Oh Those Aching Legs

September 27, 2016

by:  Susan Klick, MSN, RN, CNL

You are tired, you want to go to sleep, but your legs aren’t cooperating. You have an irresistible urge to move your legs, maybe even your thighs or your arms.  Or maybe you are at the movies, and your legs feel “jumpy”.  Long trips in the car, or a long-distance flight give you a throbbing, pulling, or creeping feeling in your legs.  This is Restless Leg Syndrome (RLS) and it can make bedtime or long car trips a nightmare.

Many times, RLS is confused or misdiagnosed as Peripheral Neuropathy. Diabetic neuropathy in particular is a nerve disorder caused by poor blood sugar control in people with diabetes.  The most common type of peripheral neuropathy results in problems with the feet.  Symptoms include numbness, pain, or tingling in the feet or lower legs and may be associated with difficulty in walking and weakness in foot muscles.

How do you know what you are dealing with? The most important questions to ask yourself are:  1) when does the pain occur and 2) does movement make the pain go away or feel better.  If the symptoms occur when you are lying down and trying to relax, in the evening, and movement makes the pain better, then you are most likely dealing with RLS.  RLS is sometimes seen in patients with kidney disease, Parkinson’s disease, people with low iron, pregnancy, and those taking antidepressants or antipsychotic drugs.  However, if you are experiencing numbness, tingling, and pricking sensations, sensitivity to touch, muscle weakness, burning pain that is not eased by walking (movement may even make the pain worse), and symptoms which do not change during particular times of the day –  you may be dealing with Peripheral Neuropathy.  What can make a diagnosis difficult is that the two can occur together.

By definition, RLS is a neurological disorder with symptoms occurring when lying down or trying to relax (primarily at night), and relief is found in moving the legs. Peripheral Neuropathy describes damage to the peripheral nervous system, which transmits information from the brain and spinal cord to every other part of the body.  It can be either inherited or acquired (as is the case with Diabetic neuropathy).

The key to managing peripheral neuropathy is to recognize the symptoms and work with your doctor to find the right treatment and approach that works for you.

  1. Keep your blood glucose levels in check. This can prevent or delay nerve damage or prevent further damage.
  2. Mild symptoms can be relieved with over the counter, nonsteroidal anti-inflammatory medications.
  3. Medications to treat epilepsy, such as gabapentin and pregabalin, may help control more serious symptoms.
  4. Some physicians may recommend a tricyclic antidepressant, such as amitriptyline or doxepin, in a modest dose, to alleviate pain. Studies show that newer antidepressants may ease discomfort

If you have a distinct “creepy crawly” sensation, consult your doctor. Treatment for RLS may include having your blood checked for levels of vitamin D and iron.  Correcting deficiencies of each helps some people control symptoms.  Reducing the use of caffeine, alcohol, and tobacco can also make a difference.  The treatment of choice are drugs known as dopaminergics, which increase the body’s dopamine and have shown to alleviate moderate to severe RLS.





Source: Diabetes Living Fall 2015; Clinical Advisor March 2015; NIH.Gov

September Recipe of the Month

September 16, 2016

by Alison Brinker, RD, LD

Labor Day, the official last day of summer has come and gone, but don’t put the grill away yet! Late summer and early fall is a great time to be outside walking and cooking up a delicious and nutritious meal.  Grilling is a healthy preparation method for a low fat protein like white fish.  Enjoy!

Grilled Florida OJ Fish Tacos with Cilantro Slaw


1-1/2 pounds Mahi-Mahi or other firm white fish

½ cup canola oil

1 cup Florida Orange Juice

1 teaspoon dried oregano

¼ teaspoon cayenne pepper

1 teaspoon finely minced garlic

Salt and pepper to taste

In a large bowl, whisk together oil, Florida Orange Juice, oregano, cayenne, garlic, salt and pepper. Reserve 1/3 cup of this mixture for the slaw.  Put fish in a zip top bag and pour the remaining marinade over the fish.  Seal bag and marinate at room temperature for 15 minutes.


¼ cup chopped cilantro

4 cups finely shredded cabbage

1 cup diced Florida Oranges or Florida Grapefruit

½ cup diced red onion

½ cup diced tomato

½ cup diced red bell pepper

1 small jalapeno, seeded and minced


Reserved 1/3 cup marinade (see above)

Salt and pepper to taste

In a large bowl, add reserved marinade, cilantro, cabbage, Florida Oranges or Florida Grapefruit, red onion, tomato, red bell pepper, jalapeno, salt and pepper. Toss well to coat and set aside to allow flavors to blend.


24 corn tortillas (6 inch size)

Fish and Slaw

Plain Greek yogurt for garnish (optional)

Heat a grill or grill pan to medium-high heat. Remove fish from marinade and discard marinade; grill about 5 minutes or just until done.  Do not overcook fish.  Remove fish from grill and flake with a fork.  Place tortillas on the grill for 20 seconds to heat them up.  For each taco, place about 1 ounce of fish into a tortilla and top with 1-2 tablespoons of slaw.  Garnish with Greek yogurt if desired.

Makes 12 servings: 2 tacos per serving

Estimated nutrition information per serving: 35 grams carbohydrate, 2 ounces protein/meat, 5 grams fat.

Source: Floridacitrus.org


August Recipes of the Month: Healthy Snack Ideas

August 23, 2016

Honey Mustard Snack Mix

Makes: 15 servings

Serving size: ½ cup


1-1/2 cups crispy corn and rice cereal

1 cup bite-size shredded wheat biscuits

¾ cup unblanched whole almonds

¼ cup peanuts

2 tablespoons butter

3 tablespoons honey mustard

1 teaspoon Worcestershire sauce

¼ teaspoon garlic powder

1/8 teaspoon cayenne pepper

4 cups plain popped popcorn



  1. Preheat oven to 300 degrees. Line a 13x9x2 inch pan with foil, extending the foil over edges of pan. In the prepared pan toss together crispy cereal, wheat biscuits, almonds, and peanuts; set aside.
  2. In a small saucepan heat butter over medium heat until melted. Remove from heat.   Stir in mustard, Worcestershire sauce, garlic powder, and cayenne pepper. Drizzle mustard mixture over cereal mixture; toss gently to coat.
  3. Bake for 20 minutes, stirring gently after 10 minutes. Stir in popcorn. Using the edges of the foil, lift popcorn mixture out of pan; cool. Store in an airtight container at room temperature for up to 3 days. Makes 15 (1/2 cup) servings.

Nutrition Facts Per Serving: 113 calories, 8 g total fat (2 g sat fat), 4 mg cholesterol, 87 mg sodium, 9 g carb (2 g fiber, 1 g sugar), 3 g pro.


Sweet Party Mix

Makes:   36 servings

Serving size: 1/3 cup


Nonstick cooking spray

4 cups bite-size corn square cereal

3 cups bite-size rice square cereal

2 cups pretzel knots

2/3 cup sliced almonds

½ cup packed brown sugar

¼ cup butter

2 tablespoons light-colored corn syrup

1/8 teaspoon baking soda

¾ cup dried cranberries, blueberries, or cherries



  1. Lightly coat a large piece of foil with cooking spray; set aside. In a large roasting pan toss together corn cereal, rice cereal, pretzels, and almonds; set aside.
  2. In a medium saucepan combine brown sugar, butter, and corn syrup. Cook and stir over medium heat until mixture just begins to bubble. Continue cooking at a moderate, steady rate, without stirring, for 5 minutes more. Remove saucepan from heat; stir in baking soda. Pour over cereal mixture; stir gently to coat.
  3. Bake in a 300 degree oven for 15 minutes; stir cereal mixture and bake 5 minutes more. Remove from oven; stir in dried fruit. Spread on prepared foil to cool. Store in an airtight container. Makes 36 (1/3-cup) servings.

Nutrition Facts Per Serving: 31 calories, 50 mg sodium, 6 g carb (1g fiber), 1 g pro, estimated 3 g total fat.

Source: diabeticlivingonline.com

Blood Sugar Swings

August 9, 2016

Do you ever experience blood sugar swings? A recent article in Diabetic Living discussed 10 reasons for blood sugar swings.

  1. Improper Control: Routinely checking your blood sugar levels, taking medications correctly, and meeting healthy lifestyle recommendations all play a role in helping to control your blood sugars.
  2. Sugary Drinks: Sugars hidden in specialty drinks, like special coffee drinks or mixed drinks can pack in carbs and cause blood sugar spikes. Know the ingredients and limit added sugars.
  3. Medication Mistakes: Taking the wrong dose of medication can cause a swing in blood sugar. Prevent incorrect dosing by using a pill box and by asking questions at your doctor’s office and at the pharmacy.
  4. Illness: Coming down with a bug can mean spikes in sugar levels. When you are sick – anything from the flu to food poisoning, your liver releases extra sugar. Stay hydrated. Check blood glucose more often.
  5. Inaccurate Counting: Letting those portion sizes get away from you can lead to miscalculating the number of carbohydrates you are actually eating. Use measuring cups and spoons.
  6. Stress! Stress comes in all forms – physical, mental, and emotional. Sudden bouts of stress can cause blood sugar to spike or drop! Practice relaxation exercises.rollecoaster
  7. Irregular Carbohydrate Intake: Consistent carbohydrate intake is the key. Spread your in-take out throughout the day to help ensure sugar levels remain steady.
  8. Your Period: Your blood sugar readings may swing around your period. Changing hormones in your body around that time of the month can raise your blood sugar.
  9. Pushing too Hard too Fast: High intensity workouts that push the body out of its comfort level can cause low and high blood sugars. Increase the length and intensity of your exercise in increments!
  10. Dehydration! If you don’t have enough water in your system, sugar concentrates in your bloodstream. Drink plenty of water throughout the day. Your urine should be close to clear if you are drinking enough.


Source: Diabetic Living; Precision Nutrition

August Diabetes Support Group Meeting

August 4, 2016

The TalkDiabetes Support Program

and the Diabetes Education Program at St. Anthony’s present:


Diabetes “Trivia”

Join us for an evening of fun while you test your knowledge and learn a little too!  We will have three “rounds” each with five questions.   Helpful hints about party snacking will be presented too.


6:30 p.m. Thursday, August 18, 2016

Hyland Education Great Room

10020 Kennerly Road

St. Louis, MO 63128

Meetings are FREE to the public.

All are welcome!


To register, call 314-ANTHONY (268-4669)

or visit stanthonysmedcenter.com/diabetes.

Diabetes Friendly Summer Sandwich Ideas

July 19, 2016

Beat the heat with these summer sandwich ideas:

Hold the Mayo Tuna Salad Sandwich

This recipe makes 2 servings (serving size is 1 sandwich).  Preparation time 10 minutes.  Per serving:  260 calories; Fat 9g; Saturated Fat 1.4g; Trans Fat 0; Carbohydrates 31 g; Protein 17g


  • 1 can (5 oz) no-salt added white tuna in water, drainedDec13_Tuna_Salad_Plate
    1 Tbsp. olive oil
  • 1/2 Tbsp. balsamic vinegar
  • 1/2 tsp. course Dijon mustard
  • 1 small garlic clove, very finely minced
  • 1/8 tsp. sea salt
  • 1/4 tsp. freshly ground black pepper
  • Pinch of sugar
  • 1 large celery stalk, minced
  • 2 Tbsp. finely minced red or Vidalia onion
  • 1 tsp. drained capers
  • 1 tsp. fresh minced basil
  • 2 whole wheat English muffins


  1.  In a medium bowl, flake the drained tuna gently until fluffy.
  2. In a small bowl, whisk together the olive oil, vinegar, mustard, garlic, salt, black pepper, and sugar.  Pour over the tuna and gently mix.
  3. Add the celery, onion, capers, and basil.  Gently combine.
  4. Divide the tuna salad and serve the English muffins.

Buffalo Chicken Pita

This recipe makes 4 servings, each 1/2 pita pocket.  Each servings has 250 calories; 6 grams of Fat, 21 grams of Carbohydrates, and 26 grams of Protein.


  • 2 cups cooked and chopped chicken breastBuffalo Chicken Pita
  • 1 cup chopped celery
  • 1/4 cup bottled buffalo wing sauce
  • 2 whole wheat pita pockets
  • 4 romaine lettuce leaves
  • 4 Tbsp. reduced-fat blue cheese salad dressing


  1.  In a large bowl, combine the chicken, celery, and Buffalo wing sauce.  Stir to coat the chicken evenly.
  2. cut the pitas in half to form pockets.  Fill one half with one lettuce leaf, 1 Tbsp. blue cheese dressing, and 1/2 cup chicken salad mixture.  Repeat for the remaining three pita halves.


Source:  Diabetes Forecast

Heat and Humidity – What about those Test Strips???

July 5, 2016

By Susan Klick, MSN, RN, CNL

Summer Storage of Test Strips: Heat, humidity, temperature and exposure to air can all affect strips. Store test strips at a temperature less than 86 degrees F.  DO NOT FREEZE and DO NOT expose test strips to direct sunlight.

Other Good Test Strips Tips:

Loose diabetes test strips. If you put individual diabetes test strips into your purse or wallet this can affect the accuracy (unless they are foil-wrapped from the manufacturer). Also, try not to move the few remaining strips of one vial into the new vial you are opening if the code numbers don’t match. And if you have one vial of diabetes test strips at home and one vial at work but just use the one meter – make sure the vials have the same coding. WAIT!!! Ahhh. . . and one more thing. Even if the strips have the same code, they may have different expiration dates! After transferring a few strips a couple of times, you could end up with some pretty outdated strips floating around in a vial!

Age of blood sugar monitor: Old blood sugar monitors may be inaccurate simply because of age. But old diabetic meters also tend to need cleaning or the dirt/dried blood could affect the accuracy of the reading. Be sure to follow cleaning instructions from the manual to ensure accurate results. If you have a diabetic meter older than 5 years please consider calling the meter company (often there is a 1-800 # on the back of the meter) and asking for a free updated model. They should want to keep you as a customer buying their strips.

Expired diabetes test strips? Check the expiration date when the pharmacy gives you the diabetes test strips. If you don’t feel you’ll be using them before that date, ask for another batch with a later date

Underfilled? Most newer meters have under-fill detection of some sort, and some beep after a few seconds even if the chamber isn’t full.   You may get a reading lower than anticipated.   Some meters tend to “err” and waste strips if you don’t hold your finger in place long enough. It’s a good practice to hold your finger to the strip for 1-2 seconds after the beep to avoid wasting diabetes test strips because of under fill.

Date vial opened? For some diabetes test strips, once you open the vial you should use the content of the vial within 3 months no matter what the expiration date (because of repeated exposure to air). Some products have a lid with a preservative in it so they are supposedly good up until the actual expiration date on the bottle. However, other vials of strips are good for a limited time once the lid is opened (regardless of the date). Check the information in your diabetes test strip box to be sure.

Storage of meter: Don’t leave blood sugar monitors in the car on hot or freezing days. They are just tiny little devices and you know how temperamental electronics are.

Have a safe and healthy summer!




Source: American Diabetes Association


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