The Most Underrated Tool to Manage Your Blood Sugar. 

Vegetables can be sexy and delicious. 

Vegetables can be sexy and delicious. 

Attitude is the difference between an ordeal and an adventure.
— Bob Bitchin

"Eat your vegetables!"  This phrase is  touted by nutrition expects and our mothers to improve our health. This may be exactly why we may resist eating them. What we fail to realize is vegetables are a powerful tool  for optimal health. Recently, researchers conducted studies proving why vegetable intake is so imperative to managing type 2 diabetes. 

A new study published in the Journal of Medicine College of Nutrition found individuals with type II diabetes who ate a plant-based diet lost twice as much weight and reduced muscle fat than individuals who ate the standard diabetic diet that included meat. Both diets contained the same amount of calories and all participant had the same exercise regimen.  The only animal product the vegetarian group ate was 8 ounces of low-fat yogurt a day. 

If you still are convinced maybe you need a little  motivation. Researchers at Stanford University Department of Psychology found one simple tool to get people to eat their vegetables; make it sexy!  Researchers  offered food to college students using terms such as "slow roasted caramelized " and "citrus infused"  versus "low-fat" and "low-calorie" to describe the same vegetables. All things being equal, when the researchers used the more descriptive name on the menus, student ordered the vegetables with the sexy names 41% MORE often. 

Maybe part of the reason people avoid vegetables is because they think it is boring? 

Mixing vegetables in your smoothies, sneaking vegetables into your casseroles and trying new recipes are tactics you can use to get more vegetables in your diet. 

If you have any other tips or have any opinions regarding this subject please leave a comment in the section below. Your input can help others. As always you can schedule an appointment with me.







Staying in the shade will protect your skin and your health. 

Staying in the shade will protect your skin and your health. 

Summertime. The living is easy and obviously hot. A little sun gives us our needed vitamin D. On the other hand too much sun can be harmful, especially for  folks with diabetes.

There are several reasons why the heat severely affects people with diabetes.

Nerve Damage or Neuropathy compromises the sweat glands making the body less efficient at cooling down. The result is heat exhaustion or heat stroke.

Another reason heat adversely affects people with diabetes is their increase risk for dehydration. Poorly managed blood sugar causes the body to lose excessive water resulting in dehydration. Also, some blood glucose medications along with medications to treat the complications of diabetes such as diuretics for high blood pressure causes water loss. 

Finally, the body uses insulin differently when temperatures are high and sunburn increases your blood sugar. 

Here are some tips to protect yourself during the hot weather.

  1. Drink plenty of water BEFORE you feel thirsty.
  2. Avoid high caffeine and alcoholic beverages. These drinks increase fluid loss. 
  3. Wear sunscreen, loose fitting light clothing and hats when outside.
  4. Do not go outside barefoot, even at the beach or pool area. 
  5. Exercise indoors . If you must exercise outsidedo it BEFORE the temperature rises.
  6. Check your blood sugar, before, during and after exercising.
  7. Keep your medications in a cooler.

These simple tips should help you deal with your diabetes during the summer.

If you have any other questions or suggestions please post them in the comment section below. Your input could help others. As always, you can schedule an appointment with me.







Diabetes Foot Care

It's more than a good manicure.

Keeping your feet soft and supple is essential to good diabetes care. 

Keeping your feet soft and supple is essential to good diabetes care. 

Our feet. Sometimes we forget how much we need them to get where we are going along with the wear and tear they take to get our destination.  Most of us need to take better care of our digits, especially individuals with diabetes. 


 Poor blood sugar(glucose) control for people with diabetes impairs blood circulation and causes nerve damage in their feet. Also, small sores on their feet can lead into infections and eventually amputations.

Here are some top tips to proper foot care for your diabetes.

1. Be proactive, keep your blood sugar under control.

Sounds obvious but it never hurts us to remember. Keeping your fasting blood glucose to 80-130mg/dl and your 2 hour post-meal(postprandial) blood sugar under 140mg/dl helps to prevent problems from occurring. 

2. Wash and lotion your feet daily to keep them clean and soft.

Dry cracked smelly feet are not only unattractive they are a haven for bacteria.  Too much bacteria can cause infections. Wash your feet and invest in lotion to keep your feet clean and soft. However, avoid adding lotion between your toes since this can create environment that favors fungal growth. 

3. Avoid over-the-counter products or sharp products for removing corns and callouses.

Over the counter medications to remove  foot warts  or corns are not recommended for people with diabetes. If you have neuropathy or nerve damage to your feet have a podiatrist or foot nurse provide foot care. 

4. Wear well fitting shoes and socks at all times.

Most foot specialists recommend padded socks made with acrylic and acrylic blends for people with diabetes. Change your socks daily and rotate your shoes daily to reduce wear and tear on your feet.  Also, make sure your shoes are actually comfortable to avoid corns and callouses.

6. Protect your feet from extreme hot and cold temperatures.

Wearing shoes at the beach and hot pavement, wearing socks at night when your feet are cold, never testing bath water with your feet and avoiding heating pads on your feet will protect your digits from potential problems. 

7. Exercise regularly and avoid any movement that restricts blood flow to your feet.

Try to get in at least 30 minutes of movement daily.  Wiggle your toes and move your ankles for 5 minutes several times daily.  Avoid crossing your legs for long periods of times. These are actions you need to take to keep proper circulation in your feet. 

The National Institute of Health or NIH has more detailed information and resources to provide for foot care.

If you have any comments or questions please share them in the comment section below. As always your input could help others.







Solving the Mystery of The Glycemic Index

Popcorn has a glycemic index of 55-89 depending on how this snack is prepared. 

Popcorn has a glycemic index of 55-89 depending on how this snack is prepared. 

Don’t live the same year 75 times and call it a life.
— Robin Sharma

Every so often  someone will ask me about Glycemic Index.

"What is glycemic index?", you ask. 

Glycemic Index(GI) was invented in 1981 by researchers  Dr. Thomas Wolever and Dr. David Jenkins who were able to prove certain carbohydrates raise blood glucose(sugar) levels higher than other carbohydrates. 

Participants were given 25 grams of carbohydrates and based on the results foods were ranked from 0 to 100. High Glycemic Index(GI) food made blood sugar spike faster and low GI food absorbed carbohydrates at a slower rate. 

According to glycemic professionals, people with diabetes should aim for food with a glycemic index of 55 or less.  Fat and fiber helps decrease a food's glycemic index so don't be afraid to add either to decrease your blood sugar(glucose) load.  Many people with diabetes, hyperlipidemia and who  just want to lose weight have food success using the glycemic index . There are many websites with tips on how to decrease your glycemic load and look for foods labeled GI for more information. 

If you have any questions about the glycemic index or would like to share your experience using this technique to deal with your diabetes,  please feel free to share your thoughts in the comment section below. Your comments could help others. As always, you can schedule an appointment with me.










Don't let Mondays break you down. 

Don't let Mondays break you down. 

If Monday was a mannequin....
— Unknown

Monday morning.

We all know the feeling.

For most of us, Monday represents a feeling a dread and we may be justified with this feeling.

Researchers found most heart attacks occur on Monday; particularly Monday mornings. 

For me, the question is why?

I decided to ask few coworkers for their opinions partly for information but mostly for stress relief. The answers varied. A social worker named "Aretha" stated she felt most people had heart attacks on Monday because many were partying or eating unhealthy throughout the weekend and their bodies caught up with them on Monday. Interesting?

"Kathy", a physician assistance, told me she had never heard of this fact although in her experience most people had heart attacks after a "traumatic event." I responded, "Kathy for some people Monday IS a traumatic event!" She thought about my statement and started to chuckle. 

Since we now know Mondays increase your chances for a heart attack here are some suggestions to beat the odds.

1. Prepare for your week on Sunday night.

Iron your clothes for the week the night before so you won't stress about what to wear in the morning. Pack your lunch and bring it work so you can have healthy food available instead of rushing to the vending machine.  Make sure you have a full tank of gas in your car before you go to sleep.  Most stress is caused when you are feeling out of control so preparing for your week on Sunday will make you feel more empowered.

2. Get plenty of sleep.

Instead of waking up tired and drinking a gallon of coffee throughout the day, try getting at least seven to eight hours of sleep the night before. Your mind and body will thank you

3. Play your favorite music in the morning.

The right song can get your through the day. Maybe you need  to hear something soft and relaxing to sooth your mind.  On the other hand, maybe you need a hard thumping Gangsta rap song to get your blood pumping.  Anything to lift you mood works. No judgement here!

4. Pray or meditate before you leave the house.

Think of at least one thing you are grateful for when you wake up. If you can't think of anything remember there are many people in the world who did not have the privilege of waking up.  You will be amazed how this simple exercise can help put your life in perspective. 

5. Treat Mondays like a new beginning.  

Instead of thinking of Mondays as the end of the weekend envision this day as a clean slate. Maybe this is the week you try a new restaurant or read a new book. How about changing the part on your hair today?  Change the quote on your email. Use Monday to kickoff all the new experiences you want to try and actually try them. 

Are Mondays stressful to you and if so how do you deal with this feeling? Please post your tips so you can help others. As always you can notify fill out the information section below if you have any questions.






Insulin 101-Part 2

Managing Insulin In a Emergency

putting out fire
Don’t dwell on what went wrong. Instead, focus on what to do next.
— Denis Waitley

In my last post I talked about the differences between the basic types of insulin.  In this post, I will write about correction bolus insulin. 

Basal insulin(i.e. Lantus or Levemir)  affects your fasting blood glucose(sugar). If your blood sugar is too high in the morning or before meals you need to adjust your basal insulin.

On the other hand, if your blood sugar is too high after meals you need to adjust your bolus insulin.  Fast acting insulin such as Humulin or rapid acting insulin such as Novolog are considered bolus insulin. Bolus insulin is considered a mealtime and correction( AKA emergency) insulin.

Sometimes an individual with diabetes will do all the right things but for whatever reason their blood sugar may occasionally be too high. The reasons may be varied: they may have an infection or unknowingly consume too many carbohydrates during a meal. 

Ideally, if you have diabetes, two hours after mealtime(post-meal or postprandial) your blood sugar should be less than 140mg/dl. Sometimes, health professionals with liberalize post-meal(postprandial) blood sugar level to less than 180mg/dl for people struggling with hypoglycemia. Talk to your doctor or pharmacist if to find what works for you. 

The first plan of action to reduce the need for correction bolus is be proactive. Learning how to  count carbohydrates can help you find the right dose to prevent hyperglycemia. Monitoring your blood glucose more frequently when you are sick can also help. Many chain restaurants menus are online and provide information on carbohydrate content to help you adjust your insulin accordingly. 

How much insulin you need to give yourself varies so please work with your doctor and pharmacist if you are having difficulty managing your blood glucose(sugar).

Please leave your comments below if you have any questions or tips regarding this topic. Your input could help others. You can also schedule an appointment with me if you need help managing your diabetes.







Insulin 101

Insulin Demystified!

Insulin Demystified!

The capacity to learn is a gift; the ability to learn is a skill; the willingness to learn is a choice.
— Brian Herbert

Disclaimer: This post is for informational purposes only. Please consult with doctor and/or pharmacist regarding your insulin dosage or if insulin is right for you.

It seems like a week does not go by where someone asks me about insulin. For many people with diabetes and health professionals insulin can be confusing. What is insulin? Why do some people with diabetes need insulin and other don't? What is the difference between basal insulin and bolus insulin? I hope this post will answer your questions.

I could give you the formal encyclopedia definition of insulin but I will keep it simple by defining insulin as a hormone produced by the pancreas to help your body properly use glucose(sugar).  EVERYONE needs insulin to survive! 

The next question I am usually asked is what is the difference between people with type I and type II diabetes regarding insulin? People with type I diabetes make no insulin and need take insulin to survive. PERIOD. About 5% of people with diabetes have type I diabetes. These individuals also need two types of insulin to properly manage their diabetes; basal and bolus insulin. We will discuss these types later. 

95% of people with diabetes have type II diabetes. These individuals make insulin but they do not make enough for their body to properly use  or they are "insulin resistant". A simple technique to make the body more sensitive to insulin is to lose weight for people with type II diabetes. 

There are two main types of insulin; basal and bolus insulin. First let's talk about basal insulin.

Your body is producing glucose(sugar) 24 hours a day. The difference between someone with or without diabetes is how much insulin their body is producing to keep their blood sugar(glucose) stable. People without diabetes are producing the same amount of insulin as glucose(sugar). People with type I diabetes is producing no insulin so their blood sugar stays high and people with type II diabetes are somewhere in between. 

Basal insulin is used to keep your blood sugar(glucose) stable when you are sleeping or between meals. There are two types of insulin doctors prescribe; immediate acting and long acting.

Humulin N or Novolin N AKA NPH are considered intermediate acting basal insulin.  This insulin is usually injected twice daily.  Lantus, Levemir and Toujeo are the brand names for long acting insulin. Long acting insulin come in generic form so do not panic if you don't see these brand names on your prescription. Long acting insulin is usually injected once a day. Talk to your doctor and pharmacist to find the right dose.

When you eat a meal with carbohydrates your body needs extra insulin to process the glucose(sugar) properly. By the way, you need carbohydrates to survive so totally avoiding carbohydrates is not advised. As always, people without diabetes produce enough insulin to digest glucose(sugar), people with type I diabetes have no insulin to metabolize sugar(glucose) and people with type II diabetes are somewhere in between.  Bolus insulin is required at meal times to keep people with type I diabetes under control. 

Short acting and rapid acting are two types of bolus insulin doctors prescribe. Humulin, Novolin and Regular Insulin are typically the names used to describe short acting insulin. Short acting insulin usually starts working about 15 to 30 minutes after you inject it. Novolog, Humalog and Apridra are the brand names for rapid acting insulin. Rapid acting insulin works quickly after you inject it. How quickly? Usually five minutes after you take it so make sure you ready to eat as soon as you take it. Again, talk to your doctor and/or pharmacist. 

Some of you are probably asking, "Why have the not invented insulin with basal and bolus insulin already available?" Well there is such an insulin. 70/30, 75/25 and 50/50 insulin are premixed basal and bolus insulin. Premixed insulin is usually injected twice daily before breakfast and dinner. Many doctors love to prescribed this insulin to people with type II diabetes with poor glucose(sugar) control to help them manage their diabetes. For some reason this mix does not work well with people with type I. Let me repeat again, "TALK TO YOUR DOCTOR AND/OR PHARMACIST!"

Now, the final question is how soon do I start insulin if I have diabetes?  If you are diagnosed with type I diabetes the answer is NOW. People with type I diabetes will not survive without BOTH basal and bolus insulin. If you have type II diabetes it may be a different story. Most people, except for maybe recreational drug users, are not happy about injecting themselves  with insulin. However, for the 5% of people with type I diabetes and individuals who are not meeting their targets with type II diabetes insulin is a life saver.

If you have any more questions about insulin please feel free to leave comments below. Understand you are probably not the only person with this question and your input could help others. 












How to Fight Stress

Relaxing activities such as prayer and meditation can calm the best of nerves. 

Relaxing activities such as prayer and meditation can calm the best of nerves. 

Stress and diabetes can be a a deadly combination.  Many people with diabetes are unaware stress can increase their blood glucose(sugar).  A group of hormones, appropriately called the stress hormones, have an inverse relationship with insulin. If you feel physically or mentally sick, these hormones will activate causing your blood glucose to rise.  Here are some tips to fight stress.

1. Get enough sleep.

Sleep deprivation places undue stress mentally and physically on your body.  There is no substitute to a good night's sleep. A cup of Joe or a Five Hour energy drink will only add fuel to the fire. 

2. Walk away your woes.

Routine exercise can burn away extra calories and extra stress. People who exercise routinely usually have high self-esteem. 

3. Find a support group.

Sometimes talking out your feelings helps relieve stress. If you feel uncomfortable confiding in others try prayer or meditation. 

4. Avoid your triggers if possible.

A resident at a nursing home I worked at blood sugar would rise each time her daughter came for a weekly visit. Luckily the daughter only visited the resident weekly. Some of us are not as lucky! Try taking a deep breath and count to ten before facing a potentially stressful situation and remember to walk away if the situation is unbearable. Your health is too important.

Do you have any other tips to fight stress? Please share in the comments below so together we can help others.






3 Tips to Fight Hunger

Trading your candy bowl to a fruit bowl can improve your health. 

Trading your candy bowl to a fruit bowl can improve your health. 

Many people with diabetes complain of hunger throughout the day. This is no coincidence. Frequent hunger is a classic sign and symptom of diabetes. For some reason, food tends to digest faster with individuals with diabetes (unless you have gastroparesis of course). 

Here are three tips to fight hunger.

1. Eat more fiber.

High fiber food such as fruits, vegetables and whole grain help food process digest slowly to decrease hunger. Switching your candy bowl for a fruit bowl, eating fresh salads along with adding vegetables, whole grains and beans to your dishes are simple actions to increase your fiber intake. 

2. Limit television watching.

Never underestimate the power of suggestive thinking. Television watching is associated with increased food intake.  Multiple studies associate obesity with television watching, especially with children. Avoid watching television at dinner time so you are mindful of what you are eating.

3. Drink more water. 

Most Americans do not drink enough water and sometimes thirst is confused with hunger. Also, if as your fiber intake increases so should your water intake  to prevent constipation. 

These three tips should help curb hunger. What other tips have worked for you to fight hunger? Please share in the comments section below so you can help others.