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Metaphor In Diabetes

Diabetes And Metaphors

Diabetes And Metaphors

Join the fight against diabetes on Facebook By Ross Bonander , Thu, September 18, 2014 Here at this site, the URL encourages visitors to 'Battle Diabetes' but how appropriate is the war metaphor among people with this disease? A metaphor is a rhetorical device designed to mediate the gap between the unfamiliar and the familiar. We use them extensively when talking about human illness, because often, disease pathology is so confusing that an effective metaphor can help us to understand what's really going on. The war metaphor is very, very common, perhaps because illness is perceived as a direct threat to continued existence and facing such drastic circumstances metaphors involving ballerinas or unicorns just won't fly. Nowhere is the war metaphor on greater display than in cancer. You can go back to 1971 and find President Nixon declaring war on cancer ... or you can go all the way back to 1937 and the establishment of the National Cancer Institute and the Washington Post headline, "'Conquer Cancer' Adopted as Battle Cry of Public Health Service." Combat rhetoric dominated cancer in the 20th century, maybe because a pair of World Wars that collectively claimed the lives of 60 million people impacted the century as well, although good luck finding a century in human history free of warfare. Still, we're drawn to compare anything similar to this to a fight. Combat. Kill or be killed. Receiving a cancer diagnosis is equivalent to forced conscription into the anti-cancer army, which does not wear the usual fatigues but is instead outfitted in pink, or purple, or blue, or whichever color one's cancer subtype has co-opted for the purposes of fundraising. The problem is that for many, this metaphor is ill-fitting. In cancer this is especially true since the life of a cancer p Continue reading >>

Side Effects Of Metformin 500 Mg Tablets

Side Effects Of Metformin 500 Mg Tablets

Metformin is a prescription medication used primarily in the management of type 2 diabetes. This pill is sold under brand names such as Glucophage and Riomet. A member of the drug group known as biguanides, this drug’s 500 mg tablet is the smallest available pill -- and a common starting dose for this first-line diabetes medication. This widely used medication is an effective tool to help lower blood glucose levels, used alone or in conjunction with other pills or insulin. However, metformin can also produce adverse effects. Video of the Day The most common side effects from metformin use include gastrointestinal (GI) discomfort, including diarrhea, nausea, vomiting, gas and abdominal pain. A diabetes prevention trial, published in the April 2012 issue of “Diabetes Care,” noted that over a 4-year period, 9.8 percent of metformin users reported GI side effects, while only 1.1 percent of those using placebo had these adverse effects. These side effects usually occur at the beginning of metformin therapy and go away as the body becomes adjusted to the medication. Taking the metformin with food and having the dose gradually increased also helps minimize these adverse effects. Extended-release tablets, such as metformin XR (Glucophage XR, Glumetza or Fortamet) may be easier on the stomach -- and an option for anyone who has these common metformin side effects. Other Less Common Side Effects As with most medications, the potential list of side effects is lengthy. Insight into the adverse reactions experienced by metformin users was noted in an analysis of multiple studies published in the February 2012 issue of “Diabetes Care.” While less common than GI discomfort, other potential metformin side effects include dizziness, headache, palpitations, urinary tract infect Continue reading >>

"doing Battle": A Metaphorical Analysis Of Diabetes Mellitus Among Navajo People.

"Doing battle": a metaphorical analysis of diabetes mellitus among Navajo people. Department of Nursing, Northern Arizona University, Flagstaff 85011-5035. Effective communication with patients and their family members forms the foundation of a therapeutic relationship. This is particularly important when the occupational therapist, other health professionals, and the patient are from different cultural backgrounds. This paper describes one aspect of the findings of a ethnographic study of chronic diabetes among the Navajo people (referred to here as Dine'). It focuses on the dominant metaphorical images that were used by the informants to describe their illness experiences. The data suggest that diabetes can be considered a metaphor for larger social changes in the life-style and traditions (e.g., away from sheepherding as a means of basic subsistence to obtaining urban-centered employment) of native Americans and their effects on the Dine'. Implications of our findings include the importance of metaphorical communication for perceptions of compliance, powerlessness, and patient and therapist satisfaction with the therapeutic relationship. Continue reading >>

Metformin, Oral Tablet

Metformin, Oral Tablet

Metformin oral tablet is available as both a generic and brand-name drug. Brand names: Glucophage, Glucophage XR, Fortamet, and Glumetza. Metformin is also available as an oral solution but only in the brand-name drug Riomet. Metformin is used to treat high blood sugar levels caused by type 2 diabetes. FDA warning: Lactic acidosis warning This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects. Lactic acidosis is a rare but serious side effect of this drug. In this condition, lactic acid builds up in your blood. This is a medical emergency that requires treatment in the hospital. Lactic acidosis is fatal in about half of people who develop it. You should stop taking this drug and call your doctor right away or go to the emergency room if you have signs of lactic acidosis. Symptoms include tiredness, weakness, unusual muscle pain, trouble breathing, unusual sleepiness, stomach pains, nausea (or vomiting), dizziness (or lightheadedness), and slow or irregular heart rate. Alcohol use warning: You shouldn’t drink alcohol while taking this drug. Alcohol can affect your blood sugar levels unpredictably and increase your risk of lactic acidosis. Kidney problems warning: If you have moderate to severe kidney problems, you have a higher risk of lactic acidosis. You shouldn’t take this drug. Liver problems warning: Liver disease is a risk factor for lactic acidosis. You shouldn’t take this drug if you have liver problems. Metformin oral tablet is a prescription drug that’s available as the brand name drugs Glucophage, Glucophage XR, Fortamet, and Glumetza. Glucophage is an immediate-release tablet. All of the other brands are extended-r Continue reading >>

Metaphors As Artefacts For Adults With Type 2 Diabetes Mellitus According To Their Professional Cultures

Metaphors As Artefacts For Adults With Type 2 Diabetes Mellitus According To Their Professional Cultures

Metaphors as artefacts for adults with type 2 diabetes mellitus according to their professional cultures Melek Ardahan ( Faculty Nursing, Ege University, Izmir ) Leyla Muslu ( Faculty Nursing, Akdeniz University, Antalya ) Ilhan Gnbayi ( Faculty Education, Akdeniz University, Antalya,Turkey ) Objective: To investigate why and what mental images patients who suffer from type 2 diabetes mellitus use to describe their experiences of the disease based on their professional culture. Methods: This qualitative study was conducted at the Akdeniz University, Antalya, Turkey, in 2015, and comprised diabetics. Purposive sampling method was used. Data was gathered through the use of semi-structured interviews, incorporating qualitative data. Results: There were 13 participants in the study. The metaphors revealed by participants on what type 2 diabetes mellitus meant to them, according to their professional culture, included flower, grass, diet, cancer, virus, horse race, cat, friend or sibling, secret agent, broken machine, dishwasher calcined, watch, cigarette, burnt house, accident, and dangerous path. Conclusion: The outcome of this research addressed important implication for diabetics on how to self-manage their disease. Keywords: Chronic disease, Cognitive image, Metaphor. (JPMA 68: 334; 2018) Diabetes is an important public health problem and its prevalence is progressively increasing both in Turkey and the world over. It is well known that although life expentancy has increased in the 21 st century, diabetes which used to be seen as a disease for the aged is now being increasingly observed in the young. It is rapidly increasing worldwide due to adverse changes in lifestyle. Its complications create great problems in terms of public health and health expenses; and its phys Continue reading >>

Nightclubs As A Metaphor For Diabetes

Nightclubs As A Metaphor For Diabetes

I may add illustrations to this little essay later, who knows. Possiblyrepurpose a Least I Could Do strip. ;) Consider, if you will, a nightclub district. Every club is like a cell inthe body, with the street outside being the bloodstream. At the door toevery club is a bouncer, whose job is to keep out the riff-raff and limit thenumber of "average" people who get in. The bouncers (who are a bit moresimple-minded than real world bouncers) will always let in the pretty people,the rich people and the famous people, but those people do need a certainleavening of schlubs to look prettier, richer or more famous than. And, ofcourse, a mostly empty club is a boring club. Left to their own devices, thebouncers will only let in average people very rarely, and usually only whenthe street is absolutely flooded with them. They also occasionally let inthe wrong sort, especially when bribed. The bouncers are the cell membranes, engaging in selectivepermeability. And those average people? They're glucose. The clubneeds some of them, but the bouncer doesn't want to let in too many. If thechamber of commerce uses advertising to drive more people to the clubdistrict, that's like eating more. Viruses and other pathogensare the scum that bribe or trick their way past the bouncers. Got it so far? Good. Now, in this hypothetical nightclub district, the clubowners have collectively hired a bunch of guys whose job it is to mingle,gauge the mood of the room, and occasionally tell the bouncer to let in a fewmore average folks to keep the party from dying out. These guys areinsulin. As long as they're on the job, the party will never end solong as there's anyone even remotely acceptable on the street wanting to getin. And they're also pretty good at recognizing if the street's getting toocrowded, Continue reading >>

Diabetes Metaphors | Waving And Drowning

Diabetes Metaphors | Waving And Drowning

February 1, 2011 in diabetes metaphors , illness with type 1 diabetes , parent of type 1 , set change , sibling of type 1 diabetic , teenagers with type 1 diabetes , temp basal , type 1 diabetes | Tags: coping with diabetes on your own , correction dose , diabetes hyper , hyper , illness , ketones , temp basal | 1 comment Yes, its been a bit like that: like ha ha lets play ping-pong Sigh. Two nights ago E is 10 mmols at 12am. I do a correction dose, thinking okay not bad number, little unusual to be that high 4 hours after eating, but hey Then at 3 am I hear him coming to our room. Hes big now, bulky in the doorway like his father, and for a moment I have no idea who it is! Then he says, Im 24 mmols and feel absolutely awful. A sudden spike like this hasnt happened in a number of months. And of course it would happen when R and I are both hammering through huge piles of work markings, plans Hence why Im up at 12am testing him! Anyway. Nothing to be done. All hands on deck. Check pump is working as far as we can see fine. Give whacking huge dose of insulin (what the pump recommends plus a whole extra unit) and put him on 200% temp basal (eg twice the amount of insulin he normally has dripping in per hour). We wait for the insulin to take proper effect, which we know will be about an hour and a half. Meanwhile E feels sicker and sicker, and then, with awful predictability, begins to throw up. We know he has ketones. He tries to drink water, but cant keep it down. An hour later his level has hardly come down, 22 mmols. This too is not unusual with such a high, the body can become resistant, and it takes more aggression with insulin to lower things than it normally would. To cover all possibilities (in case something invisible is wrong with the infusion set currently in hi Continue reading >>

Metaphors Of Diabetes...

Metaphors Of Diabetes...

Friend T1... before I can ever remember (3yo) I loathe with every fiber of my being this evil beast. I have stood watch at the mouth of this "proverbial cave" and tried my entire life to keep this sleeping dragon within it. I and others who have loved, cared for me have stood watch and done battle endless times with it to prevent its escape. It is an ancient reeking beast with huge claws, and wicked teeth. It lays in slumber in the darkness like the dragons of childhood fairytales. When it awakens beware. It cares nothing for my alacrity, my watchfulness. It trys to escape and kill, set fire to the world....if it is able. I fight to keep it where it belongs as have others who stood this watch beside and before me. For brief times I have been granted sweet relief, as others stood in my place allowing brief moments of rest. For thirty nine plus years, I have fought to keep it "contained" and have succeeded most days. My armor is dented and shreaded. My sword is badly notched. I say plainly that I am weary beyond endurance and belief but I still stand and will fight... Continue reading >>

Diabetes Education | Sugar Surfing

Diabetes Education | Sugar Surfing

I find metaphors useful in describing diabetes concepts and our approaches to self-care. One I often evoke with patients is "how do you walk with diabetes"? In my experience as a person with diabetes for a half century, and as a Diabetologist, I can say that there are only three ways we "walk" with our condition. We journey through our lives with diabetes always nearby. That is not a choice, but a fact. However, where we position ourselves relative to our condition IS a choice. Read on. A common position is to place our diabetes behind us, out of emotional sight. "Huh? What diabetes"? you might say or think to yourself. In ignoring or denying our disease we are prone to ignoremany (if not all) of the essential tasksnecessary to keep it reasonablycontrolled. This is the most dangerous of the three positions. After all, denial is the first response to dealing with things we feel are out of our immediate control. Wehide in plain sight. In putting diabetes behind us (figuratively speaking) our self care choices are directly affected. Missing a scheduled insulin dose or oral medication, omitting a blood sugar check, overeating, and missing doctor check ups are just a few obvious examples of taking the "out of sight, out of mind"stance. The second position is placing diabetes directly in front of us, like an impenetrable barrier. "I can't do that (fill in the blank) because I'm a diabetic" is a common expression reflecting this attitude. Rarely is it justified. Using our diabetes as an excuse to not act only serves to foster a "can't do" attitude than erodes self esteem and personal initiative. Over my decades of living with diabetes I have been blessed to meet manyaccomplished people with diabetes who didn't let the diseaseblock their path to thegoals they set for themselve Continue reading >>

Metformin

Metformin

Tweet Metformin is an oral antidiabetic drug for the treatment of diabetes. Created by Bristol-Myers Squibb Company, Metformin is approved in the US and the UK as a treatment for type 2 diabetes. Click here to read our Diabetes and Metformin FAQs including information on lactic acidosis. Other Names for Metformin Metformin is sold both under brand names, and also as a generic drug. Common brand names include: Glucophage Riomet Fortamet Glumetza Obimet Dianben Diabex Diaformin Metformin Treatment Metformin contains the active ingredient metformin hydrochloride (or metformin hcl). Metformin is available both in combination with other drugs, or as a single treatment (a monotherapy). Metformin was approved in 1994 (in the USA) and is prescribed as: 500mg tablets 850mg tablets 500mg modified-release tablets 750mg modified-release tablets 1g modified-release tablets 1g oral powder sachets sugar free 500mg oral powder sachets sugar free 500mg/5ml oral solution sugar free Metformin SR Metformin is also available as metformin SR, a slow release or modified release form of the medication. Modified release versions of metformin may be prescribed for people experiencing significant gastro-intestinal intolerance as a result of standard metformin. Type 2 drug Metformin is a type 2 diabetic drug, and helps diabetics to respond normally to insulin. Like most diabetic drugs, the ultimate goals of Metformin are to lower blood sugar to a normal level and maintain this level. Metformin can be used in conjunction with other diabetic drugs, and diabetics should also use diet and exercise to help control their condition. How Metformin Works Metformin helps the body to control blood sugar in several ways. The drug helps type 2 diabetics respond better to their own insulin, lower the amount of Continue reading >>

Health As Metaphor: Are You Feeling Herculean Or Sisyphean?

Health As Metaphor: Are You Feeling Herculean Or Sisyphean?

Health as Metaphor: Are you feeling Herculean or Sisyphean? By Keith Carlson, RN, BSN, NC-BC in Blog: Inspirations From Nurse Keith On May 7, 2015 Your health can be viewed in many ways, and metaphor is an interesting tool with which to approach your wellness and diabetes with consciousness and intention. Metaphors have been used for milennia as a method for describing or putting into context various aspects of the human condition, and diabetes and personal wellness are equally open to such metaphoric consideration. Even the prestigious Yale Journal of Biology and Medicine discusses the uses of metaphor and narrative in medical practice. Managing diabetes can sometimes require Herculean efforts.Sisyphus and Hercules Sisyphus is a myth in which the man names Sisyphus is doomed to roll a boulder up the side of a mountain every day for the rest of eternity. He sweats and grunts and works all day, only to have the boulder roll back down the mountain at the end of the day. Diabetes and chronic illness can feel like a "sisyphean" struggle, and we just have to get up every morning, put our feet on the floor, and start anew with hope that our own struggle will feel less burdensome than that unfortunate mythological man. In comparison, Hercules was a mythical hero, and his so-called "herculean" efforts found him vanquishing his foes, defeating hordes of enemies, finding the solution, and otherwise using his prowess, intelligence, and strength to get it done and do it well. Our lives can sometimes feel herculean, and sometimes they can feel sisyphean. Perspective is important, and we can consciously choose which mythological figure we want to inhabit. Have you ever heard someone say that you need to keep your finger on the pulse of something in order to know what's happening? Su Continue reading >>

Thoughts On The Depression As Diabetes Metaphor

Thoughts On The Depression As Diabetes Metaphor

Ive shared with you my struggles with depression and darkness. Its no fun when the lights begin flickering and my mind becomes an enemy. Eventually the lights come back on and I treasure the light even more. As Ive written before, Ive found that when the lights are on is the time to do fierce battle, so the times of darkness arent nearly as intense. There is one metaphor that Ive found to be incredibly unhelpful. Its unhelpful because it is incomplete. It is the idea that depression is like diabetes. This metaphor is given in an attempt to help people not feel so bad about themselves for depression. You dont shame someone with diabetes, you acknowledge that theyve got a medical condition. You take medicine to help with the problem and you move on. Thats fair enough but the metaphor usually doesnt stop there when you are battling depression. Lets set aside for a moment all the arguments about psychotropic medicine. Assume for the sake of argument that depression is a medical condition just like diabetes. What Im arguing today is that if you use that depression is like diabetes metaphor you need to fill it out a bit more. Imagine with me a woman who has been diagnosed with diabetes. She is now put on meds to get her disease under control. Is that the end of the story, though? What if she keeps eating Snickers candy bars, potato chips, and drinking Mountain Dew? Or rather than fighting the disease with things like exercise she develops an even more sedentary lifestyle? Is such a woman blame-free? Is diabetes the only problemor is her very real biological problem compounded by lifestyle choices? We must think of depression the same way. And while we make every effort not to shame people for having mental health issues we really need to be cautious in that we dont at the sa Continue reading >>

Metformin Side Effects

Metformin Side Effects

Generic Name: metformin (met FOR min) Brand Names: Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet What is metformin? Metformin is an oral diabetes medicine that helps control blood sugar levels. Metformin is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. Metformin is sometimes used together with insulin or other medications, but it is not for treating type 1 diabetes. Important information You should not use metformin if you have severe kidney disease or diabetic ketoacidosis (call your doctor for treatment). If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you will need to temporarily stop taking metformin. This medicine may cause a serious condition called lactic acidosis. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart rate, dizziness, or feeling very weak or tired. Get emergency medical help if you have signs of an allergic reaction to metformin: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Some people develop lactic acidosis while taking this medicine. Early symptoms may get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness; numb or cold feeling in your arms and legs; trouble breathing; feeling dizzy, light-headed, tired, or very weak; stomach pain, nausea with vomiting; or slow or uneven heart rate. Common metformin side effects may include: low blood sugar; nausea, upset stomach; or diarrhea. This is not a complete list of side effects and others may occur. Call your doc Continue reading >>

The Ubiquitous Garden Metaphor

The Ubiquitous Garden Metaphor

This summer Ive been gardening. Lots. Hours in the yard on weekends and in the evening. See, Ive always wanted perennialsa flower garden thick with coneflowers and black-eyed Susans and daisies (among the 2030 other species I covet). So Ive expanded and refreshed a few neglected beds out back and for the past few weeks have been digging two sprawling beds in front. Its a slow, deliberate process, and Im relying only on hand tools for the job. Spade creating shape and shovel turning soil. I break the grasss hold with my hands, pull its roots away, crumble earth with hand and rake, add compost, cover with wood chips, and wait to plant this fall. My time in the yard gives me time to think about my diabetes. Buthave I come up with a brilliant extended metaphor for gardening and diabetes? Something such as, Soil is like the endocrine system, and one must nurture the soil just as one must nurture the body? Hardly. I dont know that I could. In truth, I gave it a shot and there were too many holes in my logic. What keeps recurring, however, is how important process isthe diligence, dedication, patience, and time required in learning to do something successfully, whether it be creating a garden or managing diabetes. And this is what I find fulfilling about gardening, and, yes, even about managing diabetes. At any given moment in the garden, the reward is presence, a mindfulness. I pay attention to the soil, noticing only whats going on within a three- or four-foot radius. At the same time, however, I must carry with me the larger picture of what Ill be doing in five or six weeks when Ill get the flowers for fall planting, how Ill ensure their health throughout the winter and in the spring, and what I must do throughout the years to come to keep the garden healthy and beautiful. Continue reading >>

Diabetes Is Like..twice Diabetes | Twice Diabetes

Diabetes Is Like..twice Diabetes | Twice Diabetes

Trying to explain type 1 diabetes to someone who doesnt have it is difficult. In terms of trying to keep your blood sugars in the normal range I think its a bit like trying to drive a car that has only two wheels and the tyres on those wheels are also flat. It is sort of possible to drive if you can manage to balance with a drivers side front wheel and passenger side rear wheel but you will be precariously balanced and it will be anything but a smooth ride. I suppose some might say that they dont like the image of being broken, Im fine with accepting that my body (well my pancreas) doesnt quite work the way it should and that people with diabetes are the most awesome, skillful drivers in being able tothrive despite such poor substitutes for a fully-functioning pancreas. I have also seen educational similes. I expect these have been around for a long time but Ive only really noticed them in the last few years. The most common of these is to say that diabetes is like living with a lion or a tiger. William Lee Dubois has written a book, Taming the Tiger, Your First Year with Diabetes Can you have a pet tiger? Sure. As long as you feed it well, groom it, and never turn your back on it, you can co-exist with a tiger in your living room. But if you neglect the tiger, starve it, turn your back on it the tiger will pounce on you and tear you to shreds. I can understand where health care professionals are coming from with this and suspect they are thinking about those patients whose diabetes has taken a huge toll from a combination of all sorts of factors, including ignoring problems that could have been treated or fixed. Indeed, taking care of diabetes (and I dont just mean having the ideal hba1c but also managing, not ignoring complications if and when they arise) really will Continue reading >>

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