http://www.usatoday.com/life/people/2009-03-22-mtm-diabetes_N.htm Mary Tyler Moore tells how she took control of diabetes By Mary Brophy Marcus, USA TODAY GREENWICH, Conn. ? As you enter the gated property of Mary Tyler Moore's residence in this posh town and approach the front door, you almost expect a butler to answer the bell and a bichon frise or two to scamper out yapping at your feet. Nope. Nothing so precious here. Moore herself opens the door of the rambling, antique-filled home she shares with her cardiologist husband, Robert Levine, and a posse of dogs. BETTER LIFE: The latest news on diabetes The place is down-to-earth and warm, as is Moore, 72, who first gained fame in the 1960s and '70s for her endearing roles in the television series The Dick Van Dyke Show and The Mary Tyler Moore Show. In the latter, Moore played an independent young woman living on her own and working in a television newsroom in Minneapolis ? a novel sitcom theme for the time. Her character, Mary Richards, won laughs and affection for her smarts and spunkiness as she juggled career, dating and friendship conundrums. The opening credits are so memorable that most women who grew up in the 1970s can still rattle off the lyrics, ending with "You're gonna make it after all" as Moore tosses her beret to the sky. Moore's career later moved to the stage, TV specials and film, including her 1980 Oscar-nominated role in Ordinary People. She also has been an activist for animal rights over the years. But her energy most recently has been focused on advocating for diabetes research and educating people about the disease. She is the international chairwoman of the Juvenile Diabetes Research Foundation, a group she has worked with for years. Few viewers knew that around the time The Mary Tyler Moore Show launched, she was diagnosed with type 1 diabetes, a life-threatening illness with serious health implications. In type 1 diabetes, the body's immune system attacks the beta cells in the pancreas. The beta cells make insulin, a hormone needed to convert sugar, starches and other food into energy. Type 2 is more common, accounting for about 90% of cases of diabetes, and occurs when either the body does not produce enough insulin or the cells in the body ignore the insulin. Both forms of the disease can lead to serious short- and long-term complications. Moore has lost most of her vision because of diabetes-related nerve damage. In a new book, Growing Up Again, which comes out this week, she offers a personal account of living with diabetes. As her adopted dog, Spanky, lies nearby in Moore's favorite well-worn chair, she talks about her reaction when, at age 33, she got the news of her diagnosis. "When the doctor said I had diabetes, I conjured images of languishing on a chaise longue nibbling chocolates," she says, laughing. "I have no idea why I thought this." But she soon learned about insulin syringes and blood sugar readings. Dinner and a roast Moore says matter-of-factly and with no self-pity that with type 1 diabetes, there is little chance for spontaneity in life. She chooses not to use the newer glucose monitors and insulin pumps that can reduce the burden by taking automatic readings for the patient and deliver a dose without a syringe. Instead, she still prefers using finger pricks and test tapes to measure her blood sugar and a syringe of insulin whenever it's needed. "You've got to always plan," she says. "It is a fact of life that if someone invites you out to dinner you have to think, 'What are they going to be doing when they serve you dinner? How quickly are they going to get it on the table from the time I arrive? When should I take my shot? What should I eat of what's available?' " She says she has learned to carry a loaded syringe in her pocket, and if she eats a little more than expected, she can give herself a quick injection of insulin to level her blood sugar. "I shoot myself right through my clothes there at the table, right here in my thigh. I seldom wear white as a result," she says with a chuckle. But she does enjoy a little spontaneity from events such as the one she attended this month when she was honored by the historic theater group The Players club in Gramercy Park, in New York City. That's where her close friend Bernadette Peters, whom she talks about in her book, helped "roast" her and applaud her career achievements. "That was fun," she says. "And I was so absorbed by what Dick Cavett and my dear friend Bernadette had to say about me." A sunny room off her living room houses an array of workout equipment, and Moore, who moves gracefully but slowly because of her lack of peripheral vision, says working out for an hour five to six days a week helps her stay fit and fight the disease. As her vision has declined, she has been forced to give up her beloved ballet and horseback riding. But with her long-time trainer's guidance, she says, "I do a combination of treadmill (hands on the support rails because her balance isn't what it used to be), the elliptical machine, rowing and Pilates. I never get bored." Blood sugar dips after a workout sometimes, so she keeps orange juice on hand to sip afterward to push it back up. "In all these years, I've never gotten sick of orange juice," she says. As she has gotten older, she says, her ability to sense a low-sugar moment coming on has lessened ? she used to feel lightheaded and weak as a warning ? and the episodes occur more often than in the past. That's dangerous because too-low blood sugar can lead to a life-threatening coma. A low sugar level "can happen while I sleep at night," she says, "and my husband will wake me up and make me sip some juice." Though Moore downplays diabetes' ravages on her eyesight and other parts of her body, it's hard to ignore a big bandage wrapped around her left hand. "Isn't that awful? I slammed a door ? not on purpose ? on my thumbnail, and I went to the doctor to show him, and it had already turned black so he had to go in there and scrape it off," she says, indicating the area where gangrene from poor circulation ? another effect of the diabetes ? had begun. She acknowledges she wasn't always vigilant about tracking her levels and taking the proper medication in her younger years; she says work, a busy social life and motherhood distracted her. (She had one son, Richie, with her first husband, a cranberry products salesman. Richie died in his early 20s from an accidental gunshot wound.) But she says taking ownership of her diabetes, after many years of sidelining it and living a life that included stress and heavy social drinking and smoking, helped her grow up and learn to rely on herself. "I've always been independent," she says. "I've always had courage. But I didn't always own my diabetes." Coming into her own Though she includes tips and advice from doctors in Growing Up Again, the book is more a memoir than a how-to for the newly diagnosed. She shares work anecdotes and family tales. She writes candidly about her relationship with her devoutly Catholic father and alcoholic mother, and about her three marriages and her not always emotionally healthy penchant for "alpha" men. She talks about coming into her own in this, her third marriage, finding equity and loving companionship with Levine. She rounds out her story by including reflections from others with diabetes, young and old, and lauds the young people she has met for their intelligence and commitment to managing their disease ? something she says they do far better than she did in her early years. Moore doesn't say other patients should model their lives after hers. She says she just hopes the stories about her losses, the dead-ends and the triumphs she has experienced that have helped her "grow up" will be a comfort to others, with or without the disease, and help them better understand themselves and find new ways to face their own challenges. Of her life overall, Moore says, there have been a few blips along the way. But, she says, "I must say, I did a remarkable job of it."