Letters to the Editor
I Loved Taking NPH
I read every issue of Diabetes Health with interest. I was particularly drawn to the article "Kiss NPH Goodbye" (March 2002, p. 42).
I have had diabetes since 1944 and remember taking three to four shots a day with big steel needles that had to be sharpened frequently. I would take Regular insulin. Then, once NPH became available, I started taking it. I remember the joy of only having to take one shot a day. I took it until 1997, when I went back to taking three to four shots a day in preparation for going on a pump. I am in remarkably good health, and I have to attribute it to my strong genes and positive attitude rather than to tight control.
I love using an insulin pump and look forward to a time when it can be hooked up to a continuous glucose monitor. I read about the research and new innovations in medicine and technology with fascination.
Thank you for your outstanding magazine. Also, I love the smaller size.
Cape Canaveral, Florida
Thank you for such a wonderful and informative magazine. After reading your article concerning the advantages of after-meal BG testing (April 2002, p. 52), I felt that one additional point might be added.
I have employed this technique of testing after meals since Chemstrips first became available. In a diabetes meeting years ago, a doctor asked rhetorically, "How can we prevent low blood-glucose reactions in the workplace?" I raised my hand to answer, saying that I test about two hours after meals to check my blood-glucose level. If it is too high, I skip my snack; too low, I have a little larger snack. I have found that testing at this time is very valuable because it can also be predictive, thus avoiding an extremely low BG.
At that time, with injections, I found after-meal testing very useful. I still do it even though I now have a pump (and A1Cs in the 5% range for the last five years). I have had diabetes since 1952.
Comment About Editor's Reply
I was disappointed with your editor's reply to Mr. Yegerlehner in the March 2002 issue (p. 12) related to his concern over your equating diabetes with type 1 only. A better response might have been to simply state that islet transplantation could benefit type 2s as well as type 1s. People with either type have problems that result from insufficient insulin inside cells. While the causes are clearly different, insulin supplements can benefit those with either type 1 or type 2 diabetes. Why would someone with type 2 diabetes who cannot be controlled with pills want to inject insulin if they could have the extra insulin supplied by implanted islets? Implanted islets might cure type 1 by supplying absent insulin, but they might also "cure" type 2 by simply eliminating the impact of insulin receptor deficiency.
My Daughter's A1C Control
My daughter is 13 years old and was diagnosed last Dec-ember with type 1 diabetes. Her A1C was 8.5%, and her fasting blood-glucose level was 264 mg/dl at diagnosis. Her doctor started her on Lantus (14 units at night) and NovoLog (1 unit per 12 grams of carbs). Now, almost five months later, her A1C is 5.3%. She is on 5 units of Lantus and barely takes any NovoLog for meals because she is at 1 unit per 35 grams of carbohydrates and is still having lows of around 60 at lunch. I know of the "honeymoon" period, and I'm sure that is where she is right now, but I believe that the Lantus and NovoLog have helped stabilize her blood-glucose levels.
Plus, her father is on Dr. Robert Atkins's diet, so she knows how to count carbs. She looks wonderful and eats almost anything she wants. She tries to stay away from "junk" food. She is a terrific daughter with an attitude that has been unbelievable from the start. She has been taking her own shots since being diagnosed. I keep a log every day on her diet, blood-glucose levels, lows/highs and what caused them. We have noticed that during the week before her period, her blood-glucose levels are elevated somewhat.
She has always wanted to become a nurse, and now she wants to be a diabetes educator so she can help kids cope with diabetes. I love my child. She's definitely a blessing!
Charlotte, North Carolina
Include the Children
Our family greatly appreciates Diabetes Health. It generally has excellent content relevant to the person with diabetes who is interested in good control.
However, there are many children who have this disease, both type 1 and 2, and they are usually forgotten when articles cover blood-glucose control numbers, goals, etc. The numbers stated in your articles are generally too low and unrealistic for children to reach, let alone maintain until adulthood. This can make their parents, and even the older child reading the articles, feel like a failure until they are able to reach their doctor, nurse or educator, who can reassure them the control they are achieving is more realistic for a child with diabetes. Or, worse yet, the unrealistic numbers could make an overachieving parent work at reaching and maintaining those same numbers and could cause their child to have excessive lows, which can be very dangerous and make the child feel horrible. I suggest that you include a sidebar with these articles that includes the range and information for children.
Thank you for listening. I am the mother of Caitlin, age 12, who was diagnosed in January 2002 with type 1 diabetes.