Tag Archives: diabetes

Can food timing prevent diabetes?

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Putting off meals for an extended period of time can lead some to over-indulge when it comes time to eat. (Courtesy Spectrum Health Beat)

By Sarah Mahoney, Spectrum Health Beat


Intermittent fasting—the fancy term for going up to 14 or 16 hours without eating anything—is all the rage these days.


Dietitians and their celebrity clients are touting it as the latest and greatest weight-loss tool.


And there’s been some promising evidence that the approach may even lower the risk of developing Type 2 diabetes, one of the most serious chronic illnesses in the world.


Researchers who have linked intermittent fasting to improved sensitivity to insulin also recently discovered it might lower pancreatic fat in rats. And that may reduce the odds of developing diabetes.


In a small study of humans with pre-diabetes, participants who ate from the hours of 7 a.m. to 3 p.m. saw significant improvements in their insulin sensitivity and blood pressure.


But don’t approach intermittent fasting without some measure of caution.


Kristi Veltkamp, MS, RD, outpatient dietitian at Spectrum Health Blodgett Hospital, said it makes sense to take intermittent fasting with a healthy sprinkling of skepticism, especially when it comes to its relationship to diabetes prevention.


“Some people do lose weight when they try this style of eating,” she said. “And the No. 1 way we know to prevent diabetes is by losing weight.”


Even shedding as little as 5 to 10% of your body weight can reduce the risk of diabetes by 58%.


“So this type of eating may be helpful because people are losing weight,” she said. “But that doesn’t mean intermittent fasting gets the credit. From that perspective, any weight-loss method can be said to lower diabetes risk.”


The strict timing of meals can have a significant downside for some people.


“Often, they get so hungry that they overeat during their eight-hour window, sometimes making poor food choices,” Veltkamp said.


For others, it’s just not convenient, especially if they are trying to eat meals as a family.


Most people consume the last meal of the day in the evening, not by 3 p.m.


“By all means, experiment,” she said. “For example, often people are surprised to discover that they feel better eating breakfast later in the day.”


But until more conclusive data emerges, pay close attention to the guidelines already proven to prevent diabetes.

5 proven ways to keep diabetes at bay:

1. Eat the Mediterranean way

If you haven’t already experimented with a Mediterranean diet, now’s the time. Eating meals with plenty of fish, vegetables, whole grains and olive oil has been linked to an 83% lower chance of developing diabetes.

2. Nix the nighttime snacks

Even if you never try intermittent fasting, those evening snacks—often scarfed down in front of the TV—can sabotage any healthy diet. Once you’ve left the dinner table, try to stop eating for the evening.

3. Pay attention to protein

Veltkamp recommends including some protein in every meal and snack. This includes dairy, nuts or cheese. “It keeps people full longer and helps with cravings,” she said.

4. Quit bashing carbs

While processed foods, soft drinks and white sugar cause rapid ups and downs in glucose levels, Veltkamp worries that too many people vilify all carbohydrates.


Whole grains and fruits are a healthy part of every diet, she said.


“Sugar isn’t all bad,” Veltkamp said. “I’ve yet to have to tell a patient that they’re eating too many apples.”

5. Strive for flexibility

Finally, when you’re looking for a lifetime approach to healthy eating, it’s smart to be gentle with yourself.


While all-or-nothing diets may be the craze—from the Keto plan to Whole 30—she advocates a much more forgiving approach, with an 80/20 rule.


Strive for solid, sensible meals 80% of the time, then relax with the remaining 20% of meals.


Reprinted with permission from Spectrum Health Beat.




Beat the clock, reverse the stroke

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Photo by Taylor Ballek, Spectrum Health Beat

By Eve Clayton, Spectrum Health Beat

Photos by Taylor Ballek


Tramell Louis Jr. has diabetes, and his friends all know it.


So when he collapsed at lunch while waiting to place his order, his buddy thought Tramell was having a diabetic attack.


He helped him out to his car and called LaGenda, Tramell’s wife, who drove to meet them outside the restaurant.


It didn’t take her long to figure out that this was no low-blood-sugar attack, so she followed her instincts and called 911.


“I’m asking him questions and he’s looking at me, but he won’t respond. So at that point I knew something was grotesquely wrong,” she said. “I just knew it wasn’t related to the diabetes.”


As she watched “his mouth go crooked,” she wondered whether he was having a stroke.

Clot retrieval

An ambulance took Tramell to the emergency department at Spectrum Health Butterworth Hospital, where doctors confirmed LaGenda’s suspicions: At age 37, her husband had suffered an acute ischemic stroke.


The doctors quickly got him hooked up to an intravenous drip and administered a clot-busting medicine known as IV tPA. As the only drug approved by the Food and Drug Administration for treating acute ischemic stroke, this is the standard of care in a case like Tramell’s.


At the same time, emergency room staff called one of the hospital’s stroke specialists, who ordered a CT angiogram to pinpoint the source of the stroke. Tramell was rushed to the interventional radiology suite for imaging.


With the images on screen, the Spectrum Health Medical Group neurointerventionalist could see that Tramell was a perfect candidate for an advanced intervention called a mechanical thrombectomy, or clot retrieval.


Tramell’s brain scans showed two blood clots—one in the carotid artery in his neck and the other lodged in the left-middle cerebral artery, a major artery supplying the brain.


This second clot had shut down the blood flow to the left side of his brain, like a dam blocking a river.


“When the doctor showed me the CT scan of his brain, you could clearly see that (one) side of his brain had no blood flow to it at all,” LaGenda recalled.

Time is brain

With stroke, speed is everything. The longer the brain is deprived of blood, the more damage the brain suffers.


Studies have shown that for every minute blood supply is blocked, approximately 2 million neurons die.


So if a patient fits the criteria for intervention, “the sooner you start the procedure, the sooner you take out the blood clot, the sooner you restore the blood flow, the better the outcomes at three months.” That’s the standard measurement in the United States today.


Thankfully, Tramell beat the clock. From the moment he arrived at the hospital to the time he underwent surgery, less than an hour had passed.


Because there were two clots, the doctor used a two-step process to retrieve them. First he inserted a catheter into a blood vessel in the patient’s groin and fed it up to the carotid artery. Using a tool called the Solitaire device, he trapped the first clot in a tiny mesh stent and pulled it out.

Photo by Taylor Ballek, Spectrum Health Beat

Then he repeated the technique, fishing out the clot in the central brain. Immediately the blood began to flow again, in what doctors call complete recanalization—the channel was open again.


The results for Tramell proved to be dramatic.


His symptoms—loss of language function and right-side weakness—improved literally overnight, said Vivek Rai, MD, a neurologist with Spectrum Health Medical Group who specializes in stroke and vascular neurology. He took over Tramell’s care after his release from intensive care.


“After the procedure, the next morning when he woke up, he was night and day,” Dr. Rai said. “And he continued to do so well.”


Now that Tramell is in the clear, Dr. Rai will see him annually in the neurovascular program’s stroke clinic, keeping tabs on his carotid artery disease, which was the cause of the stroke, and monitoring his general health. To prevent a future stroke, Tramell will need to take aspirin and cholesterol medication, and carefully control his diabetes and blood pressure.

Driven to change

At five months post stroke, Tramell is feeling better than ever.


“I feel great. I really do,” he said. “I feel healthier than I have in a long time.”


He looks and sounds healthy, too, with no lingering effects. At least, none that a bystander would notice.


“The only problem I have is my speech,” he said. “When I speak, if it’s a word I haven’t used after I had my stroke, it takes—it’s like a pause and then I have to remember the word and then it jogs it, and then I start using it fluently.”


The stroke served as a major wake-up call for the father of two. Realizing his life could be snatched from him—separating him from his wife and children—brought out strong emotions.


“I felt anger, extreme anger—with myself. I just knew I had to change. I had the worst—the worst—eating habits in the world,” he said, noting that before he started taking insulin, he weighed over 300 pounds.


Today Tramell is eating better, faithfully taking his medications, drinking more water, kicking his soda habit and “running on a treadmill like crazy”—even when his job as a shipping and receiving clerk keeps him at work late.


“My wife—she’s the one that motivates me to do all the things I do,” he said.


Reprinted with permission from Spectrum Health Beat.


Diabetes and foot care

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By Gretchen Stelter, Michigan State University Extension

 

There are many complications that accompany diabetes. Most of us just worry about what we eat and our blood sugar level, but a person with diabetes, you may run the risk of getting foot ulcers. To avoid this complication, you must check your feet daily. Foot ulcers are sores generally on the bottom of your feet in a weight bearing area. They are sores that do not heal if unattended to. A further complication of this is that open sores affect deeper tissue which can lead to bone and nerve damage, called peripheral neuropathy. Some of the other issues that come with peripheral neuropathy could be poor circulation and hammer toes. Those that suffer from poor circulation and foot ulcers are most at risk, says Steven Kavros, who specializes in vascular wound care at the Mayo Clinic.

 

With poor circulation, you may not feel an ulcer on your foot, therefore it is extremely important to self-examine your feet daily. If unattended, these sores will become worse and major health risks may become a factor. See a doctor and don’t let the wound go for days without care.

 

To control the wounds and the development of wounds, a person with diabetes must be proactive and monitor:

  • blood sugar levels,
  • kidney disease,
  • eye disease,
  • weight,
  • smoking,
  • and alcohol consumption.

If any of the above are out of control, your chances are increased of developing foot ulcers that, left untreated, may lead to amputation.

 

Try these easy steps to prevent wounds:

  • Check your feet daily. Look for blisters or open wounds and, if you have them, see a doctor immediately.
  • Wear the correct shoes. Make sure shoes fit properly to prevent damage if you stub your foot. Cotton socks or those made from natural fibers that breathe are better than socks made of man-made fibers.
  • Take care of your feet. Keep your feet clean and dry them well after cleaning them. Don’t soak your feet for the risk that skin may become easier to tear.
  • Exercise gently. You must exercise to help control your weight and diabetes. It is always important to talk to your health practitioner with regard to the best exercise for your condition.

Take these practices to heart. If the above tips can help prevent you from losing a limb, then it will give you a better quality life!

 

You can find more information about foot care for diabetes through the National Kidney Foundation and the Centers for Disease Control and Prevention. Michigan State University Extension provides education in chronic disease prevention and management.

 

This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).

Diabetes and travel: Behind the wheel precautions

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By Pamela Daniels, Michigan State University Extension

Courtesy Michigan State University Extension

It’s that time of year for residents of the northern states to drive south in search of warmth and sunshine, leaving the cold and snow behind. For others it’s time to take that long-awaited family road trip, escaping harsh weather for more mild conditions. No matter the distance or length of the road trip, what’s at the top of everyone’s list is arriving there safely. For individuals with diabetes, getting there safely becomes more than just safe driving.

For a person who is insulin-dependent, blood glucose level is paramount to the ability to drive safely. Experiencing a rapid drop in insulin levels (a severe hypoglycemic event) could possibly bring on symptoms of double vision and disorientation. Clearly problems for any driver behind the wheel.

For road trip safety, understand your physical health, chart your blood glucose levels frequently and don’t skip meals. Be prepared. Talk with your doctor about fast-acting glucose products that can be used in the event of an emergency. Your doctor and diabetic nurse educator are the best people to talk to regarding which glucose products are right for you.

Michigan State University Extension recommends these behind the wheel tips for diabetics:

  • Keep a glucose kit in your car at all times, it should be tolerant to warm and cold temperatures.
  • Before driving any distance be aware of your levels; think about how you are feeling, don’t be afraid to ask someone else to drive you if you’re feeling tired or stressed.
  • Carry your cell phone with pre-programmed numbers of 911 and family members in the case of an emergency.
  • Stop often, don’t skip meals, eat the right foods and sugars which will keep you active and alert.

As always, buckle-up, don’t text and drive and enjoy your road trip!

Michigan State University Extension recommends the following professional diabetes resources:

American Diabetes Association: Driving & Diabetes

National Institute of Health: Understanding the risk of diabetes and driving

This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).

Holiday planning for diabetes

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Courtesy Michigan State University Extension

By Kris Swartzendruber, Michigan State University Extension

 

It can be very difficult to be health conscious this time of year as food and festivity will always be a major part of the holiday season. It’s an especially challenging time for those who have diabetes. The American Diabetes Association recommends planning ahead and provides the following tips and guidelines to help those with diabetes enjoy the foods associated with the holidays, while still staying healthy:

  • Think about the timing of your meal. Holiday meals, such as Thanksgiving, are often served at times that don’t align with our regular meal schedule. Take this into consideration if you are taking medication such as insulin injections or pills that lower blood glucose. Talk to your health care professional about having snacks available if low blood glucose is a concern.
  • Be physically active. Consider incorporating more exercise, such as walking, riding a bike or visiting the gym when you know you’ll be eating more than usual. Encourage family members to join you in starting new traditions that involve physical activity such as playing a game of Frisbee, soccer or touch football.
  • Try healthier versions of your favorite holiday foods. Try using fat-free or light ingredients when preparing your favorite holiday dishes. Add less sugar to dishes that already provide natural sweetness such as winter squash casseroles and fruit pies. Check out the American Diabetes Association website as well as other diabetes friendly recipes available online.
  • Have low calorie foods such as raw vegetables with low-fat dip or cheese on hand while you’re cooking or waiting to eat. Avoid high-calorie and/or fried foods that are often served as appetizers during the holidays.
  • Be selective. High carbohydrate foods are a staple when it comes to many traditional holiday foods. Choose reasonable portions of your favorite high carb foods and allow yourself to pass on the rest.
  • Eat smaller portions. Don’t forget to use portion control when selecting foods that are higher in carbohydrates. Be mindful of keeping your total carbohydrate intake within a recommended range.
  • Eat your vegetables. Incorporate more color and nutrition to the holiday table by providing non-starchy vegetables dishes such as green salads and steamed vegetables to the menu. Vegetables not only fill you up, they can also help prevent you from overeating other foods that are loaded with calories and fat.

Michigan State University Extension recommends that people with diabetes always work with your health care team and offers diabetes programs that educate on proper eating and self-management, such as Dining with Diabetes.

 

This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).

Diabetes and your mouth

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By Nicole Kooiker, DDS, Heart of the City Health Center

 

Q: Does diabetes really affect my teeth?

 

A: If you are one of the nearly 30 million people living in the U.S. with diabetes, you have special oral health needs. As a dentist practicing in Grand Rapids, I see first-hand how diabetes affects the mouth. It can lead to gingivitis, an early stage of gum disease, and it can cause periodontitis, the most severe and common dental disease affecting those with diabetes. If left untreated, periodontitis may cause you to lose your teeth or have them pulled. It also reduces your body’s ability to regulate the level of sugar in the blood. High blood sugar can make diabetes harder to control and contribute to worsening gum disease.

 

Below are tips for keeping your mouth healthy while living with diabetes.

  • Control your blood sugar level.
  • Brush and floss daily.
  • If you wear dentures, remove and clean them daily.
  • Visit your dentist regularly; in fact, deep cleanings can help lower your HbA1c.
  • Watch for signs of gum disease, including red, swollen, tender, and /or bleeding gums when you brush or floss; bad breath; permanent teeth that are loose or moving away from each other; and gums that have pulled away from teeth.
  • Avoid smoking.
  • Tell your dentist and hygienist any time there is a change in your medication or the severity of your diabetes.
  • Postpone any non-emergency dental procedures if your blood sugar is not in control.

Reprinted with permission from Cherry Health.

Living with Diabetes: The importance of great oral care

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Courtesy of Cherry Health

By Alisha Walker, Bilingual Dental Referral Coordinator Team Lead at Cherry Street Health Center

Diabetes can affect every part of the body, including your mouth. If you or someone you care for has diabetes, you need to spend extra time and attention to maintain great oral health. Tooth and periodontal (gum) diseases are more common and serious for people with diabetes. Periodontal disease is a broad term used to describe various stages of disease that affect the gums and bone surrounding of the teeth. Periodontal disease can also make it harder for people with diabetes to control their blood sugar, however by taking better care of your oral health both periodontal disease and diabetes can improve.

 

Are you at higher risk for periodontal disease if you have diabetes?

  • Yes, when diabetes is not under control your mouth and your body’s germ-fighting powers are weakened.

What other oral health problems can develop if you have diabetes?

  • Diabetes also makes you prone to other mouth problems such as oral infections like thrush, dry mouth which can cause soreness, ulcers, infections and cavities and poor wound healing.

What are the early warning signs of periodontal disease?

  • Red or swollen gums
  • Bleeding gums
  • Painful or tender gums
  • Loose or shifting teeth
  • Constant bad breath or taste
  • Pus between teeth and when gums are pressed
  • Gums pulling away from teeth

Should you tell your dentist and dental hygienist that you have diabetes?

  • Yes, people with diabetes have special needs. Keep your dentist and dental hygienist informed of any changes in your condition and any medication(s) you might be taking.

How can I keep my gums and teeth healthy to prevent and/or fight off periodontal disease?

  • Keep blood sugar as close to normal as possible. That means taking medications that were prescribed as directed. It also means keeping the amount of consumed carbs in check.
  • Brush twice a day with a fluoride toothpaste.
  • Floss your teeth at least once every day.
  • See your dentist at least twice a year, or as often as your dentist recommends.

Remember, good dental care can result in a healthy mouth and a smile that will last a lifetime.

 

Reprinted with permission from Cherry Health.

 

You can prevent or delay complications of type 2 diabetes

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By Linda Cronk, Michigan State University Extension

 

Why is it so important for people with type 2 diabetes to maintain day-to-day normal blood sugar levels? As we have often been told, the complications of diabetes caused by high blood sugar levels can, over time, do permanent damage to many parts of our bodies. According to the book Living a Healthy Life with Chronic Conditions, by Dr. Kate Lorig, et al, the number one complication of diabetes over time is heart disease.

 

Other complications include:

  • nerve damage or neuropathy, which might mean burning, tingling, numbness or loss of feeling in our hands and feet
  • liver and kidney damage
  • vision problems such as cataracts, glaucoma or even blindness
  • infections that persist
  • gum disease
  • skin and foot problems from poor wound healing
  • sexual problems for men and women — erectile dysfunction, yeast infections, vaginal dryness or loss of desire.

What are the best ways to maintain healthy blood sugar levels day-to-day? Michigan State University Extension says that the most basic ways to prevent or delay complications of diabetes are to choose elements of a healthy lifestyle:

  • Keep yourself physically active
  • Pick healthy food options in portion sizes that are right for you
  • Don’t smoke
  • Be proactive to manage your stress levels
  • Take any medications as directed by your health care provider
  • Monitor your blood sugar levels as directed by your health care provider
  • Have regular tests to determine how your health strategies are working and to modify strategies, in consultation with your health care provider, if tests show you need to make changes

What are the tests and procedures that people with diabetes need to determine whether their health strategies are working? If you are not familiar with tests that all people with diabetes need on a regular basis, the book Living a Healthy Life with Chronic Conditions explains:

  • Blood pressure: should be measured at every doctor visit
  • Feet: should be checked for unhealed sores at every visit, and have a complete foot exam at least once a year
  • A1c: should be tested at least twice a year, A1c is a blood test to determine what your average blood glucose level was for the past 2-3 months. Most people should aim for an A1c below 7, or as recommended by your healthcare team
  • Kidney function: should be tested once a year by means of a blood or urine test or both
  • Blood lipids (fats): total cholesterol; LDL, low-density lipoprotein; HDL, high-density lipoprotein; and triglycerides should be tested at least once a yea
  • Eyes: should be tested once a year with a dilated eye exam, in which your eye care professional uses eye drops to dilate the pupils
  • Teeth and gums: should be checked by a dentist twice a year
  • Pneumonia shot: People with diabetes should receive a shot no matter what age. Even if you have had one shot and are over 65, ask your doctor about having another shot
  • Flu shot: recommended once a year for people with diabetes

As with all chronic diseases, active managing of Type 2 diabetes is an ongoing necessity to prevent or delay complications of the disease. Ensuring that your blood sugar levels remain within a healthy range is crucial.

 

Besides the medication management, the other requirements to manage diabetes are very similar to living a healthy lifestyle under all conditions: be physically active, choose a healthy eating plan, manage stress levels, don’t smoke and visit your health care provider regularly. For more information about managing Type 2 diabetes, visit the National Diabetes Education Program website. To find disease prevention programs available in your area please visit the MSU Extension website.

 

To learn more about diabetes self-care strategies, participate in a Michigan State University Extension led diabetes management series.

 

This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).

Tips for type 1 diabetes teens that struggle with an eating disorder

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Teens with type 1 diabetes are twice as likely to experience an eating disorder, so it’s important to watch out for symptoms.

By Pam Daniels, Michigan State University Extension and Emily Marr, Mecosta County Student Intern

 

According to the National Institute of Mental Health, surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives. For teens with type 1 diabetes (T1D) eating disorders can be characterized by actions of both manipulating food and manipulating medications.

 

Characteristics & symptoms of eating disorders

 

Studies from the Journal of Diabetes Science & Technology have shown that girls and women with T1D are about 2.5 times more likely to develop eating disorders than those who do not have diabetes.

 

When referring to an eating disorder involving insulin restriction, a common term used is diabulimia: (di meaning diabetes/ bulimia meaning to purge) The American Association of Diabetes Educators explains common characteristics of diabulimia, which include:

  • Obsession – Constantly focus on eating and counting food
  • Poor self-image – The result T1D has on self-image
  • Comparing oneself to others – Due to the increased average weight associated with T1D compared to teens without.

The Journal of Diabetes Science & Technology and American Association of Diabetes Educators (AADE) report a list of symptoms associated with diabulimia:

  • Insulin restrictions or purging – T1D often include insulin restriction as a way of calorie “purging” (getting rid of calories) this can lead to severe medical consequences.
  • Insulin manipulation – Skipping or under-dosed insulin regimes.
  • Being underweight and weight loss – Fast and drastic weight loss also increases the risk of both acute and long-term T1D complications and increased risk of death.
  • Poor adherence to one or more treatment regimens.
  • Poor metabolic control with elevated glycated hemoglobin (A1C) – The A1C percentage measures how much sugar is attached to the blood’s hemoglobin protein.
  • Recurrent symptoms of hyperglycemia (high blood sugar) & recurrent episodes of ketoacidosis (a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones).
  • Growth retardation and pubertal delay.

The most current information on diabulima

 

You can find the most current information concerning diabulima from the National Eating Disorder Association, including:

  • Warning signs and symptoms
  • Identity and eating disorders
  • Body Image
  • Prevention
  • Statistics and research
  • Treatment

There is treatment, help and support for those struggling with eating disorders. If you’re struggling with an eating disorder, please seek help. Contact your primary care doctor, a registered dietitian who specializes in eating disorders.

 

If you’re struggling with an eating disorder, please seek help. Contact your primary care doctor, a registered dietitian who specializes in eating disorders or the National Eating Disorder Association. For more information on nutrition, health and diabetes self-management visit Michigan State University Extension.

 

This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).

Teenage drinking and type 1 diabetes

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What your teen with type 1 diabetes should know if they decide to drink

By Christi Demitz, Michigan State University Extension 

 

As parents, we want to believe that our children will always do what we ask of them, but we quickly learn that is not the case. Especially as our kids grow older and assert their independence, what we ask of them and what they do are often in conflict. If you are a parent of a teen with type 1 diabetes, the choices they make can have serious health consequences when what they do and what you ask of them are in conflict. One common choice teens are faced with is whether or not to drink alcohol.

 

According to the Michigan Department of Community Health, almost one-third of 9th – 12th graders report having at least one drink in the past 30 days. Again, we like to think our children will do what we ask and not drink, but how can we prepare our teens with type 1 diabetes to be safe when they decide to drink?

 

Bottom line: underage drinking is illegal, and underage drinking can have legal consequences if your teen is caught. For best results, you should talk to your teen about drinking before they decide to drink and when you both are calm. Having a talk after your child has come home drunk is not the best time. If you are having difficulty talking to your teen, ask a family member or friend that your teen trusts for help. Your teen’s healthcare provider is another place to turn. Their advice and guidance on diabetes care for your teen should always be followed.

 

If your teen decides to drink, they should understand how alcohol affects their blood sugar. Though there might be a temporary spike in blood sugar levels, drinking alcohol usually causes blood sugar to go down. Hypoglycemia (or low blood sugar) occurs because the liver kicks in and works on ridding the body of the alcohol first, and is slower to release glucose into the system causing low blood sugar. According to the Diabetes Teaching Center at the University of California, San Francisco, it takes approximately 1 – 1 ½ hours for the liver to process one drink. It’s during that processing time when people with diabetes are at risk for low blood sugar. If you have two drinks, you would be at risk for 2 – 3 hours. The more drinks you have, the length of time you are at risk for low blood sugar is longer.

 

An article from Diabetes UK provides additional information that parents can share with their teen to help keep them safe if they decide to drink:

  • Eat before drinking alcohol, and eat some carbohydrate-containing snacks such as a sandwich or chips while drinking.
  • Tell a trusted friend that they have diabetes and how to treat low blood sugar if it occurs.
  • Alternate alcoholic drinks with water or other sugar-free drinks to avoid dehydration.
  • Wear a diabetes ID bracelet or necklace, because low blood sugar can be mistaken for drunkenness.
  • Eat before going to bed after a night of drinking. Alcohol stays in the system for a while, so low blood sugar can occur after going to sleep. Eat something with fat and protein, such as chips with dip, cheese, nuts, etc.
  • Test frequently when drinking. If your teen vomits, the College Diabetes Network suggests that he or she should test at least once an hour for several hours while drinking non-alcoholic beverages and eating some crackers, cereal, bread, etc. If your teen is not able to keep food down and hypoglycemia occurs, they should follow their diabetes care plan to raise blood sugar. If nothing is working, someone should call 911.
  • Be aware of contraindications of pain relievers while taking diabetes medication or using a continuous glucose monitor. Acetaminophen can cause monitors to read inaccurately for several hours.

We hope our kids make the right decisions. But when they don’t, we can help them by making sure they know what to do to stay safe.

 

Michigan State University Extension has many other articles that address topics related to type 1 diabetes in children and teens, such as symptoms of type 1 diabetes in children.

 

This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).

Type 1 diabetes children and sleepovers

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Some things to consider when your type 1 diabetic child is ready to start sleeping away from home.

By Erin Carter, Michigan State University Extension

 

As children gain more independence and have a stronger need to be away from home to spend time with friends, sleepovers become a customary part of children’s experiences. Sleepovers can cause concern among parents with the worry of not monitoring every moment of their child’s day and night. It takes parental adjustment to allow children to begin to have this freedom.

 

A parent’s job is to have their child eventually leave the nest making healthy life choices for themselves and the people they come into contact with. Sleepovers offer time away from the watchful eyes of parents to begin to practice decision-making skills important to the development of individuality. Many parents have personal guidelines they follow to allow a sleepover at another family’s home.

 

The typical personal guidelines or rules families have regarding a sleepover are more complicated when the child considering a sleepover is type 1 diabetic (T1D).  It is possible for T1D children to have the same experiences children without the illness experience.  There are considerations to be in place when a sleepover is in the works between T1D children and their friends.

 

The American Diabetes Association (ADA) is a reliable resource for T1D families for the concerns of working through a chronic disease such as diabetes. Starting with the host family being aware of the issues associated with diabetes is a good place to start. A conversation and training session may be of great importance so all feel at ease. It is best to keep routines consistent when away from home and blood sugars can change (hypoglycemia, hyperglycemia) with the excitement and activity of being with friends overnight. There are signs and symptoms of hypoglycemia and hyperglycemia for an adult in charge of a sleepover with a T1D child in the mix to be aware. A discussion of these signs and symptoms should happen prior to the party. It will be easier to recognize changes and the need for a blood glucose reading. Along with a discussion, a print out of these signs and symptoms can be given to the host family for their review and to carry with them.

The ADA gives guidance about the demonstration training of the adult in charge prior to the sleep over:
  • Checking blood glucose levels
  • Counting carbs or stick with the food plan
  • Checking and giving insulin
  • Treating highs and lows
  • Responding to an emergency- especially when it requires glucagon
  • Helping the adult in charge to know what your child can eat and how that relates to his diabetes care.  If possible, create a menu with your child so that you all can agree on meals, snacks and insulin doses ahead of time.
  • You may want to request a text or phone call for an update during the evening to know how things are going with the diabetes management.

As the day of the sleepover gets closer, and it is time to pack your child’s diabetic supply bag the ADA has some advice of things to remember. First, pack twice the amount of diabetes supplies you think your child will need.

The packing list should include:
  • Insulin
  • Syringes
  • Blood glucose testing supplies
  • Pump and/or continuous glucose monitor (CGM) supplies
  • Ketone testing strips
  • Glucagon
  • Glucose tablets or fast-acting sugar to treat low blood glucose
  • A medical ID card (your child should always wear a medical ID bracelet)
  • Day and night phone numbers for your D-team
  • All your contact numbers
  • Batteries
  • Snacks like peanut butter and crackers
  • First aid kit
  • Anti-diarrhea pills
  • Anti-nausea drugs

There are many concerns when parenting a child with diabetes, but it is important to have diabetic children have the experiences letting them try to have diabetes be at the forefront of their thoughts. It is hard enough to deal with having a chronic disease when you are the adult, but when children are trying to fit in and make friends, diabetes can be even tougher. Michigan State University Extension has many programs to help people diagnosed chronic disease and the prevention of disease. Find a program fitting your health needs at the website or Facebook page.

 

This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).

Active living and diabetes

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Walk Your Pet — Pets love to go outdoors, even on miserable weather days.

By Gretchen Stelter, Michigan State University Extension

 

The Centers for Disease Control and Prevention recommends physical activity to help control type 2 diabetes. This does not mean you have to endure more workouts, but incorporating activities into your daily routine will help. As always, talk to your health care provider before you change any daily routine that may affect your diabetes.

 

Focus on Movement: Forget the term exercise and replace it with movement. Thirty minutes of movement in 10-minute blocks is great. So, how can you do this?

  • Stroll With a friend: Time passes quickly as you strike up a conversation while walking.
  • Clean Your Home: To boost your calorie burn, dust, vacuum or scrub floors, to music: this will make you move faster and enjoy the chores more.
  • Walk Your Pet: Pets love to go outdoors, even on miserable weather days. Many times, they will take you on a nature adventure!
  • Gardening: You will use muscles you are surprised you have with all the digging, watering and stretching. Keep using them and as time goes by the muscles will not hurt.
  • Parking: If safe, park in the space furthest from the building. Those extra steps definitely add up!
  • Track Your Steps: Many phones have “FIT” apps on them or find a pedometer. You will feel more motivated as those steps add up and you will find you have a little completion with yourself.
  • TV Time Movement: During every commercial break get up and move. Stretch, dance or walk around the house. Do jumping jacks or march in place while watching the commercial. In one hour of TV you can accomplish 20 minutes of movement!

Everyone wants to be healthier. “Exercise and controlling your weight will help. If you have a goal to lose 5 percent of your body weight, this 5 percent will reduce health risks that are factors with diabetes such as heart disease, high blood pressure, and the action of insulin.” According to the CDC, you not only will have the above health benefits, but also the energy to do more activities.

 

With the onset of spring, try new activities. The fresh air, walking, visiting with friends and spring-cleaning will give you a new positive attitude and help control your diabetes.

 

This article was published by Michigan State University Extension. Reprinted with permission. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888.678.3464).

Catherine’s Health Center receives $20,000 grant from CVS Health Foundation

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By WKTV Staff

 

The CVS Health Foundation — a private charitable organization created by CVS Health — in partnership with the National Association of Free and Charitable Clinics (NAFC) has awarded a total of $30,000 in grants to Catherine’s Health Center (CHC) and Holland Free Health Clinic to help patients with diabetes and other chronic diseases, manage and fully understand their conditions.

 

The CVS Health Foundation recently extended its commitment to the NAFC with $1 million in new grants. The Michigan clinics are two of 49 free clinics across the country receiving funding as part of the Foundation’s ongoing effort to make quality healthcare convenient and affordable for more Americans.

 

“The rising cost of healthcare can make finding quality and affordable care harder to come by for many Americans,” said Eileen Howard Boone, president of the CVS Health Foundation. “Through our support of the National Association of Free & Charitable Clinics, we’re able to increase access to quality care, improve chronic disease management and care coordination to help improve health outcomes for the most vulnerable patients and reduce health care costs in the communities we serve.”

 

Its $20,000 grant will allow Catherine’s Health Center in Grand Rapids to fund Partners in Health, a program that will support patients with chronic diseases such as diabetes and hypertension with tools that will help them achieve better health outcomes. Patients learn the risks of their disease and participate in the development and coordination of their plan of care. Participants may also receive resources such as scales, home blood pressure and blood sugar monitors and needed medications, as well as connect with medical professionals to provide care and support.

 

“We have patients who haven’t had access to healthcare for a long time and come to us with very complex issues and multiple diseases,” said Karen Kaashoek, Executive Director of Catherine’s Health Center. “The grant will support the role of RN Care Manager to coordinate care before, during and after their visit, maximizing our provider time and empowering patients to take control of their health.”

 

Holland Free Health Clinic (HFHC) will utilize its $10,000 grant to support the clinic’s Diabetic Support & Education program, which is designed to equip patients with the knowledge and tools they need to live healthy lives.

 

The new funds bring the Foundation’s total contribution to NAFC to more than $4.5 million since 2015. To date, CVS Health and its Foundation has contributed nearly $300,000 in grants, event sponsorships, foundation scholarships, gift cards and product donations, among other initiatives and items, to nonprofits in the state of Michigan that align with the company’s purpose of helping people on their path to better health.

 

For more information on how the Free and Charitable Clinics will be utilizing their grants to improve community health, please visit www.cvshealth.com/NAFC.

 

Local physician completes first U.S. case for end-stage critical limb ischemia

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Metro Health – University of Michigan Health physician, Jihad A. Mustapha, MD, FACC, FSCAI, is the first in the U.S. to complete treatment on a patient utilizing the LimFlow Percutaneous Deep Vein Arterialization (pDVA) System. The investigational device is used for the treatment of end-state critical limb ischemia (CLI) after all other efforts have been exhausted.

 

CLI can be a painful and limb-threatening for individuals who develop it. Common characterizations of CLI include pain at rest, ulcers, or gangrene in one or both legs stemming from arterial disease. Diabetics, smokers, and older individuals are among those with the highest rates of CLI.

 

“The only other disease with worse life expectancy than CLI is pancreatic cancer,” Mustapha, the study’s primary investigator, said. “Because of the mortality rate associated with amputations due to ischemia, a new approach to treat CLI is needed now more than ever. In the LimFlow study, we hope to help patients with no other options that are on their way to amputation.”

 

The procedure completed by Mustapha in July is the first case in the U.S. as part of an international feasibility study of the LimFlow system. The study is a multi-center, prospective, single-arm study conducted at three U.S. centers.

 

“The medical treatments being done at Metro Health – University of Michigan Health are pioneering,” said President and CEO Mike Faas. “I am so proud of the work of Dr. Mustapha, and all of those who comprise our Heart & Vascular team. They are so passionate about the work that they do—and are willing to push the level of care to new heights if it will safely and effectively increase the quality of life for patients.”

 

“I’m delighted that Metro Health – University of Michigan Health can lead the way in pioneering new treatments for patients,” Mustapha said. “This would not be happening here were it not for the vision of Mr. Faas, our president and CEO. Seven years ago we began work to fight the epidemic of CLI. In that time, our amputation prevention program has grown like no other in the country because the leadership at Metro believed in the pioneering work we were doing, and they recognized this work is improving the health and wellbeing of our community.”

Metro Health hosts free screenings for peripheral artery disease Saturday

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peripheral_arterial_diseaseCold feet. Cramping in the legs. Legs falling asleep. These are all signs of peripheral artery disease or PAD.

 

This Saturday, Oct. 1, Metro Health Hospital will be hosting free screenings for PAD. The screenings are painless, usually involving taking a person’s blood pressure in the arms and ankles, with the screenings taking about 30 minutes. Screenings are available from 8 a.m. to 12:30 p.m. at Metro Health Hospital, 5900 Byron Center Ave. SW. Space is limited and registration is required. To register call, 616-242-4880 or visit metrohealth.net/pad.

 

“Peripheral artery disease is where there is blockage and plaque buildup in the arteries that supply blood to the legs,” said Dr. Fadi Saab,  who specializes in cardiovascular disease at Metro Health, during a recent interview. Saab said the same can happen in the arteries to the heart or brain with people having PAD being a higher risk for cardiovascular disease.

 

People who have PAD usually have other health issues such as hypertension, diabetes, or high cholesterol, Saab said. Those at-risk include those over 50 with diabetes, those who are obese or those who have a family history of heart disease. High blood pressure, high cholesterol, smoking, other circulatory problems and a family history of PAD also put patients at advanced risk. Those who are African-American and Native-American also are at a higher risk.

 

The free PAD screenings can help high-risk patients learn about the disease early enough so they can make lifestyle changes to help their circulatory system. The goal is to detect issues early enough in patients to reduce the risk of amputation.

 

legs_of_womanAnyone experiencing leg cramping or pain with walking or leg pain at rest should get screened. Slow-healing wounds or sores on legs or feet also call for a screening.

 

Results will be provided to the participant to take back to their physician for further review. For more information, visit the Metro Health website.