It was “Derby Day” in Kentucky Saturday- the run for the roses. I lived in Lexington,the center of Kentucky horse country (even though the Churchill Downs is in Louisville), and I can promise you that it was party day at many homes around that state. For our Kentucky members….I’m trusting that you watched what you ate and drank.
The Kentucky Derby is the first leg of the “Triple Crown”, which also includes the Preakness and the Belmont Stakes…I’m unsure of the order. Few horses win the Triple Crown, in part because each race is different. I guess it’s hard for a horse to be really good in three very different circumstances. The Kentucky Derby is extra special because only the winner here has the opportunity to win them all. Athletic contests are like that- the winner gets all the attention. You may have noticed that if you watched the race’s aftermath.
There’s a “Triple Crown” in diabetes management too…..I call it the diabetes management triangle. The three “races” are medical treatment and monitoring, diet, and physical activity. And guess what? We can win the diabetes Triple Crown without winning one single “race”……… but we can’t win the diabetes Triple Crown without competing in them all.
Too many of us focus all of our attention on only one area….probably the “race” we’re best at, and that’s often the medical “race” because at first the medical race is the easy one. But, if we don’t even compete in the diet and exercise “races” (the “lifestyle” factors) we might just find that winning the medical one hands down isn’t enough. Diet and exercise play a key role in reducing our elevated risk for heart disease and other complications, AND help our medications work better.
So, as we watched the winner of the Kentucky Derby get all of the attention Saturday let’s remember that effective diabetes management doesn’t require us to be a thoroughbred or a winner. Our “run for the roses” is a different race all together- we can win none and still be the big winner if we devote ourselves to doing our best in all three “races”.
Doctor of Physical Therapy John Voelz joins Joan Hammel, Tony Skerbec and Toby to discuss his structured physical activity programs at Northwest Senior Health and Fitness in Huntley, Illinois where seniors with diabetes discover firsthand the benefits of exercise to blood sugar control and cardiovascular health.
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Screening for colorectal cancer is an extremely important preventative procedure, but the preparation can be tricky when diabetes is involved. Managing blood glucose levels is best accomplished with routine- a routine eating schedule, routine physical activity, routine sleep. The preparation for this procedure, however, includes 12 hours of “only clear liquid” and another 12 hours of “nothing by mouth”. With Type 1 diabetes or with some type 2 medications, avoiding low blood sugar- hypoglycemia- is quite important. Here’s my “video blog”.
A “shock ad” from the New York City Department of Health illustrating a cause-effect relationship between soda consumption and diabetes-related amputation drew heavy fire on two fronts, and maybe lost its message in the process. The ad features an obviously overweight African American man with his right leg missing at the knee, and crutches leaning against the background wall. An illustration of increasing sizes of soft drink cups and the text, “Portions Have Grown; So has Type 2 Diabetes Which Can lead to Amputations”, complete the poster
Not surprisingly, soft drink manufacturers objected to the association between soft drinks and amputation, by way of Type 2 diabetes. But the real “headline grabber” was a revelation that the missing the leg was actually lost to “Photoshop”, and not surgery, when the actual photographic subject was found to have complete possession of both his original legs.
The image was taken by a professional photographer, and you can bet that the subject signed a waiver that makes this kind of manipulation perfectly legitimate. The NYC ad, along with other “shockers” in New York and elsewhere, is the latest strategy to figuratively “slap some sense into” the American public with respect to our unhealthiest habits because these health risks are in great measure preventable.
Unfortunately, there is a key message that has gotten lost because of this almost irrelevant deception—diabetes is “life and limb” serious! The message is lost in this specific case in the drama about the altered photo, as if every magazine cover hasn’t been “touched up”. But, do these shock tactics work? I honestly don’t know. What can it hurt to try, however?
I’m afraid that diabetes has become so common that we will begin to view the disease as a simple consequence of aging—reading glasses and metformin as the “welcome package” to one’s forties. But avoiding diabetes, on the one hand, and managing diabetes to avoid awful “complications”, on the other, is the same assignment except for the medication. It is diet and physical activity, we need to wake up America. But while the wake-up call can come anywhere along the line– a shock ad, a diabetes diagnosis, tingling feet or an amputation– some points along that line are just too late. Diabetes is “life and limb” serious.
February is, by declaration of the President, American Heart Month, and tomorrow is the holiday of love Valentine’s Day. If I asked you to visualize the connection between these two February events you would almost certainly picture the iconic red heart symbol first. Even the American Heart Association uses the familiar shape in its logo that, it turns out, is thousands of years old.
So the “heart” represents both health and love, and this month is the perfect time to commit to doing what is necessary to preserve both—and commit is the key word. Neither health nor love can be adequately “nourished” in a single day’s or a single month’s observance. Commit is a word that says “long term”, and while I’ll pass on dishing out advice for lovers I will offer a word or two about health.
Cardiovascular (heart) disease is the number one killer of Americans, and the number one killer of people with diabetes. Having diabetes, in fact, is a major risk factor for cardiovascular disease. Some say that having diabetes is equivalent to having already suffered one heart attack. That’s why the “ABC’s” of diabetes control involves not only blood sugar control (A1C), but also other cardiovascular risk factors—Blood Pressure and Cholesterol. The connection between diabetes and heart disease is strong, but the good news is that we can be stronger.
Both diabetes self-management and living “heart healthy” depend upon lifestyle commitments we can freely make, and we all know what those are—diet, exercise, regular physician care, no smoking, alcohol in moderation, adequate sleep, and managing stress to name a few. It isn’t always easy, but the opportunity to impact our own long term health for the better is there for us to seize.
When it comes to love the fate of our “heart” isn’t always in our own hands, but when it comes to health we can be our own best Valentine for years and years to come.
My husband Tony and I have an anniversary next week, so it seems like a good time to post this interview our friends Joan and Tony (Skerbec) did with my partner and me about supporting a loved one with diabetes. You’ll hear stories of insulin forgotten, wild guava for hypoglycemia, and real advice on diabetes-management in partnership. Happy Anniversary to us!
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My sister was recently visiting the famous Alcatraz Island and sent me a photo of the menu served to inmates when this island was an inescapable prison. How interesting, early in 2012, to look back in time to the early 1960’s, and consider how our dietary habits have changed.
The breakfast menu read: assorted cereal, steamed wheat, milk, 1 egg, stewed fruit, toast, butter and coffee. The interesting point is that this really was a fairly healthy meal the inmates were offered, and so very different to how we currently eat. I find so many people now either skip breakfast, or go for an artery clogging feast like multiple eggs, sausage and bacon or jelly filled doughnuts!
This morning I was giving a presentation about whole grains, and again realized the difference in how we “used to” eat compared to now. Examples of whole grains are millet, bulgur, quinoa, amaranth, barley, buckwheat and oats. Some of these are the grains we used to cook with on a regular basis. But now, who even knows where to these food products? Ironically many of these grains are still sold at your local grocer, but you’re more likely to find them hidden with “organic” or “specialty” foods.
We’ve learned a lot about what habits from our past we shouldn’t keep. Maybe if we took a closer look at what we should preserve our health would be better off?
This past week I was scheduled to speak at an International Food Summit about plant based diets and diabetes. My session was scheduled between breakfast and lunch. So, with a breakfast meeting for speakers set up prior to the presentation and lunch provided after my talk I thought I was all set for food until dinner. Surprises are often the case with diabetes, and I was in for two.
Our breakfast was a serve- yourself buffet which included scrambled eggs, bacon, sausage, and sweet rolls…period. Hmm, sweet rolls as my first carbohydrate of the day? Thank goodness I brought a fiber granola type bar in my purse! Having a breakfast alternative stashed away gave me options for better blood glucose management, and a healthier choice for my first meal. Ironically, the breakfast was sponsored by the soybean board, and an hour later I was speaking on the benefits of a plant based diet!
Lunch was not any better for me that day. That menu offered a choice of heavily sauced pork or chicken with a mountain of mashed potatoes and sprinkling of green beans as sides. As I thought about the limited options I scanned the table and noticed some mini glazed cakes on the table, obviously our dessert. It was time to prioritize. Believe it or not, I said my goodbyes to the facilitators of the meeting and left to go eat at a restaurant where I could find the best food choices for my health (and a tasty lunch after a granola bar breakfast).
Eating out definitely can be a challenging, but is often a part of our lives. And prioritizing our dietary choices in circumstances like this is one of the hardest things we face if we’re going to do effective diabetes management every day. One defense is to plan ahead so we are prepared. In this scenario at the Food Summit breakfast I made sure I was carrying other food choices to fill in any gaps for healthy food choices and glycemic control. It was a priority for me to eat a healthy meal and to keep my blood sugars in check, especially with an important public appearance just an hour away. I could not help but wonder how many attendees with diabetes (it’s one of every three of us remember) simply ate what was offered.
The lunch was more tempting, and I could have made some educated guesses about sauces. But I was leaving anyway, so I chose to find better choices elsewhere. The hotel restaurant, it turns out, had the most fabulous tuna topped salad I have ever had.
I truly love opportunities to enjoy great food someone else prepared, and never take the granola bar alternative without regrets for the meal that could-have-been. That’s what prioritizing often amounts to, however. We make the most important choice even when we regret having to do so. Sometimes, we get the granola bar, but sometimes we find exactly what we wanted in the first place. In either case, it’s our health that wins.
Joan, Tony and Toby interview Illinois State Representative Michael Tryon. Representative Tryon is a co-founder of the Illinois Diabetes Legislative Caucus, a bipartisan caucus of the Illinois General Assembly established to consider and enact diabetes related legislation in Illinois. Mike also discusses his unique perspective as a person managing Type 2 diabetes for the past five years.
Be sure and watch Toby and Mike prepare his “Good Morning Quinoa Cereal” and some blood glucose friendly Pizza recipes.
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Sunday I participated in the local Walk To Stop Diabetes, and we were very fortunate to have a beautiful day here in Northern Illinois for outdoor activities. You may know (if you have ever participated) that people with diabetes are given special recognition….you’ll see I received a special red hat. I am a Red Strider.
There were some emotional moments for me. As we started the walk we passed a group of young girls who were lined along the route cheering us forward, and something about that “got me”. Maybe it was that they seemed about the age when I began my diabetes journey….maybe just being a “guest of honor”. Every PWD received a red carnation at the finish line…..being presented with the flower “got me” too.
Or, maybe it was one of those moments when the “gravity” of diabetes sinks in….a small recognition of my personal success managing diabetes tempered by walking teams wearing various shirts sharing the phrase “in memory of….” Just a day earlier I had an impromptu discussion with a middle-aged man in a cell phone store who was struggling with blood sugars in the mid-400 mg/l range, and early retinopathy and neuropathy….he asked me about diabetes after seeing my diabeteseveryday.com email address. His family and his co-workers are really worried, and they should be worried.
Too often that is the story of diabetes. The critical message about protecting health with effective self-management behaviors isn’t delivered or isn’t received, and the consequences ripple out into a wide circle of friends and family….”in memory of….” In some ways that is the sad undercurrent that motivates the organizers and participants all over the country to “Step Out” for this great event.
A beautiful day, fun with friends, kids cheering, and many dollars raised…..a good time for sure, but I’ll bet I wasn’t alone in tearing up for a moment or two.
It was “Derby Day” in Kentucky Saturday- the run for the roses. I lived in Lexington,the center of Kentucky horse country (even though the Churchill Downs is in Louisville), and I can promise you that it was party day at many homes around that state. For our Kentucky members….I’m trusting that you watched what you ate and drank.
