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How can I prevent my child from developing diabetes, which runs in my family?

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By Dr. John Maddox, Pediatrician
Pentucket Medical/ Haverhill

There are two types of diabetes. Type 1 develops in childhood, but it is less likely to run in families. Unfortunately, based on current knowledge, there is not as much a parent can do to prevent type 1. Thankfully, this type is more rare. I’ll add that families that deal with type 1 are some of the most resilient that I have seen as a pediatrician.

Type 2 is more likely to run in families but is also much more preventable. Diabetes, as its core, is about not having enough insulin to help glucose get from the blood stream into the body’s cells to provide energy. The primary key to avoiding type 2 comes from good nutrition. All foods are eventually digested into glucose (also called blood sugar) as our fuel. Foods that are digested slowly allow our body’s pancreas to release insulin slowly, creating a gradual rise and fall of input and output that generates optimal health. Foods that are slowly digested (like an apple) have a low glycemic index; foods that are rapidly turned to sugar (like a potato) have a high glycemic index.

Fascinating new research reveals that a window of taste preference exists for infants ages 6-12 months. A baby might make a face the first few times peas or green beans are offered. However, with 8-10 days of persistence, we can successfully prime their palate for a healthier lifetime ahead.

Pentucket Medical Associates’ Diabetes Team receives recognition status from The American Diabetes Association

Posted on by Pentucket Medical

 

Certified Diabetes Educators Granted Education Recognition from The American Diabetes Association

The Certified Diabetes Educators at Pentucket Medical Associates have been granted Education Recognition again for their performance in meeting national standards for providing quality Diabetes Self-Management Education and Support.

Continue reading “Pentucket Medical Associates’ Diabetes Team receives recognition status from The American Diabetes Association” →

The Importance of Paying Attention to Prediabetes

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Written by Marcia Sikorski, RD, LDN, CDE; member of PMA Diabetes Education Team

Diabetes awareness is becoming a focal point to help reduce the consequences of the disease and to provide information about its management and prevention. Prediabetes is the red flag waving to tell you that you are on the path toward diabetes. There is good news about this waving flag, if you take action at this stage you may never experience the many complications of diabetes. Continue reading “The Importance of Paying Attention to Prediabetes” →

Healthy Holidays: Spinach-Roasted Red Pepper Dip

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Ingredients:

✦1⁄2 cup shredded part- skim mozzarella cheese

✦ 1⁄2 cup plain low-fat or fat-free yogurt

✦ 1⁄2 cup light mayonnaise dressing or salad dressing

✦ 1⁄4 cup grated Parmesan cheese

✦ 1 tablespoon all-purpose flour

✦ 1 teaspoon Dijon-style mustard

✦1 cup loosely packed fresh spinach leaves, coarsely chopped

✦3⁄4 cup bottled roasted red sweet peppers, drained and chopped

✦1⁄4 cup thinly sliced green onions

✦3 red and/or yellow sweet peppers, seeded and cut into strips, or desired dippers

Directions:

1. Preheat oven to 350°F. In a large bowl, stir together mozzarella cheese, yogurt, mayonnaise dressing, 2 tablespoons of the Parmesan cheese, the flour, and the Dijon mustard.

2. Stir in the spinach, roasted red peppers, and 2 tablespoons of the green onions. Spread the cheese vegetable mixture evenly into a 1-quart ovenproof shallow dish or a 9-inch pie plate. Sprinkle with the remaining 2 tablespoons grated Parmesan cheese.

3. Bake the dip, uncovered, for 15 to 20 minutes or until the edges are bubbly and the mixture is heated through. Sprinkle with the remaining 2 tablespoons green onions. Serve with red and/or yellow sweet pepper strips. Makes 21⁄4 cups.

NUTRITION FACTS PER SERVING: Calories: 21, Total Fat: 2 g (0 g sat. fat), Cholesterol: 3 mg, Sodium: 47 mg, Carbohydrates: 1 g, Fiber: 0 g, Protein: 1 g.

What Tests Should I be Running Regularly if I have Diabetes?

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Diabetes can be caused when a person has high blood sugar or because the body isn’t responding properly to insulin. All types of diabetes are treatable, but it’s important to keep an eye on hemoglobin levels, LDL levels and blood sugar levels if you are diabetic.

testingbloodsugar

Self-testing blood sugar levels regularly is extremely important for the following reasons:

  • Prevent long-term complications from diabetes
  • Gauge how well your treatment is working
  • Understand how different diet changes affect your levels
  • Understand how illness affects your blood sugar levels

How often you need to test your blood sugar depends on the type of diabetes you have.

For type 1 diabetes, your doctor may suggest testing your blood sugar levels three or more times a day after meals or exercise. If you are taking insulin for type 2 diabetes, it’s recommended that you test one or more times a day, depending on how much insulin you are using.

Testing Hemoglobin Levels

A hemoglobin A1c test is a test that shows how well diabetes is being controlled. The test provides an accurate estimate of your average blood sugar levels throughout a two or three month period. When used in addition to an at-home blood sugar test, diabetics are able to effectively monitor their diabetes to ensure it’s under control. Normal hemoglobin levels for people with diabetes is around seven percent, which is about two percent higher than someone without diabetes.

Why do I Need to Test Cholesterol when I have Diabetes?

When you have diabetes, you are also at a higher risk of heart disease. Monitoring cholesterol, especially LDL levels, are important when it comes to preventing heart disease later on in life. There are two ways to test cholesterol levels,

including:

  • A non-fasting test which will show total cholesterol level and can also show you HDL levels, which is the “good” cholesterol.
  • A lipid profile, or fasting test, which measures triglycerides, LDL, HDL and total cholesterol.

Contact our office for information on testing blood sugar, hemoglobin and cholesterol levels.

Diabetes Awareness

Posted on by Pentucket Medical

information on diabetes

by Kelly Sinclair, MS, RD, CDE

Type 2 diabetes is a condition characterized by high blood glucose levels caused by either a lack of insulin or the body’s inability to use insulin efficiently. Type 2 diabetes develops most often in middle-aged and older adults but can appear in young people.

Here are just a few of the recent statistics on diabetes:

  • Nearly 30 million children and adults in the United States have diabetes, about 9% of the population.
  • Of the 30 million with diabetes, 8 million people do not yet know they have the disease.
  • Another 86 million Americans have prediabetes a condition in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes.

People with prediabetes are at increased risk for developing type 2 diabetes, heart disease and stroke.

The American Diabetes Association has developed a 5 minute test you can take to check your own risk for Type 2 diabetes. Follow the link below:

http://www.diabetes.org/are-you-at-risk/diabetes-risk-test/

There are things you can do to significantly lower your risk of developing diabetes:

  • Lose 5-10% of your weight. For a 200 pound person that would be 10 to 20 pounds. Weight loss is the number one way to prevent type 2 diabetes.
  • Move your body almost every day. Choose activities that you enjoy and get your heart rate up like brisk walking, jogging, dancing, and swimming. If you haven’t exercises in a while start with 5 or 10 minutes every other day. The goal is 30 minutes 5 days per week. Exercise burns up calories and will help you reach your weight loss goal.
  • Eat 3 non starchy vegetables and 2 fruit servings each day. A serving is about ½ cup. Eating lower calorie vegetables and fruits can help you to lower your weight. Non starchy vegetables (everything except corn, peas, and potatoes) are so low in calories you can eat multiple servings! Add them to every meal to help you feel full.
  • Meet with a certified diabetes educator to help you get started. We are here to help you reach your goals and answer your questions.

Preventing and Controlling Diabetic Foot Problems

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Preventing and Controlling Diabetic Foot Problems

by Joan Hultgren, RD, LDN, CDE

What types of foot problems are more likely seen with diabetes?

  1. Neuropathy (Nerve damage)

Neuropathy is one of the most common foot problems associated with diabetes.

Symptoms can include tingling, pain, burning, stinging and foot weakness. Over time, the nerve damage can lower the ability to feel temperature changes and pain. Without knowing it, burns, cuts or broken skin can occur. Items on the ground can get lodged in the foot and lead to complications.

Additionally the nerve damage can change the shape of the foot. Special shoes designed with wider and higher toe boxes can allow deformed feet from being further damaged.

  1. Callouses

Foot callouses can occur more often and build up faster with diabetes. Callouses, if not trimmed, thicken and turn into open sores (foot ulcers). To avoid burns and infections from doing home foot “surgery” and using over the counter remedies, it is best to have callouses safely removed by a podiatrist.

  1. Skin changes:

    Dry, peeling and cracked skin may occur because the nerves that control the oil and moisture in the foot are no longer working. Healthy skin is one of the ways the body is able to fight infection. Keep feet clean and use lotion.

  2. Poor Circulation:

    Diabetes causes the blood vessels of the feet and legs to narrow and harden making it difficult to fight infection and heal adequately. Feeling may be compromised, leading to difficulty in determining hot and cold sensations.

  3. Foot ulcers:

    Ulcers can form from poorly fitting shoes. They most often occur on the ball of the foot or on the bottom of the big toe. They may or may not hurt. It is extremely important that the ulcer is examined by a health care provider. X-rays may be needed to determine if the infection has reached the bone. Keeping pressure off the foot is key to healing. The foot needs to be cared for long after the ulcer heals.

  4. Amputation:

    Rates are higher with diabetes due to nerve damage and peripheral artery disease, both of which reduce blood flow. Complications requiring amputation can be greatly reduced by controlling blood glucose and blood pressure, and by not smoking.

What can be done to prevent any problems?

  • Work with your doctors and certified diabetes educators to keep blood glucose levels and blood pressure under control.
    • Additional medications, weight loss and exercise will all help.
  • Check feet daily for blisters, redness and cracked skin. Call your healthcare provider immediately if the area looks red, is swollen or worse than the day before.
  • Moisturize the feet with lotion, but limit the amount of lotion in between toes to avoid infection.
  • Wash feet daily, but avoid soaking as this can further dry the feet.
  • Avoid walking barefoot!
  • Walk to improve circulation.
  • Find ways to stop smoking! This will greatly improve circulation.
  • Make an appointment with a podiatrist for foot inspections, nail care, foot appliances and shoes to help limit complications.

 

Written by : Joan Hultgren RD LDN CDE (Certified Diabetes Educator)

Program Coordinator Pentucket Medical Associates
November 2014

Hot Days and Diabetes

Posted on by Pentucket Medical

Diabetes can be challenging to control on a day with comfortable temperatures, but as the temperatures and humidity rise, it can be downright dangerous if the body gets dehydrated. The quick loss of fluid can increase thirst, decrease urine output, result in dark urine, dizziness, excessive sweating, muscle cramping, cool/clammy skin, nausea and vomiting headaches and rapid heartbeat. If left untreated severe dehydration causes confusion, weakness, organ failure and coma.

Those with high blood glucose (sugar) to begin with are more likely to see even higher numbers as the blood becomes more concentrated.

BEST TO KEEP AHEAD OF IT!!

Drink extra non calorie, preferable decaffeinated fluids like water and non calorie flavored seltzer or water throughout the day. Avoid sweetened drinks and large amounts of caffeine! These can be more dehydrating.

Check blood glucose (sugar) numbers more often.

Avoid exercise and strenuous activity in hot weather. Do chores in the morning or later evening as temperatures cool.

Recognize the symptoms of dehydration and act quickly. Delayed treatment can difficult to treat.

Should fever, nausea and vomiting occur it is important to treat as soon as possible. Medications can be given to control symptoms. Drink small, frequent amounts of clear liquids (apple juice, regular gingerale, regular Jell-O, clear soups are all examples of fluids that replace the carbohydrates normally supplied by food)

Emergency services should be called if extreme tiredness, confusion, uncontrolled fever, nausea and vomiting can’t be controlled. Call immediately if seizures occur.

TREAT DIABETES SUPPLIES WITH CARE IN HOT WEATHER TOO!!

Just as the body struggles with hot temperatures, glucose meters, strips and insulin should be protected from the high heat. All products need to be stored in a cooler with an ice pack if in a hot car.

Insulin that is being used can be kept at room temperature for 28 to 42 days (depending upon the product) from when it is opened. If the location is hotter than room temperature, then instead store in a cooler or refrigerator.

KEEP SAFE AND ENJOY YOUR SUMMER!!!

Brought to you by the Diabetes Educators –

Joan Hultgren RD LDN CDE; Kelly Sinclair MS RD LDN CDE ; Marcia Sikorski RD LDN CDE

 

(888) 227-3762

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