Knee Replacement Surgery and Diabetes

Posted on January 23, 2013 by janekdickinson

I recently read an article about a study looking at people who had had knee replacement surgery. The study showed that 30% gained weight afterward. I was actually surprised by this finding, because I figured people with a new knee would naturally want to be more active – especially if their old knee had kept them inactive for a long time.

But I guess these researchers found that people got used to being inactive and stayed that way after surgery. They also found that people who lost weight prior to knee replacement surgery had a tendency to gain the weight back after surgery – maybe because they’d reached their goal and were done. I also wonder if the pain of surgery and physical therapy (or even the fear of pain) stops people from being active with their new knee.

Another point in the article is that health care providers may not do a good job explaining to knee replacement patients (before surgery) the importance of getting and staying active after surgery. One approach is to use physical therapy as a starting point and then stick with the routine of exercising three or even more times a week until it becomes a habit.

I wonder how often this phenomenon is happening in the real world – not just in one isolated study. Have you or anyone you know had a knee replacement surgery and then gained weight afterward? If so, what do you think caused that? If not, what helped you to get/stay active with your new knee? A lot of people with diabetes have knee replacement surgery every year, and I think it’s important for us as health care professionals to know how to help prepare people to achieve the best possible outcomes.

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Blood Glucose Monitoring and Type 1 Diabetes

Posted on January 21, 2013 by janekdickinson

Current IssueAlthough the vast majority of the time I blog about topics related to diabetes in general – for people with all types of diabetes – today I’m focusing on type 1 diabetes (autoimmune diabetes). I am trying to catch up on my diabetes articles, and I just came across one from December 24th (ok, so I’m still a little behind) that discussed the new American Diabetes Association Standards of Medical Care for Diabetes.

One of things the new standards focus on is blood glucose monitoring (BGM) in patients with type 1 diabetes. It’s about time! The recommendation for type 1 and BGM has been “3 to 4 times a day” for as long as I can remember, yet reality is we often check far more than that. I certainly do. I check before meals, after meals (not all the time, but when I want to see what’s going on), before exercise, sometimes before driving, during/after exercise, when I feel low or high, when I’m sick, and so on.

I recently came very close to running out of strips, and realized that my prescription was not enough for the amount I check. At my endocrinologist (diabetes physician) visit last week I had them increase the number of strips in my 3-month prescription, and hopefully that will cover it. But it felt good to see that the American Diabetes Association supports (and put in writing) what we are actually doing, and what will help us make more informed choices and stay healthier in the long-run. Now if they would just stop using the word “test.”

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Dirty Little Syringe Secrets

Posted on January 14, 2013 by janekdickinson

Many people fear or resist going on insulin because of the needles. The truth is the needles we use for insulin today are very different from what we had years ago: they are shorter and thinner. The upside to shorter and thinner is that we feel them less. The downside is that they get duller faster.

Lots of people reuse insulin syringes (needles). The official message is to change your syringe each time you take insulin. But realistically it’s easier (and cheaper) to reuse them. In this case, it’s important to make sure you are the only person using your insulin syringes (don’t share!!). When the needle gets dull it will hurt more going in, or it may not go in at all.

When I was at diabetes camp years ago, we were told that it was ok to inject through clothing. The point was that it’s better to take insulin – even if that means injecting through clothing – than to not take it at all. Over the years I have occasionally injected through nylons (panty hose), jeans, or other clothing. This is a particularly good option if we’re wearing something that is not conducive to being removed quickly or in a public or semi-public setting.

Recently I was in this situation, and I attempted to inject through my jeans. Yikes! I discovered that the short needles I use are too short to make it through the jeans and into my fatty tissue! So a little update to the whole injecting through clothing deal is that we now need to make sure the needle is long enough. It’s fine to use short needles; however, if you’re using a needle that is 8mm or less in length, it is most likely too short to go through jeans.

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Please Don’t Should on Me

Posted on January 9, 2013 by janekdickinson

If you’ve been reading my blog posts with any consistency, you’ve probably noticed that I have a little language thing going on. About twenty years ago I realized the importance of language. There are many, many judgmental words and phrases used in health care, and people with diabetes hear them so often that maybe they don’t even realize it. I sometimes wish I were oblivious to these words, but it’s so in my face that I’ve decided to continue to work on it.

One of those words is “should.” My goal is to use person-centered (put the person, not the disease, or numbers, or anything else, first when speaking) and strength-based (use words and phrases that build people up, and don’t tear them down or judge them). “Should” doesn’t accomplish this goal. I once heard a friend say, “no one likes to be ‘should’ on.”

The other day I saw a web link titled “9 Foods You Should Eat for Diabetes” and I immediately came up with this blog post idea: “9 Reasons I Don’t Respond to Things That Say ‘Should’.” So now I will come up with those 9 reasons:

1. I immediately see a giant thumb pushing down on me.

2. Someone else is telling me what to do, rather than informing/supporting me.

3. I am so focused on seeing ‘should’ that I have no interest in the actual content of the article/link.

4. I imagine the 9 foods are nothing I’m interested in eating.

5. I immediately feel judged – as if I’m doing/have done something wrong.

6. I  feel that I am not in charge.

7. I don’t trust information from someone who would ‘should’ on me.

8. It makes me feel tired.

9. It’s just very negative and doesn’t feel good.

I should stop now. 🙂

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New Year Energy

Posted on January 7, 2013 by janekdickinson

My New Year’s resolution is to get up earlier in the morning. I figure if I get up earlier, I’ll get more done. Today was the first day I actually did it. And that’s ok. It’s still January; it’s still the New Year.

I was working at the hospital last Wednesday, and it was really busy. People were calling for appointments, etc. I was thinking about how this always happens in January. The new year really does present a great opportunity to start over, make changes, refresh.

Yet we often read about how many people never start their resolutions. Or they make the changes and then don’t stick with them. I’d rather focus on successes than failures. Maybe it takes a few attempts before a new habit sticks. That’s ok. Maybe the changes don’t look exactly like we thought they would – maybe they are partial changes. That’s ok too.

Seth Godin wrote a blog post about “This might not work” the other day. It’s true that anything we try might not work. But then again, it might work. It’s worth a try.

What was your New Year’s resolution?

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Grief and Diabetes

Posted on December 21, 2012 by janekdickinson

It’s been a week since the horror at Sandy Hook Elementary, and honestly, I have not been able to blog since it happened. I just can’t figure out how writing about diabetes (or anything else) would make any sense in these days.

The irony for me, is that we are also preparing for Christmas – a time of magic, music, and joy. And yesterday I learned that my grandmother is dying. She is 103, and she is ready to be finished in this world; I know that. But it’s hard and sad nonetheless.

And what about all the people who were diagnosed with diabetes during the last week? How does that compare to a mass murder in an elementary school? Does it matter?

I guess I’ve taken a week off, so to speak, out of respect, and out of recognition that there really are no words. And words are what this blog is all about. I realize that the world goes on despite the Newtown families’ unimagineable grief, just as it will go on without my grandmother. New and good things will happen again. And those who now have diabetes will have the opportunity to learn about the disease, and make choices about how they will manage it. And their lives will go on too.

But for now it is still fresh, and really hard. And it’s ok to feel, to grieve – for a life, for a loved one, for a healthy body.

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What is Type 1 Diabetes?

Posted on December 10, 2012 by janekdickinson

Type 1 diabetes, once called “juvenile onset” or “insulin-dependent” or “Type I” diabetes, is an autoimmune disorder. The body turns on it itself and attacks the cells in the pancreas (beta cells in the islets of Langerhans) that make insulin. Scientists have been working for years to figure out exactly why this happens, and there are theories, but still no definitive answer. We know that some people have antibodies against insulin and/or insulin-making cells, and that some trigger sets them in motion. Although once thought to be a childhood disease, people of any age can be diagnosed with type 1 diabetes.

People who have type 1 diabetes take insulin in order to live. Insulin is a hormone that maintains blood glucose in a healthy range (for those without diabetes that range is 70 to 110 mg/dL). Taking insulin from an outside source never works as perfectly as the normally functioning human body, so those with type 1 diabetes work hard to manage blood glucose levels. Diabetes management includes checking blood glucose levels (putting a drop of blood on a strip in a meter that gives a reading), exercising, paying attention to food choices, and taking insulin. It’s also important to manage stress, as stress typically raises blood glucose.

Blood glucose levels that are higher than normal over time can lead to negative health outcomes, while blood glucose levels that are too low can cause immediate danger. Therefore, managing blood glucose levels makes a difference in the short and long term. There are several tools available to help people with type 1 diabetes manage their disease: blood glucose meters, insulin pens, insulin pumps, smart phone apps, and continuous glucose monitoring systems.

Type 1 diabetes is a full-time job, and doing the work of a pancreas is not easy, but with effort and the use of resources, it is possible.

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Does Facebook Cause Diabetes?

Posted on December 5, 2012 by janekdickinson

 

 

 

 

 

 

 

 

 

Did you know that studies have been done on the effects of facebook on obesity and credit card debt? Probably even more, but I’ll have to check later. This particular study looked at self-esteem and self-control and their link to obesity and credit card debt. The researchers found that people who spend a lot of time on facebook also have a higher tendency to be overweight/obese and to have higher credit card debt.

So does it necessarily follow that facebook could cause diabetes? I guess it’s all how you look at it. We know that lifestyle habits can contribute to someone’s risk for diabetes, although that are several factors involved (this may be one of them). But spending a lot of time on facebook means spending less time being active, which isn’t great for any of us. The researchers were also looking at people’s tendency to eat high-calorie foods while “facebooking.”

I don’t tend to eat while I’m on facebook, but I’m quite sure that if I went for a walk or climbed the stairs every time I would have gone on facebook, I would be that much healthier. The self-control muscle is all the same, whether we’re using it to exercise, to make healthy food choices, or to avoid spending too much time on social networks. I think I’ll go take a walk!

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Diabetes Awareness

Posted on December 3, 2012 by janekdickinson

I’ve often said, “Everyone knows someone with diabetes.” And the number of people with diabetes in 2012 supports this statement. There’s a lot of diabetes out there!! Yet the other day I met someone who told me she doesn’t know anyone with diabetes. I was really surprised!

I recently gave a talk to a group of business women. I was disappointed in myself for not getting to my point sooner (I only had three minutes), because I spent most of the time discussing the differences between type 1 and type 2 diabetes. Afterward, one of the women in the audience told me it was a very helpful presentation because “people like us don’t know anything about the different types of diabetes.” Then today I read a report that 92% of Americans surveyed do know there are differences between type 1 and type 2 diabetes. Oh, the inconsistencies! But then maybe it makes sense that people know there are differences, but don’t know what those differences are.

So then I had to ask myself, is it really important for the general public to know the differences between type 1 and type 2 diabetes? Maybe the most important thing is for people to have a basic idea of what diabetes is, so they can at least be a little bit prepared should it ever become an issue with someone close to them. Also, as this same report showed, it’s important for people to know that type 2 is sometimes preventable. With that information we can actually do something!

Another time more on the differences between types of diabetes.

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Four Ways to be Healthy

Posted on November 28, 2012 by janekdickinson

This is what I tell my kids, and it’s true for all of us. Four things you can do every day to get or stay healthy:

1.) Drink lots of water 2.) Get enough sleep 3.) Be active 4.) Make healthy food choices

 

 

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