The 5th step in Transforming Diabetes involves the results we realize.  Remember, we never “arrive.”It’s the journey not the destination.  One of the agreements we made early on was to treat our results without judgement and take pleasure in them.  Step 5 is about celebrating our results.  So, lets see what we have.  We established 3 goals.  There will be results.

Exercises:The Exercises in this section come a little early.  Write at least one page for the following.

Our Goals/Objectives/Desired Outcomes were:

1.) To engage in the process with 100% commitment and as a player.  What are your results from setting this as a goal and working the process?

2.)  To reduce suffering for ourselves and others.  What are your results from setting this as a goal and working the process?

3.)  To achieve more balanced blood sugar and eventually receive A1C results below 7.0 on a continual basis.  What are your results from setting this as a goal and working the process?

Now take the time and the energy to validate yourself and to celebrate your results.  You will have achieved results.  Under no circumstances should you allow yourself to invalidate your results or beat yourself up for falling short.  That may be done in other environments where goals are set and results are assessed.  Not here.

The next part of step 5 is to close the loop by circling back to step 1.  Whatever your results you have moved along the path.  The way to keep moving is to re-commit to either the same goals and objectives or make some new ones if you are ready to “step it up” or “go to the next level.”  This process is cyclical not linear.  If you loop back with judgement and invalidation you inject that into your process.  Loop back with validation and celebration and that is what you will cultivate into your life experience.

Yoga:

If you are have found value in the yoga practice then I strongly encourage you to pursue it further.  It has been an invaluable tool for me in creating movement and balance.  If it has not been of value to you then let it go but do something else that is physical and gets you centered.

Thank you for allowing me to describe to you my process and to guide you through it.

In the final post I will wrap up the Transforming Diabetes Series and present my vision for future work.

Transforming Diabetes ****** Chakras

1. Goals/Objective/Seed Level  ******Root

2. Functions/Component Parts ******Relationships/Desires

3. Integrated System ****** Balance/Power/Energy

I see the first three Chakras, as a group, to be a triple burner type cycle.  The intent in yoga is to open these energy centers and create alignment amongst them.  It is only when you open and align the lower three chakras that the energy moves to the fourth.  Most human beings have their energy stuck somewhere within the lower three chakra areas.

The fourth Chakra is the Heart Center.  It is located 2-3 inches above the solar plexus in the center of the chest.  It is the love center and represents unconditional acceptance, love and compassion.  When the lower three chakras are open and in alignment then the energy moves into the fourth chakra; the Heart Chakra.  Open chakras are characterized by how fast they spin.  The faster the better.  Closed chakras are shut down or blocked and spin slowly or not at all.  As we work the three steps in the triple burner we are spinning, moving, learning, doing.  As we get things moving here and cycle through them as much as we can based on the feedback we are receiving then we begin to align things and when this happens we enter the 4th step in Transforming Diabetes.

The fourth step is Ilumination and Mastery.  Whereas in the first three steps we were doing, when we reach the fourth step we are becoming.  This is where the shift in perspective takes place.  This is where enlightenment happens.

Due to our willingness to do what it took to work steps 1-3 and to get back in posture as soon as we can we are now given the opportunity and ability to move from the high wire to the plane.  The fourth step just happens.  There is only one thing to do and that is to be the observer.  Watch.

In the fourth step we gain wisdom and start becoming more intuitive and response-able.  We feel and see from the heart.  It is so healthy for Type 1 diabetics and those close to them to reach this point.  This condition is such a difficult thing to cope with, let alone accept.  But the reward is worth the hardship we had to endure.  That is the nature of things; “The bigger the front, the bigger the back.”

It is easy to slip back into the lower three chakras and it will happen from time to time.  Now you know that all you need to do is get them spinning again.  Work the three steps that make up the triple burner and mastery is close at hand.

The Chakras above the heart chakra are all included in step 5, the final step, of Transforming Diabetes.

Exercises:

1.) Become the observer.  Become aware of the nature of your quick reactions.  Restrict these reactions.  Watch what happens.

2.) Write at least one page beginning with the words.  I am so thankful for……

3.) Spend 1 hour in the woods, at a park, at the beach or any other place with a lot of nature and just observe.  Observe what you see, hear, taste, smell and feel. Thoughts may arise.  Don’t entertain them.  Let them pass away.  Focus on what you are observing.

Yoga:

It is now time for you to explore your own yoga practice.  Research studios in your area and check out their schedules.  I am familiar with several types of yoga and I am certified in Kripalu yoga – www.kripalu.org.  I practiced Bikram yoga for 6 years intensely.  I am now more into Vinyassa flow, Yin Yoga and Pranayama (Controlled Breathing) yoga exercises.

In the next section I will introduce the final step of the process.

1.)  Established your Insulin dosage requirements.  Basal, Insulin to Carb and ISF

2.)  Become consciously aware of the number of Carbohydrate and Fat grams you are ingesting and are getting better at knowing what you are eating.

3.)  Explored and investigated how other factors influence your blood sugar and insulin efficiency.  Factors like,  amount of carbs/fat per meal, jogging, yoga, meditation, going to the dentist, driving your car.

4.)  You are testing your blood sugar at least 10x/day.  You are beginning to understand spikes, peaks and trends.

If you have not completed or engaged in all four points above then you are not ready to move on.  STOP.  Go back and review the three goals.  Where are you not 100% accepting or committed?  Where or what is the resistance?  Identify the resistance and apply what you have learned from this process so far to resolve it.  Return to this point in the process when you have completed or are 100% engaged in the four requirements above.

If you are confident that you are on track then you have a green light to move forward.

Our mission in this step is to put everything together into an integrated system we understand and can work with.  We are already 80% there as a result of the work we have done.  If you are a type 1 diabetic and came into this process with A1C’s above 7.0 you may be experiencing some frustration in some of the blood sugar results you may be getting.  This is normal.  I go high often.  Remember, our goal is not perfection; normal blood sugars.  Our goal is to average below 150 mg/dl.  This means that you will go above 150 often.  It is the nature of what we are dealing with right now.

Our process kind of looks like this so far:

3. Create Integrated and Optimally Functioning System

2.  Identify and Understand  component parts

1. Establish and commit to Goals/Objectives/Desired Outcomes

(I want to make this a cycle like image)

Yoga is a system with objectives and component parts.  These three “steps” in the process are what I call the lower three or the triple burner.  This is where the “work” and “practice” occurs.  The attitude in which we engage in these three steps will determine the results we experience and quality of feedback we can gleen.  The “seed” level is in step one.  Our attitude here must be one of acceptance, commitment and non attachment.  As we move to step two we begin  to see more clearly.  We add the characteristic of genuine interest and a desire to know and understand.  Moving to step 3 we unleash our creativity.  We are one step away from mastery.

There are many approaches one could take to creating an integrated, optimally functioning system for type 1 diabetes.  It depends on your strengths, your weaknesses, your wants, your expectations.  Whatever the case the primary relationship in this system is the balancing of two seemingly polar components; Carb/fat intake and Insulin.  When we were diagnosed it is like we are sent to the circus to perform the high wire act.   We are given a five foot balancing stick in our hands.  On either side of the stick we have weights that hang down.  The high wire represents blood sugar level and the weights represent insulin injections on one side and carb/fat grams on the other side.  On the top of our head we need to account for and balance any change in physical exertion or exercise.  We are constantly having to negotiate strong and sudden gusts of wind represented by stress, the common cold, injection or insulin port site issues, quality of insulin, uncertainty in how much we are really eating, etc.  A fall to the right and we experience a low blood sugar episode.  A fall to the left and we experience high blood sugar.  Trending too fast down or too fast up makes for unique and interesting experiences and challenges.

The day we were diagnosed we were sent to the circus to perform.  Some of us never really accept this life circumstance that is suddenly cast upon us.  Instead we choose to deal with the grief, the sadness, the depression, the anger, the denial, the resentment, self-pity, the difficulty.  This is understandable and normal.  Those of us that are in this place are still required to “walk the wire” everyday but we tend to do it with eyes closed or stop when we fall and stay there as long as possible.

A yoga teacher of mine once said to me after I told her I was a type 1 diabetic, “Now that is a yoga pose!”  Confronting, understanding, creating and committing to a systems approach in response to type 1 diabetes is the same as being in Asana (A yoga pose).  Yoga means union.  The practice of yoga seeks to discover a method to experience and maintain union and balance between body, mind and spirit.  Transforming Diabetes takes the exact same approach to the task at hand.

Another yoga teacher once said during class, “falling out of a yoga posture means that you are normal.  Getting right back in means you are a yogi.”  Everyone falls off the wire.  Getting right back up is what leads to mastery.  It is a continual process of trial and error.  I fall off.  But I don’t fall off as often and I am not down as long as I use to be.  And the more I get back into posture the longer I am able to stay in posture.

Moving from the high wire metaphor to the plane analogy represents what happens when you have done the work in the triple burner sections of this process and made the shift in  perspective that Transforming Diabetes seeks to achieve.  You will know when you have made the shift when:

1.)  You want as much feedback as you can get.  You are testing 10X per day.  Perhaps you are using a CGM.  You want to know where you are at.  You understand that this is a challenging task and you have made it your number 1 priority in your life, whatever that takes for you.

2.)  You are confident that you know what your basal rate, Insulin to Carb Ratio and ISF are.  You test them constantly understanding that it is not an exact science but rather an art form.  You can see and feel the subtle influences that can affect blood sugar and insulin efficiency and are becoming more an more capable of making the appropriate corrections and adjustments.  You are on the insulin pump or you are looking into it because it is the best way to deliver insulin.

3.)  You know with a reasonable degree of certainty how many carbohydrate and fat grams you are ingesting and you focus on feeding yourself proper food with an attitude that less is better in this area.

4.)  Everyday you exercise.  You want your body (vehicle, plane) to be in optimal shape.  If you are going to be up there you might as well create and enhance your equipment.  You want to fly in the sleekest, fastest, stealthiest and most responsive vehicle you can.

5.)  You are experiencing more peace, wellness and harmony.  You have achieved a sense of control over your condition and you feel good about it.  Everything in your life improves because your relationship to yourself has improved.  People close to you are proud of you and less worried about you.  You have reduced your suffering and theirs as well.

This is the system and these are the results.

Exercises:

1.)  Write at least one page beginning with the words…..In order to move from being on the high wire to flying my own plane I need to……………………

2.)  Go to Amazon.com and purchase “The Art of Living, Vipassana Meditation” by William Hart.  I attended a Vipassana Meditation retreat a few years ago.  While I was there my insulin requirement dropped by 45%.  Meditation is the “seed level” for yoga.  Yoga postures were created primarily so the monks and yogis could sit in meditation more comfortably and longer.  Finding one’s center is a critical component to being in balance.  I offer this book as a suggestion and not a requirement.  It has nothing to do with religion or spirituality.  It is a step by step process with the objective of eradicating suffering.  As such, it may serve as a mirror for the Transforming Diabetes process.

Yoga:

We are going to change it up a bit.  Choose a time during the day when you can practice your yoga for 30 minutes.  Try and start when you have little insulin on board.

Child pose to downward dog to forward bend to upright to chair pose to forward been to downward dog to child.  Cycle through 5 times.  Sit – deep breathing- two pranayama holds, sit in meditation for final 5 minutes.  (probably need to demonstrate this on video if you don’t know these)

Buckminster Fuller, Critical Path.

In order to re-create the system that has been damaged due to the onset of Type 1 Diabetes we must determine what it is we have to account for and then receive and assess the feedback (results) we get.  We are aware that it will not ever be perfect.  In this “training” and process our objective is to attain average blood sugar levels of 150 and below over a 3 month period.  We know that normal blood sugar averages below 120.  We want to avoid going low (below 75) and we want to keep our “spikes” after we eat below 200.  There are so many component parts and functions to this system.  Let’s focus on the critical ones here.

We need to account for:

1.)  Food.  We need to eat.  Food is the fuel for the system.  Traditionally, Diabetics are provided with a low carbohydrate, low fat and high protein diet.  We must account for the food we eat.  Glucose in the blood comes from the amount of carbohydrate and fat grams we ingest.  Therefore, we must measure these.  It is my experience that “less is better” here.  I try and limit my meals to under 40 grams of carbs and under 5 grams of fat.  If I exceed that number I am creating more uncertainty.

2.)  Insulin dose; The missing key.  There are three “numbers” to establish for your system to work.  I want to emphasize here that this is how I understand current insulin dosage strategy and how I have established my my insulin delivery within the system.  It may not be the way you understand or have been instructed.  You must feel comfortable and confident in making any insulin alterations.  If you are not then don’t.

A.)  First, basal dose is determined.  The basal dose is the amount of insulin a body requires to maintain a relatively level blood sugar  with the absence of food.  If you are taking injections this is your Lantus injection which is typically administered before bedtime.  Lantus works for 24 hours and does not peak.  If you are on the insulin pump your basal dose is programmed into the pump when you set it up.  Insulin pumps use short acting insulin (lasts for about 3-4 hours). The pump will deliver insulin every 3-5 minutes.  The basal dose covers one hour.  My basal dose is .775 units.  The pump delivers .775 units every hour in 3 minute intervals.  There is only one way to check  to ensure your that your basal is accurate.  You must refrain from eating for a period of time and check your blood sugar often.  The best way to check your basal is to wait 4 hours after eating a meal and giving yourself a bolus.  You want your blood sugar level to be below 150 and above 110.   Refrain from eating and don’t exercise or engage in increased physical exertion.  Test your blood sugar at least once every hour.  Your blood sugar should not vary more than 25 points in either direction.  When testing basal the longer the better.  Try for 4-6 hours the first few times and then extend it as you become better and are able to hone in on your number.  If you trend up more than 25 points then you know that you must increase your basal dose.  If you trend down more than 25 points then you know your basal dose is set too high and you should reduce it.  Basal requirements may change during different times of the day.  So basal testing should vary during different times of the day.  Remember, this is a dynamic system and many factors can be influencing blood sugar levels.  You can probably begin to see why I believe the insulin pump is far superior than injections.  If you are taking Lantus injections then your basal dose is set for 24 hours.  You cannot make an adjustment until you take your next injection at bedtime.   The insulin pump allows you to set multiple basal doses over a 24 hour period.  It also allows you to adjust your basal on the fly.  You can also set what is called a temporary basal.  This allows you to reduce or increase your basal based on what you are doing or how you are feeling.

B.)  Insulin to Carb Ratio.  When we eat carbs we must inject a bolus amount of insulin to “cover” them.  How much insulin must you inject to cover the carbs you eat?  My number here is 11 grams.  For every 11 grams of carbs I eat I must bolus 1 unit of insulin.  Do you know your number?  You can see how important it is to have a proper basal dose in this system.  I have mentioned fat grams often throughout.  Fat grams also affect glucose levels.  My experience is that if I am eating more than 8 grams of fat in a meal I must account for it.  Below 8 grams I don’t have to worry.  Fat reduces the efficiency of insulin.  You need more.  Fat is tricky.  It can affect things for several hours.  Also, there are different kinds of carbohydrates.  Carbohydrates from orange juice must be dealt with differently than carbohydrates from pasta.  One peaks faster than the other.  An attitude of a scientist or investigator is required here.  Test often and  get to know how different foods influence blood sugar.  I have also mentioned that when I eat more than 40 grams of carbs things become more uncertain.  Watch for this as well.

C.)  Insulin Sensitivity Factor (ISF).  Your ISF is the number of points your blood sugar will drop with one unit of insulin.  It is also called the correction number.  You will be course correcting all the time.  It is the nature of what we must do.  To determine ISF wait at least 3 -4 hours after a meal with little or no fat.  Blood sugar level should be 170 or higher.  Take one unit of insulin.  Don’t eat.  Test your blood sugar at the 2 hour mark, the 3 hour mark and the 4 hour mark.  Subtract the number at the four hour mark from starting blood sugar yields the ISF.   My ISF is 40.  My blood sugar will drop 40 points with every one unit of insulin.  Note:  When you are correcting for a high you must take into consideration the amount of Insulin on Board (IOB).  This is the amount of insulin that is still working.  Remember, there are many other factors that could influence this number at any given time.

3.)  Exercise/Physical Exertion.  Our bodies use or burn glucose all the time.  That is why normal blood sugar is 80 mg/dl – 120 mg/dl.  The brain cannot function without glucose present.  Exercise or physical exertion will lower blood sugar and make insulin more efficient.  Therefore, you must account for your physical exertion.  This includes structured exercise routines, cleaning the house, moving things around and increased brain functioning (i.e., working on a project that requires increased concentration or exertion).  You must get to know how these different physical activities affect you.  You must compensate for them by increasing your carb intake or reducing your insulin.  In my opinion, the more exercise the better.

4.)  Stress.  If you are under stress your body reacts by secreting hormones that may elevate blood sugar levels or reduce the efficiency of insulin.  I know people who must increase their insulin when driving or spending time with their mother in law.  Be aware that this is a factor that must be accounted for.  Investigate it and find creative ways to account for it.

5.)  Current Physical Condition.  In our flying a plane analogy your body is the plane.  You should strive to make your body as sleek and in condition as possible.  If you are more than 25lbs. overweight than you may have an issue when it comes to implementing this system.  Make it a priority to get in shape.  It is critical.  You will lower your insulin requirement and metabolize food more efficiently when you are in top physical condition.

These are the primary components of the system that we must account for.  Now, what is our feedback?  The three goals that we established earlier determine we look for our feedback.

1.)  Are we engaging in this process with an attitude of acceptance and commitment?  If not, why?  Are we still feeling sorry for ourselves, in denial, angry, depressed, overly anxious?  Are we using diabetes as a way to avoid?  You cannot do this if you are not 100% committed.  This process is all about you becoming the master of Diabetes.  Several years ago I attended a personal development program.  The facilitator of the group read a “poem” he wrote.

The Difference Between Leaders and Victims

Leaders make mistakes and say, “I made a mistake,” and make up for it.

Victims make mistakes and say, “I’m sorry,” and do the same thing the next time.

Leaders say “I’m good, but not as good as I can be, yet.”

Victims say “I’m not as bad as a lot of other people.”

Leaders affect others.

Victims are affected by others.

Leaders would rather be admired than liked, and wind up having an abundance of both.

Victims would rather be liked than admired, and wind up having little of either.

Leaders respect others and try to learn something from them.

Victims resent others and try to find their faults.

Leaders stand for something and are willing to to fight for it if necessary.

Victims stand for nothing and either fight about everything, or nothing.

“There are essentially two categories of people in the world…leaders and victims.  Leaders are those whose purpose seems to be to inspire and motivate victims until they become leaders.  Victims are those whose purpose seems to be to criticize and resist leaders until they become victims.”

Ross Quinn

It is time to be a Leader.

2.)  Are you realizing a decrease in the suffering you are experiencing because of diabetes.  If you are working this system you should be.  And you will be reducing the suffering of those around you by gaining more control.

3.)  The continuous feedback we are receiving are  blood sugar results.  We have begun testing at least 10x/day.  You should always test before eating.  You should always test 2-3 hours after eating.  You should test anytime you want to know where you are at.  You should test more often if you want to see how you are trending.  Feedback is good.  In my early days I did not want to test.  I hated to test.  Now, I test all the time.  I am the master of my diabetes and I want to know where I am.

This was an intense section with a lot of information.  Take time to let this sink in and begin to incubate.

Exercises:

1.)  Test your basal rate.  What is it?  Write it down.

2.)  Test your Insulin to Carb Ratio.  What is it?  Write it down.

3.)  Test your ISF.  What is it?  Write it down.

4.)  Ok.  This is tough one but it must be done.  As you test these things create a chart or log.  I could not stand doing this because I did not want the nurses, CDE’s or doctors to see how bad I sucked.  No one has to see it except you.  Chart your carb and fat intake, insulin dosages, exercise, stress level and blood sugar  results.  Do this for one week.  This is the difficult part of the process.  It is a necessary part.

Yoga:

Continue with the current yoga practice everyday as you complete the exercises above.  Give yourself 5 days to work on these things before moving on to the next section.  Stay positive and committed.  You are well on your way to Transforming Diabetes!

]]> http://www.choicetimes.com/?feed=rss2&p=221 0 http://www.choicetimes.com/?p=216 http://www.choicetimes.com/?p=216#comments Wed, 01 Sep 2010 15:48:56 +0000 Michael http://www.choicetimes.com/?p=216 The problem we face with with Type 1 Diabetes is the absence of insulin. The solution to the problem is to inject insulin subcutaneously; a bit deeper than under the skin but not in the muscle and not directly into the blood stream. In a normal body the insulin is introduced through a duct in the pancreas directly into the digestive track. The solution enables the body to survive but now we are left with a very difficult challenge. We want to try and attain “balanced” blood sugar levels with this synthetically manufactured insulin that is going into the body in an abnormal manner. Not an easy task. Definitely a 10.0+ on the degree of difficulty scale. There are many other challenges that the “solution” presents:

1.) Injected insulin works differently than human insulin. It takes time to take affect and it peaks.

2.) Because normal blood sugar is between 75 and 120 mg/dl we must be aware of not taking too much insulin. If normal was 0 then it would be an easier task. A balance must be struck here. A normal body is always seeking balance (homeostasis) in all of its systems. It does this in the system we are interested in by secreting a “basal” dosage of insulin at all times. It is kind of like flying a plane. Normal functioning maintains an altitude of 80 feet and rarely goes above 140. So the accelerator (insulin) is always on. In a normal body this is done unconsciously.  It recognizes when food has been eaten and secrets just enough to cover it and keep the blood sugar level in the normal range.  It is a perpetual motion system. It is on continuous auto pilot. Type 1 Diabetes means that the accelerator is gone. It’s replacement is not our own, but rather, synthetically produced and  a bit different. Our altimeter is broken. A blood sugar monitor takes its place. A normal body is continuously monitoring altitude and making the appropriate corrections in acceleration. We must manually apply the “new” and foreign accelerator and check our rudimentary altimeter in order to ensure we are “in range” and what direction we are trending.  Talk about flying blind?Continuous Glucose Monitors (CGM’s) have recently been invented and provide a blood sugar result every five minutes. I have a CGM and I recommend getting one. I will talk more about CGM’s later. This process requires 10 finger prick tests throughout the day.

3.) Food is the fuel. A normal body “handles” the food that is digested and maintains blood sugar balance. Because we do not produce insulin we must match the insulin we inject with the food we eat. This presents a myriad of issues. Glucose in the blood comes from Carbohydrate grams and fat grams. Every body is different so the amount of insulin required is different. And it is not an exact science. I will be getting more into insulin dosage and food later in the process.

4.) Physical exertion burns glucose. Less insulin is required.

5.) Other hormones and chemical reactions in the body affect the efficiency of insulin and blood sugar levels. For example, under stress adrenaline is produced and this raises blood sugar.

6.) Illnesses like the common cold reduces the efficiency of insulin. Being sick may require an increase in insulin by 40 to 100%. It depends. As one gets better this requirement will ease back.

7.) When blood sugar levels go high (above 250) insulin works differently.

These are just a few of the challenges that the “solution” presents.  So, perhaps, you can see that this is not a condition in which you can “take your medicine” and watch what you eat  and otherwise live a normal life.  You may be able to survive with this attitude but it will be far from normal.

Your mission, should you decide to accept it, is to re-create this damaged perpetual motion system knowing it can never be perfect. It requires attention 24/7.  One of our goals is to attain A1C results below 7.0.  This can be done.  If I can do it you can as well.   If you are ready let’s get to it.

Exercises:

1.)  Do some research on the cause of diabetes and the invention of insulin.

2.)  You need to know many carbohydrates and fat grams you are ingesting on a daily basis.  Educate yourself if you don’t know how to do this.  There are books that you can buy that provide you with this information.

3.)  Document your daily dose of insulin.  If you are Type 1 I know that the best way to deliver insulin is via an insulin pump.  I understand that there are reasons and excuses to be taking injections, however, I encourage you to at least check out the pump.   If you are taking injections you are probably on Lantus for your basal and a short acting insulin to bolus for food and corrections.  If you are on a different insulin regimen then I am not sure this process will be of much help.   Write down your basal rate, your total daily basal dose, your carbohydrate to insulin ratio, your total bolus dose for the day, your total daily dose (basal and bolus combined) and your Insulin Sensitivity Factor (ISF) also known as your correction number or how many points does your blood sugar drop with 1 unit of insulin.  If you don’t know or are not clear about what basal, bolus, ISF or correction means you will be introduced to them in the next few posts.  Hang in there.

Yoga Practice:

Prior to sitting for your morning meditation begin by standing, feet hip width apart, knees slightly bent, pelvic floor tucked a bit under.  Lift up through your midsection, push out in your sternum (heart) area, extend your neck.  Your chin should be perpendicular to the floor.  Energetically, extend the crown of your head upward.  Very slowly and with conscious intent and awareness extend you arms out until the y are perpendicular to the floor.  Pause here for at least 10 seconds.  Take a deep breath in through the nose and slowly continue and extend your arms all the way upright.  Bend your knees a bit more and sink down, Stay here for 30 seconds.  Take a deep breath and bring your knees back to their original position by straightening your legs.  As slow as possible begin to lower your arms to your side.  The slower the better.  Take another deep breath.  Exhale.  Sit and begin your meditation.

In the next post we will breakdown the component parts of the system we must build.  Remember, your attitude throughout this process is one of 100% acceptance and commitment.  Cultivate and maintain this attitude as best as you can.  You may move on to the next post at anytime.

“Transforming Diabetes” has three goals:

1.) Engage in this process as a player eager to play and commit 100% for the 21 day time period. This means mentally and emotionally accepting diabetes fully. Fake it until you make it. You can hold any thought you want. It takes practice but anyone can do it. The emotional response will follow. It also works in reverse. Don’t give up. Remember it is only for 21 days. If you slip mentally or emotionally out of this state then acknowledge it and get back in as soon as you can.

2.) Reduce suffering. This means reducing or eliminating low blood sugar, high blood sugar, worry, frustration, depression, anger, denial of what is, hopelessness, helplessness, grief, shame, guilt, etc. There are a lot of them. As we reduce suffering we will uncover and begin to experience what is buried deep, has always been there, will always be there and is there now; peace, harmony, wholeness, health, balance, wisdom and integrity.

3.) Consistently, achieve A1C results below 7.0. A1C blood tests are done every 3 – 5 months and measures the average blood sugar over a 2-3 month period. After the initial 21 day immersion give yourself or your loved one 6 months to get there, especially if you have been running above the 8.0 range.

We talked a little bit about insulin in the previous posts. I want to now focus on blood sugar. Yes, the immediate cause and problem with Type 1 diabetes is the absence of insulin. Well, actually that is not the immediate cause. The immediate cause, in almost every case, is a dysfunctional immune system response. However, what we are left with is a body that cannot or, more accurately, will not allow it to produce insulin. Thank God for the guys who invented insulin. I just wish they could have figured out to make it in pill form. There must be a reason beyond a physical one for that.

The first injectable insulin allowed people to live longer than they would have. There was no thought of keeping the blood sugar levels in any kind of normal range. Blood sugar tests took days back then. No. The goal was to provide the missing key to the failed system. Get the body to accept the glucose that was coursing through its veins. The insulin was crude and the needles were huge. Back then the afflicted had to take multiple shots because the insulin was effective for only a few hours. The destruction of the ability to produce insulin is a single point of failure to the body. There is no back up plan in place. No insulin then you are going to die soon and it is not going to pretty. The rest of the body breaks down in an attempt to provide energy. All available water is sucked out in an attempt to rid the blood stream of an overdose of glucose. Think about what that must feel like. It is like you are flooding your car with maple syrup and have drained the oil tank. Going to shut down soon. The goal in the early days was to survive; not die.

Too much insulin is a major problem as well. Too much insulin results in the blood sugar dropping below the low point of the normal range, 75mg/dl. Get to 65 and feel shaky, confused, sweaty, anxious, hungry. Get to 50 and the alarms start going off. More confusion, inability to complete a simple task, loss of judgement. Get below 30 and you are probably going unconscious. Untreated, a person goes into coma and can experience a stroke, brain damage and death. The body needs glucose in its blood stream to survive. Imagine taking an injection of insulin and getting stuck in an elevator with no food. Problem. Suffice it to say, the variations in blood sugar that a Type 1 diabetic experiences ranges from stressful to downright traumatizing.

Achieving consistent normal blood sugars as a type 1 diabetic has always been and is today, in my opinion, pretty much impossible. There are two many factors to account for in the system we have to re-create and oversee. And while the tools we have are 1000X better than when I was diagnosed 34 years ago they are still not good enough to get us there. In a normal body the process is extremely dynamic. A normal body is monitoring blood sugar every second. Insulin is delivered in the exact precise dose to compensate for food. There is no lag time for it to take affect. There is no need to count carbohydrate and fat grams. The normal body intuitively knows the number. And there are more factors too numerous to name here.

An A1C of 7.0 means that the average blood sugar was around 150 over a 2-3 month period. An A1C of 6.0 means an average blood sugar of 120 (the high end of normal). My current goal is to get to 6.0. My last few A1C’s have been in the high 6′s. I am working this process to get to 6.0 as I did to get to 7.0.

Another one of my training Gurus once said……”Goals are for planning. Results are for pleasure.” This quote reflects a mental and emotional perspective to goal setting. We have established our three goals. Yes we have. Now let’s release attachment to the attainment of these goals. Instead, let’s understand that we have created and committed to these goals as a way of planting seeds for the results we wish to realize. When we do realize results let’s not judge them. Instead let’s celebrate them and take pleasure in them. Remember, this is a process and are goal is not to “arrive.” Our goal is to get unstuck, to get moving and to create more control over the speed and direction we take. If you engage in this process you will achieve these results.

Two agreements are required to move to the next step:
1.) We understand that goals are for planning. We have established our goals and now we will let them be and allow them to serve their purpose.
2.) We will not judge our results. Instead we will celebrate the results we achieve. Will will take pleasure in the fruits of our labor.

Three Exercises:
1.) Write free hand (at least one page) beginning with the words – I find it difficult to accept diabetes because……….
2.) Write free hand (at least one page) beginning with the words – If I accepted and took 100% responsibility for diabetes then…..
3.) Test your blood sugar at least 10X/per day. You will not know what is going on if you don’t. I say at least 10X because you may have to or desire to test more. If you have a continuous glucose monitor that is fine and it will assist you here but you still need to finger prick test 10X. During the next 21 days you must work to cultivate an attitude of wanting to test. You want to know where you are and how you are trending. This is a critical part of this system and process. This is non-negotiable. It is like we are in pre-season training camp getting ready for the regular season. It may be hard work but it is necessary to get in the kind of shape you need to be in to play. This means you need 300 test strips in a month. You need about $230 to cover the 21 days. Get it done. Have your doctor change your prescription to 300/month. I am not asking you to write any results down or chart at this time. I am telling you to get 300 strips for the month if don’t not already. I am asking you to cultivate and attitude of wanting to test. Stop here if you are not equipped or unwilling to test a minimum of 10X/day and come back when you are.

Yoga Practice:

I will be introducing yoga concepts and practices throughout. FInd 5 minutes in the morning and 5 minutes in the evening to sit and be quiet. It should be in a secluded place where you will not be disturbed. Sit on the floor. you may use a meditation cushion or other cushions. You want your hips above your knees with legs crossed. If this is too uncomfortable you can sit in a chair with feet on the floor and back away from the chair. In other words your back must be straight and unsupported by the chair. When you sit begin to be aware of your breathing. Take three deep breathes. In through your nose and out through your mouth. Relax and breathe normal for a minute. It helps to close your eyes. Take three more deep breathes in through the nose and out through the nose. Relax and breathe normal. Thoughts will arise. Try not to get too attached to them. This is not a contemplation exercise. This is 5 minutes of sitting in silence breathing and relaxing. You may want to do this meditation exercise just prior to completing your writing exercises.

Wait 24 hours before moving on to the next session.

Back then there were no blood sugar monitors. I peed on a strip. It changed color and told me how much sugar I was “spilling” in my urine. If I got a lot of high results the doctor would up my insulin dosage. If I got shaky or started to sweat I was probably experiencing low blood sugar and I had to drink some orange juice or eat a candy bar. I took one shot of insulin before breakfast. The insulin was extracted from a pig and worked over a 24 hour period. It would peak between 4-6pm so I had to be sure to be careful at this time. There was no way to know what my blood sugar was at any given moment. The object of the game back then was to eat a low carbohydrate diet, take your shot every morning, try to avoid going low and try to not spill too much sugar in my urine.

About the time I went to college blood sugar monitors were invented. They took a minute to register a result and were not that reliable. New and improved insulin was being created. Insulin that lasted four hours and peaked at the 1 hour mark was introduced. A new blood test called an A1C was created that measured your average blood sugar over a 3 month period. I figured I probably averaged around 230 mg/dl most of my teenage and early adult years. I had managed to find a way to survive even though I was often experiencing low blood sugars and staying high most of the time. Testing my blood sugar only made me more frustrated and led to feeling helpless and hopeless. I figured I probably wouldn’t live to the age of 40. I was depressed and not that motivated.

Having high blood sugar increases the viscosity of the blood. It gets thicker putting pressure on the circulation system. This is why the future complications of the disease are associatedl with the small blood vessels in the body; tingling in extremities, retina problems, kidney function, heart disease, stroke, etc…

It is only in the last eight years that I have been able to gain a sense of balance with my blood sugars. When I was first diagnosed this would have been impossible. In the last six years I have consistently achieved A1C results below 6.9. Normal A1C is below 6.0. I have not reached the normal level, yet! However, it is widely agreed in the medical community that if a Type 1 Diabetic can get A1C results below 7.0 they reduce their risk of acquiring the complications associated with the condition by 75%.

Most of my career has, ironically, been in the area of systems and procedures creation and training development. In the past 5 years I have deepened my yoga practice and have become a certified yoga instructor.
In this series entitled Transforming Diabetes I will show you and guide you through a process utilizing my 34 years of experience living with diabetes, my career experience, my yoga expertise and other studies that will enable you to achieve A1C results below 7.0. You will not only reduce your risk of complications by doing this you will also,
1.) Feel better physically. You will not experience as many lows or be in the high range as often.
2.) Heal others. Diabetes is a serious chronic condition. If you are not balanced you affect those around you. If you demonstrate balance and mastery of your condition you will ease the worry, frustration, depression and anxiety of those who love you, care for you and work with you. This may be the best result in the bunch.
3.) Achieve a sense of hope and control you never imagined possible. This will spill over into all of the other areas in your life. Your relationships will improve, your outlook will improve, your feeling of worth, confidence and responsibility will increase.
4.) You will transform your life. A great Zen master once said, and I am using my own words not his……..Life is not about getting from A to B. If you get to B then you can stay there or go to C or maybe back to A or even somewhere else. Life is not linear. It is more like being somewhere along a big circle. Does not much matter where you are just that you keep moving.

Diabetes is a chronic condition. It is easy to get stuck. You will begin to move forward and begin to realize choice in how fast or slow you want to go.

If you are already achieving A1C’s under 7.0 with few episodes of hypoglycemia (less than 3 throughout a month) then you have achieved mastery in my book. You probably have already realized many of the things I have discovered and will discuss in this series of posts. If you are still not satisfied with your progress or are interested in my process and perspectives then I encourage you to continue on.

If you are not achieving A1C’s below 7.0 or are not a diabetic but wish to learn more about it then you will benefit from this process. In fact, when understood and applied, this process will assist anyone experiencing any chronic condition in moving forward.

This series of posts is but one path. There are many. At this stage it requires that you understand and are able to find agreement in 2 areas.
1.) This is a very serious condition. I was only able to find the path to balance and mastery of Diabetes when I was willing to be 100% accountable and 100% responsible. And the only way to get there is to make a commitment. One of my training gurus once said…..”99% commitment is a bitch. 100% commitment is a cinch.” This process requires a 100% commitment for 21 days. For 21 days you must make diabetes your number one priority. Nothing else comes first. If you are able to establish that mindset for 21 days then you will achieve results. This means reading the posts, watching the videos, engaging fully in any interactive processes, doing the exercises and practicing, on daily basis, the yoga I present. If you are not able or willing to do this I understand. I wasn’t able or willing to do it for 25 years. I wanted to be able to “take my medicine,” avoid sweets and live an otherwise normal life. I wanted diabetes to be in the background. It wasn’t until I brought it front and center that I was able to find balance. In order to benefit from this process you must be 100% committed for 21 days. If you are unable or unwilling to make to this commitment at this time I understand. Stop here and come back when it is.
2.) For 21 days you agree to play the role of player and I will play the role of coach. It is critical we are able to establish this relationship. After 21 days we can change that. As coach I will provide you with your assignment. As player you will carry out that assignment to the best of your ability. We understand and are in agreement that we both have the same intention; to ease the suffering being experienced.

In the next post we will further define the objectives of the game we will be playing and begin to review some of the component parts.

I was diagnosed with type 1 diabetes in 1976 at the age of 14. I have 34 years of experience living with the dis-ease. In the past five years I have had the opportunity to make the management of my diabetes my top priority.

Transforming Diabetes is intended to be informative, enlightening and useful.  Any discussion of diet, insulin, exercise or what to do, or how to do it are what I have done to transform my diabetes and achieve balanced blood sugar.  You should make no change in diet, insulin or exercise unless you feel comfortable doing so.

Transforming Diabetes is designed for those who:
1.) Have Diabetes
2.) Know someone who has diabetes and either cares for them or wishes to know more about the disease
3.) Healthcare professionals who desire to explore a different approach and perspective

There are two “types” of diabetes. 20 million Americans are afflicted with the condition and the numbers are rising to epidemic levels. About 95% of those afflicted have what has been called late onset diabetes or Type 2 Diabetes. The remaining 5% are diagnosed with Juvenile Diabetes or Type 1. They are similar in that the diagnosis is based, primarily, on the elevated blood sugar levels in the body. Yet they are very different conditions. I will be first talking about Type 1 and introduce Type 2 as we progress. I encourage those affected by or interested in Type 2 to follow along from the beginning because as Type 2 progresses it effectively turns into Type 1.

Type 1 Diabetes is usually diagnosed in children or adolescents. It is considered an Immune deficiency disease because for, some reason, shortly before diagnosis, the immune system decides that the cells in the pancreas that produce insulin are invaders and should be eliminated. Within a few months the job is done and the body is unable to produce any insulin. If you are interested in finding out more about how or why this happens to a human body then I encourage you to do some additional research. I can tell you that the medical research community is still a bit baffled here. They believe it has some genetic component to it. They are also looking at a virus and outside agents like chemicals and cow’s milk. Nevertheless, it is important to know that the reason why the condition arises is because of this immune system reaction. Of course, there are people who have type 1 diabetes as a result of damage to the pancreas but this is rare. And as I mentioned above, Type 2 diabetes turns into type 1 as the disease progresses. As soon as a Type 2 requires injectable insulin (there is no other kind, no pills, they did try an inhaler but that flopped), they are type 1 in my book. Also, it appears as though Type 1 is being diagnosed more and more in people who have reached adulthood. This may bode well for the outside agent or virus cause.

So, what is insulin? Insulin is a critical hormone that is produced by the islet cells in the pancreas. It is an integral component in the digestion and metabolism of food, especially the carbohydrates and fat we eat. The body needs to eat to survive and insulin acts as a kind of key that opens the doors of the cells of the body to receive the food (energy) in the form of glucose that the body has transformed and placed in the blood for circulation to the entire organism. When a human body is unable to produce insulin it slowly starves to death. Glucose is unable to get from the blood to the cells. The key to unlock the door is not there. What happens is that the blood sugar level in the body rises and, at the same time this starvation is going on, other systems in the body kick into action to try and feed it. The liver begins to break down the stored sugar it has. The kidneys try to eliminate the excess sugar and suck all the water from the body. All hell breaks loose. Before the invention of injectable insulin around 1920 everyone died in a matter of weeks. What we have here is a critical system failure. Insulin quality, delivery systems, ability to monitor blood sugar levels and many other components to the management of diabetes has improved over the years, however, what is required is the implementation, understanding and daily monitoring of a manual system in place of an automatic perpetual motion system that a normal body has. And there is so much more in play.

As I mentioned in the beginning of this post, my objective is to ease the suffering the condition can produce. Therefore, I will be talking about this manual system that must be built, understood, integrated and monitored. But there is so much more to this disease. Believe me I know. I know about the anger, the depression, the anxiety, the panic, the worry, the sadness, the manipulation, the deception. I know how hard it can be and is. I know the feeling of hopelessness and helplessness. I stayed in it for about 2 years in my early 30′s. I know. I am not a parent but I can imagine. I think it is worse for you then for us. I really do. It is hard enough to have to re-create and monitor this metabolic function/system that has failed. We also must deal with all of the consequences and effects it can produce. Add to that the feeling of low blood sugar, high blood sugar, rapidly rising or rapidly decreasing blood sugar and worry about future complications associated with the disease and you have a situation that is difficult, challenging and sometimes seemingly impossible. This series of posts will provide you with some different perspectives and several tools with which to confront, understand and master this most difficult challenge.

I will be introducing you to a way of “seeing” this condition that you may not have thought about yet. I will share with you my experience with acupuncture, meditation, food, massage, cranio sacral therapy, vitamins, supplements, strategies of emotional and mental acceptance, spiritual insights, yoga and other methods. In the past five years I have deepened my yoga practice. Yoga has been a very useful metaphor for what I have to do on a daily basis to live with diabetes. It is my intention to introduce several yogic perspectives and practices to assist you as we go along.

While I am focusing on diabetes, the process that I will be presenting is one that is universal in nature and can be applied to any chronic condition whether it be anxiety, depression, relationship issues, health, career or financial. I have utilized it in all of these areas.

In Post #2 I will introduce some important objectives and targets we should be establishing in this balancing act we have been asked to participate in.