Blue rush

November 1st kicked of National Diabetes Month in the USA and a month of programs leading up to World Diabetes Day (WDD) on November 14th. I promised to blog each day leading up to WDD but I have already broken my promise. I did not write anything yesterday so today I have given myself permission to write two blog posts about diabetes.

But what to write about? Where do I start? How do I find a topic related to this month's events?

Earlier this week when the [Big Blue Test]( video and web site launched I decided to submit my first reading. [I tested]( and then did some casual walking around Princeton with my wife and son. Before the walk my blood glucose (BG) tested at 90 mg/dL. When I tested 14 minute later, my BG was 91 mg/dL. I had expected my BG to go down due to the exercise. I expected my BG to in the mid 80s. But ... a lot of variables come into play that affect BG.

While attempting to cross the street I notice that a car was parked across the other end of the cross walk blocking access to the side-walk. As I was around the car I made eye contact with the driver with a look that I hoped said, "Please don't park on the cross walk". He must have received my non-verbal communication because he started his car just as I walked around the front end. I was startled - adrenaline.

Early humans had to survive in a very hostile environment. Warriors from another tribe might attack in the middle of the night or you might be attacked and eaten by a large predator. Adrenaline helps our liver secrete extra glucose - from stored fat - into the blood stream to provide muscles with the energy to fight or flee. I wasn't in any danger - at least I don't think I was - but that burst of adrenaline pushed my BG up.

Exercising requires extra glucose for energy to fuel muscles. Continuous, moderate exercise — such as that required by the paparazzi as they run to catch Kim [Kardashian] — can cause muscles to take up glucose at nearly 20 times the normal rate. This process lowers blood sugar levels. Even after the chase, the body replenishes the glucose stores (called glycogen) in muscle cells and the liver, which lowers blood sugar levels even more, for hours afterward.

(via [Beat Diabetes Daily](

I often find that my BG rise after watching an intense action movie or when I get angry. Emotional stress is just another thing that a person with diabetes has to deal with. However, I'm not about to stop watching action movies but I can work on curbing my reaction to unwanted events. Maybe I can release my demons playing [Angry Birds](

Six things I want you to know about diabetes

It's not my fault.

I can't speak for all people with diabetes but in my case, there was nothing I did to cause diabetes nor was there anything I could have done to prevent it. I have Type 1 diabetes. The doctors think &ndash, but are not certain – it's caused by a malfunction of the immune system. My immune system thinks some of the cells in my pancreas are a foreign invader and is doing battle. This means my pancreas is damaged and unable to produce sufficient insulin. Eventually, all those cells will be destroyed. In any case, I'm dependent on insulin injections for my survival. Without multiple daily injections of insulin, I die.

There is no cure

Some people after I tell them I have Type 1 diabetes, will get very excited to tell me, "You can cure diabetes.  There is a plant/treatment/spice/meditation technique that my Uncle uses.   His diabetes is gone now."   Um, really! And how long has this treatment been around?  "Years". Um, really!   That's odd, I've had diabetes for years now and my endocrinologist has never mentioned it and I have never read about any research like that.   Oh, they are keeping it a secret.   blood streamA secret that only you happen to know about.   recognisedYou know what, good for your Uncle, but I am going to keep taking my insulin and donating to the Denise Faustman Lab and the Juvenile Diabetes Research Foundation.

It's about blood sugar, not food sugar.

When I am talking about my blood sugar being low/high I am not referring to icing on the slice of cake you just ate. I am talking about the chem bloodstream. I am talking about the metabolic process of converting food into blood glucose. Let's focus on the carbohydrates.

Macromolecules such as starch, cellulose or proteins cannot be rapidly taken up by cells and need to be broken into their smaller units before they can be used in cell metabolism. Carbohydrate catabolism is the breakdown of carbohydrates into smaller units. Carbohydrates are usually taken into cells once they have been digested into monosaccharides. Once inside, the major route of breakdown is glycolysis, where sugars such as glucose and fructose are converted into pyruvate and some ATP is generated. Pyruvate is an intermediate in several metabolic pathways, but the majority is converted to acetyl-CoA and fed into the citric acid cycle.

How was your high school biology and chemistry? Food goes through the citric acid cycle —  including proteins and fats —  and raises blood sugar. Carbohydrates get metabolized more easily and quickly than proteins and fats. So that slice of cake will raise my blood sugar just as much as the slice of pizza. It just might do it faster.

Insulin is not a cure.

"But you have a cure now, right. You can take insulin". See "There is no cure" above. Here's my research on the two words. I used a dictionary.

A treatment treats a problem and may lead to its cure, but treatments often ameliorate a problem only for as long as the treatment is continued, especially in chronic diseases.

Oops, I used a SAT word. Ameliorate means to "make better".

Cures are a subset of treatments that reverse illnesses completely or end medical problems permanently.

Insulin is a treatment. Not a cure. If I stop taking insulin, I die.


Flickr image, soldiers, by [Heather Aitken](

Anyone can get diabetes

There was a time when doc recognized two types of diabetes –  Type 1 or Juvenile diabetes and Type 2 diabetes. Type 1 diabetes normally occurred in the young while Type 2 normally occurred in older overweight and unhealthy people. That's a load of crock. First, off Type 2 diabetes is now occurring at an alarming rate in the young. In fact, the rate of incidence is so high it's becoming an epidemic. As for Type 1 – well I am no Juvenile. I was diagnosed with Type 1 at the age of 38. Some people like to call that Type 1.5. Another call is LADA –  Auto-imAutoimmune Diabetes in Adults. Some women get diabetes only while they are pregnant –  gestational diabetes. So diabetes can affect anyone – old, young.

There is a Type 3

After I was diagnosed my wife decided that this was our disease. Together we learned about all the things I would need to do to stay healthy. She has been there through the scary lows (blood glucose) and the disappointing highs. We've raised our kids to read food labels and be conscious of the quality of the foods we eat. Type 3 is reserved for those special people in our lives that make living with diabetes easier. November is National Diabetes Month.

Our 2010 JDRF Walk for the Cure Team, Sir Lancet-a-lot and the Knights of Pokey Land