Letters to the Editor
My 10 Good Things About Having Diabetes
At age 18, after a long swim in rough waters, I staggered out of the ocean one summer day near Asbury Park, New Jersey, and promptly fell on my face in the sand. The next day, I was diagnosed with type 1 diabetes and put on 40 units of NPH insulin.
Today, 50 years later, I look back in amazement that I, two years later, drove myself across the country to attend graduate school in California and learned how to manage this chronic disease practically alone.
Still living on the West Coast, I attribute whatever accomplishments I have had in life—now at age 68—to discipline, perseverance, accumulation of knowledge, and the philosophy outlined below.
In response to your August 2002 cover story ("Ten Good Things About Having Diabetes," p. 30), I have compiled my own list:
- Being your own doctor. This means learning everything you possibly can about diabetes so you can seriously manage and control your condition on a daily basis, with assistance from professionals as available.
- Depending more on yourself than on others. An extension of point #1. You must master the daily regimen of blood-glucose testing, insulin injections, pills or pump. "You are the captain of your ship and the master of your fate."
- Educating others. It is incumbent on each one of us to be alert and sensitive to symptoms of diabetes in others and to help educate others in the management and potential complications of our disease.
- Gratitude to science and medicine. Drs. Banting, Best and Joslin, the Edmonton Protocol team, our own physicians, certified diabetes educators, dietitians and others deserve constant praise and recognition. Our very existence is a living example of all their work.
- Lifestyle. Living a "good" life free of illegal drugs, using moderation in consumption of alcohol, eating a well-balanced diet in moderation, engaging in regular exercise, not smoking, and enjoying your family and friends—these are a formula for longevity.
- Positive attitude. It's important to realize that diabetes is not a death sentence. You should realize that occasional "highs" and "lows" in blood-glucose readings will not kill you, nor should you feel guilty about infrequent "cheating" in one's diet. I was told when diagnosed that I'd never be able to enjoy my cravings for chocolate again—Ha!
- Excelling. Overcoming a condition like diabetes requires strength. Using such strength can carry over to excell-ing in any endeavor one chooses, such as work, sports, hobbies, etc.
- Challenges. Being a conscientious person with diabetes will help you meet and beat all challenges.
- Help. Knowing when and where to seek advice, counsel and expertise is essential to diabetes management.
- Philosophy. Finally, in the words of philosopher/physician Sir William Osler: "To live a long and healthy life, develop a chronic disease and take care of it."
Daniel M. Anzel
Los Angeles, California
I just read an article in your August 2002 edition entitled "Ten Good Things About Having Diabetes." A very good article!
It brought back memories of an "11th" good thing about diabetes. In the Commonwealth of Pennsylvania, young adults with type 1 diabetes are entitled to some free college! When I used this benefit 30 years ago, it was offered through the Bureau of Voca-tional Rehabilitation. I don't know the current name of the bureau.
I know the benefit still exists in Pennsylvania. In a recent conversation, a lifelong friend who also has diabetes informed me that his son (who has diabetes too) had been approved for two free years (tuition, room and board) at the University of Pittsburgh.
Michael P. Soloski
Diabetes Should Not Be Big Business
After reading "Too Rich for My Blood Glucose" in the July 2002 issue of Diabetes Health (p. 28), I am in complete accord with Manny Patino from Flushing, New York. Diabetes has become big business for many corporations.
Diabetes has been here since the Egyptians, so why hasn't there been a cure? I have had type 1 diabetes for 36 years and would love a cure. The GlucoWatch would be a great addition to the pump if the price were more reasonable.
Welcome Back, Sleep Sentry
I have a Sleep Sentry that is one of the original models, and it still works nightly. I was thrilled to see your article in the July 2002 issue ("Going Low at Night?" p. 24), since I have been trying to acquire a new one for quite some time.
I remember what I paid for my first one, and I'm interested in what this one will cost. Please let me know as soon as the new model is on the market. I want to be one of the first to get one.
Breastfeeding Article Didn't Discuss Effect of Weaning on BGs
I just wanted to say that I appreciated the article "Breastfeeding at Birth" (May 2002, p. 62). However, one part of this subject is seldom mentioned: weaning and the effect in a mother with diabetes.
When I decided to start weaning my two-year-old, my blood-glucose levels went much higher than they had been before the beginning of this process. No doctor let me know about this factor. It was very frustrating trying to figure out why my blood glucose was going higher. When I finally figured it out, I started doing some investigation and found nothing that addressed this risk.
I hope some research will be done on this. I would love to get more information.
Editor's reply: We asked four experts on breastfeeding by women with diabetes to respond to this question.
Once diet and insulin are adjusted and control is achieved, the mother with diabetes is more like other breastfeeding mothers than different from them.
As weaning happens, mothers most often compensate for periods of decreased nursing by eating less. If the weaning is gradual, adjustments of insulin and diet can be equally slow and smooth. It is usually easiest for the mother's body to adjust to natural weaning—allowing your child to outgrow his or her need for breastfeeding over time. However, if you choose to become actively involved in the weaning process, reducing nursing by no more than one daily feeding per week is a good rule of thumb.
Each mother is different, and each breastfeeding couple is unique. Though diabetes requires you to be very careful about your health, you share in common with all mothers the remarkable ability to nourish your child at your breast. No one else knows your child as well as you do, and no one else can provide for your child in the early years as well as you can.
Karen Peters, MBA, RD, IBCLC
Breast-milk production uses a lot of glucose from the mom's supply. Picture it as all the carbohydrate (sugar) in the milk being produced out of mom's blood-glucose supply. Insulin doses that are well matched for a breastfeeding mom will change once she stops producing milk.
Sherri Shafer, RD, CDE
San Francisco, California
It seems quite obvious to us that if you have been doing aerobic exercise consistently and then you stop, you would utilize your glucose less effectively, so it seems the same for lactation and weaning. There are no studies that we know of, but we recommend (based on common sense) that weaning be done slowly over two to three months so that the changes in glucose metabolism are easier to manage. This means reducing one feeding every week.
Maribeth Inturrisi, RN, CNS, MS
Cathy Fagen, MA, RD
California Sweet Success Program