I know that I've been very quite on the blogosphere for the last several weeks. I appreciate more than I can express all the comments and e-mails asking me how I'm doing and wishing me the best.
I won't bore you with the details here except to say that I'm in the middle of some type of depression. It's not earth-shattering and for those of you who have diabetes, it's probably not entirely unexpected. Taking care of a chronic disease is a big burden and it takes its toll. The good news is that I'm working pro actively to get this under control and get through it. And in the meantime I'm focusing on essential activities because I've not got a whole lot of energy for other things.
It's been a busy year on the blogosphere and busy one for me. I've been blessed with a lot of accomplishments over the last year, in no particular order:
I met Allison and Mel in Boston. It's always fun to get together with fellow diabetics! If you're going to be near Boston in 2008, please let me know.
I got to some meetings of the insulin pumpers group that meets in Woburn, MA each month. A fun, supportive and informative group. Every state should have a group like this.
I marked my 35th year with diabetes by raising over $11,500 for research in a diabetes bike ride. Hint: it's not too late to support this.
I received an award from Lilly and Joslin for 25 years with diabetes. Thanks Dr. Spatola for organizing this one.
I setup the diabetes search engine. It now indexes over 800 sites and I like to think that it's helpful for folks.
I joined the great TuDiabetes.com social networking site for diabetes. Big kudos to Manny for starting this.
I worked together with Beth to start the diabetes365 project (originally her idea). As of today there are about 1,750 photos that give some insight into what it's like to live with diabetes.
I almost completed NaBloPoMo for this year. I didn't post for every day of November. Next year will be better.
I started using the Dexcom STS continuous glucose monitoring system and moved to the Dexcom SEVEN system later in the year. Life with a CGM is a lot easier, though it still has its frustrations.
And of course I posted many blog entries. Along the way I hope that I informed some readers. I know that I learned a lot from your comments and I also managed to get lots of practice with my writing skills.
So what's in the cards for 2008?
I'm getting some blood drawn in January as part of the research for Dr. Faustman's work on a possible cure for Type 1 diabetes. No, I'm not getting an early version of the cure, I'm just donating blood samples for the work. I hope to meet her and ask a few questions, I'll let you all know what I learn.
I'll keep blogging, though maybe a little less.
I hope to get involved in another fund-raising bike ride in September.
It's been a tough week for me. And I don't really understand why.
Maybe it stems from my A1C at the end of October. In July my A1C had plummeted to 7.0 from 8.4 in April. So I was really looking forward to an even better number.
Running the stats from my Dexcom, I expected at least a small improvement. Especially because I'd been working really hard at improving my diet, adding more exercise. For maybe the first time ever I was starting to think that I had wrestled my diabetes to the ground and won.
Then I got my end of October result.
8.1
What's going on? This number just didn't feel right.
Since then I've had two further A1C tests. One by means of Kevin's excellent A1C-by-mail, HomeCheck A1C, which gave me a result of 7.6 in mid-November. Another at my doctor's office a week later that gave me an A1C of 7.4.
This is one of the great frustrations of diabetes. I'm using a lot of diabetes technology:
And with all of this, I can't seem to get my A1C levels down to a lower level. That's really frustrating.
But I notice that my life seems very flat. Colorless.
Yes, I'm still blogging, and still taking daily photos for the Diabetes365 Project. For the most part I'm taking care of myself.
Recently this has gotten a lot harder. Maybe it's the same kind of issue that Allison is struggling with, but I don't think so.
Perhaps it's some type of low-level depression, which I know often accompanies diabetes. This disease is so wearing, it's a wonder that more of us aren't depressed.
Whatever it is, I just wish it would stop.
If you've got any suggestions, do please let me know.
I just read a report from The Well on the New York Times that covers a recent study which shows that treating depression in older patients with diabetes may prolong their lives.
Suprisingly "the researchers found that treatment of depression did not influence death rates among the otherwise healthy patients. But death rates among the diabetic patients were affected: the group who had received care from case managers were half as likely to die as those who had received less intensive care...". It's an important finding that taking care of depression can both improve the lives of people with diabetes and help them to live longer.
One thing that bothers me about this investigation, which was also reported on MedPage Today, is that it's not clear which type of diabetes is being talked about.
Are these older patients with Type 2 diabetes, or patients with Type 1 diabetes who are now older? To me, this is a really important distinction. I find it shocking that the reports that I read on this research don't bother to point this out.
I don't know whether to blame the authors of the original research, or just sloppy reporting on the part of the New York Times and others. To me all parties are equally responsible.
I do hope that journalists soon start to realize that Type 1 and Type 2 diabetes are completely different diseases and that what helps or affects one group may be of little use to another.
Normally I try to concentrate on diabetes-related issues. But I wanted to let you know about a group that's doing a great job and really needs some help.
Today the Wall Street Journal's Health blog reports that the rate of teen pregnancies is rising. The rise of 3% in 2006 is "across all ethnic groups and most teen age groups". I'd say that's a big problem, and the best way you can tackle something like this is by working locally.
My Father's House is a small organization that's local to us and that is working hard to help pregnant teens. They provide counseling, support and accommodation to a small number of teens and they work to help these young women to become self sufficient. I think the work they accomplish is astounding. They truly change the course of these teenage lives and that of their children.
My Father's House does this without any state or federal funds. This is because they want the freedom to introduce the young women to Jesus Christ and let them know about the Gospel.
Despite this 'restriction' they have managed to fund this important work entirely through contributions by individuals and a variety of churches. My family is one of their large group of supporters and we love the work that Kevin and Cathy Coffey are doing here with a small group of dedicated volunteers.
The people behind My Father's House are trying to create some transitional housing so they can help these young mothers become successfully independent. They've finally received permission from the town of Chelmsford and they're applying for a grant. To be successful they need to raise a lot of money. A total of about $60,000.
If you're moved to help them because of the holiday season, or because you believe in this type of work, or some other reason, then go to their site and donate online via their Paypal link.
I stumbled across this interesting article that outlines what it might take to actually turn a stem cell into a beta cell. Beta cells are the pancreatic cells that produce insulin.
The author, Paul Myers, is an associate professor of biology at the University of Minnesota, so I'd hope he's fairly accurate in his description of the process.
Let me summarize the article by saying, making beta cells from stem cells isn't going to be easy. Reading the steps involved reminds me of the song Dry Bones, 'With the leg bone connected to the knee bone, and the knee bone connected to the thigh bone...'.
To make a beta cell, you have to first convert ES cells into mesendoderm, then into endoderm, then into Anterior Definitive Endoderm (ADE), then into midgut endoderm, then into general pancreatic tissue, then into pancreatic endocrine cells, and finally, you can apply a signal to switch them into the beta cell state.
And even if this could all be done, you'd still need to deal with the
chronic difficulty of removing whatever destroyed the patient's original set of beta cells.
So I won't be holding my breath on this line of research. I think it'll bring benefits, but probably not anytime soon. My money is still on the research being done by Dr. Denise Faustman.
The New York Times has a really useful tool that lets you watch and read the recent Republican presidential debate. This was brought to my attention thanks to a recent blog post by Jon Udell.
There are two tabs, the Video Transcript which comes up by default, and the Transcript Analyzer.
In the first tab you can watch the debate and see a scrolling text transcript at the same time. Or you can scroll down through the text and click on a section to get taken to that part of the debate. That alone is pretty cool.
But the Transcript Analyzer is even more useful. You can see the number of words spoken by each candidate, the moderator, and by the You Tube videos. And if you click on a name in the list on the left, you'll see where in the overall debate they actually spoke. Those sections are highlighted in dark blue. By moving your mouse over any section, you'll see the text.
You can also enter a word in the Search box at the top of the page. And if the word appears in the text you'll a little black mark showing its location and a word count for each of the speakers. I tried the word health and found that it was mentioned a grand total of five times in the entire debate. That's pretty shocking to me.
The NYT also has an election guide section where you can see a lot of information about the various candidates and a summary of where they stand on various issues, including health care.
Personally I think health care is going to be very important in the near future for the United States and I'll be watching closely to see what the various candidates say about it.
All of us - insurance companies, legislators, health care providers, and health care users - need to figure out a way to ensure more of the population is covered for at least basic health care. Otherwise I think we're going to see some really big cost problems in the next decade or so.
And guess who'll be footing the bill unless we can figure out a compromise? The American taxpayer. Which would be you and me.
I was reading Paul Levy's blog, Running a Hospital, and he'd just posted about this new alert system that has been developed "in consultation with local and federal emergency officials to help you determine when to panic and rush to the store to buy milk, eggs and bread."
My favorite recipe for French Toast is from Cook's Illustrated magazine. We have a copy of the recipe in a plastic folder so we can use it at a moments notice, together with fresh eggs from our chickens.
Just writing about this makes me want to rustle up a batch right now.
Diabetes: technology, devices, software, and other stuff.
About Me
Name: Bernard Farrell
Location: Massachusetts, United States
I was born in Ireland and now live in the US.
I have had Type 1 diabetes for over 35 years. I struggle with my blood sugar, the same as most people with diabetes.
I wear a Cozmo 1800 insulin pump and a Dexcom SEVEN CGM to track my blood glucose levels. I also take Symlin to help control my post-meal blood sugars.
I'm blessed by God, and every day brings the possibility of a cure.
