Type 2 Diabetes - An Imperfect Disease

"What are my options? I don't have any, so I have to work 

with what I have, with what they are going to give me, 

and then I have to help myself. 

~ Tony Flores, DiabetesHealth.com

Diabetes is an imperfect disease that imperfect people imperfectly try to manage.  The following link takes you to Tony's story from DiabetesHealth.com.  Tony gives a realistic view of what it is like to live with diabetes.  What I love about Tony's story is his realistic reminder that people living with diabetes will have rough, imperfect moments but they can get back on track with a positive attitude and a change in diet, exercise, weight loss, and (when needed) medication.  Tony also reminds health care providers of the importance of explaining to patients in simple frank terms the complications that can occur when diabetes is not under good control instead of repeatedly asking patients to take medications and make lifestyle changes without explanations. Lastly, Tony reminds health care providers that encouragement in small changes toward management of blood sugar control carry a lot of weight in helping patients continue to improve their health.  I only know you through your story Tony but thanks for sharing a part of your life as you seek to live perfectly with such an imperfect disease!

http://www.diabeteshealth.com/read/2011/03/15/7087/type-2-profile-tony-flores/#commentpost

"People have to be explained about diabetes. There's got to be someone who will tell you what's going to happen if you don't do what you're supposed to do. They can't just tell you, ‘Okay, this is the medicine. Take it and you'll be okay.' No. You have to let them know that there is something else behind it, that they're going to die if they don't change. A lot of people that I know, they tell me, ‘Oh Tony, I don't know how you manage. I've been trying hard, and I'm still at 300." Meanwhile, they're drinking soda. They are still just playing with the idea. Diabetes doesn't make you feel anything. There's no pain until they tell you, ‘Okay, that's it, you are done, the game's over.' You don't want that. You have to let people know in advance, ‘This is what's going to happen, and when it is happening, it will be too late: We're not going to be able to help you."  ~ Tony Flores

Meal Planning To Right Or Create Your Plate

Healthy eating is an essential treatment for blood sugar control.  Contrary to popular belief, there is no diabetic diet.  People with diabetes are encouraged to eat healthy meals with a combination of foods from all food groups.  Many meal plans are available to assist people with diabetes to plan healthy meals.  Do you find carbohydrate counting to difficult?  Are you unsure of how to stick to a healthy meal plan when eating out and away from home?  One of the most simple ways to stick to a healthy meal is to use the plate method to "right" or "create" your plate.  The following video from the American Diabetes Association demonstrates an easy way to structure your foods on your plate so that you can enjoy a healthy, nutritious meal without worrying about counting carbs, remembering the glycemic index of foods, or remembering service sizes for food exchanges. 

For more information on meal planning visit http://visionsofcontrol.com/HealthyMealPlanning.aspx

Diabetes, Intimacy, and Sexual Dysfunction

Sex and intimacy is an important part of any relationship and "problems in the bedroom" can wreck havoc on relationships. Women may experience problems such as vaginal dryness, frequent yeast infections, vaginal pain, and a lack of sexual desire. Men may experience lack of desire and/or erectile dysfunction. Sex is not only a physical act, it is also an emotional, intimate connection that bind couples together. If you are experiencing sexual dysfunction you may feel depressed, embarrassed, and alienated and may find it difficult to openly approach your health care provider to discuss these issues. But your sexual health is a part of your overall health and your health care provider is readily available to discuss your problems or prepared to refer you to the appropriate resources to get the assistance that you need for your problems. A few key issues that will probably be screened/discussed in your conversation with your health care provider are:

• Depression
• Stress
• Blood sugar control
• Blood pressure control
• Medications, particularly blood pressure medications.  You may benefit from a change in medication or a change in dose.

Following are 3 videos that discuss sexual dysfunction:

1. Erectile dysfuntion


2. Female Sexuality


3. Sex, Intimacy, and Diabetes

If you are experiencing challenges with intimacy and sexual dysfunction then I encourage you to speak with your health care provider today. Take care.

Bittersweet

Diabetes can sometimes feel self-defeating because it seems too overwhelming to do all of the "right" things every single day to keep the blood sugar, blood pressure and cholesterol under good control.  But like the  videos below emphasize, if you believe in yourself and don't give up, your victory will be bittersweet.  Take a moment to exhale then breathe in the inspirational messages in the 2 videos below.  If you are feeling defeated reach out to your health care team TODAY and always, always, always ... believe in yourself and think control!

Code Red Alert

Why Aren't Physicians Being Trained to Treat Diabetes
(click on article to open link and read article)

The article "Why Aren't Physicians Being Trained to Treat Diabetes" is a code red alert for anyone with diabetes.  If we can't trust health care providers to have the knowledge and skills to treat people with diabetes then who do we trust?  When patients challenge me and make comments about what their doctors did or did not say or do I address their concerns and I also politely respond "you are your own best advocate".  I am in no way making excuses for physicians or any health care provider to not be knowledgeable about treatment for diabetes but there is a wealth of information available for patients with diabetes, even for patients with low literary comprehensive skills.  Diabetes is a multi-faceted disease and require skills beyond physician management.  Learning self-care management skills is also an important aspect of diabetes care.  Health care has changed and it is not always for the better so be proactive.  If your physician does not know how to treat your diabetes then find another physician.  Also, attend a diabetes education class every 3-5 years, attend a local diabetes conference, join the American Diabetes Association or at least access their website for free, join a diabetes support group, ASK for a referral to a dietitian and a Certified Diabetes Educator, etc., etc.  In other words, don't let a physician or any health care provider be a barrier to your care because if you do, you alone may be the one to suffer the ill-fated consequences of poor diabetes control.  Take care of yourself and be proactive so that you will live a long, healthy, comfortable life.  Peace!

Hypoglycemia Unawareness

I am a Nurse Practitioner and Certified Diabetes Educator.  I also have type 2 diabetes and today my blood sugar was 59 mg/dL!  I was shocked at my blood sugar reading because I did NOT feel bad at all.  I take Metformin for my diabetes.  Three hours prior to checking my blood sugar today I had eaten banana-walnut pancakes with regular syrup.  I have not had any changes in activity, food intake, or medications, I  have not consumed any alcohol, and I am not stressed or depressed.  In other words, I could not think of any reason why my blood sugar was so low.  I last checked my blood sugar 2 days ago and over the past several weeks my blood sugars have consistently ranged in the 80s to low 100s range.  

Hypoglycemia unawareness is defined as a low blood sugar that occurs without any of the physical warning symptoms of a low blood sugar (i.e., shaking or nervousness, headaches, sweating or clammy wet skin, confusion or anxiety, palpitations, etc.).  It occurs more frequently in patients on insulin therapy (patients with type 1 diabetes and patients with type 2 diabetes that require insulin) but it also occurs in patients with type 2 diabetes such as elderly patients, patients that have had diabetes for several years, patients that consume alcohol, patients with diabetic neuropathy (nerve damage), and patients that take beta-blockers for heart disease and/or blood pressure control.  Hypoglycemia unawareness is potentially life threatening because low blood sugars (especially blood sugars less than 50 mg/dL) can lead to loss of consciousness, confusion and behavior changes, coma, seizures, and death.  Usually when blood sugars are low our body hormones send out physical warning symptoms that we recognize and can act upon to immediately raise our blood sugar.  With hypoglycemia unawareness we lose this response and do not experience those physical warning symptoms.  

Today was an anxiety-provoking experience for me because prior to checking my blood sugar I was preparing to travel in my car.  Had I not checked my blood sugar I could have potentially had a fatal accident and killed or injured myself, my daughter and other people.  This is why I advocate people with diabetes to check their blood sugars, including patients with type 2 diabetes that are not on insulin.  Talk to your health care providers about how often you should check your blood sugar and what blood sugar ranges are safe for you.   

Click on the following links to learn more about hypoglycemia and hypoglycemia unawareness:

http://visionsofcontrol.com/AcuteComplications.aspx

http://www.diabetesnet.com/diabetes_control_tips/hypoglycemia_unawareness.php#axzz1As2yTKLx
http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html

Refuel, Reshift, Refocus

It's 2011 and we made it here!  Whew, 2010 was some kind of year.  Some of us excelled, some of us were status quo and some of us were deeply challenged.  Every new day is an opportunity to refuel and overcome our challenges and we can make 2011 our best year yet.  The festive holidays have ended and most of us have returned back to work or at least re-established our daily routines.  What now?  How do we refuel, reshift, and refocus?  How do we get from the "thinking" mode ("I need to ...") to the "action" mode.  I propose 3 actions:

• Take a few minutes every day to reflect on WHY it is important to gain and maintain good blood sugar control.  Do you desire to live a long, healthy life free of complications?  How important is it to you to be able to continue to drive your own self to the places that you desire?  Do you wish to fulfill your plans to travel, shop, and enjoy your future grandkids?   What are your goals?

• Find out where you are (realistically, no guessing).  What are the values for your A1C, blood pressure, cholesterol, weight, and BMI?  This may require a visit to your health care provider.  We make time to do the things that are important to us so why not start with making your health a priority in 2011.  

• Start with where you are.  We have different challenges but everyone has challenges that can be overcome.  Maybe one person needs to complete their eye exam.  Maybe one person can stop eating cookies (That would be me ... thank God that all of the holiday treats are gone!).  Maybe one person needs to refill a prescription.  Maybe one person needs to restart home monitored blood sugar checks.  What are your challenges?

It's okay that you fell off the bandwagon in 2010.  The 2011 wagon is 

coming along so jump on, refuel, reshift, and refocus!  Peace!