WPADE.org

Is the reason Americans are getting heavier because they expend fewer calories in daily physical activities? In our automated world of push buttons for T.V. remotes, power car windows and locks, automatic washers, dryers, garage door openers and gas-powered and electric lawn mowers, is it not logical why we see this rapid rise in obesity over the last few decades?

There are some surveys that suggest that our caloric intake has consistently increased and our eating habits have changed. It has been shown that the more variety avialable in choices, the more will be eaten because the taste buds don’t get “bored”. There has been a vast increase in the number of new product varieties introduced into the market place, including snacks, candy, bakery products, high caloric items and rich tasting entrees. We consume more fatty and sugary food. Soft drink consumption increased by 60% between 1977 and 1998 including soda pop and fruit juices. Fluids quench thirst but not hunger, consequently, you will replace at least as much of the calories that you drank later on in the day with food.

Portion sizes have risen dramatically and research has proven that adults consume more when larger portions are served. It may be easier to eat less if meals were more basica rather than the delectable, ethnic cuisines prepared with lots of fat and enticing seasonings and sauces. Snacks need to be chosen more judiciously. The number of snacks and the type have changed dramatically in the last two decades. And finally, increased restaurant frequency has attributed to increase body weight. Physical activity is very important for weight control and overall fitness, curbing appetites and motivating individuals to keep in shape. However, the focus should definitely be more directly focused on calories taken in rather than on calories burned.

(Survery were conducted at Purdue University and Tufts University)

DID YOU KNOW THAT AMERICANS DRINK ANNUALLY PER PERSON APPROXIMATELY:
24 gallons of milk
26 gallons of coffee
32 gallons of beer
51 gallons of soda pop

By Jolynn Gibson RN, CDE
Membership Chair

When asked me to come up with a synopsis about “me”, I wasn’t sure what I was going to say. I could be as professional or as personal as I wanted to be. I knew right away that I was going to take the personal route. After a couple of days of putting the task off, I was invited to the Sigma Theta Tau induction ceremony, where a good friend of mine was going to be honored. Sitting in the audience listening to the accomplishments of others in the nursing profession, I felt a distinct wave of inadequacy (or was it nausea?). What have I done in my career that might take me to an induction ceremony in the future?

Perhaps, one in which my name would be printed in the program? At the time I was thinking, “…Jolynn enjoys sleeping in..falling asleep with the latest diabetes journal in hand..running..shopping”. These are not activities that will secure my place in nursing history.

With that in mind, here’s my brief history. I started my career in the 80’s at West Penn Hospital. I worked on the diabetes floor before the Joslin Program started. I enjoyed diabetes care and teaching, but deviated from it to try my hand at administration. After 3 years as a nurse manager, I entered the world of home care. I loved the challenge of nursing in this setting because I was no longer distracted by am care, pm care, passing food trays or prepping patients for tests – I actually had to be a nurse. After 5 years and some more fun with administrative jobs I accepted a job doing telephonic diabetes instruction for an insurance company. Here I was, back to the job I wanted to do in the first place. Three years later, I wanted to see and touch patients again. I have been working as a diabetes educator at the Center for Diabetes and Endocrinology at UPMC, Falk Clinic for the past 2 year. I was able to get my CDE in October of 2001. I enjoy my job and actually believe that I am making a difference in people’s lives.

You grab the meter after cutting YOURSELF - that big drop of blood’s just too perfect to waste!

Everyone in the family comes to you to test their kids just to make sure.

You test your non-D child whenever she begins drinking too much.

You don’t care about the nutritional content of the food you’re buying, just how many carbs per serving it has!

When your child is cranky you ask “are you high?” and you don’t mean drugs!

You’re proud when your 3 year old can ‘aim’ to hit the ketone test strip.

You can’t let your kid take an afternoon nap without first checking for a low. <

You’ve forgotten what the phrase “good night’s sleep” means.

Instead of whispering “sweet nothings” to each other in the middle of the night, you and your spouse are talking about blood sugar numbers.

You sneak into your child’s room at night just to make sure they are still alive.

You are afraid to give them the freedom that you gave your other kids because “something” might happen.

You clean the lint trap of your clothes dryer and find a bunch of test strips.

“Let me shoot you up” has a whole new meaning for a teenager.

You glance at the digital thermostat, which reads 68, and immediately run for glucose tabs.

You look at all children’s wrists to see if anyone else is wearing a medical alert bracelet.

When you and spouse play “guess the carb count” and keep score!

When you get suspicious looks from the cashier at the store when pointing out the “free” gum to your child.

When you base your entire self-worth on your kid’s last A1C!

If you’ve ever accidentally used Cake Mate as lip gloss (and it was green!).

When your spouse, you and your child place wagers on what the blood sugar test will reveal.

There are test strips EVERYWHERE - in the beds, under the beds.

When you look into your purse (now a back pack), and there are no longer brushes or makeup. It looks more like the doctors little black bag.

When you can’t look at a plate of food without counting the number of carbs.

You get up at 3 a.m. with the baby (non-d) and check her blood sugar before you give her a bottle.

When you realize just how nuts you look when you dip the ketone/glucose stick in a soda just to make sure that it is diet.

When it takes you three hours to go grocery shopping, because you are checking every label.

When snacks are divided up into Baggies with carb counts written on them in black magic marker.

When your husband’s beeper goes off and the first thing you check is the insulin pump.

You are able to to set up the meter and get the lancet into the device half asleep with only one eye open.

Your child has gone away for camp, and you start dreaming that you are the one that needs shots and blood checks.

Test strips are everywhere! You know your child was somewhere because you found a strip in the dirt by the garbage can, not to mention under the couch, bed, rug, car seats, etc.

In a last ditch effort to get the carbs in, you consider a cupcake to be a food group.

When your child doesn’t want to wake up early on a Saturday morning it sends you into a tailspin looking for the meter. Previously, you would take this time to enjoy a few cups of coffee and the peace and quiet.

Your child falls asleep on a road trip and you wonder whether he’s low or just tired.

Your non-D toddler comes and tells you her pump has come unclipped to get attention.

You’re on a first name basis with the nurse at your child’s school.

Your son’s report card from school says that he has learned to manage his diabetes well during the second semester.

You can’t find a measuring cup.

You child with diabetes eats more candy than the rest of your kids do, and it’s for his/her own health. Your back hurts from your purse being so heavily loaded with carbs and diabetes supplies.

You get at least one good night’s sleep in a month because you forgot to set the alarm for 2 am.

You hand out glucose tabs to the neighbor kids, instead of candy treats.

Other parents contact you to find out how you get your kids to drink more water than pop.

You encourage your child to eat candy to bring them out of a low and then say, “You want a sandwich?”

You have syringes in your purse that fall out when you pull your wallet out and get VERY funny looks (REALLY a riot when you are showing ID to an officer!).

Your child asks if breast milk is sugar free for the baby.

People think your child gets bit by chiggers a lot on their arms from testing blood sugars.

You tell your child to “check their sugar” and the kid next to them starts pulling candy out of their pockets to show how much they have.

The latest styles and designs in kit bags are more exciting than purses.

You tell someone your child’s blood sugars and they say they were high or low and they gie you a look like “Oh yeah?” and then you realize you have to explain what the norms are.

People don’t understand when you get excited about a new diabetic product (GlucoWatch, etc.) and can’t wait for it to come in more than a new house, car, etc.

Halloween consists of weighing the bag of candy to get an estimate of dollar worth in exchange for the treats.

Holiday’s consist of getting candy that will keep to treat lows.

Your non D child says they are low to get candy too.

Your non D child says they are low to get out of doing something physical (cleaning a room, etc.).

Your child asks, “When am I not going to have diabetes anymore?”

The top shelf in the refrigerator door is reserved for bottles of insulin instead of eggs.

You have a list posted on your fridge with 20 different phone numbers to call “In Case Of An Emergency.”

You have the symptoms of hypo and hyperglycemia posted prominently in your home.

You know what glucagons is and what it does.

You refill prescriptions for strips and insulin just as soon as your insurance will let you, just in case!

You supply the neighborhood with sugar free Popsicles.

You supply the neighborhood with flavored water.

You are always handing 1 oz snacks out to your child’s friends.

When your teenager says “I’ve been really high today” and she means blood sugar!

When I’m out with the boy I wear a “fishing” vest. Lots of pockets loaded down with test kit, glucose, glucagons and snacks.

Your car is full of food and juiceboxes , and your pocketbook too!

You know more doctor’s than your grandmother.

People ask your advice on the best pharmacy in town.

You lay awake at night wondering if those three glucose tabs you just gave him are going to rot his teeth.

Your year is broken up into endo visits every quarter.

You know which tech at the clinic can draw blood for an A1C with very little pain.

You use EMLA on your eyebrows before you tweeze them.

You start spitting out carb counts to adults as soon as they start talking about food.

This is a call for any diabetes supplies that you or our patients may have on your shelves, closets or garages! Spring cleaning? Doing inventory? Have diabetes supplies that are not needed? Please don’t throw diabetes supplies away, but pass them on to the newly formed Malawian Diabetes Association. This effort is affiliated with the Pittsburgh Presbytery Partnership Committee which provides support to churches in Malawi.

Malawi, Central Africa, is about the size of the state of Pennsylvania. Diabetes care is virtually non existent in Malawi. Diabetes is not frequently diagnosed and when it is diagnosed and when it is diagnosed, there is no treatment. If you happen to be lucky enough to live near the only diabetes clinic in Malawi and need insulin, you may be able to obtain one bottle of insulin per month. If you live elsewhere, you must move or die. The hospitals and physicians in Malawi do not even have the availability of glucose meters, but use a laboratory glucose, even in the emergency room!

I have been assisting efforts to get supplies into the hands of medical people, fostering application to the International Diabetes Federation, and communicating with key people who work with the Malawian Ministry of Health. Until there is a sustained ability for the hospital to obtain supplies through their “Central Hospital System”, I will be collecting donations at Brother’s Brother Foundation (Pittsburgh North Side) and will send them with medical personnel and missionaries who travel there. There will be 20 people going to Malawi in June.

The country is so needy that in many ways it is like “spitting in the bucket”, I am reminded of the story of the little boy and his dad walking on the beach after a storm. There were thousands of starfish dying on the sand, and the little boy picked one up and threw it into the water. As he reached for another, his father said “Look at all theses starfish! There are so many that throwing a couple back won’t make any difference…” But as the boy picked up the starfish, he said “I know. But it sure made a difference to that one!”

We need syringes, new meters, many strips, lancets, pen needles, glucagons, oral agents, and insulin. Please call me for arrangements for pick-up.
May God Bless you for your donation!

Jean Betschart Roemer
Children’s Hospital of Pgh
412 692-8722 (work)
412 257-8756 (home)
Jeanwrites4U@aol.com

Annette Karnash RN, MSN
Between 1992-1996, 587 Norwegian people with a history of heart disease were surveyed in a research study. Sixty-four men and women, many of who had by pass surgery, that had died were found to have elevated levels of the amino acid, homocysteine. Since that time there have been more than 50 studies suggesting a correlation between high homocysteine levels and coronary disease mortality.

Homocysteine appears to respond to nothing more than vegetables and taking a few vitamins, unlike cholesterol, which is associated with coronary problems but can often be treated only by medication and a rigid diet. Homocysteine appears to be a difinite risk factor for heart disease. The body to help manufacture proteins and carry out cellular metabolism uses Homocysteine. However, too much can couse blood platelets to clump together and vascular walls then begin to break down. In older patients, it is felt that a lifetime of this damage present scarred, thickened arteries that produce circulating cholesterol with a place to stick and grow. It is felt that the underlying cuase of heart disease is an imbalance in the system that controls homocysteine levels.

When in 1969, Dr. Kilmer McCully from Harvard, studied the case of an 8 year old boy who died from a stroke, he found the boy’s bloostream had an excess amount of homocysteine and his sclerosed arteries had the look of an elderly man. Accelerated homocysteine production caused by a genetic defect apparently led to the accelerated damage.

The 64 Norwegians who died were among those with the highest levels of homocysteine. Those individuals with elevated homocysteine are 4 1/2 times as likely to die of heart disease as those with normal levels.

Evidence points to a shortage of vitamin B6, B12 and folic acid in those who overproduce. All of these help to convert amino acid into a molecular form the body can use. The Harvard Health Letter recommends increasing consumption of grains, peas, certain meats, dairy foods and leafy green vegetables to keep homocysteine in check.