Little Annoyances – Big Annoyances

This is a topic that has been building over the months and I need to let it out.

One of the biggest annoyances is the writers of medical reports and press releases. When a writer is writing about blood glucose readings or levels, they use the term blood sugar. To me this says that sugar is the main source of our diabetes problems. If your meters measured sugar, then they would be correct, but our meters measure blood glucose.

So we need to educate these writers to use the term blood glucose and make the term blood sugar off limits. Yes, they may abbreviate it BG or BGL or BGR for blood glucose, blood glucose level, or blood glucose reading. They are acronyms that can be used, but please not BS.

Some would argue not to capitalize, but I find it easier to know that it is an acronym and there is a generally accepted meaning for it. David Mendosa has some very good terms that need eliminating from or used correctly in our vocabulary and please take time to read his blog here. I have also tackled this topic before and still see many of the terms continuing to be in use. Read my blog here.

In a blog David Mendosa posted on Health Central, he also discusses some other terms he would like to see eliminated from our vocabulary or used correctly. He discusses the meaning of words in context and there is a lot to be said in agreement with him. I do agree in the use of manage, managing, and management of diabetes. Even David is in changing to not using the term control and its derivatives. We cannot control diabetes, only manage it for our good health.

A lot of the discussion needs to center around attitude and a positive attitude about diabetes. A positive attitude can make diabetes manageable, but a negative attitude can ruin your management of diabetes. If you have a positive attitude about diabetes, you will agree with another blog by David that diabetes is not progressive unless you choose not to manage your diabetes.

Another term that I am seeing again in some blogs is a term that David has clearly and legally defined – Glucometer. This is a registered trademark of Bayer, and unless you own one, you should not use it. Meter is the correct term otherwise. Recently, I had a CDE use this term with me and when I asked if she was talking about the one marketed by Bayer, she said no all are glucometers. In trying to discuss this error, I was told “you are the patient”, “I am the professional”. I promptly ended the discussion by leaving.

I would like to get inside the heads of some of the medical writers and have them use correct terms like mg/dl as this is the correct usage for deciliter, and not mg/dL, which many writers persist is using. I continue to see its misuse.

One term that I am not as clear about is one I see on a regular basis in medical press releases, medical articles, and blogs by doctors is healthcare or health care. My dictionary of choice uses them interchangeably so I am open to discussion on this. I often use them as healthcare for care facilities like hospitals and nursing homes. I try to use health care when talking about caring for your health or discussing the topic of health.

I admit I misuse type 1 and type 2 so I need to stop using Type 1 and Type 2. I have developed this bad habit from using LADA and MODY, but I don't use Pre-diabetes capitalized unless it is the first word in a sentence.

Another term that I apparently misuse frequently by what David has written is prediabetes as he recommends pre-diabetes. Until the DOC can standardize the terms we use, our strength and usefulness may not be as strong a voice as it should be. Am I picking nits – I don't believe I am, as we need to use the correct terminology as a community.

The Whole Grains Mantra

Are you sure you want to eat all those whole grain foods? The grain industry must be advertising very heavily because of all the advertizing I am seeing and even many of the more reputable web sites are again pushing whole grains and bringing prior articles back to the fore. Apparently some of the better medical doctor bloggers and others are making a dent in their income.

So I will also revisit the whole grain mantra again. Yes, I believe that much of the whole grains is partially behind the increased obesity epidemic around the world. The mantra pushed by the American Heart Association and the American Diabetes Association to eat whole grains is just adding to the myth that this is good for you – NOT!

Go back and reread this blog and the link for it. This should make you rethink the whole grain mantra and the fact that it can't be all it is promoted as being. People just hear the mantra over and over from the doctors, diabetes educators, and dietitians ad nauseam until they believe it to be true.

Again I need to refer you to Dr. William Davis and encourage you to read several of his blogs. The first one is here. If you have a person that is acting like the diabetes police, this blog by Dr. Davis could convert this person to really being a caring person and especially if the person happens to be overweight.

The article that got me back on this topic this one. Take time to read it and learn that if you think you are eating whole grains, chances are you are not. Most of the food industry wants you to think you are, but they add enough to meet the current standards or Federal guidelines, and the balance is not whole grains.

The arguments for whole grains are convincing, but you need to understand that the advantages claimed by whole grain advocates can be found in other foods without the large quantities of carbohydrates which people with diabetes need to avoid.

Restoring Happiness in People With Depression

This seems to be a new way for people to battle depression, but has very little scientific basis to support it and has not been attempted (that is known) on people with severe depression. Researchers at the University of California, Riverside and Duke University Medical Center have been working on practicing positive activities as a way to mitigate mild depression.

Positive Activity Interventions (PAIs) is the new approach for treating depression as covered by a team of UCR and Duke psychology, neuroscience, and psychopharmacology researchers. This method is something that I can believe will work for many people. I say this because I have used slightly different activities in the last several years and it does help. Other people will need to read this article and find what may work for them, but I am confident that they can find something that can help.

Depression does not affect everyone with diabetes, but about two-thirds of us do have to deal with depression. Many people refuse to recognize depression and often suffer the effects. Others refuse help and this can often cause them to be in depression for longer that they should and this in turn affects the management of diabetes and makes regaining good management often more difficult.

Quote - PAIs are intentional activities such as performing acts of kindness, practicing optimism, and counting one's blessing gleaned from decades of research into how happy and unhappy people are different. This new approach has the potential to benefit depressed individuals who don't respond to pharmacotherapy or are not able or willing to obtain treatment, is less expensive to administer, is relatively less time-consuming and promises to yield rapid improvement of mood symptoms, holds little to no stigma, and carries no side effects. Unquote

People often underestimate the long-term impact of practicing brief, positive activities. Positive activities have been around for many years and it is just recently that researchers have taken notice and are now applying measuring applications to determine their benefits and understanding why these positive activities work. The one factor that is being seen is they are simple to practice and extremely practical to do with little cost.

An association that is active in promoting the science and practice of positive psychology is the International Positive Psychology Association (IPPA). You may read about them on their website here.

I therefore plead with everyone that may suffer from depression to recognize it and learn how to deal with it for the benefit of your diabetes management.

Making Changes in Managing Diabetes

Changes – life is full of changes and we need to know how to make them for the improvement of our health. This blog from the Mayo Clinic makes some excellent suggestions and will hopefully start you on the right path to change. I know it is helping me, but I still need to make more changes.

First they lay out three steps or fundamentals in making changes and then walk you through the steps.

The first step is the unfreezing step. In other words becoming used to the new idea or change needed and motivating yourself to make the change. In diabetes, this involves or can involve many ideas and some motivators. The diagnosis itself can be a huge motivator. Then later an increase in A1c can become a change motivator. A great motivator for me was my doctor asking me what I could do to make a change and did I want his help. It took some discussion, but after he had laid out some possible changes, I was able to select two for starters and discuss them with him.

Others can realize that changes are needed when family members ask the right questions and we realize the current path is not working and that staying the course will not make the situation get better. When you realize a change is necessary, the mind over matter mental game needs a resolution. Real or imagined anxieties can get in the way of making the change.

The second step in making the change. This step involves deciding on what changes need to occur. This is when laying out the pros and cons on paper can often show you what needs changing and sometimes can become a boost in making the change. Other activities may also help. This can include may of the following. Choosing the specific change or changes you want to work on changing. Please be realistic and avoid trying to change everything.

Write the change or changes down and post it where you will see it every day. This can be your daily reminder of what you need to accomplish. If you have others (family members or significant other) available, ask for their help and encouragement. If necessary find a support group to assist you. See you diabetes health care team on a regular basis. Track you test results and work to keep the test results where they belong or improving.

The third and last step is making this change permanent or freezing the behavioral change. While this may be the most difficult step, it does need to become a habit and something you can do automatically. Succeeding here makes you a better person, dedicated and living for better health.

Once this is accomplished, repeat the steps for the next change or changes. There is nothing better than having success to make you want to do more changes. But often it takes doing them one or two changes at a time.

Have success and live healthy!

I Do Have to Believe AACE Is Not PR Motivated

Yes, I do believe AACE is not motivated in public relations and now I am getting concerned. Back on April 29, 2011 we were told by the American Association of Clinical Endocrinologists (AACE) George Grunberger, MD, national board director through a Medscape article that AACE and Takeda Pharmaceuticals were putting up a new website to assist people with type 2 diabetes.

According to Dr. Grunberger, “The idea of the new Web site is not to provide new patient information about diabetes, but to direct patients to educational resources on the Web that provide credible information about the disease. Inaccurate or incomplete information can lead to unnecessary stress or confusion for people living with type 2 diabetes. We need to make it easier for healthcare professionals, patients, and caregivers to access reliable sources of information, which can form a foundation for treatment and care decisions." Read my blog about this here.

In this blog on July 1, I asked if it was all hype. Now it is the first of August and I still have seen no results. This time I am doing my homework as I had been wondering if the article was printed with no backup information. On that I would be wrong as on the Takeda Pharmaceuticals website they do have a news release dated March 22, 2011 to confirm at least this much. You may read this for yourself. I have been contacting people to find out what is planned and when.

So rather than just vent, I will have to say that in an answer from AACE and Takeda, I have been told that it is still coming, just that it was taking longer than anticipated. Both responders are confident in their reply. Apparently the experts can't agree and vetting is taking longer than anticipated (my thoughts).

Am I upset, somewhat, if it had been an appointment with a doctor and I missed it, I would have been sent a letter telling me how valuable their time was and to reschedule. What I get upset about is when a doctor(s) or an association misses something, they don't feel an explanation is in order. Whether I speak only for myself, or if others agree, we should have been told that there was an unforeseen delay and our patience is appreciated. Even if they would have said that it would be longer than anticipated, at least then I would not be quite so upset, and avoided venting my feelings about how doctors do more to destroy doctor/patient relationships than patients will ever do.

I am still concerned about the delay and why one hand does not know what the other hand is doing and why when something is released that it will happen in June, the public relations people did not inform us that there would be a delay. I still wonder which sites will obtain the approval of those doing the vetting of sites. With the delay, I do have to wonder again if some of the sites selected will allow for individualized selection of treatment options or whether it will be a one size fits all approach. The latter will kill it before it even gets going!

I will continue to watch for the site's appearance and what websites make the initial selection criteria. This will be an indicator of what to expect and the stand of the AACE about the approved websites.

Brits Concerned By Lack of Testing Supplies

Now we need another study and not a survey. The British have a right to be concerned as do all the people in other countries. Without testing supplies, how are people with diabetes supposed to manage diabetes? The doctor can not see them every day and the office would not be open for the dinner or bed time hours or weekends.

If the authors of the survey are finding that not having access to proper supplies is a source of anxiety and goes against the theory that home tests may cause anxiety or depression, then they need to have a sit-down with the American diabetes online community and learn what causes depression and what causes anger.

Anger can be generated against study authors like this that have preconceived ideas and do nothing to disprove them until they have a faulty survey or study that points to results like this. Then they claim that it disproves a theory. So bloody nice of them to say so. There are many bloggers saying we need more testing supplies in the USA, but the supplies continue to be limited and patients need to chose when to expend them to gain maximum advantage.

Have an emergency when you need to test several times and then what do you do when you have needed to expend several days supplies for an emergency. And when you have errors generated for a test strip, another one or two may not be available. Do we get replacements and are allowed to obtain more by our insurance No way, the insurance companies need the profits and we don't need the test strips is the game they play.

The authors did say, “home testing is a vital part of good diabetes management. It gives patients the opportunity to control their blood sugar levels, and work out which foods and routines affect blood sugar levels. With home testing, the patient is able to make informed decisions regarding lifestyle.” Sound familiar? This is what doctors, educators, and insurance companies have been denying for years in the USA. They don't want patients that are knowledgeable and proactive. They also claim that home testing causes depression. This is why many doctors will not authorize meters or test strips.

To combat this we patients need more proactive patients with diabetes that can combat the misinformation that is fermented by the medical community and the medical insurance industry. Yes, many of the myths were concocted by the medical profession as a way of instilling fear in their non-compliant patients.

When will they learn that a positive attitude and treating patients as people who are intelligent would get them better patients and make life even easier for them. Never happen – they are ingrained during medical school that fear is the preferred method of dealing with patients and gets the best results. It is the great doctors that can realize the fallacy of their training and that patients are people also.

On July 19, 2011, Ron Gregory at the Poor Diabetic dot com had an excellent blog about people with diabetes coming out of the closet and getting a voice. Obtaining testing supplies could be a good place to start voicing concern.