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.

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.

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.

Have fun and remember, always always double check.

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.

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.

Please take care of yourself.

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.

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.

OK, so it’s not January 1st any more. Does that mean you should throw your hands in the air and not bother setting any goals this year? Of course not! Simply focusing yourself on one particular aspect of your diabetes can make a tremendous difference this year.

Several years ago, Bill O’hanlon wrote a book entitled Do One Thing Different: Ten Simple Ways to Change Your Life. I don’t pretend that this blog can change your life, but I like O’hanlon’s concept. The changes we need to make can easily overwhelm us if taken all at once. But when we decide to start with one thing, we all can do one thing different.

So for 2008, what will you do different? What are the simple steps (or just one step) that you can take to make a difference in the management of your diabetes?

I share some ideas here to get you thinking. I won’t try to prioritize them because each diabetic’s needs are unique. In fact, this is probably a great topic for you to discuss with your doctor at your next appointment.

Regular Doctor Visits
Speaking of your next doctor’s appointment, getting a regular check up is essential for any diabetic. Prevention is so vital for your long-term health. A doctor can watch for warning signs, can provide education, and can answer your questions. If seeing the doctor regularly is a struggle for you, this would be a great choice for the one thing you could do differently this year. If you don’t see a doctor because of financial reasons, contact your state health department and ask for information about financial assistance and insurance programs.

That One Food Weakness
For my son, it’s hot chocolate. He loves hot chocolate like no one I’ve ever seen. There are times that he’s in the mood for a good cup of regular, not-sugar-free hot chocolate. And sometimes, he decides he wants it so bad that he won’t test his blood sugar before or account for it in his meal plan. It is his weakness. Do you have a weakness? Something you’re willing to make an exception for that you know isn’t good for your health? One thing you could do differently this year is to use your food weakness only as a reward you give yourself when you’ve planned for it properly.

Regular Exercise
A few weeks ago, there was a news report about the benefits to diabetics of combining cardiovascular exercise with resistance or weight training. Perhaps, regular exercise is a challenge for you. Or perhaps your routine needs a kick-start. You could choose to do one thing different in your exercise routine. Start walking every morning. Take the stairs instead of the elevator. Buy a pass to the local swimming pool and go regularly. Every bit of extra physical activity you add makes a difference.

Lose One Pound
Everyone knows how important it is to maintain a healthy weight. But if you’re caught in a cycle of weight gain, it’s easy to feel so helpless. Taking O’hanlon’s approach, don’t decide that you’re going to lose 10 pounds or 40 pounds or 60 pounds. That can be completely overwhelming. But could you lose one pound? Could you eat a little different this week? Or add an extra 15 minutes to your exercise routine? Start with one thing, one pound. Then once you have one success, try to build on it.

Know Where You Are
I’ll share with you my “one thing different.” We have this three-ring binder full of diabetes information we’ve collected over the years. It is also where we put my son’s A1C test results. But unfortunately we have developed the bad habit of just stuffing them inside the front cover. They easily get out of order and rarely have the date written on them. My goal for this year is to always write the date on the test results and place them in order behind a tab. This way, we’ll always know exactly what his last test was and we’ll know whether we need to be focused on lowering his A1C, maintaining, or avoiding too many lows. Could you be more organized with your information too? Could it help you stay focused on your care better?

I hope you take these suggestions and add to it. Perhaps even review with your doctor the one or two things you could do this year that would make the biggest difference. Let’s all have an exciting and healthy 2008. Happy New Year!