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!

Ouch, this hurts!

"I'm not claiming diabetes.  I don’t like to stick my fingers.  I don’t like insulin.  I can’t eat more than 1 time a day.  I don’t have time for exercise. I went to a diabetes class 10 years ago and I have that information at home, I just need to find it and read it.  Everybody in my family has diabetes so it’s no big deal.  I’ve been on a cruise last week and I ate too much, that is the reason why my A1C is too high.  My BS are 200 and that's good for me; they used to be higher than that.  I take too many pills already.  When my blood sugars are less than 180 I feel bad so I try to keep them above 200.  Just give me 3 more months to change my diet and lose weight; yeah, I know I said that 3 months ago, I just need some extra time.  My medicines are too expensive.  It costs too much to buy healthy foods.  The medicine makes me feel worse when I take it.  I take my medicine once a day and that is enough for me.  I don’t want to start insulin because I will never get off of it and I don't want to make my body dependent on insulin.  What happened to pancreatic transplants?, I want one.  When I don’t eat my blood sugars are still too high anyway so what's the point?  I don’t know why my blood sugars are high because I don’t eat a lot of meat.  I just need to cut down on what I drink.  I promise you my labs will be better the next time.  I’m too busy to take my medication.  I can’t get a day off of work to come to the doctor.  I’m too stressed out.  I don’t want any more pills for my diabetes, I only want you to give me some Viagra and Penicillin.  I hate cooking for me and then a different meal for my family, it's just too much!  I'm not taking any medicine for my diabetes, I'm going to a herbal doctor.  I don't want that medicine, I'm going to to cleanse my blood.  I just need a colon cleanser to clean my colon and then my blood sugars will go down; it worked for me 5 years ago and it will work again.  I'm too depressed to make any changes.  I don't know what to do.  No, I can't do that because it won't work for me."

Can you relate to any of the above excuses?  Some excuses are legitimate, some are real challenges, and some are just that - excuses.  However, what is inexcusable is not taking control of your diabetes before it takes control of you.  Research and large studies have established without a doubt that uncontrolled diabetes cause major, irreversible long-term complications.  Diabetes is a silent sneaky disease.  If you has a tooth abscess you will go to the doctor or dentist and ask for medication and you will take it because a tooth abscess hurts.  Diabetes does not hurt so it is easy to ignore it and sweep it under the rug.  As a person living with type 2 diabetes and a Certified Diabetes Educator I challenge you to find the motivation to take control of your diabetes and overcome your excuses and challenges.  Ask yourself the following questions:  What do I want my life to look like 10, 20, 30 years down the road?  Who will care for me when diabetes cause a complication such as kidney disease and blindness and I can no longer care for myself?  How will I pay my bills if I have to stop working; who will support me? 

Unfortunately, we can't put an ointment on our diabetes then cover it up with a band-aid until it heals like we can with a boo-boo.  However, we can thrive and live long, healthy lives with type 2 diabetes.  Yes, it does require effort and planning.  Yes, it can be discouraging sometimes.  Yes, sometimes we do have to take medications, maybe even insulin.  Yes, we do have to LEARN about carbs and healthy meal planning.  Yes, we really do need to attend that diabetes education class sometimes.  Yes, we can take a day off of work if we plan in advance.  Yes, we really do need to check our blood sugar.  We must stop looking at all of the "no's" of diabetes and find some "yes's" of diabetes.  Yes, we can ... yes, we can ... yes, we can.  After all, what is the price tag for quality of life?  Life is beautiful.  Take control.  Peace!

http://visionsofcontrol.com/default.aspx

Are Artificial Sweeteners Safe?

"Live with Passion." ~ Anthony Robbins

People with diabetes can enjoy  the same healthy meal plans as people without diabetes but it is a fact that people with diabetes have to be careful with their food and beverage choices.  Too many carbohydrates in the diet from sweetened food and beverages are guaranteed to raise the blood sugar and negatively impact blood sugar control.  So what about artificial sweeteners, are they safe alternatives to table sugar?  Are the rumors true that artificial sweeteners are dangerous to your health because they cause brain cancer and actually cause weight gain?    Below is a link to an excellent article from the American Diabetes Association on artificial sweeteners.  Enjoy.  Peace!

http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/artificial-sweeteners/