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[Diabetes] General Chat and Support Thread

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  • Registered Users Posts: 16,515 ✭✭✭✭banie01


    The Diabetic Retinal screening scheme is under threat due to the fallout from the Cervical Scan controversy.

    https://www.independent.ie/irish-news/courts/diabetic-eye-scans-under-threat-due-to-legal-judgment-38125435.html

    Surely the frequency of Diabetic Retina screening offers a high degree of mitigation against missing or misdiagnosis of an issue?

    IIRC Smear test frequency is every @3yrs and a misread test can lead to a 6yr gap in identifying an issue.
    Which as we have seen can lead to catastrophic consequences.

    With the DRS service, the frequency is yearly and the chance of something being missed repeatedly on such a short interval is surely an order of magnitude lower than with long interval cancer screening?

    The DRS is to my mind both a vital point of early intervention for anyone who develops Retinopathy and a point of continued reassurance for those who take up the screening offer.

    In addition, I do feel the likelihood of something causing visual field loss will be picked up both by the patient themselves and the screening service before becoming a serious issue.

    The bright side of Retinopathy I suppose in this particular circumstance is that it rarely develops without symptom to the point where treatment can't at least mitigate.
    Unlike many Cancers that can and do burn through a patient without symptom until all that is available is palliative care.


  • Closed Accounts Posts: 20,633 ✭✭✭✭Buford T. Justice XIX


    banie01 wrote: »
    Surely the frequency of Diabetic Retina screening offers a high degree of mitigation against missing or misdiagnosis of an issue?

    IIRC Smear test frequency is every @3yrs and a misread test can lead to a 6yr gap in identifying an issue.
    Which as we have seen can lead to catastrophic consequences.

    With the DRS service, the frequency is yearly and the chance of something being missed repeatedly on such a short interval is surely an order of magnitude lower than with long interval cancer screening?

    The DRS is to my mind both a vital point of early intervention for anyone who develops Retinopathy and a point of continued reassurance for those who take up the screening offer.

    In addition, I do feel the likelihood of something causing visual field loss will be picked up both by the patient themselves and the screening service before becoming a serious issue.

    The bright side of Retinopathy I suppose in this particular circumstance is that it rarely develops without symptom to the point where treatment can't at least mitigate.
    Unlike many Cancers that can and do burn through a patient without symptom until all that is available is palliative care.

    I think their problem is with the 'absolute confidence' required and the potential liability those tasked with diagnosing progression of potential damage if they diagnose it as less serious than might be the actual case.

    Misdiagnosis would be less serious than with cancer screening alright but the term 'absolute confidence' places a huge amount of extra responsibility on those screening the shots and they feel it's unnecessary?


  • Registered Users Posts: 16,515 ✭✭✭✭banie01


    I think their problem is with the 'absolute confidence' required and the potential liability those tasked with diagnosing progression of potential damage if they diagnose it as less serious than might be the actual case.

    Misdiagnosis would be less serious than with cancer screening alright but the term 'absolute confidence' places a huge amount of extra responsibility on those screening the shots and they feel it's unnecessary?

    100% agree as to the interpretation of "Absolute Confidence".
    One of the unfortunate aspects of our being a common law jurisdiction is the weight albeit usually correctly, afforded to precedence.

    The simple and inescapable fact of any screening programme is that none is 100% accurate and certain.
    The weight afforded to the "absolute confidence" ruling will do far more harm than good if it is allowed to impact upon the screening programmes in place.

    Medical accuracy and mistakes are a serious issue across all fields, and no doctor, no test and no process is completely infallible.
    But a fallible process open to review and continiuous improvement will go a lot further in ensuring better outcomes for the majority of patients.
    I'd rather that course of action, than throwing the programmes to the side to avoid litigation.

    I'd liken the risk profile to vaccination injury.
    In the vast, vast majority of cases vaccination is a public health matter that prevents disease and the likely catastrophic outcomes of epidimec illness.
    It is a path to huge savings both in society and treatment and care costs.

    This is offset by the risk and however rare that risk is, it is still quite real.
    That a very tiny cohort of vaccine recipients will have a severe reaction to the vaccine.

    Does that risk? Outweigh the very obvious and massive public health benefits?

    Screening much like vaccination is never 100% effective, however those cases that are caught in the screen have a massively increased chance of a positive and cheaper treatment outcome than those caught later.

    It really is quite worrying that a learned judge would expect such a complete and accurate outcome on what is basically a judgement call by a specialist on each and every review.
    Almost as if we were to demand infallibilty from our Legal system and in doing so abolished the appeals process and refused to countenance any possibility of a miscarriage of justice.


  • Registered Users Posts: 7,008 ✭✭✭not yet


    Lads, I'm new to all this so maybe someone can tell me if I have this right..

    Glucose levels highish over the past year. 7.2 twice. Done again recently low 6s. Cut most sugars and carbs from My diet.

    Played golf today and had mash spuds with dinner (first time in ages) dessert after it. Done finger test after an hour came in at 5.4

    Am I right in thinking my pancreas has been given a break over the last few months and when I had these carbs and sugars was able to react and pump out insulin. I've heard it explained that your pancreas just gets worn out trying to pump insulin when you continue to eat sugars and carbs, am I making any sense..?


  • Moderators, Sports Moderators Posts: 24,500 Mod ✭✭✭✭CramCycle


    Your making sense but that's unlikely what has happened. What's most likely happened is you have regained your insulin sensitivity. In many type 2 cases, your beta cells failing is the last thing. It's reduced sensitivity to insulin that sets off the warning signs of type 2. Giving your body less carbs /sugars means your cells insulin and glut receptors weren't being bombarded all the time, hopefully meaning your bodies normal response has been restored.

    Long story short your doing well, keep eating well and exercising and type 2 Diabetes is unlikely to ever affect you again, it might but keep on the right track and it's unlikely. The pancreas getting worn out, in your words, is late stage type 2 and you wouldn't be coming back from that so easily, if at all.


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  • Registered Users Posts: 7,008 ✭✭✭not yet


    CramCycle wrote: »
    Your making sense but that's unlikely what has happened. What's most likely happened is you have regained your insulin sensitivity. In many type 2 cases, your beta cells failing is the last thing. It's reduced sensitivity to insulin that sets off the warning signs of type 2. Giving your body less carbs /sugars means your cells insulin and glut receptors weren't being bombarded all the time, hopefully meaning your bodies normal response has been restored.

    Long story short your doing well, keep eating well and exercising and type 2 Diabetes is unlikely to ever affect you again, it might but keep on the right track and it's unlikely. The pancreas getting worn out, in your words, is late stage type 2 and you wouldn't be coming back from that so easily, if at all.

    Cheers,

    As said in a previous post my energy levels are very good since cutting the heavy carbs and sugars. It's only now I'm a little bit aware that I know the damage sugar, in all forms can do.


  • Registered Users Posts: 711 ✭✭✭Xofpod




  • Registered Users Posts: 17,848 ✭✭✭✭silverharp


    I always find these interesting ( the graph in the second post)

    https://twitter.com/AnnChildersMD/status/1131223300414197762

    A belief in gender identity involves a level of faith as there is nothing tangible to prove its existence which, as something divorced from the physical body, is similar to the idea of a soul. - Colette Colfer



  • Registered Users Posts: 4,588 ✭✭✭LLMMLL


    So can finally afford a Freestyle Libre and their website is not accepting new customers.

    Any info on when it will be available again?


  • Registered Users Posts: 3,193 ✭✭✭Eircom_Sucks


    Whats peoples ideas on diet fizzy drinks

    Or

    Cordials with no added sugar ???


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  • Registered Users Posts: 9,786 ✭✭✭wakka12


    I think they are fine in limited quantities, just dont make a habit of it I guess. There doesnt seem to be any unanimous verdict on whether they trigger an insulin response or not, and seems to differ depending on the artificial sweetener used


  • Registered Users Posts: 2,654 ✭✭✭Royal Legend


    The no added sugar bit is misleading, they still contain sugar, just less.

    Miwadi now do a sugar free cordial.

    Personally see no real harm IMO with diet coke etc, but not sure what the official line is.


  • Registered Users Posts: 9,786 ✭✭✭wakka12


    https://www.healthline.com/nutrition/diet-soda-good-or-bad#kidney-health
    Although diet soda has no calories, sugar or fat, it has been linked to the development of type 2 diabetes and heart disease in several studies.

    Research has found that just one serving of an artificially sweetened drink per day is associated with an 8–13% higher risk of type 2 diabetes (22Trusted Source, 23Trusted Source).

    An observational study in 64,850 women found that artificially sweetened drinks were associated with a 21% higher risk of developing type 2 diabetes. However, the risk was still half that of regular sugary drinks. Other studies have found similar results (24Trusted Source, 25Trusted Source, 26Trusted Source, 27Trusted Source).

    Conversely, a recent review found that diet soda is not associated with an increased risk of diabetes. Also, another study concluded that any association could be explained by the existing health status, weight changes and body mass index of participants (28Trusted Source, 29Trusted Source).

    Diet soda has also been linked to increased risks of high blood pressure and heart disease.

    A review of four studies including 227,254 people found that for each serving of artificially sweetened beverage per day, there is a 9% increased risk of high blood pressure. Other studies have found similar results (30Trusted Source, 31Trusted Source, 32Trusted Source).
    Because most of the studies were observational, it may be that the association could be explained another way. It’s possible that people who were already at risk of diabetes and high blood pressure chose to drink more diet soda (24Trusted Source, 34Trusted Source, 35Trusted Source).

    More direct experimental research is needed to determine if there is any true causal relationship between diet soda and increased blood sugar or blood pressure.

    So its not really well known at all the effects that diet drinks have on our bodies. Theres just too many chemicals and interactions in all the different drinks to be ever accurately able to assess their effects on the human body, so as I said I would just drink it in moderation. Most highly processed foods and beverages are just really really bad for your body, theres hardly any exceptions, no matter how good it might look on the surface(such as diet drinks with no fat no sugar no salt etc) so steer fairly clear. On the other hand, if you are unable to stop yourself from drinking full sugar drinks then this is obviously a much better alternative though


  • Registered Users Posts: 16,515 ✭✭✭✭banie01


    As Wakka12 has shown there is no real consensus as yet as to whether or not sugar replacements used in Diet drinks have any pronounced response on actual insulin response or resistance.

    As already pointed out, be very wary of "No added sugar" claims, it simply means that no "free" sugar was added.
    The sugar present as a constituent of other ingredients is still present.
    Also a sneaky tactic is labelling sugars as "natural" or "fructose". Treat all sugar the same and count it, its origin is irrelevant to diabetic control IMO.
    Any bottled/packaged drink will list the carbohydrates, use that as a guide rather than the marketing.

    From a purely anecdotal viewpoint with a sample size of 1.
    I knocked sugar in drinks on the head for the most part. None in tea or coffee, use a sweetener.
    My usual soft drinks are either diet or just plain sparkling water.
    It frees up having to worry about counting drinks and means that for carb/sugar control I can just focus on food.
    Even at that, I don't count carbs anymore.
    Rather just try and be moderate and balanced in what I eat, no special diet other than a perhaps being more aware of my portion sizes.


  • Registered Users Posts: 737 ✭✭✭vargoo


    And thats just the sugars end, lots of studies showing sweeteners do no favours to gut bacteria.

    Can never understand how they are approved for food when they don't know their affects.


  • Registered Users Posts: 40,184 ✭✭✭✭ohnonotgmail


    Had my annual checkup yesterday in Beaumont yesterday and all was good. HBA1C was 50 (6.7 in old) and cholesterol was 3.6. Told to keep on keeping on so i'm happy out.

    For those who attend Mr Smith he is now Professor Smith so congratulations to him.


  • Registered Users Posts: 17,848 ✭✭✭✭silverharp


    kind of a random question but anyone have the CAC test done? it seems to be bubbling up as a great go to test to see what your likelihood of having heart disease is, whatever your number is the main idea seems to be to try stabilise it and not see it increase too much on a yearly basis



    for example the Mater do it.
    https://www.materprivate.ie/dublin/centre-services/all-services/coronary-calcium-scanning/

    A belief in gender identity involves a level of faith as there is nothing tangible to prove its existence which, as something divorced from the physical body, is similar to the idea of a soul. - Colette Colfer



  • Registered Users Posts: 1,529 ✭✭✭BlackEdelweiss


    Hi,
    I have returned from living overseas for 6 years. I have life insurance with a company from the country I was in but it is a bit of a pain making the payment each month as it has to be done by requesting an email to get a payment link which is easy to forget.

    Can anyone recommend a company in Ireland who provide life insurance for a Type 1 diabetic.

    My monthly payment is E172 however about E35 of that is for my wife. Is that expensive or cheap compared to Ireland?


  • Moderators, Sports Moderators Posts: 24,500 Mod ✭✭✭✭CramCycle


    Hi,
    I have returned from living overseas for 6 years. I have life insurance with a company from the country I was in but it is a bit of a pain making the payment each month as it has to be done by requesting an email to get a payment link which is easy to forget.

    Can anyone recommend a company in Ireland who provide life insurance for a Type 1 diabetic.

    My monthly payment is E172 however about E35 of that is for my wife. Is that expensive or cheap compared to Ireland?

    Depends on your age, there is a guy recommended earlier on this thread who helps T1 diabetics get the best quote. Ours is a good bit cheaper, 60euro per month, and that is almost double what it would have been if i wasn't Diabetic.


  • Registered Users Posts: 6,748 ✭✭✭ebbsy


    So back over to Newcastle today to get another 6 months of Noctura 400 Glasses, plus a scan.

    It appears to show that the eyes have remained stable in the last year, the same outcome that I got when at the eye and ear hospital 2 months ago.

    Onwards and upwards I guess.


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  • Registered Users Posts: 16,515 ✭✭✭✭banie01


    ebbsy wrote: »
    So back over to Newcastle today to get another 6 months of Noctura 400 Glasses, plus a scan.

    Great news!
    Thanks for the update ebbsy!


  • Registered Users Posts: 3,193 ✭✭✭Eircom_Sucks


    What type of foods do people with type 2 usually eat ?


  • Registered Users Posts: 7,008 ✭✭✭not yet


    What type of foods do people with type 2 usually eat ?

    Just look for low carb, Chicken, meat, cheese, nuts, berries, green veg etc..


  • Registered Users Posts: 16,515 ✭✭✭✭banie01


    not yet wrote: »
    Just look for low carb, Chicken, meat, cheese, nuts, berries, green veg etc..

    Low carb, medium/high protein and high fibre if possible.
    Fibre is really great in helping to regulate glucose levels.

    It's more a matter of being sugar aware, and then keeping your diet as balanced as you can while keeping any additional carb intake low.

    Portion control and ingredient awareness really goes a long way towards hitting all the bases without descending into full on weighing and carb counting.


  • Registered Users Posts: 1,673 ✭✭✭uli84


    silverharp wrote: »
    kind of a random question but anyone have the CAC test done? it seems to be bubbling up as a great go to test to see what your likelihood of having heart disease is, whatever your number is the main idea seems to be to try stabilise it and not see it increase too much on a yearly basis



    for example the Mater do it.
    https://www.materprivate.ie/dublin/centre-services/all-services/coronary-calcium-scanning/

    I haven’t but feel like I should, think my time is coming, is it possible to get it on public system anyone knows?

    Or else how much is it?


  • Registered Users Posts: 7,008 ✭✭✭not yet


    uli84 wrote: »
    I haven’t but feel like I should, think my time is coming, is it possible to get it on public system anyone knows?

    Or else how much is it?

    It's a straight forward CT scan, Probably around 250 euro private.


  • Registered Users Posts: 269 ✭✭silverwood


    Hey all, my 13 year is a T1D (diagnosed just over 2 years ago). Things going well enough I suppose. I’m a big believer in what technology can and will bring to world of diabetes over the coming years.

    One thing I’d love to get more involved in is OpenAPS/Looping. I have been researching loads over the past 6 months and feel ready to make a start. My boy is already on a Medtronic pump but unfortunately its not compatible with looping.

    Anybody have any ideas where I could buy an older model Medtronic pump? I’ve been pulling my hair out trying to source one with no success. Any ideas?

    Anyway, thanks in advance for any replies. Wish you all the best of luck with your diabeticking. Take care.


  • Registered Users Posts: 16,515 ✭✭✭✭banie01


    silverwood wrote: »
    One thing I’d love to get more involved in is OpenAPS/Looping. I have been researching loads over the past 6 months and feel ready to make a start.

    Hey SilverWood.
    I didn't know know anything about openAPS until I started googling as a result of your post.

    I must say, the more I read the more I am fascinated by it!
    What a fantastic open source endeavour!
    I don't know where you'd source the pump you are after, but maybe post the request over on Reddit at r/diabetes ?
    Really big community over there and a lot of American users who seem to switch pumps a lot more than Irish T1's

    Best of luck with getting sorted!


  • Registered Users Posts: 2,937 ✭✭✭IrishHomer


    Folks,

    I was diagnosed type 2 a couple of months ago and I was given medication and a blood sugar meter.

    I wasn't given any guidelines about taking readings but from Google it appears I should check at least daily and two hours after eating.

    Is this correct?

    Yesterday my reading was 5.2 and I felt great as if I am winning the battle to reverse it.

    However today at midday I got 6.2 and later this evening I got a 9.2 :(

    Today was my worst readings since I started recording 6 weeks ago. Feeling very down tonight


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  • Moderators, Sports Moderators Posts: 24,500 Mod ✭✭✭✭CramCycle


    IrishHomer wrote: »
    However today at midday I got 6.2 and later this evening I got a 9.2 :(

    Today was my worst readings since I started recording 6 weeks ago. Feeling very down tonight

    None of which are terrible, had you eaten before the 9.2, were you stressed, had you done any intense exercise, long story short, there could be a load of reasons, if your bloods are typically in the 5.2 range, I would not be too stressed at all. 5.2 is incredible. What did you change other than medication after diagnosis? because those numbers are pretty epic for just medication.


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