The Power Within: Advanced Diabetes Retreat 2014 Stephen W. Ponder MD, FAAP CDE
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This is the slide deck for the opening talk by Stephen W. Ponder MD, FAAP, CDE on Saturday April 26, 2014 in Kerrville, Texas. Please go to the website www.stephenpondermd.com and the Facebook page "The Power Within by Stephen Ponder MD, FAAP CDE to continue in the discussion of how to unlock your "Power Within" and start taking charge of your own diabetes self care
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The Power Within: Advanced Diabetes Retreat 2014 Stephen W. Ponder MD, FAAP CDE
- 2. Welcome2014 Advanced Diabetes Retreat Texas Lions Camp Kerrville, Texas Like “The Power Within by Stephen Ponder MD, FAAP CDE” www.stephenpondermd.com
- 3. Managing “d” well requires… • Comprehending a system with basic principles/concepts • Adjusting to changing or shifting conditions/situations • Frequent assessments and re- assessments • Driving a car • Flying an airplane • Walking a tightrope • Surfing
- 4. Appreciate the flux of sugar levels in non-d persons
- 5. Remember: Sugar Surfing is all about managing…
- 6. Diabetes is best approached 1 day at a time
- 7. “Life is not a matter of holding good cards, but of playing a poor hand well.” R.L. Stevenson (1850-1894)
- 8. Unleashing the “Power Within” Like “The Power Within by Stephen Ponder MD, FAAP CDE”
- 10. These are classic illustrations by a famous graphic artist from the early 20th century. These specific images were taken from a handbook for new patients with diabetes. Some things NEVER change and never will. Here are 3 priceless pieces of diabetes wisdom…
- 11. Diabetes Police?
- 12. To unleash your Power Within… Work to let go of… • Judging • Feeling defective/broken • Shame • Fearing the future • Isolation • Pity • Insecurity/denial Embrace/cultivate… • Acceptance • Normalcy • Openness • Enjoying the moment • Teamwork • Empowering/supporting • Self-confidence
- 15. Diabetes care is about choices
- 16. Diabetes care must be individualized
- 17. “Chance favors the prepared mind” Louis Pasteur
- 18. 3 virtues of the well managed
- 20. “I haven't failed. I've just found 10,000 ways that won't work.” Thomas Edison
- 21. Knowledge alone does not imply understanding
- 22. “You can delegate authority but you can’t delegate responsibility”
- 23. Do 2 RN’s = 1 kid? = Ok? Ok to me!
- 24. Concrete thinkers* can’t… 1. Consider a hypothesis 2. Consider multiple possibilities in a scenario 3. Systematically solve a problem 4. Use combinatorial logic *Lasts until 15-17 years of age *25% of adults are concrete thinkers.
- 27. You CAN influence how long it lasts diabetes treatment preserves INTERNALLY made insulin
- 28. Diabetes, July 30, 2012 - DOI: 10.2337/db11-1625; data interpretation DX'd 1950-1964 DX'd 1965-1980
- 29. Is the future already here? 50 55 60 65 70 75 80 1964 1980 Lifespan with type 1 diabetes vs. without Average American Type 1 Diabetes Linear (Average American) Log. (Type 1 Diabetes) 1996 DX'd 1950-1964 DX'd 1965-1980 DX'd 1980--??
- 30. Five things to remember about T1D 1) Diabetes care isn’t a contest. It’s overrun with numbers. Don’t judge. 2) Let the remaining guilt (if any) go! NO one is perfect. 3) Diabetes care is not an action, it is a SKILL SET. Therefore, it can be practiced and improved upon. 4) Control is the end result of your decisions and choices. This applies to minute to minute control as well as long term control. 5) NO health care provider manages anyone’s diabetes. They never can and they never will. It’s a self managed condition.
- 31. Five practical advanced diabetes care tips 1) Better synchronize your insulin and your meals 2) Check blood sugars 2-3 hours after meals 3) Correct any out of range sugar you discover (“treat to target”) 4) Work to get morning blood sugars into target range (F-F-F) 5) Review/analyze your blood sugars at least weekly
- 32. Diabetes Family Teamwork and Teens: What is Success? 11:30-12:00 Anderson
- 33. Road to the Artificial Pancreas 11:30-12:00 McMahon
- 34. Common diabetes emergencies 1:00-1:45PM Schreiner
- 35. Sugar Surfing with a CGM 1:45-2:30PM Ponder
- 36. Advanced Pump Features 2:45-3:30PM Anderson
- 37. Q&A Open Forum 3:30-4:30PM Ponder You McMahon Schreiner AndersonAnderson
- 38. In diabetes, you want to play with your food 9:30- 10:15AM 23% 221 Anderson
Editor's Notes
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- Thomas Edison (Considered that greatest inventor of all time, 1846 - 1931): Embrace your inner scientist/inventor
- TitleThe carbohydrate counting in adolescents with type 1 diabetes (CCAT) study.AuthorsBishop, F. K.; Maahs, D. M.; Spiegel, G.; Owen, D.; Klingensmith, G. J.; Bortsov, A.; Thomas, J.; Mayer-Davis, E. J.Journal Diabetes Spectrum 2009 Vol. 22 No. 1 pp. 56-62 ISSN1944-7353DOI10.2337/diaspect.22.1.56URLhttp://spectrum.diabetesjournals.org/cgi/content/a...This article reports pilot study results evaluating the accuracy of carbohydrate counting among adolescents with type 1 diabetes. This cross-sectional observational study included 48 adolescents ages 12-18 years (mean 15.2±1.8 years) with type 1 diabetes of >1 year in duration (mean A1C 8.0±1.0%) who used insulin:carbohydrate (I:C) ratios for at least one meal per day. The adolescents were asked to assess the amount of carbohydrate in 32 foods commonly consumed by youths. Foods were presented either as food models or as actual food, with some items presented as standard serving sizes and some self-served by study participants. T-tests were used to assess the significance of over- or underestimation of carbohydrate content. For each meal, accuracy was categorized as accurate (within 10 grams), overestimated (by >10 grams), or underestimated (by >10 grams) based on the commonly used I:C ratio of 1 unit of insulin per 10 grams of carbohydrate. Only 23% of adolescents estimated daily carbohydrate within 10 grams of the true amount despite selection of common meals. For dinner meals, individuals with accurate estimation of carbohydrate grams had the lowest A1C values (7.69±0.82%, P=0.04). The pilot study provides preliminary evidence that adolescents with type 1 diabetes do not accurately count carbohydrates. Further data are needed on carbohydrate counting accuracy and other factors that affect glycemic control.