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

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



Protect Yourself from Influenza (The Flu)

October 15, 2014

by Susan Klick, MSN, RN, CNL Diabetes Educator

If you have diabetes, you are three times more likely to be hospitalized from the flu and its complications such as pneumonia, than other people. The flu may also interfere with your blood glucose levels.

But there are steps you can take to protect yourself.

  • Get a flu shot! It’s the single best way to protect yourself against the flu.            
  • Take prescription flu medicine when your health care provider prescribes it.
  • Follow sick day rules for people with diabetes.
  • Take everyday steps to protect your health.

People with diabetes should talk with their health care provider now to discuss preventing and treating the flu. People infected with the flu can pass it on to others a day or two before any symptoms appear. That’s why it is important to make sure the people around you get a flu shot as well.

A flu shot is the single best way to protect yourself against the flu.

The vaccine is safe and effective. It has been given safely to hundreds of millions of people.  Everyone ages 6 months and older should get the flu shot unless told otherwise by a health care provider, especially people with diabetes. The flu shot is given with a needle, usually in the arm. The vaccine used in the shot is made from killed virus. You cannot get the flu from the flu shot. A few people may be sore or notice some redness or swelling where the shot was given or have a mild fever.

Pneumococcal vaccine is also recommended for people with diabetes. One possible complication of flu can be pneumonia. A pneumonia (pneumococcal) vaccine should also be part of a diabetes management plan. Talk to your health care provider for more information on getting both vaccines.

St. Anthony’s offers the flu vaccine without an appointment from 8 a.m. to 8 p.m. daily at each of its four urgent care centers. For more information on St. Anthony’s flu shots, call our flu shot hotline at 314-525-4999 or 314-ANTHONY (268-4669).


CDC: Diabetes Public Health Resource

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; http://www.va.org; http://www.wikipedia.org


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, http://www.aaaai.org; National Institute of Allergy & Infectious Diseases, http://www.niaid.nih.govhttp://www.fda.gov; Asthma, and allergy Foundation of America, http://www.aafa.org; US National Library of Medicine/National Institutes of Health, http://www.nlm.nih.gov.

Photo credit: David Castillo Dominici

Resources for lab test information

April 15, 2014

On March 19th, I posted an article regarding information about kidney tests/kidney health from the American Diabetes Association (ADA) (http://www.diabetes.org). I am glad that some of you submitted comments indicating the information was helpful. Others have inquired about information regarding several other lab tests.  In addition to the ADA website, additional resources regarding lab test information are: http://www.webmd.com; http://www.mayoclinic.org; National Institute of Diabetes and Digestive and Kidney Diseases, http://www.nkdep.nih.gov; National Heart, Lung, and Blood Institute (NHLBI), http://www.nhlbi.nih.gov; US National Library Of Medicine/National Institute of Health, http://www.nlm.nih.gov..  While I applaud your commitment to be an active, informed participant in your health care management, remember the information presented via any website is often times very general and may not be specific for your particular health situation.  Please note that your Health Care Provider is your best source for interpreting test results, in conjunction with your specific medical conditions, medications, and other factors. The  goal is for you to be a collaborative partner in your health management!

Step Out Walks to Stop Diabetes

March 30, 2014

Remember that goal to increase activity that many of us made for a New Year’s resolution? You’re in luck! There are several American Diabetes Association (ADA; http://www.diabetes.org;) fundraising events in the bi-state area planned for 2014.

A Step Out Walk to Stop Diabetes event is next weekend, April 5th, , at Livestock Pavilion, Lions Lake, in Washington, MO/Franklin County; registration time is 9am & the Walk starts at 10am. Their website posts the following information: “the power of one makes a world of difference! Lace up your walking shoes, bring your friends, family, and co-workers and join us for the 11th Annual Franklin County Step Out Walk. Enjoy a light breakfast, health and wellness fair, live music, raffles and then walk around beautiful Lions Lake! All registered Franklin County Step Out Walk participants raising $100 will receive a commemorative Step Out event t-shirt on the day of the event. Celebrate those who live with diabetes everyday and help us find a cure! For more information, contact: Michael Marek at mmarek@diabetes.org | 314-822-5490 x 6826.

Future events include: May 31, 2014; the St Louis Tour de Cure bike ride is at the Alton Riverfront Amphitheater, 1 Riverfront Dr; Alton, Il. Registration Fee: $25.00; Fundraising Minimum: 200 Route Distances: 10, 30, 50, 100; there are staggered check-in & start times for the various route lengths. Routes will take you on the scenic Great River Road along the Mississippi River. A great variety of easy to challenging courses to test your endurance and push you to new heights! After you ride stay for the amazing finish line party with lunch, live music and FREE admission to Raging Rivers WaterPark! Contact Shawn Martin, at smartin@diabetes.org or 314-822-5490 x 6824

A Step Out Walk to Stop Diabetes is October 4, 2014; SIU-E, Edwardsville, Il; 62026. For more information contact Rawnie Berry at 314-822-5490 x 6829 or rberry@diabetes.org.  Another Step Out Walk to Stop Diabetes is October 11, 2014; at Creve Coeur Park; contact Michael Marek at mmarek@diabetes.org or 314-822-5490 x 6826.

So with the Mother Nature teasing us with warmer weather, start preparing for a more active lifestyle!



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