Shani, there are many causes of tingling sensations that include diseases other than diabetes such as fibromyalgia, multiple sclerosis, injury to cranial nerves radiating from the spinal cord, tumor or nerve impingement in the spinal cord area, autoimmune disorders, circulatory disorders, infections, even something as seemingly benign as a vitamin B12 deficiency or a drug side effect. Anxiety and stress can also cause these sensations but they are usually only transient. If the symptoms came on rapidly/suddenly and are accompanied by dizziness, weakness, confusion or headache, the condition could be more serious requiring prompt medical attention.
Diabetic neuropathy is often listed as a possible cause for tingling sensations. However, it often takes persistent elevated blood sugars over an extended period of time before a diabetic person's nerves get damaged enough to become symptomatic. The symptoms also usually start gradually; typically in the feet and lower extremities and gradually spreading from there. Your best bet is to discuss this with your own doctor at your next appointment (or sooner if the symptoms are of concern). If you do not have a regular doctor, you might ask your mom or dad to ask their doctor (e.g., "I am concerned about my daughter"026") and see what their doctor has to say. One last option: type "ask a doctor" into the search engine of your choice and post a question to one of the many online doctors available. Don't be too surprised if you are given a less than helpful response but it might still provide ideas for you to explore further on your own.
Dry mouth, like tingling, can have many causes. Even taking an antihistamine or cold prep can frequently cause dry mouth as can breathing through the mouth instead of the nose. Check out this WebMD article to see if it helps shed any light on your particular situation. As with tingling sensations, anxiety and stress can also result in dry mouth. Blood glucose levels of a non-diabetic person (true normal and not the toxic levels suggested by the A.D.A. and those health practitioners who follow their protocols) is 70 to 85 mg/dL. Your readings are safely within the true normal range as is your A1c if that helps put your mind at ease. I am insulin-dependent myself but set the true normal ranges as my own personal target. However, my A1c is only 4.8 instead of in the more desirable 4.2 to 4.6 range that Dr. Bernstein recommends.
Your BMI of 22 is superb and you do not have to worry about weight issues. This will probably climb gradually as you age but keeping it under 24.9 is a healthy limit. Assuming that you might be female (can't tell by your generic avatar) and decide to become pregnant, temporary excursions above this range is still quite healthy during the pregnancy and your OB doctor will provide you with more specific guidelines. Fatty foods and meats are quite healthy despite media hype to the contrary. However, you should still include vegetables and some fruit (the latter in moderation) in your diet as these foods provide phytonutrients and micronutrients that are not available from fats and meat protein sources. A quality multivitamin plus a sublingual B-12 supplement may also provide added insurance to ensure good health. The foods that you should avoid or limit are processed foods and those containing GMOs. I personally rarely eat anything that contains non-food ingredients such as flavoring agents, food coloring, preservatives, extracts, artificial sweeteners, sugar alcohols, and all those tongue-twister chemicals listed on the labels of every processed "food." I actually don't consider processed items as real food but as food products.
If you do have a regular doctor (I didn't when I was your age), discussing your two symptoms (tinglings and dry mouth) might still be advisable but IMO, you don't have to worry about diabetes being the cause based on the info you posted.[br>View Thread
The HbA1c for a non-diabetic person is in the range of 4.2 to 4.6. By that standard, you are NOT diabetic or pre-diabetic. Your experience of a fasting BG measurement of 123 is definitely hyper-normal but a single reading is insufficient to draw any conclusions and could even have been a false reading (error). Did you take a second reading for confirmation when that reading occurred? Your genetic background suggests a heightened risk factor but keep in mind that genetics only loads the gun but environmental factors (i.e., diet and lifestyle) pull the trigger. Use your BMI instead of body weight to gauge whether you are at increased risk. Reducing consumption of processed foods and starches will go a long way towards staving off the possibility of having the "genetic trigger pulled." In other words, modify your lifestyle to include plenty of low-carb, plant-based foods in your diet and include lots of physical activity and healthful exercise. Do it now while you are relatively young and you may be able to avoid the fate of your parents and elder brother.
LCHF diets have been proven to improve blood sugar levels despite myth-information to the contrary. A peer-reviewed study published in the journal, Nutrition, concluded that "Diabetes is a disease of carbohydrate intolerance. Reducing carbohydrates is the obvious treatment. It was the standard approach before insulin was discovered and is, in fact, practiced with good results in many institutions. The resistance of government and private health agencies is very hard to understand." You can read an overview of the study at asweetlife.org . In other words, change your lifestyle and behave as though you were already diabetic or pre-diabetic and you may never have to contend with becoming so.[br> [br> To answer your final question, fats do NOT increase your BG levels nor does ingesting fats in your diet make you fat. In the absence of carbohydrates, fats are burned off. Dr. Bernstein added 900 calories of fat (using olive oil as the vector) to the daily intake of several underweight patients who needed to gain weight. After six months, not a single one of those patients gained a single pound! Food for thought. View Thread
IMO, there are several components in your husband's roller coaster blood glucose results summarized as follows (not intended as criticism but as objective evaluation of his outcomes): 1. He is consuming far too many carbohydrates in his meals than his body can handle using the medications he is currently taking. This could include insufficient physical activity/exercise but that might be presumptuous on my part since you have not mentioned anything about his physical state. 2. His medication regimen does not include a faster acting insulin that can be used to correct roller coaster, pre-meal, and bedtime highs. He has only been prescribed an insulin pre-mix and NPH, neither of which can reliably be used for adjustment dosing to correct unexpected hyperglycemia in a precise, predictable manner. 3. He has not been proactive in his own self education and self-management efforts, if any.
In the last four months, I have counseled two friends in how to use insulin more effectively and both have been successful in lowering their blood sugars into the 5% club (click the link to read more). They were the ones who had approached me and asked for assistance, not the other way around. Forum rules prevent us from providing medical advice and my comments above are not intended as such; only as simple observations. The advice that I was able to provide to my friends cannot be done in a public forum as it requires close monitoring and follow-up. That doesn't mean we can't discuss matters of interest and concern including topics that you/your spouse should explore with his doctors and healthcare team.
I am going to propose an exploratory change in his DIET for you to try with your husband. It does NOT include any change or adjustment in his medication as that is something that will have to be discussed with his own doctor. However, whenever one changes their diet significantly and lowers carb intake, it usually requires making an adjustment in medication. If medication adjustments are not made, it could increase the risk of hypoglycemia (low blood sugars) over the long term. Therefore, I am proposing only a very short term temporary change for evaluation purposes.
If you haven't yet read the Diabetes Solution Chapter 10 that I previously linked for you, be sure to do so or you can just start here: SO WHAT'S LEFT TO EAT? (from Dr. Bernstein's Diabetes Solution , Chapter 10). Although Dr. Bernstein recommends 6-12-12 (number of carbs per meal) to his patients, I am suggesting that your husband reduce his carb intake to 15 grams per meal for just one day. This should lower his overall blood glucose and stop the roller coaster fluctuations he has been experiencing. If his meter readings do not fall below TEN mmol/l, continue with the 15 gram dietary limit per meal a second day. Ten mmol/l is still more than twice normal but lowering BG levels too rapidly is not well tolerated in some people.
Processed foods will state the amount of carbs on the label; the 15 gram limit will automatically place most such foods on the taboo list. To determine the amount of carbs in fresh vegetables (the best source for carbs), fruit, nuts & seeds, etc. consult Carbohydrate Counter or CalorieKing or just type the phrase, "how many carbs in _____" into your favorite search engine.
This exploratory test should provide you with plenty of insight into what needs to be done long term but requires consultation with his doctors, adjustments in medication, and a host of other factors. Post back with the results and we can go from there (note: in the very unlikely event that he should fall below 6.0 mmol/l, just have him drink a few oz. of orange juice or a sugared beverage).View Thread
I have always questioned the wisdom of a patient using both insulin and a sulfonylurea oral medication. If a patient is already on insulin, why add an oral medication to increase the amount of insulin secreted? Why not just inject the needed insulin instead and preserve what remaining beta cells, if any, the patient may have left (not to mention the undesirable long term side effects)? Of course, I personally advocate the use of injected insulin over a sulfonylurea drug for a different reason: much tighter and far more precise control over blood sugar levels. With an oral medication, you must rely on the drug to exert its affect at whatever timetable and extent that the drug dictates. Depending on a host of variables, the drug may cause over- or under-production of the insulin that you require. With insulin, you can just inject what you need based on your I:C ratio and the amount of carbs in your meal. If you under-project, you can simply inject a small corrective dose. You can't do that with an oral med.
In addition, most patients on sulfonylureas have to increase the strength taken because the effectiveness of the drug declines over time (perhaps due to beta cell burnout?). With insulin, you can just inject the amount that you need and not have to depend on a drug that may cause over- or under-production of the insulin that you require. Injected insulin can also be used to correct unexpected highs; particularly at bedtime.
I know that my posts are long (WebMD has a 4,000 character limit per post) and that I should probably just refer you to some good books and online references on the topic. However, books take even more time to read, require the reader to wade through a lot of filler material (and thus often go unread), and your husband doesn't have the luxury of time. Had he undertaken his educational quest fifteen years ago when he was first diagnosed, that would have been an entirely different matter with a much brighter outcome. In any event, I'm taking a hiatus and my next post will skip directly to a recommendation that may fast track him to potentially better control.
In the meantime, here are some financial assistance links that could help you if you haven't yet explored them on your own:
Financial Assistance Programs for People with Diabetes (PDF Download Link) Ontario Monitoring for Health Program (NFHP) — Diabetes Test Strips and lancets — 1-800-361-07961-800-361-0796 Trillium Drug Program (TDP) ) — Rx Drug Cost Assistance Program — 1-800-575-53861-800-575-5386 Ontario Drug Benefit (ODB) Program — you would be eligible only if are a Trillium Program recipient Lilly Canada Cares Insulin & Glucagon Assistance Program (a possibility) — 1-888-545-59721-888-545-5972 S.U.G.A.R. — 1-855-577-84271-855-577-8427[br> [br> [a target="_self" id="skype_c2c_menu_click2call_action" class="skype_c2c_menu_click2call_action">Call [a target="_self" id="skype_c2c_menu_click2sms_action" class="skype_c2c_menu_click2sms_action">Send SMS [a target="_self" id="skype_c2c_menu_add2skype_text" class="skype_c2c_menu_add2skype_text">Add to Skype You'll need Skype CreditFree via SkypeView Thread
Carb Counting As you may already know, the food that we eat consists of three macronutrients: protein, fats and carbohydrates. Macronutrients provide calories to the body as well as performing other functions. Protein is the source for essential amino acids and fats (lipids) are the source for essential fatty acids. The term "essential" means that the body requires them for good health and they must be obtained from food sources because they cannot be synthesized by or within the human body. There is no such thing as an essential carbohydrate. This is basic junior high or middle school Biology and Physiology 101. All carbohydrates (except some forms of fiber) convert to glucose when digested. Protein (up to 50%) can also convert to glucose via a process known as gluconeogenesis (in the liver). But it is carbohydrates that have the fastest and most pronounced impact on blood sugars. Limiting the types and amounts of carbs in the meals eaten by a diabetic are critical to achieving good BG control and will help prevent otherwise organ-damaging consequences.
Carb counting is a simple meal planning technique for helping diabetics manage their BG levels. It enables all insulin-using diabetics to balance their insulin dosages against the amount (number of grams) of carbohydrates consumed. If the insulin dose (together with other medications) is insufficient to offset the impact of the amount of carbs ingested, the surplus carbs will cause blood sugar levels to continue to rise well after the insulin dose has been used up (hyperglycemia or elevated BG levels). If the insulin dose is greater than the amount needed to metabolize the amount of carbs consumed, the surplus insulin will cause low BG levels (hypoglycemia). The goal for most diabetics is to achieve normoglycemia.
In your husband's case, the carb content in his meals far exceeds what his insulin dose and glyburide can handle. That's one of the reasons why his blood sugar levels are so high. He is consuming far too many carbs than his current insulin/glyburide doses can accommodate. There are two ways to offset this: increase the insulin dose or decrease the dietary carbs. The latter, of course, is the best, safest, and healthiest option. You can get more detailed information on carb counting here on the WebMD website at this link . How many carbs should your husband include in his meals? That's difficult to answer and varies from person to person as forum members here can easily attest to (I will provide some recommendations in a future post).
Unfortunately, clouding up the BG control picture and making it far more of a guessing game in your husband's case is the fact that he is taking both insulin plus an insulin-stimulating sulfonylurea medication (glyburide). Glyburide and other sulfonylurea medications work by stimulating overworked, exhausted, declining beta cells to secrete more insulin. Studies have shown that this will accelerate beta cell death or burnout. (to be continued).View Thread