From Halloween to New Year’s: Tips for Celebrating With Diabetes

By Joan Bardsley, MBA, BSN, RN, CDE
For someone with type 2 diabetes, managing to enjoy all of the celebrations of the season can seem hard. The Halloween tradition of getting – and eating – candy is just around the corner, followed by the holiday food spiral of Thanksgiving, December holiday parties, the holidays themselves, and then New Year’s Eve. But our message is clear: Type 2 diabetes will not stop you from enjoying the holidays!

Below are some tips from the American Association of Diabetes Educators. But the first tip is this: See a diabetes educator. These are nurses, dietitians, pharmacists, and other healthcare professionals who have additional expertise as diabetes educators. They provide education so that people with diabetes can successfully self-manage their condition.

Diabetes self-management is built around seven core behaviors: Healthy eating, being active, monitoring blood glucose, taking medication, problem-solving, reducing risks, and coping in healthy ways.

Every year, as we begin the “eating season,” the needs of people with type 2 diabetes are increasingly understood and accepted. This is because diabetes is an epidemic (everyone knows someone), and healthy eating has become more common. More and more, people want to eat healthy as much as they can.

*Halloween: Don’t Be Tricked by Tempting Treats
Even adults will be tempted by Halloween candy. The best thing for anyone with type 2 diabetes is to make a plan. Candy can be tempting if it’s in the house, but try other options such as popcorn, sugar-free or low-carb candy, or something homemade, so that the ingredients are known. If you do have candy, choose the fun-size rather than the full-size to eat. Know how much candy you plan to eat right away or save for later and then have fun.

*Thanksgiving: Give Thanks to Sticking With Your Goals
Eat breakfast or snacks earlier in the day as you normally do. If you skip meals, it may be harder to control your blood sugar.

Manage the number of servings of starchy foods on your plate. Mashed potatoes, sweet potato casserole, and rolls could be hard to resist; however, try to choose just one of these items. Or, just take a few spoonfuls or bites of each.

After your meal, take a walk with family and friends. Exercise will get you moving, keep you focused on your goals, and give you a welcome break from being surrounded by treats. Exercise is also a great way to lower blood sugar levels.

*Holiday Parties: Healthy Celebrating Does Not Have to Be a Buzzkill
Holiday buffets are notorious for tempting people into overindulging on less healthy eats. But knowing how to navigate the buffet is key. Choose fruits and vegetables served raw, grilled, or steamed. Avoid vegetables in creams, gravies, and butter. Stick to calorie-free drinks such as water, tea, seltzer, or diet sodas instead of punch or mixed drinks.

The holidays can also mean travel, so remember to regularly check your blood sugar. Adding a few extra checks on a party day may help guide your choices.

*New Year’s Eve: Ring in a New Year Where You Are in Control
What’s a New Year’s toast without the clinking of champagne glasses? If you choose to drink alcohol, limit the amount and have it with food. Talk with your diabetes educator about whether alcohol is safe for you. Women should drink no more than one alcoholic beverage a day and men should drink no more than two.

Enjoy your favorite holiday treats, but take small portions, eat slowly, and savor the taste and texture.

The most important focus should be on enjoying the holidays. Remember to manage the stress that often comes with the holidays, and spend time with family and friends, or some time alone. 
You are in control!

Food for Thought: Food Gifts

Food Gifts are very popular this time of year . You may have a few people  left on your gift-giving list and have no idea of what to give  them , or you simply may enjoy  the holiday baking . Either way , you can turn  to your kitchen to get started . While  the gesture may be heart-felt , the  foods may not be heart healthy . Here are a few tips to make sure  your  gift is one received  with a healthy appreciation .

***Look at your recipes  . Can they be altered to make them healthier  treats ? Simple alterations  such as  no icing  or sprinkles  can save  lots of calories .
***Use smaller portions . Bake mini  cookies  or loaves . The result  is the same  wonderful treat , just in less-fat and less-calorie version .

***Include a copy of your recipe  with your treats . This helps  those watching  their weight  and those with food allergies .

***Add fresh seasonal fruit  to baskets  and arrangements  as colorful and healthful fillers .
                                       Nee's Cheese Log:

2  pounds  pasteurized process cheese, regular
1  pound pasteurized process cheese, Mexican or hot
12  ounces cream cheese, softened
3/4   cup green onion tops, chopped
2   tablespoons de-seeded jalapeno pepper, chopped
3/4  cup chopped pecans
3/4  cup red and green bell pepper, chopped
Blend together (with hands) both Velveeta cheeses and place on
 non-stick foil. Roll out thin into a large rectangle. Place in refrigerator to firm up while mixing remaining ingredients. For filling, mix together cream cheese, pecans, jalapeno pepper, green onions and bell pepper. Remove cheese rectangle from refrigerator and spread filling over it. Beginning at long side, roll up jellyroll fashion. Cut roll into two or three sections; wrap in plastic wrap and refrigerate. Serve with assorted crackers and Jezabel Sauce (recipe follows).
Yield: 60 servings
                                  Jezabel Sauce:

1    (16 ounces) jar pineapple preserves
1    (16  ounces) jar apple jelly
1-½   ounces can dry mustard
1    (5 ounces) jar horseradish
Salt and pepper, to taste

Combine all ingredients with mixer; refrigerate. Serve with pork, ham, beef, egg rolls. For the cocktail table, drizzle over cream cheese or cheese balls. For a great holiday food gift, place in ½-pint jars and add tie a festive ribbon and the recipe. This keeps in the refrigerator for weeks.

A proud grand-poppa             G.

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.

6 Diabetes Medication Mistakes to Avoid

By Beth W. Orenstein Reviewed by Pat F. Bass, III, MD, MPH

Treating type 2 diabetes can be tricky. Here are common mistakes that can prevent you from taking your medication as prescribed and tips for avoiding them.
Taking medication is part of your type 2 diabetes treatment plan, following your doctor's directions is essential.

“It's important you take your medications on schedule because they have a timed-release,” says Toby Smithson, MS, RDN, LDN, CDE, a spokeswoman for the Academy of Nutrition and Dietetics, the co-author of Diabetes Meal Planning and Nutrition for Dummies, and founder of DiabetesEveryDay.com. Your healthcare provider has calculated the dosage and scheduling to best manage your blood sugar levels and keep them within normal range.

There's no single, exact formula when it comes to treating diabetes. But following your individualized course of diabetes medication makes it more likely to work as desired, says Matthew Corcoran, MD, CDE, ASCM, an endocrinologist in Egg Harbor, New Jersey, and founder of the Diabetes Training Camp at Franklin & Marshall College near Lancaster, Pennsylvania.

Controlling type 2 diabetes through medication and lifestyle changes can help you avoid serious complications such as heart disease, blindness, and kidney and nerve damage, according to the Independent Diabetes Trust. Yet it can be easy to get off track with your diabetes treatment plan, especially if you're newly diagnosed and think of yourself as healthy, according to a study published in April 2015 in Diabetes Care.

Here are common mistakes that may prevent you from sticking to your prescription routine and how you can avoid making them.

Mistake #1: You don't realize the role of your medications. “It is important you understand how the medications you are taking work,” Dr. Corcoran says. You’re more likely to take them properly if you do — and if you don't, ask questions of your healthcare providers. “Don’t be shy about asking your doctor to explain how your medication works,”  he says.

Mistake #2: You forget or skip doses. Sometimes it happens, and you should know what to do if you miss a dose. Ask your doctor if you should take it as soon as you realize the mistake, or simply take the next dose on schedule. Don’t simply double up. To stay on track, set reminders, such as an alarm on your smartphone or computer. Try to connect each dose with another daily activity done at the same time. “For instance, if you are to take your medication before breakfast, keep the medication bottle by the area you eat or next to your toothbrush as part of your morning routine,” Smithson says. Once you develop a habit of taking your medications at certain times, she says, you'll be less likely to forget or delay.

Mistake #3: You stop taking your meds if you experience unpleasant side effects. Some diabetes drugs can cause nausea, vomiting, or diarrhea — any of which could tempt you to go off your care plan. Don't do that, Corcoran says. Instead, talk to your doctor about the side effects. There are many different diabetes medications available, and more on the horizon, according to the Joslin Diabetes Center, so you have options. An alternative drug or a different dosage of your current medication may help alleviate side effects, Smithson says.  

Mistake #4: You take the wrong dose or the wrong medication. If you’re on insulin for type 2 diabetes, you may be given long-acting and short-acting insulin to take at different times, and the doses for each are likely to be much different. For example, short-acting insulin is designed to quickly lower blood sugar and is tied to pre- or post-meal blood sugar. "If you are supposed to take 40 units of long-acting at bedtime, but take the short-acting insulin instead, your blood sugar could fall too low. Pay attention each and every time you take insulin and make sure you’re grabbing the right one,” Corcoran says. It may be helpful to color-code your vials or keep the long-acting and short-acting on different shelves of the refrigerator, he suggests.

Mistake #5: You confuse the medications for your various health conditions. You may be taking medications not only for diabetes but for other illnesses as well. Consider using a daily pill organizer with various compartments for each day — morning, afternoon, and evening. Sit down every Sunday night and carefully fill your pillbox. It’s also wise to use just one pharmacy so that the pharmacist can cross-check all your prescriptions for possible drug interactions. Also, be sure to tell your doctor about any other prescriptions or over-the-counter medications or supplements you’re taking, Corcoran says.

Mistake #6: You ignore signs that your medication isn't as effective as it used to be. Over time, your diabetes medications may need adjustment, according to the Joslin Diabetes Center. A drug might stop working. Losing or gaining weight, or exercising more or less, can affect your medications and dosing schedule. If you’re having symptoms of low or high blood sugar, or if your blood sugar numbers are going out of range, talk to your doctor. “You need to work continually with your doctor so that you don’t have unexpected low or high blood sugars,” Corcoran says.

Food for Thought : Leftovers

Thanksgiving Day has come and gone , but have you really let go ? During this time of year  we typical  have a refrigerator  full of leftover food  from parties  and meals . Many times  we safe foods  that are high in calories  and fat  and end up  consuming  more  of the foods  that are not in line with  our healthy plans . Also , safe handling  of leftovers  is very important  to reducing  foodborne illness . Here are a few tips to help  you safely  and healthfully  kept  left overs .
    Give  away the least healthy  food first , brownies , cakes pies , cookies , gravies  and the like can be  very tempting  when snacking or less than mindful eating . If  they are  gone they cannot tempt you .
     Store  leftovers in airtight  containers . If using the microwave  to reheat  , place a damp paper towel  over the food  to help retain moisture  and prevent messes . 
    All foods not eaten within 4 days  should be thrown out  . If you know you will not eat before  4 days  , throw out now or  freeze .
     When reheating leftovers  , be sure  they reach 165*F as measured with a food thermometer  . Reat sauces , soups  and gravies  by bring  them to a rolling  boil . Only reheat  the portion  you plan to eat in one  sitting . Cover the  leftovers to reheat .
                           Wasabi Crusted Salmon

Serves 4

Wasabi is the Japanese version of horseradish. It’s an Asian root vegetable that is sold in paste and powdered form. The powdered form is mixed with water to form a thick paste. The green wasabi served with sushi is usually white wasabi powder that is mixed with colorants and mustard. Fresh wasabi root can be found in some Asian stores.
My daughter  says  this  is a good dish  for  diabetis  and heart patients . My grands  says  it good for  everyone .  

3     teaspoons wasabi powder
4     tablespoons reduced-fat mayonnaise
Olive oil spray
2-1/2   pounds wild salmon fillet
Salt and freshly ground black pepper
1      cucumber, peeled and sliced
1/2   whole grain baguette, sliced

1.   Mix wasabi powder and mayonnaise together and set aside.
2.   Heat a nonstick skillet over medium-high heat and spray with olive oil spray. Add salmon and sauté three minutes. Turn and sauté another 3 minutes. Remove from heat; sprinkle with salt and pepper to taste.
3.    Spread salmon with wasabi mixture. Cover and let sit two minutes. Divide cucumber slices between two plates. Divide salmon in half and place each half over the cucumbers. Serve with the bread.

My posts  will return to normal after the first of the year , family is here  from all over  , I will continue to bring  you a  recipe  that is healthy for  you . 


A proud  Grand-poppa     G.

Will he make it this year ??

  

I love this cool visualisation of Santa Claus’ Christmas Eve trip around the world as seen from space. Can Santa deliver on his promises this year? The question is tricky, but he's pulled it off every year, so far, in spite of climate change.

8-Step Daily Diabetes Checklist

By Mikel Theobald Reviewed by Farrokh Sohrabi, MD
Juggling the daily tasks necessary to manage type 2 diabetes can be overwhelming. But this daily diabetes checklist can help simplify your routine.
Managing type 2 diabetes can seem like an endless to-do list of eating healthy, exercising, testing your blood sugar, and taking medications. But by taking some simple steps to control diabetes, you can help prevent or delay serious diabetes-related complications including nerve damage, vision loss, kidney disease, and stroke.

Streamlining your daily checklist will help you stick to it more easily. Here are the essentials:

1. Test your blood sugar and record it in a logbook :
Monitoring your blood sugar levels is an important part of managing diabetes. Daily monitoring provides ongoing feedback about your blood sugar levels and diabetes management . Use this information to guide your decisions about what to eat and when and how to exercise, and to provide insight into proper medication dosing if you’re on insulin /

Recording the information in a logbook is vital, according to the American Diabetes Association (ADA). Your logbook becomes a tool that can be used during visits with your doctor to see how well your diabetes management plan is working and to make changes if necessary.

2. Take your medication.
When diet and exercise alone are not able to keep diabetes under control, your doctor may prescribe medication to help with blood sugar management , “It’s important to understand how your diabetes medications work to control blood sugar levels, how to treat low blood sugar if that happens, and how and when to take your medication" Your doctor or a diabetes educator can provide medication scheduling recommendations best suited to you based on your health history.

3. Inspect your feet.
Diabetes can cause a variety of foot problems, such as calluses that can turn into ulcers, poor circulation that can affect your ability to fight infection, and nerve damage, which can cause diminished sensation. Check your feet daily to make sure that there are no wounds, blisters, or other issues. Ordinary problems can turn far more serious if left untreated. And if you have poor circulation or nerve damage, it’s possible to have an injury or infection on your foot without feeling it. Daily inspection allows you to spot problems early and get treatment.  

4. Brush and floss your teeth.
High blood sugar levels can impact oral health — uncontrolled blood sugar levels may lead to more plaque buildup and increase the risk for gingivitis and even advanced gum disease. The ADA recommends brushing your teeth for three minutes at least twice a day and flossing at least once a day.

5. Be physically active.
Exercise is great for overall health and helps lower blood sugar levels. “The general recommendation is for 30 minutes at least five times per week." In addition to lowering blood sugar levels, exercise helps improve blood flow, increase energy, reduce the impact of stress, and helps you sleep better, making it essential to put it on your schedule.

6. Eat healthy meals and snacks.
Your blood sugar levels can be directly impacted by what you eat and by the scheduling of meals and snacks. Planning your meals each day, rather than just winging it, can make a difference in your blood sugar readings.

There are several approaches to diabetes meal planning that you can use as a guide to help you eat healthy, including carb counting and using the glycemic index.  Alison Massey  recommends working with a registered dietitian to get on the right track with food choices and setting up a daily meal and snack schedule.

7. Protect your skin.
Diabetes can wreak havoc on your skin, causing bacterial or fungal infections. Check your body for skin concerns on a daily basis, especially in skin folds such as underarms, between toes, and the groin area. Help protect your skin by keeping it clean and dry. If you notice an injury, even a minor cut, clean it with soap and water. Talk to your doctor if you notice serious injuries to your skin or have a condition you can’t treat on your own.  

8. Get a good night’s sleep.
Poor sleep patterns can negatively impact glucose metabolism, according to a study published in April 2014 in the Annals of the New York Academy of Sciences. Practicing healthy sleep habits can help you get the sleep your body needs. The National Sleep Foundation recommends going to bed at the same time each evening and waking up at the same time every morning, even on the weekends. Also, engage in a nightly sleep ritual that prepares your body for sleep, such as reading a book or another calming activity that allows your body to wind down. Another way to sleep more soundly is to turn on a white noise machine and close room-darkening curtains. You want to make your bedroom environment as conducive to sleep as possible.