What is in your Gut?

June 13, 2017

by Susan Klick, MSN, RN, CNL

Your gut carries about six pounds of a diverse group of bacterias, known as “gut microbiobes” which are responsible for many things. These six pounds of gut microbiobes form our gut microbiome which helps to protect us against outside bacteria, support our immune systems, and help us to use different vitamins and regulate hormones. Now, recent studies are finding that some microbes may play a role in insulin sensitivity and metabolism.

New research is suggesting that in addition to genetics and lifestyle (physical inactivity and poor diet), certain gut microbes may cause an inflammation in the body that affect liver and fat cells resulting in altered insulin sensitivity and metabolism. Although nothing has been proven, there is enough evidence to warrant more research.

Diet is probably the single most important factor influencing the gut microbiome. Studies have shown that changes in diet result in changes in the gut microbiome. A healthy diet with low-fat, high fiber has been linked to a more diverse and better gut microbiome compared to a diet high in fat and low in fiber. The gut microbiome also adapt and shift quickly to plant-based diets compared to animal-based diets.

There is still a lot to learn and we will be able to use this knowledge to find new ways to treat many different diseases including diabetes. Until then, eating healthy and staying active can help maintain and develop a healthy gut microbiome.

 

 

Source: health.clevelandclinic.org; Forecast Diabetes Magazine

Diabetes, Websites, Apps Oh My!

February 28, 2017

If you missed our February 16th Support Group, don’t worry!  Here is a list of our recommended applications for your mobile devices and websites to help track your diabetes:

BG Monitor Diabetes: Allows you to track everything, calculate how much insulin you need, set reminders, create spreadsheets and graph your data. Organize your entries with tags.  Create a photo log of meals.

My Fitness Pal: Track food intake, exercise and weight. At the end of each day you are given an overall nutritional snapshot of your eating and an estimate of how long it will take to reach your weight loss goal based on current eating habits.  You can also log activity from an extensive list of exercises and the app will calculate calories burned.  You can also input numbers from a heart rate monitor from your treadmill for example of some other fitness tracker.

Calorie Counter PRO: This is a weight loss app that can help track your daily eating and can be useful when managing your diabetes. It allows you to chart your progress and take daily notes without being overwhelming.  It also tracks body measurements.

Glucose Buddy: Tracks food, insulin, blood sugar results and will show a graph of your glucose results. You can set an alert to remind you to check your blood glucose throughout the day.

Lose it: Used for weight management. Create a profile and use the apps recommended amount of calories for weight loss or input your own.  It has a large food database.  Input custom foods, scan bar codes or it will suggest foods based on a photo of your meal or snack.

MySugr: Track everything in one place, meals to mood. Create monthly reports.  This app does offer advanced services for a fee.

Fooducate: Offers good community support, has a scanner that gives groceries a grade. Good choice if feeling overwhelmed at the grocery store.

Diabetes Goal Tracker: This app was developed by the American Association of Diabetes Educators. Set goals to manage diabetes based on the 7 self-care behaviors we use when tracking our program participants.  Set goals for yourself and the app will send you reminders to help keep you on track and give inspiration.  The My Nutrition section allows you to scan bar codes of foods or enter foods and track calories, carbs, fat and sodium.

Diabetes.org: This is the main website for the American Diabetes Association. Under the Food and Fitness tab you will find tips for eating out, planning meals, and carbohydrate information.  Under this tab is also a link to My Food Advisor where you can find nutrition information about various foods and even create a database of your own recipes.  You will need to create an account, but it is free.

Diabetesselfmanagement.com: This site was created by the providers of Diabetes Self -Management magazine. Good resource for recipes and general information about caring for diabetes.

Nutritiondata.com: Create your own food database; use the website to analyze nutrition content of your favorite recipes

 


Diabetes Etiquette for Family and Friends

November 17, 2016

Last week our blog was about dealing with “Food Police”. This week we are focusing on diabetes etiquette for people who DON’T have diabetes –  well-meaning family members and friends of those with diabetes!

DON’T offer unsolicited advice about eating or other aspects of diabetes. You may mean well, but giving advice about someone’s personal habits, especially when it is not requested, isn’t very nice.  Besides, many of the popularly held beliefs about diabetes (“you should just stop eating sugar”) are out of date or just plain wrong.

DO realize and appreciate that diabetes is hard work. Diabetes management is a full-time job that wasn’t applied for, didn’t want, and can’t quit. It involves thinking about what, when, and how much is eaten, while factoring in exercise, medication, stress, blood sugar monitoring, and so much more – each and every day.

DON’T tell horror stories about your grandmother or other people with diabetes you have heard about. Diabetes is scary enough and stories like these are not reassuring! Besides, we now know that with good management, odds are good you can live a long, healthy, and happy life with diabetes.

DO offer to join your friend/loved on in making healthy lifestyle changes. Not having to be alone with efforts to change, like starting an exercise program, is one of the most powerful ways that you can be helpful. After all, healthy lifestyle changes can benefit everyone!

DON’T look so horrified when you see someone check their blood sugars or give themselves an injection. It is not fun for them. Checking blood sugar and taking medications are things they must do to manage diabetes well. If they have to hide while they do so, it makes it harder!

DO ask how you might be helpful. If you want to be supportive, there may be lots of little things that would be appreciated. However, what is needed most may be very different than what you think is needed, so please ask first.

DON’T offer thoughtless reassurances. When you first learn someone has diabetes, you may want to reassure them by saying things like, “Hey, it could be worse; you could have cancer!” This won’t make anyone feel better. And the implicit message seems to be that diabetes is no big deal. However, diabetes (like cancer) IS a big deal.

DO be supportive of self-care efforts. Help the person with diabetes set up an environment for success by supporting healthy food choices. Honor their decision to decline a particular food, even when you really want them to try it. You are most helpful when you are not being a source of unnecessary temptation.

DON’T peek or comment on glucose numbers without asking first! These numbers are private unless shared! It is normal to have numbers that are sometimes too low or too high. Your unsolicited comments about these numbers can add to the disappointment, frustration and anger being felt!

DO offer your love and encouragement. Sometimes just knowing that someone cares can be very helpful and motivating.

 

 

 

Resource: Behavioral Diabetes Institute

Handling the “Food Police”

November 10, 2016

Everyone manages their diabetes differently these days, including choices about food. Unfortunately, many well-intentioned people have outdated or incorrect information about how a person with diabetes is “supposed” to eat.  Hearing comments such as “should you be eating that?” can make people with diabetes feel frustrated, angry, isolated, and less likely to make diabetes-friendly choices.  Here are some tips for successfully navigating the challenges of the “food police”:

  1. Know when to speak up: Decide when it’s worth the hassle of responding to others who have commented on your eating or any other aspect of your diabetes management. Some factors to consider: your relationship with the person, how likely he or she is to change, and whether you want to spend your holiday time explaining your diabetes care.
  2. Choose your response: While you may want to tell the food police to mind their own business, choose a response that can help educate and keep the peace. An appropriate response will differ based on the person. For example, you might choose to educate your coworker about how modern diabetes management allows for occasional splurges. But you may decide to change the subject when faced with comments from your grandmother (while reminding yourself that she cares about you but has outdated knowledge and is unlikely to change).
  3. Be ready: Putting some forethought into what you would like to say can help things to smoother. What do you want people to know and what would you like them to do differently? For example, you might say, “I appreciate your concern for my health. You may not know that no foods are off limits for people with diabetes. I can have sweets for a special treat. I have planned ahead for this party, so you don’t need to worry!”

Holiday gatherings can cause the food police to come out in full force. Know when you would like to speak up and have a response ready.

 

Resource: Diabetes Forecast, Nov. 2016

 

 

 


A Wee Bit of Wisdom About Alcohol and your Blood Sugar

March 10, 2016

By Susan Klick, MSN, RN, CNL

 Happy St. Patrick’s Day! Have you ever really thought about why we celebrate St. Patrick’s Day? Or is it just a holiday when you decorate your front door with something green, cook corned beef and cabbage, paint a street green and maybe indulge in an Irish coffee or green beer? The truth is, it is a day to celebrate not just the Irish culture, but to celebrate the life of St. Patrick himself, the patron Saint of Ireland. But did you know that St. Patrick is also the patron saint of engineers???? That is because one of St. Patrick’s achievements was teaching the Irish to build arches of lime mortar instead of dry masonry. These beginnings of ceramic work developed into organized crafts, and that is how St. Patrick became a patron saint of engineers.

Should you decide to kick up your heels a wee bit on St. Patty’s day, here are some guidelines on Diabetes and Alcohol: If you have questions about whether alcohol is safe for you, talk to your doctor.

Alcohol and your body

Alcohol goes from your stomach straight into your blood. The alcohol in your blood stream is highest 30 to 90 minutes after drinking. Your liver slowly breaks down alcohol. If you weigh 150 pounds, it takes about 2 hours to break down one drink. Two drinks take twice as long, or 4 hours. If you drink faster than your body breaks it down, the alcohol stays in your blood and affects other body parts. When alcohol affects your brain, you feel or act drunk. Some signs of too much alcohol (slurred speech, confusion) are similar to low blood glucose. If you drink a lot of alcohol (3 or more drinks a day), you may develop liver disease and other health problems.

Alcohol and blood glucose

Alcohol can make blood glucose too high or too low. You need to know when and how to drink to keep your diabetes under control. When no alcohol is in the blood, your liver keeps blood glucose from going too low by releasing glucose into your blood. However, if the liver is busy breaking down alcohol, it cannot release glucose into your blood!

If you take insulin or diabetes pills, your blood glucose may go too low when you drink alcohol because the medicine causes your blood glucose to go low and the liver is not releasing any glucose.

The sugars in many drinks can cause blood glucose to go too high and alcohol can also cause high blood triglycerides (fats).

Alcohol and Diabetes

Many people with diabetes can have a moderate amount of alcohol if they want. Still, there are some people who should avoid alcohol. A moderate amount of alcohol is no more than:

1 drink for women per day                           2 drinks for men per day

One drink is equal to:

  • 1 ½ ounces of liquor
  • 12 ounces of beer
  • 5 ounces of wine

When to avoid drinking

  • You are pregnant
  • If you are under the age of 21
  • If your doctor has told you not to
  • If your diabetes is not in good control, wait to drink until it is in better control
  • If you have complications such as severe neuropathy
  • If you take medicines that say avoid alcohol on the medicine bottle
  • If you have high blood triglycerides
  • If you have eye disease
  • If you have had problems with alcohol abuse
  • After vigorous exercise

Be safe if you drink alcohol:

  • It is best to drink alcohol only when diabetes is under control.
  • Always eat if you drink alcohol. Munch on pretzels, popcorn, or crackers if you are drinking apart from a meal.
  • Check your blood glucose more often the day you drink and the next day to see how alcohol affects you.
  • Tell people with you that you have diabetes and teach them about signs of low blood glucose.
  • Check the size of your glasses. Most wine glasses hold much more than 5 ounces of wine. Large beer glasses are more than 12 ounces.
  • Sip slowly to make the drink last.
  • Try a wine spritzer (wine and diet club soda) or mix liquor with plenty of water or diet soda to make it last.
  • Limit yourself to 1 or 2 drinks a day
  • Wear medical identification. If you have a low blood glucose reaction, you want others to know that you have diabetes and are not drunk.
  • Alcohol can change your judgment. Be careful with medicine, food, and testing.
  • Do not drive after drinking alcohol.

Lower calorie options

  • Light beer instead of regular
  • Dry red or white wine
  • Drinks made with sugar free mixers like diet soda, light juice, or diet tonic water.
  • Skinny mixes 

Avoid high calorie drinks

  • Liqueurs – like Irish Crème
  • High calorie mixed drinks like margaritas, Pina coladas, Mudslides
  • Drinks mixed with cream
  • Full sugar soda and other sugary mixes

 

 

Sources: American Diabetes Association; Academy of Nutrition & Dietetics; Diabetes.org

February is Heart Month

February 15, 2016
by Alison Brinker, RD, LD and Susan Klick, MSN, RN, CNL

Diabetes and Cholesterol

Heart attack and stroke are the leading causes of death for people with diabetes.  Having lipid levels within the recommended range can help prevent heart attack and stroke.  Other factors contributing to heart attack and stroke are elevated blood pressure and elevated A1C levels.  By keeping these at the recommended levels your risk of complications from diabetes is decreased.  Lipid levels can improve with healthy eating, weight loss, physical activity, and, if necessary, medications.

Lipids are fat-like substances found in the blood.  Cholesterol and triglycerides are two types of lipids.  The body needs some lipids to stay healthy, but elevated lipid levels can damage artery walls, causing heart disease, hardening of the artery walls, and atherosclerosis all which can cause heart attack and stroke.

Cholesterol is found in the blood and some is actually made by the liver.  Cholesterol is also found only in animal foods such as eggs, milk, cheese, liver, meat and chicken.  The recommendation is for cholesterol levels to be under 200.

LDL (also called “bad cholesterol”) is found in the blood and high levels over time can damage arteries.  When LDL is present, high “plaque” forms in the blood and can block blood flow through arteries.  The recommendation is for LDL to be less than 100 or less than 70 if you have diabetes.  LDL is the most important factor in determining risk for heart disease.  You want to get this number as low as possible to lower your risk.

HDL (also called “good cholesterol”) is the lipid that works to clear LDL or bad cholesterol from the blood helping to keep arteries open.  When HDL is too low, not enough of the LDL cholesterol is removed from the blood increasing the risk of damage to the arteries.  The recommendation is HDL should be greater than 40 for women and greater than 50 for men.

Triglycerides, a fatty substance in the blood, high levels prevent HDL from removing LDL from the blood.  It is recommended the triglyceride level be below 150.

The Cholesterol/Diabetes Connection:  Glucose attaches to LDL’s in the blood.  LDL’s coated with glucose stay in the bloodstream longer, causing sticky plaques to form.  People with diabetes often have low levels of HDL and higher levels of triglycerides, raising the risk of heart attack or stroke.

Join the Diabetes Support Group on Thursday, February 18th at 10:00 a.m. in the Great Room at the Hyland Education Center for a discussion on Heart Health and Cholesterol. Registration is required. Please call 314-ANTHONY (800-554-9550) or register at http://www.stanthonysmedcenter.com/diabetes.

 

 

 

Sources:  Joslin Diabetes Center, Mayo Clinic, CDC, NIH

 

 

 

 


Flu Season is Here

November 4, 2015

by:  Susan Klick, MSN, RN, CNL

Risks:

The flu can make existing health conditions worse and is especially dangers for people with chronic health conditions, like diabetes. People with diabetes both (Type 1 and 2), even when well-managed, are at high risk of serious flu complications, often resulting in hospitalization and sometimes even death. Pneumonia, bronchitis, sinus infections and ear infections are examples of flu-related complications.

Illness can make it harder to control your blood sugars. The illness might raise your sugar but sometimes people don’t feel like eating when they are sick, and this can cause blood sugar levels to fall. It is important to follow sick day rules.

Prevention:

Vaccination is the best protection against the flu, and flu shots are approved for use in people with diabetes as it has a long, established safety record in people with diabetes. Therefore, the CDC recommends that both Type 1 and Type 2 diabetics, who are 6 months of age and older, receive a flu vaccine.  Check with your physician regarding the nasal spray vaccine as  the safety of the nasal spray vaccine in people with diabetes and some other high risk conditions has not been established.

Your physician may also recommend a pneumonia vaccine if you have Type 1 or Type 2 diabetes.

Treatment:

Contact your doctor’s office immediately if you experience flu-like symptoms.  Anti-viral medications may be prescribed if you test positive for the flu that can make your symptoms less severe and make you feel better faster. Antiviral drugs fight influenza viruses in your body. They are different from antibiotics, which fight against bacterial infections. Antiviral medications may help people with conditions that increase the risk of complications from flu (like diabetes) if given within the first 48 hours after symptoms start.

Sick Day Rules:

  • Continue taking your diabetes pills or insulin
  • Test your blood glucose every four hours and track your results
  • Drink lots of calorie-free liquids to stay hydrated
  • Try to eat as you would normally
  • Weigh yourself every day. Losing weight without trying is a sign of high blood glucose

Contact your health care provider or go to an emergency room immediately if you:

  • Are unable to eat normally
  • Go six hours without being able to keep food down
  • Have severe diarrhea
  • Lose five pounds or more
  • Have a temperature over 101o Fahrenheit
  • Get a blood glucose reading lower than 60 mg/dL or more than 300 mg/dL
  • Have trouble breathing
  • Feel sleepy or can’t think clearly
Sources:
www.flu.gov
American Diabetes Association

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