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

Entries Tagged as 'Psychosocial'

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Beyond Diabetes

September 10th, 2011 · No Comments

About four years ago I started a diabetes support group here in Boulder, Colorado, where I live. A few days ago my friend, Phil, and I happened to be talking about it.

“The support group can help people who don’t have diabetes,” Phil told me. “We should include people with pre-diabetes or weight problems or anyone who wants to have as healthy a lifestyle as we do.”

Phil talked about how the very low-carb and paleo diets that we follow have made such a big difference in our lives. He also mentioned how active each of us are.

I agreed with Phil that the members of our group are some of the healthiest people I know and that we could share what we have learned the hard way. The lessons that managing our diabetes have taught us apply just as well to people who haven’t yet had to face up to the need to making health their first priority.

But I told Phil that it wouldn’t work.

Until I wrote an article about our diabetes support group for a magazine last month, I had hoped that our support group would keep growing. But three of our members who I interviewed for that article know a lot more about group dynamics than I do. One of them has taught it at the university level and two others have studied it. All three told me that the current size of our group — about a dozen people at each meeting — is ideal for giving us the mutual support we need to manage our disease.

We do have a lot that we could teach other people. I might start another support group for people who know that they have pre-diabetes and want to avoid the full-blown condition. Maybe a group for people who really want to lose weight. Even a group for “healthy” people who would like to be and feel as well as the members of the diabetes support group.

But this isn’t the American Way. We always have to go to the brink of disaster before waking up. Whether its politics or health, we keep on playing Russian roulette.

For most people a diagnosis of pre-diabetes doesn’t feel like being on the brink of disaster. Neither does being overweight or obese.

Even when we learn that we have diabetes, most of us go into denial — even the typical people who go to support group meetings. They tend to drag down the level. That’s the big reason why I started a group limited to those of us who want to be as healthy as we can be.

The irony is that those of us who have diabetes are on the brink of disaster. And at the same time we can be even more healthy than most.

Fortunately, our bodies have amazing recuperative powers. With a little work we can manage our health before we completely destroy it.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Posted in: Psychosocial

Diabetes Clinical Trials

August 18th, 2011 · No Comments

People with diabetes enroll in clinical trials for several reasons. But before we do we need to know all the pros and cons.

One of the best ways to learn about clinical trials is a new website. Corengi.com, which stands for Clinical Options Research Engine, can match us to appropriate clinical trials.

But before you sign up for one I recommend that you take a look at its new video, “What ARE Clinical Trials?” In five short minutes the video explains many of the key concepts in clinical research. It explains, for example, the different phases of clinical trials, it highlights the differences between interventional and observational trials, it provides examples of inclusion and exclusion criteria, and it describes the purpose of an Institutional Review Board.

Ryan Luce, Corengi’s president and founder, told me that his company produced the video to help people with diabetes understand more about “the convoluted process” of clinical research.

“We focus on type 2 diabetes trials now,” Ryan says. “We really need to get an analogous tool for type 1. And we plan to add several other chronic conditions later.”

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Posted in: Psychosocial

Finding Your Passion

July 7th, 2011 · 1 Comment

Maybe “passion” is too strong a word. But we all need to have something in our life that deeply interests us. Those of us who have diabetes probably need it more than most people because of the burden of our chronic disease. We need something to live for.

Someone very close to me says that she envies my passion. Her husband died about two months ago, and she understandably feels numb.

“Hopefully in the future I will get passionate about something again,” she says. “I guess after what I have gone through that is natural.”

She continues.

“Married women with children generally put others first. In my case, with all of my husband’s problems, I lost my own wants. There just wasn’t time or energy for anything else.”

Sound familiar? If you are a woman, it probably does. And anyone who has diabetes will recognize the burnout that she feels.

I want to help her to find her passion. And I want to help you too. The key, I think, is to expand and develop your interests in whatever it is that you care at least a little about. For example, if reading somewhat interests you, then you could join a book club.

You can even make lemonade out of the lemons in your life. My real passion is helping other people to control their diabetes, which is one big lemon for all of us. I was diagnosed with diabetes in 1994. At that time I was an editor of a small business magazine.

When I discovered that I had diabetes, I became much more interested in diabetes that I ever was in business. As soon as I could, I got on the Internet and searched for information. I found that I really learned a lot about it from the Internet, far more than I learned from my health care providers, and I became interested in setting up my own website. In 1995, I established my website and have written about diabetes there and elsewhere ever since then.

Another example: If you appreciate nature, you can become a photographer. That’s what I did in spades. My love of nature has also led me to travel to beautiful places.

I recently traveled to Portland, Oregon, to visit Powell’s, my favorite bookstore in all the world. After spending several hours there, I went to sit down in a nearby coffee shop. The shop has only two tables so I wasn’t surprised when someone asked to sit at my table. Of course, I agreed.

Turned out he works at Powell’s. We got to talking about a big book about birds, Audubon’s Birds of America, that I had just bought there. I talked about birds and photography, including how much they mean to me.

He mentioned the word “obsession,” which triggered in my mind the word “passion.” I asked him whether he had a passion and how people could find one of their own.

His passion is cycling. Some of his thoughts were that people need to give themselves permission to find their passion. That they are so wrapped up in what they have to do that they don’t take time to do what the want to do. A passion, he says, can give people a perspective on why they do what they have to do.

It all comes down to having balance in our lives. In this case, a good life balances our needs — like taking care of a spouse or earning a living or controlling our diabetes — and our desires — with having fun doing what we love.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Posted in: Psychosocial

Donating Diabetes Data

July 7th, 2011 · No Comments

Recording and sharing how well we control our diabetes helps us to do it better. Just the act of measuring something changes it, a phenomenon known in physics as the uncertainty principle.

Now, a study published last month in PLoS ONE has mined the information stored in a diabetes social media site for public health research. The site is TuDiabetes.org, which my friend Manny Hernandez founded four years ago as a non-profit organization.

Any TuDiabetes community member can join TuAnalyze, an application of the site that allows those touched by diabetes to track, share, and compare their health information.

One of the TuDiabetes goals has been to help advance diabetes care and the public health response. The new PloS ONE study by researchers at Children’s Hospital Boston has begun to use the information gathered in TuAnalyze.

They invited members to participate in a “data donation drive,” sharing data about their A1C levels. Members could share their information either publicly or anonymously, as they preferred. In any case, the researchers aggregated all of it and displayed it on state- or country-level maps.

When the researchers began the project, TuDiabetes had 14,678 members. People in the U.S., of course, comprised the great majority of participants, 77 percent. But Canadians accounted for 6 percent, people from the U.K. 4 percent, and from Australia 1 percent. People from many other countries accounted for 12 percent. Members have to be at least 18, unless they join with a parent or guardian.

Most members themselves have diabetes, although about 15 percent are significant others or friends of persons with diabetes. TuDiabetes.org has news articles, blogs, and discussion forums. The site lets members create an online profile to interact with other members.

The average A1C level of those who provided their data to the researchers was 6.9 percent. I know that this is significantly lower than that of most people with diabetes.

These TuDiabetes members are helping themselves. And by doing so they are also helping the whole diabetes community.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Posted in: Psychosocial

Embrace Diabetes Support Groups for a Healthy Lifestyle

May 11th, 2011 · No Comments

If you have ever participated in a diabetes support group, you probably know that it helps you to stay in control of your diabetes. While I don’t know of any research that will prove this, a new study shows that group support meetings offer remarkable benefits for people who have pre-diabetes. If group support helps people who have pre-diabetes, it is probably much more likely to help those of us who are already burdened with this condition. For most people I know who have pre-diabetes this is just one more thing to deal with. Sometime.

Those of us who have diabetes know that we have to deal with it. Every day. But some people who have diabetes still don’t take advantage of the support that other people can give them. For some of us diabetes is something to keep quiet about, either out of shame or concern that our employers might cause them problems. Or because their health insurance rates might go up.

Some of these concerns are certainly legitimate. But when we ignore the social advantages of sharing, we ignore the support we can get from friends in similar situations.

More and more of us are choosing a third alternative, online support. Groups like MyDiaBlog can help anyone with diabetes, even those among us who can’t or won’t share with local groups.

The study of people with pre-diabetes who have benefited from support groups that prompted these thoughts comes to us from Australia. Between 2005 and 2009 the Victorian Department of Health recruited 300 people from both the big city of Melbourne and the rural community of Shepparton to see if community meetings are as good for health as they are for making friends.

They are. The bottom line is that people who attended regular meetings had a 43 percent success rate in reversing their pre-diabetes within six months of learning that they had it. By comparison, only one quarter of the people who had learned that they have pre-diabetes in that time but only had the support of their doctor succeeded.

Swinburne University of Technology in Melbourne evaluated the study and reported it in the March 2011 issue of Swinburne Magazine. This article says that the Victorian Department of Health is taking these positive findings a step further by rolling out a state-wide program.

The question is whether people here who already have diabetes will take the further step to get valuable support from others.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Posted in: Psychosocial

Diabetes Social Networking

March 27th, 2011 · No Comments

The social network space for people with diabetes lags well behind the Internet’s superb ability to provide information. Websites like HealthCentral far exceed the older sources of information that we have — including our health care teams, our books, and our magazines — in the quantity and often even the quality of information that we seek about diabetes.

But the Internet hasn’t been doing a good job in connecting the real people who have diabetes with other real people. Those of us who have diabetes often feel isolated from our communities because of the special need we have to control our condition. Many of us, particularly those who live in small towns or rural areas, don’t have anyone with whom to discuss our dietary, activity, and medication requirements.

Local support groups often fail to provide positive reinforcement when they exist at all. Many of us in fact lack that option within a reasonable driving distance.

Support and communication are functions that the Internet can provide to people with diabetes on a much larger scale than even the best local support groups. But even the so-called social networking sites are instead top heavy on information.

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Posted in: Psychosocial

My Goals

March 20th, 2011 · No Comments

Until now, I haven’t shared much of my goals. What I have shared is information — some of the things that I have learned about diabetes in the years since I was diagnosed with type 2 in 1994.

I also once shared my ideas on how to write, because that’s what I do. You can read my article, “My Style” here. And since photography is a passionate hobby of my I share my photo essays on my “Fitness and Photography for Fun” blog. I’m writing today from Florida where I visited our Dry Tortugas and Biscayne National Parks and today am photographing birds, alligators, and other wildlife in the Everglades National Park. I share my photo essays because I want to inspire everyone who has diabetes to get the activity we all need by doing what we love to do.

A Purple Gallinule This Morning

But until now, I haven’t really told you where I am coming from. A couple of people from Chicago named Jenny and Jannick dragged it out of me when they interviewed me last week. They posted the interview on their website, “Julio’s Sol, Our Dream is to Make Yours a Reality.” Their interview with me is on this web page.

Jenny and Jannick told me from the first that they wanted to interview people who had a passion driving their life. I told them when they interviewed me that my passion is helping people with diabetes. I hope that I am helping you.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Posted in: Psychosocial

Walking Meditation

March 3rd, 2011 · No Comments

As I hiked out of the wilderness all I could think about was how much my feet hurt. It was one of the most wonderful experiences of my life.

Wearing a brand new pair of boots on a long backpacking trip into West Virginia’s Dolly Sods Wilderness about 35 years ago could have been a big mistake. The new boots gave my feet terrible blisters, and I had forgotten to take any moleskin. Returning to the trailhead after four or five days, I knew I had just one other way to control the pain. Deliberate walking meditation put my entire consciousness into my feet.

I don’t punish my feet any more to get the high that walking meditation brings. But I still hike or walk and meditate at the same time.

A leading exponent of walking meditation is Thich Nhat Hanh, a Buddhist monk, teacher, author, poet and peace activist who is one of the important influences in the development of Western Buddhism. His book with Nguyen Anh-Huong, Walking Meditation (Sounds True: Boulder, Colorado, 2006), says that when we practice walking meditation, “We walk for the sake of walking…We walk slowly, in a relaxed way, keeping a light smile on our lips.”

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Posted in: Exercise, Psychosocial

Medical Marijuana for Diabetes

February 2nd, 2011 · 4 Comments

Here is a copy of a letter — with the author’s name and other identifying information redacted out — about anecdotal evidence that medical marijuana might help some complications of diabetes.

The person who wrote me has a better memory than I do. I don’t remember corresponding with him before, but he remembers that when I used marijuana I was addicted to it. It got to where I had to be high all my waking hours. My correspondent is also quite correct in writing that I would not be a good candidate for medical marijuana, except as a last resort.

The jist of what he wrote follows:

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Posted in: Complications, Medication, Psychosocial

Indigenous Diabetes

January 16th, 2011 · 3 Comments

Diabetes is the scourge of civilization. A disproportionate number of people living in the most advanced societies suffer from it.

But the people who suffer the most are the original inhabitants of the lands that the Western societies occupied. Whether they are the Native Americans, people of Canada’s First Nations, Australia’s Indigenous population, or other conquered peoples, the result everywhere has been the same — lots of diabetes.

The reason why is no mystery. The conquerors destroyed the indigenous cultures, often intentionally but with what they thought were good intentions. By punishing students in native schools for using their own language, by attacking native religion, and by extolling the wonders of Western food, the victors hoped to integrate the defeated into mainstream culture. Instead, they marginalized the defeated from both their own culture and from that of the West.

Decrying their food choices of the defeated misses the point, as Sousan Abadian elucidates in her Harvard University Ph.D. dissertation. The point is that they suffer what she calls “collective trauma.”

Craig Lambert interviewed her for his brilliant article, “Trails of Tears, and Hopes,” for the March-April 2008 issue of Harvard Magazine. You can read the PDF of the full article online.

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Posted in: Psychosocial