and life style etc
One fine morning I received a response from a member of the Forum from USA and she says. You don't have Type One Diabetes as your pancreas are still producing Insulin. But then you don't have Type 2 diabetes either as your pancreas are producing adequate insulin and the fact that you are on such a massive dosage of injected insulin , suggests that you are like me. You and I have what is called Type 1.5 Diabetes ( I bet none of you or even your doctors know about this Type 1.5 Diabetes)
Type 1.5 Diabetes is also known as LADA which is Latent Autoimmune Diabetes in Adults caused by Metabolic syndrome. This means that the body is producing adequate insulin but our Body cells were rejecting this Insulin as well as from external Injections. I rushed to my Lady doctor Endocrinologist to ask if I had LADA. She got cranky and spit the Chips and I walked never to return.
My respiratory specialist Dr Alvin Ing said it makes sense Ram and gave me a Referral to the Metabolic Clinic at Concorde Hospita that was conducting some research. I ohoned for an appointment and the nurse in charghe asked me how much do you weigh and I said "a Tonne" jokingly. When I told her I weighed 110 kilos she said sorry sir you don't qualify for this trial. Minimum required weight is 135 kilos.
I turned to my neurologist Dr Penelope Spring to suggest another endocrinologist and she gave me a referral to see Dr Brownwyn Crawford. Another God send/ She prescribed a new Tablet called Forxiga 15mg just one tablet a day Plus Galvumet 1000mg twice a day and to stop all Insulin that very minute
To Day I weigh 78 Kilos and my Hba1c is 7.0 and I eat chocolates and ice cream and cakes when I feel like but not in excess
She also told me if you cheat and sugar levels go above 10 just take a small dose of fast acting insulin
This is My Diabetes Journey. Very few Doctors who are Endocrinologists even know about Type 1.5 Diabetes also known as LADA caused by Metabolic syndrome an Auto Immune disease
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