The Life of a Needle

There's a lot of diabetes happening in my house. I'm a type 1 and my wife is a type 2. One Saturday morning recently she drifted into the kitchen and said, "Hey, babe, I'm starting a new Byettapen. Should I move the old needle over to it, or put a new one on?"

"Well, that depends on how long you've been using the needle," I said.

There was a long hesitation. A hint of a shadow flitted across her dark eyes.

"Ah…. How long have you been using it?" I finally asked.

She shrugged one shoulder. "It's the same one you put on when you showed me how to use the pen."

My head crunched the math. "You used the same needle all month?"

"Uh-huh."

"Sixty shots?" I asked, shocked. I run the diabetes education and treatment program for a rural nonprofit health center. I've seen needle use stretched out quite a bit, but right here under my own roof was a new record.

"Yeah..."

"Well, OK then, I think you can change it now, Hon," I told her, recovering my wits. "We got our money's worth out of that needle."  (Note: the retail cost of a pen needle is 22¢)

So, OK, I confess that was an extreme case of needle use. And my lovely bride tells me that she never noticed any pain using an arguably over-used needle. But how many times could you use a needle? How many times should you use a needle? And what about those little lancets that you use to poke your finger? Can they be stretched too?

In short, how long can you, or should you, stretch the life of all the pokey things we use to break our skin with? When do you risk losing their effectiveness? At what point does stretching the life of your sharps put you in danger? What kind of danger does that put you in?

But before we dig into the nitty-gritty details, we should back up for one quick second and ask the bedrock question: Why would you want to use a needle over and over and over? And there are only two answers I can think of: money and, frankly… laziness.

But we all do it. Some of us stretch how long we use our sharps because we can't afford not to stretch. Either our insurance is poor or the part of the burden we carry is too high for the family budget. And some of us stretch how long we use our sharps because swapping out those little things as often as we should takes time. And time is in short supply too. And you know, come to think of it, there is a third reason for stretching the length of use of our sharps.

Gimmie a minute here.

I'm trying to come up with a polite word for "paranoid."

Well… Darn. No luck. OK, so bluntly put, while most of us with diabetes are grateful to the various companies that supply us, I think that there's also a degree of suspicion that they might just be more concerned about their bottom line than they are concerned about our health.

What Do Your Thoughts Have to Do with Eating and Weight Loss? Using Cognitive Behavioral Therapy to change your behavior around food. By Jen Nash, DClinPsych

This article continues the theme of emotional eating, diabetes, and weight loss. So what do your thoughts have to do with weight loss? We have many thousands of thoughts every single day and it is likely that you rarely pay much attention to them. However research has demonstrated that our thoughts contribute much to our decisions around eating behavior. If we can become aware of them, we can influence them, and therefore dramatically change our behavior around food.

Psychologists began paying attention to the role of thinking styles back in the 1960s as a reaction to traditional Freudian psychoanalysis, which has considerable value but could often take many years to achieve long-lasting results. Aaron Beck, the founder of Cognitive Behavioral Therapy (CBT), was a psychiatrist who worked with patients with depression. He found that they experienced streams of negative thoughts that seemed to pop up spontaneously. He termed these "automatic thoughts," and discovered that their content fell into three categories: negative ideas about themselves, about the world, and about the future. Beck found that his clients would tend to accept these thoughts as true and valid, without reflecting on the authenticity of their content.  He began helping his clients identify and evaluate these thoughts and found that by doing so, they were able to think more realistically, which led them to feel better emotionally and behave more functionally. He termed this therapy Cognitive Behavior Therapy to reflect that it addresses both cognitions (thoughts) and behavior.

CBT is now widely used to treat many emotional problems, including issues with food and eating, Further, the tools and strategies it provides are useful life skills for everyone. Although many people work with a therapist, counselor, or psychologist to learn the skills of CBT, it is not essential. CBT can be used at home without a therapist, as long as you understand the principles of treatment. CBT is a skill, and like any skill it takes time and effort to learn it well. It isn't a quick fix. By learning the skills and practicing their implementation you will develop control over your eating, weight, and also your general well-being.

According to the theory of CBT, there are four aspects to any of your experiences. First, there are the physical symptoms – what happens to you physically and the sensations you are aware of in your body. Secondly, there are your moods, emotions, and feelings. Thirdly, there your thoughts – what goes on in your mind and your thinking styles, images, and memories. Finally, there are your behaviors — the actions that you take or fail to take. These four categories of your inner experience all interrelate. Your thinking affects your body sensations, which affects your behavior, which affects your moods.

So what does this mean in practice? Let's look at an example to help us. Claire wants to lose weight and has been attempting to eat more healthily for a week. She steps on the scales at the end of the week to check her progress and discovers that she has not lost any weight despite all her efforts. Claire's thoughts may be, "What's the point of trying? I have tried to eat healthy and I have not lost any weight! There is nothing I can do to change this." If Claire were thinking these thoughts it is likely that her mood would decline and she may feel fed up, anxious, and/or depressed. If she were thinking these thoughts and feeling these emotions it is probable she would experience some changes in her bodily sensations such as fatigue and irritability. If she were thinking these thoughts, feeling these emotions and experiencing these bodily symptoms, it is likely that her subsequent actions may be affected. For example she may snap at a family member who asks how her healthy eating is going. Or she might decide to eat something fattening as a ‘treat' to cheer herself up.

According to the theory of CBT, all of these experiences — thoughts, emotions, body sensations and behaviors — interact to bring about a certain outcome. CBT focuses on your thoughts as playing the central role in our psychological wellbeing. Therefore by changing your thinking patterns you can change the emotions you are experiencing and the behaviors you are most likely to engage in. this means if you can gain insight and control into your thinking styles, you can gain control over your eating behaviors. Exciting isn't it?

So how can you change your thinking patterns? Perhaps you can identify with the example of Claire and have had the experience of getting on the scales, realizing you hadn't lost any weight and feeling disappointed. However Claire's reaction was only one of a number of possible ones. Other possibilities are, "Well it's only been a week – I'll keep going for another week and see how I get on." If you were thinking these thoughts it is likely you would have a different set of moods, a different set of body sensations, and therefore a different set of behaviors. Instead of snapping at your partner or deciding to eat a sweet treat to comfort yourself you may instead think, "This IS frustrating, but what can I have for dinner tonight that is healthy and will help me stay on track to reach my goal next week?" You might tell your partner you are disappointed and ask for a hug or a reminder of how good you'll feel once you've reached your goal.

This shift in thinking has the potential to profoundly affect both your emotional experience around eating and your subsequent behavior. Focusing on your thoughts and replacing unhelpful thoughts with more supportive and empowering ones can help you to reach your weight loss goals and overcome the barriers that prevent you from behaving the way you would like in relation to eating.

In the next article I'll be discussing the 5-step process of how to challenge the thoughts that don't empower you around food. Looking forward to connecting with you then!

Dr. Jen Nash is a clinical psychologist who has lived with diabetes for more than 20 years. She runs www.PositiveDiabetes.com, an education, therapy and coaching service that supports people with type 1 and 2 to manage the emotional and psychological impact of day to day.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

16 Non-Drug Ways to Lower Blood Pressure By Rebecca Abma

All too often, diabetes and hypertension go hand in hand. As many as two out of three adults with diabetes have hypertension (high blood pressure), too. And both conditions increase your risk of heart attack, stroke, and eye and kidney diseases.

Like blood sugar, your blood pressure levels can fluctuate throughout the day. Normal readings are at or below 120/80 mmHg, but a single reading above that isn't cause for alarm. Hypertension is defined as two or more consecutive readings above 140/90.

However, people with diabetes have a lower blood pressure target than the general public: Because of the increased risk of heart disease that comes with diabetes, the American Diabetes Association and the National Institutes of Health recommend that people with diabetes keep their blood pressure below 130/80.

If your blood pressure is elevated, your doctor may recommend lifestyle changes, such asfollowing the DASH diet, before prescribing medication. The following are some other, non-drug blood-pressure reducers worth adopting whether or not you have hypertension.

1. Cut back on salt. It's no surprise that sodium can raise your blood pressure. If everyone in America cut their salt intake to no more than 1,500 mg a day, 16 million cases of high blood pressure would be prevented every year, according to the Centers for Disease Control and Prevention. (Current average daily intake for Americans exceeds 3,400mg.)

2. De-stress. A recent review of 107 studies on stress reduction techniques and blood pressure found that Transcendental Meditation, biofeedback, stress management training, and progressive muscle relaxation were all effective in lowering blood pressure.
Also, a study presented at the American Society of Hypertension's annual meeting in May 2008 found that listening to relaxing music for 30 minutes a day reduces blood pressure.

3. Go easy on the alcohol. Experts recommend no more than one drink a day for women and two drinks a day for men. In fact, studies show that when heavy drinkers cut down on alcohol, it lowers blood pressure. If you drink alcohol and are at risk of high blood pressure, talk to your doctor.

Reviewed by Susan Weiner, R.D., M.S., C.D.E., C.D.N. 10/02

Maybe Food is Love - Rachel Myhre, MS, RD, CD

Food, Relationships and Love

 

At the core of the human heart -- indicative of an innate longing -- is a desire for connection. Connection with people. The words and life of Christopher McCandless capture this notion well. The24-year old hiker -- who ventured into the Alaskan wilderness, desiring a time in solitude – stated these words near the end of his life: “Happiness is only real when shared.” [Italics mine]The very wildness that would take his life, exposed his profound realization. A realization that rings true for so many.

Although unique to each individual, the desire for genuine relationships, connection and love is safe to assert. And may we pause to reflect on the fact that human connection is unattainable separate from the building blocks of life which sustain it.

“Everyone runs on food. Every hug, every kiss, every page ever written is because of food. Without food there is no life. Everyone has to eat! I was so disconnected from the real purpose of food as nutrition and so focused on the emotional uses of food that I forgot that we all run on food. This was an important realization in my recovery and still strikes me as important.” –TA ¹

How often do we become disconnected from the primary purpose of food and nutrition that we overlook the fact that food is fundamental to life? And thus fundamental to connection. This is not breaking news to anyone I am sure. And yet, how often do we neglect the role of food as nourishment? And letexpectations, diets, fears or destructive habits pertaining to foodbecame our focus? How often do we trust our innate ability tolovingly fuel our body?

In the midst of this appreciation, we acknowledge thatconnection can be stirred by a candlelit dinner. We acknowledge that memorable holidays and celebrations would not be the same without the food traditions that enrich them.

Food nourishes our body in a way that is vital to life.Connection nourishes our soul in a way that breathesrelationship, meaning and love into our existence. Our experience with food can never replace the genuine connection we experience with people. And connection with people, alone,cannot sustain our lives. So let us embrace the relationships and love that are beside us. And may the nourishment of your bodyset the stage for the nourishment of your soul.

 

1.

8 Keys to Recovery from an Eating Disorder. Carolyn Costin &Gwen Schubert Grabb

Google embarks on smart contact lenses for diabetics-Dara Kerr

What if people with diabetes didn't have to prick their fingers several times a day to conduct blood sugar tests -- but instead could simply wear contacts?

A prototype of Google's smart contact lens that could measure glucose levels in people with diabetes.

Google

Google has been working on smart contact lenses embedded with sensors "so small they look like bits of glitter" and an antenna "thinner than a human hair."

But these lenses aren't being developed to give people super-human sight or cast the Internet over their field of view -- rather, they could potentially help diabetics monitor their glucose levels.

Google announced Thursday that it's been working on this secret project at its Google[x] research lab. Not only has it developed prototypes of these smart contact lenses, but it's also done multiple clinical research studies, met with the US Food and Drug Administration, and is looking for potential partners to bring the product to market.

"We're now testing a smart contact lens that's built to measure glucose levels in tears using a tiny wireless chip and miniaturized glucose sensor that are embedded between two layers of soft contact lens material," the project co-founders Brian Otis and Babak Parviz wrote in a blog post. "We're testing prototypes that can generate a reading once per second."

Diabetes is said to be one of the fastest growing diseases in the world. According to Google, it affects one in 19 people around the globe. In order to keep blood sugar levels in check, diabetics must give themselves finger prick blood tests throughout the day.

These tests can be time consuming and painful. But they're crucial -- if glucose levels get out of control, diabetics risk damage to their eyes, kidneys, and heart.

For years scientists have been investigating other ways to test blood sugar levels. One branch of research has been exploring breathalyzers as a way to detect heightened glucose levels. Researchers have also looked into using tears for glucose tracking, which is where the idea of a contact lens came along.

Using tears is complicated, however, because it's been hard for scientists to collect tears for testing. So, it's still unclear how effective this body fluid works in measuring glucose levels. Additionally, this product is far off from any sort of mainstream use. Not only does Google need to find partners to get the contact lenses to market, but it also needs to go through the arduous FDA clearance process.

Besides blood sugar testing, Google also hopes that the smart contact lenses can warn users if their glucose levels are high or low.

"We're exploring integrating tiny LED lights that could light up to indicate that glucose levels have crossed above or below certain thresholds," Otis and Parviz wrote. "We hope this could someday lead to a new way for people with diabetes to manage their disease."

A Resolution to Make 2014 Your Best Year Yet!

     2014 is here! After the celebration on New Year’s Eve with a glass (or three) of champagne, and that special kiss to ring in the New Year, we turn our focus onto New Year’s Resolutions; the list of resolutions which we’re really (we swear), going to commit to and keep this year.  After some brainstorming we often come up with a list that seems to resemble that our peers'. Maybe to sleep more, become more organized, save money and often to lose weight.

     In Googling “New Year’s Resolutions”, Tips on how to maintain your resolutions, appear first. Why are our resolutions so difficult to maintain? Why do our lists resemble last years' and the year before? Why can't we seem to lose the weight, or become more organized? 50% of Americans make a New Year’s Resolution, and within 30 days, only 8% of them are still committed. Experts say that it has a lot to do with the approach we take when making our resolutions, and that using guilt or fear as motivation seems to be a deterrent.

     So how to we achieve success? On Bankrate.com, they offer a tip. ”Make a resolution to fit with your own values."  My own values? After thinking and internalizing this idea, I have come up with a resolution that might just make 2014 the best year yet:

• "To put myself first.

     Webster Dictionary defines Self-Centered as having or showing concern only for yourself, however it continues to add independent of outside forces or influences. I can only assume most of you are thinking that, living this way is being selfish. Yes, by definition, Self-Centered is considered to be negative, however can we redefine it as being centered on ourselves. Not influenced by media, our significant others or friends/family's' opinion, but truly what is important to us. Influenced simply by our own values. Being authentic to who we are. If we can acknowledge that we OWE it to ourselves, to love, care for, and respect ourselves, then it becomes easier to achieve our own resolutions.

     In today’s world we constantly lose, what I like to call our self-center. We center ourselves on friends, spouses, school, and family. We often lose our values in the midst of this. We put all of our external responsibilities and obligations first and fall into a cycle of fatigue, anxiety, and stress. This activity of putting others first consistently seems to ignite feelings of resentment, guilt and a sense of failure. By making a resolution to put ourselves first, we acknowledge that once we meet our basic needs and desires, we are able to give and accept from a place of true joy and happiness because we eliminate the cycle that leads to resentment and feeling overwhelmed.

     What would a life of putting ourselves first actually look like? It would include remembering each decision we make should point toward our own values. It would include saying “no” more often, and allowing space for our own thoughts. Showing ourselves love and respect on a daily basis would mean letting some people down once in a while, and in turn, it would be giving from a space of true love and happiness.

     Our resolutions of wanting to lose weight, or to eat better, often fail because we fall into feelings of guilt and fear from an outside force or influence. So if we allow ourselves to be self-centered and focus on our own values and what our own desires are, we might see that the world has endless possibilities. Our goal is to, eventually, through putting ourselves first, have our resolutions become a part of who we are!
-Sarah Morrison, RD, CD, Director of Medical Nutrition Therapy for Ramey Nutrition

 

 

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