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Is It REALLY All About the Scale?

April 5th, 2011

I read the Joslin blog from a few weeks ago written by C. Ronald Kahn, MD about Obesity and Diabetes.  He writes about the importance of cutting insulin resistance as much as possible in both Type 2 and Type 1 diabetes.

It’s a frustratingly shallow article, overall.  Especially when it’s written by someone with such expertise!!

So here’s my take on some of the topics he mentions:

Cut down your body weight to decrease insulin resistance.  While the Joslin blog doesn’t explain why insulin resistance is considered harmful, I’m willing to pose a few ideas:

Insulin Resistance leads to elevated blood glucose, which in turn leads to damaged micro- and macro-vascular systems that lead to traditional complications of kidney and eye damage.

Excess Insulin removes free fatty acids from the bloodstream and sends them to your body’s fat storage cells.  This creates a circular cycle as added body weight in the form of increased fat stores also increases your body’s resistance to insulin.

Dr. Kahn also says the bottom line is what you see when you step on the scale.  I disagree.  I think the bottom line is somewhat more complicated than that.  I think your body composition matters quite a bit as well as your weight.

You need to increase or at the very least maintain your lean muscle mass if you want to keep yourself strong and healthy for the long haul.  As you age, your body begins to lose its lean muscle at the alarming rate of about 1/2% each year after the age of 25… and that loss doubles after the age of 60 UNLESS YOU STAY ACTIVE with exercise and resistance training.

(Because muscle is more compact than fat, you may be a muscular trim size 6 and weigh more than a weak flabby size 4.)  To maintain your body’s performance, you need to work at preserving and hopefully increasing the lean muscle you have.  It’s never too late to start!

Joslin says it’s important to work with your physician, nurse or dietician to lower your body weight to a healthy weight.  I would also like to jump up and down, wave my arms, and shout “WORK WITH A KNOWLEDGEABLE TRAINER, TOO, TO KEEP YOUR BODY WORKING AT ITS BEST!”

You know where to find me!

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Posted in Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized

Feedback

April 1st, 2011

Diabetes is a constant-feedback kind of disease.  It often leads to frustration, confusion, exhaustion, and can result in an intense desire to throw things across rooms.

I feel I know this very well today, since I woke at 12:45am at 451 (thanks for the warning at 175, CGM) and stayed awake until 3:50am until I felt I could fall asleep again (until 5am when I get up for bootcamp).  I was going to fall asleep earlier, but then the insulin hit and I was dropping and it was just feeling too complicated to sleep through.

I’m so lucky I had a good book to read.

But one of the tough things about living with type one diabetes is that I know if I say something to anyone who knows about diabetes they’ll start in with the questions and the suggestions.  (Probably not those living with type one ourselves, we’re busy questioning what’s going on in our own bodies!) While I know they are always intended to convey concern and caring, sometimes, on too little sleep, they come across as criticisms.

It can get tough to manage the advice and feedback, especially when we are the ones who feel the swings and the highs and sometimes all we really want to do is sleep at night!

I saw Carrie Cheadle’s blog post today on receiving feedback and using it to our mental advantage.  I think I’ll use some of her advice to review last night for myself. 

I doubt I’ll be open to suggestions from my doctor, but since I made my husband stay awake through some of the high and some of the low, I might run through this with him, just to share and hear what things are like from his side (and it’s a way to ask for help!).  I need to be running through these kinds of things more often for myself, so that I can better learn how to keep at this!

Carrie lists three questions that we should ask ourselves to discover constructive feedback after any event of significance.  For her, this is any athletic competitive event and for me, today, it happens to be my last 15 hours.

-What did I do well?

-What would I have done differently?

-What did I learn that I want to carry forward into the next event?

I think these thoughts are good for each of us to keep in mind as we deal with ups and downs of life with diabetes.  I particularly like the “what did I do well” question because it calls for a thoughtful compliment of the work we put into our health every day… something that we often forget when we find ourselves with a higher number than expected or desired. 

In case you aren’t feeling it, remind yourself that you ARE doing a good job taking care of yourself with a crazy mixed up disease.  Pat yourself on the back, answer the above questions constructively, ask for as many hugs as feel good, and keep at it.

You deserve it.

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Posted in Living with Type 1 Diabetes, My Soapbox, Random Musings, Uncategorized

Last Day of the March Challenge

March 31st, 2011

You know I’ve been encouraging you to figure out ways to ask for help all month when it comes to living with your (or your child’s) diabetes.  It’s important.

I had a strange afternoon yesterday, and it showed me the total awesomeness of strangers and it has been making me grin ever since.  How lucky are we to be a part of such an amazing world??

(Okay so it has been rain-free and sunshiny and today it’s going to be in the 80s so I freely admit I may be a little wacky just because of the change in weather!)

I thought I’d close out the month with a reminder that we could ALL use this skill in our lives, with and without diabetes being a part of it.

Check out this little story a reporter wrote about a woman at a Texas road race:

___

Before I ran my first half marathon six years ago, Barbara Sucher sent me an email. She wished me luck, said she knew I could do it, and then told me this, which I’ve thought about every time I’ve run a half-marathon:

“In a race, I always write the Winston Churchill quote ‘Never give in’ on the back of my legs. Many, many people have told me how inspiring that is and that it keeps them going.”

Barbara is 66 now, still running marathons and half marathons. Last Sunday, she ran an amazing 2:12 at the Rock ‘n’ Roll Dallas Half Marathon , finishing third in her age group. Elated, she headed for her truck on the huge Cotton Bowl parking lot.

“I knew where I’d left it, but an ambulance came by and I got a little off track,” she says. “I continued to search until I was getting cold and a little panic-stricken.”

Suddenly, Barbara says, she tripped on buckled pavement and landed face first. Totally stunned, she just lay there.

“A very nice man named Andy rushed over and asked if I was all right,” she continues. “I couldn’t even think of who I was or anything else about me…Finally, I realized I was wearing my Road ID and I pointed to it. He tried calling the numbers and finally left a message for my daughter, Kelli.”

Then he told her, “I won’t leave until someone comes to get you.”

Other people stopped by, too, offering to help Barbara find her truck. She couldn’t remember what it looked like, but thought it was a Toyota. They set off searching, and she could hear them calling out to one another. She finally felt able to sit up. Andy kept watching until Kelli called and took Barbara to the emergency room.

A CT scan of Barbara’s head showed two enormous bumps. She hadn’t broken anything, hadn’t bruised any ribs. She finally began “to get my senses back,” she says. “But I have a huge and startling black and green and red eye and look pathetic!”

Her point of telling me this, she says, was — well, basically to say thank you. She knew her fellow runners were cold and tired, yet they went out of their way to help her.

Life can turn on the proverbial dime, or on the twist of an ankle. It can be tripped up by a 3 a.m. phone call, or by a piece of concrete on a parking lot. When that happens, what a blessing it is to have people around to make sure you’re OK; to guide you to where you need to be; and to make sure, if at all possible, that you never give in.

___

Let the concepts of asking for and giving help and what those two actions give you in return carry you well past the month of March.  Let it be something you always hope to share, in either form, wherever you go and whatever you encounter.

All my best to each of you!

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Posted in Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized

Leading A Charmed Life?

March 30th, 2011

Joslin directed me to a WebMD Health News article today.  The title: Why Some May Avoid Type 1 Diabetes Complications: researchers say more than just blood sugar control may be at work for some patients.

So of course I read it.  (Especially after my eye visit yesterday when my doctor said she saw no diabetic retinopathy!)  I didn’t understand the other proteins, the ones referred to as advanced glycation end products… there are times I just need to draw a line in the sand of how much of some of these things I need to understand in a day.

Continuing on through the article, they quoted one of the experts as saying “those with diabetes who are free or mostly free of complications [after 50 years] are leading a charmed life.”  That one didn’t make me happy or motivated to seek that guy out.  I think a large part of what he calls “charmed” involves quite a bit of work every day over the course of several decades.

The author won me immediately back when she quoted another expert who said that most of the [Joslin 50 years of living with type one diabetes] medalists “do fairly rigorous exercise at least three times a week, 45 minutes or more.”

So check it out: EXERCISING DOES NOT REQUIRE LUCK, GENETIC GIFTS, TALENT OF ANY KIND, COORDINATION, INTELLIGENCE, MONEY, or anything, really.  You’ve seen that people without legs can exercise, and do!

Since exercise, and I do mean rigorous exercise, can lead to so many benefits and is one hallmark of a long life with type one diabetes, and since exercise requires so little of us other than carving out the time it takes to work up a sweat, my vote remains in favor of exercise as a way to deal with and combat some of the unwanted outcomes of type one diabetes.

In fact, I’m now re-energized and heading out for a nice long run to celebrate.

Who’s with me?

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized

Exercise as Medicine?

March 25th, 2011

I’ve said food (more specifically, simple sugars or juice) is medicine to me to young kids who question what’s going on if I’m low.  I’ve said that exercise is like medicine, as well, particularly for those of us living with type one or type two diabetes.  But is it?  Have I been thinking about things all wrong??

 I read a newsletter yesterday that put a different spin on the “exercise as medicine” idea.  I hadn’t thought of it this way in the past but I love it a lot and I’m thinking of changing my opinion!

 The newsletter comes from Brett Kilika via Todd Durkin at Fitness Quest 10; I’ve blogged about FQ10 and Todd in the past.  Love him.  One of the FQ10 trainers wrote a piece for the newsletter:

“Exercise As Medicine”

By Brett Klika, Director of Athletics at Fitness Quest 10*

In America, too many people view exercise as medicine for an ailment. When you get fat, take exercise until you’re not fat. Exercise is not medicine. You take medicine for a brief period of time until you are no longer sick. Exercise is merely using our body the way it was designed to be used. It’s a lifestyle we were created to lead, not some trendy novelty.

Years ago, we didn’t have to think about creating opportunities to be physical. Very few things in our lives were automated, so our daily activities were enough to keep everything going. Right now, we have very little, if any daily activity requirements. We have to create them. If you don’t use it, you will lose it. You’re body runs a tight ship. It frequently goes through a “spring cleaning” process to get rid of anything it doesn’t need. If we don’t create daily reasons for our body to keep moving, it will stop. When your body stops, it hurts. It’s debilitating and you begin to suffer.

How do you plan to live your later years? You want to be able to walk? You better be walking quite a bit right now. You want to be able to pick up your grandchildren? You better be picking up heavy stuff on a daily basis right now. You want your heart to beat? You better be giving it good reason to beat hard every day! You don’t have to go to aerobics class, lift weights, or play a sport. You don’t have to strive to look like a model. You do, however, need to do something that gives your mind, body, and soul a reason to show up to work.

 _________________

Perhaps we should re-think exercise in our lives.  As a means to an end we all want.  Let’s work toward that end every day and see what happens! 

I’m here if you’re struggling with exercise and your diabetes. 

*Brett Klika, Director of Athletics at Fitness Quest 10 is an international speaker, educator, author, and motivator with 17 years experience in the realm of training and coaching. Through writing, speaking, and various other forms of media, Brett educates and inspires trainers and clients all over the world to optimize their lives through wellness.

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Posted in Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized

Endurance

March 22nd, 2011

I’ve completed countless half marathons and two full marathons (so far).  When I started law school, everyone said “it’s a [three year] marathon, not a sprint.”  Neither of these are what any would consider “slight” or “easy” accomplishments.

But whenever anyone said that to me, I just smiled and nodded.  They were absolutely right, but I already knew I had it in me.

I live with type one diabetes.

I know endurance.

Someone (thanks CS!) commented on the Diabetes Outside Facebook page yesterday that diabetes is all about falling and getting back up.  I may phrase it differently, but she’s right: IT’S ALL ABOUT GOING THE DISTANCE WHEN IT COMES TO LIVING WITH DIABETES.

Yes, that means a lot of drudgery and a lot of pain in the neck things, but it also means you know what it takes to keep at a difficult task day in and day out.

There is no vacation from diabetes, but you know how to handle that.  You know how to ask others for help when it comes to just needing to share a smidge of the load.  You know how to look a lifetime of checks and shots and counting carbs and worries and mini crises smack dab in the eye and say “I’m still here.  I’m living my life.”

You know that diabetes isn’t about one meter reading, or one meal or one bolus.  It’s not one number, but is instead a mountain of numbers that seem to multiply exponentially over time.   It’s about putting one foot in front of the other over and over and over.  And over.

Every single one of us knows this, and every single one of us accomplishes a great thing every day.

THAT is, to me, endurance.

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Posted in Living with Type 1 Diabetes, My Soapbox, Random Musings, Uncategorized

You Can Do This, Too!

March 21st, 2011

The IDEA Fitness Journal March 2011 has a little article about a trainer and successful client that caught my eye. 

The client lives in Maryland and at the age of 50, weighed 260 pounds in 2009.

Oh, yeah, and she has type one diabetes!

Working with her trainer, she lost 58 pounds in 18 months—practically perfect in every way, given a healthy weight loss rate of about a pound a week while she built lean muscle mass. 

She says that she used to need 125-150 units of insulin each day to manage her blood sugar and she now uses 18-20 units!  She had also been on numerous medications that she no longer needs.  (Since insulin moves not only carbohydrates from your bloodstream into your cells but also moves fat from your bloodstream into storage, the less insulin you need, the better.)

What a great story!

The best part, according to me, is not that she went from a size 20 to a size 10, but that she reports  now that “I have energy for all that I want to do.”

If THAT isn’t a success story, I don’t know what is!

As a trainer, I want everyone to have this same success.  Why let our overweight bodies tell us what we can and cannot do?  I’ve never let my diabetes tell me what I can or cannot do, and let me tell you, living with diabetes is waaaay more work than obesity.

As soon as I realized I was heading in the direction of letting my body determine what I could and could not be or do simply by being overweight, I wanted to change things and fix it.

And I did.

And so did this woman.

It worked for both of us and YOU CAN DO IT, too!  Sure, there will be some hurdles and things to figure out with your diabetes, but isn’t that true of every part of your life? 

I’m just so happy to see that someone else worked to make herself as healthy and fit as possible… and she got there like a champ!  Congratulations to her, and to everyone else who has achieved a similar feat with his or her body and his or her diabetes. 

It’s absolutely possible.

Go for it.

(And of course you know I’m here if you need support, guidance, knowledge and experience when it comes to physical fitness with diabetes.  Just ask!)

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Posted in Living with Type 1 Diabetes, My Soapbox, Random Musings, Uncategorized

Sticking With Exercise (Part 2 of 2)

March 18th, 2011

Yesterday I wrote about the first two of the four most critical factors that stop people from sticking with an exercise program; today I’m tackling the remaining two.

As you know, Dr. Bryant listed the four most critical factors for exercise adherence:

  1. Injuries
  2. Time
  3. Boredom
  4. Results

Now to the tough ones.

BOREDOM.  I’ll put it right out there: this one confuses me a bit.  I think that I get bored all. the. time.  Really!  My attention span is remarkably short; I just hide it fairly well most of the time.

But that boredom, or rather trying to avoid that boredom, is essential when it comes to fitness.  Our bodies get bored with the same workout just like our brains get bored with the same old, same old.  By mixing up our workouts we can kill two boring birds with one stone! 

Get off the cardio machine at the gym and go outside for a walk, run, or interval workout.  Get on your bike and go someplace new.  Try a Zumba class.  Try a rockclimbing class!  There are so many gyms, classes, parks and rec offerings that are currently at rock bottom prices (check out any of the daily deal websites!) I simply don’t think there is a valid excuse for being bored with your workouts.

RESULTS. We all want them.  It’s a major motivator for most of us!  But geez they can take a long time to show up.  Bryant recommends keeping an exercise log, and I absolutely agree.  When you can look back on your log and see how many workouts you fit in, how many miles you logged, how many minutes you spent improving your physical self, that’s pretty cool.  It’s nice and free of judgments—it’s only listing what you’ve already accomplished—and is a silent little pat on the back every time you look at it.  You are capable of making progress every day—why not recognize that?  That progress is a result in itself.

Staying free of serious injury, making exercise a priority, beating boredom and seeing results are each necessary for continual exercise success.  Good thing we are all capable of this success in our lives!

Don’t let anything stand in your way; go for it!!

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Posted in Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized

Sticking With Exercise

March 17th, 2011

If you have ever battled the motivation gods, emerged victorious, and started following a regular exercise program, you probably know what can happen next.

You stop exercising.

Augh!  That wasn’t supposed to happen!!  You were supposed to start with your New Year’s Resolution and stay with the program!! 

Ah; but we’ve all been there.  Looking through one of my old fitness professional magazines, I came across an article written by Cedric Bryant, Ph. D., the chief science officer for the American Council on Exercise, about sticking with exercise programs.

And, as I am wont to do, I thought I’d share his wisdom here.

Dr. Bryant summarizes the four most critical factors for exercise adherence are:

  1. Injuries
  2. Time
  3. Boredom
  4. Results

Each one makes sense!  You don’t want to exercise if you’re hurt (or fear you will get hurt).  You don’t want to exercise if you feel like you barely have time to get dressed in the morning much less spend 30 minutes sweating!  You won’t keep doing something that bores you (unless you are unusual), and you won’t keep doing something if you have to wait 5 years to see any result. 

So how to battle THESE potential roadblocks?  I’ll go through the first two today and the rest tomorrow.

INJURY.  Of course, first plan for injuries when exercising is to avoid them.  But how often does Plan A work?  You need to make sure that you are being smart when you exercise—don’t go so hard too quickly that your body won’t recover.  Exercise really is breaking down your body, resting and rebuilding, and then repeating the process.  Give yourself enough rest and start slowly and safely.  If you do twist your ankle, rest until you are itching to get back… and then wait another 2-5 days to make sure. 

TIME.  I think a lot of people just don’t put a lot of importance on exercise in their lives.  Chances are you have a load of time in your day that you don’t even know about!  If you make exercise a priority, it will happen.  I read something once about a science teacher who gave his class a jar and both large and small stones; the assignment was to put all of the stones in the jar. 

After several tries, the students saw that the stones all fit in the jar only when they placed the big ones in first.  (Turns out the same exact thing happens with dishes in the dish rack; try it!)

Make sure that your exercise is one of the big stones in your life, and the other smaller things will still fit if you need them to.  I promise.

Happy St. Patrick’s Day!

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Posted in My Soapbox, My Workouts, Random Musings, Uncategorized

Parents of Type One Kids and Teens

March 15th, 2011

I went to the UCSF Symposium this weekend and heard a lot of questions from parents as they struggle with being good parents and being good caretakers and being good diabetes nurses and good nutritionists and coaches and therapists for their kids…

I heard some questions more than others, and thought maybe you’d have more questions beyond these.  If you do, please let me know!

One speaker, Bill Polonsky, gave five important general rules for parents of type one kids.  I think it’s a great list so I’m re-posting it here.

  1. Have faith that your type one kid can live a long and healthy life.  Well managed diabetes is the leading cause of NOTHING.
  2. Scaring your child into better management of their diabetes will not work.  Forget it.  It won’t.  Ever.
  3. Develop a sense of humor about life with diabetes.  Learn and accept that aggravations over diabetes will occur and get used to them!
  4. Have a family plan that establishes clear, meaningful, and reasonable goals for action—for everyone in the family.
  5. Listen to each other.  Diabetes is hard on everyone and we all need to support each other.

How handy we have this March Challenge going on, isn’t it?  Here’s where you can look for inspiration to ask for help in different ways—from others in your family, and of yourself.

I’m here to help if you, your child, or your entire family needs a little experienced help with day to day life, or with a current crisis.

Go for it.

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Posted in Living with Type 1 Diabetes, My Soapbox, Random Musings, Uncategorized