& book giveaway!
When Gloria Loring began writing about turning points in her life she realized that coincidence was a key player in many of these events. So she began to wonder . . . what is coincidence? Just a quirky aligning of timing or something more? Soon she found herself on a self-guided trip through scientific theory, religious beliefs, and more as she tried to untangle the mystery we call coincidence.Coincidence Is God's Way of Remaining Anonymous
is Loring's spiritual exploration of how coincidence helped her make sense of life's challenges and uncertainties. Coincidence helped her raise $1 million for diabetes research; it arrived in the form of mysterious letters during her separation and eventual divorce from actor-writer Alan Thicke; and it helped her discover and then heal from the trauma of long-forgotten childhood sexual abuse. It also brought her a chance encounter with the man she is married to today. With eloquence and humor, Loring takes readers on a quest for a deeper understanding of life's journey and the role coincidence plays in all of our lives, revealing that even the most difficult circumstances can be beneficial. Her experiences may be just the evidence readers need to begin watching more closely what they are attracting and what they are running from in their own lives.
While coincidences may appear to come out of the blue, Loring suggests that we can all play a starring role in their appearance. "For years, I'd been waiting for someone else to make (my life) better. You'd have thought I was starring in "The Perils of Pauline." In truth, I wasn't a victim, I was a volunteer. . . . Coincidence gave me an experience of the lesson I needed to learn: You don't have to wait for someone to save you."Paperback:
264 pages Publisher:
HCI (October 12, 2012) ISBN-10:
#TheGloriaLoringCoincidence Is God’s Way of Remaining Anonymous
is available as a print and e-book at Amazon
and Barnes and Noble
as well as your local bookstores.Book Giveaway Contest:
To win a copy of Coincidence Is God’s Way of Remaining Anonymous
, please enter using the Rafflecopter form at the bottom of this post. The giveaway contest closes this Friday, March 8 at 12:00 AM EST. We will announce the winner the same day in the Rafflecopter widget. Good luck!About the Author:
When not starring on the soap opera Days of Our Lives
, Gloria Loring found herself expressing herself with music. She is the recording artist of the #1 hit song Friends and Lovers
as well co-composer of television theme songs Diff’rent Strokes
and Facts Of Life
. Gloria’s new musical show TV Tunez
, a celebration of television’s best theme songs that earned standing ovations, is in development for a Las Vegas run. She is currently in the studio with producer Ted Perlman and songwriting legends Burt Bacharach and Desmond Child.
After her four-year-old son was diagnosed with diabetes, she created and self-published two volumes of the Days Of Our Lives Celebrity Cookbook
which raised more than $1 million for diabetes research. She has also written Kids, Food and Diabetes, Parenting a Child with Diabetes, The Kids, Food & Diabetes Family Cookbook
, and Living With Type 2 Diabetes: Moving Past the Fear
. Gloria was honored by the Juvenile Diabetes Research Foundation with the Lifetime Commitment Award and the Founders Award from the National Disease Research Interchange.
The Miss America Organization gave her the Woman of Achievement Award, an honor she shares with past recipients Barbara Bush, Roslyn Carter, and Hillary Clinton. She is listed in Who’s Who in America and Who’s Who of American Women.
Find out more about the author by visiting her online:
Gloria Loring’s website: http://www.glorialoring.com/
Twitter: @TheGloriaLoring-----Interview by Jodi WebbWOW: Coincidence Is God's Way of Remaining Anonymous spans many years of your life? How long did it take you from when you first decided to write your book until its publication?Gloria:
Twelve years. I started the process in 1999, and at first it contained only my stories. Yet I knew I wanted it to be valuable to the readers, so I researched coincidence, reading dozens of books on the subject. And because Albert Einstein said the words that title by book, I began reading about the intersection of scientific observation and spiritual wisdom. What I found fascinated me. Then I read up on lives of the great saints and sages to better understand their spiritual experiences. All of it supported and expanded my perspective on coincidence, and yet even then I couldn’t finish the book.
Some of my hesitancy was the fear that people might think it’s a religious book, because the word “God” is in the title. But when I noticed how many books on the bestseller lists were about spiritual issues, I realized the time had come. Only a few months after completing the writing, I found an agent and a very good publisher, HCI.WOW: Do I spot another coincidence? You’re writing a spiritual book, spiritual books are popping up on the bestsellers lists? But let’s get back to those twelve years. That is a long time. But of course, since most WOW readers are writer/something else—whether it be writer/teacher or writer/president of the PTA or writer/dog rescuer—we all understand about there not being enough hours in the day. In the beginning, how long did you expect it to take to write your book?Gloria:
I thought it might take a year or so. I was also writing the songs that accompany each chapter at that same time, and imagined them as a “book with its own soundtrack” set. I finished recording the songs and released the CD, but each time I went back to the book, I realized there had to be more depth, more common sense, more expanded understanding. I took titling my book with Albert Einstein’s words and genius very seriously!WOW: First of all, I’m blown away that you wrote a soundtrack for your book! You have such a busy life: performing, raising money for diabetes, having a family, writing literary soundtracks! How and when did you find time to write? Gloria:
At one intensive writing time, I wrote from 7 to 9 every morning and made quite a bit of progress in those months. But then the fear arose again, “who’s going to read a book by singer and actress Gloria Loring that has 'God' in the title?” WOW: Oh, we all know that fear, no matter what type of book we're writing. But I'm wondering about the evolution of your book. Coincidence Is God's Way of Remaining Anonymous doesn't feel like a book that was planned. You don't seem like an outline kind of gal. Can you give us some insight into the creation of you book. Gloria:
This book is like Topsy from the “King and I” - “It just growed.” The story in Chapter One, “Expect a Miracle,” prompted me to remark to an interviewer that it was an amazing coincidence, and he replied, “Yes, but coincidence is God’s way of remaining anonymous. Those words of Albert Einstein’s inspired my writing the book. His words stayed with me and as my life unfolded, I saw the gracious hand of coincidence everywhere I looked. I was also encouraged by a quote in Julia Cameron’s book The Artist’s Way
, “We must share the gifts we have been given.” WOW: So what happened when one year turned into two turned into . . . did you ever feel discouraged about not having enough time to dedicate to your writing? How did you keep yourself enthusiastic for your book . . . did you give yourself pep talks, did you have a group of supportive writers behind you, what made you keep going?Gloria:
Until the last months, when I began to read and share chapters with others, I wrote the book with very little input. I just kept asking myself, is it true, is it real, is it useful? My favorite part was doing the research. I had files of clippings, pages of quotes. Coincidence was always working on my behalf. It seemed every time I picked up a magazine or book, I found something that fed the book.WOW: It's difficult to pinpoint your book . . . it's part memoir, part inspirational/spiritual, part self-help. It seems there is something for everyone. If you had to describe what type of book you wrote—in ten words or less—how would you describe it?Gloria:
It’s a memoir with a message of healing and inspiration.WOW: You included many personal stories to help illustrate points throughout your book. Was it difficult deciding what to include and what to cut? Did you worry about telling family secrets or did you find it empowering?Gloria:
Trying to understand my personal stories led me to find the wisdom, the teachings, and the scientific and spiritual perspective I found supported my experiences. My goal was to explain what I had been through and how coincidence leads us to what we need to know and what we need to grow.
Although writing of the inappropriately sexualized contact with my father was difficult, the ways coincidence led me to healing were too powerful to dismiss from my personal storyline. Telling the truth was absolutely empowering. As one brave person told me, “We are only as sick as our secrets.”WOW: What's the single most important thing you learned during your writing?Gloria:
To never again be afraid to tell my truth.WOW: That’s a powerful lesson to take away from your writing. I hope we can all gain as much meaning from our work. Can you tell us what will be next for you?Gloria:
I do have the set-asides from this book, a few chapters worth of wisdom I had gleaned, that already has a title as a follow-up book. This summer and fall, I will be conducting workshops based on the healing principles in the book, and am also developing twelve “lessons on coincidence” with Dr. Alvin Jones for a CD set.
I just completed the audio version for Audible.com and after reading through the whole book out loud for three days, I am thinking of creating a one woman show. The songs that begin each chapter so beautifully illustrate and illuminate the stories. I’m excited about all the possibilities ahead of me. It’s as if a new chapter of my life has begun.WOW: Oh my goodness, that last answer exhausted me! I may have to take sympathy nap! But I would love to see you in a one woman show based on Coincidence Is God’s Way of Remaining Anonymous. Call me when your show comes to Pennsylvania.
----------Blog Tour DatesMonday, March 4@ The Muffin
Stop by for an interview and book giveaway!http://muffin.wow-womenonwriting.com/Wednesday, March 6 @ A Writer’s Life
We all face times when we're "on stage" as the center of attention (wanted or not)--everything from work presentations to wedding toasts to a solo in the church choir. Performer Gloria Loring gives tips on conquering stage fright. http://carolineclemmons.blogspot.comFriday, March 8 @ Donna’s Book Pub
Learn more about the real person behind the Days of Our Lives character Liz Chandler with an interview of actress (and author) Gloria Loring. http://donnasbookpub.blogspot.comMonday, March 11 @ Colloquium
Soap opera star Gloria Loring reveals "The Good Use of Celebrity" and gives away a copy of her latest book Coincidence Is God's Way of Remaining Anonymous
. http://www.jhsiess.com/ Wednesday, March 13 @ Words by Webb
Learn what an old soap fan has to say about Gloria Loring’s venture into the writing world.http://jodiwebb.comFriday, March 15 @ Soaps
Stop by soaps.com for an interview with Gloria Loring, including a few questions from her soap opera fans. You'll also get a chance to win a copy of her book Coincidence Is God's Way of Remaining Anonymous
. http://www.soaps.com/Tuesday, March 19 @ CMash Loves to Read
Learn more about how soap opera star Gloria Loring became a diabetes advocate and author enter to win her memoir Coincidences Are God's Way of Remaining Anonymous
.http://cmashlovestoread.com/Friday, March 22 @ Lori’s Reading Corner
Gloria Loring, actress, singer and diabetes advocate, tells you how to "Make It Up and Write It Down." She's also giving away a copy of her memoir Coincidence Is God's Way of Remaining Anonymous
. http://www.lorisreadingcorner.comWednesday, April 3 @ Tiffany Talks Books
After you read today's review of Coincidences Are God's Way of Remaining Anonymous
, you'll jump at the chance to enter and win a free copy!http://www.tiffanytalksbooks.com Friday, April 5 @ Thoughts in Progress
We've all had them. Some we remember fondly. Others we wish had been exiled to a deserted island. They're lousy boyfriends and that's what actress, diabetes activist and author Gloria Loring wants to talk about today! Join the fun and get a chance to win her memoir Coincidences Are God's Way of Remaining Anonymous
To view all our touring authors, check out our Events Calendar
. Keep up with blog stops and giveaways in real time by following us on Twitter @WOWBlogTour
If you have a website or blog and would like to host one of our touring authors or schedule a tour of your own, please email us at firstname.lastname@example.org.Book Giveaway Contest:
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! Just fill out the Rafflecopter form below. We will announce the winner in the Rafflecopter widget this Friday, March 8. a Rafflecopter giveaway
Whilst browsing the Oxford journal Age and Ageing last week, I came across a paper focusing on diabetes in the elderly. Interestingly, it noted that men and women with diabetes aged 65 or over are one and half times more likely to have recurrent falls than people in the same age bracket without diabetes. Having two sets of grandparents in their seventies, one pair with diabetes and one without, I wanted to know about this correlation between diabetes and falling, and how it might apply to them. Here, I speak with Ms. Evelien Pijpers (EP), author of this paper, to learn more. – Nicola (NB)
NB: Your recent paper says that in a three-year study of 1145 Dutch participants aged 65 and over, you discovered an increased risk of recurrent falls associated with diabetes. Can you explain why those with diabetes are more likely to have a fall?
EP: We examined a number of possible contributing factors which led to this increased likelihood of recurrent falls, yet we can only explain about half of the increased risk faced by older patients with diabetes.
The factors which we did link with the increased risk of recurrent falling in patients with diabetes included the use of four or more medications; higher levels of chronic pain, mostly experienced in the muscles and bones; poorer self-perceived health; lower physical activity, grip strength and sense of balance, combined with greater limitations in the performance of daily activities such as bathing and dressing; and more significant problems with cognitive impairment.
Fortunately for the patients, we didn’t record enough major injuries or fractures over the three-year study period to be able to track any correlation between diabetes and fracture risk in older people.
NB: What are the consequences of recurrent falling?
EP: As a geriatrician, I see a lot of mobility problems in older patients. They are present in older people in the accident and emergency department, the hospital wards, and the care and nursing homes. When I visit my older patients at home, it is both the mobility difficulties and the fear of falling which stop them from walking to the shops or strolling through the cobblestone streets of Maastricht.
My older patients with diabetes seem to be especially prone to fall and injure themselves. Even if they avoid lasting injury, I find that afterwards they try and avoid situations in which they could fall again. This unfortunately limits their social contact and the number of physical activities they are willing to undertake, and as such their physical condition declines, sometimes to the point where disability and loss of independence are inevitable. For those with diabetes who are more likely to fall, it is more likely that they will face this quandary.
NB: So what could be done to prevent the increased fall risk in older persons with diabetes?
EP: To improve the quality of life of this growing group of older patients with diabetes, it is important to keep them physically and mentally active, mobile, and able to avoid falls and injuries. Therefore even though we cannot yet account for the entirety of the increased risk of falling, it is possible to address fall risk factors we now know about. A medication review can help, as can muscle training and activities to improve balance – which in turn may even improve pain induced by osteoarthritis. Improving mobility helps individuals to perform everyday activities, and it is easier to feel positive about your health if you are able to maintain independence. It is important that we teach older patients how to fall with the least risk of injury, and how to pick yourself up (both physically and mentally) when you have fallen without losing confidence. As such, physicians should be in the practice of counselling all elderly diabetic patients about active lifestyles and the importance of mobi
Writing, reading, researching diabetes has brought me many surprises. One continual surprise is when friends I have known for many years contact me to let me know they too have the chronic disease. Here is information never relayed, never shared until this moment because I have been writing about diabetes. This is the power of the word: to speak diabetes through words, song, painting, dance.
And so it goes with ire'ne lara silva
. I have known ire'ne for many years but until this year, we had not shared our experiences and struggles with this chronic disease. I'm very pleased to bring ire'ne lara silva to this Sunday's Bloga. ire'ne is a fierce poet from Austin, Tejas, whose words instruct me. She has also taught me how to "hechar el grito" and now she is gritando diabetes in her poetry. When ire'ne's first collection of poetry, furia
, was published October 2010, it was featured right here on La Bloga
received an Honorable Mention from the 2011 International Latino Book Award in poetry.
Now she wants to follow furia with a collection that focuses on diabetes. she has titled it, blood/sugar/canto.
Here is one of the poems from the collection:
"diabetic love song"
understand there are things I will never do with you I will never go to the beach with you in the summer I will never share a stack of pancakes with you I will never stay up all night I will never toss back tequila shots with you or have a beer or a glass of wine I need naps and I need rest and when I get too tired I stop functioning my brain begins its meltdown at 90 degrees I will cancel plans it will all be more than I can bear
and now there are pills in the morning and pills at night and more than one syringe a day there may be three there may be four and everywhere everywhere there are alcohol pads in the house in the restroom on the floor in my purse in my pocket and spent lancets and testing strips with one miniscule drop of blood and I will be pricking my fingers and pricking my fingers and pricking pricking pricking
I can never skip meals I will always need more water I will always have doctors’ appointments looming and sometimes I will rail against all of it and I will howl and gnash my teeth and throw things about and I will despair and there will be not
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This is the latest post in our regular OUPblog column SciWhys. Every month OUP editor and author Jonathan Crowe will be answering your science questions. Got a burning question about science that you'd like answered? Just email it to us, and Jonathan will answer what he can. Today: what happens when our immune system doesn’t work as it should?
This blue circle is the global symbol for diabetes – developed as part of the Unite for Diabetes awareness campaign. The significance of this blue circle is positive and hopeful. Cross-culturally, the circle symbolizes life and health, with the color blue reflecting the sky that unites all nations and is the color of the [...]
By: Amelia ML Montes,
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Frayed Edges, Loose Thread
A Short Story by Amelia M.L. Montes
(originally published in “Saguaro Journal”)
There was diabetes all over my house while I was growing up. There was diabetes in some of the old clothes Mamá wore after my sister Nina died of it. There was diabetes in some of the rags we used to dust the house with because when tío Tan lost his arm, he always gave Mamá the sleeves for us to use on the furniture. There was diabetes in our family photos.
Tía Concha had died long before I was born but I knew her through the yellowed pictures in the green shoe box—the box on the shelf above the hanging clothes in the closet. Tía Concha had no legs and sat in a long chaise lounge with many blankets on top of her so no one could tell, “but of course we all knew,” Mamá would say. Tía Concha posed in her chair, smiling toward the camera, her crooked fingers waving hello, or arranged carefully one on top of the other over the blankets. The close-up of tía Concha didn’t really focus on her long gray braid or front silver teeth. Instead, the camera caught her looking down at her fingers extended over a book. Her fingers reminded me of the twisted trees I saw on the coast of Monterrey—the ones that line the cliffs on the 17 mile drive—the trunks that look like they’re going straight but then curve off, now right, now left, leaning into each other, leaning out toward the sea.
Tía Concha lived by the sea but it wasn’t on the Monterrey coast of California. She lived in Mazatlán, where the trees are long lean palms. Mamá said that she and her cousins would take large palm branches and fan her on hot days. In one of the pictures, Abuela is ho
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Robert Tattersall is an internationally recognized authority on diabetes. He received specialist training at King’s College Hospital, London and the University of Michigan in Ann Arbor. He moved to Nottingham in 1975 where he became Professor of Clinical Diabetes. His most recent book, Diabetes: The Biography, is part of the series Biographies of Disease which we will be looking at in the upcoming weeks. Each volume in the series tells the story of a disease in its historical and cultural context – the varying attitudes of society to its sufferers, the growing understanding of its causes, and the changing approaches to its treatment. In the excerpt below we learn about the discovery of insulin- a moment that changed the lives of diabetics forever.
After war service in Europe, Frederick Grant Banting (1891-1941) failed to get a surgical job at the prestigious Toronto Hospital for Sick Children and so set up as a doctor in London, Ontario. This was not a success, and to make ends meet he got a part-time job at the University of Toronto. In October 1920 he had to lecture the students on carbohydrate metabolism, about which he knew little. While preparing, he read an article about a man in whom a stone had blocked the pancreatic duct leading to atrophy of the digestive-enzyme-producing part of the gland but leaving the islets intact. This was hardly new, since it had been known for thirty years that this was what happened when the duct was tied in animals, but in his notebook Banting wrote:
Ligate pancreatic ducts of dog. Keeping dogs alive until ancini degenerate leaving Isletes.
Try to isolate the internal secretion of these to relieve glycosurea [sic]
Against the background of the fruitless attempts described in the previous chapter, it is not surprising that Macleod did not take Banting seriously. Macleod wrote: ‘I found that Dr Banting had only a superficial textbook knowledge of the work that had been done and no familiarity with the methods by which such a problem could be investigated in the laboratory.’ Quite apart from Banting’s ignorance, Macleod had lost interest in diabetes and was researching acid-base balance. Banting later said that during the first interview Macleod was so disinterested that he started reading letters on his desk. Nevertheless, he offered Banting a disused lab and two students, Charles Best (1899-1978) and Clark Noble (1900-78), who were to do alternate months. They tossed a coin to decide who should to the first month. Best ‘won’, but was so involved at the end of the first month that Noble agreed that he should continue.
Banting need an assistant, because he did not know how to measure blood sugar, and Macleod had wisely insisted on this as the end point of their experiments. During his research on the blood sugar of the turtle, Best had learned the new Lewis-Benedict method, which needed as little as 0.2 ml blood, whereas other methods needed 25 ml. Another stumbling block was that Banting had never done a pancreatectomy, an operation that at the time was used only in animal research. Macleod assisted at the first operation, but Banting and Best then worked alone, writing from time to time to Macleod, who replied with advice. In August 1921they depancreatized two dogs and treated one with pancreatic extract leaving the other as a control. The untreated dog died in four days which the treated one remained well. Macleod was encouraged by their results but felt that the falls in blood sugar might be due to dilution or even normal fluctuations. He suggested further experiments, to which Banting objected violently and accused Macleod of trying to steal their thunder. Nevertheless, the experiments were done. When Macleod returned in October, he had a stormy interview with Banting, who threatened to go elsewhere if better facilities were not provided. At a departmental meeting on 14 November 1921 Banting and Best gave a preliminary presentation of their work. One important suggestion at this meeting was that the best of showing that the extract worked would be if regular injections could prolong the life of diabetic dogs.
This was a logistic problem, because the duct-ligation method needed many dogs and a wait of seven weeks while the exocrine tissue degenerated. Banting’s solution was to use foetal calf pancreas, which Best got from the local abattoir. The rationale, as Sobolev had suggested twenty years before, was that it contained a high proportion of islets in relation to exocrine tissue. An important breakthrough came in December, when Banting decided to use alcohol in making extract (an idea Macleod had suggested some months before). It worked well and led them to wonder whether they could get a similar result with the more easily available adult beef pancreas. That they did must have been a surprise, because the original rationale for duct ligation was that the internal secretion would be destroyed by pancreatic enzymes. In fact, although Macleod and others believed this, it had been known since 1875 that fresh pancreas did not break down proteins. The intact gland contains an inactive precursor trypsinogen, which is converted into the protein-dissolving enzyme trypsin only by contact with duodenal juice. Around this time Banting and Best were joined by a biochemist, Bert Collip (1892-1965)-more accurately, he was foisted on them by Macleod, who regarded him as a proper scientist. Collip had come on a Rockefeller fellowship and was studying the effect of pH on blood sugar. Later he was asked to help with the purification of insulin and made rapid progress, although afterwards he downplayed his role, suggesting that any biochemist could have done the same.
Some time in December 1921 Collip began making extracts from whole pancreas and, at Macleods suggestion, tested them on rabbits. The extracts reduced the rabbit’s blood sugar, and how far it fell was a useful and cheap way of telling how potent the extract was.
The first use of insulin (an extract made by Charles Best) on a human being was on 11 January 1922. The pancreatic extracts were relatively impure, and the house physician at Toronto General Hospital described what he injected into the buttocks of 14-year-old Leonard Thompson as ‘15 cc of thick brown muck’. Thompson has been on the Allen diet since 1919 and weighed only 65 lb (29.5 kg). After the injection, his blood sugar fell from 440 to 320 mg/dl (24.4 to 18.3 mmol/l), but no clinical benefit was seen. The experiment was resumed on 23 January, when he was given Collip’s extract, and now his blood sugar fell during one day from 520 mg/dl (29 mmol/l) to 120 mg/dl (6.7 mmol/l). He continued treatment for ten days with marked clinical improvement and complete elimination of glucose and ketones from his urine. Subsequently he lived a relatively normal life, although reliant on insulin injections, before dying of pneumonia in 1935.
The first clinical results were published in the March 1922 Canadian Medical Association Journal, where the authors reported that they had treated seven cases…
Diabetes mellitus is a complex, multifactorial disease that is often associated with progressive retinopathy and visual loss. In Diabetes and Ocular Disease: Past, Present, and Future Therapies, 2nd edition, edited by Ingrid U. Scott, MD, MPH, Harry W. Flynn, Jr., MD, Dr. William E. Smiddy, MD, readers have a practical reference for the diagnosis and management of ocular disease in diabetic patients. In the excerpt below, from the opening essay by Robert E. Leonard II, MD, and David W. Parke II, MD, we learn about the consequences of diabetes.
Treatment of complications due to diabetes is a growing source of health care expenditures. While ophthalmologists focus on the retinal and ophthalmic complications of diabetes and their treatment costs, it is important to note that these represent only a fraction of the overall costs of uncontrolled diabetes. Chronic complications of diabetes include accelerated atherosclerosis and its associated macrovascular disease processes of CHD, stroke, and peripheral vascular disease. These are responsible for the majority of diabetes-associated morbidity and mortality. Peripheral and autonomic neuropathy, renal impairment and failure, and diabetic retinopathy are associated with the microvascular complications of diabetes. As an example, Haffner and colleagues compared the 7-year incidence of myocardial infarction (MI) in diabetic and nondiabetic subjects with and without prior CHD. Their data suggest that diabetic patients without a previous MI have a higher risk of MI than nondiabetic patients who have had a previous history of MI. Persons with diabetes have a nearly seven-fold increase in heart disease compared to nondiabetic patients. CHD is the number one cause of death in the developed world, and accounts for over 500,000 deaths per year in the United States alone. It is clear that the emerging diabetic epidemic facing the developing nations of the world will significantly change rates of CHD and associated mortality in coming years.
In the United States alone, the cost of treating uncomplicated diabetes is over 6 billion dollars per year. Acute complications of diabetes, such as emergent hypoglycemia or hyperglycemia, raise that cost significantly. The chronic complications of diabetes, as mentioned above, totaled over 44.1 billion dollars in 1997. That represented 10,071 dollars per each diabetic patient in the United States. The total cost related to diabetic complications in the United States is estimated to be at least 100 billion dollars per year…
Numerous studies have shown that the key to decreasing diabetic complications lies with strict glucose control. The Diabetic Control and Complications Trial (DCCT) has shown the benefits of intensive blood glucose control in patients with type 1 diabetes. Intensive glucose control reduced the risk of developing reti
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This is a layered cake I make my husband on his birthday, which is today and I just ate two pieces! You’re probably saying to yourself, “Yes, Carolyn, but you’d eat two pieces of ANY birthday cake.” True, but this one is guilt-free and it doesn’t make John, who was diagnosed with Type 1 diabetes 28 years ago, feel like he’s being deprived. We could easily order a regular birthday cake, but this one doesn’t force him to take an unusual amount of insulin and he doesn’t get a sugar rebound.
Here’s exactly what I did, but you can experiment with the flavors your family likes. The carb count on the Angel Food Cake is 11 grams per serving.
2 boxes vanilla or banana-flavored sugar-free, fat-free Instant Jell-O pudding. (1 oz box)
2 boxes strawberry sugar-free Instant Jell-O. (0.30 oz box)
1 Sugar-free Angel Food Cake loaf made by Hill & Valley. (7 oz. Got mine at Jewell)
1 container of Cool Whip reduced sugar
Make the strawberry Jell-O and pour it into an 8 x 8 baking dish. Slice banana and add to Jell-O. (I only used about 3/4ths of the Jell-O.)
Chill it just until it starts to gel. Slice the Angel Food Cake loaf length-wise so you have two retangular pieces. Remove Jell-O from the fridge, and press the pieces of cake into the Jell-O to make the second layer of the cake. The cake shouldn’t be completely immersed in the Jell-O. Return to the fridge and let it chill for about a half hour more. Make the pudding, and spread it on top of the cake for your third layer. Cover the entire cake with Cool Whip for the fourth layer.
Hope you like it!
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By Rowan Hillson
The first time I increased a patient’s insulin dose I lay awake all night worrying that his blood sugar might fall too low. I was a house officer, and insulin was scary! The patient slept well and safely.
Diabetes is common, chronic and complicated. A recent nationwide audit of 12,191 people with diabetes in 206 English acute hospitals found that 15% of beds were occupied by people with diabetes. Worryingly, 37% of these patients experienced at least one error with their diabetes medications (the full results can be read here).
The National Patient Safety Agency (NPSA) has had over 16,000 reports of insulin incidents. In 2010 the NPSA issued an alert requiring action for all health care professionals to improve prescribing and administration of insulin, which was linked to a “Safe use of insulin” e-learning course.
I trained over 30 years ago. Are junior doctors more confident now? Apparently not. A study of 2149 junior doctors by George et al provides worrying evidence that UK trainees lack confidence in managing diabetes. Just 27% were fully confident in diagnosing diabetes, 55% in diagnosing and managing dangerous low glucose and 27% in managing intravenous insulin. Regarding management of diabetes, 24% of respondents would “not often, rarely or never” take the initiative to improve diabetes control. 43% would not adjust insulin in patients with poor glucose control.
Confidence is a combination of knowing what to do and believing you can do it. Experience helps. Also, we all need to know what we don’t know and when to ask for help. An unconfident doctor may make the patient anxious. Galen believed that in the 2nd Century: “Confidence and hope do more good than physic”.
Trainee doctors receive varying amounts of diabetes training and variable supervised experience of looking after people with diabetes. With too little training, trainees may rightly be worried about managing diabetes. Inadequate care of people with diabetes in hospital could worsen virtually every clinical outcome regardless of the main reason for admission. It also worsens patient experience. Diabetes is a common, potentially dangerous but eminently treatable condition. All units in all hospitals should have access to a specialist diabetes team. And trainee doctors should have training and support in diabetes management until they each feel confident in looking after people with diabetes under their care.
Table from the paper ‘Lack of confidence among trainee doctors in the management of diabetes: the Trainees Own Perception of Delivery of Care (TOPDOC) Diabetes Study’, QJM: An International Medical Journal, Advanced Access, 21 April 2011
Read on for an excerpt from Dr Hillson’s commentary ’Diabetes – big problem, little confidence’, which is published in QJM: An International Journal of Medicine, Advanced Access, 21 April 2011. You can read the
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