Taking Charge of Diabetes, One Action Step at a TimeFriday, May 10, 2013
Diabetes patient expert and advocate Riva Greenberg has written a new book, Diabetes Do`s & How-To`s: Small yet powerful steps to take charge, eat right, get fit and stay positive. Her book serves as a guide and empowerment tool for people with diabetes, providing the action steps necessary to create healthier and happier lives.
By: John Parkinson, Clinical Content Coordinator, DiabetesCare.net
Riva Greenberg hears the concerns and confusion of fellow people with diabetes. She travels the country making presentations, conducting peer workshops, and she has intimate and frank discussions with people who are largely confused about how to manage their disease. For instance, they don`t know what they can eat and how much, or why their provider has prescribed additional medicine.
While Greenberg (pictured here) knows diabetes management information is available, it’s not necessarily forthcoming to people with the disease—especially for those who do not see a diabetes specialist or have a health care team.
Wanting to create one concise, easily-digestible "instruction-manual" for managing diabetes, Greenberg has written her latest book, Diabetes Do`s & How-To`s: Small yet powerful steps to take charge, eat right, get fit and stay positive.
(Editor`s note: Greenberg has a special limited time offer where buyers can get $5.00 off her print book. The offer is only good at the Create Space e-store found here until May 24. Buyers can use the discount by typing in the following coupon code: JZX3ASA8.)
This book serves as a step-by step guide delving into what Greenberg says are the four cornerstones of diabetes management: food, exercise, attitude, and medicine. Greenberg breaks diabetes down into exactly what to do and how to do it. As such, the book contains 65 ”Do’s” and many action steps that can be done immediately for quick successes. These small steps not only help people with their management, but aid them in building confidence to take more actions. With her 41 years of type 1 experience, Greenberg has lived with the complexity of the disease and understands how easy it is to feel overwhelmed or not know where to begin.
Greenberg also had five medical providers contribute to the book. They come from an array of medical backgrounds including two registered nurses, a coach, an exercise physiologist, and a dietitian. Except for one of them, they are also certified diabetes educators.
While the book outlines the action steps needed for those with diabetes, it also applies to people with prediabetes. Greenberg points out that 80 million Americans have prediabetes and most are lacking in guidance and resources that could help them avoid progressing to type 2 diabetes.
DiabetesCare.net sat down recently to discuss some of the book’s overarching themes, the significance of attitude and emotional strength, and insights into further understanding the relationship between healthcare providers and patients.
DiabetesCare.net: How did you come up with the name of your book, Diabetes Do`s & How-To`s: Small yet powerful steps to take charge, eat right, get fit and stay positive?
Greenberg: The title truly says what the book is—what to do and how to do it live your healthiest life with diabetes. This is not a book—as so many are—about diabetes. It`s a practical guide of action steps to have your best health.
DiabetesCare.net: How do you describe the nuts and bolts of the book to people who might want to pick it up?
Greenberg: In the book, there are 65 actions or "do’s", and each of them has what I call two quick-starting steps people can do right away and experience success. Then there is a longer list of suggested how-to’s. These are suggested actions and people can choose what appeals to them. There are also personal tips from fellow patients, worksheets to help you set goals and achieve them and Haidee S. Merritt’s fabulous cartoons because if I’m asking you to do some work, you deserve a reward.
DiabetesCare.net: One of the overarching themes for the book is empowerment, and the book serves as a tool for patients to be in charge of their diabetes. Why did you think this is important?
Greenberg: Our healthcare providers guide us and give us a lot of good information, but while we may spend up to a dozen hours a year with them, we spend over 8,700 hours a year on our own making our own daily decisions that affect our diabetes. With diabetes, the patient is really in charge of their management. So you need to know what to do. Our healthcare providers just don’t have enough time to give patients all the information and advice they need.
DiabetesCare.net: The emotional component and staying positive is so important to good health, isn’t it?
Greenberg: The first book I wrote, The ABCs Of Loving Yourself With Diabetes, was about building emotional strength. We know now from the psychology field that the more time we spend with positive emotions like love, joy, forgiveness, patience, self-compassion and appreciation, the better we do in life. Positive emotions energize more positive actions, and these are emotions that can really help us manage this condition.
It’s not a matter of saying daily affirmations, but a practice. In general, being more loving and kind to yourself. You’ll do a lot better appreciating your efforts rather than beating yourself up when your diabetes doesn’t do what you want it to or you give in to that piece of chocolate cake.
My second book, 50 Diabetes Myths That Can Ruin Your Life: And the 50 Diabetes Truths That Can Save It, was really about what is true and not true about diabetes—the knowledge aspect of diabetes. Now “Diabetes Do’s & How-To’s” is about the actions to take.
If you have the tools to build emotional strength, the knowledge about diabetes, and the action steps to take, you have a great foundation to live well with diabetes.
DiabetesCare.net: What are your overall impressions in how attitude is handled with people with diabetes as well as medical providers? What are we missing and what are we getting right in the public dialogue?
Greenberg: Unfortunately, I think when it comes to health professionals, most don’t consider attitude. They haven’t been trained to consider it. They don’t know how to work with patients in a way that inspires hope and a positive future, so that patients are motivated to begin and maintain healthier habits.
I do, however, believe we are looking at this more than before. At the American Diabetes Association’s meeting this coming June, Novo Nordisk is going to release its Diabetes Attitude Wishes and Needs (DAWN) 2 study. They did their first study in 2001, and they just completed a broader study.
They are quantitatively and qualitatively studying the emotional burden that people with diabetes have; finding out what their wishes and needs are; and asking what can we put in place to help support patients.
I think when the results of the study begin to be translated into various programs and tools it will open the door a little wider on how important emotional resilience is in managing diabetes.
DiabetesCare.net: Why the decision to have diabetes medical providers contribute to the book?
Greenberg: I am not a medical provider; I’m a well informed, successful patient and diabetes expert. The beauty of the book is that since it’s written by a patient, it’s friendly and conversational and I "get it." I do the actions I’m asking people to do. That said, the book does cover medical issues and I wanted to make sure it had all the latest guidelines and recommendations, which it does.
DiabetesCare.net: Do you think the greater challenge to diabetes is the lack of disease management information openly available overall or do you think it is more of conflicting messages being said?
Greenberg: In a way, it’s not that there isn’t enough information, but most patients just don’t get the information. Most patients with type 2 go to their general practitioner who is not an expert in diabetes, who himself might not know the latest care guidelines, medicines, and may not work with them in titrating insulin, for example.
So, the book is also a tool for health care providers. Diabetes educators can use it to guide patients in adopting healthier behaviors and general practitioners can learn the latest about diabetes and what works in the real world.
DiabetesCare.net: You also cover exercise in the book. Do you see this component of exercise as an area which needs to have a greater influence in people with diabetes?
Greenberg: Yes, it is, but that said, I don’t know that it is more important than food or medicine. Food, exercise, medical, and attitude are the four foundational cornerstones of diabetes health.
In regards to exercise, what’s been shown in some of the latest studies is the importance of moving throughout the day. For example, many people who have sedentary jobs go to the gym for an hour a few days a week. That hour at the gym is great, but they also need to move more often through the course of the day.
It sounds like I’m kidding but one of the ways to get more movement is in doing what your mother always told you not to, fidgeting. Things like tapping your leg against the table, twirling your hair and walking while you’re on the phone are called NEAT exercises, (the acronym stands for Non-Exercise Activity Thermogenesis), and they can burn up to 350 calories a day.
DiabetesCare.net: Who is your target audience for this book?
Greenberg: Anyone with diabetes, prediabetes, caregivers, family members and medical professionals.
I often think of the 80 million people with prediabetes as waiting on a train platform for the train to type 2 diabetes to pull in. A recent study revealed only 11 percent of people with prediabetes know they have it and most doctors don’t tell people with prediabetes to take any action. Yet if they follow the Food and Fitness Do’s in the book, they may prevent getting diabetes altogether.
DiabetesCare.net: What are your hopes for this book?
Greenberg: For the people that buy the book, I hope it will make life easier for them, and they will see their health improve dramatically.
I’d also love to see insurance and or pharmaceutical companies provide this information to their members and patients. By living healthfully today, we can keep ourselves healthier for the long run and avoid the dire consequences and healthcare costs of uncontrolled diabetes. Now, with this book, everyone has a resource to do just that.
For those interested in purchasing the book, Greenberg has made a $5.00 savings available for the print version at the Create Space e-store here, using this discount coupon code: JZX3ASA8. Offer valid until May 24. You can also get the book on Kindle here.
Greenberg will also be co-presenting at a session at this year’s AADE conference in Philadelphia. She will be at the session titled, Dancing Together: The Power of a Relationship-Centered Approach, on Friday August 9 at 8:00am. To get more details about her presentation, go to the AADE’s conference here.