Comments on: The “Bang for Your Buck” Principle in Diabetes Management http://www.diabetesmine.com/2009/08/the-%e2%80%9cbang-for-your-buck%e2%80%9d-principle-in-diabetes-management.html A gold mine of straight talk and encouragement for people living with diabetes Mon, 13 Feb 2012 01:28:10 +0000 hourly 1 http://wordpress.org/?v= By: Teaching Diabetes Prevention-What is it? | Common Diseases | Your Personal Health Care Blog http://www.diabetesmine.com/2009/08/the-%e2%80%9cbang-for-your-buck%e2%80%9d-principle-in-diabetes-management.html/comment-page-1#comment-401763 Teaching Diabetes Prevention-What is it? | Common Diseases | Your Personal Health Care Blog Fri, 16 Oct 2009 18:18:30 +0000 http://www.diabetesmine.com/?p=8613#comment-401763 [...] The “Bang for Your Buck” Principle in Diabetes Management (diabetesmine.com) [...] [...] The “Bang for Your Buck” Principle in Diabetes Management (diabetesmine.com) [...]

]]> By: Worst Diabetic | Wellness Health,Beauty and Dental wellness http://www.diabetesmine.com/2009/08/the-%e2%80%9cbang-for-your-buck%e2%80%9d-principle-in-diabetes-management.html/comment-page-1#comment-377308 Worst Diabetic | Wellness Health,Beauty and Dental wellness Fri, 11 Sep 2009 08:12:48 +0000 http://www.diabetesmine.com/?p=8613#comment-377308 [...] The “Bang for Your Buck” Principle in Diabetes Management (diabetesmine.com) [...] [...] The “Bang for Your Buck” Principle in Diabetes Management (diabetesmine.com) [...]

]]> By: Kelly Rawlings http://www.diabetesmine.com/2009/08/the-%e2%80%9cbang-for-your-buck%e2%80%9d-principle-in-diabetes-management.html/comment-page-1#comment-366442 Kelly Rawlings Fri, 21 Aug 2009 18:12:21 +0000 http://www.diabetesmine.com/?p=8613#comment-366442 Hans, one of the reasons that there's much more to diabetes management than just blood glucose control is that blood pressure and cholesterol management are also very, very important for avoiding complications (as Dr. Polonsky mentions in his first point). It's estimated, for example, that nearly 75% of people living with diabetes also have high blood pressure. And high blood glucose plus high blood pressure work in tandem to increase risk of both micro and macrovascular complications. Although a young person with type 1 may have perfectly good blood pressure and blood cholesterol numbers during the first years of his or her life with diabetes, we're all prone to blood pressure and cholesterol issues as we age. Those problems are, of course, compounded by overweight and inactivity. Plus, even without having high blood pressure, the blood pressure drugs ARBs and ACE inhibitors actually provide some kidney protection (which is why I'm on one of them after living for 36 years with type 1--no protein in the urine, but I want to keep it that way). It's very cool if you are able to live like a person without D and keep the daily bg curve in the non-D range--but how exactly do you manage that without any blood glucose testing, regular activity, and attention to what you eat?!!! Do share. Hans, one of the reasons that there’s much more to diabetes management than just blood glucose control is that blood pressure and cholesterol management are also very, very important for avoiding complications (as Dr. Polonsky mentions in his first point). It’s estimated, for example, that nearly 75% of people living with diabetes also have high blood pressure. And high blood glucose plus high blood pressure work in tandem to increase risk of both micro and macrovascular complications.

Although a young person with type 1 may have perfectly good blood pressure and blood cholesterol numbers during the first years of his or her life with diabetes, we’re all prone to blood pressure and cholesterol issues as we age. Those problems are, of course, compounded by overweight and inactivity. Plus, even without having high blood pressure, the blood pressure drugs ARBs and ACE inhibitors actually provide some kidney protection (which is why I’m on one of them after living for 36 years with type 1–no protein in the urine, but I want to keep it that way).

It’s very cool if you are able to live like a person without D and keep the daily bg curve in the non-D range–but how exactly do you manage that without any blood glucose testing, regular activity, and attention to what you eat?!!! Do share.

]]> By: Olga http://www.diabetesmine.com/2009/08/the-%e2%80%9cbang-for-your-buck%e2%80%9d-principle-in-diabetes-management.html/comment-page-1#comment-366198 Olga Fri, 21 Aug 2009 04:52:41 +0000 http://www.diabetesmine.com/?p=8613#comment-366198 susan f. -- cool hint! you're right, that's half a day right there. thanks for the perspective tweak! susan f. — cool hint! you’re right, that’s half a day right there. thanks for the perspective tweak!

]]> By: susan f. http://www.diabetesmine.com/2009/08/the-%e2%80%9cbang-for-your-buck%e2%80%9d-principle-in-diabetes-management.html/comment-page-1#comment-365408 susan f. Wed, 19 Aug 2009 18:29:32 +0000 http://www.diabetesmine.com/?p=8613#comment-365408 Honestly these recommendations are too general and will do little to improve the a1c of a patient. My advice to those who struggle is to focus on perfect numbers overnight. Yes, it is hard with carb counting and schedule during the day to keep perfect numbers, BUT... Just imagine that everyday from 9pm to 9am you have perfect numbers, your a1c will improve dramatically. How do you do this? Mainly by tinkering with your basal rates until you have nailed them. In addition, cut out a bedtime snack to avoid a bad carb count guess and/or delayed rise in bg. Test 2.5 hours after dinner, correct if needed, and then enjoy your stable night. Yes it may take some sleepness nights to nail the overnight basals, but it is so worth it in the long run. Honestly these recommendations are too general and will do little to improve the a1c of a patient. My advice to those who struggle is to focus on perfect numbers overnight. Yes, it is hard with carb counting and schedule during the day to keep perfect numbers, BUT…

Just imagine that everyday from 9pm to 9am you have perfect numbers, your a1c will improve dramatically. How do you do this? Mainly by tinkering with your basal rates until you have nailed them. In addition, cut out a bedtime snack to avoid a bad carb count guess and/or delayed rise in bg. Test 2.5 hours after dinner, correct if needed, and then enjoy your stable night.

Yes it may take some sleepness nights to nail the overnight basals, but it is so worth it in the long run.

]]> By: Carb O'Phile http://www.diabetesmine.com/2009/08/the-%e2%80%9cbang-for-your-buck%e2%80%9d-principle-in-diabetes-management.html/comment-page-1#comment-364982 Carb O'Phile Tue, 18 Aug 2009 20:29:35 +0000 http://www.diabetesmine.com/?p=8613#comment-364982 It is so refreshing to heat someone voice opinion that matches my own. I would argue that, with limited face time, no-one knows me better than, well, err, me, and that the prioritisation needs to be a consensus of opinion 'twixt physician and patient; ultimately both have the same outcome in mind - what's best for the patient. It is so refreshing to heat someone voice opinion that matches my own.

I would argue that, with limited face time, no-one knows me better than, well, err, me, and that the prioritisation needs to be a consensus of opinion ‘twixt physician and patient; ultimately both have the same outcome in mind – what’s best for the patient.

]]> By: Marcia http://www.diabetesmine.com/2009/08/the-%e2%80%9cbang-for-your-buck%e2%80%9d-principle-in-diabetes-management.html/comment-page-1#comment-364801 Marcia Tue, 18 Aug 2009 12:05:41 +0000 http://www.diabetesmine.com/?p=8613#comment-364801 I think because of the increasing rates of obesity, the media is much more focused on Type II diabetes nowadays, with less of an emphasis on Type I. I think because of the increasing rates of obesity, the media is much more focused on Type II diabetes nowadays, with less of an emphasis on Type I.

]]> By: Lauren K http://www.diabetesmine.com/2009/08/the-%e2%80%9cbang-for-your-buck%e2%80%9d-principle-in-diabetes-management.html/comment-page-1#comment-364541 Lauren K Tue, 18 Aug 2009 00:35:27 +0000 http://www.diabetesmine.com/?p=8613#comment-364541 Hans - my thoughts exactly! That is the realistic way to manage type 1. I generally ignore and avoid CDEs because they do not understand the on-the-ground daily realities of living with this problem. Diabetics are not robots, we're people leading complex lives. I check my glucose 10-15x a day and have super-tight management, but diabetes is far from the center of my life. I keep it in the back of my mind, and check, eat, and exercise responsibly, but I do not tailor my life to my diabetes. That is unsustainable and foolish. The bottom line for me is to manage my disease so I can live like any other person, and have blood sugar levels like a person without diabetes for the majority of the time (A1c under 6). And so far so good. Thank God I didn't listen to the CDEs who've crossed my path, toting their misguided "one size fits all" information kits and working within their very limited understanding of type 1 diabetes. Hans – my thoughts exactly! That is the realistic way to manage type 1. I generally ignore and avoid CDEs because they do not understand the on-the-ground daily realities of living with this problem. Diabetics are not robots, we’re people leading complex lives. I check my glucose 10-15x a day and have super-tight management, but diabetes is far from the center of my life. I keep it in the back of my mind, and check, eat, and exercise responsibly, but I do not tailor my life to my diabetes. That is unsustainable and foolish.

The bottom line for me is to manage my disease so I can live like any other person, and have blood sugar levels like a person without diabetes for the majority of the time (A1c under 6). And so far so good. Thank God I didn’t listen to the CDEs who’ve crossed my path, toting their misguided “one size fits all” information kits and working within their very limited understanding of type 1 diabetes.

]]> By: Hans http://www.diabetesmine.com/2009/08/the-%e2%80%9cbang-for-your-buck%e2%80%9d-principle-in-diabetes-management.html/comment-page-1#comment-364350 Hans Mon, 17 Aug 2009 14:52:59 +0000 http://www.diabetesmine.com/?p=8613#comment-364350 Nicely written but far too complicated for my liking. Why not just go on living like people without D and just keep the daily bg curve mostly within the non-D range? Nicely written but far too complicated for my liking. Why not just go on living like people without D and just keep the daily bg curve mostly within the non-D range?

]]>