Diabetic Management Blog

Massage Therapy: My weapon against glycation

November 21st, 2008

I’ve been reading a lot lately about glycation. This is nothing new to diabetics. We all know about the hemoglobin A1c test which simply tests the glycation of the hemoglobin in the body. Or in other words, how much glucose has attached itself to those cells. But lately I’ve been reading more about glycation of the blood vessels. This glycation can cause the blood vessel walls to become less elastic. That in turn leads to high blood pressure and all it its associated problems.

Well, as I’ve been imagining my blood vessel walls becoming harder and less flexible, I started thinking of ways to fight it. (Now, of course, the first line of defense is good blood sugar control.) So I decided that what I needed was a way to increase circulation, increase flexibility, and relax. And I came up with the perfect solution: massage therapy. I visit a local spa once a week (oh, how I’d like to go more often!). I get a full body massage. It feels great. But I hope more than feeling great, it helps me in my battle to preserve the blood vessels that I expect to keep me healthy well into my old age.

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Diabetes: the star of the Health 2.0 Conference

October 31st, 2008

I had the opportunity to attend and speak at the Health 2.0 Conference in San Francisco, California, last week. It was amazing to see all the attention that is being focused on how to use the web to improve healthcare. It was particularly impressive to see how people had come not only from all over the U.S. but also from all over the world to see the latest web innovations for patients, caregivers, and health professionals.

In one session, I sat next to a doctor. I asked him his specialty and he said he was in family practice. Imagine that, a family practice doc sitting in a conference to hear how his patients can now access more information about their health conditions and treatment options than ever. He was impressed and concerned. He worried a little about self-diagnosis and people perhaps pursuing treatments unnecessarily. But he was also impressed with the way patients can be more educated and more connected with others who can encourage healthy behaviors.

But perhaps the most remarkable thing about the conference was how prominent diabetes is is this whole conversation. Many sites (including the one that I presented www.DiabeticConnect.com) are geared specifically toward helping those whose lives have been touched by diabetes. But beyond that, when Google and Yahoo were presenting examples, they very often chose diabetes as the case study of how patients access health information on the web.

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Diabetes and Career Choices

September 23rd, 2008

So my son is at that age where he’s starting to consider colleges and career choices. So this recent headline really got our attention: “Diabetes Discrimination: A New Headache for Employers.” Obviously, we would never want our son to be the victim of discrimination due to a disease that he had no choice about getting.

So we read the article. And though the article contained some insights about issues employers are dealing with when it comes to diabetes, it was more insightful to see how terribly uninformed people are about this prevalent disease. The reporter failed to acknowledge any difference between type 1 and type 2 diabetes. The recent court rulings seemed to place diabetics in two categories. Either they have the disease under control and are therefore, not protected under the American’s with Disabilities Act, or they are out of control and can be fired because they are a liability to the company.

As my son embarks on higher education and making a career choice, it certainly doesn’t help to have these perceptions in the marketplace. Though he has less than perfect control, he’s never missed a day of work or been unable to fill an assignment with his current employer. We can only hope that the next few years brings more understanding to the workplace.

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Healthier Eating Tips for Diabetics

September 8th, 2008

I’ve been thinking a lot about food choices recently. I decided to write down a few of my favorite healthy eating tips.

1. Stop buying white bread and white rice. Plain and simple, if you don’t have it in your house, you will eat a lot less of it. These white carbohydrates have very little nutritional benefits and a whole lot of blood sugar spikes.

2. Check your plate for color before you start eating. If your plate is all one color (usually brown or white), you need to make drastic changes. You should have greens, yellows, reds, and oranges on your plate as often as possible.

3. Avoid toppings and condiments that you don’t need. Why does everyone put butter on their bread? Why do we have to have cream cheese on a bagel? Why add 200 calories to a sandwich with a spread that you don’t need? Ask yourself if you can simply leave it off. Choose low-calories/low-carb alternatives like mustard and balsamic vinegar.

4. Fresh raw vegetables are your best friend. When you’re planning your meals, start envisioning building your meal from crisp, fresh, dark-green lettuce or cruciferous veggies (like broccoli, cabbage, and collared greens). Then add your favorites: carrots, squash, cucumbers, peppers, onions, whatever.

5. Lean proteins are your next best friend. Chicken breast, turkey breast, and fish. These proteins provide good sustained energy without spiking your blood sugar. Beef and pork (and other red meats) will do the same but the lean meats have much lower fat and cholesterol.

6. Use carbohydrates as a garnish. We have to change our thinking. The “bowl” of mashed potatoes filled with gravy was the center-piece of the dinner plate for our grand parents. We simply can’t rely on starchy vegetables or breads to be the foundation of our diet any more.

7. If it comes in a sealed plastic wrapper, it most likely shouldn’t go in your mouth. There’s a reason why we use the same word to describe garbage and highly processed high-calorie packaged foods: JUNK.

8. When you do choose carbohydrates, choose healthy ones. Whole grain breads. Brown and wild rice. Fresh fruits.

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Goals for Diabetics

August 13th, 2008

It seems since diabetes entered our lives 9 years ago, we’ve been flooded with goals. Count every carb. Eat less refined sugars. Eat more whole grains. Test more. Lower the 14-day average. Keep the A1c below 7.

And that’s just the beginning. There’s also a host of other essentials that go hand-in-hand with finding out you have diabetes. Make sure you get your eyes checked. Don’t miss your regular dental exams. Watch your feet for cuts or scrapes that aren’t healing.

Sometimes it can be exhausting. And it’s so much to do, it simply isn’t possible to be perfect. That can lead to feeling like you’re a constant failure.

So my advice for this week: Celebrate every small victory. If you have a blood sugar test that’s right in your target range, CELEBRATE! If you choose to munch on a carrot stick instead of a cookie, CELEBRATE! If you get out of bed and get in 30 minutes of any kind of exercise, CELEBRATE! Pat your self on your diabetic back for heaven’s sake. Take a bow and enjoy the moment. You’re doing great. Don’t be too hard on yourself.

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Traveling with Diabetes

April 16th, 2008

We love taking road trips. Seeing new sites and getting away from the daily grind are always a welcome relief. However, with a diabetic in the family, traveling always brings it’s own share of challenges.

1) How do we keep the insulin cooled? Depending on how long your trip is and where you’re going, this can be a significant issue. For longer trips, we always use a small ice cooler specifically for the insulin. We try to plan ahead for where we’ll be able to get it back in the fridge or get more ice. Sometimes we leave ourselves a note on the car steering wheel to remember to get the insulin out of the fridge when it’s time to head home.

2) What do you take for emergency carbs? We try to keep some juice boxes always in the car—not just for road trips. If we’re doing a lot of hiking or walking around outside of the car. We like granola bars which can be stuffed in pockets and provide both quick carbs and a little fiber and protein to last.

3) How do you remember all your supplies? There are so many different supplies for diabetes. Especially for those on insulin pumps and/or continuous glucose monitors. If our trip is more than just a one day trip, we find that we have to make a list. We think through the whole routine and then gather all the supplies into one bag/carrying case. If we ever just try to wing it, we inevitably forget something. And if you’ve ever tried to get diabetes supplies in a remote town or when you’re far from home, you know what a pain that is.

4) The tester, the tester, the tester. Whatever you do, don’t forget the glucose meter. And make sure you bring extra test strips. No matter if you’re sure you have enough, grab another canister of test strips. You just can’t be TOO prepared.

Finally, it is often helpful to make sure you have a diabetes ID bracelet or necklace. Whether it’s entering a stadium or a theme park, the last thing you need is someone in security getting all worked up about a needle or a glucose meter. Often, the diabetes ID bracelet or necklace is all they need to see.

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Getting the Most Out of Your Endo Visit

April 8th, 2008

Here are my tips for getting the most out of your visit to the endocrinologist. First, get your blood sugar records together. Make sure you have a log book or that you have a downloadable meter so that the doc can see how you’re doing.

One common mistake is to forget to set the proper time on your meter, either due to a battery change or a change to Daylight Savings Time. When you do this, you have no way to accurately assess what is causing your highs and lows because it’s too hard to tell if a test was before or after a meal, in the middle of the night, or in the middle of the afternoon. Making sure the time is always set right is key to interpreting your results.

Also, it’s very helpful to do before and after meal testing. Don’t test after every meal. But about 1 to 2 hours after you begin eating one of your meals during the day, test to see how your insulin dosing and carb counting are going.

Second, write down questions you have for the doctor. It’s so hard when you’re in the office to remember what happened in the weeks and months since your last visit. Keep a journal of questions that you want to ask at your next appointment.

Remember that there is usually a whole team there to help you. Specialists with injections, with nutrition, with insulin pumps—whatever. Don’t just think about questions for your doctor. You can even take in your favorite recipes and ask for help in counting the carbohydrates or even in modifying the recipe to be more diabetic friendly.

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19 Million

March 26th, 2008

So as Americans, we’re living longer. Now, the population bubble called the “Baby Boomers” is dramatically changing the dynamics of American health as they officially become seniors. A large portion of us seniors make up a part of the 19 million diabetics in America.

Some have called the proliferation of diabetes an epidemic. The numbers are definitely concerning. If you are a senior and have diabetes, I hope that you are taking your condition seriously. One good friend of mine is one of the “good old boys.” He’s been in the cabinet making business for years and years. He tries to take care of his diabetes by injecting insulin. But his diet is the typical contractor diet: fast food, fried food, sodas, and the like.

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The Education of a Diabetic and His Dad

January 29th, 2008

So my son and I will graduate together. He will be graduating from high school and I’ll be graduating from graduate school. We stay up late doing homework together. We commiserate about teachers. We celebrate good grades together. And we console each other when a test or assignment doesn’t go so well.

But what my son doesn’t understand is how much his diabetes has to do with my schooling. It’s not like I’m in medical school or something. I’m not researching to try to find a cure for diabetes. In fact, I’m in business school. And I guess that’s appropriate because it’s the business of diabetes that drove me back to school. As the reality set in of just how much this disease costs and the length of time my son will need to be on my insurance, I realized that I must find a way to make more money.

My professors have explained that MBA students rank the highest in the “what’s in it for me” personality types. Truthfully, I don’t fit in great with that crowd. But as I sit in a classroom full of those who are openly aspiring to be CEO’s, I realize that though my motivations may be a little different, I too am driven to achieve a larger paycheck and the added responsibility that goes with it.

And I hope that along way toward my MBA, I just might build a stronger relationship with my son as we learn about life and what it will take to take care of his diabetes for a lifetime.

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Fears of a Caregiver

January 24th, 2008

So my son is 15 now. He’s had diabetes for 7 years and 5 months. He is such a great kid and from the very beginning he wanted to take charge of his diabetes. For year after year, his A1C was terrific. And my wife and I knew we were doing the right thing by letting him take charge as much as he could. After all, he’s the one that’s going to live with this disease the rest of his life (or until there’s a cure).

It seemed like a perfect plan. And he did such a fine job that we settled into our supportive yet very uninvolved roles. Well, then several months ago, he had his first A1c over 8. It was shocking. I hardly knew what to say. His doctor hardly knew what to say. My son had been a star patient up to this point.

So we had a good discussion. The doctor reminded my son of some of the basics that he was letting slide. We all committed to being more conscientious. And for a few days we were. But then I sensed that I was annoying my son a little, so I backed off, reassuring myself that I knew he could do it if he wanted to.

Three months later, we went to his check up anxious to see what progress he had made. His A1c was lower—by 0.2—but was still over 8. More discussion with the doctor. More reminders. More commitment.

And now I find myself in this awkward and frightening position. I can see some of my son’s bad diabetes habits. I know that with more diligent effort he could quickly get his A1c below 7. But I can also see in his body language and hear in his tone of voice that he wants to handle this. He doesn’t want me watching over his shoulder and asking questions all the time. But at the same time, I know the tissue damage that’s happening every time he runs high. I know the risks. And I remember how invincible I felt at 15. I completely understand why he feels like it’s “not a big deal.”

So I’m afraid I’m doing the wrong thing.

I’m afraid of alienating my son.

I’m afraid of what’s happening inside his body.

I’m afraid I may look back at this time in his life and have regrets.

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