Ideas That Work

I love my Diabetes Forecast magazine. It’s so comforting to find other people with the same questions or problems that I have. It’s my support group.

The Feb. ’08 editorial “Time to Downsize” confirmed to me that I’ve been doing things right. My husband used to be embarrassed when I asked for a take-out box at restaurants. Not now! It didn’t take me long to figure out that portion size was just as important as what I ate. Smaller portions work.

Another editorial in the same issue, “One Small Step,” describes another practice I use. Rather than feeling guilty because I know I should exercise, I just do those small things like parking farther away or taking the stairs. I went on to read the Research Short “Longer Living Through Therapy,” and learned that depression is bad for my blood sugar readings. I put all this information to use, and I am somewhat in control.

Sanna Obermiller
Ruidoso, NM

Also Missing Exubera

I am in total agreement with Marianne Evans (Mail Call, Mar. ’08, p. 13) regarding Exubera. What a miracle it was!

Exubera gave me back my smile; I actually enjoyed mealtimes again. Not only was the ease great, but the control was a miracle. When it was discontinued, I felt heartsick at the thought of having to go back to needles four times a day.

I pray that another company will step in with the inhalant or some other non-invasive insulin. The loss of Exubera is a step backwards in the progress of controlling diabetes.

Robin Eason
Finksburg, MD

Struggling With CGM

I must admit that I felt some relief reading about Denise Payne’s experience with her continuous glucose monitor (Mail Call, Apr. ’08, p. 15). I felt completely unequipped to handle something that appeared so simple, and Denise’s letter made me feel like I was not alone.

My local representative warned me that correct calibration was critical to the success and accuracy of the monitor. Like Denise, I found that opportunities to calibrate seemed few and far between. And, as she pointed out, 90 percent of the time that I am wearing a sensor I have disrupted sleep.

I still do finger sticks as often, if not more often, than I did before starting on the monitor. Looking at the big picture, though, my A1C has dropped from 7.1 to 6.2, so I will continue to persevere with my sensor and hope to get the kinks worked out.

Kathy Griffin
Coatesville, PA

More on Vitamin D

In “D for Diabetes Prevention” on p. 24 of the Apr. ’08 issue, Bridget Murray Law writes about vitamin D as it relates to type 2 diabetes.

There is also a Finnish study that indicated that vitamin D supplementation might reduce the risk of type 1 diabetes (published in The Lancet in 2001). The study basically indicates that giving vitamin D supplements to infants reduces the risk of the child developing type 1 diabetes.

Today, everyone accepts the value and the need to provide pregnant women with folic acid to prevent the chances of birth defects. Perhaps adequate vitamin D supplementation should be seen in the same light.

Pete Campbell
San Jose, Calif.

Additional Info Needed

In the Apr. ’08 issue, p. 55, you used a term that was unfamiliar to me, “hypoglycemia unawareness.” I need to know more. My wife has had several instances of hypoglycemia.

Hugh Davis
Umatilla, FL

Christy Parkin, MSN, RD, CDE, responds: Treatment of hypoglycemia is usually fairly simple as long as you have your wits about you. It’s hard to ignore the symptoms: You may feel shaky, sweaty, nervous, irritable, and hungry, and your heart may start racing. Your natural response is to grab something to eat or drink to alleviate the symptoms. But what happens if you don’t feel the warning symptoms of low blood sugar? A serious hypoglycemic reaction can occur, resulting in loss of consciousness or coma if the hypoglycemia is not reversed.

A person with hypoglycemia unawareness is unable to feel those warning signs and unable to deal with the low blood sugar, which means they need assistance to manage the situation. This can be particularly dangerous when driving, operating machinery, or living alone. It is much more common in people with type 1 diabetes.

If you have hypoglycemia unawareness it is important that you test your blood glucose frequently, especially before driving or other activities that could be dangerous if you lose consciousness. It’s also important that you always carry a source of glucose with you so that you can treat hypoglycemia quickly. Make sure family members and coworkers know how to give you a glucagon injection in case you become unresponsive. And always wear medical identification indicating that you have diabetes.

The most important thing to do is to prevent hypoglycemic episodes. This means managing your diabetes as carefully as possible and testing your blood glucose more frequently.

Talk to your doctor if you are prone to severe hypoglycemia. He or she may want to adjust or change your medications or modify your glucose targets. Your doctor may recommend that you try wearing a continuous glucose monitor to alert you if your blood sugars are dropping low.

Hypoglycemia unawareness is a serious condition. The good news is that there is strong evidence to show that avoiding low blood glucose and getting your glucose levels under good control can help you regain your ability to detect the warning signs of hypoglycemia.