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November 16, 2009

5 Questions with Bob Greene: How To Live Your Best Life With Diabetes

Posted: 03:00 PM ET

Bob Greene, Oprah Winfrey's expert on diet and fitness, and author of the best-selling "Best Life" books, has a new book out: "The Best Life Guide to Managing Diabetes and Pre-Diabetes."  In this "5 Questions," Bob shares his best tips with us on dealing with the disease.

Editor's Note: November is Diabetes Awareness Month

LKL Blog: What is the single most important thing people with diabetes need to do?

Bob-GreeneGreene: You have to be diligent monitoring your blood sugar.  You think it would be a no-brainer, but it's not.  People get tuned into changing their diet and exercise habits, then ignore getting a handle on blood sugar.  Everyone hates the finger prick, but it's the most important thing, and so many people just don't do it.

As experts we advise "eat this, don't eat that," but each individual is different.  We really don't know how each person responds to changes in diet and exercise, so you have to do regular blood sugar tests as you make these changes to see what works best for you.

LKL Blog: What simple thing can people do to combat diabetes?

Greene: It may sound strange, but move around more.  Type II diabetes used to be called adult-onset diabetes, but now we're seeing it in kids.  The reason it was adult-onset was we slowed up as we aged, but not now.  Our lives have become more sedentary, and that has led to children getting diagnosed with it.

When you move around more, it changes your sensitivity to insulin, making the insulin more effective.  Of course, regimented exercise is the best way to achieve this, but barring that, wear a pedometer, move more and things will improve.  Nutrition habits, reducing carb intake, and sleep are also very important.

LKL Blog: Is there anything you can do to prevent getting diabetes?

DiabetesGreene: Let's just talk about type II, because lifestyle can contribute to that.  If you're inactive most of your life, that greatly increases your chances.  An active lifestyle can prevent many cases of diabetes.  My book addresses pre-diabetes too.  Someone with pre-diabetes can, with the right lifestyle changes we've discussed, significantly decrease their chances of becoming diabetic.

LKL Blog: What is the goal of your approach?

Greene: People need to know diabetes is a serious condition.  I want to give people hope, but they need to realize this is serious.  I want people to manage their condition.  You can live a normal life by modifying your lifestyle.  That's the overriding message.

When people get a condition or disease, there are two usual responses.  Sometimes it motivates people to tackle their condition and make positive changes in their life.  But unfortunately, for most, it gives them an excuse and they trow up their hands and feel sorry for themselves.  That's who we're trying to reach.  You can manage this condition.  Some people say their life is better after being diagnosed.  They didn't exercise or eat well before, and now they do and feel healthier for it.

LKL Blog: Your "Best Life" approach also deals with the mental and emotional state of people, and how it contributes to weight.  Does that approach apply to someone with diabetes?

Greene: It applies even more to people with diabetes.  The missing piece for people with diabetes is managing emotions.  If you're in a bad relationship, financially stressed, or generally unhappy, there's a tendency to use food for comfort.  This gets you in even more trouble if you have diabetes.  This is what will strip your motivation to control this disease.  So I'd say emotional well-being is an extremely important factor.

To learn more, go to www.thebestlife.com/diabetes.

Filed under: 5 Questions • Health • LKL Web Exclusive


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A. Smith, Oregon   November 16th, 2009 4:05 pm ET

So many seniors become diabetic, there needs to be better health education in America to help prevent the flood of new diabetic patients.

Diabetes causes many of its victims to lose their eyesight, feet and lower limbs, and fewer years of productive lifespan.

The best approach for yourself and American society is NOT TO become a diabetic.


Ron SOlano   November 16th, 2009 5:42 pm ET

Bob is right. You really need to monitor your glucose and be your own advocate when you see the doctor. I chart my glucose readings, my AIC, my blood pressure, amount of insult I take all into a software product I obtained for free by a product manufacturer. I also have the ability to get reports on my levels to help me manage my diabetes. The software also has my blood test lab readings as well so I can check my kidney functions as well. -Ron SOlano


Lightsinger   November 16th, 2009 7:41 pm ET

Diabetes is largely diabetic, and for many of us, avoiding it altogether is not something entirely in our control. My mother was a Type 2 diabetic, as was my grandmother. I might have delayed onset, but the idea that you can always avoid it throws more guilt on people who get it than they deserve.

Having said that, Bob is right: getting more active, watching your carb intake and testing are absolutely critical. I've been a well controlled diabetic for eight years and I feel better than I have in the last 20 years. I am at a normal weight, I exercise at least one hour a day, and I have more energy than I did 20 years ago. I don't want any of those ugly complications that this very serious condition can lead to. If you can't avoid diabetes, then take ownership if and when it happens, and live a long healthy life.


Lightsinger   November 16th, 2009 7:42 pm ET

Meant to say "Diabetes is largely genetic."


frank dillon,ca   November 16th, 2009 7:57 pm ET

If you are diagnosed with diabetes once and cut out the sweets and never have been diagnosed with it again, do you still have diabetes?


sheila   November 16th, 2009 8:23 pm ET

My 17 year old son is Type 1. I wish the media would talk more about how there are 2 types of diabetes and the difference between the two. If my 17 year – who is super skinny – mentions he has diabetes, other teens think it is because he has poor eating habits. They don't seem to have a clue that type 1 exists. I do agree monitoring your blood sugar levels is imperative – but that is not enough. You must respond to what you see on your meter.


Mary   November 16th, 2009 8:52 pm ET

I agree with you Sheila. My 8 year old daughter was diagnosed with Type 1 diabetes on her 6th birthday (she, like your son, was on the underweight side). Sometimes it feels that the whole focus regarding diabetes is on Type 2. However, the need for a healthy diet and excercise is the same for both types. The misconceptions regarding diabetes are profound – as well as the insensitivity that exists. After my daughter's diagnosis, I have spoken with many adult diabetics and learned that the difference in post diagnosis care of adults and children is huge – adults don't seem to get the amount of training, information, support from their doctors that families with children do. Our daughter has taught many adults about counting carbs, the effects of excercise on insulin efficiency, the importance of changing shot/pump sites, etc. We have learned that treating diabetes is a science, with a little bit of intuition thrown in. We check sugars 10-12 times a day and adjust insulin accordingly. But throw in a day of swimming or illness – and the ratios can change! Frustrating!
Best of luck to all!


Mary   November 16th, 2009 8:57 pm ET

By the A. Smith, I wish my daughter had the choice you speak of. Please be careful of insensitivity. After reading and hearing comments like yours, she has asked me if she did anything wrong to get diabetes. Don't forget, words and judgements can hurt.


mia   November 16th, 2009 9:22 pm ET

does diabetes SKIP a generation ? am concerned @ my children & grandchildren.do sm patients tke meds? & sm shots? ..


James McKenzie   November 16th, 2009 9:33 pm ET

Type II diabetes is largely preventable IF you decide that you are going to make the changes necessary to avoid it. Some folks feel that they are destined to get it. However, you NEED to talk to your doctor and get on a monitoring program if you even THINK you have it. Also, not every Type II is a fat, lazy person. I've met Type IIs that were thin and appeared to be fit as a fiddle. However, they made poor diet choices and that is what caused their problems. You need to track your fasting Blood Sugar, A1C levels, liver function and other things to insure that you are not going to have problems.


L. Koch   November 16th, 2009 10:57 pm ET

If Type II diabetes is a preventable illness, and I don't believe it is, why would researchers, like those at the Cleveland Clinic, be testing whether gastric bypass "cures" Type II? The cure happens within a week of the surgery...before weight is lost. So it isn't caused by weight.

Something else is going on...some signaling process is screwed up in the body. Insulin is being made, but the cells aren't using it efficiently. But after a bypass, all of a sudden, insulin levels are fine, and the body's cells are using it again.

We are being inundated with man made chemicals that mimic hormones and change the way our bodies function. Something out there is causing both Type I and Type II diabetes.

We need to find out what, and quickly. The incidence of both is rising to epidemic proportions.

BTW, I am 55 years old, and was recently diagnosed as Type 1. Scary.


myrna   November 16th, 2009 11:30 pm ET

I find it interesting that there is no mention of how critical it is for someone who has a diagnosis of diabetes keep their blood pressure below 130/80. A blood pressure higher than that increases one's risks for developing chronic kidney disease which can lead to dialysis or kidney replacement therapy.


Linda Dibble   November 16th, 2009 11:35 pm ET

There are major differences between Type 1 and Type 2 diabetes and most of the general public don't understand those dissimilarities. Although the current focus appears to be on Type 2 perhaps because more poeple are being diagnosed with it. I feel the public would benefit from understanding the differences between the two. I've been a diabetic since 1958 and living with this disease has never been easy. Although the efforts being done to raise awareness, solicit donations, and conduct reasearch to find a cure are significant, this hasn't alway been the case. I often wonder what would have been my decision if when diagnosed with the disease, a change in my eating and excercise habits meant I could delay and/or avoid its onset. Most pre-diagnosed and/or newly diagnosed Type 2 individuals do have that choice – too bad some don't get it.


Melanie   November 17th, 2009 12:04 am ET

What a load of hog-wash. My mom died of type 2, weighing 90 pounds dripping wet, walked all the time, and lived a vegan diet. She was at 700 when she entered the hospital.

I am now a type 2 diabetic on metformin and an insulin pen to keep my sugars under 200. It's hereditary, and no matter what I eat or don't eat, doesn't make a darn bit of difference. Yes, exercise does keep it lower, but mum was 72 when she passed. And she did all the right things.


Bobby Goodwin   November 17th, 2009 12:40 am ET

This is a great article.


Nancy Porter   November 17th, 2009 12:42 am ET

Just found out that under Obamacare I can only test once a day instead of twice. Medicare will only pay for testing strips for me to test once since I am on the pill and not taking shots.....
This is so crazy. It will cost Medicare much more if I can't test to keep my diabetes in control.


A. Smith, Oregon   November 17th, 2009 1:13 am ET

@Mary, your daughter is absolutely correct in blaming you for her diabetic condition at age 6.

IF you were reckless with drugs, alcohol during your pregnancy that has been proven to have bad consequences on the newborns genetic coding.

IF you lived in high areas of environmental toxins which you ate, breathed or drank during your pregnancy, that also has been proven to have bad consequences on the newborns genetic coding.

IF you didn't take moderate to high levels of Folic Acid supplements during your pregnancy, then you were not adequately protecting your fetus against genetic damage.

IF you didn't have any previous diabetic victims in your immediate family, then the aforementioned comments are certainly important.

IF you did have previous diabetic victims in your immediate family, why didn't you work with your family physician to isolate sperm which didn't contain any of the diabetic markers to fertilize your eggs with?


Stacey Abraham   November 17th, 2009 2:16 am ET

Does Halle Berry have Type 1 Diabetes, or Type 2? Why have I never read an article where the answer is straightforward? If there is one, where can I find it? I am a Type 1, 41 year old woman who is active and consistently attempts to have good A1Cs. I appreciate any people in the spotlight coming forth with their diabetes ( Larry King, Nick Jonas); it gives me hope to know that they are doing well, and hopefully instrumental in helping find a cure...for both types!! Yahoo for stem call research; let's have faith in humanity to use it for excellent reasons.


Steven W.   November 17th, 2009 2:21 am ET

Many "so called experts" simply miss the entire reality of diabetes. I have type I diabetes and was diagnosed 3/29/1979 and insulin dependent since that time. I have lived over 30 years with this disease, so I am a true "expert" in the field by all standards.

Since the age of 15 (diagnosed at 13) I have lived my life without any complications, have never been in the hospital due to problems with diabetes and have lived my life care-free as a almost totally "normal" person.

I eat whatever I wish, including many quarts of chocolate milk in a day, I eat cake and any other foods under the sun at any given time I wish. I have not checked my blood sugar is well over 10 years.

The "so-called experts" might state this is impossible and I would be more than happy for them to examine me and varify my health status. I am a 44 year old male, 5'7" tall and 160 lbs. I do not regularly "exercise" in the traditional sense, but do stay very active by walking and typical errands can include carrying up to 100+ lbs of items (usually a 50 lb bag of dogfood included) several miles every few weeks.

My method has been simple. I adjust my insulin to what I eat...just as a normal body would.

The main key in controlling this disease is knowing and listening to your body! Your body will tell you when your sugar may be getting low, or high. There are plenty of easily recognizable signs. Take action to either reduce the level or increase it as needed.

Diabetes kills in a simple manner. It is as easy as placing it on a graph chart. High highs and low lows create "spikes" on the chart, which are the cause of damage to the body. The key is to maintain a rolling level in the chart, by keeping the blood sugar within the bodies tolerable range. Everyone is different so the ranges can vary for each individual case. The main pojnt is to AVOID THE SPIKES, because that is what causes the shock and trauma to the body organs. Know your body signals and maintain the proper range.

It is very possible to live an almost entirely normal life with diabetes, including the most serious type I. I not only speak it, I have lived it for over 30 years and I can easily challenge any so called expert's opinion with my life long fact of my own life with this disease.

Any "expert" can not justifiably argue with such a clear track record of over 30 years, with no complications what so ever, having a totally normal diet as an average person (including all the ones they warn against, like chocolate, sweets, candies, pies, cakes and all those wonderful things in life that can still be fully enjoyed at anytime, just like any person without diabetes.

Diabetes does not have to control your life and I am living proof of this. And that is from a true legitimate expert who has lived with type I diabetes for over 30 years.


rcpherenow   November 17th, 2009 4:41 am ET

I'm a 25 year old male, active, and have had type 1 diabetes for 20 years now. Just within this year...my eyes are shot and I've had to get glasses, and I lie in bed 3 days out of the week because of diabetic neuropathy that also, just hit me this year. Diabetes sucks. I was never overweight and have ALWAYS preferred a good cucumber over a bowl of ice cream. Nobody in my family has it...just me. I'm so over hearing about the "breakthroughs" in type 2 and the ways to help type 2. Call me selfish, but fix type 1 diabetes....and preferably...lets fix it before I'm blind and have no feet!


Tom Swenson   November 17th, 2009 5:14 am ET

Steven W. If you have not at least had your HGA1C checked periodically you are a fool.
I too have been type 1 for over 20 years and know that nobody can appreciate their true diabetic status without the benefit of blood testing. A quarterly HGA1C testing would not imposition you all that much...............Don't get me wrong, I test several times a day and am not infrequently surprised by the result., so I'm most certainly not advocating less testing. It is the tool that allows you to adjust your insulin.
Your blase attitude towards your serious disease is your business; but hopefully no one reading this blog thinks that you know what you're talking about!
I should mention here that I watched my father die of type 1 at the age of 36; before the advent of easy home testing.


Tery Hish   November 17th, 2009 5:20 am ET

Hello Larry. I watch you all the time. Keep up the good work. Maybe I'll get to see you in person someday. I have a story the people might be interested in. as for right now, I keep reading the food labels and the most frequently occuring ingredient seems to be that high fructose corn syrup. They put it in things that you wouldn't even expect sugar to be in. What's a diabetic supposed to do with all that extra sugar? It's a jungle out there, so stay healthy. Love your show!!!!


Bill Williams   November 17th, 2009 9:17 am ET

This is very timely information. A couple of weeks after my 43rd birthday I was emergency rushed to the hospital for a severe case of pancreatitis, and I was diagnosed with type-2 diabetes. My numbers were extremely off the charts – trigylcerides at 913, cholesterol at 623, blood sugars in the 300+ range, and pancreatic proteins at 4500 (yes, you read that right). My wife said I was for the most part a walking time bomb and could have had a heart attack or stroke and died, leaving her a widow with two children. She also pointed out it was only by the grace of God that I survived and getting to the hospital in time that I survived.

What was equally scary is that I exhibited all of the symptoms of type-2 diabetes – continuous thirst, going to the bathroom constantly, dry mouth, fatigue in my body, blurred vision, and drastic weight loss (I went from 240 down to 210 by the time I left the hospital) – and I never knew that these were symptomatic of diabetes.

Since that time I've been taking Metformin twice a day, baby aspirin once a day, and checking my blood sugars three times a day per doctor's orders. My blood sugar levels have fallen for the most part to normal levels (103 as of this morning). As of my last checkup my trigylcerides fell to 613 (still four times high but working on it), my cholesterol level down to 180 (in normal levels), my pancreatic proteins were down to 121 (a very significant drop!), and my AIC is normal again.

I've been eating a lot of heart-healthy carbo-friendly foods, thanks to input from my wife and from the hospital nutritionist with whom I keep in contact for any questions – primarily baked or grilled chicken, turkey, and fish, along with salads and low-calorie vegetables. Ninety-five percent of the foods I used to eat, I no longer eat. (I can't even watch shows like "Extreme Pigouts" or "Man vs. Food" without getting sick!)
I also walk a half-hour a day to keep my body in motion and exercised.

However, the doctor had also put me on Benazepril for my diabetes, but I soon began having serious allergic reactions to the Benazepril that mirrored my pancreatitis. I'm off the Benazepril.

My wife recently gave me the book "Diabetes for Dummies", and just yesterday I picked up a magazine at the store about diabetes awareness. These are great resources. Knowledge is power, and in this case not knowing and not heeding can cost you your life. I've been given a second chance at life from God as a result of my experience, and I'm not taking it lightly. I plan to beat this.


ImDiabetic   November 17th, 2009 9:53 am ET

I was diagnosed at age 29 – I'm now in my mid-40s. I've always been thin. My eating habits were "pretty good" at the time of diagnosis. There's no other diabetics in my immediate family. I puzzled the doctors so much the diagnosis took quite a while and I may have been diabetic for years prior. Initially, the doctors told me I was "developing" Type I and would be on insulin in a matter of weeks if not sooner.

I fooled them.

My blood sugar immediate when back to normal with increased attention to my diet and exercise. I can OCCASIONALLY eat sugary treats but really have to watch the intake.

I would love to test my blood sugar regularly. However, because I'm not medication for blood sugar control, insurance absolutely refuses to pay for the testing supplies. I can not afford them on my own. I am on low dosages of medication for other diabetes related problems but not blood sugar control. So if I feel my blood sugar is high, I either have to find someone who does have supplies and is willing to let me borrow them or go to my doctor's office for testing.

Yes, I'm definitely diabetic. Just a very lucky one. I only wish insurance would see the importance of me testing my blood sugar levels. My status could change overnight and I wouldn't know it. It is very easy to say "you must monitor your blood sugar levels daily" but how can someone do that when supplies are so expensive? I could afford them IF I stopped taking the medications.


Kat   November 17th, 2009 10:04 am ET

I have been type 1 diabete for the last 23yrs (diagnosed at 12). I live a very "normal" life now that I have the insulin pump. I test my sugar several times a day and adjust my insulin to what I eat. I do enjoy my sweets and carbs like anyone else. But everything in moderation. I don't have any of the complications that has been associated with long term diagnoses of diabetes, and will do everything in my power not to every get them.

I think it is extremely narrow minded of some who think that you just get diabetes by what you eat. If that was the case everyone in America would have some form of the disease. Heredity is a factor in all of this. Education and a good endrocrinologist is the answer to a lot a people getting the help that they need.


Rob   November 17th, 2009 10:10 am ET

A. Smith, your post is one of the most uneducated, insensitive I have read in a long time. To blame my wife and I on our 3 year old daughter being a Type 1 diabetic is just absurd.

Do you have ANY idea what you are talking about? Environment? Drinking? Folic acid? My daughter's genetic makeup left her vulnerable to Type 1, not the actions of her parents.

What my wonderful kid has had to deal with the last 2 years has left me more impressed/proud of her than I could ever have imagined. What my wife and I have had to handle over those same two years I hope you never have to face.

Knowing that your child has a chronic disease that must be constantly monitored and the fear of a mistake costing her her life, I wonder how you would handle that? And how would you feel if someone pointed out that it was your fault?

Think before you post on a subject that you obviously have no knowledge of. I'm typing this shaking wishing I could show you just what a small child with Type 1 must go through every day.


Rob Allan   November 17th, 2009 10:12 am ET

As someone who has lived with Type 1 diabetes for over 20 years, I agree with most of what Steven W. says, although I wouldn't drink "quarts of chocolate milk!"

The key is to educate yourself, learn everything about Diabetes, and then do whatever is necessary to bring your sugar levels under good control (and those numbers can be slightly different for everyone).

Personally I have had great success managing Type 1 through insulin pump therapy, reversing both the onset of diabetic neuropothy and vision problems.

What I have seen time and time again, is that some simply refuse
to take the actions necessary to remain in good control, or ignore the disease all together. One of my customers' brothers went blind
because he would not take the actions necessary to manage his blood sugar levels.

Diabetes is definitely manageable, if you listen to your body and doctor.


Johnny M   November 17th, 2009 10:16 am ET

I got Type 1 about 12 years ago and was kicked out of the military for it (within 2 months of diagnosis).

For the most part, Type 1 is genetic (my dad has it as well, same type). However, the onset of this illness could have been slowed down if I had changed my diet early. Its too late for me...but if anyone else may possibly have the genetic pattern, eats poortly, and still doesn't have Type 1...you need to make a lifestyle change RIGHT NOW.

Diabetes can bring the strongest person to his/her knees. It is no joke. Don't give it any leeway or it WILL bite you later on...and you won't like where it bites.


Shelly   November 17th, 2009 10:26 am ET

I get so frustrated when the media and health companies talk about type II being preventable. It is not always so. I was diagnosed with type II at the age of 27, controlled with diet and exercise for 10 years, then oral meds for another 10, and now on insulin. I have never been overweight, generally have a healthy diet and exercise regularly. My A1Cs are traditionally in the 6 range, with the occasional 5 and 7. So I am not sure what I could have done not to have gotten this diagnosis.


ashvin patel   November 17th, 2009 10:39 am ET

Mr L King
Great artical, Ask same Question to Sanjay Gupta.
ap


Jim H.   November 17th, 2009 10:52 am ET

I was diagnosed with type 1 at about the age of 4. I'm 57 and had a kidney/pancreas transplant in March of 94. Things have been going fairly well the past 15 years but diabetes does take it's toll. Listen to your doctor and be honest with him/her. I don't take insulin and follow a heart healthy diet. Life is good.


Leia B.   November 17th, 2009 11:05 am ET

Steven W. there is NO WAY that you are avoiding spikes without taking your blood sugar. How do you even know what your blood sugar is doing without testing? I have serious doubts you even are Type 1 diabetic if you are able to drink all that chocolate milk- that is just irresponsible and stupid. Even if you take the correct dosage of insulin for the choc milk you would still spike at some point- it is IMPOSSIBLE to exactly mimic the body's natural dispersal of insulin with synthetic insulin. I have had Type 1 diabetes for 17 years since I was 9, it is people like you who trick people into thinking this is a disease that does not require constant monitoring, diet, and exercise- WHICH IT DOES.

A.Smith from Oregon- Do you have kids? If so I would be curious to know if you did all these things while you were pregnant, although I believe the world would be better off if narrow minded, misinformed, people like you did NOT reproduce.

Melanie- People like your mother diagnosed with diabetes are usually considered to have developed the disease through genetics. However, because of your description, her diagnosis is the exception rather than the rule. Type II diabetes is a combination of genetics and lifestyle. Some get it just from genetics (like your mother) some get it just because the are overweight and unhealthy, and some get it because of both. I would like to point out, though, that diagnosing the type of diabetes one has is a relatively complicated process- and I believe that people are misdiagnosed all the time, we now have many different types of diabetes other than 1 and 2- there's LADA and MODY.

Please, people, educate yourselves!!!


Erin   November 17th, 2009 11:29 am ET

I too wish that the media would distinguish between type 1 and type 2 more than they do. While there can be a genetic pre-disposition to both types, there are many differences and type 2 can be preventable. I have had type 1 since age 3 and I am now 24. Type 1 is caused by both parents having a genetic predisposition and another factor causing an autoimmune attack to occur.

A. Smith: You seem very certain in your accusations, but it isn't as clear as you imply. Yes, there are factors that cause the autoimmune attack but type 1 is not solely caused by drug use and highly toxic areas. If this was true, there would be geographic areas and socioeconomic populations with a higher occurrence of type 1 – and this hasn't happened. It would also mean that type 1 occurred more frequently before advanced medicine developed. Since the discovery of diabetes to today, the prevalence of type 1 cases has not fluctuated much, which means there is more to a diagnosis than what you say.


smilinggreenmom   November 17th, 2009 12:18 pm ET

With all of the benefits that probiotics have, I would like to say how much our family loves our chewable probiotics called Vidazorb and that they have really helped our family in many great ways. I have read that they are safe for diabetics and that the sweetener they use is recognized as safe by the American Diabetes Assoc. and feel this is important to mention because our son has had a limited diet due to ingredients that he is sensitive/allergic to. I think it is important to share healthy choices and products with others who have limited choices and these are really good probiotics for anyone and everyone. We love them and I just hope this helps diabetics who might be looking for ways to incorporate probiotics into their life too! 🙂


Ray   November 17th, 2009 1:06 pm ET

Somehow we must find a way to have people become self-motivated to actually change(!) lifestyles and behaviors. Education alone about diabetes and its consequences (or obesity for that matter) has not produced significant changes in people's behaviors to reduce the risks of diabetes, or to improve substantially the individual diabetes self-management. (Certainly, there are exceptions)

Thus I believe that only when changes are made in a person's basic psyche will substantial and lasting change occur in human behavior toward the prevention and control of diabetes.

Bring psychoanalysis into the diabetes prevention and control arsenal!


Sarah   November 17th, 2009 1:11 pm ET

I FIRMLY believe that the medical society and government has set us up for Diabetes. I have done testing with different oral medication and meters. I get different readings from different meters, which means the poor sucker who has the company 'who decides' for the next vial of strips they want it to run higher, it can.

The entire government and medical society has set us up for this supposed 'epidemic' by upping the sugar/carbos in every glass of pop; and in our food. Do some Nutrition Fact reading and you will find those items have sky rocketed! They have all but made us sugar and carbo addicts.

We don't have to eat it if we don't want to; what in God's name are we supposed to eat. The fast food restaurants dry out their potatoes and then use sugar to fuse them back together and presto-along with ketchup....we have extra sugar; Equal will kill you because it plays games with the body, if you see someone with a Diet Pop look at the other hand, they probably have a candy bar.

It is insane! The only thing I can say is turn about fair play. These same people will get back what they put out to us--then what will they do?

Get more than one diabetic monitor; tell your doctor what you are doing......they are probably in sync by now, but try using two (2)
different monitors and strips; when you use one, use the other at the same time to verify.

This is my take on the whole thing from a personal view.

The government and medical society SELLS SICKNESS! Watch the show....you will be astounded!


cristina   November 17th, 2009 1:16 pm ET

A Smith:

Your ridiculous conjectures and invented science are just moronic. You have clearly never even been near an introductory biology course so you should probably stop spewing nonsense.

Diabetic markers on sperm? Really? Maybe you've made this amazing discovery in your basement alongside your meth lab? If that's how this works, then riddle me this. Diabetes runs on my mother's side of the family. My mother, her brother and my grandmother were/are all diabetic. I had gestational diabetes and am now a diabetic. Last I checked, Mom doesn't make sperm and my diabetes is clearly hereditary on my mother's side of the family. Perhaps we should all have our eggs prescreened as well? While we're at it, lets only select the longer sperm because this will ensure that our kids are tall! Nonsense, pure nonsense.

For the sake of all who read this article: don't post garbage on a topic you know absolutely nothing about.


Frank   November 17th, 2009 1:25 pm ET

Being diagnosed with diabetes is not the end of the world. I am fortunate in that I have found an excellent diabetic counselor who is positive and not judgemental. I am in good control using oral meds. I do agree that testing is crucial, otherwise you have no idea how well you are doing. I continue to exercise although not as vigorously as I could when I was much younger.

Yet I still feel the need to keep my condition hidden from friends, family and co-workers. The medical community is understandably obliged to publish advice on how to avoid, or delay the onset of diabetes. Yet the information ( and disinformation) the media bombards us with leads to stigma on diabetes. The public perception that a diabetic person is a loser, a failure, and an invalid just infuriates me.


CAA Dover, NH   November 17th, 2009 1:47 pm ET

I was diagnosed with Type 1 at 24 years of age. I'm now 44 and have been battling diabetes ever since. As best the doctors could track, I appeared to have been exposed to some form of environmental condition that might have exacerbated the genetic predisposition for it (which means I had strep throat, mono and pnemonia continuously for approximately nine months when I was 21 years old. The doctors suspected all the meds and continuous runs of antibiotics did a number on my pancreas).
To A Smith: My parents have blamed themselves for over 20 years now that something they did caused this. I never would even consider blaming them; I find it hard to believe someone else would, either. We might one day get to the world of designer children, and killing off the genetically faulty ones, but I'm grateful I probably won't be around to see it.
To everyone else struggling with this disease: I've never truly had it under control. My A1C's have never been normal, and that includes the past two years of a vegan diet with no sugar items (ever!). I exercise daily, even though I've fought with doctors in the past that thought my activities, horseback riding, yoga, swimming and weightlifting, were "too strenuous" for someone with diabetes. I'm doing what I'm supposed to, but it has been a difficult struggle with, at best, mixed results. My best friend was recently diagnosed with Type 2, and is very scared about it, considering her mother died from Type 2 complications when she was 42 years old.
Genetics, activity, food, lifestyle: all contribute to it, but there is something else that science hasn't found yet. I've developed additional allergies since I was diagnosed, including environmentals (plants, chemicals, etc) as well as food (dairy) that doctors can't seem to figure out. Treatment is a mix of science and art. I just hope I can get it balanced for a few more decades to come.


pwb   November 17th, 2009 2:23 pm ET

cutting out sweets does not cure diabeties. My problem was carbs such as rice.
and it does not skip generations. Niether of my parents were diabetic, but I have an uncle and a cousin that are.
I was on glipizide and metformin and even though I was going to the gym 3x a week, watching my diet, etc, I was still gaining weight like crazy. Doc took me off the glipizide and put me on Byetta, and 45 lbs fell off within months! My A1C is 6.0 and I'm feeling great!


pwb   November 17th, 2009 2:27 pm ET

A. Smith, I don't t hink anyone "allows" themselves to become a diabetic. As I have said before, it's not all sweets and candy. Bread, potatos and rice are a staple at so many of our meals. And my parents and grandparents were not diabetic.


Jude   November 17th, 2009 2:30 pm ET

I was diagnosed in 2008 as pre-diabetic and with hyperthyroidism. I'll admit that at that time I used to eat a LOT of junk; cookies, cake, etc. and not much in the way of fruits/veggies. I've always been a skinny guy, so I was at risk for Type 1. I went on a thryoid med for a year and pricked my finger regularly. After a year, my thyroid was back to normal, as was my A1C. I'm no doctor, but in the past year I learned a few things that might help anyone like me.

The first, and most obvious, is cut out the sugary junk food. Fruits, although high in sugar, are high in fructose which I've read doesn't spike your blood sugar like refined sugar does.

Second, move. I bike/climb a lot, but was suprised to see how much a half-hour walk would reduce my blood sugar when compared to a 60-100mile bike ride. (more for the walk, less for the long endurance rides)

Third, look into supplements for control/reducing blood sugar (again at your own risk/research). A new article in Mens Health says that subjects who drank 8oz of (wild) blueberry juice for 8 weeks lowered their blood sugar by 10%....I'm just saying...DO YOUR RESEARCH

Fourth, and probably the hardest to find information about, sleep. I recently learned in bike magazine how critical adequate sleep is for our endocrine system, of which the thyroid and pancreas are a part. I used to sleep about 4 hours a night (because of my overactive thyroid), but I saw a statistically signifcant improvement in my blood sugar levels when I increased my sleep to around 8 hours a night.

Lastly, as someone pointed out, the accuracy of different blood sugar monitors are frustrating. I remember pricking my finger, getting a reading, and pricking another finger and finding the values pretty far off.

One last point–my endocrinologist said that my blood sugar tends to be higher when I wake (even when I'm fasting) because of something called the "dawn phenomenon". Look it up. It has to do with how your body responds or "wakes up" from sleep. Don't let this phenomenon, along with the varying accuracy of blood glucose monitors, be the only test a doctor uses for diagnosis!!

Good luck everyone.


Karen   November 17th, 2009 3:17 pm ET

I am a Type II diabetic, I didn't have a choice, I got the disease. I didn't choose this I am of average weight exercise regulary. I have a genetic predisposition to it, so yes there are risk factors for Type II, but there are even underweight people being diagnosed with Type II. Yes if you can help it reduce the risk factors, but Diabetes is a progressive disease and just like cancer or any other illness you may get it you may not. But I have friends who are morbidly obese and who have normal blood sugars, it's frustrating for me. But I just have to manage it that's all I can do.


Marianne   November 17th, 2009 3:27 pm ET

There are several simple things someone can do to help them live with diabetes.

Exercise moderately
cut way back on refined carbohydrates,
drink a lot more water,
eat smaller meals more frequently,
drink green tea and add cinnamon to diet.

Diabetes is in fact a "health sentence" ... meaning that it's telling you to get health habits now, the same habits and everyone else should do, a diabetic has to do to keep living .


Fawn   November 17th, 2009 4:55 pm ET

Wow, some really good comments, and some really offensive ones.

To A. Smith I can honestly say my mom took all the right supplements, avoided as many possible environmental triggers as possible, and at 13 years old I was a diagnosed type 1 weighing in at a dangerous 70 lbs. I went maybe 7 or 8 months before I was diagnosed and I can now say I have some eye complications and gastroparesis as a result of that.

Having studied genetics, microbiology, immunology, and some biochemistry I believe most of A Smith's comments have little scientific foundation, especially the stuff about genetic screening [because you'll have markers for genetic resistance or susceptibility and they're discovering new genetic markers in weird places affecting that all the time now (genes they wouldn't expect to)]. The more the scientific community starts to understand about causes for the development of type 1 and type 2, the more questions arise and the less we find we really understand.

I wish more people understood the differences between gestational, type 1, type 2, double or 1.5 diabetes, MODY, and LARA.

Yeah, it can break the bank paying for supplies, even with insurance. II know insurance denied my parents the ability to cover my insulin and testing supplies for a year, and they almost went bankrupt because of that in the 90s.

I can honestly say it's tough to be a type 1 diabetic and complications can really add to that challenge. I think I'm a better person for the challenges I've faced though and I saw how depressed my mom became when she found out my diagnosis 17+ yrs ago, she really thought it was her fault because there had been no type 1s in my family, just some type 2s and a few people with thyroid issues. A lot of stuff affect this condition (regardless of how you got this). A. Smith needs to take a step back off the judgemental arena, sounds like he (or she) is speaking more out of bitterness and some serious resentment than anything else.

Sleep is one of the least talked about and most significant ones though, I totally agree with that! I'd love to see more research on the amount of sleep affecting blood glucose levels and other hormones (like amalin) as well as some more work on dawn phenomenon (Jude mentioned this, basically the liver kicking up and out glucose production and raising blood sugars, making reserves, etc).


ImDiabetic   November 17th, 2009 5:26 pm ET

I'm familiar with MODY diabetes as I sent some information on it to my family doctor several years ago. He said although he doesn't have enough information or expertise to change the Type II diabetic diagnosis, he said MODY would explain a lot of my atypical traits. (I don't see a specialist right now as my blood sugar is in great control and my diabetes-related issues are well under control.... When I show signs of worsening, I'll be sent back to a specialist. It is a long story, but I was extremely tired of being poked and tested when they finally figured out I was diabetic)

But what is LANA? I tried a search and only came up with diabetics and diabetes specialists named Lana.

I agree with everyone who says diabetes is NOT our faults! At least in many cases. As I said earlier, my diagnosis took a long time because I just don't fit the Type II stereotype and my symptoms were not severe enough for Type I. An ear doctor actually caught it when I didn't heel following sinus surgery.

We're all different, at least Type IIs – I'm very mild. I have Typie II friends who are very severely diabetic. What did help my attitude was having gone to school with a boy with Type I diabetes whose mother would occasionally do little presentations to our elementary school classes about it. I knew I'd have to adapt, but I also knew the diabetes would NOT defeat me. I control the diabetes, the diabetes doesn't control me. There's a chance I could become worse quickly and even then I'll still do what I must to live with it!

I don't think there should be an argument over curing either Type I or Type II. Let's go for making steps to defeat BOTH!!! 😉


Fawn   November 17th, 2009 5:37 pm ET

ImDiabetic, I think you're asking about LADA (I may have stated LARA earlier). It stands for Latent Autoimmune Diabetes in Adults (slow onset but I've also heard it called type 1.5). Diabetesnet.com has a good explanation of some of it 🙂


n2vjb   November 17th, 2009 6:39 pm ET

Wow, there really ARE some kooks out there! To A. Smith, "What does the A. stand for?", I have my ideas. LOL.
I am a type 1 diabetic for the last 39 years. I have all of my parts in as good a working order as someone nearing 55 would have. Type 1 and type 2 are totally different beasts and that fact is poorly communicated in the media. Type 1 REQUIRES insulin as we no longer have the ability to produce insulin. It is an auto-immune disease like many others and requires a genetic proponent and possibly an activator to develop. In my case, a viral infection (cold) seems to have been the trigger. My pharmacist daughter, also type 1, manifested in the same manner. She has had it easier than I due to advances in technology (a good thing since she is with child). I test 5 times a day and adjust dosage according to the readings and the planned meal. Almost anything can be eaten IF you can calculate the glycemic value of the meal. You must be diligent in yours testing and remain VERY aware of 'how your body feels' in order to live a 'normal' life. It's really only discipline!


vic   November 17th, 2009 6:44 pm ET

In 1984 I was diagnosed with Type 1, brittle, stress-induced juvenile diabetes with adult onset. Back then brittle was what they now call out of control. The doctors felt that I had probably had gestational diabetes as my children were quite large. Insulin has changed quite a bit over the years and aren't we fortunate that the medical society no longer calls this disease "sugar diabetes", making people think we ate too many candy bars when we were kids. I actually had a person tell me that and also stated that she couldn't feel sorry for me because of that. Education, education, education is the key to being able to cope with this disease. Fortunately, the medical society does not consider my type of diabetes hereditary. Never, ever should anybody let a child think that their parents "gave" them this disease or that they did something wrong to get it. Support is what we all need and fortunately my diagnosing doctor was a comforting, compassionate research doctor who taught me all the "good stuff."


Billy   November 17th, 2009 6:48 pm ET

There is hope. In 1998 at age 37 I was diagnosed with diabetes. My glucose was 250, I weighed 320 pounds. After 5 years of diet and exercise I dropped 60 pounds and got down to 260 pounds and my blood sugar dropped to 95.

I have been off medication since 2003, I eat a normal diet, I exercise and my A1C is 4.2 my fasting sugar is between 90 and 100 and I have maintained my weight at 260 pounds.

So if you have been diagnosed with this disease, it is NOT a life sentence. You can change your lifestyle and change your life.


Carol   November 17th, 2009 8:24 pm ET

I am a 71 yr old female diabetic. (age is a risk, BTW). My diagnosis came after a 15 day course of prednisone(a trigger). My doctor said I am a thin diabetic. My daughter, son and brother, as well as my cousin and her mother, my maternal aunt, are also diabetic. My cholesterol has always been good, but triglycerides(recently linked to diabetes) were routinely high for a number of years. It was shocking to me that Obama said diabetes is a preventable disease. It is hereditary. If you have the DNA, are old enough, and have other health issues, It doesn't take much to trigger it. My doctor has me testing 3 times a day. I'm on Metformin and insulin pen and doing fairly well. I'm also feeling much, much better. Another interesting point, I do not crave potatoes anymore. I have come to believe cravings might be a signal that something could be wrong; a craving that is persistent and unusual for you might be something to talk to the doctor about.


pwb   November 17th, 2009 8:25 pm ET

Fawn – what is MODY?


pwb   November 17th, 2009 8:27 pm ET

I want to thank you all for the information. I am thrilled to see some web sites that I didn't know about. Keep up the sharing!


Diabetic   November 17th, 2009 8:45 pm ET

A Smith – diabetes is only partially hereditary. For Type II, exercise and eating habits are critical and the misinformation about in utero exposure is a bunch of bunk because what we are talking about is insulin resistance and conditions like Polycystic Ovary Syndrome and other hormonal imbalances have more to do with it than what your mother was doing when she carried you.
Mr Dillon – being diabetic is like being pregnant, either you are or you aren't. Once diagnosed and then brought under control means continue doing what you are doing but be aware that you may end up moving to pills and then insulin as you age. Exercise and diet can delay or prevent the complications and that is the goal whether you aupplement with pills/insulin later.
To all of you, go to the American Diabetes Association site as well as reading all these books and listening to uninformed comments. Just like the informed interpreters of politics, law, and science, the crap spewed in comments is rediculous but when it comes to health also can be harmful to those who believe them. Watch your starches, monitor cholesterol, monitor fats, control blood pressure, do not believe that meat is there to fill you up because protein digestion wears on the kidneys, check your retinas yearly, check your feet and above all, monitor the blood sugar.


Frank   November 17th, 2009 9:04 pm ET

A. Smith. Where do you get off judging people who are afflicted with this disease. Your comments are not only cruel and inconsiderate, they are pure unscientific bunk. I am type 2 diabetic and have a son that is type 1. Thank God we raised our son to blow off people like you. You are truly an anachronism. You belong in the Spanish Inquisition.


Terry Plaxton   November 17th, 2009 10:46 pm ET

Greetings,

That gentleman who has had Type I diabetes for 30 years and considers himself an "Expert" because of this is being kind of simple which is typical for an experienced ROOKIE! I was diagnosed on December 10, 1956. I am now 59, can see with both eyes, (Duh, had some lasar therpy back in the late 70's and had a couple cataracts removed within hte last ten years.) Both feet and both toes. I have had four toenails "Amputated" though it was not done as an emergency.
I too lived a very active life and to an extent ate what I wanted though the "Bad Things" I ate in limited quantities. A person of normal weight can easily inject enough insulin to offset large amounts of food, but cannot inject emough fast acting insulin (Such as humalog or Regular) to prevent a carbohydrate rush with a resulting spike in Blood sugar then a drop.

I lived that way a long time but about ten years ago wanted to fly. To get a med waiver, I had to behave, go to a Doctor once every 3 months, get A1C tests, test glucose, etc. I do that now but frankly, if my meter said I was high and I felt low I would eat.


Carol L-M   November 17th, 2009 11:50 pm ET

I was diagnosed with Type II five months ago, and was devastated, at first. My blood glucose was 353, where a year earlier it had been at 110. My A1C was 12.6, where one year earlier it had been at 6.6. My doctor had never warned me previously, other than telling me I should lose weight. I'm 56 years old, and weighed almost 200 pounds, lost about ten before my diagnosis (a symptom I was not familiar with), and had many of other symptoms, but clearly was in denial. So I got the diagnosis, and in the first three months I increased my exercise to 6 days a week, about 45 minutes to an hour, alternating going to Curves with walking on my treadmill. Also began to walk the dog more frequently, which is good for her too. I greatly improved my diet, and read a lot of books, including Diabetes For Dummies. Anyway, in 3 months I got my weight down to 178, my glucose level down to 100, and my A1C was at 5.5. My challenge now is to keep up with these changes, and to not get lazy. I've hit a plateau with my weight, around 175, so it's hard to keep working so much with no result there, but I need to persevere. My weight should be in the 130-140 range, and that's my goal. I take Glucovance twice a day, and my hope would be to lessen the dosage, or hopefully get off of it altogether. My biggest concern is that my doctor did not instruct me to check my blood glucose levels daily, and my insurance company will not cover any such supplies without a prescription from him. I asked the doctor why, and he simply stated 'there are two schools of thought on that', so I assume his is the old school. I find it difficult to sift through all of the advice and info, since I feel it's up to me to manage this, with very little help from my doctor. I plan to see him again in four months, for bloodwork, and depending on how I progress, I will most likely be looking for an endocrinologist, in my medical plan, to help me going forward. I do feel now that it is not a death sentence, but continue to feel a little in the dark and on my own.


william fitzwater   November 18th, 2009 1:10 am ET

another big point is access to care many many people die from the complication of this disease. I'm a type 2 and I am having a very difficult time keeping my insurance and I have been out of work for 1 year. It is not considered a disability however when I become more sick from this disease because I can't get my medication then I will get help. It is a reverse reward where staying healthy should be reward.
Next year I will loose my medical coverage because I can't pay for it. The costs are increasing beyond my ability to pay for medical insurance. I will surcome to the complications of this disease. After that at a increased cost to the tax payer I might get help only to be deneyed again because I am not disabled or indifferent to my predicament. Medical care in the 21st century at the county hospital emergency room . It will be the only place thta will take me.

While those idiots play games in Washington. I get sick go to the hospital you pay. They all should do with out insurance they would sing a different tune. I say shame on both parties ; shame on them. Does this make sense when helping to pay for my insurance or giving the tools to keep me well will lower the bottom line .
Because I exercise such as it is try to eat right and I am still suffering with this relentless disease.
The news media confuses people with town hall screamers and shout nonsense of socialism . For what; ratings that short changes Americans and makes the insurance & medical industry more in more in control of both parties.
This is how America doesn't work . China, Europe many other places put far more value on its citizens. We don't; its about the bottom line.


Stephen L Spero   November 18th, 2009 1:22 am ET

I have had type 2 diabetes for 12 years. I find the best way to deal with it is watch what you eat, and get at lest 150 minutes of aerobic exercise a week. I am on my exercise bike every day.


aubreay   November 18th, 2009 10:54 am ET

diabetes are a big thing and what you eat can either make it worse or better. most people weren't conscious about it


Fawn   November 18th, 2009 1:09 pm ET

MODY stands for mature onset diabetes in the young. Essentially it's got similarities to straight type 1 and type 2 but is neither one or the other so it's sort of a 1.5 if you will. LADA is as well but because there's an autoimmune component the causal factors a bit different (and labwork). It's hard to get a MODY diagnosis without some genetic testing though and most insurance companies don't cover that kind of testing. I'd recommend checking out diabetesnet.com or american diabetes association (although I think diabetesnet.com has better descriptions of MODY and LADA personally).


pwb   November 18th, 2009 1:59 pm ET

thanks Fawn. love what I'm learning here!


Donna Yirka   November 20th, 2009 11:07 pm ET

I have type 2 diabetes. I cannot affort testing supplies and have no medical. I have no way to figure out my spikes and am very scarred.
I need help.


Cydella   December 2nd, 2009 1:31 am ET

I grew up on a farm and was very active most of my life. I worked hard since I was 7 years old. As I grew up I finally landed a position as Postmaster in my hometown. It was more or less a sedentary position with minimal physical activity. As the years passed I began developing more and more medical issues. Finally my health forced me to retire on disability at the age of 36 years-old. At the age of 44, I was diagnosed with type 2 Diabetes. Only problem is that I had it for quite some time and it went undiagnosed, even though I constantly went to my doctor with symptoms. When I was finally diagnosed I had already accelerated peripherial neuropathy. A few years later I was placed in a power chair as my muscles in my legs became weaker and my balance was bad. It was too risky to walk. I agree, we need to quite taking the easy way round about. We need to ditch the processed foods, get out and move around more. Even developing a program to help people learn to cook natural foods, prepare meal plans, prepare and fulfill exercise plans on a consistant basis, develop support systems, get educated. America is just plain LAZY! We cannot committ unless it is to a lack-a-daisy attitude or way of living. I fear for the future in regard to diabetics. God save us from our own destructive selves.


ImDiabetic   December 2nd, 2009 8:30 am ET

Cydella,

Although I don't think you meant for it to sound that way, you are making it look like all diabetics are diabetic because they are lazy and their life style. That is NOT the case for all of us. It isn't for me and I am Type II. It isn't for Type I diabetics.

No one knows why I'm diabetic but I've never been more than a few pounds overweight if that much and I certainly wasn't when diagnosed. I've always been fairly active. You may have been diabetic anyway, just perhaps better controlled.

But I do agree with you that people need to get up and move! I have a friend younger than me who is now nearly blind because although she knew she was Type II, she felt the medication should do everything, didn't go to her eye doctor for over ten years, always had an excuse not to exercise, and is now paying the price. This all came to light after my last comment on this article.

However, there isn't a "one size fits all" reason for diabetics. Some of us are not lazy and still get Type II.


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