Type 2 diabetes: The sign in your shoulder that could signal the chronic condition

From express.co.uk

TYPE 2 diabetes is a common condition yet many people in the UK will not realise they have it because the symptoms do not necessarily make you feel unwell. Symptoms are caused by consistently high blood sugar levels, and, overtime, this can affect different parts of the body, including the shoulder.

Type 2 diabetes is the direct result of either not producing enough insulin or not producing any at all. Insulin, which is produced by the pancreas, plays an essential role in regulating the body’s blood sugar levels and unregulated blood sugar levels poses a number of health concerns. If left untreated, uncontrolled blood sugar levels hike the risk of developing potentially irreversible complications, such as heart disease.

It is therefore vital that you know and act on the warning signs associated with high blood sugar levels and seek the appropriate treatment to stave off the risks.

One warning sign is frozen shoulder, also known as adhesive capsulitis, which occurs when ligaments around the shoulder joint swell and become stiff.

As Diabetes.co.uk explains, the inflammation of this tissue can make normal healing hard and result in your shoulder being so stiff that everyday activities can be troublesome, such as buttoning your shirt.
“Patients with frozen shoulder can ease their symptoms, but this can sometimes take several years,” notes the health site.

           Type 2 diabetes symptoms: Frozen shoulder is a sign of consistently high blood sugar levels                                                                          (Image: Getty Images )

How is frozen shoulder connected to diabetes?

Research has shown that people with diabetes are up to twice as likely to suffer from frozen shoulder.
Dr. Richard Bernstein, a pioneer in the field of diabetes, reports this is due to effects on collagen in the shoulder, which holds the bones together in a joint.
Collagen can become sticky if sugar molecules become attached, resulting in movement being restricted and the shoulder beginning to stiffen. This process is known as glycosylation.

As Diabetes.co.uk explains, poorly controlled diabetes has long been linked to muscular and skeletal problems, with consistently high blood sugars likely to increase the risk of complications such as frozen shoulder.

How to treat it

In the short-term, treatment for frozen shoulder focuses on controlling the pain and helping restore some movement. This can vary across levels of severity, explains Diabetes.co.uk.
Shoulder exercises and stretching is commonly advised to keep the shoulder from further stiffening, and anti-inflammatory painkillers may be advised to ease the pain, as well as ordinary painkillers such as codeine, says the health body.

“A steroid injection to reduce inflammation can provide relief from symptoms, while surgery may be considered when all other treatments are not helping,” it adds.

Long-term treatment involves overhauling your lifestyle to bring your high blood sugar levels under control.

There are two key aspects of blood sugar management: diet and exercise.

There's nothing you cannot eat if you have type 2 diabetes, but you'll have to limit certain foods to keep rising blood sugar levels at bay.
Foods with a high carbohydrate content pose the greatest risk to blood sugar levels because carbohydrates are broken down into blood sugar relatively quickly, causing blood sugar levels to soar.
Restricting your carb intake is therefore a necessary precaution and this is easily achieved by following the Glycaemic Index (GI).
The Glycaemic Index (GI) is a relative ranking of carbohydrate in foods according to how they affect blood glucose levels.
Carbohydrates with a low GI value (55 or less) are more slowly digested, absorbed and metabolised and cause a lower and slower rise in blood glucose and therefore insulin levels.
A food's GI ranking is usually displayed on the front of food packets in supermarkets to help you navigate this area.

The other key component is keeping physically active and you should aim for 2.5 hours of activity a week, according to the NHS.
You can be active anywhere as long as what you're doing gets you out of breath.
This could be:

• Fast walking
• Climbing stairs
• Doing more strenuous housework or gardening

https://www.express.co.uk/life-style/health/1230686/type-2-diabetes-symptoms-signs-frozen-shoulder-diet-exercise-lower-blood-sugar

Report: To reverse diabetes, surgical weight loss tops diet, exercise

From mercurynews.com

“The best option for medically uncontrolled type 2 and (obesity) is the Roux-en-Y gastric bypass”

People who have weight-loss surgery are more likely to achieve remission of diabetes than those who try to shed excess pounds by dieting and exercising, a recent study suggests.

Researchers randomly assigned 61 participants with type 2 diabetes to one of three weight-loss interventions: an operation known as Roux-en-Y gastric bypass; a type of surgery known as laparoscopic adjustable gastric banding; or an intensive weight-loss program focused on cutting calories and increasing exercise.

After five years, six people who got the Roux-en-Y procedures, or 30%, achieved partial or complete diabetes remission, compared with four people, or 19%, of the participants who had gastric banding, the study found. None of the people in the diet-and-exercise group achieved remission.

“Any degree of weight loss, even that achieved by non-surgical means (typically about 5% of starting weight as shown in this study), can be helpful in controlling health issues such as diabetes, lipids, and hypertension,” said Dr. Anita Courcoulas of the University of Pittsburgh Medical Centre, the study’s lead author.

“Nevertheless, the head-to-head comparison of lifestyle treatment versus surgical procedures, as in this study, shows (the) superiority of the surgical treatments for diabetes-control endpoints and weight loss,” Courcoulas said by email.

Laparoscopic adjustable gastric banding, also known as lap-band surgery, is a less-invasive procedure that involves placing an adjustable inflatable belt around the upper portion of the stomach. The band can be made of silicone and tightened by adding saline, and the effects are reversible. It effectively reduces the amount of food the stomach can hold, and people are advised to eat portions about the size of a shot glass post-surgery.

Roux-en-Y gastric bypass is a more invasive procedure in which a surgeon staples off the upper portion of the stomach and reroutes food to bypass the rest of the stomach and the small intestine. The working part of the stomach is reduced to the size of an egg, and this cannot be reversed.
Everyone in the study had type 2 diabetes, which is associated with aging and excess weight. Patients were 47 years old, on average, obese and living with dangerously elevated blood sugar levels.

Five years after the procedures, people who had the Roux-en-Y bypass surgery lost an average of 25% of their body weight, compared with about 13% with the lap-band and 5% in the group assigned to intensive lifestyle management.
In addition, 56% of the people who had Roux-en-Y procedures had stopped taking medications to manage diabetes by the end of the study, compared with 45% of the people who had laparoscopic adjustable gastric banding and none of the participants in the lifestyle group.

One limitation of the study is that researchers only tested one approach to diet and exercise for weight loss, and other approaches might have achieved different results, the study team notes in the Journal of Clinical Endocrinology & Metabolism. The study was also small, and done at a single medical centre, so results might differ with more people or in other locations.

Still, the findings add to evidence suggesting that surgical weight loss may be the best approach to achieving diabetes remission, said Dr. Michel Gagner of Herbert Wertheim School of Medicine at Florida International University in Miami.


“It decreases the overall caloric intake more efficiently and sustainably than just diets,” Gagner, who wasn’t involved in the study, said by email.

Patients with poorly controlled diabetes should consider surgery when they’re obese and unable to lower their blood sugar enough with medications, said Dr. Ricardo Cohen, director of the Centre for the Treatment of Obesity and Diabetes at Hospital Oswaldo Cruz in Sao Paulo, Brazil.

“The best option for medically uncontrolled type 2 and (obesity) is the Roux-en-Y gastric bypass,” Cohen, who wasn’t involved in the study, said by email.

https://www.mercurynews.com/2020/01/16/report-to-reverse-diabetes-surgical-weight-loss-tops-diet-exercise/

Diabetic retinopathy: Understanding diabetes-related eye disease and vision loss

From health.harvard.edu/blog

By Leo Kim, MD, PhD

Over 30 million people in the United States live with diabetes, and approximately 7.7 million people have diabetic retinopathy, making it the most common cause of vision loss in working-aged adults. The prevalence of diabetic retinopathy has increased significantly over the past 20 years, due to the rise in the number of people diagnosed with diabetes.

How does diabetes affect the retina?

The retina is the light-sensing component located in the back of the eye. It is composed of blood vessels, nerve cells (neurons), and specialized cells called photoreceptors that are involved in directly sensing light. The ability of the retina to sense light requires energy, which is dependent on the oxygen supplied by blood circulating through blood vessels.

In diabetes, elevated blood sugar levels damage the blood vessels of the retina. These damaged blood vessels leak fluid, bleed, and do not provide adequate oxygen to the retina, leading to retinal ischemia. As a result, retinal cells begin to die and the retina is unable to function properly. In addition, diabetes also damages the neurons of the retina directly. Together, these effects cause diabetic retinopathy.

Vision loss associated with diabetic retinopathy may initially affect central vision due to a condition called diabetic macular edema. This swelling of the macula, a portion of the retina responsible for sharp, central vision, can lead to blurry vision and distortion of images.

Advanced diabetic retinopathy is characterized by the formation of irregular blood vessels that can bleed inside the eye, causing a rapid loss of vision. This results in a sudden, curtain-like vision loss as blood fills up the inside of the eye. Further worsening of advanced diabetic retinopathy can lead to retinal detachment, which requires urgent surgical intervention and can result in permanent, irreversible vision loss if not promptly treated.

What can I do to prevent diabetic retinopathy?

The American Diabetes Association recommends that most people with diabetes keep their A1c level (a measure of average blood sugar levels over the previous two to three months) below 7% to prevent the risk of complications. As blood glucose directly damages retinal blood vessels, there is strong epidemiological evidence that blood sugar control translates to decreased incidence and severity of diabetic retinopathy.

In order to reduce the cardiovascular and microvascular complications of diabetes, which include retinopathy, nephropathy (kidney disease), and neuropathy (nerve damage), it is recommended that people achieve and maintain a normal blood pressure. Blood pressure reduction can delay the onset of diabetic retinopathy, but it is unclear if controlling blood pressure can alter the course of established diabetic retinopathy. Similarly, managing cholesterol is advocated for overall diabetes management, but it is not clear whether doing so reduces the risk of diabetic retinopathy.

How can I find out if I have diabetic retinopathy?

An ophthalmologist can diagnose and begin to treat diabetic retinopathy before sight is affected. In general, people with type 1 diabetes should see an ophthalmologist once a year, beginning five years after the onset of their disease. People with type 2 diabetes should see an ophthalmologist for a retinal examination soon after their diagnosis, and then schedule annual exams after that. You may need to see an ophthalmologist more frequently if you are pregnant or have more advanced diabetic retinopathy.

What can I do to prevent or slow down vision loss if I have diabetic retinopathy?

As mentioned above, damage to the blood vessels deprives the retina of oxygen. Insufficient oxygen leads to production of a signal protein called vascular endothelial growth factor (VEGF). VEGF and its role in eye disease were first discovered at Harvard Medical School.

Currently, there are medications that can bind VEGF and subsequently improve the symptoms of diabetic retinopathy. These “anti-VEGF” agents are injected directly into the eye and can improve diabetic macular edema, and can even improve the severity of diabetic retinopathy. In some people, steroids injected directly into the eye may also improve diabetic macular edema. In some advanced cases of proliferative diabetic retinopathy (the most advanced form of diabetic retinopathy), patients may require retinal laser therapy or retinal surgery to stop or slow bleeding and leakage, to shrink damaged blood vessels, or to remove blood and scar tissue.

https://www.health.harvard.edu/blog/diabetic-retinopathy-understanding-diabetes-related-eye-disease-and-vision-loss-2020011618394

10 tips for healthy eating with diabetes

From diabetes.org.uk

There are different types of diabetes, and no two people with diabetes are the same. So there isn’t a one-size-fits-all way of eating for everyone with diabetes. But we’ve come up with tips that you can use to help you make healthier food choices. 

These healthy eating tips are general and can help you manage your blood glucose (sugar), blood pressure and cholesterol levels. They can also help you manage your weight and reduce the risk of diabetes complications, such as heart problems and strokes, and other health conditions including certain types of cancers.

We've based our tips on research involving people with Type 1 and Type 2 diabetes. If you have a different type of diabetes, like gestational, cystic fibrosis-related diabetes or MODY, some of these tips are relevant to you. It’s important, whatever kind of diabetes you have, to see your dietitian for specific advice.

What does eating right mean for you?

If you have Type 1 diabetes, carb counting is really important to keep your blood glucose levels steady. This is where you estimate how many carbs are in your meal and match it with how much insulin you need to take.

If you have Type 2 and you’re overweight, finding a way to lose weight is important as it really improves diabetes management. This is because it can help to lower your blood glucose and reduce your risk of other complications. There are different ways of doing this like the low-carb, Mediterranean or very low-calorie diets. Losing weight can help you lower your blood glucose levels, and we now know that substantial weight loss can even put some people's Type 2 diabetes into remission.

Whether you have Type 1 or Type 2 diabetes, you might need to lose, gain or maintain your current weight but it’s important to make healthier food choices while you’re doing this.

Portion sizes are important to think about whether you have Type 1 or Type 2. It makes calculating nutritional facts when you’re carb counting or managing your weight a lot easier. Remember, portion sizes are different for everyone, so what’s right for someone else might not be right for you.
If you feel overwhelmed about your feelings about food and diabetes, we have plenty of information to help you.

Our top 10 tips

1. Choose healthier carbohydrates

All carbs affect blood glucose levels so it’s important to know which foods contain carbohydrates. Choose the healthier foods that contain carbs and be aware of your portion sizes.
Here are some healthy sources of carbohydrate:

• whole grains like brown rice, buckwheat and whole oats
• fruit
• vegetables
• pulses such as chickpeas, beans and lentils
• dairy like unsweetened yoghurt and milk.

At the same time, it’s also important to cut down on foods low in fibre such as white bread, white rice and highly-processed cereals. You can check food labels when you’re looking for foods high in fibre if you’re unsure.

2. Eat less salt

Eating lots of salt can increase your risk of high blood pressure, which in turn increases risk of heart diseases and stroke. And when you have diabetes, you’re already more at risk of all of these conditions.

3. Eat less red and processed meat

If you’re cutting down on carbs, you might start to have bigger portions of meat to fill you up. But it’s not a good idea to do this with red and processed meat, like ham, bacon, sausages, beef and lamb. These all have links with heart problems and cancers.
Try swapping red and processed meat for these:

• pulses such as beans and lentils
• eggs
• fish
• poultry like chicken and turkey
• unsalted nuts

Beans, peas and lentils are also very high in fibre and don’t affect your blood glucose levels too much – making them a great swap for processed and red meat and keeping you feeling full. Most of us know that fish is good for us, but oily fish like salmon and mackerel are even better. These are rich in something called omega-3 oil, which helps protect your heart. Try and aim to eat two portions of oily fish a week.

4. Eat more fruit and veg

We know eating fruit and veg is good for you. It’s always a good thing aim to eat more at meal times and have them as snacks if you’re hungry. This can help you get the vitamins, minerals and fibre your body needs every day to help keep you healthy.

You might be wondering about fruit and if you should avoid it because it’s sugary? The answer is no. Whole fruit is good for everyone and if you have diabetes, it’s no different. Fruits do contain sugar, but it’s natural sugar. This is different to the added sugar (also known as free sugars) that are in things like chocolate, biscuits and cakes.

Products like fruit juices also count as added sugar, so go for whole fruit instead. This can be fresh, frozen, dried or tinned (in juice, not in syrup). And it’s best to eat it throughout the day instead of one bigger portion in one go.

Try to limit yourself to a maximum of 6g (one teaspoonful) of salt a day. Lots of pre-packaged foods already contain salt so remember to check food labels and choose those with less salt. Cooking from scratch will help you keep an eye on how much salt you’re eating. You can also get creative and swap out salt for different types of herbs and spices to add that extra flavour.

5. Choose healthier fats

We all need fat in our diet because it gives us energy. But different types of fat affect our health in different ways.
Healthier fats are in foods like unsalted nuts, seeds, avocados, oily fish, olive oil, rapeseed oil and sunflower oil. Some saturated fats can increase the amount of cholesterol in your blood, increasing your risk of heart problems. These are mainly found in animal products and prepared food like:

• red and processed meat
• ghee
• butter
• lard
• biscuits, cakes, pies and pastries.

It’s still a good idea to cut down on using oils in general, so try to grill, steam or bake foods instead.

6. Cut down on added sugar

We know cutting out sugar can be really hard at the beginning, so small practical swaps are a good starting point when you’re trying to cut down on excess sugar. Swapping sugary drinks, energy drinks and fruit juices with water, plain milk, or tea and coffee without sugar can be a good start.

You can always try low or zero-calorie sweeteners (also known as artificial sweeteners) to help you cut back. Cutting out these added sugars can help you control your blood glucose levels and help keep your weight down. If your diabetes treatment means you get hypos, and you use sugary drinks to treat them, this is still important for your diabetes management and you shouldn’t cut this out. However, if you are having regular hypos it is really important to discuss this with your diabetes team.

7. Be smart with snacks

If you want a snack, choose yoghurts, unsalted nuts, seeds, fruits and vegetables instead of crisps, chips, biscuits and chocolates. But watch your portions still – it’ll help you keep an eye on your weight.

8. Drink alcohol sensibly

Alcohol is high in calories, so if you do drink and you’re trying to lose weight, think about cutting back. Try to keep to a maximum of 14 units a week. But spread it out to avoid binge drinking, and go several days a week without alcohol.

If you take insulin or other diabetes medications, it’s also not a good idea to drink on an empty stomach. This is because alcohol can make hypos more likely to happen.

9. Don’t bother with so-called diabetic food

To say food is a "diabetic food" is now against the law. This is because there isn’t any evidence that these foods offer you a special benefit over eating healthy. They can also often contain just as much fat and calories as similar products, and can still affect your blood glucose level. These foods can also sometimes have a laxative effect.

10. Get your minerals and vitamins from foods

There’s no evidence that mineral and vitamin supplements help you manage your diabetes. So, unless you’ve been told to take something by your healthcare team, like folic acid for pregnancy, you don’t need to take supplements.
It’s better to get your essential nutrients by eating a mixture of different foods. This is because some supplements can affect your medications or make some diabetes complications worse, like kidney disease.

Don’t forget to keep moving

Being more physically active goes hand in hand with eating healthier. It can help you manage your diabetes and also reduce your risk of heart problems. This is because it increases the amount of glucose used by your muscles and helps the body use insulin more efficiently.

Try to aim for at least 150 minutes of moderate intensity activity a week. This is any activity that raises your heart rate, makes you breathe faster and feel warmer. You should still be able to talk and only be slightly out of breath. And you don’t have to do all 150 minutes in one go. Break it down into bite-size chunks of 10 minutes throughout the week or 30 minutes 5 times a week.

https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/10-ways-to-eat-well-with-diabetes?utm_source=bronto&utm_medium=email&utm_term=Check+out+our+guide&utm_content=Check+out+our+guide&utm_campaign=Enewsletter+January+2020

Wash diabetes guilt away with water, knowledge

From delgazette.com
By Bobbie Randall - Contributing columnist

When some people receive the diagnosis of diabetes, guilt feelings develop. This is a normal reaction. Few people develop diabetes without someone else in the family dealing with it also. It is a predominantly genetic disease. It does not skip generations.

Some of my clients will swear that no one in their family ever dealt with elevated sugar in the blood. Since heart disease is the number one cause of death for people with diabetes. I ask them if anyone ever died of an early heart attack in their family. They may have had diabetes without the diagnosis.

Years ago, this disease was not as easily detected as it is now. Portable home blood glucose monitoring kits were not available 40 years ago. The early process of checking blood glucose was not as accurate as it is today.

                                                                  Bobbie Randall

The initial guilt of developing diabetes can be defused with learning more about this chronic disease. Researchers continue to study and develop new strategies to deal with the production and use of insulin in the body. What may have been the gold standard of treatment and knowledge even five years ago may be updated. Do not let your guilt leave you in a diabetes desert of information.

Make small changes that will produce big results. Start with breakfast. Instead of just eating a bastardized edition of dessert as the first calories of the day, eat some protein foods with it. Learn to read labels. An average size person with a moderate activity level needs approximately 45 grams of total carbohydrates at meals. Consume 10 to 20 grams of protein at the start of the day. Keep added sugars to below 10 grams for breakfast.

Being aware of the foods that are chewed and swallowed is a key in controlling blood glucose levels. Make protein a part of breakfast. It will help to keep you full until lunchtime.

Eat more fruits and vegetables. Fruit has natural sugar and can be added to a meal plan. The vitamins, minerals, and fibre that fresh fruits and vegetables contain cannot be replicated in any pill or powdered drink. In fact, there are healthy properties of fruits and vegetables that haven’t been discovered yet that you can benefit from without even being aware.

Being mindful of what is consumed requires smaller portions and smaller bites. It may sound creepy but watch other people eat. Mindful eaters take smaller bites and eat slower. It takes twenty minutes for your belly to tell your brain that you are full.

Let water wash your guilt away. Drinking 8 ounces of water in the morning wakes up your internal organs and flushes the urinary tract of overnight toxins. Keep drinking water throughout the day until the urine turns light yellow. More trips to the restroom can be considered exercise.

https://www.delgazette.com/opinion/81310/wash-diabetes-guilt-away-with-water-knowledge

8 Great New Year’s Resolutions for People with Diabetes

From asweetlife.org

‘Tis the season for self-improvement! All around the world people will take the opportunity of the dawn of a new year to dwell on the last year’s failures, and promise to make things better. This process comes naturally to people with diabetes – after all, we get report cards in black and white at the doctor’s office. It’s more serious too. When your pancreas can’t get the job done by itself, it’s up to you to make sure you avoid the twin threats of hypoglycaemia and chronic hyperglycaemia.

It takes discipline and hard work to thrive with diabetes, but it’s possible and it’s definitely worth the effort. If you think you’re ready to take your blood sugar management to the next level, here are some ideas that could serve you well in the coming year:

Hit the Weight Room

How many how many times have you rocked the treadmill in January only to fall off the wagon long before the first signs of spring? Make this year different and commit to pumping iron two to three times a week. If you think that lifting weights is just for the bodybuilders among us, you’re out of the loop. Resistance training is now recommended to just about everyone, regardless of age or gender, and is even seen to be of particular benefit to those who need to lose weight. Some of the many benefits include boosted metabolism, improved bone health, and better endurance, and a good weights session can be accomplished with more speed (and less sweat) than miles on the elliptical machine.

And there are some special benefits for a person with diabetes. Resistance training improves insulin sensitivity, and as a bonus, many find that it’s easier to manage glucose levels during a strength-training session than it is during aerobic exercise.

No More Bedtime Snacks

The late-night snack has been a mainstay of the diabetes diet for decades, but now is probably a good time to consider whether you can do without. The research is in – food consumed late at night is particularly unhealthy– and the issue is even more important for people with diabetes, as it may cause your blood sugar to behave unpredictably while you’re asleep and cannot monitor it.

A late-night snack may have been important to avoid overnight lows back when most patients using insulin were on the older generation of long-acting insulins, which lasted less than 24 hours and had distinct peaks. But the modern 24-hour basal largely avoids this issue. If you still need a snack before bedtime to prevent your blood sugar from dropping overnight, you likely need to adjust your basal insulin dosage. “Feeding” your insulin is a good way to eat more than you need to.

Check Your Blood Sugar Twice as Often

Fingersticks: they sting, they’re annoying, and they can be expensive. But perhaps the single most important thing you can do to improve your glucose management is to check your blood sugar more often.
How often do you check now? Make a promise to yourself to double it. The less often you check your blood sugar, the less information you have about how diet and exercise affect you. A single fingerstick after a meal is a mere snapshot of what’s actually happening in your body, and can never give you the type of actionable data you need to optimize your blood sugar control.
Even better? Ask your healthcare provider about a Continuous Glucose Monitor.

Drink Water, not Sugar

This might be the single easiest way to instantly improve your health.
We should all know by now that soda is emptiest of all “empty calories,” basically a scourge on your metabolism, triggering the vicious cycle that causes you to overeat and drive up insulin resistance and then go back for more. Soda contains an unbelievable amount of sugar and essentially zero nutritional value.

But fruit juices, even 100% juice, are just about as bad. The same goes for energy drinks and sweetened coffee and tea drinks; it’s pretty much just liquefied sugar, with zero added nutrition. It’s bad for your teeth, bad for your waistline, and simply ruinous for your blood sugar management. Knock it off!

Banish all of these beverages and choose water instead.

A word of warning about diet sodas and other diet drinks: many studies have found that these alternatively sweetened beverages still drive sugar cravings and are otherwise correlated with bad health outcomes. They may have no calories and no immediate blood sugar impact, but they’re not a healthy choice.

Pre-Bolus, Every Time

It’s so easy to forget to pre-bolus for meals, but that little infusion of insulin 20 or 30 minutes before a meal can make a big difference in leveling out your blood sugar. High glycemic variability (wild blood sugar swings up and down) is associated with the development of complications above and beyond what is already predicted by A1C. Endocrinologists are increasingly looking at patients’ time-in-range and standard deviation, and the pre-bolus is one of the most powerful techniques for improving those markers.

Pre-bolusing can be tricky, especially when eating out, when you don’t know exactly when your meal will arrive, or how many carbs it will contain. But then again, cooking your own food and eating more consistently are probably good habits to get into too.

Get Serious about Site Rotation

Whether you use a pump, a pen or an old-school syringe, if you’re using insulin, you are constantly deciding where to stick yourself with the pointy objects that deliver your life-saving medicine. You’re probably been told that rotating those sites is important, but do you really understand why?
When you inject insulin into the same spots repeatedly, you develop lumps of unhealthy fat under the skin, causing the insulin to be absorbed unpredictably. This is called lipohypertrophy, and you may be surprised to learn that it can result in a host of major negative consequences: more frequent hypos, rollercoastering blood sugars, increased insulin needs, and rising A1C.

It’s astonishingly common. Even if you don’t have visible lumps on your body, you may have some measure of lipophypertrophy, and you may be suffering its insidious consequences without even knowing it. Time to take site rotation seriously.

Switch to Glucose Tabs for Hypos

We’ve all done it before: used a low blood sugar as an excuse to snack. Sometimes your brain is screaming “FOOD!” and it seems like there’s no way to hold back. Nothing tastes better than carbs when you really need them, but there’s no surer way to set off another blood sugar rollercoaster than by overindulging yourself and overcorrecting, sending your blood sugar skyrocketing up again.
So why not use glucose tabs? They are precise – no more ransacking the pantry at random. They are fast-acting – unlike chocolates or cookies or ice cream there’s no protein or fat or fiber to slow down absorption.
It’s true, most glucose tablets don’t taste all that great. But, hypoglycemia shouldn’t be an invitation to indulge! Treat it like the serious medical condition it is.

Update Your Glucagon Rescue Plan

Many of us have a glucagon kit lurking somewhere – at the bottom of a handbag or in the back of a closet. It may or may not be expired. Ideally, we never have to use these rescue devices, but because they can save your life, we have to take them seriously.

Who have you trusted with your glucagon rescue kit? Who knows where you keep it, who is trained on its use?

All of these questions are getting a lot easier to answer. Baqsimi, the first nasal glucagon spray, is now on the market, and it will soon be joined by other next-gen glucagon devices that also promise to make hypo rescue easier than ever. The days of nervously mixing and swirling during an acute emergency are over.

This year consider updating your prescription to one of these snazzy new glucagon rescue options, and when you do it, take the opportunity to reengage and retrain family members, friends, co-workers, caregivers and whoever else might be able to help. The new glucagon rescue products are easier to use than ever, which makes a good opportunity to bring even more people into your confidence.

Happy New Year!

https://asweetlife.org/8-great-new-years-resolutions-for-people-with-diabetes/?utm_source=ASweetLife.org+List&utm_campaign=fd9093bce5-ASweetLife+Weekly+Update++-+Nov.+14%2C+2017_COPY_01&utm_medium=email&utm_term=0_5125b14cf8-fd9093bce5-413392997

Woman 'gains control' of her Type 2 diabetes through weight loss

From cumnockchronicle.com/news

LESLEY Halbert is celebrating after losing over 3 and a half stone and gaining control of her diabetes.
Lesley’s inspirational story supports research revealing that losing weight with Slimming World is successful in supporting patients who have type 2 diabetes to lose weight and manage their glucose control.

Lesley who attends an Ayrshire Slimming World group, joined in February 2019 after feeling very uncomfortable in her clothes while on holiday.
She says: “Enough was enough, apart from the fact that I hated the pictures of myself from the holiday, the impact on my health was huge. I was diabetic, had high blood pressure and high cholesterol too.

“Being overweight impacted on so many aspects of my life, from struggling to find clothes that I like to fit to not being able to do simple everyday tasks without feeling tired and out of breath. I always felt like I was lacking energy, I felt like I was on a slippery slope to gaining more and more weight and I didn’t really see a way out.”

Lesley decided to join her local Slimming World group. She says: “Walking through those doors was one of the hardest things I’ve ever done, I was embarrassed about my size and scared that I might be the biggest person there. I needn’t have worried though, everyone there was so friendly especially my Consultant Sharon. The group were so welcoming too.

“Since then my fellow members have become real friends and I honestly don’t think I could have done it without their support each week. They helped me with recipes and tips and if I was ever struggling they were always there to remind me why I’d wanted to lose weight in the first place and how far I’d come since first stepping through the doors.”

Lesley followed the Slimming World’s Food Optimising eating plan and started cooking healthy meals from scratch. She swapped fatty meals for cajun chicken, pasta and many more tasty meals. She says: “People think slimming means going hungry, yet it’s not like that at all with this healthy eating plan. I love food and it’s never once felt like I was on ‘a diet’ – in fact, people are always surprised at how much food I have on my plate and can’t believe I’m losing weight eating so much delicious food and without ever feeling hungry. I can tailor the plan to fit my dietary needs and I can do this with support from my consultant, group and partner.

“This means I still enjoy all my favourite meals like burgers and chips and roast dinners and steak with peppercorn sauce I’ve just learned how to make small changes like eating lots of vegetables, using lean meat or cooking with low calorie spray instead of oil or butter.”

Today Lesley’s lost a total of 3st 7.5lb. She’s also more active nowadays and regularly walks over 10,000 steps a day – despite working in an office.

“Thanks to the changes I’ve made my health has improved dramatically and I have drastically reduced the diabetic medicine I take down to one tablet a day, I no longer take any medication for my high blood pressure and my cholesterol is completely normal now."

Sharon who runs the Ayrshire Slimming World group, says: “We know the obesity crisis is a ticking timebomb, and type 2 diabetes is linked to obesity too. We believe the support you get from being in a warm, empowering group environment is key to helping you eat more healthily and becoming more active too. The changes we’ve seen in Lesley are incredible. I hope her success will inspire other people in Ayrshire who’d like to lose weight and improve their health by forming new lifestyle habits and become happier to take action."

https://www.cumnockchronicle.com/news/18150019.woman-gains-control-diabetes-weight-loss/