Indholdsfortegnelse for March/April 2020 i Diabetes Self-Management

Dear Readers, Tax time is looming, which means decisions about finances are front and center for many people. And if you’re living with diabetes, you know the impact the condition can have on your wallet. Between prescriptions, medical equipment and supplies, co-pays for doctor visits, healthy food and more, it can really add up. Fortunately, there are strategies you can use to trim your budget while maintaining your health. Whether you’re looking for ways to save at the pharmacy counter (page 26), tips to reduce your outlay for common supplies and nutritious foods (page 42), or approaches to spend less for fitness (page 16), there’s something here for you. Beyond monetary considerations, avoiding complications—or effectively managing them if they occur—is another top concern. In “Managing Diabetic Kidney Disease” (page 34),…

It’s well known that having poorly controlled or longstanding diabetes increases the risk of developing complications, including diabetic kidney disease (DKD)—a leading cause of disability in people with diabetes that can end in organ failure. That’s because elevated blood glucose levels cause damage to blood vessels over time, and the tiny blood vessels in your kidneys are especially prone to this type of damage. But blood glucose control and duration of diabetes aren’t the only factors in developing diabetic kidney disease. In a new study—the largest ever to look at the genetic factors behind this complication—researchers at University College Dublin (UCD) in Ireland have identified 16 areas of the human genome that contribute to diabetic kidney disease risk in people with type 1 diabetes. Scientists have long known that there…

The goal of developing a closed-loop artificial pancreas—a device or system of devices that regulates a person’s blood glucose levels completely automatically—has inspired efforts from many different companies in recent years. One contestant in that race is Beta Bionics, Inc., which recently announced in a press release that it has received the U.S. Food and Drug Administration (FDA)’s Breakthrough Device designation for its iLet bionic pancreas system. This designation gives the company priority review in future steps of the FDA’s approval process. According to the press release, the iLet is “a pocket-sized, wearable” device that’s similar in form to an insulin pump. Still in its investigational stages, the device requires users to enter only their body weight in order to begin regulating blood glucose levels. By reading the user’s blood…

In the media, exercise sometimes seems to be portrayed as an extravagance for the rich, what with personal trainers, fancy gear and expensive health club memberships. But it doesn’t have to be that way! All you really need to exercise is a willingness to do it. Here are ways to stay fit and lose weight without losing your shirt. CARDIO Most people can walk, and it doesn’t require instruction, expensive gear or a health club. A decent pair of sneakers is all you need to get started. You can walk on sidewalks, quiet roads and trails. When it’s rainy or cold, many people find shopping malls a convenient place to walk. Running needn’t be expensive either. Wear comfortable, supportive footwear and clothing that’s appropriate to the season, and you’re good…

Beans, peas and lentils—all members of a class of vegetables known as legumes—are nutrition powerhouses, packed full of protein, fiber, phytochemicals and folate. A vegetable and a plant-based protein source, beans contain nutrients found in both food groups, making them one of the most versatile and nutritionally complete foods. And unlike meat-based proteins, beans are naturally low in fat and free of saturated fat, trans fat and cholesterol. With today’s escalating food prices, legumes (especially dry beans) are an economical protein source compared with animal protein. One half-cup of cooked or canned legumes provides 6 to 8 grams of protein and 5 to 11 grams of fiber, which accounts for roughly one-fifth to nearly one-half of the Daily Value for fiber (25 grams per day based on a 2,000-calorie diet).…

The underappreciated but very important endocrine system is critical to regulating a number of vital organs, such as the pancreas and thyroid gland. When a person’s endocrine system malfunctions and the pancreas fails to produce adequate (or any) insulin, diabetes occurs. When that person is also dealing with thyroid problems, often manifesting as low amounts of thyroid hormone, resulting changes in insulin levels and overall changes in energy metabolism can make blood glucose control even more challenging. “Unmanaged thyroid disease can have a significant impact on the overall management of diabetes,” said Noah Bloomgarden, MD, assistant professor of medicine in the department of endocrinology, diabetes and metabolism at Albert Einstein College of Medicine in New York City. “Thyroid disorders make it harder to manage your glucose levels if you already…

Diabetic kidney disease (DKD) is a common and serious complication of diabetes. Kidney failure can cause death or contribute to death from heart disease or stroke. Along with high blood pressure, diabetes is the leading cause of kidney disease, with 20% to 40% of people with diabetes having some level of DKD. But like all complications, DKD can be prevented, slowed or reversed with good treatment and self-management. Kidneys are miracles The kidneys are among the greatest miracles of the human body. These bean-shaped organs, each about 4 inches (11 centimeters) long in adults, constantly take waste products and extra water out of the blood and excrete them in the urine. Without working kidneys, toxins and water would build up in the blood and rapidly kill us. According to the…

5 According to the National Kidney Foundation, approximately 37 million people in the United States have chronic kidney disease, including 35% of people age 20 or older with diabetes. Ninety percent don’t know they have it. Controlling your blood sugar and blood pressure can help prevent or slow the condition. For more steps on maintaining your kidney health, see “Managing Diabetic Kidney Disease” (page 34). 4 The fitness industry generated more than $30 billion in the United States in 2018, says the International Health, Racquet & Sportsclub Association, and it has been growing by 3% to 4% per year each of the past 10 years. Looking for ways to buck the trend and work movement into your routine on the cheap? Check out the tips in “Minimalist Training: Doing More…

Counting Carbohydrates Like a Pro When it comes to keeping blood glucose levels under control, carbohydrate counting works better than any other system. Here are four simple recommendations for counting carbohydrates accurately and easily. Diabetes and Sexual Health Did you know that diabetes-related issues can impact your sexual health? In this video, get three tips from Certified Diabetes Educator Alison Massey that can help. Tried and True Weight-Loss Techniques Are you resolved to lose weight—and keep it off? Then be sure to check out these strategies that have stood the test of time. Vibrant Veggies Want to make sure you’re getting plenty of vegetables in your meal plan? Download our free guide for eight fresh and seasonal recipes starring spring’s luscious harvest. Easy Lemon Chicken If you’re looking for a…

Good health is your wealth. But if you have diabetes, you know that the rising prices of medications, supplies and co-payments can deplete your bank account. How familiar are you with money-saving tips for cutting the costs of diabetes care? Test yourself with this quiz. 1. On average, people with diagnosed diabetes spend over four times more on their healthcare than those without diabetes. ○ True ○ False 2. Drugstore prices for identical medications can vary. ○ True ○ False 3. In comparing insurance plans, which of the following options should you consider to make cost-effective choices? ○ A Coverage for prescription medicines. ○ B Co-payments and deductibles. ○ C Coverage for medical supplies and devices. ○ D All of the above. 4. Which of the following is NOT a…

Aculief Wearable Acupressure Most people experience headaches every now and then. Aculief is a small, wearable device that uses acupressure (not acupuncture) to help relieve blockage and promote energy circulation throughout the body. Take it with you while traveling, going to work or doing your favorite activities. One size fits all! aculief.com Cocotopia Dark Chocolate Truffles* Each truffle contains just 40 calories and is 45% lower in calories and fat, and 30% lower in sugar than the leading dark chocolate truffle. With just 6 grams of carb, you can indulge in chocolatey goodness without worrying that your blood sugar will climb sky high later. cocotopia.com Tree Hut Coconut Lime Shea Sugar Scrub When you exfoliate, you are removing dead cells from your skin’s surface. Made with organic shea butter, sugar…

Our national parks house some of the most beautiful landscapes in the country, but few are as majestic as Yellowstone. Spread across Wyoming, Idaho and Montana, Yellowstone is most known for geysers like Old Faithful, but it also plays host to diverse adventures including river rafting, animal watching, fossil hunting and learning about Native American culture. Founded in 1872 as the world’s first park, Yellowstone has five entrances to begin your journey—North, Northeast, East, South and West. Each entrance leads you to different sites and scenery that showcases different aspects of the 2.2 million acres of parkland. Looking on a map does not prepare you for the vastness of Yellowstone nor the amount of time you’ll spend in the car. Do your best to group activities together based on how…

The soaring cost of medications is not news to people with diabetes. But did you know that a number of factors can influence the price you pay for your diabetes drugs? The price of a medication can be extremely high and variable from one pharmacy to another, especially if you don’t have prescription insurance. Even if you have insurance, co-pays, deductibles and coverage gaps can still make it difficult to afford the medications you need to manage your diabetes. And it can be challenging to prioritize the high costs of necessary medications when other expenses arise. Recent data from the National Health Interview Survey of Americans found that 15% of people with diabetes did not take their diabetes medication as prescribed due to the cost. Among this same survey group,…

Have you recently been diagnosed with type 1 diabetes? If so, you might feel a lot of different emotions right now. And you might wonder what having type 1 diabetes means for you—how are you going to handle taking insulin, pricking your fingers or counting carbohydrates? Can you play sports? Can you travel? Can you ever eat ice cream again? How will having diabetes affect your life at work, school or home? Can you have children? Why did you get this condition in the first place? And will it ever go away? There are so many questions that pop up when you are hit with a diagnosis like this, and it can be really hard knowing where to turn. Yes, your life as you know it will change—and not necessarily…

Americans like—make that love—to go out to eat, so much so that, on average, we eat out 4.9 times per week, according to a Zagat dining trends survey. And while many people dine out because of the convenience or due to hectic work schedules, the reality is that eating out is enjoyable. But what if you have diabetes? Does dining out have to become a thing of the past? Not necessarily. You can definitely dine at an infinite number of restaurants and still keep your blood sugars well-managed. Timing of meals, remembering to take your diabetes medication, and portion control are key factors to pay attention to when eating away from home. In addition, using the healthy plate method is a simple but helpful way to keep you on track…

We all know that getting a good night’s sleep is important to our health, and that includes the health of people with diabetes. But exactly what does “a good night’s sleep” mean? Recently, researchers in the Netherlands investigated that very question and published the results in the journal Diabetes Care. The researchers collected data on 172 patients with type 2 diabetes (T2D) who were receiving care from the Amsterdam University Medical Center. The researchers’ goal was to learn how different sleep measures affected the subjects’ HbA1c, which is a measure of a person’s average blood glucose (sugar) levels over the previous two to three months. The investigators looked not only at how long the patients slept but also at other sleep measures—sleep efficiency, sleep variability, midsleep time and subjective quality…

Since its approval for marketing in the United States in 1994, metformin has become the first-line drug for treating type 2 diabetes. It’s no exaggeration to say that this medicine has revolutionized how type 2 is treated, since it lowers blood glucose levels without the significant risk of hypoglycemia (low blood glucose) associated with older classes of drugs for type 2. It also appears to have a range of secondary benefits, from weight loss to better heart health to improved cognition to reduced anxiety. But in the wake of warnings from the Food and Drug Administration (FDA) that low levels of the potentially cancer-causing contaminant N-nitrosodimethylamine (NDMA) were found in the acid reflux drug Zantac (ranitidine), the agency has confirmed that it is testing samples of metformin for the same…

Q I am traveling to the United States soon and will be asked to go through full-body scanning equipment at airports. I use an insulin pump and have been advised by the pump company not to wear my pump through the scanner. The last time I flew, the airport security staff said it was OK. Are you able to provide any advice on this? A Pumps on a plane. Sounds like the title for a good action-thriller. Everyone who wears a pump must choose between the inconvenience of removing the pump while passing through security checkpoints and the guaranteed safety of following the manufacturer’s recommendations. From a purely practical standpoint, consider this: Air travel is already a major hassle. Why add to it? Wearing your pump through the scanner may…

• Sex (women are seven to eight times more likely than men to have the condition)• Age (it can occur even in children, but the risk is increased in those over 50)• Genes (i.e. if family members have Hashimoto’s or other thyroid diseases)• Presence of other autoimmune diseases (type 1 diabetes, rheumatoid arthritis, lupus, celiac disease, etc.)• Previous thyroid surgery• Too much or too little iodine• Exposure of the neck to radiation• Certain medications (e.g. lithium, amiodarone, interferon alpha, interleukin-2)• Damage to the pituitary gland SOURCE: AMERICAN THYROID ASSOCIATION…

Are the costs associated with diabetes management weighing you down? If so, you are not alone. A study published by the American Diabetes Association found that the total cost of diagnosed diabetes in the United States during 2012 was $245 billion, with average annual medical expenditures for people with the condition totaling almost $14,000. Costs for diabetes essentials such as test strips, glucose monitors, insulin, syringes, lancets and healthy diabetes-friendly snacks can quickly add up. Often, people with diabetes look for inexpensive solutions or substitutes to help bring down the high costs, but improperly cutting corners can lead to ineffective diabetes management and potential health problems. Here are some safe and effective ways for you to save money on diabetes supplies without risking harm to your health. Personalize your blood…

The spring season is a time to explore and renew. Just as physical and mental well-being are important components of healthy living with diabetes, so is eating deliciously well. If available in your area, your local farmers’ market or community-supported agriculture (CSA) program make excellent places to purchase foods fresh and in season and talk with the farmers. TIP The unpretentious nutty and mild-tasting parsnip is easy to cook and pairs well with its cousin, the carrot. It is no nutrition slacker—parsnips are a good source of dietary fiber, folate, potassium and manganese. Manganese is a trace mineral responsible for many body functions, including the metabolism of glucose. Roasted Parsnips, Carrots and Red Onion 4 SERVINGS | ABOUT ¾ CUP CAL 107 | FAT 3G | SAT FAT 0G |…