[grannynurse FNP student]

Today is the last article, in the NYT and it dealt with children and the rise in Type II. What I was surprised to learn was one of the studies show that Asians, who generally do not develop the type of belly fat we do (and which is a warning sign) are twice as likely to develop the disease as a white man of similar weight. Also many older Asians are unlikely to test their blood sugars because of a belief that blood is life essence and should not be lost..
Also they address the lack of require P.E. And the selling of high sugar snacks and drinks in schools. Think this is only a NYC problem? Think again. The expanding Asian population is spreading across this country.

Grannynurse

[earle58]

when you do some research on the web, we all know that one link leads to another and another....inevitably we find sources that we weren't looking for in the 1st place.
when i was in nsg school, some diseases we would cover in a week.
when we learned about diabetes, we studied it for 2 semesters!

anyway, a few interesting links....

www.diabetes.org/home.jsp

www.niddk.nih.gov/

http://www.docguide.com/news/content...s?OpenDocument

leslie

[fergus51]

Originally Posted by grannynurse FNP student

And what about those of us, that for a variety of reasons, including our own innate weakness, are not able to ever adjust our taste buds? Are we just weak and totally lacking in self-restraint and responsibility? Are you not assuming that just because you are able to do so, everyone should be able to do so as well? I realize that I started this discussion as a means of learning what my peers thought of diabetics, their problems with their disease, of suggestions on how to deal with a variety of problems I and others face daily. What has transpired it not exactly what I expected. I expected some to hold all diabetic responsible for their own control of their disease and was not disappointed. I expected to read some worth while suggestions, something that I have generally been disappointed in. And some of my peers, who suffer the same challenges that I do and I thank them for their responses. One of my peers has taken the challenge of educating her own peers and patients. I applaud her and am encouraged and encourage her. How about instead of applauding yourselves on your backs, you offer us some realistic suggestions on how to deal with our diet and exercise problems. I posted that request last evening and am still waiting for a response.

Grannynurse

Wow, I don't think your response really is in line with what I was saying at all. Am I saying all those who don't do what I do are weak? No. Do I expect all people to live perfectly? No, I certainly don't live perfectly. I'm just sharing what worked for me. I shared that because I never thought I could give up my regular Coke vice but managed to do it. So maybe some people who think they could never change their habits can see that they may be able to do that too (if it's something that they want to do).

As to suggestions for living well, I didn't add much because I think most of us know what we have to do. It's the doing that's so hard. I've struggled with weight for a long time and what finally worked for me was structure and changing my environment. I would only buy diet soda and healthy snacks and not bring any change with me to work so that I couldn't buy regular coke or candy bars from the vending machines. I also told some of my friends of my plan to stop drinking coke and eating so much junk food so that if I was ever tempted, the knowledge that they would be on my back served as a little extra incentive. I don't even really miss any of it often. I'll have a candy bar here and there, but not every single night. There are a lot of good snacks out there that aren't bad for you (I especially like yogurt, fruit cups, trail mix and jello) and I found a lot of drinks out there other than soda aren't bad either. I still don't drink much water at all, so that's something I may work on next. That or increasing the amount of calcium I get... As for exercise, I think the old suggestion of just doing what you can is the best advice. A lot of people have health challenges that severely limit their activity and I wouldn't expect any of them to run a marathon. My grandpa certainly wasn't going to do that on his one good leg, but he was good about lifting light weights while watching the television. It was a small thing, but any small thing is good IMO.

And you know what? I am gonna give myself a pat on the back for changing one little thing that was important TO ME. Why shouldn't I feel good about accomplishing one little goal that will improve my health? Rather than chastise me, I would think you would be happy for me. Here's my happy dance:

[grannynurse FNP student]

Originally Posted by earle58

when you do some research on the web, we all know that one link leads to another and another....inevitably we find sources that we weren't looking for in the 1st place.
when i was in nsg school, some diseases we would cover in a week.
when we learned about diabetes, we studied it for 2 semesters!

anyway, a few interesting links....

www.diabetes.org/home.jsp

www.niddk.nih.gov/

http://www.docguide.com/news/content...s?OpenDocument

leslie

Thanks

Grannynurse

[grannynurse FNP student]

Originally Posted by fergus51

Wow, I don't think your response really is in line with what I was saying at all. Am I saying all those who don't do what I do are weak? No. Do I expect all people to live perfectly? No, I certainly don't live perfectly. I'm just sharing what worked for me. I shared that because I never thought I could give up my regular Coke vice but managed to do it. So maybe some people who think they could never change their habits can see that they may be able to do that too (if it's something that they want to do).

As to suggestions for living well, I didn't add much because I think most of us know what we have to do. It's the doing that's so hard. I've struggled with weight for a long time and what finally worked for me was structure and changing my environment. I would only buy diet soda and healthy snacks and not bring any change with me to work so that I couldn't buy regular coke or candy bars from the vending machines. I also told some of my friends of my plan to stop drinking coke and eating so much junk food so that if I was ever tempted, the knowledge that they would be on my back served as a little extra incentive. I don't even really miss any of it often. I'll have a candy bar here and there, but not every single night. There are a lot of good snacks out there that aren't bad for you (I especially like yogurt, fruit cups, trail mix and jello) and I found a lot of drinks out there other than soda aren't bad either. I still don't drink much water at all, so that's something I may work on next. That or increasing the amount of calcium I get... As for exercise, I think the old suggestion of just doing what you can is the best advice. A lot of people have health challenges that severely limit their activity and I wouldn't expect any of them to run a marathon. My grandpa certainly wasn't going to do that on his one good leg, but he was good about lifting light weights while watching the television. It was a small thing, but any small thing is good IMO.

And you know what? I am gonna give myself a pat on the back for changing one little thing that was important TO ME. Why shouldn't I feel good about accomplishing one little goal that will improve my health? Rather than chastise me, I would think you would be happy for me. Here's my happy dance:

I would applaud you, if you didn't consistently hawk what you have accomplished. Great, your friends supported your effort. I have my family. Their support consist of reminding me of the amount of soda I drink a week. My SIL is a good cook but he tends to use starches, gravies and sauces in almost all of our evening meals. I restrict my meal size but it still adds the pounds on. What do you suggest I do? I can't tell him what to cook. For one thing he wouldn't listen. I am somewhat successful in cutting down my soda, from 7 2 liter bottles a week to three. Want to pat me on the back? And your exercise suggestion, using your grandpa. I applaud him. But your suggestion doesn't help me or others much. Did any one actually take the time to read my physical limitations. Ever stop and think about why those with physical disabilities have trouble controlling their weight? For everyone who is successful, there are nine with problems. Guess they lack the self responsibility and motivation. I would really like some real suggestions on how to improve my activity level, taking into consideration my physical limitations and problems Or perhaps I should just do the happy dance

Grannynurse

[fergus51]

Originally Posted by grannynurse FNP student

I would applaud you, if you didn't consistently hawk what you have accomplished. Great, your friends supported your effort. I have my family. Their support consist of reminding me of the amount of soda I drink a week. My SIL is a good cook but he tends to use starches, gravies and sauces in almost all of our evening meals. I restrict my meal size but it still adds the pounds on. What do you suggest I do? I can't tell him what to cook. For one thing he wouldn't listen. I am somewhat successful in cutting down my soda, from 7 2 liter bottles a week to three. Want to pat me on the back? And your exercise suggestion, using your grandpa. I applaud him. But your suggestion doesn't help me or others much. Did any one actually take the time to read my physical limitations. Ever stop and think about why those with physical disabilities have trouble controlling their weight? For everyone who is successful, there are nine with problems. Guess they lack the self responsibility and motivation. I would really like some real suggestions on how to improve my activity level, taking into consideration my physical limitations and problems Or perhaps I should just do the happy dance

Grannynurse

I didn't realize replying to a thread was constantly hawking my accomplishments. I have a long way to go as far as living healthy goes, but I guess my ego is just too big. Sorry about bothering you with it, I won't post again on this thread after this one.

The difference between the two of us is yes, I would applaud you for cutting down on soda intake because that's an accomplishment. Cutting out half of your soda intake is a big deal and not easy to do.

Well from what you say, I guess there is nothing more you can do to improve your health since you can't change your diet or incorporate any more physical activity. Sorry I couldn't give you great suggestions for healthier living. Maybe since you know yourself better than anyone else possibly could, the answers will have to come from you and not some strangers on a bb.

[mandana]

Originally Posted by grannynurse FNP student

I am an RN. I am certainly well educated,holding an MS. While I am generally complient, there are times when I am weak and noncomplient. Does that mean that I should be written off? Should I be written off because I drink several regular sodas a week? Or should I be offered some more support in terms of a peer group? Should I and others like me, be offered more education? Should a nutritionist and educator sit down with me, after I've keep a food diary for several weeks, go over my mistakes, help me choose food that I like and fit into my diet plan? How should I increase my physical activity? I have a partial herniated L4-5 disc on the left side. I suffer from SOB because of the weather changes. I can't walk more then 50 to 75 feet. I can't stand for more then a few minutes. I am open to any suggestions. Please bear in mind that I cannot afford to join a gym, not even the Y. I have very limited resources to invest in equipment. Diabetes, care, education, compliance is not as simple as some appear to believe it is. And it certainly isn't entirely a matter of self responsibility.

Yesterday I typed a huge, long response to this thread, went to submit and it went "poof". DM is very important to me for personal reasons. I watched someone I loved much die far too early from complications. I'm only a nursing student at the moment, but becoming a diabetic educator is something that I'm considering.

In brief, I will tell you that in my area, there are tons, tons, tons of available resources. We take every possible opportunity to educate diabetics once hospitalized with specialized nurse educators and nutritional consults. I personally beleive that every dollar spent on the front-end of education will pay tenfold if we can prevent complications and help people live longer, better.

But ultimately, grannynurse, it DOES come down to personal responsibility. I'm not begrudging anyone with DM any bit of education they want, and heck, I'll give it to them. But, and I say this gently and with respect, there are always excuses. As a school project, I held a seminar (free, of course) on living with DM. I chose a community center where I knew the membership included many people with DM. I advertised this seminar at the community center where it was to be held for one month. I made sure it was at a convenient time to maximize attendance. I gave contact information for people to contact me for more information/help with transportation/questions before hand. Wanna know how many people showed up?!?! ONE. And, she wasn't a diabetic - her husband was and she just wanted to support him. He didn't want to come.

You can't force people to take care of themselves. I would educate them forcefully - let them see what a diabetic foot ulcer looks like, make sure they know that they may go blind, or suffer kidney failure, or become dependent on dialysis. I'd take them to a dialysis clinic and make sure they knew how tortorous getting dialysis 3 times a week really is. But if they aren't coming to me, I simply cannot help them.

Should they all be managed by endocrinologists? Yes. Should their testing supplies be inexpensive, or even better, free? Absolutely. But, I can't even attempt to arrange that if they aren't coming in in the first place. I have noticed that newly graduating docs are keeping glucose under MUCH tighter control than those that have been around a bit longer. That's positive in my book. It's a start.

Now, this has all been very general, but as for you: You can't walk very far I understand. So, start with what you CAN do. Walk 50 feet three times a week. Then, make your goal 75 feet. It won't take long and your endurance will increase. Just be sure to examine your feet every night!

As for food, you know what to eat and what not to eat. You have to have your coke, go ahead and have it, but cover it. And make it a treat. Look forward to it at the end of a long day. The person cooking for you makes lots of gravies, sauces and what-not - that's really simple - SKIP IT. Eat the pot roast, just don't smother it. Restrict portions. You know all this, you just have to DO it.

Look, I'm not trying to be harsh here, but its the truth. There will always be excuses for why things aren't managed but in the long run, it's a simple decision. It's a choice. And to watch someone you love very much be unwilling to make the choice to LIVE and choose to DIE - well, it's almost too much to bear.

Amanda

[grannynurse FNP student]

Originally Posted by mandana

Yesterday I typed a huge, long response to this thread, went to submit and it went "poof". DM is very important to me for personal reasons. I watched someone I loved much die far too early from complications. I'm only a nursing student at the moment, but becoming a diabetic educator is something that I'm considering.

In brief, I will tell you that in my area, there are tons, tons, tons of available resources. We take every possible opportunity to educate diabetics once hospitalized with specialized nurse educators and nutritional consults. I personally beleive that every dollar spent on the front-end of education will pay tenfold if we can prevent complications and help people live longer, better.

But ultimately, grannynurse, it DOES come down to personal responsibility. I'm not begrudging anyone with DM any bit of education they want, and heck, I'll give it to them. But, and I say this gently and with respect, there are always excuses. As a school project, I held a seminar (free, of course) on living with DM. I chose a community center where I knew the membership included many people with DM. I advertised this seminar at the community center where it was to be held for one month. I made sure it was at a convenient time to maximize attendance. I gave contact information for people to contact me for more information/help with transportation/questions before hand. Wanna know how many people showed up?!?! ONE. And, she wasn't a diabetic - her husband was and she just wanted to support him. He didn't want to come.

You can't force people to take care of themselves. I would educate them forcefully - let them see what a diabetic foot ulcer looks like, make sure they know that they may go blind, or suffer kidney failure, or become dependent on dialysis. I'd take them to a dialysis clinic and make sure they knew how tortorous getting dialysis 3 times a week really is. But if they aren't coming to me, I simply cannot help them.

Should they all be managed by endocrinologists? Yes. Should their testing supplies be inexpensive, or even better, free? Absolutely. But, I can't even attempt to arrange that if they aren't coming in in the first place. I have noticed that newly graduating docs are keeping glucose under MUCH tighter control than those that have been around a bit longer. That's positive in my book. It's a start.

Now, this has all been very general, but as for you: You can't walk very far I understand. So, start with what you CAN do. Walk 50 feet three times a week. Then, make your goal 75 feet. It won't take long and your endurance will increase. Just be sure to examine your feet every night!

As for food, you know what to eat and what not to eat. You have to have your coke, go ahead and have it, but cover it. And make it a treat. Look forward to it at the end of a long day. The person cooking for you makes lots of gravies, sauces and what-not - that's really simple - SKIP IT. Eat the pot roast, just don't smother it. Restrict portions. You know all this, you just have to DO it.

Look, I'm not trying to be harsh here, but its the truth. There will always be excuses for why things aren't managed but in the long run, it's a simple decision. It's a choice. And to watch someone you love very much be unwilling to make the choice to LIVE and choose to DIE - well, it's almost too much to bear.

Amanda

Amanda, I do appreciate what you have said. Yes, I basically know what I can and can not eat but I no longer have the control over my meals that I had when I lived by myself. Pot roast, I wish. Here is what my SIL made this week. Meat sauce and noodles, meatballs, creamy white sauce and noddles, quesida(?) chicken, hamburger, mixed vegetables, mashed potatoes and cheese as a pie. I tried cutting down the size of my portions to the barest minimum and have gone to bed hungry every night. I don't know how long I can stick to this. I am going to explore changing my diet even more with the special assistant Medicare has promised. I offered to cook but my grandchildren would not eat what I cook.

Walk fifty feet. It causes me severe pain to walk walk thirty feet to the carport. I am not trying to excuse my lack of exercise, just trying to find a realistic way to to increase my activity without increasing my pain. And also without causing me to wheeze.

And it is not a simple decision. It is a decision that is influence by my own likes and dislikes; my families likes and dislikes; funds; other chronic health problems, to name a few. And I and other diabetics are aware of the possible complications we can face and how our own decisions impact on them. And a lot of us push them beyond our horizons. We tell ourselves that it will not happen to us.

And a word of advice, one based on personal experience and that of other diabetics, don't be too forceful; don't make it a do it or else you will suffer, we will just nod our heads and tune you out. Sorry but that is just the truth. Believe it or not, we are adults and while we sometimes make wrong choices, we are not children. But thanks again.

Grannynurse

[TheCommuter]

As I had mentioned last night, my family history is quite 'sugary'. A disproportionate number of my relatives, first-degree and extended, are diabetics.

Honestly, it all comes down to personal responsibility. The healthcare team possesses the responsibility of educating the diabetic about his condition and treatment, and the diabetic possesses the ultimate responsibility of making the lifestyle changes that are necessary to prolong life expectancy and prevent the hellish complications.

My diabetic family members are fully aware that they should visit the podiatrist once yearly for a microfilament foot test for sensation, but they refuse to go. They know they shouldn't perform 'bathroom surgeries' on their feet, but they continue to use razor blades and sandpaper to reduce the calluses, corns and bunions. They know they should visit the eye doctor regularly for exams, but they insist on going once every 5 years when blurriness is no longer being corrected with their old glasses.

The family members know that exercise will help their bodies utilize the excess blood glucose, but they refuse to make that lifestyle change (even though they are all able to exercise). My parents, both diabetics, continue to smoke a pack of cigarettes daily, though they fully know that smoking and diabetes equals an early death sentence. My father, a type 1 diabetic, continues to drink a 6-pack of beer daily, though he knows the alcohol is reducing his liver and kidney function slowly.

[bsugaRN2b]

Ditto to everything said in the post below.

I have diabetes myself (Type 1, 15 years come March '06), and I think I'm coming from a slightly different point of view than others here, as I'm 20 y/o, but any way you look at it, a lot of the factors are the same. I ultimately agree, it does come down to personal responsibility in the end. I was really lucky, and I KNOW I was lucky - I was diagnosed at 5 years old, so I had people helping me out from the beginning, not to mention that the two diabetes teams I went to are definitely one of the best ones in the state (Atlanta, GA) - and it scares the heck out of me that some PCPs only spend 10 minutes w/their patients - shows what I could be taking for granted when I get a minimum of 50 minutes with a CDE.

Also said in the quote - the whole "excuses" thing - agreed, granted, there are some that are easier to fix than others. Everybody's going to mess up with the food every now and again, I'd be lying if I said I hadn't, lol! The thing with the food/weight/etc. is that an endo/PCP can tell you all of this, but you just have to do it - in my case, it was checking blood sugars more than 4x/day (I'm on an insulin pump - my baby ), and I've had my bad points (not testing for 1.5 months, gotta love that denial), but I finally listened, so I'm ok there, but I have my bad days, and that's ok - I move on and say I'll do better tomorrow.

On the other hand, the supplies...again, got lucky - basic supplies are expensive enough, insulin pump supplies in themselves are incredibly expensive, and they also double what you need in basic supplies. Example: if I didn't have insurance, an insulin pump w/3 months of supplies for me would be roughly $9,000, and roughly $2,000 every three months after initial purchase...so basically, it's an expensive disease, and this is one of the main reasons people can't take care of themselves, b/c they can't afford the treatment, let alone top of the line treatment, and yes, that's upsetting to me. And like someone mentioned before, there's no way there is this much money in a cure.

Exercise-wise, can't say too much on this - I do have bad knees, and I eventually found swimming/water aerobics to be my forte, amazingly, as I was always a not-so-good swimmer, but I was forced to learn by the PE requirement at school, and was stunned at the results, so it stuck - it's anti-gravity, so to speak, so the knees don't mind it - that's my on that. And I definitely understand the medicine/blood sugar thing, granted I have the opposite problem - winter for me is always a rollercoaster of sorts b/c Sudafed is equivalent to insulin to my system - can be sitting on the sofa doing absolutely nothing, glucose 360, 2 hours after taking a Sudafed, 50 mg/dl - guess that's diabetic life for us!

So, yeah, personal responsibility is what I think it ultimately comes down to, and from personal experience, it's not easy, quite frankly, it's far from! And even if you have the best of the best of diabetes educators, the only person that can put what they are saying into effect is the patient. (One of my pet peeves, diabetes educators that think they are GOD and can change everything about you...won't happen, only person that can change a person is themselves, hence why we diabetics can tune the ultra-forceful CDE out!) But you don't have to be Superman/Wonderwoman while doing it - baby steps are the key, just start little, they can and will get you somewhere, trust me, I've been there!

~Adria (Hopefully RN in 2008, CDE in 2010)

Originally Posted by mandana

Yesterday I typed a huge, long response to this thread, went to submit and it went "poof". DM is very important to me for personal reasons. I watched someone I loved much die far too early from complications. I'm only a nursing student at the moment, but becoming a diabetic educator is something that I'm considering.

In brief, I will tell you that in my area, there are tons, tons, tons of available resources. We take every possible opportunity to educate diabetics once hospitalized with specialized nurse educators and nutritional consults. I personally beleive that every dollar spent on the front-end of education will pay tenfold if we can prevent complications and help people live longer, better.

But ultimately, grannynurse, it DOES come down to personal responsibility. I'm not begrudging anyone with DM any bit of education they want, and heck, I'll give it to them. But, and I say this gently and with respect, there are always excuses. As a school project, I held a seminar (free, of course) on living with DM. I chose a community center where I knew the membership included many people with DM. I advertised this seminar at the community center where it was to be held for one month. I made sure it was at a convenient time to maximize attendance. I gave contact information for people to contact me for more information/help with transportation/questions before hand. Wanna know how many people showed up?!?! ONE. And, she wasn't a diabetic - her husband was and she just wanted to support him. He didn't want to come.

You can't force people to take care of themselves. I would educate them forcefully - let them see what a diabetic foot ulcer looks like, make sure they know that they may go blind, or suffer kidney failure, or become dependent on dialysis. I'd take them to a dialysis clinic and make sure they knew how tortorous getting dialysis 3 times a week really is. But if they aren't coming to me, I simply cannot help them.

Should they all be managed by endocrinologists? Yes. Should their testing supplies be inexpensive, or even better, free? Absolutely. But, I can't even attempt to arrange that if they aren't coming in in the first place. I have noticed that newly graduating docs are keeping glucose under MUCH tighter control than those that have been around a bit longer. That's positive in my book. It's a start.

Now, this has all been very general, but as for you: You can't walk very far I understand. So, start with what you CAN do. Walk 50 feet three times a week. Then, make your goal 75 feet. It won't take long and your endurance will increase. Just be sure to examine your feet every night!

As for food, you know what to eat and what not to eat. You have to have your coke, go ahead and have it, but cover it. And make it a treat. Look forward to it at the end of a long day. The person cooking for you makes lots of gravies, sauces and what-not - that's really simple - SKIP IT. Eat the pot roast, just don't smother it. Restrict portions. You know all this, you just have to DO it.

Look, I'm not trying to be harsh here, but its the truth. There will always be excuses for why things aren't managed but in the long run, it's a simple decision. It's a choice. And to watch someone you love very much be unwilling to make the choice to LIVE and choose to DIE - well, it's almost too much to bear.

Amanda