When Ostracizing Type 2 Diabetes Became an Accepted Lifestyle

When it comes to Diabetes, and the messages being put out there in the media, it is really hard for myself and other folks not to become angry -- if not downright furious. I have to tell you, I generally look through articles, and skim through different headlines, and just tend to "cherry pick" whats going to be real news, and ignore and pass over the fluff. If I were to read it all, I might be en route to a heart attack in less time than you can say "duck fiabetes."

But on Wednesday, just having gotten home from a long, physically and mentally exhausting shift at work, I failed to listen to my own advise. A dear friend of mine shared a news article, in my "Living with Diabetes" Facebook group... and I just lost it. I dont think I have ever been so outraged by an article before. (Well, except maybe for Wendell Fowlers abusive tirade against little Type 1 Diabetic children having ice cream. OMG, how dare they! Thats almost as dangerous as Paula Deen having a cheeseburger! *snark, snark*) I was seeing so many shades of red, and purple, I just could not think straight. I said a bunch of things, in my group, about the article, and to my husband... went and kicked a few things around... flipped off Dr Oz on the TV... and then I felt like my head was going to explode. It was just too much.

Having taken at least, a few days, to calm down... I can probably now tell you what I really think about this piece, with a little more perspective. The piece is called "Curing Diabetes: How Type 2 Became an Accepted Lifestyle" (Yes, you are reading right... That IS the headline for this article), and it was written for The Atlantic, by reporter John-Manuel Andriote, who has supposedly been specializing in HIV/AIDS reporting since 1986. I guess, I would like to think that being exposed to such a world would have given Mr. Andriote some perspective, and a keener sense of tact, and to an extent it has... but, apparently, not enough to have helped him rethink such a terrible headline.

The article itself makes a few key mistakes, which well, to an outsider would not be as self evident. And why would they? Our current government, medical advisory agencies, and medical industry want to do all they can to pass blame onto the Type 2 patient, entirely, and take on NO responsibility themselves. Ive shared on this, before, many times. Especially, the deep denial of how multi-faceted the triggers are for Type 2 Diabetes, and the roles pollution and other medications, etc., have in the development of the disease. It is unfortunate that everyone in the industry quotes such poorly done research studies that do not take these complexities into account, or even consider to do so, to blanket claim that 80% of all Type 2 Diabetes is "largely preventable." These simplistic allegations lead to discrimination, misunderstanding of a very complex disease, denial of health management resources and tools by the insurance industry, and uneducated reporting that often leads to societal abuse, bullying, and further discrimination.

Still, there is some good, among the bad, to be found in this article. I do feel that, had the author taken some time to meet with members of the diabetic online community, this article could have really shed some light more adequately, on a lot of issues that affect our community, without contributing so much to the problems it so tries to address.


The Good in this Article: 

• Right off the bat, the article addresses the issue that the medical industry does not like to discuss with patients, or at least seldom does, the idea that they can manage their diabetes without medications, much less what Diabetes even IS. This is, indeed, a struggle we have right now. But it is a deep, and complex problem involving a lot of ethical concerns which affect almost every aspect of the health industry, including the American Diabetes Association itself (its probably not an accident that they recommend diabetics keep their blood glucose levels at or below 180 mg/dL -- a very high, and potentially long term dangerous, blood glucose level), as well as other diabetes medical guideline agencies. The fact is, many medical professionals receive kick backs and incentives from the pharmaceutical industry -- large kickbacks and benefits -- and its in their pocketbooks best interests to keep as many of their patients taking certain medications. This is not something exclusive to the diabetes industry, though. I am sure this is one of the prime reasons why there are now, commercials on mainstream media, for prescription only medications. Its BIG business, and theres no better salesman out there than your doctor. 
• Andriote does some thinking outside the box, which is helpful: Chronic illness, particularly obesity and diabetes, are multi-faceted diseases which do not have just one contributing factor to them (though at times he seems to suggest they do) and thus, will need a multi-sector response. He speaks about our sedentary jobs, and a poor transit system, and the lure of the food industry, and how addicting high fat/high sugar/high salt/food combinations can be... and the supposed "myth" that healthy foods cost more than unhealthy foods. He even quotes an article from someone who supposedly "destroyed" this myth. What is perhaps not understood by people who claim that healthy food is cheaper than fast food is that most dedicated Type 2 diabetics dont consider healthy food what they consider healthy food, and they have to cut back on carbohydrates in order to control blood glucose, and not rely solely on their medications for control. Id like to see Andriote actually trying to live a lower carbohydrate lifestyle, at a grocery store, with a maximum of $350 for 2 people, for a month worth of groceries, and not being able to eat as many starches, grains, and other foods which ARE the cheaper foods, for their value and how far they go. Living on lean proteins, and veggies, and cutting back on all those starches and breads, and grains is NOT cheap. Also, per the fast food cost example he uses, if one assumes poor people buy value meals at fast food joints to feed all of their family members, one might be very, very naive: there is such a thing as a dollar menu, or less, at these places... And people KNOW this. How can you beat $2 for two double cheeseburgers at McDonalds??? It costs me $2.88 a lb alone, for chicken! (And its cheaper in Iowa, than in many places...) 
• Andriote talks about the need for balance in media industry reporting (Surprisingly): On the one hand, you dont want people dismissing diabetes as not serious enough, but on the other, you dont want to create a public backlash for patients. "When the media do focus on type 2 diabetes, said Sarah Gollust, assistant professor at the University of Minnesota School of Public Health, they give twice as much coverage to the behavioral risks for it than any of the other factors that contribute. But this over-emphasis on personal responsibility tends to blame and stigmatize people with type 2 diabetes or who are obese. Those living with the disease may feel its their fault if they cant always maintain the ideal blood sugar level. Worst of all, said Gollust, public support could erode as people are expected to cover the costs, however they can, of a medical condition its believed they brought on themselves ... Public support for addressing diabetes is imperative when you consider the tremendous amount of money it costs to manage the disease." This is a very important reality that we, as Type 2 Diabetes patients face as we strive to manage this disease. We NEED support, and we cant succeed without it. However, many of the undercutting remarks Andriote makes, including his headline, are FAR from being fair and balanced, and certainly not supportive! On page 2, Andriote has a "listing" of facts, and goes on to say that "Although there is a genetic predisposition for type 2 diabetes, the vast number of cases are the outcome of poor diet, obesity, and a sedentary lifestyle." Of course, this is contradictory... because ALL cases are of genetic predisposition. If not, then ALL obese persons would have diabetes -- and this is simply not the case. (I wont even go into his usage of the phrase "people of color" to talk about African-Americans, Latinos, and other minorities...) 

The Bad in this Article: 

• Andriote, sort of, implies that most Type 2 Diabetics could manage their condition without the need for medications, if they just try a little hard, and then they would be cured. There is a BIG disconnect in here: 
• For one -- he fails to realize that by the time the average person is diagnosed with Type 2 Diabetes, their disease is so advanced, they have lost nearly 40-80% of their beta cell function, making it extremely challenging to near impossible to control blood glucose levels without the assistance of oral medications, or insulin. Again, being the multi-faceted disease that it is, diabetes NEEDS a more aggressive and aware medical community, as well as increasing efforts in continuous education FOR the medical professionals, as well as patients. A medical professional who cannot think diabetes, and catch all the symptoms and markers of diabetes, in an age when its being considered as an "epidemic," is a medical professional who will endanger lives, and contribute to the rising costs of the disease when it comes to complications that are not being caught on time. 
• Secondly -- The kind of lifestyle changes to achieve true remission and euglycemia, are a lot more stringent than what the ADA might tout. You *cannot* reach euglycemia -- true euglycemia -- while thinking that blood glucose numbers below 180 mg/dL are normal. True euglycemia are levels that are below 140 mg/dL or lower, after 2 hours of eating, and in fact, rarely exceed that. In fact, some might even say below 120 mg/dL at 2 hours, or less. Not everyone can achieve those levels -- especially, if they struggle with hypoglycemia, or  have other health related dietary considerations to make that might not allow them to easily cut back on carbohydrates, or increase certain levels of exercise, etc. I, for example, have to consume 80-100 grams of carbohydrate a day, at a MAXIMUM, in order to maintain my euglycemia. This is unrealistic to many people... and its not a character flaw! It is HARD, often unrealistic, work. 
• Thirdly, he goes on to claim that if folks worked hard at it, they could "cure themselves," and he uses an opinion paper, mind you, to try to back up his assertions. He even goes as far as claiming that this is the opinion of the American Diabetes Association (ADA), by claiming that the ADA says that "maintaining normal blood sugar without medication for at least a year could be considered a "complete remission,"" when in fact, the ADA specifically highlights a the end of the second paragraph, in that same opinion paper that "The opinions and recommendations expressed herein are those of the authors and not the official position of the American Diabetes Association." Moreover, the panel of those expressing their opinions recognized that they had clear conflicts of interest in the matter, and also, found it difficult to reach consensus considering the wide arrange of questions to be considered. The group does, though, make a very telling distinction between a cure, and a remission... which the author of this article seems to gloss over, quite nicely, to what he could take out of context, and better fit into his piece: "Medically, cure may be defined as restoration to good health, while remission is defined as abatement or disappearance of the signs and symptoms of a disease (3). Implicit in the latter is the possibility of recurrence of the disease. Many clinicians consider true cure to be limited to acute diseases. Infectious diseases could be seen as a model: acute bacterial pneumonia can be cured with antibiotics, but HIV infection, currently, can at best be stated to be in remission or converted to a chronic disease. The consensus group considered the history of childhood acute lymphoblastic leukemia, which evolved from a uniformly fatal disease to one that could be put into remission to one that can now often be considered cured (4). Conversely, chronic myelocytic leukemia is now considered to be in prolonged remission, but not cured, with therapies such as imatinib ... For a chronic illness such as diabetes, it may be more accurate to use the term remission than cure. Current or potential future therapies for type 1 or type 2 diabetes will likely always leave patients at risk for relapse, given underlying pathophysiologic abnormalities and/or genetic predisposition. However, terminology such as “prolonged remission” is probably less satisfactory to patients than use of the more hopeful and definitive term “cure” after some period of time has elapsed. Additionally, if cure means remission that lasts for a lifetime, then by definition a patient could never be considered cured while still alive. Hence, it may make sense operationally to consider prolonged remission of diabetes essentially equivalent to cure. This is analogous to certain cancers, where cure is defined as complete remission of sufficient duration that the future risk of recurrence is felt to be very low."

You see, it is one thing to call something a "cure," because it is more hopeful, and more satisfactory to a patient... than for that to be, actually, a cure. The likelihood might be low, but it is, in fact, not a cure. As a comparison to HIV made above, for example, people like Magic Johnson have had their HIV infection in remission for years, but would would we say that hes cured? Not in a million years. Just because I cant "infect you" with diabetes does not mean Im cured. This debate among colleagues does not equate to something actually being "officially" considered a cure. Obviously, operationally, we cannot treat presently uncontrolled diabetes in the same way as diabetes in tight control, or in remission... So DUH, it can be "operationally" a cure, but not in truth. Remission is remission. A cure, is a cure. This is truly, irresponsible journaling at its best. 

I would add that the amount of mental focus that is required in maintaining diet, food carbohydrate counts, exercise, and meal planning often borders on obsessive and unhealthy, and ends in many an eating disorder for many diabetes patients. The psychological ramifications of attaining euglycemia, at all costs, for many... have NOT been assessed, and yet, they are just as much a part of the disease as hyperglycemia and other markers. Diabetes is NOT just a disease of high blood glucose!  

• The author uses statistical scare tactics to put the fear of God in you: But he does not put them in perspective. Its one thing to discuss how the rate of diabetes will triple, or double, or whatever. Its quite another to not discuss the rate of population growth, right along with that. Obviously, people ARE reproducing, and diabetes isnt just happening in a vacuum where the rate is growing by leaps and bounds larger than what it is. Its hard to say, because what will the population be in 2050? Our population is EXPLODING to what are potentially unsustainable levels, and of course, thats going to make numbers for any disease seem scary high, without some perspective. What would the rate be in RELATION to total population at that time? THAT is what the question should truly be... In addition, the author wrongly states that the prevalence of obesity has been increasing, year after year, when the prevalence of obesity has remained STEADY for the last 12 years.  Could it change, tomorrow? Sure... but for now, I think we can say many folks are starting to be more conscious of obesity, and their health, even if they might not see themselves as overweight. Andriote fails to keep balance in the picture hes trying to paint.
• While Andriote wants to instill a sense of seriousness to diabetes, while claiming we need support, he attacks commercials with friendly faces and role models, claiming that persons who are fit, or joggers, or younger folks -- are not what most Type 2 Diabetics are like. Perhaps not (some) newly diagnosed Type 2 Diabetics, but is it wrong to have positive role models to aspire to? Is it wrong to see that some of us HAVE made changes, and CAN live a healthful life? Is it wrong for me to see another 35 year old I can relate to, on the tv? I fail to see just what he wants to accomplish, here. Does he want a fat, old Joe, sitting on a sofa, not able to move, and popping pills, or doing leg exercises from a chair, because he cant move? Would THAT be more appropriate? Or perhaps, he wants people with their limbs amputated, like the city of New Yorks shocking diabetes ad campaign? Im not sure whats the alternative hes looking for, here, and whats running through his mind. 

Of course, I cant end without discussing... that headline. "Curing Diabetes: How Type 2 Became an Accepted Lifestyle" ... Im guessing hes trying to say most people just "accept" and take the diagnosis as a given, that they will need to live with this disease, forever... and take pills forever. But boy, is it an uneducated headline. Yes, people can live pill free, for a while... and depending WHEN they were diagnosed, if it was late in life -- maybe they might never have to take any meds, ever. But no, its not a cure. Type 2 Diabetes IS a progressive illness, and the likelihood of a need for medications increases with the LENGTH of time weve had this disease -- and not exactly with how well weve taken care of it. Time goes by, and not in vain... our bodies DO age. Things break down. My father was in remission for years, yet he was never cured; diabetes still progressed, and still took his life. It happens.

Diabetes is not an "accepted lifestyle" anyone chose, anymore than people who got AIDS or HIV (by whatever method), CHOSE that as their lifestyle. I bet you $1,000,000 that this author would NEVER dream of writing "Curing HIV: How HIV Became an Accepted Lifestyle," merely because he read an opinion piece on how one can keep HIV in remission for YEARS. The headline even seems to sort of imply that we "coddle" people into being lazy about their care, and lazy about "curing themselves," so that we dont need to support them. Its not a disease, if you would, its a "lifestyle." Yes, because Type 2 Diabetes is sooooooo glamorous. Its the lifestyle of the fat, and sloppy, and just give me my Metformin, over here. Ill take it with a side of that value meal, please. 

Sadly, Andriote could have done SO MUCH to advocate and help our community, but instead he chose the low road of blame, and veiled vitriol in between his lines. How someone who has written for the AIDS community can be so close minded about the needs of another equally ostracized community is BEYOND me. 

Type 2 Diabetes Rates Increasing Among Teenagers

A poor diet and lack of exercise arent leaving their mark on just adults.

Researchers who analyzed data from the 1999-2000 National Health and Nutrition Examination Survey (NHANES) found that 1 in 10 boys (10%) and 1 in 25 girls (4%) between the ages of 12 and 19 had a pre-diabetic condition. For overweight teens, the rate jumped to 17.8%. After an 8-hour fast, these adolescents had a blood glucose level between 100 and 125 mg/dl, a condition known as impaired fasting glucose (IFG).

People with IFG are at increased risk for developing diabetes and cardiovascular disease as they age.

For adults, theres evidence that lifestyle changes can prevent this progression. From the National Institutes of Health (NIH):

"Progression to diabetes among those with pre-diabetes is not inevitable. Studies have shown that people with pre-diabetes who lose weight and increase their physical activity can prevent or delay diabetes and even return their blood glucose levels to normal. "

The study was published in the November issue of Pediatrics. The authors are examining whether these rates may have increased in the 5 years since their analysis.

________
For a summary of the study:
Study: 2M Adolescents Have Pre-Diabetes

For the study itself:
Prevalence of Impaired Fasting Glucose and Its Relationship With Cardiovascular Disease Risk Factors in US Adolescents, 1999–2000

Diet Methods for Blood Type O

Diet Methods for Blood Type O - If you have blood type O, so one diet method which you can apply are: methods of diet based on blood type you are, because it is more precise and specific. So that big of possible success, then what is the appropriate method of diet for blood type O ?


Diet Methods based on Blood Type was actually invented by a doctor named Dr. Peter DÁdamo, he who wrote a book about the "Eat right for you type." Already know what that means. According to him, the chemical reaction occurs between the blood and the foods you eat, this reaction is part of your genetic heritage derived in the form of blood. And the factors of this reaction called Lectins. So, with a diet based on blood type, then the chemical reactions that occur in the body and the negative impact can be minimized.

Before we describe Diet Methods for Blood Type O you should know also characteristic of blood group O, that is:

• Has an immune system that is relatively better than other blood types.
• Blood type O, to overcome stress can be with aerobic.
• Blood type O can also easily customize the diet accord to around.
• When the food consumed does not match, then you are at risk of a disease caused by inflammation and organ damage such as arthritis.

Blood type 0 diet

It is recommended to eat foods that are high in protein and low in carbohydrates.
Allowed to eat meat menu, fish, vegetables and fruit.
But to menu grains and beans is better limited.

Important thing to note/avoid for blood type O in the weight loss program are:

• wheat
• corn
• red beans
• nuts
• Brussels sprouts
• cabbage
• mustard

While diet for blood type O that recommended are:

• seafood dishes
• salt
• liver
• red meat
• spinach
• broccoli

That is method diet based on Blood Type O, while for the other blood types, the article will follow.

different type of apples

Different Type of Apples
Different Type of Apples,different kind of apples, 

different type of apples

Granny Smith Apple is one of the most famous fruit instantly recognized between all apples and it is most famous export of Australia, where earned benefits per annum, also Granny smith helped out the country of Australia to known as world famous country in Apple production. This kind was discovered by Mr. Maria Smith in Australia in 1860 as a seed grown with unusual tip. As per her research that Apple is versatile and good for cooking and eating, also it consist of many benefits and support to prevent different kind of diseases, this is the main reason to be Granny smith as a famous apple in the world.

Granny Smith was the first international original variety who is still stable in his originality in this global world, and by cause of his tough skin and strange amazing qualities it could be export all around the world easily. Granny Smith requires warm climate and atmosphere and suitable properly for warmly weather. Granny is also performing well in the main apple growing in France because of warmer climate; also it produces in North America. The Greenish skin of apple requires hot days and nights but we seen that Granny Smith Apple grows in France where the climate is like days are warm and night temperature moved towards down and towards the end of growing season.

By survey of different countries we describe the Flavor of Granny Smith as “acidic”, it is really crisped hard kind of apple with sweetness and sharp taste, which is very refreshing and especially used in Salads because of its sweetens and also can easily store in international markets to present it in off season.

different type of apples

Gala Apple:

Gala Apple is most widely grown apple varieties, its flavor is sweet, pleasant also having good keeping qualities. Gala Apples having a great quality that it can be produce between both temperature, means warm and cold temperature is suitable for Gala Apple, and gala generally regarded as a low chill variety also it can grow with good and excellent quality from very less than 800 hours of cool winter temperature every year. Gala apple basically cross between Kidd’s orange red and Golden delicious from start. Gala Apple also has credit that it is worlds most distinctive and important apple quality. Gala’s flavor having potential to deliver delicious flavor.

Gala Apple is basically widely grown and keeps easily in storage, it shows in twice in year once after April from South Africaand New Zealand which is crisper and tasty and twice from France, UK and Italian, France Gala Apple is better than United Kingdom and Italy, it is most delicious than others.

different type of apples

Red Delicious Apple/ Golden Delicious Apple:

Red Delicious Apple is one the most famous apple produced by America, it is famous as its bright red color. Red Delicious as found in red delicious and golden delicious are entirely two different kind of varieties, also a lot of similarity occurred between both varieties whereas the USA discovered this unique taste at the end of 19^th century.

Red and Golden Delicious Apples need warm climates, also both having very interesting history and having sweetness which is the main cause of their familiarity. 

Basically Red Delicious apple is the original delicious apple by his bright red color that makes it more commercially and become very important commercial apple in global world especially in North America. Red delicious is normally medium size apple with a tall conical shape, unfortunately red delicious apple is famous by his flavor which is sweet by very mild flavor, also people called it juicy and light crisp with quite tough skin. Over all red delicious apples are a quite refreshing apple to eat but the major characters reflect it almost has no flavor. Recently research shown that golden delicious apple gradually decreasing his value by his character as comparison with red delicious because of red delicious having sweetness and softness while golden delicious apple is little bit change as having hard and tough skin with acidic flavor.

different type of apples

Rose Apple:

_{Rose Apple is one of the most beautiful and different than other kind of apple, it is more} delicious than others, its real name is Rose and generally famous in France as Jamb osier and in England it is called as Plum Rose and Malabar Plum.

_{Rose Apple basically found in Malaya and East Indies, also it is naturalized and cultivated in India. Rose apples tree is unique because of its tallness, it is almost 25 to 40 feet tall, dense crown of slender, having very wide branches, and Rose apple’s flowers are generally greenish white or sometimes are creamy white. Rose apple is best for brain, Livers, Diabetes, and Asthma and especially for Dysentery. It’s Juicy and delicious flavor attract people and mostly eat out of hand by children, in the homes it is often served as dessert and used in Salads.}

different type of apples

Anna Apple:

different type of apples

Anna apple is the one of most delicious apple in the world it is early season Golden delicious kind of apple from Israel, also is required low temperature and able to eat within 300 hours and prepare from about 6C /45F, mostly Anna apple comes up in end of June or early of July. It is firs apple bring in markets whereas people of the world takes happily to enjoy his delicious taste.   

Graven Stein Apple:

Graven Stein Apple is very old kind of apple variety from Denmark, it is most famous in North America and Europe because of high quality flavor and juicy, which described in 1797. It is also famous and well known in northern Europe and USAand grown commercially on a small scale. Graven stein apple is different kind of variety which produces with large trees and with dark thick leaves. It shows red sport known as red Graven stein apple where the red color reflects his popularity and interest.

Graven stein having a real problem that this kind of apple suffering from many diseases and cannot achieved the popularity as Graven stein has deserve. By this cause this kind of apple really hard to get grow in climate. 

About Apple

BENEFITS:
 Low in calories and high in soluble fibers that help lover cholesterol.

DRAWBACK:
Relatively low in nutrients.
May contain pesticide residues.

A fresh apple is and ideal snack. its easy to carry, flavorful, filling, and low in calories, a medium size (5 ounces) piece of fruit has only 90 calories. Apples can be eaten fresh or cooked in myriad ways baked into pies, crisps, and tarts; added to poultry stuffing and made into jelly, Apple butter, and sauce. Apple cider vinegar is an ingredient in many salad dressings. Pasteurized apple juice and fresh pressed cider are popular soft drinks, while fermented apple cider, wine, and brandy are gaining in popularity. 
Apple trees thrive in most temperate climates, but they are especially vulnerable to worms, scale and other insects; they are usually sprayed with pesticides several times during the growing season. Apples should always experts even suggest peeling them, especially if the have been waxed.

NUTRITIONAL VALUE:

Despite the old saw " An Apple a day keeps the Doctor away," the average apple provides only 8 mg of vitamin Cm, or 13 % of the Recommended Dietary Allowance (RDA). The skin does contain small amounts of beta carotene, the flesh adds some potassium and iron.
On a more positive note, apples are a good source of fiber, especially pectin (a soluble fiber that is used to thicken jellies), which helps lower blood cholesterol levels. Another type of soluble fiber in apples absorbs large amounts of water from the intestinal tract, which helps prevent constipation because applesauce is pleasant tasting and easily digested, doctors recommend it as an early baby food. 
Fructose, the sugar that occurs naturally in apples, is absorbed into the bloodstream more slowly than sucrose (table sugar); thus, diabetics can enjoy an apple without worrying about an abrupt increase in blood glucose level.
Apples have long been called natures toothbrush while they dont actually cleanse that teeth, they still enhance dental hygiene. Biting and chewing an apple stimulates the gums, and the sweetness of apple prompts an increased flow of saliva, which reduces tooth decay by lowering the levels of bacteria in the mouth.

DRIED APPLES:

Usually served as a snack or used to make pies, dried apples are a more concentrated source of energy than the fresh from. It takes about 5 pounds of apples to make 1 pound of dried apple slices, which provide about 70 calories per ounce. Except for fiver and a small amount of iron, most nutrients are lost in the drying process. On the positive side, dried apples are less likely to promote cavities than other dried fruits.
Sulfur dioxide is often added to dried apples to preserve their moistness and color, it can provoke an allergic reaction in a susceptible person.