A life in the day

Well, it’s been fourteen weeks since diagnosis. I wanted to report progress after three months, but I didn’t have the results of the bloodwork at that point. So fourteen weeks will have to do.

My diagnosis of diabetes has meant changes to my diet and my exercise habits. The exercise has not been as regular as I would like, but hasn’t been bad. The changes in my diet seem to have been quite successful. Just last week, I stopped one of the medications I’ve been on. I think I’ll be on the other for some time still. But I retain hope that I can eventually get off it altogether.

The most important number I need to track is my blood sugar. There are two types of readings:

• My twice-daily readings measure glucose in the blood in units of milligrams per deciliter. My targets are for values below 120 for a morning fasting level, and absolutely below 180 at bedtime, preferrably below 140. But, at least within reason, the lower the better, so a morning reading of 110 or lower is still a better goal, and maybe 130 at bedtime. I’ve been pretty close. Until I got an infection recently, my morning levels were 95 - 105, and bedtime, 90 - 120. Right after I licked the infection, I stopped one of the medicines, and my numbers have been higher than they were. But the morning levels are still 100 - 120, and evening levels have been 100 - 140, except for two readings around 160. These are slowly going back down, too. I hope that in a few weeks I’ll be back to the levels before the infection, and I’ll be managing it without taking the glipizide. For comparison, the readings that led to my diagnosis were 340 and 270 mg/dl.
• A hemoglobin A_1c reading measures blood glucose as well, but on a longer scale. It records the average level of sugars in the blood over the course of two or three months. The mechanism is simple. Red blood cells’ lifespans are around 120 days. At any time in their life, a hemoglobin molecule in a red blood cell can get glycated, which means that it has a glucose molecule attached to it. It will stay attached as long as that cell lives. So the percentage of hemoglobin molecules that are glycated is a good indication of the amount of sugar in the blood over the last two months. When I was diagnosed as diabetic, my HbA_1c reading was 10.8%. The target is to keep it under 7%. My recent bloodwork has a reading of 6.2%.

There are other factors to consider besides blood sugar. At diagnosis, I was at least 75 pounds overweight, and probably more like 90 pounds. In the fourteen weeks since, I’ve lost 28 pounds. My blood pressure was slightly high at diagnosis. For diabetics, they prefer blood pressure below 130/80. Mine was more like 140/85 or 140/90. At my last doctor’s visit it was down to 120/78. And finally, my cholesterol numbers are very good. Total cholesterol was 137 mg/dl, which is well inside the desirable range (below 200); the LDL (bad) cholestorol number was 82, which is in the optimal range (below 100) ; and the triglycerides were 103, which is well in the normal range too (below 150). The only slight issue is that my HDL (good) cholesterol was a bit low. For men, the normal range is 40 - 50. Mine was only 34. That points to a need for more exercise and to the fact that I still have a great deal of weight to lose.

I was told that when I got my diabetes under control, I would notice many positive benefits, including greater energy and possibly clearer eyesight. I’ve not noticed any changes. But I hadn’t had any particular problems with energy. And I hadn’t had any incidents of fuzzy vision, beyond the normal expectations of my astigmatism. I’m sorry not to see greater positive benefits. But I understand well the risks of diabetes, and I’m quite sure I have the discipline to keep with the program.

And there is one clear and obvious result: my profile is shrinking noticeably. I need to buy new belts!