Eating SmartHow You Can Help Control Your Diabetes At Home—Check Those Carbs!
Volume 16, No.4, Fall 2008
Eating SmartBy Debra Gibbons, R.D.
November is designated Diabetes month. There are now 24 million Americans with diabetes and more than double that with pre diabetes. So chances are you know someone with this condition or may be at risk yourself.
Years ago people would say they had “sugar” diabetes or a touch of sugar or perhaps old age diabetes, but nothing serious like those people taking “shots.” They would eat a regular diet, but avoid table sugar. Only limited education on what to eat, or whether to exercise or awareness of potential problems was offered. There were no glucometers to check blood sugar at home. Instead you would check the sugar in your urine, or just wait for your next doctor’s appointment.
Now we know a lot more about diabetes and patients are given more information regarding their diet and physical activity, plus how this affects other aspects of their health.
The view has changed, from the physician solely managing the diabetes to empowering patients to learn how to control their condition—with, of course, the help of their doctors and other health care professionals. This allows the people to go home alone to handle the everyday task of caring for their diabetes with confidence in their daily decisions.
Most people with diabetes call meal planning the most challenging aspect of their care.
This means controlling blood sugars while meeting nutritional needs and striving to obtain a healthy weight. For most, eating modest amounts 4-5 times a day and not skipping meals is a first step.
The diabetic food exchange lists have been around for a long time and are still in use. But now there’s another approach in meal planning. Learning how to count the amount of carbohydrate in particular foods increases the flexibility of one’s choices and improves the management of blood sugars. Controlling the carbohydrates and distributing them through the day will help control blood sugars.
Carbohydrates have the greatest influence on the blood sugar and consist of all starches, sugars and fiber, of which 90-100 percent turns to sugar.
The carbohydrate content of packaged foods is listed at the top of the Nutrition Facts label as Total Carbohydrate per serving as listed on the label. Ignore the sugar amount since it is already included in the total carbohydrate. Remember to check the serving size listed and see if that is the amount you plan to eat. If not, adjust the carbohydrate content to your serving size. The carbohydrate content of foods without packages such as fresh fruits, vegetables, meats and fish can be found in reference books in most bookstores and on websites.
People with diabetes who take insulin before meals are now able to learn how to adjust their insulin according to the amount of carbohydrates they are eating rather than always being forced to limit their intake of food according to a fixed dose of insulin. Since appetites may vary at different meals, a person can be taught how to make insulin adjustment to prevent their blood sugar from being too high or too low after eating.
There are a variety of approaches to use in meal planning and each person has to see which one works for them. Healthcare providers specializing in diabetes such as Certified Diabetes Educators provide reliable education to help people learn about diabetes and the meal planning options. Then it is up to the patient to put them into practice to discover which approach is best for them.
Regardless of the type of diabetes, the goals are the same—maintaining a heart-healthy diet that controls blood sugars and weight. This formula will help decrease the risks of complications and improve your quality of life.
(Ms. Gibbons, a Registered Dietician and Certified Diabetes Educator, provides outpatient nutrition medical therapy at Cape Cod Hospital.)
By Denise M. Dever
Thousands of Americans find themselves caring for seniors as well as young children, which adds to the burden of those who also must juggle full-time outside jobs as well.
This situation has inspired many employers to investigate back-up care programs for their workers as a way to reduce employee stress and improve absenteeism rates and productivity. These programs provide lists of providers who can be accessed and contacted quickly when back-up care is required.
Work Options Group, a Colorado-based company that specializes in providing corporate-sponsored back-up care, shares some feedback from employees who may require this service. Survey results indicate that this employee benefit does indeed reduce stress and unscheduled absenteeism while also improving productivity and staff loyalty.
More than 1,200 employees who used their service over a three-month period earlier this year participated in the survey and here are some of the key findings to the critical question:
“If back-up care was not offered, what would you have done?”
Work Options Group is one of a number of companies that serve as a third-party liaison to link employees with a network of service contractors who can provide back-up care on short notice for loved ones of any age–from infants and school-aged children, to adults and seniors.
(Ms. Dever is President and Co-Owner of Home Instead Senior Care providing non-medical home care for seniors, 508-778-8613 or www.homeinstead.com.)
By Debra Babcock, D.C.
Oh, our aching backs! And wallets.
We may find it hard to believe that while spending on traditional treatments for serious back pain has soared over the last decade, the number of people affected by these painful and often debilitating conditions continues to rise.
As Dr. Andrew Weil, guru of the alternative or integrative medical world, put it in an article in the magazine Self Healing, despite the fact that spending on treating pain conditions stemming from overstretched, strained, or spasming muscles, ligaments and tendons as well as slipped discs, has exploded during this time, the number of people suffering from these conditions continues to rise.
“Research shows,” Dr. Weil writes, “that testing, surgeries, injections and drugs—while useful for some—are being used more widely than the evidence supports.”
Thousands of laymen, as well as practitioners of various kinds, including standard medical doctors, already have come to the conclusion that looking at back pain as a purely physical problem is outdated. Instead, it has become widely recognized that emotional and psychological attitudes can and do have an enormous impact on our health.
Various symptoms such as pain can be the body's way of getting our attention to show us that something needs to change. When we simply eradicate the “noise” of the symptom, through pharmaceutical pain relievers for example, without changing anything else in our lives, often we have just silenced the cry of the body that is determined to make itself heard, one way or another.
Factors such as a positive mental attitude, sufficient rest and relaxation, positive relationships, healthy diet and exercise—difficult as it sometimes may be to achieve these days—have been shown to affect our overall health, including those aching backs.
Chiropractors have the additional emphasis on the health of the back. This home of the central nervous system coursing through the spine can be called the hard drive that is central to the health of all of the body's systems and how we are able to perceive and respond to ourselves, our bodies, and our world.
Practitioners and teachers of yoga and meditation for thousands of years have been demonstrating and suggesting that these practices promote not only an enhanced sense of well-being, but a healthy, strong, flexible, and adaptable spine.
Although there certainly are situations in which more drastic interventions such as surgery or medications may be advised and beneficial. But, in many cases, patience, practice and perseverance in self-help techniques may prove most useful for the long term health of our bodies…including our backs.
(Dr. Babcock is a writer, yoga teacher, chiropractor and founder of Harmony Network Chiropractic & Yoga here on Cape Cod, www.harmonychiroyoga.com or 508-419-7070.)
Christopher Jones and Michael Kennally, physical therapists at Broad Reach Healthcare in North Chatham, can now add Doctor to their titles after recently completing their advanced degrees in physical therapy. Both received the Doctor of Physical Therapy (DPT) degree from Simmons College while working full-time at Broad Reach Healthcare's Outpatient Clinic and the inpatient setting at Liberty Commons Skilled Rehabilitation and Nursing Center.
The advanced studies for both were sponsored entirely by the tuition reimbursement program at Broad Reach Healthcare. DPT is a relatively new degree and they are among the first physical therapists on Cape Cod to be practicing with this degree.
Dr. Jones, who resides in Sagamore Beach, received his master's degree from Springfield College. He also has developed a unique program for Chatham High School where students can receive credit for attending his cardiovascular fitness and strength training program.
Dr. Kennally is a graduate of American International College in Springfield. He resides in Brewster with his wife Kathryn, who also received her DPT the same day. A retired Marine Corps corporal, he captained his college lacrosse team and was the first above-the-knee amputee to play NCAA sports at that level.
Neuropathy has been described as the most common disease you’ve never heard of. It’s a nerve disorder that wears many masks and 20 percent of older Americans have it.
Peripheral neuropathy is a general term that means damage to the nerves beyond the brain and spinal cord.
The symptoms vary widely but can include:
While there are about 100 known causes, the most common are diabetes and heredity. Other causes include diseases such as rheumatoid arthritis, Lyme disease, alcoholism and carpal tunnel syndrome. Neuropathy also is linked to vitamin deficiencies or high dosages (greater than 10 mg/day) of vitamin B6, and to use of some common medications such as Tagament, Lithium, and several powerful anticancer drugs.
Depending on the cause, peripheral nerve damage–unlike damage to the central nervous system—is potentially reversible.
If your personal care physician can’t find a cause for your frequent stumbling or pain or numbness in your extremities, ask for a referral to a neurologist. Remember, some symptoms can be minimized and even reversed with proper diagnosis and treatment.
Here on Cape Cod, Jackie Stowell, herself a neuropathy sufferer, heads the local branch of the national Neuropathy Support Group that meets about six times a year at the Orleans Senior Center. The group was started some eight years ago by Bev Boynton to allow folks with neuropathy to discuss symptoms, the effectiveness and side effects of new drugs they had tried, and to learn about the disorder.
Ms. Stowell has been in charge for nearly three years, organizing speakers ranging from neurologists to physical therapists and from podiatrists to specialists in pain management. This helps people understand and discover treatment options for that tingling or numbness or just plain old pain in the feet and hands.
Information on the support group can be obtained from Kay Nagle at 508-240-1766 or kaynagle@verizon.net.