Diabetic Friends Action Network (DFAN)
Online Diabetes Newsletter - June 1996 Edition

June is the month for flowers, pools, barbecues and suntans.  It's
also a month of oppressive heat.  If you're going to be outside
take special care of your diabetes supplies.  Keep your insulin in
a place where it will stay cool.  Don't put it right next to the
ice in your cooler or it might freeze.  There are cases available
that will allow you to keep your insulin, syringes and other
diabetes supplies in a safe place during the summer.  If you can't
find any at your local pharmacy try to get a copy of Diabetes
Forecast and look in the ad section.

Our weight loss club now has 106 members so far and I'm happy to
say that it's still growing!  If you need to lose weight or would
like to maintain your weight why not join our free weight loss
club?  Our daily club e-mails include a phrase for the days,
motivation, information, and daily club news.  We also have weekly
club files, recipes, and a club project that will help you with
your diabetes management plan in some way.  If you're interested in
joining or would like to receive a sample club e-mail send your
request to: BELVE@AOL.COM

We have no articles or poems for next month's newsletter so if
you'd like to send one in please don't hesitate.  It can be fiction
or non-fiction.  Your story can be happy, sad, angry, fearful or
any other emotion you'd like to share with out readers.  This
newsletter depends on your stories.  Your story or poem can be five
words or five hundred.  It's up to you.  Send your stories or
inquiries to: BELVE@AOL.COM

Our text file offers have been a great success so and we'd like to
thank all of you who requested them.  This month we are offering
the following files for upload to your e-mail box:

File #1: Chromium & Diabetes
File #2: Diabetes & Vascular Damage (Diabetic Complications)

If you'd like to read any of these files please specify that you
want the "June Files".  State if you want "#1", "#2", or "both".
Send your request to: BELVE@AOL.COM

One more thing.  Last month my computer crashed.  About 80 e-mails
got deleted so if you requested to be taken off the distribution
list or requested an e-mail address change please send me another
e-mail and you'll be removed.  Also if you were on the weight loss
club distribution list and stopped receiving club e-mails please
let me know so I can add you back to the list.


_____ARTICLE_____

/BLAMING NO ONE

I wasn't used to "being a diabetic" so when I was told I had
to go see a dietician I was happy that I would finally be
learning something about what I could and couldn't eat.  I was
scared too, but that had to be put on the back burner.  It was
time to get some of the knowledge I needed.  My father was
with me for this visit with the dietician.  At that time he
had Type II diabetes for about five years.  He was coping with
it very well.  My Dad was the first diabetic I had known
personally so I was relying on him a lot.

We were a bit early so the dietician wasn't at her office.  My
Dad and I made small talk while we waited.  Finally the
dietician arrived and she started to tell me about how what I
ate would have a great influence on my diabetes control.  I
spent about a half hour with her learning everything from how
to prepare my meals (very little frying, low-fat foods,
etc...) to what I should eat when my blood sugar went low.

The conversation then moved on to how I got diabetes.  This
wasn't on my mind much because I was too busy being nervous
about things.  The dietician explained to me that my diabetes
was passed down to me from my Dad.  When my Dad heard that he
really got upset.  He asked, "What do you mean I made her get
diabetes?".  The dietician went on to explain how diabetes is
passed from the parents to the children.  My Dad just got more
upset.  He said, "I didn't give her diabetes!"  I could tell
that if I didn't get my Dad out of that room things might get
out of hand.  So the visit was cut short and we left.

I didn't think about what happened for a long time.  Then one
day I started wondering how my Dad must have felt.  To feel
that he had been "blamed" for giving me this disease that no
one wants to have.  "Blamed" for giving me this disease that
brings daily challenges into my life that sometimes leaves me
in tears.  The dietician and I didn't blame my Dad for
anything.  Yes, some of his genes may have made me susceptible
to getting diabetes but it isn't anything that he did
deliberately.  He has diabetes too so I know he would never
want me to have to go through what he's gone through.

My Dad hasn't always told me what I wanted to hear.  Sometimes
I don't agree with the choices he makes.  But I do know one
thing.  I know he isn't the one to "blame" for me getting
diabetes.  No one is to blame.


_____ARTICLE_____

LOSING WEIGHT FOR BETTER CONTROL

A weight reduction plan can be another "tool" you can use in
your diabetes management plan.  Yes, losing weight can help
you just as much as insulin, oral medications, and blood
glucose testing strips.  Losing weight isn't easy for anyone
to do and when diabetes is also involved it can bring new
challenges and obstacles to your weight reduction plan.
Although it can be difficult to lose weight there are things
you can do to help shed some pounds so you can feel better
and get your diabetes under better control.

First, always make sure the weight reduction plan you want
to use is approved by your doctor.  There may be certain
foods you're not supposed to eat or certain exercises you're
not supposed to do.  For example, people with retinopathy
should stay away from weightlifting since they could
re-injure their eyes.  So check it out with your doctor
FIRST.

Linda shares, "The first thing my doctor and I discussed
after diagnosis was weight loss.  Our next appointment will
be totally dedicated to weight loss."

If you were overweight prior to being diagnosed with
diabetes the fact that you have diabetes might be the only
incentive you'll need to lose weight.  For some Type II
diabetics losing weight is all that is needed to get their
blood glucose levels down closer to normal range.  That can
be a powerful incentive to slim down.

When asked if it was easier for her to lose weight after she
was diagnosed Linda says, "Actually, I have found it easier
to lose weight since I was diagnosed.  I now have an added
incentive to lose weight.  Now I know weight loss will make
me healthier and if I don't drop the pounds I am putting
myself at increased risk."

You may also need to deal with some emotional issues in
order to lose weight.  You may have eaten for years eat
because of stress, anger, or sadness and you'll have to find
another way to deal with these emotions besides eating.
Finding
another outlet for these emotions may be difficult but it's
worth the effort.

Pat, a Type II diabetic who has been overweight most of her
life says that she had to learn how to cope with anxiety and
tension without eating, "Fat and sugar were my consolation
friend when I was hurting from the pain of the day, whether
it was pain from stress or some other emotional pain.  I
could always eat a big bowl of ice cream and find myself
humming a happy tune."

Losing weight can be thought of as a complete lifestyle
change that will last for the rest of your life.  Don't
think of it as something you only have to do for a limited
amount of time.  If you want to lose weight and get your
diabetes under control, your new weight reduction plan must
be in effect constantly and consistently every day from now
on.

Ken, who has dealt with Type II diabetes for six years also
has heart disease.  He has reached his goal weight and
shares, "I was overweight for ten to fifteen years.  When I
was diagnosed with diabetes, I began to watch both my sugar
and carbohydrate intake and added regular exercise.  But I
believe the exercise made the difference."  Ken walks for
thirty to forty-five minutes daily, (weather permitting) and
also uses a stationary bike and cardio-machine (exercise
machine).

You're not a robot so don't expect yourself to do everything
right.  There will be times when you make a mistake and eat
something that's not on your mealplan or you may not
exercise for a day or two.  The trick is to get back on your
plan as soon as you can.  Don't be too hard on yourself.
Yes, you made a mistake but you don't have to let that small
mistake foul up your entire weight reduction and diabetes
management plan.

Carolyn has had problems exercising and drinking water, "I
sometimes have problems eating more than I should at a meal.
Sometimes I'll sneak a piece of chocolate after dinner, when
I'm out of exchanges for that meal. At least it's sugar-free
chocolate.  And there are times when I'm not honest with
myself about it.  But I am getting better about it."
Carolyn is working on losing weight to help control her
diabetes, "I don't have an option to lose weight.  This is
not a diet but a change in lifestyle.  By getting in better
shape my diabetes is under control and I hopefully will have
a longer life."  Carolyn has been a Type II diabetic for
five months.

There may be times when you find yourself or others
sabotaging your weight loss efforts.  If you find yourself
skipping meals, that may lead to overeating when you finally
have your meal.  If you're making excuses for not exercising,
try not to miss too many days before you start exercising
again.   If members of your family are constantly offering
you foods that aren't on your meal plan, explain to them that
you're trying to lose weight and they can help you a great
deal if they don't offer you any off-limit-foods.  Once you
explain your goals to your family and friends you might even
find that they try to help you.

Barb, from Westminster, Colorado says, "Having diabetes has
helped me lose weight.  It actually helps in that people
don't try to make me eat sweets.  They tell me not to eat
things!  They're nosy, but caring."

If you're thinking about using a commercial weight loss
service, such as Jenny Craig, etc.., there are a few things
you should think about.  Make sure the commercial weight
loss service you choose knows how to help a person with
diabetes lose weight.

Diabetics have special needs that must be taken into account
when planning a weight reduction plan.  For example, a
non-diabetic might be told to never eat candy.  A person
with diabetes might have to eat candy in order to treat a
low blood sugar reaction.   There are also certain exercises
people with diabetes can and cannot do depending on whether
or not they are suffering from diabetic complications.

Helen, a Type II diabetic used Weight Watchers prior to
being diagnosed, "I did well while I was on the program but
I haven't gone back."  Helen is still trying to lose weight
and recognizes her progress as well as what she needs to
work on, "I'm writing everything down but I still tend to
skip meals, and then overeat.  Exercise is also a problem
for me due to a back injury."

If you go to a commercial weight loss service and they can't
convince you that they know how to help a person with
diabetes don't use that service.  Here's one specific
question you can ask a commercial weight loss center before
you decide to use them:

Question: Do you have specific weight reduction plans for
people
with diabetes?

If they tell you "Yes", ask to see the plan and check it out
with your doctor BEFORE you sign up.  If they say "No", walk
out the door.

You may have heard about the Phen/Fen diet which uses
medication to help people lose weight.  These medications,
Phentermin and Fenfluramine have given some people great
results.

Tony has been overweight all his life.  "I've had Type II
diabetes for about five years.  A couple of months ago I
heard about Fen/Phen and it sounded good, so I tried it.  A
combination of getting older and complete inactivity was
becoming more and more annoying and I thought losing weight
would help."  Tony lost weight using Fen\Phen but had to
stop using it, "I lost nine pounds the first week, two
pounds the second, and one pound the third.  However,
because of the dramatic decrease in weight loss and three
side effects I quit taking Fen/Phen.  My vision had become
blurred, my feet ached terribly at night, and I only had one
good night's sleep in all the time I was taking the
medication."

You may also want to find out about support groups for
people who want to lose weight.  It may be better to find
support groups that have diabetic members so you'll have
someone to talk to about your diabetes related weight loss
needs and concerns.  If you can't find any support groups
for diabetics trying to lose weight join one for
non-diabetics, but always adapt their goals and suggestions
to your diabetes management plan.  Try not to join a support
group that gives you suggestions that would be detrimental
to your diabetes control.

Here are some things you can do when you start your weight
reduction plan:

1) Clean out your cabinets - get rid of the foods you that
aren't on your mealplans.  If the rest of your family will
eat these foods then put them on one side of the cabinet.
Put your foods on the other side.

2) Make sure you have the correct snacks around the house -
It's easier to eat the right snacks when they're readily
available to you.  Try to avoid snacks that are high in
sugar and fat (if you're on a low-fat diet).  Add them to
your regular shopping list and keep them in the refrigerator
and cabinet.

3) Choose your exercise realistically - make sure you choose
and exercise that you LIKE to do (or you should at least be
able to tolerate the exercise).  If you know you don't like
the outdoors don't go out and buy a bicycle which will end
up sitting in the garage gathering dust.  If you know you
don't like to exercise in front of others don't buy a
membership at a gym, etc...  Walking is an exercise that
most people can do and the only thing you need are some
comfortable clothes and a good pair of walking shoes.

4) Start a food journal - write down everything you eat
including single pieces of candy, sticks of chewing gum,
"tastes" of food while you're cooking, and anything else you
eat.


Here's some advice from people with diabetes who are trying
to lose weight to get their diabetes under control.

Advice #1:

Be sensible.  Don't expect it to happen right away.  Give
yourself time - six months, a year, - but stick with it.  I
write my weight down so I can see it.  I might even graph
it.  Also, don't let weight loss be your goal.  Good control
should be the goal.  I live by my blood glucose readings.
If they turn out high, I really pull in the reins.

Advice #2:

Just keep plugging away, if you are not losing the weight
you want to make sure you are weighing and measuring your
food.  That is what will get me sometimes.  Don't guess, be
exact.


Advice#3:

Don't give up, and if you can get a family member or friend
to help you and be supportive.  Also try a new food or
recipe at least once a week.


Advice #4:

"Exercise"


Advice #5:

The one piece of advice that I would give anyone, diabetic
or not, who is trying to lose weight is not to get
discouraged and not to get down on yourself for a mistake.
We are all human.  No one is perfect, so if you don't follow
a plan exactly one day (or one meal) there is no reason to
give up.  Its just an incentive to continue to work hard at
it.  Instead of looking at the mistakes, look at all the
positive things you've done.   Congratulate yourself for
walking only 15 minutes instead of saying I should have
walked for half an hour.  You did something and that's
better than nothing.


Advice #6:

Set small goals.  Start with a goal of "things" rather than
pounds.  For example, a goal of keeping a meal plan for a
week.  Then the next week set a goal of exercising each
week.  After these goals are met and instilled set a goal of
losing one pound
per week.


_____POLL RESULTS_____

Last month's poll question asked:  Have you ever felt ashamed
or embarrassed to let your doctor know you've been getting
high blood glucose results from your home testing?  How did
you deal with this problem?

Here is a response we received:

"I have always kept a log of BS readings (usually in a BM log
book) and\I always show this to the Dr.  Any particularly high
values can usually be explained and I normally annotate the
log with potential explanations: e.g. "Fred S. 40th birthday"
or "pasta!".  I find that this helps reduce any guilt feelings
on my behalf and censure on the Dr's part associated with
higher readings.  The bottom line though, is that glycosylated
hemoglobin is a more important indicator of control
than spot readings recorded by me - fortunately my Dr. is well
aware of this."


GLOSSARY:

Glycosylated Hemoglobin Test - a blood test that measures a
person's average blood glucose level for the past 2-3 months
period before the test.  Also referred to as Hemoglobin A1C.


_____THIS MONTH'S POLL QUESTION_____

Next month's issue of our newsletter will include an article
dealing with food issues.  Making friends and family realize that
food isn't just something you can have whenever you want it can be
a difficult task.  Have you ever had to deal with a friend or
family member who tries to get you to eat foods that aren't on your
mealplan?  How did you deal with the situation?

All responses will be kept confidential.


_____ARTICLE_____

111 AND GOING STRONG!  THERE'S STILL TIME TO HELP!

The Lifescan offer the Meter Bank is currently taking
advantage of ends 7/31/96 so there is STILL TIME to help
someone with diabetes get a free meter.  The free meter
coupons received will be valid until 10/31/96 so they will
still be able to be distributed after the Lifescan offer has
expired.

If you have any Lifescan Lifepoints and/or Lifescan
fulfillment coupons please send them in to the Meter Bank as
soon as you can.

The Meter Bank has placed *111* meters into the hands of
diabetics all around the world!  This is a worthwhile cause so
why not take the time to send in your Lifepoints?

There is also an urgent need for Lifescan Free Meter
Fulfillment coupons (in specially marked boxes of Lifescan
strips).  If you run across these fulfillment coupons please
send them to Richard so he can use them to help more
diabetics get free meters.  If any of your family members or
friends use Lifescan strips please let them know about the
Meter Bank and the need for these fulfillment coupons.

The Meter Bank also needs the following:

Meter Coupons that sometimes can be obtained from Lifescan.
These coupons are for the meter itself and are blue in
color.

New Unused Meter Information (to be added to the New Meter
Database)  This information will be used to match new unused
meters with people who need them.

Used Meter Information (to be added to the Used Meter
Database)  This information will be used to match used
meters up with trade-in allowances and rebates offered by
companies.

Stamps & Envelopes

There is a Meter Bank FAQ" available for the asking.
This Frequently Asked Questions file will give you
background information about the Meter Bank and the person
who runs it.  If you'd like to read this FAQ send a request
to:

          xjmv62a@prodigy.com   -or-  belve@aol.com


We'll get the FAQ right out to you (or your family and/or
friends) so you can start participating!

or if you'd like to write Richard directly send an e-mail
to:

          batman@phoenix.net   -or-   arthur@tenet.edu

The Meter Bank is using 50/50 Pharmacy to have the meters
delivered to people.  This pharmacy donates fifty percent of
it's profits toward diabetes research.

The Meter Bank is a way for you to help people with diabetes
get new meters to help them with their diabetes management
plan.  Having a blood glucose testing meter plays a critical
role in someone being able to control their blood glucose
level.  So why not help someone in a meaningful worthwhile
way and donate to the Meter Bank.


_____ARTICLE_____

AIDA is an interactive PC(DOS)-based freeware computer program
aimed at insulin dependent (Type I) diabetics.  It is intended to
simulate the effects of insulin and diet on the blood glucose
level.  AIDA is only intended to be used for
educational/teaching/demonstration purposes.  The human body is
complex and it is not possible for a program such as AIDA to
accurately predict an individual patient's blood glucose levels.

Dr. Eldon Lehmann, one of the authors states, "AIDA comes with 40
case scenarios which can be simulated as examples.  Additional case
scenarios can be added by users.  AIDA also contains a very simple
knowledge based system which can identify problems in the displayed
case.  A list of suggestions which might correct some of these
problems can also be generated. This list is provided solely as a
prompt to the sort of insulin dosage adjustments that users might
like to try simulating with AIDA."

For example you could simulate what would happen to a hypothetical
patient's blood glucose profile if the carbohydrate content of
breakfast was increased by 10 grams or if the supper time Humulin
R dose was decreased by 4 units, or the injection time moved
earlier or the meal time shifted later.  The list of possibilities
is endless - an infinite number of simulations can be performed
with AIDA.

NOTE:  AIDA is not intended for individual patient glycemic
prediction, individual patient management or therapy planning.
Furthermore, AIDA cannot generate individual patient specific
therapeutic advice.  Changes in therapy should always be discussed
with a doctor.

A DFAN beta tester tried the program and shares, "While the text
states that this is dos software it ran with no trouble under
windows 3.1. I do have a big system (24meg. ram) and those with
smaller systems may have to run it under dos.

The graphics were stunning. I wish they had a way of printing them!
I can do a screen capture but this is the long way around and again
not everyone has this capability.

To use this software effectively will require some computer skill
and knowledge of diabetes that isn't universal.   My overall
assessment is: Good information, great graphics but a limited
audience since some newly diagnosed diabetics might have a problem
understanding it."

AIDA could be a great tool to use in your diabetes management plan.

So if you're a newly diagnosed diabetic download it anyway and give
it a try.  Knowledge is one of the keys to better control so use
AIDA to increase your Diabetes IQ!


System Availability
-------------------

Both a demonstration version of AIDA and the full interactive
program can be obtained free of charge from the Diabetes UK World
Wide Web site on the Internet from:

        http://www.pcug.co.uk/~diabetes/aida.htm

or by FTP (file transfer protocol) from:

[site]         ftp.win-uk.net
[directory]    /pub/users/diabetes/software
[filename]     aidainst.exe       (full installation program 1.5Mb)

or [filename]  aidadem.exe        (demonstration program 305Kb)

For more information about AIDA please contact:
aida@globalnet.co.uk


_____CORRECTION_____

In last month's newsletter the incorrect information was given for
subscribing to the Lehign diabetic listserve.  Here's the correct
signup information:

To subscribe to the DIABETIC mailing list, send a mail message to:

listserv@lehigh.edu

Leave the subject line blank. Put the line:

SUBSCRIBE DIABETIC Your name

(where Your name is your name!) as the body of the message. You
should get back a confirming message with more information about
the list.

Note that the list traffic is about 300 messages per week. Be
prepared! You may want to consider receiving the postings in a
daily "digest" format. The confirming message you receive once
subscribed describes more about this option.


_______________BACK ISSUES_______________

If you'd like to receive our list of back issues send an
e-mail to: belve@aol.com


This document (c) Copyright 1996, all rights reserved.
Redistribution of this document is hereby freely granted so
long as the document is redistributed in its entirety (here
interpreted as all text which was not automatically
generated by software as part of the distribution  process);
in particular, with attributions and this copyright notice.

