Anne Peters M.D. - Conquering Diabetes: A Complete Program for Prevention and Treatment

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Table of Contents

A PLUME BOOK

CONQUERING DIABETES

ANNE L. PETERS, MD, is a nationally and internationally respected diabetologist, one of bestdoctors.coms Best Doctors in America, and one of the top physicians treating diabetes in America today. As professor of medicine and director of the USC Clinical Diabetes Programs, Dr. Peters treats a wide variety of patients in her two diabetes centers. One is near Beverly Hills, where she treats patients from all over the world and does clinical research on new treatments for diabetes. Her other center is in East Los Angeles, where she cares for people without health insurance. In addition, with foundation funding, she is developing a diabetes prevention and treatment program that should impact many people in Los Angeles, which has one of the largest public health systems in the world.

Dr. Peters research has been published in leading medical journals such as JAMA, Annals of Internal Medicine, the American Journal of Medicine, and Diabetes Care. She has published a book on the treatment of diabetes for health care providers. As a respected expert on diabetes and its treatment she has been quoted in publications such as the Los Angeles Times, the Wall Street Journal, and the New York Times. The former chairperson of the American Diabetes Association Council on Health Care Delivery and Public Health, she has consulted for organizations such as Blue Cross, Wellpoint, Cigna, UniMed, and Health Net. In addition to speaking to patient groups nationally and teaching health care providers about optimal diabetes treatment, Dr. Peters has been a consultant for E.R., where she made a cameo appearance in 2001, and has appeared on Dateline, CNN, and the Discovery Channel. She resides in Manhattan Beach, California, with her husband, Mark Harmel, her son, Max, two desert tortoises, Myrtle and Yertle, and Max-the-wonder-cat.

To my parents,
William and Virginia Peters,
with love

ACKNOWLEDGMENTS

Laureen Rowland, my editor and friend, conceived of the need for this book, convinced me that I could write it, and provided unending enthusiasm and support throughout the process of its creation. Without her there would be no book. Jim Levine, my agent, has patiently guided me through the unfamiliar world of non-medical publishing and I am grateful for his encouragement and many words of wisdom.

Meg Moreta, RD, CDE, my nutritionist and Mary Rose Deraco Sosa, RN, CDE, the diabetes educator who has taught me everything I know, contributed to the writing of the nutrition and exercise chapters of this manuscript, and I am deeply grateful for their help.

This book wouldnt exist were it not for my wonderful patients, who teach me something new every day. They are some of the kindest and most honest people I have ever had the opportunity to know. My other teachers were those who shared their enthusiasm for knowledge and scientific inquiry during my many years of schooling. They include Mr. Kind (high school), Dr. James Donady (college), Dr. Arthur Rubenstein (medical school), and Dr. Mayer Davidson (fellowship and beyond).

Some patients help you much more than you could ever help them. Susan and Leslie Gonda are two of the dearest people I know, along with their children, Lou, Lucy, and Lorena, and the rest of the Gonda clan. From them I have learned much about survival, philanthropy, and grace. Marc Nathanson has been steadfast in his support, friendship, and advice. Anne and Arnold Kopelson have taken me under their wing and helped produce the confident-me. Barbara, Marvin, and Dana Davis, and Kelly and Robert Day have been generous and loyal supporters.

To the people Ive had the pleasure to work with over the years, you have been fantastic and it is truly an honor to work with you. This list is long and includes many friends and colleagues such as Katie Arce, Bob Baravarian, Janet Bau, Dan Berger, David Boyer, Bob Briskin, Tom Buchanan, Chuck Burant, John Buse, Peter Butler, David Chan, Pejman Cohan, Ed Crandall, Jon Dann, Susan Dopart, Steve Edelman, Rob Etherington, Banning Eyre, Care Felix, Susan Fleischman, Ruth Grayless, Jeff Gutterman, Robert Henry, Paula Hunt, Lois Jovanovic, Rebecca Lyman, Jim Lower, Ruchi Mathur, Donna Miller, Flora Molina, Mike Rice, Mike Roybal, Steven Schwartz, Alan Shabo, P. K. Shah, Lauren Somma, Scott Votey, and Karol Watson.

Thanks especially to Eric Roth, for his faith in me as a person and as a doctor; to David Kendall for being the worlds best adopted brother; to Howard Wisnicki for providing transcription services through his company Soft Script; to Lee Solters for generously helping me with publicity; and to Francine Kaufman for being my role model, research partner, and dear friend. And thanks to my dear now-gone grandmother Louise, who was so proud of her granddaughter doctor that she paid off my medical school loans so I could be a doctor free and clear.

Finally, and most of all, thanks to my son Max and husband Mark, who are my strength and my solace, who see me less often than they should, but understand something of my passion to heal those who need help, and are willing to let me go.

INTRODUCTION

Every day, all day, I take care of people with diabetes. My patients come in all shapes and sizes; ethnicities and ages. I see the success stories and the chronic problems. I see people I can help and, sadly, others whose complications of diabetes are too far advanced for me to impact. I see twelve-year-old girls, still innocent and on the verge of becoming young women, who are struggling to give themselves five daily insulin injections without their parents help. I see overweight middle-aged men and women who wrestle daily with diet and exercise so they wont suffer complications of diabetes, such as blindness or life on dialysis. On the same day I see a fifty-six-year-old diabetes-related double amputee in a wheelchair I may see a seventy-six-year-old, who has had diabetes since the 1940s, who never misses his daily four-mile walk with his dog.

I know that for each and every one of these people I can minimize, possibly even prevent, diabetes complications. In many cases, I may even have prevented or delayed diabetes to begin with.

This book is an attempt to share with you the knowledge and experience I draw upon when trying to help my patients. I hope to help you, too. The information in these pages can make a big difference in your health or the health of your loved ones with diabetes. You dont need a medical degree to live well with diabetes. In fact, most doctors dont know a lot about treating diabetes. So it is up to you to gather as much knowledge as you can if you have or are at risk for diabetes.

Diabetes is growing at an epidemic rate, both worldwide and in the United States. According to the most recent statistics from the year 2000, one out of every three children born in the United States will develop diabetes in their lifetime. This number increases to one in two if the child is Latino or African American. Whats traditionally been known as adult-onset diabetes is being diagnosed at younger and younger ages. If diabetes is diagnosed at age twenty, seventeen years of life will be lost, compared to people without diabetes. Seventeen years! It could mean you wont live long enough to retire or play with your grandkids or celebrate your thirty-fifth wedding anniversary. Even if you get diabetes later in life, say at age sixty, nine years of life will be lost. So you could miss seeing your grandkids graduate from high school and you wont be able to go on that cruise to celebrate fifty years with your spouse. But if you get good treatment for your diabetes you dont have to miss out on these and other wonderful experiences due to complications that areand I cant stress this enough

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