So far I have not found this in American news sources, but this from the Jamaica-Gleaner is disturbing. Titled “The Diabetes Deception” this article is about as false as they get. While the author is correct that about 95 percent of people have Type 2 diabetes, but to say this is curable, degrades all people with diabetes.
To declare that Type 2 is a lifestyle-related disorder instead of a disease, is wording that snake oil salespeople use profusely. For many Type 2 people, the diagnosis is often made too late and the damage to the pancreas is already done. If the medical community and the American Diabetes Association (ADA) wakes up and advises doctors to be aggressive in their diagnosis, what these people advocate may be possible, but still will not be a cure. See a supporting study that I blogged about for that here.
Using exercise and nutrition may possibly delay the onset of Type 2 diabetes. If the person is overweight or obese, then the reduction of weight will aid in reducing insulin resistance. Even these measures will not ensure a cure, but still are highly advisable to delay full onset of diabetes.
Many of the lifestyle changes promoted by this article will indeed promote good health and delay full diabetes, but there is nothing that will prevent or “cure” diabetes. Let any of these people stop doing regular exercise, over eat carbohydrates, and stop following the recommendations, and Type 2 diabetes will take over without hesitation.
The other argument for eating only low glycemic foods is a good guide, but not fool-proof in preventing diabetes. Total low glycemic eating habits may also not be as healthy for diabetes as they proclaim. Dr. William Davis in his “The Heart Scan Blog” will inform you about some of the dangers in a low glycemic diet. At the same time he also believes in a cure for diabetes. See his blog here. I can't say I totally agree with him, but he at least does not promote snake oil cures.
Some people are talking about early detection of problems with the pancreas and what can be done to reverse the problems, but still these are not cures and if not followed very strictly, will still develop into diabetes Type 2. So read with care.
November 24, 2010
November 17, 2010
Components of Lifestyle Change?
This may be just semantics; however, I would like to clarify some parts of the term “lifestyle”. The definition from an on line dictionary says lifestyle is a way of life, the attitudes, tastes, moral standards, economic level, etc., that comprise an individual or group.
This of course says nothing about diabetes and managing diabetes. In my reading, blogging, and participation in a few diabetes forums, I have seen lifestyle described many ways. I have a slightly different perspective as most writers start off with diet. I believe the elements of lifestyle change should start with exercise if you are physically and medically able. It is the key that generally makes the rest of lifestyle fall into place.
What you need to recognize is that all are interlinked and bypassing one part of lifestyle change will normally make changes generally unachievable. What different writers choose of emphasize depends on their philosophy and how they view their career. Most that work in the medical profession, be they doctors, nurses, educators, dietitians, or licensed caregivers, must follow the guidelines of the American Medical Association, the American Diabetes Association, and other professional medical groups if they want to have their license updated and current.
Since I answer to myself and a few bloggers that agree exercise should be listed first, this is where I will start. This is the list I have pulled together from various sources. It may not agree with everyone's list, but for me, the list needs to be updated as changes are found that affect the way we look at diabetes and lifestyle.
The main elements of lifestyle should or must include the following; exercise, sleep, food, medication, illness, hormones, stress, heart health care, and two other elements, alcohol and smoking. Some people would include weight loss. For me this needs to be part of exercise and food changes plus others to effect weight loss.
Exercise – If you are physically and medically able, get your doctors okay to exercise, and remember to exercise good judgment and don't do something that will be wrong and cause injury. Start out slowly and build up gradually. Regular exercise helps make insulin more readily available and reduces insulin resistance. Find a form of exercise or a mix of routines that you enjoy and follow through with it.
Food – Healthy eating is important and even more important if you are unable to exercise. It is good to be consistent in eating times and amount of food. Whether you eat low carb or another way, learn to use your meter to determine how different foods affect your blood glucose. Learn to coordinate your food with the medication you are taking.
Sleep – Where did this come from? It is not included on most lists, but should be after a study I wrote about here. I keep being surprised how important sleep is to our well being as a person with diabetes. That is the main reason I am adding it to lifestyle and encouraging all to get the sleep needed. If you are having trouble getting enough sleep, change your habits and if that does not help, talk to your doctor about doing a sleep study to determine if you have a form of sleep apnea.
Medication – Be sure that you follow the doctors instructions. Yes, I know that you want to avoid all medications. This is an excellent goal if you are diagnosed early on and can make this work. Remember that you need to consider getting the diabetes managed as soon as reasonably possible. Do discuss with the doctor getting off medications if you do it. If you do bring diabetes under good management and the doctor wants to keep you on medications, then ask yourself if a change needs to be considered.
Heart health care – Because people with diabetes are at 50 percent risk of having cardiovascular events, many of the same changes for diabetes help with heart health. It is still necessary to consider medications for heart health. Exercise and food choices become primary for heart care and managing cholesterol and hypertension.
Illness – This was a little surprising until I thought about how illness affects our diabetes management. So as an element of lifestyle change we need to learn to take our medications timely and know when to talk to the doctor about variations like illness which can cause problems unless we know not to take certain medication to prevent hypoglycemia. This means having a plan with your health care team of what medications to take or not take during an illness.
Hormone levels – This is normally for women who have problems with blood glucose swings related to the monthly menstrual cycle. I personally think the authors failed to talk about the change in life for women and problems some men can have when male hormones cause problems and can affect blood glucose as well. You need to talk about this with your doctor to be prepared for these changes.
Stress – This is definitely a lifestyle change that affects everyone with diabetes. When stressed, almost anyone can toss aside their usual good diabetes management practices, forget to eat healthy foods, and lose control of your blood glucose. Prolonged stress may prevent insulin from working properly which also creates additional problems. Some find logging your stress level (1 to 10 scale) each time you log your blood glucose level helps them see patterns and allow you to adjust accordingly. Learn about ways to relax and find ways to reduce stress.
Alcohol – This can be a bad one if not thought out. First, you need to talk this over with your doctor. Alcohol can aggravate diabetes complications like nerve damage and eye disease. If your diabetes management is excellent, and the doctor agrees, an occasional alcohol drink with a meal may be okay, but a daily drink is generally discouraged.
Smoking - This is a habit that must be broken. Many writers do not want to cover this lifestyle change that needs to happen, and the sooner the better. Not only does this increase the effects of neuropathy, but it can affect an increase in cardiovascular risks. Do not take this lightly, the effects of continuing to smoke do not make blood glucose management easier.
To sum up, these are the lifestyle changes that need attention for those of us with diabetes.
This of course says nothing about diabetes and managing diabetes. In my reading, blogging, and participation in a few diabetes forums, I have seen lifestyle described many ways. I have a slightly different perspective as most writers start off with diet. I believe the elements of lifestyle change should start with exercise if you are physically and medically able. It is the key that generally makes the rest of lifestyle fall into place.
What you need to recognize is that all are interlinked and bypassing one part of lifestyle change will normally make changes generally unachievable. What different writers choose of emphasize depends on their philosophy and how they view their career. Most that work in the medical profession, be they doctors, nurses, educators, dietitians, or licensed caregivers, must follow the guidelines of the American Medical Association, the American Diabetes Association, and other professional medical groups if they want to have their license updated and current.
Since I answer to myself and a few bloggers that agree exercise should be listed first, this is where I will start. This is the list I have pulled together from various sources. It may not agree with everyone's list, but for me, the list needs to be updated as changes are found that affect the way we look at diabetes and lifestyle.
The main elements of lifestyle should or must include the following; exercise, sleep, food, medication, illness, hormones, stress, heart health care, and two other elements, alcohol and smoking. Some people would include weight loss. For me this needs to be part of exercise and food changes plus others to effect weight loss.
Exercise – If you are physically and medically able, get your doctors okay to exercise, and remember to exercise good judgment and don't do something that will be wrong and cause injury. Start out slowly and build up gradually. Regular exercise helps make insulin more readily available and reduces insulin resistance. Find a form of exercise or a mix of routines that you enjoy and follow through with it.
Food – Healthy eating is important and even more important if you are unable to exercise. It is good to be consistent in eating times and amount of food. Whether you eat low carb or another way, learn to use your meter to determine how different foods affect your blood glucose. Learn to coordinate your food with the medication you are taking.
Sleep – Where did this come from? It is not included on most lists, but should be after a study I wrote about here. I keep being surprised how important sleep is to our well being as a person with diabetes. That is the main reason I am adding it to lifestyle and encouraging all to get the sleep needed. If you are having trouble getting enough sleep, change your habits and if that does not help, talk to your doctor about doing a sleep study to determine if you have a form of sleep apnea.
Medication – Be sure that you follow the doctors instructions. Yes, I know that you want to avoid all medications. This is an excellent goal if you are diagnosed early on and can make this work. Remember that you need to consider getting the diabetes managed as soon as reasonably possible. Do discuss with the doctor getting off medications if you do it. If you do bring diabetes under good management and the doctor wants to keep you on medications, then ask yourself if a change needs to be considered.
Heart health care – Because people with diabetes are at 50 percent risk of having cardiovascular events, many of the same changes for diabetes help with heart health. It is still necessary to consider medications for heart health. Exercise and food choices become primary for heart care and managing cholesterol and hypertension.
Illness – This was a little surprising until I thought about how illness affects our diabetes management. So as an element of lifestyle change we need to learn to take our medications timely and know when to talk to the doctor about variations like illness which can cause problems unless we know not to take certain medication to prevent hypoglycemia. This means having a plan with your health care team of what medications to take or not take during an illness.
Hormone levels – This is normally for women who have problems with blood glucose swings related to the monthly menstrual cycle. I personally think the authors failed to talk about the change in life for women and problems some men can have when male hormones cause problems and can affect blood glucose as well. You need to talk about this with your doctor to be prepared for these changes.
Stress – This is definitely a lifestyle change that affects everyone with diabetes. When stressed, almost anyone can toss aside their usual good diabetes management practices, forget to eat healthy foods, and lose control of your blood glucose. Prolonged stress may prevent insulin from working properly which also creates additional problems. Some find logging your stress level (1 to 10 scale) each time you log your blood glucose level helps them see patterns and allow you to adjust accordingly. Learn about ways to relax and find ways to reduce stress.
Alcohol – This can be a bad one if not thought out. First, you need to talk this over with your doctor. Alcohol can aggravate diabetes complications like nerve damage and eye disease. If your diabetes management is excellent, and the doctor agrees, an occasional alcohol drink with a meal may be okay, but a daily drink is generally discouraged.
Smoking - This is a habit that must be broken. Many writers do not want to cover this lifestyle change that needs to happen, and the sooner the better. Not only does this increase the effects of neuropathy, but it can affect an increase in cardiovascular risks. Do not take this lightly, the effects of continuing to smoke do not make blood glucose management easier.
To sum up, these are the lifestyle changes that need attention for those of us with diabetes.
November 11, 2010
Pharmacies Becoming Sources for Medical Care?
Normally I will not post the same blog to both of my blogs. I feel this topic needs the exposure so that people can determine for themselves where they want to be on this issue.
Is this what we want or what we need? I have to wonder if this will be a good thing for people with chronic diseases. I am not sure I want my medical care retailized or taken care out of a storefront. But this is the latest desire from Walgreens – to become your one-stop health care facility.
Walgreens and other large retail pharmacies are lobbying to make this a fact of life. I do not want to have nurse practitioners in charge of my medical health care. I am thankful that in some of the more remote areas or largely rural areas in the United States, nurse practitioners have been needed to get medical care to people and have done excellent work. This has been a necessity because of the lack of doctors in these areas. But for a retail store like Walgreens in non-rural area, this runs against my better nature.
Walgreens is wanting to do this because of the “national shortage of primary care doctors”. They are proposing to “assist patients in managing chronic conditions of diabetes, hypertension, and high cholesterol”.
We have to wonder if we are going to be prescribed extra drugs or medications as a result. Is the American Medical Association going to allow this to happen? Are the states going to allow this to happen? It is happening in some states that have nurse practitioners, but I hope that this does not come to pass in our more populated states.
Many pharmacies are now giving blood screening, flu shots, and other medical advice mainly under the supervision of pharmacists. This is not always the best for many patients as they do not check any medical records to verify allergies and other medical conditions which might preclude some treatments.
What many are banking on is the new health care act providing insurance to people and they want to cash in on the potential increase of cash. And Walgreens is not bashful about saying this.
Before I would want to utilize pharmacies (or what name they will change to), I would want to know who is responsible for writing the prescriptions and whether they have met the education requirements necessary to be able to write prescriptions. Are the pharmacies going to require filling the prescriptions in their store or can these prescriptions be filled at any pharmacy?
These are just some of the questions that need to be answered before I would accept pharmacies taking over primary medical care. Will pharmacies be required to have doctors available to consult or oversee and supervise prescriptions with appropriate approvals available for states to audit? Will this action create or necessitate more state agencies to oversee questionable medical decisions and audit procedures? Will this just increase medical fraud, Medicare, Medicaid, and other fraudulent practices.
And with the shortage of nurses that exists today, where will all of the nurse practitioners come from? Or will they come from our hospitals and doctors offices thus creating a more critical shortage there?
Before this becomes practice, I would hope that our federal and state legislators will examine this very carefully. The last question I would want answered or information made available to the public is the political contributions made in the last election and to whom were they made.
Is this what we want or what we need? I have to wonder if this will be a good thing for people with chronic diseases. I am not sure I want my medical care retailized or taken care out of a storefront. But this is the latest desire from Walgreens – to become your one-stop health care facility.
Walgreens and other large retail pharmacies are lobbying to make this a fact of life. I do not want to have nurse practitioners in charge of my medical health care. I am thankful that in some of the more remote areas or largely rural areas in the United States, nurse practitioners have been needed to get medical care to people and have done excellent work. This has been a necessity because of the lack of doctors in these areas. But for a retail store like Walgreens in non-rural area, this runs against my better nature.
Walgreens is wanting to do this because of the “national shortage of primary care doctors”. They are proposing to “assist patients in managing chronic conditions of diabetes, hypertension, and high cholesterol”.
We have to wonder if we are going to be prescribed extra drugs or medications as a result. Is the American Medical Association going to allow this to happen? Are the states going to allow this to happen? It is happening in some states that have nurse practitioners, but I hope that this does not come to pass in our more populated states.
Many pharmacies are now giving blood screening, flu shots, and other medical advice mainly under the supervision of pharmacists. This is not always the best for many patients as they do not check any medical records to verify allergies and other medical conditions which might preclude some treatments.
What many are banking on is the new health care act providing insurance to people and they want to cash in on the potential increase of cash. And Walgreens is not bashful about saying this.
Before I would want to utilize pharmacies (or what name they will change to), I would want to know who is responsible for writing the prescriptions and whether they have met the education requirements necessary to be able to write prescriptions. Are the pharmacies going to require filling the prescriptions in their store or can these prescriptions be filled at any pharmacy?
These are just some of the questions that need to be answered before I would accept pharmacies taking over primary medical care. Will pharmacies be required to have doctors available to consult or oversee and supervise prescriptions with appropriate approvals available for states to audit? Will this action create or necessitate more state agencies to oversee questionable medical decisions and audit procedures? Will this just increase medical fraud, Medicare, Medicaid, and other fraudulent practices.
And with the shortage of nurses that exists today, where will all of the nurse practitioners come from? Or will they come from our hospitals and doctors offices thus creating a more critical shortage there?
Before this becomes practice, I would hope that our federal and state legislators will examine this very carefully. The last question I would want answered or information made available to the public is the political contributions made in the last election and to whom were they made.
November 9, 2010
The Types of Diabetes
This subject is unusual for me and yet it has an appeal as I have a friend with a child which fits this very well. He has already been talked to about this and sent several emails. He notified me that he is having his infant son tested this week. After reading the background for this blog, he started checking where to have his son tested.
First I would like to set some terms which are new to me. We are all familiar with Type 1 and Type 2. The term used for these, polygenic, comes from the fact that they develop from multiple genes. The other term, used for the more rare types of diabetes is monogenic. These develop from mutations of a single gene.
This defines the types into two distinct classes. Monogenic diabetes forms comprise two to three percent of all diabetes in young people. This is either inherited for some and others have the gene mutation develop basically overnight. Both sides reduce the ability of the body to produce insulin. This is the area of greatest confusion for the medical professionals as they diagnose Type 1, when it is not.
The different types of monogenic diabetes include permanent neonatal diabetes (PND), transient neonatal diabetes (TND), and maturity onset diabetes of the young (MODY). These are the main forms and some may not respond to treatment and some are mild and should not be treated – a complete surprise. The newborn children and children generally under the age of seven months are likely to have PND or TND. MODY then normally is found in children and adolescents, but may be mild. Therefore it may not be detected until they are adults.
This is the reason I urge that all children be properly tested to determine what type of diabetes they have. I suspect that many that are diagnosed with Type 1 may not in fact have Type 1, but one of the monogenic types. If they truly have Type 1, then you will know for sure by full testing, and genetic testing is the only way to know positively.
Some monogenic forms may be treated with oral medications while others will require insulin, and still others are mild and require very little treatment. This is why I urge testing rather than relying on a doctors diagnosis if Type 1. Definitely consider testing for monogenic diabetes if you or members of your family meet the following criteria:
diagnoses with diabetes under seven months, familial diabetes in the immediate family, mild hyperglycemia, and other pancreatic features.
Testing for monogenic diabetes are often simple and inexpensive and at the time of diagnosis are not typically done. Many doctors are not even aware of the tests. Am I? No; however, two of the tests are listed here. The list of all tests is apparently are not available to non-medical people. The tests should also make management of blood glucose easier and treatment more reliable plus better long-term health.
To repeat, NDM generally occurs in the first six months of life and only one in 100,000 to 500,000 infants. NDM is often mistaken for Type 1, but Type 1 diabetes normally occurs later after the first six months. In about half of those with NDM, the condition becomes permanent. In the other half, NDM is short lived or transient and disappears during early childhood; however, it can reoccur later in life. NDM can be identified to specific genes.
There is a point that is often overlooked with NDM. NDM can also affect the unborn. They do not grow well in the womb and are born much smaller in weight. If caught early by knowledgeable doctors, and given appropriate therapy, they can often be normalized in growth and development.
The other monogenic, MODY, usually develops during during early adolescence or adulthood. It can often be missed until later in life. MODY accounts for one to five percent of all cases of diabetes in the United States. If a parent has MODY, the children are at a greater risk for developing MODY. Each child of a parent with MODY will have a 50 percent risk.
There are several types of MODY because there are a number of gene mutations that cause MODY. It is often confused for Type 1 or Type 2 as the people a seldom overweight and do not have other risks. People with MODY can be treated with oral diabetes medications, but treatment varies with the genetic mutation causing MODY.
Commercial genetic testing for NDM and MODY is now available. See this reference for one company. The Kovler Diabetes Center at the University of Chicago offers help to parents and offers many other services related to NMD and MODY. Check out their web site here. Also check out monogenic diabetes dot org. There is a lot of good information available.
The article that got me started is this one. Continue reading the next article listed at the bottom of each section. Some of this is repeated from the monogenic diabetes dot org.
November 5, 2010
Emergency Hospitalization for People with Diabetes
Another hospitalization situation that can cause problems for people with diabetes is going into the hospital alone in an emergency situation and no medical alert identification. A case in an emergency room about 65 miles from here this summer really emphasized what can go wrong. These are the type of instances that get my feelings in an uproar when they should not have happened.
The person had collapsed and passed out from heat exhaustion (I'm guessing heat stroke). He was transported to the hospital with an IV in place per orders of the emergency room doctor. When they arrived at the hospital no alert identification was found so the IV was continued and a second one added and and then his billfold was opened. An emergency telephone number was found and called.
The person arrived at the hospital and went to the room where he had been admitted. This person was not aware he had diabetes so could give no insight into treatment or who the doctor was. So the IV's continued. The fellow did not come out of the heat exhaustion, so no changes were made. They did stop the IV's after the fifth one. On the second day the fellow still had not come around, but the emergency person had contacted an older brother, who arrived. Even he did not know about the diabetes, but knew of the doctor his brother was seeing.
Contact was made with the doctor then and it was discovered that he had diabetes Type 1. At that point they did a blood glucose test and if I understood correctly it was “HI”, so they had to do a test from a blood draw. This showed over 900 and I was not given a more accurate figure. Of course they administered insulin. Then they started testing every hour and administering more insulin every five hours. They also continued to test him regularly.
They continued monitoring him and on the fourth day he came to. When the nurse told me about the following, I nearly fell off the chair. The patient said nothing about having diabetes and asked for a Pepsi to drink. When he was told no, he got abusive, and asked for food. When he was told after his insulin, he went ballistic and refused to be treated. The fifth day he checked himself out against doctors wishes.
I don't understand totally what happened as I was not able to get more information. I do not understand why this person did not want to have diabetes identified and when it was, why he reacted this way. I know from the diabetes forums that some people will come out on them, but will not say anything to people near to them or wear a medical alert of any kind.
I can understand privacy, but not the extreme desire for it. He should be thankful that an older brother did know the doctor and that the doctor gave out the information. There are lots of unanswered questions about this, but the nurse would not identify anyone and only gave me a little that she could.
I think she was wanting me to see how important it was to have proper medical alert information on me. When I showed her mine, she asked to see it and thanked me for wearing it. I wear mine on a necklace and need to have it updated for sleep apnea which is not on it presently.
This is why I feel so strongly about educating close friends and family so that they can advocate for you and prevent these types of instances from occurring. And in this case, the person on the emergency notice did not have information. This is not what should have happened.
The person had collapsed and passed out from heat exhaustion (I'm guessing heat stroke). He was transported to the hospital with an IV in place per orders of the emergency room doctor. When they arrived at the hospital no alert identification was found so the IV was continued and a second one added and and then his billfold was opened. An emergency telephone number was found and called.
The person arrived at the hospital and went to the room where he had been admitted. This person was not aware he had diabetes so could give no insight into treatment or who the doctor was. So the IV's continued. The fellow did not come out of the heat exhaustion, so no changes were made. They did stop the IV's after the fifth one. On the second day the fellow still had not come around, but the emergency person had contacted an older brother, who arrived. Even he did not know about the diabetes, but knew of the doctor his brother was seeing.
Contact was made with the doctor then and it was discovered that he had diabetes Type 1. At that point they did a blood glucose test and if I understood correctly it was “HI”, so they had to do a test from a blood draw. This showed over 900 and I was not given a more accurate figure. Of course they administered insulin. Then they started testing every hour and administering more insulin every five hours. They also continued to test him regularly.
They continued monitoring him and on the fourth day he came to. When the nurse told me about the following, I nearly fell off the chair. The patient said nothing about having diabetes and asked for a Pepsi to drink. When he was told no, he got abusive, and asked for food. When he was told after his insulin, he went ballistic and refused to be treated. The fifth day he checked himself out against doctors wishes.
I don't understand totally what happened as I was not able to get more information. I do not understand why this person did not want to have diabetes identified and when it was, why he reacted this way. I know from the diabetes forums that some people will come out on them, but will not say anything to people near to them or wear a medical alert of any kind.
I can understand privacy, but not the extreme desire for it. He should be thankful that an older brother did know the doctor and that the doctor gave out the information. There are lots of unanswered questions about this, but the nurse would not identify anyone and only gave me a little that she could.
I think she was wanting me to see how important it was to have proper medical alert information on me. When I showed her mine, she asked to see it and thanked me for wearing it. I wear mine on a necklace and need to have it updated for sleep apnea which is not on it presently.
This is why I feel so strongly about educating close friends and family so that they can advocate for you and prevent these types of instances from occurring. And in this case, the person on the emergency notice did not have information. This is not what should have happened.
November 2, 2010
Enjoy Your Holiday Food!
It is interesting how families celebrate holidays. The question is how do you celebrate the holidays? Do you go overboard with the meal and deserts? For people with Type 2 diabetes holidays can be one of dread and fear of the diabetes police.
First, relax! This is not a rant about the holidays. Hopefully you have a few holidays under your belt and have found yourself able to cope or are looking for ways to do better. If you are new to diabetes, the holidays can be real problems. Hopefully this will provide some help and guidance.
For the parties and friends social gathering, read this for some tips. I would only emphasize that moderation is the key to these events. Do not overdo and select the serving size that is small enough to not raise you blood glucose into the stratosphere.
The next article is definitely for families and is one of the better articles for people with diabetes. I appreciate the statement by Marlene Schwartz, PhD, deputy director of the Rudd Center for Food Policy & Obesity at Yale University when she says “don't tell family members that they're eating more healthfully”. She calls it "stealth health".
This is sound and sage advice. If the food is just served without comment, everyone should be content. They also advise you to involve immediate family members in planning of the menu, especially if they are picky eaters and the younger generations.
There are many good tips and from experience I know that they will work for most families.
The third article is another take on planning for the holidays. It does suggest making a game plan to avoid problems and if you make it work, you can still enjoy the holidays. The best plan is sticking to the plan. Realize that this is the holidays and one day (at a time) is the best method for not being overwhelmed. If you happen to overindulge do not berate yourself. Just be careful the next few following days, and take care of yourself.
From Thanksgiving to at least New Year's Day is often very tempting for people with Type 2 diabetes. Be assured that you will find yourself being tempted, but by careful planning and conservative food selection you should survive. So relax and happy holidays!!!
First, relax! This is not a rant about the holidays. Hopefully you have a few holidays under your belt and have found yourself able to cope or are looking for ways to do better. If you are new to diabetes, the holidays can be real problems. Hopefully this will provide some help and guidance.
For the parties and friends social gathering, read this for some tips. I would only emphasize that moderation is the key to these events. Do not overdo and select the serving size that is small enough to not raise you blood glucose into the stratosphere.
The next article is definitely for families and is one of the better articles for people with diabetes. I appreciate the statement by Marlene Schwartz, PhD, deputy director of the Rudd Center for Food Policy & Obesity at Yale University when she says “don't tell family members that they're eating more healthfully”. She calls it "stealth health".
This is sound and sage advice. If the food is just served without comment, everyone should be content. They also advise you to involve immediate family members in planning of the menu, especially if they are picky eaters and the younger generations.
There are many good tips and from experience I know that they will work for most families.
The third article is another take on planning for the holidays. It does suggest making a game plan to avoid problems and if you make it work, you can still enjoy the holidays. The best plan is sticking to the plan. Realize that this is the holidays and one day (at a time) is the best method for not being overwhelmed. If you happen to overindulge do not berate yourself. Just be careful the next few following days, and take care of yourself.
From Thanksgiving to at least New Year's Day is often very tempting for people with Type 2 diabetes. Be assured that you will find yourself being tempted, but by careful planning and conservative food selection you should survive. So relax and happy holidays!!!
October 28, 2010
Goals for the New Type 2 Organization
I am a bit disappointed in the response to the first blog on Type 2 diabetes needing their own organization, but just in the comments. The emails were only from one person and not very friendly.
Outside of the need to have an organization for those of us with Type 2 diabetes, I had hoped to get some more objectives and goals that would give us more ideas. So with that in mind, I will attempt to list a few of them and hope that we can draw some responses.
Besides raising funds for research, finding the proper research venues will be a big priority. There seems to be some areas that are coming to light now that may need more exploration that may lead to keys for managing diabetes. Being more accurate in the diagnosis of diabetes should not be overlooked as the ADA has opted to support the A1c test only.
Something will need to be done for educating the medical profession in being more aggressive in diagnosis, early treatment, and follow up. See this for some hope. Patient education also needs to be strongly promoted. I am not sure how this would be best accomplished, but one suggestion would be on line resources. This could be accomplished by having pamphlets or booklets that every doctor or endocrinologist can hand out when diagnosed.
Sadly in need of education are the insurance companies in preventative medicine and early work for patient education, patient followup, and working with other doctors for overall health. This may include, heart disease prevention, sleep apnea, kidney health, neuropathy, eye health, and many other related areas.
Research will need to be done to find out what other people with diabetes want for support, what education they want and need, and what services would better serve them. I suspect some work will be needed with government agencies, medical groups, and diabetes manufacturers of all types.
Because of the problems specific to women and to men, there should be special education and on line help for each. Education will need to be considered for the younger people now being diagnosed with Type 2 diabetes.
Education programs will need to be developed for hospitals and elder-care facilities. This will develop new standards for how patients with diabetes should be treated, allowed to be self-medicated while in these facilities, and procedures for reducing errors in IV solutions and medications. The attitudes of hospitals does need to be adjusted in many situations.
There has to be more objectives and goals. Help!
Outside of the need to have an organization for those of us with Type 2 diabetes, I had hoped to get some more objectives and goals that would give us more ideas. So with that in mind, I will attempt to list a few of them and hope that we can draw some responses.
Besides raising funds for research, finding the proper research venues will be a big priority. There seems to be some areas that are coming to light now that may need more exploration that may lead to keys for managing diabetes. Being more accurate in the diagnosis of diabetes should not be overlooked as the ADA has opted to support the A1c test only.
Something will need to be done for educating the medical profession in being more aggressive in diagnosis, early treatment, and follow up. See this for some hope. Patient education also needs to be strongly promoted. I am not sure how this would be best accomplished, but one suggestion would be on line resources. This could be accomplished by having pamphlets or booklets that every doctor or endocrinologist can hand out when diagnosed.
Sadly in need of education are the insurance companies in preventative medicine and early work for patient education, patient followup, and working with other doctors for overall health. This may include, heart disease prevention, sleep apnea, kidney health, neuropathy, eye health, and many other related areas.
Research will need to be done to find out what other people with diabetes want for support, what education they want and need, and what services would better serve them. I suspect some work will be needed with government agencies, medical groups, and diabetes manufacturers of all types.
Because of the problems specific to women and to men, there should be special education and on line help for each. Education will need to be considered for the younger people now being diagnosed with Type 2 diabetes.
Education programs will need to be developed for hospitals and elder-care facilities. This will develop new standards for how patients with diabetes should be treated, allowed to be self-medicated while in these facilities, and procedures for reducing errors in IV solutions and medications. The attitudes of hospitals does need to be adjusted in many situations.
There has to be more objectives and goals. Help!
Which sweeteners are you consuming?
When I started this, I had no idea what I was getting into. The way the sweeteners are looked at and discussed varies more than a person might think. Much depends on site objectives and manufacturer influence. Sugar and sweeteners are generally viewed as a poison by some groups, and should not even be looked at for people with diabetes irregardless of type. So those articles have been ignored as I wanted something that made some sense and might be of interest.
While the glycemic index values may vary from what I have located, generally they are within a few points in the sources checked. A few values could not be found and I used (??) to indicate that. The value can also change when processed differently as in pasteurized and raw honey. The GI values listed are therefore only guides and can vary depending on method of processing.
Various sweeteners Glycemic Index Value
Sugar GI 80
Other calorie containing sweeteners:
all have approximately 15 grams of carbohydrates per teaspoon
Honey, pasteurized GI 75
Raw Honey GI 30
Maple syrup GI 54
Pancake syrup GI (??)
Malt syrup GI 42
Karo syrup GI (??)
Corn sweeteners GI 62
Molasses GI 58
Jellies GI (??)
Jams GI 46
Marmalades GI 55
Agave syrup, nectar GI 15
Brown Rice syrup GI 25
Brown sugar GI 64
Fructose GI 22
Lactose GI 46
Glucose GI 96
Blackstrap Molasses GI 55
Stevia – FOS Blend GI <1
Artificial sweeteners GI <1
Name Brands
Aspartame NutraSweet, Equal
People who have a condition called phenylketonuria should avoid
this sweetener.
Acesulfame K Sunett, Sweet One, Swiss Sweet
Sucralose Splenda
Saccharin Sweet'nLow, Sugartwin
Avoid this sweetener if you are pregnant or breastfeeding
Sugar alcohols - These are neither sugars or alcohols, but pure carbohydrates. Examples of common sugar alcohols are maltitol, sorbitol, isomalt, and xylitol and are called “polyols”. There are other manufactured sugar alcohols, but these occur naturally in plants. This article explains more on sugar alcohols.
The key to non-artificial sweeteners is to use in moderation. Overuse of any sweetener is not good for maintaining tight management of diabetes and for many people will cause weight gain.
The above information is knowledge you should make use of when reading labels. While the GI values will not be listed, these are listed here to hopefully give you ideas when you are looking at labels. This article in WebMD may answer some more questions.
While the glycemic index values may vary from what I have located, generally they are within a few points in the sources checked. A few values could not be found and I used (??) to indicate that. The value can also change when processed differently as in pasteurized and raw honey. The GI values listed are therefore only guides and can vary depending on method of processing.
Various sweeteners Glycemic Index Value
Sugar GI 80
Other calorie containing sweeteners:
all have approximately 15 grams of carbohydrates per teaspoon
Honey, pasteurized GI 75
Raw Honey GI 30
Maple syrup GI 54
Pancake syrup GI (??)
Malt syrup GI 42
Karo syrup GI (??)
Corn sweeteners GI 62
Molasses GI 58
Jellies GI (??)
Jams GI 46
Marmalades GI 55
Agave syrup, nectar GI 15
Brown Rice syrup GI 25
Brown sugar GI 64
Fructose GI 22
Lactose GI 46
Glucose GI 96
Blackstrap Molasses GI 55
Stevia – FOS Blend GI <1
Artificial sweeteners GI <1
Name Brands
Aspartame NutraSweet, Equal
People who have a condition called phenylketonuria should avoid
this sweetener.
Acesulfame K Sunett, Sweet One, Swiss Sweet
Sucralose Splenda
Saccharin Sweet'nLow, Sugartwin
Avoid this sweetener if you are pregnant or breastfeeding
Sugar alcohols - These are neither sugars or alcohols, but pure carbohydrates. Examples of common sugar alcohols are maltitol, sorbitol, isomalt, and xylitol and are called “polyols”. There are other manufactured sugar alcohols, but these occur naturally in plants. This article explains more on sugar alcohols.
The key to non-artificial sweeteners is to use in moderation. Overuse of any sweetener is not good for maintaining tight management of diabetes and for many people will cause weight gain.
The above information is knowledge you should make use of when reading labels. While the GI values will not be listed, these are listed here to hopefully give you ideas when you are looking at labels. This article in WebMD may answer some more questions.
Subscribe to:
Posts (Atom)