XPost: misc.health.diabetes, news.answers
Archive-name: diabetes/faq/part1
Posting-Frequency: biweekly
Last-modified: 30 May 2010 (excludes change list and Table of Contents)
Changes: add aspartame topic in research section (14 July 2005)
fix Avogadro's number (15 Dec 2006)
correct U of Louisville link (10 March 2009)
add a point to the mg/dl vs mmol/l table (27 Feb 2010)
clarify conversion section (30 May 2010)
------------------------------
Subject: READ THIS FIRST
Copyright 1993-2010 by Edward Reid. Re-use beyond the fair use provisions
of copyright law and convention requires the author's permission.
Advice given in m.h.d is *never* medical advice. That includes this FAQ.
Never substitute advice from the net for a physician's care. Diabetes is a critical health topic and you should always consult your physician or personally understand the ramifications before taking any therapeutic action based on advice found here or elsewhere on the net.
------------------------------
Subject: Table of Contents
INTRODUCTION (found in all parts)
READ THIS FIRST
Table of Contents
GENERAL (found in part 1)
Where's the FAQ?
What's this newsgroup like?
Abuse of the newsgroup
The newsgroup charter
Newsgroup posting guidelines
What is glucose? What does "bG" mean?
What are mmol/L? How do I convert between mmol/L and mg/dl?
What is c-peptide? What do c-peptide levels mean?
What's type 1 and type 2 diabetes?
Is it OK to discuss diabetes insipidus here? What is it?
How about discussing hypoglycemia?
Helping with the diagnosis (DM or hypoglycemia) and waiting
Exercise and insulin
BLOOD GLUCOSE MONITORING (found in part 2)
How accurate is my meter?
Ouch! The cost of blood glucose measurement strips hurts my wallet!
What do meters cost?
Comparing blood glucose meters
How can I download data from my meter?
I've heard of a non-invasive bG meter -- the Dream Beam?
What's HbA1c and what's it mean?
Why is interpreting HbA1c values tricky?
Who determined the HbA1c reaction rates and the consequences?
HbA1c by mail
Why is my morning bg high? What are dawn phenomenon, rebound,
and Somogyi effect?
TREATMENT (found in part 3)
My diabetic father isn't taking care of himself. What can I do?
Managing adolescence, including the adult forms
So-and-so eats sugar! Isn't that poison for diabetics?
Insulin nomenclature
What is Humalog / LysPro / lispro / ultrafast insulin?
Travelling with insulin
Injectors: Syringe and lancet reuse and disposal
Injectors: Pens
Injectors: Jets
Insulin pumps
Type 1 cures -- beta cell implants
Type 1 cures -- pancreas transplants
Type 2 cures -- barely a dream
What's a glycemic index? How can I get a GI table for foods?
Should I take a chromium supplement?
I beat my wife! (and other aspects of hypoglycemia) (not yet written)
Does falling blood glucose feel like hypoglycemia?
Alcohol and diabetes
Necrobiosis lipoidica diabeticorum
Has anybody heard of frozen shoulder (adhesive capsulitis)?
Gastroparesis
Extreme insulin resistance
What is pycnogenol? Where and how is it sold?
What claims do the sales pitches make for pycnogenol?
What's the real published scientific knowledge about pycnogenol?
How reliable is the literature cited by the pycnogenol ads?
What's the bottom line on pycnogenol?
Pycnogenol references
SOURCES (found in part 4)
Online resources: diabetes-related newsgroups
Online resources: diabetes-related mailing lists
Online resources: commercial services
Online resources: FTP
Online resources: World Wide Web
Online resources: other
Where can I mail order XYZ?
How can I contact the American Diabetes Association (ADA) ?
How can I contact the Juvenile Diabetes Foundation (JDF) ?
How can I contact the British Diabetic Association (BDA) ?
How can I contact the Canadian Diabetes Association (CDA) ?
What about diabetes organizations outside North America?
How can I contact the United Network for Organ Sharing (UNOS)?
Could you recommend some good reading?
Could you recommend some good magazines?
RESEARCH (found in part 5)
What is the DCCT? What are the results?
More details about the DCCT
DCCT philosophy: what did it really show?
Is aspartame dangerous?
IN CLOSING (found in all parts)
Who did this?
------------------------------
Subject: Where's the FAQ?
This FAQ attempts to answer the questions which have been most frequently
asked in misc.health.diabetes (m.h.d). This is not a complete informational posting. My only criterion for inclusion is that the topic has frequently appeared in m.h.d, either by an explicit question, or implicitly by
posting a
related question or a common misconception.
This FAQ is posted biweekly to the Usenet newsgroup misc.health.diabetes.
If you obtained this article by some method other than reading Usenet,
refer to the section on "Online resources: diabetes-related newsgroups"
for brief information on how to obtain access to Usenet newsgroups and misc.health.diabetes in particular.
Feel free to make copies of this FAQ for your personal use or for a
friend or
relative, including to share with health care providers. If you want to make this FAQ available to others on an ongoing basis (for example, on a BBS), please do *not* post or copy the entire FAQ. Instead, post only this
section,
entitled "Where's the FAQ?". This will enable others always to retrieve the most recent version.
I have removed the outdated informational posting on insulin pumps.
An informational posting on diabetes-related software is posted to m.h.d at
the same time as this FAQ. See below for retrieval information. It was developed and is maintained by Rick Mendosa <mendosa(AT)mendosa.com>.
I've used ideas and information from many people in writing this FAQ. With a few exceptions I haven't attempted to identify them, but I thank them all.
The words herein are mine unless otherwise credited.
If you read this and it helps you, please let me know what part helped, and why. If you read this and can't find what you want, let me know that too.
Such comments will help me decide what is worth working on, and whether.
You'd be surprised how little feedback I get. If you are reading this on the newsgroup, just reply to this article. If you found this on the web, send
email to <
edward@paleo.org.SPAMNOT>.
These documents -- the FAQ and the software overview -- are available
from the news.answers archives at rtfm.mit.edu. Using anonymous ftp, get
the files:
/pub/faqs/diabetes/faq/part1
/pub/faqs/diabetes/faq/part2
/pub/faqs/diabetes/faq/part3
/pub/faqs/diabetes/faq/part4
/pub/faqs/diabetes/faq/part5
/pub/faqs/diabetes/software
or in web browser format:
ftp://rtfm.mit.edu/pub/faqs/diabetes/
You can reach a formatted version of the FAQ and other documents at
http://www.faqs.org/faqs/diabetes/
Unfortunately, faqs.org has not updated reliably for the past several
years, so rtfm.mit.edu is the best source for the latest version.
------------------------------
Subject: What's this newsgroup like?
Posting topics range through emotional support, treatment techniques, psychological factors, health care practices, and insurance. We talk about
our problems, frustrations, depressions and complications to find out how others handle the same issues and for mutual support. The atmosphere is generally a highly supportive one, and most participants believe strongly
that this is an important aspect. As in other parts of the net, there
are one
or two regular participants who believe that it is important to question the motives and/or knowledge of anyone posting a new problem. If you find that
the first response is antagonistic, please wait a few hours. Every
antagonistic response will elicit a dozen sympathetic responses.
Meta-topics include discussions of how to best convey health information on
the Usenet, ethical treatment of other participants, what topics and information are appropriate for m.h.d, where to find diabetes information,
and what the newsgroup should be like.
Betsy Butler says eloquently:
The positive posts of people who are in great control are very
motivating, but it is also helpful to hear from people who don't find
it so easy. I'm sure there are a lot of people who struggle to keep
control. The people who are having trouble also need to know that there
are others who struggle, and that they are not alone. It can be very
intimidating, and a blow to self-esteem for people to suggest that if
you would just do X, Y and Z, you will be in control. There are 100s of
factors to balance, and I think people need to be reassured that "yes,
it's hard to balance so many things, many of which can't be measured or
that don't act predictably."
Topics closely related to diabetes mellitus which do not have their own
place
in Usenet are welcome. Examples are diabetes insipidus, hypoglycemia,
glucose
intolerance, legal and employment ramifications of chronic illness, effects
on family members, how family members can best provide support, and so on. misc.health.diabetes tends to be inclusive of anyone who needs it.
The same caveat applies here as in all newsgroups: the advice is worth what
you paid for it. This applies in spades to a critical health topic such as diabetes. Never substitute informal advice for a physician's care. Advice
given in m.h.d is *never* medical advice.
The variety of individual responses to diabetes is exceeded only by the
variety of individual responses to life. No two patients respond alike, and many respond *very* differently from others. These differences are physiological, not just psychological. They reflect not only varying
responses, but the fact that diabetes itself probably has many causes, many more than the few types currently recognized (see section on types).
When you
read advice, realize that what works (or doesn't work) for someone else may
not work (or may work) for you. When you give advice, try to remember that
most advice is relative to the individual, not absolute. Recognize that you can't treat your own diabetes by a set of rules, but only by knowing how
your
own individual body and physiology work and by adjusting to your own mechanisms.
------------------------------
Subject: Abuse of the newsgroup
As mentioned above, a few participants believe that name-calling and abusive language are more effective than polite discussion, support and interchange
of information. They are wrong, and the vast majority of participants
support
a more civilized and polite view of humanity. Since misc.health.diabetes is unmoderated, we all have to live together.
A few m.h.d. participants have received abusive email. Some are afraid to expose such abuse, having been told that email must always be private.
However, abusive email is no more deserving of privacy than obscene phone
calls or threatening letters. There is no authority to which you can report abusive email (unless it contains an actual threat, in which can you may be justified in contacting a law enforcement agency). Steve Kirchoefer <swkirch(AT)chrisco.nrl.navy.mil> is willing to try to mediate problems with email. Though Steve has no official authority, he has experience in dealing with problems on the net and may be able to help clear up such problems.
Send
him complete copies of any abusive email.
------------------------------
Subject: The newsgroup charter
The actual charter which led to the creation of the newsgroup in May 1993 follows. This charter was proposed by Steve Kirchoefer <swkirch(AT)chrisco.nrl.navy.mil> and approved by a public vote of the
Usenet
readership, and is the official statement of the scope and purpose of this newsgroup.
1. The purpose of misc.health.diabetes is to provide a forum for the
discussion of issues pertaining to diabetes management, i.e.: diet,
activities, medicine schedules, blood glucose control, exercise,
medical
breakthroughs, etc. This group addresses the issues of management of
both Type I (insulin dependent) and Type II (non-insulin dependent)
diabetes. Both technical discussions and general support discussions
relevant to diabetes are welcome.
2. Postings to misc.health.diabetes are intended to be for discussion
purposes only, and are in no way to be construed as medical advice.
Diabetes is a serious medical condition requiring direct supervision
by a primary health care physician.
------------------------------
Subject: Newsgroup posting guidelines
The following posting guidelines were adopted by a vote of m.h.d
participants
in September 1994.
Posting guidelines for misc.health.diabetes:
Postings to misc.health.diabetes should be compliant with the standards
for all material posted to Usenet. The following articles may be found
in news.announce.newusers, and should be reviewed by all posters:
-Emily Postnews Answers Your Questions on Netiquette
-Answers to Frequently Asked Questions about Usenet
-A Primer on How to Work With the Usenet Community
-Rules for posting to Usenet
-What is Usenet?
Posting to misc.health.diabetes should be compliant with the group charter, [which is in the previous section].
In addition to the above, the following guidelines are emphasized as particularly relevant for contributions to misc.health.diabetes:
-No personal attacks or insults. Avoid argumentative debates. Responses
should concentrate on the issues presented.
-No private discussions. Take private discussions to email. When in
doubt, use email.
-Edit responses to avoid unnecessary inclusions of earlier postings.
-Edit subject lines as necessary to remain consistent with the topic.
-Support factual statements with your sources. If you can not recall the
source, then say so. Do not imply authority which you can not actually
support.
Additional information can be found in the general FAQ posted periodically
to this group.
------------------------------
Subject: What is glucose? What does "bG" mean?
Glucose is a specific form of sugar, one of the simplest. It is the form
found in the bloodstream. "Blood sugar" always refers to blood glucose, and
is abbreviated bG. All bG meters are specific for glucose and will not
respond to other sugars, such as fructose, sucrose, maltose and lactose.
Although sucrose (table sugar) is the most common sugar in food, glucose is also common. Most fruits, fruit juices, and soft drinks contain large
amounts
of glucose, and many foods contain small amounts. This means that you
must be
very careful to clean any food residue from your fingers before drawing
blood
for a bG check. Since the normal level of bG is only 1g/L (=100mg/dl), it
only takes a tiny speck of glucose on your finger to contaminate the sample
and give you a falsely high reading. 10 *micrograms* of glucose could raise
the reading enough to cause you to overreact dangerously.
------------------------------
Subject: What are mg/dl and mmol/l of glucose? How do I convert?
This section discusses the conversion ONLY for glucose. The conversion is different for every chemical. See the following section for conversions for cholesterol and other substances.
There are two main methods of describing concentrations: by weight, and
by molecular count. Weights are in grams, molecular counts in moles. (If you really want to know, a mole is 6.022*10^23 molecules.) In both cases, the
unit is usually modified by milli- or micro- or other prefix, and is always "per" some volume, often a liter.
This means that the conversion factor depends on the molecular weight of the substance in question.
mmol/l is millimoles/liter, and is the world standard unit for measuring glucose in blood. Specifically, it is the designated SI (Systeme
International) unit. "World standard"is not universal; not only the US but a number of other countries use mg/dl. A mole is about 6*10^23 molecules; if
you want more detail, take a chemistry course.
mg/dl (milligrams/deciliter) is the traditional unit for measuring bG (blood glucose). All scientific journals are moving quickly toward using mmol/L exclusively. mg/dl won't disappear soon, and some journals now use mmol/L as the primary unit but quote mg/dl in parentheses, reflecting the large
base of
health care providers and researchers (not to mention patients) who are
already familiar with mg/dl.
Since m.h.d is an international newsgroup, it's polite to quote both figures when you can. Most discussions take place using mg/dl, and no one really expects you to pull out your calculator to compose your article. However, if you don't quote both units, it's inevitable that many readers will have to
pull out their calculators to read it.
Many meters now have a switch that allows you to change between units. Sometimes it's a physical switch, and sometimes it's an option that you can set.
To convert mmol/l of glucose to mg/dl, multiply by 18.
To convert mg/dl of glucose to mmol/l, divide by 18 or multiply by 0.055.
These factors are specific for glucose, because they depend on the mass
of one molecule (the molecular weight). The conversion factors are
different for other substances (see following section).
And remember that reflectance meters have a some error margin due to
both intrinsic limitations and environmental factors, and that plasma
readings are 15% higher than whole blood (as of 2002 most meters are
calibrated to give plasma readings, thus matching lab readings, but this
is a recent development), and that capillary blood is different from
venous blood when it's changing, as after a meal. So round off to make
values easier to comprehend and don't sweat the hundredths place. For
example, 4.3 mmol/l converts to 77.4 mg/dl but should probably be quoted
as 75 or 80. Similarly, 150 mg/dl converts to 8.3333... mmol/l but 8.3
is a reasonable quote, and even just 8 would usually convey the meaning.
Actually, a table might be more useful than the raw conversion factor, since
we usually talk in approximations anyway.
mmol/l mg/dl common
glucose glucose interpretation
------ ----- --------------
2.0 35 extremely low, danger of unconciousness
3.0 55 low, marginal insulin reaction
4.0 75 slightly low, first symptoms of lethargy etc.
5.5 100 mecca
5 - 6 90-110 normal preprandial in nondiabetics
7.0 126 fasting cutoff to diagnose diabetes, per ADA
recommendation established in 1997
8.0 150 normal postprandial in nondiabetics
10.0 180 maximum postprandial in nondiabetics
11.0 200
15.0 270 a little high to very high depending on patient
16.5 300
20.0 360 getting up there
22 400 max mg/dl for some meters and strips
33 600 high danger of severe electrolyte imbalance
Preprandial = before meal
Postprandial = after meal
------------------------------
Subject: Converting mmol/l<->mg/dl of cholesterol, triglycerides, creatinine
To convert mmol/l of HDL or LDL cholesterol to mg/dl, multiply by 39.
To convert mg/dl of HDL or LDL cholesterol to mmol/l, divide by 39.
To convert mmol/l of triglycerides to mg/dl, multiply by 89.
To convert mg/dl of triglycerides to mmol/l, divide by 89.
To convert umol (micromoles) /l of creatinine to mg/dl, divide by 88.
To convert mg/dl of creatinine to umol/l, multiply by 88.
------------------------------
Subject: What is c-peptide? What do c-peptide levels mean?
Thanks to Andrew Torres <andym(AT)ku.edu> for this section.
C-peptide blood levels can indicate whether or not a person is producing insulin and roughly how much.
Insulin is initially synthesized in the form of proinsulin. In this
form the
alpha and beta chains of active insulin are linked by a third polypeptide
chain called the connecting peptide, or c-peptide, for short. Because both insulin and c-peptide molecules are secreted, for every molecule of insulin
in the blood, there is one of c-peptide. Therefore, levels of c-peptide in
the blood can be measured and used as an indicator of insulin production in those cases where exogenous insulin (from injection) is present and mixed
with endogenous insulin (that produced by the body) a situation that would
make meaningless a measurement of insulin itself. The c-peptide test can
also
be used to help assess if high blood glucose is due to reduced insulin production or to reduced glucose intake by the cells.
There is little or no c-peptide in blood of type 1 diabetics, and c-peptide levels in type 2 diabetics can be reduced or normal. The concentrations of c-peptide in non-diabetics are on the order of 0.5-3.0 ng/ml.
------------------------------
Subject: What's type 1 and type 2 diabetes, and gestational diabetes?
The term diabetes mellitus comes from Greek words for "flow" and "honey", referring to the excess urinary flow that occurs when diabetes is untreated, and to the sugar in that urine.
Diabetes mellitus (DM) comes in the following classifications (which some
will argue don't really represent the actual types very well):
type 1 -- characterized by total destruction of the
insulin-producing beta
cells, probably by an autoimmune reaction. Onset is most
common
in childhood, thus the common (but now deprecated) term
"juvenile-onset", but the onset up to age 40 is not
uncommon and
can even occur later. Patients are susceptible to DKA
(diabetic
ketoacidosis). There seems to be some genetic tendency,
but the
genetic situation is unclear. Most patients are lean. Always
requires treatment by insulin. Not sex-linked. Also
referred to
as IDDM (insulin dependent diabetes mellitus).
type 2 -- characterized by insulin resistance despite adequate insulin
production. A large majority of patients are overweight at
onset,
and a majority are female. Most are over 40, hence the common
(but now deprecated) terms "adult-onset" or
"maturity-onset", but
onset can occur at any age. Patients are not susceptible
to DKA
(diabetic ketoacidosis). There is a strong genetic
tendency, but
not simple inheritance. Depending on the individual, treatment
may be by diet, exercise, weight loss, oral drugs which
stimulate
the release of insulin, or insulin injections -- and usually a
combination of several of these. Also referred to as NIDDM
(non
insulin dependent diabetes mellitus) *even when treated with
insulin* -- a confusing terminology which, unfortunately, is
supported by the ADA.
gestational -- occurs in about 3% of all pregnancies as a result of
insulin antagonists secreted by the placenta. It is
recommended
that all pregnant women receive a screening glucose tolerance
test (GTT) between the 24th and 28th weeks of pregnancy to
detect
gestational diabetes early if it occurs, as diabetes can cause
serious difficulties in pregnancy. Sometimes requires insulin
treatment. Not susceptible to DKA (diabetic ketoacidosis).
Usually disappears after childbirth, but about 40% of patients
develop type 2 diabetes within five years. Most
authorities state
that the typical patient is female ...
malnutrition-related -- severe malnutrition sometimes causes diabetes --
hyperglycemia and all the usual symptoms. The reason is
unknown,
and since this syndrome occurs almost entirely in third world
countries, research on this form of diabetes is nearly nonexistent.
other types -- sometimes called secondary. A catchall for forms not
covered
by the types described above. Causes include loss of the
entire
pancreas (to trauma, cancer, alcohol abuse, or exposure to
chemicals), diseases that destroy the beta cells, certain
hormonal syndromes, drugs that interfere with insulin
secretion
or action, and some rare genetic conditions.
These terms are not used entirely consistently. Some doctors will refer to
any diabetic using insulin as type 1, and will refer to the early onset of
type 1 diabetes as type 2 until insulin therapy is required. This usage does not fit with most modern usage as described above (type 1 is beta cell destruction, type 2 is insulin resistance). The situation is complicated by
the fact that early in the course of the disease it can be difficult to determine which type is occuring, especially for patients in their 30's, the age when the onset of both types is common.
Different patients respond very differently to what is categorized above as
the same disease. The root causes of all forms of diabetes are not
understood, and are likely more complex and varied than the simple
categories
show. Type 1 diabetes likely has a few root causes, and type 2 diabetes probably has a larger number of root causes.
There are also well documented reports of cases of diabetes with unexplained combinations of syndromes from types 1 and 2. These are sometimes
referred to
as "type 1-1/2", and the reasons are not understood.
The classification above is not completely standard, and other
classifications
exist.
About 90% of diabetes patients are type 2 (some 12 million in the US), and about 10% are type 1 (some 1 million in the US). Discussion on m.h.d
tends to
run about 2/3 type 1, I'd guess. This probably reflects the fact that type 1 diabetes is harder to ignore, and that type 2 seldom strikes the younger
people who are more likely to have net access. Type 2 is *not* less serious.
"1" and "2" are often written in Roman numerals: type I, type II. Because typography is often unclear on computer terminals, I've stuck with the
Arabic
numeral version.
Diabetes accounts for about 5% of all health care costs in the US, some
US$90 billion per year.
------------------------------
Subject: Is it OK to discuss diabetes insipidus here? What is it?
Diabetes insipidus (DI) results from abnormalities in the production or
use (two main types) of the hormone arginine vasopressin. The main
symptoms are excessive thirst and massive urination. The excess urine
flow is devoid of sugar. There are no blood glucose abnormalities, and
in fact there is nothing in common with diabetes mellitus except the
excess urination when untreated.
Diabetes insipidus caused by failure to produce vasopressin. This is
known as neurogenic DI (or central DI, or pituitary DI). It can be
treated with hormone replacement (by nasal spray or other routes). DI
caused by failure to use vasopressin (nephrogenic DI) is more difficult
to treat, but several drugs are available which help.
DI is much less common than diabetes mellitus, though a few people have discussed it on misc.health.diabetes and are reading m.h.d. Such
participation is certainly welcome, but because the number of DI
patients is only 1 or 2 per 10,000 population (25,000-50,000 in the
US), there probably isn't a critical mass for discussion on Usenet.
I'm aware of two organizations which offer support specifically
related to DI.
DIARD publishes a support newsletter, maintains a support network,
distributes information on DI, and promotes education and research
related to DI, and has a web page with information and links:
Diabetes Insipidus and Related Diseases Network
535 Echo Court
Saline, MI 48176-1270
USA
+1 734 944 0078
email: GSMAYES(AT)aol.com
web:
http://members.aol.com/ruudh/dipage1.htm
The DI Foundation publishes a quarterly newsletter, Endless Water,
promotes public awareness and understanding of DI, and provides
informational material to patients, medical practitioners and
researchers:
The Diabetes Insipidus Foundation, Inc.
4533 Ridge Drive
Baltimore, MD 21229
USA
+1 410 247 3953
email: diabetesinsipidus(AT)maxInter.net
web:
http://diabetesinsipidus.maxInter.net
------------------------------
Subject: How about discussing hypoglycemia?
Sure ...
To clarify: the term "hypoglycemia" is used to refer to two distinct conditions. The word just means "low blood glucose". This can occur as
an insulin reaction, the result of too much injected insulin (taken to
treat diabetes) compared to food intake and exercise. But low blood
glucose can also be a chronic condition resulting from abnormalities of
insulin secretion, and this chronic condition is also called
hypoglycemia.
Chronic hypoglycemia may be caused by beta cells which overreact to an
increase in blood glucose (bg) by releasing too much insulin, which
then causes a too-rapid drop in bG. Such a condition, called reactive hypoglycemia, is usually handled by dietary adjustments, in particular
avoiding refined sugars and large meals which stimulate the
overreaction. This often requires an effort in calculating the diet and monitoring bG levels that is equal to what anyone with diabetes needs.
Tumors (insulinomas) can cause a steady overproduction of insulin.
These generally require surgical removal.
There are other causes as well. Mayer Davidson discusses some in his
book _Diabetes Mellitus: Diagnosis and Treatment_. But you'll have to
find the Second Edition, because he dropped this chapter from the Third Edition. I don't believe anyone claims to understand all the causes of hypoglycemia. The US NIDDK has a booklet online which discusses some of
the less common causes:
http://www.niddk.nih.gov/health/diabetes/pubs/hypo/hypo.htm
So chronic hypoglycemia is closely related to diabetes mellitus in
being a disorder of insulin production and use, and requires many of
the same techniques for its treatment. The two are a natural for
discussion in the same newsgroup. Which is good, since there really
isn't anywhere else in Usenet at present to discuss chronic
hypoglycemia. Welcome.
A hypoglycemia mailing list, HYPO-L, is available and sees moderate
traffic. See the section on mailing lists in part 4 of this FAQ for subscription information.
Lars Idema maintains a hypoglycemia FAQ and information on a variety of hypoglycemia resources on the Internet. See his web page at
http://hypoglykemie.nl
------------------------------
Subject: Helping with the diagnosis (DM or hypoglycemia) and waiting
Diagnosis of marginal type 2 diabetes, and even more so of
hypoglycemia, can be an iffy task. Single-point blood glucose
measurements often miss significant readings, especially for
hypoglycemia. While I don't recommend self-diagnosis, you can take some
steps on your own to aid your health care team in your diagnosis and
treatment. These are safe and useful steps. The first is purely
monitoring and not treatment or diagnosis on your part. The others are
good advice for anyone who does not have some other medical condition
to contraindicate the action, and are particularly good for those with
type 2 diabetes.
1) Get a blood glucose meter and start checking your blood glucose
before meals and at bedtime. Keep records. Also note what you ate, any exercise, any unusual stress. If you suspect type 2 diabetes, also try
to check an hour after eating. If you suspect hypoglycemia, check any
time you have suspicious symptoms; you may also want to set up a few
runs where you check every 15-30 minutes for up to five hours after
eating.
Don't try to make any adjustments based on the readings until you review
them with your doctor -- just keep the record and show it to the
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