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.

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?

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!