Month: July 2013

Learn more diabetes in one day at TCOYD

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The latest TCOYD (Taking Control of Your Diabetes) online newsletterfeatures my new diabetes survival guide – “Diabetes Do’s & How-To’s” – on its back cover. My thanks to all my generous friends at TCOYD and Dr. Steven Edelman, its founder. Read the whole newsletter and start learning.

I interviewed Dr. Edelman as a diabetes change leader on The Huffington Post. He created a true breakthrough – the delivery of diabetes education directly to patients via conferences. Don’t hoard conferences just for doctors was his enlightened thinking. For while Edelman is a doctor he has also been living with type 1 diabetes since the age of fifteen.

I also found my whole thinking about my power to live well with diabetes change when I attended my first TCOYD event. That was back in 2005 in San Diego. I was sitting in CDE/Psychologist, Bill Polonsky’s session. He said, “Diabetes doesn’t cause blindness, heart attack, amputation. Poorly controlled diabetes does.” Today he often says, well controlled diabetes is the cause of nothing. 

It made me realize my actions largely control my illness and I have power over my actions. Take good actions and you will benefit. I began using my power: eating healthier, eating less and walking more. The results have paid off and I see it each year when I get my blood work done. 

I highly recommend getting to TCOYD’s one day event, even if you have to travel. You will learn so much and it costs a mere $10 or $20 depending on when you register. 

Events are presented around the country, so see if there’s one coming up near you or take a trip, it’s worth it. This fall TCOYD will be in Worcester, MA, Omaha, NE, Albuquerque, NM and San Diego, CA. Here’s the schedule.

For now, sending my best to all my friends at TCOYD, the thousands of patients who have benefitted from a TCOYD event, and those who yet will.

Bronx, New York where diabetes thrives in a food desert

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IMG_1709 Your in interaction

Saturday I gave the A1C Champion program in the Bronx. The Bronx is one of the five boroughs of New York City. The one also where diabetes has the highest concentration, largely because it is the poorest.

I was speaking at a storefront church converted from an ordinary building. Bishop David was jamming as the afternoon’s DJ. There were about ten or twelve small folding tables in front of the church on the sidewalk where people could pick up some information about diabetes. A hot buffet table was set up where the hosts were ladling out a relatively healthy lunch – chicken, rice, beans, veggies, corn.   

Before my talk, I walked around the neighborhood. I wanted to see where you could shop for something to eat and what you would find. Certainly, I’m sure, there are supermarkets not far, but within the few blocks I walked, there were several “bodegas.” Little delis like this one above where you could run in and find food – sort of. 

This is what was on offer: sandwiches on big white bready rolls and packaged snack foods everywhere, it took up 95% of the store: candy bars, chips, bakery goods and sugary soda and juices. They covered the store from top to bottom. In one store, one lone bottom shelf held a few onions and potatoes. Those were the only fresh vegetables in the store, no fruit. In another store, I saw only rotting bananas as fresh foods go. And this food desert – the Bronx – is only a subway ride from where I live.

We keep saying people need to eat healthy; yet how are we helping them to do so? I also don’t have to tell you if it costs $1 to buy an apple and $1 to buy a Big Mac, where’s the incentive for people to spend their hard-earned cash on a piece of fruit?

It saddened me to see what I read about in article after article. The food deserts in America. Those poor neighborhoods where there is no fresh food available and fast food brothels line the landscape – McDonalds, Burger King, Kentucky Fried Chicken, Taco Bell. Places that seduce us with sugary, fatty, salty foods and low prices. 

Obesity and diabetes are not merely about individual responsibility – they are also about infrastructure, what the government subsidizes, safe neighborhoods with places to play. It is about getting healthier foods into poorer neighborhoods and helping people do the right thing for their diabetes. 

Yet, it also gladdened me to find the 20 people I spoke to were engaged, curious, thirsty for information and many were eating better than their parents. They shared their strategies from a one day a month “cheat day,” to sautéing fish with plenty of lemon and herbs instead of frying, replacing half the juice in a glass with seltzer and sneaking ten minute walks into the day.

The city councilman above gave a talk just before I went on and let people know how important it is to get exercise and about the parks he’s been building in the Bronx. His eyes were bright and clear as he greeted me and his passion for improving his community and helping people, was earnest. 

Saturday I traveled to a place so close to my home, yet so far from my world. But I also became a bridge for people to take a step from being under the thumb of this disease and its burdens to doing a little better. Riding home on the subway afterward, I was full from the adventure and my heart was light.

Medicare’s cost-slashing for test strips creates a DOC movement: Strip Safely

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StripSafely is the Diabetes Online Community’s raised voice to protect ourselves from inaccurate blood glucose meters and test strips.

This month Medicare begins offering a limited variety of glucose meters to its beneficiaries. Many of the test strips offered, and manufactured overseas, fall below the FDA approved standard for accuracy. That standard is already too low but don’t get me started.

I’m asking you to join the movement. It’s easy. Write a letter (samples provided) asking the FDA to ensure strip accuracy. If you have diabetes, know someone who does or love someone who does, you know this is a life and death issue.

And while you may think this doesn’t concern you because Medicare is a lifetime away, this may drive US manufacturers of meters and strips out of business. That means: no quality control, innovation, support services, educational programs, and oh yea, accuracy.

It only took me 15 minutes to write my letter. Here are sample letters to make it easy. And here’s mine. As you can see, I took the sample “Short Letter” and just made it personal.

Jeffrey Shuren, MD JD
Director, Center for Devices and Radiological Health
Food and Drug Administration
10903 New Hampshire Avenue, WO66-5442,
Silver Spring, MD 20993

July 2, 2013

Dear Dr. Shuren:

I’ve had type 1 diabetes for 41 years and I’m turning 60 next month. Two weeks ago my A1C was 5.5%, yes, normal. How is that possible? I adhere to a healthy diet, exercise every day, and check my blood sugar diligently using a meter and strips recognized among those with the tightest accuracy.

I am writing to you because while I might have said as a teenager, “I’d die if I don’t get that!” I actually could die if I don’t have accurate test strips.

Those of us living with diabetes truly need your help and advocacy. We are facing losing our health due to Medicare’s July 1st cost-slashing program. In only a few years I will be affected by this if nothing changes, and meanwhile US manufacturers may get squeezed out of the market due to price. That means we will lose further quality control and standards, innovation, new product development, service support and educational programs.

At a recent meeting with the Diabetes Technology Society, the FDA acknowledged that many blood test strips do not deliver the accuracy for which they were approved. Further, the FDA has no plan to fix this problem.

I need you to have one. My Aunt needs you to have one, my downstairs neighbor needs you to have one, and hundreds of my friends and acquaintances need you to have one. And my husband, who doesn’t have diabetes, desperately needs you to have one. Otherwise, one day he may not have me.

Blood sugar fluctuates all day, every day both as a consequence of what we do, and by its own nature. I don’t need the quality of test strips to also be uncertain.

Please, I am asking you to, at the least, implement a program of ongoing random sampling of strips to insure that all brands consistently deliver at least the minimal accuracy approved by the FDA.

While I have previously written that the FDA should tighten the ISO standard, how wonderful it would be if Fixing Diabetes Accuracy is one of the things for which the FDA becomes known.

Riva Greenberg

Don’t wait. This is something we can do together. And lives depend on it. Feel free to copy my letter, just fill in your own specifics.

Thank you