Type 1 (Insulin Dependent Diabetes Mellitus)
The more severe form of diabetes is type 1, or insulin-dependent diabetes. It’s sometimes called “juvenile” diabetes, because type 1 diabetes usually develops in children and teenagers, though it can develop at any age. With type 1 diabetes, the body’s immune system attacks part of its own pancreas. Scientists are not sure why. But the immune system mistakenly sees the insulin-producing cells in the pancreas as foreign and destroys them. This attack is known as “autoimmune” disease. These cells – called “islets” (pronounced EYE-lets) – are the ones that sense glucose in the blood and, in response, produce the necessary amount of insulin to normalize blood sugars. Insulin serves as a “key” to open your cells, to allow the glucose to enter — and allow you to use the glucose for energy. Without insulin, there is no “key.” So, the sugar stays — and builds up– in the blood. The result: the body’s cells starve from the lack of glucose. And, if left untreated, the high level of “blood sugar” can damage eyes, kidneys, nerves, and the heart, and can also lead to coma and death. So, a person with type 1 treats the disease by taking insulin injections. This outside source of insulin now serves as the “key” — bringing glucose to the body’s cells. The challenge with this treatment is that it’s often not possible to know precisely how much insulin to take.

Type 2 (Non-insulin Dependent Diabetes Mellitus)
The most common form of diabetes is called type 2, or non-insulin dependent diabetes. This is also called “adult onset” diabetes, since it typically develops after age 35. However, a growing number of younger people are now developing type 2 diabetes. People with type 2 are able to produce some of their own insulin. Often, it’s not enough. And sometimes, the insulin will try to serve as the “key” to open the body’s cells, to allow the glucose to enter. But the key won’t work. The cells won’t open. This is called insulin resistance. Often, type 2 is tied to people who are overweight, with a sedentary lifestyle. Treatment focuses on diet and exercise. If blood sugar levels are still high, oral medications are used to help the body use its own insulin more efficiently. In some cases, insulin injections are necessary.

Insulin is a hormone produced by the pancreas. The pancreas has two primary functions. It secretes digestive enzymes and hormones. The hormones are produced by clusters of cells in the pancreas called Islets of Langerhans. Within these clusters are alpha and beta cells which regulate glucose in the body. Alpha cells produce glucagon which cause the liver to dump glucose into the blood stream and raise blood sugar levels. Beta cells produce insulin which facilitate glucose transport from the blood into the body’s cell and lower blood sugar levels. Without enough insulin in the blood stream, glucose cannot fuel the work of your body’s cells and symptoms of diabetes occur.

Much like athletes can perform better by having a coach or trainer to help them with their goals, encourage them on and suggest improvements, a diabetes coach is there to assist you with the game of diabetes. Most PWD only see their providers 3-4 times a year, which really isn’t enough to help them to make the necessary lifestyle changes they need to. During office visits, the precious time with the provider is spent understanding how your body is coping with your treatment plan. During coaching sessions, you learn about your motivation, set goals, understand your challenges, develop healthy strategies and get frequent support and feedback. It is also a place to voice your frustrations, journal about your feelings and be with an empathetic listener. Be prepared to have some of your ideas and habits challenged if we find they aren’t serving you. A diabetes coach can help you implement and stick to the treatment plan prescribed by our provider and diabetes educator.

A fifty-minute session is $150.00. I provide a 15% discount on package programs.

There are several options depending on your schedule and preference. I live in the Dallas / Fort Worth area and there are many quiet places to meet depending on your location. The first several visits will be in person or via Skype. It is important to see each other and make a connection. After that, we may alternate with face to face meetings and phone calls. In between sessions, I encourage you to text or email me with updates.

There are countless articles on the subject of diabetes and depression, but from my personal experience and nursing education, I believe that much of the negative emotional issues that accompany diabetes is related to incomplete grieving. Dictionary.com defines grief as: “[greef] noun 1.keen mental suffering or distress over affliction or loss.” We can all agree that learning you have diabetes for the rest of your life is a cause for distress and worry as you realize life will no longer be what you are used to. You literally lose your old life. And that is worth grieving. There are 5 stages of grieving as defined by David Kessler and Elizabeth Kübler-Ross in their book On Grief and Grieving. They are familiar when you translate them into conversations about diabetes:

Denial – “There must be some mistake. Are you sure those are my lab results?’ “Not me, I just have a touch of diabetes.” “My sugars are always good, I checked it last week.”
Anger – “The doctor is an idiot. It’s not possible, no one in my family has diabetes”. “This sucks! I hate diabetes!”
Bargaining – “If I don’t eat any carbs and work out, I will be fine”. “I can take pills but I am not taking insulin”. “If God I promise, if you take this away, I will do whatever you want”
Depression -‘There is no hope”. “No one understands.” “I want it to just go away. I can’t do it anymore”
Acceptance – “Ok I am still alive.” “I still have choices.” “I will take control and do it on my terms.” “I got this.” “Diabetes doesn’t mean a bad life, just a few more things to manage”
Sound familiar? I think the emotional side of diabetes is far more difficult than the medicine and testing. We spend a lot of time in coaching exploring these topics.

I bring a unique perspective on what it really takes to live happily with diabetes. Engagements include keynote address, community events, and online webinars. In addition to a customized presentation for your audience, she offers these standard presentations

Both Sides of the Needle – a personal account of the chasm between the healthcare system and the patient experience
Dealing with Diabetes – what it really takes to live well with diabetes
The cost of Presenteeism – exploring the impact of diabetes in the workplace
Diabetes 101 – understanding the basics in a visual and easy to understand format
Non-c0mpliance – why it really doesn’t exist in healthcare (geared toward medical audience)
Empowered patient – the secret to improving health in America

Although other chronic illnesses share many of the same issues, my area of expertise is diabetes so I limit my practice to persons with diabetes only.

According to CDC ‘s latest reports from 2012 diabetes costs $245 billion in the US for medical costs, lost work and wages. More than 20% of all healthcare spending in the US is for PWD. These estimates are considered to be low as they do not include the costs of self-pay care or the impact of lost wages and work from those who are undiagnosed.

According to CDC reports in 2015 there are over 19 million working age Americans (age 18-65) that have diabetes which totals 10% of the US workforce. One in three American adults have pre-diabetes (blood sugar is higher than normal, but not yet at level to meet diabetes diagnosis criteria) and don’t know it! Indirect costs such as absenteeism, presenteeism and disease related disability total over $50 billion according to this CDC Report

Presenteeism is a loss of worker productivity, both in quality and quantity, when they are not feeling their best. Studies have definitively shown that pain and depression (common with diabetes) can significantly impede performance as much as 30%. Presenteeism is hard to track since employees physically come to work but may take more breaks, make more mistakes and be off task. Some studies have estimated that presenteeism may cost US businesses from $82-150 billion annually and is costlier than absences or disability. Logically it makes sense. If you aren’t feeling 100%, you aren’t likely to be giving 100%.Presenteeism impacts your most valuable asset as an employer, your Human Capital. Investing in your workforce with wellness initiatives can impact your bottom line with a healthier workforce that is at maximum performance.