Category: Diabetes Education

Diabetes Health, You’re In Charge..

Diabetes Health, Your in Charge.

This evening on the yahoo face page, (April 14, 2014) an interesting article on the new Affordable Care Act (ACA/ObamaCare)  and diabetics.  The focus is to prevent complications of Type 2 diabetes before it destroys a life OR  costs the insurance company a fortune.   Well,  hallelujah ,  I have been saying this for years.  If they could have  made our simple basic supplies affordable, with or without insurance,  many complications could have been avoided earlier.

However in this article, apparently it helps those who are already ravaged by the disease, or have been too stubborn to change bad habits.  They focused on a 62 year old woman, who for years struggled with her Type 2 diabetes, which she blames on her “love to bake and eat her sweet creations”.  They write of many of her episodes of uncontrolled blood sugars, loosing a foot in a car accident, (what was her  blood sugar at the time of the accident?) and that thinking about her insulin was ”the last thing on her mind”!!!   Excuse me, WHAT!!  are you 62 or 2, diabetes is your life, and for  many people, your choice,  take responsibility for it.   The article reads, “About 60 percent or so of the people with Type 2 diabetes can keep side effect at bay by simply managing sugar levels, exercising and watching their weight“.   It goes on to read, “about 26 million Americans have diabetes, and two-thirds (approx 17 mill) of them are overweight or obese.  The above mentioned woman went on to ACA, it costs her less than $2 a month, thanks to a tax credit of  $574 a month, which WE are paying.   Given the choice of eating smart, moving more, and taking ownership of what you did to your health vs  being slowly ravaged by diabetes complications, I would vote for a little self-control and a lot of education.

I for one, am Type 1, I had no choice in my condition, however, I do choose to take control of it, manage it, and remain as relatively healthy as I can, even though I am learning it is not in my best interest monetarily.    I  cannot get on the group insurance plan for small business owners, (as my husband is a small business owner) because of my, (wait for it), pre-existing condition.  I know, I too though this was a thing of the past, however the agent from this small business group plan informs me he is not allowed to sign  me up on their plan.  They can take my husband, but I must be directed to the “market place” crap.   As I have shopped these ACA plans, and learned again, because I choose to work with my “disabilities”, I would get no assist with subsidies, tax breaks or hand outs, whichever they choose to call it.  My premiums and deductibles would be doubled.   My co-pays at the pharmacy have already tripled for my insulin and test strips, and this is helping me  how Mr. Prez?  The articles does go on to tout all the good programs and work-shops they are setting up,  alas the same problems will exist, how to get people to attend now, if they wouldn’t  in the past.

I am just planning ahead, testing the waters for my future, as I feel my group insurance at work may be drastically changing come August, and considering the fact that I am hardly able to continue wrestling obese patients and senior citizens around full time much longer.   Quoting a line from the article  above, “Diabetic Beware.”  a “relatively healthy person with diabetes can cost insurers  around $5,000 a year”,  but if you  let any of those long term  complications develop, then you’re talking $100,000 dollars plus.”    People, people…. given the choice of eating smart, moving more, and taking ownership of what you did to your health vs  being slowly ravaged by diabetes complications,  I would vote for a little self-control, more activity,  and a lot of education.

 

Glycemic Index Basics

healthychoicesAn overload of nutritional information out there in the cyber world  has made finding the simplest answers extremely confusing,  even for me, who has felt fairly secure in my knowledge of “good vs evil” food exchanges and choices.  To add to the confusion, good carb/bad carb is now complicated by glycemic index numbers, and not just glycemic index, but glycemic load  numbers to add to the confusion.   The February 2014 issue of Diabetes Forecast,  one of my favorite Go-To resources has an exceptional article,  Carbs; Beyond the Basics,   which is where much of my following references are taken.

The glycemic index (GI) measures the glucose response to a given number of grams of  carbohydrates.  They would measure your glucose levels during the first 2 hours after consuming 50 grams of  carbs.  These carbs are then compared to the response of blood glucose spikes after consuming 50 grams of pure glucose.  They then, label these foods High GI or Low GI, obviously, Low GI are much better as glucose does not rise dangerously after your meal.  Sounds simple right? Wrong, because it was then realized by the ADA that following a low GI diet alone, did not make any measureable difference in you A1C.   So the Glycemic Load was invented.   This  factors in two important measures of diabetes control;  carb counting and the glycemic index.   While carb counting considers the total amount of carbohydrates,  the glycemic index accounts for the quality of THAT carbohydrate,  the glycemic load considers both.   The best example;  1 cup of mashed potato  vs 1 cup of watermelon, both high on the glycemic index, however, because 1 cup of mashed potato has a much higher carb count, its’  glycemic load is  higher.

There can be up to a “threefold difference in the glucose response to the same quantity of carbohydrates.”   to  confuse matters  more,  a foods origin, how it was cooked/prepared, the degree of processing, ripeness, and even the brand all affect these numbers.  Things to consider;  choose unprocessed foods, bypass “puffed” grain products, as well as “instant” products like oatmeal, instant potatoes, rice.   There is even a difference in over-cooked grains/starches, cold potatoes are preferred, and fruit which is not overly ripe.

I would advise that you get on the site for Diabetes Forecast and read this article.  They cover a bit more and explain in better detail the “why nots” of the above food choices.  I found this tid-bit of info amazing,   the glycemic index measures were not done on PWD?  Which qualifies my belief that our diabetes and our bodies respond differently than the next person, as a matter of fact, my body does not react the same way to the same foods eaten from day to day…..

Prevent, Not Treat the Highs

Prevent, Don't Treat Highs

My greatest reason for this website has been to help educate and free people, diabetics especially, of feeling like their life is nothing but limitations.  A diagnosis of Diabetes should be considered a health alert, a warning  of impending danger, or damage, which you are inflicting on your body by your poor food choices.  However, my greatest challenge is that of the several nursing facilities  in my area,  and THIS, has been a great motivator, as these residents do not make their own choices and should not be victims of the ignorance of the medical professionals making it for them, including nursing and dietary.

I have recently had a heated discussion with nursing about  a diabetic patient who innocently answered my question of  “how have your blood sugars been reading?”  and not for the first time, the response was,  I don’t know, I don’t think they have been checking.  Of course my response is,  you would certainly remember if your fingers were getting stuck.  As it turns out, after asking her nurse about this, I was informed because she is a Type 2, on oral  medications, we have no orders to check her BS levels (blood sugar) and nursing informs me we do A1c checks when necessary.  In the  mean time, daily numbers are somewhere in the clouds, affecting this persons health and  daily activity levels.   Apparently because most oral medications do not cause hypoglycemia, or low blood sugars, they are not worried.  Well EXCUSE ME, but this patient suffers from  “pins and needles”  on both hands and also from the knees down, causing her balance to be non-existent, a common risk factor of neuropathy, is losing her vision, and reports her sugars before she got here were always over 300,  I would think her doses would require some monitoring and adjusting, but then again, I am not a doctor.     She may not be the most aware person, but she did tell me when she was home she checked at least twice a day.  To top it off,  she tells me she eats the cakes or other deserts on her tray because as she puts it, ” they should  know I’m diabetic, I thought it was sugar free”.

I see the meals that are served in several area nursing homes,  there is no difference from a diabetic meal plan to regular meal plan.  Apparently the choice of treatment for the elderly diabetics is to treat AFTER the meal , of course if they are not checking post meal BS levels, there will be no correction, however, if you are on oral medications, there really is no correction other than simply eating the appropriate meal.  In my mind,  simply crafting an overall  “healthier” diet  would fix this, however, I have been informed this is how the people of this territory  are used to eating and to change this would certainly be unacceptable, or in other words, a  “culture shock.”

I moved here 6-7 years ago, and my eating habits were constantly criticized from fellow employees, until on two separate occasions, co-workers, overweight and newly diagnosed with Type 2, would religiously ask me questions about meals, from what they had for breakfast to what they brought for lunch,  exercise, and anything else that affected their diabetes.  Over several months, both these young ladies lost weight, both of their doctors were thrilled with their new glucose levels, including A1c, one even improved her sleep apnea problem.   They would always come into my office and report their lab numbers to be, and they were just beaming with accomplishment.  These are the two young ladies who inspired me to start this site for people of my geographical area, and obviously anyone else who takes the time, and it does take time,  and commitment,  to improve your health.  It’s not an overnight thing, but it can be done.

Unfortunately, I cannot take on the medical field, the old way of thinking of some of these doctors, but hopefully, I can put a bug in the ear of the family members to voice their concerns for their loved ones.   A little education can go a long way.   Yes, they do have my business card, but most do not have computers, but I will continue to be an advocate and  voice my concerns along side of them.

 

 

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