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Tampilkan postingan dengan label Diabetes. Tampilkan semua postingan
Tampilkan postingan dengan label Diabetes. Tampilkan semua postingan

Kamis, 28 September 2017

Diabetic Snack Ideas Food list Plan For Foods And Puddings

03.58 0
Diabetic Snack Ideas Food list Plan For Foods And Puddings, Good Diabetic Snack Ideas With Healthy Snacks For Diabetics. 88 List Foods To Avoid With Gestational Diabetes And Puddings. 

Like Popcorn, Fresh Fruits and Cookies For Diabetics. Gestational diabetes having much prescription medication steps to get followed, bundled how to take those right baking pan of food and treat. In the condition we getting gestational diabetes so we required to Diabetic Diet Breakfast.

For the reason that we have to food aimed at diabetes, so we can be select nourishment for diabetes.
Maybe Perhaps Possibly Maybe we have got to take our food through feature. diabetes having a lot medication measures to be adopted, included tips on how to take the appropriate pan associated with Gestational Diabetic Diet Menu Plan of meals and dessert.

Diabetic Snack Ideas
Diabetic Snack Ideas


Diabetic Snack Ideas And Gestational Diabetes Diet Menu

Diabetic Snack Ideas Food list Plan For Foods And Puddings - The nutrition that you pick stays, Maybe you protein on the way to make extra energy, but you likewise necessity cellulose. You requirement carbohydrate nonetheless you must squat your sugar, nevertheless you ought to bother ample your protein. The sugar too makes energy, liveliness you must careful for cellulose can change to high your gore honey.

Don’t apprehension around your vigor, you fair annoy your nourishment and you can make energy although your carbohydrate is squat.


Gestational Diabetes Meal Plan

Diabetic Snack Ideas Food list Plan For Foods And Puddings. So countless instructions of food strategy through diabetes before deprived of diabetes, we need towards learn how we can good régime for fitness. In some life, we can see people that exertion trendy AC apartment.

That room is really cool then that brands they starving, then doubt that happen about people continually famine to bother then drink. They are exertion with their intelligence, consequently that if they get nourishment, thus they continuously annoy and eat.

Doesn’t upkeep, doubt that makes fat, nonetheless toward some folks that see their selves actually overweight, they twitch toward hop their overwhelming, but he remained truly hard to distinguish pardon stands that nutrition canister reasons diabetes before not.

Foods To Avoid With Gestational Diabetes

Diabetic Snack Ideas Food list Plan For Foods And Puddings - Leisurely you can position your well-being decent food. Maybe you essential the guide to make the rule toward arrange your menu toward eat. To know gestational diabetes you have to distinguish pardon remains the meaning. 

This diabetes hooked on kind 3 of diabetes. Maybe this is the uppermost level after diabetes disease, actual frightened to texture this illness because it can be demise.

Read About : Diabetic Lunch Ideas 

Diabetic Snack Ideas and Gestational Diabetes Desserts

Diabetic Snack Ideas Food list Plan For Foods And Puddings - We altogether poverty toward see that what the drug of diabetes, but diabetes fair a slight drug, nonetheless the finest medicine is pardon we bother and drink, pardon we eat, and what we skip toward our entrance. We consume toward know and learn pardon element in each food. Don't brand mistake toward bother approximately food.

Don't lease your body is too weighty, you need to equilibrium your form toward take care of your health. Every day we have toward learn on the way to see what stays apposite near your body. Gestational diabetes diet plan canister be a good mode if we doing the regime with rules.

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Diabetic Lunch Ideas Diet Menu Plan For Meals And Sweets

03.21 0
Diabetic Lunch Ideas With Diet Menu Plan For Meals And Sweets. Best Foods To Avoid With Gestational Diabetes like as health fruits and fresh vegetables. Gestational diabetes possessing much prescription medication steps being followed. Integrated how to take the right pan of meal and dessert.

Diabetic Lunch Ideas Diet Menu Plan For Meals And Sweets - In the condition we taking gestational diabetes so we need Diabetes Recipe App plan.
Since that we consume to regime intended for diabetes, therefore we could pick fare used for diabetes.

Maybe Perhaps Possibly Maybe we have got to select our by feature. diabetes having a lot medication methods to be followed, included tips on how to take the proper pan of Gestational Diabetic Diet Food selection Plan of meals as well as dessert.

Diabetic Lunch Ideas
Diabetic Lunch Ideas

Gestational Diabetes Diet Menu

Diabetic Lunch Ideas Diet Menu Plan For Meals And Sweets. The sugar similarly types vigor, get-up-and-go you have to cautious because carbohydrate can become from top to bottom your plasma honey.

The nutrition that you choose stays, Maybe you protein towards make supplementary get-up-and-go, nonetheless you also requirement starch.

You requirement carbohydrate nonetheless you must little your carbohydrate, nevertheless you ought to eat ample your protein. Don’t worry near your energy, you fair annoy your sustenance and you container type liveliness though your sugar is low.


Gestational Diabetes Meal Plan

Diabetic Lunch Ideas Diet Menu Plan For Meals And Sweets - Gestational diabetes diet idea perhaps you container placed your bill of fare with about pods. are actually supported good nourishment. So numerous rubrics of régime plan through diabetes or short of diabetes, we necessity toward study in what way we can decent régime aimed at fitness. In about lifetime, we can get people that exertion fashionable AC apartment.

That room is actually unruffled then that types they famished, besides doubt that ensue some persons continuously poverty to annoy besides beverage. They are exertion by their intelligence, so that if they see food, thus they continuously annoy and annoy.

Doesn’t upkeep, if that makes overweight, but toward approximately people that know their selves actually fat, they start to bounce their intense, nonetheless it remained really hard towards distinguish pardon remains that food canister reasons diabetes or not.

Foods To Avoid With Gestational Diabetes

Diabetic Lunch Ideas Diet Menu Plan For Meals And Sweets - Slowly you can arrange your wellbeing decent food. Maybe you essential the guide to brand the rule toward arrange your blackboard to eat. 

Toward distinguish gestational diabetes you consume to distinguish pardon stands the definition. This diabetes into type 3 of diabetes. Possibly this is the highest equal from diabetes illness, very afraid to texture this disease because he can be demise.


Gestational Diabetes Desserts

Diabetic Lunch Ideas Diet Menu Plan For Meals And Sweets - We altogether poverty to distinguish that pardon the drug of diabetes, but diabetes just a slight medicine, nonetheless the finest medicine is what we eat and beverage, pardon we eat, then what we skip to our entrance. We have to know then learn what ingredient cutting-edge each nourishment. Don't make mistake to bother some food.

Don't let your body is too weighty, you need to balance your body toward income care of your fitness. Every day we consume toward learn to see what is suitable near your body. Gestational diabetes diet plan can stay a good way uncertainty we deed the diet with directions.

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Diabetic Brownie Recipe Menus Plan For Weight Loss With Desserts

02.59 0
Diabetic Brownie Recipe Menus Plan For Weight Loss With Desserts - when we getting gestational diabetes so we required to Diabetic Cookie Recipes. Because that we consume in the direction of regime aimed at diabetes, so we can pick food intended for diabetes.

Maybe Perhaps Possibly Maybe we have got to our nourishment thru detail. diabetic having very much medication measures to be put into practice, included tips on how to take the right pan of Gestational Diabetes mellitus Diet Food selection Plan associated with meals and also dessert.

Gestational Diabetes Diet Menu

Diabetic Brownie Recipe Menus Plan For Weight Loss With Desserts - The nutrition that you indicate is, Perhaps you essential protein on the way to make more get-up-and-go, but you also essential sugar.

The sugar also makes liveliness, vigor you must vigilant as carbohydrate can get tall your lifeblood darling. You essential carbohydrate but you have to low your starch, but you consume to eat abundant your protein. Don’t concern around your liveliness, you fair eat your nourishment and you can type vigor while your starch is little.


Diabetic Brownie Recipe In Gestational Diabetes Meal Plan

Diabetic Brownie Recipe


Diabetic Brownie Recipe Menus Plan For Weight Loss With Desserts - Gestational diabetes diet idea possibly you canister put your bill of fare with around fruits. are truly maintained respectable food. So countless rubrics of food idea with diabetes or short of diabetes, we necessity to study in what way we can good diet aimed at fitness. In approximately lifespan, we can see persons that work in AC apartment.

That apartment is actually cool then that types they hungry, then doubt that occur about people always want to bother and drink. They are exertion with their intelligence, so that if they get food, consequently they always bother besides eat.

Doesn’t upkeep, if that brands fat, but to approximately persons that know their selves actually fat, they twitch toward hop their consuming, nevertheless him was really hard towards see pardon remains that nutrition container reasons diabetes or else not.

Foods To Avoid With Gestational Diabetes

Diabetic Brownie Recipe Menus Plan For Weight Loss With Desserts - Gradually you can position your wellbeing good nourishment. Perhaps you need the leader to brand the law to position your blackboard toward eat. 

Toward distinguish gestational diabetes you consume to distinguish what stands the definition. This diabetes into kind 3 of diabetes. Possibly this is the uppermost close after diabetes illness, actual afraid toward feel this illness because it can be death.

Read About : Diabetic Lunch Ideas

Diabetic Brownie Recipe For Gestational Diabetes Desserts

Diabetic Brownie Recipe Menus Plan For Weight Loss With Desserts - We all poverty towards know that pardon the medicine of diabetes, but diabetes just a slight medicine, nonetheless the finest medicine is what we bother and drink, pardon we eat, then what we skip to our mouth. We consume to know then learn pardon element cutting-edge each food. Don't make mistake to bother some nourishment.

Don't let your form is too weighty, you need to balance your form toward income upkeep of your health. Each day we have toward acquire to see pardon stays apposite near your frame. Gestational diabetes diet plan can be a virtuous mode if we doing the regime with directions.

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Senin, 25 September 2017

Guest Post - "I Know Better"

08.40 0
Today we are excited to have a guest post from a VMG patient about his experience with diabetes. Seth has type I diabetes and has completed our diabetes education program. Thanks Seth!



My name is Seth Rothberg. Let me tell you something about myself that embarrasses me. There's a plate of homemade brownies up in the staff room. My CGM tells me I've had an even blood sugar all morning. 

I walked to work. And I seem to have hit the mark for my lunch time bolus. I know I should resist the brownies. But there they are, cut in small squares, with light brown crispy tops, and walnuts peeking out from fudgey sides. 

Carbs unknown, but maybe a square is 25 grams, plus or minus, probably plus. I'm not even hungry, so of course I bolus for 150 carbs and grab 4 and I know without thinking about it that I�ll be back in a few minutes for a couple more. An hour later my CGM beeps. It�s showing two arrows pointing up and a blood sugar about to hit 200. 

I don�t bother to test, I just give my self a 7 unit bolus. Why 7 units? I have no idea, but 2 hours later I�m gobbling glucose tabs. What embarrasses me about this is not just that I do it, but that I think that this kind of behavior defines me as a diabetic. I feel that I�ve just told you nearly everything there is to know about me and my diabetes.

I ask myself 2 questions after I pig out on brownies, or pretzels, or oreos, or Pepperidge Farm Sausalito cookies (to list a few of my sins). Why do I do it and (I�m sure you saw this immediately) how do I manage to not manage it? The truth is, I�ve never been able to answer these questions. I�ve done everything wrong. Either I guessed wrong for my bolus, or I over ate. What�s worse, I bolused again based on nothing but impulse.

O.k. I should give myself a little break here. After all, I started the day really well. I had yogurt mixed with blueberries and walnuts for breakfast. It was a perfect 50 degrees when I walked to work and there was a full blue sky. 

The gardens and hedges of the houses I walk by are blooming with flowers I can�t name, but their colors stun me. I�ve managed to keep my blood sugar in the low hundreds. It didn�t just happen. I managed it. Yes! Not to mention that I had those glucose tabs when I needed them.

Let me tell you a little more about myself. If you asked me what the most important thing to me about my diabetes was, I wouldn�t tell you the brownie story.  

I would tell you that I've been diabetic for 48 years, since I was 10, and that I�m aiming for the 50 year Joslin medal. I�ve noticed, though, that when I bring this up outside of medical appointments, no one's as proud of me as I am. I guess I understand that. 

Who wants to hear an old man going on about how he had to walk 10 miles to school, in the snow, in bare feet. One of the few things I really do know better is not to  bore you with my early days on regular and lente insulin, or how I had to pee into a cup to test sugars. 

In future blog posts I will try to limit any of my �in those days� tendencies to what I hope will be stories that are still relevant to what�s it�s like to be a diabetic now. 
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What Is Dka In Diabetics?

08.12 0
What Is Dka In Diabetics? - Diabetic ketoacidosis (DKA) is often the first indicator of type 1 diabetic issues in people who have not been identified. It could additionally occur in someone who has been identified with kind 1 diabetes mellitus. Infections, injuries, major disease, missing out on dosages of insulin shots, or surgical procedure can lead to DKA in people with kind 1 diabetic.

What Is Dka In Diabetics?
What Is Dka In Diabetics

What Is Dka In Diabetics?

A complication of diabetes deadly due to the lack of insulin in the body of the person is commonly known by the name of diabetic ketoacidosis. This condition can occur when the body can't process blood sugar (glucose) due to insufficient insulin in the body.

As a substitute of glucose, the body uses fat as a fuel substitute. The results of the process are the acidic compound with the amount of quite a lot of named ketone, which is dangerous for the body.

This condition is very common in people with type 1 diabetes, however quite rarely encountered in patients with type 2 diabetes. Sometimes diabetic ketoacidosis can appear in people who are not aware of if he suffered from diabetes. In particular children and adolescents.

Symptoms Of Diabetic Ketoacidosis

A symptom is something that is felt and told by the patient. The main symptoms in diabetic ketoacidosis the early phase is:
  • A short breath or shortness of breath.
  • The Volume of urine increases.
  • Feel thirsty constantly.
  • Fatigue.
  • Increased levels of blood sugar and/or ketone.
  • Abdominal Pain.
  • If left untreated, patients will experience symptoms:
  • A faster heart rate (takikaardia).
  • Breath faster.
  • Vomiting.
  • Dizziness and confusion or daze.
  • My breath smells like drops children or cleaning nail Polish.
  • Easy sleepy.
  • Coma.

If you feel some of the above symptoms, immediately consult a doctor. Because diabetic ketoacidosis is not treated can be fatal. Here are some of the complications that could be due to diabetic ketoacidosis:

  • Low blood sugar levels (hypoglycemia).
  • Low potassium levels (hypokalemia).
  • Brain swelling (cerebral edema).
  • Acute respiratory distress syndrome.
  • Renal failure acute.

Causes Of Diabetic Ketoacidosis

Sugar is the main energy source for muscle cells and tissues of the body. When insulin deficiency, the body is not able to process glucose so that the body fat will be taken as fuel. The process of processing this fat will produce a substance called ketone which is harmful to the body.

Because it can not be processed body, glucose levels in the blood will be high. The combination of high levels of glucose and ketone can cause symptoms-the symptoms of diabetic ketoacidosis.

Some of the things that usually trigger the appearance of diabetic ketoacidosis are:

  • Physical or emotional Trauma.
  • The abuse of alcohol and drugs.
  • Pain or other infections, and as a result make the body produce several hormones that have the opposite effect to insulin.
  • Of a heart attack.
  • The problem of current insulin therapy. The lack of insulin therapy can lead to decreasing the amount of insulin in the body system.
  • Some treatment, for example kartikosteroid and diuretic.
  • Diabetes are undiagnosed.

The Diagnosis Of Diabetic Ketoacidosis

Diagnosis is a step doctor to identify the disease or condition that explains the symptoms and signs experienced by the patient. To diagnose diabetic ketoacidosis, the doctor will run some tests like:
  • Physical examination.
  • A blood test, to determine the blood sugar levels, ketone levels, and the level of acidity of the blood.
  • Imaging X-ray the chest to see the complications that may arise.
  • Urine test.
  • Tests electrolytes blood.
  • An electrocardiogram test, to record the electrical activity of the heart.

Treatment and Prevention of Diabetic Ketoacidosis

To treat diabetic ketoacidosis usually the doctor will assess how severe what is the symptoms of the patient. Usually patients will ditangain with a combination of three types of treatments below:
  • The replacement of the minerals of the body, which disappear when the patient is dehydrated. For example, potassium.
  • Insulin therapy. Pumping insulin directly into the blood vessels of the patient.
  • The replacement of body fluids. Fluid will be pumped directly into the veins to replace the lost body fluids.

People with diabetes should follow the treatment recommendations of a doctor to avoid ketoadosis diabetic. Some of the things that can be done to prevent diabetic ketoacidosis are:
  • Always keep and monitor your blood sugar levels. Eating healthy foods, regular exercise and always check your blood sugar levels.
  • Inadequate fluid needs of the body.
  • Adjust the dosage of insulin the body needs. Consult with a doctor to adjust the dose of insulin.
  • Check the levels of ketone. Especially when Your blood sugar levels are also high.

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    Senin, 27 Maret 2017

    Is Popcorn Bad For Diabetics?

    14.25 0
    Is Popcorn Bad For Diabetics? Enjoy popcorn will never be the wrong thing. For diabetics we don't recommend mixing the instant seasoning served in a wrap. Replace taste with natural ingredients to stay healthy is eaten.
    Diabetes Popcorn, Is Popcorn Bad For Diabetics
    Is Popcorn Bad For Diabetics

    Is Popcorn Bad For Diabetics?

    Popcorn is just one of life's little snacking satisfactions, after all, that could visualize visiting a flick without coming by the snack counter for a little bucket? While individuals with diabetes mellitus must aim to avoid the highly salty and also buttery variations, popcorn can still be safely incorporated into the diabetic diet regimen. In its unprocessed form, popcorn is thought about a considerable source of whole-grain fiber. In addition, one offering of popcorn has a really low glycemic tons compared to standard junk food, so as long as it is eaten in moderation, popcorn makes a healthy enhancement to the diabetic diet regimen. Why Is Popcorn Bad For Diabetics?

    Nutritional Web content of Popcorn

    Is Eating Popcorn Bad For Diabetics? Like any type of entire grain source of carb, air-popped as well as unrefined popcorn is an exceptional resource of nutrients for individuals with diabetes mellitus. A lot of "light" popcorns have 80 to 100 calories and also 3 grams of fiber each serving. Due to the fact that it is made from corn, which is an entire grain, popcorn does not impact blood sugar level degrees as considerably as various other sugary snack foods. In fact, one offering of popcorn has a glycemic tons that is 2 to 4 times lower than other snack foods, such as raisins, graham biscuits, or potato chips.

    The Diabetic Section Size of Popcorn

    According to the American Diabetes Association, one diabetic section dimension of popcorn amounts to 3 cups of stood out popcorn, or about 15 grams of carbohydrates. Because individuals with diabetic issues can consume in between 15 and also 30 grams of carbohydrate for snacks, no greater than two servings or 6 cups of popcorn need to be eaten at one time. Many individual, 1 ounce bags of microwave popcorn bags consist of roughly 21 grams of carb, making these sections best for people with diabetic issues.

    Selecting the Right Popcorn

    People with diabetes mellitus have to be mindful of the type of popcorn they consume because several variations have added fats, sugars as well as salts. When choosing popcorn at the grocery store, people should check the nutrition labels for overall fat, trans fat, sugar and sodium. Complete fat and sugarcoated should be restricted as high as feasible, and also ideally there should be no trans fat noted on the label. Salt must be kept below 150 milligrams each serving since this is 10% of the advised everyday salt consumption.

    Providing Popcorn Flavor

    The majority of people include flavor to popcorn by snuffing it in salt and also butter; however, these techniques are not conducive to management of diabetes mellitus, weight or high blood pressure. Rather, individuals with diabetic issues could flavor their popcorn by spraying it with butter-flavored spray or olive oil. They can likewise include garlic or onion powder to provide it a kick without every one of the extra salt. For those who delight in kettle corn, sprinkling on a teaspoon of powdered sugar-free sugar such as stevia can satisfy that wonderful craving without all the sugar.

    Taste Snack Foods

    For a light popcorn treat, people with diabetes mellitus could consume a 100-calorie bag of low-fat popcorn. They could additionally get hold of a one-serving bag of the "light" kettle popcorn if it is made with an artificial sweetener. For an entirely non-processed treat, diabetics can pop their very own fresh popcorn and period it with garlic and onion powder. Is Popcorn Okay For Diabetics To Eat.
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    Kamis, 19 Februari 2015

    Update from the Diabetes Support Group

    10.19 0
    Hi all! Today Margie Sobil, our nutritionist in Greenfield, has an update about the Diabetes Support Group. Also below - a quick easy alternative to sugary grocery store fruit-flavored yogurts!


    Marjorie D. Sobil, RD, LDN
    The diabetes support group is in its 3rd year now! We continue to combine a mixture of activities at the meetings:
    •          member sharing and support
    •           Tips, skills building and new ideas
    •           Recipes and food demos
    At some of our recent meetings, we all got a chance to practice a variety of chair exercises thanks to Ann Marie (great for many of us who feel confined to home during this time of year of being snow-bound) and we looked at the Diabetes Blog on the Valley Medical Group website- where we got to see our favorite VMG volunteer (from our support group)- Ann Marie.

     Some comments from participants about the group: 


    �What I like about this group is the sharing of ideas and having a place to talk about what is working, and the challenges.  I get help for myself, and sometimes it just feels good to offer some  ideas and help someone else.� 

    �I like the food samplings and new recipe ideas- it helps me to know I can expand my food options and know that I am eating something that is healthy for me without overdoing the carbs�

    AND, we have been learning creative/tasty tips for lower carb food items  that are simple to prepare. 
    Zucchini and summer squash spaghetti spirals,  saut�ed and combined with whole wheat pasta, to create a low carb spaghetti that everyone loved.  We also learned that 2 oz dry pasta on the box (40-45 grams of carbs) is about 1 cup cooked- something everyone had to admit has always been a mystery to figure out.


    But today I want to share this easy way to make a healthy alternative to grocery store fruit-flavored yogurts. After looking at a variety of yogurt containers, we learned that there are only about 6-7 grams of carbs in a container of plain yogurt.  Many people in the group eat flavored Greek yogurt- the �light� Greek style yogurt has only about 9 grams of carbs, while the sweetened yogurt has about 20 grams.  Once we figured out the difference between sweetened yogurt (20 grams) and the plain (6 grams) = 12 grams, we learned that 12 grams sugar is equal to 3 teaspoons of added sugar.  



    Instead try this, for almost 2x as much food as fruit flavored cups, without all the sugar: 
    • 1 cup frozen berries (strawberries, blueberries and blackberries) thawed in microwaveable bowl
    • Pulse with small blender or chopper
    • mix berry mixture. 3/4 cup plain Greek style yogurt and 1 packet stevia or Splenda. 
    • Mix and enjoy. 
    • Carb count: approx 20 grams carbs









    At 22 grams of carbs (minus a few grams of fiber from the fruit)- we got a serving of yogurt and real fruit for roughly the same amount of carbs as a sugar sweetened yogurt.  Not only that- but everyone, even the most skeptical members of the group- had to admit that it was DELICIOUS!!!!

    So, if you haven�t been to the group for a while, or if you would like to give it a try- come any month- 2nd Tuesday.  Our next meeting is Tuesday March 10, 5:30-7:00 p.m.  Feel free to call Margie with any questions at (413) 992-7392.
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    Senin, 01 Desember 2014

    Recipe of the Week - Pumpkin Cranberry Applesauce!

    07.15 0
    I hope you all had a nice Thanksgiving weekend! 
    I love the seasonal flavors of fall - apples, spices, pumpkin... but I am already getting sick of rich holiday food. 
    I made up this recipe this weekend just to use up some apples, but I think it has already become a new favorite dessert in my house! And it uses no sweetener at all - just the natural sugar in the apples.

    Pumpkin Cranberry Applesauce


    PUMPKIN CRANBERRY APPLESAUCE

    Ingredients: 

    • 8-10 apples (macintosh or cortland type work best)
    • 1 bag of fresh or frozen cranberries
    • 1 sugar pumpkin
    • Spices: cinnamon, nutmeg, cloves, pumpkin pie spice, ginger...

    First, I microwaved the pumpkin to soften it and make it easier to chop up. In my microwave, this took about 5 minutes on high.  Slice the pumpkin in half and scoop out the seeds. Slice off the outer rind and dice the pumpkin flesh up into big chunks. 

    Core and slice the apples and add them and the diced pumpkin all to one large stock pot. Add cranberries. Cook on medium heat until juices are released and the whole mixture starts to bubble, then cover and let simmer on low until everything starts to soften and blend together when you stir it. 

    Options: This recipe is super flexible. Instead of a pumpkin, you could use a butternut squash, some leftover sweet potato puree from thanksgiving dinner, or a can of prepared pumpkin. Be creative and use what you have! 

    This recipe is nice and tart the way I like it - but if you have more of a sweet tooth, I think adding some stevia would sweeten this up nicely. When I made it for company, I put a tablespoon of butter in the bottom of the pan before I added the apples. 

    Feel free to experiment - and enjoy!
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    Thoughts from a Doc: Why do my sugars DO that?!? (Part 3)

    07.01 0

    Today's post comes from Dr. Stuart Chipkin, Valley Medical Group's Endocrinologist and Diabetes Program Director


    This is Part 3 of 3 of this series from Dr. Chipkin. So far we have heard his thoughts on exercise, food, insulin, and counter-insulin hormones. This week - his thoughts on a few remaining factors that can  influence your numbers. 

     Insulin-sensitizing hormones: these are sometimes called �incretins� because they increase the action of insulin.  There are now medications based on these incretin hormones which help to lower blood glucose levels and also have modest benefits on weight loss.  Examples are exenatide [Byetta] and liraglutide [Victoza].  Other medications inhibit the enzymes that break down the body�s own incretin hormones- these medications generally don�t help with weight loss- they include sitagliptin [Januvia], saxagliptin [Onglyza] and linagliptin [Tradjenta]

     Factors x, y, and z:  These are the wild cards that sometimes make it really hard to either predict or understand why glucose values do what they do.  Most of these won�t change blood glucose values by large amounts but can contribute to not having them be exactly on target.  Examples can include: hormonal changes during phases of the menstrual cycle, the efficiency or inefficiency of how food is absorbed from the intestines, emotional stresses, antibodies that some people make against insulin, etc. 

    With all these different factors, and the ways that each of these factors can change blood sugar values, it�s pretty impressive we every get things close to being on target!!   This is where each individual has to learn their own personal diabetes and some of the �quirks� of how their body responds.  
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    Kamis, 30 Oktober 2014

    Thoughts from a Doc: Why do my sugars DO that?!? (Part 2)

    03.00 0

    Today's post comes from Dr. Stuart Chipkin, Valley Medical Group's Endocrinologist and Diabetes Program Director. 


    This is Part 2 of 3 of this series from Dr. Chipkin. Last week we heard his thoughts on how exercise and food impact blood sugars - this week we get his perspective on some medications that can influence your numbers. 

    Thoughts from a Doc: 
    Why do my sugars DO that?!? (Part 2)

    Insulin: (as my daughter would say- d�uh!).  Oral pills like glipizide [Glucatrol], glimepiride [Amaryl] or glyburide [Micronase] cause your pancreas to release insulin which can certainly lower glucose values over the course of many hours.  Other medications (repaglinide [Prandin] or nateglinide [Starlix]) act more rapidly and only cause insulin to be released for a few hours.  But the effectiveness of these pills is based on two things: (1) the ability of your pancreas to make and release insulin; and (2) the ability of your body to use the amount of insulin made by the pancreas.  If your pancreas �worn out�, then these medications won�t be very effective (the analogy is that you can�t squeeze anything out of a dry sponge).  Even if these pills help the pancreas to release insulin, if your body is very resistant to insulin, then it won�t be enough.  Resistance to insulin can occur for many reasons including excess weight, infections, and steroid medications such as prednisone, hydrocortisone or dexamethasone. 



    Counter-insulin hormones: These can be thought of as �anti-insulin� hormones - fighting against the action of insulin.  The most common of these are steroid medications like prednisone, hydrocortisone or dexamethasone.  These medicines are sometimes used as pills for weeks at a time and can raise blood sugars a lot.  Sometimes, they are injected into joints or other locations and can raise glucose values for a few days.  Other counter-insulin hormones are stress hormones that are released when people are sick with other illnesses.


    Next week's post will discuss a few other factors, including the "element of mystery" that anyone with diabetes knows all too well. Not as simple as it seems, sometimes!!
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    Senin, 27 Oktober 2014

    Guest Post - "I Know Better"

    06.12 0
    Today we are lucky enough to have another guest post from Seth, a VMG patient. Seth has type I diabetes and has completed our diabetes education program. Thanks Seth!


    I hate vacations, not that this has ever stopped me from taking one. Maybe I should say that it's my diabetes that hates them. Truly, I'm not sure I can tell the difference between me and my diabetes. It�s the excess that usually does me in. Excessive lack of exercise and excessive eating push the bg bar line on my cgm up to Himalayan levels. I feel rotten about my poor self-control.

    For the past week I�ve been on a staycation. This time was going to be different. In the end It was, too. Just not exactly what I wanted it to be. I told myself I was going to be very, very, good. O.k., I knew I�d be pretty good and, really, I have been. I�ve exercised and eaten right almost everyday. I relaxed. I watched the final two seasons of Borgen. I read magazines that had been piling up on my sofa. I finished a book I�m preparing for the book club I lead. I even lost a  few pounds. Heaven.

    I still hate vacations. Most days started well. I managed to wake up with a bg around 100 and feel 100% proud of myself. I had the kind of super healthy breakfast certain internet sites say will prevent colds: a single portion of steel-cut oatmeal with half a banana and walnuts, soymilk and an egg on the side. When I�m working, I count that at 25 carbs�yes, I know that it�s actually more than that, but that�s what I bolus for if I don�t want to sink into the 70s two hours later�and, yes, I know there's a better of way to do that.

    So there you have it. I�d wake up with a great, no, not just great, a perfect blood sugar. I�d eat a beautiful, healthy breakfast. I�d drink too much coffee, but I�m pretty sure that�s a good thing. Over the next 2 hours my blood sugar would rise a bit, just as it should. I'd get on the exercycle and peddle through half-an-hour of a Borgen episode. Post-exercise my bg is back to it�s near-hundred level. I�m in the groove. I�m throwing a no-hitter. I�m going to Harvard on these test scores.

    Then it all goes wrong. For the rest of the morning my bg would rise until by lunch I�m around 140. This happened all week. I know 140mg isn�t that bad. But a lunch time bolus for 65 carbs�way more than I�m really eating�didn�t change anything. I'm  eating the kind of super healthy super foods that certain internet sites say cure colds, and in good portions, too. Still, my blood sugar was the same or worse at dinner, and even then, bolusing for way more carbs than I ate worked just as well as it did at lunch. I�d finish the day with a correction bolus.

    Which is why I really hate vacations. As much as I need them, my diabetes needs special coaxing to behave itself when I change my schedule. I�m guessing that it missed the small, steady amounts of activity I get at work. I tried upping my basal. But that didn�t help, either. Probably I should have upped it more than I did, but for once I thought I�d better be cautious. I decided I didn�t want to bump it again because I�d be back at work in a few days, anyway. I have a suspicion that makes no sense, and I should have known better. At least I'll go to work tomorrow. Hope no one has left any cookies in the staff lounge.

    P.S. Borgen is a great TV show.
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    Senin, 06 Oktober 2014

    Thoughts from a Doc: Why do my sugars DO that?!?

    11.58 0
    Today's post comes from Dr. Stuart Chipkin, Valley Medical Group's Endocrinologist and Diabetes Program Director. 

    This is only Part 1 - stay tuned in coming weeks for more. 

    Thoughts from a Doc: 
    Why do my sugars DO that?!? (Part 1)

    I get asked this question several times a week. I usually take this as a chance to remind people how complicated blood sugar control is.

    There are at least six factors that influence blood sugar (glucose) levels. Let's start with two: 






    Food: obvious, and yet not so easy. �Simple� sugars cause rapid increases in blood sugar. More complex sugars (those from milk, grains, starches) cause glucose levels to rise more slowly and over a longer period of time.  We try and take advantage of that when we talk about eating more �complex� carbohydrates- either to let your body �catch up� to the carbohydrates that have been eaten or to be available over a longer period of time (after exercise or after a low blood sugar).  And it turns out that the way sugar is absorbed can be affected by other foods such as fiber or fat.  So sometimes foods make sugar levels go up fast and sometimes they go up more slowly.


    Exercise: also obvious but also not so easy. Activity that uses a lot of muscles cause those muscle cells to absorb glucose (sugar) from the blood.  But your liver usually makes extra glucose for your muscle cells.  Very vigorous exercise (e.g., running longer distances) can cause your body to release adrenalin (also called epinephrine) which makes your blood glucose levels rise further.  But those muscle cells that absorbed the sugar during exercise continue to absorb it after exercise.  In addition to �soaking up� more sugar following exercise, muscle cells also become more sensitive to insulin.  In some cases, the increase in sensitivity can last over 12 hours!  So sometimes exercise can raise your blood sugars initially but sometimes exercise can make your glucose levels decrease after exercise and then, sometimes, your body may seem to overreact to insulin for many hours afterwards (not typically more than 18 hours).  


    Next week's post will discuss other factors, including hormones, medications, not to mention the "element of mystery" that anyone with diabetes knows all too well. With all these different factors, and the ways that each of these factors can change blood sugar values, it�s pretty impressive we ever get things close to being on target!!  This is why each individual has to learn about their own personal diabetes and some of the �quirks� of how their body responds. 
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    Jumat, 08 Agustus 2014

    Good and Cheap

    12.17 0
    Hi guys! Today I wanted to share a great FREE resource with you. According to NPR, Leanne Brown wrote this cookbook to help inspire folks on SNAP benefits/food stamps to eat healthier. For any of you who think it's too expensive to eat healthy, this is the help you needed (and finally, evidence that it CAN be done!)

    Download for free here: Good and Cheap

    Now remember - not all of these recipes are guaranteed low fat or low carbohydrate - but I do think they will give you some new ideas for using a lot of different types of vegetables in creative ways, and getting through the week more efficiently! Don't forget about portion size - everything in moderation.

    Have a good weekend!
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    Selasa, 01 Juli 2014

    What Does Self-Management Mean?

    08.13 0
    We use the term "diabetes self-management" a lot. One patient recently asked me, "does that mean I have to do everything myself?"

    At Valley Medical, we offer Diabetes Education, Nutrition, and Endocrinology because we want to make sure you have everybody on your team that you need to better manage your diabetes. That includes:

    � Endocrinology
    � Eye Care
    � Foot Care
    � Behavioral Health Services
    � Physical Therapy

    And, of course, Diabetes Self-Management Education. That means classes or one-on-one appointments with diabetes educators and/or nutritionists to help you learn more about diabetes, trouble shoot your lifestyle choices, answer your questions, and help you to set goals.



    So what does Diabetes Self-Management look like? It might include:
    - monitoring your blood sugars at home
    - keeping a food diary
    - counting carbohydrates or measuring out your portion sizes
    - incorporating physical activity into your routine
    - seeing your doctor regularly
    - managing stress

    But you don't have to do any of it by yourself - we are here to teach you how, help you through, and continuously adapt your plan to your personal wants and needs.

    Our goal is to see you empowered with the tools you need to manage your diabetes effectively - but when you need us, the resources are here. That's what self-management education means to us.
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