St. Anthony’s Diabetes & Nutrition Education Office moves to new location

July 30, 2014

St. Anthony’s Diabetes Education & Nutrition Services Office has moved from the Medical Plaza building to a new location across Tesson Ferry; it is across the street from St. Anthony’s Medical Center, in the former Blockbuster building. The new address is: 9964-D Kennerly Road, St. Louis, MO, 63128; at the southern end of the Kennerly Center strip mall; 314-525-4508,option 2.

DIABETES EDUCATION SERVICES: the St. Anthony’s Diabetes Education Program provides Diabetes Self-Management Training (DSMT) for a variety of topics, including diabetes lifestyle changes, meal planning and weight loss strategies, monitoring blood glucose, medication management, and problem-solving skills. Individual and group class sessions are available. Instructors include Certified Diabetes Nurse Educators and Certified Diabetes Dietitian Educators (CDE’s). Many insurance companies will cover Diabetes Self-Management Training or Medical Nutrition Therapy with a physician’s referral. A Physician’s referral is required for an appointment. The education Staff also hosts a quarterly support Group meeting. For more information about our services, call 314-525-4508, option number 2. Also, visit for updates, diabetes news, and archived recipes.

NUTRITION COUNSELING: Appointments are available for Medical Nutrition Therapy (MNT). Registered, Licensed Dietitians provide: education, coaching, counseling, and intervention for nutrition-related medical diagnoses including: gastrointestinal conditions, renal disease, cardiovascular disease, diabetes, and cancer. Many insurance companies will cover Medical Nutrition Therapy with a Physician’s referral; a physician’s referral is required for an appointment. For more information about our services, call 314-525-4508, option number 2.



Afrezza inhaled insulin recently approved

July 14, 2014

Afrezza is an inhaled, ultra-rapid acting mealtime insulin therapy designed to improve glycemic control in adults with Type 1 and Type 2 diabetes. In patients with type 1 diabetes, it must be used with a long-acting insulin.  Afrezza is a drug-device combination product, consisting of an inhalation powder in a single dose cartridge & a small inhaler. Each cartridge can deliver a dose of 4 units or 8units; For doses exceeding 8 units, inhalations from multiple cartridges are necessary.  It is administered at the start of a meal with onset of action 12 to 15 minutes later. Peak action is usually seen about 90 minutes after dosing & the effects last about 160minutes. The insulin contained in Afrezza is regular human insulin.

Adverse affects seen in trials: Acute bronchospasm has been observed in patients with asthma and COPD. Lung Cancer: increased cases were seen in clinical trials; however, data was insufficient to determine whether Afrezza has an effect on lung or respiratory tract tumors. Others include: hypoglycemia, Diabetic Ketoacidosis, cough, throat pain or irritation, headache, fatigue, nausea urinary tract infection, weight gain. Before starting Afrezza, a medical history, physical exam and spirometry (FEV1) tests should be performed in all patients to identify potential lung disease. Long-term safety and efficacy of Afrezza in patients with chronic lung disease has not been established. Afrezza causes a decline in lung function over time as measured by FEV1. Pulmonary function should be assessed at baseline, after the first 6 months of therapy, and annually thereafter, even in the absence of pulmonary symptoms.

Additional info: insulin exposed to temperatures higher than 98.6°F (37°C) should be discarded. Store unopened product in refrigerator. If a foil packet is not refrigerated, the contents must be used within 10 days. Inhaler may be stored refrigerated, but should be at room temperature before using. Before use, cartridges should be at room temperature for 10 minutes.


New insulin pen delivery device

July 4, 2014

NovoNordisk has a new re-usable insulin pen injector device, NovoPen Echo, that was recently approved for use. It uses NovoNordisk Penfill insulin cartridges (prefilled, 3ml=300 units).  The Echo allows delivery of insulin doses in 1/2 unit increments, with a max dose of 30 units per use. It has a “dose memory” that displays the amount of insulin most recently injected and the time that has elapsed since that dose (in full hour increments). The pen device comes in red and blue, which could be helpful if using 2 types of insulin. It uses a non-replaceable battery that lasts about 4 to 5 years.

This information is not meant to replace your healthcare Provider’s advice. It is not an endorsement of this product or of the NovoNordisk company.

Diabetic Peripheral Neuropathy Awareness

June 11, 2014

TheMissouri General Assembly has designated the 3rd week in June as Diabetic Peripheral Neuropathy (DPN) Awareness Week.  This year it is June 16th through June 21st. The State resolution cited statistics that in 2009, 346 thousand Missourians were diagnosed with diabetes. DPN is a serious condition that can occur, as a result of damage to the lining of the nerves, from prolonged exposure to poorly controlled blood glucose. The areas of the body most affected by DPN are the legs and feet. Nerve damage to the feet can cause numbness, pain, tingling, a burning sensation, or loss of sensation. Loss of sensation can result in injury and/or an open wound. Due to diminished circulation, elevated blood glucose can interfere with healing and may cause infections or gangrene. As many as 40 to 60% of lower extremity amputations are due to severe forms of DPN. If you already have DPN, discuss treatment options with your Health Care Provider; there are several medications available to help with nerve pain. The goal is to prevent it from getting worse by improving blood glucose control. The Legislature is encouraging all Missouri residents to observe this week by raising public awareness regarding the symptoms and treatment of DPN.

St Anthony’s Diabetes Education Program provides diabetes self-management training (DSMT) for a variety of topics including diabetes life-style changes, meal planning & weight loss strategies, monitoring blood glucose, medication information, and problem-solving skills. Instructors include Certified Diabetes Nurse Educators and Certified Diabetes Dietitian Educators (CDE’s). Many insurance companies will cover DSMT or Medical Nutrition Therapy (MNT). For more information about our services, call 314-525-4508, option 2.

Memorial Day History

May 27, 2014

I sincerely apologize for the technical difficulties that delayed the posting of this blog article; it was originally scheduled for this past Saturday morning;                                             Nancy Trebilcock, BSN, RN, CDE 

For many, Memorial Day weekend signals the beginning of summer activities and the opening of swimming pools. For some of us, though, Memorial Day is not a recreational activity; it is a time of reflection, sadness, pride, prayer and honor. Do you know the origins of this U.S. Federal holiday?

Pixoi Natural Light Collection uid 1500615
Memorial Day is a holiday wherein the men and women, who died while serving in the Unites States Armed Forces, are honored and remembered. This holiday, celebrated annually on the final Monday of May, was formerly known as Decoration Day and originated during the Civil War. In Columbus, Miss., on April 25, 1866, a group of women visited a cemetery to decorate the graves of Confederate soldiers who had fallen in battle at Shiloh. The graves of Union soldiers nearby were barren and neglected because they were considered “the enemy”. Disturbed at the site of bare graves, these women placed some of their flowers on those graves as well. Small local ceremonies took place in various places. For “our” local connection, a cemetery stone in Carbondale, Ill, carries the statement that their first Decoration Day ceremony took place on April 29, 1866. After the Civil war ended, on May 5, 1868, the head of an organization of Union Veterans, the Grand Army of the Republic (GAR), established Decoration Day as a time for the entire nation to decorate the graves of war dead with flowers. Carbondale was the wartime home of Major General John A. Logan, who declared that the holiday should be observed on May30th, because of the belief that flowers would be in plentiful bloom all over the country: “use the choicest flowers of springtime; we should guard their graves with sacred vigilance. Let no neglect or ravages of time testify, to the present or to the coming generations, that we have forgotten as a people the cost of a free and undivided republic”. The first large observance was held that year at Arlington National Cemetery and by the end of the 19th century, Memorial Day ceremonies, honoring the Civil War veterans, were held on May 30th, throughout the nation. It was not until after World War I that the day was expanded to include honoring those who have died in all American wars. In 1971, Memorial Day was declared a national holiday by an Act of Congress and placed on the last Monday in May. In December 2000, Congress established the National Moment of Remembrance Act which encourages all Americans to pause, wherever they are, at 3pm local time on Memorial Day for a minute of silence to remember and honor those who have died in service to our Nation.
This year marks the 70th anniversary of D-Day and the 50th anniversary of Vietnam. Memorial Day is not to be confused with Veterans Day. Memorial Day honors those who died while serving in the military; Veterans Day honors the service of all U.S. military veterans. No matter what your political or religious preferences, please remember those who made the ultimate sacrifice, overseas or on the home front, who earned the freedoms in this great Country that many of us take for granted.

For Veterans reference: Benefits = 1-800-827-1000; Health Care = 1-877-222-8387;
Veterans Crisis Line: 1-800-273-8255, press 1.

Sources: U.S. Department of Veterans Affairs;;


Is it allergies or a cold?

May 12, 2014

This time of year is often known for unpredictable weather and for variable pollen/mold counts in the air. We often attribute allergy symptoms to a cold or vise-versa. “Many people misdiagnose allergies as a cold or the flu, so they never receive appropriate care,” says Stanley Naides, M.D., Medical Director for immunology, at Quest Diagnostics.  He notes that untreated allergies can cause problems, such as sinusitis (a sinus infection due to fluid build-up); middle ear infections (inflammation or fluid build-up in your ear) or can cause asthma.

Allergies are the body’s reaction to outside substances called allergens. When allergens are encountered, the body tries to protect itself by making chemicals, called histamines, which can cause allergy symptoms. Common allergens include airborne particles like pollen, dust, animal dander and mold. Certain foods, insect bites, medications and latex can also cause allergic reactions. Allergy symptoms will vary according to the parts of the body that an allergen touches. Symptoms can include: breathing problems, coughing, sneezing or runny nose; burning, watering, itchy or swollen eyes; itchy skin, hives and/or rashes.

Do you know the difference between a cold and an allergy?  The information in this chart and in this article provides only general guidelines and does not take the place of your health care Provider’s advice, but it may help to prevent delay of treatment.

Symptoms Cold Airborne Allergens
Cough Common Sometimes
General aches/pains Slight Never
Fatigue/weakness Sometimes Sometimes
Itchy eyes Rare or never Common
Sneezing Usual Usual
Sore throat Common Sometimes
Runny nose Common Common
Stuffy nose Common Common
Fever Rare Never
Usual duration 3-14 days weeks

For problems with indoor allergens, there are a few tips to help minimize your problems: dust, vacuum, and wash bedding often; use clean filters in your vacuum cleaner, as well as in your heating/air conditioning units; minimize moisture in the kitchen & bathroom; close windows & doors when pollen counts are high; some house plants can contribute to indoor pollen & mold, so you may need to limit the amount you have. Talk to your Doctor to determine if your symptoms are from an allergy. Allergy testing can help you both choose the appropriate treatment.

Talk to your Doctor and/or Pharmacist before using any over the counter remedies, as many can cause interactions with your prescription medications, especially if you have diabetes, high blood pressure or kidney problems. Be aware that antihistamines can cause drowsiness and dry mouth. Decongestants might cause a jittery or nervous feeling, a rapid heartbeat or interfere with sleeping.

Sources: American Academy of Allergy, Asthma, & Immunology,; National Institute of Allergy & Infectious Diseases, http://www.niaid.nih.gov; Asthma, and allergy Foundation of America,; US National Library of Medicine/National Institutes of Health,

Photo credit: David Castillo Dominici

Program Topic: “Diabetes Medications Revisited”

May 9, 2014

The TalkDiabetes Support Program and the Diabetes Education Program Staff of St Anthony’s Medical Center is hosting it’s quarterly meeting on Thursday, May 15th, at 7:00pm. There are a variety of medications available to help treat diabetes. From pills to injectables to insulin pumps, Kristen Rider, BSN, RN, CDE (Certified Diabetes Educator), will discuss the different diabetes medications and updates. The meeting location is on the St Anthony’s Hospital campus: the Hyland Education & Training Center(HETC) — The Great Room; 10020 Kennerly Rd; 63128 (drive past the Emergency Room & the helicopter landing pad; HETC will be on the right). We sponsor an ongoing green (recycle) table, so bring your unwanted magazines, books, coupons. Meetings are FREE and all are welcome! Registration preferred via 800-554-9550 or


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