Should More People with Type 2 Diabetes Use a CGM?

The continuous glucose monitor (CGM) has been hailed as vital technology for good blood sugar management in type 1 diabetes. But although it could provide similar benefits to people with type 2 diabetes, the expensive technology is not yet widely available for type 2 patients. 

Enthusiasm is growing for the use of CGMs for patients with type 2 diabetes, but some experts remain skeptical. And some of the critical decision-makers still need to be convinced before access will really expand.

Patients with type 2 diabetes typically experience fewer intense and unpredictable blood sugar swings than those with type 1. Only a minority of patients with type 2 diabetes have been prescribed insulin, and only a minority of them use rapid-acting insulin multiple times a day, the way that patients with type 1 require. 

Many experts are eager to give patients with type 2 a new tool to help manage their condition. And nothing would make CGM manufacturers happier than to sell their products to the type 2 market; for every patient with type 1 diabetes, there are about 20 potential customers with type 2. But scientists have yet to make the case that the CGM is so helpful to patients with type 2 diabetes that it justifies its high price.

Current Guidelines

So far, the American Diabetes Association has only recommended CGMs for patients with type 2 diabetes that are on “intensive” insulin regimens – patients that are using insulin pumps or multiple daily injections to control blood sugar levels aggressively.

It certainly makes sense for patients on intensive regimens to get the earliest access to the tech. Frequent blood sugar readings allow these patients to dose insulin for meals, exercise, and corrections far more precisely. The alarm function can be a literal lifesaver in the event of low blood sugars.

However, millions of patients with type 2 diabetes use only basal insulin, and millions more do not require insulin at all. They may not need to make multiple insulin dosing decisions every day, and may have a less critical need for low blood sugar alarms, but the device could still play a huge role in improving their glucose management.

Many people with type 2 diabetes are eager to use a CGM but cannot pay for it out-of-pocket. Some find themselves in the disheartening circumstance of knowing that they can only access this valuable technology if their control gets worse.

But a new study may help change this situation.

The MOBILE Study

Dexcom, the manufacturer of the popular G6 CGM system, recently unveiled the results of a randomized clinical trial pitting its continuous glucose monitors against traditional blood sugar meters. The studies were published in the medical journal JAMA and presented at the recent Advanced Technologies & Treatments For Diabetes (ATTD 2021) conference.

The MOBILE study looked at 175 adults with “poorly controlled” type 2 diabetes who used basal insulin but had not been prescribed multiple injections of mealtime insulin. The participants began the trial with an A1c between 7.8% and 11.5%. They were randomized into two groups: those given CGMs, and those given blood sugar meters.

After eight months, both groups had improved A1c’s, but the group using CGMs improved much more: −1.1% vs. −0.6%. On average, the CGM users spent about four more hours in range and four fewer with very high glucose (>250 mg/dL).

Those improvements appeared to apply across the board. When researchers split the study group into different subsections based on age, education level, or “diabetes numeracy,” the group using the CGM always had significantly better results than the group using fingersticks.

second study was published in the same edition of JAMA; this one observed the outcomes of patients that began using Dexcom CGMs in real life (without any intervention by the researchers). Patients with type 2 who initiated CGM use were overwhelmingly likely (97%) to be using intensive insulin regimens, just as the guidelines recommend.

The results? Type 2 CGM users improved from an average 8.2% A1c to 7.64%, an even larger improvement than patients with type 1 enjoyed in the same study. They also experienced significantly less hypoglycemia than they had previously.

Dexcom, unsurprisingly, was ebullient, describing the publication of the two studies as “a pivotal moment in diabetes care innovation.”

Skeptical Experts

Not everyone agrees that CGMs should be prescribed to more patients with type 2 diabetes. In March, Kaiser Health News argued that there is actually very little evidence that the technology does much good for most patients in the type 2 community.

The writer noted that the small number of studies of the CGM’s efficacy in type 2 diabetes have so far come up with conflicting results; several find little benefit. And while the data from the two new Dexcom studies wasn’t yet available, it might be wise not to take the results of industry-sponsored science at face value. Several of the older studies that found good results for continuous glucose monitoring were similarly organized by CGM manufacturers, including Dexcom.

Dr. Katrina Donahue, director of research at the University of North Carolina Department of Family Medicine, was one skeptical expert quoted in the article: “I don’t see the extra value with CGM in this population with current evidence we have… I’m not sure if more technology is the right answer for most patients.”

Money Talks

Price is going to be a big issue. Dexcom, Abbott, and any other competitors not only have to convince patients and doctors that the CGM is can help type 2 diabetes. They also have to convince insurance companies that it’s worth paying for.

That might be a tough job. Many CGMs users are already acutely aware of how expensive the product can be. If the benefits to patients with Type 2 that do not require intensive insulin treatment are less dramatic, insurance companies will be less enthusiastic about covering the system.

Some doctors agree. Dr. Silvio Inzucchi, director of the Yale Diabetes Center, was quoted by Kaiser Health News: “The price point for these devices is not justifiable for routine use for the average person with Type 2 diabetes.”

Short-Term CGM Use

Interestingly, the results of the two studies suggest that the improvements in glycemic control were not the result of increased insulin use but improved patient engagement. The CGM can serve as a constant gentle reminder of the importance of glucose management. Hopefully, the thinking goes, CGM users are more likely to make good eating or exercise decisions.

That finding might help support the advance of temporary CGM use for patients with diabetes. If the CGM works primarily by informing its user about the glycemic impact of different lifestyle decisions, maybe people could benefit from only a week or two of CGM use. They might learn lessons that they could put use to improve their glucose management even after ceasing to use the device.

The temporary CGM has long been rumored as the next big step for patients with type 2. Some healthcare providers already have CGMs that they will loan to patients for short-term rentals, and Dexcom has recently made its CGM available on a trial basis through its Hello Dexcom initiative.

Moving Forward

JAMA simultaneously published an editorial arguing for expanding the use of CGMs for patients with Type 2 diabetes. Authored by doctors Monica Peek and Celeste Thomas of the University of Chicago, the letter calls for “important policy changes in Medicare eligibility to CGM for type 2 diabetes and institutional changes that promote its use in primary care.”

The writers also noted that patients “from racial and ethnic minority populations, those in low-income groups, and other socially marginalized groups are disproportionately affected by type 2 diabetes,” and that improved access to CGMs could especially help the most vulnerable diabetes patients.

The MOBILE Study is just one step, but perhaps a significant one, in widening access to the CGM for the type 2 community. Advocates will hope that such data will convince the diabetes authorities, especially the American Diabetes Association, to expand their recommendations.

Source: diabetesdaily.com

Olympian Laurie Hernandez, Her Dad, and Diabetes

Laurie Hernandez is an elite athlete. To keep up her Olympics-quality form, she needs to take her lifestyle decisions, like diet and exercise, very seriously.

Anthony Hernandez is similarly mindful. He’s not an elite athlete – he’s Laurie’s dad. He takes care of his health because he has type 2 diabetes.

“I’ve always watched him take care of himself. It was just something he did because he had to do it. For me and gymnastics, going to physical therapy, and doing preventative bodywork, and eating the right things … all of those are key things that I’ve watched him do.”

Photo by Harry How/Getty Images

Laurie, a gymnast, won both individual silver and team gold in the 2016 Summer Olympics in Rio. 

I spoke to Laurie only days after she had sustained an unfortunate injury that put her Olympic return in doubt. A hyperextended knee forced Laurie to withdraw from the U.S. Gymnastics Championships, a critical competition that helps determine which athletes can make the team for the upcoming Tokyo games. In the days after our talk, Laurie decided not to petition for a spot on the Tokyo team – potentially ending her career as a competitive gymnast.

We talked about gymnastics and the Olympics, but we mostly talked about her dad. Anthony’s had diabetes for as long as Laurie can remember, but he never made a big deal about it.

“He wanted things to appear as normal as possible, so it wasn’t a big topic. It was just something that he did. He would prick his finger, and he would take his medication.”

Laurie’s grandmother also had diabetes – little Laurie would watch her take insulin shots. As her grandmother got older and more unsteady, Laurie would help her with her injections. Everyone helped out like that.

“I didn’t see it like an odd thing. ‘Oh, here are two people taking care of themselves. That’s my family!’”

I was struck by the contrast, but similarity, between Laurie and her dad. They’re in very different stages of life, but each is similarly motivated to take their health seriously, and each inspires good decisions in the other. Growing up in a household where diabetes was an everyday fact of life gave Laurie early models of self-care.

“I had that representation of somebody taking care of themselves.

“This gymnastics training is crazy, but let me show you how I learned all the in-betweens, how I learned to take care of myself. A big part of that comes from my dad. Watching him do that and set that example for me and my siblings.”

Anthony still manages his diabetes in a subtle way, and isn’t one to draw much attention to himself. But over the years, he’s gotten more in tune with his body and addressed his condition in a little bit more depth.

He’s also been more open about how his children helped inspire him to improve his control. He didn’t want his disease to force him to miss out on their lives, especially Laurie’s superlative athletic career.

“He would say, ‘I wanna be there for those things.’”

I spoke to Laurie because she’s the newest spokesperson for Trulicity, a GLP-1 agonist approved for type 2 diabetes. Trulicity is a once-weekly injection that studies have shown can confer both improved glucose control and weight loss. It also may help reduce the likelihood of major cardiovascular events.

Laurie told me that representing a diabetes medication “resonated” with her.

“I get to talk about my dad and show all the hard work that he’s done in quiet. It’s life, it’s something that he takes care of every single day. He doesn’t really have a choice! So to give him grace and kudos for that, I do think it’s important.”

If anyone’s curious why Laurie, who doesn’t have diabetes, decided to represent Trulicity, she has a simple answer: “It’s my dad. That’s my family, that’s my core, he’s a big part of who I am.

“I’m so proud of him. He talks about how proud he is of me, all the time, but now I have an opportunity to tell everyone how proud I am of him.”

Diabetes care can be a team effort for the Hernandezes.

“My mom would always carry snacks with her, you know, just in case he ever got low. It didn’t click for me, up until the last few years, that she was doing that to take care of him. I thought, you know, that’s just mom being mom, but it was always for him. It was a way to keep an eye out.”

Even when she’s on the other coast, she makes an effort to keep up with her dad as much as possible:

“I make sure to check in and see that he’s doing ok. Just give him an encouraging word or call. Me and my siblings, we have a big family group chat, and we’ll let him know that we’re so proud of him. If he does have an off day, not reprimanding him for it, but letting him know, hey, everybody’s got an off day. Lots of love and support.”

In a remarkable coincidence, Laurie’s roommate Charlotte Drury, also an Olympic hopeful, was recently diagnosed with Type 1 diabetes. Performing at an elite athletic level while dealing with newly diagnosed type 1 diabetes can’t be easy, but Laurie reports that Charlotte “is kicking major butt.” She certainly lucked out in having Laurie as a roommate. Laurie has accompanied her to the doctor’s office, and is happy to run and grab a juice box when Charlotte’s blood sugar goes low.

It’s been a strange year for Laurie, as it has for everyone, but the pandemic did bring some benefits. Laurie usually trains in California, far away from her hometown in New Jersey, but after her gym closed down she switched for about six months.

“I got to spend a lot of time with my family, got to watch my nephew grow, which was awesome. There was a lot of family time that I should not have gotten but did, so that was a huge silver lining.”

What advice does the high achiever and devoted daughter have for other people with diabetes?

“The biggest thing is just to do your best, to not let it stop you from doing things you really want to do. From watching my dad be a good dad and do his best to show up for all my different meets, diabetes did not get in the way of that. I’m sure it was a challenge for him, but he constantly showed up.”

“I’m really proud of all of you. You’re strong because you have to be, but you are strong.”

 

Source: diabetesdaily.com

Purple Cabbage and Carrot Slaw

This content originally appeared here. Republished with permission.

Summer cookouts are back, baby! And I’m celebrating by cooking all the good stuff, like this purple cabbage and carrot slaw.

It’s crunchy, sweet, lightly spicy, and tangy, so it hits all the high points, and it’s just perfect on a hot summer day. Best of all, there’s almost no work required to make it–just prep the veggies, mix, and enjoy!

Now if you know me, you probably already know I’m a fan of bright side dishes. I make some good ones, too, like my broccoli slawpickled cabbage, or corn salsa, and more!

But today, since I’m grilling pork tenderloin, I’ll be making this cabbage slaw to serve with it. The creamy, tangy dressing goes beautifully with a rich bbq sauce, and the crunchy veggies perfectly compliment the tender meat.

Purple Cabbage and Carrot Slaw

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Purple Cabbage and Carrot Slaw

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This purple cabbage and carrot slaw is a crunchy, tangy, and lightly spicy side dish, perfect for summer cookouts!
Course Side Dish
Cuisine American
Keyword cabbage
Servings 6 servings
Calories 107kcal

Ingredients

  • 1/2 purple cabbage medium
  • 3 carrots medium
  • 1/2 – 1 jalapeño
  • 1/4 red onion thinly sliced
  • 2 cloves garlic
  • 1 tbsp fresh cilantro minced
  • 1 tsp dijon mustard
  • 3/4 cup mayo or more to taste
  • 1 tbsp apple cider vinegar
  • 1/2 tsp salt
  • 1/2 tsp pepper

Instructions

  • Use a mandolin or sharp knife to thinly slice the cabbage. Use a box grater to shred the carrots.
  • Mince the red onion, garlic, jalapeño, and cilantro.
  • Add all ingredients to a large bowl. Toss to combine and mix the slaw well. Season to taste with salt and pepper.
  • Keep the coleslaw covered and refrigerated until you're ready to eat! For best results, let it sit for at least 2 hours.

Notes

To store leftovers: Transfer leftovers to an airtight container and store in the refrigerator for 3-5 days. If using homemade mayonnaise, consume within 4 days.

Nutrition

Calories: 107kcal | Carbohydrates: 12g | Protein: 2g | Fat: 6g | Saturated Fat: 1g | Polyunsaturated Fat: 4g | Monounsaturated Fat: 1g | Trans Fat: 1g | Cholesterol: 4mg | Sodium: 452mg | Potassium: 301mg | Fiber: 3g | Sugar: 5g | Vitamin A: 5935IU | Vitamin C: 46mg | Calcium: 48mg | 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.

Purple Cabbage and Carrot Slaw Recipe

Source: diabetesdaily.com

Bethany’s Story: My Eye Started Bleeding the Day My First Child Was Born

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

By Ginger Vieira

“My first bleed was almost 12 years ago — the day my first baby was born,” explains Bethany, who’s lived with type 1 diabetes for nearly 40 years, since she was 3 years old.

Despite receiving preventative laser treatments to the concerning blood vessels in this area of her eye prior to and throughout her pregnancy, the stress of pregnancy and pre-eclampsia (high blood pressure during pregnancy) were enough to cause them to bleed.

“There was a bunch of trauma around that, because the bleed was the catalyst for me to have an emergency c-section. That was the biggest bleed I’ve had and it took a long time to clear up.”

Since then, Bethany has experienced minor bleeds off and on, but has also gone long stretches of time without any new bleeds.

Ginger Vieira

Image Source: Beyond Type 1

“Last October I had another bad one,” says Bethany. “It was so discouraging, because I haven’t had any new abnormal vessel growth, I’m not pregnant, I don’t have blood pressure issues, and my A1C is stellar. It just happened.”

“It’s cleared up since then without traditional treatments like a vitrectomy or steroid shots, but it took quite a while because it leaked more blood and fluid for a few weeks after the initial burst,” she adds. “At this point, I’d say I’m back to where I was pre-October in terms of vision, but maybe it’s a bit messier.”

My Experience With Laser Treatments for Retinopathy

“I’ve only had laser treatments,” says Bethany, who’s been able to manage her retinopathy without more invasive treatments.

“I’m not sure the experience qualifies as ‘pain’ so much as ‘misery’. It’s horribly uncomfortable, and it does begin to be painful as the treatment goes on, but it’s not what I’d describe as particularly painful.”

Eventually, Bethany says she used a low dose of a mild sedative to help take the anxiety out of receiving laser treatments. While it can’t change how it feels physically, it can help make the overall experience a bit less stressful.

“It’s hard to catch your breath, and it feels like being tortured, and my eyes pour with tears, but it’s all more of a dull feeling other than a bit of a sensation that a rubber band is being snapped behind your eye.”

Parenting a Newborn With Low Vision

“Nursing a baby and not being able to see her face clearly when she’s on your left side was heartbreaking,” recalls Bethany.

“Struggling to read a book to a child, wondering if you’ll have another bad bleed when you’re at the store with your child, not being able to lift an older child because it might exacerbate the bleed—it all sucked.”

Fortunately, by the time her second pregnancy began, Bethany’s eyes were ready.

“It was so much easier,” she says. “No pre-eclampsia, no eye issues. It was such a relief after being so terrified to try it all a second time.”

Today, she says she’s careful how much to share with her children about her eye complications.

“After my recent bad bleed, it was my oldest daughter (the one who was born the day of my first bleed) who held me while I sobbed, because she was ready to support me,” recalls Bethany. “That was so bittersweet and beyond meaningful.”

What My Vision Is Like Today

“I wouldn’t say I live with ‘low vision’ today but there is a blobby mess in one eye,” explains Bethany. “My brain has learned to adapt, and I can see around it. I don’t read super fine print very well, but I’m not sure I would even without retinopathy since I’m getting old!”

However, Bethany would say she did have low vision for a period of time — and it wasn’t easy.

“After those two bad bleeds, I did have trouble with the vision in one eye for a while, until the blood cleared. That was hard, but I’m grateful it wasn’t long-term.”

However she says that it’s also affected her life in other ways when there are bleeds.

“My eyes feel strained, I have headaches, and I definitely don’t feel comfortable driving until the bleeding has cleared up.”

The worry and anticipation of a potential new bleed feels like a ticking time bomb.

“I try not to think about what my vision could be like later in life, but I do wonder if I’ll be able to see my grandkids clearly, and if I should retire early so I can make the most of my later years while I still have vision. In day-to-day life it’s pretty minimal, but in terms of mental/emotional load it’s huge and it’s always there.”

How My Diabetes Management Has Changed

“I smartened up with my diabetes management big time since the first time the doc saw something in my eye,” explains Bethany. “Since that day I’ve been highly motivated to do this well.”

Having lived with type 1 diabetes since age 3 in the 1980s with early glucose meter technology and insulin options were severely limited, Bethany feels quite sure the first 25 years of her life with diabetes led to the complications in her eyes.

“My A1c was usually in the low double digits when I was a child, because avoiding low blood sugars was considered the safest way to manage diabetes in a young child back then,” says Bethany.

By the time she was in her 20s, technology and advancements in insulin helped her manage an A1c in the 7s and 8s. Once she started using an insulin pump, she was able to maintain an A1c below 7.0 during both pregnancies.

“I’ve always, always, tried really hard with my diabetes,” adds Bethany, “but it was like I spent 25 years trying to solve a puzzle that finally started to come together in the last 15 with a pump, a continuous glucose monitor (CGM), and eating low-carb.”

While Bethany used an insulin pump for 5 years, she’s managed her diabetes with MDI (multiple daily injections) for the last 8 years, and maintained an A1c below 7 percent, and around 5.8 percent for the last year.

“Using a pump, two pregnancies, and eating mostly low-carb definitely taught me so much more than I knew before I used an insulin pump,” explains Bethany. “But I was having a lot of issues with scar tissue which made infusion sites for pumping complicated. And I hated being tethered to my pump.”

The mental game of diabetes, she adds, is a huge part of it.

“There’s always a fear lurking that it could happen again at any time. More so since this last one,” says Bethany. “You never really escape it because you never know that you’re safe. You can do everything right from a certain point on, but the damage is already done.”

Source: diabetesdaily.com

Remember, Your Time in Range Isn’t a Grade Either

This content originally appeared on diaTribe. Republished with permission.

By Eliza Skoler

Time in Range (TIR) is another number for people with diabetes to pay attention to and use to improve their daily diabetes management. We talked with three women in the diabetes community about how they use TIR as a helpful number to keep them on track and inform their care.

Time in Range (TIR) is a helpful tool that captures the highs, lows, and in-range glucose values that characterize life with diabetes. TIR can help people understand how their daily habits and behaviors affect glucose levels, so they can use this information to feel better and reduce glucose swings. But it’s also another measurement to keep track of – and the goal is to look at it as a number and not have it loaded with emotion or negativity if it falls short of your goal.

For many people, it can be challenging to get past seeing glucose levels as “tests” and A1C checks as “grades.” But as Adam Brown explains, blood sugars are just numbers – they are neither good nor bad, but rather they are information that will help you make a decision about your diabetes. Click here to read about how Adam transformed how he views diabetes data. Seeing your A1C level as a grade can actually cause harm – some people are demotivated to take care of their diabetes when they feel they are frequently failing. Renza Scibilia and Chris Aldred write more about this in “What’s Your Grade?

Enter Time in Range (TIR), the percentage of time that a person spends with their glucose levels in their target range. TIR is a powerful tool to assess patterns in glucose levels throughout the day and over time, and this can help inform lifestyle changes and treatment decisions in a way that A1C cannot. People with diabetes should aim to spend as much time in their target range as possible.

With the TIR number comes the risk that people may see it as yet another test of their diabetes management. It might be another mark that tells them they are not measuring up.

“When I read about Time in Range, it was a bit scary at first, simply because it seemed like it was a ‘grade,’ like you would get in school, so I didn’t want to think of it too much because my own fear of failure is high,” said Sarah Knotts who has lived with type 1 diabetes for 32 years. She has two young children and works with mySugr as the US Head of Customer Support.

Stacey

Image source: diaTribe

Stacey Simms agreed. Simms is the host of Diabetes Connections and author of The World’s Worst Diabetes Mom: Real Life Stories of Parenting a Child with Type 1 Diabetes. Her son Benny was diagnosed with type 1 diabetes in 2006, right before he turned two.

“It’s easy to look at TIR and other diabetes markers as a judgment on your value as a person. I think there’s a bit of a danger in looking at these markers as anything but math and management tools” she told us. “Less TIR doesn’t mean you’re a bad person or worth less than a person with more TIR. I don’t know how we can keep these tools from weighing on the mental burden of diabetes, but I do think being aware they can have this effect is a good first step.”

Headshot

Image source: diaTribe

Knotts now uses TIR regularly. “My biggest hurdle to get past was that I equated TIR to being a grade – as if I was turning in a term paper or project and those percentages related to a letter grade,” she said. “Just as your A1C is not an accurate picture of your control, a TIR is also not a complete picture either. Yes, I have a range that I want my TIR to be, but I’m not focusing on one average number, or one A1C target. I’ve been able to learn that if I can keep my numbers close to the target range, everything else (A1C, standard deviation) tends to also be better, and I feel better overall.”

Christel Oerum, who was diagnosed with type 1 diabetes at the age of 19 and created Diabetes Strong with her husband in 2015, thinks about TIR both every day and in a long-term sense.

Christel

Image source: diaTribe

“I use TIR daily in the sense that I aim for glucose levels in my target range (70-160 mg/dL, but I don’t focus on always meeting a daily TIR goal, as I think that’s too stressful and not realistic,” she said. “There are going to be days where I’m in range most of the day and days where I’m not, and for me, that’s okay. I do have a monthly TIR goal that I’d like to see myself hit, but that’s more of a retrospective analysis.”

Oerum acknowledged how easy it is to get obsessed with making TIR goals. “For me, that’s not healthy, which is why I try to not use TIR as a daily goal but rather as an overall indicator of whether I should make changes to my care,” she said. “TIR is not a grade or score. It’s a tool to help you manage your diabetes to the best of your ability.”

Simms’ family focuses less on the actual numbers (like TIR and A1C) and more on helping Benny thrive with diabetes: “I spend a lot less time working on TIR than on things like fostering independence, teaching Benny to trouble shoot and helping him advocate for himself. TIR is a great tool to check on for trends and adjustments, but we don’t use it very often. I wouldn’t want Benny checking TIR every day or even more than once a week unless he was really tweaking settings or trying something new.”

We don’t want TIR to be scary or intimidating. At diaTribe, our hope is that more and more people will be able to use TIR in a non-judgmental and informative way, helping themselves and their families lead healthier lives. Oerum summed it up well. “TIR for me means more details on how my management is going and can help me hone in on what to change and what to leave alone. Diabetes can’t be about perfection, and just as my A1C isn’t a grade of my effort, neither is my TIR.”

This article is part of a series on time in range.

The diaTribe Foundation, in concert with the Time in Range Coalition, is committed to helping people with diabetes and their caregivers understand time in range to maximize patients’ health. Learn more about the Time in Range Coalition here.

Source: diabetesdaily.com

Review: Twisted Healthy Treats Keto Ice Cream Bars

Low-carb ice cream is hard to come by, and finding one that tastes good and is affordable isn’t an easy feat. I was thrilled to come across Twisted Healthy Treats Lick Keto Bars, which are both low-carb and sugar-free, perfect for me and my blood sugar management.

This Australian company was kind enough to send me their Lick Keto Bars to try out at no cost, so that I could try this low-carb treat (as a person living with type 1 diabetes) and share my experience with our community. I did not receive additional compensation for this review and all opinions are my own.

Who They Are

Twisted Healthy Treats is a company that was started by a mother looking for treats that didn’t come loaded with artificial flavors and sugar. Since her background was in Food Science and Technology, it only made sense that she took her expertise and put it to good use. Today Twisted Healthy Treats is all female-run company, manufacturing in a state of the art facility. All of their products contain:

  • All-natural ingredients
  • No sugar or low-sugar
  • Natural based sweeteners

Products

Here’s what the company is offering today:

  • Twisted low-calorie frozen yogurt in a variety of flavors, including Watermelon & Mango, Chocolate & Coconut, Strawberry & Vanilla Bean, and Chocolate & Vanilla Bean. These products are not recommended for those aiming for keto or perfect blood sugar lines, but they can be a nice treat, with around 20 grams of carbs!
  • Licks Frozen Juice Bars have no sugar added and only contain about 7.5g of carbs. They come in Pink Lemon Twist, Mango Delish Twist, and Berry Buzz, and all are made with 99% real fruit juice.
  • Licks Frozen Ice Cream Bars in Rich Chocolate and Vanilla Latte, which contain only 2 grams of net carbs.

My Review

It has been such a wonderful feeling to know I can open up my freezer and have a quick healthy choice that can satiate my sweet tooth without impacting my blood sugars or my weight loss efforts. The Lick Keto Bars are dense, unlike many other low-carb frozen treats that leave me wanting more. They have a great creamy consistency, and each bite is packed with flavor. Each pack comes with 4 bars, and prices vary according to retailers – at Costco you can buy a large pack of mini-cups for less than $1 per cup. Check their website for locations in both Australia and the United States.

As a person living with type 1 diabetes, I wanted to see how the Keto bars affected my blood sugar. I decided not to take any insulin beforehand and watch what happened. I started the experiment at a blood sugar level of 115 mg/dL and watched carefully to see if there was a spike or even just a slow rise. 2 hours later, my blood sugar was stable and coasting at 102. It really is rare to find something enjoyable that I don’t even have to take insulin for. I am sold! I highly recommend this product to anyone looking for a delicious dessert that is nutritious and blood sugar-friendly!

Have you tried any of these? What are your favorites?

Source: diabetesdaily.com

Why You May Be Experiencing High Blood Sugar

High blood sugar is part of a life with diabetes, whether it’s type 1type 2LADA, gestational diabetes, even the more rare forms of the disease. But sometimes, hyperglycemia can seem unexplainable, persistent, and stubborn.

This article will outline the reasons why you may be experiencing high blood sugar, and what you can do about it.

What Exactly Happens When Blood Sugar Is High?

High blood sugar, by definition, is when there’s too much glucose in the blood and not enough insulin to help the cells digest it. That extra glucose floating around in the bloodstream is what brings about symptoms of frequent urination, fatigue, brain fog, headache, body ache. In severe cases, it can lead to diabetic ketoacidosis (DKA).

People with diabetes manage their blood sugars by taking either oral medications or insulin, and monitoring both their food intake and exercise on a daily basis.

But even when you’ve done everything “right,” like counting carbohydrates and taking your medications, your blood sugar may rise and stay annoyingly (or dangerously) high. These are the top reasons why you may be experiencing unexplainable hyperglycemia.

You’re Stressed

Ever wonder why when you’re stressed about work or school your blood stays high? That’s because the release of natural hormones in your body, like adrenaline and cortisol, spike when you’re stressed, leading to insulin resistance, and in people with existing diabetes, high blood sugars. Whether you’re prepping for a big test, selling your home, hustling for that promotion at work, or fighting with your spouse, stress can send your blood sugars skyrocketing.

Dawn Phenomenon

Dawn Phenomenon describes the high blood sugars and insulin resistance people experience in the morning, usually between 2 a.m. and 8 a.m. 

The phenomenon is natural: late overnight, the body releases a surge of hormones in preparation for the new day. These hormones can trigger the liver to dump glucose into the bloodstream. In people with diabetes, the body cannot produce a healthy insulin response, and therefore blood glucose levels spike up.

Many people with diabetes require more insulin during those hours, maybe even twice as much, to counteract this age-old hormonal effect.

A different, less common (but more dangerous) phenomenon may also explain morning blood sugar highs: Somogyi effect.

You’re Sick

When people with diabetes are under the weather (or fighting off an infection), their blood sugars tend to be much higher than normal, and they become much more insulin-resistant.

This can sometimes result in needing 75% (or more!) of your average daily insulin requirements. Make sure you’re staying hydrated, monitoring for ketones, and taking as much insulin as you need to keep your blood sugars in range.

If you cannot control your blood sugars during illness – especially if you’re having trouble eating or drinking – it’s very important to get in touch with your doctor.

You’re Eating Too Many Carbs

Let’s face it: carbohydrates spike blood sugar. It’s something that people with diabetes need to think about nearly every time they eat.

Test your blood sugar frequently to see how your own body responds to different foods. Some people may find that they can comfortably eat fresh fruit, but not added sugars or white rice. Some may find something completely different.

And if you use insulin before meals, you probably already know that carbohydrate counting can be an inexact science. The more carbs you eat, the more insulin you need to take, and the more difficult it is to deliver that perfectly dosed and perfectly timed pre-bolus.

Even a little carbohydrate restriction is likely to help reduce the frequency and intensity of blood sugar highs.

You’re Eating Hidden Carbs

Ever order a salad at a restaurant, thinking it will be a nice, low-carbohydrate option, only to experience debilitating high blood sugars for hours on end afterward? There are many deceiving foods that we think are low-carb, but are anything but.

Sugar and starches hide in many foods where you wouldn’t expect to find them, especially at restaurants and among the processed foods in the grocery store. Some examples of foods that seem “healthy” but can cause a blood sugar nightmare include:

  • Salads with sweet dressings and croutons or other toppings (or salad in a bread bowl)
  • Soups
  • Smoothies (especially fruit smoothies)
  • Fruit juice
  • Foods labeled “gluten-free”
  • Granola
  • Flavored yogurts
  • Fat-free ice cream
  • Restaurant foods (especially due to extreme portion sizes)

“Healthy” does not necessarily mean “diabetes-friendly.” Fat-free products are often fortified with sugars and starches. And many gluten-free products have even more carbohydrates than their standard gluten counterparts.

If you’ve chosen a restaurant that can provide nutritional information, ask for it, so you’ll know exactly how many carbohydrates you’ll be consuming. Consider asking for salad dressings and sauces on the side. 

Your Insulin Pump May Be Kinked

If you’re insulin-dependent, the first thing you should do at the sign of stubborn high blood sugar is to check to see if you have a kink in your insulin pump cannula. This can block the delivery of insulin, leading to a very frustrating day.

If you’re unsure, change your pump site! Make sure to call your insulin pump manufacturer to let them know of the issue, and they will usually mail you a replacement for free.

You’ve Injected Into Scar Tissue

If there’s no kink in the cannula, or if you’re using syringes to deliver multiple daily injections (MDI), you may have also just picked a “bad” site. When insulin is injected (either manually or with an insulin pump infusion set) into scar tissue, absorption suffers, resulting in unpredictable and high blood sugars.

Make sure to always rotate your sites as much as possible to avoid developing scar tissue and the inevitable high blood sugars they bring.

Your Medications Need Adjusting

Our bodies are constantly changing. It would be silly to expect the same insulin to carbohydrate ratio or insulin sensitivity factors or even the same number of milligrams of our oral diabetes medications for our entire lives.

Make sure you’re seeing your endocrinologist or diabetes doctor regularly; they can help refine your medication regimen.

You may be especially likely to require adjustments if you’ve recently lost or gained weight, have increased or decreased your activity levels, are going through a stressful life change, are pregnant, or planning on becoming pregnant, or haven’t been to the doctor for a while.

Your Medications Are Expired

Always check to make sure your medications aren’t expired! At room temperature, insulin will lose potency

Oral medications can last much longer, but you still need to be cognizant of expiration dates and make sure you’re refilling your prescriptions regularly to avoid taking an expired (and potentially useless) dose.

What to Do When Your Blood Sugar Is High

High blood sugars can range from not-a-big-deal to a life-or-death emergency. Make sure to check your blood sugar often and monitor for any signs of diabetic ketoacidosis (DKA). If you have blood sugars that are over 250 md/dL for more than a few hours and you have moderate to high ketones, you will need to seek emergency medical care immediately. If you don’t have ketones, but want to feel better as soon as possible, try some of these tactics:

  • Exercise – cardio (a walk, jog or even jumping jacks) can bring blood sugar down quickly
  • Take a correction bolus of insulin
  • Change your pump site
  • Chug water
  • Take a hot shower or bath 
  • Manage stress with a quick yoga sequence or meditation
  • Test for ketones (if you have moderate or high ketones and your blood sugar has been high for several hours, call your doctor or go to the emergency room right away)

Understanding why you’re experiencing high blood sugars is one more way to improve your life with diabetes! Always work with your doctor before changing your oral medication and/or insulin therapy.

Have you ever experienced a mystery, stubborn high blood sugar? What helped you to get it down quickly? Share this post and comment below; we love hearing from our readers!

Source: diabetesdaily.com

Lemon-Thyme Vegetable Salmon Wraps

This content originally appeared on ForGoodMeasure. Republished with permission.

One-pan dinners are a go-to for family night, but in most cases a bit too real for guests. This recipe will change your dinner parties. Hearty Swiss chard leaves wrap a savory treasure of salmon and snappy vegetables bathed in lemon-thyme butter. Recyclable foil packets jazz up the presentation and keep everything in place, while minimizing cleanup so you can spend time with friends outside your kitchen. Perfect al fresco with fresh greens tossed in a light vinaigrette.

Lemon-Thyme Vegetable Salmon Wraps

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Lemon-Thyme Vegetable Salmon Wraps

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Hearty Swiss chard leaves wrap a savory treasure of salmon and snappy vegetables bathed in lemon-thyme butter. 
Course Dinner, Lunch
Cuisine American
Keyword fish, one-pan, salmon
Prep Time 15 minutes
Cook Time 15 minutes
Total Time 30 minutes
Servings 4 servings
Calories 405kcal

Ingredients

  • ¼ cup butter softened
  • 1 tablespoon chives chopped
  • 1 tablespoon lemon juice
  • 1 tablespoon thyme chopped
  • 1 teaspoon lemon peel grated
  • 8 pcs large Swiss chard leaves center stems trimmed. Remove stem to the leaf edge creating a solid surface
  • 2 cups summer squash sliced
  • 2 cups green beans trimmed
  • 4 6- ounce salmon fillets skinned
  • ½ teaspoon sea salt
  • ¼ cup lemon sliced

Instructions

  • Preheat oven to 450 degrees.
  • In a small bowl, combine butter, chives, lemon juice, thyme and lemon peel.
  • Set lemon-thyme butter aside.
  • Tear four 12×12 squares of aluminum foil.
  • Working in batches, overlap two trimmed chard leaves stem-to-stem, making a rectangle.
  • Place arranged chard on each foil square.
  • Layer ½ cup summer squash and ½ cup green beans on each chard base.
  • Add one 6-ounce salmon fillet.
  • Sprinkle each fillet with ⅛ teaspoon salt.
  • Dot each with one tablespoon lemon-thyme butter, topping with a lemon slice.
  • Fold bottom chard leaf over each fillet, follow with the top.
  • Holding closed, fold aluminum foil, creating a sealed packet.
  • Place prepared packets on rimmed baking sheet.
  • Bake until salmon reaches 145 degrees, approximately 12-15 minutes.
  • Open packets and serve.

Notes

* Naturally low-carb & gluten-free

Nutrition

Calories: 405kcal | Carbohydrates: 14g | Protein: 38g | Fat: 23g | Cholesterol: 124mg | Sodium: 552mg | Fiber: 5g | Sugar: 6g


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.

Lemon-Thyme Vegetable Salmon Wraps Recipe

Source: diabetesdaily.com

Community Table: Women’s Health and Living Empowered with Diabetes

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

During our third Community Table discussion, Beyond Type 1 sat down with a group of experts and community members to discuss women’s health and living an empowered life with diabetes within both the type 1 and type 2 communities, and share helpful resources and personal perspectives. Watch the discussion in full!



Speakers included:

Partial transcript of conversation below, edited for content + clarity.

What’s the one thing you wish someone had told you about women’s health and diabetes?

Dr. Gomber: It’s okay to not strike that perfection of 100%. It’s absolutely all right if you can’t figure out how to deal with everything, including your hormones. As a person living with type 1 diabetes and as a trained physician, I realized it by trial and error by realizing that hormones are something which I need to adjust, make a balance myself.

Lexie: There are so many things that can affect your body in so many different ways. Nobody ever really explained to me what insulin resistance was, and everything that can come from insulin resistance. I recently got diagnosed with PCOS (polycystic ovarian syndrome) at the beginning of 2020 and it’s been a crazy journey. My husband and I have been trying to get pregnant and for the past 3 or 4 years, I’ve had irregular menstrual cycles. I just thought it was normal.

Doctors never put two and two together for me that PCOS and insulin resistance are linked in a lot of cases. Years ago, when I was in college, I had an endo tell me, “Hey, you’re showing signs of insulin resistance.” But he never said anything else. I thought, “Okay. Well, my A1C isn’t that bad so I’m good.” I never made any changes because I didn’t know what that actually meant.

Whenever I was going to see my OBGYNs they never really connected the dots for me either. When I said I was having irregular cycles it was just, “Okay, well let’s put you on birth control.” It wasn’t, “Maybe this is linked to your diabetes.” I never had any idea until I went and did my own research.

Jessica: How many people actually have diabetes, and I wish I would have told myself to reach out to other people with diabetes sooner. When quarantine hit, I made an Instagram just so I could talk to other people because I’m the only one with type 1 and no one in my family has type 2. It seemed like I was an outsider sometimes and I really needed to know that I am not alone in this.

Marina: Diabetes management is much more than counting carbs, then giving insulin, and having a blood sugar of 110. It is so much more than that. It is emotional health, it is wellbeing, it’s so much more. Sometimes we want to have a feeling of control, and we control the food or we control whatever thing we can. That’s really the beauty of what I do is ask how we can have a positive relationship, and a holistic view in how we eat.

What should people know if they’re heading into the age of menopause that might help them out a little bit with that?

Dr. Porter: It is important to understand everyone’s body is going to react very differently to menopause, and you need to be your own advocate with your OBGYN to tell her that things are not going right. They might need to adjust your blood sugar management routine because it’s counterproductive.

When it comes to menopause, there is this one massive hormone called progesterone which acts as a complete monster when it comes to blood sugars. Progesterone actually increases your blood sugars. You need to adjust your insulin regimen to understand how your body is going to react to progesterone. Also, during menopause, there are other additional things that you can incorporate into your regimen like incorporating exercise or yoga. Which will improve your insulin sensitivity and help incorporate that resistance that is coming up with progesterone in your body.

What’s a challenge that you’ve faced that taught you how strong you are as a woman living with diabetes?

Marina: I just bring it back to pregnancy. I think that’s been my most challenging moment because again, I’ve studied. It wasn’t necessarily new to me, but these are new human beings. Once they were born, it was like, “Wow, you’re healthy.” That is all that matters, nothing else. That really proved to me how resilient people with type 1 diabetes are. We really have an extra skill, like we have two brains. We’re able to not just manage our blood sugar, but also be a mom, be a doctor, be a wife, be all of these different things on top of all of the demands of diabetes.

Lexie: There have been different phases years of my life that always reminds me how strong I am. So, the first thing was looking back at the time I didn’t realize it, but Aussie kids, little young kids on Instagram, like giving themselves an injection or changing their pump site. And I’m like, “Oh my gosh, they’re so young.” And then I’m like, “Let’s see. You were doing this same thing.” Then I’ve given myself insulin while driving. I inject it, and in my mind, before I would go somewhere, I’m already calculating, “Okay, I’m going to be gone for this long. Let me go ahead and get this number of snacks.”

Growing up with a chronic illness, it forces you to have compassion for any and everybody which has helped me be able to support others. I don’t think I’ve ever really felt more accepted and loved by a community like the diabetes community. It just teaches you to love people.

A question from a community member: “I was diagnosed at age 41. I’m now 44. I also live with Hashimoto’s. I’ve been using Dexcom for a year and the Tandem pumps in september. Will I ever learn my body?”

Jessica: Yes, you will! Obviously my experience is different than yours, but you just got to take it day by day. Again, find someone who is just like you. There’s someone else out there dealing with the same thing.

Lexie: I agree that you will learn your body, but also know that your body is going to change all throughout your life and diabetes is literally a journey. You’re never going to get to like a destination where it’s like, “Okay, I’ve got it. I’m good for the rest of my life.” That’s why it’s definitely important to connect with other people who are going to be with you on this journey literally for the rest of your life. Because your body is always changing. Like everybody has said, it makes such a huge difference to feel like you’re not alone.

Lala: You’ve only had diabetes for three years, you’re a baby. There are things that you’re going to keep learning for a very long time. I’ve had type one for 23 years. As you know, I just learned new things from this conversation. There’s always a learning curve and the learning curve is long. Have patience with yourself.

Marina: Sometimes it just takes either a visit to somebody that knows to say, “Hey, have you noticed this, this and that?” And it might take somebody that might have that experience or that education or that has gone through the same thing to say, “I did not know that.”

So just know that there are people that are educators, doctors, or people that have diabetes that could just help you out in a professional way as well to say, “Hey, look at your Dexcom. This is what’s happening. Have you noticed this?”

Source: diabetesdaily.com

Heart Failure – The Overlooked Diabetes Complication, Part 1: What and Why?

This content originally appeared on diaTribe. Republished with permission.

By Ben Pallant

Learn what heart failure is, what it has to do with diabetes, and how to identify and talk about this complication that’s often less discussed.

Healthcare professionals often discuss diabetes complications such as vision loss (retinopathy), chronic kidney disease (nephropathy), and cardiovascular disease (referred to as atherosclerotic cardiovascular disease by healthcare professionals). However, there is a less talked about heart complication, heart failure. Heart failure refers to a condition where the heart’s ability to pump blood is less than normal, often meaning not enough blood is effectively circulating to the rest of the body.

This is part one of a two-part series on heart failure and diabetes.

What is heart failure?

First, it’s important to differentiate heart failure from other conditions such as cardiovascular disease, a heart attack, or cardiac arrest. There is also the broad term “heart disease,” which can encompass any heart issue. Because the names can get confusing, here are some brief explanations:

  • Cardiovascular disease, or atherosclerotic cardiovascular disease, is related to the process called atherosclerosis, which occurs when a substance called plaque builds up in your arteries making it difficult for blood to flow normally. The plaque buildup can be caused by high blood pressure, high cholesterol or triglycerides, smoking, or a number of other reasons. When it builds up in the arteries that supply blood to heart muscles or the brain, a heart attack or stroke can occur. Read our article on diabetes and heart disease here.
  • In a heart attack, the blood flow (and the oxygen supply, since blood carries oxygen throughout the body) to the heart muscle is blocked, causing damage to the heart muscle.
  • Heart failure happens when the heart isn’t able to pump enough blood to the rest of the body.
  • Cardiac arrest is the sudden loss of heart function. Usually due to an issue with the heart’s electrical system that disrupts a regular heartbeat, cardiac arrest causes the heart to stop pumping blood to the rest of the body.

There are a number of reasons why heart failure can occur, including coronary artery disease, high blood pressure, previous heart attacks, or other conditions and structural issues that damage the heart muscle (like cardiomyopathy or heart valve problems). Your chances of developing heart failure also increase as you get older. The heart’s inability to pump enough blood usually happens in one of two ways:

  1. When the heart muscle becomes stiff, the chambers in the heart cannot relax. This decreases the fill capacity of your heart chambers. Nevertheless, the heart is still able to release more than 50% of the blood in the heart chamber to the rest of the body. This type of heart failure is called “heart failure with preserved ejection fraction,” or HFpEF.
  2. When the heart muscle becomes weaker, not enough blood goes out to the body with each heartbeat. Thus, the percentage of blood that is released to the body is less than 50% of the amount in the heart chamber. This type of heart failure is called “heart failure with reduced ejection fraction,” or HFrEF.

Diabetes and prediabetes have been associated with both types of heart failure. Heart failure overall is a widespread health challenge – over 6 million Americans live with heart failure, and it leads to about 1 million hospitalizations per year in the US.

Heart failure is usually a chronic condition that progresses over time. At first, people may not experience any physical symptoms at all because the body has ways of trying to compensate – the heart may become bigger, it could develop more muscle mass, or it could try to pump faster. Over time though, heart failure worsens leading to shortness of breath, fatigue, inability to exercise, and more. Eventually the heart’s decreased ability to pump blood causes fluid to build up in other parts of the body, including the legs and lungs, which makes ordinary things like breathing and walking difficult. This is called congestive heart failure (CHF).

To learn more about heart failure, check out the American Heart Association’s heart failure resources.

What does heart failure have to do with diabetes?

Heart failure is unfortunately one of the most common and deadly complications of diabetes, especially for people with type 2 diabetes. They are two to four times more likely to develop heart failure than people without diabetes, and having diabetes increases a person’s risk for repeat hospitalizations for heart failure. This is partly because many of the key risk factors for heart failure are common in people with type 2 diabetes, such as a body mass index (BMI) over 25 (click here for a BMI calculator), high blood pressure, coronary artery disease, or a history of a heart attack. Other risk factors for heart failure include heart valve problems, sleep apnea, lung disease, and smoking.

But the shared risk factors alone don’t explain everything – diabetes itself is an independent risk factor for heart failure. According to several research studies, each percentage point increase in A1C is associated with an increased risk (8-36%) of heart failure. Researchers suspect that over time, high blood sugar levels either damage the cells of the heart muscles or force the heart to work harder due to damage to smaller blood vessels throughout the body and in the heart – this may be why high glucose levels are associated with heart failure.

Signs, symptoms, and screening

The Mayo Clinic and the American Heart Association have identified a number of possible symptoms of heart failure. These include:

  • Shortness of breath during activity or when you lie down
  • Tiredness and weakness
  • Swelling in your legs, ankles and feet, and very rapid weight gain (due to fluid retention)
  • Rapid or irregular heartbeat
  • Persistent coughing or wheezing (or coughing that produces pink, foamy mucus)
  • Chest pain if the heart failure is caused by a heart attack
  • Lack of appetite or nausea
  • Confusion or impaired thinking

It is especially important to seek immediate medical attention if you experience chest pain, severe fatigue or weakness, rapid or irregular heartbeats with shortness of breath or fainting, or sudden, severe shortness of breath especially if it is associated with coughing up pink, foamy mucus. For CHF especially, seeking timely medical attention is essential.

Talking to your healthcare team is key to making sure you are staying healthy, and it can help identify an early diagnosis. If you are experiencing any of the above symptoms, ask your healthcare professional if you can be tested for heart failure. Even if you aren’t exhibiting symptoms, start a conversation about what you can do to stay healthy and prevent future complications.

How do healthcare professionals test for heart failure?

Heart failure is most commonly assessed using medical imaging techniques that allow healthcare professionals to “see” the heart and assess its function. The most common test associated with heart failure is echocardiography (often called an “echo”) which is a non-invasive, painless ultrasound image of the heart. The echocardiogram can show how thick the heart muscle is and how much blood is pumped out of the left ventricle (one of the heart’s four chambers) with each beat. This information can be used to determine whether heart failure involves preserved or reduced ejection fraction.

Other imaging tests include an x-ray, an MRI, and a myocardial perfusion scan. An x-ray can see if the heart is enlarged or if there is fluid in the lungs, two signs of CHF. If your healthcare professional is concerned that there may be damage to the heart muscle or blockages of major blood vessels to the heart muscle, they may recommend an MRI. A myocardial perfusion scan uses a tiny amount of a radioactive substance that allows the heart to be imaged. It can show how well the heart muscle is pumping and areas with poor blood flow. This scan is often done with an exercise stress test (explained below).

In addition to these different imaging techniques, healthcare professionals use exercise stress tests (which measure how a person responds to increasingly difficult exercise) as a measure of heart function, blood tests to check for heart failure-associated strain on the kidney and liver, or an electrocardiogram (EKG or ECG) test to look at the heart’s electrical activity for signs of a heart attack and to see if the heart rhythm is abnormal.

Before any of these heart tests are ordered, your healthcare team will usually conduct a physical exam to determine what your symptoms are and what tests are needed. It’s important to be honest – your healthcare team needs to know about your lifestyle, including whether you smoke cigarettes, eat a lot of high-fat foods, and are physically active. Be prepared to answer other questions too:

  • When did symptoms begin?
  • How severe are the symptoms?
  • Does anything make the symptoms better or worse?
  • Do you have a family history of heart disease, diabetes, or high blood pressure?
  • Are you taking any medications, including over-the counter-drugs, vitamins, supplements, or prescriptions?

To learn more about heart failure, including prevention, medication options, and management tips, read “Heart Failure – The Overlooked Diabetes Complication, Part 2: Prevention and Management,” which our team will be updating this summer. You can also check out the Know Diabetes By Heart resources on heart failure.

This article was originally published on June 15, 2018. It was updated in May 2021 by Matthew Garza as 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

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