The new doctor: the patient

new patient

As the number of people with diabetes continues its astonishing rise – from 26 to nearly 30 million and in pre diabetes from 79 to 86 million – the number of endocrinologists who specialize in their treatment remains flat. 

There are roughly only 5,000 endocrinologists and 19,000 diabetes educators across the country today. How are we going to take care of the millions more people with diabetes adding to the statistics every year?

Few primary care providers refer patients to a diabetes educator and most patients with Type 2 diabetes are treated by their family doctor. Unfortunately, many are not up on the latest research, medical guidelines and/or drugs – and don’t want to spend the time titrating new patients on insulin.

But an unexpected and critical new member of the diabetes team has lately appeared: the highly informed or ‘smart patient.’ 

More and more smart patients are filling the educational gap – and filling a gap health care has been slow to recognize, the — “I get it” gap. To be blunt, health practitioners who don’t have diabetes for the most part simply don’t “get it.”

Looking at how patients are inserting themselves into the health landscape, we should be encouraged by our influence to continue and congratulate ourselves. We are making a crucial difference to thousands, maybe millions, of others living with diabetes.

The educational influence of patients

Since the first social media sites began popping up to widely share  knowledge, advice, experience and wisdom, offerings have grown more sophisticated catering to specialized audiences — Type 2s, Type 1s, parents of children with diabetes, women, athletes.

8 note-worthy social media/blog sites:
Children with Diabetes

Further, take a look at this year’s Top 10 recognized social health makers in diabetes. 

My first inkling that patients held sway was five years ago when Roche invited 30 top diabetes bloggers to their headquarters to better understand how to talk to their customer base online. Several other pharmas, including Medtronic and Eli Lilly, quickly followed suit.

More recently, patients have taken the stage at major diabetes conferences – the International Diabetes Federation World Congress, American Diabetes Association, American Association of Diabetes Educators and Children with Diabetes’ Friends for Life – sharing personal wisdom, device knowledge, social media information, and their distinct expertise.

I conduct workshops with health care providers to help them extend their repertoire from working with people with diabetes from a “coping approach” to a “flourishing approach”

Kelly Close, editor in chief of diaTribe, who has type 1 diabetes, said one of the most notable developments at the recent 74th American Diabetes Association Scientific conference, where more than 17,000 top diabetes medical professionals, scientists, researchers and trade people gathered, was the room given to the patient voice.


innovation summitAmy Tenderich, founder of the top patient news-reporting blog, DiabetesMine, has been running an annual Innovation Summit at Stanford University School of Medicine for four years. Patient advocates, device designers, researchers, clinicians, pharma R&D leaders, mobile health experts and regulatory experts gather to develop new ideas, products and tools to improve life with diabetes.

Two years ago big pharma, Sanofi, launched a similar initiative. Patients are nimble and quick where corporations and institutions often are not. A few months ago Tenderich launched “TestKitchen,” video reviews of diabetes products by and for people with diabetes.

Patients as mighty advocates

Diabetes blogger, Kim Vlasnik, launched her inspirational video, “You Can Do This”project three years ago from a personal passion to validate and share “honest talk” among people with diabetes and their loved ones. It’s popularity is the benefactor of the “I get it” factor.

The Diabetes Online Community this past Valentine’s Day asked people to buy their ‘Valentine’ 11 roses instead of 12 and contribute the change left over to Life for a Child, the humanitarian organization that provides clinical care and insulin to children in developing nations.

The campaign brought donations from 24 countries and raised more than US $27,000 dollars. That’s an additional year of life for 454 children.


stripsafelyBennet Dunlap, who has two children with type 1 diabetes, created StripSafely. It’s hard-charging message – to tell the FDA that people with diabetes want glucose test strips checked for accuracy both before, and after, they enter the marketplace – was driven across the diabetes space by advocates.

Last March, Bennet hosted a Q&A webinar with the FDA whose public docket on meter accuracy received record levels of comments from the diabetes community. The FDA is now creating a post-market surveillance-testing program.

This is a mere slice of what patients are doing – and only in diabetes. 

AtPatientsLikeMe patients are tracking and sharing their health information, according to the Company on more than 2,000 conditions – from medical diagnosis to treatment plans and outcomes. In addition to patient-sharing, data from this rich repository of real-world experiences is being shared with pharmaceutical companies to improve and quicken drug development and treatments. 

When I wrote my second book in 2009, 50 Diabetes Myths That Can Ruin Your Life, my book agent said we’d never sell it without a doctor’s name on the cover. She was wrong, only my name is on the cover, but five medical experts who vetted the work are prominently listed inside.

Now, every month, books written strictly by patients appear in my mailbox.

Peer-mentoring is supplementing healthcare

Medscape’s article, “Peer Coaching Improves Glucose Control in Diabetes,” confirms both the value of peer-coaches to help create clinical improvements in patients and their ability to fill the gaps where primary-care providers are in shortage, particularly in low-income and rural areas.

Since 2007 I have been a peer-mentor in the Sanofi A1C Champion program. Having grown from three peer-mentors in 2003, today 87 of us contribute and criss-cross the U.S. on any given day delivering five different educational programs.

Henry Anhalt, D.O, Interim Head of Sanofi U.S. Diabetes Medical knows the strength of the program, and of patients. As Anhalt told me, “We recognize that the patient’s voice is extremely powerful in motivating other patients to adopt positive health behaviors and become more engaged in their health.”

Rachel Sexton, Vice President of VPR POP, the company that manages the A1C Champion program, hears often from physicians after a program, “I’ve been telling my patient this for years, but it didn’t sink in until they heard it from another patient.”

Part of the magic peer-to-peer programs offer is what’s often missing in healthcare, empathy. Sanofi has already developed with VPR peer-mentor programs in two additional disease states – Gaucher and Multiple Myeloma.

Expanding opportunities for patients 

HealthDay just reported that one in ten visits to the doctor involves diabetes. The epidemic is growing. While patients should never, and will never, replace health professionals, we can offer something medical practitioners cannot.

Not bound by the restrictions of a mammoth health care system that providers and insurers labor under, we can be fleet of foot, more innovative and across the internet reach thousands like ourselves. One day millions. 

The influence of patients also benefits practitioners. By reading diabetes social media sites and books written by people with diabetes, practitioners can learn what patients think, feel, need and are concerned about, and – in our time-starved medical system – share these resources with their patients.

young leaders
International Diabetes Federation’s ‘Young Leaders in Diabetes’ conference, Melbourne 2013. 124 diabetes patient leaders from more than 60 countries. 

I believe what Sexton foresees – patients will be inserted into more programs and places including educating medical students, those at healthcare corporations and anyone with a vested interested in health.

We should be looking now at creating ever more opportunities where people with chronic illness can serve as educators and inspirers.

We should be more fully leveraging this powerful and critical “smart patient” movement to educate, cut costs, amplify resources and offer the sole province of patients – shared empathetic understanding.

For in the end, no one “gets it” like the one who has it.

For a list of more diabetes social media sites, blogs, books and more on the A1C champion program click here.

Diabetes resources and A1C Champion program information

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More and more patients living well with diabetes are teaching and supporting other patients by sharing their wealth of knowledge and experiences.

Here are lists of trusted diabetes web sites, social media sites, blogs, books and information about the A1C Champions peer-mentor program I participate in.

If you are interested in a free A1C Champion program for your patients, or becoming an A1C Champion peer-mentor yourself, the contact information is below under “The A1C Champion Program.”

Recommended Diabetes Websites  (in alphabetical order)

American Diabetes Association (

Social Communities

#DSMA (Weekly twitter chats) (female-specific)

EstuDiabetes (Spanish) (Type 1 diabetes-specific) (Type 1 diabetes-specific) (Various disease states) (Type 1 diabetes-specific)

A list of those in the infamous Diabetes Online Community

Blogs, communities and more. The most exhaustive list I’ve seen.

Several books written by people with diabetes

Balancing Diabetes – by Kerri Sparling

Diabetes Do’s & How-To’s, 50 Diabetes Myths That Can Ruin Your Life and the 50 Diabetes Truths That Can Save It and The ABCs of Loving Yourself With Diabetes – by Riva Greenberg

Emotional Eating with DiabetesYour Diabetes Science ExperimentDealing with Diabetes Burnout – by Ginger Vieira

Kids First, Diabetes Second – by Leighann Calentine

My Sweet Life: Successful Women with Diabetes and My Sweet Life: Successful Men with Diabetes – by Beverly Adler

SHOT – by Amy Ryan

The Book of Better: Life with Diabetes Can’t Be Perfect. Make it Better – by Chuck Eichten

The First Year: Type 2 Diabetes: An Essential Guide for the Newly Diagnosed and Prediabetes: What You Need to Know to Keep Diabetes Away – by Gretchen Becker

The Sisterhood of Diabetes – by Judith Jones Ambrosini

The Smart Woman’s Guide to Diabetes – by Amy Mercer

TypeCast: Amazing people overcoming the chronic disease of type 1 diabetes – by Andrew Deutscher

Books by parents of children with diabetes

Raising Teens with Type 1 – by Moira McCarthy Stanford

Kids First, Diabetes Second – by Leighann Calentine

And now for some books written by patients who are also medical professionals:

Dr. Bernstein’s Diabetes Solution – by Richard Bernstein (Also a doctor)

Taking Control of Your Diabetes – by Steven Edelman (Also a doctor)

Any of Sherri Colberg’s books (Also an exercise physiologist)

Any of Gary Scheiner’s books (Also a CDE)

The A1C Champions Program

If you’re a medical professional and work with people who have diabetes, you can request one of these six free, hour long educational programs for your patients. Each program is presented by someone living successfully with diabetes.


• Taking Control – Basic educational program

• Managing Diabetes: The Next Step (live and webinar)

• Telling My Story – Adult with type 1 diabetes speaking to type 1 youth

• Our Diabetes Journey – Given by parent and child for parents and kids

• Me-Power – Program from a person with diabetes and CDE

• Diabetes Together – Given by a person with diabetes and his/her care partner

To request a program, please visit or call: 816-756-5999.

If you have diabetes and would like to become an A1C Champion, please contact the website or call the number above.

I’ve been an A1C Champion since 2006 and love going out and helping others with diabetes learn, grow and gain the confidence to do better.

Whether I’m speaking to a support group of patients in rural Ohio, or am part of a full day health event in Albuquerque, New Mexico, it’s the cliché in action – “you get when you give.”

Many A1C Champions say being in the program keeps them more committed to their own health. Fellow Champion, Doreen, says, “When I share my story people open up their lives to me, wanting to talk and share their challenges about diabetes. I can’t imagine doing something more rewarding.

81 years young Charles has been with the program almost since it’s beginnings in 2003. “These programs give hope and information that patients often do not receive from their healthcare provider, and, they actually see that people can manage their diabetes.”

Finally, as my new friend, new Champion, William, said, by way of Groucho Marx’ quote, I wouldn’t belong to any club that would have me, “I’m ecstatic beyond words that the A1C Champions program would have me, and allows me to be part of the team, do this work and give back.”

“Diabetes Do’s & How-To’s” the essential action-book on Kindle!

Screen Shot Do's bookPM

As I travel around the country one of the outstanding things I see, and hear, is confusion about managing diabetes. So many of us, whether you’ve just been diagnosed or had diabetes for decades, whether you have type 1 or type 2, truly don’t know how to really take care of it, and ourselves. 

It’s not surprising. We get at most a few hours a year with our doctors and then have to make our own decisions what actions to take during those other 8,700 plus hours. And no one ever gave us an instruction booklet. Think about it – you don’t get to drive a car without first taking driving lessons, yet we’re all walking around with a complicated, life-threatening illness without  instructions.

That’s why I wrote this, my third book. It is the “instruction-manual” for diabetes. The small, yet powerful, doable, “real-life” actions to take – what to do and how to do it – regarding food, medicine, fitness and staying positive so you can live your healthiest life with diabetes. 

For example, you’ll discover how you, or a loved one, can eat healthy, bring your weight down if necessary, without dieting, how you can easily get a little more physical activity, manage your blood sugar much better to avoid highs and lows, keep your medicines stocked, know what you lab test results mean and what to do about them, prevent and delay complications – all that you need to know to live longer and better. Not to mention the incredibly funny cartoons from magnificent cartoonist and fellow PWD Haidee Merritt. Well, I figure there have to be rest-stops and rewards while you’re working.

For health care professionals the book is a tool to help you more easily, and more collaboratively, guide your patients, through steps and worksheets, to healthier behaviors. 

And while a team of top-notch certified diabetes educators consulted with me, and a slew of outstanding medical professionals and patient advocates endorsed it, this is not a “medical” book. It’s me talking to you from my real-life and sharing what keeps me healthy. It’s all the latest national standards and recommendations you need to know, and some pioneer-thinking I embrace. Most of all, it’s the practical actions to guide your steps, at your pace, to improve your health: to get the most reward for your efforts.

But don’t take my word for it, really. My passionate portrayal of the book is only because I want you to benefit. Go on Amazon, Search Inside the book, where you can see quite a lot. 

Also, check out my four upcoming posts about the book on Diabetes Dailythis month beginning next Tuesday. You’ll also get a $4.00 savings off the book (there’s a discount coupon on my posts at Diabetes Daily), so you can give yourself the gift of better health however you like it – in print or Kindle.

If you find the book helps you, share it with a friend. I want nothing less than for all of us to enjoy our best health, and the life we deserve.

Two new diabetes food books worth chewing on



Not food in the sense of recipes and cooking, but food in the sense of how to eat healthy. This Spring I had the pleasure, along with several other women, to contribute to Amy Mercer’s new book, The Smart Woman’s Guide to Eating Right with Diabetes: What Will Work.

This is a great read if you’re still trying to figure out how to eat sensibly and not give up everything you love – and who among us isn’t to some degree? Amy shares her own struggle and successes with food and invites about 10 of us fellow smart, successful women with diabetes to share what we do so that we manage to control our blood sugar, and manage our carbs, while still eating things we love. Not only will you get tips, but I guarantee you will feel you have a community of women to hang out with while yore reading and a cheering squad who get “it”.

This is also an exceptional book for health care providers to get, and share, a real-life picture of what actually works for patients, rather than just dispense the standard dietary guidelines.

Two weeks ago I read Ginger Vieira’s new book, Emotional Eating with Diabetes: Your guide to creating a positive relationship with food. Ginger is not only an amazing diabetes videographer, power-lifter and writer, but she’s also a health coach. So when Ginger talks about ‘emotional eating’ she knows of what she speaks.

The book is big in size, yet short in pages. Just the right length to cover just the essential, most important topics regarding eating: both the difficulties and hardships, the battling and fighting food, and how to be more successful with an eating plan and staying positive. 

Ginger’s topics include: Habits that lead to overeating, Over-treating lows, (boy, don’t I remember early on eating everything in sight from pie to toast and jam, cookies and fruit, all at the same time, to get my blood sugar up!), Using food to stuff emotions and then coming into the light to develop a more positive relationship with food. 

Psychologist, Dr. Bill Polonsky writes the forward and there are several worksheets in the book, for as any good coach does, Ginger asks you to do the work. You’ll also get Ginger’s insightful questions to help you, and her mantra, which I love, which is that we are all a work in progress. 


5 Top Diabetes Myths Debunked

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Now that the holidays are fully upon us – I know because I can’t seem to stop eating – here’s a perfect gift for yourself or a loved one with diabetes: my book, “50 Diabetes Myths That Can Ruin Your Life and the 50 Diabetes Truths That Can Save It.”

Sure I’m being self-promoting, but I wrote the book so you would benefit. Having the latest, accurate information, recommendations from top diabetes experts, tips and tools, along with my story how I’ve become successful managing my diabetes, and other patients’, is worth gold, let alone $10 in paperback on Amazon. Also available on e-readers.  

Oprah says, “You do better when you know better” and I agree. If you feel in the dark about managing your diabetes, get 5 myths debunked right now in my Huffington Post post

Then go for the whole 50. The book is easy to read and getting all the information you need through dispelling myths is a simple, memorable and fun way to start doing better. I guarantee you’re sure to find a few ahas that will make a huge difference in what you do taking care of your diabetes. Really, or I’ll eat this page.

50 Diabetes Myths book now available in China

I couldn’t be more pleased, and more amused, to see that my book, 50 Diabetes Myths That Can Ruin Your Life and the 50 Diabetes Truths That Can Save It is now in Mandarin and available in China.

Quite shocking, actually, to hold a book in your hands that you not only can’t read, but can’t figure out if you’re actually holding correctly. 

While China is economically becoming “the new Japan,” part of its new wealth is also contributing to making it the country with the largest number of people with diabetes. 

According to the International Diabetes Federation 92.4 million adults in China have diabetes, superseding India’s ranking as fastest growing nation with diabetes, and it’s expected by 2030 there will be close to half a billion people in China with diabetes.

Well, all I can say is I hope a few people buy a book before they end up reproduced on the black market for a nickel a copy. 

Do check out the addition I insisted on – the ice cream cone on the cover 😉

“The ABCs of Loving Yourself With Diabetes – a hit with 3-year olds!


Gets raves from toddlers!


I was planning to write something smart and studious about my book, “The ABCs of Loving Yourself with Diabetes” given that I just gave a workshop at TCOYD using several of the “loving lessons” from the book. 

But before I could put my mind to it, my mother gave me a better story.

She just spoke to the financial planner we both use, and while on the phone, he told her that every day his wife reads my ABC book to Sarah (their 3-year old). She loves it, it’s her favorite book, and she begs his wife to read it to her. Listen, I told you, you can’t make this stuff up!!!

So, here’s my offer. If you haven’t checked out the book yet and you have a little one at home, I think we’ve just found a new application. 

Make it the storybook you read your toddler. Studies show (well, Sarah shows) that toddlers will enjoy the illustrations and soothing words and you just might absorb the “loving lessons” and grow stronger, happier and healthier managing your diabetes. 


The power of loving yourself from New York to New Mexico


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!

A Sweet Review

Screen Shot 2015-02-08 at 11.19.37 AMAvailable in bookstores and on Amazon

Hmmm…let me see, it must be at least a few posts since I last reminded you about this fantastic book I wrote that was released this summer, “50 Diabetes Myths That Can Ruin Your Life and The 50 Diabetes Truths That Can Save It.” Nice thing is people keep discovering it.

I wouldn’t bring it up again (well, maybe) except this morning Catherine Price not only reviews the book but also includes in her review my answers to some really great questions she asked me like: “What 3 things would you tell people about diabetes?” “What kind of policy changes do we have to make to help stop the spread of diabetes?” and “How do I personally stay positive managing my diabetes?” among other questions.

You may remember Catherine – who among her many writer hats blogs on A Sweet Life, a great savvy and diverse site that brings you news, expert advice, tips, recipes and blogs – wrote a great piece in the NY Times recently

If you don’t know “50 Diabetes Myths That Can Ruin Your Life” also has its very own web site. Now there’s just no reason to let myths ruin your life. 

2,000 amazing book signings

All smiles

With little fanfare, my husband turned to me about two months ago and said, “Wouldn’t it be something if we gave away your books to the speakers and member nations who’ll be at the International Diabetes Conference this year? After I rolled my eyes I said laughingly, “It sure would.” And, I’m here to tell you it was!

1,000 copies of “50 Diabetes Myths That Can Ruin Your Life and the 50 Diabetes Truths That Can Save It” and 1,000 copies of “The ABCs of Loving Yourself with Diabetes” made their way to Montreal where they were on display last week in the Exhibition Hall of the IDF as my gift to all those who work to make life better for people with diabetes. The books were accompanied by thisletter that expresses my appreciation.

By noon the second day of the conference all the books had been handed out and are now heading back to libraries, clinics, hospitals and patients as far away as China, South Africa, the Philippines, Russia and most everywhere in between. The IDF has more than 200 member countries around the world.

For an author who rarely sees the impact of her work, chatting with those who surrounded me, seeing their delight in the colorful and unique pages of the ABC book, hearing them agree how we only talk about negative emotions in diabetes rather than strength, joy, appreciation and pride, was thrilling. Seeing their smiles glance over the playful cover of the 50 diabetes myths book that dispels a huge myth right on its cover was also a thrill.

So much so in fact that when the books were gone by 11:30 AM the second day I felt bereft. It had been so fulfilling to talk to so many who are working tirelessly every day in diabetes that I wished I had brought another 2,000 books! 

I did spend a fair amount of time at the many behavioral sessions offered at the conference where I heard confirmed the value of story-telling in helping patients in their healing process and that most behaviorists in the field are currently advocating motivational interviewing and patient-centric methodologies. I actually find both a step in the right direction but at the same time not quite the right step. Motivational interviewing is a directive approach where the HCP largely directs the conversation and intent rather than without prejudice openly exploring  the patient’s ideas for options, and as pointed out in one presentation, the HCP can bring his or her own prejudices to the process and a number of other blocks. Also, while most HCPs need to become more patient-aware, making the patient/doctor interaction patient-centered, too heavily weights the interaction on the shoulders of the patient and minimizes the HCP’s contribution. I am well aware of these approaches and working on a behavioral intervention that moves patients further and will be unique to the diabetes world.

Back to the conference, while it was a chore to leap out of bed early the first morning and walk a half hour in the cold to the conference center for the 8:30 AM session, it was the session that resonated most deeply with me and was most akin to the work I’m developing. 

It was given by Dr. Jean-Philippe Assal who spoke with the knowledge of a physician, the understanding of an educator and the eloquence and wisdom of someone who has evolved in his study of patient/physician interaction and human nature to understand that treating patients with diabetes is as much art as science.  

Dr. Assal also presented a remarkable video about gondoliers developing their skills to maneuver the waterways in Venice and comparing the development of those skills to how we develop the skills needed to live successfully with diabetes. An incredible metaphor and one that can only be recognized by those who look beyond the traditional care model.

The second day of the conference my husband and I found ourselves to our good fortune lunching with Dr. Assal, his wife, Tiziana, an education specialist, and their assistant, Benedetta Barabino, a biologist who is working in stage directing to help patients and physicians work through blocks and barriers. Needless to say it was a stimulating lunch centered around how the patient must be regarded as an equal expert to the provider as he/she is the expert on his/her life, and that working together the best outcomes can be achieved. 

One outcome that was immediately achieved over lunch is the husband and I have an invitation to visit the Assals at their Geneva home. Hmmm…I wonder how long it takes to get to Geneva from Brooklyn?