Indholdsfortegnelse for January/February 2020 i Diabetes Self-Management

Dear Readers, Ready for a refresh and reset after all the hustle and bustle of the holidays? You’ve come to the right place! Health-related goals are among the top lifestyle changes many aim to achieve for the new year, with eating better, exercising more and losing weight rounding out the top three most popular resolutions. If you’re among the nearly half of Americans who has committed to a resolution this year, you’ll want to check out our roundup of advice that can help you make positive strides for 2020. Learn our top tips for getting organized and taking control of your diabetes routine (page 26), find out how to enhance your fitness program with resistance exercises (page 46) and more. The beginning of the year is also the time when…

The results of a six-month test of an artificial pancreas system have just been reported in The New England Journal of Medicine, and the findings are impressive. The artificial pancreas system combines two devices from two companies. The first device is the t:slim X2 insulin pump made by Tandem Diabetes Care, a San Diego-based company that specializes in products for diabetes patients. The t:slim X2 is equipped with a feature called Basal-IQ, which looks 30 minutes ahead and suspends insulin delivery to help lessen the time and frequency of episodes of hypoglycemia (low blood sugar). Employing Basal-IQ technology requires the use of a continuous glucose monitor (CGM), which is where the second device comes in. The CGM used in the trial was the G6 Continuous Glucose Monitoring (CGM) System, a…

Islet cell transplantation—a procedure in which insulin-producing cells from a donor pancreas are given to someone with type 1 diabetes—isn’t considered a mainstream option for diabetes anywhere, since it’s expensive and requires taking drugs to suppress your immune system, which carries certain risks. But it’s a real option for difficult-to-treat diabetes in Europe, Canada and Australia. Now, a new study from France shows just how effective islet transplants can be at improving blood glucose control and quality of life in people with type 1 diabetes. Published in the journal Diabetes Care, the study looked at 28 people who received an islet cell transplant over 10 years. The main outcome researchers were interested in was how many could maintain an HbA1c level (a measure of long-term blood glucose control) of 6.5%…

Exceed your limits!” “Push through the pain!” “Find your goal and crush it!” This is the kind of talk you hear in the world of competitive athletes. But what about the everyday athlete, the person who just wants to exercise because it feels good and improves health? Everyone enjoys perks from exercise, such as lower blood pressure, better weight control and stronger bones—but it has special benefits for people with diabetes. Both cardiovascular (aerobic) exercise and strength training can lower blood glucose levels and decrease insulin resistance, one of the hallmarks of type 2 diabetes. Setting goals can be extremely helpful in starting and maintaining a healthy exercise program, but these goals must be achievable and ultimately good for your body. A good starting point is the 2008 exercise guidelines…

A morning cup of coffee is a daily, almost sacred ritual for many of us. For most people, moderate amounts of coffee can be healthy and may lower the risk of certain diseases. But while it is OK to enjoy a cup of coffee, take a moment to think about what you are putting in it. When glancing at coffee creamer labels, the calorie and fat content seems minimal, so it may be hard to understand why you would need to hold back. Keep in mind, however, that most people add one to two tablespoons (or more) of liquid or powdered creamer to an 8- to 12-ounce cup or mug, which adds unhealthy fats and added sugars. When it comes to coffee, black is best. For those who desire the…

It’s the beginning of another new year. And if you’re like most people, decluttering, getting organized and living a healthier life are all on the top of your to-do list. But if you are really like most, the idea of getting started is overwhelming. Where do you begin? How do you know what systems will be the most effective for you to maintain? Now add daily diabetes management into the mix, and getting and staying organized may seem much more challenging. The list of things you need to do each and every day may leave you feeling disorganized and overwhelmed. The truth is, you’re not alone. We’ve put together a list of very usable and practical strategies to get you started. These are our most oft-repeated organizing principles. Take them…

If you’re feeling fatigued, join the club. Fatigue is a common symptom that affects almost everyone with diabetes—whether they have type 1 or type 2. Ginger Viera, who has lived with type 1 diabetes since 1999, wants to nap when her blood glucose (sugar) drops. “It makes my muscles so tired and weakens my mental energy as well,” she said. “The best naps are after severe low blood sugar, but I rarely have time for that with two kids and a busy work life.” Whether you call it “being tired,” “sleepiness,” “exhaustion” or “lacking energy,” fatigue can wreak havoc with your life. Fatigue is a serious issue for many—even though there is limited research related to fatigue and diabetes. However, in one survey of 361 insulin-treated people with diabetes, fatigue…

Protecting Your Kidneys Diabetic nephropathy (kidney disease) is the leading cause of kidney failure in the United States. Fortunately, there are a number of measures you can take that have been scientifically proven to protect your kidneys and lower the risk of developing diabetes-related kidney disease. What Is the Mediterranean Diet? If you’re living with diabetes, you may have heard about the potential health benefits of the Mediterranean diet. In this video, get five top tips for trying a Mediterranean-style meal plan. Blood Sugar Chart The fasting blood sugar, 2-hour post-meal blood sugar and HbA1c are important ways to indicate how well a person’s diabetes is being managed. Learn more about recommended blood sugar ranges. A Guide to the Mediterranean Diet Interested in trying the Mediterranean diet to kickstart your…

With a new year in full swing, it’s a good time to think about a fitness plan. You probably already know that exercise is good for your overall health, but did you know that it can also help you control your diabetes? Take this quiz to see how much you know about physical activity and diabetes management. 1. How does exercise affect your blood glucose (sugar) level and insulin sensitivity? ○ A It can raise glucose but lower insulin sensitivity. ○ B It can raise both glucose and insulin sensitivity. ○ C It can lower glucose but raise insulin sensitivity. ○ D It lowers both glucose and insulin sensitivity. 2. True/False: Both aerobic exercise and resistance training are helpful at reducing hemoglobin A1C (HbA1c) levels in people with type 2…

Often overshadowed by its neighbor, England, Scotland is a proud country with a rich history. A haunting land of ancient castles and rugged terrain, Scotland gently seduces you with its beauty and history. With over 5 million people, the country is home to populations with unique heritages—from Anglo-Saxon traditions and Gaelic Highland culture to the Norse customs of islanders. Pivotal to the history of this small nation, the capital, Edinburgh, is a good place to begin your visit. The most eye-catching feature of the city’s skyline, Edinburgh Castle, is also its most popular tourist destination. Set dramatically on a jagged volcanic cliff, the castle offers spectacular views of the city and bay, known as the Firth of Forth. There is so much history and architecture to see, joining a tour…

It is well known that vitamin D is critical for good health—but can the sunshine vitamin protect against type 1 diabetes (T1D)? Current studies are attempting to answer this question. Connecting the dots Vitamin D is most well-known for its role in regulating bone metabolism. However, there has been increasing speculation about whether vitamin D levels are associated with T1D due to the presence of vitamin D receptors on insulin-secreting pancreatic beta cells and immune cells, as well as the influence of vitamin D on the immune system, including autoimmunity. In the body, vitamins D2 and D3 are converted into a metabolite called calcidiol, which in turn is metabolized to calcitriol. Calcitriol helps suppress autoimmunity (in which the immune system attacks itself because it is unable to differentiate between invading…

It’s often said that breakfast is the most important meal of the day, and for good reason. Eating a nourishing breakfast can kickstart your metabolism, give you sustained energy and stave off cravings, leading to healthier choices throughout the day. And when you’re getting ready to power through a workout, taking the time to prepare a delicious morning meal (even if you take it on the go) sets a tone of success to carry you through your exercise time. Whether you’re looking to “carb up” or get in a boost of protein and healthy fats, these breakfasts will give you options. From a bright green smoothie to a hot bowl of grain-free “porridge,” these nutritious dishes are sure to power up your workout—and your day. Power Bowl Breakfast When I…

With a new year comes new resolutions—such as eating better, exercising more and losing weight. Research shows that physical activity has numerous health benefits for people with diabetes and prediabetes. Indeed, it can improve blood glucose management as well as overall health. Many people with diabetes focus their exercise goals on aerobic exercise, such as cycling or walking at a brisk pace. But while aerobic exercise is important, resistance training (strengthening your muscles) is another significant part of achieving maximum health benefits when you have diabetes. What is resistance training? The term resistance training, or strength training, often conjures images of buff men and women in the gym lifting heavy weights. The truth is that routine strength training is appropriate and beneficial for most people with diabetes. Resistance training consists…

People who achieve a weight loss of 10% or more in the first five years after being diagnosed with type 2 diabetes have the best chances of the condition going into remission, according to new research from the University of Cambridge. The findings indicate that it may be possible to “reverse” type 2 diabetes without extreme dieting or lifestyle interventions. More than 30 million people in the United States have diabetes, and 90% to 95% of those affected have type 2 diabetes, which is characterized by insulin resistance and insufficient insulin secretion. Risk factors include overweight and obesity, family history of the disease, hypertension (high blood pressure), impaired glucose tolerance, metabolic syndrome and low levels of physical activity. Previous research has indicated that type 2 diabetes remission is possible by…

The U.S. Food and Drug Administration (FDA) has approved the first oral GLP-1 medicine for blood sugar management in adults with type 2 diabetes. Manufactured by Novo Nordisk, Rybelsus (semaglutide) oral tablets are the first drug in their class that do not need to be injected. A member of the class of medicines known as GLP-1 inhibitors, it works by increasing feelings of fullness, slowing stomach emptying, increasing the release of insulin, and decreasing the release of glucagon (a hormone that raises blood glucose). Rybelsus is approved for once-daily use in 7-milligram or 14-milligram doses. According to the manufacturer, “A savings card program will be available at the time of launch for eligible commercially insured patients to keep out-of-pocket costs down to as little as $10 a month.” “Patients want…

Q Is there a way to lose weight if you take insulin? I’ve heard that insulin causes weight gain, but I need it to control my blood sugar. This really has me confused! A I can feel your frustration. Take the insulin needed to control your blood sugar, and the weight is stubborn to come off. Reduce the insulin, and the weight comes off, but blood sugars may go way up. For many people, reducing insulin doses can aid weight-loss efforts, but how can you do so without sacrificing blood sugar control? There are several ways to accomplish this, but it is VERY important to work closely with your healthcare team when doing so. Otherwise, you could wind up with dangerously high or low blood sugar levels. Many of the…

To maintain a healthy weight, you need to work on your fitness. This will require a concerted effort to integrate exercise into your daily schedule—no matter how busy you are. The first place to start is choosing the best exercise for you and your needs. DOES PERSONALITY MATTER? According to fitness coach Eric Stevens, the key to finding the right fitness program is to match it to your personality. Are you an extrovert—outgoing and socially confident? You are likely to enjoy high-energy exercises such as Zumba and high-intensity interval training (HIIT), team sports and social get-togethers like group hikes. Are you an introvert who is more focused on your internal world? Quieter physical activity might be more for you, including activities that allow you to clear your head, such as…

Starting a new fitness routine this year? Don’t forget to consider how food and hydration choices might impact your workout and recovery. Read on for insight on the best pre- and post-workout snacks and answers to the most common question about staying hydrated. Should I snack before or after working out? Whether or not you even need to include a snack before or after a workout depends on a few different factors, including hunger, duration and intensity of physical activity, and, for those living with diabetes, blood glucose levels. Hunger: A very basic but critical question: Are you hungry? If it’s been a while since your last meal and your stomach is grumbling, it might be worth considering having a small snack before tackling your next workout. Paying attention to…