Indholdsfortegnelse for Winter 2021 i Diabetes Self-Management

Dear Readers, Winter is, in its way, a tale of two seasons: It is marked first by the joyous, festive—and often hectic—holiday span, culminating in celebrations on New Year’s Eve. This merry period is followed by the promise of a fresh start on the first day of the year, complete with resolutions to adopt new and, hopefully, healthier habits. No matter where you are on your journey with Jack Frost, we have tips and strategies that can help you achieve your goals. Do you find yourself in the midst of the holiday rush and wondering how you can enjoy the feasting while keeping your blood glucose levels in check? Check out the tips in “Healthy Holiday Meals” (page 64), then try some of our healthful holiday recipes in “At the…

The U.S. Food and Drug Administration (FDA) has approved the new drug Kerendia (finerenone) as a treatment for kidney and heart complications in people with chronic kidney disease (CKD) linked to type 2 diabetes, according to a statement from the FDA. The approval comes after the FDA gave the drug priority review status in January 2021, based on the promising results of a clinical trial. That trial also serves as the basis for the drug’s approval, which means that the pharmaceutical company Bayer is free to sell and market Kerendia in the United States. There were 5,674 participants who completed the clinical trial, who were each randomly assigned to receive either Kerendia or a placebo (inactive pill). All participants had type 2 diabetes and chronic kidney disease at the start…

Let it snow! And let’s make good use of it. If you are looking for a winter sport that can help you manage your blood sugar, heart health, weight, and more, consider cross-country skiing. Find out how this activity can help you live well with diabetes while enjoying the great outdoors by taking this quiz. (Everyone is different, so it is important to ask your health professional which exercises are best for you prior to starting any new physical activity.) 1. True/False: You can burn more calories by cross-country skiing than alpine skiing. ૰ True૰ False 2. Cross-country skiing in a forest can do which of the following? ૰ A. Lower your blood pressure.૰ B. Reduce the stress-related hormones cortisol and adrenaline.૰ C. Boost your immune system.૰ D. All of…

Using a continuous glucose monitoring (CGM) system for a limited period of time—to look at the amount of time people with diabetes spend in their target glucose range—may be a better way to assess how well diabetes treatments are working than using A1C levels as a guide, according to a recent presentation given at the 2021 Heart in Diabetes conference. A1C has long been a standard blood test used to assess how well diabetes treatment and management are working. But A1C has some inherent limitations as a measurement. For instance, the fact that A1C tends to approximate a person’s average blood glucose level, rather than look at how their glucose level changes or remains constant over time, makes a CGM assessment an attractive alternative, according to the conference presentation by…

The health of the entire body structure depends, in part, on healthy, strong, flexible feet. In fact, according to movement specialist Carol Robbins, having strong feet “changes the way we use our muscles and our gait mechanics. Your feet are reading the ground and relaying info[rmation] to your brain with every step.” Fortunately, although diabetes is linked with an increased risk of a variety of foot issues, there are many ways to safely improve the health of the feet. All joints in the body need movement to be strong and healthy, and especially the 33 joints and 26 bones of each foot, which provide a foundation of stability and balance for the body above. When the natural ranges of motion within the feet are limited, the joints and ligaments can…

Resolutions are often made in the cold winter months, but there isn’t really a specific time of year that we should commit to better wellness habits. Change can occur each day, and it can, in fact, be the small decisions we make on a daily basis that truly change the course of our health. In my case, it was an innocent inquiry at an endocrinology visit four years ago that resulted in a new diagnosis of celiac disease. I didn’t have the classic symptoms but merely a family history of celiac. My endocrinologist at the time wasn’t sure insurance would cover the test based on my lack of reported symptoms, but I insisted on having it. I’m not sure what really prompted me to inquire at that particular visit, but…

Jumping from youth football to the high school game can be challenging. More than a few kids struggle with the change, and practices can be exhausting. But for DeAndre Carter, the transition felt especially rough. Football practices the summer before his freshman year left him feeling completely wiped out. He was sleeping all the time and losing weight. One day, his coach sent the then-14-year-old home from practice when he felt especially terrible. “I told my dad I wasn’t feeling well and went upstairs,” remembers Carter. “I tried to lay down, but I started throwing up a lot, so my dad took me to the hospital.” When they arrived, the staff measured Carter’s blood sugar level. It was off the charts at 740 mg/dl. “If I didn’t get into the…

Maria walks into my office looking distressed. “I had an appointment with the endocrinologist, and he barely allowed me to talk.” She was under a lot of stress trying to balance work, her husband and children, and family visiting from the Dominican Republic. She shared many details about how happy she was having her relatives visit and all the places they had seen. She also noted that her exercise and meal-prepping routine were disrupted, and she was having problems managing her blood glucose. At doctor’s visits, do you find the need to set the stage and tell the backstory before you focus on signs and symptoms? Do you embed the symptoms in your story? If others have told you that you are long-winded, you may simply be a circular or…

’Tis the season when we celebrate holiday traditions and create lasting memories with family and friends. This year, social gatherings are especially meaningful following the separation we experienced due to COVID-19 last year. How wonderful it will be to enjoy festive meals and visits with vaccinated folks who live near and far. However, multiple celebrations, hurried schedules, and endless food choices during the holidays have the potential to wreak havoc on your daily diabetes management. No worries! Here are five tips and strategies to boost your meal-planning confidence during the busy holiday season. 1. Figure out your menu in advance. While it’s not always possible (or realistic) to create your entire menu ahead of time, it can be helpful to think about your food choices before mealtime. Meal and snack…

Diabetes and NAFLD If you have diabetes, you’re likely aware of the risk of certain complications, but you may not be familiar with non-alcoholic fatty liver disease (NAFLD). Learn more about this lesser-known diabetes complication, along with steps you can take to avoid or even reverse it. bit.ly/3ka3VJQ Diabetes Winter Tips Winter is upon us. As the seasons change, so can managing your diabetes. The holidays and a sense of hibernation can make your diabetes a little more challenging to deal with. But all things are possible—it’s a matter of adapting and maybe having a few hacks up your sleeve. bit.ly/3B0Ezok Lower A1C Levels Naturally Your A1C is a blood test that provides information about your average blood sugar levels over the past three months. There are a number of…

Following a low-carb diet may improve kidney function in certain people with type 2 diabetes, according to a small new study published in the journal Current Opinion in Endocrinology, Diabetes and Obesity—showing that a higher-protein diet may not always be bad for kidney function. Many doctors advise that people with chronic kidney disease (CKD) limit protein in their diet, since some studies have suggested that a high protein intake—especially from meat—is linked to faster progression of CKD. But the new study shows that the benefits of limiting carbohydrate in people with type 2 diabetes and mild CKD may potentially outweigh any risks from greater consumption of protein. For the latest study, researchers followed 143 adults with type 2 diabetes, with an average age of 61, who followed a low-carb diet…

Retail giant Walmart recently announced that it will sell a lower-cost version of NovoLog (insulin aspart) under its diabetes care brand ReliOn, the result of a partnership with Novo Nordisk, the manufacturer of NovoLog insulin. For the last couple of years, Walmart has offered low-cost insulin options—priced at $25 per vial—based on older formulations of what’s known simply as human insulin (Regular, NPH, and 70/30 mix). But in the United States today, the most widely recommended types of insulin are what are known as insulin analogs, meaning that their molecules look slightly different from insulin produced naturally by the pancreas. These tweaks to the insulin molecule allow it to act differently in the body, such as by having a longer or shorter duration of action. All of the best-known rapid-acting…

Q I heard that there are now pumps that automatically adjust insulin based on continuous glucose monitor (CGM) data. Does this mean that diabetes is cured? If so, how do I get one? AI wish it were that simple. While it is true that some insulin pumps can automatically adjust insulin delivery, we are still a long way from a cure. The systems that are currently available utilize “hybrid closed-loop” technology. In other words, the pump takes data from a continuous glucose monitor and adjusts the basal insulin if the glucose is trending high or low. Some devices will administer doses of insulin all at once (boluses) to fix high readings. By “touching up” glucose levels around the clock, these systems are pretty good at helping users avoid dangerous highs…

Humans evolved to increase their calorie intake and fat stores over the winter months. Back when we were hunters and gatherers, this made perfect sense and was important for survival. Today, however, this inclination can severely hinder weight management and be detrimental to our health. Here are some steps you can take this winter to ensure your blood sugar levels and weight don’t spike. 1 Focus on activity rather than calorie restriction. If short-term increases in weight are not addressed immediately, they are more likely to translate into long-term weight gain, which could prove more difficult to shed. However, restricting your calories beyond a healthy limit is not the answer to managing winter weight gain. In the cold season, your metabolic rate (or how much energy your body uses to…

The air outside is cold and dry. Inside, fires and furnaces bake away what little moisture is left in the atmosphere. Break out the lip balm and hand lotion. It’s the dry, itchy skin and chapped lips time of the year—winter in Diabetes Land. What can you do to keep dry skin in check this time of year? How bad does dry skin have to get before you need to see your doctor? And why do we seem to have more problems with dry skin than everyone else? Is dry skin caused by diabetes or high blood sugar? John Anthony, MD, a board-certified dermatologist for the Cleveland Clinic, thinks something lurks in the skin or DNA of people with diabetes that makes them prone to dry skin. According to him,…

One of the most common side effects of taking insulin or certain types of diabetes pills is hypoglycemia, or low blood glucose. Hypoglycemia can be mild, moderate, or severe. It can also strike fear in people who are at risk, and sometimes this fear can be a barrier to taking diabetes medication in the amount prescribed. What is hypoglycemia? As mentioned above, hypoglycemia means low blood glucose (sugar). According to the American Diabetes Association’s Standards of Medical Care—2021, “Hypoglycemia is the major limiting factor in the glycemia management of type 1 and type 2 diabetes.” Hypoglycemia is defined as a blood glucose below 70 mg/dl. But signs and symptoms of hypoglycemia can vary from person to person, and certain symptoms are more worrisome than others. The American Diabetes Association has…

Today’s blood glucose meters are small, fast, and portable, and they are getting more accurate—and sophisticated—with each generation. Most of them interface with computers, and some have the ability to send data wirelessly to other diabetes devices. Some meters allow you to reapply blood to the test strip, if needed; others let you easily share your glucose data with your family members and/or doctors. Still others enable you to track not just your glucose levels, but your medication, carbohydrates, and exercise, too. But are you taking advantage of all that modern meters have to offer? Are you checking smart, or just checking? Are you even doing it… right? This primer on blood glucose self-monitoring will help you assess how you’re doing and guide you toward using your numbers to improve…

We asked T’ara Smith, MS, Nutrition Education and Senior Manager of Beyond Type 2 and developer of taratalksfood.com, to share her favorite nutritious holiday recipes, which include easy-to-find ingredients. She has been living with LADA (latent autoimmune diabetes in adults) since 2017 and has a passion for creating exceptional cuisine for her friends and family. Smith says, “My family and I love these recipes because they’re easy to prepare, even during the hectic holiday months. The Herb-Roasted Chicken and Sautéed Garlic Green Beans recipes add elegance to any holiday meal. Several of my relatives and close family friends are living with diabetes, and we all enjoy these nutritious and traditional holiday dishes, made with simple ingredients.” Sautéed Garlic Green Beans 6 SERVINGS | ⅙ OF TOTAL RECIPE CAL 72 |…

Taking the type 2 diabetes drug Trulicity (dulaglutide) may reduce the risk for erectile dysfunction (ED) in men, according to a new analysis published in the journal The Lancet Diabetes & Endocrinology. Diabetes—especially type 2—is well established as a risk factor for erectile dysfunction. A 2019 study even found that people with genetic risk factors for type 2—whether or not they actually develop diabetes—are more likely to develop erectile dysfunction. Erectile dysfunction affects about 30 million men in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases. It’s more likely to occur if you’re older, have certain health conditions (including cardiovascular disease), take certain medications, or have certain mental health problems. It’s also linked to factors like being overweight and smoking. For the latest…

Tirzepatide, which is the first in a new class of medications being studied for type 2 diabetes, has been shown to be effective in reducing both blood sugar levels and body weight, according to a new trial. The medicine, which is administered through a once-weekly injection, is what’s known as an “investigational dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist.” Previous studies have demonstrated that GIP lowers the intake of food while also increasing the expenditure of energy—actions that promote weight loss. The development of tirzepatide was based on the premise that if GIP were to be combined with a GLP-1 receptor agonist, the result might be even greater weight loss, along with a strong effect on blood sugar levels. Thus, tirzepatide combines GIP and GLP-1 into…

Standing more throughout the day is linked to better insulin sensitivity and may help prevent chronic diseases like type 2 diabetes, according to a new study published in the Journal of Science and Medicine in Sport. Insulin resistance happens when cells in the body become less sensitive to the effects of the hormone insulin, which helps regulate blood glucose levels. While insulin resistance by itself doesn’t mean your blood glucose levels will be abnormal, it indicates that a disease process may be under way—potentially leading to prediabetes and type 2 diabetes. Insulin resistance can lead to elevated blood glucose when cells become so insensitive to the effects of insulin that the pancreas can no longer compensate by producing more insulin. The study authors noted that while there is a large…

Strength training has multiple health benefits, especially for people with diabetes. The best-known type of strength training is lifting free weights such as barbells and dumbbells, but when used incorrectly, this equipment can cause injury. Here are some safer methods of strength training. Strength-training benefits Those of us who aren’t professional weightlifters or wrestlers might wonder why strength is so important. For mere mortals like us, strength is crucial for good balance and for everyday tasks such as climbing stairs, getting in and out of chairs, and carrying groceries. Strength training also increases bone density, helping to ward off osteoporosis. Like cardiovascular exercise, strength training lowers blood glucose levels, and it also increases insulin sensitivity by building muscle. Having more muscle mass means using more glucose for energy (thereby reducing…

Peanut butter has always been a childhood favorite, and our love for PB&J sandwiches often continues into adulthood. But many people can’t eat peanuts due to a peanut allergy. Fortunately, there are plenty of other nut butters—seed butters, too—to choose from. Most nut and seed butters provide protein, healthy fat, and not too much carb; plus, they contain vitamin E, magnesium, zinc, and copper, and maybe a little bit of fiber. Not surprisingly, some nut and seed butters are loaded up with things we don’t need, such as saturated fat, sugar, and sodium (not to mention the chocolate, cookies, collagen, or egg whites). Choose nut or seed butters with around 200 or fewer calories, no more than 3 grams (g) of saturated fat, no more than 3 g of added…

The management of diabetes comes with a toolbox of sorts: lancets and lancing devices, test strips, blood glucose meters and continuous monitoring devices, pill bottles and insulin vials, insulin pumps, and more. But beyond the more obvious accoutrement, there are a variety of products that can help you improve your health in a number of ways, from upgrading your sleep to ensuring you stay hydrated to keeping snack time wholesome and beyond. Interested in learning more? This roundup can provide some inspiration. The Republic of Tea People’s Green Tea Colder days and nights are here, and what better way to warm up than with a nice cup of tea? Green tea, in particular, is thought to be especially healthy, as it contains compounds called catechins and epicatechins, believed to help…

For decades, the diabetes care community has been obsessed with three little characters: A-1-C. A1C, which is short for hemoglobin A1C, is a blood test that reflects a person’s average glucose level for the past eight to 12 weeks. Ever since the Diabetes Control and Complications Trial (DCCT) showed a relationship between A1C and the development of long-term diabetes complications, most research and clinical efforts have focused on A1C reduction. Unfortunately, the A1C has some serious limitations. For one thing, many health conditions and blood abnormalities, such as anemia and iron deficiency, influence the accuracy of the A1C. Additionally, obtaining an A1C isn’t the easiest thing to do: Measurement usually requires a blood draw at a lab (with several days’ wait time for the result) or a visit to a…

FIELD TIP 1: Several old-style coded meters are now being marketed as self-coding by virtue of having all strips for them manufactured with the same code. While it’s true that you don’t ever need to change the code, it’s still possible to accidentally change the code by bumping the arrow keys on the meter after inserting the strip, so you still need to be vigilant with these meters. FIELD TIP 2: With coded meter systems, the batch code for the strips is printed on the label of the test strip vial, an important reason not to throw out (or recycle) the plastic containers the strips come in while the strips are in use. (The other reason is that the vial is lined with a desiccant material that helps preserve the…

5 According to “History of Glucose Monitoring” by Irl B. Hirsch, MD, commercial urine glucose testing was introduced in 1908. The first glucose test strip was developed in 1965, and the first home blood glucose monitor, the Ames Dextrometer, was launched by 1980. Want to learn how to use today’s monitoring technology to help manage your diabetes? Check out “Your Ultimate Guide to Glucose Monitoring” (page 50). 4 Ripe cranberries can float and bounce. Christmas trees, which originated in Germany, were originally decorated with foods such as apples, candies, and cookies hung with ribbon. Turkey and chicken contain roughly the same amount of the amino acid tryptophan. Do these food facts have you feeling hungry? Learn how to prepare for seasonal feasting in “Healthy Holiday Meals” (page 64). 3 Skin…