This is the second of a series of blog posts in which I will recount my adventures at Stanford's Medicine X, Conference: An experience which has changed my life, and I will not soon forget. :-) 

Much of my first day at Stanford MedicineX left me feeling like I didn't belong there. I wasn't an innovator, or a CEO of anything (except, perhaps, CEO of my type 2 diabetes), and I wasn't quite sure what my voice was going to be at this conference. I wasn't even close friends with any of the other diabetes advocates who were attending. I felt, well, maybe I was a bit bold in having applied for this conference. But by the time our orientation dinner came around, I became a bit more confident in myself.

Carb centered food everywhere.
How apropos. 

Dinner was had at the quirky, randomly decorated Buca di Bepo restaurant (where you have to cut through the kitchen to get to the dining room), and there I found some comfort. Many health advocates of all walks of life, with all sorts of conditions, all in my same spot. Some with a few more dollars than I, some with fancy positions; some with just their blog. All just like me. People, passionately believing in raising patient awareness, having a friendly dinner and conversations of where they'd been on their various health journeys.

Things were going to be alright. I could do this, I thought. The twitter voices of the many I had met, now echoed into my reality. The voices of those surviving and thriving with breast cancer, rare diseases, heart conditions, liver transplants, rheumatoid arthritis, asthma, Crohn's disease, and of course... diabetes, among many others. Stanford's Med X was going to be patient centered, and we were going to take front row seats into a whirlwind of personal stories, and imaginative ways in which silicon valley wants to make an impact.

Day 1: The Self Tracking Symposium

"The best way to anticipate the future is to fully understand the present ...  the best way to design useful tools is to notice and respect what people are already juggling in their lives." -- Susannah Fox, Pew Internet & American Life Project, on the future of self tracking.

Pretty sure this app's not
going to help anyone, though.

I'm no stranger to self tracking. There's self tracking everywhere. Track your weight, track your heart rate during exercise, track your laps, track your steps, track your BMI, track your waist circumference, track your period, track your basal temp, track your anything, and everything. There are even many apps and things out there to help patients track these things, as well as their glucose levels, or their insulin and medication usage. MedX discussed several of those apps during various startup and innovation segments. Those can be useful, in their own level... and some will be so revolutionary, that they will no doubt, forever change the ease of use of many of our medical services, and ideally, save us a lot of money as a whole (patient, industry, nation, etc.)

But what I wasn't aware of... was that the science community was on to us. On to us patients who actually self track for something more meaningful than this. Some of us patients self track because we are our OWN science experiments... because clinicians have stopped paying attention to us, or acknowledging our conditions. Because we need meaningful ways to learn, and track patterns, and self adjust for the daily grind of managing cumbersome chronic health conditions. Because those things are never found in textbooks, and are seldom ever discussed by medical professionals. Yes, some of us self track because we want to live another day, month, year, or decade... and because we want to be heard by our medical team -- and we need a voice, and we need ammunition. We need co-operation. We need acknowledgement. Sometimes, we may even need a diagnosis.


So, meet Allan Bailey. Allan Bailey is one of the self trackers. One of us. There were other self trackers, with very impressive stories to be told... but Allan Bailey has been living with type 2 diabetes for the last 27 years (onset at age 18), so I find myself a bit biased to bring him up. Allan is one who seriously took matters into his own hands... and paid for it big time. Yes, and he paid for it to the tune of around $2K. You see, Allan got pretty tired of being given the runaround as to why his blood sugars were always so all over the place... he was told his control was 'okay' and kept being treated by conventional medical standards, but Allan was not satisfied. Allan was already living with heart complications, and four stents in one vein. So... Allan bought himself a CGMs (a continuous glucose monitoring system), to really help him learn why his blood sugars were all over the place. I'm really not sure how he managed to arm wrestle his clinician into prescribing him this device, but Allan had to pay for it out of pocket, in full. Of course, it didn't take long for him to see who the real culprits in raising his blood glucose were: breads, grains, etc. Carbs. Allan never imagined that his CGM would turn into this instantaneous feedback loop for what he ate, nor that it would turn into a behavior modification device that would lead him to euglycemia, and weight loss. Doctors never care for prescribing CGMs to persons with type 2 diabetes -- usually only to those living with type 1 diabetes, particularly because it has alarm systems to help deal with potentially dangerous low blood sugar levels, and because of how costly it is. (Nevermind that the cost of complications from uncontrolled diabetes far outweighs a $2K device, and it's supplies.) Allan now has an A1c of 5.1%, has greatly improved his health, and reduced his medications.

Now, as wonderful, encouraging, and brave as Allan's story is... it makes me angry. Very angry. Can you imagine why? Wait for it...

WHY THE HELL WOULD A MEDICAL TEAM NOT EXPLAIN TO THEIR PATIENT THAT THE BIGGEST REASON OUR GLUCOSE LEVELS RISE IS BECAUSE OF OUR CARBOHYDRATE CONSUMPTION??????????? WHY DOES SOMEONE NEED TO SPEND THOUSANDS OF DOLLARS OF THEIR OWN HARD EARNED MONEY TO FIGURE OUT THAT BREAD AND GRAINS, AND PASTA ARE LIKE POTENTIAL KRYPTONITE TO A DIABETIC? WHYYYYYYYYYYYY????????? HADN'T ANYONE EVER HEARD OF COUNTING CARBOHYDRATES, AND MEASURING PRE AND POST PRANDIAL RESPONSE? YOU CAN DO THAT, AND PLOT YOUR OWN BELL CURVE WITHOUT THE NEED OF A FANCY $2K DEVICE!

This, of course... is not Allan's fault in any way. Allan was a creative person, and did what he HAD to do... and is now very healthy for it. All the power to him.

My story could have well been Allan's. Except that I ate food, noted what I ate, tested every 30 minutes, spent a heck of a lot of money on test strips (even discounted ones) as well as relying on the kindness of strangers for them, and quantified this information on a spreadsheet. It didn't take long for me to bring a 10.5% A1c to 5.3%, and it has remained below 6% ever since my diagnosis. But, like Allan, I was given a big runaround for a while... When I was diagnosed, my clinician initially refused to accept I had diabetes of any kind, even though I had such a high A1c and had multiple fasting blood glucose tests well above 200 mg/dL. And when she did concede I had a problem, she merely said "I'll google the ADA website, and tell you what you need to do." HECK, I CAN DO THAT, MYSELF! Why was I wasting my precious time in her office, for that?!?

I'd love to have a CGMs, because who doesn't love to see instant graphs and things... and I am SURE that it helps a lot with compliance (and yes, it probably adds to guilt, too, when we fail.) But it's sad that persons with type 2 diabetes routinely get denied useful, powerful, quantitative technology... and this denial is not limited to the CGMs. Many patients are denied an adequate numbers of testing strips, or even a meter at all! But what good would these tools do a person with type 2 diabetes if what they are denied is the most important thing of all... KNOWLEDGE?

. . . 

At the previous dinner, when meeting several of the other "ePatients" attending Medicine X, I had a few, sort of incredulous questions as to the state of type 2 diabetes care... and the adequacy of that care, and education for the patient. What about the ADA, I was asked? Yes... what about it? In the words of Amy Tendrich, "Patient advocacy groups are not really patient advocacy groups."

I really hope that Allan's story was able to bring even a snippet of acknowledgement into our reality as persons with type 2 diabetes, the reality and importance of self tracking, and the need for patient inspired/centered care and technology. I know that I was FLOORED to see a different take on the usual 'just diet and exercise' testimony.

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It's been a couple of months since I've shared anything significant with my fellow readers.

It's not that I don't appreciate you; nor it's not that I had nothing worthy to share. But, as the pressure cooker that is often my mind, I try to give myself some time to digest new lessons or new experiences. Sometimes, those situations are just personally painful.

The last Diabetic Ice Cream Social was no exception. While I truly believe in this event, and what we're trying to accomplish, and while I had many, many supporters, a few things grieved me from it:

• The lack of support from other prominent advocates: Honestly, on the regular, I could care less if these folks read my blog, if they like me, or if they think I'm a worthy advocate... but I found it personally disturbing when not many would participate, or share in this particular event -- which was really not about me. It was an event about setting a precedent that we diabetics can manage our own selves, with moderation and self control, and that we don't need to be treated like children (or alcoholics/foodaholics) who can't make food choices -- regardless of what those food choices are. "Ice cream is poison," some may claim, but then why are we supporting efforts to help teach young diabetics to learn how to drink in moderation, and appropriately balance diabetes, but not other types of food choices, instead of just telling them 'DON'T DRINK'? Isn't alcohol a poison, too, and with much more potentially dangerous consequences? ... And I am sure there are many more ice cream eaters than alcohol drinkers out there. (Because you believe in moderation, that's why!) I also don't mind exercising, and doing something to show how a simple modification in my life can control my glucose numbers... but it would be equally reasonable to me (and very realistic) to help teach others there's no shame in enjoying an occasional treat in moderation (perhaps even preventing binges, and eating disordered situations caused by deprivation). I came away feeling many advocates were really more concerned with folks not 'judging' them, and 'tarnishing' their own images, for promoting 'unhealthy habits' than of really wanting to make an impact. 
• The attack from diabetic food fundamentalists: People who, will not skip a beat to tell you there's no 'diabetic diet,' yet the minute you discuss having a scoop of ice cream, you're called irresponsible, or even childish in your health advocacy... and then take the opportunity to try to impose THEIR personal dietary choices on you, or others (while denying they are doing such a thing -- they are just 'responsibly' telling you that you're wrong). I don't think we can make many inroads into respect for the diabetic patient, and his or her personal choices, as long as these fundamentalist food attitudes are around. The event itself wasn't even about ice cream, it was about food independence -- the freedom to eat what YOU want to eat, as your choice -- in moderation, versus what others want you to eat... And it was just really disheartening to see these kinds of folks mud slinging the event, or myself, in blogs, etc., as someone intent on promoting an 'ice cream eating binge' that further creates more diabetes. Yes, the same people who speak of food and sugar not causing diabetes, accusing me of causing more diabetes. I'm sorry to say, but this statement isn't just valid for some types of diabetes, and not for others. NO diabetes is caused by any particular food choice. 
• The annoyance of Facebook's notification system: Facebook has just changed their system so much, that a simple event is now used to notify the heck out of others -- even if they haven't yet RSVP'ed for an event, and it thus made us look like 'spammers.' Not so Facebook savvy people kept attacking me, personally, for spamming them with 'the event' or for 'not taking them off the list,' or for revving up their cell phone notifications. We tried hard to educate folks on how to turn off their notifications, but there were just too many not-so-bright, self entitled, persons out there... whining about why we weren't doing these things for them. How these persons have managed to survive in Facebook's world is honestly beyond me. In future Diabetic Ice Cream events, we might hunt for a different method to keep track of 'likes' or 'rsvp's' so that such a massive amount of notification overload doesn't bring us down. We do suspect a large number of folks attended, but simply hit 'decline' to the invitation, just to avoid notification spam. 

So, in essence, it kind of hurts a little bit when the social media tools that are at your disposal are backfiring on you, and when persons who are supposed to support you -- especially because their own personal dietary choices might be different or varied -- are not doing so. It divides us, and weakens our message of food independence. I mean, the only way we can be vegan, or raw vegan, or low carb, or anything else, is because we decided to become independent of the mandate that we had to live by a classic ADA style diet. And thank goodness we no longer live under the notions that we HAVE to eat by what a dietitian exactly says we have to eat, or by what the olden days used to believe -- avoid table sugar, only. 

I am, in no way, an ADA diet advocate... but I will advocate for anyone who thinks that's a diet that gives them the self control, glucose wise, that they need. I will advocate for any regimen which they feel is balanced, isn't intrinsically dangerous or based on pseudoscience, and brings them euglycemia, ease of implementation, AND quality of life -- that's our goal! 

I felt I needed to say a few things on the matter... before I blogged on anything else. The goal of the Diabetic Ice Cream Social has, and will always be... FOOD INDEPENDENCE.

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One of life's many reminders that
 I am not alone, with diabetes.

"Who are you?," I asked, as strange and odd faces peered over me, picked me up and placed me on a stretcher. "What am I doing here?"

No one answered.

The world felt really odd, and weird. My head, compressed and pained, while my vision was at odds with my mind... as if I had put on a pair of someone's prescription glasses many times more powerful than my own vision, and making everything in sight oddly concave.

"She keeps saying that!" said the voice of a red headed woman with too much eye make up, in an exasperated tone, and incredulous that I could not remember who any of them were. Funny, I thought I'd only asked once. The attention was unnerving, and frightening... and their annoyance was oddly embarrassing. I really wanted to get out of there, and go home... If only I could of remembered where home was.

On October 26th, 2007, I had a massive seizure at my desk, at work... Or so they tell me. I can't remember when it started, or what provoked it... I can't remember much of anything about it, or that day, for that matter.

All I can remember is laying in a hospital bed, in a medical gown and no underwear, under the gaze of my former Human Resource Manager, and trying hard not to look like a woman who's not wearing a bra. He was a brutish man, with a hot temper, and little human resource education. It's the way of the world in some of these up and coming companies. You get to be buddy-buddy with the head honchos, join the good ol' boys club, and then it doesn't matter if you have any qualifications for a job. His way of qualifications was a 6 month stint as temporary HR manager back in 1984. (Yes, you can laugh out loud.)

... And so it was that a company who sold out to a much bigger company, coincided with a production foreman (wise in the ways of verbally intimidating employees) being made into an HR Manager (a position which requires extreme diplomacy), and me... developing extremely debilitating, and uncontrolled type 2 diabetes, with no one knowing what it was, at the time.

It was a perfect storm, really.

They needed to cut down on employees... and I got sick. I was a good target. We all knew they were going to cut SOMEONE. They kept having all those 'behind closed doors' meetings. And no one knew what I had at the time, so I got to be made to look like a mediocre employee who just wanted to play hooky and not show up to work. A great way to cut staff (and I made quite a bit of money, in my position, so it was quite the savings for them, I am sure). They had already tried to intimidate me... by demoting me, claiming I was unorganized, and had made many mistakes. (It didn't matter that, when I asked, they had absolutely no examples to provide to back up their assertions, other than my illness related absences, which had been closely monitored by my doctor... nor that a few months earlier, they had given me perfect praise... nor that my previous review had been above excellent.) They wanted to break ME as a person, and get me to quit. They wanted to treat ME as worthlessly as another unskilled production employee.

So, I had a seizure. It was on a Friday, and I spent a really ill weekend at the hospital. Went home on a Sunday, with a very chewed up tongue, migraines and dizziness issues... And when the HR Manager demanded I be at work on Monday -- but couldn't do so, for obvious reasons -- he fired me. The company NEVER contested my claims for unemployment insurance; they never even showed up for the hearing.

I can't tell you... HOW MUCH I have blamed myself over the years. How much I have felt like a worthless person who just couldn't keep running as hard as she could, who couldn't just grin, and bear it. Still, to this day, I sometimes have many nightmares... sometimes reoccurring dreams where someone calls me, 'forgives me,' and just gives me back my job. I loved my job. I loved making a difference. I loved making people smile with my organizational skills, and my programming skills, and my language interpreting skills. I loved interviewing new hires, and giving new employee orientations, and speaking to big audiences... I loved educating, and writing, and speaking, and everything I did. I had been promoted to a better position within 4 months of hire, and given hefty salary raises for my skills. I had dreams of further certifications, promotions, and continuous education degrees. I LOVED MY JOB. I loved my life. 

For many years I felt like I lost my soul on that day. I lost my soul, and I let myself go. I let myself go, and felt like I died. Long, lost, and forgotten... someone who forever had ruined her life. I felt great shame, and hurt. Great anger.

Diabetes came into my life with a BIG bang, and like a tsunami... washed up many parts of my life with it. Great post traumatic stress took over, and made me shy away from new jobs, job situations, and new friendships. Finding a job, a permanent one, and keeping it... for the last 5 years has been HARD. I wanted to cry and wallow in self pity.

Diabetes is HARD. And it's often embarrassing. And people JUDGE you. They do. People DON'T understand. People think their lives are textbook examples for how other people's lives need to be. They judge you, and they often try to bring you down.

But you get up. You get up, and pick up the pieces of you... as many times as you need to... and you keep going.

I now work minimum wage. I don't do anything near as glamorous as I once did. I have two jobs. I work unloading trucks, and at a fast food place. I don't even have a car. I walk long and far... just to make minimum wage. But I am... OKAY. I'm OKAY, and I am even happy, sometimes. Heck, I'd say most of the time.

My bosses don't really get diabetes... but they LISTEN,  and they try to understand, and try to help me be safe at work, and make concessions. My coworkers LISTEN, and they care... My bosses let me be ME, with diabetes. They let me be ME, in spite of diabetes. Sharing with coworkers the other day, and even opening up about my traumatic past, really made realize... that it's OKAY. That I can move on. THAT I AM SAFE.

Sometimes, some of those people I used to work with at the Human Resource job, show up for lunch at the fast food place. They seem to look down upon me with a certain pity in their eyes, or with embarrassment that I am doing a fast food job, and I just smile kindly back to them. I smile because I'm happy, and they don't understand my journey... and I hope they NEVER have to.

I smile... because though I loved, and miss my job... happiness and freedom are not found in jobs, nor what people think of us. They are found in those 5 year detours in the desert... when all you have is YOURSELF.

(... And, ironically, the original founder and owner of the company passed away, not long ago, of type 2 diabetes complications. I may have lost my job, money, insurance, etc... but I guess at least I still have my life... and boy am I LIVING it.) 

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Last year, a certain man writing for his local newspaper, took advantage of the health struggles faced by people with type 2 diabetes to push his OWN agenda: Food Alarmism. In it, he claimed folks with type 2 diabetes were like alcoholics, who needed to be kept away from all sugar, and be on a fruits, vegetables, and grains only diet. 

It was a very hurtful column, not just for type 2 diabetics -- who get BULLIED constantly because of the massive amount of assumptions and misinformation in the news and media, but it also hurt type 1 diabetics as well. In his post, the man became indignant because the local type 1 diabetes organization in his community was having an ice cream social to generate funds so they could send some children to diabetes camp, and he confused them for type 2s. Not only did he wrongly confuse type 1 children for type 2 patients, but he also tried to be our food police! These kinds of strict views on food are the views that often lead to many eating disorders, and poor self images. Diabetics world wide were enraged, and responded swiftly against this level of ignorance. Soon thereafter, the newspaper took his columns down.

It was no surprise to me to find out he was a "Chef, Motivational Presenter, CBS Host, and Syndicated Author." It's always this type of 'persona' that want to stir the pot. He needed READERSHIP, and MONEY! And what a way to do it, than with food alarmism. 

Food Alarmism is becoming more the rage these days, what with the credible threats of pollution, pesticides, GMOs, cattle hormones, etc. There is no doubt that we, as consumers, need to become a little more discerning with what we put in our bodies, and be more mindful of moderation.  

The problem is that food alarmists feed on our constant food insecurities. They are like any intolerant religious zealots or fundamentalists: they leave NO room for anyone else to live life, or their diets, differently... PLUS they want to make money off of you. They feed on YOUR 'concern' and 'fear' and your desire to be 'healthy.' Then you go around recruiting OTHER people with your genuineness, and bring them over to their side. They can be just as bad for you, health-wise, as the fast food industry we so want to attack. They also love to claim they have the all the aswers, and the science to prove anything... taking advantage of those who aren't savvy enough to recognize junk science when they see it. Small studies with minimal results, studies with inconclusive results, studies done by organizations with biased interests, studies where little is known about the population groups used, or research promoted by people trying to sell you something, etc, etc. People regularly flock to 'The Doctors,' 'Dr. Oz,' 'Dr. Hyman,' and 'Dr. Mercola,' for their daily dose of alarmism. They DON'T care about how you felt better thanks to the placebo effect, when you took their supplements; they care about the $60 you spent on their supplements, or their books.

So, last year... intent on proving that we, diabetics, can control our own diets -- in MODERATION -- and that we do NOT need to be policed, or be on diets of just fruit, veggies, and grains only... I set out to create the first online, and worldwide, Diabetic Ice Cream Social.

I just got tired of people telling me what I can, and cannot have. Writing articles giving license to others to police, or bully me, or using their OWN fears of food to control my life... or assuming I'm a lazy slacker, or a person with a bad diet, if I choose to have a treat, once in a while. Over 2,400 people responded in support... and yes, I'm going to do it again. We need freedom to mind our own lives, and our own illnesses... without busybodies out there pushing us around as to what we can/can't/should/shouldn't eat. 

I've been criticized left and right this week, by a few who are against my social: 

• I'm irresponsible, and promoting gluttony (a moderated portion of ice cream hardly classifies as gluttony);
• I'm irresponsible and not promoting good eating habits (excuse me, moderation is a GOOD eating habit);
• I should instead write letters to editors, and just attack the problem directly (we can all raise awareness in different ways... but perhaps YOU should write the letters, instead);'
• I should be holding a 'marathon' or a 'walk-a-thon' instead (why? so that a lot of people aren't able to participate, because they have mobility issues, or neuropathy?) 
• That I am increasing the type 2 diabetes epidemic (surprisingly, this one came from a type 1 diabetic who should know eating a scoop of ice cream is not going to give ANYONE diabetes.) 
• That I am wasting my time, and instead I should go around collecting insulin to give to needy diabetics (ummm... how about YOU get off your behind, and collect insulin? If it needs to get done, DO IT... don't accuse me of not doing it! Do what YOU have a conviction that needs to happen.)

So... controversial as it might be, because of these reactions and more, I am convinced -- more than ever before -- that we NEED this type of awareness. Going around lecturing people on how sugar doesn't cause diabetes is not the most effective way to do it... Teaching people that moderation is what makes LONG LASTING healthy habits, and not just crazy, restrictive, fad diets -- IS. 

YES WE CAN. 

My numbers after last year's ice cream social.

(See also: The 'Betes Preachers)

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September 29th, 1985.

I remember I was with my dad, out in the country. My dad was a real estate appraiser, and often would go appraise homes or farms 2-3 hours away, deep in the Puerto Rican country side. I loved it. I put on my 'Tinkerbell' brand make up, and dressed up... and dad would let me take pictures of the properties. You got to see a different way life; farm animals up close, and the people were always so kind. Sometimes they'd pay you in fruit, giant bunches of plantains or bananas, or even legumes. Sometimes in animals, like rabbits.  (I came by a pet rabbit that I adored, this way.)

I don't remember the town we had gone to (it might have been Mayag�ez), but I remember it was raining soooo much, and we had to cross the A�asco river bridge. You could see the river was really right up to the edge, and it was quite scary. Dad took a risk that day, and crossed anyway. We made it home, but many other people did not... Just a few moments after we crossed that bridge, the river took the bridge, cars and all. 

To say we had a tropical wave is to put it mildly. We always have tropical waves. No one bats an eye. Some rain, no big deal. Except... I have never seen another tropical wave like this, that wasn't - well -- a hurricane. No one was prepared. The wave didn't have a defined center, so it was never classified as anything stronger, and no one issued any warnings, or was seriously worried.

But on September 29th, the rain began... and it didn't let up. We had about 32 inches of rain in ONE day. By comparison, Oregon gets 37 inches of rain in a year, and Hawaii about 23.

The night was even more horrific. We had no power for a long time, and would listen to reports from a battery operated radio.

There were many awful stories, but (in my mind) the most traumatic story came from a man who was travelling late at night, when suddenly and by grace, he noticed the bridge was out. (Many bridges fell that night, and I can't remember which one this was, but I do remember it was a very tall bridge with a river raging below. The river had taken the bridge.) He stopped his truck by the side of the road, and tried... as much as he could, to flag and stop other drivers and keep them from plunging into the cold, raging waters. But he failed. People thought he was a lunatic, a mugger... a crazy person. One by one, he saw many cars plunging into the depths... No one cared to listen. They were sure of themselves, and their judgments of the man.

The scene... played out in my mind over and over. It gave me many nightmares. (I was only 8...) The chance were I, too, could have died... also played in my mind. It was an unnecessary risk. A foolish risk.

This is how I sometimes feel, when I work with people with diabetes who are not exactly knowledgeable, or in control of their care. I feel like a desperate person, trying to flag down helpless people... unaware they're an inch from losing their lives, because of their own pride. 

• People with constant out of control numbers, thinking it's 'no big deal,' because they aren't 'as bad' as their previous numbers... or because they don't feel bad.
• People not getting on much needed insulin, afraid of myths, and stereotypes, or for crying out loud, of a needle, and poking themselves. (I'd much rather be afraid of the horrible consequences of uncontrolled diabetes than some needle.) 
• People who want to obey everything said to them by medical professionals, hook, line, and sinker... without much thought, or research; who stay on dangerous regimens, out of control numbers, and ineffective medications, or diets, because they're too afraid to say something, or seek a second opinion. 
• People being lead away by 'miracle cure' nut jobs, or crazy fad diets, and supplements. 
• People who won't check their blood glucose numbers, because their doctors said they didn't need to! 
• People who just don't wake up... no matter how much you share with them, or try to guide them. 
• People lacking in courage... to truly admit to themselves the seriousness of this condition. (Out of sight, is out of mind, I guess...)  

I know I can't police people, or change their minds... or tell them how to manage their diabetes, or how to tell when a medical professional is less than professional, or bad... or that they ought to seek more in-depth information about their condition. I know. But often, in groups, and forums... it sometimes feels like someone wants to start a conversation by asking you your opinion, and then not letting you have an opinion; telling you you're wrong... or just brushing you off. Or by bragging of their careless life. (Yes, there are occasional folks who brag about their out of control lifestyles... and not just occasional escapades, mind you, and bring down the whole mood of everyone around them.) 

As someone who has seen what it's like to die from ALL the most horrific complications of diabetes, I can't help but feel like that man, on the side of the road. I just do. Denial is a powerful thing... and I wish I could slap people right out of it. Uncontrolled diabetes (especially type 2 diabetes) is like a thief in the night; you don't hear it or see it coming... and one day, you've just been robbed blind. It makes some folks overconfident in themselves, and their lack of care. 

And these people... who want help, but don't want help. That is the MOST frustrating type of diabetic. And none of us can help them, medical degree or not, until they want to be the pilot in their care, and not the silent co-pilot. A Stepford Diabetic.  

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The headline declares: "Curing diabetes via surgery, without weight loss". It's a bold statement. It's enough to make one stop, and read. I admit I did just that.

Every week, it seems, we are bombarded with a new article declaring the magical, curative qualities of gastric bypass surgery. These articles make it seem like gastric bypass is the simplest, most sensible way of managing diabetes -- and gosh darn it -- everyone ought to pursue it so we can put a stop to this overwhelming epidemic that's going to just take over America, and murder us all. (Please note I am being sarcastic here.)

I admit I don't have all the answers -- if I did, I'd have long ago found a cure for all of us, and retired to my white castle atop a hill, facing the ocean. But what I can tell you is that I have a lot of questions and skepticism. And so should you.

Whenever there are articles like this, I look for red flags:

• Is the article edited properly? It might seem like a simple thing, but honestly, if someone in a professional, journalistic setting, doesn't care enough to edit their articles for grammar, spelling, content, and accuracy, they certainly might not care about outright lying to you to get some readership.
• Is the article unusually chipper or eager to present this as an 'all around' solution to a problem? Does it present ALL sides of the debate? Does it present ALL alternatives?
• Does the article portray accurate medical conclusions, information, and accurate explanations, or does it confuse the public about its target audience? 
• Does the article present accurate, statistical data, as has been reported by other research outlets, and scientific journals? 
• Is the study funded by third parties with deep pockets, and deep interests in the outcome of said study?

Taking all these questions into account, let's look at this week's gastric bypass article (which I have linked to above.)

Red Flag #1

The article starts off by telling us about Cristina Iaboni (a woman who was selected as a test subject for gastric bypass in leaner patients), and offers this description of her situation:

"Cristina Iaboni had the dubious distinction of being not quite obese enough. For all the pounds on her 5'5" frame, she did not meet the criteria for bariatric surgery to help control her type-2 diabetes.  

Yet six years of medications and attempts at healthy living had failed to rein in her blood glucose, leaving Iaboni terrified that she was on course to have her kidneys fail "and my feet cut off" -- common consequences of uncontrolled diabetes." 

Right off the bat, I'm kind of concerned about the quality of medical care Mrs. Iaboni may have received. Did her medical team question everything that needed to be questioned? Was she on insulin? When I read "6 years of medications," it literally screams at me that they kept her on every oral medication combination out there, and did NOT put her on insulin, like they should have. What kind of 'healthy living' changes did she attempt to make? Was she she still consuming a high carbohydrate diet, and just substituted her carbs for wheat, and whole grains? Did she even know how to carb count? Did her doctor ever test her for antibodies, and is she a LADA, instead? While the article declares she's 'cured,' I have the strong feeling this woman might rebound down the road.

Red Flag #2


Follow this logic statement with me: "If smoking triggers lung cancer, than smoking cessation should cure cancer."

Oh, it doesn't work that way, you say? Once you have it, you're stuck with it? Oh. Then why do some media and some 'researchers' assume that if obesity triggers diabetes (in those who are genetically predisposed, mind you), that losing weight should cure the diabetes?

The simple answer is "I don't know." The complex answer is "Because they probably have something to sell you."

Certainly, one can assume smoking cessation helps better manage cancer -- I am sure. One will be healthier, and respond better to treatments, and will have a stronger immune system... But one cannot say one is suddenly cured of the cancer. (Even when one is in remission.) Diabetes and weight loss are much the same: weight loss merely makes one healthier, and be able to respond better to treatments (ie, be more insulin sensitive, use less insulin and medications, sometimes none, etc.) These are only ways of tightly controlling diabetes, though, and slowing down it's progression. The absence of medicine is NOT an absence of illness. In this case, it is the strict diabetic patient's regimen that is the patient's medicine. The pancreas has damage, and this damage is irreversible, thus far. It is not, suddenly, magically healed.

Interestingly, this article seems ready to admit (though hesitantly so) that gastric bypass -- since people seemed to be 'magically' better just days after surgery -- proves that a diabetic 'cure' is NOT about weight control, or weight loss. However, here is where the red flag comes in: they are NOT willing to admit that the extreme dietary restrictions a patient must submit to (caloric and, consequently, carbohydrate level restrictions), post op, will play a role and immediately make less glucose available to the patient, and therefore, less high blood glucose issues. Now, normally, a patient who chose to control diabetes with diet and exercise would take a bit longer to achieve euglycemia (or normal blood glucose levels) when consuming a diet lower in carbohydrates and eating 'normal' amounts of food -- but they don't get a head start. A pre-op gastric bypass patient has to be on a type of fast with limited food and liquid intake, so they're already starting out with less available glucose in their system for a couple of days. Yes, they are going to have great numbers in just a few days. Barring other variables, yes, it's that simple, sometimes. I don't think this is rocket science.

Quite frankly, a patient could just go on the restricted diet, and skip the surgery, and achieve similar results... And not that long ago, some of these 'researchers' were practically claiming this same argument: A 'very low calorie diet' could cure type 2 diabetes. 


This article though, quickly sidesteps the discussion and dismisses it without much more than an acknowledgement.


Red Flag #3


The idea that type 2 diabetes begins in the gut is not a new one. It has been, however, a seldom reported one.

More commonly, you see articles speculatively linking the bacteria most known for leading to peptic ulcers (h. pylori), to endocrine disorders (as well as diabetes), and these have been quietly making the rounds since at least 2009, maybe even earlier. There's even an interesting study dating back to 1999, and involving children with type 1 diabetes, insulin requirements, and the presence of h. pylori. The most recent finding came this month, and it involves h. pylori and it's impact on A1C.

The underlying message is clear: bacteria, and inflammation, alter the body's ability to process glucose -- whether in the stomach, or in the gut.

But are the researchers missing the obvious clues? They mention that 'in the past,' patients with peptic ulcers who had surgeries altering their stomachs, and gut connection, 'cured' their diabetes. Or did they just achieve better control of their diabetes because a.) they were now having to, forcefully, eat far less, and b.) the surgery removed chronic inflammation from bacterial infection (which would have dramatically raised blood glucose levels)?

Other articles, and research, have pointed to a bacterial imbalance in the gut as a trigger to an imbalance in processing glucose, and development of type 2 diabetes, but they do NOT suggest surgery for 'curing' the disease. In fact, they suggest a more preventative method -- receiving gut microbiota transplantation. This seems to me like the less invasive, less dangerous, less costly and time consuming, way to go when it comes to researching a cure. Why are we not investing in this? Why is there such a PUSH for getting this dangerous surgery?

The attempts to also connect this surgery to a potential 'cure' or reversal of type 1 diabetes seem a bit far fetched, and improbable to me, and make me question if this researcher has a proper understanding of the etiology of type 1(a) diabetes -- and that it isn't just an insulin insufficiency scenario. I'm pretty sure people need insulin to live, and for many various metabolic functions, and just 'bypassing' a gut mechanism isn't going to make a person insulin independent. I'd like to see more than just three sentences in a poorly edited FOX news article, on the matter.

Red Flag #4


Numbers.

These articles always seem to exaggerate diabetes incidence numbers. This one is no exception. It claims that 8.3% of the world's population has diabetes, and that 11.3% of Americans, have it. Honestly, I don't know where the 11.3% figure came from, with these folks -- but according to the most recent data (released January 26, 2011 -- and not the 2010 date these folks claim) released by the American Diabetes Association, only 8.3% of Americans have diabetes -- and this includes all types, and the undiagnosed. 


Similarly, these folks make these grandiose claims for the 'remission' rates of Roux-en-Y to be 80-85%, and to be incredibly superior to other forms of gastric surgery. But major studies DON'T show that.

"New research reports that no procedure for weight loss surgery is any better at treating diabetes than another. The study, presented May 7 at the International Congress of Endocrinology/European Congress of Endocrinology in Florence, Italy, uses a large ongoing study to show that improvements to diabetes in patients undergoing such surgery is likely to be due to the degree of weight loss itself rather than the type of procedure." (http://www.sciencedaily.com/releases/2012/05/120507102225.htm)

And here's a more startling fact...

"Weight loss surgery is not a cure for type 2 diabetes, but it can improve blood sugar control, according to a new study published in the British Journal of Surgery. Whereas some previous studies have claimed that up to 80 per cent of diabetes patients have been cured following gastric bypass surgery, researchers at Imperial College London found that only 41 per cent of patients achieve remission using more stringent criteria." [emphasis added by me] (http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_4-1-2012-13-32-26)

And that's the ticket here, isn't it? What kind of criteria are these folks using to claim someone is cured? What are their A1Cs, now, and what are their average blood glucose numbers like? I've had folks tell me "I have an A1C in the 6.5% range, so I no longer have diabetes." But wait a minute? That's the number used to diagnosed diabetes to begin with! 

Hey, but you no longer need medicine (for now, anyway), so you must be cured, right? It sounds so pretty... It sounds like such a good sell.

And because it sounds like such a good sell... I give you:

Red Flag #5

"The cost of the bypass surgery is covered by a grant from Covidien Plc, which makes laparoscopic instruments and surgical staplers." 

Oh, so let me see... the people who profit the most from this surgery are the ones funding a study to tell me how awesome this surgery is, how high a success rate it has (even though it is absolutely not supported by independent studies), and how I will just be so cured.

Hmmmmmmmm. Let me think about that. Fox guarding the hen house much? This reminds me of last year, when the ADA published a study done by the Australian Dairy Association, claiming that milk consumption lowered risk of diabetes.

Of course you're going to tell me it's awesome! You want me to buy more of it, and you want me to fall in love with it. You need to make money, too, like everyone else! It's MARKETING.

The problem comes when the money making interests muddle the big picture, and really go against the best interests of the INFORMED patient.

What am I trying to get at, with this blog post? 


Should you avoid gastric bypass? Is it a dangerous alternative?

These are questions you must weigh for yourself... but what I would like to see is for patients to be able to weigh the TRUTH against the hype. NO ONE should promise that surgery will be a success, that it will heal and cure diabetes, or that it will be complication free; but, instead, they must help guide the patient to a point where they can soberly weigh their current health risks against the surgery's very real risks and potential failures. It is easier to accept the roll of the dice when we know that risks are possibilities -- and when we aren't lead to believe that this is just a simple, routine procedure, that will fix our woes forever.

More importantly -- the type of lifestyle changes required by these surgeries are far more demanding than say, pursuing a low carbohydrate regimen (like Berstein's Diabetes Solution, or Atkins), or even raw dieting. If a patient fails at these, or simpler life style changes -- when their life is not at stake -- what makes them feel they could do okay with the dietary demands of such a surgery? Because they got 'two weeks' of psychological counseling pre-op? Disordered eating, and compulsion, take years of counseling to improve (much more to 'fix')!

Additionally, studies have shown that after some time, people's diabetic symptoms may return, and some folks even regain weight and end up pursuing additional gastric surgeries. I am not entirely sure that the costs of surgery, with it's attendant complications, are worth my getting a 'free pass' for a few more years; especially, when I can just give myself that free pass with a more calorie restricted, low carbohydrate diet.

And I don't know about you... but I just like eating food in portions larger than a peanut.

» Read More...

Copyright � 2010 Julie King 
/ Gleeful Things. All Rights Reserved.

Today, I'd like to add a fun, new, regular segment to our blog called "The Moldy Cupcake Awards."

Ya' know... It's just so inspiring to read or watch the news, every week, and see ALL manner of misinformation, quacks, outright lies and drivel, just regularly being fed to the public for the sake of ratings. So, because you've inspired us, ALL of you who are the most deserving for writing, or producing, the shittiest materials out there for the public, will get a wonderful mention here... along with a not so sweet, and oh, so moldy critique.

You've worked HARD (not!) for it, so you're gonna get it! Today's deserving green, stale, sad, and moldy cupcake goes to... The View!

That's right. Earlier this week, the View produced this GEM for it's regular audiences.

 
Let's take a moment to examine this, not so educational moment, play by play. 
Right off the bat, I am immediately annoyed because for all her education, Barbara Walters CANNOT pronounce diabetes correctly. I'm sorry Barbara, it would seem you've spent your free days watching too many Wilford Brimley commercials.
If that doesn't annoy you, then the big letters headlining "The Fat Show," in the background, should. Oh, sure, Barbara, you aren't fat. Let's see your saggy behind in a bikini. I double dare you.  
She goes on ahead, and introduces this man, David Nathan, as the Director of the Diabetes Center at the Massachusetts General Hospital. It should SCARE the beejesus out of you that someone with such a title (and employed at a hospital, mind you) would get on such a show, and FAIL to grasp the opportunity: 

"So I think everyone recognizes that diabetes is a condition where your blood sugar is elevated. We all KNOW that. What many people don't understand is that when your blood sugar remains elevated over many years, blah, blah, blah... feet falling off... blindness... blah, blah..." (Okay, that's not entirely, a literal quote.) 

Dr. Nathan, for someone who calls himself a doctor you are surely very disconnected from reality.

1. NO, people do NOT know what diabetes is about. You could've spent a minute or two, telling people that our condition is a condition in which the body FAILS to be able to process glucose adequately, and that ALL food gets converted into glucose. NO, people do NOT know the difference between sugar, and blood glucose. People think if we just stop having Paula Deen lady donut burgers, and ho-hos, that blood sugar goes down, and diabetes goes away.

This is the kind of situation that gets people bullied by idiotic people thinking they can take on the role of diabetic police.

2. Meanwhile, everyone DOES know the serious complications diabetes may bring, so since they associate them with eating too much sugar, they are ALWAYS making jokes about our feet falling off, and us going blind. You could've clarified a little better that well controlled diabetes is the main cause of NOTHING... But you really missed the boat on this one. Thanks for letting the bullying cycle persist.

Now, I don't really understand why The View would have Paula Deen as some kind of 'interviewer' for this segment, asking things she really doesn't understand because she's just too new, and uneducated -- but it matters not, because this Dr. Nathan fails to answer her questions directly. She asks him what the connection is between obesity and diabetes, and he doesn't really say... He just muddles the picture by starting to talk about other majorly recognized risk factors, and how now, younger folks are getting diagnosed because of weight. Okay? So tell us something we DON'T know. Why not tell people "gee, the more you are overweight, the more your body will struggle to produce insulin -- and if you are genetically predisposed to insulin resistance, and diabetes, the more it will likely trigger your developing the condition at an earlier age..." Is it that difficult to speak to people with truth and honesty, and clarity? Do we think The View's audience are a bunch of simpleton housewives, who only know about dish soap? I wonder...

Oh, and I love how you describe Type 1 as "the insulin dependent, juvenile form... the Mary Tyler Moore form..." That's metaphor, right there!! A definitive moldy cupcake award for dialogue. Here's a TALL idea, for you: how about calling it the "my autoimmune system sucks, so it attacked itself" form. People will have this FOREVER, and can get it at ANY age. They don't grow out of it, and gosh darn it, MANY adults, every year, get it... WAY past their 'juvenile' years. Oh, and to add to it, you make it sound like type 2s don't need insulin, when in fact, if a type 2 diabetic is diagnosed early enough in their lifetime, they will more than likely need insulin before they die. MOST type 2 diabetics will go on to need insulin. It's a fact. Hell, it's an American Diabetes Association researched fact -- even when they're trying to act like it's not. 

One thing is pretty juvenile, though -- your casual approach to discussing diabetes. You nailed that one right on the head.

Now, dear Paula Deen tries so hard to stay relevant in this discussion. Paula, honey, NO ONE is born with type 1 diabetes. And I think an awful lot of parents out there would kind of take offense to your portraying their children as like 'having leukemia.' I say this, because while type 1 diabetes can be deadly and challenging, we all know you weren't trying to suggest they were 'troopers, fighters, survivors, and well adjusted kids...' No, you were trying to suggest they were sickly, weak, and likely to die from sneezing. Paula, I support your journey with diabetes, but sometimes... you gotta shut your lady burger pie hole. Okay? We should not comment on things we know not about.

I am not completely angry at the intense stupidity of this segment (okay, I lied...); I'm actually happy for your patient, Misty. I'm happy she's doing better, and is healthier.

What I'm not happy about is that Misty doesn't seem to understand what a diabetic diet is all about. She keeps talking about sugary drinks, sodas, juices. She doesn't talk AT ALL about controlling her carbohydrate intake, carefully weighing out her meals and portion control, in any way. In fact, NO ONE ever mentions carbohydrates and their role in any way -- and continuously focus on sugar!

Dr. Nathan, this is the BIGGEST disservice you can do for people -- letting them go on believing that diabetes is about sugar. IT IS NOT. Diabetes is NOT about juice boxes, soda, cookies, etc. It takes a hell of a lot more effort to control diabetes than to just cut out soda and juice boxes. In fact, I am so scared of Misty's apparent lack of knowledge of what it all entails, that I truly wonder what her A1C is, and what you justified to yourself was "excellent control" to make it seem she needed to get off the Metformin. I guarantee it's not in the 5.0-6.0 percent rating. It can't be. Not with her thinking it's just sugar. She probably goes home and has a plate full of wheat pasta, and calls it good.

"That's the beauty of type 2 diabetes... is that it is reversible." 

Diabetes is not reversible. Whenever folks discuss diabetes as 'reversible,' what they are referring to are the symptoms of uncontrolled diabetes. Blurry vision, dizziness, slow healing cuts, some forms of early neuropathy, thirst, continuous urination, headaches, mood swings, etc.

I have news, for you Paula... You'll still have diabetes, even when all those things are gone. You live life so that you CONTROL those things -- but you can't stop your routines, or those things WILL return. And quickly. Your diet is your MEDICINE. It's just exactly like medicine.

In this sense, Paula... ALL diabetes is reversible. Yes, even type 1 diabetes. It's a BOLD statement, but I know some pretty TOUGH type 1 diabetics out there that could run circles around me, any day, and to the average world look like they have NOTHING wrong with them. They have worked hard to REVERSE the horrible grip of uncontrolled diabetes which they had at diagnosis. TIGHT control is what we ALL aim for -- but it takes CONSTANT work and effort, and it is SO not a cure.

Photo by RingoFuentes

You can't go on living like just testing once a day, and not knowing what carbs do to you is, somehow, having diabetes in control. It is a full time job, and it causes a lot of psychological trauma, and exhaustion. There's just NO beauty in this pile of dung. (But you'd be a little prettier if you spoke a little less. :) Thank you.) The beauty is in US -- and how we evolve to adapt to the harsh winds of diabetes.

Additionally, Dr. Nathan, it is embarrassing that you would suggest to people that all they need to do is lose a modest amount of weight to better manage their diabetes -- this is untrue. While weight loss helps lessen some of the challenges of insulin resistance, it is NOT the way to control diabetes -- the way to control diabetes is to control one's diet and carbohydrate intake, along with weight lifting and resistance training, and sometimes, medication. When you tell people that losing 5-7% of their weight would reduce diabetes by 58%, you are leaving them with a lot of confusion, and mixed feelings. I mean... what the HELL does that even mean?????

You can't reduce diabetes by 58% when YOU ALREADY HAVE IT.

You must be talking about the poorly done, not so large, diabetic studies... who used a lot of extrapolation, inference, and ignoring of many, many additional risk factors and components, along with populations that did NOT represent a cross-section of the country... to claim that 58% of diabetes could have been PREVENTED. Which is another poorly used word. One can only REDUCE one's odds of disease -- not eliminate them. There is NO SUCH guarantee that you won't get diabetes, even if you do 'everything right.'

So, Dr. Nathan, Paula Deen, Barbara Walters... for all these reasons -- and I'm sure -- many more... You have earned yourself a Dung Cupcake. But they don't make dung cupcakes, so here's a moldy one, instead. You've earned it.

One big, so not so heartfelt, THANK YOU... for all the work you DON'T DO. You make the world one heck of a crappy place for diabetics everywhere.

(Oh, and in case you didn't get it... That's called sarcasm. It's a young people thing.)

. . . 

If you would like to submit 'nominees' for the week's crappiest stories worthy of a Moldy Cupcake Award, feel free to 'Contact Me,' and they shall be thoughtfully considered. :D We shall leave no moldy cupcake left behind. 

» Read More...

With the rising tide of juvenile type 2 diabetes, the debate on school lunches is one which is slowly starting to take the stage. It is, however, one of those subjects in which everyone has an opinion -- but not many have an actual evidence based opinion. Throw in the wrench that every school district is different, and you'll find mudslinging from all sides of the opinion spectrum:

Why can't parents just make healthful lunches for students? 

Well, right now, some schools are actually BANNING parents from preparing school lunches for their kids, claiming it is the parents making unhealthful meal choices. Of course, this is often true... No one can deny that. But it also makes many of us with diabetic loved ones CRINGE at the thought of what a school cafeteria lady, or health department, might think is a healthful school lunch. These places often lack in options. I'm thinking a main course of carbohydrates slathered in cheese and hot dogs, with a side of carbohydrates slathered in butter or salt, with a dessert full of carbohydrates, and a glass full of carbohydrates (because it has vitamins, so it must be good for your health, unlike that can of soda.) Your main sources of protein come from that powdered, grade A government issued cheese, and that powdered, grade A government issued milk. YAY. To top it off, throw an apple at it, for good measure, because apples make ANYTHING look healthy.

Some will argue, why can't parents just trust the school lunch system? 

'I always got healthful meals from the school system, and I turned out JUST fine.' I love these people the most. To them, anecdotal evidence is ALL the evidence that anyone will ever need, and it somehow, trumps everything. It's like seeing nothing but yellow parakeets, and assuming there are ONLY yellow parakeets in existence because that's all your local store carries. (Never mind that many of these folks have NO IDEA what a healthy meal even looks like, and tend to think that all a kid needs to do to stay healthy is to avoid candy and soda, and eat lots of fruitsandvegetables.)

Well, here's something that will blow your mind.

Did you know that the original idea of a 

'food pyramid' started  as a way to help 

ease food costs by spending money on basic, 

cheaper foods, and still get nutrition? The rest 

of the foods were meant as complements 

to enhance whatever nutrients were missing. 

Ever since the USDA started making low fat, 

high carb recommendations in the 80s, and 

implemented it's OWN food pyramid in 1992, 

obesity rates have skyrocketed.

The USDA describes their National School Lunch Program as: "a federally assisted meal program operating in public and nonprofit private schools and residential child care institutions. It provides nutritionally balanced, low-cost or free lunches to children each school day. The program was established under the National School Lunch Act, signed by President Harry Truman in 1946."

Right away, when you brush away the chaff... what should jump at you is the 'low-cost' descriptor used in this paragraph. What does this, casually thrown in, adjective have to say about this program? What is hidden between the lines? Well, what they don't tell you is that the National School Lunch Program started as a way to help a poor, starving population, through government subsidies --  the same subsidies programs which are still, to this day, overpowering our agricultural industry, and making it possible to produce mass amounts of low quality, less nutritionally dense foods. (McDonald's anyone?) When you invest in low quality, less nutritionally dense foods, they become LOW-COST, and easy to mass market to a multitude of industries, and other countries. Smaller farms CANNOT compete with the HUGE agribusiness industry that has come to dominate the markets, including... you guessed it -- the school lunch program market. While the school 'lunch ladies,' might VEND food for you, it usually comes pre-packaged, pre-made, or 'ready to make' sources, and local state federal agencies will contract their local school lunch program to a food service management company, to save a few bucks. If your local school district does not contract to one of these, they are the EXCEPTION.

The three companies, right now, that dominate the industry are Aramark, Compass Group, and Sodexo. They mass market less nutritional foods, serve nutritionally imbalanced meals, cut corners to save dollars, and contract with fast food giants to market to kids -- yes, including, soda manufacturers. Not only that, but they have been under investigation in the past, for serving foods SO low in quality, they were rejected by fast food industry safety standards. (It's gotta take a lot of balls to serve a kid something WORSE than fake fast food meat.) They have such a strong arm in the system, many of them have been able to lobby, and block legislation that would improve standards, including legislation that would have banned soda vending machines in some schools, for example. 

So when you throw in less nutritionally dense foods (so, even if you have a small serving of them, they're still not so great for you,) in an array of unbalanced meals (all carbs, and hardly anything else), no allowances for or enforcing of portion control (and just eat what you want, and how much you want of it), and the attending results of kids who will a.) not feel the stop and go of their hunger signals anymore, and b.) constantly feel hungry because they got no real nutrition, you will get increased likelihood of illness, development of chronic diseases, and a national fat kid tsunami.

That's right... every time your kid eats at one of these national school lunch programs, it's eating food that's probably worse than McDonald's. (And even if it would appear "balanced," the fact is... it's still food that is nutritionally inferior. Remember that. It's like comparing a home made creme filled cake, to a Twinkie. They are technically, the same thing, but that's where it ends. One of them still has FIBER, and many, many vitamins and minerals. I'll let you guess which one that is.)

Are you freaked out yet? YOU SHOULD BE.

Still, some people have blind faith in their National School Lunch Programs... And disbelieve or disregard those who try to stand up against it, and call for change. (Including some politicians.) But folks are fighting BACK. 


Folks like Sarah Wu, who "compelled by her own frustration with school meals � both as a mother and a teacher ... known anonymously as "Mrs. Q." committed to eating school lunch every school day in 2010 just like her students. Mrs. Q documented her experience and described the meals by blogging, tweeting and sharing photos on her blog Fed Up With Lunch: The School Lunch Project." Her blog is one of the first blogs to help capture national attention on this very concerning issue. Mrs. Q risked her employment on this... and there were many days I worried she'd get caught. Still, I cheered for her. Her voice has been effecting some serious awareness and change... but we need more.

More, nationally, as well as globally... Like little 9 year old, Martha Payne, from Scotland... who writes about her poor lunch school program at NeverSeconds. While you're not going to see her giving you an in-depth analysis on the corruption, and backdraft, of agribusiness subsidies... she will hold up every meal to critique, and scrutiny, so you can see with your own eyes what she and her peers are being served.

. . . 

America is at a critical point, right now... we are at a point where it's starting to matter very little what type of food you eat, because it was all cheaply made, and nutritionally bankrupt. Movies like "King Corn," "Supersize Me," and "Food, Inc.," have created some discussion... but quickly get swept under the rug as 'passing the buck,' and not taking personal responsibility for what we eat. But we are clearly living in a very obesogenic environment where it is getting increasingly difficult to make right and wrong decisions, and increasingly easy to be deceived. Yes, a lot of foods that make false health claims have food labels, and we could be better trained and educated at reading them... but what if we thought we were eating meat, and instead were getting meat with an incredibly high risk of bacteria, and lots of corn filler? What if it was given to us by a school lunch program, with no labels (just trust), and not the 'you should know better,' fast food industry?

Yes, we have freedom of choice, in America... as to what we eat. But to what EXTENT should we let the government and the food industry tamper with our food supplies? Market to us? To children who haven't yet developed some of the necessary critical thinking skills, and disciplines, to make good life choices? (Especially, when they don't even have a parent around, to help...) Or to populations with less income, less education, and less access to nutritious alternatives?

The rights and freedoms of those who want to make me less healthy (and not just by consuming more 'fats' and 'sugars,' mind you), start mattering VERY LITTLE to me... when the lives of children, and the future of our nations are involved.

I don't know how ALL chronic illnesses, cancers, and autoimmune conditions come to pass... but sometimes, I have a very good idea what might be contributing to their explosion... And it's not just having an extra piece of pie.

» Read More...

Here at the Angry Type 2 Diabetic, we see 'ourselves' as a voice to ALL persons with diabetes... So, even though we generally use this space to share about our own type 2 diabetic experiences, we'd like to cheerfully lend the spotlight, this week, to our friend, Michelle. Michelle is a wonderful mom to a type 1 diabetic child, and she has a very important message to share with ALL of you. You may find Michelle's regular blogging space at The Tightrope Tango, and show her some follow love.  

My name is Michelle, and first I want to thank my good friend Lizmari for lending me space on her awesome blog. Lizmari is an awesome advocate for all people living with diabetes, regardless of type. She�s also the reason we enjoyed some pretty awesome Ice Cream Sundae�s last August.

Most people I talk to (and I talk quite a lot these days) have never heard of a diabetes alert dog. We all know about Guide Dogs for the Blind, and most of us have heard of dogs to assist people with other disabilities such as mobility, seizures, hearing, etc. Diabetes alert dogs are specially trained dogs that focus on the scent of their person, and let that person know when their blood sugar begins to drop to an unsafe level. These dogs are most commonly used by people with type 1 diabetes, but some with type 2 diabetes are also using diabetes alert dogs to keep them safe.

Why is this necessary? Well, a lot of diabetics either never have, or lose the ability over time to sense changes in blood sugar. My daughter, Sarah, is 12. She�s had type 1 diabetes for about two and a half years. Since the beginning she�s had trouble recognizing when her blood sugar is low, until it is dangerously low (sometimes in the 40�s and 50�s mg/dL). Normal blood sugar (for a non-diabetic) ranges from around 70mg/dL to 130mg/dL. If blood sugar drops too low, unconsciousness, seizures, and death can occur. Sarah has difficulty feeling drops in her blood sugar during the day, but she does not feel them at night, period. Since she�s been diagnosed, she has never� not once� woken because she felt a low blood sugar. That is scary. The JDRF (Juvenile Diabetes Research Foundation) reports that 1 in 20 people with type 1 diabetes will DIE of a low blood sugar. 1 in 20! That's not a typo. It's not 1 in 20,000, it's 1 in 20. (http://www.jdrftalk.org/2011/11/07/percentage-people-type1-diabetes-die-low-blood-sugar-hypoglycemia/). I can�t let my beautiful child become a statistic, so right now I set alarms for 10:30, 11:30, and 2am. Sometimes more, sometimes less, depending on her food and activity for the previous day.

But I�m not perfect, and I make mistakes.

Once, last December, she went extremely low (27mg/dL). She was unresponsive. It was only around midnight and I only caught the low because I checked on her and found that she was horribly pale and covered in sweat. I saved her life that night, because she was still dropping and the body can't sustain a blood sugar much lower than that for very long. If I hadn't checked on her, she very easily could have slipped into a coma and been gone by morning.

We tried a CGM (continuous glucose monitor) but Sarah has a metal allergy and gets a severe rash. This is where the diabetes alert dog comes in. Diabetes alert dogs are not for everyone. They require a lot of care. They eat a lot, they poop a lot. Honestly, in the beginning I thought that a diabetes alert dog was too much responsibility for a child. But my child proved me wrong by volunteering many hours every month with Guide Dogs for the Blind. She learned to handle, groom, and correct them. She grew to love her new friends, and has taken weekend responsibility for a Guide Dog puppy on a number of occasions. 

I believe that in a few years, maybe 5, maybe 20, that diabetes alert dogs will be much more common and understood. Discounting the fact that an alert dog is a living animal, an alert dog is a medical device, a tool. An alert dog is always on watch with their wonderful nose. An alert dog can think, and will go find help if their charge doesn�t respond to their warnings. Guide Dogs call it intelligent disobedience, a term that describes when a dog makes a decision to take an action outside its normal training that is in the best interest of their person. This could be a dog that leaves Sarah�s side during school to go take the alert to the teacher or other adult. This could be leaving Sarah�s room during the night to come into my room and let me know that Sarah needs help.

The last thing I�d like to say to everyone who reads this is to not discount the needs of someone with diabetes simply because they don�t have an obvious disability. Many kids, like my Sarah, are active, funny, enthusiastic, and because their health, food and activity is watched very closely, they often appear healthier than the average child their age. I�ve had a few eyerolls when I�ve told people that my bouncy child, who just exudes health and vitality, needs a service dog to keep her safe. For someone with type 1 diabetes, safe and healthy require a lot of work, lots of acting on instinct, guesswork, etc. It�s not as easy as it looks, and even with constant effort we have lows and highs that could not have been predicted. Diabetes is always. It never stops. It never goes away or gives us a break. Sarah takes large doses of insulin 4-6 times a day. Any one of those could send her to a fatal low if she or I misjudge the carbohydrates in her food or misjudge how her activity will affect her.

Can you be 100% right ALL the time?

At this time, diabetes alert dogs are not covered by insurance. Those of us who have made this choice for our child must generally pay for the cost of training the dog. My hope is that once the abilities of these dogs are more fully understood and accepted, more groups like Guide Dogs for the Blind can be formed to raise funds and provide these amazing dogs at low or no charge to the family. The first step in making this a reality is education. Tell someone you know about these dogs, and help spread the word. Even if you don�t know someone with diabetes, someone you know does.

Talk. Educate. Your words can help save someone�s life.

If you�d like to learn more about Sarah�s journey to a diabetes alert service dog, please visit either her facebook page at https://www.facebook.com/ADiabetesServiceDogForSarah or her website at www.pawsforsarah.com. Sarah�s dog is coming from Canine Hope for Diabetics in Riverside, CA, hopefully in early 2013. 

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"I do what I have to do, so that I can do what I want to do."

Life is not a simple exercise for me. While it just seems to come naturally to some, it's just not so, for me. Having a positive state of mind is a continuous choice I have to make, and it is a continuous decision to stop self destructive thoughts in their tracks, and choose to believe the positive mantras that might seem cheesy, or ludicrous to me.

I don't really know why I am like this... and I could psycho-analyze it to death, but I'm not sure how helpful that would be. I'm pretty sure that some of the hurdles I've faced (especially in my childhood) have helped me develop a somewhat dim view of the world. Things like childhood obesity, a grim personal appearance (thanks to undiagnosed PCOS), constant exhaustion and mood swings (thanks to undiagnosed Hypothyroidism), uninvested parents and a lack of personal development, etc.

I felt so alone most of my childhood, and so inadequate, that I spent it trying to pursue instant gratification. In my teen years, eating and TV became my sole companions and comforts, while my family was mostly off in their own world. It's still like this today, you know. I don't get social phone calls from family, nor so much as a card on a birthday, or a holiday... and quite frankly, I don't remember the last time I got anything at all in the mail, from them, or even a social phone call. You can see why a child would try to drown itself with 'love' in the form of whatever one came across -- be it food, or TV, or what have you. Pick your poison.

When one is swimming in loneliness, illness induced mood swings, life induced anxiety, and self loathing... it is extremely hard to have self control of any kind. Whether it be with your refrigerator, or with your checkbook, or whatever brings you immediate release. What's worse is that when you don't have deadlines or commitments of any kind, you can put off desperately needed changes, for as long as possible and tell yourself that 'tomorrow, you will start;' but when someone tells you that you have NO choice, that it's the hour zero and you need to buckle down, or else... your life turns into a shiny, red button. Do not press the shiny red button, they say... You must guard yourself to never press the shiny red button. Everyone's anticipating, and policing you. Everyone knows.

History Eraser Button

If the video doesn't show, follow the link above.

This is what life is like for many of my fellow type 2 diabetics, right now... A shiny red button. It's easy to understand how one gets to that kind of place, and ever soooo hard to help someone get out of that place, see the light, and understand that although life may be smacking us with its behind (like the announcer guy on this Ren and Stimpy video), that we have a choice. We indeed have a choice, and our lives don't automatically go down the drain... Our destinies are not planned for us. We MAKE our own futures; we write them today.

Someone I admire profoundly, once said to me: "Lizmari, you are no one's victim." 

But it's so comforting to believe that I am; that I am life's victim, that I have no choices, that I am like a small boat, with no sails, and no paddles... at the mercy of life's waves. That I am being held hostage at the mercy of a big, shiny red button, awaiting to erase history; MY HISTORY. Or at least, in my warped sense of self I like to think it is... "Woe is me..."

Why? Because it's PAINFUL to not be anyone's victim. It takes MUSCLE, and exercising your discipline muscle is just as painful as stretching your calves. Ouch. 

... But I am not anyone's victim. I AM NOT, and neither are you. 

Listen to me, friend. You who decided to google "When will I die from Type 2 Diabetes?" and suddenly chanced upon my blog: You are not a tiny raft, alone at sea. You are a MASSIVE ship, and you can take charge of your course. You can choose to stir your ship into the icebergs, you can choose to press the shiny red buttons of your life, every day... Or you can choose to tell diabetes to buzz off.

"Hey, diabetes... GET LOST. You may place hurdles in my life, but you will NOT take me. Not today. TODAY WILL NOT BE THE DAY. I am NOT your victim. You are NOT my master. I AM, and I am allowed to BE, and you do NOT get to tell me who I am, what I am, and when I get to leave." 

I have my own shiny, red buttons... and I understand. Believe me, I do... 

But you have choices... And while you may decide to throw in the towel, let me remind you (or perhaps inform you), that Type 2 Diabetes =/= death. YOU have the power to let it equal LIFE. A life reborn, a life re-defined, a life EMBRACED. 

Embrace life, WITH diabetes. It may take courage to not be a victim... but I promise you, if you do it, you will NOT be disappointed. You will be OKAY. You will not just survive, but you will THRIVE. You can do this thing... Life awaits you! 

I promise. 

Will you take the challenge?

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