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

Entries Tagged as 'Diabetes 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: Diabetes 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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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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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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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: Diabetes 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: Diabetes 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: Diabetes Basics

Correlation or Cause

August 29th, 2011 · No Comments

We can divide everyone into two types of people — those of us who have diabetes or those who don’t. Or we can divide us into men and women. Or into people who can read and write compared with those who can’t.

“Wait a minute!” you might exclaim. “That’s already a lot more than two types.”

Precisely. And that’s just the problem with all those studies that purport to show that two situations that occur today have a cause-and-effect relationship.

A greater proportion of people in those countries with a high rate of literacy have diabetes than in those countries where people are less educated. That’s a correlation between diabetes and literacy. It doesn’t prove that education causes diabetes.

Maybe the rate of diabetes has gone up in this country because more people live in homes that have air conditioning. Those two variables do correlate. But that doesn’t prove that one caused the other.

We have so many types of people in fact that each of us is unique. And no study can possibly control for every type of difference among us.

Yet scientific researchers continually bring forth new studies correlating one sort of change with another. These studies do have a real value.

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Posted in: Diabetes Basics

Are You a Noncompliant Diabetic?

July 9th, 2010 · No Comments

Does it make you angry by my asking if you are a noncompliant diabetic? I didn’t mean to do that by asking you that in the title of this essay. I just wanted to grab your attention.

Getting angry is as unproductive as called us noncompliant or a diabetic. In fact, a new study in Hormones and Behavior shows that when we get angry, our heart rate and arterial tension increase along with other psychobiological changes. So please relax and read on.

No doctor ever dared call me noncompliant, but plenty have labeled me a diabetic. Those terms don’t make me angry — any more. But I don’t like them at all and am doing my best to stomp them out.

As a writer, words are important to me. As a positive person I try my best to avoid these “negative cues.”

This morning a friend mentioned another negative cue that health professionals sometimes use to describe the way we lead our lives. I hadn’t thought of this before, and that conversation is what prompted this essay.

“How are you managing your diabetes?” is the common clinical phrase that they throw at us. While to speak of managing doesn’t appear negative on its face, it really is. It focuses on our burden.

Likewise, I talk all the time about controlling diabetes. I’m now going to try to stop doing that.

The positive way to ask the question is whether we are living our lives boldly and fully. That’s a lot more than a dry, narrow emphasis on management or control.

Six years ago I first wrote about these and other “incorrect diabetes terms” at in an article with that title. I wrote there that many people who have diabetes actively resist being labeled as a diabetic, as if we were an illness. A correspondent writes, “What I give as an example to doctors and other technical people is: If a person has hemorrhoids, does that make that person one?”

If you have diabetes but aren’t a diabetic or a hemorrhoid, I think that you might enjoy exploring my earlier article about the other words and phrases that our language would be better off without.

This article is based on an earlier version of my article published by HealthCentral.


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Bad Science

December 11th, 2009 · 2 Comments

Whenever I become conscious of a word or concept new to me, I began to notice it everywhere. All of you probably have had this experience.

It is so common that we even have a nice big word for it thanks to the great Swiss psychiatrist Carl Jung: Synchronicity.

A couple of weeks ago a member of the diabetes support group that meets in my apartment loaned me a book called Bad Science. A practicing physician in the U.K.’s National Health Service and newspaper medical columnist named Ben Goldacre wrote it and Fourth Estate published it last year in the U.K.

The book is a detailed indictment of the British press for its woeful ignorance of some basic scientific concepts. Like one of my favorites, “regression to the mean.” This sounds complicated. But it is simply the fact that everything, including our health, has a natural cycle. Since we tend to see a doctor when we feel the worst, we think that his or her treatment helped us, while we would soon feel better no matter what the treatment was. [Read more →]


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