Recently, I read about a new concept that uses a contrast in the plate color and the food served on it.  The contrast of the plate and food can affect how we view portion sizes. 

You can perform your own experiment to see how this works.

• Place cream colored pasta on a white plate
• Serve pasta with red sauce on a white plate.

You will notice that you have a larger portion of creamed colored pasta compared to the pasta with red sauce. This shows that the less contrast between the color of food and the plate, the more you will eat.  Two-hundred people participated in a study and this is exactly what happened. It was also noted during the same study, when a white plate on a black tablecloth is used, the servings were 10% larger than a white plate on a white tablecloth. So, the opposite occurs; The higher the contrast the larger the food portions.

Try this and see if it makes a difference in controlling your food portions.  Let us know how it goes!

^{http://online.wsj.com/article/SB10001424052970204753404577066253349009674.html?KEYWORDS=heaping+plates , accessed 11/29/2011.}

Have You Made Your New Year’s Resolution?  Now is the time to start.  Look back over the past year and think about what you may want to change, fine-tune or learn. Here are some suggestions.

I will:

• test my blood glucose daily and know my target range
• keep my doctor appointments
• eat three portion controlled meals per day, no skipping or delaying
• drink more water
• check feet daily and use moisturizing lotion daily
• eat small amounts of protein with each snack
• make better choices when eating away from home
• go for a walk sometime during the day
• always take my diabetes medications
• relax and treat each day as a new day
• make an appointment with a dietitian to review meal plan (Medicare covers 2 hours of medical nutrition therapy with a physician order every calendar year following initial training)
• set one new goal every three months
• call a CDE at CCS Medical with questions regarding diabetes

I have made my diabetes New Year’s resolutions. Have you?

I found out some exciting news about a “gastric pacemaker”.  It will help obese people lose weight.  You would be a good candidate for this if you have a BMI between 35-55.  There has been much talk among researchers to create a device that can be implanted with less invasive surgery than the gastric by-pass.  This device is the size of a pocket watch.  After you eat, the implant stimulates the stomach so it feels full.  This helps obese people learn to eat smaller portions and lose weight.

I know many people with type 2 diabetes are having gastric by-pass surgery to help them with weight loss as a 5-10 pound weight loss can result in better control of their diabetes.  Imagine what a 100 pound loss would do!  I am so excited over what could happen in a couple of years.  

How do you feel about this innovation?

Have you or a loved one ever found yourself in this scenario? 

You were diagnosed with type 2 diabetes recently and now you have lost interest in things. The holidays are the happiest time of the year but you are sad.  You don’t understand what is going on. You may also be struggling with managing blood sugar levels and you have stopped testing altogether.

You talk with your doctor about your feelings and she performs a mental health screening. She tells you that there is a link between diabetes and depression. A 10 year study at the Harvard School of Public Health found a relationship between diabetes and depression, called a “two-way street”.  This means that diabetes puts people at risk for depression, and people with depression are at risk for type 2 diabetes.  The doctor says she will pay close attention to your mental health and the psycho-social aspect of diabetes care.  It is comforting to know that you are not alone and there is help for this problem.

Help yourself, if you have experienced any symptoms of depression, ask your doctor for a screening.  Remember, treating depression in people with diabetes can improve diabetes care. Also, people with depression can decrease their risk for type 2 diabetes. Both of these conditions can be treated and managed.

^{References: http://www.hsph.harvard.edu/news/feat}

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?