Popping in for a Quick "Hello"

Wow, that "summer" went fast!  (The quotes are because I think we had less than 10 sunny days the entire summer.) There's a lot I could write about right now, but we're back to school today.  The first day went great; Things 1 & 2 were very happy when I got home.  I knew Thing 1 was excited and happy; he has had the same teacher for 3 years now (it's a combined 3/4/5 classroom) and he knows what to expect.  Thing 2 was anxious about having a new teacher, but she reported that she LOVES her new teacher.  Whew!  Things 1 & 2 go to a small school, only about 80 kids, so they know everyone in their classes except for a few new kids to the school this year.

Anyhow, I have 10 minutes before bedtime.  Here's tonight's train of thought:

• How are Pubsgal and fast food restaurants alike?  Saw a great article on the Mills Peninsula blog, about portion sizes, by one of their nutritionists. The link includes a video segment.  Here's the link: http://www.mphsblog.org/2011/05/portioncontro/.  Here's an interesting fact regarding restaurant portion creep:  The child-size portion at fast food restaurants today? "That was a standard adult-size portion 20 years ago." This is timely, because the panicked ranting & raving post I drafted back in January and never published, about not having an "Overweight" BMI anymore?  Well...same situation, plus a few more pounds.  It's not so much about the number on the scale or BMI number anymore as it is about as feeling physically uncomfortable in my own skin, never mind my pants!  And I swear I thought of that before I started listing to Lynn's interview on Two Fit Chicks and a Microphone, in which she talks about becoming physically comfortable in her own skin, and that discomfort being a sign to rein things in.  Anyhow, my food plan is to weigh and measure portions and to use the My Fitness Pal tracker daily.  I've been enjoying this tool, because I swear, its search finds EVERYTHING!  I hardly have to enter any new data. My other goals are to stay under my quite reasonable calorie allotment, eat healthy things I enjoy, and limit my starches and sugars to only the MOST worthy items and quantities.  Oh, you know, all the stuff that worked before when I did it consistently. ;-)  Updated fitness goals to follow:  right now, I'm rebooting my running with C25K in preparation for the Pumpkin Run in October, hoping hula class will survive the new school year, but I need to figure out a new strategy for getting more strength in there.

• Speaking of running:  ALL events at the Half Moon Bay Marathon were sold out before I had a chance to register!  How RUDE!  But before I could get too "pouty puffer" about it, I submitted a volunteer application. Turns out that I'll be working at the Maverick's aid station, and then helping at the start/finish line.  I always wanted to volunteer for an event, so this is a great opportunity!  (With riding my bike to and from the event locations and helping out, I'll probably burn as many calories as running my 10K. And my volunteers' t-shirt will be free.  :-)  If you're interested in volunteering, here's the link: http://halfmoonbayim.org/event/volunteer/.  They need help for the race expo on the days preceding the event, not just event day itself.
  

• Speaking of sports and events:  Diabetes Hands Foundation will be having a fundraising party at Sports Basement in Walnut Creek on September 10, from noon until 2 p.m. (It's Thing 1's 10th birthday, so I can't go, but maybe YOU can!)  According to organizer Emily Walton, "We will be screening our fundraising videos, offering food and drinks, and you will receive a coupon for 10% off everything you spend. Sports Basement will also donate 10% of everything you spend to DHF! They have great TRI gear, trust me, I shop there all the time!" Event details on the TuDiabetes web site: http://www.tudiabetes.org/events/583967:Event:2160403.
  

• And speaking of triathlon and fundraising:  Can the woman who kicks Type 2 diabetes' ass on a regular basis help kick blood cancer's ass too?  If anyone can, Foodie McBody can!  She joined Team in Training and is going through an amazing, "stress-citing," and inspiring journey in triathlon training.  Read all about it here: http://foodfoodbodybody.wordpress.com/ And here's her donation page: http://pages.teamintraining.org/sf/Marine11/sitoo6.

 Sheesh...how did 10 minutes turn into 1 hour?  I had better post this and get to sleep now....

Weekly Update, 3/31/10

Thanks for all of your kind comments last week!  This week is going to be rather dull in comparison, which makes me glad that I did okay and don't have to distract you with flashy race reports and such.

So I've got this combination of allergies and a cold.  I felt horrid on Sunday afternoon through Monday, and now I feel pretty good, but now it's mostly in my chest and throat.  I sound like a cross between a pubescent boy and one of Marge's twin sisters on The Simpsons.  I've done a little reading online, and to my surprise, tea with lemon and honey is supposedly more irritating because of the acidity.  (Guess I should have gone for the cherry cough drops instead of the lemon ones!)  Caffeine and alcohol are also not recommended, so no hot toddies.  Drat.  Resting one's voice, drinking water, and keeping one's throat moist are what the Mayo Clinic recommends for laryngitis.  If you have diabetes, be sure to be careful about cough syrups and drops; they can have a surprising amount of sugar!  I found a sugar-free cough suppressant/expectorant and some sugar-free cough drops, so I'm good to...rest and get better.

Also some exciting news on the triathlon planning front:  one of my neighbors is interested in joining me for a relay leg in the Tri the Coast!  Woo hoo!  (She received my email asking her about it *right after* reading my Treeathlon report!  Definitely one of those "woo-woo" moments.)  Now to find a third...so if any of you local lurkers get an email immediately after reading this post, why, yes.  It IS your destiny to just "tri" it.

Progress This Week

7-day blood glucose average: 106 (met goal of less than 120)
7-day fasting blood glucose average: 107 (met goal of less than 120)

Weight goals: -.6 pounds.

Food goals: I did well with tracking during the week days, not so well on the weekend.  It has helped me be more mindful about my intake, which is a good thing.
Fiber: Averaged 37 grams/day.

Exercise goals: I did 4 days of at least 30 minutes/day, missing my goal of 5 days due to being sick on Monday. I also missed my goal of 2 strength workouts in the same week.  I am happy that I ran more frequently, even though I didn't do especially long runs.
Total mileage for the week was 17 miles.
Wednesday - 60 minutes, BodyPump class
Thursday - Nothing
Friday - 85 minutes (6.34 mi) - 1.91 mile walk at lunch, 1 mile on elliptical + 3.43 miles on treadmill (mostly running) at gym after work.
Saturday - Nothing
Sunday - 70 minutes (3.38 mi) - .38 mi stroll with the dog and 3 mile run (with about a 5 minute pause to talk to a neighbor).
Monday - Nothing (sick today)
Tuesday - 31 minutes (7.28 mi) - "mini brick" of 6 miles of spin machine + 1.28 mile on treadmill (1 mile run + .28 walk)

Sleep: 7 hours just doesn't seem like enough sometimes...

Goals for Next Week

7-day blood glucose average goal and fasting numbers: below 120.
Weight goal: Maintain or make progress toward goal.

Food goals: 
* Track food intake.
* Track fiber, aiming for at least 30 grams/day average.

Exercise goals:
* 30 minutes of activity 5 days/week.
* 20 miles minimum distance.
* 2 strength sessions (BodyPump + something on my own)

Misc. goals:
7 or more hours sleep/night.

The Big Blue Post + Weekly Update 11/18/09

The Big Blue Test!

Saturday was World Diabetes Day 2009. Landmarks all around the world were lit up in blue in honor of diabetes awareness. And Tu Diabetes sponsored an event called "The Big Blue Test," in which people with diabetes would test together, exercise together, and then test again. The point of exercising was to raise awareness of how exercise can help with blood glucose levels.

Thanks to Thing 1, here is my Big Blue Test, in pictures!

Here I am, ready for The Big Blue Test! (That's my *eager* face!)

Testing: 1, 2, 3.... Used my pinkie, guess I was in a *fancy* mood.

95 before exercise!

It was a beautiful fall day, so I decided to go for a walk. I wanted to see how a lower impact exercise would affect my numbers.

I took a brisk, 15-minute walk, I'm guessing about 3/4 mile to 1 mile in length.

Here's the view from the end of my street. Wish I could have treated you to a view of some lovely horses, too, but the pasture was empty.

"Holy coronitas!!!" You can't see what I'm disbelieving, but it's a reading of...64?!?!
Must be a bad strip, I'll test again....

Second test: 69?!? Testing one more time...

Third and final test: 70! Think I'll have a little snack....

So there is some variation on test strips. This batch, on the whole, has seemed a little lower during the month, so it will be interesting to see how I trend on the next batch of test strips. But still, when I looked at other Big Blue Test participants' results on Twitter during the day, many had dramatic drops after only 14 minutes of exercise. I knew exercise was beneficial, but it was interesting to me to see how even mild exercise could make a noticeable difference. As my good friend Foodie McBody tweeted to me, "It's too bad the (weight) scale doesn't show such wonderful and instantaneous results, eh?"

I saw other participants' results going up rather than down; that had to be discouraging! There are variations on how one's body responds to exercise, and I've noticed this in my own experience. Sometimes I tend to run a little higher on race days (race-day excitement affects my blood glucose levels), when I perform harder exercise (stress on my body can raise blood glucose levels-I noticed this more when I was starting to run), and when I am not getting enough rest.

Anyhow, if you're newly diagnosed and have been advised by your doctor or diabetes educator to use exercise as part of your plan to manage your diabetes, why not try your own "big blue test" and see if your results confirm or deny the effect of exercise on your blood glucose levels? (Unless, of course, you cannot exercise due to disability or medical advice!)

Progress last week

7-day blood glucose average: 88 (met goal of less than 120) <-skewed a bit by the BBT
7-day fasting blood glucose average: 95 (met goal of less than 120)

Weight goals: +1.6. Drat, back up in the 190s! I'm not doing so hot with my eating at home...I've pin-pointed it to stress-feeding, and I need to figure out a better outlet than grabbing salty, high-calorie snackage.

Food goals:
- Brought lunch from home on only one work day, but went nice & healthy & somewhat frugally on the buying days and used protein that I already had in my desk (love dry roasted edamame!).
- Ate lots of veggies. I think this is the first weekend in some time that I didn't make my ratatouille.
- Got in at least 4 meatless meals but 0 fish meals.
- Fiber: at least 4/7 days were over 30.

Exercise goals: Didn't meet 30/day for 5 days, but I wasn't expecting to do so this week.
Total estimated mileage: 21.56 miles
- Wednesday: 20 minutes run (1.44 miles)
- Thursday: 40 minutes walk (1.84 miles) + 10 minute video (ab exercises)
- Friday: 37 minutes (20 walking the dog, .25; 17 running, 1.44 miles) + 1 hour vigorous playing at the park with the kids
- Saturday: 15 minutes walk (.75 mile)
- Sunday: 15 minutes on stationary bike (no mileage estimate)
- Monday: 35 minutes walk (1.84 miles)
- Tuesday: 60 minutes spin class (monitor broken, so I have no idea of the distance; estimating 14 miles)

Sleep: Met goal of 7 hours/night.

Goals for this week

7-day blood glucose average goal and fasting numbers: below 120.
Weight goal: Maintain or make progress toward goal.

Food goals:
- Keep going with the veggies!
- Rein in the nuts and dark chocolate; pass by some of the "just a taste of this" and "I'll have a dab of that." Get the homefront eating under control.
- Bring lunch from home 4/5 work days.
- 4 or more meatless, low-fat meals and 2 or more fish meals.
- Track fiber. Minimum 30 grams fiber/day. (Include both insoluble and soluble sources.)

Exercise goals:
30 minutes of activity 5 days/week. Prepare as best I can for the Pillar Point 10K on Sunday!

Misc. goals:
- 7 or more hours sleep/night.

PMS and Type 2 Diabetes: A Tricky Combination

MizFit's timely (for me) post today, "PMS Cravings & Active Rest," reminded me of something that frustrated me beyond belief at first: why, every so often, did my blood glucose levels rise (both fasting and post-meal with stuff that usually didn't raise them much), out of the middle of nowhere? Until I realized that "out of the middle of nowhere" was typically PMS week, and no wonder I felt extra irritable about it! I then read in Sheri Colberg's excellent book Diabetic Athlete's Handbook (highly recommended, especially for insulin-dependent athletes) that women tend to be more insulin resistant during the time between ovulation and the start of one’s period (luteal phase)? (p. 41, Diabetic Athlete’s Handbook) It's all those raging girl-hormones at work.

Well, talk about cruelty! Especially when I can no longer satisfy PMS cravings with a bag of Salt & Pepper Kettle Chips and a pint of Phish Food.

Scoot on over to MizFit's article and read all the great ideas for dealing with the cravings. (See comment #49; tuff's Frozen Peanut Butter Cups recipe looks very tasty!) MizFit mentions why we should seek out more Omega 3 sources when cravings hit, even if they don't seem particularly appetizing. There may be something to it, though: I have been consuming more Omega 3 sources on a daily basis (fish oil pills, flax, chia...occasionally fish and walnuts, but not as often as I ought to) as well as choosing less processed carbs, and I have noticed that I don’t have super strong PMS cravings anymore. (I wonder if Metformin affects PMS food cravings? I couldn't find anything particular about this.)

Even so, sometimes I just want a "schmall schmackerel (as opposed to a "mackerel," even though that would probably be a better choice) of something sweet", as Pooh-Bear would say. Here are my go-to items. Some of these would not have worked for me earlier on, when I was working to get my blood sugar levels regulated and to eliminate my sugar cravings. I still check things that I introduce back in with my meter, and I count the carbs toward (vs. adding them on top of) a meal or snack. I'm happy I did the up-front work (exercise, making better food choices), though, because before diagnosis, I never thought I'd be able to eat some of these items again if I had diabetes. Any-hoo, with no further ado....

Well, there's a little more "ado"...

Disclaimer: The foods/products that I mention on my blog are my own personal preferences, and they work for me...they might not float your boat or be your best choice for your diabetes. Consult your health care practitioner if you have questions about them. Also, for what it's worth, I am not compensated for mentioning ANY products in my blog.

Okay, no more "ado," I promise:

When only chocolate will do (chocolatey/sweet/salty/creamy): I find dark chocolate *very* satisfying and fairly carb-friendly for the 70% variety…just plain, or sometimes with peanuts or peanut butter. (I found that after eating clean for a few months, I lost my taste for milk chocolate. Too sweet.) Or here's a very simple hot chocolate recipe.

When I want comfort food (sweet/salty/good fats/creamy/warm): Oatmeal and peanut butter with some sugar-free maple syrup. I really love the steel-cut oats these days...I'll be trying oat bran next and see if I like it as much. I put a 1/4 cup of milled flax seed in my oatmeal for extra nutritional goodness.

Because I'm weird this way (warm/fats, good and bad/creamy/mushy): Coffee, half-and-half, and chia (ground or whole seed--different textures, same...odd-but-goodness). I know, it IS weird, but it works for me sometimes when my green tea+chia doesn't satisfy.

An apple a day...(sweet/salty/fats, good or bad/cold/mushy+crunchy): Good ol' apple and peanut or almond butter. Or cheddar cheese. My favorite variety, Gravensteins, are in season right now; if you can find them, try them! They have a wonderful tart + sweet flavor.

And the ubiquitous (sweet/sour/cold/mushy...crunchy/good fats optional): Nonfat Greek-style yogurt with fresh fruit. I like mine with berries, oranges, or apples. I also put cinnamon in mine, and sometimes milled flax seed, other times some walnuts and a tiny drizzle of honey. I also found this Chia Goodness cereal stuff that's acceptable carb-wise if just sprinkled on...the cranberry/ginger flavor is quite strongly flavored but works well in yogurt, its consistency being similar to granola.

Processed, but quick (sweet/salty/crunchy/sticky/FAST): I like the South Beach Living peanut butter & chocolate crispy meal bars (1 carb, 2 lean meat) or their high-protein peanut butter cereal bars (1 carb, 1 lean meat). Read the label and see if it works for you...they're not the cleanest-of-clean eating, but I find them to be darn convenient and okay for me in moderation. (Like now, when I need to pound something down before hitting the gym.)

Because I'm human (whatever strikes my fancy--not recommended, but....): I have been known to eat some potato chips. (This works best if I plan for an measure out an ounce into a dish, and sit down, and savor them...otherwise, I'm picking out of a bag and it's too easy to lose track.) I've also bought sugar-free candy and eaten more than I'd planned to eat. I don't go as crazy as in the pre-D days, and I usually feel physically icky the next day, so it's something that is tending to happen less often over time. Especially if I work in reasonable amounts of stuff I really like (see "when only chocolate will do") into my regularly scheduled feedings. And don't get me started on salted, roasted nuts...still a tricky food for me.

Finally, my original go-to when in processed carbs/sugar detox mode (warm/sweet/spicy): Good Earth Original tea. I like it because it tastes much more flavorful and sweet to me than regular herbal teas. I also like mint tea with sweetener.

"What Do You Do?"

Recently, Fitness Surfer asked for my advice for a friend of hers with prediabetes.

I'm not a medical person [BIG OL' STANDARD DISCLAIMERS APPLY!], but I'm happy to share what's been working for me. Naturally, your mileage may vary and you should discuss with your doctor, do your own research, etc.

Type 2 diagnosis itself sure put the wheels in motion for me. Being diagnosed made it mandatory for me to get myself back to good health. What I didn't realize at the time was that the disease symptoms themselves were working against me: I felt tired and fuzzy-headed a lot, and that made it hard to feel motivated to exercise and to eat properly (which involves a bit more effort and clear-thinking than eating whatever, whenever).

But what do I do, specifically? Here's a list:

I monitor my blood glucose levels and strive for normal blood sugar levels.

If you kinda sorta suspect that you *might* be at risk for diabetes, it is tempting to keep your head buried in the sand about it. (I did. Bad idea.) Not everyone who is overweight, obese, or
morbidly obese develops type 2 diabetes; from what I've read, there are other factors involved.

That said, I would recommend getting screened. I had been reluctant to let a doctor test me, but I did a health screening at my local drugstore and it confirmed that I had diabetes. (I had the
HbA1c test, which shows the "average" of the past few months, not just the fasting blood glucose test.) I also had a pretty awful cholesterol panel and low bone density.

Faced with these facts, I didn't feel like I had a choice: I needed medical help. I suppose I could have ignored it, or researched it and tried to control it on my own. But without a blood glucose meter, I knew I would be flying blind...and would possibly *become* blind if I wasn't successful. I went to my doctor, and got a prescription for a blood glucose meter; this tool tells me how what I eat affects my blood glucose levels, by giving me a "snapshot" of my blood glucose level at the time of testing. I was instructed to test once in the morning before eating, and once after one of my daily meals, between 1-2 hours after the meal. I ended up testing more, to see how certain foods affected my blood glucose levels, and sometimes when I felt not quite right.

Yes, that means it's now part of my permanent insurance record. Yes, it meant a lot of hassle and stress and appointments at first. But boy, if I could bottle up the feeling of "Before" vs. "Now" and let people try it, the difference would astound them.

So...what's a "normal blood glucose level"? Surprisingly, it's subject to debate. The American Academy of Clinical Endocrinologist levels (http://www.aace.com/pub/pdf/guidelines/OutpatientImplementationPositionStatement.pdf; it's the 3rd page.) recommends a Fasting/Preprandial of Fasting/Preprandial of less than 110 mg/dL and a 2-hr Postprandial of less than 140 mg/dL (source: http://www.phlaunt.com/).

I exercise at least 30 minutes/day, 5 days/week. It doesn't have to be super strenuous (although it usually is now, because I'm training for a sprint triathlon). I aim for mix of cardio and strength.

The biggest eye-opener for me when I went to see my diabetes educator was her "prescription" for 30 minutes of exercise 5 days/week, to help reduce my blood glucose levels. "You need to view this as being as important as taking medicine," she said. I took up running--which, ironically, raised my blood glucose levels after running at first. (However, this wasn't as much of an issue once I got into shape, and as I figured out how to fuel my body before I ran.) I needed something high impact for better bone density, but moderate exercise would have had a similar effect on blood glucose levels. I also started doing light strength exercises for upper body bone density, but developing some muscle mass also helped with the diabetes, I believe.

I became an athlete.

I was going to write, "I am becoming an athlete"...I still don't know which phrasing I prefer, because I don't know what one has to achieve to say, "I AM an athlete." I train for and participate in events, rather than it being a one-time thing. But anyway, it's more about the mentality of training for a specific goal rather than the mentality of "I'm on a treadmill to nowhere...." I wrote about this new mentality before my first 5K (other than my one high school cross country season) here:
http://oppositelife.blogspot.com/2008/10/detest-running-try-walking-5k.html

I found that having an event scheduled helped me stick to my new exercise habits. This blog entry has links to training programs for a 5K walk. I myself didn't follow the ubiquitous couch-to-5K program; I felt it was too intense for my level of fitness at the time. (Er, pretty much zero, and morbidly obese, clinically-speaking.) I set my own pace, more along the lines of the Zen Habits article "Beginner's Guide to Running" (http://zenhabits.net/2007/05/beginners-guide-to-running/). Once I did my first event, though, I was hooked! I decided to do one event per quarter. My 2009 race schedule (and reports) are down at the very bottom of the blog page, if you're curious about them.

The downside is sometimes you feel like you need to do more, more, more...but don't fall for that one. MizFit had an excellent article last Wednesday, "Overtraining: Less Can Be More." Excellent discussion in the comments, too.

I developed a food plan. Yes, for me, it meant developing portion control and other sensible eating habits.

I started with my gestational diabetes food plan, but then I did a little research online and found that a lot of people with diabetes were finding good success with lower-carb diets. (Varying from
Atkins-style low carb to more of a South Beach-style diet.) I based my food plan on the Low-carb Diabetes Diet on Prevention.com's web site (http://www.prevention.com/cda/article/the-low-carb-diabetes-plan-that-works/548c68f271903110VgnVCM10000013281eac____/weight.loss/popular.diets/low.carb.diets/0/),
although I adjusted for a little more dairy. (I like my yogurt!)
Having an understanding of food exchanges helps with this; refer to
this document for more details: http://dtc.ucsf.edu/pdfs/FoodLists.pdf

Other articles that helped me:
"How to Get Your Blood Sugar Under Control": http://www.phlaunt.com/diabetes/14045524.php
"What Can You Eat When You Are Cutting Carbs?" http://www.phlaunt.com/diabetes/18856280.php

At my meals, I ensure that I have a balance of protein and not too many carbs; at least one serving each per meal or snack. When I had gestational diabetes, I learned from the nutritionist that one can maintain a more even blood sugar by spreading out one's carb servings throughout smaller meals and snacks during the day and by ensuring that you eat a little of your protein when you eat your carbs. (Similar to the recommendations made by the insulin resistance diet authors.) I eat a lot of non-starchy vegetables, sometimes omitting a starch serving in favor of more non-starchy vegetables. I eat as "clean" as possible: fewer processed foods, more "real" foods. Oh, and I kicked the diet soda habit...not sure how much that helped, but I suspect it did.

I don't have any "forbidden" foods. (In fact, I just ate a tiny, totally-worth-it, chocolate-caramel truffle.) Forbidding foods totally backfires for me. I may choose to not eat or drink certain things in general (e.g., diet soda) or at certain times (e.g., Hmmm, I had a piece of bread with dinner, so I will postpone having dessert until tomorrow night.). This doesn't mean the choice is always easy and painless, though! I've had plenty of times where I thought to myself, "Oh, why can't I just eat any ol' thing I want???" I may choose to eat smaller portions of a food, so that I don't screw up my blood sugar readings. So far, that has worked for me.

I found a backup plan: the plate method.

If the above seems like way too much analyzing, try a "plate method."

Here's one: http://www.dlife.com/dLife/do/ShowContent/inspiration_expert_advice/expert_columns/rondinelli_jan06.html

Here's the Zone system version: http://www.zonediet.com/EATING/QuickStartGuide/tabid/108/Default.aspx

I find the "plate method" very useful when dining out or on vacation. I weigh and measure portions when at home, but when I can't, this works nicely.

I found some alternatives for when food cravings hit.

I was super-strict when I was working to get my blood glucose levels under control. It probably took about a month to get rid of the intense sugar-cravings. (It was worth it, because now I find a lot of the foods that used to trigger me are sickly sweet to me now.) When I got hungry in between meals, or felt like I wasn't quite satisified after a meal, I went for "free foods" that were high on flavor and low on calories: Good Earth Original tea (strong, sweet cinnamon flavor), good-quality broth (beef and chicken when I was getting used to reducing my portion sizes), lots of non-starch veggies. The occasional sugar-free candy,
popsicle, jello, or gum. (Here's the Mayo Clinic's Free Food exchanges list, since the ADA web site is not responding: http://www.mayoclinic.com/health/diabetes-diet/DA00076)

I take 2 fish oil capsules and 2 calcium+vitamin D pills per day.

I started doing this a few months before diagnosis, because my husband's doctor recommended this to improve his heart health and cholesterol. I figured it would probably be good for me, too. I believe it's helped my low bone density and my cholesterol, in combination with the other changes.

I take metformin, as prescribed by my doctor.

The Diabetes Prevention Program study indicated that lifestyle changes plus metformin therapy can prevent or help delay the onset of Type 2 diabetes. (UCSF's Diabetes Education Online summarizes this study here: http://dtc.ucsf.edu/type2/health-management/what-trial-research-shows/dpp.html) I balked at the idea at first, but it became obvious (about 1 month after trying) that exercise and dietary changes alone were not reducing my blood glucose levels enough. It seems to work well for me, though. Metformin regulates how the liver releases sugar into your bloodstream. It requires a doctor's prescription.

No, I did not have any surgery.

I'm a wuss. From what I've seen personally, observing people I know who have had this surgery, it does get the weight off, and pretty quickly. But it's not what I'd call the "easy" way...the surgery itself is probably the easiest part, actually. Adjusting to life after surgery is extremely challenging. So I'd definitely recommend giving lifestyle change the "matter of life or death" try before going this route.

There has been a lot of press about gastric bypass surgery "curing" diabetes. But what does a "cure" look like? You might want to read this and decide for yourself:
http://diabetesupdate.blogspot.com/2009/07/real-truth-about-gastric-bypasss.html

I track everything...more or less.

I created my own health log to keep track of it all, because I was writing it all down in a notebook and that got onerous. I have a single sheet, with each day being a column, and rows that track my two blood glucose readings, my food intake, supplements/medication, water, exercise, and some misc. things (flossing, foot care, fiber intake). I've gotten a bit lax on the food tracking lately, and my weight tended to rollercoaster over the last few weeks. But when I stick to
my plan completely, I see good results.

I gained inspiration from the health and fitness online community.

So many wonderful sites; I have all of my regulars in my Blogroll.

Bloggers in this space who successfully manage their type 2 diabetes are Biz of "The Biggest Diabetic Loser" (http://biz319.wordpress.com/) and Foodie McBody of foodfoodbodybody (http://foodfoodbodybody.wordpress.com/ - she was first diagnosed with prediabetes, and then diabetes...very inspiring story and similar to my own). I also like Alan's "Type 2 Diabetes - A Personal Journey" (http://loraldiabetes.blogspot.com/), although he doesn't post as
often. I'm a dedicated follower of Jenny Ruhl and her excellent work ("Blood Sugar 101" book and web site, plus her "Diabetes Update" blog provides excellent research summaries/discussions, see http://diabetesupdate.blogspot.com/). And there's Amy Tenderich's "Diabetes Mine" (http://www.diabetesmine.com/) which includes blog + additional resources.

You'll probably see me quoting the MizFit and Cranky Fitness blogs a lot, because I enjoy their humor, perspectives, and the insightful comments they inspire.

Even before diagnosis, the tiny seed of "hey, it *is* possible" was planted by reading (and re-reading) Lynn Haraldson-Bering's story on cnn.com: http://www.cnn.com/2008/HEALTH/diet.fitness/02/08/weightloss.lynn.bering/index.html, and then reading her full story on her "Lynn's Weight-Loss Journey" blog (and she continues on her "Lynn's Weigh - The Journey Continues" blog, which sustain my "hey, it's possible to maintain, too!" thoughts).

I have lots of help from my incredibly supportive family.

This blog focuses a lot on me and my journey. But deep down, I was motivated by my desire to be as present and functional as possible for as long as possible for my family: my husband and my two children, whom you'll see mentioned as "Mr. Handsome & Handy" and "Thing 1" and "Thing 2" (ala the Dr. Seuss pranksters). My husband thought that the Healthpoint article made it sound like I was a single mom, and nothing could be further from the truth. He takes care of our home and our kids, and he cooks wonderful, healthy meals for us all. I often work late, and most of the time there's a pre-measured dinner in the toaster oven waiting for me, as well as a lunch packed for the next day. (He's also frugal, and this helps keep me out of Whole Foods! ;-) Because he handles a lot of tasks, my stress level is lower (and stress is bad for your blood glucose levels). If I make it look easy, he's a big reason why.

Anyhow, hope this summary helps, both Fitness Surfer's friend and anyone else out there who's looking for their own answers about how to deal with type 2 diabetes.

American Diabetes Alert Day

Today is the 21st annual ADA "American Diabetes Alert Day". I'm a *leeeetle* bit skeptical about people wanting to excavate head from sand regarding their risk for diabetes...but that's based solely on my own experience. For the longest time, and with all of the risk factors staring me in the face, I.did.not.want.to.know. Oh, I knew it was going to be "someday." I suspect that was part of the problem: because I felt it was inevitable, I went the "eat, drink, and be slothful, for tomorrow we shall have diabetes" route. Oy. [shaking head in self-reproach] Why are smart people so dumb sometimes?

I have to admit, though, facing up to my diagnosis was the catalyst for quite a lot of good changes in my life. I feel so much better now and way more energetic. I don't know what the future will bring with me and this disease, but my priority right now is best quality of life for as long as possible. Maybe, just maybe, putting some of the good stuff I've learned into play much earlier could have made "someday" a little later. While challenging at times, being healthy is not as onerous as I had previously suspected.

Anyhoo, I thought I'd share some items I've stumbled across....

Gold's Gym (Hey! That's MY gym!!!) has a new initiative for Diabetes Alert Day, including a free (and nicely done) guide to starting an exercise program. You can download it from their "Fighting Diabetes with Fitness" web page (http://www.goldsgym.com/healthy/diabetes.php). I like that they advised new exercisers to set goals, work up to their goals (rather than going gung-ho in the first session, getting sore and tired, and abandoning it), and to combine strength training and cardio. (In a way, it's kind of ironic, because I always associated this gym with the serious fitness nuts. But after I got over feeling intimidated--with much encouragement from my blog buddies--I've found it to be a really positive place.)

Excellent article on Diabetes Mine, highlighting various Alert Day goings-on. I like that Amy highlighted LifeScan's list of resources for those with little or no health insurance.
http://www.diabetesmine.com/2009/03/dismissed-on-diabetes-alert-day.html

And, if you did take the risk assessment, or have been recently diagnosed, there are some really great references available in these places:
Blood Sugar 101; especially Jenny Ruhl's "Lower Your Blood Sugar" flyer
UCSF Online Diabetes Education (Promotes higher carb intake than the lower-carb sites like Blood Sugar 101, but who says you can't do it in phases? This site has a lot of information you'd get from a diabetes educator, and if you're without one, it may help getting one closer to better blood glucose management.)

Hmmm...I also discovered today that the ADA "Tour de Cure 2009" has an event in Palo Alto, California...and it's on June 14. Mr. Handsome-and-Handy's and my 15th wedding anniversary and my diagnosis day. All together now with the eerie coincidence sound effect: wooooooWEEEEEEEwoooooooo! Oh, and they have a 25K (11.47 mile) ride. How doable! (I've gotta get me one of those hot, "Red Rider" jerseys!!!)

Weekly Weigh-in: -28 pounds!

Yeay!!! I've lost over 10% of my starting weight!!!

And, hurrah! I survived the family Michigan trip! I lost 3 pounds and I had as good of control as possible over the numbers. I didn't keep up with my exercise routine, but I was generally active. I didn't eat to plan, but I did skip the obvious offenders and kept my choices low-carb in general. I probably ought to have had more veggies. My splurges: lots of sugar-free popsicles, one double White Castle with middle bun removed, half of a Villa Bakery pizza roll. My only regret is not having stopped in at Uncle Ray's in Fenton for a memorial scoop: the founder, Uncle Ray himself, passed away last month. Especially since I was good and did not drink what I really wanted: a margarita. I stuck to one and a half servings of wine. I felt a little bitter about that (grumble, grumble, how come everyone ELSE gets to drink and eat what they damn well please, grumble grumble), but my sister-in-law's mom was there, and she's diabetic, and she was a poignant reminder of the trouble I'll have if I don't do my best now to get things under control.

Said sister-in-law lent me a fleece jacket (Eddie Bauer, XXL) that she said she doesn't fit anymore (it's too big) and that she also said she had lent to her pregnant sister (who isn't exactly petite either). I like the jacket, but it was a little discouraging to think that I was receiving someone else's "too big" hand-me-downs. It reminded me of how far I have to go, and it seemed to lessen how far I've come already. I know that totally was not her intention, though; she just wanted a good home to a favorite jacket. On the other hand, I know the cost of her struggle with weight & health issues, so I'd better live up to my intention and do the opposite: I now hereby choose to look at it as an inspiration: "she did it; so can I!"

Opposite Month #1

Well, it's been one month since I wandered out of Long's Drugstore with a Type 2 Diabetes diagnosis. Quite the eventful month:

• Threw away the chocolate glazed donut I bought for breakfast that morning.
• Felt anger, disgust, and shame. Why-oh-why had I let it come to this?
  
• Clamped down on my food plan. I had dug out my old gestational diabetes food plan a couple of weeks ago--when I'd decided I'd had enough of being fat--but I wasn't following it precisely. I eliminated all refined sugar products and other forms of junk food; cut white rice, regular breads, and regular pasta; sodas (diet, rarely drank regular). Started eating only whole grain products. One serving of my starches is a combo of wheat germ and milled flax seeds in my plain Greek-style yogurt with a serving of fruit. I am becoming my mother...not a bad thing, in this case!
  
• Celebrated our 11th wedding anniversary! (Splurged on sharing some tempura...oooooo. Bought used books instead of fancy desserts.)
  
• Went to see the doctor on June 19. Yep, it's the big D, alright. We discussed--I told her I wanted to try diet and exercise first, since my previous years had been spent wallowing in sloth and gluttony. She wrote my Rx for a meter and strips, but she said to not fill it right away, because she thought our health group had some sort of contract with someone. (Word to the wiser-than-me: Be sure your doctor specifies the number of strips and lancets. Also, call your insurance company right away regarding how to get a meter! It's the *insurance company*, not the medical group, that determines which brands and models are covered. More on that later...)
• Plodded along with my food plan and started exercising 3 days/week for 30 minutes. Decided to take up walking and--gasp!--jogging. I'd felt inspired by the Zen Habits blog article "How to Go From Sedentary to Running in 5 Steps," which describes how to get started with a running routine. (There's another good article I found on the Cool Running web site, "The Couch-to5K Running Plan, which is similar.) Yes, I guess aliens *have* taken up residence in my body.
• Finally got the referral letter for the diabetes educator appointment. Called and made the appointment. I'm a little surprised that they let 2.5 weeks go by, but oh well.
• July 1: At least I don't have breast cancer! I had my first mammogram today. The breast center at Mills Peninsula is soooo luxe! We had nice robes instead of paper ones, and the interior design was not sterile. Friendly, professional staff, too. I kept wondering when they'd call me for my facial and manicure.
  
• Got overwhelmed by the conflicting info on the web. Low carb vs. low fat, Bernstein vs. ADA...oh my! My gestational diabetes food plan from 2001 seemed a bit high on the carbs, so I went with a modified version, "Low-Carb Diabetes Diet" from the prevention.com web site. I liked its inclusion of a "nut" portion, a *whole* ounce of nuts! Woo hoo! I made a modified version, though, to include 2 portions of milk and 2 portions of fruit and to total 1800 calories. My version has approx 131 grams of carbs, which is more than they recommended (they recommend 125 grams max).
  
• Saw the diabetes educator and nutritionist on July 7. To my dismay, they were unable to issue me a blood glucose monitor, because they do not have the ones my insurance company covered. Got lots of good info: The nutritionist told me that my food plan looked good for now, I could probably eliminate some of the snacks if desired, but that research supported only dropping to 130 grams of carbs. She thought that the Bernstein diet was not practical and a bit extreme. (I had done a more restrictive plan during the end of my 2nd pregnancy, when seeing an endocrinologist, and I hated not being able to have fruit! Just lemme have a couple of apples, damn it!) Got some bad info: I wasn't exercising enough, according to the Rn: 30 minutes, 5 days a week is recommended for someone trying to control with diet and exercise. (And...when am I going to find the time? Oh, well, flight o' the bumblebee, right? Or, "when faced with the impossible, choose the improbable"...I think that's how the Sherlock Holmes quote goes.)
  
• Went through the whole rigmarole of obtaining a meter. I was given the numbers to call to get either a One Touch or an Accucheck meter via the companies' free meter programs. I was unable to determine, even after two calls to the pharmaceutical part of the plan's info line, whether test strips for the Accucheck models they were offering were covered! Grrr...So I decided to geek out and get the One Touch UltraSmart, even though the Rn said she didn't care for the One Touch meters as well. OH well. Probably jacked up my blood glucose just getting the darn thing.
  
• Received the meter on July 10 and started checking. Good news: my post-meal numbers are within range (137-158). Bad news: what IS UP with my fasting blood glucose? It's running between 160-170, even with all my good habits. I have a feeling I might be put on some meds. Ugh.
• Started flossing again. Flossing is almost as irksome a chore as ironing clothes, but it must be done. *sigh*...

So, there you have it: the first one month of Opposite Life. Next time: How do I prevent myself from getting overwhelmed with the idea that this is The.Rest.Of.My.Life!

"Someday" is "Now"

Or, "About this blog":

I've always loved eating good food and (to quote the Sweet Potato Queens) "doing jack shit." My ideal life would be somewhere like this; getting served excellent, plentiful meals and tasty cocktails; snorkeling a little; laying around in the balmy air and reading books. It's a good thing I never won a Lotto jackpot.

I turned 40 this year. Foooooooooorty. Ooo. And I thought maybe I should get my act together. I am overweight, sedentary, married with two small kids. I had also had gestational diabetes during both pregnancies (you can see where this is going) and was therefore more likely to develop it someday. (Family history, too.) Ironically, I had started to make some changes for better health, and I went and got some screening done at Long's. Just to see where things were at.

"Someday" turned out to be "now": my fasting blood glucose was 202, a1c 9.5. Damn!

So now I'm living the "Opposite Life": opposite day, every day, when it comes to food and fitness. This blog records my journey, and maybe it will help others on the same path.