Blessed Assurance: Success Despite the Odds

by Jacquie Lewis-Kemp, Author & Health Coach for Living life with diabetes and organ transplants, rather than limiting life because of them.

Browsing Posts tagged diabetes management

When you decide not to listen to your doctor’s advice and eat whenever you want to or miss doses of critical medication, what’s the big deal? You’re only hurting yourself, right? Wrong! YOUR NONCOMPLIANCE AFFECTS EVERYONE AROUND YOU!

 

A woman living in the sandwich generation (sandwiched by needing to take care of college students and aging parents) was perplexed because her mother complained that she never visited her father. The woman’s parents were both in their eighties and somehow Stephanie found it difficult between work and immediate family commitments to visit her parents.

 

Stephanie’s father suffered from insulin-dependent Type 2 diabetes and found it difficult to walk and to see due to the onset of neuropathy and retinopathy, complications of uncontrolled diabetes. He especially felt bad when Stephanie would abruptly end a phone call needing to return to work, and forgetting to return the call.

 

One day after receiving a tongue lashing from her mother about not visiting them and her father in particular, Stephanie decided to confide in a close friend about the situation. Stephanie’s friend listened intently and explained,

 

“Stephanie, I know you well and I know how much you love your parents. I also know that you find conflict challenging. Diabetes, left uncontrolled can lead to very debilitating illnesses. I believe that the reason that you haven’t made time for your father is because you have watched him ignore advice from his doctor, refuse to monitor his glucose and eat regularly. As a result, he walks with a cane and is losing his sight. He has passed out requiring EMS to treat ailments that wouldn’t occur if he better managed his diabetes.

 

What happens when people see an accident about to happen? When two trains are barreling down the track toward one another? They look away don’t they? No one wants to watch something bad happen. And so I think you subconsciously don’t visit your parents to avoid seeing the train wreck about to happen–what will likely happen to your father if he doesn’t get serious about controlling his diabetes.”

 

This holiday season, if you don’t take care of yourself for you, do it for someone who loves you.

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Jacquie Lewis-Kemp

Because I have been affected by both diabetes and chronic kidney disease, it has become my mission to help others by providing information and tips on how best to live with these conditions. Recognizing that all people who suffer from diabetes aren’t necessarily affected by kidney disease, and that not all people affected by chronic kidney disease developed it as a result of diabetes, I have separated the blog subjects into two separate blogs.

Over the coming weeks and by the first week in January, this website will be used primarily to buy books and other information products related to Diabetes Management and Chronic Kidney Disease and Transplant Living.  I will have two separate blog sites, one for Diabetes related matters and another for CKD, organ donation and transplant.

If you have subscribed to www.jlewiskemp.com, initially you will be subscribed to both blog sites, however feel free to only subscribe to the blog site you are interested in if it is only one of the subjects.

Look for my new blogs Diabetes Success and CKD Success.

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Diabetes and Christmas

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Try these tips for festive gatherings this holiday season, brought to you from across the pond.

 Christmas brings seasonal joy and the comfort of the family. With a wealth of food available though, it can also be a trying time.

 

Keeping discipline to control sugar levels and portions can be particularly difficult.

 So for those of us for who willpower doesn’t come too easily, here are our tips for enjoying sensible eating at Christmas.

Commit yourself to a food plan

It’s very easy to get carried away by what’s on the table. To reduce the chance of this happening plan how much you intend to eat and make a point of sticking to it. If you’re not cooking, find out what will be served in advance.

 For sensible drinking see Diabetes and alcohol

 It’s best to make this plan at a time when you’re not hungry as hunger can distort your judgement. Don’t forget to factor in that alcohol contains high calorie content and also causes sugar levels to fluctuate.

Plan how much or whether you will drink and stick to this too.

 

It’s a good idea to let you your family know in advance of the Christmas meal too so they won’t offer you anything you’ve planned not to have.

Avoid feeling hungry for too long

It’s a well drilled family that gets the Christmas meal to the table on time. If the meal is taking longer to prepare, it can lead to an unusually long period of hunger and anticipation. 

Say you actually wanted to overeat, the best way would be to make yourself very hungry before eating.

One way to avoid being so ravenous is to break the delay.

 Protein and/or non-starchy vegetable based pre-meal snacks are a good choice as they are filling and slowly broken down.

Have a glass of water before eating

Having a glass of water before you start your meal is an easy and effective way of reducing your food intake; it makes you feel full earlier on, thus reducing your appetite.

Base your meal on non-starchy vegetables

Vegetables are the staple of sensible eating. Make sure that vegetables account for a good percentage of your plate.

Eat gradually

Eating with the family is a nice occasion but if you’re a fast eater, it can make things more difficult. If others are still eating, you may be tempted to have another helping. 

Eating slowly will help with this and will also allow you to savor and better enjoy the food you’re eating.

Don’t feel guilty about turning offers down

Any food you eat is going to end up in your blood stream and on your body so don’t feel shy about turning food down

Feeling stuffed can be quite unpleasant by itself and it’s also worth bearing in mind that the body’s natural reaction to having to digest a particularly large meal is to release extra sugar into the bloodstream.

Go easy on the puddings

One can be forgiven for indulging every once in a while. If you’re a pudding person Christmas can be something of a trial of restraint though. If you cannot resist pudding make sure you stick to at most one and keep the serving sensible, remembering that sweet dishes are very fast absorbed. Once again apply the rule about eating gradually.

After and between meals put foods away or under cover

Remember the classic Christmas cracker joke about a ‘sea food’ diet – “I see food and I eat it”? Food left out and exposed grabs the eye, therefore grabbing the attention of the mind and this can all too easily lead to ‘small’ indulgences. 

A couple of mince pies will typically have over 500 calories, a quarter of a woman’s daily energy, and a fifth of a man’s; not forgetting the 70 plus grams of fast acting carbohydrates. Apply the rule ‘out of sight, out of mind’ and this can help to avoid between meal snacking.

Walk away from the craving

If temptation is proving a taxing task and hard to avoid, it can help to literally walk away from the craving. A 20 minute walk in the crisp air should be enough to increase endorphins and serotonin which can help to overcome cravings.

Test your blood where possible

If you self test, commit yourself to testing your blood sugar more regularly, over the Christmas period, to catch those blood sugar fluctuations early.

 

Reprinted from http://www.diabetes.co.uk/food/diabetes-and-christmas.html

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When first diagnosed with diabetes it is likely that you have to develop a new routine and change some bad habits. While many young people with Type 1 diabetes haven’t established a routine and so the prescribed routine from their doctor easily becomes their routine, often people newly diagnosed with Type 2, Gestational or Pre diabetes have a more difficult time making change to their established routines and habits.

Much like fad dieting, biting the bullet and deciding to try to eat the right food and  test like a robot three times a day, doesn’t create a routine and you are likely to slip back into old habits. On the other hand, understanding the reasons for eating certain foods and testing glucose levels with a purpose in mind will bring about permanent change.

According to author of Changing for Good, James Prochaska, PhD, there are six stages of change that a person has to go through in order to make permanent change and they are

  1. PRE CONTEMPLATION- recognizing that a change or routine is necessary.

  2. CONTEMPLATION – thinking about what that new routine might look like.

  3. PREPARATION – organizing thoughts and supplies necessary to begin the new routine.

  4. ACTION – Beginning to eat, test and exercise according to the new routine.

  5. MAINTENANCE – the action steps are now a daily routine with seamless modifications for schedule changes,

  6. TERMINATION – for some types of change like smoking cessation, the maintenance phase may no longer be necessary, however for Diabetes Control, the maintenance routine never ends and provides a very healthy lifestyle whether a person has diabetes or not.

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from www.dlife.com

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Although philosophies about the treatment of diabetes and maintenance technology have improved in my more than 40 years, you should understand the very staggering statistics that now exist.

  • •      Over 20 million Americans have some form of diabetes (most of them Type 2 diabetes) and 60 million Americans are now considered pre-diabetic. (5 million people have diabetes and don’t even know it!)
  • •      Diabetes kills more Americans every year than AIDS & Breast Cancer combined.
  • •      Diabetes is the #1 cause of new blindness in adults ages 20 to 74
  • •      Diabetes doubles the risk of heart attack and stroke. It is also the leading cause of kidney failure, and responsible for more than 60% of all non-traumatic lower limb amputations.

 

Regular checkups with your doctor can identify and perhaps diagnose a condition known as Pre Diabetes and allow you to prevent a diabetes diagnosis.

If you have been diagnosed with diabetes, careful and committed management of the condition is necessary to reduce your chances of long term complications such as kidney disease, blindness, amputation, heart attack, stroke and other disorders.

Symptoms of diabetes include constant thirst and frequent urination, headaches, dizziness and weight loss. If you’re not sure whether you have diabetes but have some or one of the symptoms, see your doctor and get tested.

 

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The following study from the Thomas Jefferson University Hospital describes diabetes as “a self managed disease whereby the patient provides 95% of the daily care”. It continues that education is the prerequisite and ongoing contact (coaching) maintains compliance and saves lives as well as health care cost.

 

HealthWorks – Achieving Balance with Diabetes

A Diabetes Self-Management Education Program

of Thomas Jefferson University Hospital

 

Diabetes is a common, serious, and costly disease that affects an estimated 16million people in the United States. It impacts many aspects of the lives of diagnosed patients and their families, the health system, and society. People with diabetes are more likely than their non-diabetic peers to have heart attacks, strokes, amputations, kidney failure, and blindness. As a result, they have a more frequent and intensive visits within the health care system. A great number of hospitalizations are for acute problems such as foot ulcers, acute myocardial infarction, circulatory and nerve problems, and pneumonia.1 As evidenced by the Diabetes Control and Complications Trial (DCCT), many of these complications can be prevented with better glucose control.2

 

Because diabetes is a self-managed disease with the patient providing more than 95% of the daily care, patient education is the fundamental prerequisite for diabetes Self-management.3 Diabetes education is viewed by many as a “process” whereby a patient develops his/her knowledge base and improves his/her skills related to compliance with the recommended treatment plan. Modern diabetes self-management education programs emphasize patient empowerment rather than strict adherence to a regimen.4 HealthWorks at TJUH has been designed to support the current model of self-management education. In order to accomplish this, the program places emphasis not only on one’s knowledge and skill level, but most importantly on improving one’s self-confidence by helping them to:

 

• Identify and set realistic goals;

• Problem-solve

• Manage stress caused by living with diabetes;

• Identify and obtain social support; and

• Develop a plan for changing behavior

References

1. Patient-reported outcomes measurement to be featured in diabetes management

study. UHC Clinical Practice Alert. June 1997.

2. Implications of the Diabetes Control and Complications Trial. Diabetes Care 1998;21; Suppl.1:88-90.

3. Anderson RM, Fitzgerald JT, Oh MS. The relationship of diabetes-related attitudes

and patients’ self-reported adherence. Diabetes Educator 1993; 19: 287-292.

4. Anderson RM, Funnell MM, Butler PM, Arnold MS, Fitzgerald JT, Feste CC. Patient

empowerment. Diabetes Care 1995; 18(7): 943-949.

 

 

Read more of this article at http://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1100&context=hpn

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The final leg of our 3 Legged stool of glucose control is diet. Our diet or the food we consume is the source of the glucose our bodies use to fuel our cells. Therefore the more we focus on the ultimate purpose for the food we eat, the more efficiently our bodies can use the fuel and function best.

According to the National Institutes of Health, “It [The diabetic diet] should take into account your weight, medicines, lifestyle, and other health problems you have.

Healthy diabetic eating includes

  • Limiting foods that are high in sugar

  • Eating smaller portions, spread out over the day

  • Being careful about when and how many carbohydrates you eat

  • Eating a variety of whole-grain foods, fruits and vegetables every day

  • Eating less fat

  • Limiting your use of alcohol

  • Using less salt

With these parameters, The American Diabetes Association recommends a “meal plan” which it describes as “a guide that tells you how much and what kinds of food you can choose to eat at meals and snack times. A good meal plan should fit in with your schedule and eating habits. Some meal planning tools include the plate method, carb counting, and glycemic index. The right meal plan will help you improve your blood glucose, blood pressure, and cholesterol numbers and also help keep your weight on track. Whether you need to lose weight or stay where you are, your meal plan can help”.

The Exchange Method

Medicinenet.com gives a detailed account of the food pyramid and how to incorporate each of the food groups into a daily meal plan. It also details the serving sizes in order to comply to the appropriate calorie limits prescribed by your doctor.

http://www.medicinenet.com/diabetic_diet/page4.htm#tocf

Carb Counting

TheJoslinDiabetesCentersuggests the following steps for Carbohydrate Counting.

1.     The first step in carb counting is to have a meal plan.  A meal plan is a guide that helps you figure out how much carb, protein and fat to eat at meals and snacks each day.  If you don’t have a meal plan, meet with a registered dietitian.

2.      Step two involves learning which foods contain carbohydrate. Most people know that starchy foods, such as bread, pasta and cereal contain carbs.  But other food   groups, such as fruit, milk and desserts and sweets, have carbs, too.
There are three main ways to learn about carbs in foods:

o       Ask for a food choice list from your dietitian.

o       Learn how to read the Nutrition Facts Label

o       Purchase a food counts book that provides the number of grams of carb in various foods.

3.      Measuring tools.  In order to accurately count carbs, you’ll need to be accurate with the portion sizes of foods that you eat.  Invest in a food scale to weigh foods such as fruit and bread.  Use measuring cups to measure cereal, pasta and rice, and use liquid measuring cups for carb-containing beverages such as milk, juice and energy drinks.

The Glycemic Index

Web MD defines,  “The glycemic index is a ranking that attempts to measure the influence that each particular food has on blood sugar levels. It takes into account the type of carbohydrates in a meal and its effect on blood sugar.

Foods that are low on the glycemic index appear to have less of an impact on blood sugar levels after meals. People who eat a lot of low glycemic index foods tend to have lower total body fat levels. High glycemic index foods generally make blood sugar levels higher. People who eat a lot of high glycemic index foods often have higher levels of body fat, as measured by the body mass index (BMI).

Talk to your doctor, a registered dietitian, or a diabetes educator and ask if the glycemic index might work to help gain better control of your blood sugar levels”.

The Plating Method

Here’s a quick video from the American Diabetes Association on how the Plating Method works.

Ask your doctor to prescribe or refer you to a dietician to prescribe a meal plan or daily calorie count, and also ask which diet method is best for you.

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