The University of California at SFO (UCSF) has a fairly good educational website entitled "Diabetes Education Online ." The courses are not only free, UCSF does not require registration and you can learn at your own pace. UCSF also offers classes in a campus environment at reasonable costs. The online course is pretty thorough and covers many different topics. The link for the Type 2 diabetes course begins here. After you finish the introductory material, you should go to the "Living With Diabetes " section that covers a wide range of topics such as diet and nutrition, activity and exercise, dealing with emotions and weight issues, tips for healthier living, and a whole lot more.
Stanford University also offers a free 6-week online Workshop (enrollment is free but registration is required). I am still evaluating whether it is worthwhile as it appears to be structured primarily for seniors who may have a different set of control issues than the general population. I did enroll in it strictly for evaluation purposes and am now into the second week. The Workshop is fairly basic and includes some material that I feel is misleading and dated (e.g., the recommendation that diabetics should eat 45 to 60 grams of carbs per meal). I'm not ready to pass judgment yet and will probably follow the Workshop through to its conclusion. This will enable me to determine if it is worthwhile for some of the UNcontrolled seniors that ask me for advice. However, do check out the UCSD Online Education site linked above.View Thread
Remembering to take your meds is as simple as mentally linking the task to something that you do every day. I don't take oral meds but I do take supplements, LOTs of them. However, I take them only with food/meals so I use a pill organizer similar to the 4X a day one shown below (the bottom one). The upper one is color coded and a neighbor uses that type for her twice a day dosages (AM & PM). It can also be split up and used for two separate weeks if you only take once a day meds. I leave my 4X box on the kitchen table and link it to a very basic and simple task: EATING. Whenever I have my meals, I automatically mentally link it to taking my supplements. Since I can't "forget" to eat (except consciously if I'm going to skip a meal), there is no way that I'm going to forget to take my supplements. You don't have to link the taking of your meds to food but you certainly can link it to something that you do EVERY single day, preferably at the same time of the day.
Flute gave you some good examples of simple reminders but let me expand on just one of them. If you take your meds at bedtime, place your pill box on your pillow. You can't sleep properly with the container on your pillow so the reminder is a no-brainer. After taking your meds, place the pill box on the night stand next to your clock, radio, or whatever other appliance you have. In the morning upon arising, move the pill box back onto your pillow and repeat the ritual in the evening. On the other hand, if you take your meds in the AM, place the pill box on top of the toilet tank or some other obvious place where you go to every AM, preferably resting it on a towel to ensure cleanliness. Upon arising, take your meds first (very important) before going about with other tasks. Easy, simple, virtually foolproof.
An_258381, your problem is more serious than you may realize. Assuming that you have diabetes (or you wouldn't be posting in this forum), skipping meds can make your diabetes progressively worse. In addition to all of the horrible things that you might have heard about damage to nerves, kidneys, eyes, heart, amputations, etc., people with uncontrolled diabetes have a significantly higher risk for dementia. This article on the Blood Sugar 101 site hammers this message home and includes lots of references so that stubborn skeptics can check it out for themselves. The longer you let the problem persist, the worse it is likely to get. Flute's ominous warning could then come to fruition because if you continue to decline, you will eventually need a caretaker. It may ultimately make the difference between truly living your life or just vegetating away. That could result in the loss of your independence and perhaps some of the very qualities that make life worthwhile. Get with a program now and stick with it. Good luck. View Thread
Here's a graphical representation of the values that I go by. The upper set of values are target goals set by many diabetes care professionals. The bottom set of values are "True" normal or what a non-diabetic person usually has. A picture makes it much easier to remember although some might argue with the "Target" levels being too strict.
MJ, your response suggests that you possess a greater sense of self-awareness than many teens your age. I am fully confident that you will be among the well-controlled (10%) instead of the mediocre controlled (15%) or UNcontrolled (75%). This post is intended to focus on a four-letter word called H-O-P-E instead of on specific tips and suggestions. For starters, Miss Idaho Wears An Insulin Pump , is an inspirational story about a young lady just a few years older than yourself who recently won the Miss Idaho pageant.
Then there's the considerable activity in the research and development arena for diabetes. Some of the research may produce tangible products this time around. They should enable more PWDs to get their diabetes under control to prevent serious complications. Some of these include: 1. VC-01 Diabetes Therapy , a BandAid-sized implant . Although this is an out-patient surgical implant, it does not require taking immune-suppressing medications for the rest of one's life and emulates natural beta cell output, not just insulin. 2. Human gut cells turned into insulin producers . This technology, if it reaches fruition, could be in the form of an oral pill that can activate the necessary mechanisms without surgery or implantation. Since the gut cells are already native, field trials should be easier to conduct and the opportunity for successful end results may be more promising. However, drug companies make their billions by hooking patients on meds that require ongoing refills. This one doesn't so it may never make it to market. But who knows? Maybe the government will step in because the cost to the economy for treating diabetes is enormous and could reach crisis proportions in less than a decade. 3. Bionic Pancreas WebMD/HealthDay has a feature article that describes the bionic pancreas in detail. While it is still undergoing trials, it may become available within the next few years. Clicking on the first link provided will give you a general overview but you can read the more detailed 3-part WebMD (1) article (2) here (3). 4. Non-invasive glucose "meters" have been under development for a while and one actually made it to market in Europe even though the product was developed here in the States. Sadly, the company's website and phone lines have since shut down and it is unknown whether they just lacked adequate funding or whether it was due to a large test strip or CGM company buying them out and then sweeping the product under the rug (to protect or preserve their strip or CGM profits). One that is still viable is the GlucoTrack but it's an overseas (Israeli) company. Their product performs BG testing by clipping an attachment to the ear lobe. I don't have any details on cost but don't believe that it has yet received FDA approval for sale in the States. Without such approval, it won't be covered by any insurance plans but has great potential. Another promising technology that's still virtually in its infancy is this optical device invented by a UMSL scientist .
Non-invasive blood glucose testing is on the horizon and I personally look forward to the day when I no longer have to prick my fingers (or any other body part). Noninvasive monitors will also end the virtual ransom of being held hostage to the use of over-priced consumables. Imagine being able to check your blood sugar on a whim whenever and wherever you desired without punctures, strips or other consumables. You would then be able to react immediately to either highs and/or lows. This would also provide you with the knowledge needed to be able to accurately determine how a given food affects you personally. If the food item didn't appreciably affect your BG levels, you would be able to embrace it as part of your diet. On the other hand, if the food item did spike your BG, you would know that it would be wise to simply avoid that item in the future. No more guessing and no more excuses. In my view, that's the closest thing to a form of diabetes Heaven.View Thread
This is a weekend and many of us do not frequent the forums as often. But first things first. Please put your mind at ease. Getting stressed only makes your blood sugar levels rise even more. Despite what you have heard, diabetes in and of itself is NOT the demon that it is made out to be. It is one of the few chronic diseases that is controllable. However, UNcontrolled diabetes is quite a different animal and deserves all of the bad press, myths and rumors that it has received. Your mission is to become one of the controlled PWDs (person with diabetes), the current "politically correct" term used to describe a diabetic (I have personally never found the term to be offensive).
You can live a normal (well, almost normal) life by simply keeping your blood sugars under control. As an example, I can relate (capsule view) my own personal experience. My diabetes was actually was a self-diagnosed (confirmed by an endocrinologist) when I began stumbling over objects that I should have been able to easily avoid. Then I began to develop neuropathy in my feet which eventually included foot drop syndrome (loss of ankle muscle control). After struggling with oral anti-diabetes drugs and getting worse, I started using insulin in a slow but tightly controlled fashion. It took three months for my symptoms to fade (essentially symptom-free) but I did not achieve full "recovery" for about two years.
I am currently 100% complications-free (its been over ten years since diagnosis) based on the absences of any detectable symptoms or tests. I also do not obsess over my BG levels because my procedures are now almost done on auto-pilot without having to dwell on them or consuming excessive amounts of time. I am using my own example so that you can be assured that it is do-able. It will take lots of self-education and the ability to determine what works for YOU. The educational process is an ongoing journey and not a destination. Just don't make the mistake of relying on stereo-typed ivory tower advice which is extremely common, particularly when it comes to dietary advice. There's a lot for you to learn and I (as well as other members) will post back with lots of suggestions. I'm currently tied up in an online workshop but had a short break. Please let us know more about the severity of your condition such as your A1c level, your average blood sugar ranges (before and after meals), etc. Be assured, however, that you will be able to join the ranks of the controlled and not be at the mercy of being UNcontrolled. It will just take the desire to do so and the ability to weather the ups and downs that go with the territory.View Thread
That is a common effect with many of us and it is due to something called the "Dawn Phenomenon" or "Dawn Effect." WebMD has an article that describes the effect in greater detail that you can read here . Discuss the matter with your doctor to explore the best option for you. Many of us use insulin to counter the effect and others can dampen the effect using other means. Discussing the matter with your doctor is your best option.View Thread
I think it's terrific that you have finally found an endocrinologist you can work well with to improve your BG control. I recently lost a friend who died from end stage renal failure. In his case, he knew what was required to stop the progression but admitted that he just didn't care. The previous year he had lost his wife of fifty plus years. Although he had children and grandchildren who adored him, the loss of his wife was more than he was willing to bear. He was actually doing quite well on dialysis but it took up a lot of time (essentially consumed three days per week). He finally tired of the ritual, refused further treatments, and was gone in less than two weeks.
You BG levels are still way too high in by all standards but since you are on insulin and now under the care of an endocrinologist, the following charts may be of value to you: Adjusting Bedtime Insulin Insulin Action Times Correction Doses The charts are in PDF format and will automatically download to your hard drive when you click on the links.
Knowing the action profiles of various insulins will help you avoid lows. Understanding and adjusting insulin doses is vital to bring your blood sugars into healthy ranges (it's the only way you're going to arrest your ongoing decline in kidney function and save them). For example, your fasting BG of 130 is my own post prandial (AFTER a meal) target. When I retire for the night, If I exceed 99 mg/dL, I will inject a correction dose to bring me back down to my target range (70-85 mg/dL). I don't use the values in the charts myself because they only provide general guidelines. However, some of my friends have found them to be useful in terms of breaking their previous mindset of adhering strictly to static, physician-prescribed insulin doses so it's my hope that you will also find them to be beneficial. For good BG control, dynamic insulin dosing is essential. Each of us should (in fact MUST) set our own individual targets for a healthy range. Do discuss these charts with your new doctor to find something that will work for you. You seem to have a loving grandson and it's my sincere hope that you will continue to enjoy his company for many years to come. Keep us posted of your progress and if you have any questions regarding dynamic insulin dosing, quite a few of us here in the forums have engaged in this organ-saving practice for many years and can answer any questions you may have.View Thread
Your post is terrific and should help inspire newbies who are often clueless as to how to begin to cope with diabetes after being diagnosed. The two books that you mentioned are also my own two "best of breed" selections and I often recommend them to acquaintances. Both are now available in eBook formats which are less expensive than their hard copy editions. If you purchased Jenny's book from Amazon.com, the vendor has a "price match" offer that enables you to purchase the digital version for only 99 cents (I did).View Thread