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If you could see all of the activity around me today, you would know that the answer to that question is “yes.”  Of course I would say that as a librarian, but the last few days have brought home to me how much our services are needed.

There is so much information available on the internet that people need someone to sort through information for them.  Librarians find creditable sources and libraries pay to use online databases that the general public cannot afford as individual  subscriptions.  Yesterday I showed a mother the Tumblebooks link on our kids page.  With a computer, children can see the pages of picture books on which the words are highlighted while the computer reads the text aloud.  I also explained the Maker Lab to a very excited patron.These are two of the many resources you can access with your library card.  We offer e-books and audiobooks that can be downloaded to your mp3 player through Overdrive, streaming movies from Hoopla, magazines through Flipster, music downloads through Freegal and a language learning program called Mango.  All of these services can be accessed from home through whatever internet device you own.

We currently have two terrific apps for your mobile device: the ACPL mobile app lets you browse the catalog, check the events calendar, store your library card info and renew books with a touch of your screen; the family app has games, information and much more to offer to parents of young children.  You currently need to have an Apple device to access the family app, but I’m told it will be available for android in the future.

Libraries are gathering points for the community.  Parents attend the same story times each week with their children and make friends with other parents.  Groups use our meeting rooms for quilting, dance, yoga, scrap-booking and, of course, meetings.  ACPL has its own theater and art gallery. There are also live music concerts throughout the year.  This summer ACPL again offers Rock the Plaza concerts outdoors on Saturday evenings.  Oh, by the way, we also have books.

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Diabetes and DADs

The Allen County Public Library has many books about health and disease on its shelves. Since November is National Diabetes Month, I am going to focus on diabetes. Nearly 26 million Americans have diabetes and an additional 79 million have prediabetes and are at risk of developing the disease.  There are many other diseases and diagnoses that people come to the library to research.  Diabetes is just the example. If you have questions about researching any health topics, please contact Ask a Librarian.

lifesaving labradorsThis is the fourth and final entry in a series about diabetes, and it is the one I am most excited about because I am planning to add a DAD (Diabetes Alert Dog) to my life in the near future.

Service dogs have been in use for many years as guide dogs to the blind and as military and police animals to sniff-out drugs and explosives, but formal training for guide dogs did not begin until 1975. Other types of service animal training for individuals has developed since that time.  In 2011 the ADA (Americans with  Disabilities Act) defined it as:  “Service animal means any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability. … The work or tasks performed by a service animal must be directly related to the individual’s disability.”Hero Dogs

Service dogs are used to alert someone with diabetes when they are having changes in blood glucose (bg) — usually before even a continuous glucose monitor picks up the changes.  We’re pretty sure they can smell changes in blood glucose, but scientists have not been able to prove that. They are trained to scent both low and high bg using dental cotton that the person with diabetes has filled with saliva during episodes of low and high bg. DADs wear a harness when they are working, like many other service dogs.  They will use whatever signal they are taught to use to alert their person (a paw on the knee or a nose in the hand) and not stop alerting until they see that the person is responding.  If their persons do not respond, the dogs tend to look for someone else (usually a family member) to notify.  They will go so far as to roll a person out of bed if he or she is not responding.  DADs save lives.  I won’t be getting a dog until next December, but I am getting very excited about the idea.  This will give me some freedom from worry.  My family will be relieved, too.  I have had several incidences at night where my insulin pump failed, usually because of problems with the tubing.  A dog would have alerted me much sooner that I had a problem and I would not have had blood glucose readings higher than my meter could read.  foundThat’s a pretty scary experience.

Going too low can be just as scary and dangerous.  Children in particular have blood glucose readings that swing dramatically from one extreme to another.  People who have had diabetes for a long time also have problems with control and complications. A DAD will alert any time you are going low or high, and if both the individual with diabetes and the dog are properly trained, it can help prevent accidents such as those due to driving with high or low blood glucose.

DADs are companions as well as lifesavers.  They make it more possible for people with diabetes to live alone and for students to go to college without their parents constantly worrying about their well being.  Parents are still going to worry, but a DAD will take some of the edge off the worry.

I hope these four posts have taught you a little about diabetes.  They should also have shown you some of the many ways you can find information at the library.  We have books, journal articles, government websites, videos, computers, and more.  If you are having trouble finding what you need, a reference librarian will be happy to help you get reliable information.  Please remember that researchers for any disease need funds, so if you have a cause that you feel strongly about, please consider donating to the cause of your choice.

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Diabetes – R&D

The Allen County Public Library has many books about health and disease on its shelves. Since November is National Diabetes Month, I am going to focus on diabetes.  Nearly 26 million Americans have diabetes and an additional 79 million have prediabetes and are at risk of developing the disease.  There are many other diseases and diagnoses that people come to the library to research. Diabetes is just the example. This is the third in a series of four posts about diabetes.  If you have questions about researching any health topics, please contact Ask a Librarian.


Research and Development

pumpsI have lived with type 1 diabetes for 40 years and the changes in treatment are in some ways tremendous, but in other ways they have changed very little. Some of the changes are as simple as being able to check your blood glucose with a home monitor. Insulin pumps are a good way to approximate the way insulin is delivered by your body, but what has not changed is that there is no cure for the disease. We only have ways to treat it that do not eliminate the disease.

Insulin is not a cure. It is a synthetic hormone that replaces the insulin produced by your body, but then you have to fit your lifestyle and your eating patterns to the drug, rather than the other way around. This can be a very rocky road. I use an insulin pump and 4-6 blood glucose checks per day, but that by itself it is not a perfect solution. A perfect solution would sense changes in blood glucose and react by adding glucose or insulin as needed. There are some companies with continuous glucose monitors that can notify the insulin pump of changes, but you still have to do a finger stick to see what is really happening and adjust the insulin dose from the pump accordingly.

The exciting changes, however, are coming very quickly. Right now researchers are working on several different ways to treat type 1 pancreasdiabetes that are approaching the way your body was designed to work. Several companies are working on artificial pancreas devices that would take the human element out of the equation. These have both insulin and glucagon to address high and low blood glucose and are run with a modified iphone. The artificial pancreas is a fascinating device, but it is still a device that has to have insulin and glucagon reservoirs and runs the risks of any device — it can malfunction. They have entered into human trials of these in Europe.

Other companies are working on the development of “smart insulin.”  One daily injection of smart insulin circulates in the bloodstream and only turns on when it is needed.  It turns off when it isn’t needed.

The development I am waiting for is one that researchers have been working toward for nearly 50 years. Beta cells are the cells that produce insulin in your pancreas. Transplantation of beta cells has been a difficult goal because diabetes is an auto immune disease, or one in which your body attack its own cells. Beta cells are the target of the antibodies that cause diabetes. There are now human trials for encapsulated beta cells that allow insulin to get out, but do not allow the auto immune antibodies to get to the cells. The first human implantation of beta cells occurred on 10/29/2014. Researchers are also looking for a way to stop the destruction of beta cells in newly diagnosed diabetics and to restore pancreatic function, which may be the best idea of them all.  Changes in diabetic treatment are so recent and moving forward so quickly that you need to use our e-resources databases to find much information.  There are also government webpages that can be accessed through our online catalog.  These developments are so exciting that I think we may see a cure for diabetes in my lifetime!

 

 

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The Allen County Public Library has many books about health and disease on its shelves.  Since November is National Diabetes Month, I am going to focus on diabetes.  November is also blogging month, so I am writing a blog entry each week for As You Like It.  Nearly 26 million Americans have diabetes and an additional 79 million have prediabetes and are at risk of developing the disease.  There are many other diseases and diagnoses that people come to the library to research.  Diabetes is just the example. If you have questions about researching any health topics, please contact Ask a Librarian.


Complications

guide

Diabetes is an insidious disease.  It affects not only the pancreas and its ability to process carbohydrates, but it can lead to complications in most of the other systems of the body.  Complications of the nervous system, circulatory system, digestive system, skin, eyes, kidneys and skeletal system can occur at any time, but usually come after a long period of uncontrolled blood glucose. The risk of complications can be reduced but not eliminated by tight control of blood glucose.

Changes in the eye caused by diabetes are one of the first signs of complications that can be detected. The retina is one of the ways that the health of small blood vessels can be observed.  An eye doctor will dilate your pupils in order to look at those blood vessels.  If the blood vessels in your eyes are healthy, chances are that your other blood vessels are healthy, too.  Diabetes is the leading cause of blindness in adults, but tight control of blood glucose levels will help prevent blindness as well as other complications of the eye that are more common in people with diabetes than they are in the general population, including glaucoma and cataracts.

Nearly 50 percent of all people with diabetes will eventually develop neuropathy — damage to nerves throughout the body. Damage to nerves and to small blood vessels can contribute to kidney failure, which  is eventually developed by 30 percent of all people with type 1 diabetes.  Neuropathy also causes a loss of sensation in the hands and feet, which can lead to a failure to notice and treat injuries before they become bigger problems.  Broken bones in the feet can cause deformities that can rub inside shoes, forming ulcers that can lead to amputation.

People with diabetes have an increased risk of heart disease, stroke, high blood pressure, elevated cholesterol and a decreased resistance to infection.  Each of these possibilities make life challenging for people with diabetes.  If you would like to know more, look in the ACPL catalog or come to any library in Allen County for books and journal articles.

There is good news.  The Centers for Disease Control reported in April that the rates for diabetes complications have fallen even though the number of people with diabetes has tripled in the last 20 years.  This decline is attributed to advances in treatment and understanding of complications.  Next week’s entry will be about advances in treatment and research.

 

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The Allen County Public Library has many books about health and disease on its shelves. Since November is National Diabetes Month, I am going to focus on type 1 diabetes.  Nearly 26 million Americans have diabetes and an additional 79 million have prediabetes and are at risk of developing the disease.  There are many other diseases and diagnoses that people come to the library to research. Diabetes is just the example. If you have questions about researching any health topics, please contact Ask a Librarian.

How much do you know about diabetes?  Take this short quiz.

 

These are just a few of the hundreds of books related to diabetes in the ACPL catalog

What is diabetes?  The simplified version is that it is the body’s inability to take glucose from the bloodstream and move it to the cells where glucose provides energy for everything your body does.  The key to moving glucose molecules into the cells is insulin. Some people have type1 diabetes, which means their bodies do not produce insulin.  Others have type2 diabetes, which is an insulin insufficiency.  People with type2 either don’t produce enough insulin or they don’t produce the right kind of insulin.  Their bodies are resistant to insulin.  November is National Diabetes Awareness Month, so I plan to write a little about the disease every Wednesday this month.  Today’s installment is about a day in the life of diabetes type1.  I have had type1 diabetes for 40 years.  I have used several different types of insulin in those years with anywhere from 1 to 6 injections of insulin per day.  I currently use an insulin pump, which delivers a basal amount of insulin 24/7 via a tube inserted under my skin.  When I eat, I calculate how many grams of carbohydrate I consume and based on rates programmed into my pump, it calculates how much insulin to deliver in a dose called a bolus.  The bolus can be a normal bolus(delivered all at once), a square bolus (delivered over a period of time) or a dual bolus(split between a normal and a square bolus).

This is my log for November 1 2014:

2:15 a.m. I woke knowing my blood glucose (bg) had rebounded to high  from a low yesterday evening.  I took a 5 unit bolus without checking my bg because the monitor was downstairs and I did not want to put on my boot to go get it (I have broken bones in my right foot and am wearing a fixed ankle boot during the day.)  That’s not the best idea, but we do what we can.

8:30 a.m. I checked my bg – it was 389.  (90-100 is normal)

9:00 a.m. I took a 9 unit bolus to bring bg down.

10:30 a.m. bg 84.  Lunch isn’t until 1:00, so the bolus brought it down too quickly.  I ate 10 g of carbohydrates and suspended my insulin pump so that it did not continue to give me a basal dose while my bg was low.

11:00 a.m. bg 87.  If that stays stable I should be fine until lunch.

12:00 p.m. bg 64  Called daughter who lives close to bring candy;  I don’t have any with me today (unusual).  Pump is still suspended, but 3.1 units of insulin are still active in my body from the 9:00 a.m. bolus.  My daughter brought me a can of pop.  37g carbohydrates.  Turned pump back on so it was again giving me a basal dose of insulin.

1:00 p.m. bg 192  Time for lunch.  I had a queserito from Taco Bell.  I estimated it at 32g of carbohydrates. My pump calculated 2.8 units of insulin for a normal bolus and 2.2 for a 30 minute square bolus for a total af 5 units.

3:00  p.m.  bg 362.  Queserito was actually 62g of carbohydrates.  I plugged this information into my insulin pump and it calculated that I needed 1.6 more units of insulin.

5:30 pm. – pre- driving home bg check.  bg 286.  Pump calculated 2.0 bolus of insulin.  Work ends at 6:00.

6:45 p.m. – home for dinner.  bg was 232.  I ate a hamburger patty, corn and green beans for dinner.  45 g carbohydrates.  3.8 units normal bolus, 2.8 units square bolus over 30 minutes.

9:30 p.m.  bg was 210.  No bedtime snack needed. The reservoir on my pump was empty, so I filled a new one and changed the insertion site and the tubing. I turned the clocks back and went to bed at 10:00.

My activity level for the day was low due to the broken bones in my foot.  My day at work was mostly spent seated and my evening at home was spent reading.  Different activity levels require different responses with the pump and can make bg go low very quickly.

Fasting bg Nov 2: 116.

 

Please come back next Wednesday to read about complications that can develop from diabetes.

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Breastfeeding: take two

Breastfeeding has become taboo in some ways in our culture.  As working moms, we have had to deal with the decision how to feed our children, and figure out how to mesh that with our time away from our children. Meg and I would like to share our journeys through breastfeeding with you. There are some similarities in our stories – we both have two children: older boy followed by a girl. But every child and every experience is different.

The Decision

Meg: Four years ago when my husband, Steve, and I decided to try for a family, the thought of how we were going to feed that child once he/she arrived did not concern us much. We knew I was a breast-fed baby, but the only reason my mom chose that option was because she was single and poor (her words, not mine). She could not afford formula, so the decision was made for her. I also knew she enjoyed it and didn’t regret she had to feed me that way. Steve and I had a different situation — we could either breast feed or formula feed. It was up to our discretion. As we moved through a very normal pregnancy we decided breast feeding was something we wanted to try. We weren’t bound and determined we were going to succeed; just that we wanted to try.

Sara: My mom breastfed me and my four siblings. I always knew that growing up. It seemed like my mom remembered the experiences fondly.  When my partner David and I found out that we were expecting, nursing was one thing that we were in agreement on, though we didn’t discuss it much. All of my research confirmed that breast is best. We were hoping for a natural birth and me feeding our child.

The First Time Around

Meg: baby 1When we found out at 26 weeks that our son was going to arrive a lot earlier than we anticipated we were still committed to our plan. I went on restrictions at that time, got two steroid injections, and we waited for our little fella to make his entrance into the world. He arrived at 34 weeks, six days. He was over five pounds, and by all appearances very healthy. He spent one night in NICU and came home with us just two days later. Steve and I were in a panic. Did the doctors really know what they were doing? Shouldn’t he stay in the hospital a little longer being monitored by nurses who had experience and knowledge when it came to pre-term babies? No to all of that! So there we were, first time parents with an early baby who cried a lot, couldn’t sleep, and wanted to eat all the time. We were a hot mess!

Sara:

nursing new baby 10.11.08 - photo by Kat Hickey

Photo by Kat Hickey

My mom and sister had both delivered their babies “late” (after the estimated due date at 40 weeks).  I had a feeling that my baby would be born after my due date and wanted to find a care provider who would support letting this happen. I switched from an OB to a midwife at 30 weeks (7.5 months) pregnant.  I didn’t end up going into labor until I was over a week past my due date. My labor was very long, and after several hours of pushing with no progress, my son was born via cesarean. There were no complications and he nursed within a half hour of birth in the recovery room. The tubes and wires melted away from my awareness – it was all about the tiny person I was finally getting to hold in my arms and nurse. After my surgery, I was not very mobile. David was wonderful at changing diapers and outfits. I was very good at sitting and eating and nursing our baby. 🙂

(more…)

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Three Rivers Festival, once again, brings Food Alley to Headwaters Park. To indulge your junk food urges once a year is probably not harmful and can be part of the festival experience. There is even a free trolley ride to Headwaters if you’re downtown at lunchtime. Easy peasy.

I confess to visiting Food Alley several times over the years, and I don’t ever remember seeing nutritional information or calorie counts on a booth menu or promotional sign. And, no wonder. Knowing more about those bad little goodies you’re eating would take away some of the enjoyment. If you are counting calories though, or have dietary restrictions, buyer beware.

According to the website Livestrong.com, Dietary Guidelines for Americans 2010 provides estimated calorie needs for adults based on average height and weight. Based on those estimates, daily calorie needs for men range from 2,000-3,000, and for women, 1,600-2,400 calories. Buying a large Philly Cheesesteak sandwich? At 900 calories, you’re getting about half of your daily requirements in that one sandwich, plus 40 grams (g) of fat. Yes, you’re getting some protein and carbohydrates but also a whopping 1,000 milligrams (mg) of sodium. Cutting the sandwich in half and sharing it might be a wise move. I admit to liking a good lemon shakeup, but at around 200 calories (11 calories from lemons, 190 from a quarter cup of sugar), I don’t indulge too often.

There are wiser choices that can be made when grazing Food Alley, or, at least, less damaging choices. One turkey leg has about 210 calories with the benefits of 29 g of protein and healthful omega-3 and omega-6 fatty acids. Sodium content is relatively low at 77 mg. If you have to end your meal with something sweet, a slice of pumpkin roll at 370 calories with 280 mg of sodium would be a better choice than an elephant ear at 526 calories, without the sugar, and 1,112 mg of sodium.

Deep fried vegetables sounds like a healthy choice because, well, it’s vegetables, right? I frequently opt for the fried veggies myself. Although I couldn’t find exact calorie content, Livestrong.com says that nutritional value of deep fried vegetables varies with the cooking conditions. Be aware that the frying destroys vitamin E content and decreases vitamins A and beta-carotene (orange pigment in carrots and sweet potatoes that is beneficial to skin, eyes, and vision). Also, the repeated use of reheated frying oil can destroy antioxidants in each batch of vegetables. Anyway, the thought of reheated frying oil is not exactly appetizing.

The Livestrong.com website is helpful for comparing nutritional content of food. I also like the Eat This, Not That series of books by David Zinczenko, which show side by side photos of junky food and the wiser alternate choice. So, be smart in Food Alley and forgo that trolley ride so you can walk off some of those calories you just consumed.

 

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