Spring Quarter Newsletter

NEWSLETTERMY

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

Spring 2013 Volume 43

Individualized Care (continued on page 2)

Dr. Edelman’s Corner

What a Novel Thought! Individualizing Diabetes Care and Education

All 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”.

Foundation SupportPage 3

Nine Major Tips Your Teens Think You Should KnowBeing A Teen with DiabetesPage 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 YouSmall Advances with Big Impact0

Question of the MonthPage 11

INSIDE

medications, in addition to several types of insulin preparations and injectable incretin agents, such as Bydureon and Victoza. The good news is that we have lots of tools in our tool box but, at the same time, the choice of which medication to use first, second, third, etc. can get complicated. The decision truly needs to be made based on the pros and cons of each medication plus taking into consideration all of the individual variables listed earlier. This is the main premise behind individualized care and it requires a bi-directional conversation between the provider and patient in order for it to be most effective.

The treatment strategies for folks with type 1 diabetes are also expanding for the better! New insulin pumps (patch and traditional), continuous glucose monitoring and other medications, such as Symlin, are just a few of the ever-expanding treatment options for type 1’s. It is also important for individuals with type 1 to be knowledgeable about the many off-label approaches (not officially approved by the FDA), such as the incretins (Victoza and Bydureon), metformin and the newest group of oral medications approved for type 2 diabetes, SGLT-2 inhibitors (see the on-line Edelman Report, “Pee Your Way To Better Blood Sugars”). We all know you cannot just start these new medications or slap on a CGM device

2 My TCOYD Newsletter, Vol. 43

Board of DirectorsSteven 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 AuthorsJennifer BraidwoodSteven Edelman, MD Susan Guzman, PhDWilliam Polonsky, PhD, CDERobyn SemberaSara Shelden

TCOYD TeamSteven 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 SemberaAssociate Manager CME and Outreach

MyTCOYD NewsletterEditor: Jennifer BraidwoodAssistant Editor: Robyn Sembera Design: Hamilton Blake Associates, Inc.

MyTCOYD Newsletter is offered as a paid subscription of Taking Control Of Your Dia-betes. 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.

Individualized Care (continued from page 1)

SpecialAcknowledgements

Steven Edelman, MDFounder and DirectorTaking Control Of Your Diabetes

without proper education. You need the knowledge to fully understand the initiation and on-going adjustments that may be necessary to achieve the best results possible with each intervention.

Diabetes education also needs to be individualized because there are major differences in the

etiology, prevention strategies, treatment approaches, use of devices, genetics and family planning, associated conditions

and lifestyle issues between type 1 and type 2 diabetes. This is why we now have both a type 1 and type 2 track at our TCOYD conferences and health fairs. And, of course, we never forget the importance of educating family members, friends and loved ones who are so vital in helping those living with diabetes.

Individualizing therapy should not be considered a novel approach to any health care provider. However, it is definitely the responsibility of people with diabetes to become as educated as possible in order to have constructive and productive conversations with their caregiver. Become an active

partner when it comes to individualizing your care!

Individualized care requires a bi-directional conversation between provider and patient...

Taking Control Of Your Diabetes 3

Grant Support Helps TCOYD Expand!

By Jennifer Braidwood

Giving Back

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

the two different tracks we can really focus in on what type 1’s and type 2’s need and want when it comes to getting the right type of management strategies and education,” Edelman said. The type 1 track, for example, has workshops on family planning, genetic screening, use of medications other than insulin, CGM and pumps, celiac and other autoimmune conditions, as well as targeting a cure, including updates on the artificial pancreas. The type 2 track has more time to focus on the plethora of new drugs, age and weight appropriate dietary and exercise approaches, reducing heart disease and sleep apnea. Of course,

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 CommunityThe different tracks have also

allowed TCOYD to start reaching more of the type 1 community. “During our first two conferences of the 2013 season we have really seen increased attendance from the type 1 community and it’s great to see that individuals are responding to the changes we have made with both the ‘Type 1 and Type 2 Tracks’, the new type 1 hands-on sessions, and our expanded type 1 and type 2 focused social media sessions,” said TCOYD’s Executive Director Sandra Bourdette. “Without the support from these two funders we wouldn’t have been able to expand in this way. We are very grateful and hope to continue this trend.”

Why 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.

4 My TCOYD Newsletter, Vol.33

Being 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.

1Stop 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.

2When 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.

3 Please acknowledge when I’m doing something right, not just

when I’ve messed up. You may not notice it, but taking care of diabetes is a lot of hard work. And it is not fun! I may not be perfect, but there are a lot of things I am doing right every day just to stay alive. A pat on the back for a job well done would be awesome.

4Don’t always be in my face about diabetes, but don’t leave

me completely alone with it either. I know this is a tough balance.


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 through. The reality is that diabetes is unfair, inconvenient, a lot of work, and it sucks. No need to cheer me up, or to tell me that it could all be worse. You don’t have to fix it; instead, just listen when I need to vent or complain.

6 Don’t tell everyone about my diabetes, especially not during

the first minute you meet them. Do you have any idea how embarrassing this is? I know you mean well, but my goal is to fit in, not stick out. Everybody does not have to know.

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

Nine Major Tips Your Teen Would Like You to Know


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

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 diabetescontrol 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 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.

By Sara Shelden

Being A Teenager With 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


An Interview with Dennis

Kim, MD, Cebix Chief Medical Officer

Cebix 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

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 once-weekly 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 [email protected].

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

What’s New in the Type 1 Community?

Glu is New!Glu is an active and diverse, type 1 diabe-tes, 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.

SupportGlu 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.

Are you on Glu?Dr. Dennis Kim

By Steven Edelman, MD

Know Your Numbers

Phil 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.


EmpowerEmpower 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.

EducateYou will learn from the ever-

changing 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 [email protected] with questions, comments or to get involved.

By Jennifer Braidwood

A TCOYD

Extreme

Diabetes

Makeover:

The Jerry Lund

Story

I’m pretty lucky that I get to wake

up every morning and spend another

day being a part of this incred-ible journey,” said Jerry Lund on February 4, 2013 during his third interview with TCOYD’s Execu-tive Director, Sandy Bourdette. We started following Jerry through his life-altering journey on September 26, 2012 when he decided make a change, take control of his diabetes and most importantly, his entire life. “The thing is, I’ve always wanted to be healthier, to be thinner, to have a more active lifestyle and look in the mirror and like what I see, but, to be honest with you, those things were not at the forefront of my mind because I was always think-ing about the next donut, muffin or

cheeseburger.” And, that is exactly what interviews three and four were focused around…food! Early on in the interview Jerry whole-heartedly admitted, “food, basically, got me into this situa-tion and food is

what is getting me out of it.”

Before Jerry decided to make a change, his daily diet consisted of close to 4,000 calories of packaged, processed and fast foods. Take a look at the chart on the next page to see what Jerry was consuming on a daily basis and what his diet looks like now.

What we really wanted to know from Jerry was, how did he revolutionize his diet and, most importantly, was it difficult? “I jumped online and read about four or five postings about diabetes diets and I just dug right in. I made a lot of notes. There were resounding similarities, almost identical things in each article, so it was pretty easy to figure out what I should be eating. I also backed up that information with a bunch of nutrition pamphlets that I got at the TCOYD conference in San Diego. I put everything together and came up with a plan that was good for me and a plan that I liked.”

Remembering what he had learned from Dr. Edelman at the TCOYD conference, Jerry focused


Interview # 3

February 4, 2013

Current Weight: 208

58 pounds lost

BP: 145/90

A1C: 6.3

Total cholesterol: 159

LDL: 99

Day of diagnosis:

September 26, 2012

Starting Weight:

266 pounds

‘‘Jerry’s Diet:

Then vs. Now

Start

‘‘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.

Today

A TCOYD

Extreme

Diabetes

Makeover:

The Jerry Lund

Story


Extreme Diabetes Makeover (continued on page 12)

on consuming much smaller por-tions, 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

that he never had before, matched with a gripping sense of self-control. “We need to have strength and self-control 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 becom-ing a much healthier person.’ You know what? My diabetes is improv-ing because my health is improving. You just can’t have one without the other. They go hand-in-hand.”

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

Interview # 4

April 9, 2013

Current Weight: 197

69 pounds lost

BP: mid 130’s/85

A1c: 5.9

Total cholesterol: 155

LDL: 91

Jerry’s Diet:

Then vs. Now

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 weekBagels (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)

Things Jerry Eats Now:FishChickenTurkeyLow-fat string cheeseHigh-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)ApplesPearsStrawberriesGreek yogurt (non-fat plain, sweetened with Splenda) plus berriesLow-fat cottage cheeseLentil soupTrader Joe’s organic black bean enchiladasTrader Joe’s veggie lasagnaYellow and orange bell peppersFruit juice barsSpinachBroccoliTomatoesAlmondsWalnuts


TCOYD 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

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

Save on visits to MinuteClinic®MinuteClinic, which is inside

select CVS/pharmacies, has nurse practitioners and physician assistants trained to diagnose and treat common illnesses. Simply show your RxSavingsPlus card at MinuteClinic locations and save up to 10% on any regular priced health service or screening that is not covered by your insurance. While savings may vary by drug and by pharmacy, the RxSavingsPlus prescription drug discount card program provides

Start Saving on Your Prescriptions Today!

an average savings of 22 percent on retail prescriptions and up to 50 percent on select generic medications through the CVS Caremark Mail Service Pharmacy. To learn more about additional savings available through the mail service pharmacy visit http://tcoyd.rxsavingsplus.com or call toll-free 1-877-673-3688.

The RxSavingsPlus program includes 99 percent of all commonly prescribed brand-name and generic medications, and is accepted at 9 out of 10 retail pharmacies nationwide. No membership fees, no enrollment and no waiting makes it easy to start saving immediately.

Just 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”

Start Saving Today!Visit http://tcoyd.rxsavingsplus.com

TCOYD in Motion

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 basal-bolus 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

Small Advances Have a Big Impact in the Diabetes Community

By Robyn Sembera


When 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.

Can 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!

Question of the Month

By Steven Edelman, MD

Taking Control of Your Diabetes is Generously Supported By:

Silver Corporate Sponsors

Platinum Corporate Sponsors

Gold Corporate Sponsors

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 toll-free 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!

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

Not much larger than a berry!


NonprofitOrganizationU.S. Postage

PAIDSan Diego, CAPermit No 1

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

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

Extreme Diabetes Makeover (continued from page 9)

Taking Control Of Your Diabetes1110 Camino Del Mar, Suite “B”Del Mar, CA 92014 | www.tcoyd.org

Tel: (800) 998-2693 (858) 755-5683 Fax: (858) 755-6854

TCOYD Conferences & Health Fairs 2013 Schedule

February 23 Tucson, Arizona March 23 Santa Clara, California April 27 Honolulu, Hawaii April 28 Kauai, Hawaii May 18 Savannah, Georgia June 15 San Francisco, California Living Your Best Life – A Conference for Type 2’s September 21 Worcester, Massachusetts October 12 Omaha, Nebraska November 2 Albuquerque, New Mexico November 23 San Diego, California

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

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.”

Spring Quarter Newsletter

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