Re: correction - diabetes email/Natalia

[Guest guest]

Natalia, I was told when I was diagnosed with cfrd that it is very different

from Type I and greatly different from Type 2--that it can hit early in

childhood or late in adulthood in cf, but that there are some specific

differences. One of them was that cfrd is more likely to cause capillary

damage rather than vein or arterial damage, but was not as likely to cause

ketoacidosis, that is ketone bodies in the urine which indicate loss of nu

trients. Apparently, we are subject to diabetic coma, without ketoacidosis,

and to hypoglycemia (LOW blood sugar episodes), frequently the first sign

seen along with fatigue. Every cf doctor, every endocrinologist, every pri

mary care internist seems to have a different view of all this. The single

most important indicator of over-all non-compliance or compliance is the

90-day test, which uses its own scale, and should always be UNDER 7!!!!!!

The other thing, and yes we are pincushions, but it beats the alternative--

is to test, test, test and test again if in doubt. I am no big example of

purity

here, but I do test upon awakening (fasting), three hours after breakfast, so

I can figure out what lunch should consist of, three hours after lunch, so I

can figure out what dinner should be, and often need a small protein snack

before dinner. I suspect she has classic Type II, is way out of control and

should be hospitalized. One of the things they do in a hospital, in addition

to insulin or other blood-sugar control, is to infuse FLUIDS to dilute the per\

centage of sugar in the blood. This is a crisis measure: as we say in the usa,

" Do not do this home alone! " Then, while in hospital they will work out

a better insulin regimen (may take both short-acting and long-acting), and

scare her into eating properly. My hopes are with you and with her,

Love to you, Natalia,

n Rojas, who once had to take her cousin to the local hospital with

blood sugars nearly 800!! I nearly had to get violent to get them to admit

her, so phoned her internist from the hospital. In 14 hours her sugars were

down to 105, and she was not acting " extremely strange! " I went through

the same thing with one of my sisters--one really wonders! Take care of

you! n

correction - diabetes email

Correction of 8th line...

**Now the CARB to insulin ratio is how much INSULIN

you need to cover the carbs that you intake.**

Sorry for the lazy typing.....

[Guest guest]

I am not a doctor, I just gave the advise that all diabetics should

follow. Insulin works the same in our bodies when it comes to carbs

and how they turn into sugar. If anything ours is more complicated,

and we have to adhere to more rules since our diet is the opposite of

Type 1 or 2 Diabetes. She is going to see her doctor, and of course

that is encouraged. I just know that not al people listen to doctors,

or even go see them. If that was the case, then so many people would

not be seeking advise on the internet.

I hope that her doctor does the right thing for her and that she

listens. But the proper use of insulin is just that, and when done

properly it does keep sugars under control.

I know that it is SO hard to get blood sugars under control and that it

takes work. I keep records of everything I eat still to make sure that

nothing changes since the drugs that I am on raise my blood sugar, as

do chest infections. It's like chasing a moving target. though I do

have blood sugars between 6-8 always, which is whrer I should be.

And I agree with you about scaring people to eat well.

On Sunday, February 1, 2004, at 08:28 PM, n Rojas wrote:

> Natalia, I was told when I was diagnosed with cfrd that it is very

> different

> from Type I and greatly different from Type 2--that it can hit early

> in childhood or late in adulthood in cf, but that there are some

> specific differences.  One of them was that cfrd is more likely to

> cause capillary

> damage rather than vein or arterial damage, but was not as likely to

> cause

> ketoacidosis, that is ketone bodies in the urine which indicate loss

> of nu

> trients.  Apparently, we are subject to diabetic coma, without

> ketoacidosis,

> and to hypoglycemia (LOW blood sugar episodes), frequently the first

> sign

> seen along with fatigue.  Every cf doctor, every endocrinologist,

> every pri

> mary care internist seems to have a different view of all this.  The

> single

> most important indicator of over-all non-compliance or compliance is

> the

> 90-day test, which uses its own scale, and should always be UNDER

> 7!!!!!!

> The other thing, and yes we are pincushions, but it beats the

> alternative--

> is to test, test, test and test again if in doubt.  I am no big

> example of purity

> here, but I do test upon awakening (fasting), three hours after

> breakfast, so

> I can figure out what lunch should consist of, three hours after

> lunch, so I

> can figure out what dinner should be, and often need a small protein

> snack

> before dinner.  I suspect she has classic Type II, is way out of

> control and

> should be hospitalized.  One of the things they do in a hospital, in

> addition

> to insulin or other blood-sugar control, is to infuse FLUIDS to dilute

> the per\

> centage of sugar in the blood.  This is a crisis measure:  as we say

> in the usa, " Do not do this home alone! "    Then, while in hospital

> they will work out

> a better insulin regimen (may take both short-acting and long-acting),

> and

> scare her into eating properly.  My hopes are with you and with her,

> Love to you, Natalia,

> n Rojas, who once had to take her cousin to the local hospital

> with

> blood sugars nearly 800!!  I nearly had to get violent to get them to

> admit

> her, so phoned her internist from the hospital.  In 14 hours her

> sugars were

> down to 105, and she was not acting " extremely strange! "   I went

> through

> the same thing with one of my sisters--one really wonders!  Take care

> of

> you!  n

>   correction - diabetes email

>

>

>   Correction of 8th line...

>

>   **Now the CARB to insulin ratio is how much INSULIN

>   you need to cover the carbs that you intake.**

>

>

>   Sorry for the lazy typing.....

>

>  

[Guest guest]

I am not sure of the original email about CF related diabetes, but I am sure

we all get differing ideas and thoughts on it.

My own diabetes is now 15 years old to me. I have excellent control of it.

I read a few of the emails and found some of the info interesting.

We were always told that CF diabetes is NOT as bad as others, as it is based

on our CF. Also, while exercise is good and a help to controlling it,

CFers need to eat the fat and carbs that provide the right nourishment and

nutrients and minerals and exercise alone is going to not aleviate that, as we

need

to eat so we can gain what we loss with the exercise.

CFers unlike others with Diabetes do not watch their fat intake. If you do

get diagnosed at your CF center, be sure that you are seen by a diabetes doc

that knows CF. When I was diagnosed when I was 26 the doc was my primary care

doc and he said to this 5'5 " 103 pound person - " well you will have to control

it with your food " He looked at me up and down and said " Well, you are thin,

but can lose a little weight " OH YEAH!!!

I don't think any CF team will allow the diabetes to be controlled by diet.

In fact they want you to eat all the carbs and sugars you want and then control

with the oral meds or insulin.

Being diligent about checking blood sugars, doing the carb calculations and

sliding scale should keep you well controlled. It takes a little learning,but

it is now automatic to me.

If you still cannot control the glucose ask about the insulin Pump. This is

for people who have a hard to control and need more coverage.

There was an email with the number 180 as a goal!!! A goal? What kind of

goal is that. Any doctor would be looking for 90-120 as a good goal My

numbers are about 90 to 110 all the time.

Diabetes is very doable and it is not that bad as I thought when diagnosed

originally.

The main things are taking the right meds, having a good diabetes team that

TRAINS you well. I have an excellent team here in Rochester and also in North

Carolina. They did a great job training me.

If anyone has any questions, don't hesitate to email me.

Joanne Schum

> I am not a doctor, I just gave the advise that all diabetics should

> follow. Insulin works the same in our bodies when it comes to carbs

> and how they turn into sugar. If anything ours is more complicated,

> and we have to adhere to more rules since our diet is the opposite of

> Type 1 or 2 Diabetes. She is going to see her doctor, and of course

> that is encouraged. I just know that not al people listen to doctors,

> or even go see them. If that was the case, then so many people would

> not be seeking advise on the internet.

> I hope that her doctor does the right thing for her and that she

> listens. But the proper use of insulin is just that, and when done

> properly it does keep sugars under control.

> I know that it is SO hard to get blood sugars under control and that it

> takes work. I keep records of everything I eat still to make sure that

> nothing changes since the drugs that I am on raise my blood sugar, as

> do chest infections. It's like chasing a moving target. though I do

> have blood sugars between 6-8 always, which is whrer I should be.

> And I agree with you about scaring people to eat well.

Joanne M. Schum

Cystic Fibrosis

Bi-lateral Lung Transplant Recipient

September 12, 1997

University of North Carolina Hospitals Chapel Hill

Residence: Upstate New York

email: luckylungsforjo@...

Manager of: Transplant Support - Lung, Heart/Lung, Heart

http://groups.msn.com/TransplantSupportLungHeartLungHeart

" Taking Flight - Inspirational Stories of Lung Transplantation "

Compiled by Joanne Schum

Authored by lung recipients around the world

http://www.trafford.com/robots/02-0497.html

http://www.trafford.com/