[Diabetes-talk] Introduction and the first of many questions.

[Mike Freeman]

Dear Linda:

First, despite the guilt-trip medical personnel put on you, there's
absolutely no reason to feel guilty or embarrassed because you have been
stuck with diabetes. Although genetics plays a role in who does or doesn't
get diabetes, the strongest risk factor for Type 2 diabetes is age! The
older one gets, the more likely one is to contract Type 2 diabetes.

Nor is gluttony necessarily a factor. Although there is an association
between being overweight and becoming diabetic, it's not at all clear which
causes which, health gurus' assertions to the contrary notwithstanding.
There are some indications that a tendency toward diabetes may cause weight
problems.

And some people develop Type 2 diabetes with no previous history in their
families. In fact, this seems to be what's happened to you. So there's no
reason to feel ashamed. And remember that it's the complications of diabetes
that can cause visual impairment or blindness, not the other way around.

Before proceeding, allow me to recommend an NLS BARD book to you. It's an
excellent discussion of Type 2 diabetes that doesn't presume that you're
either a simpleton or an endocrinologist with advanced specialization in
diabetes. Here's the description of the book:

DB64186: The First Year: Type 2 Diabetes; an Essential Guide for the Newly
Diagnosed 
Becker, Gretchen. Read by Kerry Dukin. Reading time 15 hours 19 minutes. 
Medicine and Health 
Updated edition of Type 2 Diabetes (RC 54748), a guide to managing blood
sugar levels in type 2 Diabetes, includes treatment options and medications
available since publication of the 2001 edition. Discusses interpreting lab
results, preventing complications, dealing with stress, and making lifestyle
changes to cope with the disease. 2007. 

Again, allow me to highly recommend this book. Get it and read it carefully.

Second, as you will discover from the book, although Type 2 diabetes (and,
for that matter, Type 1 diabetes) has certain commonalities for everyone,
the way a particular type of diabetes acts -- how certain foods affect you,
how you respond to various diabetes treatments, what diet works best for
you, etc. -- is extremely personal. Each person's case of diabetes is
unique. What works for one person may not work for another.

Third, as you learn more, you will discover that the reason the various
Wait-watchers diets don't work so well for diabetics without modification is
that those diets are primarily designed for weight-loss, not for control of
diabetes. Although the subject can be complex, in general, carbohydrates are
what affect blood sugar the most. Therefore, diabetes treatment results are
best when one watches one's carbohydrates. In fact, it isn't even
carbohydrates in general but, more particularly, the part of carbohydrates
that aren't soluble fiber or roughage that affect your blood sugar the most.

I'm attaching to this email a text file with a list of NLS BARD books on
diabetes. There, you will find both the Joslin and American Diabetes
Association guides on diabetes. Both these books have excellent explanations
of nutrition and diabetes including what carbohydrates are and how they
(along with protein and fat) affect one's blood sugar. Another good book
from Learning Ally is Hope Warshaw's "complete Guide to Carb Counting".
Learning Ally also has Dr. William Polonsky's "Diabetes Burnout: What To Do
When You Can't Take It Anymore". Also in the BARD list, you'll find
cookbooks, meal-planning guides, exercise books and books advancing various
theories about diabetes and diets from low-carb stuff such as "the Atkins
diabetes Revolution" and "Sugar Nation" to the usual conventional diets.
You'll have to go to Bookshare to find the *really* low-carb stuff such as
the books by Richard K. Bernstein, though. Just bear in mind that each book
has its own point-of-view and ultimately, it's up to you to determine what
makes sense for your diabetes. Gretchen Becker's book is an excellent place
to start, though.

Fourth, although some folks lose enough weight that they need no longer take
medication, their diabetes doesn't go away. The person just doesn't have
symptoms and can control the disease with diet and exercise. Alas, this
isn't true for Type 1 diabetics and, frankly, for most of the Type 2
diabetics on this list.

I myself have a form of Type 1 diabetes -- Latent Autoimmune Diabetes of
Adults (LADA) that I got in the spring of 2005. I was completely normal in
the summer of 2004 and in the hospital in ketoacidosis (a complication of
diabetes when one has little or no insulin left) in March, 2005. I am
completely insulin-dependent.

I won't go over which are "good" or "bad" carbs as it's probably best you
read from the Becker book. But, very broadly, what causes the problems are
foods with lots of carbohydrate but little fiber to slow down absorption of
carbohydrates into your system (and it's carbohydrates -- broadly-speaking
-- that increase your blood glucose inordinately).

What are carbohydrates? Sugar (mainly the glucose component but fructose
also), bread, pasta, potatos, cake, cookies, icecream, bagels, hot or cold
cereals (although some have lots of fiber and some, like Cheerios, are
surprisingly low in carb).

Why test your blood sugar? Because it's high blood glucose that eventually
causes the complications of diabetes -- neuropathy, kidney disease, heart
attacks, strokes, ulcerated limbs that may need amputation, etc. But if you
can keep your blood glucose as close to "normal" as possible -- say a
fasting bg reading between 70 and 130 milligrams per deciliter, your risk of
diabetic complications goes waaay down. So it's a good idea to practice
testing your bg. The Becker book practically beats you over the head with
this.

I don't eat the conventional "diabetic diet" -- low-fat,
medium-to-high-carb, etc., lots of fish and veggies. Yes, I eat both fish
and veggies. But, contrary to some recommendations, I eat all the red meat I
wish and worry more about carbohydrate than calories.

But this is getting into too much detail for a newly-diagnosed person. You
don't have to learn this all at once. For now, it would be a good idea to
see a diabetes educator (a certified one -- a CDE) and a registered
dietitian who specializes in diabetes. I don't have an endocrinologist; I
just have a good internist who knows his stuff.

There's a fine dietitian who has diabetes herself and is blind -- Sandy Ryan
-- who's the newly-elected President of the DAN of Iowa (it formed with
eighteen people this last Sunday). She is not a fanatic and would be an
excellent resource for you.

That's enough for now. Download the Becker book and read it. And look at the
attached booklist.

You'll master this thing. And just as it's respectable to be blind, it's
respectable to be diabetic! Read my article on this in the June Monitor.

And just remember that the most important things you can do are to learn
both about diabetes in general and about your personal diabetes and to
practice discipline. Even more important, learn that you're okay with or
without diabetes.

Please ask all the questions you wish. That's what we're here for.

Warmly,

Mike Freeman, President
Diabetes Action Network
National Federation of the blind


-----Original Message-----
From: diabetes-talk-bounces at nfbnet.org
[mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Lynda Canaday
Sent: Friday, September 28, 2012 3:37 PM
To: diabetes-talk at nfbnet.org
Subject: [Diabetes-talk] Introduction and the first of many questions.

Hello to All:

This is Lynda and I was diagnosed with diabetes type 2 almost 2 months ago.
Because my blindness is congenital, I didn't think I could get this disease?
condition?  My doctor says it is a disease.  I hate that 
label!  I'm having a very hard time coping with this.    Embarrassment 
is my immediate reaction to this because no one in my family has it and it
has never been one of the things we have delt with.  Is this common or, am I
as out of place in the world as I now feel?

I am a Classical singer and voice teacher in Kansas where I currently reside
with my husband, Jim and our pet yellow lab, ten-year-old Darby who should
be getting out of surgery about now.

I followed the "Weight Watchers Quick Start Plus Program when it first came
out in the 1980s and several people in my class who were diabetics followed
it as well.  so, I thought, "I'll just go back on that because it was the
one version of the program that I completely understood and I love it!
However, this time it isn't working.  My husband has blood sugar problems
because He takes a lot of steroids for his various very complicated health
issues.  Although he watches his sugar he is not 
diabetic.    He says that with diabetes you count carbs not calories.  
Of course, he can't explain how it's done but, if I have a "bad
carbohydrate, like half a bagel, he can say it's bad.  He also says that the
Weight Watchers exchanges are different from the diabetic ones but he can't
tell me why that is or the conversion formula if there is 
one.    Can anybody help put this right for me?  How are the exchanges 
different?  How can you tell which carbohydrates are good or bad?  How about
portion control?  Both of us could stand to lose more than a few pounds
which is fine with me, I would happily change whatever I need too in order
to accomplish that.  As far as Jim goes... ask him what he eats in one meal
and you will get the picture.  I have asked more than my one question.  and
I have so many more about diet and nutrition, obtaining glucose readings or
ratings.  Are there diabetic cookbooks available?  Where might I find them?
My doctor says that if I can drop the excess weight, I won't have this any
more.  Is this true?  
Sometimes I can't tell if that man is joking or telling the truth.

                Some time ago when Jim ordered more sugar testing supplies,
the company gave more than requested.  We didn't know that they were going
to be needed so soon.  They sent him an extra Prodigy Meter, and enough
neetles to last him for a lifetime, several lancets, testing solution and
bottles of strips.  I have benefited from this bountiful supply.  After
inheriting the new Prodigy Meter, two Lancet shooters, strips for the Meter,
about thirty boxes of neetles, and testing solution for the strips, and a
carying case I am in the process of figuring out just where to store things
until I need them.  Learning to take my blood sugar before my first cup of
coffee is difficult at best and some mornings I can't get it at all.  My
diabetes educator at the hospital said that I have to practice taking my
blood sugar in the same way that I practice for an upcoming performance.  If
I did that, my fingers would be varying shades of purple and who knows what
other colors I might turn.  I can't see myself poking my fingers for four
hours a day just to get one silly little two or three digits to flash across
a screen and tell me what they are.  What do they mean and why 
is it necessary to know them.           I will look forward to your 
answering as many of my questions as you can and it is my hope that some of
us will become good friends.  I'll be watching my inbox.

Lynda

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