Will you be indulging in Halloween candy? Are you going to go to several holiday parties this year? Controlling your diabetes can be very difficult during these holidays. Keep in mind, it can be done by making some smart choices.

According to The American Diabetes Association, people with diabetes can have sweets. This includes chocolate, pies, brownies, cakes and much more.  Play it smart and keep the portions small.  Plan to fit these carbohydrates into your meal plan.  For example, if you want a brownie, exchange it for your potato.

Most people say it is ok to eat whatever you want because it is a special occasion.  While this is true and everyone deserves a treat sometimes, over doing it is never a good idea.  Here are some ideas that you can use to help you make the holidays fun and healthy. 

• Try to limit treats to once a day and remember to keep the portions small
• Before going to a party, eat some raw vegetables or fruit so you do not over-eat at the party
• Use the smallest plate and have more vegetables than carbohydrates
• After eating, get others to take a walk with you. 

What guidelines do you generally follow to help you control your diabetes over the holiday seasons?

My diabetes patients often ask me if cinnamon will help lower their blood sugar.  Some have reported that they have successfully used cinnamon while others have said cinnamon had no impact on their blood sugar readings.
I decided to do some research on my own.  I found a mix of results.  One study showed that cinnamon may lower blood sugar by decreasing insulin resistance.  In another study, cinnamon had no effect.  A third study suggests its use in the diet as a supplement.  In my opinion, it appears that more research is needed to confirm these findings and it may not yet be time to throw your diabetes pills away for cinnamon!
 
So, is Cinnamon Safe for People with Type 2 Diabetes?

It appears to be. It is classified as a food supplement and not a drug.  Just be aware that large amounts may increase liver problems in people with liver damage.  If you do plan to use cinnamon, speak to your physician first. 

What are your thoughts on supplements to control your blood sugar?

 

^{http://care.diabetesjournals.org/content/26/12/3215.full  Accessed 9/16/2011.}

^{http://www.ncbi.nlm.nih.gov/pubmed/16549460?dopt=Abstract Accessed 9/17/2011.}

I talk with patients daily about blood sugar testing. When questioned why they are testing less than their doctor has ordered, their excuses are too many to list.

When I hear this, I look back on my own life with diabetes over the past 51 years.  When diagnosed with diabetes that many years ago, I had urine test tape.  When placed in the urine the tape would turn colors.  I would compare it to the color chart and the chart would tell me the range the sugar was in.  I then progressed to the Clinitest which measured the amount of glucose in the urine, this was the only way for diabetics to keep a check on their glucose levels at the time. These tests were unreliable and you can imagine how happy I was when the blood glucose meters became available.  Now, I could actually see a specific number associated with my test.  It improved the ability to control my diabetes and my medications could be adjusted properly. This is why I encourage people to test their blood sugars as prescribed by their doctor.

We have come a long way in diabetes testing management. There are so many types of diabetes blood glucose meters on the market that you are bound to find one that fits your needs.  Blood sugar testing is the most important thing you can do to manage your health and prevent complications.

If you have been managing diabetes for quite a few years - what is your favorite benefit of the new blood glucose meters?

People with celiac disease tend to have digestive problems.  They are unable to tolerate foods that contain gluten.  Gluten is a type of protein found in foods made with barley, rye and wheat.  A gluten-free meal plan can help prevent the intestinal problems that occur.  If you have type 1 diabetes, celiac disease is more common, about 10% of people with type 1 diabetes have celiac disease as well.  It can be hard for people to combine both a celiac and diabetes meal plan, but many are doing just that.

I just heard about another challenge people with celiac disease face.  There is a risk of something called cross-contamination.  This occurs when gluten-free foods come in contact with foods that contain gluten and the gluten-free food no longer remains gluten-free.  Have you heard about this happening?

Here are some tips from the American Dietetic Association:

• Store gluten-free foods and baking supplies away from gluten foods.  Always label these containers as gluten-free flour or pasta.
• Prepare gluten-free foods first then make any gluten foods for your family or friends.
• Squeeze bottles work best for ketchup, mustard or mayonnaise.  If you “double-dip” knives in a spread there is a chance that some of the gluten-free bread crumbs can contaminate these spreads.
• Wash toasters and bread machines inside and out.  If you can, buy separate appliances for your gluten-free foods.

 

What other tips do you use to help control your diabetes with celiac disease?

 

 

^{Nutrition Care Manual, American Dietetic Association, 2011 editionhttp://www.diabetes.org/food-and-fitness/food/planning-meals/gluten-free-diets/?utm_source=RightHandRail&utm_medium=SitePromotion4&utm_content=glutenfree-june2011&utm_campaign=CON accessed 10/15/2011}

At work I educate people who have diabetes and many of them use an insulin pump to deliver their insulin.  During our conversations I always ask, “What are the features & benefits of your insulin pump?”  Since starting on the pump some people felt their control had improved and they felt more relaxed.  Another benefit mentioned was the move from multiple insulin injections and not having to stick themselves with a needle several times a day.  Since starting with the pump, they now change their site every three days which reduces the number of shots per day from approximately 12 every three days to one injection.  Each “insulin pumper” expressed the feeling of freedom, flexibility and confidence.  An Insulin Pump can be a life altering change.

P.S.  I wear an insulin pump too!

Did you ever think there was anything good about fat?  Well, there is!  It’s called brown fat and it is the type of fat that burns away the “bad” white fat.  This burning process results in weight loss.

Brown fat increases in children up until puberty and then starts to decline.  However, brown fat is active in about 5 percent of thin adults, with higher rates seen in women.  Researchers have discovered two pathways that activate brown fat production. Their study has opened the door for new ways to treat obesity.

With this development, what can we expect to see in the future?  Most likely, a new medication will be developed that can stimulate brown fat growth.  Some researchers believe they may be able to grow brown fat in the laboratory and then transplant it into the body.  Whatever  the treatment, this discovery could play an important role in fighting obesity and diabetes.

Have you heard any news about brown fat or a new way to fight obesity?  

 

 

 

^{Reference:   http://endo.endojournals.org/content/152/10/3680 accessed 10/1/2011}

One of my friends who has been a type 1 diabetic for over 25 years asked me if diabetes can affect your hearing.

My answer to her was, “yes”.  Why? She asked.  I explained the amount of time you have been living with diabetes paired with high blood sugars can cause hearing loss.  The tiny vessels and nerves in the inner ear can be damaged by high blood sugars.  It occurs over time, so a person may not realize that it is happening, but your family and friends will.

What signs of hearing loss should you look for?

• Asking people to repeat what they say
• Difficulty hearing in noisy places
• Turning the volume up on the television or radio
• Unable to hear what people say unless you are directly facing them

Don’t forget to have your doctor check your hearing on your next visit to prevent complications.

A friend with diabetes was telling me how she was trying to prevent the signs of aging. I asked, “What are you doing?”  She answered by saying, “I use face moisturizers, special soap etc.”  I said, “Do you know, when you have diabetes the aging process starts from the inside out?”  That is how complications start.  High sugar levels are like syrup running through every vessel and every organ of your body twenty-four hours a day. It causes the vessels to harden, and the organs to become less efficient. This results in the aging of the body.

What you should be doing is eating healthier, drinking plenty of water, exercising and taking your medicine as prescribed. Good blood sugar levels are the key to prevent the signs of aging in diabetes.

What are you going to do to prevent the aging process?

Every day one of my diabetes patients state that they saw a diabetes meter on TV that does not “prick the finger”.  I then explain that this is true, but blood is still needed to check blood sugars. This commercial is advertising a meter that you can test with alternate sites.  You can now use your palms, forearms, upper arms, thighs or calves.   

Follow these simple steps to make alternate site testing (AST) successful:

• Only use the clear cap on your lancing device.
• Rub the site until it is warm to increase blood flow
• Press the lancing device firmly against the skin
• Hold the lancing device down on the skin and press button to lance
• Push up and down on the skin with the lancing device (do not remove from the skin)
• Once you see the proper amount of blood, touch the test strip to the blood drop
• Wait for result

Is AST for Everyone?

If you have frequent low blood sugars, the finger is your best choice because it gives the most accurate blood sugar readings.  Always check with your health care team to see if alternate site testing (AST) is right for you.