This weekend I drove down to Des Moines, Iowa for the TCOYD conference and for a meeting at the offices of Diabetic Living, one of the magazines I write for (I’m in their current Fall 2014 issue!).
When I arrived at the Meredith Corporation (which publishes DL), my editor, Martha, greeted me and showed me some of the behind-the-scenes of how the magazine is put together. We went down to the test kitchens, which is an enormous room that looked like an IKEA showroom. There were about six or eight fully functioning kitchens all in a row. There was a lot going on, including one cook that was making some chicken marsala that will be in next summer’s issue. It smelled so good! I love Indian food.
Then we went to the Photo department. I saw the Prop room, which has just about every kind of dish, glass and servingware you could imagine! The room was huge. Then we went over and saw some of the photo shoots going on, including a feature on some healthy desserts. We taste tested a brownie with mint creme filling and it was pretty good! Martha says that they taste test every recipe that goes into each issue, which not every magazine does. She also explained that when they do the photo shoot, they photograph the precise serving amount you should have. It’s very technical!
On Saturday, I went to the TCOYD conference at the Iowa Events Center. A few DOC favorites were there, but there were also a couple missing faces because of the fires in Chicago that delayed flights. So sad. But it was still a good conference!
Here are some key take-aways:
“There’s never been a better time to have diabetes” – Dr. Steve Edelman
There was a heavier emphasis on type 2 diabetes than at some other D conferences I go to. Dr. Edelman shared that:
- Any drop in your A1C will reduce the risk of complications. It’s not a sprint, it’s a marathon.
- It’s never too late to take control of your diabetes by putting diabetes high on your priority list.
- The gene for obesity may be linked to the gene for type 2 diabetes.
- Your therapy may change over time. Even if you do everything right, your therapy may change. It’s not that you’re failing, that’s the progression of type 2.
- It’s important to get regular eye screenings and kidney labs done, because symptoms of those complications aren’t felt until it’s severe.
Change Your Mind, Change Your Diabetes – Dr. Bill Polonsky
- No shame, no blame. Some people believe the reason they have diabetes or not good diabetes, is because they are bad. That is scientifically not true. genetic link and often invisible environmental factors. even when we look at numbers attached to weight or when we check BGs. we must remember it’s just a number. no good or bad numbers, just information. we give too much power to these numbers, to give self-worth as human beings. “it’s just a number.”
- Remember the good news. With good care, the odds are good that you can live a long and healthy life with diabetes.
- 1978: more than 30% with severe vision loss, 38% with nephropathy, 10% amputations
- 2009 – 1% severe vision loss, 1% amputation, 6% nephropathy.
- There is a normal life expectancy for type 2 PWDs compared with the general population when you have good care.
Sir William Osler says, “To live a long and healthy life, develop a chronic disease and take care of it.”
- Make sure that you have concrete and reasonable diabetes care goals.
- Focus on the important stuff. Not everything is equally important. “bang for your buck list.” Being on the right medication and taking it is the biggest bang.
- Give yourself a break. You can’t be perfect and you don’t need to be.
- Take a diabetes vacation, just plan it ahead. how can you give yourself a little break in a way that is restorative. it’s people who take unsafe vacations like ignoring the disease for 20 years. Talk about it with HCP to get a little break and get what you need.
- You don’t have to do diabetes alone.
- Find people who will root for you and help your loved ones help you. Have conversations with loved ones who are supporting your efforts, but sometimes you might have people who are giving you too much support. They all mean well but you end up working against each other. They are always coming from a place of love and caring but they may not know what to do. Because they love you, they are never going to stop. You have to distract them, give them something clear of how they can help.
- Develop a sense of humor.
CGM: Revolutionizing Diabetes Care – Dr. Jeremy Pettus and Kelly Rawlings
- According to new studies, the Dexcom really is more accurate than Medtronic
- However, Medtronic is an integrated system and the 530G has the Low Glucose Suspend, both of which could be very useful for some people.
- Dr. Pettus suggests that in the future, rate of change arrows will play a bigger role. If your blood sugar is 200 mg/dl and rising, you might need more insulin than if you were 200 mg/dl and dropping. He said that at first we’ll learn to do it manually, and then later it will be automatic.
- Dr. Pettus, who has type 1, boluses off his CGM almost all the time. (Not sure I could be that brave!)
- One patient of his uses the Earthquake app on his iPhone to make the alarms louder!
Diabetes Criminals and Diabetes Police – Bill Polonsky and Steve Edelman
This was a session where patients and healthcare providers had a chance to air their grievances.
- Patients shared that providers are often: not interested, don’t listen, give bad advice, and aren’t empathic.
- Providers shared that patients often: don’t come prepared, stop taking medications without consulting with their doctor, won’t spend the time to get educated, feel like they are working harder on their diabetes than the patient.
- Edelman and Polonsky shared that: patients should come prepared with a short agenda to maximize efficiency with time, show appreciation for what their doctors do, and understand that providers went into the field to help people but they are under a lot of stress.
- They told providers that no one asks to have diabetes, so we need to be careful not to blame patients. Guilt does not create motivation.
Keynote speaker – Joe Piscatella (a motivational speaker and author on living healthy)
- Stress is a major reason why people don’t take care of their health, because they are stressed out and don’t feel they have the time.
- Major causes of stress:
- Anger and hostility
- Constant connection
- No such thing as stress reduction, but you can learn to manage stress. You learn to manage diet and exercise better.
- Deep breathing (in through the nose, stomach out, hold it, out through the mouth for 5 beats)
- Dxercise – the most important element: regularity by getting a partner
- Perspective — it’s the way we view an event that makes it stressful or not stressful.
Joe shared that he had coronary bypass surgery at age 32 and was diagnosed with an aggressive cardiac heart disease. His doctor told him that he should continue on living the way he was, because there was no hope! He would likely not see his children, then 4 and 6, graduated high school. But his wife believed that he should do whatever he could to live a healthier, longer life.
She said, “You can’t change the cards you’re dealt, but you can change the way you play them.”
Now Joe is in his seventies, and has seen his children graduate high school, college, grad school and law school and has four grandchildren! Now that’s the power of positive thinking and healthy living!