2010 Spring Vol 32

Spring 2010 Volume 32

Our Extreme Diabetes Makeover (XDM)program will not only show the non-diabetic world what it is like to live withdiabetes on a day-to-day basis, but it willalso be a comforting eye-opener for themillions of people living with diabetes,helping to validate the multiple emotionaland physical barriers that come with theircondition.With the help of an expert film crew

and personal HD Flip Cams, XDM isfollowing seven PWD (5 type 2’s and 2type 1’s) from various walks of life for 5

months as they are given the tools to helptake control of their diabetes. We are documenting the successes as

well as the challenges of the participantsas they work with our “Dream Team” ofdiabetes healthcare professionals to assistthem in their journey. The Dream Teammembers include: Dr. Steve Edelman,Diabetologist; Bill Polonsky, ClinicalPsychologist; Janice Baker, Dietitian;Angela Norton, Certified DiabetesEducator; and Larry Verity, Exercise

Dr. Edelman’s CornerDr. Edelman’s Corner

(Makeover, continued on page 2 )

The rumors are true! TCOYD is coming out with a cuttingedge, reality-based, documentary-style online series that has

the potential to do something that has not been done before.

inTHISissue

®

Dr. Edelman’s Corner

The Friend Factor

Finding a Balance

Question of the Month

Victoza (liraglutide)

Chronic Stress and Your Heart

Know Your Numbers

Diabetes in Motion

Diabetes Etiquette

The Spirit of Giving

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TCOYD’S EXTREME DIABETESMAKEOVER PROGRAMThe Next Big Thing To Hit the Online Airways

TCOYD’S EXTREME DIABETESMAKEOVER PROGRAMThe Next Big Thing To Hit the Online Airways

11

(Photo) The participants ofExtreme DiabetesMakeover and the ExtremeDiabetes Makeover “DreamTeam” enjoy the sunset atthe TCOYD office.

Physiologist. As an added bonus, ourfantastic fitness trainer from NBC’s“The Biggest Loser,” Kim Lyons willmake an appearance in the show, whilespending an afternoon with the groupsharing her fitness expertise andworking the participants to their limits!Premiering this fall on TCOYD.org

and RealAge.com, a top-of-the-lineconsumer health website, ExtremeDiabetes Makeover is filled with the true stories of real people, all strugglingwith diabetes, who have two things incommon: poor control of their diabetesand the desire to improve theircondition.The diverse group, includes

Celeste, a 68 year old astrologyconsultant living with type 2 diabetes;Daron, a 38 year old individual who is living in a homeless shelter and hastype 2 diabetes; Chet a 53 year old San Diego State University Azteccheerleading legend and county workerwith type 2 diabetes; David, a 22 yearold UCSD student who has been living

with type 1 diabetes since the age offour; Tim, a 62 year old lawyer livingwith type 2 diabetes; Renee, a 55 yearold professional woman with type 2diabetes and Liz, a 30 year old eventsprofessional and exercise instructorwith type 1 diabetes. Watch them asthey work to lower their A1c’s, changetheir life-long habits and battle theiremotions in order to take control oftheir diabetes.XDM is the most exciting project we

have done at TCOYD since our veryfirst conference at the San DiegoConvention Center in 1995! I wantedto call it “Pimp My Diabetes,” but I gotshot down! Trust me, you won’t want tomiss this much-anticipated dose ofdiabetes reality!

Steven Edelman, MDFounder and DirectorTaking Control Of Your Diabetes

Makeover (continued from page 1)

2 MyTCOYD Newsletter, Vol. 32

SpecialAcknowledgements

MyTCOYD Newsletter is offered as a paidsubscription of Taking Control Of YourDiabetes. All material is reviewed by amedical advisory board. The informationoffered is not intended to constitutemedical advice or function as a substitutefor the services of a personal physician. Onthe contrary, in all matters involving yourhealth, TCOYD urges you to consult yourcaregiver. ©2009 All rights reserved.

Medical Advisory BoardChair: Ingrid Kruse, DPMVeterans Affairs Medical Center

Alain Baron, MDCEO, Elcelyx Pharmaceuticals

John Buse, MD, PhDUniversity of North Carolina

Jaime Davidson, MDDallas, TX

Mayer Davidson, MDDrew University

Daniel Einhorn, MDDiabetes & Endocrine Associates

Robert Henry, MDVeterans Affairs Medical Center

Irl Hirsch, MDUniversity of Washington

Board of DirectorsSteven V. Edelman, MDFounder and Director, TCOYD

Sandra BourdetteCo-Founder and Executive Director, TCOYD

S. Wayne KayCEO, Response Biomedical Corp.

Margery Perry

Terrance H. GreggPresident & CEO, DexCom, Inc.

Daniel SpinazzolaPresident, DRS International

Contributing AuthorsSteven V. Edelman, MDDoug BurnsSusan Guzman, PhDCandis M. Morello, PharmDCourtney Shakowski, PharmDJoe Piscatella

TCOYD TeamSteven V. Edelman, MDFounder and Director

Sandra BourdetteCo-Founder and Executive Director

Jill YapoDirector of Operations

Michelle DayDirector of Meeting Services

Antonio HuertaDirector of Latino Programs & Exhibit Services

Roz HodginsDirector of Development

Alice HoweManager of Continuing Medical Education &Website Development

Julia BaronMarketing and Communications Associate

MyTCOYD NewsletterEditor: Julia Baron, Editor

Design: Hamilton Blake Associates, Inc.

Celebrity fitnesstrainer Kim Lyonsworks with Liz,Daron and Davidto test theirstamina.

Taking Control of Your Diabetes 3

We are built with a need to developand interact with other people.Friendship fulfills a key component in life—acceptance. From ourbeginning to present, we pursueacceptance from others and ourselvesmore than anything else in life. Manyof the kids I’ve spoken with in juvenilehalls said they joined gangs for thatvery reason—they wanted to beaccepted somewhere. Lack of friendships can be crushing.

It implies rejection. Rejection kills ourspirit and leads to low self-esteem, lowself worth and isolation. It contributesto and heightens depression as well.What does this have to do withdiabetes? Controlling a disease thatrequires daily attention becomes evenmore chaotic and, therefore, loses itsimportance. Friendship and acceptanceare as vital as the foods we eat.Diabetes is like other obstacles we

meet in life. It takes a healthyperspective to persevere, treat andovercome them. People with friends,whether they are family or others, aremore apt to control their diabetes.Friends provide us with accountabilityand a reason to live better. The

thought of my kids and my friendsimplores me to treat this diseasebetter—to forget the mistakes andpush forward. The thought of otherathletes with diabetes does the samething. We have a solution for othersand ourselves. Diabetes creates various obstacles

that all of us must address. By helpingsomeone else it lessens the power theseobstacles have. It’s virtually impossibleto help someone else when we arefocused solely on our own problemsand/or circumstances. Finding friendsmeans being friendly and friendshiprequires us to put others first. People from our past, our work, our

experiences, places we frequent and, ofcourse, social networks all offerchances to help and befriend eachother. Friends we text and connectwith online create an ever growingopportunity to meet and keep up withpeople throughout the world.Friendships hold us accountable andprovide needed feedback for both sides. Most of us have a list of friends, but

if you’re searching, remember to findfriends, reach out and be friendly.Those of us with diabetes and other

obstacles have a common bond.Become creative. I thought that Dr. Edelman had too many friends.Though it was difficult in thebeginning, I siphoned many of mynew friends from his surplus and we are all better for it!Friends have supported me

through dire situations and theirhelp is always before me. The nexttime our friend or physician tells uswe need to lose weight, start testingmore, start exercising or check oursugar right now, remember theProverb: “Wounds from a friend can be trusted, but an enemymultiplies kisses.”

Doug Burns is aninternationallyrespected fitnessconsultant andrecord-holdingstrength athlete.Doug has also hadtype 1 diabetes sincethe age of seven.

Doug feels blessed to have been able tobring a message of overcoming to people allover the world. He has keynoted on diabetesand health and fitness for senate hearings,children’s and adult conferences, publicschools, and juvenile detention centers.

Doug resides in Northern California and authored The Diabetes Antidote. Heserves on the Board of Directors for theADA, JDRF, Father of the Year, and varioussports associations.

How important are your friendships with regard to livingabove the confines of diabetes? Surprisingly, they are more

important than many of us realize. Friends give meaning to ourlives and are a main reason we strive to succeed in our pursuits.

By Doug Burns

The Friend FactorHow Your Relationships With OthersAffect Control of Your Diabetes


Did you ever marvel at a masterjuggler who can throw all kinds

of objects in the air and, seemingly,without looking, manage to keep themall afloat? I have observed those who areliving well with diabetes have developedskills that are comparable to those of amaster juggler. They toss up in the air all of life’s stuff—work, family, friends,diabetes self-care and even someoccasional fun—and strive to find abalance. Occasionally, things get out of balance and a ball will drop. Despitethese minor oversights, it seems thatthese masters subtly observe when a ballhas fallen, carefully adjust their stance,pick up the dropped ball and toss it backinto the air. Even if the juggler happensto misstep and all ofthe balls tumble tothe ground, hesimply starts over,one ball at a time.I am inspired by the many master

diabetes jugglers that I know and I amamazed when they manage to find ahealthy balance in all of the work ofchecking blood glucose, adjusting foodand medication, remembering to fit inexercise however they can, while alsohaving a job, dealing with relationshipsand coping with the stresses of tough

times. They have the ability to noticewhen things have gotten out of balanceor a ball or two has been dropped andsimply take necessary steps to get backon track. These master diabetes jugglersrecognize that the goal is to find balancebetween having good (not perfect)control of their diabetes and having a meaningful life.

Here are some strategies forincreasing your “diabetesjuggling” skills:1) Recognize that even master jugglers

drop balls—it’s the nature ofjuggling. Having diabetes involvesups and downs, frustrating results anddays you just don’t feel like “doingdiabetes.” Accept that this is thenormal experience of living withdiabetes and does not make you a “bad diabetic” or mean you’ve“blown it.” Try to let go of what isdone and focus on what you can do right now.

2) Decide how manyballs (and which) tothrow in the air. Thereare only so many hoursin the day and only

so much energy to spend. Makeconscious choices about what youput into your day. Choose what isreally important, especially when you are in a time of high stress andpick diabetes self-care activities that will give you the biggest payoff(like making sure you take yourmeds/insulin and exercise).

By Susan Guzman, PhD

Susan Guzman, PhD, Director ofClinical Services, Behavioral DiabetesInstitute (Far Right photo)

Dr. Guzman is a licensed clinical psychologist specializing in diabetes,both as a researcher and a clinician.She developed and leads the multi-week depression series, “FeelingGood Again: Breaking theDepression/Diabetes Connection”.She is also project coordinator forBDI's Behavioral and EmotionalAttitudes towards Diabetes (BEAD)study, which investigates the impactof type 2 diabetes followingdiagnosis, and has previously beeninvolved in studies examiningfamily-based interventions indiabetes as well as psychologicalinsulin resistance.

FindingtheBalance...Bec

oming a Master Juggler

[ “Having diabetes involves upsand downs, frustrating results,and days you just don’t feel

like “doing diabetes.” ]


3) Reconsider if you are jugglingchainsaws! Sometimes wechoose to put harmful things,high-stress jobs, unhealthy rela-tionships or dangerous behaviorsin our lives that jeopardize ourwellbeing and make findingbalance nearly impossible for any length of time. Be honestwith yourself and considermaking a change that makes your physical and emotional self-care more of a priority.Just as the master juggler has

learned the rules and physics ofjuggling, the master of diabetes has learned the rules and patterns of his own body and recognizes that diabetes management requireschange, flexibility and an attitudethat keeps diabetes in its properperspective. Remember, this requires practice and perseveranceand you too can do it!

nswer: I honestly tried to get a clinical psychologist to answer myquestion but they all chickened out! So, after thinking about it for awhile, I have decided to answer my own question to the best of myability.Stealing is wrong....plain and simple. However, is taking a few extra

Splenda or Equal packets for later use stealing? Having diabetes doeslimit the amount of real sugar you can use and artificial sweetenerpackets are readily available in restaurants and fast food establishments.I think it is fair to say that when you feel guilty about doing something, it is probably wrong and when I take more than a modest number ofpackets I do feel guilty. On the other hand, when I only take a fewpackets, I feel okay.So, the answer to my question is that like everything in diabetes, the

key is moderation! This answer leaves the door open to interpretation soif you have opinions or feedback that you would like to share about thisissue, please comment on the discussion board of our TCOYD Facebookpage. If you haven’t yet joined us on Facebook, please do. It’s easy.

I have an unusual ethical and psychological question. I findthat everywhere I go, I seem to scan the environment, seekout, and quite frankly, take Splenda packets. I shove them inmy pockets in a cool calm manner like I am doing somethingcompletely normal and acceptable. I use Splenda (or otherzero calorie products) as my sweetener to avoid getting highblood sugar and to reduce the amount of calories that Iintake. Is this wrong? Should I be afforded special privilegesas a person who has to live with diabetes?

Question of the Month

By Steven Edelman, MD

A

®


In January of 2010, the Food and DrugAdministration (FDA) approved theuse of Victoza (liraglutide) in theUnited States in adults with type 2diabetes in order to improve glycemiccontrol in addition to diet and exercise.Now, Victoza joins Byetta (exenatide)in the class of drugs called GLP-1s.

What is Victoza?GLP-1 is an incretin

hormone. You may findyourself asking, “What are incretins?” Incretinsare hormones released from theintestines after eating a meal that cause the pancreas to secrete insulin,decrease glucagon secretion andpromote appetite suppression. One ofthe most important incretin hormonesis the glucagon like peptide-1 (GLP-1).Unfortunately, if normal GLP-1 were to be administered, it would rapidly bedeactivated by natural enzymes in thebody. Novo Nordisk, the developer ofVictoza, has figured out a way to trickthe body by developing a drug thatmimics the action of GLP-1, butdifferent enough that it does not get rapidly degraded by the body’s enzymes.

How does Victoza work?

Victoza, a GLP-1 analog, works bymimicking the important functions ofGLP-1 in the body. First, it causes thepancreas to secrete insulin in a glucose-dependent manner. This means whenglucose concentrations rise, GLP-1

helps insulin secretion. Conversely, asglucose concentrations lower, Victozastops working, preventing hypo-glycemia. GLP-1 also decreases thesecretion of glucagon from thepancreas. If glucagon increases, it leadsto an increase in glucose productionand increase in blood glucose. Additionally, GLP-1 works in the

brain to promoteappetite suppression,which ultimatelyleads to sustainedweight loss. Lastly,

GLP-1 helps regulate the rhythmic contractions of the stomach, which aretoo fast in people with type 2 diabetes.This typically leads to the dumping ofnutrients into the intestines andelevations in glucose. By replacingGLP-1, people with type 2 diabetes can achieve better glucose control after eating, as well as, weight loss. Similarly, Byetta increases GLP-1

effects, but acts as a GLP-1 agonist.Currently, it requires twice dailyinjections compared to Victoza, which only requires one injection perday. However, a once weekly Byettaformulation is currently under reviewby the FDA.

Is Victoza right for me?In addition to diet and exercise,

Victoza will help people with type 2diabetes achieve good glycemic control.The earlier glycemic control is achieved(targeting an A1C of less than 7% formost people) the better! This will helpprevent the onset of long-term

[ “Victoza, a GLP-1 analog,works by mimicking theimportant functions ofGLP-1 in the body.” ]

(Left) Candis M. Morello, PharmD,CDE, FCSHP, Associate Professor ofClinical Pharmacy at UCSD SkaggsSchool of Pharmacy andPharmaceutical Sciences andClinical Pharmacist at VASDHS

(Right) Courtney Shakowski,PharmD Candidate 2011 at UCSDSkaggs School of Pharmacy andPharmaceutical Sciences

Victoza(liraglutide)“V” is for Victory for Type 2Diabetes: The Once DailyGLP-1

Victoza(liraglutide)“V” is for Victory for Type 2Diabetes: The Once DailyGLP-1

Candis M. Morello, PharmD &Courtney Shakowski, PharmD

(Left) Candis M. Morello, PharmD,CDE, FCSHP, Associate Professor ofClinical Pharmacy at UCSD SkaggsSchool of Pharmacy andPharmaceutical Sciences andClinical Pharmacist at VASDHS

(Right) Courtney Shakowski,PharmD Candidate 2011 at UCSDSkaggs School of Pharmacy andPharmaceutical Sciences


microvascular (small vessel) compli-cations that can arise from poorglycemic control.Before you start taking Victoza,

tell your provider if you have hadthyroid cancer, a history of pancre-atitis or stones in your gallbladder.These conditions may predisposeyou to serious side effects of Victozaand you should avoid using thisproduct. Remember to consult your provider before starting anynew medication to ensure that aproper dose and schedule can bedetermined.

What can I expect?Most importantly, you can expect

a decreased A1C by 1.0% – 1.5%,which will help accomplish yourgoal of achieving glycemic control. Furthermore, you can expect

significant and sustained weightloss. This doesn’t mean you can quit your diet and exercise plan! As you know, regular exercise andmaintaining a well-balanced dietare crucial to goodglycemic control.When first starting

Victoza, you mightalso expect nausea, as it is the most common side effect.However, as your body adjusts tothis medication within a few weeks,the nausea will decrease. In themean time, eating small, frequentmeals, chewing sugar free gum, orsucking on sugar free lozenges may help.

Victoza has little risk of causinglow blood glucose when used alone.It is important to know that yourrisk for low blood sugar is higher if you take Victoza in combinationwith another medication that causeslow blood sugar, such as glimepiride,glipizide or glyburide. Signs andsymptoms of low blood sugarinclude: sweating, headache,confusion, irritability and hunger.Talk to your primary care providerabout the medications you aretaking that might cause low blood sugar, in addition to how torecognize and treat low blood sugar.

The Bottom LineInsulin is not the only hormone

in the body affected by diabetes.The incretin hormones are alsoaffected. We now know an emergingclass of drugs, GLP-1s, which incombination with diet and exercisehelp to achieve glycemic controland promote weight loss. This isgreat news because many of the

currenttherapies for type 2diabetesactually cause

weight gain, which can be veryfrustrating! Keep your eyes open for long-acting GLP-1s. Theseagents would only require weeklyinjections rather than daily ones.This would mean another victoryfor people with type 2 diabetes!

[ “...GLP-1 works in the brainto promote appetite

suppression, which ultimatelyleads to sustained weight loss.”]

(Top) Renee is excited to learn aboutnew therapies to control her diabetes.

(Middle) David and “Dream Team”Dietitian Janice Baker discuss hislatest numbers.

Liz tries out a new and healthy recipe in the kitchen!

We are all used to traditionalcardiac risk factors such as

elevated cholesterol, diabetes, smoking,high blood pressure and family history.But these days, research is being focusedon a link between chronic stress andheart attacks.If there is a common element to

modern life, it is that weare a hurried, harried and“stressed-out” society.Most people simply donot have enough time fortheir overcommitted andoverscheduled lives. Chronic stress hitseveryone from the elderly coupledealing with extensive medical bills tothe young mother who is rushing fromwork to drive carpool. Such unbridledstress can have a significant adverseinfluence on cardiac health. Peopleunder stress tend to smoke, eat high-fat food and lead sedentary lives, all ofwhich increase heart attack risk. Butchronic stress can also impact hearthealth more directly including:u Surges in heart rate and bloodpressure

u Increases in cholesterolu Promotion of artery wall inflammation

u Constriction of coronary arteries,which can result in heart attacks

u Heart rhythm irregularities, whichcan trigger sudden cardiac death

u Increases in blood clotting

An eight-year study of day-of-the-week variations in heart attackincidence showed the incredible impact

of stress: significant peaks were foundbetween 7 and 10 o’clock on Mondaymornings, when the occurrence of heart attacks was 21% higher thanduring the rest of the week. The lowwas on Saturdays.So, do you retire from the world to

reduce stress? Of course not. The fact isthat we live in a fast-paced, out-of-time

lifestyle andType A-fosteringculture thatcombines to

produce high levels of frustration,anxiety and anger. There will always be traffic jams and checking overdrawnaccounts. And there will always bestress. The secret is not to avoid stress,but to manage it.The first step is to make a decision to

take control, to decide to manage yourstress rather than have it manage you.Next, identify what causes you to

feel stressed. Is it coming from your job,your home, or both? Are you always outof time? Do you exhibit Type Apersonality traits?Finally, do something positive about

combating stress. Make a consciouseffort to do one or two things each dayto help you handle your stress. A fewexamples include going for a jog or awalk, taking a hot bath, building extratime into your schedule, practicingpositive self-talk, breathing deeply,keeping a journal andgetting enoughsleep.

Joe Piscatella is theauthor of thebestseller bookDon’t Eat YourHeart Out. In 1977,at the age of 32, heunderwent anemergency open-heart bypasssurgery after experiencing chestdiscomfort while playing tennis. Hisprognosis was not good, his doctors didnot expect him to be able to watch hiskids grow. Refusing to accept hisprognosis, he did extensive research andinterviewed medical experts. He createda plan for a healthy, balanced life-stylethat he could implement. Joe wrote hisoutcome in his book and in 1982 hefounded the Institute for Fitness andHealth. Today, Joe is one of the country’sleading authorities on changing behaviorto increase health and productivity.

Chronic Stress

By Joe Piscatella

[ The first step is to make adecision to take control, to

decide to manage your stressrather than have it manage you.]


& Your Heart


Iam a 30-year old woman with type 1diabetes and have been living with this

condition for many years. I am growingfrustrated trying to control my diabetes. I have an insulin pump and recently goton a continuous glucose monitor (CGM).My A1c is not that bad, however I seem to yo-yo up and down on a daily basis. I tryto be as regular as possible, but I travel alot and that makes things difficult.

Question: My carbohydrate to insulin ratio is 10:1 and my correction factor is 1:35 with a goal of 100mg/dl. Seethe download of a typical day. What could be the cause(s) of my erratic control?Answer: Although easier said than done, trying to keep your glucose levels in a good “zone” while avoiding theextreme highs and lows is the key to success. First of all, when you are high, make sure you have the appropriate correction dose. If you are giving yourself

more than you need, it will drive you down into the low range. Also, be careful not to “stack” your dose by takingseveral correction doses too closely together in time (typically you should wait at least an hour before giving asecond correction dose). On the other end of the spectrum, make sure you do not over treat your lows, which will drive you back up too

high and then you will definitely be on the roller coaster. Also, test to make sure your carbohydrate to insulinratio is appropriate (pre and post meal testing) because if you are not giving yourself enough insulin with meals,you will commonly be too high after eating creating the up and down cycle. Make sure you have your upper andlower alert levels set appropriately (i.e. 80 mg/dl for the low and 180 mg/dl for the high). You will defeat thepurpose of having a CGM device if you have your limits too high and too low. Remember to pay attention to thealerts and do something when you cross the line in order to avoid the extremes. Lastly, it will take you several months to learn how to correctly interpret your CGM readings and make the

appropriate micro-adjustments throughout the day.

KnowYourNumbersBy Steven Edelman, MD

Silver

Gold

Platinum

TCOYD Corporate Sponsors

San Diego Area LatinConferencesTwo will be held in the

North County at Tri-CityMedical Center and one will be held in theSouth County at the San Ysidro HealthCenter. The dates will be announced.

TCOYD-TVWe are currently filming our 4th season

of TCOYD-TV. There will be six episodesthis year that will begin airing in the comingweeks and will be listed on our website. This season, we will include new lifestyle

pieces featuring dietitian Janice Baker andexercise physiologist Larry Verity that recurin every episode. Dr. Edelman will alsointerview several children with diabetesabout their condition and what they do to manage it. The segment will be called,“Kids With Diabetes Say the SweetestThings.”We will continue to focus on a specific

topic with Dr. Edelman hosting and inter-viewing expert guests throughout the season.

Diabetes in Motion:Step Forward and Move Ahead!


Live Conferences - TCOYD and MTCIn the fall of 2010, we will hold four ‘Taking Control Of YourDiabetes’ conferences and health fairs along with three ‘MakingThe Connection’ continuing medical education symposia.Registration for all the events will be available on our website.These are cities and dates we will be visiting:September 11 Providence TCOYD / MTCSeptember 25 Des Moines TCOYD / MTCOctober 30 San Diego TCOYD / MTCNovember 13 Native American, Oklahoma City TCOYD

San Diego Mini-Series Evening ProgramsWednesday July 28 6:30 – 8:30 p.m.Wednesday September 22 6:30 – 8:30 p.m.

San Diego Area Latino Mini-Series Evening ProgramsMonday June 7 6:00 – 8:00 p.m.Monday September 13 6:00 – 8:00 p.m.Monday November 8 6:00 – 8:00 p.m.

(Top) Dr. E takes a break with some of the fantastic childrenfeatured in, "Kids With Diabetes Say the Sweetest Things.”

(Right) Dr. E interviews Dr. Irwin Goldstein about diabetesand sexual health.


DON’T offer unsolicitedadvice about my eating

or other aspects of diabetes.You may mean well, but giving adviceabout someone’s personal habits,especially when it’s not requested, isn’tvery nice. Besides, many of the popularlyheld beliefs about diabetes such as, “youshould just stop eating sugar” are out ofdate or just plain wrong.

DiabetesEtiquetteFor peopleWho DON’THave Diabetes

1 DO realize andappreciate that

diabetes is hard work.Diabetes management is a full-time jobthat I didn’t apply for, didn’t want andcan’t quit. It involves thinking aboutwhat, when and how much I eat, whilealso factoring in exercise, medication,stress, blood sugar monitoring and somuch more—each and every day.

2 DON’T tell me horrorstories about your

grand-mother or other people with diabetes you have heard about.Diabetes is scary enough, and stories likethese are not reassuring! Besides, wenow know that with good management,odds are that you can live a long,healthy and happy life with diabetes.

DO offer to join mein making healthy

lifestyle changes.Not having to be alone withefforts to change, like startingan exercise program, is one ofthe most powerful ways thatyou can be helpful. After all,healthy lifestyle changes canbenefit everyone!

DON’T look sohorrified when I

check my blood sugars orgive myself an injection.It’s not a lot of fun for me either.Checking blood sugars and takingmedications are things I must doto manage diabetes well. If I haveto hide while I do so, it makes thetask much harder for me.

DO ask how youmight be helpful.

If you want to be supportive,there may be lots of little thingsI would appreciate your helpwith. However, what I reallyneed may be very different thanwhat you think I need, so pleaseask first.

DON’T offer thoughtlessreassurances.

When you first learn about my diabetes,you may want to reassure me by sayingthings like, “Hey it could be worse; youcould have cancer!” This won’t make mefeel better. To add to that, the implicitmessage seems to be that diabetes is nobig deal. However, diabetes (like cancer)is a big deal.

DO be supportive of my efforts for self-care.

Help me set up an environment forsuccess by supporting healthy foodchoices. Please honor my decision todecline a particular food, even when youreally want me to try it. You are mosthelpful when you are not being a sourceof unnecessary temptation.

DON’T peek at or comment on my blood

glucose numbers without asking me first.These numbers are private unless I chooseto share them. It is normal to have numbersthat are occasionally too low or too high.Your unsolicited comments about thesenumbers can add to the disappointment,frustration and anger I already feel.

DO offeryour love and

encouragement.As I work hard to managediabetes successfully,sometimes just knowingthat you care can be veryhelpful and motivating.

Brought to you by:

The BehavioralDiabetes InstituteP.O. Box 501866San Diego, California 92150858-336-8693©2007 Behavioral DiabetesInstitute. All Rights Reserved.To learn more, please visit us atwww.behavioraldiabetes.org

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NonprofitOrganizationU.S. PostageP A I DSan Diego, CAPermit No 1

TCOYD Conferences & Health Fairs 2010 Schedule

February 6 Augusta, Georgia February 27 Sacramento, California March 20 Kalispell, Montana April 24 Honolulu, Hawaii April 25 Kauai, Hawaii May 8 New Orleans, Louisiana May 22 Raleigh, North CarolinaSeptember 11 Providence, Rhode IslandSeptember 25 Des Moines, Iowa October 30 San Diego, CaliforniaNovember 13 Native American Program Oklahoma City, Oklahoma

Taking Control Of Your Diabetes1110 Camino Del Mar, Suite “B”Del Mar, CA 92014 | www.tcoyd.org

Tel: (800) 998-2693 (858) 755-5683 Fax: (858) 755-6854

®

TCOYD is a not-for-profit 501(c)3charitable educational organization.

At Taking Control Of YourDiabetes, the support we provide

to people living with diabetes andtheir loved ones makes a differenceon so many levels. We help make itpossible for people to achieve theirpersonal goals and take control oftheir disease. Whether it be reducingtheir blood sugar levels, loweringtheir A1c’s, losing weight or workingwith family members who care for aloved one with diabetes, TCOYDrelies on your continued support

throughout this very personal process. TCOYD relies on private philan-

thropy to sustain our critical work.Your monthly gift, whether large orsmall, provides the sustained incomewe need to propel our outreach topeople with diabetes throughout the country, while educating andempowering them to live well withtheir diabetes.Become a monthly donor and your

gift will automatically be transferredfrom your credit or debit card each

month, providing a fast, easy andsecure way for you to partner withTCOYD in our mission.To donate, visit www.tcoyd.org

and click on “Make a Donation.” You can choose to make a single one-time gift or establish a recurringgift. Every donation helps TCOYDachieve our mission, to educate andmotivate people with diabetes to takea more active role in their condition.Thank you for your kindness and

generosity!

To learn more about giving, please contact: Roz Hodgins TCOYD Director of Development1110 Camino Del Mar Del Mar, CA 92014 (858) 792-4741 Ext. 20or toll free: 1-800-998-2693email: [email protected]

The Spirit of GivingBy Roz Hodgins

2010 Spring Vol 32

Documents

Transcript of 2010 Spring Vol 32