Friday, 5 May 2017

Recipe: Leek and potato salad

From diabetes.org.uk

Serves 6
  • Prep 10 minutes + 15 minutes to cool
  • Cook 15-20 minutes

  • Ingredients
    • 600g baby new potatoes
    • 1 large leek, cleaned and finely sliced
    • 200g 0% fat Greek yogurt
    • 10g chives (and a sprinkle to garnish)
    • 25g parsley (and a sprinkle to garnish)
    • 1 heaped tsp Dijon mustard
    • good pinch white pepper
    Method
    1. Boil the potatoes whole for 15-20 minutes until just cooked. Refresh in cool water and set aside.
    2. Meanwhile, place the leeks into a bowl with the yogurt, chives and parsley, mustard and pepper. Mix together well to ensure all the leeks are coated. Set aside in the fridge.
    3. When the potatoes are cool, cut in half and toss in the yogurt dressing and sprinkle with more herbs.
    Chef's tips
      • Spice it up with a teaspoon of curry paste and a tablespoon of sultanas.
      • Try using coriander, instead of parsley, or add fresh mint leaves and a handful of peas.





      Diabetes nurse organisation releases insulin safety leaflet

      From diabetestimes.co.uk

      A leading diabetes specialist nurse organisation has published an insulin safety leaflet. 
      TREND-UK has released a patient booklet entitled Keeping Safe with Insulin Therapy because “insulin management and prescribing errors are very common and can lead to patient harm”.
      The booklet provides information on dosage, technique and devices. There are over 30 different insulin available in the UK so those who use it are being warned to always check they have the right one for them.
      Insulin requirements differ from person to person, so the booklets recommends people always carry their insulin passport or insulin safe card with them at all times.
      Detailed advice on how to inject to avoid lipohypertrophy or ‘lipos’ has also been issued. People who need insulin are being reminded to inject at a 90 degree angle in either the upper outer thighs, upper outer buttocks and abdomen.
      A spokesperson for TREND-UK said: “Insulin treatment improves the quality of life in many people and saves the lives of others. It is used to lower blood glucose levels. However, insulin management and prescribing errors are very common and can lead to patient harm.
      “This booklet can help patients to get the most out of their insulin treatment and keep them safe.”
      TREND-UK provides lots of helpful resources for patients and nurses. To gain access users must create an account and log in.

      Thursday, 4 May 2017

      11 Everyday Habits That Are Absolutely Ruining Your Diabetes Control

      From rd.com

      Living with diabetes is a daily challenge, but tweaking these behaviours improves control over your blood sugar. Say goodbye to the behaviours derailing your quality of life, and wave hello to these tips to take charge of your diabetes.

      Portion sizes
      Surprise: We eat more than we should—even when we're focusing on healthy foods. (Yeah, you already knew that one.) For people controlling diabetes, portion sizes of carbohydrate foods determine how much medication they need or how their blood glucose responds. Try this rule of thumb for the carb portion of your plate—it should take up about a quarter of the typical, nine-inch dinner plate. Optimal servings of peas, potatoes, or whole wheat pasta is one cup per meal. Compare that to a usual Mexican restaurant plate, where high-carb foods cover the entire plate: rice, beans, tortillas, chips. Too much carbohydrate sabotages glucose control for diabetics.

      Beverages
      Why drink your calories? Drinks high in sugar and calories add up quicker than anything else. That giant fountain soda easily boasts over 500 calories, all from sugar, skyrocketing your glucose out of control. Sports drinks, fruit juices, smoothies, energy-boost drinks, sweet teas, and fancy coffee drinks contain significant amounts of simple carbohydrate (re: sugar). Even the healthy seeming stuff: Consider that 12 ounces of orange juice has 45 grams of carbohydrate—about the same as 12-ounce can of soda. Sure, the juice includes healthy vitamins, but the glucose load is the same as a cola. For those controlling diabetes, skip these sugary beverages and opt for water to rehydrate. Your blood glucose will thank you!

      Skipping meals
      Timing your meals throughout the day is key for controlling diabetes. Skipping a meal puts you at risk for hypoglycemia because your medications won't have carbohydrates to work with. Worse, we commonly overeat at the next meal when we miss one. Eating breakfast within 90 minutes of waking is ideal. Optimally, three meals per day, spaced 4-5 hours apart, will keep your blood glucose steady and constant. If your sleep pattern includes more than 10 hours of shut-eye, eat a snack with 15 to 30 grams of carbohydrate before retiring.

      Highly processed carbs
      While all carbohydrates affect blood glucose, some carbs (the complex kind) are the best choices. Why? Complex carbs such as whole grains, vegetables, and beans contain fibre—long molecular chains of carbohydrate that take longer to digest (or, in some cases are indigestible). Slowing down digestion will help prevent sharp spikes in blood glucose—something all of us should try to avoid, but especially people with diabetes. Simple carbs like those in refined flours and sugars are small, easily digested molecules. As the preferred quick energy for cells, these can cause rapid peaks and valleys in your blood sugar. For that reason, choose whole wheat pasta, beans, peas, sweet potatoes, brown rice, oats, fresh fruits and veggies.

      Not enough veggies
      Yeah, Mom was right: "Eat your vegetables!" Non-starchy vegetables like lettuce, broccoli, onions, peppers, spinach, and tomatoes are rich in vitamins (A, C and folate, especially), minerals (potassium, magnesium, phosphorous) and fibre! Yet, their carb content is fairly low. This makes them the optimal food group to load up on and enjoy. Make fajitas with bell peppers and onions, stir-fry broccoli, or mix up a cucumber-tomato chopped salads; these are delicious foundations for meals with a low-carb load. Try filling half of your plate with low-starch veggies.

      Tricking out healthy foods
      Oatmeal, smoothies, coffee, salads and sandwiches—straightforward healthy stuff, right? Sabotaging these seemingly good-for-you choices is easy when they're mixed with simple carbs. For example, adding fruit juice to smoothies pumps up the simple carb load in a hurry. Honey or syrup, and handfuls dried fruits easily triple the carb load of oatmeal. Jacking up your coffee with squirts of syrup, whole milk, whipped cream, and even crushed cookies turn it into a carb bomb! When counting carbohydrates for optimal glucose control, be sure to include all ingredients for accuracy.

      Your snack is like a meal
      Snacking can be good: You can take the edge off between meals and help steady blood sugar. But when your snacks drift upward to the size of a meal, weight gain and hyperglycemia is in the offing. The calories and carbohydrates of a snack should come in at less than a third of a healthy meal. Your general rule of thumb for diabetic snacks is to aim for 15 to 30 grams of total carbohydrate plus a protein source. Some examples: hummus and veggies, peanut butter and apple slices, almonds and dried cranberries.

      Eating out too often
      Fast food, drive-throughs, pizza delivery, chain restaurants: So tempting for a busy weeknight or when the cook isn't in the mood to slice and dice. Unfortunately, many favourite eats are loaded with more carbohydrate than a person with diabetes can handle. Searching the Internet for menus with nutritional analysis can help you choose the best meals for controlling carb intake. Aim for 45-60 grams of total carbohydrate per meal, or check with your registered dietitian for your individual carb goals. Other eating out tips include avoiding the bread basket or endless chip refills. If portions are too large, take half home for lunch tomorrow. Choose grilled, baked or broiled meats, rather than fried. Remember, when you cook at home, you have control over the ingredients, methods, and portion sizes.

      Too much screen-time
      When your face is glued to a screen, you're in suspended animation. Television, laptops, e-readers, phones, tablets and desktop computers suck time and rob your body of its need to be active. Exercise lowers blood glucose and provides health benefits to the heart, lungs, muscles and mind. The American Diabetes Association recommends 30 minutes of moderate intensity exercise for 5 days of the week, for a total of 150 minutes per week. Walking, biking, swimming, or aerobic activity are all options. Additionally, instead of sitting all day staring at a screen, the ADA suggests you break up your screen time at least once every hour. Stretch or do chair exercises at your work desk. Take a walk around the office at lunch. Park farther away from work. Wash your own car. Do your own housecleaning. Walk the dog. So many possibilities!

      Avoiding all carbs
      Extreme low-carb food plans aren't the answer. With so much attention given to very low-carb diets (think less than 50 grams per day), people with diabetes could go too low. Your body needs carbohydrate for energy, which is why nutritional advice recommends getting a minimum of 150 grams. Remember that your heart, other organs, muscles, and lungs all run on blood sugar. In fact, the brain uses glucose as a preferred fuel source. Also, switching to a very-low carb diet increases the risk of hypoglycemia—low blood sugar—especially if medications are a part of your care. Aim for a goal of moderate carbohydrate intake—not too low, not too high.

      Medication mishaps
      According to dietitian and certified diabetes educator Tamara Lutz, taking the wrong dosage of medications at the wrong time or skipping medications will wreak havoc on your blood glucose control. Both highs and lows occur with medication mistakes. Taking oral medications or insulin right after eating can result in hyperglycemia (high blood sugar) because the medication starts working long after the food raises your blood glucose. On the flip side, taking the medications too long before a meal may lead to low blood sugar. Lutz warns, "Skipping your medications completely causes high blood sugar as the body lacks adequate medication to work on your meal." Follow your prescription instructions carefully.



      Fruit May Have Benefits for Diabetes

      From nytimes.com

      A large study has found that eating fresh fruit may reduce the risk for developing diabetes, and the risk for its complications.
      Fresh fruit has well-known health benefits. But some experts, and some people with diabetes, question whether its high sugar content could pose risks.
      The study, in PLoS Medicine, tracked diet and health in 512,891 Chinese men and women ages 30 to 79 for an average of seven years, controlling for smoking, alcohol intake, blood pressure and other factors.
      Among those without diabetes at the start, eating fresh fruit daily was associated with a 12 percent lower risk of developing the disease compared with those who ate none. The more frequently they ate fruit, the lower their risk.
      In people who were already diabetic, those who ate fruit three times a week had a 17 percent lower risk of all-cause mortality, and a lower risk for diabetic complications like heart and kidney disease, than those who didn’t eat fruit.
      The study was observational and the reason for the effect remains unclear. But the lead author, Dr. Huaidong Du, a research fellow at the University of Oxford, said “the sugar in fruit is not the same as the sugar in manufactured foods and may be metabolized differently. And there are other nutrients in fruit that may benefit in other ways.”

      https://www.nytimes.com/2017/05/03/well/eat/fruit-may-have-benefits-for-diabetes.html?_r=0

      Saturday, 29 April 2017

      How to Get Moving With (or Without) Diabetes

      From health.usnews.com

      Physical activity is an important part of a healthy lifestyle for everyone. However, for people living with or at risk of diabetes, regular physical activity is an essential tool for managing blood glucose (also known as blood sugar) and preventing and/or delaying diabetes-related complications and their progression. For many people who have an already busy schedule filled with many responsibilities, it may seem impossible to fit in regular physical activity. And, to add more stress, there are always new trends and fads making it difficult to figure out what you should be doing to be active. However, did you know that health risks decrease with even modest amounts of physical activity?
      Since I'm often asked for guidance on how to include physical activity in a daily routine, here are a few tips on how to get started and keep active:

      Get started with something that fits into your existing lifestyle.
      Just as diabetes management is unique to each person, your physical activity routine should be customized to you. Not all activities are right for everyone, including people with diabetes, so be careful when starting new activities, and check with your doctor if you have questions.
      A good way to start planning for more activity is to track your activity habits for a few days. You might be surprised by how much time you spend sitting. Once you have an idea of your habits, start with small changes in your activity. Take one step at a time, and it might not feel so overwhelming.

      First, find time to do short 3-minute movement breaks every 30 minutes. These breaks will help you move your muscles and improve blood flow in your body, and can help with managing blood sugars. Activities can include taking the stairs, walking while on the phone or marching feet on floor while seated. Once you're able to add in activity during your daily life, you might be ready to plan in more structured exercise time. Whether your goal is to lose weight or to better manage your blood sugar, it's recommended that you gradually work up to getting at least 30 minutes of moderate-to-vigorous aerobic exercise at least five days a week.

      Make sure to incorporate strength training your muscles into your week.
      Strength training is movement using a resistance, such as a hand weight or your own body weight, to work your muscles. Strength training exercises can help increase insulin sensitivity, which helps to decrease blood glucose. Because strength training contributes to maintaining and building strong muscles, it is also key to preventing muscle loss as you age. Another added benefit to strength training is that the more muscle you have, the more calories from food your body uses – even when you're not moving.
      Strength training exercises range from using resistance bands and free weights to activities that use your own body's weight such as wall push-ups, leg raises and wall sits. Try to include strength training of all your large muscle groups (like your legs, back, shoulders and arms) at least two days each week. Make sure they aren't two days in a row though, since your muscles need time to repair after the training. People that have certain diabetes complications, like diabetic eye disease, may have certain restrictions when doing resistance exercises. Check with your doctor before beginning strength training or if you have any concerns or questions.

      A comprehensive physical fitness plan also includes flexibility and balance training.
      In order to safely be active and prevent injury, it's important to stretch your muscles at least two to three times each week. Try to hold each stretch for at least 10 to 15 seconds without holding your breath. Older adults, and especially those with Type 2 diabetes, can benefit from balance training activities two to three days each week to stay steady on their feet and prevent risk of falls. Simple stretching and balance activities, such as standing on one foot at a time for 10 seconds, can be included into your day and are easy to fit into your busy schedule. If yoga or tai chi are interesting to you, they can help improve strength, flexibility and balance in one activity.

      Trying the latest exercise trends can be fun, but find activities that work with your current level of physical fitness.
      It seems like there's a new physical fitness fad every season – from trampolining to spinning to high intensity interval training boot camps. While it's definitely tempting to sign up for a workout that is equivalent to a dance party on a bike or reminds you of your carefree childhood days on a trampoline, remember to include new activities with caution to prevent injury. That might mean talking to the instructor before a class to help adapt the activity to your current fitness ability, or discussing it with your doctor or health care team before starting a new and intense exercise routine. These fitness trends can be fun ways to spice up your activity plan and get moving, as long as they are safe for you to do.
      If you're at risk for hypoglycemia (low blood sugar), make sure to check your blood sugar before, during and after exercise, and have glucose tabs or another snack ready in case your blood sugars get low while you exercise. Most importantly, listen to your body in order to protect yourself from potential injury. Exercise can be challenging, but if one activity feels too difficult to do or causes pain, it might not be an activity you should continue.

      Just try to get moving.
      It can be overwhelming to add yet another activity to your calendar, so try to just get moving as often as possible throughout the day. An inactive lifestyle is unhealthy for anyone, and breaking up sitting habits is one of the most effective ways to improve your overall health. This is why the American Diabetes Association recently issued new recommendations on physical activity and exercise for people with diabetes, encouraging them to move around at least once every 30 minutes. If you work in an office, you can even do activities right at your desk to increase your activity. If time is of the essence, you can also break your 30 minutes a day into three 10-minute activity sessions.
      Make a commitment to yourself to be more active each day, and make physical fitness a core part of your healthy lifestyle. For people living with or at risk for diabetes, taking small steps to incorporate daily physical activity into your schedule can make a big difference.

      http://health.usnews.com/health-care/for-better/articles/2017-04-28/how-to-get-moving-with-or-without-diabetes

      Friday, 28 April 2017

      Diabetes Tied to Brain Abnormalities

      From nytimes.com

      Diabetes may be bad for the brain, especially if you are overweight.
      Researchers studied 50 overweight and 50 normal weight people in the early stages of Type 2 diabetes. All had been given a diagnosis within the previous five years. They compared both groups with 50 healthy control subjects.
      The scientists performed M.R.I. examinations of their brains and psychological tests of memory, reaction time and planning. Those with diabetes scored worse than the healthy controls on tests of memory and reaction times.
      M.R.I. scans revealed significant differences in brain areas related to memory, planning and the visual processing of information. Compared with the controls, those with Type 2 diabetes had more severe thinning of the cortex and more white matter abnormalities. Overweight people with diabetes had more brain deterioration than diabetic people of normal weight.
      Are these changes reversible? Probably not, according to a co-author, Dr. Donald C. Simonson of Brigham and Women’s Hospital in Boston.
      “When structural changes are seen on an M.R.I. scan, the processes leading up to them have probably been going on for years,” he said. “On the positive side, patients who maintain good control of their diabetes do seem to have a slower rate of deterioration.” The findings were published in Diabetologia.

      https://www.nytimes.com/2017/04/27/well/mind/diabetes-tied-to-brain-abnormalities.html?_r=0

      Sorry, But These Things Will Not Cure Diabetes

      From asweetlife.org

      As editor of ASweetLife, the Diabetes Magazine, one of my jobs is to block the barrage of comments we receive from people claiming to have cured their own diabetes with a home remedy, or those espousing the instantaneously successful treatment of a doctor whose name appears to be an amalgamation of Latin suffixes. Daily, I delete suspicious comments, things along the lines of a man who claims a donut a day keeps diabetes away, which he can prove because he has been eating a donut a day for the past 52 years and does not have diabetes. He can also sell you donut extract for $4.99 per drop, if you want to avoid all those donut calories. It might be sold on Goop, but I have not checked.
      If we get a message proclaiming a one-pill-cures-all-diseases from a devotee of someone with a name like Dr. Abiliusesco, who is only reachable by clicking HERE on this very safe link, it gets marked as spam. But as I bid adios to the snake oils, I do so not only with the satisfaction of obstructing the swindlers and scoundrels, but with a tinge of regret. I grew up with a mother who had an incurable disease. Over the duration of her illness, which progressively worsened, we tried to cure my mother with everything from experimental surgery to bee venom to acupuncture. Though only a young child, I understood we were fighting a battle that was already lost. Those scarce moments of hope, however, that perhaps a charlatan’s newest injection would give way to even the slightest improvement, were glorious. What I’m trying to convey is not that I believe in tossing aside scientific facts and reason, but having worn the shoes of desperation, I feel tremendous compassion for the desolate, and I don’t enjoy being the one to mark hope as spam. Luckily, it’s not all on me. The FDA monitors companies claiming to cure diseases, and a few days ago it issued 14 warning letters and four online advisory letters to companies illegally selling more than 65 products that claim to prevent, diagnose, treat, mitigate or cure cancer.
      Last May the FDA issued a consumer update warning for people with diabetes to beware of illegally marketed diabetes products.  The statement said, “As the number of people diagnosed with diabetes continues to grow, illegally marketed products promising to prevent, treat, and even cure diabetes are flooding the marketplace.”
      For anyone with type 1 diabetes even the slightest suggestion that there is a cure or a way to live without insulin should elicit an immediate red flag. Or more like a thousand red flags. Yet, the internet abounds with individuals who will attest to curing their type 1 diabetes with diet and supplements. For example, Michelle, a blogger, claimed to have cured herself with the paleo diet. If that doesn’t raise your eyebrows, the dubious comment below the post thanking Dr. Gaga for casting a lucky spell should do the trick. A year later Michelle shared a post called “I’m back on insulin and I quit the paleo-diet.” Chances are Michelle experienced a diabetes honeymoon period, where the pancreas starts working again—though not perfectly—after diagnosis. ASweetLife contributor Katie Bacon explains, “The theory, in layman’s terms, is that the hard-working pancreas has given up the ghost, but then revives a bit after getting the rest that outside insulin injections provide honeymoon phase.” A low carb diet, that puts less stress on the pancreas, may help extend a diabetes honeymoon. However,  anyone who publicly claims she’s cured type 1 diabetes with diet and understands that, in fact, she has not, has the responsibility to remove misleading posts, titles, or information.  To suggest that a person with type 1 diabetes can live without insulin is not only to give false hope, but it may put a person’s life in danger.
      It’s not only personal blogs, that dole out purported cures. A website called GreenMedinfo, founded by Sayer Ji, published an article that says type 1 diabetes is a ‘so-called incurable disease’ whose cure may be in your kitchen cupboard. GreenMedinfo has an endorsement from  Dr. David Perlmutter, author of the best selling book, Grain Brain. Dr. Perlmutter calls GreenMedinfo, “An incredibly rich venue of leading-edge scientific, user-friendly, health empowering information.” GreenMedinfo also charges for membership. But the article that suggests a flaxseed treatment cure is free! Other ‘natural’ substances that may help cure type 1 diabetes, include avocado extract, chard extract, and… wait for it… honey!  To each her own, but I’ll take a grain brain over a honeyed pancreas any day. And the GreenMedinfo cure-related theory that involves kitchen cupboard remedies is hinged on their ability to regenerate beta cells. Fortunately, there are scientists who’ve looked beyond the kitchen and into the lab. And the challenge of creating insulin-secreting beta cells has, for the most part, been met. What remains to be solved is the problem of the autoimmune attack on beta cells, whether they be the original cells or the tumeric-regenerated ones.
      Hopefully, there will be a diabetes cure one day very soon, but until someone other than Mr. Ji, Dr. Perlmutter, and bloggers (understandably) desperate to rid themselves of a chronic illness that requires constant attention, I’m going to side with the Mayo Clinic. “There are no treatments — alternative or conventional — that can cure diabetes, so it’s critical that people who are receiving insulin therapy for diabetes don’t stop using insulin unless directed to do so by their physicians.”
      In other words, drinking unicorn milk won’t give you diabetes and it also won’t make it go away.  If someone offers you something that sounds too good to be true, then it’s probably a scam. The FDA recommends watching out  for these and similar red flags:
      “Lowers your blood sugar naturally!”
      “Inexpensive therapy to fight and eliminate type II diabetes!”
      “Protects your eyes, kidneys, and blood vessels from damage!”
      “Replaces your diabetes medicine!”
      “Effective treatment to relieve all symptoms of diabetes!”
      “Natural diabetes cure!”
      To their list I will add that it’s worth being wary of anything with one or more of  the following words: natural, supplement, extract, miracle, overnight, free, tincture, elixir, healing, cinnamon, okra, bitter gourd, or the phrase, the simple thing pharma doesn’t want you to know about.
      The FDA created a video to alert people with diabetes to fraudulent diabetes treatments. Interestingly, at 13 seconds into the clip, the featured person with diabetes hears a beep, which comes from his glucose meter. His meter shows 425, and he appears to have received this reading without the involvement of a drop of blood or a test strip, which brings the word fraudulent to mind… or maybe it’s just one of Dr. Gaga’s spells. Either way, the FDA should quickly investigate.

      https://asweetlife.org/sorry-but-these-things-will-not-cure-diabetes/#