Presenting at IDF World Congress in Vancouver

Screen Shot 2015-11-27 at 10.26.20 AMI’m just about over jet lag having returned from San Francisco for DiabetesMine’s Innovation Summit. It was an enervating day getting meeting some great people and getting caught up on diabetes device usability.

Sunday the husband and I are off to Vancouver for the International Diabetes Federation (IDF) World Congress. IDF is the global advocacy diabetes organization and every two years about 12,000 clinicians, researchers, scientists and others in the diabetes space gather. They’ll also be the notable exhibition hall crammed with current and new products, devices and meds.

This year I am receiving the IDF Lecture Award in recognition of my diabetes education and advocacy. The Award graces me with the opportunity to give a lecture on the topic of my choice. You will find me, should you be there, Tuesday morning in Rm. 119 at 8:30 AM presenting, The Flourishing Approach: A way to treat and live with diabetes that goes beyond coping. Click here for details. I am introducing a different treatment approach for health professionals; in short, to shift their focus from the medical markers of diabetes to also involve patients and foster their strength, resilience, confidence and motivation through various tools.

The next morning Wednesday, also at 8:30 AM also in Rm. 119, the husband and I will be presenting in the Living with Diabetes stream. Our presentation is titled, How living with diabetes helps our relationship grow. We will share how diabetes has gone from mine to  “ours,” strategies we’ve developed for making life with diabetes easier for both of us, and how it has brought us even closer as a couple. Click here for details.

If you’re at the conference please do come to our sessions.

Relaxing, sort of, on World Diabetes Day

Boudewijn RG

I realize just a few years ago I would have made sure I had a post up first thing in the morning on World Diabetes Day. Yet today I’m enjoyingan ordinary Saturday. Well, I must admit I have a cold so maybe I’m not moving as quickly as ordinarily. But, even so, while I am mentally marking this auspicious occasion – WDD honors the birthday of Frederick Banting who helped discover insulin -I’m basically enjoying just being an ordinary person on an ordinary sunny Autumn Saturday.

That said, I do feel I have to say something. So here is what I posted on Facebook this morning:

A friend of mine, Elizabeth Snouffer, also a fellow type 1 and editor of the Internation Diabetes Federation’s (IDF) magazine, Voices, related in a recent article something her beloved endocrinologist had said to her which I soooo took to heart. “The call for people with diabetes to self-manage without failure and achieve near Herculean results is cruelly unparalleled compared to other therapeutic categories in disease management.” Amen And so I believe today all of us with diabetes should honor ourselves for whatever we do to manage this disease, and honor others we know with it.

As for the more World Diabetes Day news, here are the highlights from the new IDF  Atlas:

-Number of people with diabetes has risen to over 400 million for the first time – if diabetes was a country population it would be third after China and India

-Half a million children now live with type 1 diabetes-the exact causes of this complex disease are still unknown (we have experts who can talk about environmental and genetic factors)

-Diabetes deaths total greater than HIV/AIDS, TB and Malaria combined (WHO data used for comparison)

-Gestational diabetes (diabetes onset during pregnancy) now affects one pregnancy in seven. This an increase risk of development of type 2 diabetes in both

-12% of global healthcare budget is being spent on diabetes-this is larger than the US military budget. Total spending will reach 800 billion USD by 2040.

-There are strong links to rising type 2 diabetes rates in regions and countries where income is sky-rocketing alongside other factors such as urbanisation (as seen in the Middle East). IDF anticipates that South America or African countries could be the next diabetes hubs.

-The big opportunity: catching the 300 million people at risk of diabetes– there is still the possibility here to prevent the development of type 2 diabetes and bring blood sugars back to a healthy range through healthier lifestyles.

Zoe’s marathon run looking back

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I wrote about Zoe Heineman (above center) on The Huffington Post and here a few posts ago who ran the NYC marathon November 3rd. Zoe has Type 1 diabetes. It was also the third marathon Zoe has run.

This morning she emailed me with this note which I’m passing on to you:
Hi Riva,

Thank you so much for your well wishes before and message of congrats after the marathon.  I was really pleased with how it went.  As before, I really enjoyed the experience.  It was a beautiful day – so your prayers worked!  I finished with a personal record, despite feeling nauseous for the last few miles.  My blood sugars were on the low end of normal for the entire race even at the end, (65-90 mg/dl) – unusually so consistently low and within range.  I actually took the pump off altogether early on and then just left it off because my blood glucose was staying so low.  My (Achilles) guides were great about helping me test while walking – we never stopped once.  They did to go to the bathroom, but I didn’t and was able to keep moving forward, albeit walking up the steep hils to pace myself and when my blood sugar was in the 60’s.
Most of all I am happy that I felt great, even the next day.  Stiff in the quads but that’s to be expected after a long run anyway.  Tired too, because I slept more than usual the next few days.
Thank you for making the marathon more fun with your article.  I received so many favorable remarks and encouragement because of it.  People really enjoyed reading it.  Brava!

JDRF’s campaign: T1D Looks Like Me

jdrf campaign

This month, Diabetes Month, JDRF is showing all the colors of type 1 diabetes. Well, one color, blue, the universal color for diabetes. But in its many shades – us. All of us who have Type 1 diabetes are the face of type 1 diabetes this month.

Please be part of the awareness raising. It’s oh so simple. Go here to JDRF’s site and download a photo of yourself. Your photo will be processed with a blue tint, as above, and the campaign logo will be added. You can share it on Facebook, Twitter, or any which way you like to share. Hashtag, #T1DLOOKSLIKEME.

As my friend Scott Benner, diabetes dad, said, “Such an easy and wonderful way of putting a face to type 1 …”

NYC Marathon where all are winners

Screen Shot 2015-11-01 at 11.36.03 AMThe New York City marathon is taking place right now. And I’ve just returned from watching, only a few streets from my apartment, the thousands passing through my stretch of Brooklyn. Hordes of runners in bright shirts, people on the curb cheering them on, music playing from small set up bands and apartment windows. And, for the first time I noticed lots of runners in bright chartreuse T-shirts with the name “Achilles Guide” on it.

I learned while interviewing Zoe Heineman for the Huffington Post, who is running today with type 1 diabetes (those are her medals above), that she runs with Achilles guides. They are a group of dedicated athletes who will run with anyone who has a physical or mental challenge. My heart actually swelled as I saw them all running by protecting their assigned athlete.

In our interview you’ll learn Zoe is not just running her third marathon today, but is also a passionate advocate for hypoglycemia awareness.

Fat, Fatter, Fattest – Obesity now in every state

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I keep hearing conflicting reports. Some experts say obesity has plateaued. Some say obesity is declining in kids and teens. Yet the CDC just released stats that obesity now exists in every state of the U.S. In a self-reported study, results show among others:

• No state has less than 20% obesity

• 19 states show obesity at 30%-35%

• Arkansas, Mississippi and West Virginia, always the winners, are the fattest states

• Colorado once again has the least amount of obesity

Just being obese, while uncomfortable and for most people shaming, isn’t a disease in itself. Or is it? There’s a debate going on about that as well. But for a great many people, obesity leads to medical conditions like diabetes, joint problems, sleep apnea, heart attack and more.

If you are trying to lose weight, get in shape or looking to protect your heart, here are a few resources that may help.

Diabetes Meal Plans and Healthy Diet

Heart-healthy diet

Exercise for heart health

How to avoid having a heart attack/quiz

Save your sight and your eyes

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Every year without fail I go to my ophthalmologist, my eye doctor. And every year, along with checks for vision and glaucoma, I get a dilated eye exam. Someone will put a drop of liquid in each of your eyes, you wait 20 minutes for your pupils to get bigger, and then the doctor will take photographs of the back of your eye looking to see if there’s any damage.

High blood sugar can cause the small blood vessels in the back of your eye to burst or leak. This can cause big diabetes eye diseases, like retinopathy or macular edema, not to mention vision problems. But don’t expect vision problems to warn you there’s trouble brewing. Often at the start of a diabetes eye disease you won’t notice anything. So it’s really important for a qualified eye doctor – ophthalmologist or optometrist – to perform a dilated eye exam.

Eye get it. There’s a ton to do if you have diabetes to keep yourself well. But don’t overlook your eyes. The non profit organization,, has a great site for eye education. I pulled this photo above from one of their fun and thorough educational presentations.

You owe it to yourself to invest a few minutes to learn about taking care of your eyes and eye health. Then make an appointment with an eye specialist if you haven’t seen one in more than a year and request a dilated eye exam.

I made a little eye video myself for dLife earlier this year – look after your eyes.

The Big Blue Test is here again!

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Take the test you can’t fail. Get moving for 14 minutes – walking, gardening, skating, biking, dancing, trampolining – and watch your blood sugar come down. That’s the power of movement on your blood glucose. If you have type 2 diabetes, it’s one of the few ways to bring down high blood sugar.

The Big Blue Test is a grassroots movement begun 7 years ago by the Diabetes Hands Foundation. Big Blue is a way for people with diabetes to see in minutes the value of exercise. And it’s a way to benefit those less fortunate. By recording your blood sugar before and after your 14 minutes of movement, $1 will be donated to people with diabetes living in need. Thousands of dollars, have been raised. Vital supplies have been given. Let your effort help someone who may not even have access to medicine.

Log in, take the test. Do a little good today for yourself – and someone else.

JDRF and the American Diabetes Association announce new staging for Type 1 Diabetes

2 yrs old heh heh heh

Me at three. Pre, pre, pre-type 1 diabetes?

The news was announced today about a new classification approach for the development of type 1 diabetes (T1D). Three distinct stages will mark the development of the disease – from its earliest pre symptomatic stages to full blown onset. The aim of staging is to help preserve more insulin-producing beta cell function and make further strides toward prevention.

JDRF and the American Diabetes Association, with several leading diabetes research and clinical organizations, collaborated on the development of the staging approach. The American Association of Clinical Endocrinologists, the International Society for Pediatric and Adolescent Diabetes and The Leona M. and Harry B. Charitable Trust have already endorsed it.

“We know type 1 diabetes begins long before insulin dependence occurs, and the best time to halt the disease’s progress is before the loss of insulin-producing pancreatic beta cells,” said JDRF’s Chief Scientific Officer, Richard Insel, M.D. “Decades of research in at-risk individuals have provided the foundation for developing this new three-stage diagnostic approach, which we believe will help optimize the design of clinical trials to prevent symptomatic disease and more quickly evaluate interventions.”

Desmond Schatz, M.D., president-elect, medicine and science at American Diabetes Association explained, “Type 1 diabetes is diagnosed relatively late in the disease process.” Now pre-type 1 diabetes can be identified both in higher risk relatives and the lower risk general population by using a combination of genetic, immunologic and metabolic markers and categorization of the natural history of the early disease process which is now possible.” According to Schatz this will facilitate prevention studies at different stages of the disease process.

Personally, I always keep hearing as well that figuring out how to prevent type 1 diabetes may be necessary before we find a cure.

Regarding staging, two years ago I wrote on The Huffington Post that we should characterize type 2 diabetes in stages – “The Lie That’s Killing Us: Pre-Diabetes.” Diagnosing people with “pre-diabetes” doesn’t inspire the action that calling it stage 1 of type 2 diabetes likely would. Many of the current 80 million people with “pre-diabetes” will go on to get type 2 diabetes. Yet, if they heard that they had stage 1 type 2 diabetes they might well make the lifestyle changes – eating a healthier diet, losing weight, being active and possibly medication – that might prevent it. I’m still in favor of this.

For myself as a type 1, I remember how surprised I was years ago when endocrinologist Gerald Bernstein, who ran the Friedman Diabetes Center in Manhattan, told me that while I got type 1 diabetes at age eighteen, I probably began developing it when I was twelve. And I have a theory why that might be so.

We talk about type 1 diabetes coming on like a bullet train but apparently there’s a slow escalation and now researchers are able to see distinct metabolic markers of the disease’s progression. Marking the stages of the disease will help facilitate prevention studies, and hopefully one day, prevention – and a cure.

My favorite hotel food, a pancake

Screen Shot 2015-09-23 at 1.46.18 PMI’ve just read over a number of my recent blog posts and realize how heavy they’ve become on food. Without realizing, healthy eating and how to achieve that, have become consuming passions. Now you ask, “So how can pancakes be your favorite hotel food?”

Well, I am human after all. I travel a lot speaking at conferences, speaking as a peer-mentor with the A1c Champions program and having a Dutch husband. That means I’m often lodging in hotels. My favorite breakfast at a hotel is not the all-you-can-eat buffet. I know I’d eat more than I should and I’m not interested in most of what’s on offer – the breads, muffins, cold breakfast cereals…Nope, I want two freshly scrambled eggs and one pancake.

If I could I’d wave a magic wand and make it a buckwheat pancake, trust me I would. But hotels have not gotten this far on the healthy breakfast spectrum. So buttermilk fills the bill.

I order my meal as two sides: Two eggs and one pancake. And most of the time after the strange look from the server, he or she becomes very accommodating. And I’m very specific, “One pancake please, no sugar, no syrup, no butter, no fruit.” When it comes I remove the orange slice and parsley garnish, which always seems to be there, and sprinkle my pancake with a little salt. A bite of sweet, dense and chewy pancake with the warm egg is quite delicious. Really, try it. Then, if the gods are smiling, I have time to head to the hotel gym and bring down the outrageous blood sugar rise one pancake causes.

Surfing this morning on pancakes, this recipe looks great if you’re making them at home – no flour, but almond meal and flax seed. If I actually cooked pancakes at home, I’d be sure to try it. Somehow I just like to keep my pancake confined to hotels.