Diabetic Nephropathy

Diabetic Nephropathy

Affecting up to 40% of type 1 and type 2 people with diabetes, diabetic nephropathy is one of the major causes of kidney disease among those beginning renal replacement therapy (such as dialysis). [1] It is a complication caused by high levels of glucose needing to be constantly filtered out by the kidneys which damages the organs over time. Proper kidney function screenings with your doctor is a must. Know the screening process and what questions to ask your doctor about keeping your kidneys healthy.

What do the kidneys do? These two bean-shaped, fist sized organs (situated just below the rib cage on each side of your spine) have the critical job of filtering your blood to remove waste and excess fluid. On a daily basis, your kidneys will filter out waste from 120 to 150 quarts of blood which leaves your body through the bladder as 1 to 2 quarts of urine.[2] The kidneys help give stability to the composition of your blood. In addition to filtering your blood your kidneys help to:

  • Keep your pH balance
  • Regulate blood pressure
  • Keep bones strong by making an active form of vitamin D and
  • Assist in the creation of red blood cells by releasing a hormone called erythropoietin.[3]

The kidneys are composed of about a million tiny sieves called nephrons. The nephrons contain a filter, the glomerulus, which allows fluid and waste to go through, but stops blood cells and large molecules (like proteins) from passing through. The filtered fluid then goes through the tubule, which removes waste through the urinary tract and returns needed minerals to the bloodstream.[4]

How are the kidneys affected by diabetes? When your blood glucose levels are consistently Diabetic Nephropathyhigh, your kidneys have to work more to filter the blood. This extra work load causes the filters in your kidney to start to leak. The larger molecules, like protein, that should be reabsorbed into the bloodstream are now able to pass through the kidney and are lost in the urine. Low levels of protein in the urine, microalbuminuria, is one of the first signs of diabetic nephropathy and is used as a point of diagnosis.[5] Other symptoms include high blood pressure, swelling of the legs and ankles, more frequent urination at night, high levels of blood urea nitrogen and serum creatinine and a decreased need for insulin or other antidiabetic medications.[6]

As kidney disease progresses, higher levels of protein are found in the urine (microalbuminuria). The kidneys can lose their filtering capabilities and waste products then build up to dangerous levels in the blood stream. A person in this situation may need to go on dialysis or consider a kidney transplant.

What should you be asking your doctor? Speak to your doctor about when you should been screening for diabetic nephropathy. The criteria will depend on what type of diabetes you have and when you were diagnosed with diabetes. If you have type 1 diabetes you should be tested five years after diagnosis. Those with type 2 diabetes should begin monitoring should begin right away. For children, screenings should begin after age 10 and after the child has had had diabetes for 5 years. A simple dipstick test can pick up trace amounts of protein in the urine. Yearly blood work should also check for creatinine levels, which can indicate how well your kidneys are functioning.[7]

What are your prevention and treatment options? A key plan for preventing diabetic nephropathy is to maintain your blood glucose levels as best you can. Dario can help you to better manage your diabetes by logging your readings automatically into charts and graphs to review with your doctor. Maintaining your blood pressure is also vital to helping keep your kidneys healthy. Your healthcare team may recommend ACE inhibitors as part of a treatment plan or may suggest limiting the amount of protein in your diet.[8]

Not everyone with diabetes develops diabetic nephropathy. But awareness of the symptoms and disease progression are key so that you can make better healthcare decisions with about your long-term diabetes management goals.

*The information provided here is for informational purposes only and does not constitute medical advice. If you would like more information on these topics, please consult with your healthcare provider. 

[1] Gross, J. et al (2005). Diabetic nephropathy: diagnosis, prevention, and treatment. Diabetes Care. Vol 28 (1).

[2] National Kidney and Urologic Diseases Information Clearinghouse. (2014). The kidneys and how they work. NIH Publication No. 14-3195

[3] National Kidney Foundation. (2016). Top 5 jobs kidneys do. New York.

[4] National Kidney and Urologic Diseases Information Clearinghouse. (2014). The kidneys and how they work. NIH Publication No. 14-3195

[5] American Diabetes Associate. Kidney Disease (Nephropathy). Website.

[6] Butt, S., Hall, P., & Nurko, S. (2010). Diabetic Nephropathy. Cleveland Clinic Center for Continuing Education.

[7] http://www.webmd.com/diabetes/tc/diabetic-nephropathy-exams-and-tests

[8] Gross, J. et al (2005). Diabetic nephropathy: diagnosis, prevention, and treatment. Diabetes Care. Vol 28 (1).

Diabetic Foods

Look down any pharmacy or supermarket aisle’s health food section and you’re sure to find low-carb, low-sugar and low-fat items up and down the shelves. But what about foods labeled “diabetic”? What makes a food “diabetes friendly”? Is it actually good for people with diabetes? Is it worth the extra cost? More importantly, does it even taste good?

Foods that carry the label “diabetic” are usually lower in sugar or no sugar, low carb or low on the glycemic index (carbohydrates that do not affect a large increase on the body’s blood glucose levels).[1] When a food is labeled as low sugar, it often means that while sugar has been removed from the recipe, it has also been replaced by artificial sweeteners. This is done in order to maintain flavor in that cookie or scoop of ice cream you are munching on. Many contain sugar alcohols, like Sorbitol and Xylitol.

While artificial sweeteners can help in lowering the carb count on particular foods, be sure to read the nutrition facts on the back of the box. The sugar may be lower, but some more fat and calories may have been snuck in as well.  Too many sugar alcohols can cause gastric distress or have a laxative effect as well.[2] Recent studies have even suggested artificial sweeteners may lead to the development of glucose intolerance and type 2 diabetes.[3] Other research claims that artificial sweeteners can actually cause you to consume more calories. Your brain responds to sweet tastes with signals to eat more, but getting sweet signals without calories can make you feel hungry and eat more than if you had eaten a full sugar food.[4]

Many low carb products came to grocery store during the Atkin’s Diet craze in the last decade and now low glycemic foods are the up and coming fad.  The higher the glycemic index (GI), the more it raises blood glucose levels when compared to foods with a lower GI. The level of fat and fiber in a food tend to categorize it as lower on the GI scale. Low GI foods (55 or less) include steel-cut oatmeal, sweet potatoes, legumes, and most fruits. Foods high on the GI index (70 or more) include white bread, instant oatmeal, russet potatoes, and pineapple. While foods lower on the GI scale may have their benefits, it is still important to take into consideration the amount of carbs eaten and that GI can change when combined with other foods[5].

Many diabetes advocacy organizations, like Diabetes UK, are against the labeling of foods as “diabetic” or “suitable for diabetics.” It is viewed as a simple marketing ploy and some advocates feel that such labels are misleading people that other options may be less healthy. They are also concerned that the label of “suitable for diabetics” often unnecessarily raises the price of the food item. There is very little regulation on what can be or cannot be label as “diabetic” food.[6]

Bottom line: Pretend like you are back in your high school chemistry class and read the list of ingredients and nutrition facts on the foods that you buy. Whatever the label is on the box of pasta or cookies, know what you are putting in your body and count those carbs. The Dario App can help you find all the carb values you need to keep informed and on track.

[1] (2011). International Markets Bureau. Market Analysis Report: Consumer Trends Food for Individuals with Diabetes in the United States. Agriculture and Agri-Food Canada.

[2] (2014). American Diabetes Association. Sugar Alcohols.

[3] (2014). Associated Press. Artificial sweeteners linked to diabetes in study. CBS News.

[4] (2016). The Nutrition Source. Artificial Sweeteners. Harvard School of Public Health. Online.

[5] (2014). American Diabetes Association. Glycemic Index and Diabetes. Online.

[6] (2016). Diabetes UK. Diabetic Food. Online.

T1 vs T2: We Both Have Diabetes, Can’t We All Just Get Along?

Type 1 vs Type 2 Diabetes

No, I’m not talking about the first and second “Terminator movies starring Arnold Schwarzenegger. I’m talking about the differences between Type 1 and Type 2 diabetes. What both types of diabetes have in common is that they are defined by higher than normal blood glucose levels.  The major difference is what causes different types of diabetes and how each type develops.[1] However, media misconceptions that pervade stereotypes about people with Type 1 and Type 2 diabetes can make it seem like there is bad blood between the two types. Which begs the question: we both have diabetes, can’t we all just get along?

So what’s the difference between Type 1 and Type 2 diabetes? The hallmark of diabetes is that the body either stops making or properly producing enough insulin to regulate glucose (a type of blood sugar), resulting in overall high blood glucose levels.[2] Type 1 diabetes, which is generally diagnosed in childhood, is caused by an autoimmune response that destroys the cells in the pancreas that create insulin. People will T1 diabetes will need insulin injections to help regulate their blood glucose levels. [3]

Type 2 diabetes is generally diagnosed later in the lifespan, but recently the number of T2 cases is on the rise for all age groups – even kids. For people with T2 diabetes, their bodies are still producing insulin. But the process of regulating blood sugar levels after eating becomes impaired when the cells that would normally react to glucose entering the blood stream by absorbing it for later use, become resistant to the insulin, causing blood glucose levels to rise.[4] T2 diabetes can be managed with diet and medications, but eventually some people with type 2 diabetes will need to treat themselves with insulin injections.

What people with Type 1 and Type 2 Diabetes have in common is that they must take an automatic function of the body to regulate blood sugar and operate it in manual mode – either by insulin injections, tablets, or diet.

Myths and stereotypes about people with diabetes.

According to the World Health Organization, an estimated 347 million people across the globe have diabetes – approximately 90% have Type 2 diabetes, while the remaining 10% are people with Type 1, LADA, and gestational diabetes.[5]

In part due to the high prevalence of type 2 diabetes, much of the information about diabetes that is dispersed to the public is focused on T2. The media often casts Type 2 diabetes in a light that it is a completely preventable disease. And while the intended message to try and inform people about prevention is good, it can be misinterpreted by some and turn to victim blaming or disease shaming. While obesity, diet, and exercise play a role in the incidence of Type 2 diabetes, genetics and other environmental factors also contribute to its development.  It does not occur simply because someone eats too many candy bars or is overweight or doesn’t exercise.

The public judgement that people with Type 2 diabetes have brought the disease upon themselves and is something that can be cured just by not eating sugar or exercising is painful to people with both Type 1 and Type 2 diabetes. David Spero from the Diabetes Self-Management blog notes that many T1s buy into this judgement about people with T2. They may feel angry about being lumped together with type 2 diabetes and society’s self-blaming attitude towards them.[6]

The truth is that living with Type 1 or Type 2 diabetes is not easy and T1s and T2s can often find comfort and support in each other experiences of living life with diabetes. Using the Dario Smart Diabetes Management System can make your diabetes care regimen simpler – with blood glucose results loaded directly onto your mobile device and reminders to test. Get support from the greater diabetic community, from both type 1s and type 2s, through our Facebook page and the Dario Lounge Groups. It is important for members of the diabetes community and their families to combat media information about the condition and raise awareness for better treatment and research funding for all diabetes.

We can all get along!

 

[1] Diabetes UK. (2016) Difference between type 1 and type 2 diabetes.

[2] Diabetic Care Services (2016). Types of Diabetes, causes, and symptoms.

[3] European Food Information Council (2016) Can you please explain the difference between type 1 and type 2 diabetes?

[4] European Food Information Council (2016) et.al

 [5] WHO (2014). Mobile phones help people with diabetes to manage fasting and feasting during Ramadan. World Health Organization

[6] David Spero. (2010). Type 1s Vs. Type 2s. Diabetes Self-Management.

Caregiving Tips for Senior Parents with Diabetes

Senior Parents with Diabetes

Caring for your parents as they age can be a difficult responsibility to take on. If your parent is a person with diabetes, there are special considerations to be taken into account.  Whether your elderly parent is someone who has been living with diabetes for decades or is newly diagnosed, be sure to keep an open dialogue about their diabetes management and other health issues. To keep on point with your parents’ healthcare, consider these caregiving tips for senior parents with diabetes.

Know your Parent’s Diabetes Regimen and Treatment Goals. Do you know how often your parent with diabetes is testing their blood sugar? How many times did they administer a dose of insulin? If your parent is using the Dario Smart Diabetes Management System, then you can simply log-in and check. But it is also important to have a discussion with your parent, and ideally their doctor, about their diabetes treatment plan. The treatment goals for seniors with diabetes can change and are often focused on more short term goals, like keeping the number of hypoglycemic events down.[1]

A1C targets may also vary and should be based on the overall health of the individual, not on age alone. While the Mayo Clinic recommends an A1C level treatment goal of 7% or less for people with diabetes[2], a goal of 8% may be more attainable and acceptable in older adults. Depending on their physical condition, seniors may not benefit as much from having tighter control of their blood glucose levels and may also have other health issues to contend with, like cardiovascular disease and high blood pressure.[3]

If your parent is taking medications for anything other than diabetes, make sure you know what other prescriptions and supplements they are taking. Certain drugs can have interactions with other diabetes medications and can have side effects such as lowered blood glucose levels or affect kidney function.[4]

Foot Care. People with diabetes of all ages must take care to keep their tootsies in good shape, but foot care is critical in seniors with diabetes. Vision and mobility issues can make it difficult for older people to tend to their toenails and to conduct self-inspections of their feet. Caregivers should regularly inspect feet for fungus, sores, or any other injuries to the feet.[5] If your parent does present with any foot problems, it’s best to take them to their podiatrist or doctor. Don’t care for any wounds or ingrown toenails yourself.

Mental Health and Cognitive Functioning. Seniors with diabetes have a higher probability to experience depression and should be screened for depression by their physician. If you notice any changes in your mom or dad’s behavior, like moodiness, irritability, loss of energy or interest, or any differences in their eating and sleeping patterns, talk to their doctor.  Older adults with diabetes can also experience diabetes burnout, which is basically just getting fed up of having to deal with diabetes daily and ignoring blood sugar monitoring and necessary treatments.[6] Seniors with diabetes also have an increased risk of more rapid cognitive decline associated with aging. This can lead to deficits in the ability to provide self-care for diabetes management.[7]

While it can feel overwhelming, remember you don’t have to help your parent’s manage their diabetes alone. Enlist the support of your siblings, your parent’s medical team, and social media support groups to get added help. It may seem like a daunting task, but having the Dario Diabetes Management Solution in your tool kit can help give you added piece of mind. With features such as sharing blood glucose measurements, statistics reports, and text message alerts for hypo and hyper events, Dario can help you feel more at ease for caring for your senior parents.

[1] Wahowiak, L. (2014). 5 Ways to Help Seniors with Diabetes. Diabetes Forecast.

[2] http://www.mayoclinic.org/tests-procedures/a1c-test/details/results/rsc-20167939

[3] BD. (2016). Diabetes Care Guidelines for Older Adults. BD Online.

[4] BD Ibid.

[5] South Eastern Florida Regional Diabetes Program. (2009). Care of Older People with Diabetes. Diabetes Research Institute: University of Miami.

[6] Wahowiak, L. (2014). Ibid.

[7] American Geriatrics Society Expert Panel on the Care of Older Adults with Diabetes Mellitus. (2013). Guidelines Abstracted from the American Geriatrics Society Guidelines for Improving the Care of Older Adults with Diabetes Mellitus: 2013 Update. Journal of the American Geriatrics Society. 61:2020-2026.

How Exercising Can Effect Blood Sugar Levels

Exercising Blood Sugar Levels

Have you heard the news? Exercise, exercise, exercise! Yes, we all know that we should exercise and the benefits of burning calories and building muscles span across the body’s ecosystems that improve health and organ function. But did you ever wonder how exercising can effect blood sugar levels?  For people living with diabetes, understanding how workouts impact your blood glucose is important to avoiding swings in your blood sugar levels and reaping the overall benefits of regular exercise.

Muscles make you move. And they also store glucose. As you start working out, your body will need more fuel to pick up the slack for all the extra energy you’re burning – and glucose is the major power source.  The glucose that is accumulated in the muscles gets used up rapidly. At around the same point, your liver will emit glucose into the bloodstream for an extra energy boost. Your body also uses fat for fuel, which is released through adipocytes (fat cells) into the bloodstream. Special receptors on the muscles allow glucose to go from the bloodstream to the muscles to keep them moving.[1]

At the beginning of an exercise session, blood glucose levels can rise briefly before they start to go down – after about 30 minutes of exercise.[2] Because blood glucose levels can shift during periods of exercise, it is important to test with your Dario Smart Glucose Meter before and after your workouts. If your blood sugar levels are high and/or ketones are present prior to a workout, then don’t exercise until your blood glucose levels go back down to an acceptable level.[3]

How a workout or a run can affect your blood glucose depends on many factors including how long and how intensely you are working out. For many, the main issue with working out when you have diabetes is hypoglycemia. Exercise may lower your blood glucose for as long as twenty-four hours or more even after you have stopped as it increases your body’s sensitive to insulin.  This is another key reason that you should test before, after, and during your workout if you feel any symptoms of a hyper or hypo event. If you have a low blood sugar reading during or after a workout, treat your hypo as you normally would. Then re-test about 20 minutes later and repeat if needed.[4]

Testing your blood sugar regularly, especially pre- and post- exercise, will give you a better overall picture of how working out uniquely affects you. It can be a challenge when starting a workout routine if you find yourself experiencing hypos often, especially if your goal is to lose weight and you need to consume extra calories to treat your hypo. Stick with your diet and exercise plan as much as you can, and always enlist the help of your doctors before beginning any exercise plan and if you need the added support.

[1] Weil, R. (2016). Managing your blood glucose during exercise. BD website.

[2] Goodwin, M.L. (2010). Blood Glucose Regulation during Prolonged, Submaximal, Continuous Exercise: a Guide for Clinicians. Journal of Diabetes Science and Technology. 4 (3) pp. 694 – 705.

[3] Joslin Diabetes Center. (2016). Exercises to Avoid When You Have Diabetes.

[4] American Diabetes Association. (2013). Blood Glucose Control and Exercise. ADA website.

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic Ketoacidosis – while it may be one of the only things to rhyme with supercalifragilisticexpialidocious, this serious condition needs immediate attention and more than just a spoonful of sugar for treatment. In fact, your sugar levels can get dangerously high when ketones build up in your blood stream. The body creates ketones when it uses fat cells for energy instead of available glucose. It is normal to produce some ketones, especially if you are aiming to lose weight. But if you test positive for ketones and have at least two or more high blood glucose readings within two hours, it’s time to call your doctor.

What are the causes and symptoms of Diabetic Ketoacidosis (DKA)? DKA happens when your body cannot get access to glucose as source of energy because there is little or no insulin available. Your body then breaks down fat instead for fuel. They byproduct of this process are ketones, an acid which can be poisonous in high levels.[1] You are also more likely to develop DKA if you are stressed or have an infection.

Ketones can be tested through urine on a special strip. You can ask your doctor which ketone test they recommend, but depending on your region an over-the-counter ketone test kit can picked up from your pharmacist. Read the instructions for the ketone test kit you choose. In general, you can urinate over the test area of the strip or collect your urine in a clean container and then place the test area of the strip into the cup. The strip will change color based on the level of ketones in your urine. The ketone test kit will include a color chart to compare your results and find the range of ketones present.[2]

In most cases the development of DKA progresses slowly. If you experience any vomiting, it may be a sign DKA will progress more rapidly. Symptoms include extreme thirst or dry mouth, increased urination, high blood glucose levels, and high levels of ketones.

More serious indications of DKA include:

  • Constant fatigue
  • Difficulty focusing or feeling confused
  • Dry or reddened skin
  • Feelings of stomach pain, nausea or vomiting
  • Trouble breathing
  • Fruity breath smell[3]

How is DKA treated? DKA can be treated by additional doses of insulin. Get in touch with your doctor or diabetes educator to know how much insulin and which type to administer. You can use your Dario to easily share your recent blood glucose reading with your healthcare team. It is also recommended to drink plenty of water to help flush out the ketones from your system.[4]  In more serve cases of DKA, you may need to be hospitalized and given insulin and intravenous fluids. Your healthcare team will also monitor your electrolytes and monitor your brain for signs of swelling.[5]

How can I prevent DKA from happening? DKA mostly affects people with Type 1 diabetes but can happen in rare cases to those with Type 2 diabetes. To keep DKA from occurring, make sure to test your blood sugars regularly with your Dario and don’t skip insulin doses. Test for ketones if you have extremely high blood glucose readings or if you are fighting any illnesses or infections. Avoid exercise if your blood sugar is high and you are positive for ketones. It is also recommended to drink lots of water when you are having high blood sugars.[6]

[1] https://www.nlm.nih.gov/medlineplus/ency/article/000320.htm

[2] Diabetes UK (2016). Ketone Testing.

[3] ADA. (2015). DKA (Ketoacidosis) & Ketones.

[4] Joslin Diabetes Center. Ketone testing: what you need to know.

[5] http://www.webmd.com/diabetes/tc/diabetic-ketoacidosis-dka-topic-overview

[6] Albany Medical Center. 2006. Preventing Diabetic Ketoacidosis

Another New Year’s Resolution

Another New Year’s Resolution

It’s New Year’s Eve…Yeah? A new year, a new you… okay? The end of 2015 is almost here so it means it’s time to make another New Year’s resolution. Or is it? While certainly courageous to commit to making a positive transformation as we enter 2016, are you really ready to take a chance on change? If you are keen on resolution, first figure out if you’re ready, willing, and truly able to set and meet new goals for yourself on January 1.

Identify the Goal. What is that you are looking to change? Weight loss? Exercise? A lower A1C level? These goals are rather broad. So if you have a goal like this, break it down into smaller parts that can make it easier to manage. If weight loss is your goal, commit first to logging the meals you normally eat in a day for two weeks’ time. You can easily do this in your Dario app. This will give you a basis for the amount of calories you normally consume and a better understanding of how many calories you need to cut in order to shed some pounds. If you want to lose a total of 25 pounds for example, break it down in to five pound increments and reward yourself after each 5 pounds lost with a little treat. Breaking it down and setting smaller goals along the way can also give you better more incentive to progress.

What is your motivation? What’s driving you to change? Understanding what is underneath your desire to change is key. Do you want to lose weight for your high school reunion or exercise more to run a faster 5K? Are you aiming to lower your A1C because your doctor told you to or because you want to stay healthy for family and loved ones? Knowing what pushes you to dedicate to making a change can give you great inspiration to the get across the finish line.

Activate and track your plan. Once you have identified your goal and your motivation it’s time to put it in action. And according to some, if you didn’t track it, it didn’t happen. This is where your Dario App can really come in handy. If your goal is to lower your A1C in the New Year, taking action to test your blood glucose more and entering your carbs and insulin doses can get you closer to your goal. It will help you understand where you need to adjust your plan to better manage your diabetes.

Recognize setbacks as teachable moments. There are 365 days in the year, so you can still take it one day at time. Don’t let one bad apple – or pie – spoil everything. People’s perfectionist perception of how they should act can sometimes turn defeatist when setbacks arise. Don’t give up on your goal. Learn from the setback and understand what caused it and how you can handle it in the future. Also it’s okay to indulge yourself from time to time with a savory meal or a lazy Sunday on the couch. Depriving yourself completely of things you enjoy can leave you feeling unmotivated to meeting your goal after a while.

No matter what your resolution is – or if you choose not to make one – Dario wishes you a very happy, healthy and successful 2016. Happy New Year!

Drinks and Diabetes: How Alcohol Affects Blood Sugar

Drinks and Diabetes: How Alcohol Affects Blood Sugar

If you’re planning to booze it up this New Year’ Eve in celebration of 2016, think before you drink! Get to know how alcohol affects your blood sugars if you are living with diabetes.  Much misinformation exists about whether or not people with diabetes should knock back a beer, but the truth is that sipping on a little gin and juice in moderation is okay. It may even have some health benefits. Even so, when drinking with diabetes there are certain steps you should keep in mind to avoid a hypo at the pub.

The general guidelines for alcohol consumption are one drink per day for the ladies and two drinks for the gents (a drink is defined as 12oz for beer, 5oz for wine, and 1.5oz for distilled spirits like whisky and vodka). This guideline is the same for people with or without diabetes.[1] Before you decide to consume alcohol, you should always consult first with your diabetes healthcare team. Certain medications or diabetes complications you are experiencing may not make it a good idea to drink alcoholic beverages.

One of the biggest risks to consider if you plan to drink alcohol is that it increases the chances for experiencing hypoglycemia. Alcohol can put added pressure on the liver. Your body views alcohol as a toxin and your liver works hard to get clean it from your system. Your liver is also working hard to help regulate your blood sugar, so when you drink you are essentially putting it to work a double shift. It can also become difficult to distinguish between the signs of hypoglycemia and being tipsy since the symptoms are similar, like feeling sluggish or dizzy.[2] Let your drinking buddies know that you have diabetes and what they should look out for or do if you need some help.

  • Make sure you don’t liquor up on an empty stomach or if your blood sugar is too low. Eat as you would normally and don’t replace your meals with a liquid lunch. Carry snacks with you just in case you need to treat your hypo.
  • Check your blood sugar before, during, and after you drink. Don’t forget to check before bedtime too. If you are having a hypo, your Dario app can alert your family members or friends that you need some help. Adjust your insulin if needed and as discussed with your doctor.
  • Beware of sugary mixers that can be added to your drinks.
  • Wear a medical alert ID or flash your diabetic tattoo somewhere if you have one.
  • Don’t drink and drive!
  • Don’t chug-a-lug; sip-and-savor! Make that drink last longer and drink a couple glasses of water or no calories beverages in between.[3]
  • If you’re also out on the dance floor, don’t forget that exercise (and sex) can also lower your blood glucose levels.[4]

Being in social situations where alcohol is a focal point can be difficult in a society that indulges in everything but moderation. And remember it always your choice whether or not you want to drink – you don’t have to give into peer pressure. Plus you could be a great help to friends if you can be the designated driver for a night out on the town. So whether or not you decide to drink this New Year, cheers to a happy and healthy 2016!

[1] American Diabetes Association. (2014). Alcohol.

[2] Healthination (2015). Video: Alcohol and Diabetes.

[3] Diabetes UK. Alcohol – Drinking and Diabetes.

[4] MacNaught, N. & Holt, P. (2015) Type 1 diabetes and alcohol consumption Nursing Standard. 29, 50, p. 41-47.

Living with Diabetes and an Eating Disorder

Diabetes and Eating Disorders

Living with diabetes and the constant need to monitor your blood sugar and carb intake can create a complicated relationship with food. For some, the combination of body image issues mixed with depression and anxiety from diabetes burnout can lead to the development of an eating disorder. This complex cycle of negative body images, the stigma of having diabetes, and carb restriction can create a very challenging and dangerous situation for people with diabetes – both for their emotional and physical well-being.

Eating disorders in persons with diabetes are most commonly found in teens and young women with type 1 diabetes who develop “diabulimia” – diabetes and bulimia. Bulimia is the recurrent eating of large quantities of food and then purging – either through vomiting, laxative use or excessive amounts of exercise.  People with diabetes and bulimia also reduce or completely stop using insulin to lose calories and glucose through the urine. This causes extremely high blood sugars and can lead to diabetic ketoacidosis and coma. Some may refrain from treating a hypo because they do not want to consume the extra calories.[1]

Anorexia and Binge Eating Disorder are other common eating disorders. Anorexia is defined as severe calorie restriction and weight lose by self-induced starvation. Binge Eating Disorder is more prevalent in women with type 2 diabetes. People with this condition often overeat impulsively to the point of being uncomfortably full and without purging.[2] Overtime the risk for earlier onset of diabetes complications such as eye and kidney disease increases.

The warning signs of an eating disorders in diabetes include:

  • Increases in A1C values that cannot be explained
  • Multiple episodes of diabetic ketoacidosis (DKA)
  • Obsessive thoughts about weight
  • Overly intense exercise routines (sometimes accompanied by frequent hypos)
  • Amenorrhea (missing a monthly menstrual cycle).[3]

One leading influence in the development of eating disorders like anorexia and bulimia for the general population is the constant barrage of unrealistic standards of beauty portrayed and edited with Photoshop in popular culture. Such societal pressure can push a desire to be thin to an obsessive point. Myths in the media about people with diabetes being overweight and being to blame for their condition can make people feel ashamed and push people to the brink of engaging in harmful behavior to be thin.

In diabetes treatment, there is a lot of emphasis on the word control. Control your blood sugars. Control your carbs. Control your weight. Control your body. Constantly being told to be in control of a chronic disease like diabetes can actually make you feel out of control, leading to feelings of depression and anxiety when you don’t meet your compliance goals. People can develop negative coping mechanisms to redirect the control over their diabetes – like an eating disorder where they are over controlling their food intake.  Experts claim the recommended attention to diet, blood sugar, weight, and exercise as part of a standard treatment recommendation for diabetes is comparable to the rigid thinking about food and body image that is found in people who have eating disorders but not diabetes.[4]

Relinquish the idea of complete control and focus on managing your diabetes. Don’t be so hard on yourself. You cannot control how every little part of your daily diabetes life will affect you. Using a Diabetes Management Solution like Dario can help to better handle diabetes and give you data to make better informed decisions in your diabetes care.  You can still have goals for weight loss and carb intake, but be sure to set healthy boundaries. Keep body positive and accept your body for everything that it is and isn’t. If think that you or someone you love may have an eating disorder it is important to seek help from your medical team.

[1] https://static.diabetesaustralia.com.au/s/fileassets/diabetes-australia/bd9877a3-3289-43d9-a2ee-7598b4d1f1ca.pdf

[2] http://www.diabetes.org/living-with-diabetes/treatment-and-care/women/eating-disorders.html

[3] http://www.joslin.org/info/Eating_Disorders_Diabulimia_in_Type_1_Diabetes.html

[4] http://dst.sagepub.com/content/2/3/530.full.pdf+html

Winter Workout Woes

Winter Workout Woes

Have you ever thought to yourself, “Gee, it’s too cold to exercise today. I better just stay in my pajamas”? If so, then it sounds like you have a case of the Winter Workout Woes. It is important to keep up with your fitness as HbA1c levels tend to rise for people with diabetes in the winter as outdoor activity drops.[1]It’s easy to choose your warm, cozy house over braving a trip to the gym or a jog in the snow. You may also find less motivation to get in a workout if you’ve been able to more easily hide – or maybe not even notice – the extra pounds from the holiday season in your chunky sweater. Don’t let a few snowflakes get in your way. Here are some tips and motivational tools for heating up your winter exercise plans.

In some spots on the map, it literally may be impossible to make it to the gym if the roads are covered with ice and you’re stuck as home with the kids on their snow day. So make your house your gym. You don’t need any equipment to get in a good workout. There are many exercises that can be done only using your body weight or simple household items like a chair or a couple cans of soup. You can use your Dario app to log your physical activity. Some examples for indoor workouts that require no equipment:

  • Dancing
  • Crunches
  • Leg Lifts
  • Push-ups
  • Jumping Jacks

If you do venture out into the cold it is important to dress warmly. Wear layers so that you can cool off if you do get too hot. Take care to keep the layer of clothing closest to your body light and made of a breathable synthetic fabric that wicks away sweat from your body.[2] You don’t want to be cold AND wet. Some runners report that running in the colder temperatures allows them to run a bit faster than running in the summer sun – so taking a jog outdoors in the cooler months can be an incentive to beat your personal bests for speed. Plus you are burning calories to run and to keep your body warm – double burn![3]

To keep inspired, create a fitness plan with goals. If you can get a buddy to come along with you on workouts it is even better. The accountability to each other is great motivation and makes working out more fun too. Try a 30 day challenge – like the 30 Day Squat Challenge or the 30 Day Plank Challenge and make a competition between friends to commit to the challenge. Creating Facebook Fitness Group among your mates and posting your daily accomplishments can also be a great incentive – the more the merrier.

Remember that every exercise you do can help with insulin sensitivity and give your body a better way to regulate your glucose levels. When you are working out, make sure to test often with your Dario as your activities can impact your blood glucose for as long as two days post workout. Especially if you are using insulin, be mindful of your blood sugar levels as you may need less insulin than normal.[4] So what are you waiting for? Get your winter workout on!

[1] http://www.diabetes.co.uk/diabetes-and-cold-weather.html

[2] http://www.joslin.org/info/Warming_Up_to_Winter_Exercise.html

[3] http://www.runningroom.com/hm/inside.php?id=2739

[4] http://www.diabetes.co.uk/diabetes-and-cold-weather.html

 

Pregnant with Diabetes: Gestational Diabetes

gestational diabetes

The onset of diabetes during pregnancy, gestational diabetes, is identified by high blood sugars and glucose intolerance that is first recognized only after a woman has conceived.  Gestational diabetes was previously believed to affect 3% to 5% of all pregnancies, but updates to the criteria used to diagnose the condition and better data collection put the number as high as 18%.[1] The good news is in most cases after the baby is born, gestational diabetes resolves itself. Get to know the symptoms of gestational diabetes and what the risk factors are to developing the condition.

Why does gestational diabetes happen? During pregnancy, there are many hormonal changes that occur in the body. In particular, the placenta produces hormones that increase the amount of sugar in the blood stream. If the pancreas cannot keep up with this, the mom-to-be essentially becomes resistant to her own insulin.[2] Screening for gestational diabetes is done at about 20 weeks into the pregnancy. Those with a family history of diabetes, obesity prior to the pregnancy, over the age of 25, and being from certain ethnic groups (African-American, Latino, Native America or Pacific Islander) are at greater risk of developing diabetes during pregnancy. If you have had gestational diabetes during a previous pregnancy, there is a bigger chance that you will have it again during subsequent pregnancies.  Usually there are no recognizable symptoms of diabetes and if they do occur they are similar to normal pregnancy symptoms such as increased urination, thirst, and weight gain. Keeping a healthy diet and exercise plan and losing weight before pregnancy are simple steps you can take to reduce the chance of developing gestational diabetes.[3]

How is gestational diabetes treated? Being diagnosed with diabetes while pregnant can be frightening, but it can be easily managed. The Dario Smart Meter is a great device to have if you are newly diagnosed with gestational diabetes. You can use your Dario to track blood sugar, carbs, and insulin injections if needed. Easily share your Dario logbook with your medical team and your loved ones. Having the tools to keep your blood glucose levels in the range normal for pregnant women can reduce the risks of gestational diabetes to mom and baby.

In most cases of gestational diabetes, a treatment plan includes limiting carb intake and exercise although insulin is needed in some cases. Keeping your blood sugar in range reduces the risk of complications for both mom and baby. Mothers are at an increased risk of developing type 2 diabetes later in life and preeclampsia during pregnancy. Poorly controlled blood sugar can lead to high birth weight (and increased chance of C-section), early delivery, respiratory distress syndrome, hypoglycemia, and developing obesity and type diabetes.[4]

Global diabetes organizations, such as the International Diabetes Federation, have noted that while gestational diabetes is on the rise, the medical community needs to invest more resources in this critical issue for the health of woman and children.[5] If you are expecting a baby or planning your family, speak to your doctor about your risk of gestational diabetes and discuss ways to keep your blood sugars in range to have a happy and healthy pregnancy.

[1] http://www.parents.com/pregnancy/complications/gestational-diabetes/pregnancy-gestational-diabetes/

[2] http://www.webmd.com/diabetes/gestational-diabetes-guide/gestational_diabetes

[3] http://www.parents.com/pregnancy/complications/gestational-diabetes/pregnancy-gestational-diabetes/

[4] http://www.mayoclinic.org/diseases-conditions/gestational-diabetes/basics/complications/con-20014854Ges

Make the Most of Doctor’s Appointments – Discussing Diabetes

Doc picA doctor’s appointment can be months in the making, but sometimes last only 10 minutes. Preparing for your visit can help you make the most of your doctor’s appointment and discussing diabetes. Being more prepared and having better communication with your doctor is key to improving diabetes management and keeping your blood sugars in better range.

  • Know your medical history. If you are meeting with a new doctor, be prepared with your medical history like dates of surgeries, medication allergies, and family history of heart disease and cancer.
  • Do a little homework. Prepare questions ahead of time. Write down a list of any symptoms or complications that you are experiencing.[1]
  • If there is something in particular that you are concerned about, call your doctor or nurse prior to your visit and tell them your concerns. They may suggest coming for a blood test or other measure prior to your visit. Your medical team can also tell you if you need to do anything like fast or stop certain medications prior to a blood test. This way you and your doctor can have a more informed conversation about the issue at hand when you do finally meet.
  • Review your blood glucose readings with your doctor. app shares your readings easily with your doctor. You can also have them printed out to take with you to the appointment. Highlight days that you had difficulty keeping your blood sugars in range and talk about what might have led to the instability in your blood sugar for that day.
  • If you are new to diabetes, make sure your doctor explains the condition to you and refers you to a diabetes nurse or Certified Diabetes Educator.[2]
  • If your doctor keeps the visit short, try not to take it personally. But demand the time that you need! Spending more time with patients gives doctor’s more time to understand the issues at hand and make better treatment plans. However, many public medical services (and private practices also) are pressured to only give patients a small window of time by healthcare governing bodies and insurance companies.
  • Don’t fear difficult topics like depression, sexual dysfunction, and toilet troubles. It is your quality of life and health at stake – many times these issues are indications of bigger issues like heart disease or side effects of medication. You may be embarrassed by these topics yourselves – but trust us; your doctor has heard it all.
  • The doctor patient relationship is important. If you don’t feel like the communication is open with your physician, tell your doctor you are not feeling heard and see how you can improve your relationship. And if it doesn’t work out, find another doctor that you connect with better.

Preparing for your medical appointments can help you feel more confident speaking to your doctor about your healthcare concerns and can get you the answers you need to improve your health. Try to take a team approach with your doctor in improving your diabetes management. Have a dialogue with your doctor about what you need from your doctor and what your doctor needs you do to help keep yourself healthy and your blood sugars well managed.

[1] http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/basics/preparing-for-your-appointment/con-20031902

[2] http://www.webmd.com/diabetes/questions-doctor-diabetes

 

Take Diabetes to Heart: The Connection between Blood Sugar and Heart Disease

heart

People living with diabetes have a higher chance of developing cardiovascular disease (CVD) and other coronary complications. The best chance of preventing CVD is to take diabetes to heart and understand the connection between your blood sugar levels and the warning signs of heart disease. See how you can take steps to keep your ticker tocking and have yet another vital reason for better managing diabetes.

Understand the risk. Heart disease is a major complication of living with diabetes. According to the National Diabetes Education Program, the chance of developing heart disease or having a stroke is between two to four times greater in adults with diabetes.[1] The symptoms of CVD are not always as obvious as other complications, like increased risk of skin infection, but the risk is real. Since diabetes can interfere with nerves and diminish pain signals, someone with diabetes may not experience the usual warning signs of a heart attack.[2] Having diabetes is in itself a risk factor for heart disease, but there are other risk factors that you can have some control over to decrease your chance of heart attack or stroke.

  • Smoking. Seriously?!? Are you still doing this? Smoking elevates the likelihood of heart disease, not to mention that it increases the risk of diabetic retinopathy and damages blood vessels which can lead to amputations. Find help to quit the smoking habit.
  • High Blood Pressure. If your blood pressure is on the high side, it can cause strain on your heart and blood vessels as your body must work harder to pump the blood. Reducing your intake of sodium and finding ways to keep stress low can help lower blood pressure.
  • High Cholesterol. High LDL cholesterol collects in your blood vessels, which overtimes narrows and hardens your arteries, blocking blood flow. Avoid saturated fats and add foods rich in omega-3 and fiber.
  • Central Obesity. This refers to carrying too much weight around the middle than opposed to other areas of the body like your hips. Fats stored around the belly can increase the production of LDL levels.[3] Adding exercise and a plan for a healthy diet for weight loss and help reduce overall body fat.

Lower the risk with your ABC’s. To decrease the development of heart disease, it is key to keep your diabetes well managed. To do this, test regularly (with the Dario Diabetes Management Solution to help) and pay attention to your “ABC’s”[4] to track how well your diabetes is managed.

  • AA1C – Your HbA1C level is the average blood glucose level from the past three months. It is recommended to keep it below 7% unless your doctor recommends a different goal.
  • BBlood Pressure – Ask for a blood pressure test at every doctor’s visit and discuss with your doctor what the ideal blood pressure is for you.
  • CCholesterol – Have your cholesterol level checked at least once a year or more if recommended by your doctor. Keep your LDL and triglycerides low and your HDL cholesterol within range.

While your blood sugar levels are a key tool to keeping your overall health in check, make a comprehensive plan with your doctor to keep your other organs at their optimal functioning level. Speak to your doctor about exercise plans and if aspirins regimens or other medications for blood pressure and cholesterol are right for you. .[5] If you experience any chest pain, pain while walking, slurred speech or facial or arm weakness, speak to your doctor or call emergency services immediately.

[1] National Diabetes Education Program. (2007). The link between diabetes and cardiovascular disease. National Institute of Health.

[2] National Institute of Health (2013). Diabetes, heart disease, and stroke.

[3] Ibid.

[4] National Diabetes Education Program. (2007). The link between diabetes and cardiovascular disease. National Institute of Health.

[5] Ganda, O. (2006). Diabetes and cardiovascular disease. Joslin.

Ways to Honor World Diabetes Day – November 14, 2015

World_Diabetes_Day_logo.svg

If you haven’t heard the news, the entire month of November is Diabetes Awareness Month and World Diabetes Day on November 14. World Diabetes Day falls on the birthday of Dr. Frederick Banting who was part of the Canadian team to first discover insulin, which happened way back when in 1924. A great deal of progress has been made since then, but there is still a lot of room for progress in developing improved treatments for children and adults living with diabetes. So how can you be part of the push to bring diabetes awareness to your community and advocate for improved diabetes healthcare? Here are a few ideas.

Get involved with a local diabetes organization or group. Diabetes advocacy groups and research foundations like JDRF, International Diabetes Federation (IDF), and Diabetes Hands Foundation are all running special campaigns during the month of November. JDRF has a great awareness campaign #T1Dlookslikeme. If you or someone you care for is affected by Type 1 diabetes, you can upload your picture to the JDRF website with a blue filter and hashtag to share on social media sites, like Twitter and Facebook. You can also find ways to connect with these organizations face-to-face by attending monthly meet-ups or annual conferences like IDF conference to be held in Vancouver, British Columbia from November 30 – December 4 (and Dario will be there too!)

Advocate for healthcare change with your elected officials. Amongst the members of our Dario Lounges, we constantly hear complaints about a lack of quality of care or resources for people with diabetes; general practitioners who don’t fully understand diabetes, long waits for appointments with diabetes specialists, limits on the number of strips prescribed per month, or those with type 2 diabetes who must pay out of pocket for all of their testing supplies. Don’t like it? Speak up! Write to your locally elected officials to let them know you are not satisfied with the level of care you are receiving. If you want to keep it short and sweet, you can probably find your locally elected officials Twitter page and send a few poignant 140 character swings their way. You are not only helping yourself, but potentially thousands of others experiencing the same issues. The more times your local MPs or senators hear about your issue, the more they are likely to push for diabetes healthcare improvements.

Fight diabetes myths and share your personal stories. For the hundreds of times daily that diabetes is brought up in the news as a global epidemic, there are still pervasive myths that follow it. Like if you have diabetes you can never ever eat sugar. Try telling that to someone who is having a hypo and needs to up their blood sugar to avoid passing out. It is can be easy for others to pass judgement on people with medical conditions that they don’t understand first hand or have a personal connection to. Sharing your personal story can help battle the untruths that exist around diabetes by putting a name and face to the condition. You can feel free to share your stories on Dario’s Facebook page.

Make a commitment to your own diabetes management and self-care. If you are not ready to tackle the global diabetes epidemic, start with yourself. In honor of World Diabetes Day, make a commitment to personal health and reaching your diabetes management goals. Invest in tools that can help you make progress, like the classes to learn about diabetes treatments methods or finally getting that gym membership that you know can help keep your health on track. Celebrate yourself.

Finding Support for Diabetes on Social Media

person-woman-apple-hotel (1)

Today people turn to social media for practically everything. From food to fashion to friends, Facebook is by far the most popular social media outlet. Many join groups on Facebook to connect around common interests or to find support for health conditions – like diabetes.  The Dario Lounge is one such group where fellow Dario users can get support about how to best utilize the Dario Smart Meter, yet also receive peer feedback, support, and information from each other. Mounting evidence shows that receiving support for diabetes via social media outlets can actually help improve health outcomes and compliance to diabetes treatment plans.

If you are living with diabetes, then you are in the unique situation of having to make constant medical decisions and calculations for yourself; how much insulin do I need to inject? How many carbs did that have? What was my last blood sugar level? It can leave you feeling like a walking high school chemistry project. And while your diabetes is 24/7, your doctor may not be. Online groups for people with diabetes have the capacity to fill the support gap, with others offering their own experiences of managing their diabetes. These groups are not meant to replace the medical expertise that only your doctor can provide – some healthcare professionals warn that the info from these resources may not be clinically accurate. But they can help you to have more informed discussions with your health care providers.[1]

More than just a place to find medical information, Facebook groups for people with diabetes can virtually offer a real sense of community and interpersonal encouragement. It can be empowering to hear how others are really living with the daily challenges of diabetes – progress and setbacks, highs and lows – and to not feel discouraged if you are living up to the “control” exactly how your doctor wants you to. Positive peer reinforcement can be the key to motivating behavioral changes to improve diabetes management. Such groups can also offer a way to diminish some of the disparities that prohibit people from getting information or support due to economic reasons or to living in more isolated or rural parts of the globe.[2]

What kinds of posts will you find in an online diabetes support group?

  • People searching for information about topics such as medication side effects, complications from diabetes, the pros and cons of becoming a pump user and more
  • People sharing their personal stories – the trials and tribulations of living with diabetes
  • Peer support and encouragement

If you can think of a topic, there is probably a diabetes group for it; regional groups, type 1, type 2, teens, travelers, and parents. And if there isn’t a group the fits you to a tee, then you can create one yourself. Facilitating a diabetes support group can be a very rewarding and empowering experience. But it isn’t always easy. Since it is a virtual world and you can’t hear someone’s tone of voice on a Facebook post, group members can sometimes have disagreements that can feel very personal. If you find yourself in the midst of an online verbal tussle, its best to walk away from the situation before it escalates. Remember that whoever is making unpleasant comments isn’t someone who actually knows you.

The rise in the amount of Facebook support groups for diabetes and other chronic health conditions is a testament to the fact that we are truly entering Health 2.0 – the idea that people are using the internet more for health information than speaking to medical professionals. With more access to information and peer support, diabetes management will continue to become more patient-centered.

[1] Greene, J., Choudhry, N., & Kilabuk, E., et al (2010). Online social networking by patients with diabetes: a qualitative evaluation of communication with Facebook. Journal of General Internal Medicine.

[2] Barrera, M., Glasgow, E. & McKay, H.G, et al (2002). Do internet-based support interventions change perceptions of social support?: an experimental trial of approaches for supporting diabetes self-management. American Journal of Community Psychology. Vol. 30, No. 5

Cure Diabetes with What? Claims of Kitchen Counter Diabetes Treatments

People living with diabetes probably have Facebook and Twitter feeds that are inundated with posts about ways to cure diabetes. As if curing diabetes were as simple as shaking a little cinnamon on your cereal or eating a few slices of dragon fruit for lunch. Most of these remedies are geared towards type 2 diabetes and herbal remedies can help a bit, but is there any validity to these kitchen counter diabetes cures?

Cinnamon.  Some evidence suggests that adding as little as ½ teaspoon of dreamstime_xs_36663174cinnamon to your yogurt, oatmeal, or coffee (which also lowers the risk for developing type 2 diabetes) can substantially lower HbA1c levels. In turn, a lower HabA1C means a lower risk for developing other complications from diabetes such as retinopathy, kidney problems, and heart disease.[1] But before you go and take the cinnamon challenge, take it with a grain of salt. Other studies have shown no added value and too much cinnamon can increase the chance of liver damage and is risky for people taking blood-thinning medications.[2]

Okra. Delicately referred to as ‘lady fingers’, okra is a green pod veggie popular in Indian, Caribbean, and Middle Eastern dishes. It is also known to be a bit on the slimy side. The claim to fame for okra and diabetes stems from the assertion that if you soak okra overnight in a glass of Bucket_of_raw_okra_podswater and drink it the following morning it can help regulate and lower your overall blood sugar levels. Some people swear by it, but it sounds kind of yucky to me. The research conducted so far about okra and diabetes has only been on rats; there are no known human studies to-date. Okra is good for you in general as it is high in fiber and antioxidants, but be careful how much you consume if you are also taking metformin. Okra can affect the absorption of metformin in the blood stream and decrease effectiveness.[3]

Pitaya or Dragon Fruit. This exotic fruit harvested from cactus in Central America and Mexico is dreamstime_s_43683738tasty and filled with fiber which can help to stabilize blood sugar levels. Snacking on a dragon fruit can also help you to avoid spikes in your sugar after munching on meals high up on the glycemic index.[4] However the study this was based on was also only tested our little rodent friends and not on humans.

Fenugreek. A spice found in India and commonly used to flavor curry dishes, these tiny seeds have fenugreekbeen studied to lower glucose levels, improve blood sugar range maintenance, and a lower insulin resistance. You can mix the Fenugreek seeds with coffee or tea or add it in a powder form to baked goods and stir-fry. More research is needed, but it is not recommended to be consumed during pregnancy as it can cause uterine contractions.[5]

Wine! A cure for diabetes or not, this stuff is good. Red wine, white wine, or blush there are many benefits to wine drinking in moderation. A recent study found that in woman who had one glass of wine per day had a decreased risk of developing diabetes. Stick to dry wines has they tend have less carbohydrate than compared to sweeter, dessert wines and make sure to log what every carbs you consume to your Dario app.[6]

While there continues to be many advancements in the treatment of diabetes, there is still no proven cure. Seeing there may be something as simple as adding a superfood or spice to your diet to stop your diabetes can be enticing, especially during those moments when you are feeling the pangs of diabetes burnout. Whatever you try to do, discuss it with your healthcare provider to understand the risks, benefits, and medication interactions of adding supplements to your diet and diabetes treatment.

[1] http://www.readersdigest.ca/health/diabetes/kitchen-cabinet-cures-diabetes

[2] http://nccih.nih.gov/health/diabetes/supplements

[3] http://www.healthline.com/health/diabetes/okra#Overview1

[4] http://www.medicaldaily.com/benefits-dragon-fruit-6-health-reasons-eat-more-exotic-fruit-341194

[5] http://www.readersdigest.ca/health/diabetes/kitchen-cabinet-cures-diabetes

[6] http://winefolly.com/update/carbs-in-wine/

What HbA1C is really saying…

Confusion

If you are living with diabetes and looking to understand how your daily blood sugar averages over time, your HbA1C level can tell you how well you have been managing your diabetes over the past two to three months. The HbA1C test is used to both diagnose diabetes and monitor how well your diabetes treatment plan is functioning. How often your HbA1C level is tested is based on which type of diabetes you have, if you are administering insulin or other medications, and is directed by your doctor and diabetes treatment team.[1]

Unlike a normal blood sugar test that you take with your Dario that evaluates your blood sugar at that specific moment, the HbA1c measures what percentage of your hemoglobin (the protein which carries oxygen in your red blood cells) is covered with glucose. The time frame for the HbA1C is based on the life cycle of red blood cells that live for up to three months at a time before your body generates new red blood cells.[2]  In many regions the standard method of reporting an HbA1C reading is as a percentage, however other locations like the UK are starting to report A1C as mmol/L instead of the percentage measure.[3]The higher the percentage, the higher your blood sugar levels have been over the past three months.

Discuss with your doctor how many times a year you need to have your Hba1C level tested and make it apart of your treatment plan. There is nothing that you need to do to prepare for your Hba1c test. Since there is no need to fast, you can eat and drink as you normally would without affecting the results. In order to be diagnosed with diabetes, two separate tests with an HbA1C level 6.5% and above are the necessary indications. Those with an HbA1C a range between 5.7% and 6.4% can be deemed pre-diabetic. For those living with diabetes, a goal of 7% or less is a common target goal.[4] The higher your A1C level is there is an increased risk of developing diabetes complications like retinopathy and peripheral neuropathy.

The best way to keep your HbA1C level down, is to do your best over time to keep your blood sugars in their target range as much as possible. Since blood sugar level knowledge is power in diabetes management, test yourself regularly. Count those carbs and calories and adjust your insulin doses accordingly. The Dario insulin calculator really helps to take out some of the guess work in managing your insulin doses well. And since we are fans of fitness here at Dario, get in a least 30 minutes of movement daily to decrease or keep your HbA1C level.

[1] NIH (2014). The A1C Test and Diabetes. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIH Publication No. 14-7816.

[2] Mayo Clinic Staff (2013). Test and Procedures: A1C test. Mayo Clinic.

[3] http://www.diabetes.co.uk/hba1c-to-blood-sugar-level-converter.html

[4] Mayo Clinic Staff (2013). Test and Procedures: A1C test. Mayo Clinic.

Childhood Onset of Type 2 Diabetes on the Rise

T2 Child Blog

A recent and shocking buzz that pulsed across Facebook and Twitter newsfeeds in the diabetes community was the story of a three-year-old girl from Texas who became the youngest known person to be diagnosed with type 2 diabetes.  The toddler weighed in at 35 kilograms (77 pounds) and presented to her doctor with tale tell symptoms of extreme thirst and frequent urination.[1] During the last two decades, children have increasingly met the criteria for the diagnosis of type 2 diabetes. Such a diagnosis was extremely uncommon that type 2 diabetes carried the label of adult onset diabetes. Nowadays, up to 20% of all type 2 diagnoses are in children under the age of 19. [2]

Some of the signs that your child may be developing type 2 diabetes include:

  • More frequent urination
  • Increased thirst
  • Increased hunger
  • Weight loss
  • Acanthosis Nigricans – a skin condition in which a patch of very dark, velvety, and rippled skin develops under the arm, nape of the neck, or between the fingers and toes. [3]

Should you recognize any combinations of symptoms in your child, be sure to make an appointment with the pediatrician.  What has changed in the past twenty years that is making children more susceptible to developing Type 2 diabetes? Well, the same thing that is causing the number of adult type 2 diabetes cases to escalate; in general a poor diet and lack of activity which is leading to a worldwide rise in obesity.  For adults and children alike, making changes in diet and exercise can prevent or even reverse a diagnosis of type 2 diabetes, as it luckily did for the Texas toddler. If you are the parent of a child at risk of developing or diagnosed with type 2 diabetes, Dario Diabetes Management System can help you monitor what the overall picture of your kids’ meals and blood glucose measurements.

Healthy eating is key to the prevention of type 2 diabetes in youth. While parents cannot be around 24/7 to control what their children are eating, you can greatly influence your kids’ eating habits by the example you set at home. It is granted that it is not always practical to have a three-course organic, farm-raised chicken dinner ready on the table when you are working full-time and driving your kids from school to football practice to sleepovers, and study groups. However, planning ahead and taking simple short cuts to cut back on unnecessary sugar intake like no sugary soft drinks at the dinner table or simply using smaller plates to control portion size can make a big impact. If fast food or dining out several times a week is a necessity, try and pick places that have healthier options. Parents should align with each other on what foods are acceptable for their kids (sorry Mom, but Dad always bought us a box of magically delicious, marshmallow filled Lucky Charms that we had to finish by the time you came back from your work trips – he ate it too!)

As it starts to get colder in some parts of the world and are children are globally distracted by their smartphones, texting, Facebook and more it can be hard to motivate kids to get outdoors and get moving. Not only are physical activity and sport important to burning needed calories, it is also important for social and motor development in your kids. If you notice that your child is less active and gaining weight it can be a difficult conversation to have. Make sure there are no underlying medical conditions or social situations that are causing a decline in your child’s activity or an increase in their weight. It is delicate balance to talk to your child about gaining weight while encouraging positive body image. If you child’s weight is a concern, finding fun ways to exercise with them is great for bonding and motivating your child towards their health goals.

[1] http://www.iflscience.com/health-and-medicine/obese-three-year-old-youngest-known-case-type-2-diabetes

[2] http://consumer.healthday.com/encyclopedia/diabetes-13/misc-diabetes-news-181/type-2-diabetes-and-kids-the-growing-epidemic-644152.html

[3] NDEP. Overview of Diabetes in Children and Adolescents. National Diabetes Education Program (NIH).

Working Out Without “Exercise”: Five Ways to Burn Up To 100 Calories Doing Everyday Activities

Senior couple jog

Staying in shape and sticking with a fitness regime is a goal that many of us have to keep healthy and our diabetes under better management. But finding the time and motivation to hit the gym like the Incredible Hulk or a Kardashian isn’t always in reach. Everyone has their down days in their exercise routines, but if you miss the opportunity to make it to the gym or out for that 5k run, don’t give up completely. There are simple yet effective ways that you can burn up to 100 extra calories to log in your Dario doing the daily things you love to do.

Not to be Rude…But Go Take a Hike! Literally! Getting a 20 minute walk into your day can help you burn up to 100 calories.[1] If you can’t find a nice park or trail near you to walk and enjoy the outdoors, you can opt to take the stairs in your office instead of the elevator or go for walks around the block. Have a phone call that you think will take you a while? Walk and talk (just watch where you’re going, huh?)

Dance like no one is watching. Dancing is an enjoyable way to burn some calories. And you don’t have to put in any fancy footwork like the professionals from Dancing with the Stars or break it down like Beyoncé. Just pump up the volume for about 20 minutes of your favorite songs and let the music move you. Make a point to pick music that is more upbeat to help you keep your heart rate up at a level that can maximize the energy burn.

Dance again… horizontally.  Sex is an awesome way to burn calories; it just depends on how you do what you do and how long it lasts. An entertaining calculator to determine how many calories you burn during the horizontal cha-cha can be found at: http://www.sexcalculator.co.uk/

Clean the house. Definitely not as fun as the previous suggestions, but really giving your home a good scrub down is a great way to burn calories. You’ll have to clean for close to 30 minutes to burn about 100 calories[2], so pick a project like making your windows sparkle or cleaning every crevice of the kitchen. Besides burning calories, getting things in your house tidy and organized can make it easier to focus on other personal projects.

Playtime with the kids.Don’t just watch your kids play in the park while you sip a latte, have fun with them too! You’ll burn some extra calories playing catch, kicking the ball around or helping your child learn to climb the jungle gym or ride a bike. Not only will you expend more calories this way, it a great way to develop your relationship with your children and teach them the importance of play and exercise. Playing with your kids provides a fun and positive influence for both your kids and your waistline.

[1]  Redbook. “25 ways to burn 100 calories just like that”. http://www.redbookmag.com/body/health-fitness/advice/g651/ways-to-burn-calories/?slide=4

[2] Sparkpeople. “50 Easy Ways to Burn 100 Calories. http://www.sparkpeople.com/resource/fitness_articles.asp?id=1777

 

Blood Sugar, Sex, and Finding the Magic: Intimacy and Diabetes

Sex Blog Picture

It’s doubtful that the Red Hot Chili Peppers were speaking about diabetes when they wrote their 1991 hit album Blood Sugar Sex Magik, but they highlight yet another great reason why it is important to have good management of your blood sugar; Sex! Both men and women with diabetes are at an increased risk of developing sexual dysfunction, but living with diabetes isn’t the end for your love life or libido. Keeping your blood sugars in range, speaking to your healthcare providers, and having honest discussions with your sexual partner are all things you can do to keep the “magic” in the bedroom.

The number of people with diabetes affected by sexual dysfunction varies greatly from study to study, from as much as 25% to 71% of the population with diabetes being affected.[1] For both men and women, the sexual issues that occur are mainly related to diabetic neuropathy (nerve damage) and associated cardiovascular issues that affect blood flow to all parts of the body, including your sexual organs. Men with diabetes are at an increased risk of developing erectile dysfunction and retrograde ejaculation, a painful condition when semen enters into the bladder instead of exiting through the urethra. For women, common problems are vaginal dryness, painful sexual intercourse, a drop in libido and a decline or lack of sexual response.[2]

Despite the number of people with diabetes experiencing sexual dysfunction, very few people are able to broach the subject with their doctors. And sadly sometimes, even our doctors can be unprepared to have a discussion about their patients’ sexual health. Perhaps because some people are still uncomfortable in this day and age to talk about sex or because some medical professionals view sexual health as secondary to issues like too many hypos or high cholesterol. Sexual health is often put on the back burner. But it shouldn’t be! You have a right to discuss with your doctor all of your options to enjoy a happy, healthy sex life. Evaluate with your doctor all of your medications (some prescriptions, such as heart medications, can impair sexual function), medications and treatments that can help (like Viagra and lubrication), and most-importantly, getting your blood sugars in better range to avoid the sexual complications of diabetes.

Sex isn’t just physical; you also need to take into consideration the psychological components of sex. The mere suggestion or warnings about erectile dysfunction when you are living with diabetes can cause difficulties in arousal.[3] Living with diabetes your body can go through many changes such as weight gain or loss, scarring from insulin injections, and amputations. For insulin pump users, navigating sex with something constantly attached to you can be a challenge at first. The body image issues that can stem from diabetes complications can have a very real impact on your self-perception and confidence during sex and other moments of intimacy. The first step towards regaining your sexual confidence if you are feeling it lacking is to accept and love yourself for the way you are. Sounds a bit corny, but it’s true. Speaking with your partner about how you are feeling about sexual complications and body image issues is the next step; secrecy and shame about your sex life or your body will only create more diversions in bed. Remember that intimacy with your partner does not just mean sex; foster the emotional aspects of your relationship as well.[4]

Keeping track of your blood sugars and communicating are key to improving sexual health and intimacy. And yes, that is your Dario in your pocket! Monitoring your blood sugars with Dario and keeping track of their changes can help you stay healthy and feel sexy. If you are experiencing symptoms of sexual dysfunction, speak with your doctor to discuss your options. Start an open dialogue with your partner about how you can increase the intimacy in your relationship. And since we started off on a musical note, to quote Justin Timberlake, you can “bring your sexy back!”

[1] Mazzilli R., Imbrogno N., Elia J., et al (2015). Sexual dysfunction in Diabetic  women: prevalence and difference in type 1 and type 2 diabetes mellitus. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. Vol 8; p 97-101.

[2] NIH Publication (2008). Sexual and Urologic Problems of Diabetes. NIH Publication No. 09-5135

[3] Castleman, M. (2013) The Real Truth About Sex and Diabetes. Psychology Today (Online).

[4] Spero, David. (2008) Partners speak out about sex. Blog Diabetes Self-Management. (Online)