• Seeking internist/GP to help me manage my diabetes
• Diabetes and pregnancy services at Alta Bates
• Helping diabetic middle schooler to eat better
• Helping my diabetic dad find sugar-free foods
• Just diagnosed with Type 2 - need help with diet
• Diabetic child starting school
• See also: Endocrinologist Recommendations
• Related Page: Gestational diabetes

Seeking internist/GP to help me manage my diabetes

Just moved to East Bay (Montclair section of Oakland). Looking for a physician specializing in internal medicine or endocrinology. Need someone to help me manage my diabetes and monitor the other meds I take. db

I am diabetic, and have recently had difficulty managing my blood sugar levels. My primary care physician has not seemed particularly concerned -- to the point that I have found it pretty frustrating, as I would really like to be aggressive in treating this (I'm pretty young, with a toddler to care for, and would like to be part of his future!). Any recommendations for a primary care physician (Alta Bates Medical Group) who's good at working with diabetes?

For ABMG, there are only two that I know of--the best one, my first doc, moved away five years ago, leaving most if not all of his patients to Randall Ammon, in Orinda, or Michael O'Conner in Pinole. Dr. O'conner is straitforward and his staff is ok. I think you have a bigger concern with your PCP--that he/she is not so concerned about your overall health enough to recommend you to someone--it's not his/her job to specialize in your diabetes management, but it is certainly his/her responsibility to recommend someone who can. I would be looking for both a new PCP and Endocrinologist if I were you. Please feel free to email me with any other questions/concerns you might have.

Diabetes and pregnancy services at Alta Bates

Does anyone know about the diabetes and pregnancy services available at Alta Bates?

I'm new to the East Bay and wonder if I should keep using my OB/GYN in SF. I was very pleased with the Sweet Success program at CPMC (I gave birth there) and felt their service was great and taliored to me. I would love to switch to a doctor on this side, but wondered about how Alta Bates supports pregnant women with diabetes.

thanks for your thoughts... Diabetic Mom

The result of all of this? A really super healthy baby boy first time around, and a perfectly normal pregnancy so far with #2. Best of luck! If you'd like to talk to me directly, please ask the moderator for my contact information. Type 1 mama

Helping diabetic middle schooler to eat better

We have a daughter in middle school with recently diagnosed, diet controlled, Type 2 diabetes. Eating a diet that is quite different from that of her peers- especially in terms of reduced sugar and carbohydrates- is essential to her health. Home is fairly easy, but school and outside activities are very difficult. One strategy we've found is to pack meals that she can eat and make them as tasty and varied as possible (but any cookbooks and/or recommendations would be welcome). We are also doing our best not to be the ''gatekeepers'' who are responsible for restricting her diet, but this is can be challenging too. We’re very interested in hearing how other parents of children with food restrictions- especially diabetics- help their kids resist eating foods that will harm them. Thanks much! Parent of a diabetic

As for helping your daughter come to terms with her illness and understanding how important dietary management is, education is critical. I had a 62 year old client with newly diagnosed diabetes (fasting glucose over 300). Within a year of his diagnosis and with a combination of exercise and a low carbohydrate diet (no refined foods), he told me he was no longer diabetic!

Once she has to take medication for her disease, the possibility of reversal diminishes substantially. Nori Hudson, NC

The New York Times (www.nytimes.com) January 9, 2006 Bad Blood Diabetes and Its Awful Toll Quietly Emerge as a Crisis

By N. R. KLEINFIELD

It costs nothing to log in to read this article. Nori Hudson, NC

Avoiding an overly restrictive diet plan can keep feelings of deprivation at bay and stave off binges. I like carbohydrate counting because no food is off limits and this may be appealing to your teen. I understand your concern about becoming a food cop and agree it's best to help your daughter be as engaged as possible in her diabetes management.

Have you checked out www.diabetes.org (American Diabetes Association) or any other reputable websites? While there's a lot of great free info out there, you and your daughter should consider a consultation with a registered dietitian. You can get referrals from the American Dietetic Association (www.eatright.org).

I work at a Health Center, have been providing diabetes education for over 17 years, and while I don't have a private practice, I occasionally do private consultations. I didn't respond to your post to promote myself, but if you are interested in a consultation, feel free to email me. Good luck. Arinna

Helping my diabetic dad find sugar-free foods

My dad was recently diagnosed diabetic, and I've been trying to find sugar-free foods for him (i.e. sugar free desserts)and it seems hit or miss. (The folks at most grocery stores don't even know if they carry sugar free items, which seems really strange to me.) I know there are other diabetics out there. Where do you find the good stuff? There was a recent discussion about Splenda, which doesn't seem to be on the archives. Where do you find that? Does anybody know more about the negatives about splenda? Thanks Janet

There doesn't seem to be a lot of negative press on Splenda (yet); the very small amount of stuff I've seen has been vague, and not really based on solid research. So for now I'm letting myself use it. My best luck has come from making stuff myself. There's an additive called ''Stevia'', 300 times sweeter than sugar, natural, and it has been used in Japan for years and years (apparently with lots of safety studies etc.). It works pretty well, although a lot of it does tend to make things taste funny. There are some odd politics surrounding this, which have led to it not being able to be sold as a sweetener in the US; instead, it's sold as a ''dietary supplement'' in health food stores.

One can also use sugars that are mostly or entirely fructose (you can get either plain fructose or some stuff called Agave syrup at Whole Foods, in addition to Stevia). While these are still sugar, they are apparently absorbed by the body more slowly than table sugar, and so somewhat better for you. Also, they are sweeter so you can use le! ss of them. If you'd like, I can send you some information provided by my nutritionist, as well as some simple recipes for sugar-free dessert items. Feel free to email me if you'd like this. kd

Just diagnosed with Type 2 - need help with diet

I was just diagnosed with Type 2 (Adult onset) Diabetes. I immediately started eating strictly by the ''Zone'' diet guidlines. I am having some major questions about the way I should be eating and how my sugar level is doing during different times of the day. HOWEVER, all the dieticians I have talked to (mostly at Kaiser) totally subscribe to the classic ''pyramid'' and way more carbs than my body can tolerate. Does anyone know of a good nutritionist/ diabetes educator who has alternative knowledge? Does anyone have a word of advise for a beginner like me? Thanks!

Diabetes seems to be a disease that has many idosyncratic features that vary from person to person. You will find that certain foods will raise your blood sugar very high, very quickly. For instance, my daughter should not eat bagels or grapenuts, because it's too hard to keep her blood sugar value in an acceptable range. On the nutrition front, our sense is that the best diet for diabetics is also a very healthy diet for everyone in general--the basic food pyramid. We have found, though, we get better control if our daughter eats meals that have a blend of fat and protein with the carbohydrate. Whenever she eats meals with minimal amounts of fat/protein (e.g., pasta with veggies, bread, fruit) her numbers spike. The fat and protein slow the absorption of the carbohydrates.

I applaud your efforts to find a good nutritionist. I also encourage you to read as much as you can. They don't call diabetes the ''thinking person's disease'' for nothing. It's quite a challenge, and I wish you the best of luck. anonymous

FWIW, I agree with you that the food pyramid does not work for everyone and it has way too many carbs for this diabetic. My experience, though, is that the Zone diet is similar to a diabetes diet in some ways but problematic for many diabetics in other ways.

Also, the hardest things about diabetes are not the blood tests or the shots. The hard parts are getting past denial, finding resources that actually help, and living in a world that neither understands nor accommodates living with diabetes.

Usually, some doc tells you that you have diabetes, hands you a pamphlet, and sends you off to flounder about on your own. I went to three doctors and two nutritionists before I found someone who seemed to be paying attention and sending me to resources that worked.

Everything I learned about successfully managing diabetes I learned while I was pregnant, when I was constantly under the watchful eye of skilled specialists including a diabetes dietician who monitored my diet weekly. During that time, with their constant attention and customized treatment plans, I learned a tremendous amount about diabetes in general and my diabetes in particular.

It turns out that everyone's body is different, and everyone's diabetes is different. But my experience is that most medical people are trained to offer only ''cookie cutter'' treatment plans. They also often seem jaded, because, I suppose, it gets discouraging when most diabetics don't fully address managing their health. So, typically, all you hear is vague, generalized advice to get more exercise, lose ''even a few pounds,'' and ''count carbs'' (a concept that wasn't totally clear to me until I met weekly with that one wonderful dietician).

By keeping a daily journal to track my blood sugar, meals, and exercise, then going over my journal each week with committed specialists, I learned a lot about how diet, exercise, and medication worked together in my specific body to control my diabetes.

Unfortunately, that kind of personalized care is usually unavailable to non-pregnant diabetics. To get good advice, you have to work at ferreting out resources and people who will be straight with you and see your case with fresh eyes.

One great resource: The Diabetes Center in Berkeley has a terrific *free* drop-in support group. (Stop by or call them to get the schedule.) There, you'll find other diabetics who can tell you who's who and what's what in the bay area.

The Diabetes Center also has some good people -- the support group facilitator (Mary Kelly) and the diabetes educator (Lori Lorenzo) are both very smart and very clear.

The dietician there (Sue, I think) is more the jaded, cookie- cutter-solutions type. I felt that had I listened to her advice it would have been five steps backward for me.

As mentioned, the support group is free to anyone with diabetes; you don't need a referal, just drop in. I don't know if Kaiser offers referrals to the Diabetes Center, but maybe they have a similar facility and maybe you'll decide to spring for a consultation there.

Also, the book ''Diabetes for Dummies'' is really the best comprehensive primer I've seen anywhere. Skim through it and you'll be well on your way to understanding how to face your new challenges.

Good luck, and remember that your health is yours, not your doctor's. By owning your diabetes and taking care of yourself, you can minimize the effects and build habits into your life that will become as ordinary as brushing your teeth and combing your hair. Anonymous

I went to 3 different endocronologist (with a nutritionist on staff) and they gave me different suggestions which some was very misleading. I finally went to California Pacific (in San Francisco) diabetics center, I register as a patient of Dr. Elliot Main. They are very helpful and the nutritionist are specialist in dealing with gestational diabetics, I can tell they have a big staff and can get a little unorganized with the appointments. But I think I wouldn't know how to deal with the diet without them.

At the end, you are the one who will figure how much carb you need a day. As long as, you balance them with enough protein. That's what I learned from the expert anyway, to create my own menus. You have to be proactive on what you want to have in your diet otherwise they gave you standard diet which might not work for you. I tend to eat lots of fruit and I don't like cheese, so that was a little difficult to work into. But I found a good balance diet that I like and it work out. Good luck! purna

Diabetic child starting school

My 4.5 year old was recently diagnosed with diabetes. We are doing fairly well with our current preschool situation with respect to monitoring her blood sugar levels (at lunchtime) and making sure she eats the right foods at the right time in the right amounts. Our big concern is what to expect/request when she starts kindergarten in the fall. If anyone is a parent of a young diabetic child, I'd love to hear from you. Any advice or suggestions regarding school, afterschool programs, sports, principals, teachers, etc., would be greatly appreciated. I currently work fulltime and don't know whether I should prepare to cut back my hours in order to make sure I'm more available in case the need arises. Thanks.