I have two friends who have had the gastric bypass surgery.  They qualified for two reasons; Their BMI ranged between 35.0-39.9 and they have type 2 diabetes.  Both of my friends lost almost 100 pounds each!   Most importantly, they were taken off of their diabetes medicine to manage it with diet and exercise.  One of my friends actually suffered from frequent hypoglycemic episodes after this.  She was able to get it under control quickly, having known before-hand that this is a common side effect with this type of surgery.  Gastric Bypass is becoming more common for people with type 2 diabetes as an option to lose the weight.  

Gastric Bypass sounds like a quick and easy fix to dropping some serious weight, right?  What some people don’t understand is that you can gain the weight back by overeating very easily.  That is exactly what happened to both of my friends.  As a result of not following a smaller/strict diet, they both are back on their diabetes medicine and have regained the weight that was dropped from the gastric bypass surgery.

What are some other safe options for weight loss with diabetes?

Do you know anyone this has happened to?  Did they decide to have the surgery again?

I found a wonderful web page that shows how to enjoy Thanksgiving and still eat healthy.  It demonstrates exactly how to enjoy the stuffing, sweet potatoes and pumpkin pie we all love to eat on Thanksgiving Day.  The plate is divided into three portions/sections so you don’t have to measure your food.  Fill one portion with vegetables, divide the other half into two equal sections, one for stuffing and sweet potatoes and the other for the turkey. 

You will also find easy recipes to make these favorite foods with healthier ingredients.  One recipe that caught my eye was the tangerine cranberry relish which has zero grams of carbs or fat.  Also included are eleven health tips for you to use for a happy, healthy Thanksgiving!

I’m going to try to stick to calorie-free drinks throughout the day so that I can enjoy some dessert!

Also, don’t forget to sign the Healthy Holiday Eating Contract (Page 5 of the web page).  It is always helpful to set goals and list what you want to accomplish this holiday season.

Happy Thanksgiving from CCS Medical!

 

http://www.diabeteseducator.org/export/sites/aade/_resources/pdf/general/ThanksgivingPlateResource.pdf Accessed 10/21/2011.

The holidays can be a challenge for people with diabetes and the stress can be too much with all the activities going on.  You are probably preparing for entertaining, family visits, buying gifts and parties.  Besides all of this, you are working full time, therefore, diabetes care is put on the back burner.

Here are some tips to plan for a relaxing and enjoyable holiday season:

• Plan your schedule, make a list of gifts to purchase and do some shopping online
• Always carry glucose tablets and your blood glucose meter in your car, purse or pocket
• Carry a healthy snack like nuts, a small apple with cubes of cheese or peanut butter and crackers instead of eating in the food court
• Keep your exercise schedule, it can reduce stress
• Prepare your traditional holiday food with healthier ingredients
• Bring a pre-mixed light alcoholic drink for fewer carbohydrates. Follow the American Diabetes Association alcohol guidelines for women 1 oz. and men 2 oz. per day.
• When traveling, get all prescription medication (insulin/pills) filled ahead of time. Take syringes, lancets, test strips, pump supplies and batteries

Enjoy your holiday season while effectively still managing your diabetes!

Do you have any tips for the holiday season?

Have you heard of the term “Dawn Phenomenon” or the “Somolgyi” effect? Many people with diabetes haven’t, and yet it happens quite often.

The “Dawn Phenomenon” is a sudden rise in blood sugar between 3:00am and 6:00AM. It occurs in type 1 diabetics and occasionally in people with type 2 diabetes. It is caused by the body’s reaction to hormones that are released when you sleep. The result is an increase in blood sugar due to lack of insulin in the blood stream.

The “Somolgyi” effect, also known as the “rebound” effect, is a period of low blood sugars followed by high blood sugars. It usually happens in the middle of the night. Normally this occurs as a result of taking too much insulin or an oral medication that works at the wrong time.  When the blood sugar is low the body releases hormones and stored sugar is released from the liver which also results in high blood sugars.

How do you know which one you have? This is the fun part! Your doctor will ask you to test your blood sugar between 2:00AM and 3:00 AM a few nights in a row. If the blood sugar is normal or high at this time, suspect the dawn phenomenon. However, if your blood sugar is consistently low during this time, you are experiencing the “Somolgyi” effect, caused by too much night time insulin or too small of a bedtime snack for the insulin given.

What can you do? Ask your doctor about an insulin pump to manage your diabetes.  One of the features that the pump can do well is stop the dawn phenomenon. You can set different basal rates to increase or decrease insulin according to your needs.

Feel free to share your “Dawn Phenomenon” or “Somolgyi” effect stories…what steps did you take to overcome this?

Everybody is talking about the economy today.  The question on most people’s mind is how can I save money and how does my spending affect the bottom line?  If you have Medicare and are getting your glucose strips from CCS Medical, you are already helping save Medicare money.  Mail order glucose strips are paid by Medicare at $31 per box, while glucose strips you get from your local pharmacy (i.e. Walgreens, Rite Aid, or Sav-On) are paid at $38 per box.  This is a difference of $7 per box.   This means that pharmacies are making on average $84 more each year on a patient that fills a prescription for 1 box a month. 

Now I know $84 a year doesn’t sound like a lot of money but let’s put this into perspective:

• 66% of all patients with diabetes are covered by Medicare at about 14 to 16 million. 
  • If you take out just 1 million people with diabetes that are getting their glucose strips from the local pharmacy, that is $84,000,000 going out of the Medicare coffers each year. 

Don’t you think that with this type of savings would take Medicare dollars farther?   

Do you know people with diabetes that are not using mail order for their prescription needs? 

Let them know how they can have a more positive effect on Medicare’s bottom line by getting their strips through mail order. 

How will you pay for your prescriptions in the future if Medicare disappears?  You decide.

You may have found yourself in this situation:

You scraped your foot while working outside.  You actually didn’t even know it had happened until you saw that your foot was bleeding.  After you washed and dried the area it appeared fine.  A couple of weeks later you notice that your foot is swollen, red, and painful to touch, plus a dark scab has covered the area. You are now concerned because you have heard people with diabetic foot wounds can develop complications quickly.

In this situation or when you develop a diabetic foot ulcer, the most important thing to do is to go see your doctor for an assessment of the wound and circulation.  Good blood flow to the area is very important for healing.  Diabetes can reduce blood flow to legs and feet even when you do not have a diabetic wound.  Other factors such as blood sugar control, smoking and diabetes eye or kidney problems can also be a risk for slow healing.  The doctor says that because you have feeling loss in your feet (Peripheral Neuropathy), you were unable to feel the pain when you cut your foot.  Your wound is cleaned by removing the dead tissue from the area, which is called debriding.  A treatment regimen is set up for you to follow when you get home for good diabetic foot care  You will need to clean and cover the wound twice a day with wound dressings and antibiotics are prescribed for the infection.  Following the treatment plan ordered by the doctor is very important for the wound to heal.

The underlying cause of this situation is uncontrolled diabetes which will also need to be managed more closely starting right away!

Has this ever happened to you?  What prevention steps can you recommend?

Have you been wondering what has caused your blood sugars to elevate? Your first instinct is to look at your food intake or lack of exercise.  But there are other things that can affect your blood sugar readings, and STRESS is one of them.  Your body’s stress hormones, such as cortisol, can increase in the blood stream when you are stressed out.  The major function of these hormones is to help boost energy, this is referred to as the “fight or flight” reaction.  It causes tremors, fast heart beat and shakiness.  These hormones send your blood sugars skyrocketing to boost energy when needed.

 

Here are some ways to prevent this from happening:

• Make time for yourself and do something you enjoy
• Have an exercise routine
• Take a break when you feel overwhelmed

 

What is your biggest stressor and how do you cope with it to keep your blood sugar under control?

 

Yesterday I went to see my dentist for a routine visit.  We got to talking and she commented on how the diabetic patients that she treats have a very poor understanding on how diabetes can affect their teeth.

Did you know that people with diabetes are likely to experience tooth loss?  Why is this?  It is because bacteria is always present in the mouth, even though we don’t like to think about it.  When blood sugars are high, the bacteria will settle into the gums and results in gum disease.  The germs destroy the bone around the tooth and promote infection.

What signs and symptoms should you look for?

•      Bleeding gums when brushing and flossing
•      Gums appear red, irritated and swollen
•      Loose teeth
•      Puss oozing around the tooth
•      Mouth odor

How can you prevent this from happening?

•       Control blood sugars
•       Routine visits to your dentist

 

Remember it is easier to prevent gum disease than treat it!  What additional steps can you recommend to stay on top of your dental hygiene?

My husband and I love to cook with flavorful spices.  His cholesterol is always a little high but his triglycerides are in good shape.  A recent study found that adding spices to high fat meals reduces triglycerides by 30%!  This is valuable information as many people with diabetes have high triglyceride levels.  What a flavorful way to lower them with some spiced up meals! 

 

Here are some spices that you can try:
(Click through for recipes containing that spice)

• ·         Rosemary
• ·         Oregano
• ·         Cinnamon
• ·         Turmeric
• ·         Black Pepper
• ·         Cloves
• ·         Garlic Powder

 

What type of spice have you used or heard of that helps lower your triglycerides?

 

 

 

http://jn.nutrition.org/content/141/8/1451 Accessed 9/15/2011.