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. 








5 Small Steps to Improve Your Blood Sugar.

Because Change Does Not Have to Suck.

Drinking fresh water saves calories and carbohydrates.

Drinking fresh water saves calories and carbohydrates.

Change. For many people this word conjures up fear and for others opportunity and excitement. I noticed through the years two types of the individuals when it comes to change.

The first type jumps in full frontal completely altering their life. They are going to lose 40 pounds in 40 days. They are going to move to a different city. They are going to join a high impact aerobic class after sitting on the couch for 10 years. 

What I notice is some of these individuals ACTUALLY commit to these changes  but most burn out and become frustrated. After all, most habits do not vanish overnight. It takes time. 

The second type becomes completely paralyzed and resists change at all cost. They know they need to lose those 40 pounds to improve their blood glucose but this means they will have to completely change their diet. Who wants to do that? They know they need to get in shape but the idea of waking up at 4:00am to exercise for two hours sounds exhausting. They know their blood sugar and their cholesterol is too high but there is NOTHING they can do about it. 

However, what if there is a middle ground to change? What if the act of committing small changes could add up to big results? Maybe these same people would be motivated to take their first step. 

Here are five small steps to improve your blood sugar:

1. Check your blood glucose (sugar) daily.

Monitoring blood sugar is associated with improved long term blood glucose control. Many insurance agencies provide 100 test strips every 90 days for individuals with type 2 diabetes  so smart monitoring is essential. If meeting your blood glucose targets is a challenge, check your blood sugar after your largest meal of the day and use the result as a barometer of the changes you will need to make. 

2. Move 30 minutes per day.

Daily exercise helps your body burn excess glucose and builds muscle tissue.  The big secret is you do not need to become a gym rat to lower your blood sugar. A 30 minute walk can improve your blood glucose for 24 hours. Dancing, biking and gardening are other methods to increase activity. If 30 minutes of movement sounds too challenging, break it down to 10 minute intervals. Michelle Obama, the former first lady said it best, "Just Move"!

3. Drink more water.

Replace those soda calories with good old fashion water. Water is calorie free, fat free and a necessary element for your body. Add lemon or buy sparkling water to mix things up. 

4. Eat a fresh salad each day.

Push start your vegetable intake buy eating a fresh basic salad. A basic salad includes raw leafy greens along with fresh fruit and vegetables. Many people forget tomatoes are a fruit. Try to limit heavy additions such as bacon  and request dressing on the side to reduce your fat intake.

5. Limit coffee to one cup per day preferably before noon. 

Proper sleep is essential to improving your blood glucose and overall health. Inhaling coffee all day causes sleep deprivation for most people. If you need coffee to keep your engines running try to limit intake to 8  to 12 ounces daily before noon.  

These changes can be the first step to managing your blood glucose and get you on the path to optimal health. Try these changes and tell me your results. Also, if you taken other small steps to improve your health please share them in the comments below to help others .









Pay Dirt!

How Supporting Your Local Farmers Feeds Your Body and Soul.

Farmer's Markets or Community Supported Agriculture is the next best thing to our home gardens.

Farmer's Markets or Community Supported Agriculture is the next best thing to our home gardens.

It finally happened this weekend...


After four years of drought, Northern California was blessed with rain.

LOTS of rain! 

Of course with excessive rain comes flooding.

When I read the forecast today I jumped for joy. Finally, I can ride my bike and not worry about running over puddles. One of my favorite activities is riding my bike around town. I take indoor cycling in the winter but nothing can compare to the fresh air and the scenery of a bike ride.

Also, bike riding enhances my creativity and today I was really suffering from writer's block. 

As I was in the bike store filling up air in my tires I was contemplating on this week's blog topic. "Maybe diabetes and exercise would be a great topic" or "How about diabetes and depression". I was perplexed until I arrived to my destination.

The Farmer's Market.

Thanks to my aversion to rain I have skipped my weekly Farmer's Market run in the past few months and apparently I was not alone. The market was almost empty. The farmers were practically giving away the food! Since the weather has improved people need to visit the Farmer's Market for the following reasons:

1. The food is more nutritious.

Yes, we love the grocery store. The supermarket is convenient and for some communities a luxury. Nonetheless, eating a nectarine in California in February is just not natural. Think of how many miles that nectarine traveled to arrive in the fruit bin. The  local food at the Farmer's Market was recently harvested, thereby, retaining most of its nutritional value. 

2. The food is usually more economical.

Food at the Farmer's Market is usually cheaper than food from the grocery store because the Farmer's Market items requires less packaging and processing. Nutritious but less attractive produce is usually available for less. Also, if you go the Farmer's Market about half an hour before closing time the vendors usually cut prices so they do not have to bring the food back home. 

3. Buying at the Farmer's Market creates a sense of community.

The vendors are really friendly and knowledgeable about the food they produce. Parents are often spotted educating their children about how food is grown. Meeting the farmers up close and personal reminds us how we are all interconnected. If you REALLY want to get more connected CSA(community supported agriculture) programs is an option. 

What other advantages would you like to share about the Farmer's Market? I look forward to your answers. 







Heart Disease and Diabetes; It's All About Circulation

Protecting your heart is essential in managing diabetes.

Protecting your heart is essential in managing diabetes.

February is American Heart Month making  it an appropriate time for us to discuss  heart disease and diabetes. People with diabetes have an increased risk of heart attack and stroke. For many individuals with diabetes high blood pressure and high cholesterol are involved with these increased risk. 


It is all about circulation.

Remember the saying "Your body is your temple." Think of your blood vessels and veins as the plumbing of your temple(home). If you dump honey in sink after some time the plumbing in your house(temple) is going to clog up. This is what happens to someone with poorly managed diabetes. High blood sugar(glucose) stays in the bloodstream "clogging up" or eventually damaging your blood vessels and nerves responsible for carrying blood to your heart. Blood from your heart also carries important nutrients to your brain, kidneys and other vital organs.  Poor circulation leads to stokes, heart attack, amputations and dialysis. 

Here are some steps you can take if you have or don't have diabetes to decrease your risk.

1. Stop smoking.

Smoking increases people with diabetes blood sugar up to 20%. Also, high blood sugar and smoking narrows blood vessels in legs increasing the risk of lower leg infections, ulcers and amputation.  Join a smoking cessation program if you having difficulty stopping on your own.

2. Follow a healthy eating plan.

Eating more vegetables and fruit is associated with managing heart disease. Also, limiting your intake of packaged foods helps to reduce salt and fat intake.  Cooking with more herbs can enhance the flavor of your favorite food thereby decreasing your need for salt. Sticking to whole food is usually the best way to go to improve your health and lose weight.

3. Increase your activity.

Thirty minutes of low impact exercise such as walking can improve your blood glucose(sugar) 24 hours later. If you do not like to walk gardening, dancing and cycling are just as effective as walking. Just move!

4. Try to maintain a healthy weight.

Losing 5% to 7% of weight will help improve blood sugar for overweight people with diabetes. Losing 10% of weight will help improve blood pressure for people with hypertension. You can work with a dietitian to find a sustainable plan to lose weight. 

5. Get plenty of sleep.

Failing to get adequate sleep increases your stress level. Increase stress level elevates your blood sugar and blood pressure. Also, when people are tired they tend to drink caffeine. Caffeine and heart disease is a bad combination for many people with hypertension. Try avoid caffeine intake in the afternoon and try relaxing activities such as reading a book before you sleep(not the computer!) to wind down.

I hope these tips provides you some insight on how to manage diabetes and hypertension. If you need any more information or would like to schedule an appointment fill out the information on the contact page.






Navigating Through Valentine Season

How to Stay in Control When Cupid Unleashes His Bow.

Remember a little chocolate is all you need. 

Remember a little chocolate is all you need. 

Valentine's Day can be tough for someone with diabetes. It seems like candy is everywhere this time of the year. Here are some simple tips to get through the season of love.

1. Remember the reason for the season.

Valentine's Day is about love. PERIOD. However, like most events in our society marketers are going to cash in. Remember when we were young and just a simple handmade card was enough. Now, as adults card companies, restaurants, flower businesses and hotels are in on the act. No need for us to be mad because their job is to sell and part of selling is to make us feel like we can't live without what they are offering.  Maybe we need to step and remind ourselves having someone who loves us is all we need.

2. Remember to count your carbohydrates.

I am not going to tell someone with diabetes to give up chocolate on Valentine's Day. First of all, for most people, especially women, this is not an option! On the other hand, watching your carbohydrate intake can prevent high blood sugar(glucose).  One chocolate dipped strawberry has between 18 to 22 grams of carbohydrates. This is barely over one carbohydrate exchange.  There are also sugar free chocolate options. However, remember, sugar free does not mean carbohydrate free. You need to find out how many carbohydrates are in a serving of candy you plan to eat and plan accordingly. 

3. Consider other options to celebrate the season.

If your love one needs advice on my what to give during the season flowers and cards are always an option. A romantic weekend is ideal and of course diamonds are always a girl's best friend! 

I hope this blog provided you some short and simple techniques to get through the season of Cupid. If you have any other ideas on how to manage your blood sugar during Valentine's Day please feel free to leave a comment below. If I don't hear from you in the next 48 hours, Happy Valentine's Day!