A Day Without Diabetes

Posted on February 24, 2012 by janekdickinson

Tudiabetes.org has started a monthly series with questions for blogs, discussions, etc. One of the questions this month is What would you do with a diabetes-free day?

I thought about this question while I was on the treadmill this morning. I really had to give it some time, as I don’t often ponder this sort of topic. Of course I started out thinking about the obvious eat-everything-that’s-not-nailed-down answer. This really doesn’t appeal to me, however, because I know I would still feel disgusting even if my blood glucose was normal.

Instead I came up with these two things: 1) I would engage in some type of endurance athletic event and 2) I would travel in a foreign place for the day.

I chose these two activities because I want to do them, yet am somewhat afraid to do them. I don’t need to participate in an ultra-marathon or anything like that, but I do have secret fantasies about long hikes and other strenuous activities. I also love the thought of traveling to interesting and exotic places. I know that I can do these things; I also know that managing diabetes during them, while very possible, would be a challenge and a hassle, so not having to deal with that would be nice.

What would you do if you had a day without diabetes?

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What is Diabetes?

Posted on February 22, 2012 by janekdickinson

What is diabetes? That is truly a loaded question. I imagine each person who has diabetes could answer that question in a different way. I am going to answer it historically and scientifically…this time.

Diabetes mellitus is characterized by high blood glucose. Diabetes is a Greek word for “to pass through” and mellitus is Latin for “sweet like honey.” When Greek people first identified diabetes (1500 BC), they saw that people were passing unusual amounts of urine. Others noted that the urine attracted insects because it was sweet. Today, we typically refer to diabetes mellitus as just “diabetes,” and health care professionals sometimes call it “DM.”

There is also a rare disease called diabetes insipidus, characterized by extreme thirst and large amounts of urine. Diabetes insipidus can be caused by the body not producing antidiuretic hormone (ADH or vasopressin) or by the kidneys not responding to ADH properly. Diabetes insipidus is unrelated to diabetes mellitus; they share the name diabetes because they are both characterized by excessive passing of urine.

In this blog, unless otherwise stated, I am only referring to diabetes mellitus.

There are a few different types of diabetes mellitus: type 1, type 2, and gestational diabetes mellitus (GDM) are the most often talked-about. We also hear the terms LADA, type 1.5, secondary diabetes and maturity onset diabetes in youth (MODY or monogenic diabetes). I will wade through these names and what they mean in future posts.

For now the important thing to know is that in people with diabetes, the body does not do what it is supposed to do to metabolize carbohydrates, and the amount of glucose in the blood is therefore elevated. Because the body is always working to establish balance, it tries to flush out the excess glucose through the urine.

 

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Diabetes & Ayurveda

Posted on February 20, 2012 by janekdickinson

I am honored to have a guest blog by my friend, Tracy Zuschlag, who is a licensed Ayurvedic Lifestyle Consultant. I recently heard Tracy give a talk about Ayurveda and thought it would be something interesting to share with readers. Have you ever heard of Ayurveda? Tracy explains what it means, what it is and how you might be able to apply some of the principles of Ayurveda in your own life.

Ayurveda (pronounced Eye-Your-Veda), is a sanskrit word, that is broken down into two root words: Ayu=life and Veda=science or knowledge, so Ayurveda is the “science of your life.” Ayurveda is also the sister science to yoga and one of the oldest health care systems in the world (over 5,000 years old). Ayurveda gives us the tools and knowledge to understand the five elements or energies – ether, air, fire, water, earth – that are in nature and every living system on earth.  Every organism is comprised of ether, air, fire, water, earth and yet every organism is a different combination of these elements – not one of us is the same.  The balance we strive for in Ayurveda begins with understanding our biological constitution and how that relates to the seasons of the year, the time of our life, time of the day, nutrition and lifestyle.

Once we understand our biological constitution, we can look at our current imbalances and how we can bring ourselves back to a state of balance and optimal health. Remember it took a lifetime to get where we are, so it may take time to get back to where we want to be.  This type of approach isn’t a one-size-fits-all plan. When I work with people, we develop a plan that works for the individual. When it comes to nutrition we look at seasonal foods, herbs, spices and within that framework we talk about recipes, when to eat, what to eat, how to eat. Ayurveda is a whole foods-based eating plan that encourages a variety of foods, depending on one’s tastes and what works for them. In terms of lifestyle we talk about daily routines, exercise, stress reduction and therapies intended to calm the nervous system and improve overall health and well-being. Ayurveda is a whole healing system of health that balances the body-mind-spirit.

Basic principles of Ayurveda that can help everyone:

  • Drink warm water to remove toxins
  • Eat when digestion is strongest (10 a.m. to 2 p.m.)
  • Stay in tune with nature: eat foods that are in season
  • Like increases like: the more you do the same – the more you’ll get the same results

Websites with more information on Ayurveda:

http://www.wholehealingayurveda.com/

www.ayurvedaboston.com

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Diabetes Benchmark

Posted on February 17, 2012 by janekdickinson

It’s incredible how something that’s been around for more than thirty years – hemoglobin A1C – is just now becoming more well-known. At any rate, I saw an article about A1C today that was called “Future Diabetes Test.” I was intrigued because I misinterpreted that title. They did not mean that the A1C is coming out in the future – it’s already out! It meant that A1C is now being used to detect one’s chances of getting diabetes in the future.

The A1C is a measure of the amount of glucose attached to hemoglobin, the protein in red blood cells. Here’s a nice video explanation of A1C. I remember way back in the 80s having blood drawn for something called “glycosylated hemoglobin.” Unfortunately, I don’t think they really knew what to do with the information until after the results of the DCCT were published.

During the 90s I remember my endocrinologists measuring my “hemoglobin A1” and for the last thirteen years it’s been called “A1C.”  I have to admit I’ve never really understood all these names, so I did some checking. From this article I understand that there are three “fractions” of the hemoglobin A1 molecule. When the glucose content of all three are combined it’s called hemoglobin A1, otherwise the particular fraction is identified (e.g., “A1C”). Now it makes sense why my hemoglobin A1 was always higher than my A1C (as was the normal range).

If you are not familiar with A1C, it’s time to do some reading. A1C helps us figure out how we’re doing with our diabetes. While blood glucose monitoring gives us a snapshot of one moment in time, A1C helps us see the big picture. Talk to your health care provider about getting your A1C checked if you haven’t already.

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Don’t overlook talent

Posted on February 15, 2012 by janekdickinson

Are you selling yourself short? I just read an article about Jeremy Lin, a Harvard graduate who is playing basketball for the New York Knicks. The article discusses 10 lessons for success, based on Jeremy’s experiences. I especially like lesson #5: Don’t overlook talent that might exist around you today on your team.

This got me thinking about how every person who lives with diabetes has strengths (and weaknesses, but let’s focus on strengths for now) or talents. Perhaps someone is a good listener or a talented musician. Others are good at math or sports or something else completely.

Perhaps it’s time to identify your diabetes talents. Forget what you stink at and get in touch with what you do well. Do you always remember to check your blood glucose or take your meds? Do you exercise every day or make healthy eating choices? Maybe you are good at managing stress. Whatever it is, focus on that and then determine how you can maximize that skill(s) and make it work for you in the big picture.

Stop beating yourself up for the things you don’t do or don’t do well and start praising yourself for the healthy choices you make each day. The more you focus on the positive, the more positive you are likely to feel and the more positive your outcomes are likely to be.

The second part of the lesson is the talent on your team. Hopefully you have an amazing diabetes care team (if not, it’s time to start looking…). Use your team to get the information and support you need. By the way, the third lesson is that your family will always be there for you. That’s true of your support system here in the Diabetes Online Community. Take advantage of us!

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Never too late; always too soon

Posted on February 13, 2012 by janekdickinson

I love this article for many reasons. My grandmother is 102 years old, so whenever I see an article about centenarians, I read it. What if that happens to me? I’ve mentioned before that my goal is 85…

I like how Dr. Bortz gives straight-forward suggestions for a healthy lifestyle: move more. Exercise is key to health: research is showing that fitness may be more important than weight. Not to mention that exercise just makes us feel good – it releases endorphins! His quote: “It’s never too late to start, but it’s always too soon to stop” is just perfect.

I also like his recommendation to not waste time on hoaxes (anti-aging ones, in this case). Don’t waste your money – spend it on healthy fruits and vegetables!

The advice to stay engaged is important – this is how we remain active (young), involved and excited about life. Find things you enjoy doing and do them!

And I absolutely love “own your self-care” not only because Dr. Bortz gives a positive mention to diabetes educators (yea!), but more importantly because ownership is what successful diabetes management is all about. No one else is going to own our disease for us, so we need to take initiative. If we get bogged down in being a victim, that’s just going to increase our stress, which diminishes all the work we do to manage the darn thing anyway. Owning our self-care is moving forward every day, believing in ourselves, advocating for ourselves, supporting each other and getting the support we need.

I guess I’m ok with living to 100 if I am still able to own my diabetes.

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Overweight despite fewer calories

Posted on February 10, 2012 by janekdickinson

I’ve met many people who are overweight or obese and tell me they don’t eat much. This may be the case because they are purposely withholding calories, or because food is not readily available. Here is an article about scientists who are studying this phenomenon.

I think of it as the body going into panic mode if it doesn’t know when the next meal is going to come. This can happen when people follow extremely restrictive “diets,” for some that is less than 1000 calories a day, but there’s not necessarily a magic number. Instead of losing weight, their bodies may actually hang onto it. The body adjusts its calorie needs based on how much it is getting. This means that when the person does eat, their body converts the calories to fat at a higher rate.

Another problem with not eating enough is that when food is available (or when we go off the “diet”) there is a tendency to overeat. It can turn into a vicious cycle. The trick, therefore, is to consistently eat the right amount for our bodies. This can be difficult if we don’t consistently have the funds to purchase food, let alone healthy food. It can also be difficult to eat consistently when we are faced with a busy life, stress, or depression.

Diabetes professionals are constantly looking for ways to help and support people with all aspects of managing the food part of diabetes. Unfortunately, there are no easy answers. By working together we can share ideas, information and support.

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Fail Better

Posted on February 8, 2012 by janekdickinson

Failure is a routine part of managing diabetes. How’s that for a downer intro? But it’s true, at least if we are striving for perfection. Even if we are only striving for mediocrity, we fail to achieve that at times, because our bodies fail us. For some, the pancreas just doesn’t make enough (if any) insulin; for others, the cells don’t respond to insulin the way they are supposed to; for most, their genetic make-up set them up for failure.

This article discusses the importance of our being able to handle failure, which is called resilience. Resilience is the ability to bounce back when things don’t go the way we want. In diabetes management resilience is critical. If we weren’t resilient, one blood glucose reading out of the target range might send us spiraling into despair. Imagine how we would feel when someone made a judging comment or when we ate something that we know makes our blood glucose go high.

Scenarios such as these happen all the time for people with diabetes. We can’t let them paralyze us; we have to learn from them and get on with our lives. This is easier said than done, of course, but it’s a skill we work on in order to successfully manage diabetes and life. So maybe we use our little diabetes “failures” to grow and learn and get stronger every day. We can use them to build resilience. Who knows? It might just make us more resilient in the rest of our lives as well.

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My three words

Posted on February 6, 2012 by janekdickinson

I just watched a video that I have to share. The hospital where I work is currently doing a very cool campaign, where members of every department are asked to come up with their three words. Three-word phrases like “better health now” are cropping up all over the building. Because I am only at the hospital once a week now, I wasn’t aware of how this got started until today (ok, I’m out of the daytime television loop). Thanks, Good Morning America, for starting this fun and touching trend.

I could not resist sharing this video and this idea. It’s hard to sum up your life, your beliefs, your goals or something else about yourself in three words, but here’s what I came up with today (it could be different tomorrow):

ALWAYS SEEK BALANCE

What are your three words?

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Do you speak up?

Posted on February 3, 2012 by janekdickinson

Are you good at speaking up for yourself? Advocating for yourself? Tooting your own horn? Many people aren’t. There’s evidence that women are worse at it than men.

This skill is particularly important in the workplace. In order to get a raise or a promotion, you are probably going to have to let your boss know what you’re doing and how well you are doing it. In diabetes management, I think it translates to asking questions. When you visit the diabetes health professional do you ask questions?

It is important for your diabetes educator or other provider to know what you don’t know, what’s confusing or unclear to you, or what you are just plain getting mixed up. I write my questions down – starting immediately after my visit – and save them for my next appointment (months away). I make sure to ask all of my questions and that I get answers that make sense.

As a diabetes educator, I can assure you that we want you to ask questions. We don’t want to talk about things that don’t interest you; rather, we want to focus on what’s important, unclear, or scary to you. Bring a list of questions to your next appointment and let the provider know you want to leave time to ask them. If you don’t feel comfortable doing this, it may be time to consider finding a new diabetes health professional.

Don’t forget that you are the most important person on your health care team.

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