Diabetes Specialty Center

Senin, 11 Mei 2015

Carb Counting the Cookout

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Summer cookout season is starting, so I thought I would offer a few tips to help you count your carbs and keep your blood sugars on track all summer long, without missing any of the fun.

1. Remember Key Carb Exchanges

A few key 15 gram carb servings can be used to estimate the carb content of a wide variety of dishes. For example, knowing that 1/2 cup of potato is around 15g of carb might help you to estimate the carb content of a similar size portion of potato salad or fries. Here are a few more that I use all the time to help me "guesstimate":

15 grams of carbs is:

- 1/2 of a hamburger or hot dog bun

- 1/3 cup of pasta or rice

- 1/2 of a large corn-on-the-cob

- 1/2 cup of beans (but only 1/3 cup of baked beans with the sugary sauce!)

- 9-13 potato or tortilla chips

- 1 1/4 cups of watermelon cubes

- 1/2 cup of ice cream

2. Use Your Hands

When you can't use a measuring cup to check your portion size, try comparing what's on your plate to these visuals:

your palm = 1/2 cup

your fist = 1 cup

your thumb = 1 tablespoon

your thumb tip = 1 teaspoon

3. Don't Forget to Count the Condiments...

1 tablespoon ketchup = 5g carb

1 tablespoon of barbeque sauce = 7g carb

4. ... And the Beverages

8 oz lemonade = 25g carb

1 can (12oz) soda/soft drink = 35g carb

5. Avoid The "Fillers"

Social gatherings and special seasonal foods are important to all of us, and you don't want to miss Aunt So-and-So's amazing famous dish. But at most of these events, there are many other foods you have all the time or that are just not that exciting. It's different for everyone - some people skip the boring white hamburger buns so they can have macaroni salad; others wait all year for that one taste of white bread. But be mindful and have a strategy - choose what you really love, savor it, and skip the rest.

6. Contribute Something Healthy

I like to volunteer to bring something healthy and lower in carbs, so I know there will be something I can have a larger portion of that will be filling. Chances are, others will appreciate this too. Try bringing something like a green salad or a chopped salad with beans that will be filling, colorful, and healthy.

Don't forget to have fun and enjoy the season!

Senin, 27 April 2015

VMG's Diabetes Services

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Happy spring (finally!)!

Are you taking advantage of these VMG services to help you manage your diabetes? Confused about what these mean? We offer:

Endocrinology:

To help you manage your diabetes, analyze your blood sugar levels and develop a regimen of lifestyle changes and medicines which are right for you.

Diabetes Education in an Individual or GroupSetting:

To help you understand your diabetes and your treatment plan, including help with blood sugar monitoring, medications, insulin, and more. Focused on practical and personalized goal setting.

Nutrition Therapy:

One-on-one education, support, and goal setting. Incorporating all your medical and lifestyle needs into a practical and personalized plan.

Support Groups:

We offer free support groups for both diabetes and weight loss, led by our diabetes educators and nutritionists! These are a great opportunity to connect with others in a fun, informal setting. These vary by center - check HERE for current dates/times.

We also recommend taking advantage of these VMG services:

Eye Care

Comprehensive eye examinations

Foot Care

Diabetes foot care from a podiatrist

Behavioral Health

Psychiatrists, psychologists, social workers and therapists to help you navigate the social and emotional stressors of managing diabetes

Physical Therapy

Physical therapists to help you prepare for increasing your physical activity and establishing a program of exercise for you to complete independently

Questions or feedback - our contact information is listed in the "meet our educators" tab - please let us know how we can help you!

Senin, 06 April 2015

National Nutrition Month: Wrap-Up

National Nutrition Month

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Thanks to all who participated in our National Nutrition Month activities! We had four prize winners in all four centers, and 4 UMass students who volunteered their time to staff our tables and offer healthy creative food samples and recipes. It was a great month!

Before we get too far away from March I wanted to share some info about one more awesome phytochemical with you - LUTEIN!

Lutein is a type of phytochemical called a carotenoid. It concentrates in the macula of the eye, and research shows it can actually prevent or slow macular degeneration! Macular degeneration is a leading cause of blindness in the elderly.

Lutein's antioxidant power can also help reduce the risk of heart disease and certain types of cancer.

Fill up on these (mostly green leafy) vegetables to get your lutein and protect your eyes:

collard greens
kale
spinach
broccoli
Brussels sprouts
lettuces
artichokes

For more information, recipes, and more visit: http://www.fruitsandveggiesmorematters.org/

Senin, 16 Maret 2015

Recipe: Cauliflower Rice!

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This week's recipe comes from Margie Sobil - she made this last week with her Diabetes Support Group and they enjoyed it both ways!

Cauliflower Rice

This makes a wonderful side dish on its own, or could be used any way you'd use rice. For example, I have served stew, chili, or saucy curry over a spoonful of this "rice", and I have used it in stuffed peppers or cabbage rolls as part of the filling instead of rice.

This helps to make your meal lower in total carbohydrates, even if you have a big heaping spoonful (or two). It adds a lot of fiber and volume, without a lot of calories.

Ingredients:
1 head raw cauliflower
1 yellow onion
olive oil
salt, pepper, garlic, herbs or spices to taste

Chop the cauliflower in a food processor until it is approximately the size and texture of rice:

Dice the onion. Saute onion in a pan with olive oil for a few minutes, then add the cauliflower "rice" to the pan. Saute until slightly softened. Flavor to taste.

In the support group we tried making it two ways. One recipe used salt, pepper and garlic powder. The other used about a tsp of curry powder. You could invent many more ways to use this versatile dish - share in the comments section if you come up with any more yummy variations!!

Senin, 09 Maret 2015

National Nutrition Month Update: Week 1

National Nutrition Month

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If you forgot to fill out our National Nutrition Month quiz this week, don't forget you have 3 more weeks to enter the drawing for a prize!! The display is in or near the waiting room of all 4 VMG centers this whole month.

Our theme this year is Health Benefits of Fruits and Veggies. Nutrition is about a lot more than calories and weight loss.

Here were some of the highlights of this week's quiz:

Resveratrol:

Resveratrol is an antioxidant found in red wine. It is a type of phytochemical called a polyphenol. Some people attribute the health benefits of the Mediterranean Diet to this compound. In studies, resveratrol has been shown to be anti-inflammatory, and may help lower the risk of heart disease, cancer, and asthma!

Food sources: red wine, peanuts, grape skin and grape juice

Quercetin:

Quercetin is the main flavonoid in most of our diets - it lowers the risk of asthma, heart disease, and lung cancer!

Food sources: onions, apples, broccoli, cranberries, and grapes

Anthocyanidins:

Anthocyanidins are antioxidants found in blue/purple and red fruits and vegetables that improve blood vessel health!

Food sources: blueberries, blackberries, plums, cranberries, raspberries, red onions, red potatoes, radishes, strawberries

Of course, it's not important that you remember these names and categories. The point is that a wide variety of compounds are found in fruits and vegetables that have wide-ranging benefits on health and longevity! And there are different types in all the different colors of produce, so when you are planning your meals, see how many different colors you can include! That will go a long way toward improving and protecting your health.

This info is thanks to: www.pbhfoundation.org. For more information, check out their website!

Rabu, 04 Maret 2015

March is National Nutrition Month!

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In keeping with our various wellness initiatives throughout the year at VMG, we hope you�ll join us by participating in our National Nutrition Month event. This year the National Nutrition Month theme is: �Bite Into a Healthy Lifestyle.�

At Valley Medical, we are focusing our NNM theme on the �Health Benefits of Eating Fruits and Vegetables�.

Watch for the display table in the lobby of each health center. Both VMG staff and patients are invited to participate. There will be a new quiz and a new prize each week in all 4 centers!

Quiz topics will focus on recognizing the antioxidants in various fruits and vegetables, and the specific health benefits to us when we eat foods that contain these antioxidants.

New this year: we have 4 students from the Nutrition Department at UMass who will be volunteering in each center once during the month, and offering taste testing and information to staff and patients. We will let you know when they will be here, so you can drop by and say hello.

We hope you will find the time to participate! Enjoy and good luck!

Senin, 23 Februari 2015

Warning about Supplements

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A new study on supplements has revealed that 4 out of 5 supplements sold at stores like Walmart, Target, or GNC contained none of the herb listed on the label. Can you believe that? NONE.

We already knew that supplements are not as carefully regulated as prescription drugs and are not tested for efficacy by the FDA.

But most of these supplements contained mainly fillers like rice and houseplants!!

Read full articles describing the study: here and here.

Hopefully this will help improve supplement regulation - but in the meantime, maybe just stay out of the supplement aisle altogether!

Bottom line: don't waste your money, and don't risk your health.

Kamis, 19 Februari 2015

Update from the Diabetes Support Group

Recipe

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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!

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- 2^nd 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.

Selasa, 03 Februari 2015

Guest Post: Are You Ready For an Emergency?

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After yesterday's storm, Dr. Stuart Chipkin has a few reminders for you all about being prepared for an emergency. Thanks Dr. Chipkin!

Whenever the snow starts falling or the electricity fails, I can count on several phone calls from patients who �all of a sudden� realize they don�t have glucose test strips or other supplies to help with their diabetes. It�s completely understandable- we all think �Oh, I�ll run out and get those tomorrow�, or �the weather will only be bad for a day or so- I won�t have a problem�. But any weather that can limit your ability to travel or suddenly put you without electricity can �snowball� (OK- maybe I intended that pun) into a much bigger problem.

And I recommend all patients have a Medical ID (bracelet, necklace, even a tattoo!) in case they are unable to respond when initially found (again, independent of weather- could be in a car accident or brought into an Emergency room).

Listed below are some things you should think about to make sure that you are prepared for having diabetes during severe weather:

A week�s worth of medication
Glucose tablets or gel if you are at any risk for having low blood sugars. If you have had reactions without symptoms, you should find out about having a Glucagon emergency kit as long as someone at home will learn how to use it.
For those on an insulin pump- have extra supplies including:

Cartridges, infusion sets, prep wipes and batteries
Extra sensors (if appropriate) and chargers
Non-pump insulin options (see #4) in case of a pump failure;

If you are on insulin injections, make sure and have enough:

Insulin pens and pen needles OR insulin vials and syringes- both short and long acting
Extra alcohol wipes;
Consider having something in which to discard insulin syringes, needles and lancets (e.g., an empty hard plastic detergent bottle with cap)

Glucose measurement supplies including:

Extra meter
Lancet device and lancets
Alcohol wipes
Test strips and batteries

For patients with type 1 diabetes, I encourage you to have urine ketone test strips (independent of bad weather)- these are good to have if you have several high blood sugars to see if you are getting to the point that you need to consider going to the Emergency room;
Other general information to have:

Copy of your recent medical records including current medications and doses

You should think about having something to put all these things in- a container (maybe even waterproof) that may also have a place for a cold pack for insulin.

For more information, visit either:

http://www.diabetesforecast.org/2012/aug/how-to-stockpile-for-emergencies.html

http://www.nj.gov/health/fhs/documents/diabetes_disaster_guidelines.pdf

Senin, 12 Januari 2015

Guest Post: A Reluctant Diabetic

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Hi everybody! Today I am thrilled to share a story from a VMG patient. Anne Marie Meltzer has been an amazing volunteer for our diabetes program, including helping with diabetes support groups at our GHC office. Thanks, Anne Marie!!

Annual Physical February 2012. I complained of tingling and numbness in my fingers, toes and nose. I thought it was due to weakness resulting from a small stroke I had in 2009. I also gained 25 pounds but thought that was also due to the stroke and inactivity. My MD, Ross Midler, decided to do and A1C to rule out Diabetes. It came back high � Type II Diabetes. I was put on a 500mg of Metformin.

This hit me hard, as it was not expected. When I was young, I lost a friend to kidney failure resulting from Diabetes and I knew this disease as a killer. I withdrew into a deep sadness. When my MD recommended Diabetes Education, I rolled my eyes and reluctantly attended the sessions. I am highly independent and I don�t like to be told how to live my life. I got angry and decided to take control � I wasn�t going to let this disease take away my life.

How I eat is a challenge. I adjusted the regimen of carbs to even out my food intake over six small meals a day. I keep low carb snacks in my car and purse, and I have learned to order wisely in restaurants.

I cook my foods from scratch, sometimes including bread, and eat no processed foods because I am allergic to a preservative used in pre-made food. Under these circumstances, counting carbohydrates can be difficult. I also have intermittent attacks of Gastroparesis, my stomach does not empty and bloats. I change what I eat when this flares up - low residue foods, liquids, and very little or no fiber. The two diets are not compatible and my blood glucose fluctuates.

I began to exercise again and trained to be certified to teach strength and balance classes to older people. This keeps me in shape � I cannot say that I am too tired to exercise because I am teaching the classes.

My A1C now remains between 6.1 and 6.5 and I have lost 22 pounds. I have learned to listen to what my body is telling me, although I admit I sometimes cheat.