6 Tasty Recipes for Peanut Butter Lovers

March kicks off with National Peanut Butter Lovers Day. While we think there’s more than enough reason to celebrate the existence of our all-time favorite spread every day, we’re honoring this event by featuring low-carb peanut butter recipes you (and your pancreas) will love.

Chocolate Peanut Butter Shortbread

Photo credit: Jennifer Shun

Chocolate Peanut Butter Shortbread

This shortbread is candy and cookie rolled into one. It uses low-carb almond and coconut flours for its base and rich dark chocolate with a tad of espresso for its topping, making it a flavorful option for snacks or dessert.

No-bake peanut butter cookies

Photo credit: Lisa MarcAurele

Peanut Butter No-Bake Cookies

No oven, no problem. With this recipe, you just mix the peanut butter with sunflower and pumpkin seeds, chocolate chips, and other ingredients for the batter, scoop them onto a baking sheet, and place them in the freezer. After 2 hours, you get to enjoy a sweet, crunchy, and satisfying dessert.

Peanut Butter Cheesecake

Photo credit: Brenda Bennett

Low-Carb Peanut Butter Cheesecake

Peanut butter in cheesecake sounds good, and it tastes even better if you top it with sugar-free melted chocolate. This recipe guides you on how to prepare this magical treat — without an oven. You make the crust in the processor and the cheesecake in the mixer. After putting them together, you let them set in the fridge for a few hours before adding the optional toppings.

Peanut Butter Smoothie

Photo credit: Carine Claudepierre

Peanut Butter Smoothie

This peanut butter smoothie is a light and refreshing drink for snacks. On days when you barely have time to make breakfast, or you’re bored with eggs and bacon, this can be a good alternative too. Add a scoop of low-carb protein powder if you want to make it extra fulfilling.

Peanut Butter Ice Cream

Photo credit: Taryn Scarfone

Peanut Butter Ice Cream

While the creamy and rich ice cream tastes good, the peanutty caramel sauce makes this treat even more savory. Top it with roasted salted peanuts for more protein, fiber, and crunch. If you prefer chocolate instead, the recipe has a link to a 3-ingredient keto hot fudge.

Peanut Sauce

Do you love munching vegetables for snacks? Use this recipe for your dipping sauce. Made by stirring only 5 ingredients in a bowl, this sauce has the right combination of salty, sweet, and sour. It’s also versatile; you can use it for salads, in noodle dishes, and on cooked chicken among others.

How do you like to use peanut butter in the kitchen? Share your tips with us in the comments!

Source: diabetesdaily.com

Keto Cinnamon Rolls Recipe with Coconut Flour Fathead Dough

This content originally appeared on Low Carb Yum. Republished with permission.

The first time I made low-carb cinnamon rolls, I never shared them on my blog because I didn’t love the texture. Cinnamon rolls need to be soft and chewy. Otherwise, they just aren’t right.

But a few years later, I had the idea to use the fathead dough from my low-carb bagels. That dough uses coconut flour, which I prefer to almond flour.

Sure enough, coconut flour was the answer! I was so impressed with how these keto cinnamon rolls turned out the second time. The dough is light and fluffy, like a traditional pastry, with just the right amount of sweetness.

These remind me so much of Cinnabon rolls, especially when served warm! They are amazing fresh out of the oven. If eating them later, I recommend reheating them in the microwave for about 40 seconds.

Coconut flour cinnamon rolls make for a delicious grab-and-go breakfast, or the perfect treat to savor alongside your morning coffee. They are also very straightforward to make.

keto cinnamon rolls

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Keto Cinnamon Rolls

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It’s simple to make low-carb cinnamon rolls using coconut flour fathead dough. Serve them warm with melted cream cheese icing on top. They are a heavenly treat any time of day.
Course Breads and Baked Goods, Breakfast, Snack
Cuisine American
Keyword cinnamon
Prep Time 15 minutes
Cook Time 16 minutes
Total Time 31 minutes
Servings 12 people
Calories 209kcal

Ingredients

Dough:

  • 60 grams coconut flour about ½ cup
  • ¼ cup low-carb sugar substitute
  • 2 tablespoon baking powder can be cut in half to reduce sodium but may not rise as well
  • 250 grams mozzarella cheese shredded, about 2-½ cups
  • 55 grams cream cheese 2 ounces
  • 3 large eggs beaten
  • 2 tablespoons butter melted, add a bit more if needed and use unsalted to reduce sodium
  • ½ teaspoon vanilla extract optional

Filling:

  • ¼ cup low-carb brown sweetener
  • 1 teaspoon cinnamon
  • 3 tablespoons butter softened, can be omitted but gives a better filling taste

Icing:

  • 3 ounces cream cheese softened
  • 3 tablespoons butter softened
  • ¼ cup Swerve Confectioners Powdered Sweetener
  • ¼ teaspoon vanilla extract
  • low-carb almond or coconut milk if needed

Instructions

  • Preheat oven to 400°F and grease a 9×13-inch pan baking pan if needed.
  • Mix coconut flour, low-carb sweetener, and baking powder in a small bowl. Set aside.
  • Melt mozzarella cheese and cream cheese in microwave on high power for one minute. Stir. Place back in microwave on high for another minute. Stir.
  • Add in beaten eggs, butter, vanilla extract (if using), and coconut flour mixture until a dough is formed. Dough should be a bit wet and sticky. If dry, try adding in another egg or more butter.
  • Roll dough out into a rectangle about 9×12 inches.
  • In small bowl, combine the brown low-carb sweetener with cinnamon. Spread butter evenly over the dough then sprinkle the cinnamon mix on top.
  • Roll dough into a log starting at one of the shorter ends. Slice into 1-inch thick rounds.
  • Rounds into prepared baking pan. Bake at 400°F for about 14-16 minutes or until lightly browned. Allow to cool slightly on a wire rack.
  • In a medium mixing bowl, cream the cream cheese and butter with an electric mixer. Beat in the powdered sweetener and vanilla extract. Add in a little low-carb milk (coconut or almond) if needed to thin the icing.

Notes

Pecans can be added to the cinnamon mixture if desired.

Nutrition

Serving: 1roll | Calories: 209kcal | Carbohydrates: 4g | Protein: 7g | Fat: 17g | Saturated Fat: 10g | Cholesterol: 90mg | Sodium: 262mg | Potassium: 249mg | Fiber: 1g | Sugar: 1g | Vitamin A: 590IU | Calcium: 213mg | Iron: 0.6mg


Please note that the nutritional information may vary depending
on the specific brands of products used. We encourage everyone to check specific
product labels in calculating the exact nutritional information.

Keto Cinnamon Rolls Recipe with Coconut Flour Fathead Dough Recipe

Source: diabetesdaily.com

Metformin May Reduce Your Risk of Death from COVID-19 Infection

This content originally appeared on diaTribe. Republished with permission.

By Eliza Skoler

The use of metformin – the most common initial medication for people with type 2 diabetes – was associated with a lower rate of mortality from COVID-19 among people with diabetes in a study in Alabama, confirming five previous studies.

Do you take metformin? It’s the first-line therapy used to lower glucose levels in people with type 2 diabetes. A recent study found that metformin use was associated with a lower rate of COVID-related death among people with type 2 diabetes. Since people with diabetes are at increased risk for severe illness from COVID-19, including hospitalization and death, the relationship between metformin and COVID outcomes in this report may be of interest to many people around the world who take the medication.

Want more information like this?

The study looked at the electronic health data from 25,326 people tested for COVID at Birmingham Hospital in Alabama, including healthcare workers, between February and June of 2020. Of those tested, 604 people were positive for COVID-19 – and 239 of those who were positive had diabetes. These results showed that the odds of testing positive for COVID were significantly higher for people, particularly Black people, with certain pre-existing conditions, including diabetes. This does not mean people with diabetes are more likely to get COVID-19, only that people with diabetes were more likely to test positive at this hospital.

Importantly, the study found an association between metformin use and risk of death – the study reported that people who were on metformin before being diagnosed with COVID-19 had a significantly lower chance of dying:

  • People taking metformin had an 11% mortality (or death) rate, compared to 24% for those with type 2 diabetes not on metformin when admitted to the hospital.
  • This benefit of metformin remained even when people with type 2 diabetes and kidney disease or chronic heart failure were excluded from the calculations. This is important because people with kidney or heart disease are often advised against taking metformin. By removing this population, it helps to support the notion that metformin may be involved in this difference.
  • Body weight and A1C were not associated with mortality among people with diabetes taking metformin. This suggests that the association of metformin use with reduced COVID-related deaths was not due to the effects of the medication on weight or glucose management.

The data suggest that being a person with diabetes who takes metformin may provide some level of protection against severe COVID-19 infection among people with diabetes. Other studies have shown similar results, though it is not known whether metformin may itself reduce COVID-related deaths among people with type 2 diabetes. The authors discussed some previously reported effects of metformin beyond lowering glucose levels, such as reducing high levels of inflammation (the body’s natural way of fighting infection), which has been described as a risk factor in severe COVID infection. Severe infection with COVID-19, resulting in hospital admission, can lead to damage to the kidneys and decreased oxygen supply to the body’s tissues – and in these circumstances, serious side effects of metformin can occur.

“Given that COVID leads to higher mortality rates and more complicated hospital courses in people with diabetes, it is important to consider whether specific diabetes medications can provide some relative degree of protection against poor COVID outcomes,” said Dr. Tim Garvey, an endocrinologist at the University of Alabama at Birmingham. “This study adds to growing evidence that people with type 2 diabetes treated with metformin have better outcomes than those not receiving metformin.”

Dr. Garvey also cautioned: “Of course, these case-control studies show associations and do not rise to the level of evidence that might be found by a randomized clinical trial. For example, people with diabetes not treated with the first-line drug, metformin, may have a larger number of diabetes complications or longer duration of disease compared with people not on metformin – which could explain the more severe outcomes. In any event, we advocate for early administration of COVID-19 vaccines and other protective measures for people with diabetes.”

Professor Philip Home, a professor of diabetes medicine at Newcastle University in the UK, agreed, saying, “Multiple studies have now addressed the issue of whether metformin and insulin use are associated with better or worse outcomes in people with diabetes who contract COVID-19. In line with previous literature on other diseases, it was expected that people on metformin would do better, and people on insulin worse, than people with diabetes not using these medications. This is confirmed.”

Home continued: “It is believed to happen because people using metformin are younger and have better kidney function than those not taking the medication, while those on insulin tend to have other medical conditions. The good news is that if you have type 2 diabetes and are taking metformin, you are likely to be fitter than if you have type 2 diabetes and do not take the medication – but there is no evidence that metformin itself will make a difference to your outcome if you do get COVID-19. So, get vaccinated as soon as possible!”

To learn more about metformin, read “Everything You Always Wanted to Know About Metformin, But Were Afraid to Ask.”

Source: diabetesdaily.com

Getting the Most Out of Your Remote Healthcare Visits

This content originally appeared on Integrated Diabetes Services. Republished with permission.

By Gary Scheiner MS, CDCES

A long, long time ago, before the days of coronavirus, there was a little diabetes care practice called Integrated Diabetes Services (we’ll just call it IDS for short). IDS taught people with diabetes all the wonderful things they can do to manage their diabetes. Word got out, and people who lived far from IDS’s local hamlet (better known as Philadelphia) wanted to work with IDS. Even people IN the hamlet wanted to work with IDS but were often too busy to make the trip to the office. So IDS had an idea: “Let’s offer our services via phone and the internet so that everybody who wants to work with us can work with us!” The idea took off, and IDS grew and grew.

And virtual diabetes care was born.

Today, in response to the COVID-19 pandemic, virtual healthcare has become a virtual norm. Often referred to as “telehealth” or “telemedicine,” people with diabetes are connecting with their healthcare providers for everything from medical appointments to self-management education to coaching sessions. Some consults are conducted via phone calls, while others utilize web-based video programs (like Zoom) or simple email or text messages. Regardless of the form, virtual care can be highly effective. But it can also have its limitations. Whether you’ve been receiving virtual healthcare for months or have yet to give it a try, it pays to learn how to use it effectively. Because virtual care will certainly outlive the pandemic.

What Can… and Can’t… Be Accomplished Virtually

Most diabetes care services, including medical treatment and self-management education, can be provided effectively on a remote basis. We have managed to teach our clients everything from advanced carb counting techniques to strength training routines to self-analysis of glucose monitoring data, all while helping them fine-tune their insulin program, on a 100% virtual basis.

Some clinics and private healthcare providers have gone 100% virtual since the pandemic began, while others are using a “hybrid” approach – periodic in-person appointments with virtual care in-between. Depending on the reason you’re seeking care, a hybrid approach makes a lot of sense. While virtual visits are generally more efficient and economical (and in many cases safer) than in-person appointments, there are some things that are challenging to accomplish on a remote basis. From a diabetes standpoint, this includes:

  • Checking the skin for overused injection sites
  • Learning how to use medical devices (especially for the first time)
  • Examining the thyroid gland and lymph nodes
  • Evaluating glucose data (unless you can download and transmit data to your provider)
  • Performing a professional foot exam
  • Listening to the heart rhythm and feeling peripheral pulses
  • Checking for signs of neuropathy and retinopathy
  • Measuring vital signs (unless you have equipment for doing so at home)

The Logistics

Virtual care can be provided in a variety of ways, ranging from a phone call to an email, text message or video conference. Video can add a great deal to the quality of a consultation, as it allows you and your healthcare provider to pick up on body language and other visual cues. It also permits demonstrations (such as how to estimate a 1-cup portion of food), evaluation of your techniques (such as how to insert a pump infusion set), and use of a marker board for demonstrating complex subjects (such as injection site rotation or how certain medications work).

When using video, it is important to have access to high-speed internet. A computer is almost always better than a phone for video appointments, as the screen is larger and has better resolution. If you have the ability to download your diabetes data, do so and share access with your healthcare provider a day or two prior to the appointment. It may also be helpful to share some of your “vital” signs at the time of the appointment – a thermometer, scale, and blood pressure cuff are good to have at home.

In many cases, care provided on a remote/virtual basis is covered by health insurance at the same level as an in-person appointment. This applies to public as well as private health insurance. However, some plans require your provider to perform specific functions during the consultation (such as reviewing glucose data) in order for the appointment to qualify for coverage. Best to check with your healthcare provider when scheduling the appointment to make sure the virtual service will be covered. At our practice (which is 100% private-pay), virtual and in-person services are charged at the same rates.

If security is of the utmost importance to you, virtual care may not be your best option. Although there are web-based programs and apps that meet HIPPA guidelines, there really is no way to guarantee who has access to your information at the other end. My advice is to weigh the many benefits of virtual care against the (minuscule) security risk that virtual care poses.

Optimizing the Virtual Experience

Just like in-person appointments, virtual care can be HIGHLY productive if you do a little bit of preparation.

  • Do yourself and your healthcare provider a favor and download your devices, including meters, pumps, CGMs, and any logging apps you may be using, prior to the appointment. If you don’t know how to download, ask your healthcare provider for instructions, or contact our office… we can set up a virtual consultation and show you how. If you have not downloaded your information before, don’t be intimidated. It is easier than you think. People in their 80s and 90s can do it. Oh, and look over the data yourself before the appointment so that you can have a productive discussion with your healthcare provider.
  • Be prepared with a list of your current medications, including doses and when you take them. Check before the appointment to see if you need refills on any of your medications or supplies. If you take insulin, have all the details available: basal doses (and timing), bolus/mealtime doses (and dosing formulas if you use insulin:carb ratios), correction formulas (for fixing highs/lows), and adjustments for physical activity.
  • Try to get your labwork done prior to virtual appointments. This will give your healthcare provider important information about how your current program is working.
  • To enhance the quality of the virtual meeting, do your best to cut down the background noise (TV off, pets in another room, etc…) and distractions (get someone to watch the kids). Use of a headset may be preferable to using the speakers/microphone on your phone or computer, especially if there is background noise or you have limited hearing.
  • Use a large screen/monitor so that it will be easy to see details and do screen-sharing. And use front lighting rather than rear lighting. When the lights or window are behind you, you may look more like a black shadow than your beautiful self. “Ring” lights are popular for providing front-lighting.
  • Provide some of your own vitals if possible – weight, temperature, blood pressure, current blood sugar. This is important information that your healthcare provider can use to enhance your care.
  • Prepare a list of topics/questions that you want to discuss. Ideally, write them on paper so that you can take notes during the appointment. If there is a great deal of detail covered, ask your healthcare provider to send you an appointment summary by mail or email.
  • Be in a private place that allows you to speak openly and show any body parts that might need to be examined – including your feet and injection/infusion sites.
  • Be a patient patient! Technical issues can sometimes happen. It is perfectly fine to switch to a basic phone call or reschedule for another time.
  • Courtesy. Be on-time for your virtual appointment. If you are delayed, call your healthcare provider’s office to let them know. And if you are not sure how to login or use the video conferencing system, call your provider beforehand for detailed instructions. This will help to avoid delays. Have your calendar handy so that a follow-up can be scheduled right away. Oh, one other thing: Try not to be eating during the appointment… it is distracting and a bit rude. However, treating a low blood sugar is always permissible!

If there is one thing we’ve learned during the pandemic, it’s that virtual care is a win-win for just about everybody. Expect it to grow in use long after the pandemic. In-person care will never go away completely, but for treating/managing a condition like diabetes, virtual care has a lot to offer… especially if you use it wisely.

Note: Gary Scheiner is Owner and Clinical Director of Integrated Diabetes Services, a private practice specializing in advanced education and intensive glucose management for insulin users. Consultations are available in-person and worldwide via phone and internet. For more information, visit Integrated Diabetes.com, email sales@integrateddiabetes.com, or call (877) 735-3648; outside North America, call + 1-610-642-6055.

Source: diabetesdaily.com

Easy At-Home Gym Hacks

We are nearly a year into the pandemic, which has all but frozen life as we used to know it. It has required a shift in thinking, and a transition to doing most everything at home: work, school, and even exercise. Most gyms across the country are either still closed or operating at extremely limited capacity, and many people feel more comfortable working out from the comfort of their own homes until herd immunity is achieved in the United States.

But how can you get a good, full-body workout at home, when time, space, and equipment is limited? These are our top tips.

Keep a Routine

The best workout is the one you’ll do consistently, and that means making your exercise time routine. It should be no different than when you would typically go to a physical gym: exercise should happen during the same time and in the same place every day.

This also helps create boundaries with work and family. If you go to the garage every morning at 6 a.m. for dedicated “gym” time, the kids will soon learn that you’re not available to play then. Alternatively, if you block out 20 minutes at noon every day for a run on your Outlook calendar, your boss is much less likely to schedule impromptu meetings during that time.

Also, it’s important to know yourself. If you’re a morning person and start to fade around dinnertime, don’t wait to get your exercise in after the kids go to sleep. By prioritizing your exercise time and making it routine, you’re guaranteed to make it a habit that will stick.

Set Yourself Up for Success

Adjusting to home workouts does not need to be complicated. You can start small with Youtube yoga and dance videos, high-intensity interval training (HIIT) workouts, and even meditation to deal with stress. Listening to Spotify or Pandora while working out can help bring fresh music to your routine, too.

Accumulating some at-home gym equipment can also keep you stimulated and less likely to become bored.

Michelle, from Madison, Wisconsin, says that she uses the Nike training app religiously, as it helps prevent ennui and always mixes up workouts. The app comes with multi-week programs, including a prescribed series of workouts, nutrition tips, and wellness guidance to help users build healthy habits. Each flexible program is led by a Nike Master Trainer and is created to cater to those working out at home.

Additionally, Michelle recommends Bowflex adjustable dumbbells, which replace 15 sets of weights! The weights adjust from 5 up to 52.5 lbs each. By easily turning the dial you can change the resistance, enabling you to gradually increase your strength.

Ryan, from Albany, New York, uses the Bowflex C6 bike in combination with the Peloton app (which is just $15 per month!). The bike has 100 levels of resistance, just like the Peloton bike, but is half the cost, so you can follow along to Peloton workouts while saving a ton of money.

If you’re not into collecting a ton of equipment but want to build strength and get your heart rate up, simply investing in a kettlebell and a jump rope can be all you need to take squats and lunges to the next level.

If you don’t want to buy all new equipment for your home, see if you can crowdsource some from friends and family. Pool resources together, and share weights, a rack, a bicycle, treadmill, or other equipment, to make assembling an at-home gym more affordable.

Jennifer, from Des Moines, Iowa, says, “My sister lives across town and has a great treadmill in her garage. She works the night shift and I work during the day, so will pop on over to her house to get a run in on cold mornings while she’s still at work. It works perfectly.”

Some people have even had luck renting equipment or even borrowing equipment from their gyms while they are closed due to COVID-19 restrictions. Jessica, from Boulder, Colorado, says. “I emailed my local rec center, and they’ve let me borrow some heavier kettlebells that would have been prohibitively expensive to buy. They let members borrow equipment for 72 hours, which works perfectly to spice up my workout routines.”

exercise accountability buddy

Photo credit: iStock

Find an Accountability Buddy

No one is inspired to exercise all the time. Having a friend or family member checking in with you to make sure you’re meeting your fitness goals can be a crucial nudge to help you stick to your routine. Perhaps you have a weekly check-in call with a friend every Friday to review what you did to get your heart pumping, or you email different workout plans to each other every week to stay motivated.

If you feel safe enough to do so, maybe you meet someone for a walk each weekend, to get fresh air and a change of scenery. Whatever you do, it should help you stay motivated, not hinder your progress.

Even if your accountability buddy isn’t actively trying to improve their fitness or lose weight, they could benefit too: a recent study showed that when 130 couples were tracked over six months, the accountability buddy not actively trying to lose weight had success in some weight loss too, if their partner was on an exercise plan.

Make It Fun!

In this strange time, it’s important to make exercise fun. Have goals and work hard to meet them, but make sure to celebrate your progress, too. Maybe you’re trying to deadlift 150 lbs, lower your HbA1c, do twenty weighted lunges in a row, or run a faster mile.

If and when you meet those goals, celebrate them! This may look different in 2021, but ordering takeaway coffee from a favorite coffee shop, ordering your favorite candle online, or buying a new swimsuit are all well-deserved awards for hard work put in at home.

Working out at home does not need to be boring or uninspired. With these tips, you can keep your fitness levels high, stay motivated, save money, and get healthier, even during the quarantine. Remember to always check with your doctor before starting a new exercise routine.

Have you been working out at home during the pandemic? How is it going for you? What strategies or advice would you give others? Share this post and comment below!

Source: diabetesdaily.com

Keto Nutella Fat Bombs

This content originally appeared here. Republished with permission.

Fat bombs are bite-sized snacks that are sugar-free, very low in carbohydrates, and high in fat, and they can be sweet or savory. They’re usually designed to help keep you in ketosis, but you don’t have to be in ketosis to enjoy fat bombs. Our bodies need fat to thrive, so there’s an easy Paleo-friendly adaptation included below.

And what better way to enjoy a fat bomb than with the famous flavors of Nutella! Nutty, earthy, and distinct hazelnut flavor paired with rich chocolate are what give Nutella its nutella-ness, and those foods are both keto and Paleo-friendly. Just add some creamy coconut oil and whatever sweetener you prefer, depending on if you’d prefer to keep it keto or Paleo, and you’re in business!

This dessert is gluten-free, grain-free, and refined sugar-free. So no matter who you’re cooking for, there’s something for everyone to love!

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Keto Nutella Fat Bombs

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Made in the blender with just four ingredients, these are the perfect no-bake treat or dessert!
Course Dessert
Cuisine American
Keyword fat bombs, nutella
Prep Time 10 minutes
Resting Time 30 minutes
Total Time 40 minutes
Servings 12 servings
Calories 182kcal

Equipment

  • High speed blender or food processor

Ingredients

  • 1 cup hazelnut butter
  • 1/3 cup coconut oil
  • 1/4 cup cocoa powder or substitute cacao powder + 1/4 tsp. vanilla extract
  • 3 – 3.5 tbsp monk fruit sweetener swerve (erythritol), or xylotol, or substitute any Paleo or Keto friendly sweetener of choice – see notes below for more options.
  • 1/2 tsp flakey sea salt optional
  • 1 tbsp chopped hazelnuts optional

Instructions

  • Add all ingredients to a high speed blender or food processor. Blend until completely smooth.
  • Pour the mixture into 12 lined muffin cups and transfer to the refrigerator. If you aren’t using muffin cups, transfer the mixture to a bowl and set in the refrigerator.
  • Allow the fat bombs to chill for at least 30 minutes. Remove the fat bombs from the muffin cups or scoop from the bowl into small 1-2 inch balls. Sprinkle with flakey sea salt and hazelnuts, if using. Keep chilled in the refrigerator or freezer until you're ready to serve, and enjoy!

Notes

Keto-friendly sweetener substitutions: 1/4 tsp liquid stevia.

Paleo sweetener options: 4 dates, 4 tablespoons maple syrup, or 4 tablespoons agave.

To store: Transfer to an airtight container and store in the refrigerator for 2-4 weeks or freezer for 1-2 months. Keep chilled until serving.

Nutrition

Calories: 182kcal | Carbohydrates: 4g | Protein: 3g | Fat: 18g | Saturated Fat: 6g | Sodium: 1mg | Potassium: 163mg | Fiber: 3g | Sugar: 1g | Vitamin C: 1mg | Calcium: 25mg | Iron: 1mg


Please note that the nutritional information may vary depending
on the specific brands of products used. We encourage everyone to check specific
product labels in calculating the exact nutritional information.

Keto Nutella Fat Bombs Recipe

Source: diabetesdaily.com

Is COVID-19 Causing a Diabetes Epidemic?

As the COVID-19 pandemic rages on into its second year, researchers have discovered a new, disturbing trend: there has been a statistically significant rise in both type 1 and type 2 diabetes diagnoses observed in patients after an experience of severe COVID-19. Even more disturbing is that nearly 14.4% of people who are hospitalized with COVID-19 go on to have either a type 1 or type 2 diabetes diagnosis, according to a November 2020 study that followed nearly 4,000 patients with severe COVID-19 infections.

It’s too early to tell if these forms of diabetes are permanent or temporary, but the correlation between severe COVID-19 cases and the development of diabetes is strong.

It’s well known that viruses can sometimes trigger diabetes. When someone contracts a virus, the immune system starts mounting a defense to fight it, mostly with T-cells. Sometimes the body will overreact, and start destroying its own pancreatic beta cells, the result being type 1 diabetes.

Scientists believe the same thing may be happening in the case of COVID-19 patients. Traditionally, COVID-19 has been an attack on the lungs, but a host of other issues and complications have come to light from sufferers of “long-haul COVID”: neurological disorders, blood clots, kidney failure, heart damage, and now many believe an epidemic of both type 1 and type 2 diabetes diagnoses may soon be added to the list.

The association between other coronaviruses and the development of diabetes has been made in the past during the SARS outbreak as well.

After the 2003 SARS pandemic, Chinese researchers tracked 39 patients who had developed high blood sugar levels characteristic of a diabetes diagnosis, within days of hospitalization with the disease. For all but six, blood sugar levels had returned to normal by their hospital discharge, and only two still had diabetes after two years.

This isn’t entirely new, either. Doctors in Wuhan, China reported a link between COVID-19 and elevated blood sugar levels back in April 2020. Italian scientists also looked into whether higher blood sugar levels could lead to a diagnosis of diabetes. That study, from May 2020, admitted more research needed to be conducted before a conclusion was reached.

Because COVID-19 is a global pandemic and the link to new diabetes cases has been observed in multiple countries, researchers globally are collecting data points about those patients in a registry called CoviDIAB.

Scientists do not know whether COVID-19 might exacerbate already developing issues or actually cause them; some believe it’s both. Many people who have had COVID-19 and have gone on to develop type 2 diabetes already have existing risk factors, such as obesity and a family history of the disease. Perhaps the increased medical attention sought out by people suffering from COVID-19 has detected the disease early, when a diagnosis was inevitable later on down the line anyway. Some medical experts believe that more people are getting medical attention than ever before, being closely monitored by experts in the field, and are unveiling underlying issues that may have been there all along.

Another theory is that elevated blood sugar levels also are common among those taking dexamethasone, a steroid that is a common treatment for COVID-19. Steroid-induced diabetes is rare, but not unheard of, and may trigger diabetes in people who have no known health risks for the disease.

“Researchers are working like crazy to see if COVID attacks the beta cells of the pancreas, which makes insulin,” pediatrician Dr. Dyan Hes said. “Some studies feel that they do, but other studies have been repeatedly saying it is not attracted to the beta-cell.”

How exactly the two conditions are connected isn’t quite clear yet, but a prominent theory is that the COVID-19 virus destroys or alters insulin-producing beta cells in the pancreas possibly by binding to ACE2 receptors, according to a short letter published in the New England Journal of Medicine.

Whatever the association is, researchers from the journal of Diabetes, Obesity, and Metabolism say a direct effect of COVID-19 on the development of diabetes, “should be considered.”

Francesco Rubino, a diabetes surgery professor at King’s College London, is convinced there is a connection between the two conditions and has been tracking and studying the phenomenon since early last year. “We really need to dig deeper, but it sounds like we do have a real problem with COVID and diabetes.”

Additionally, Rubino thinks the type of diabetes being developed as a result of COVID-19 may be a hybrid form, something of a cross between type 1 and type 2. His findings show that the symptoms in these patients have some characteristics of each form of diabetes, which he finds concerning.

Researchers are also now seeing a rise in type 2 diabetes diagnoses in children who have had asymptomatic COVID-19, which is even more troubling, as many schools are back in session, many public places do not require masks on children, and the tipping point of a diabetes epidemic may rest solely on the shoulders of our youngest, most vulnerable citizens.

This can also complicate a few things for people: firstly, that neither the Pfizer-BioNtech nor the Moderna COVID-19 vaccines are approved for children, and secondly, that type 1 diabetes is not being prioritized on the Centers for Disease Control and Prevention’s list for vaccine dissemination. States are able to follow their guidance or dismiss it out of hand, but federally, there is no coordination to prioritize the population.

With nearly 10% (34 million people) of the United States already affected by diabetes, and another 100 million living with prediabetes, the tidal wave of COVID-19 cases could very well send our country into catastrophe fighting two disasters at once: both uncontrolled community spread of COVID-19 along with a (COVID-triggered) explosion of new diabetes diagnoses, especially in children. This would not only send our country into panic mode but could also completely overwhelm our already fragile health care system that everyone is so heavily relying on.

Scientists are rushing to find the exact connection between severe COVID-19 cases and new diagnoses of diabetes, but between diabetes being a major risk factor for death in COVID-19 cases (nearly 40% of COVID-19 deaths have been in patients with diabetes), along with the increased risk of developing diabetes from a severe bout of COVID-19, one thing is for sure: we need to find the connection and fast and get the diabetes community and those at risk for diabetes vaccinated as quickly as possible. We don’t have time to waste.

 

Source: diabetesdaily.com

Study Compares MiniMed 780G and MiniMed 670G Algorithms

This content originally appeared on diaTribe. Republished with permission.

By Albert Cai

A new study in adolescents and young adults with type 1 diabetes directly compared two automated insulin delivery algorithms. Medtronic’s newer Advanced Hybrid Closed Loop (built into the MiniMed 780G system) improved glucose management more than the MiniMed 670G, though both systems showed impressive increases in Time in Range for this population. Ultimately, the 670G gave users over an hour and a half more time in range each day, while the 780G gave wearers over two hours every day in range!

Two Medtronic automated insulin delivery algorithms, the Advanced Hybrid Closed Loop and the MiniMed 670G, were recently compared in a cross-over study, allowing 113 participants to use both algorithms. Results from the study were published in the medical journal The Lancet. Notably, the study tested this technology in adolescents and young adults with type 1 diabetes ­– a group for which diabetes management is notoriously challenging. View our resources for adolescents with diabetes here.

For an introduction to automated insulin delivery (AID), check out our piece on current and coming-soon AID systems in 2021.

What is the MiniMed 670G?

The MiniMed 670G is an AID system that has been available since spring 2017 – it was the first system ever to “close the loop.” The system includes the MiniMed 670G pump, the Guardian Sensor 3 continuous glucose monitor (CGM), and an automated insulin adjustment algorithm. The algorithm adjusts basal insulin delivery every five minutes based on CGM readings, and a target of 120 mg/dl.

What is Advanced Hybrid Closed Loop?

Advanced Hybrid Closed Loop (AHCL) is Medtronic’s next-generation AID algorithm. The AHCL algorithm is used in Medtronic’s MiniMed 780G system, which is currently available in at least twelve countries in Europe. While it is not yet available in the US, Medtronic hopes to launch the 780G in the US this spring. In addition to automatic basal rate adjustments, the AHCL algorithm can also deliver automatic correction boluses and has an adjustable glucose target that goes down to 100 mg/dl. This is big news because many people using closed loop do not want to target the higher 120 mg/dl, even as a safety measure. The 780G algorithm is designed to have fewer alarms and even simpler operation than the MiniMed 670G system.

What was the study?

The newly published FLAIR (Fuzzy Logic Automated Insulin Regulation) study was conducted over six months across seven diabetes centers (four in the US, two in Europe, and one in Israel). The study enrolled 113 adolescents and young adults (ages 14-29) with type 1 diabetes. The study sample is notable, because teens and young adults with type 1 diabetes have the highest average A1C levels of any age group.

At the beginning of the study, participants performed their usual diabetes management routine for two weeks to establish their baseline glucose levels. Half of the group was then randomly assigned to use the MiniMed 670G system, while the other half of the group used the same pump and CGM, but with the new AHCL algorithm. After three months – the halfway point of the study – the two groups “crossed over,” switching to the opposite technology.

What were the results?

Nearly every measure of glucose management favored the AHCL period over the MiniMed 670G:

  • Compared to baseline, participants reduced time spent above 180 mg/dl by 1.2 hours per day when using MiniMed 670G and 1.9 hours per day when using AHCL.
  • Time in Range (TIR, time between 70-180 mg/dl) improved from a baseline of 57% to 63% using Minimed 670G and to 67% using AHCL.
  • Time spent below 70 mg/dl fell 0.2% of the time. While those 28 minutes a day may not be statistically significant – and time in severe hypoglycemia, or below 54 mg/dl, did not increase from baseline when using either algorithm – many people with diabetes would benefit from that additional half hour in range.

The graph below shows the time spent in glucose ranges during baseline, MiniMed 670G, and AHCL periods. For both algorithms, the Time in Range increase from baseline was significant – use of either AID system led to at least 14 hours more each week spent in range. Nevertheless, we also point out, of course, that the group (again, the group that has the most challenges of any age group managing diabetes) still experienced a fair amount of time above 250 mg/dl. This is  another reason for healthcare professionals and people with diabetes to think about the “whole person” when considering diabetes management, and another reason why we always recommend Adam Brown’s Bright Spots and Landmines for ways to improve diabetes management in terms of food, exercise, mindset, and sleep – it includes many strategies for people, especially teens and young adults, to use each day.

AID comparison

Image source: diaTribe

  • The biggest Time in Range improvement came overnight (between midnight to 6am). During this six-hour overnight period, AHCL users spent an average of 4.4 hours in range (74% TIR), compared to 4.2 hours (70% TIR) for 670G, and 3.5 hours (58% TIR) during baseline. While the overnight Time in Range difference between AHCL and 670G may not seem large, it added up to nearly a 22-hour difference over the three-month the AHCL period.
  • With daytime numbers, the average AHCL user spent 63 more hours (about 2.6 days) in range than the average 670G user in each three-month study period.

The graph below shows daytime and nighttime differences in time spent in range (70-180 mg/dl), and the data is included in a table at the end of this article. Better sleep the night before can also make diabetes management more effective during the day.

Comparison

Image source: diaTribe

  • Using MiniMed 670G drove an average A1C improvement from 7.9% to 7.6%, while AHCL use improved A1C from 7.9% to 7.4%.

Both systems showed extremely positive results and were found to be safe for use in young people with type 1 diabetes. The AID algorithms led to dramatic increases in Time in Range in a population that stands to benefit – over the course of a year, adolescents and young adults could spend more than ten additional days in range. The direct comparison between these two AID algorithms is highly informative – we hope to see similar trials in the future.

Comparison

Image source: diaTribe

Source: diabetesdaily.com

Survey Reveals the Heavy Burden of the Pandemic on People with Diabetes

The COVID-19 pandemic has now been ongoing for over a year, and even with the light finally visible at the end of the tunnel, it is undoubtable that it will have lasting effects, for years to come.

Late in 2020, we partnered with the American Diabetes Association (ADA) to conduct a survey-based analysis to assess the effects of the COVID-19 pandemic on Americans living with diabetes.

Approximately 2,600 responses were collected from the Thrivable online patient panel. People from all 50 states shared their experiences during the pandemic, describing the impacts on access to healthcare, food, outlook on receiving a COVID-19 vaccine, and more.

Key Findings: Reduced Health Care and Food Access

  • About 4 of 10 Americans with diabetes delayed seeking routine medical care, with more than 50% stating the fear of COVID-19 exposure was the primary reason.
  • About 1 in 5 Americans with diabetes have foregone or delayed getting an insulin pump or continuous glucose monitor (CGM).
  • More than 1 in 4 stated their access to healthy food was reduced, with about 1 in 5 relying on food assistance programs.
  • Almost half who receive assistance report that the food they receive negatively affects their diabetes management.
  • About 1 in 5 people who receive nutritional assistance report not having enough food to eat.

Moreover, about 1 in 5 Americans with diabetes have reported having to choose between buying food vs. affording their diabetes supplies.

The effects of the COVID-19 pandemic are widespread and span across multiple facets of people’s lives. For people with diabetes, many of whom are already struggling to afford their healthcare expenses, the financial effects of the pandemic may be particularly grim.

Perspectives on the COVID-19 Vaccine

When asked about their comfort level of receiving a COVID-19 vaccine as soon as it is made available to them, people with diabetes reported being more likely to want to receive it right away as compared to data collected from the general population.

Less than half as many people with diabetes stated that they would never want to get the vaccine as compared to data on the general population (10% vs. 21%, respectively).

It is perhaps not surprising that people with diabetes feel more strongly about receiving a COVID-19 vaccine than the general population. Currently, the Centers for Disease Control and Prevention (CDC) state that people with type 2 diabetes  “are at increased risk  of severe illness” from COVID-19, while people with type 1 diabetesmight be at an increased risk for severe illness.”

Other Insights: Barriers to Clinical Trials Participation

In addition to exploring the financial burden of the pandemic and assessing readiness to receive a COVID-19 vaccine, we also gathered information regarding previous participation or willingness to participate in a clinical trial. As per the recent press release,

“People with diabetes have participated infrequently in clinical drug trials in the past (only 11% report having done so), but the majority – 60% – say they are likely or very likely to participate in such a study in the future. Yet nearly a quarter of those who responded to the survey said they didn’t know how to participate in a drug trial if they wanted to do so.”

Check out the full press release from the ADA as well as the more data below:

New Data Alert: COVID-19 Brings Crisis of Access for Millions Living with Diabetes

Effects of the COVID-19 Pandemic on People with Diabetes

Methodology and Panel Demographics

These figures are based on Thrivable’s survey of more than 2,500 people with diabetes nationally, between December 7th and December 14th, 2020

  • A multiple-choice survey was distributed online to people with diabetes (U.S. residents) who signed up for the Thrivable Insights panel.
  • Participants were not compensated for their responses.
  • Data was analyzed using Qualtrics and Excel.
  • Details on panel breakdown include:
    • N = 2,595
    • o 47% with type 1 diabetes, 53% type 2
    • o 69% female, 31% male
    • o All 50 U.S. states are represented

Source: diabetesdaily.com

Feta and Roasted Red Pepper Dip

This content originally appeared on ForGoodMeasure. Republished with permission.

In my humble opinion, picnics are ubiquitous with summer & no al fresco dining experience is complete without crisp, crunchy vegetables & an accompanying dip. Here’s one of our favorites. A simplified version of Greek Ktipiti, this recipe combines the briny tang of fresh feta with the sweet, slightly smokey undernote of roasted red bell peppers. Cutting the traditional heat allows the flavor of an accompanying crudités to shine through, although you could always jazz things up with a dash of hot sauce or pinch of red chili flakes.

Print

Feta & Roasted Red Pepper Dip

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This recipe combines the briny tang of fresh feta with the sweet, slightly smokey undernote of roasted red bell peppers.
Course Dip
Cuisine Greek
Calories 84kcal

Equipment

  • Food processor

Ingredients

  • 2 red bell peppers halved & seeded
  • 1 cup feta cheese crumbled
  • 2 tablespoons olive oil
  • 1 teaspoon garlic minced
  • teaspoon black pepper
  • teaspoon salt

Instructions

  • Preheat oven to 400 degrees.
  • Line a rimmed baking sheet with parchment.
  • Arrange halved peppers cut-side down on baking sheet.
  • Locate a glass or ceramic bowl large enough when inverted to cover the peppers, set aside.
  • Roast peppers for 40 minutes, until skins are soft & blackened.
  • Invert bowl over charred peppers, creating a steam bath.
  • After 15 minutes, remove the charred skins from the peppers.
  • Using the processor, combine the skinned peppers, feta cheese, olive oil, garlic, black pepper and salt, until thick and creamy.
  • Chill before serving.

Notes

Naturally low-carb & gluten-free.

Nutrition

Serving: 2tbsp | Calories: 84kcal | Carbohydrates: 2g | Protein: 3g | Fat: 8g | Cholesterol: 17mg | Sodium: 485mg | Fiber: 1g | Sugar: 1g


Please note that the nutritional information may vary depending
on the specific brands of products used. We encourage everyone to check specific
product labels in calculating the exact nutritional information.

Feta and Roasted Red Pepper Dip Recipe

Source: diabetesdaily.com

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