Originally Posted by RusM
Haha! Fucking toast and oatmeal for a diabetic?
No wonder people take continually higher and higher doses of insulin and get their limbs cut off listening to that shit advice.
Your response tells me you're ignorant on the disease itself and its management so let me break it down for you. Before I became a certified diabetes educator (CDE) I too was ignorant.
What is diabetes mellitus (DM)? The word diabetes itself means, to filter. Mellitus means, honey. To filter honey? Da fuq?
In ancient Greece a person would start pissing a lot (polyuria) and the dogs would start drinking their urine because it was sweet and honeylike. Few weeks later the person was dead.
DM is defined as having a Hemoglobin A1C of 6.4% or greater. What is Hemoglobin A1C? It's glycosylated hemoglobin. Basically the glucose sticks to the hemoglobin (the molecule that carries oxygen to your cells and CO2 back to your lungs) and never lets go. Just like my Mexican wife. It was discovered by an Indian researcher who noticed a strange spike on his spectrograph when he was looking at blood samples. This spike was only on pts who had DM. Since the red blood cell lives 3 months it is a way to determine blood sugar control over the past 3 months.
There are 2 types of DM, type 1 and type 2:
Type 1 was formerly known as juvenile onset or insulin dependent diabetes but it is now known as an autoimmune disease that destroys the beta cells in the Islets of Langerhans in the pancreas and can happen at any age. I had a buddy that came back from Iraq and got sick and ended up with it. Type 1 DM requires insulin to be given in order to manage it as the endocrine portion of the pancreas is basically dead and makes no more insulin.
Type 2, formerly known as adult onset diabetes is now found increasingly in obese children. Type 2 DM is starts with insulin resistance in the body. What is insulin resistance? You have to think of insulin as like a key. Keys only fit the lock they were designed for. Our cells have insulin receptors on the surface (the lock) that only insulin (the key) can plug into. When the insulin plugs into them (inserting the key into the lock and turning) the cells allow glucose to enter the cell and hormones indicating satiety are released.
Insulin resistance occurs due to many factors, obesity and poor diet being the chief ones. Underlying inflammation is present as well. When the body is inflamed, the diet is poor, and the person is a fat bastard then the insulin receptors get tweaked. It's like the lock gets jammed with dirt. The insulin can no longer tell the cells to open the door for the glucose. The glucose in our blood then rises which is the blood sugar everyone talks about. At the same time the cells are sending out hormonal signals indicating they are starving so the pancreas responds by producing more insulin.
So inflammation plus bad diet plus fatassness >>> Insulin resistance >>> Pancreas produces more insulin.
At this point your pancreas has been doing this for years. A third of us on this forum are developing DM as we speak and don't know it. So what happens when the pancreas keeps doing this for year? Pancreatic exhaustion. The cells cannot keep making insulin at a rate higher than they were designed to for that long. Basically the pancreas ran out of duty cycles.
End result is the insulin resistant cells combined with the pancreas not being able to produce extra insulin any longer. Your blood is full of glucose yet your cells aren't getting any so you're in a form of starvation. Your body compensates for this and goes into ketosis and starts burning fat and protein (your muscles) as a fuel instead of glucose. This leads to a massive spike in blood sugar since it's really not being used and fat boy ends up in the hospital feeling like shit, they check his blood sugar and see that it's like 700 and his A1C is 12%. Dude's had DM for years and his body was able to compensate until it was too much. Ironically he probably lost weight in the process because his body was consuming the fat and muscles to live.
Pancreatic exhaustion >>> Pancreas reduces insulin output >>> Blood sugar rises uncontrollably
Now that we know what DM is and what causes it, why are people getting limbs cut off? Is it the evil oatmeal? That's a gross oversimplification. Diabetes is a progressive disease. Your pancreas is going to keep making less and less of its own insulin and no matter how well you manage your DM you will eventually need to start taking insulin on your own if you live long enough. Limbs being cut off is a symptom of poor medical care as much as anything else. It typically starts with a foot injury and leads to an infection. DM makes the immune system weaker and thus makes it harder to fight off infections.
How is DM managed? If you catch it in the Pre-DM phase, that's when your A1C is between 5.7 and 6.3%, you can reverse it with diet and exercise though that almost never happens. Once it hits 6.4% you are considered to have DM and it requires a multi phased approach.
1. Diet. You want to eat a well balanced diet that includes carbohydrates. Oatmeal and whole wheat bread have fiber and are a good source of carbs. You have to remember that fat boy spent the last 40 years eating wonder bread and cookies to get in this mess. Oatmeal and whole wheat bread is a step in the right direction.
2. Exercise. Minimum 2.5 hours of moderate intensity exercise, such as walking, spread out over 5 days combined with strength training 2 days week per week. Walking at 4 mph is great. When you hit 10 miles in a week the health benefits start to appear.
3. Medication. Oral meds first followed by insulin later. If your kidneys are healthy the first line med is Metformin. It's an old school med that kicks ass. It sensitizes your body to insulin, aka it counteracts insulin resistance. Biggest side effect is diarrhea and it's only good if your kidneys are good. If Metformin can't get your A1C below 7% they add a second oral med, usually Glipizide. Glipizide works by making the already exhausted pancreas make more insulin. Major side effect is hypoglycemia which is low blood sugar and can be life threatening. If that doesn't work they will add a 3rd oral or a non-insulin injectable. If that is not enough then insulin will be added. Because DM is progressive insulin will usually have to be given later in life. Sucks but it is what it is.
Can anything cure DM? No. Gastric Bypass can reverse it, sometimes for years, but the damage to the pancreas is permanent.