Black and White. Hot and Cold. Fire and Ice. Heaven and Hell. Like all other extreme opposites in the world: hyperglycemia and hypoglycemia. Hyperglycemia consists of  high blood sugars, which is typically classified as diabetes. However the other side to hyperglycemia is hypoglycemia, which is low blood sugars. Despite the extreme opposites in blood sugar levels that separates these two diseases, the diseases are also interconnected and very similar.

Just like hyperglycemia, hypoglycemia is also a chronic condition that requires full attention and proper management. Insulin that is used to treat the high blood sugars of hyperglycemia can often cause the low blood sugars of hypoglycemia. These low blood sugars are characterized by sweating, nervousness, extreme hunger, anxiety, trembling, weakness, palpitations, and slowed motor reflexes and cognition. In addition to these symptoms, it is dangerous and bad to have low blood sugars; hypoglycemia, if left untreated, can result in insulin shock, unconsciousness, and possible death in the case of extremely low blood sugars (anything that is below 40 is reaching the extreme territory).

Living with diabetes’ high blood sugars are difficult and stressful, but in my opinion, living with hypoglycemia’s low blood sugars is worse. Hypoglycemia requires more attention and care to keep blood sugars from dropping too low, and also insuring that the foods one consumes will keep his or her blood sugars stable (no spike of high blood sugars that will instantaneously drop to low blood sugars - the roller coaster affect of going up and down, and then up and down again). For those who do suffer from hypoglycemia, you have my full support and understanding, and I hope for the best for you.

November 14, 2011  - World Diabetes Day - celebrates the awareness and attention brought to diabetes and the search to find a cure. For this special day, Juvenile Diabetes Research Foundation selected 60 primary and active members of its organization to represent those with Type 1 Diabetes in Parliament. This is an opportunity to voice the concerns of diabetics and explain what it is like to live with Type 1 Diabetes.

Such a valuable opportunity should not be wasted or taken lightly, but I do not think think that our JDRF representatives will disappoint the diabetic community. One of the 60 representatives, George Dove, is Nottingham’s Young Person of the Year for his active work and volunteering for JDRF. Also, Amy Wilton is a Type 1 Youth Ambassador, who has also served as a delegate in the JDRF’s US Children’s Congress at the UK. While both of these people have experience serving with JDRF, they also have experience living with Type 1 Diabetes themselves and are aware of the diabetic crisis that needs to be addressed and brought to attention.

Furthermore, this event has been organized by Adrian Sanders, MP Chair of the All Party Parliamentary Group for diabetes. Not only is Sanders passionate about the diabetes politics, but she lives with Type 1 Diabetes as well. I trust that she has professionally and effectively organized this Parliament address, and that exemplary representatives have been chosen to speak to Parliament.

As far as discussion goes, I hope the following issues are brought to attention:

• The need for more research and development
• The need to further raise awareness about this disease
• The need to properly educate people about what diabetes is and its different types
• The need to allow more access to treatment, supplies, medical appointments, and proper education for diabetics by providing more health care and medical coverage to people with diabetes
• The need for government and politics to participate in the diabetic community 

Since it is only just now November 14, the details of the Parliament address will not be known until later. For now, all that can be done is to hope that JDRF’s voice can be heard and make more of a positive impact on the diabetic community.

JDRF. Sixty JDRF Supporters Spread the Word About Type 1 Diabetes in Parliament. Market Watch. 2011. Accessed November 14, 2011 <http://www.marketwatch.com/story/sixty-jdrf-supporters-spread-the-word-about-type-1-diabetes-in-parliament-2011-11-13>

Medical Analyst, Steven Lewis, breaks down the health care system, its need for reform, and its incapability to achieve a universal status. According to Lewis, health care is imperfect and and is far from being universal because:

1. Social justice combined with administrative efficiency is a rare achievement.

2. Health care is a private, market-driven economy and not a public good.

3. Universal health care requires raised taxes, which is a difficult agreement to reach in government.

4. It would “lubricate the private economy”

5. Prices might decrease, and upset producers

6. People believe that others choose the states of their healths.

By these standards, it is incapable for America to establish universal health care, despite how much it is coveted or deserved.

To Steven Lewis, I say that universal health care would improve America, because the well-being of people is more crucial than the economics of health care. As naive as that sounds, it is morally sound to say that the welfare of people should be placed before money, and that the health and care of American citizens should be of utmost importance to the United States Government. If America cannot establish itself to be a nation that protects and cares for its people, than perhaps this nation needs to reevaluate their priorities.

Lewis, steven.   Single-payer, universal health insurance: still sound after all these years. CMAJ: Canadian Medical Association Journal. 171.6 (Sept. 14, 2004): p600.

Today, November 1, marks the first day of Diabetes Awareness Month. November means more than thanks. For millions of people, this is a time for unity, declaration, pride, discovery, and appreciation. In a community, people with diabetes (Type 1, Type 2, Gestational, or MODY) can find comfort and strength to draw on and inspire themselves and others. We are a community that includes those who are diagnosed, those who know people with diabetes, those involved with diabetes medicine, and those who fund diabetes research. We are several people, but we are one voice, one  body, and one heart.

All of us have different stories, but diabetes is what brings us together. November is the month for being the voice for diabetes. During this month we speak about the severity of diabetes and the importance of caring for ourselves. We reach out to those who are struggling with their disease and diagnoses. We fund-raise for research to hope for better futures in diabetes. We we celebrate who we are and know that while we have this disease, we are great and just as normal as anyone else.

Even more, this is a time to learn about diabetes. If you already have diabetes, discover more about the disease and find appreciation for yourself, peers, and community. If you do not have diabetes, learn about it, ask people with diabetes questions, and try to understand the disease and its lifestyle. This is a time to decrease the ignorance of diabetes and decrease the shame and pity that is geared towards diabetes. It is not a weakness. It is not a death sentence. It is a characteristic that describes a person.

While we may have diabetes, we are not diseased. We are people just like every other human being on the planet. Diabetes may be a disease, but that does not make us any less capable, any less strong, or any less healthy.

So stand up with us in the month of November, and help to celebrate Diabetes Awareness Month!

Michael Aviad with asweetlife.org conducted an interview with Iron Man and Type 1 Diabetic, Jay Hewitt. Hewitt was diagnosed at the age of 23, and his diabetes motivated him to reach a new line of potential that he never would have accomplished had he not been diagnosed with diabetes. Jay Hewitt’s diabetes motivated him to show his diabetes that he was in control, which prompted him to run his first marathon, his first triathlon, and first Ironman. Years later, the list has grown to several races and events, as well as Hewitt’s status as a member of the US National Team for Triathlons.

For someone who had never been an endurance man before, that certainly changed with diabetes. Hewitt details the extent to which he trains; how his training involves strength, heart, and mind. Anything can be done, so long as one puts in the effort and plays it smart, doing what he or she needs to do to stay at the best condition and health possible.

When asked how he felt about those who said people with diabetes should not participate in extreme sports, Jay Hewitt responds,”I’d like to hear one of them tell me that.But I am smart about it, and plan and prepare – that is the key to diabetes management and to life in general.”

Jay is an inspiration to all with diabetes, proving that not even disease can stop a person from rising to the extreme and ultimate, beyond the races and competitions also as he addresses people with his motivational speaking and inspiring book. Hewitt’s main message is, “make the bad thing that happens to you the best thing that happened to you, and use it as a motivation.” Even to children, he tells them to be role models to other children, exemplifying healthy attitude and lifestyle. With new diagnoses, it is difficult to manage diabetes and there are good days and bad days, but it does get better and it can be done.

After reading this interview, I feel as though Jay Hewitt belongs on the wall of heroes, because he is a reminder that diabetes does not control us. We may have a disease, but that does not mean we are weak. Thank you Jay, for proving to the world that diabetes is not a death-sentence, and that we can choose what to make of it.

Aviad, Michael. “Doing it All with Type 1 Diabetes: An Interview with Jay Hewitt.” A Sweet Life. 2011. Accessed October 31, 2011 <http://asweetlife.org/a-sweet-life-staff/articles/exercise/doing-it-all-with-type-1-diabetes-an-interview-with-jay-hewitt/20612/>

When one lives with diabetes, he or she must adapt to the disease. Diabetes can turn a life upside-down, but those lifestyle changes can become normal with time and can help to make a more normal lifestyle.

Living with diabetes means living on the “d”-fense: always have a plan of action, think one step ahead of the diabetes, and having a back-up plan.

If one with diabetes is about to have a scrumptious, heavenly slice of buffalo chicken pizza, be ready to deliver insulin for the high-carb food. Also, because pizza has fat, tomato sauce, and buffalo sauce, expect a high blood sugar and curb the potential hyperglycemia by giving insulin at least 15 minutes before eating (that way it has a chance to hit the system). The back-up: despite the plan, it is still possible to have a high blood sugar after the pizza, so it would be wise to have extra insulin on-hand to deliver for a high-blood-sugar correction.

On the other hand though, let’s suppose one is going to be participating in intense activity, such as playing football or dancing. The plan of action: be on “d”-fense and be prepared for a drop in blood glucose levels. After thinking ahead of potential consequences of being active, be ready to treat any low blood sugar with extra food, juice, or glucose tablets on hand. The back-up plan: even after being smart and proactive about one’s diabetes it could still not be enough, so make sure that a glucagon kit is on hand in case of insulin shock, that there are still more treatments for hypoglycemia, and that someone will be able to help in case the situation does get to be serious.

However, living on “d” is not always 100 percent effective. Like life, diabetes has a way of goofing up or acting in unpredictable ways. No matter what we do, diabetes will still act on its own. For instance, this morning I had a nice breakfast with eggs, sausage, oatmeal, and grapes. I knew how much insulin to give based on the carbohydrates of the breakfast, delivered after eating because I knew I would walk to class this morning and would want my blood sugar a little high (to prevent hyperglycemia). Despite my best efforts to stay in control and have a leg up on my diabetes, My blood sugar spike to 300 about 1 and a half hours after breakfast! Let me be the first to say, “Flippin’ flapjacks!” I may have been trying to prevent a low, but I did not want to go high either.

Again, sometimes the best we can do is just think ahead, but to always go with the flow and stay calm. A clear head helps to keep treating the diabetes as needed, and a clear slate of emotions helps to keep other factors from affecting blood sugars further in any undesired ways.

The Journal of the American Medical Association published “Effect of Improved Gylcemic Control on Health Care Costs and Utilization” in order to inform readers about a study’s results concerning the effects of diabetes management on health care costs. The study contained 4,744 participants - with diabetes - and this large sample provides credibility to the fact that what results are found can be based for multitudinous people. JAMA concluded that successful blood glucose control actually decreased health care costs, and by approximately 685 to 950 dollars each year for good control.

However, how can people with diabetes better manage their blood glucose levels when they do not have adequate health care coverage or access to the proper tools and medical assistance that can improve the condition of their diabetes. The results of this study is reason to give people with diabetes more legal access to health care. When the costs of proper diabetes management can be afforded with the assistance of beneficial insurance coverage, there are rewards:

• People with diabetes are successfully managing their disease and blood glucose levels.
• Successful management and control leads to less complications and hospital visits due to poor control, which in turn decreases health care costs for the individual.
• The insurance companies then benefit by not paying as much for extra necessities to manage that diabetics life.
• When you sum the 24 million diabetics in America, that will mean a lot less costs toward managing the healths of such a large medical community.

Therefore, it is confirmed that providing diabetics with more legal access to health care is beneficial for diabetics, insurance companies, and America.

Grothaus, Louis C. and McCulloch, David K. and Newton, Katherine M. and Ramsey, Scott D. and Sandhu, Nirmala and Wagner, Edward H. “ Effect of Improved Glycemic Control on Health Care Costs and Utilization.” JAMA – The Journal of the American Medical Association. 285.2 (January 10, 2001): p182. doi: 10.1001/jama.285.2.182.

Edited by Umberto Di Mario, Frida Leonetti, Giuseppe Pugliese, Paolo Sbraccia, and Alberto Signore, Diabetes in the New Millenium is a book that details the new productions in Diabetes research at the turn of the year 2000. A collection of trained and educated researches delve into new discoveries and productive findings about Diabetes and what its future can be.

Paolo Brunetti and Geremia B. Bolli discuss in Chapter 7 the topic of intensive insulin therapy in Type One Diabetes. As researchers in the Department of Internal Medicine in the University of Perugia, Italy Brunetti and Bolli are well qualified to share and conduct knowledgeable experiments in Diabetes management. It was found that injections of insulin are a very effective form of blood glucose control, which can be treated with a short-acting insulin (bolus insulin) for food and basal insulin for normal blood glucose levels while there is no food in the body. However, it was also concluded that intensive insulin therapy was difficult due to economical and cultural reasons, particularly costs and affordability.

Even in the year 2000 cost was an issue of effective diabetes management. It is a shame to see 11 years later that cost still interferes with good blood glucose control. Due to expensive care (insulin, blood monitoring, quarterly doctor visits, annual eye exams, insulin pump supplies, needles, or a continuous glucose monitor) people with diabetes do not get the 100 percent care required to successfully control blood glucose levels. The ineffective care and management then turns into poor control, which can result in serious complications - kidney failure, heart disease, diabetic neuropathy, cataracts, bacterial functions, and more.

While it is fantastic that there are such great treatments and technological devices to assist in successful diabetes management, it would be more beneficial to provide these tools as affordable expenses. Cost as a barrier in effective diabetes treatment calls for more health insurance coverage for diabetics. Less burden about money will allow full care to manage diabetes and improve the quality of health for those living with diabetes.

Mario, Umberto Di and Leonetti, Frida and Pugliese, Giuseppe and Sbraccia, Paolo and Signore, Alberto. Diabetes in the New Milleniuum. Wiley; Baffins Lane, Chichester, UK (2000): pg 65-80.

As a college student it is common to see other people go out to parties and indulge in alcohol. While we know that drinking before the age of 21 is illegal, and not that I’m encourage students and other adolescents to drink underage, it still occurs. Drinking in itself does come with potential dangers, but mixing diabetes with one’s alcohol can become more dangerous. Alcohol does lower blood glucose levels, and when drinking irresponsibly that low can turn into severe hypoglycemia. To insure that those with diabetes are drinking safely and those who know people with diabetes understand the effects of drinking please note the following safety guidelines:

1. When drinking, make sure that you eat with the alcohol. This will prevent low blood sugars and also slow the rate of absorption.

2. Drink in moderation and try to limit your drinking approximately two drinks a night.

3. When drinking or partying with friends, make sure the people you are with know you have diabetes and understand the consequences of drinking with diabetes.

4. If you do get “hammered” do not sleep it off, because if your blood sugars are too low it will be dangerous to allow yourself to sleep considering there is the chance you may not wake up.

5. If a hangover does come into play and you are physically ill, treat yourself with insulin as usual and treat yourself with the “sick rules” that you would implement if you had a cold or virus.

6. Drinking and driving in general is a horrible idea, but it is even worse for someone with diabetes who has been drinking. Not only will the alcohol impair your ability to drive, but so will hypoglycemia because that affects mental and physical reaction time and coordination (all necessary skills to drive safely).

Please take this information seriously and understand the consequences of mixing diabetes and alcohol. While people with diabetes should not be discouraged from drinking, they should drink responsibly and follow their rules for safe experiences with alcohol

JDRF. The Scoop on Drinking: Alcohol and Type 1 Diabetes. <http://www.jdrf.org/index.cfm?page_id=103535>

A study was conducted to analyzed the immediate and extended families of children with type one diabetes, and those family members medical histories. The objective was to determine a the family dynamics of a child with juvenile diabetes and the development of diabetes and other autoimmune disease. The result was that while type one diabetes does formulate or show traces within immediate family members - parents and siblings - it is more prevalent within the type one diabetic’s extended family members.

However, the study is not completely reliable and should not be taken for full value. This study was conducted in the United States, which has the largest population of people with diabetes, so it is not a global conclusion that this research is true. Also, the medical histories that researchers used to trace the family histories of juvenile diabetes was based on the histories provided by the family members part of the study; considering the majority of the study relies on what people have told the researchers about their families and themselves, there is room for error because their given information may be incorrect.

In addition to the diabetes family trees of these children, it was found that the children with type one diabetes were more likely to have other autoimmune diseases as well, such as juvenile thyroiditis, celiac disease, and juvenile rheumatoid arthritis. Once again, this generalization and correlation cannot be confirmed due to the fact that scope of this study was so small (only 380 families and children). In order to confirm the prevalence of juvenile diabetes and additional autoimmune diseases in children, the study needs to be expanded and advanced to more reliable information.

While the study is fascinating, it proves the discrepancies of surveys and fallacies that arise due to early research and minimal testing. Science is always learning, so it would not be surprising to see more discoveries and analyses on the development of diabetes and other autoimmune diseases in the families of children with juvenile diabetes. However, this young research is still not a 100 percent reliable source of information.

. Salla Alhonen, Mikael Knip, Sari Korhonen, Paivi Tapanainen, and Riitta Veijola. Diabetes Care. 34.1 (Jan. 2011) p115