Thursday, August 2, 2012

Living with Diabetes, By Randi Bjornstad

I have attached an article by Randi Bjornstad . I rediscovered this while searching for a  photo included in the article.  No picture found but she did and excellent job of putting my random thoughts into a readable article. I am still working on the followup to the post a few days ago , " Will lowering my glucose help me prevent a heart attack"

David Calder,MD

Living with diabetes

A retired doctor’s book and iPhone app offer help to patients

Appeared in print: Monday, Oct. 25, 2010, page D1
Take it from retired physician David Calder: When it comes to managing diabetes, you can’t take the Greyhound approach and simply “Sit back, relax and leave the driving to us,” he says, quoting the well-known bus company slogan.
Just the opposite, says the 73-year-old, who ought to know for a couple of reasons. One, because he devoted his entire medical practice to diabetes treatment and helped launch the Diabetes Wellness Assessment Program for the three-state PeaceHealth medical system.
And also because he was diagnosed as prediabetic — his fasting blood sugar is not diabetic but not normal — two years ago. Since then, he’s taken a look at diabetes from the patient’s point of view.
He exercises regularly and carefully monitors what he eats. He has dropped 20 pounds in the process. He also takes medication to slow development of the condition.
When it comes to describing how to live well with diabetes, Calder switches to a Hertz car rental analogy. “This is a time when you have to slip into the driver’s seat,” he says.
Having a personal as well as a professional interest in the subject, Calder has taken his knowledge and interest a step further.
He’s written a book, “The Diabetes Office Visit: Helping You Help Your Doctor Help You,” available either in paper or electronic form.
On top of that, being a self-described iPhone fanatic, he’s also created an application for the device that allows diabetic patients to log glucose levels, carbohydrate consumption, medication and exercise into a tiny spreadsheet that maps patterns to help guide treatment and adjust behavior.
Because Type II diabetes in its early stages has no symptoms, at least a quarter of the nearly 23 million people in the United States who have it don’t know it, according to the U.S. Centers for Disease Control and Prevention.
An additional 57 million are prediabetic and probably don’t know it either. About 1.6 million new cases are diagnosed every year.
Even when they do know they have diabetes, “Lots of people don’t take it seriously because they have no symptoms,” Calder says. “They don’t wake up until they have that first heart attack or they develop retinopathy or some other serious problem.”
The whole purpose of his book and iPhone app is “to have your goals for dealing with diabetes at your fingertips,” he says. “I really believe 100 percent of people could control their risk factors by keeping track of critical information so they can work as partners with their doctors in adjusting what they do to stave off diabetic complications as long as possible.”
With the system he lays out in the book for keeping track of food, exercise, medication and glucose levels, a patient can present a complete look at the disease when visiting the doctor.
Likewise, the app’s spreadsheet can be e-mailed directly to the physician or viewed during an appointment.
Once a person becomes prediabetic, full-blown diabetes is bound to follow at some point, Calder said. But how fast that happens depends a lot on how seriously the patient works on keeping the disease at bay.
In a nondiabetic person, the pancreas creates the right amount of insulin to convert glucose found in dietary carbohydrates to provide fuel for bodily functions.
If the pancreas doesn’t create enough insulin, glucose is left over and stored as fat — pot belly, spare tire or love handles — around the body’s midsection.
A diabetic person’s body no longer can adjust insulin production upward to match the intake of carbyhydrates, so either carbohydrates must be reduced or insulin replaced through medical means.
In any case, Calder says, keeping track of carbohydrate intake and relating that to glucose levels in the blood is key to controlling the speed with which diabetes worsens.
Most diabetic patients are instructed to test their glucose levels several times a day, using an instrument that tests a drop of blood from a finger-prick.
“I’ve had patients come to me with the numbers from glucose tests completely unorganized, just written down on napkins or pieces of scrap paper,” he says. “There’s no way a doctor can develop a pattern from that and see what’s happening with a patient and what needs to be adjusted.”
The doctor’s goal is to make treatment recommendations.
But a diabetes patient must be responsible for providing good data, he says.
That means developing a partnership between patient and doctor, Calder believes, and sometimes it also might even require changing doctors to find one that is willing to be an adviser as much as a physician.
Dealing with diabetes is complicated but necessary, something Calder didn’t realize entirely until he moved from being doctor to patient.
When he first became prediabetic and started paying attention to his own lifestyle habits, he suddenly understood that he was doing “exactly what I have observed my patients doing for the past 35 years,” Calder writes. “There really is a big difference between knowing and doing ... My life is on the line, and I alone am responsible for the outcome.”
“My life is on the line, and I alone am responsible for the outcome.”

1 comment:

  1. Nice healthy review you have shared on diabetes. Thanks for your great healthy support.


Your comments and questions are appreciated. David Calder,MD