Some Long-term Sequelae of Poorly Controlled Diabetes that are Frequently Undiagnosed, Misdiagnosed, or Mistreated

By Richard K. Bernstein, MD, FACE, FACN, CWS

Many years of scientific studies of both animals and humans have provided overwhelming evidence that the long-term adverse sequelae of diabetes are caused by elevated blood glucose (BG). A recent meta analysis of studies of over 95,000 individuals demonstrated that even within BG ranges generally considered normal, the risk of cardiovascular events increases exponentially with blood sugar. Elevated BG adversely affects every tissue of the body, with the possible exception of hair.

Read more Some Long-term Sequelae of Poorly Controlled Diabetes that are Frequently Undiagnosed, Misdiagnosed, or Mistreated

Health promotion when the ‘vaccine’ does not work

The epidemics of obesity, metabolic syndrome and type 2 diabetes have worsened over the past decades. During this time our preventive and therapeutic approach (the ‘vaccine’), consisting of a low-fat diet and exercise, has remained fundamentally unchanged. A case is made that these conditions are inter-related and may be caused by a single underlying factor related to the carbohydrate content of diet. Read more Health promotion when the ‘vaccine’ does not work

Endings and New Beginnings

Now. I do recollect that I said I would read you a story. But until this site gets a bit more sophisticated technically, you will either need to read it to yourself or perhaps ask your helpers to read it to you.

This is a very special story. It is one of my favourite fairy stories that my mum used to tell me when I was little . And just like then, I’d like you to settle back and take a well deserved rest. Now we will begin.

Once upon a time. In a distant land, in a far away kingdom, a King and Queen, a bit past their youth, reigned.

The Queen was very happy.

A few months before she had given birth to a much longed for and awaited child. Her first born. Aurora.

But the Queen had her worries. It was soon to be her daughter’s naming ceremony. And just like many of us today, she only had so many gold plates and goblets.  She couldn’t possibly invite everyone she ought to.

Her happiness at being able to get into her lovely gowns again was somewhat dimmed. Decisions. Decisions.

The day of the great event dawned.

Among the most favoured guests were several of the Queen’s old school chums. They were to be Godmothers to the new Princess.  Their gifts would be in the form of blessings. You see, Aurora was destined to be the most spoiled and pampered Princess ever.  No siblings.  Middle aged doting parents. Unlimited wealth. No Marks and Spencers vouchers.  No  hand knitted cardigans. No babygrows from Bloomingdales. It was THAT sort of family.

One by one the Godmothers approached Aurora’s crib to give their blessings on the babe.

Beauty. Grace. Kindness. A lovely voice. Then. Suddenly. The door was thrown open and a hush descended on the room.

“Hells Bells!” cried the King, “ It’s my big sister, Carabos. Here to ruin it all!”

“You bet!  You little runt. If they had changed the succession laws in time it would have been me, Me, ME who would have been Queen” glared the tall, angry, dark clad figure that was Carabos.

The Queen quivered with fear. She had never got on with “Big Sis.” She trembled with apprehension.

She could see Carabos glide nearer and nearer her precious child and her heart was gripped with fear. She lunged to save her baby …only to fall flat on her face as her Manolo Blaniks buckled beneath  her.

From floor level her sister in law’s angular, pitiless face  looked even more terrifying than ever.

“ I have a gift for the child. “ Carabos said slyly, picking up the little pink bundle. “ Yes, my SWEET….You will indeed grow up to be beautiful, graceful and kind. Yes. You will have a pleasing voice. BUT. When you are seventeen years of age you will prick your finger on a poisoned needle on a spinning wheel and you will die!”

As the sounds of “You will DIE, you will Die, you will die…” faded into the walls of the corridors a feeling of terrible foreboding clutched the heart of every living soul.

“Our daughter is doomed!” yelled the King. “That bitch of a sister of mine will never lift that curse !”

He slouched on his throne. And buried his wet face in his hands.

A woman quietly approached him and gently placed her hand on his arm.

“King. Do not despair. I have not yet given my blessing.”

“What difference can you possibly make?” sobbed the Queen, still prostrate.

“The forces of evil are strong. I’ll admit. “ The woman started hesitantly. “ Aurora will indeed grow up. She will indeed prick her finger. This I cannot change.  But she will NOT die. Instead she will fall asleep, as will you all, until the curse is lifted by someone who is not yet born.”

Now you would think that Mum and Dad would have been happy with the poor Godmother’s efforts. But they weren’t. They became very, very depressed. All the could think of was the harm that was to befall their only child.

They banned all the spinning wheels in the kingdom. Aurora’s immunisation schedule was everything.  It started Dip Tet Polio and ended Hepatitis A to Z.

The years passed.

Despite her paranoid and over protective parents Aurora grew into the lovely young woman that her birthright demanded.  Yet.  Even though she couldn’t stand the sight of needles due to all those vaccinations, the day came when  Aurora pricked her finger on a spinning wheel just as her evil aunt had planned.

As the blood spurted from her finger, Aurora had a few last gasps. “ The curse has come true! I’m going to die! I’m never going to university !  I might as well as watched “Neighbours” with my pals instead of all that studying….I should have just eaten all the donut…”

Well, regrets. We’ve all had a few. But then again too few to mention compared to the fate of this poor wee lassie and her family.

A hundred years passed.


One         h..u…..n…….d………r……e………………..d………..y……e………a………….r……………………s.

Meanwhile….Aurora tossed. She turned. She snored. She squirmed. She was not entirely continent.

Then one day.  A handsome Prince – who looked a bit like David Beckham- was playing football outside some old overgrown walls when he kicked the ball so high that it went right OVER the wall.

He climbed right over the wall using his muscular yet agile build to help him.

To his amazement he saw the outline of what looked like a huge palace in the jungle that had become of the once immaculate gardens.

“Too posh to do the garden!”  He chuckled with his faintly Mancunian/Spanish/Los Angeles accent. “I’ll fix that in a jiffy.”

With a bit of help from the rest of the football playing lads they assembled all their “in case of road rage”  car boot tools.

Chain saws. Grappling devices. And midgie repellant.  And they got to work.

To some of them it was a bit strange seeing old people, oddly dressed, all around, wearing wigs, fast asleep. To others they had seen it all before at their local Sheriff Court.

As if love was guiding our handsome hero, the Prince at last found the chamber in which our lovely Aurora reclined.

At once he took in the hairy legs, the wet mattress and the matted locks of our still youthful but not quite pristine Princess.

At first he was a bit put off by the you know, nursing home type smell. But she had such a lovely, sweet smile. And before he realised he had kissed her and she woke up.

Did they live happily ever after?

Did they get a new mattress?

Did she ever get to university?

Well. We don’t know.

But if you are waiting for a cure for diabetes you can do more than lie about in bed dreaming about it.  If you want it to take less than a hundred years, please look at our links below.

Thank you.

If you have enjoyed this course please pass the address for D-solve, , onto someone who needs this gift.  Also, as stated in the introduction please send me any feedback or comments by clicking on my name below.

Dr Katharine Morrison


Where to Next?
…the beginning of course.



How To: Keep Healthy with Type 1 Diabetes

This section is for everyone – who is still here!


For most children or young people they will find out very quickly after diagnosis that they will need to be on injected insulin for life. Perhaps they will have had symptoms of weight loss, drinking a lot and passing urine a lot.  Others will have become very ill with diabetic ketoacidosis and will have been hospitalised.

More and more often younger people are being diagnosed with metabolic syndrome and type 2 diabetes. This is usually related to being overweight, sedentary and genetic influences.  Women with type 2, gestational or type one diabetes may find themselves being intensively treated with insulin during the planning or carriage of a pregnancy. Outwith pregnancy most people with type 2 diabetes will remain on diet and oral medications to control their diabetes. After about six years around half  of type 2 diabetics will have needed to add insulin to their medication regimes to maintain good control. Diabetics who use certain drugs to stimulate the pancreas to produce more endogenous insulin from their own pancreatic beta cells are more at risk of beta cell failure.

Type one diabetes results when the pancreas can no longer make enough insulin to prevent high blood sugars.  For early onset patients it is an autoimmune disease that used to be a death sentence.  Now that insulin is widely available for most people it is rarely as rapidly fatal. But until a real cure can be found and made available it can still feel like a life sentence.

Insulin is a drug that needs to be used very carefully.  It can rapidly lower blood sugars and cause hypoglycaemia which can cause death if it is very severe and is untreated. Lower levels of hypoglycaemia may not be obvious to drivers or their passengers and yet can cause impaired reaction times and judgement which can lead to accidents.  High blood sugars are less of a worry on the short term but on the long term damage accumulates that can severely affect the nerves, eyes, kidneys and heart.

Pancreatic beta cells start to die in tissue culture at sugar levels of 6.1 or higher. This is not a threshold effect and if blood sugar levels are brought below this level soon enough the cells can start to recover.

At the time of diagnosis and for up to decades afterwards type one diabetics still produce a small amount of insulin. The remaining beta cells are still subject to attack by autoimmune antibodies but can be nursed along for many years if high blood sugars can be avoided.

The more of your own pancreatic beta cells that are still active the easier it is to control your diabetes as the pancreas can still fine control sugar levels in a way that injections cannot. This is a major reason for all new diabetics to strive for normal blood sugars so they can prolong the “honeymoon” phase of diabetes.

Even the most rapidly effective injected insulins eg novorapid and humalog cannot replicate the immediately effective blood sugar lowering effect of the stored insulin from a normal pancreas beta cells. This means that blood sugars will be inappropriately high for at least some time after even small amounts of very fast releasing carbohydrates are eaten in eg bread or fruit. Over the long term these sugar spikes can add up to a lot of damage to body tissues.

We have already discussed what level of control you already have and what level of control may be optimal for certain groups of people in the Type Two Section. Please take a moment or two to review this.

This Type One section aims to give you more specific information on the use of insulin and other information to help you achieve the best health you can.

The insulin users section tends to lean heavily towards younger type ones. I will give some guidance about when older type twos can skip.

Quick Quiz:
1. For insulin users it is safe to go straight onto a low carb diet as long as you have…
a Thrown out all your crisps, breakfast cereals and biscuits.
b Bought a good low carb book to help you.
c Bought in plenty of meat, vegetables and olive oil.
d Planned out a gradual reduction of carbohydrates and appropriate reduction in your insulin.

2. Type One diabetics…
a Make plenty of their own insulin from beta cells in the pancreas.
b Can be sure there will be a cure within the next five years.
c Rely on carefully measured and timed amounts of injected insulin to keep well.
d Can eat whatever they like, when they like.

3. You are an insulin user going into hospital for a planned operation. You need to do three of these….
a Speak to an anaesthetist well before your operation to let them know how you manage your blood sugars.
b Speak to the dietician about your meal choices from the Healthy Diabetic section of the menu.
c Bring in your insulins, testing kit and any special foods or drinks you may need.
d Arrange for a friend to provide, transport, supplies and to liase with clinical staff.

4.Type ones can do three of these things…
a Get other autoimmune diseases.
b On first diagnosis go through a honeymoon period when pancreatic function improves for a period of time.
c Use inhaled insulin to control blood sugars.
d Die rapidly from severe hypoglycaemia.

5. Tests type ones should be having regularly include three of these…
a Amylase which is raised in pancreatitis.
b Thyroid function tests.
c Tissue transglutamase for coeliac disease.
d Albumin creatinine ratio which is a kidney test.

Have you got it?

1. D is correct. You MUST plan and change your diet and insulin doses GRADUALLY. This means more freqent blood sugar testing till you are stable on your new regime.

2. C is correct. If only we could be certain of a widely available and affordable cure within the next five years then we possibly could eat what we want, when we want without paying too much for the consequences. Unfortunately for the forseeable future most certainly DO have to live with the consequences so the tighter the control the better for most diabetics.

3. You need to do ACD. You don’t need to speak to the dietician. You decide yourself from the entire menu.

4. ABD are correct. Inhaled insulin is available now. It comes in 3 unit increments though and this is likely to make it less precise than is required for really tight blood sugar control for type ones. It may have a place for type twos who are still producing some of their own insulin.

5. Tests type ones should be having regularly include three of these…

Thyroid tests, coeliac tests, and kidney tests are all needed. Blood pressure, eye examination or retinal photography and foot examinations are other necessary tests.

Reference Info:

Where to Next?
Please proceed to the section How To: Deal with the Stress of a Newly Diagnosed Child section.