The Ongoing Sugar Struggle

wonderful pear pieI write periodically about the dangers of sugar consumption and my own efforts to control if not banish this substance from my life. Right now I’m working on re-doing my recipes over on the hospitality blog, and for every dessert I’m including information on how many grams of sugar each serving contains. The typical amount is around 25 grams, or about 6 teaspoons, which, coincidentally, is the limit given by most researchers for the daily maximum we should have for added sugar.

So I can have a slice of my luscious pear pie pictured above, but I can’t have any sweetened whipped cream or ice cream with it. (But heavy cream poured over it in a stream? That’s, like, totally okay.)

I went through the holidays being pretty much a sugar abstainer and have continued that into January. On most days I consume minimal added sugar, and I was therefore hoping to have good news when I went in for my six-month A1C check. Last time it was 6.2, which is not good as it’s only .3 of a percentage point from full-blown diabetes. (I’ve explained before what this number means, but I ran into a great description which I’ll include here: the A1C number tells you what percentage of your red blood cells are “encrusted with sugar.”) So . . . when the doctor’s office called I was all set to hear good news, a reward for my good behavior. But alas. Good deeds don’t always get rewarded. My A1C was exactly the same. What it would have been if I’d just thrown caution to the wind over Christmas is kind of frightening to contemplate.

My doctor doesn’t seem too concerned; he has said that he doesn’t think I’ll ever tip over into full-blown diabetes, but I’m not so sure. While I like him very much, I’m realizing that I have to take responsibility for figuring out what’s going on with me and then deciding on what action to take from there. We’ve had this type of situation before in our family; if we had just taken the doctors’ word for what was going on with my son back when we were trying to figure out why he was in such pain, he would almost certainly now be at least partially paralyzed. (Or worse–but I don’t let myself think about that one too much). We had to realize that no one was in charge of Gideon’s case but us. So we had to keep coming up with new avenues to pursue when the current doctor wasn’t finding the answer.

Same here. Part of living a happy life is a feeling of control, of taking action instead of sitting passively and letting others make decisions for you. So I’m trying to figure out what’s going on with me. It’s sometimes frustrating and misleading to explore medical information online, with extreme care needed. I try to confine myself to reputable websites such as the one for the Mayo Clinic. And I’ve found out that my condition (higher-than-normal blood sugar without accompanying obesity or high sugar consumption) is probably not run-of-the-mill Type 2 diabetes. Instead, I may have something called “LADA,” or “latent autoimmune diabetes of adults.” This condition is basically a late-onset and gradual development of Type 1 diabetes. “Normal” Type 1 usually affects children (and so is often called “juvenile diabetes”) and occurs when the beta cells in the pancreas stop producing insulin. There is therefore no way for the glucose in the bloodstream to get into the cells to be burned for energy. Treatment of Type 1 therefore always has to include insulin injections. Treatment of LADA is still somewhat problematic and controversial. If I had Type 2 diabetes my best bet at this point, when I’m still under the diabetes threshold, would be for me to go on some type of medication to stimulate the beta cells to produce more insulin. But if my beta cells are instead wearing out because they’re being attacked by my immune system, then stimulating them is probably the worst thing I can do. Some endocrinologists think that starting LADA patients on supplementary insulin may help prolong the life of the beleaguered beta cells since the added insulin would in a sense “take the pressure off” them. Boy, I can’t possibly express how much I don’t want to go on insulin!

So here’s the program I’ve come up with:

1. Continue my efforts to stay off sugar and to limit any kind of refined-carbohydrates.

2. Get back into my regular walks. For a variety of reasons I’ve fallen down on those. My cholesterol is also higher than it should be, so that’s yet another reason for me to get back on track.

3. Carefully monitor my blood sugar and track my results. I have an at-home glucose monitor and just need to get some more test strips. The results I had been getting several months ago seemed fine, but I guess I’d better continue to keep an eye on things.

4. If my morning fasting blood levels continue to be high I will need to push for further testing. (My fasting glucose level at the doctor’s office was 123, which is way too high; that reading should be 90-100.) There is a blood test for the antibodies that are associated with LADA, but it’s not something that would normally be ordered through a GP’s office. I’d probably need to see an endocrinologist.

So I can’t just assume that everything is going to be okay. If in five years I’ve lost beta cell function entirely and have to be on an insulin pump (which may happen anyway) and in the meantime have developed problems that go with unchecked blood sugar, I’ll be very unhappy, to put it mildly. One area where I’d be more liable than most to develop problems would be vision. Unchecked sugar causes circulation problems as the toxic levels damage blood vessels, and my retinas are already very fragile because of my extreme nearsightedness. Taking the long view, taking action now to avoid future problems, is always a good idea. Hard for a procrastinator like me, so I have to keep reminding myself of the dangers of passivity.

​What proactive course do you need to take today to avoid problems in the future?

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