Know Your Numbers, Outlive Your Diabetes - Author Interview With Amy Tenderich

Today, I’m very happy to welcome Amy Tenderich to the Kudos For Low Carb blog. Amy is the owner of the Diabetes Mine blog at www.diabetesmine.com and she’s co-author of a new book entitled ’Know Your Numbers, Outlive Your Diabetes’ available at Amazon.com and most fine bookstores.

Congratulations on your new book, Amy. Thank you so much for allowing me to interview you and share with readers your knowledge and experience on diabetes and its management.


















Photo of Amy Tenderich, Co-Author of 'Know Your Numbers, Outlive Your Diabetes'

Your book covers 5 Essential Health Factors You Can Master to Enjoy a Long and Healthy Life. Please give us a run down on these health factors, why they're so crucial to managing diabetes, and why people with diabetes need to be proactive about medical care and self care.

"Know Your Numbers, Outlive Your Diabetes" is an easy-to-read and highly motivational guide to the 5 crucial tests that everyone living with diabetes needs to have and monitor on a regular basis:

* hemoglobin A1c (average blood glucose levels)
* blood pressure
* lipid profile (cholesterol and triglycerides)
* microalbumin (demonstrating kidney damage)
* annual eye exam

These 5 simple medical tests are the best and ONLY measures currently available that indicate each person's own individual diabetes health risks. Yet despite being widely accessible and easy to administer, fewer than 42% of adults with diabetes have either had these tests, or understand what the results mean, according to an April 2006 report by USA Today.

Without measuring and controlling these key factors, a great number of people in this country are headed straight down the path towards diabetic complications, including blindness, kidney failure, cardiovascular disease, and limb amputation. This doesn't have to be the case!

Most people with diabetes know they need to make crucial lifestyle changes including monitoring blood sugar, strictly following medical advice and prescription directions, eating a proper diet, and exercising regularly. Yet compliance seems difficult for many people. What encouragement or advice would you offer people to stick to their management program?

Dr. Jackson (co-author of ‘Know You Numbers, Outlive Your Diabetes’) and I really hate the terms "compliance" and "non-compliance." What we know is that with current medical knowledge and proper self care, people with diabetes can live a long, healthy, and fulfilling life and avoid the damaging complications of this disease. Most people ARE MOTIVATED to live a long and happy life. But managing diabetes can be incredibly difficult and overwhelming. Many people fall into the trap of thinking, "I feel fine now, so I must be fine" (but diabetes does its damage over the long-term). Or they believe, "I'm doomed anyway, so it doesn't matter what I do" (not true! You can make a significant impact on your own health and your future).

In terms of finding your own motivation, we encourage people to think about what matters most in their life: career, family, hobbies or whatever makes them tick. Whatever it is, you have to be making healthful food and exercise choices and taking your medications not because your doctor said so, or even due to your family's pestering, but because YOU (the person with diabetes) care about your own health and believe that your actions matter.

Because carbohydrates are rapidly converted into sugar, raising blood glucose, and causing a glycemic reaction, some diabetes caregivers are recommending patients follow a diet that limits refined carbohydrates. Eating a diet that stresses low glycemic foods helps diabetics as well as dieters stay on program because blood sugar stabilizes and hunger is better controlled.

What's your take on limiting refined carbohydrate foods like white rice, white flour breads, potatoes, pasta, and processed sugary foods to control blood sugar?

Carbohydrates are the most important foods you eat, comprising the main source of energy for your body. But as a person with diabetes or pre-diabetes, you do need to be aware of the carb content of your food, especially if your A1c is not in target range, because limiting carbs can be a useful tool for regulating your A1c.

For this reason, it's also true that lower glycemic index (GI) foods -- which absorb more slowly into your system -- are good choices for people with diabetes; they do not make your blood glucose levels spike so sharply. Refined carb foods, on the other hand, are high on the glycemic index, meaning they absorb immediately and make stabilizing blood glucose levels on a daily basis difficult.

Regarding the starchy foods you mention, there's an old diabetes axiom that says: "If it's white, it's not right." I personally do not eat any white flour products at all because I'm gluten-intolerant as well as diabetic, so that makes controlling carbs easier in some ways.

As a cookbook author, gourmet cook, and amateur bodybuilder on a diet high in protein and fiber, and low in refined carbohydrates, I'm always interested in what other people following a healthy lifestyle do to liven up their cooking. Can you offer any specific tips for diabetics on cooking, eating out, or handling social situations involving food and eating?

As you probably know, there is no such thing as a one-size-fits-all "diabetic diet." Our book guides people through making incremental changes in their eating habits based on their specific concerns about their A1c, lipids, blood pressure, or weight.

We stress the fact that you don't necessarily need to make drastic changes just because you have diabetes, and you don't need to give up all your favorite foods. What you may need to do is increase the frequency of some of the healthy foods you're already eating, and maybe add a few new foods (such as using Canola oil when cooking), and decrease the frequency or portions of some foods that are less beneficial for your health.

Personally, living gluten-free, I eat a lot of protein -- fish, chicken, and lean beef -- and vegetables in every imaginable form. I still take a fiber supplement because the gluten-free baked goods are generally made from rice or potato flour, which don't offer as much dietary fiber as the nice whole-grain breads other people can eat.

Here are a few general tips on eating with diabetes that we offer in the book:

• A carb is a carb — most carbs, whatever kind they are, have the same effect on your body; they convert to glucose, so keeping tabs on the overall amount of carbs you eat is important

• "Sugar-free" is not carb-free! — don't let marketing labels fool you into believing that some carbs "don't count"

• Fiber does the trick — high fiber content in a food (more than 5 grams per serving) can reduce the impact of that food on your blood glucose

• Eye on portion size — the most important thing you can do when dining out is limiting the "super-size" portions served. Try sharing an entree with a friend, or using the 50-50 Plate Rule, which says you should fill half your plate with high-fiber foods like fruit, fibrous vegetables, and grains, and the other half should be split between protein and other vegetables.

When you have diabetes, striking a balance is everything. Your body needs a variety of foods in moderate amounts. And eating should be enjoyable.

I know your book stresses exercise and I heartily agree. Exercise is a vital part of any healthy lifestyle and of particular value to diabetes control, yet it's overlooked by the majority of Americans. One recent survey reported that more than 60 percent of U.S. adults don't exercise regularly, and 25 percent are completely sedentary. Almost 15 percent of young people under 18 aren't physically active at all.

Can you explain why exercise is crucial to diabetes management and how people can get motivated and fit exercise into their busy lifestyles?

Exercise, physical activity, moving your body through space—whatever you want to call it—is perhaps the single most important action you can take in caring for your diabetes and for yourself. This is because diabetic complications primarily stem from poor circulation. Foot problems, increased infections, eye damage, wounds that won't heal, heart disease… the blood just isn't flowing like it's supposed to. Because over time, elevated blood glucose levels damage blood vessels, making the walls thicker and less elastic, so the blood has a harder time passing through.

In addition, people with diabetes tend to have higher fat levels in their blood, also caused by higher blood glucose. These fats or "lipids" clog and narrow the blood vessels. Sometimes they clog completely. This is what your doctor calls "atherosclerosis." Any blood vessel in your body can become narrow and clogged, and this can lead to a heart attack, angina (heart pain), stroke, or painful legs.

Also, when you have Type 2 diabetes, exercise is the single most potent treatment for insulin resistance, which is one of the major causes of the disease. Regular aerobic exercise, or a combination of aerobic exercise with some resistance training, significantly improves the insulin resistance problem.

This is why exercise -- which improves circulation and also boosts your metabolism -- is so important. Not just on the face of it because you can take less insulin or skip your oral medications.

Exercise is also "the most effective and portable stress-management tool on the market," as one diabetes educator puts it. Plus it boosts your mood, improves your body image, promotes a wonderful sense of well-being, and can even improve your sex life. (Studies show that muscle strength and tone enhance sexual function, and the endorphins released in the brain may well work as an aphrodisiac.)

What? You need more motivation than that? Yes, of course: you're so busy, it's hard to find the time for exercise.

We recommend combining exercise with regular errands or routines. Try walking a little further for your morning coffee or paper, parking a mile away from work, or using your bike for some errands. You are the one who best knows your daily schedule and responsibilities: What would be the easiest time to slot in your exercise? It might be easier to slot in several shorter sessions than one or two long ones. Frequency is important, so you may actually get more impact out of several short sessions per week than you would out of just one or two workouts.

What other issues do you feel diabetics must deal with to maintain a healthy lifestyle and why? What issues have you personally found challenging?

Oy, that's a hard one to answer, because everything about diabetes can be a hassle, an annoyance and sometimes utterly overwhelming! See the recent article I wrote in Diabetes Health magazine about the Top 10 Patient Gripes (at http://www.diabeteshealth.com/read,1044,4892,1.html ) and what you can do about them. Coping with diabetes successfully really boils down to breaking it down into "bite-size" bits, so you don't feel so snowed under by trying to be the "perfect diabetic" on every front all the time.


I plan on buying copies of your book to give to my diabetic friends and relatives, and also to share with clients. I heartily encourage my readers to do the same.

I'd like to thank you again for making yourself available for this interview, Amy. I know your time is valuable. I wish you great success with your book, 'Know Your Numbers, Outlive Your Diabetes', as well as with your blog, and your career.

Thanks so much! Carol

Amy Tenderich is the 2006 Winner, LillyforLife Achievement Award for Diabetes Journalism