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Column marks 10th year of advice

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While contemplating a topic for this article, I realized that this month marks the 10th year that I have been creating this column.

What started in August 1999 as an idea that there "may be a need for diabetes information" has changed to show that diabetes has reached epidemic proportions in the United States.

Let's look at some of the changes to diabetes care over the years and use the five points of the star as our focus:

• Blood glucose testing

• Medication

• Nutrition

• Activity

• Support of family



Glucose testing

Glucose testing has advanced dramatically since the 1600s, when urine was tasted for the sweetness.

Less than 30 years ago, testing involved combining urine with water and adding a Clinitest tablet. The resulting color indicated the amount of sugar in the sample.

In the early 1980s, home glucose monitors were developed and they empowered patients to test their blood glucose at any time. Continued technology has diminished the testing time from three minutes to five seconds, the blood sample size has decreased and the size of the monitor has gotten almost too small to read.



Medication

Since the discovery of insulin in 1921, new diabetes medications have been developed to improve glucose control. Oral medications cover a wide range of actions.

For example, drugs may stimulate the pancreas to increase insulin production, decrease the release of glycogen from the liver or slow the absorption of glucose in the small intestines.

Numerous types of insulin have been developed ranging from rapid acting to insulin that is peakless and lasts for 24 hours.

Whatever medication your health care provider prescribes, there are several options available.

Nutrition

"What can I eat now?' is a common question that I hear when someone has diabetes.

In the past, a diabetic diet was the gold standard. Then the food pyramid came into favor and now carbohydrate counting is the measurement tool.

The rationale is that our body prefers carbohydrates as fuel for energy because carbohydrates are easily converted to glucose. Consuming controlled amounts of carbohydrates at each meal provides a continual source of fuel, just like putting another small piece of wood on a campfire. Carbohydrates and sugars are found mainly in milk, fruit and pasta/bread. By focusing on "Mother Nature" foods, you will provide your body with the nutrients, vitamins and minerals that are needed for good health.

As always, portion control is an additional tool to help with control of diabetes.



Activity

Exercise has gone through a variety of phases. Mark Spitz increased the popularity of swimming, and Lance Armstrong gave publicity to bicycling. Step aerobics classes were in vogue for several years, and now Pilates and Zumba classes are popular.

Whatever you do, our bodies were built to move and we need to do a minimum of 30 minutes of activity on days that we eat. Exercise burns excess glucose and makes your cells more receptive to the insulin you are producing. Make exercise a priority every day.



Support

Support always has been important. Everyone needs to know that he or she is not alone in facing the daily challenges of diabetes.

There are two free local support groups that welcome new members:

• From 10-11 a.m. the first Wednesday of the month at the Sequim Senior Activity Center, 921 E. Hammond St., Sequim.

• From 7-8 p.m. the third Tuesday of each month at Olympic Medical Center, 939 Caroline St., Port Angeles.

The future holds many changes in diabetes care and I will be here to keep you informed. Talk to you next month.



Susan Sorensen is a registered nurse who does diabetes education in the community and can be reached at www.starlady diabetes.com.

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