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[amlithist]

I doubt I'm the only one here on the fora dealing with Type II diabetes, though I'm probably the one dealing with it the worst (i.e., my idea of "dealing" has been "act like everything is OK, and it will go away").  I know, I know--stupid.  But life has been nuts the past few months (oh, hell, all right--YEARS), and frankly, this has been way down on my list.

I was diagnosed while in the hospital for another problem (cellulitis) this summer.  There's no family history; I'm close to 50 and have all the risk factors, so it shouldn't have come as a surprise (overweight, overworked, love my carbs, etc. etc.)  I did really well for the first 6 weeks or so, but after school started again in the fall, it all went to hell.  I taught all summer, too, but it was online, so I was at home and could be better about fixing meals, using the exercise bike, and so on, and nobody there smokes, so I quit.  But once back to school, I got back into all the old habits that got me here to start with:  smoking, comfort/stress eating, not checking my sugar, etc. 

I've been lucky:  I got away with this for a couple of months, until this morning.  I woke up at 4 a.m. with the mother of all headaches, sick to my stomach, and feeling generally like I'd been hit by a train.  I'm sure it's all from the way I've been eating (or, to be specific, both what I'm eating that I shouldn't, not eating at regular times, skipping meals and then bingeing, etc), working like a fool (teaching 6 classes, plus admin and committee duties), not sleeping the way I should, worrying about Mom and my kids, etc., etc., etc.

My doctor is sure this diagnosis was triggered by stress; he has a number of new Type II patients who are just like me--sandwich generation, working full time and then some, etc. 

So, I get it, already.  But I seem to have to get smacked upside the head to make it real, like this morning when I thought I was dying.  (I'm considered "borderline" diabetic, i.e., my sugar isn't THAT far over the limits, so I'm sure that's a big part of why I think I can get away with ignoring it.  If it were outrageous, well, OK, of course I'd have to behave, but as it is. . . . )  I stopped at the store on the way to work, bought good foods, had my snack and just now my lunch, and have resolved to do better and start sticking the finger again.  If I can just make it last.  ::sigh::

How do the rest of you do it?  I KNOW I have to get this under control, sooner rather than later, but it's just so damned hard, with all the other stuff going on.  I've dealt with "female" cancer a year or so back (all taken care of now), but that seemed easier because it was a crisis situation.  This. . . . I don't know how to even envision myself dealing with something chronic like this the rest of my life.  Any suggestions or advice (aside from "quit whining" and "just fracking DO it")?

[ms_turtle]

{{{{{{{{{{{{{{hugs}}}}}}}}}}}}}

I don't have it yet, but with 8 diabetic family members (my mom, and many others on her side) and being overweight, overworked, etc. I am going to get it someday.

At many points in your life you had to learn to do things every day, sometimes multiple times per day to keep yourself clean and/or healthy. Brushing your teeth, wiping your bum correctly, dealing with Aunt Flo, etc. all had to become part of the routine.

Using your meter will have to become part of your routine. If you can tie using the meter with something that you already do several times each day, you'll be more successful. I use the toothbrush or car keys as my tie in if I have to remember to do something.

This will be OK.

[underwater]

Any suggestions or advice (aside from "quit whining" and "just fracking DO it")?

A support group might help, or perhaps Weight Watchers?  There's always a sizeable (ouch!) group of type II diabetics there, learning to incorporate better eating and more activity into their lives.  I bet once you get those two factors under control you'll feel more motivated about the testing, because it will serve more as an confirmation of what you've been doing right than an accusation of how you've been messing up.

[michigander]

WARNING:  The following is a personal exhortation based upon my own experience with which others are likely to disagree, at least in some respects.  It's just one person's opinion.  If it's not helpful to you, ignore it.

First of all, there is no such thing as borderline diabetes.  If your fasting blood sugar is regularly over 110 as commonly measured in the U.S., you're diabetic. 

I've had type II diabetes for years and spent most of that time not dealing with it well.  So, let me tell you what you have to look forward to if you keep it up because a lot of it happened to me:

Checking your blood sugar levels at least three times a day, injecting huge doses of two kinds of Insulin five times a day, possibly injecting Symlin three times a day, having to find a way to travel with three vials of medications that need to be kept cool plus all of the trappings, needing to use dark public restrooms of dubious cleanliness for your medical activities when away from home, taking multiple oral hypoglycemics several times a day, developing peripheral neuropathy in your feet so that you have pain and numbness and lose your protective sensation so that you can injure yourself and not even know it and maybe have to live with amputations someday, developing retinopathy so that your vision is adversely affected, developing nephropathy and maybe needing kidney dialysis or a transplant someday, and so forth.

Most people who end up having to take lots of maintenance meds for all of these kinds of conditions eventually end up resenting it.  I know that I did.  Most people who let their diabetes get out of control also let their weight get out of control and end up hating the way they look.  I know that I did.  With the weight gain come other co-morbidities including GERD, sleep apnea, hypertension, edema, and hyperlipidemia.  I know that they all came to me.

No, this isn't a "scared straight" lecture -- just telling you what you have to look forward to if you don't get things in check.

So, how did I get myself on track?    Eventually, I rebelled.  The more destructive among us do so by going off their meds.  Thankfully, I decided to do something more positive.  Since none of the ordinary weight control strategies worked for me, I ended up having gastric bypass surgery.  And it worked!  I weigh less than 200 pounds for the first time in decades (I'm male and six feet tall and still losing weight).  Clothes look good on me again, and I can find stylish clothes in my size in ordinary places where I can afford to shop.  People treat me differently.

I had blood drawn last Sunday morning for lab work, and my HbA1c was 4.6!  I didn't even know that was possible.  I now inject only minimal doses of one kind of Insulin, and my doctor tells me that when my weight stabilizes I may be able to stop.

BUT, I had to pay lots of money and spend over a two years going through the protocol and jumping through insurance company hoops to have my plumbing redone surgically.  I will never be able to eat like "normal" people.  Every time I eat, I will have to worry about feedback from over filling my tiny stomach pouch and about clogging my stoma if I don't chew every bite of food an amazing number of times.  I'm now lactose intolerant, so I'll never have pizza or ice cream again without regretting it.  I'll have to take vitamin and mineral supplements daily for the rest of my life.  I have a list of foods and beverages to avoid for the rest of my life.  Of course, all of this is worth it because the rest of my life is very likely to last a whole lot longer and to be a whole lot more pleasant.

At the point at which you now find yourself with the disease, you have a chance to avoid everything that could happen.  Whatever it takes for you:  frequent workouts with a personal trainer, regular visits with a dietician, counseling, time with an endocrinologist, hypnosis, pharmacology, and/or surgery should be first on your personal agenda.  MANY people control their diabetes without having to take the extreme measures that I did.  Join the American Diabetes Association and read their publications.  Find a support group at a local hospital.  Own your diabetes and control it.

[splendiferous]

I'm sorry that you're facing this.

A book I've found useful is:
Dr. Bernstein's Diabetes Solution: A Complete Guide to Achieving Normal Blood Sugars
by Richard Bernstein
http://www.diabetes-normalsugars.com/

The author's theory is that it is actually possible for diabetics to maintain normal blood sugar with very regulated diets, exercise, and small amounts of insulin. He advocates radically restricted amounts of carbs (something like 20 grams a day).

This strategy has been borne out by my family's experience (my partner is Type II diabetic and has gone from being in pretty poor condition to keeping her blood sugar mostly within a non-diabetic range). When we first read this book, we couldn't imagine living with the diet he recommends. (It doesn't help that the book fails to convey the quantity and variety of DELICIOUS foods that are available within his diet.) But now, it's not that it's no big deal to be on such a restricted diet -- sometimes it sucks -- but it's... life. And life is a lot funner when you're healthy. It's worth it.

Given this, I wonder if you could set a time period for yourself. Do the research, pick a strategy that seems to make sense to you -- I recommend the one in this book based on our experience -- and set a time period of, say, six months to try it. Long enough that if it's going to work for you you'll see that and not want to go back, but short enough that it's not overwhelming to try it. You can always go back to your old life at the end, if that's what you want -- or find some third way.

I don't know if that will work, but maybe the idea will at least get you started thinking. Please know that you're not alone, and let us know what you decide to do.

[msparticularity]

I have some more general ideas from what worked for me to share - perhaps something will strike a chord for you!

First, Type II runs in my family, and I am pre-diabetic; I have reactive hypoglycemia (generally the last stage before developing full-blown diabetes). Until a few years ago, I had spent the vast majority of my life at an inappropriate weight: either quite underweight or overweight. After I started into per-menopause in my early thirties, I quickly gained 40+ pounds, then slowly added another 15-20, ending up at 200. (My desirable weight is in the 140-150 range.)

I lived like this for seven years, including a lot of time spent carefully following the nutritional advice I was given by professionals: eat a diet high in complex carbohydrates and low in fats, exercise, etc.  I felt worse every day - tired, cranky, sick to my stomach, and weak. I developed rheumatoid arthritis - which is likely genetic but was certainly made worse by the extra weight. My asthma got worse.

One day - I have no idea why - I started really reading about diabetes. I found out that, while complex carbohydrates are certainly easier on the system that refined ones, ALL carbohydrates need to be carefully monitored for someone like me. Not just for long enough to lose weight, but forever. So I set out to design a new lifetime diet for myself. I lost weight steadily for the first two years, and have kept it off for the past five. I now weigh consistently 145-150, which while it sometimes feels a little pudgy to me is considered a healthy weight for my height and bone structure.

Here are some high points of my eating plan, which in many respects resembles both the South Beach diet and the Mediterranean one:

-I eat under 100 grams of carbs a day - generally 70-80. I do not, however, count every bite that goes into my mouth every day. I did enough reading to get a good idea for what I should and should not eat, built carefully-calculated menus for myself for awhile, and I do spot monitoring from time to time.
-No more "casual bread" - no sandwiches, wraps, tortillas, or whatever just to hold food together. I eat the "innards" only, and if I actually want a specific bread product I plan carefully to incorporate it in my day.
-Salad is my "default food." If I can't figure out what else to eat, can't make up my mind, or nothing sounds especially good, I eat salad. I make big, luscious salads with nice greens, a mix of veggies, a lean protein, some good grated cheese, olives, pepitas and/or walnuts, and a dressing of kalamata olive oil with either a fun vinegar or some lemon juice.
-I keep lots of emergency snack food everywhere. This includes string cheese, whole almonds with a variety of seasonings, pepitas with cayenne, or other similar things.
-I decided upon a set of "treats" that I'm allowed to have to indulge myself: brie (sometimes other cheeses as well), dark chocolate, red wine, and good bourbon. I like all of these so much that it's very easy to turn down other stuff, since it never tastes nearly as good.

I think my biggest discovery is how idiosyncratic this can be. It just takes awhile to hit on something that actually works for our own individual body, and it's really important to pay attention to how we're responding, and to make continuing adjustments to fine-tune it.

[amlithist]

Thanks, everybody, for the input.  Michigander, I'm so sorry you've gone through all this, and frankly, it's exactly what I'm afraid of, so I do need to get scared straight.  MsParticularity, thanks too for your ideas.  If I can get motivated to start the diet and see some success, I think I'll be OK, and your comments about the salads, the level of carbs, etc. have reinforced some things I've been planning the past few days. 

What do you guys think of this:  I'm thinking of doing some serious cooking this weekend---baking up a couple of bags of chicken breasts and freezing single portions; browning up several pounds of hamburger and freezing portions; buying some big bags of salad greens, prepping and portioning the goodies like red onion, hard boiled egg, cheese etc. so I can grab and go?  I do think the biggest part of getting myself motivated to eat right is that by the time I get home at night, not only do I not want to cook right, I am so exhausted (certainly exacerbated by not feeling good, because the diabetes isn't under control. . . ) that I either grab fast food, eat junk at home, or don't eat at all.  Maybe if I dumb it down enough, so I can just grab some chicken or beef & nuke it, throw a few things with it, and toss some dressing on a salad, I'll get started, and then when I start losing weight and/or seeing better blood sugar results, I'll get it together.

Thanks, everybody--I know I should be a grown-up about this, and I'm going to try!  :)  Hugs!

[splendiferous]

I think that's a great idea, amlithist. And I really like msparticularity's ideas too. I'm going to try to start thinking of salad as my "default food" too.

I also second the point she made about "casual bread." For my partner, the *easiest* part of adjusting to her new diet was realizing how much sugar she used to consume through things that she frankly doesn't miss at all (juice stands out here, in her case, as does having a bagel or cereal when she could just as easily have eggs).

[msparticularity]

What do you guys think of this:  I'm thinking of doing some serious cooking this weekend---baking up a couple of bags of chicken breasts and freezing single portions; browning up several pounds of hamburger and freezing portions; buying some big bags of salad greens, prepping and portioning the goodies like red onion, hard boiled egg, cheese etc. so I can grab and go?  I do think the biggest part of getting myself motivated to eat right is that by the time I get home at night, not only do I not want to cook right, I am so exhausted (certainly exacerbated by not feeling good, because the diabetes isn't under control. . . ) that I either grab fast food, eat junk at home, or don't eat at all.  Maybe if I dumb it down enough, so I can just grab some chicken or beef & nuke it, throw a few things with it, and toss some dressing on a salad, I'll get started, and then when I start losing weight and/or seeing better blood sugar results, I'll get it together.

I'm trying to do this too, with pretty good results. I agree that it's way too easy to eat badly when we're worn out, and it feels SO good to come home to food that's basically ready to be eaten!

[splendiferous]

Here's another low-carb tip from my partner: you can use fried eggplant cutlets (thin ones) in place of bread to make "sandwiches," when you have something that really can't be eaten on its own. Grilled cheese sandwiches, spreads, and things that are too salty or spicy without a base of some kind are her examples (for the latter, you can also put them in a salad of course).

[rockprof]

I'm also a Type II diabetic (just about everyone on my father's side of the family gets it sooner or later).  For years I was in denial about it.  I'm finally starting to come around and deal with it by losing weight and exercising a lot more.

For myself, carbs drive up my blood sugar.  When I go low on carbs, my blood sugar's lower and cholesterol numbers (especially triglycerides) are much better.  Exercise also helps.  Going to the gym for an hour three times a week keeps my blood sugar down even on days I don't go to the gym.

If you ignore your blood sugar, it will catch up to you.  You'll feel like crap and eventually develop all kinds of nasty complications.  Allow yourself a treat now and again, but keep your blood sugar down, lose weight if you need to, and exercise.  Easy to say, but I don't always do what I need to either so I know how hard it is.

Good luck.

[amlithist]

Checking in here. . .

OK, I cooked and boxed salads and everything yesterday, and today I was a Good Girl.  We'll see how it goes.

Rockprof, you ain't just a-kiddin':  I felt SO lousy I didn't come in until late today for a meeting.  I checked the sugar first thing this morning, and it was 167 (high for me, though I don't know where that number is in "absolute" terms).  I felt like I'd been hit by a truck when I got up, and called in sick.  This was the worst I've felt since I got diagnosed back in June.  Normally, I'd have spent the day with junk food, but I was good instead:  toast and an egg and some oatmeal for breakfast; a big salad with a bit of ham and hard boiled egg for lunch; another big salad and some chicken breast for supper at my desk (I work late on Monday nights).  I'm so proud of myself. . . . now, if I can make it past the Krispy Kreme at the stoplight by campus on my way home . . . .

Thanks for the encouraging words, everybody!

[msparticularity]

OK, I cooked and boxed salads and everything yesterday, and today I was a Good Girl.  We'll see how it goes.

You're doing great - congratulations!

Be sure that you incorporate - and plan for - some appropriate treats in your diet. Feeling too deprived is a sure way to undermine continued success! (Note my brie and dark chocolate habit.)

[splendiferous]

Great job!!!

For what it's worth, my partner adds the thought that having a low-carb breakfast actually *lowers* your blood sugar in the morning (I guess since your body is in 'fasting mode', ie conserving sugar, after sleeping through the night?). So when you wake up and feel like crap, even if it seems counter-intuitive, eating some eggs or something -- like you did -- might help.

[veleda]

amlithist, you (I) just have to do everything you can to get on top of this (I know you know...). I have t2 myself and I know how hard it is. I have a part-time job at a major diabetes research center with a clinic, and every day all day I see blind and legless people walking in the door. Talk about scared straight! And somehow I still manage to eat crappy some days, which is just impossibly stupid of me. It's such a scary scary disease. I just don't get how I justify eating poorly and not exercising regularly enough, but I do. I also work in cardiac rehab and have heart disease, but it's the blind thing that scares me the most. No reading...I couldn't live without reading. So you (I) need to just keep at it. I wish I had some great advice to share, but I'd feel like a hypocrite. All I can say is it does get easier with time.