(SOME) ENDOCRINOLOGISTS WHO TREAT TYPE 1 DIABETES

NEW TOOLS FOR DIABETES

It is expected in 2007 that this Diagnostic Tool(NMB- 200) for Diabetes will be able to measure Glucose in "Real Time" as well as O2 levels in the blood, red blood cells and iron in addition to the Heart Rate.... What I like best about this product, is that it is "non-invasive" and is worn like a wrist watch. No idea as to its price. Wow, who needs a doctor and lousy insurance forms with gossipy/up-tight/unprofessional office staff? Unfortunately, this probably will not be available for about one year. A reward for those who have patience. Read more:

Non-invasive Glucometry from Orsense Wins Award
Filed under: Diagnostics , Geriatrics , Medicine , Pediatrics

OrSense Ltd., of Nes Ziona, Israel, is another recipient of the technology innovation award from Frost & Sullivan for its non-invasive glucose monitoring system NBM-200. The system, based on proprietary "occlusion spectroscopy" technology, allows continuous measurement of blood glucose, hemoglobin, hematocrit, oximetry, and heart rates. Results from a clinical trial, reported in September, have shown that the system "accurately measures levels of glucose in a home-like setting."

OrSense's patented technology, known as Occlusion Spectroscopy, uses a non-invasive optical measurement platform combined with a ring-shaped cuff. The pressure applied by the cuff temporarily occludes the blood flow in the finger, creating new blood dynamics which generate a strong optical signal, yielding a high signal-to-noise ratio that is wholly blood specific. Analysis of the signal provides the sensitivity necessary to measure blood glucose, hemoglobin, and other analyte concentrations.

TAG LIST

The Music that I listen to this time of year is pretty much the same what I will listen to any other day of the year.Here is a list of the "5", which I have listened to for the past week.
1. Silent Night/The Temptations
2. The Way You Look Tonight/The Jaguars
3. Visions Of Johanna/Bob Dylan
4. The Bells Of St. Mary's/Bing Crosby
5. Pop Star/The Pretenders
Thanks for your Tag Andrea@ My Blog?? :D/www.acthoughts.blogspot.com
I in turn, will Tag the following as to their Music Preferences for this Christmas/Holiday Season:
1. Kathy@ PurpleHaze/kathy4762.blogspot.com
2. Scott@ Scott's Web Log/sstrumello.blogspot.com
3. Megan@ This is My Life/www.thisismylife3.blogspot.com
4. Anne@ annetics/annetics.blogspot.com
5. Lyrehca@ Managing The Sweetness Within/thesweetnesswithin.blogspot.com

THE BURDEN OF DIABETES

Sometimes on a Long Cold Night, the Burden of Diabetes Becomes Heavy.

TODAY'S MENU

This evening for dinner, I prepared and had a poached chicken in a pool of noodles simmering in a turkey broth with fresh mixed vegetables.
Dessert is a yellow cake with a rich chocolate sauce that is now cooling in the refrigerator.
Ahhh................Life with Diabetes. What more can you ask for?

ANIMALS WITH DIABETES

Since all of us go through the emotional and physical upheavals daily in dealing/living with Diabetes,
do any of you have pets that have this illness as well?
If so, are you treating your dog or cat with a basal injection of insulin (Lantus or Detemir) 1X Daily?
How do you go about testing your pet's glucose level and is it done more than 1-2X Daily?
Are you then covering any Hyperglycemia with short acting insulin and if so, what are the acceptable Glucose range in
Animals?
These are some questions that I have been thinking about since dogs and cats do develop Diabetes.

THE WHOLE DIABETES PACKAGE

As those of us with Diabetes(T1DM) already know, this Chronic Illness is more than a problem of metabolism. It is a "Package Deal". For no matter how well your blood sugars are controlled and your diet is optimized, the risk of complications related to T1DM are always there. Of course, this is only my opinion but having Diabetes(T1DM) since childhood and always educating myself about this Illness, I have come to the conclusion that the potential for complications of CHD(Coronary Heart Disease), Autonomic and Peripheral Neuropathy, Kidney Disease are always present and await for the "right opportunity" to make their presence known.
Fortunately there are those within the Medical and Science Communities who have created a number of impacts to starve off a number of these horrible "Side Effects" associated with long term Diabetes. They range from the ACE Inhibitors to protect our Kidneys to the Statins offering protection related to certain aspects of CHD. There has until now, been no way of protecting the body against the damage of Peripheral Neuropathy in Diabetes until now.
Thomas Brannagan, MD and his Staff are now in Phase ll Studies to evaluate the efficiency and Safety of a Research Medication in Patients with Mild to Moderate Diabetic Polyneuropathy.
Details of this study can be found in: The Journal Of Diabetes/3/2006 called "Orally Active Neurotrophin Enhancing Agent Protects Against Dysfunction Of Peripheral Nerve in Hyperglycemic Animals".
I have met with Dr. Brannagan and found him to have the qualities that we all wish/want every Physician that we encounter to have. They are intelligence, caring, ability to communicate and optimism for what they do. These are the qualities that describe Dr. Brannagan. Corinna on Staff w/Dr. Brannigan is both intelligent and efficient. She is responsible for the Research Medications, Study Protocol, Laboratory Tests, Appointments and "just making sure that everything operates smoothly". To reach Dr. Brannagan or Corinna here in NYC and enroll or ask questions about the study you can call @212-888-8516.

TOOTH EXTRACTION

BLOOD OOZIES FROM SIDE OF MOUTH
ONTO FRESHLY LAUNDERED PILLOW CASE
AS A BROOK IN SPRING AWAKES AFTER LONG DEEP WINTER SLEEP.

PURPLE HAZE

Diabetes has its own set/time and way that it deals in destruction. It is like a truckload of Illegal Lilliputians that are not visible to you and who have a destiny to rake your Fields(Organs) for Harvest that brings forth its fruit to those in white uniforms/Lab coats as they draw your blood, inject medicines and listen to your heart.
Dedicated to: Minnesota Nice

THE PICKPOCKET

Diabetes is like a Pickpocket.
He is able to steal your Soul w/o looking.
He is able to work Days or Night.
He is unsuspecting until too late.
He can make his presence felt or not.
He is a constant Traveling Companion.

REMEMBERANCE

God Bless All the Rescue Workers/Firemen/NYPD/Medical Personnel and Volunteers from NYC and elsewhere who helped to heal the Many on that day of 9/11/01 and the ones following.
......and God Bless the Friends that I have lost.
What we need Now are less tears and more closed fists to destroy Radical Islam as well as a change in the policy of the INS who were responsible (partially) in allowing these Terriorists to enter our country.

COFFEE, CAKE & STARBUCKS

The Lunch Rush Hour has ended in Midtown.
I arrive and take my seat at the Starbucks along the Great Window that faces the passing of people.
The Air-Conditioner provides a comfort level mixed with the Chocolate Cake Doughnut and Sumatra Coffee that will "fix" my Hypoglycemia.
My earphones play Dylan's, "Desolation Row" as I look at all the Hominid passings from the Large Starbuck's Window.
Virtual Reality at its Finest Hour

HAIKU

Hot days and nights
No Wind
Sticky sweat with Glucose lays on skin.

FINALLY!! DIABETES SOFTWARE FOR MAC OSX USERS

As most of us know by now, there is almost ∅ amount of Diabetes related software for Mac Users, which is why I was elated upon coming across
Diabetes Logbook X 1.0b5 - Track and report diabetes related events. Since Mac does have the "best" Graphics available, why not take advantage of this feature that Developer Paul Nesfield from UK has provided. The Application is a Log Book for all T1DM persons where you can input Glucose levels, Insulin amounts, Carb. numbers, Medications (in addition to Insulin) taken, Ketone data and "Notes" regarding any Problems. It is however formatted in 24hr rather than 12 hr time (which is no big deal). It has a color code that lets you visual "see" your results in the Log Reports that are generated from 7 days to 12 months. One can also "Import" and "Export" Data. Everything is very well done. What I personally would like to have as a possible "Update" is the availability of a scatter and simple line graph as well. Currently the only representation besides the numbers Data is horizontal Bar Graphs in the Report Section. BTW this is a "Freeware"/"Donationware" which is of additional benefit to many. However, since this is a Freeware and Paul Nesfield did take the time to put all this together and make available, why not "Donate" what you are able to offer. He and the Wife must now put the energy, time and anxiety (as we all know) in the caring of their wonderful 6½ yr. old son who was diagnosed w/T1DM 3 years ago. Donations will be going to The Diabetes Association of UK.

MOMENT OF JOY

Sitting on the bed on a hot Summer afternoon with my cats who have saved my Life many times.........as we eat yogurt with blueberries together......

OPPRESSIVE HEAT OR SUMMER IN THE CITY

Do any of you with T1DM also feel extremely uncomfortable during the hot/humid Summer Days? I do know, that those with Autonomic Neuropathy because of T1DM do have difficulty in their bodies "cooling down" and adapting well to hot weather.

TYPE 1 & TYPE 2 DIABETES TOGETHER

According to Professsor Francine Kaufman, Director of the Centre for Diabetes, Endocrinology and Metabolism at The Childrens Hospital, Los Angeles, California there now exists an increase in the onset of both T1DM and Type 2 Diabetes in children. What is unusal, is that both diseases exists together in the same child. Type 2 is for the most part obesity related and can be "prevented" with good and healthy Lifestyle habits. Here is a copy of the article which I hope you will find interesting.'Double diabetes' appearing in kids

[Posted: Mon 29/05/2006]

When a child or teenager develops diabetes, it is relatively easy for doctors to distinguish whether they have type 1 or type 2. However new research has found that some young people have elements of both kinds of the condition - a phenomenon known as 'double' or 'hybrid' diabetes.

Current figures show that both type 1 and type 2 diabetes are on the increase in children and teenagers. The overall prevalence of type 1 diabetes among children under 15 is increasing by over 3% every year, while in children under the age of four, it is increasing by more than 6% a year.

Meanwhile, over the last 10 - 15 years, there has been a increase in the incidence of type 2 diabetes in young people worldwide. This has largely been obesity-driven.

Writing in the International Diabetes Federation's magazine, Diabetes Voice, diabetes expert, Professor Francine Kaufman, said that while it is usually easy to determine what type of diabetes a young person has, 'in some instances, it is not quite so clear'.



While there are a number of differences between the two types of diabetes, Professor Kaufman pointed out that with type 1, the 'hallmark' is the presence of antibodies which attack the insulin-producing pancreatic beta cells.

The hallmark of type 2 meanwhile is the combination of insensitivity to insulin and the body's continuing ability to make the hormone, although not enough to overcome the body's insensitivity to the action of insulin.

"Double diabetes suggests that elements of both type 1 and type 2 diabetes co-exist in the same person...Blurring the issue further is the fact that people with type 1 have family members with type 2 and vice versa. This means that a considerable number of people may be at genetic risk for both kinds of diabetes", Professor Kaufman said.

She pointed out that at the time of diagnosis, the doctor should of course attempt to determine which type of diabetes is present. However if the type cannot be determined initially, 'the young person should be started on insulin therapy while waiting for test results that hopefully will clarify the situation'.

For people with double diabetes, it is likely that they will need both insulin and oral diabetes medication, she said.

"We need to learn more about this relatively newly recognised condition. Since the emergence of double diabetes seems to be linked to the epidemic of obesity in young people, our focus should be on how to prevent childhood obesity as a primary means of reducing the emergence of this potentially devastating condition", she added.

Professor Kaurfman is the head of the Centre for Diabetes, Endocrinology and Metabolism at the Childrens Hospital, Los Angeles, California.

THE HIDDEN SECRET THAT ISN'T ALWAYS REVEALED

All of us know that it is of prime importance to keep our HgbA1C's in great numbers as well as the day to day readings of our glucose levels. What is not (unfortunately) discussed is how to avoid the MANY complications that affect people with T1DM no matter how great the glucose numbers are. The problem is in the LONGEVITY of the Disease. That is the issue at hand. There was a time when mortality age levels were low in comparison to today. Hence the diseases and health problems that most people now encounter were never around before. One of the many many problems with T1DM is that (obviously) it is not just about SUGAR as the villain. T1DM also raises inflammatory levels in ALL of us(T1DM), which in turn makes for susceptibility towards things such as Coronary Artery Disease and various Neuropathies. These things most Physicians usually do not discuss with their Patients other than give them referrals and limit their time to Insulin/Glucose Maintenance. How unfortunate and another example of overspecialization, time constraint and the business of Medicine. The nature of the Beast is that it is not as simple as it appears. TRAGIC!!!!

ADDENDUM TO FAT PEOPLE=FAT PETS

This is pretty much an addendum to a previous posting about obesity in animals causing Diabetes. I have recently come across more information regarding this problem. The conclusions are self-evident. Another example whereby people do not take responsibility for the good health of themselves, their children and their pets. There always exits cause and effect relationships. Enjoy the read:PET DOCTOR
Middle-age thirsty cat tests positive for diabetes
Dr. Michael Fox

Dr. Michael Fox/PET DOCTOR

Q: My cat started drinking and urinating a lot more than usual. She seemed weak and walked differently, as if on her heels. I thought it was her kidneys giving out and was in shock when the veterinarian tested her positive for diabetes. She said this is common in middle-age cats and dogs. Please spread the word.

A: Your veterinarian is correct. Type 1 diabetes mellitus is common in middle-age and older dogs and cats. It is often associated with obesity. Complications include cataracts in dogs and fatty liver disease in cats. Acetone may cause the breath to smell sickly sweet. Cats develop a down-in-the-heels (plantigrade) stance.

Early signs include increased thirst, urination, hunger and muscular weakness. Secondary infections due to immune-system impairment are common, in the skin, ear, urinary tract, prostate and respiratory system.

Regular blood tests, insulin injections and a special diet high in fiber and complex carbohydrates (and low in fat) are called for. High-sugar, semi-moist cat foods and dog foods must be avoided, even in healthy cats and dogs.

The high prevalence of diabetes and all of its serious complications in dogs, cats and people is reason for concern. In many instances, proper nutrition early in life -- no junk food (and sugar-laced cereals, candy and sodas for kids!) would save many lives and prevent much suffering.

GLUCAGON REALLY WORKS!!

Last evening as I was seated at my computer, the font size appeared very small on my monitor. That was strange, since I had not changed them at all. I enlarged my page, but still was unable to read the print. Since it was my usual time to check my glucose readings, I inserted the strip and got a ☞34mg/dl☜ reading!! I began to think to myself, how was it that I was still conscious? There was no dizziness only an inability to focus clearly. I immediately went to my refrigerator and quickly took out my Glucagen HypoKit. Inserted the sterile water into the glucose powder and injected into my muscle after the solution was shook. The great thing about the Glucagen Kit was that it began to work within 5-10 minutes and when I checked my glucose at that time it nicely climbed to 160mg/dl. Much better than when I would treat my low blood sugars with soda or sweet carbs and end up with my glucose rising to the other extreme (rebound) of 200-300mg/dl. This Kit is great because it raises the blood glucose quickly without rebound. Normally I would have eaten something sweet, but my numbers were too low and I had a feeling that they were falling too rapidly.
BTW, I do not work for the company.

HYPOGLYCEMIA AT MY PHYSICAL THERAPY

This morning while I was at my Physical Therapy appointment with my Therapist, B.....I started to perspire. Experienced in the nuances of hypoglycemia, I tested my glucose and got a 42mg/dl. I showed B the results on my meter and began to ingest six sugar packets. I told her that I would be alright, but wanted to inform her ahead of time in case I was not. The irony with all this was that here I was being treated for a post fractured wrist because of hypoglycemia about two months ago and now I am again experiencing another bout with severe low blood sugar, but this time within the confines of Hand Physical Therapy. I proceeded with the proscribed exercises and when I left after about one hour, I again checked my glucose and got a repeat 42mg/dl......How strange!! It is as if the sugar ingested had no effect, or that the physical therapy for my wrist, reduced my blood sugar even further, or (and this is the one I think is correct) my glucose was dropping so rapidly and quickly,,,,,that the six packets of sugar was just enough to hold it at the same original level. I should have taken the cookies she originally offered, but even better, drank a sweet beverage which I should carry.

TYPE 1 DIABETES GETS SHORT- SCHRIFT

At my Primary Care Physician's office there are a number of R.N.'s who give classes to those with Insulin Resistance Disease(Type 2 Diabetes) to help provide better management. I met one of these nurses in the elevator today and asked her whether her patients were compliant or non-compliant? She did not know who I was, so I told her that I had Type 1 Diabetes and find that people with T1DM are usually better motivated, knowledgeable and compliant compared with Insulin Resistant Disease. In addition, I said that we for the most part do not have a "weight problem". I went on to tell her that when I was being treated by Fellows in the Endocrinology Department at that hospital that advertises, "don't you deserve this level of care", they (the Fellows) had a mind-set and disposition into just treating Insulin Resistant Disease(Type 2 Diabetes). In so doing, people with T1DM were at a disadvantage and getting "short-schrift". All she said was that most of Diabetes (90%) is of Type 2 and so Physicians will orientate themselves in that direction. This is what I propose:
1. People with T1DM should be treated by Clinical Immunilogists rather than Endocrinologists, since T1DM is "Auto-Immune" in etiology and a mind-set/bias appears in those Physicians who are trained in Endocrinology to just "handle" Insulin Resistant Disease.
2. A new medical nomenclature should be established where those with Insulin Resistant Disease should no longer be called Diabetic or having Diabetes, since it takes away from the true meaning of the word in those with T1DM as well as the fact that these are distinctly TWO DIFFERENT DISEASE ENTITIES.

IN THE ARMS OF AN ANGEL

The other day, as I was on the 51st Street Subway Station preparing to go to Farmer's Market, I felt the common signals of Hypoglycemia. I sat down on the wooden bench and prepared to open my "trusty" sugar packs. As I was doing this a woman who was dressed up as an Angel (Wings included) began singing in a beautiful and deep operatic voice, "In the Arms Of An Angel". It was beautiful but profound as well, given the juxtaposition of the situation I was in. The train arrived at the station, the song was over and my Hypoglycemia was attended to with the help of the Arms Of An Angel.

HAPPY EASTER/HAPPY PASSOVER

At the start of these Holidays, it is important for all of us to remember that in spite of having a Chronic Illness, we still are part of an Energy that is greater than that illness. I have selected this Prayer and Meditation for All:MEDITATIONS AND PRAYERS LED BY THE HOLY FATHER POPE BENEDICT XVI ON GOOD FRIDAY 2006

COMPOSED BY Archbishop ANGELO COMASTRI Vicar General of His Holiness for Vatican City President of the Fabric of Saint Peter's

•We have lost our sense of sin!
Today a slick campaign of propaganda
Is spreading an inane apologia of evil,
A senseless cult of Satan,
A mindless desire for transgression,
A dishonest and frivolous freedom,
Exalting impulsiveness, immorality and selfishness
As if they were new heights of sophistication.a

Lord Jesus,
Open our eyes:
Let us see the filth around us
And recognize it for what it is,
So that a single tear of sorrow
Can restore us to purity of heart
And the breadth of true freedom.
Open our eyes, Lord, Jesus!

•Surely God is deeply pained
By the attack on the family.
Today we seem to be witnessing
A kind of anti-Genesis,
A counter-plan, a diabolical pride
Aimed at eliminating the family.

There is a move to reinvent mankind,
To modify the very grammar of life
As planned and willed by God.

But, to take God’s place, without being God,
Is insane arrogance,
A risky and dangerous venture.

May Christ’s fall open our eyes
To see once more the beautiful face,
The true face, the holy face of the family.
The face of the family
which all of us need.

•Lord Jesus,
Purity has everywhere fallen victim
To a calculated conspiracy of silence: an impure silence!
People have even come to believe
A complete lie:
That purity is somehow the enemy of love.

But the opposite is true, O Lord!
Purity is necessary
As a condition for love:
A love that is true, a love that is faithful.

In any event, Lord,
If we cannot be the master of ourselves?
How can we give ourselves to others?

•Everything seems over,
The wicked seem to triumph,
And evil appears more powerful than good.

But faith enables us to see afar,
it makes us glimpse the break of a new day
On the other side of this day.
Faith promises us that the final word
belongs to God: to God alone!

CHOCOLATE BROWNIE RECIPE

Ok, this recipe is for Megan, the Chocolate Goddess, and others who eat, enjoy, and relish in great food and desserts. It does not matter that you have Diabetes, Life is still to be participated in and enjoyed.
RECIPE:Chocolate Brownies
INGREDIENTS:
1. 6 large Eggs at room temperature
2. 1 ½ lbs. Good Quality Chocolate(should be semi-sweet or bittersweet or a combination). Chocolate is like coffee.Everyone has their own particular likes as to preferring strong/earthy coffee or more of a medium blend. The same holds true of Chocolate. Both Chocolate and Coffee are related cousins regarding their bean.
3. 2 C Sugar
4. 1 t. Baking Powder
5. 2 T Vanilla Extract
6. 8oz. (½ Lb) Sweet Butter Softened at Room Temperature.
7. 3 C Walnut Pieces(broken Up) (Optional)
8. 3T Expresso Powder
9. 2 T Bourbon (Optional)
10. 1 ½C Sifted Flour
11. ½ t Salt

Preheat Oven to 350F at least ½ hr. before baking. Sift the Flour and baking Soda together in a bowl. Add ½ t Salt and mix together. Melt the chocolate(first cut into small pieces) with the butter in a Double Boiler or use a metal bowl over a saucepan of simmering water.You can add the Expresso Powder if you want a Mocha Flavor added to the Brownies. I did and it tasted great. Do not get any water or steam into the Chocolate. Chocolate is very sensitive to heat and MUST BE melted slowly as you stir the bowl with a Spatula(I use a Rubber/Plastic Spatula that can withstand the heat). Keep stirring until the Chocolate& Butter have mixed together and melted. Remove from heat. In your mixing bowl, beat eggs with your Paddle Whisk and slowly add Sugar. Beat at Medium Speed till the Egg Batter has lightened and thickened. Add the Melted Chocolate/Butter Mixture which should be cooled down to the Egg&Sugar Mixture in your mixing bowl. Take your
Spatula put it into the mixture (Machine is turned off) and give it a couple of quick turns from the bottom and sides.Next, add the flour on low speed till incorporated(do not overmix). Remove bowl and stir again with your Spatula......Add Bourbon if desired. Also add Walnuts, but they also can be left out. The Walnuts should be preheated a little in a cookie sheet to bring out their flavor(DO NOT BURN OR OVERCOOK THEM).
I used a Pyrex Rectangular pan that measured 9 ½ X 13 ½. Make sure that you completely butter the pan all around as well as the bottom before adding the Brownie Mix. Smooth the top after all the mix has been poured into the pan. BAKE FOR ABOUT 50min. But you must test to see if the Brownies are done by inserting a toothpick or any other long object into the pan.If some chocolate adheres to the toothpick, they still have to bake more. At this point check for doneness every 10 minutes. DO NOT OVERBAKE. Take out of oven and cool to room temperature. Then refrigerate. Brownies always taste best the NEXT DAY after they are cooked. When you take them out of the refrigerator they will be hard. That is OK....Just leave them for a while at room temperature. Cut into slices for yourself and/family or/and friends. You can serve them with berries, whipped cream or powdered sugar in top. Don't forget the Insulin Shot. Enjoy!!!!!

CHOCOLATE BROWNIES: YUMMMMMM

I just finished making chocolate brownies using all natural ingredients, of course. The new cure for Diabetes........just kidding. But definitely will make you happy by letting it swirl around your mouth as you bite into the soft chocolate while it travels down slowly within the bottom recesses of your being. Eating a good chocolate brownie is a lot like having a good love experience. Both are to be enjoyed slowly and intensely without guilt.
The brownies are now resting and cooling before I will refrigerate them and prepare for tomorrow's relish. If they are good, I will share the recipe with all of you. Before consuming, prepare for a insulin to carb ratio, since it will be treated like any other carbohydrate.
By the way, lots of good quality chocolate is needed (I use 1½ pounds of chocolate).

HYPOGLYCEMIA IN TRADER JOE'S

I just got back from that great food store, Trader Joe's. While in the store that just opened here in Manhattn, I began to feel as if I was about to blackout and lose consciousness. I immediately searched my pockets for anything sweet and found coffee sugar packets that I sometimes carry with me. There in the middle of Trader Joe's I began to dump about six packets of sugar down my mouth with my head back so as to take it all in. The security cameras in the store must have thought I was an unusual sight to behold. What I ask you could be more of an irony? To be surrounded by great and unusal foodstuff from around the world while I am about to go under from an Insulin Reaction.Lucky there was also a "Sample Bar" in the store where I availed myself of 5 small (finger size) barbecued chicken sandwiches. By the time I got to the cashier with my shopping wagon (15 minutes later) I was OK. Carbs and sweets to the rescue again!!

OVERWEIGHT PEOPLE=OVERWEIGHT PETS

It is amazing but not unique to New York City where there is always visual stimuli present, that there always seem to be an obese man or woman walking down the street with their dog who also is obese. I am an "Animal Rescuer" and find it very sad that the pets people have are totally dependent on the care that they receive from whoever cares for them. The problem being in the kind of care that they receive, which in this case, is poor and destructive care to the health of the animal. In spite of there being numerous variables responsible for the rise of Insulin Resistance Disease(Type 2 Diabetes),overeating is a major contributor. People would rather eat foods high in carbohydrates, fats and other types of "junk" because as they reason, "I just can't help myself and it tastes good". These same irresponsible people use similar faulty logic with their pets(cats or/and dogs) by giving their animals too much food to eat. As most of us know, dogs and cats also develop Diabetes and have to be treated with insulin. They are subject to the same complications as their human counterparts such as heart disease, kidney disease and other awful neuropathies. If the owners of pets have no self-control, self-respect for their bodies, they should not pass this horrible behavior to their pets. Their animals are TOTALLY dependent on their caregivers. It is not fair to these animals because they have people taking care of them who do not know what they are doing. All of them will tell you that they 'love their pets'. However creating an illness in your pet that results from overfeeding and obesity is hypocritical and nothing to do with Love. These same people often overfeed their children as well creating more Diabetes or and Heart Disease now or for later in life.
I have had animals in the past and have them now as well. They are not overweight because I do not and have not overfed them. My animals (cats) have saved my life by helping to restore consciousness in me while in severe hypoglycemia as well as alerting me to my having low blood glucose(another story for another time).

POST BRONCHITIS

A bout with Bronchitis which lasted for two weeks is finally over minus 10lbs of body weight because of not being able to or wanting to eat anything. I guess that takes me out of the "running" to be eligible to use Exubera (Inhaled Insulin). As I previously posted, "those with any respiratory problems such as Asthma, Bronchitis as well as Smokers are not candidates for Inhaled Insulin". Anyway, it was really created for those with Type 2 Diabetes who are afraid or do not want to use a needle with syringe to inject themselves for better Diabetes management/control. As we all know, in terms of "dollars & cents", Type 2 Diabetes is a larger cash flow market than Type 1 Diabetes which is about 10%. Another example of R&D being tipped in favor of those with Type 2 Diabetes since there is more money to be made.
The irony behind all this, is that Type 2 Diabetes is "PREVENTABLE". Type 1 DM is not.

SOMETIMES THE "OLD" IS BETTER THAN THE "NEW"

The Lancets used for the necessary testing of Blood Glucose are getting better and better. There now exists on the Market a Lancet that is 33Guage (very sharp and thin). This is all very good if you are newly diagnosed with Diabetes, a young child/infant/baby or someone who still has "Virgin Skin". If on the otherhand, you have had Diabetes for a long time (I have had Diabetes since I was 6), do a great number of "Finger Sticks" and have developed scar tissue, then the "New & Great 33 Guage Lancet" is not for you. The first time I had tried one, it did not even penetrate and was not even felt. There is logic within Diabetes. The more frequently that you use sites(no matter how much rotation you do) you will inevitably develop underlying scar tissue at the point of impact, preventing very thin lancets from drawing blood. One way around this is to have a Lancing Device that has greater depth and a higher degree of force. Sounds like a Bow and Arrow to me.
So I am very happy to be able to use the 31 Guage Lancet which is able to penetrate through the tissue with just enough force.

JUST BACK FROM THE E.R.

I just got back from the E.R. after yesterday's battle with HYPOGLYCEMIA. After my neighbor called 911 at 2:00AM because I yelled at her to do that, since I was on the floor of my apartment thrashing about with the Forces of Life and Death. The Paramedics arrived and asked if I wanted to go to the hospital. Since I had drunk a good quantity of Maple Syrup and my Blood Sugar was now 65mg/dl where previously it was 40mg/dl. I decided against going to the hospital. They would have given me Glucose I.V. and taken my blood. These things I was doing myself minus the Glucose I.V.
What happened was when my BloodSugar was 40mg/dl, I decided to make Crepes with Maple Syrup to raise it up. However, Time was not on my side. Yes, I began eating the Crepes w/Maple Syrup, but next found myself on the Kitchen Floor with my plate smashed doing battle with the Forces of Life & Death from the Hypoglycemia. It must have gone down to about 20mg/dl. Since I now have Hypoglycemia Unawareness, the Falling of my BS is very quick,
Before the Paramedics left, I tested my Glucose and it was now 86mg/dl. We all felt assured that things were OK. However, an hour later my L Hand began to swell. I immediately put ice compresses on it and knew that it was related to the Fall. Since the EMT people had already left, I decided to go to the E.R. in the morning after sleep.
While waiting in the E.R. Waiting Room I heard someone coughing and sneezing. I turned in the direction and again saw that the simple implement of a tissue or handkerchief was not used to cover the nose and mouth. The person looked like a Fellow American. So it shows, that All People,including Americans (based on my comments of yesterday in the TUBERCULOSIS article) can display low class, base behavior, not caring about others or themselves.
Back to the E.R. The results of the Xray revealed a fracture of the Radius on my L Hand. So I have to wear a Soft Cast for about 6 weeks. The irony about all this as I told my Physician and Nurse is that all the long years I spent in Martial Arts, I never incured a Fracture, However my Battles with staying Alive from Hypoglycemia related to Diabetes caused more Pain (Emotional & Physical) as well as Fractures in comparison.
Eventhough I ended up staying 8 hours in the E.R. from 4:00PM to 12:00AM, Dr. Kaplan who was the E.R. Attending and Dr. Gulotta , the Orthopedic Resident were great as were Thomas and Mei my E.R. Nurses.

TUBERCULOSIS

Today in New York City, the temperature was around 50℉ so I decided as usual to go to Farmers' Market for more great Food for the week. The best way of getting there for me other than biking is the Subway. I boarded the train which was fairly empty (it was around 1:00PM). At the next stop however, a woman wearing a face mask gets on and sits close to me. I immediately moved to the other end of the car. It was not long before another woman who was already seated began expectorating her phlegm into her used coffee cup. Having had worked at Columbia University School For Public Health at one time and having a healthcare background before I entered the Food Industry, I again moved my seat to a Safer part of the subwaycar.
I do know that there was a time when anyone who had a communicable disease or a respiratory infection and was coming into this country would be quarantined for the good and safety of all.
Is it no wonder that there has been an increase in Tuberculosis in New York City. There exist now entities that look like human beings who when the need arises to sneeze or/and cough it is done openly without using a handkerchief (foreign substance to many) or tissue to cover the nose or mouth. This is so that their germs and poor habits can be openly shared with others in close proximity. I once saw someone who resembled a human being (outer form only) expectorate on the floor in the Lobby of Bellvue Hospital. I am sure that this "wholesome activity" is going on in other cities as well. Afterall, isn't it more important to show "Foreigners" how accepting we Americans are of all who come to our Shores, despite being "Blown-Up" as we were on 9/11/2001?

DON'T YOU DESERVE THIS LEVEL OF CARE?

When I was on the Insulin Pump some time ago, I still would have severe hypoglycemic reactions. All the more so, since I now had what is called "Hypoglycemia Unawareness". A condition due to lack of sufficient norepinepherine levels that act as an early warning system for low blood sugars.
There is a hospital in New York City that every once in a while will advertise on radio as to 'how great they are' by saying in a very Pompous Uptight/Upper Eastside/Snobby Woman's Voice, "Dont you deserve this level of care"?
Well since I was affiliated as a patient with this hospital, I decided to go to their Emergency Room. The day before I had dropped to the floor along with my floor lamp and awoke about two hours later because of the "Hypoglycemia Unawareness". Not only did this result in a loss of consciousness, a loss of my floor lamp, but heavy contusions on both legs which caused "open cuts" resulting in skin infection. Since Medically this is considered an Emergency, I naturally went to the ER of this supposedly great hospital. It was about 5:00PM when I was admitted into the ER where still wearing my Pump and after having seen the On-Call physician in the ER who suggested an alteration in my insulin settings and a dressing for my wounds. Since I was still laying on the Stretcher-Bed waiting for the Dressing to be applied by Whoever, I decided as I often do, to check my Blood Sugar. It was 40mg/dl....I was going into another Hypoglycemic Event and those Idiots who supposedly know all about Emergency Care, did not seem to know that a person who has Diabetes and is wearing an Insulin pump, is in need of FOOD!!!! Especially since it was now 7:00PM and I had been in the ER since 5:00 PM without any food.
I then got up off the Stretcher-Bed, approached the ER Physician who had seen me and said in a very loud voice so others would hear me as well, that I was Hypoglycemic and needed food. I also showed him the reading on my meter to confirm what I had said. I am glad I embarrassed him. I did get my food and later thought to myself as I left the ER as to why there is much Litigation within the Medical Profession. Could it be that the thousands of unnecessary deaths in hospitals due to negligence and stupidity is the reason?
Don't You Deserve this Level Of Care?

ONE OF THE MANY WORSE SCENARIOS FOR THOSE WITH TYPE 1 DIABETES

This goes wothout saying fellow persons with T1DM......do everything you can to try to stay out of hospitals as an in-patient.
A number of years ago, I had to undergo an operative procedure. As many of you know, all patients who are admitted for any surgical procedure must have an IV placed. This allows for easy access to administer medications quickly via a vein. It is especially useful if a person is not allowed "anything by mouth" and again it is a very quick/reliable way to adminster medications.
So, when I was admitted, the IV nurse places a solution of D&W in my vein in order to "keep it opened" in case different medications are required. Being proactive and never giving up self-autonomy, being able to think for myself, I said "I think you should use NaCl instead. Otherwise the D&W (Dextrose & Water) will cause my glucose to become very elevated. This is in spite of the medical personnel knowing in advance that I have T1DM (Type 1 Diabetes Mellitus). Afterall, an intake form is always required for all patients where their allergies and illnesses are listed. After consulting with the Resident and Attending, the IV solution was quickly changed to NaCL (Sodium Chloride). It is blunders like this which account for many many mistakes which affect the patient and his outcome. Another reason why litigation is so prevelant in healthcare.
Another time and in a different hospital, I required surgery on my eye. The RN assigned to me after the surgery was told to put "Liquid Tears" in the eye that did not have the surgery. The eye that did have the surgery, had sutures around it so I was not able to open it until removed.
So what do you think happens? She enters my room with the "Liquid Tears" and proceeded to apply it to the eye that had the surgery and which I could not open anyway due to the sutures. In my post anesthetic state I still was able to tell her WRONG EYE!!!
The lessons to be learned from all of this (I have more stories to tell), is NEVER NEVER GIVE YOURSELF UP TO DUMMYS AND INCOMPETENCE. It is you who are in charge of your body and no one else. Afterall no one is going to feel your pain if a mistake is made. Even those who wear WHITE make mistakes. Ask any Attorney who practices Malpractice. Don't ever "sell yourself short"!! Intelligence and good judgement are not exclusively given to those who wear white. I am wearing a teashirt(white) right now as I am writing, but I still know more about T1DM than many Fellows in Endocrinology.

WHAT IS STARBUCKS GOOD FOR?

Many of you would automatically think of coffee. Since Starbucks does have great name recognition, there would be no other reason to associate the company with anything else. But wait, Starbucks has other things that are even better than coffee. Besides, their coffee is not a good as it use to be. Some of the reasons for this are that the volume of stores cannot and does not (in my opinion) keep the same quality control when it comes to the roasting of their beans. The Barristers and "others" who work for the company are not as good as once were. They seem to be people who are there to fill vacancies and nothing more. The emphasis appears to be on marketing and real estate purchasing compared with good quality and knowledgeable service. In the beginning when Starbucks "came on the scene" here in New York City, the coffee was great as compared to the cheap quality coffee that was coming in from Columbia at that time. Starbucks, since it was the "new guy on the block", had to prove itself and establish a following willing to pay more than .50¢ for a cup of coffee. They did this by having well-trained Barristers and great Roasters to handle designated areas within the city.The small number of Starbuck stores established in the city at that time enabled the fresh roasting of coffee beans to be available to each store with care and quality control. Not the case now.....there are too many stores and not enough qualified people involved with the company as once was. Basically, Starbucks has grown too big and in the process has lost quality of coffee and service."Too big to be managed effectively". OK now that I have said my little critique on Starbucks, I will answer the question posed.
Taking many insulin injections throughout the day has some risks. Since I always carry my Flash glucose meter with me in a pouch that I clip to my belt, I can always monitor my blood sugars. When I am outside (the street), I need to be able to access a place where I can either give myself a bolus if my bs is too high or take someting sweet if the opposite is true. Since I am no longer on the "Pump", I carry my insulin pen with me all the time as well. Behold Starbucks!!
How great is it to be able to sit at one of the tables and do a 5 sec. check of my blood sugar?
If my reading shows "Hyperglycemia", then all I have to do, is to walk about 15ft. to the bathroom in Starbucks and take my fast acting insulin there.
If the contrary holds where I am feeling irritable, irrational, disoriented (normal states in New York City by all) and my glucose meter shows a "Low Number", then all I have to do is again walk about 15ft. to the sugar counter and open a few sugar packets to swallow. Nothing could be easier and I did not even have to drink their horrible coffee. And if you are feeling romantic, you could always sit next to someone who you feel attracted to. All this without spending a dime. Oh, one more thing.....If you are "out and about town" and in need of going to the bathroom, there is always a Starbucks to be found (these days) on every corner. Starbucks has become a stationary ambulance for those with Diabetes that also sells coffee. Thank you Starbucks for assisting all those with Diabetes.

THE TRUTH BEHIND HbA1C

Most of us with Type 1 Diabetes are familiar with HbA1C. This test shows a 6-12 week pattern of blood sugars and is widely use as a predictor and evaluation of "how well the patient is doing" by the Medical Profession. Basically, Glucose binds with the protein Hemoglobin to give us glycosilated hemoglobin. It is now generally felt that those with Diabetes should have a HbA1c of 7% or lower, but not higher since that would mean poor control with "high blood sugars".
The thing that is wrong with this type of test to be used as a Predictor of Control is that the person could have very high blood sugars (300mg/dl and above) for 2 weeks and then have very low blood sugars 50 and below( as in the case of Hypoglycemia) for the remaining balance of the month or two.
Since HbA1C shows a median or average of the numbers.....the percentage might appear as a HbA1C of 7% and the Healthcare Providers are saying "how great and what a good job you are doing" to the patient. In reality however, the person's blood sugars are fluctuating between extremes and while the HbA1C shows "good numbers", the reality is not very good. Again keep in mind that the only thing that is measured, is the average of all the numbers and not the fluctuations that can and does occur on a daily basis.

INHALED INSULIN......BIG DEAL/SO WHAT?

The approval for Inhaled Insulin by the FDA is now going to get the "Madison Avenue Marketeers" going full steam probably with the support of some Diabetes organizations and hospitals/clinics. In reality, Inhaled Insulin is geared for those (Type 2 Diabetes) who have fears and hesitancy in taking insulin(injecting) for good Diabetes control. Dollars & Cents, it is a huge market, with about 90% of people with DiabetesType 2 as potential buyers. It will by all accounts be more expensive than vial insulin already available . In addition, it is not recommended for those who have asthma and other respiratory problems such as bronchitis. It is also not recommended or children.
This Fairy Tale, is but yet another method for taking insulin, nothing more and nothing less. Where are all the new products/inventions for Type 1 Diabetes? I'll answer that, "they are on the back burner, because Type 1 Diabetes is not as profitable as Type 2 and there is a greater monetary market potential and volume for healthcare as regards Type 2 Diabetes". This is another reason why we (Type 1 Diabetes) must be our "own Doctors" and never give up on ourselves. I have no fear injecting insulin. My big fear however is meeting up with mediocre healthcare personnel who know nothing about Type 1 Diabetes.

INHALED INSULIN

Let us celebrate!! Another star for progress in the management of Diabetes. No cures, no cures.....but lots of glucose meters,lots of insulin pumps, lots of various insulins, lots of sharp needles (31G) and lots of congraulations to be had. This all points out to where on the "Time Continuum Line" you are on. As all of you know, 100 years ago, short acting insulins, let alone disposible syringes and meters were totally unheard of and unavailable. The way people with Diabetes managed their disease was with food and starvation. I am in no way implying that all these "devices" do not make the management and life easier as far as having Diabetes is concerned, but I also know, that sometime later/later☞☞ because of the "Time Continuum", the word Cure will have a greater meaning for those with Diabetes.

WHAT SEAT ARE YOU IN?

In Type 1 Diabetes, it is most important to instill in the patient(person) the foundation for education, care and responsibility for good management. This can be made possible by having good Endocrinologists available who are more interested in Type 1 Diabetes than Thyroid Disease or Type 2 Diabetes(Insulin Resistant Disease), as well as having the opportunity to avail themselves of Certified Diabetes Educators and other Healthcare providers.
From the age of 6, I was fortunate enough to meet Physicians who stressed and encouraged my "taking care of myself and in learning as much as possible about the illness so as to become responsible for day to day living with Diabetes". This responsibility is a necessary part for the patient who is the one managing his/her illness 24/7.
I use the analogy of the Driver's Seat. You and your Physician as well as other Diabetes related Healthcare providers should both be sitting in the front seat of the car with the Physician at the wheel. Never sit in the "Passenger's Seat". You have the responsibility and duty to make decisions regarding your care along with your Physician and others.
When you choose to seat in the "Passenger's Seat" you have given up your autonomy. Not very good for ideal Diabetes Management.

HOW TO PREVENT/REDUCE CLASS 5's

Class 5's is not going back to the Fifth grade, it is however how to reduce the number of dental caries that may result in sugar intake to correct hypoglycemia.
As most of us know, that the fastest way out of low blood sugars(hypoglycemia) is to ingest something very sweet. This could take the form of any liquid such as colas, honey, maple syrup and many others. Unfortunately when we are in the middle or beginning of a hypoglycemic reaction we are not thinking about our teeth or even about what to wear the next day. Our attention is (and should be) very focused on attending to our problem and how to resolve it. If we take a beverage or any other liquid, it will not only restore our blood sugar levels to where we can function again, but a "sticky" residue from the liquid will be left on our teeth. This residue usually adheres itself to the anterior(front) layers of the enamel between the gum and tooth at the margin. If allowed to remain....it can and often does create a dental condition called, "Class 5 Caries".It is the concentrated sugar that creates this condition, and the baseline of the gum is an attractive place for caries to feed on if anything sweet is found there. I found for myself, the best way to prevent this or/and reduce the number of caries is to rinse vigorously after you are feeling better or wisely, brushing your teeth. Afterall, who wants to return to the 5th Grade?

COCONUT CAKE w/A CHOCOLATE GANACHE COVERING

On the weekends, I like to go to Farmers' Market here in NYC. I usually pick up what is in season and today was no exception. I always however pick up fresh chicken and eggs (for my baking and breakfast) so that I would have them on hand for the week. My "Poultry & Egg Vendor", is a great person and will always go out of his way to make sure that eggs and chicken are put aside for me. In turn, I will bake various desserts and cakes for him and his family. I decided to bake a coconut cake with a ganache spread to it. The combination of chocolate and coconut is great.
So I got on the subway with the cake and my large LL Bean canvas boat bag that I usually fill up from the market. When I arrived about 1 hour later, I saw an empty space where his stand usually sits. I asked the Vendor next to him as to what happened? She replied, "his truck broke down on the way to the market". Feeling a little disappointed and still carrying a great coconut cake with a ganache cover, I looked around to see if I could give the cake to anyone else in the market. I decided that I would not. So, I bought some apples and potatoes before I took the subway back home. On the subway, I started to feel a little lightheaded. Since I always carry my meter with me (Freestyle Flash) in a pouch clipped to my belt, I tested my glucose as the train headed north. Sure enough, my blood sugar was 36mg/dl. I looked in my jacket for any "sweet" things and found 3 packets of sugar (coffee packets) and immediately swallowed them. A half hour later, I checked my bs again, and it was still low at 40mg/dl. I looked in my canvas boat bag and saw the box which contained the great cake that I was unable to give as a present to my Vendor and decided that, "this would be a great way to get out of my hypoglycemia". In New York City, people as a rule do not look at others too much, since so many things and behaviors are always seen and nothing is "new". I opened the box and proceeded to cut the cake. The chocolate ganache gave way as butter would, and since the cake was so fresh it cut straight through with one slice. The best part was putting it into my mouth and eating it as I rode home. I did feel better after eating a slice of the cake and I was happy at the same time. Ode to Coconut Cake with Chocolate Ganache!!

LIFESTYLE CHANGES
It is amazing that so many people would rather continue with negative Lifestyle habits than change them for a much better quality of Life. Take the case of the French woman with the facial implant. She is now back to her previous habit of smoking cigarettes. This behavior can lead and often does to poor healing by "upsetting" the blood flow to her face as well as "interfering" with foreign tissue acceptance. It is the same with Diabetes.....It is not only in taking the correct amount of insulin on a daily basis, but it is also eating healthy, exercising and allowing "positive energy" into your life. This positive energy can be in the type of friends you associate with, the type of job you do, how much sleep you get, what kind of food you are putting into your body, how you deal with stress, doing things that "really" bring pleasure and not becoming obsessed with Diabetes by identifying with the illness(Diabetic).

THE FIVE ELEMENTS

Last night I dreamt of my "departed" Sifu(Teacher) who taught me Kung Fu.
I was in the class practicing and doing the 5 Element Form in his presence. The Five Elements are the basis for Traditional Medicine and Martial Arts within China. A fusion of Body & Mind. It is the Foundation of what the Universe is composed of and everything inclusive as well.
When I awoke, my bs was 72mg/dl......Even in sleep, the body/mind is filled with Life.

HOW TO (easily)UNDERSTAND THE STOCK MARKET
The Stock Market is like making love....It goes Up & Down. When It goes up, everyone is happy and when it goes down, people are besides themselves, befuddled and betwixted. But like all in Life, "what goes up, must come down" or priapism develops.

WAKING UP
My cats get up at day rise, which here in NYC is about 6:00AM these days. When I am still asleep they become concerned as to my safety. They have on many occasions been able to detect low blood sugar levels within me and have all "rescued " me by various means to enable me to "wake up". This morning was no exception. My Alpha male cat, Willie hopped onto the bed and used his head to nudge my arm to move as well as using his head to push my face. In addition, he knocked down my alarm clock......All these actions as well as Sammy's loud verbalizations and Sara's licking of my nose succeeded in waking me up. My blood sugar was 72mg/dl..........Time for a great breakfast of noodles, eggs and fresh coffee made the best way☞French Press.

THE AGONY & THE ECSTASY

This morning I awoke screaming in pain. I do not know if any of you have ever experienced this problem, but my calf muscle cramped up on me. The tightness (constriction) produced such pain as to warrant the scream. Since I live in an apartment in New York City where the walls are very thin, my neighbor must have thought that I was experiencing profound and intense orgasm. Both verbal expressions are very similar. I take this phenomenon to be a calling from G-D, since upon waking up and checking my blood sugar(bs) I found it to be 40mg/dl.
G-D always has a way of making his presence known so we may do the correct thing. The correct thing was to intervene so that my life would be saved.

TYPE 1 DIABETES

I first want to make it abundantly clear that this site is devoted to people with Type 1 Diabetes. There is a huge difference between Type 1 Diabetes and (the other illness, which should be called and is called in some small Medical circles, Insulin Resistance Disease). As "We" all know, Type 1 Diabetes has a different etiology, different prognosis, different complications although the "other illness" does share in some of the same complications, different methods of treatment. In this too, the only similarity is the taking of insulin. There are many other "Differences", such as motivation and identity with the illness. People with Type 1 Diabetes are usually more motivated and more fine tuned in identifying the illness as an addition to many other things that make up "who they are". This is not political correctness, but common sense. It is unfortunate that the vast amount of people within the Medical Community have not yet made that distinction. Go to any hospital in any city and you will hear people with Diabetes referred to as "The Diabetic". Not only are they in error in doing this(people are more than their illness), but they are usually referring to the other illness (Insulin Resistance Disease aka Type 2 Diabetes). To respect ourselves, NEVER refer to who we are by our Illness(Diabetic), Whenever anyone in the Healthcare community calls us "Diabetic", we should correct them by saying, "I HAVE DIABETES, I AM NOT A DIABETIC", If they do not understand this, it is time to look for a new Healthcare Provider. Remember, that you are your own best Doctor when it comes to taking care of your Diabetes. Who knows your Body/Mind better than you?