Voice of the Diabetic

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VOICE OF THE DIABETIC

The Diabetes Action Network of the National Federation of the Blind

A Support and Information Network

Volume 17, Number 2, Spring Edition 2002

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VOICE OF THE DIABETIC, published quarterly, is the national news magazine of

the Diabetes Action Network of the National Federation of the Blind. It is read

by those interested in all aspects of blindness and diabetes. We show diabetics

that they have options regardless of the ramifications they may have had. We

have a positive philosophy and know that positive attitudes are contagious.

News items, change of address notices, and other magazine correspondence should

be sent to: Ed Bryant, Editor, Voice of the Diabetic, 1412 I-70 Drive SW, Suite

C, Columbia, Missouri 65203; Phone: (573) 875-8911; Fax: (573) 875-8902.

Find us on the World Wide Web at: http://www.nfb.org and follow the links for

"diabetes."

Copyright 2002 Diabetes Action Network, National Federation of the Blind. ISSN

1041-8490

Note: The information and advice contained in VOICE OF THE DIABETIC are for

educational purposes, and are not intended to take the place of personal instruction

provided by your physician, or by your health care team. Discuss any changes

in your treatment with the appropriate health professionals.

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ADVERTISERS

Effective advertising doesn't scream at its audience. It persuades. It sells.

The key to cost-effective advertising is making your voice heard where an audience

is already listening. VOICE OF THE DIABETIC, circulation 305,515+, offers such

an outlet. Make your voice heard. For VOICE OF THE DIABETIC advertising information

contact:

Eileen Rivera Ley

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804 Hatherleigh Rd

Baltimore, MD 21212

Phone: (410) 296-7760 Fax: (410) 296-7645

or find us on the Web at:

http://www.nfb.org/voice.htm

For SUBSCRIPTION information, see the end of this document.

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FREE! FREE!

VOICE OF THE DIABETIC is offered absolutely free to any interested person upon

request. Readers may receive the publication in standard print, on audio cassette

for the blind, or in both formats. To begin receiving the Voice, please complete

the subscription form (or a facsimile), found at the end, and mail it to the

editorial office.

Please Note: We have a special bulk-mailing permit that we use to ship the

VOICE to you at low cost--it does not allow for free re-mailing. The Post Office

requires you place first class postage on any VOICE you mail to others.

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INSIDE THIS ISSUE

MY JOURNEY WITH DIABETES

by Lois Williams

YOUR DIABETES CARE SHOULD FIT YOU

by Ann S. Williams, MSN, RN, CDE

2002 NATIONAL CONVENTION

FLYING WITH DIABETES SUPPLIES?

NEW FDA BLOOD-TEST GUIDELINES

THE IMPORTANCE OF TREATING DIABETIC FEET

by Kenneth B. Rehm, DPM

NFB NEWSLINE NOW NATIONWIDE

by Peggy Chong

LETTERS TO THE EDITOR

MY KIDNEY TRANSPLANT

by Karen Mayry

NEW KIDNEY GUIDELINES

THINKING AND LIVING PRO-ACTIVELY WITH DIABETES

by William F. Schley

LOW INCOME DRUG BENEFIT

EDUCATE YOURSELF

by Peter J. Nebergall, PhD

ASK THE DOCTOR

by Roger Barth, MD

MEDICARE NOW COVERS GLAUCOMA-DETECTION EYE EXAM

TOMMY FORD: A PATIENT TO REMEMBER AND AN EXAMPLE FOR ALL

by Steven Boyd, PharmD

ASK JANIS

by Janis Roszler

DIALYSIS AT NATIONAL CONVENTION

by Ed Bryant

BOOK REVIEWS

by Marilyn Helton

RECIPE CORNER

WHAT YOU ALWAYS WANTED TO KNOW BUT DIDN'T KNOW WHERE TO ASK

(Resource Column)

NFB CAPITAL CAMPAIGN SEEKS DONATIONS

NEW HIGH-TECH METER

FOOD FOR THOUGHT

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MY JOURNEY WITH DIABETES

by Lois Willams

Photo included; Caption: Lois Williams

From the Editor: Lois Williams is a Board Member of the Diabetes Action Network

of the National Federation of the Blind. She also leads the way on Diabetes

Action Network activities for the NFB of Alabama.

Lois is inspiring and optimistic, as she strives to educate people about diabetes

and its ramifications. She knows the importance of having access to good diabetes

information, and keeping blood glucose levels under control.

Lois Williams knows that diabetics are not alone, and do have options. Here's

what she says:

Today, as I celebrate another birthday, I am deeply thankful to my heavenly

Father for my life.

I have insulin-dependent diabetes and many of the complications that can follow

it. I suffer from neuropathy (nerve damage); retinopathy (eye damage); early

nephropathy (kidney damage); osteoporosis (bone loss); periodontal disease;

dry itchy skin; anemia and more. In spite of all these health problems, I am

blessed.

A few years ago, I had not heard of any of these "opathies," even

though I've had diabetes for over 30 years. For most of that time I thought

I had good doctors, and I saw them on a regular schedule.

When I was first diagnosed with diabetes, in the late 1960s, the doctors prescribed

insulin for me. Daily injections, and regular visits to a lab for blood tests

became a part of my lifestyle. But there was no "diabetes education"--never

was I informed that uncontrolled diabetes could cause severe complications,

even death. I was only told that it was an "incurable disease."

After adjusting to insulin injections, I didn't feel any different. I didn't

see any signs that my poor diabetes control could hurt me. I didn't know. No

one told me.

At that time, my five children were in elementary and junior high schools.

I was working for the Federal Government in St. Louis, Missouri, and I needed

to advance as quickly as possible. Feeding, clothing, and educating children

is expensive. I was sure "I needed more energy to work harder and faster,"

so when everyone else took coffee breaks, I took "energy boosting breaks"

of doughnuts, chocolate candy bars and hot cocoa. I kept a container in my desk

drawer filled with these "energy boosters."

As a result of eating these things, my insulin dosage slowly increased. It never

occurred to me that these sweets were more dangerous to my health than the coffee

would have been! This was my lifestyle for years.

Eventually I was hospitalized on a frequent basis, and off work for a few weeks

each time. I knew this was a result of the diabetes, but I had no more knowledge

of the disease at this time than I had at the beginning.

The pressures of a bad marriage, my drive to succeed in my job, my church responsibilities,

the children's needs, and taking a second and third job, led to yet another

hospitalization. This time my doctors suggested that I retire on disability.

The idea was absurd to me. I had too many things to accomplish! The doctors

finally convinced me, but I didn't think the request would be approved.

The approval letter came in May of 1978. The check, for a lump sum, came two

weeks later. My oldest daughter, Debbie, was graduating from Oakwood College

the following month. The money was right on time, since I had not worked in

five months. It was a blessing. We were all able to attend her graduation.

Three years later, my marriage ended in divorce. During the next two years,

my children Ann, Marylyn and Karyle moved away from home to attend college and/or

otherwise begin living on their own. My youngest daughter, Lovely, was the only

one still at home. We decided that I needed a change of scenery. It was decided

that Huntsville, Alabama, would be the best place for my mother, daughter and

I to relocate. We packed up all we could load on a U-Haul truck. Ann's husband

George, came up from Huntsville to drive the truck back.

The change was good for me. No more hospital stays. My diabetes was in better

control. My new part-time job working with senior citizens was a wonderful experience.

In February 1987, I met the son of a couple who were members of the same church

my mother and I now attended. We formed a close friendship. The Williamses'

felt that Morgan, their son, and I were right for each other. They began matchmaking

-- and it worked! In December of 1987, we were married, and I moved to start

a new life again. This time in Philadelphia, Pennsylvania.

This new life brought on new challenges. Morgan worked day and night. I was

lonely in a big city. I loved to cook and eat. Eating the wrong things became

normal. I made regular visits to the doctor, and I continued to experience slow

increases in my insulin dosage. But still, I never received information about

controlling my blood sugar levels. No one told me what I had to do, and I gave

diabetes little thought because I didn't feel sick.

In June 1990, my mother had a heart attack. A few weeks later, I moved back

to Huntsville to be with her. For a year and three months, Morgan remained in

Philadelphia and I returned to Philadelphia only for check-ups and to have my

prescriptions refilled.

I made some drastic lifestyle changes in October 1992, after attending a health

seminar by my brother-in-law, Dr. DeWitt Williams. I immediately gave up all

meats, dairy products, and eventually, all sugars. I had increased my water

intake and began a moderate exercise program. By April 1993, I had lost 50 lbs.--and

I felt great. (Editor's Note: A type 2 diabetic who loses significant excess

weight, by whatever means, can experience significant lessening of diabetes

symptoms.) I discovered I didn't need the insulin any more. I continued following

this lifestyle for several years. (Editor's Note: Talk to your doctor about

safe weight-loss programs-not all are diabetically appropriate.)

In 1995, my daughter-in-law was diagnosed with leukemia. I often kept my grandson,

Karyle Jr., for months at a time, when Antoinette was too ill to care for him.

She went into remission, and I started a new job, in January 1997. By April

1997, she was out of remission--and not expected to live more than a few weeks.

I took emergency leave to be with my son and his family.

During my four-month stay in St. Louis, I returned to my old ways of poor nutrition,

no exercise and little water. Since I had stopped taking insulin, my blood sugar

level increased. I wasn't checking it.

In August of 1997, I returned home, and went back to work. I was feeling tired,

but did little about it. I didn't improve my harmful dietary habits.

That September, Antoinette died. The stress and pain of her death was very

hard. I continued in my old habits until December, when, after weeks of extreme

fatigue and some nervousness, I decided to check my glucose level. The reading

shocked me! It was 487 MG/dL. I immediately made an appointment with a new doctor.

She prescribed oral diabetes medications; but a couple of visits later there

was very little change in the glucose reading. She decided to put me back on

insulin. My next visit to her, two weeks later, showed that my glucose level

was now down in the normal range.

By this time, there was numbness and tingling in my feet, and pain of every

kind in my legs. When I saw the doctor, she said I had neuropathy in my feet

and hands. There are medications available for this nerve pain. I didn't want

them. I tried alternative therapies, but the real lesson I learned was that

positive lifestyle changes can bring wonderful improvements in health--but you

have to keep up--no going back to old ways when you return home. I wish I had

been told this years before--then much could have been avoided.

In May of 1998, because of my diabetic retinopathy, I had operations on my

eyes. In October of 1999, the bleeding in my eyes caused me to lose all my vision.

In January of this year, I began to get back some vision in both eyes. I am

blessed.

I am spilling protein in my urine, a sign of kidney failure. This too can change.

My God can do anything. If He chooses not to change it, I am still blessed.

(Editor's Note: Lois is right; diabetics should have their kidneys tested for

protein spillage. If it is found, a class of drugs called ACE inhibitors can

be of much benefit.)

Because of my blessings, I started a monthly support group in August of 1998,

"The Caring Link Diabetics Support Group." Health professionals have

taken an interest in our group and have offered to be guest speakers. We will

soon be on the American Diabetes Association's website. I have spoken in local

churches to make parishioners and the community aware of the seriousness of

diabetes. As the Lord provides the opportunities and the strength, I do speaking

engagements to enlighten others about this insidious disease.

Hosea 4:6 says, "My people are destroyed for lack of knowledge ..."

It is my desire to share knowledge and my own personal experiences with all

who desire to improve their health where diabetes is involved. Yes, I am blessed.

Today is my birthday and I have much to celebrate: another year of a blessed

life. I thank my God today for His many blessings!

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VOICE DISTRIBUTORS NEEDED

Since the VOICE is now offered free, our Diabetes Action Network will provide

extra copies to anyone wanting to help spread the word. We will gladly send

from five to five hundred-plus copies each quarter to be used as free literature.

Medical facilities can order as needed for patients. Individuals can usually

place copies of the VOICE in libraries, pharmacies, hospitals, doctors' offices,

or other public locations.

Diabetes education is essential. Anyone who distributes the Voice will be helping

people with diabetes, and their families, to learn about the disease and its

ramifications; to learn that they have options; and that their world is far

greater than whatever "limits" may be imposed by the disease. If you

would like to help spread the word by distributing the publication, please contact:

Voice of the Diabetic, 1412 I-70 Drive SW, Suite C, Columbia, MO 65203; telephone:

(573) 875-8911, fax: (573) 875-8902. NOTE: Please provide a phone number so

we can reach you.

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YOUR DIABETES CARE SHOULD FIT YOU

by Ann S. Williams, MSN, RN, CDE

This is a new column, which will appear regularly in the VOICE OF THE DIABETIC.

I have chosen "Your Diabetes Care Should Fit You" as its title because

this is my general philosophy as a Diabetes Educator. I try to help each individual

person find how to make their own diabetes care fit well with their own needs

and the life they lead.

I picture diabetes care as something like clothing. We all know what it feels

like to have clothes that fit well. They're comfortable for the things that

we have to do in them. When we think of diabetes care now, in 2002, with all

the advances we've had, with the multitude of new medications, and new tools

available to help us manage our diabetes--we now have so many choices, so much

flexibility! I believe we should use this flexibility to make our diabetes care

fit each of us, just as we all like to have clothing that fits us.

This was not always possible. Before we had so many choices for diabetes management,

there was much less flexibility. Back then, if you wanted good diabetes control,

you did what you needed for your diabetes, and your whole life had to fit into

that. That's sort of like buying clothes that don't fit you -- and then trying

to squeeze your body into them. Now we can fit your diabetes care to you --

if you're getting up-to-date diabetes care.

Let's look at an example. Consider two women, Cindy and Marilyn, who both have

type 2 diabetes. Both of them need insulin to control their diabetes well, but

the similarities end there.

Cindy leads a very predictable life. She works as a medical secretary, and

her schedule is almost the same every day. She wakes up at the same time daily,

eats very similar meals, at the same time every day, and exercises every day

by walking ½ hour after she gets off work. She likes her job, and although

there are some stresses associated with it, on the whole she is content with

her life. She is willing to put some effort into managing her diabetes, but

would prefer to keep her number of injections to a minimum.

Marilyn, on the other hand, is a high school teacher. Her schedule is anything

but predictable. If she has a lot of papers to grade, she might stay up late

and get up early. She is able to eat breakfast at the same time most days; but

her lunch schedule is different on Tuesday and Thursday from Monday, Wednesday

and Friday. She loves teaching, but her classes are very large, and her work

is stressful. Her appetite varies a great deal, depending on her stress and

activity levels. On some days she exercises after work, but on other days she

is too exhausted after work to do anything but go home and read. She would like

to have good diabetes control, and is willing to work at it, but she finds it

very difficult to change her erratic eating habits.

Twenty years ago, most doctors would have prescribed the same insulin regimen

for both Cindy and Marilyn -- a mixture of R and NPH inulin, injected twice

a day, ½ hour before breakfast and ½ hour before supper. Ths regimen

is designed to have the peak action of the R cover the insulin need for breakfast

and supper. The longer action of the NPH covers the background need for a basal

insulin, and NPH's peak mid-day covers the insulin need for lunch. Once the

insulin is injected, it has a predictable action time, and for a person with

a consistent schedule, the action times can be matched to the schedule, with

good diabetes control as a result.

That regimen would have suited Cindy well. Her predictable eating and exercise

habits would have allowed her to attain good diabetes control with the action

times of the insulin. But for Marilyn it would have been a disaster. Her irregular

lunch schedule, and her irregular eating habits and exercise would have combined

to produce high blood sugar some days, and low blood sugar others. And having

low blood sugar in front of a class of rowdy high school students wold be a

high-stress event for anyone!

We now have some choices for an insulin regimen that will fit Marilyn's irregular

and unpredictable life. One of the new insulins, Lantus, provides a flat action

for 24 hours, so she can use it to meet her need for a background, basal insulin

without having to worry about getting hypoglycemia when she eats. She is willing

to inject herself more frequently, if it helps her get good diabetes control,

so she could use one of the new rapid-acting insulins -- Humalog or Novolog

-- to cover her meals. To use such an insulin effectively, she would have to

check her blood sugar before each meal, and then calculate how much insulin

to give herself, based on how much she planned to eat and whether she needs

to bring her blood sugar down. Since she is much more willing and able to do

this extra blood glucose testing, calculations, and injections than she is to

change her irregular schedule and eating habits, this regimen suits her well.

This is just one small example. In coming columns, I will cover more about

the many choices available in modern diabetes care, in the areas of meal planning,

oral medications, insulin delivery, and exercise. I invite your questions, to

help make this column meet YOUR diabetes needs!

About myself:

I am a Registered Nurse and a Certified Diabetes Educator (CDE). I have worked

with blind people who have diabetes, for about 15 years, and I have diabetes

myself. I was already a Diabetes Educator when I diagnosed my own type 2 diabetes.

That I developed diabetes came as no surprise to me, since I come from a large

family that has lots of people with it, and I had gestational diabetes with

my third child.

When I developed diabetes, the only oral medications we had were the sulfonylureas,

and that kind of medication gave me intolerable side effects; so I've been using

insulin since very soon after diagnosis, for almost 10 years. I have used an

insulin pump for about two years, and the pump suits me well.

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2002 NATIONAL CONVENTION

It will soon be time for the 2002 convention of the National Federation of

the Blind, to be held at the Galt House Hotel, 140 N. Fourth Street, Louisville,

Kentucky 40202. The Galt House, site of our 1985 NFB convention, is a beautiful

hotel, in a convenient, central location.

To receive our special NFB National Convention rates, phone the Galt House at:

(502) 589-5200. Be sure you tell them you will be attending the annual convention

of the National Federation of the Blind. The hotel is actually two adjacent

establishments: "Galt House East," and "Galt House Hotel,"

but both will be ideal for conventioneers. To confirm a telephone reservation,

you will need a credit card number, and the reservation charge is $60, applied

toward your stay.

Here are our hotel rates for 2001: one, or two in a room, $57 per night; three

or four in a room, $63. Local taxes (12.36%) will apply.

Here are the convention dates and schedule:

Wednesday, July 3 -- Setup, Seminars

Thursday, July 4 -- Convention registration, Sessions

Friday, July 5 -- National Board Meeting (open to all)

Saturday, July 6 -- General Sessions

Sunday, July 7 -- Tour Day

Monday, July 8 -- Banquet

Tuesday, July 9 -- General and Business Sessions, adjournment.

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FLYING WITH DIABETES SUPPLIES?

The Federal Aviation Administration (FAA) has implemented stepped-up security

measures at the nation's airports in response to the September 11 attacks. Some

measures may affect airline passengers with diabetes. Here is an update:

1. Passengers may board with syringes or insulin delivery systems once it is

determined that the he or she has a documented medical need. Your insulin must

have a professional, pharmaceutical preprinted label that clearly identifies

the medication. No exceptions will be made. Since the prescription label is

on the outside of the box containing the vial of insulin, the FAA recommends

that passengers refrain from discarding their insulin box and come prepared

with their insulin in its original pharmaceutically labeled box.

2. For passengers who have diabetes and must test their blood glucose levels

but who do not require insulin, boarding with their lancets is acceptable as

long as the lancets are capped, and as long as the lancets are brought on with

the glucose meter that has the manufacturer's name embossed on the meter (i.e.,

One Touch meters say "One Touch," Accu-Chek meters say "Accu-Chek").

3. Glucagon is dispensed and normally kept in a preprinted labeled plastic

container or box. We advise those people with diabetes who are traveling to

keep their glucagon kit intact in its original preprinted pharmaceutically labeled

container.

4. Contrary to previous Official Information, because of forgery concerns, prescriptions

and letters of medical necessity will not be accepted.

5. FAA security measures apply to travel within the 50 United States only.

Passengers should consult their individual air carrier for both domestic (U.S.)

and international travel regulations. Be advised that the FAA's policy and the

policy of each airline is subject to change.

The above list of measures is a minimum requirement only and air carriers may

have other requirements that may impact a passenger's ability to board with

diabetes equipment and supplies. Accordingly, each passenger should call the

airline carrier at least one day in advance of his or her scheduled flight to

confirm what that airline's policy is with regard to diabetes medication and

supplies. Be advised that each airline's policy is subject to change.

Should a passenger be denied boarding a flight or be faced with any other unforeseen

diabetes related difficulty because of security measures, he or she should ask

to speak with a Complaints Resolution Official (CRO) for the airline. If a passenger

feels he or she has been discriminated against or treated unfairly by air carriers,

a complaint may be filed with the airline carrier, by contacting the Aviation

Consumer Protection Bureau (ACPD) at [email protected] or by mailing to

ACPD, U.S. Department of Transportation, Room 4107, C-75, Washington, DC 20590.

Adapted from information provided by Joslin Diabetes Center. For more diabetes

information, see Joslin's excellent diabetes information website: www.joslin.org

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NEW FDA BLOOD-TEST GUIDELINES

A number of new glucose monitors have offered the opportunity to test blood

drawn from sites other than the fingers. These meters work, but the Food and

Drug Administration has been concerned about the "comparability" of

blood glucose tests drawn from the fingers and from alternate sites such as

the forearm, the upper leg, or elsewhere on the body. Research has been completed,

and new guidelines issued.

* Under certain conditions, blood glucose test results obtained using samples

taken from the arm may differ significantly from fingertip samples.

* The conditions in which these differences are most likely to occur are when

your blood glucose is changing rapidly, such as following a meal, an insulin

dose, or associated with physical exercise.

* When blood glucose is changing rapidly, fingertip samples show these changes

more quickly than arm samples.

* When your blood glucose is falling, testing with a fingertip sample may identify

a hypoglycemic (low blood sugar ) level sooner than a test with an arm sample.

* Use arm samples only for testing prior to or more than two hours after: meals,

insulin dosing, or physical exercise.

* Testing performed within two hours after a meal, an insulin dose, or physical

exercise, or whenever you feel your glucose levels may be changing rapidly,

should be done from the fingertip.

* You should also use fingertip testing whenever you have a concern about hypoglycemia

(insulin reactions), such as when driving a car, particularly if you suffer

from hypoglycemia unawareness (lack of symptoms that indicate an insulin reaction),

as arm testing may fail to detect hypoglycemia.

What You Should Do:

* Routine testing before meals can be done either at fingertip or the arm.

* Consult your healthcare professional before you begin using the arm for testing.

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THE IMPORTANCE OF TREATING DIABETIC FEET

by Kenneth B. Rehm, DPM

From the Editor: The U.S. Centers for Disease Control tells us diabetes is

the biggest producer of non-traumatic amputations in the United States. Most

of these will be amputations of severely infected, non-healing, gangrenous feet

and lower legs (86,000 in 1996, says CDC). Once things are that bad, there are

few other options-so the best course, for diabetics and their health care providers,

is prevention.

Dr. Rehm is a specialist in problems of the diabetic foot. Lately, he has taken

his knowledge of foot care, and used it to create several foot-care products.

But the core of any prevention program is patient education - so let's see what

Dr. Rehm has to tell us.

I've been in practice for over 20 years. I graduated from medical school in

1976. I devote my practice to diabetic foot medicine. In 1992, I took a diabetic

foot care fellowship at the Hansen's Disease ("leprosy") center in

Carville, Louisiana, and we established a diabetic clinic there under the direction

of Dr. Patout. People who have leprosy have neuropathy, much like diabetics

do. We also developed diabetic foot care programs throughout the Mississippi

Delta, to help people who didn't have access to regular medical care.

There's a very high diabetic population down in the deep South. We also did

a lot of work helping to develop the LEAP, the Lower Extremity Amputation Prevention

program, that helps people save their feet.

Since I've come back to the San Diego area, we've developed our own version

of the LEAP program here. When people come to see us, we have a several-point

program of education, foot inspection and examination. We focus on the structure

of the foot, the walking, the balance, the skin and the education and inspection.

Many of our patients show diabetic peripheral neuropathy. The patient's foot

can be extremely painful, or numb, or both at the same time. Neuropathy shows

up in many different ways, as dry skin, toenail problems, loss of sensation;

it can show up as what we call hyperaesthesia, too much pain. Sometimes you

lose proprioception, the ability to tell where your foot is in space. What's

important about diabetic neuropathy is that if a non-diabetic has a numb foot,

he or she knows it has gone numb, but in a diabetic who has severe peripheral

neuropathy, the nerve pathway that tells you the foot is numb can itself be

numb, so a lot of people don't realize the foot surface is numb.

How does diabetes involve the feet? It involves the feet by basically causing

nerve problems, circulation problems, muscle and joint problems and infection

problems -- and these cause other things: Numbness, burning, dry skin, muscle

weakness, calluses, cold feet... These in turn can cause orthopedic problems,

such as: Deformities, walking problems, hammer toes, high pressure areas in

the bottom of the foot where you get the big calluses under the metatarsal areas,

thus ulcerations and other skin problems. And dry skin is a common manifestation

of diabetes.

When a person has diabetes, the textbook says over 70% of foot complications

can be prevented, but I say virtually 100% of them can, if they're caught early

enough. This is the key thing! Almost all diabetic foot problems can be prevented,

if caught in time. And when you say "caught early enough," that means

treating the problem when it happens, managing conditions like neuropathy, rehabilitating

people once they've had an injury or fracture.

PREVENTION IS THE BEST TREATMENT. The three things about prevention are very

important: Mental conditioning, overall physical conditioning, and to keep your

feet healthy. This last item includes several items, such as: Keep your feet

clean. Keep your feet warm. Keep your feet protected with the right shoes and

socks. Keep your feet SAFE -- in other words, don't mow your lawn barefoot.

Keep your feet free of excess moisture. Keep your feet conditioned and free

from excess dryness. Keep your feet and toenails trimmed and healthy.

There are three more that I'd like to mention. Keep your feet working with exercise.

In other words, excess glucose, from your diabetes, can build up in the joints

and stiffen them. Keep your feet balanced when walking. A lot of people need

arch supports, orthotics, in their shoes, so their feet don't wiggle all around,

so they're not pronating, not putting sheering pressure in the bottom of their

feet, which could cause hot spots, abrasions, and the possibility of ulcers.

The last thing in the program is "keep your feet in check." That means

you check them and you ask your doctor to check them. Diabetics should always

have good shoes, and socks that fit properly, as well as foot cream, toenail

oil, and foot shampoo.

My final word of wisdom is to be proactive. If you take care of your feet,

you don't have to lose your feet or legs. Trouble doesn't have to happen.

EDITOR'S NOTE: Dr. Rehm's clinic, The Diabetic Foot and Wound Treatment Center,

offers the following products he helped design. I've sampled them; and found

them of good quality. Contact: Dr. Kenneth B. Rehm, The Diabetic Foot and Wound

Treatment Center, 1529 Grand Avenue, Suite C, San Marcos, CA 92069; (760)744-6226

(office phone) or (760)744-6277 (fax)

* DiabetiCream, $30.00 (plus S&H), for a 4-oz. tube. Apply to clean, dry

feet to help alleviate dryness and cracking. Use with massage to help increase

circulation.

* Dr. Rehm's Special Foot Soap, $12.00/bar (plus S&H). Hand-made in small

batches by the Maeda Family in Calexico, CA 92231

* ToesEase, ( foot and toenail cleaner) $20.00 (plus S&H) for an 8-oz.

supply

* The Diabetic Sock, $10/pair (plus S&H), distributed by: Stillwater Knitting

Co., P.O. Box 287 Mount Airy, N.C. 27030. Non-binding top, extra width in calf,

non-constricting, hand- knit seamless toe, antimicrobial treatment. 94% cotton,

5% nylon, 1% spandex, Made in USA.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

NFB NEWSLINE NOW NATIONWIDE

by Peggy Chong

Photo included; Caption: Peggy Chong

Developed by the National Federation of the Blind, NEWSLINE is a free service

used by blind subscribers to read newspapers through any touch-tone telephone.

Thanks to a one-year grant through the Institution of Museums and Libraries,

subscribers in all 50 states, the District of Columbia, and Puerto Rico, will

soon be able to access every newspaper that NEWSLINE currently supports. Although

NEWSLINE has covered large population areas in over 30 states for the past few

years, over half of our country has not been able to access it without calling

long distance. As soon as this service is online, any blind person registered

for NEWSLINE can dial a new toll-free number, 1-888-882-1629, to access all

the newspapers carried on the service.

Readers already using NEWSLINE will find the new expanded service easy to use.

Pick up any touch-tone phone, dial the NEWSLINE number, listen to the menu,

and choose options by tapping numbers on the phone keypad. Instead of the usual

three national papers available each morning, subscribers can read over 50 newspapers,

from across the country. Consider how interesting it will be to read the newspaper

from a city in which a big story is breaking. In addition, NEWSLINE's non-newspaper

features, which are currently available in each area, will now be available

with all of the newspapers.

NEWSLINE is available, free of charge, to anyone at least legally blind. To

register for this new nationwide service, or to check for updated information,

contact the National Federation of the Blind, at the National Center for the

Blind in Baltimore, see the NFB's monthly magazine, the Braille Monitor, call

the local news option on your local NEWSLINE, or contact a local leader of the

NFB in your community, or visit the NFB website: www.nfb.org

The NEWSLINE application is a one-page form. Get a copy of the form, fill it

out completely, and return it to: NEWSLINE, National Center for the Blind, 1800

Johnson Street, Baltimore, Maryland 21230. Because NEWSLINE service requires

a signature, prospective subscribers must acquire or copy a print NEWSLINE application

form. A copy may be downloaded from www.nfb.org Forms are often available from

public libraries, or may be requested from local leaders of the NFB or from

the National Center for the Blind in Baltimore .

NEWSLINE hereby requests all subscribers -- help us to spread the word about

this wonderful opportunity. Please help us spread the word to special education

departments, teachers, or schools serving blind students, and anywhere else

Americans can be found who cannot read the newspapers because of their eyesight.

National headlines or local stories, sports, Ann Landers, or letters to the

editor and social commentary--there is much that our sighted neighbors and coworkers

are enjoying, thinking about, and talking about. Now we can, too.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

LETTERS TO THE EDITOR

Artwork: Quill writing pen in ink well

March 15, 2001

Greetings from Kenya, and congratulations for a most enlightening and informative

magazine.

Here at PCEA Kikuyu Hospital, we have a growing diabetes clinic. It was started

in 1993 by a dedicated certified diabetes educator, Ms. Jean V. Suren who comes

from your country. The clinic aims at providing up-to-date management and information

to our clients who number just over 3000. They are from all over Kenya, East

Africa and even some from Central Africa.

I happened to have come across a copy of your magazine at Jean's clinic. I

and my colleagues have found it to be valuable to us and our clients in our

clinic. It has up- to-date information on all aspects of diabetes, information

that is rather difficult to come by, here in Kenya.

I therefore kindly request you to consider our subscription for your magazine.

Sincerely yours,

James W. Njenga

Kikuyu, Kenya

* * * * * * * * * * * * * * *

May 28, 2001

I live in a retirement home where there are several residents who are blind,

and many who are diabetic. I first saw your publication when I attended a Diabetes

Support Group.

I felt it would be of interest and helpful to these residents, so wrote and

asked to have two print copies and two tape copies sent to me each quarter so

I could circulate them through our library. I will be happy to contribute, when

possible.

Thank you very much for the valuable information I find in your publication.

Sincerely,

Dorothy Rice

Portland, OR

* * * * * * * * * * * * * * *

June 7, 2001

I have been diabetic now for 14 years. I was told on July 2, 1999 that I have

diabetic retinopathy.

I've had three laser's per eye and a membrane peel per eye since December 8,

2000. I write today to see if I can be contacted, or contact someone who has

diabetic retinopathy.

I'm in my early 40s and just need to talk to someone, either in writing or by

phone. It will help both of us. Thank you so much for the VOICE OF THE DIABETIC

on tape. It has helped me understand a lot of thing.

Sincerely,

Vicky L. McCormick

2520 W. Carroll Ave.

Oak Creek, WI

(414) 304-0813

* * * * * * * * * * * * * * * *

October 10, 2001

We have a patient who has been bringing these in and our other patients love

this, so thank you. We appreciate the paper; please send us 25 copies per quarter.

Southwest Podiatry Center, PC

Albuquerque, NM

* * * * * * * * * * * * * * *

November 24, 2001

I have been receiving VOICE OF THE DIABETIC for about a year. It is very helpful

to me, and I always learn new things from it.

I have had a very rare medical condition. I had insulinoma, an insulin producing

tumor in the pancreas. My blood sugar was always too low. Last December, I went

to Boston to have surgery to remove the tumor. However, there were so many tumors

in the pancreas that the doctor took out the entire pancreas. The gall bladder

and spleen and part of the stomach had to be removed as well. It was very rough

going for a while, but now I feel healthy. My blood sugars are hard to control.

I get a lot of highs and frequent lows. I use the AccuChek Voicemate to check

my blood sugar, and I administer my own shots, four times a day. Since I lost

the pancreas, I have to take enzyme pills when I eat.

The first anniversary of my surgery, December 7, is fast approaching. I'm so

grateful for my health and for what the doctors were able to do for me, I feel

like I want to celebrate it. One of the ways I want to do that is by sending

a donation so that many other people like me can continue receiving VOICE OF

THE DIABETIC. I hope others find it as helpful and interesting as I do. There's

nothing I wish more than to see a cure fo diabetes.

Thank you for the good work you are doing, keep it up.

Sincerely,

Barbara Kirwan

Albany, NY

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

MY KIDNEY TRANSPLANT

by Karen Mayry

Photo included; Caption: Karen Mayry

From The Editor: Karen Mayry is a long-term diabetic who knows the importance

of good diabetes control. Karen was the original president of our Diabetes Action

Network at its inception in 1985. She also serves as president of the National

Federation of the Blind of South Dakota..

Karen discusses her kidney transplant, an important issue for anyone with diabetes.

People experiencing renal failure should realize at some point they may have

to choose between dialysis and transplantation. Kidney transplant recipients

enjoy a high rate of success (organ survival) and their quality of life is vastly

better than on dialysis.

Here's what Karen says:

In 1968, Marshall and I had been married for three years. During a routine visit

to my doctor, Marshall was told that my kidneys were failing and that my life

expectancy would be shortened dramatically. According to medical knowledge at

the time, he was correct in relating that persons with diabetes were not able

to have kidney transplants. Luckily, I did not require a transplant until 1977,

when my brother, David, donated a kidney to me. Dr. John Najarian, MD, Chief

or Surgery at the University of Minnesota Hospital, performed the surgery.

Twenty-five years later I am healthy, busy and fully involved in life's activities.

I have had the opportunity to be married to my biggest supporter and wonderful

man, join the thousands of volunteers in the National Federation of the Blind,

travel, and benefit from the love of my family and friends.

Would I do it again? In a heartbeat!

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

NEW KIDNEY GUIDELINES

Adapted from material provided by the National Kidney Foundation (NKF). For

further information, see the NKF website: www.kidney.org

Chronic Kidney Disease (CKD) is a much bigger problem than previously believed.

It is now known to affect 20 million Americans (NKF statistics), one in nine

U.S. adults. Many of these people have no idea they are affected, so they are

doing nothing to avoid further kidney damage. The NKF estimates another 20 million

Americans may be at increased risk for developing CKD. The three most at-risk

groups, according to the NKF, are diabetics, individuals with high blood pressure,

and those with a family history of kidney disease.

Note that kidney disease is a common complication of diabetes, and the U.S.

Centers for Disease Control describes diabetes as the single greatest source

of End Stage Renal Disease (ESRD, "kidney failure").

Individuals who have high blood pressure, diabetes, or a family history that

would suggest risk of kidney problems, should ask their physicians for three

tests that can be administered during a routine office visit: A blood test for

creatinine (a waste product filtered by the kidneys); a urine test for protein

(microalbumin -- a marker of early kidney damage); and a blood pressure measurement

(high blood pressure is both cause and complication of kidney disease.) These

tests should give your doctor a good picture of the state of your kidneys.

The sooner kidney disease is identified, the better chance it can be controlled,

by lifestyle changes and medication. The necessary tests are neither intimidating

nor invasive, and VOICE OF THE DIABETIC urges all those at risk, or who think

they might be, to be tested, be sure, and take the necessary action.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

THINKING AND LIVING PRO-ACTIVELY WITH DIABETES

by William F. Schley

Photo included; Caption: William F. Schley

Living with diabetes is no longer the struggle it once was. Living well with

diabetes, even with diabetic complications, is now possible through advances

in medicine and technology, but your mental and emotional condition will also

affect your diabetic health. It is possible to live a fulfilling life, to define

and accomplish important life goals, and to have a happy and healthy family

life as a long-term type 1 diabetic; but you need to know what to do, how to

do it, and above all, you must be willing to do whatever it takes to attain

maximum results. I'm still reaching for some of life's brass rings as my diabetic

history nears its 45th anniversary, but I've attained a number of my objectives,

and you can, too.

1. If you've got a glucose monitor, USE IT. If you don't have one, GET ONE.

Many doctors will give you a high-quality monitor, and some pharmacies even

have 100% rebate coupons available for the asking when you purchase one. Check

out the special offers! Test regularly, keep track of your tests, and adjust

your insulin according to your diabetic specialist's orders. This step is imperative

for good control and to help avoid long-term neuropathic damage.

2. See your doctor regularly. Make sure your MD orders the appropriate blood

tests, including a glycoslyated hemoglobin test every three to four months.

If you can't have your doctor test your blood pressure regularly, buy a good

quality blood pressure cuff, called a sphygmomanometer, and do it yourself.

High blood pressure is common in both types of diabetes and a root cause of

many circulatory and neuropathic problems. If you are already on blood pressure

medicines, don't forget to take them as prescribed. Take a good diabetes "patient

education" course, often available at your local hospital and usually covered

by medical insurance.

3. Monitor all your physical changes carefully. If you have a wound that doesn't

heal, don't delay - call your doctor. If you gain or lose weight suddenly, you

may need to make changes in diet, lifestyle, or medications. If your vision

changes, especially if you see floating or moving particles within the eye,

or you have persistent eye pain, see an ophthalmologist immediately.

4. Quit smoking! Along with all the other reasons not to smoke cigarettes,

you should be aware they cause rapid and often irreparable damage to capillaries

in the eyes and extremities. If you smoke cigars or a pipe, do so ONLY IN STRICT

MODERATION, and only in a well-ventilated area, to avoid inhaling second-hand

smoke.

Moderation goes for alcohol consumption as well. Small amounts can be factored

into your diet, but remember that it is especially difficult for insulin dependent

diabetics to digest alcohol without experiencing a rapid rise in blood sugar,

generally followed by a rapid lowering of blood sugar. Ask your doctor for the

latest information on moderate alcohol consumption in a diabetic diet.

5. See a dietician. You'll be surprised at recent advances in dietary medicine.

If your blood sugars tend to run high, you may need to increase consumption

of both water and dietary fiber, since high BGs can dehydrate the lower tract.

High protein diets were once considered fine for newly-diagnosed type 1 diabetics;

but if you have any sign of kidney trouble, your doctor should instruct you

on how to lower the amount of protein in your diet. A high protein intake is

very hard on impaired kidneys, so a weight loss diet that's all meat and fat

should be avoided.

6. Exercise at least five days each week. If you don't want other complications

of long-term diabetes to occur, exercise is imperative. If you're saying "Well,

that's not going to happen, " just remember that 30 to 45 minutes of fast

walking can often take the place of more strenuous workouts. Someone once quipped,

"Whenever I feel the urge to exercise I lie down until it goes away."

I hope he wasn't diabetic!

Park your stationary bike directly in front of the TV. When you snack try grapes,

celery, cucumber slices, or popcorn without butter. Drink at least eight ounces

of water for every ten pounds of body weight every day, and more if you're working

up a good sweat. Take a good quality multi-vitamin with chelated minerals, one

that's high in anti-oxidants.

I recently took the ANSCORE test, available from Boston Medical Technologies.

This unique test monitors the cardiac autonomic nervous system. Ask your endocrinologist

where you can have this important test performed. I recommend it highly to ALL

diabetics, as it measures responses of the heart muscle over timed and painless

stress periods. It then gives a quantified measurement of any neuropathic damage

in the cardiac autonomic nerves. The autonomic nervous system is responsible

for involuntary bodily functions, things like keeping your heart beating, adjusting

the heart rate to match your level of stress, telling the body when it's time

to sweat, sexual response, and other functions that aren't consciously controlled.

After 44 years as a diabetic, some in which I was not maintaining good control,

my test showed that my cardiac autonomic neuropathy response was abnormal for

all three tests. When ANSCORE results are abnormal, it may mean that the diabetic

patient is at risk for silent heart attack, coronary infarction without normal

symptomatic warnings. The good news is that there are positive steps that can

be take to maximize one's ability to avoid myocardial infarction. No one wants

to have a heart attack.

If you've just been diagnosed diabetic, you need to exercise each day, every

day, if your doctor says it's okay. If you're an old hand at diabetes and need

to increase your exercise, see your cardiologist and have him adjust your regimen.

7. Watch your feet. Keep them clean, and don't trim nails too short. Wear comfortable

shoes that fit properly and provide good support. Since diabetic circulatory

problems usually first develop in the lower extremities, it is wise to get acquainted

with a good podiatrist as soon as possible.

8. Enrich your spiritual life. The first stage of any program designed to end

habitual destructive behavior is to surrender your care and concern to a higher

power. Poor self-management of your diabetes can be a lot like a chemical or

behavioral addiction, since it can cause chronic damage. You need to be actively

involved in a diabetic health maintenance program, one with a positive outlook.

It's important to not only stop destructive diabetic behaviors (the activities

and inactivities that keep your blood sugars too high), but to replace bad habits

with good ones. Prayer and meditation have been positive influences for me and

other diabetics I've interviewed. For the nearly 20 years that I've been visually

impaired, I have done all that I am able to introduce spiritual light into my

daily life and practice. It doesn't cost anything, it doesn't require special

equipment, and it absolutely can't hurt you, so why not give it a try?

9. Stay positive! No matter what life throws at you, each time you wake up breathing

you are better off than the 1,500,000 humans each day who will not live to see

tomorrow's dawn. Be thankful! Every day we are blessed with life is another

gift. If you don't believe this, go out and give some of your life to someone

else. Once you get involved with helping others you'll find you have more to

give.

Don't sit. If you're not regularly active, employed or as a volunteer, get

a part time job. Visit somebody who's lonely, volunteer at a retirement center,

a veteran's center, or offer to mentor a child. Go talk to a friend, and never

miss an opportunity to tell them why you care for them. If you are dealing with

depression, do not be afraid to seek professional counseling. Those seeking

counsel are not weak, but smart enough to know when they need assistance. One

of the best habits you can develop is to quit depressing yourself by incessant

complaining.

In your leisure time, read a good book. Studies show that you'll burn more

calories reading a good story for one hour than you will watching three hours

of television.

Diabetes isn't the end of your life. You have many options and lots of choices

to make. Choose to be alive, to be thankful, to be positive, and to get involved.

Even with long-term type 1 diabetes, I live a very full life. I lost my eyesight

to my disorder, and yet I'm a professional writer, writing two columns monthly,

the manager of a prosperous machine vending company, a part-time "house

husband" who does most of the shopping and cooking for my wife of more

than 21 years, and an active lay minister. I am totally blind, and have mild

neuropathic damage in my toes and kidneys, yet I hunt deer, elk, or antelope

each fall. I play and teach drums, rough-house often with my three dogs, and

read an average of 1.5 books from the Talking Books Library each week.

Remember, even if you are dealing with diabetic complications, it is still

your responsibility to determine your own mental attitude. Follow the steps

I've mentioned, and compare how you feel about your situation after just one

month.

Those who believe nothing can be done to improve their situation, and those

who believe there is always something they can do to improve things are both

right.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

LOW INCOME DRUG BENEFIT

While politicians debate the issue of Medicare prescription drug benefits,

some of the pharmaceutical manufacturers are acting on their own. If you are

eligible for Medicare, have a gross annual income of less than $18,000 ($24,000

for a couple filing jointly), and have no other prescription coverage, you should

be eligible for the new Pfizer Share Card.

Effective March 1, 2002, holders of the card can purchase a 30-day supply of

any listed Pfizer prescription, for a flat fee of $15 each. For many drugs,

this is a major discount. As Pfizer makes both type 2 diabetes medications and

other drugs that treat common diabetes complications, this news should be of

great interest to VOICE readers.

The Pfizer Share Card can be used at retail pharmacies, such as CVS and WalMart.

Look for more pharmacies to join the program. For more information, or to receive

an application, telephone: 1-800-717-6005, or see the website: www.pfizerforliving.com

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

EDUCATE YOURSELF

by Peter J. Nebergall, PhD

Photo included; Caption: Peter J. Nebergall, PhD

Some years ago, an eminent neurologist warned me: "You can't believe everything

a doctor tells you. You need to separate the valid medical advice from the medical

nonsense."

I was irate. "But he's the doctor! He's the expert. How am I, the patient,

qualified to sit in judgement of his professional advice?"

"It's your body," he answered. "You need to get qualified."

He's right. Though it sounds a stretch, you, the patient, need to learn everything

you can about your condition, your medications, and your body's unique behaviors.

Michael Cohen, RPh, Director of the Institute for Safe Medication Practices,

says the last bastion of medication safety is not the prescribing physician,

or the dispensing pharmacist, or the bedside nurse, but you, the patient.

This is not just good diabetes advice. Could you recite your medical history

-- or have you left that to your doctor? What prescription medications are you

taking? Do you remember the dosages? The strengths? Do you know what they do?

Do you know what they look like? Why not?

Maybe you think that's the doctor's business, the province of the trained medical

professional. Well, it is; but your doctor has to be familiar with an enormous

variety of conditions, of patients, of possible procedures and medications.

You just have to be familiar with one person, yourself. Your doctor might see

you for 20 minutes a visit -- but you have 24 hours a day. You have more time,

more opportunity, and A LOT MORE REASON to make it your business.

Do you use insulin? Do you adjust your own insulin -- or do you wait for the

next clinic appointment, and let your doctor tell you what to inject? Lots of

diabetics adjust their insulins, regularly testing their blood and raising or

lowering their next dose, to rapidly bring their blood sugars under tight control.

You can learn how to do this, and be healthier for the learning of it. Talk

to your doctor about adjusting your insulins.

And what about diet? Do you know how many calories you eat each day? Do you

know how much you should eat? Can you describe a "healthy diabetic diet?"

Or are you one of those folks who eat whatever and let the insulin, or your

oral meds, cover it? There's Carb-Counting, the Exchange List, and the Food

Pyramid. Using any one of them will give you better diabetes control. There

are dietitians who'll help you learn at least one of these meal-planning systems.

Exercise is important. We've certainly preached that message to you, a lot,

but do you understand why? Better still, do you know how much difference a given

amount of regular exercise will make to your BGs? I'm not talking "textbook;"

I'm asking you to become the resident authority on just what your favorite exercise

(Treadmill? Stationary bike? Walking the dog?) does to your blood sugars. So

move yourself, test, record, and know.

Is this a lot to learn? Yes. Does it look confusing? Of course. But a lot of

people have already learned these skills, have become the ultimate experts on

their own condition and their own medical needs, and there's no reason you can't,

too. .

It's like being a pilot. An untrained person, sitting in the pilot's seat,

can be overwhelmed by the complexity and unfamiliarity of the instruments and

controls -- while a trained pilot, in the same seat, has no difficulty taking

off and flying safely to the destination. The difference is education. Just

as folks can learn how to fly, you can learn how to take care of yourself.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

ASK THE DOCTOR

by Roger Barth, MD

Artwork: Medical caduceus

NOTE: If you have any questions for "Ask the Doctor," please send

them to the VOICE editorial office. The only questions we will be able to answer

are the ones used in this column.

Dr. Roger Barth received his MD degree from the University of Washington, completed

his ophthalmology training at Washington Medical Center in Washington, D.C.

and then completed a fellowship in glaucoma speciality training at the University

of Iowa. He is now practicing ophthalmology at the Glacier Eye Clinic in Kalispell,

MT.

Q: I have diabetic retinopathy and have suffered recurrent retinal hemorrhages.

My ophthalmologist has not taken an ocular pressure reading recently and states

that elevated ocular pressure and retinal bleeding is not related. Is he correct?

How is glaucoma detected and treated in a diabetic who is already suffering

from retinal hemorrhages? Can untreated retinal bleeding lead to glaucoma?

A: Your question brings up many good points about diabetes and glaucoma. Elevated

intra-ocular pressure and retinal bleeding are not related. Your ophthalmologist

is correct. But diabetics are at increased risk for glaucoma. Monitoring your

eyes for glaucoma is important.

Glaucoma is a common, but poorly understood, disease that affects the eyes

of millions of people and can lead to blindness. By definition, glaucoma is

damage to the nerve cells that transmit the message from your retina to your

brain. Please notice that I didn't say glaucoma is high pressure in the eye.

Many factors combine to cause glaucoma. These are called "risk factors"

and include elevated intra-ocular pressure, family history, the shape of the

eye, and to a lesser degree, nearsightedness and diabetes. Because the eye pressure

is the only variable we can manipulate (and the number one risk factor), it

is important that it is checked periodically and put into context with the rest

of your exam. Normal eye pressure ranges between 10 and 21 mm of Mercury. Up

to 1/3 of patients develop glaucoma damage with pressure in the "normal"

range. Merely knowing that your pressure is OK does not mean you don't have

glaucoma or are not at risk for it.

By analyzing the appearance of your optic nerve and considering your other

risk factors your ophthalmologist should be able to assess your relative risk

for glaucoma. If there is increased suspicion, other tests may be ordered, such

as visual field testing, optic nerve photographs, measurement of the nerve thickness,

etc.

Retinal hemorrhages (or background diabetic retinopathy) should not make the

detection of glaucoma any more difficult, and won't by themselves lead to glaucoma.

If there has been bleeding into the vitreous (the clear fluid at the back of

the eye), it may be difficult to see into the back of the eye, making evaluation

for glaucoma more difficult. In addition, vitreous hemorrhage can by itself

sometimes cause increased eye pressure.

A particularly devastating form of glaucoma (neovascular glaucoma) can develop

in patients with diabetes. It is fairly rare, and can be prevented if caught

early, which reinforces the importance of regular eye exams for diabetics.

The good news when it comes to glaucoma is that as a disease process, it typically

takes years to develop. Your ophthalmologist has no doubt been observing your

eyes for signs of glaucoma, even if the eye pressure has not been checked at

each visit. If there is evidence of glaucoma, a variety of treatments can help

lower the eye pressure and help slow or stop any glaucoma damage to your vision.

Because people with diabetes are typically seen more often for eye exams, they

and you should be in good shape as far as early detection of glaucoma is concerned.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

MEDICARE NOW COVERS GLAUCOMA-DETECTION EYE EXAM

Medicare now covers an annual dilated eye examination for all people considered

"at high risk for glaucoma." This coverage began January 1, 2002.

Glaucoma, a leading cause of blindness, affects about three million Americans

- half of whom don't know they have the condition.

The new benefit defines "High-Risk" Medicare beneficiaries as those

with diabetes, those with a family history of glaucoma, and people of African-American

ethnicity aged 50 or older. Glaucoma is five times more likely to occur in African-Americans

than in whites, and about four times more likely to cause blindness in African

Americans than in whites, according to the National Eye Institute.

"Preventive benefits, such as this new glaucoma coverage, help keep people

enrolled in Medicare healthy, and improve their quality of life," said

Secretary of Health and Human Services Tommy Thompson. "An eye exam now

can prevent serious problems later, even blindness. It is important that we

make taking care of our eyes part of our overall health maintenance program."

"Glaucoma, and the risk of vision loss, remains unrecognized for millions

of Americans," says Paul A Sieving, MD, PhD, director of the National Eye

Institute. "The expanded Medicare coverage will help people keep their

vision, especially those at high risk for eye disease. Once vision is lost from

glaucoma, it cannot be restored - the damage is irreversible. Studies have shown

that early detection and treatment of glaucoma, before it causes major vision

loss, is the best way to control the disease."

The "air puff" test, which measures the internal fluid pressure in

the eye, is one part of a glaucoma examination, but the test cannot by itself

detect glaucoma. Glaucoma is detected most often (as are other serious eye conditions

like diabetic retinopathy) by eye examination through dilated pupils - in which

drops of medicine are put into the eyes to temporarily enlarge the pupils, allowing

the eye care professional a better look at the inside of the eye.

For more information, contact: Glaucoma, 2020 Vision Place, Bethesda, MD 20892-3655;

website: www.nei.nih.gov

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

TOMMY FORD - A PATIENT TO REMEMBER AND AN EXAMPLE FOR ALL

by Steven T. Boyd, Pharm.D.

Photo included; Caption: Tommy Ford

As a health care professional who works one-on-one with patients, I know it

may take several encounters to remember a patient on a personal level. Patients

have unique aspects and genuine characteristics that make them special and contribute

to a doctor's long-term memory. But every once in a while a patient arrives

who just knocks you out of your white coat, and you remember from day one.

Tommy Ford is a great example of a patient you can't overlook. I first met

Tommy when he was referred to my Diabetes Clinic. He was the first patient to

enroll into my program. Even though I thought I was ready, I wasn't quite ready

for Tommy. I'd done my research on diabetes. I knew the drugs, the nutrition

guidelines, and the exercise recommendations; but I wasn't prepared for a patient

with eyesight deficiency.

Tommy lost his eyesight about six years ago and has been battling multi-diseases

outside of the realm of diabetes. Tommy was diagnosed with HIV infection in

1995 and with Acquired Immune Deficiency Syndrome (AIDS) in 1996. In 1996, Tommy

was diagnosed with serious tuberculosis complications. As a result of anti-viral

therapy containing a protease inhibitor for HIV, he developed diabetes. Even

though Tommy has been dealt multiple challenges throughout his life, he has

been able to direct his emotions and efforts in an extremely positive way not

only to help himself, but also others.

Considering the many things Tommy has accomplished, his most amazing quality

is the desire to help other people. On a regular basis, Tommy speaks to local

school-age children on the danger of drugs, premarital sex, and the importance

of continuing their education. He states, "I enjoy helping kids. I would

like to prevent them from falling through the cracks at an early age."

He attends and is an integral component of an HIV support group at Siouxland

Community Health Center (SCHC). In addition, he belongs to two support groups

for the blind, the National Federation of the Blind (NFB) and the Siouxland

Informational Group for the Blind (SIGB). Tommy also has had speaking engagements

at the Sanford Center (a local day care and after-school program), the Boys

and Girls Group Home, Public Health Department, Shelter and Family Services

Center here in Sioux City. Many people, on a regular basis, ask Tommy for his

thoughts and ideas. He is always willing to stop whatever he is doing to help

any person in need. Tommy says, "It's hard at times, but living a Christian

lifestyle full of prayer helps me to continue to work hard."

Since Tommy enrolled into the diabetes clinic, he has lowered his average blood

sugar from 185mg/dl to 135mg/dl. He has accomplished this by multiple means,

including nutrition, medication and daily exercise. Tommy first started running

in place several times per day at home. This, of course, is challenging, but

not nearly as demanding as attending water aerobics and lifting weights at the

local YMCA! On multiple occasions Tommy has attended exercise classes specifically

for patients with diabetes and even visits the YMCA for individual workouts!

He is a true example of determination and inspiration for any patient regardless

of physical challenges.

Tommy has significantly changed his dietary habits by incorporating more fruits

and vegetables, and by counting his carbohydrate intake, which he accomplishes

in spite of his eyesight deficiency

It is extremely important for Tommy to take his medications. Adhering to his

medication regimen is no small feat, as Tommy takes up to 10 different medications

every day! Tommy accomplishes adherence by using a wristwatch with alarms, and

with help from his family.

Tommy states, "My family support has been remarkable! I would also like

to send a special thanks to all who support me."

When people ask me, "What is the most challenging aspect of your job?"

I always reply, "Motivating patients to take control of diabetes instead

of allowing diabetes to control you." Tommy is a great example of a person

who not only controls his diabetes, but also inspires others to get the most

out of each and every day.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

ASK JANIS

by Janis Roszler

Photo included; Caption: Janis Roszler

Janis Roszler, RD, CDE, LD/N is a registered dietitian, certified diabetes

educator, and certified insulin pump trainer. She has counseled individuals

with diabetes for over 14 years, and is currently the diabetes educator for

the website: www.diabetic.com

This column is for educational purposes only. For answers that meet your specific

educational needs, consult your physician.

Dear Janis:

My family treats me like I'm going to give diabetes to them. They don't understand

about my sick days. When I go somewhere and can barely walk, they get mad at

me. I get depressed because I can't do the things that they want. It makes me

feel like I'm a big burden to them.

Dear W.C..:

It is important that you share this with your doctor. Depression often comes

hand-in-hand with diabetes. Your doctor may suggest some medication that can

help. Meanwhile, see if your family will join you at your visits with your doctor.

It will help them understand the medical side effects of diabetes.

Dear Janis:

Does insulin promote healthier sperm? Do oral medications affect sperm?

Dear TT:

According to the male sexuality research specialists at the Joslin Diabetes

Center in Boston, diabetes medications and insulin have no affect at all on

sperm quality, development or function.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

DIALYSIS AT NATIONAL CONVENTION

by Ed Bryant

Photo included; Caption: Ed Bryant

During this year's annual convention of the National Federation of the Blind,

in Louisville, Kentucky (Wednesday, July 3, through Tuesday, July 9), dialysis

will be available. Individuals requiring dialysis must have a transient patient

packet and physician's statement filled out prior to treatment. Conventioneers

must have their unit contact the desired location in the Louisville area for

instructions, well in advance. NOTE: The convention will take place at the Galt

House Hotel, 140 N. Fourth Street, Louisville, KY 40202.

Individuals will be responsible for, and must pay out of pocket, prior to each

treatment, the approximately $30 not covered by Medicare, plus any additional

physician's fees, and any charges for other medications.

DIALYSIS CENTERS SHOULD SET UP TRANSIENT DIALYSIS LOCATIONS AT LEAST SIX TO

EIGHT WEEKS IN ADVANCE. THIS HELPS ASSURE A LOCATION FOR ANYONE WANTING TO DIALYZE.

There are many centers in the Louisville area, but that area is quite large,

and early reservation is strongly recommended. Here are some dialysis locations:

* Renal Care Group, Inc., 635 South Third Street, Louisville, KY 40202; telephone:

(502) 561-1314. About ½-mi. from hotel.

* BMA Dialysis, 720 East Broadway, Louisville, KY 40202; telephone: (502) 584-3021.

About ½-mi. from hotel.

* U. of Louisville Kidney Disease Program, 615 Preston Street, Louisville,

KY 40292; telephone: (502) 852-5757. About ½-mi. from hotel.

* BMA of Southern Indiana, 525 Broadway, Jeffersonville, IN 47130; telephone:

(812) 282-0420. About two miles from hotel.

PLEASE REMEMBER TO SCHEDULE DIALYSIS TREATMENTS EARLY, TO ENSURE SPACE. If

scheduling assistance is needed, have your dialysis unit's social worker contact

me: Diabetes Action Network President Ed Bryant; telephone: (573) 875-8911.

See you in Louisville!

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

BOOK REVIEWS

by Marilyn Helton

Greetings Readers! Once again it's Spring, a time which we associate with rebirth

and new beginnings. With that thought in mind, I'd like some reader-feedback

regarding your choice of the type of books you would like to see reviewed in

this column. Please choose from the following four categories:

1. Cookbooks -- All types of nutrition and food preparation for adults and

children with diabetes; proper nutrition as a prescription for diabetes; obesity/weight

loss through proper nutrition as associated with diabetes.

2. Juveniles and Diabetes -- Recognizing and dealing with children and teens

with type 1 and type 2 diabetes.

3. Motivational/spiritual books on coping with diabetes, for those who have

diabetes, their caregivers, and family members.

4. Medical or in-depth publications written to recognize and deal with the

complications of diabetes.

Please send your thoughts to [email protected] and put "VOD Book Reviews"

in the subject line. Please put your choice(s) in order of preference. If you

don't have access to a computer, drop a postcard to: Marilyn Helton, VOD Book

Reviews, P.O. Box 8340, Modesto, CA 95357-8340. I need to have your feedback

BEFORE my writing deadline of May 15, 2002, in order to share the results with

you in the Summer issue of the VOICE OF THE DIABETIC, which will be published

in July 2002.

Here are the current review selections for your Spring reading. As I always

recommend, look through them at your local book store or better yet, check them

out of the library and read them before you decide to buy. My personal rule-of-thumb

has always been, "If I check it out more than twice, I should own it!"

**********

12 THINGS YOU MUST KNOW ABOUT DIABETES CARE RIGHT NOW!

In this age of HMO-controlled medical care and drive-through medical appointments

(the kind where you sit for an hour in the waiting room in order to see your

healthcare provider for 10 minutes or less), it's essential to know the right

questions to ask and tests you should have to manage your diabetes. How many

times have you come out of your doctor's office feeling like you didn't know

any more than the last visit regarding the management of your diabetes? For

the first five years or so after my diagnosis, that's exactly the way I felt,

until I started researching the disease and reviewing books on diabetes and

its complications.

Divided into 12 areas of concern, "12 Things You Must Know about Diabetes

Care -- Right Now!" covers how to choose the members of your health care

team, what check-ups you need and when you need them, what kinds of medical

tests you should have done and what the results mean to you, and what important

questions you should ask your health care provider so you can make your own

well-informed self-care decisions. Also discussed are topics such as diabetes

and pregnancy, diabetic eye disease, lipids and exercise, hypertension, diabetic

neuropathy (nerve damage) and nephropathy (kidney complications). There are

two good appendices on the drugs used for the treatment of diabetes and diabetes-related

world-wide web sites. What a wealth of information packed into 180 pages!

Written by Irl B. Hirsch, MD, Medical Director of the Diabetes Care Center

at the University of Washington Medical Center, the book is designed to make

sure the patient is getting the best medical care according to the American

Diabetes Association's latest "Standards of Care."

It's really a wonderful read, specifically designed to help you ask your doctor

the right questions. If you want to get top medical care, you should read "12

Things You Must Know About Diabetes Care Right Now," (c) 2000 by the American

Diabetes Association, Inc. Highly recommended.

**********

UNBELIEVEABLE DESSERTS WITH SPLENDA

For those of you who still can't quite believe you can have small amounts of

refined sugar (per serving) in your diabetic recipes, I've recently received

three cookbooks for review which have recipes that do not use refined or natural

sugars (fruit sugars). One of these three is "UNBELIEVEABLE DESSERTS WITH

SPLENDA," by Marlene Koch, RD, a culinary nutritionist who combines her

love for great-tasting food with her knowledge of nutrition in the recipes she's

created using Splenda, a no-calorie sweetener made from sugar, so it tastes

just like sugar.

Splenda (sucralose) is made through a multi-step process that selectively replaces

three hydrogen-oxygen groups on the sugar molecule with three chlorine atoms.

The result is an exceptionally stable sweetener that tastes like sugar but without

sugar's same properties, and which, after consumption, is able to pass through

the body without being broken down.

Since Splenda has no unpleasant after-taste, it can be used virtually anywhere

sugar is used, and it stays sweet at high temperatures, so it can be used in

cooking and baking.

In the Low Sugar Baking Secrets section of the book, Ms. Koch informs the reader

flat out that "sugar is sugar is sugar." Honey, juice concentrates,

dried fruits, fructose, etc., are all different forms of sugar and the consumer

should not be fooled by that "no-sugar cookie recipe" which is full

of honey. Your body knows what sugars are and so should you! This section goes

on to explain what the role of sugar is in the recipes and how to adjust your

own recipes to use Splenda..

The recipes section of the book includes Hot & Cold Beverages; Muffins,

Coffeecakes, & Breakfast Breads; Cookies; Pies, Crisps, & Cobblers;

Cakes for Any Occasion; Cheesecakes to Die For; Puddings & Specialty Desserts;

and Simple Sauces & Toppings. I have not tried any of the recipes, but one

of my sisters made the cheesecake and said it "tasted like the real thing"

and was just wonderful!

"Unbelievable Desserts With Splenda," (c) 2001 by Marlene M. Koch

is published by M. Evans and Company, Inc. Since my sweet tooth is my albatross,

I think I'll try it ~ I might even like it!

**********

REAL LIFE PARENTING OF KIDS WITH DIABETES

Having a child diagnosed with a chronic illness is a frightening experience,

and parenting a child with diabetes can be wrought with fear, anxiety, and so

many questions. After all, how do you explain the importance of a finger prick

to a small child who only feels pain? How do you help them live life like any

other kid their age? How can parents learn to handle the practical, day-to-day

aspects of this challenge while also figuring out how to cope -- and how to

help their children cope -- with the emotional and psychological fallout?

Author Virginia Nasmyth Loy, whose two sons were diagnosed with type 1 diabetes

on Thanksgiving Day one year apart (one was seven, the other six years old)

gives parents a down-to-earth guide with information about raising a child with

diabetes. The reader will gain valuable insight with tips and suggestions for:

(1) developing a testing and medication routine, (2) organizing a play group,

(3), finding a doctor, (4) making sure their diabetic child gets the exercise

he/she needs, (5) preparing for sports and activities, (6) traveling with diabetes,

(7) and how to provide emotional support to your diabetic child and your spouse

when the challenges of diabetes get the best of both of you. The importance

of staying positive in the face of adversity while making sure your diabetic

child stays positive as well, is the primary theme throughout this book. Diabetes

shouldn't keep your children from living the life they want to live!

From making the decision to "take charge" to driving, drinking and

parents' issues, this is a great guide for parenting a child with diabetes.

Written in practical terms; highly recommended. "Real Life Parenting of

Kids with Diabetes," (c) 2001 by Virginia Nasmyth Loy, published by the

American Diabetes Association.

**********

MR. FOOD'S QUICK & EASY DIABETIC COOKING

Almost every cookbook collector or good ol' recipe enthusiast is probably

familiar with Mr. Food's (aka Art Ginsburg) quick, easy and delicious style

of food preparation. Well, now he's made it possible for us to share some of

his tasty recipes with our diabetic loved ones.

Citing that many of his fans had written to him over the years asking for

a cookbook with recipes for diabetics, Art Ginsburg teamed with Nicole Johnson,

Miss America 1999 (and type 1 diabetic), to produce over 150 recipes for "MR.

FOOD'S QUICK & EASY DIABETIC COOKING." Filled with numerous food tips

and helpful hints for keeping you on track, each recipe has a complete nutritional

analysis and Exchanges. Many of the recipes are old family favorites which have

been updated to healthier versions; and since I love desserts, I was pleased

to find that chapter well represented. Roasted Veggie Melt, Balsamic Chicken,

Garlic Shrimp Linguine, Carmelized Cola Roast, and Banana Cream Pie are a few

of Nicole's contributions I'm eager to try.

A good and easy cookbook for all cooking levels; recommended. Published by

the American Diabetes Association; (c) 2001 Cogin, Inc.; $16.95.

Until we meet again this Summer, try to stay balanced and centered. Life is

too short to not "live in the moment."

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

RECIPE CORNER

Artwork: Fruits and vegetables

This issue, all recipes are taken from "The Diabetic's Healthy Exchanges

Cookbook," by JoAnna M. Lund, published 1996 by Perigee.

GERMAN POTATO SALAD

Ingredients:

3 full cups (16 ounces) diced cooked potatoes

½ cup finely chopped celery

2-½ teaspoons dried parsley flakes

½ cup chopped white onion

3 tablespoons Hormel Bacon Bits

2/3 cup water

1 tablespoon all-purpose flour

1/4 cup white vinegar

2 tablespoons Sugar Twin or Sprinkle Sweet

1/4 teaspoon prepared mustard

Instructions:

In a medium bowl, combine potatoes, celery, and 2 teaspoons parsley flakes.

Set aside. In a large skillet sprayed with butter-flavored cooking spray, saute

onion until just tender, about five minutes. Add bacon bits and continue cooking

one minute, stirring often. In a covered jar, combine water, flour, vinegar,

Sugar Twin, remaining ½-teaspoon parsley flakes, and mustard. Shake well

to combine. Stir flour mixture into onion mixture. Continue cooking, stirring

often, until mixture thickens, about three minutes. Remove from heat. Pour hot

sauce mixture over potatoes. Mix gently to combine. Serve warm or cold. Makes

six 2/3-cup servings. 116 Calories, 1gm Fat, 3gm Protein, 24gm Carbohydrate,

270mg Sodium, 1gm Fiber. Exchanges: 1-½ starch.

CORN AND TOMATO COMBO

Ingredients:

½ cup chopped onion

1-3/4 cups (one 15-ounce can) Hunt's Chunky Tomato Sauce

1 cup frozen whole kernel corn

1 teaspoon chili seasoning mix

1 teaspoon Sugar Twin or Sprinkle Sweet

Instructions:

In a large skillet sprayed with butter-flavored cooking spray, saute onion until

tender, about five minutes. Add tomato sauce, corn, chili seasoning mix, and

Sugar Twin. Mix well to combine. Lower heat. Cover and simmer 10 minutes, stirring

occasionally. Hint: Canned whole kernel corn, rinsed and drained, may be used

instead of frozen. Makes four ½-cup servings. 97 Calories, 2gm Fat, 3gm

Protein, 17gm Carbohydrate, 610mg Sodium, 2gm Fiber. Exchanges: 1-½ vegetable,

½ starch.

RANCH HAND MEAT LOAF

Ingredients:

1 cup (one 8-ounce can) Hunt's Tomato Sauce

1/4 cup Brown Sugar Twin

2 tablespoons vinegar

1 teaspoon prepared mustard

16 ounces ground 90% lean turkey or beef

12 small fat-free saltine crackers, crushed

1/4 teaspoon black pepper

Instructions:

Preheat oven to 350 degrees. Spray an 8-by-8-inch baking dish with butter-flavored

cooking spray. In a medium saucepan, combine tomato sauce, Brown Sugar Twin,

vinegar, and mustard. Cook over medium heat, stirring often, until mixture just

comes to boil. Remove from heat. In a large bowl, combine meat, cracker crumbs,

black pepper, and 1/4 cup of hot tomato sauce mixture. Mix well with hands to

combine. Pat meat mixture into prepared baking dish. Pour remaining sauce evenly

over top. Bake 45 to 50 minutes. Place baking dish on a wire rack and let sit

five minutes. Cut into six servings. 151 Calories, 7gm Fat, 14gm Protein, 8gm

Carbohydrate, 412mg Sodium, 1gm Fiber. Exchanges: 2 meat, ½ starch.

HAPPY TRAILS POPCORN MIX

Ingredients:

9 cups air-popped popcorn

I Can't Believe It's Not Butter Spray

1 cup raisins

1 1/3 cups (6 ounces) chopped dried apricots

½ cup (2 ounces) chopped pecans

1 cup (2 ounces) mini marshmallows

1 teaspoon ground cinnamon

2 tablespoons Brown Sugar Twin

Instructions:

Place popped popcorn in a large bowl and quickly spray with I Can't Believe

It's Not Butter Spray. Stir in raisins, apricots, pecans, and marshmallows.

Sprinkle cinnamon and Brown Sugar Twin over top. Mix well to combine. Store

in airtight container. Hints: To plump up raisins without "cooking,"

place in a glass measuring cup and microwave on HIGH for 30 seconds. Six tablespoons

unpopped popcorn usually make about 9 cups popped popcorn, if prepared in an

air popper. Makes twelve 1-cup servings. 200 Calories, 4gm Fat, 3gm Protein,

38gm Carbohydrate, 7mg Sodium, 1 gm Fiber. Exchanges: 1 starch, 1 fruit, 1 fat.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

If you or a friend would like to remember the Diabetes Action Network of the

National Federation of the Blind in your will, you can do so by employing the

following language: "I give, devise, and bequeath unto the Diabetes Action

Network of the National Federation of the Blind, 1800 Johnson Street, Baltimore,

Maryland 21230, a District of Columbia nonprofit corporation, the sum of $____________

(or "____________ percent of my net estate" or "the following

stocks and bonds: _____________") to be used for its worthy purposes on

behalf of blind persons."

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

WHAT YOU ALWAYS WANTED TO KNOW BUT DIDN'T KNOW WHERE TO ASK

(Resource Column)

Artwork: Hand pulling a book from a shelf of books

Inclusion of materials in this publication is for information only and does

not imply endorsement by the Diabetes Action Network of the NFB.

DIABETIC FOOT PRODUCTS

The following products were specifically designed to help treat diabetic conditions

of the human foot.

* Diabeticream; $30 (plus S&H) for a 4-oz. tube. Apply to clean, dry feet,

to help alleviate dryness and cracking. Use with massage will help circulation.

* Dr. Rehm's Special Foot Soap; $12/bar (plus S&H). Hand-made in small

batches by the Maeda family of Calexico, California.

* Toesease; (foot and toenail cleaner) $20 (plus S&H) for an 8-oz. supply

* The Diabetic Sock; $10/pair. Non-binding top, extra width in calf, non-constricting,

hand-knit seamless toe, antimicrobial treatment, 94% cotton, 5% nylon, 1% spandex.

Made in USA.

All these products are available from: The Diabetic Foot and Wound Treatment

Center, 1529 Grand Avenue, Suite C, San Marcos, CA 92069; telephone: (760) 744-6226.

DIABETES SUPPLIES

American Diabetic Supply, Inc., will ship your diabetes supplies to your door.

They handle all insurance claims and provide free delivery. Folks with Medicare

and/or private insurance (no HMOs) may receive supplies at no further cost.

For information, contact: American Diabetic Supply, Inc., 400 S. Atlantic Ave.,

Suite 108, Ormond Beach, FL 32176; telephone: 1-800-453-9033.

NEW DIABETES RESOURCE LIST

The Diabetes Action Network of the National Federation of the Blind now offers

the 2001/2002 edition of "Diabetes Resources: Equipment, Services and Information,"

our comprehensive list of resources for diabetics. "Diabetes Resources"

is a compilation of companies and individuals offering products and/or information

to help diabetics, especially those who are blind or are losing vision, to self-manage

their diabetes. The list contains the following subject categories: General

and Miscellaneous, Insulin Measurement Devices, Insulin Syringe Magnifiers,

Insulin Injection Systems, Diabetic Foot Care, Blood Glucose Monitoring Systems,

Insulin Pumps, Products for the Blind, Food and Diet, Literature and Information,

Distributors of Diabetes Equipment and Supplies, and Medication Assistance.

Blind diabetics can and do accurately draw up insulin, monitor blood glucose,

and perform the other tasks of independent self-management. By using alternative

techniques and products, they can continue being independent, and control their

diabetes as efficiently as do their sighted peers. Limitations are usually self-imposed--often

all that is needed to overcome negative thinking is simply to know where to

go for information.

"Diabetes Resources: Equipment, Services, and Information" costs

$5 per copy, and is available in Braille, large print, and audiocassette (recorded

at 15/16 IPS for the blind), or you can access it on the NFB website: www.nfb.org/diabres

Please order from: National Federation of the Blind, Materials Center, 1800

Johnson Street, Baltimore, MD 21230; telephone: (410) 659-9314. Note: the NFB

Materials Center is open weekdays 8 am to 5:00 pm Eastern time.

EASY DIABETIC COOKBOOK

If you want to prepare healthy diabetic meals, but find most cookbooks just

too complicated, you need Linda Coffee and Emily Cale's "The Diabetic 4

Ingredient Cookbook." There are over 200 recipes, in all food categories,

with complete nutritional and exchange information, each one using four ingredients.

The book costs $9.95 (+$2.95 shipping), from: Coffee and Cale, PO Box 2121,

Kerrville, TX 78029; telephone: 1-800-757-0838.

FULL SERVICE DIABETES SUPPLIER

DS Medical Supply is a full-service supplier with a catalog of more than 55,000

items, dealing with diabetes, its complications, and many other medical supplies,

delivered to your home. Diabetes products range from glucose monitors by Bayer

and LifeScan, and the AccuChek VoiceMate talking glucose monitor, strips, lancets

and other supplies, to diabetic orthotics/foot care items, and much more. They

accept Medicare, private insurance, some HMOs, and, in most states, direct or

crossover Medicaid. Contact: DS Medical, 2105 Newport Place, Suite 600, Lawrenceville,

GA 30043-5561; telephone: 1-800-722-2604 , website: www.dsmedical.com

ADAPTIVE COMPUTING EQUIPMENT

Freedom Scientific is a powerhouse adaptive equipment maker for the blind and

visually impaired computer user. A union of Arkenstone, Blazie Engineering,

and Henter-Joyce, Freedom Scientific offers screen magnifiers, talking attachments

(voice synthesizers) for your computer, Braille printers and much more. Whether

you need adaptive software or hardware, check them out: Freedom Scientific;

telephone: 1-800-444-4443; website: www.freedomscientific.com

DIABETES SUPPLIES

Diabetic Supply Distributors, Inc., helps you save four ways with your diabetes

supplies:

1. Insurance billing. They file the claim, and they pay for delivery. No advance

payment needed -- and THEY do the paperwork.

2. Medicare billing. Medicare pays for approved diabetes supplies (and, since

last July, that list has covered type 2 diabetics!). Diabetic Supply will handle

the details.

3. Free, fast home delivery. Your order comes quickly to your door.

4. Friendly personal service. You're not talking to a computer.

Contact: Diabetic Supply Distributors, Inc., PO Box 1820, Laurel Springs, NJ

08021; telephone: 1-800-962-8098.

TALKING BLOOD GLUCOSE MONITOR

Based on the proven Accu-Chek Advantage meter, the Roche Diagnostics Accu-Chek

Voicemate provides the following: Clear, high-quality speech synthesis, talking

the user through preparations, test procedures, and results, without the need

for sighted assistance; an "insulin vial identifier" which reads Eli

Lilly insulin vials and speaks their type, as a safety aid in tactile insulin

mixing; a new, improved, "touchable" test strip -- the Accu-Chek Comfort

Curve (no more "hanging drop of blood" needed!); no meter cleaning

required; and a tactile "code-key" system for programming test strip

codes. The Voicemate is the most "blind-friendly" talking glucose

monitor available today, and the only one whose regular operations require no

sighted assistance at all.

The Voicemate comes with an adjustable over-the-shoulder carrying case, with

meter, voice box, battery, adapter cord, 10 Comfort Curve strips, earphone,

insulin check-vial, manual and quick-reference guide (in print), and instructions

on audiocassette. The meter (catalog # 2030802) can now be ordered through any

pharmacy (suggested retail price $495-525). To do so, have your pharmacist contact

Roche Diagnostics, 9115 Hague Road, Indianapolis, IN 46250; telephone: 1-800-428-5074.

For direct purchase, and a price below $500, contact any of the following retailers:

BeyondSight, Inc., Littleton, CO: 303-795-6455 ($498); Independent Living Aids,

Inc., Plainview, NY ($495): 1-800-537-2118; or the National Federation of the

Blind Materials Center, Baltimore, MD ($475): 410 659-9314.

CHANGE YOUR WAYS

Good diabetes management is a lifestyle. Although doctors can prescribe medication

and recommend changes, sometimes "changing your ways," adapting/adopting

a healthy lifestyle, can be a lot of work -- for there is so much to learn.

The NEWSTART Lifestyle Center offers 12- and 18-day in-house, physician-supervised

intensive education programs, that emphasize permanent lifestyle changes designed

to help the participant lose weight, maintain health, and adopt healthier habits

in nutrition, cooking, exercise, and stress management.

Contact: Weimar Institute; telephone: 1-800-525-9192; e-mail: [email protected]

RIDE IN STYLE

Sometimes a person needs some help getting about, and an electric scooter would

be just the thing. The Scooter Store, in New Braunfels, Texas (with service

centers throughout the USA), calls itself "America's largest scooter company,"

and offers a wide variety of scooters and purchase plans. If you have Medicare,

and demonstrable medical need, you may even find a new scooter is covered as

"durable medical equipment."

For information, contact The Scooter Store; telephone: 1-800-723-4535; website:

www.scooterstore.com

DIABETIC SUPPLIES ON LINE

Pharmacist Bryan Luna, Rph, offers diabetes supplies, including glucose monitors,

on line at www.diabeticsupplies.com . This convenient website is simply laid

out, and can be accessed in large print, too. For those without the internet,

telephone: 1-877-787-7543. They will file your Medicare, Medicaid, and private

insurance forms. Free product catalog; 30-day money-back guarantee.

TALKING COMPUTER

The VoiceNote, from HumanWare, is a laptop note-taker/organizer for blind individuals

and those losing vision. It combines the familiar MicroSoft WINDOWS CE operating

system, and standard computer keyboard, with voice access. You can create MS

Word documents, access your e-mail, transfer documents to and from a standard

PC computer, use your VoiceNote as a speech synthesizer for another computer,

and access a number of planning and scheduling tools. For more information,

about the VoiceNote or their many other products, contact: HumanWare, 6246 King

Road, Loomis, CA 95650; telephone: 1-800-722-3393; website: www.humanware.com

WINDOWS SCREEN READER

GW Micro now offers WINDOW-EYES Version 4 with Braille Support, a screen reader

program that also supports Microsoft WINDOWS ME, WINDOWS 95, WINDOWS 98 and

WINDOWS 2000. Once equipped with a voice synthesizer such as the Dectalk (your

standard soundcard won't do), any computer that can run WINDOWS can run WINDOW-EYES.

WINDOW-EYES reads the internet too, and provides you both speech and Braille

output! A free demo disk is available, or you may download the demo program

from the internet. The WINDOW-EYES program is available from: GW Micro, 725

Airport North Office Park, Fort Wayne, IN 46825; telephone: (219) 489-3671;

fax: (219) 489-2608, e-mail: [email protected]; website: http://www.gwmicro.com

DIABETES SUPPLIES

When you need it, you need it. When it's time to test, when it's time for medication,

you need it already there. Diabetic Care Center will ship your diabetes supplies

to your door, and they do the paperwork. No forms, no trips to the pharmacy.

Medicare and most private insurance accepted. Call the Diabetic Care Center,

telephone: 1-800-633-7167; website: http://www.diabeticare.com

NEW TALKING MEDICINE IDENTIFIER

A new product, the ALOUDÔ Model 200 Audio Labeling System, from ASKO,

can best be described as a "talking prescription container." This

is how it works:

When a pharmacist dispenses your medication, an audio version of the printed

prescription label (called an "Audio Label") is also produced, and

is attached to the medication container. The Audio Label is a bit large for

attaching to an insulin vial - it works, but it would be better if it were smaller.

When the Audio Label is placed into an ALOUDÔ Replay unit, up to 60 seconds

of recorded information is replayed.

Each of your medications needs its own Audio Label, and you can play the message

over and over, as many times as you like. It cannot be accidentally erased or

altered - the microphone (provided) must be inserted into the "recorder/replay

module" to change the message. The Audio Label is reusable, so when you

need to have your prescription refilled or changed, the message can be changed

also, and attached to your new prescription.

The record/replay unit is portable. It is only 4" high, about 2"

in diameter, and weighs less than eight ounces. It has a rechargeable battery,

so you can use it anywhere. The audio fidelity is very good, and you can also

use a small earphone for private listening. The construction is extremely durable,

the product is manufactured in the USA, there is absolutely no maintenance required

and the product comes with a one-year warranty.

Further information about the ALOUDÔ system can be obtained from: ASKO

Corporation, 2 South Street, Stamford, NY 12167; telephone, toll-free: 1-877-732-9227;

website: www.askocorp.com

FREE DIABETES LITERATURE

The National Federation of the Blind maintains an extensive literature collection,

with free materials on many subjects available in a variety of formats. The

articles listed below make up one part of the collection, the "diabetes"

category: "Arthritis and Diabetes: A Common Association," "Blind

Diabetics Can Draw Insulin Without Difficulty," "Can I Eat Sugar?,"

"Cardiovascular Health: Bypass May Be Better for Diabetics," "Check

Your Hemoglobin A1c I.Q." "Diabetic Eye Disease," "Diabetic

Peripheral Neuropathy," "Diabetics, Don't Give Up on Braille,"

"The Emotional Side," "Finger-Sticking Techniques," "How

I Went Blind...And Then What," "Hypoglycemia - Low Blood Sugar,"

"Insulin Measurement Devices," "Insulin Types: A Review,"

"Keeping Your Feet," "Kidney Disease: Prevention, Dialysis, and

Transplantation," "Male Sexual Dysfunction," "Many Blind

Diabetics Successfully Use Insulin Pumps," "New Dietary Guidelines

for Diabetes Management," "Oral Diabetes Medications Update,"

"Talking Blood Glucose Monitoring Systems," and "What Is Diabetes

Mellitus?"

These articles are available in large print and four-track 15/16 IPS audiocassette

for the blind (all the diabetes articles are on one tape, titled: "Diabetes

Action Network Articles"). All are free of charge. To order, or to request

a complete NFB literature catalog, contact: NFB Materials Center, 1800 Johnson

Street, Baltimore, MD 21230; telephone: (410) 659-9314. The Materials Center

is open 8:30 pm to 5 pm, EST, weekdays.

ORTHOTICS

SILIPOS, Inc, makes orthotics, adaptive pads and gels for people with foot

problems. As diabetes is the biggest source of non-traumatic amputation in the

U.S. today (and "non-traumatic" in this case means not caused by war,

explosion, or violent accident), many diabetics may need such equipment. You

and your podiatrist may want to look at their product line -- which seems to

forever have something new.

Also, SILIPOS has a first-rate diabetes information web page on their site,

well worth a look. Contact: SILIPOS, Inc., 7049 Williams Road, Niagra Falls,

NY 14304, telephone: 1-800-229-4404; website: www.silipos.com

DIABETES SUPPLIES

Inverness Medical Corporation carries a full line of discount-priced diabetes

supplies, including: Dex-4 glucose tablets, skin cream, and Excel test strips

for the Glucometer Elite monitor. The company also markets the Monoject line

of insulin syringes and lancets. Many Inverness (formerly Can-Am) products are

also sold as "house brand" at major pharmacy chains. Their low price

in no way compromises their high quality.

For information, contact: Inverness Medical Corporation, 200 Prospect Street,

Waltham, MA, 02453; telephone: 1-800-461-7448.

DIABETES INFORMATION

ECRI, the Emergency Care Research Institute, has established The Sharon H. Limaye

Center for Diabetes Technology Assessment and Patient Education Website: www.ecri.org/limaye

. The Limaye Center website offers, along with basic diabetes information, reviews

and assessments of diabetes technology, such as a comparison of blood glucose

monitors, and another of rapid-acting insulin products. The site also offers

links to many pertinent research and government web pages. Contact: The Sharon

H Limaye Center For Diabetes Technology Assessment and Patient Education, c/o

ECRI, 5200 Butler Pike, Plymouth Meeting, PA 19462-1298; telephone: (610) 825-6000,

ext. 5416; email: [email protected]; website: www.ecri.org/limaye

TACTILE INSULIN MEASURING DEVICE

For some years, the Count A Dose, from Jordan Medical, has been the best, most

dependable tactile insulin measuring device on the market. It could be safely

loaded and used without sight, and it facilitated reliable insulin mixing. Available

in either 1cc (for 100-unit) or 1/2cc (for 50-unit) BD syringe, it was a good

product, but in the last few years it has become increasingly hard to find.

That has now changed. Jordan Medical Enterprises has been purchased by MediCool.

Both sizes are now back in production. The "recommended selling price"

for the 1/2 cc model is $59.95, and for the 1 cc model, it is $79.95, from:

Medicool, 23520 Telo Avenue, #6, Torrance, CA 90505; telephone: 1-800-541-1193.

The National Federation of The Blind, National Center For the Blind offers both

sizes for $40 each. Contact: Materials Center, National Center for the Blind,

1800 Johnson Street, Baltimore, MD 21230; telephone: (410) 659-9314; website:

www.nfb.org.

NEW NO-CALORIE SWEETENER

McNeil Specialty Products Company, a subsidiary of Johnson and Johnson, has

received approval to market Sucralose, a new no-calorie sweetener derived from

sugar. The trade name is Splenda. Created by British researchers in 1976, the

sweetener has been subjected to more than 100 scientific studies, and has been

widely available in Europe since 1991. It has no calories, and does not promote

tooth decay; but, unlike some current alternative sweeteners, works equally

well in hot or cold foods, and already has replaced aspartame in some diet soft

drinks. For more information about Sucralose, telephone: 1-800-777-5363, or

see the website: www.splenda.com

HOME A1C TEST KIT

Doctors agree: the Hemoglobin A1c test is an important part of your diabetes

control. Given every three months, the A1c test allows you and your doctor a

good look at your average blood glucose control. Along with your daily glucose

monitoring, knowing your A1c average allows better medicine, diet, and lifestyle

adjustment. The problem is, not enough folks are getting regular A1cs - in many

cases they've found it "too inconvenient."

FlexSite Diagnostics announces the A1cAt.Home test kit. With this simple kit,

you use the provided lancet, deposit two blood samples onto the appropriate

test strip, fill out the form, insert into the special envelope provided, allow

the samples to dry overnight, and mail with payment to the lab. They will return

the results both to you and any doctor you indicate. You don't have to go the

doctor to get the test.

For information, contact: FlexSite Diagnostics, Inc., 3543 SW Corporate Parkway,

Palm City, FL 34990; telephone: 1-877- 212 - 8378.

ADAPTIVE INTERNET ACCESS

The Freedom Box is an adaptive computer device that allows the user to both

speak to the computer (instructions and text) and have the computer read back

whatever is on the screen -- with the express purpose of making the internet

more accessible. The company says: "This device allows the disabled user

full access to the internet just by talking to it -- it connects to your favorite

websites and turns all the links on the page into voice commands."

For internet access, it is necessary to use the Freedom Box's ISP. Broadband

service is available in some areas. Per month ISP pricing appears competitive

with major internet ISPs.

The user can purchase a stand-alone Freedom Box system, or an add-on for your

PC. All purchasers must complete and return a signed Eligibility Form, stating

that the user is unable to use print, due to disability.

Contact: Freedom Box, Serotek Corp., telephone: 1-877-661-3785; website: www.freedombox.info

PRESCRIPTION DRUG HELP

If you have prescription medications, and you can't afford them, you may know

a number of manufacturers provide free medications -- but the problem is finding

the right one, and then completing the paperwork. If you qualify (low income,

no prescription coverage), The Health and Wellness Educational Center will help

you find your necessary prescription medications, and will help with the paperwork.

Contact: (205) 652-6557.

DIABETES INFORMATION ON TV

ITV and Tulane Health Services Center are cooperating to prepare a 30 minute

TV special on living with type 2 diabetes. The show will concentrate on what

type 2 diabetes is, and on what you, the individual with the condition can do

to combat it. VHS copies of the program, "Managing type 2 Diabetes,"

will also be available for purchase. For information on air dates and times,

or to order a copy, contact ITV; telephone: 1-888-380-6500; website: www.itvisus.com

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

NFB CAPITAL CAMPAIGN SEEKS DONATIONS

From the Editor: The following piece appeared in the October 2001 BRAILLE MONITOR,

published by the National Federation of the Blind. The NFB, our parent organization,

is seeking to construct and equip its new National Research and Training Institute,

and is looking for donations from individuals and organizations who believe

the best authorities on coping with blindness are the blind themselves.

We, the Diabetes Action Network, and this magazine, VOICE OF THE DIABETIC,

owe our existence to the NFB. They've been doing good work for more than 60

years, and they are worthy of your support. To find out more about the NFB and

the work we do, contact: National Federation of the Blind, 1800 Johnson Street,

Baltimore, MD 21230; telephone: (410) 659-9314; website: www.nfb.org

WHOM DO YOU HANG OUT WITH?

When we think about who we know who might be in a position to make a capital

campaign gift to help build the National Research and Training Institute for

the Blind, it's easy to assume we don't know the sort of people who could help.

But Mike Jacqubouis of Maine is President of his local Lions Club, and, when

asked, they made a gift of $1,000. Jason Ewell of Ohio was a college student

when his father's Lions Club made a pledge of $25,000. Charlie Brown, Kiwanis;

Don Capps, Rotary; and Joe Ruffalo, Lions and Knights of Columbus, are all members

of the NFB national Board of Directors and personally active in service organizations.

Are you a member of a civic organization that makes grants to charities? Do

you have a close friend or family member who is? Such groups are willing contributors

to causes that their members support. Vince Connelly, who works on our NFB capital

campaign, needs to know what contacts we have. Don't put it off; contact him

today with useful information. His phone number is (410) 659-9314, ext. 368,

and his e-mail is <[email protected]>.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

THE CAMPAIGN TO CHANGE WHAT IT MEANS TO BE BLIND

Capital Campaign Pledge Intention

Name ______________________________________________________

Home Address _______________________________________________

City ___________________________ State _________ Zip ___________

Home Phone _________________ Work Phone ___________________

E- mail address _______________________________________________

Employer ___________________________________________________

Work Address ________________________________________________

City ______________________ State _________ Zip ________________

To support the priorities of the Campaign, I (we) pledge the sum of $___________.

My (our) pledge will be payable in installments of $ __________ over the next

____ years (we encourage pledges paid over 5 years), beginning _____________,

on the following schedule (check one):

__ annually __ semi-annually __ quarterly __ monthly

I (we) have enclosed a down payment of $ ________________

___ Gift of stock: _____________________ shares of __________________

___ My employer will match my gift.

Please list (my) our names in all Campaign Reports and on the

Campaign Wall of Honor in the appropriate Giving Circle as follows:

_____________________________________________________________________

__ I (We) wish to remain anonymous.

Signed: ________________________________ Date: __________________

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

NEW HIGH-TECH METER

Partners Novo Nordisk and LifeScan have developed the InDuo system, a combination

blood glucose monitor and insulin pen. The meter resembles the AccuChek Advantage,

with a touchable, "capillary-action" test strip that requires only

a small sample of blood. Controls are simple, results are fast (five second

countdown), the memory stores 150 tests, and the display window is big and contrasty

-- but this meter does not talk.

Pull the meter apart, top to bottom, and out comes an insulin pen. A big piece,

this pen uses Novo Nordisk's 300 mL insulin vials and NovoFine needles. The

pen adjusts with audible clicks, and its "memory" feature reminds

you what dose you took last time -- provided you can see.

It's a nice compact "all-in-one" (almost, the lancet is separate)

unit, but for the vast majority of us, type 2 diabetics who need to meter but

don't currently need to inject insulin, the InDuo is an answer in search of

a question.

For more information, LifeScan's website links to a special interactive site:

www.induo.com

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

HEAR YE, HEAR YE, A RAFFLE

The Diabetes Action Network of the National Federation of the Blind reaches

out and provides support and information to thousands of people. Because it

costs to operate this valuable network and to produce the VOICE OF THE DIABETIC,

we must generate funds to help cover these expenses. Our Diabetes Action Network

has elected to hold a raffle, which will be coordinated by our division treasurer,

Bruce Peters.

THE GRAND PRIZE WILL BE $500! The winning ticket will be drawn, and the winner's

name announced, on July 8, 2002, at the banquet held during the annual convention

of the National Federation of the Blind.

Raffle tickets cost $1 each, or a book of six may be purchased for $5. Tickets

may be purchased from state representatives of our Diabetes Action Network or

by contacting the VOICE Editorial Office, 1412 I-70 Drive SW, Suite C, Columbia,

MO 65203; telephone: (573) 875-8911. Anyone interested in selling tickets should

also contact the VOICE Editorial Office. Tickets are available now! Names of

persons who sell 50 tickets or more will be announced in the VOICE.

Please make checks payable to the National Federation of the Blind. Money and

sold raffle ticket stubs must be mailed to the VOICE office no later than June

10, 2002, or they can be personally delivered to Raffle Chairman Bruce Peters,

at this year's NFB convention in Louisville, Kentucky. This raffle is open to

anyone age 18 or older, and the holder of the lucky raffle ticket need not be

present to win. Each ticket sold is a donation, helping keep our Diabetes Action

Network moving forward.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

FOOD FOR THOUGHT

Artwork: Dancing fruits and vegetables

We invite blurbs and tidbit articles for inclusion in this column. Materials

received may be edited and used as space permits. Products and services included

in this column are for information only and do not imply endorsement by the

Diabetes Action Network of the NFB.

TEST YOUR KIDNEYS

One of the complications of diabetes (type 1 or type 2) can be nephropathy,

kidney damage. We know a lot of people (with diabetes or otherwise) have kidney

damage, and we know it can be treated, if caught early enough. The problem has

been to get those tests done - to make them more convenient.

FlexSite Diagnostics now offers the Kidney Screen At Home test, a simple and

convenient way to carry out the medically-accepted microalbumin test, without

the need to schedule a doctor's visit. Each test kit contains: instructions,

proper forms, test strip, disposable sample collecting kit, and mailing envelope.

You can test at home, mail the sample to FlexSite, and they will read it and

send the results to you and your doctor. For information, contact: FlexSite

Diagnostics, 3543 SW Corporate Parkway, Palm City, FL 34990; telephone: 1-877-212-8378.

BRAILLING SERVICE

We've been asked to announce: Suppose you need to send a letter, in Braille,

to a blind person - but you don't know Braille. What do you do? To the rescue

comes Hotbraille.com, a free brailling service. Write your letter, and address

it to the person you wish to receive it. Hotbraille will transcribe it into

Braille for you, and send it on to your addressee, as "free matter for

the blind," free of charge. Hotbraille can also translate your letter,

into 19 other languages.

Your letter should be no longer than two Braille passages, about 250 words

(about one page of typed, double-spaced, print.) Letters are usually processed

the day received, and then sent out as "free matter." Contact: Hotbraille.com,

2601 Mountaingate Way, Oakland, CA 94611, website: www.hotbraille.com

OBESITY HANDBOOK

Obesity is a major problem in the U.S. today. Sixteen million Americans have

diabetes, and 97 million Americans are overweight or obese - and the problem

is getting worse. But you control obesity, like diabetes, with quality information.

"THE PRACTICAL GUIDE: Identification, Evaluation, and Treatment of Overweight

and Obesity in Adults" is published by the National Heart, Lung, and Blood

Institute (NHLBI, publication # 00-4084), part of the National Institutes of

Health (NIH). It has clinical descriptions, food information, synopses of Carb

Counting and the Exchange List, discussions of "dining out," planning

an exercise program, and a discussion of weight-loss pharmacotherapy. Written

for the health professional, the book has much to offer the educated patient

as well, and is well worth the investment.

Available free for download (PDF format), or in print. Cost (print version:

$5.50, plus $2.50 shipping and handling) from NHLBI, Educational Programs Information

Center, PO Box 30105, Bethesda, MD 20824-0105; telephone: (301) 592-8573, or

on the web at www.nhlbi.gov

HUMOR IN CHURCH

(from the Internet)

A Sunday school teacher asked her little children, as they were on the way

to church service: "Why is it necessary to be quiet in church?"

One bright little girl answered: "Because people are sleeping."

* * * *

A four-year-old prayed: "And forgive us our trash baskets as we forgive

those who put trash in our baskets."

* * * *

The preacher was wired for sound with a lapel mike, and he wasn't having an

easy time with it. As he preached, moving briskly about on the platform, he

repeatedly jerked the mike cord. When he moved to one side, he got caught in

the cord, and nearly tripped and fell, before jerking the cord again. After

several more circles and jerks, a little girl in the third pew leaned toward

her mother and whispered: "If he gets loose, will he hurt us?"

* * * *

A little boy was overheard praying: "Lord, if you can't make me a better

boy, don't worry about it. I'm having a real good time like I am."

* * * *

A mother was teaching her three-year-old daughter the Lord's Prayer. They'd

recited it together, and now was time for the big solo. Proudly, the mother

listened as her daughter carefully enunciated each word, right up to the end

of the prayer: "Lead us not into temptation, but deliver us some E-mail.

Amen."

BOARD MEMBERS

The Diabetes Action Network of the National Federation of the Blind.

President: Ed Bryant

Columbia, MO

First Vice President: Eric Woods

Denver, CO

Second Vice President: Sandie Addy

Prescott Valley, AZ

Treasurer: Bruce Peters

Akron, OH

Secretary: Dawnelle Cruze

Portsmouth, VA

Board Member: Paul Price

Valley Center, CA

Board Member: Sally York

Castro Valley, CA

Board Member: Lois Williams

Huntsville, AL

ELECTIONS COMING UP

At this year's national convention in Louisville, Kentucky, elections will

be held to fill our Diabetes Action Network divisional board positions. These

are one-year terms, running from July 1, 2002 to June 30, 2003. Positions to

be filled are: President, First Vice-President, Second Vice-President, Secretary,

Treasurer, and three Board Members. If you are interested in a board position,

or know someone who you think would do a good job, then contact our Diabetes

Action Network President, Ed Bryant. Yes, hard work and dedication are prerequisites

for board positions -- but one must lead by good example.

HEALTHY SOUTHERN FOODS

When you're diagnosed with diabetes, those rich Southern foods are traditionally

the first things you've had to give up. As diabetes hits hard among people whose

traditional foods may be so described, this can be a problem - but now you have

some help. Wiley's Healthy Southern Classics is a new line of fat-free, cholesterol-free

seasonings designed to help you achieve a healthy diabetic diet: low in fat,

saturated fat, and cholesterol. Wiley's seasonings provide traditional flavors

without the need for bacon drippings, butter, cooking oils, or meat juices.

The Wiley's line includes 17 seasoning blends designed specifically for home

cooking. Use them in place of common home-style seasonings, and take a giant

step toward a healthier lifestyle. For more information, contact: Wiley Mullins,

Wiley's Healthy Southern Classics, 1220 Post Road, Fairfield, CT 06430; telephone:

(203) 259-1084; website: www.unclewileys.com

HEALING AID

We have been asked to announce: Slow healing of wounds and ulcers is a common

problem for many diabetics. In its extreme, the body's failure to heal can lead

to amputation. Doctors are always looking for more ways to help the body heal.

One approach is to use topical oxygen infusion of a wound site, by means of

a hyperbaric chamber. Massive, ponderous "full-body" hyperbaric chambers

were tried in the past (the doctor had to come in, too), but now there are small

chambers, just big enough for an affected limb (The Topical Hyperbaric Oxygen

Extremity Chamber), or even bag-like, made of soft plastic, designed to adhere

to an affected area. The manufacturer states The Disposable Sacral Topical Hyperbaric

Oxygen System will help heal stage 2, 3, and 4 wounds, and is designed to be

disposable.

For information, contact: Advanced Hyperbaric Technologies, Inc., telephone:

1-800-327-4325.

LOW-VISION AID

We have been asked to announce: Many people are "visually-impaired,"

in that they have difficulty with distance, or close up, or in bright light,

or perhaps in low light. They can "see," but they may need some help.

At home, or in the workplace, many people use CCTVs, big video magnifiers that

display onto a computer-type screen, but these systems are hardly portable.

Now there is a portable alternative.

The VisAble Video Telescope, from Betacom, looks like a little video camera.

Its zoom lens magnifies up to 20x, or down to .5x, for wide-angle viewing. You

can use it as a telescope, or as a macro-magnifier to read fine print or inspect

small objects. Its adjustable contrast allows you to see more clearly in very

bright or dim light, and it can "Hold" an image for further inspection.

Contact: Betacom, 450 Matheson Blvd East., Suite 67, Missisauga, Ontario, Canada

L4Z 1R5; telephone: 1-800-353-1107, or Betacom U.S.A., 1000 John R. Road, Suite

108, Troy, MI 48083-4317; telephone: 1-888-350-3155; website: www.betacom.com

INHALED INSULIN UPDATE

New York based Emisphere Technologies is working on oral delivery mechanisms

for a number of drugs previously limited to subcutaneous injection. One of these

drugs is insulin.

Because insulin is a complex protein, it would be digested and destroyed if

the diabetic merely swallowed it. Inhalation works, but the problem has been

to avoid the all-at-once "rush" effect, the quick spike and rapid

fall-off of drug activity. Companies working on the problem have tried to "buffer"

the "spike" effect, to moderate the body's response so the effect

of the medication could be kept safe.

Working with Hadassah Hospital in Israel, and with various labs in the Netherlands

and U.K., Emisphere has a number of phase 1 studies of its inhaled insulin under

way at this time, and its spokesmen describe their preliminary findings as "promising."

Stay tuned.

HEALTHY PASTA?

We have been asked to announce: Francesco Rinaldi Original Traditional No Salt

Added Pasta Sauce is cholesterol-free, has no saturated fat, and is low in fat

and sodium. It contains no additives or preservatives, and carries the American

Heart Association's "Heart-Check" mark, signifying a healthy food.

It's tasty! Francesco Rinaldi products are already available in the Northeast

U.S., and on the East Central and West Coast.

VOICE FORMATS

VIOCE OF THE DIABETIC is offered in two formats: standard print, and 15/16

ips audiocassette, "talking book" speed. Anyone who is currently receiving

the VOICE in print and having difficulty reading it, may receive it on cassette

at no charge. VOICE tapes require the special tape player available free to

the legally blind from Regional Libraries for the Blind and Physically Handicapped,

which can be obtained by telephoning the National Library Service at: 1-800-424-8567.

Note: Attempting to play VOICE tapes (or any other tapes in NLS format) on a

conventional music-speed tape player will yield incomprehensible "chipmunk

sounds."

All a subscriber needs to do, to switch from standard print to tape, or to receive

both formats, free of charge, is contact us at the VOICE OF THE DIABETIC Editorial

Office.

VETERAN'S NEWS

If you are a Vietnam veteran who was exposed to Agent Orange, you may have

developed certain medical conditions as a consequence. One of them may be diabetes,

and, until recently, veterans who believe their type 2 diabetes was as a result

of their service have not received a sympathetic hearing from the Veterans'

Administration. That is changing. The VA now estimates that perhaps nine percent

of the 2.3 million Americans who served in Vietnam have type 2 diabetes, and

the Federal Government is now prepared to pay benefits. The new rules have been

published in the Federal Register, so if you were refused benefits in the past,

it might be a good time to apply again. More information is available at VA

regional medical centers, offices, or on the agency's website: www.va.gov

The American Legion is prepared to help veterans with the VA claims process

and other claims matters. To locate an American Legion service officer in your

state, call the American Legion at: 1-800-433-3318, or see their website: www.legion.org

NEW URINALYSIS TEST

The National Kidney Foundation has just announced new kidney test guidelines,

with an eye toward getting many more individuals tested early, so action can

be promptly taken if kidney disease is detected.

There are several tests for the presence of kidney disease. Bayer Diagnostics

has just announced a new one. Multistix Pro Reagent Strips perform a simple

"dip and read" urinalysis test that measures protein, creatinine,

and the protein-creatinine ratio. After dipping in a urine sample, the results

can be read by the doctor's Clinitek 50 Analyzer in just 60 seconds, allowing

the physician to immediately discuss results with the patient.

Other kidney tests take more time and preparation, so the quick, in-office

results from the Multistix Pro represent a real advance in convenience.

To learn more, contact: Bayer Diagnostics, 511 Benedict Avenue, Tarrytown,

NY 10591-5097, telephone: (914) 631-8000. Bayer recommends interested readers

visit the National Kidney Foundation website: www.kidney.org

ARTICLES NEEDED

If you have diabetes, are a family member or friend of a diabetic, or a health

professional with an interest in diabetes, we invite you to submit an article

for publication in the VOICE OF THE DIABETIC.

Our philosophy regarding diabetes is positive. Do you have an inspiring, enlightening

story? We, the Diabetes Action Network of the National Federation of the Blind,

seek to show people they are not alone, and do have options, regardless of diabetic

complications. If you have experienced ramifications, others, who may be facing

the same side-effects, could benefit from what you have to say.

Perhaps you have not experienced complications--your unique insight, coping

strategies, and lifestyle can still inspire others. Are you a relative, a friend,

or a health professional? More than 303,515 Voice readers could benefit from

your story.

For information and article submission guidelines, contact: Voice of the Diabetic,

1412 I-70 Drive, Suite C, Columbia, MO 65203; telephone: (573) 875-8911.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

SUBSCRIPTION/DONATION FORM

The VOICE OF THE DIABETIC is a quarterly magazine published by the Diabetes

Action Network of the National Federation of the Blind (NFB) for anyone interested

in diabetes, especially diabetics who are blind or are losing vision. An outreach

publication, it emphasizes good diabetes control, diet, and independence.

Donations are gladly accepted and appreciated. Contributions are not only tax

deductible but are needed to keep the VOICE and the Diabetes Action Network

moving forward to help people with all aspects of diabetes.

Members of the NFB Diabetes Action Network enjoy priority services and unique

benefits such as a continuous free subscription to the VOICE, automatic access

to committees covering all aspects of diabetes, free counseling concerning all

facets of blindness and diabetes, as well as access to diabetics who have experienced

complications.

The VOICE is free to any interested person upon request. Each subscription

costs the Diabetes Action Network approximately $20 per year. To help defray

publication expenses, members are invited, and nonmembers are encouraged, to

cover the subscription cost.

To begin receiving the VOICE, please check one:

[ ] I would like to become a member of the NFB Diabetes Action Network and receive

the VOICE OF THE DIABETIC. (Members are entitled to special benefits.)

[ ] I would like to receive the VOICE OF THE DIABETIC as a nonmember. (Nonmembers

are encouraged to pay the institutional rate of $20/one year; $35/two years;

$50/three years.)

Send the VOICE in (check one):

[ ] print [ ] cassette tape for the blind [ ] both

and physically handicapped

(recorded at slower-than-

standard speed of 15/16 IPS)

Optionally check this box:

[ ] I would like to make (or add) a tax-deductible

contribution of $__________ to the Diabetes Action

Network of the National Federation of the Blind.

PLEASE PRINT CLEARLY

Name:_____________________________________________________

Address:__________________________________________________

__________________________________________________

City:_______________________ State:______ Zip:__________

Telephone: ( )________________________

Send this form or a facsimile to:

Voice of the Diabetic

1412 I-70 Drive SW, Suite C

Columbia, MO 65203

Telephone: (573) 875-8911

Fax: (573) 875-8902

Please make all checks payable to:

NATIONAL FEDERATION OF THE BLIND

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END of VOICE OF THE DIABETIC, Volume 17, Number 2, Spring 2002 Edition

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