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I am writing with respect to the article about women with abnormal menstrual cycles being at risk for type 2 diabetes (March 2002, p. 24). The condition that causes the problem for many women is polycystic ovary syndrome ("affectionately" referred to as PCOS). The connection to diabetes is that women like me who suffer from PCOS have hormones that simply don't function properly. In my case, insulin is just one more hormone to go south.
It's unfortunate that I've been complaining to doctors about my condition for at least 20 years. I was blown off by them until three years ago, when I read an article about PCOS and insisted on being tested for a diagnosis so I could get treatment. By the time I got the necessary referrals, I had already developed type 2 diabetes. The real problem was with my primary care physicians and the waiting time required for new patients to be seen by gynecologists and endocrinologists.
The question that haunts me is that if I had gotten treatment for my PCOS much earlier, could I have avoided developing diabetes? PCOS is starting to get more recognition as other woman-specific health issues are gaining more attention. I hope that after reading this other women will not avoid discussing their menstrual cycle irregularities for fear of having this problem brushed off as a "woman's complaint." It is a serious condition (albeit not necessarily immediately life-threatening), and there are medications to help. The other reason to get treatment is that they will lose weight like they never could before; after I got the right meds, I dropped 60 pounds in six months while still eating ice cream occasionally!
"I Will Not Be Punished"
I suggest that you write an article about the "I will not be punished" attitude of people with type 2 diabetes. I recently ran into a woman with type 2 diabetes with whom I had taken a diabetes education class. I asked her what she was doing to manage the disease.
"Nothing," she replied. We admitted to each other that neither of us had gone to see our HMO doctors recently.
Unlike people with type 1 diabetes, overweight women with type 2 are made to feel awful about their bodies by educators and doctors. We are put down for being overweight and not having control of our appetites. All these lectures do is turn us off.
There has been a spate of articles by the mainstream press critical of the low-carb Protein Power and Zone diets. These critics insist that the low-carb advocates are recommending diets high in saturated fat. That's simply not true. Barry Sears (the Zone Diet) and Drs. Michael and Mary Eades (Protein Power) specifically warn against the consumption of both saturated fats and hydrogenated oil. They make a careful distinction between good (essential fatty acids) and bad fats. In addition, Barry Sears recommends strict limits on daily protein consumption based on lean body mass and physical activity.
Even Dr. Walter Willet of the Harvard School of Public Health is now challenging the "conventional wisdom" that all fat is bad. The United States Dietary Association nutritional guidelines reflect the bias of the agricultural lobby. The food industry is also biased by its love affair with trans fats, which, al-though they are detrimental to health, greatly extend the economic shelf life of a host of food products. It's about time "mainstream" critics abandoned their blanket condemnation of total fats and acknowledged the growing evidence in favor of including good fats (flax-seed oil, canola oil, olive oil and fish oil), while greatly reducing consumption of hydrogenated oil and saturated fats.
NovoLog Works Better for Me Than Humalog Insulin
I was having trouble controlling my blood-glucose levels once I started taking the new Lantus insulin at night. (I was taking Humalog during the day.) Because I've had diabetes for more than 25 years, I thought that maybe my body wasn't working as well or that food was affecting my glucose levels differently. The truth of the matter is that I was running high after every meal because of my new therapy.
I went to my doctor three times last year, telling him that I was running really high numbers. He said I was fine because my A1Cs were always under 7%. But I knew that high numbers were not good. They were hitting the 300s every day. What I found out after doing more research is that I needed a new type of insulin. I stuck with Lantus, which is great for a 24-hour basal rate. But I read that NovoLog, made by Novo Nordisk, has a longer action time than Lilly's Humalog.
I told my doctor I wanted to switch to NovoLog insulin. The change has done wonders. I can't tell you how much better my control is now. I hardly ever go high after a meal. I also found a huge difference between the Novolin pen and the Lilly pen. The Lilly pen bubbled out lots of insulin after I used it. The Novolin pen hardly ever does that.
Los Angeles, California
Don't Forget Pump Therapy for Children
Your article on insulin pumps ("Pump It Up!" April 2002) laid out many of the advantages of pump therapy. But you missed an important point regarding children. It is my belief that one of the most persuasive reasons for putting small children on insulin pumps is the ability to micro-dose. When our 3-year-old daughter, Lucy, started pump therapy last May, she weighed about 35 pounds. Her total daily insulin requirement was only 11-12 units. Giving her the fractional amounts of insulin she required was impossible using a syringe. Today, her correction bolus is 0.1 unit per 50 points and her food bolus is 0.4 units per 15 grams of carbohydrate. Without the ability to accurately deliver very small doses of insulin, we would still be on the roller-coaster ride of continually underdosing and overdosing associated with injections. Since starting pump therapy, Lucy's A1C has dropped a full 2 points. Both the frequency and the severity of her hypoglycemic episodes have decreased significantly. Your article correctly noted that rather than slowing children down, pump therapy really does allow a kid to be a kid. Thank you for continuing to provide one of our best sources of diabetes information.
Correction: The chart of insulin pumps in the April 2002 issue (p. 39) misstated the lowest basal rate for the Animas R-1000. The correct lowest basal rate is 0.05 units per hour.
Correction: The "Check It Out" article in the February 2002 issue ("A Go-Getter," p. 50) misstated two facts. The correct facts are that Lauran Gangl participated in the Junior Olympics in the category of women's solo figure skating and that her father was a project engineer.
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