Monday, December 31, 2012

Those With Particular Virus Likely to Get Diabetes

A new study from the Netherlands suggests that those who have been infected with the cytomegalovirus were twice as likely to have Type 2 diabetes. Cytomegalovirus is a type of herpes which is found in 50 to 80% of adults over the age of 40. Most people show no symptoms of the infection.
The findings suggest that cytomegalovirus plays a role in the development of Type 2 diabetes in the elderly. However, it is an association, not a cause-effect link. While the research is interesting, studies following the participants in time to see if the virus causes Type 2 diabetes are needed. The study was also performed with elderly participants and may not apply to other segments of the population.
Previous studies have linked cytomegalovirus to Type 1 diabetes, but previous studies comparing the virus with Type 2 diabetes have had inconsistent results. One previous study looked at adults aged 45 to 84 and found no link. In this study, information was analyzed from 549 elderly adults in the Netherlands, 80% of which were infected with cytomegalovirus, and 15% had Type 2 diabetes. 17% of those with the virus had Type 2 diabetes, compared to 7.9% without the virus.
The researchers speculated that cytomegalovirus may predispose patients to Type 2 diabetes by harming cells of the pancreas. The virus may also increase diabetes risk after years of infection. On the other hand, it's possible that Type 2 diabetes impairs the immune system, allowing the virus to infiltrate. This explanation is not likely however, as most people are infected with cytomegalovirus as children.
If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.




Thursday, December 27, 2012

Diabetic Recipe of the Week: Cupcakes With Chocolate Mint Frosting

Makes: 16 cupcakes
Serving Size: 1 cupcake
Preparation Time: 30 minutes
Cooking Time: 18 minutes
Cooling Time: 30 minutes
Ingredients
2 cups cake flour (such as Softsilk or Swans Down)
1 cup Splenda
1 Tbsp. baking powder
1/4 tsp. baking powder
1/4 tsp. salt
1 cup fat-free milk, divided
1/2 cup canola oil
1 tsp. vanilla
4 egg whites
4 tsp. crushed sugar-free peppermint candies
Chocolate Mint Frosting
2 oz. unsweetened baking chocolate
3 Tbsp. light buttery spread (such as Promise Activ)
1 1/4 cups powdered sugar
1 egg white
1 tsp. peppermint extract
Preparation
1. Preheat the oven to 350 degrees. Line a muffin tin with cupcake liners, using more than one pan if necessary to make 16 cupcakes.
2. In a large bowl, mix together the flour, Splenda, baking powder, and salt.
3. Add in 2/3 cup of the milk, oil, and vanilla and beat for 2 minutes on medium speed of an electric mixer. Add in the egg whites and remaining milk and beat for 2 minutes on medium speed.
4. Pour the batter into the prepared cups. Bake for 18 minutes until a toothpick inserted into the cupcake comes out clean. Remove from the oven and let the cupcakes cool in the pan for 5 minutes. Turn out of the pan and transfer to a cooling rack to cool completely.
5. Frost with 2 tsp. of the Chocolate Mint Frosting and sprinkle with 1/4 tsp. crushed peppermint candy.
Chocolate Mint Frosting
1. In a double boiler over simmering water, melt the chocolate and butter. Add the powdered sugar, egg white, and peppermint extract and mix.
2. Fill a mixing bowl half with ice cubes, add water to cover. Transfer the top of the double boiler and set in the bowl of ice water. Beat the frosting with an electric mixer until the frosting is of spreadable consistency. Remove the frosting from the top of the double boiler to a bowl, cover, and set in the refrigerator for 1 hour, until thick. Spread 2 tsp. frosting on each cupcake.

If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.
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Monday, December 24, 2012

FAQs About Type 1 Diabetes

What are the warning signs of Type 1 diabetes?
Symptoms of Type 1 diabetes include: extreme thirst, frequent urination, tiredness, increased appetite, unexpected and sudden weight loss, sudden vision changes, fruit odor on breath, heavy or labored breathing, and stupor or unconsciousness. These may occur suddenly. If you or someone you know is experiencing these symptoms, call a doctor immediately. If left untreated, Type 1 diabetes can be fatal.
How is Type 1 diabetes treated or managed?
Because the body of someone with Type 1 diabetes doesn't produce insulin, it has to be replaced by other means. At present, it is usually given by regular injections or by a continuous infusion system, such as from an insulin pump. A healthy diet and physical activity, promoting growth and normal weight, are seen as a crucial part of the treatment, in addition to insulin injections. Regular monitoring of blood glucose levels is necessary so that insulin can be adjusted for food and activity levels. The aim of the treatment is to maintain the blood glucose level within the normal range for as much time as possible. Basic information on how to control Type 1 diabetes is normally given at the time of diagnosis.
An important element of Type 1 diabetes management is to have regular check-ups to establish how the body is coping. In addition, there will be an annual check-up at the hospital where comprehensive tests will be carried out. This annual check-up will also include a discussion of how Type 1 diabetes is affecting daily life and an opportunity to ask questions.
What is the optimal blood glucose range?
Check with your doctor about the individual blood glucose you should aim for. In general, optimal blood glucose goals are:
  • Before meals: 4-7 mmol/L
  • Before bedtime: 6-10 mmol/L
You may need to consult your doctor and change your treatment plan if:
  • Blood glucose is consistently lower than 4 mmol/L or higher than 10 mmol/L before meals.
  • Blood glucose is consistently lower than 6 mmol/L or higher than 12 mmol/L before bedtime.
  • Blood glucose levels may be modified for children and others who are at greater risk of hypoglycemia.
What is the honeymoon phase?
In a person who has Type 1 diabetes, the insulin producing beta cells in the pancreas are destroyed. However, during the period immediately following diagnosis people must go through a honeymoon phase in which their existing beta cells still function, producing some insulin. A number of research projects are currently underway, which hope to preserve the function of these existing beta cells past the honeymoon phase.
What foods should a person with Type 1 diabetes eat/avoid?
People with Type 1 diabetes can eat most foods and don't require any special foods. The 'diabetic diet' only needs to be a healthy diet that provides easily controllable and accessible fuel for your body. Limiting the amount of fat eaten is important for those with diabetes, because high cholesterol and diabetes are two of the four risk factors for developing heart disease.
These are some other tips about what to eat and avoid:
  • Rather than frying foods, bake, grill, poach, or saute them in non-stick pans.
  • Vegetables can be steamed or microwaved.
  • Buy tinned fish in water instead of oil and tinned fruit in fruit juice instead of syrup.
  • Dairy products such as butter, milk, cheese, yogurt, and ice cream, are fine for people with diabetes, but lower fat versions will help make managing the condition easier.
  • Low-fat meats such as turkey, fish, and chicken are better for you than red meat, which is high in fat. Remember to remove the skin before cooking.
  • Change diets based on animal protein to one that is rich in complex carbohydrates, such as starches that are found in breads, cereals, starchy vegetables, legumes, rice, and pasta.
  • When possible choose whole grain equivalents of foods such as cereals, breads, brown rice, bulgur, and barley. 
  • Eat plenty of fresh vegetables and fruits, complete with the skins. Avoid overcooking vegetables.
How will Type 1 diabetes affect my life?
The initial response to a diagnosis of Type 1 diabetes is often extremely emotional. It is not uncommon to experience emotions such as shock, anger, denial, guilt, sadness, and despair. Parents and caregivers will often feel these emotions more keenly and more immediately than the child.
At the same time as the emotional impact, there are a lot of practical issues that have to be dealt with. In the short term there is a lot of new information to take on board. There are also new skills to learn such as injecting, monitoring, and choosing foods.
In the longer future, there may be fears for the future, including the long-term health consequences of having Type 1 diabetes. Learning as much as possible and talking to others with the condition will increase your feelings of control and choice. Although daily life will always be more complicated, by managing Type 1 diabetes, many people have proved that it is no barrier to living an active, healthy, and fulfilling life.
Parents and caregivers may want to find a way to meet their emotional needs or to increase their resourcefulness at a time of intense change. One way might be to join an organization where they can meet others in the same situation or join in with activities such as helping to promote diabetes awareness or research for a cure.
How did my child/I get Type 1 diabetes?
Type 1 diabetes is an ancient condition documented as far back as 1500 BC. While we know so much more about Type 1 diabetes than we did then, there is still much we do not know. To find and understand the cause of Type 1 diabetes more research is needed.
Currently, it is thought to be caused by an auto-immune response that may be triggered by a viral or other infection, which damages the insulin producing cells in the pancreas. This in turn will eventually lead to Type 1 diabetes.
However, because the precise causes of Type 1 diabetes are not known and there is a much greater awareness of Type 2 diabetes, many myths about Type 1 diabetes are in circulation. Type 1 diabetes is not caused by eating the wrong foods or too much sugar. In fact, it isn't caused by anything the child or parent did or didn't do.
Is Type 1 diabetes hereditary?
Some people are unsure whether Type 1 diabetes is hereditary or not. While 90% of people who develop Type 1 diabetes have no relative with the condition, genetic factors can predispose people to developing Type 1 diabetes. Certain genes called HLA markers are associated with Type 1 diabetes risk. A child born with such markers will have the same risk of developing Type 1 diabetes as a child with siblings with Type 1 diabetes. However, having the HLA marker alone is not enough to cause someone to develop Type 1 diabetes- it is thought that an additional trigger causes Type 1 diabetes to develop.
How long will I/my child have Type 1 diabetes? Can be it outgrown?
At the moment there is no cure for Type 1 diabetes and it is a lifelong condition.
What is the life expectancy of someone with Type 1 diabetes?
The life expectancy of someone with Type 1 diabetes is on average 15 years shorter than someone not affected by the disease. There is no such thing as an average person with Type 1 diabetes however, as each person's experience of living with the condition is different. Type 1 diabetes is difficult to deal with and the potential consequences are extremely concerning, but research has already led to great improvements in treating Type 1 diabetes and quality of life. Future advances in technology and continued research will eventually result in Type 1 diabetes being curable.
How common is Type 1 diabetes?
In the United States 5% of people with diabetes, roughly 26 million, have Type 1 diabetes. 97% of diabetes cases in children are Type 1 diabetes. Type 1 is five times more common than bacterial meningitis, and more common than cancer, cystic fibrosis, muscular dystrophy, and multiple sclerosis.
If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.

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Thursday, December 20, 2012

Diabetes and the Holidays

From Parade Magazine, December 16, 2012, Page 12.
For the nearly 26 million Americans with diabetes, making the right choices at the holiday buffet is a serious matter. As party season gets under way, test your knowledge with our short quiz.
1. You're attending a neighborhood potluck party. Which hors d'oeuvre staples is your best bet?
a. A handful of nuts.
b. Pigs in a blanket.
c. Cheese and crackers
Answer: A. If your main concern in glucose control, you need to watch out for carbohydrates, which can cause a big spike in blood sugar. Nuts are relatively low in carbs and contain healthy fats and protein. Cheese is your second-best choice, but skip the high-carb accompaniments like crackers or jam.
2. You're meeting friends for holiday cocktails. Which beverage will least affect your blood glucose level?
a.  Beer
b. Wine
c. A gin and tonic
Answer: B. Although beer and tonic water may not taste particularly sweet, both are high in carbohydrates compared to dry, non-sweet wines. But before you indulge, it's important to talk to your doctor, since alcohol and diabetes can be a dangerous mix. Drinking can camouflage the symptoms of low blood sugar, decrease your willpower to make smart food choices, and impair your liver's ability to regulate your blood glucose level. So if you do drink, know your limit and stick to it.
3. Your office holiday party is tonight. The best time to check your blood glucose is:
a. Before the party
b. After the party
c. Both
Answer: C. Yes, it's a pain to drag your glucometer to a party, but it's the only way to tell whether your blood glucose is in a safe range. Try to test shortly before eating and again two hours afterward, says the American Diabetes Association.
If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.

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Diabetic Recipe of the Week: Chicken Pot Pie With Phyllo


Makes: 12 servings
Serving Size: 1 3 * 3 inch square
Preparation Time: 40 minutes
Cooking Time: 45 minutes
Ingredients
2 cups low-fat, reduced-sodium chicken broth
1/2 cup water
1 lb. small unpeeled red potatoes, cut into quarters
3 sprigs fresh thyme
3 medium carrots, diced into 1/2 inch pieces
1 large onion, diced
1 lb. boneless, skinless chicken breasts, diced into 1/2 inch pieces
1 1/2 cups 1% milk
1/2 cup half and half
6 Tbsp. flour
Kosher salt and black pepper
8 oz. frozen peas
8 sheets phyllo dough
Cooking spray
Preparation
1. In a 2 quart saucepan, bring the chicken broth and water to a boil. Add in the potatoes and thyme leaves, and lower the heat to medium. Simmer the potatoes for about 8 minutes or until tender. With a slotted spoon, remove the potatoes and thyme to a bowl. Discard the thyme leaves. Add the carrots and onions to the stock and simmer for 4 minutes. With a slotted spoon, remove the carrots and onions to the same bowl as the potatoes.
2. Add the chicken to the stock and simmer for 3 minutes. With a slotted spoon, remove the chicken to the same bowl as the vegetables. Boil the stock until reduced to a cup.
3. Meanwhile, whisk the milk, half and half, and flour together in a bowl until very smooth. When the stock is reduced, slowly add the milk mixture, constantly stirring until thickened, but still smooth. Add the sauce to the vegetables, and season with salt and pepper. Add in the peas and mix well.
4. Pour the mixture into a 9 * 13 inch pan. Set aside.
5. Prepare the phyllo dough topping. Spread one sheet of phyllo out onto a very lightly floured surface. Be sure to cover the remaining sheets of phyllo with a towel to avoid exposing to air; the phyllo will crack if exposed. Coat with cooking spray. Add another sheet of phyllo on top of the first and cover with spray. Repeat this process until all 8 sheets are done.
6. Carefully lift the phyllo dough stack and place over the chicken and vegetable filling. Tuck the edges under. With a sharp knife, make 3 diagonal slashes across the top of the dough. This will allow steam to escape.
7. Bake the pot pie, uncovered, at 350 degrees for about 30 minutes or until the top is puffed and golden brown. Remove from the oven and let stand for about 5 minutes. Cut into squares.
If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.


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Monday, December 17, 2012

What Is Type 1 Diabetes?

Type 1 diabetes is caused by a problem with the immune system. You cannot prevent it by adopting a healthy diet, exercising regularly, or living a healthy lifestyle. There is currently no cure.
A body that isn't affected by Type 1 diabetes has hormones that will keep blood glucose within a healthy range. Insulin is a hormone that allows glucose to move from the bloodstream into the cells, which can then be used for energy. Someone with Type 1 diabetes will not have enough insulin or insulin at all, meaning that blood glucose will rise or fall outside of the normal levels. When blood glucose becomes too high the body will do whatever it can to try and remove the excess glucose from the blood.
A person with Type 1 diabetes may then experience the following:
  • A need to go to the bathroom more- a body with Type 1 diabetes will try to get rid of the excess glucose through urine. 
  • A need to drink more- if you're going to the bathroom more, you'll become more thirsty.
  • Becoming tired quicker- Type 1 diabetes stops cells getting the energy they need, leading to people affected by the condition becoming exhausted.
  • Weight loss- the body compensates for the lack of energy by breaking down fat stores.
  • A build of up ketones- if the body continues to operate like this toxic ketones will build up in the body. This causes the breath to smell ketotic (like pear drops). More seriously, they cause stomach pain and eventually a loss of consciousness and even death.
The common signs and symptoms of Type 1 diabetes are:
  • More frequent urination.
  • Increased thirst.
  • Tiredness.
  • Weight loss.
  • Ketones.
While it can take years for damage to insulin-producing cells in the pancreas to eventually lead to Type 1 diabetes, the onset of Type 1 diabetes symptoms is rapid, happening over a matter of days and weeks rather than months. If you or someone you know experiences the symptoms of Type 1 diabetes you must seek medical treatment immediately.
If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.

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Thursday, December 13, 2012

Diabetic Recipe of the Week: Pear Cranberry Strudel


Makes: 8 servings
Preparation Time: 10 to 15 minutes
Cooking Time: 25 to 30 minutes
Ingredients
2 (15 oz.) cans light pear slices in juice, drained
1/3 cup frozen no sugar added cranberries, thawed and finely chopped
1/4 cup chopped walnuts
1 Tbsp. Splenda
1/2 tsp. cinnamon
6 frozen phyllo sheets, thawed
2 Tbsp. light margarine spread, melted
4 Tbsp. finely crushed graham cracker, cornflakes, or plain bread crumbs
8 Tbsp. fat-free whipped topping
Preparation
1. Preheat oven to 350 degrees.
2. Combine pears, cranberries, walnuts, Splenda, and cinnamon in a medium bowl and toss well. Set aside.
3. Remove the phyllo sheets from their package and lay them out flat. Cover them with a damp paper towel to prevent them from drying out. Place one phyllo sheet on a flat surface with the long edge parallel to the edge of the surface. Brush lightly with melted margarine and sprinkle lightly with crumbs. Place another sheet on top of the first, brush with margarine, and sprinkle with crumbs. Repeat with the remaining sheets.
4. Place pear filling onto the phyllo, creating a log about 2 inches away from one long edge. Gently roll filling in phyllo and place the rolled log seam side down on a sheet pan coated with cooking spray. Brush strudel lightly with any remaining margarine.
5. Bake strudel for 25 to 30 minutes or until browned and heated through. Let the strudel stand 5 minutes, sprinkle with cinnamon, and slice gently using a serrated knife.
6. Serve strudel with a tablespoon of the whipped topping.
If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.


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Monday, December 10, 2012

New Strategies For Treating Diabetes

Researchers are busy trying to find the best new approaches for treating Type 2 diabetes amid concerns that current treatment options are doing more harm than good.
New guidelines strongly encourage doctors, most of whom consider diabetes to be a public health crisis, to vary their treatments depending on age, general health, and personal preferences of the patient. 
The updated guidelines, published in June in the journal Diabetes Care, recommend doctors push their patients less to get their blood sugar to a standard level. Aiming for a very low blood sugar level might be a good goal for a younger patient, but older patients may do better with a less aggressive approach.
"We need to be less dogmatic about what matters and be open to different approaches and give patients a voice" in their treatment decisions, said Victor Montori, a diabetes specialist for the Mayo Clinic in Rochester, Minnesota, who supports the new guidelines.
Along with the less pushy approach, bariatic surgery has been more and more commonly prescribed for patients with diabetes. The surgery comes with the risk of serious complications, but the operation has been shown in recent studies to lead to a rapid lowering of blood sugar, which sometimes allows patients to go off all or some of their diabetes medications. 
Other professionals are questioning the benefits of gradually stepping up the intensity of drug therapy, which is a widely accepted approach, reaffirmed in the new guidelines. The goal is to maintain a patient's blood sugar level while keeping up with the progressive nature of the disease. Researchers at the UT Southwestern Medical Center in Dallas argue the opposite is true: hit diabetes hard and early. 
There have been conflicting findings over the benefit for patients of keeping blood sugar strictly controlled, helping to fuel uncertainty about how to best treat the disease. Many popular drugs come with side effects, including weight gain, bone loss, and even a small risk of certain cancers. And some data shows that aggressive efforts to achieve glucose control can lead to troubling episodes of low blood sugar called hypoglycemia or to increased risk for serious heart related problems. There is a lack of data to show whether available drugs prevent or delay complications of diabetes. 
"The goal for treatment and the choice of individual drug must be personalized depending on the patient," said Vivian Fonseca, the ADA's president for science and medicine and chief of endocrinology at Tulane University Health Sciences Center in New Orleans. 
The first line of therapy for newly diagnosed Type 2 diabetics is to improve diet and exercise habits to reduce blood sugar levels. Usually metaformin, a basic diabetes medication, is prescribed. Those with mild cases of elevated blood sugar levels should try to reform their diet and exercise on their own for six months to see if they can control the disease before taking medication. 
Blood sugar is considered under control when the patient's A1c level is under 7%. Newer, motivated, and younger patients should aim for an A1c closer to 6%, which is expected to keep the disease from progressing. Older patients with severe hypoglycemia or who may already have cardiovascular disease should try to aim for 8%, which should reduce the burden of side effects from medications.
Those who fail to comply with the doctor's first line of defense calls for the doctor to add a second drug. There are few trials comparing drugs against each other on long-term benefits and the new guidelines encourage doctors to discuss with patients the pros and cons of each drug. The Mayo Clinic, for example,  has developed an online tool for patients that takes account of such factors as weight change, cost, low blood sugar risk, blood testing requirements and side effects. Patients for whom weight gain is a concern should stay away from drugs where that is a side effect. 
Patients typically progress through three or four tiers, adding insulin injections to control their blood sugar. Researchers at UT Southwestern Center argue that such a graduated treatment strategy does little to change the disease process and means that patients' own insulin producing-beta cells remain continuously exposed to high blood sugar. 
In the study presented in June, reseacher Ildiko Lingvay said that two types of more aggressive treatments using insulin and drugs started when patients were initially diagnosed, effectively preserved the function of beta cells in a study of 58 patients who were followed for three years. The treatment included three months of insulin injections combined with metaformin for all patients. Patients were then randomly assigned to either the same treatment or a combination of three oral drugs, which continued for more than three years. The limitations of the study included the small number of patients and the lack of control group that was followed with standard therapy to compare benefits and side effects. 
"At our institution we treat patients intensively from the time of diagnosis. We have no question this pays off in the long term," said Dr. Lingvay. 
Other research efforts to treat patients early with insulin have had mixed results, with patients on both regiments at UT Southwestern gaining weight.
Gordon Weir, researcher at Harvard-affiliated Joslin Diabetes Center, Boston, believes in a strategy using short-term insulin treatment of a couple of weeks to several months to push blood sugar levels back to safer levels. However, diabetes "is a terribly difficult problem. If we had a great treatment for obesity, that would make a huge impact."
If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.

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Thursday, December 6, 2012

Diabetic Recipe of the Week: Holiday Carrot Soup


Makes: 12 servings
Serving Size: 1 cup
Preparation Time: 25 minutes
Cooking Time: 55 minutes
Ingredients
2 Tbsp. olive oil
2 large onions, thinly sliced (about 3 cups)
3 lbs. carrots, peeled and cut into 1 inch pieces
3 oz. fresh cilantro (about 3 cups), washed, stemmed, and chopped
1 Tbsp. ground coriander
1/4 tsp. kosher salt
1/2 tsp. ground black pepper
8 cups low-fat, reduced-sodium chicken broth
1 1/2 Tbsp. unsalted butter
1/3 cup slivered almonds
1/2 cup plain nonfat yogurt
Preparation
1. In a large stockpot, heat the olive oil over medium heat. Add the onions and saute for 7 to 9 minutes. Add the carrots, cilantro, coriander, salt, and black pepper. Cook for about 10 minutes, stirring to prevent sticking.
2. Add the broth, lower the heat, and simmer for 35 to 40 minutes, until the vegetables are tender.
3. Puree the soup in batches and return to the stockpot to remain warm. Or, remove the pan from the heat and carefully use an immersion blender; then return the pan to the burner to keep the soup warm. Add the butter and stir until melted.
4. In a small, dry skillet, toast the almonds over medium-high heat for 2 to 3 minutes, just until they are lightly browned. Garnish each soup bowl with a drizzle of yogurt and a sprinkle of the toasted almond slivers.
This recipe is from Diabetes Forecast online.
If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.


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Monday, December 3, 2012

New Insulin Device to Help Diabetics

By combining insulin pumps with continuous blood sugar sensors, people with diabetes get better blood sugar control than those using traditional finger-stick testing and insulin shots, new research suggests. The findings come from an analysis of studies comparing new technologies to traditional methods for monitoring and controlling blood sugar.
The studies find that old-fashioned insulin injections control blood sugar just as well as insulin pumps. But most studies find that people get better results by combining the pumps with new blood sugar monitoring devices.
Patients who used continuous glucose monitors to automatically track blood sugar had better blood sugar levels than people who used finger stick testing alone. However, the two methods were equally effective at keeping blood sugar from dropping to dangerously low levels. Insulin pumps were no more effective for controlling blood sugar than self-injection in most studies, but people tended to prefer the pumps over giving themselves shots many times a day. Those who used insulin pumps with coordinated, real-time continuous monitoring devices achieved better blood sugar control than people who use finger-stick testing and shots alone.
"When we compare the new to the old, we saw a much greater improvement in glucose control when the newer devices were used together," said study author Sherita Hill Golden, MD, MHS of Baltimore's Johns Hopkins University School of Medicine.
About 26 million Americans have diabetes, and that number is growing each year. Those with Type 1 and Type 2 diabetes require treatment with insulin to control blood sugar levels and reduce the risk of complications, which include foot ailments, especially the risk of amputation.
New technologies have given people with diabetes who used insulin more options to manage their diabetes, but it is not clear whether these expensive new devices actually improve the patient's health. "Health professionals and their diabetic patients need objective information when making decisions about the use of technologies that may be expensive or heavily marketed," said Golden.
Their analysis included data from 33 trials comparing continuous glucose monitoring with insulin pumps to conventional ways of monitoring and controlling blood sugar levels in people of all ages.
Continuous monitoring devices give blood sugar readings as often as every five minutes, using a sensor attached to the body. The sensor sends results to a display, which is usually worn on a belt. The device doesn't replace home glucose monitoring but can more closely track minute-to-minute changes in blood glucose. Patient still need to prick their fingers up to four times a day, but those who rely on finger pricks alone may need to stick themselves as many as 10 times a day.
The benefit of the insulin pumps is that it offers continuous insulin through a catheter placed under the skin around the belly. The pump replaces daily injections, although patients still have to make decisions about how much insulin they need.
The analysis found that insulin pumps and daily injections are similarly effective for controlling blood sugar, leading the researchers to conclude that decisions about which method to choose should include consideration of patient preference, quality of life, and expense.
Diabetes specialist Stuart Weinerman, MD, says some of his patients love the new devices, while some do not. "Some people can't stand the idea of wearing a device all the time, whether it is a pump or a glucose monitor. Others love the high-tech nature of the new devices and the fact that they have a lot more flexibility," Weinerman said.

If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.

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Thursday, November 29, 2012

Diabetic Recipe of the Week: Cranberry and White Chocolate Treats

Serves: 48
Serving Size: 1 square
Ingredients
1 1/3 cups low-fat graham cracker crumbs
2 Tbsp. sugar
5 Tbsp. butter, melted
1/2 cup dried cranberries
1/3 white chocolate chips
1/3 cup chopped walnuts
1/2 cup natural wheat and barley nut-type cereal
1 can (14 oz.) fat-free sweetened condensed milk
Preparation
1. Preheat the oven to 350 degrees.
2. In a 13 by 9 by 2 baking pan, combine the graham cracker crumbs, butter, and sugar and press along the bottom of the pan. Sprinkle cranberries, white chocolate chips, walnuts, and cereal over the graham cracker crust.
3. Pour the condensed milk over the top and bake for 20 to 25 minutes, or until bubbly. Cut into squares to serve.

If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.

Monday, November 26, 2012

Secondhand Smoke Linked to Type 2 Diabetes and Obesity

Adults who are exposed to secondhand smoke have higher rates of obesity and Type 2 diabetes than do nonsmokers without environmental exposure to tobacco smoke. The findings were presented June 24th 2012 at The Endocrine Society's 94th Annual Meeting in Houston.
"More effort needs to be made to reduce exposure of individuals to secondhand smoke," said study co-author Theodore C. Friedman, MD, PhD., chairman of the Department of Internal Medicine at Charles R. Drew University, Los Angeles.
Studies have shown an association between cigarette smoking and an increased rate of Type 2 diabetes despite the fact that most smokers are leaner than nonsmokers and obesity is a risk factor for Type 2 diabetes. Although some studies have suggested a relationship between Type 2 diabetes and secondhand smoking, Friedman said these studies have not verified exposure to secondhand smoke through blood levels of cotinine, which is a metabolite of nicotine, which measures a person's exposure to tobacco smoke.
In this current study, Friedman and his fellow researchers used cotinine levels to verify secondhand smoking. They examined data from more than 6,300 adults who participated from 2001 to 2006 in the National Health and Nutritional Examination Survey, a nationally representative sample of the US population. The investigators defined current smokers, which made up 25% of the sample, as survey participants who reported that they smoke cigarettes and had a measured cotinine level greater than 3 nanograms per milliliter. Nonsmokers, which made up 41% of the sample, were those who answered a "no" to the question "Do you smoke cigarettes?" and who had a cotinine level of .05 nanograms per milliliter. Those whose cotinine levels were above .005 nanograms were considered secondhand smokers.
The researchers controlled for age, sex, race, alcohol consumption, and physical activity. They found that, compared with nonsmokers, secondhand smokers had a higher measure of insulin resistance, a condition that can lead to Type 2 diabetes; higher levels of fasting blood glucose, or blood sugar, and a higher hemoglobin  A1c, a measure of blood sugar control over the last three months.
Secondhand smokers also had a higher rate of Type 2 diabetes, as defined by a A1c greater than 6.5%. Secondhand smokers had a similar rate of diabetes to that of current smokers. Their body mass index was high, compared to nonsmokers. Current smokers had a lower BMI than nonsmokers but a higher A1c. When the researchers controlled BMI, they found that both secondhand smokers and current smokers still had a higher A1c than nonsmokers.
"This finding shows that the association between secondhand smoke and Type 2 diabetes was not due to obesity. More studies are needed to show whether secondhand smoke is a cause of diabetes," said Friedman.
If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
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Thursday, November 22, 2012

Diabetic Recipe of the Week: Orange Balsamic Turkey

Makes: 4 servings
Serving Size: 4 oz. turkey, about 1Tbsp. sauce
Preparation Time: 5 minutes
Cooking Time: 17 minutes
Ingredients
3/4 cup fat-free, lower-sodium chicken broth
3 Tbsp. no-sugar added orange marmalade (or peach or apricot)
2 Tbsp. balsamic vinegar
1 tsp. Dijon mustard
1 tsp. cornstarch
1 Tbsp. olive oil
1 lb. skinless, boneless turkey cutlets
1/2 tsp. kosher salt
1/2 tsp. black pepper
1/2 cup diced onion
1 tsp. grated orange zest
Preparation
1. In a small bowl, mix together the broth, marmalade, balsamic vinegar, mustard, and cornstarch; set aside.
2. In a large skillet heat the oil over medium heat. Sprinkle the turkey cutlets with salt and pepper. Saute the cutlets in the olive oil for 4 to 5 minutes more. Remove the cutlets from the skillet, transfer to a plate, and set aside.
3. Add the onion to the pan drippings and saute for 3 to 4 minutes. Stir in the sauce, scraping up any browned bits from the skillet. Reduce the heat to low and simmer for 2 minutes. Return the cutlets and any accumulated juices to the skillet. Simmer for 1 minute. Sprinkle the turkey with the fresh orange zest and serve.

If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.

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