Just Diagnosed And In A Panic? – Part 1

Some people put their entire fist through the panic panel while others throw a pity party and will milk it for all they can as the world is so unjust. Go ahead, I'll wait for you to calm down. You are not ready to read this.

I read this all the time on several of the diabetes forums which I follow. Even then some are unwilling to believe what the doctor told them and don't understand that we have all been in this situation. They claim we could not possibly understand how distraught they are. Yes, we do!!!

Some say they are mourning the carbohydrates they have had to give up. Many feel that it is only sugar they have to give up, but are they in for a surprise! This blog is primarily for those with Type 2 diabetes, but others can gain some information.

The doctors in the U.S. can be very subtle about how they say things and at times I wonder if they don't want to even mention diabetes, to say nothing about diagnosing it. They like to say “watch your food intake, your sugar was a little high” as they usher you out the door. Now just what does that mean? This is when you need to stop and look the doctor squarely in the eye and ask for an explanation. Did I? Unfortunately, no, and I paid the price and needed to go on insulin within a few months after being diagnosed officially. It is no wonder that many patients feel very lost in the beginning with diabetes.

If they do tell you that you have diabetes, some doctors will not refer you to a dietitian, nutritionist, or certified diabetes educator (CDE). If they are in a largely rural area, they may not have these available. Other doctors may have had less than positive experiences and so will not work with them. As a patient, I have had experiences that have been very positive with these supporting occupations, and a few that left me wondering if they even have heard about diabetes. Some are prone to contradicting the doctor and undermining the good he may have done.

While you are waiting to have meetings or classes, I recommend that you stop by the blog site of Alan Shanley. He has some excellent information about what to eat while you are waiting for your meter. If you do not have access to the dietitians, or CDE's, then Alan has three other excellent blogs; for getting started, testing, and reviewing and adjusting. While meters can deviate up to 20 percent, what you are looking for is trends and how different foods affect your body. Learn to trust your meter and use it. Alan also has an excellent blog on painless pricks to assist you in testing and care of your hands.

Those of us in the USA may have limitations imposed upon us by Medicare and our medical insurance companies if we are on oral medications. Some still decide it is worth the out-of-pocket expense to learn how our bodies react to different foods, being our own science experiment. Much of the time the doctors, educators, dietitians, or nutritionists will supply you with a meter, it is the test strips that will cost money.

Rather than run this into pages and pages, I would refer you to some books and websites so that you may read them at your leisure. I have a blog on books here, and another with some websites here. There are many more, but this will get you started and hopefully enthused that you can do something to manage this chronic disease called diabetes. If your local library does not have copies of any of the books, obtain them at your local bookstore, or order them online at a source you trust and try to obtain the latest edition.

More in my next blog about medications and home remedies. Part 1 of 3.  To read Part 2 and part 3 of this blog click on the links.

Diabetes Bariatric Surgery – Is It Effective?

Why are bariatric surgeons becoming so active in the diabetes field? Quite simply, primary care physicians and endocrinologists have abdicated their position. Sound a little dire? It might, but considering that these doctors are not rising to the challenge of taking care of and getting people out of the moderate to mildly obese categories. The bariatric surgeons are stepping in to the void to increase the thickness of their wallets and retirement plans.

As long as no one is explaining the side-effects and hyping the benefits, these surgeons will be happy to fatten their wallets and retirement accounts at the expense of other doctors, patients, and medical insurance companies. Is there a need for this surgery? While I don't like to say so, yes, there is a need. For those individuals that have tried and failed, e.g., exhausted with honest efforts other ways to reduce weight, and are among the morbidly obese, then the surgery is probably the only route available to them for weight reduction and possible management of diabetes.

Am I opposed to bariatric surgery. YES, except for the case above, I think the bariatric surgeons are into the vanity game for many people. I am thankful that the American Heart Association has taken a position in this and I can agree with their position. Read the article about this here.

The fees for bariatric surgery are steep and unless you have exceptional medical insurance, you may need to pay a healthy part of the bill. A discussion of medical insurance, Medicare, and Medicaid can be found here. Be sure to study this carefully.

An article by the Mayo Clinic is here. This is one of the better discussions about the different types of bariatric surgery and does list most of the risks involved with the surgery and even some risks by type of surgery. If you are seriously considering bariatric surgery, please read this article in its entirety. The consequences of not following exactly the plan and lifestyle changes can be very costly and even deadly. Most medical insurance companies require that you complete a training period and know each and every risk in detail. Some vary in length, but six weeks seems to be a minimum.

Some surgeons may try to get you past the insurance requirements fearing that you will want to back out of the surgery. So even with this, I strongly urge you to do your homework and know what you will be facing beforehand. Bariatric surgery is not for everyone so don't feel that you can slide past the requirements for lifestyle changes as they are mandatory and you will have problems if you ignore them. These lifestyle changes are permanent for the rest of your life which many people cannot accept and this gets them into serious problems.

If you think I am being overly dramatic, use your search engine and do some checking on your own. Also read my blog here about bariatric surgery possibly masking diabetes. Do not think it is the absolute cure the bariatric surgeons want you to believe. There are news articles almost weekly now hyping bariatric surgery and all refuse to discuss the serious risks. Even though I have an agenda against this surgery, I hope that I have pointed you in the right direction to arrive at an informed decision.

Summer Increases Risks for People With Diabetes

This is so important. Articles are starting to appear about the dangers for those of us in the northern hemisphere that have diabetes. A lot of the normal sources are dusting off the prior years blogs, articles, and press releases to put out the word. All this is done for a good reason – many people forget lessons learned in prior years and there are new people that have been diagnosed and don't know the dangers.

It is easy to understand why this came out of the Mayo Clinic in Arizona. It is getting much warmer there now, but it will soon spread north to the rest of the northern hemisphere. The tips given are important and need to be heeded.

Because many people new to diabetes are not aware of the dangers, any advice about the dangers of heat and dehydration is good for people with diabetes (please read about heat stroke in my six blogs starting here). Also people need to protect their testing equipment (meters and strips) from the extreme heat and not store them in direct sunlight as this will make them useless. Also included is the medications (pills and/or insulin) that should be stored in cool packs (Frio packs) and not left in direct exposure to the sun. Frio packs can be found through many sources – just use your search engine and enter “Frio packs”.

I encourage you to read some of my previous blogs which can be found here about summer heat and taking care of yourself. Planning for the spring and summer heat and dangers can save you time and prevent lost money when you have to replace equipment, testing supplies and medications accidentally left in the direct sunlight or a vehicle out in the sun.

I also encourage you to read this article from the Mayo Clinic, Arizona.

Americans with Disabilities Act Gets Amended

This is an insight into what I have been working on the last few days and will take more time to fully digest – I don't like the pieces here and other pieces over there. I knew this was happening, but had not continued to follow it after the comment period was over. There is quite a few changes in the Americans with Disabilities Act that will affect many of us. From people with diabetes to service dogs, there is a lot digest and determine how regulations have changed and affect us.

The American Diabetes Association made this release which kicked my backside into action. The ADA is applauding the changes which provides clear and clear regulations protecting the rights of people with diabetes in the workplace. How far this will go in creating better climates and working conditions for people with diabetes is not as clear as I had hoped.

Some of it is bound to be tested in the courts and possibly to the Supreme Court. But I will leave this to those in the legal profession. Some changes are definitely for the best and hopefully some of these will undergo further definition in the future as there are some gaping holes still existing that need addressing. But I am straying away to areas not covered in the ADA press release.

The ADA boasts about their participation which is all well and good and I am satisfied that they did what they were able considering all the groups participating and demanding this and that regulation. Yet, I do wonder if they left some areas that were in need of action to get other regulations. This is the problem within our political system of compromise which leaves needs on the table.

Employment discrimination is a big issue addressed and for that I am thankful. The new regulations will benefit people with diabetes and employers. It will simplify the determination as to whether an individual is covered under the law and allow attention to be put on the issue of whether a person with diabetes is discriminated against because of diabetes.

I have much more information to work through and it is a time consuming task. I just wanted you to know some of what is occupying my time and why I needed a break from blogging.  And I am enjoying some time away from research.

Less Than Stellar Results From Gastric Banding

I had a different post ready for today, but it is not April Fools day yet, and I almost got sucked in by some bad information that was both misleading and hyping a poor product. Talk about following a gut instinct. I can only say this is one time I was very happy I decided to do more research. When I get past my anger about these people, I may write something about this, but I cannot see giving them any recognition or space in my blog.

Therefore I decided to do a short blog about a valid study done before the turn of the century that may not be representative of today's results.  Gastric banding is done by may obese people with diabetes to assist them in weight loss.  I know that the bariatric surgeons are less than happy that this study has been brought back, but people need to be informed about the errors of the past.

The same study has two different articles about the study done in Belgium between 1994 and the end of 1997. It also has comments about the improvements since, but none of this is backed by more recent studies. Just a way of crying foul when some little truth is exposed that might hurt some retirement funds.

I agree that the study was small and may not have been done by today's standards, but who is to know how the agenda would drive a study today. I agree that I have an agenda against the way bariatric surgery is being promoted today and the many facts that are being carefully sidestepped in the name of success and not scaring people away.

Read the articles about the same study here and here.

Are you really prepared if disaster strikes?

With many of our thoughts and sympathies with the people of Japan, I am seeing a lot of blogs about disaster preparedness plans and having one. I think this is a good thing to have regardless of where you live, or what might happen. What ever you do, it is always good to be prepared.

Comment: Everyone talks the talk, but do they really walk the walk. Everyone seems to have a plan, but at best they are incomplete. Nothing is mentioned about replenishing perishable insulin or rotating oldest medications out and fresh in. Even water needs to be refreshed if stored in plastic.  Make sure that you have extra batteries for meters, flashlights, and other equipment.  If you have other supplies that expire with age, make sure they are rotated out and used and replace with fresh.

Another idea missing from most plans is where is this emergency supply kit to be stored. And think about whether you can get to it in an emergency and before you leave. Insulin requires refrigeration and most kits are probably not stored in the refrigerator. If you are on oral medications, then you may be one step ahead of others. What ever you decide, do not put something together and then forget about it. If any of your medications require refrigeration, you may be locked as to where you store your emergency kit. Have a year-round plan to update medications and not let them expire.

These are just some thoughts that crossed my mind while reading many of the plans.
I am not even saying that what I wrote almost seven months ago is always the best, but it may be worth rereading. The link is here.

Exercise – The Key to Managing Diabetes

I have said this before and will say it again – exercise. I have learned a few morsels to this in the last few years. Some have even told me to get lost as they are not medically able to exercise. Oh, really. A neighbor just reminded me of how false this is, except for a person that is a quadriplegic and others having some types of back injuries. Even another with a prosthetic limb said exercise is encouraged.

A neighbor is confined to a wheelchair with Type 2 diabetes and still exercises. He works very hard lifting five and ten pound or higher weights and once the snow is gone, I will see him out wheeling himself around several blocks in his wheelchair. He lost the use of his legs in an auto accident several years ago and has worked very diligently to build his muscles in his arms and body. He had an operation on one leg this winter and doctors are now hopeful that he may regain partial use of his left leg.

He has talked about this with me and he hopes that his right leg will be operated on next winter, and is hoping that the new procedure will give him full use. He did qualify for a powered chair, and has one for longer trips to the grocery store and other places, but he seldom uses it as he wants the exercise. I have seen him twice this winter and the second time he was standing on his left leg. Even that was an effort, but he wanted to show me the progress. The leg is still very stiff and it is difficult to stand on for lengthy periods, but he is working the leg and has a therapist in three days a week working with him.

So for my more sedentary friends, exercise generally is possible and for many people will require a doctors permission and developing a regimen with the doctors approval. Even lifting small weights can do good things for blood glucose control.

The main key is finding a type of exercise you enjoy and doing it can help. Many think running or jogging is the only exercise for them and if that works – great. Others have found that swimming is good for them and is something that they can do year round even here in the Midwest because the indoor pools are open. Others must use exercise equipment and if they do – good for them.

The idea is to be doing something that you enjoy, can do three to seven days a week and at varying times. Walking is always good for those that can't run or jog. Your management of diabetes will improve and you will not need to rely solely on nutrition (diet) to manage your blood glucose levels. Plus, if you want to reduce your chances of developing the complications of diabetes, exercise is an excellent tool.

I have to end this with an observation about what many people with diabetes seem to think is important. On one of the forums I participate on occasionally, one member was mourning the lost of carbs. In the responses to this, exercise was never mentioned. There were some excellent suggestions about cutting carbs and finding substitutes, but I am also surprised at the lack of nutritional advice as well.

This is an area of weakness in most forums and not just diabetes forums. A few forums have members that practice what they preach and will mention exercise without hesitation while others very seldom even think of exercise.

Most forums would be well advised to have a broad range of medical professionals, dietitians and nutritionists, and people that know exercise available to offer advice and answer questions.

Do You Feel Guilty About Diabetes?

Are you buying into the myths often laid on us by the medical profession, friends, and family? This is easy to do, but you must not. First, understand that diabetes is not your fault. I have said this before and some need a constant reminder of this. Then be sure you are living in the present as the past is exactly that, the past.

Being able to manage diabetes is now your goal. This is a task that requires attention 24/7/365. There is no vacation and this does present challenges for some. There can be good and bad times, as well as days that can be planned when you can treat yourself to some relaxing time.

People with Type 2 diabetes often give up for several reasons. Often they are tempted and do give in to these temptations. Others get discouraged because they don't obtain the results the doctor had told them to expect. Some believe in the myths about diabetes and therefore do not challenge themselves to do many things that may help them in their management of diabetes. Still others do not follow the instructions of the doctor and wonder why they are not getting better.

A difficult truth for many is there are few people with Type 2 diabetes that can measure their results to another person's results. Therefore, you must become your own science experiment and find out how your body reacts to different foods, different medications, and different levels of exercise.

If you are looking for other views, two bloggers have something to say. David Spero has a blog here about this subject. And Pine Pienaar has has other suggestions here.  (The last link is broken - no fix found.)  They both have good points and I enjoy reading both.

If you have gotten past the initial shock, anger, and denial, the next step is gaining the knowledge you need to manage diabetes. There are many excellent books and web sites available that can give you much good information. Just a word of caution, there are some very unreliable websites that promise cures, but they are after your money and will promise most everything to get you to pay it over to them.

There are many studies out that criticize many of the sites for their unreliable and misleading information. Just use extreme caution and I have many sites listed in other blogs. A few are blog 1, blog 2, and blog 3.  When you find something you like or that you find useful, bookmark it to have it for reference. If something does not work for you, discard it and move on. Occasionally some ideas will work in the future.