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Kids & Teens with Diabetes
Adults with Diabetes
My 18-year-old nephew was diagnosed three years ago with insulin-dependent diabetes. I would be very grateful for advice on two fronts, for my nephew and for my sister. Since his diagnosis, my nephew, ''Charlie'', has been in a state of denial, anger, and withholding around his diabetes. He can go for - apparently - days without testing, refuses to share his numbers with my sister, and went through a period some months ago when his lows, followed by nights of drinking beer with his buddies, brought on seizures on three occaisons requiring EMT attention. He briefly had his driver's license suspended, as required by law, but it has been reinstated. Now he is so worried about lows that he is running high all the time, really high, dangerously, chronically high. He takes his long-acting insulin at night but not the short- acting during the day. He thinks his docs are worthless, hates the medical establishment, doesn't think he has a problem, feels worse every day, refuses therapy, refuses to talk about is, refuses help. Many of his friends don't even know he's diabetic. He clearly has gaps in his diabetic care education and doesn't know how to manage his numbers. And he's supposed to be leaving for college in the fall. So that's problem number one. The seccond issue concerns my sister, who - understandably - is distraught much of the time. My brother-in-law, a brilliant cerebral guy, thinks Charlie is ''smart and will work it out'' and that my sister is a ''worry-wart.'' So he's not much help at all, and just makes my sister feel more alone, more upset. Because Charlie is now 18, he is no longer required to seek medical attention or to reveal his test results to mys sister. She needs a support system (lives in another major metropolitan area far from family) and counseling and community, and my nephew certainly needs support before he brings damage to himself that is irreversible. Any ideas about how to help either Charlie or my sister would be very much appreciated. Very worried aunt/sister
Is your nephew's health care team good? Could he be getting better support from them, or elsewhere? From experience, there is a huge disparity in health care, support, and education for diabetics. Places like UCSF and some other large facilities have really good diabetes educators who can address his management, and have experience with adolescents coming to terms with their diabetes. He can also be connected to networks (via his healthcare team or a number of orgs), where he could meet other diabetics his age who understand what he's going through and have figured out how to balance being diabetic and a teenager.
Your sister should seek out resources through the ADA or many online forums to support her as a parent of a young diabetic, and maybe she can get advice on other strategies parents have used. Ultimately though, it's going to be Charlie who makes a change for himself. I went through periods throughout my 20s where I took excellent care of myself, and where I did not - these ebbs and flows are common for many young diabetics. My mother tried to push me to take leave from college, not study abroad, and a number of other things because she was not confident in my ability to care for myself - all of her pushing made me react negatively. My father (also a Type1 diabetic) believed that I would figure it out when I had to and would learn to survive on my own, and he was absolutely right. I'm not saying that Charlie's behavior is healthy or smart, or that I as a parent now would be ok with it, but giving him some space (and resources) to make better choices could yield better results. 13 years as a T1
I am requesting advice on care options for my 12 year old Type 1 insulin dependant juvenile diabetic daughter during my 3 day hospital stay for my whole knee replacment.
I am a single mom and I also have a college student son who will be temporarily home for the summer (who is not trained in diabetes management to to be primarily rewponsible). I live in a house in Alameda and have a spare bedroom.
The surgery date is Friday Ausust 5 and I have care starting the following Monday August 8. I will be completely out for those 3 days and my daughter has the need for monitoring and the occasional assistance for a high/low blood glucose event. I do not have an existing support system or family that is trained to take over completely. I may have child care that works well with remote medical/nurse/diabetes trained supervison.
I have some financial resources but do not have the money to hire an in-home nurse for the full 3 days.
Any and all thoughts, advice guidance would be greatly appreciated. This is quite a worry for me. Thank you.
General info: http://www.diabetes.org/living-with-diabetes/parents-and-kids/ada-camps/
Find a camp:
Friend of a Diabetic
I have a 12 year of daughter that was diagnosed as a juvenile diabetic last year. She is insulin dependent and we have spent the year learning how to mange diabetes. She continues to do well in school but I know that this has been difficult.
I am seeking guidance on handling some of the longer term issues. One question is does anyone have a referral for a therapist who can help my daughter deal with the emotional issues of a chronic disease such as diabetes? I live in Alameda so a close referral would be best. or a group? any other suggestions? we do know about diabetes camps, but any other suggestions or thoughts would be most appreciated. thanks from Carol
I went to see Jessica Bernstein in Alameda. She is a PHD from Berkeley and did her thesis on diabetes and a documentary called Blood and Honey about different cultures and ways of living with a chronic illness. She is also a type 1 Diabetic. I suggest contacting her: Jessica Bernstein firstname.lastname@example.org
Good luck and if you need to talk feel free to contact me. maybe I could get my daughter to be a mentor- email pal to yours? My daughter is very responsible, sensitive and mature. I believe that diabetes made her grow up fast- while other teens worry about boys/clothes she says she was worrying about staying alive and healthy.
It is a very demanding illness. I often fantasize about creating a ''resort/spa'' where diabetics could come and let someone else take over for them just for a week- so they could actual not think about it.
I wish you strength and courage and above all find a sense of humor about it and use it often. Laugh when you can and let go when you can. V.
I think the first major obstacle your daughter will face is puberty. Surging hormone levels can wreak havoc on blood sugars, and takes a lot of active management to keep things in line. I would like to recommend diabetes educator Sharon Palmer to help with this end of things - she works at both Kaiser and through Alta Bates, I believe, for people with PPOs. She is AMAZING. I worked with her when I transitioned to my insulin pump and through my first pregnancy, and credit her sensitivity, perception, and general positive nature to my success with managing my disease and maintaining an A1c of less than 6%.
I don't know of any groups in the area, but I do highly recommend looking into a day camp for the summer, which will be less stressful, medically and emotionally, than an overnight camp where worries over bloodsugar issues may be exacerbated.
I'd be happy to chat with you if you want to email me privately, but here are my suggestions for what helped me as a teenager:
1. Don't let teachers, friends, coaches, etc., treat your daughter any differently. The more people singled me out after my diagnosis, the more fragile and sorry for myself I felt. However, when I was given opportunities to ski, rock climb, etc., and treated as any other teenager would be, I thrived.
2. Try to get your daughter on an insulin pump if you haven't already. It is so much easier to manage bloodsugars and A1c levels this way!
3. Try not to hover. Your daughter was dealt a crappy hand, but she's the one who's ultimately responsible for playing it well. Give guidance when you can, but let her be responsible for her own health and well-being; showing her that you trust her to take care of herself will empower her to do it better.
4. Make exercise a key component of your daily routine. In fact, if she can exercise after most meals, she can dramatically reduce her need for insulin, as well as insulin resistance (that's easier said than done, but walking/biking to school is one great way to implement it).
5. Don't blame yourself! My mom felt SO guilty about having a ''sick'' child, and it really affected her emotional health for a while. This is in no way your fault, and do your best to take care of yourself and set a healthy example for your child. Hope this helps a bit! elkani
Also, going through puberty with diabetes is excruciating for the child and the parents. You both will need people to talk to, people who specialize in life with diabetes.
Now, I have been a volunteer diabetes mentor for pre-teens and teens since I was 16. I would be 100% willing to call or visit with your daughter. This can be a one time thing, or we can meet/talk regularly. I do this because i know what it is like to struggle everyday with diabetes as a kid and not have any one to connect with who truly understands the way only one with diabetes can. If you are interested, send me an email and we can arrange a time to meet.
I wish you the best, and your daughter the best in her diabetes management. Heather
After a short stay at Children's Hospital, his pediatrician recommended that he change endocrinologist's and move to treatment with Suruchi Bhatia, MD through Sutter Health (CPMC). This was the best choice we ever made regarding his treatment.
Dr. Bhatia has an amazing team that meets with my son at every visit, including a counselor (MSW), pediatric nurse specialist, a nutritionist. Dr. Bhatia is so personable and relates to kids, especially teens, is such a connected and down to earth manner that she is truly empowering. This was one of the main reasons our pediatrition recommended the move, especially as adolecence approaches there are lot of challenges for diabetics with changing hormones and Dr. Bhatia is highly skilled at helping kids through these changes.
Cathy Portje-Richardson is the counselor that works with my son and she is a kind, gentle advisor but is excellent at asking the right questions and giving advice that can really be heard.
Finally, I want to also recommend the Omni Pod pump. My son has been using it for over a year, and the freedom the pod provides, especially for an active life, with no tubes to get caught up in has been amazing. East Bay Mom
Would greatly appreciate advice on the following: My sister moved far from home many years ago when she married my brother- in-law, who comes from a huge family. In June 2008, her middle son, one of three boys, was diagnosed with Type 1 Diabetes not long after his 15th birthday. For some months after his diagnosis, ''John'' was in the ''honeymoon'' phase of the onset of his disease. That phase is now over and he is fully insulin- dependent. John is a smart, stubborn, willful young man. According to my sister, he treats his diabetes as though it is a minor inconvenience. The upshot of this is that he is not testing his blood sugar levels through-out the day (sometimes as little as once every FOUR days), not taking his short-acting insulin at mealtimes, is taking the long- acting insulin at the end of the day but I think his dosing is based on some real guess-work on his part. He goes to see his medical team every three months, thinks they are all idiots, has a terrible attitude about his medical education, and his numbers indicate that he is managing his diabetes very poorly. He is also a new driver; drinks a lot of beer at home on the weekends, and I think likes to get high on pot now and then. My brother-in-law thinks John is smart enough to ''figure this out on his own'', and doesn't want to intervene in any way ''at the risk of alienating him.'' My brother-in-law is a famous trial attorney and world-class debater. My sister is beside herself. No support from husband, worried sick about son, and far from home. I would really really like to help her here and have no idea what to do or offer. She's worried about joining a support group for fear of feeling even more inadaquate. Meanwhile, her son's reckless behaviour is costing her dearly. I've suggestd taking away car keys until things are better handled medically, but they feel this is too ''punishing'' and would back-fire. Any advice would be gratefully received. Very concerned big sister
I think the first issue is that the boy is a teenager. 15 is already a very difficult age to deal with as a parent, in my opinion, because this is typically the age that ''children'' feel like they should be the one's to decide for themselves, make their own choices, etc. In other words, be the ones in control. I went through this with my kid when she was 15.
Diabetes is also about control. It's an incredibly difficult disease to manage, and it's very difficult to be on the receiving end of others, whom are not Diabetic, telling you how to take care of yourself. It's not like other diseases that typically show effects right away &, unlike Type 2 as well, Type 1 can be much more insidious, & therefore it can be hard to fight something you won't see the effects of for years to come, if that makes sense.
I'm Type 1, and in my experience, I have had phases of excellent control, and terrible control. But it is a difficult undertaking for anyone, let alone a child going through such a difficult developmental stage. If he had been even 5 years younger, my guess would be he would manage himself differently and much better than he does now. I'm an adult who's been living with this disease for years, and dependent on what's happening in my life, my Diabetes management can be the better or worse for it.
That all being said, as a parent I can understand the difficulty in watching one's child NOT doing the things s/he should. And at 15 he has no comprehension of the detrimental effects that his mismanagement of his health can and undoubtedly will have. As a Type 1 Diabetic, I can also understand his feelings of resentment, his feelings toward his doctors. The combination of the two is, unfortunately, potentially dangerous.
Probably not what you or your sister want to hear, but I agree with the Dad, and would back off. Restricting his use of the car or other punitive measures will only push him further away. He may feel like he is being punished for having this disease instead of the bad behavior he is displaying, separate from his Diabetes, and of course it's not his fault for having it. My husband stopped being the ''Diabetes Police'' years ago, and it's made me much more conscious of my own actions (or lack thereof as the case may be) and I no longer resent him for trying to ''tell me how to manage my disease.''
I would recommend that your sister find out about the insulin pump for her son, if she hasn't already. I have worn one for over 10 years and, whereas it's not for everyone - it's attached to you 24/7 - it has allowed me to live a much less restricted life... I can eat when I want and what I want, within reason of course, as I have to watch what I eat just like everyone should. Alcohol is not forbidden for Diabetics by the way, but since he is 15 and under age, that's a separate issue, as is the smoking pot.
I'm very sorry to hear about your nephew's situation and I truly hope that he can come out on the other side without much damage to himself or anyone else. I feel very sorry for your sister but I would suggest that it's not that her husband his not supporting her but may have some insight to what it's like to be a 15 y.o. boy.
Support groups for Type 1's and relatives of Type 1's are very difficult to find but I would be surprised if she were made to feel ''inadequate'' - she would very definitely feel supported, and I would recommend it. But make sure it's specifically geared to Type 1 and not Type 2 or a combination. They are completely different diseases and are not treated the same. You may pass on my email to her if she would like to ask me any questions. A
There should definitely be NO DRIVING and NO ALCOHOL unless he's compliant - and he needs his Dad to be a parent, not a 'buddy'. Your sister's right to be so worried. Get the kid a medic alert bracelet or pendant, too. And the A.D.A. (Amer. Diabetes Assoc.) has helpful resources. Your sister's instincts are right - tho' it's a b*tch being the ''Diabetes Police'', somebody's got to do it! Good luck. --Been There
If your brother-in-law is an attorney, he should know that he and your sister could be liable big time if your nephew injures someone while driving. Both parents need a wake-up call!
I'm a believer in tough love and it sure sounds like this kid needs some boundaries! (regularly drinking? smoking? and underage?!!?)
One other thought -- I have another friend who has managed her diabetes with a pump. It sounds like this would provide more regular insulin for him. Maybe he also needs to be more involved with his medical care -- if he thinks those people are ''all idiots'' they should do some shopping for new providers if at all possible. For a teen the rapor with the medical team means a LOT. -tough love
My friend's 2nd grade son was just diagnosed with diabetes. They are still trying to process this news and to figure out how to handle the day-to-day challenges, particularly with respect to how to handle the monitoring of his blood sugar level / administering insulin at school. Like probably most of us, their school no longer employs a full-time nurse. They both work 30 minutes away and really don't think it's feasible for them to take time from work every day to visit the school - their son also is not mature enough to handle the blood pricks and insulin administration n this own. They would appreciate any general feedback or advice from other parents of young diabetic children, as well as information on how their schools have been able to assist. Grateful for any input
Please ask the moderator to share my email address with you if your friend wants more info. It's too long to post in the newsletter. another mom to a diabetic child
I am 36 and have type I; I've worn a pump for almost 8 years and I love it. There are good diabetes programs locally, but I can speak highly of the pumping program at UCSF Diabetes Clinic. They have excellent education and medical programs to get your family started. Pump Fan
Your friend should also contact DREDF in Berkeley for guidelines on getting her son's medical needs met at school. They are at the forefront of fighting for the needs of kids with diabetes - they are located on 6th Street in Berkeley. Their phone number is 510-644-2555.
Her son should also have a 504 plan (for children with health needs) to further outline the responsibilties of the school. She should contact the principal at her son's school to get this process started.
[Although I wish I could give an easy answer about the state law and children's rights in school, etc, this subject is a rather hot topic at the moment. In the past, parents could train a willing teacher or school employee to check blood sugars and give insulin shots at school when the school nurse was unavailable. Unfortunately, the nursing association was not comfortable with non-nurses administering insulin because it technically is still under the nurse's licence. Which, as a nurse, I understand, as a diabetic, I find it infuriating! Parents, family members and friends take care of diabetes 24 hours a day while at home, they don't need a nurse to come in and take care of them.... anyhow, I could go on all day.....but this whole battle ended in the supreme court last December and they judged in favor of the nurses.
So, now things are a little more difficult because diabetes falls under the american disabilities act and it is still the school's responsibility to provide a nurse (easier said than done). Parents are finding it really depends each individual school. Best bet for a parent seeking information would be to contact the Diabetic Youth Foundation. They work with another non-profit who specifically deals with all kinds of special needs and circumstances with students and schools (I can't remember the name at the moment). they can also provide resources of how other parents are dealing with these issues.]
I encourage your friends to ask their school district for what they need in regards to their child's glucose monitoring and insulin administration. It gives me great peace of mind that there is a pro-active plan in place to manage my son's illness at school and I appreciate the support of the committed professionals who are there to help. 504 Plan Mom
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
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.
Hi, we are moving back to the bay Area this summer. My husband is a type 1 diabetic. We are looking for both a good primary care doctor who is familiar with diabetes and a diabetes specialist--we'd be happy to got to UCSF for the specialist but it would be nice to find a primary care physician in the east bay. We have good insurance. thanks so much for your suggestions. worried spouse
In conjunction with this, my son works with Jessica Bernstein, a psychologist who has had type 1 D for 38 of her 39 years. She's great, too. 510-654-7785 She is also a documentary filmmaker and is making a film about how chronic illness is viewed and treated in different cultures around the world. See bloodandhoney.org.
Finally, Leah Statman for jin shin, if you are open to eastern energy work (along the meridians) -- she is excellent! 510-525-5080 Best wishes! savvy mom, re: type 1 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.
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
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
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
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