Category Archives: diabetes

Silent heart attack


What is a silent heart attack. An acute myocardial infarct where the patient feels no pain whatsoever. Diabetics are very prone to this. Particularly poorly controlled diabetics. If the average sugar is consistently above 10 mmol/l then the nerves to the various organs actually stop working. Which means in essence you don’t feel pain like you should.

The problem with not feeling the pain is that you don’t realise what is happening. So generally the patient presents later. Sometimes with confusion (acute), sometimes with electrolyte disturbances or unfortunately death.

Control of sugar is key.

A1c – three month average of the glucose must be performed in diabetics at least every 6 months and attended to if too high.

Controlled sugars prevent heart attacks. Controlled blood pressure prevents them too ๐Ÿ˜‰

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Tit bits and chunks of useful diabetes info


I was privileged to attend the Lilly summit 2018 in Durban this weekend with top notch speakers who literally infused my brain with a lovely soup of new information and better ways to help diabetics.

I posted most of the pearls on my face book feed – Claudine LEe/drleethegp.

There are few things more tantalising to a diabetes nerd that a day full of information soup, its like gourmet food for the brain and has the capacity to transform patients lives.

Thanks so Lilly for a lovely and well organised event. So wonderful too, to have Kenyan and Namibian continent there too.

 

Sticky mess 2


So when the sugar goes above 10 mmol/l (different values and way of measuring in the US and UK), the blood vessels : arteries and veins in the : eyes, heart, kidneys and feet and also EVERYWHERE (yes that includes the reproductive organs) SHUT – the sticky mess shuts them and so the cells can not get oxygen and they “starve” and can die.

That is when you have episodes like : stroke, heart attack or a black foot requiring amputation.

Or when you go blind, need dialysis or need to have a heart bypass/stent.

So what is the answer ? More meds, better meds ?? Maybe BUT mostly, more exercise, better eating habits, more exercise etc, consulting the team you know about re your diabetes : dietician, podiatrist, biokineticist, doctor, etc at least once a year.

If you keep the sticky mess away, did you know you live longer and better quality of life than your non-diabetic counterpart?

Diabetes college …


Should we open up a college to teach folk about diabetes. The diabetes man. Yeah.

A touch of sugar, my doctor says I have a little bit of sugar.

So much of confusion out there. Yes diabetes is here in a big way. Yes it’s logarithmically growing. Yes is perfectly preventable (type2). Yes there are massively big differences between being insulin dependant (type 1) and insulin deficient (varying degrees) type 2.

So yes maybe we need diabetes night school or even day school to tutor folk.

Yes you can not stuff endless amounts of carbs in your mouth. Yes that includes beer. It’s a carb. Yes it is.

Whiskey and water is better but in the quantity of one drink.

Yes fruit is full of carbs – sugar. Yes it is. No it is not great for diabetics. Does that mean you can’t eat fruit at all? No but the quantity and the type count.

Can a dietician help you ? Yes very much so.

Will exercise help ? Indeed, at least one hour though and a few times a week.

Do you have to run ? No, walking is actually better exercise.

Bottom line when your sugar goes above 10 in the blood stream things stick together. A Sticky mess.

Diabetes is not a myth -so why do we pretend it is???


So funny to me how there is still a lack of acknowledgment as well as a bit of head in the sand when it comes to this massive diabetes epidemic. WE seem to think we are all fairies in a fairy tale and bad things will never happen to us despite our bad behaviour.

We are currently in a pickle. A sticky soup mess of diabetes by the gazillions and yet you see no REAL action. Why?

Confusing really.

Especially problematic to have this many children “suffering” mostly silently from undiagnosed disease.

So much knowledge available and yet so little interest even.

Until the day it hits you or your family. In terms of type 2 especially in children there is so much we can do as well as reverse this if found early. So why are we not going out and actively diagnosing it?

Unfortunately in type 1 in children through no fault of their own, their bodies have attacked their pancreas and essentially killed the pancreas. And without insulin they would die.

More awareness, less scaremongering, less head in the sand, more action. More at least attempt to slow the log curve of growth. Why don’t we at least try to slow the log.

type2 chilrdrentype2kids.jpg

New insulins


Is it not a joy and a delight to be able to know that these days we can prescribe an insulin that is far more predictable and sticks to the rules than ever before.

If you are not a type 1 diabetic or parent of one you will never understand how easy it is to either over or under dose on this medication. Add to the fact that sometimes 10 u behaves a certain way and other days it behaves in another way.

So to have both Toujeo and Tresiba – true long acting analogues with SMOOTH delivery available in SA at a price that is competitive fills my whole being with delight. I can prescribe knowing that what I am hoping the insulin to do will ACTUALLY happen ๐Ÿ™‚

By the way this lovely awesome cellist is also a type1 – no-one can deny his talent and poise. Just saying ! Type 1’s ROCK!!!!

Gut microbiom and diabetes – of cats, kefir and insulin :)


I have a patient who is a type 1 diabetic and that patient has a cat who is also type 1. Needless to say they are both on insulin. Now if you thought that is it hard to dose a human try dosing a cat or a dog with insulin. It’s so hard and the margin for error is SO big.

These 2 patients have cut their insulin dose by half and halved their hypos by having kefir three times a day.

Then I came across an article in the Journal of Diabetes (South africa) about the gut bugs and diabetes. It mentions how important gut bugs are in terms of metabolic functioning – normal functioning as well as disease. It concludes by saying that “gut microbiota represents an exciting field with novel therapeutic potential”.

I say you have nothing to lose. Give it a try.kefir.jpg