Spring Quarter Newsletter

NEWSLETTER

MY

Spring 2013 Volume 43

What a Novel Thought!

Individualizing Diabetes Care and Education Dr. Edelman’s Corner

INSIDE Foundation Support Page 3

Nine Major Tips Your Teens Think You Should Know Being A Teen with Diabetes Page 4

Type 1 Trial with Cebix What’s New in the Type 1 Community Page 6

Know Your Numbers Page 7

The Jerry Lund Story, Part 2 Page 8

Prescription Savings for You Small Advances with Big Impact Page 10

Question of the Month Page 11

A

ll of the major diabetes professional organizations come out with new treatment guidelines every few years. These treatment guidelines help doctors who are in the trenches taking care of their patients to provide better care. The new buzz word within these new treatment algorithms is “individualization”.

Individualization refers to the approach and treatment of people with diabetes according to their individual characteristics and specific needs, such as cultural and ethnic backgrounds, personal beliefs, living situation, education level and financial situation.

Oh, My Gosh! What a novel thought!

Individualization has been needed since the beginning of time and diabetes is a

classic condition where it may be needed the most. By taking these important differences into account, medical professionals can design a successful treatment plan for the many different faces of diabetes. This is the way every physician or provider should approach every patient with any type of problem.

For those of you with type 2 diabetes there are eight different classes of oral Individualized Care (continued on page 2)

Individualized Care (continued from page 1)

Special Acknowledgements Board of Directors Steven V. Edelman, MD Founder and Director, TCOYD Sandra Bourdette Co-Founder and Executive Director, TCOYD S. Wayne Kay s2a Molecular, Inc Margery Perry Terrance H. Gregg DexCom, Inc. Daniel Spinazzola DRS International Contributing Authors Jennifer Braidwood Steven Edelman, MD Susan Guzman, PhD William Polonsky, PhD, CDE Robyn Sembera Sara Shelden

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 Michelle K. Feinstein, CPA Director of Finance and Administration Antonio Huerta Director, Latino Programs Jennifer Braidwood Manager, Outreach and Continuing Medical Education Jimm Greer Manager, Multi-Media David Snyder Manager, Exhibit Services Robyn Sembera Associate Manager CME and Outreach

MyTCOYD Newsletter Editor: Jennifer Braidwood Assistant Editor: Robyn Sembera 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. ©2013 All rights reserved.

2 My TCOYD Newsletter, Vol. 43

medications, in addition to several types without proper education. You need of insulin preparations and injectable the knowledge to fully understand incretin agents, such as Bydureon and the initiation and on-going Victoza. The good news is that we adjustments that may be necessary to have lots of tools in our tool box but, achieve the best results possible with at the same time, the choice of which each intervention. medication to use first, second, third, Diabetes education also needs etc. can get complicated. The decision to be individualized because truly needs to be made based on the there are major differences in the pros and cons of each etiology, prevention Individualized care medication plus taking strategies, treatment requires a bi-directional into consideration all of approaches, use of conversation between devices, genetics the individual variables provider and patient... and family planning, listed earlier. This is the main premise behind associated conditions individualized care and it requires a and lifestyle issues between type 1 bi-directional conversation between the and type 2 diabetes. This is why we provider and patient in order now have both a type 1 and type 2 for it to be most effective. track at our TCOYD conferences The treatment strategies for folks and health fairs. And, of course, with type 1 diabetes are also expanding we never forget the importance of for the better! New insulin pumps educating family members, friends (patch and traditional), continuous and loved ones who are so vital in glucose monitoring and other helping those living with diabetes. medications, such as Symlin, are just Individualizing therapy should a few of the ever-expanding treatment not be considered a novel approach options for type 1’s. It is also important to any health care provider. for individuals with type 1 to be However, it is definitely the knowledgeable about the many off-label responsibility of people with diabetes approaches (not officially approved to become as educated as possible by the FDA), such as the incretins in order to have constructive and (Victoza and Bydureon), metformin and productive conversations with the newest group of oral medications their caregiver. Become an active approved for type 2 partner when it comes to diabetes, SGLT-2 inhibitors individualizing your care! (see the on-line Edelman Report, “Pee Your Way To Better Blood Sugars”). We all know you cannot just Steven Edelman, MD start these new medications Founder and Director or slap on a CGM device Taking Control Of Your Diabetes

Giving Back

Grant Support Helps TCOYD Expand!

By Jennifer Braidwood

W

hy do TCOYD’s 2013 national conferences look and feel a bit different this year? TCOYD has been graciously awarded support funding from two fabulous grantmaking organizations, The Leona M. and Harry B. Helmsley Charitable Trust and the Medtronic Foundation.

With this new level of support funding, TCOYD has been able to focus on individualizing the way people with diabetes learn how to manage their condition. “This was a great opportunity for us to address the different educational needs between the two conditions and we were able to do that by creating a brand new all-inclusive ‘Type 1 Track’ at our national conferences,” said Dr. Steven Edelman, Founder and Director of Taking Control of Your Diabetes. Now, conference attendees have the choice of attending a newly developed ‘Type 1 Track’ or the improved ‘Type 2 Track’ in order to get more precise and type-specific information about how to effectively manage diabetes.

Individualized Education “We have always made sure that the information and education people received at our conferences addressed the needs of people with type 1 and type 2, but now, with

Now, conference attendees have the choice of attending a newly developed “Type 1 Track” or the improved “Type 2 Track” in order to get more precise and type-specific information...

there are also overlapping topics that focus on emotional barriers, health maintenance, preventing and treating eye, kidney and nerve diseases and dealing with the health insurance companies.

Reaching the Type 1 Community The different tracks have also allowed TCOYD to start reaching the two different tracks we can really more of the type 1 community. focus in on what type 1’s and type “During our first two conferences 2’s need and want when it comes to of the 2013 season we have really getting the right type of management seen increased attendance from the strategies and education,” Edelman type 1 community and it’s great to said. The type 1 track, for see that individuals are responding example, has workshops on family to the changes we have made with planning, genetic screening, use both the ‘Type 1 and Type 2 Tracks’, of medications other than insulin, the new type 1 hands-on sessions, CGM and pumps, celiac and other and our expanded type 1 and type autoimmune conditions, as well as 2 focused social media sessions,” targeting a cure, including updates said TCOYD’s Executive Director on the artificial pancreas. The type Sandra Bourdette. “Without the 2 track has more time to focus on support from these two funders we the plethora of new drugs, age and wouldn’t have been able to expand weight appropriate dietary and in this way. We are very grateful exercise approaches, reducing heart and hope to continue this trend.” disease and sleep apnea. Of course,

Taking Control Of Your Diabetes

3

Nine Major Tips Your Teen Would Like You to Know

By William Polonsky, PhD, CDE and Susan Guzman, PhD

B

eing a parent to a teen with diabetes can be a tough, frustrating job. You must walk a difficult path between taking good care of your teen while also encouraging independence. You need to care, but not care too much.

This article will give you and your teen some new ideas about how to survive diabetes together. No need to follow all of these etiquette points, and give yourself a pat on the back if you are doing any of them! Let this be the start of a conversation, a new beginning for you and your teen.

1

Stop trying to scare me with diabetes statistics. You’ve told me a million times that many years of high blood sugars can hurt me.

I understand you are scared and want the best for me, but bugging me about complications just makes me want to tune you out. If I need motivation, it has to be something important to me right now, not way down the road.

4 My TCOYD Newsletter, Vol.33 Vol. 43

2

When my blood sugars are high, don’t assume I’ve done something stupid (although I may have). It may be hard to believe, but sometimes it really isn’t my fault. Blood sugars can get wacky even when you do everything right.

Instead of grilling me about why they are high (which may have no answer) or what I might’ve done wrong, let’s figure out what to do now.

I don’t want to be constantly hassled about what I should be doing. I need to handle diabetes more on my own.

Still, though I hate to admit it, I am glad to know you’ve “got my back.”

Let’s figure out where you can trust me to do things on my own and where I could still use your involvement.

5

Make the effort to understand diabetes from my point of view. If you don’t have diabetes, you can’t possibly know what I am going Please acknowledge when I’m through. The reality is that diabetes doing something right, not just is unfair, inconvenient, a lot of work, when I’ve messed up. You may not and it sucks. No need to cheer me notice it, but taking care of diabetes up, or to tell me that it could all be worse. You don’t have to fix it; instead, is a lot of hard work. And it is not just listen when I need to vent or fun! I may not be perfect, but there complain. are a lot of things I am doing right every day just to stay alive. A pat on Don’t tell everyone about my the back for a job well done would be diabetes, especially not during awesome. the first minute you meet them. Do you have any idea how embarrassing Don’t always be in my face about diabetes, but don’t leave this is? I know you mean well, but me completely alone with it either. my goal is to fit in, not stick out.

Everybody does not have to know.

I know this is a tough balance.

3

6

4

Give me a chance to tell people about diabetes when I am ready to do so.

7

Recognize that I am never going to be perfect with my diabetes care, no matter how much you want this. I know it can make you nervous when you see a high blood sugar reading or notice that I haven’t made the best food choice, but let’s get real. No one can manage diabetes perfectly. I’ll do my best (and yes, maybe I need to do even better), but I also need to have a life.

8

Don’t limit my activities based on diabetes. If you do, people may see me as fragile, sick, or think something is wrong with me. I can do anything those without diabetes

Be sure to check out BDI’s newest online offering, Just For Parents, a no-cost, automated program developed specially for parents of teens with type 1 diabetes. Learn about your own stresses and what may be causing them, and discover personalized tips that can help you survive and thrive with a type 1 teen. Start here: http://justforparents.behavioraldiabetes.org can do, though it may require some creative problem solving. Sports, sleepovers, traveling, and parties are all things that can be done safely.

Support me in figuring out a way to make it all possible.

9

Don’t be the food police. Yes, I make choices that you don’t like (and sometimes aren’t so smart).

But trying to control what I eat isn’t going to help; instead I’ll just do my best to avoid you when I eat.

Remember that good diabetes control is doable even if you don’t eat healthy stuff all the time.

William Polonsky, PhD, CDE, is the Founder and Chief Executive Officer of the Behavioral Diabetes Institute and an Associate Clinical Professor at the University of California, San Diego Susan Guzman, PhD, is a clinical psychologist and is the Co-Founder and Director of Clinical Services of the Behavioral Diabetes Institute, a non-profit organization devoted to the emotional side of diabetes.

Being A Teenager With Diabetes

By Sara Shelden

B

eing a teenager with diabetes is no doubt a challenging lifestyle. It’s comforting to read that Dr. Polonsky and Dr. Guzman show a great understanding of the minds of teenagers who are living with diabetes.

Sometimes, as teens with diabetes we feel alone or misunderstood.

However, we still manage to go out with friends, we make decisions on our own and ultimately we’re becoming independent. For me personally, it has taken about five years for my mom to finally grasp the concept of how to deal with my diabetes and me. Unfortunately, parents will never fully understand the concept of being a person with diabetes. At times, this can make life frustrating. In fact, it happens more often than not. Teens with diabetes need to keep in mind that although we may sometimes feel badgered by our parents, they’re only interested in keeping us healthy and happy! Having diabetes is a huge responsibility and it isn’t necessarily easy.

But when you make the best of the situation and become flexible with the people in your life, especially your folks, you may be surprised at the weight that’s lifted off your shoulders.

Taking Control Of Your Diabetes

5

Be a Part of Change Participate in this Type 1 Trial with Cebix Incorporated

A

n Interview with Dennis Kim, MD, Cebix Chief Medical Officer Cebix Dr. Dennis Kim Incorporated is currently looking for volunteers who are 18-65 years old having type 1 diabetes mellitus (T1DM) for at least 5 years to participate in a clinical trial (called ACT1VE).

The goal of the study is to determine if an investigational drug (i.e., not approved by the US Food and Drug Administration) called Ersatta™ is safe and effective in people with a complication of diabetes called peripheral neuropathy. We recently sat down with Cebix Chief Medical Officer, Dennis Kim, MD, to learn more about this study.

What is Diabetic Peripheral Neuropathy (DPN)?

DK: DPN is a common complication of diabetes, involving damage to the nerves in the body, which can cause loss of sensation and diminished quality of life.

Symptoms can be very subtle at first, and many people with diabetes are not even aware that they have symptoms of DPN. It is estimated that 60-70% of all people

6 My TCOYD Newsletter, Vol. 43

with diabetes will eventually develop DPN. As the condition progresses, it can lead to serious complications such as ulcers, infections, and even amputation of limbs.

What is the ACT1VE Study?

DK: ACT1VE is an on-going clinical trial studying the effects of a modified version of C-peptide, called Ersatta, on DPN. Volunteers will receive onceweekly subcutaneous injections of Ersatta (60% of participants) or placebo (40% of participants).

Participants and study doctors will be blinded to which study drug (Ersatta or placebo) is being administered. The study will last for approximately 1 year and participants will have to come in to the study clinic for about 12 visits during that time. There are over 30 study sites located throughout the US, Canada, and Sweden.

How can I learn more about the ACT1VE Study?

DK: To learn more about the about the ACT1VE study, please call 858-729-6501, visit www.cebix.com or email clinicaltrials@cebix.com.

What’s New in the Type 1 Community?

Glu is

New!

Are you on Glu?

Glu is an active and diverse, type 1 diabetes, online community designed to accelerate research and amplify the collective voice of those living with type 1 diabetes. In Glu you will connect with people just like you, contribute to discussions and research, and learn from the wealth of rich information found within the pages…and that’s just the beginning.

Support

Glu makes it easy to find and connect with others touched by type 1 diabetes, allowing you to learn from each other within a safe, secure, and supportive community.

Know Your Numbers

Empower

Empower yourself by becoming a citizen scientist and help transform the way research and development is conducted.

You can participate in studies and surveys, answer the Question of the Day, start your own discussion or respond to someone else’s post.

Educate

You will learn from the everchanging community discussions, news, articles, and ideas, found within the pages of Glu and have the opportunity to educate others by sharing your own personal experiences.

Glu is a unique and dedicated destination transforming the way research and development for the treatment of type 1 diabetes is conducted. By logging in you are entering an environment of support and shared wisdom, where your questions and answers matter. By joining Glu you become a citizen scientist, promoting the sharing of knowledge across key audiences to improve research, learning, and discovery.

Setting up an account is quick and simple. Visit myglu.org to sign up or download the free app from the App Store or the Android Marketplace. Search for “MyGlu”. Contact info@myglu.org with questions, comments or to get involved.

By Steven Edelman, MD

P

hil is a 46-year-old man who developed type 1 diabetes at the age of six.

He went on insulin pump therapy in his mid twenties and started using a continuous glucose monitoring device a few years ago. Phil did pretty well controlling his diabetes until his late thirties when he developed central obesity (excess fat around his belly), high blood pressure, abnormal cholesterol levels and sleep apnea. His logbook shows that his glucose levels bounce around quite a bit but, what is really unusual, is that his insulin requirements are extremely high for a person with type 1 diabetes.

Phil has developed both type 1 and type 2 diabetes. We call that double diabetes or hybrid diabetes. Both of Phil’s parents had type 2 diabetes and, eventually, he was prescribed two oral medications used for people with type 2 diabetes (metformin and Actos), in addition to his insulin pump. He responded well to the adjustments that were made to his therapy. His glucose values dropped and there was an overall improvement in his A1c.

Everyone with type 2 diabetes develops some form of insulin resistance which, in turn, usually requires a large amount of insulin to be injected. It is important to remember that type 1 diabetes is an autoimmune condition and type 2 is a very common condition with a strong genetic component. The two types are not mutually exclusive and anyone can develop both types of diabetes.

The treatments used in Phil’s case would be the same if he had just type 1 or type 2 diabetes. In his case, with Phil having both type 1 and type 2, the two different types of therapies are used together.

Taking Control Of Your Diabetes

7

D Y O C A T reme Ext etes Diab eover: Mak

cheeseburger.”

And, that is exactly what interviews three and four were focused around…food!

Early on in the interview Jerry whole-heartedly admitted, “food, Today basically, got me into this situaStart d o tion and food is raidwo nifer B

By Jen what is getting me out of it.” f Day o osis: Before Jerry decided to make a iagnr 26, 2012 d change, his daily diet consisted of e #3 ptemb Weight: w e S e i v g close to 4,000 calories of packaged, Startin unds Intearry 4, 2013 08 o p processed and fast foods. Take a look 266 Febru t Weight: 2 n at the chart on the next page to see Curre nds lost u o what Jerry was consuming on a daily 58 p / 90 ’m pretty lucky 5 4 1 : basis and what his diet looks like now.

BP that I get to wake .3 59 6 1 : : l C o 1 r A What we really wanted to know up every morning holeste Total c from Jerry was, how did he and spend another 9 LDL: 9 day being a part of this incred- revolutionize his diet and, most importantly, was it difficult? “I ible journey,” said Jerry Lund on jumped online and read about four or February 4, 2013 during his third five postings about diabetes diets and interview with TCOYD’s Executive Director, Sandy Bourdette. We I just dug right in. I made a lot Jerry confessed that of notes. There were resounding started following Jerry through his he had a very stark life-altering journey on September similarities, almost identical things in each article, so it was pretty easy to realization during his trip 26, 2012 when he decided make a change, take control of his diabetes figure out what I should be eating. I to China. His addiction and most importantly, his entire life. also backed up that information with to junk food was a lot “The thing is, I’ve always wanted to a bunch of nutrition pamphlets that I stronger than he thought be healthier, to be thinner, to have got at the TCOYD conference in San when the junk food was Diego. I put everything together and a more active lifestyle and look in only an arms reach away. the mirror and like what I see, but, came up with a plan that was good for to be honest with you, those things me and a plan that I liked.”

Remembering what he had were not at the forefront of my learned from Dr. Edelman at the mind because I was always thinking about the next donut, muffin or TCOYD conference, Jerry focused

The Lund Jerr y Stor y

I

‘‘

‘‘

8 My TCOYD Newsletter, Vol. 43

w#4 e i v r Inte 13 on consuming much smaller portions, and really loaded up on stuff that he enjoyed eating. “All the foods I am eating are foods that I like and foods that are healthy, so it’s pretty easy.”

But what about temptation? Was it hard for Jerry to resist all those things he was eating before? Does he ever crave them? Does he ever falter?

“The temptation is there. Every time I drive down the street I drive by a Jack In The Box. The holidays were tough, with all the candy and treats.

Was I tempted? Yes, I was tempted! I was definitely tempted. Did I have a couple of things? I sure did! But, the key was, instead of eating the entire box of See’s candy I’d only have one piece and I really enjoyed that ONE piece.” Jerry stressed the fact that he has a sense of willpower now

t: e i D s ’ Jerry s. Now Then v Things Jerry Used to Eat:

Cheeseburgers (3-4 per week) Pastrami or other Italian meat sandwiches Fries (3-4 per week) Donuts (4-5 per day) Big muffins (4-5 per week) Cookies (1 big bag per week) Chips (1 big bag per week) White bread 1 loaf per week Bagels (3-4 per week with lots of cream cheese) Cheese (2-3 slices per day) Ice cream (2-3 bowls per week) Candy (1-2 per day) TV dinners (2 per month) Cereal (2 boxes per week with lots of milk) Orange juice (1/2 gallon per week) Favorite breakfast (eggs, bacon, hash browns, pancakes)

that he never had before, matched with a gripping sense of self-control.

“We need to have strength and selfcontrol to do things that are good for us instead of those that are bad for us. Sometimes, most times, those bad things, they look good, they taste good, they might make you feel good, but they aren’t good for you.”

When the interview was coming to an end Jerry stressed that he really isn’t focused in on his diabetes, but rather more on his general well being and his overall health. “Diabetes is a symptom, it’s an indicator of really poor health as a whole, at least that’s what I think. I don’t think to myself, ‘Man, I am really going to beat this diabetes thing.’ I think, ‘I’m becoming a much healthier person.’ You know what? My diabetes is improving because my health is improving.

You just can’t have one without the other. They go hand-in-hand.”

Things Jerry Eats Now:

Fish Chicken Turkey Low-fat string cheese High-fiber bread (1-2 slices per day) High-fiber cereal (2-3 times per week with non-fat milk) High-fiber mini bran muffins (3-4 per week) Apples Pears Strawberries Greek yogurt (non-fat plain, sweetened with Splenda) plus berries Low-fat cottage cheese Lentil soup Trader Joe’s organic black bean enchiladas Trader Joe’s veggie lasagna Yellow and orange bell peppers Fruit juice bars Spinach Broccoli Tomatoes Almonds Walnuts

, 20 7 April 9 t Weight: 19 Curren nds lost 69 pou 130’s /85 d BP: mi 9 .

55 A1c: 5 holesterol: 1 Total c LDL: 91

W

e met up with Jerry again a few days after he returned from a 10-day work trip to China. Most importantly, we wanted to see if he was successful in adhering to his diet plan but we also wanted to find out if he had encountered any struggles along the way. Anyone will tell you, it’s a lot easier to keep up with a diet regimen when you are in the comfort of your home and sticking to a strict routine. However, to move outside of that, and not to mention, travel to an entirely different country and stick to the same diet regimen is a pretty big feat. “I’m going to China. This is going to be easy! I don’t like Chinese food,” Jerry said at the start of the interview with a bit of a laugh. “That first night in the hotel though, I knew I had run into a big problem. I had awakened at two, maybe three in the morning.

I couldn’t sleep because of the time difference and there was nothing on TV. The hotel I was staying at had a mini-fridge in the room that was stocked with snacks. Just like the old Jerry, I started snacking. Chips, cashews, cookies, Dove chocolate bars, you name it. I ate two maybe three things out of that mini-fridge every night. Going out to eat at Extreme Diabetes Makeover (continued on page 12)

Taking Control Of Your Diabetes

9

TCOYD in Motion

Start Saving on Your Prescriptions Today!

T

COYD is pleased to provide you access to a new program called RxSavingsPlusSM which you can start using immediately.

RxSavingsPlus is now available to you and your family to provide another way to make your prescription medications that are not covered by your insurance more affordable. Print your card now and start saving right away!

Visit tcoyd.rxsavingsplus.com to print your card.

Use RxSavingsPlus for discounts on medications to treat diabetes, heart disease, birth control, smoking cessation, weight loss, hair loss, ED

Start Saving Today!

Visit http://tcoyd.rxsavingsplus.com

and more— even save on many medications for your pet.

an average savings of 22 percent on retail prescriptions and up to 50 percent on select generic medications through the CVS Caremark Mail Save on visits to MinuteClinic® Service Pharmacy. To learn more about MinuteClinic, which is inside additional savings available through select CVS/pharmacies, has nurse practitioners and physician assistants the mail service pharmacy visit http:// tcoyd.rxsavingsplus.com or call toll-free trained to diagnose and treat common illnesses. Simply show your 1-877-673-3688.

The RxSavingsPlus program RxSavingsPlus card at MinuteClinic includes 99 percent of all commonly locations and save up to 10% on prescribed brand-name and generic any regular priced health service medications, and is accepted at 9 out or screening that is not covered by of 10 retail pharmacies nationwide. your insurance. While savings may No membership fees, no enrollment vary by drug and by pharmacy, the and no waiting makes it easy to start RxSavingsPlus prescription drug saving immediately. discount card program provides

Small Advances Have a Big Impact in the Diabetes Community

By Robyn Sembera

J

ust as cell phones are evolving to become smaller, thinner and more compact, the technology in the diabetes world is right behind it. Fans of Insulet’s OmniPod® will now get to experience an up-to-date wireless and waterproof pump that is 34% smaller, 25% lighter, 16% slimmer and still carries 200 units of insulin. The “new-generation”

10 My TCOYD Newsletter, Vol. 43

OmniPod is finally FDA approved along with its partner, the Personal Diabetes Manager (PDM). The PDM has a built-in FreeStyle® blood glucose meter that makes it easy to manage and help control your diabetes by keeping track of your insulin delivery, simplifying data, suggesting bolus values, and more!

Another quick and easy to use

pump is the V-Go®, recently brought to you by Valeritas. The V-Go is a one-time use only pump for basalbolus injections, meaning you change the pump and add fresh insulin every day. This is a non-electronic pump that you simply patch on to your skin. It is a basal-bolus delivery system designed for the type 2 community or for those

Question of the Month

It’s easy to save with your RxSavingsPlus prescription drug discount card.

Using your RxSavingsPlus drug discount card is simple. Just present your card to your pharmacist the next time you purchase a prescription not covered by insurance and then pay the pharmacy. You will always pay the discounted price offered through this program or the pharmacy’s retail price, whichever is lower. There is no paperwork, no claim forms and no waiting period!

If you have questions please call RxSavingsPlus Customer Care tollfree at 1-877-673-3688.

There is a maximum savings of $10 per person, per visit. Operated by CVS Caremark.

This is not insurance. Discounts are only available at participating pharmacies. © CVS Caremark 2011

looking for an alternative to multiple daily injections.

If you’re in the market for a smart and discreet pump, take a look at one or both of these new options, whichever satisfies your diabetes needs. Summer time is approaching and you’ll want to get your bronze on minus “pump lines”…or at least have smaller ones!

By Steven Edelman, MD

A special thanks to all of our Facebook fans who sent in questions for Dr. Edelman!

W

hen I’m low and I have a 15g snack, why does my blood sugar sometimes go even lower when I check it 15 minutes later? I can never figure this out!

Answer: This is probably occurring because the amount of insulin in your body is still overpowering the amount of carbohydrates that you are consuming. Also, remember that when you eat something it takes time for your stomach to process it for absorption. Drinking juice or regular soda is always the fastest way to get your blood sugar up compared to a candy bar, which is full of fat and protein. Lastly, your glucose meter or continuous glucose monitor gives you a blood sugar reading that is 10 to 15 minutes behind, known as a lag period, so your blood glucose could actually be on its way up but your meter result is lagging.

C

an you discuss how excess fat makes it more difficult for cells to respond to whatever amount of insulin is being produced by the pancreas?

Answer: What you are referring to is called “insulin resistance.” Insulin resistance is very common in most obese individuals, including the majority of folks with type 2 diabetes. The answer is not completely known and is very complicated, especially if you are not a scientist. It has to do with insulin receptors on the adipocytes and defects in intracellular glucose metabolism...told ya, it’s complicated!

Not much larger than a berry!

Taking Control of Your Diabetes is Generously Supported By: Platinum Corporate Sponsors

Gold Corporate Sponsors

Silver Corporate Sponsors

Taking Control Of Your Diabetes

11

TCOYD Conferences & Health Fairs 2013 Schedule

February 23

March 23

April 27

April 28

May 18

June 15

September 21

October 12

November 2 November 23

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 Nonprofit Organization U.S. Postage

Tucson, Arizona Santa Clara, California Honolulu, Hawaii Kauai, Hawaii Savannah, Georgia San Francisco, California Living Your Best Life – A Conference for Type 2’s Worcester, Massachusetts Omaha, Nebraska Albuquerque, New Mexico San Diego, California

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.

Extreme Diabetes Makeover (continued from page 9)

restaurants, that was the easy part.

I always ordered a salad, or grilled chicken or fish. But, once I got back in the hotel room it was all over.”

A bit later in the interview Jerry confessed that he had a very stark realization during his trip to China.

His addiction to junk food was a lot stronger than he thought when the junk food was only an arms reach away. “The food thing, this diet thing, it’s really second nature to me now. When I go shopping, I know what to buy. I know what to eat, what’s good for me and, most importantly, I know the healthy

12

My TCOYD Newsletter, Vol. 34

things that I really enjoy eating. But this trip taught me how important it is to keep junk food out of my house and how important it is to keep a clean house free from temptation.

It taught me that I’m not strong enough yet to resist when it’s right in front of me. A recovering alcoholic can’t live with someone who likes to drink and keeps the cupboards stocked with whiskey and bourbon and I learned I can’t live with a mini-fridge stocked full of junk food.” The important message to take away from this is that Jerry’s inability to resist junk food doesn’t

make Jerry a failure or a bad person.

It makes him aware of a weakness he has and we all have them! To be aware of your weaknesses makes you a stronger person as a whole.

“I know now the importance of creating a very particular environment, an environment free of junk food that ultimately supports my well-being and my success. The other day I told my daughter I was planning on losing another 10 or 15 pounds and she said to me, ‘No! You are just right, right now!’ It was a great feeling to hear her say that. I know I’m still on the right track.”