Complementary Therapy: Reader's Respond
Knowledge Leads to Advancements
I have really been enjoying Diabetes Health since I started my subscription last year. I have learned more about diabetes in the last year than I did in my previous 33 years as a type I. I was diagnosed in 1963, in the dark ages, with chemistry sets to test urine and glass syringes with needles that I filed to sharpen! Oh, the progress that has been made in the last twenty years. It is amazing, especially home blood glucose monitoring.
I finally started monitoring my blood glucose levels in 1985, while watching the slow progression of complications take their toll on my father-a pediatrician and a type I for 40 years. He had arterial claudication, which finally killed him in 1987.
I could write volumes about my life as a diabetic, but I won't, except to say I have had a great life. My husband and I have been backpacking and skiing-we even went rock climbing in the Andes. We had our son in 1976 (before home glucose monitoring), and he was perfect and still is! I consider myself extremely lucky.
Thank you for the great newspaper. Keep up the good work!
"Stand up and be Heard"
I am a systems operator for Dave Grove's Diabetes Forum on Compuserve. My son was diagnosed with type I diabetes in June 1993 at the age of six. As much as I've tried to keep a positive outlook and learn all that I can about the disease when my daughter was diagnosed with type I in August of 1995 at the age of five it was like having "another death" in the family. First my oldest son, then my only daughter, now I fear for my two year old son as well. Diabetes has robbed my entire family. But, as hard as it is we will go on and will live as well as possible.
I've heard the praises of your publication for some time now. I would just like to add my thanks for publishing what so many of us think and feel. While diabetes may not have the media coverage of AIDS, it destroys lives just the same. The members of the diabetes community need to stand up and be heard.
Deborah A. Green
Islet Info Online
I read with great interest the article "Victor or Victim" in the October 1996 issue of Diabetes Health. Until recently I shared David Groves' and Joan Hoover's cynicism regarding financial plugs for diabetes cure research. I have had diabetes for 29 years and strongly believe that the disease is too big a business for those benefiting financially from it to give up easily.
Last night however, I had the immense pleasure of meeting Dr. Anthony Sun of the University of Toronto. Dr. Sun has cured naturally diabetic monkeys with microencapsulated pig islets. None of them required anti-rejection drugs. The monkeys' blood sugar levels returned to normal and stayed there for up to two years.
The Islet Foundation is working to get funding for Dr. Sun, as he is ready to begin human trials. Funding, FDA approval (in the states) and BOB approval (in Canada) are the only remaining barriers. You, and all your other readers, would find the Islet Foundation web site a worthwhile adventure. On the home page there is a link to Dr. Sun's research that was published in the September issue of the Journal of Clinical Investigation. I encourage you to take the time to read up on this exciting research. It's the best news I've heard in almost three decades of waiting for a cure.
The Islet Foundation - www.islet.org
Editor's note: Thanks for writing. We are currently gathering data for an article on islet cell research and funding-your help is appreciated.
Humalog-The Pros and Cons
I just reviewed the latest issue of Diabetes Health. Like the issues before, it contained a great deal of useful information for dealing with my own diabetes and that of my patients. Jennifer Ogar's article on Humalog was very extensive and included quotes from prominent individuals in the diabetes care community.
I was surprised however at the omission of two particular groups from the article; one for whom Humalog will be very beneficial and one for whom Humalog could cause problems.
The first group is very young children (under age three) who often get their insulin injection and then refuse to eat or claim they are full after a few bites. Caretakers can become frantic trying to find something the child will eat. At the very least this dynamic can result in the child learning the art of manipulation at mealtime. With Humalog, the child can eat, and the caretaker can estimate the number of carbs taken in and give an appropriate amount of Humalog. Obviously this is not ideal, but it could prevent hypoglycemia problems as well as circumvent the development of behavior problems.
The group for whom Humalog could present a frequent problem is individuals who have gastroparesis. If the absorption of food from the digestive tract is unpredictable, a fast acting insulin could start working and even hit it's peak before adequate food is available. Even for people taking medication for this complication, food absorption is not always predictable. In the last couple of years, our pediatric diabetes team has seen ever increasing numbers of older adolescent and college age subjects experiencing symptoms related to gastroparesis.
As always, thank you for the fine job you and your staff do with Diabetes Health.
Rebecca P. Spillar, MA, CDE, Research Coordinator and Certified Diabetes Educator at the University of Texas at Houston
Editor's note: Thanks for this helpful information. As always, we appreciate the comments and suggestions of our readers.
Another Animal Insulin Advocate
I read with great interest the report you wrote in the July issue of Diabetes Health concerning "Animal Insulin-An Endangered Species?" I am one of those type I diabetics who has not done well on human insulin. I am a diabetic of 26 years in tight control on pork insulin. My last HbA1c was 7.4%. Four years ago I was switched to Novo Nordisk human insulin at the request of my HMO. I started having many episodes of hypoglycemic unawareness and even passed out at work for the first time since being diagnosed with diabetes. I consulted with three internists, one endocrinologist and a CDE. They all concurred that the human insulin could not be the cause of my hypoglycemic unawareness because studies indicated that this could not be the case. Finally, my primary doctor wrote to my HMO requesting that I be allowed to return to pork insulin. I had been experiencing hypoglycemia on human insulin, and because of my hypoglycemic unawareness I could not consciously counteract it.
If the drug companies decide to remove all animal insulins from the marketplace, I am not sure I will be able to continue working. This possibility is indeed depressing.
Thank you for addressing this subject in your referenced article, and being an advocate for maintaining our current choices of insulin. Please let me know if I can be of any assistance in this very important crusade.
Janet A. Walper
James S. Hirsch wrote an article in the August 29, 1996 issue of the Wall Street Journal about a woman who passed out from low blood sugars while driving her car. He neglected to mention the animal/human insulin debate going on right now, and its effect on numerous people with diabetes. Perhaps, you should write to Mr. Hirsch and remind him of this very important aspect in the debate over diabetes management.
Frozen Shoulder Syndrome-A Two Year Cure?
I am writing in reference to your article on Frozen Shoulder Syndrome in the March 1996 issue of Diabetes Health. About one year ago I was experiencing stiffness and limited movement in my left shoulder. My first response was to learn more about the condition so that I could find the most appropriate treatment. After some searching, I found an article through the Diabetes Information Clearinghouse in Bethesda, Md.
The article, titled "Rheumatic Syndromes Associated with Diabetes Mellitus" by Sharon Selinger, MD, recommends resting the afflicted joint, using non-steroidal anti-inflammatory agents and physical therapy. One other fact mentioned was that in 80 percent of the cases, Frozen Shoulder Syndrome may simply go away in two years.
I chose to see a chiropractor rather than a physical therapist. She is a Palmer School graduate. In short, Palmer graduates are trained in specific adjustment techniques and are more medically oriented than those from other chiropractic schools. She worked very diligently with me and even discussed getting a second or third opinion, which I did.
I consulted with my endocrinologist and his response was to send me to a rheumatology specialist who wanted to inject me with cortisone. I turned his offer of cortisone down and left his office with the two year plan in my mind.
I wanted a non-invasive treatment plan because in another article I read that steroids such as cortisone, should be used rarely-only for fast, temporary relief of severe pain and inflammation. They are avoided because of major side effects, such as masking of infections, prevention of healing and dramatically increased blood sugar levels. In the end, I felt that my chiropractor was the consultant with the most reasonable approach.
My chiropractor gave me some exercises with dumbbells and monitored the amount of weight I should use and the number of flexes I should do. She also showed me exactly what motions/exercises would help my arm, shoulder and wrist muscles, since different muscles were compensating for muscles in the shoulders that were "frozen."
It wasn't easy-nothing about diabetes is. More people with diabetes need to know about the two year plan when faced with Frozen Shoulder Syndrome. In my mind, it beats the uncertainty and danger of either surgery or cortisone. My chiropractor did incredible work with me and her other patients with diabetes who came to her with Frozen Shoulder Syndrome. My twice a week visits have now diminished to once every three weeks, and I can move both my arms quite freely with only a small bit of stiffness that I am anticipating will go away.
I have had diabetes for 36 years and am 38 years old. My hemoglobin A1cs have been under 8.0% and still things go wrong. I appreciate the opportunity to bring additional information to people who, like me, are always searching for more information and better answers.
Sandra T. Manning
San Francisco, Calif.