Letters to the Editor
Over 50 and Going Strong
Being laid up with a broken leg, I picked up some older issues of Diabetes Health (too much good information to throw away!).
In the August 2000 issue there was a letter from Dr. Maurice Sonnenwirth asking for an article about folks with diabetes over 50 years of age who are doing well. I suggest not only an article on the topic, but a letter each month from a long-termer. This is a long neglected source of vital information ignored by the medical profession. It was November 1950 when my doctor said to me, "You have a moderately severe case of diabetes." I am now 81 and still going strong with no severe complications. When I went to Dr. Steven Edelman’s "Taking Control Of Your Diabetes" one-day seminar, he asked, "To what do you attribute your success?"
He asked a good question to anyone with over 50 years experience of living with diabetes. I came up with 12 reasons, all equally important:
- Have a positive, optimistic attitude. Ask yourself each morning, "How’s your positive mental attitude?"
- Have a good doctor. Mine gave me a book by the Joslin Diabetes Center and said, "Make this your second Bible and read everything you can about diabetes because you have to be your own doctor."
- Lose excess weight and keep it off.
- Learn to like vegetables, especially those with few calories like lettuce, cabbage, celery, peppers, etc.
- Take one aspirin a day (doctor’s advice).
- Take two one-a-day vitamin tablets (another piece of advice from a doctor).
- Eat apples and oranges. Watch the BGs! Use raisins (natural glucose) to raise low BGs.
- Have a supportive spouse who understands and helps you eat right.
- Take blood tests regularly and often. At the beginning, all I had was Clinitest tablets for urine. The older I get BGs fluctuate to the extreme, requiring at least four tests daily.
- Absolutely no smoking or alcohol.
- Have a job that keeps the creative and challenging juices flowing.
- Last, and by no means least, having a personal, inner, sharp awareness of God working in your life. Pray a lot!
Let us hear from all those out there with over 50 years experience.
Asheville, North Carolina
In Support of Marathon Runners Who Test Their Glucose
As a type 1 since 1976 who has completed several long-distance races, including a marathon, I was appalled by the comments made about blood-glucose testing by Allan Steinfeld, race director of the New York City marathon ("Going the Distance," February 2001).
Mr. Steinfeld implies that people with diabetes who perform regular BG monitoring during races cannot handle serious running, and "shouldn’t be in the marathon" to begin with.
I am surprised that someone in Mr. Steinfeld’s position is so ignorant of the role of BG testing in the life of an active person with diabetes. BG testing is no different than using a heart-rate monitor to check one’s pulse—it tells the athlete how they are doing physically. If my heart-rate monitor says my pulse is too high, I slow my running pace. And if my BG reading is too low, I take some carbohydrate to raise it. It is as simple as that. Surely, Mr. Steinfeld would not begrudge someone using a heart-rate monitor during his race! Until such misconceptions are cleared up, people with diabetes will continue to be treated as if they can’t live normal lives.
I was both delighted and confused to read the New York City Marathon report in February’s issue ("Going the Distance"). I was delighted to see that this important concept of diabetes support is being addressed, but confused by the narrow attitude of professionals involved in the case.
I do not agree with Dr. Maharam’s and Mr. Steinfeld’s abbreviated viewpoint that BG testing is the full monty of diabetes support. There are some vague and incomplete answers to questions, like how the Diabetes Sports And Exercise Association (DESA) managed to successfully set up volunteer stations of diabetes support for eight years if we were not sanctioned by marathon authorities. We were given badges and NYC marathon T-shirts and ponchos, in addition to workstation tables set up alongside the Red Cross volunteer team.
In the article, John Madden wrote, "The availability to test BGs while participating in a long distance event such as a marathon is the difference between running in the dark and running in the daytime. You can see where you’re going." This, very eloquently, says it all. Based on what they are quoted as saying, Dr. Maharam and Mr. Steinfeld seem to spurn the necessity of testing during a duration event, in a sense discarding the immensely powerful tool of BG testing.
I always thought the DESA and the diabetic runners were a vanguard, a sparkling example of the possibilities available to people with diabetes who incorporate sports and exercise into the management of the disease. We are not all marathon runners, but the marathoners are an inspiration for all of us to find the athlete within ourselves. Dr. Maharam and Mr. Steinfeld seem locked into the notion that if a runner needs to test, she or he shouldn’t be running a marathon. Shame on them for their myopic, nescient judgment.
Judith Jones Ambrosini
New York, New York
More Media Coverage on Diabetes Needed
I am writing in regard to the article "Huge Gap in Diabetes Knowledge" (January 2001). The announcement by the JDRF from their survey is not surprising news to people with diabetes or their caregivers. I’ve had type 1 diabetes for 23 years, and have not seen any comprehensive coverage defining both types of diabetes, explaining its complications or how to properly treat the disease from any of the well-known networks on television. There are magazine articles occasionally published on the latest research, but they are written after a breakthrough (such as the Edmonton Protocol’s research on islet transplants), or a finding (such as the CDC’s announcement about the increase in type 2) that would make it newsworthy. You rarely see a major publication run a piece on diabetes for informational purposes, especially during November Diabetes Awareness Month. Considering 5.4 million people of the 16 million cases are undiagnosed, shouldn’t more information be repeatedly thrust out to the public via the media? I see commercials repeatedly played for erectile penal dysfunction and pancreatic cancer, but nothing for diabetes. Does diabetes not have any importance in disease coverage? The only difference in public knowledge between now and 20 years ago is that the word "diabetes" is no longer whispered when alerting another that someone has it.
Glen Cove, New York
More on The HMO System
My colleague and I were reading your column in the February 2001 issue ("Seeing Red") and are a little confused as to what the role of the HMO is. You say that physicians are not updated on the latest types of wound care techniques, especially for people with diabetes. Other than one statement you made about "feeling pressure to make up for what my mom’s HMO lacks…" you did not discuss the HMO system. Did you try to get a different podiatrist for her but were refused? Patients have the right to change physicians if they feel the care they are getting is not accurate.
We are concerned that your statement was not made with supporting data. Even though HMOs deserve comments regarding poor care, you do not seem to do so in your letter. Perhaps you may want to reread it and clarify for the readers next month. We do get Diabetes Health in our office and recommend it to our patients, as we feel you do a good job of showing both sides of issues.
As far as your mom is concerned, is a vascular surgeon involved? In Boston, a well-known podiatrist, Dr. Habershaw, works hand-in-hand with vascular surgeons to prevent and treat further complications. Because, if a person has neuropathy, they more than likely have Peripheral Vascular Disease as well. The combination of both increases risk of poor healing and amputation. Also, your mom should make sure her blood sugars stay below 200 for optimal healing of everything. (I advocate with my patients that even though less than 200 will do...the closer to ADA recommendations...the better.)
We look forward to hearing back from you and will keep your mom in our thoughts and prayers for a speedy recovery.
Maryann Krutsick, RN, BS, CDE
Cheryl Barry, RN, MS, CDE
Southern New Hampshire Medical Center
Nashua, New Hampshire
Editor’s note: Thank you for making these very good points. After writing my column, I made some phone calls and got my mother appointments with the HMO’s endocrinologist and wound-care doctors. She also received several visits from the home health-care nurse and a referral to a shoe specialist. Her toe is now much better.
A Heartfelt Thanks
This year I celebrate my 43rd year with type 1 diabetes and thank the lord (and my pump) for my survival and good health. I always enjoy reading about Scott’s children and the fun he is having with them. And talk about an inspiration—Diabetes Health helps so many people. I recommend Diabetes Health as a must if you have diabetes. Even if you don’t have it or you have a family member with it, the information and the articles are wonderful and informative. I often think of how nice it would have been to have it back in 1959 when I was first diagnosed.
Dorothy C. McCauley, RN, CDE
Some Progress, More Needed
I must say that being a type 1 for 47 years, I am rather tired of promises. I also understand that the profit motivation of various manufacturers and the huge cornered market. But, being very selfish, I would love to see a cure discovered and be rid of my need to test, puncture and inject.
I am also thankful for the advances I have seen in the past century. No boiling syringes and needles, no test tube and tablets to check your urine and no shoe-box-size meters.
Yes, I do thank God for progress, but I’d like to see more.
Clifton, New Jersey
Aloha from Hawaii!
I am the Community Relations and Communications Manager for Kaiser Permanente Hawaii Region.
First of all, I would like to thank Diabetes Health for the February article ranking our region number one among health plans for diabetes care ("Health Plans Making a Difference for People with Diabetes"). There are so many caring, compassionate individuals here who care for our members with diabetes, and their reach is not limited to just our members. As an organization, we actively participate with and support diabetes organizations like the ADA Hawaii Chapter, the Juvenile Diabetes Research Foundation, the Diabetes Education and Counseling Center and many others.
It’s nice that someone finally told our story.