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People with Diabetes Consider Xenotransplantation (barf alert)
Scoop Independent News ^ | May 7, 2005 | New Zealand Bioethis Council

Posted on 05/08/2005 7:04:03 PM PDT by Investment Biker

If xenotransplantation - animal-to-human transplantation - were to offer a person with Type one diabetes a life without insulin dependency - would that make it OK?

This is a proposition people with diabetes are being encouraged to consider by Toi te Taiao: the Bioethics Council and Martin Wilkinson, chair of the Council's xenotransplantation working group, who is a key-note speaker at this weekend's annual Diabetes New Zealand Conference.

"People with Diabetes will understand, perhaps better than anyone, the pros and cons of xenotransplantation because it has the potential to affect them personally. There are in fact several xenotransplantation procedures but one involves the insertion of cells, like pig pancreatic islet cells, into humans. This has the potential to treat Type one and severe Type two diabetes.

"A key question is, if xenotransplantation can relieve significant suffering or even save lives, does this outweigh the potential hazards, such as transferring diseases from animals to humans and onto other humans? "If xenotransplantation were simply a risky trial treatment, it might be that individual consent would be enough to justify the risk. But the risk of xenotransplantation to public health cannot be justified merely on the grounds of individual consent. If this were the case we would have a set of techniques that potentially helps a large number of badly-off people but potentially threatens the health of a very large number. "The risk of disease spreading might be reduced by forcing xenograft recipients to submit to lifelong monitoring and treatment, breaching confidentiality, preventing their reproducing, and compulsorily quarantining them. These measures appear to infringe on rights, so the ethical question is: would this be justified?" says Wilkinson. Alternative uses of xenotransplantation include using brain cells to treat Parkinson's disease (which is currently untreatable) and inserting whole organs like pancreas, kidneys and hearts. It is also possible to undertake therapies outside the body, such as sending the blood of a person with acute liver failure through a type of dialysis machine and back. Growing human cells on layers of animal cells is also an option for treatment of such conditions such as motor neurone disease. All of these are at an experimental stage - some much further along than others.

Xenotransplantation is effectively blocked in New Zealand at the moment, largely for reasons of public safety. Australia has recently blocked xenotransplantation research for at least five years. Canada has also blocked it. The US and the UK permit it, although the UK has a very high barrier. China and Mexico are doing xenotransplantation on a relatively large scale.

"Concerns about xenotransplantation do not stop with public health risks. There are cultural considerations about animal cells introduced into humans, particularly live cells. Does this affect our essential humanness? Is it part of a desperate grab for immortality that humans cannot possibly achieve?" says Wilkinson. The Bioethics Council is encouraging public discussion around the cultural, ethical and spiritual dimensions of xenotransplantation and is looking at the individual and community points of view. It will provide independent advice to Government on its findings. The deadline of 20 May for the online forum and submissions process is fast approaching and the Council will then enter the final stage of assessing the feedback.

Results will contribute towards a report on the cultural, ethical, and spiritual aspect of xenotransplantation in September.

For further information about diabetes see www.diabetes.org.nz and www.bioethics.org.nz

ENDS

To stimulate discussions and inform people of the issues around xenotransplantation before the dialogue process, the Council launched a discussion document in February entitled "The Cultural, Spiritual and Ethical Aspects of Xenotransplantation: Animal-to-Human Transplantation" - it can be found at www.bioethics.org.nz .

Public are also invited to become involved in one or more of the following activities which will be taking place between March and 20 May 2005:

* Visit www.bioethics.org.nz for background info and links to more detailed background research

* Join the online discussion forum, to register, log on to www.bioethics.org.nz/dialogue/forum/

* Make a submission by mail, email or online. There is a submission form on our website, or just send a letter or email.

* Get together with whanau, friends or workmates and have a discussion. We want people thinking and talking about these topics, even if you do not end up writing anything down. Our website has links to ideas on running dialogue groups.


TOPICS: Australia/New Zealand; Culture/Society; Miscellaneous
KEYWORDS: bioethics; diabetes; health; xenotransplant; xenotransplantation
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Does this affect our essential humanness?

How stupid is this question? I had bacon today and I did not ask if it impacted my humanness? When individuals have porcine heart valves implanted do they ask this question? Do they ask the question if living attached to an insulin pump machine affects my essential humanness? Do they ask if taking insulin generated by bacteria impacts my humanness? The only thing that impacts my humanness is stupid questions asked by meaningless ethics personnel.

Is it part of a desperate grab for immortality that humans cannot possibly achieve?"

No you dumb a$$ is is a rational attempt to live a normal life. What a DUMB A$$

1 posted on 05/08/2005 7:04:04 PM PDT by Investment Biker
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To: Investment Biker

Haven't we been using pig heart valve transplants for a few decades?


2 posted on 05/08/2005 7:15:02 PM PDT by John Jorsett (email: mistersandiego yahoo.com (put the at sign in between those two))
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To: John Jorsett

That is correct. But pig heart valves are not live cell transplants. At least that is my layman's understanding. Wereas insulin producing islet cells are live. They ahve already been transplanted into many individuals with no known disease risk.


3 posted on 05/08/2005 7:17:26 PM PDT by Investment Biker
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To: John Jorsett

"Haven't we been using pig heart valve transplants for a few decades?"

Not only heart valves but arteries for those on dialysis.


4 posted on 05/08/2005 7:20:06 PM PDT by politicalwit (USA...A Nation of Selective Law Enforcement.)
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To: Investment Biker

Good read. I doubt if I'd feel comfortable with a transplant, but also recognize that that is probably the closest they will come to a "cure" in the foreseeable future. It should definately be an option for those who are interested.

I am quite happy with my pump, aka my pancreas on a belt, for the present time. But who knows, once the transplant procedure is perfected I might have to look into it. I definately wouldn't have wanted the first model pumps (which looked like a hiker's backpack), but I can't imagine living without the current model.

I give much credit to the first wave of patients who try out revolutionary medicine. I am much happier being in the third or fourth wave myself.


5 posted on 05/08/2005 7:24:17 PM PDT by Cyclopean Squid (History remembers only what was, not what might have been.)
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To: Investment Biker

Until about 10-15 years ago, insulin dependent diabetics (Type 1) depended primarily on pig insulin. Some on beef insulin, but not nearly as much. In fact, the early "human" insulin (which is not from humans) was not as good as the pig insulin. If it was not for animals, diabetics between the 1920's and the 1980's would have died just like all diabetics before them.

I say, bring it on!


6 posted on 05/08/2005 7:26:21 PM PDT by jim_trent
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To: Investment Biker
Well, if you’re down with the basic concept you've got your choice of research programs: xenotransplantation, or the cloning of entirely human replacement organs.

Myself, I’d prefer to get my spares from a decephelated clone rather (for example) than as material of porcine origin.

But for a lot of people, the squick factor is going to be pretty formidable either way.
7 posted on 05/08/2005 7:28:59 PM PDT by M. Dodge Thomas (More of the same, only with more zeros on the end.)
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To: Cyclopean Squid
Here is the real rub behind this. A company that was in NZ was trying to adapt encapsulation technology to be able to transplant these cells without the use of immune suppression. Just put the cells into the capsule insert cells into the portal vein of liver and you are cured at least for a couple of years. NZ nixed them and they went to Mexico City and had it done with a very crude system that did not encapsulate but used testicle cells to protect them from the immune system. These experiments had limited success.

Then they moved to Australia. Aussies then produced regulations to stop them from going forward with their new company LCT technologies. LCT has one of the more promising encapsulation technologies and has performed one human cell transplant in the Italy at the University of Perugia using encapsulation. But there simply are not enough human cells. Estimates are that if they could recover every cell they could only cure less than 1/2 of one percent of T1 diabetes. That is why xeno is so important. It can only be stopped by the heavy hand of government.
8 posted on 05/08/2005 7:37:01 PM PDT by Investment Biker
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To: M. Dodge Thomas

Two comments regarding cloning. One is there is considerable ethical resistance to creating life simply for spare parts. I for one could not do it.

Second, if I could relax my ethics, cloning and development of spare parts through the process is decades away. Pigs cells exist today and could be used very quickly to cure most T1 diabetes.


9 posted on 05/08/2005 7:41:41 PM PDT by Investment Biker
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To: jim_trent
You are correct that until the introduction by Lilly of recombinant DNA insulin the insulin of choice was porcine. Bovine was used by many but was not as common as porcine. The original inventor of insulin gave away the patents to a meat packing area so that insulin could rapidly reach those that were dying from diabetes. That is why Lilly is in Indianapolis, a former meat packing town.
10 posted on 05/08/2005 7:44:57 PM PDT by Investment Biker
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To: politicalwit
Not only heart valves but arteries for those on dialysis.

They also used cow's arteries for dialysis; my mother had a "bovine graft" back in the late 70's.

11 posted on 05/08/2005 7:45:05 PM PDT by Born Conservative ("Mr. Chamberlain loves the working man, he loves to see him work" - Winston Churchill)
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To: Cyclopean Squid

Diabetic Freeper here too. I only have been diabetic for 5 years, so let the 20-30 year survivors take the new stuff.

Frankly, I think the best stuff sounds like the of stem cell-beta cells inside a ball of immune reaction preventing membrane. That got tried out recently. No immuno-suppression.


12 posted on 05/08/2005 7:46:10 PM PDT by struggle ((The struggle continues))
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To: Investment Biker

Don't hold back, tell us how you really feel...


13 posted on 05/08/2005 7:49:20 PM PDT by null and void (...that no man, rich or poor, free or bond, shall buy or sell, save he that has the chip...)
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To: Cyclopean Squid
I give much credit to the first wave of patients who try out revolutionary medicine. I am much happier being in the third or fourth wave myself.

Aye yup.

The early bird gets the worm, but it's the second mouse that gets the cheese...

14 posted on 05/08/2005 7:51:55 PM PDT by null and void (...that no man, rich or poor, free or bond, shall buy or sell, save he that has the chip...)
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To: struggle
I think the best stuff sounds like the of stem cell-beta cells inside a ball of immune reaction preventing membrane. That got tried out recently.

No stem cell has been shown to be changed and behave like the body's natural islets (beta cells). Many are trying but many, many questions and much research remain. Then there is the ethical questions. So rather than wait a decade and have to compromise my ethics I would use pig cells in a heartbeat. The encapsulation has recently been tried by one company in Italy and another less promising company in Toronto. The Toronto Company claims to have functional system for producing the cells. None of their claims have been peer reviewed. Another company is trying to raise $2.5 million for preclinical studies.

15 posted on 05/08/2005 7:52:50 PM PDT by Investment Biker
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To: Born Conservative

My 23-year-old wife has a synthetic conduit with a dead human valve in it acting as part of her pulmonary artery (it was replaced with a new one about a year ago due to calcification of the valve she had implanted at age 8). Anyhow, the conduit also has a bovine vessel segment at the end, to fuse with her own tissue I assume.

Sometimes I call her a cannibal when she eats steak. :)


16 posted on 05/08/2005 7:53:24 PM PDT by Sloth (I don't post a lot of the threads you read; I make a lot of the threads you read better.)
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To: struggle

AmCyte Announces First North American Encapsulated Islet Transplant without Long-Term Immune Suppression into a Patient with Type 1 Diabetes

Press Release

LOS ANGELES, March 9, 2005--AmCyte Inc., a leader in encapsulated islet replacement and pancreatic adult stem cells, announced today the transplantation of the first Type 1 diabetic patient in North America to receive islets without long-term immune suppression.

The transplant took place on February 22nd at Toronto General Hospital. The patient experienced no complications during the minor 20-minute surgical infusion. The patient was released from the hospital three days after the procedure and is resting at home.

The transplanted islets are protected from rejection by the patient's immune system with AmCyte's novel microencapsulation technology. About the size of a pinhead, each clear gel bead contains multiple islets, and floats freely in the patient's abdominal cavity. The capsules are permeable so that nutrients and glucose can get to the islets, and secreted insulin from the islets can get out into the blood.


"At this point we are very happy that the patient is doing well," said Oliver Foellmer, AmCyte's Director of Business Development. "The clinical trial represents a new generation of islet transplantation technology and is part of a multi-prong clinical trial strategy to bring a treatment for diabetes to the market."

"We are excited to contribute this important step towards a treatment for diabetes without the health risks of immune suppression," said Dr. Wen G. Tsang, Sr. VP R&D. "In conjunction with our Adult Stem Cell Regenerated Islet Program, we look forward to being able to address both the limitations of immune suppression and islet supply."


17 posted on 05/08/2005 7:56:16 PM PDT by struggle ((The struggle continues))
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To: Sloth

Yea and I would be afraid that anytime someone told a bovine or pig joke I would not be able to laugh but would rater snort like a pig. Oh well, I could live with that - snort snort.


18 posted on 05/08/2005 7:57:27 PM PDT by Investment Biker
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To: Investment Biker
Tell ya what I've got type 2 and if i thought it would get rid of it i would do it in a heartbeat we use animals for virtually everything under the sun why not this ?
19 posted on 05/08/2005 7:58:23 PM PDT by ATOMIC_PUNK
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To: struggle
I do not trust Amcycte. Their forerunner were involved with Mylan Labs years ago. The forerunner was the first to transplant cells in a human using Vivorx encapsulation. Steven Craig was the man's name. He committed suicide and Mylan eventually sued Vivorx. I simply do not trust them.
20 posted on 05/08/2005 8:00:53 PM PDT by Investment Biker
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To: MoralSense; Mjaye; The Game Hen; Chesterbelloc; Petes Sandy Girl; MarMema; From many - one.; ...

21 posted on 05/08/2005 8:01:05 PM PDT by Born Conservative ("Mr. Chamberlain loves the working man, he loves to see him work" - Winston Churchill)
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To: Investment Biker

You are of course correct that the immediate ethical decisions lie with "xenotransplantation", broadly defined.

As for cloning though, I suspect though that you may be a bit pessimistic about the prospects, at least for hybrid “technologies”.

For example I would not be surprised if a 10-12 years hence we were seeing experiential therapeutic use of entire “non-human” organs harvested from cloned animals which had been genetically modified to become sources of much more tractable transplant material.


22 posted on 05/08/2005 8:10:26 PM PDT by M. Dodge Thomas (More of the same, only with more zeros on the end.)
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To: Cyclopean Squid

How does an insulin pump work? Does it contain a device that measures your blood sugar and then dispense insulin based on the level? Or does it just dispense a constant flow of insulin? Can you remove it easily, or do you even need to?

I hope my questions aren't too intrusive. I know several diabetics, but none of them use the pump, so I'm curious.


23 posted on 05/08/2005 8:14:51 PM PDT by Huntress (Possession really is nine tenths of the law.)
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To: M. Dodge Thomas
Here we can agree. Pigs have already been modified with human DNA. They have also been breed not to present a sugar that causes hyperacute rejection in immune suppressed individuals. The day is coming when hybrid animals will provide spare parts and those parts will have human DNA contained within them. I believe, for example, that one cells from pigs cure humans, it will not be too long that they also provide human insulin sequence through DNA insertion.
24 posted on 05/08/2005 8:16:22 PM PDT by Investment Biker
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To: Huntress
It is a little larger than a cell phone. It contains a reservoir of insulin and a computer. It has a menu system that lets you program the pump to dispense insulin continuously and as needed for blood sugar correction and meals. Mine does have a meter built into it (Deltec Cozmo) but it does not read your blood sugar without a finger stick and the insertion of a test strip. It is attached to an infusion line that is placed into the skin and lasts about three days.
25 posted on 05/08/2005 8:20:48 PM PDT by Investment Biker
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To: struggle

Ah yes, the transplants are usually for the "roller-coaster" diabetics--goodness knows they need them.

I've had the sugar for 12 years so far...so good...so what! (sorry, Megadeth fan). I've had a pump for about 7 (has it been so long...where has my life gone, LOL), and am quite a fan of it. I received word that one will soon be available that is constantly monitoring blood sugar levels and adjusting the basal rate of insulin in order to compensate. I have my fingers crossed that the pump will include glucagon so that I don't have to carry 4 rolls of Lifesavers with me everywhere (yes, I really do use lifesavers--for the poetic irony, and the taste!).


26 posted on 05/08/2005 8:23:40 PM PDT by Cyclopean Squid (History remembers only what was, not what might have been.)
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To: Huntress

I forgot to mention that many diabetics do not use them because they are expensive, about $6,000 plus expensive supplies (infusion sets and insulin cartridges).


27 posted on 05/08/2005 8:23:50 PM PDT by Investment Biker
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To: Investment Biker

Thanks for the info. Does the supply of insulin or the infusion line last about three days? Do you have a port in your skin where the pump attaches?


28 posted on 05/08/2005 8:24:28 PM PDT by Huntress (Possession really is nine tenths of the law.)
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To: Investment Biker

Does insurance typically cover it?


29 posted on 05/08/2005 8:25:42 PM PDT by Huntress (Possession really is nine tenths of the law.)
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To: Investment Biker
From the Book of Genesis:

And God blessed them, and God said unto them, Be fruitful, and multiply, and replenish the earth, and subdue it: and have dominion over the fish of the sea, and over the fowl of the air, and over every living thing that moveth upon the earth.

There. That should about answer that question.

30 posted on 05/08/2005 8:26:40 PM PDT by Bloody Sam Roberts (This tagline will be destoyed to make way for a new Hyperspace bypass.)
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To: Investment Biker

Does extended periods of physical exercise cause your blood sugar to go low, or can you compensate by changing the setting on the pump?


31 posted on 05/08/2005 8:29:23 PM PDT by c-b 1
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To: Cyclopean Squid
There are several continuous meter being developed. The one you are referring to is a Minimed system. Abbott is also developing the Freestyle navigator. There is another but the name eludes me at the moment. It will be a while before they are automatically connected to a pump. But a semi-accurate continuous read out would be a great assistance.

PS Amcycte was the company not a "Toronto" company. The operation was done in Toronto.
32 posted on 05/08/2005 8:29:30 PM PDT by Investment Biker
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To: M. Dodge Thomas

Instead of creating/conceiving a severely disabled human from whom to harvest organs and tissues, why not use DNA splicing to grow human islet cells in porcine hosts, then harvest the cells from the pig? ... It is no more wrong than killing pigs for bacon and it avoids the cannibalism of 'decephelated human clones' ... BTW, just when would the branecase be emptied and what is the being prior to the 'decephelating'?


33 posted on 05/08/2005 8:29:59 PM PDT by MHGinTN (If you can read this, you've had life support from someone. Promote life support for others.)
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To: Huntress

Investment Biker did a good job answering, but check one my post 26 (they're doing wonders with technology these days, I tell you!).

The level of insulin in the reservoir will hold out about 3 days, and then you have to refill it and attach it to a new infusion set. The infusion set has a catheter in the end that fits into the subqutaneous layer, but it is not permanently attached. You rotate the site every time you refill the pump. I use my ample belly for the infusion site.

There is a way to remove the pump itself if you need to, and then you can reattach with ease.

Pumps operate on a basal rate, which I program in advance. It will deliver a certain amount of insulin every hour (that I figured out from trial and error). I can put it on a lower temporary level if I am going to do a little light exercise (such as jogging).

The, if I am going to intake carbs, I program a bolus based on the amount of carbs (I give 1 unite for every 10g of carbs). Most food items will tell you the total carb level, and those that don't I have learned to guess.


34 posted on 05/08/2005 8:31:45 PM PDT by Cyclopean Squid (History remembers only what was, not what might have been.)
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To: Investment Biker
The entire question will be moot with the strides being made in nanotechnology. Someday, islet cells will manufactured and be available to your doctor for implantation with a syringe. Tejal Desai at the University of Illinois has developed a nano-engineered implant that could mean people with diabetes would no longer have to inject insulin. Diabetic rats with the implant have now gone for several weeks without needing insulin injections. "This is the first we've seen of these technologies actually getting past the bench top and being implanted," Desai says.
35 posted on 05/08/2005 8:33:22 PM PDT by jonrick46
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To: Huntress
Most insurance will cover if deemed medically necessary. Get the doc on your side and you are home free usually. The pump holds about 30% of a vial of insulin. So depending on usage that is how many days it will last. There is no port in the skin it is a soft Teflon coated tube that is inserted into the skin with each infusion set using a needle.
36 posted on 05/08/2005 8:33:32 PM PDT by Investment Biker
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To: c-b 1
Yes I bicycle to aid the control of my diabetes. If I am going on a long ride I turn down of off the pumps basal settings.
37 posted on 05/08/2005 8:37:16 PM PDT by Investment Biker
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To: c-b 1

I periodically need to readjust the basal settings on my pump if I find I am going too low or too high on a consistent basis at a similar time each day. If I exercise, I will usually put on a temporary low basal rate, or turn the pump into suspend mode, depending on how strenuous the exercise is. Plus, it never hurts to down a glass of orange juice before preparing to exert oneself.


38 posted on 05/08/2005 8:37:46 PM PDT by Cyclopean Squid (History remembers only what was, not what might have been.)
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To: Investment Biker; Cyclopean Squid

Thanks to you both for the information. This sounds like a great piece of technology.


39 posted on 05/08/2005 8:38:02 PM PDT by Huntress (Possession really is nine tenths of the law.)
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To: jonrick46
The problem with all encapsulation is fibroid reaction by the body over time, immune attacks through imperfections in the capsule, and sufficient oxygen from blood vessels to nourish the cells. I am aware of Dr. Desai's work but am not convinced that the implants she envisions can overcome these obstacles.
40 posted on 05/08/2005 8:40:50 PM PDT by Investment Biker
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To: Cyclopean Squid


>>>I've had the sugar for 12 years so far...so good...so what! (sorry, Megadeth fan). I've had a pump for about 7 (has it been so long...where has my life gone, LOL), and am quite a fan of it. I received word that one will soon be available that is constantly monitoring blood sugar levels and adjusting the basal rate of insulin in order to compensate. I have my fingers crossed that the pump will include glucagon so that I don't have to carry 4 rolls of Lifesavers with me everywhere (yes, I really do use lifesavers--for the poetic irony, and the taste!).

Man that's unreal. Pardon the crappy remark, but I went diabetic at a good time. I still am on the Novapen, myself. I'm always lower than or near 7 on my Ghb. My eyes go a little nearsighted after a few hours of high blood sugar so I know to excersize or shoot up a little more right away.


41 posted on 05/08/2005 8:41:07 PM PDT by struggle ((The struggle continues))
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To: struggle

Sounds exciting. My son was diagnosed about a month ago, and we're still getting settled into this whole thing. It sounds like a lot of stuff is changing pretty fast -- I'm willing to wait and see for a while, to see what shakes out....


42 posted on 05/08/2005 8:42:38 PM PDT by r9etb
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To: r9etb

Yeah, the only real important thing is daily testing (I test my blood twice a day) and daily excersize. Exersize opens up the receptors for insulin so it is used more efficiently. It also keeps you from shooting up a lot. I run 2 miles a day after dinner and it kills all my carbs instantly.


43 posted on 05/08/2005 8:46:25 PM PDT by struggle ((The struggle continues))
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To: struggle

Oh, it's not so bad. "My blood sugar is low" has gotten me out of so much trouble it's almost been worth it. Anytime in school if I went out of line I would blame hypoglycemia, and ditto at one of my summer jobs if I wanted to get out of a tedious project. I have to say that, from a certain point of view, I got diabetes at the perfect time too (I was diagnosed when I was 12).

Since I got the pump I've been in great control too (similar to where you are), and I can always "feel" it if my sugar is too high or low.


44 posted on 05/08/2005 8:47:03 PM PDT by Cyclopean Squid (History remembers only what was, not what might have been.)
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To: Cyclopean Squid

>I can always "feel" it if my sugar is too high or low.

When sugar is too low, who can't feel it!


45 posted on 05/08/2005 8:48:15 PM PDT by struggle ((The struggle continues))
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To: Xenalyte
Xenotransplantation

A band YOU should form.

46 posted on 05/08/2005 8:49:00 PM PDT by Senator Pardek
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To: struggle
Exercise also drains the liver of glycogen. And it depletes the muscle cells of sugar. I test 6 times a day and if I wake in the middle of the night to urinate I test again.
47 posted on 05/08/2005 8:49:21 PM PDT by Investment Biker
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To: Cyclopean Squid
Thanks for the information.

I have been taking insulin for about 18 years, about 10 years ago I started taking Sugar Eze along with it, which really helped to stabilize my sugar level. Every dr. I have been to has been an idiot, they didn't understand what I was doing, and didn't want to. When my blood tests came back, they got a blank look on their face, and said "I don't know what you are doing, just keep doing it."

My Wife's Arthuritus Dr. (prolotherapist) knew all about it when I brought it up to him. He knew the components, in Sugar Eze, and explained why it works.

48 posted on 05/08/2005 8:55:51 PM PDT by c-b 1
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To: c-b 1
I would also take a look at using high dose benfotiamine (300mg or more). It, along with Alpha Lipoic Acid has very important protective functions.
49 posted on 05/08/2005 8:59:38 PM PDT by Investment Biker
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To: struggle
When sugar is too low, who can't feel it! I can feel it, when I started taking insulin I would feel it about 75, now I don't feel it until my sugar level is below 60.
50 posted on 05/08/2005 9:02:38 PM PDT by c-b 1
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