My Photo
Name:
Location: Minneapolis, Minnesota, United States

Diagnosed with Type 1 diabetes in April of 1980. I recognize the incredible mental struggle of living with diabetes. I hope to share my struggles, my successes, and everything in between.

Monday, August 20, 2007

The One That Scares Me the Most

I think that most of the people reading this are pretty familiar with the possible complications of diabetes.

I’m not going to dwell on the details of them. There’s just no good to be had there.

What I do want to write about is the one that scares me most, and gather some information from the all-knowing OC.

Most (all?) of the possible complications we might face are silent. No outward signs or symptoms. Many of them can be tested for though – with annual dilated eye exams or routine lab test or filiment test/tuning fork tests.

But what about our heart?

That is the one that scares me the most. The silent heart attacks that cause damage, you may not even know are happening. Then one day, the big one, and Boom – it’s all over.

Are there tests that can be done to see if your heart is Ok? Should I be asking my endo to refer me to a cardiologist? Can a cardiologist do anything to figure out where I am with things?

I think that a lot of my concern stems from the fact that I know my diet has not been “heart healthy” for most of my life. Have I done damage to my heart above and beyond what diabetes does? Do I worry about each and every “twinge” I think comes from near my heart?

Have any of you out there dealt with heart “things”? What have your experiences been? Is it too early (32 years old) to worry about these things? If so, when? How? What should I be doing, or thinking about?

16 Comments:

Blogger Jenny said...

Scott,

Most of what has been promoted all these years as "heart healthy" turned out NOT to be. The low fat diet is not, for example, and in fact it raises cardiac risk factors like LDL and triglycerides. Low carb turned out to be heart healthier for people with diabetes in several studies. Fruits are great unless they raise your blood sugar. Fructose causes the liver to store a lots of fat. Veggies still work, but of course half of them are full of pesticides and lord knows what else from the 3rd world.

It's a jungle out there!

So should you freak out? No. Eat a diet that keeps your blood sugar as close to normal as possible. There's a straight line relationship between A1c and heart risk starting at 4.7%, but if you can make the 5% range, it really should help.

Exercise sanely. A brisk walk daily is less likely to cause strain and injuries and is very good for your heart. Beating yourself up in the gym may actually end up damaging your body to where you can't exercise in your 50s. I learned THAT the hard way!

Cholesterol levels don't predict heart attack. 1/2 of those who have them have normal cholesterol. Blood sugar levels do, though, so study up on how to improve control. Get a hold of a CGMS if you can and learn what causes your peaks.

And finally, and I know this sounds a bit ghoulish, but it isn't, there are MUCH worse ways to go than a heart attack. I've watched a few people I love go the other ways and I pray I do get the swift heart attack when it is my time to go. Beats 8 years of dementia or 3 spent wasting away with a horrible, incurable extremely painful cancer.

And live each day when you are alive knowing that any one of us could die if we just drove over the wrong bridge. Diabetes makes us feel more vulnerable, because we KNOW our bodies are imperfect, but no one gets out of here alive!

7:10 PM  
Blogger George said...

This is not my biggest fear (amputations) but I have in a weird way accepted that it may be my fate.

My father died of a heart attack at age 43. His father had one and died when he was about the same age.

I watch my cholesterol and always mention my history to my doctor whenever my Cholesterol numbers are even remotely elevated.

I agree with Jenny that freaking out is prolly not a good route to take BUT I am a believer of paying a co-payment now and then just to sleep a little better.

Just my two cents brudda.

7:46 PM  
Anonymous Maniacally Monday said...

you can have stress tests done and there are tests that cardiologists can run to see if your heart is working as well as it ought to be. (Do I know what they are, no, but you can get them done, especially if you can convince your doctor that you want to get exercise but are worried because of your heart.)

8:25 PM  
Blogger Zazzy said...

Blindness is my biggest fear. Heart stuff is scary though, scary for everyone I've known no matter how "minor" the issue.

I've had an arrythmia for 20-odd years and was diagnosed with additional heart problems in '98 which have since mysteriously disappeared. When I first started having issues, every little twinge, every funny feeling, every little tightness - all sent me into panic. There are a lot of other reasons besides heart for those little twinges though - esophogeal spasms are my personal favorite.

I think you should talk to your endo about your concerns. Do you have a family history of heart disease? Are you having symptoms of concern? I don't see why you couldn't have some testing done as a preventative measure - but stressing yourself out about it probably won't be helpful.

11:14 PM  
Blogger Scott said...

Truthfully, the "complication" that bothers me most is actually a complication of treatment, notably hypoglycemia. Of course, I have good reason, as I have not had any hypo symptoms for over 15 years and rely on heavy testing and knowing the peak of activity associated with insulin. The reality is that we're all going to die ... someday (sorry to sound negative) ... and I am less troubled by cardiac risk than I am killing someone else by driving south on the northbound lane on the interstate. The typical response, however, has been that it must be due to patient error, not the non physiological manner in which we are attempting to replace the hormone. This is an issue that plagues virtually all hormone replacement therapies.

Incidentally, isn't it curious that about 4 years ago, there was a huge uproar about estrogen replacement in post-menopausal women being a cardiac risk, yet the same question was never asked about another hormone replacement: insulin. I suppose we're supposed to be thankful, but cannot help but wonder why diabetes complications are always due to patient error, yet when we replace other hormones, the medical profession questions whether its the manner they are being replaced.

6:09 AM  
Blogger Jenny said...

Scott,

There actually has been quite a bit of research into the question of the effect of insulin supplementation on heart disease (and other health issues.)

I don't have the references, right now, but I have read up on this, and the findings did NOT suggest that insulin supplementation caused problems.

Now one thing that HASN'T been researched is the effect of the ANALOGS which are only 8 years old and MAY, alas, cause problems since they aren't identical to homemade insulin. Since the molecule is different, there could be problems with disposing its breakdown products.

This is one reason I prefer R, since it is the human molecule. But I use Novolog some, too.

Remember too, that a Type 1 uses a tiny fraction of the insulin a Type 2 normally produces. It is possible that a person using 300 units of insulin a day (injected OR homemade) is going to promote growth in things you don't want growing. But the typical Type 1 is exposed to less insulin than most middle aged, insulin resistant folks, and remember, MOST people become insulin resistant in middle age.

7:31 AM  
Blogger Khurt Williams said...

My biggest worry was eye sight. Shortly after I was diagnosed I noticed that I no longer needed to wear my galsses to drive or to watch TV. The effect wore off ( darn it! ) and while I enjoyed being able to see cleart for the first time in my life I suddenly realised that diabetes was having a real affect on my body.

As Jenny said, "Eat a diet that keeps your blood sugar as close to normal as possible." I have followed her advice ( after talking with my endo ) and made dietary changes that have kept my daily average BG in the 90-100 range for the last month. I reduced my carbohydrate intake ( and hence need for large insulin doses ) and increased my fat ( good fats ) intake ( to maintain caloric needs ).

Managing this disease may always be a challenge but I plan on dying with all my parts intact and living long enough to see ( with good eyes ) my great grandkids.

10:41 AM  
Blogger mollyjade said...

I think good glucose levels, lipid levels, blood pressure, diet, and exercise are the best recipe we have for diabetic heart health so far.

My favorite nutrition resource is the Harvard School of Public Health. They do a very good job of putting nutrition studies in context and avoiding nutrition fads (no low fat, but also no low carb). And all their advice is based on peer reviewed, large population studies. http://www.hsph.harvard.edu/nutritionsource/

Whenever I start worrying about any complication (it's usually my eyes), I try to do something concrete: make a doctor's appointment, plan a healthy lunch, get some exercise. That way I feel a little more in control.

1:46 PM  
Blogger Carol said...

Hey Scott, good questions. If CV risk is so high for us diabetics, I wonder why our docs aren't routinely suggesting a stress test? A couple of years ago, I started having some intermittent chest pains and mentioned it to my Endoc. He referred me for a treadmill stress test, and all check out OK. Eased my mind, and might do same for you :).

2:55 PM  
Blogger Bernard said...

Scott

I used to worry about it all (blindness, kidney failure, neuropathy leading to amputation, heart problems). Thanks to a long impromptu talk with my endo of about 14 years ago that all went away to a great extent.

I'm now starting to come around to the fact that I just need to stay away from carbs. But as Amy T. says, they taste just too good.

I think the key for me is more regular exercise and staying away from carbs. I'd replace these with more vegetables and limited amounts of protein.

7:49 PM  
Blogger Jonah said...

When I was in the hospital, my mother told me sternly that the most common problem coming from diabetes was heart disease, but somehow in my head heart disease has more to do with type 2- with people who have diabetes plus something else.
I worry the most about my kidneys.

7:50 PM  
Anonymous snacks for diabetics said...

I agree to everyone, specially to Jenny. For me, to worry is just another "disease" that add to what we have right now.

Lets take advantage of those medical breakthrough that keep us more vigilant and comfortable. Be thankful everyday which somehow release some stress in our lifes.

8:27 PM  
Anonymous Anonymous said...

Hello all. I am a 29 year old female (WELL I FEEL 29). I was diagnosed in 1970. There is NOTHING that has kept me down. I camp, hunt, target shoot, white water raft, go on survivalist outings, hike, rock climb. I ride a motorcycle and ATV all the time. I am married to the perfect husband. My A1c the last three times was 5.9. I have been taking insulin for 38 years and I feel great! My father died after having diabetes for 18 years. I am not nuts, but, if civilization collapses, I want to know how to get insulin. Has anyone done any research? I am having difficulty finding info. Please, anyone who has any data email me at sxgremlin@yahoo.com. Thanks

9:18 AM  
Anonymous Anonymous said...

Homemade insulin perhaps. Anyone know how?

9:50 AM  
Blogger Diabetes Supply said...

At first, your blood sugar level may rise so slowly that you may not know that anything is wrong. One-third of all people who have diabetes do not know that they have the disease. If you do have Type 2 Diabetes Symptom, they may include: Feeling thirsty. Having to urinate more than usual, Feeling more hungry than usual, Losing weight without trying to. http://diets-diabetes.blogspot.com/

5:39 AM  
Blogger Gabby Stone said...

Suffering from a long term disease and can't find a real solution for the disease by using pills or medicines just try some Home Remedies for that disease. Home remedies are the best way to get rid of any disease. Becasue home remedies have no side effects and you can take them regularly and treat the disease permanently.

10:07 PM  

Post a Comment

Subscribe to Post Comments [Atom]

<< Home