It’s no surprise to anyone who has diabetes how much the medication costs. Though some are covered by insurance, many are not. It’s easy to brush off the hundreds of dollars it would cost for a month or two supply of test strips when the insurance pays for it, it is quite different when you have to yourself.

But the truth is there more to pay for and more at stake than just paying for the medicine and supplies. There are the cost of surgeries and hospital visits that are the results of diabetic complications.

From a Yahoo! Article: The Surprisingly High Cost of Diabetes

“Nearly 3 out of 5 of the 18 million Americans with Type 2 diabetes suffer from at least one serious health complication such as heart attack or chronic kidney disease, according to a new study. Taken together, complications from the disease accounted for an estimated $22.9 billion in medical spending in 2006; annual health care costs per person were nearly $10,000, almost three times higher than for non diabetics.”

Some of the notables:

• 3 out of 5 Type-2 Diabetics in the U.S. suffer complications costing an estimated $22.9 Billion in 2006.
• It accounts to nearly $10,000 per person in health care costs.
• That cost is nearly 3x higher than for non-diabetics.
• On average, people with complications paid $1,566 out-of-pocket annually.

Definitely something to think about. The cost of diabetes is rising in more ways than one. This just underlines the need for better management, better education and overall better awareness of diabetes from diabetics themselves as well as the general public.

I found an interesting post on the healthwealth blog regarding sugars and the various types of sugars you find in the food you eat everyday.

This is an important topic as there is MUCH more to consider when eating food than simply what the sugar count is. You have to take into consideration the carbohydrate count, what type of carbs they are, the mix of different ingredients/chemicals and much more.

“Sources of sugar that you should check in the food labels include the words that end in “ose” or “ol” . These are all forms of sugar. Very important to note is that syrups such as corn sweetener, sorghum syrup and high fructose syrups are sweeteners that are often added to drinks and therefore high in calories. Remember also that brown sugar, molasses and honey are said to be better than regular sugar because they are ”natural” but they all give you the same calories as regular table sugar! So BE AWARE!”

An interesting side note,especially in the U.S., is that almost every major soda manufacturer now uses high fructose corn syrup instead of regular cane sugar simply because it is cheaper for them. Not that cane sugar is a good solution for a diabetic (You should stay away at all cost or moderate heavily), there are some studies that show high fructose corn syrup could be much worse for you.

You can find the rest of the post here, take a look. How much sugar is in my food?

Medical news today has an excellent article up regarding the effects on embryonic cells high blood glucose has which affects pregnant women.

What I’m curious is how this (or if) can turn into possible gestational diabetes in women? Studies like this just put the spotlight even more on regulated glucose levels, especially if its affecting the development of fetus’.

“Over the past several years, Joslin Investigator Mary R. Loeken, Ph.D., and her colleagues at Joslin Diabetes Center have unlocked several mysteries behind what puts women with diabetes more at risk of having a child with birth defects. Even though those risks have decreased significantly over the years, thanks in part to advancements at Joslin, women with diabetes still are two to five times more likely than the general population to have a baby with birth defects, especially of the heart and spinal cord, organs that form within the first few weeks of pregnancy.”

They discovered the protein called glucose transporter 2 (Glut2) enabled high amounts of glucose to be easily transfered into embryonic cells which affects the critical early development stages of fetus’

“Now, in this latest study done in mice, Dr. Loeken and her colleagues have discovered that the protein called glucose transporter 2 (Glut2) makes it possible for the high concentrations of glucose to get into the embryonic cells efficiently when the mother’s blood glucose concentrations are high. Also involved in the study was Rulin Li, Ph.D., a former postdoctoral fellow at Joslin. The study, supported by the National Institutes of Health, will appear in the March print edition of Diabetologia and was published online by the journal.”

They also found that those without the Glut2 gene were protected against deformation in diabetic pregnancies:

“Using mice that lacked Glut2 genes, which were developed by one of the study’s co-authors, Bernard Thorens, Ph.D., of the Center for Integrated Genomics at the University of Lausanne in Switzerland, Joslin researchers found that only embryos carrying normal Glut2 genes developed malformations when the mothers were diabetic, whereas embryos that lacked Glut2 genes were protected from malformations during diabetic pregnancy. “This shows that the high-transport Glut2 transporter was responsible for getting higher concentrations of glucose in the cell and causing the malformations.” The embryos were examined on the 10th day of gestation. The time span in the mice, Dr. Loeken explained, is comparable to about the fourth or fifth weeks of a human pregnancy, which is about the time a woman may discover that she is pregnant.”

Though I’m not sure what the ratio or chances are of a given person having the Glut2 gene, there are 14 other transporter genes as well.

You can read the whole article here: Protein Makes It Possible For High Blood Glucose To Enter Embryonic Cells

If you do find you’re HbA1c levels are high, here are some tips:

• Take your diet seriously – Meet with a diabetic dietician to create a meal plan specialized for you and to lower your HbA1c levels. In case you haven’t heard it before, moderation is key.
• Start exercising – Focus especially on cardiovascular activity. If you’ve sustained high HbA1c levels for long periods of time, chances are you’ll have deterioration in your blood vessels and capillaries. Get that blood moving!
• Take more frequent glucose meter readings – (and record them into SugarStats ) In order to keep your sugars balanced in a day-to-day setting, this is important as each day plays its role in the overall picture.
• Implement Limits & Restrictions – If you get a meal plan setup then you’ve got a lot of ground covered. But you still need to be very conscious about everything else. Especially when it comes to snacks and alcohol. Moderation is key.
• Keep medication on hand, always. – In case you don’t already, get into the habit of keeping around medication wherever you go. If you do some research, you’re sure to find a semi-convenient way to carry/store your medication safely wherever you go. Because if you eat a small snack with lots of carbs and sugar, or seriously over-compensate for a low you had and it takes you 1-2 hours to get home then that is not good. Thats 1-2 more hours your glucose levels are going to stay elevated.
• Start making targets and goals – Part of any plan or project is that of setting targets and goals to meet and the project of managing your diabetes is no different. By setting goals for target blood sugars, target meals or meal sizes, target insert anything related to reducing your blood glucose levels here, you’ll have a clear picture of where you want to be and at the same time give yourself motivation to reach those goals.
• Bonus tip: If your’e a diabetic smoker, try to stop – When it comes down to it, everything is a conscious choice. Though some decisions we consciously made long ago and could have been making unconsciously ever since. One for example could be smoking, you decided to try at one point and just kept doing it. Well if you’re a smoker and a diabetic with elevated HbA1c levels then you’re doing a major double whammy to your body, cardiovascular blood circulation and blood vessels. If it is in your decisive will to do, quiting (or at least cutting down) on smoking is something that your body will thank you for.
  
  

Traveling is a big part of many people’s lives, something many take for granted without a second thought. But for those with Diabetes there is a bit more thought and planning involved.

Here are some common and not-so-common tips that just might help you next time you’re trotting the globe.

1. When traveling for hours bring a timer or stop watch – If you’re using insulin, chances are you’re on a time based schedule. If you end up flying coast-to-coast or international then you end up skipping many time zones and can easily lose track of time. An easy mistake to make is taking your next dosage once you’re off the flight in accordance to the local time. Depending on where you came from, there could be several hours too late or too early. One way to combat this is to bring a timer and measure exactly how long it has been since your last injection. You can do this to follow you’re normal time-based injection schedule until you’ve eased a bit more into the time zone you’re in If you’re traveling more than 2-3 time zone be sure to consult with your doctor for a good plan of action regarding meal and insulin schedules.
2. Look into travel insurance – Especially when staying on longer trips and even after extensive packing there is still a chance for things to go wrong. What happens when your luggage with your 5 weeks worth of medication gets lost at the airport? Contact your insurance company and see what they can cover in case you aren’t already covered. It also might not hurt to inquire about international travel insurance if you plan on going abroad.
3. Tell those you’re with – Especially when traveling alone, make sure to tell at least one person that you have diabetes. A good idea is to tell an airplane attendant, a bus driver, the person sitting next to you on the 9 hour flight. Also make sure you able to be identified as a diabetic quickly and easily. The Diabetic alert bracelets and wallet cards are ideal for this.
4. Invest in quality travel equipment – No I don’t mean a brand new set of Gucci luggage. When traveling, one of the most important things is to keep the potency of your medication. Proper storage is very important as insulin retains its potency for up to 30 days in room temperature. But it’s just not worth taking chances. Think about investing in some high quality cases that are easy to travel with yet also have refrigerating properties to keep things like insulin cold. At the very least something to keep it cool while in transit.
5. Checkups, Premeditation and Emergency Equipment – In case you’re going on a rather long trip, it is a good idea to get checked out a few weeks before going by your doctor. Consult with them and explain the length and extent of the trip. You could even talk about the cultural and culinary differences between your home and where you’re going and how it might affect your blood sugar. Also make sure you’ve brought more medical supplies than you think you’ll need. This includes extra insulin/pills, syringes, fast acting glucose tables, fast acting insulin for emergency highs etc.
6. Test Glucose Frequently – I know there are plenty of you out there testing 8, 12, 16+ times a day, so for to you I give a thumbs up :-). But for others I would suggest, especially if traveling more than 3 times zones to test glucose levels more frequently. We all get in the habit of keeping a mental note of what effects certain foods have on our blood sugars (at least I do). But being in a different time zone and eating different foods can have a much greater effect on your blood sugar than you think. For example, I fly between Europe and the West cost of the U.S. regularly and notice drastic changes once I reach each side. My blood sugars get extremely low even when eating the same foods. It’s almost as if my insulin starts working 50% more within my body for the next few days after arrival and I have to make constant adjustments. This is something that would be good to consider.
7. Don’t stay stagnant for too long – In the case that you’re in transit for a long time (or even just a few hours), it is important to keep your blood and circulation going. Don’t sit on that rear-end for too long, every change you get try and take a break to stretch and shake things up a bit. If you’re on an airplane this isn’t so uncommon as you’ll see people walking up and down the isle, join them! A great place to do in-place stretching is usually by the restrooms and the main cabin door exit. For long car trips there is no excuse like stopping for gas or small snack breaks.
8. Keep a similar diet – It may be quite tempting, but try not to stray of the beaten path regarding your diet wherever you go. An intense switch in completely different foods could be a sort of shock to your body and blood sugar. Be sure to take new foods with moderation and see how they affect you and your blood sugar in your new location.
9. Watch the Alcohol – Ah yes, temptation again. You may feel like “letting loose” with a few too many martini’s at the coconut bar on your island get away but try to resist. People with diabetes can enjoy alcohol just like everyone else but the key is moderation (Just like everyone else ). Some tips involve being selective about what you drink, the sugars and calories in those mixers add up real quick. Also eat something before drinking, drinking on an empty stomach is never a good idea whether you’re diabetic or not. I’m sure (hopefully) you’re “celebrating” with other people and just not getting drunk by yourself, if so make sure they know your situation in case of emergency and even to support you in not over doing it.
10. Bottled Water, Drink it! – Hydration is very important, but just as important is the quality of your hydration source. Especially if you’re in a foreign country where the water quality is debatable then pick up a few bottles of drinking water. Even in locations within the U.S. the water quality is far from optimal. Better safe than sorry.

With a bit of common sense and forward thinking you will be well on your way to a safe and complication free traveling experience.

I stumbled upon quite an interesting piece at the New York times contributed by Michael Pollan, the Knight professor of journalism at the University of California, Berkeley.

This isn’t specifically about diabetes but I do think it is directly related. The article itself is quite lengthy, around 12 pages, but it is packed full of very insightful and useful information regarding the state of our society (and the world) regarding how we eat and the influences we have regarding nutritional consumption.

Especially taking into account how your diabetic health is directly related to your diet and what you eat, it could make you consider twice next time you think you’re making a health conscious decision. As they say: “The right choices are sometimes the hardest to make”. Regarding food, that is something I can definitely attest to.

Some interesting snippets:

“FROM FOODS TO NUTRIENTS

It was in the 1980s that food began disappearing from the American supermarket, gradually to be replaced by “nutrients,” which are not the same thing. Where once the familiar names of recognizable comestibles — things like eggs or breakfast cereal or cookies — claimed pride of place on the brightly colored packages crowding the aisles, now new terms like “fiber” and “cholesterol” and “saturated fat” rose to large-type prominence. More important than mere foods, the presence or absence of these invisible substances was now generally believed to confer health benefits on their eaters. Foods by comparison were coarse, old-fashioned and decidedly unscientific things — who could say what was in them, really? But nutrients — those chemical compounds and minerals in foods that nutritionists have deemed important to health — gleamed with the promise of scientific certainty; eat more of the right ones, fewer of the wrong, and you would live longer and avoid chronic diseases.”

and

“Also, people don’t eat nutrients, they eat foods, and foods can behave very differently than the nutrients they contain. Researchers have long believed, based on epidemiological comparisons of different populations, that a diet high in fruits and vegetables confers some protection against cancer. So naturally they ask, What nutrients in those plant foods are responsible for that effect? One hypothesis is that the antioxidants in fresh produce — compounds like beta carotene, lycopene, vitamin E, etc. — are the X factor. It makes good sense: these molecules (which plants produce to protect themselves from the highly reactive oxygen atoms produced in photosynthesis) vanquish the free radicals in our bodies, which can damage DNA and initiate cancers. At least that’s how it seems to work in the test tube. Yet as soon as you remove these useful molecules from the context of the whole foods they’re found in, as we’ve done in creating antioxidant supplements, they don’t work at all. Indeed, in the case of beta carotene ingested as a supplement, scientists have discovered that it actually increases the risk of certain cancers. Big oops.”

I wasn’t fully aware until recently, but today is World Diabetes Day (November 14th).

From the website:

“World Diabetes Day, organized by the International Diabetes Federation (IDF) and supported by the World Health Organization (WHO) is the primary global awareness campaign of the diabetes world. It was first introduced in 1991 in response to concern over the escalating incidence of diabetes around the world. Since then, it has grown in popularity and now unites more than 350 million people worldwide including opinion leaders, health-care professionals, carers, people with diabetes, and the general public.”

Why November 14th? Well it was chosen based on the birthday of Frederick Banting who along with Charles Best first conceived the ideas which lead to the discovery of insulin.

There appears to be a nice list of places to celebrate:

• Radio and television programmes
• Sports events
• Free screenings for diabetes and its complications
• Public information meetings
• Poster and leaflet campaigns
• Diabetes workshops and exhibitions
• Press conferences
• Newspaper and magazine articles
• Events for children and adolescents

To find out whats happening in your country, contact your local/national association.

Just wanted to wish a happy Halloween to all of you out there. Of course don’t go overboard with all the sugar and try to make smart substitutions where you can. Keep those stats in check!

We don’t need any emergency ambulance calls for sugar over doses. So have a fun one and have a safe one and hopefully your body will thank you for it