Lesson to be learned

Before doing this, I had to do some hard thinking and get back to my positive side.  If you are interested, please read a post by Dr. Bill Quick at My Diabetes Central.  He did an excellent post correcting information put in the public domain by the American Diabetes Association.  This information was, to say the least, poorly thought out and not the full truth.

I must thank Tom Ross for his blog of Nov 9, 09.  I agree with his analysis of a common concern of newly diagnosed people with diabetes.  Most do seem to want the "rules" that they can follow to be able to be compliant with their doctors' orders (if indeed the doctor ordered anything).

I belong to a couple of forums about diabetes and this repeats itself very often.  All are searching for some simple rules to get their blood glucose under control so they can return to living.  They do not realize that diabetes is a 24/7 problem they must deal with.  Many, but not all, do not want to hear what they are told and never post again.  Others take a different tack and reposition their question to elicit a response more in their favor.  Failing with this, they post the same or similar questions on several forums.  A few wake up, pay attention, and proceed to ask the real questions.  They are receptive to the variables and the idea that the "rules" are the ones they discover about their own situation and body chemistry.

We can tell people that "what works for me, may not work for you", but many do not listen.  When something does not work, they blame the forum and its' members and do not return.  They keep looking on other forums for answers, but do not find them and never post again. 

I may be wrong, but "rules" and "quick fixes" seem to be at the top of a list of what these people are looking to find.  Few are type 1's, but the majority are type 2's.  Many, unfortunately, do not have insurance and are unable to do everything they should to test as frequently as they need to for determining what foods their body is capable of handling.  Controlling their blood glucose now becomes a problem which the doctor often can not help.

Since November is diabetes awareness month, there are many bloggers putting out some excellent blogs for diabetes awareness.  Hopefully they are reaching more than just fellow bloggers.  I am listing several that have something to say.  Amy Tenderich has an excellent blog on Nov 13 about some interesting technologies on the horizon (and in the near future I hope).

The over commercialization of diabetes and the attempt to take advantage of people with diabetes is the subject of posts by Janet Rulh on Nov 8 and Scott Strumello on Nov 13.  They both make valid points that must be considered and expose some of the shortcomings of diabetes awareness month and diabetes day (Nov 14).  I admit that I was unaware of what happened during diabetes awareness month other than it was a month on the calendar.  I had never heard of diabetes day.  Some bloggers are doing a lot within the diabetes community, and a few are actually channeling their efforts outward to the public to make them more aware of the truth of diabetes.  This is where I hope to make some effort next year. 

I appreciate Scott Strumello's blog about dogs for the hypoglycemicly unaware.  He listed one supplier that is being sued by the State of Missouri for violations, but otherwise the blog was good to put in front of the people.  This is a repeat for a previous post.

George Simmons took a different view of veterans's day.  Since he is unable to serve his country in the military, he has chosen to view himself as a veteran in his war on diabetes.  Good interpretation and a worthy cause George.

Notice on Diabetes Alert Dogs

For all future blogs about diabetes alert dogs, service dogs, and related blogs, these will be found at the following link.   Thank you, Bob

I feel that separating the two topics will allow more concentrated effort for each.

Diabetes Resources on the Web

The number of web sites devoted to diabetes continues to grow. This should be a good thing, but I am wondering if we are getting the advantage. It seems that many of the sites do nothing but promote more studies about nothing and create more misinformation.

I had hopes when Amy Tenderich covered a new site "TheDiabetesResource.com" that had been sending out emails to announce it arrival on the scene. Its mission was to be a resource for all that is about diabetes. Amy's coverage was on October 5, 2009.

So to see what Amy was talking about I did some investigation. I discovered that it had a listing of blogs about diabetes; however, when I looked further, many of the blogs are misclassified, listings are duplicated, and in some cases are dead sites still on the web (anything with no activity for more than two years is a dead site to me). There is a lot of work for this site to correct the errors it has created for itself in the rush to go public.

I commend the site for what it wants to accomplish, but it did not do its homework before exposing its flaws to the public. Many of the errors will probably remain uncorrected while the site tries to get the latest information on line. Yes, we all make mistakes and live to regret proper prior planning and this site will have a lot of work to do to become the source for all that is diabetes.

Until some of the misinformation and errors are corrected, I will sit on the sidelines and wait before joining. I like the concept, but not the product that is now available for public consumption.

Here's hoping that this site is able to fulfill it mission and be the one source for diabetes - there is a need for this.

Types of Service Dogs

This is off the topic of diabetes, but necessary to be grounded in the subject of assistance/service dogs of which diabetes service dogs are an integral part.

Assistance Dogs International Inc. (ADI) uses a simplified definition, listing guide dogs for the sight impaired, hearing dogs for the hearing impaired and service dogs for other disabilities.  While guide dogs have a 70-year history and hearing dogs a shorter history, other service dogs are a recent development and have not gained the recognition in numbers to be in a class by themselves.

Please take time to browse their complete site.  It has much valuable information for determining whether you are being given the correct guidelines for training and the essentials for measuring the training your dog needs to be an excellent assistance/service dog.

Now, service dogs for other disabilities will take up the rest of the discussion.  There needs to be a list of these service dog types for medical or health related disabilities.  Standards may be developed for all these types or for each type of service dog.  Service dogs for disabilities are covered by Americans with Disabilities Act (ADA).

Please note that Therapy Dogs, Search & Rescue Dogs, Forensic Dogs, Police K-9's, Military Working Dogs and other types of working dogs are NOT Service Dogs.  This may be what ADI is referring to for facility and therapy dogs for which currently do not have standards established.  

Liz Norris of Pawsabilities Unleased has a list of eight types and some of the tasks they can be trained to accomplish.  The US Service Dog Registry lists 13 types of service dogs in addition to guide and hearing.  Not mentioned in either list is service dogs trained for cancer, strokes, and migraines.  More types are being added regularly and many service dogs are trained for multiple disorders in their human partners.

The latest type of service dogs added is for soldiers suffering from post-traumatic stress disorder (PTSD).  This project is part of a study funded entirely but the Department of Defense and put service dogs with 10 soldiers.  The other type recently added is a service dog for autonomic neuropathy.  Autonomic neuropathy is a disease that damages the autonomic nervous system, a branch of the central nervous that helps people adapt to changes in their environment, according to the American Heart Association. 

Today only 0.9% of persons with disabilities have service dog partners.  This means that there are approximately 15,000 service dogs across the U.S.  These dogs have a significant influence on their human partners' lives and are able to function more independently with the help of their canine partners.

Diabetes Alert Dogs - Part 2

Getting Prepared

Think you want a diabetes alert dog?  Are you prepared and do you know where to find one?  Chances are you are pretty much in the dark.  You are looking for information - any scrap of information that may lead you to where you can obtain more.

The information is out there in the internet, the difficulty is finding reliable information and knowing what you need.  Learning is the most important part.  This is the step you do not want to rush.

There are two terms that you should know.  Service dogs is a common term and diabetes alert dogs is one of several types of medical service dogs.  Americans with Disabilities Act (ADA) is the law that makes it possible to take the service dogs into places they would not otherwise be allowed.

The following is from "Clickin' Canines" website of Rita Martinez, used with her permission.

Quote

LIVING WITH A SERVICE DOG

So you want a service dog!!!

Service dogs can be a wonderful asset for someone with a disability, but it is always good to go into anything with your eyes open from the beginning.  Many factors come into play with the use of a service dog.  These dogs can be a life saving partner, but they come with needs and can change every aspect of your life.  Below are some things to think about:

1. Do you like dogs?  Enough to share your life with them 24/7?  These dogs are not simply a tool, they are individual intelligent creatures with their own set of needs.  They become a part of your everyday life.  Are you ready for this kind of sharing?
2. Are there other animals in the home?  Do you have family support for a dog?  Keep in mind that bringing in a working partner while there are other animals in the house will change the dynamics.  Are the current animals likely to adapt easily?  Does the rest of the family want an addition to the household?
3. Having a service dog is like growing an appendage.  You are no longer just you - you are a 'we'.  That means there are frequent times that it will be inconvenient.  You have to make sure the dog has a place to be comfortable with you yet safe from heat or cold or tight quarters etc.  Yes, that means even in public restrooms...
4. Are you ready and able to care for your dog's physical requirements?  Dogs need proper exercise, grooming, bathing, feeding and off-duty outlets.  There also needs to be a provision for the financial responsibility of regular healthcare and preventative medicine.
5. Are you ready and able to participate in continued training to keep the skills from degrading?  Training is never finished - Maintenance is forever.
6. Are you aware that there are licenses, equipment, and miscellaneous costs associated with having a working dog?
7. A service dog is on call 24/7 for you.  Are you ready to be equally dedicated to your dog?  They aren't machines with a off switch, they are living partners.
8. Are you aware of the public issues you will come across?  You will forever be answering the same questions, educating the general public about service dogs, never be simply un-noticed, and will have to deal with the individual fears that people have of dogs!  You will have to consider where you can walk, sit or stand and be safely out of harms way.  You will have to seek appropriate places for your dog to relieve itself.  You will be responsible for all your dogs needs at all times.
9. And lastly, are you comfortable with the liability of having your dog with you in all situations in the public?

These questions are not meant to discourage you from having a service dog.  But, it is wise to approach  something this important with real thought.  Having a dog as a working partner is a commitment that lasts many years.  It is a decision that needs to be well thought out.  End of quote.

I would like to expand on Rita's number 2 above.  If there is family support and there are other pets in the house, will the family members be willing to give up those animals for your service dog if it becomes necessary?  If there are cats in the household, how difficult will this be for the service dog?  While some pets do get along well together, is the family willing to part with those pets that do not get along with the service dog?

And I would include some specifics not mentioned -

• Do you have the patience required to have a service dog?  They cannot be mistreated or neglected.
• Under financial and miscellaneous fees, there will be vet bills and the need to have emergency vet care available.  Have you located or know where to locate this service?  To keep a service dog requires weekly expenses for dog food.
• And, as the service dog ages, will you be ready to take on a replacement dog and retire the current service dog?  Most people writing about service dogs do not bring up this issue, but it needs to be thought about.  All dogs age and lose their usefulness in 10 to 14 years and need to be retired.

All are questions that need to be answered before the search begins.

If you have answered all of the above questions and are comfortable with the answers, what is next?  There are several ways to proceed.  You will have to decide what is best for you and your own circumstances.

1. It is my belief that you need to locate a trainer before thinking about getting a dog.  Both the trainer and the dog will require much research, but having the trainer first gives you an advantage because the trainer will while assessing your needs, be able to make recommendations for a possible dog and have suggestions on finding a good fit for you.  You still will have to make the final decision.  The links provide a place to start in locating a trainer.  Rita Martinez lays out some excellent frequently asked questions (the first three are very important), how to choose a trainer, and choosing the trained dog.  Please read this carefully.
2. For those persons who know they desire a certain breed of dog, check with the American Kennel Club for locations of breeders.  You will need to then follow the same steps under choosing a dog, but apply this to the breeder and you will need to check out their trainers as well.  Do not bypass any of the steps as this could cost you many dollars being misspent.  How do I get this point across - Do not make decisions based on emotions!!!  There are breeders out there that are counting on your emotions taking over once you see the dogs.  Never make a visit until you have completed your homework.  Yes, visiting the breeder's facilities is the next to last step, but be prepared to leave if you don't like your first impression.  Make them show you the entire facility before they show you the dogs.
3. Then there are those of you who will want to go to the local SPCA or animal shelter.  Now I would strongly urge you to have a trainer first.  You will want to have discussed this with them and they will have prepared you for the questions to ask.  You will want to make sure that the recent history of potential dogs is known.  I may cost more to retrain out bad habits and past abuses that the animal may have suffered.

For both the trainer and the breeder, check the Office of the State Attorney General in the state where they are located for complaints or actions on file against them.  Once you have the references, do not put them in a drawer and think you have completed you due diligence.  Call or correspond and get the information!  It just may prevent future disappointment.

There are dog breeders, trainers, and others that are reputable.  The above is to help make your experience a pleasant and positive one - not one of regret.  Always remember, they should put your needs first and fully answer your questions.

Now comes the big decision - getting the dog!

Note:  I have used Rita Martinez as a resource person for much of this because her philosophy is close to my own and while we may differ sometimes, she offers many pointers that I might have missed otherwise.  Both of us want to make the experience of getting and having a service dog a pleasant and satisfying experience.  Rita has and is working with about 40 dogs for diabetes alert dogs.

Random Topics

I thought I was ready with two new blogs, but discovered a couple of problems. So back to the research to find the answers.

A Favorite Blog
I feel the need to mention the blog by Tom Ross of September 14. For having type 2 diabetes, this modest gentleman is doing exceptionally well in managing his health. While he makes no claim that it will work for others, or that he may never have to go on medicines, eight years of success speaks volumes.

There are not enough people willing to put their lives under such close scrutiny by posting a daily diary. We must congratulate him for his efforts and success!  Knowing that his way is not remotely possible for me makes me even happier for him.  Therefore, Tom, take a well-deserved bow.

I sincerely wish my brother were alive to read Tom's blog, as he would appreciate this as a vindication of what he was able to accomplish until cancer took him. All those who are able to control their diabetes with nutrition and exercise, please do not remain in the shadows.  We need more role models that can be seen and give others hope that it can be done.

Diabetes Alert Dogs
The blogs for diabetes alert dogs is presently on hold for lack of communications.  This is mostly my fault for not asking the right questions of busy people.  Lack of good journalism skills which I need to learn.  Reaching out to people and organizations for answers is taking time.  One organization mentioned in an in-country article, said they have no idea that they were mentioned as resource as they have no interest in diabetes alert dogs and did not know there were any in their country.

Interesting Diabetes Web Site
About a month ago, I came across the web site for the Behavioral Diabetes Institute in San Diego, CA.  It got my interest and I have been exploring the site.  There are some interesting discussions and articles on the emotional and psychological aspects of diabetes.  This is too often ignored by the press and people writing about diabetes.  This group is presently too small to have presentations outside their local area, but I have hope for a larger area in the future.  The site is worth the time to explore.

Changing of Seasons
The first day of Autumn will be here next week and I am looking forward to the display of beautiful colors Mother Nature will put on across our country.

An Open Challenge to Diabetes Bloggers

I have a feeling that is hard to rationally put in writing.  That is it reason for the open challenge to all bloggers that write about diabetes.

When people are justified in their feelings, whether positive or when a cause for indignation is right,  some writers seem to feel that the use of profanity is justified.  I disagree.  Most of us are not journalists by occupation or training, but we still should know better.

As such, I have to quote Kerri Morrone Sparling in her blog of September 1, 2009.  What she was writing made my blood pressure rise as well.  Her writing was about just cause and case of discrimination that made me sit up and take notice.  The title is "No Moral Lifeguard on Duty?".  Her opening paragraph is and I quote  

"I'm refraining from using the words that are REALLY flying around in my head regarding this discrimination issue.  But believe me, Yosemite Sam ain't got nothin' on me this morning.  My whole brain is "frick-a-frackin' ...""

The tone is easy to understand and the point is made.  No profanity is used and the message is still positive.  If you have not read it, it is well worth following the link "September 1, 2009" above.

Back to the challenge.  We are writing about diabetes.  This topic alone brings up all types of negative connotations,  discrimination, mis-information, etc..  And to the individual diagnosed, anger, frustration, and denial to name a few feelings encountered by the person.

So why, when bloggers are writing about diabetes, do we have to add to the negative side by the use of profanity.  There are other ways of showing our displeasure and disapproval without adding to the down side of diabetes.  Our readers need to be told the facts, need encouragement, and often support to help them when they are down.  We as bloggers also need a shot of encouragement from time to time.

So on that, I leave this subject and hope that it encourages you as a blogger about diabetes to be more positive in your writings.

Diabetes Alert Dogs (DAD's) - Part I

Why is a person writing for T2's writing about something that primarily affects people with type 1 diabetes?  Besides growing up with dogs and a father who trained dogs for duties around the farm, I have a keen interest in dogs.  I am also doing this to flush out and challenge the T1 bloggers who have ignored this topic, and maybe to encourage others to write about this topic that are not involved enough in helping others.

First, some background for this topic.  Seven,  and even four years ago, very little information existed about Diabetes Alert Dogs (DAD's).  Some have called them service dogs.  There were no standards for determining whether a dog was suitable and no published standards exist today.   There is no National Organization to aid people seeking these dogs, to set standards, or even a database of reputable dog kennels and breeders for DAD's.  Most of those in existence today have expanded from other service dog areas or are already dog breeders for other purposes.

Because some breeders know that people tend to let emotion control their buying habits, some are hoping to cash in on these buyers.  These people are in the business of misleading potential owners of DAD's.   I have not found any reliable concrete scientific evidence that there is a smell, odor, or body chemical that would cause a dog to react to a hyper or hypoglycemic episode.  There are some Pharma's that are doing studies as they want to develop a piece of equipment to do what the dogs are capable of doing.

Before you castigate me, try telling that to the young people that have a DAD.  There are some incredible instances of their dogs saving their lives.  In essence, it is our young T1's that are the pioneers making this happen - along with some dedicated parents.  Not only in the USA, but in Australia, the United Kingdom, and Germany.  This points to something that causes the dogs to be able to alert.

The demand is potentially great, because many T1's are hyper and hypoglycemic unaware, or will lose their ability to sense when they are having high or low blood glucose levels.  Most T2's know when they are having a glycemic event.   This is the place for the diabetes alert dogs.

There is a need for a National Organization to certify trainers and operations in the business of selling dogs to be DAD's.  The American Diabetes Association (ADA) is not qualified although it has given minimal recognition to DAD's and their potential place in the world of diabetes.   The American Kennel Club is in no position to step into this role.  It has enough problems in meeting it's own needs, not to take on this task.  The Americans with Disabilities Act (also ADA) is working hard to allow dogs to be present where they have not been allowed before.

Training of dogs is vital to their ability.  There are primarily two types of training available but only one that is suitable of service dogs.  More on this in another blog.  Service dogs and especially DAD's need to be easily controlled, even tempered, and responsive to the person for whom they are working.  While most dogs, whether they are mutts or purebreds, are capable of being trained, some breeds are better suited for training because of the traits they possess.

Before a person gets excited about obtaining a DAD, they must do their homework.  Why?  Because "it is a buyer beware" climate where there are many persons and businesses holding themselves out as "experts" in training or having trained dogs available, that are less than reputable.

Learn to put emotion on hold and investigate, and then investigate some more.  Check the internet using search engines, check with the Better Business Bureaus in the area of the trainer or breeder, the State's Attorney General, and always ask for references.  Use the search engines to check for complains also.  Enter the business name and add complaints.  Do not be surprised, they exist!  Some are legitimate complaints, and some may have complaints that are more mean spirited in nature - hence not necessarily valid and often anonymous.

If the references are not received promptly, take that as a warning.  When references are received, then ask some hard questions of them - don't put them in a drawer.  Ask how long they have known the people and the business?  When did they last do any business with them or last have contact with them?  Do they know anyone that has done business with them?  If you receive no answer or a "no" answer, then take that as a warning.

Reputable good trainers and businesses have a network of people that support them which is not solicited because they are well thought of by their clients who will willing discuss the strengths and weaknesses (if any).  These are what you are looking for.

For those wanting to look further, I list the following as a place to start.  For a forum investigate Phorum. 
Owner and Administrator is Rachel Thornton in Mississippi.  Check a site still under development owned by Rachel Thornton.  For trainers check out Rita Martinez from the San Francisco Bay Area, California, Dee Bogetti from Richmond, Virginia, and Liz Norris from Frankfort, Kentucky.

For future blogs, I am working on training techniques, IRS issues, DAD's in other countries, and ownership issues, and breeders.

I hope this introduction to DAD's has created an interest and that T1 bloggers will take up the challenge.

Diagnosis - Type 2 Diabetes

Are you newly diagnosed?  Remember the doctor pronouncing the diagnosis and muttering something about changing your diet, and sending you on your way? Does this sound familiar? Or did the doctor say that you will be scheduled for classes with a dietitian and diabetes educator?

Now what do you do in the meantime? Many stress out as they have been told about people, relatives maybe, that had an amputation, gone blind, and other scary tidbits of "more than you wanted to know information", and panic sets in.

I do not have all the answers, but my advice is to relax. Go home and take an inventory. Look at the cookbooks already on the shelf or in a pile somewhere. Most can be adapted for your needs. In addition, you now have a lifestyle that must be changed.

Going out and purchasing new cookbooks like I did is not the answer. I thought they would help me and I have regretted it since. Most had the word DIABETIC in the title. Bad, bad mistake and money poorly spent. They were generally written by people without diabetes and the recipes were high in carbohydrates.  They might be okay for type 1 diabetes, but not for type 2.

If you happen the have a "diabetic cookbook", and have no other information, use it for starters until you are comfortable with adjusting regular recipes. Then donate it somewhere.

The classes may or may not be of value. It will depend on the dietitian/nutritionist and what they know about diabetes. There are some good people doing this, and I hope yours is one of these like mine was. If they start talking about the exchange system or eating over 160 grams of carbohydrates daily (three meals and two snacks), then you may want to consider another method of learning.  Do finish the classes, as you will be able to adapt what you learn.

Certified Diabetes Educators in the US are required to pass an exam and are being required to have continuing education to retain their certification. So generally you will be in good hands with these people.  This is often when you will get a glucose meter.  Learn how to use it!  It will become a good friend!  If you do not and are without insurance check out this.

When you are ready, take an inventory of the food you have in the house. If is is white - potatoes, rice, and pasta - keep it for other family members or give it away, depending on your finances. You do not want these foods on your plate. If it is highly processed foods, you may want to do the same. The local food box is always looking for donations.

Examples of labels on different foods:
Looking at the label on a can of cut green beans, I see serving size is 1/2 cup (120grams). There are 3 1/2 servings in this can. The rest of the label in based on one serving. Fat is 0g (all categories), Sodium is 400 mg, total carbohydrates is 4g and protein is 1g. Under carbohydrates it lists dietary fiber as 1g and sugars as 2 g. For counting carbs, I would normally eat two servings and would count 6g of carbohydrates. Yes, the 1g of dietary fiber is subtracted times two servings.

Now of some pasta (not white, but whole grain) - the label on a box of elbow macaroni. Serving size is 2 oz (56g - 1/8 box), eight servings per box. Total fat is 1g, sodium is 0g, total carbohydrates is 46g (high), and protein is 7g. Under carbohydrates the dietary fiber is 2g and sugars is 1g.

So if I would have this for an evening meal, I would count 46g of carbs (not including anything added to this meal which needs counting), which is higher than I like. I strive to stay under 100g (80 if possible) of carbohydrates for three meals and two snacks.  You have to determine what will work best for your own control of diabetes.

When looking at your cookbooks, make use of them. With Calorie King, Nutrition Analysis, and other tools available on the internet, the nutrition and carbohydrate count can be reasonably calculated.

If you are not comfortable with this, then next time you are in the book store, look at the recently published cookbooks.  While I am not promoting any, the most recent editions of Betty Crocker, Better Homes & Gardens, and The Taste of Home cookbooks all have the nutritional information with each recipe.  There are others as well that have the nutritional data.

I also recommend Alan Shanley for some excellent basics in getting started.

For vegetarians, I hope the following will provide a start to further investigation.  There may be vegetarian cookbooks at the local library or find them at Amazon.com.

If you are ambitious and want to start with low-carb. you may want to consider 500 Low-Carb Recipes by Dana Carpender.

Have some fun with the cookbooks already on your shelf.  If you have a food scale, use it.  You can eat regular foods, just smaller servings.  Learn which recipes work the best for you.  Cook, taste, and test, test, test with your meter to find out serving size of what you can eat, or need to eliminate.  Stay away from HFCS (high fructose corn syrup).  This is not always easy to determine on some labels.  It will get easier!

When you are comfortable, learn about the Glycemic Index, Glycemic Load, and lower glycemic index foods.  These work to level the absorption rate and make your medications more effective.

Learn how to use condiments and spices.  Do not settle for bland food.  Good eating!

Diabetes on the Internet

Since some of the information, other than personal experience, that I rely on is from the internet, I feel that the following reading must be recommended. The link is probably the leader in "do's and do not's" for medical web sites. The link is broken unfortuntely and includes many excellent perspectives on evaluating what you are reading. It tells you how to interpret the information presented - all from a "patient empowerment" perspective. With diabetes, this is the watchword to success in getting and maintaining control. Each person must manage his or her diabetes, not the doctor. The doctor should help and give you some guidance, but you (the one with diabetes) know how you feel and what you blood glucose readings are on a day-to-day basis.  The format of the original link has changed, but this still takes you to patient empowerment section.

Please take time to read it carefully, maybe bookmark it to be able to refer back to the information later. It is my desire to give you resources you can use - intelligently - with your doctor.

The tcoyd web site is part of my research. This web site lists (with links) companies, organizations, and associations working for the cure of diabetes and providing information to those having diabetes. Many of the sites discuss the latest developments in bringing diabetes under control. In addition, tcoyd is now one of my favorite acronyms (take charge of your diabetes).

The first web site below, I discovered about a week after diagnosis and it continues to be a favorite. Each of the web sites I have bookmarked in my browser. I go back and read, and often reread portions of the sites for review and what now peaks my interest. Each writer writes with a different style and presents points of view that keep me interested and learning. Each writer is also a person with diabetes, type 2.

David Mendosa writes almost entirely about diabetes and related health problems, types of insulin, diabetic equipment, and testing supplies. He does write about problems not caused by diabetes, but that are often associated with having diabetes. He maintains his own web site (this one) and writes for several magazines and web sites. He is the author of several books and is a sought after speaker on diabetes. If you have diabetes, please do yourself a favor and read his web site.


Alan Shanley is from Australia. He combines diabetes and common sense with his down under humor which is enjoyable to read. He has battled another disease into remission and is a rather remarkable person for his accomplishments.


Tom Ross is from California. He maintains a diary of his battle to maintain control of his diabetes with diet and exercise. His positive attitude and determination have spared him the tribulations of being on medications for control of his diabetes. He is also talented musically.

Janet Ruhl is from the northeast part of the country. Her writings are factual and well documented.

Gretchen Becker is from Vermont. She writes with the same insights and humor that are in her book. I am happy that she now has her own blog. She writes for several web sites as well.

This is not meant to be a comprehensive list. I do follow a couple of writers with type 1 diabetes.


The following diseases can be caused by diabetes. They are heart disease, diabetic neuropathy, diabetic retinopathy, and diabetic nephropathy. These are the most common associated problems, but there may possibly be others.

Other factors that affect diabetes and its control are stress and sleep apnea. Both were a part of my life and made control difficult in the first year.

I encourage self-education as it has taught me what my doctors did not tell me. Everyone needs to learn at the start that diabetes cannot be reversed, and that now a new lifestyle must be adopted to successfully manage diabetes. Yes, there are some procedures that hold out hope for a reversal or short-term cure, but to date no long-term cure.The American Diabetes Association currently recognizes only three types of diabetes. Type 1, which generally occurs in childhood - and is estimated to be about 5 to 10 percent of the diabetes population. Type 2, generally occurs after age 40 and normally is gradual - and is estimated to be about 90 to 95 percent. Gestational diabetes in women is a small percentage.  Shortly after this was written ADA issued new additions to the  list.

Several medical teams are clamoring for acceptance of Type 3 or possibly Type 4. Research is mounting evidence in their favor. Insulin produced in the brain (or lack of production) is wanting a type 3 and there is now a link to alzheimers.

Published Resources

I am writing about my personal experiences. I am a person with Type 2 Diabetes. Any advice that sounds good should be discussed first and always with your doctor.

I was diagnosed in October 2003 while in the hospital with angina problems. The last (now over) seven years have been a learning experience and has not been easy.

The first thing I had to learn and accept was - it was not my fault. The second lesson took a lot longer - I cannot change the past - it is the past and I have to learn to live in the present. Painful, yes, and at times harder than a real job. This requires my attention seven days a week and does not allow for a vacation.

Several books, all in paperback, have influenced and made an impact on my life with diabetes. I would recommend for anyone diagnosed with type 2 diabetes to read them. As with any book written about diabetes, glean what is important to you. If you are like me, you will refer back to something you skimmed earlier when it becomes important to you.

First book: The First Year - Type 2 Diabetes, New York, Marlow & Company, 312 pages, by Gretchen Becker. I discovered this book within a month of diagnosis. It gave me information that I was not receiving from my doctor. Gretchen has type 2 diabetes and she gives the best definitions and reasons for controlling diabetes in non-technical language.  Look for the Second Edition.

Second book: Diabetes Type 2 Complete Food Guide Management Program, New York, Three Rivers Press, 350 pages, by Sherri Shafer. She is a RD, CDE and tackles health issues and food for the person with diabetes. While higher in carbohydrates than suits me, this book came to my rescue when I had my first severe hypoglycemia. It gave me the resources to deal effectively with them. It has been handy for hyperglycemia information as well.

Third book: Myths of a Diabetic Diet, American Diabetes Association, 238 pages, by Chalmers and Peterson. While this book is dated, it is a well written guide for preventing excesses in eating changes. This concept is important for people new to diabetes. Even though there is no diabetic diet in today's understanding of diabetes, this book is still good to read.

Fourth book: Reversing Diabetes, Warner Books, Inc., 435 pages, by Julian Whitaker. This is not a cure book. This is for people with type 2 diabetes who wish to stay off or get off of medications. If you are insulin dependent like me, this may not be for you. It can be valuable for those who are not insulin dependent. I had hopes at one time, but it was not meant to be.

Fifth book: The New Glucose Revolution, New York, Marlow & Company, 349 pages, by Dr. Jenny Brand-Miller, et al. This book is a recent addition to my library and should be on everyone's read list. It gives an excellent explanation of the Glycemic Index and the Glycemic Load values of many foods. It is aimed toward those of us with diabetes, but those wanting to lose weight and be capable of keeping the pounds off will benefit from this book.

All the books are or have been available at Amazon.com.

There are many other books that are available for those of us with diabetes to read. I will review other books when I finish them and know that I will add them to my library or pass them to someone else. The above books will remain part of my library.

Sunscreens, Safe or Not?

People with diabetes as well as other people need to protect our skin from the sun. During the height of summer, this is an important issue.

Getting a sunburn can create healing problems if it is a severe burn. Also the level of blood glucose is naturally increase because of the heat and evaporation that takes place from your body.

While not my favorite, the Environment Working Group has published a new report that three out of five sunscreens sold offer inadequate protection from the sun. Some are even dangerous to use.

Seventy percent (70%) of sunscreens products now contain strong UVA filters, compared to 29% last year. The bad new is that much UVA protection is still too thin to save your skin. Be careful what products you waste your money on.

For those interested the following link give the full report: which sunscreens are best. I am listing only the best five.

Tests done on leading sunscreens from name brands like Coppertone, Banana Boat, and Neutrogena, shows that 42% of the sunscreens still contain the chemical oxybenzone, which has been shown in laboratory tests to disrupt the endocrine system and release oxygen that could contribute to skin cancer.

Here are the best rated sunscreens

1. Soleo Atlantis Organics All Natural Sunscreen, SPF 30+
2. Badger Sunscreen, SPF 30
3. Turkid Sunny Days Facestick Mineral Sunscreen UVA/UVB Broad Spectrum, SPF 30+
4. Purple Prairie Botanicals Sun Stuff, SPF 30
5. Lavera Sunscreen Neutral, SPF 40

I have found three of the above at Amazon.com.

The article also alerts us to watch out for lip cancer. Because the sun hits the lower lip where most lips cancers develop. It is as important to protect the lips as it is keeping them from drying out.

The article states that people who cover their lips more than once a day with lip balm or even colored lipstick may cut their cancer risk in half. This comes from the American Cancer Society and the National Cancer Institute.

My advice is to carefully plan your time in the sun. Use care in the protection you use, use it wisely, and avoid exposing unprotected skin for long periods.

Guideline for Discussion

Many refer to first rule as a platitude, but for type 2 diabetes, it is a fact of life.

What works for me may not work for you. That is the first rule.
Always discuss things with your doctor(s). That is the second rule.
Always discuss changes with your doctor(s). That is the third rule.
The fourth rule is - all of the above!

I will advocate certain positions or ideas for those of us having type 2 diabetes. This is because I feel strongly about something, but you will have to decide if and how well it may apply to you.

If you are like me, you will glean ideas and apply what works for you and come back later to see if something may be applicable or explain something that is happening in your life. I do this with other blogs and sites.

I will not tell you that you must do this or that; you have a doctor(s) for that purpose. Your doctor(s) is the only person that can diagnose and prescribe proper treatment.

If what I write gives you ideas to discuss with your doctor(s), then I will be grateful. If you disagree with me and give me a sound reason, then I will have learned as well. I welcome constructive criticism, as I am human and make mistakes.

I advocate a team approach for the treatment of diabetes (the reason for doctor(s) above), with the patient in charge, except in emergencies. This has worked well for me. Members of the team should include a regular family doctor, a dietitian/nutritionist, and an endocrinologist. The following are optional depending on your needs - a neurologist, for neuropathy and sleep apnea, a podiatrist, for proper foot care and preventing amputations, a heart doctor, for heart disease, and an urologist, for monitoring kidney health. I almost forgot - an eye doctor for monitoring eye health and problems from diabetes (maybe not part of a team for some).

I know some people that have other doctors and specialists on their team for various medical problems. When it is possible, I also advocate making your pharmacist part of the team, but this is often more difficult for some. The biggest advantage to this is the communication and not prescribing conflicting medications and treatments. More doctors are working this way with knowledgeable patients who are willing to take charge. Even some insurance companies are finding out that there are less duplicate tests when one doctor orders the tests and shares with the rest.

Not everyone can have a team approach. This is because some people live in remote areas or in areas where the distance is great just to see a doctor. Other people find a doctor that is capable and has kept him or her-self up-to-date on diabetes and associated complications.

Diabetes is a 24/7 problem that requires a positive attitude and attention to detail for control. Most of us get derailed periodically. Sometimes we are able to determine the cause. Other times we never discover the cause, but are still able to regain control. The latter is the most frustrating and I am not immune to this.

Introduction

I have heard all the arguments before and I don't want another blog to read. A friend with diabetes made this statement to me when I told him I launching this site.

When I asked him what he did read, I knew that he did little or no reading about diabetes, so his lack of an answer did not surprise me. He is too busy traveling to garage and yard sales looking for items he can buy cheaply and resell for more money. This occupies his days and earns him a little income after expenses.

I also know that he is going from one doctor to another doctor when he hears something he does not agree with, or is told something he does not want to hear. As a result he spends about two months each year in the hospital for diabetes or other medical problems.

This is not the way I want to live. I like being retired and enjoying the time I have available for my family and a few close friends still living.

So why am I doing this? Because I enjoy researching about diabetes and the challenge of reviving some writing skills. My goal is to help people with type 2 diabetes. This means helping them meet the challenge of diabetes and succeed in keeping it under control, living a full life, and not feel that diabetes has robbed them of celebrating life. Yes, helping many people would be great, but I will settle for one at a time right now.

In a world filled with misinformation and ignorance about diabetes, if I can enlighten a few people, then I will have accomplished what I set out to do. Hey, who knows, maybe, just maybe I will be able to educate many people.

When another friend with diabetes asked why, with all the good writers doing this, why would I do this? I know he reads a lot and is very knowledgeable. I told him that challenges motivate me and I am not worried about displacing another writer. We need each other to spread the word. Each writer has his or her own style of presenting information, and each reader may not like a particular style. If they cannot find something they enjoy reading, then diabetes may have won the battle.

Therefore, with that in mind, I am starting this blog for people with type 2 diabetes.