Point of diagnosis educational interventions are powerful "teachable moments" that set the stage for positive change and help your diabetic patients understand that a positive clinical outcome is a shared responsibility. I introduce my patients to a plan I call the 5Ms of Diabetes Self-Care.1 It's a common sense plan that's as easy to explain as it is to understand and follow.
Happy New Year! I hope that 2013 has a greater impact on those of us with diabetes than 2012. The past ten years, we have been blessed with the development of many new medications and devices that make it a bit easier to live with diabetes. For me, 2012 was quite disappointing since several important new classes of drugs to treat diabetes that many people thought would be approved by the Food and Drug Administration (FDA) were NOT. I was especially disappointed that the FDA required more tests of an exciting product called Afrezza. It is an inhaled insulin product that is absorbed into the bloodstream very rapidly and broken down quickly. It will be a fantastic product once approved since diabetes patients can easily and conveniently inhale it as a bolus insulin. It will keep after meal blood glucose levels in check. The device is very small and easy to carry with you.
The holiday season is a worrisome time for many of my diabetes patients. Family dinners, office parties, and holiday cheer often make them feel apart from, instead of a part of, life. They are everywhere reminded that we eat food for many reasons besides nourishment; celebration, tradition, family. And so they worry. I wish it were not so. Certainly trying to control blood sugars during the holiday season is something to be concerned about. But is it helpful to worry?
Thanksgiving, Christmas and New Year’s have always been magical times of the year for me. I had a great family and my social worker mother always invited homeless people and many relatives to share the feasts associated with each holiday.
I was 8 years-old when I was diagnosed with diabetes and that was 63 years ago. For 30 of those years, self-monitoring devices for blood glucose were not available and the ability to know your blood sugars and keep them close to normal levels was a guessing game at best. I remember learning very early in my life with diabetes that there were not many foods, including desserts, that were forbidden.
Recently, one of my diabetes patients commented that she enjoyed watching Dr. Oz, but worried that if she bought all of the supplements he recommended she would need an extra room in the house and a second job. Americans spend 25 billion dollars on supplements and herbs each year in an effort to improve their health. A physician survey found that 44% of their patients admit to taking at least one over-the-counter supplement. What are patients to think about the hype they hear about supplements? And what should we be telling them when even the experts don’t agree? Are our patients gaining any benefit from these treatments or are they wasting their money?
It is estimated that there are 79 million people in the United States with a condition known as PREDIABETES. People who develop type 2 diabetes seem to have a number of characteristics that predispose them to eventually being diagnosed. Pharmaceutical manufacturers that have an interest in diabetes would love to have a product they could offer to individuals with prediabetes that would prevent them from developing diabetes – it would obviously be a huge money maker for them.
Studies are being conducted to see if any of the medications that are approved for type 2 diabetes could indeed be used to postpone the diagnosis of type 2 diabetes for this population.
Diabetes, the leading cause of amputation of the lower limbs, places an enormous burden on both the individual and the health care system. It’s estimated that the annual cost for treating diabetic foot problems is over one billion dollars. During their lifetime, 15 percent of people with diabetes will experience a foot ulcer and about 20 percent of those will require amputation.
A friend of mine introduced me to his 3 year-old granddaughter the other day. She was quite a character and asked me if I knew my numbers. Before I could answer, she stated, "I know my numbers!” She began to count everything around us and was proud that she could add. When she finished, I told her that I also knew my numbers, but they were numbers that related to my health status. Many people do NOT like to share their numbers, especially things like age, weight, body mass index, their A1C number and if their blood sugars are high.
In a previous post I described how large amounts of fructose in the diet induce a cascade of metabolic changes that directly contribute to insulin resistance and the corresponding abnormalities described as the metabolic syndrome. Research suggests that how and where we get our fructose is also important. Most of the fructose in our diet is concentrated in sugar-sweetened beverages, such as soda and juice drinks. Data show that over the last 30 years Americans have consumed 278 more calories per day, and the largest concentration during that period is from an increase in soda consumption, accounting for 43 percent of all new calories.