Diabetes Everyday

Living your best life with diabetes. Toby Smithson provides professional guidance with personal experience.

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“Complications”- We Need a Better Word

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I have grown to really abhor the word “complications” in the context of diabetes. In the medical world we have a pretty clear understanding of the possible scope of the word, but in real life the word “complications” is relatively equal to the word “inconveniences.” An online dictionary demonstrates the use of “complications” in its definition as follows: “Because of the complications involved in traveling during the strike, we decided to postpone our trip.” A thesaurus lists “embarrassment”, “aggravation”, “snag”, “drawback”, “difficulty” and “problem” as words meaning the same thing.

Now, I don’t believe in trying to frighten patients into taking diabetes seriously, even though there is plenty to be scared about. But, the dictionary and thesaurus make it clear that in common, everyday language the word “complications” doesn’t call up images of premature heart attack or stroke, kidney failure, loss of vision, or amputation. And, of course these (among other less life-threatening outcomes) are the accepted “complications” of diabetes- a real aggravation!

Diabetes is overwhelming our medical system, and no doubt some patients don’t get messages that adequately emphasize the importance of lifestyle. Studies show many aren’t even overly adherent to their medication schedule, much less diet and exercise. But, it’s one thing to talk about whether patients do or do not receive care that most consider appropriate. It’s something else to perpetuate misconception through standard terminology all medical professionals use. “Complications” as a word has a profoundly different meaning inside the medical community and in common use, and getting patients to take diabetes self-management seriously is no place for misunderstandings.

I’m not sure there’s a single word that can, or should, replace “complication” in discussions about the prospects of serious health outcomes, but “tragedy” comes to mind. That’s an excellent word for describing something terrible that is also unnecessary.I have grown to really abhor the word “complications” in the context of diabetes. In the medical world we have a pretty clear understanding of the possible scope of the word, but in real life the word “complications” is relatively equal to the word “inconveniences.” An online dictionary demonstrates the use of “complications” in its definition as follows: “Because of the complications involved in traveling during the strike, we decided to postpone our trip.” A thesaurus lists “embarrassment”, “aggravation”, “snag”, “drawback”, “difficulty” and “problem” as words meaning the same thing.

Now, I don’t believe in trying to frighten patients into taking diabetes seriously, even though there is plenty to be scared about. But, the dictionary and thesaurus make it clear that in common, everyday language the word “complications” doesn’t call up images of premature heart attack or stroke, kidney failure, loss of vision, or amputation. And, of course these (among other less life-threatening outcomes) are the accepted “complications” of diabetes- a real aggravation!

Diabetes is overwhelming our medical system, and no doubt some patients don’t get messages that adequately emphasize the importance of lifestyle. Studies show many aren’t even overly adherent to their medication schedule, much less diet and exercise. But, it’s one thing to talk about whether patients do or do not receive care that most consider appropriate. It’s something else to perpetuate misconception through standard terminology all medical professionals use. “Complications” as a word has a profoundly different meaning inside the medical community and in common use, and getting patients to take diabetes self-management seriously is no place for misunderstandings.

I’m not sure there’s a single word that can, or should, replace “complication” in discussions about the prospects of serious health outcomes, but “tragedy” comes to mind. That’s an excellent word for describing something terrible that is also unnecessary.

Battle of the Brains

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One of the major themes of my upcoming book, Diabetes Meal Planning and Nutrition for Dummies, is how planning can help us overcome impulsive or “mindless” eating. You probably already realize that one of the most challenging things about managing diabetes is making yourself think about food – calories, carbohydrate, and maybe even insulin dosing to match – but you may not realize why. In the most basic sense, food sets off a battle between our instinctive brain and our thinking brain.

Our human thinking brain is the most amazing biological phenomena ever, and with the right data and enough time to evaluate the options it will make solid decisions you can depend upon. But, when you put your thinking brain in a contest of willpower against your instinct to eat when you’re already sitting in front of food it can seem like useless wasted space in your skull. The chemical signals urging you to eat everything in sight are simply too powerful, and your thinking brain cannot gain control over decision making.

But, you can take advantage of your thinking brain by planning ahead – deciding what you will eat before being confronted by food. Here’s the key- I don’t mean planning ahead as in “I’m going to eat something healthy and not overload on carbs at dinner tonight.” I mean planning as in “I’m having a 4 ounce skinless chicken breast, ½ cup of garbanzo beans, ⅓ cup brown rice, steamed broccoli, a dinner roll, and a pear for dinner tonight.” When you allow your thinking brain to make specific decisions like this, you are equipped to resist impulse – you have used your most powerful weapon in a circumstance where it functions best.

The book goes into considerably more detail, of course, and the story isn’t quite as simple. But ultimately planning ahead is the only way your most powerful tool- your human brain- can help you win the battle of the brains.One of the major themes of my upcoming book, Diabetes Meal Planning and Nutrition for Dummies, is how planning can help us overcome impulsive or “mindless” eating. You probably already realize that one of the most challenging things about managing diabetes is making yourself think about food – calories, carbohydrate, and maybe even insulin dosing to match – but you may not realize why. In the most basic sense, food sets off a battle between our instinctive brain and our thinking brain.

Our human thinking brain is the most amazing biological phenomena ever, and with the right data and enough time to evaluate the options it will make solid decisions you can depend upon. But, when you put your thinking brain in a contest of willpower against your instinct to eat when you’re already sitting in front of food it can seem like useless wasted space in your skull. The chemical signals urging you to eat everything in sight are simply too powerful, and your thinking brain cannot gain control over decision making.

But, you can take advantage of your thinking brain by planning ahead – deciding what you will eat before being confronted by food. Here’s the key- I don’t mean planning ahead as in “I’m going to eat something healthy and not overload on carbs at dinner tonight.” I mean planning as in “I’m having a 4 ounce skinless chicken breast, ½ cup of garbanzo beans, ⅓ cup brown rice, steamed broccoli, a dinner roll, and a pear for dinner tonight.” When you allow your thinking brain to make specific decisions like this, you are equipped to resist impulse – you have used your most powerful weapon in a circumstance where it functions best.

The book goes into considerably more detail, of course, and the story isn’t quite as simple. But ultimately planning ahead is the only way your most powerful tool- your human brain- can help you win the battle of the brains.

Watch “The Weight of the Nation” HBO Documentary, Part I; Consequences

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This 4 part HBO series is a “must see” for all Americans, and you can watch it online here. I’m re-posting the first episode, but you can find all 4 parts under my blog link.

The obesity epidemic is literally becoming an issue of national security, with the health of our workforce compromised and the cost of obesity related illness racing toward overwhelming. Worse, our children are almost certainly going to be less healthy than our current adult population.

Part I explores the systemic effects of extra weight, including, of course, type 2 diabetes. This will be a difficult “watch” for some- obesity and obesity related disease is complicated physically and emotionally. But, this episode in particular confronts my first essential commitment to diabetes self-management- reality.  I suggest you watch it with all of your attention no matter how uncomfortable you find it. Before we confront this challenge personally we must feel the urgency intensely.

We’ll post episode II next week, and episode III and IV after. If you want to watch it in one dose click here to visit HBO.
This 4 part HBO series is a “must see” for all Americans, and you can watch it online here.

The obesity epidemic is literally becoming an issue of national security, with the health of our workforce compromised and the cost of obesity related illness racing toward overwhelming. Worse, our children are almost certainly going to be less healthy than our current adult population.

Part I explores the systemic effects of extra weight, including, of course, type 2 diabetes. This will be a difficult “watch” for some- obesity and obesity related disease is complicated physically and emotionally. But, this episode in particular confronts my first essential commitment to diabetes self-management- reality.  I suggest you watch it with all of your attention no matter how uncomfortable you find it. Before we confront this challenge personally we must feel the urgency intensely.

We’ll post episode II next week, and episode III and IV after.

This Was Hard!!!

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The book is complete- well, the first draft is complete. And, most importantly, it looks like there may be a few days rest before the editorial inquiries start. But, there can’t be too much rest since the release date is set for October 28th – we all know how time flies.

I am really pleased with the result, and I have an even greater appreciation for the work that my friends – including the authors you enjoy through DiabetesEveryDay- put into their work. I only thought that I understood before this undertaking – now I REALLY understand how challenging this book writing process is.

So, before I duck back into my cave to begin the final polishing I’ll just express a wish that this work helps people take control of their own diabetes. My co-author and I were on the same page, literally and figuratively, the whole way, and I appreciate the credibility that Dr. Alan Rubin brings to the subject of diabetes and food. This post is more or less just a big exhale, but I will look forward to sharing the ideas we covered, and a few new recipes from Chef Lindsey Singleton, as we approach Diabetes Awareness Month this November.

Now, it’s back to work!!

Are You Wearing the “Healthy Halo”?

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There’s an interesting tendency among people who are not nutrition professionals to make certain assumptions based upon the general quality of a particular food, like salads, for instance – salads are healthy. Taking that a step further, one can declare to oneself that if I eat salads often, I am eating a healthy diet. Nutrition professionals know better.

The issue is that salads aren’t necessarily healthy- it all depends upon what you put into your salad. We call the blanket assumption that eating a food with a healthy reputation means one is eating a healthy diet the “healthy halo.”

To demonstrate, I asked my husband Tony to visit the salad bar at a local restaurant for demonstration purposes, and his salad is the image you see. I can assure you that this salad includes healthy foods – lettuce, spinach, and peppers, to name a few, but let’s look at what’s showing (if you can make it out beneath the sesame ginger dressing). There are eggs, a healthy protein, but that’s a lot of eggs. I recognize bacon bits and sesame seeds, one not so healthy, but both high in fat (meaning calories). I see a number of olives….healthy, but fat and calories to spare…..and some Mandarin oranges. At the top of the photo you may recognize oil packed anchovies, and in the five o’clock position you’ll recognize avocados. Frankly, this is more like the typical salad Americans eat.

Here’s the point, even the healthier add-on’s….oranges, avocados, sunflower seeds, eggs, fish, and olives….bring lots of calories and fat (remember, fat packs more than twice the calories of protein or carbohydrate). So, a 300 calorie salad of nonstarchy vegetables can easily become a 1200 or 1500, high fat meal that approaches your daily recommended calorie intake.

Don’t wear the healthy halo. Make the decision to actually learn about the food you’re eating, rather than making unfounded assumptions and generalizations. You might be surprised, and even disappointed, to learn how your salad fixin’s add up, but in the end you’ll get the results you want.There’s an interesting tendency among people who are not nutrition professionals to make certain assumptions based upon the general quality of a particular food, like salads, for instance – salads are healthy. Taking that a step further, one can declare to oneself that if I eat salads often, I am eating a healthy diet. Nutrition professionals know better.

The issue is that salads aren’t necessarily healthy- it all depends upon what you put into your salad. We call the blanket assumption that eating a food with a healthy reputation means one is eating a healthy diet the “healthy halo.”

To demonstrate, I asked my husband Tony to visit the salad bar at a local restaurant for demonstration purposes, and his salad is the image you see. I can assure you that this salad includes healthy foods – lettuce, spinach, and peppers, to name a few, but let’s look at what’s showing (if you can make it out beneath the sesame ginger dressing). There are eggs, a healthy protein, but that’s a lot of eggs. I recognize bacon bits and sesame seeds, one not so healthy, but both high in fat (meaning calories). I see a number of olives….healthy, but fat and calories to spare…..and some Mandarin oranges. At the top of the photo you may recognize oil packed anchovies, and in the five o’clock position you’ll recognize avocados. Frankly, this is more like the typical salad Americans eat.

Here’s the point, even the healthier add-on’s….oranges, avocados, sunflower seeds, eggs, fish, and olives….bring lots of calories and fat (remember, fat packs more than twice the calories of protein or carbohydrate). So, a 300 calorie salad of nonstarchy vegetables can easily become a 1200 or 1500, high fat meal that approaches your daily recommended calorie intake.

Don’t wear the healthy halo. Make the decision to actually learn about the food you’re eating, rather than making unfounded assumptions and generalizations. You might be surprised, and even disappointed, to learn how your salad fixin’s add up, but in the end you’ll get the results you want.

Happy Valentine’s Day- Two Reasons for Diabetes Awareness

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Happy Valentine’s Day. It’s a day we think about our “significant other”, so here are a couple of gift ideas.

For you, Valentine’s Day could represent how important a focus on heart health has to be when diabetes is in our life. We say it again and again- diabetes raises our risk for heart attack or stoke by at least double, and that’s even if blood sugar is well controlled. Remember, the “ABC’s” of diabetes management are A1C, Blood pressure and Cholesterol- two of these are in the heart health basket. And, a new study suggests that many of us don’t realize there are diabetes management “targets” for blood pressure, LDL (“bad”) cholesterol and HDL (“good”) cholesterol. A heart healthy diet and physical activity can be a Valentine’s gift for yourself.

And for your significant others? Ditto! What could be a better gift than to do all you can to make sure you are alive and healthy for many more years. On average diabetes can rob us of a decade of life, and can make more time than that miserable. We all tend to avoid thinking about the negative, but there are two very different ways to put those thoughts to rest. One is to just refuse to acknowledge how our lifestyle can impact our life and the future of those who care for us. The other is to make a commitment to do everything we can to reduce the risk. Guess which way is better?

There are many significant times of the year we could choose to make a commitment to health, but when you think about the gift of life it seems Valentine’s Day is perfect.Happy Valentine’s Day. It’s a day we think about our “significant other”, so here are a couple of gift ideas.

For you, Valentine’s Day could represent how important a focus on heart health has to be when diabetes is in our life. We say it again and again- diabetes raises our risk for heart attack or stoke by at least double, and that’s even if blood sugar is well controlled. Remember, the “ABC’s” of diabetes management are A1C, Blood pressure and Cholesterol- two of these are in the heart health basket. And, a new study suggests that many of us don’t realize there are diabetes management “targets” for blood pressure, LDL (“bad”) cholesterol and HDL (“good”) cholesterol. A heart healthy diet and physical activity can be a Valentine’s gift for yourself.

And for your significant others? Ditto! What could be a better gift than to do all you can to make sure you are alive and healthy for many more years. On average diabetes can rob us of a decade of life, and can make more time than that miserable. We all tend to avoid thinking about the negative, but there are two very different ways to put those thoughts to rest. One is to just refuse to acknowledge how our lifestyle can impact our life and the future of those who care for us. The other is to make a commitment to do everything we can to reduce the risk. Guess which way is better?

There are many significant times of the year we could choose to make a commitment to health, but when you think about the gift of life it seems Valentine’s Day is perfect.