It appears that you are currently using Ad Blocking software. What are the consequences? Click here to learn more.

Pathfinders

My Life with Diabetes

Interview with Me Gina Tuttle of HealthTalk Interactive


Click here to listen (19 minutes 37 seconds)
Requires the free RealOne Player from Real.com


Imagine going for an annual checkup and hearing your doctor say, "Has anyone ever told you you have diabetes?" That's what happened to Rick Mendosa [now known as David Mendosa], a gifted writer from California. Today we'll find out how that diagnosis brought him health, love, and the respect of thousands of people living with diabetes.

I'm Gina Tuttle, and this is the HealthTalk Interactive's Diabetes Education Network. We are so happy to visit with David Mendosa, who created and maintains David Mendosa's Diabetes Directory, welcome.

‘The irony of diabetes [is that] I'm in better shape now than when I was well.’

David:
Thank you, Gina.

Gina:
Your directory links to about 800 diabetes sites, and you personally update and maintain the list for no money. So, why do you do it?

David:
Well, that's a good question. I started the list in February of 1995, just one year after I was diagnosed with diabetes. In a nutshell, you could say that the Internet fooled me. It tricked me. I had no idea the amount of work that this would turn out to be. When I started my Web site, it was only the second Web site dealing with diabetes. There was only one other. It was the government's Web site, NIDDK. Even the American Diabetes Association wasn't online at that time.

And I started it basically to tell people how to get on and off of some of the mailing lists. Mailing lists are good ways for people to get support and some information about diabetes, and people had a hard time subscribing and unsubscribing, and so I prepared a Web page that told them that. And then as the additional sites came on, I then made sure that I linked them, and before you knew it, there were more than 800 of them.

Gina:
Let's go back to when you were first diagnosed. How did that come about?

David:
I was living in Santa Barbara, California, or actually in a suburb called Carpinteria, and I was a freelance writer at that time, doing a lot of freelancing for a Hispanic business magazine where I had been an editor up until recently. But when I left the magazine, I lost my health insurance. Fortunately, I am a veteran. There's a VA clinic in Santa Barbara that I went to for a problem that I had, and the doctor told me in February, 1994, that I had diabetes. He said, "Has anybody ever told you that you had diabetes?" And I said no. And in fact, nobody in my family has or has had diabetes. But he said my hemoglobin A1c test, which measures the percentage of glucose that is stuck to a part of your blood or a fraction of your blood, came in at 14.4 percent, which is...

Gina:
That's high.

David:
It's quite high. It should not be above seven, or maybe even six. If you don't have diabetes, it'll be in the five or six range. So, it was very high, and that's how I found out about it, about six years ago.

Gina:
So, how did you feel when you got that diagnosis?

David:
I'm a journalist, so my first inclination was to find out everything I could about the disease. I realized that there was more information even then available on the Internet than there was available to me practically any other way. And that was probably the major impetus for me to get on the Internet, as I did as soon as I could after that.

Gina:
And how did you initially control your blood glucose level?

David:
Initially, the doctor gave me a pill, one of the sulfonylureas called Micronase, which I took every day, and I also exercised. I also lost weight. And within, oh, five or six months, my numbers were looking so good that I went back to him. I said, "Hey, do I still have to use these pills?" He says, "No, you don't. Just keep it up, keep up exercising, and watching what you eat," because I had gotten quite a bit overweight. And I have been able to stay off of pills ever since by keeping up that program.

Gina:
Now, not all type 2 diabetics can do that, correct?

David:
I'm sure that's true. Perhaps I had a lighter case. Or perhaps I was, at least in part, more disciplined than many people are. My discipline came through fear, and this is probably for most people not the best motivator. It's a negative motivator. But I was not at all concerned, frankly, about having diabetes, what I learned about the disease. I was concerned, incredibly, about the complications that I could get from diabetes. It was that fear of complications that led me to take control of my diabetes. Perhaps my doctors caught it early enough. I did feel an awful lot better as my blood sugars dropped. I wasn't so sleepy. Some of the pains that I'd gone in for had gone away.

Gina:
That's great. Now, what is your diet like?

David:
You know, my diet has varied tremendously as I've tried one thing or another: a standard, relatively high amount of carbohydrates, 50 to 60 percent, down to a fairly low amount of carbohydrates and a higher amount of protein. The main thing with the diet, I'm convinced, is to lose weight, and the only way to lose weight is not low carb or high carb, it's low calorie. You cut down the number of calories that you eat. Right now, my diet is reasonably low carb, and it is when I do eat carbohydrates, the carbohydrates that I do eat, I try to stay low on the glycemic index.

Gina:
And let's talk about that glycemic index. Please explain what that is and how it affects blood sugar.

David:
It's really a very simple concept, although people get confused about it. The glycemic index is a scale that measures how fast and how high or how much your blood glucose goes when you eat certain carbohydrate foods.

Gina:
And it's not always self-evident, is that right?

David:
It's not always self-evident, as the foods need to be tested for their glycemic index. It is not just the simple carbohydrates that will raise your blood glucose the most. For many years we believed that complex carbohydrates were safe, that it was the simple carbohydrates, the simple sugars like sucrose, table sugar, that would raise your blood glucose levels the most. It is not true. In fact, one of the worst culprits, we've discovered, is baked potatoes, with a glycemic index 50 to 60 percent higher than table sugar.

Gina:
Hmm. Not at all what a person would just expect.

David:
Not at all.

Gina:
And yet sweet potatoes are not as high as regular potatoes, is that right?

David:
Sweet potatoes are not as high as regular potatoes, even though they taste sweeter.

Gina:
And, so, this is a pretty confusing issue. How do we find a Web site that will tell us more about that?

David:
Well, I'm glad you asked, Gina. I happen to have one. I have several Web pages dealing with articles about the glycemic index. Then I have broken off from that the list of the foods that have been tested.

And that latter page is one of the pages that people look at the most on my site. I wish more people would look at some of the information about how the glycemic index was developed and how it should be used, but most people aren't concerned and refer back to those lists of about 300 foods that have been tested for their glycemic index.

Gina:
And I want to just briefly touch on something else. You talked about the way to lose weight is to eat less and also, of course, to exercise. How much exercise do you do?

David:
My exercise is following the guidelines of what everybody says. It's based on doing what you love to do. I don't like to work out in the gym. I don't like to swim particularly. But I do like to walk. And fortunately, I live in a place where that's very easy to do. I set a goal of walking every day—don't always reach it. But it is important, everybody says, to not skip more than one day or you'll lose that conditioning that the exercise gives you.

Gina:
What is your take on this time in history about diabetes treatment? Where do we stand now?

David:
Well, you know, when I was diagnosed with diabetes, I mentioned that I was taking one of the sulfonylurea pills. This was in 1994. And the doctor could have given me a sulfonylurea or insulin. That was all. There were no other oral hypoglycemic agents, no other pills available at that time. Since then, we have had many, many more classes or types of drugs approved. Metformin is by far the biggest prescribed drug, and more recently, the glitazones, Actos and Avandia, are working on insulin resistance rather than on pumping out insulin from the beta cells. Both are problems with diabetes. You have to have both conditions to have diabetes. And a lot of doctors believe that it makes more sense to attack insulin resistance as these newer drugs do.

And there's even more drugs coming on the market. Starlix is expected in the next few months, which will be advertised as a smart drug. It will work as long as it needs to work, and then it will stop working. That's pretty amazing, I think.

Gina:
It is.

David:
So, in terms of drugs, we've had a tremendous explosion of drugs, just in this time period that I've had diabetes. In terms of insulins, too, we've had the first insulin analogs. An analog, as I understand it, best way to describe it is a man-made type of insulin where they switch around the molecules a bit to make them perform a little bit better.

And we have coming within the next few months the very first insulin that will provide a true, oh, very long-lasting dosage lasting about 24 hours. It's an insulin called Lantus, which the third major insulin manufacturer in the world is going to be introducing to the United States. Until now, all insulin in the United States has been sold just by two companies: Lilly and Novo Nordisk.

Gina:
So, we've got more opportunities. Is it an exciting time to have diabetes, if you've got to have it?

David:
It sure is. The other big change is in meter technology.

Gina:
Oh, the meters, the testing to find out where your blood sugar is so you know how you're doing.

David:
Right. And if you don't know how you're doing, there's no way that you can make any of the necessarily course corrections: exercise more or eat less or take more insulin or get your dosage of your pills changed. Without testing, you can't know that. And one of the labors of love that I wrote as an article about diabetes not too long ago, was the history of blood glucose monitors. And the blood glucose monitors have been available in the hands of laymen for only about 30 years now. Before that, it was much, much more difficult to measure your blood. You had to test your urine, basically.

Gina:
And that wasn't very accurate.

David:
It wasn't very accurate and not a lot of fun.

Gina:
And they just keep getting smaller and faster and easier to use all the time.

David:
Yeah.

Gina:
What do you see on the horizon for diabetes? We've talked about the near term, the new kind of insulin that's coming up. Five years from now, do you think they'll be able to treat it much differently? Cure it, prevent it?

David:
The cures for diabetes depend on whether you have type 1 or type 2 diabetes. We may well have a cure for type 1 diabetes before we have one for type 2. With type 1 diabetes, you know that your body produces no insulin.

Gina:
Right, the kind that often comes on when you're fairly young.

David:
Correct. It used to be called "juvenile-onset diabetes." And there's been some fascinating research and testing done at the University of Alberta in Edmonton this year where islet cell transplants have been successful, the last I heard, in 10 out of 10 cases.

The problem with islet cell transplants, as with any other transplants, is immunosuppression, rejection of the transplant by the body itself. And the people at the University of Alberta are working with new drugs where you may not have to take the immunosuppressive drugs the rest of your life. As long as you have to take an immunosuppressive drug for a transplant, whether it's a pancreas transplant, which has been fairly common, maybe 10,000 cases to date, it's not really a cure as long as you have to take the immunosuppressive drugs.

Gina:
They have their own very serious side effects.

David:
Precisely. Precisely. So, we don't have a cure yet. The Edmonton work is not a cure, but it is a huge step forward for type 1 diabetes. Now, for type 2 diabetes, it's a different story. The problem is more insulin resistance and how to deal with insulin resistance, and I don't see that cure shaping up yet. There has been some recent discoveries of genes that I understand you or one of your associates will be interviewing some of the people who have discovered one of the genes responsible for type 2 diabetes, and that's probably the leading edge, because I don't see anything else on the horizon immediately that can compare with possible gene therapy.

Gina:
So, it's important to take good care of ourselves right now, starting today. How do you feel about your life, David, right now. Do you regret getting diabetes?

David:
Oh, I use the old cliché, Gina. When life gives you a lemon, you make lemonade out of it. And I think maybe I have, too, by being able to write about diabetes. Before I got diabetes, I wrote about business, and I'd had some experience with business, but business is a pretty broad topic, and I was by no means an expert based on my personal experience. Well, I have the personal experience to write about diabetes, and it's worked out very well for me.

I'm very happily married. I love the challenge of taking care of myself. I take care of my body so much better now than I ever have before. That's the irony of diabetes. I'm in better shape now than when I was well.

Gina:
David, it has been such a pleasure to talk with you, one of the Internet's information pioneers, and to find out how diabetes has in some ways made a positive difference in your life. Thank you.

David:
Thank you, Gina.

Gina: And for our audience, please check back with us frequently. We will be posting great new information on the Diabetes Education Network often, including reports from the International Diabetes Federation congress in Mexico City, starting in early November. From all of us at HealthTalk Interactive's Diabetes Education Network, we wish you the best of health.


This interview originally appeared on the HealthTalk Interactive website in 2000.


Last modified: November 26, 2003

[Go Back] Go back to Home Page

[Go Back] Go back to Diabetes Directory

Advertisment
Never Miss An Update!
I comply with the HONcode standard for trustworthy health information. You can verify my HONcode certificate here.
Advertisment