Why are we letting them get away with doing this? Again, I need to bring in something Tom Ross has written about on his home page.
I quote: “The usual, depressing message about diabetes is sometimes tactfully disguised, but anyone who has been diagnosed with the disease soon learns to decipher it. The message is: "Give up! Resistance is futile. You are now in the grip of mysterious, uncontrollable forces, and there's nothing you can do about it. Please resign yourself to a life of helplessness, drug-dependence, disability, and early death. Have a nice day!"
Oddly enough, this message generally fails to energize and inspire people. In fact, once people realize this is the future that has been mapped out for them, they tend to become depressed and apathetic. The result is that a lot of people who have been diagnosed with Type 2 diabetes fail to do any of the things that could improve the situation. They don't know, or don't believe, that there actually is anything they could do to improve the situation. And there might as well not be, if people don't try! A solution which people don't take advantage of is effectively the same as no solution. Therefore, there is an urgent need for patients to find out what they can do, and do it.” Unquote. (My emphasis in bold)
While I do not always agree with the wording, the message is exactly right and is often the result of the medical profession not wanting to face the patient. Many doctors do not want to talk with the patient about this chronic illness that the patient now has. It is also because the medical professional does not know how to communicate or lacks the communication skills to explain the consequences clearly of not dealing with the chronic diseases – diabetes in this case. For a doctor's honest perspective, read this.
Often, the doctor does not have the time or resources to aid the patient. By resources, it needs to be understood, it is the trained people who can spend the time to get the patient off on the correct course of action to gain control of their diabetes. What even these doctors do not realize is how easy it is to recommend them to some people that are trained in this type of assistance. There is also websites on the internet that can be used to give them assistance or at least get them started.
Why then will they not use these resources? Often because they don't trust these sources and do not want to give their patients sources that may conflict with with what they want their patients to know. Some do not want to spend time answering what they consider silly questions. Other doctors do not like that fact that some, if not a good share, of the resources on line do not have professional degrees or are not operated by people with professional degrees. And regrettably some of the medical professionals just feel that they are the only source their patients need.
If you say, “not good enough”, then you are right. While almost all of the sources on line do say that for medical information that they should consult with their medical team or doctor, they do have much information that can take the fear out of their diagnosis, get them started in the right direction and maybe the biggest advantage is showing the patient that there is hope, and that there are others in the same or similar situations and that there is help available for those willing to be proactive in their care.
I feel it is important to say at this point that the doctor is not the person living with the disease (although some do have diabetes) and that this disease is your diabetes. You, the patient, are the person in charge, who with the doctors assistance can learn to control and even manage your diabetes to prevent it from progressing rapidly to the finality of the complications and that you can live a long and good life. The doctor is not the person taking the pills or injecting the insulin. They are also not the ones sitting beside you telling you what you can eat and what the effect will be if you do eat that.
They can advise you and keep tract of the HbA1c results to know how well you are or are not managing your diabetes.
Some doctors don't want you testing your blood glucose levels as they think this will only discourage you and not motivate you to do more to control your diabetes. So they do not give you a meter or prescription for one and the test strips. Bad move by your doctor. Ask for a prescription and don't be put off. If you can't get a prescription, consider this a clue that you desperately need a different doctor.
Your meter should be your best friend and it will tell you how the meal you just ate is affecting your blood glucose levels. This meter will also let you know if you either need to eliminate this food or reduce the quantity eaten.
For more information about the best methods and how to use your meter check out these blogs by Alan Shanley. SMBG means self-monitoring of blood glucose.
Blog 1, blog 2, and blog 3.
August 20, 2010
August 18, 2010
The attitudes of diabetes
Tom Ross, who writes in his home page at Not Medicated Yet explains some of the nature of type 2 diabetes very well.
I quote “ … because of an unusual aspect of Type 2 diabetes: it's a treatable disease, but it can't be treated by doctors. The practitioner who is going to be administering your diabetes treatment is you. Doctors can advise you, and they can give you legal permission to buy certain controlled substances, but (unless you happen to be in a coma), they can't treat your diabetes for you, any more than the GPS device which advises you to take the River Road exit can drive your car. Doctors simply aren't in the driver's seat, because they cannot live your life for you. Success or failure at getting healthy (and staying healthy) after a diabetes diagnosis will be determined mainly by what goes on during that part of your time which is not spent at the doctor's office or the pharmacy. Diabetes care involves a lot of things, and getting prescriptions filled is a pretty small part of the picture. (For me, so far, it's no part of the picture at all.)
Although the idea of solving your diabetes problem by taking pills (and doing nothing else) has a certain appeal, it's clear by now that this approach doesn't work very well. It's also clear by now that there is another, better approach available. Most doctors try to talk their patients into adopting it. Unfortunately, most of their patients would rather be given pills than advice on how to live. "Why change my habits when I can simply take prescription drugs?", they ask themselves. That would be a valid question, if the drugs were enough, by themselves, to keep diabetes patients healthy and safe. They aren't. Unquote.
Tom manages his diabetes with exercise and nutrition (diet for those who prefer the term - that fails for so many). This takes effort and dedication, something that many patients decide to bypass. Tom covers two of the attitudes of diabetes, those of many patients and many doctors, and hints at the third attitude – his - a lifestyle change.
Although the attitude displayed (pushing pills) by doctors is common, and hides other motives, this commonality is an attitude that must be challenged by every patient. Will this happen? When we read the attitude Tom described by the patient, it is highly doubtful. Too many patients are in the “pill cure attitude, and let's get on with life”. What these patients do not understand is that the oral medications can be much more harmful than nutrition and exercise, or even insulin. At least some in the medical community are trying to emphasize the change in lifestyle as a viable route in controlling diabetes.
Leaving Tom's attitude aside, I need to cover something I did in my blog on Doctor – Patient Relationships in my blog of May 18, 2010. The first type of patient has an attitude that too many patients subscribe to. They could care less about pills from the doctor and some won't even take them. As soon as they are outside the doctors office, they are on the cell phone or on their way to the local health food store to check in with someone to find out what the local snake oil salesman has for diabetes, or to talk to a neighbor about what to take that is natural for diabetes. If these people are in the early stages of diabetes, they may have some temporary relief, but this will not last long and they will be in big trouble, unless they change their lifestyle.
If they have the desire to change their lifestyle and among those that are able to control their diabetes with nutrition and exercise, they should go for it. This along with the stage that they are at will determine how much they have as a possibility of delaying the progression of diabetes. A good thing for those that are able to to control their diabetes early on.
Another attitude of diabetes is depression. This often arises after you, the patient, realizes what the daily routine is and the time, patience, and education this disease requires from you. Diabetes is a disease that will not go away, constantly makes changes to confuse us, and at times seems to have a mind of its own. One of the hardest parts of depression is not letting it take control as this will help diabetes get the upper hand and then the problems really multiply.
Yes, there is anger, denial, acceptance, but these are all stages of the process of coming to terms with your diabetes, and not attitudes.
And last is Tom's attitude, of “get it done” - let's see what can be done to maintain tight control and manage my diabetes instead of it managing me. His attitude takes determination in addition to effort and dedication. This is the attitude of a person that is proactive in their health care. This attitude also requires the best attitude - a positive attitude which is often lacking with the other attitudes.
There can be a multitude of other attitudes, but none of them matter unless you can cultivate an attitude like Tom's. Everyone can have this attitude regardless of the point they are at with their diabetes. Read his blog of August 10, 2010 for his answer of what moved him to do what was necessary. This is Tom at his best.
I quote “ … because of an unusual aspect of Type 2 diabetes: it's a treatable disease, but it can't be treated by doctors. The practitioner who is going to be administering your diabetes treatment is you. Doctors can advise you, and they can give you legal permission to buy certain controlled substances, but (unless you happen to be in a coma), they can't treat your diabetes for you, any more than the GPS device which advises you to take the River Road exit can drive your car. Doctors simply aren't in the driver's seat, because they cannot live your life for you. Success or failure at getting healthy (and staying healthy) after a diabetes diagnosis will be determined mainly by what goes on during that part of your time which is not spent at the doctor's office or the pharmacy. Diabetes care involves a lot of things, and getting prescriptions filled is a pretty small part of the picture. (For me, so far, it's no part of the picture at all.)
Although the idea of solving your diabetes problem by taking pills (and doing nothing else) has a certain appeal, it's clear by now that this approach doesn't work very well. It's also clear by now that there is another, better approach available. Most doctors try to talk their patients into adopting it. Unfortunately, most of their patients would rather be given pills than advice on how to live. "Why change my habits when I can simply take prescription drugs?", they ask themselves. That would be a valid question, if the drugs were enough, by themselves, to keep diabetes patients healthy and safe. They aren't. Unquote.
Tom manages his diabetes with exercise and nutrition (diet for those who prefer the term - that fails for so many). This takes effort and dedication, something that many patients decide to bypass. Tom covers two of the attitudes of diabetes, those of many patients and many doctors, and hints at the third attitude – his - a lifestyle change.
Although the attitude displayed (pushing pills) by doctors is common, and hides other motives, this commonality is an attitude that must be challenged by every patient. Will this happen? When we read the attitude Tom described by the patient, it is highly doubtful. Too many patients are in the “pill cure attitude, and let's get on with life”. What these patients do not understand is that the oral medications can be much more harmful than nutrition and exercise, or even insulin. At least some in the medical community are trying to emphasize the change in lifestyle as a viable route in controlling diabetes.
Leaving Tom's attitude aside, I need to cover something I did in my blog on Doctor – Patient Relationships in my blog of May 18, 2010. The first type of patient has an attitude that too many patients subscribe to. They could care less about pills from the doctor and some won't even take them. As soon as they are outside the doctors office, they are on the cell phone or on their way to the local health food store to check in with someone to find out what the local snake oil salesman has for diabetes, or to talk to a neighbor about what to take that is natural for diabetes. If these people are in the early stages of diabetes, they may have some temporary relief, but this will not last long and they will be in big trouble, unless they change their lifestyle.
If they have the desire to change their lifestyle and among those that are able to control their diabetes with nutrition and exercise, they should go for it. This along with the stage that they are at will determine how much they have as a possibility of delaying the progression of diabetes. A good thing for those that are able to to control their diabetes early on.
Another attitude of diabetes is depression. This often arises after you, the patient, realizes what the daily routine is and the time, patience, and education this disease requires from you. Diabetes is a disease that will not go away, constantly makes changes to confuse us, and at times seems to have a mind of its own. One of the hardest parts of depression is not letting it take control as this will help diabetes get the upper hand and then the problems really multiply.
Yes, there is anger, denial, acceptance, but these are all stages of the process of coming to terms with your diabetes, and not attitudes.
And last is Tom's attitude, of “get it done” - let's see what can be done to maintain tight control and manage my diabetes instead of it managing me. His attitude takes determination in addition to effort and dedication. This is the attitude of a person that is proactive in their health care. This attitude also requires the best attitude - a positive attitude which is often lacking with the other attitudes.
There can be a multitude of other attitudes, but none of them matter unless you can cultivate an attitude like Tom's. Everyone can have this attitude regardless of the point they are at with their diabetes. Read his blog of August 10, 2010 for his answer of what moved him to do what was necessary. This is Tom at his best.
August 15, 2010
Sleep Apnea CPAP Nasal Mask Liners
Disclosure – This is something I purchased for my own use, but since I have been very satisfied with it, I wanted others with sleep apnea and using a CPAP machine and nasal masks to be aware of some of the benefits. I am receiving no compensation for this.
Have you had problems with air by-pass from your nasal masks? I have had many problems with air leaks, especially with certain masks. These are normally the ones that I mistakenly let the the local supplier talk me into. I had finally found a mask that was comfortable and very seldom had caused air by-pass or air leaks. Wouldn't you know it, next time I needed to replace a mask, they no longer had it in stock. Not that the new mask that replaced it does not work, it just has too many air leaks.
Even after adjusting it several times and working with different strap adjustments, it still allows too much air to leak around the mask. When you add in the facial oil build-up over the night, it was not a pleasant experience, I would often wake up with air blowing in my eyes. How I found these liners, I am not sure of, but in looking at some sites that sell different CPAP masks, I know that I saw something that I passed over the first few times.
Since I had stopped using the current mask and returned to the comfortable one, I started looking in earnest. This time I saw the ad and decided to check it out. Still I was not impressed, so I went searching and found the manufacturer's site. After reading much of the site information, I sent them an email and asked a few questions. Since this was after hours for them, I did not expect an answer until the next day.
An hour later I had an answer. I did not order then, but I should have. A couple of days later, I did order a sample of six nasal mask liners. When I received them the following week, I tried one that night. I needed to readjust my straps and found that I did not need as much tension on them. It still needs to be firm, but the air leaks stopped. Yes, if I turn while sleeping, some air will escape, but normally by adjusting my mask it stops. Since then I have ordered the 30 day supply.
Now before you tell me that there are other options like nasal pillows, or other appliances, I will only say that they do not work for me. Yes, there are other nasal masks and I may try others in the future. I will also be investigating full-face masks in the future, but for now, I have my solution. The nasal mask liners cost less than a dollar per day if used the way it is recommended by the manufacturer.
Disadvantage for me is that at present Medicare does not cover these liners. So now I am working on several experiments to see what can be done to get more use from the CPAP nasal mask liners. The manufacturer strongly recommends using a new liner each night. I have found that if I am careful and turn the liner over and carefully lay it out, I can use it for two nights. I have tried using it for three and four nights, but then there are problems of the air leaks happening again. The facial oils have filled the pores of the liner and it looses it's effectiveness.
Washing the liners in my wife's delicates bag in the laundry does not work. The liner basically disintegrates as it does not have a sewn edge holding it together. So I took eight of the used liners and soaked them for about four to five hours in a mild laundry soap. After rinsing them carefully three times to remove the laundry soap, I carefully laid them out on a sweater rack and laid a couple of paper towels over the top using a couple of large bamboo spoons to anchor the paper towels and let them dry.
They have worked well for another two nights. Now I will need to see if they will accept another washing – doubtful. Even without washing them another time, my effective cost per liner usage for four nights will be less that 25 cents each. While this is not recommended by the manufacturer, I had to see what could be done. Am I satisfied, very definitely yes. Will I do this for each liner? I may. It has just been interesting learning what can be done and finding out how well the mask liners hold up.
So if you are one that has problems with air leaks or air by-pass from your CPAP nasal masks, check them out. Now to make sure that my supplier has the nasal mask that I prefer in stock the next time I need a replacement. Otherwise, it will be time to replace the supplier.
I have learned that each face has a different requirement in size of mask and one mask does not fit every face. There are normally two or three sizes for each mask and the mask that works for you may not work for me. Thank goodness for the RemZzzs nasal mask liners! Take time to explore the site.
Have you had problems with air by-pass from your nasal masks? I have had many problems with air leaks, especially with certain masks. These are normally the ones that I mistakenly let the the local supplier talk me into. I had finally found a mask that was comfortable and very seldom had caused air by-pass or air leaks. Wouldn't you know it, next time I needed to replace a mask, they no longer had it in stock. Not that the new mask that replaced it does not work, it just has too many air leaks.
Even after adjusting it several times and working with different strap adjustments, it still allows too much air to leak around the mask. When you add in the facial oil build-up over the night, it was not a pleasant experience, I would often wake up with air blowing in my eyes. How I found these liners, I am not sure of, but in looking at some sites that sell different CPAP masks, I know that I saw something that I passed over the first few times.
Since I had stopped using the current mask and returned to the comfortable one, I started looking in earnest. This time I saw the ad and decided to check it out. Still I was not impressed, so I went searching and found the manufacturer's site. After reading much of the site information, I sent them an email and asked a few questions. Since this was after hours for them, I did not expect an answer until the next day.
An hour later I had an answer. I did not order then, but I should have. A couple of days later, I did order a sample of six nasal mask liners. When I received them the following week, I tried one that night. I needed to readjust my straps and found that I did not need as much tension on them. It still needs to be firm, but the air leaks stopped. Yes, if I turn while sleeping, some air will escape, but normally by adjusting my mask it stops. Since then I have ordered the 30 day supply.
Now before you tell me that there are other options like nasal pillows, or other appliances, I will only say that they do not work for me. Yes, there are other nasal masks and I may try others in the future. I will also be investigating full-face masks in the future, but for now, I have my solution. The nasal mask liners cost less than a dollar per day if used the way it is recommended by the manufacturer.
Disadvantage for me is that at present Medicare does not cover these liners. So now I am working on several experiments to see what can be done to get more use from the CPAP nasal mask liners. The manufacturer strongly recommends using a new liner each night. I have found that if I am careful and turn the liner over and carefully lay it out, I can use it for two nights. I have tried using it for three and four nights, but then there are problems of the air leaks happening again. The facial oils have filled the pores of the liner and it looses it's effectiveness.
Washing the liners in my wife's delicates bag in the laundry does not work. The liner basically disintegrates as it does not have a sewn edge holding it together. So I took eight of the used liners and soaked them for about four to five hours in a mild laundry soap. After rinsing them carefully three times to remove the laundry soap, I carefully laid them out on a sweater rack and laid a couple of paper towels over the top using a couple of large bamboo spoons to anchor the paper towels and let them dry.
They have worked well for another two nights. Now I will need to see if they will accept another washing – doubtful. Even without washing them another time, my effective cost per liner usage for four nights will be less that 25 cents each. While this is not recommended by the manufacturer, I had to see what could be done. Am I satisfied, very definitely yes. Will I do this for each liner? I may. It has just been interesting learning what can be done and finding out how well the mask liners hold up.
So if you are one that has problems with air leaks or air by-pass from your CPAP nasal masks, check them out. Now to make sure that my supplier has the nasal mask that I prefer in stock the next time I need a replacement. Otherwise, it will be time to replace the supplier.
I have learned that each face has a different requirement in size of mask and one mask does not fit every face. There are normally two or three sizes for each mask and the mask that works for you may not work for me. Thank goodness for the RemZzzs nasal mask liners! Take time to explore the site.
August 14, 2010
Roche 2010 Social Media Summit conference call
Scott Johnson posted on August 11, 2010, his summary of the teleconference call as that will be quarterly for those of us that had attended the Roche 2010 Social Media Summit. Excellent post Scott.
The one point Scott made that I think needs repeating here is that social media does include more than just blogging. I agree that some of what is said may be over the terminology or semantics of a word. I do think that instead of using terms like “blog roll” or “blogs”, we should consider the term “diabetes social media roll” or DSMR to include all of the social media, even possibly “diabetes social media community” (DSMC).
While I am only involved in the blogging aspect of social media, I must remind my readers that we had several present at the Roche summit that were from other aspects of the diabetes social media community.
Charlie Cherry is involved with production of podcasts of topics on diabetes and interviews of people with diabetes and leaders in the diabetes community. Included was Kelly Close, who writes at diaTribe, an on-line diabetes news publication, Manny Hernandez who owns several diabetes on-line services, including TuDiabetes. David Edelman, who is not a person with diabetes, but owns a forum on Diabetes Daily and includes feature blog writers in a blog area of which Scott is one of the featured writers. Also in attendance was Kitty Castellini from Diabetes Living Today, who with her partner broadcast an on-line radio broadcast.
There were others that are not necessarily bloggers per se, but we cannot say that Roche has excluded those who do not blog. While the majority were from the blogging community, many of the bloggers also participate in Twitter and Facebook.
Yes, I am sure there are other areas of the social media that I haven't mentioned, but least I am confident that Roche has included a good variety of social media in their summit.
I generally do not participate in surveys, but for the Roche survey I did do my part. I am also disappointed that only about 60% of us did reply. This was an excellent opportunity to have our say in the development of future summits. The other 40% should sit up and take notice that their lack of input does them and the rest of the diabetes social media community a disservice.
I may not be as concerned about how the participants are selected to attend; however, Roche in their survey did give those participating an opportunity to nominate potential participants for future summits. I did nominate several people from outside the USA for consideration. I like the idea of having an international flavor for our summit and we can learn about what is happening in other countries. Who knows, the cure for diabetes may well originate outside the USA.
Several of the comments to Scott's blog were well placed about the need for type 1 advocacy and the help they need. As a type 2, I will not cry foul, as the need is definitely there and must be met. I would say that with more children now developing type 2 and the same for young adults, both sides need any assistance that can be offered by the on-line community and any diabetes supply manufacturers, diabetes drug manufacturers, and others willing to put forth the effort that Roche is now doing.
So I will recommend that you take time to read Scott's post. He has some excellent thoughts in areas that I did not cover.
The one point Scott made that I think needs repeating here is that social media does include more than just blogging. I agree that some of what is said may be over the terminology or semantics of a word. I do think that instead of using terms like “blog roll” or “blogs”, we should consider the term “diabetes social media roll” or DSMR to include all of the social media, even possibly “diabetes social media community” (DSMC).
While I am only involved in the blogging aspect of social media, I must remind my readers that we had several present at the Roche summit that were from other aspects of the diabetes social media community.
Charlie Cherry is involved with production of podcasts of topics on diabetes and interviews of people with diabetes and leaders in the diabetes community. Included was Kelly Close, who writes at diaTribe, an on-line diabetes news publication, Manny Hernandez who owns several diabetes on-line services, including TuDiabetes. David Edelman, who is not a person with diabetes, but owns a forum on Diabetes Daily and includes feature blog writers in a blog area of which Scott is one of the featured writers. Also in attendance was Kitty Castellini from Diabetes Living Today, who with her partner broadcast an on-line radio broadcast.
There were others that are not necessarily bloggers per se, but we cannot say that Roche has excluded those who do not blog. While the majority were from the blogging community, many of the bloggers also participate in Twitter and Facebook.
Yes, I am sure there are other areas of the social media that I haven't mentioned, but least I am confident that Roche has included a good variety of social media in their summit.
I generally do not participate in surveys, but for the Roche survey I did do my part. I am also disappointed that only about 60% of us did reply. This was an excellent opportunity to have our say in the development of future summits. The other 40% should sit up and take notice that their lack of input does them and the rest of the diabetes social media community a disservice.
I may not be as concerned about how the participants are selected to attend; however, Roche in their survey did give those participating an opportunity to nominate potential participants for future summits. I did nominate several people from outside the USA for consideration. I like the idea of having an international flavor for our summit and we can learn about what is happening in other countries. Who knows, the cure for diabetes may well originate outside the USA.
Several of the comments to Scott's blog were well placed about the need for type 1 advocacy and the help they need. As a type 2, I will not cry foul, as the need is definitely there and must be met. I would say that with more children now developing type 2 and the same for young adults, both sides need any assistance that can be offered by the on-line community and any diabetes supply manufacturers, diabetes drug manufacturers, and others willing to put forth the effort that Roche is now doing.
So I will recommend that you take time to read Scott's post. He has some excellent thoughts in areas that I did not cover.
August 12, 2010
Dangerous Myths – Myths Part 2
Are there really dangerous diabetes myths? For those that believe them, yes. Many people believe some of the strangest things when it comes to diabetes.
Do injections hurt? I have been asked this many times. While I have never liked needles, I have been known to flinch when having blood drawn, and it seems like I will never get the needle in when injecting my own insulin. I have had few actually painful injections, but occasionally I will hit a nerve, but not that often.
Even when having blood drawn, most nurses have actually been very good at not causing pain, while others can never hit a vein and cause me much pain. Some even go thru the vein and wonder why there is no blood until they withdraw the needle.
Most of us do have to get over the fear and realize that our lives, and good health, demand that we use insulin and inject ourselves several times a day. This to me is a small problem and I have been able to overcome it.
Some of the more dangerous fairy tales about insulin really get to me and makes me wonder why we have some of the medical professionals we do. Too many doctors use insulin as a threat to get diabetes patients to get serious about controlling their blood glucose with oral medications. Often the side effects of some oral medications are far more dangerous than insulin.
Then our unenlightened medical professionals tell us that we have failed and that is the reason we need to take insulin. Failed - - - I don't think so! Most people that feel this way have been programed that way by our medical pros. These patients need to reevaluate the instructions and guidance they have received. Many have been told to eat far too many carbohydrates for control of their diabetes and for some people their bodies are unable to handle this level of carbohydrates. Also many patients have not been told to exercise.
Even more problematic are the medical professionals that feel we should not have meters to have readings of our blood glucose levels. They worry that seeing the high levels of blood glucose for the carbohydrates they have told us to eat will only discourage or cause depression in these patients. If you have any of these types of medical pros, I strongly suggest finding another doctor.
Everyone has different needs based on their body and body chemistry and until the medical pros wake up and realize this, it is a small miracle that so many type 2 people with diabetes are as healthy as they are. If it was not for the patients becoming proactive in their own care, many would soon end up with the more serious problems of the accompanying diabetes complications. Some doctors do realize that one treatment does not fit all, but we as patients also need to learn this and make our doctors aware of this. We need to learn how to stand up for what we need.
What is disturbing to me has been stated to me by other people with type 2 diabetes. The statement is that only type 1 people can see an endocrinologist. While it is understandable that people with type 1 diabetes want to see an endocrinologist, many type 2 patients also see them, and not just those type 2 patients on insulin.
A lot of the problems arise from the fact that in many areas of this country, local endocrinologists do not exist as they are not drawn to sparsely populated areas and therefore some people can have hundreds of miles commute round-trip to see one. In heavily populated areas it is easy to find them. The problem is finding one that is a good fit for you or has any openings for new patients.
Another misconception is some people with type 2 diabetes do not think they have a serious disease and therefore do not need to worry about changing their lifestyle or eating habits. No this is not denial, they truly feel this way and their doctors have done nothing to explain the seriousness of diabetes. Why is this so? Often these people are in good physical condition and have taken care of themselves, or in other words, they are not over weight.
It is only when the complications set in that they get the wake-up call that they have something serious. Even then some do not heed the call and wonder why they are called upon to have this complication or these complications – remember their body mass index (BMI) is ideal so it should not be happening to them. I even had one of these people actually tell me this when they found out I did not have any retinopathy or kidney problems, in other words, because I am overweight and they are not. Life can be so unfair.
Do injections hurt? I have been asked this many times. While I have never liked needles, I have been known to flinch when having blood drawn, and it seems like I will never get the needle in when injecting my own insulin. I have had few actually painful injections, but occasionally I will hit a nerve, but not that often.
Even when having blood drawn, most nurses have actually been very good at not causing pain, while others can never hit a vein and cause me much pain. Some even go thru the vein and wonder why there is no blood until they withdraw the needle.
Most of us do have to get over the fear and realize that our lives, and good health, demand that we use insulin and inject ourselves several times a day. This to me is a small problem and I have been able to overcome it.
Some of the more dangerous fairy tales about insulin really get to me and makes me wonder why we have some of the medical professionals we do. Too many doctors use insulin as a threat to get diabetes patients to get serious about controlling their blood glucose with oral medications. Often the side effects of some oral medications are far more dangerous than insulin.
Then our unenlightened medical professionals tell us that we have failed and that is the reason we need to take insulin. Failed - - - I don't think so! Most people that feel this way have been programed that way by our medical pros. These patients need to reevaluate the instructions and guidance they have received. Many have been told to eat far too many carbohydrates for control of their diabetes and for some people their bodies are unable to handle this level of carbohydrates. Also many patients have not been told to exercise.
Even more problematic are the medical professionals that feel we should not have meters to have readings of our blood glucose levels. They worry that seeing the high levels of blood glucose for the carbohydrates they have told us to eat will only discourage or cause depression in these patients. If you have any of these types of medical pros, I strongly suggest finding another doctor.
Everyone has different needs based on their body and body chemistry and until the medical pros wake up and realize this, it is a small miracle that so many type 2 people with diabetes are as healthy as they are. If it was not for the patients becoming proactive in their own care, many would soon end up with the more serious problems of the accompanying diabetes complications. Some doctors do realize that one treatment does not fit all, but we as patients also need to learn this and make our doctors aware of this. We need to learn how to stand up for what we need.
What is disturbing to me has been stated to me by other people with type 2 diabetes. The statement is that only type 1 people can see an endocrinologist. While it is understandable that people with type 1 diabetes want to see an endocrinologist, many type 2 patients also see them, and not just those type 2 patients on insulin.
A lot of the problems arise from the fact that in many areas of this country, local endocrinologists do not exist as they are not drawn to sparsely populated areas and therefore some people can have hundreds of miles commute round-trip to see one. In heavily populated areas it is easy to find them. The problem is finding one that is a good fit for you or has any openings for new patients.
Another misconception is some people with type 2 diabetes do not think they have a serious disease and therefore do not need to worry about changing their lifestyle or eating habits. No this is not denial, they truly feel this way and their doctors have done nothing to explain the seriousness of diabetes. Why is this so? Often these people are in good physical condition and have taken care of themselves, or in other words, they are not over weight.
It is only when the complications set in that they get the wake-up call that they have something serious. Even then some do not heed the call and wonder why they are called upon to have this complication or these complications – remember their body mass index (BMI) is ideal so it should not be happening to them. I even had one of these people actually tell me this when they found out I did not have any retinopathy or kidney problems, in other words, because I am overweight and they are not. Life can be so unfair.
August 8, 2010
Methods of food preparation
In my blog about avoiding bland food, I mentioned different methods of food preparation. Now I will try to explain the advantages of the many methods of preparing tasty meals.
Before purchasing any equipment that you might want, check the local library to read cookbooks or books for each type of cooking. This will let you know whether you want to try any appliance. Most of the equipment is available on line or in stores in your area. The telephone will save much running from store to store by asking what cooking utensils they carry and what the prices are. I highly recommend carefully reading the instructions with each appliance. I do not use the pressure cooker regularly, but the slow cooker and steamer get regular use.
Use of a pressure cooker is much easier today and meals prepared in them are much tastier. Cooking with pressure cookers, slow cookers, and steamers for me has been an education and an enjoyable experience. I have had to learn how to place the food in each appliance for best cooking.
I do enjoy the pressure cooker for some cuts of meat and chicken as the herbs and spices can provide some great tastes and fill the house with a pleasant aroma. I like this for many vegetables as the cooking time is short and they come out with the taste of the herbs and spices infused in them.
Some vegetables are best in the steamer especially broccoli, cauliflower, asparagus, and some others. Some people will disagree, but this is my preference. I enjoy many fish meals from the steamer as well. I also like some fish prepared by the poaching method. How you cook is up to you and your taste preferences.
For some cuts of beef and pork, and occasionally chicken, the slow cooker works great and when you add celery, onions, and some other vegetables with herbs and spices, yummy. Sometimes when left to marinate in the refrigerator overnight, the next day also adds flavor that sometimes is not there the first time. You do need the space in the refrigerator and this can be a drawback if you are lazy like me to transfer to another container. I love to use some cling wrap and put the lid back on top and let sit until the next meal.
I am still experimenting with the wok, but in general I have to relearn everything as I don't like the oily taste and broth seems to boil away too quickly. Once in a while, I do have a success or two.
I thought when I purchased my new stove, I could go back to pan frying some foods by using broth or other liquids, but I need to relearn there also. By using the marinading methods below, this has helped keep the meats from drying out and becoming too bland.
I do use the stock pots more and especially the electric ones as this allows for browning meats and then cutting them in smaller sizes and slowly cooking them in herbs and spices. This works especially well for chicken and turkey and lean meats. Then I can add a measured quantity of fat or broth (low sodium when possible) and have several good meals. Or I use my own broth when we have it available and that is mostly no sodium, which I really like.
I have a difficult time getting the barbeque sauce to thicken properly that I make myself, but I am not fond of many of these dishes so I don't go to the effort. I will use the broiler in the oven on occasion, but here I do not do this in the summer to keep down the heat and cause the air-conditioner to work overtime. The wintertime is my time for baked dishes and broiled foods. Yes, some of these can be somewhat bland, but I make some sauces to put over them which helps.
I am doing less cooking now that my wife has taken over most of the cooking, but we still do a lot of it the same. For me it was learning to properly use the cooking utensils and appliances to know what each is capable of and how the herbs and spices mix with and in the foods that makes for tasty meals. After my first wife passed, it took me about a year of experimentation to really appreciate cooking, but I was and am able to learn. This is where the pleasure of using herbs and spices (maybe not always correctly) has kept me away from the highly processed foods and away from the bland foods that I hear so many people with diabetes complain about.
Thanks to my daughter, I learned about marinading meats and really like the Food Saver marinade container which vacuum seals and assists in drawing the marinade into the meats. This means instead of doing it for eight hours or overnight, I can forget and still do a very adequate job in one half to two hours depending on the meat and/or cut of meat.
If you are a person that likes to grill, marinading meats does keep them from being quite so dry. I have a thing about fighting insects so this is not something I enjoy doing outside as I don't need that added protein. If you enjoy this, then go for it.
Before purchasing any equipment that you might want, check the local library to read cookbooks or books for each type of cooking. This will let you know whether you want to try any appliance. Most of the equipment is available on line or in stores in your area. The telephone will save much running from store to store by asking what cooking utensils they carry and what the prices are. I highly recommend carefully reading the instructions with each appliance. I do not use the pressure cooker regularly, but the slow cooker and steamer get regular use.
Use of a pressure cooker is much easier today and meals prepared in them are much tastier. Cooking with pressure cookers, slow cookers, and steamers for me has been an education and an enjoyable experience. I have had to learn how to place the food in each appliance for best cooking.
I do enjoy the pressure cooker for some cuts of meat and chicken as the herbs and spices can provide some great tastes and fill the house with a pleasant aroma. I like this for many vegetables as the cooking time is short and they come out with the taste of the herbs and spices infused in them.
Some vegetables are best in the steamer especially broccoli, cauliflower, asparagus, and some others. Some people will disagree, but this is my preference. I enjoy many fish meals from the steamer as well. I also like some fish prepared by the poaching method. How you cook is up to you and your taste preferences.
For some cuts of beef and pork, and occasionally chicken, the slow cooker works great and when you add celery, onions, and some other vegetables with herbs and spices, yummy. Sometimes when left to marinate in the refrigerator overnight, the next day also adds flavor that sometimes is not there the first time. You do need the space in the refrigerator and this can be a drawback if you are lazy like me to transfer to another container. I love to use some cling wrap and put the lid back on top and let sit until the next meal.
I am still experimenting with the wok, but in general I have to relearn everything as I don't like the oily taste and broth seems to boil away too quickly. Once in a while, I do have a success or two.
I thought when I purchased my new stove, I could go back to pan frying some foods by using broth or other liquids, but I need to relearn there also. By using the marinading methods below, this has helped keep the meats from drying out and becoming too bland.
I do use the stock pots more and especially the electric ones as this allows for browning meats and then cutting them in smaller sizes and slowly cooking them in herbs and spices. This works especially well for chicken and turkey and lean meats. Then I can add a measured quantity of fat or broth (low sodium when possible) and have several good meals. Or I use my own broth when we have it available and that is mostly no sodium, which I really like.
I have a difficult time getting the barbeque sauce to thicken properly that I make myself, but I am not fond of many of these dishes so I don't go to the effort. I will use the broiler in the oven on occasion, but here I do not do this in the summer to keep down the heat and cause the air-conditioner to work overtime. The wintertime is my time for baked dishes and broiled foods. Yes, some of these can be somewhat bland, but I make some sauces to put over them which helps.
I am doing less cooking now that my wife has taken over most of the cooking, but we still do a lot of it the same. For me it was learning to properly use the cooking utensils and appliances to know what each is capable of and how the herbs and spices mix with and in the foods that makes for tasty meals. After my first wife passed, it took me about a year of experimentation to really appreciate cooking, but I was and am able to learn. This is where the pleasure of using herbs and spices (maybe not always correctly) has kept me away from the highly processed foods and away from the bland foods that I hear so many people with diabetes complain about.
Thanks to my daughter, I learned about marinading meats and really like the Food Saver marinade container which vacuum seals and assists in drawing the marinade into the meats. This means instead of doing it for eight hours or overnight, I can forget and still do a very adequate job in one half to two hours depending on the meat and/or cut of meat.
If you are a person that likes to grill, marinading meats does keep them from being quite so dry. I have a thing about fighting insects so this is not something I enjoy doing outside as I don't need that added protein. If you enjoy this, then go for it.
August 4, 2010
Myths about diabetes – Myths Part 1
Myths about diabetes are a dime a dozen. Everyone wants us to believe this and to believe that about diabetes. When it gets down to realities, there are some basics facts that everyone needs to know, but to me the myths have been created to sell books and articles and make people believe there are some rules that guide us.
Myth as a noun is defined as a traditional or legendary story, usually concerning some being or hero or event, with or without a determinable basis of fact or a natural explanation, especially one that is concerned with deities or demigods and explains some practice, rite, or phenomenon of nature.
Misconceptions would seem more appropriate than myths, but a long word isn't always the best.
The only rule that I am aware of as a person with type 2 diabetes is “what works for me, may not work for you” There are many ways to say this, but I will not get into all the variations. There are people that insist that their way is the only way and for a few people in the near proximity of them on the bell curve, this will work.
Many people have forgotten the principles of the bell curve. Take approximately seven million people and spread them out on the curve. On the left side, start with those who have diabetes, but are able to get by with just minor changes in nutrition and no exercise. Then move a little to the right and you have to add exercise for a larger number of people, but this group still can manage tight control without oral medications.
Now go to the far right of the curve. Here you will find people near the end of life, on dialysis and unable to exercise, or blind and needing daily assistance. Not a pretty way to see life, but this is life. While many believe that type 2 diabetes is progressive, this is partly true, but does not necessarily need to be the way of life. People die every day and may have never reached the right side of the bell curve. This is because of other causes that also can affect our daily lives and result in death. And like any curve, it can be skewed to one side or the other depending on the circumstances of the people being analyzed.
Now I take you to carbohydrates which is according to this article is myth number three, and the one that raised my ire. Some people eat very few carbohydrates or no carbohydrates, and live very well. Yet most medical personnel claim that the carbohydrates are foremost in keeping us living well, and our brains properly fueled. These medical professionals also do not understand it when people with diabetes have severe blood glucose problems with too many carbohydrates for them.
And then there are the low carb people that have to preach their religion and then wonder why some of us don't and won't listen to them. This is because some of us are able to consume different level of carbohydrates. For people eating carbohydrates the population also varies like the bell curve. Yes, there are a few people that are maintaining excellent control that are eating high amounts of carbohydrates. They have reduced their weight and their insulin resistance and with exercise are able to do this. And there are also those that must eat low carb.
Everyone needs a good place to start, and this book does debunk the need for some people to go on radical diets (which fail) and encourages many (although in a round about way) to stop their panic mode and start finding out what works for them.
More on some of the more dangerous myths later.
Myth as a noun is defined as a traditional or legendary story, usually concerning some being or hero or event, with or without a determinable basis of fact or a natural explanation, especially one that is concerned with deities or demigods and explains some practice, rite, or phenomenon of nature.
Misconceptions would seem more appropriate than myths, but a long word isn't always the best.
The only rule that I am aware of as a person with type 2 diabetes is “what works for me, may not work for you” There are many ways to say this, but I will not get into all the variations. There are people that insist that their way is the only way and for a few people in the near proximity of them on the bell curve, this will work.
Now go to the far right of the curve. Here you will find people near the end of life, on dialysis and unable to exercise, or blind and needing daily assistance. Not a pretty way to see life, but this is life. While many believe that type 2 diabetes is progressive, this is partly true, but does not necessarily need to be the way of life. People die every day and may have never reached the right side of the bell curve. This is because of other causes that also can affect our daily lives and result in death. And like any curve, it can be skewed to one side or the other depending on the circumstances of the people being analyzed.
Now I take you to carbohydrates which is according to this article is myth number three, and the one that raised my ire. Some people eat very few carbohydrates or no carbohydrates, and live very well. Yet most medical personnel claim that the carbohydrates are foremost in keeping us living well, and our brains properly fueled. These medical professionals also do not understand it when people with diabetes have severe blood glucose problems with too many carbohydrates for them.
And then there are the low carb people that have to preach their religion and then wonder why some of us don't and won't listen to them. This is because some of us are able to consume different level of carbohydrates. For people eating carbohydrates the population also varies like the bell curve. Yes, there are a few people that are maintaining excellent control that are eating high amounts of carbohydrates. They have reduced their weight and their insulin resistance and with exercise are able to do this. And there are also those that must eat low carb.
The one difference that does not follow the bell curve happens in those people who do not maintain even moderate control of their diabetes, and what I would say is little to no control of their blood glucose levels. Their progress into the world of complications is a “J” shape starting out at no complications on the left and then rapidly increasing on the right. This alone is the reason for those of us with type 2 diabetes to maintain tight control of our diabetes.
Yes, I do have a book by the American Diabetes Association titled Myths of a “Diabetic Diet” and the book basically lists 16 myths. I admit it was rather convincing when I was new to diabetes. As I have gained experience, I keep the book around to remind myself about the fallacy of the “myth” doctrine. If I want to get my blood pressure up, I just read some of the book, and up it goes. Not a good thing to do, but that is what I believe today. There is one good feature to the book and I covered it here and I agree that it should be read for that reason alone - it is a well written guide for preventing excesses in eating changes.
Everyone needs a good place to start, and this book does debunk the need for some people to go on radical diets (which fail) and encourages many (although in a round about way) to stop their panic mode and start finding out what works for them.
More on some of the more dangerous myths later.
August 1, 2010
Five important lab tests – maybe six or more
I am not even sure where I got the following information, but I know that I should have blogged about this before. I know that the following five tests are very important for people with diabetes. The tests are: HbA1c, blood pressure, cholesterol tests (lipid panel), micro-albumin test for kidney damage, and annual eye exam.
These five simple tests are currently the best and only indicators of each person’s own individual diabetes health risks. They also provide you with a kind of “report card” for you to see that your efforts have made a difference. Just don't ignore these test because they show trends, areas for concern, and/or if everything is doing well.
I think after my post on the July 6, 2010 that the annual screening with a blood test be done to check for liver problems/disease. The problem is that the sensitivity of blood tests needs some study while the ultrasound is not that great for identifying fatty liver disease. A liver biopsy is not a feasible screening method. Even though there is some concern as to the reliability of liver testing, I will state that it needs to be considered as an important sixth lab test especially for many of the chronic diseases.
There are other tests that will need to be determined on a case by case basis. One of the tests is the one for B12, which should be done for anyone that has been on Metformin for several years. Vitamin D levels need to be checked as a person gets older or does not spend very much time in the sun. Some of the other autoimmune diseases that often accompany diabetes may require tests.
One last important note – make sure that your doctor or in some cases, the lab, provides you with a copy of the lab results. This will assist you in tracking your health.
These five simple tests are currently the best and only indicators of each person’s own individual diabetes health risks. They also provide you with a kind of “report card” for you to see that your efforts have made a difference. Just don't ignore these test because they show trends, areas for concern, and/or if everything is doing well.
I think after my post on the July 6, 2010 that the annual screening with a blood test be done to check for liver problems/disease. The problem is that the sensitivity of blood tests needs some study while the ultrasound is not that great for identifying fatty liver disease. A liver biopsy is not a feasible screening method. Even though there is some concern as to the reliability of liver testing, I will state that it needs to be considered as an important sixth lab test especially for many of the chronic diseases.
There are other tests that will need to be determined on a case by case basis. One of the tests is the one for B12, which should be done for anyone that has been on Metformin for several years. Vitamin D levels need to be checked as a person gets older or does not spend very much time in the sun. Some of the other autoimmune diseases that often accompany diabetes may require tests.
One last important note – make sure that your doctor or in some cases, the lab, provides you with a copy of the lab results. This will assist you in tracking your health.
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