Vacation tips

TRAVEL TIPS

Whether your vacation plans involve staying close to home or going around the world –  it is important for diabetics to put as much thought into their health while traveling as planning for their trip.
D-Life offers the following tips for travel:
1. PRESCRIPTION MEDS-  take a least a weeks supply of prescription meds in your carry-on in case your luggage is lost. Any nonperishable or unbreakable items beyond a weeks supply can be packed into your checked luggage.  However when it comes to insulin storing it in your carry-on is the best way to go.

2. TRAVEL LETTER-  Today security concerns have made it more difficult for the average traveler to get from Point A to point B. For a person with diabetes, the necessary tools for diabetes management can present yet one more hurdle in the quest to get to the destination. To keep things flowing as smoothly as possible, obtain a letter from your doctor and keep it with you at all times. The letter should explain that the person has diabetes, and requires specifically listed drugs and medical supplies be available at all times. These would include blood glucose meters and testing supplies, insulin for injection, glucose tabs to treat blood sugar for example. The letter should be signed by your physician with his phone number included.

3.  TRAVEL FOOD –  Sometimes when traveling it is difficult to find healthy low carb food options.
According to Holly Clegg – author of Trim and Terrific  Diabetic Recipes.  Cheese sticks or jerky make quick but easy snacks to take with you.  Fruit is also a great choice for travel.   Berries are your best low carb option.  Fresh cut up veggies are easy to take along.  Everyone likes nuts.  Usually a handful of nuts is equal to  1/2 cup.  Portion control is important and nuts can be put in baggies ahead of time.

4.  BE PREPARED FOR LOW BLOOD SUGAR:   Remember to  take a long glucose tabs or a fast acting source of carbohydrate in the event of low blood sugars.

.**************************************************************************************************************************GAINING YEARS

Forget the fountain of youth. If you want to live longer go for a walk. An analysis of studies of more than 650,000 people calculated how exercise affected life expectancy after age 40 according to PLOS Medicine magazine.  About 10 years of follow-up of those 650,000 people showed that those who walked  briskly for 15 minutes per day, five days a week, gained an average of 1.8 years of life. Those who exercised as often but for 90 minutes at a time added 4 1/2 more years to their lives. When weight was taken into account, the researchers learned that normal weight people who walked 30 minutes per day , five days a week gained 7.2 more years of life than sedentary obese people.

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STAY HYDRATED!

With summer and hot weather in full swing it is very important to keep hydrated – especially if exercising or working outside.  West Virginia University extension service suggests fruit-infused water as a healthy alternative to juice or soda.  It is all natural with more vitamins and minerals, and no added sugar. Try some of the following recipes. Note that each recipemakes 1 gallon. The drinks are best if chilled overnight in the refrigerator.

Watermelon- Rosemary:   **  1/4 seedless watermelon   ** 2 sprigs Rosemary
Scoop watermelon directly into container. Add Rosemary and fill the rest of the way with water. Let it sit overnight.

Strawberry-Kiwi:    ** 5 strawberries.      **. 2 Kiwi
Slice the strawberries and kiwi before adding into the water to release the flavors.

Blueberry- Orange- Basil.
** 30 to 45 blueberries.  **3 Oranges. ** 9 Basil leaves
Squeeze the blueberries, quarter the oranges, and tear the basil leaves in half before adding to the water.

Pineapple Orange
** 1/4 Pineapple.        **. 1/2 Orange
Slice the pineapple. Leave the peel on  the
orange slices. You may be able to add water 2 to 3 more times before  flavor is gone.

Remember these food safety tips:  1.   Wash hands, containers, fruit and preparation services.
2. Do not mix batches. Use it up, clean the container, and make a new batch.

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QUICK FACTS ABOUT NEUROPATHY:   People with diabetes are at risk for a type of nerve damage called Diabetic Neuropathy. .  The most common form is Peripheral Neuropathy, so called because it affects the peripheral parts of the body- the hands, arms, lower legs, and feet.
Symptoms can include pain, burning, tingling, and/or numbness in these areas. However, diabetic neuropathy can affect other parts of the body, as well as causing a broad range of symptoms.

Following are some facts about Neuropathy:   1.  As many as 70% of All people with diabetes will develop diabetic neuropathy.  There are  many different types of neuropathy.  Another type is called Autonomic Neuropathy. This type can affect your heart, digestive system, and sweat glands among other things. Your risk of developing neuropathy increases with age, and with the amount of time you’ve had diabetes.

2.  Exercise has been shown to help reduce and manage the pain associated with neuropathy.
The nutrient vitamin B 12 plays an important role in nerve function, if you’re not getting enough in your diet, neuropathy can result.

3.  Fluoroquinolone antibiotics, which include Cipro, Levaquin, Avelox and Floxin i’ve been found to cause  peripheral neuropathy that may be permanent. This can happen while you’re taking the drug, or even years after you stopped taking it.

4.  Diabetic neuropathy and affect the nerves that send and receive signals in the tongue and nose, causing problems with taste and smell. Neuropathy can cause sexual dysfunction in both men and women. Nerve damage and also that the eyes, causing colors to seamless vibrant and affecting the pupils response to light.
When diabetic neuropathy affect the bladder, you may have trouble starting or stopping urination, or recognizing when your bladder is full.

5.  Studies have shown that acupuncture can provide pain relief for people with peripheral neuropathy. Massage is also helpful in treating the symptoms of neuropathy; improve circulation and stimulates healthy nerves to override the pain signals sent of the damaged ones. Metanx- A specially formulated medical food available by prescription may help some people with neuropathy.

6.  Checking your feet daily for blisters, sores, hotspots, and any other changes is a good habit to adopt.  That’s because neuropathy and reduced blood flow to the feed and slowly healing process, giving infection more time to set in. However, checking your feet is in the only thing you can do. There are also some warning signs of autonomic neuropathy that you should be aware of. Changes in your frequency and ability to urinate ; Changes in your ability to focus your vision or adjust between bright environments and dark ones; or sweating too much or too little can all indicate different forms of diabetic autonomic neuropathy.

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FROSTY GRAPES
A cool easy to make summer treat!!

Ingredients:  1 – 2 lbs of red or white seedless grapes..  One 3-ounce  sugar- free flavored Jello mix.  Lime green goes well with white grapes and cherry flavored goes well with red grapes.

Pluck grapes from their stems and rinse in a colander.  Pour the gelatin mix onto a plate.  Place grapes on the plate one handful at a time and roll around in the coated. Transfer to a pretty dish refrigerate for one hour or overnight to allow the  gelatin to set.

17 grapes = a carbohydrate serving.   Eight servings in recipe.  119 calories.

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ARE YOU DIABETIC?  THERE IS HELP AVAILABLE!!  You’re not alone living with his chronic disease. For classes, education, grants to the wellness Center, please contact Pam Francis RN CDE  at 304-813-6588 or Valerie Starcher RN at 304-822-4561.

Upcoming Wellness Expo, July 18

UPCOMING EVENTS:    July 18 2015 –  Wellness Expo at the Wellness Center parking lot from 9 am to 12 noon.  Lots of displays and information!

Also on the 18th of July-  Dr Wehner will be doing free retinopathy screenings for the community.
This will also be at the Wellness Center.

July 23 and 24th-  4th Annual Diabetic Kids camp. The camp is open to pre-diabetics – type 1’s and type 2 Diabetics. The event which is open to ages 8 to 18 will be held at the wellness center and will include speakers -arts and crafts – education and swimming.  Campers may bring a nondiabetic sibling or friend. The camp is free of charge for all participants. For more information contact Pam Francis at 304-813-6588.

DID YOU KNOW?

There are still grants available for the Diabetic exercise program at the Wellness Center.  Grants are also available for the pre-Diabetic education program.  Contact Valerie Starcher at 822-4561 for more information.

ACCORDING TO DIABETES HUB MAGAZINE:  Patients  with suspected or confirmed diagnosis of diabetes should be screened for lower extremity complications at every visit. Strong evidence suggests that  the consistent provision of foot- care services and preventive care can reduce amputations among patients with Diabetes.

Patients with diabetes and glucose that is poorly controlled have an increased risk of ulcers and wound infections.

THE TEN TOP STATES WITH DIABETES:    1.  Alabama. 2. West Virginia  3. Mississippi.
4. South Carolina.  5. Tennessee. 6.  Louisiana.  7.  Arkansas.  8.  North Carolina.
9.  Florida.  10.  Delaware

WHAT IS THE BEST BLOOD PRESSURE MEDICINE FOR PEOPLE WITH DIABETES?

Many medicines are used to treat hypertension and they all work differently. One type of blood pressure medicine is called a ACE Inhibitors. This type of medicine and help to prevent damage to the kidneys and so it is a good choice for a person with diabetes according to C-Diabetes magazine.  ACE Inhibitors make it easier for your heart to work.  They block  chemicals that narrow blood vessels in the skin help slow down the damage to the kidneys that have like glucose causes.  Talk to your Physician about Ace inhibitors and if they would be right for you.

TRAVELING WITH DIABETES

With summer time  here – many people are going on vacations. If you have diabetes you can do anything and go anywhere – it just takes a lot of extra planning according to an article in Diabetes Digest.

Before any trip asked for two things from your healthcare provider:   1.  A letter stating that you have Diabetes.  It should include a list of the medicines and supplies you need to manage your diabetes.  2.  A prescription for insulin, supplies, and any other medicines that you take.

Don’t forget! ALWAYS wear a Diabetes medical ID bracelet or necklace.

It is good to see your healthcare provider at least one month before you leave on your trip. They can check if your diabetes is well-controlled. If it is not in control you have enough time to make changes.

The rule of thumb for packing your diabetes medicines and supplies is:  Pack at least twice as much of your medicines and blood testing supplies as you think you will need.  If flying, at least half of these items should be placed on your carry-on suitcase or bag and kept with you at all times.

While on vacation you may choose to store your insulin at room temperature instead of in the refrigerator. Be sure to keep your insulin out of extreme temperatures.  A good idea would be to bring a pack is made to store insulin.

If your vacation involves a lot of walking, keep this in mind when you pack your shoes. Bring comfortable socks and good fitting shoes to avoid blisters.

Don’t forget to check your feet each night for blisters or any sore areas.

Remember to take snacks when traveling such as fruit – cheese and cracker packages and
some form of glucose tabs or quick-acting glucose to treat low blood sugar if necessary.

LEMON FROZEN YOGURT RECIPE

Ingredients:    *. 1/2 cup fresh lemon juice
*  1 1/2 cups of vanilla whole-fat yogurt
*.  2 tablespoons of agave nectar
*.  1/2 banana
*.  4 cups ice

Instructions:    1.   Add ingredients in order listed and place in a blender- securing lid.
2.   Select ice cream/ milkshake setting
3,   Serve with your favorite berries or frozen yogurt topping.

Nutrition Information:   *. Servings-  8
*  Serving Size-  1/2 cup
*. Calories-   72
*. Fat. –  1.5 grams
*. Carbohydrates-  13,5 grams
*. Fiber- 1 gram
*  Protein-  1.5 grams

DID YOU KNOW – DIABETIC FOOT CARE

If you had asked any Diabetic 50 years ago one of their greatest fears about the disease the majority would have answered ” losing a foot or a leg.”

At that time this fear was often a reality.  It could begin with a wound as simple as a blister that became infected and in the worse case scenario would progress to an amputation.

Amputations are less frequent now and this is due in large part to the emphasis on foot care and prevention.

There are several components of diabetic foot care:

1. On a daily basis look at your feet in a location with good lighting. Ask a family member to help if you cannot see.  Use a mirror if necessary.

2.  Look for dry areas/ cracks in the skin- blisters – changes in the color of the skin or swelling.

3.  Wash your feet daily with  warm not hot soap and water.  Dry well – especially between the toes.

4.  Examine your shoes daily. Shake them out in case something has fallen into them.

5.  To soften dry feet and keep the skin from cracking use a mild cream or lotion EXCEPT between the toes.

6.  If the feet sweat use a light foot powder. Wear socks that are mostly Cotten and change them when they become damp.

7.  Cut toenails straight across and smooth the edges with an emery board,

8.  Avoid “bathroom surgery” to remove corns or calluses.  Do not use a harsh antiseptic-solution or a heating pad or hot water that could burn or injure the skin.  See a Podiatrist or any foot problem.

9,  Avoid going barefoot especially on hot pavements or sand.

10.  Socks should be seamless and fit well to avoid blisters.

11.  Wear shoes that are comfortable and well fitting.  Avoid flip flops or thong sanders.
Shop for shoes in the afternoon and not in the morning.

12.  Keep the blood flowing to your feet.   Your feet up when sitting,  do not cross your legs for long periods of time.  Do not wear tight socks.   Do not smoke.  Smoking can lower the  amount of blood flow to your feet.

13.  Be sure to ask your health care team to:  Check Your Feet at each visit.  While waiting for your practioner take off your shoes and socks and ask them to check your feet.  Have a baseline foot exam done with a monofilament and then done yearly.

In April at the Hampshire County Wellness Center there will be a Foot Care Clinic held in the Lobby.  Foot exams will be done at this event.

SCHOLARSHIPS AVAILABLE- The Hampshire County Diabetes Coalition is continuing to sponsor scholarships to the Next Steps for Diabetics program at the Wellness center.  Ask for Chris there or call Pam Francis. At 304-813-6588.

May 16 2015 will be the annual Walk For Diabetes Awareness at the wellness center.  Applications will be out soon and walkers can complete the course on the honor system prior to the walk and still receive a t-shirt and be eligible for door prizes.

RECIPE OF THE MONTH.   Frozen Banana Shake with Strawberries and Tea

Makes 2 servings.  Serving size – 1 cup.   Freezing time – 2 hours.  Preparation time – 10 minutes

Ingredients:   1 medium Banana – cut into 1 inch pieces
1 bag Decaffeinated black Tea
1/2 Cup Nonfat Milk
1 cup strawberries – stemmed, hulled and washed
1 tsp stevia-sugar blend

1.  Add the Banana pieces to a large resealable plastic  bag and freeze for 2 hours.

2.  Place the tea bag in a large glass measuring cup. In a  small saucepan heat the milk over medium heat until lightly boiling.  Pour the milk over the tea bag and steep for 3 minutes.  Remove the bag from the milk discard the bag. Allow the milk-tea mixture to cool completely.

3. Add the frozen bananas, cooled milk-tea mixture, strawberries and stevia-sugar lend to a blender and nun till smooth.

Per serving:  Calories- 110.  Fat. O  Protein  3 gram.   Choices:  Fruit. 1.5

From Diabetes Forecast Magazine

DID YOU KNOW?

November is National Diabetes Month. West Virginian’s have struggled with this disease. In 2010 according to the WV Diabetes Prevention and Control Program the national prevalence of diabetes in the United States was 9.2% but in West Virginia the prevalence was 11.7%. 229,000 people in West Virginia have diabetes with over 62,000 under diagnosed.

In southern West Virginia Logan County’s prevalence of diabetes is 14.8% – the highest in the nation.

For all West Virginian’s knowledge of the disease is one of the best ways to combat it. This includes knowledge of exercise- diet – medications and potential complications.

In Hampshire County there are several agencies working together to offer education and programs to local residents, On the 4th Wednesday of each month at 1 pm at the Romney Senior Center the Hampshire County Diabetes Support Group meets. It is free of charge and offers the latest information in diabetic education.

The Hampshire County Wellness Center offers a next Step for Diabetes program featuring 8 weeks of exercise with a trainer. Contact the Center at 304-822-7255 for more information.

The Wellness Center will offer a Diabetes Awareness information with educators on Tuesday November 18th from 9 am to 11 a.m. A Registered Dietitian will be available at 11 am for questions about meals/ food.

Hampshire Memorial Hospital offers Diabetic Education classes with Valerie Starcher RN.
Contact Valerie at 304-822-4561.

The Hampshire County Diabetes Coalition is the sponsoring organization behind the Walk For Diabetes Awareness in May and the Diabetes Kids Camp in July as well as other events throughout the year.

The Hampshire County Committee on Aging has Diabetic supplies for a minimal donation. For more information contact Sandy at 304-822-2465.

WHAT’S NEW?

A DIABETIC CONTACT? Swiss drug manufacturer Novartis has struck a deal with Google to make smart contact lenses that would help diabetics track their blood sugar levels or restore the eye’s ability to focus.

The device would measure glucose levels in tear fluid and send the data wirelessly to a mobile device. The second purpose of the contact lens would be to correct nearsightedness much like a camera lens focusing. It is not known how long it will take to develop this technology nor were financial details revealed.

AN INSULIN PATCH PUMP FOR TYPE 2’S. – In a recent article in Diabetes Self Management Magazine CDE Jennifer Goldman- Levine explores one of the newest ways for insulin administration- the insulin pump that is disposable – has no tubing and adheres directly to the skin. Known as the V-GO this pump is designed for adults with Type 2 Diabetes who require insulin. The device holds fast acting Novolog or Humalog insulin.

DIABETES and HEPATITIS B: The CDC recommends vaccination for Hepatitis B because Diabetes may increase the chance of developing the disease. The CDC now recommends that the Hep B Vaccine should be given to adults with Diabetes who are between the ages of 19-59.

HOW MANY CARBS PER MEAL? A frequently asked question is how many carbs should be eaten at each meal? In general the target should be 45-60 per meal for women and 70-75 per meal for men. Snacks should contain 15-30 grams of carbohydrate.

One carb choice = 15 grams of carbohydrate. This is the amount of carbohydrate found in a small Apple – a glass of milk- 5 crackers or a small cookie.

IT’S BACK! Inhaled insulin that is. The FDA has cleared AFREZZA an inhaled rapid acting insulin for Type 1’s and Type 2’s. It is not recommended for smokers or those with lung disease. It seems to work faster than injected rapid acting insulin. The manufacturer is hopeful that it will succeed where the original and more expensive inhaled insulin Exurbera. It is smaller than the Exurbera and is expected to cost about as much as an insulin pen. However this is just for short acting insulin- long acting insulin will have to be injected.

BYDUREON – a once weekly injection is now available as an adjunct to diet and exercise to improve glycemic control in adults with Type 2 Diabetes.

For more information about Diabetes or for speaking engagements contact Pam Francis RN at 304-813-6588.

Blood Pressure goals for diabetics

DID YOU KNOW?
The American Diabetes Association recently changed its Blood Pressure goals for people with Diabetes. The top number or the systolic pressure is measured while the blood vessels are at work pushing blood through the vessels. The Bottom number or the diastolic is a measure of the heart at rest between beats.

The new goal for diabetics is 140/80. The former goal was 130/80. The Diabetes Association made the change based on a recent study that found that people with Diabetes who keep the stricter goals were no more likely to have have a heart attack or stroke than those who did nit follow the recommended goals.

CAN SMOKING CAUSE DIABETES? According to the Diabetes Self Management Magazine the US Surgeon General reports that diabetes has been added added to the long list of illnesses caused by smoking . It has now been exactly 50 Years since the landmark report by the Surgeon General that declared that smoking causes lung cancer. In the last five decades researchers have learned more and more about the health problems that smoking can cause and that over the years heart disease, bladder cancer and cervical cancer have been added to the list.
In January of this year a new list of smoking related illnesses entitled “Health Consequences of Smoking” states that smokers have a 30-40% increased risk of developing Type 2 diabetes than no smokers.

HOW IS DIABETES DIAGNOSED?

My grandfather was diagnosed with Diabetes in the 1950’s by a urine test. For years after that diabetics were diagnosed by the oral glucose tolerance test – drinking a very sweet mixture with blood work done at intervals.

Today there are four tests commonly done to evaluate whether someone has Diabetes or Pre-Diabetes as noted in Diabetes Self-Management Magazine.

1. The HEMOGLOBIN A1C – this test gives an estimate of your average blood glucose level over the past three to four months. This test is non fasting and can be done any time of the day.

A Hemoglobin A1C result of 6.5% or higher will diagnose a person as diabetic.

A diagnosis of Pre-Diabetes occurs if the Hemoglobin A1C is between 5.7 and 6.4%.

2. FASTING PLASMA GLUCOSE – for this test a person needs to not eat or drink anything (except water) for at least 8 hours before the blood sample is taken. The test is usually done the first thing in the morning before a person eats breakfast in a lab setting.

A nondiabetic normal range for this test is a blood glucose level between 65 and 99.

If the fasting glucose is between 100 and 125 – the diagnosis of pre- diabetes may be made.

If the test result is greater than 126 on two separate occasions, diabetes is diagnosed.

3. RANDOM BLOOD GLUCOSE – a random or casual blood glucose test is a check done at any time during the day, without regard to when the person last ate.

A random glucose blood level of 200 or higher indicates diabetes.

4. ORAL GLUCOSE TOLERANCE TEST

The oral glucose tolerance test (OGTT) is generally used for the diagnosis of gestational diabetes. Generally the pregnant woman fasts before the test, has her fasting blood sugar measured when she arrives at the lab, drinks a premeasured glucose solution and then has her blood sugar measured again one hour, two hours and sometimes three hours after drinking the glucose.

A blood glucose of 200 or higher at the two hour mark indicates Diabetes.

A blood glucose between 140 and 199 means a person has Pre-Diabetes.

DIABETES DICTIONARY

LATENT AUTOIMMUNE DIABETES IN ADULTS (LADA)

A condition in which Type 1 develops in Adults.

NO BAKE ENERGY BITES Recipe. From Deb Berg RD CDE –
Valley Health Diabetes Management Program

1 Cup Oatmeal. 1 Cup Coconut flakes (unsweetened preferably) 1/2 Cup Peanut Butter

1/2 Cup a Flax Seed or wheat germ. 1/3 Cup Honey. 1/2 Cup Mini- Chocolate Chips

Mix the dough – then refrigerate for about 1/2 hour – then roll into small balls.

Serving Size: 2 bites. 83 calories. 18 grams of Carbohdrate

5 recommended tests for Diabetics

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The Joslin Diabetes Center in Boston Massachusetts is one of the best and oldest teaching facilities for diabetes education in the United States.

In their booklet ON THE ROAD TO LIVING WELL WITH DIABETES there are 5 tests recommended that all Diabetics should have done on a regular basis. Not being in range on the results of these tests doesn’t make the individual a bad diabetic but instead should be seen as being like a smoke alarm – they can detect danger and warn you that you need to take action.
Acting on the results can lower your risks for complications.

The five tests are: 1. The A1C test
2. Blood Pressure Check
3. Microalbumin test
4. LDL Cholesterol test
5. Eye exam

THE A1C TEST

This is the most important test for a diabetic. Also called the Glycated Hemoglobin test – it is a non fasting blood test that gives a picture of your average blood sugar over a 3-4 month period.

Checking your blood sugar at home shows your blood sugar at the time it is taken- like a snapshot. The A1C gives the long term picture of how well your diabetes care is working.

A Target number for the A1C test is 7 or less. If it is higher than 7 then your blood sugar levels are too high and action is needed!

Action to lower the A1C would include being more active- following a meal plan- checking your blood sugar daily and adjustment if diabetic medications.

The A1C should be checked every 3 months if it is not within range and twice yearly if the target is being met.

Lowering the A1C number will help prevent eye, kidney, and nerve problems. Every one point drop reduces your risk by half.

The A1C is now being used to diagnose Diabetes. Two separate A1C tests with a result of 6.5 or greater can indicate that the person is diabetic.

THE BLOOD PRESSURE CHECK

Many diabetics have hypertension or high blood pressure as well as other cardiac complications.

Diabetics are twice as likely to have a heart attack or stroke as non-Diabetics so it is important to check your blood pressure regularly before complications occur.

Blood pressure officially be checked once a year but it is a good idea to have it checked regularly.

The target number for blood pressure according to Joslin is 130/80. However in January of this year the American Diabetes Association changed the recommendation to 140/80.

Action that be taken to lower blood pressure include becoming more active- losing weight- stopping smoking and started blood pressure medications.

THE MICROALBUMIN TEST

This is also one of the most important tests for Diabetics as it shows how well your kidneys are working. This is a urine test that can be done at your Doctor’s office or a clinic.

This test measures the amount of protein or albumin in the urine. Protein should not be detected in the urine. It’s presence is the first warning sign of kidney disease. If caught in the early stages it is very treatable .

The target number for the Microalbumin test is 30 or lower. The test should be done at least once a year. It is very important to know your number. Action needs to be taken promptly if your number is higher than 30- without treatment your kidneys can be damaged.

Actions to lower or slow kidney problems would include keeping the A1C and blood sugars levels in target level, keeping blood pressure under control, and talking to your Doctor about medicines called Ace Inhibitors which can protect the kidneys and keep your microalbumin from rising.

THE LDL CHOLESTEROL TEST

This test measures the amount of fat in your blood. Cholesterol is made in the liver and can come from food.

The two main types of cholesterol are the HDL ( the “good” kind that protects against heart disease) and the LDL ( the “bad” kind that can damage your heart)

The LDL in your blood sticks to the walls of the arteries, clogging them and preventing blood from flowing freely. This can lead to heart attacks, strokes or other circulatory problems. But treatment can lower the LDL.

The LDL test should be checked at least yearly.

The target for the LDL test is 100 or lower, A number higher than 100 means that you and your Doctor need to take action,

Action to lower the LDL includes increasing you activity level, keeping your blood pressure at or near target range, stop smoking, losing weight, eating less saturated fat ( meat and dairy products) and discussing with your physician the need for a statin medication to lower the LDL cholesterol.

THE EYE EXAM

Having diabetes can put a diabetic at high risk for serious eye problems. Diabetics can have cataracts , glaucoma or diabetic retinopathy involving the tiny fragile blood vessels of the eye.
Any one of these can result in vision loss or blindness.

Some Diabetic eye disease show no signs or symptoms until there is a problem. However early discovery and treatment can prevent or stop most of these problems.

The eye exam should be done at least once a year and the eye should be dilated- with drops to enlarge the vessels so they can be examined.

Action to lower the risk of diabetic eye disease would include keeping your A1C and blood sugar levels in the target range, stop smoking and having the yearly eye exam.

OTHER EXAMS

Other exams that are of benefit to diabetics would include a dental exam every 6 to 12 months and a foot exam by a Health Care professional at least yearly,

Prevention is an important part of diabetic management.

DID YOU KNOW?

The Hampshire County Diabetes Support Group meets monthly on the 4th Wednesday at 1 pm at the Romney Senior Center.

There are still scholarships available for the Diabetic Exercise program at the Wellness Center. The scholarships are sponsored by the Hampshire County Diabetes Coalition. A MD referral is required for the program. To apply for the scholarship contact the Wellness Center at 304-822-7255.

Applications are available for the 6th Annual Walk For Diabetes Awareness. The walk is May 17th OR CAN BE DONE ON YOUR OWN after registering. The cost is $10 and each participant will receive a t-shirt. Call Pam Francis at 304-813-6588 for more information.

MOVING ON program offered at Hampshire Wellness Center

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DID YOU KNOW?

The Hampshire County Diabetes Coalition is offering 5 scholarships to the MOVING ON program at the Hampshire County Wellness Center.  This is an 8 week program for diabetics that provides a personal trainer and an exercise program.  For more information contact Pam Francis at 304-813-6588 or Chris at the Wellness Center at 304-822-7255.

Use EXTEND nutritional snack bars?  Need a coupon?  Contact Pam Francis Diabetes Educator for one.  Also available are coupons for Chobani Yogurt.

According to Endocrine Today- Stephan Martin MD of the West German centre For Diabetes and Health found that diabetics who participated in a 12 week interactive exercise video program improved  their blood sugar and quality of life.  The study which used Nintendo’s Wii Fit Plus showed also that “Exercise games may potentially be used in a home setting as a tool to reduce inactive behavior in people with Type 2 Diabetes.”

UPCOMING EVENTS

The 6th Annual  WALK FOR DIABETES AWARENESS will be held on Saturday May 17th 2014 at the Hampshire County Wellness Center.  The 2 mile Walk will begin at 9 am.  All participants will receive a t-shirt and an educational packet.  Door-prizes will be given on the day of the Walk.
Registration will be $10.00 per person or $30.00 for a team of 5.   New this year will be the opportunity to register and then walk independently beginning April 17th the 2 miles using the honor system. If registered the participant will receive a t-shirt and be eligible for the door prizes on the day of the walk.  For more info contact the Wellness Center or Pam  Francis.

The 4th Annual Diabetes Kid Camp will be held on July 24 and 25th beginning at 9 am.
The Camp is open to Type 1- Type 2 and Pre-Diabetics ages 8 to 18.  For more information or for an application contact Pam Francis.

DIABETIC DICTIONARY

Gestational Diabetes Mellitus- a type of diabetes that develops only during pregnancy and usually disappears upon delivery, but increases the risk that the mother will develop diabetes later in life.

A DIABETIC LOVE STORY

Eva Saxl was born in Prague Czechoslovakia in 1921.  She married her husband Victor, a scientist- at age 20. World War 2 broke out and she and Victor fled to  Shanghai  China.  It was shortly after that Eva was diagnosed with Type 1 Diabetes.  When the Japanese attacked Pearl Harbor in 1941 security was tightened and Eva soon had no access to insulin. When her supply ran out there would be no more to purchase.
Victor – desperate to save the life of the woman he loved decided to do the unconventional – make his own insulin.  A Chinese chemist lent them a small laboratory and it was there that Victor learned to extract insulin from the pancreas of  a water buffaloes.  After much work- using a medical book as a model -he developed  a brown colored insulin.

With time running out and no other choices the day came when Victor was forced to try the brown insulin on his beloved wife.  He was so tense that he had to leave the room as they waited to see if there would be a fatal reaction to his  homemade brown insulin.

The results were amazingly successful.  Eva could not believe how well she felt.  2 patients at a local hospital were given the insulin woke up from a diabetic coma and did
well.
With his new insulin perfected, Victor manufactured insulin for all people with diabetes I in the Shanghai ghetto.  In all 200 people survived by using the dark colored insulin- each coming to the lab daily to receive an injection.

Eva and Victor  left  Shanghai  after the war and immigrated to the United States. She became a spokeswoman for the American Diabetes Association and Victor worked for the United Nations.
During the 1940’s and 1950’s the general public was misinformed about diabetes and there was a real stigma attached to the disease. Most diabetics tried to hide the fact they had the disease.
Eva Saxl was a pioneer in  educating  the public about diabetes and the true facts about the disease.  She appeared on television- did speaking engagements and even met with the President.

When Victor died she moved to Chile where her only sister lived.  For the rest of her life she devoted herself to diabetic education.  Hers was a life well lived – possible only by the love of her husband who risked all to develop the insulin that saved her life.

COPING WITH THE STRESSES OF THE SEASON

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D-Life offers some tips for making it through the Holiday season with sanity and blood sugar intact:   1.  SHOP STRATEGICALLY:  -Plan ahead and start shopping early to avoid the stress of the mall and crowds.  Stress  = increased blood sugar levels   2.  SNACK SMART:  When you are out on long shopping excursions – bring healthy snacks along and avoid the food court.  Small frequent meals are best for keeping your energy and blood sugar in a comfortable zone.   3.  GIVE THE GIFT OF HEALTHY FOOD:  Treat your host or hostess to a tasty low-care or sugar-free dish at the next holiday party you attend.    Chances are that more than one health conscious guest will appreciate you for doing so.   4. HAVE A ROAD MAP FOR DIABETIC EMERGENCIES:   If planning to travel – develop a plan for doing so.  Call ahead for any airline – trains or cruises and discuss your needs and preference to make sure the food that you want is accessible.  Bring snacks and plenty of medication in case of unforeseen delays on the road – rails or air.    5.  WRAP UP A CURE –  Shop for and help Diabetes advocacy groups  to help find a cure.

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DID YOU KNOW?    DIABETES AND SURGERY:    According to Diabetes Living Magazine – if you are scheduled to have surgery – talk with your Doctor `about your blood glucose levels.  Surgical site infections are the most common hospital acquired infection in surgical patients and people with diabetes are at a higher risk that people who do not have diabetes.  Keeping blood sugar levels between 80-110 mg/dl during the first 48 hours after surgery has been shown to reduce infection.
It is also very important when facing surgery or any outpatient procedure to let your Health Care Providers know if you are on Metformin (Glucophage).  This would include dental surgery and would also include any x-ray procedure in which dye is injected. You may need to stop taking metoformin  before the procedure and wait 48 hours to restart treatment.  Your Doctor will give you exact instructions.  Metformin  has the potential to cause a life threatening illness called lactic acidosis so make your provider aware.
THE HEALING POWER OF SILVER AND COPPER::
Wounds in diabetic patients are a concern because of the difficulty in healing them.  The worse case scenerio in a Diabetic patient is a small wound that leads to an infection and amputation of a limb or part of a limb.
For years Home Helath or Wound Care Nurses recognized the positive efect of silver on a wound.  Burns have been treated for years with a silver ointment that looks like “white icing” known as Silverdene
But in recent years wound care specialists have found that silver in a gel form is extremely effective in treating bacteria at the level of the wound bed.  Specialists have found that Antibiotics by mouth are not nearly as effective as treatment of the wound bed. As a result some companies have started to seel socks that have very small amounts of silver interwoven in them.  These socks combat not only bacteria in a wound but also can help with yeast and fungus – other problems that affect Diabetics.
Recently a company called Cupron has developed a pair of socks that has copper woven in the fabric as a preventative for Athlete’s foot and other fungal infections.
Check the internet for companies that sell them
The HAMPSHIRE COUNTY DIABETIC SUPPORT GROUP  meets monthly at the Romney Senior Center on School street.  It is the 4th Wednesday of each month at 1 pm.   For more information call Pam Francis RN Diabetic Educator at 304-813-6588.
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DIABETES DICTIONARY:
A1C:       A test that measures a person’s average blood glucose over the past 2-3 months.  Hemoglobin is the part of the red blood cells that carries oxygen to the cells and joins with glucose in the blood stream/  This test should be done twice yearly if within range and every 3 months if not.  To be in range results should be 7 or less.
BETA CELL:      A cell that makes insulin.  Beta cells are located in the islets of Langerhans in the Pancreas
CALORIE:   Food energy that animals including humans derive from their food..
About 3500 calories equal a pound of body weight.  So to lose a pound a week you would have to decrease 3500 calories from your regular intake for the week
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PORTIONS CAN DECEIVE?
Often we feel that if we eat portions that are smaller it will also mean the food has less calories and carbohydrates.
One example where this is not true is a small pan/individual meat lovers’ pizza.  One of the 6 inch pizza’s with pepperoni – ham or ground beef is a big calorie and fat bomb according to Dietitican’s with Academy of Nutrition and Dietitics.   And lower calories is not an option as they contain about 830 calories.
To burn off one of these pizzas you would have to :  1.  Shop for 5 hours and 8 minutes
2. Bike for 3 hours and 5 minutes  3.  Cook for 4 hours and 38 minutes   4.  Walk for 2 hours and 48 minutes  or 5.  Do jumping jacks for 1 hour and 31 minutes.
Next time to make it healther:  1.  Pick just one meat  – ham would be the better choice.
2. Use the Mushroom trick:  To satisfy a meat craving – order mushrooms instead.  These vegetables will fill you up and deliver the same meaty texture..
3.  Think thin (crust) – Thick crusts are always higher in calories.  The thinner the better.
4.  Go easy on the cheese.  Ask for half the cheese or order without cheese and sprinkle on afterwards.
5.  Stick with Veggies – this slashes almost 300 caloreis – cuts the fat in 1/2 and the sodium content by 40%.
6.  Eat salad first.  You will most likely eat less slices
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QUOTE OF THE MONTH:
Well controlled Diabetes is the leading cause of ……..nothing!
Dr William Polonsky – Diabetess Behavioral Institute
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WANT TO MAKE HEALTHIER CHOICES?
Western Maryland Health Systems offers a guided tour of a local supermarket by a Registered Dietitian.  She will show you how to read labels and shop for healthy choices.
Tours are scheduled regularly and they are free!  For dates of upcoming tours – you can call them at 240-964-2302 or visit www.wmhs.com
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HEPATITIS B AND DIABETICS
The Center for Disease Control (CDC)  recommends vaccination against Hepatitis B because having Diabetes may increase the chances of getting the disease.  Because Diabetes affects the immune system Hepatitis may affect the Diabetic.  The CDC now recommends that unvaccinated adults with Diabetes who are between the ages of 19-59 to have the Hep B vaccine and Diabetics age 60 or older to have the vaccine as determined by a Healthcare provider.
HOW MANY CARBS PER MEAL?   This is one of the most frequently asked questions as a Educator that I receive.  In general the target should be 45-60 carbohydrates per meal for women and 60-75 per meal for men.  Snacks should contain 15-30 grams of carbohydrate.
One carb choice = 15 grams of carbohydrates.  The is about the amount found in – 1 small apple – 1/2 cup of mashed potatoes – 5 crackers or 1 small chocolate chip cookie

2014 UPCOMING EVENTS

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May 17th-  Walk For Diabetes Awareness at the Hampshire County Wellness Center.

July 24th and 25th – the 4th annual Diabetic Kids Camp.  Open to any pre-diabetic -Type 1 or Type 2 diabetics ages 8 -18.

For more information about either event contact Pam Francis at 304-813-6588

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DIABETIC DICTIONARY:        RULE OF 15 –  A conservative way to treat hypoglycemia or low blood sugar.      If the blood sugar goes low or if symptoms of low blood sugar occur then:
1.  Take in 15 grams of a simple carbohydrate serving.  2.  Wait 15 minutes.    3.  If after 15 minutes the blood sugar remains below 70 or symptoms of low blood sugar remain – then take another 15 grams of carbohydrate.  Once the blood sugar comes up then follow with a meal or a snack that contains a protein -a fat and a carbohydrate.

What is low blood sugar?  By definition it is a blood sugar of 70 or below.

What is a 15 gram  serving of carbohydrate?  This could include 1.  8 ounces of milk  2. 1/2 cup of juice or regular soda. 3.  4 glucose tabs or  5. A tube of glucose gel.

Will a candy bar raise my blood sugar just as well?    While a candy bar will increase the blood sugar – it is not ideal because candy contains fat which will provide a slow rise in the sugar not the rapid rise that is needed to prevent a crisis.

————————————————————————————————————–November is  National Diabetes Month  – a time for raising awareness of this disease that affects so many.  Some recent statistics on Diabetes :  ** Nearly 26 million children and adults in the United States has diabetes.    ** Another 79 million Americans have pre-diabetes and are at risk for developing Type 2 Diabetes. **  the American Diabetes Association estimates that the total national cost of diagnosed diabetes in the United States is $245 billion.

Certified Diabetes Educators ( CDE’s ) are health care professionals – nurses- dietitian – pharmacists or exercise physiologists who are specialized in diabetes education and care management.  Currently there are around 15,000 CDE’s in the United States.

Diabetes Education focuses on 7 Self-care behaviors recommended by the American Association of Diabetes Educators (AADE) as essential for improved health status and greater quality of life.

1.  Healthy Eating
2.  Being Active
3.  Monitoring
4.  Taking Medicine
5.  Problem Solving
6.  Healthy Coping
7.  Reducing risks

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DID YOU KNOW?  There is no longer a “diabetic diet” or a “one size fits all eating pattern” for all adults with diabetes.  Though many health care professionals may not be aware of this – the concept of a diabetic diet went out with the 1994 American Diabetes Association Dietary guidelines 20 years ago,

Do you have Type 2?

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DID YOU KNOW
West Virginia had the highest prevalence of adult diabetes in 2012 and Alaska had the lowest rate according to the Robert Wood Johnson Foundation.  In West Virginia 13% of adults had diabetes last year as compared to 7%  for Alaska.

Type 2 Diabetes Risk

The exact causes of Type 2 diabetes aren’t completely understood but it is known that there is a strong family or hereditary component.  According to Diabetes Life individuals who have a parent or sibling with Type 2 Diabetes have a 7-14% chance of developing the disease.

The following Quiz can be used to determine the risk of developing Type 2 Diabetes:

1.  I am overweight or obese. (a).Yes (b).No

2.  I have a parent, brother, or sister with diabetes. (a).Yes (b).No

3.  My family background is African American, American Indian, Asian American, Pacific Islander or Hispanic American/Latino. (a).Yes (b).No

4.  I have had gestational diabetes or I have given birth to at least one baby weighing more than 9 pounds.  (a).Yes (b).No

5.  I am fairly inactive,  I exercise fewer than 3 times a week.  (a).Yes (b).No

6.  My cholesterol levels are not normal. My HDL cholesterol (good cholesterol) is 35 or lower, or my triglyceride level is 250 or higher. (a).Yes (b).No

7.  My blood pressure is 140/90 or higher, or I have been told that I have high blood pressure. (a).Yes (b).No

According to the National institute  of Health (NIH) one or more Yes answers indicate that you might be at risk for Type 2 diabetes. The NIH recommends that people over age 45 should consider getting tested for diabetes, and the American Diabetes Associates (ADA)  suggests a routine test every 3 years for those over 45 especially if they are overweight , or for those under 45 if they are overweight and have at least one other risk factor.

iCookbook Diabetic now available for download for free! This can be used for iPads – iPhones or the iPod touch. It is available at the App Store.  This App contains 500 delicious diabetes-  friendly recipes as well as nutritional in formation and health related articles force opel with diabetes.

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