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Living With Diabetes

Diabetes Diet

Promises to Myself

I’m getting desperate. I’m stuck. To completely control my diabetes I know that I have to control my weight.

Like Robert Frost, “I have promises to keep and miles to go before I sleep.”

Today I make these promises to myself:

I promise to take or accept no snacks at supermarkets or my barbershop — not even meat or cheese.

I promise not to buy any food that doesn’t fit my eating plan.

I promise not to buy any food, no matter how good for me, that I can’t resist eating too much of, like macadamia nuts.

I promise to eat no more than I usually eat at home when I eat a meal out.

I promise to drink one liter of water before every meal.

I promise to eat dinner at least three hours before bedtime.

I promise not to eat anything after dinner.

I promise not to eat any dairy (except for the one container of Greek yogurt now in my refrigerator).

I promise not to eat any grain or potatoes.

I promise not to eat any sucrose or fructose — not even spicy chai sweetened with honey (except the fructose that occurs naturally in up to one serving of fruit per day).

I promise not to use any oil with an unfavorable omega 3:6 ratio (except extra virgin olive oil).

Each of these public promises is binding on myself, David Mendosa, at least until I have lost the six more pounds that I want to lose so that I can get back down to a BMI of 19.5.

I promise to report back here when I have reached my ideal weight and that I kept these promises to do so.

Do you want to make any promises — either public or private — to help promote your weight loss and better health?

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

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Diabetes Complications

Visualize Yourself

My friend Jay has type 2 diabetes and is a member of the diabetes support group that meets every month in my apartment. But he is also a primary care physician, and almost half his patients have diabetes.

Jay is therefore uniquely qualified to help us. At the most recent meeting of our support group we were already  running overtime. But it was Jay’s turn to speak, and he wanted to share with us the “shock treatment” that he uses with his new patients who have diabetes. I’m glad that he did and that I can share this treatment with you.

Jay starts by explaining that diabetes, high blood pressure, and heart disease are the three main silent killers. Because they usually don’t offer us any advance warning of the hidden damage that they do to our bodies, these diseases are truly insidious.

Then, he suddenly turns off the lights in the windowless office. “Visualize yourself 15 years from now,” he says. “This is what you might be seeing then, if you don’t control your diabetes.”

This is Jay’s shock treatment. But any technique that will get us to open our eyes to the consequences of uncontrolled diabetes is better than none, he says.

Jay asked each of the members of our support group to look in the mirror each morning and visualize ourselves 15 years later. For me this gave me one more piece of encouragement to eat right, stay slim, and exercise so I will still be able to see my face in the mirror 15 years from now when I will be 90. If I’m still around then, I hope to continue seeing a computer monitor so I that I will still be able to write you.

As Jay left my apartment that day, I took him aside and told him that I already could visualize his shock treatment. My ophthalmologist had just told me after my semiannual checkup that I have two small micro-aneurysms in my left eye that he hadn’t seen before.

Jay’s shock treatment worked especially well because I was already shocked. Micro-aneurysms can lead to diabetic retinopathy, which can, of course, lead to blindness, the complication of diabetes that I have always dreaded the most.

Now I have even more incentive to keep my A1C level in the low 5 range, if not down to 4.5, which is my goal. I hope that you don’t need any more incentives to control your own diabetes.

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

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Diabetes Complications

Standing Up for Your Heart

You don’t have to exercise to help your heart. Sure, exercise will probably make your heart last longer, but it’s not the only thing you can do to avoid the biggest complication of diabetes.

Just standing up — otherwise known as giving your butt a rest — now seems to work independently of physical activity to reduce your chance of dying from heart disease. A new study that the American Journal of Epidemiology published online in advance of print on July 22 indicates that the less leisure time we spend sitting the better it is for our hearts.

You can read the abstract of the study, “Leisure Time Spent Sitting in Relation to Total Mortality in a Prospective Cohort of US Adults,” online. The lead author, Alpa Patel, Ph.D., of the American Cancer Society’s epidemiology research program, sent my the full-text of the study when I requested it.

Dr. Patel and seven of her associates explored the connection between sitting and mortality by analyzing the survey responses of 123,216 people who had no history of cancer, heart attack, stroke, or emphysema or other lung diseases. These were people who enrolled in the American Cancer Society’s 1992 Cancer Prevention II study.

The researchers examined how much time those people sat down after work as well as how much exercise they got between 1993 and 2006. The results were clear.
How much time they spent sitting was associated with an increased risk of death from heart disease for both men and women. Women — but not men — who sat less had a smaller risk of dying from cancer.

Women who reported that they sat for more than six hours a day during their leisure time versus those who sat for fewer than three hours a day had a 37 percent higher death rate from all causes. For men it was about 18 percent higher.  After adjusting for the amount of physical activity these people got, the researchers found that the association remained virtually unchanged.

But when people sat more and exercised less, the difference was even greater. Women had a 94 percent highr death rate from all causes. For men it was 48 percent higher.

“Several factors could explain the positive association between time spent sitting and higher all-cause death rates,” Dr. Patel says. “Prolonged time spent sitting, independent of physical activity, has been shown to have important metabolic consequences, and may influence things like triglycerides, high density lipoprotein, cholesterol, fasting plasma glucose, resting blood pressure, and leptin, which are biomarkers of obesity and cardiovascular and other chronic diseases.” Continue Reading

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Psychosocial

Natural Vitality

“Often when we feel depleted, we reach for a cup of coffee,” says Dr. Richard Ryan, a professor of psychology at the University of Rochester, “but research suggests a better way to get energized is to connect with nature.”

He is the lead author of a series of studies that the Journal of Environmental Psychology just published in this June 2010 issue. I asked him to send me a PDF of the full-text of his research report, “Vitalizing effects of being outdoors and in nature,” and he did. You can find the abstract online.

Instead of coffee, I restore my energy by going out for a hike. In fact, one of the most popular parts of my website is my blog of photo essays, “Fitness and Photography for Fun.”

Certainly, physical activity makes us feel better. Staying fit is indeed one of the four legs that those of us with diabetes have to keep our blood glucose levels down in the normal range (the other three legs are diet, reducing stress and inflammation, and usually taking oral medication or insulin).

Over the years I have written many articles extolling the benefits of exercise. Some of those articles say how much better I feel after going out for a hike.


Nature This Morning

That’s all true. But these new studies for the first time have teased out the effects of being out in nature alone from the feel-good effects that we get from physical activity and from the socializing that we often get at the same time.

Dr. Ryan and his co-authors were able to separate out the effects of nature alone. To do so they conducted five separate experiments with 537 of the usual suspects — college students.

What they found was so clear, Dr. Ryan says, that “being outside in nature for just 20 minutes in a day was enough to significantly boost vitality levels.” The Journal of Environmental Psychology article defines vitality as having physical and mental energy giving us a sense of enthusiasm, aliveness, and energy.

When we have a greater sense of vitality we not only have more energy to do the things that we want to do but were are also more resilient to physical illnesses. “One of the pathways to health may be to spend more time in natural settings,” he says.

I’m not knocking physical activity. Most of us who have diabetes need to get up and out a lot more. If you aren’t getting out yet, this beautiful late spring weather is a great time to start. I’m saying that getting our physical activity outdoors in nature gives us two for the price of one.

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

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Psychosocial

Life Isn’t Fair

All of us feel sorry for ourselves once in a while. That goes double for those of us who have diabetes.

We do have a serious disease that can be awfully hard on us. The complications of this disease are almost too much to even think about.

But we aren’t alone. If you are as inquisitive as I am, you talk to lots of people who have diabetes. And you will find some who have even worse conditions, believe it or not.

For example, last summer I hiked 132 miles in two weeks on a Sierra Club outing. Four other people made the same High Sierra trek with me, and I assumed that none of them had any physical limitations. Was I ever surprised to learn that every one of them had serious physical conditions — some worse and much more painful than my diabetes!

And this isn’t the half of it. I seriously encourage everyone to watch a bit of Nick Vujicic’s story. Nick is an Australian of Serbian descent.

“He was bitter until age 12, when his mother showed him a newspaper article about a man dealing with a severe disability,” according to an article about him. “It would change his outlook on life. Suddenly, he wasn’t the world’s only struggling person.”

I won’t say any more. Just watch a YouTube clip about him at www.youtube.com/watch?v=Gc4HGQHgeFE

Life wasn’t fair to Nick, but he is far from bitter about it, which would be about the only thing that could be worse. Life is Beautiful.

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

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Diabetes Basics

Are You a Noncompliant Diabetic?

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 www.mendosa.com/incorrect_terms.htm 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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