Ending my sweet life the second part

Dear Bloggers,

I was asked a couple of times by fellow blog writers to make a part two on my sweet life is ending. It took me a while to produce a sequel on this story. I am now pretty experienced if it comes to my own case.. In the beginning it scared the hell out of me. And yes I probably will not get very old but that doesn’t bather me. I have it pretty much under control and my life is full of imperfections but I am not much of a cry baby and sit in a corner whining. I have a future to live for and I hope one day to play with my grandchildren. Both my my wife and me have health issues and climbing stairs is getting us into trouble. We decided to put our family home on the market and look for something with everything on ground level. My next move after this one will be in a wooden coffin. Let us hope that we have a couple of great years left with the kids at home and if they fly out that they come and see us frequently with their kids.



Once you know the facts, it is hard not to care about diabetes. In the Netherlands alone, 1 million people have diabetes. Approximately 71000 Dutch are diagnosed each year, and a third of all the people with diabetes are unaware they have it. WHO (World Health Organization) has declared that there is an epidemic of diabetes. Worldwide, there are 200 million diabetes patients, not including those who still do not know that they have it. In the next decade, the projected number of known diabetics is expected to reach over 250 million. Because of the small amount of attention that has been paid to the disease despite these alarming numbers, the rise in diabetes has often been called the “Silent Epidemic”. A possible cause for this epidemic has been attributed to changes in modern lifestyle:

• The type of food consumed contains higher numbers of calories and purified sugars;
• The typical meal size has increased; • People are not exercising adequately;
• Higher stress levels, and;
 • An increase in the elderly population.

What exactly is diabetes? There are several definitions of diabetes, but the most commonly agreed upon definition is that diabetes is a condition when a person's ability to metabolize carbohydrates (sugar) is impaired. Basically, blood sugar does not get burned inside the muscles and tissues, but rather stays in the blood. This results in high blood sugar levels. A person with a sugar level above 150 ml/dl in the blood in the morning is diagnosed as ‘diabetic'. Insulin allows the body to convert sugar in the blood into energy. It is secreted by ß (beta) cells in the pancreas. So, in a diabetic, either no insulin or inadequate levels of insulin are being produced. Furthermore, even if insulin is produced in a diabetic, it is highly unlikely that it will be properly utilized.



How can having high blood glucose affect me?
Diabetes is much more than just a relative lack of insulin. In one sense, it is a disease that affects the blood vessels, or capillaries. A high concentration of sugar in the blood from relative lack or sensitivity of insulin is still not completely understood. However, it has detrimental effects on the blood vessels and they gradually cease to function properly. Since every organ or tissue in the body depends upon capillary flow to transmit oxygen and glucose and remove waste products, this eventually leads to end-organ damage. Yes in the end we are all going to die.



As every cell is dependant to a large degree on glucose for its fuel, any impairment in its supply or being able to properly metabolize that glucose will lead to impairment in the function of those cells and organs. Consequently, the tissues that have the highest demand for proper blood flow and utilization are most susceptible to the damage of impaired flow or metabolism, e.g., the kidneys, heart, nerves, retina. A lack of blood flow and oxygen to the tissues can also result in many infections, and often the only treatment left is amputation. A high concentration of sugar can also cause increased fatigue and weight gain. It does not kill instantly, but causes long-term, permanent damage over many years with lethal complications. That is why we often take a lax attitude: slow and gradual but certain and fatal.



What related complications can result from diabetes?
Diabetes is not only the leading cause of kidney failure, but it is also the leading cause of blindness, particularly among patients between the ages of 25 and 70. It also increases the chance of having and dying from cardiovascular disease and stroke. The probability of dying from stroke and cardiovascular disease is increased by 400% in people with diabetes, and 2 out of 3 people with diabetes die from heart disease and stroke. Diabetes also damages the nervous system. Approximately 60%-70% of diabetics have some form of nervous system damage. This is especially a concern for diabetic males because they usually have trouble functioning sexually. Erections involve blood flow and nerves.



Because diabetes causes nerve damage and affects blood flow, many males struggle with sexual dysfunction. The first question doctors ask when a patient complains of erectile dysfunction is, “Do you have diabetes?” According to statistics, more than half of sexual dysfunctions among males come from diabetes. In addition, diabetes is a major risk factor for heart attacks and amputations. Sixty percent of amputations occur among people with diabetes. This means that each year, 82,000 amputations are performed on people with diabetes.

Long John Silver did not loose a leg to diabetes

What is the relationship between diabetes and obesity?
Diabetes basically involves an inherent metabolism problem. Because of the inability to absorb and process blood sugar in the muscles, the muscles are constantly experiencing malnutrition. Insulin that has been produced may not be efficiently used. Coupled with lack of exercise, excess glucose eventually becomes fat. We also know that this abnormal blood sugar metabolism affects appetite. All of these lead to weight problems. Between 70%-80% of people with obesity have diabetes. Likewise, 70%-80% of diabetics have difficulty controlling their weight.



I don’t have diabetes, why should I be concerned?
Diabetes is the “silent killer”. Often people who have diabetes do not know it because they cannot feel it. People must take a direct measurement of their blood glucose levels to know if they have diabetes. Even more alarming, when a person is diagnosed with diabetes, the actual development of the disease actually started on the average of seven years prior. Once the active symptoms and complications are observed, diabetes has already entered the later stages. Early detection is good, but prevention is even better. A yearly blood test is essential, even if you feel healthy.



What is Pre-Diabetes?

Pre-diabetes is when a person has a higher than normal blood glucose levels (hyperglycemic) but the level is not high enough to be diagnosed as diabetic or they are unable to secrete enough extra insulin in response to a glucose challenge. This is a cause for concern, especially when 700000 people in the Netherlands have “Pre-diabetes”. At this point, long term damage to the body is already occurring and often leads to Type II diabetes. If the blood glucose is controlled at an early stage, the development into Type II diabetes can be prevented. Often, diabetes is referred to as the “Silent Killer” due to the unobvious symptoms of diabetes. People who have diabetes or are pre-diabetic initially do not feel pain or feel any symptoms. It is only when the diabetes has reached a serious stage when all the complications, pain and symptoms surface. As previously mentioned, according to statistics, once a person is diagnosed as diabetic, it is likely that the onset of the diabetes actually started seven years ago. On average, every 10 years afterward, there is a rise in blood sugar of 100 milligrams per deciliter. Diabetes is a progressive disease.




Treatment Goals
The main goal for diabetes management is good blood glucose control. Your doctor will recommend a desirable range for you. Keeping your blood glucose as close to your target range as possible will help keep you healthy. Other important health goals for people with diabetes are lowering high blood pressure and decreasing cholesterol and triglyceride (blood fat) levels. If these are high, you may be more at risk for heart disease and stroke. A big goal for anyone who smokes is to stop! Smoking accelerates all of the problems associated with diabetes, because it cuts blood flow and oxygen to the cells. Good Nutrition Matters Your food choices will affect your diabetes control. Foods that contain natural or added sugar or starch (carbohydrates) will affect your blood glucose more than foods that are mainly protein or fat. A registered dietitian can help you plan a healthy meal plan using a variety of your favorite foods. Controlling calories is important for diabetes control. A weight loss of just 10 to 20 pounds can make a big difference in your blood glucose and blood pressure control. Drinking plenty of water, eating higher fiber foods, and eating less fat will help. Watching your sodium intake is also helpful if you have high blood pressure. Limiting solid fats will help control your cholesterol level.

Eating less fat so next time eat only half of it.

Most people find that eating the same amount of food at about the same time each day helps them control their blood glucose. Skipping meals is a bad idea, especially if you take diabetes medicine. Missing a meal also makes you more likely to overeat later. 2 You do not need to buy special food for your diabetes. The diabetic meal plan is good for both you and your family. Getting Active Is Important Blood glucose and weight control are very difficult to achieve without regular physical activity. Activity may include merely moving around more during the day, driving less, taking the stairs more often, doing yard work, or walking the dog, all of which increase caloric use.


Regularly scheduled exercise is also good. For weight loss, exercise that gets the heart rate up helps the most. Good choices are brisk walking, swimming laps, water aerobics, and biking. If you have not exercised regularly lately, have a doctor’s exam before you start. The results of this checkup will help you choose the activity that is best for you. The main goal is to do more of something you enjoy. You should exercise 5 to 7 days a week. Exercising with a partner or group may help you better stick to your program. Exercising at the same time each day may make your blood glucose levels more predictable.


Blood Glucose Monitoring is the only way to tell how well you have your diabetes under control. Your medical team will tell you how often to check. These blood glucose readings will help you see patterns in your diabetes control. If you have three values at the same time each day that are above or below your target range, you may need to change your eating, exercise, or medication habits. Recording your blood glucose readings, what you ate, what you did that day, and how much medicine you took will help you see those patterns. There are many monitors available. A diabetes educator or a pharmacist can help you decide which one is best for you. Always take your monitor and blood glucose records with you when you see your medical team. They can test to be sure your monitor is working correctly and that you are checking it properly.

Obese and diabetic a deadly combination

Medication Choices
New medicines for diabetes seem to appear every day. Your doctor will decide which medication is right for you. Some people with type 2 diabetes may only require better eating habits and more physical activity to control their diabetes. Medication needs often change over time, so you may switch diabetes medicines or add medicine more than once. Blood glucose monitoring is essential in deciding the correct amount of diabetes medicine for you. Diabetes pills work in different ways. They are not insulin. Some pills cause your pancreas to produce more insulin. Some make your liver produce less blood glucose after meals. Others slow the absorption of carbohydrate. Another type makes you more sensitive to insulin. You may need one or more of these medicines to control your diabetes. You may need insulin shots. Some people need insulin along with diabetes pills. How often you take insulin depends on how much insulin your body still produces and how closely your doctor wants to control your diabetes. Different types of insulin last different amounts of time. Your medical team will tell you how much of each kind you need to take and how often.

 In the beginning your overwhelmed by all the information and medication

Don’t Be Overwhelmed
Diabetes is a complex disease, and it takes time to develop the skills needed to control it. A certified diabetes educator can help. Ask your doctor to refer you to an educator for diabetes education. A diabetes support group may also help.
  

You will be surprised how much you will learn and how much easier it is to adjust your diabetes care so that it fits your lifestyle.

The Old Sailor,

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