5 Tips for Travel with Diabetes

May 25, 2015

By: Kristen Rider, BSN, RN, CDE

travel diabetes

As the warmer months approach, many people have trips and vacations planned. Don’t let diabetes ruin your travel plans. Plan ahead and be prepared for any “bumps in the road”.

First, always make a checklist for packing. Whether you will be gone for a day or a month, you need to be sure and pack the necessities.   The excitement of getting ready for a trip can sometimes be distracting, causing you to forget to pack certain things. The focus may be on remembering things like the camera, the hiking boots, the bathing suit, etc. Items that you use every day, like your glucometer or medications may be overlooked.

Second, be prepared for anything! Things do not always go according to plan. Have a back-up plan in case of delayed arrival times, altered meal times and medication times. Always carry snacks, whether traveling by car, plane or boat! Make sure your snacks include fast-acting carbohydrates in case of hypoglycemia. Bring a written prescription along to use for a back-up should you need to fill a prescription while you are out of town. Your glucometer, medications and snacks should be kept nearby when traveling (e.g. in your carry on, not in your checked luggage). Wear or carry a medical ID.

Third, take care of your feet. Wear comfortable shoes that fit well, especially if you will be doing a lot of walking. Don’t forget socks! Do not go barefoot. Wear shoes on the beach or on hot pavement.   If you have a long drive or flight, keep your feet moving to promote good circulation. Point and flex your toes and get up and move around when you can. Inspect your feet frequently for problem areas or abnormalities such as blisters, sores, redness, discoloration.

Fourth, test your blood glucose often. When travelling, blood glucose levels may vary more than they normally do. You may have to test more often than you would at home. Various factors such as altitude, time change, and temperature may affect blood glucose levels.   Try to keep blood glucose levels on target. Bring extra testing supplies if possible.

Finally, enjoy yourself! If you are planning on a relaxing vacation, don’t let diabetes get in the way. Try new foods, just keep in mind moderation. Keep your personal targets in mind at meals, but remember nobody is perfect all the time. Increase your physical activity where possible…take the stairs instead of the elevator. Walk the golf course instead of riding in a golf cart. This can help keep blood glucose on target. With proper planning, people with diabetes can travel safely and confidently.


Granola – Quick and Healthy or Just Quick?

May 12, 2015

Granola Bars

by Alison Brinker, RD, LD

Granola bars can be tricky. Some are good and others not so good. The bars can be a very convenient, on-the-go snack, but following a few guidelines will ensure that it isn’t just convenient, but healthy too.

Look for the first ingredient to be whole grain oats or some other whole grain (wheat, barley, brown rice, quinoa). This will indicate the bar is a good source of fiber and other nutrients. When a product is made with the whole grain it contains more vitamins, minerals, and antioxidants too.

Also watch for too much sugar. When sugar is listed as one of the first few ingredients the bar will be higher in calories and may be lower in nutrients.

Limit the bars with coatings. You are pretty much guaranteed a higher calorie content if the bar is coated with chocolate or yogurt. A bar with an icing drizzle won’t be quite as high in calories, but a bar with no drizzle is best.

Chocolate chunks are a tempting ingredient, but consider bars that are flavored with nutrient-rich dried fruit, nuts and seeds as an alternative to chocolate.

Some numbers to look for per serving:

Total carbohydrate: 15-20 grams, less than 10 grams of sugar

Fiber: 3 grams or more

Protein: 3 grams or more

Total fat: 3 grams or less—this may be a little higher if the bar is made with nuts and seeds which are a healthy source of fat so it will still be a good choice.

Saturated fat: 2 grams or less

Avoid any bars with hydrogenated oil or palm oil listed in the ingredient list

Enjoy your quick AND healthy snack!


Diabetes and Dental Health – A Two Way Street

April 27, 2015

by:  Susan Klick, MSN, RN, CNL

Did you know that the risk of oral health problems for diabetics can be up to three times that of patients without diabetes

Having diabetes increases the rate at which the condition progresses. But the problems run both ways – poor oral health increases the risk of poor blood glucose control and the development of diabetes complications. Oral health diseases include:

  • Periodontal disease (gum disease).
  • Xerostomia (dry mouth).Tooth-1024x987
  • Tooth Loss.
  • Dental caries (cavities) and abscesses.
  • Oral candidiasis (thrush).
  • Oral lichen planus (an inflammatory condition causing painful lesions)
  •  Burning mouth syndrome.

Warning signs of periodontal disease may include: bad breath, or a bad taste in your mouth that won’t go away; red or swollen gums; tender or bleeding gums; painful chewing; loose or sensitive teeth; gums that have pulled away from the teeth; any change in the way teeth fit together when biting down or any change in the fit of partial dentures.

Tobacco use promotes periodontal disease and delays healing. Poor nutrition, such as diets rich in carbohydrates and with high sugar content has a negative effect on oral health. Other risk factors include poor general hygiene in general, stress, heredity, crooked teeth, an immune deficiency, defective fillings, medications that cause dry mouth, ill-fitting bridges, hormonal changes, and bulimia.

Good blood glucose control is key to controlling and preventing mouth problems. People with poor blood glucose control experience gum disease more often and more severely than people whose diabetes is well controlled. Daily brushing and flossing, regular dental checkups every six months and good blood glucose control are the best defense against the oral complications of diabetes.

Keep your mouth and teeth healthy and keep smiling!




Today’s Dietitian March 2015


Are you Prepared?

April 14, 2015

Emergency Preparedness

by Susan Klick, MSN, RN, CNL

Spring time in St. Louis reminds us that Emergency preparedness is important for everyone.   When you have diabetes, it requires that much more planning and gathering of supplies. However, it being human nature to procrastinate, many people (maybe even you?) are not fully – or even partially – prepared to deal with having to leave home in a hurry or to survive at home for several days with no power, no running water, a limited ability to communicate with others, and no way to buy groceries or get to a pharmacy.

When you think about being prepared for a natural disaster, keep the following in mind:

  • Do you have enough medication and supplies? For example: blood glucose monitoring supplies; insulin syringes, or an extra battery for your pump and monitor.
  • Who can you reach out to in case of emergency? Do you have family nearby who will be able to get to you?
  • Do you have enough water and non-perishable food items that could last you for up to 2 weeks?

Do you have non-perishable foods to treat hypoglycemia?

Basic Emergency Preparedness steps include:

  1. Have a plan that includes proper diabetes care.
  2. Emergency Supplies – store three days’ worth of supplies in an easy-to-identify container, and store it in a location that is easy to get to in an emergency.
  3. Emergency contacts: Keep a list of emergency contact phone numbers in your supply kit.

Other Helpful Hints:

  • Identify yourself to relief workers as having diabetes and wear diabetes identification.
  • Prevent dehydration. Make sure you are taking in enough fluid to meet your body’s needs. This must be done safely so make sure you are drinking clean water or non-carbohydrate fluids.
  • A word about hypoglycemia: Keep something with you to treat low blood sugar at all times. Due to the serious concerns of low blood sugar and the unusual circumstances faced in the aftermath of an emergency such as a natural disaster, particularly if you are unable to monitor your blood glucose, it may not be best to strive to keep your blood glucose levels to as close to possible as normal, but allow the level to be somewhat higher. Remember too that certain medications require certain diet requirements that may be altered, and activity levels may be different. Excessive work (activity) to repair damage to your home, neighborhood, etc. may cause a drop in blood glucose as well as erratic meal times.
  • Prevent Infection – People with diabetes are naturally at higher risk to develop infections, particularly in their feet. Be aware! In catastrophic events, there may be debris that presents additional danger. Wear protective clothing and shoes.
  • Medications: If you are insulin dependent and insulin is NOT available, carbohydrate intake will most likely need to be cut. The most important priority is to stay hydrated. When medications are available they should be started cautiously as diet and activity levels may be different, or weight loss may have occurred.
  • Pharmacies in affected areas may allow you to get your medications without a prescription if you have the pill bottles.
  • High blood sugar – Look for elevation in blood sugar as a result of stress, erratic meal times, lack of medication(s).
  •  Check your kit every time the seasons change and watch expiration dates.

Food Supplies Suggestions for your Emergency Kits:

Unopened crackers (saltines)                                                         checklist-cartoon

Peanut Butter

Powdered Milk

Bottled Water

Cheese Crackers

Dry/Unsweetened Cereal

6 cans regular soda

6 cans diet soda

6 cans light/water packed fruit

6 cans juice


Disposable Cup

Glucose Tablets or hard candies

Canned tuna/Chicken/Nuts

Mechanical Can Opener







Diabetes Self-Management

American Diabetes Association



An Easter “Sweet”

March 27, 2015

Sweet ‘n’ Salty Raspberry Bars                                            

by Alison Brinker, RD, LD

April showers bring May flowers……..it also brings Easter candy……candy tempting us from every basket. Try this low carbohydrate dessert when gathering with friends and family. It’s refreshing and as bright and colorful as a Spring day. The sweetness of the raspberry gelatin is a great compliment to the salty pretzel crust. Enjoy!

What you will need:

1 ½ cup finely crushed pretzels

¼ cup plus 1 ½ tablespoons Splenda Sugar Blend, divided

½ cup light tub margarine, trans-fat free, melted

1 package (4 serving size) sugar-free raspberry flavored gelatin

1 cup boiling water

1 (12 ounce) package frozen raspberries, slightly thawed (see Note*)

1 (8 ounce) package fat-free cream cheese, softened

1 (8 ounce) frozen fat-free whipped topping, thawed

What to do:

  1. Preheat oven to 400 degrees. Coat an 8-inch square baking dish with cooking spray.
  2. In a medium bowl, combine crushed pretzels, 1-1/2 tablespoons Splenda, and margarine. Press mixture into bottom of prepared baking dish.
  3. Bake 8 minutes; let cool
  4. In a large bowl, dissolve gelatin in boiling water. Add raspberries and chill until slightly thickened. In another large bowl, using an electric mixer on medium speed, combine cream cheese and remaining Splenda until smooth and creamy. Fold in whipped topping and spread evenly over pretzel crust.
  5. With an electric mixer on low speed, beat gelatin and raspberries until berries are broken up. Spread over cream cheese layer. Cover and chill at least 4 hours, or until firm.

*Note: Although the raspberries need to be thawed slightly so they are not frozen solid, the colder they are, the faster the gelatin will thicken.

Cut pan into 16 servings. Each serving is 107 calories, 18 grams of carbohydrate, 3 grams of fat

Source: Everydaydiabeticrecipes.com

51 Ways to Prevent Type 2 Diabetes

March 18, 2015

by Susan Klick, MSN, RN, CNL

Put less on your plate, Nate.

  1. Drink a large glass of water 10 minutes before your meal so you feel less hungry.
  2. Keep meat, chicken, turkey, and fish portions to about 3 ounces.
  3. Share one dessert.

Eat a small meal, Lucille.

  1. Use teaspoons, salad forks, or child-size forks, spoons, and knives to help you take smaller bites and eat less.
  2. Make less food look like more by serving your meal on a salad or breakfast plate.
  3. Eat slowly. It takes 20 minutes for your stomach to send a signal to your brain that you are full.
  4. Listen to music while you eat instead of watching TV (people tend to eat more watching TV).

Dance it away, Faye.

  1. Show your kids the dances you used to do when you were their age.
  2. Turn up the music and jam while doing household chores.
  3. Work out with a video that shows you how to get active.

Let’s go, Flo.

  1. Deliver a message in person to a co-worker instead of sending an e-mail.
  2. Take the stairs to your office
  3. Catch up with friends during a walk instead of by phone.
  4. March in place while you watch TV.
  5. Choose a place to walk that is safe, such as your local mall.
  6. Get off of the bus one stop early and walk the rest of the way home or to work during the week if it is safe.

Snack on a veggie, Reggie.

  1. Buy a mix of vegetables when you go food shopping.
  2. Choose veggie toppings like spinach, broccoli, and peppers for your pizza.
  3. Try eating foods from other countries. Many of these dishes have more vegetables, whole grains, and beans.
  4. Buy frozen and low-salt (sodium) canned vegetables if you are on a budget.
  5. Serve your favorite vegetable and a salad with low-fat macaroni and cheese.

Cook with care, Claire.

  1. Stir fry, broil, or bake with non-stick spray or low-salt broth. Cook with less oil and butter.
  2. Try not to snack while cooking or cleaning the kitchen.
  3. Cook with smaller amounts of cured meats (smoked turkey and turkey bacon). They are high in salt.

Cook in style, Kyle.

  1. Cook with a mix of spices instead of salt.
  2. Try different recipes for baking or broiling meat, chicken, and fish.
  3. Choose foods with little or no added sugar to reduce calories.
  4. Choose brown rice instead of white rice.

Eat healthy on the go, Jo.

  1. Have a big vegetable salad with low-calorie salad dressing when eating out. Share your main dish with a friend or have the other half wrapped to go.
  2. Make healthy choices at fast food restaurants. Try grilled chicken (with skin removed) instead of a  cheeseburger.
  3. Skip the fries and chips and choose a salad.
  4. Order a fruit salad instead of ice cream or cake.

Rethink your drink, Linc.

  1. Find a water bottle you really like (from a church or club event, favorite sports team, etc.) and drink water  from it every day.
  2. Peel and eat an orange instead of drinking orange juice.
  3. If you drink whole milk, try changing to 2% milk. It has less fat than whole milk. Once you get used to 2% milk, try 1% or fat-free (skim) milk. This will help you reduce the amount of fat and calories you take in  each day.
  4. Drink water instead of juice and regular soda.

Eat smart, Bart.

  1. Eat foods made from whole grains every day, (whole wheat bread, brown rice, oats, and whole grain corn.)
  2. Use whole grain bread for toast and sandwiches.
  3. Keep a healthy snack with you, such as fresh fruit, a handful of nuts, and whole grain crackers.
  4. Slow down at snack time. Eating a bag of low-fat popcorn takes longer than eating a candy bar.
  5. Share a bowl of fruit with family and friends.
  6. Eat a healthy snack or meal before shopping for food. Do not shop on an empty stomach.
  7. Shop at your local farmers market for fresh, local food.

Keep track, Jack.

  1. Make a list of food you need to buy before you go to the store.
  2. Keep a written record of what you eat for a week. It can help you see when you tend to overeat or eat foods  high in fat or calories.

Read the label, Mabel.

  1. Compare food labels on packages.
  2. Choose foods lower in saturated fats, trans fats, cholesterol, calories, salt, and added sugars.

You can exhale, Gail.

  1. Take time to change the way you eat and get active. Try one new food or activity a week.
  2. Find ways to relax. Try deep breathing, taking a walk, or listening to your favorite music.
  3. Pamper yourself. Read a book, take a long bath, or meditate.
  4. Think before you eat. Try not to eat when you are bored, upset, or unhappy.


St. Anthony’s Medical Center is presenting a FREE class on Preventing Type 2 Diabetes. Please join us on Saturday, April 11, 2015 from 9:00 – 11:00 a.m. in the Hyland Education Center Great Room. Registration is required. Call 314-ANTHONY (268-4669). For more information visit http://www.stanthonysmedcenter.com


Source: National Diabetes Education Program

Adding to your Physical Activity

March 2, 2015

By:  Susan Klick, MSN, RN, CNL Diabetes Educator

Aerobic exercises such as walking, cycling, swimming, and cycling are part of the focus in managing blood sugar for all diabetics.  However, there is also much to gain from other forms of exercise such as resistance, balance, flexibility and strength training.   These muscular fitness activities can slow the age-related loss of muscle mass and improve mobility, endurance and function.  Resistance training exercises include weight machines, resistance bands, or the use of one’s own body weight as seen with pushups and squats.  Because some of the main tissues in the body that are sensitive to insulin are the skeletal muscles; by increasing the amount and sensitivity of skeletal muscles with resistance exercise, many diabetics can better manage their blood glucose levels and weight by adding resistance training.

Performing resistance training two to three times per week and incorporating it with aerobics is most beneficial for type 2 diabetics.  The combination of the two improves blood glucose control and reduces cardiovascular risk factors more than either type of exercise alone.

Those diabetics with balance issues have a higher risk of falling due to slower reaction times, and an unsteady gait.  Diabetic related complications such as neuropathy, vision problems, and side effects from certain medications (lightheadedness for example) may contribute to the risk of falling.  Many people who are at risk of falling develop a fear of falling, which further limits their activity level!   These individuals can benefit from balance training, which can improve their gait and reduce their risk of falling.  Tai Chi and Yoga exercise programs involve varies combinations of flexibility, balance, and resistance training.   Lower-body and core strengthening exercises will also improve balance.

Flexibility is the ability to move our joints through a complete range of motion.  Certain activities of daily living will require more flexibility than other ones.  People with diabetes are more prone to develop changes in their joints that can limit movement.  Stretching exercises help to increase flexibility, and it may be included as part of a physical activity program.  It should not be used as a substitute for other training as its beneficial impact on blood sugar is unclear.  Flexibility training combined with resistance training increases joint range of motion, and when combined with balance training can reduce the risk of falls.  Remember though – time spent on flexibility does not count toward meeting the aerobic activity time guidelines of 30 minutes/day or 150 minutes/week.

Exercise is a vital component in managing diabetes.  Ultimately, diabetics should aim for at least 150 minutes of moderate to vigorous aerobic activity per week, together with activities that build muscular strength two to three times per week.  It is important to find activities that you enjoy and that you are able to perform safely.  If you are unsure, check with your physician.  St. Anthony’s Medical Center offers a variety of fitness classes Monday through Saturday at the Body, Mind, and Spirit Center in the Medical Plaza building.  For more information on these classes visit stanthonysmedcenter.com



Diabetes Spectrum

St. Anthony’s Get Fit




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