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Breaking the vicious cycle

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Diabetes
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deltaforce
Veteran Member
Joined : Jun 2010
Posts : 2373
Posted 12/19/2020 7:13 AM (GMT -6)
Hello folks,

I am new to the diabetes subsection. I went through a few threads here to get an idea, but I don't find a case similar to my mother. My apologies for the long post. I appreciate any advice/suggestions you may have.

65YO mother, obese (BMI 32), has diagnosed Pancolitis, osteoporosis, hypertension, atherosclerosis, type II diabetes, and probably neuropathy. She went into menopause in her early 40s. Since then she started putting on weight. I am trying to get things in order. Things were under good control until my father was alive but after his passing 4 years ago, she has become careless. Her current Hb A1c is 10.

In addition to the diagnosed conditions, her body aches all the time. Due to pancolitis, which is in remission for more than 25 years without meds, she can not use regular pain killers. So it gets really tricky to address pain on a day-to-day basis. I suspect that her pain, muscular pain, has some of the other sugary angles. I just don’t know what it is and how to address it. Her pain was relieved significantly when she tried Cinsulin from Costco.

Due to the muscular pain or other ailments, she can not sleep well. Even with using melatonin (5mg slow release), it takes a couple of hours to sleep. After she sleeps, she can not get more than 2-3 hours of sleep at night. I am pretty sure this lack of sleep adds to all the health ailments she has.

If she is to do any physical exercise, her muscular pain is so much that she can not walk more than a block. She does not have access to the swimming pool and due to COVID, she is pretty much stuck at home.

Her diet was never bad, to begin with. Even now, her diet is completely plant-based and little to almost no sugar/starch ingestion. I think, everything taken together, she is stuck in a vicious cycle. Until she breaks that cycle, adding one drug after the other is not going to cut it. She does not have access to a functional medicine physician where she lives, and not willing to travel to the US.

I suggested her calorie restriction, on top of what limited diet she has, but she complains, if she tries that, she becomes so shaky that she can not take a few steps from one room to the other. I believe that is an indication of hypoglycemia. She is afraid, if she falls, osteoporosis will bring new troubles. I am extremely worried as she lives alone.

She is on Telmisartan and Amlodipine for hypertension, Metformin, and Glimepiride for sugar control, and Gabapentin for neuropathy. She does not have access to GLP-x class of drugs. If things don’t improve, the physician is only going to increase the dose or prescribe insulin shots.

Does anyone have any ideas, how she can break the vicious cycle and get things under control?
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Lanie G
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Joined : Nov 2006
Posts : 6869
Posted 12/19/2020 11:19 AM (GMT -6)
Hi Deltaforce and welcome. This is difficult especially because you're not there with her. Honestly I don't know what to suggest. If her diet is very low in carbs, then her blood sugar should be pretty controlable but there are other factors that contribute to elevated blood sugar. Pain for example. Stress, pain, sickness, being overweight and certain meds for other conditions can raise blood sugar. Exercise will certainly help but if she can't walk that much then maybe a stationary bike can help. This kind of bike doesn't impact the feet as walking does and it also helps circulation which helps avoid neuropathy (or at least the worsening of it) and is very good for the heart. It's safer, too, because it's in her own house. Of course she should get the approval of the doctor that she is seeing at least. There are chair exercises for people who have trouble standing. You can Google these.

I don't know how effective supplements like cinnamon and tumeric are for diabetes but for joint pain, tumeric (with pepper) and glucosamine are effective for some people. Costco sells a few of these.

Other factors can be a problem, too. She's living alone, your dad has passed, the isolation from COVID making the situation seem even worse, she may be depressed. And that's a whole other issue.

Can you face time with her on the phone? Are there other family members around to keep in touch with?

I wish I could help you more. Maybe others have some ideas....
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deltaforce
Veteran Member
Joined : Jun 2010
Posts : 2373
Posted 12/19/2020 12:09 PM (GMT -6)
Thank you, Lanie.

I actually talk to her almost daily. A stationary bike is a good idea. I will look into it.

The state that I described is going on for some time. Since she has not followed up with her physician due to COVID, not too sure if he would be making any changes to her meds.

What I am looking into by this post is, if anyone tried not-so-mainstream methods to get sugar under control, or if there is any component I misunderstood, like, if she is to do caloric restriction or intermittent fasting and she ends up shaking a lot, is my understanding correct that its an indication of hypoglycemia, so on so forth?
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Lanie G
Forum Moderator
Joined : Nov 2006
Posts : 6869
Posted 12/19/2020 2:33 PM (GMT -6)
I'm not sure about intermittent fasting, to be honest. Especially for an older person with other health issues. Would that affect her pancolitis? I don't know.

Hopefully other members will post about your questions. I don't take any supplements. I'm only on metformin.
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Sometimes i am me (HT)...
Elite Member
Joined : Mar 2009
Posts : 22181
Posted 12/19/2020 9:48 PM (GMT -6)
hi, yes, the intermittent fasting and calorie restriction unwatched will lead to hypoglycemia....
The shakes, blur vision...etc.
I am 48, male, diabetic, mobility issues, pain-nuropathy , arthritis, bp meds etc.
I can empathise with pain, and nuropathy and not wanting movement,
however, stabilising the food intake, more good stuff
will help with energy and thus movement.
I now have, just recently bought a smart watch, i set up the sedentary function,
get a buzz and it says move!

If ya mum has no digestive issues, then diabetic supplements are pretty much
useless.

Yes, i would look into the depression. Plays a major role.
Little walks are better than none, even inside.
Keep strong. HT
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straydog
Forum Moderator
Joined : Feb 2003
Posts : 18365
Posted 12/20/2020 9:23 AM (GMT -6)
Deltaforce, just some thoughts to pass along to you. Your mom's painful muscles & not being able to move around much, sounds a lot like she is deficit in vitamin D3. Low vitamin D3 can caused many issues, painful muscles & joints, depression & the list goes on. You would be amazed what low vitamin D3 can cause especially for us older people. Sunlight & diet are not always enough drs have learned. The Cleveland Clinic's website has great information about the vital role of D3. If possible I would suggest she get some, it will not be harmful to her.

An example, my husband does not spend much time outside, the dr checked his vitamin D3 level, he was very low. His B12 was also low, so now he takes both vitamin D3 & B12 supplements OTC. He is type 2 & on insulin.

Your mom should eat a snack in between her meals, this will help with the sugar crashes. I go through this with my husband, he get dizzy & shaky. My former boss was on insulin & he had terrible crashes. He got weak & would break out in a horrible sweat & drench his shirt. I kept orange juice on hand most of the time for him & sometimes he would drink a soda. Our bookkeeper had terrible crashes. She would start slurring her words, she would laugh & cry & couldn't stand on her feet, it was like she was intoxicated. When this happened I had to call her husband & sometimes paramedics. Stress was her trigger when these incidents happened. She ended up quitting her job because it was affecting her health too much. My point in telling you this is to give you an idea how the sugar crashes affects people differently.

In all honesty, try to dial it back on the weight issue. I know you mean well, however, she has more than being overweight going on. Your mom is more than likely depressed over the loss of her mate. Yes it's been 4 years, but the loss of her mate will affect her differently than it did you. Her life changed completely when she lost him. I have friends that have lost their spouse & some do not handle it well at all. Your mom sounds like she is dealing with some depression, I have great empathy for her. I am 67 & know all too well how health issues can impact a senior.

I don't know if she lives in a house or an apartment, but encourage her to go outside once a day for fresh air. The virus has restricted so many of us, however, I go outside on my patio every day to get some fresh air. A little fresh air can lift the mood a little.

Take care.
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Girlie
Forum Moderator
Joined : May 2014
Posts : 44542
Posted 12/22/2020 2:38 PM (GMT -6)
My husband takes Metformin...and with the addition of the supplement Berberine, his blood sugar is under control now.

It's definitely worth a try with an A1c of 10

You can order it online.

Always discuss with her Dr.

edit to add: his last A1C was 5.6
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deltaforce
Veteran Member
Joined : Jun 2010
Posts : 2373
Posted 12/29/2020 10:12 AM (GMT -6)
Thank you all.

Her diet is not bad at all, but the way her health is, no matter how healthy diet is, it doesn't contribute to much of benefit. Hence, I asked her restricting it even further, if possible. I do worry about the crash because if she falls and ends up with a fracture due to osteoporosis, it isn't going to be good. That's the reason I was wondering if anybody can do anything that the imminent crash is detected and she takes appropriate steps. I looked into a continuous glucose monitor, but her PCP didn't think it was necessary.

I too think she is depressed but if I ask her, I won't be pretty. I was thinking, I could put her on a Bupropion regimen. I personally take Bupropion, but not for depression, to tame TNFa levels (due to my colitis). Since she also has Pancolitis (in remission for 20+ years), it could be beneficial.

Even though she is in pain, she tries her best to go out for a walk. She lives in a gated community, so I suggested her to stay within the community's limit. In case anything happens, someone will notice and get her help.

At the end of the day, all I care that things don't get any worse than they already are. Since I do not trust her PCP to do any other job than just prescribing one medication after the other, I have taken things into my hand and trying to educate myself. I will be posting some more threads and I hope that experienced folks will chime in so that in addition to scientific information, I will get some anecdotal evidence as well.

@straydog,
Thank you for mentioning Vit. D. Her PCP is so useless that I don't have any kind words for him. The last time, I was visiting her, I accompanied her to the PCP. Her Vit D was 9. I had taken 5000IU caplets for her. I mentioned it to him. His response, her Vit D is fine. She doesn't need anymore!!! I still asked her to finish the bottle.
I will try to put her on B-complex. I read that other B vitamins are also necessary.
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Lanie G
Forum Moderator
Joined : Nov 2006
Posts : 6869
Posted 12/29/2020 4:19 PM (GMT -6)
I really can't add any more about what she should do, to be honest. She has different health problems that need addressing and should have a doctor that does this without blowing her needs off as if they're not important. This sometimes happens to older people (and especially to older women, I might add), but these health concerns are important. Regulating blood sugar is tricky because there are other factors besides the food she eats that affect it: lifestyle, other meds, pain, being sickly, etc. That all needs to be taken into account

When you say she eats well, I don't exactly understand what you mean. Can you give me what she eats everyday? For different meals? And what she drinks?

I can't help you with supplements personally, sorry. Beside the link in my signature, you might check into the books and website for Richard Bernstein, M.D. He is a type 1 diabetic and has written a very detailed book The Diabetes Solution. You might also check out his other website: http://www.diabetes-book.com/
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deltaforce
Veteran Member
Joined : Jun 2010
Posts : 2373
Posted 12/30/2020 4:50 AM (GMT -6)
I understand @Lanie G. Honestly, I never knew diabetes is such a multifaceted disorder.

Her eating habits, she eats small portions, to begin with. She doesn't eat/drink anything white (except Cauliflower). She is a strict vegetarian all her life. She doesn't eat wheat at all, instead, she prefers millet. She claims that Wheat bothers her and millet doesn't. Her overall carbohydrate consumption is not much to avoid triggering sugar spikes. She rarely eats deep-fried or fatty food. For drinks, she only drinks black tea with loads of ginger (no sugar/sugar substitute or milk) every morning and water for the rest of the day. The only problem is, she doesn't have access to many leafy green vegetables. Most of them are loaded with pesticides and oxalates and grown in polluted water, so most physicians suggest to avoid as much as one can. Since her diabetes Dx, her sugar-containing food intake is almost zero. In spite of all of this, a month ago, her HbA1c was around 10, random blood sugar was around 170.

I actually checked your website before posting this thread. It has good info for beginners.

What I suspect is a missing piece is exercise or physical movement and lack of sleep. She can't walk a block without excruciating pain, so walking is not her preferred exercise. I suggested a stationary bike. She tried that last week and she had to take pain killer twice (usually she takes only once a day). My mom's pain tolerance is very good in the family and when she complains, she for sure is in pain.
She can't sleep more than 2-3 hours a night, Melatonin hasn't helped her much.

I think she is in a perfect storm with catch 22s at every corner. Unless she manages to break at least one, I don't see any hope for progress.
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Lanie G
Forum Moderator
Joined : Nov 2006
Posts : 6869
Posted 12/30/2020 1:38 PM (GMT -6)
When I lived overseas years ago, the tap water was not potable and the fresh fruits, vegetable and greens had to be treated/washed because of parasites. There are different ways to handle this but the easiest and cheapest is using bleach. First you filter the water if necessary. Then put two drops of bleach per liter or eight per gallon and let the water sit for about half an hour. The best thing to do is always keep containers of treated water in the fridge so you know it's safe for cooking and drinking. As far as vegetables and fruit, we would always peel them if possible. We would wash and soak lettuce in treated water (I always upped the bleach content for washing food.) Some people used white vinegar. In any case, though, cooking will kill bugs but for fresh food. you do have extra steps to take but even that's not 100% effective depending on who's doing it.

And of course, growing your own food is the best.
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Sometimes i am me (HT)...
Elite Member
Joined : Mar 2009
Posts : 22181
Posted 12/31/2020 7:55 AM (GMT -6)
For sore muscles...
Magnesuim. I eat one daily...
Sometimes twice.

Blessings. HT
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