Re: Flash! Whoosh! Flutter, ker-thump! as lff joins the ranks

In message <c7o4045b4rpqn94vll3bipq8vmcs4p7n6a@xxxxxxx>, Linda Fox <linda.ff@xxxxxxxxxxxx> writes
On Sun, 13 Apr 2008 12:33:22 -0700 (PDT), Bob E
<robert.embleton@xxxxxxxxxxxxxx> wrote:

The only good thing is that when they photograph your retina they
inject a flourescent dye which means you can a good few hours fun in
the toilet if you have a UV light handy.

Did you mean "inject"?

lff

No he didn't - not in my experience anyway. Don't panic! The procedure I've had for the last few years (since Digital diabetic retinopathy was introduced in wales) is that a couple of drops of a substance which dilates the pupils is dropped in each eye. It stings just a little. You then sit for about 20 minutes while it works and they then take several images of each retina with a digitalcamera and a laptop PC. These images are then checked you later get a letter (copied to your GP) telling you if everything's OK. I've always been fine so I don't know what the wording would be if there has been any deterioration. It's an excellent check which is far more accurate than the visual inspection done by an optician. The only thing to be aware of is that the drops take a couple of hours to wear off so IMHO driving is out for that time.

I've been type 2 for about 12 years now - diagnosed when I was 52. To stat with I panicked! I had just left full-time staff employment with all the benefits that offered and gone freelance. My ex-wife was a poorly-controlled Type 1 so my entire experience of diabetes was coloured by that experience (including a pregnancy) :-( However I've continued working in a fairly stressful job since then with no problems. In particular the job makes regular meals and the like difficult. That certainly wasn't anissue when I was diet-controlled and even now barely needs thought. It's not like the situation used to be for a Type 1 where they needed to eat as they'd taken a long-acting insulin in the morning. Diet-controlled Type 2's don't go hypo.

I managed to control things by diet alone for 5 years or so, then needed gliclazide alone and in the last month have added Metformin to the cocktail. So, as has been mentioned, Type 2 is progressive, it won't get better and the pancreas will gradually lose it's residual ability to produce any insulin. If/when I reach that stage I'll be glad to move on to insulin as that'll give me the best chance of a prologed life without the worst side-effects of diabetes. However I'm nowhere near that yet and may never be. My father is 91, Type 2 and still on tablet medication, though it has to be said that his GP his far more relaxed about his blood-sugar level than my GP is about mine.

You've been given the best advice for the moment. Lose weight (I shifted 2 stone in the 2 months after I was diagnosed) and in conjunction with small adjustments to my diet I got my HbA1c down to 6.5 after that time. Apart from that eat a healthy diet ie plenty of fibre and low fat. I was lucky, I had eaten wholemeal bread, pasta and cereals rather than white for years (as they have some taste!), also non-dairy spread and had given up sugar in tea and coffee ages ago purely on general health grounds.

There's every chance that you'll be diet-controlled for years. However it really is very much up to the individual. I do know at least one person who largely ignores the advice given and consequently has poor control. I've always been very pro-active and determined to retain good control. As a result it's me who's generally gone to my doctor or Diabetic Specialist nurse and said that I'm not happy with my control and can we look at a change in medication.

To take charge of your own destiny like that means being prepared to use a blood-sugar meter from time to time. I'm doing more measurements atm as I've been ramping up my Metformin dose from 500mg to 1500mg over 3 weeks but usually I'd do 2 or 3 at random times (1 fasting in the morning) each week. That's more than often recommended for a type 2 but as I say I intend to keep control of my own destiny! The more important measurement is the one called HbA1c which is done via a blood sample taken by your GP or clinic. That is in effect a measure of the average blood glucose level over a period of about 6 weeks before the blood is taken. Good control of this is far more important than the odd high instant reading or "spike". My GP wants mine to be at or below 6.5. The reason I've started taking Metformin is that I'd noticed more high readings of instant blood glucose than I liked over a period of weeks and when I got an HbA1c done it was 7.5.

As someone else said, there's nothing to be worried about in using a meter. The modern finger prickers are adjustable and damned nearly painless and the amount of blood need is very small. You get the result in about 10 seconds or so. Many meters, including my Accucheck Compact, can be linked to a PC with software provided free by the manufacturer. This lets you download test results and produce produce trend graphs and the like. Again very interesting if you want to be in charge!

I should say a couple of other things. I'm very lucky ATM. I've never had to deal with a hospital clinic. My GP has a special interest in diabetes so manages his diabetic patients himself with the support of a specialist nurse who runs regular diabetic clinics at the surgery. Secondly, because I take my condition very seriously but don't let it rule my life and have this direct relationship with my GP, I long since got the cofidence to be able (and to be encouraged to) tweak my gliclazide dose to suit my food intake if I feel it's appropriate. I have spare gliclazide for that purpose. For instance, I know that indian or Chinese (even if i keep off the sweet and sour!) food will cause a spike so I automatically take an extra half tab if I'm going to eat it.

For you all of this is a long time ahead. I write it mainly to reassure you that if you adopt a "healthy lifestyle" , if you don't already have one :-) you shouldn't not find type 2 a great burden.

BTW you will get all prescriptions free and also your normal annual eye test at the optician.

The other areas they worry about are cholesterol and blood pressure. If yours are above the target range you may well find yourself taking med's for them as well!

In my case I take Gliclazide, Metformin, Ramipril (Blood pressure) and Simvastatin (Cholesterol) apart from a couple of other non-diabetic-related things.

Sorry to have gone on so long. I've lurked here for ages and rarely posted but this is something I do have experience of and felt that I could usefully share the info.

I'm sure there are plenty of others here who will agree/disagree with my views, which are very much based on my own particular situation and attitude.

Good luck Linda and "don't panic"

Guy
--
Guy Morgan
nb Virgo, WFB, Stockton GU
Defend the waterways.
Visit the web site www.saveourwaterways.org.uk
.

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