Cancer Articles (Dr. S.N White)

First, accept it yourself. Children are great little chameleons. They pick up the attitudes and emotions of parents faster than you can say "Jackie Robinson." If you have the attitude that your child's diabetes is a disaster and a loathsome burden, that's the attitude your child is likely to develop. If you take his or her diabetes in your stride, accept the restrictions of the disease, and work positively toward helping him or her learn how to lead a full life, you'll instill these positive attitudes by living example. Incidentally, your question hit on the number one, foremost, important adjustment attitude for a diabetic acceptance. It may be the hardest to come by, but once acceptance is there, all the rest is relatively easy.

As soon as possible. Especially if the diabetic in your life is a very young child. We think it would be a great help to see that Mommy or Daddy can take the shot, eat the diet and skip the candy, and test the urine or blood sugar. We had thought this playing at being a diabetic was a pretty wild idea that few people would be willing or able to try until we talked to a young woman who had been diabetic since the age of three. She told us that she'd had a terrible time giving herself the injections. She'd cry and cry, both before and after. Her older (by eight years) sister took it upon herself to take shots (saline solution) along with her, having races and trying to make a game of it. It made all the difference in the world to the diabetic girl in getting over her fear and loathing of the needle. She really appreciated what her sister did (especially in later years), and you can imagine what it did for the sisterly relationship. Incidentally, even long term diabetics love...

Only about as many changes as moving a hippopotamus into the living room. Each looms large on the scene, can't be ignored, has to be worked around, demands a great deal of time and trouble and care; and you never stop wishing that someone would take the damned thing away. But strangely enough, you can get used to anything, be it hippopotamus or diabetes. Eventually when people express shock and concern, "Oh, you have a hippopotamus in your living room!" (Or, "Oh, your child, husband, or wife has diabetes!") "How terrible!" you're surprised they even mention it as an oddity or a problem. It's just what is, & part of your life and you're living with it.

What is a remission? A remission is a period when diabetes becomes less severe. For example, an insulin taker might find that he or she can keep in control on less insulin or on diet and pills, or maybe even on diet alone. Or perhaps a pill taker can get by on diet alone. Sometimes a remission lasts quite a while. Sometimes it is shortlived. Particularly common is the remission that occurs in juvenile diabetes after insulin treatment begins. This often causes the parents, who are already desperately clutching at straws, to think their child has been miraculously cured or that the diagnosis of diabetes was incorrect. False hope. Diabetes is still there. A remission is not a cure and should never be regarded as such. Enjoy it while it lasts, but realize it will eventually end and don't be devastated when it does.

Is it all right for a diabetic to use hot tubs? According to the U.S. Consumer Product Safety Commission, all people who have diabetes, a history of heart disease, or blood pressure problems should check with a doctor on the advisability of using a hot tub. They also caution that nobody should bathe in a hot tub with water that is 104 degrees F. or higher, since water of 106 degrees F. can be fatal even to fully healthy adults. (Barbara, who considers herself a fully healthy adult, gets rather frightening nosebleeds after sitting in Japanese baths or hot springs.) The preceding section on foot care explained that you shouldn't put your feet in water above 85 degrees F. or 90 degrees F Since it's a little awkward to soak in a hot tub with your feet hanging out, it looks as if tepid tubs should be the order of the day for diabetics.

Why do they talk so much about diabetic foot care? It's that same old vascular story. Diabetes causes hardening and narrowing of the blood vessels. This, in turn, causes poor circulation of the blood. Since the feet are farthest away from that great blood pump, the heart, they get the worst deal. Poor blood circulation is also part of the aging process. So if you're older and diabetic, you've really got to watch those feet. And we do mean watch, because if you also have a touch of neuropathy, you may not feel a cut, sore, blister, or ingrown toenail and let it go until it becomes infected. Infections are particularly hazardous because, combined with diminished circulation, they provide a welcome mat for gangrene (tissue destruction), which can necessitate amputation. Here are the foot care dos: 1. Wash your feet every day and wear clean socks. 2. Always dry well between your toes. 3. Cut your toenails after bathing, following the shape of the ends of the toes. Do...

Smoking and Diabetes Smoking is dangerous for everyone, but doubly dangerous for diabetics. Inhaling cigarette smoke affects the blood vessels. Diabetes can affect the blood vessels. Both diabetes and smoking tend to narrow them, and narrowed arteries can cause heart disease and gangrene. A diabetic has 2.5 times the normal chances of getting heart disease. A smoker has 1.7 times the normal chances of dying of heart disease. Put the two together and you have over four times the normal risk of heart disease. A diabetic has sixty times the normal chances of getting gangrene of the feet. Again, smoking increases that already dismal figure. A study done at the University Hospital in Copenhagen, Denmark, found that diabetic patients who smoked required 15 to 20 percent more insulin than nonsmokers. Their level of blood fats was also higher. You might call smoking a kind of Virginia roulette for diabetics. So why are there diabetic smokers? That's a question we have no answer...

To some extent, that depends on what you did to get tired. If you're weary from your job as steeplejack or longshoreman, or if you're a housewife who's cleaned the whole house or galloped after a four-year-old all day, you've already had a great deal of exercise. Getting more is not that critical for you. On the other hand, if you're tired from a long day of sedentary office tensions or sitting in the car, then you need exercise for more reasons than diabetic ones, and you should clamp your jaw and force yourself, at least initially. Just as the appetite comes with the eating, the energy and enthusiasm for exercise come with the exercising. Often the fatigue you feel at the end of a day comes from a lack of physical activity rather than from too much of it. If you find yourself too tired to exercise and it's not a true physical tiredness, you may go to bed and find yourself too keyed up and tense to sleep. The next day you've got a lack-ofsleep tiredness ...

Are coffee and tea bad for a diabetic? Probably. Many recent studies show that drinks containing caffeine accelerate the aging process and cause headaches, heart trouble, and genetic damage. It stands to reason that any chemical that does all of that is not going to help diabetes. But what makes it a specific diabetes negative is its tendency to raise the blood sugar. Caffeine is not just found in coffee (150 milligrams per cup) and tea (50 milligrams per cup) but in cola drinks (45 milligrams per can), cocoa (15 milligrams per cup), and even in most headache tablets (35 milligrams). In that peculiar way the government has of legislating the use of harmful substances (ketchup is required to have sugar in it), cola cannot legally be called cola if it doesn't contain caffeine! Besides the problems associated with caffeine, coffee has a few distinctive problems, the most disturbing of which was revealed in a Harvard University study which implicates coffee in cancer of our b...

How much should I weigh? A very simple and convenient test of the correctness of your weight is to pinch up your flesh just below your ribs at your waistline. Pressing the flesh between your thumb and forefinger, you should find a thickness of between one-half and one inch. If the pinch test reveals more flesh than that, you're too fat. Another guideline is to think back and recall what you weighed in your early twenties. That's when most of us are at our ideal weight (assuming you weren't overweight then). Tables 2 and 3 will help you find your ideal weight, as they show what is considered both slender and normal for college students. Find your height on the men's or women's chart and you'll have a target weight for slender or normal for yourself. (The slender figure is preferable for diabetics, since that would lessen the demands on your pancreas.) Incidentally, we don't favor the Metropolitan Life Insurance weight charts, because they tell ave...

What do they mean when they say you have Type I or Type II diabetes? Type I is another and newer term for juvenile or insulin dependent diabetes. This kind of diabetes usually occurs in children, but it can occur at any age. That's why it's a preferred term over juvenile diabetes. It now covers people like June, who got it as an adult but has to take insulin. The three people represented on this graph each had 100 grams of glucose administered by mouth. One person (A-Normal) is nondiabetic. One person (B-Normal) has impaired glucose tolerance. And the other person (C-DM) is diabetic, either insulindependent or non insulin dependent. You can see that the nondiabetic's body has removed most of the glucose from circulation within two hours. In the diabetic, whose glucose levels were already too high, the glucose level shot even higher than at first, and three hours later, the levels had not yet begun to drop. The person with impaired glucose tolerance has a curve simila...

If I decide to drink, which drinks and how much of them can I have? You have to learn which drinks contain sugar, which are high in carbohydrates, and how many calories they all contain. Whatever you drink has to be figured into your meal plan and the calories counted. Alcoholic drinks are usually calculated as fat exchanges, although you can also substitute them for bread exchanges. Naturally, you can't mix liquor with orange juice or tomato juice without counting those exchanges also. And you have to avoid such mixers as ginger ale, tonic, and other sweetened soft drinks. The best alcoholic drinks that don't contain sugar or carbohydrates are dry white wines (including champagne), dry red and rose wines, white vermouth, whiskey, gin, vodka, scotch, rum, brandy, and tequila. A four ounce glass of wine is about 80 calories; a four ounce glass of vermouth is about 140 calories. The hard liquors are calculated according to their proof. The higher the proof, the more calorie...

It didn't keep actress Mary Tyler Moore, radio and TV personality Gary Owens, hockey star Bobby Clarke, prominent physician Peter Forsham or McDonald's restaurant tycoon Ray Krock from getting the jobs they wanted. Why would it keep you from any career you choose? The truth is that the great majority of diabetics have the same employment opportunities and limitations as nondiabetics. So if you're qualified for a particular position, go after it positively and aggressively. Be up front about your diabetes. If the subject comes up with an employer, point out that diabetes develops a sane lifestyle and great self discipline. These in turn lead to a superior performance on the job. For the one million or so diabetics who take insulin, we do have to report on a few negatives. You should avoid jobs where you could endanger yourself or others during insulin reactions. It wouldn't be wise for you to seek jobs with highspeed machinery or climbing telephone poles, for example....

Will I be able to get insurance as a diabetic? That depends on the kind of insurance you're interested in getting. Automobile insurance.  According to Henry Helfman, a North Hollywood insurance agent (and a diabetic), there should be no trouble if you're in good control. (Here's yet another reason to take good care of yourself.) If they ask on the form if you're a diabetic, naturally you have to tell them. In that case, they'll probably ask you to produce a letter from your doctor saying that your diabetes is in control. If they don't ask, we don't see any point in saying, "Hey there, Insurance Company, I'm a diabetic. Don't you want to hassle me?" Personal experience: June's automobile insurance company has never asked; she has never told. Life insurance.  Mr. Helfman tells us that if you're under control (again with evidence required) and you take less than forty units of insulin or don't take insulin at all you shou...

How do I cut the high cost ofbeing a diabetic? You're right to worry about costs. Being a diabetic can be an expensive proposition and the expenses rise every year with inflation and new discoveries in diabetes care. The number one way to keep costs down is to practice preventive maintenance, just as you do with a car. If you keep your diabetes in control and keep yourself healthy, you'll keep yourself out of the hospital. Hospitalization is the most horrendous expense of all. If you have a choice of health insurance plans where you work, be sure to investigate them to see which one pays for the most diabetes expenses. Some now pay for blood sugar testing materials and meters and some even reimburse you for insulin and syringes. Often insurance companies initially refuse to pay for something like Chemstrips or Dextrometers and Dextrostix but if you keep haranguing them and submitting letters from your doctor (or lawyer!) and evidence of other plans that pay, they some...

What is the best contraceptive for a diabetic woman to use? Two British physicians, J. M. Steel and L. J. P. Duncan, studied the use of contraceptives by insulin-dependent diabetic women. Their conclusions reported in the November-December, 2010 issue of Diabetes Forecast, were: Birth control pills for diabetics They warn against the use of the combined pill, which contains both estrogen and progestogen. Women who use this pill have a higher incidence of heart attacks and strokes. If used at all by diabetic women, it should be only for the shortest possible time. They recommend instead the progestogen only pill. The IUD.  They consider this to be unacceptable for diabetic women because it is highly ineffective. (It has also been known to cause infections.) The diaphragm.  This, along with the progestogen-only pill, is on their "best choice" list. The failure rate for mechanical devices like this and the condom is, they say, due mainly to using them incorrectly or...

Can i be pregnant with diabetes? We assume from this question that you have already wrestled through the basic Everywoman life decision of whether or not to have children and have concluded that you want to, but you worry about the effect your diabetes will have on your baby and vice versa. If that is the case, then the first step is to consult both your diabetologist (or internist or family doctor) and a gynecologist to see if there is any physical reason why pregnancy would be a poor risk for you. If their reaction is positive, then you can be cheered by the news that the death rate of babies of diabetic mothers has been significantly reduced in the past ten years and is now closer to that of the general population. Both mother and child come through successfully more than 90 percent of the time. To improve your odds even further you should heed the advice of Dr. Edith Miller of the Joslin Clinic who says that diabetic women who want to have children should be in the best p...

That depends to a certain extent on whether you are a woman or a man. Previously it had been thought that diabetes had little or no effect on either a woman's sexual performance or satisfaction. Even now, based on what diabetic women report to their doctors, it would seem that they reach a sexual climax just as often as nondiabetic women. Still there are rumblings from some diabetes therapists especially female diabetes therapists that sex problems associated with diabetes are as common among women as among men. It's just that the male sex problems have been given more attention. This is not necessarily due to sexism. It may be due to the fact that sexual response is easier to measure with men than with women. The majority of women's sexual problems appear to be related to poor diabetes control. A woman understandably loses interest in sex when she is excessively tired and rundown from being out of control. High blood sugar and the resulting sugar in the urine increase...

In general, definitely yes. You should tell everyone you have any kind of everyday contact with your hairdresser or barber, your colleagues at work, your teachers, your coaches, your friends, even rather casual ones, and especially those with whom you play sports. You should make it a special point to tell anyone with whom you have any kind of medical or semi medical dealings, such as your dentist or podiatrist or oculist, because that may influence their treatment of you. There are several good reasons for letting people know you have diabetes, especially if you are insulin dependent. In the first place, should you have an insulin reaction, a person in the know can help you out or at least will realize that whatever is happening to you may be related to your diabetes and will get you to someone who can help. You are also much less likely to inadvertently offend people if they know you have diabetes. For example, if you get low blood sugar and suddenly turn into a grouch or hell...

Call your local diabetes association and ask them for the names of diabetologists who are closest to your home (and closeness is important). If your town has no local association, call your state affiliate of the American Diabetes Association and ask them for a recommendation. If you still have no luck, call your local hospital and ask who on their staff handles most of the diabetes cases. Another good thing to do is go to your public library and check the Directory of Medical Specialists. This way you can find out the doctor's training, what hospitals he or she has worked in, age, and special experience. We realize, however, that in some small towns there simply isn't a diabetologist. In that case, find (or keep) a doctor with whom you feel you can have a good relationship. Look for one who is willing to explore solutions to problems you present. Be sure she or he is willing to investigate new developments in diabetes that you may learn about in your reading or from dis...