Siwgrstorm

During the past few days, I have had a little “big sugar;” just the lingering effects of cold, corrected for easily with a little bolus or two. But what to do about the United States’ High Blood Sugar problem? Charlie Rose’s show inspired me to do some research about “Big Sugar,” an industry that is able to put a stranglehold on the political process, most insidiously as it affects the WHO - World Health Organization’s - recommendations on the global epidemic of diabetes and obesity. While I may not count as the “media” – I decided to take my own advice and put some of those contrasts between the food industry and diabetic care I mentioned in my previous post on this blog.

SIX REASONS WHY TYPE ONE DIABETICS ARE A CAUSE FOR HOPE

1 – Who Are the Sugar Experts Now? WE ARE
We as Type 1s have to get our own mini-master’s degrees in self-care and carbohydrate digestion, despite a poor climate for good science education in the US. “Both children and adults like me who live with type 1 diabetes need to be mathematicians, physicians, personal trainers and dieticians all rolled into one. We need to be constantly factoring and adjusting, making frequent finger sticks to check blood sugars, and giving ourselves multiple daily insulin injections just to stay alive.” — Actress Mary Tyler Moore (JDRF) The general public is not there with us yet, and indicators suggest that leaders are in short supply. But we can get them there. “Not since the Soviet Union’s launch of the Sputnik satellite has the need to improve science and mathematics education in America been as clear and as urgent as it is today. And never has it been more apparent that the pivot point for change and improvement is the nation’s teachers and the institutions that train them.” National Science Foundation “Talking Points”

2 – We Don’t Have a Choice, But They Do, And WE SHOULD LET OUR REPS KNOW.
All Types of Diabetes cost the US a lot of money, but we are not committed to education;
Cost of diabetes care to the US in 2002: Total (direct and indirect): $132 billion - NDIC
The new budget for the Diabetes and Digestive Health arm of the National Institute of Health is going DOWN by 11% in the 2006-2007 budget. The new budgeted number is 1.8 billion. But, the doubling of co-payments for prescription drugs that some of us have experienced in the past 5 years results in a 10 to 12 percent reduction in use of medications for chronic disease conditions such as diabetes and hypertension. National Center for Health Care Check out Curious Girl's post about what you can do right now.


3 – We Exercise, We Eat Right, WE ARE THE NEW LEADERS
One key to good control is increased aerobic activity, but it is much more than just good HgA1c’s that we are promoting when we dedicate ourselves to healthy lifestyles. "According to analyses by Graham Colditz, a professor of epidemiology at the Harvard School of Public Health, the direct medical cost of inactivity is at least $24 billion a year. An analysis of health-care costs by a team from the federal Centers for Disease Control and Prevention suggests that because individuals who are physically active have significantly lower annual direct medical costs than those who are inactive, getting people to become more active could cut yearly medical costs in the U.S. by more than $70 billion" HSPH Harvard

4 – How former GA rep Zell Miller and other ‘Sugar-Beholden’ Congressional Reps Want to Blame Families – WE ARE SMARTER THAN THAT.
From Ruskin and Schor’s article in the Nation; “During child nutrition reauthorization hearings, the man some have called the Senator from Coca-Cola, Georgia's Zell Miller, parroted industry talking points when he claimed that children are "obese not because of what they eat at lunchrooms in schools but because, frankly, they sit around on their duffs watching Eminem on MTV and playing video games." And that, of course, is the fault not of food marketers but of parents. Miller's office shut down a Senate Agriculture Committee staff discussion of a ban on soda pop in high schools by refreshing their memories that Coke is based in Georgia.” As parents, we know that no matter how healthy our household, we are faced with an overwhelmingly poor media environment to counter. BUT WE DO KEEP GOING. WE CAN OUTLAST THEM.

5 – The Money Is Out There, But Big Sugar Gets It, Not Families – A LOT OF IT, WE CAN GET IT BACK
We make sugar ourselves in the US and yet….US Sugar Imports in 2001 were $480 million while US Sugar Exports 2001 were $3 million USDA, According to Wikipedia, in 2004, Coca-Cola made $21.9 billion. Diabetes costs approximately $1,000 per patient per year. For type one: that means we are spending: $980 Mill. So, they could pay for all of us to be treated each a year and still have 19 Billion. Slate.com “Growing industry influence is also apparent at the President's Council on Physical Fitness. What companies has the government invited to be partners with the council's Challenge program? Coca-Cola, Burger King, General Mills, Pepsico and other blue chip members of the "obesity lobby." (Ruskin and Schor) These companies, however, are being forced to pre-empt the disaster that was Big Tobacco but implimenting new programs for health and wellness, and avoiding kid-marketing. Will it work? Well, a lot teenagers I see still smoke, but the adults are getting the message. And the more often the JDRFI gets people front-and-center in congress, the better. "Not since AIDS activists stormed scientific meetings in the 1980s has a patient group done more to set the agenda of medical research."
— Wall Street Journal, March 31, 2004.

6 – A Sweet Family Fortune SUCKING OUR COLLECTIVE PANCREAS DRY, AND BOTH PARTIES ARE GETTING SICK OF IT
Where to begin? With the Fanjuls? "Despite its small size, accounting for just 1 percent of American farm receipts and 61,000 direct jobs, sugar is the single largest agricultural donor to political campaigns. The Fanjul family, descendants of a Cuban sugar baron who was forced out after the 1959 revolution that brought Fidel Castro to power, operates the nation's largest cane-growing and refining operation through the Flo-Sun Company, based in Palm Beach, Fla. While Alfonso Fanjul Jr. donates to the Democrats, his brother, Jose Fanjul, contributed more than $200,000 for George W. Bush's re-election effort." (New York Times - see below) The sugar industry’s heavy handed lobbying efforts to change WHO recommendation about reducing sugar in children’s diets have been nasty and, according to the reporters, typical of their tactical style. They succeeded in keeping the recommendations weak and vague. (think: “new food pyramid” - ??) But recently, politicians of all stripes are considering letting CAFTA and other free trade negotiations look past sugar...that's a sign of hope right there.



Recommended Reading:
* New York Times
* Common Dreams
* The Nation
* Mother Jones
* (had to find a non-liberal news source so…..) The Heritage Foundation
* VANITY FAIR
** Photo from www.bridgeandtunnelclub.com

Thanks Simpsons(!), and thanks Amy T for suggesting that D-bloggers post about the Charlie Rose show from March 16th. To begin, I used to be a regular "Charlie Rose" viewer, until I decided that most of his interviews felt canned, uninformative, and self-referential. HOWEVER, I still feel that his list of guests is consistently relevant, and must give the old gas-bag some credit where credit is due. I downloaded the show with high expectations, in other words....

Like the New York Times series, "Bad Blood," this panel discussion had its work cut out; distinguish between two (3?) highly misunderstood diseases, describe the landscape diabetics and diabetic care exist in today, and then project, project, project until someone is scared into getting on a treadmill.

I think the fact that the speakers had to explain such basics is part of the hurdle to getting anything done. Arguing about diets has never worked. If Charlie Rose had to ask "What are carbohydrates?" (I'm sure he was already aware but he's asking for his audience, WHO SHOULD ALSO KNOW) then how can we get to actually adding gym time to schools?!?

Lets think big - What about those CORN SUBSIDIES mentioned by Marc Santora - what are those for? High Fructose Corn Syrup! For example did you know that: "The United States is the largest producer of high fructose corn syrup (HFCS). Corporations that also receive the majority of farm subsides produce most of it. Most of the corn they grow is genetically modified. Such corn cannot find a market in many places in the world, as in the European Union, Uganda, and until recently Brazil, all of which refuse the import of genetically modified products." (navdanya.org) WE ARE EATING IT - A LOT OF IT. Check your pantry.

We need more of these types of stark contrasts in the press: what multinational companies in the food industry are marketing food to the poor (poor in time, money and resources), how much of this food is unhealthy based on a diabetes-prevention diet. What kinds of subsidies are they getting and how does this compare to our health education programs? For example, have you seen the Seva Foundation's Native American Diabetes Prevention Program .

I choose to eat more labor-intensive food (i.e. unprocessed things I cook myself) when I can, in order to avoid this conglomerate of poor farming/poor economics/poor health. The trade-off is simple; it takes time I don't have and money I don't have to do so. No wonder so many people are having trouble with their diets.

One interesting "global" solution would be adopting the Slow Food style of dealing with digestion. Another would be to walk more. But as the authors of these studies demonstrate, this message "calories in - energy out" - is very hard to get across, even to the "converted." Even if you've been well educated, the pace society requires does not reward your efforts a lot of the time. This isn't all doom and gloom, however. If you've attempted to live with even a little more "cruchiness" in your life, you are probably doing a lot more good than you realize.

VS



Standing at a Quest Diagnostics counter in Chinatown I have a realization. There is no way in hell that the receptionist's estimate of a 30 minute wait is possible. The people in the waiting room are even sitting slowly, somehow, and some über-stylista is having trouble with her forms while she tries to call Quest on her cell phone and rudely yells at the over-worked receptionist at the same time....I have 45 minutes.....I start feeling a little low....ugh. This was one of my precious 45 minutes, one that won't come again for days, one that I already resented wasting in a waiting room and was now going to waste on NOT getting the test I needed in that waiting room. Start feeling lower. I remember that I worked out a little more that usual (i.e. at all) at the gym this morning. OK, I think, I'm outta here. I go downstairs to that strange curvy part of Mott. I need sugar. I ate my tube of InstaGlucose and forgot to replace it last week. I search between the dangling good luck dogs and knock-off toys. My brain on glucose would know what I was looking at, but I am feeling dizzy and dazzled by the tchokes. I don't know what any of this stuff is! My glucose-free brain is confused; is there candy in that store? in that one? is that candy? is that???? Finally I see an enourmous red smoothie thing at an ice cream shop. I order it, I drink it. I walk away. Eww. Eww Eww Eww. In one more block I realize I was right next to a store with juice. JUICE! Insta-glucose "1", random candy "0."

I am constantly debating how to create the appropriate "Sugar Culture" in my house. The extremes, perhaps: Anything goes just bolus 'till you drop or Alexandra Jamieson's (girlfriend of Super Size Me's Morgan Spurlock) organic, caffeine-free, animal liberation inspired, sugar-free, millet-popping herbal tea bonanza. We fit somewhere inbetween, being vegetarians, but the sugary edges are blurry, and I wonder how influential a young child's diet is on their future habits and health. It is undeniable however; families adopt an attitude towards consumption that kids follow. Sometimes it bleeds into other realms; material objects, environmental stewardship, cultural diet, etc. Being a type 1 diabetic, I've tried to be neutral about sugar some days, I rage against its chemistry the next, decide its worth the bite now and again on other days.

Web pediatrician Dr. Green's article on sugar and kids is annoyingly uncommitted: "The effect of sugar intake on children's behavior is a hotly debated topic in pediatrics. Parents and educators often contend that sugar and other carbohydrate ingestion can dramatically impact children's behavior, particularly their activity levels. Physicians, on the other hand, have looked at controlled studies of sugar intake and have not found hypoglycemia or other blood sugar abnormalities in children who are consuming large amounts of sugar."

Everything is good in moderation, including moderation, they say. But is there reason to ban things from the house (such as high fructose corn syrup). How have you managed to "contain" the madness? Have you had your cake and eaten it too??

Here are the contents of my emergency kit. Now all I need is an instant shrinking machine. How do you stuff it all away while still holding onto The Lorax, the stuffed hedgehog, one small mitten and an unsatisfactory assortment of broken crayons? If you are a diabetic Mom, you probably have some tricks up your sleeve...share them!

I've let my daughter play with my Minimed pump before, thinking that she shouldn't be told it was completely strange and off limits. I assumed that she could not push the buttons in the right order to deliver an unintended bolus. But eventually I knew that day would come.....I caught her just in time. She's also figured out when my blood sugar is low, and which types of sugar will help it get better ("Remember you said chocolate won't help mommy...") I remember when she would wear a block in her back pocket and talk about wanting a pump one day, but these days are over.

Speaking of which, I am wondering if any Moms/Dads out there have screened their children for Type 1. I learned of the two methods on 'genetichealth.com's' Amy Adams article recently; Does anyone have an experience to share about this?

If a child has a parent or sibling with Type 1 diabetes, they are at about 15 times higher risk than the general population for developing the disease. There are two tests a doctor can use to find out if a child has inherited a high risk for diabetes. However, because knowing a child's risk does not help doctors prevent the disease, the American Diabetes Association only recommends using these tests in children who have a parent or sibling with diabetes and who are entering to a scientific study that requires the information.

HLA Typing
Certain genes in the HLA (human leukocyte antigen) region of the genome can increase a person's risk for developing diabetes. These genes make proteins that are located on the outside of some immune cells. Doctors can screen a child's immune cells to determine which form of the HLA proteins are present. If the child has high-risk forms of the protein — called DR3 and DR4 — that child has a higher than average risk of developing Type 1 diabetes.

Antibody Screening
In Type 1 diabetes, the immune system attacks insulin-producing pancreas cells. When the immune cells attack the pancreas, they make proteins called antibodies that are designed to fight against pancreas tissue. These antibodies are present as much as eight years before the onset of diabetes. If doctors find these antibodies, the child is at higher risk for developing diabetes than the general population.

Diabetes Talkfest had a chat with Nicole Baker Johnson, Ms. America 1999, the transcript is here: Nicole Johnson Chat . Her comments were generous and interesting, but I was most interested to learn that she had trouble finding a Dr. that could help with the pregnancy details. When I had trouble getting more medical advice than "keep your sugars in control!" I was sure it was because I hadn't enough connections, but if Nicole Johnson had to search for more that 3 minutes, it must be a tough job. I would love to find out more about the studies she became involved with. Check out her website for updates.