How do you come to terms with the changes you need to make to manage Type 2 diabetes? For the most part, we’re older, with jobs and families and habits galore. If you’re like me, you’ll go through several styles before finding the one that fits you while still allowing you to maintain as much control as diabetes lets you. (You see, diabetes doesn’t like to play nice.)
When I selected my emerald in Colombia earlier this year, I chose a rough cut. It hasn’t been cut and polished and fit into a premanufactured setting. Instead, it was allowed to maintain its natural shape and the setting was fit around the stone. I chose it because I don’t want to have something everybody else has. However, while looking at it recently, it seemed to fit my way of looking at diabetes: Don’t stuff me into a box (or prongs or bezels); teach me how to run free.
My fasting level was 311 mg/dl when I was diagnosed on January 2, 1986. The only education I got was: “Here. Follow this. Don’t eat any sugar.” And I was given a piece of paper with the American Diabetes Association’s exchange diet on it. Diabetes education? What was that?
For those of you who are unfamiliar with it, you ate a set amount of meat, fat, vegetables, fruit, dairy, and grains per meal. Portion sizes were listed under each category, and you could substitute this amount of, say, peas, for that amount of carrots, etc. Also, as I recall, it was a pretty bland diet. There was absolutely no nod to different ethnicities, religious practices, or anything like that. Heck, I couldn’t even figure out how to make an everyday casserole from that darned piece of paper, much less whomp up a batch of tzimmes. And when Passover came along and I couldn’t even find anybody who knew what a matzoh was, much less how much equaled a slice of bread…I gave up.
Oh. Did I tell you about my job? It wasn’t exactly conducive to carefully thought-out meals. It was more grab-and-go whenever you could. I was a reporter and then night city editor for a daily newspaper. Meals tended to be interrupted by things like murders, fires, earthquakes… Stuff like that. Schedules? You could make all you wanted, but they usually fell apart.
So I ignored diabetes for nine years or so. The problem with diabetes is, it doesn’t ignore you. I had a recurring yeast infection for three years, but didn’t know enough about diabetes to know that running consistently high blood glucose contributed to that. I was told to check my glucose, but — still not sent for education — didn’t have a clue what my glucose was supposed to be. I couldn’t drink enough water. I couldn’t stay out of the bathroom. I couldn’t stay awake and was afraid to drive very far.
Why didn’t I go to the doctor? I at least knew that insatiable thirst and frequent urination was connected with diabetes. Simply, I didn’t want somebody to hand me that dreaded piece of paper.
Came the day when the mayor (I was then working for the city) told my assistant to take me to the emergency room. There, I gave myself my first insulin injection. At that point, I later found out, my HbA1c was 17.4%. (I believe they have different charts now that don’t go that high.)
I started taking insulin, but my doctor didn’t quite know what to do. A friend recommended an endocrinologist. She promised they wouldn’t give me a piece of paper with a diet on it, so I went.
Wow! The office had certified diabetes educators (CDEs)! I saw a nurse educator and a registered dietitian (RD). Not only did I begin learning about diabetes, but the RD, CDE was asking me questions like what did I like to eat? What brands? When did I eat? She worked with me to develop a meal plan I could live with.
The plan was based on two injections a day of NPH and Regular insulin — which is what was available at the time. I had three meals and three snacks, of a set amount of carbohydrates, at particular times, based on insulin peaks.
“I can do this for the rest of my life!” I told myself. “Everybody should eat like this!” And I set forth to convince my friends with diabetes that I’d found the Holy Grail and they should all jump on the bandwagon and ride it with me into everlasting diabetic euglycemia.
Luckily, my friends listened, smiled, did what they wanted, and remained my friends.
Did it last? Well, there was the day I went slamming into the bedroom, threw myself on the bed and began crying, “I can’t do this any more!” And there was the dinner out when I decided to finally order a dish I’d been looking at for some time and (after the server left and I’d taken my insulin) my husband said, “Jan, your diab…” After which I wasn’t hungry, but had to eat, and did so with tears running down my face.
Needless to say, even without the dreaded piece of paper, lack of flexibility in carb counts and timing of meals and snacks weren’t my thing.
Next step? Multiple injections and a loosened schedule made easier by the release of rapid-acting insulin. Although I did get the usual, “but you’re a Type 2 in good control,” from my endocrinologist. (So what? I wanted my freedom! Why don’t people with a functioning metabolism understand that?)
Finally, the ultimate freedom: an Achilles tendon fiasco. Now exercise is kind of contained to moving back and forth from my scooter to chairs, my kitchen stool, the toilet and bed, and boogying in my chair. A friend told me about recumbent tricycles, which I still need to check out to see if I can get in and out of one.
I feel like I have freedom now while still taking care of diabetes. I’m not perfect — far from it. But I’ve learned that, when I stumble, the best thing to do is pick myself up and get back with the program.
If you want more freedom, more flexibility, there may be a way. Find a good CDE and see what you can work out. My belief is that you’re more likely to maintain decent control most of the time if you have a diabetes regimen that fits your style.
Tuesday, 3 July 2012
Stylin’ the Diabetes Way
Diabetes, Exercise and Empowerment - The Big Blue
"One of the most important lessons I learned and often have to remind myself regularly over the years is the importance of exercise in keeping diabetes nice. For reasons that I’m sure a medical practitioner can better explain than me, exercise is one of the major ingredients in keeping both you and your
diabetes nice and SANE! ”
Be Inspired - What a great scheme
HBA1C its not as easy as 1,2,3
"Like any measurement, its information provided that you can use or ignore. The actions that occur next are entirely up to you. For me, I like to use it a benchmark to make sure that I’m on the right track."
<a href="http://www.nicediabetes.com/nice-diabetes/nice-diabetes-hba1c-or-in-english-how-is-your-diabetes-travelling">survive diabetes</a> Want more...Sunday, 1 July 2012
Nice Diabetes - Cinnamon and Type 2
Reports about the possible benefits of cinnamon for people who have type 2 diabetes have been circulating for years, and not all of them have been positive. A new study from China, however, bears some sweet news and lends support to the research on the positive side of the issue.
What benefit is cinnamon in type 2 diabetes?
A research team from Shanghai Institutes for Biological Sciences, led by Yan Chen, set out to determine if supplements of cinnamon extract could help control blood sugar (glucose) and triglycerides in people with type 2 diabetes. The investigators used a water extract of cinnamon rather than whole or ground cinnamon.
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The randomized, double-blind, placebo-controlled study involved 66 individuals with type 2 diabetes who were assigned to one of three groups: placebo, 120 mg of cinnamon supplement daily, or 360 mg daily for three months. All the participants were also taking the antidiabetic drug gliclazide, a sulfonylurea like glipizide and glyburide.
After three months, fasting blood glucose levels were significantly lower in patients who took cinnamon: an average of 1.01 mmol/L in the low-dose group and 1.62 mmol/L in the high-dose group. No change was observed in the placebo group.
Triglyceride levels also were significantly lower in the low-dose group by an average of 0.78 mmol/L, but only slightly lower in the high-dose group.
Based on their findings, the researchers proposed "that cinnamon be considered a promising supplement for the therapy of type 2 diabetes when hyperglycemia cannot be satisfactorily controlled by other strategies such as diet, exercise, and prescribed medication."
They also noted that "the effect of cinnamon on blood glucose control is likely dependent on the form of cinnamon used for the patients," and that the "different extraction methods might affect the efficacy of cinnamon." Some studies, however, have seen good results with other forms of cinnamon.
Other studies of cinnamon in type 2 diabetes
A meta-analysis conducted at the University of California-Davis included eight clinical studies of the impact of whole cinnamon and cinnamon extract on people with type 2 diabetes or prediabetes. The authors reported that both types of cinnamon use resulted in a statistically significant decline in fasting blood glucose.In a more recent meta-analysis, this one from the University of West London, investigators examined the impact of cinnamon on glycemic control in patients with type 2 diabetes. Six randomized controlled trials with a total of 435 patients were considered.
Overall, the reviewers found that use of cinnamon resulted in a significant decrease in mean hemoglobin A1c and mean fasting plasma glucose. They concluded that cinnamon had a good effect on glycemic control and that the short-term effects looked "promising."
As always, more research is needed to better determine the role of cinnamon in managing this growing epidemic. The most recent study provides some sweet news for individuals with type 2 diabetes who are looking for natural ways, like cinnamon, to help them with this task.
SOURCES:
Akilen R et al. Cinnamon in glycaemic control: systematic review and meta analysis. Clinical Nutrition 2012 May 12
Davis PA, Yokoyama W. Cinnamon intake lowers fasting blood glucose: meta-analysis. Journal of Medicinal Food 2011 Sep; 14(9): 884-89
Lu T et al. Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes. Nutrition Research 2012 June published online. DOI: 10.1016/j.nutres.2012.05.003Image: Morguefile
On a recent trip to Sir Lanka, the cinnamon growers were also saying its beneficial for Type 1s
Nice Diabetes - The Video
Sometimes its the small things that help keep our diabetes nice
Thursday, 28 June 2012
The Way I Am
My 16-year-old son and I spent the day together recently and decided to head out for burgers at lunchtime. Sitting in a rather exposed booth at a restaurant, we chatted and began eating. I wasn't really thinking about anything, just enjoying the rare moment of hanging out with my sweet son, when he remarked, "I'd feel so awkward if I had to do that." I asked him what he meant and actually looked around to see what he was talking about. Then it hit me, as he mimed taking an injection and said, "Having to take shots in front of random people all the time." Moments before, I had taken a shot in my hip, capped my syringe, and popped it back into my handbag without even thinking about it. After 18 years of shots, it's practically instinct for me.
I know he meant it with a good heart. He wasn't embarrassed by me, but, rather, worried about how he'd feel if he had diabetes. I explained to him that I used to feel so awkward about taking my shots that I would literally hide from people to do it. But eventually I realized that I had done nothing wrong and that I am not ashamed of having diabetes. I also told him that diabetes is a part of me and will be forever. "It's the way I am," I said. He nodded and returned to talking about a school friend of his as we finished our burgers.
Still, his comment made me wonder about how other people in my family feel about my shots. I decided to ask for complete and utter honesty from my husband. My question to him was "How do you feel for me when we are out in public and I take a shot?" My husband told me that he doesn't think anything about it. "It's just a part of who you are," he told me. "You have green eyes and diabetes." When I pressed him about how he felt when he first met me, he said, "The only time I felt weird was when we were on our first date and I tried pushing you to have some of the super-sugary coffee drink I was having. When you said you had diabetes, I regretted having pressured you. Now I know better, and I don't think about it at all." It makes me happy to know that he looks at diabetes as just another part of me, like my eye color, and not at all like I have something wrong with me.
When I was 18, I never would have taken a shot in front of other people. I was mortified that I was different. Today I feel a sense of strength when I take my shots. I know that I'm different, but honestly, different isn't always a bad thing. We are different in that we need to be brave and strong each and every day, with no breaks. I still remember those early days of trying to fit in with the other teens, but now that I'm all grown up, I think that being ordinary is highly overrated.
Tuesday, 26 June 2012
The importance of diabetes and exercise
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