BS: Diabetes... another thread

Subject: RE: BS: Diabetes... another thread
From: gnu
Date: 15 Mar 10 - 02:30 PM

Re reusing the lancet. Could one cleanse the lancet with an alcolhol swab immediately after and BEFORE use?

Subject: RE: BS: Diabetes... another thread
From: GUEST,Janet
Date: 14 Mar 10 - 04:51 AM

I have Type 2. My best friend has Type 1, which is so much harder. Re: Type 2: a program on US public television has recommended a Vegan diet to control and even reverse Type 2. I'm off meds for now because of diet and exercise but have read that most Type 2s will need insulin within 5 years of diagnosis. I love meat and diary, but at that point I may try a Vegan diet to see if it works for me. In the meantime, I hope to accept insulin usage. My life depends on glucose control. I have a heredity genetic predisposition to Type 2 on my maternal and paternal sides and developed this condition when I was in a comma after a medical disaster.

Subject: RE: BS: Diabetes... another thread
From: GUEST,mg
Date: 12 Mar 10 - 04:56 PM

I have a doctor who has written books about metabolic syndrome, which I most obviously have..he has put together some ideas that are not usually put together..read his books..Dr. Robert Thompson, of Swedish Hospital in Seattle..and metabolic syndrome preceeds or coincides with diabetes II..and if you are overweight, that is part of the process so don't say being overweight leads to diabetes..other way around. Being overweight is a function of diabetes, or metabolic syndrome. Anyway, he says it is not that the insulin does not work..it is that the cells become "candy coated"..and nothing gets in. Or that is what I think he says.

And people are still saying the incredibly stupid thing that diabetes II people do not produce enough insulin..or they said until very recently. Hopefully they are ashamed of themselves now for saying that without testing people..why say that when an inexpensive blood test will tell you if you produce insulin or not? Mine was 5 times too high when I had it tested and you have to stomp your feet and insist on having it tested. Pay for itself if you must..even if some doctor says you aren't diabetic..if you have high insulin scores and are overweight you are in a diabetic process regardless of your blood sugar levels.. mg

Subject: RE: BS: Diabetes... another thread
From: frogprince
Date: 12 Mar 10 - 02:59 PM

JohnInKansas, you have it all "spot on" with the possible caveat that you may underestimate the share of type 1s who produce no insulin whatever.

Subject: RE: BS: Diabetes... another thread
From: Dave the Gnome
Date: 12 Mar 10 - 02:49 PM

That's a bugger, Michelle! Nothing else I can say really apart from if you need any help from a short fat Salford lad - Just shout.

Cheers

Dave

Subject: RE: BS: Diabetes... another thread
From: JohnInKansas
Date: 12 Mar 10 - 02:48 PM

The "definition" of Type I vs Type II varies from place to place only because there are several different ways of saying the same thing, and different places have different concepts of what way of saying it will be best understood by the patient.

"Type I diabetes" means that your body does not produce sufficient insulin.

"Type II diabetes" means that your body produces insulin, but the insulin is not effective in transporting the sugar through the cell walls so that it can be used.

As even "normal" people vary in the amount of insulin they produce, there probably are very few cases of "pure Type I" in which no insulin at all is produced. It probably is more common for an individual to produce some, but an inappropriate amount, of insulin. Individual doctors may vary in the level of insulin production that marks a borderline at which they will declare a patient to be "Type I."

Ideally, the body should respond to an increase in sugar circulating in the blood by producing more insulin, and should produce less insulin when blood sugar is low. The principal organs that produce insulin generally do well at the regulation, but insulin can be produced in lesser amounts by a variety of tissues that do not "regulate" their production, and dump a more or less constant stream of insulin regardless of sugar level.

If insulin production is not regulated normally, the cells themselves may learn to "ignore an excess." This may a significant factor in the development of Type II diabetes, also called "insulin resistant diabetes," in which there is "sufficient" insulin, but it doesn't work right at the level of the cells. Some Type II diabetics may actually produce an excess of insulin, but it just doesn't work at all effectively.

Some adipose tissue (fat cells) are a type of cell that can "excrete" small amounts of insulin (along with other things). This may be part of the reason why obesity seems to be a "cause" of Type II diabetes; but the obesity may also be partly a response by the body to poor cellular management of the insulin present.

(The "other things" produced by some fat cells include hormones, and/or serum components that "act like hormones." The majority of these substances tend toward "feminising" effects. Particularly in adolescent boys, obesity frequently produces a degree of "feminization" that's fairly obvious to impartial observers.)

Medications used for Type II diabetes are mostly intended to facilitate the effectiveness of insulin present, so that it can "open the holes" in the cells and transport the sugar into the cells.

It is entirely possible for a person to have both Type I and Type II diabetes, if insufficient natural insulin is produced, and at the same time the insulin that is present doesn't work very well. A person in this "fuzzy area" that crosses over between, or overlaps, the two types may need additional insulin along with medications to improve how well the insulin works.

Most general practicioners, in my experience, will "assign" one or the other of the types to an individual patient partly for simplicity in discussion - - but mostly because of their (probably appropriate?) belief that patients may have difficulty with understanding a detailed diagnosis.

This causes no particular problems with "easily managed" diabetes, and most GPs will refer "difficult" patients to direct management by an endocrinologist for more specialized advice.

The key to understanding, for diabetics especially, is remembering that, "Ma Nature is a messy b**ch," and simple "definitions" are usually, at least partly, wrong.

Note that I am not a doctor; but I have been dealing with an "incredibly difficult" diabetic for more than a decade, along with having a degree of Type II tendency of my own. We've been to lots of "training" with specialists - but yours may disagree with ours.

John

Subject: RE: BS: Diabetes... another thread
From: LilyFestre
Date: 12 Mar 10 - 02:44 PM

Not only do they newer meters require less blood, you can actually handle all parts of the strip...no balancing act required! YAY!

Michelle

Subject: RE: BS: Diabetes... another thread
From: frogprince
Date: 12 Mar 10 - 02:42 PM

A lot of diabetics must be thankful for new meters that require only a minute drop of blood, so the lancet can be much finer than was necessary a few years ago. (My wife has been type I for about 55 years now).

Subject: RE: BS: Diabetes... another thread
From: LilyFestre
Date: 12 Mar 10 - 02:41 PM

It's kinda stupid to only look at the A1C test every 3 months since that is only the average of your daily readings to begin with! If I see that my daily readings are high, I either need to adjust my diet or my medications or call the Dr. If you have high daily readings, your A1C is going to be equally high. Isn't that kind of a no brainer? Why wait the 3 months? Buy some strips, check yourself as often as you like and get a jump on the whole deal.

Michelle

Subject: RE: BS: Diabetes... another thread
From: Backwoodsman
Date: 12 Mar 10 - 02:38 PM

"I understand that some GPs are reluctant(!) to prescribe test strips etc for Type 2 but I haven't encountered this."

They don't prescribe them in the Backwoods, the official line being that a long-term average is the most meaningful measurement, hence the reliance on periodic HbA1C testing.

Diabetes UK are currently campaigning for frequent testing to be made the norm for T2 patients as well as T1.

"I get a thorough diabetes health check (weight, blood, eyes, feet)every 6 months by a specialist nurse at my GP's surgery and an annual one at the Diabetic Clinic at the hospital plus an annual Podiatry check and 6 monthly Retinal Screening."

I get pretty much the same, but only once a year. I go to a podiatrist anyway, every six weeks, so she keeps my feet under scrutiny.

I wish we could have standardised treatment for T2 patients, irrespective of where they live. Another stupid Postcode-Lottery.

Subject: RE: BS: Diabetes... another thread
From: LilyFestre
Date: 12 Mar 10 - 02:35 PM

I have Type 2 Diabetes and have had to take as much as 80 units of insulin twice daily. You do not have to be Type 1 to take insulin. Also, I lost about 60 pounds and no longer needed any diabetic medication or diet of any kind.

When my cancer reared it's ugly head, the diabetes came back and I now am taking oral meds for that, despite now having lost about 110 pounds.

Michelle

Subject: RE: BS: Diabetes... another thread
From: LilyFestre
Date: 12 Mar 10 - 02:31 PM

Here's a picture of the top of a lancet that has been used repeatedly...gives you an idea of WHY you should use a new one each time.

Lancet used Repeatedly

Michelle

Subject: RE: BS: Diabetes... another thread
From: Dave the Gnome
Date: 12 Mar 10 - 01:27 PM

Quite right about type 1 MP, but it is often the most vunerable, including children, who are most susceptible to the virus closing down bits it shouldn't:-(

DeG

Subject: RE: BS: Diabetes... another thread
From: GUEST,mauvepink
Date: 12 Mar 10 - 01:21 PM

Yes Becca, thanks. Obviously I can only go by what happens in the UK

take care

mp

Subject: RE: BS: Diabetes... another thread
From: Becca72
Date: 12 Mar 10 - 01:12 PM

MP, as I stated above, though, the definitions of Type 1 and Type 2 vary depending on where you are from.

Subject: RE: BS: Diabetes... another thread
From: gnu
Date: 12 Mar 10 - 12:23 PM

It's short, sooo I'll just c&p...

A normal blood glucose level is less than 6.1 mmol/L, when measured after a fast. In general, a normal glucose would be less than 7.8 mmol/L if taken about 2 hours after eating. Within 3 hours of eating, the glucose should be under 6.1 again.

The glucose levels we aim for — and consider good control of diabetes — may be a little looser than this. Fasting glucose (or glucose before other meals) less than 7 mmol/L is usually considered good glucose control. If testing 2 hours after eating, we would generally recommend levels less than 10 (less than 9 would be even better).

The above values are based on glucose levels associated with complications of diabetes, particularly eye and kidney disease. It's quite possible that we should be aiming for much lower glucose values to reduce the risk of heart disease, perhaps less than 5 before meals, and less than 6 after meals.

Subject: RE: BS: Diabetes... another thread
From: GUEST,mauvepink
Date: 12 Mar 10 - 11:36 AM

Type I can happen any time though and is not just a childhood disease. A virus can shut down your insulin production at any age. Basically, Type I you produce no insulin of your own and type II you produce some insulin. Type II can be brought on by a number of factors too.

The Diabetes UK site is very good as mentioned earlier

mp

Subject: RE: BS: Diabetes... another thread
From: Michael
Date: 12 Mar 10 - 10:40 AM

I'm Type 2, diagnosed when I was about 60, initially treated by diet, then with Metformin and now (about three years later) with a single daily insulin injection (Glargine) added in.

In The UK once your diabetes is treated with any medication your drugs and equipment are free.

I understand that some GPs are reluctant(!) to prescribe test strips etc for Type 2 but I haven't encountered this.

I get a thorough diabetes health check (weight, blood, eyes, feet)every 6 months by a specialist nurse at my GP's surgery and an annual one at the Diabetic Clinic at the hospital plus an annual Podiatry check and 6 monthly Retinal Screening.

Mike

Subject: RE: BS: Diabetes... another thread
From: Dave the Gnome
Date: 12 Mar 10 - 10:34 AM

Yep - I believe it can happen. Conversley I have a friend who was being treated for type 2 - Including insulin injections - for over 5 years. He had a gastric band/bypass type op and lost around half his body weight. Doesn't even need the tablets now! The difference is absolutely amazing.

Not saying this can happen to everyone. Just that there are some exceptions to every rule!

Cheers

Dave

Subject: RE: BS: Diabetes... another thread
From: Becca72
Date: 12 Mar 10 - 10:21 AM

I know several people who developed diabetes as adults who are insulin-dependent.

Subject: RE: BS: Diabetes... another thread
From: Backwoodsman
Date: 12 Mar 10 - 10:10 AM

"According to my doctor's office the daily blood sugar level is not as important as the HbA1C (3 month average) which should be under 6.5"

Yep, that's what my Dr. says too Becca.

Dave, it's usual for T2 to be controlled by diet and oral medication (mine is), but I'm reliably informed that there are cases where insulin is required. Not sure what the circumstances are though. Pretty well every T2 patient I know controls their glucose level by diet/oral medication.

Subject: RE: BS: Diabetes... another thread
From: Dave the Gnome
Date: 12 Mar 10 - 09:41 AM

Type 1 is usualy, though not always, childhood onset and can only be controlled by insulin injections. Type 2 is generaly, again not always, acquired in later life and can be controlled with diet and oral medication.

Dave

Subject: RE: BS: Diabetes... another thread
From: Becca72
Date: 12 Mar 10 - 09:38 AM

According to my doctor's office the daily blood sugar level is not as important as the HbA1C (3 month average) which should be under 6.5. Anything over 6.5 is considered diabetic.
It also depends where you're from as to what Type 1 and Type 2 means - around these parts Type 1 is childhood onset and Type 2 is adult onset.

Subject: RE: BS: Diabetes... another thread
From: Backwoodsman
Date: 12 Mar 10 - 08:27 AM

Callingbird, mp - currently the 'recommended' glucose level in the UK is around 6 mmol after fasting. My doctore likes 5.5 to 6.5. I find myself feeling hypo at around 4, so I don't like to drop that low.

Type 2 in the UK is treated usually by diet control often combined with by oral medication but, I learned recently from another 'Catter, sometimes by insulin too.

Self-testing is recommended and supported by some health authorities, but not by others where reliance is placed on periodic HbA1C laboratory testing. My own area does not recommend or support self-testing, so I have not been issued with a kit. However, I bought my own and I test once a week, first thing in the morning before eating or drinking.

My kit instructions state that a new lancet should be used every time, and that the test site should be swabbed or the hands thoroughly washed before testing.

A good place to get information about both types of diabetes is

http://www.diabetes.org.uk/

or your local Diabetes Support Group.

Subject: RE: BS: Diabetes... another thread
From: Dave the Gnome
Date: 12 Mar 10 - 07:48 AM

I have had direct experience of type 1 diabetes for almost 20 years. Not got it myself but someone very close has. So we know quite a bit about sticking needles in! The swab cleans the skin of infection before being pieced. Even if you use a new needle or lancet every time you may have picked up an airbourne infection which in itself does no harm on the skins surface but can do some damage when it enters the bloodstream. Likewise the needle or lancet can pick up micro-organisms which may or may not survive long enough for you to stick them in you. Idealy you would use a swab to make sure the skin is sterile before being pierced and a sterile needle or lancet each time to ensure no infection gets under the skin.

That's the theory. In practice the needle or lancet is a lot less likely to carry an infection than your own skin. Provided no-one else has used it of course! An airbourne micro-organism is far more likely to get to your skin and survive than it is to infect a needle. A needle or lancet, however, is far more likely to get infected by the presence of micro-organisms that are already under your skin. Provided that the ones already there don't get together with the ones on your skin and start their own party you will probably be OK:-)

It's a call you have to make yourself realy but, from experience, swabbing the skin before anything penetrates it makes sense. Re-using a needle or lancet should be OK as long as you are happy that it is clean and you do not re-use it too often.

Hope that helps.

Cheers

Dave

Subject: RE: BS: Diabetes... another thread
From: GUEST,mauvepink
Date: 12 Mar 10 - 07:41 AM

If memory serves around 4-6 mmols would be an 'acceptable' fasting blood sugar level. Slightly above that and there may be some impaired glucose tolerance. When it gets higher then diabetes is diagnosed.

Diabetics 'run' their sugars at different levels. Some a little higher dependant on activity, and control it with insulin (type I diabetes). Type II diabetes I know less about but a Google should tell you more. IO think they can control theirs more with diet.

mp

Subject: RE: BS: Diabetes... another thread
From: GUEST,Callingbird
Date: 12 Mar 10 - 07:30 AM

Can anyone tell me what a 'normal' blood sugar level is?
My GP keeps testing me for sugar but says it is just 'raised slightly'. So what level would anyone be declared 'diabetic' or is it not as simple as that?

Thanks

Subject: RE: BS: Diabetes... another thread
From: GUEST,mauvepink
Date: 12 Mar 10 - 07:27 AM

Using lancets again has to be a bad choice. Diabetics are already compromised on peripheral circulation and just once, only once, will you need to get an infected finger to risk losing a great deal. I cannot comment on actual costs so pass no judgement on anyone who feels the need to save the money new ones cost. Diabetes is not kind to sufferers in many ways :-(

I thought the little guns that fire the lancets into you were free in the UK along with the 'jabbers'.

Whilst we used to always swab before pricking for a blood sample on the wards I believe the advise now is that it not required. So, it seems, pricking with a fresh lancet each time is far more safe than reusing a lancet cleaned with alcohol?

mp

Subject: RE: BS: Diabetes... another thread
From: gnu
Date: 11 Mar 10 - 06:17 PM

Ahhhh... okay, whatever. But, if a lancet cannot be used more than just once, it's suspect for using just once. I have used the same needle to sew many buttons and seams. If it wears out, I'll use another. What kind sandpaper fingertips youse guys got that can dull a lancet in one prick?

Gee whiz.

Subject: RE: BS: Diabetes... another thread
From: JohnInKansas
Date: 11 Mar 10 - 06:06 PM

Blimey, I've never cleaned my finger with a swab. Just used water.

Would that depend on how the water had been used?

Seriously(?), the main reason there's so much advertising for diabetes supplies in the US is that Medicare pays for them with few objections - compared to most other medical stuff - and it's profitable for dispensers to encourage their (over?) use. Many private insurance plans also are fairly liberal on providing the consumable supplies like test strips.

The test devices are sold here at prices that probably are "below cost," and some dispensers will give you a cheap on "for free" if you order the strips from them. The profit is in selling the test strips (around $1 US each to the dispenser) - and most of the fancier devices require strips specific to the device you're conned into "buying," making you a "captive user."

John

Subject: RE: BS: Diabetes... another thread
From: LilyFestre
Date: 11 Mar 10 - 05:11 PM

I hate to bring bad news but used lancets really aren't a good idea. The tip gets more dull each time you use it and can bring infection. My grandmother ended up with a nasty infection from reusing her lancets....required home health to come in and help take care of it. Personally, I change my lancet each time.

Michelle

Subject: RE: BS: Diabetes... another thread
From: gnu
Date: 11 Mar 10 - 04:32 PM

I have always relied on the kindness of alcohol.

Subject: RE: BS: Diabetes... another thread
From: Lizzie Cornish 1
Date: 11 Mar 10 - 04:27 PM

>>Yeah, but...how do you know the swab's actually sterile?"

Ahhh, it's an alcohol swab. It is a tool for same.<<<



Ahhhhahhhhh..but if you'd watched the programme I watched this morning, about fake medicines that are flooding the world, fooling even the NHS, you'd stop trusting almost anything...

YIKES!

Use home-grown moonshine, then you're safe! ;0)

Subject: RE: BS: Diabetes... another thread
From: CarolC
Date: 11 Mar 10 - 04:10 PM

LOL

Subject: RE: BS: Diabetes... another thread
From: gnu
Date: 11 Mar 10 - 04:07 PM

"Yeah, but...how do you know the swab's actually sterile?"

Ahhh, it's an alcohol swab. It is a tool for same.

"...it has more to do with the lancet losing its sharpness..."

Well, I am a injuneer. A pencil pusher. I don't think a lancet is gonna get too roughed up on my delicate fingers in one prick.

Subject: RE: BS: Diabetes... another thread
From: katlaughing
Date: 11 Mar 10 - 02:47 PM

At home I would probably reuse also BUT I would clean it off with an alcohol swab each time.

Subject: RE: BS: Diabetes... another thread
From: GUEST,mg
Date: 11 Mar 10 - 02:38 PM

I check my blood sugar often, and I don't change lancets often at all..but I am a sturdy sort...100 lancets should last years for me..decades...mg

Subject: RE: BS: Diabetes... another thread
From: katlaughing
Date: 11 Mar 10 - 02:23 PM

Esp. when I had a friend, who wasn't even diabetic, yet had a small wound opening, contracted some kind of bacteria and was dead in two days. It's just a matter of sterility, the discovery of which has saved countless lives, esp. women giving birth. They used to die all of the time because docs didn't know they were contaminating the women's "childbed" with non-sterile, ungloved hands whilst delivery a baby.

I get my blood coagulation checked every month due to the artificial heart valve and the blood thinner I take to prevent it making clots. I wouldn't want the nurses to touch me with a lancet or needle without making sure my finger is sterile with a swab and they have on gloves, esp. in that environment.

Subject: RE: BS: Diabetes... another thread
From: CarolC
Date: 11 Mar 10 - 02:21 PM

From what I've read, it has more to do with the lancet losing its sharpness and causing more pain and bleeding rather than anything else. I don't know if that's true or not, though. It's just what I've read. I know someone who reuses lancets, too.

Subject: RE: BS: Diabetes... another thread
From: Lizzie Cornish 1
Date: 11 Mar 10 - 02:12 PM

Yeah, but...how do you know the swab's actually sterile?   I mean..?

I'm befuddled at the amount of hand disinfectants that are now being pushed on everyone. Anti-bacterial Swine Flu wipes....there's a whole business been born from Flu. Kinda weird, really. Makes you wonder how we ever survived BS. (Before Swabs)

"Soooo... why not clean the lancet with the swab and leave it in for at least several days?"

Why not?

Subject: RE: BS: Diabetes... another thread
From: Becca72
Date: 11 Mar 10 - 02:03 PM

My take on swabbing your finger is because if your hands are dirty you are creating a tiny opening for the bugs to get in through;regardless of if the lancet is clean your hands need to be also, especially since diabetics are prone to infections and don't heal quickly.

Subject: RE: BS: Diabetes... another thread
From: Lizzie Cornish 1
Date: 11 Mar 10 - 01:58 PM

Blimey, I've never cleaned my finger with a swab. Just used water.

When I was first diagnosed, I tested my blood daily. Then, I realised that for me, this was silly. I didn't want to end up being paranoid about blood sugar levels. They change, all the time, in many of us.

If my reading read 10 or above, I went out for a walk...I got into the habit of walking all the time, riding my bike..and that keeps things under control. I refuse to be a slave to the blood testing thingummyjig. So I've replaced all that stuff with exercise. Much more fun and it doesn't hurt so much.

Yes, I test now and then, just to be on the safe side, but in 6 years it's all been OK.

I guess Diabetes is a money spinner, same as blood pressure and so many more medical conditions.   Invent the gadget, then sell it to the people through fear...We can all end up neurotic...and broke. The trick is to remember that diabetics were still keeping healthy and surviving, long before they had blood monitoring kits.

And I'm writing this through blurry eyes after having my retinopathy test..

Apparently, large pupils are supposed to be sexy, but I think waking into walls and tripping over things kinda kills the sex appeal off a little!   ;0)

Subject: BS: Diabetes... another thread
From: gnu
Date: 11 Mar 10 - 01:49 PM

I thought a second thread in two years would be a good idea.

So, my buddy gets the free meter when he buys 100 test strips and he bought 100 lancets. The meter came with 17 lancets. The druggy sold him a pack of 100 alcohol swabs. The lancets cost 3 times the cost of the swabs. You clean the finger with a swab before and after.

Soooo... why not clean the lancet with the swab and leave it in for at least several days?

My buddy ain't dumb. He's a injuneer.