Diabetes Dialogue

Since contracting diabetes I can raise an interest but not the means to have sexual intercourse. I have tried many times with a Viagra tablet but they just give me a slight tingle accompanied by a headache. There are two other tablets possible, Levitra and Cialis, and I'll be trying the latter soon. Watch this spice.

Yes, I can understand the link between diabetes and ED. But be careful with the type of medication you tried. Heart disease is a common complication of poorly managed diabetes. I'm 60 and a cardiologist with Type-2 since 1996. I've had 3 heart attacks so far and Viagra/Cialis would be far too unsafe for me. I've just had to accept it and be thankful for the memories. If you can maintain GOOD blood sugar control and are not on either an Alpha-Blocker (for high PSA), or a Beta-Blocker (to lower blood pressure) and don't smoke then you stand a good chance of normal erections.

I fully empathise with your frustration. It raises real questions about the qualifications of the person giving you your diagnosis. On diagnosis of any disease or problem etc. for anything, let alone diabetes, you need to be talked through and agree to a Careplan for you and you alone! Included in that should be what to do with your diet, how to manage itetc. to suit you and best HbA1 levels. A good Dietician would surely benefit you? Our team at the local Diabetic Day Care Centre is very good - if over stretched as are most. As to not providing blood testing on prescription - again we have local training sessions to help all different types of diabetic management.

As you have noticed eating highly refined carbohydrates such as breakfast cereals and bread cause big spikes for most diabetics both type ones, twos and those with "glucose intolerance". Potatoes, rice and white flour products and of course sugar also have the same effect. Vegetables that grow above the ground however have a lot less starch in them and a fibrous structure that allows a more gentle release of the sugars they contain. Eating very small portions of high sugar releasing (glycaemic) foods and combining them in a meal with adequate protein and fat can also reduce spiking.

Every time your blood sugar goes above 7.8 you irreversibly kill off some of your pancreatic beta cells and nerve cells. There is evidence that beta cells are killed off at blood levels even lower than 7.8 the lowest level I have read is 6.1. This is why people with glucose intolerance also are at risk of the same complications as diabetics. If people with this condition persist in eating high carb meals they will progress more rapidly into type two diabetes because the pancreatic beta cells perish. For those with type two diabetes high carb/glycaemic diets will also cause beta cells to diminish and insulin injections will be needed more rapidly than would be the case with a low carb diet. For newly diagnosed type one diabetics the reduced rise in post meal spikes with a low carb diet will help to prolong the "honeymoon phase" but sadly due to the progression of the underlying autoimmune disorder this can only delay rather than prevent complete death of the insulin producing pancreatic beta cells.

Low carbohydrate,moderate protein and high fat diets have been proven to reduce blood sugar spikes and to give a more even distribution of blood sugars for a lot longer after meals than the low fat high carb diets advocate by Diabetes UK and most probably your local NHS dietitian. In addition the lipid profile of most patients improves on this diet. For the small number of patient who have raised LDLs on a low carb diet they usually benefit from either reducing saturated fats considerably and reducing high arachidonic acid items such as red meat and egg yolks or if they prefer they could take a "statin" which is a drug often prescribed for diabetics as a preventative measure.

Although the American Diabetes Associatiion has recently produced a low carb diet cookbook for diabetics and a carb counting guide the NHS is still way behind on this.

Fortunately there are a lot of internet resources that can help you. I would suggest you start with "Rick Mendoza". It is a pity that we cannot get the same service from our local dietitians.

I believe the current dietary advice for diabetes is wrong, not supported by the evidence, and does enormous damage. For more information see:

Power Point Presentation on the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh site:

LOW CARBOHYDRATE, LOW INSULIN, MODERATE PROTEIN, HEALTHY FATS AS THE BASIS FOR BLOOD GLUCOSE NORMALIZATION IN DIABETES

http://www.pitt.edu/~super1/lecture/lec17721/index.htm

I was issued a meter by my hospital, St Mary's in Paddington, some years ago. You can test as often or as infrequently as you like - it is not invasive just a small prick which brings me on to another subject.....
Best reading after no food or drink for two hours. Mine varies between 8 and 10. US measures things differently which is confusing when looking at American websites. There is a test carried out by doctors which establishes long term blood sugar level. Mine is 6.

In UK we measure blood readings in mmol while in USA they meausre in mg/dl. As a rule of thumb to convert the USA readings to mmol you would divide the mg/dl by 18.

The test carried out by the doctors I believe measures blood sugar levels in your blood over a three month period and is called an Hba1c test. This should ideally be conducted every three months.

Glucose only gets into your urine as an escape route - when it is too high.

PCTs were told a few months ago that they MUST NOT limit the number of test strips prescribed if required by a patient.

Urine testing only tells you when your BG is over [I recall] 10 mmol which I have always been told is too high for most people.

Perhaps, this is just ignorance?