My Fall From Grace

MDminute Diabetes  2006

Saving Sight

One day in the not-too-distant future, there may be a drug that can prevent some of the complications of diabetes. When someone has diabetes, cells in the lining of blood vessels in the retina and kidney become saturated with glucose. Excessive burning of this glucose activates a cascade of reactions that ultimately lead to vision problems as well as kidney and nerve disease. Now researchers at the JDRF International Center for Diabetic Complications at Albert Einstein College of Medicine in New York City are testing ways to block such glucose-related damage. Michael Brownlee, M.D., director of the center, is heading a clinical study of benfotiamine, a synthetic derivative of thiamine (vitamin B1). The researchers had positive results in animal studies: In the journal Nature Medicine they report that retinas of long-term diabetic rats treated with benfotiamine remained normal, while retinas of untreated diabetic rats developed vascular damage. Dr. Brownlee says he is reasonably confident that benfotiamine will prove to be safe: “Benfotiamine has been used extensively in Germany for many years, and to my knowledge there are no reported negative side effects.”

Preserving Memory

Low blood sugar incidents can damage brain cells. Now researchers at the San Francisco Veterans Affairs Medical Center and the University of California, San Francisco, are evaluating a naturally occurring by-product of glucose—pyruvate. The quest: to determine whether pyruvate can help prevent hypoglycemic-related memory and learning problems.

In animal studies, the results were quite promising. When pyruvate was given along with glucose at the time of a blood sugar crash, it provided an important safeguard against brain cell damage. The hope is that it will have the same effect in humans. Related Links
Reversing Nerve Damage
All the Nerve

I read this in Diabetes Forecast the other day and just had to let you all read it.

1. We are a family. Thanks to the guy on the neighboring bench in Estes Park, Colorado, who saw me testing during a big low and said, pointing to his young daughter and himself, “We are diabetic , too!” It feels good to know others are out there.

2.We can gross out squeamish people. I have no sympathy for those who don’t like to watch me test. Too bad for you. Just be grateful you don’t have to do it. It’s easier for you to turn your head or close your eyes than it is for me to manage my blood sugar, so my needs trump yours.

3.We know a lot about nutrition. Not that we always make the best choices, but we sure know a lot about what’s good for fueling our bodies.

4.We know what’s important. Even with excellent self-care and a good medical team, the specter of complications looms. So maybe this makes each moment we enjoy a little more special.

5. We understand not being Perfect. I don’t know about you, but I’d never park in a handicap parking spot if I didn’t need one. Ever.

6. We have power. With other diseases the doctor decides treatment. With This disease, treatment is in our hands.

7. We are strong. A regimen of constant blood sugar checks, careful selection of food, battles with insurance, etc., etc., strengthens character

8. We have a sense of humor. Most days.

9. We want to help others. I’ve never met a selfish diabetic.

10.We are so much more than our disease. Wife, mother, daughter, friend, editor, type 1: I’m proud to be me, whether I’m happy with my latest A1C result or not .

Not much left to say but “RIGHT ON!!!!!!!!!!!!!!!” (Hey I grew up in the 70’s)

Maybe you have a top 10???

Top 10 list Written by Editor of Diabetes Forecast April/May

By Kalia Doner
Diabetes Focus First Quarter 2007 Repeat one more time: “Preventing diabetes is a team effort!” Here’s who can lend a hand—and proof that lifestyle changes work.

Changing the habits of a lifetime is difficult; for people with prediabetes, glucose intolerance or metabolic syndrome who are told to make radical adjustments in their diet and level of physical activity, it can seem almost impossible. Well, it’s time to ask for help. That help might come from a doctor, diabetes educator, nutritionist and/or diabetes nurse practitioner.

The Finnish Diabetes Prevention Study let researchers in Finland look at the health of participants over many years. They found that when people had ongoing counseling about how to eat right, exercise and make other lifestyle changes, the frequency at which they went from glucose intolerance to diabetes was cut by an amazing 43 percent. Reporting their results in The Lancet, the researchers noted that once counseling stopped, the group that had received the support kept a 36 percent reduction in their risk of developing diabetes.

Complementing these findings, an article in Diabetes Care looked at results from the Diabetes Prevention Program and singled out weight loss as the lifestyle change most effective in preventing diabetes. For every kilogram (about 2.2 pounds) of weight that a study participant lost, his or her chance of developing diabetes was cut by 16 percent. Even among those who didn’t reach their weight-loss goals, cranking up their level of physical activity to meet the program’s standards cut the risk for diabetes by as much as 44 percent.

Strategies to Fight Nerve Pain MediZine’s Healthy Living Third Quarter 2006 If you’re one of the 10.5 million Americans with diabetes-related peripheral neuropathy (nerve damage), you may have had only limited success in vanquishing the pain. Now there are formal guidelines for diagnosis and management, and two medications, duloxetine and pregabalin, to treat the discomfort.

“In the past, doctors may not have made the connection between pain complaints and diabetes,” says B. Elliot Cole, M.D., M.P.A., executive director of the American Society of Pain Educators. “Now patients can expect physicians to be more sensitive to the fact that nerve damage can lead to painful conditions; patients can expect better diagnoses and more coherent care for their pain.”

Nothing is better for pain prevention than controlling the underlying cause. So, check your blood sugar regularly and keep it close to normal; follow a low-glycemic diet; exercise; care for your feet and wounds properly; and report tingles, aches and pains to your doctor.

By John McIntosh
Diabetes Focus 

True or false?

Up to 90 percent of people who have surgery on peripheral nerves that have been damaged by chronically high blood sugar levels regain sensation and become pain free.

TRUE! And the reasons are as simple as A, B, C:

A. Diabetic neuropathy occurs when chronic high blood sugar causes damage—such as swelling and stiffness—in the peripheral nerves that are typically located in the hands and feet. This results in pain, a decrease in motor skills, numbness and even paralysis.

B. Peripheral nerves—the nerves that branch out from the central nervous system of the brain and spine into the arms and legs—can be repaired. These nerves have the ability to recover from injury.

C. By using a technique called decompression surgery, doctors are able to reduce pressure on peripheral nerves in the extremities, alleviating a great amount of physical discomfort.

Curing Neuropathy with Surgery

“What has been shown,” says Michael Rose, M.D., a board-certified plastic and reconstructive surgeon and partner at the Plastic Surgery Center in Shrewsbury, NJ, “is that once you release the pressure on a peripheral nerve, a significant amount of regeneration happens. That is starkly different from the central nerves of the spine. The nerves of the peripheral nervous system regenerate all the time.”

Until recently, Dr. Rose didn’t think it was possible to treat any kind of diabetes-related nerve damage surgically. But about three years ago he accidentally fixed a patient’s neuropathy when he operated on one of her nerves. After she got better, he looked into the phenomenon. He found a doctor who had been successfully treating neuropathy with surgery for about 15 years—A. Lee Dellon, M.D., professor of plastic surgery and neurosurgery at Johns Hopkins University in Baltimore and director of the Dellon Institutes for Peripheral Nerve Surgery.

“Dr. Dellon is responsible for figuring out all of this,” says Dr. Rose. “He identified these tunnels in the arms and legs where pressure develops, and he was able to relieve symptoms of diabetic neuropathy. He expanded our understanding of nerve entrapment syndromes.”

So Dr. Rose called Dr. Dellon and went to his clinic. There he was able to learn Dr. Dellon’s techniques. “Now I lecture at his annual scientific meeting and am slated to assist him with the courses that he teaches for other surgeons,” says Dr. Rose. “Our whole thing is that we have seen people turn their lives around after having this surgery, and we are trying very hard to get the word out.”

Dr. Rose has done over 100 of these procedures, and he says Dr. Dellon has done nearly 1,000. Currently there are approximately 200 doctors in the United States who perform this surgery.

The Procedure

Decompression surgery is a procedure that relieves pressure on the peripheral nerves as they pass through three different passageways or tunnels on their way to each extremity.

The procedure is probably best explained by using as an example the tunnel that most people are familiar with: the carpal tunnel. It is found in the palm of the hand and is the tunnel through which the peripheral nerve passes as it extends from the forearm to the wrist and into the hand. High glucose levels may cause that nerve to swell and stiffen, which in turn causes pressure inside the carpal tunnel.

Dr. Dellon found that opening up the tunnel alleviates pressure on the nerve, and sensation in the hands, as well as range of motion, can be restored. “The surgery is relatively straightforward,” says Dr. Rose. “It takes about an hour and fifteen minutes. It’s done on an outpatient basis and can be done under either local or general anesthesia.

“Essentially what we do is open up the skin at the different compression points in order to get to the tunnels where a nerve is sandwiched between a ligament and a bone. We cut away the roof of the tunnel, releasing the swollen, damaged nerve. The nerve has room to ‘breathe’ and is no longer compressed.”

Well today we did it! We donned our sweat suits, socks and beach shoes , backed up, hitched up and hit the boat ramp for the first day of boating season.  There was a slight wind, clouds and a hint of rain,but this did not dampen our spirit. As usual  that first time the  propeller hits the water you hold your breath hoping that all will go as planned.  There are quit a few things that can happen on the first day.  Anything from broken water pumps to stopped up lines to fouled plugs can cause failure to launch.  But then that engine fires, the prop turns and smiles light up, the dog barks and you are off.  Flying across the water leaving your wake for those behind to deal with.  it is at this time that you know the long cold winter is gone and there will be sun and wind and days on the water, sun burns, burnt hot dogs,and a renewed sense of well being.  The world around is waking to a new season, and all you can say to this is “AAhhhhh!”

“Today in the U.S. a typical doctor’s visit lasts between seven and nine minutes. That’s it. In order to make the most of that time there are a few things that the patient needs to know and be prepared for ahead of time,” says Ian Blumer, M.D., author of What Your Doctor Really Thinks: Diagnosing the Doctor—Patient Relationship.

Here are three of the most important steps to take to make sure your doctor knows what’s important about you-and you know and understand vital information about your health.

1. Make a list and check it twice.

For you:
Write out a list of questions that you want to ask. And consider bringing someone else with you to the appointment so that if you don’t remember something, they can remind you.

For the doctor:
If you are on medication, take your drugs with you so the doctor can see the labels.

For you:
Insist on knowing your numbers for blood pressure, cholesterol and other blood fats (have the doctor break them down into HDL, LDL and triglycerides). Then write them down and date them so you can track your changes over time. And then find out what your optimal target should be, how far off you are and what to do about it.

2. Wear the right clothes for an exam.

For you and the doctor:
Wear clothing that facilitates getting blood pressure checked. “Most people go to the doctor and don’t consider whether or not clothing makes a difference,” says Dr. Blumer. “Since most visits to a primary care doc are so short, a lot of things get rushed. Wear a short-sleeve shirt so you’re more likely to get your blood pressure checked. You can also have feet checked. So take off your shoes and socks. (Women shouldn’t wear panty hose.) Checking feet is important if you have diabetes and because between the toes is a prime place for skin cancer to appear—and be overlooked!

3. Let your doctor know you are engaged in keeping yourself healthy.

For you and the doctor:
Take time to educate yourself about the basics of staying healthy: Given your age, height and gender, you should know what your ideal weight, your ideal blood pressure, glucose levels and cholesterol are. Then ask how you can work with your doctor to achieve those target numbers. “Some people worry that your doctor might feel offended if you’re asking things like that,” acknowledges Dr. Blumer. “But to be honest, the great majority of doctors are thrilled to have people work with them to achieve optimal health.”

 By Natasha Persaud
June 8, 2006.

1. Get Motorin

Produce your own horsepower whenever possible by getting out of the car and walking. It may take extra time and effort to do an errand or go to work, but you get the time back by living longer! Brisk walking dramatically improves longevity, say scientists who reviewed data from the Centers for Disease Control and Prevention’s National Health Interview Survey. People with diabetes who walked for at least two hours weekly had a 39 percent lower overall death rate compared to those who did not walk, and a 34 percent lower death rate from heart disease. Among those who walked between three and four hours a week, the benefit was even higher: a 53 percent lower death rate from cardiovascular disease. And there’s no need to go overboard: Walking longer didn’t result in further benefit.

2. Rake It In

Head outdoors to plant flowers and do yard work and you’ll reduce your blood pressure—a common and serious health problem for people with diabetes. (Having both hypertension and diabetes doubles the risk of serious cardiovascular disease such as heart attack and stroke. And it contributes to the development of diabetic kidney and eye diseases.) A recent study in Medicine & Science in Sports and Exercise found that people with prehypertension or hypertension who kept busy for around four hours a day doing everything from yard work to bicycling, cleaning the house—they even counted climbing the stairs—lowered their blood pressure for an extra six to eight hours. The most beneficial activities are moderate-intensity and require you to use several parts of your body. Try to keep busy for at least 30 to 40 minutes a day.

If you have high blood pressure and diabetes, the American Diabetes Association recommends that you get treatment aimed at keeping your blood pressure at 130/80 mm Hg or lower. The same healthy habits that can improve blood sugar—a balanced diet, reduced salt intake and moderate or no alcohol consumption, plus regular exercise—can also help reduce blood pressure.

3. Do-Si-Do

Besides being fun, fast-paced folk dancing can give you a serious workout. In one study of middle-aged women who were obese—obesity is a major risk factor for type 2 diabetes and its complications—folk dancing for 60–90 minutes three times a week produced significant positive changes in body weight, overall body fat, muscle strength, muscle endurance, flexibility and balance. Need further inspiration? Turn on celebrity dance contests on TV, and samba along!

4. Schlep Around

Tote those groceries, carry those boxes. Turn fun into muscle-building: Wander local flea markets, antique or yard sales and search for hot collectibles to take home. Bending and lifting boxes and weighty objects (remember lift with your legs, not your back!!!) provides strength training—a proven way to enhance insulin action in the body. In a Danish study, researchers examined the effects of strength training on leg muscles in individual men, including those with type 2 diabetes. For comparison’s sake, the men strength-trained one leg three times per week for six weeks while the other leg remained untrained. The researchers discovered that strength-training helped insulin move glucose out of the blood and into the body’s cells. The exercise sessions lasted 30 minutes, and involved light weights and a high number of repetitions.

The bottom line? Participate in fun strength-training activities at least three times a week to see benefits. And use both your legs. Consult your doctor about your physical limits first before heading out to hunt.

5. Team Up, Cheer Up

Join a sport like baseball, basketball, tennis, or swimming for fitness and friendship. Several studies indicate that diabetes—particularly when complications are present—doubles the risk of depression. In a vicious cycle, depression makes it harder to take care of your diabetes and that in turn creates metabolic problems that trigger depression. But exercise is an effective way to relieve moderate depression: One study compared those who took antidepressants, who did aerobic exercise, and those who did both medications and exercise. Everyone improved: 68.8 percent of those in the combo group, 60.4 percent of participants in the exercise group and 65.5 percent in the medication group were no longer classified as clinically depressed after treatment. In addition, many studies confirm the role of social interaction and friendship in buffering a person against life’s stresses. Find a sport or group activity that suits your interests and abilities, and play ball!

1. Mix It Up

Varying your exercise routine may help you remain active week after week. So try the tango, the cha-cha or even belly dancing—active dancing burns off at least 325 calories an hour. Ride your bike—good for 350 or so calories an hour—or burn up 286 calories with an hour’s worth of weeding in the garden. Researchers at the University of Florida concluded that people who changed their workout every two weeks over an eight-week period not only enjoyed their exercise more, but were much more likely to stick with it compared to people who did the same form of exercise all the time.

2. Get Carb Smart

Give up some—but not too much—of the bread, pasta, crackers and pizza you usually eat in a month. Let’s figure you have four bagels a month—give up two and save 320–500 calories or more. (The largest deli bagels can weigh in at 500 calories apiece.) Give up two English muffins? Another 300 calories? Cut out 10 slices of white bread—800 calories. Pasta? Eliminate three meals and give up as many as 2,200 calories, counting sauces. You can see how it would help you cut 300 calories a day from your diet without much feeling of sacrifice. But don’t cut out too many carbs: A study in the American Journal of Clinical Nutrition in May 2006 found that people on a diet that restricted carbs to 26 percent of calorie intake saw their good HDL cholesterol levels drop and their bad LDL levels rise, while those who opted for a diet with 54 percent carbs saw a significantly greater drop in bad LDL cholesterol.

3. Step Wisely

Burn 475 calories an hour walking upstairs. If thats a weeks worth of stair climbing, in a month you will burn half a pounds worth of calories. In addition, walk as often as you can at a moderate pace for 30-60 minutes. You will burn stored fat and boost your metabolism. Walking an hour a day has been found to reduce the risk of heart disease, breast cancer, colon cancer, diabetes and stroke. And you will be glad to know that according to a paper presented at the North American Association for the Study of Obesity, people who are trying to lose weight (and are taking in the same amount of calories—in this case 1,200 to 1,500 a day) do as well if they add two miles of walking a day to their schedule as do those who work out at a gym four days a week.

4. Control Portions

If you know how much food you should be eating before you sit down for a meal, you will give yourself a powerful tool for managing calories and achieving weight loss. The USDA Food Pyramid gives recommended serving sizes for most food groups, and packaged foods sold at the supermarket show serving size information on their nutrition labels. Want an easy way to remember appropriate portion sizes? This handy guide from the American Cancer Society  compares food portion sizes to everyday objects:

Normal Portion Sizes

5. Plan to Succeed

It is true in weight loss, as it is in life: When you set specific goals, you are more likely to make progress. So focus on losing weight gradually and keeping if off instead of trying quick fixes that you may not stick with. Follow the NIDDKs (National Institute of Diabetes, Digestive and Kidney Diseases) guidelines for safe weight loss:

Looking at the Food and Drug Administration database of 3,000 Americans who have lost an average of 60 pounds and kept it off for 6 years reveals a lot about what works and what does not. The FDA reports that people who most successfully lose weight and keep it off follow this pattern: They eat a low-fat (24 percent of calories from fat), high-carb diet; they weigh themselves frequently; they are very physically active, exercising for about an hour or more a day; and they eat breakfast.

 Source; Diabetes Digest

Yesterday I went to the doctor for my yearly physical.
My blood pressure was high, my cholesterol was high,
I’d gained some weight, and I didn’t feel so hot.
My doctor said eating right doesn’t have to
be complicated and it would solve my physical
problems. He said just think in colors…

Fill your plate with bright colors… greens,
yellows, reds, etc.
I went right home and ate an
entire bowl of :

And sure enough, I felt better immediately
I never knew eating right could be so easy!

Hope you don’t mind some humor but lately around here things have been a little shaken up some so I thought we needed it.  Thank goodness it is only Earth day and not Earthquake day.