My mentor would always say, "you can tell a great deal about someone's health by looking at their feet." It didn't take me long in the field of diabetes to understand what she meant by that. I have seen patients with amputated toes, foot injuries, fungal infections, bunions, ulcers, hammer toes, and corns. I have also seen people with beautiful feet-healthy, soft and peachy colored feet. The difference between the two? Chronically high blood sugars, elevated blood pressure, smoking and obesity can negatively impact your feet. If you are someone with diabetes, you are more susceptible to peripheral neuropathy and other foot related deformities. It's important to have a comprehensive foot exam annually, check your feet daily and practice good hygiene. Not all people with diabetes are destined to have foot related issues, but those you ignore their foot may.
Knowing what to look for and how to protect your feet can protect your limbs. If you have diabetes foot related issues, you may be eligible for diabetes shoes. Medicare covers one pair yearly. Get educated on your foot health today so that you can save your limbs.
Lunch can be a tough meal, especially if your work days are hectic. Packing a lunch is a good idea, because bringing your own food saves on calories, fat, sodium, carbohydrates and money. Leftovers are one of the best lunch options - convenient, tasty and efficient. I like to pack my lunch while serving dinner. I set aside a portion for the next day and don't have to think about it in the morning when I am pressed for time. Make it a goal to bring lunch at least three days a week.
March 25th was Diabetes Alert Day. The American Diabetes Association estimates that nearly 7 million people have diabetes and don't know it. Early detection of diabetes is important for preventing complications. Last week, I was working with a gentlemen referred to me for weight loss. He has a family history of diabetes and heart disease, and takes medicine for blood pressure and cholesterol. Because his doctor never tested him for diabetes, we arranged for him to have blood work this week. In the event that he has diabetes, we can start to treat it. Or, if his blood work indicates that he has prediabetes, we can make efforts to prevent it. Perhaps this test will motivate him to make some lifestyle changes that will improve his health. I really hope I can help him to reach his health goals. He just needs to find his motivation: awareness may be the driving force. I encourage all my patients 45 and older with diabetes risk factors to get tested for diabetes.
This week one of my patients was feeling a bit lethargic, but thought that she was just tired because she didn't sleep well the night before. The first thought that came to my mind was that her blood sugar was low. I asked her to take out her meter and test her blood sugar. Sure enough, it was low - 60. She was shocked. I gave her a 4oz juice box and we re-tested 15 minutes later. Her blood sugar had risen to a safe level - 85. After some talking, we pinpointed the reason her sugar dropped - she took her diabetes medicine without eating. The medication she takes sends a signal to her pancreas to make insulin, therefore I explained to her that she cannot take her diabetes medication without food. And if she is not going to eat, she shouldn't take it. Being that she doesn't seem to recognize or feel her low blood sugars, we also discussed the possibility of getting her a continuous glucose monitor (CGM). A CGM could alert her when her blood sugar is dropping. In the event that she is out and her blood sugar drops, she would avoid a dangerous situation by being notified as to where her blood sugar was trending. We are going to talk to her doctor this week about getting a prescription for a CGM. I am really happy about this because she is an older woman who lives alone. Our goal is to prevent low blood sugars and a CGM can help to do that.
Healthy eating and diabetes isn't always easy. Aside from having the food police knocking on your door, you are bombarded with perhaps too many resources. I know that may sound odd, but sometimes too many options is not a good thing. With thousands of resources, it can be a tough job to weed out the credible ones from the gimmicks. The reality is that healthy eating and blood sugar control is specific to each individual. Everyone responds differently to certain foods. While one person may have a blood sugar spike when eating melon, another person does just fine. Experimenting with food combinations is important. Having the right tools to do so is even more important. I decided that I would narrow them down for you - the best cook books, on-line guides and diabetes meal planning resources. I hope you can find something that works for you.
St. Patrick's Day might over, but I know that some of my patients celebrate all week. In fact, just yesterday a gentlemen arrived at his session wearing his shamrock scarf - still in the St. Patrick's Day spirit. He told me that he was about to sit down to this third St. Patrick's Day feast. While this may not be ideal for weight and blood sugar control, he looks forward to this all year long and makes it work without negatively impacting his blood sugars. He did some experimenting with his food choices - kept a blood sugar and a food log. He discovered that his blood sugars are best when he loads up on vegetables, reduces his portion of Irish soda bread to one piece, and limits his potatoes to one serving (about 1/4 of his plate). He uses his glucometer as a tool to help him regulate his portions and food intake. During our session we also discussed green food alternatives that he could bring to change it up a bit and boost his nutrition. This way he would still be in the spirit of St. Patrick's day. I would imagine that by the end of the week he would be tuckered out from eating the same foods over and over - he agreed. While he loves a good Irish meal, he also enjoyed hearing about alternatives. Sometimes it's nice to change this up a bit.
Fruit is refreshing, healthy and delicious. But, like anything you can't eat unlimited fruit, especially if you are someone with Type 2 diabetes and are following a consistent carbohydrate diet. You don't need to avoid fruit completely either. It always frustrates me when patients are told by loved ones that they can't eat fruit because it's too sweet. Fruit although it contains fruit sugar, fructose, also contains fiber, vitamins and minerals, and is rich in water. If fruit is a love of yours', you can find out ways to incorporate it into your meal plan without wrecking havoc on your blood sugars. Ask your Registered Dietitian or Certified Diabetes Educator to help you.
A patient of mine thanked me graciously after learning that he could actually test his blood sugar without fear or pain. He had been avoiding testing his blood sugars because he was afraid it would hurt. In the past he was using the pads of his fingers. I explained - lancing the tips or pads of fingers can be painful because there are more nerve endings there. Instead, it's best to test the sides of the finger - between the bottom of the nail bed to the tip of the nail. He tried it in the office and was shocked that he barely felt a thing. Now he is monitoring regularly, losing weight and getting his sugars in range. It was a win for both of us.
If you are someone with diabetes and are not monitoring your sugars because it's too painful - rest assure knowing that there are ways to avoid pain. It's never too late to learn.
Invest in your health - that is my motto for all my patients. This especially hit home today when a young woman walked into my office with a broken spirit. After the birth of her last child and years of fad dieting she is heavier than ever before. With a strong family history of diabetes and heart disease, sustainable weight loss is critical for preventing or delaying diabetes.
We talked for a long time about her motivation and her diet shortcomings. I discovered that what prevented her from achieving her goals was her lack of confidence in herself and her inability to make herself a priority. In the past she relied on pills or quick fixes for weight loss and then threw in the towel when her weight plateaued. She came to me because she needed hope - reason to try again.
I told her to think of her body as an elite care, let's say - a Mercedes. If you spent a great deal of money on a car, wouldn't you want to give it the best fuel possible so that it could last long and run well? Now, I know our body is far from a car, but the analogy makes sense. We only get one body - and it's important to give it the best fuel we can so that we can try our best to prevent disease, increase our energy, and longevity. We all work hard to get the things in life that we want. I have never met one person who doesn't want to be healthy - they just don't know how or where to start. It's never to late to change behaviors, get motivated and adapt a healthy lifestyle.
My patient today left with her head held high - confident that she would start small and continue to work on dietary and exercise changes. She needs a cheerleader - someone to motivate her. I can be that for her when she comes to visit me.
So to all my readers out there - think of this as reassurance - you can change your life. You can start tomorrow. Start small. Get motivated - get a cheerleader.
Yesterday, I asked one of my patients to test her blood sugar during our session. She doesn't test her blood sugar regularly and was eating a diet rich in carbohydrates. To her dismay the glucometer read: 350mg/dL. She had been walking around with high blood sugars for so long that she didn't even realize her sugars were elevated. We came up with a plan together: she would test her blood sugars regularly - morning and two hours after a meal for one week. If her blood sugars were above target range she would cut back on her carbohydrates and schedule an appointment with her physician to assess her medications. One of the best ways to pattern manage and prevent hyperglycemia is to test your blood sugar.