Diabetes Mine - the all things diabetes blog

Life Disrupted, The Book

For those of you who were old enough at the time to remember life before your diabetes, the term "disruption" may seem like an understatement.  Diagnosis is more like a crossroads, where your life morphs from one form into another entirely. 

Health writer and blogger Laurie Edwards knows all about this.  Maybe even more so than us PWDs, because her life has literally been a string of disabling symptoms, invasive medical tests, IVs, casts on her limbs, and hospital stays. She's living with multiple chronic illnesses (PCD or Primary Ciliary Dyskinesia, bronchiectasis, celiac disease, and more). Despite being "sickly" since childhood, she didn't even have a clear diagnosis of what was wrong with her until her early 20s, and even then getting the right treatment has been a fight every step of the way.

Laurie gives the term "survivor" a whole new flair in her brand new book, Life Disrupted: Getting Real About Chronic Illness in Your Twenties and Thirties, due out in bookstores June 24 (and available for pre-order now).

 

For someone who's been through so much -- who seemingly couldn't possibly have a "normal" life -- you will be amazed at her humor and insight around living a good life with chronic illness (CI).  What I love is that the book is so "narrative," stringing together Laurie's own experiences with those of a dozen others living with other ailments, including Kerri's comments on Type 1 diabetes.

She writes a lot about the primary imperative of finding the right doctor:
"Like a first date with someone, the first appointment with a physician tells you so much.  Does the doctor look you in the eye when you tell your history?  Does she ask follow-up, probing questions that show she understands the connections your are beginning to draw?  These subtle cues reveal so much..."

And there are wonderful chapters on everything from Why I Dress in Layers ("Certain details reveal our medical condition whether we're comfortable with that or not") to Financial Friction ("So often, the choices we know we should make for our bodies' sake are intertwined with many conflicting variables") to Marriage By Numbers ("You just don't see a lot of literature that addresses chronic illness in younger marriages. It's so hard").

I'm delighted to report that Laurie, who once believed no one would commit to loving someone with such severe CI, is now happily married to a loving and supportive partner.  For this and many other reasons, hats off to her!

To wrap it up, here's my review "blurb" in a nutshell:

"Life Disrupted is a book like no other about the top-to-bottom experience of living with chronic illness (CI).  Laurie Edwards is eloquent and funny as she delves into everything from relationships with doctors and boyfriends, to 'full disclosure' at work, to when and where comedy is appropriate in the illness game. If you've experienced CI, or care for someone who has, you need to read this book."

[Walker & Company, $10.19 on Amazon]

Grace, Achieved

Who knows Birdie?  Who loves her like I do?  Her blog, Aiming for Grace, always offers a combination of the most compelling images and simple words about living with diabetes that stop you in your tracks.  It's the purity of the them that gets you.  For example, this recent post about the compulsion to explain ourselves to perfect strangers.

Well, when Birdie marked 20 years of living with Type 1 diabetes in March 2006, she wanted to commemorate it in some way.  On the flight home from a business trip that year, she began to jot down a list of "20 things I really knew about my life with diabetes." 

"What suddenly occurred to me is that I knew a lot about diabetes and that my experience had its own tone," she writes.

These 20 things, along with Birdie's unique eye for abstract photography, eventually became this lovely little book:

With just a single sentence on each pair of pages, it doesn't say much.  But it speaks to me in ways I can't describe.

Even though we still don't have a clue as to Birdie's true identity, I think you'll agree that her blog posts and this little book make you feel a strong and tangible connection to a kindred spirit striving to live the PWD life with dignity and grace.

 

[Self-published, available for purchase off Birdie's site for the non-too-economical price of $25.95 for the paperback version.  An investment?  Or a touching gift?]

A Shot of Joy

I talk a good bit about Joy, but I'm actually a rather cynical person.  What, you noticed?  Anyway, I don't exactly believe in the "mood cure" either, so when writer and advocate Riva Greenberg sent me her sweet little new book with bunnies on the cover, I was... well, skeptical. 

The book is called "The ABCs of Loving Yourself with Diabetes," and it features A-Z alphabet illustrations with grinning bunnies, cherubs, mermaids and mice, each accompanied by a short inspirational essay on the right-hand page.  Honestly, it looked like something I'd read my kids at bedtime.  This is supposed to be a diabetes book for adults?  Huh?

But what the heck?  We were in the middle of one of our most violent Pacific storms this year and my hubby had the fireplace roaring to the melodies of Bach.  So I curled up on the couch and began to read. 

The words kind of seemed to float on the melodies.  After just a few pages, I knew I would read this book cover to cover and cherish it for many evenings to come.  What a wonderful little ode to self-acceptance and motivation.  Like a skilled quilter, Riva has somehow managed to patch together poetry, self-help, and diabetes advice into an irresistible pattern.  Some may find it sappy and old-fashioned, but isn't that exactly the charm of a well-made quilt?

I'd like to share a few excerpts worthy of repeating.  Admittedly, they may sound flat taken out of context here on the Web, without the crackling fireplace or classical chords in the background.  Just try to picture all that as you read:

Peace and Tranquility Await You

Some Days are harder than others when you live with diabetes. You may already be living with some complications, and then there are so many things you need to do.  It's like there's a ticker-tape in your head constantly calculating meal times, pill times, up times and down times.  There's the 100th diet you've tried and fallen off of -- again. Sometimes diabetes is just a pain to live with, not unlike a houseguest who never leaves.

At these times, you need a place to retreat to where you can take a "time out."  There is such a place; a kind of paradise where peace and tranquility await you. You won't have to pack a bag or rush to the airport because this peaceful place exists within you.

    *****    *****

Laugh Loudly, Fully and Often

Joy, happiness and laughter are not something you find in life, but something you bring to life.  So stop to see the magic of a snowflake, and laugh 'til the tears run down your cheeks. 

A big belly laugh, researchers say, releases a hormone that keeps your immune system healthy.  So stack up some funny  movies for tonight, because, amazing as it sounds, just anticipating a good laugh has significant neuroendocrine effects.

    *****    *****

There's New Research Every Day

Fortunately and unfortunately, the increase of diabetes around the world has led to a wealth of new medicines, devices, approaches and research that offer greater health.  There is also greater focus on helping people manage the emotions that may arise having diabetes.

If you feel sad or overwhelmed at times having diabetes, acknowledge your feelings. Then remember that today you can live a full, rich and long life with diabetes.  For that, you can thank your lucky stars!

    *****    *****

Make All Your Actions Count

Your actions, attitude, determination and willingness to do your best create your health each and every day.  No matter how many times you've failed, it does not mean you will fail again.  Develop an unshakeable desire to succeed and chances are you will. 

When you make your actions count, you open your arms to your best health -- today, tomorrow, and for all the years to come.

    *****    *****

What Do You Love?

Diabetes is handled best when you make it a part of your life, not the whole of it. You are so much more than your diabetes.  Think about what makes your life joyful and meaningful, and find ways to continue doing those things.  Life can be as exciting, rich, fun and filled with possibilities as it was before you got diabetes.

What do you love? Are you doing it? Regularly? If not, why not?  Doing what you love makes life fulfilling.  What you put your attention on tends to grow.  Put your attention on being sad, frustrated or angry, and life will become a series of unhappy events.  But put your attention on what you love, and happiness will come flying back riding full-speed atop the wind's tail.

My recommendation?  Take a little quiet time, on an off-day. Curl up on your couch, with some of your favorite soothing music, and read this book from A to Z.  It won't take you much more than an hour, and if you're not 100% the cynic, you'll find yourself (not cured by any means, but) refreshed and smiling.

{Self-published, starting at $14 on Amazon.}

The Little Diabetes Book for YOU

As you can see, this compact new 250-page volume by Michael A. Weiss and Martha M. Funnell is actually called, "The Little Diabetes Book YOU Need to Read."  How's that for making your book sound indispensable?

Mike is a former chair of the American Diabetes Association who's been living with Type 1 diabetes for over 23 years. Marti (Martha) is registered nurse and prominent certified diabetes educator (CDE), who's made quite a name for herself in research and training. Their book is interspersed with commentary from each of them -- a personal perspective from a patient and an educator.

And it's a really neat book. I  like the plain-talkin' writing style. I like the way it's organized into three simple sections: Learning, Doing, and Now What?  I don't particularly like the ongoing quarterback analogy, but maybe that's just me... not a football fan.

In the Learning section, you're encouraged to learn everything you can about diabetes itself, about your health care team, and about yourself.  To me, that last item is key, because it's the missing link in diabetes care in the past.  The Old School approach was to throw orders at patients, without any regard to their personal preferences or life situation.  This book represents the polar opposite, encouraging you to THINK HARD about your own unique reality: time constraints, diet preferences, culture and religion, social dynamics, your emotional state, anything that might affect your diabetes care. 

In the Doing section, you're again encouraged to be realistic: rather than shooting for "perfect" numbers, you can start by aiming for goals that are an improvement over where you are now. The authors talk about the cost-benefit trade-off of various actions, and how far you are willing to push yourself.  On page 163, you finally get to the nitty-gritty of "identifying your guiding principles." In addition to setting personal goals for daily BG levels, lipids, weight and other physical parameters, you're asked to rate, on a scale of 1 to 10, how much RESPONSIBILITY you want for your own diabetes plan (versus your doctor or educator), and how much FLEXIBILITY you desire.

You're presented with simple, unalienable truths like: "The more intensively you manage your diabetes, the more decisions you will have to make. The more choices you are willing and able to make, the more flexibility you will have." Right. If you don't want to eat the same exact thing for breakfast every day, you're going to have to work harder to keep your BG in range.

In the Now What? section, you're again encouraged to do some soul-searching with regard to facing challenges and handling stress.  For example, faced with a special event or holiday, your options basically are:

* Choose to ignore your plan for that meal
* Eat small portions of food you would usually avoid
* Take additional insulin
* Exercise more to balance your blood sugar
* If it's a potluck, choose the foods you enjoy that actually fit with your goals

Pretty common sense, but it's nice to be reminded that a logical approach will yield more predictable results.

And to sum it all up, the authors have an acronym for you (surprise!).  Create a LIFE plan:

Learn all you can about diabetes and yourself

Identify your three guiding principles (role, flexibility, targets)

Formulate a plan

Experiment with and evaluate that plan.

In truth, I was amazed at how much this down-to-Earth approach to diabetes/life balance has in common with that of our book, Know Your Numbers, Outlive Your Diabetes.  It's all about understanding yourself and your diabetes, and making a realistic plan for taking charge of your own health. 

A central theme in Weiss and Funnell's book is: Real diabetes is not easy. Thank heavens! Another set of authors willing to put that down in black and white.

[ Running Press, July 2007, $10.36 on Amazon.com]

Mr. Universe's Little Book with Big Pom-Poms

It's only 110 pages.  I read it on the plane on the way home from St. Louis.  It's an "exercise prescription" to prevent Type 2 and combat Type 1 diabetes.  It's The Diabetes Antidote from Mr. Natural Universe Doug Burns, with Denny Dressman (he's the journalist who helped NFL star Jay Leeuwenberg write Yes I Can! Yes You Can! -- a review for another day).

This little book from Mr. Big Type 1 is a like a field guide to gettin' your diabetic head in the game. It tells the story of how a scrawny kid diagnosed with diabetes at age 7 morphed himself into an award-winning body builder.  And in-between the snippets of his story, we get a lot of empowering messages about the indispensable effects of exercise and how important it is to "just do it." 

I couldn't agree more that "exercise is the best diabetes medicine."  What struck me in particular was the authors' quotable quote on its significance for people with Type 1:

"If you're not very active, even though you have insulin regulated, you're not helping yourself."  They explain that exercise not only boosts your metabolism and thus burns body fat, but also -- with increasingly strenuous workouts over time -- "causes the body to consume glucose of its own, and less insulin is required."  Doug tested the theory empirically by recording his own stats on training, insulin, calories, and body fat leading up to his 2004 Mr. USA victory.

Now I'll be darned.  Can you believe that when I mentioned my workout regime to my first diabetes educator a few years ago, she actually said, "Well, as a Type 1, you can exercise till the cows come home, and it won't change your diabetes."  Hah, I just knew that couldn't be right.  Vindicated!!

Doug also talks realistically about "bouncing around" -- from 146 to 296 in 90 minutes, after skipping an insulin dose to avoid a low during intense training, his notes recant (with obscenities removed).  So superstar body-builders do the BG yo-yo, too?  Grin.

The big message of this little book is in fact the age old axiom: you can do anything, if you put your mind to it.  It's a little rah-rah in particular for those already committed to the benefits of regular exercise, but still worth a look for a little "empowerment boost" on your next plane or train ride.  Or if you know anyone with diabetes who just can't get off the couch... I'm not sure this book alone is the antidote to inertia, but it certainly can't hurt. 

(ComServ Books, online for $12.95).

TCOYD!

Nope, nothing to do with frozen yogurt.  Just a reminder that if you haven't attended one of Dr. Steven Edelman's Taking Control of Your Diabetes (TCOYD) conferences around the country, get off the couch and do it, will ya?!

Here's the deal:

They're one-day Saturday sessions running from about 8am-5pm.  The day starts with a welcome from Dr. Edelman himself, which you will not want to miss (suffice it to say his wife thinks he has A.D.D. -- in a good way :)  The morning is then packed full of more entertaining and informative speakers talking on topics ranging from "psychological secrets" to keeping your feet healthy.

Then there's a light and nutritious lunch, during which some awe-inspiring PWD personality delivers a motivational talk.  At the next venue, this is none other that Mr. Universe Doug Burns himself, sharing his drive to exercise and succeed. 

The afternoon is almost the best part: you get to choose from an array of small workshops that get you up close and personal with experts on pumps, continuous monitoring, sleep apnea, alternative treatments, carb management, glucose control tips, walking and muscle toning, and much, much more.  I was so not kidding when I said, everything I need to know I learned at TCOYD.

Did I mention that there's also a "Health Fair" going on simultaneously, with exhibits from all the relevant drug, device, and supply companies?  Get your free ball-point pens!

And did I mention that TCOYD has introduced a new program for kids and teens (Keens) ages 8-18, who will get in for absolutely free?  Their day includes an "active living theater performance" and diabetes games.   

Oooh, and did I mention that the fee for adults is an extremely modest $35 per individual person, or $30 per person when two or more register together?  (TCOYD's a not-for-profit gig).  In addition -- get this -- several health plans have offered to pay the registration for their enrollees.  In Northern California, that includes Health Net, Blue Shield and several other regional plans.

Oooh, oooh: And did I mention that I'm actually giving a talk at next month's Santa Clara conference about the online diabetes community?  That's from 3:30 to 4:25 for anyone planning to attend :)

More dates + registration info HERE.

And a small reminder of the upcoming venues for the rest of this year:

September 15, Silicon Valley, California

October 6, Little Rock, Arkansas

October 20, Kalispell, Montana

November 17, Milwaukee, Wisconsin

December 8, San Diego, California

 

Pssst!... 50 Secrets of the Longest Living PWDs

Dr. Sheri Colberg of diabetes exercise science fame and Dr. Steven Edelman of TCOYD have come out with a new book with a quite intriguing title.  Everybody loves a secret, right?  Well they've got dozens of 'em for you, in 50 Secrets of the Longest Living People with Diabetes (Marlowe Diabetes Library, 2007).

It's encouraging, informative, and easy to read... definitely my kind of diabetes book! If nothing else, you'll be delighted to discover how many of the "secrets" you've already mastered.

What they've done is essentially strung together a series of over 50 interviews with Type 1 and Type 2 patients who've lived with the disease for 19 to more than 83 years (!)  Nearly 40% of their interviewees have had diabetes for 50 years or longer, so we're talkin' veterans of treatment change over the years. More than half of them are currently insulin pumpers.  The authors "sifted out the gems" from the interviews, relying on a host of supporting materials for substantiation.

The "secrets" are divided into eight irresistible categories:

• Emotional Secrets
• Knowledge Secrets
• Dietary Secrets
• Control Secrets
• Exercise Secrets
• Medication and Technology Secrets
• Support Secrets
• Other Life Secrets

Now doesn't that just sound like a list you want to sink your teeth into?  Of course, I can't give it all away here (they're secrets after all), but I can share a few of my own favorite gems from the book:

Fave patient quote: "Live first, and be a diabetic second" (on the very first page)

Fave author anecdote: Dr. Edelman's "pissing contests" at summer camp prior to diagnosis (see page 37)

Fave myth-buster: The lowdown on OJ, "the least effective rapid treatment for hypoglycemia" (p. 87)

Fave diet tips: Fibersure (p. 106); "lots of small meals" (p. 135); and the "tootbrush trick" to put a lid on stuffing yourself (p. 127)

Fave take on exercise: use it to "erase your mistakes" (p. 147)

Fave peek at Dr. Bernstein: "His goal is to have no more spikes in his BG than a non-diabetic person." (p. 161)

Fave tech tip: "A pump is only as good as the person in charge of it" (p. 180)

Famous last words: "Have kids if you want to" (p. 223); "Always listen to your body" (p. 239); and "Practice moderation in all things, diabetes included" (p. 251).

Obviously, I found a lot here to sink my teeth into. 

Thinking it over, there are probably a few too many books with "list titles" out there -- "50 Tips..., Seven Habits..., Ten Steps...," etc., etc.  But to my mind, for anyone living with diabetes, this one's definitely worth a read.  Enjoy.

** UPDATE:  Consider this a book (P)Review, as it appears this title is not physically available till November.  Good things take time, no?**

CWD's Summer Bash

Darn it, another great event I'm going to miss!  This year's Children With Diabetes Friends for Life 2007 Conference July 11-15 (at Disney's Coronado Springs Resort in Florida) looks, well... extraordinary.

This is the annual reunion-type bash for families and individuals living with type 1 diabetes -- although I happen to know that reknowned type 2 journalist David Mendosa will be "sneaking in as an imposter" this year as well.  Organizer Jeff Hitchcock tells me they're expecting 3,000 people. I sure hope the Disney Resort is stocked up on diet sodas.

The list of "Notable Guests" is pretty knockout:

Surgeon General Ken Moritsugu, MD, who'll be presenting the keynote address; basketball stars Chris Dudley and Adam Morrison; NFL star Jay Leeuwenburg; reigning Mr. Universe Doug Burns; Phil Southerland from champ cyclist group Team Type1 (about to ride the Race Across America yet again!); Canadian country music hit George Canyon; and, for all those Idol fans out there, Kevin Covais, aka last year's American Idol "Chicken Little."

There will be loads of useful focus groups, two full days of incredible sessions, a large exhibit hall, the annual Family and Friends banquet, and of course a shared day at the Magic Kingdom. 

Everyone who's ever attended this shindig tells me: get there if you can. Unfortunately our summer sojourn to Germany conflicts again this year... in fact, I'll be sitting out the 2007 ADA Scientific Sessions (June 22-26 in Chicago) as well, sorry to say. 

But I do plan to attend the annual American Association of Diabetes Educators (AADE) Annual Meeting & Exhibition in St. Louis Aug. 1-4.  Never been to St. Louis. Should be fascinating -- especially in August ;)

Dr. Jackson and I will be promoting our new book, and I plan to report back here on "educating the educators" -- so let me know what you'd most like to learn from that event, Y'all.

                *****            *****
Final NEWS FLASH: Allison Blass, our fearless leader of the Diabetes OC, is in the very early planning stages for a brand new annual conference espcially for adults with type 1.  The Planning Committee will be asking for volunteers at some point down the road, so keep your eyes peeled.

Survivorship Reconsidered

My new column this month at dLife is not exactly a book review, but something more akin to a "book encounter."

I recently received an advance copy of medical writer Jill Sklar's The Five Gifts of Illness.  Sklar was diagnosed herself with Crohn’s Disease in 2002.

What she's done is explore the whole concept of "survivorship" from a new angle:

“Surviving chronic illness is a relatively new concept in the history of civilization,” Sklar writes. “Looking back over the last millennia, most individuals were lucky to survive long enough to reach adulthood…” She points out that Lance Armstrong with his LiveStrong campaign was the first to “pierce the American psyche by adopting a symbol of survivorship.”

Right-O.  Years ago, "coming to terms" with your disease was a non-issue, since surviving generally wasn't an option.  If that doesn't make you feel lucky, the rest of her book just might.

She’s interviewed over 100 people living with serious illnesses about their diagnosis experience and how they’ve since re-assessed their lives. (Several interviewees come from our diabetes community, including myself {briefly}, Violet, and Gina Capone.)

In the end, nearly everyone interviewed found their chronic illness experience in some way life-affirming -- leading to a kind of Reverse Midlife-Crisis: instead of fretting that your life is halfway over, the disease impels you to celebrate all the life that you have left.

According to Sklar, the five themes or “gifts” that emerged after people were unexpectedly diagnosed with serious illness were:

• Relationships – some existing friendships were “weeded out” by the bad news, but many others deepened, and rewarding new friendships were discovered

• Time and Being – a sense of well-being is no longer taken for granted, and actually becomes a motivational force (like wanting to marry, have children or travel NOW, rather than later)

• Altruism – finding new value in volunteer work, and devoting their lives to helping others

• Emotions – becoming “committed to having a more emotionally fulfilling life.” Ironically, many people felt less fearful and more emotionally free after their diagnosis

• Goals – a strong shift in life goals (professional, family, retirement, spiritual) that altered the course of their life for the better, they said

I certainly wouldn’t wish diagnosis on anyone, but personally, I could relate.  My diabetes truly has brought me all five of these “gifts.”  Read more about it at Straight Up.

Sheri Colberg-Ochs: Honing In on Diabetes and Exercise

Another kindred spirit, and this one found me!  Sheri Colberg-Ochs is an author, lecturer, researcher, professor, exercise physiologist, and expert on exercise and diabetes.  She is also a mother of three school-aged children, and living with Type 1 diabetes herself (just like me).  She was diagnosed as a child, and has built her life around making a better world for people with diabetes.  She writes numerous articles and columns in addition to her five book titles -- including the recent "The 7-Step Diabetes Fitness Plan" and "50 Secrets of the Longest Living People with Diabetes."

Sheri contacted me last month with some questions on blogging, so I seized the opportunity to query this veritable font of diabetes guidance.  (btw, Sheri started her own weekly blog on Diabetes and Exercise April 2. Check it out!)

DM) Sheri, you’ve done extensive research on exercise metabolism in individuals with Type 2 diabetes. What are some of the most important findings to date?

SCO) Exercise is GOOD -- great, actually!  I'm still convinced that it's one of the most important things you can do to prevent diabetic complications.  I study changes in skin blood flow in the feet (which is improved by being regularly active), but others have shown improvements in kidney function, a
lower risk of clogged arteries, and even improvements in the health of your eyes and nerves with exercise.  We also know that regular exercise is critical in improving insulin action in the body, which is a sure-fire way to keep your blood glucose levels under better control. I tell all about how to improve insulin action in my book published last year called "The 7-Step Diabetes Fitness Plan: Living Well and Being Fit with Diabetes, No Matter Your Weight."

DM) So what’s the most important advice you give PWDs (people with diabetes) about starting an exercise plan?

SCO) Everyone is unique, and you have to set realistic goals for yourself when embarking on a new exercise program. The most important thing to remember is to start out slowly, progressing only when you feel ready.  If exercise is too hard, you'll likely end up finding excuses not to do it or, worse yet, injure yourself so that you have to take time off.  Start at a lower intensity; increase duration first and then either frequency or intensity later.

DM) One of our biggest challenges always seems to be fitting exercise into our busy schedules.  When you have diabetes, how important is timing of workouts really?

SCO) When you exercise is not nearly as important as just fitting it in somewhere.  Studies have shown that you can do 10-minute bouts of exercise throughout the day that accumulate to reach the recommended 30 to 60 minutes a day.  You may not get quite as fit, cardiovascularly speaking, as if you do the exercise continuously, but it will still have the same beneficial glucose-lowering effect.  You should keep in mind, however, that pre-breakfast workouts will usually not cause as much of a drop in glucose levels as exercise done after breakfast or later in the day.

DM) What’s your principal strategy for avoiding lows?

SCO) During exercise, the best way to avoid developing lows is to learn your body's response to particular types, intensities, and lengths of exercise.  You really need to check your blood sugar more often when you start doing new activities.  If you check before and after, you can find out your body's normal response and begin to predict what will happen next time.  If you take insulin, you may need to lower pre-exercise doses and/or eat more carbs to compensate.

DM) You’ve had diabetes yourself since 1968. Can you tell us how your perspective has changed over the years –- especially with regards to exercise?

SCO) When I was a kid, I started exercising because it always made me feel better (and that was back in the days of not having blood glucose meters).  Today, it still makes me feel better, but with a meter, I can see how beneficial of an effect it has on my blood sugar control as well.  I've always been an exerciser, and I have no intention of stopping -- ever!

DM) What kind of exercise do you do personally?

SCO) I'm mainly a recreational athlete at this point.  I vary my exercise routine because I've found that "cross-training," as it's called, is the best way for me personally to avoid getting tendonitis or other overuse injuries.  I also alternate hard and easy days.  Right now, two non-consecutive days a week I do heavy resistance training (8-12 reps with the heaviest weight I can lift that many times) and work out hard on conditioning machine, like the elliptical strider, StairMaster, or others.  Another day a week I swim laps at a good pace for an hour.  The other days of the week, I either ride a stationary bike at home (while reading) for 30-45 minutes (which I consider an easy workout), walk, or rest (at least 1-2 days per week).  The real key to keeping insulin action high is to not take off more than one day in a row and to occasionally do some harder workouts, even if it's just some faster intervals during your exercise session.

DM) Your “Diabetes-Free Kids” book is actually about preventing and treating Type 2 diabetes in children. Other than avoiding junk food and becoming more active, what’s the main premise of the book?

SCO) You make it sound so simple!  There's a lot more to it than just doing those two things, but they are an integral part of the needed lifestyle changes for kids to avoid getting Type 2.  Obviously, you have to find ways to sneak more exercise into kids' daily lives, and I give tips on how to do just that.  If they're going to eat less junk, you need to find kid-friendly alternatives for them to eat.  I also talk about how certain vitamins (e.g., D and others) are critical to help prevent diabetes and how antioxidants may help prevent complications.  It's good advice that anyone with kids in today's culture could benefit from reading.

DM) So you and Dr. Steven Edelman have a new book coming out in October called "50 Secrets of the Longest Living People with Diabetes."  Can you give us a preview of some of the coolest secrets?

SCO) The most amazing part, I think, is that I actually found a woman living in Washington State who has had diabetes for 83 of her 90 years (since 1924).  Most of us only hope to live that long, but doing it with diabetes and for so many years without a blood glucose meter is totally amazing.  We've profiled her, Bob and Gerald Cleveland (living 82 and 75 years with diabetes, respectively), and many other really inspiring people with both type 1 and type 2 diabetes.  The secrets are, well, secret...until the book comes out.  I can share with you, though, that every one of the longest-living people found regular physical activity and an active life to be a key to longevity.

DM) If you had unlimited time and resources, what would you most like to accomplish for the Diabetes Community?

SCO) I'd like to be able to prevent the onset of Type 2 diabetes in everyone, and I'd also strive to help people learn what to do to prevent getting diabetic complications regardless of what type of diabetes they have.  Personally, I watched my grandmother suffer through lots of diabetic complications (and with having only "borderline" diabetes, or so they called it back then) that completely obliterated her quality of life for the last six years she lived.  I really wish I could help keep anyone from having to suffer like she did, and I want everyone to live a long and healthy life despite having diabetes.  I think education is a large part of accomplishing these goals, so I have and am continuing to do my part to help educate everyone with the time I currently have to spare (and with some I don't).

Nice, Sheri, thank you! We'll keep an eye out for your new books.

New Sites, Camps, and Meters

Happy Spring, All!  If you're reading this, you've survived this year's second annual Sugar Fest (Valentine's Day, Easter, Halloween), so congratulations.  And now for an update on some stuff that might interest you, on and offline:

ON THE WEB:

* The "Patient Empowerment Movement" has a new champion?  At least that's the sense you get at Kevin J. Leonard's Patient Destiny blog.  Kevin is an associate professor of medicine at University of Toronto, working to create a  National Patient Advocacy Program in Canada. His sidebars are tré wordy, but his posts are good stuff. He also wrote an intriguing new book called A Prescription for Patience, all about becoming more involved in your own care and health management and what to expect more from providers.

* Check out a new health-related search site called Healia.com. The marketing folks tell me this one is different because: 1) it only provides high-quality results, 2) it lets you filter your results to fit your profile and needs, and 3) it shows relationships among medical terms to help you search more accurately. Healia was developed under a grant from the National Cancer Institute and recently received an award from the Emerging Technologies and Healthcare Innovations Congress. They're looking for user feedback, so don't be shy about contacting the company with constructive criticism.

* Amlyin Pharmaceuticals (makers of Byetta and Symlin) is getting into the personal online D-management game with a new site called YourDiabetesGoals.com. It's supposed to help you learn about and achieve these four objectives: reduce blood sugar swings, especially after meals; reduce your A1C level; lose weight with better blood sugar control; and improve insulin therapy.  That's pretty damn ambitious, I'd say.  At least from a design standpoint, the site is very well done. You can also print out a list of the goals you selected, along with questions to ask your healthcare professional on your next visit.  That might be useful, since being prepared is always a good thing...

HAPPY CAMPERS:

* Time to remind you about this year's Diabetes Safari camp for diabetic kids in Mexico.  This is a not-for-profit four-day adventure from May 12-15 in Oaxtepec, Morelos, México (near México City).  The cost is $240 USD per person including all meals, snacks, and complementary insulin.  Read all about it at the Diabetes Safari site, or contact  director Dr. Stan De Loach at saludo@usa.net.

* Who heard yet about the Diabetes Training Camp for adults with Type 1?  It's called "Stroke, Spin, Stride," developed by Matthew Corcoran M.D., CDE, an endocrinologist and specialist in Type 1 diabetes, sports and exercise.  They're offering two week-long sessions this year in Allentown, PA: June 17-24, and June 24-30.  Neat! Check out the all-star list of coaches, including fellow author and popular CDE Gary Scheiner.  Good for him. I wish I had time for camp this year!

METER BUZZ:

* BodyTel Scientific will be exhibiting its new innovative wireless GlucoTel System at the American Association of Clinical Endocrinologists (AACE) Annual Meeting in Seattle on April 11-15.  GlucoTel is the world's first and only wireless Bluetooth(TM) enabled blood glucose meter.  The data is retrieved using a secure web site.  Read all about it and watch an animated demo HERE.

* I'm sure many of you have read recently about the launch of Minimed's Guardian Real-Time continuous monitoring system.  This is the stand-alone portion of the Paradigm pump/CGM combo. Apparently there are still major barriers to health plan reimbursement (surprise, surprise!), so not a lot of people have this one yet.  My hope is to get an up-close-and-personal look at it soon, and report back here.  The sensor is smaller than the Dexcom's, but then you still have that disc-thing attached via wire and stuck on your tummy (see photo), so a big improvement?  The jury's still out...

* Diagnostic Devices of Charlotte, NC, has just introduced the Prodigy Autocode talking blood glucose monitoring system -- which delivers audible results in English or Spanish. "For the many diabetics who are blind or visually impaired as a result of their disease, it provides freedom and peace of mind – especially since Roche has abandoned its cumbersome and expensive VoiceMate product," their marketing team writes.   

More tidbits are continuously coming my way, so please keep your eye on the Weekly Nuggets section at left. I'd need an army to write a post on everything I should and could :)

KYN Book Update

So what's it like to be an author?  Somewhat uneventful, so far.  Probably because most of the promotions for our new book, Know Your Numbers, Outlive Your Diabetes (January '07), to date have been here in cyberspace. So it's more of the tush-in-the-chair kind of diabetes advocacy I've grown used to :)

Here's a snapshot of me, visiting the lone copy of our book in our local Barnes & Noble.  My husband said they either sold the other 12 copies the first day out, or there was just one other copy, which got damaged and thrown in some reject bin at the back of the store.  Danke!  At least this copy was displayed prominently, even if the "Diseases & Conditions" aisle is hidden under the rear of the escalator at the back of the lower floor. 

Still, the endorsements from doctors, patients, and educators have been hearty and generous thus far! Check out my Vox blog for all the details on our "Virtual Book Tour." Here are a few I'm especially proud of:

"What a great book! ... It helps you not only understand your five most essential health factors, but also guides you in setting doable action plans. You'€™ll find very serious topics -€“- including the complications of diabetes -- addressed in a fresh, upbeat (and even humorous) style. Dr. Jackson, a seasoned Joslin endocrinologist and researcher, and Amy Tenderich, a journalist who has type 1 diabetes, make a perfect team blending academics and real-world diabetes experience."
--€” Melinda D. Maryniuk, American Diabetes Association Outstanding Educator of the Year for 2005

"Richard Jackson and Amy Tenderich have really hit the bull'€™s eye by focusing on the key things that help people gain control over their diabetes. I expect that many people will find this sensible, easy-to-read new book enormously helpful."
--€” Dr. Gordon Weir, former editor of Diabetes, former Medical Director of the Joslin Clinic, and chaired professor at Harvard University

"This book allows even the mathematically inept to understand their lab values and what area of their health is most important to work on .... Even those without diabetes will wish they had it just so they can use this book."
-- John Walsh, Certified Diabetes Educator and author of Pumping Insulin

"It's the perfect diabetes reference handbook."
--€” Deb Manzella, RN, Diabetes Expert for the NY Times'€™ About.com

Also, see my recent discussion with author and mother of a T1 child Martha O'Connor at her literary blog. Oh, and be sure to check out the book review and author interview at ChronicBabe.com -- the online community for ladies with an attitude (and chronic health issues). 

Meahwhile, Dr. Jackson and I are taking some flack this week over not putting enough emphasis on the benefits of a low-carb diet for people with diabetes.  (This from a blogger who scorns the concept of "eating in moderation.")  In fact, the unspoken theme of our book on the lifestyle front is to approach all aspects of diabetes care with moderation. We do talk a lot about limiting carbohydrates, but steer clear of recommending the kind of severe eating restrictions that tend to pit a person against their own willpower -- which for so many people ends in binging, or creates a roller coaster cycle of eating.  That said, we probably could have done a better job of at least introducing Dr. Bernstein's approach. Second edition, anyone?

Thankfully, Jimmy also says our book (first edition) is "very well put together in an enjoyable format, mixing a healthy dose of diabetes facts alongside some hands-on practical advice about how to best implement the proper lifestyle changes that need to take place for optimal diabetes management."

The latest stop on our Virtual Book Tour is scheduled to go live later today at HealthCareVox.com, where communications analyst Fard Johnmar sheds light on nationwide health and medical trends.  Thank you for having us, Fard!