Author: User

Including sweets in your meal planning

Sweets count as carbohydrates in your meal plan. The trick is substituting small portions of sweets for other carbohydrates — such as bread, tortillas, rice, crackers, cereal, fruit, juice, milk, yogurt or potatoes — in your meals. To allow room for sweets as part of a meal, you have two options:

  • Replace some of the carbohydrates in your meal with sweets.
  • Swap a high carb-containing food in your meal for something with fewer carbohydrates and eat the remaining carbohydrates as sweets.

Let’s say your typical dinner is a grilled chicken breast, a medium potato, a slice of whole-grain bread, a vegetable salad and fresh fruit. If you’d like a frosted cupcake after your meal, look for ways to keep the total carbohydrate count in the meal the same. Trade your slice of bread and the fresh fruit for the cupcake or replace the potato with a low-carbohydrate vegetable such as broccoli. Adding the cupcake after this meal keeps the total carbohydrate count the same.

To make sure you’re making even trades, read food labels carefully. Look for the total carbohydrate in each food, which tells you how much carbohydrate is in one serving of the food.

As part of diabetes nutrition, artificial sweeteners can offer the sweetness of sugar without the calories. Artificial sweeteners may help you reduce calories and stick to a healthy meal plan — especially when used instead of sugar in coffee and tea, on cereal or in baked goods. In fact, artificial sweeteners are considered free foods because they contain very few calories and don’t count as a carbohydrate, a fat or any other food in your meal plan.

Examples of artificial sweeteners include: Acesulfame potassium (Sweet One, Sunett), Aspartame (Equal, NutraSweet), Saccharin (SugarTwin, Sweet’N Low), Sucralose (Splenda). Artificial sweeteners don’t necessarily offer a free pass for sweets.

Keep an eye out for calories and carbs. Many products made with artificial sweeteners, such as baked goods and artificially sweetened yogurt or pudding, still contain calories and carbohydrates that can affect your blood sugar level.

Sugar alcohols are not calorie-free. Sugar alcohols, another type of reduced-calorie sweetener, are often used in sugar-free candies, chewing gum and desserts. Check product labels for words such as “isomalt,” “maltitol,” “mannitol,” “sorbitol” and “xylitol.” Sugar-free foods containing sugar alcohols still have calories. Also, in some people, sugar alcohols can cause diarrhea.

Two naturally derived sweeteners, stevia (Truvia, Pure Via) and agave nectar (Wholesome Sweeteners, Madhava) offer another option when it comes to sweetening your food. Keep in mind that the sugar-to-sweetener ratio is different for each product, so you may need to experiment until you find the taste you like. Also, agave nectar isn’t calorie- or carbohydrate-free, so it shouldn’t be considered for weight loss, but it has a lower glycemic index than does sugar, so it won’t affect your glucose level as much.

Eating out at a restaurant

If you have an eating plan for your diabetes this does not mean that you cannot go out to eat. Your meal at a restaurant can be part of your eating plan if you are well aware of what you need. Here you find some suggestions about how to ease the process of going to a restaurant and to stay committed to your eating plan:

Research restaurant menus

When available online check a restaurant’s menu, and ethe nutrition facts if available.

Keep portion sizes in check

Generally speaking you should eat moderately. So try to avoid big portions:Choose the smallest meal size if the restaurant offers options, for example a lunch-sized entree. Share meals with a dining partner. Request a take-home container

Consider avoiding “all you can eat” buffets. They make it difficult to resist and moderate your meal.

Make substitutions

Don’t settle for what comes with your sandwich or meal but customize it according to your needs. For example avoid French fries in favor of grilled vegetables. Do not be afraid to ask.

Watch the extras

Keep in mind that extras, bacon bits, croutons and fried chips, can sabotage diabetes nutrition goals by quickly increasing a meal’s calorie and carbohydrate count.

Even healthier additions — including fat-free salad dressing, barbecue sauce and fat-free mayonnaise — have calories. But you can enjoy small servings of these without adjusting your meal plan. Ask for them on the side to further control how much of them you eat.

Speak with the chef

Food preparation is also something to consider. Avoid breaded and fried food. Instead request that your food be:

  • Broiled
  • Roasted
  • Grilled

Don’t feel like you’re stepping out of line if you request healthier options or substitutions. You’re simply doing what it takes to stay committed to your meal plan.

Watch what you drink

Remember that calories come from drinks as well. So avoid high-calorie drinks. Instead of soda try following: diet soda, water, unsweetened iced tea, sparkling water or mineral water. Remember also that alcohol may be highly problematic. If your diabetes is under control and your doctor agrees, an occasional alcoholic drink with a meal is fine. But alcohol is rich in empty calories and can lead to diabetes complications. When choosing alcohol, choose options with fewer calories and carbohydrates such as:

  • Light beer
  • Dry wines

Limit alcohol to no more than two drinks a day if you’re a man and one drink a day if you’re a woman.

Eat on time

Your meal schedule is important to maintain steady blood sugar levels — especially if you are taking medications or insulin.

If you’re eating out with others, follow these tips: Schedule the gathering at your usual mealtime.To avoid waiting for a table, make a reservation or try to avoid times when the restaurant is busiest.If you can’t avoid eating later than usual, snack on a fruit or starch serving at your usual mealtime.

Save room for dessert

Remember that dessert isn’t necessarily off-limits. Sweets count as carbohydrates in your meal plan. If you’d like dessert, compensate by reducing the amount of other carbohydrates — such as bread, tortillas, rice, milk or potatoes — in your meal.

Remember the ground rules

Whether you’re eating at home or eating out, remember the principles of diabetes nutrition. Eat a variety of healthy foods. Limit the amount of fat and salt in your diet. Keep portion sizes in check. And above all, follow the nutrition guidelines established by your doctor or registered dietitian.

Since I have been taking insulin, I have the feeling that I am gaining weight. Is that possible?

Weight gain is a common side effect for people who take insulin — a hormone that regulates the absorption of sugar (glucose) by cells. However, controlling your weight is not only possible but also an important part of your overall diabetes management plan.

When you take insulin, glucose is able to enter your cells, and glucose levels in your blood drop. This is the desired therapeutic goal. However, if the number of calories you take in and your activity level result in more calories than you need to maintain a healthy weight, your cells will get more glucose than they need. Glucose that your cells don’t use accumulates as fat.

Weight gain may also be related to other complex functions of insulin in the body related to how cells use fats and proteins.

Eating healthy foods and staying physically active every day can help you prevent unwanted weight gain. The following tips can help you keep the pounds off:

  • Count calories. Eating and drinking fewer calories helps you prevent weight gain. Stock the refrigerator and pantry with fruits, vegetables and whole grains. Plan for every meal to have the right mix of starches, fruits and vegetables, proteins, and fats. Trim your portion sizes, skip second helpings and drink water instead of high-calorie drinks. Talk to your doctor, nurse or a dietitian about meal-planning strategies and resources.
  • Don’t skip meals. Don’t try to cut calories by skipping meals. When you skip a meal, your body is less efficient at using energy, and you’re more likely to make poor diet choices at the next mealtime because you’re too hungry. Skipping meals also causes large fluctuations in blood sugar levels. Three modest meals a day with healthy snacks in between can result in better control of weight and blood glucose levels.
  • Be physically active. Physical activity burns calories. A reasonable goal for most adults is a minimum of 150 minutes per week of moderately intense aerobic activity — such as walking, bicycling, water aerobics, dancing or gardening — plus muscle-strengthening exercises at least two times per week. Talk with your doctor about activities and exercises that are appropriate for you.
  • Ask your doctor about other diabetes medications. Some diabetes medications that help regulate blood glucose levels — including metformin (Fortamet, Glucophage, others), exenatide (Byetta), liraglutide (Victoza) and pramlintide (Symlin) — may promote weight loss and enable you to reduce your insulin dosage. Ask your doctor if these or other medications would be an appropriate part of your diabetes treatment plan.
  • Take your insulin only as directed. Don’t skip or reduce your insulin dosages to ward off weight gain. Although you might shed pounds if you take less insulin than prescribed, the risks are serious. Without enough insulin, your blood sugar level will rise — and so will your risk of diabetes complications.

I found a blister on my foot, what should I do?

Diabetes complications include nerve damage and poor blood circulation. These problems make the feet vulnerable to skin sores (ulcers) that can worsen quickly and are difficult to treat. Proper diabetes management and careful foot care can help prevent foot ulcers.

When foot ulcers do develop, it’s important to get prompt care. An ulcer that won’t heal causes severe damage to tissues and bone and may require surgical removal (amputation) of a toe, foot or part of a leg.

Here’s what you need to know to keep your feet healthy, and what happens if amputation is necessary. (Hyperlink)

Vaccinations

Keep your vaccines up to date.

High blood sugar can weaken your immune system, which makes routine vaccines more important than ever. Ask your doctor about:

  • Flu vaccine. An annual flu vaccine can help you stay healthy during flu season as well as prevent serious complications from the flu.
  • Pneumonia vaccine. Sometimes the pneumonia vaccine requires only one shot. If you have diabetes complications or you’re age 65 or older, you may need a five-year booster shot.
  • Hepatitis B vaccine. The Centers for Disease Control and Prevention (CDC) currently recommends hepatitis B vaccination if you haven’t previously been vaccinated against hepatitis B and you’re an adult aged 19 to 59 with type 1 or type 2 diabetes. The most recent CDC guidelines advise vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you’re age 60 or older and have diabetes and haven’t previously received the vaccine, talk to your doctor about the whether it’s right for you.
  • Other vaccines. Stay up to date with your tetanus shot and its 10-year boosters. Depending on the circumstances, your doctor may recommend other vaccines as well.

Foot Treatment

Begin taking good care of your feet today. Set a time every day to check your feet.

Check your feet on a daily basis. Look at your bare feet for red spots, cuts, swelling, and blisters. If you can’t see the bottoms of your feet, use a mirror or ask someone to help.

Wash your feet daily. Wash your feet in lukewarm water once a day. Dry them gently, especially between the toes. Use a pumice stone to gently rub the skin where calluses easily form. Sprinkle talcum powder or cornstarch between your toes to keep the skin dry. Use a moisturizing cream or lotion on the tops and bottoms of your feet to keep the skin soft.

Don’t remove calluses or other foot lesions yourself. To avoid injury to your skin, don’t use a nail file, nail clipper or scissors on calluses, corns, bunions or warts. Don’t use chemical wart removers. See your doctor or foot specialist (podiatrist) for removal of any of these lesions.

Keep your skin soft and smooth. Rub a thin coat of skin lotion over the tops and bottoms of your feet, but not between your toes.

If you can see and reach your toenails, trim them when needed. Trim your toenails straight across and file the edges with an emery board or nail file.

Wear shoes and socks at all times. Never walk barefoot.

Wear clean, dry socks. Wear socks made of fibers that pull (wick) sweat away from your skin, such as cotton and special acrylic fibers — not nylon. Avoid socks with tight elastic bands that reduce circulation, as well as thick bulky socks that often fit poorly and irritate your skin.

Buy shoes that fit properly. Buy comfortable shoes that do not fit tightly and that provide support and cushioning for the heel, arch and ball of the foot. Avoid high heels or narrow shoes that crowd your toes. If one foot is bigger than the other, buy shoes in the larger size. Your doctor may recommend specially designed shoes (orthopedic shoes) that fit the exact shape of your feet, provide cushioning and evenly distribute weight on your feet.

Protect your feet from hot and cold. Wear shoes at the beach or on hot pavement. Don’t put your feet into hot water. Test water before putting your feet in it just as you would before bathing a baby. Never use hot water bottles, heating pads, or electric blankets. You can burn your feet without realizing it.

Keep the blood flowing to your feet. Put your feet up when sitting. Wiggle your toes and move your ankles up and down for five minutes, two or three times a day. Don’t cross your legs for long periods of time.

Don’t smoke. Smoking impairs circulation and reduces the amount of oxygen in the blood. These circulatory problems can result in more severe wounds and poor healing. Talk to your doctor if you need help to quit smoking.

Schedule regular foot checkups. Your doctor or podiatrist can inspect your feet for early signs of nerve damage, poor circulation or other foot problems. Schedule foot exams at least once a year or more often if recommended by your doctor.

Take foot injuries seriously. Contact your doctor if you have a foot sore that doesn’t begin to heal within a few days or other persistent problems with your feet. Your doctor will inspect your feet to make a diagnosis and prescribe the appropriate course of treatment

Preventing long-term conditions

Preventing long-term conditions – Your own help is needed

Don’t smoke

If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications, including heart attack, stroke, nerve damage, and kidney disease. Talk to your doctor about ways to stop smoking or to stop using other types of tobacco.

Keep your blood pressure and cholesterol under control.

Like diabetes, high blood pressure can damage your blood vessels. High cholesterol is a concern, too, since the damage is often worse and more rapid when you have diabetes. When these conditions team up, they can lead to a heart attack, stroke or other life-threatening conditions.

Eating healthy foods and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. Sometimes medication is needed, too.

Schedule yearly physicals and regular eye exams.

Your regular diabetes checkups aren’t meant to replace yearly physicals or routine eye exams. During the physical, your doctor will look for any diabetes-related complications — including signs of kidney damage, nerve damage and heart disease — as well as screen for other medical problems. Your eye care specialist will check for signs of retinal damage, cataracts and glaucoma.

How to correctly manage medication intake

Medication non-compliance is the failure to take drugs on time in the dosages prescribed. It’s a common problem. According to an April 2011 Mayo Clinic Proceedings article, only about half of those who are prescribed medication take it exactly as prescribed.

There are many reasons you might not take your medication as prescribed. They include not understanding medical terms, not being involved in the medical decision making, poor communication on the part of your health care provider, your doctor having an incomplete medical history, limited finances or access to health care, complex medication regimens, cultural barriers, memory issues, health beliefs or misconceptions and many others. It’s a complex issue with no single solution.

So then what can be done? What can you do?

First, ask questions. You have the right to understand your own medical program. Consider inviting a family member or friend to your appointments in order to assist with understanding instructions.

A lot people tend to forget to take their medication. Taking medication is a behavior, and all behaviors can be changed, although change isn’t always easy. Consider tools designed to help — such as medication organizers, dispensers, pill box timers, alarms and written schedules or calendars.

Preparing for your next Doctor appointment

Prepare for your next Appointment

Here’s some information to help you get ready for your next appointment.

What you can do

  • Be aware of any pre-appointment restrictions. When you make the appointment, ask if there’s anything you need to do in advance. This will likely include restricting your diet, if you need to complete a fasting blood sugar test.
  • Write down any symptoms you’re experiencing, including any that may seem unrelated.
  • Write down key personal information, including major stresses or recent life changes. If you’re monitoring your glucose levels at home, bring a record of the glucose results, detailing the dates and times of testing.
  • Take a family member or friend, if possible. Someone who accompanies you can help you remember information you need.
  • Write down questions to ask your doctor. Ask about aspects of your diabetes management you’re unclear about.
  • Be aware if you need any prescription refills. Your doctor can renew your prescriptions while you’re there.

Preparing a list of questions can help you make the most of your time with your doctor. For diabetes, some questions to ask include:

  • Are the symptoms I’m having related to my diabetes or another condition?
  • What else can I do to protect my health?
  • What are other options to manage my diabetes?
  • I have other health conditions. How can I best manage these conditions together?
  • Should I see another specialist, such as a dietitian or diabetes educator?
  • Is there a generic alternative to the medicine you’re prescribing?
  • Are there brochures or other printed material I can take with me? What websites do you recommend?

Don’t hesitate to ask any other questions you have.

Insulin Safety

For many people with diabetes, injecting two types of insulin is a daily requirement. Giving yourself your injections can become so much a part of your routine that you can do it without thinking — which can lead to errors.

To increase insulin safety and avoid taking the wrong insulin:

  • Pause and double-check that you’re taking the correct insulin.
  • Label insulin vials or pens with different-colored tape, so that you can differentiate between them. For example, use red tape for short-acting insulin and yellow tape for long-acting insulin.

If you accidentally give yourself the wrong insulin:

  • Call your local emergency number.
  • Test your blood sugar frequently until help arrives. Eat or drink a fast-acting carbohydrate to maintain a blood sugar within your goal range.

In preparation for such issues, it’s a good idea to always carry a simple sugar source with you, such as glucose tablets, juice, regular soda or hard candy.