MARCH NEWSLETTER

NATIONAL NUTRITION MONTH!

By: Jessica Cook MS, RD/N, LD/N CDE (Director of Education)

March is National Nutrition Month and registered dietitians here at Palm Beach Diabetes and Endocrine Specialists would like to know a few rules our dietitians recommend for meal planning and grocery shopping when it comes to diabetes:

1. Always include lean protein with your meals such as baked or grilled skinless chicken, fish, eggs, low-fat cheese, low-fat cottage cheese, lean pork or non-fat Greek yogurt.
2. Make sure you are choosing reduced fat items for heart health! Choose reduced fat or 2% cheeses, fat free or light yogurt, 1% or 2% cottage cheese, reduced fat mayo, salad lite dressing and light margarine.
3. Avoid any item containing partially hydrogenated oils such as regular peanut butter, baked goods, crackers and margarines. Partially hydrogenated oils convert into trans-fat, so always read the ingredient list.
4. Read the total carbohydrate content of your foods NOT sugar amounts. Sugars are included in the total carbohydrate value on the food label and carbohydrates turn into sugar in your body, so beware of products that claim to be “’sugar free” but contain many carbohydrates.
5. Always include non-starchy vegetables with meals including spinach, cabbage, salads, tomatoes, carrots, zucchini etc. Non-starchy vegetables will not contribute to blood sugar spikes, contain plenty of fiber, reduce cholesterol and aid in weight loss!

Please enjoy this Month’s Living well with Diabetes Newsletter and spring into a new healthy attitude!

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PREVENTING DIABETES

By: Kort Knudson, M.D., F.A.C.E.

About 30% of the adult population is considered at higher than average risk to develop diabetes sometime in his or her lifetime. People with pre-diabetes are more likely to develop heart disease or stroke. Risks for people with pre-diabetes includes obesity, family history, history of gestation diabetes, delivering a baby heavier than 9 pounds or being physically inactive, less than 3 times per week. The rate of pre-diabetes are about the same for people of Mexican, African American or Caucasian decent.

The blood sugar can tell if someone is pre-diabetic. Fasting blood sugar greater than 100mg/dL or HbA1c value greater than 5.7% is an indication of higher than average risk of developing diabetes. People who are pre-diabetic have an average of 50% chance of developing diabetes sometime during their lifetime.

Within this group there is great variation in risk. For example, someone with fasting glucose greater than 100mg/dL, but less than 110mg/dL will have only 15% chance of developing diabetes, but the risk increases to 50% if both parents have diabetes. Obesity increases the risk by a factor of 6.

Here are some recommendations to prevent pre-diabetes:

1. The pre-diabetic state can be reversed or diabetes can sometimes be prevented by lifestyle changes or medications. Exercise, both aerobic and resistance training for 30 minutes 5 days per week in combination with a low calorie diet can also reduce the chance of developing diabetes by 60%! Weight loss of 5-7% of current body weight is recommended.
2. Your diet should put you in a negative calorie balance. Restricting both fats and carbohydrates can reduce insulin resistance. Drinks such as juice, milk, soda and other sweetened beverages should be restricted. Stone fruits such as peaches, plums and apricots may help lower insulin resistance.
3. You should get plenty of sleep. Sleeping less than 6 hours per night or sleep apnea can increase insulin resistance and lead to higher sugar levels in the blood.
4. Most people benefit from referral to a nutritionist. Almost all people who see a nutritionist learn new ways to improve their overall diet and become educated to prevent pre-diabetes through food intake.
5. Changing lifestyle and diet is sometimes not enough. Medications may help. Metformin has been shown to reduce insulin resistance and reduce the progression to diabetes by 30%. Troglitazone reduce development of diabetes in people with gestational diabetes, but the medication is no longer available. Pioglitazone is in the same class however and also may help. There are some new and safe diet pills on the market which may help reduce weight and could prevent onset of diabetes in some people who cannot lose weight without appetite reduction.

We should keep in mind that the diagnosis of pre-diabetes is not absolute. The risk can be modified by changing diet and lifestyle. Most of us would be healthier if we followed a good diet and exercised even if we are not pre-diabetic. We should probably worry less about the consequences of our habits and focus more on the benefits of improving them!

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Turning the Lion into the Lamb

By: Gail Starr LCSW, CDE

There is an old proverb that “March comes in like a lion and goes out like a lamb.” It certainly did that in the Northeast this year. Interestingly, the arrival of the diagnosis of diabetes can be equated to the month of March. It can come at you like a lion, roaring its way into your life, trying to turn your world upside down. No one asks for the Lion of March, no one can control its coming; no one wants its wrath or the devastation it can create. No one asks to have diabetes. It falls on one’s head and can create the feeling of being out of control.

I have met with hundreds of people who have diabetes and have never met anyone who said, “I am so happy to have it.” But I have heard people say, “Ok, I have diabetes. What can I do about it?” And that is the crux of the situation. Those are the people who usually have better blood sugars, who have better quality of lives. Accepting that March is going to be lionesque makes living through the month easier. Accepting the diagnosis of diabetes is the first step in being back in control. From that acceptance can come the attitude of wanting to learn what to do…. and then to do it.

Your Education team wants to help you to get back into control, to be able to control that lion of diabetes so that the least amount of damage to your life and to your body occurs. How does that happen? That happens through taking education classes, both individual classes and group workshops, that are given all over Palm Beach County, and which provide the tools and the knowledge with which you can tame the lion. The Education Team of Palm Beach Diabetes and Endocrine Specialists provide the resources you can count on for support and continued information. We are there for you when you decide that you want to be in control.

It is never too late to begin changing behaviors, to take that lion and turn it into more like a lamb. We also provide refresher classes for people who have had diabetes for a while and want to learn new things as well as to reinforce previous education.

All you need to do is to choose health and then call us. We are waiting to assist you in your quest for a healthier life!

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Are You Interested in Learning How to Create Healthy Meals?

Join us for the Healthy Meal Planning with Diabetes Refresher course Monday April 20th from 10am – 12pm in West Palm Beach. Our expert staff will teach you ways to complete healthy grocery shopping, meal planning, meal preparation and we even provide healthy snacks to try in class! Each participant also receives a healthy recipe book created specifically for diabetes by our diabetes educators and registered dietitians. This class is also covered by most insurance plans including Medicare. If you are interested please call (561) 513-5100 Ext 8001 to book your appointment 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 our 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) 513-5100. We would love to hear from you!