7 Minute Workout

Posted on February 25, 2014 by janekdickinson

hand-mobile2Have you heard of the 7-minute workout? I guess it was featured by the New York Times, but I was told about it by a friend who is a personal trainer. It was created by exercise professionals at Johnson & Johnson’s Wellness + Prevention, Inc.

Last night I tried it, and I could only do 15 seconds of each exercise!! Or should I say that’s all I chose to do…

But it was a start, and I plan to keep at it until I choose to not only do the whole thing, but maybe a couple-three times a day. This will be a great way to incorporate exercise when I travel, too! It would even be fun to gather a few friends and work out together.

It is definitely challenging, and it definitely lowered my blood glucose. In fact, my blood glucose was on the low side all morning today as a result (and remember I only did the 3.5-minute version!).

So for those of you who are looking for quick, but effective ways to exercise – give it a try!

PS I am happy (although somewhat embarrassed) to report that this may be the first app that I officially downloaded for myself. All of the other apps on my phone were downloaded by my kids and mostly for my kids. Stay tuned for a future post about sifting through all the different versions of the 7-minute workout as I wrote this! Yikes.

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Food Prices and Glucose Levels

Posted on February 20, 2014 by janekdickinson

pineapple1I just saw this article about rising food prices coinciding with rising blood glucose levels, and it really doesn’t surprise me. Produce, low fat dairy, whole grains, and lean meats are expensive!! I am amazed, appalled, and frightened at the cost of healthy food every time I shop at the grocery store.

The article says that it costs about $1.50 more per day to eat healthy foods than unhealthy foods. They also say that may not be a stretch for middle class families. I’ve even heard some health care professionals say it doesn’t cost more to buy healthy food – I disagree! I would say it’s a stretch for everyone. And many, many people do not put the money they have toward healthy food – there are so many other things to pay for!!

The article also says we need to think about prices, not just food, and I agree. This is something all Americans cannot just think about, but worry about, and then figure out some ideas for solutions. Producing enough healthy food and at affordable prices is a priority. It would be ideal if we could all grow our own food, but that’s not realistic. Maybe we need to think seriously about community gardens.

I’m glad these research results are being shared, and I hope it leads to change. This is a serious problem, and we can talk all we want about making healthy food choices and eating whole foods, but if they aren’t available and aren’t affordable, what’s the point?

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Diabetes & Travel

Posted on February 18, 2014 by janekdickinson

Usually when I travel I feel fuzzy and somewhat gross due to lack of exercise, lack of sleep, and generally not eating well.

I wrote about traveling with diabetes last fall, and here I am doing it again. What’s fun about this trip, though, is that I am finally able to anticipate what I’ll need and how things will work (and this is at 38 years with type 1, folks). I bought the same salad at the airport yesterday and ate it on the plane (this time I remembered a fork!) and it was awesome again!

Last night I had dinner in a fancy restaurant and I realized that I did not have to go crazy. In fact, by not overeating I felt good afterward. This morning I discovered that despite there not being a fitness room listed in the hotel directory, there was one in another building. And I used it!

My point in all this is that I am capable of traveling and managing diabetes and feeling good. And it feels good! (But I’m glad no one saw me using the rowing machine, cuz it wasn’t pretty.)

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Slippery Insulin Bottles

Posted on February 13, 2014 by janekdickinson

DSCN2322People who draw insulin from a bottle into a syringe may find the bottle(s) slippery at times. Worst case scenario: dropping a bottle of insulin on a concrete or tile floor and having it break (and not having a spare one handy). I’ve experienced the tile floor situation…

There are some gadgets available to help with this problem! One is called the Securitee Blanket, which “fits around an insulin vial to make it easier to grip and less likely to break if dropped.” Another is the Vial Safe, which “protects insulin vials from breaking and helps users get a good grip while drawing insulin.” There’s another one called “Insucozi,” but I could only find vendor pages for it.

You can do your own search for a gadget to protect your insulin vials, but here’s a place to start. And if you like to read magazines and don’t already subscribe, the American Diabetes Association has a wonderful publication for people with diabetes, called Diabetes Forecast (you can also access articles online). Every year they publish a “consumer guide,” which reviews diabetes equipment, gadgets, and more. It’s a great place to stay current on what’s available in the world of diabetes stuff.

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Preventing Type 2 Diabetes

Posted on February 11, 2014 by janekdickinson

There’s a lot more involved in developing type 2 diabetes than just eating too many candy bars. And it may not be possible to prevent it, per se. However, it is possible to reduce one’s risk of getting type 2 diabetes and it is possible to delay the onset of type 2 diabetes, through lifestyle changes.

There is a nationwide program called the Diabetes Prevention Program, that aims to lower the risk and delay the onset of type 2 diabetes for Americans. You can visit this website to learn more about it.

It is never too late to make lifestyle changes – choose healthier foods and add exercise – and it’s always too soon to stop.

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“Dead” Pancreas

Posted on February 6, 2014 by janekdickinson

crukmig_1000img-12213I wanted to clarify something for those who don’t make their own insulin anymore (people with various types of diabetes). The pancreas is the organ, or gland (or “glandular organ”), that produces insulin. This is part of its endocrine function (it also produces other hormones). The pancreas also produces digestive enzymes, which we need to properly digest our food, and this is part of its exocrine function.

In people who have type 1 diabetes the pancreas stops making insulin (or at least not enough to keep the person alive without taking insulin – there is research showing that many people with type 1 still make a teeny tiny amount of their own insulin). In LADA, the pancreas makes some insulin, but it may not continue to do so forever, and people with LADA need to take insulin at some point. In type 2 diabetes, the pancreas continues to make insulin, but it is not used properly. In addition, the pancreas typically overproduces insulin for a while before the diabetes is detected, which can lead to burnout. Many people with type 2 diabetes end up needing to take insulin at some point – sometimes to augment what their pancreas makes and sometimes to replace it if the pancreas is no longer producing any insulin.

Here’s the catch: the pancreas is not dead! Many people jokingly (or not) refer to their pancreas as “broken” or “dysfunctional.” I’m ok with those terms. But “non-functioning” and “dead” just aren’t correct. I once heard a patient in a hospital being taught that their pancreas was dead and just “floating around in there.” Clarification: the pancreas is still working hard to produce those enzymes I mentioned earlier and maybe even some other hormones. Although the pancreas of someone with diabetes is most likely not meeting all of it’s job requirements, it’s not dead, and it’s not floating.

 

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Insulin Pen vs. Vial and Syringe

Posted on February 4, 2014 by janekdickinson

insulin pensI still draw insulin from a vial into a syringe. I’ve written before about why I’m not using an insulin pump. Although I do think pumps are amazing, they aren’t for everyone and that’s ok. We actually have a third option – the insulin pen – which I’m told is the most popular insulin delivery method in other countries.

Insulin pens got a slow start in the United States. Regardless, they are a great option for people who take insulin. For many years pens were encouraged for those who had trouble seeing or with manual dexterity. Pens have a “dial-a-dose” feature, where you turn the dial at the end of the pen and listen for “clicks,” which correspond to units. Quite handy. In addition, pens are easy to carry along in a backpack or purse (or pocket).

Insulin pens do have some drawbacks. They tend to collect air bubbles pretty easily, so it’s usually necessary to expel air prior to taking a dose. This invariably results in wasting some insulin, but probably not enough to worry about. Also, pen needles need to be changed frequently. Ideally we would put a new needle on the pen every time we use it, but in the real world many, if not most people reuse their pen needles.

Even then, the pen needle needs to be changed at the very least after three uses to avoid insulin crystallizing (hardening) inside the needle. This can lead to blockage, which can cause us to use extra force and accidentally break the entire pen mechanism, resulting in major insulin wastage.

A recent study showed that people with type 2 diabetes prefer pens to syringes/vials. This study also showed no difference in outcomes (including A1C) between those using insulin pens vs. vial and syringe. As long as they are used correctly, and there is no problem with cost, there’s no reason not to use insulin pens.

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News for LADA

Posted on January 30, 2014 by janekdickinson

DSCN2314We often talk about three forms of diabetes: type 1, type 2, and gestational diabetes. But there is another type of diabetes called LADA (Latent Autoimmune Diabetes in Adults), which can be baffling. Many adults are diagnosed with type 2 diabetes and later find out it’s LADA because their blood glucose doesn’t respond to type 2 medications. In fact, six to ten percent of people diagnosed with type 2 diabetes actually have LADA and need insulin at some point – usually within six years of diagnosis.

A recent study looked at combining insulin plus a type 2 medication called a DPP-IV inhibitor, and found that this appeared to prolong the function of beta cells in the pancreas. Since beta cells are responsible for producing insulin, this means that people with LADA could possibly make their own insulin longer and more of it.

If you have been diagnosed with type 2 diabetes, and you don’t see a difference in your blood glucose levels with your current treatment (medications, etc.), talk to your health care provider about checking to see if you have LADA. You will need to have a couple blood tests drawn: c-peptide determines how much insulin your body is making. In type 2 diabetes the c-peptide level is often high because the body is working overtime to produce insulin. In LADA c-peptide can be normal to low normal (in type 1 diabetes the c-peptide is usually below normal).

You would also have a blood test to detect antibodies. If you have positive antibodies again islet cells or antibodies called GAD (glutamic acid decarboxylase), this shows an autoimmune process happening in your body, which means that you have LADA and not type 2 diabetes.

It’s important to know which type of diabetes you have in order to most effectively manage it and live well!

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Making eye contact

Posted on January 28, 2014 by janekdickinson

DSCN2310Health care providers spend too much time looking at computer screens, which can have an impact on communication with patients. Research showed that physicians spend one-third of patient visits staring at computer monitors. This is not just a problem for physicians: the nurse in our pediatrician’s office turns her back to us when she enters information into the computer and when she looks at the screen (which is mounted on the wall opposite the exam table).

In fact, as a diabetes educator, I know that I have been concerned with looking at the computer when I first meet a patient and have to enter information. I tried to arrange the office so I can still look at the patient, but truthfully, I have to turn my head to do so. Even if the screen were directly between the provider and the patient, if one’s focus is not on the patient, then it’s not on the patient.

Is there a good answer? We have to get information into the computer, and we have to look at the people with whom we work. Maybe we can take notes on a piece of paper and enter everything later? Not cost-effective, but perhaps the improvement in patient-provider relationship will pay off in the long run.

I relate to this from both sides: as patient and as provider. I have been to many appointments where health care professionals look at the computer more than they look at me. One of my favorites is being asked, “Do you have a fear of falling?” at the ophthalmologist’s office, while the person asking is staring at the monitor. What if I answered, “No,” but my face said, “Yes”? They’d never know.

Diabetes educators/health care professionals – how do you deal with this quandary? And those who sit in the patient’s seat – what have your providers done that works for you?

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Paying Cash for Junk Food

Posted on January 24, 2014 by janekdickinson

DSCN2308Once again, food researcher Brian Wansink is uncovering important information about the way we eat – how much and what types of food – and now how payment method affects food choices. He found that American kids are more likely to buy fruits and vegetables when paying with cash and more likely to buy desserts when using a debit card.

I wonder if this translates for adults when eating out, especially in cafeteria-type settings.

After reading this I immediately thought I’d just send cash for hot lunch, but I don’t know if they even allow cash at my kids’ school. Parents are encouraged to put money on their kids’ accounts through the web – even sending a check is discouraged these days. Applying Wansink’s study results, it seems kids would think even less about their food choices when the money comes from an account they don’t see. They don’t even swipe a card!

In an effort to find ways to teach Americans to make healthier food choices and lower health risks, Wansink has some great ideas. He suggests putting cookies/treats behind the cashier so kids have to ask for it. He found that kids are up to 50% less likely to get a cookie when it’s set up this way. Another idea is to require cash payment for less healthy food items, and allow debit cards for fruit/vegetables purchases.

We need to keep thinking of and implementing creative ideas like these to improve health and lower risks for all!

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