Archive for Living With Diabetes

5 Super Foods That Should Be On Your Diabetic Food List

Have you ever wondered what foods should be on your diabetic food list?

Ideally these foods will have a low glycemic index, while providing the nutrients you need. Glycemic index (GI) looks at the impact of a food on your blood sugar. Foods are characterized as having a low, medium or high GI. When you eat a diet with a low glycemic index, you will hopefully get improved diabetes control.

Beans

Eating beans daily may just improve your A1c. A study published in JAMA internal Medicine demonstrated that patients consuming at least a cup of beans daily for 3 months reduce A1c levels by half a point and even decreased cardiovascular risk through lowering of blood pressure.

Low GI foods like beans are digested slowly and raise blood sugar levels slowly. High GI foods (think rice, potatoes and other starches) do just the opposite. Alternatively, the benefit may be due to high fiber rather than the low GI. Either way, other than being a little gassy, eating beans may improve your diabetes control and certainly will not hurt.

Berries

Berries are high in fiber, vitamin c, and folic acid. It does not really matter what kind. Blueberries, strawberries or others are all packed with benefits and are low in carbohydrates (also a low GI). Investigators in another study found that patients taking foods with a high flavonoid content (e.g berries along with chocolate and wine) had lower insulin resistance, improved regulation of blood sugar, and lower levels of inflammation. What is not clear from the current research is exactly how much, how often, or in what proportion berries and other foods containing flavonoids should be consumed for optimal glycemic management. For now it seems reasonable to to include berries as part of a well balanced diet.

Tomatoes

One of my favorite things about growing up in New Orleans were the thick meaty juicy red tomatoes that you can get there every summer. Tomatoes are low carb, low cal and contain the antioxidant lycopene that is thought to protect against both heart disease and prostate cancer. Tomatoes contain vitamin C, vitamin A, potassium, and fiber. Tomatoes also are a very low GI food.

Green, Leafy Vegetables

Like the other foods mentioned, most green, leafy vegetables have a low GI. In a UK study that looked at more than 200,000 people, increasing green leafy vegetable intake by one and a half cups per day reduced the risk of developing type 2 diabetes by 14%. Green leafy vegetables contain not only high levels of antioxidants, but foods such as spinach are also rich in magnesium. These foods have a low GI and are low in calories so you do not need to worry about eating too much.

Nuts

Replacing carbohydrates with nuts has been shown to improve glycemic control in some diabetic patients. The idea is that you substitute a healthy fat for a carbohydrate. Benefits have included not only a reduction in A1c, but also in lipids, a risk factor for heart disease

In the study that demonstrated this benefit, a mixture of unsalted and mostly raw almonds, pistachios, walnuts, pecans, hazelnuts, peanuts, cashews, and macadamias were given to participants.

Many patients will ask me if they can just take supplements of the chemicals that are thought to provide the benefits rather than take in these 5 diabetes super foods. Several clinical trials In the last several years that have taken this approach have not produced favorable results. I think you are much better discussing with your doctor or nutritionist what foods you should be on your diabetic food list and take the real foods rather than a supplement of what we think the beneficial compound is.

I would love to hear your thoughts and comments.

10 Misconceptions About Diabetes Care

While 1 in 10 U.S. adults have diabetes, many people still have mistaken beliefs about the disease. If you understand these misconceptions about diabetes care, you will be much closer to better health and understanding what you need to do to achieve better diabetes control.

  1. Having diabetes is no big deal. Diabetes not only places you at increased risk of heart disease and stroke, but two out of three people with diabetes die from one of these conditions. Early diagnosis and appropriate management can prevent or delay long term complications.
  2. Diabetes only effects old people. Not true. The American Diabetes Association found 1.9 million new cases of diabetes in Americans over the age of 20 in 2010, and that more than 11% of people between 20–65 had a diagnosis of diabetes.
  3. Being overweight will cause diabetes. Overweight and obesity are risk factors for diabetes. However, being overweight or obese does not guarantee that you will develop diabetes as a fait accompli. Talk with your doctor about risk factors you can modify like physical inactivity, high blood pressure, or a poor diet.
  4. I will never be able to eat good food again. Restrictive diets are much less likely to succeed. You are more likely to be successful following general healthy eating guidelines that include eating more fiber, increasing vegetables, limiting soda, minimizing saturated fats, and eating more healthy fats. You do not need to go out and purchase special diabetes foods. While you will commonly hear fruit is good for you all over the press, talk to your doctor or dietician about how much and what kinds you can eat.
  5. I do not think I can take insulin. Not all types 2 diabetics need insulin. Diet and exercise my be tried alone first. A fair number of people may only need this or the addition of oral medications like metformin. Many patients with type 2 diabetes go a very long time before needing insulin.
  6. I do not want to catch diabetes. Diabetes is not a contagious disease that you can catch like the flu. If your mom or dad developed diabetes then you would be at increased risk compared to others.
  7. Eating too much sugar causes diabetes. While the average American consumes nearly 152 pounds of sugar per year and would all be better off if the number were less, there is no evidence that eating sugar directly leads to diabetes.
  8. I cannot prevent diabetes. Clearly false. Some estimates indicate that as much as 80% of type 2 diabetes could be prevented by increasing physical activity levels and making other healthy lifestyle choices.
  9. Insulin means that I have failed or am not taking care of myself. Eventually after years of having type 2 diabetes, your pancreas will decrease insulin production. It is nothing you did or did not due, but insulin is required to get blood sugar levels under control. Type 2 diabetes is a progressive disease and it may progress even though you are doing the things your doctor is asking of you.
  10. Insulin is difficult to take. With the development of insulin pens, you can take an easy to read injector and dial up the correct number of units without having to worry. Additionally, with the long acting insulins available today, many type 2 diabetics only need to give themselves one shot per day.

Hopefully identifying and addressing these misconceptions about diabetes care will clear up some concerns that were preventing you from improving your health. If you know of other common misconceptions related to diabetes please let me know. I would love to hear from you.

Yoga For Diabetes

Yoga For Diabetes

Yoga For Diabetes

Yoga For Diabetes

Do you know the benefit of yoga for diabetes? While yoga is well known to have a number of general health benefits, yoga may specifically benefit your diabetes.
General health benefits include:

  • Decrease stress and anxiety
  • Improved flexibility
  • Increased strength and tone
  • Stress relief

Research on Yoga For Diabetes

Much of the research on yoga for diabetes has been done in India– the country credited for its creation. A 2005 report from a medical school in India found that asana yoga regime under the supervision of an expert improved fasting glucose, post prandial glucose, and decreased waist-to-hip ratios. Other research suggested that the potential mechanism resulting from asanas yoga was increased insulin sensitivity. A report in the Indian Journal of Endocrinology and Metabolism in 2013 suggests that if you have had type 2 diabetes for less than 10 years and your fasting glucose is less than140 mg/dl, your blood sugar may respond to yoga alone. However, if you have more significant control problems, you will need medication along with yoga.
Overall, reports in the medical report the following diabetes outcomes can be improved with yoga:

  • Fasting glucose levels
  • Hemoglobin A1c levels
  • Insulin levels
  • Lipid levels including total cholesterol, LDL, VLDL, total cholesterol/HDL
  • Waist to hip ratio
  • BMI
  • General well being

Given that yoga started in India, it may not be surprising that research there has been positive. A UK study of complementary and alternative medicine treatments demonstrated improvements in HbA1c, fasting glucose, total cholesterol, low-density lipoprotein cholesterol, and weight. The intervention consisted of an Ayurvedic diet, meditation instruction, and an Ayurvedic herb supplement, while the control patients received standard diabetes education classes and standard care from their doctor. A 2005 systematic review in the Journal of the American Board of Family Practice suggests that yoga for diabetes may decrease insulin resistance and other cardiovascular risk factors, improve clinical outcomes, and aid in management of diseases such as diabetes. However, they also state that further high quality studies are needed to tease out and delineate the potential benefits of yoga and diabetes.

 

Specific Yoga Poses Meditation Yoga woman meditating at beach sunset

Many patients have trouble getting started. A relatively easy beginner yoga routine is called the “Sun Salutation.” It is great because it is simple and achievable no matter your current fitness or flexibility. (Make sure, however, to consult your doctor about your particular health situation before starting any exercise program). Give the following a try:

  1. Stand with a straight back with your palms together as in a prayer position.
  2. Breathe in and stretch your arms above the head.
  3. Breathe out and bend forward while touching your toes. It you cannot reach all the way just reach as far as you can.
  4. Breathe in and stretch the right leg away from the body in a big backward step and keep the hands and left foot firmly on the ground. Bending the head backward the left knee should be between the hands.
  5. Breathe in and hold the breath. Move the left leg from the body and, keeping both feet together and the knees of the floor, rest on the hands (arms straight) and keep the body in a straight line from head to foot.
  6. Breathe out and lower the body to the floor. In this position, only 8 portions of the body come in contact with the floor: the two feet, two knees, two hands, chest and forehead.
  7. Breathe in and bend back as much as possible bending the spine to the maximum.
  8. Breathe out and lift the body of the floor. Keep the feet and heels on the floor.
  9. Breathe in and bring the right foot along the level of the hands; left foot and knee should touch the ground. Look up, bending the spine slightly (same position as #4).
  10. Breathe out and bring the left leg forward. Keep the knees straight and bring the head down to the knees as in the third position.
  11. Lift the arms overhead and bend backward while inhaling. As in Position 2.
  12. Breathe out and let the arms drop and relax.

Steps 1–12 complete one round. Try to preform a set of 3. You will need to gradually build up the number of rounds you can complete. In the beginning you can shoot for a starter goal of 6 and should not do more than 30. Depending on your speed and intensity, this can be completed in 5- 15 minutes.
Traditional teaching would have you do this early in the morning before an open air window, but I would say to complete whenever you can. Yoga for diabetes does not have to be incredibly complex or time consuming.

Yoga For Diabetes video

Check out this video that shows you the basic yoga for diabetes steps discussed above.

 

 

Talk with your doctor and begin a yoga plan for your diabetes today.

Sources
1. Malhotra V, Singh S, Tandon OP, Sharma SB. The beneficial effect of yoga in diabetes. Nepal Med Coll J. 2005 Dec;7(2):145–7.
2. Manjunatha S, Vempati RP, Ghosh D, Bijlani RL. An investigation into the acute and long-term effects of selected yogic postures on fasting and postprandial glycemia and insulinemia in healthy young subjects. Indian J Physiol Pharmacol. 2005 Jul-Sep;49(3):319–24.
3. Elder C, Aickin M, Bauer V, Cairns J, Vuckovic N. Randomized trial of a whole-system ayurvedic protocol for type 2 diabetes. Altern Ther Health Med. 2006 Sep-Oct;12(5):24–30.
4. Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review. J Am Board Fam Pract. 2005 Nov-Dec;18(6):491–519.

Diabetes Scholarships

Diabetes Scholarships

Did you know that if you have diabetes, a diabetes scholarship can help you pay tuition for college?

The Diabetes Scholars Foundation Scholars Foundation offers scholarships for any student seeking higher education- n accredited four year university, college, technical or trade school.

The scholarships are merit based (i.e. your current grades are important), but you should also be active in the diabetes community. Your extra curricular activities are taken into consideration as well as how you manage your diabetes in the context of your everyday life. Your financial need is not one of the criteria for this scholarship.

There are a number of different diabetes scholarships you could consider applying for:

  • Leona M. and Harry B. Helmsley College Scholarship. 10 – $5,000 scholarships for a new freshman with type 1 diabetes.
  • Lilly Diabetes Tomorrow’s Leaders Scholarship. 11- $5,000;  5-  $4,000 ; 5-  $3,000 scholarships awarded to a new freshman with type 1 diabetes.
  • David’s Diabetes Scholarship. 1 $5,000 awarded to a student residing in South Carolina.
  • Lance Underwood Rising Star Scholarship. 1 $5,000 for a new freshman with type 1 diabetes.
  • Jay Franke Scholarship. 1 $4,000 scholarship for  a student pursuing an Arts Degree (ie music, theater, dance).
  • Bradley D. Gendron Memorial Scholarship. 1 $1,000 scholarship for a Colorado student.
  • Josh Smith Memorial Scholarship. 1 $1,000 scholarship for an Ohio student.
  • JDRF Medical/Research Scholarship. 1 $1,000 scholarship for a student majoring in a healthcare related field.
  • JDRF Advocacy Scholarship. 1 $1,000  scholarship for a student majoring in Political Science.
  • JDRF Outreach Scholarship. 1 $1,000 scholarship for a student majoring in Mental Health (Psychology/Social Work),
  • Nicky Randazzo Memorial Scholarship. 1 $1,000 scholarship for a student majoring in Business.

How Do I Qualify For A Diabetes Scholarships?

In order to apply you need to be a/an:

  • Type 1 diabetic applying to an accredited four year university, college, technical or trade school.
  • High school senior
  • U.S. citizen

You will need a recommendation from from your doctor or diabetes educator as well as a teacher from your school. All scholarships are reviewed by a blinded committee and then a separate committee awards the scholarships.

Communicating With Patients- 10 Signs Your Doctor Is Good

How Well Are Doctors Communicating With Patients Today?

Good communication, doctor to patient and patient to doctor,  is an essential part of your diabetes care. When doctors do well in communicating with patients, a number of things about your care will be improved. If your doctor is a good communicator:

  • Your problems and concerns will be more directly addressed.
  • You will be more satisfied with your diabetes care.
  • Your instructions will make more sense and you will have opportunity to ask questions.
  • You will achieve more success with behavioral change such as increasing exercise or quitting smoking.
  • You will have less anxiety about your diabetes.

Communicating With Patients – 10 Things Your Diabetes Doctor Should Be Doing

Doctors can do many things to make you feel comfortable and improve communication with patients.  How many of the following does your doctor use regularly? The more of these skills they demonstrate when interacting with you, the better their communication skills.

1. Your doctor asks you about your main diabetes problems, concerns  and then focuses on those issues. Does your doctor:

  • Make eye contact with you and speak directly to you throughout the office visit?
  • Encourage you to explain your diabetes problems and concerns in detail?
  • Talk to you about your perception of your diabetes control and symptoms?

When your doctor asks these things it will help you better communicate your diabetes concerns.

2. In communicating with patients, is your doctor an active listener?

Doctors who are more effective at communicating with patients will use a technique called ‘active listening’ to clarify and better understand your problem. Effective doctors will clarify problems to make sure they understand your concerns and then further explore your diabetes problem as needed. Active listening includes the following components:

  • Hearing: When communicating with patients, does your doctor pay close attention to what you are saying?
  • Interpretation: Does your doctor confirm what they hear so they know they understand?
  • Evaluation: Does your doctor ask questions about what you said?
  • Respond: Does you doctor express, either through words or non-verbal cues that what was said matters and that they will address it?

3. Lets you talk.

Do you know how long the average physician in the U.S. allows a patient to speak before interrupting? Less than 1 minute from most surveys. In communicating with patients, a sign that your diabetes doctor is a good communicator  is if the let you finish speaking or let get out all the information you want to say before interrupting.

 4. Summarizes your main points.

If your diabetes doctor periodically summarizes to make sure they understand what you are saying, chances are your doctor is better than average in communicating with patients. Your doctor may say something like “so for the last 3 weeks you have” … This gives you the opportunity to make sure your diabetes doctor heard what you were saying and to correct any mistakes.

5. In communicating with patients, does your diabetes doctor ask about how your are living with diabetes?

Your diabetes care involves more than just the blood glucose values and does of your medication. If the social and daily living aspects of your diabetes are not addressed, your diabetes will not be under optimal control.

6. Checks for understanding.

Doctors receive years of training and have a wealth of knowledge to give, but doctors who are netter than their peers at communicating with patients will also check for understanding from their patients. For example,  your doctor may ask you to repeat back to them the side effects of a medicine are or what steps will happen as part of a treatment plan.

7. Uses non-verbal communication techniques.

To improve communication with patients, non-verbal skills are really important. If your doctor does these well, you may not even notice.  More likely, you will get a sense that your doctor is a poor communicator  if your doctor does these poorly. For example, when your doctor leans toward you while maintaining direct eye contact, they are using their body language to  convey concern about what you are saying.

What do you think the following say about doctor patient communication? Has this ever happened to you? How does it make you feel?

  • Does your doctor sit down at your level and talk with you, or do they just ask questions and type into a computer screen?
  • Does your doctor allow them-self to be paged and interrupted during your visit?

Non-verbal skills can improve communication with patients or leave a patient feelining like they have not been heard.

8. Seeks your input in developing your diabetes treatment plan.

Have you ever been to see a doctor, have them ask you a bunch of question, and then receive a prescription and the doctor is gone? Doctors who do this will also be surprised if you return to see them and the treatment has not had expected results.

Actively involved patients are not only more satisfied, but they also are more successful. This may be because patients who actively participate in the development of a treatment plan are more likely to follow the treatment plan. While it is very easy for your doctor to tell you to eat better, drink less soda, or quit smoking, it is much more difficult for your doctor to figure out your perspective and adapt your beliefs to a diabetes treatment plan. If your doctor takes this extra step, your doctor is certainly more effective in communicating with patients. If you are thinking about changing doctors, ask other patients question about how their doctor formulates a treatment plan with them.

9. Is your doctor empathetic?

Doctors who express empathy are much more appreciated bu their patients than those who do not. Statements like “It must have been really scary to when your child’s glucose was so low” demonstrate your doctor cares about diabetes affects you. Such statements, even if your doctor has incorrectly understood what happened, show your doctor’s concern of  how diabetes is affecting you.

10.  Persuades rather than tells you what to do.

The decision to follow your doctor’s advice is yours alone, and you are unlikely to do anything just because your doctor tells you to. Doctors who are better at communicating with patients will present plans for diagnosis and treatment as options. The idea is that while your doctor can recommend, the ultimate decision is up to you.

What do you think? Can you think of any other factors that demonstrate a doctor is a good communicator?

Sources:

Gordon GH. Defining The Skills Underlying Communication Competence. Seminars In Medical Practice 2002; 21-28.

Maguire P, Pitceathly C. Key Communication Skills And How To Acquire Them. BMJ 2002;325:697–700.

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5 Diabetes Travel Tips To Make Your Trip Go Smoothly

Traveling With Diabetes Doe Not Need To Be A Hassle

Your diabetes travel experiences can be wonderful with a little planning. When you are traveling with diabetes a little planning can relieve your stress tremendously. These 5 diabetes travel tips may make your next trip a success.

1) Get a check up before traveling with diabetes. See your doctor before you leave. A pre diabetes travel check up is especially important if you are going to be traveling outside of your home country. Make sure that you have had a recent HbA1C and that your blood pressure is under control.
Make sure your doctor gives you a letter saying what medications you are on and what supplies you might have with you. This will be important in case there are any questions at security check points. Make sure you have enough medication to last longer than your trip in case there are any delays. You may also want to bring an extra prescription in case of lost medication

2) Where a medical ID bracelet that states you are diabetic. If you are going out of your home country, a bracelet that states you are a diabetic in the local language would be ideal. You do not want any medical problems because someone could not read your medical ID.

3) Keep all of your medication and diabetic snacks in your carry on bag. Your bag can get lost, so you will want to keep it with you at all times. You will need to make sure that you pack not only your medication, but your testing supplies, foods to combat hypoglycemia for your diabetes travel. It is also a good idea to keep your medication in its original packaging. This can prevent a misunderstanding as to why you are caring syringes or insulin

4) Keep your medication in its original box, complete with pharmacy labels. It will prevent misunderstandings about why you are carrying drugs and, if you are on insulin, syringes.

5) Be aware of time zone changes, especially when altering your watch. Remember when you travel east your day becomes shorter; if you travel west your day becomes longer. You may need to alter the timings of your medication.

Traveling need not be traumatic. A sensible attitude and a bit of pre-travel planning can make things go far more smoothly.

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