Thursday, February 27, 2014

It’s time to make progress…again

I’ve been moving down a path with my diabetes.  This path has had a few bumps and curves but the course was mostly straight.  The goal: see improved blood glucose, maintain a healthy weight and basically kick diabetes’ butt.  I’ve done fairly well in the 8+ years that I’ve been dealing with diabetes but now I find myself at a crossroads, of sorts.  It seems that my path has taken a sharp turn and I’ve lost my bearings.  

It’s been a rough winter, for a lot of reasons.  Last autumn I began to see my glucose numbers rise, especially in the morning. My sensitivity to carbs has increased, meaning that I can no longer eat most carbs without seeing big spikes.  I realized that over the course of a year I had gained 15 pounds (which has now crept up toward 20) all at a time when I’ve been exercising most days and eating less than I have in years.  Frustration abounds.  Depression makes itself known much too often.  I have felt defeated.

Today I had an appointment with my healthcare provider to discuss how things are going.  I was sad to sit there and list all my woes when I can remember my past appointments being more about “I’m doing just fine.”  My doctor came to the same conclusion I had: my diabetes is progressing and I need more help.

I’ve written before about my desire to use insulin.  I had actually hoped that she would give me a small dose of basal insulin to get things under control.  Nope. Not gonna happen.  You see, according to her, my diabetes isn’t at a point where insulin would be a good move.  Had I been in a better frame of mind, I might have argued with her, but she had a good point: I often have nearly normal glucose numbers (except in the morning).  My numbers are all over the place, but she said that she’s afraid that insulin would put me in danger of severe lows, not to mention it might cause me to gain even more weight.  I decided to be ok with letting that go for now.  

Next we talked about Victoza.  Her thinking was that it would help with my glucose and hopefully help me with the weight issue.  There’s just one problem: I have thyroid cancer which means I’m not a candidate for Victoza. 

The final answer ended up being an increase of my Metformin to 2000mg per day and adding Januvia.  I’m afraid that headaches and stomach distress are in my future, hopefully only for a short time.  I admit to being a bit bummed about adding yet another drug.  It helps that I read an article just today (thanks for posting that Bea) that says they are backing away from saying that Januvia is causing pancreatic cancer.  I am aware that there are possible serious side effects with this drug but I’m willing to give it a try.

It was a good appointment.  She listened to me.  She told me that I know more about diabetes than all her other patients combined and that I had even taught her a few things (and she’s a CDE! That's a good example of how we, as patients, need to speak up about what life with diabetes is like.).  She encouraged me to give myself a break now and then.  Those are words I needed to hear.

The word progression means “forward or onward movement”.  Sounds like a good thing until you pair it with diabetes.  My diabetes is progressing. Progress, on the other hand, is “a movement toward a goal.”  I can still work to make progress despite the progression of my diabetes.  It’s interesting to me that both words are derived from the same origin but can have such different effects on my life.  I have a choice to make.  I can wallow in the suckiness that is diabetes progression or I can choose to move forward; make progress toward better control.  I can do this.  I WILL do this.  The alternative just isn’t something I’m willing to accept.

Monday, February 24, 2014

So you’ve started a diet; let’s talk

We’re nearing the end of February and I’m certain that some of you who are reading this made a commitment in January to do something about weight loss or blood sugar control.  I’m betting that some of you have already given up.  January is the month when gyms see the highest rise in memberships and sale of exercise equipment is also higher.  March is most likely the month when you can find said exercise equipment in yard sales…cheap, and if you were to run into the trainer from your new gym, they wouldn’t recognize you at all.  Not because you’re all buff, but because you rarely go to the gym. Am I right?  That is SO normal.  

I’ve read a lot about different diets and ideas for what’s the best way to lose weight.  I’ve also read a lot about the “best food to eat for weight loss” or what to eat to control your blood sugar.  I’ve noticed a trend and I thought I’d share that with you.  I’m not going to discuss the weight loss plans that sell you their food.  (I personally don’t feel that they are a good idea.)  I’m here to talk with you about low-carb, low-fat, high-protein, vegetarian, vegan, fruitarian etc.  Every one of these food plans push the idea of eating whole foods.  They may suggest that you shun carbs or meat.  They may encourage you to eat bacon at every meal (mmmm bacon).  They all have a different idea on what types of foods you should be eating, but they all encourage the consumption of whole foods…and tell you to avoid all processed foods.  That’s the key, regardless of the plan, they are all promoting the same idea that we need to get back to the basics and shun processed foods.

This idea of avoiding processed foods isn’t easy.  In fact, it requires lots of dedication and time.  It may require more money but I’m not necessarily convinced of that.  I feel that a healthy diet doesn’t always mean a more expensive diet.  Let’s face it: processed foods are easy.  They’re quick and convenient.  In our busy, hectic lives it’s so much easier to open a box or nuke a meal.  I get that.  I’m that person too, but we’re doing ourselves a huge injustice.  It takes longer to cook something from scratch but it is so worth the effort.    Planning meals in advance and spending one day a week cooking meals ahead is a great idea, one that takes dedication.

We have a chronic disease; one that requires us to pay attention daily to what we’re eating and how much we’re moving.  Heck, we’re already spending so much time thinking about this, why not spend some of that time preparing fresh, whole foods?  It’s not that hard.  Aren’t you worth it?

What I am promoting here is not a certain diet; that’s your decision.  Pick something that works for you, one that has foods you enjoy eating.  Follow the food plan that helps you control your blood glucose and, hopefully, allows you to shed some pounds, but remember to pick one that is sustainable!  Don’t try to become this other person overnight; that never works.  There isn’t “one food” that will make you healthier.  It requires a variety of whole foods to do the trick.  Whether you choose to eat low carb, or only veggies or bacon-wrapped everything, it doesn’t matter.  What matters is that you are taking the time to cook good foods that nourish your body.  Oh…and go for a walk!  In the immortal works of Adrian Monk, “You’ll thank me later”.