goingf rwar - friends with diabetes · 2007. 6. 6. · conjunction with, and under the guidance of,...

Weight Management

Summer Fruit Roundup

7

15

22

Make a Splash

GoinGF rWarDFriends With diabetes

Summer ‘07 zWxa, .heVolume I Issue 3

Going ForWarD | 2 | Winter 5767

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F.W.D. is under the rabbinical supervision of Rabbi M. M. Weismandl shlit”a of Nitra–Monsey, endorsed by many other renowned Rabbonim, and by leading medi-cal professionals.

the information in this publication is meant to be used in conjunction with, and under the guidance of, your health care professional. it is nOt meant to diagnose or treat medi-cal conditions, nor as advice or prescriptions. it is provided for educational purposes only. in the event that you use the information without your doctor’s approval, you are prescribing for yourself, which is your constitutional right, but F.W.d. and the authors of this publication assume no responsibility. We strongly advise that you inform your doc-tor of any changes you wish to make.

Please consult your physician for medical questions, and your Rav (Rabbi) for halachic (Jewish law) decisions.

FWD does not assume responsibility for the kashrus of any products advertised in these pages.

31 Herrick Ave. Unit B Spring Valley, NY 10977(845) 352-7532 Fax: (845) 573-9276 [email protected] www.FriendsWithDiabetes.org

Going ForWarD | 4 | Spring 5767

I thank Hashem for guiding us this far, and pray for continued siyata dishmaya in all of FWD’s meaningful endeavors. Our efforts are B”H helping thousands of individuals, and we are grateful to

Hashem for giving us this opportunity.

Still, we are very keenly aware that too many Jews struggling with diabetes and related health concerns do not know about our services. The math is simple: our member list includes several

thousand people, out of hundreds of thousands of Jews who have diabetes.

Think of how your life was literally transformed after you tapped into the FWD resources. Finding out that you’re not alone, networking with people in similar situations, sharing tips and ideas, and joining support groups, can make the difference between relentless suffering and constant growth and fulfillment.

So think of how many more people can be helped with proper guidance and support! Our goal is to reach out to as many as possible, and for that we need your help.

Please use the enclosed FWD pamphlet for this purpose. Pass it on to a person you know who has diabetes, whether type-1 or 2, GDM, or one of the lesser known conditions such as LADA, MODY, PCOS, or pre-diabetes.

If all who receive our mailing would pass on the pamphlet to even just one friend, we can double our member list in just a few weeks! Just think of all the

exclamations such as “why did I never hear of this before?” and “I wish I knew about FWD sooner” this will bring.

We hope you enjoy this informative issue. Please share your comments and suggestions with us, and let us know about any noteworthy experiences. And of course, don’t forget to share your simchas with all Friends With Diabetes.

Wishing you a safe and healthy summer,

Rabbi Hirsch Meisels

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important notice:

those living out of the Usa who would like to continue being on our mailing list, please furnish us with a Us address of a relative or friend who will forward the publication to you. thank you for your cooperation.

Summer 5767 | 5 | Going ForWarD

Letters to theEditor

dear rabbi Meisels tWyhka

What a vjna when FWd publication,

arrives to its destination,

everybody wants to read it first, so we all “take shifts,”

to see it, read it, and gather all the tips,

What a euzhj all the way to Montreal,

and our diabetic son, he feels so special about it all,

so we thank you & wish you lots of vjkmv

in your asuev ,sucg you should always see the vfrc

and we should all be vfuz to the tWcc vnhka vkutd

jnau raf dj

With cuy ,rfv,

Family G.

לכבוד הרב מייזליש שליט”אi would like to thank you per-sonally for the unbelievable informative lecture given by Mr. hitchcock. the information alone made it well worth com-ing, but the added חיזוק that one gets from being together and discussing issues with families in the same situation is immeasurable! Your ser-vices are truly life saving and only someone who has the need for FWd knows what an unbelievable contribution it is to כלל ישראל and the נחת רוח that the בורא עולם has from the organization.

Thank you so much for everything,rabbi F.

Going ForWarD | 6 | Summer 5767

although it is extremely hard, Working to keep our numbers level by always being on guard. “don’t get too ‘high’,” and “don’t get too ‘low’.” More and more instructions we get, in our daily lives – how will it flow?? We are only humans – surely we forget! but! בסייעתא דשמיא helps that we can, diabetes, too, is a gift from the One above and although we can’t see the Master Plan, We take it, and accept it, with all our love! Editor’s response: Dear M.L. and R.G., Thank you for sharing this wonderful poem! We were touched by the staunch emunah and bitachon it so poignantly portrays. At the same time, it pained us to read about the difficulty diabetes poses in your daily lives. Is there really no alternative? Does everybody with diabetes share these sentiments? Readers, please respond! Please note that the topic of secrecy will iy”H be explored in a future issue of Going Forward.

Letters to the Editor

the following poem was submitted by M.L. (13) & r.G. (14) two readers from england. “A SpEciAl GiFt” sometimes it’s better to keep things quiet at other times, let them out, but when letting them out, be careful they can get spoken all about. secrets, secrets, secrets; secrets galore! sometimes it’s good to get them off the load, secrets, secrets, secrets, more and more! it’s too much – soon we’ll explode! People speak, even when they shouldn’t do, and think the listener won’t repeat, but …the subject is all about you… she’d repeat it to the next person she’d meet. Many things in life seem to be bad, diabetes being one of them… but in reality, it’s just not true! because we know it’s all from hashem. diabetes requires much self-control,


Just mention the water park and i’m instantly transported to a sag-ging mattress in a dark bunk house. i was a counselor that summer, rev-eling in the sensation of being just another normal teenager in camp, diabetes and all. tomorrow’s full-day outing to Mountain Creek water park promised to be a major trip we would never forget, but i didn’t remember until the very last minute. i didn’t remember that i was connected to an insulin pump, didn’t remember that it was not waterproof (this was back in the days of the MiniMed 507), and didn’t remember that i was fac-ing a full day of hefty, blood-sugar-lowering exercise.

i paid a heavy price for being so foolishly forgetful. What i do re-member until today is the crush-ing loneliness and helplessness that engulfed me that night before the trip. realization struck when there was no one to turn to and no time to try. i was up for hours that night, tearfully agonizing over the best way to climb this complicated mountain called Mountain Creek. if there’s one thing i learned that night, it’s this: no peak is too high if you’re well-equipped to scale it. be PrePared!

Tips for The waTer park heard over The phone


Rrrinngggg….

Mrs. K. “hello? rabbi Meisels, my shimmy is attending day camp here in the city, and he’ll be going on a trip to the water park tomor-row. What do we do about his insu-lin pump?”

Rabbi Meisels “hmmmm… We have to tackle several issues here. First off, let me tell you what animas warns in their user guide (for the ir 1250) regarding amuse-ment parks in general:

Very powerful electromagnets are sometimes used on “free-fall” amusement park rides. insulin pumps should be removed and not taken on these “free-fall” types of rides.

high gravity forces can be experi-enced when riding on some roller-coasters. it is recommended that you disconnect (nOt suspend) the pump while on roller-coaster rides.”

Mrs. K. “are you saying that shimmy should disconnect from the pump?”

Rabbi Meisels “hold on! so far, we’ve only spoken about standard amusement parks. a wa-ter park would appear to be even more problematic.”

Mrs. K. “My son’s pump is wa-terproof. in fact, the company told me it could be immersed in up to 12 feet of water for 24 hours!”

Rabbi Meisels “You’re right, but these guidelines refer to nor-mal swimming conditions. i would assume that the high pressure and intensity typical of water rides are more than the pump can handle. and there’s another factor in this case as well: exercise. how long will shimmy be staying at the water park?”

Mrs. K. “he’s scheduled to spend the entire morning there, from 8:00am to 12:00 pm.”

R a b b i Meisels “ in that case, he w i l l b e encounter-ing about four hours of walking, c l i m b i n g , swimming, and what not… the activity will prob-ably lower his blood sugars considerably. so it ap-pears that we have three separate reasons for entirely disconnecting shimmy’s insulin pump at the wa-ter park:

1. the pump should always be disconnected and removed when going on amusement park rides.


2. the pump is not entirely water-proof in this situation, and

3. shimmy will be engaging in an unusual amount of activity, which will also necessitate lower amounts

of insulin.”

Mrs. K. “it shouldn’t be a problem for one of

my son’s counselors to hold his pump.

but i’m a bit hesi-tant about this. since the insu-lin pump holds only short-act-ing insulin, isn’t it dangerous

for him to go without the pump for long periods of time? My doctor once t o l d m e that shimmy

c o u l d b e disconnected

from the pump for up to two

hours. ”

Rabbi Meisels “Of course! You did very well

by consulting your doctor about this! i would suggest that the four-hour trip indeed be divided into two-hour blocks. at the start of the trip, shimmy might bolus to compensate for some of the basal insulin he will be missing over the next two hours. but remember

that he should only compensate for a part of the amount, because the intense exercise will lower his sugars as well. after two hours, i think he might check his blood sugars and, depending on the re-sult, perhaps reconnect and again bolus for some of the basal he will be missing. he could also adminis-ter a correction if his blood sugars are too high, or refrain from doing anything if they are in the normal range. the most important piece of advice i can convey is for your son to check his blood sugars as often as possible! Only then will he really know how the activity and lack of insulin are really affecting him.”

Three days laTerRrrrinnngggg…

Mrs. K. “rabbi Meisels? this is shimmy’s mother calling again. i wanted to thank you for your won-derful, on-target advice and sug-gestions. shimmy had a phenom-enal trip! he disconnected from the insulin pump and checked his blood sugars periodically. in fact, due to the intense activity, he did not need to administer any insulin throughout the trip.

i only have one heartfelt request: i am sure that many young mem-bers in our group could benefit greatly from the guidelines you gave me. Please print them in one of your publications!”

and so we are. n


Adar 5767March 07

For so many of us harried wives and mothers, life is like a relentless merry-go-round, a dizzying chain of daily routine, appointments, meal preparation, housework, usu-ally a crisis or two, and more often than not, a job out of the home as well. and did we mention diabe-tes control? Unfortunately, once we’ve looked after everybody else’s needs, our own self-care is neglected time and again. that’s why my heart skipped a cheer-ful beat as i read the unexpected invitation: an eve-ning of education and support for adults with type 1 diabetes and their spouses. even more than a cov-eted night out, this would be a chance

to catch my breath and renew my commitment to diabetes control. it would be an evening to recharge and revitalize, an evening to trea-sure.

and in fact, March 11 turned out to be more than i bargained for, beginning with the pleasant walk my husband and i took to the hall (a rare bonus!). entering the softly-lit auditorium, we were warmly welcomed by teenaged members of the group, who handed us use-ful packets containing stickers that

Rabbi Meisels and Mayer Stender


identified us as ‘PWd‘, person with diabetes, or ‘spouse’. there were also “business cards” with our names and phone numbers. both items were immediately helpful, as we mingled (separately) with the sizable crowd, exchanging infor-mation with people we had never seen before, and heartily greeting familiar faces. For myself, a “gradu-ate“ of several FWd shabbatons, the evening held that special exu-berance of a high school reunion, as i gleefully hailed old friends i had barely seen since we last sat together, checking blood sugars and sharing secrets at 2:00 am…

rabbi Meisels started the program on an uplifting note by rec-ognizing the achieve-ments of Mr. Meyer stender, an FWd member who recently

received Joslin’s “ 5 0 - y e a r s - o n -insulin” award. a collective sense of admiration and awe was palpable as Mr. stender urged us all to make use of the modern ad-vances in diabe-tes care that were n o n - e x i s t e n t when he was first diagnosed half a century ago.

rabbi Meisels then presented him with a beautiful plaque in honor of his 50-year triumph. it was a mo-ment of inspiration and hope that stirred the fervent prayer that all of us with diabetes merit to reach that same milestone.

rabbi Meisels then introduced dr. Gary scheiner, the evening’s main speaker. having read some of dr. scheiner’s excellent articles in a popular diabetes journal, i was

The Audience

Gary Scheiner addressing the Audience


particularly excited and honored to hear him talk tonight. and i was not disappointed! the highly-regarded doctor presented a thor-ough overview of diabetes and then concentrated on the proper setting of basal insulin doses. his well-for-mulated lec-ture advanced steadily from diabetes basics to the intrica-cies of good control, thus appealing to

all members of the audience. Pep-pered with humor and accompa-nied by a clear visual presentation, his talk spurred a lot of discussion and thought.

the event concluded with op-portunities to collect information, and even a free blood glucose meter from booths on the side. One emotion reigned supreme as we said our good-byes that night: gratitude. From the depths of our hearts, thank you, Friends With di-abetes, for being much more than a friend for people with diabetes!

–Written by a participant

Dr. Scheiner’s visual presentation, ”The Art and Science of Basal Insulin Regulation,” is a clear and comprehensive guide to understanding and de-termining proper basal insulin doses. It is available to the participants of the event in a printed version from Friends With Diabetes (8 slides per page).

Rabbi Meisels reading the “50 years on insulin reward” of Mayer Stender

Gary Scheiner’s Book


Iyar 5767 – May ‘07

at the “Childhood Obesity & type 2 diabetes” awareness seminar held in Maimonides hospital rabbi Meisels was invited to lecture on “resources that Can Make a dif-ference.” below is an informative excerpt of his speech.

everyone who is present here to-night came to learn more about diabetes prevention and control, due to either having this condi-tion or being at risk of developing it. the respectable speakers have already discussed diabetes preven-tion at length. however, i would like to demonstrate an important fact related to diabetes control and prevention. as it is said: see-ing is believing.

First, let’s get the underlying principle straight: Carbohydrates – which the body uses as sugar – directly causes obesity. When the body is overloaded with sugar and starches, the result is significant weight gain. although fruits and whole grains are full of nutrients and vitamins, when a person is over-w e i g h t ,

or there is a history of diabetes in the family, it is very important to pay attention to the total amount of carbohydrates in the foods he consumes, even when these carbs are found in food we wouldn’t nor-mally label as “junk.”

this 1 cup of rice is considered a normal, healthy food, by most peo-ple. Without going into a lengthy explanation of what a glycemic load is, we’ll compare the body’s response to the carbohydrates in this 1 cup of rice to its equivalent in refined sugar.

how many sugar cubes would you have to consume in order for your body to have the identical response as after eating the rice? any guess?

these 15 sugar-cubes – quite a chunk of sugar by any standards – have the same weight-gaining effect on the body as the rice. this is not to say that you should eat sugar or not eat the rice; i wish to demonstrate the importance of be-


ing in control of the carbohydrate load you consume. if you have that portion of rice, be wary of giving fruit-pie or kneidel at the same meal. it’s all a matter of being aware of what’s in your food, and being careful of not to stock-pile them one on top of the other. it’s perfectly fine to eat rice for dinner. but don’t load even more sugar on top of that. be careful. sugar doesn’t only destroy your teeth – it can severely com-promise your health ch”v.

some of you may think – who ever eats so much sugar at once?

this bottle of snapple has the same 52 grams of carbohydrate! that’s also the same amount of sugar, and still not too much for many people to consume in a few min-utes. so let’s watch out. the trick is not to be afraid to eat anything, but to empower ourselves by knowing the real facts. read nutri-tion labels and focus on the line that reads: “total carbohydrates,” and compare it to the actual serv-ing size you’re having – not to the skimpy serving size the food-man-

ufacturers often figure. For foods without nutrition labels, it pays to have a good carb-counting book

as a reference. Once you become aware of what’s really in your food, you will be able to better control

what you want to be in your food.

there is an interest-ing Gemara הני בבלאי) טפשאי דאכלי נהמא בנהמא)“the people of bavel are foolish because they eat bread with bread.” i always wondered what this means – do they spread bread on their bread? and if they do, why are they foolish? but based on what we just discussed, i’ll venture to say the

Gemara means eat-ing carbohydrates and

carbohydrates, like bread and potatoes, noodles and

potato blintzes, or cake and soda. Foolish indeed!

Carb-counting is an important tool everyone can and should master. by adopting a common sense ap-proach to food control, we will bezras hashem protect our health and the health of our families.

May we all see hatzloche in the important mitzva of guarding our health. n


Summer is the time when the low carber’s restric-

tion on fruit really begins to chafe. Just how high carb are

these delectable morsels? Can you get away with enjoying at least

a bit of the summer’s bounty?You bet you can! here’s some good news for

you: Compared to most of the winter fruits, such as apples, pears, oranges, pineapple,

grapes, and bananas, most of the summer fruits are much lower in carbs and sugar!

SummerFruit Roundup!

–by Dana Carpender


Here’s a rundownof the best of the

summer fruits

PeachesOne 2 ½ inch peach has 9.7 g of carb, with 1.7 g of fiber, for a usable carb count of just 8 grams. they’re a good source of vitamin a and the b vitamins, not to mention potas-sium, and they contain a smatter-ing of other minerals.

Plums a plum just bigger than 2 inches across has 8.6 g of carb, and about a gram of fiber, for a usable carb count of about 7.5. they have a bit less vitamin a than peaches, but the rest of the nutritional profile is similar.

Nectarines nectarines are a bit puzzling. they’re a hybrid between a peach and a plum, yet they’re substan-tially higher in carbohydrates than either of their ancestors, at 16 grams in a 2 ½ inch nectarine. even after you subtract the 2.2 g of fiber it contains, the carb count is still high.

they’ve got a pretty good nutri-tional profile otherwise, including a lot more vitamin a than a peach (1000 iUs), but they’re not the best choice. You could have both a peach and a plum for the carb price of a nectarine!

Cantaloupe a half of a 5 inch cantaloupe has 22.3 grams of carb, and 2.1 grams of fiber, for a total usable carb count of 20.2 grams. Quite a lot, but then, that’s a big serving! a 2


inch wedge would have about 5 g, and that should fit into anyone’s diet. besides, it’s hard to think of a better nutrition bargain; canta-loupe is full of vitamins and min-erals. You’ll get over 2000 iUs of vitamin a, more potassium than a banana, a hefty 27 mcg of folic acid (prevents birth defects and heart disease), and plenty of minerals. a wedge of cantaloupe and a half-cup of cottage cheese is a lovely, light, cool summer breakfast.

Honeydew a half-cup of honeydew has 7.8 g of carb, and .5 g of fiber, so the us-able carb count is 7.3. honeydew is nowhere near as good a source of vitamin a as cantaloupe, at only 80 iUs. still, it’s a good source of potassium, and has some other minerals and b vitamins as well.

Watermelon

Watermelon can be hard for the simple reason that they’re big, and so are the slices of it you’re likely to be served. a 1” slice from a melon 10 inches in diameter will cost you a whopping 34.6 grams of carb. even when you subtract the 2.4 grams of fiber in it, that’s way too much. however, if you cut that slice into four triangles, you’ll cut that back to 8 grams a serving. and you’ll get 585 iUs of vitamin a, 186 mgs of potassium, a bit of folic acid, and some other assorted vitamins and minerals.

Other Melons Casaba, crenshaw, or any of the other melons contain about 4-7 grams per half-cup.

Strawberries a whole pint of strawberries will cost you just 15.1 grams of usable carb, and who eats a whole pint? a half-cup of sliced strawberries has just 3.5 grams of usable carb! no wonder strawberries are a fa-


vorite low carb dessert. they’re a pretty good source of vitamin C, at 42 mg per half cup. (although only about half of what you’d get in an orange, the orange will run you 13 grams of usable carb.) You’ll get a ton of folic acid, a good dose of potassium, and bits of other vitamins. strawberries are also an excellent source of a phytochemi-cal called ellegic acid. a powerful anti-oxidant, ellegic acid is being studied intensively and appears to have very potent anti-cancer properties.

Blueberries a half-cup of blueberries has about 8 grams of usable carb. they’re not the vitamin C source that strawberries are, but other-wise they’re pretty comparable, nutritionally. blueberries also have a phytochemical in them that stabilizes capillary walls and, as a result, may defend against some “long-term-uncontrolled-diabetes complications.” they may also help prevent macular degeneration, the most common cause of blindness in aging. if you don’t like blueber-ries, be aware that bilberries have the same chemical, and are avail-able in capsules.

Raspberries* Perhaps the best source of cancer-fighting ellegic acid, raspberries are also a low carb fruit. a half-cup has 7.1 grams of carbohydrate, but fully 4.2 of those grams are fiber, for a usable carb count of just 2.9 grams. raspberries contain some vitamin a, vitamin C, potassium (although less than some other fruits), and considerable amounts of a variety of minerals.

Blackberries* Once again, a source of ellegic acid! (if you don’t like any of the berries, it’s good to know that wal-nuts are a good source of ellegic acid as well; and, to a lesser extent, so are pecans.) blackberries are a little higher in carbohydrate than raspberries, at 9.2 g in a half a cup, of which 3.6 g is fiber, for a total us-able carb count of 5.6 grams. still very easy to fit into your diet!


blackberries have a bit more vita-min a than raspberries, and are a bit richer in minerals as well.

Cherries Cherries aren’t as low carb as some other fruits. there are 11 g of carb in 10 ripe bing cherries (the blackish-red sweet cherries that are the most popular for out-of-the-hand eating.) Only a gram of that is fiber, so you’re still looking at about a gram of usable carbohy-drate apiece. i know this is getting repetitive, but cherries are a pretty good source of vitamin a, folic acid, potassium, and other miner-als. they are not, however, much of a source of vitamin C.

if you can get sour cherries, also known as pie cherries, they are, of course, lower in sugar - just over half the carb count of sweet cher-ries. You won’t want to eat them out of your hand, of course, but cooked with a little splenda (and a drop of almond extract – almonds and cherries are close botanical relatives) they’re wonderful on top of a sugar-free cheesecake or stirred into low carb muffin batter.

Apricots Fresh apricots are a carb bargain. three medium apricots have 11.8 grams, with 2.5 grams of fiber, so the usable carb count is 9.3 grams, and again, that’s for 3. One would have just over 3 grams!

they’re a terrific source of vitamin a, with 2769 iUs in those three apricots, or over 750 iUs apiece. they’re an okay source of folic acid and potassium, and of course, have a smattering of other vitamins and minerals. however, if you’re a fan of dried apricots, remember that each piece is one half of a fruit, so you can’t afford to eat more than a few pieces.

Clearly, summer fruits can be a de-licious and healthy addition to our low carb diets. enjoy them often as long as they last!

*Make sure to follow rabbinical guidance for finding and remov-ing insects.

raspberries and blackberries have a high level of infestation. Follow rabbinical guidance. n


In a Nutshell

Portion/SizeTotal Carbs Fiber

Net Carbs ECF* Code**

peach 2 ½ inch 12.4 1.9 10.5 0.09 264 (w/o pit)

plum 2 ₁/₈ inch 7.5 0.9 6.6 0.12 278

nectarines 2 ½ inch 14.9 2.4 12.5 0.10 256

Cantaloupe Half of a 5 inch 22.5 2.5 20 0.08 254

2 inch wedge 5

honeydew Half-cup dices 7.7 1.4 6.3 0.09 255

watermelon 1 inch slice 34.6 2.4 32.2 .07 291 (w/o rind)

Cut into 4 8

strawberries 1 pint 27.42 7.1 20.3 .05 286

Half-cup sliced 6.3 1.6 4.7

Blueberries Half-cup 10.7 1.8 8.9 .11 220

raspberries Half-cup 7.3 4 3.3 .05 283

Blackberries Half-cup 6.9 3.8 3.1 .08 219

Cherries 10 ripe Bing 11 1 10 .14 225 (w/o pit)

1 1

apricots 3 11.7 2.1 9.6 .09 211 (w/o pit)

1 3.2Numbers are based on the USDA database * explained in our Tu B’shevat article in the “Winter 5763” book.

**For use with the NutriBalance scale.

Dana Carpender,author of seven cookbooks, including the best-selling 500 Low-Carb recipes, runs a weekly online newsletter “Lowcarbezine,” which has over 25,000 readers every week. Long before low- carb diets were fashionable, Carpender published her first book: How i Gave Up My low Fat Diet and lost 40 pounds. she excels in making eating healthy fun, easy and delicious.

Winter 5767 | 21 | Going ForWarD

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By Gabrielle Kaplan-Mayer

i ncreasing numbers of people living with Type 1 and Type

2 diabetes are choosing insulin pump therapy. The advantages of a pump are clear. Not only does pump therapy allow for a more flexible lifestyle than mul-tiple daily injections, it is the cur-rently available insulin delivery system that most closely mimics a real pancreas. Like a pancreas, an insulin pump delivers a small amount of insulin continuously, 24 hours a day. A key difference between a pancreas and a pump is that a pump needs to be oper-

ated intelligently by the person who’s wearing it. This includes delivering bolus insulin to cover all carbohydrates that are eaten.

One of the challenges that comes with pump therapy is that it is possible to bolus enough insulin to cover all carbs eaten, while still maintaining a normal blood sugar range. For many people who first start on pump therapy, this is an amazing discovery. Many pump-ers recollect the first time they correctly bolused for a chocolate bar, a large order of French fries or an entire ice cream sundae.


Insulin is a fat-building hormone

in the body and is therefore closely related to weight gain. Most

people with type 1 diabetes take normal amounts of insulin and are not overweight, but they

must tackle rising levels of obesity just like everybody else in this generation. However, gaining excess weight is of particular concern to all in-

dividuals, including type 1’s, who have a blood relative with type 2 diabetes. At one FWD shabbaton we actually noted that participants with a family history of type 2 administered, on

average, much higher doses of insulin than their comrades.

With this in mind, we are proud to present the following article by the noted author of “Insulin Pump Therapy Demystified” (Marlowe & Co.).

& Weight ManageMent insulin PuMP theraPy

Don’t“Fill uP”with your PuMP:

Because pressing a button to deliver insulin is so easy, pump users (especially those new to the experience) may simply lose sight of the excess food they’re eating…and the extra weight they can conceivably gain.

While not healthy for anyone, people with diabetes need to be especially vigilant not to have any added risk for cardiovascular dis-ease and high blood pressure.

So, is there a way to have your pump and stay slim and enjoy the

occasional cake, too? Absolutely! Here are five steps to managing your weight while on the pump:

Weight ManageMent insulin PuMP theraPy



not only is it important to count carbohydrates when you need to bolus, but it is also important to look at how many total grams of carbohydrate you eat in the course of a day. You may want to sit with a nutritionist and determine how many grams of carbs you need to eat in order to maintain (or de-crease) your current weight. You may decide to make one meal a day a very low-carb meal; for ex-ample, lunch may be a green salad with grilled turkey or chicken with some crackers on the side. For this kind of meal, you will probably require only a very small bolus of insulin. Pay attention to what and how often you’re snacking and re-cord your total bolus doses at the end of the day. did you take extra insulin to cover a bag of chips here, a cookie there? it may be helpful to keep a food diary and write down everything—including those little snacks— for review with your doc-tor, Cde (certified diabetes educa-tor) or nutritionist.

One of the great advantages of pump therapy is that pumpers can adapt to any type of physi-

cal activity and are uninhibited in sports, recreation, and work. People can program their pumps to deliver less insulin in order to avoid a low blood sugar reaction during heightened physical activ-ity, and they no longer need to eat carbohydrates before exercising to avoid a low. so the need to eat those “extra calories” is eliminated. talk to your doctor about getting started on a fitness plan. For more information on pump therapy and exercise, go to www.diabetes-exercise.org, the homepage of the diabetes, exercise and sports as-sociation.

if you are struggling to balance weight issues and blood sugar management on the pump, you are not alone! this is an issue that other pump users also wrestle with. Get in touch with other pumpers to get their tips, advice and support. Find an insulin pump support group in your area or join an online group, such as www.insulin-pumpers.org.

it’s also critical to make sure, from time to time, that your basal insu-lin dosages are set correctly (re-

2 exercise

3 seek suPPort

4 test thosebasals:

1 countthose carbs!

member, excess insulin can lead to weight gain). You may need to lower your basal rates especially if you are in the process of losing weight. talk to your healthcare provider about how to best check your basal rates.

Yes, being on the pump still means we need to pay attention to how and what we’re eating…but it also means that we have the oppor-tunity to indulge in special foods from time to time. allow yourself the pleasure of enjoying a special occasion or eating a snack that you really love. but do so in a planned way—say, a weekly ice cream cone, rather than bolusing for sugary snacks all day long. When you don’t feel deprived, it’s easier

to make smart choices about food.

Pump therapy is an incredible tool to help manage diabetes and weight—if used with knowledge and a dash of common sense. Good luck with your pumping and feeling your best!

rabbi Meisels aDDs:

While the mentioned ideas will work for most, some individuals will require more intervention in order to reach their optimum weight. some doctors will pre-scribe Metformin (which was invented originally for type 2 dia-betes) to help the type 1 lose or maintain weight. another option would be to inject the newly dis-covered hormones that decrease appetite (see “byetta and symlin” in our previous issue).

5 Plan Fortreats:


“Insulin Pump Therapy Demystified” (Marlowe & Co.).

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Spring 5767 | 27 | Going ForWarD

Mr. steiner pulled his car into the driveway and grimaced

at the sight that appeared in his rear-view mirror. “that eyesore again!” he muttered as he gritted his teeth in frustration. “and to think that all the time and money we spent to stop it went down the drain. how unfair!”

he stepped out of his car, slam-ming the door shut. as he made his way up the pavement to his front door, he stopped for a moment and watched the new neighbors’ kids from across the street riding their bikes on their shared drive-way. the front lawn was strewn with some overturned plastic lawn chairs, scraps of building material and empty boxes that were not yet cleaned up.

Mr. steiner pursed his lips as he envisioned the dense overgrowth that used to adorn that parcel of land, until it was purchased by some money-minded developer who cared nothing for the charac-ter of the neighborhood. since the zoning in the area was changed, the near-acre parcel across his home now sported a three-family dwelling. Just last week, two of the tenants moved in with their families.

Mr. steiner and his next-door neighbor, Mr. benjamin, were the most active opponents of the de-velopment. they appeared at all public hearings and spent fortunes on civil litigation, but were pow-erless to stop it. apparently, the developer managed to gain the

RealWinner

Going ForWarD | 28 | Spring 5767

support of some other neighbors, who didn’t live in such close prox-imity to the proposed develop-ment, and looked forward to the appreciation in the value of their homes due to the zoning change. steiner and benjamin were out-numbered and outvoted, and the multi-family dwelling across the street did not let them forget this sorry fact.

as Mr. steiner stood watching with a frown on his face, he saw some-thing that almost knocked him off his feet. Mrs. benjamin from next door calmly walked over to the new neighbors, bearing a large tray full of cake and fruit. she smiled to the kids who played in the driveway and knocked on one of the front doors. a bewildered woman opened the door and in-vited her in. angrily, Mr. steiner stomped up the steps and entered his house in a huff.

“the nerve!” he muttered furi-ously.

“What’s wrong, Yosef?” his wife inquired, popping her head out of the kitchen.

“You should have seen!” he seethed in reply. “Mrs. benjamin just walked over to those new neighbors of ours across the street with some fancy cake or something. i can’t believe they’re abandoning us in this feud. Going over to the oppo-

sition, just like that!” he snapped his fingers to emphasize his point.

“Oh, i just hung up the phone with her,” Mrs. steiner interjected calm-ly, “and she told me she would be going over.”

“she did?” her husband was in-credulous. “and you let her?”

“i said it’s wonderfully nice of her. Why should i not let her? i mean, they’re here to stay, regardless of how we welcome them. they are actually very nice people. i think we should take something over, too, like flowers or a small gift.”

“You’re not serious! after all they’ve done to us - ruining our neighbor-hood and defeating us in court!”

“Yosef, please don’t be a sore loser,” she tried to reason gently. “being unfriendly won’t make them move away. We are the only ones who stand to lose from be-ing angry. We’ll have all that resentment eating us away, everyone will think of us as just being mean, and we’ll still have the multi-family dwell-ing across the street to face every day! i think it’s time to swallow our pride


and make the best of the situa-tion.”

“You have a point,” Mr. steiner grudgingly admitted, “but why should we go out of our way to be friends? it’s quite enough if we don’t harass them in court anymore. don’t you have the self respect to at least keep your dis-tance?”

“and then what?” his wife ratio-nalized, “there’s no such thing as keeping a friendly distance. Un-less we accept them fully and let go of our resentment completely, this situation will forever be thorn in our sides. and you know some-thing, Yosef; we never know what good neighbors we stand to

lose!”

a calmed Mr. steiner sat down for lunch. he ate quietly as he

mulled over his wife’s words.

n

it was on a gorgeous shab-bos morning when Mrs. steiner sat on Mrs. benja-min’s front porch and schmoozed pleas-antly. they saw their husbands walking home from shul

together, their talleisim swaying in the cool breeze.

“What a stunning morning!” Mrs. benjamin remarked.

Mrs. steiner’s eyes were fixed to the figure of her husband, walking serenely beside ephraim, one of the new neighbors from across the street. after much soul-searching, the steiners agreed to accept the new neighbors in friendship. On the following shabbos, Mr. steiner bought ephraim an aliyah to the torah. since then, the two became good friends.

strangely, the multi-family dwell-ing across the street no longer bothered the steiners as much. they might have preferred some-thing smaller that would have blended into the surrounding trees much better, but the current structure belonged to some very good friends of theirs, and on this beautiful shabbos morning, that was the only thing that mattered.

n

One of the most important keys to happiness is accepting things that cannot be changed. if we dwell on the unfairness of a situation, resent it, and allow feelings of bit-terness to overtake us, who stands to lose?

as faithful Yidden, we must accept the nisyonos hashem sends our way. if we accept a difficult situa-tion with complete bitachon, we may be able to tap into a hidden source of blessing. difficulties help us grow, refine our middos, make us more sensitive to others and strengthen our connection with

hashem. dealing with diabetes can be difficult, but if we accept it as a test from hashem and focus on be-ing as positive about it as possible, we may discover that it builds our confidence and self-control, makes us more appreciative of the good things in life, refines our middos, and affects us positively in so many other ways. We might have preferred something easier to deal with, but through acceptance we will discover in these nisyonos so many hidden treasures that, ul-timately, are the only things that matter. n

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Recent Mazel Tovs

Mazel tov to member and his wife upon the birth and bris of their baby boy174

Mazel tov to member and her husband upon the birth and bris of their baby boy132

Mazel tov to member and his wife upon the birth, bris and pidyon haben of their son530

Mazel tov to member and her husband upon the birth and bris of their baby girl342

Mazel tov to member and their chasanim upon their engagement and marriage206 2389 78 432 76

Mazel tov to member and their kallahs upon their engagement and marriage292 501

Condolences toDavid Mendosa: a writer on the web on the passing of his wife Hannah Ariela

goingf rwar - friends with diabetes · 2007. 6. 6. · conjunction with, and under the guidance of,...

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