My interest in nutrition began when I worked as a waitress in a New York City vegetarian restaurant. There I met many people who maintained their health through food, exercise and relaxation. The waitressing took me through four years of college resulting in a bachelor of science degree in media.
For the next eight years I worked in television production but continued working in restaurants. The job was just a job and a very unrewarding one. Almost 5 years later, I graduated with a masters degree in nutrition and physiology.
Although my family history is not strong in diabetes, it has been extremely rewarding for me to be able to help people with the disease. There is no question that people with diabetes benefit from understanding how to control their disease and how fortunate it is to be able rely on yourself for good health.
Having managed a diabetes center for over 12 years, counseling people with diabetes in groups and individually, lecturing in the community and to healthcare professionals and being a member of diabetes committees, I have found my passion.
As a registered/licensed dietitian and certified diabetes educator, my strength in counseling is offering sensible advice to allow you to achieve your goals. I like to listen to who you are, where you are in your life, your capabilities, what you like to eat, what activity, if any, you partake in and then walk you through the education with the least amount of pressure. Afterall, even though you may have diabetes, you are still a human being. We all know what we “should be” doing but we just aren’t perfect. I like using humor, practicality and compassion.
With diabetes, there are many “rules” to follow – testing blood sugar daily, making healthy food choices, eating moderate carbohydrates, exercising and basically trying to avoid the frightening complications that you hear all about. There are many rules in life as well and we don’t always follow them.
Look at me, I gained over 30 pounds while I was in graduate school studying to be a food and exercise specialist! It’s just like losing weight, you need discipline. The difference is that now you have more motivation to succeed, you are trying to control a disease that may have devastating consequences. How is that for a kick in the butt to do what you need to do for yourself?
I look forward to coaching you through this disease that can clearly be controlled, on the forum, blog, newsletters and/or online diabetes counseling.
23.6 million American adults and children have diabetes – 8% of our population! According to the Centers for Disease Control and Prevention, newly diagnosed cases of diabetes rose from 4.8 per 1,000 from 1995-1997 to 9.1 per 1,000 from 2005-2007. Why is this? Obesity, lack of physical activity and poor eating habits are the top reasons. What can we do? Increase our knowledge and take charge!
Diabetes may be preventable and certainly it is controllable. This website is designed for you, the person with diabetes, who is eager and ready to understand their disease and how it affects their body’s unique chemistry and learn all the ways of how to "Do-It-Yourself" or manage their disease.
This practical information is written in user-friendly language to support you in this endeavor. My "article of the month" will give you the latest diabetes news, tips and any information to assist you in gaining that control you need to keep healthy and feel good.
Don't you ever wonder which cereal truly helps to lower your cholesterol? Or what exactly "sugar free", "no sugar", "net carb", "low carb" and just plain "regular" means? Why is 2% milk referred to as "reduced fat" when years ago it used to be called "low fat"?
Are we confused or are we made to feel that way? Don't feel alone. Here are my top 10 pointers for reading and understanding the food label:
March 24, 2009 marks the 21st Annual American Diabetes Alert Day. The statistics are staggering: 8% of our population has diabetes. Approximately 90-95% of those with diabetes have Type 2 and 5-10% have Type 1. However, due to the prevalence of obesity among children, 45% of the youngsters with diabetes have Type 2 (previously known as the "adult diabetes"). Over 23 million Americans have diabetes and 57 million have pre-diabetes.
Diabetes could lead to heart disease, stroke, blindness, kidney disease, nerve damage and even amputation. There are treatments and many of them are within your control, if you learn how from your support team of health care providers and diabetes educators. If you have pre-diabetes, you may be able to slow down the progression of, or even put to a halt to, diabetes if you address it early enough. Properly managing your diabetes may reduce or delay the risk of developing diabetes-related complications. It is also possible to avoid diabetes if you know the risk factors and follow good diet and exercise programs.
American Diabetes Wholesale, in support of the American Diabetes Association, wants to alert those people with and without diabetes about the seriousness of this disease. Many people have no symptoms of high or low blood sugar, and they tend to disregard their disease until complications arise. Some people may unknowingly have pre-diabetes and don't find until out after it has already progressed to diabetes and done damage to the body.
Some factors that increase the risk of developing diabetes:
Some conditions associated with diabetes include: high blood pressure, high triglycerides, low HDL (healthy) cholesterol and high LDL (unhealthy) cholesterol. Request an HbA1c test from your doctor at your next annual physical exam. The HbA1c test indicates your 3-month average blood glucose.
Trying your best to control glucose levels and reducing your cardiac risk factors can save your life. Over 65% of people with diabetes die of heart disease or stroke.
How can you love your heart? Below are some tips I encourage my diabetes patients to try. If you are doing some or all of these, then I congratulate you!
You've probably heard this time and time again - take care of your body, and your body will take care of you. Here are my 10 daily essentials for a healthier you:
Although you don't need to incorporate the following in your daily routine, they are important to taking the best care of YOU!
The holiday season is upon us, and many of us are looking forward to the festivities that this time of the year brings. Holidays are often centered on food so it’s no surprise that people tend to gain weight at this time of year – in addition to having their blood sugar run higher than usual. People eat and drink to celebrate with their friends and family and also in attempt to satisfy themselves if the holiday brings them sadness. If your blood sugar is consistently elevated during this time of year it not only wrecks havoc on your body but it may make you feel sluggish and moody, both are not conducive to enjoying a very festive time of the year!
You can enjoy the holiday season without gaining weight and mismanaging your blood sugar. But how?
Use these pieces of the pie to help set your goals for the best diabetes control in the New Year. Each component is necessary to start the year off right and achieve your health goals for the whole year.
Specialists such as:
In December 2008, the U.S. Food and Drug Administration (FDA) approved Rebiana, also known as Reb A or rebaudioside A, found in the stevia leaf. Stevia is derived from the leaves of a South American shrub and has been used to sweeten foods in Brazil, Paraguay, Japan, South Korea and China for many centuries. Reb A is one of two compounds; the other being stevioside, found in the stevia leaf. Reb A is less bitter and sweeter than stevioside. Rebiana is approved by the FDA as "generally recognized as safe" (GRAS).
Stevia previously had been sold only in health food stores as a dietary supplement. Due to some studies indicating that stevia may reduce fertility or cause genetic mutations that could lead to cancer, it was banned as a food ingredient in the US and approved only as a dietary supplement. Supplements, similar to GRAS substances, are not required to be scrutinized as much as foods are.
Today, Truvia and PureVia are available in packets similar to other sugar substitutes such as Splenda, Equal and Sweet n' Low, and will soon be seen in a growing number of sugar-free products. The main ingredients are Reb A (from the stevia leaf) and Erythritol (a sugar alcohol with no effect on glucose levels and little or no laxative effect).
Truvia can be found at Whole Foods, Walmart and other grocery stores.
PureVia can be found at grocery stores.
Use moderately. Moderate use is 4 servings a day: 4 packets or food servings similar to food exchanges (8 ounce drink, etc.)
You've been diagnosed with diabetes. It may have been yesterday, last month, last year or many years ago. Unlike a host of other possible diseases (cancer, rheumatoid arthritis, liver or kidney disease), this is one of the few diseases that YOU can self-manage. But how?
KNOWLEDGE IS POWER! I’m sure you've heard that quote before. You first need to understand what diabetes is and what is affecting this disease. Luckily, ADW has provided a wealth of information for people with diabetes so now you can gain that knowledge. Sure, there’s a lot of fine-tuning but where do you begin?
By reading through this website, you will be lead through the 12-steps to controlling diabetes. But briefly, you need to test your blood sugar (there are so many simple monitors for you to use!) so you know how certain things are affecting you – otherwise you'll have no idea! Yes, you need a tiny drop of blood, and yes, you'll feel a slight needle prick, but this is your life!
Your food choices, exercise regimen, stress level and hormones will affect blood sugar levels. There is a lot to know but you owe it to yourself to find out and take charge on this disease before it controls you! I can help you. Please read my articles and if you need further assistance to fine-tune a few things, I am available to counsel you online/on the phone. Once you are clear about diabetes and its effects on your body and your lifestyle then you will be in control. Your diabetes team of doctors and educators are there to lead you on the right path and to follow through always but you are most important.
How do you control your diabetes? You do-it-yourself!
24 million Americans have diabetes and ⅓ of them don’t even know it! Diabetes can lead to many complications – since it is a disease of the vessels: heart disease, kidney disease, blindness, nerve damage and amputation are some of the problems that can result from uncontrolled diabetes. The good news is that diabetes can be managed by you! With proper education, you have the power to avoid or reduce the severity of these complications.
You can make a life-changing difference by following these guidelines:
a. Before meals blood sugar should be 90-130 mg/dL (American Diabetes Association - ADA guidelines*) or 80-110 (American Association of Clinical Endocrinologists – AACE guidelines**)
b. After 2 hours blood sugar should be under 180 mg/dL * or under 140 mg/dL**.
c. Blood sugar can expect to rise about 30-50 points from a meal.
There are no secrets when managing diabetes. You have all the tools you need to find out how food, exercise, medications and even stress affects your glucose readings. In time, you will learn how to fine tune and better manage your disease. The HbA1c will tell you what range your blood sugar is in. Your glucose monitor will provide you with critical information so you can find out how daily living affects your blood sugar. Don’t allow the diabetes to rule your life when you are in charge!
Everyone gets the flu or a cold or an upset stomach from time to time. Minor illness will alter your blood sugar and will require some changes in your daily diabetes routine. It is difficult to control your blood sugars when you are ill. It is especially important to test your blood glucose level frequently to know where your level is.
You should suspect that your blood glucose level is high when you experience any of the following: flu, nausea or vomiting, diarrhea, fever, infections, physical injury, dental problems, or emotional stress.
When you have days of sickness, you need to make the appropriate choices, which include the following:
CONTACT YOUR PRIMARY HEALTH CARE DOCTOR IF:
IF VOMITING/POOR APPETITIE INTERFERES WITH NORMAL FOOD INTAKE:
Traveling is exciting and diabetes should not stop you from enjoying your trip. Here are my guidelines for a worry-free trip:
How it works
What you should know
|Glyburide: Micronase, Diabeta, Glynase||Encourages the pancreas to produce more insulin||May cause low blood sugar.
Caution if you have an allergy to sulfa medication.
Glucotrol, Glucotrol XL
|Encourages the pancreas to produce more insulin||May cause low blood sugar.
Caution if you have an allergy with sulfa medication.
|Encourages the pancreas to produce more insulin||May cause low blood sugar.
Caution if you have an allergy with sulfa medication.
|Encourages the pancreas to produce more insulin in response to carbohydrates at a meal.||May cause low blood sugar.
Caution with sulfa allergy. Taken 0-30 minutes before each meal that carbohydrates are consumed.
|Encourages the pancreas to produce more insulin in response to carbohydrates at a meal.||May cause low blood sugar. Caution with sulfa allergy. Taken 0-30 minutes before each meal that carbohydrates are consumed.|
Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet (liquid form)
|Helps the body use insulin more efficiently. Decreases the glucose produced by the liver.||Possible gastrointestinal upsets. May subside in 2-3 weeks. Use cautiously in people with kidney or respiratory disease and those taking medicine for heart failure or those over 80. Not recommended for people with liver disease or who drink alcohol excessively. Take with meals to decrease possible GI effects.|
|Acarbose: Precose||Slows the digestion of carbohydrate foods.||Possible gastrointestinal upsets: Excess gas (flatulence) or bloating. Take with the first bite of each meal. Caution use with inflammatory bowel disease, other intestinal diseases or bowel obstruction.|
|Miglitol: Glyset||Slows the digestion of carbohydrate foods.||Possible gastrointestinal upsets: Excess gas (flatulence) or bloating. Take with the first bite of each meal. Caution use with inflammatory bowel disease, other intestinal diseases or bowel obstruction.|
|Rosiglitazone: Avandia||Helps the body use insulin more efficiently.||May cause water retention. Monitor with liver function tests. Not recommended for people with heart failure. May take 3-6 weeks to see the full effect on blood sugar.|
|Pioglitzaone: Actos||Helps the body use insulin more efficiently.||May cause water retention. Monitor with liver function tests. Not recommended for people with heart failure. May take 3-6 weeks to see the full effect on blood sugar.|
|Sitigliptin Phosphate: Januvia||Helps pancreas make more insulin. Prevents the liver from releasing too much glucose.||Does not usually cause hypoglycemia. Possible side effects: Upper respiratory infection, stuffy or runny nose, sore throat and headache.|
|Avandamet||Avandia and Metformin|
|Glucovance||Glyburide and Metformin|
|Metaglip||Glipizide and Metformin|
|ActosplusMet||Actos and Metformin|
|Avandaryl||Avandia and Amaryl|
|Janumet||Januvia and Metformin|
|Duetact||Actos and Amaryl|
Injectible Medication – Non-Insulin
How it works
What you should know
• Increases insulin production
• Decreases sugar production by the liver
• Reduces appetite
• Reduces high post-prandial(after-eating) glucose
• Delays stomach emptying
|Injection is twice a day within 60 minutes of the morning and evening meals.||Treats Type 2 diabetes. Caution use if you have GERD/reflux. May cause nausea when first starting drug but it should decrease over time. Talk to doctor/nurse about side effects you may experience.|
• Decreases sugar production by the liver
• Reduces appetite
• Reduces high post-prandial (after-eating) glucose
|Injection is given at mealtimes.||Treats Type 1 and Type 2 diabetes. Used with insulin to lower blood sugar, especially for after-eating glucose. May lower the amount of insulin you currently inject.|
SPEED OF ACTION/TYPE
INSULIN NAME BRAND/GENERIC
TIMING OF DOSE
Starts working quickly and is effective for a short period of time.
|Take 5-10 minutes before meal.|
|Short or Fast-Acting
Starts working relatively quickly and is effective for a fairly short period of time.
|Novolin R (Regular human insulin)
Humulin R (Regular Humulin insulin)
|Take 30 minutes before meal.|
Starts working a little later but lasts a little bit longer.
|Novolin N (NPH human insulin)
Humalin N (NPH human insulin)
|Take once or twice daily AM and/or PM|
Starts very slowly and lasts a long time – nearly without a peak
|Usually taken once daily or twice if needed.|
Pre-mixed Insulin – Combinations of the above types:
|Novolog Mix 70/30
Humalog Mix 75/25
Humalog Mix 50/50
|All are a mix of rapid-acting and intermediate-acting insulin.
Take 5-10 minutes before meal.
|Short or Fast-Acting Mix (CLOUDY)||Novolin 70/30
|All are a mix of short-acting and intermediate-acting insulin.
Take 30 minutes before meal.
Diabetes can be controlled and self-managed, however, it requires you to think about it everyday, throughout the day. What is a typical day in the life of a person with diabetes?
You get up in the morning and test your “fasting” blood glucose
Today, it reads 105 mg/dL (excellent reading!)
You prepare and consume your breakfast of 30 – 60 grams of carbohydrates and 1-4 ounces of protein and maybe 1-2 fat servings ** such as: ½ bagel with low-fat cheese and a slice of tomato or 1 cup cooked hot cereal with nuts and cinnamon and a poached egg or 1 cup high-fiber cold cereal with ¼ cup berries and ½ cup low-fat milk and a scoop of low-fat cottage cheese or perhaps two pieces of bread/English Muffin (anything but white) with an omelet.
Medication must be taken as directed. Some pills need to be taken before a meal, others during or after a meal.
Test your blood glucose to see how your breakfast choice and medication regimen affects YOUR body. Does your glucose remain the same? Drop? Or rise less or more than 50 points? If it drops then perhaps you are taking too much medication or you need to eat more carbohydrates. You never want to eat to feed your medication. If you need to gain weight you can eat more. If you are trying to lose weight then speak with your doctor about possibly lowering your medication if the numbers drop consistently around this time of day.
Time for lunch! Test your blood sugar. How has the medication and your morning routine affected your blood glucose? Prepare and consume 45 grams of carbohydrates and 3 ounces of protein and 1 fat serving ** such as: 2 slices rye bread, 2 ounces turkey and 1 slice low-fat cheese with 1 Tbsp light mayonnaise, lettuce, tomato and 10-15 baked potato chips.
Test your blood sugar. How did lunch affect you, along with your medication regimen and your daily routine?
Snack time! Since you need to eat every 3-4 hours to maintain the most level blood glucose (see “12-Steps to Control” article) your snack can be a combination of carbohydrate and protein or fat for best results. Try a yogurt and chopped walnuts or 10-15 tortilla chips and guacamole.
Time for dinner. Check your blood glucose at this point. You may need to take more medication if that was advised by your doctor. Choose 45 grams of carbohydrates, 6 ounces of protein and 3 fat servings such as 6 ounces wild salmon teriyaki, 1 cup cooked barley, 1 cup of cooked broccoli, salad with 1 Tbsp. olive oil and vinegar.
Check your blood sugar to see how your dinner choice and medication regimen affects you.
Snack (optional). Have a healthy snack such as a fruit and nuts or low-fat cheese.
It’s time for bed! Check your blood sugar one last time for the day. This will enable you to see the difference in glucose readings at bed vs. first thing in the morning (fasting).
With all of this information you will assist your team of diabetes experts in making the best recommendations for you and to fine-tune your disease. Remember, everyone’s body works differently so you are unique and must be treated as an individual. When you get to know how your body is affected by the diabetes and your lifestyle and daily routine, you won’t need to test as often.
To control your diabetes you need to exercise, eat right, take the appropriate medication regimen (if medication is needed at all), monitor your blood sugar, stay on top of your HbA1c number (3-month blood sugar average percentage), visit your diabetes team and always remember that
Making Time to Exercise
Morning, noon or night, just try to fit in your 30-60 minutes at least 5 times a week for best diabetes control. And remember to be careful if your blood sugar is dropping during exercise, perhaps due to your diabetes medication peaking or because you had not eaten in several hours.
With your doctor’s approval, try a mix of cardiovascular exercise such as the treadmill, riding a bicycle, walking or running, aerobics AND strength training such as lifting weights and toning and endurance exercises like Pilates or Yoga.
Exercise is over and now you want to see how many points your blood sugar changed from exercising. Did it drop? OK, exercise can lower your blood sugar because you are using energy to get you through the exercise. Remember, sugar IS energy. The more energy you expend the lower your sugar should drop. Did your blood sugar remain the same? Some people maintain their blood glucose for various reasons: the liver stores sugar and sends it into the bloodstream as needed (and sometimes it sends more than is needed).
If your blood sugar starts to drop, the liver will protect you and try to help balance the sugar level. HOWEVER, for some, the blood sugar rises. In this case, if your blood sugar is dropping too dramatically because you have expended a lot of energy in your particular exercise and/or your medication is still working or even peaking during exercise, your liver will overcompensate and send out too much sugar into the bloodstream which results in higher glucose.
BE CAREFUL not to exercise when your medication is peaking (working it’s hardest).
YOU are the most important part of your diabetes care team!
**See diabetic food exchanges list. The amount of carbohydrates and protein are determined according to your height, weight, age, activity and gender.
I know this is called "Do-It-Yourself Diabetes Management." I firmly believe that you are the #1 person who can control and manage your diabetes. However, you cannot do it alone.
People with diabetes need a team to work with to help manage their disease. Your team should consist of these key people to support your health and wellness:
Also, a cardiologist (to monitor heart disease), nephrologist (to monitor kidney disease) or neurologist (to monitor nerve damage) would be needed at some point.
After finding out you have diabetes from your primary care doctor you should request to be referred to a certified diabetes educator. The diabetes educator will teach you how to control your disease with meal planning, exercise, medication (if applicable), blood glucose testing, and basically answer all the questions you might have. These visits may be individual or in small group classes and are usually covered by insurance.
Once you understand how to control your diabetes, you may want to attend support groups to keep updated about possible changes or to help you stick with your plan.
Your next step is to make appointments to see a podiatrist, ophthalmologist, and endocrinologist. Since different parts of the body can be affected by diabetes, it is critical to have annual or bi-annual exams to protect yourself against serious complications.
YOU are the most important member because diabetes is self-managed. This means that you make food and exercise choices, you control the times you test your blood sugar to determine the effects things you do have on your body and you also choose to reduce stress in your life with helpful techniques such as support groups, deep breathing, spending time with family and friends and if necessary, a therapist.
Blood sugar (glucose) testing is essential to successful diabetes management. Here’s why you should be testing:
When testing your blood sugar, here are some important points to remember:
Target Blood Sugar Levels
*According to the American Diabetes Association (ADA)
** According to the American College Of Endocrinology (ACE)
|Test||People without diabetes||People with diabetes|
|Blood sugar before meals mg/dL||Less than 100||90-130*
|Blood sugar 2 hours after the start of meals||Not clearly defined
Less than 140 on a glucose
|Less than 180*
Less than 140**
|A1c||Less than 6%||Less than 7%*
Less than 6.5%**
The hemoglobin A1c is a 3-month average blood sugar test that may be included in your annual, bi-annual or quarterly blood work:
How to compare A1c to blood sugar
|4% =||65 mg/dL||10% =||275 mg/dL|
|5% =||100 mg/dL||11% =||310 mg/dL|
|6% =||135 mg/dL||12% =||345 mg/dL|
|7% =||170 mg/dL||13% =||380 mg/dL|
|8% =||205 mg/dL||14% =||415 mg/dL|
|9% =||240 mg/dL||15% =||450 mg/dL|
With so many diets and gimmicky foods available to us it's no wonder the majority of Americans are unhealthy and overweight. It's important to realize that you can be thin and yet unhealthy or obese and malnourished.
Thin folks may not be eating enough nutrients and obese people may overindulge in low quality/nutrient foods that are high in calories like chips, dips, candy, and sweet drinks.
In over a decade of counseling nutrition, I have come to understand why so many people are living an unhealthy existence. We are human, after all, and the plethora of foods and exercise gadgets that promise us miracles are hard to resist! Sunday mornings are a great time to catch up with the latest quick weight loss scheme or the new, latest and greatest exercise machine to help you lose miraculous inches in no time or achieve ultimate health. Of course the small print must inform you how rare or as they say, 'atypical', this really is. I decided several years ago to do it the hard way. To learn, once and for all, how to eat healthy for life. I realized in order to be successful in my eating and exercise habits they had to be realistic ones that I could stick with. We must work hard for results! What comes easy in life? Do relationships, careers, school, raising children, etc. come easy? No! We need to work hard for what we want in this life and being healthy is no different. As soon as we accept this we may be ready to make lifestyle changes forever!
My answer is to provide a sensible, reasonable meal plan with foods that sustain the appetite that one can follow for life. I individualize each meal plan so that each person can feel comfortable with their food choices. Some of my patients may enjoy chocolate. If I do not incorporate any chocolate into their meal plan then their craving for it will become overwhelming and they will overeat it anyway. Therefore, I incorporate the chocolate in smaller, but reasonable, amounts for them to enjoy while they are reaching their goals. After all, these new eating patterns must be for life otherwise they shouldn’t bother starting them to begin with.
To control glucose or weight you need to eat healthfully and conscientiously. There are many foods that are healthy and can satisfy the appetite. By combining foods like protein (fish, lean meat, poultry, low-fat cheese, eggs) and dense/high fiber carbohydrates (grains, high-fiber cereal, sweet potatoes, non-starchy vegetables like broccoli and spinach) or healthy fats (olive oil, olives, avocado, nut butters, nuts) with the carbohydrates mentioned above you will satisfy your appetite, level out your blood sugar (the two go hand in hand) and you will be incorporating high nutrient/quality foods into your day. It is also important to eat every 3-4 hours to help you to reduce fluctuations in blood glucose, reduce food cravings, and keep your weight in control since it will optimize your metabolism while ending the need to overeat at the next meal.
Because of the high rate of "food-failure" my patients inspired me to write my book, The Diet Game: Playing for Life! I am also available to counsel you on-line! Become a player! Your journey to improved health and happiness begins right now, with YOU! So, be good to yourself.
C = carbohydrates servings/exchanges
P = protein servings/exchanges
F = fat servings/exchanges
I've developed an easy way to plan your meals around calories. Although, these are especially designed for people who have diabetes, they are just plain healthy diets for anyone. I've included suggested foods and serving sizes for breakfast, lunch, dinners and snacks for an entire day for the following daily calorie intakes.
Just how many calories are correct? Read the this article that includes the FDA’s Counting Calories Chart, or contact your doctor or dietitian.
Keeping a food and activity log, as well as blood sugar records, is critical in determining our individual patterns. This will help to fine-tune your diabetes control. Try to keep up with these logs throughout the day if possible since, as human beings, we tend to truly or conveniently forget what we have consumed unless we write it down! Don’t forget to record your beverages or that extra piece of cheese or pretzel!
Download and print your daily food and exercise log as many times as you need.
Alcohol is high in calories and has few nutrients. If you drink and this is approved by your doctor, please drink wisely and moderately.
Moderate drinking is 1 drink per day for women (1 ounce liquor, 4 ounces wine or 12 ounces beer) and 2 drinks per day for men.
Alcohol is metabolized similar to fat in the liver. Your liver supplies you with glucose for energy when you are not eating. When you drink alcohol and have not eaten any food, your body concentrates on breaking down the alcohol and forgets to send out glucose into the bloodstream. This can cause you to have hypoglycemia (low blood sugar). Try to eat some food, like cheese and crackers) if you indulge moderately in alcohol. With mixed drinks, use diet soda, diet tonic, club soda, or vegetable juice (low-sodium).
Keep in mind that red wine contains high levels of resveratrol – a heart healthy antioxidant – and may help to increase HDL (health cholesterol) levels. If you choose beer, try light beer. The calories and carbohydrate amounts are significantly different from regular beer. Regular beer has 145 calories per serving and 13 grams of carbohydrates. Light beer has 99 calories and 4 grams of carbohydrates. All distilled spirits (liquor) per ounce has about 100 calories and zero carbohydrates. Wine (per 4 ounce glass) has about 75 calories and 1-2 grams of carbohydrates.
When you dine out, please continue to use your common sense. Make reasonable choices for continued success. Take a moment to consider all the foods that will have the most impact on your blood sugar and be moderate with them. Also, think heart health! Here are some suggestions:
Think: What is affecting my blood sugar from this meal?
Hint: Rice, sauces, noodles, egg roll wrapper, wonton wrappers and dessert.
Think: What is affecting my blood sugar from this meal?
Hint: Breading, bread, pasta, sauce, beans and dessert.
Think: What is affecting my blood sugar from this meal?
Hint: Nachos, tortillas, beans, chips and dessert.
Think: What is affecting my blood sugar from this meal?
Hint: Rice, dumplings, teriyaki sauce, noodles and dessert.
Think: What is affecting my blood sugar from this meal?
Hint: Bread, potato, pasta, rice, corn, peas, beans, soups with beans or rice or noodles and dessert.
The most important nutrition message to take away from this material is to consume wholesome, slow-digesting, high fiber carbohydrates in combination with healthy choices of protein and fat.
My Do-It-Yourself diabetes nutrition guidelines will assist you in avoiding fluctuations in blood sugar and the highs and lows that are dangerous to you and result in low energy levels.
Carbs, short for Carbohydrates, are starch (including vegetables), fruit, milk and sweets that turn 100% into sugar within 1 to 2 hours (except for the fiber part). They have the greatest impact on your blood sugar.
Blasters are quick-digesting or high glycemic carbohydrates that BLAST sugar into your bloodstream. Blasters make your blood sugar spike. Blasters make your insulin work harder to bring the sugar from the bloodstream into the body’s cells like the brain, muscles, organs and tissues so the body can have energy to live and function.
Tricklers are slow-digesting foods or low glycemic carbohydrates that TRICKLE sugar into your bloodstream. Tricklers make your blood sugar level out. Tricklers make your insulin work much easier to bring the sugar (energy) from the bloodstream into the body’s cells.
Equation for Best Blood Sugar Control
Here is my equation for controlling your blood sugar. It will also help with weight loss and reduced hunger!
HIGH FIBER CARBS
+ LEAN PROTEIN
+ UNSATURATED FATS
= CONTROLLED BLOOD SUGAR
CARBOHYDRATE is a macronutrient that turns completely into sugar within 1-2 hours. Below you will find 15 gram carbohydrate portions.
Starch carbohydrates - 15 grams of carbohydrates and approximately 80 calories:
Fruit carbohydrates - 15 grams of carbohydrates and approximately 60 calories:
Milk carbohydrate - 12 grams of carbohydrates:
When/if choosing these foods please be moderate since processed sugar will spike your blood glucose quickly. There are lower fat versions and no sugar added or sugar free that might reduce the rise in blood sugar.
Try to more often choose a fruit and combine with nuts, nut butters or low-fat cheese or plain/fat-free yogurt with nuts or wheat germ/flaxseed meal/psyllium husks or other high fiber type of topping.
Examples of 15 grams worth of carbohydrates:
These foods may contain high amounts of unhealthy fats, therefore, choose wisely.
PROTEIN is a macronutrient that turns 50% into sugar within several hours. Therefore, the effect on your blood glucose is minimal. Choose the leaner types of protein so you are heart healthy.
Very lean protein has 35 calories per ounce and 0-1 gram of fat. Examples of hearth health proteins are:
Lean protein has 55 calories per ounce and approximately 3 grams of fat.
Medium-fat protein has 75 calories per ounce and approximately 5 grams of fat.
FAT is a macronutrient that turns 10% into sugar within several hours. Therefore, the effect on your blood glucose is insignificant. Each fat serving has 5 grams and 45 calories. Eat mostly unsaturated fats in your diet to reduce heart disease risk.
Monounsaturated fats are the most heart healthy. Examples are:
Polyunsaturated fats are relatively heart healthy. These are in most processed foods. Examples are:
Saturated fats are not heart healthy. They clog your arteries and encourage your liver to produce more cholesterol. Use these infrequently and choose the unsaturated fats more often. Examples are:
Trans fats are not heart healthy. They work similarly to saturated fats and may produce carcinogens. They are most often found in processed foods listed in the ingredient list as partially hydrogenated fat. The polyunsaturated oils are hydrogenated (hydrogen is added) and heated to create a solid fat that is trans.
Since we don’t always carry around measuring cups and food scales, here are my "handy" food portion guides. You can carry these measuring tools every where you go!
It is most important to understand the concept behind glycemic values (Glycemic Index, or GI). In order to level out your blood sugar and avoid fluctuations in glucose you must eat slower digesting foods. These foods typically have a low glycemic index or load.
The glycemic index is a system in which a number is given to a particular carbohydrate food to determine how quickly or slowly the food breaks down into sugar in the bloodstream.
This number is important since people tend to consume many high-glycemic index foods such as refined carbohydrates (white pasta, white bread, white rice) that turn quickly into glucose (sugar) in our bodies. These foods do not sustain your appetite or energy (blood sugar) level and people end up overeating them.
If you incorporate low-glycemic index foods (foods that turn into sugar slowly), you can sustain a more even energy level and you also will not get hungry very quickly. This is due to non-fluctuating blood sugar. You know that sugar equals energy.
When you eat refined or high-glycemic index foods, your blood sugar quickly climbs and then drops. When the blood sugar drops, you feel hungry since your brain signals your body to eat in order to maintain your energy level. However, if you consume mostly low-glycemic index foods, your blood sugar tends to level out and not fluctuate. This results in diminished appetite and a more sustained level of energy! In addition, by metabolizing sugar more slowly and over a longer period of time we have a chance to utilize the sugar or glucose before it gets stored as fat (triglycerides)!
Glycemic Load is a newer and more accurate term. The glycemic index tells you how rapidly a particular carbohydrate turns into sugar. It does not tell you how much of that carbohydrate in grams is in a serving of food. The Glycemic Load is the amount of carbohydrate grams in a food multiplied by the GI of that carbohydrate.
Glycemic Index Values
|Low GI||55 or less||most fruit and vegetables (except potatoes, watermelon), grainy breads, pasta, legumes/pulses, milk, products extremely low in carbohydrates (fish, eggs, meat, nuts,oils)|
|Medium GI||56 - 69||whole wheat products, brown rice, basmati rice, orange sweet potato, table sugar|
|High GI||70 - 99||corn flakes, baked potato, watermelon, some white rices (eg. jasmine), croissant, white bread, candy|
Source: Wikipedia http://en.wikipedia.org/wiki/Glycemic_index
Go nuts with nuts, reasonably!
Nuts are high in calories and loaded with nutrients so please use them and do not abuse them. However, nuts offer many healthful benefits primarily from unsaturated fats, fiber, protein and carbohydrates plus they taste great.
Nuts also contain many heart healthy vitamins and minerals as a bonus! Added to meals or snacks these nuts help to sustain the appetite and maintain a healthy level of blood sugar while satisfying the desire to crunch.
Nuts can be used to replace the more typically consumed refined carbohydrate snack foods that have a tremendous effect on your blood sugar them like pretzels and other chips that offer little nutritional value and simply encourage your appetite.
Nuts have many calories, about 150-200 calories per ounce. For a delicious, healthy snack try:
Why not try mixing one ounce with a lower calorie carbohydrate like fruit or yogurt.
So like I say, "go nuts" and reap all the benefits.
I’ve taken a typical food label and "deconstructed" it to help you make healthy choices. Take a look at the following food label and then follow along with the numbered bullets below it to better understand what is in the food you’re eating and how your food choices, based on their labels, meet your daily dietary goals.
Some additional food label reading how-to's:
When looking at food labels, be sure to look at total carbohydrate, NOT SUGAR, when trying to determine what will breakdown into glucose in your bloodstream. The sugar listed is included in the total carbohydrate. It refers to natural sugar, like fruit sugar (fructose) or milk sugar (lactose) or refined/processed sugar like table sugar.
The total carbohydrate encompasses everything in that food that will eventually become sugar. Dietary fiber, however, may be subtracted from the total carbohydrate, since fiber is a non-digestible part of the carbohydrate.
Try one of Marci's convenient diabetes-friendly "Calorie Diets" based on the daily calorie intake recommended by the FDA or your doctor.
In sugar free, no sugar added or low carb foods, the sugar (quick digesting "blaster") is replaced with sugar alcohol (a slow-digesting "trickler"). Sugar alcohol has fewer calories than sugar, is not as sweet as sugar and has a significantly less impact on blood sugar levels than regular sugar. Some common sugar alcohols are: sorbitol, xylitol, mannitol, lactitol, maltitol, and isomalt. As you see, most of the names end in "ol" just as alcohol does. Sugar alcohol is derived from fruits and vegetables. Some people who eat sugar alcohol in excess experience a laxative effect.
Sugar Free Foods
There is no sugar in the food but there may be carbohydrates that turn completely into sugar. (starch, fruit or milk). For example: sugar free cookies are not made with sugar but the flour is a starch that turns completely into sugar. The sugar is replaced with sugar alcohol and, typically, artificial sweeteners to enhance sweetness. What effects your blood sugar in the sugar free cookie is: the flour and the sugar alcohol (to a minor extent). However, if you eat a large portion due to the food being "sugar free" you will see more of a rise in blood sugar.
No Sugar Added Foods
There is no sugar added to the product that already contains some natural sugar. For example: no sugar added ice cream that has milk (lactose is natural milk sugar) already in the product. The processed sugar that is usually found in ice cream will be replaced by sugar alcohol. If you eat a large portion due to the food being "no sugar added" you will see more of a rise in blood sugar.
Net Carbs or Low Carbohydrate Foods
These foods have fewer carbohydrates and therefore less sugar as well. Again, slow-digesting sugar alcohol replaces the quick-digesting sugar so there will be less of a rise in blood sugar levels. Be aware of other macronutrients (carbohydrate, protein or fat) that may be harmful like saturated fat. Saturated fat clogs your arteries and makes your liver produce more cholesterol. The maximum amount of saturated fat recommended for the day is 15-20 grams. More than this amount may contribute to heart disease risk.
The Bottom Line
You may eat sugar free, no sugar added or low carb foods moderately or you may help to slow-digestion by eating a more moderate amount of the low-fat or regular food item and combine it with healthy protein and/or fat. For example, you may have a scoop of low-fat ice cream with chopped nuts. The ice cream may breakdown into sugar quickly, however, the nuts (protein/fat) will help to slow the digestion down and level out the blood sugar. A more healthful choice would be to eat a fruit (carb) with a piece of low-fat cheese (protein and fat) to help to level out blood sugar and avoid spikes and dips.
Sugar with other names – HAVE an effect on blood sugar levels
|Dextrose (glucose, corn sugar)||Bread, cookies, soft drinks|
|Fructose (fruit sugar)||Health foods and drinks|
|Lactose (milk sugar)||Milk, yogurt, breakfast pastries, whipped topping mixes|
|Corn Syrup||Beverages, cake, candy, cereal, cookies, syrup, some yogurt|
|High-fructose corn syrup||Soft drinks, prepared foods|
|Invert sugar||Candy, soft drinks|
|Maltodextrin||Thickening agent, sweetener in canned fruit, salad dressing, instant pudding, prepared foods|
|Oligofructose||Sweetener bulking agent, emulsifier, cookies, energy bars|
|Polydextrose||Bulking agent in salad dressings, baked foods, candy pudding, prepared foods|
Natural Sweeteners with nearly ZERO calories – HAVE NO EFFECT on blood sugar levels **
May all be used in cooking and baking
|Brand||Ingredient||What It Is/Considerations|
|Stevia||A dietary supplement|
|Inulin (not insulin) is a naturally occurring soluble fiber that does not raise blood sugar levels.||A vegetable fiber that encourages "good" bacteria in the intestines|
** may have slight effect
|75% erythritol (sugar alcohol)
|Excessive use may cause a laxative effect|
|Excessive use may have a laxative effect|
Artificial Sweeteners – HAVE NO EFFECT on blood sugar levels
|Ingredient/Brand Name||What It Is/Found In|
|Aspartame (Nutrasweet) – "Equal"||Sugar-free, No sugar-added foods, frozen desserts, diet soda|
|Acesulfame Potassium – "Ace K" or "Sunett"||Chewing gum, diet soda, sugar-free foods, No sugar-added baked goods and desserts|
|Saccharin – "Sweet n' Low"||Sugar-free, No sugar-added foods|
|Sucralose – "Splenda"||Sugar-free, No sugar-added baked goods, frozen desserts, ice cream, soft drinks|
|Stevia is currently not known as an artificial sweetener ("Natural sweetener/dietary supplement")||Natural sweetener|
|Neotame||Diet soda, other diet foods|
According to the National Center for Complementary and Alternative Medicine at the National Institutes of Health (NCCAM/NIH), dietary supplements were defined in a law passed by Congress in 1994. A dietary supplement must meet all of the following conditions:
Vitamins, Supplements & Herbs
The following vitamins, supplements and herbs may have some specific benefits for people who have diabetes. Please check with your pharmacist or doctor before considering any of these supplements – especially pregnant women. There is not strong evidence to support any of the claims listed below so use with caution. Be extra careful if you are already taking diabetes medications to lower your blood sugar and you add some supplements that can also help to lower your blood sugar. Carry glucose tablets or some form of sugar with you at all times.
Peripheral neuropathy affects the legs, feet, and toes, and to a lesser extent, the arms and hands. Peripheral neuropathy causes pain or loss of feeling in the affected areas. Some people with diabetes experience burning or prickling sensations, become very sensitive to touch, or lose balance or coordination. Foot injuries must be given particular attention for people with peripheral neuropathy. The following vitamins, supplements and herbs may provide a benefit:
Please consult your doctor and/or pharamcist prior to taking supplements. You should be monitored if you take a combination of blood thinners: Coumadin, Plavix, aspirin, CoQ10, Ginkgo Biloba, fish oil, Vitamin E.
Also, Reiki, which is a healing touch that is not hands on, may help to relieve symptoms of neuropathy.
For more information: Visit the NCCAM/NIH Clearinghouse
Good health habits are important to everyone. These habits include taking care of yourself both physically and emotionally. The mind and body are connected and have an affect on each other. For example: if a person is stressed then they may feel a headache coming on. While a person with diabetes who feels stress may have the same headache in addition to finding his or her blood sugar elevated. Nutrition, exercise and relaxation are a few important good habits to learn and follow. Many habits affect your diabetes care.
High blood glucose levels increase your risk for tooth and gum problems. Just think of what happens to your teeth when you eat too much sugar!
For additional information about keeping your teeth and gums healthy:
Exercise can help you stay healthy, control blood sugar, maintain a healthy weight, and to increase energy levels. Always consult your doctor before starting an exercise regimen. Here are some tips and guidelines that people with diabetes should follow when exercising:
Gastroparesis (stomach paralysis) is a condition sometimes associated with diabetes when there is a delay with the stomach emptying its contents. This delay is due to stomach nerve damage caused by high blood sugars over a long period of time.
The result of gastroparesis is that instead of contractions pushing the food through the stomach, the food stays around in the stomach until acid and digestive enzymes break it down and gravity helps the process. When food lingers in the stomach too long, it can cause bacterial overgrowth from fermentation of food – flatulence. The food can also harden and cause nausea, vomiting and obstruction in the stomach.
How do you know if you have it?
You may feel full or bloated after only a few bites of food. You may experience vomiting, heartburn, nausea or excessive belching after eating.
Common treatments for gastroparesis:
Please consult your doctor to determine if you have this condition to avoid serious complications.
One of the most common and serious complications of diabetes is heart disease. Diabetes is a disease of the vessels. High blood sugar damages your blood vessels by building a plaque which leads to clogged arteries or atherosclerosis. More than 65% of deaths in diabetes are due to heart disease. In fact, when you have diabetes, you're 2-4 times more likely to have a heart attack or stroke, you’re more likely to die from a heart attack, complications from heart disease results at an earlier age, and your risk of sudden death from a heart attack is the same as for someone who has already had a heart attack.
The good news is that even after your diabetes diagnosis you have the power to prevent heart disease.
What's a heart healthy way to eat?
Here's to your good heart health!
Diabetes affects all the small blood vessels in your body, including your kidneys. Kidneys filter the blood. Waste products that have collected in the blood are removed and leave the body in the urine. Over a long period of time, the small blood vessels that are vital to proper kidney function can be damaged by exposure to high blood glucose levels and high blood pressure.
When damaged, the kidneys can no longer filter the blood as well as before, so the waste products stay in the blood and products that the body needs are lost in the urine. This is called nephropathy, as the nephrons, which are small filter in the kidneys, are damaged.
Please remember to request a copy of your blood work. Microalbumin is a test that can show the beginning of kidney problems. BUN or blood urea nitrogen and creatinine are two tests, when elevated out of range, show some damage already may be done to the kidneys. GFR, or glomerular filtration rate, shows how well the kidneys are functioning as filters.
In the early stages, the kidneys work harder to compensate for the damage, and there are no symptoms. Over many years, as the kidneys deteriorate, they lose their ability to repair themselves. When this occurs, kidney damage can be life-threatening and may require a kidney transplant or regular treatment with an artificial kidney machine called dialysis.
You can help prevent kidney problems and possibly avoid serious kidney disease by:
Diabetes can damage all parts of your body, including your nerves. This is called neuropathy. Neuropathy is partly due to the effects of blood sugar.
There are two types: Peripheral neuropathy and autonomic neuropathy.
Less sensitive nerves do not send feelings of pain, heat or cold to the brain as easily. There may be a feeling of numbness or pins and needles in your feet. You may injure your feet and not be aware, due to the decreased sensitivity to pain. You must take extra care not to injure your feet and you must check your feet daily to see if an injury has occurred.
Your nerves may also develop increased sensitivity at times. When this happens, you may feel burning, numbness or tingling, or shooting pains in your legs and feet. You may not be able to tolerate the touch of clothing or sheets on your legs and feet.
Neuropathy can also affect the nerves that control sexual function. This may result in impotence for men and vaginal dryness or difficulty to achieve orgasms for women. Discuss these symptoms with your doctor.
Common treatments for diabetic neuropathy:
If you are sleep deprived, your chances for diabetes increases since your insulin will not work as well as you need it to for lowering blood sugar. In fact, your cortisol levels (stress hormone) will rise and that causes your liver to produce more sugar.
Remember, if your insulin is not working 100% efficiently (“insulin resistance”), then the extra sugar your liver is producing will cause an even higher blood sugar reading. In addition, your brain, which seeks energy primarily from glucose or sugar (carbohydrates), will not function at its highest level.
Think about how “foggy” your head feels after having a sleepless night.
The symptoms of sleep deprivation are:
The risk factors of sleep deprivation are:
Diabetes and sleep statistics:
Sleep apnea is a common sleep disorder that is associated with fatigue, weight gain, high blood pressure, diabetes and heart failure. Answering YES to 2 or more questions below indicates that you may have sleep apnea.
Diabetes can affect eyesight. Elevated blood sugar levels may cause changes in the body’s blood vessels, the veins and arteries that carry blood throughout your body. It can cause cataracts, glaucoma, and damage to the blood vessels inside the eye.
Diabetic retinopathy is a complication of diabetes caused by changes in the tiny blood vessels of the retina. The retina is the light-sensitive nerve layer at the back of the eye that sends images to your brain. Without a retina, the eye cannot communicate with the brain, making vision impossible.
There are two types of retinopathy:
Diabetic retinopathy is the leading cause of new blindness among adults in the USA. People with untreated diabetes are said to be 25 times more at risk for blindness than the general population.
There are no early warning signs with diabetic retinopathy. At some point you may have blurring. If new blood vessels form, they can hemorrhage and may leave spots floating in your vision. This can also be as severe as only being able to tell dark from light.
A medical examination by an ophthalmologist is the only way to find changes inside your eye. This includes visual acuity testing, pupil dilation, ophthalmoscopy, and tonometry (tests fluid pressure). Further testing may include fluorescein angiography - dye given intravenously to obtain color photographs of the retina.
The most significant treatment is laser surgery. This seals the leaky blood vessels. A small burst of light is beamed on the damaged retina. This reduces macular edema. Laser surgery retards vision loss. Other treatment such as cryotherapy and vitrectomy may be recommended for persistent hemorrhaging.
Early detection of diabetic retinopathy is the best protection against loss of vision. People with diabetes should schedule examinations by an ophthalmologist at least once a year.
Peripheral neuropathy and decreased circulation can lead to serious foot problems. Please be sure to:
People with diabetes do not heal as efficiently as people with normal blood sugar levels. Certain foods can also help keep your blood sugar optimal.
Protein helps to repair tissue:
Carbohydrates give you energy:
Fat allows you to absorb your fat soluble vitamins – A, D, E, K:
The following vitamins are excellent to heal wounds most efficiently:
** Egg yolks contain vitamins and cholesterol while egg whites contain protein
Hypertension, or high blood pressure, is the force that moving blood puts on the artery walls. As the heart muscle pumps out blood, the aorta (main blood vessel) is stretched until a peak pressure is reached. This peak pressure is called the “systolic pressure.” As the heart rests between beats, the arteries are more relaxed but maintain enough tension to allow smooth blood flow. This tension is called the “diastolic pressure”.
If you have high blood pressure it means the heart is under pressure to pump blood and there is an increased tension on the artery walls. This may cause damage to the arteries since any injury causes plaque to build up. This ultimately weakens the heart muscle because hypertension requires the heart to work much harder.
Essential tips for getting to and maintaining healthy blood pressure levels.
Please consult your doctor before starting an exercise program or changing your diet.
Life, like diabetes, goes up and down and round and round and we try our best to carry ourselves through. Along the way, we reach out for help. Help from people like our family, our friends, acquaintances and sometimes strangers. We also seek help, or comfort, from habits. Good habits can be created as easily as bad habits. Understanding what we should do and actually doing it can be two different things. Therefore, you are encouraged to use the support at this site to assist you in managing your diabetes. Read over and possibly even recite the A-Z inspirational messages, learn to meditate or read and share your stories on the forum and blog. If you need a good laugh (with education involved as well) indulge in my "Have You Ever?" stories.
Smiling and laughing seems to create a positive spin to your day.
Have a fun one!
Understanding the diabetes and depression is like asking the question: What came first the chicken or the egg?
Stress can affect blood sugar levels and having diabetes can add stress to people’s lives. Experiencing stress for a prolonged period of time may result in depression.
Many people newly diagnosed with diabetes go through stages of mourning:
Many people are in denial about their disease. “Oh, it’s just a little sugar,” some might say or “I feel fine, I’ll just cut back on my sweets,” or “I’m only borderline.”
Sometimes these people who are in denial will end up with a complication of diabetes, like nerve damage, and then they start to take it seriously and become angry.
While angry, they acknowledge how much of a responsibility diabetes is and the devastating complications they may suffer from if they choose to ignore it. For many, the next stage is acceptance. They accept their disease and make strides in controlling it the best way possible. Others, become depressed.
Are you depressed?
People with diabetes tend to have a greater risk of depression than people without diabetes. This may be due to the responsibility of managing a disease that requires a lot of thought, daily. The possible complications may add stress to your life. Even fluctuating blood sugars can affect your moods.
If you have been feeling very sad, or if you worry that you may be depressed please seek the help of a professional – a psychologist, psychiatrist or social worker, or:
Your doctor tells you, your friends and family confirm it and that high blood sugar reading surely finalizes it – you have diabetes. It’s so difficult to hear about all the “shoulds” and “should nots” while you’re still coming to grips with the fact that you have a disease with so many possible complications. You wonder how you will be able to stay healthy? How will you self-manage or control this disease and live your life? How can you learn to “do-it-yourself?"
Controlling diabetes is a process and I am here to assist in that process. You are at the right place to begin taking steps toward understanding and implementing some changes in your lifestyle. I understand that it is difficult to make changes and it’s especially frightening when you are doing so to save your own life.
My “Have you Ever” vignettes are designed to take some of the fear out of your diabetes learning experience. These real-life situations allow you to more easily understand how to cope with day-to-day living with diabetes. It’s okay to laugh a bit, it doesn’t diminish the seriousness of the disease, rather it shows that you’re already seeing that there is life after diabetes, one you will continue to enjoy.
P.S. Do you have a real-live funny, heart-warming, inspirational or educational story you would like to share? Share your diabetes story now.
You joined the neighborhood gym months ago and now you think it’s a good idea to attend. You push, push, push yourself to go and there you are in your “gym get-up” (aka oversized T-shirt and shorts) ready to work out. You look around at all the cute girls in their fancy “work-out gear” with tons and make-up and perfume, flirting with the cute guys and you think to yourself, why am I here? Then you spot an older gentleman who is kind of hot, focusing on his exercise, and that gives credence to your decision to stay.
You proceed to the exercise machines where you first eye the stairclimber and think this is what your rear-end needs to perk it up a bit. You get on, but before you start climbing, you think about your fasting blood sugar – 95 mg/dL and the breakfast you ate – a bowl of cereal, milk and fruit - and when your medication is going to peak – RIGHT NOW!
You jump off the machine before you start to break a sweat – or even climb one step for that matter – and you run to the bathroom and check your blood sugar. 85 mg/dL! Are you kidding? It’s going down……….You think to yourself before you head to the smoothie bar to decide between a vanilla almond milk with peanut butter smoothie or a blueberry, banana, kiwi smoothie with extra whey protein and flaxseed meal to take you through the exercise – this is NOT a good time to exercise! But you’re here anyway, so you relax with your delicious and sweet, but slow digesting, smoothie, knowing you made a better choice by throwing in the protein and fiber to slow down fruit sugar from blasting in your bloodstream and you’ll be ready to go in about 30 minutes.
Thirty minutes pass and you test your blood sugar again and now it is 120 mg/dL. Mission accomplished! You get some water to take with you and start climbing. Sixty minutes after drinking and sweating you take a break and re-check your blood sugar. You haven’t worked out this hard in years and you feel so out-of-shape. Oh no, the sugar is now 250! What happened? Oh yeah, you remember that diabetes educator telling you that your liver stores glucose and will overcompensate in some instances – like now!
When your blood sugar is dropping it protects you by sending out glucose into the bloodstream. The bad part is that it is overly generous……your liver did such a good job that now you have high blood sugar! You drink more water to hydrate yourself and learn from this incident. Obviously, your body can not exercise with blood sugar in the low hundreds when your medication is peaking. Next time, you will exercise at a different time or ask the doctor to adjust your medication(s). Perhaps your doctor can cut back on your medication, suggest that you take it at different times, or you may not even need it on those exercise days!
You've desired it for awhile now. You've thought about it almost every day. You've longed for that "forbidden food." You have truly wanted it so badly and for so very long that you could taste it. You find it difficult to understand how Billy Joel sang such a romantic tune about it and yet all you can equate it with is dreadfully high blood sugar.
But, the antipasto wins out and you finally convince your friend to accompany you to your favorite Italian Restaurant. You walk in knowing this could be trouble. The scent of the garlic rolls follow you from the front door all the way to your seat. Before you even look at the menu you can hear that dietitian/certified diabetes educator’s song ringing in your ears about testing your blood sugar before the meal and about 2 hours later so "it will either give you peace of mind or you’ll know you better not do that again" and you can make a better choice next time.
Alright, so she was reasonable and never told you to refrain from your favorite food, just find out things. And then you remember – oh, that voice again – she also said to sit down, peruse the menu and think of every food you would like that might have a dramatic effect on your blood sugar. Minestrone soup or salad? How many garlic rolls? Side of pasta or full plate? Breading on the chicken parmigiana or chicken cacciatore? The tomato sauce? Dessert?
Decisions, decisions. You get angry for a moment because you really want to just eat what you want and not think so much about it. Just then, your friend comments about her desires and how she needs to choose carefully because she is trying to keep her weight in control and that she works so hard exercising and making healthy choices. She decides to order the salad with dressing on the side, shrimp parmigiana – hold the cheese (saturated fat, 100 calories an ounce and tons of sodium) – and sautéed spinach. As she orders, she munches on one garlic roll and pushes the rest aside. "I'll have the same", you say, as you indulge in a delicious meal at your favorite Italian restaurant knowing you can come back here as often as you like.
|Chicken Soup for the Soul Healthy Living Series: Diabetes
Chicken Soup for the Soul Healthy Living Series: Diabetes gives information about the causes of diabetes, how to prevent it and how to live a healthy lifestyle if it develops in an inspiring way by renowned diabetes experts.
Medical experts from all over the country, including Destination Diabetes expert advisor, Marci Sloane, contributed to this informative and heartwarming volume in the Chicken Soup for the Soul Healthy Living Series.
|The Diet Game: Playing for Life!
Author: Marci Sloane
Diabetes educator/nutritionist and Destination Diabetes expert advisor, Marci Sloane presents a fun and healthy way to lose weight in The Diet Game: Playing for Life! Marci shares her professional experience and secrets with 30 days of practice menus and simple, easy recipes to help you avoid or treat conditions such as diabetes or high cholesterol.
Body Mass Index (BMI) Calculator - assesses your body weight relative to your height.
Carb to Insulin Ratio - Calculations of carb to insulin ratios for Type 1 Diabetes.
One Week Meal Plan - Marci's week of healthy diabetes meals planned for you!
Daily Food & Exercise Log - Track your food and exercise daily for diabetes control.
Calorie Diets by Marci Sloane - Convenient planned out diets from 1,200 to 2,000 calories.
Body Mass Index (BMI) assesses your body weight relative to your height. The American Dietetic Association uses the following BMI formula: multiply your weight in pounds by 700. Then divide
that number by your height in inches two times.
For example: a person weighs 135 pounds and stands 5’7” tall. 135 pounds x 700 = 94,500. Divide that twice by 67” (5’7”). 94,500/67 = 1,410 divided by 67 again = BMI is 21
BMI was designed to determine how your weight affects the status of your health. Too high of a BMI means that you are more prone to illnesses such as heart disease, cancer and diabetes. A pear-shaped person, who has excess weight in their hips and thighs, is at a much-decreased risk of many diseases than is an apple-shaped person, who has much of his or her weight in the chest and abdominal area.
What number do you hope to see?
|BMI||WEIGHT||RISK (PEAR)||RISK (APPLE)|
|18.5 – 24.9||Normal||N/A||N/A|
|25 – 29.9||Overweight||Increased||High|
|30 – 34.9||Obese||High||Very High|
|35 – 39.9||Obese||Very High||Very High|
A carbohydrate to insulin ratio is the amount of insulin used to lower the blood sugar from a particular amount of grams of carbohydrates eaten. For example, some people have a 15:1 carbohydrate-to-insulin ratio or they take 1 unit of insulin for every 15 grams of carbohydrates they eat. But other Type 1s need 1 unit of insulin for every 10 or even 8 grams of carbohydrates. Every person responds a little differently to insulin.
The 450/500 rule goes as follows:
If a person is taking rapid-acting insulin such as Humalog, Novolog or Apidra they would follow the 500 rule which states:
Divide 500 by the total daily dose of insulin. The result is the grams of carbohydrates that are approximately covered by 1 unit of insulin. For example, add up all the insulin you take for the day and divide by 500. If your total daily dose was 45 units, you would divide 500 by 45 and your ratio would be 11:1.
If a person is taking short-acting insulin such as Humulin R or Novolin R (Regular insulins) they would follow the 450 rule which states:
Divide 450 by the total daily dose of insulin. The result is the grams of carbohydrates that are approximately covered by 1 unit of insulin. For example, add up all the insulin you take for the day and divide by 450. If your total daily dose was 45 units, you would divide 450 by 45 and your ratio would be 10:1.
Marci Sloane, MS, RD, LD/N, CDE, is a registered and licensed dietitian/nutritionist and certified diabetes educator. She grew up in NYC where she graduated with a degree in Nutrition and Physiology from Teachers College at Columbia University.
For over a decade, Marci managed a Diabetes and Nutrition Education Center at a multi-bed hospital in South Florida and has been counseling people on healthy eating, weight loss, and managing diseases and conditions such as: diabetes, pre-diabetes, healthy eating, heart disease, weight loss, high cholesterol, high triglycerides, hypertension, hypoglycemia and a host of other nutrition-related diseases.
Marci is an American Diabetes Association Valor Award recipient and lectures frequently to the public and healthcare professionals. Marci was a featured panelist for the Sun-Sentinel's "Let's Take It Off" weight loss program, was highlighted in the Palm Beach Post: Meet Your Neighbor, "Woman's book on healthy eating uses humor as a key ingredient" and was a participant in their Diabetes Series in 2007. Marci Sloane is a member of the American Diabetes Association’s Health Professional Committee.
Marci authored The Diet Game: Playing for Life!, a comprehensive and humorous guide to all you want to know about nutrition and sensible eating and contributed stories to the Chicken Soup for the Soul Healthy Living Series: Diabetes for Health Communications, Inc.
Marci started "Nutrition Day" at a local charter school, an event to inform kids about making healthy choices, and also developed a nutrition and fitness program where she shared her original songs about nutrition using familiar children’s tunes for in attempt to encourage them to eat healthy and exercise.