TCOYD Newsletter - Spring 2011 Vol.35

NEWSLETTER

MY

Spring 2011 Volume 35

How Sweet Is Sweet Enough?

What Should Your A1c Be? Dr. Edelman’s Corner

INSIDE Heath Care Reform and YOU Page 3

V-Go On the Go! Page 4

Spirit of Generosity

T

he A1c is the most important test in diabetes management. It tells all of us folks living with diabetes and our caregivers how our blood sugars have been on average over two to three months. In recent years, a controversy has developed amongst diabetes professional organizations regarding the ideal A1c value.

Page 5

Mindful Meditation Page 6

Diabetes Hotspots Page 8

Portrait of An Educator Page 9

Sweet Membership Page 12

The American Diabetes Association (ADA) says the ideal goal should be less than 7% (average blood sugar of ~150 mg/dl), while the American Association of Clinical Endocrinologists (AACE) and American Association of Diabetes Educators (AADE) state it should be less than 6.5% (average blood sugar of ~120mg.dl). There have been many

heated debates over these limits with no real consensus to date.

Adding to the differences of opinion came the results of three large clinical trials, all demonstrating that there are no obvious benefits of tightly controlling blood sugar levels in terms of reducing heart disease (medically speaking, macrovascular complications) in people Sweet (continued on page 2)

Special Acknowledgements Medical Advisory Board Chair: Ingrid Kruse, DPM Veterans Affairs Medical Center Alain Baron, MD CEO, Elcelyx Therapeutics John Buse, MD, PhD University of North Carolina Jaime Davidson, MD Dallas, TX Mayer Davidson, MD Drew University Daniel Einhorn, MD Diabetes & Endocrine Associates Robert Henry, MD Veterans Affairs Medical Center Irl Hirsch, MD University of Washington

Board of Directors Steven V. Edelman, MD Founder and Director, TCOYD Sandra Bourdette Co-Founder and Executive Director, TCOYD S. Wayne Kay CEO, Response Biomedical Corp.

Margery Perry Terrance H. Gregg President & CEO, DexCom, Inc. Daniel Spinazzola President, DRS International Contributing Authors Steven V. Edelman, MD Jeff Zlotnik Julia Baron Roz Hodgins Brenda Fagan Johnson Mary Ellen Taylor

TCOYD Team Steven V. Edelman, MD Founder and Director Sandra Bourdette Co-Founder and Executive Director Jill Yapo Director of Operations Michelle Day Director, Meeting Services Antonio Huerta Director, Latino Programs Roz Hodgins Director of Development Julia Baron Manager, Public Relations and Outreach Jennifer Braidwood Manager, Continuing Medical Education Jimm Greer Administrative Assistant David Snyder Manager, Exhibit Services

MyTCOYD Newsletter Editor: Julia Baron Design: Hamilton Blake Associates, Inc.

MyTCOYD Newsletter is offered as a paid subscription of Taking Control Of Your Diabetes.

All material is reviewed by a medical advisory board. The information offered is not intended to constitute medical advice or function as a substitute for the services of a personal physician. On the contrary, in all matters involving your health, TCOYD urges you to consult your caregiver. ©2010 All rights reserved.

2 My TCOYD Newsletter, Vol. 35

Sweet (continued from page 1)

levels (hypoglycemia unawareness) with type 2 diabetes, which happens and what type of diabetes medications to be the main cause of death. As you are on. mentioned above, there is no arguIf you are an older person with diament that proper glucose control will betes and have heart disease, then it prevent or reduce the incidence of would be prudent to not get your A1c microvascular complications. Adding down too low, especially if you are on even more fuel to the fire, one of the insulin or other medications that may three large studies (ACCORD trial) cause low blood sugar. Concentrating showed a higher death rate in the on reducing your cardiovascular risk group of people with type 2 diabetes factors should be whose A1c values one of your highest were the lowest!

“One thing that remains health priorities.

Researchers are constant is that there If you are young investigating the is no one perfect value and healthy and reasons for this, but for everyone and have a long life they are concludindividualization is key.” ahead of you living ing that severe low with diabetes, getting and keeping blood glucose, or hypoglycemia, may your A1c as low as possible is a good have played a role in these excessive idea. deaths.

The bottom line is that your A1c With all these differences of should be as low as possible as long as expert opinion and surprising clinithat level can be achieved and maincal trial results, where should people tained safely while avoiding hypoglywith diabetes keep their A1c values?

One thing that is not debatable is that cemia and not interfering with your there is no one perfect value for every- lifestyle in an adverse way. This is a statement that all organizations would one and individualization is key. agree with.

There are many important variDon’t be in the dark when it ables that may influence what your comes to your A1c. Talk with your A1c goal should be, including age, caregiver to find out how sweet you how long you have lived with diashould be and how you can betes, presence of risk improve for the future! factors for heart disease (such as high blood pressure and abnormal cholesterol levels), having heart disease (such as a heart attack), not being able to Steven Edelman, MD Founder and Director recognize low blood sugar Taking Control Of Your Diabetes

Health Care Reform What It Means to You

From the Desk of Brenda Fagan Johnson

“Until the Patient Protection and Affordable Care Act (PPACA) was passed, health plans continued to limit preventive care.”

H

ealth Care Reform is a complex piece of legislation that has consumers and healthcare experts still trying to figure it all out. However, there are a few key components that are significant for healthcare consumers. There are important insurance changes that can help you manage your diabetes and other chronic diseases. One of the many struggles people with diabetes are faced with is plan limitations for supplies such as test strips and needles. Many health plans limit a patient to 200 test strips per month instead of the 300-500 that their doctor recommends. The savings that a health plan receives by limiting diabetic supplies is a drop in the bucket compared to the cost of a hospital stay that can occur when diabetes is out of control.

Prevention is the key to controlling costs for this chronic disease.

Until the Patient Protection and Affordable Care Act (PPACA) was passed, health plans continued to limit preventive care. Beginning September 23, 2010, plans that were considered non-grandfathered were required to remove co-pays and co-insurance for preventive services.

Most insurance companies have published their list of preventive services that will no longer have a co-pay or coinsurance. To find out what your plan covers, contact your plan administrator or refer to your summary plan description.

Below is a partial list of preventive services that are important in diabetes maintenance. Refer to your health plan’s summary plan description for specific coverage. u Colorectal cancer u Well woman care (pap smears, mammograms) u Obesity screening u Vision Screening u Physicals including diabetes screening In addition to removing co-pays from preventive services, PPACA

Brenda Fagan Johnson Brenda is President and CEO of Discovery Benefit Solutions, Inc. an employee benefit firm based in San Diego, CA. Ms. FaganJohnson has been a benefit specialist for more than 25 years. DBS specializes in self funded medical, dental and vision plans as well as full benefit packages for small and large companies.

required all plans to remove annual limits on “essential benefits.” Since the law does not define “essential benefits” it is open to interpretation. Most insurance companies have removed limits using a broad definition of essential benefits. Health plans claim that these benefit changes have added more cost to the already unaffordable health care premiums.

The removal of limits on many essential benefits can be a positive result for those living with diabetes.

Health Care Reform (continued on page 9)

Taking Control Of Your Diabetes

3

Ask Your Pharmacist

V-Go on the Go!

Valeritas, Inc. Announces Newest Innovation for People Living with Type 2 Diabetes

By Julia Baron

By Julia Baron & Steven Edelman, MD

V

aleritas, Inc. a medical technology company committed to developing and commercializing innovative drug delivery solutions, announced the FDA approval for its new insulin pump for people living with type 2 diabetes. The V-Go Disposable Insulin Delivery Device is the first pump in its class and designed primarily for those with type 2 diabetes who are taking multiple daily injections of insulin to control their condition.

What Sets The V-Go Apart?

Unlike electronic insulin pumps on the market that are specifically designed with type 1 patients in mind, the V-Go is the first and non-electronic basal-bolus device for people living with type 2 diabetes.

As more and more people living with type 2 diabetes begin insulin regimens, the V-Go allows for users to easily and accurately deliver insulin without the need for multiple needle sticks.

Insulin pumps like the V-Go deliver subcutaneous preset basal rates of insulin (replaces the long acting insulin such as Lantus and Levemir) as well as an on-demand bolus rate by pushing a button. In addition, the pump is disposable, allowing for users to administer a new, insulin-filled device every 24 hours.

The pump is also lightweight and sturdy. It is worn almost anywhere

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on the body and measures exactly 2.4 x 1.3 x 0.5 inches (the size of a very small bar of soap) and weighs approximately 1 ounce when filled with insulin.

How Do These Pumps Deliver Insulin?

If you and your caregiver decide you would like to try the V-Go, then based on your current total daily basal insulin dose (Lantus, Levemir or NPH) you will be prescribed either the V-Go 20, 30 or 40. These numbers are referring to the basal rate of the pump. For example, the V-Go 20 pump will deliver 20 units of fast acting insulin very slowly and evenly over a 24-hour period, which equates to 0.83 U/hr.

All 3 of the V-Go pumps have an on-demand bolus dosing in 2-unit increments (up to 36 units per one 24-hour time period). Your bolus

dose will be similar to what you are doing on your multiple daily injection regimen but may need adjusting depending on what you are eating, how much exercise is anticipated and your home glucose monitoring results.

Filling the V-Go pump is easy and (for convenience) users will be able to do so a week ahead of time.

Novolog and Humalog have specifically been studied in the V-Go, however, any fast acting insulin can be used.

If you are living with type 2 diabetes and are currently on a basalbolus or multiple daily injection insulin regimen, talk to your caregiver to see if you would be a good candidate to try the V-Go pump. The V-Go has been designed to take the stress off of people who require multiple daily injections, promote insulin adherence and ultimately, provide better control for those living with the condition.

For more information about Valeritas, Inc. and the V-Go Pump, visit www.valeritas.com

Giving Back

The Spirit of Generosity Continues with Gift Planning The Difference Generation Society

By Roz Hodgins

The most common planned gift “Planned gifts are sometimes is a bequest in your will or living referred to as “stop-andtrust. Other planned gifts include: think” gifts because they u A charitable gift annuity require some planning and, u A charitable remainder trust often, help from your u A charitable lead trust professional advisors.”

To learn more about giving, please contact: Roz Hodgins TCOYD Director of Development 1110 Camino Del Mar, Suite B Del Mar, CA 92014 (858) 792-4741 Ext. 20 or toll free: (800) 998-2693 email: roz@tcoyd.org

u

An endowment fund u Retirement plan assets s our base of generous donors Rita and Randall Brown, by includu Life insurance policies continues to expand we’ve ing TCOYD in your estate plans. u A remainder interest in been asked what other ways people If you have already put TCOYD in your home can contribute. In addition to outyour estate plans, then please let us Gift planning is not only for right gifts of cash or securities, all know so we can acknowledge you. the “wealthy.” The truth is even of which are tax-deductible, If you would like more inforpeople of modest means can make another consideration is including a difference through gift planning. mation on joining The Difference TCOYD in your estate plans. Gift Join The Difference Genera- Generation Society and how gift planning is finding ways to make planning can benefit you personally tion Society, chaired by valued charitable gifts now or after your TCOYD advocates and supporters, and TCOYD, contact Roz Hodgins. lifetime while enjoying financial benefits for yourself.

Planned gifts are sometimes TCOYD Corporate Sponsors referred to as “stop-and-think” Platinum gifts because they require some planning and, often, help from your professional advisors. Unlike cash Gold donations, they are typically made from assets in your estate rather than disposable income, and come to fruition upon your death.

Silver

A

Taking Control Of Your Diabetes

5

Mindful Meditation

How to Keep Your Mind, Body and Spirit in Balance and Avoid the Pitfalls of Stress

By By Julia Baron Jeff Zlotnik, Executive Director, The Meditation Initiative

M

any people fear they don’t know how to meditate or that they are not doing it right. You may have said to yourself in the past you can’t meditate. Not to worry, The Meditation Initiative has simplified it for you. The most challenging part of meditation is actually making the time to sit and meditate.

Once you are sitting the rest is very easy.

Let’s clear up many of the common misconceptions of meditation and if you need more help, please contact us: u Realize there is no right or wrong way to meditate. Any time you sit and pay attention to your breath and watch your wandering mind, you are meditating. u You must realize that your mind will not stop thinking. You are not trying to stop your mind or control your thoughts, you are simply trying to watch your thoughts. Realize that any good mood is from thoughts you have and any bad mood is from thoughts you have. u You will not think nothing; do not try

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to empty your mind. You are trying to pay attention to your mind. u Do not approach meditation as an escape from reality.

Approach meditation as a way to actually listen to your own mind and understand your thoughts. Meditation is not an escape, it is direct perception into your own thoughts. u When meditating, do not expect anything to happen to you. You will not float away, you will not solve all your problems, and do not meditate with the expectation of any reward. Meditate for no other reason than sitting and getting familiar with your breath.

Expections When you begin your meditation practice, do not expect anything to happen. You are not meditating to be good at meditation, there is no reason to be good at sitting and doing nothing. You are meditating to experience more peace and calm in your everyday life outside of meditation. Meditation is just the practice of being peaceful. We have become really good at being angry, sad, depressed, anxious, and stressed. So now we need to become better at feeling peaceful.

Since there is no goal or time limit with meditation, it becomes very easy and something anyone can do. Even if you are angry, sit for 5 minutes, try to follow your breath and watch your thoughts. Just begin to know what it is like to be angry and not act on your anger. Begin to develop a daily habit of sitting in meditation for 5 minutes a day. Just like brushing your teeth, meditation should become something we do daily. Meditation is a preventive measure to decrease stress, anger, sadness, anxiety and depression. Do not wait for these negative emotions to occur. Practice meditation daily regardless of the mental state you are experiencing.

Meditating for Beginners When you begin to sit in meditation, simply close the eyes and take three deep breaths. Taking a few more deep breaths and beginning to really follow each breath,

feeling the breath from the stomach, up into the chest and lungs and up into the head. Then follow the breath all the way out.

Begin to notice the busy mind, the racing thoughts and any mental emotional state you bring into the practice. After a few moments, settle into a natural rhythm of the breath. Never expect silence during the meditation, just expect to sit and breathe.

Begin the meditation with bringing your attention and awareness to the stomach or the chest.

When breathing in, feel the stomach and chest rise and when breathing out, feel the stomach and chest fall. Spend a few minutes just following the sensations of the breath. When the mind wanders or gets lost in thought (which it

will), simply recognize the wandering mind and bring it back to the breath. Do not become frustrated with the wandering mind. Do not try to stop the wandering mind.

Try to notice it and let it pass. Just as clouds slowly float by, so do the thoughts. Always pull your attention back to the breath. We want to simply learn to be comfortable in silence, observing all sounds, sensations, thoughts and constantly guiding our attention gently back to the breath. We use the breath as a guide because it is always there.

At the end of your meditation, recognize the body being still, the speech being quiet and the mind beginning to settle. Now know what it is like to just sit and breathe. Again, take three deep breaths to end the meditation.

Once you have finished, notice how you feel paying attention to the speed of the mind and the pace of the thoughts. Compare that to when you began.

When you continue with your day, notice how long that calm feeling stays with you. The more you practice meditation, the longer you will stay calm and peaceful outside of meditation. In fact, when you stand and continue with your day, it is truly the beginning of your meditation practice. If at any time during the day you feel anger, stress, or any negative emotion, simply stop and take three deep breaths, then continue.

To learn more about

mediation and The Meditation Initiative, visit www.meditationinitiative.org.

Fit to Eat— Healthy Breakfast On the Go!

E

veryone knows that breakfast is the most important meal of the day, but it is not always easy to find a delicious meal on the go without avoiding the fast food trap. Here is a great breakfast option that is not lacking in taste or ease!

Nutrition Facts:

Calories ~270

Total Fat Saturated Fat ~8g ~3 g

Saturated Fat Cholesterol Sodium

~3 g ~20 mg ~850 mg Carbohydratea Protein

~29 g ~18 g

Egg whites - 70 calories English muffin - 120 calories 1 slice of cheddar cheese 70 calories Turkey Bacon - 60 calories TOTAL: 267 calories (~270)

Hea

lthy Bre 1/4 cup akfast choleste r olfree egg 1. Cook e gg 1 whole- whites pan (or u whites in a nonwheat En s stick ing lig glis muffin, split, toa h on medium h ht cooking spray ) e s 1 slice o f chedda ted mately 2-3 at for approximinutes r cheese or until s 2. Place et.

1 slice T egg whit urkey Ba e s h o a n lv m e c u s o f w fin n ith one c (cooked) heddar s and one lide piece of turkey b acon.

3. Enjoy!

Taking Control Of Your Diabetes

7

Living Well

Diabetes Hot Spots and the Cost of Care: Cutting-Edge Study Breaks Down the American Diabetes Epidemic

By Julia Baron

O

n March 17th, in a partner study with Novo Nordisk, the Institute for Alternative Futures (IAF) released the most up-todate statistics regarding the top states with the highest prevalence of diabetes (also called “diabetes hotspots”). The study also estimates the burden of diabetes in all 50 states from 2015 to 2025, as compared to 2010. Needless to say, the results are startling.

This forward-thinking study is aimed at providing insights into how the staggering diabetes epidemic is projected to spread across the United States and how this demographic shift might affect states’ economies on a local level, as the rising number of diabetes cases are generating higher projected costs.

Initial results from the study estimate that the overall number of people in the United States living with diabetes will increase by 64 percent from 2010 to 2025 (32.3 million today to 53.1 million), also equal to approximately 1 in 7 Americans in as little as 15 years.

In terms of the overall costs for “diabetes hotspots,” the following states have spent the most money to treat diabetes and its complications: 1. California ($35.9 billion) 2. Texas ($29.6 billion) 3. Florida ($20.7 billion) 4. New York ($18.9 billion) 5. Ohio ($12.9 billion) 6. Illinois ($13 billion) 7. Georgia ($11.7 billion) 8. Pennsylvania ($12.4 billion) 9. North Carolina ($7.4 billion) 10. Michigan ($10.6 billion)

Initial results from the study estimate that the overall number of people in the U.S. living with diabetes will increase by 64% from 2010 to 2025...

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The overall costs to treat and control end stage diabetes and its complications in the United States alone total a combined $297 billion, whereas the 2010 overall Medicare budget is at $299 billion. Only a small fraction of these funds are going into necessary prevention and educational programs. Study projections also show that the aforementioned hot spot states comprise nearly half the population burden of diabetes in the United States.

In light of these statistics, it is imperative that the United States takes action on a federal and local level to promote the prevention and management of diabetes before it spirals out of control. Despite the need for action from the United States government to heighten diabetes awareness, the call to action lies in the hands of people like you. With many diabetes-related resources online and in communities across the country, we can work together to spread diabetes awareness and educate those who are at risk or living with the condition.

At TCOYD, we believe knowledge is power and you are your own best advocate when it comes to preventing and treating diabetes. If you believe you may be at risk for developing diabetes, talk to your caregiver about what you can do to improve your lifestyle. If you already have diabetes, strive to learn more regarding the latest treatment options, benefits of diet and exercise, testing and current technologies that can

Tip of The Month

help you stay under control and free of complications.

A special thanks to Novo Nordisk, The Institute for Alternative Futures, the American Diabetes Association, the Centers for Disease Control and the National Diabetes Prevention Program for helping to bring this information to millions across the country.

For more informat i on, visit www.altfutures.org/diabetes2025 and use the interactive map to see just how many people are living with diabetes and how much it will cost to effectively control their diabetes.

Did You Know?

Tips to Avoid Problems with Medications

By Mary Ellen Taylor, Food and Drug Administration

T

o o o o

o o o o

The Centers for Disease Control and Prevention estimate the diabetes epidemic in 2050 to affect one out of every three Americans.

Health Care Reform (continued from page 3)

Partial List of Essential Benefits u Mental health/substance abuse u Ambulance services u Bariatric surgery u Chiropractic u Diabetic supplies (test strips, needles, etc)

u u u u u u u

here are lots of things you can do to take prescription or over-thecounter (OTC) medications in a safe and responsible manner.

Always read drug labels carefully.

Learn about the warnings for all the drugs you take.

Keep medications in their original containers so that you can easily identify them.

Ask your doctor what you need to avoid when you are prescribed a new medication. Ask about food, beverages, dietary supplements, and other drugs.

Check with your doctor or pharmacist before taking an OTC drug if you are taking any prescription medications.

Use one pharmacy for all of your drug needs.

Keep all of your health care professionals informed about everything that you take.

Keep a record of all prescription drugs, OTC drugs, and dietary supplements (including herbs) that you take. Try to keep this list with you at all times, but especially when you go on any medical appointment.

The Food and Drug Administration (FDA) has a Web site where you can get more information visit: www.fda.gov

Diagnostic services Durable medical equipment (insulin pumps) Hearing aids Kidney disease Diabetes screening Pharmacy Physician office services

For more information about health care reform see these websites www.healthcare.gov www.anthem.com www.dol.gov www.aetna.com www.medicare.gov www.healthreform.kff.org

u

Prosthetic devices/limbs u Transplant services Major Health Care Reform Changes effective Jan. 1, 2011 u Lifetime limit moves to unlimited by 2014 u 2011 Annual limit is $750,000 u 2012 Annual limit is $1.25 million u 2013 Annual limit is $2 million u 2014 Unlimited lifetime begins u Dependents to age 26 with no student status required. u Children to age 19 no longer have pre-existing limitations

Taking Control Of Your Diabetes

9

Taking Control

By Steven Edelman, MD and Roz Hodgins

I

was offered a place in the summer program at Michigan State University,” says Hazel.

During her time in Michigan, Hazel was able to acquire a working fellowship, and then upon earning her masters, she was hired on as faculty for the University. It was then that she began using her own education to educate others on Soon after the end of the war, pressing societal issues. “I worked Hazel completed her senior year with unwed mothers and their of high school and was offered a children and motivated them to scholarship to the University of go back to school or follow a Hawaii where she studied nutrition. “I would test cholesterol levels career path.”

After years of helping families, in overweight students as a part of Hazel decided to take on another my studies. My research opened educational project. This time, it new doors for me. After that, I

t’s not every day you meet someone like Hazel Amen of Honolulu, Hawaii. She is a small woman with kind eyes, a big heart and wisdom that extends far beyond her 84 years. Education, regardless of discipline, is her passion and has been since a young age. For the past eight years, Hazel has donated her time and energy to the TCOYD Honolulu programs, despite the fact that she herself is not living with the condition.

Hazel was born in 1927 to two hardworking parents of Chinese descent. As a young girl, Hazel grew up against great adversity.

Her family originally settled on Oahu in the mid 19th century and worked as plantation farmers while they struggled to make a living.

Despite her family’s hardships, Hazel had a strong desire to learn.

“Being educated and making a good living was very important to my family. I knew it was going to bring me a better life,” she shares.

During World War II, Hazel was forced to put her high school education on hold in order to support her family. She got a job, as did the rest of her siblings, and began volunteering at Pearl Harbor Naval Base. It was there that she worked as a substitute teacher while she was only 15 years old. “The war was more important at that point.

Education for children was put on hold,” she recalls.

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Know Your Numbers

was something completely foreign to her—diabetes. “One day I went to the doctor and he told me I had diabetes. I needed to educate myself on this topic, yet I didn’t know where to start,” says Hazel. It was then that she found TCOYD. After a second series of tests, Hazel learned she didn’t have diabetes after all. “Even though I discovered I didn’t actually have diabetes, I wanted to get involved in educating those who do,” says Hazel. She began volunteering with TCOYD at the Honolulu conference in 2003 and has been with us ever since. She is an inspiration to everyone who attends the event and is always eager to learn more about diabetes and how to better the lives of those who live with the condition.

“TCOYD is an unusual organization. By unusual I mean something new and different. I am so happy to be a part of all that they do. I truly have never found an educational program that beats TCOYD,” says Hazel.

We appreciate Hazel’s 8 years of friendship and thank her for inspiring us all to continue doing what we do best—educating the diabetes community across the country.

Hazel is a Charter Member of our TCOYD Directors Council, the newly formed giving council supporting our Living Well With Diabetes Scholarship Fund.

Practical Lifestyle Changes May Prevent Diabetes

By Steven Edelman, MD

P

eter* is a 56-year-old man with a history of being overweight, along with high blood pressure and abnormal cholesterol levels.

His mother, brother, sister and two paternal uncles have type 2 diabetes. He came to my office to ask what he can do to prevent diabetes.

I gave him a loaner glucose meter and he came back with the results shown in his log book. As you can see, his before-breakfast numbers range from 86 to 123 mg/ dL and his after-meal values go as high as 198 mg/dL. The official ranges for the fasting (before food in the morning) is less than 100 for normal individuals and over 126 is people with diabetes (in between is called prediabetes). The postmeal

glucose values for people who are normal are less than 140 and over 200 in people with diabetes (again, in between is called prediabetes).

Peter’s values are not normal, but nor are they within the diabetes range. He clearly has prediabetes.

I recommended a good dietitian and exercise physiologist to slowly begin practical lifestyle changes that will help him to avoid developing full-blown diabetes.

After we see how his blood glucose does with lifestyle modifications, I will make sure Peter is aware of medication options to see if he wants to be aggressive about attempting to prevent diabetes. *Names have been changed

Taking Control Of Your Diabetes

11

TCOYD Conferences & Health Fairs 2011 Schedule February 12

March 5

March 6

April 2

May 21

June 11

June 25

September 10

October 1 November 12 November 19

TBA

Taking Control Of Your Diabetes 1110 Camino Del Mar, Suite “B” Del Mar, CA 92014 | www.tcoyd.org

Tel: (800) 998-2693

(858) 755-5683 Fax: (858) 755-6854

Santa Rosa, California Honolulu, Hawaii Kona, Hawaii Tucson, Arizona Albuquerque, New Mexico Albany, New York Latino Conference San Ysidro, CA Amarillo, Texas Tampa, Florida San Diego, California Latino Conference Oceanside, CA Native American Program

Nonprofit Organization U.S. Postage

PAID

San Diego, CA Permit No 1

For schedules, bios, trailers and more, visit www.tcoyd.org

TCOYD is a not-for-profit 501(c)3 charitable educational organization.

Diabetes in Motion

Becoming a Member Now Sweeter Than Ever!

T

he Sweet Membership Program is here!

We consider each and every one of our conference attendees to be members of our organization, but by joining the Sweet Membership Program, you can keep up with all things TCOYD all year long!

By becoming a “Sweet Member,” you will receive quarterly copies of our newly revamped newsletter as well as a choice of one of our books or DVDs for only $20 per year!

This program also reinforces the positive

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My TCOYD Newsletter, Vol. 34

messages about taking control of your diabetes and provides you with up-to-date information you can use in your daily life with diabetes.

All proceeds from the Sweet Membership Program go back into providing quality diabetes education, motivation and empowerment for people across the U.S. Make a commitment to your health and join today!