Losing my confidence

[Grazer]

I can't believe some of the stuff I've read on here. Man up people! Let me give you my take on this with a few facts:
Diabetes is the biggest single cause of lower limb amputations in the western world
It's a major cause of kidney failure
It's a major cause of ocular problems including blindness
It's a major cause of vasco cardular disease
HOWEVER:
Diabetes is totally harmless and does none of this in itself.
It's high sugar levels that cause this devastation.
Manage them and everything will be fine.
I won't suffer any complications
I will live longer than the average male, because my sugar levels are fine and, in getting them there, I've become fitter than the average male
I will live longer and healthier than if I wasn't diabetic, because I look after myself now and didn't before.
Live long and prosper

 

[WhitbyJet]

+1 Grazer
Excellent post, thanks

 

[Unbeliever]

Unforunately. it is not alogether true to state that keeping blood sugar low guarantees no complications .

Sometimes they occur even wih good control and sometimes stability is at least as important as I and others know, ,however.
I totally agree with Viv about the statisticcs.however. So many things have changed regarding diagnosis and treatment that we cannot possibly be comparing like with like. The huge panoply of diabetic nurses and specialiss etc that we have nowadays don't seem to cope all that well nowadays when there is such a focus on the subject. How must it have been in the past?

Now at least some preventative medication is offered for some of the risks although that brings its own problems sometimes. In the past it may have been the case that diabetics were more likely to die of certain diseases. Now ,arguably, they may even become less likely to die from these causes than the general population.

The worst thing about diabetes for me is the fact that I am at the mercy of HCPs who don't know or care very much about the condition but who are obliged to interfere with my life in order to tick their boxes.
Very often they make matters worse and make it difficul for you to achieve and maintain control
I believe hat wih T2 things are slowly changing as people show that they wan o take charge of their own healh and can dmonstrate good results .when allowed to do so.

 

[AMBrennan]

Re studies: big study (83-93, analysed for CVD risk in 2005, details here http://diabetes.niddk.nih.gov/dm/pubs/c ... iovascular)
Finding was that diabetic have 10x CVD risk, with tight control reducing 42%.
Simply put, that means that if 10 out of N otherwise healthy people develop CVD, one would expect 100 out of N diabetics to develop CVD (given no information about control). Further, one would expect 58 out of N well controlled diabetics to develop CVD i.e. risk is still 6x baseline risk for well controlled diabetics (HbA1C < 6%).
Of course tight control was only followed for the duration of the study* and not for the 10 years between the study and the follow-up, so the reduction might be greater if one followed tight control permanently.

You can talk about improved treatment, tests, meters, etc, all day but at the end of the day we still only achieve a HbA1C < 6% (although I think that I've read that only 20% of patients actually meet the target of < 7.5%) - which is no better than the tight control in the above study (well, it might be, considering that newer analogues cause fewer hypos; I would conjecture that a patient today would have shorter and less severe periods of high blood sugar compared to a patient with the same HbA1C 20 years ago)

* Which I don't understand - you've achieved good control, you have evidence that this will reduce your risk of going blind, etc, and you stop?

I won't suffer any complications

I really can't tell if you are serious or not.

I will live longer than the average male, because my sugar levels are fine

Despite your sugar levels being higher than the average male's?

I agree that diabetes provides one with a strong incentive to be healthy though (Do I really want to write down X units insulin for a Mars bar in my log that I'll have to show to my consultant?)

 

[Grazer]

You live in your sad (and flawed) statistical world ambrennan and I'll live in mine.

 

[Gappy]

I'm with Grazer on this, lets look positive this is a support forum after all! Ok ok I know some will say look at facts and be realistic but figures can be manipulated either way, I know that if I look for the positive and aim that way I'll be a lot happier and healthier in the long term

 

[AMBrennan]

I'll take that as a compliment (being a mathematician). And I'm sorry for not seeing the point of pretending that all is well when it clearly isn't.
I'll do whatever I can today and deal with the problems if and when they arise, but I am under no delusion that I'm invincible.

 

[Grazer]

And I'm sorry for not seeing the point of pretending that all is well

Perhaps you will see the point of this whole thread if you read it. A newly-diagnosed and depressed diabetic posted us looking for support and re-assurance, not for mr doom monger telling us we're all going to die. And don't take being a mathematician as a compliment. Having had 320 actuaries and 350 other mathematicians working for me on one project for 3 years, I can tell you that the only difference between a mathematician and an accountant is that accountants are a little less boring.

 

[viviennem]

AMBrennan posted:

Finding was that diabetic have 10x CVD risk, with tight control reducing 42%.
Simply put, that means that if 10 out of N otherwise healthy people develop CVD, one would expect 100 out of N diabetics to develop CVD (given no information about control). Further, one would expect 58 out of N well controlled diabetics to develop CVD i.e. risk is still 6x baseline risk for well controlled diabetics (HbA1C < 6%).

I've already admitted that I'm no mathematician and that statistics baffle me, so please bear with the ignorant, AMBrennan! I even failed O-level maths - though that doesn't mean I'm completely innumerate. Maths is a language I don't speak, but I function much better than many in the world of everyday maths - mostly arithmetic, but I have enough geometry for surveying etc.

In terms of what I want to know, your statement above is meaningless to me :? . Without the value of N, how can I apply it to my own circumstances? N could = 10, or 10 to the power 10. Please tell me what it means.

I note you're Type 1, while Grazer and I are both Type 2. We can keep tighter control of our blood glucose than you can, because we don't have the danger of hypos. I'd be horrified with an HbA1c of 6.5 - that's what I was diagnosed with, and I've worked hard to get it down. My last one was 5.2, and that's where I aim to keep it.

And that's the reason that I don't intend to let any so-called increased risk to apply to me - at least, not via diabetes. I might be wrong - but I'm certainly not going forward with a negative attitude!

Viv 8)

 

[didie]

I hate statistics - especially ones with regard to health. I can remember reading many years ago that Japanese people have the lowest rate of colon cancer in the world. What that report failed to mention was that there was another report which said that Japanese people have the highest rate of stomach cancer in the world. After that I decided that statistics could be twisted and turned to suit any point of view.

I think that most people who find their way to this forum have already looked on the internet for diabetic complications and may well have freaked themselves out totally. They might have been given the diagnosis on the phone and then left to stew for a week or two until they have an appointment with the Diabetic Nurse and so they go hunting. I certainly did. I wasn't particularly freaked out because being a medical secretary I was already quite familiar with some of the complications, and as I said in my post before in the thread, being diagnosed as a diabetic after a stroke was a relief as I could do something about it.

Anyway in my humble opinion, what newcomers to here need is help and advice from which they can glean what they need and make informed decisions about their own management of their condition. Some people are really shell-shocked and they really don't need to have the dreaded complications set down in stark details. That could be enough to make someone who is really down just give up as they feel they have a huge mountain to climb and it is just not worth it. What is important is that people start to get their blood sugars under control asap - every tiny bit that blood sugar levels drop is good and is reducing the risk of complications later. Little steps can then lead to bigger steps and successful control. Once people start to bring their levels down, change their eating habits and maybe exercise more, they start to see an improvement and this is an incentive to keep going - rather than scaring with with dark statistics.

I want to hear about people like theblokefromstoke completing a half marathon and planning his next races. That is seriously inspiring!

Anyway that's the way I see things

 

[Otenba]

It is very difficult to see the benefits of near enough obsessing over the negative when it comes to diabetes. It can be very self-destructive. Sure, it's a prompt to make you motivated to look after yourself, but then there's looking after yourself and then there's living like a robot.

Life is still for living, you've just got to be brave enough to go for it. A life lived in fear is a life half lived after all!

I spent a lot of my young life being too afraid to try new things and live my life because of the basic fear of what it would mean for my sugar levels. This was all caused by a simple lack of understanding - how happy I was when I took the DAFNE course. It knocked down so many self-build walls for me. I sing it's praises even if it annoys others.

It has been quite apparent to me over my years of being a Type 1 that people get very filled with pride when it comes to how they look after themselves - I myself included. There is still a lot of guesswork out there so it is very easy to get a situation where "this works for me, therefore it'll work for everyone else"; and in turn get very passionate about it when that idea is challenged. I've also noticed that a lot of Type 1s see the world in black and white.

This can also be helped or hindered by things such as the internet considering the vast amount of ignorance and no regulation on what information can be found.

You're not a robot, you are a person living with diabetes. You won't always get it right all the time, but that is life for you! It is too unpredictable! Don't beat yourself up about it if you have an bad result or a bad day - as long as bad days are not every day over a long period of time, you have nothing to fear when it comes to your diabetes. Just live your life the best you can!

Statistics don't mean anything to your control - they don't provide the help or assistance you need, just another thing to wind you up (and some aren't even true anyway - just chinese whispers!).

 

[Patch]

Great post, Otenba.

I'm the type that reads absolutely EVERYTHING diabetes related - this can be a good or bad thing, depending on my mood. (And I am quite a moody guy - of course, I blame the diabetes for that!)

Confidence/mood/depression/anxiety - they're all closely related to diabetes. Unfortunately.

 

[Unbeliever]

The OP had already frightened himself before posting. Of course it is great to see people getting on with things inspite of and sometimes even because of their diabetes.
I have always believed that there are worse hings and also that eachl of us has a predisposition to various unpleasant conditions and all we can do is ry to live as well as we can . Physical and mental healh are equally important . I see no point in dwelling on the worst aspects of diabetes.
Personally .although I think that those who run marathons etc are wonderful I find it just a touch patronising to pretend that all you have to do to avoid complications is to keep your levels low.
I find that exercise is absolutely essential o good control but I find DUK's {for example} attitudevery irriating.
Realistically how many of us actually want to run the Three Peaks ,climb Mt Everest etc etc.?

I am sure people do find all this inspiring but I know I couldn't {and wouldn't have wanted }to do any of these things before diagnosis so don't find it inspiring at all.

I don't think it is right to try to tell people that it is as simple as keeping your BS low. This is certainly the best , indeed the only thing we can do , but sometimes they do happen regardless. All we can do is to reduce the risk.
Certainly we should support and encourage newly diagnosed- we have all been there -but I think it is possible to go overboard in this direction. The poster is not a child and is obviously aware that complications exist. But here is no need to panic as we all know.

As others have said , just concentrate on learning how to control your own condition and forget the rest.
That is what we have to do in life in general..

 

[Grazer]

don't think it is right to try to tell people that it is as simple as keeping your BS low. This is certainly the best , indeed the only thing we can do

I know where you're coming from, but as you correctly point out, it is the best and only thing we can do. So what else are we supposed to tell them to do? And who said it was simple? I don't think it's patronising at all. I think the message is to do all the things you need to do to get your BGs as good as you can and stop worrying about the "what ifs"

 

[borofergie]

I don't think it is right to try to tell people that it is as simple as keeping your BS low. This is certainly the best , indeed the only thing we can do , but sometimes they do happen regardless. All we can do is to reduce the risk.

Whyever not? You are speculating that complications happen if you keep your BG low, there is almost no credible data to suggest that this is the case.

As I've said elsewhere, I prefer to reduce the risk of DIABETIC complications (by controlling my BG). I can live with the risk of SPECULATIVE complications.

As Malc says, you can only do what you can do. If you try your best and you still get nobbled by some complications, at least you won't have any regrets (apart from the odd missed hob-nob or two).

 

[Grazer]

Missed hob nobs? No one said anything about that did they?!

 

[Unbeliever]

I am not the only diabetic to have suffered complications from he drugs I have been given to control the condition.

I was diagnosed accidentally and was never given the opportunity to try to conrol the condition by die and eercise alone as I was and had always been very slim. I had quite a strong genetic link to he condition and although I suspected I had T" for en years before diagnosis all ests were negaive , After diagnosis I was told hat I had probably had it all my adult life and had been comnrolling it well by my die and lifestle.
I had no complicaions when diagnosed byut developed one which will probably blind me after a short course of rosiglitazone. eighteen months later. At least I insisted upon coming off it before I developed heart failure too.
This effect appears o be welll known to opthalmologists.

What happened to me is well documened . Of course it is better to avoid drugs if you can. I have worked very hard to reduce my medication and have been quite successful.

the initial treatment after diagnosis of this problem exacerbated it too. This is not speculative or

anecdotal. In fact it is quite common o read that good conrol will "reduce the risk of complicationns" nothing can rule hem out completely because the condition is not fully understood.

I am sure others have suffered other complications throuhg medicaion and incorrect treatment. That is why we have to be constantly vigilant.

I know what has happened to me. I know the medical profession accept that this can happen. Some newly qualified doctors have great diffficulties accepting that my control is so good but the condition is not improving or responding o reatment. All the research I have done on he subject however , recognisess
that some people develop this scomplication despite good control and that there is a group of people for whom he existing treatmen does no work. Unfortunately I am one of this group,

I have no idea how many people come into any of these categories but they do eist.

It would be good to t. hink that there is a formula o enable us to eascape complicaions or to reverse them in every case I am convinced hat the bad advice i was given initially and the effecs of some other medicaions conributed o my problems but it takes time to learn to cope and o understand the condiion sometimes paricularly when he diagnosis is sudden and dramatic .
I don't want o burst anyone's bubble or to depress hem but it is as galling to be told that my complications are my fault as it is to be old hat I can't be T2 because I am not overweight.