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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That does not mean that you have no choice but to sit and wait for the foot-specific complications of diabetes to occur. You can keep your feet healthy and avoid the many complications of diabetes related to the feet by keeping a few simple things in mind.

Prevention is the best treatment for diabetes and foot problems. And protecting your feet is the best way to prevent problems from developing. Reduce chafing as much as possible, doing so is important because the feet of diabetics are delicate and can be damaged very easily. This can very  lead to both foot ulcers and other problems. In order to prevent chafing, seamless socks or mens compression socks should always be worn beneath any footwear you happen to be using.  Another benefit to compression socks is that they can help ease the symptoms of poor circulation.

Proper foot sanitation is a necessary method of preventing complications. Diabetics may also suffer from frequent infections of various kinds, and one of the most likely places that these infections develop is the feet. The reason that infections such as these are as dangerous  is that if the infection spreads to an open wound, it can quickly spread and further impair the wound’s ability to heal. In addition to making sure that the water for washing the feet is not too hot, because you may have lost some sensitivity in the feet,  wash the feet regularly to help preventing infections.

The link between diabetes and foot problems is well known. To avoid the development of foot problems, the best thing that a diabetic can do is to prevent them in the first place. In order to ensure the continued health of your feet, it is very important that you take extra care of them.

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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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Diet, Exercise, and Weight Loss

The three main strategies to achieve normal blood sugar levels – the aim of every diabetic — are Diet, Exercise, and Weight Loss. The dietary approaches through meal planning and an understanding and explanation of the choice of food items, calories, nutritional categories, Glycemic Index, and such, are covered on my websites Diabetic Menu Guide and Diabetic Food List + Plus.

Exercise and weight loss are naturally linked because exercise requires energy that can be measured in calories and body weight loss, usually measured in pounds, can also be equated to calories. Since most diabetics are overweight, national diabetes associations recommend an increase in exercise activities to achieve a healthy bodyweight.

Food calories and body weight
The generally accepted equivalent number of calories to one pound of body weight is 3500. Meaning in simplistic terms, that in order to lose one pound of body weight requires a calorie deficit of 3500 calories, either through consuming fewer calories or increasing physical activities or a combination of both.

Caution
Consult your doctor when starting a program to substantially increase activity levels or decrease dietary intake of calories. You may be advised to monitor blood sugar levels more carefully before and after exercise to see what effects are caused, if any, by the exercise. All diabetics must be under the continuing care of a physician.

Exercise can range from outdoor activities such as the most basic forms of walking, jogging, bicycle riding, or for some who are younger and more agile there are the competitive sporting activities, tennis, basketball, or golf for example.

Indoor activities may require membership to a health club or a gym where there is specialized exercise equipment available. This can be beneficial especially where a personalized exercise and weight loss program is designed for each individual.

Some equipment can be acquired for use in the home, the simple items such as weights, skipping ropes, exercise balls or the more complex items such as stationary bicycles and treadmills. These can be very good in regions where weather makes it less comfortable to exercise outdoors. Whatever contributes to your main objective of losing excess weight and managing your blood sugar levels in order to reduce the risk of suffering the complications that are faced by all persons who have diabetes.

Don’t rush, avoid possible injury or lowering blood sugar levels too much

The main thing is to get moving and shed excess pounds but in a sensible and gradual way, not by fast and crash diets. For walkers maybe a pedometer would be of use as a  guide to how many paces have been covered. For more strenuous exercises such as jogging, perhaps even a simple portable blood pressure measuring device would be worthwhile. Certainly avoid the risk of doing too much too soon. When a comfortable level has been reached the pace an be increased and also the number of times to work out each week.

Keep an emergency pack of supplies in your bag with an energy snack and some suitable drink such as apple juice in case you experience those feelings that tell you your blood sugars are becoming too low. Know your limitations.

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Battling the Blood Sugar Levels

As diabetics, we all know that we should follow an appropriate diet that follows a sensible diabetic meal plan. One that focuses on our diabetic condition, providing nutritious meals with the right ratios of proteins, fats, and carbohydrates while at the same time meeting our personal preferences and tastes in the foods we like and are accustomed to. And not to forget that the portion sizes of the food items in our meals should not provide more calories each day than are needed to meet the calories burned in all the day’s activities.

Being Active
But in addition to following the right dietary routine if we are overweight and experiencing higher than normal blood sugar levels it is very important to get down to a healthy weight.

To do so requires adding some form of activity and physical exertion, to get moving, to make the muscles work, they will then burn calories and take up some of that excess blood sugar and that should automatically bring the blood sugar levels closer to normal.

Sometimes it is tough mentally to start adding activities to life if you have become accustomed to a leisurely and sedentary life style, Our modern way of life in North America provides so many outlets to capture our attention and interests, to amuse us or to entertain us, but mostly without having to do much more than watch or sit at a desk. If your blood sugar levels are above normal you should make some changes.

Exercise does not demand a gym or expensive equipment and the need to join a health club, not that there is anything wrong with them if you can afford to do so. In fact some have excellent facilities with a wide range of specially designed exercise equipment and often with a professionally qualified trainer on staff, and sometimes an indoor swimming pool. Some of them even have childcare facilities. I believe costs run from about $30 to $50 monthly with an upfront enrolment fee but costs differ depending on the region. A gym can be an advantage in areas where winter whether is too severe to venture outside for very long.

But for someone with a limited budget there is the time honored basic walking, it works very well as long as it’s for about 30 or 40 minutes every day or every other day and is brisk but without being exhausting. It is sensible to start initially for a shorter time period and shorter walks and gradually build up to your target distance. Physical activity can lower your blood pressure and will raise your heartbeat rate, which is good if you are otherwise healthy but this is where it is time to issue a caution:

Consult your doctor first, before you engage in strenuous activities and exercise.
That is especially important if exercise has not been part of your routine for a long while. And some people may have other health conditions besides diabetes that must be considered. Unfortunately, not everyone can begin to include a lot of exercise into their daily activities. For some older diabetics, arthritic knees are a quite common ailment.

The objective is to lose weight and stay fit. Being overweight does place some limitations on what activities are suitable, but in addition to walking, if not already part of your life, there is bicycling and swimming.

Exercise equipment for the home
There is a lot more than can be said about exercise than I have mentioned here and I especially want to make reference to equipment that could be purchased to use in your own home, bypassing the need for a gym membership. This is especially beneficial if you live in area where winters are cold and you just have to stay indoors.

There is also the benefit of home equipment being right there whenever you want to exercise, any time that it is convenient. For instance, you can work out in the morning before dressing for the day, the shower is close by and then, with your wardrobe at hand you are ready to get dressed appropriately, all the while listening to your radio or music system. What could be better than that?

For example, to begin that healthier life, here’s a good place to check out Electric Treadmills.

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An Always Present Challenge

A challenge for many persons with type-2 diabetes is the constant battle with their higher than normal blood sugar levels. Even though aware of what should be done, it can be a daunting task on occasions and a review and a reminder might be in order to help renew enthusiasms to beat the blood sugars challenge that most of us diabetics face from time to time. The standard approach does work and is probably the easiest to follow. That means paying attention to the four pillars of blood sugar control:

1. Follow an appropriate diet.
2. Inclusion of physical activity in your life.
3. Weight control, know what constitutes a healthy weight for your body type and work to achieve that weight, or close to it, in whatever way suits you.
4. Medication if needed and prescribed by your doctor.

1. An appropriate dietary plan We have to eat to provide energy and stay alive, but let’s make our food intake as enjoyable and healthy and affordable as possible. For the diabetic that means a diabetic menu adjusted to personal tastes and preferences but taking into account the acceptable ratios of carbohydrates, proteins, and fats and no greater number of daily calories than are needed to meet the energies expended in the daily work and lifestyle activities.

Suggestions for diabetic menu planning and related topics can be found on my companion website here: Diabetic Menu Guide.

2. Physical activity is part of life anyway and varies with what activities that are normally part of getting through the day and doing what you do. If you are not overweight or underweight by any significant amount, then there is less need to add any additional special exercise routines, at least as far as losing weight is concerned although a pleasant walk or swim or bicycle ride might add enjoyment and provide a sense of well-being in spirit and mind. If you are overweight, then some form of regular physical activity that burns up excess calories will need to be added to your routine, daily or perhaps several times a week, and the particular type of activity will depend on personal preferences of course. Comments elsewhere on my website regarding exercise can be found here: The Diabetic Menu and Exercise.

I might add that if you are not overweight then you are in the minority, the average American, according to poll published earlier this year shows that more than 60 percent of adults in the United States are overweight or even obese.

3. Weight Control – what is a healthy weight? To find out how your weight compares to the weight that is considered healthy for a person of about the same height, probably the easiest way is to check with a chart called the Body Mass Index (BMI). The BMI is a chart that shows a range of height and weight ranges and a numerical ranking of a combination of those two factors. The ranking number is what you need to know and it is easy to find it on the chart. Everyone’s target is “25”. You can check yours on the chart, with its simple instructions by clicking: Body Mass Index.

4. Diabetes Medications: Above normal blood sugar levels can be lowered with the aid of medications of which there are several different categories, mainly to either promote more production of insulin by the body’s pancreas or to lower the resistance to insulin by the cell receptors that normally should allow entry of the blood sugars into the cells. But this aspect is primarily a medical matter that we don’t need to go into here.

Important: There is no cure for diabetes
Anyone with diabetes must be under the care of a doctor who will provide appropriate treatment and advice and monitor the progress of the disease as it continues over time.

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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 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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Vitamin D Research and Higher Intake Levels

The more I read and learn about vitamin D the more it seems that those like me who have diabetes, and those who have the related condition called prediabetes, may be missing out on a possible inexpensive supplement that could help us in our efforts to control the higher than normal blood sugar levels that characterize our disease and make us diabetics.

Whenever vitamin D research findings are referred to, and that’s frequently these days, it is so often accompanied by mention of its potential benefits in lowering or treating the risks in cancer, cardiovascular disease, and diabetes, among others. It is important to note that the research involves significantly increased intake levels of vitamin D than are currently recommended as being adequate. With exposure of bare skin to sunlight it is possible to obtain those higher levels but to do so in that way is not advisable because such exposure increases skin damage and risks of skin cancer.

Important in the case of diabetes
There is evidence suggesting that vitamin D may increase sensitivity to insulin. Insulin is the hormone that is essential to assist the entry of blood sugars into the cells of the body. Also, evidence indicates that the vitamin helps the body to secrete more insulin, a major plus for anyone with type-2 diabetes or prediabetes. If that is so, then it combats the dual conditions that causes higher than normal blood sugar levels, those being either insulin resistance or lack of insulin production by the body, and sometimes a combination of both of those causes.

Maybe because of the very fact of having the disease it is too easy to get excited when vitamin D is again mentioned as perhaps playing a role in the development of diabetes and can lower the risks of complications, something not widely recognized previously. But who can blame us when we are so conscious of our blood sugar levels that most of us test for every morning and sometimes during the day, when we see the blood sugars begin to rise to high levels. Preoccupation with blood sugars can become excessive..

But it should not be overlooked that there are 50 million or more Americans who have prediabetes according the Center for Disease Control. Prediabetes is a condition that will lead to full diabetes for many, just consider how they could benefit if their prediabetes could be prevented from worsening with the aid of vitamin D.

Diabetes associations not yet advocating changes
I realize that it may be premature to think of vitamin D in this way, the merits of increased vitamin D intake are still a matter of debate. The American and the Canadian Diabetes Associations are taking a more cautious view and not advocating any change in vitamin D intake above the current recommended levels.

In a Research Summary, the American Diabetes Association, states that more studies are needed in order to know whether taking more calcium and vitamin D is effective in preventing diabetes and its complications. Elsewhere, in a lengthy position statement, without specifically mentioning vitamin D, they say in a section headed Recommendations: “There is no clear evidence of benefit from vitamin or mineral supplementation in people with diabetes (compared with the general population) who do not have underlying deficiencies.”

But some researchers and scientists are critical of the slow action in the review process to assess the evidence pointing to increased intakes being beneficial. In the United States, the advisory board for vitamin D is expected to conclude studies in the summer of this year that can determine such possibilities. However, many scientists remain skeptical that any recommendations to increase intake levels will fall short of the amounts they should be.

Additional Information:

http://www.vitamindcouncil.org/

http://forecast.diabetes.org/magazine/your-ada/vitamin-d-and-diabetes

http://www.vitamindcouncil.org/health/deficiency/am-i-vitamin-d-deficient.shtml

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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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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?