Hydrate and Refuel: Best Low-Sugar Sports Drinks

There are many sports drinks on the market that promise numerous health benefits but come with a price tag and are loaded with calories and sugar. As people living with type 1 or type 2 diabetes, we are mindful of what we are eating and drinking. Often times we are looking for a drink that can help give us a boost of energy before we exercise or one that will replenish us after a rigorous workout. The last thing we want is to mess with our blood sugar after doing something good for our body, so a drink with minimal sugar is ideal.

To give you an idea of what these so-called sports drink typically contain, regular Gatorade has 140 calories and 34 g carbs in a 20-oz bottle; yet it is the most popular sports drink on the market. However, high-carb drinks will make the absorption of fluids take longer. Opting for a lower-carb alternative will help hydrate you quicker. Make sure you read labels and pick a drink that fit with your own personal health goals.

Here are some of the sports drink I found with the lowest sugar and the most health benefits:

Photo credit: Propel Water

Propel

By the makers of Gatorade, this brand has quickly become a fan favorite. It is a great option for many because it contains zero grams of sugar and zero calories. This drink can be beneficial both pre- and post-workout and is packed with electrolytes and vitamins. While some may shy away from it due to artificial flavors, they offer an unflavored version as well.

You can purchase Propel at many grocery chains, including Walmart, Target, and Kroger. You can find a store near you using their store locator.

Photo credit: Gatorade

Gatorade Zero Sugar Thirst Quencher

This drink comes in four tasty flavors-glacier cherry, orange and lemon-lime. With just 5-10 calories and zero sugar per serving, this is a delicious option that will fuel your body and hydrate you too.

You can look specifically for this product on their website to find out where it is sold by you.

Body Armor

Photo credit: Body Armor

Body Armor Lyte

The secret ingredient to this refreshing sports drink is that it contains 10% coconut water. It comes in a variety of flavors, including blueberry pomegranate, peach mango, orange citrus and coconut. This drink delivers 200% of your daily recommended dose of vitmains B3, B5 and B12 as well as vitamins A, C and E to help you refuel. This drink is also packed with potassium and is a great option for those looking for a low-sugar drink that delivers multiple health benefits.

I have seen this product in Target but be sure to check their store locator to find a store near you.

Nooma

Photo credit: Nooma

Nooma Organic Electrolyte Drink

Made with organic coconut water and sea salt, and loaded with electrolytes, potassium and sodium, Nooma will be sure to keep you hydrated through your workout. Each drink is organic and non-GMO with only 30 calories and 5 grams of sugar, all of which come naturally from the coconut water. Nooma comes in five great flavors- blueberry peach, mango, watermelon lime, lemonade and chocolate mint. All have no artificial ingredients or sugar added.

You can purchase Nooma Organic Electrolyte Drink at Amazon starting at $29.99 for a variety pack of 12 16-ounce bottles or directly through their website, where shipping is free if in the United States!

Nuun Life

Nuun Sport: Electrolyte Drink Tablets

Nuun Sport created an electrolyte-rich sports drink tablet that is packed with electrolytes, and is low-calorie and low-sugar. There are no artificial flavors or sweeteners (uses high-quality Stevia) and is keto-friendly and gluten-free. Nuun’s Drink Tablets come in four tubes of 10, with each tube containing one of the following tasty flavors: Lemon Lime, Tri-Berry, Citrus Fruit, and Orange. These tubes are extremely easy to take on-the-go and make staying hydrated super easy.

You can purchase Nuun Drink Tablet’s on Amazon or directly through their website where you can by individual tubes as well.

BCAA

Photo credit: Celsius

Celsius BCAA + Energy

This brand keeps on gaining traction, likely due to the great taste and price. With 200 grams of caffeine, this drink is a refreshing alternative to tea or coffee and ideal for both pre and post-workout. Celsius BCAA + Energy has zero sugar and contains no artificial flavors, colors or preservatives. It comes in 3 flavors: Sparkling Tropical Twist, Sparkling Tart Cherry Lime, and Sparkling Blood Orange Lemonade. This drink is made with a blend of branched-chain amino acids (BCAAs), tart cherry, vitamin D3, electrolytes and caffeine, to reduce inflammation and will also help to replenish your body during and after a rigorous workout

You can purchase Celsius directly off their website or use their store locator to find a retailer by you. I was surprised to see so many drugs stores and grocery stores carrying this product.

Photo credit: Powerade

Powerade Ultra

Powerade Ultra helps to build strength and muscle as it contains both creatine and BCAAs. Since amino acids are the building blocks of protein, they are essential for new muscle growth. And supplementing with creatine, you can help aid muscle growth as well. This product contains zero sugar, and is available in Mixed Berry, White Cherry and Citrus Blast flavors. These drinks are sure to keep you hydrated and give you energy while helping you make progress in the gym.

You can purchase Powerade Ultra on their website or use their store locator to find a retailer by you.

When choosing a sports drink, consider your nutritional goals, fitness level and energy needs. All the sports drink mentioned above will hydrate your body and replenish the minerals lost, without adding back the calories you just burned. And even better, none of them will mess with your blood sugar!

Do you have any low-sugar sports drinks that you love? Share and comment below!

Source: diabetesdaily.com

How to Handle Halloween for Children with Diabetes

It’s that time of year again: the leaves are falling, the temperatures are dropping, and all things scary and spooky are on store shelves. While pumpkin picking and catching a hay ride are (for all intents and purposes) “low carbohydrate” activities, trick-or-treating can be anything but. So, how do you handle Halloween with a young child with diabetes? Do you allow them to “be a kid” for an evening, and go all out on the chocolate and sugar spike? Or do you limit them to a few, portion-controlled treats, with a food scale nearby? While there’s no one right answer to this question, here are some helpful tips to make your Halloween a little less spooky this year.

Take the Focus Away from Food

This is helpful for all children, for all holidays. No holiday needs to be 100% about the food, especially for a child with diabetes. For Halloween specifically, focus on carving pumpkins, watching scary movies, dressing up in really elaborate Halloween costumes, and yes, if you and your child wish, some candy, too.

Noelle from California says, “Our kiddo is three so our main focus is on creating traditions that will be helpful for her later on with type 1. For parties, I create treats that aren’t food-related.”

Lila from New York City says, “We completely avoid the candy thing. Trick or treating isn’t a huge deal in our neighborhood, so this hasn’t been an issue yet.”

Kate, from Pennsylvania, says, “We go out a little, but limit the number of stops. After we get home, we go through our candy, keeping only what we really, really like. The rest, we give to the Switch Witch, and she brings the girls a little present in the morning as an exchange for giving her their candy.” There’s even a book you can buy that helps explain the magic of the Switch Witch.

Create Unique Traditions

Perhaps you have a spooky, scary dance party or movie night on Halloween, or the whole family dresses up in matching costumes to go walking around the neighborhood. Maybe you bob for apples or roast pumpkin seeds after carving, or let your child have a few friends sleepover. Creating unique family traditions that are inclusive will be beneficial not only for your child now, but will be helpful as they grow up with type 1 diabetes.

Be Wary About Restrictions

Be cognizant about putting too many restrictions on candy for your child. Children with diabetes are much more likely to develop an unhealthy relationship with food. If your child really wants to indulge, just make sure they’re carbohydrate counting appropriately, and let them enjoy themselves (within moderation, of course). Most of the time children intuitively eat anyway, and don’t actually end up eating that much candy.

Melissa, from Iowa, says, “We bring any candy home and carb count it ahead of time, and then put a post-it note on each piece, so our daughter can dose appropriately whenever she’s hungry or wants a treat.”

Plan Ahead

Like all things diabetes-related, it helps to plan ahead. Make sure your child eats dinner with some protein and fat before going trick-or-treating, so they’re not just eating sugar on an empty stomach, which can cause the roller coaster effect. Make sure you know where and how far they’ll be walking, or better yet, walk along with them. Have your child carry low snacks (they shouldn’t solely rely on candy that won’t have any nutrition facts or carbohydrate information on it), and make sure they’re drinking plenty of water. It’s helpful if your child also has fresh continuous glucose monitor (CGM) and insulin pump sites on, but not absolutely necessary.

Hannah says, “Planning ahead a learning to navigate holidays with type 1 diabetes is critical and so empowering once you find what works for you and your family.”

Don’t Stress the Small Stuff!

It’s important to remember that Halloween is only one night, and you shouldn’t stress the small stuff. Some parents of children with diabetes shy away from candy, while others let them indulge, and there is no one right answer. Do what works for you and your family, but don’t let the stress of one holiday ruin the evening for you and your child. Relax and let them have fun! They’ll be doing so much running around anyway that you’ll be glad they had the extra “low snacks” on them anyway.

Lija, from Minnesota, says, “We don’t do anything different for my type 1 and non-type 1, and it works out fine. We find that she tends to go low while out trick or treating, so she just eats and boluses a little while out; it isn’t actually a difficult holiday for us!”

The key is finding what works for you. There are no right or wrong answers. Here’s to a happy, spooky Halloween! Hopefully the candy (and subsequent blood sugars) are the least scary part.

How do you and your family handle Halloween in a household affected by diabetes? What tactics and strategies have helped you manage appropriately? Share your experience in the comment section below; we love hearing from our readers!

Source: diabetesdaily.com

What I Wish People Knew About Type 3C Diabetes

This content originally appeared on Beyond Type 1. Republished with permission.

By Jen M.

What do you think of when you think of a diabetes diagnosis story? It could be a type 1 diagnosis story when someone experiences diabetic ketoacidosis (DKA) symptoms and gets admitted to the hospital. It could be a type 2 diagnosis story of someone diagnosed through blood work at a routine doctor’s appointment. My story is a little bit different.

I am a type 3c diabetic. Most people I converse with have never heard of my type, and that’s okay. Since my diagnosis, I have found a passion for educating the general public and the diabetes community about type 3c and what life is like living without a pancreas.

You read that right, I don’t have a pancreas at all!

In December 2015, I woke up with severe abdominal pain. At first I thought it may have been a stomach ache and tried to rest. As the day went on, the pain continued to get more severe. And when I say severe, I mean the worst pain I have ever felt. It is difficult to even put the experience into words. I was visiting my parents for Christmas and my mom drove me to the local emergency room. What I thought would be a quick trip turned into a 4 week stay. I was diagnosed with pancreatitis and they spent those weeks trying to get the pain under control and figure out why this was happening.

The journey to figure out why I, a 25 year old with no family history and no alcohol use, was having repeated episodes of pancreatitis took about 7 months. I was in and out of the hospital every few weeks with recurring flares. I’ll spare all of the details, but it was finally determined that I had two genetic mutations in the SPINK gene and the CFTR gene. The combination of these gene mutations explained why I had chronic pancreatitis. I consulted with several doctors at different hospitals and they all agreed that the best plan of action to improve my quality of life would be to perform a total pancreatectomy.

I had my surgery on February 2, 2017, a little over 1 year after my first diagnosed pancreatitis flare. The surgery is called a total pancreatectomy with autologous islet cell transplant (TPAIT). The surgeon removed my pancreas, spleen, gall bladder, duodenum, and lower portion of my stomach. As people with diabetes know, insulin is incredibly important, so in an ideal case, the surgeon would remove the pancreas and isolate the islet cells from the pancreas and transplant them into my liver. According to my surgeon, 36.9% of patients in his research studies became independent from insulin after islet transplant. Hearing this before surgery made me optimistic, however there was extensive damage and calcification to my pancreas when they removed it and the islet cell yield made my transplant unsuccessful. I have been fully insulin-dependent since the second my pancreas was removed from my body.

So I want to explain briefly exactly what type 3c diabetes is. It is referred to as “pancreatogenic” diabetes, which means diabetes that results from a pancreatic condition. Examples of pancreatic conditions could be exocrine insufficiency, pancreatitis, cystic fibrosis, pancreatic cancer, or partial or total pancreatectomy. As you can imagine, it is a complex condition that is not widely researched or even recognized by many medical professionals. After asking my close TPAIT friends, most of us don’t even have the diagnosis of type 3c in our charts, because insurance won’t cover devices and supplies under that diagnosis code. Most of us have type 1 diabetes as our chart diagnosis, an entirely different autoimmune condition.

Type 3c may have similarities to type 1 due to the fact that both conditions require insulin, but that’s the only similarity. There are a few big differences to note. With TPAIT related type 3c specifically, since our pancreases are completely removed we have no alpha cells. In the most simplified definition, alpha cells secrete glucagon, which works opposite to insulin by increasing the amount of glucose in the blood. Without these alpha cells we are at risk for “brittle” diabetes and large swings in our blood sugar. Another big difference between TPAIT type 3c and other types is the malabsorption issues that we can face after surgery. Since we have large portions of our digestive systems removed, including the lower stomach and duodenum, the way our food and nutrients are digested may impact our insulin needs.

The pancreas has both endocrine and exocrine function. The endocrine function is secreting hormones, such as insulin, into the blood and the exocrine function is secreting digestive enzymes, bicarbonate, and water into the duodenum to begin the digestion of food. Most type 3c diabetics require prescription digestive enzymes when eating. Pancreatic conditions typically affect the exocrine function of the pancreas so we have to supplement these enzymes to aid with digestion. Without the proper dosage and timing when taking the capsules, we cannot properly digest food and can face serious gastrointestinal complications and malabsorption of nutrients.

When it comes to the diabetes community, there is not a large representation of people with type 3c. Type 3c is rare and often misdiagnosed. When someone is suffering from a pancreatic condition and they develop diabetes as a result, doctors often just call it type 2. I imagine this is due to a lack of information, research on type 3c, and insurance coverage.

There are a few things that I wish people knew when it comes to type 3c. The most important to me is that, when you have diabetes alone, your pancreas isn’t “dead”. The pancreas is often referred to as dead or useless in the diabetes community. Using these terms is false and misleading.

Endocrine cells make up 5% of the overall pancreas. Diabetes is an endocrine disease, and diabetes doesn’t necessarily mean you have zero pancreatic endocrine function. Many people with type 1 diabetes may have functioning alpha cells (producing glucagon) because the initial autoimmune attack is limited to the beta cells of the pancreas. Exocrine cells make up the other 95% of the pancreas, and for people with type 1 diabetes and no other pancreatic condition, this function is still working smoothly. Both endocrine and exocrine functions are vital in their own way to the body. Your pancreas could be considered “useless” if you are missing both of those functions. In any other context, it spreads misinformation.

I feel that most people with diabetes, of any type, want the general public to better understand our condition. We want them to understand the differences between the types. We want them to understand what causes or doesn’t cause diabetes. If that’s the case, why would we want to give them misinformation in the process? It’s not helping society understand diabetes. It’s not helping people with diabetes to understand diabetes. I honestly think that some people who say their pancreas is useless believe it to be true, because it’s what they’ve heard others say. And I know the diabetes community can do better to help educate within our community and also to the general public. I know the type 3c community would appreciate being recognized and validated. We haven’t had many opportunities to have our voices heard from large diabetes organizations or within the community. I know I will never stop using my voice to advocate for us. I can only hope to have the support of the diabetes community behind us.

Source: diabetesdaily.com

Flying with Diabetes During COVID-19

While not currently especially recommended for people living with diabetes, air travel is sometimes necessary, and people with diabetes will inevitably have to fly from time to time (for work, a funeral, or a family or medical emergency) during the current COVID-19 pandemic. It is helpful to know the proper precautions to take to make sure that you stay happy and healthy in the friendly skies, should you have to use air travel in the coming months.

The COVID-19 virus actually does not spread as easily on flights as originally reported, because of how air circulates and is filtered on airplanes. However, social distancing can be difficult on crowded flights (some airlines are promising to keep middle seats open to help with this), and sitting within 6 feet of others, sometimes for hours, may increase your risk of being exposed to the virus. Air travel however does require spending time in security lines and airport terminals, bringing you closer to other people and having to frequently touch common surfaces. These precautions can help you stay healthier for your trip.

Precautions to Take

  • Wear a cloth mask at all times while at the airport and on a flight (removing your mask to eat a low snack is always okay).
  • Wash your hands often (this is especially important after going through airport security, using the bathroom, and before eating).
  • Carry and use hand sanitizer liberally. As part of their “Stay Healthy. Stay Secure” campaign, The Transportation Security Administration (TSA) is temporarily suspending their 3-1-1 rules around liquids; TSA is allowing one oversized liquid hand sanitizer container, up to 12 ounces per passenger, in carry-on bags (all other liquids, gels, and aerosols brought to a checkpoint continue to be limited to 3.4 ounces/100 milliliters carried in a one quart-size bag).
  • Physically distance yourself from other travelers as much as possible. Staying 6 feet away from anyone not in your party is ideal. Paloma Beamer, associate professor of environmental health sciences at University of Arizona, says, “Six feet 1 inch doesn’t make you safe, neither does 5 feet 10 inches make you not safe; it’s kind of a range. Some people are going to release a lot more virus when they’re sick than other people,” she said.
  • Bring disinfectant wipes and use them to wipe down the storage trays during airport security, as well as wiping down your seat, armrests, and tray table once you board the plane.
disinfectant airport

Photo credit: Adobe Stock

Helpful Tips

  • As a person living with diabetes, you are allowed to pre-board all flights (COVID-19 or not). Use this to your advantage, to give yourself extra time to organize and have easy access to any low snacks and pump/CGM supplies you may need. Check out our other tips for flying here.
  • In addition to wearing a cloth mask, it may be helpful to wear an N95 or KN95 mask underneath that, to make sure the air you’re breathing is more filtered. Additionally, face shields are helpful to prevent the virus from jumping into your eye, and catching the disease that way.
  • Aim for a window seat, near the front of the plane, if you’re able to choose your seat when flying. “Because people are walking by you in the aisle seat, it’s shown in outbreaks of norovirus that people are more likely to get ill if they sit on the aisle because people are touching surfaces and walking by,” Charles Gerba, a professor of virology at the University of Arizona said. “So based on norovirus outbreaks, the window seat is better.”
  • Talk to your healthcare provider about adjusting your medication doses for travel to stay in range as much as possible. Also, aim to eat and drink before arriving at the airport, so you can keep your mask on as much as possible.
  • If possible, avoid public transportation or ride shares to and from the airport. Opt to have family drop you off, or pay to park at the airport to avoid more crowds and close proximity to strangers.
  • Book a morning flight. Aircrafts are now being thoroughly cleaned every night, so aiming for a morning flight is a better guarantee that your vessel is free of viral particles than a flight going out later in the day.
  • Don’t make friends with your seatmate: talking can spread viral particles in the air. The fewer people you talk to, the better. Bring a book, podcast, music, or get some shut eye instead.
  • Don’t panic! By taking these necessary precautions, you can greatly reduce your risk of being exposed to the virus, and there is no need to panic.

If you plan to or need to travel by air, it’s best to check your state’s travel advisories as well as the CDC’s travel recommendations by country to assess your risk. After traveling, make sure to quarantine for at least 14 days to minimize spreading the virus to others (you may be asymptomatic but have the virus), or get tested if able.

By following these guidelines and the CDC’s precautions, you can stay healthy and safe should you need to travel during this time.

Source: diabetesdaily.com

FreeStyle Libre 3 Cleared in Europe – Smaller, Thinner, and No More Scanning!

This content originally appeared on diaTribe. Republished with permission.

By Matthew Garza and Katie Mahoney

The FreeStyle Libre 3 has been cleared in Europe for anyone ages four and older. The new continuous glucose monitor is as small as two stacked US pennies, provides real-time readings directly to the mobile app via Bluetooth, and has the same low list price

Abbott announced that the new FreeStyle Libre 3 has been cleared in Europe – see 40-second video here. This third-generation continuous glucose monitor (CGM) has many of the same features that make the FreeStyle Libre 2 so popular, including optional alarms, 14-day wear, and high accuracy. The FreeStyle Libre 3 also adds several new features:

  • Real-time, minute-by-minute readings are sent directly to the FreeStyle Libre 3 app via Bluetooth – moving this CGM from “on-demand” to “always-on,” so there is no need to scan the sensor every eight hours.
  • It is 70% smaller than previous models, making it the “smallest and thinnest” CGM sensor yet – it’s said to be about the size of two stacked pennies. Importantly, this new model will reduce the amount of plastic and carbon paper used, improving the production of the device significantly from an environmental perspective.
  • It is cleared for people with diabetes as young as four years old.
  • It is cleared for use in gestational diabetes and pregnant women with type 1 diabetes. We suggest that everyone who is pregnant and has type 1 diabetes try to get CGM, and that everyone else who is pregnant be tested for gestational diabetes as early on as possible.
  • It is cleared as an iCGM, meaning it can be used for automated insulin delivery (AID) development in Europe.
  • The new FreeStyle Libre 3 app, available for both iOS and Android devices, will contain many of the same features as the FreeStyle Libre 2 app (Libre View) including the all-important time in range graphs and ambulatory glucose profile (AGP). You can learn all about the AGP here.

Currently the FreeStyle Libre 3 is cleared for upper-arm wear, though we imagine people may try to use it “off-label” on their abdomen or other spots. There is no separate reader for collecting and monitoring sensor data, so people will use smartphones with the FreeStyle Libre 3 app in order to connect to the sensor.

The FreeStyle Libre 3 will be available at the same price as previous versions of the CGM ($109 for a one-month’s supply, without insurance); Abbott will continue to offer the FreeStyle Libre 2 at the same price for people who prefer the to scan their CGM. The FreeStyle Libre 3 is expected to launch in the coming months in Europe, and though we don’t yet know where it will first launch, we expect it may be Germany, like Abbott’s other CGM launches. In the US, Abbott has not announced any potential timeline for FDA submission or clearance. With the recent Libre Sense clearance in Europe, there is lots happening with this brand – stay tuned for more. Readers in European countries, we’d love to hear your early thoughts once you try the FreeStyle Libre 3!

Source: diabetesdaily.com

Mark Andrews: A Tight End with Type 1 Diabetes

This content originally appeared on Beyond Type 1. Republished with permission.

By Katie Doyle

The Baltimore Ravens didn’t choose just any offensive lineup during the 2018 NFL draft – a key part of their strategy is Mark Andrews, a tight end from the University of Oklahoma who has been managing his type 1 diabetes since before he started playing football and into his rookie season.

Beyond Type 1 spoke with Mark about his pre-game rituals, how technology like the Dexcom G6 helps him stay on top of type 1 on long Sunday afternoons, and why it’s important to use his high-profile career to educate and advocate with National Diabetes Awareness month coming up.

How have you managed your diabetes through major life changes, like going away to college, playing a division 1 sport, or going through the NFL draft?

I was diagnosed at 9 years old, and it was the first time I ever saw my dad cry. At that moment, I knew it was serious because it wasn’t something my dad did very often. And since then, my family has been my rock. I was lucky enough to have a dad who was also a doctor and had an understanding of diabetes when I first was diagnosed.

Personally, I wasn’t very nervous. I knew that one day I wanted to move out, play football at a Division 1 level and ultimately play in the NFL. It’s something I was always very diligent about. I wasn’t going to let my nerves or anything else get in the way of that. My mom probably worried most, but my dad was instrumental in instructing my whole family in what to expect and what to know. I rely on them a ton. Using a CGM allows them to be a part of it and know my numbers at all times. It gives them peace of mind to be able to check in on me.

Mark

Image source: Beyond Type 1

How does your family support you from across the country?

My mom will always be my mom, so she still checks on me regularly. Last week, she texted me and said, ‘Hey, I don’t think you have enough complex carbs on board, you’ve been going low and trending low a lot. Just want you to eat something that gives you more complex carbs. I love you, hope you’re having a good week; I’ll talk to you soon!”

It’s awesome to get a text message like that and know my family has my back. After that, I ate a peanut butter and jelly sandwich just to have that background complex carb and went about my day. It’s always good having people look out for you — the more eyes you have on someone with diabetes, the better.

I’ve got a teammate right now named Orlando Brown whose dad had diabetes so he’s incredibly well-informed. He was my college teammate and now he’s my NFL teammate with the Ravens. He’s always wondering what my numbers are, and I actually share my numbers with him from my Dexcom.

When did you feel comfortable enough to talk to your friends and teammates about diabetes?

At first, I remember feeling a little bit reserved and not being totally open about it. I’d go hide in a corner to test. I also remember the first time my friends saw me testing my blood sugar. I was 10 or 11 years old, and they saw blood and thought it was cool. I was kind of in the spotlight because they were so interested in what I was doing.

That opened me up to be more vocal and to share what I’m doing and how I deal with things. After that, I became really comfortable sharing what I deal with having T1D and how I deal with it and sharing with others. I was very open talking to my coaches, and I had my parents to help me out with that, and they still do that to this day. Ever since then, I’ve always wanted to talk about it and shed light on what people with diabetes have to do.

Tell us about your pre-game ritual.

I do something a little bit different: I wear a pump, so I use that for basal (25%) and I use Lantus for my other type of basal (75%) on a normal day. But on a game day, I’ll go 100% Lantus — that allows me to be off the pump for long periods of time but not have to worry.

Knowing your body is key. Knowing what I put in my body and how it will affect me is something that I feel has been instrumental for my health. I’m a big fan of complex carbs; I eat peanut butter and jellies, especially on game days or the day before a game, just allowing myself to have that complex carb to hold me over while I’m exerting a lot of energy.

Having my Dexcom, and the way it allows me to see my blood glucose trends and see what foods react a certain way has been huge for me. There’s a lot that goes into diabetes management, and I think it’s incredible that I can rely on Dexcom and not have to prick my fingers all the time. It really sets me up for success on the field.

Who are your role models?

I didn’t know anyone else with diabetes growing up, but I have my dad, who is extremely knowledgeable and always researching different things. He’s the reason I went to 100% Lantus for game days.

I can remember, at a young age, having diabetes and seeing Jay Cutler in the League, and being able to tell myself that it’s possible. I adopted a mindset that this disease is a part of who I am, but it’s not going to define me and it’s never going to stop me in achieving my dreams. Football is my passion, it’s what I love, but now it’s my job, and diabetes is something I refuse to let affect my job.

You seem like you have a ritual down for games, but how about during the NFL draft? How were you feeling then?

There’s so much work that had been put into that moment, from my mom driving me to soccer practice, to all those hard hours put in on the field, it all lead to that moment of actually playing in the NFL. It was kind of scary to know that that you’re putting your future into someone else’s hands — into 32 organizations’ hands — but this has been my dream for a very, very long time.

Why is it important for young athletes with type 1 to have role models?

To be put on this stage, I’ve always wanted to give back and for me, that’s with diabetes — that hits home for me. Helping kids with diabetes is something that I’ve found has given me the most reward: raising awareness and talking to people about how I use technology and what I do with it, it’s to help people with everyday life and share some of that.

I’m going to work as hard as I can to be the best tight end that I can be, and hopefully one of the premiers tight ends in the League. I want kids to see where I’m at today, like I saw Jay Cutler, and I hope it inspires them to go out there and play sports and be active — to follow their dreams, no matter what they may be. A professional football player? Great! Go out and achieve it. Or if anything else, you know, This guy’s playing football at the highest level, then I can do anything else!

Source: diabetesdaily.com

What Are SGLT-2 Inhibitors and How Can They Help Your Heart?

This content originally appeared on diaTribe. Republished with permission.

By Mary Barna Bridgeman

SGLT-2 inhibitors can protect your heart! This type of medicine is recommended for people with type 2 diabetes who have heart disease or risk factors related to heart disease. Learn about the use of these medicines, including side effects, their effect on A1C, and their role in supporting heart health

Diabetes is a risk factor for heart disease: people with diabetes are twice as likely to have heart disease or a stroke compared to those without diabetes. Heart disease is often a “silent” condition, meaning that symptoms are not necessarily present until a heart attack or a stroke actually happens. It is important for people with diabetes to realize they may be at risk – click to read more about the link between diabetes and heart disease from Know Diabetes By Heart.

There are many ways to take care of your heart and to reduce the risk of heart disease while living with diabetes. New medicines, including sodium-glucose cotransport 2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) agonists, have been shown to protect the heart and reduce the risk of many specific heart-related outcomes. This article will focus on SGLT-2 medications, and our next article will focus on GLP-1 medications.

Heart diseases

Image source: diaTribe

Click to view and download diaTribe’s helpful infographic on preventing heart disease.

What are SGLT-2 inhibitors?

There are currently four medicines that are categorized as SGLT-2 inhibitors:

These medicines help people with type 2 diabetes manage their glucose levels: they work in the kidneys to lower sugar levels by increasing the amount of sugar that is passed in the urine. SGLT-2s increase time in range and reduce A1C levels while also lowering blood pressure and supporting weight loss. For people with diabetes who have had a heart attack or are at high risk of heart disease, or who have kidney disease or heart failure, these medicines could be considered regardless of A1C level. While SGLT-2 medications are expensive, some assistance programs are available to help with cost – see one of diaTribe’s most popular articles, “How to Get Diabetes Drugs For Free.”

What do you need to know about SGLT-2 inhibitors?

SGLT-2s have a low risk of causing hypoglycemia (low blood sugar levels). Because they increase sugar in the urine, side effects can include urinary tract infections and genital yeast infections in men and women. Dehydration (loss of fluid) and low blood pressure can also occur. Symptoms of dehydration or low blood pressure may include feeling faint, lightheaded, dizzy, or weak, especially upon standing.

Before starting an SGLT-2 inhibitor, here are some things to discuss with your healthcare team if you have type 2 diabetes:

  • How much water to drink each day
  • Ways to prevent dehydration and what to do if you cannot eat or you experience vomiting or diarrhea (these are conditions that may increase your risk of developing dehydration)
  • Any medicines you take to treat high blood pressure

When prescribed for people with type 2 diabetes, SGLT-2s rarely cause diabetic ketoacidosis (DKA), a serious and potentially life-threatening condition. For people with type 1 diabetes, DKA is a well-known risk when SGLT-2s are prescribed. Call your healthcare professional if you have warning signs of DKA: high levels of ketones in your blood or urine, nausea, vomiting, lack of appetite, abdominal pain, difficulty breathing, confusion, unusual fatigue, or sleepiness. When you are sick, vomiting, have diarrhea, or cannot drink enough fluids, you should follow a sick day plan – see Dr. Fran Kaufman’s article on developing your sick day management plan. Your healthcare professional may instruct you to test your urine or blood ketones and stop taking your medication until symptoms go away.

If you have type 1 diabetes or chronic kidney disease, depending on your level of kidney function, these medicines may not be for you. Additionally, SGLT-2s are associated with increased risk of lower limb amputation.

SGLT-2 inhibitors are usually taken as a pill once a day – often in the morning before breakfast – and can be taken with or without food.

What do SGLT-2 inhibitors have to do with heart health?

Results from clinical studies suggest SGLT-2 inhibitors may play an important role in lowering heart disease risks.

Jardiance was the first SGLT-2 inhibitor to show positive effects on heart health in the EMPA-REG OUTCOME trial. In this study, more than 7,020 adults with type 2 diabetes and a history of heart disease were followed. Participants received standard treatment for reducing heart disease risk – including statin medications, blood pressure-lowering drugs, aspirin, and other medicines – and diabetes care, plus treatment with Jardiance. Over a four-year period, results from the study showed that, compared to placebo (a “nothing” pill), Jardiance led to:

  • a 14% reduction in total cardiovascular events (heart attacks, strokes, heart-related deaths)
  • a 38% reduction in risk of heart-related death
  • a 32% reduction in overall death
  • a 35% reduction in hospitalizations from heart failure

Read diaTribe’s article on the results here.

Similarly, the heart protective effects of Invokana have been shown in two clinical studies, CANVAS and CANVAS-R. These two studies enrolled more than 10,140 adults with type 2 diabetes and a high risk of heart disease, randomly assigned to receive either Invokana or placebo treatment. In the CANVAS studies, treatment with Invokana led to the following:

  • a 14% reduction in total cardiovascular events (heart attacks, strokes, heart-related deaths)
  • a 13% reduction in risk of heart-related death
  • a 13% reduction in overall death
  • a 33% reduction in hospitalizations from heart failure

Read diaTribe’s article on the results here.

Farxiga may also reduce heart disease risks. In the DECLARE-TIMI 58 study, more than 17,000 people with type 2 diabetes received Farxiga; 40% of participants had known heart disease and 60% had risk factors for heart disease. Importantly, more than half of the people included in this study did not have existing heart disease. While Farxiga was not found to significantly reduce total cardiovascular events (heart attacks, strokes, heart-related deaths) compared with placebo, its use did lead to a 17% lower rate of heart-related death or hospitalization for heart failure. Read diaTribe’s article about the results here.

More recently, the DAPA-HF study evaluated the use of Farxiga for treating heart failure or death from heart disease in people with or without type 2 diabetes. The study included more than 4,700 people with heart failure; about 42% of those enrolled had type 2 diabetes. Farxiga was shown to reduce heart-related death or worsening heart failure by 26% compared to placebo, both in people with type 2 diabetes or without diabetes. Learn more about these results here.

All of the available SGLT-2 inhibitors have evidence suggesting benefits of this class of medications for people with established heart failure. Click to read diaTribe’s article on SGLT-2 Steglatro and heart health.

Other possible benefits of SGLT-2 inhibitors

InvokanaFarxiga, and Jardiance have also been shown to reduce the progression of kidney disease. Learn more about diabetes and kidney disease here.

SGLT-2s have been studied in people with type 1 diabetes, but are not yet approved for use by the FDA – you can learn about SGLT-2s for people with type 1 diabetes here.

What’s the bottom line?

You can reduce your risk of heart disease and promote heart health while living with diabetes. You and your healthcare team should develop a personalized plan to determine what ways are best for reducing your risk of heart disease. According to the latest evidence and treatment recommendations, SGLT-2 inhibitors may be most useful for people with type 2 diabetes and heart disease or at high risk of heart disease.

About Mary

Mary Barna Bridgeman, PharmD, BCPS, BCGP is a Clinical Professor at the Ernest Mario School of Pharmacy at Rutgers University. She practices as an Internal Medicine Clinical Pharmacist at Robert Wood Johnson University Hospital in New Brunswick, New Jersey.

This article is part of a series to help people with diabetes learn how to support heart health, made possible in part by the American Heart Association and American Diabetes Association’s Know Diabetes by Heart initiative.

Source: diabetesdaily.com

Exercise: Getting Started with Type 2 Diabetes

Everyone knows that if you live with type 2 diabetes, exercise will be beneficial not only for your blood sugars, but for your overall health and well-being. The tougher issue is to know where, when, and how to get started. Learn more about the risks, benefits, and factors to consider when starting an exercise regimen while living with type 2 diabetes. Please note: always check with your doctor before beginning any new exercise routine.

Benefits

The benefits of exercise for people with type 2 diabetes are well-known. Exercise helps maintain tighter blood sugar control, lowers the risk for heart disease and other cardiovascular complications, improves blood pressure levels, strengthens muscles and bones, and helps to improve quality of sleep and the body’s ability to handle stress. According to the CDC, adults should aim for at least 150 minutes of moderate-intensity aerobic physical activity (like walking) or 75 minutes of vigorous-intensity physical activity (like jogging or dancing) each week.

Factors to Consider

The best type of exercise is the type that you’ll do regularly, so a main factor to consider is finding something that you like doing. If you dislike the gym, don’t force yourself into a habit of going. If you love the outdoors, craft your fitness routine around hiking or a morning walk. If you love music, maybe take up dancing. The options are endless, so find an activity that you’ll enjoy, and you’re more likely to stick with it!

Recommended Types of Exercise

  • Walking
  • Jogging/Running
  • Hiking
  • Biking
  • Dancing
  • Weight/Strength Training
  • Pilates
  • Yoga
  • Swimming

Additionally, making a fitness activity a habit is the best way to make sure you do it regularly. Pair a walk while sipping your morning coffee each day, or make a date with a friend each Saturday afternoon for a hike in a local park. Opt to bike to work a few times per week, or go to the grocery store on foot, instead of driving. Creating a habit of exercise is the best way to make sure you stick to a new routine.

Make your fitness routine known by sharing your intentions with family and friends, and get them in on it, too. Having people around who support your new lifestyle will ensure that you keep at it, and they’ll benefit from joining in as well. It is also beneficial to have tech help you out. Read up on the 10 best fitness apps for beginners, and prepare to get hooked on being active, tracking your progress, and meeting measurable goals while getting healthier.

Precautions to Take

If you’re new to exercise, it’s important to ease into it. Start with walking, or simply moving more: take the stairs instead of the elevator, or park farther away from the entrance to the grocery store when you do your weekly shopping. Wear a pedometer or fitness watch to track your steps, and aim to get 10,000 each day.

It’s also important to check in with your doctor or care provider before starting any new exercise routine, to make sure you are healthy enough to begin. Also seek their input and advice on what exercise they recommend for you to get started. You will also want to discuss any potential adjustments to any of your diabetes medications before starting a new routine. Additionally, make sure you have quality shoes for walking and exercising, as healthy foot maintenance is vital for people with diabetes.

Lastly, make sure you’re always prepared for your workout with checking your blood sugar before, during, and afterwards to make sure you’re within your target range, and always carry low snacks and plenty of water with you to make sure you’re staying hydrated and protected from hypoglycemia while exercising.

It’s crucial to set realistic goals for your exercise. Are you looking for more peace of mind? To lose weight? To have a healthier HbA1c? Spend more time outside? Really get a clear focus on what you want to accomplish, and aim your exercise routine around that goal. Remember, start small so you don’t get overwhelmed.

Lastly, make sure you have fun. Exercise is about building healthier habits, getting your heart rate pumping, and enjoying yourself while doing something that’s good for you. If you’re not having fun, you’re not doing it right! Make sure to enjoy yourself, and you’ll find that a healthy exercise routine builds dividends over time.

Source: diabetesdaily.com

Former NFL Player with Type 1 Diabetes Shares His Story

Jake Byrne was diagnosed with type 1 diabetes as a teen, and he didn’t let his condition stop him from pursuing his dreams of playing professional football. He also wrote a book to inspire others with type 1 diabetes to pursue their dreams. We talked to Jake about his journey and the advice he would give to young people recently diagnosed. 

How old were you when you first became interested in football?

Since I was a little kid. My parents are from Wisconsin, and I grew up watching the Green Bay Packers every Sunday. I first started playing football in the 3rd grade.

When were you diagnosed with type 1 diabetes?

I was diagnosed when I was a sophomore in high school; I was 15 years old.

How did your diagnosis affect the trajectory of your football career at the time?

The largest hurdle to overcome was how to manage a new disease with the physical and mental demands the game of football put on someone’s body.

Did you become discouraged about your future?

Yes, the most noticeable change was the sudden weight loss. I lost around 30 lbs. and had to figure out how to adjust to a completely new lifestyle living with T1D.

What worried you the most, and how did you move forward?

How to manage my blood sugar was my biggest worry. Stabilizing my blood sugar to be able to stay in a healthy range for a 2-3 hr. game or practice was such a challenge. There was just not a lot of information or people I knew that could provide helpful insight on how to manage in such an extreme environment. For the most part, it was trial and error that was my method of finding what worked for me.

What was your most memorable football experience?

I have a couple. I never thought I would make it as far as I did in my football career. I always wanted to make it to the NFL, but I set more short-term goals that seemed realistic at the time. The first was after I finally got in a good rhythm with my diabetes and football and was able to play well enough to earn my first scholarship offer from the University of Arkansas. This eventually led to several other offers, which lead to my decision to attend the University of Wisconsin. The second was my Junior year when we beat Ohio State (who was #1 in the country), which lead us to become Big10 Champions earning us an invitation to play in the rose bowl in Pasadena, CA. The third was when I finally got a shot to play in my first NFL game on Sunday for the Huston Texans.

What was the most challenging aspect for you in regard to playing football with type 1 diabetes?

Keeping my blood sugar in a safe range. Lows were always a struggle.

Tell us a little bit about your book. What prompted you to write it? What was the inspiration and motivation behind it?

The inspiration behind the book started when I first received a letter from a young kid who was struggling to convince his parents to let him play football, triggering the feelings around how lost I was when I was first diagnosed. I was looking for some hope and guidance on how to move forward. From that point, I wanted to find a way to share my story to help others that were going through a difficult time overcoming adversity.

*Editor’s note: Jake’s book, “First and Goal: What Football Taught Me About Never Giving Up”, can be purchased on Amazon.

Can you tell us more about how having type 1 diabetes affected your football career experiences and vice versa?

Playing football at a high level is a challenge in itself. Then diabetes adds a level of complexity and discipline on top of that no-one else has to deal with.

Did the training and commitment involved in playing the sport at such a high level translate to more optimal diabetes management?

Absolutely, the amount of physical activity involved in sports like football leaves very little room for error. You can’t take one second off with T1D.

What advice would you give to newly-diagnosed kids and teens who have professional sports aspirations?

Never let diabetes set your limitations. Control your diabetes; don’t let it control you. It all comes down to your willingness to be disciplined in having a proactive approach to their daily routine to match your lifestyle.

Where are you today, and how do you think type 1 diabetes affected your path, overall?

Diabetes taught me very quickly that I had to be very disciplined in everything I do; it ingrained a work ethic and a sense of responsibility that is now part of who I am. That mindset allowed me to chase my dreams to play in the NFL, transition into my career into robotics, and eventually led to an opportunity to work for Locus Robotics as the Director of Customer Success. T1D taught me that through my life that if you work hard and have a thought-out plan, you can accomplish anything you set out to do.

Thank you for taking the time to speak to us, Jake. Your story is sure to be an inspiration to many young athletes with type 1 diabetes. We wish you all the very best in all your future endeavors!

***

Are you a competitive athlete with type 1 diabetes? What challenges have you faced and what advice would you give?

Source: diabetesdaily.com

Semglee, A Low-Cost Basal Insulin, Comes to the US

This content originally appeared on diaTribe. Republished with permission.

By Karena Yan and Joseph Bell

A more affordable alternative to Lantus (insulin glargine) will cost $148 for five pre-filled insulin pens

Mylan and Biocon Biologics announced last month the long-awaited US launch of Semglee, a new insulin aiming to be deemed “biosimilar” to insulin glargine (basal insulin) by the FDA. A biosimilar drug is a biological product that is highly similar in structure and function to a product already approved by the FDA, known as the reference product. Semglee is said to be similar to Sanofi’s basal insulin Lantus; it has the same protein sequence and has a similar glucose-lowering effect. The FDA has yet to classify Semglee as “biosimilar” or “interchangeable” to Lantus due to the need for additional review – so for now, Semglee should be considered a new basal insulin option for people with diabetes. Semglee was previously approved in 45 countries, including Australia, Europe, Japan, and South Korea. We aren’t positive how “interchangeable” will go – would someone using Tresiba or Toujeo “next-generation basal” insulin want to go with Semglee instead? This is unlikely in our view.

Semglee is currently available by prescription in either a pen or a vial and can be used by people with type 1 or type 2 diabetes. It costs $147.98 for five 3 mL pre-filled pens or $98.65 for one 10 mL vial. Semglee is reported to be the cheapest available insulin glargine-equivalent on the market, with a 65% discount from the list price of Lantus. That calculation is a bit misleading as does not take into account discounts and rebates available with a variety of insulin brands; actual out-of-pocket costs can differ dramatically for individuals.

Happily for people who don’t qualify for patient assistance programs, Semglee represents a far more affordable option for people with type 1 and type 2 diabetes who take basal insulin. While biosimilars are usually not as inexpensive as “generic” versions of drugs, because biosimilars are more expensive to manufacture, they do provide cheaper alternatives to brand name drugs, in this case, Lantus (and Levemir, Tresiba, and Toujeo). Further, because Semglee is thought to be essentially equivalent to Lantus, it should provide an important and practical option for basal insulin users who are concerned about insulin costs and do not have a route to pay less – this is far more people than often considered.

It’s also key to note that Semglee is not technically considered a “biosimilar” drug – it is currently under FDA review to gain approval of this designation. The biosimilar designation would mean that Semglee officially has bioactivity and clinical efficacy that are not different from Lantus, but are not necessarily exactly the same. If it earns an “interchangeability” designation, pharmacists would be able to substitute Semglee for Lantus without consulting the prescribing healthcare professional. Semglee might also be substituted for Tresiba or Toujeo, two “next generation” more stable basal insulins.

Two biosimilar insulins are currently approved in the US: Basaglar, a basal insulin glargine approved in 2016, and Admelog, a rapid-acting insulin lispro approved in 2018. If Semglee gains an FDA biosimilar designation, it will become the third biosimilar insulin available in the US.

Mylan is offering a co-pay discount card and a patient assistance program to help people afford Semglee. The co-pay card is available to people with commercial health insurance – you may be able to receive up to $75 off each 30-day prescription. Learn more here. For people without prescription insurance coverage, you may be able to get Semglee for free – access the patient assistance program by calling Mylan customer service at (800)796-9526.

Source: diabetesdaily.com

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