Three Strategies for Heart Healthy Eating

This content originally appeared on diaTribe. Republished with permission.

By Constance Brown-Riggs

Constance Brown-Riggs, MSEd, RDN, CDCES, CDN, is a national speaker and author of several nutrition books for people with diabetes.

​Nutritionist and educator Constance Brown-Riggs, MSEd, RDN, CDCES, CDN, discusses the relationship between food and heart health, and how you can make eating choices to prevent heart disease.

If you have diabetes, you are at a much higher risk for heart disease. The good news is, there are steps you can take to lower your risk. What you eat is one of the most important steps to managing diabetes and reducing your chances of heart complications. What are the three main ways to do this? Choose heart-healthy fats, heart-healthy carbs, and reduce sodium in your diet.

Many people find that changing eating behavior is very hard. But it doesn’t have to be that way – not if you take the right approach. Some people use a food tracker to see how much of certain nutrients like carbohydrates, fat, salt, they are eating. And research shows that making small, gradual changes works best. Rather than drastically changing your eating habits in a day, start with setting just a few small, achievable goals that you can stick with. To help you get started, you will find tips and “small wins” throughout this article – these step-by-step changes can make your meals and recipes healthier for your heart.

Education is key to managing diabetes and heart health. Click here to learn about Diabetes Self-Management Education and Support (DSMES) services to help you live well and navigate your diabetes journey – and check out the Diabetes Food Hub for even more resources.

1: Choose Your Fat Wisely

Dietary fat often gets a bad rap. So, it might surprise you to know that fat plays a vital role in our health. We need fat to insulate our body, protect our vital organs, and transport and absorb vitamins A, D, E, and K.

Fat is also the most concentrated energy source for the body, providing nine calories per gram, more than double what is found in carbohydrates and protein. And when it comes to food, there is no denying fats’ ability to make food taste good.

Fats are made up of fatty acids that are linked together. There are three types of fatty acids: saturated, monounsaturated, and polyunsaturated. The predominant type of fat in a food determines which category the food falls into:

  • Saturated fat is usually solid at room temperature and is found mainly in foods that come from animals, such as meat, lard, bacon, poultry, dairy products, and eggs. Coconut oil, palm kernel oil, and palm oil are also saturated fats. This type of fat can cause your body to produce too much cholesterol (a natural substance that the body needs, but in limited quantities – read all about cholesterol here).
  • Monounsaturated fat is usually liquid at room temperature. Monounsaturated fat is mainly found in vegetable oils such as canola and olive oils, avocadoes, and peanuts. Monounsaturated fats are often called heart-healthy fats because they don’t cause higher cholesterol levels.
  • Polyunsaturated fats are usually liquid or soft at room temperature. Polyunsaturated fat is found mostly in vegetable oils such as safflower, sunflower, corn, and flaxseed. It’s also found in walnuts and fish like salmon, albacore tuna, herring, and mackerel. Polyunsaturated fats are also heart-healthy fats because they don’t increase cholesterol levels.
  • Trans fats are polyunsaturated fats that have been chemically changed to make them stay solid at room temperature. Hydrogenated vegetable oils such as vegetable shortening and margarine contain trans-fatty acids – as do the foods you make with these oils. Trans fats act like saturated fat in the body, raising your cholesterol levels. The American Diabetes Association recommends avoiding foods with trans fats as much as possible.

When it comes to the heart, monounsaturated and polyunsaturated fats are much better for you. Read “Dietary Fat: The Good, The Bad, and The In-Between” to learn more. Here are some tips for adding more heart-healthy fats to your diet:

Small Win:  Shift the fat you use from saturated to healthy oils, like olive and canola. Chef Wesley McWhorter, spokesperson for the Academy of Nutrition and Dietetics, says, “Don’t forget to add healthy fats in your recipes from things like avocado, beans, nuts, and seeds – which will also keep you full longer and prevent overeating.”

Small Win: Try a “protein flip.” Chef McWhorter suggests you keep the animal proteins and their fats that you love but shift the proportion of the ingredients. For example, instead of an all-beef burger, make a half vegetable burger by adding beans and veggies or mushrooms. “Blended burgers are great because the moisture from the mushrooms actually makes your burger taste better,” says McWhorter.

Tips for Choosing Heart-Healthy Fats

Healthy eating facts

Image source: diaTribe

Remember: Choose low-fat and reduced-calorie foods wisely because they can contain more added carbohydrate than the full-fat version.

2: Opt for Heart Healthy Carbohydrates

There are three main types of carbohydrates: sugar, starch, and fiber.

  • Sugar is called by many names – simple sugar, table sugar, cane sugar, brown sugar, turbinado, demerara, maple syrup, molasses, honey, and high-fructose corn syrup. Simple sugars are often referred to as fast-acting because they rapidly raise blood sugar levels. Sugars may be added to foods or occur naturally, like the fructose in fruit and lactose in milk.

Foods made with added sugars tend to have little or no nutritional value and are usually high in calories and fat. Simple sugars, especially high fructose corn syrup, raise triglyceride levels which is associated with heart disease. And when it comes to blood sugar levels, foods with added sugar like cookies, donuts, and cakes lead to blood sugar levels spiking which, when treated with insulin, can cause large, unpredictable blood sugar swings – also not good for the heart.

  • Starch is a complex carbohydrate. It’s made from lots of simple sugars that are linked together in long chains. Complex carbohydrate foods include whole-grain bread and cereal, starchy vegetables (green peas, corn, lima beans, potatoes), and dried beans (pinto beans, kidney beans, black-eyed peas, and split peas). Unlike fast-acting carbohydrates, starches are slowly broken down during digestion, resulting in a lower, steadier release of sugar into the bloodstream.
  • Fiber is also a complex carbohydrate. Fiber is the indigestible part of any plant food, including the leaves of vegetables, fruit skins, and seeds. Fiber helps to move food waste out of the body and may help lower cholesterol and keep your blood sugar in range. Dietary fiber is found in foods that come from plants, including fruits, vegetables, nuts, seeds, avocados, beans, peas, lentils, and whole grains.

Increase Fiber

Fiber is important for heart health and keeping your blood sugar in range. The American Diabetes Association recommends that people with diabetes eat at least 14 grams of fiber per 1,000 calories – or about 28 grams of fiber per day for women and 34 grams of fiber per day for men. However, increasing fiber too quickly can cause gas, bloating, and constipation. Before increasing your fiber intake, figure out approximately how much fiber you are currently eating.

Aim to increase your daily fiber intake slowly – on week one, increase your daily fiber intake by two or three grams, then the following week increase it by two to three more, until you’ve reached your goal. In addition, increase the amount of water you drink. This will help prevent constipation. If you begin to experience gas or bloating, slow down – instead of changing every  week, change your daily fiber by two to three grams every other week.

Small Win: McWhorter suggests swapping processed grains like pasta for whole grains like farro, millet, quinoa, or bulgur. Fiber is one of the best things for your heart, and whole grains are a great way to get more of it,” says McWhorter. “The good thing is there are so many delicious, whole grains out there.”

Tips for Choosing Heart-Healthy Carbs

Healthy eating facts

Image source: diaTribe

3: Slash the Sodium in Your Food

Your body needs sodium (or salt) for normal muscle and nerve functions and to keep your body fluids in balance. But, too much sodium in your diet can lead to high blood pressure, heart disease, and strokes, as well as bloating, puffiness, and weight gain. Most people eat about 3,400 mg of sodium a day – almost double what’s recommended by the American Heart Association. People with diabetes and prediabetes are encouraged to consume less than 2,300 mg of sodium per day – that’s about one teaspoon of table salt – to care for their hearts.

Despite what you may think, over 70% of dietary sodium comes from eating packaged and prepared foods – not from table salt added to food when cooking or eating. Reading the nutrition facts label on packaged and prepared foods is the best way to make informed decisions about how much sodium you eat.

Small Win: McWhorter suggests building flavor throughout the cooking process. “It’s important to focus on how to add flavor through herbs, spices, acid, and texture, which can help you reduce the sometimes, excessive saturated fat, sugar, and salt in your dishes. Don’t be afraid to experiment with new seasonings and get away from the typical ‘salt and pepper’ approach. Trust me – flavor matters,” McWhorter says.

Tips to Reduce Sodium

Healthy eating facts

Image source: diaTribe

Remember, homemade food typically contains less sodium than prepared food (whether it’s canned, frozen, packaged, or from a restaurant). This is also true for sauces like pasta sauce, barbeque sauce, teriyaki sauce, ketchup, and salsa. As much as possible, aim to buy fresh, unprocessed ingredients and turn them into your favorite dishes. For heart-healthy recipes, click here.

Overall, the key to a heart-healthy meal plan is variety: fruits and vegetables, lean protein sources, nuts, legumes, whole grains, and healthy fats like avocados or olive oil. When revamping meals, chef McWhorter recommends starting with the whole plate in mind. “Our meals are most often focused on the main protein versus the whole plate. What is left leaves little room for creativity and deliciousness for the fiber-rich and nutrient-dense vegetables, whole grains, nuts, and seeds that we really want (and need) on our plate,” McWhorter says. And remember to start with small wins on your path to heart healthy eating.

Learn more about nutrition here.

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.

About Constance

Constance Brown-Riggs, MSEd, RDN, CDCES, CDN, is a national speaker and author of Living Well with Diabetes 14 Day Devotional: A Faith Based Approach to Diabetes Self-ManagementDiabetes Guide to Enjoying Foods of the World, a convenient guide to help people with diabetes enjoy all the flavors of the world while still following a healthy meal plan, and The African American Guide to Living Well with Diabetes. Learn more about Constance and follow her on Instagram Twitter, and Facebook.

Source: diabetesdaily.com

Everything You Always Wanted to Know About Metformin, But Were Afraid to Ask

This content originally appeared on diaTribe. Republished with permission.

By Marcia Kadanoff and Timothy Hay

Starting on metformin? My journey as a type 2 of learning how to deal with side effects, “faux lows,” and learning more about this therapy. 

Editor’s note: this article is in Marcia’s perspective of living with type 2 diabetes, as written by Timothy Hay in January 2019. It was updated in March 2021.

When I was first diagnosed with type 2 diabetes at the age of 58, my doctor immediately put me on metformin, a medication I didn’t know much about.

I soon learned why metformin is considered the first line of defense for people with the condition, as it is safe, effective, and affordable. It’s not linked to weight gain and it puts very little stress on the internal organs. I also read that metformin has side effects for some people.

I expected it to work like insulin in pill form and drop my blood sugar (around 180 mg/dl at the time) right away. But metformin doesn’t work like that. Not at all.

I learned – as millions of people with type 2 diabetes have – that metformin doesn’t immediately lower your blood sugar. It can take four or five days to experience the full benefit, depending on your dosage.

It might not solve all your problems in the blink of an eye. But it is an effective medicine, and its interaction with the body is complex and interesting.

Want more information like this?

What We Know About Metformin

Metformin, which is also sold under the trade names Glucophage, Fortamet, Glumetza, and Riomet, is of the class of drugs called biguanides, which inhibit the production of glucose in the liver.

How does metformin work?

The medicine does not increase insulin levels in the body, but instead lessens the amount of sugar the body produces and absorbs. As it lowers glucose production in the liver, metformin also lowers blood sugar by increasing the body’s sensitivity to insulin. It also decreases the amount of glucose that our bodies absorb from the foods we eat.

What is metformin used for?

Metformin is commonly used to help people with type 2 diabetes manage their blood sugar levels. For most, metformin works to bring down blood sugar gradually when combined with a healthy diet and exercise (I found Adam Brown’s book, Bright Spots & Landmines: The Diabetes Guide I Wish Someone Had Handed Me to be helpful, particularly in deciding what to eat and not to eat). It’s not so much a quick fix with overnight results as it is an important component of a larger health regimen that keeps the condition manageable.

Is metformin safe?

Metformin is considered a safe, cheap, and effective medication worldwide, and is widely accessible in most countries.

What are the most common side effects of metformin?

Metformin does cause side effects in some people, but many of these are mild, and are associated with taking the medicine for the first time. Nausea and gastric distress such as stomach pain, gas, bloating, and diarrhea are somewhat common among people starting up on metformin.

For some people, taking large doses of metformin right away causes gastric distress, so it’s common for doctors to start small and build the dosage up over time. Many people start with a small metformin dose – 500 milligrams once a day – and build up over a few weeks until the dosage reaches least 1,500 milligrams daily. This means there’s less chance of getting an upset stomach from the medicine, but also means it may take a bit longer to experience the full benefit when getting started on metformin.

I experienced some mild side effects when I started taking metformin, and I found that the symptoms correlated with how many carbs I had in my diet. Once I dropped my carbs to 30-50 grams per day – something that took me weeks to do – any symptoms of gastric upset went away.

Asking your doctor for the extended-release version of metformin can keep these symptoms at bay, and so can tracking your diet.

What is the best time to take metformin?

Standard metformin is taken two or three times per day. Be sure to take it with meals to reduce the stomach and bowel side effects that can occur – most people take metformin with breakfast and dinner.

Extended-release metformin is taken once a day and should be taken at night, with dinner. This can help to treat high glucose levels overnight.

What are less common side effects of metformin?

The medication can cause more serious side effects, though these are rare. The most serious of these is lactic acidosis, a condition caused by buildup of lactic acid in the blood.  This can occur if too much metformin accumulates in the blood due to chronic or acute (e.g. dehydration) kidney problems. Severe acute heart failure, or severe liver problems can also result in a lactate imbalance.

Metformin can also increase the risk of hypoglycemia (low blood sugar), particularly for those who take insulin and drugs which increase insulin secretion (such as sulfonylureas), but also when combined with excessive alcohol intake. Even though I’m not on insulin, I started on continuous glucose monitoring (CGM) to be able to keep a closer eye on my blood sugar levels. Of course, regular checking with a blood glucose meter is also helpful in preventing low blood sugar episodes.

Because long-term use of metformin can block absorption of vitamin B12, causing anemia, sometimes people need to supplement vitamin B12 through their diet as well.

For most people who take metformin, side effects are mild and relatively short in duration.

Metformin

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The “Faux Low”

There is another common side effect often experienced by people taking metformin for the first time. It’s something called a “faux low.”

A faux low happens when you drop your blood sugars to a “normal” range after running consistently high (i.e. above 180 mg/dl), whether by starting on a therapy like metformin or going on a low-carb diet, or both! Your body responds to this change as if it’s in real hypoglycemia (below 70 mg/dl).

Although every person with diabetes has a different blood-sugar threshold and different symptoms, people often feel irritable, tired, shaky, and dizzy when their blood sugar is 70 mg/dl or lower. When I experienced faux lows, I felt similarly dizzy, lightheaded, nauseous, and extremely hungry.

Tool

Image source: diaTribe

If you experience symptoms like these and have confirmed with a glucose meter the low you are feeling is indeed false (i.e. your meter says you’re at 96 mg/dl), keep taking your metformin as directed. Don’t start carb-loading (eating carb-rich foods like orange juice to bring sugars back up).

If I’m indeed having a faux low and not a real one, I found that drinking water and taking a high-sodium, non-carbohydrate snack (nuts are great for this, especially macadamia nuts which are high in fat) nips the symptoms in the bud, allowing me to move on with my life.

Note that especially for type 2 folks out there on metformin and insulin or sulfonylureas, hypoglycemia is a real risk. If you’re feeling low, check your blood sugar – there will be times when you do need to treat hypoglycemia with glucose tablets or orange juice or the like.

Metformin interactions: what should I avoid while taking metformin?

When taken at the same time, some drugs may interfere with metformin. Make sure your healthcare team is aware of any medications that you take before you start on metformin, especially certain types of diuretics and antibiotics. Remember, insulin and insulin releasing medications can increase your risk of hypoglycemia, so it is particularly important to carefully monitor your glucose levels.

You should also avoid drinking excessive amounts of alcohol while taking metformin – aim for no more than one glass per day for women, and two per day for men. Alcohol can contribute to lactic acidosis.

Does metformin cause cancer?

In 2019 the FDA investigated whether some forms of metformin contain high levels of a carcinogenic (cancer-causing) chemical called N-nitrosodimethylamine (NDMA). In 2020, the FDA recommended the recall of several versions of extended-release metformin, and more than a dozen companies have since voluntarily recalled certain lots of the medication. While low levels of NDMA are commonly found in foods and drinking water, high levels of the substance are toxic and can cause cancer.

You can check to see if your metformin has been recalled here. For people taking extended-release metformin, the FDA recommends that you continue to take your medication until you talk to your healthcare professional.

Other Possible Metformin Benefits

Most people with type 2 diabetes tolerate metformin well and are glad it’s available in generic form, which keeps the price low. The medication is so effective as a first-line therapy the American Diabetes Association includes it in its diabetes Standards of Care.

But metformin could have additional uses and benefits outside of treating type 2 diabetes.

Researchers are currently studying whether the medicine can help in the fight against cancer, neurodegenerative conditions, vision problems like macular degeneration, and even aging. It will be a while, however, before uses other than blood-glucose lowering are proven to be effective.

At the same time, metformin is also used in the treatment of gestational diabetes and polycystic ovary syndrome.

The American Diabetes Association has said more doctors should be prescribing metformin to treat prediabetes (a state of higher-than-normal blood glucose levels that doesn’t meet the diagnostic criteria for diabetes), especially for people under the age of 60, although the FDA has yet to bless metformin’s use for the condition.

Can metformin cause weight loss?

The FDA has also not officially approved metformin as an aid in losing weight. Many people with type 2 diabetes have lost weight after taking the drug, as researchers are still torn over exactly how metformin affects the weight. Some believe it decreases appetite, while others say it affects the way the body stores and uses fat.

Scientists are also examining metformin’s potential to protect against heart disease in people with type 2 diabetes – some older data supports this. While robust heart outcome trials with metformin are yet to be conducted, more attention is being paid to this research area.

Metformin and type 1 diabetes

It will be an exciting development if metformin is helpful in the treatment of cancer or neurodegenerative conditions like Huntington’s. But what if it is found to help people managing type 1 diabetes?

Metformin is not currently approved by US or European regulatory agencies for use in type 1s, but people have been known to take the medication anyway, and many doctors prescribe it if someone with type 1 diabetes is overweight. There are actually several reasons metformin is an attractive option for many type 1s. One, metformin has been found to help reduce glucose production in the liver, which is a problem in type 1 diabetes. Two, people often form resistance to the insulin they take, and metformin can help improve insulin sensitivity.

And, metformin may support weight loss and protection against heart disease. A study published in the Lancet following type 1 participants for three years found that compared to placebo, participants taking metformin lost weight. Particularly because insulin often causes weight gain, healthcare providers prescribe metformin “off-label” (not for intended use approved by regulatory agencies) to their type 1 patients. While the study didn’t find that metformin definitively protects against heart disease, based on observed trends in the data, the authors concluded that it may have a role in heart disease risk management.

The Bottom Line?

Metformin

Image source: diaTribe

If you are a person with type 2 diabetes, there are plenty of benefits to taking metformin for its original, intended purpose.

Its side effects are minimal for most people. It’s affordable and covered by Medicare and most insurance plans. Speaking for myself: metformin doesn’t have to cure aging or cancer to be immensely valuable. It helps me process insulin and go on with my life. For me, that’s enough.

About Marcia Kadanoff

Marcia Kadanoff is an advisor to The diaTribe Foundation. She was diagnosed with type 2 diabetes in June 2017 at the age of 50-something, and both her parents and grandparents died of diabetes-related complications. With the help of diaTribe and Adam Brown’s book, Bright Spot & Landmines, Marcia discovered that type 2 diabetes can be put into remission with lifestyle changes. Over the next 7 months, Marcia worked to reverse her diabetes through a LCHF (low-carb, healthy fat) way of eating and regular exercise. Along the way, she lost 45 lbs (!) and found that she no longer suffered from sleep apnea and fibromyalgia. Marcia has maintained her weight loss for a year and had a 4.9% A1C at her last checkup. She wants other people with type 2 to know that they too can put their diabetes into remission.

Source: diabetesdaily.com

What Causes Prediabetes and Type 2 Diabetes on Coaches Corner

What Causes Prediabetes and Type 2 Diabetes on Coaches Corner

mySugr Coaches Kristen and Maggie fill us in on what causes prediabetes and type 2 diabetes. Learn what you can do about the risk factors you can control and how to shed the guilt around the risk factors you can’t control.

Let’s learn about the factors that can help prevent, delay, and better manage prediabetes and type 2 diabetes, as well as factors that are non-modifiable.

Note: We cannot provide medical advice. Please contact your doctor directly for specific questions about your care.



Topics

  • Modifiable risk factors vs. non-modifiable risk factors
  • Weight as a risk factor
  • Working on small changes that make big impacts

Transcript

Scott K. Johnson – Hey, thanks for tuning in to another episode of Coaches Corner, it is great to see you again. Let me know where you’re watching from today. One small way that mySugr is giving back, is by hosting these short conversations with our diabetes coaches to talk about staying healthy in body and mind. We really appreciate you sharing some time with us. Now I do have to give the standard disclaimer, we cannot provide medical advice. Please contact your doctor directly for specific questions about your care. And another quick housekeeping note, we are shifting to two broadcasts per week through the end of May. On Mondays and Wednesdays at 3 p.m. Pacific time with the exception of next Monday which is Memorial Day. We’re going to take that holiday off. We’ve got some great topics lined up for the rest of the month, so I do hope that you’ll join us. Today, mySugr Coaches, Kristen and Maggie fill us in on what causes pre-diabetes and type 2 diabetes. Learn what you can do about the risk factors you can control and how to shed the guilt around the risk factors you can’t control, let’s take a look. Alright, Kristen and Maggie, always great to have you back again. Today we’re talking about what causes diabetes and pre-diabetes and if I ever heard a loaded question, this is one of them but we’re going to try and break down some of the common topics and dig into this a little bit. So, but maybe before we go into what causes pre-diabetes and type 2 diabetes, how would you define type 2 diabetes?

Maggie Evans – Great question, Scott, so I would think, you know, one of our main pillars that we kind of talk about when it comes to type 2 diabetes is the concept of insulin resistance. So when you think of insulin resistance, we know insulin is a hormone that our pancreas, which is a little organ next to stomach, our pancreas makes insulin which technically acts kind of like a key to a lock on the cell site that allows glucose to go into ourselves to make energy. So for us to live and be active and do the things that we want to do, so we need that mechanism to happen in order to live, essentially. In diabetes and in insulin resistance specifically, we tend to see that, that key mechanism just isn’t working as well, so that insulin just isn’t as effective at getting that glucose into the cell, that sugar into the cell, for it to make energy. So what ends up happening is we tend to see this larger amount of sugar building up in the bloodstream and then the pancreas kind of goes into a little bit more overdrive and tries to produce more insulin in a way to try and get that glucose into the cell. So we see kind of a rise in insulin and it’s just still not as effective. We also see this rise in blood sugar. So that kind of starting point where we see these rises in blood sugar but not necessarily numbers that would merit type 2 diabetes, we call that pre-diabetes. So it could be referred to as like, “impaired fasting glucose,” just “impaired glucose levels.” That might be something that your doctor refers to as that. And then once that gets to a point where the blood sugar numbers are high enough to be classified as diabetes, then we can kind of consider that, to be more so that full-blown insulin resistance.

Scott K. Johnson – And these are, when we talk about doctors checking our glucose levels and things like that, these are typically part of like, an annual physical lab exam, things like that, right? Something that the doctors would look at, on a pretty periodic regular basis.

Maggie Evans – Of course, yeah so these, especially the A1C might be on something more like, a yearly lab panel. There’s something called a complete blood count or a CBC for short and typically our glucose levels will be on there, so no matter what, if you’re fasting for those, you know, monthly or you know, quarterly labs, you can still see your fasting glucose on there and sometimes that can be that indicator that tells your provider, “Hey, these glucose levels are rising,” so there might be potential for that to develop into type 2 diabetes.

Scott K. Johnson – And I know that, understanding where diabetes comes from, what causes diabetes, it’s an incredibly complicated topic. There’s a lot that’s not yet understood and a lot that’s misunderstood. One of the things that many people newly diagnosed with diabetes think about or feel, is that they’ve done this to themselves. They’ve eaten themselves into having diabetes. We’re going to touch on some of the factors but just right off the top I want to put it out there that it’s not quite that simple, alright, that’s not quite the case, but we’re going to look at what these factors are and I like the way that you two are breaking these down into modifiable risks or things that we can actually do something about and then there’s also a handful of non-modifiable risks or things that are very much out of our control. So let’s jump into the factors.

Kristen Bourque – Yeah so, kind of as Maggie put it so well about, you know, we talk about pre-diabetes and type 2 diabetes, so when I kind of go over this a little bit, this is where it’s very important to work on those modifiable factors, like you mentioned, Scott so, if I were to put two separate columns, essentially, non-modifiable risk factors are things that maybe, again are, of course including like, age, ethnicity, a family history of type 2 diabetes, so things that of course we can’t change or modify which is why it’s called a non-modifiable factor. But there is this whole other category of modifiable risk factors, things that we can work on and of course modify to help either prevent or delay the development of type 2 diabetes but also if we do have type 2 diabetes, to help manage it better. So of course when we look at a couple things that right off the bat of course, is our intake of our, you know, nutrition, right, so our diet as well as our activity. So those are two things that can really have a substantial impact on our blood sugar values, depending on where our numbers are in terms of our weight, and we do want to preface this by saying, of course, this is something you want to talk with your doctor about, but weight loss might be a recommendation that is beneficial for you to either again, delay type 2 diabetes or again manage it better. Also there’s another piece of it too is medication so depending on the type of medications and we know that can actually encourage things like, weight gain, excuse me, as well as like, steroids which can impact blood sugar values too. So it’s hard to put that category of medications ’cause it may be something that you need to have in your life as well, so potentially could be a non-modifiable risk, but in general, it might be something where it’s a short period of time that you’re on that medication and that might be causing those values to be a little bit higher. So again we always like to encourage people to kind of look at what are the things that we can work on and change, to help improve those blood sugar values, over time as well.

Scott K. Johnson – You mentioned around the topic of weight, that often times some weight loss can actually help matters quite a bit, but what are we looking at in terms of numbers or you know, if someone is overweight, dealing with diabetes or pre-diabetes, I think they can often have this misconception that they need to go from where they are today to this super fit athlete, you know, lose a bunch of weight, but that’s not really true, is it?

Kristen Bourque – No and that’s such a great point too and this is why I kind of say, you know, make sure and talk with your doctor about kind of, where your numbers are at. Something that we do use is our body mass index, it’s a measurement of our height versus our weight, but the problem is, it doesn’t account for a lot of important factors so, you know, age, of course, muscle mass, so there’s a lot of pieces of that puzzle missing. One thing that we really like to recommend is, and you could do this at home, it’s actually just to measure your waist circumference. We found that people that have a larger waist circumference or more, we call visceral fat, so, fat in that midsection area do also have an increased risk of developing type 2 diabetes and that insulin resistance that Maggie was mentioning, so I actually prefer that, over the BMI because we can simply measure it at home, and we also know even if we don’t have a tape measure, we know, if those pants are fitting a little tighter, that maybe we are struggling a little bit. But that could be a good marker of, you know, again, even if we were to lose a couple inches, we’re also going to help improve those numbers and those other risk factors, you know, again in turn as well too, you know, again, just overall, the big picture there.

Maggie Evans – Another measure that we can use too, is just simply about 5% of your weight as well so a reduction in about 5%. So it doesn’t have to be a large number. For most people that ends up being just about 5 or 10 pounds and of course when, you know, we’re working with people and we make these recommendations, this isn’t 5 pounds in a week, it’s 5 pounds over a period of time. It’s making these slower, more sustainable changes over that period of time to really help make us more insulin-sensitive versus insulin-resistant.

Scott K. Johnson – Yeah that helps put it into perspective quite a bit. So when I look at the, and hear the list of things that are modifiable risks or things that are in my control, I’m actually quite encouraged that there’s a lot that I can do to help myself if I’m worried about or dealing with pre-diabetes or type 2 diabetes, so I really appreciate breaking it down in that way.

Kristen Bourque – Yeah and I think, Scott you bring up a great point that, I know it can seem overwhelming, especially if your doctor, you know, tells you that you have a diagnosis of pre-diabetes or type 2 diabetes but even working on one of these risk factors will help improve those values so I know it can seem a little bit overwhelming to digest all that information, but even small, small changes make a big impact over time.

Scott K. Johnson – It’s a great point, alright well, thank you, this was a quick session on pre-diabetes and type 2 diabetes but I think that we covered quite a bit. Is there anything else that either if you want to go into on this topic?

Kristen Bourque – I think we covered it pretty well yes and definitely, message your coach if you, you know want to, again work on some of these modifiable risk factors, we’re here to support you on that journey for sure.

Scott K. Johnson – Sounds good, thank you and we’ll see you again very soon for another session. Alright I hope that that was helpful and if you have additional questions or want us to dive deeper, go ahead and leave us those questions in the comments. We are happy to follow up and address them in an upcoming episode. And then I hope that you’ll come back on Wednesday, when I catch up again with Maggie and Kristen about the signs and symptoms of pre-diabetes and type 2 diabetes. Until then, stay well and we’ll see you next time, bye.

Source: diabetesdaily.com

Book Review: Diabetes Essentials

Diabetes Essentials: Tips & Recipes to Manage Type 2 Diabetes, is a brief, easy-to-understand, illustrated introduction and guide to living with type 2 diabetes, that was recently published by registered dietitian and diabetes educator Karen Graham, and endocrinologist Dr. Mansur Shomali. I received the book for review at no charge and all opinions are my own.

My Review

When a person is newly diagnosed with type 2 diabetes it can feel isolating and overwhelming, especially for those who were previously unfamiliar with the condition and what diabetes management entails. This short, easy-to-understand, illustrated guide covers the main concepts and provides concrete advice to help set new patients on the right path to healthy living with diabetes.

The information in the book is organized in easy-to-read “top-ten” lists and focuses on many categories that are relevant to life with diabetes, including diet, exercise, blood sugar management, healthy lifestyle choices, weight loss, mental health, planning for pregnancy, and much more. The information covers the basics, without going into detail, and is in line with the commonly prescribed medical advice that is typically offered to patients with diabetes.

Throughout, the book offers helpful and specific tips that aim to help people with diabetes better understand their condition and improve their health. From advice on mindful eating to smoking cessation to preventing and identifying complications, this book covers so many aspects of living well with diabetes. I particularly liked the list with advice for getting through the first 10 days after a diabetes diagnosis, as well as the guide to different doctors’ appointments.

A considerable section of the book is dedicated solely to “diabetes-friendly” recipes, including a sample ten-day meal plan, along with ideas for salads, soups, dinners, snacks, and desserts. Most of the recipes are moderate in carbohydrates, high in fiber, and low in fat. Detailed nutritional information is provided alongside each recommendation.

One section I liked, in particular, discussed trending research and recent diabetes advancements. These included a discussion of continuous glucose monitoring technology, as well as newer insulins and diabetes medications. The authors also cited some relevant information from the national Diabetes Prevention Program (DPP). I thought this section was particularly useful to help new patients understand how recent advances in care (even if not yet practiced in the mainstream) can help people with diabetes better manage their condition.

The last section of the book consists of quizzes on various topics to help readers reinforce their understanding of the educational materials. This also provides a fun way to learn about some common misconceptions. Finally, the detailed index at the end makes it easy to quickly find a specific topic of interest.

Summary

Overall, this text provides a competent and easy-to-understand overview of type 2 diabetes basics and advice for newly diagnosed patients. It informs without overwhelming the reader with too many details and provides concrete strategies to help manage the condition and related health issues.

Diabetes Essentials costs $24.95 and can be purchased online here.

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Have you purchased this book already? Please share your thoughts with us in the comments below.

Also, check out this comprehensive list: The Best Books About Diabetes.

Source: diabetesdaily.com

Can Continuous Glucose Monitors Help Change How We All Eat?

If you share with someone results from a study indicating that even “healthy” people often eat foods that cause harmful blood sugar spikes, they may believe you and understand the underlying reasons. However, they may be much more likely to act on this knowledge if they wear a device that shows them in real time […]
Source: diabetesdaily.com

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