Managing A Child's Mind

I have never had a child to care for, so I can't give the perspective of the parent. I can only tell you what I felt when I was growing up. Maybe you will be able to use something from below to help your child through a difficult period in their life.

Being diagnosed with Type 1 Diabetes at the age of four was a shock to my parents. My mom and dad managed and taught me about the disease. They had the task of keeping up with improving technology, keeping an eye on my diet, emergency hospital visits, regular doctor visits and trying to keep me happy all at the same time. At such a young age, I wasn't willing to help them out with this whole process.

Several times a day, mom or dad would check my blood sugar and inject me with insulin. They had a strict eye on me. Big brother was watching every movement, every misstep..."are you okay?", "eat your mozzarella stick", "here are extra juices for your soccer game", "do you need something to eat?".

Diabetes turned into a routine, a routine controlled by my parents. I had no real responsibility, it was all done for me. As life continued I started to grow sick of having my parents bother me with this whole Diabetes thing, all I wanted was to be normal. By the time I reached my mid-teenage years, I didn't want to monitor my health, it had become a hassle. I feel that in some way it was a direct result of my parents smothering me with Diabetes knowledge, but now I know they were doing the best any parents could. I can only blame my young fragile mind.

My temper grew from all the glucose checking, shot taking, hearing about how if I didn't take care of myself, then horrible things would happen to me like amputation of my extremities. My mind developed a barrier that blocked reasoning when it came to managing my Diabetes. As a teenager in high school, I never practiced what was taught to me by my parents and the endocrinologists. For some odd reason, maybe because of the repetition, I never forgot what they taught, I just didn't practice it.

I can't tell if my learning was a success or not. I believe that my parents meant well and did everything in their power to raise me correctly. So far, my Diabetic life has seen its ups and downs, highs and lows. If I could have them redo some of my Diabetic learning, then I would suggest trying these tips:

1. Teach your son or daughter to feel comfortable with their diabetes around peers and strangers. This is most likely the hardest task of all. I do know that comfort comes from trust.

2. Don't allow their life to be centered around Diabetes, they need to be a kid too.

3. When one method of persuasion (with managing Diabetes) doesn't work, stop using it and come up with an alternative solution. For me, when my parents would keep nagging, it would just frustrate me more, and make me block everything out.

4. Scare tactics don't work.

5. Allow distance between you and your Diabetic child in regards to management, otherwise they might become smothered and agitated.

6. Food is always going to be an issue, especially when it comes to candy. Halloween was the worst. Maybe when something like this comes up, offer an exchange for the candy. If your child forfeits their candy, they get to stay up an hour later, or something like that.

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All About Insulin: By Naomi Cook

Naomi Cook earned her bachelors in Animal Science from Cornell University and received her masters from NYU in Science Education. Currently Naomi teaches AP Biology in Wetchester, NY. She includes concepts from both Type 1 + 2 Diabetes in her core curriculum.

If you are Diabetic or you know someone who has Diabetes, then you might know how important a role the hormone insulin is. Insulin's main purpose is to help regulate the glucose levels in the human body. Glucose levels rise in accordance to food intake, and can rise faster with the consumption of sugar or simple carbohyrdrates. Unfortunately for Type 1 Diabetics, the pancreas cells do not produce insulin, and therefore it must be injected.

Considering its importance, insulin is a relatively small and simple protein. Insulin is only made up of 51 amino acids. Genes, which are made up of your DNA and packaged in the chromosomes you inherit from your parents, contain the instructions to make proteins in your body. The gene that contains instructions for insulin protein is located on the eleventh chromosome of humans. This gene should actively produce insulin in the cells of the pancreas.

So where do we get insulin for injection? Up until 1982, insulin for Diabetics came from pigs and cows. Bovine and porcine pancreases were ground up and the insulin was purified and sold to Diabetics. This created inflammation at the site of injection, because the insulin was not compatible with the human’s immune system. In addition, inherent molecular differences between human and pig or cow insulin meant the response of the human were not as optimal as it could have been. Finally, retrieving insulin from slaughtered cows and pigs is just not the most efficient way of harvesting a protein for pharmaceutical purposes.

Since genes are made of DNA, the relatively recent advances in our knowledge of DNA have meant that we are able to produce insulin more easily. In 1982, we started using recombinant DNA technology to harvest insulin. Scientists identified and isolated the insulin producing gene on the eleventh chromosome of humans. Next, scientists turn to plasmids. Plasmids are small, circular pieces of DNA that can contain several genes and are naturally found in bacterial cells. Unlike us, bacterial cells can easily accept these plasmids, and once they have accepted the plasmid, the bacteria will produce the proteins that are coded for by the genes in the plasmid. Scientists use restriction enzymes to cut open the plasmid. Then, they can take the human insulin gene and literally paste it into the plasmid using ligase enzymes.

Through a process called transformation, bacteria can be induced to accept the plasmid into their cell. Once the plasmid is in the bacteria, that bacteria will begin producing human insulin. This insulin can then be purified and packaged for therapeutic purposes. What’s more, scientists have been able to create insulin analogs, which are slower acting and better able to regulate blood glucose levels throughout the day of the diabetic. The next time you take your insulin, say a little thank you to that bacteria (probably E. Coli) that is working so hard for you.

Considering how far we have come with producing effective insulin therapeutics cheaply and effectively over the past thirty years, let’s hope that funding for genetics research will continue and we will develop an effective treatment or cure for Diabetes.

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Nova Max Glucose Monitor Review

The Nova Max Glucose Monitor made by Nova Biomedical was the first on my list to review, primarily because it was the quickest one to get. I was able to acquire this free monitor by going to their website and filling out a quick survey which produced me a voucher. This voucher accompanied with a prescription from my doctor, let me walk into my nearest pharmacy and without any trouble, receive a free glucose monitor. So let's get on with the review...

Opening the box, I was supplied with several documents including a owners manual, log book and an easy first setup sheet (with visual aids). An over sized, black zippered holding bag contained the Nova Max glucose meter, ten test strips and a lancet pricker. They also provided me a round battery and 10 lancets to go with the pricker.

The Nova Max glucose monitor was bigger than I expected. Even though bigger than other meters made today, it wasn't too much of an eye sore. It could still fit in your jean pocket if need be. I was most disappointed in the bag that holds all the equipment. The compartments didn't hold everything properly, and even though it was over sized, it still didn't seem to fit everything. I wish they put a little more thought into the design.

At first thought, I guessed the battery was for backup purposes, I was wrong. It seems, as I was following the beautiful looking direction sheet, that the battery must be installed in the device prior to use, even though there is no mention of this in the directions. I was all ready to use the device but couldn't because I needed to install this stupid battery, couldn't they just put it in there to begin with?

The battery wasn't hard to install and only took about 30 seconds for me to accomplish. Please note that I am young and tech savvy, so this might be more difficult for someone else. After installing the battery, I pushed the memory button to configure the initial date and time. This setup was extremely easy and I don't believe many would have trouble with it. I was pleased with the size of the display and easy to read format.

This is the first monitor I have ever used that didn't require coding. I just popped in a test strip, pricked my finger (alternate site testing available), applied the drop of blood (small amount needed) and five seconds later I received an accurate result (compared to what I was feeling). The number was easy to read and I felt confident with the result.

Nova Max was designed with simplicity in mind. There is only the basic memory reading for each testing and it also gives your average BG for 1, 7, 14 and 30 days. There is no back light to read your results in the dark.

Pros:

- Easy to setup.
- Easy to use.
- Larger readout screen.
- Fast readings
- No coding.
- Alternate site testing (forearm)
- Accurate.
- Clear Directions except for battery install.
- Very good lancet pricker.

Cons:

- Too basic?
- No software included for recording/graphing results.
- Had to install battery on first use.
- Bigger than average.
- No back light.
- Horrible holding bag.

Ratings:

Price - 5/5 Stars (Free)
Ease of use - 4/5 Stars
Appearance - 3/5 Stars
Features - 1/5 Stars
Overall Rating - 3.5/5 Stars

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Famous People With Diabetes: Past and Present

We as Diabetics struggle everyday with this deadly disease and so do many of the people we look up to. If you are a parent, show this list to your son or daughter to motivate them to accomplish their dreams no matter what the obstacle. Here is a list of famous people with Diabetes. If you know of any others, feel free to share them.

LIVING

Halle Berry, Oscar-winning actress

Wilford Brimley, of television and films, “Cocoon” and “The Firm”

J. Anthony Brown, actor (“Drumline”), comedian

Delta Burke, of television’s “Designing Women”

Nell Carter, of the television show “Gimme a Break”

Dick Clark, television emcee, producer

Stephen Furst, actor on the television shows “St. Elsewhere” and “Babylon 5”

Victor Garber, actor (“Alias,” “Titanic,” “Sleepless in Seattle”)

Dorian Gregory, actor (“Charmed,” “The Other half”)

Nicole Johnson, Miss America 1999

Zippora Karz, former New York City Ballet soloist, ballet teacher


Larry King, talk show host

Jerry Lewis, comedian, telethon host

Jerry Mathers, actor of “Leave It To Beaver” fame

Mary Tyler Moore, actress and star of “The Mary Tyler Moore Show”

Park Overall, actress (“Empty Nest”)

Della Reese, singer, actress (“Touched by an Angel”)

Sir Harry Secombe, Welsh singer, former president of the British Diabetic Association

Jean Smart, actress on “Designing Women”

Elaine Stritch, comedian

Elizabeth Taylor, actress (“National Velvet,” “Cleopatra,” “Who’s Afraid of Virginia Woolf?”)

Aida Tuturro, actress (“The Sopranos”)

Hafez al-Assad, dictator of Syria

Menachem Begin, Israeli prime minister

Marion Barry, former mayor of Washington, D.C.

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Mikhail Gorbachev, former Soviet premier

Mike Huckabee, governor of Arkansas

Janet Jagan, president of Guyana

Bill Janklow, former governor and congressman, South Dakota

Wei Jengsheng, Chinese dissident

James Lloyd, congressman, California

Winnie Mandela, South African anti-apartheid leader

Buddy Roemer, governor, Louisiana

Damon Dash, entrepreneur

Ray Anderson, jazz trombonist

Carol Channing, Tony Award-winning singer/actress in “Hello Dolly”

Mark Collie, contemporary country star

David Crosby, member of The Byrds and Crosby, Stills, Nash & Young

Phife Dawg, rapper, (“A Tribe Called Quest”)

Mick Fleetwood, singer in rock band Fleetwood Mac

Aretha Franklin, The Queen of Soul

Shirley Horn, Grammy-winning jazz singer

Marvin Isley, singer, The Isley Brothers

Waylon Jennings, country singer

Nick Jonas, lead singer, the Jonas Brothers

B.B. King, rhythm and blues star

Patti LaBelle, pop singer

Tommy Lee, of heavy metal band Motley Crue

Meat Loaf, singer

Bret Michaels, lead singer of the rock group Poison

The Pump Girls

Jessica Stone, actress and singer

Elliott Yamin, singer

Andrew Lloyd Webber, Broadway composer

Neil Young, rock singer and guitarist

Norman Whitfield, Grammy-winning R&B producer and songwriter

Cynthia Ice, developer of Lotus software

Lois Jovanovic-Peterson, scientist, endocrinologist, author of “Diabetic Women”

Wasim Akrim, Pakistani cricket bowler

Sarah Bina, champion clogger

Nick Boynton, hockey player

Ayden Byle, runner

Bobby Clarke, hockey player for the Philadelphia Flyers

Scott Coleman, first man with diabetes to swim the English Channel

Chris Dudley, New York Knicks basketball player

Rick Dudley, hockey

Scott Dunton, world-ranked competitive surfer

Mike Echols, NFL

Curt Frasier, hockey player for the Chicago Black Hawks

“Smokin’ Joe” Frazier, heavyweight boxing champ

Walt Frazier, NBA, New York Knicks

Kris Freeman, Olympic cross-country skier

Joe Gibbs, NFL coach

Bill Gullickson, pitcher for the Cincinnati Reds

Gary Hall, Olympic gold medalist in swimming

Jonathon Hayes, tight end for the Pittsburgh Steelers and Kansas City Chiefs

Chuck Henderich, skier

Chris Jarvis, champion Canadian rower

Jason Johnson, pitcher for the Baltimore Orioles

Billie Jean King, tennis player

Ed Kranepool, baseball player with the New York Mets

Kelli Kuehne, LPGA golfer who wears a pump on the golf course

Jay Leeuwenburg, offensive tackle for the Cincinnati Bengals

Michelle McGann, LPGA golfer

Calvin Muhammed, football player for the Washington Redskins

David Pembler, baseball player, Milwaukee Brewers

Sir Steven Redgrave, rower, winner of five consecutive Olympic gold medals

Ron Santo, third basemen for the Chicago Cubs

Art Shell, NFL player and coach

Kendall Simmons, NFL

Michael Sinclair, NFL defensive end

Hank Stram, NFL coach

Bradley Suttle, major League second baseman

Sherri Turner, LPGA golfer

Scott Verplank, PGA golfer

Jo Ann Washam, LPGA golfer

David “Boomer” Wells, major league pitcher

Wade Wilson, NFL quarterback

Richard Bartlett, film

June Bierman, author of books on diabetes

Fran Carpentier, editor of Parade magazine

Sylvia Chase, ABC News Reporter

Rodolfo Garcia, AP reporter

Linda Goodman, horoscope book author

Anne Rice, “Interview With a Vampire” author

DECEASED

Jack Benny, ’50s television host

James Cagney, producer, director and actor

Alvin Childress, actor (“Amos & Andy)

James Doohan, actor (Scotty on “Star Trek”)

Dale Evans, actress, singer and wife of Roy Rogers

Jackie Gleason, actor and comedian, star of “The Honeymooners”

Dana Hill, actress (“Shoot the Moon”)

Gordon Jump, actor on “WKRP in Cincinnati”

Mabel King, actress who played Mama on “What’s Happening”

Al Lewis, actor (“The Munsters”)

Marcello Mastroianni, actor who appeared in 142 films

Richard Mulligan, actor on the television show “Empty Nest”

Carroll O’Connor, actor (“All in the Family,” “In the Heat of the Night”)

Minnie Pearl, entertainer, actress on the variety show “Hee Haw”

Esther Rolle, actress on the TV Show “Good Times”

George C. Scott, Academy Award-winning actor

Kate Smith, singer who sang classic “God Bless America” rendition

Spencer Tracy, famous leading man of Hollywood movies

Mae West, actress (“She Done Him Wrong,” “My Little Chickadee”)

Jane Wyman, actress on “Falcon Crest”

Yuri Andropov, former premier of the Soviet Union

Samuel Block, civil rights activist

Ralph Bunche, Nobel Peace Prize winner, U.S. ambassador to the United Nations

Lucille B. Chapman, a five-time Menominee Indian tribal chairwoman

Paddy Devlin, co-founder of the Social Democrat and Labor Party in Northern Ireland

King Fahd, king of Saudi Arabia

James Farmer, civil rights pioneer

Anwar Sadat, Egyptian leader

James Conkling, founder of The National Academy of Recording Arts and Sciences

Bill and John Davidson, founders of Harley Davidson motorcycles

Tom Foster, former head of Foster Poultry Farms

W.L. Gherra, of Payless Drugs

Howard Hughes, industrialist, eccentric billionaire

Ray Kroc, entrepreneur who bought and built McDonald’s restaurants into the world’s largest fast food chain

Nat Adderley, jazz trumpeter

Hoyt Axton, folksy baritone, songwriter and actor

Syd Barrett, of the rock group Pink Floyd

Danny Joe Brown, singer (Molly Hatchet)

James Brown, The Godfather of Soul

Johnny Cash, legendary country singer, known as “the man in black”

Johnny Darrell, country music singer

Miles Davis, legendary jazz great

Mama Cass Elliott, singer, Mamas and the Papas

Freddy Fender, actor and country singer

Ella Fitzgerald, jazz vocalist

Jerry Garcia, lead singer of The Grateful Dead

Dizzy Gillespie, jazz trumpeter

Mahalia Jackson, singer

Rick James, singer (“Super Freak”)

Herbert Kahury (“Tiny Tim”), singer (of sorts)

Peggy Lee, ’50s songster

Curtis Mayfield, soul singer

Elvis Presley, The King

Luther Vandross, singer

Morris Braunstein, scientist

Thomas Edison, inventor

Albert Ellis, psychologist, rational emotive therapy

George Minot, first person with diabetes to receive Nobel Prize in medicine

Arthur Ashe, tennis legend

Walter Barnes, former Philadelphia Eagle turned actor

Ty Cobb, baseball player for the Detroit Tigers

Buster Douglas, boxer

Kenny Duckett, football player for the New Orleans Saints

Del Ennis, baseball player

Catfish Hunter, pitcher for the Oakland A’s and the New York Yankees

Ham Richardson, tennis pro

Jackie Robinson, baseball star who broke the color barrier in the Major Leagues

Sugar Ray Robinson, boxer

Jersey Joe Walcott, boxer

David “Boomer” Wells, major league pitcher

Wade Wilson, NFL quarterback

Ernest Hemingway, 20th-century novelist

Ken Kesey, novelist (“One Flew Over the Cuckoo’s Nest”)

Walt Kelly, animator and cartoonist (“Pogo”)

Mario Puzo, author of “The Godfather”

Carl Rowan, syndicated editorial columnist

H.G. Wells, writer, “The Invisible Man”

Laura Ingalls Wilder, author


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BG Levels: Weekly Roundup

This weeks glucose readings were more positive overall. I have found that testing my sugars have made me more aware of what I have been eating and how they have affect my health. Mornings have still been hard for me but with the help of my girlfriend have been able to slowly lower my sugars. She has introduced more healthy snacks before bedtime that wont make my BG rise in the morning and I am thankful for it.

If you have any suggestions for nighttime snacks to keep your blood glucose down and satisfy that unbearable craving, please comment on what you recommend. Without further ado, here are my weekly readings:

Time	Breakfast	Lunch	Dinner
2/16/2009	85	195	80
2/17/2009	252	167	142
2/18/2009	203	55	49
2/19/2009	126	136	47
2/20/2009	342	262	58
2/21/2009	219	89	111
2/22/2009	74	156	N/A

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Glucose Monitor Review

In the next month or so I will be testing and reviewing different brands of glucose monitors. My current meter is over three years old, and I felt it was time to put it in the junk pile. Surfing the web I have found many alternatives, each with a different selling point.

My goal is to review a new monitor each week. I will post a review on each describing the pros and cons with a rating for price, ease of use, appearance, features and an overall rating. These rating will be out of five stars (one being the worst). Pictures will also be included.

At the end of reviewing all the glucose meters I will post my pick for the top three. So far I have sent out a request for six monitors that I have listed below.I will try and get at least ten monitors to review. If you have any suggestions, please leave a comment or email me with a glucose meter you would like reviewed.

Glucose Monitors:

- Nova Max
- Freestyle Lite
- One Touch Ultra Smart
- One Touch Ultra-Mini
- Bayer Contour
- Bayer Breeze2

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Wilford Brimley and Diabetes

Ok, now I don't want to disrespect anyone, but this guy is just hilarious. The first clip is Wilford Brimley and one of the commercials he usually does, funny by itself if you ask me. The second video is one from Family Guy to make fun. So let's relax and enjoy some short videos:





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All About Carbohydrates: By Naomi Cook

Naomi Cook earned her bachelors in Animal Science from Cornell University and received her masters from NYU in Science Education. Currently Naomi teaches AP Biology in Wetchester, NY. She includes concepts from both Type 1 + 2 Diabetes in her core curriculum.

It’s virtually impossible to eat any food that doesn’t contain carbohydrates. This is because all biomass on Earth has its origins in photosynthesis, which produces glucose. It’s also impossible to sustain oneself on a diet that excludes all carbohydrates, since glucose is the main molecule from which a living organism derives its energy for life functions. Why then has it developed such a bad reputation? Probably because diets that are high in simple sugars, a type of carbohydrate, are linked to obesity and the onset of Type 2 Diabetes. And considering that 23.1 percent of the US population 60 years and older suffer from Diabetes, it makes sense that we are hearing a lot about carbohydrates. (National Institute of Diabetes and Digestive and Kidney Diseases)

But information on carbohydrates seems confusing to me. Molecularly, carbohydrates come in many different forms, and our bodies process, store and use each form differently. Depending on the type of carbohydrate we are ingesting, our hormones will respond very rapidly, which is usually not so good, more slowly which is better, or not at all, as is the case with a Diabetic. This makes it difficult to know exactly what a nutrition label means for your body when it says that it contains 23 grams of carbohydrates.

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The molecular building blocks of carbohydrates are simple sugars like sucrose (table sugar) and glucose (the product of photosynthesis). Plants synthesize much longer chains of simple sugars for storage. An example of a storage carbohydrate is starch. They will also synthesize longer chains of simple sugars for structural purposes. An example of this is fiber. When we eat food that lists carbohydrates on its nutrition label, we are probably eating a combination of simple sugars and more complex carbohydrates.
Simple sugars will be absorbed quickly into the blood. In order to respond to the rapid rise in blood glucose levels, the pancreas must respond quickly by producing large amounts of insulin. Over time, the spikes in insulin causes cells to become unresponsive to the insulin and Type 2 Diabetes may develop. The more processed a food is, the more simple sugars it tends to contain. Manufacturers add it to food so that it tastes better. Unfortunately, nutrition labels often do not distinguish between added sugars and carbohydrates that are found naturally in foods.

Longer chains of sugars which may be referred to as complex carbohydrates must be broken down in the digestive system and are generally released into the blood more slowly. This is less stressful on the body. The less processed a food is, the more slowly its constituent sugars seem to be released into the blood stream. Whole grains, fruits and low starch vegetables are broken down and released slowly, causing gradual increases in blood sugar. (Harvard School of Public Health)

Humans are unable to digest fiber, the carbohydrate constituent of a plant’s cell wall. As a result, these sugars are never released into the blood stream and do not add to the calorie content of a food. They do however bind to fats in the intestines, carrying fatty substances out as waste, and contribute to a person feeling full. Therefore, when looking at the nutrition label, it is important to take the fiber content into consideration when looking at the overall carbohydrate content. Fiber does not increase blood glucose levels.

Since the rate at which sugars are released into the blood seems to play an important role in how much stress your body experiences after a meal, scientists have begun to categorize foods based on their glycemic index. For example, potatoes are filled with the complex carbohydrate starch, which seems to be broken down and released as simple sugars into the blood just as quickly as the added simple sugars from a processed food product enter the blood stream. Foods with a lower glycemic index release their sugars more slowly than foods with a higher glycemic index. While it is still debatable whether or not foods with a high glycemic index can be linked to things like Type 2 Diabetes or obesity, it is a unique way of analyzing different foods. It does not however, take into account carbohydrate density of foods. For example, watermelon has a high glycemic index, but its carbohydrate density is so low, that it ends up releasing very little sugar into the blood. (Harvard School of Public Health) A comprehensive glycemic index of foods may be found at http://www.glycemicindex.com/.

When planning meals, it is still helpful to just go with the nutrition label. The American Diabetes Association recommends that Diabetics take 45-60 grams of carbohydrates per meal. (American Diabetes Association) Foods that contain carbohydrates, whether complex or simple, need to be taken into account when Diabetics are planning meals. These foods are breads, cereals, crackers, rice, fruit, yogurt, juice, milk, beans and soy products, potatoes, corn, sweets and juice. Non-starchy vegetables such as lettuce and peppers do contain carbohydrates, but very little in comparison. (American Diabetes Association) Again, it is probably best for as many of those 45-60 grams of carbohydrates to be from unprocessed foods such as whole grains, fruits, vegetables and beans.

The American Diabetic Association has an incredibly helpful interactive website that allows users to find the nutrition information on almost any natural and many processed foods. It also allows the user to create meals by adding ingredients and changing serving sizes to view the total nutrition content of the full meal. Nutrition content of foods can be directly compared, and the website can find healthier alternatives to ingredients. I have found it helpful even though I am not a Diabetic. You may access the link here. Happy eating!

Work Cited
American Diabetes Association. "Carbohydrate Counting." February, 2009.

Harvard School of Public Health. "Carbohydrates: Good Carbs Guide the Way." February, 2009.

National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Statistics, 2007 fact sheet. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, 2008.

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BG Levels: Mid-Week Update

Below are my blood sugar results for the first half of the week. Starting at dinner time on Monday, I began testing with the new Nova Max glucose monitor which I received for free from an online survey. Previously I was using a One Touch Ultra monitor, but have decided to start reviewing other monitors for me and my Diabetic audience. Next week I will start posting full reviews of each monitor with pictures.

Time	Breakfast	Lunch	Dinner
2/16/2009	85	195	80
2/17/2009	252	167	142
2/18/2009	203	55	49

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Mourning the Dead

Today was one of grieving for a fellow co-worker. My co-worker's father passed away last Sunday and today they held what is called the Shiva in Jewish tradition. My co-worker is a good man and I believe that his father, even though I never met him, must have been also. He has a beautiful family and many loving friends, all that came to visit today. My heart goes how to him and his family as they deal with the loss of someone special.

I am not feeling well tonight so I will leave you with some information regarding the Shiva with a link to more in-depth information:

After the burial, the immediate mourners return to a home called the "shiva house," to begin a seven day period of intense mourning. Shiva is from the word sheva, which means seven. This week is called "sitting shiva," and is an emotionally and spiritually healing time where the mourners sit low, dwell together, and friends and loved ones come to comfort them with short visits referred to as "shiva calls."
Read more about the Shiva stage in Jewish Mourning

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Blogs On My Radar

Below are some of the blogs and forums that have appeared on my radar recently. I would recommend checking out these sites and reading a little, you might find something special. These blogs contain recent Diabetes news, personal stories, chats on different subjects regarding both Type 1+2 Diabetes and communites for you to share your pain and joy with.

- The Diabetes OC

         - TuDiabetes.com

                    - Diabetes Forums

                            - Sugar Free Style

                                          - Diabetic Supply

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BG Levels: Weekly Roundup

As promised, here is my roundup of BG levels for the week ending 2/15/09. As you can see, my results have been wobbly at times, especially in the morning, but I have gradually tried to lower them. My one true hiccup came during my climbing competition on Valentines Day. I took care of the situation quickly and efficiently to stabilize myself. Here is the table for the week, excluding tonight's dinner, which hasn't happened yet:

Time	Breakfast	Lunch	Dinner	Random	Random
2/9/2009	250	232	165
2/10/2009	253	135	102
2/11/2009	181	88	211
2/12/2009	307	55	61
2/13/2009	75	58	72
2/14/2009	245	76	495	242	88
2/15/2009	180	148	N/A

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Climbing High

Before I begin, I want to wish everyone a Happy Valentines Day!

Today I competed in the Manhattan Plaza Health Club rock climbing competition located in New York City on 43rd and 10th. I have been climbing for the past two and a half years and have competed in several competitions, mostly for fun and to satisfy my competitive side.

Starting at 1:30 today, 90 competitors from beginner to advanced, young and old put their strength and endurance to the test for the next three hours. The climbing gym is smaller than average being that it is in a confined part of the main gym which is housed in an apartment style high rise in NYC.

I started the climbing day feeling well, energized and I checked in with a blood sugar reading of 75 while having lunch an hour before the competition with my girlfriend. After a quick warm up I started to tackle the harder problems.

After a hour and a half, I felt a little tired so a short rest was in order. I supplemented my decreasing energy with a power bar which happened to be a disaster in the long run. This will teach me to test my BG level before eating anything of significant nutritional value.

I continued climbing for the next hour and a half slowly getting more and more irritated from the crowds, small spaces and inability to finish problems. My legs felt heavy and I didn't want to climb anymore. I decided to leave early with my girlfriend because of the way I felt and we needed to attend a Bar Mitzvah later that night.

We arrived at Grand Central by subway 15 minutes before our train was supposed to leave. "Do you have my water bottle?" I received a Sigg water bottle as part of my Valentines day gift. "No, is it in your backpack?" Thrashing through my bag I couldn't find the bottle. I must have left it at the gym.

I wanted to explode, scream out loud my anger. How could I lose something I had just received that morning? For some reason I couldn't handle this thought or mishap or whatever you want to call it. Sitting down on the train I pulled out my glucose monitor and tested my sugar level. 495.

It's funny how much an out of whack BG level can affect your mood and body. If I checked my sugar before eating that power bar earlier, I would have found out that I didn't need it. Maybe a shot of insulin instead, or nothing at all. I was able to manage the lowering of my glucose within the next hour by injecting myself with Apidra insulin. Another life lesson learned through a simple misstep.

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Mahi-Mahi Spinach Salad

I made this dinner last night and it tasted great. It is also very healthy too! Lot's of protein, little carbs and a bunch of veggies. This recipe will provide 2-3 servings depending on the size of your stomach. This recipe was made up on the fly by me, so you won't find it anywhere else:

Ingredients:
- 2 Lemons
- 1 Lime
- 1 Red Bell Pepper Sliced Thin
- 1 Green Bell Pepper Sliced Thin
- 1 Golden Delicious Apple Dice
- 1 Cucumber Sliced Thin
- 1 Bag of Baby Spinach Leaves
- 1.75 Pounds Mahi-Mahi
- 2 Cloves Garlic Minced
- 2 Tbsp Olive Oil
- 2 Tbsp Dried Basil
- 2 Tbsp Thyme
- 1 1/2 Tbsp Salt
- 1 1/2 Tbsp Black Ground Pepper

Mix the baby spinach leaves, 3/4 green bell pepper, 3/4 red bell pepper and cucumber into a large salad bowl. Place in refrigerator.

Remove the skin from the mahi-mahi and cut into 1/2 inch cubes. Lay mahi-mahi onto a sheet of tin foil. Mixing with your hands, add basil, thyme, 1/2 tbsp salt and 1/2 tbsp of black ground pepper.

Put olive oil into a large skillet and cook over medium-high heat for 1 minute. Add garlic, stir and cook for 1 minute. Add mahi-mahi to skillet, turn fish to cover with oil. Squeeze 1 lemon and 1/2 lime onto mahi-mahi and stir/flip. Add remaining red and green pepper to skillet and mix. Continue to mix while cooking for approximately 4 minutes or until fish seems fully cooked.

Add apple to salad bowl and mix. Now take the mahi-mahi with the oil and mix into salad bowl. Squeeze 1 lemon and 1/2 lime into bowl and mix. Sprinkle remaining salt and pepper into salad bowl and mix again.

You're done! Now sit down and enjoy.

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BG Levels: Bi-Weekly Update

I've decided to do a bi-weekly update instead of the usual day to day frequency. This was clogging up my blog to much. So I will give you a mid-week update on Wednesday and a weekly summary on Sunday. I have put the results in a fine looking table, so enjoy:

Time	2/9/2009	2/10/2009	2/11/2009
Breakfast	250	253	181
Lunch	232	135	88
Dinner	165	102	N/A

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What I Learned: Reliving the Holocaust

My trip to Washington, DC brought some unforgettable surprises with my Diabetes. Here are several important things that I learned from it:

1. Intense heat can play havoc on your sugar levels.

2. Eat small snacks in between a long delay of meals to keep you BG levels in check.

3. Wear a medic alert bracelet or necklace, it saved my life.

4. When not feeling 100 percent, tell someone.

5. Check your blood sugar with a glucose monitor frequently.

6. Don't walk across four lanes of traffic!

7. Now being older, I actually like Vermont quite a bit. It's a very peaceful place with great people and scenery. The skiing also rocks!

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Walking Small: Reliving the Holocaust

Spring in DC felt like summer in Africa. Temperatures were soaring and the soles of my shoes were getting up close and personal with the concrete in a sticky way. The couple of days away from the normal grind of classes were welcomed, no matter how hot it was.

Once a year, sophomores at the Green Mountain Valley School are treated with a trip to either New York City or Washington, DC. Since I had been to The City so many times before, I decided to go against the grain and check out our nation's capital instead. The trip from Vermont to DC was long, but I didn’t mind. I was escaping from Vermont, for young people a not so exciting state, unless if you are really into cows and Ben and Jerry’s. Our first stop on the trip was a gloomy one, the Holocaust Museum.

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"The Holocaust is the state-sponsored systematic persecution and annihilation of European Jewry by Nazi Germany and its collaborators between 1933 and 1945. Jews were the primary victims -- six million were murdered; Roma and Sinti (Gypsies), people with mental and physical disabilities, and Poles were also targeted for destruction or decimation for racial, ethnic, or national reasons. Millions more, including homosexuals, Jehovah's Witnesses, Soviet prisoners of war, and political dissidents, also suffered grievous oppression and death under Nazi Germany."
(Source: USHMM FAQ)

The building looked like a concrete fortress on the outside surrounded by a moat of flowing street traffic. With the hot sun beating down upon our bodies, our school group rushed inside to the museum’s wonderfully accurate, cooled enclosure. The day was young and we were full of energy. Each of the three floors of the museum would provide our eager minds and bodies with the entertainment we would need for the next several hours.

I took it all in, and as quickly as possible. My attention span seemed minimal at best as I shot from one exhibit to the next. In what seemed to be approximately 5 minutes, I and a few friends had navigated through the three floors; it had all gone by in a blur. Considering that the rest of our group was only half-way through the tour, one more go-around seemed appropriate, so we started our sprint again.

Were we running? It felt like it as the exhibits passed by with blazing speed. The air is getting hotter in the building, maybe they had turned down the air conditioning to save money. My legs were tired from all this exercise. I had finished my walk through again before the rest of my group had even finished their first. I sat down on a marble bench near the entrance. The dome that enclosed the entrance was ever so slightly expanding before my eyes...

Had I fallen asleep? I think I'm dreaming. Feeling as light as a feather I levitate to my feet. My steps seem to slow in my dreamlike state. I'm not controlling my body anymore as some supernatural power floats me from one point to another. I can see people walking by me as I open the doors to another world. Everything is bright, hazy and feels soft to the touch. Am I dead? This place doesn't look like heaven...

And heaven it was not. The quick pulsating sounds of the ambulance brought me back to reality. Awkwardness stared back at me in the form of a paramedic. His eyes darted away as he checked my vitals. Not again I thought to myself. My mind had cleared, I know what had probably happened, I just couldn't remember how or why.

"I’m going to ask you a few questions, answer them to the best of your knowledge.", "Ok.", "What’s your name?", "Marc Epstein", "When where you born?", "February 25th, 1984", "What year is it?", "2000". There was one question that baffled me, an important one, "Where are you right now?", "An ambulance", "I meant, what city?", "Um...I don't know". How could I not know where I am? I thought long and hard, but the answer never came to me. The ride seemed short but stressful to the hospital.

I lay in confusion on the hospital bed for what seemed like hours. Would my group ever find me, would I be in trouble? Had I done anything absurd? I gave the nurses all the information I had about the school I went to, what my teacher's names were. They took the information from my medical alert necklace to call my parents and inform them of the situation.

Somehow, without my knowledge, the connections were made and my group was notified of my location, which I still was unsure of. When I was finally picked up by my caretakers, I was given the story of what supposedly happened.

More than likely, all the running around had put some strain on my blood sugar levels. I hadn't eaten anything since breakfast and by the time I had finished my second viewing of the Holocaust Museum it was already around 12:30pm. Combining this with the extreme temperatures outside threw me into a Diabetic reaction. One that made me lose all touch with reality.

I had wandered around the main entrance hall of the museum for a few minutes, and then decided to venture outside, never a good thing when you're in a drunken like state. After taking in the view, I decided to go for a stroll across 4 lanes of traffic. Fortunately a police officer noticed me before I was struck by a moving vehicle. He grabbed me, called for an ambulance, and then I was whisked away. The rest, is history.

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BG Levels: The Weekly Roundup

Even though my blood sugar testing started out very sporadic, I'm glad to report that Sunday was a lot smoother. I feel that my morning levels are high due to my craving of food right before bed time. This is something that I will have to gradually reduce as time passes.

Last night I had a bowl of Lucky Charms before falling asleep. My sugar suffered a bit in the morning, but it felt so worth it! Maybe I can cut down to half a bowl :). Well, without further adieu, here is the weekly roundup of my sugars including today:

2/5/09:
9:45pm - 129
2/6/09:
7:32am - 239
12:50pm - 67
7:40pm - 278
9:53pm - 50
2/7/09:
9:00am - 200
12:30pm - 194
5:30pm - 65
2/8/09:
7:45am - 209
1:24pm - 130
7:17pm - 110

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BG Levels: Update 2/7/09

So my second full day of testing has shown some sporadic results. I feel that this may be because I am overreacting to a result and counteracting with either too much insulin or too much food. In the long run I would like to eventually show a more stabilized pattern in my BG testing. Currently I would be comfortable with a range from 100 to 125.

Personally when I get to around 80, I feel a little nervous. Last night right before dinner I had a high sugar and decided to take 5 units of Apidra to lower it. Unfortunately I decided to skip out on all the carbohydrates in my meal and eat just the chicken and salad (no bread). When I checked myself later that night, my sugar had dropped a little quicker than I expected. I drank a glass of OJ to fix the problem.

I also had a snack bar before bed, but probably didn't need it as you can see from my morning result:

2/6/09:
7:40pm - 278
9:53pm - 50
2/7/09:
9:00am - 200
12:30 - 194

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BG Levels: I'm Checking In

Ok, I'm going to tell you a little secret. I haven't been checking my blood sugar levels consistently for quite some time now. Every once and a while I go through a phase where I start checking my BG (blood glucose), and I try to stick with it, but then something clicks off in my brain and I stop testing.

So from last night at about 9:45 I will start checking my levels again, hopefully for good. I will update you daily with a single posting of my blood sugars for that day and then a weekly roundup at the end of the week. If I don't post my BG levels for a certain day that could mean one of two things: either I forgot to post or I have stopped monitoring.

If I stop monitoring, feel free to send me a nasty email or comment via the posts (not too nasty please :) ). My goal is at least 3 checks per day (breakfast, lunch, dinner) Below are my BG readouts from last night until lunch today:

2/5/09:
9:45pm - 129
2/6/09:
7:32am - 239 (Little high, I had a bite to eat right before sleeping)
12:50pm - 67 (Eating a little later than usual - work related)

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Diabetes 101 - By Naomi Cook

Naomi Cook earned her bachelors in Animal Science from Cornell University and received her masters from NYU in Science Education. Currently Naomi teaches AP Biology in Wetchester, NY. She includes concepts from both Type 1 + 2 Diabetes in her core curriculum.

Diabetes is literally a disorder that results in increased urination. This can be directly caused by a higher than normal blood glucose (sugar) level, as the kidneys work harder to rid the body of the excess glucose. The hormone insulin is produced by the pancreas and acts like a chemical messenger that instructs cells to allow glucose in. Once in the cell, glucose can be oxidized to release energy for life functions or it can be stored in the cells of the liver as a molecule called glycogen. When insulin is produced and cells are responding to it properly, blood glucose levels are stable. When a person’s cells become either unable to respond to insulin or unable to produce insulin, blood glucose levels increase and Diabetes results. There are two types of Diabetes, Type I and Type II.

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Type I Diabetes occurs when the body stops producing insulin, usually during childhood. The Type I Diabetic injects insulin in order to regulate his or her own blood glucose level. There is currently no cure for Type I Diabetes. Type II Diabetes occurs when the body continues to produce insulin, but cells become unresponsive to the insulin. Therefore, Type II Diabetics do not take insulin. Instead, they regulate their blood glucose levels through diet and exercise. Unlike Type I, Type II Diabetes usually develops in adulthood.

In Type I Diabetes, the insulin producing cells of the pancreas called the Islets of Langerhans, are attacked by the person’s own immune system. We do not know why this happens yet, but it usually occurs in childhood and scientists think that it may be linked to genetics or viral infections. As a result, that person stops producing insulin, and blood glucose levels increase. This is called hyperglycemia and occurs when a Type I Diabetic eats a large meal. The person will experience increased urination, thirst, fatigue, blurry vision and nausea. In order to prevent this, he or she injects insulin, which will lower blood glucose.

If too much insulin is taken, hypoglycemia (low blood sugar) can occur. This is process is exaggerated with either not enough food intake or when the person engages in physical activity. The symptoms of hypoglycemia are sweating, shakiness, hunger and dizziness. If not treated, hypoglycemia can result in slurred speech, drowsiness, confusion and in its worst case, diabetic coma as the organs of the body shut down because they are starved for glucose. The most effective treatment is ingesting anything with high levels of sugar such as juice or candy.

A condition called ketoacidosis may also result because cells are not getting the glucose they need. This can happen if the Diabetic is not taking his or her insulin and glucose is not able to enter into the cell. Cells will begin to excessively utilize fats and proteins for energy. Unfortunately, the byproducts of this reaction are ketones, which are toxic to the body.

The Type I Diabetic is responsible for lowering blood glucose after a meal by injecting insulin, but not letting it get so low that hypoglycemia begins to happen. It’s a difficult task. Because insulin is a peptide (a small protein) it can not be taken as a pill. Proteins are digested into their amino acid building blocks in the stomach, before the Diabetic can absorb the insulin into the blood stream. Therefore, it must be injected, making treatment even more complicated, but extremely important.

If not controlled, the short term effects of hypoglycemia can be dramatic and dangerous. The long term effects of hyperglycemia can seriously affect quality of life. Damage to the tissue of the heart can lead to heart attack, stroke and high blood pressure. Damage to blood vessels serving the retina can lead to blindness. Nerve damage in the leg may lead to tingling, numbness and an inability for wounds to heal. Nerve damage to the kidneys can result in kidney failure.

In Type II Diabetes, the person’s cells become unresponsive to insulin, even though the pancreas continues to produce it. Similar to Type I Diabetes, blood glucose levels will increase. Because cells are unresponsive to insulin, Type II Diabetics do not control their sugar by taking insulin. They must do so through diet and exercise. As Type II Diabetes progress, the pancreas continues producing insulin even though cells remain unresponsive, and can eventually become overwhelmed. At this point, the Islets of Langerhans stop producing insulin and the Diabetic may need to start insulin treatment. Type II Diabetics can suffer from hyperglycemia and will also suffer from hypoglycemia if they are on glucose lowering medications. If blood glucose is not regulated, the long term effects of hyperglycemia will damage tissue just as it does with the Type I Diabetic.

Although the exact mechanism for developing Type II Diabetes is unknown, certain factors seem to increase the likelihood that a person’s cells will become unresponsive to insulin. Excess fatty tissue and inactivity is linked to Type II Diabetes. Unlike Type I Diabetes, a person’s risk increases with age. There also appears to be a genetic link to Type II Diabetes. A person’s risk increases if a sibling or parent has the disease, and certain races such as Asians Americans, Native Americans, Hispanics and Blacks have higher incidences of Type II Diabetes.

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Walking Tall: Biking for Charity

This past summer I started biking(road cycling) to help with my cardio. For me running puts a lot of stress on my back and feet so I wanted to find an exercise that was fun, exciting, and kept me in shape. Biking is all that rolled up into one.

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While riding during the summer I noticed a charity bike event for the Kelly Brush Foundation called the Kelly Brush Century Ride. I decided to sign up for 1 loop which is half of a century (50 miles).

Starting out was tough, as is with almost any sport, but once I started to get into better shape, I noticed my mileage increasing each ride. 50 miles seemed like an unreachable distance at first, but a friend of mine let me tag along with him while he rode which kept me motivated. We pushed each other to the next level every mile we rode.

The training cut off extra fat from my body, I felt better than I ever did, and my metabolism shot up decreasing the amount of insulin needed for my Diabetes. Riding outside on the warm summer days was joyful and helped me forget about any problems I was having with normal day life (at least temporarily). Relieving stress is an important part of Diabetes control for me.

Well the day came for my charity bike adventure and I felt both nervous and prepared. The weather was a little cloudy and cool, perfect for biking. I decided to bring with me two power bars, a bottle of water and a bottle of Gatorade/water mix. Its always important to be prepared for any type of exercise with food and water, Diabetic or not. My bg tested normal and I was ready.

The ride started out strong with me keeping pace with the top guys in the event. I know it wasn't a race, but I have such a competitive nature! After about 12 miles I decided to drop off of the front peloton to conserve energy because I knew that I wouldn't be able to keep up that pace for 50 miles. Around mile 20 I decided to eat half of my power bar to keep my carbohydrate levels up. I felt strong all the way until about mile 40 and then the long hills came into play.

Never been a great hill climber (in my minimal experience), but I kept pushing, even at a slower than average pace. I wasn't with the elite, but I was doing better than the average cyclist in the event. I was tired for the last 3 miles of the ride but when I saw the finish I realized that I had accomplished my goal.

I finished the ride in 2 hours and 37 minutes, around a 19 mph pace. I felt great. My blood sugar was in check throughout the whole ride, I had fun, and I did better than I expected. I guess you can say that I was Walking Tall that day, or would that be riding?

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