Sunday, February 19, 2017

Maxy sez : How Type 2 Diabetes Can Change Over Time

By Madeline R. Vann, MPH Reviewed by Farrokh Sohrabi, MD
Even when you work hard to control type 2 diabetes, the progression of the condition will likely require adjusting medications and lifestyle over time. Here’s what you may expect.

You probably already know that type 2 diabetes can cause long-term damage if you don’t control it, but it’s also important to understand that even well-controlled diabetes progresses over time — meaning you may have to adjust your treatment plan more than once.

The key to learning about the progression of diabetes is to understand the role of your pancreas, which produces insulin. For people with type 1 diabetes, the pancreas does not make any insulin, so they must take it through injections. With type 2, the pancreas doesn’t make enough insulin or the cells don’t respond to it adequately, according to the American Academy of Family Physicians. This means that the body has trouble moving sugar from the blood into cells to be used for energy. Diet, exercise, and medication, if prescribed, can all help those with type 2 diabetes lower their blood sugar levels and help their bodies use insulin made by the pancreas, according to the American Diabetes Association (ADA).

If blood sugar levels remain high, the ADA says, you may be at risk for such diabetes complications as vision loss, heart disease, nerve damage, foot or leg amputation, and kidney disease. However, proper diabetes management can help prevent or delay the onset of these complications.

How Your Diabetes Treatment Plan Might Change
Over time, your medications, diet, and exercise goals may need to be adjusted. “Initially the pancreas produces extra insulin to make up for insulin resistance, but in most people, the pancreas eventually is unable to make the extra insulin to keep blood sugar levels normal,” says Marc Jaffe, MD, a San Francisco endocrinologist in practice with Kaiser Permanente in Northern California.

After a type 2 diabetes diagnosis, your doctor will set blood sugar goals for you, recommend lifestyle changes, and perhaps prescribe oral medications such as metformin to help manage blood sugar levels, Dr. Jaffe says. “Because type 2 diabetes usually progresses over time, even people who don’t need medications at first are likely to need medications eventually,” he notes.

The next step in diabetes management, if these strategies aren’t working, is to change or add medication or add insulin, according to the 2014 Standards of Medical Care in Diabetes, published in the January 2014 issue of Diabetes Care. Your blood sugar goals might also be adjusted, based on your overall health and history with diabetes control, according to the guidelines. For some people who are obese, bariatric surgery might also be an option.

The guidelines also note that because many people with type 2 diabetes will eventually need insulin, insulin therapy should not be feared or viewed as meaning that you’ve failed at managing your diabetes.

“This is a progression of the disease and not to be thought of as something that you caused,” says Erin Palinski-Wade, RD, a certified diabetes educator in Franklin, New Jersey, and author of Belly Fat Diet for Dummies.

Tailoring Your Diabetes Treatment as You Age
Not only does diabetes itself progress, Palinski-Wade points out, but your body also changes over time. For example, you may experience complications from diabetes, like nerve pain, or develop osteoarthritis, which could make exercise more challenging, she notes. Those kinds of changes in your body would lead to adjustments in your diabetes management plan.

Because of the way diabetes progresses as people age, the ADA, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics came together in June 2015 to publish a joint statement recommending that doctors give people with diabetes a referral to see a registered dietitian or certified diabetes educator at least once a year to fine-tune their management plans, including diet and exercise. It’s also a good idea to see a diabetes educator any time you’re facing a new challenge that’s getting in the way of your self-management, such as when you’re diagnosed with another health condition or have physical limitations. Research published in 2014 in Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy also emphasizes that a personalized approach to diabetes nutrition with realistic goals that meet the individual’s lifestyle is an important part of diabetes treatment.

Coping With Type 2 Diabetes Progression
Even though type 2 diabetes is progressive and you will likely need to make adjustments to your management and treatment plans, you can take steps to cope with the changes:

Eat healthfully. Your diet should be individualized, but people with diabetes can also benefit from Palinski-Wade’s advice to “focus on filling your plate halfway with plant-based foods such as vegetables at all meals.” She also urges people to learn to read labels and understand portion sizes — skills that will serve you well throughout your life.
Aim for a healthy weight. Losing weight can improve your diabetes control; the ADA's 2014 guidelines for self-management suggest that many people with diabetes can benefit from losing at least a small amount of weight. Check with your doctor for a specific recommendation for you.
Check your blood sugar. “As diabetes progresses, people may need to start checking or increase the frequency of checking their blood sugar levels, especially when blood sugar levels are high or low, hard to control, or in people who take insulin,” says Jaffe. Talk with a certified diabetes educator about the testing strategies that would work best for you.
Be active. A mix of aerobic activity and resistance training helps to improve insulin sensitivity, which means your body uses insulin more efficiently, according to the ADA guidelines.

It can be challenging to live with a chronic condition, but taking care of yourself each day and checking in with your doctor and diabetes educator regularly can help you stay on top of your diabetes management.

Thursday, February 16, 2017

Food for Thought : 6 Secret Ways to Keep Produce from Going Bad

By Brianna Steinhilber
 1 . Keep Produce Out of the Garbage Bin
One of the most common excuses for not eating a healthy diet is the cost. And while stocking up on fresh produce and whole foods is an investment, it’s often the amount we waste that causes us to feel like we’re throwing away money. Luckily, there are some tried-and-true-tips to keep your healthy ingredients fresher, longer. Say goodbye to limp lettuce, moldy mushrooms, and sprouting potatoes: Here’s how to keep six common ingredients from going rotten – and to ensure you put every last penny’s worth of that grocery bill to good use!
                                           2 . Problem: Mushy Bananas
Solution: Wrap tops of bananas in plastic wrap.
A handful of fruits emit ethylene gas to ripen themselves — and bananas are one of them. If you know you won’t be able to eat the entire bunch within a few days, simply wrap the stems (where most of the gas is released) tightly in plastic wrap. This helps reduce the amount of ethylene emitted, slowing the ripening process and keeping the fruit fresh for a longer period of time. The gas also causes other fruits and veggies to ripen more quickly, so this trick will help prevent nearby produce from going bad as well. Like bananas, cantaloupe, nectarines, pears, plums, and tomatoes also emit ethylene gas and should be stored away from other produce.
3 . Problem: Rubbery Celery
Solution: Wrap in aluminum foil and store in the fridge.
Celery is one of those veggies that can quickly go from crisp and crunchy to rubbery and tasteless, but you can lengthen the life of this vegetable by taking a few extra minutes to store it properly. After separating, washing, and drying the stalks, wrap them tightly in aluminum foil. This keeps the air out and moisture in, but still allows the ethylene gas to escape (as opposed to plastic bags, which trap it in), slowing the ripening process and keeping the veggie fresh for up to a few weeks.
                                                       4 . Problem: Limp Lettuce
Solution: Line the bottom of your refrigerator’s crisper drawer with paper towels.
We all grab big heads of leafy lettuce with the intention of serving up light, healthy salads for summer dinners, but a few days go by and suddenly those crisp leaves become limp and soggy. To lengthen the shelf life of leafy greens as well as other produce in your fridge, line the crisper drawer with paper towels. Moisture in the fridge is what causes most fruits and veggies to lose their crisp texture and start to soften and go bad. By lining your fridge’s veggie drawer, you’ll absorb excess moisture and keep fresh produce crunchy for an extended period of time.
5 . Problem: Moldy Berries
Solution: Wash berries in a vinegar bath before refrigerating. 
As we enter the summer months, shelves packed with delicious, vibrantly colored berries line the produce aisle. With blueberries, strawberries, and raspberries now in season, the low prices make it tempting to pick up a large container — but if you don’t gobble them down quickly, berries can quickly soften and begin to mold. To extend their shelf life, rinse the berries in a vinegar bath (one part vinegar to three parts water), then rinse again with just water to remove any vinegar taste. Once dry, place the berries back in their container and store in the fridge. The vinegar kills bacteria on the berries, which helps prevent mold growth and keeps them fresher, longer.
                                                   6 . Problem: Sprouting Potatoes
Solution: Throw an apple in with your potatoes.
A big bag of russet potatoes can be a lifesaver on busy weekdays. The starchy vegetable can quickly be turned into a baked potato, French fries, or morning hash browns to feed a hungry family. The downside of keeping a large bag on hand is that potatoes stored for an extended period of time begin to sprout. Keep your spuds ready-to-eat by storing in a cool, dry place, as sunlight and moisture encourage sprouting. Another trick: Throw an apple in with the potatoes. While scientists have mixed opinions about whether this kitchen hack actually rings true, many experimenters claim that adding an apple to the bag does indeed delay the sprouting of potatoes, adding weeks to their shelf life. Give it a try yourself and you be the judge.
                                               7 . Problem: Slimy Mushrooms
Solution: Keep mushrooms in a paper bag, not plastic.

Mushrooms are a delicious, hearty ingredient to use in everything from a chopped salad to a morning omelet to a stir-fry, but nothing is more unappetizing than reaching in for the vegetable and pulling out a slimy, mushy mess. To keep mushrooms meaty and fresh for as long as possible, it’s all about how you store them in your kitchen. When we get veggies home, it’s a habit to reach for plastic bags, but for mushrooms, paper should be your go-to. Plastic traps in moisture that causes mushrooms to mildew; opting for paper allows the vegetable to breathe and for moisture to escape, slowing the rate at which they begin to decay .

A proud grand-poppa        G.    

Tuesday, February 14, 2017

Related image
Image result for beautiful friend greetings for valentines day

Thank you so much my wonderful cubs
Your card made me so happy
Thank you for  thinking of me as family
Close friends are very hard to find
 And impossible to let go
Much love to you all
Jonny ,  Sha  , Jenny , Man, Chris , Sheryl & Bubba  
Image result for beautiful friend greetings for valentines day
Aunt Jeannie

Aunt Jeannie --- Happy Valentines Day

 Family isn't always blood . It's the people in your life who  want you  in their's; the ones who  accept you for what you are .  The ones who would do anything  to see you  smile  & who  love you no matter what .

Have a great day from the Cubs  with love .

Jonny ,  Sha  , Jenny , Man Carano

Chris , Sheryl , Bubba Landrieau 

Sunday, February 12, 2017

Beef With Red Wine Sauce ------slow cooker

 This is an easy way to make a simple one-dish dinner that is sure to wow your guests. This beef recipe, flavored with gravy and mushrooms, is a hearty, filling dish. Pair it with a salad or bread, for sopping up the sauce, and you're ready to eat. That is just how it should be, and your slow-cooker beef will be just as delicious if you follow this simple recipe. The red wine sauce will make it even more rich and delicious, and you will savor every incredible bite.
 Makes 6 servings

3       pounds boneless beef chuck roast, cut into 1-inch pieces
1      medium onion, sliced
1      pound fresh mushrooms, halved
1     (1.61-ounce) package brown gravy mix
1     (10-1/2-ounce) can beef broth
1     cup red wine
2     tablespoons tomato paste
1    bay leaf
Hot cooked egg noodles or rice
Garnish: chopped fresh parsley

1 .  Place first 3 ingredients in a 6-quart slow cooker.

2 .  Whisk together gravy mix and next 3 ingredients; pour evenly over beef and vegetables. Add bay leaf.

3 .  Cover and cook on HIGH 6 hours. Remove and discard bay leaf. Serve over noodles. Garnish, if desired.
Heart healthy

Maxy sez : 4 Top Diabetes Diet Myths Exposed

By Erin Palinski-Wade, RD, CDE
If you’ve recently been diagnosed with type 2 diabetes, or even if you’ve had diabetes for a long time, you may be confused about how to eat to manage your blood glucose levels. It seems that everyone has an opinion, and many of these opinions contradict each other.

So what are you to believe? And what truly works at helping you keep your glucose levels in a healthy range?

Let’s take a look at some of the biggest diabetes diet myths, why they don’t work, and what actually will.

Myth No. 1: If You Have Diabetes, You Must Avoid All Sugar

The Truth: A lot of sugar isn’t good for anyone’s diet, regardless of whether you have diabetes or not. But just because you have diabetes doesn’t mean that sugar and sweets are entirely off limits. All carbohydrates, including simple sugars as well as complex carbohydrates, are broken down into glucose during digestion. This glucose is then used as energy in your cells. Because all forms of carbohydrates break down into glucose and therefore raise your blood glucose levels, you need to monitor your total carbohydrate intake — especially what you eat within one sitting — for optimal glucose management.

Although you must be careful not to overeat carbohydrates at one sitting, you can still indulge in a few sweet treats on occasion. Complex carbohydrates such as whole grains, fruits and vegetables, and low-fat milk are the best choices for everyone due to their rich nutrient and fiber content. But as long as you keep portions under control, you can still enjoy foods containing simple sugars (such as cookies) in moderation without spiking your glucose levels. Keep in mind, though, that when it comes to simple sugars, moderation is key for everyone — not just people with diabetes.

Myth No. 2: All White Foods Are Bad for People With Type 2 Diabetes

The Truth: When you think of white foods, what comes to mind? White flour, white sugar, and white bread? What about white potatoes, cauliflower, and onions? Are all of these white foods bad for glucose levels? Definitely not! Sure, some white foods are highly processed, such as enriched flour and sugar. But just because a food is white in appearance doesn’t mean it will be rapidly converted into glucose in the body and spike your levels. In fact, white vegetables such as cauliflower and onions are excellent for blood sugar control because they’re very high in fiber, and low in both calories and carbohydrates.

White potatoes get a bad rap as well. It’s true that sweet potatoes are digested more slowly and prompt a smaller elevation in glucose levels after eating than their paler counterparts, but that doesn’t mean you need to avoid white potatoes altogether if you have diabetes. In moderation and as part of a balanced meal — with vegetables, lean proteins, and healthy fats — you can enjoy white potatoes as your starch and still maintain healthy glucose levels.

Myth No. 3: The Only Way to Lower Glucose Levels and Body Weight Is to Follow a Low- or No-Carb Diet

The Truth: If you are newly diagnosed with diabetes, you may feel as if everyone around you is telling you to steer clear of all sources of carbohydrates. Since carbohydrates are found in everything from fruit to bread to milk and even vegetables, you may feel as though there’s nothing left to eat. But the good news is that you can actually still eat carbs. Managing diabetes is about keeping your glucose levels in a healthy range. Glucose levels that are too high can damage your body, but very low levels can be dangerous as well. Eating carbohydrates as part of a well-balanced diet will help you keep your levels within a healthy range.

Instead of avoiding carbohydrates, focus instead on choosing the healthiest types.  Space your carbohydrate intake out throughout the day by balancing your plate with carbs, lean protein, and healthy fat at each meal. A balanced diet will not only help you achieve optimal glucose levels — it will also improve your overall health.

Myth No. 4: Sugar-Free Foods Won’t Impact Blood Sugar Levels

The Truth: Sugar-free doesn’t necessarily equal carbohydrate-free. Many foods marketed as sugar-free have replaced sugar with sugar alcohols, which provide fewer calories and make less of an impact on glucose levels than regular sugar — but can still elevate glucose levels if you consume them in large amounts. In addition, bread-based sugar-free foods, such as sugar-free desserts, are typically rich in carbohydrates from sources such as flour and grains. It’s essential to read labels carefully on sugar-free foods: In particular, look at the total grams of carbohydrates, not just grams of sugar. If you focus only on the marketing claims such as “sugar-free,” you may struggle to lower your glucose levels without knowing why.

As you can see, there are many diet myths surrounding diabetes. But managing your glucose levels doesn’t have to be complicated. A balanced diet rich in whole foods and limited in processed foods and simple sugars — the same diet that we should all follow, regardless of whether or not we have diabetes — can help you keep your glucose levels in a healthy range.

Erin Palinski-Wade, RD, CDE, is a nationally recognized nutrition and fitness expert who has contributed to national media outlets such as  The Doctors, and the Chicago Tribune. She serves as a media spokesperson, nutrition consultant, and speaker. Erin is the author of multiple publications, including Belly Fat Diet For Dummies and the 2-Day Diabetes Diet, and coauthor of the Flat Belly Cookbook For Dummies. She specializes in the areas of diabetes, adult and child weight management, sports nutrition, and cardiovascular disease. 

Thursday, February 9, 2017

Chicken with Field Pea Succotash -----slow ccoker

You’ll love the simplicity of this Creole Chicken with Field Pea Succotash that you will become full-bodied and deliciously flavored after simmering throughout the day in your slow cooker. This recipe is made even easier by using a few packages of frozen vegetables to help it all come together—frozen field peas, a frozen gumbo mix, and frozen corn can all be tossed right in. Spice it up with a few teaspoons of Creole seasoning that bring just the right amount of heat. Complete the meal by trying this easy side: Drizzle sliced fresh tomatoes with oil-and-vinegar dressing; season with salt and pepper to taste.
 Makes 6 servings             Total time: 5 Hours, 30 Minutes

1       (16-ounce) package frozen field peas with snaps, thawed
1      (10-ounce) package frozen vegetable gumbo mix, thawed
1      (16-ounce) package baby gold and white whole kernel corn, thawed
2      teaspoons chicken bouillon granules
4      teaspoons Creole seasoning, divided
1-1/2       teaspoons paprika
6       skinned, bone-in chicken thighs (about 2-1/2 pounds)

1. Stir together first 4 ingredients and 2 tsp. Creole seasoning in a lightly greased 6-qt. oval-shaped slow cooker.

2. Combine paprika and remaining 2 tsp. Creole seasoning; rub over chicken. Arrange chicken on top of vegetable mixture. Cover and cook on LOW 5 to 6 hours or until chicken is done.
Heart healthy