NEWSLETTERMY

Dr. Edelman’s Corner

For those of us with type 1 diabetes, we have fast and long acting insulin analogs, insulin pumps and pens, home glucose monitors and continuous glucose monitors (CGM). I feel that the avail-ability of CGM devices is the single

greatest advance for people with type 1 diabetes since the discovery of insulin 90 years ago. One of my resolutions is to educate healthcare providers about this powerful technology, alert and educate the people most affected by this condi-

F or all of us living with diabetes, there has never been a better time to make some New Year’s resolutions about taking and keeping control

of our diabetes with confidence. In years past, it has been extremely dif-ficult to achieve our individual goals due to the lack of safe and effective medications and devices. 2011 truly marks a new era for people with any type of diabetes in terms of living a long and healthy life. The moving target and biggest challenge, which will require education, motivation and self advocacy from all of us, will be getting access to these advances.

INSIDE

Winter 2011 Volume 34

Resolutions (continued on page 2)

A Startling Wake Up Call – What You May Not Know About Sleep Apnea Page 3

New Additions for Your Diabetes Toolbox Page 4

Winter Skiing TipsPage 6

Up Close & Personal with XDM ParticipantsPage 8

New Cities Added for 2011 ConferencesPage 12

Sweeten Your New Year’s ResolutionsSweeten Your New Year’s Resolutions

On the cover: (from bottom left) Alice Howe, Julia Baron, Dr. Steve Edelman, Sandy Bourdette, Michelle Day, (from top left) Roz Hodgins, Antonio Huerta, Jennifer Braid-wood, Jill Yapo, Jimm Greer and Michelle Feinstein. Not pictured: David Snyder.Staff New Year’s Resolutions, page 11.

Dr. Edelman’s Corner

SpecialAcknowledgements

tion that CGM can help them live a much more normal life and fight each and every road block that the insur-ance industry puts in front of me in order to get access for my patients. It is a rare person with type 1 dia-betes who would not benefit from a CGM device, which will help them predict the unpredictable and reduce the frustrating ups and downs of this condition. At this time next year, I hope to share more informa-tion about the Artificial Pan-creas Project, ultra rapid acting insulin and more advances in the prevention and reversal of type 1 diabetes.

For all of you out there with type 2 diabetes, we have several new oral medications as well as a new obesity drug just approved by the FDA. One of the biggest advances is the development and availability of the relatively new class of agents called GLP-1 agents or Incretins (Byetta and Victoza). These medications not only lower glucose levels safely without causing hypoglycemia, but they also help with weight loss. Several medica-tions we use now to treat type 2 diabetes cause weight gain and hypoglyce-mia, which is frustrating for PWD and healthcare providers. It now comes down to educating the medical community (only

a fraction of the people in the country with type 2 diabetes have been pre-scribed Byetta or Victoza) and once again, to fight like hell to get it for them. On the horizon are newer medications that are effective and safe as well as patch pumps and even more weight loss agents.

Your New Year’s resolution needs to be focused on getting smart and getting access. You cannot rely on

your healthcare provider to research every potential new option to help get or keep your diabetes under control. You

need to know your individual goals for glucose (A1c), cholesterol levels and blood pressure. Help your caregiver take better care of you by being an active partner in your diabetes man-agement. Keep up-to-date with the opportunities provided by the new healthcare reform act and do not back down from your insurance company if you are being denied a drug or device that you and your doctor have deter-mined to be beneficial for you. It is a sweet time for obtainable New Year’s resolutions that will help us live life

first and be diabetic second. I wish you all a happy and healthy New Year.

2 My TCOYD Newsletter, Vol. 34

Medical Advisory BoardChair: 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 DirectorsSteven 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 AuthorsSteven V. Edelman, MD Chris Sadler MA, PA-C, CDEJulia BaronRoz HodginsUrban Miyares

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

Antonio Huerta Director, Latino Programs

Alice Howe Senior Manager, Web Development

Roz Hodgins Director of Development

Julia Baron Manager, Public Relations and Outreach

Jennifer Braidwood Continuing Medical Education Associate

Jimm Greer Administrative Assistant

David Snyder Exhibit Services Associate MyTCOYD NewsletterEditor: Julia Baron Design: Hamilton Blake Associates, Inc.

MyTCOYD Newsletter is offered as a paid sub-scription 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 physi-cian. On the contrary, in all matters involving your health, TCOYD urges you to consult your caregiver. ©2010 All rights reserved.

Steven Edelman, MDFounder and DirectorTaking Control Of Your Diabetes

Resolutions (continued from page 1)

“It is a rare person with type 1 diabetes who would not benefit

from a CGM device, which will help them predict the unpredictable

and reduce the frustrating ups and downs of this condition.”

Taking Control Of Your Diabetes 3

A StArtling WAke Up CAllWhat You May Not Know About Sleep Apnea

My wife had complained about my loud snoring for years,

but I never associated it with how fatigued and sleepy I felt, espe-cially in the afternoons. I would often struggle to keep my eyes open when charting on my patients at the end of the day or when reading medical journal articles. I just wrote it off as being tired due to working long hours and pushing myself too much. I had recently become more informed of sleep apnea and its telltale symptoms after we did a research study in our patients with type 2 diabetes. In this study con-ducted by Dr. Einhorn, 35 percent of our patients had sleep apnea (49 percent of men and 19 percent of women tested had the disorder). I had even diagnosed sleep apnea in

many of my patients, but didn’t rec-ognize the same symptoms in myself.

After another day of falling asleep into a stack of charts on my desk, I finally asked my wife, “Have you ever noticed if I stop breathing during the night for short periods?” She initially said she wasn’t aware of it, but within a few days she came back to me saying that indeed there were frequent pauses in my breath-ing during the night. Sure enough, a diagnostic sleep study followed and I joined the ranks of the millions of people who have been diagnosed with obstructive sleep apnea.

Sleep apnea is a common condi-tion that typically goes undiagnosed. Signs and symptoms include:• Excessive daytime sleepiness• Waking with an unrefreshed

feeling after sleep• Having problems with memory and concentration• Experiencing personality changes• Headaches• Heartburn or a sour taste

in the mouth at night• Getting up during the night

to urinate (nocturia)• Sweating and chest pain

during sleep

Risk factors for obstructive sleep apnea include:• Excess weight. Fat deposits

around your upper airway may obstruct your breathing. However, not everyone who has sleep apnea is overweight. Thin people develop the disorder, too.

Sleep Apnea (continued on page 5)

From the Desk of Chris Sadler, MA, PA-C, CDEChristopher E. Sadler, MA, PA-C, CDEChris is affiliated with Diabetes and Endocrine Associates in La Jolla, California. He specializes in inten-sive insulin therapy using MDI and insulin pumps, management of type 2 diabetes and other endocrine disorders. He is the current president-elect of the American Society of Endocrine Physician Assistants.

Author or coauthor of several jour-nal articles and abstracts on continuous glucose monitoring and other diabetes related subjects. Mr. Sadler has presented at local and national conferences on dia-betes related topics. He also has extensive experience in clinical research. Mr. Sadler is past president of the San Diego Association of Diabetes Educators and currently the vice president of the American Society of Endocrine Physician Assistants.

Symptoms of sleep apnea that are often unnoticed by those who are affected:• Episodes of not breathing (apnea) during sleep• Loud snoring. Almost all people who have

sleep apnea snore, but not all people who snore have sleep apnea

• Restless tossing and turning during sleep• Nighttime choking or gasping spells

4 My TCOYD Newsletter, Vol.33

Here is where Onglyza comes in:

Onglyza works by inhibiting the enzyme (DPP-4) that breaks down the incretin hormones GLP-1 and GIP. Therefore, these hormones are not degraded, but instead their dura-tion of action is prolonged. Thus, Onglyza works by enhancing the action of these hormones and, as a result, decreases blood glucose levels. Onglyza can automatically sense when blood glucose levels are too high, as it works best to stimulate insulin release only when blood glucose levels are elevated, preventing the risks of low blood sugar.

Onglyza is FDA approved for use in patients with type 2 diabetes who have not been able to achieve adequate glucose control with diet and exercise. Onglyza can be used alone or in combination with other oral medications. The recommended dose of Onglyza is 5mg taken once

daily with or without food. For people with kidney prob-lems, a dose adjustment

is required. Onglyza is not for use in people with type 1 diabetes, children or during pregnancy. Onglyza is not a replacement for insulin therapy.

Some of the benefits of Onglyza besides its ability to improve glucose

control include: No weight gain, very low risk of hypoglycemia and it is highly tolerated. In studies, side effects associated with Onglyza are similar to taking a fake pill or placebo.

Kombiglyze XR from AstraZen-eca and Bristol-Myers Squibb, is the newest diabetes combination pill consisting of Onglyza and Glucophage (metformin). Glucophage is the most widely used medication for type 2 diabetes and has been prescribed in the US since 1995. The combination of a DPP-4 inhibitor, such as Onglyza and Glucophage represents a safe, powerful and simple way to achieve your A1c goal with minimal risk of hypoglycemia and weight gain. Like other diabetes medications, a prescrip-tion for Onglyza and Kombiglyze XR is required. Your healthcare provider will determine if any of these new agents is appropriate for you.

For more information on both Onglyza and Kombiglyze XR, visit the following:www.bms.comwww.onglyza.comwww.astrazeneca.com

By Julia Baron

Ask Your Pharmacist

O nglyza (Saxagliptin) from Bristol-Myers Squibb is a member of a new class of drugs used to treat diabetes known as DPP-4

inhibitors. In order to understand how this drug works, you need to know how the body regulates glucose control. In addition to insulin, our body releases certain incretin hormones named GLP-1 and GIP. These hormones are released from the gut in response to the ingestion of food at meal times. They also work to lower blood glucose by stimulating insulin release, and sup-pressing the release of glucagon (this is a good thing since gluca-gon causes the blood sugar to go up). In type 2 diabetes, the levels of GLP-1 and GIP are below normal. Similarly in type 2 diabetes, once these incretin hormones are released, they are rapidly inacti-vated in the gut by an enzyme called DPP-4.

4 My TCOYD Newsletter, Vol. 34

Onglyza & Kombiglyze XRThe Newest Additions to the Type 2 Diabetes Treatment Toolbox

“Onglyza and Glucophage represents a safe, powerful and simple way to achieve your A1c

goal with minimal risk of hypoglycimia and weight gain.”

By Steven Edelman, MD and Julia Baron

Taking Control Of Your Diabetes 5

• Increased neck circumfer-ence. A neck circumference greater than 17 inches (43 centimeters) is associated with an increased risk of obstructive sleep apnea.

• High blood pressure (hypertension). Sleep apnea is more common in people with hypertension.

• A narrowed airway. You may have inherited a naturally narrow throat. Or, your tonsils or adenoids may become enlarged, which can block your airway.

• Being male. Men are twice as likely to have sleep apnea.

• Being older. Sleep apnea occurs two to three times more often in adults older than 65.

• Family history. If you have family members with sleep apnea, you may be at increased risk.

Sleep Apnea (continued from page 3)

• Use of alcohol, sedatives or tranquilizers. These substances relax the muscles in your throat.

• Smoking. Smokers are three times more likely to have obstruc-tive sleep apnea than are people who’ve never smoked.

• Prolonged sitting. Studies suggest that long periods of daytime sitting can cause fluids to shift from your legs when you recline at night, narrow-ing airway passages and possibly increasing the risk of obstructive sleep apnea.

In addition, there are also signifi-cant consequences directly related to untreated sleep apnea includ-ing worsening insulin resistance, increased blood glucose, obesity, heart disease and even sudden death.

After treatment with a CPAP or Continuous Positive Airway Pres-

sure machine my symptoms have dramatically improved. No longer do I struggle to stay awake at work and I feel more energetic. My wife is also sleeping much better without my loud snoring.

If you or someone you love is experiencing the symptoms of sleep apnea, a simple conversation with your doctor can initiate an appropri-ate evaluation that may not only improve symptoms, but dramatically improve health.

Question of the Month

By Steven Edelman, MD

Answer: Sugar-free desserts have slightly fewer carbohydrates than regular desserts. The sugar is replaced with sugar alcohols, which have less of an impact on blood glucose levels.• Remember that sugar-free cookies and cakes still contain other sources of carbohydrates,

such as flour.• Sugar-free is neither calorie-free nor carb-free. You should carefully read the food label and

count both the calories and carbohydrates.• As always, moderation is key, whether the cookies and cakes are sugar-free or otherwise.

I’m finding that these days, there are a lot of sugar-free cookies and cakes being sold in grocery stores. Are these really a better

alternative for people with diabetes?[ ]

The CPAP machine made by ResMed is comfortable and easy to use.

Diabetes on the SlopesBy Urban Miyares

Even though my competitive skiing days are behind me, I just

can’t help but yearn for those crisp winter days on top of a 12,000-foot peak, and then heading downhill—refreshing and invigorating.

But first, before hitting the ski slopes, whether for Alpine or cross-country skiing, here are a few quick, pre-skiing tips to get you ready for a day or weekend of true enjoyment that also serves as a learning experi-ence with your body and diabetes:

1Are you physically ready? Even though you may walk

and exercise regularly, skiing is an activity that utilizes many different muscles that are left unattended to in one’s daily routine. You’re quickly going to be introduced to these for-gotten muscles after a day on the powder.

2Your pre-skiing warm up begins with stretching every

day—something you should already be doing each morning.

You should now know and be doing some simple stretching exercises. Check with others or go online to get some stretching routines you can use. Make it com-

fortable, and if it’s painful, talk to a medical professional right away, and before going skiing.

3Pay attention to your legs. To avoid muscle aches and

pains, muscle cramps and spasms that many experience after their first day on the snow, nothing can beat walking as an exercise. Make a point to walk everywhere and take the stairs, instead of the elevator.

Exercise tip: One leg exercise I did, year round, was standing on the ball of one foot (make sure to hold onto something for balance), bending my knees slightly, for a count of 10, to start, and switching to the other foot and repeat the count; later, add to that count and see how high you can get.

4Remember your sit-upsI hate sit-ups, but they are

needed. Go slow here if you are not accustomed to doing them on a regular basis. I like to do sit-ups on the edge of the bed with my feet touching the floor, while watching TV or listening to music. Go ahead and use your arms if you must.

After a while, you may be able to lift your legs, or at least your knees, at the same time you bend at

the waist to raise your body’s torso. Whatever exercise routine you

begin, hopefully weeks before your first day on the snow, do it gradually, frequently and don’t push yourself. You’re not going for the World Cup, only an enjoyable and healthy day on the slopes or in the mountains with family and friends.

5Don’t forget about blood sugars and your diet.

Skiing is physically exhausting and you can easily burn a few hundred calories quickly depending on the type of skiing and your overall activ-ity. Don’t count on being able to take routine blood tests especially if the temperature is cold, as your glucose monitor may not work in such conditions. You need to avoid low blood sugar at all costs, as it

6 My TCOYD Newsletter, Vol. 34

Urban Miyares has had Type 1 diabe-tes for more than 40 years, and is a blinded Vietnam veteran. He is the U.S. National Alpine Ski Champion (1990-91), and consid-ered the fastest total blind Alpine skier in the world, having reached speeds of 63 mph in many competitive downhill races. Urban is a regular speaker at TCOYD Conferences across the nation.

WinterSkiing

Taking Control Of Your Diabetes 7

could lead to a number of medical complications and be the (preventable) cause of a skiing accident and/or injury.

When I ski, I tend to start out with a minimum blood sugar of 140 to 175. I constantly consume food throughout my day of skiing and between meals. For me, raisins and quick energy (not chocolate) food bars are great options. Eating nuts and popping a sugar-candy in my mouth was also common.

Most importantly, remem-ber to constantly drink water throughout your day of skiing.

6Finally, and above all else, don’t overdo it.

Start out the day skiing on the beginner or intermediate slope, and gradually work your way to the more demanding ski areas, if you are comfortable. Most skiing accidents happen on “that last run,” when the skier is already exhausted. Know when to quit, have fun and enjoy the nightlife as you marvel at your blood sugar control and how a rigorous exer-cise, like skiing can be enjoyed when you have diabetes.

Above all else, test your blood sugar even more frequently over the next 24 hours. Also consider waking up in the evening to test after that day’s skiing, as blood-sugar rebounding is a common phenomenon when having fun on the snow.

See you on the mountain or at the après party at the lodge!

This year, TCOYD established the The Living Well With Diabe-tes Scholarship Fund to support conference attendees needing

financial assistance and who otherwise could not afford to attend one of the many TCOYD patient-centered conferences.

TCOYD invites you to support its efforts in assisting individuals to take control of their diabetes, by making a financial gift and becoming a partner of TCOYD. By supporting The Living Well With Diabetes Scholarship Fund you will provide financial assistance to those who are unable to pay for their conference registration.

Through the generosity of donors, TCOYD is able to extend a hand to those in need and who, with your help, will have the opportunity to learn how they can live well with diabetes.

Become a partner with TCOYD by supporting The Living Well With Diabetes Scholarship Fund

with giving generously today.

For more information about the many ways to give, and the benefits of the newly established Director’s Council, please contact Roz Hodgins, Director of Development at (858) 755-5683 or email her at roz@tcoyd.org

By Roz Hodgins

The Living Well With Diabetes Scholarship Fund

Giving Back

To learn more about giving, please contact: Roz Hodgins TCOYD Director of Development

1110 Camino Del Mar, Suite BDel Mar, CA 92014 (858) 792-4741 Ext. 20 or toll free: (800) 998-2693email: roz@tcoyd.org

Our beautiful “giving” bird-cage filled with donations at the San Diego conference on October 30th.

I had failed and that is why I had to go on insulin. After talking with the dream team and finally adjusting my dosage, I realized that it was my body that needed the insulin. It was there to help me, not hurt me.

How the Program Changed Her Life with Diabetes: The program helped me clear up all the misconceptions I had about my diabetes. Since I have had the disease for so long, I had forgotten all the things I had been told to do over the years by my doctors. I was re-educated and re-enlightened more than I ever thought I could be! New research and medical innovations come up in the area of diabetes all the time. Things keep changing, and I keep learning!

Renee StantonLiving Well with Type 2 DiabetesBirthday: Nov. 5th (Age 55)Diagnosed: More

than 20 years agoCurrent City:

El Cajon, CA

Aspirations: To become a moti-vational speaker for people with diabetes.

Words of Wisdom: Controlling your diabetes starts with small steps. Don’t keep your diabetes a secret. Find a buddy and/or mentor to help you through it.

Biggest Game Changer: Begin-ning my insulin regimen was tough for me. I blamed myself for having to use insulin. I thought after all these years of living with diabetes,

8 My TCOYD Newsletter, Vol. 34

UP CLOSE

By Julia Baron

David LimLiving Well with Type 1 DiabetesBirthday: June 17th (Age 22)Diagnosed: Age 4Current City: San Diego, CA

Dream Destination: BaliWords of Wisdom: Reach

out to family and friends, and to your doctor and diabetes support groups in your area. Online diabe-tes forums are also a great resource, which allow different people with similar experiences to learn from each other. I believe that we are each other’s greatest resource, and that sharing our collective experi-ences, whether they are good or bad, will help immensely.

First Impressions of the Program: I actually did not apply to be part of the Extreme Diabetes Makeover program, however I am a regular patient of Dr. Edelman’s. I experienced a very bad hypoglyce-mic incident in the middle of 2008 that left me unconscious and para-medics had to be called to revive me. When the program was getting started, Dr. Edelman reached out to me and asked me if I would like to participate.

On Growing Up with Diabe-tes: As I grew up, I began to under-stand what I was up against. I would worry about what would happen to me when I was older with the lack of control I had throughout my teenage years. I have to maintain

Taking Control

Meet seven people with diabetes, who in the beginning of the XDM program, only shared two things in common: Poorly managed diabetes

and a true desire to improve their condition. Over a 22-week period, they were educated, empowered and motivated to take control of their diabetes with the help of a “dream team” of diabetes care specialists. They were given HD Flip Cameras to document their ups, downs, triumphs and tribulations. Through the good times and the bad, they helped show the world the importance of a team approach to diabetes care and the time, effort and patience that goes into managing the disease.

Here they are after the end of the program, up close and personal offering their advice, sharing how they were able to change their lives and how they continue to thrive.

An Inside Peek Into the Thoughts, Insights and Lives of Our Extreme Diabetes Makeover (XDM) Participants

Taking Control Of Your Diabetes 9

the changes I have learned from this program if I want to live a long and happy lifestyle.

Chet CarneyLiving Well with Type 2 DiabetesBirthday: Jan. 2nd (Age 53)Diagnosed: 3 years agoCurrent City: San Diego, CA

Future Goal: Roller skate for a 100-mile stretch on the Pacific Coast Highway

Words of Wisdom: You have to learn to crawl before you can walk. You have to learn to walk before you can run. Learn about your system and how it operates and then start taking control. For example, keep a results journal regarding what you eat, the medication you are taking and when you are testing. This will give you a clearer picture of what your system can and cannot do.

On Becoming Activated: It encourages me to keep going! This is a program I can live with and stick with. Cheating is not an option. If I stick with this program,

I will be able to have my diabetes under control, for good.

Greatest Obstacle During the Program: Loss of French fries as a regular part of my diet and getting down on myself if I wasn’t losing weight was tough for me. I love French fries and I thought I could never eat them again! After going through the program and learning about nutrition and moderation, I learned how my system could handle French fries.

In terms of my weight, I learned not to be let down by weigh-ins. It was just my body adjusting to the new me, and eventually, I lost the weight.

Liz Van VoorhisLiving Well with Type 1 DiabetesBirthday: Dec. 31st (Age 30)Diagnosed: Age 15Current City: New York, NY

Accidental XDM Moment: Dropping her Dexcom CGM in the toilet

Words of Wisdom: Find a great physician who is not only your healthcare provider but also a true partner and team member who is genuinely involved in your diabetes care. Knowing that they have your health and best interests in mind is reassuring and essential in taking control of your diabetes.

Biggest Game Changer: Getting a continuous glucose monitor (Dexcom) was amazing. The visibility that it provides for my diabetes is unparalleled and has changed my life. I have up to the minute, accurate results. I think a

lot of my success in this program was due not only to my motivation to stay under control, but to my Dexcom for allowing me to know my numbers even when I am on the go.

On Everyday Life with Diabetes: Diabetes is a disease you have to face everyday. Even though I’ve had great results and learned tips and tricks to improve my diabetes, when things in your life change, it can throw off your control. I moved across the country, changing my living situation, job and routines. Unfortunately, that requires a bit of a re-do to get things adjusted, but it’s possible if you work at it.

Tim SmithLiving Well with Type 2 DiabetesBirthday: Aug. 31st (Age 62)Diagnosed: 5 years agoCurrent City: El Cajon, CA

Hobbies: Cooking, collect-ing classic cars, shooting canons, hiking, and soon, maybe piano (to name a few)

Words of Wisdom: It helps to gather in groups for mutual support. Doing it alone is so overwhelming and can often dis-courage people. Being in a group setting makes you realize you are all in the same boat. Also, if you live with diabetes your whole life, you have a greater awareness than people who were just diagnosed (especially type 2’s). For someone like myself who lived many years without diabetes and now have it, you get a certain perspective that

10 My TCOYD Newsletter, Vol. 34

Taking Control

you otherwise wouldn’t if you were without a support system.

Teaching Moments: When I first came to TCOYD that Saturday, I quickly recognized the diversity of the group and the commonality that we all had. As diverse as we all were, we all shared a common element. I think that to me was a very significant realization for me. I learned that diabetes doesn’t pick and choose. It is non-discriminatory disease that can affect anyone at anytime.

New Diet and Exercise Regi-mens: Cooking is my passion. Now, I am more conscious about the weight and content of a recipe. I used to think that everything tasted better with butter and sugar. As for exercise, I am still very active. I hike, take long walks before or after lunch and go to the gym.

Daron HowardLiving Well with Type 2 DiabetesBirthday: Oct. 5th (Age 38)Diagnosed: 3 years agoCurrent City: San Diego, CA

Memorable Quote: “I’m not crazy, I’m just a little dysfunc-tional!”

Words of Wisdom: When you are first diagnosed with diabetes, it can be scary. Some might think it is a death sentence (although it is not). Talking face to face with your healthcare provider is very important. Asking questions and doing your research is even more important. There are tons of web-sites including TCOYD.org and RealAge.com that have great

information on diabetes and what you can do to take control.

On Living in a Homeless Shelter with Diabetes: In the shelter, it was difficult to stay under control. The food that is served is designed to fill you up and has a lot of carbs. As I learned in XDM, your body turns carbs into sugar, causing changes in your blood sugars. Even when I was low, it was difficult to find juice because the kitchen was only open at certain hours. I would have to beg the staff to give me juice so that I would not pass out.

Missing in Action: There was a point when I fell off the face of the earth. I was unhappy with myself and had no confidence. I was using drugs and I felt ashamed and embarrassed. When I came back to TCOYD to give the program another try, everyone showed me support. They didn’t judge me, they embraced me and helped me stay off drugs and control my diabetes. They took a chance on me and I appreciate that more than anything.

Celeste KelleyLiving well with Type 2 diabetesBirthday: July 13th (Age 68)Diagnosed: 20 years agoCurrent City: Escondido, CA

Favorite Quote: “Be outrageous. It’s the only place that isn’t crowded”

Words of Wisdom: Get involved with your diabetes. It may be tough at first, but get a friend or family member to help support you and treat it one day at a time. Ask yourself, “What am I doing

today to help myself?”On Growing and Learning

from the Program: I couldn’t believe how much the makeover program increased my self-confi-dence in managing my diabetes. I became so orderly and efficient in terms of caring for myself. I was encouraged not just to test fre-quently but also to understand the numbers on my meter and how they related to exercise, eating, etc. Before the program, I noticed that my doctors would have me log my numbers, but do nothing with them. They would sneeze and say, “See you later!” Now I understand what I need to do to improve my blood sugars.

Greatest Challenges: Before the program began, I saw myself as my greatest challenge. I needed to get out of my own way. I knew that with this program, there was no time to fall asleep at the wheel. It’s get up and go. Although there were many times when I wanted to avoid being active, I knew it wouldn’t work. I was motivated and my team motivated me as well. Eventually, I gained the self-assurance to make it all happen.

Taking Control Of Your Diabetes 11

TCOYD Corporate SponsorsPlatinum

Gold

Silver

Wilson is a 54-year-old male with type 2 diabetes who has

recently started using insulin. His current regimen includes 90 units of Lantus at night and about 15 units of Novolog before meals. Wilson eats a pretty consistent breakfast, lunch and dinner at 7am, 12 noon and 6pm respectively.

As you can see from his logbook, he is frequently getting low over night and in between meals, just before lunch and in the afternoon. He is on too much insulin, but which one? Lantus or Novolog?

Answer: When an individual on a multiple daily injection regimen, consisting of a basal and bolus insulin, the ratio should be close to 50% of each. This is not a hard and fast rule but in this case, it appears that he is on too much basal insulin since he gets low in between widely spaced meals and in the early morning. His current ratio of basal to bolus insulin is 90:45 or 67% basal and 33% fast acting. This lop-sided ratio may indicate too much basal or not enough bolus insulin, and in Wilson’s case, it is the former.

Keeping Your Basal to Bolus Insulin in Balance

By Steven Edelman, MD

Know Your Numbers

TCOYD New Year’s Resolutions

Sandy Bourdette: Instead of a resolution, I would like my 401k to do well this year!

Michelle Day: I will meditate for 5 minutes every day, focusing on the here and now and not on my never ending to do list.

Jill Yapo: I will think more positively and learn to relax a little!

Alice Howe: I want to con-tinue getting straight A’s in my Masters in Nursing Program. I am also taking up piano.

Julia Baron: To be more adventurous in 2011! I hope to travel to the South Pacific and go skydiving.

David Snyder: I resolve to be more peaceful, easeful and useful.

Jimm Greer: I don’t do New Year’s resolutions. I just try to make changes whenever I can!

Antonio Huerta: I vow to live a simple life and live within my means.

Jennifer Braidwood: In true Eckhart Tolle fashion, I want to realize whole heartedly that the present moment is all I truly have, to make the NOW the primary focus of my life.

Roz Hodgins: I hope to build our pyramid of support for TCOYD.

Michelle Feinstein: I will try to be more organized at home.

We wish you all a safe and joyful New Year! See you in 2011!

12 My TCOYD Newsletter, Vol. 34

We are very excited to announce three new cities

that will be added to the TCOYD mix! In 2011, we will be holding conferences, health fairs and CME programs in Tucson, Arizona; Albany, New York; and Tampa, Florida.

“We are very excited to be

broadening our reach to these three new cities. We will be able to offer education and empowerment to a multitude of new folks who otherwise may not have been able to attend a TCOYD conference in another city,”

says Dr. Edelman of the new lineup.Full conference schedules and

registration information will be available approximately 2 months before each scheduled event. Check TCOYD.org or your inbox for details!

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 or www.realage.com

Tucson, Arizona April 2, 2011

Tucson Convention Center

Albany, New York June 11, 2011The Desmond Hotel & Conference Center

Tampa, FloridaOctober 1, 2011Tampa Convention Center

NEW IN 2011: On the Road with TCOYD

By Julia Baron

Diabetes in Motion

TCOYD Conferences & Health Fairs 2011 Schedule

February 12 Santa Rosa, California March 5 Honolulu, Hawaii March 6 Kona, Hawaii April 2 Tucson, Arizona May 21 Albuquerque, New Mexico June 11 Albany, New York September 10 Amarillo, Texas October 1 Tampa, Florida November 12 San Diego, California TBA Native American Program TBA SoCal Latino Programs

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