I can’t decide if my left brain is stronger than my right brain?  Yes, I’m a diabetes educator who wants to save everybody from the disease and from themselves.  At the same time, I realize that we’re all only human and knowing what we need to do and actually doing what we need to do ……………..may be two very different things.

My intellectual side realizes this and my creative side wrote a song about it.  It’s called, “It’s Not Too Late” and it’s sung to the Carole King (sure I’m almost old) tune, “It’s Too Late”.  So, for all of you who actually know the song, please join me and sing your hearts out!

Stayed in bed all morning just to pass the time, I have diabetes there can be no denying      I don’t want to change but they’re telling me to keep on trying.  They say it’s not too late no it’s not too late to make critical lifestyle changes, but I don’t want to deal with this burden but I can’t ignore it and I have to take it

Oh no…………………

It used to be so easy without this disease, now I test my blood sugar and care more about what I eat.  The exercise is important and relaxing is what I need.

They’ll be a long life for me and you , if we use the education and comply with it too, my support team motivates me and now I have what I need.

It’s not too late to be educated, it’s not too late to help my body, it’s not too late life is for changing, it’s not too late life is for accepting, it’s not too late

©2009 Do It Yourself Diabetes with Marci Sloane. All Rights Reserved.

New day, new patient.  Fasting glucose is 124 mg/dL.  Triglycerides are 560, HDLs 28.  Patient is 50 pounds overweight.  Does she or doesn’t she?  Is it or isn’t it?  The difference between having NO diabetes, pre-diabetes and diabetes can be so minor, a fine-line.  Fasting blood glucose between 65 mg/dL and 99 is “normal” while 100-125 is pre-diabetes and 126 and higher (measured on two different ocassions) is considered diabetes.  Other numbers need to be looked at as well.  The typical profile for a person with diabetes is high triglycerides and low HDL (healthy cholesterol aka high density lipoproteins).  This patient was diagnosed with pre-diabetes and yet wasn’t concerned because it was not a true, full-fledged, diabetes diagnosis.  Looking at the other numbers (triglycerides and HDLs) I suggested another glucose test and HbA1c (3-month blood sugar average).   Many cases of diabetes are missed and therefore, over the years, the guidelines have been changed.  We should request an “A1c” – especially if we are over the age of 45.

©2009 Do It Yourself Diabetes with Marci Sloane. All Rights Reserved.

Yesterday I had a “young” patient – a mere 46 years (my age!) who was just diagnosed with Type 2 diabetes.  His doctor called me to make sure I’d be able to see him this week and sent me his blood work.  Glucose was 638 mg/dL!!  The man stated that he felt extremely weak and had lost 30 pounds in the last month.  His diet for breakfast that day was: whole wheat toast (1 – 2 slices) with 2 tangerines, lots of low-fat milk and and egg white with one slice bacon.  I wasn’t sure if the Fortamet medication, given in it’s low dose, would be enough to lower his glucose.  We tested it about 1-2 hours after that breakfast and after taking one pill and the glucose was now 364 mg/dL.  We were thrilled that it had improved but knew we still had a lot of work to do.  We discussed how milk will turn into sugar and how it is often used to treat low blood sugar (as long as it is low fat or skim so it gets into the bloodstream rapidly).  We further discussed his carbohydrate “budget” and about mixing food groups to improve and stabilize glucose levels.  And then, of course, I directed him to the DestinationDiabetes.com website with the abundance of information and support for his healthy future.

©2009 Do It Yourself Diabetes with Marci Sloane. All Rights Reserved.

Today is the beginning of 2009 and my patients have a new and improved attitude.  The chocolate and cakes are eaten and now is the time to get serious!  I laugh as I say this since all year we just have to be MODERATE!  It’s never time to OMIT or QUIT rather we need to have less of the stuff we know can hurt us.

My 80 year old patient today is another favorite who I’ve known and counseled for about 12 years.  She complained of edema (swelling) in her legs and is quite worried.  Luckily, she is visiting her doctor for blood work followed by her endocrinologist in the next week so and we will get to the bottom of WHY?  The food part of all of this is: she wanted to have a corned beef sandwich.

We spent a little time talking about the effect a high-sodium corned beef sandwich might have on her edema.  Again, we shouldn’t omit foods from our diets, rather be moderate. However, if they will hurt your body (especially acutely) – please be careful.  The high-sodium corned beef would simply add to the water retention problem and make my patient more uncomfortable and worried than she already is.  Would the sandwich be worth it at that point?  On the other hand, if she wanted a small slice of pie and counted those carbs into her meal plan, it should not be a problem.

©2009 Do It Yourself Diabetes with Marci Sloane. All Rights Reserved.

The dreaded diet counseling continued this week.  I don’t dread the counseling, but the patient may dread it until they are overjoyed with their new knowledge to help them succeed with their goals!

I happen to enjoy the look on my patients face when I tell them that 4 ounces of orange juice is 75 calories and turns into 4 teaspoons of sugar (over 1 tablespoon!), or that the avocado they are eating as part of their healthy weight loss plan may be healthy (and it is filled with monounsaturated fats – the most heart healthy fat!), but every 2 tablespoons have 45 calories and is considered one fat serving.   One patient this week was so excited to learn about nutrition.  She has been successfully cutting back on portion sizes and fats but didn’t realize some of the hidden calories and how quickly they can add up.  She was surprised to learn that 3,500 calories equal ONE POUND and ………….if you reduce your caloric intake by 500 calories a day, for one week, you will lose that pound!

It’s so easy!  She was eating 1/2 an avocado.  If 2 tablespoons has 45 calories how many calories in 1/2 of the avocado?  Too many!  One piece of cheese is 100 calories, 15 almonds is 100 calories, 6 ounces of juice is 100 calories, 8 ounces of skim milk is 90 calories, 4-6 crackers is 100 calories – and there you have it – your lost pound.

The moral of the story is:  calories add up when you don’t think about them.

©2009 Do It Yourself Diabetes with Marci Sloane. All Rights Reserved.

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