For those of us who have already been diagnosed as being diabetic and who have been fighting to control our blood sugar levels without always achieving complete success in doing so, we now have the added possibility of yet another fight, a fight to minimize the effects of cardiovascular disease and to reduce the risks of heart attack and stroke.

In my own case it started at the doctor’s office after completing a stress test and an electro-cardiogram and the doctor prescribing yet another medication and informing me that I have angina, apparently a symptom of cardiovascular disease (CVD).  The reason for the tests was that I had reported a shortage of breath and some pain in my upper chest in recent weeks when trying to walk fairly briskly. That’s somewhat ironic considering that my brisk walking was following the usual recommendation to exercise to help combat the higher than normal blood sugar levels of my long-term type-2 diabetes.

It’s a disappointing outcome that I realize many of my fellow diabetics must also be coping with. However, I tell myself that surely there must be something that can be done to delay the inevitable, something to avoid an early incident with dire consequences.

But where to start?
I am now in process of reading up on the topic, looking for hope that the condition can perhaps be reversed. If that is not possible, I assume that, like other health complications, it is best to come to grips early with the problems and prevent them from developing to a more serious phase.

In addition to following my doctor’s advice and taking prescription medications as directed, I also like to know whether there are any non-pharmaceutical products that might benefit my cardiovascular condition. Such products may be vitamins or minerals or plant substances, often called nutraceuticals.

For my first source of information I am considering the advice and approach set out in several books by a Dr. Stephen T. Sinatra, a cardiologist who believes that, in addition to conventional and traditional medical practices, there is also an important role for a nutritional approach and the use of specific readily available supplements that can meet the special needs of heart disease.

CoQ10, L-carnitine, D-ribose
In his book, The Sinatra Solution, published in 2005 by Basic Health Publications Inc., Dr. Sinatra goes into much detail in explaining the oxygen needs of the heart and how the cells of the body convert dietary nutrients to energy, making it relatively easy for the non-professional -person to understand the process. From that, Dr, Sinatra identifies substances that help support and enhance the energy production and maximize the amount of essential oxygen that can be made available for the heart to use. Those substances include CoQ10, L-carnitine, D-ribose, available in health food stores and some pharmacies.

The diabetes “bonus” comment
As a diabetic, often encountering periods of higher than normal blood sugar levels, I was pleased to read in a book focused on CVD, of Dr. Sinatra’s opinion that there are many nutraceuticals that can be taken for the regulation of glucose metabolism. Noted were alpha lipoic acid, gymnema sylvestre, vanadyl sulphate, also available in health food stores and some pharmacies. Also mentioned in the Sinatra book was Cinnamon, with reference to “exciting research”. I have written about cinnamon elsewhere, at Diabetic Food List + Plus, my article can be found here: Cinnamon: Does It Help Combat Diabetes?

It is Dr. Sinatra’s opinion that in battling type-2 diabetes or the insulin resistance of diabetes and syndrome-X, it is essential to follow a low glycemic load carbohydrate diet with 40 % or less calories derived from the low glycemic value carbohydrates. The 40% of carbohydrates is, I believe, lower than the current American Diabetes Association’s recommendations. Check this link for more about about Glycemic Load and Glycemic Index.

In conclusion
There is much more to be learned about the combination of diabetes and cardiovascular disease and I will report back on what I discover, and perhaps my own progress too.

While not forgetting my blood sugar levels, I am also aware that attention must be paid to cholesterol levels and the need to for higher amounts of the good HDL’s and less of the bad LDL’s, topics I have referred to in my last post for which the reference is given below in the list of related posts.

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Cardiovascular disease
In the simplest of terms, cardiovascular disease involves the heart, arteries and blood vessels and is the cause of heart attacks and strokes. There are several medical names applied to describe the different conditions and events of cardiovascular disease but the “bottom line” for those of us who may be developing CVD, it means that we are at increased risk of heart attack or stroke.

From the viewpoint of a diabetic:
According to the American Heart Association, heart disease is the primary cause of death for people who have diabetes. Diabetes, a condition of higher than normal blood sugars, is also recognized by many health authorities as being a major risk factor in the development of cardiovascular disease. All diabetics must be under the care of a doctor and it is hoped that on their periodic visits to the doctor’s office that in addition to their high blood sugar levels, they are also monitored for high blood pressure and possible developing heart problems

It is frequently the situation that a person with high blood sugar levels will develop high blood pressure and also be found to have high cholesterol levels, all typical of cardiovascular disease. Diabetes is serious enough when it is the only major problem that the diabetic has to face. The added health complication of cardiovascular disease (CVD) requires even more special efforts in order to bring its conditions under control and to minimize the effects of CVD as much as possible.

Heart disease, can be treated and reversed?
Many recent books and articles published on the subject claim that heart disease can be treated and prevented from developing to a more serious level, although different cardiologists may suggest different approaches. There are several cardiologists who insist that, in addition to accepted mainstream medical treatment, it is also necessary to supplement with various vitamins, minerals, and other non-pharmaceutical products. Among those supplementary products named are CoEnzyme Q10, l-carnitine, d-ribose, magnesium, potassium, vanadyl sulphate, l-arginine, some of which have, in the past, been associated with treatment of diabetes to reduce blood sugar levels, especially by physicians who recommend a nutritional approach.

In today’s newsletter of the Mayo Clinic, January 19, 2011, under the heading “Get more Potassium”, it states:

. . . to lower blood pressure you should consume less sodium and more potassium because sodium increases your blood pressure whereas potassium can minimize the damage through the lessening of  the effects of sodium on blood pressure. Good sources` of potassium include bananas, cantaloupe, strawberries, tomatoes, peas and spinach.

So, for those of us who face the possibilities or likelihood of CVD, the question remains, what should we do? Not all doctors will necessarily be aware of the various supplementary types of treatment suggested by other specialists in the field, or perhaps in some cases, may not wish to deviate from the “standard” treatment, whatever that may be.

In my case, I think I will choose to add to my current prescription medications, by implementing the supplementary approach within reason and to the extent of affordability – the cost for supplements appears to be at least $100 per month for the main supplement items alone.

Cholesterol or saturated dietary fat?
There appears to still be a difference of opinion on the role of cholesterol in the risk of heart disease. For a long time in the past it was thought that high levels of cholesterol in the blood were a primary cause of heart disease but, in recent years, some heart specialists have placed less emphasis on cholesterol and have claimed that the real culprit is too much saturated fat in the daily diet, among other things.

The American Heart Association publications state that cholesterol plays a major role in heart health and that it is important for everyone to know their cholesterol levels in addition to knowing the other risk factors for heart disease and stroke. A more detailed explanation of cholesterol and the recommendations of the American Heart Association can be found at:

http://www.americanheart.org/presenter.jhtml?identifier=4500

In September of 2007, researchers at the Saint Louis University School of Medicine published their conclusions that the risk of heart attack and stroke is greatly increased by cholesterol that suppresses the activity of a key protein that normally should protect the heart and blood vessels.

About cholesterol levels
The determination of cholesterol in the blood is made by measuring substances called lipoproteins, referred to as LDL’s (low density lipoproteins) and HDL’s, (high density lipoproteins) which are measured in mg/dL (milligrams per deciliter). The LDL’s are commonly referred to as the “bad” cholesterols.

In addition to the cholesterol values categorized and noted below, many other factors are also taken into consideration when assessing the risks for heart disease

According to the American Heart Association, when the LDL and HDL are added together:

• Total Cholesterol Level should be less than 200 mg/dL.
  Any level above 200 mg/dL raises the risk for coronary heart disease.
• Cholesterol Levels between 200 to 239 mg/dL are considered as being “borderline”.
• High blood cholesterol levels are those of  240 mg/dL and above.
  Persons with high cholesterol levels have a greater than twice the risk of coronary heart disease as those with cholesterol levels below 200 mg/dL.

The levels and categories for the individual HDL and LDL are:
HDL:

• An HDL level that is less than 40 mg/dL in men, or less than 50 mg/dL in women, is considered to be a major risk factor for heart disease.
• An HDL level that is 60 mg/dL or above is considered as being protective against heart disease

LDL:

• An LDL level that is less than 100 mg/dL is considered to be optimal
• An LDL level between 100 and 129 mg/dL is also considered to be good or above optimal
• An LDL level between 130 and 159 mg/dL is considered to be Borderline High
• An LDL level between 160 and 189 mg/dL is High
• An LDL level between 190 and above is Very High.

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The major concern for every person who is diagnosed as having diabetes is blood sugar control and for many that is a problem difficult to deal with.

For most diabetics, the three primary pillars of diabetes treatment to control higher than normal blood sugar levels involve diet, exercise, and weight loss for those who are overweight. And it is estimated that most diabetics and pre-diabetics are overweight.

Diet and the need to avoid foods that contribute too much sugar too fast

For most non-diabetic people, a diet is usually thought of as a means to lose weight and is often a temporary pattern of eating until their goal of weight loss is achieved.

But for the diabetic person, a diet is something quite different and is not a temporary situation but involves a more tailored dietary eating plan that often requires a change in the types of foods that are eaten in order to control blood sugar levels and to also maintain a healthy body weight. But that does not require drastic measures or eating special foods, in fact, most common “every day” foods are perfectly appropriate, and it becomes an exercise in eliminating or minimizing the foods that cause the greatest rise in blood sugar levels above the normal range.

Sugar, essential fuel for the body’s cells
Sugar is required by the cells of the body to use as a source of energy to fuel their respective metabolic activities and food supplies the needed sugars. Some foods contribute more sugars to the body than others and the sugars in foods can exist in several forms, some with a simpler molecular structure than others. It is the simpler sugars, those with the a simpler molecular structure, that can most easily and quickly raise a person’s blood sugars to above normal levels.

Because the person with diabetes has difficulty in processing the sugars, it is preferable to avoid simple and high sugar content foods and replace them with foods of lower more complex sugar content.

Foods provide the essential nutrients that sustain life and are classified into six categories as follows, in no special order:

♦ Carbohydrates

♦ Proteins

♦ Fats, including oils

♦ Vitamins

♦ Minerals

♦ Water

Carbohydrate content of foods
While some sugars can be obtained from proteins and fats, it is the carbohydrate portion of foods that is the usual and by far largest source of sugars for the body and the carbohydrates are the foods that are usually focused on when looking for ways to lower blood sugars.

For assistance in choosing the appropriate foods for a diabetic menu, it is helpful to check out this link that explain the Glycemic Index and Glycemic Load tables,  useful aids to help determine the carbohydrate content of foods.

Follow an appropriate diabetic food plan
The major objective in all methods of diabetes treatment is to bring the higher than normal blood sugars down to within an acceptable range. Making a modification to an existing diet or a change to a more suitable diet may well play the greatest role in accomplishing that objective.

A suitable diabetic diet or diabetic food plan will provide a nutritious and balanced range of foods tailored to the tastes and preferences of the individual person with diabetes. Factors involved in formulating a diabetic menu and diabetic menu planning have been discussed in our companion websites, Diabetic Menu Guide and Diabetic Food List.

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Contributed by Guest Poster:

Metabolic Syndrome occurs when the three health issues of .high blood pressure, obesity, and unhealthy lipid levels, exist together. When an individual has all three of these conditions existing together, that individual’s risk of heart disease, a heart attack, and stroke is increasingly higher.

Metabolic syndrome is partially avoidable

If the primary factors that contribute to the condition can be eliminated or sufficiently lessened. Those factors being: inactivity, overeating that leads to weight gain, and insulin resistance, a component of many diabetes and pre-diabetes conditions.

Diabetes and pre-diabetes, if untreated and allowed to spiral out of control can be very dangerous. One of the roles of insulin in the human body is to aid in the take-up of blood sugars into the cells of the body. When a person has insulin resistance, it means that that a person’s cells don’t respond to insulin as they normally should do. The pancreas, the organ that produces insulin, then produces more insulin to try to compensate or overcome this cellular insensitivity. This eventually becomes ineffective, even though the body receives more insulin, the cells continue to resist the activities of the insulin and cause the levels of blood sugars to rise. The continued demands on the pancreas sometimes cause a shutdown of the insulin producing activities – by then the diabetic condition exists.

What should those who have metabolic syndrome do?

Fight the disease full force, and work to address all three issues at the same time. And this must be done before diabetes becomes a reality.

Increase physical activity and modify an unhealthy diet

Exercise can help shed body fat and enable a healthier weight to be attained. It is also extremely important to change to a better, nutritious diet that provides the right proportions and amounts of healthy foods. A diet low in saturated fat is key to helping lower both cholesterol levels and triglyceride levels. A diet that is extremely high in the wrong types of carbohydrates, those with a high glycemic index values and a high glycemic load will cause the condition of higher than normal blood sugar levels.

A balanced nutritious diet requires proteins, carbohydrates and fats, vitamins and minerals, eaten in appropriate quantities to sustain health but not contribute excess calories. Such a diet moght include lean animal protein, low-fat, moderate carbohydrates, and be high in fiber. Where necessary, medications may also be prescribed to help control blood sugar, hypertension, cholesterol, and triglycerides.

Continue reading for more workouts to lose belly fat, information on how to lose weight and eat a healthy diet.

As diabetics we face a lot of numbers, especially in our blood test results, both our self monitored and our clinical tests, and we need to know and understand them well enough to help guide us in managing our diabetic condition, to assess our progress in meeting objectives or perhaps to alert us on whether we need to adjust our daily routines to bring them into line.

For me, it is easy to see from my meter readings whether or not I am achieving suitable control on a day-to-day basis. But the clinical tests taken at intervals of every three or four months always cause some trepidation while I await the more extensive range of test results, those other than for just the glucose levels, especially since for cholesterol my levels are somewhat higher than they should be, so my doctor tells me, and also I am already taking prescription drugs to combat the early stages of kidney deterioration, a fairly common occurrence for those with a long-term diabetic condition.

My doctors take care of me, ordering the necessary blood tests to check for the various items that help determine my state of diabetic health and, depending on their interpretation of those results, prescribe and adjust my medication as needed, but they usually do not spend much time discussing those numbers that show up on the blood test report, and even if I am told, it is not possible to really comprehend their significance at the time anyway.

So, rather than “stay in the dark” as it were, I have made two charts to show the target values for which I should aim and which I keep close at hand for occasional reference and as a reminder to stay vigilant. In this way, I can compare the actual clinical blood test values with my target values to see how well I am doing. By the way, I have to ask the doctor for a copy of my results, in my experience it is not usually offered voluntarily and one of my doctors charges me $25 for a copy!

It is a hassle to have to monitor these readings but that is a situation I share with many of my fellow diabetics. I post my target charts here in case it may be of interest to other diabetes sufferers.

The following charts are target values for a type-2 diabetic, check out this link for Normal Blood Sugar Levels.

On the charts below, I show both of the commonly used units of blood measurement, the mg/dL (milligrams per decilitre) used in the United States, and also the units of measurement used outside the United States, the mmol/L, (millimols per litre).

Blood Pressure Target Maximums:

The target maximum for diabetic persons is 129/80, that is, 129 systolic over 80 diastolic, compared to 139/80 for non-diabetic persons.

Those are maximums, lower is better, a systolic of 120 would be good.

For an explanation of the units of measurement used in blood tests and how to convert them go here.

For a simple explanation of blood testing for diabetes go here.

If you are a diabetic you must be under the care of a physician

Your physician will diagnose and monitor your progress and will prescribe the appropriate medications if required. The doctor may also advise you on how you should direct your own personal efforts to help minimize and combat the diabetes and that may involve some life style changes. It is important to follow your physician’s advice. Optimally, your diabetes health care team would include a diabetes educator and a dietitian.

For a description of our purpose and objectives and who we are, What you need to know, Why we are here, Why this website? please go here: About Us.

Web addresses for government diabetes agencies can be found Here: National Diabetes Associations.

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Blood and sugar
Sugar exists in the blood quite naturally. The sugar that is carried in the bloodstream is called glucose and is obtained from the foods and beverages eaten everyday. Sugars, depending on their chemical structure, can be simple or complex, glucose is a simple sugar and like all sugars is a carbohydrate. Carbohydrates are a category of essential nutrients, together with proteins, fats, vitamins, minerals, and water, needed to keep us alive.

When carbohydrates in foods are eaten, the body’s digestive process breaks them down to their simple form of glucose which then passes through the intestines and enters the bloodstream that circulates and carries the glucose throughout the body where it is taken up by the body’s cells that use the glucose as a source of energy.

Normal Blood Sugar Levels
In America, blood sugar levels are measured in metric units of milligrams per deciliter, mg/dL, where there are one-thousand milligrams to a gram and a deciliter is one-hundredth of a liter.

The normal levels of sugar in the blood range narrowly from 64.8 and 104.4 mg/dL, although they are usually higher for about 2 hours after meals and are usually lower in the morning after an overnight’s sleep.

Why blood sugars rise above normal levels
To enter the cells of the body, the glucose requires the assistance of a hormone called insulin that is normally manufactured in response to rising blood sugar levels by an organ in the body called the pancreas. But sometimes the production of the essential insulin becomes impaired and insufficient amounts become available, and in some individuals, usually children or young adults, the supply ceases altogether, leading to type-1 diabetes. Alternatively, the cells of the body become resistant to insulin, blocking its role of conducting the blood glucose into those cells. The result is that the glucose remains to a large extent in the blood, an unhealthy condition.

Why the higher than normal blood sugar levels are dangerous
When the condition of high blood sugar levels exists for a long period of time, it is called diabetes. If left untreated and allowed to persist, the high blood sugar condition damages the small blood vessels of the body and increases the risk of developing many other serious health conditions, some of which are life threatening.

The statistics tell the story, the principal diabetes authorities of the United States, Great Britain, and Canada, jointly published a report called the National Diabetes Fact Sheet, 2007, the latest year for which full statistics are available, reporting that

¨The risk of stroke for diabetics is 2 to 4 times higher than it is for non-diabetics.

¨The death rate for diabetic adults is also about 2 to 4 times higher than it is for non-diabetics.

¨The leading cause of kidney failure is diabetes.

¨The leading cause of new cases of blindness in adults 20 years and older is diabetes.

¨Over 60 % of all non-accident amputations are associated with diabetes.

¨In 2005, the latest year of available data, diabetes was associated with almost 235,000 deaths, making it the 7th leading cause of death in the U.S.

Cure and treatment
There is no cure for diabetes, although research efforts never ceases in trying to find the cause and the cure, but until that is achieved the treatment and management of the disease is mainly centered on lifestyle changes of diet, exercise, and weight control and, in some case, prescription drugs.

The lifestyle changes require the adoption of an appropriate dietary plan. A diabetic diet plan can include almost all available food items and can be tailored to meet the personal preferences of the individual diabetic. A nutritious diabetic diet attempts to limit the consumption of simple carbohydrates, the sugary sweet foods that can cause sharp upward spikes in blood sugar levels. Also the diabetic diet limits the amount of saturated fats to be consumed and the daily amounts of foods eaten should not provide more calories than are needed to equal the amounts of energy expended in all the activities of the day.

Overweight people are at higher risk of developing diabetes and prevention and treatment of diabetes requires that efforts be made to bring body weight to within a range considered as healthy. Exercise may play a part in that and the type of exercise must vary with the physical abilities or infirmities of the individual concerned but frequent exercise of any sort is beneficial.

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Type-1 diabetics will take further blood tests throughout the day, type-2 diabetics may also test during the day, more likely if they are trying to closely manage blood sugar levels that are getting out of control, otherwise a single morning test may be deemed sufficient.

Lower than normal blood sugars
Perhaps because with type-2 diabetics it is not a very frequent occurrence, especially in adults or in children over 10 years of age, the possibility of having an episode of lower than normal blood sugars is often overlooked. But it does happen, most diabetics have experienced those uneasy feelings leading up to the realization that blood sugars are too low and are causing an unpleasant experience and perhaps ending with a slightly traumatic shock to the “system” that’s sets you back for a while. Although most cases are mild and can be treated easily and further damage prevented.

The warning symptoms that give the alert can vary but my personal experience is of having a queasy nauseous feeling, trembling hands, slight perspiration and a general feeling of something in process of going wrong that might be leading to a faint or dizziness. Others have reported shakiness, nervousness, light- headedness, anxiety, confusion, difficulty in speaking, and sleepiness. With diabetes, without a measuring device, you usually cannot tell when your blood sugars are above normal levels but when they are below normal you certainly know because of the feelings of malaise mentioned above.

In extreme cases, a frightening situation to be avoided
All persons with diabetes and their families should know what has to be done in the event that an episode caused by lower than normal blood sugar levels is occurring. If the diabetic can take the necessary actions themselves, that is very good but that may not always be the case, that is why others should be aware of what has to be done, otherwise the condition will worsen, possibly to the extent that it can be life threatening, a frightening possibility. For children at school, teachers and staff should also be prepared with the knowledge of what to do and have appropriate food items close at hand.

If blood sugars are lower than 70mg/dL (4.0 mmol/L)
When a diabetic person’s glucose blood measuring meter is available, it takes just a minute to confirm blood sugar levels. If the reading is 70mg/dL (4.0 mmol/L) or lower, it is too low and is a hypoglycemic condition, a doctor’s name for low blood sugars.

If levels are too low the remedy is quite simple: food or drink is required to quickly provide needed glucose. That can be accomplished with any of the following:

• a half glass or half cup of about 4 ounces of apple, orange, or other natural fruit juice or sugary non-diet soft drink
• a teaspoon of honey or sugar
• 5 or 6 pieces of hard candy
• an 8-ounce glass or cup of milk
• an energy snack bar or glucose drink that can provide about 15 grams of carbohydrate quickly

Such items should always be readily available in the home of a diabetic person and appropriate similar items should be assembled if staying overnight elsewhere or traveling away from home base. When the consequences of a hypoglycemic event are known, common sense can be the guide – but always have an emergency supply available just in case.

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On Vitamin D and Diabetes

There are plenty of videos that can inform you about diabetes, you have to be patient and prepared to spend some time in watching them, but if you have the time, close to an hour, you can certainly become reasonably well informed about Diabetes.

Here are a couple I have selects featuring experts who make a good presentation

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What is a Vitamin D deficiency?

Free Download — UCtelevision — February 09, 2009 — Can vitamin D help prevent certain cancers and other diseases such as type 1 diabetes, cardiovascular disease, and certain autoimmune and chronic diseases? To answer these questions and more, UCSD School of Medicine and GrassrootsHealth bring you this innovative series on vitamin D deficiency. Join nationally recognized experts as they discuss the latest research and its implications. In this program, Robert Heaney, MD, gives an overview of vitamin D deficiency. Series: Vitamin D Deficiency – Treatment and Diagnosis [2/2009] [Health and Medicine] [Professional Medical Education] [Show ID: 15751]

Vitamin D and Diabetes-Can We Prevent it?

Dr. Fuhrman Cures Diabetes – But Drug Companies Object

headveg — September 28, 2007 — Joel Fuhrman MD has cured hundreds of people of diabetes using diet and lifestyle. The American Diabetic Association wanted him to write about his work — but then objected because their sponsor, Eli Lilly drug company, might feel threatened by an MD promoting a cure which could destroy the market for their diabetes medications. This is an excerpt from Dr. Furhman’s presentation at the Healthy Lifestyle Expo 2007.

To learn more, or to get a copy of Dr. Fuhrman’s full talk on DVD, go to:

https://secure.vegsource.com/catalog/

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We obtain those nutrients in varying amounts from the foods we eat and drink on a daily basis. The nutrients supply the materials and energy required to sustain life and growth, to build and repair the tissues and organs of our bodies. An unconscious but miraculous process of life when one stops to think about it.

But here we are discussing carbohydrates, let’s abbreviate that name to carbs, it’s all the same as long as everyone understands.

Carbohydrates are the primary source of our blood sugars and perhaps the cause of our higher than normal blood sugar levels, the problem of many people with diabetes.

The carbohydrates obtained from food are further classified as sugars, starches, and fiber, but we can ignore the fiber content as a source of blood sugars because it cannot be digested. And the starches are more complex in their chemical formulation. They are not broken down in the digestive process as easily or quickly as the simpler sugar content of the carbohydrate foods consumed.

The digestive system “breaks down” the components of the carbohydrates and the other nutrients in the food. These then pass through the walls of the intestine into the bloodstream. It is the speed of the delivery of the glucose molecules into the bloodstream that causes the rise in blood sugar levels. The simpler form of carbohydrate provides the fastest conversion to glucose and the fastest rise in blood sugar levels, whereas the more complex and starchier components of carbohydrate take longer to break down, they stay in the stomach and take longer to get into the bloodstream.

From the foregoing it can be deduced that the carbohydrates that take the longest to get into the bloodstream are probably going to be better for the diabetic person than are those that are quickly reduced to glucose and more quickly enter the bloodstream. That deduction is correct.

The Glycemic Index
A very useful index of food items and their related speeds of conversion to glucose and absorption into the bloodstream has been devised, called the Glycemic Index (GI). The Glycemic Index ranks food items numerically in relation to the speed it takes for them to be absorbed into the bloodstream compared to our blood sugar, pure glucose, which is given the value of 100.

Meaning that the lower the glycemic index number assigned to a food, the longer that food takes to have an affect on the rise in blood sugar levels compared to pure glucose.

The Glycemic Load
The Glycemic Load (GL) is an enhancement of the Glycemic Index that takes into account the amount of carbohydrate in a standard serving of food, providing better information than the basic index which only measures the effects of 50 gram amounts of the type of carbohydrate in a food. 50grams may be too large a quantity to actually consume in any one type of food item. For instance, 25 grams of the cereal Shredded Wheat has a GI of 67 whereas its Glycemic Load is 12. That makes Shredded Wheat a good choice because of the smaller glucose portion of the total amount, 25 grams, being consumed. That may be an over simplification but I think you get the principle.

In summary
What is established is that some carbohydrate foods create fewer problems than others. The low numbered glycemic load foods should create fewer blood sugar problems than do the high numbered foods. But personal tastes and preferences, and perhaps nutritional factors, also play a part that might make some higher numbered foods an individual’s first choice.

And the response may not be the same for everyone, it is possible that some people react differently than others to some of the carbohydrate foods.

Why blood sugars are needed
Glucose, which is a simple form of sugar, is needed by all the cells of the body to use as fuel to produce energy for the cellular processes of life. The glucose is carried in the bloodstream where it has to associate with the hormone insulin. The insulin mediates with the receptors of the cells and only in that way can the glucose be taken into the cells that need it. Another of the body’s rather complicated but ingenious processes.

Ratios of carbohydrates to proteins and fats
There are differing views on what should be the ratios of carbohydrates to the other nutrients, the proteins and fats, in a diabetic meal.

Some favor a low carbohydrate approach in order to minimize the amount of glucose that can be produced to enter the bloodstream and thus not create elevated blood sugar conditions. It works well, and some doctors insist that it is the best way for diabetes patients to overcome their diabetic problems.

An opposing view from the American Diabetes Association (ADA), who have shown in their own clinical studies that restricted carbohydrate diets do indeed result in lower blood sugar levels, is that such diets are too difficult to adhere too for any practical length of time. For that reason, the ADA believes it is better to adopt a higher carbohydrate diet that is, they say, more appetizing and for which the diabetic component is manageable. I have discussed those differing views in other articles that can be accessed through the links shown in the Author’s Comments below.

The healthy body can cope with the glucose load
The mechanisms of a healthy body can process the sugars derived from carbohydrates and other nutrients. Some of the glucose is used by the cells, as described above, and the rest is taken up by the liver, converted to glycogen and stored for possible future use at a later time. If needed, it will then be converted back to glucose.

The dual activities involving absorption of glucose by the cells and that of the liver in converting the glucose to glycogen takes place with the aid of insulin. Insulin is a hormone produced by a healthy person in an organ called the pancreas. Yet another of nature’s efficient systems.

But the diabetic body cannot cope
However, in the case of the human body with diabetes, the sequence of actions fails as one or another or several of the components become impaired, in some cases the cell receptors become desensitized making them resistant to insulin, sometimes the pancreas fails to produce enough or any insulin and sometimes it is a combination of both of those factors.

This is diabetes
The end result is that the glucose stays in the bloodstream, leading to a condition of much higher than normal blood sugar levels that can create serious consequences for other organs and tissues in contact with the blood as it circulates throughout the entire body.

It is a dangerous condition that cannot be cured, only controlled and managed within a tolerable range by adopting changes that usually include modified dietary intake, weight loss, and physical activity.

There are more than 18 million Americans diagnosed with diabetes and millions more, it is estimated, who have the disease and are not aware of it. The incidence of diabetes is rising to epidemic proportions in North America.

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Diabetic neuropathy, a common problem for diabetics

I have read that extended periods of higher than normal blood sugar levels can lead to diabetic neuropathies, nerve disorders caused by diabetes. According to the U.K.’s National Diabetes Information Clearinghouse (NDIC), about 70 percent of diabetics have some type of neuropathy that can develop any time although more likely after a lengthy period of time living with the disease.

Common symptoms, if there are any, are tingling and numbness and loss of feeling at the body’s extremeties, the hands and feet, the arms and legs most frequently. Although neuropathies can occur in any of the body’s organ systems, including the heart and reproductive organs. Not a very encouraging situation for us diabetics.

A doctor’s advice
Recently, I was offered hope by a suggestion made by my new doctor that there might be a solution to what is probably a circulation problem in my feet.

For many years now I’ve had a problem that I believe is experienced by many of my fellow diabetics, the problem being that the sensation I feel in the soles of my feet is very strange. I can only describe it as a feeling as if I have something stuck to the soles of my feet, what I’m not sure.

Without ever testing it out, but in my imagination, I thought it might be something like the feeling would be if there was paper stuck to the soles of my feet. The type of paper that, in my youth, was referred to by my mother as “Grease-proof paper”, but not what we now refer to as wax paper. Anyway, it’s only a visualization in my mind.

But such specifics do not matter, the point is that I seem to have lost any real sensation in the soles of my feet except, perhaps in contradiction, they feel very cold when I am laying down in bed and it is very difficult to get them warmed up for comfort. Fortunately I seem to fall asleep fairly easily, but otherwise my cold feet preoccupy my thoughts until I do.

The doctor’s suggestion, vitamin B-12
After receiving the report from my new doctor on my A1C blood sugar levels, (they weren’t bad) I explained about my cold feet. Her response sounded so simple, but the advice I was given was to purchase an over-the-counter vitamin supplement called B-12, also known as cobalamin, one of the B family of vitamins. I was instructed to take 1000 mcg of B-12 daily.

I later discovered there are several forms of cobalamin with the main two types available in the health food store being cyanocobalamin and methylcobalamin. After a little research I learned that the methylcobalamin is the neurologically active form of B12, making it the best form because of its superior biological activity. Methylcobalamin is apparently better absorbed and stays in the body’s tissues in greater concentration for a longer period of time, compared with the other forms of B-12.

It is inexpensive compared to any pharmaceutical medication, costing a little over $8 for a bottle of 90 small 1000 mcg tablets that are taken sublingually, meaning that they are placed under the tongue where they dissolve.

Please note that this is not a recommendation or advice
As a precaution, I should emphasize that I’m relating the advice of my doctor to me in connection with my own problem only. I cannot and I am not making any recommendations or offering any advice here, it is necessary for anyone who has such problems to consult their doctor to receive appropriate qualified professional information. But I have drawn attention to it here in case you may wish to ask your doctor about it.

I will mention that there were no cautionary notes on the B-12 packaging. Regarding the recommended use, the label states that it helps to form red blood cells, prevent vitamin B-12 deficiency, and maintain good health.

I hope it will help me get relief from my cold foot problems. That would make me happy for sure. I’m encouraged and will try to remember to report back on what happens if anything. Meanwhile I will continue to battle my main problem, high blood sugar levels. It never ends, does it?