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

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

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.

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

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
National Advertising Sales Manager
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.

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

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.

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

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

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

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!

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

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.

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

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.

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

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.

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

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

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

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.

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

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

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

END of VOICE OF THE DIABETIC, Volume 17, Number 2, Spring 2002 Edition

Back to Top