Yesterday, I responded to the question about "things you wish your doctors knew about diabetes and the daily task of living [with it] by mentioning that many healthcare providers' knowledge of diabetes is incomplete and/or out of date. Rather than be a part of the problem, I've proposed a first-draft solution — some things I would put into a Continuing Medical Education (CME) syllabus to fill in some of those gaps. I'm sure I'm missing rather a chunk of stuff, but then again, this is a first draft.

If I were to develop a syllabus to fill in the gaps in professional diabetes education, as I perceive they exist today, these are some of the things I would consider:

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After a lot of tsuris which I'm certain Mom never meant to visit upon us, her remains were laid to rest on Friday the 13th, and — for what it's worth, since we've been far from traditional about it — the week of shivah, the deepest mourning, has been observed.

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While I really hate being such a "Debbie Downer" this early in the year, I'm getting extremely frustrated with the red tape surrounding my mother's passing. The basic: we are still waiting on the life insurance to cut loose enough money to bury my mother. While she pre-paid the funeral expenses, she didn't have enough money to pay for a plot —
and without the life insurance money, neither do we.

I'll spare the details of dealing with government-based life insurance (Mom was a Federal Government retiree). The funeral home has been as helpful as possible (which is actually very helpful, especially in terms of compassion and empathy), but the end result is that we are dealing with businesses, and at the end of the day, they need to report a profit (or at the very least, the lack of a loss).

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Just as hyperglycemia is but the tip of the iceberg when discussing the physical ravages of diabetes, depression is but the most visible diagnosis of how diabetes affects our minds.

I'm not talking about the temporary states of anxiety or paranoia, lassitude or somnolescence, that accompany our glycemic highs and lows, but the long-term, "you should get psychological help for this" effects of living with chronic disease in general, and diabetes in particular.

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Time and distance have also served to blunt not just periods of psychological distress, but also some of the everyday things I used to savor before.

As in, before I was diagnosed with diabetes.

Before I had diabetes, I didn't have to worry about eating a hamburger, pizza, Fettuccini Alfredo, or my favorite restaurant "cajun pasta" dishes. Now, any version I make at home is significantly modified to eliminate refined flours, reduce fats, and raise the vegetable count. You can hardly find the pasta in any of my "pasta" dishes.

Before I had diabetes, breakfast was a pint of orange juice and a bagel with cream cheese. Now, bagels are eaten in parts, and orange juice is a special-occasion item: a quarter bagel is one carbohydrate exchange, and a cup of orange juice is a huge portion of the daily calorie count.

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There's something that haunts every person who remembers Life Before Diagnosis. We describe it as spontaneity, carelessness, social acceptability, freedom.

What it boils down to are food and money.

For starters, diabetes robs from us the ability to "just" eat when we are hungry, not-eat when we're not, and not have to weigh, measure, and log every morsel that passes our lips. Then, it robs from us the (admittedly ill-advised) pleasures of the occasional ice-cream sundae or wolfing down half a pizza pie. And because we can't be certain of the foods that we don't prepare ourselves, it robs us of the ability to eat at friends' and relatives' homes, or even casual-dining restaurants.

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