Riva is finally doing what she set out to do in high school – writing her observations of life and human behavior - little did she know then that diabetes would be her muse. Riva has had type 1 since 18 and is the author of “50 Diabetes Myths That Can Ruin Your Life: and the 50 Diabetes Truths That Can Save It” and “The ABCs Of Loving Yourself With Diabetes.” Read full bio

PepsiCo’s Imperative to Increase Wellness: Derek Yach

Derek Yach is a physician, epidemiologist and Senior Vice President of Global Health and Agriculture Policy at PepsiCo.

The first part of my interview with Yach talked about global health and how we need to change our agricultural policies and work more closely with farmers.

Here, Yach shares what PepsiCo is doing through their product lines, to be a major player on the world stage helping to reduce hunger and obesity.

Q: What initiatives is PepsiCo involved in to help produce more nutritious foods?

2012-01-31-Screenshot20120131at9.07.16AM.png

 (Yach in yellow shirt in Ethiopia for chick pea program)

 

Derek Yach: We’re investing in small farmers around the world and we’re involved all along the chain, from the seed and development of farming practices to the final product and its consumption. We’ve partnered with the World Food Program and the United States Agency for International Development to fund better seeds and drip irrigation systems in Ethiopia so farmers can improve their yield of chickpeas. We believe this project can potentially reduce famine in Africa over the long term. Excess chick peas PepsiCo doesn’t use, the World Food Program is using in a ready-to-eat food product to address famine in Pakistan.

PepsiCo is also fortifying many of its products to get micro-nutrients into millions of people’s diets. For example, we’re addressing iron deficiency in India with an iron-fortified cookie. In Mexico, we’re fortifying some of our more nutritious cookies with Vitamin A.

Internationally we’re at some of the largest global conferences, like the World Economic Forum, as part of a consortium looking at what the agricultural industry feels needs to be grown to address world hunger.

And across Africa and parts of Pakistan and when there’s a crisis in the U.S., like Katrina, the company mobilizes a range of food, water, related relief and cash.

Q: Why don’t more companies feel a moral obligation to move in this direction?

DY: I can’t answer for other companies but I think a great business is one that is doing things that are both right for the business and right for society.

We are seeing that over the medium and long terms, the companies that started investing in healthier foods and in agricultural supply chains that are less vulnerable to climate change are the ones that will win.

It’s less the moral case but the business case that needs to be made inside companies for doing this.

My hope is that increasingly we’ll be competing against each other to see who can become the healthiest company.

Q: Was there any resistance within or without PepsiCo to move in this direction?

DY: Yes, but being a South African growing up in a period of profound national change, I have seen there will always be resistance to change. When you have a senior team all speaking the same message, a CEO, Indra Nooyi, who sees the business growth opportunities that come with developing healthier products and investment in research and development, suddenly the change that seems so tough, happens. And suddenly, the investment in innovation you made is no longer visionary, but business as usual.

Today, the annual revenues from our health and wellness portfolio — brands like Tropicana, Quaker and Naked — are about $13 billion. We believe that will grow to $30 billion by 2020.

This is a company that has been focused on health and wellness for quite some time. This journey accelerated about a decade ago when the company acquired Tropicana, Quaker and Gatorade — three businesses which became the new engine of growth for the company and the foundation of our health and wellness portfolio.

Q: How do you reconcile doing this work in a company that’s also the largest producer of what we think of as less than healthy snack foods?

2012-01-31-Screenshot20120131at9.02.07AM.png

DY: I can answer that by saying there are two big strategies underway. One is to take many of our products and make sure that the salt, sugar and fat levels are at the lowest possible level and that they meet nutrition criteria, without sacrificing the great taste consumers expect from PepsiCo products.

We’re pretty close to that in many of our products. If you take our Sun Chips, for example, they would do very well on almost every nutrition criteria. Yet because Sun Chips are a classic snack food, and people equate snacks with junk food, many still don’t see how healthy they are.

Our beverage selection offers a full range of zero calorie and small calorie options that are inherently healthy like water, tea and Gatorade products for athletes. Also, the full calorie ones are starting to come down.

This year we’re launching a new soft drink, “Pepsi Next.” I think it’s going to be a revolutionary product that gives consumers real cola taste with 60 percent less sugar.

While we invest in our core brands, we’re also growing other parts of the company in order to build that $30 billion health and wellness portfolio that I mentioned earlier.

For example, we’re expanding our Quaker line and many of our smaller brands. We have a range of healthier pita bread related products, like our hummus brand, Sabra and some of the healthiest low fat and skim milk yogurt-related products in Russia and the Middle East. Over the next few years you’ll see more of these products.

Q: You sound enormously hopeful.

DY: Absolutely. If you look at the trends for demanding healthier foods the trend lines are upward in every market in the world. Even in the current economic environment with people turning, in part, to comfort foods, the overall trend toward improving health and nutrition seems to universally be going in the right direction. And the trend lines are echoed by steadily improving life expectancy and steadily declining diseases we thought we would never be able to conquer.

I was in South Africa at the start of the upswing of the AIDS epidemic. The evidence is now that it’s starting to go down. I was very involved in tobacco control and now we’ve seen dramatic decline in tobacco-related mortality like lung cancer. That was unthinkable 15 or 20 years ago. I’ve seen the almost complete collapse of measles and almost complete eradication of polio.

Over the course of my career I’ve seen changes that people thought would be impossible.

I’ve also seen that individual and community action can make a big difference to global health. And as an epidemiologist I’m stimulated by changing the shape of the trend line to make sure as bad things are going up we can slow them down and bring them back down sooner. 

We’re starting to see the peak of obesity in a number of European countries and a slowdown or first indication of reduction in parts of the U.S. I think a decade from now we’ll be looking at a reversal of the diabetes epidemic in many parts of the world and a continued upward trend of people living longer, healthier lives.

For Part 1 of this interview click here.

I find how Yach is looking at health and wellness — from the ground up — almost revolutionary amid the status quo, and his working within this snack foods giant to improve quality of life around the world a mighty stand. While some will say, “How healthy can it be to fortify cookies?” — and while I can hope PepsiCo will spend more of their wellness effort creating more product lines that rely on fresh foods — it would be great to see more companies joining in, as Yach said to me, “to do things that are right for the business and right for society.”

Originally published on Huffington Post.

No comments yet

Taking On Agriculture to Reduce Obesity And Hunger: Derek Yach

2012-01-25-Screenshot20120125at5.16.58PM.png

I heard Derek Yach speak at Albert Einstein’s Global Diabetes Summit last September. He presented a case to curb obesity, hunger and diabetes that we don’t often hear: turn our agricultural policies around and work more closely with farmers.

Mr. Yach — a physician and epidemiologist — is a noble fish trying to change the sea around him and around us. Formerly an Executive Director at the World Health Organization (WHO), Yach is Senior Vice President of Global Health and Agriculture Policy at PepsiCo.

Yach’s mission is to help address global challenges such as hunger and obesity, and the ills they cause, by finding ways for PepsiCo — the world’s second largest food and beverage business — to be a part of the solution.

Yach is the 15th leader featured in my series on diabetes change agents. This is Part 1 of a two-part interview. Yach talks here about the world situation and our agricultural policies. Part 2 covers what role PepsiCo is playing.

Q: When you were at the World Health Organization you were instrumental in reducing smoking. Why is it so much harder to get food companies and consumers on the path of producing and eating healthy food?

Derek Yach: Reducing tobacco use was much simpler. You demonize the industry, then tax it to the sky, ban marketing and reduce smoking in public places. Those are all very crude, easy things to do. They don’t have the nuance of a diet, the complexity of the thousands of things available for people to eat or the numerous invested parties.

What makes food complex to regulate according to Yach:

 

1. You can consume too much of a healthy food, and then it is no longer healthy.

2. Everyone thinks they’re an expert — the consumer, the policy makers, agricultural people, politicians, dietitians, nutritionists — yet no one has come up with clear and coherent strategies.

3. Everything you ask people to eat less of has enormous interests behind it. If you want people to eat less meat, there’s a red meat lobby and a Cattleman’s lobby.

4. The groups that are asking people to eat more healthy foods, like fruits vegetables, whole grains and beans, don’t advocate their causes very effectively.

I think we’re going to need incentives rather than regulations. And we’ll need to apply them all the way along the agricultural supply chain and human behavior. There isn’t one single instrument, as we had in tobacco, that’s going to change food consumption for the better. It will take years of different interventions to reverse the trends we see today in obesity.

Q: What has to happen regarding agricultural policies in order to help stem the tide of obesity and diabetes?

DY: Simply, we need a far more nutrition-focused perspective embedded in agricultural policy. In terms of health, our food policies have failed miserably. The escalation of diabetes around the world is an indicator of how off course we’ve gone.

As an epidemiologist I look at trends and see problems before they begin and things getting better before it’s noticed.

 

The public hasn’t yet seen our agricultural policies translate into a direct impact on diabetes-related death, but it has. And, they are having significant consequences regarding increased diabetes, ill health and health care costs.

Q: What else needs to happen at a national and global level?

DY: In the public sector, agricultural and health departments need to be brought closer together to align their priorities, specifically for diabetes. Our current support structure and subsidies are for meat, not fruits and vegetables, and we need just the opposite.

We need to more closely link farm subsidies with the prevention of chronic disease, and that means we need to play a more active role with our agricultural partners. Farming and agriculture play a root role in the quality of calories we furnish, and right now we have an energy imbalance.

We are caught between hunger in the world and obesity and both come from the same cause: cheap calories. We must play more actively with our partners in agriculture.

Fruit and vegetable consumption will also be helped if the relative price of fruits and vegetables become more competitive with corn, corn syrup and sugar-related products. Then companies will want to innovate and use those products across their product lines and this will benefit both companies and consumers.

Q: How can governments and businesses work more closely with agriculture to stem the tide of obesity and produce more healthful foods?

DY: That’s the critical question. When I was at the WHO, one of the things we failed to do when working on diet and physical activity policy was persuade agricultural organizations to look at what agricultural supply would be if it was meeting the health and nutrient needs of the world. I think that’s the intimate bridge between what gets grown and what is needed from a health point of view.

In the U.S. the structure for agriculture did not start by asking the question, “How can we make sure that the healthiest foods are those we grow the most of and are most available in terms of pricing, availability and accessibility?”

Q: What question underlies the food industry in the U.S.?

DY: I think it’s one of agricultural output, “How do we increase yield and maximize yield output for the return of farmers?” That’s an important question but what we need to ask is, “How do we maximize the use of agriculture to meet nutrition needs?”

The good news is the World Economic Forum is now asking the question. Many domestic discussions are on how we can meet the gap in fruit and vegetable consumption. And, it’s part of the bigger, complicated issues around subsidy structures and research and development for fruit and vegetables as opposed to soy, corn and palm oil. And the food industry’s toughest critics, like Michael Pollan and Marion Nestle, as she reviews farm bill issues, are asking the question. But this shift will not happen overnight since we’ve built our current system up over many decades.

In Part 2 of my interview Yach talks about PepsiCo’s commitment to health and wellness.

Originally published on Huffington Post.

No comments yet

Changing Whole Towns to Reduce Type 2 Diabetes: Itamar Raz

2012-01-20-HeadshotRaz2.png

This is the second part of my interview with leading diabetologist, Professor Itamar Raz. Raz is the director of the Hadassah University Hospital’s diabetes unit and one of the world’s leading researchers and clinicians in diabetes.

In addition to being close to preventing Type 1 diabetes, Raz is working to protect the heart and kidney from diabetic complications, educating doctors how to treat patients with diabetes and changing towns across Israel to improve lifestyle behaviors.

Q: Tell me about the research you’re doing in Type 2 diabetes 

Itamar Raz: I’m working on a number of things. We’re developing a drug to decrease the muscles’ resistance to metabolizing glucose. You know of course Type 2 is a situation of insulin resistance. We’re developing small proteins that may overcome this insulin resistance.

Mostly I’m doing clinical research to protect the kidney and the heart from complications. Now I’m running studies that show certain drugs can protect the kidney from deterioration. 

For the heart it’s more complicated. We have to show the FDA that while a drug can reduce blood sugar we need to assure that it doesn’t cause heart damage. Most Type 2 patients die and suffer from cardiovascular events. For one of the recently-developed oral hyperglycemic drugs (saxagliptin) we are running a very large study, 16,500 people at 800 centers, with a leading cardiology group in Boston.

Q: What else are you working on that you’re excited about? 

IR: Here in Israel I was nominated by the Ministry of Health to head the National Council of Diabetes. That makes me responsible for all the policy and treatment of diabetes care. In this capacity I am expanding the knowledge of the general doctor on diabetes treatment.

Ninety percent of diabetes patients in Israel and worldwide see a general practitioner (GP), but there’s so much diabetes knowledge and experience the GP doesn’t have. Especially with the vast array of new drugs available for treatment. So we’re teaching them when to start insulin, how to start insulin, which drug to use first, how to combine drugs and many more things like this. 

We run large scientific meetings in Europe, Asia and Latin America where we sit everybody together, diabetologists, nurses, doctors, dietitians, social workers, psychologists, representatives from organizations like the JDRF, and we talk with them about how to improve treatment and care. We’re also publishing that knowledge in medical journals like Diabetes Care to make it accessible to more doctors and nurses.

Members of the OECD, that’s an organization that works at improving the economy — and they’re looking closely at medicine — they just came here to Israel to learn one thing from us. How we deal with diabetes. We are very good at it.

Q: Are you also teaching doctors that Type 2 diabetes is not just about medicine but also behavior change?

IR: Yes, and I completely agree with you. If you want to cure Type 2 diabetes, you must change your lifestyle. We see it in evidence-based studies. Do more exercise, eat properly and you have a 60 percent chance you’ll be cured of diabetes. Take a drug and it’s only a 30 percent chance and over a few years most people deteriorate. But no one has taught doctors how to help patients embrace a healthy lifestyle. Many doctors themselves are fat so doctors don’t put enough emphasis on lifestyle.

In Israel we’re changing people’s lifestyle by changing whole towns. We learned from the U.S. and Britain that government cannot change people’s lifestyle. You have to change the environment.

People need places to exercise. If a person works they should have an hour to stop and do exercise. You can’t just tell somebody, “You have to run five miles a day!” You have to give him that ability.

So we are in the process of instituting what we hope will become a nationwide program in Israel called “Healthy Living.” We went into 10 towns and began making changes. We are using one town, Ashdod, which has about 250,000 people as a model.

Last year we began creating opportunities for people to exercise. We went to the factory where many people work and now they serve healthy food and give an hour off for exercise. We are changing drinks in school to only water. We are going into people’s homes and explaining the best foods to have in their refrigerator. We are making a green line in the supermarkets to show where the healthy food is. And we’re trying to make healthy food cheaper than unhealthy food. Next year we will have another three towns and each year more.

I’m a diabetologist, why am I doing this? I think we have to do this. And I am trying to do this without too much money and in a way that two or three years from now the government won’t have a choice but to continue.

Q: What are you most proud of in all that you’ve done?

IR: That I can sit with each one of my patients and after five or 10 minutes I can change them from people who are terribly worried to being less worried and more relaxed.

I see about 50 new patients a week. At the end of the day, after all these things I do, I’m just a simple doctor who wants to help people and wants to do good.

I came away from my entire interview with Professor Raz awed that we may actually be so close to preventing Type 1 diabetes and deeply curious what we may yet see emerge in the next few years.

Originally published on Huffington Post.

No comments yet

Itamar Raz: A Few Years Away From Preventing Type 1 Diabetes

Forty years ago I was diagnosed with type 1 diabetes. I was told — as we all were — that the cure was five to 10 years away. There still is no cure, but I just interviewed the man who may be a breath away from preventing type 1 diabetes.

“Right now we can diagnose who will develop type 1 diabetes within five years.” — Diabetologist Itamar Raz.

2012-01-10-Screenshot20120110at1.32.16PM.png

Last month after I was in Dubai to cover the International Diabetes Federation Congress, I went to Israel where Professor Raz’s secretary, working extremely hard, found 30 minutes for me to meet with Raz.

Professor Raz is Director of the Hadassah University Hospital’s Diabetes Unit and one of the world’s leading researchers and clinicians in diabetes. Raz’s work is changing the future of type 1 and type 2 diabetes.

But what I remember from the almost 50 minutes we spent together is the warmth that radiated over his desk toward me. His bright blue eyes that never left mine and how intensely present he was, wanting me to understand both his work and the fact that he is still a simple doctor who wants to ease patient’s pain. 

This is Part I of a two-part interview and the 14th in my series of profiles on diabetes change leaders.

Q: Tell me about the work you’re doing to prevent type 1 diabetes.

Itamar Raz: Before you develop type 1 diabetes, for most people and mainly in children, you develop antibodies against your pancreas. Most of the time it is two or three antibodies. When these antibodies are seen in a child you know that he/she will most likely develop diabetes within three to four years. If you follow such children you can track how fast they respond to glucose with their own insulin secretion. The moment they are not responding as quickly as before you know it’s only another year before they will develop diabetes.

We have an assumption about how type 1 diabetes occurs. When the beta cell is under stress, current theories suggest from a possible viral disease or early exposure to cow’s milk (rather than breast milk) we don’t really know yet, a part of the cell and a protein inside the cell get exposed in a way that the white blood cell sees the beta cell as an invader and attacks it.

Now we’re trying to stop this attack. Simply, we’re injecting an antigen (a foreign molecule that triggers the body’s production of an antibody) that the cell expresses when it’s under stress. Then we’re stimulating the part of the protein inside the beta cell that goes into action to prevent the attack. When we inject this antigen into animals we can prevent diabetes.

Different studies have been done with other antigens but they have all failed. But three weeks ago we were the first in the world to show in our study that what we are doing works in newly-diagnosed diabetic patients. We are in trials now and soon hope to try it in young children before they develop diabetes to see if we can stop the disease from occurring.

 

Q: Do you think we will see a cure for type 1 diabetes in your lifetime?

IR: I think it’s a hard question. Hoping that my life will extend for another 20 or 25 years, I’m sure we will see many treatments emerge to stop the attack on the beta cell without causing damage to the patient. Whether we will have a full cure I don’t think so, but I don’t know.

A cure may come in three ways. Either we’ll turn stem cells into beta (insulin-producing) cells, or infuse beta cells, or it will be some kind of artificial pancreas. Stem cell therapy is still very far away from being a solution. Islet cell transplantation is a big disappointment. We learned that within three years most patients are insulin dependent again.

I think we’re going to have an artificial pancreas within five or 10 years that will make the life of someone with type 1 diabetes much easier. You won’t have to check your blood sugar and you’ll be able to live more or less a normal life. You won’t have to deal with diabetes all day long and you’ll have an A1C that will probably protect you most of the time from complications.

2012-01-10-AuthorandRaz2.jpg

Photos ©Riva Greenberg

Q: Why did you go into this work?

IR: I went into medicine because I love to help people. This is me, I love people and I love to give.

When you are a doctor you are like a god, and you can be a good or a bad god. You are a bad god if a patient comes to you and you say, “Why don’t you do this! Why don’t you do that! What you are doing now, you are killing yourself!” You can be a good god if you show your patient that most of the time things are not so bad and you take whatever he worries about and help him worry less. You have a lot of strength in your hand to do good for people.

I went into diabetes for two reasons. I found it very interesting and I thought that this was going to be the main disease the world would face. I saw how our lifestyle was changing. I was right, but 30 years ago no one thought this way.

The other reason was I thought I’d like to have a little time for myself. If I was a cardiologist I’d be running to my patients all hours of the day and night. I didn’t go into cancer because at the time I thought what can I do about cancer? But, diabetes, I thought I’ll have a little time for myself. Of course do I have any time for myself? No, but I love it. 

No comments yet

Paula Deen’s Diabetes: Are We Getting the Right Message?

The blogosphere was thrumming about whether the Food Network’s down-home Southern queen, Paula Deen, has Type 2 diabetes. Yes, by now you know she does.

It doesn’t bother me that she kept it “close to my chest” as she announced on the Today Show to Al Roker. She said she didn’t want to talk about it until she had something to offer her public.

So I’m left to wonder, did the three years it took Deen to come clean mean she waited until she could help others by being spokesperson for a new Novo Nordisk campaign, “Diabetes in a New Light”? (Deen takes Victoza, a Novo Nordisk injectable, to manage her diabetes.) Or should we finally recognize and admit, just as Deen now has, that diabetes is a lot for a person to take in and learn how to responsibly manage?

No matter what Deen’s real reason was for keeping her diagnosis mum, I applaud that she’s now using her popularity to help inspire the millions of Americans who eat as she ate: an unhealthy high-fat, high-carb, excessive-calorie diet.

What I fear, however, is that too many Americans will still dismiss weight and healthy eating as inconsequential to managing diabetes. Already Deen appears to be dragging her feet on just saying that being overweight or obese, along with a lack of physical activity, is one of the most common causes of Type 2 diabetes. Together, these factors are responsible for nearly 95 percent of diabetes cases in the U.S.

When asked by Roker what the main causes of diabetes are, Deen seemed to fumble and then said genetics, age and lifestyle (an easy cover for unhealthy eating and excess weight), and put emphasis on stress. 

In the USA Today article, “Paula Deen Spreads Word About Diabetes in Down-Home Manner,” Deen answered who gets diabetes by saying, “It’s about heredity. It’s about age, lifestyle, race.” Funny that weight has once again gone missing in this string of risk factors.

Let’s also be clear: Age is becoming less and less relevant to who gets Type 2 diabetes, with increasing obesity in children. According to the U.S. Surgeon General, the number of overweight children in the U.S. has doubled and the number of overweight adolescents has tripled since 1980. The CDC reports 151,000 youths under the age of 20 have diabetes, and cases of Type 2 diabetes among youth and adolescents has been reported with increasing frequency. Understand there’s a reason why Type 2 diabetes, once called “adult-onset” diabetes, is no longer.

I applaud Deen for coming out. I give her a lot of credit for putting her credibility and career at risk and for all she’s overcome in her life, including crippling years of agoraphobia and poverty.

I also love the positive take of Novo’s campaign, a new light – diabetes is not a death sentence. We can live with diabetes and have a full life.

I only hope as Deen leads a nation of almost 26 million with diabetes and 79 million with pre-diabetes that she doesn’t sidestep the importance of healthy eating, maintaining a normal weight and activity. Let’s not soft-peddle the “lifestyle” bit and merely replace it with medicine. 

As those of us in diabetes do know, the Diabetes Prevention Program in 1992 with 3,000 participants showed that 58 percent of participants — across all ethnic groups, for both men and women — reduced their risk of developing Type 2 diabetes with moderate weight loss and exercise. In those over age 60, the risk reduction was a whopping 71 percent! Those participants who were taking metformin, an oral diabetes drug, only reduced their risk by 31 percent.

So Paula, keep it going, keep it clean and keep it real. Let’s not create more diabetes myths, and let us do recognize that managing diabetes takes a personal commitment to healthy eating, proper weight, activity, being well informed, yes, managing stress and yes, taking your meds if prescribed.

And let’s particularly stress that healthy eating, weight and activity are the best tools the nearly 80 million Americans with pre-diabetes have to prevent or delay their diabetes diagnosis.

What do you think? Are we spreading the right message by having Paula Deen as a spokesperson for diabetes?

Originally published on Huffington Post.

6 comments

A ‘Bucket List’ to Change Your Life Right Now

In the movie, “The Bucket List,” Jack Nicholson and Morgan Freeman, both dying, create a wish list of things to do before they die — their “bucket list.” I got to thinking, why not create a list of what’sin my bucket now, rather than what I still want to fill it with? 

Most of us know that when we appreciate what we have instead of looking at what we don’t, we’ve got our hands on a pretty powerful elixir. Appreciation is like a drug. Just taking a few minutes a day to appreciate what we’re grateful for can make us more energetic, confident, flexible, creative, open, connected, happy, able and strong.

So here’s perhaps the first ever “What’s In My Bucket List.” While it’s a bit random, it’s a bucket-full of things I have, am grateful for and have learned so far.

My “What’s In My Bucket List”

2011-12-23-Screenshot20111223at2.13.36PM.png

llustration ©Riva Greenberg

1. I’ve had, and have, lots of love in my life and many opportunities to love. I have a loving, supportive husband, great friends and family members I still talk to.

2. I’ve wondered for decades what my mission was, and because I never stopped asking the question, I found the answer. Now I live it in the work I do every day.

3. I have a chronic illness — type 1 diabetes — that has given me greater empathy for others and shown me my strengths and determination in a way that I can’t deny.

4. I never lacked for food or shelter, not even when I fed for years on tuna subs (college) and shelter was an attic apartment where I slept with a frying pan (also college, but alas another story).

5. I had two girls bully me throughout junior high school, which gave me the resolve to always fight for the underdog, and I always do.

6. I may not be the brightest bulb in the box, but I am persistent and persistence has brought me everything. It allowed me to find a home where I wanted to live and gave me a magazine column I wanted to write.

7. People have always trusted me with their heartaches and secrets. I have always relished that trust.

8. I’ve learned the power of language: Stop using “can’t,” “don’t,” “should.” Start using “yet.”

9. Vegetables are my drug and will pave my way into heaven

10. I try to meet people where they are without judgment. After all, if I’m not always having a great day why should I expect that they are?

11. I’ve learned that doing more of what I love, more often, makes everything better. I prescribe it to others.

12. I spend more time acknowledging the small successes on the way to wherever I’m going. Those small successes are where I experience my growth, and they give my work its delight and sense of play.

13. I’m grateful for the people who seem to just show up in my life, who are kind and help me on this journey. They are the sunshine that gets me through the darker days.

14. I’ve learned that being bold is not about ego, but inspiring others. I’ve also learned, even if I embarrass myself, everyone else is too self-absorbed to notice or remember.

15. Most of all I’ve learned the only thing to be is authentically me. How I wish I had known this when I was younger!

I plan to renew this list every year. I know looking at what’s in my bucket makes me happier now and is a pretty good way to avoid regrets when the end comes.

What’s on your “What’s In My Bucket List”? Writing one is a great way to see how much you already have.

Originally published on Huffington Post.

2 comments

Dear Santa

I posted this last year on the Huffington Post but if you missed it I’m reposting it here. It makes me laugh and I’m hoping it makes you laugh too. And, humor can’t be overrated for any of life’s ills.

This year perhaps it’s even more significant because I’m posting it while vacationing in Jessica and Mike’s backyard, Tel Aviv.

 

Dear Santa,

 

All I’d like this Christmas is for you to take this diabetes away. I’m so tired of it already. All the time stabbing my fingers for blood and guessing when my sugar’s too high or too low.

 

Now that I’m in menopause I can barely tell whether I’m sweating because I’m losing estrogen or because my blood sugar’s crashing at 50 mg/dl!

 

And, can we talk… I mean the constant figuring out how many carbs are in a ravioli or bread stick or that fried calamari that will be at the company Christmas party. Some days I just want to lie down and shoot myself. Please, please, Santa, would you take this diabetes away?

 

Sincerely,

Riva

 

***

Dear Riva,

 

I’m very sorry you’re having a tough time during my favorite season. I only want people to be singing carols and drinking eggnog and feeling good cheer. Unfortunately, it says in my contract that I’m not allowed to interfere with life’s natural occurrences. So here’s my suggestion: although you’ve already opened your holiday gifts, go back and look under your Hanukkah bush for the gift in having diabetes.

 

You may have to spend a few days looking, so why don’t you schedule it for the week between Christmas and New Year’s while you have some down time? Then you can start the new year fresh.

 

Best wishes,

Santa and the gang

 

***

Dear Santa,

 

A gift in my diabetes? What are you, crazy? Meshuggah? Thanks, but no thanks!

 

Riva

 

***

Dear Rabbi,

 

I seek your wise counsel. I wrote to Santa to take away my diabetes, but he wasn’t helpful at all. Surely you who have studied the Torah and represent our people who have suffered throughout history can help me with this awful diabetes.

 

It’s such a strain, Rabbi. I have to test my blood sugar when I really want to be lighting the sabbath candles. I forgot all about the High Holy Days this year because I was so busy counting carbs in the Challah, bagels and honey cake.

 

Rabbi, please, what solace can you offer me? What words of wisdom? Surely you would tell me to just forget about this diabetes thing and go shopping, right?

 

Please write soon,

Riva

 

***

Dear Riva,

 

Santa and I just returned from the Caribbean, and he told me about your difficulty. He said he told you to look for the gift in your diabetes. I concur with Santa; there are many gifts to be found in diabetes, if you look. For one, my child, you won’t have to drink the traditional Manishewitz holiday wine anymore. The Counsel all agree that it is much too sweet. Bring out the Chardonnay!

 

When Santa asks you to look for a gift in your diabetes, he is not saying this because you are not Catholic and he is not bringing you anything, although this is true. He is speaking like our brothers the Buddhists, who profess that there is a gift in everything if you look for something positive that it can bring into your life.

 

Let me tell you a story, my child. My own Aunt Sheila had diabetes, and after she stopped kvetching, she went to a spa and learned how to eat healthfully. She shopped along Rodeo Drive and bought a cute little jogging outfit and started running. On her jog along the ocean she met her fourth husband, Marvin, and they’re very happy. They just moved into a $6 million mansion in Jupiter, Fla. — right next to Burt Reynolds! Everyone’s plotzing! The house was in foreclosure so they have even more money to decorate!

 

Darling girl, find a gift in your diabetes, because to be honest, since you’re not orthodox, and all I have are these great wigs I got on sale from my cousin Schlomo, I’m not bringing you anything, either. And really, it’s not very pleasant to whine.

 

Shabbat Shalom

Rabbi, Local Union 107

 

***

Dear Rabbi,

 

I thought about what you and Santa said and have decided to become a Buddhist. I picked up the Dalai Lama’s book, “The Art of Happiness.” He says, “Happiness is a butterfly, which when pursued, is always just beyond your grasp, but which, if you will sit down quietly, may alight upon you.” I told my friend Joe I like butterflies, and I like the robe, so these aren’t bad gifts.

 

Joe said the quote meant that we are the source of our happiness, that happiness can only come from inside us, regardless of what happens in our lives. Hmm, I said, maybe I need to learn more. So I booked a flight to Tibet.

 

Now if only I didn’t have to drag all this damn diabetes stuff with me…. ohm… ohm… oy.

 

Riva

 

 

4 comments

How 24 Women Live Successfully With Diabetes

My Sweet Life: Successful Women with Diabetes is a heartfelt and inside view of 24 women’s lives. Women, who have each found a way to successfully manage a career and/or their family and their diabetes.

The book’s publication is the successful accomplishment of clinical psychologist and certified diabetes educator, Dr. Beverly S. Adler, who has had type 1 diabetes for 36 years. Adler followed a personal conviction to bring these stories of inspiration and triumph — and often times hard work, self-reflection and resolve — to light.

Here follows my fourth “Book View,” a short interview with an author about a book that offers an intriguing proposition.

Q: You spent a year pursuing a publisher. Why was it important to you to get this book published?

Beverly Adler: Because I always felt I would have appreciated having a book like this, a source of inspiration and something that validated my feelings, when I was diagnosed and through the years. As my fellow clinical psychologist, Dr. Wendy Satin-Rapaport, said this book is like have a support group around you.”

Q: Reading the stories of your 23 fellow contributing authors, did you see commonalities among these successful women?

BA: I did, and what amazed me was how many of their stories sounded similar to my own. Depending on the woman’s age of onset, many women experienced the “Why me?” syndrome. They pondered why they were “chosen” to have diabetes. Over time, however, they came to the conclusion, “Why not me?,” and each was able in some way to accept her diagnosis.

Q: Was there anything else these women’s stories had in common?

2011-11-28-Screenshot20111128at5.37.54PM.png

BA: I noticed most of the women had a “pivotal” moment when they were able to change their attitude about diabetes from negative to positive. That then changed their actions in the direction of achieving better health. The women were able to recognize that diabetes is just a part of who they are like having green eyes or being left-handed. And many realized, while it may have felt like they were alone, they actually had the support of their family and friends.

Q: What stands in most women’s way of being successful in their lives and/or with their diabetes management?

BA: I can tell you what I see in my private practice. Many women feel so hopeless and overwhelmed by their diabetes that they give up before they even try. Many women, for instance, need to make healthier food choices, but they’ve already experienced failure dieting and their past negative experiences paralyze them from making positive changes. Usually it takes a scare like the start of retinopathy in their eyes or neuropathy in their feet to shake them up enough to redouble their efforts.

Q: Most, if not all the women’s stories in the book, refer in some way to diabetes as a ‘blessing in disguise’

BA: Yes, and that’s very much how I see it. Shortly after my diagnosis in college I realized that diabetes wasn’t fatal so I felt relieved. Today, thanks to diabetes, I take good care of myself. Thanks to diabetes I have a successful career focused on helping others with diabetes.

Q: Is there an innate characteristic that enables people to see diabetes as a ‘blessing in disguise’?

BA: I think it requires being able to look at life from the perspective that everything happens for a reason although we may not understand the reason why things happen as they do.

Q: What do you hope the book will accomplish?

BA: I hope any woman with diabetes will be able to relate to the women in these chapters and be able to use these successful women as role models in their lives, whether they are struggling with family, career or managing their diabetes. Each woman in the book shares a very intimate story about where she started and how she arrived at where she is in her life, her “lessons learned” and how she kept going and got where she is today. For all of us, our shared stories are inspirational.

I also worked hard getting this book published so that health care providers will get a better understanding of what it’s really like to live with diabetes. I hope they will also share the book with their patients as a source of inspiration.

Q: What ultimate message do you want readers to take away?

BA: None of us are perfect, but we can all do the best that we can do, and we don’t have to let diabetes control us, we can manage it. All the negative expectations that I was given when I was first diagnosed have proven to not be true. We can live long and healthy lives, we can have healthy children, we can have successful businesses, travel and participate in whatever activity we choose. Nothing — especially diabetes — has to hold us back from being the person that we want to be.

Nuggets from a few contributing authors

“It’s been 25 years since my type 1 diabetes diagnosis, and life is still built on quicksand. You never know what the next day will bring, for better or for worse, but living with diabetes has helped shape my perspective and I’m more appreciative of the joys I do have. Like my daughter, husband, and a job that I love. Being successful to me is feeling happy. I feel very, very successful.” — Kerri Sparling, Diabetes Writer and Patient Advocate at SixUntilMe, 25 years with type 1 diabetes.

“I am 71 years old and a few years ago after being told it wouldn’t work I invented a product called WarmFeet® that has helped people with diabetes improve blood flow to their feet. I don’t take “No, you can’t” for an answer, not in my professional work or my diabetes care.” — Birgitta Rice, Researcher and Educator at the University of Minnesota, Pharmacist, 52 years with diabetes

“Returning from a military tour performing for our troops in Afghanistan, I was diagnosed with type 1 diabetes. Until then, as an L.A. based professional dancer, I was living my dream. Now, my vibrant, confident self was being stripped away by a threatening and tedious “condition.” My therapy was to create something helpful for myself and others. So, frustrated by all the depressing, standard-issue diabetes tools and supplies, I started a business of fashionable diabetes accessories. My business has helped me take control of my health and rejuvenated my spirit.” — Kyrra Richards, Entrepreneur, Myabetic, 4 years with diabetes

“The secret to my success as a woman who has lived with diabetes and survived breast cancer twice, is my quest for knowledge and willingness to take action. When I found out I had diabetes, I hired a cycling coach and we formed a team with my endocrinologist. That collaboration became Team WILD. At 39 I found out I had breast cancer. Doing athletic events as a cancer survivor, I realized that we needed something similar for diabetes so I founded the “Red Riders” which is now used by the American Diabetes Association Tour de Cure bike rides! — Mari Ruddy, Team WILD, two-time breast cancer survivor, endurance athlete, 30 years with type 1 diabetes

 

Most of the contributing authors have type 1 diabetes, however, their stories inspire no matter what type of diabetes you have, or even what chronic condition you may live with. These are stories about women who encountered an obstacle and climbed the mountain.

Whether you are newly diagnosed or a veteran you’ll find hard-earned wisdom and 24 different routes to the same place: a successful life and making peace with diabetes.

A portion of the proceeds from the sale of this book will be donated on behalf of the author and the contributing writers to the American Diabetes Association. Currently the book is available through the publisher, PESI HealthCare, and will soon be available on Amazon.com.

In full disclosure, I am one of the featured women.

Originally published on Huffington Post.

No comments yet

International Diabetes Federation Congress in Dubai

“Today 366 million people have diabetes. At a conservative estimate there must then be 1 billion people who either have diabetes or live with someone who does,” said Professor Jean Claude Mbanya, President of the International Diabetes Federation (IDF).

Dignatariesopeningceremony.jpg


Mbanya made his proclamation at the opening ceremony of the IDF World Congress. Almost 15,000 participants have descended upon Dubai, part of the United Arab Emirates (UAE) and where I am now, for the Congress. Researchers, scientists, heads of state, diabetes organizations, professors, medical practitioners — and several of Dubai’s royal highnesses including His Highness Sheikh Hamdan Bin Rashid Al Maktoum, Deputy Ruler of Dubai, and His Excellency Qadhi Saeed Al Murooshid from the Dubai Health Authority — are here to stem the tide of diabetes.

Why Dubai? Because here, hidden behind the towering skyscrapers, falafel, palm trees and sand, and throughout the region, Professor Mbanya told us, “one in five people has diabetes.” IDF is here to encourage governments in the region to act in the face of the diabetes epidemic.

The United Arab Emirates’ explosive urbanization, economic development and increasingly unhealthy lifestyle have catapulted type 2 diabetes in the Middle East, as well as North Africa, to pandemic proportion.

Among the staggering statistics revealed at the opening ceremony: Six of the top 10 countries with the highest incidence of diabetes are in the Middle East.

Said Mbyana in his keynote speech:

“Much of the world has been shaken from a deadly slumber. Governments have woken up at last and realized that diabetes and related NCDs (non-communicable diseases) constitute a global epidemic that requires urgent action. And they must not be allowed to go back to sleep! … Faced with an epidemic that will claim more than 4.5 million lives just in 2011, we worked with a measured urgency to mobilize our community. As a result of that action, much ground has been covered in our push for change — change so deep and far-reaching it will affect the way the world prepares itself for centuries to come. That is no mean feat, my friends! But it is one we must achieve, for we are in a race against time.

Until the conference closes Dec. 8 I’ll be writing highlights from the Congress. You can follow me on twitter at http://www.twitter/diabetesmyths.com and in pictures athttp://www.flickr.com/photos/71272098@N04/.

Originally published on Huffington Post.

No comments yet

Brandy Barnes’ Community Of Women With Diabetes

In only four years Brandy Barnes has created something unique in diabetes, yet one quickly thinks, “Why didn’t someone think of this before?”

2011-11-28-Brandy.jpg

Brandy is the founder of Diabetes Sisters (DS), a website solely devoted to supporting, educating, and advocating for, women with diabetes.

The website is only a first portal. Diabetes Sisters also makes possible face-to-face sharing opportunities, and as you’ll discover, support for women in countries where diabetes isn’t even talked about.

This is the 13th in my series of profiles on diabetes change leaders.

Q: Why did you choose to focus solely on women with diabetes?

Brandy Barnes: I was diagnosed in high school and throughout high school and college I kept looking for ‘that girlfriend with diabetes’ whom I could talk to about girl things, like what do you tell someone when you’re dating. The isolation really came crushing down on me with the birth of my daughter. I desperately wanted another women who’d been through pregnancy and could say, “No, you don’t have to worry about this or now that’s something to worry about.”

I looked on the internet, in my local community, I even asked my endocrinologist to connect me with another woman. I thought this is scary and other women must feel this way too so two years after my daughter was born I started thinking about a way to support and connect with other women with diabetes.

Q: You tell a great story about talking to God that led to the creation of Diabetes Sisters.

BB: For a few months I was praying about what I was meant to do here. I felt this internal pull like God was telling me, “I gave you all these skills and abilities and opportunities and what are you doing with them?”

At the time I was a pharmaceutical sales representative. I spent a lot of time on the road and I remember talking to myself in the car. “Please, God, just tell me what it is I’m supposed to be doing! If you tell me, I’ll do it. But I can’t do it if I don’t know what it is.”

A couple of days later driving down the road the whole idea came to me. I pulled off the Interstate and grabbed a pad and started writing down all these ideas like a weekly blog, women’s forum, shopping for women with diabetes, annual retreat. At this point I hadn’t even read a blog! The only thing I’d done on the internet was check email and visit web sites.

After I wrote everything down it was overwhelming. I thought this is way too much for me to even try to do. I had said, “If you tell me what to do I’ll do it” but I didn’t think it was going to be so huge. I stuck the pad in the back of a drawer but every day I found myself thinking how could I make this work?

I kept seeing in my mind all these women at a retreat talking and laughing, it got me so excited I knew I needed to figure out how I was going to do this. A few weeks later I took the notepad to my husband Chris and before I could finish explaining he cried, “Oh, my God, this is what you should be doing!”

Q: I’ve seen Chris at that retreat that leapt from your mind to reality, ‘Weekend for Women,’ and it’s obvious how proud he is of you

BB: He has been my biggest supporter from the very beginning. He even came up with the name “Diabetes Sisters.”

Q: Is support the key to Diabetes Sisters?

BB: I think you have to address support before you get to the other pieces we provide, education and advocacy. Being connected to others takes you to a place where you care what your blood sugars are and will do the work. Being around other women who are doing well with their diabetes you think, ah, I want to do that. You also have to feel good about yourself before you want to, or can, take care of yourself. When you feel like you’re in this disease all by yourself you don’t have much motivation to put up with everything you have to do.

Q: What’s interesting is you began online but now have taken that support into the community in women’s living rooms

BB: Yes, in 2010 we had just finished our ‘Weekend for Women’ annual conference and a number of women wanted to take something like it back to their home town. That grew into our PODS Meetups. The name came from our first group of women who piloted the program in Raleigh, NC. PODS stands for Part oDiabetes Sisters. The idea is to transcend the tired old hospital support group and move into a new arena that truly focuses on meeting women with diabetes where women gather–in someone’s living room or a local restaurant.

2011-11-28-Screenshot20111128at3.04.48PM.png

Women meet once a month and let it all hang out. The first few meetings, or even the first year, it’s just a coming together to share and talk and get to know each other. Then Diabetes Sisters provides topics for the second year that the group can talk about.

Q: Are there specific topics women tend to want to talk about?

BB: Women really want to talk about relationships, about dealing with your significant other and extended family. Women want to talk about how and when do you tell a new boyfriend you have diabetes? Then there’s how do you handle people who want to be in your ‘diabetes-business’ like how do you correct family members who say, “You know if you’d just lose weight you wouldn’t have diabetes!”

A big thing that comes up at ‘Weekend for Women’ is sex. There’s little attention paid to sex for women with diabetes and really nowhere for women to talk about sexual issues so we always have a session on that at the conference. And questions about sex cross all lines. Diabetes Sisters includes women with any type of diabetes, type 1, 2, 1.5, gestational, ages twenty to eighty, and different ethnic backgrounds, and everyone has questions about sex!

Another message women need to hear from us and from each other is to put themselves first. Women want to take care of everyone else and if they have time they’ll get around to taking care of their diabetes. But you have to put yourself first so that you’ll be around to take care of your family.

Q: What do you get the most pleasure and satisfaction out of doing related to DS?

BB: Getting up every day and working on something that directly helps other women. I get chills when I think there are millions of women everywhere who need this.

I get emails from women all over the world and some of the saddest ones are from women in India. We get a lot from women there because it’s taboo to have diabetes, nobody will marry you. Women write, “I have diabetes and I haven’t told my future husband and his family doesn’t know because I know when they find out they won’t have anything to do with me. Should I tell them now or wait?” It’s so sad but at least they can go online to our web site and talk to other women in a forum, and get support and learn, because they can’t talk about their diabetes where they are.

Q: Diabetes Sisters is a nonprofit organization. Are you looking for more sponsors?

BB: Of course, always. We need sponsors for our ‘Weekend for Women’ Conference and our PODS Meetup programs. Anyone who’s interested can contact me on our web page or send me an email at director@diabetessisters.org or call our office, 919-361-2012.

Q: What’s next for Diabetes Sisters?

BB: We’re expanding our PODS Meetups to as many states and countries as possible. We’ll continue to hold our annual ‘Weekend for Women’ conference and we’ve just launched our Sister Matchprogram.

Sister Match is an online social game that helps women find other women they have the most in common with. It could be they match via their location, sharing a hobby or a similar challenge. Through playing the game, women share their stories, opinions, meet various challenges, gain mentorship, knowledge and friendship, and end up weaving an online tapestry together.

Q: Before you were diagnosed did you have a life plan?

BB: I was going to be the next Barbara Walters or the next Oprah Winfrey, and I was dead serious about that. I really enjoy meeting different people and hearing people’s stories and bringing out people’s strengths. So maybe I’m shooting for the Oprah of diabetes.

No comments yet

Page 5 of 11« First...34567...10...Last »