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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.
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.
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.
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.
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?
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.
