Using the Basics to Manage Blood Sugars
By: Jessica Hrdlicka MS, RD, LD/N, CDCES
Many times we focus on diet and medications to control blood sugar levels or we want to blame diet and medications when we can’t reach our blood sugar goals, but have you considered using the basics?
Many people do not understand that simple changes can yield huge results when trying to manage blood sugars! Here a few things to start implementing now for a better A1c at your next doctor’s visit.
Step 1: Hydrate! Staying hydrated can not only improve blood sugars, but can improve energy, kidney function, support a healthy liver and promote weight loss. When you are dehydrated, blood sugars will increase and it makes it more difficult for your body’s insulin levels to perform its basic duties of lowering blood sugar levels. Coffee, tea, sparkling water and diet drinks count as fluid intake, but you need at least half your body weigh in ounces of water each day.
Step 2: Move your Body! Moving even for 10-15min per day can greatly improve insulin sensitivity and circulation. Movement also promotes weight loss, lower cholesterol, lower blood pressure and stress relief. Try walking, stationary biking, swimming or chair exercises. Any way you choose to move is better than sitting all day!
Step 3: Rest & Relax. Stress, anxiety and lack of sleep can all make managing blood sugars more tricky. These states can increase stress hormones and increase glucose secretion via your liver, which leads to fatigue, increased hunger along with increased blood sugars. Make time for sleeping, yoga, deep breathing, meditation or other activities that help you de-stress such as reading, walking or spending time with friends. Your body will thank you for it!
For more information on diabetes management, weight loss and nutrition call 561-659-6336 ext 8012 to schedule an appointment with a certified diabetes care education specialists or registered dietitian today. Please enjoy our May 2022 Living Well with Diabetes Newsletter!
Understanding Abdominal Fat
By: Gary Pepper, M.D., F.A.C.P
It’s tempting to think that all fat is built the same, but this is not true.
There are actually three types of fat; white, brown, and beige fat, and they are distributed in different parts of the body in different proportions, as either visceral fat (inside the body and organs) or subcutaneous fat (under the skin).
White fat is the fat most people are familiar with - over 73.2% of all Americans carry too much and are classed as either overweight or obese (CDC, 2017 to 2018). While some white fat is absolutely essential for a healthy metabolism, every body has its limits.
Brown fat is found mainly in babies and plays a key role in providing energy and keeping us warm. Adults retain a small percentage of brown fat around their necks and shoulders.
Beige, or brite fat, is similar to brown fat and is optimized for burning fat rather than storing it, unlike white fat.
As we can see, white fat is the ‘bad stuff,’ and is the type of fat that many of us worry about.
Visceral and Subcutaneous Fat
Fat is distributed as either visceral or subcutaneous fat, and there is a big difference between the two.
Subcutaneous Fat
Subcutaneous fat is stored under the skin in the limbs and extremities; arms, belly, thighs, and buttocks. When you pinch your arm or leg, you’re likely feeling a layer of subcutaneous fat distributed under the skin. Made up of mostly white fat, some subcutaneous fat is essential for hormonal function, as well as keeping warm.
While people with different body compositions will likely carry different percentages of subcutaneous fat, everyone has their limits. Subcutaneous fat is not totally harmless, but it poses fewer risks than visceral fat.
Visceral Fat
Visceral fat is stored primarily around and inside the abdomen. Yes - fat is more than skin deep and is stored inside of us as well as under our skin.
Whilst excess subcutaneous fat is still unhealthy, many recent and reputable studies such as this large-scale meta-analysis of 2.5 million participants suggest that visceral fat poses a much greater health risk than subcutaneous fat.
The increased health risk of visceral fat is linked to its proximity to the vital organs.
The closer fat is to the stomach and abdomen, the greater the chance is that it penetrates under the skin, wrapping itself around the liver, heart, kidneys, pancreas, and other organs. A study conducted by the University of Chicago and published in 2016 also found that visceral fat behaves differently from subcutaneous fat and resists fat burning (lipolysis). This also explains why abdominal fat is seen as ‘stubborn fat’ that is hard to lose.
Around 59% of all US adults were abdominally obese in 2015 to 2016, representing a massive increase from around 47% in 1999 to 2000 (CDC, 2016).
Visceral fat poses a much greater risk than subcutaneous fat in developing in the following conditions:
- Heart disease
- Type 2 diabetes
- Insulin resistance
- High blood pressure
- High cholesterol
- Certain types of cancer, such as stomach cancer, bowel cancer, pancreatic cancer and liver cancer
How to Measure Visceral Fat
Traditionally, BMI (body mass index) has been the go-to yardstick for measuring body fat. Today, many health authorities encourage the use of both BMI and abdominal fat measurements. It's possible to have a healthy BMI and high waist measurement, and vice-versa. (explain here a bit more)
This is Harvard Health’s technique for measuring visceral, or abdominal fat:
- Take your shoes off and stand with your feet together.
- With a bare stomach, relax and exhale all air from your diaphragm.
- Use a fabric tape measure to measure your waist circumference at the naval.
- Record the measurement.
- Be aware that this measurement is likely not the same as what many consider to be their ‘waist’ measure (i.e. the measurement they use to fit trousers).
Men | Women | |
Low Risk | 37 inches and below | 31.5 inches and below |
Medium Risk | 37.1 to 39.9 inches | 31.6 to 34.9 inches |
High Risk | 40 inches and above | 35 inches and above |
Does Abdominal or Visceral Fat Increase With Age?
The short answer is yes, it does. The plight of the so-called beer belly or middle-age spread is real!
This study published in the International Journal of Body Composition Research found that visceral fat increased by over 200% in men and 400% in women between the age of 30 and 70.
Why?
As we age, our metabolism changes and slows down, but the ‘middle-age spread’ is also linked to changes in behavior and diet.
We’ve covered these changes in detail in the article What is Metabolism and How Does it Change With Age?
To briefly summarize, aging reduces our percentage of lean muscle mass, which lowers our metabolic rate. Additionally, whilst it’s perhaps natural to indulge a little more as we get older, it's easy to eat more and exercise less. That gives your body every excuse to pile on that abdominal fat!
Abdominal Fat and Menopause
Studies have shown that estrogen plays a major role in body fat distribution, hence why women experience a much greater change in visceral fat with age due to menopause (400% vs 200% in men between the ages of 30 and 70).
“If women gain weight after menopause, it’s more likely to be in their bellies,” - Michael Jensen, M.D., professor of medicine at Mayo Clinic.
Multiple studies, including this one published in the Journal of Menopausal Medicine, have also found that estrogen replacement therapy (ERT) can mitigate some of this weight gain. However, estrogen replacement is not without its risks and is unsuitable for many.
Namely, ERT can increase the risk of blood clots leading to strokes and embolisms and cause headaches, swelling, or edema. ERT is also often linked to an increased risk of breast and ovarian cancer, but studies reviewed by Breastcancer.org have shown that the risk is only significant after using ERT 10 years or more (in the case of estrogen-only therapy). Combination HRT poses a much greater risk.
As such, ERT is certainly not a ‘silver bullet’ for treating menopause-related abdominal weight gain.
Omnipod 5: Automated Insulin Delivery System
By: Ines Cobo RN, CDCES
On January 28, 2022, Insulet announced the FDA clearance of the Omnipod 5 Automated Insulin Delivery System for people with type 1 diabetes aged 6 years and older, Omnipod is tubeless and is now an automated insulin delivery (AID) system with compatible smartphone control and Dexcom G6 Continuous Glucose Monitor (CGM) System integration to help protect against highs and lows.
Just like Omnipod DASH, it includes a waterproof tubeless insulin Pod(25 feet, 60 minutes) that can be worn almost anywhere you would inject insulin. Each Pod delivers up to 3 days (72 hours) of continuous insulin, but now it’s automated.
Omnipod 5 comes with:
SmartAdjust technology:
Every 5 minutes, the system automatically increases, decreases, or pauses insulin delivery based on your customized target—helping to protect against highs and lows¥, day and night.
Activity feature:
When using the Activity feature, Omnipod 5 reduces insulin delivery when glucose typically goes low, like when exercising or increasing physical activity.
SmartBolus feature:
Omnipod 5 includes a built-in bolus calculator that automatically incorporates your CGM data and trend, so you don’t have to.
Announcing Brand New Insulin Pump & CGM Class Sessions!
Advanced Pump Class
West Palm Beach Location
Temple Israel 1901 N. Flagler Drive
West Palm Beach, FL 33401
Tuesday May 10th 10am-12pm
CGM Data Interpretation Class
West Palm Beach Location
Temple Israel 1901 N. Flagler Drive
West Palm Beach, FL 33401
Tuesday June 21st 10am-12pm
& Weight Loss Class Sessions!
Join our classes to stay motivated,
& stay healthy!
West Palm Beach Location
Temple Israel 1901 N. Flagler Drive
West Palm Beach, FL 33401
Tuesday June 14th 10am-12pm
Jupiter Location:
550 Heritage Drive, suite 150 Jupiter FL, 22458
Wednesday May 11th 5:30pm-7:30pm
Boynton Beach Location:
6056 Boynton Beach, Suite 245
Boynton Beach FL 33437
Thursday May 19th 10am-12pm
If interested attending this program please contact our scheduling department at (561) 659-6336 Extension 8001 today!
At Healthy Living with Diabetes we want to ensure that you are satisfied with all services received. We also would like your input on educational workshops that you would like us to offer, information you would like to read about in Healthy Living with Diabetes Monthly or feedback on any workshop that you may have attended. You can contact the director of education personally by email jcook@PBDES.COM or leave a message at (561) 659-6336 ext. 8012. We would love to hear from you!
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