Friday, July 29, 2011

I’m Just Not Feeling the Love


I recently read a story on NPR.org about an obese woman and her struggles to lose weight.  Apparently, she was quite thin and active up through high school but began to gain weight in her 20’s until she found herself topping out at 300 lbs.  Now she finds that, no matter what she tries, she’s unable to take the weight off. The title of the story is “One Woman's Struggle to Shed Weight, And Shame” and you can read it/listen to it yourself at: NPR story

Did you catch the word shame in the title?  She and too many other adults in this country are ashamed of how they look and have to deal with untold insults and humiliations on a day-to-day basis.  I was, in fact, appalled at the horrible, rude comments that some of the people left after the article.  I again saw a lot of, “all you have to do is….” “I don’t feel sorry for her at all.  She did this to herself.” “Obese people are nothing but a bunch of lazy, good for nothing dolts.” It left me feeling sad and frustrated.  Is there no compassion in this world?

When I was at my mom’s apartment this last weekend she was watching a show about a morbidly obese woman who weighed 800 lbs.! She was going to have gastric bypass surgery.  It was appalling and sad.  (I have NO idea why Mom watches that stuff.  Maybe it makes her feel better knowing that someone else is worse off than she is.)  This woman’s story apparently prompted other morbidly obese people to ask to be rescued from their homes so that they could get help too; rescued from their homes since the walls needed to be torn down because they no longer fit through the doorways.  The media is fond of sensationalizing these stories so it’s no wonder that many Americans are angry about the obesity problem and rise in type 2 diabetes in our country.  Not all type 2 diabetics are obese and yet when the media talks about the obesity epidemic it is quite often linked to the diabetes epidemic, ergo: diabetics are obese and therefore idiots for doing this to themselves, lazy and not worthy of compassion.

Obese is such an ugly word.  It means very fat or overweight; corpulent. Corpulent is large of body.  Portly.  Stout.  You can read and hear so much in the media these days about obesity and how it is adding to the numbers of people who are diagnosed with diabetes, type 2 but you rarely hear the more personal stories; the stories of how these people got where they are and what a struggle it is to overcome their weight issues.

What determines who is obese? The Body Mass Index, or BMI, is used to determine a healthy weight, overweight or obesity. The formula used is weight divided by height squared = BMI. A BMI over 25 is considered overweight, a BMI over 30 is considered obese. A medical diagnosis generally also takes into account factors such as age and sex. AARP has an online calculator at: BMI calculator.  This calculator doesn’t consider age, fitness or gender but it can give you a good idea of where you stand.

But these are just numbers and don’t take into consideration a person’s frame of mind or circumstances at home.  These things tell us WHAT determines that a person is obese but doesn’t touch on WHY.  Eating is such a personal thing.  Everyone has to eat to stay alive but many people eat for other reasons as well.  We’ve all heard of stress eating or comfort eating.  Eating to socialize and eating because we’re bored.  Yes, I believe that the fast food industry and other processed foods have done a lot to make our country fat but there has to be some light shed on the mental side of eating.  People who find themselves weighing 300-800 lbs. didn’t get there overnight and they certainly didn’t do this to themselves on purpose.  We aren’t paying attention to what we’re doing!! 

Now let’s talk about the differences between type 1 and type 2 diabetes.  There has recently been yet another uproar in the diabetic community about how the media sends out misleading and incorrect information about diabetes.  Too many type 1 adults and children have to deal with people who don’t understand that type 1 diabetes has nothing to do with what they eat or how healthy they are.  Type 1 diabetics didn’t “do this to themselves”.  Type 1 is an auto-immune disease.  Type 2, on the other hand, is a condition that can be brought on by inactivity and too much weight.  I can see why PWD, type 1 hate being compared with those of us with type 2.  The general public just doesn’t get it.

So here’s why I’m not feeling the love.  I am a person with diabetes, type 2.  I am not obese. I am an overweight woman who is working very hard to lose weight and exercise more so that I can control my condition.  I try very hard not to blame myself for developing this disease and yet I’m confronted on all sides by information that says that PWD, type 2 are fat and lazy.  That we did this to ourselves.  That all we have to do is eat less and move more.  That we can reverse this if we just don’t eat ice cream.  No wonder many type 2s are reluctant to divulge that they are diabetic!  I know that PWD, type 1 can empathize with type 2s.  We face many of the same struggles but we aren’t really in the same club, are we?  Sometimes I feel like type 1’s would rather that we just go away.  I know that there are many who wish there were different names for our disease types so they can stop being compared to us.  I get it, I do.  The media vilifies us and type 1’s want some space…..I’m just not feeling the love.

Tuesday, July 26, 2011

Exercise Your Right…..and Your Left


I don’t think that we’re lazy.  We all know someone who we could call lazy but the majority of us aren’t.  Lazy – adj.  not inclined to work or exertion. Ok, so maybe I’m lazy on occasion but not regularly.  I think the word lazy is way over-used.  Our society has made it sooooo easy to be “lazy”.  Is it being lazy when we turn up the furnace instead of throwing another log on the fire?  Is it being lazy when we open the fridge to find something to eat instead of chasing the poor hen around the yard with a hatchet so she can join us for dinner?  Back in the day we, as a people, had to work so much harder just to survive.  If we didn’t bust butt on a daily basis we might die.  Our ancestors were hard-working people (other than that darn, lazy Uncle Wilbur) so they didn’t need to include an exercise routine in their lives in order to be healthy.  Many of us, on the other hand, make our living sitting at a desk.  We leave our desk, get in our car to drive home, sit down to dinner and then plop ourselves in front of the tv for the evening. If we don’t throw exercising into our routine we’re doomed.

My dear friend Sally sent me a copy of a newsletter that she received with a cover story titled Decoding Diabetes. The newsletter is called Nutrition Action Health Letter and is put out by the Center for Science in the Public Interest. This edition of the newsletter focuses on diabetes; what causes it, what happens in your body in regards to fat, insulin and what you eat, how to avoid it as well as a great article on aging and exercise.  I wish I could photo-copy it and send it out to everyone I know.

Sally told me that the last article, on aging and exercise, really opened her eyes and caused her to take notice.  Sally is a nurse so she obviously knows quite a bit about the human body and how it works yet even she wasn’t tuned in to why it’s important to move as we get older.  I’m sure she knew all of this but she wasn’t paying close attention.  (Sally is a very intelligent woman.)  It’s really a great article that explains, in a simple way, how aging can increase your risk of developing diabetes.  “Overeating isn’t the only cause of diabetes. Aging also increases the risk, even if you’re lean.  But you can counter some of the consequences of aging with strength training and aerobic exercise.”

As we age our muscle mass declines.  “Less muscle may raise the risk of diabetes because muscle is where the body sends most of its blood sugar (glucose) to be burned or stored.”  Less muscle = fewer places where our bodies can burn up the sugar in our system.  Makes sense.

We get fatter as we age (dammit). “As you age, you not only lose muscle, you also gain fat, especially the deep visceral fat that is linked to diabetes.”  Visceral fat is the fat found in the abdomen and surrounds the internal organs.

What can we do?  The article recommends incorporating both aerobic and resistance training exercise into our routine.  Aerobic exercise may be more helpful for weight loss but it doesn’t build muscle.  Strength/resistance training is all about muscle so it’s easy to see why both are important.  Here is what the article recommends:
  •  Strength training – “Shoot for 8 to 12 repetitions of 8 to 10 exercises at moderate intensity two to three times a week.”  Take a day off between days of strength training because you’re actually damaging the muscle and it needs time to repair itself.  Self-maiming at its finest. 
  •  Aerobic exercise – at least 30 minutes of brisk walking or other aerobic exercise at least five days a week.
Phew!  I’m tired just thinking about all this exercise!  How will I ever fit it into my schedule?  It’s daunting, isn’t it?  The article ends by saying that “What helps the most is being active all day long.  Get up and walk around.  Get a treadmill in your office.  Don’t sit at the computer all day.” That’s encouraging.

I’m a huge advocate of starting out slowly.  It isn’t necessary to run right out and join a gym or spend $$$ on fancy exercise equipment.  We also don’t have to immediately begin exercising at these levels.  The important thing is to start.  If you aren’t regularly exercising then begin by walking around the block 3 times a week.  Work up to going farther and farther each week until you’re walking at least 30 minutes.  Not into strength training? Find one exercise you can do without putting yourself into traction and do 10 reps 3 times a week.  (Search the internet for exercises.  There are plenty of articles that will give you routines to try.)  We’re talking maybe 10 minutes here.  You can spend 10 minutes to improve your health, can’t you?  Each week add another exercise or 2 until you’re doing the recommended 8-10 exercises.  Another cool tip I read somewhere is to do your reps “backwards”.  In other words, count DOWN instead of up.  Do 10 reps, rest for 10 seconds, do 9 reps, rest, do 8 reps etc. until all you have to do is 1!

It’s so important that we do this.  I’m doing so much better at exercising regularly but I’m not so good at the strength training part.  I hope that writing this post will encourage me to start.  I can spend 10 minutes to improve my health, can you?

Saturday, July 23, 2011

How to Succeed at Camping with D without Really Trying - Or - Why I Sleep With My Meter

Ray and I just got home from a 3 night camping trip.  We are lucky that we only have to drive about 10 minutes from home to find ourselves surrounded by a national forest.  We enjoy dispersed camping which means we camp in the “middle of no-where” without facilities (we don’t much like campgrounds).  It was a great trip; the weather was perfect and only 1 ATV drove by our camp.

You might think that camping with diabetes would be tricky but I’ve found that, with some careful planning, it’s quite easy!  (If I was using injectables it would be a different story, ie: keeping the meds cold etc, but I thankfully don’t have to deal with that as yet.)  The thing about camping is that you can only eat what you bring with you.  You can’t decide you want a burger and drive through for fast food.  Ice cream isn’t an issue since you don’t have a freezer handy. If you’re someone who is tempted by things you maybe shouldn’t eat (like me) then just don’t bring them along!

We eat well when we camp.  Check out these tasty chicken breasts that Ray cooked up for one of our dinners.  (I only eat ½)


Yummy huh? Breakfast was either cereal with almond milk or an egg scramble that I whipped up: egg substitute, bell peppers, onion, vegetarian breakfast sausage crumbles, some potato (cuz I love em) and a sprinkling of shredded cheese.  This makes great burritos or you can just eat it in a bowl. Lunch is easy too since sandwiches can be made anywhere, bag salads or munch on crackers/veggies with hummus or spinach dip.

Dos and Don’ts:

DO bring along something to snack on.  I find that when I feel deprived, I overeat.  Overeating anything is bad (well maybe not celery but who wants to overeat on celery?)  I had some nuts on hand to munch and the aforementioned crackers/veggies/hummus. It was nice to know that I could have a tasty snack if I felt like it.

DON’T bring along chocolate.  There are two reasons for this.  First, it’s too easy to eat too much and second, it melts. :-)

DO set an alarm on your cell phone so you remember to take your meds in the evening.

DON’T eat the crackers straight out of the box.  <insert sheepish grin here>  Portion control is just as important when you’re in the woods as when you’re in your recliner.

DO get off your butt and MOVE!  What better place to get some exercise than in the woods?  Ray and I, I’m proud to say, took a walk each day we were there.  We walked at least an hour with one walk ending up being nearly 2 hours. (I didn’t say we got lost!  We did not!!  Really!  We actually didn’t get lost but we did spend some time exploring an old homestead looking for bits of history etc and taking pictures.  Fun times.)

DO protect your meter from extreme temperatures.  This is why I sleep with my meter.  It may be hot during the day or get rather chilly at night.  Temps in the woods can be more extreme than at home.  I discovered years ago that my poor meter suffered from the cold overnight so I started sleeping with it.  I just pop the little bag beside me and go to sleep.  I don’t have to worry about it getting too cold and it doesn’t bother me a bit.  During the day you should be sure to stow it somewhere cool so it doesn’t overheat.

This camping trip was a blessing.  I was so relaxed; I ate sensibly (and well); I read; I watched the stars from around our campfire; I exercised; I slept very well.  All this added up to some GREAT numbers.  Just look! 


It was the perfect storm: great weather, great food, relaxation and great numbers.  Camping with D is a breeze.  I highly recommend it.

Monday, July 11, 2011

Go-to Foods


As PWD who are not using insulin, we have all experienced those times when our blood sugar is higher than it should be.  It’s really a pain if we are hungry when that happens.  It sucks to not be able to eat because our sugars are high. It occurred to me that I have some go-to foods that I eat when my sugars are higher than they should be.  I think it’s a good idea to have a list of foods that you can eat that don’t spike your sugars so that you’re ready for those times.  If we’re not prepared it’s too easy to eat something we shouldn’t, right?  So here’s my list of go-to foods.  Remember, that not all diabetics are created equally.  What works for me may not work for you, and vice-versa.  It’s important to test how certain foods affect your blood sugar.  Never assume!

Breakfast:

Oatmeal – I was surprised to discover that oatmeal doesn’t spike my sugar!  I was also surprised to find out that oatmeal doesn’t really stick to my ribs.  I tend to get hungry too soon after eating it but I’ve been able to adjust.  I use quick oats and add raisins, cinnamon and a sprinkling of Splenda.  Yum!  Try to avoid the instant oatmeal as it adds “stuff” you don’t need.

Veggie scramble w/rye toast – when I have more time I like to cook up an egg scramble.  There are many variations on this theme but the basics are: sauté veggies, add egg substitute, sprinkle with some cheese and salsa.  My preferred veggies are sweet peppers, onion and mushrooms. I substitute frozen stir fry veggies I’m not well stocked with fresh veggies.  I use egg substitute and save my “real eggs” for egg sandwiches.  Other addition options include ham or sausage substitute, ie: frozen veggie “tastes somewhat like sausage” crumbles.  If I want/need some carbs I have 1 slice of rye toast.  I found that Oroweat Jewish Rye has only 13 g of carbs per slice.  It’s not whole grain but I like it and it’s not carb heavy.

Lunch:

Tuna or chicken salad sandwich on rye – pretty basic and easy.  I use fat free mayo or canola mayo.  Add tomato and lettuce or other veggies.

Veggie burger on skinny bun – I like veggie burgers.  I heat them up in the microwave and use “skinny buns”.  I guess the actual name is sandwich thins but I like my name better.  Maybe if I eat enough of them I’ll get some of my own.  Add tomato and lettuce or veggies of your choice.  Again, I use the fat free or canola mayo.  Mustard is “free” but don’t use catsup!!  I also add pickle slices.  I love pickles.

Dinner:

Tilapia – there are many ways to cook tilapia.  I like it because it’s quick and yummy.  If you watch your side dishes this can be a very low-carb dinner.  I’ve been eating a LOT of cauliflower as a side in place of potatoes or rice.  I buy the frozen fillets and broil them with a parmesan topping.  15 minutes from start to finish.

Asian stir fry with fat free ginger sauce – a meal with lots of veggies is very filling without spiking your sugar.  I found a fat free ginger stir fry sauce that we love.  Fresh veggies: snow pea pods, mushrooms, sweet peppers and onions are the best, imho.  When in a hurry I use canned chicken (98% fat free) but you can use fresh as well.

Snacks:

Yogurt – yum.  I need to try freezing it for a cold dessert.

Sugar free pudding or Jello – make your own instead of buying the pre-made.  It’s easy and more cost effective. 

Sugar free See’s candy – I bought a box at Walmart and kept it in the fridge.  I simply adore creams.  I was worried that I would over-eat but I’m content with just one now and then.  Maybe my eating habits really are changing!

Cut-up veggies – it doesn’t hurt to have some veggies cut up and ready to eat in the fridge.  I’m not very good at doing this but I need to.  I love bell peppers and if they were already to eat they would make a quick and yummy snack.  Add some hummus.  Yum!

Trail mix – I found a trail mix that is only 14 carbs per ¼ cup.  I have some small snack size containers that hold exacly ¼ cup so I don’t have to measure.  I think they’re made by Rubbermaid.  Just fill up the container and that’s all I get!  I use these same containers when I make my pudding or Jello.  Perfect portion control.

So there you have it.  I go to these foods when I need to eat something that won’t spike my sugar. 

What are your go-to foods?

Friday, July 1, 2011

Extremes


My son recently found an article online regarding a study of Type 2 Diabetes and how an extremely low calorie diet reversed the disease in 7 out of 11 people who participated in the study.  The study was conducted by scientists at Newcastle University in England. The study was small (only 11 people participated) but they are calling the results “remarkable”.

“The research, presented today at the American Diabetes Association conference, shows that an extremely low-calorie diet, consisting of diet drinks and non-starchy vegetables, prompts the body to remove the fat clogging the pancreas and preventing it from making insulin.”

The scientist, Roy Taylor, who led the project was intrigued by the fact that patients who undergo bariatric surgery have normal blood glucose levels as soon as one week after surgery.  It was universally thought that there was a hormone in the gut that was causing the diabetes but Taylor wondered if the sudden decrease in caloric intake might have something to do with it.  The participants ate a diet that consisted of 3 diet drinks per day along with salads and other non-starchy veggies.  No more than 600 calories per day for 2 months!  Yikes.

You would think that reading an article that says they may have found a way to reverse Type 2 Diabetes would make me happy, even giddy!  Unfortunately, it had the opposite effect.  I was a little depressed by it all. Here’s why:  this method isn’t feasible for the majority of people which means that most of us are stuck with diabetes and its progression.  I don’t like reading about the fact that this disease is progressive and can cause a whole laundry list of serious issues in my future.  I may be aware of it but that doesn’t mean I like it thrown in my face on a regular basis.

Surviving on a 600 calorie a day diet is extreme!  Having your stomach stapled to the size of a walnut is extreme!  These are drastic ways to solve a problem.  Those people who have bariatric surgery will, for the rest of their lives, have to eat no more than ¼ cup of food/liquid at a time.  Forcing someone to eat only 600 calories per day isn’t teaching them how to eat properly.  I’m afraid that the majority of people would soon fall back into their pre-diet eating habits and find themselves right back where they started from. In fact, the article states that it’s possible that only 10-15% of people would even be able to stick to the diet in the first place.  As many as 20% of bariatric patients fail to change their eating habits post-surgery and end up either losing no weight or actually gaining weight.  How depressing is that?

What is encouraging is that this has shed some more light on why some people develop diabetes.  The idea that it’s possible to remove some of the fat from the pancreas allowing it to again spit out insulin is enlightening.  This study doesn’t address, however, how to fix the issue of insulin resistance.  What about those of us whose pancreas manages to spew insulin but our cells just won’t accept it?

Kudos to those people whose lives have been saved/changed by such extreme measures!  I, for one, plan to continue on my quest for a healthier life by losing weight slowly and sensibly, exercising on a regular basis and eating a healthy, normal diet.  Maybe someday scientists will find a way to smack my cells around and make them accept my insulin again.  I’m happy that there are people out there who are looking for a cure.  Let’s hope they find it soon!

I'd be interested to hear what some of you think about all this. Here is a link to the article for anyone who would like to read it for themselves. Link to article