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Barbie Cervoni, RD, CDE

Type 2 Diabetes Blog

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Can't Stop Eating Late at Night

Saturday May 31, 2014

Eating late at night isn't the best habit. Especially if you are snacking on high calorie, high carbohydrate foods. It's is also a really hard habit to break. But, with time and perseverance you figure out a way to change your behavior and create a new, healthy one - where there is a will there is a way. You can do it!

Can I Be a Vegetarian and Have Type 2 Diabetes?

Wednesday May 28, 2014

Many of my patients fear that they cannot follow a vegetarian diet if they have Type 2 diabetes because the diet is carbohydrate dense. The opposite is true, in fact, many people with Type 2 diabetes are very successful in following a vegetarian diet. Vegetarian diets include higher intakes of vegetables, whole-grain foods, starchy vegetables like corn and sweet potatoes, legumes, and nuts. These types of foods are rich in fiber, healthy fat and good carbohydrates. They are low in saturated and trans fat, sodium, and sugar. The key to eating a vegetarian diet when having diabetes is to make sure you eat adequate amounts of protein, and keep your carbohydrate intake consistent and portion controlled. I advise that if you are deciding to follow a vegetarian diet - you consult with a dietitian to assure you are getting all the vitamins, minerals and protein that you need.

 

Diabetes Can Affect Kids Too - Are Your Children at Risk?

Thursday May 22, 2014

I began my career as a dietitian and diabetes educator working with children with both Type 1 and Type 2 diabetes. I have not worked with this population for about two years, but recently I ran into one of my old colleagues and we started chatting about the pediatric world. She told me that although the obesity epidemic has appeared to level off, the incidence of Type 2 diabetes in children is increasing. And the children appear to be heavier at younger ages.

I left the conversation feeling a bit sad - how could this be? As an educator for adults with Type 2 diabetes, I now know how hard it is for adults to manage their diabetes - to put that stress on a child is just too much. I decided that it would be valuable to get some more information and share it with all of you. It's so very important to know if your child is at risk for Type 2 diabetes because the ultimate treatment is prevention.

Enjoy Your Memorial Day with Good Food and Drink

Thursday May 22, 2014

It's almost Memorial Day - time to get prepared for good food, family, friends, and fun. While there may be lots of temptation coming your way - snack foods, sweet treats and festive cocktails, I encourage you not to worry. You have the tools to make good decisions and you are in control when it comes to your diabetes. People may want to remind you of things you cannot eat - corn, watermelon, and other fruit. Politely tell them that they are incorrect. You can incorporate these foods into your diet with some planning. Typically, there is something to eat for everyone at a barbecue. And if you're hosting it's even better - you get to plan the menu. Have fun with it!

Great Resources for all the Mommy's-to-Be with Gestational Diabetes

Monday May 12, 2014

In honor of Mother's Day, I thought it would be appropriate to help all the mommy's-to-be with gestational diabetes find reliable, credible information on how to plan and cook simple meals, carbohydrate count, and dine out healthfully. If you have gestational diabetes, additional tools can help add variety to your diet. Once you've found things that work for you you you can share your info with someone else. I have learned from other educators and patients that having a good cook book, a reliable carbohydrate counting app and snack ideas, makes meal planning so much easier. As a mother myself I know how tough it can be to plan meals for the family. Add diabetes to the mix and things get more complicated. I hope that these resources can help you find peace during meal time. Happy Eating!

Metformin - Take it Right and Prevent Side Effects

Monday May 12, 2014

Last week, one of my patients abruptly stopped taking his Metformin without alerting his physician or anyone else. He was having diarrhea and stomach cramps and thought it would be best to just stop his medicine. Diabetes is tough enough as it is - the last thing you need is to have unbearable side effects of a medication. But you shouldn't stop taking a medicine without telling anyone. Metformin should be taken with food - it helps to ease stomach discomfort and food helps with its absorption. My patient was taking Metformin on an empty stomach. We talked about how and when to take it during our session - he opted to give it another try. When he returned for a follow-up appointment, two weeks later, he was pleasantly surprised to find that he no longer had symptoms and his blood sugars were at goal.

The moral of the story here is - if you are a person with diabetes and are starting a new medicine or have been taking medicines for a while that are resulting in side effects - reach out to your health care team to get educated on proper timing/usage of your medicines. You have enough to do when it comes to diabetes, that you deserve to be educated.

The Other Diabetes

Tuesday April 29, 2014

We know a tremendous amount information about Type 1 and Type 2 diabetes and our efforts to manage the disease seem to continue to develop and expand. But, there is another type of diabetes that we still don't know enough about. Latent Autoimmune Diabetes in Adults, aka, LADA is topic I certainly don't fully understand. LADA is an autoimmune disease characterized by age, positive antibodies, a gradual increase in insulin requirements and decreasing ability to make insulin as indicated by a low C-peptide.  People with LADA eventually need to use insulin as a form of managing there blood sugars.

I have only come across a handful of patients with LADA. My first patient was a 30-year-old woman with a history of hypothyroidism and a family history of both Type 1 and Type 2 diabetes. She presented with elevated triglycerides and an A1c in the 'prediabetes' range. She managed to control her blood sugars with diet and exercise for about six months, yet slowly her blood sugars began to creep up and she was diagnosed with Type 2 diabetes. After being treated with metformin for about six months her blood sugars were still not at goal and her A1c continued to rise. Her endocrinologist tested her c-peptide levels and islet cell antibodies to find that her c-peptide was low and her antibodies were positive. She was diagnosed with LADA and placed on an insulin pump.

During this time, this young woman was discouraged and frustrated - she continued to feel like it was her fault. Perhaps if we tested her antibodies and c-peptide earlier we could intervened more appropriately by beginning insulin sooner and treating the autoimmune disease. The problem is that there is no clear, universal method as to how to treat LADA. Persons with LADA are often misdiagnosed with Type 2 DM. It is very frustrating and I continue to learn about this disease.

Do you have LADA? What was it like for you going through the process of discovery?

Easter Candy Binging?

Thursday April 24, 2014

Now that Easter is over, the question is: What have you done with all the candy? The parents of the children I used to work with with Type 1 diabetes would get creative - kids would trade in candy for games, movies and excursions. As adults with Type 2 diabetes - the solution is up to you. It can be nearly impossible to regulate blood sugars when you are constantly snacking on candy. But, you can get creative too - learn how!

Tired of Insulin Injections

Thursday April 24, 2014

A colleague of mine recently started two patients on the V-Go - an insulin patch pump. The V-go is a disposable insulin delivery system that acts similarly to a pump without extensive programming. My colleagues intentions were to potentially help these patients with Type 2 diabetes whose blood sugars were constantly elevated get their blood sugars in control. These patients previously prescribed a diabetes regiment that required them to take multiple daily insulin injections.The problem was that they were not taking their medicine as prescribed - often they would miss injections because they would forget or felt it was inconvenient to carry around their pen devices.

The V-Go sounded like a good solution for them. They could get insulin without having to give multiple daily injections. I am wondering if this new device will take off. Have you ever heard of the V-Go? What are your thoughts?

 

4 Surprising Foods You Should Avoid with Type 2 Diabetes

Thursday April 24, 2014

I don't enjoy telling people what not to eat. It makes me feel judgmental, but the reality is that it's part of my job. And sometimes people appreciate it - especially when we discover something that they had no idea was bad for them. In fact, just yesterday,I counseled a patient with multiple heath issues, including Type 2 diabetes, who takes pride in bringing me his food and blood sugar log at each visit, but this week he was perplexed. He couldn't figure out why his pre-dinner blood sugars were so high. He said: "I don't understand I am eating whole wheat pretzels for a snack." The light bulb turned on in my head. I hated to tell him that his favorite snack was wrecking havoc on his sugars, but I had no choice. I explained to him that pretzels, even whole wheat, are rich in carbohydrates and sodium and lacking in fiber and protein. They are also a high glycemic index food which can elevate blood sugar. He was shocked, but happy that we found the culprit. He wondered if there were any other foods he was eating that perhaps weren't the best for him.

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