The Angry Type 2 Diabetic: 2013

Tuesday, December 3, 2013

Don't Restrict Test Strips for People with Type 2 Diabetes

My fasting glucose at diagnosis,
versus currently.
All around us there are people who are struggling or living with challenging health conditions or diseases. Some are very visual, and apparent, and some are not. For those with apparent health conditions or diseases, we feel an immediate sense of empathy. However, it is not so easy for us to empathize with those whose needs we cannot openly see. We may assume a person is exaggerating (they really don't have it that bad), is being 'wimpy' (they should just shut up and 'deal with it'), or is simply lying.

Type 2 diabetes is one of these misunderstood diseases; it is a hidden illness and people with hidden illnesses often end up being judged as if they had no needs, or should be restricted in needs. These attitudes often end up in discrimination, particularly from employers, health insurance companies, and some health care providers and agencies. The problem becomes compounded because type 2 diabetes is also a silent disease. It is a disease which can remain silent (not showing very many outward signs of its presence) for many years, even decades. Hence, many people will often ignore their condition because they feel fine and healthy, and the condition does not seem real to them. Because there is NOTHING telling them they are sick, they feel a certain sense of invincibility... until they get their blood glucose level tested with a finger prick.  Persons with type 2 diabetes must check their blood glucose levels regularly if they are to be kept constantly aware that they a.) have a serious medical condition, and b.) that they need to adjust their food intake according to what their glucose levels are. A person with type 2 diabetes needs to be able to eat 'to their meter' in order to be able to manage their disease.

If the medical establishment (who are constantly preaching on the diabetes 'pandemic,' and how serious this matter is, and how the condition is costing our governments, worldwide, billions of dollars) had any inkling of the issue at hand, or indeed, if they believed their own warnings, they would realize that in order to reduce the risk of type 2 diabetes, and to control the health of those with current type 2 diabetes diagnoses, we need...

  • Educated clinicians: Clinicians who are not trivializing the condition to their patients, but which strive to understand the condition, its potential risks and dangers, and who are committed to empowering their patients and properly educating them as to what the condition is; and
  • Access to Proper Tools and Medicines: Sufficient glucose testing strips to make appropriate nutritional decisions, from day to day, to help control glucose levels, as well as access to necessary medications -- including insulin. 
How do we expect to control already diagnosed type 2 diabetes, in patients, if we will not allow patients to have an adequate amount of testing strips? Yes -- a testing strip should not just be a tool that is used to avert immediate danger (an extreme high, or an extreme low level of glucose.) A test strip is also a rudder to help a patient know to make the best, and most appropriate meal decisions, because we never know just how much glucose we have in our bodies at any given time. You can't just tell us to go eat whole wheat, grains, and fruit, and call it a day. I am sorry, medical establishment... Diabetes doesn't work that way. I have the RIGHT to know what my blood glucose is doing, and to be able to make educated decisions on what to eat, as to to reduce the risk of the potential long term complications of high blood glucose. It is my right, as a patient! You preach about the costs of diabetes, but something tells me you really do not understand how the game works. You see -- no one complains about the high cost of performing 3,000 mile oil changes on their vehicles; instead, they understand that if these are not performed, instead of paying $19.95 for an oil change, they'll end up paying over $1,000 for a new engine. But clinicians and insurance companies are practically telling people with diabetes that they'd rather they pay $1,000 for a new engine, than $19.95 for an oil change. I mean, isn't it cheaper, long term, to pay for some strips than to, oh, I don't know... have to pay for someone's dialysis, new organs, eye procedures, or amputations? 

Where is the common sense in the medical establishment, right now? I want to KNOW. I am SICKENED that people with type 2 diabetes who are on Medicaid  in Oregon, right now, are close to being severely restricted on their glucose test strip usage. According to diaTribe
Currently, the OHP provides 100 test strips every 90 days, but a new plan would severely restrict access to strips for type 2 patients unless they are newly diagnosed, take insulin, or meet a few other special requirements. For people not taking insulin – which covers the vast majority, about 70% of all type 2 patients – those with an A1c above 8.0% would be entitled to one test strip per week, while those with an A1c below 8.0% would not be provided with any test strips at all.
This is obscene!! One test strip a week tells NOTHING to a patient with type 2 diabetes! Tests need to be done in pairs so that we can see the cause and effect of things like meals, exercise, illness or periods, or even overnight sleep. Patients with type 2 diabetes are practically being PUNISHED for having good control, and being told that their health is not important enough to merit an educated management of their disease. Besides that, patients are supposed to work hard to keep an A1C which is at or below 6.5%. Telling a person that they will only get strips if they have higher A1C levels is not only not a good recommendation, but it is also unconscionable. It is the testing that keeps me at a lower A1C! I'm not psychic, for crying out loud. As of yet, there is no magical Glucose Level 8-Ball.

We need to stand together as a type 2 community against these kinds of things, or we will continue to be bullied by the medical establishment. If we are to stem the tide of unfortunate complications, and type 2 diabetes diagnoses, then we need to stand up for our rights as patients. We DESERVE education, quality treatment, tools, and medications, to manage our condition and lead healthy lives.

Really... whatever happened to the Hippocratic Oath?


We have very little time... Please sign the petition, here: Don't Restrict Test Strips for People with Diabetes.  

Thursday, November 28, 2013

Top Ten Tips For Managing the Holidays with Diabetes

Happy Holidays, to you and yours! As my turkey slowly cooks in the oven, I've decided to take a moment to write a little bit. I've had a few comments from fellow sweet peeps, lately, in regards to traversing the holiday food extravaganza that is approaching, and there's much understandable fear and trepidation. 

So, I wanted to take a moment to reassure my fellow readers, especially newcomers, that, yes...

You Can Do This: 
  1. DO count your carbohydrates. Think about your favorite foods for the holiday, and plot out your total carbohydrates through the day. For example, have some turkey and greens, if you prefer to have a small piece of pie later. Or... Have some turkey, some greens, and a small amount of mashed potatoes, if you're not much into pies. But... 
  2. DON'T practice deprivation. Instead, practice moderation. Try eating just a tiny amount, of some of your favorites, instead of telling yourself you can't have anything. Besides, do you see the skinny people NOT eating anything? What do they do on a holiday like this? Some definitely pig out, and some others simply grab a few things, and taste here and there. But... 
  3. DON'T feel like you have to eat everything there, out of obligation. Instead, you may find  it helpful to plan ahead of time which two food favorites you HAVE to have, and when the day comes, pick one extra item you'd like to try. If you have more things you'd like to try, you can always get a doggy bag, and eat them later.  
  4. DO have some salad, leafy greens, and non-starchy veggies. Veggies are full of fiber, and because of this, they don't just help us with sensations of fullness and satiety, but also help keep our blood glucose levels steady throughout digestion. In other words, fill up on the broccoli on the snack plate, as it passes by... it'll help you absorb carbs, and digest and deal with any extra fat. Raw is better. But...
  5. DON'T assume all veggies will be good. There are quite a few veggies out there that are high in their own natural sugars and starches. To help you navigate through the confusion, the American Diabetes Association has put together a list of non-starchy veggies, for your review. Assume that any veggie dishes which are slathered in various sauces have extra added sugar before consuming them. When in doubt, ask the host. 
  6. DO make your own diabetes friendly dishes. Whether at home, or if going to a party, feel free to make one or two dishes which you know will be diabetic friendly -- whether that is a dish that is low carbohydrate, or a dish that is made with alternative sweeteners. Perhaps even have a favorite beverage with you, so that you can have something to 'nurse' through the day. This can be bringing your own diet tea, diet sodas, etc. But... 
  7. DON'T forget to have water. Water is essential for your body. It helps control our eating signals of hunger, satiety and fullness. In many ways, water helps us appreciate the food we consume, and taste it better. When we taste food better, we can better focus on it, and we can better tell when we've had enough. 
  8. DO try to practice eating with awareness. We go through life in such a hurry all the time, that we often eat incredibly quickly! Before we know it, the food is gone. Instead, really take some time to revel in the food you're about to consume. Notice its aroma, its colors, its textures, and flavors. Take each bite with slow, and deliberate delight. If you feel you need to put your fork down between bites, or have a sip of water, please do. Try to listen to when you're body has told you it's had enough, or even, if it is simply just satisfied. But... 
  9. DON'T feel guilty if you overeat. It's a very food centered holiday. There is soooo much food, and people do tend to overeat, or indulge a little extra. It comes once a year, and we only live once. Focus instead on friends, family, loved ones, and being thankful. 
  10. DO make it a family tradition to go for a walk around the block when you're done. A walk after eating a meal helps digestion, can bring time for conversation, and the focus AWAY from the table. If it's too cold outside, maybe it's time to break out the Wii Sports. 

Just remember, diabetes is NOT a life sentence because you 'messed up' being healthy, and active. It's simply a condition a few of us developed because we have the genes for it. Regardless of our past life choices, we can still live daily, healthful lives, and enjoy holidays and celebrations in moderation. So, kick back, and relax!   

Wednesday, October 23, 2013

World Diabetes Day, and Four Years of Living with Diabetes

Hello sweet peeps! It's about that time of the year again! Diabetes awareness month is fast approaching... and with it will come another year of living with diabetes, for me. November 17th will mark my four year anniversary of living with this insidious disease.

What will you do for diabetes awareness month? Will you wear a diabetes awareness pin? Will you hand out fliers, or educational materials? Will you donate money to the cause, or participate in a walk? Will you help the International Diabetes Federation light up a building blue? There are so many things we could do. I was considering making little educational booklets for the recently diagnosed type 2 diabetic, being as there is often so little information given to patients. This might take me a little time, and expense... but it's a goal I have. 

November is also a month in which I contemplate my life with diabetes: Where am I? Where am I going? Am I where I want to be? What have I learned about myself. 

Through my four years of living with diabetes, I've gone through several approaches as to how to manage and cope. From stricter, to less so, to more of a balanced and moderate approach. I've had to sit down and think long and hard about my attitudes toward food, weight loss, and how I was emotionally comforting myself. For a while, I practiced extreme low carbing, and realized it was not the best approach for me: it was not financially doable, plus it was also not realistic as to enjoying life with others in social situations. And well... I just dislike almond flour and excess fat. Now, I love the approach of eating with awareness, or intuitive eating, but I must be aware that as a person with diabetes, I must mind my level of carbohydrate consumption, as well as some of my calories, so I still needed to put some limitations on myself. 

So far, I've come to a place where I practice a sort of hybrid of both: I try not to eat more than 400 calories per main meal (I'm only 4'9... I really don't need that many calories), and then I eat my meals with awareness, so I may not end up eating that whole meal, if I don't feel like it. I can be one of those people who eat distractedly, or emotionally, so if I 'fail' to stop where I want, at least I won't have eaten a lot more than 400 calories in one sitting meal. If I am physically hungry and need more food than this, I'll eat it. I try to do this approach of mindful eating when I'm in restaurants, too. If I can, I will order less of the regular portion, or box away half of the portion, etc., adding veggies or side salads, helping to balance things out, as well. I generally don't like to take portions home.  

I've started trying to cut ties with certain foods, not because I can't have them, but to reduce my cravings for them, while increasing my appetite for others. It has given me quite a bit of freedom in my walk with diabetes... leaving some foods to rare occasions. I won't say what these foods are: I think that's irrelevant, really. What those foods are, could be different for everyone. It's the concept that matters. 

I am fortunate right now, that I have a very physical job at a restaurant, and I get quite a bit of exercise running around a busy dining room all day, and often lifting heavy things. I should add more physical activity to my life, though, as I go along. And this won't be too difficult to do. I just need to schedule it in, and go do it. 

Pacing myself with weight loss has also been another big lesson. When I first was diagnosed with diabetes, I was in such a hurry to lose weight and be healthy -- I was so scared of this disease. I did manage to go from 243 lbs down to 170, which was a great accomplishment, but it left me feeling tired, deprived and trapped by having diabetes. It made me burnt out. Eventually, I yo-yo'ed a lot with my weight, gaining and losing weight quite a few times, up to reaching 226 lbs again. I am now, presently at 183 lbs... and losing slowly, and as peacefully as possible. Even us advocates need to be reminded that this is not a sprint, but a marathon; that we need to pace ourselves along the way. Love ourselves along the way. It is hard to feel much love for life, ourselves, or any peace with diabetes, when one is pursuing strict, short term solutions, to long term problems. This rocky relationship brings moodiness as well; depression, anger, eventual high blood sugars, and further uncontrolled emotions.  

Diabetes has been for me then, a deep exercise in introspection: a deep learning to pay attention to my needs, to want those things I'm doing for myself, to love and desire to be healthy, and in good spirits. It is the courage to look at what we want in the face, versus what we need... and to turn what we need into what we want.  

Friday, May 24, 2013

The Moldy Cupcake Awards: Artificial Sweetener Alarmist Crap, by WHO-TV Channel 13

Copyright © 2010 Julie Kin
/ Gleeful Things. All Rights Reserved.
Welcome to another edition of the Moldy Cupcake Awards.
The award we give out for excellence in communicating nonsense, lies, misinformation, and outright uninformed, alarmist drivel, about diabetes and related health informationfor the purposes of garnering ratings, by the mass media, and others.

This installment's winner is: WHO-TV Channel 13 News, Des Moines Iowa!

I'm not much of a TV viewer, these days, but I must confess: I had a little accident this week -- I accidentally spilled water on my laptop, so I had to spend a good day without the internet. What was left, but the TV? (Yes, I know... reading, walking, exercising, crafts, etc. lol) Anyway... after a year or so of not watching any TV, I was quickly reminded why I had given it up: gullibility, stupidity, emotional appeals, and alarmism for the sake of ratings. They sure know how to hook us in. 

So, here I was, taking a dose of mental junk food, when I saw a commercial for the local news regarding artificial sweeteners. In it, the anchors sounded the alarms of doubt... "are artificial sweeteners and low calorie foods safe for you, or are they just a sweet deception?"

Oh, there was no way I was going to miss that... and they did not disappoint -- by which I mean, they completely disappointed me, as I expected. I am always amused by how the media portray their stories on artificial sweeteners, and other controversial subjects. They violate every law of sound journalism: 
  •  You first portray anecdotal evidence, by someone that has really no proof of their claim, just a gut feeling;
  • Then you speak to expert sounding non-experts;
  • And finally, you have them make lofty claims, with absolutely NO scientific evidence or basis...
And there you go! A recipe for just about every "investigative" segment on the news, today. 

This 'investigative report' is no different. They start out with the story of Renee Chiaramonte, a woman who is a registered nurse, at one of our local hospitals. That, by default, would give people the idea that Renee has some 'authority' on what she says, because she's a nurse. In my experience as a diabetes advocate, assuming one has sound medical knowledge or health expertise by virtue of being a nurse, simply couldn't be farther from the truth. 

But I digress... We're left to ponder on the life of Renee, who was not feeling healthy, and felt like this was
likely due to poor diet; artificial sweetener abuse, to be exact. She claims she was consuming up to 500 artificial sweetener packets a month (besides countless diet sodas) and that she experienced weight gain, joint pain, and a torn tendon in her knee. These are some pretty hefty claims to make of artificial sweeteners. 

But it doesn't stop there... How dare these companies try to sell you artificial sweetener?!

They want to build a case of blame against artificial sweetener companies, so they interview a Marketing Professor at one of the local universities. "Oh, no, companies make you crave the sweet stuff by giving the boxes pretty colors, and putting them on the most accessible shelves! How dare they!" Yeah -- it's called being a company with a product, which you want to sell. Should they package it in corrugated boxes, written over with Sharpie marker? Please.

Then, for the clincher: A "medical" expert's opinion. Now, is this expert a registered dietitian? Is she an M.D.? Is she, perhaps, a food scientist? Maybe even a scientist with the FDA, or the Department of Health?  I would've even accepted a researching chemist. 

No... that would be too ideal. The woman in question, is "Dr." Ann Buenger -- a chiropractor. 

Listen here, fools at WHO-TV News Channel 13... 

A chiropractor is not a medical expert. In fact, they are not really doctors of anything, but of pseudo-scientific claims, and most of their claims and services are WOO. How dare you ask this woman's mere unscientific opinion on this subject (of which she is NOT an expert, by any means)? Let's limit her to such things as back adjustments, for crying out loud.

So, instead of interviewing an actual expert, they interview Mrs. Buenger (I refuse to call such a person a doctor) and she makes even more preposterous claims: 
  • Artificial sweeteners are stored in your fat;
  • They are all a "chemical," thus they are toxic to the body;
  • "Experts" say artificial sweeteners can trigger weight gain, migraines, depression, and cancer;
  • Consuming artificial sweeteners is like directly injecting them in your veins; and
  • 75% of your neurons have to die before all your symptoms of artificial sweetener consumption come out.
  • "Adverse symptoms" can last for several years.
I really miss the days when journalists were actual journalists, and did investigative work. NO ONE in their right mind would want to quote such a non-expert on such a subject. I wonder if all the other real experts simply told them there was nothing to discuss? No controversy? They had nothing to work with, and were grasping at straws. 

I sure would love to know to which so called studies and experts this woman was referring. Since she doesn't say, and even a cursory search on google doesn't yield any credible links (medicine journals, with findings, for one), I am left with assuming 99% of her claims came right out of her ass. 

You see, artificial sweeteners are not stored in fat; they do NOT affect your neurons in such a way that most of them have to die off, somehow, before you can feel better, nor do they trigger any of the symptoms mentioned above. And if something is toxic to us, just by virtue of it being a chemical, well lady... throw away ALL your medications, and you'd better hope you don't get any major illnesses. 

Aspartame, for example, has no more likelihood to induce headache in people who consume it, than a placebo; further studies of the association between aspartame and cancer found this association to be exclusive to rodent physiology, and not supported in humans; and any idiot who has any knowledge of the body's digestive process knows that drinking something is NOT the same as injecting it in one's veins... otherwise we'd drink insulin. DUH. 

Now there is some truth as to the likelihood of weight gain and usage of artificial sweeteners, but it is not due to artificial sweetener 'storage' in adipose tissues. 

You see... the desire to eat is driven by the same reward-circuitry we have in our brains for other pleasurable activities, such as sex, and drugs (hot damn!) When we consume sweet foods in particular, they reward our pleasure senses, but they also trigger satiety mechanisms which tell our bodies we have had enough. Since artificial sweeteners do not possess any caloric content, they thus trigger those 'hedonistic' pleasure neuronal signals, but do not seem to trigger satiety signals. The hypothesis is that a person can end up over-craving, and overeating, or looking for more food, because they didn't feel 'satisfied.' Also, if one abuses sweet foods, one trains one's palate to prefer such sweet foods, over other foods, even craving them. The studies for these behaviors are not, by any means, definitive; they are often large population studies, from the 1980s, over a 7-8 year period. Food attitudes, and diet notions can change a lot in such a period... especially in the 80s, when people would often eat a slice a cake with a diet Coke, and think they were doing well; or consume honey, in place of sugar, and think they were cutting out problems. 

This does not, by any means, mean that consumption of artificial sweeteners immediately leads to weight gain, on its own. It does not. If one is aware of one's eating, has a well balanced diet, and consumes enough water through the day, there really should be no problems. One of the prime examples of how artificial sweeteners do not lead to weight gain are the foolish anchors of this story, themselves, which at the end of the story (while not shown on this clip) were freaking out about all the foods they had consumed through the day, or earlier in the week -- while being the picture of fitness. 

Interestingly enough, just to show HOW psychological this woman's perceived malaise was, from her artificial sweeteners, she claims she now consumes Stevia (by way of Truvia), which is "the only healthy alternative, right now." They assume this because Stevia is naturally derived... but in fact, Stevia is no different in way of 'anecdotal' symptoms expressed by consumers -- as well as, also, not having caloric content. If it's sweet, and it has no caloric content, it should behave in the same way as the other sweeteners when it comes to partial activation of food reward pathways. 

One is left to ponder upon the other ways in which this woman was possibly not taking care of herself: not enough sleep, poor diet (hence a lack of vitamins), and dehydration. If she has any history of carpal tunnel, lack of enough Vitamin B-6 and Vitamin B-12 can seriously affect her joint health. It could have also been the result of poor hydration, if she was simply not having enough water (just chugging diet sodas), and was retaining a massive amount of water weight from dehydration (a safety mechanism), as well as causing her joint pain, and even muscle cramps, and torn tendons, in the presence of high activity (such as a 12 hour work day). These are all well known side effects of dehydration.  

This was, simply, an inexcusable piece of irresponsible journalism, WHO-TV. A lot of people greatly depend on artificial sweeteners -- many with various illnesses they need to manage, such as diabetes. We live with enough guilt, as it is, without uneducated lay people giving us crap over a 'piece' they saw on your channel. When you create such poorly researched segments, what you do is push people into the arms of conspiracy theorists, scammers, and quacks, claiming they have the latest and best in 'natural' medicine, or a quick fix for their problems. Not to mention, WHO-TV, that you slander an industry. Sweeteners are used in all kinds of things, from toothpaste, to Lean Pockets. 

This woman was simply living a poor lifestyle, and instead of taking responsibility, decided to blame the artificial sweeteners. And instead of researching, you went with questionable sources. The worst part is that you brought NO balance to your piece, only adding a lame 'Editor's Note' at the end of your hard-to-find written piece, with 'differing opinions.' WHO-TV, these aren't simply 'opinions.' You can have your own opinions, but you can't have your own FACTS, and then call those opinions. SHAME ON YOU! 

Sunday, May 12, 2013

The Seasons of Diabetes

I wrote this post last fall -- and left it to 'simmer' under my drafts, until I felt I could more fully, and more maturely, develop it. 

It's cool outside. The air is crisp, and clean; tinged with so much moisture that I can feel its mist on my cheeks. Wondering home after work, in the early afternoon, gives me pause. The crunching leaves underneath my feet, the neon yellow colors, and the scent of trampled ginkgo biloba wakes me right up. Ginkgo biloba is pungent, that's for sure; it's scent is something between icky bodily functions, and rotting flesh.

No matter though. The heavy atmosphere begins to release a mild rain... and though there's no umbrella and it's quite cool outside, I find myself embracing the very awareness of being alive that the new season brings upon my senses.

I realize, suddenly, that I love Fall. But then, don't I also hate it sometimes? I know I've told myself that before... Why is that?

[Walking gives one much time for thought. Deep thoughts by Jack Handy kind of thoughts, I guess. (If you hate walking for the exercise, well, at least love it for the thinking.)]

So... what is it that I love about Fall, or any season, anyway? The answer is both obvious, and not so obvious; one of those much clich├ęd "Aha!" Oprah kind of moments. I love seasons because of their promise of RELIEF.

This brief moment of relief brings my soul much healing from the previous season; a much needed break from the burden of dealing with whatever else was before. Yes, relief. You see, I start out loving a season, and then it slowly becomes annoying to me, and outright burdensome... I then get sick of it, or even depressed from it. I get sick and tired of the stupid season! It seems long, and never ending... and there's only so much of -20°F or 100°F (and everything in between) one can tolerate. So, every new season brings me relief from the previous season. It brings me a much welcome change of pace. It brings me an opportunity to love life again. To smile... to take in the wonder of how much nature can change from one moment, to the next.

And it's much the same with diabetes, and our "seasons" of self care, isn't it? We make up our minds to begin caring for ourselves, anew, and start out with the joyful promise of good things to come... and then we get sick of it. We seem to perpetually live in one season, and one season only -- often with little flexibility with our routines; we impose the new "season" on ourselves --with strong militance -- and then we burn out. Then after a little while, we start yet another season, but with the mindset of 'rectifying the previous bad behaviors.'

But, should we change things before our "season" changes us into something we don't want? Maybe we ought to begin a new season simply pondering what lead to the 'bad behaviors' in the first place... I know I'm guilty of it, particularly with my routines. With it's dietary calculations, carbohydrate juggling, testing, supplements, medication management, exercise routines, and doctors appointments -- diabetes can be one long, and boring, and often, depressing season. Some people thrive in that kind of season, just like some love perpetual sunny days... but once in a while, my soul needs a little rain.

So, how do we avoid this cycle? What can we do so that we don't get stuck being miserable, in a crappy season, and completely giving up on diabetes management, over and over again? Well, it's obvious that we're creatures of spontaneity -- we need, and crave change, so wherever we can, we must allow ourselves some flexibility. With this in mind, we must take a moment to consider...

a.) Which things are negotiable; and
b.) Which things are not negotiable.

And we must be realistic. We need to sit down with ourselves, and realize that we simply cannot put everything in the "not negotiable" camp. For example -- as much as I, in principle, would love to eat nothing but eggs, every morning, so that I have the best blood glucose numbers -- I know that I am quite sick of eggs. I don't want eggs all the time; I don't want flax seed meal muffins, I don't want weird food. I want to eat a chicken soft taco, with lots pico de gallo, lettuce, and a little hot sauce. It's about 35-40 carbs. IT'S FINE. My morning blood sugars aren't below 100, but quite frankly, they don't go over 150, either... and I'm okay with that.

Will I have a bunch of cereal, of any kind, for breakfast? No. Cereal is not negotiable for me, and not even because of the spike. It's just not satisfying to me -- psychologically, it doesn't seem like I've eaten anything, and physically, it just doesn't fill me up. It makes me need more food, and I'm not much of a pleasant morning person to be going around, making extra things. I tend to like regular meals at that hour, OR, a light snack and a brunch later on. If we think about it, most breakfast foods are just an excuse to eat desserts in the morning, anyway. So... I'm not going to kill myself with eggs, nor cereals, nor weird substitutes.

Now, in my desire to eat with awareness, what I seek to avoid is binging; that is not negotiable. (As non-negotiable as completely giving up testing.) Overeating may happen from time to time, as we learn our limits -- but binging is not negotiable. So, what does my body want to eat, intuitively, the most? These days, my body wants and craves veggies the most. Non-starchy veggies, and lean proteins. Sometimes, though, I might crave a bit of creamy tomato soup, with a small portion of gnocchi in that soup -- and I can have that. I need to recognize, though, that I will NOT and CANNOT live forever on just veggies, and just protein. That the occasional starch and/or grain is okay -- even if it's not 'whole.' I am perfectly aware that this is not deadly, that it is not untenable, and that some people make the change, without issue -- but if I did this, I know I would soon fail.  I am not a person, psychologically, to endure such a restriction -- to endure deprivation and strict eating rules. I do eat low carb most every day -- but every once in a while, I am OKAY with my blood sugar not being perfectly below 120 after every meal. If it's below 160, sometimes, it'll do. Yes -- it'll do. So... I tend to cycle some days when I eat very low carb, with some when I eat moderately low carb, and with some when I allow myself a treat. Studies have shown that an intermittent low carb diet is still much better at reducing insulin levels in one's blood, than a Mediterranean diet (or standard dieting). We're not speaking of insane changes, here... It's not like I'm going to sit out in the rain all day, because I got tired of sunny days. (No, no... sorry, there's not going to be an "all brownie day." Put down the icing.) But maybe one or two days of splashing in some puddles might do me some good. After all, who wants to go to a favorite restaurant and ALWAYS have to stick to the same food option?

No one. They'd soon fail. So then, we must learn to be realistic, and keep a balance between our own desires for freedom, spontaneity and change -- and our limitations.

Another change in season which we may consider, is simply changing how we view the way a meal affects us. Not every meal is going to be perfectly within blood glucose goals -- but perhaps the bigger question should be: "how well do I feel when I eat it?" Quite frankly, I have to limit heavy breakfasts -- proteins with too much fat, or calories, will make me feel bogged down and sick -- even if they give me great numbers. Most of the time, I cannot handle a great work day, if I'm bogged down in a very heavy breakfast. I also can't eat very bitter or tart foods at that hour, like yogurt, or grapefruit. Hey, I admire the people who eat that every day, and can get away with it -- but it seems to be unsatisfying to me, both physically, and emotionally. On the other hand, a home made tomato soup, with lots of veggies, and a bit of gnocchi -- while giving me blood glucose levels sometimes in the 160s -- make me happy, joyful, and healthy. And the highs do not last very long. Since I've started eating more like this, I've also had better fasting numbers in the mornings -- usually in the 80s.

But perhaps, by far -- one of the things we ought to consider when managing our 'seasons' with diabetes, is to enlist the help of our friends and family. If one has a "Type 3" person enlisted in one's care, one should use this moment now to plan out a 'new season' with them. That could be as simple as choosing one or two weekends a month, where they are the person who makes meals, so that you don't have to be the main meal maker ALL the time. Or, it could be the other way around... maybe we can be the main meal maker, so that we give one's Type 3 a break from having to make our meals all the time. Learning to plan, and prepare, diabetes-healthy meals can be a lot of fun, sometimes.

What concessions are we willing to give ourselves in order to learn why the caged bird sings? Diabetes is a steady stream of seasons; it's best to let ourselves change and flow with the wisdom they bring. I'm only 36, and I have a good 30+ more years with this disease, so I have to learn to run a good race... and be consistent at it. This, for someone like me, is a HUGE challenge... and though I may seem like I have it all together, believe me, I'm still, very much, a work in progress.

I never have quite the same consistent answers about my eating habits, or exercise routine... because well, there is no consistent answer. I simply try to do whatever makes me feel healthy, so long as Mr. Meter approves... and I'm not sick of it. Mr. Meter, though, is going to have to learn to be a bit more flexible, sometimes. Or he'll end up decorating my wall. As you can see by this 14 day average, he can be a real drill Sargent, sometimes... even with those silly, googly eyes.

In order to survive, we need to change our seasons. We need to redecorate, to transform, to change the same four 'diabetes walls' we stare at, every day... because we need RELIEF. 

Sometimes, our souls just need a little rain.

Friday, April 26, 2013

Temptation Wears a Red Dress Pin

Many of you might know that, currently, I work as a cashier for a local restaurant. It can sometimes be a fast paced job, with unique 'diabetes adventures,' as well as unique opportunities to meet people. Sometimes, it's just an opportunity to see people react weirdly to their environments.

Our restaurant isn't exactly a health venue. It's a local fast food type joint, which has at least, some merits: it's privately owned, it makes all of it's food fresh-from-scratch, and since it's family owned, the people are wonderful to work with. For the most part. Every job has it's ups and downs.

I admit I've never been what you would call -- a people person. But I can be a congenial person, and I do love watching people; studying them in their environments, when they think I'm not watching them. Especially as a cashier. Cashiers are like wallpaper to a customer.

One thing which has come as a sort of surprise to me is that most of the people who eat at our restaurant are pretty thin. They'll order the largest thing in the whole joint, deep fat fried, and a trash-can sized cup of soda. Some come and eat this EVERY DAY. Always looking the same weight. Lucky bastards. Then there's the heavy women. They're always ordering salads. A salad, and a cup for water... or a salad, and a diet Coke. And they always look heavy. They never seem to lose weight.

Of course, I don't live with these people -- I don't know what they do or eat when they're not at our restaurant. Who knows if the thin people go running every day, or if the heavier people go eat their entire refrigerators, later. I don't know. But it's a very interesting thing to watch. It makes me feel curious about all the accusations people always have for the obese, like they live, and breathe, fast food... and the level of self awareness some of them must have when they dine out.

And speaking of self awareness... a very curious thing happened to me last Monday. This slender, tall, vivacious looking woman approaches the register, and I happily greet her. She makes eye contact with me, and suddenly, starts freaking out: "Please don't judge me for what I'm about to order because I'm wearing a red dress pin, and I'm about to order really unhealthy food." Quite frankly, I hadn't even noticed the red pin. I was simply more intent on getting her order, and getting it right. I tried to reassure her "Oh, don't worry, it's okay." She looks at me, half smiles, and places her order: two fried items, with a side of fried tater tots, and soda. Then she says "You know, we're allowed to have a treat once in a while." Again, I offer the supportive reply, "Of course. I completely understand." Then she looks flustered, and says "You know what, I'm just going to take it off," as if it were an electronic ankle bracelet, from her local parole officer.

So many responses ran through my mind... like "Lady, I don't give two shits about your damn red dress pin." Obviously, I couldn't have used that one. I smiled warmly, and just offered a light-hearted "Oh, don't you worry yourself about it!," and with a side wink, an "I won't tell."

I also thought... Should I have told her "Hey, I have diabetes. I understand?" I didn't do so... I try not to tell people too much about my private life -- mostly, because I can tell people like that wallpaper feeling when they get their food. (I admit, I don't care too much for knowing people's personal stories when they're just selling me something.) I also thought to myself, "What if she judges me the way she thought I was judging her?" She might think to herself "Of course she has diabetes... look at where she works!" or "look at how heavy she is!" or some other lame conclusion -- as people often love to believe about us people with type 2 diabetes.

But I have to admit, I was quite surprised at her. She felt guilty, from the pin, and it made her aware of her behavior. It was giving her an accountability -- which was only in her mind, really -- but which was a reminder to herself of how she wasn't taking care of herself.

That this woman was embarrassed because of a disease she didn't even have, and of choices she knew were poor, was quite the irony... She may have the option of removing her red dress pin, and ending the stigma, but people who are obese can't easily remove their weight, and put it away, like some sort of suit, and weird fashion statement. We can't easily shut down the stigma, and judgment, others might give us for our condition -- nor can we cure our diabetes with a green salad and a diet Coke. And I sure as heck wish I could 'put my diabetes away,' like some kind of pin, for when I wanted to eat junk... as I'm sure many women with heart disease might wish they could do the same.

And I thought... well, maybe I ought to get a diabetes pin. A pin which always reminds me that I must care for myself. That my health is important... a pin which might make people ask me what it is, perhaps. Blue Fridays is just something meaningless at my workplace, because all my shirts are blue. :-) No one would think to ask, nor could I claim it was 'my choice.' But a blue circle pin, on the other hand... that's a different thing.

A blue circle pin can be awareness, accountability, responsibility, and advocacy. A way to not only remind ourselves of how we matter -- to care for our own bodies -- but to also show others we can do this, and we're not afraid to show it. If I feel bad, on a certain day, I can always take it off.

It's an idea, anyway... Do you feel self conscious in front of strangers when you order junk? Pin, or no pin? Some people always seem to emphasize the diet drink, especially. That's a DIET drink, with the side of fried food. heh We're silly humans, after all.

We're all just so easily embarrassed, I guess.

But perhaps it ought to be a BIG reminder that if we can't handle the imagined stigma of any one disease, even for ONE moment, perhaps we ought to be kind to those who CAN'T easily remove any of their health challenges, like a pin. We need to give others some empathy, some respect, and some space... Especially, when it comes to occasionally letting their hair down, and tasting life.

Wednesday, April 17, 2013

The Privilege of Living with Diabetes

Dear Beautiful Person (who happens to have diabetes),

Today, you are here. Is there a purpose to your being here? A universal, master purpose? Many claim to have the answer to this, but the honest response is that no one knows. The question is, in fact, irrelevant. You are here. That is a fact. Everything else is just speculation.

It matters not if it's an illusion, a grand plan, a godly design, or a happenchance. You are here.

And while you are here, think upon the magnitude of your existence: The last science knew, the universe was 13.8 billion years old. During much of that time, Earth was a big, hot mess. Life only began to evolve 3.5 billion years ago. Modern man, alone, has only existed for about 200,000 years...  and only in the last 30 years or so, have we seen vast improvements in industry, technology, education, science... and medicine.


If you would have been diagnosed with diabetes (of almost any type) back in the 1800s, it was most certainly a death sentence -- if not, a very challenging life.

Insulin wasn't discovered as a treatment for diabetes until the 1920s, thanks to Banting and Best, when many children were literally dying of malnutrition and emaciation. Banting had the heart to insist on not patenting their new-found medicine, so that it could reach as many as needed it.

Metformin was invented in the 1920s as well, and has been used in other countries since the 40s, and 50s. It was not, however, approved in the United States for use with type 2 diabetes until 1994! Yes, that is not a typo. 1994.

Back in the pre-insulin days, starvation was all people knew to do to control diabetes. To eat basically no carbohydrates, or really anything much -- as proteins and fats can also raise glucose (though, admittedly, to a lesser degree). Many simply died because it was so stressful -- or they just couldn't resist pinching food, while no one was watching.

It wasn't until the 1980s when a person with diabetes was able to monitor their levels, independently, and the first glucose monitors appeared. If they had insulin -- that was a good tool -- but if they didn't, all they knew to do was avoid eating sweets. Diabetes has always been with us, at least in the archaeological records, since Egyptian times, and we've known it's a disease about high glucose, but aside from that, there wasn't much monitoring of glucose levels until well into the 80s. Ask anyone who was diagnosed many years ago, and they will tell you stories of urine testing (sometimes, once a month, at a doctor's office), and sharpening and boiling their own needles, for sterility.

In fact... we really didn't know that diabetes was not a disease caused by eating excess sugar and sweets, until at least the early 90s. The other day, I saw a very old VHS tape for an old Vitamix blender I have acquired, and in it, they recommended diabetics substituting honey, in place of sugar. I guess in their minds, anything that was natural sugar, was not really sugar.

And here we are now... 2013. With a variety of different types of insulin, mimicking both basal and bolus outputs from our pancreas, insulin pumps and CGMs to allow us to eat with more freedom and catch hypoglycemic events, the knowledge of counting carbohydrates and the freedom to eat cake, diabetes alert dogs, and glucose meters small, sleek, or indistinguishable from an iPod, small, and painless needles... and on the thresholds of smart insulin, biohub and artificial pancreas options, and noninvasive glucose testing.
. . .

Yes. Diabetes is still hard. But we are blessed to live in 2013, and not 1913. We can see ourselves as the victims of fate, or as the blessed recipients of a grand universal lottery. Think about the kind of life you have the chance to pursue, right now... that you would have never had a chance to pursue back then. Let it sink in -- let it's blessings humble you. 

Yes... diabetes can be embarrassing. But all disease is humbling. 

Even if you never had diabetes, life is much of an embarrassing process, as well... At birth, and near death... someone has to wipe our behinds. We get old, and lose our good looks... we may get cancer, and lose our breasts, we may get alopecia, and lose our hair... We may be like Farrah Fawcett, and get colon cancer -- colon cancer. 

Illness is humbling -- for we have to accept that we are frail, that we get sick, that we get old, and yes, sometimes... that we haven't always done the best to take care of ourselves. But, can you think of anyone who has been perfect -- all of their lives? Always perfect? I know one or two who claim they were -- and you know what -- I honestly don't like them very much. For one, they are liars. They may have read the manual on living, but they haven't actually lived very much. No one learns to ride a bike from reading a book -- and thus it is with living. Some of us just have to fall a few more times, than others... and it is our beautiful, gnarly scars, which make us who we are.

I never thought of Farrah Fawcett as much of a hero -- until her war with colon cancer. And I never thought much at all, about Ryan O'Neal, until his passionate devotion to the woman he sought to wed on her deathbed. 

Don't be angry at your loved ones, beautiful person (who happens to have diabetes). It is not a matter of blame. It is not a matter of fault. Don't leave this world, and lose hope... for these massive amount of events I have listed had to have gone through... and for you to be here, in this point in time. Your loved one, well... your loved one simply LOVES you. They are in deep fear because they do not want to be without you -- at least -- not sooner than life will will. Can we blame them? 

I was angry once... at my father for (in my own warped perception) not trying harder, at life and circumstance, and God, and you name it. I was once that angry loved one... living in FEAR. Sheer fear. But, you see... for whatever reason, you are here -- in this very moment in time, and a time when you happened to meet your loved one. This is a very precious moment in time... In fact, to quote Lawrence Krauss -- a renowned Theoretical Physicist: 
“Every atom in your body came from a star that exploded. And, the atoms in your left hand probably came from a different star than your right hand. It really is the most poetic thing I know about physics: You are all stardust. You couldn’t be here if stars hadn’t exploded, because the elements - the carbon, nitrogen, oxygen, iron, all the things that matter for evolution and for life - weren’t created at the beginning of time. They were created in the nuclear furnaces of stars, and the only way for them to get into your body is if those stars were kind enough to explode . . . The stars died so that you could be here today.”
Is diabetes embarrassing? Well, sometimes... But I am in fact honored to be so privileged to be alive, today... right now... Experiencing this universe, the love of friends, and family... The patter of rain on my window pains, the loving purr of my cat, and the imperfect love and friendship of that idiot that still lives here which I call my husband.

Yes, I am honored... to be living here, and living with diabetes.

Thursday, April 4, 2013

The Diabetes Funk

One of the wonderful things of having a blog is that, often, people ask you deep questions; deep questions which you may be working towards resolving, yourself... (unbeknownst to the reader) thus, giving one ample opportunities to think "out loud," if one could, on the internet. 

I'd like to address one of those questions...

It's a particularly common one. Many people ask me this question, and it's truly one which is bound to come up in a person with diabetes' life sooner or later: "How do I get out of a funk??? Can you point me in a direction to get my eating back on track?"

I think it's safe to say, this question has no easy, or simple answer.

Whenever we get into a funk, we are in many ways, tired of the burden we have to bear. We have to come to grips with that, and acknowledge it, before we can even begin to understand how to fix it.

We have to recognize that we are tired... 

In particular, with type 2 diabetes, we are tired of having to guard against an invisible monster -- who much like the boogeyman under the bed, or inside the closet -- seems as a figment of our own imaginations. That's the big problem with pre-diabetes and type 2 diabetes -- particularly, at the stages where we have no complications, or can manage with just diet and exercise, or even with some oral medications. How does one keep being a lookout for something that never seems to show up? How can one take it seriously? Why does one need to keep taking pills for something that doesn't seem to show up? It seems a bit hard to believe that the minute we stop being a lookout, something will show up. And then... outsiders don't help. They can't see anything serious, either, so many egg us on to just 'enjoy life,' or to quit being 'melodramatic.' "Come on, it's not like you have cancer."

This particular dynamic makes it hard to commit to making serious changes in one's health, particularly when one has had a lifetime of other choices etched into our internal scripts.

We have to recognize that this is real... 

Sometimes, we forget that the point of the exercise is NOT the waiting for something to show up -- but to intimidate the something into NOT showing up. It seems as a futile exercise with no rewards. But... if I shine a light in the closet, well, the monsters never materialize. The child never asks "But what's the point of this flashlight? I never see monsters in the closet, so why should I need it?" No. The child merely reasons "the flashlight scares the monsters away, and keeps them from coming." The things we do... the exercise, the diet, the medications. They all come together, in one big, powerful flashlight.

We can change part of our mindset by simply changing how we ask the question.

Now, how sensible would it be... if a person with HIV decided that all their treatments were pointless, because AIDS was not a real threat (somehow)? And we all understand how nonsensical it is for a person with a deep mental health concern, to forgo medications, because they now feel well... But it is, in essence, the same dynamic. We are all fighting to keep something larger, at bay, which is as real as full blown AIDS, or as real as cancer. In fact, it is so real, that diabetes kills more people than AIDS and breast cancer, COMBINED.

Yet, people like to speak of it as if it were a mere inconvenience -- like some kind of bunion on your foot, that bugs you when you walk... when it's more of a darker, more sinister situation. I'll save you the metaphor... I'm sure you don't need it, right now. But I'm sure we've all been there, and thought deeply about the darker sides of diabetes.

We have to recognize that diabetes is scary... 

Especially when people are always gracing us with stories of their Aunt Jenny, who lost her foot, or their Uncle Bob, who had to go on dialysis. Diabetes can instill a serious dose of fear into those who live with it, and who struggle holding up that flashlight into the closet -- often making us feel we're doomed into an uncertain future. We get tired, we don't want to face reality, and we get scared into inaction. And it's probably because diabetes is more like an endless night, and the flashlight eventually needs new batteries.

So we fumble. 

We fumble, and we won't eat 'right,' or we won't take the god-awful medications, or we 'fudge' the insulin. We want to pretend normalcy, again. We want to believe we live in a world where we are not the ones with diabetes. Or, perhaps, where we sinned and then got diabetes. But... why shouldn't we be the ones with diabetes? Do you know of anyone else more worthy of having diabetes than you, or I? More deserving, somehow? Who had it coming? What makes someone worthy, or not, of having diabetes? Or of having any disease? The answer is nothing. Both birth, and death... happen to all of us. The number one risk factor for getting ill... is living. And if you enjoyed your living, thus far, make peace with it. Don't somehow, 'forgive yourself',' as if you've erred. You haven't. No. Make peace with it. You lived, you loved... and that's what we ALL do. In our own way. Now it's time to live differently. To enjoy differently.  

Diabetes is not a judgment on your previous life; it is merely, a different life. In many ways, coming to terms with accepting diabetes, is coming to terms with our own mortality, for managing one, is preserving the other. 

And we have to strive to preserve life, to enjoy life. To take life one step at a time.

We have to recognize that it takes baby steps...

It takes baby steps to accept our life, our mortality, and the things we need to embrace to preserve that life. Managing diabetes is an exercise in self-love. And self love is something that takes a great deal of patience, and self-awareness. 

There are a few things one can do, such as:
  • Start small: Seek to make one small change a day, and focus on it for an extended period of time. Perhaps that change can be as small as taking your medications as prescribed, until it becomes an innate habit. Or, perhaps that change can be going out for a small walk around the block, every morning... Maybe even just having ONE meal a day in which you have a non-starchy vegetable. You get the idea... 
  • Work on other projects: Often, when I feel my health life is a mess, I simply go and deep clean the living room, or the bedroom, or the bathroom... or I organize the kitchen. It seems silly, but it often helps give me motivation to take on almost anything -- and put it back in order. Plus, it helps give me some immediate victories to focus on, and not look for the constant 'far away' victory of 'not worsening my diabetes.' In essence, I shift the focus to something else, more immediate. And it's silly, but it helps me feel a bit whole. It's a great big victory when one has cleaned out an entire closet full of junk! So... shift the focus.
  • Give yourself time off: Diabetes is like a job. Diabetes IS a job. It's a 24/7 job in which you get no time off, and constant worry. You're meant to always watch your health, mind what you eat, and test, test, test... always worried the boogeyman is coming through the door. We tend to get very strict with ourselves -- jump on all manner of fad diets, cleanses, and various things -- because we want to fix the problem NOW. (It's a leftover problem from how we deal with weight, and obesity, and they don't work, and they are wrong.) Look... even skinny people let their hair down once in a while. Schedule one day a week, where you let yourself have some kind of fun, with yourself -- or friends and family -- and look forward to it. You can have a slice or two of pizza... if you like. The world will NOT end, and your foot will NOT fall off. 
  • Do not judge yourself: "I can't believe that wimp's been running that marathon for 10 miles, and he's already tired! Let's berate him until he makes it to the finish line!" -- said no one, ever. Diabetes is a marathon. You're going to get tired, emotional, upset... and sometimes make bad decisions. IT'S OKAY. Tomorrow is another day. Recognize and accept those feelings. DO NOT ABANDON YOURSELF. Simply acknowledge yourself... and see what you learn! Tomorrow is ALWAYS the beginning of a brand new year, not January 1st. 
  • Don't hide: Find a support system. I know... family, and friends, often don't get what we go through. But if you're reading this blog, you're probably already a bit familiar with the diabetic online community. In it, you can find lots of people who like you, and I, are going through this struggle. You can vent to us! We know, and we can relate. There are a lot of places where you can read through people's sincere journeys of struggle, and hope -- or where you can read others' questions, and learn from the responses they get -- even if you want to remain anonymous. 
  • Ponder the benefits: Do you like feeling good? Do you like having energy? Do you like feeling confident that you can set, and complete goals? Do you like not getting sick as often? Do you want to have health and energy for your family? I know I take these for granted more than I would like, and when I do... it's easy for me to get into a funk. 
  • Seek appropriate medical advise: Find a medical team that is willing to work with you, and to educate you. If need be, find a therapist who has experience with patients facing chronic health conditions. Diabetes is very much a psycho-social health condition, as well as a physical ailment. It's very hard to make progress when you work with people who seek to blame you, or leave you off on your own, with few tools to work with. This also goes for managing any side complications you may have, which may add to the burden of diabetes, such as hypothyroidism, depression or carpal tunnel worries. With carpal tunnel, for example, a good doctor can set you up with overnight braces, to keep pain at bay, as well as with a steady Vitamin B6 therapy to help reduce inflammation. Proper hypothyroid medication can also help reduce depression issues. And -- it's important to mention -- that reducing blood glucose levels helps improve ALL of these conditions to some degree, or another. 
  • Seek to learn about 'the funk': There are quite a few resources, available, from persons going through 'the funk,' which can help you be better prepared the next time you feel you might stumble. The goal isn't so much 'averting' a stumble -- but learning from it, and getting back up!  
As a person living through her third year of a type 2 diabetes diagnosis, I am far from being an expert in these topics. I struggle along like a blind man, in a dark room, trying to find a black cat. I have to constantly remind myself that, though I may know how to play the game, I need to actually play the game. I hope that, even with all the things I have said here, just the thought of knowing someone else out there is going through a similar battle... is enough of a wind beneath your wings. 

It's certainly given me an excuse to ponder some of these things... a bit more than I would like. :)  

Thursday, February 14, 2013

Finding Balance in an Unbalanced World of Diabetes Support and Education

Nature often plays a delicate balance,
like these two bugs holding on against
the wind, behind these delicate, white
blooms.  It's a rainy, cold, and wet
 day, in Iowa.  Fall is just around
the corner. (September 11, 2008)
One of the biggest challenges, when helping newly diagnosed persons with diabetes, is finding balance in the information provided. Helping create a positive environment, which encourages a person to learn the scope of the disease and its complications, but still keeping their heads above water. No matter the diabetes community -- this is a struggle that I have found almost everywhere. Even in my own diabetes groups.

Whenever I share any information, my hope is for you, the patient, to be able to make your OWN decisions -- and not make MY decisions as yours. I have this crazy idea that, when empowered with basic information, people will tailor their diabetes regimes to their own circumstances, and find balance. That I don't need to tell anyone what to do, and that since this is diabetes we're talking about, what has worked for me... will definitely, and not necessarily, work for you.

The problem is that diabetes is a dick. Diabetes doesn't play fair, and it doesn't give two shits about our feelings. It doesn't. It doesn't care that the news of the things it can do, can scare us, nor does it politely pass us over when we decide to close our eyes against it. So... sometimes, this harsh bit of reality might lead people to behave in one of two ways: either by becoming inflexible with their ideas of control, or by becoming completely lax in their control. Neither of these two ideas is good, even if one of them has much, much better numbers.

Inflexible Control

There's nothing wrong with having tight control. In fact, international diabetic guidelines call for patients with diabetes to aim for postprandial (after meal) numbers which are less than 140 mg/dL at 2 hours. For some time, I belonged to some communities with large numbers of internationals (people in any number of countries, outside the United States) -- and they consistently made their goals to be 140 or less, and never once did I ever see anyone complain about that, or try justify a much higher goal, or A1C, without some serious reasoning behind it. Sure, no one's perfect... but it IS the number they shoot for, so, it is the NORM for the world to shoot for those numbers This is, also, a number which even the American Association of Clinical Endocrinologists endorses. The American Diabetes Association is pretty much alone in their call for persons with diabetes to keep postprandial numbers at less than 180 mg/dL (but even they have this caveat under their goal guidelines: "More or less stringent glycemic goals may be appropriate for each individual.") 

The fact is that the LIKELIHOOD for damage and/or complications caused by high blood sugar increases, in a correlated manner, the higher the blood glucose level is... and that correlation begins at 140 mg/dL. That's really scary. Not only that, but the risk for heart attacks increases by leaps and bounds the higher our A1Cs are. This is basically truth. This is not my opinion... it's not my way of calling people to go eat nothing but twigs all day, nor raw dieting, etc. IT IS THE UNVARNISHED TRUTH. 

The problem is... some people use that truth to assume that everyone must tackle their diabetes in the same way. In fact, some persons are so disturbed by the potential damage of diabetes, that they push for normal, non diabetic numbers, near <90 mg/dL fasting, and <120 mg/dL postprandial. If one can pull that off, that's great. I do it all the time, and I shoot for it... But it's really not something that is ideal for everyone, nor should we expect everyone to easily overcome what we can. We are not all the same. And in fact, the likelihood for complications is also, very strongly determined by genetics. One can have great control, AND STILL GET COMPLICATIONS! So, if someone worked super hard to attain control (out of sheer fear), and they still got complications... what kind of setup for disappointment are we creating? Nothing is truly a guarantee. We do the best we can, and it doesn't really help to overfocus on the axe in the ceiling. 

So here, you get people who may be well intentioned, and caring, and wanting to help others achieve control, pushing things like raw dieting, alkaline dieting, paleo dieting, and Atkins or Bernstein dieting, etc. This is not a basic truth a person with diabetes needs to learn. One's chosen diet plan is NOT a basic truth a person with diabetes needs to learn. 

Persons with diabetes need to learn: 

  • What diabetes is -- a condition in which the body can't use glucose adequately, because the pancreas has either stopped producing enough insulin (which can be fatal), or has lost sensitivity to it (or sometimes both); 
  • What glucose is -- a type of sugar in which our bodies convert food, to use as fuel for energy. It is NOT the same as table sugar, nor is it exclusively derived from sweets. The body converts ALL foods we eat, from one degree to another, into glucose. 90-100% of carbohydrates, 50% of proteins, and around 10% of fats get converted into glucose. Table sugar and sweets are just another carbohydrate;
  • What a glucose meter is -- a tool which allows us to measure our blood glucose, and how it is affected by the foods we eat (mostly the carbohydrates we eat), exercise, illness, medication, stress, temperature changes, hormonal changes, etc; 
  • What carbohydrate counting is -- a total, daily, number of carbohydrates we allow ourselves in our diets, in order to control blood glucose levels. We can adjust it in our meals (cut back on it, or add more) based on our glucose meter readings, and divide them up through the day, between three meals, and snacks. We are the most insulin resistant in the mornings, and the most receptive in the afternoons; 
  • What insulin is -- a hormone, which under normal circumstances, is produced by the body in order to help the body's cells and muscle tissues uptake glucose. Insulin takes up glucose found in our blood streams and uses some for immediate energy use, some for energy reserves (like when we need to wake up in the mornings), and some for storing as fat, etc. Insulin itself does not make one gain weight; overeating, and particularly overeating too many carbohydrates, can make one gain weight, because they a.) put too much glucose in the system, and in persons with type 2 diabetes, b.) may lead to too much insulin in the bloodstream;
  • What insulin resistance is -- insulin resistance is a condition in which the body's cells are not able to bind with insulin, effectively, which would have allowed the entrance of glucose into cells for energy use. The body then finds itself with excess glucose floating around, so then the pancreas produces more insulin to try to take care of the matter. If the excess glucose is not taken care of, again, the pancreas will keep producing insulin. This creates a condition known as hyperinsulinemia -- or excess insulin in the blood stream, which can lead to weight gain, as a lot of that excess insulin tries to manage the situation best by storing that excess glucose as fat. One of insulin's functions as a hormone is to store glucose as fat, for potential energy stores. 
  • What the treatment alternatives are -- which can run the gamut from diet and exercise, to diet and exercise + oral medications, to diet and exercise + oral medications + insulin, to diet and exercise + insulin... but ALWAYS diet and exercise is a requirement for ALL types of diabetics. No exceptions. 

Note -- insulin deficiency doesn't just make one
'lacking in energy,' it can also make one dead. It is a 
serious condition, not to be taken lightly.

If a person KNOWS how all of these work, then they can decide what to eat. They don't need an extreme diet, "diabetic cookbook," or really, anything else. One counts carbohydrates, one tests pre and post prandially, and one learns from those measurements. "Oh, no! It looks like that plate of whole wheat pasta was NOT a good choice. Maybe I ought to cut back to 1 cup, and maybe add some broccoli, and some chicken on the side... or maybe I ought not eat any pasta, at all." Learning is what we do here. We are little scientists of our own planet. We colonize our OWN planets when we have information. 

There are dangers when we tell other people what to eat, or get them to lower their glucose levels too quickly... it can sometimes lead to ketoacidosis, people often have heart conditions, allergies, particular health conditions, genetic high cholesterol issues, other dietetic restrictions they may need to follow in order to manage OTHER conditions... or they might simply be a growing kid, etc. It's truly not up to us to tell people how to eat -- only to give them the basic information so that they can make an informed choice. Honestly, that's a hell of a lot more than most doctors do, right now, for type 2 diabetics. 

We blame type 2 diabetics a lot for not taking care of themselves, but we should be blaming many of those people's doctors, instead. If I blindly trusted my doctor, I'd be in no better position than most folks I know... who think they can just pop a pill, and forget about it. 

But... unfortunately, a lot of people live this way. "Pop a pill, or take insulin, and forget about it." 

Laxed Control

Some folks take on the attitude that it doesn't matter... That because nothing is guaranteed, then nothing matters, at all, so... "please stop showing me that I can get complications, because then why should I bother taking care of myself?" It can become quite hard to educate whoever might be new to the disease. And educate we MUST. We cannot avoid these parts of the disease education. 

Diabetes is hard, but maybe we can become a bit self entitled, or spoiled, sometimes? Some persons have real critical conditions -- with no real hope of avoiding some awful things -- yet they still care for themselves. They do so because LIFE MATTERS; our families, and our loved ones MATTER... WE matter... and it's better to be informed, then to be caught off guard. Life just happens to all of us... and that's no reason to live in fear. In fact, I find it helps me live in peace. It just is what it is. Not to be morbid here, but do we honestly know of anyone who, barring some accidental event, is not going to get sick and die? It's just life.

I've also known persons with diabetes who have literally advised others to not bother taking care of themselves because they have spent all their teenage years being a 'bad diabetic,' and now they have none, or minimal complications, to show for it... so that people should have nothing to worry about. I kid you not. People who have advised others "Oh, I was pregnant and had horribly high A1Cs of like 13% or higher, and all my kids were born healthy, so don't worry about it." That is the height of irresponsibility. One person's GENETIC LUCK is not another person's health regime.

That doesn't stop there... it's the same culture who encourages parents to keep kids at A1Cs of 8% or higher, for no real reason. The reasons are mostly a whine -- assumptions of kids rebelling, some references to kid's biology being different which I have never seen any proof for, and wanting kids to be like everyone else. 

Listen, don't get me wrong... everyone has the right to pick their A1C goals as they see fit. It's hard for me to comment on many of these issues because I don't have any kids... I don't really have a place of 'emotional authority' in order to appease most people, so that I can give my two cents. But... from what I know about childhood, and coming into one's own adulthood, learning moderation, and learning the discipline to control things like finances, cleanliness, diet, exercise, and emotions happens in childhood. Chronic illness would also fall under that. Obviously, not all children are the same... and some might have some real challenges at keeping a lowered A1C, but truthfully, those are potentially dangerous levels, with some real potential complications. If it's not a paramount necessity to risk it, why do so? Doctors tend to keep kids at high A1Cs, when the circumstances don't call for it, for the same reason they tend to keep type 2 diabetics from access to insulin, when the circumstances DO call for it -- FEAR OF LIABILITY. Fear that people are not smart enough to manage their own kids, without killing them with lows, or manage themselves, and lead healthy lives. There are plenty of kids with A1Cs at the 6% range, and doing just fine. Also, plenty of type 2 diabetics using insulin, and doing just fine. 

To be honest, I don't trust anyone's judgement very much, but my own, with this disease, and my own research. I don't. So I respect when people use their OWN judgement, too. But -- they must have ALL the right information to make those judgement calls. And a doctor really needs to prove more to me, than his diploma, to gain my trust. Doctors are just archaic, more often than not, when it comes to diabetic care and knowledge. It's an embarrassment. Don't take my word for it... ask the average person with type 2 diabetes, on the street, or anywhere, what diabetes is, what drives glucose numbers up, and what carbohydrates are... and they WON'T KNOW. They won't know, and they'll somehow think they don't need to test, because some doctor or nurse will have told them it wasn't necessary. Seriously! "Just take a pill..." The IDF has called for persons with diabetes to TEST post meal numbers, as an imperative, to good control... and yet doctors and nurses are telling patients it doesn't matter.

Sometimes... people get burnt out, and I understand that. We all can get burnt out. But there are folks who just don't want to hear about control, AT ALL, nor for people in groups with a goal for education, to teach about the real consequences of diabetes, and the potential dangers of glucose mismanagement... And we just can't educate well, that way. 

This IS a chronic health condition. This CAN kill you. This isn't a toe fungus. I'm sorry that it isn't! I wish I could just treat it with some Lamisil, and have it GO THE FUCK AWAY! But diabetes, not type 1 nor type 2, doesn't have a cure. The ugly little critter is just not going to go away, even if I do keep him well confined, and restricted.

These are things we need to impress upon people, sometimes. No, not oversaturate them constantly with it... but with the realities of living with it. Honestly, I just don't know how to candy coat complications, and death. Especially when I had to live through them, with my own father. I guess I'd rather offend many of you with some talk about complications, and the risk of death, then to have you live through what I had to live through. 


So, when it comes to diabetes sharing, and education... I guess what I'm saying is this: a spoonful of sugar makes the medicine go down, but please, do take your medicine.

Give people balanced information, and give them the basics. People will learn what they need to do, and take a hold of their own lives. Some people will never learn, and we can't berate them -- they are responsible for their OWN lives. But, we can't hammer on again and again, with negative data... like alarmist conspiracy theorists. That's what Doctor Mercola does, and I hate that asshole. 

Also, let's not settle for living like an ostrich, with our heads in the sand against the storms of reality. The negative data is there, and we must somehow learn from it, make sense of it, and help ourselves find a meaningful, balanced place, where we embrace our lives with diabetes. If I get a complication, c'est la vie. I'll spray paint my mandatory diabetic shoes in neon, hot pink. 

Diabetes can suck it. 

Friday, February 8, 2013

The Moldy Cupcake Awards: Yahoo! Shine Alarmist Crap

Copyright © 2010 Julie Kin
/ Gleeful Things. All Rights Reserved.

*Re-edited* Now with 30% more gripe. 

So, today, a new diabetes alarmist article is making it's rounds on Yahoo! Shine, earning it a Moldy Cupcake Award. The article makes some tremendously sweeping generalizations, about some supposed research from France, showing that diet soda causes diabetes, and that high consumption of sugar causes diabetes.

#1 Where is the link for this research? I'd like to read it for myself, thank you. I don't need someone else interpreting it for me. As readers, and advocates, we deserve to be able to double check your sources.

#2. Sugar, nor high consumption of sugar, causes diabetes. It never has, and it never will. One has to have a genetic predisposition, and weight gain, to perhaps trigger the illness, but no consumption of any specific foods causes diabetes. Sugar is no different than any other carbohydrate. High fructose corn syrup, however, is a different matter. Why don't you do us all a favor, and tackle that, for a change?

#3. "Furthermore, aspartame, one of the main artificial sweeteners used today, causes an increase in glycaemia and consequently a rise in the insulin level in comparison to that produced by sucrose." WHERE ARE YOUR SOURCES? Aspartame DOES NOT raise blood glucose. Honestly, I don't know how you dare report that. That is irresponsible journalism. Aspartame does NOT raise blood glucose. It has no calories, and no nutritional value like sugar -- it does NOT raise blood glucose. Some of us who already have diabetes would be in a lot of trouble if it did. Where's your evidence? You have NONE.

#4. The only thing diet sodas have been LOOSELY shown to do is increase the craving for sweet things, in some people, who then go on to overeat, and then could go on to gain a lot of weight -- which if they have the genetic predisposition for getting diabetes -- could lead them to develop the disease. This is not extensive research, nor is it unequivocal. So no. It is an extreme grasping at straws to say that diet soda causes weight gain, much less diabetes. Don't believe me? Ask WebMD!

#5 Why not report on how overconsumption of soda (diet or otherwise) can cause a person to not give its body enough of the proper hydration it needs? How it might make the body 'swell' from dehydration, if one gets severely dehydrated? Oh, here's an idea, why not instead promote moderation??? You fail to see, Yahoo! Shine, that people who are diagnosed with such a life altering, and deadly disease, as diabetes, need transitional foods, and foods that given them a semblance of normalcy. Why? BECAUSE IT IS DAMN HARD, THAT'S WHY! Don't like soda, don't drink it. But don't LIE about it to get readership.

#6 "Type 2 diabetes—which can be controlled by diet and exercise rather than a daily insulin injection ... " Why can't you people ever, at least, talk to a doctor, advocate, or some expert when it comes to describing diabetes?  Do you now how simplistic, and moronic, this statement is??? Type 2 diabetes is NOT the same for every individual, and if they are on insulin, it is often NOT because they don't want to follow a good diet and exercise regimen. For many, many people, diet and exercise, alone, are NOT an option! Diabetes is a progressive condition in which treatments often need to be altered or changed, in order to keep up with a failing pancreas... and that includes insulin! And newsflash, I wish it were just one simple daily insulin injection! Obviously, you don't really know much about how a pancreas works, and the amount of insulin (basal, and bolus) that a body needs. No, no, but that's okay. Don't let your ignorance hit you in the ass on your way to misinforming people.

Cite your sources, or don't write an article at all. PROOF, or it didn't happen. 

Oh, and one more thing... if aspartame is good enough for Joslin, it's good enough for me. So when it comes to diabetes, SHUT UP, Yahoo! Shine. You don't know jack. Don't make things worse for persons with diabetes than they already are. Shame on you.