Virtual Book Tour: Amy Tenderich's Know Your Numbers, Outlive Your Diabetes

Prominent MedBlogger Amy Tenderich from DiabetesMine has co-authored a book and is taking it out on the virtual road.

She and her co-author, Dr. Richard Jackson of the Joslin Center, graciously made themselves available not only to share the normal boilerplate book pitch, but to answer my specific questions that I thought were most relevant to what i write about here at HealthyConcerns.

First, I'll give you the basic deets, though:

Title: "Know Your Numbers, Outlive Your Diabetes” (Avalon/Marlowe Publishing).
Summary: The "first-ever, hands-on guide to achieving a long and healthy life with diabetes."
Authors: Dr.  Richard Jackson and Amy Tenderich
Publication: early January (Here's the link to it at Amazon.)

Some facts about diabetes:

• According to the CDC, 62 million Americans are now affected by diabetes – more than 20 percent of the population, making it the fifth deadliest disease in the United States. [Ed. note: Yikes That is frightening! Although note, this figure is for those "affected"...see bullet #2.]

• Of these 62m, 21m people are already diagnosed and aware that they have the disease – yet more alarming, the additional 41m people are at heightened risk with a condition called “pre-diabetes” and may not even know about it or understand the serious health risks involved.

• The risks for diabetes patients include: early heart attack and stroke, blindness, kidney failure, nerve damage and limb amputations. [Ed. note: not to mention the healthcare costs...again, yikes!]

• The book focuses on how patients can work with their doctors to regularly monitor 5 basic health risk factors: hemoglobin A1c (average blood glucose levels), blood pressure, lipid profile (cholesterol and triglycerides), microalbumin (demonstrating kidney damage) and an annual eye exam. And that close attention to these factors can help patients manage their diabetes. Yet, 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.
• The book is designed to educate patients and enable them to be more empowered to monitor their own health and halt the typical decline associated with diabetes.

So, that's their standard info, but here are the answers Dr. Jackson provided to my specific questions:

HC:  Given the stats you provide on how few people actually take the proper tests to identify, start preventing or manage their diabetes, what are the primary factors responsible for such a discouraging number?  Patients don't know the symptoms of pre-diabetes? Patients avoid the doctor due to coverage concerns? Doctors don't diagnose early enough? Or administer reliably enough these tests?

RJ: "Know Your Numbers, Outlive Your Diabetes" is geared towards people who already have diabetes or pre-diabetes.  It’s the first-ever, hands-on guide to proactively preventing “diabetes-related complications, “ meaning the long-term damage the disease can cause (rather than preventing diabetes itself).

That said, there are a variety of reasons contributing to the fact that patients often don’t recognize pre-diabetes or understand the urgency of monitoring these five risk factors. Sometimes medical care providers give the information, but it is not absorbed. This could be due to the speed and handling of information delivery, the awkwardness of the names (A1C, microalbumin, LDL cholesterol vs HDL cholesterol), and/or the fact that the information is not written down for them so that they can refer back to it (such important information shouldn’t be given just verbally).

Studies show that even directly following an office visit, patients’ recall of events is often different than the doctors', and that topics doctors thought they stressed are often not remembered by the patients at all. Also, lab test results are sometimes only delivered as “OK” or “not OK,” leaving the patient with no idea about what their actual number is or what it really means to their health.

HC: What are the cost ramifications of these tests? Do insurers typically cover these, or cover them often enough to make a difference?

RJ: All of these tests are covered by any medical insurance. They are very standard and easily accessible at any lab across the country.

HC: Given diet has such impact on several of the basic health risk factors you list below, what is your/your co-author's position on diet...particularly vegetarian and vegan diets and diabetes.

RJ: Many different diets can fit in well with diabetes. The most important factor is knowing the content of your diet (fats, carbs, calories, sodium, etc.), and the effects of that content on your A1c, lipids, blood pressure, and cardiovascular health. A vegetarian diet is almost always low in saturated and trans-fats, usually contains more fiber than other diets, and usually contains more whole fruits and vegetables, which are all positive. A vegan diet doesn’t offer any further health advantages, unless someone has particular food sensitivities.

I want to thank Amy and Dr. Jackson for so promptly answering my questions. And I'm happy to hear that, as I suspected, a vegetarian diet is pretty much a big positive re: diabetes. Conventional wisdom actually used to direct diabetes patients away from vegetarianism (my cousin has diabetes, and we had this debate years ago.)

Congrats to Amy on the publication of this book. Amy is a wonderful, local, blogger who has become one of the most prominent MedBloggers out there...and is clearly using that blog-fame for the greater good!

Comments

[Shawn]

Remember to have the eyes checked for diabetic retinopathy!