Type 2 Diabetes: Five tips for a Diabetic Friendly Diet

There are several things that I do to help me stick with my diet.  All are designed to keep me from over indulging in A1C raising foods.  Below are some of the things that I do that they make work for you:

Drink Water:  I usually try to drink a half a gallon of water a day to flush my kidneys.  While water may not be as satisfying as a sugared beverage, I’ve found that it keeps me hydrated and away from other beverages such as soda.

Use stevia instead of sugar:  Many people are not familiar with the leaf plant that is twice as sweet as sugar, but I’ve found that stevia satisfies my sugar craving just fine.  There are several types of stevia brands, but pure stevia is better that stevia blends which often include added ingredients that are found in other sugar substitutes, such those found in Sweet-n-Low.  While some may complain of an aftertaste with stevia, I haven’t found anything displeasing about it.  I use it to sweeten my tea, oatmeal, coffee, and anything else I would add sugar to.  Best of all, stevia has zero calories!  I often stash a few packets in my car so whenever I stop by a gas station for a cup of coffee, I can sweeten it with stevia in stead of sugar.

Load up on the tuna:  Tuna is high in Omega 3.  In addition to my Flaxseed capsules; I also eat a healthy dose of tuna each week.  While a succulent fat ribeye may be tempting, I try to stick to tuna whenever possible.

Supplement with supplements:  While it would be nice to get all of the nutrients that we need to fight diabetes through our food intake, sometimes we have to supplement with vitamins or herbs.  I place flaxseed high on the list of anti-diabetic foods, but I haven’t integrated flaxseed into my cooking.  Instead, I use flaxseed supplements since they are more convenient and easier to take.  Some foods naturally contain chromium, but I regularly use chromium capsules instead.

Eat fiber:  A high fiber diet is good in the fight against diabetes, and I get a good amount each week usually in the form of black or kidney beans.  Legumes can add up to 32% of the recommended daily value per serving.  Many fruits and vegetables also offer high amounts of fiber in addition to other nutrients, so I also try to add a significant amount of these to my diet as well.

Sticking to a diabetic friendly diet can be like trying to eat an entire elephant in one bite.  I have found that I can have much more success in sticking to a diet if I try to adhere to a few, more manageable goals.

references:  Diabetes Health Magazine June 2017/  Eric Morris

 

5 Ways to Safeguard Your Sight

  1.  Tune into vision changes.  When blood sugar is high, it can cause fluids to leak into the lens of the eye, causing blurry vision.  As blood sugar returns to normal, vision should sharpen.  If blurry vision is a persistent problem, report it to your care team ASAP.  And try this test:  Check your blood sugar during an episode – if your reading is in a normal range, it could be a sign of retinopathy.  NOTE:  Blurriness my occur when you start treatment with insulin and other medications, typically due to your changing blood sugar levels.
  2.   Keep tabs on your BP.  People with diabetes often have high blood pressure too.  And the combo can damage eye vessels.  Aim for healthy blood pressure levels-130/80 or below-and ask your care team if you’re a candidate for medication.
  3.   Get a dilated eye exam once a year.  This allows your healthcare provider to look inside the eye for any signs of damage.  When caught early, doctors can treat diabetic retinopathy and prevent blindness.
  4.   Eat greens.  People with diabetes are also prone to cataracts, a clouding of the lens.  Green like spinach, kale, broccoli and collards are packed with the anitoxidants lutein and zeaxanthin, which have been study-proven to help fend off cataracts.
  5.   Don sunglasses:  Direct exposure to sunlight can lead to cataracts. so wear UVA/UVB-protective sunglasses whenever you’re in daylight, even if it’s cloudy.

References:  Diabetes  Healthmonitor Magazine  Spring 2017 pg.26

 

Yoga is The Perfect Workout for Diabetes

My passion for Yoga started in my teens.  While everyone else was signing up for track I was in the gym breathing and stretching and gazing at my navel.  I’m not quite sure why yoga caught my attention but I am absolutely glad it did.  Eight years ago I was diagnosed with type 1 LADA diabetes, almost 22 years into my life as a yoga practitioner and teacher.  The diagnosis floored me.

Before my diagnosis I taught and shared yoga worldwide and was adamant that yoga had the potential to cure any disease.

After my diagnosis?  A cure was questionable at best.

Yoga has many benefits to support anyone living with chronic disease, but nothing can replace a life saving medication like Insulin, especially if you live with type 1 diabetes.

In spite of my diagnosis, I didn’t give up on yoga.  I truly believe yoga saved my life. Yoga not only works on the physical body to increase our strength and stamina it also supports us to let go of accumulated stress and tension.  This is crucial when managing our health.  How many times have you noticed your own moods shift and change with unpredictable blood sugars?

SO WHY IS YOGA SO BENEFICIAL?  It is a physical activity.

Findings suggest that when you participate in regular physical activity blood glucose control improves and type 2 diabetes can be prevented or delayed.  More specifically, Yoga, due to  the engagement of the musculo-skeletal system, hugging muscles to bones and moving isometrically, improves Insulin resistance which in turn enables those of us with either type of diabetes to uptake the insulin more efficiently.

IT IMPROVES YOUR NERVOUS SYSTEM FUNCTION THEREBY REDUCING STRESS

The autonomic nervous system governs automatic functions in the body like heart rate, breathing, digestion etc.  Reducing stress is key because due to mental and emotional stress around unpredictable lows and highs, we spend way more time in the fight or flight response.  A human being is designed to spend about 80% of the time in the relaxed nervous system and 20% in the fight or flight response, but that’s not what happens with diabetes.  Every incident in managing the disease increases stress so our time spent in the fight or flight mode is more like 80% while the relaxed part gets the 20%.

YOGA MAY HELP PROMOTE WEIGHT LOSS.

Regular physical exercise has been known to improve anyone’s health and wellbeing and to keep the body weight at its optimum.  But what about Yoga exercises?  According to a study held in India which recruited people not only with type 2 diabetes but with a family history of type 2 for an 8-week program.  The results indicated that yoga is a feasible intervention strategy and may help reduce weight, BMI and waist circumference, three important factors in the risk of type 2 diabetes.

YOGA IMPROVES SLEEP AND IMMUNE SYSTEM FUNCTION

Something that’s not talked about much in the management of diabetes is how much our sleep suffers.  For those of us with type 1 we can be up at all hours of the night with fluctuating levels.  With type 2 the fear of complications can be so overwhelming that we suffer from anxiety and depression.  When we don’t spend enough time in the deep sleep state our immune system suffers.  Ideally a good nights sleep equals a healthy immune system.  So how does Yoga help?

Specific restorative postures support the body and mind to be comfortable in a state of deep rest while specific breathing ratios to increase the length of the exhalation enable the mind to relax and slow down.  Also the sister science of yoga, ayurveda offers specific lifestyle guidelines which includes a daily self massage with sesame oil (called abhyanga) which penetrates the layers of the skin to relax the nervous system.

In my personal experience yoga over many years of practice has also increased my physical strength, flexibility, concentration and improved my overall wellbeing.

But, to be honest when there are so many factors involved in managing my diabetes on a daily basis, it takes discipline to step onto my mat every day.

What gets me there, more than knowing the benefits, is the overall feeling I get from my daily practice.  It’s in those last few moments after opening my eyes and gazing out at the world that I know why yoga works.

The world always feels bright, I feel calm and rejuvenated and ready to face the day exactly as it is.

Rachel Zinman is a senior yoga teacher with over 30 years’ experience teaching internationally.  At 42 she was diagnosed type 1 LADA diabetes.  Passionate about the benefits of yoga for diabetes, Rachel writes diabetes publications.  Find out more about Rachel on HER blog http://www.yogafordiabetesblog.com

References:  Diabetes Health Magazine pg, 6-8    2/2017  Rachel Zinman

CASES OF DIABETES ARE DROPPING

The number of new cases of diabetes in Americans ages 18-79 has dropped in recent years, according to the latest data from the CDC.  Between 1980 and 2009, the annual number of newly diagnosed cases skyrocketed from 493,000 to 1.7 million.   Since then, the number has dropped to 1.4 million per year.  More than 90 percent of these cases are type 2 diabetes.  Overall, about 11 percent of American adults, or 29 million, have diabetes, the highest percentage among developed nations, according to the International Diabetes Federation.  It isn’t known why the diabetes rate has started to drop in the U.S., though a reduction in the per capita intake of sugary beverages and a leveling off of the obesity epidemic are likely contributors.

References: Diabetes Focus Magazine  pg.6, Fall 2016

Diabetes and Influenza

COMING  down with a case of the flu is no fun for anyone.  But it poses extra risks for people with diabetes or other chronic health problems.

A bad case of the flu can lead to viral or bacterial pneumonia, dehydration, ear infections and sinus infections, especially in children.  Influenza can also make chronic medical conditions such as diabetes, asthma and congestive heart failure worse.  Though numbers vary from year to year, an annual average of more than 200,000 hospitalizations and approximately 36,000 deaths are attributed to influenza or complications from influenza in the United States alone.  On a global scale, the flu is responsible for the deaths of half a million people each year.  People with diabetes make up a disproportionately large number of those affected.  They are six times more likely to be hospitalized with flu complications than the population at large.  Deaths among people with diabetes rise 5 to 15 percent during flu epidemics, according to the Centers for Disease Control.  Each year, between 10,000 and 30,000 deaths among people with diabetes are associated with influenza and pneumonia. 

WHY INFLUENZA  IS ESPECIALLY DANGEROUS FOR PEOPLE WITH DIABETES.  Flu symptoms such as fatigue can make it harder to perceive both high and low blood-glucose episodes.   Some medicines, antibiotics and steroids used to treat illness can also raise blood-glucose levels.

” A lot of times people with think that because they aren’t eating, their blood sugar isn’t going to go up,” said Kris Bischoff, certified diabetes educator and registered dietitian at Adams Memorial Hospital in Decatur, Indiana.  “What people don’t understand is that when you are sick, your body has that fight-or-flight response.”  Because your body can’t run away from the germs that are causing the infections, it dumps sugar into your bloodstream to help prepare for battle.  “For some people,” she explains,”a higher blood sugar reading is the first sign that they are getting sick or getting an infection.”

Diabetes can compromise the body’s immune system, making it less effective at fighting viral infections such as the flu.  This puts people with diabetes at greater risk of developing secondary infections such as pneumonia.  And pneumonia is nothing to take lightly; according to the CDC, about 5 percent of cases involving adults who develop pneumonia result in death.

People with type 1 diabetes who get influenza may be more prone to dangerous levels of ketones.  This can cause diabetic ketoacidosis (DKA), which can result in coma or even death.

THE HIDDEN BENEFITS OF GETTING A FLU SHOT FOR PEOPLE WITH TYPE 2 DIABETES    The best way to protect yourself against influenza and the complications that can arise is to get a flu shot.  Not only does the vaccine protect against some of the viruses that can cause influenza, but a recent study has suggested that people with type 2 diabetes who receive flu vaccinations may have a reduced rusk of cardiovascular disease.

The study, published in July 2016 in The Canadian Medical Association Journal, sought to examine the effectiveness of influenza vaccination in preventing hospital admissions for cardiovasular and respiratory conditions.  The research subjects were 124,503 British adults with type 2 diabetes who were studied over a 7 year period, from 2003-2010.  About two-thirds of the people in the study had received influenza vaccinations.

Even after controlling for variables such as age, sex, smoking, medications and body mass index, the researchers found that having received a flu shot was associated with a 30% reduction in flu-season hospital admissions for stroke.  Hospital admissions for heart failure were down 22%, hospitalizations for heart attack were down 19%, and hospitalizations for pneumonia or influenza were down 15% among people with type 2 diabetes who had received a flu shot.

MOST SIGNIFICANT OF ALL:  The death rate among those who received a flu shot was 24% lower than in those who had not been vaccinated, the researchers said.

The study wasn’t intended to prove a cause-and-effect relationship between influenza vaccine and the reductions in death and hospital admissions.  However, the results do suggest that the benefits of getting a flu shot extend beyond simple peace of mind.

References:  DiabetesHealth Magazine/ DEC. 2016  pg. 8-10

 

Glycemic Index and Diabetes

The glycemic index, or GI, measures how a carbohydrate-containing food raises blood glucose.  Foods are ranked  based on how they compare to a reference food-either glucose or white bread.

A food with a high GI raises blood glucose more than a food with a medium or low GI.

Meal planning with the GI involves choosing foods that have a low or medium GI.  If eating a food with a high GI, you can combine it with low GI foods to help balance the meal.

Examples of carbohydrate-containing foods with a low GI include dried beans and legumes (like kidney beans and lentils), all non-starchy vegetables, some starchy vegetables like sweet potatoes, most fruit, and many whole grain breads and cereals (like barley, whole wheat bread, rye bread, and all-bran cereal.

Meats and fats don’t have a GI because they do not contain carbohydrate

Below are examples of foods based on their GI.

LOW GI FOODS (55 OR LESS)

* 100% stone-ground whole wheat or pumpernickel bread

* Oatmeal (rolled or steel-cut), oat bran, muesli

* Pasta, converted rice, barley, bulgar

* Sweet potato, corn, yam lima/butter beans, peas, legumes and lentils

* Most fruits, non-starchy vegetables and carrots

MEDIUM GI (56-69)

* whole wheat, rye, and pita bread

* Quick oats

* Brown, wild or basmati rice, couscous

HIGH GI (70 OR MORE)

* White bread or bagel

* Corn flakes, puffed rice, bran flakes, instant oatmeal

* Shortgrain white rice, rice pasta, macaroni and cheese from mix

* Russet potato, pumpkin

* Pretzels, rice cakes, popcorn, saltine crackers

WHAT AFFECTS THE GI OF A FOOD?

Fat and fiber tend to lower the GI of a food.  As a general rule, the more cooked or processed a food, the higher the GI; however, this is not always true.

Below are a few specific examples of other factors that can affect the GI of a food:

* Ripeness and storage time – the more ripe a fruit or vegetabe is, the higher the GI

* Processing – juice has a higher GI than whole fruit; mashed potato has a higher GI than soft-cooked pasta)

* Cooking method – how long a food is cooked (al dente pasta has a lower GI than soft-cooked pasta)

* Variety – converted long-grain white rice has a lower GI than brown rice but short-grain white rice has a higher GI than brown rice.

OTHER CONSIDERATIONS

The GI value represents the type of carbohydrate in a food but says nothing about the amount of carbohydrate typically eaten.  Portion sizes are still relevant for managing blood glucose and for losing or maintaining weight.

The GI of a food is different when eaten alone than it is when combined with other foods.  When eating a high GI food, you can combine it with other low GI foods to balance out the effect on blood glucose levels.

Many nutritious foods have a higher GI than foods with little nutritional value. For example, oatmeal has a higher GI than chocolate. Use of the GI needs to be balanced with basic nutrition principles of variety for healthful foods and moderation of foods with few nutrients.

GI OR CARBOHYDRATE COUNTING?

There is no one diet or meal plan that works for everyone with diabetes.  The important thing is to follow a meal plan that is tailored to personal preferences and lifestyle and delps achieve goals for blood glucose, cholesterol and triglycerides levels, blood pressure, and weight management.

Research shows that both the amount and the type of carbohydrate in food affect blood glucose levels. Studies show that the total amount of carbohydrate in food, in general, is a stronger predictor of blood glucose response than the GI.

Based on the research, for most people with diabetes, the first tool for managing blood glucose is some type of carb counting.

References.  American Diabetes Association  www.diabetes.org  02/06/2017

What Foods Have Gluten?

Gluten is found in wheat, rye, barley and any foods made with these grains.

Avoiding wheat can be expecially hard because this means you should avoid all wheat-based flours and ingredients.  These include but are not limited to:

*  White flour

*  Whole Wheat Flour

* Durum Wheat

* Graham Flour

* Triticale

* Kamut

* Semolina

* Spelt

* Wheat Germ

* Wheat Bran

Common foods that are usually make with wheat include:

* Pasta

* Couscous

* Bread

* Flour Tortillas

* Cookies

* Cakes

* Muffins

* Pastries

* Cereal

* Crackers

* Beer

* Oats (see the section on Oats below)

* Gravy

* Dressings

* Sauces

This may seem like a long list, but there are still plenty of gluten-free foods out there!  Choose from many fresh, healthy foods like fruits, vegetables, beans, dairy, nuts and gluten-free grains like quinoa or rice.

There are also gluten-free versions of many of the foods above available in most grocery stores.  You just have to look for them!`

You may not expect it, but the following foods can also contain gluten:

* broth in soups and bouillon cubes

* breadcrumbs and croutons

* some candies

* fried foods

* imitation fish

* some lunch meats and hot dogs

* malt

* matzo

* modified food starch

* seasoned chips and other seasoned snack foods

* salad dressings

* self-basting turkey

* soy sauce

* seasoned rice and pasta mixes

There are also many additives and ingredients in packaged foods that may contain gluten.  Always check labels and ingredient lists for these.  For a more comprehensive list of gluten-containing additives, contact your local celiac support group.

OTHER TIPS TO REMEMBER

Don’t forget that ingredients in food products change freqquently, so always check the label before buying packaged foods.

* Remember that “wheat free” does not automatically mean “gluten free.”  While a product may not contain wheat, it can still contain rye or barley in some form.

* If you have any question about whether a food contains gluten, contact the manufacturer.

THE FUSS ABOUT OATS

Pure oats are a gluten-free food, but most commercially processed oats have been contaminated during the growing, harvesting or processing stages.  In the past, many experts recommended completely avoiding oats those on a gluten-free diet in addition to wheat, barley, and rye.  Now some oats are grown and processed separately, and can be labeled “gluten-free.”

Many people with celiac disease are still advised to avoid oats initially.  However, oats can help provide fiber and other important nutreints.  Over time, most people with celiac can reintroduce pure oats in small amounts (about 1/2 cup of dry oats per day) without any trouble.

If you do choose to include them, let your doctor know and only eat oats that are marked “gluten-free.”

References:  The American Diabetes website.  diabetes.org  02/06/2017

 

 

SEE FOOD, EAT MORE

Where you eat makes a difference in now much you eat.  According to a study, people eat more in spaces with open floor plans.  Researchers offered 57 college students buffet-style meals in a laboratory where folding screens were used to create different arrangements of the kitchen and dining areas.  When the kitchen area was open and visible from the dining area, the students served themselves an average of 170 calories more than they did when the kitchen and dining areas were separated.  You can use this information at home by serving dinner from the kitchen, rather than at the dining room table.  At work and in restaurants, try sitting where you can’t see the kitchen.

Source:  Environment and Behavior, published online 9/8/2016

FUNNY BONE

Laughter is the best medicine.  No, really:  In a study, older adults in assisted-living centers participated in a program called LaughActive, which included two 45-minute sessions per week.  In between strength, balance, and flexibility exercises, the seniors were instructed to laugh for 30-60 seconds, no jokes necessary—the body can’t tell the difference between real and forced laughter.  Either way, it relaxes and strengthens muscles.  After six weeks, participants showed major improvements in mental health and endurance.  The laughter also prompted the seniors to exercise more, which means they may be more likely to stick with it, giggles and all.

Source:  The Gerontologist, published online 9/15/2016

NOVEMBER / NATIONAL FAMILY CAREGIVER MONTH

 

Caregiving often comes with difficulties and lack of cultural support, even though it can offer the caregiver unexpected joys and possible tighter family bonds, experts say.

We see a primarily negative view of caregiving in our culture,” explained Dr. Barry Jacobs, a clinical psychologist who has spent his life helping patients build stronger relationships with family members who have had heart attacks or stroke.  “But people can get positive rewards from caregiving – confidence, competence dealing with medical staff and issues, spiritual rewards and renewed family closeness, to name a few.”

During National Family Caregivers Month this November, Jacobs and his wife, Dr. Julia Mayer, who is also a clinical psychologist, are working to encourage caregivers to repair rifts and be grateful for “this gift of time.”

“We worked clients who were caregivers for years, but you don’t know what it is like until you are in it.  The anger, guilt, feeling you wish you could do more, negotiating with your siblings – you have to experience it,” said Mayer, director of Behavioral Sciences for the Crozer-Keystone Family Medicine Residency Program in Springfield, Pennsylvania, and a co-author with Jacobs of AARP Meditations for Caregivers – Practical, Emotional and Spiritual Support for You and Your Family.

The couple, who have been married for 26 years, found new meaning in their work when they took on caregiving for their own parents.

It was harder than expected, they found.

“But at the end of the day, it’s the right thing to do and we’re glad to have done it,” said Jacobs.

If tension is rising among adult siblings caring for an aging parent, Mayer offers this advice:

  • Don’t hide from your family. Have an honest discussion about the workload and balance.
  • Know that the level of care each person provides won’t be equal, but do expect a contribution from each person.
  • Long-distance caregivers can struggle to find a role. “Not all help is helpful,” Mayer said.  “Don’t criticize or suggest, but instead ask how the primary caregiver is doing, support them and visit or call when you can.”
  • Develop a plan to keep all caregivers on the same page about the patient’s medical condition, treatment and caregiving plan. “Knowing who will do what for whom helps everyone feel connected and when the caregiving job is done, the family will feel better knowing they rallied together,” said Jacobs.

 

Caregiving is a chance for family – no matter how far-flung – to pull together toward a common foal.

 

“Everyone is watching your choices,” Jacobs said.  “You don’t need to make the same sacrifices as someone else, but you do need to be on the same team.”

 

Reference:  www.americanheartassociation.org