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Posts Tagged ‘diabetes’

The UK’s Home Secretary, Theresa May, has revealed that she was recently diagnosed with Type 1 Diabetes.

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It was a real shock and, yes, it took me a while to come to terms with it,” she said. “It started last November. I’d had a bad cold and cough for quite a few weeks. I went to my GP and she did a blood test which showed I’d got a very high sugar level – that’s what revealed the diabetes.

“The symptoms are tiredness, drinking a lot of water, losing weight, but it’s difficult to isolate things. I was drinking a lot of water. But I do anyway. There was weight loss but then I was already making an effort to be careful about diet and to get my gym sessions in.”

The Home Secretary says she has been told that she will have to inject herself with insulin twice a day for the rest of her life–but she has no fear of needles and intends to carry on in her Cabinet post.

Mrs May’s determination to get on with her life reminds me of my mother, Molly Ellis.

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June 1955. Brother Jack in Molly’s arms. Her doctors overcame their doubts about letting her proceed with the pregnancy despite being a Type 1 diabetic.

Molly was diagnosed with Type 1 aged 38 in 1953.

She too injected herself twice a day for the rest of her life.

Eventually she died of a sudden heart attack linked to her condition–but she made it to 67–almost 30 years with Type 1 diabetes–and in those days treatment was not as advanced as it is now.

Molly was not a professional politician–and the cabinet she loved best was hanging in a corner! But she carried on leading a full life, running the household and raising three boys.

The last six years of her life were spent in a Buckinghamshire village called Brill–not too far from Oxford. She and Dad retired there from London. They threw themselves into village life and were much appreciated for it.

I’d wager that not many in the village, apart from her doctor,  John Spence, knew she was diabetic–and few would have understood what it meant.

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Molly relaxing in Brill–after preparing lunch I’d guess!

She never liked to make a fuss.

Her heart attack happened one morning as she was finishing dressing to go shopping. Her heart finally gave up after years of struggle.

Her gift to me was an understanding of how damaging diabetes can be if ignored. When I received my diagnosis of Type 2 diabetes in my mid-fifties, I took it seriously, thanks to witnessing my mother’s journey.

There’s still a shocking ignorance surrounding the condition.

Theresa May’s high profile and very public admission that she is Type 1 helps focus attention on and heighten awareness of this ruthless and insidious menace.

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As I came out of the new organic supermarket this morning, the dry heat hit me–transporting me directly to California.

That would be nice.

Enter the shop in France and exit six thousand miles away and close to the ocean–all stocked up!

Dream on–though they did put a robot on Mars this week–not in my lifetime.

Good weather for a stressful day–a double clinic visit and the results of a blood test.

On second thoughts, maybe California and the land of perpetual sun is not such a good idea….

My first clinic visit is to a skin surgeon for him to look at a small cancer on the left side of my nose.

Stop PressPoldark’s scar becomes a reality!

Pas de soucis–the dermatologist assured me, providing a referral to Docteur Mylonas, the plastic surgeon–nothing to worry about!

He confirmed what she’d told me–that the culprit was the sun.

I had spent all my sun capital!, she’d said, charmingly.

Docteur Mylonas picked a date at the end of August for the small operation.

Just after lunch on the 28th suit you?

It’s this easy? Seems so. 

That’ll be forty euros for today, says the receptionist, all reimbursable barring 2 euros.

Quel système!

The blood sample was taken–here in the kitchen–at 8 am Tuesday by our friend, Sylvie, one of the local team of nurses.

Just the quarterly A1C  (measuring the glucose levels in my blood).

Sometimes the result comes in the post from the lab the next day.

Nothing yesterday.

I listen anxiously for the postal van’s vibrations on my return from the clinique.

Just before 1pm–a tad early–I hear it and go out to the box.

The envelope is there and the moment of truth–eek!

Worryguts in my head, it’s bound to be bad…

I unfold the paper and…

6.4% is clearly written–0.1% less than 3 months ago. In the range of normal–just!

A silent whoopee is followed by a moment of self-satisfaction as the anxiety recedes.

But there is no room for complacency, Robin, I quickly remind myself.

The 6pm appointment with the cardiologist will round off the day!

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The book event in Washington was held in this Georgetown home.

Signing books in advance of the evening

A brief talk to the assembled group

Wonderful book event in Georgetown last night!

Thanks to author, nutritionist and all-around whirlwind, Katherine Tallmadge for organizing the event; Nancy Taylor Bubes for opening her beautiful home to more than 80 guests, the American Institute of Wine and Food  for co-sponsoring, and Executive Chef, Janis McLean of Bistrot Le Zinc for demonstrating the potato-less salmon fishcakes recipe–and thanks to all who turned out, many bringing dishes prepared from recipes in Delicious Dishes for Diabetics.

The Washington Post’s Food Editor Bonnie Benwick was present the entire evening and wrote a wonderful account today: http://wapo.st/xGHO30/.

We leave balmy Washington D.C. where the magnolia blossoms are opening for the Windy City  tomorrow!

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An early post this time last February was a short account of my annual eye test. This week I went through the identical procedure–Mr Nguyen is reassuringly methodical.

Arrive–present my Carte Vitale (the card accessing the French health care system)–take a seat in the waiting room.

This is usually backed up with a crowd of anxious, silent people but is empty this year (maybe it’s the freezing weather)–apart from a couple who whisper together as though the Queen were in the next room!

No sooner do I unfold my copy of The New Yorker magazine when out comes the doctor with a patient and–moments later–the summons:

Monsieur Ellis?

Eye Test–(15/2/2011)

I learned early on, that managing Type 2 Diabetes involves more than watching what you eat—it’s really a head to toe job!

The villain sugar is a ruthless foe. It will take advantage of any weaknesses with alacrity, and insinuate itself into those vulnerable spots like eyes and feet if you drop your guard, causing damage that cannot be reversed.

“Put your chin on the strap please and place your forehead against the bar—look straight ahead and don’t move”.

The forced intimacy of doctor and patient is strange. As he leans forward and shines his special torch deep into my eyes, we are eyeball to eyeball. For a moment I feel like the Man in the Iron Mask, receiving a visit.

The short pause before he says–pas de diabetes [no sign of diabetes], is a bit nerve-wracking; on occasion I’ve caught myself crossing my fingers under the table—though I forgot this morning!

Phew-another year gone!

Being tested has become part of life again. Just like schooldays.

I see Cyril for feet every three months and have a blood test to check cholesterol and glucose levels as often. No big deal really—when your life depends on it.

Pas de diabete!   Encore phew!

Less than 15 minutes after “the summons, I had paid 27 euros for the consultation (to be reimbursed later), made an appointment for February next year and was searching for my car key outside in the cold.

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It was heartening to spy through the mist from our friends Susan and Jean-Michel’s bathroom window in Strasbourg (Alsace-Lorraine in NE France) a sea of allotments stretching a hundred yards to the elevated road on the horizon.

Dotted with little sheds and pockets of green (but no sign of anyone working–well it’s winter!)–they at least were proof that vegetables are grown in this part of France.

Heartening in both senses–good news and good for the heart–after several veg-free meals eaten over a weekend in the restaurants of this ancient regional capital.

Meat is big here–the displays of it in butchers’ windows are impressive.

And often it seems little else on the plate.

True there is the chou (white cabbage)in the ubiquitous choucroute (sauerkraut) but that is not a fresh vegetable and it’s true there are potatoes but they are not an option for me.

Even white fish is served with sauerkraut here!

Vous allez manger bien la-bas! [You'll eat well there!] we were assured enthusiastically by our friend and neighbor, Thierry, an amateur [fan] of good food when he heard we were heading to Strasbourg for the weekend.

Heavy–yes but bee-an!

At a reception in the celebrated Wine Cave Historique des Hospices de Strasbourgthe guide casually mentioned that there is more cadiovasular disease and Type 2 diabetes in this region than any other in France!

In a cave underneath the hospital of Strasbourg great casks of local wine are stored--including the oldest cask of drinkable wine in the world--so they say!

Our host in Strasbourg, Jean-Michel–(who by the way cooked me a delicious omelette for lunch on Saturday!)–said this part of France had the lowest life expectancy.

Cause and effect?

QED!

But it made me think how difficult it is to change ingrained habits….

The people of Alsace are clearly proud of their cuisine.

It reflects centuries of tradition and daily consumption, deeply connected with the customs and rural way of life autrefois (in times gone by).

But “in times gone by” the people (peasants) worked hard all day in the fields and the food they ate in this northern climate stoked their boilers.

Times have changed–but not the way of eating it seems.

Come to think of it a couple of days hard digging at the allotment would take care of at least two plates of choucroute–and there’d be some vegetables to see for the effort too!!

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It was the lead story Wednesday morning on BBC Radio 4′s The Today Programme and headlined in the British broadsheet newspapers.

 

A devastating new report says diabetics in Britain are dying far too early due to poor management of their condition.

This includes not receiving basic diabetic health checks on the NHS,  unhealthy lifestyles and not properly understanding how to take prescribed medication.

The new report urges better education and support for people with diabetes.

Teaching people how to  manage their condition (including exercising and improving one’s diet) reduces the risk of complications.

Education is vital–not just for people with diabetes, but also for friends and loved ones, if they are to provide the necessary support.

 For example,  persuading loved ones to recognise that they are at risk may be problematical:
Fit as a fiddle me–maybe a bit overweight; got to get exercising and cut out the extra chips–going to start tomorrow, honest! Don’t worry about me.
Denial is an easy option and with Type 2 diabetes–not just for the diabetic, but for family and friends–as there are seldom obvious signs and symptoms early on.
With no family history of the condition, for instance, why would you go for a blood test when you feel more or less “on form”?  Why put yourself through the stress?
Well, an estimated 800,000 (!!) Brits have diabetes but DON’T KNOW IT!
You could be one of them.
A simple blood test will tell.
None of this is easy on one’s own.
Family and friends can play a vital role.

I was lucky–I was diagnosed with Type 2, inadvertently one could say, thanks to a friend.

An old schoolmate convinced me to have a blood test for prostate cancer, after he’d been diagnosed with it.

My blood test was clear for cancer–but it turned up higher than normal glucose (sugar) levels in my blood. A second test six months later confirmed the diagnosis of Type 2 diabetes.

In a way I was doubly lucky.

My mother had Type 1 diabetes (injecting) for 30  years; I knew from watching her struggle that I had to take my own predicament seriously.

The support of friends and family is important.

In a recent interview for Diabetes UK‘s Balance Magazine I was asked :

What would you do if you were head of NHS Diabetes Services for a day?

I’d have a day for the partners of people with diabetes. There’s a lot of ignorance around and more people need to learn about the condition.

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In 1981  (30 years ago) The AJCN

The American Journal of Clinical Nutrition

published a paper by Canadian Dr.  David Jenkins  (University of Toronto), which was to have a profound effect on the ability of people living with diabetes to make better choices of what they eat on day to day basis.

It established the Glycemic Index a measure, on the scale of 1 to 100, ranking carbohydrates according to their effect on our blood glucose levels and thus their post-meal impact on a malfunctioning system.

It was followed by the Glycemic Load which is a measure of the impact of the glucose in a single portion of food.

Dr Jenkins is interviewed in the latest newsletter of GI news.

Dr Alan Barclay charts in the same news letter the progress made in studies of GI and GL since 1981 .

GI started a world-wide glucose revolution, he states, as it clearly showed that carbs didn’t affect our blood glucose levels the way we thought they did–freeing people with diabetes from overly restrictive diets.

Despite controversial beginnings, the GI is now widely recognized as a reliable, physiologically based classification of foods according to their postprandial glycemic effect.

I have found the GI and the GL essential guides to everyday eating. Though I now take a pill a day, I credit them with allowing me to control the condition for six years without medication. 

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“Myth versus Fact”

This simple piece from the Los Angeles Times, busting a few myths about diabetes, is worth posting on its own–in full.

Learning about Type 2 diabetes and the risk factors involved can help a person detect the disease early or know what he or she needs to do to minimize their risk. Type 2 diabetes, which used to be called adult-onset diabetes, is becoming more common, especially in children and young adults. Here are common myths associated with Type 2 diabetes:

1. Type 2 diabetes is not a serious disease. 

Because Type 2 diabetes tends to develop slowly over time, many people believe it is not a serious disease. According to the American Diabetes Assn., diabetes kills more people each year than AIDS and breast cancer combined. 

2. Only overweight people develop Type 2 diabetes. 

Though being overweight or obese is a risk factor, it is not the only one. There are other risk factors to consider, such as family history. If you have immediate family members who have developed Type 2 diabetes, you have a greater risk of developing it. 

Ethnicity also plays a role. African Americans, Hispanics and Native Americans are more likely to develop Type 2 diabetes than Caucasians. 

3. There’s only one dangerous kind of diabetes.

Not true. Diabetes refers to a group of diseases — all of which require serious attention — that have in common the body’s inability to properly convert glucose from food into energy, leading to a high level of sugar in the blood. The main types of diabetes include Type 1 (formerly known as juvenile-onset diabetes), Type 2 and gestational (which occurs only during pregnancy). Managing any type of diabetes requires balancing food, physical activity and, if needed, medications.

4. People with diabetes must eat a special diet.

A healthful diet for someone with diabetes is the same as a healthful diet for anyone else. A good meal plan is based on whole-grain foods, lean protein, vegetables and fruit. Such a diet is low in fat (particularly saturated and trans fats), salt and simple sugars. 

5. Only older people develop Type 2 diabetes. Type 2 diabetes used to be an adult disease, developing primarily in people over 40 who were overweight or obese. Sedentary lifestyles, combined with being overweight, have led to an increase in the diagnosis of Type 2 diabetes in children as young as 10. 

If you would like to learn more about diabetes, go to http://www.diabetes.org.

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Testing times…

Our friend Simon–who also has Type 2– emailed:

Why do you not do the early morning thing? (to start with my doc had me finger-pricking morning and evening)… I jot down the count every day, so could easily work out an average. Is that what one should do?
It’s a good question.
I have the hemoglobin A1C test every three months and occasionally the fasting plasma glucose test (FPG). 
Different doctors have different approaches for different patients–makes sense.

Jottings on the test I take every three months:-
The Hemoglobin A1C test measures your average blood sugar in the previous three months to see if it has stayed within a target range.[5-7]

This is an explanation of how the test works and for me is helpful in understanding why it is effective:-

“Your red blood cells contain hemoglobin, which allows cells to transport oxygen to tissues. As a cell ages, the hemoglobin becomes increasingly “glycated”, meaning that more glucose molecules stick to it.

Higher glucose levels in the blood mean higher glycated hemoglobin, which translates into a greater HbA1c reading.”

The level of glycated hemoglobin provides information on the average level of glucose in the body over a 90 to 120 day period.

[You don't need to fast or prepare for an HbA1c test.]

The Food and Drug Administration (FDA) in the US, has cleared the first over-the-counter test that measures glycated hemoglobin in people with diabetes to help monitor how well they are managing their disease (glycemic control).

Whichever test you take, it’s clear that the most important thing is TO TEST.
Enrico Cagliero, MD, a diabetes researcher and assistant professor of medicine at Harvard Medical School, has recently noted that:
 “If you look at the nationwide data [in the US], it’s sobering–a lot of diabetic patients are missing essential checks.
People with diabetes should know that complications aren’t inevitable.
Unfortunately, we still see a lot of complications, and a lot of those could have been prevented. It’s absolutely essential to get into this preventive mode as soon as possible. It definitely pays down the road.”


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“Good afternoon Ladies and Gentlemen, this is train 127 to Waahshington–train 127 to Waahshington”

En route to Washington from NYC by Amtrak–a three hour journey.

We find the “Quiet Coach” (no loud voices–no cell phone use)–perfect.

Meredith starts to read the in-house magazine, which has a photo of Michelle Obama on the cover looking in radiant health. Her mission is to stem the rise in juvenile obesity.

The theme this month is Health and Wellness–no escape.

Inside Meredith finds a short article written by Dr. Francis Collins, the director of the NIH–the National Institutes of Health–entitled: “Change your life style and save your life”–no escape.

These days you can’t even take a trip in the “quiet coach”  without being exhorted to examine your lifestyle!

Dr.  Collins  writes that shortly before taking up his post, he took advantage of one of the programmes funded  by the NIH and had a DNA scan designed to look at the hereditory risks of disease.

To his surprise the scan revealed he had a risk of Type 2 diabetes.

“The strategy that caught my eye,” he writes, “was an NIH funded Diabetes Prevention Program which found the the combination of increased physical activity and modest weight loss is a highly effective way to lower the risk of Type 2 Diabetes. When trial participants–all with elevated levels of glucose–exercised 2.5 hours a week and lost 7% of their weight on avereage, many were protected from developing diabetes, with preventive benefits lasting at least a decade.”

He decided to act and started working out. In the first six months of his new routine he lost 25 pounds.

“I’ve never felt fitter, ” he says.

“Taking charge of your health by choosing the right foods and the right exercise programme is among the most important investments you can make in your future”–no escape!!

“Ladies and Gentlemen–15 minutes to New Carrolt’n– New Carrolt’n 15 minutes. Twenty-five minutes to Waahshington, 25 minutes to Waahshington–New Carrolt’n, Maryland is next”.

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