IHoP

Posted on January 13, 2012 by janekdickinson

Once known as the International House of Pancakes, IHoP now stands for Islet Homeostasis Protein. There is so much irony here that I just couldn’t pass up the opportunity to discuss.

People with type 1 diabetes typically lose both insulin and glucagon production. Both hormones are made in the pancreas (in the Islets of Langerhans*, clusters of endocrine cells); while insulin’s job is to lower blood glucose, glucagon raises it. Both actually have very important roles in glucose regulation in the human body.

Because people with type 1 diabetes no longer produce these hormones, we have to do all the regulating ourselves. Try as we might, however, it is not possible to achieve perfection (as the normally functioning human body can). Were we to visit IHOP and have a big stack of pancakes, we’d have to carefully calculate insulin doses and likely deal with crazy blood glucose levels the rest of the day.

Now scientists have discovered a protein in the glucagon-producing cells. They think this protein has a role in glucose regulation, because it is present in lab rodents and humans without diabetes, but it is not present in those with diabetes.

We’ll see where this research leads, but it’s exciting that we may have a new angle from which to approach things. One never knows…maybe a new angle will lead to something further.

*As an aside, I was fascinated to learn that Paul Langerhans discovered these pancreatic islets when he was 22! There is a trend in science right now to stop calling parts of the body names that reflect the people who discovered them. I really don’t have a problem with it. Give the guy a little credit!

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Do you know who your provider is?

Posted on January 11, 2012 by janekdickinson

There is an interesting discussion taking place on the New York Times Well Blog about the term, “provider.” In health care we often hear and use the provider as a generic word for a physician, nurse practitioner, or physician assistant (PA). It turns out that this word really bothers some people. I appreciate that, because there are some words that really bother me (stay tuned).

I use provider when I am referring to a health care professional in a general, inclusive sense, and not identifying (either on purpose or because I don’t know) which type of provider it is. For instance, “be sure to talk to your health care provider to see if it is safe for you to start an exercise program.” Where it gets confusing for me, though, is when people use “provider” to mean health insurance company or even HMO (for instance, United Health Care or Kaiser Permanente).

I think the most important thing is that we share information openly and honestly between health care professionals and those who use our services (typically referred to as “patients” but more recently being called “consumers”). It is important for health care providers to introduce themselves to patients and identify their role. For example, “Hi, I’m Jane. I’m a nurse and certified diabetes educator,” or “Hi, I’m Dr. Bennett. I’m a nurse practitioner,” and so on.

Today there are many doctoral degrees: pharmacists, psychologists, physical therapists, nurses, dietitians, and many others can earn a doctorate. We will, therefore, meet a variety of health care professionals who call themselves “doctor,” and may or may not be a physician. The patient deserves to know who they are talking to and what their credentials are. If your provider does not offer this information, be sure to ask.

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Time to sleep

Posted on January 9, 2012 by janekdickinson

Sleep is very important, and I am a huge proponent of sleep. As a result, my kids are good sleepers. We’ve known for a while that type 2 diabetes is closely linked with sleep apnea, a dangerous sleep disorder. Those who are overweight or obese often have sleep apnea. Sleep apnea means the person literally stops breathing during sleep. They then wake up and restart breathing. This happens repeatedly all night long, and the person has no idea.

Typically it’s a bed partner or someone living in the same home who complains about the person’s snoring. Signs of sleep apnea include difficulty getting up in the morning, daytime drowsiness, lack of energy, loss of productivity, irritability, and sometimes falling asleep at the wheel.

An article recently came out about sleep disorders in kids with type 1 diabetes. Poor sleep can lead to behavior problems, elevated blood glucose levels, and serious health problems down the road.

Checking overnight blood glucose is something parents may do for their children, and this is fine every once in a while. If it is becoming a nightly ritual, it’s time to consider something else; perhaps continuous glucose monitoring. Getting up every night to check a blood glucose leads to poor sleep for the parent and possibly for the child (even though we think they sleep through it).

Middle of the night low blood glucose can also cause lack of sleep (or poor sleep). The other night I woke up low, went downstairs to treat it and found my husband working on his computer. He decided it was time to have a full-blown conversation and kept me up for a while. Major sleep disruption. If you are experiencing consistent overnight lows, it’s time to talk to your health care provider about making a change in your medication or food.

Take sleep seriously. It’s important. Now it’s time for bed.

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Motivation to Lose Weight

Posted on January 4, 2012 by janekdickinson

News flash: you need motivation to lose weight. But seriously, we do. Here’s an article that gives some helpful tips and emphasizes the importance of not beating yourself up when you have a setback. I think that’s very important. Just like when you see a number on your meter that you don’t like, adjust and move on. With eating habits, if you fall off the wagon and eat something unhealthy or overeat, make a plan for tomorrow and move on. With exercise, if you miss a day, get back to it the next day and don’t stress over it. Eventually you will form healthy lifestyle habits and your cravings for unhealthy food and your days without exercise will be the exception.

One of my favorite quotes:

Courage does not always roar. sometimes courage is the quiet voice at the end of the day saying, ‘I will try again tomorrow.’ Mary Anne Radmacher

Have a great day tomorrow!

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493 does not equal 128

Posted on January 3, 2012 by janekdickinson

You’ve probably heard this advice many times: wash your hands and dry them before checking your blood glucose. Most of us would admit we don’t always do it. Sometimes we wipe our hands on our jeans; other times we figure “they’re clean enough” and go for it.

How many of you have experienced a false high blood glucose because you had jelly or some other substance on your finger? It happens. In fact, it just happened to me. I checked my blood glucose just minutes ago and it was 493. I had even rinsed my hands prior to checking. I was puzzled by this number, since it really made no sense: I hadn’t eaten anything in approximately 4 hours.

I had, however, just cut up several apples and made applesauce. I figured my hand-rinsing job wasn’t sufficient, so I washed them, dried them and checked again. This time I was 128. So glad I didn’t take insulin to bring down that 493! I’d be eating all the applesauce (and more) in one sitting.

Wash your hands and dry them before checking your blood glucose. Good advice.

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Success in 2012

Posted on December 30, 2011 by janekdickinson

The next time I post it will be 2012. It’s traditional to make New Year’s resolutions, and people always talk about how most resolutions don’t stick. One way to succeed with your resolutions is to make only a limited number of them – say, three or less. The more resolutions you make, the less likely you are to stick with them.

Another suggestion is to make resolutions that really matter to you. If it’s something you don’t really care about, or aren’t overly invested in, you probably won’t stick with it. Finally, make resolutions that are do-able. Set yourself up for success, not failure. Make it something you can measure, so you know you are doing it. For example, “I will take the reusable bags into the grocery store and use them every time I shop” rather than “I will be more environmentally conscious.”

Here’s an article about setting goals (or resolutions) this New Year’s. Have a safe and fun New Year’s Eve and a very happy, healthy and successful 2012!

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Where’s Your Vitamin D?

Posted on December 28, 2011 by janekdickinson

Vitamin D is getting a lot of attention these days. I was alerted to an article about diabetes risk in children of moms with low vitamin D levels, so I did a little snooping. In addition to bone health, vitamin D appears to have a relationship with immunity, inflammation, cancer, hypertension, chronic diseases (including diabetes), and more.

It is pretty well known that a natural source of vitamin D is the UV rays in sunlight. Unfortunately we need to be careful how much direct sunlight we get; we protect ourselves from skin cancer by wearing sunscreen, which blocks our ability to make vitamin D. Another problem is the angle of the sun at different times of year. I live in a place that gets sun most days of the year, yet all winter long we aren’t at the right angle for the vitamin D benefit. It’s a good idea to balance your sun exposure time (a little) with your sun protection time (a lot).

People also tend to know that milk is fortified with vitamin D. A reminder: all commercial milk contains vitamin D; not just whole milk, but everything down to fat-free. Some people argue they (and their children) have to drink whole milk because it has vitamin D – argue no more!

Another article has some excellent and very thorough information about vitamin D sources, levels, and more. Parts of it get a little technical, but most is very helpful. Talk to your health care provider about getting your vitamin D level checked, be aware of where you are getting vitamin D, and be informed about whether or not you need a vitamin D supplement.

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Open mind, insert ideas

Posted on December 26, 2011 by janekdickinson

I was cleaning my desk and came across a little piece of paper that says the following:

The mind is like a parachute – it does not work if it’s not open. — Charlie Chan

Not wanting to misquote anyone or give the wrong person credit, I did a quick internet search on this quote and discovered that a very similar one is attributed to Frank Zappa: A mind is like a parachute. It doesn’t work if it is not open. I also found the following attributed to Frank Zappa: The mind is like a parachute it works best when opened.

It’s like a game of “Telephone.” The exact words (and the person who said them) keep changing. But the message is the same. This, of course, reminded me of diabetes because we all get slightly different words from our friends, relatives, health care providers, but the message is the same: take care of yourself, be healthy and have a good life.

How we go about doing that will vary from person to person – some exercise more, some watch food more carefully than others, some check blood glucose levels more frequently, some use all the gadgets, others stick with what’s been working for years.

Regardless of how much we do or how we do it, keeping an open mind can help us meet new people, learn new “tricks,” and enjoy new experiences. Not always easy, but something to strive for.

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100th Post

Posted on December 21, 2011 by janekdickinson

It’s not surprising that I’m thinking about holidays and holiday eating these days.

There are countless articles circulating about how to make healthy food choices at the holidays. I’ve read many and shared some too. But just like parenting advice, holiday advice can get overwhelming and annoying. For me the most important thing is to stay focused on what’s important. Food is not the most important part of the celebration. If I focus on visiting with friends, etc., the food can actually take a (somewhat) smaller role.

Don’t get me wrong, food is definitely a prominent part of every celebration. It’s unavoidable and it’s delicious. I do a lot of mental preparing – thinking about how I’ll handle the food that will inevitably be at whatever event I’m attending. Sometimes I do very well at the moderation thing, and other times I don’t. Most importantly, I don’t spend a lot of time worrying about it. I get back on track as soon as possible and move on.

I also work hard to continue my exercise habits during the holidays. Unfortunately, the exercise class I started recently is not being held all next week. I’m a little nervous about that. Not because I won’t be working out on those days (I’ll do something else), but because I’m worried about whether I’ll have it in me to start back up the following week. But there’s only one way to find out!

Happy Holidays to everyone! Enjoy whatever you celebrate. Enjoy the music, the lights, the candles, the festivities, the people – THE FOOD.

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GDM – part 4

Posted on December 19, 2011 by janekdickinson

Once the woman with gestational diabetes mellitus (GDM) delivers her baby, the GDM is gone. The pregnancy hormones are no longer an issue, and she makes enough insulin to keep her body functioning as it should be. At least for a while.

One of the biggest risks with GDM is developing type 2 diabetes later in life. Women who have or have had GDM (even those who delivered a large baby {over 9 pounds} and weren’t diagnosed with GDM) have a roughly 40 percent chance of developing type 2 diabetes in the next 10 to 20 years. There is research that shows women who took insulin to manage GDM have a higher risk for developing type 2 diabetes.

This is something to take very seriously. Women who have had GDM can prevent developing type 2 diabetes by sticking with the healthy habits they established during pregnancy: healthy food choices and regular exercise. Start right away by taking Baby for walks in the stroller.

If you had GDM during a pregnancy, you need to get checked for diabetes routinely. At least yearly, you have a fasting blood glucose drawn to make sure it remains in the normal range. It’s best to prevent type 2 from ever happening, but if you are diagnosed with type 2 diabetes, the earlier it is diagnosed and treated/managed, the better.

If you are at risk for type 2 diabetes, your children are too. It’s important to lead by example and teach your children to maintain a healthy lifestyle. Teach them to be active every day, and provide healthy food for them.

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