From your description can I am guessing that you have type I diabetes (your pancreas no longer produces ANY insulin)?

None of my comments contradict your second statement, if you are talking about type I diabetes. Type I cannot be altered or changed through lifestyle changes, because the pancreas is not producing any insulin. Type I is NOT caused by obesity, bad diets, etc, it is a random (often following flu like symptoms) and a trigger event (it happens suddenly and is irreversible).

Type II diabetics have MANY more options for treatment than Type I. In addition to insulin, there are oral medications that can be used such as Avandia (which increased cellular response to insulin by decreasing insulin resistance), or Glucophage (which reduces the production of glucose by the liver and increased the muscles’ glucose uptake and use). These types of treatments can (with life-style changes such as diet and exercise) prevent a Type II diabetic from becoming insulin dependent and can also reverse some of the diabetic process. They can also be used in conjunction with insulin to more effectively manage diabetes for Type II Diabetics.

Where I disagreed with your first statement was when you suggested that nothing besides insulin effects diabetes. It depends on what kind of Diabetes you have (I or II) and other factors specific to each person.

The fact that you do not have any other symptoms (such as neuropathy) may be because a.) you are lucky b.) you are managing your sugar levels well (if they are more steady and do not have a lot of peaks and valleys, you will have less adverse effects on your body or c.) you just have not gotten them yet (unfortunate, but true).

Unfortunately, many people with diabetes do have many more complications.

I don’t say I am an expert on the subject, but I am a MSN student who is working with diabetes patients in the hospital and also studying the pharmacology and pathophysiology of diabetes as we speak (for a test I need to take later today). If you would like to know my sources they are: Pharmacology and the Nursing Process by Lilley, Rainforth Collins, Harrington, and Snyder, 2011), and Pharmacology for Nursing, version 4.2 by ATI. p. 441-459).

Your first response neither negates nor adds much to my statement about the pancreas. As for the last sentence of your second response, I take umbrage and will cut you some slack only if you are an insulin dependent diabetic as I am, or an endocrinologist with several years of practice.

At 65, after 15 years on insulin, I have yet to experience any of the effects you describe (sounding as if quoted from literature). The fact that I need to inject large amounts of insulin lead me to believe that my pancreas doesn’t produce any. If my sugar levels are not under control it is because I am not a disciplined person, often fall off the wagon, and don’t exercise enough.

It is clear from your response that you know all the bad effects and their extreme manifestations, however, I must disagree with your implied conclusion that those prognoses are inevitable no matter what. Early diagnosis and aggressive insulin therapy is the only solution generally available and I have my endocrinologist’s assurance that ‘it works’. Diabetics, today at least, can hope to live long with no symptoms more dire than those of other older people. Whether that goal is attainable depends entirely on the individual’s commitment and resolve. You have to take my word that the regimen is irksome at best and impossible for most mortals at worst – and I belong to the latter category.

I have also seen and heard of individuals who upon being diagnosed have stopped going to their doctors from some warped rationalization that they can fix ‘it’ on their own – quacks, home remedies, herbals, do-nothing-about-it, and the like. Your words of wisdom are best spent on them.

I suppose what was on my mind when I posted my comment was frustration with the manner in which information and warnings about diabetes is promulgated. Terror / horror / fear approaches distort the nature of the beast and can have unintended effects besides the predictable ones of terror / horror / fear (as evinced by the opening sentence of this post and your second comment). Every one of the growing handful of depictions of diabetics and insulin use I have seen on TV or film have got some or all of it wrong, which further exacerbates public misunderstanding.

Where’s the message of hope in all of this? I got mine from my endocrinologist. My primary physician, in stark contrast, is a self-avowed pill pusher who is, in my book, no more diabetes-wise than the general educated public.

Thanks for your concern regarding ‘many shots a day’. When I was on that regimen I didn’t find it onerous. Famously, the film ‘Memento’ shows a diabetic taking insulin intravenously – as an addict might take heroin. Frightening, no? Irresponsible, yes! A better depiction is in the film ‘Cobb’, if you can see past Ty Cobb’s manic state in the scene. The film ‘Panic Room’ has an extended scene of dubious authenticity that might promote misconceptions.

For the past five years I have been on an insulin pump so I need break skin only once in four days. Were I richer I’m sure I could have fancier gadgetry that might provide autonomous control and make life easier. Or perhaps futuristic islet transplants.

Still, none of what I’ve said is of any relevance to the Third World poor. I am amazed to see the nutrition labeling on some packaged Indian foods with the words ‘at least XX g’ for carbs per serving, and servings expressed in ‘g’ as if that made life any simpler. An eminent doctor in my family maintains that sugar is the only source of food energy readily available to the Indian poor!

If you still think my information on the subject is inaccurate, I will have to insist that you show your own credentials in the matter.

Diabetes has a lot more to it then testing,doctors and insulin. Testing blood sugar levels and taking insulin (I’m sure taking many shots a day would not be a problem for you?) is one aspect, but there are MANY more problems with Diabetes. Insulin injections are not a cure.

Other problems with Diabetes include poor circulation with leads to sores and lesions, especially on feet and legs. The changes in sugar levels, especially high sugar levels- destroy nerves in the body, creating neuropathy in a person with Diabetes– this results in loss of sensation, especially in legs and feet but it can spread elsewhere. Loss of sensation can lead to injury and also pressure ulcers (When you do not feel pain and adjust your body your skin can begin to breakdown and form into a ucler or wound).

People with Diabetes are also more likely to have cardiac concerns as they get older.

I have seen an elder diabetic patient who has both of his legs amputated, has a stage 5+ pressure ulcer on his bottom (he cannot feel well and he cannot move). Stage 5+ means the ulcer is down into the bone and muscle.

Narayan, the information you have on diabetes is highly inaccurate.

Type I Diabetes is when there is an acute LACK of insulin (i.e. the pancreas is not working, or not producing enough insulin)

Type II Diabetes is a relative insulin imbalance, relative insulin excess, ineffectual insulin or insulin resistance.

In Type I something can just trigger the body, and the Beta cells of the pancreas (where insulin is produced) are destroyed. Type I diabetes lack insulin completely and need life-long treatment.

Type II Diabetes is when the demand of the body for insulin (i.e. diet) is outweighing the supply. (The pancreas cannot make enough insulin to support the sugar intake). The pancreas will try to increase the supply, but is unable to keep up with the demand (It is like if you use your car everyday the parts will wear out faster than if you use it once a week). In addition, insulin resistance often occurs– where the insulin is no longer having the same effect as previously. Type II diabetes is progressive (Type I is usually very sudden) and if someone is starting to have the symptoms for type II, lifestyle changes can halt or reverse the progression.

There is a third type of diabetes that can occur which is gestational diabetes (in pregnant women) which I won’t go into here.