WWTBAM Bored

Saw my GP for a previously-scheduled checkup; 1st I've seen or talked to them since the diabetes diagnosis. I've been relating through the NP, but from now on I'm supposed to be communicating through either a nurse or an awful electronic system to the GP. Maybe it's to do with how they bill for the practise, I can't help but think.


GP has new rules, beyond what the NP said & "what the nutritionist will say". One of them is to cut fruit down to one serving a day "even though the nutritionist will tell you differently". So does the internet tell me differently. A recent study, covered in the NY Times, says that Type II diabetics who cut fruit back had no significant improvements. But my GP lumps fructose in with the other "bad carbs". Sorry, I've already got my blood sugar way down, to around 100, with more fruit than that. Not a lot more, but my life is pretty bleak right now for other reasons. Let that 1/2-pomegranite or carambola continue to be the bright light of the day, please.


GP also wants me to cut down on fats, despite my cholesterol levels being what were considered good before I became diabetic, because LDL cholesterol can lead to heart problems in diabetics. I have an LDL reading of 112; "desirable", says their own chart, is "under 130". They've crossed that off & put "under 100".


This was kind of a bummer of a visit. I'm going to continue the strict diet to keep the blood sugar down, with the ultimate goal of being able to dial back & eventually eradicate the injected long-acting insulin. They think I'm going to be on Metformin for the rest of my life. Despite various places on the web (seel "Life Extension" or something-like-that magazine) claiming that Metformin is so wonderful that everyone, including non-diabetics, should be taking it, & that it would have prevented my cancer & 4 or 5 other types of cancer (GP winced at that newsflash), I really don't want to be dependent on any drug for the rest of my life.


Well, other than "food & water".

Dr. Internet agrees with real GP on the LDL target. Sorry, my LDL has been around 112 forever, if I'm remembering correctly (kind of like my blood sugar being around 97 forever, until now). I can appreciate their concerns, but if I cut down on fats/oils to the point where I can't even eat cheese or whole-milk Greek yogurt or handfuls of nuts, food is going to get to be even more like medicine. I've been good with this diet through now (a month & counting) & I just don't want to break it with making it really disheartening. That's what happens with all diets.

Do the best you can but do make it something you can live with. Few of us will follow every single rule all the time, at least this kind of rule.

Think of their edicts as guidelines, to be bent sometimes. For most of us, if we think of them as laws, we are more likely to break them. It's human nature. The trick is to work with that instead of against it.

And just for what it's worth, I try to make my rewards not be food-related, more like a new CD or an extra hour of TV time of something special.

Thanks for the input, Ritterskoop. I've been following varous diabetes web sites, & finding some people far too concerned, in my opinion, with getting their meds calibrated to their food down to the last 1/10 of a gram of carbs; this is necessary for Type I diabetics, but is not supposed to be for Type II, but some think it is.

I'm interested if you had tests done that determined the best med for you was the one you're on, a beta-cells-stimulating drug.

Right now, a doctor the NP I was seeing, who they had to bring in to OK their treatment of me, poo-poohed my desire to have them measure what my insulin output really is; they said "it will be high right now, probably" but the interpretation seemed to be that for whatever reason, it wasn't doing its work.

Seems your body can fail here in so many ways; Type Is "simply" aren't producing insulin; its supposed to be an immune-system attack that destroyed their beta cells. At least that's the current theory. There are treatments afoot which are about rescuing their beta-cells before they're all destroyed. Which makes older Type Is, for whom any such treatment will be too late, bitter. But maybe advancements in stem cell work will someday allow them to be injected with stem-cell-derived versions of their own new beta-cells. But if science can't figure out how to turn the auto-immune attack mechanism off, it could happen all over again.

Type IIs can have low insulin output, resistance of muscle cells to insulin for some undefined reason, &/or the liver not getting its signal to stop turning carbs into glycogen & releasing the glycogen into the blood; the latest news on Metformin is that it replaces a hormone that is supposed to be giving that signal, but isn't. In my case, they're assuming I may have all of these. I wish they'd test for "what it really is", but my requests have fallen on deaf ears.

That I've gotten my blood sugar way below what they thought I would by now (yesterday it was 78 about 4 hours after lunch, & that lunch did include carbs, though a very small amount) with increased insulin tells me something is working, but I'd like to know what. I dialed the insulin dose back a little on my own, as I was worried about not waking up today. Obviously, I did. Wake up.

In my Mom's case, the beta-cells-stimulating drug was new then, & they automatically put her on it, without any testing of "what is really happening here" either.