Archive for October, 2011

Researchers

October 7th, 2011

Researchers crack me up sometimes!

First off, I don’t know what they originally studied here, but the abstract that I can access mentions “re-examining” so clearly there was a first step we can only imagine.

The researchers here checked the brains of young adults with type one to see if either a history of severe hypoglycemia, a history of severe diabetic ketoacidosis, or a history of long-term glycemic control affected cognitive functioning.

Not a bad idea for a research study, if you ask me.

They took 34 non-diabetics aged roughly 19 years of age and they took 33 type one diabetics roughly the same age who had all been living with diabetes for about 16 years.  A1cs on the diabetic subjects was about 8.7%. (This is not a number that I would consider appropriate for the label “long-term glycemic control,” for the record.  Of course, it’s about 6% better than mine was at the time, but I digress.)

The full-scale IQ scores were the same between each group.

The researchers lined all these subjects up and tested them on a few subjects, I guess (have to guess as I have less than no idea how people test brains when brains are still alive and working) and this is what they found: These data suggest no difference in general intellectual ability, memory, and emotional difficulties in our cohort of young adults with early-onset type 1 diabetes compared with control subjects and no deterioration over time.

Woot!

And then the kicker: There were, however, findings to suggest subtle changes leading to poorer performance on complex tasks of executive function.

So, okay.   I understand.  Apparently having diabetes since the average age here of three (3!!) means these 33 young adults may perform poorer than their non-diabetic peers on “complex tasks of executive function.” (Not that I can tell you without Googling it what that means.)

Oh geez!!  Wikipedia says:   Executive function is an umbrella term for cognitive processes such as planning, working memory, attention, problem solving, verbal reasoning, inhibition, mental flexibility, multi-tasking, initiation and monitoring of actions.

Going down that list, from my perspective of living with type one diabetes:

Planning.  What do I need to do to keep from going low?  What do I need to do if I do go low?

Working Memory. What did I eat was it enough carbs to cover the insulin?

Attention. Where are all of my supplies? What is my blood sugar right now?

Problem Solving. I don’t feel great and my meter just said I’m 80.  Now what?

Verbal Reasoning. I need to ask for some sugar but they don’t know I have diabetes so I have to explain it.  (or) My mom just yelled at me for not checking so I have to tell her why I didn’t check.

Inhibition. I didn’t check because I was at the new sports thing and no one knows I have diabetes and I don’t want to deal with the questions.

Mental Flexibility. I think I’m low so I will check.  Oh shoot I’m not low I’m 220 maybe I’m just hungry what am I supposed to do now?

Multi-Tasking. I’m supposed to be taking that test next period but I just had P.E. and I’m feeling shaky and shoot I didn’t finish my assignment for this class and where is my meter and oh no I think I forgot my lunch.

Initiation of Actions.  Feeling junky.  Gotta eat or check.

Monitoring of Actions.  Still feel shaky.  I’ll give it 15 minutes and check again.

This just gets funnier and funnier to me.  I makes me have to ask: Are you serious, researchers??  Did you somehow not account for the COMPLEX TASKS OF EXECUTIVE FUNCTION that is blood glucose management every minute of every day of life with type one diabetes?

I think they should have somehow accounted for the fact we call diabetes the thinking person’s disease for a reason. 

Now THAT is a study I want to see.

It’s That Time of Year Again. Boo.

October 6th, 2011

I’m not a big fan of Halloween.  As in, really not a big fan.  I know that makes me a big ole party pooper, but there it is.

For one thing, everybody tries to be somebody else.  Um, I think being myself is plenty hard enough thank you very much and I don’t appreciate people trying hard to fake it as someone or something else.

Totally just me; I get that.  Heck, it weirds me out how many people color their hair.  I’m telling you.

And then there is the fear factor of Halloween, when people dress up as dead people and hide and jump out and dear me are you kidding.

We won’t even DISCUSS the fake spiders or webs.  *shudder*

At my elementary school, we had a parade on Halloween.  That was okay.  Less sitting still in class, more walking around.  Way better!

So for the first ten years of my life, sure, dress me up and put itchy face paint on and make me not touch the makeup all day, fine.  Just pay me in candy and I’ll be juuust peachy.

And then came diabetes.

At the time, candy for a diabetic was a no-no.  My “medical team” aka my pediatrician didn’t ever think about even a sliding scale of insulin to cover carbohydrates, much less carbohydrate counting or whatever the heck a bolus was.

Doesn’t mean I didn’t eat candy, though!

I just had to sneak it. (Tell me how you sneak candy when you take the exact same dose of insulin each day and eat the same food just now with candy.  How?  For me, hide the numbers too.  THIS IS WHY parents need to see the whole 5 second blood check.  In person.  With real blood.  Every time.)

Thankfully, we do things differently now when it comes to life with type one diabetes: carb counting, insulin shots, pens, and pumps.  All foods generally allowed if counted, and if parents say okay.

October means a lot of things (Happy 10th birthday kitten loves Gracie and George! Winter socks! Cranberry-Orange tea!) and Halloween gives me a chance to smile at how far we’ve come in terms of life as a kid with diabetes.

Maybe it isn’t such a crummy holiday after all.

Just get rid of the spiders; I’m begging you.

Walking it Off

October 5th, 2011

I saw a woman who had taken the summer off her regular exercise routine and walked instead.  Yesterday was her first day back at bootcamp and she looked like she was sorry to have taken the time away!  She acknowledged “walking for fitness” isn’t anything like an exercise class.

I know a lot of people walk as exercise.  Are you sweaty by the end?  Are you climbing hills when you’re out there?  Does the weather change your routine?  Do you add in intervals of intense speed to help increase your heart’s capacity to pump blood?

All things to consider.

If you’re in an area of the world that has seasons (unlike me) with snow, walking for exercise probably takes a huge hit during the cold months.  So do you take it indoors?  In front of your television or onto a treadmill?

Running or walking, a treadmill can offer some great benefits but there is also a downside of the treadmill too.  This article discusses benefits of treadmill walking and walking outdoors.  It has some great things to keep in mind for those of us who want to cover some miles several times a week!

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Using a motorized treadmill with no incline, you may burn fewer calories per mile than you do outdoors. The moving tread does some of the work for you, and you have no wind resistance. According to research, you can overcome these by adding a slight incline, as little as 1%.

Holding onto the handrails will reduce calories burned further, and wreck your walking posture. It is best to train yourself to walk a speed you can sustain without holding onto the handrails.

Calories Burned Walking

Work More Muscles Walking Outside

Walking outside has its biggest advantage in challenging your balance and stability with all of the small obstacles, dodges, starts and stops. This will give you an advantage for distance walking as well as overall health as we age — maintaining our stabilizing muscles. Here is what you face walking outside vs. on a treadmill:

  • Up and down curbs, steps, short stairways, and stepping over small obstacles. A little workout for your climbing muscles.
  • Sloped sidewalks and road sides. A challenge to your balance muscles.
  • Dodging people, puddles, and poodles. A challenge to move side-to-side as well as forward.
  • Stops and starts at street crossings. A challenge to the muscles to come to a halt and to start from zero.
  • Treadmills only go uphill or level, only very rare models have downhill incline. Going downhill challenges muscles in a completely different way.
  • On the treadmill, the tread is moving and you may not be giving yourself a good push off with your back foot. Concentrate on doing this correctly on the treadmill.

Advantages of Treadmill vs. Outside Walking

Using a treadmill for your regular workouts is a great way to burn calories and give basic training to your walking muscles and practice your walking form.

  • Workout Programs: You may enjoy the pre-programmed workouts the treadmill offers to give you a controlled workout challenge. The treadmill may also have readouts for heart rate, calories burned, etc. which give you data feedback.
  • More Speed = More Calories Burned: Most people set their treadmill workout for time rather than for distance, and can often go faster on a treadmill due to lack of obstacles. More speed = more distance for the same amount of time = more calories burned than if they walked outside for set distance rather than for time.
  • Safety: If you don’t have access to a safe walking route, a treadmill is a good substitute.
  • Weather: You can usually control the indoors weather, but never the outdoors weather.
  • Easy access to restrooms, water, and changing your gear.
  • Entertainment: Some of us are bored with treadmill walking, while others prefer watching TV or listening to their music indoors to walking outdoors.
  • Fewer excuses: If your treadmill is always available, you can’t use excuses such as the weather, darkness, etc.

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No matter where you go, keeping yourself happy and fit is critical.  Have fun and work hard!

“Bad Knees”

October 4th, 2011

I spoke with a woman this morning who said she couldn’t work out because she “has bad knees.”  This is not the first time I’ve heard this type of sentiment.  (My favorite was when a lady told me her doctor told her to not bend her knees.  I was amazed she could walk to me to say that, much less take care of almost every other movement in her life!)

First of all, if you have seen a doctor for your knees and have had surgery or your doctor has advised you to stop exercising, then you can be excused from reading further.  (Unless you think perhaps you should seek out a second opinion already because what kind of doctor would tell you to stop exercising my word.)

Second of all, you need your knees for almost every movement you make from the waist down.  Every time you stand up, every time you sit down, every time you take a step, every time you reach for that dollar you just dropped.  Every movement.

So it isn’t like you can just remove your knees from the equation.

Thirdly, knees are just like everything else: use it or lose it.

Fourthly: (is “fourthly” a real word?!) your knees were DESIGNED to support your weight and all the impact that entails.

Take a look at the structure of your knee joint as opposed to the structure of your shoulder (side view of the shoulder blade).

One looks like it was built to take a beating, the other looks almost bird-like.

 

It goes a long way toward explaining why we don’t walk on our hands.

So what to do if your knees cause you pain?

  1. Make sure you exercise with proper form.  That means you keep your knees in mind throughout your lower body workouts.  Keep your calves stretched to increase flexion at your ankles so you can keep your heels pressing down as you squat.
  2. Exercise your weak spots.  A lot of back pain and I would argue knee pain as well can be attributed to weak glute muscles, believe it or not.  If you have one part of your body that is too weak to function optimally you are placing excess load and strain on the other portions of your body.  So, keep working on your weaker muscles to bring them up to snuff.  You can find a load of floor exercises like the bridge at the ACE Fitness website under “exercise library”.
  3. Keep yourself balanced.  Working on your balance is a fantastic way to keep your smaller muscles and tendons working to benefit you at all times.  We can all use some of that!

Don’t let laziness or fear get in your way.  Be smart about how you take care of your body and it will in turn be better able to take care of YOU!!

Parents Are People, Too

October 3rd, 2011

Just because you’re in charge of a kid, or even more, a kid with diabetes, you still need to carve out some time to take care of yourself, too.  Why?  Because you teach your children how to care for themselves when you take care of yourself.

It’s super important.

They’ve done studies where they looked at moderately obese children (5-9 year olds) and focused not on the kid at all—they looked at the parents.  By educating the parents and specifically training them in ways to make good, healthy choices their kids lost about 10% of their body weight, and kept it off for two years.

It isn’t just about you, and it isn’t just about your kid.  It’s about making good choices for EVERYONE.

But.  How. Do. You. Do. This. Amazingly. Difficult. Job. On. Top. Of. Your. Other. Jobs.

Some suggestions from a recent ACE magazine article:

  1. Take the kids along for the ride. “The best way for me to exercise is to take both kids out in the jogging stroller. Once or twice a week I meet some other moms at the walking trail. Pushing 60-plus pounds of kids and stroller up and down hills for an hour is a pretty good workout!” recommends Danielle Rattray, mother to Owen (4) and Hannah (1).
  2. Ask for help. Lean on a spouse or partner to watch the kids for a few minutes and go for a quick workout. Working parents often want to spend every non-working moment with the kids, but sometimes carving out a few minutes of personal time can make all the difference. “It’s hard not to feel guilty taking time to exercise by yourself when I already feel like I don’t get to spend enough time with [two-year-old] Xavier,” says Amber Curran. “But it keeps me happier and less crazy, so I figure that benefits him as well.” After all, she says, “No one wants a nutty mother!”
  3. Make a game of it. Barb Ruvarac, mother of school-aged children, Samantha and Zach, pushed herself to meet a predefined number of steps each day. If that means staying up late to get the steps in, so be it. “When Samantha went to bed I would finish my steps on the treadmill to reach 10,000 steps. Some days I’d only have to walk for 30 minutes, some days it would take longer. Then, I graduated from walking to running. Then my husband signed us up for the Shamrock Shuffle in 2010—first running event ever! And by May of 2010, I’d lost 20 pounds and two dress sizes!” Barb is now an avid half-marathoner and highly active role model to her highly active children.
  4. Prioritize. In describing her commitment to exercise despite working full-time and raising a nine-month-old, Beth Read uses an analogy that we all can relate to: “Like they tell you in the airplane…put on your oxygen mask first before assisting others.” Whether that means waking up before the children or staying up a little bit later, getting a few minutes of physical activity sets the stage for a more productive day and well-balanced person.
  5. Set goals. Tackling the most challenging health struggles becomes a little bit easier with goal-setting. Try this exercise: Write down three goals—a nutrition goal, a fitness goal and a behavioral goal. Operationalize this goal as much as possible by trying to make sure that the goal is SMART. Specific: What is it exactly that you hope to achieve? Measurable: How will you know if you got there? Attainable: Make sure it is something realistic that you are going to be able to achieve with some moderate amount of effort. Relevant: Choose goals that really are meaningful to you and that will help you feel like you’ve really accomplished something. And Timely: Set a date for when you hope to achieve your goal that is far enough in the future to give you time to meet it, but not so far that you will lose interest before reaching it.
  6. Commit to setting an example. It’s simple: Kids pay attention to what their parents are doing. Despite the many barriers to physical activity, taking the time—even if it’s just a few minutes per day—to engage in physical activity sets a powerful example for children. The repeated opportunities to see how you eat and play make it easy for kids to remember the experiences. And kids are motivated to copy their parents’ actions.

You aren’t alone in thinking this is a big giant task.  It is, and you’re lucky to love your kids enough to find a way to make it work for both of you.

You can do it!!!