What can people new to diabetes eat?

After receiving the diagnosis of diabetes, many people are in a panic. What will they be able to eat? What will they be able to do to manage the diabetes? For most, it is fairly straight forward, they must reduce the quantity of food they are consuming and increase the quality of the food they eat. And I mean quantity replaced by quality.

Many suggest using a 8.5 or 9 inch plate instead of a 10 to 12 inch plate. And for many this is a good idea. Just don't overload the smaller plate as that will defeat the purpose. Decreasing the serving size is another idea that deserves much consideration.

To get you started, consider reading this from fellow blogger Alan Shanley. If you have not received your meter and testing strips he lays out some excellent ideas and advice to get you started. Then consider reading his blog titled “I'm Type 2, What Should I Eat?”.

The following site is for your reading, but read with a jaundiced eye. The article is very correct in the first paragraph when they say that what is good for the person with diabetes is good for all family members. They are also correct in saying that the amount of carbohydrates must be limited for the person with diabetes.

At least the author included exercise, but after the recommendation of healthy foods. The advice of meeting with a dietitian should be a dietitian specializing in diabetes. This cannot be emphasized enough and the nutritional value is important for a balanced meal. Leave the medications and testing training for the Certified Diabetes Educator, but do not use them for nutritional planning.

Now if you haven't read the blogs by Alan, please take the time to do this. The article of four pages by WebMD is in general fair and does have some excellent advice, but when it comes to whole grains they may have missed the point. See my blog here.

Listen to the dietitian because the number of carbohydrates and the glycemic index of foods is important in managing diabetes. While the glycemic index is important, it should be used as a guide and not an end-all as some are prone to recommend.

The first paragraph on page three is excellent and more people need to be aware of this. While I tend to eat under a 120 carbs total per day, some must go lower while some people can tolerate more. That is why each person must find what their body can tolerate by testing after eating. Testing suggestions post meal range from one hour to two hours and sometimes longer depending on the amount of fat in the foods ate.

The advice for fat on page three holds true for some, but not all people. A lot will depend on heart risks and therefore consultations between the doctor and dietitian must take place before amount to fat can be determined. Sodium intake which is not mentioned, also must be determined.

The last idea for this is the discussion of artificial sweeteners. Take time to read this as in general this is good advice.

Peer to Peer Diabetes Help More Advantageous

I am happy. This is now the second article about peer to peer assistance taking place under university direction and doing better than those trained to do this. What does that tell us? Apparently there is a need for more peer workers, although it appears that this is on a volunteer basis, there is a need that the trained professional are not meeting. This is what I wrote about the first one I found. The same study is covered here by another Type 2 blogger, Elizabeth Woolley.

This involved a group of veterans and the University of Michigan Medical School. The Veterans Affairs Ann Arbor Health System established the peer partnership group and the study was based on this group. Each peer pair received initial training in peer communication skills. Communicating by telephone at least once a week was expected between the peer pair.

This was a learn by doing example for reinforcing what they were learning. Michele Heisler M.D., the study lead author and research scientist for the Center for Clinical Management Research at the Ann Arbor plus other credentials stated “We are trying to tap into the under-appreciated expertise of patients.” Good for her!

Using 244 VA patients with unmanaged diabetes that were randomly assigned to peer support or traditional nurse care management, the study concluded that peer to peer assistance led to a greater A1c improvement. While we are not informed about the before average of either group, the level of improvement was 0.58 percentage points lower in the peer support when compared to the nurse care management group.

There was overall better results in the peer group and a feeling of success not expressed by the other group. This again points to the need for more efforts to involve patients with diabetes to be allowed to assist new patients and existing patients and shows the need to remove the over trained people and let them function in other areas where that are shortages of trained professionals.

One of the doctors in talking about the study apparently did not like peer to peer or “Johnny-do-gooder” as he called them. He seems to have forgotten who is paying him and was doing his best to downplay the results. Read his comments here in the latter part of the article. (link is broken)

I would encourage finding a way to compensate patients that are doing this, but that will need to be worked out with doctors and the insurance companies. And this may be difficult in view of the attitude of the above doctor and others like him.

Role for Salsalate?

A medication that has been available for quite a few years, salsalate is getting another look for diabetes and reducing the risk of diabetes. But before getting too interested, learn about the side effects and problems associated with salsalate. I have to wonder what is driving these people to promote a drug as dangerous as this drug for diabetes.

It is being used with some success for severe rheumatoid arthritis, osteoarthritis, and other conditions causing swelling. While it is a non-steroidal, anti-inflammatory medication it is not a medication to be taken lightly. The largest concern is its interaction with many of the medications that those at risk for diabetes, especially the young and young adults.

Please read the following article carefully. Read the following section very carefully titled “What special precautions should I follow?”, and the “Important Warning” section at the start. This medication may interfere with certain lab tests possibly causing false test results like thyroid hormone levels.

So I would warn you to carefully read the two articles I have linked to above. I cannot emphasize enough how important it is to tell your doctor, pharmacist, and anyone preforming any surgical procedure what and all medications, supplements, and herbal remedies you are taking. Especially if salsalate is even mentioned for prescription.

While the article lays out some good ideas, but apparently even a respected medical center is not above putting a spin on something for study money. They mention a study, but not any substantial facts relating to the study. Then when you follow the link at the bottom of this article – it takes you to a place to sign up for the study.

This is another case of follow the money. This also shows how easy it is to get drawn in by Popular Press Spins. Thank goodness for Gretchen Becker's Blog. And yes, I spent too much time on this one, but I did get an good education about salsalate.  I have to thank Gretchen for her blog and what it has taught me.

Placebo Composition – How Important?

Possibly this should be subtitled “How are Placebos Used?”.

This is about placebos, page down to number 2 in the article. There are several types of placebos depending on definition. The first part is about the placebos used in medical research, specifically in trails. Placebos are generally substances with no known activity against the health condition involved in the study.

What is left out of the majority of studies is the composition of the placebo used in the study. We will never know for sure if the placebo was truly a placebo. Hopefully this will be rectified in the future. The authors of a group of researchers have recommended that the journals require placebo composition and that the CONSORT (Consolidated Standards of Reporting Trails) group amend their rules to require placebo composition disclosure.

The second is about a person that does not have diabetes using a CGM (Continous Glucose Monitor), and this case it is a placebo of a different kind. The person is Larry Hausner, the CEO of the American Diabetes Association. Read this to find out why he would do this. I will give him high marks for doing this, but only for doing this.

I would call this a placebo for several reasons. First, he did not have diabetes. Second, while it was a good trial, he did learn something; however, some will view this as a publicity stunt. I am happy he did this. I will have to see what others say, and to-date everything is positive.

Diabetes and Self-Esteem

This topic is in support of George “The Ninjabetic”. After reading his post of October 18, 2010, I could not reply. Why? Because I have not had his problem. Self-esteem issues, yes in other areas, but never because of diabetes.

His blog is excellent and I have to wish him well for expressing some feelings that many others must also overcome. Go over and read his blog.

Many people with diabetes often can have problems with self-esteem because of diabetes. From the comments to his blog, this is a problem for many people with diabetes and needs to be talked about, and not just by those suffering self-esteem issues.

Even though I have not had self-esteem issues because of diabetes does not mean that I cannot understand where he is coming from. I am glad that the diabetes online community has given him so much support and has in a way helped him recognize and define this problem.

I think that developing diabetes late in life has some effect and helps many of us to avoid some problems, but there are still many problems that can overtake us. I think feeling generally good about myself helps in so many ways. But, yes, always an exception, it does not prevent depression, but could well be why I overcome it more easily.

Hold your head up high George! You've earned the right.

Before I close this I would invite you to read a delightful blog by Mike Durbin dated October 17, 2010. He is doing this for Diabetes Awareness Month and World Diabetes Day.

This is the Pill Cure Generations

I keep forgetting that the “Pill Cure” generation may involve more that one generation. As such I should not have been surprised, but still this study is a little disconcerting. The CDC (Centers for Disease Control) reports that prescription drug usage is rising in the US.

A little surprising is the four medications topping the list – statins, asthma meds, antidepressants, and stimulants. According to a study released by the CDC supposedly on September 2, over the last ten years, the percentage of Americans taking at least one prescription drug went from 44 percent to 48 percent.

Those people using two or more drugs went from 25 percent to 31 percent and people using five or more prescription drugs went from six percent to eleven percent. The study also said that 20 percent of children and 90 percent of adults of the age 60 and older reported using one prescription drug in a one month period.

It is no wonder then that the amount spent for prescription drugs doubled in cost from 1999 to 2008. This also points out why among seniors, the use of many drugs is causing harmful drug interactions.

The study also points out that women are more likely than men to use prescription drugs and that white Caucasians had the highest use of prescription drugs. The access to insurance also helped facilitate the higher use of prescription drugs.