D•blog | Welcome to the Diabetes Stories website | riva greenberg

Diabetes feet around the world

Sun, 05 Sep 2010 20:17:48 -0400

On this Labor Day weekend, I am not traveling but laboring. Whew! And admittedly, enjoying the calm and emptiness of New York City as everyone is somewhere else.

But those who know me, know I was born with a wanderlust. Maybe it's my mother's Hungarian gypsy roots but I love to see new places and meet new people and I've done a lot of it.

Giving presentations to diabetes patients I get to travel across the country, and it's always a treat whether I'm heading for San Fran, Bangor, Mechanicsville or Bend.

I love to take a breather from the big city, truly put my feet on the ground, and I always meet someone who makes my life richer.

Having a Dutch husband who works around the world, and having lived myself for 6 years in Japan and 1 in Sydney, I move around the globe as well as around the States.

For some reason that I absolutely no longer remember, I began photographing my wandering feet to mark the places I've been.

Yesterday, looking thru my little photo gallery, I noticed with a grin, that there is actually one photo that also commemorates diabetes - of all things!

So while feet are definitely one body part we should all pay careful attention to, for the moment you might just enjoy seeing where mine have been.

And then maybe you can tell me where the mysterious PWD photo was taken. I have no idea.

Turning a page at 11:05 PM tonight

Thu, 02 Sep 2010 08:32:08 -0400

First, I have to thank everyone for their birthday wishes on my Facebook page today. Quite a delight to see first thing in the morning.

Second, I have to tell you that many people have noticed my infusion site tattoo as I've wandered around the big apple this week, giving me the opportunity to enlighten a few folks as to insulin pumping. You should have seen their faces!

Third, a friend once told me that in New Zealand, on your birthday you do nice things for others.

So, my first task is to pass along my friend, Manny Hernandez's (founder of the Diabetes Hands Foundation, tudiabetes and estudiabetes) request for a small donation to keep these amazing social media sites, and the outreach projects Diabetes Hands Foundation does all year, thriving. The work of DHF keeps thousands of us connected and generates continual awareness of diabetes, both inside the community and out.

With your donation you may receive a copy of the Foundation's poetry book, No Sugar Added, but you'll definitely get that lovely feeling of helping others. After I make my donation, I'm going back into the city to return that birthday belt that looked so darn good on the rack and so darn bad once I got it home. Drat!

Happy day everyone.

It's national "Infusion Site Awareness Week"

Mon, 30 Aug 2010 07:59:27 -0400

No, I’m not making it up. Roche Diabetes Care, makers of the ACCU-CHEK® meters and test strips has named August 30-Sept 5 National Infusion Site Awareness Week - and with good reason.

For those who use an insulin pump there are a few things to pay mind to and your infusion site is one of them.

The infusion site is the area of skin where a pump's needle introduces a little plastic tube under your skin for insulin delivery.

Cleaning the skin properly before the needle insertion and rotating your infusion site each time so you don't use the same spot can prevent infection and the build up of scar tissue that can block the flow of insulin.

A 2007 study in the American Diabetes Association journal Diabetes Care reported that some adult patients experience as many as 12 issues of irritation or infection a year because of improper site maintenance.

Infusion site management includes: choosing a location on your body, cleaning and preparing your skin at the site, properly inserting the needle, regularly rotating the insertion site to avoid infection and monitoring insulin flow. It’s recommended people change their infusion site every three days and not use the same site for about two weeks.

Notable irritations due to infusion site problems include: having two unexplained high blood glucose readings in a row, itching, burning, pain, blood or air in your tubing.

Roche launched Infusion Site Week to help diabetes educators increase understanding and education among their patients. Roche has also distributed Infusion Site Awareness Week kits to CDEs across the U.S.

Inside is a DVD, fact sheets and talking points, calendar, buttons, media outreach materials and site tattoos. I know because I got one. If you'd like to request a kit you can do so here.

Actually, I don't use an insulin pump but today I'm wearing the pin and I'm sporting one of the tattoos that came in the box. The tattoos are meant to mark where your infusion site is so you don't use the same spot twice.

Of course I thought about tattooing all my injection sites until I realized there’d be no skin left showing on my body.

The power of loving yourself from New York to New Mexico

Thu, 26 Aug 2010 08:06:31 -0400

Recently I read about one of my fellow diabetes bloggers who also attends Roche's social media summit, yet I've never known much about the modest, quiet Wil Dubois.

Wil is a type 1, CDE, author and Diabetes Coordinator for the nonprofit Pecos Valley Medical Center in New Mexico. The clinic serves one of the poorest counties in the U.S., about 1,000 square miles of rural, underprivleged people and relies heavily on state funding.

Moved by the work Wil has dedicated himself to, I wanted to help. I looked around my bedroom where boxes of books are piled and offered to send him 24 copies of my book, The ABC's Of Loving Yourself With Diabetes that I had translated into Spanish, El ABC para aprender quererte teniendo diabetes. The book provides 26 lessons to build more emotional strength, and happiness, on this journey we take with diabetes.

Will accepted my offer of books immediately and graciously, and so that afternoon I was standing in the middle of my bedroom furiously packing books and then running them down to FedEx.

A few days later Wil told me they'd arrived. I asked him to use the books in any way he saw fit -- give them to patients, use them working with patients...and to let me know what his patients thought.

He promised to do so and told me one of his colleagues has already made off with a copy. Now that's sweet.

As life would have it, just a week after I shipped the books I had the opportunity to thank my two United Nations translators, Georgina Báez-Sommer and Amparo Fernandez, over a Mexicn dinner in the hood. Now that was spicy!

Join me for the TCOYD event Rhode Island, September 11th

Sun, 22 Aug 2010 15:50:32 -0400

TCOYD, which stands for Taking Control of Your Diabetes, is a non-profit organization that provides one day health fairs all across the country to help people better manage their diabetes. The organization alsobroadcast in-depth discussions with renowned health professionals and patients.

Next month, September 11, if you're anywhere near Rhode Island, you should attend because I'll be there presenting. Of course, it's not the only reason you should come. You'll hear lectures on facets of diabetes care from your feet to your heart, learn and get some exercise, bond with many others and attend interactive workshops where the learning is personal. It's a full day affair of fine tuning your diabetes management provided to you by many respected people in the field. All for only $30. Register here.

Joining you will be top physicians, psychologists, educators, foot specialists, exercise physiologists and there's much to see and do in the exhibition hall including many new devices, products and foods.

TCOYD was the first diabetes health event I attended way back in the early part of this decade. There I attended, among others, psychologist's Bill Polonsky's workshop where I learned something crucial -- that diabetes is not the leading cause of heart attack, blindness and amputation but poorly-controlled diabetes is. It made a huge difference to me: 30 years of fear slid down my shoulders and the resolve to master my self-care led me to the healthy regimen I have today.

I also met a lovely gentleman in the exhibition hall who answered all my questions and then guided me to the peer-mentoring programs I deliver today around the country speaking to fellow patients.

TCOYD is the labor of love of Dr. Steven Edelman who founded it almost 15 years ago. Dr. Edelman was recognized last year with the 'Outstanding Educator' award from the American Diabetes Association. Edelman himself has lived with type 1 diabetes since the age of 15, and has dedicated his life and work to helping as many people with diabetes as possible to live healthier, happier lives.

My workshop by the way is titled: The ABCs of loving yourself with diabetes and I'm on at 3:30 PM. You'll discover how to live a life with diabetes where you don't just cope with diabetes, but actually flourish. If you come, do let me know. I'll want to say hello.

Vitamin D deficiency in people with diabetes

Sun, 15 Aug 2010 13:42:37 -0400

A quick reminder--or an alert--that people with diabetes tend to be Vitamin D deficient. Well, actually, most people seem to be Vitamin D deficient.

I know that came up on my lab report last time I had my blood drawn. So now I'm downing one Vitamin D-3 1,000 IU pill each morning after breakfast.

Vitamin D helps with calcium absorption, and so keeps bones strong. It seems a deficiency may also play a role in cardiovascular disease, multiple sclerosis and complications of pregnancy.

We get most of our Vitamin D from exposure to the sun, but even being in the sun, in Northern climates, can prevent you from getting the essential supply needed.

And you won't find Vitamin D in many foods. There's cod liver oil (yuck!) and fortified milk.

It appears every cell in the body has Vitamin D receptors, so I guess this is one supplement to get a read on next time you get your blood panel done.

For more info, click here.

Back from the AADE

Mon, 09 Aug 2010 10:29:49 -0400

I know I've just returned from San Antonio because my body is craving guacamole and the smell of fresh mint in those juicy mojitos! Ah, but that's not what you tuned in for, is it?

The annual diabetes educators conference was a hit with thousands of diabetes educators, nurses, physicians and pharmacists attending the 4 days of lectures, bonding, learning and renewing their credentials, and their spirit. The first evening at the poster event while all were mingling, I asked several CDEs what keeps them going. The answer was always the same, "Making a difference in someone's life," and that feeling was palpable.

The meeting kicked off with President, Deb Fillman's welcome address. I was extremely happy, and surprised, to hear her talk so emphatically about the need for change. The need for educators and the profession to look outside the box for new ways of working as more will be asked of them.

Prevention is becoming a big topic in health care and for CDEs. The U.S. Senate's passage of the health care reform bill late last year includes a provision to establish a National Diabetes Prevention Program. This means an expanded role for CDEs in the prevention of diabetes. Although god only knows how they will do more given the thousands of educators for millions of patients.

Fillman asked the audience to be more adventurous with change in their personal lives, taking on challenges and reaching for more fulfillment and success, as it will flow into being even better mentors and educators. Fillman also spotlighted the AADE's new online tool, "My AADE Network" which helps members connect wherever they are and create an online community and remote learning.

Rear Admiral and former Assistant Surgeon General, Susan Blumenthal, was the keynote opening speaker. She pressed the sense of urgency upon us that we need to stand up to deal with the obesity epidemic now that's taking a huge toll on America's health and economy.

The exhibition hall, always interesting to me, didn't get as much traffic as usual and vendors didn't know why except to suggest the short hours precluded many attendees from spending much time there if they were sitting in on continuous lectures. Also, the bookstore made a decision to only carry ADA publications and those of their speakers doing book signings. Other authors needed to show their own book(s) at their own booth, if they had one.

I presented Saturday morning a behavioral program titled, "Beyond Motivational Interviewing: What Can Happen When You Catch Someone Doing Something Right." There were about 100 attendees excited to be introduced to an entirely new mindset and model for working with diabetes patients: a mindset of "flourishing" with diabetes and a coaching model that enables health professionals to work as facilitators with patients, as appropriate, to:

1. Explore the context of patients' lives

2. Play "Strengths Detective" to help patients recall and reconnect with capabilities they've used in the past

3. Collaboratively design mechanisms for sustaining healthy habits, causing positive behavior change faster and more sustainably than when only using the traditional model of "telling patients what to do."

This is exciting stuff that you'll be hearing more about. I am currently putting the finishing touches on a curriculum to train health professionals on this mindset and model along with my two partners, Boudewijn Bertsch and Eileen Murphy.

A phenomenal play called, 'Close to the Heart' produced by Amylin was one of the conference's highlights. With real actors in tow, it dramatized a patient getting a diagnosis of diabetes and how she deals with it, along with her relationships with her jealous best friend who is struggling with her diabetes, her supportive, yet pre-diabetic husband, and physician. Even I who have had diabetes for 38 years felt anew this woman's confusion and pain.

After the half hour performance Dr. Steven Edelman of TCOYD, Psychologist Bill Polonsky of BDI, heart surgeon Robert Chilton, Dr. Stephen Brunton and host Davida Kruger, certified nurse practitioner, answered questions in a panel discussion. Kudos to Amylin for going outside the box. It was a smash, and I know Amylin has plans to make short videos of it.

The general session closed with an in-your-face presentation by Dr. Michael Roizen, Chief Wellness Officer at Cleveland Clinic about the cost, both physical and economic, of our obesity and diabetes tsunami. Roizen has been an impressive change-agent spearheading the "Lifestyle 180 Program" at the Cleveland Clinic, which was first piloted with Clinic employees and now available to patients.

One point Roizen made that still resonates is -- food is an absolute, you can't make a deal with food. What you eat is critical to your body and your health and either will or won't turn on the genes for illness. For instance the sugar in ice cream will change the proteins in your body. That, he says, is a given. You can burn off the calories, but too many unhealthy foods and you're creating inflammation which creates disease.

Next year's conference is in Las Vegas. I think my husband is already booking the hotel and buying his binoculars to look for Elvis.

AADE annual conference this week

Mon, 02 Aug 2010 21:44:30 -0400

Tuesday I'm heading off to the airport for the annual American Association of Diabetes Educators conference in San Antonio, Texas. Well, I've always heard if you have to be in Texas, San Antonio is a lovely spot.

I'll be presenting a session at the conference on Saturday, August 8th at 8:30 AM on a new model for sustainable behavior change. The session is titled, "Beyond Motivational Interviewing: What Can Happen When You Catch Someone Doing Something Right." If you're there, please do attend. I'll also scour the exhibition hall and get a pulse for what educators are doing, thinking and looking for in their practice.

I will report back, and I'll try not to eat too many chicken fried steaks while roaming the river walk.

Take a short survey and tell me about your success

Wed, 28 Jul 2010 16:48:50 -0400

In my work to help people better manage their diabetes, I'm doing research on how people create and sustain good management.

I've written a short survey (13 questions, many multiple choice) that I'd love for you to fill out. It will take you about 15 minutes. Click on this link to go to the survey: https://www.surveymonkey.com/s/riva_research.

At the end of the survey, just click the "submit" button.

I intend to use the results in what I write and in presentations as appropriate to help others better manage their diabetes. I offer you the same opportunity to use the results if you send with your completed survey, your name and email address, and credit the research to me.

Your name and email address will be anonymous. They will only be used to send you back the survey results and enter you in a random drawing for a prize - a new silver apple ipod shuffle. Your contact information will not be sold, or shared, or used in any way.

Please submit the survey back to me by this Friday, July 30, 3 PM Eastern Standard Time.

My heartfelt thanks for helping me in this endeavor and for sharing what you've come up with so others will benefit.

riva

The Power of our health possibility

Mon, 26 Jul 2010 13:07:59 -0400

I'm reading a great book, Ellen Langer's Counter Clockwise: Mindful Health and the Power of Possibility. It's about being more mindful in everything we do and how that breaks through many of our assumptions and beliefs and can help us maintain and attain greater health, and happiness.

It's about thinking about our health, and aging, differently, turning our own stereotypes on their head, and taking back much of our power.

It's about how language either empowers or disempowers us, and sets us down a path of expectation, and how we then tend to create what we expect.

For instance when you go to get a "second opinion" don't those two words already make you feel it can't be quite as credible as the first doctor's diagnosis? After all now you're going for "second" and it's only an "opinion."

Langer, a social psychologist and teacher, has written a book, this is actually her fourth on mindfulness but first on health, that is philosophical in part, and practical throughout. It is based on many of her studies and those conducted with her students. One classic study Langer conducted had senior citizens, some of whom were in nursing type facilities spend a week living as though it was 1959 again, wearing the type of clothes they wore then, doing things like carrying their own suitcases, which they hadn't done in years, bringing photos of who they were then and "acting as if" they were their younger version, again. A week later, most were actually livelier, stronger and healthier, they expressed more vitality and took more interest in life than they had in years.

Langer pokes through our routine thinking as in where did these thoughts come from? Do they make sense? And she beseeches us to be mindful, to notice new things. And she reminds us that our routine thinking may indeed be deteriorating our health rather than vitalizing it.

For instance she proposes that maybe older people are thought to have poor memories not because they lose their faculty to remember but because they're not much interested in what's going on in a world geared for younger people. So they don't pay attention. What looks like memory loss may be a case of older people never having listened to something to begin with because it doesn't interest them.

Or maybe older people seem weaker because we've been socialized to see them that way, and they've been socialized to expect they will become that way. Maybe 80 year olds have trouble getting out of a car not because they're feeble. Maybe cars just aren't built for 80 year old bodies.

Langer and her students' experiments will offer you lots to reconsider that may change how you think which may impact your health more positively.

Counter clockwise tests many of our assumptions about healthfulness and reading it would be a very healthy choice.

Writing for the Huffington Post

Fri, 23 Jul 2010 15:31:18 -0400

I've never written about what it's like to write for the Huffington Post, until now. Here's the story. Actually, it was a fun question to ponder, and you'll find out more about me than just that single bit of info.

Amy Tenderich, blogger of the terrifically newsy DiabetesMine.com, posed the question when she asked me to guest post on her blog for today.

Amy does us all a service posting almost daily about the ongoing news in diabetes. If you haven't taken a look, roam around the site once you've finished my guest post.

If you want to be happy...

Mon, 19 Jul 2010 09:34:17 -0400

I found this passage that I wrote down months ago on a slip of paper while finally clearing the clutter near my computer. Doesn't matter, though, because it's timeless.

This is from Martin Seligman's book, Authentic Happiness.

"If you want to be happy

for an hour, take a nap

for a day, go fishing

for a month, get married

for a year, get an inheritance

for a lifetime, help someone"

What more is there to say?

Food Is Medicine appears on HuffPost

Wed, 14 Jul 2010 11:53:18 -0400

I posted another version of my beef with food - that food is medicine - on The Huffington Post.

It appears as a lead story today.

A loyal fan already wrote me,

"What an inspiring article to read first thing in the morning - thank you for your latest Huffington Post piece on healthy eating.

Great tips in there - and makes me glad I have a fridge full of fresh produce waiting for me at home for tonight's episode of Top Chef (a weakness of mine)."

It also occurs to me maybe I should let you know one of my little secrets for health.

I not only have a medicine cabinet in my bathroom, but I also have one in my kitchen.

It doesn't have a mirror on it, although to be frank that would be a great incentive to eat healthy, wouldn't it?. But it does have these big shiny silvery doors.

I'm sure having a medicine cabinet in my kitchen is not particular to New York City. You probably have one too.

And just to show you I'm a woman of my word that food is medicine, I've put up a picture of what you'll find in my kitchen medicine cabinet most days.

Come to think of it there's probably more medicine in my kitchen medicine cabinet than in my bathroom medicine cabinet.

I like to think that's a good thing.

Food is medicine

Mon, 12 Jul 2010 07:53:38 -0400

For the last several months I've really shifted my view about food. I see it as medicine. Not that I don't enjoy it, but I see what I eat as either making me more healthy, or less. I see what I eat as being almost as important to my health as my insulin.

Now that doesn't mean I have a perfect diet. But it does mean I'm more motivated to eat foods that are nourishing me -- infusing me with healthy anti-oxidants and strengthening my overall body and fitness, rather than degrading it, or setting me up for the side effects of unhealthy eating - heart disease, overweight, guilt and personal frustration with myself.

So I wanted to share this great article from Men's Health magazine giving their take on the 40 Best Age-Erasing Superfoods.

My healthy eating, and by this I mean smaller portions and eating mostly vegetables, fruit, beans and lean protein, automatically maintains my weight. I'm trimmer these last several years than I've ever been, and without trying. Healthy eating also gives my psyche a reason to feel pretty good about myself every day instead of guilty and frustrated. But you got that already, didn't you?

And so you know I'm not just blowing smoke, it's reflected in the blood tests I get twice yearly: A1C 5.7%, LDL (lousy) cholesterol 108, some would say a little high, yes, it's in the family, but my HDL (good) cholesterol is an astronomical 107, triglycerides 50 mg/dl, blood pressure 90/60 and a heart Al Pacino would say is "Strong like bull."

If you're curious what I typically eat here's my day food-wise:

Breakfast - a bowl of steel cut oats, I cook, to which I add: flax seeds, sunflower seeds and fruit, and then top with a spoonful of non-fat Greek yogurt, non-fat cottage cheese, and a spoonful or peanut or almond butter. I can't tell you how much I like this - it's creamy, crunchy, sweet and delicious. I could eat it for every meal. Maybe having a breakfast I love and knowing I get to eat it every morning, helps me stick to my healthy eating throughout the day; I know a reward is coming tomorrow morning.

Lunch - usually left over veggies from last night's dinner, or a spinach salad, with some feta cheese or a slice of turkey and some beans. I may add avocado or cooked squash depending upon what's in the house. If I eat lunch out it's usually a spinach feta omelette with one slice of whole grain toast. No butter. Olive oil, herbs and mustard are my main taste-boosters. Butter, mayonnaise, bottled salad dressing and such I don't use anymore.

Dinner - usually fish or chicken grilled, broiled or sauteed with a mix of veggies and beans. Snacks are usually nuts, particularly walnuts (yes, they have fat, healthy fat which you need, just don't eat too many), veggies, less sugary fruits like berries, melon, peaches and after dinner usually some dark chocolate.

Now you're thinking I must be a monk, or a martyr, keeping to such an austere meal plan. I know you think that, people have said it to me. But neither is true. It's just that over the years, particularly after reading Bernstein's book, Diabetes Solution, I've rid most of the refined carbs from my diet knowing how much they made my blood sugar swing from high to low; it was awful. Now I have tons more control. And feel better. And, to be honest, while rapid-acting insulin and pumps give us more spontaneity, routine as in eating similarly day to day, makes my blood sugar more predictable.

I've also lost my taste for most sweet and fatty foods. It happens when you begin to eat "real food" again. I'm a big fan of Michael Pollans, Food Rules. I follow his mantra: Eat food, mostly plants, not too much.

That said, I'm not a vegetarian and I'm not a zealot. Fried calamari, the occasional slice of cheese or flourless chocolate cake, crusty bread and olive oil, anything friends make for dinner and eating everything in my house - everything - those occasional nights when the world tips out of balance also co-exist with my healthy eating. Oh, yes, so does wine with dinner. Another reward. Thank goodness years ago some French marketing guy said it was healthy.

So, check out this list of 40 Superfoods and try to put more of them in your diet. And, if you've tried to eat healthy before only to have given up, perhaps this is the day it will take. Here are a few tips that may help:

1. Decide why being healthy is important to you - only to you - and keep that front and center

2. Fill your house with healthy foods and throw out the junk. If when you're hungry you can reach for a carrot instead of pretzels, you will.

3. The day you fall off the wagon, is only a day. Start new the next day. What you do in a week counts more than what you do in a day.

4. Your history doesn't have to be your future. Ever.

5. Honor yourself enough to make healthy eating important, and your mission.

6. Know that in a few weeks, your tastebuds will change. You will lose your taste for synthetic food, sweets, salt and grease.

7. Talk yourself through a weak moment. Tell yourself if you're dying for that piece of cake at 10 PM, you can wait till morning.

8. Nothing's off limits. If you need it, eat a little of it. Parcel it out onto a plate, don't stand over it in the kitchen. You won't stop.

9. Go slow or cold turkey. Whatever works for you.

10. Remember, you can do it - millions do. It may take time, but depending upon what you do now, next year you'll either be exactly where you are now, less healthy or healthier.

"T" is for thank you Dex4

Mon, 05 Jul 2010 10:18:10 -0400

Every summer in Orlando, Florida, Children With Diabetes, an online community for families with diabetes, runs an amazing conference for families called "Friends for Life." It's just winding up today.

Children with diabetes come and play and make new friends (for life). Parents attend lectures to learn more about: managing diabetes, helping their children manage their diabetes, managing the emotions of having a child with diabetes and to bond with other families. There's also access to a mini-vacation with Minnie and Mickie over at Disneyworld.

Every year since 2007 I've attended at least one diabetes conference. Friends for Life was the first diabetes conference I ever attended. It felt instinctive--at 54 I still was, and always will be, a child with diabetes.

Since 2007, I have wanted to make my book, "The ABC's Of Loving Yourself With Diabetes" available to families at Friends for Life. This year, Dex4 (manufacturer of glucose products) gave me the opportunity to donate 150 books and distribute them in their welcome gift bags that they handed out to new families attending the conference.

I sincerely thank Dex4. I also hope as families leave the conference this year, buoyed with new learning, memories and friendships, that when they need a booster shot of strength again, they'll dip into my book and find their way there. When you live with diabetes from a place of courage, confidence, forgiveness, patience, joy and pride, as my book guides you to, this ride utterly changes for the better.

Dex4 is working, through both education and products, to help one always be prepared to correct a low blood sugar. I work with Dex4 upon occasion as a patient-expert advisor.

Orlando, a hotbed of diabetes activity

Thu, 01 Jul 2010 07:23:46 -0400

It's not just the temperature in Orlando that makes it a hotbed of diabetes activity these two weeks, but the enormity of activities going on.

The American Diabetes Association's (ADA) 70th annual scientific conference has just drawn to a close. Roche just held its second social summit and Children With Diabetes (CWD) begins today.

Amy Tenderich over at DiabetesMine has been following and reporting on some of the ADA highlights, start here with opening day and see the next few posts, as is Kelly Close over at CloseConcerns, look down the left-hand column.

I attended Roche's social summit where they invited 37 type 1 and type 2 diabetes bloggers and broadcasters to a day of exchanging ideas about meter accuracy, best practices and an open dialog between us and representatives of the American Diabetes Association and the American Association of Diabetes Educators.

These conversations drew fire, well we are a feisty group, about how the patient seems all but lost amid their constituencies, but the ADA was extremely open about the need and desire to turn their battleship org around to be more representative and serving of patients' needs, including type 1s - and create more transparency. They also obviously took this seriously sending six representatives including David Kendall, their Chief Scientific & Medical Officer. Kendall talked about the ADA's "Stop Diabetes" campaign which is one of their first steps in being more patient-centric.

Unfortunately, the conversation with the AADE was less successful. To be fair, many of us felt it was taking place with the wrong organizational person. She seemed unable to put her finger on our concerns - MAINLY the fact that diabetes educators are a dying breed while patients are an epidemic and need them.

There are only 15,000 educators nationwide, relatively poorly paid and many suffer burn-out and leave the profession. On top of that, it's hard to become an educator. There's no direct route, and, a big catch-22. You need to have 1,000 hours working as a diabetes educator with patients before you can sit for an exam to become certified, but how do you get hired as an educator with no experience? After ricocheting these thoughts around we also voiced that we would like to see the organization advocate to improve the track to become an educator. An interesting point was also raised by my fellow bloggers - why not create a track where patient-experts can also be educators in some recognized fashion?

In the end, we offered our assistance to help both organizations in any way we can. Specifically with the AADE to link their professional members to more social media. While that idea was warmly received and seen as a benefit to CDEs, allowing them to hook their patients up with us, I hope the AADE also realizes that CDEs can benefit tapping into social media to get inside patients' heads, and hearts, and follow the trends and news we report on.

I am impressed by Roche. With their genuineness, commitment and desire to have an open forum with we, who have an open channel to you. And, yes, while we can assume all this will benefit Roche's sales and marketing, I believe they hope just as much that it will benefit us in getting products we need and want.

At the 2009 social summit Roche put their toe in the water wanting to learn from us how to enter social media as a "good citizen." This year's meeting was heavily weighted on what they believed would be of value to us. Either way you slant it, a pharma better understanding the experience of living with diabetes and doing something with that knowledge can only benefit all concerned.

To this end, Lisa Huse, Roche Director of Strategic Initiatives, opened the meeting with a recap of the four initiatives Roche has enacted based on what they heard from us last year:

1) "Keep it real" - display the real experience of diabetes, the real blood sugar numbers we get and teach patients what to do with them. I think I heard there's actually a TV commercial where someone shows a 273 mg/dl on their meter, yea! Then again, I could have been dreaming.

2) Address costs of diabetes - through Accu-check there's now a 15% prescription discount card and Patient Assistance Program.

3) Advocate for the diabetes community - through their Diabetes Care Project. A coalition of like-minded organizations improving care for those living with diabetes.

4) Help the diabetes community amplify its voice - clearly evident with our exchange with the ADA and AADE.

Lisa also told us that during this past year of following our blogs and having her ear on the ground with us, she's come to understand diabetes much more than her first 11 years with the company. As the meeting came to a close I wondered why more companies don't spend more time, money and attention listening to, and getting to know, their end users. It can only be a win-win.

Personally, for us bloggers in our virtual world, it's wonderful to get together, to shake a hand, play ping-pong (hope the table's back next year), give and receive a hug and say to each other, as we hope we say to you, you are not alone.

By the way, if you blow up the photo, and notice I'm wearing a lovely blue boot, it's the result of a freakish accident. Don't worry, five or so more weeks in my lovely footwear and all will be well. (Thus the hope the ping-pong table reappears next year.)

In full disclosure all expenses were paid for by Roche for this meeting.

Top 50 Diabetes Blogs

Sat, 26 Jun 2010 08:41:56 -0400

There's a list of top diabetes blogs out by Masters In Public Health. The site's creators, Mary and Paul Hench, say their list represents excellence in content and research, and blogs are listed in no particular order.

The list is neatly categorized into "Personal Blogs Of Diabetics," where you'll find DiabetesStories, "Diabetes Social Networks," "Diabetes News and Updates" and "Blogs From Moms of Diabetics."

Each blog has a line or two describing it making it easier for you to chose where to dip in. The Hench's created their site after spending months researching masters in public health programs and unable to find a reliable database of usable information. So, you guessed it, they created one.

Take a look at the blog list and see what value might be there for you. The Hench's would be pleased.

Aimee Mullins and her 12 pairs of legs

Wed, 23 Jun 2010 10:00:07 -0400

If you don't know who Aimee Mullins is, you should. She's an athlete, fashion model and inspiration on two prosthetic legs that often graces the TED stage.

Born with missing fibula bones, she had both her legs amputated below the knee when she was one year old.

But Aimee has risen so far above her perceived handicap that she's redefining how we see disability.

She talks of the empowerment that can come from a perceived deficit and how we can, if we chose, be the architect of our lives, and identity. How the conversation is shifting from overcoming "deficiencies" and "disabilities" to having them augment us and our potential. And, she redefines "adversity" along the way.

In her quiet, unpretentious way, and with humor, she opens your mind to think differently and see your condition, whatever it be - for most of us it's diabetes, as a launch pad for doing greater things.

This 10-minute video is, as are all her TED videos, smashing - for the places your mind will go and its visual richness, as she shares her dozen legs. In her tallest pair of legs, Mullins says she stands six feet one inch high. I think she stands far taller no matter which pair she may be wearing.

New Facebook game creates a healthier you

Fri, 18 Jun 2010 13:27:24 -0400

Leave it to Manny Hernandez, founder of tudiabetes and estudiabetes, to come up with a Facebook game to help people with diabetes improve their eating and fitness habits. And the gem is, while you’re learning and doing, your ‘friends’ are helping you through it!

The game is called HealthSeeker™ and was launched June 14^th with Joslin Diabetes Center collaborating on content and the sponsorship of Boehringer Ingelheim. Already, there are more than one thousand players.

How it works is you enlist your Facebook ‘friends’ to be your support circle and ravers as you take action steps that help you meet your healthy lifestyle goals. You’ll track your progress and you can share your game results via Facebook status updates and send them out to your Twitter followers.

As Manny, who has been living with diabetes since 2002 says, "I cannot overstate what a source of support, information and inspiration social networking tools like this can be for someone living with a chronic condition like diabetes."

HealthSeeker™ provides simple action step suggestions and rewards your success through achievement badges and experience points you earn, kudos your friends can send you and comments they can leave on your Fridge door. (Your game Fridge door, that is!)

While your computer is home base, getting away from your computer is where the action happens - in the supermarket, in your kitchen, on the basketball court, in the pool. Then you come back and share your results.

The game is set up so that you choose “Missions” (healthy actions) as in the lingo of the old TV show, Mission Impossible – “Your mission if you choose to accept it….”

These missions are the stepladder to achieving your goals. As you complete your mission, you move up in the game and get access to more and more detailed action steps where you will need to sharpen your healthy living-chops. For example, if a mission on Level 1 suggests you eat a certain kind of food once a week, later on you will have to do it twice or three times per week - and that’s the beginning of building new habits.

Manny has made going after health fun to give us all a helping hand to improve our diabetes management, and our life. Further, the fun of playing the game with hundreds of others, scoring yourself, seeing yourself gain more points and sharing your results, may be just the motivation you need to now get in the game.

So get online and then get out on the field! There’s nothing holding you back now but you.

Way to go Manny!

Vancouver-based social game development group, Ayogo Games, Inc. developed the game code.

DiabetesMine design contest winners just announced!

Fri, 11 Jun 2010 11:46:48 -0400

Catch the Grand Prize winners of DiabetesMine's design challenge.

All are innovative ideas for apps and devices, like fun games for kids and beyond-the-pail glucose meters, to make diabetes-life a little easier .

Great design and innovation were equal priorities. After all, don't we deserve tools as cool as your iphone?

If I tell you, "Finn the Glucose Fish" is a grand prize winner, you just gotta look, don't you?

All winners receive funding and marketing help. Who knows, one may change your life in the near future!

The 1st annual "Food for your Whole Life Symposium" shows we know a lot, but aren't making good use of it

Tue, 08 Jun 2010 20:21:24 -0400

The first of hopefully an annual event was held this past June 6 & 7– the "Food for your Whole Life Health Symposium" – spearheaded by Dr. Oz. It was a two-day free event held at the Grand Hyatt Hotel in New York City to explore how food and lifestyle choices affect overall health. And, to better arm dietitians to help patients make better food choices.

I happened to miss the first day that was open to the general public and drew 1,000 people, but attended the second day exclusively for health professionals, largely dietitians and some diabetes educators, and media.

I find it interesting with all the constant information coming at us these days on health and healthy eating that people just aren't indulging in it. So I asked the same questions of everyone I met while meandering between lectures and standing on the long line into the ladies room: “Why, with all the information out there on healthy eating, are people fatter than ever?” “Why are half the people with type 2 diabetes not managing their diabetes very well?” “What has to change so that people change their behavior?”

I heard the same reply from everyone—there is too much information out there and it has become too confusing. Some of it is contradictory, and none of it is laid out for people to act on easily.

In a private interview I conducted (yes, I’m still getting used to this Huffington Post blogger status) with a key speaker at the symposium, Dr. David Katz - a Yale University researcher and authority on nutrition, weight management, and the prevention of chronic disease and a leader in integrative medicine and patient-centered care - he confirmed these observations. He also pointed to the media’s collusion. With an endless need for "new" news and a ravenous appetite to titillate us, the media barrages us with an endless supply of findings that has left the general public reeling with confusion. The result: heightened stress and not knowing what to do. The other result: people do nothing.

Katz has been working along with several others on a nutritional ranking system called "NuVal™" that's being piloted by Kroger, a chain grocery. Kroger is piloting it in 23 stores in Lexington, KY. It's anticipated they will roll NuVal out to their additional 2500 stores in 31 states.

NuVal ranks foods from 1 to 100 as a guiding system on nutrition to help consumers make healthier choices among a category of food. For instance, you'll know the healthiest crackers among all the available crackers in the supermarket.

Right now NuVal is in 600 stores with another 400 stores rolling it out later this year. Katz believes if people begin to choose the most nutritious foods in most categories, these small shifts can make a significant health difference. Katz also shared with me that his wife, a PhD, returned to their house one day with five loaves of supermarket bread and said basically - You pick the healthiest one!

Katz also said regarding diabetes that many doctors tell their patients in very vague terms what to do, like “Lose some weight” and “Get some exercise.” These directives fall right off patients’ shoulders as soon as they walk out of their doctor's door. He also said most doctors think diabetes patients are “non-compliant” because they have no willpower, but Katz made it abundantly clear that it is not a matter of willpower, but the enormous lack of translating all this information into easy-to-understand, actionable steps.

The day I attended the symposium, the speakers elucidated us on the upcoming changing dietary guidelines, likely out in November, and took us through a healthy eating map from childhood through old age. The message, throughout however seemed pretty consistent: eat mostly fruits and veggies, whole grains, lean protein and healthy fats.

Dr. Michael Roizen, Chief Wellness Officer at the Cleveland Clinic with numerous other impressive titles behind his name, and Oz’s writing partner, closed the event outlining Cleveland Clinics' progressive "Lifestyle 180 Program" that they first test-piloted on employees of the Clinic with remarkable results and a cost-savings to the Clinic well worth the investment.

For patients, the program encompasses a six week immersion program that is geared to change the four factors 75% responsible for chronic illness: smoking, food choices and portion sizes, physical inactivity and stress.

Very briefly, the program includes overhauling one's cultural climate, largely your kitchen ridding it of toxic foods, having participants experience “I can do it” aha moments, muscle memory of right eating and exercise and a buddy system. One of the bottom line messages was - while our genes are our inheritance, our lifestyle determines whether they get turned on or not.

For those with diabetes who have gone through the program, Roizen said 60% were able to discontinue one or more of their medications for blood sugar, cholesterol or hypertension (high blood pressure) within six months.

Most of the people I met at the event thought it was of value and, for me, it only points to the urgency with which we are all recognizing we must turn this ship around that is so badly headed in the wrong direction.

The principal sponsor of the event was the California Walnut Commission. Affiliated sponsors numbered 7, including Healthcorps and the Wild Blueberry Association of North America.

I did manage to sample the delicious wild blueberries which I was told are available in my favorite grocery, Trader Joe, as well as other chain groceries. I also got to grab a few packets of 1 oz servings of walnuts - that’s about 7 whole walnuts. Unfortunately, I also managed to forget the bag I stowed them in, leaving it under my conference table.

Obviously, I need to eat more berries and walnuts to improve my aging memory!

New, less painful lancing device by One Touch

Fri, 04 Jun 2010 08:23:14 -0400

I've been trying out a new lancing device sent to me by the public relations firm for One Touch. It's called the OneTouch® Delica™ Lancing System and it's available now at some retailers and will be available across the country mid-July.

A few days after using it I emailed this report:

Pros

1. Thin needle and non-vibrating action makes lancing less painful than other similar devices (except for the Pelikan Sun. However, I am sad to say it's no longer being made.)

Cons

1. Device is so lightweight that it's sometimes hard to hold steady against my finger when lancing

2. Replacing one lancet at a time is time consuming and laborious

3. Thin needle is easy to bend, has happened already

I thought that would be that, and I'd return to my tried and true Accucheck Multi-clix. This is my favorite among typical lancing devices because it's less painful and 6 lancets come in an easy-to-load drum.

But, I surprised myself. Every other time I lanced my finger I would reach for the Delica™, sturdiness be damned.

I did actually find it less painful than the Multi-clix. And now I use it more often than my Multi-clix. Of course, I don't change the lancets each time, probably after 6-10 finger pricks, and I'll soon run out because my sample only came with 10 lancets.

So I leave you to decide for yourself.

The press copy says:

The OneTouch Delica System features a new, proprietary 33 gauge lancet that is 40% thinner than current industry standard 28 gauge lancets.

In a clinical study of nearly 200 people with diabetes, 4 out of 5 reported the OneTouch Delica Lancing System was virtually painless/pain free and the most comfortable Lancing Device they have ever used.

And yes, I can attest to its non vibrating motion and 7 adjustable depth settings.

The estimated retail price is $19.99 and includes 10 lancets. 100-count OneTouch Delica Lancets have an estimated retail price of $15.99. Both the device and lancets are covered by Medicare Part B and most private insurance plans.

Turns out quite by accident, Amy Tenderich over at DiabetesMine is also reviewing pain-free lancing devices today, so you can catch additional info.

As for me, I still like that my Accucheck Multi-clix is sturdy, easy to hold and load so it doesn't require fussing or touching the needle.

Guess, I'll have to make the big decision when my Delica™ lancets run out.

Type 1 vs type 2 diabetes debate continues

Fri, 28 May 2010 09:34:35 -0400

Wow, I am late to this discussion, but felt it worthwhile to join because it appears the debate continues...

Last month Diabetes Health published "What People with Type 1 Diabetes can Learn from Type 2s" by Clay Wirestone It set off a firestorm of comments, mostly from type 1s, about how dare you tell us we can learn something from those lazy, fat type 2s!

David Spero, blogger over at Diabetes Self Management then wrote this post, "Type 1s Vs. Type 2s?" calling for type 1s and type 2s to come together for the sake of our health and that both sides are not fully aware of what the other side lives with. Interestingly, the comments posted on Spero’s site were almost unanimously empathetic.

It seems to me, Wirestone’s biggest goof was his argument (that t1s can learn from t2s) and his tone. If he’d approached the topic from the point of view that t1s and t2s share some commonalities and we can each learn something from each other, the war may have never ensued. But it is a fascinating study in how we all emotionally hold diabetes.

You should go read the stories and comments to both stories. In reading all the comments to Wirestone’s post, I found Allison Blass nailed it for me:

"The problem with this article isn't so much that it's saying people with type 1 can learn something from type 2, but assuming that people with type 1 aren't already learning these lessons for themselves. Plenty of PWDs with type 1 exercise regularly, take their medication faithfully, and make small changes to get healthy. These aren't genius concepts divined by the type 2 community.

I will say that the amount of misinformation and misconceptions about type 2 diabetes in the comments are disgusting. Type 2 diabetes is not CAUSED by obesity - it's a contributing factor. Type 2 is not cured through diet and exercise - it is managed, just like insulin. Type 2 diabetes does not have the same flexibility as type 1 - blood sugars have to be dropped through extra exercise or changes in diet, not just a simple bolus. People with type 2 diabetes can go years without being diagnosed, which means that many people with type 2 are diagnosed at the same time they find out they have complications.

Type 2 diabetes is a bitch, same as type 1 diabetes. And yes, they are different. But we both have to do things that are different, we both have a health issues and learning tactics and strategies for handling certain situations could help.

In any event, if you don't like people spreading misconceptions about your disease, you should probably be damn sure you're not spreading misinformation about someone else's. It's not nice."

-Allison Blass www.lemonade-life.com

And then, as I said, even tho I came late to the game, I felt compelled to add my own 2 cents worth and so I posted this today on Spero’s blog:

"As a type 1 for 38 years I understand the cry of type 1s that no one understands how hard and intense it is to live with this disease, and that we are grouped under the same umbrella of those lazy, fat type 2s who did it to themselves.

Yes, many type 2s engaged in poor health habits that may have led to their diagnosis, but not all. One in five are slim actually. For some the genetic component is so strong they would have gotten it regardless of their actions. And there must certainly be type 2s who are annoyed with the bad press their own brothers and sisters bring them.

But one diabetes being worse than the other? It's all a matter of perspective. I wrote a book recently, "50 Diabetes Myths That Can Ruin Your Life and the 50 Diabetes Truths That Can Save It" and the myth I always quote is, "Type 2 diabetes is not as serious as type 1."

It is one of my favorites, because the emotion runs so high and because the answer seems so obvious, but is not. Both are extremely serious because they can both lead to the same devastating complications. While type 1s will never get off their insulin, and endure more intense management, type 2s are asked to undertake preventive behavior, which anyone can tell you, is a bitch.

Since most type 2s are diagnosed years after they have the illness, many already have complications by time they're diagnosed. And while most type 1s will live with their illness longer than type 2s, many will also live more healthfully with it because they developed healthy habits earlier and they see more directly the positive result of healthy habits.

When “What People with Type 1 Diabetes Can Learn from Type 2s,” appeared on Diabetes Health what incensed most readers was the cavalier notion that type 1s aren't doing good enough, so obviously we could learn a thing or two from type 2s. That reeks of presumption and offends.

We all have something of value to share from our experiences, and it's up to us as individuals how we manage our diabetes. And, how we choose to see it - some see themselves as victims and only see hardship, others see diabetes as a welcome wake-up call and get healthier, and others see diabetes as a signal that life is precious and go about making the most of it.

Since no one can argue with your experience, it's foolish to throw rocks at someone else's. And while personally, I would vote to change the names of type 1 and type 2 diabetes to better reflect the differences and educate the general public about the differences, when it comes to helping each other out, let's not overlook that living with any chronic disease we share many similarities."

What's your take on this?

A success for "Weekend for Women"

Tue, 25 May 2010 11:19:36 -0400

I just returned from the first "Weekend for Women" event put on by Diabetes Sisters and sponsored by TCOYD. Actually, the two events dovetailed this past weekend in Raleigh, North Carolina.

Diabetes Sisters was started just a few short years ago by Brandy Barnes, to bring women living with diabetes together and break the isolation so many of us feel.

As Brandy opened the event Saturday evening she said she couldn't believe how quickly she was seeing her dream come true as she looked out at the 100 faces staring back at her.

For there we were: type 1s, type 2s pretty evenly divided, and all ages from early twenties to eighty. I talked with 80 year old Liza, who got type 2 diabetes three years ago and I only hope I have her vitality, and her looks, when I'm 80! Women also came from both the local area and as far away as California, Illinois, New York and Texas.

The event kicked off Saturday night with dinner, socializing and a pampering treatment: massage, nails, hair or make up.

Sunday former Ms. America and diabetes advocate, Nicole Johnson, gave a truly inspiring talk. She developed type 1 diabetes at 19 and went on, against the wishes of many around her who thought it would be too much for her, to win the Ms. Virginia and then Ms. America title.

While she is beautiful, her talk - warm, funny and personable - showed she is beautiful on the inside too. And while there was probably no other beauty contest winner in the audience, I think we could all identify with the limitations she talked about that others often put on us and that in mass we turn that around to show just how capable and remarkable each of us is.

The day continued with a host of informational lectures from keeping your heart healthy, feeding your body, mind and spirit and dealing with body image to having a healthy pregnancy and going through menopause. Sheri Colberg was our ending key note speaker and she shared from her book secrets of the longest living people with diabetes.

As much as we came together to bond, celebrate and learn, it was also inspiring for me to see what Brandy had created bringing us together, and the uncompromising support she appears to have from her beloved type 3 husband and sister.

There's another "Weekend for Women" in the works for next year and it may even happen sooner than expected. If you'd like to participate you might want to stay current on the Diabetes Sisters web site.