April 1 Support Group Meeting

Yes, we know all about “April Fools” jokes; however it was decided to have a meeting anyway and then possibly another on April 29. And, we had a new CDE (Beverly) to welcome back to the group. And then we had an even larger surprise when Beverly also announced that we had a new CDE as a member. None of us knew that Jennifer was in the program and had been accepted as a Certified Diabetes Educator.

This brought a round of applause that surprised many of us, but was welcomed as well. Brenda asked both to stand up front and accept a congratulation line. This took some time, but everyone went forward to congratulate both of them.

Then Brenda asked both of them to speak briefly to the group. Jennifer started by saying she was happy that there were two of us. She said that when she needed support she had found it in our group. She thanked Brenda, Sue, and Beverly and then asked Beverly to thank Suzanne or give her an address so she could send a thank you card.

Beverly said she would give her an address later. She said the hospital had used both of them for diabetes education and this had allowed for better results for more patients. Jennifer was nodding her head. Beverly said that there would be another nurse/CDE about next April that would also work in the hospital.

At that point, Brenda said Beverly would have the program about foot care and avoiding amputation.

Beverly thanked me for the many blogs I had written about foot care and avoiding amputation. She said that most people only think of amputation involving the feet and lower legs, but she said that she was surprised recently by an arm amputation. The person entered the emergency department with gangrene in the hand and half way to the elbow. She continued that normally people go to the doctor for anything not healing in the hand or arm so this was a real surprise when it came time for the amputation.

Beverly said they average five to eight toe, foot, or partial leg amputations per month and she said that everyone here should check their feet daily or ask someone to check them for you if you are unable or don't have a mirror to see the bottom of each foot.

Next, she asked for a show of hands from those that see a podiatrist at least quarterly. Of the 26 present, only 13 of us did see one quarterly. She next asked if there were some that saw one more or less often. Four more hands were raised. She asked each how often and all said twice a year. Then she asked how many had mirrors to check their feet and six more hands were raised. She asked how the other three were handling checking their feet and all said they were able to look at the bottom and Sue and Bob said they also help each other at times.

She then asked Brenda to include the three blogs of mine, blog 1 on avoiding amputations, blog 2 on foot care, and blog 3 also on foot care in the newsletter she sent out, as they were important.

Then Beverly opened for questions and the discussion lasted another half an hour. Then cleanup was done and the meeting was over.

April Meeting with Both Nutritionists

Normally I would have posted this for Sunday, but I wanted to complete the series since I had to hand out copies for Sunday to members. Our April meeting was very different and many were discussing the blogs on nutrients. Both Allison and Suzanne were there and Suzanne commented that our group was very different from most people or small groups she has had contact with and wanted to thank us for thinking of them. Allison said yes, even she could appreciate the blogs as Brenda had made her aware of them.

Tim told them to take over as he had the slides ready and would use them when needed. Allison said we had hit on two ideas that would definitely help them balance our food plans easier and wanted everyone to be aware of these.

1. Always have any lab results available if any of the nutrients were tested and are part of the lab reports.
2. Try to keep a food log available for them to look at and if necessary a recipe of some of the ingredients in the foods. Example, if cauliflower is substituted for potatoes, make a note of this.
3. Always have a list of medications and supplements you are taking. Indicate which dietary supplements may have been ordered by the doctor. Example, vitamin B12 for long time metformin users as this may indicate that you have lost the ability to absorb vitamin B12 from the foods rich in them.

Suzanne said that several had two of the above, but no one has had all three. She said Allen and Bob have had the first and third and have been told by their doctors to take vitamin B12 and D. She says this means both have lost the ability to absorb vitamin B12 from the foods. Vitamin D is lack of sunshine more than likely.

There were several questions about vitamin B12, and Suzanne said she would answer the first. There were several about metformin and vitamin B12 and Suzanne said that now we have a link that metformin does cause a deficiency of vitamin B12. We are not sure of why this happens, but if you have taken metformin for several years, you should be tested for vitamin B12. This is the safest way to know and many doctors will not do the test and just tell you to eat animal foods, liver, sardines, and salmon rank highest, with liver having the largest amount of vitamin B12. Kidney, eggs, beef, and pork are also good sources.

Allison continued that often the elderly do not have enough acid to digest the animal foods and absorb the vitamin B12, thereby causing the vitamin B12 deficiency. For any of you that are vegetarians, or vegans, you must take a supplement to maintain vitamin B12 levels.

This drew a few more questions about vegetarians and one asked if they should eat some liver or salmon to prevent vitamin B12 deficiency. Suzanne said that this would not happen because people that were strict vegetarians would not have enough acid in their stomach to absorb vitamin B12. The question was then rephrased to say that she was considering moving to a vegetarian diet. Suzanne said that initially she could have enough acid, but that in a month or two she would not and a supplement would be necessary.

Allison said that if a vegetarian or vegan moved away from this way of eating, that it could take a year or longer to be able to absorb vitamin B12 and some individuals never regain this ability if they are older. People in their 20's still can remain deficient for a year or longer and children have been deficient into their teens. She continued that is one reason we generally stay away from these situations.

Suzanne agreed and said with a group like this, we will work with you to a point, but discourage you from adopting either of these on a full-time basis. The next question was what Suzanne was waiting for and it was about why was it necessary to take many of the nutrients with knowledge or under supervision of a knowledgeable doctor.

Suzanne said that like the B vitamins, they are all water-soluble and the excess is flushed by your system. Vitamin A and E are fat-soluble and can become toxic if you consume too high a dosage. Vitamin D is in truth a hormone and will not become toxic until near 400,000 IU or above. Some people use 10,000 IU and have no problem for several months.

Allison said that the minerals are important, but can become toxic if not taken carefully under the supervision of a doctor. Safety should always be first and care taken to void problems. The mineral iron is tested in women of child-bearing age because they need enough and not too much for carrying the baby. Men can often be ignored by doctors and other doctors just refuse to test for many of the nutrients covered by Bob.

Tim said the meeting was over and then the questions really began as many wanted answers and but did not want everyone to know who asked the question. A few of us started the cleanup and as we finished, Suzanne asked to speak to Tim and myself. She said she would not be able to attend meetings until the next year and was just happy for this meeting. We said thank you for letting us know and asked if she would be doing any consultations. She said no and she would be too busy for consultations. Tim asked for everyone's attention that was still there and made the announcement about Suzanne's planned absence.

Allison then stated she would also be gone for the month of May until the end of September. She said that she would schedule as many as she could before the end of April and the rest would need to wait until October. Tim thanked her and we both asked if there was anyone we could talk to if the need arises. Both said they would each supply two names and phone numbers to Tim after they had approval to do so. We thanked them and the meeting broke up.