Bright Spots in Health: The diaTribe Advisory Board Speaks Up

By Jeemin Kwon and Kelly Close

Physicians, diabetes educators, and research scientists share their own health bright spots in food and exercise, technology, and more

It’s hard to believe, but diaTribe has now been around for eight years, and we just passed the 150^th mailer milestone! Given the excitement generated by Adam Brown’s book, Bright Spots & Landmines: The Diabetes Guide I Wish Someone Had Handed Me, we’ve asked our entire advisory board to respond to the question, “What is your bright spot in health?”  The responses focused on our advisory board members’ own clinical practices and lives, covering topics such as food and exercise, technology, advances in research, and more. Click to jump to a topic:

• Food and exercise
• Technology
• Research

Food & Exercise

Dr. Francine Kaufman, MD, Children’s Hospital Los Angeles

Food offerings in public venues – such as the workplace, schools, hospitals – are important for promoting health and defining social norms. People who advocate for ditching cookies and cakes during meetings or eliminating juice from school lunches are often called the food police. But that is not what they are; they are public health advocates.

If high-calorie, low-nutrient foods are available freely while we sit around a table discussing our company’s budget, or doled out in classrooms for good behavior, or found in every nook and cranny of our hospital waiting rooms and gift shops, we will be enticed to consume them. But if they are gone as part of a new social norm, and replaced with fruits and vegetables, they likely won't even be missed. Let’s all get together to have our shared spaces become health-promoting environments. I did in 2003 when I was part of a large team that helped ban soda sales in schools in Los Angeles. That was my big bright spot.

Hope Warshaw, RD, CDE

Each week(end), I usually:

• Cut up oranges, apples, mango, grapefruit. With pre-cut fruit that lasts about five days, it makes that morning bowl of fruit with Greek yogurt and berries quick and easy.

• Cut up a sufficient supply of what I call “salad accessories” – carrots, cucumbers, red onion, red cabbage, radishes, broccoli, etc. They’re ready to go for easy-to-prepare salads, which is lunch most days of the week for me.

Dr. Anne Peters, MD, University of Southern California

I think the key to health is learning to love vegetables. That goes for everybody. But I have others:

• Exercise has to be a habit — an obligation, if you aren’t inclined to like it — for your entire life.

• Small amounts of dark chocolate probably don’t hurt you.

• Similarly, a moderate (and I stress moderate) amount of regular alcohol consumption is likely good for you.

• Use a lot of common sense when it comes to health. Ask questions. Don’t be afraid to take medication if you need it, but be sure you understand the reason for it.

There are many, many quirky things that happen to the human body and often we have no answers or explanations. Don’t get caught up in fear and anxiety trying to understand it all — they key to all health is separating “sick” from “well." It is important to focus on what is healthy and good and use the positive to heal. Separate discomfort from pain.

Gloria Yee, CDE, CPMC, Sutter Health

I learned that I do better with trying to change one or two behaviors at a time, no more than that. Bright spots for me are food portions and eating more slowly. When I eat, I enjoy my food – I was one of those toddlers who bounced up and down and smiled when they ate.  I LOVE food, and I fortunately live in San Francisco, where food is tasty and easily accessible, but that also means it’s so easy to eat more and more.  However, I’ve learned that if I wait even just 5 to 10 minutes after I’ve finished my original portion, I am no longer hungry; I have enjoyed my food without overeating.

I have sustained this now for over a year through vacations, stressful times, Chinese banquets, and holidays.  I can say that I enjoy eating and love food more than ever. And I have achieved this through smaller portions and eating more slowly.

Dr. Aaron Kowalski, PhD, JDRF

My good friend Dr. Irl Hirsch once asked people with diabetes at a conference, “What is the most under-prescribed diabetes treatment?” The answer he gave: exercise. I firmly believe this. Exercise/activity has so many benefits for people with diabetes: glycemic, weight, psychological, etc… My tip is find an activity that you enjoy and get up and go!

Dr. Irl Hirsch, MD, University of Washington

For decades, we have promoted “diet and exercise” as the backbone of type 2 diabetes management. But I would maintain it is the backbone of everyone’s health, including type 1 diabetes…Though issues of how to do this safely with diabetes to avoid hypoglycemia (or hyperglycemia!) need attention, those who are physically fit do so much better with their sense of well-being, recovery from illness (especially after surgery), and diabetes management itself. We need more research into this topic, and I always marvel at Mike Ridell and Craig Taplin’s work in this area. I also continue to wonder if the reduction of systemic inflammation with exercise in newly diagnosed T1D may help to preserve beta cell function. I hope someone someday does that study, but in the meantime, it is an important message I give to those newly diagnosed and a good message for everyone.

Technology

Professor Philip Home, MD, Newcastle University, UK

“Self-empowerment! Blood glucose control if you have type 1 diabetes is often capricious, thanks to the nature of insulin therapy, but continuous glucose monitoring (CGM) really can make a difference. You can see what is happening in real time, and even if you cannot change this, you can take action to adapt what you are doing. This is a real revolution and has already made tens of thousands of people happier.”

Virginia Valentine, CDE, Diabetes Network, Inc.

My bright spot for the last few months has been the Abbott Freestyle Libre. I have used glucose monitoring for many years – most of the 37 years that I have had diabetes – but getting the complete picture of what happens after meals and overnight has been a real eye opener. A few of my “aha” moments have been seeing how high my glucose goes after cereal, but on the plus side, ice cream isn’t all that bad… yay!

Research

Dr. Barry Ginsberg, MD, Diabetes Technology Consultants

“The bright spot of my medical career was the DCCT. This period of my life was special because of the dedication of both the patients and the providers. As a clinician, for the first time in my career, I had all of the necessary resources and time to treat my patients properly.”

Dr. Roy Taylor, MD, Newcastle University, UK

Type 2 diabetes is caused by a person having more fat in their body than they personally can cope with. This is so irrespective of how heavy they are – it is an individual matter. The brightest spot is that the condition is entirely reversible in most people in the early years after diagnosis. Most people need to lose around 15% of body weight, and it has been possible to devise several ways for people who really want to escape from diabetes to achieve this.

And, finally, Dr. Lutz Heinemann said his bright spot in health was Kelly Close (Founder and Editor-in-Chief of diaTribe) and her team who work to “spread the relevant information about new diagnostic and therapeutic developments so widely – the key to pushing diabetes treatment ahead.” We are so grateful for both diaTribe readers and the diaTribe advisory board and are excited to continue delivering information to empower people living with diabetes.