(Screen of the G5 app on my iPhone)

Yes, I’m one of those: I had a Dexcom G4 and was all excited about it the first few weeks and months and then my enthusiasm waned. But really there’s a very good reason.

My life is generally very predictable and routine. I work at home, and so can control my food and exercise. So after I saw my routine life on my Dexcom for a few months, it didn’t reveal to me anything new of much value.

But I used it pretty religiously when I traveled. After all, that’s when I’m out of my routine. It didn’t matter whether I was going to Pennsylvania overnight to give an A1C Champion peer-mentor program, or going to Holland for two weeks, I strapped on Pinkie. I did so a few days ahead of time because the first day’s numbers are unreliable not having yet synced with my meter.

Then, remarkably, for I would not have guessed it, I tired of doing this too. Little by little, Pinkie stayed behind when I went to Buffalo or London. I just wasn’t a big fan of wearing a device (no, I don’t wear an insulin pump). Plus I had another issue.

When I’d see Pinkie’s little arrow pointing upward toward the sky I wanted to stop it. More than anything, I wanted to stop those escalating white little spots before they went past my yellow line. So, I’d give myself some extra insulin. Splat! An hour later I was dropping low at a ferocious rate. No one to blame but myself. Operator failure FULL STOP! And I was tired of this routine too.

Pinkie’s (if you haven’t guessed, Pinkie is the name of my Dexcom G4 receiver) been laying low now, retired for about a year. But in a few weeks I’m going on a big trip – 14 cities in 3 days, okay, not exactly, but 5 cities in 5 weeks with tons of time zone crossings – and I figured it was time to pull her dance card out again.

Little did I know but what happens to many people when they retire happened to Pinkie. She died. And none of my numerous, pleading charges could bring her back to life.

That began my frantic scurrying to get a new receiver before my trip. Which I did, and I now have. But it was not without enough headaches to make a Monk race for his Frangelico! The minor migraine includes the fact that I was moving from a Dexcom G4 to  G5 that would now use an app to show me my results on my iPhone. Steep learning curve here – for me.

You likely know this getting anything from your insurance company game. First I called my insurance company to find out what the Dexcom G5 would cost me. They sent me to my durable goods supplier, who sent me back to the pharmacy division of my insurance company.

They could give me a retail price, about US $2500 for a receiver, two transmitters (they only last 3 months now and are programmed to shut down 90 days from when you start them) and a 90 day supply of sensors, that means 12. They could tell me the retail price but not what my insurance would cover. So it was close your eyes and jump. I did.

I had my endo submit a script for the CGM of course only to be contacted again to submit prior authorization. I had been made aware this was likely how it would go, but not the fact that when my insurer called my endo for the prior authorization, they didn’t have her new office phone number. And everything halted to a stop. Did anyone call me for the correct number? No, for five days when my request sat. It was only reinstated because I called to check on how things were progressing. Mind you my big trip was only weeks away.

Proper phone number given, I held my breath. Remarkably, the wheels were set in motion and without another hitch Pinkie 2 showed up ten or so days later at my door. Then the real fun began…

For some reason you don’t get a full user guide/set up guide or a video. You get a small booklet from which to set up this CGM with all its wizardry on your phone. And I am a low-tech fool and allergic to apps.

First I plugged Pinkie in to charge her not realizing she’d come fully charged from the factory. I didn’t realize because IMHO the battery icon stinks. It’s shaded in grey and hard to read. Then the transmitter icon kept flashing so I figured I’d walk through the app to see what’s what. I realized I could only get through a few first screens before I had to be wearing the sensor to set the app up. So, I stopped. It was past 10 PM. I’d sleep on it.

Rested, this morning I went into action. I put on my new sensor and transmitter (I always have to watch the insertion tutorial because I find the finger placement awkward.) Then I continued reading through and filling out screen after screen in the app. By screen 15 (okay a slight exaggeration) I was so farmisht (Yiddish for mixed up, crazy) I went desperately googling for a set up video. Luckily some nice man put one up. Here it is if you need it.

The video tipped me off to the fact that I had to set up both the app on my iPhone and the receiver for the 2 hour warm up period. Done, I decided to go for my hour walk and finish the set up when I came home. Nearly home, I get a beep from my phone. I look down on the screen, “Signal loss.” Sh&t!

Luckily, when I got home and my phone and receiver cozied up on my desk, the lost signal was remedied. When the warm up period ended I did my two calibrations with my meter and entered the numbers on both my iPhone and receiver. Now we’re swimming.

My IT husband showed me how to set up a widget so i can see my blood sugar without having to first swipe the unlock on my phone, enter the 4 digit code and tap on the Dexcom app.  And, woa, since I’m sharing my numbers with him, he just showed me how they pop onto his iWatch! Okay, I might have to get one of these watches…

But for now, since I am a controlling, analytical, researcher-crazed Virgo, I’m off to read the small G5 booklet cover to cover.  

…says Dr. David Katz, leader in integrative medicine, nutrition and public health. And, I believe him. We do know how to reduce obesity. According to Katz every eating plan, from Atkins to Paleo, from The Zone to the Mediterranean, while they differ somewhat share the same basic healthy foods: mostly vegetables and fruit, healthy fats like nuts and seeds, avocado and olive oil, some lean protein, whole grains, legumes and not a lot of red meat.

Katz says we need to stop fighting over this plan or that, this nutrient or that, and focus on just eating mostly whole, real foods. As Michael Pollan, author of Food Rules, put it, “Eat real food, mostly plants, not a lot.”

Katz is forthright in saying we obfuscate declaring this is the way because media’s ratings go up when we disagree or shout about new diets, big food manufacturers profit while making people believe Doritos are healthy because they took out the fat, and society so far has been unwilling to do the hard work – making our environment conducive to maintaining a healthy weight. As they say in public health, ‘People will make the healthy choice when the healthy choice is the easy choice.’

Here’s Katz in a brief 5-minute video that sums it all up and a longer article, one of many, that puts the whole discussion to bed.

I wrote about this topic in my most recent article for the Huffington Post.

I believe in addition to the cost-savings Community Health Workers (CHW) offer helping to fill in gaps in healthcare where professional health providers don’t exist, they also offer a second cost-savings benefit.

This benefit is largely unseen. But CHWs may be even more effective than HCPs at helping patients begin healthier behaviors. As members of their community drawn to serve their neighbors, CHWs foster relationship, trust and self-regard in those they see more than most of us feel from visits with our more highly trained health professionals.

For the full article click here.

As the cartoon says, ‘Relationships Have Power.’ Unfortunately not much when a health professional’s relationship is with your electronic record – not you.

Relationship Power in Health Care: Science of Behavior Change, Decision-Making and Clinician Self-Care is a new book by John B Livingstone MD and Joanne Gaffney RN, LICSW. This cartoon is from the book.

I’ve just started to skim this text book and it excites me for two reasons. 1) It’s about my favorite topic – the seminal importance of relationship between provider and patient. 2) The book is a declaration, based on much research and professional experience, that the relationship in healthcare between provider and patient is an integral part of successful outcomes and healing. And, that medical training all but leaves this out of the curriculum.

This book’s authors are extremely learned, with both medical and therapy backgrounds, and aim to equip health professionals to work constructively with patients, taking into account that patients are whole human beings. That while we don’t see it on display, we come into the exam room an entire library of personal beliefs, memories, experiences and cognitions.

I don’t know how successful a book can be in this mission, but it’s recognition how grossly needed relationship skills are.

 

A moving, humble and heartfelt 15 minute talk by Dr. Peter Attia, who as a young surgeon, felt utter contempt for a diabetic patient he had to perform an amputation on. Couldn’t she have avoided getting fat? It’s not that hard, he thought, now she has to have her foot removed!

That judgment, and his own 40 pound weight gain and loss, made him think twice about obesity. Maybe we have this obesity thing all wrong he thought. Maybe it’s not obesity that causes insulin resistance, diabetes and metabolic syndrome  – but insulin resistance that causes obesity and these linked conditions.

I’ve heard this before and I think he’s right. The talk is well worth watching.

I just returned from Washington DC. For the past several years, my lovely, supportive husband has said to me intermittently, particularly when I write something inspiring, “Riva goes to Washington!” In the spirit that I should be invited to address the highest committee on diabetes at the seat of our government. My normal response is to roll my eyes at him and say lovingly, “That’s nice, honey.”

But now I can actually say I went to Washington. I was invited by Abt Associates,  who are working with Medtronic Philanthropy, to create programs that expand community-based access to care and management of diabetes and heart disease in the US, Brazil, India and South Africa. The project is called HealthRise. Above is lovely Ronaldo from Brazil. I’ve met Ronaldo before through his work as an IDF Young Leader with Diabetes.

The emphasis of the three day conference was discussing ways to engage and empower patients. The head of Abt’s Health Division had heard my Award Lecture at the IDF World Congress in December on a Flourishing Treatment Approach and invited me to share it with this group: Public Health PhDs, government reps of diabetes and health organizations, Medtronic Philanthropy grantees and patients.

If I were sixteen years old again my description of the work I got to do with the group would be “awesome.” Working with committed people in various sectors of the healthcare system, from different parts of the world, is a reminder how similar our difficulties are engaging and empowering patients – and making care accessible, especially to low income populations. And it is my personal take, that we shouldn’t be limiting engagement and empowerment to patients, but include health professionals as a group also who need to be engaged and empowered working with people who have a chronic illness.

Unfortunately many health professionals are hindered by their training – knowing only to tell patients what to do and employing little to no empathy and listening skills. Of course there’s also time limitations, crushing budgets and targets to be met and measured. You get the idea.

The highly educated conference attendees quickly grasped the value of adding a positive and possibility-focused flourishing approach to the already traditional more negative and limited-focused coping approach,  working with people who have diabetes. It resonated instinctively. The simple common sense that treating patients like human beings is a powerful connective strategy. And that health professionals aligning as partners, lending support, praising what patients do well, and bringing out patients’ resilience and strengths – that in turn fosters trust, confidence, action and skills – is wholeheartedly where we need to go.

My half day workshop was preceded by a day led by professional story-teller Noa Baum. She taught the group the craft and power of sharing our stories. Especially as telling one’s story relates to advocacy. We experienced the ability of our stories to move others and create trusting relationships almost immediately. And that attentive listening and serving as a Thinking Partner, which I had the group practice, is a gift we give others. It supports people in thinking more deeply and sharing their story with the ease and confidence of knowing you won’t be interrupted.

I commend Abt. It was a risky move on their part to use a story-teller and inspirational speaker when they could have devoted more of the conference to working on organizational and systems issues, data conversion and transference, scaling operations and such. But I think all agreed it was a risky move that paid off. People were excited and energized to see what’s possible and have the opportunity to use the other half of their brain.

At the end of my lecture I facilitated an exercise to help the group bring out strengths and resources in a partner. Then the conference closed with each stakeholder group creating a plan for how they will use what they learned to achieve their project aim.

So, yes, riva’s been to Washington. But word has it, from riva herself, that she wouldn’t mind going again.

The husband above.

I panicked. Just around midnight. Minutes after I took my once nightly injection of my long-acting insulin.

Had I taken my once nightly shot, twice?

Like others with type 1 diabetes who don’t use an insulin pump, I take what’s called MDI. Multiple Daily Injections. I take an injection of rapid-acting insulin before meals and snacks to lower the rise of my blood sugar produced from carbohydrates.

I also take an injection of long-acting insulin once a day for the background metabolic functions that require insulin.

For years I took this once daily injection at 9 AM. But when I switched my long-acting insulin, from Lantus to Toujeo recently, taking Toujeo at night seemed to work better for me. Now I take it every evening at 9 PM. Yet, this habit isn’t really fully formed yet.

It was easier to take my once-a-day insulin in the morning. I’d take it at the same time I took my rapid-acting insulin to cover breakfast. But there is nothing to remind me to take my 9 PM injection.

So I’ve written it onto my computer calendar. It’s there in the box every day. Well, every night. Of course this does require me to be behind my computer at 9 PM to see the calendar alert. Sadly, I usually am, but that’s another story.

Last night, though, from 8 to 10 PM I was watching a movie on my iPad sitting on the couch. Chances are my calendar alert came up on my iPad but, watching the movie and intermittently Facebooking a friend, I likely didn’t see it.

Yes, the horrible dopamine of social media and multi-tasking had kidnapped my diabetes-tasking-mind. But I was trying to do a good deed. My “friend” had asked, “How do I adjust my long-acting insulin for flying to Germany?”

Of course this should have reminded me to take my own insulin injection. And, maybe I had. That was the problem, now at midnight. I couldn’t remember if I had. Please, no sneers, life with diabetes is tough enough.

Reviving myself from my near slumber, I ambled into the kitchen where I keep my long-acting insulin pen. I stared at the pen begging it to answer my unspoken question, “Did I stick you in my body just a few hours ago?”

When I’m not certain I can usually answer that question by remembering where on my body I injected. If that doesn’t work, I try to remember where in my apartment – in the kitchen, in the bathroom, on the couch? I was coming up blank.

When I was using Lantus, I relied on a Timesulin cap to keep track for me whether or not I had taken my shot. Timesulin is a pen cap with a counter in it. I always knew how long it had been since my last shot. Simple, yet fantastically effective.

But Timesulin doesn’t make a cap for Toujeo. And while I was using my Timesulin cap on an old Lantus pen, “shadowing” my Toujeo injections, the cap’s battery had run out just three days ago. I was in the process of getting a replacement.

Standing right at the fork of do I or don’t I, I dialed up my dose and injected. If this was my second long-acting shot of the night, I would have double my dose of insulin in my body for the next 24 plus hours.

This month I’ll have lived with type 1 diabetes forty-four years. Yet, for anyone who has it, we know every day is a new day.

Years in don’t prevent making a mistake. Or being at risk every day and every night for taking too much insulin. Leaving you wondering, as I was now, if I was about to overdose in a few hours and not wake up. Trust me, that’s a terrifying feeling.

Immediately after I took the shot, I googled, “Who has double dosed their basal insulin?” “What do you do if you take two long-acting shots by mistake?” I read the stream of comments and then followed the strategy many well-wishers suggested. Set your alarm and wake up every two hours to check your blood sugar.

I read for another hour til 1 AM and set my alarm for 3 AM. Laying there, I wondered how long it would take my husband, who was in Holland on business, to discover tomorrow that I hadn’t woken up, but had died.

Next thing I knew I heard music. It was my alarm. Instinctively I scanned my body for signs of low blood sugar: Was I convulsing? Was my heart beating frantically? Was I sweating? Were my thoughts muddled? No, no, no, no, a very good sign.

I walked to my bureau where I had laid out my glucose meter ready for the check. Before going to sleep my blood sugar was 135 mg/dl (7.5 mmol/l). Voila, a lovely 120 mg/dl (6.6 mmol/l)! I had not taken two shots. This small overnight drop in my blood sugar is my normal.

In the morning my blood sugar was 105 mg/dl (5.8 mmol/l). Fantastic, no worries. But I do worry.

It can happen again. It can happen anytime. And I wonder if the chances will grow greater that I forget if I took a shot or not as I get older.

Type 1 diabetes is not just arduous to take care of. It is a scary disease. Frightening for the almost inevitable miscalculations that will occur in a lifetime of every days.

I, like many people, have mixed up my rapid-acting and long-acting insulin. Once, exactly a year ago. Drinking a quarter cup of maple syrup prevented a near death experience then.

Insulin is a dangerous drug yet we must rely on it to live.

But please don’t forget, those of us who live with type 1 diabetes, and to a lesser degree those with type 2 diabetes who take insulin, are making daily decisions for their health – that can just as easily snatch their lives away any day, or any night.

I saw this on my twitter feed from Andreas Eenfeldt who calls himself diet doctor. I usually read what he tweets as he is a fellow low-carber. He’d posted the photo above.

I love that this grocery is looking for solutions rather than moaning about the problem: kids eat too much junk.

I posted it on my Facebook page and one comment that came back was, “When that banana peeling drops on the floor, and someone steps on it…watch out! Messy floor, messy buggy, messy child’s clothing. Not a good idea, in my opinion.”

Well, that’s perfectly legitimate. And truthfully I hadn’t thought of it. But once again we’re looking at the potential problem. How much better to think – okay, if the kid is left with a banana peel, then we’ll put lots of trash cans around the store. Or some such idea.

We have such a penchant, and I don’t know how much is cultural and how much nature or nurture, to look at the problem and stop right there.

My father is now in a nursing home and has dementia. So I recently watched a documentary called “Alive Inside.” It’s the story of a social worker who brought personalized music to dementia patients living in nursing homes.

He had an idea – music awakens the brain and he wanted to see if it could also do so with people suffering with dementia.

He began finding out what music was meaningful to a number of patients in the home. He ripped those tunes onto an iPod for each patient. They got “their personal music” and headphones. People who’d barely spoken in years began to chatter. One woman who’d been in a wheelchair for two years got up and danced.

Seeing the beauty of what happened, and having a doctor agree that reaching the human soul through something like music can do more than drugs, he began to call nursing homes around the country to invite them to start such a project.

What did he initially get? “Well, we’d need an iPod for every patient. We can’t afford it.” And, “We’re not sure this will work.” He got resistance. He got small thinking. He got the company line. Luckily, he continued promoting the idea and in time many nursing homes began such a program. Of course, not enough, but it’s rolling.

If we dare, let’s think “yes” before we think “no” and then figure out how to make it possible. Yes, let’s go outside the norm to where amazing things happen by virtue of passion, dedication, commitment and being willing to buck the status quo.

Those who follow me on Facebook saw me litter my page this week with a bunch of screen shots from Dr. Mark Hyman’s “The Fat Summit.” I also talk about it in the post below.

Dr. Hyman, best-selling author of health and nutrition books, particularly around carbs, fat and blood sugar, and Director of the Cleveland Clinic Center for Functional Medicine, interviewed more than 30 nutrition xperts on whether it’s healthy for us to be eating fat, including sat fat from meat.

His expert panel included top people in the medical, scientific and lifestyle sciences. Just to name a few: Deepak Chopra, MD, Chris Kressler, MS, Aseem Malotra, MD, Gary Taubes, David Ludwig, MD, PhD, Walter Willett, MD, Christiane Northrup, MD, Michael Roizen, MD, Neal Barnard, MD.

Hyman, and most of his experts, advocate a diet high in healthy fat – nuts, seeds, olive and coconut oil, avocado, eggs, full fat dairy and some meat. And no refined carbohydrates. I should say right now that’s my own personal bias, as well and how I eat.

Most of his experts validate it’s not a matter of calories in, calories out we we’ve always heard or eat less, move more. It is the quality of those calories and how your body uses them.

Interestingly, the very friendly and charismatic Hyman, talked frequently about how contradictory the information is coming at Americans about nutrition and how difficult it is for the average person to know what’s right and what’s wrong. No doubt. So I found it funny that even among his guests, not all agreed with each other.

Very briefly: all agree healthy fat is better than bad fat. Healthy fat is better than refined carbohydrates. The disagreement is whether we should really eat a lot of healthy fat, like neurologist Dr. David Perlmutter, who pours olive oil on his morning eggs. Or should we severely limit healthy fat too like Dr.s Dean Ornish and Joel Fuhrman do who think the benefit doesn’t outweigh the calories consumed. Yes, pun.

For me, having diabetes, eating a diet plentiful with healthy fat and low in refined carbs is a no-brainer. Carbs raise blood sugar. Refined carbs spike blood sugar. Higher blood sugar requires more insulin. Insulin is a fat storage hormone. The more of it circulating in your blood stream, the more it’s causing calories to be stored – in the liver as fat. Voila, you gain weight, mostly putting it around your belly, and you end up with fatty liver disease to boot. By the way, most people with Type 2 diabetes also have fatty liver disease and don’t know it.

Dr. Hyman is also popularizing the notion that goes a step beyond “food is medicine” to “food is information.” Food tells your body how to act, respond, behave; it guides your metabolic response, tells your body what hormones to stimulate and influences what genes get turned on. That’s why a more nutritious diet decreases the risk of all dis-eases.

Here were some of the take-aways from the conference mid-way. It continues another three days:

• The typical American diet: 55% of calories come from processed food (white flour, sugar, cola, cookies…), 30% of calories come from animal products, 5-7% from unrefined plant foods (vegetables)
• Food is more powerful at lowering blood pressure than mediation
• Low fat vegans don’t live as long as those who eat more nuts and seeds
• If you want to lower your A1C, eat more fat and less carbs
• A1C levels of 5.6% and higher show brain shrinkage on MRIs
• When the brain burns fat as fuel instead of carbohydrates it does so more efficiently and without creating as many free radicals
• Insulin keeps fat locked in our fat cells preventing it from getting burned or used. Eating fat does the opposite.
• Obesity kills more people than smoking and alcoholism and being sedentary combined.
• Soda consumption is the number one contribution to obesity in America
• The process of getting fat makes us overeat
• Most of our cows today eat corn, which they aren’t designed to eat but corn fattens them quickly inflaming their fat cells.  Eating them fattens us and contributes to our body’s inflammation.
• In a statin study, 96% of people who already had a heart attack saw no benefit, 1 in 83 had their lifespan extended, 1 in 39 were helped to prevent a repeat heart attack, 10% suffered muscle damage
• The food industry is giving at least 50 million dollars a year to politicians
• Since 1948 Procter & Gamble has been a major funder of the American Heart Association. You do the math.
• Media no longer has time to do investigative research on food plus their news outlets are usually owned by corporations that have an agenda

One thing not to forget as has become a catch phrase in diabetes, “Your diabetes may vary.” As Hyman stressed, we are all individuals. Different things may work better for different individuals. So whether you should eat a lot of healthy fat, moderate amounts or very little, may differ for you. The best way to know is to try the variations on yourself.

For me eating a liberal amount of healthy fat – nuts, seeds, tahini, avocado, coconut and olive oil, eggs and some cheese and Greek yogurt, and grilled chicken and fish with occasional red meat, tons of vegetables and little to no refined carb – works extremely well in keeping my weight down and my blood sugar from spiking. I haven’t counted a calorie for a decade. And I feel good.

Of course we also don’t live in a food vacuum. I walk an hour most days, drink wine with dinner most nights, drink a lot of water and no sugary beverages and have the genes I was born with.

I don’t think there’s any easy answer to this nutritional debate. But I do think we’re lucky more information is coming out that we can all access.

So take the daily contradictory news headlines about food and what the government says and ads say, even I hate to say it but must, what the behind-the-curve organizations like the Heart Association and the American Diabetes Association say, with a grain – or a plantation full – of salt.

As I mentioned in the list, the American Heart Association gets an enormous amount of funding from Procter & Gamble. See a hidden agenda?

People can always make studies and statistics say what they want them to say and food lobbyists are a powerful force.

How can we dismiss that 40 plus years or so ago, when we were all pushed to stop eating fat and eat more carbs, Americans got fatter than ever?

It’s occurring right now online. It’s not clear to me if you can still register but if you email info@fatsummit.com you may be able to find out. Thirty plus experts in nutrition science debunking the myth that fat, including sat fat and dairy fat, is bad and the cause of heart disease, obesity and other ills like diabetes.

Junk science has vilified fat and led Americans for the past three decades to replace it with carbohydrates. Take a look around. How could anyone not put two and two together? We’re ingesting more carbs and fatter than ever. Specifically high glycemic index carbs, refined and processed carbs like cookies, cake, pie, candy, muffins, scones, white potatoes, rice and pasta and sugary drinks. The stuff you love that keeps you craving more.

If you’ve followed this blog you know I’m a proponent of a modified version of the paleo diet – high quality fat – nuts, seeds, olive and coconut oil, avocados – vegetables, some fruit, protein, including some red meat (of course grass fed is always better), and some full fat dairy. I lost 8 pounds in a matter of weeks without trying by switching the way I eat to this diet from the typical American diet. And if you didn’t know, I was heavy as a young adult always trying unsuccessfully to lose weight by counting calories and starving.

Forget “calories in, calories out.” That’s not how it works. The body processes nutritious foods differently than junk and chemicals. Think instead, “What is nutritious to put in my body?” Forget losing weight. Think, “I want to eat healthy food, the weight will come off.” And here’s the simplest explanation why refined carbs make you fat. First, they spike your blood sugar. This causes your body to pump out more insulin to bring your blood sugar down. Or if you make no insulin or your body doesn’t use what it makes well, you may be injecting insulin. Eat refined carbs and you have to inject more.

Now you’ve got rivers of insulin floating in your blood stream. Guess what? Insulin is a fat storage hormone. It takes that blood sugar now floating in your body and stores it in your liver as fat. It’s the reason why most people with type 2 diabetes also, unknown to them, have fatty liver disease.

These summits give me hope. Hope we are making progress sharing new science about how food affects our health and obesity. Here are the names of the first two days presenters if you want to go to their web sites and look up their articles: Deepak Chopra, Chris Kressler, Aseem Malhotra (he was great), Gary Taubes (one of the people who started it all), David Ludwig, Nick Ortner and of course Dr. Mark Hyman.

You may also want to consider making a small investment in my third book, “Diabetes Do’s & How-To’s” and a large investment in you. It has 20 food do’s – actions you can take and how to take them – based on this way of eating. It also contains action steps on fitness, medicine and attitude regarding living with diabetes well. Make it a gift to yourself and change your diabetes health and your life. It’s available to you at any moment.