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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa

Entries Tagged as 'Basics'

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Diabetes Help on the Internet

April 11th, 2014 · No Comments

Recently a fellow passenger asked me what I missed most about home. We were on a small ship and were out of contact with the rest of the world.

I realized that besides missing my friends and my usual food and drink, being able to use the Internet was what I wanted most. In fact, just as my shipmate asked that question, a devastating rainstorm had hit my hometown. I didn’t learn about it until the end of the week, when I could check my email and found messages from several friends.

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Posted in: Basics, Psychosocial

Prepare to See Your Diabetes Doctor

March 15th, 2014 · No Comments

When we learn how to manage diabetes without drugs, we rarely need to see an endocrinologist, a doctor who specializes in diabetes and the rest of the endocrine system.

I haven’t had an appointment with an endocrinologist in more than 10 years. I do have regular checkups that we all need with an opthamologist, a dermatologist, a podiatrist, and a dentist. I also go to my primary care physician at least once a year to get an annual physical examination and to help me manage my other chronic medical condition, hypothyroidism.

Not all of us who have diabetes need to see an endocrinologist, but certainly some of us do. All children with diabetes need a pediatric endocrinologist, and other people will benefit from a referral to an endocrinologist in eight different situations. My friend and colleague at HealthCentral, Dr. William Quick, suggests “When to Go to an Endocrinologist.” He is both an endocrinologist and someone who himself has diabetes.

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Posted in: Basics

Beginning Anew With Diabetes

February 16th, 2014 · No Comments

Each of us has the opportunity every day to begin life anew. But we usually grab that chance only at the beginning of the year. This is the time for resolutions. We make our resolutions in January, but to avoid breaking them in February, we have to accept where we are and know where we want to go.

The key to resolution success is to set our sights low. When we focus on one goal for one resolution, we are much more likely to achieve success than if we adopt the usual scattershot approach. We can concentrate on only a limited number of objectives at one time. That’s why people who meditate generally focus on the breath alone.

Take, for example, the very common resolution of losing weight this year. If we decide that we want to lose a lot of weight, exercise more, stop smoking and drinking, and get along with our mother-in-law, all at the same time, we are setting ourselves up for failure. That’s the main reason studies show that we generally keep on track for one month just 55 percent of the time, and for six months only 40 percent of the time.

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Posted in: Basics

The Top Ten Diabetes Terms

November 5th, 2013 · 4 Comments

This post is a text preview of a slideshow that my associates at HealthCentral will be preparing next week. This is my way of explaining the most important terms that we have to live with non-technically in 65 words or less each.

Insulin Resistance
When you need more insulin than the beta cells of your pancreas can provide, glucose builds up in your blood instead of going into the cells in the rest of your body. This resistance to your own insulin causes high blood glucose, which doctors call hyperglycemia. It can lead to prediabetes, which in turn can lead to diabetes, if you don’t change your lifestyle.

Type 2 Diabetes
When the cells of your body are resistant for several years to the insulin that the beta cells of your pancreas makes, they compensate by making more insulin. Eventually, however, they works so hard that they can’t keep up and begin to die off. That’s when you get type 2 diabetes, formerly called adult-onset diabetes. But now, even children are getting it.

Type 1 Diabetes
If you have type 1 diabetes (formerly called juvenile diabetes), you usually aren’t resistant to the insulin that your beta cells make. Instead, something else, perhaps an infection, kills most of the beta cells so the rest of the cells in your body get little or no insulin that your body makes. To make up for this lack you have to take insulin shots.

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Posted in: Basics

Cutting the Cost of Diabetes

September 7th, 2013 · 5 Comments

The experts tell us that diabetes is the most expensive disease we can get. But it can be the cheapest.

The costs are not just the oral medications and insulin, the blood glucose meters and test strips, and the visits to the doctors. But the financial drain can also include income lost from missing work. And the biggest costs have to be the poorer quality of life that so many of the complications of diabetes can bring in their wake.

So then how can I write that we could be so lucky as to have a disease that costs us practically nothing?

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Posted in: Basics

Easy Summer Living with Diabetes

August 23rd, 2013 · 2 Comments

Ah, summertime when the living is easy! Sometimes it can be too easy for those of us who have diabetes.

Rest and relaxation is much of the reason why we love summer so much. We need relief from the stress of work, relationships, and city living. Stress produces cortisol, which is the primary stress hormone, and it increases the amount of blood sugar that we have.

But, like anything else, the rest and relaxation can go too far for our own good. When we rest so much that we are lying down or sitting most of the time, our bodies don’t get the activity they need by standing or walking. When we relax so much that we relax our standards of diabetes management, our blood sugar levels can go through the roof.

Summer vacations don’t have to mean eating so much food that we gain weight or eating those foods that we know from our experience will do a number on our levels. Wise eating for those of us who have diabetes is all about delayed gratification.

This means resisting the temptation for an immediate reward and waiting for a later reward. Delayed gratification is connected with resisting a smaller but more immediate reward in order to receive a larger or more enduring reward later in life.

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Posted in: Basics

Successful Diabetes Resolutions

February 12th, 2013 · No Comments

Everybody who has diabetes is going to change in the year 2013. The change coming to each of us will be significant or minor, planned or haphazard, for the better or for the worse.

But it’s coming, ready or not.

Change is an integral part of life. Scientists tell us that except for the neurons in our cerebral cortex the very cells that compose our bodies change every few years. Nothing is permanent and whatever lives changes more quickly and profoundly than inanimate objects.

We change our minds and habits a lot more often than our cells change. We can direct the change in what we do by putting our minds to it.

This is reason for the tradition of making New Year’s Resolutions. The trick is to keep the resolutions that we make so for us it’s not an empty, meaningless, and ultimately disappointing tradition.

We can start on the path to a healthier new year but setting aside a few minutes on New Year’s Day for reflecting on where we want to go and how we intend to get there. Each year a group that I belong to starts the near with the “Beginning Anew” ceremony, a ritual that Thich Nhat Hanh created to help us let go of the past and to set a clear, strong intention for the coming year.

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Posted in: Basics

Prepare to See the Doctor

November 22nd, 2012 · 2 Comments

When we make an appointment to see our doctor, it’s because we recognize that we need help with our health. But when we enter his or her office we need to be sure not to abdicate our responsibility.

We have the primary responsibility for our health. Diabetes is a disease that, perhaps more than any other, depends much more on those of us who have it than on the doctor.

Actually, how could it be otherwise for anyone? Few people will get more than 15 minutes of the doctor’s time every three months.

We decide what we eat, how much physical activity we get, and whether we will take our prescribed medicine. While that’s obvious, too often we trade this active role in managing our health for a passive role at the doctor’s office.

Have you noticed that people who are successful in managing meetings almost always prepare a written agenda? We need to do exactly that for each office visit.

An agenda works best when we write it out in our priority order. We need to cover a limited number of points that we can work on together in a quarter of an hour. The agenda should be bullet points, not paragraphs. It works best when we give a copy to our doctor.

When we prepare an agenda, it forces us to think out what we want to get out of our appointment. At the same time it leads our doctor to focus on what’s troubling us the most.

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Posted in: Basics

Managing Diabetes on a Budget

November 15th, 2012 · 2 Comments

Diabetes is usually one of the most expensive diseases we could get. But it doesn’t have to be.

If we didn’t have diabetes, the amount that we would have to spend for healthcare would be a lot less. Specifically, diabetes costs us about 2.3 times as much in medical expenditures as it does for people who don’t have it, according to the American Diabetes Association. And that doesn’t even consider the lost income from losing work because of diabetes.

But that’s money under the dam. We’ve got diabetes and we’ve got to figure out how to live with it within our means.

The trick is to manage our diabetes so it doesn’t manage our life. Easier said than done, of course, but it’s certainly possible.

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Posted in: Basics

Saving Dollars with Diabetes

August 31st, 2011 · 3 Comments

We all know that diabetes is one of most expensive diseases. But the greatest cost of diabetes is treating the complications that come when we don’t keep our blood glucose levels low enough.

When we manage diabetes well, the cost goes way down. The four cornerstones of diabetes management are diet, exercise, stress reduction, and — if necessary — medication. Two of these cornerstones are inexpensive.

We can get a lot of exercise with just a pair of shoes or boots. In a pinch I once bought an adequate pair of sneakers at a Wal-Mart for $10.

Stress reduction can be even less expensive. The best way that I know to control my stress is meditation, which is free. The title of one book on meditation speaks to me, “Don’t Just Do Something, Sit There.”

But medication is a different story. If you have type 1 diabetes and no insurance, the cost of insulin can be substantial. If you use an insulin pump and/or a continuous glucose sensor to manage your diabetes, the cost can be tremendous, even if you have otherwise excellent insurance coverage. Otherwise, the maximum dose of one of the best diabetes drugs, metformin, is available as a generic for as little as $32 per month.

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Posted in: Basics