Diabetic Recipe of the Week: Feta, Arugula, and Mushroom Bruschetta

Makes: 14 Servings
Serving Size: 1 slice
Preparation Time: 10 minutes
Cooking Time: 10 minutes
Ingredients
1 loaf Italian bread, about 1 lb. preferably whole wheat
4 garlic gloves, 2 peeled and left whole, 2 minced
1 Tbsp. olive oil
3 cups sliced cremini mushrooms
4 cups torn basil leaves, stems removed
Salt and pepper to taste
1 cup reduced fat feta cheese
Bunch baby arugula leaves or baby spinach leaves or large arugula leaves, torn
Preparation
1. Preheat the oven to 400 degrees. Slice the load of bread diagonally into 14 slices half-inch thick. Lay the bread out on a single layer on a baking sheet, and bake for 5 to 6 minutes or until lightly golden. Remove from the oven and rub the whole garlic cloves over one side of each toast.
2. Heat the olive oil in a skillet over medium-high heat. Add the mushrooms and saute for 3 to 4 minutes. Add the minced garlic and cook for 1 more minute. Remove the pan from the heat, and stir in the basil, then season with some salt and pepper. Sprinkle the feta on each slice of bread (spread it if you can). Toss the arugula with the sauted mushroom mixture. Place this mixture over the feta. Return the bruschetta to the oven for 1 minute to blend the flavors.
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.

Greek Yogurt for Diabetics?

Greek yogurt is one of the hottest foods right now, with its pudding-like texture and slightly tart flavor. This type of yogurt has more protein and fewer carbohydrates than its sister varieties. Great news for diabetics is that Greek yogurt can be appropriate for your diet.
Tami Ross, RD, LD, a diabetes educator and vice-president of the American Association for Diabetes Educators says "My patients love the consistency of it. Even the patients who are not big on yogurt or milk products overwhelming seem to like Greek yogurt."
Greek yogurt's thick consistency comes from straining it to remove liquid whey. This process increases the amount of protein per serving and removes some of the carbohydrates, which people with diabetes must watch carefully.
"For folks with diabetes, the lower carbs are a plus," Ross notes. "You can work in the yogurt for a snack without having to account for so many carbohydrates."
The increased protein can also help you feel that you've had a more substantial snack, so you'll feel more satisfied and won't be hungry for something else quite so quickly. "In terms of promoting satiety, and helping people feel full, it's great," Ross says.

Of course, not all Greek yogurts are created equal. With many brands and flavors on the market, it's important to read nutrition labels carefully to find one that will go with a diabetes diet. Carbohydrate content is the most important item to look for on a nutrition label of Greek yogurt, since it accounts for the sugar content that diabetics must watch. The best choice is always a nonfat version, Ross says.
In terms of flavor, plain varieties also work best for diabetics over the fruit-filled choices. "If there's fruit on the bottom, it means that there is going to be more sugar and carbs in it," Ross says. "It's almost too good to be true." To avoid accidentally exceeding your carbohydrate limit, you should also check the label to see how many servings are in a single package. "In some products, one container may be two servings, so you have to be careful," Ross says.
Most people with diabetes have anywhere from 45 to 75 grams of carbohydrates to "spend" on each meal, and snacks should range from 15 to 30 grams. With many nonfat Greek yogurts weighing in at about 7 to 12 grams of carbohydrates per serving, it's easy to integrate them into a meal or as a between-meals snack, Ross says.
Greek yogurt can also be used in recipes. Ross suggests using plain Greek yogurt in place of sour cream on baked potatoes or in dips; blend in your favorite chopped fresh or dried herbs. You can also try this decadent-tasting dessert. Mix a teaspoon of honey and a handful of chopped walnuts into a single serving size container of plain, nonfat Greek yogurt. If desired, add in a drop of your favorite extract, such as vanilla or almond, for extra flavor.
This can give you a nice treat without all the carbs you'd get with ice cream or other foods," Ross says.
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 Doctor 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: Egg Sandwich

Makes: 1 serving

Preparation Time: 5 minutes

Cooking Time: 3 minutes

Ingredients

1 whole wheat English muffin

Butter flavored cooking spray

1 large egg

1/2 oz. lower sodium ham

1 Tbsp. shredded, reduced-fat sharp cheddar cheese 

2 medium slices tomato

Preparation

1. Toast the English muffin. While the muffin is toasting, spray a large skillet, and if desired, the inside of an egg ring with the cooking spray. The egg ring will help you create a circular cooked egg. 

2. Crack the egg into a small bowl. Carefully slide the egg into the skillet or the ring. Cook the egg, covered, for about 3 minutes or until the yolk and white are firm. 

3. Sprinkle the bottom half of the toasted English muffin with the cheese. Top with the egg and ham. Add the tomato slices, and top with the remaining English muffin half. 

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.

Hispanics and Diabetes

Hispanics are more than 66 percent more likely to be diagnosed than non-Hispanic whites, according to the American Diabetes Association (ADA).
Lack of physical activity, poor diet, and genetics are all leading causes of Type 2 diabetes, a disease that kills more people each year than breast cancer and AIDS combined, according to the ADA. Each of these risk factors is especially high among the Hispanic population, the fastest growing minority group in the US, which has created a perfect storm of diagnosing diabetes.
The APMA "Knock Your Socks Off" campaign urges people with diabetes to take one simple action to help avoid some of the more serious complications of diabetes: Get an annual foot exam from a podiatrist.

"Your feet are a mirror of your health- especially when you have or are at risk for diabetes," says Dr. Ehle. APMA's Knock Your Socks Off campaign encourages people to get an annual foot exam, particularly if you are part of the Hispanic community. Getting a foot exam, along with maintaining a good diet and proper exercise, is vital to staying in control of diabetes and living a healthy life.
According to the Center for Disease Control, 60 to 70 percent of all people with diabetes have mild to severe forms of diabetic nerve damage, which often includes impaired sensation or pain in the feet. Severe forms of nerve damage can lead to diabetic foot ulcers and lower-extremity amputations. However, a Thomson Reuters healthcare study showed the US health-care system could save $3.5 billion annually and dramatically reduce hospitalizations and amputation if every American at risk for a diabetic foot ulcer visited a podiatrist once, before complications set in.
Diabetes tend to strike Hispanics at a younger age than the non-Hispanic white population. The diabetic rate increases with obesity and decreases with education levels. In 2009 roughly 182,000 residents of Connecticut were suffering with diabetes, or 6.7%. In 2002 1,060 amputations were performed because of uncontrolled diabetes, costing the patient $23,561 in hospital bills.
If you are Hispanic and have diabetes, please call our Bristol office today to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Doctor 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: Frozen Peanut Butter Pie

Makes: 10 servings
Serving Size: 1/10 of pie
Preparation Time: 16 minutes
Freezing Time: 6 hours
Ingredients
1 quart fat-free vanilla ice cream, softened
1/4 cup crunchy natural peanut butter
1 9 inch lower-fat graham cracker crust
1/4 cup chopped, roasted, unsalted peanuts
1/4 cup sugar free chocolate syrup
Preparation
1. In a mixing bowl, use an electric mixer at medium-low speed to combine the softened ice cream and peanut butter.
2. Spread half the mixture into the prepared crust. Sprinkle with half of the peanuts. Spread the remaining ice cream mixture on top. Sprinkle with the remaining peanuts. Drizzle the entire pie with chocolate syrup.
3. Freeze the pie for at least 6 hours, until firm. Remove the pie from the freezer, about 10 minutes before serving. Use a knife warmed in hot water and wiped dry to make clean cuts.
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.

Dangers of Pedicures for Diabetics

What woman doesn't love to sink into a massage chair, stick her feet into a massaging pool, and surrender to the able hands of a nail technician? For many who get pedicures, it is more about relaxation than it is about getting your toenails painted. Those with diabetes find it even more important to relax and forget for a few moments about their condition.
There are several downsides a diabetic needs to be particularly careful about. "People with diabetes are at risk for a number of complications. Foot infections are common. If they develop a break in the skin, it can be a life-threatening complication," says Lee J. Sanders, DPM, chief of podiatry at VA Medical Center in Lebanon, PA. "I would caution individuals with diabetes not to receive a pedicure because of the sanitary conditions of the salon, the skills of the individual performing the procedure, and the cleanliness of the instruments used."

Still women and men with diabetes are flocking to pedicure salons and spas. Aside from being an indulgent way to spend an afternoon, pedicures can ensure that feet are clean and hydrated, which is important when you are managing diabetes. That's why doctors, such as Jodi S. Politz, DPM, a podiatrist with her own practice in Las Vegas, says pedicures are possible- if you're picky about your salon. "Anyone with diabetes can get a pedicure anywhere," she says, "as long as the nail technician is using very clean instruments and they know what they're doing." At her own practice, Politz has a spa that provides sanitary, medically supervised pedicures. "Women are going to get pedicures whether they are diabetic or not," she points out, adding that people with diabetes do "have to be more conscious about it."
If you are healthy and complication-free, getting a pedicure doesn't pose a threat the way it does for people with foot complications of diabetes. But if you have an infection, ulcer, cut, or neuropathy, don't book an appointment. An open wound is an open door for any bacteria that may be in the foot basin's water, and nerve damage will make it harder for you to tell if you've been cut or if the bath's water is too hot.
Scheduling a pedicure at any old nail salon is a bad idea. "The most important thing is that wherever people go, they need to make sure they're using clean practices," says Donna Perillo, owner of Sweet Lily Spa in New York City. As podiatrist Sanders puts it: "We don't know how clean the basin is. We don't know how clean the water is." He urges women to look into the places sanitation practices, the technician's training- make sure she's licensed- and how the tools are cleaned. "If a woman is going to seek out this service, it is important she addresses these issues," he says.
If the water looks clean, but you're still unsure about the sanitation process, don't be afraid to ask. "Ask them how they clean their things," says Perillo. "We get asked all the time and I'm happy to answer." According to Lisa Tep, owner of Sesen Spa in Vienna, VA, after each service, foot baths should be cleaned with a hospital-grade, EPA-registered disinfectant made specifically for pedicure chairs. If the spa doesn't clean as often or with the proper chemicals, walk away. "I wouldn't take a chance," says Perillo. "There are so many things you can catch. Fungus is the number one thing you see."
Carroll Kingbile of Damascus, Oregon, who was diagnosed with Type 2 diabetes 3 years ago, inspects new nail places by getting a manicure first before leaping into the pedicure chair. "I've walked in and sat around and waited" in order to check a salon out, she says. "There are a couple places I've walked out of."
Sure, sinking your feet into a pool of warm, bubbly water is relaxing. But did you know bacteria may be introduced into your bath thanks to the pipes that carry the water? Avoid soaking in someone else's bacteria by being picky about your foot bath. Some spas, such as Sesen, use "pipeless" pedicure chairs, which reduce the area in which bacteria can hide. Others, like Sweet Lily, opt for easy-to-clean individual buckets or bowls. Before you book your service, ask the spa which type of basin it uses. And remember, regardless of basin type, the technician should clean between each client.
Before you let a pedicurist touch your feet, find out how her tools are sanitized. Like foot baths, implements should be cleaned between each use. But, be warned: Just because tools were pulled from a sterilization pouch or drawn from a jar of blue liquid doesn't mean they are safe, says Tep. Dirty instruments used on past customers may soak in unchanged fluid or open containers. Ask if the salon operates an autoclave (a hot, pressurized chamber used to sterilize medical instruments), and make sure packages of uncontaminated tools aren't opened until the minute you sit down- otherwise they may have been compromised, she says.
Another tip: Pick a salon that uses stainless steel instruments, which are easier to clean than porous nail files and those wooden sticks used to push back cuticles. If emery boards or nail buffers are used, they should be thrown out after each client to prevent the spread of bacteria.
Some people even tote their own tools as an extra precaution. But then cleanliness becomes your responsibility: "You have to, as an individual, make sure you wash your tools," says Perillo. "You can infect yourself. As long as you go home and wash them really good... that's a great solution."
 "I always tell people: If they have diabetes they should let us know," says Perillo. "The massage should be gentler." Although you may feel nervous about saying something, nail technicians actually want you to speak up. "I tell my pedicurist, 'You know, I can't have the water too hot,'" says Kingbile. "I have never found anyone to be nonresponsive to that. They've always been very, very nice."
Request that the technician not clip your cuticles or file heels or calluses. Make sure the basin's water is warm, not hot, and that your toenails are being cut straight across. Ensure that moisturizing lotions are thoroughly massaged into your feet to prevent excess lotion collecting between the toes. And insist the pedicurist avoid a credo blade- that's one that looks like a razor- on your feet. The tool is illegal in many states.
As lovely as fresh shaven legs are, in this case they can do more harm than good. Stop shaving your legs two days before your scheduled pedicure to prevent skin from getting irritated or bacteria from entering any tiny nicks or cuts.
These measures may sound extreme, but consider the alternative: Unsterilized instruments can pass bacteria and infections between clients. So, what do you do if you suspect a salon isn't practicing safe sanitation? "I would say get up and leave," says Tep. "You're risking a lot for a pedicure. If you're not sure, and you're not comfortable, it's better to be safe than sorry."
If you have diabetes and do not currently see a podiatrist please call our Bristol office today to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Doctor 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 With Porcini Mushrooms

Makes: 4 servings
Serving Size: 3 to 4 oz chicken, about 1/4 cup mushroom sauce
Preparation Time: 10 minutes
Cooking Time: 45 minutes
Ingredients
1 oz. dried porcini mushrooms
1 cup hot water
1 lb. boneless, skinless chicken thighs
3/4 kosher salt
Freshly ground black pepper
1 1/2 Tbsp. olive oil
1 large onion, diced
1 garlic clove, minced
1/2 cup dry white wine
2 Tbsp. tomato paste
1/4 cup mined fresh parsley
Preparation
1. Place the porcini mushrooms in a heatproof bowl. Pour enough hot water to cover the mushrooms and set aside.
2. Pat the chicken thighs dry. Sprinkle the thighs with salt and pepper to taste.
3. In a large skillet, heat the olive oil over medium-high heat. Add the chicken and saute for 4 to 5 minutes. Flip the thighs and saute for another 4 to 5 minutes until golden brown. Remove the thighs from the skillet and set aside.
4. Add the onion to the skillet, scraping up any browned bits. Lower the heat to medium, and saute the onion for 6 to 7 minutes. Add the garlic and saute for 2 minutes.
5. Drain the mushrooms, reserving the mushroom liquid. Coarsely chop the mushrooms, and add them to the skillet. Saute the mushrooms for 1 minute. Add the wine, tomato paste, and mushroom liquid, bringing the sauce to boiling.
6. Lower the heat to simmer. Return the cooked chicken to the skillet. Cover and simmer for 15 to 20 minutes until the chicken is cooked through. Using a slotted spoon, remove the chicken from the skillet and put it on a serving platter. Cover the chicken with foil to keep it warm.
7. Raise the heat to high and boil the sauce, stirring occasionally, until it has thickened and is reduced by half. Pour the sauce over the chicken, garnish with fresh parsley, 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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Tips For Travelling With Diabetes

Vacations can seem idyllic until you pack. That's when reality hits: You've filled your carry-on with an entire wardrobe, a pair of shoes, and backup toiletries- but what about diabetes stuff? Start here to head off hassles.
People have a tendency to overpack- bringing those backup shoes just in case the safari includes a formal dinner- except when it comes to medication. Along with any meds, there are a few other items that will come in handy.
Refill any prescriptions and otherwise ensure you're well stocked with medications and devices. Alene Kelsey Metcalf, 38, of San Antonio always brings double the amount of supplies she needs. "I learned the hard way over 9/11. I was traveling and got stuck in Seattle for four days. I ran out of syringes." If you use a pump, bring syringes and vials of long- and short-acting insulin as backup.

Make a list of your healthcare providers, including their names and phone numbers, note your medications, and carry a copy of your health insurance card. If you run out of medication, experience a health problem, or have a medical emergency, you or a travel companion will know whom to call.
If you don't speak the language of your destination, write down translations of diabetes terms. Include phrases such as "I have diabetes", "I need juice", and "Where is the hospital?" A good site for quick translations is babelfish.yahoo.com. Metcalf asked a coworker who spoke Mandarin to write "type 1 diabetic on insulin pump". The note helped Metcalf get through airport security in Shanghai.
To smooth your way through airport security, learn your rights. For answers to specific questions, call the Transportation Security Administration's toll-free help line for people with medical conditions at: 1-855-787-2227. "I've gone as far as printing out the rules from (the TSA) website and giving it to them," says Kelly Kunik, who has Type 1 and blogs at diabetesailciousness.blogspot.com.
Now your bag is packed and you are ready to go! Time to hit the road.
Carry a letter from your doctor explaining you have diabetes. For those using insulin and other injectables, the note should include information on how you take the meds- via syringes, pens, or an insulin pump- and if you use a continuous glucose monitor (CGM). A doctor's note isn't required by the TSA for a person with diabetes to pass through security, but having one makes the process go smoother if an officer questions your meds and supplies.
Everything you need to care for your diabetes and any other medical condition should be packed in a carry-on. "I would never put anything critical in a checked bag," says Doug Dyment, a packing expert and founder of onebag.com. The risks of temperature extremes, unpressurized cargo space, and losing your luggage are too great. Keep your diabetes supplies together and separate from nonmedical supplies. This makes it easier to explain your rights to a TSA officer if necessary.
All diabetes supplies are fair game for carry-ons, including insulin, which is an exception to the 3-ounce liquid limit.
Don't worry about keeping your opened insulin vials or pens cold- insulin in use will be stable at room temperature for about 30 days, says Janie Lipps, ANP, BC, CDE, diabetes nurse practitioner at Vanderbilt University Diabetes Center. If you bring backup insulin for a long trip, keep it cool during travel by using strategically placed cold packs. But be cautious: Too-cold temperatures are equally as damaging to injectable meds as heat and sunlight.
Whether you're traveling by plane, train, or automobile, bring glucose tablets, candy, or gel to treat lows. And always pack more than you think you'll need for the entire trip.
Pack snacks or a small meal that you can eat in transit- in case there's no place or time to purchase a bite to eat. Even if your flight will serve a meal (which occurs only on long flights), packing snacks is smart.
When taking multiple daily injections and crossing time zones, use background (long-acting) insulin at the same time you take it at home, says Lipps. That is, if you take it at 9 a.m. at home but traveling east has put you three hours ahead, you'd take insulin at noon. (Wearing a watch set to your home time zone will help) Short-acting insulin can still be taken at mealtime, regardless of the time change. Different rules apply to pumps. "With a pump, it's good to change (to the destination time) as soon as you start flying," says Lipps.

Identify your name and conditions on a bracelet or necklace, just in case.
Access to safe medications and best-practice medical care is not guaranteed in every country; these travel tips can help.
Should you need an emergency prescription refill, be comfortable asking for your medication in the country's language. Pointing to the written phrases on a note card will do the trick.
When it comes to pharmacies in foreign countries, "the thing you have to be careful about is, where did the medication come from?" says Dyment, who notes that this isn't an issue in most Western European countries. If you're in another region, you may want to go to the hospital, not a pharmacy. If you're really in trouble, contact the American embassy. Also be aware that some countries use insulin that's a different concentration than U.S. U-100 strength.
How you'll pay for an emergency hospital visit abroad depends on the country. In some, you'll need to pay out of pocket and then submit the charge to your insurance company when you get home (Not all plans reimburse expenses from overseas travel; check with your plan to find out). You can buy travel medical insurance, but policies often exclude preexisting conditions. According to Kelly Regan, editorial director of Frommer's travel guides, companies such as InsureMyTrip.com and SquareMouth.com provide coverage for medical treatments and emergency evaluation.
Chances are, you'll be doing plenty of sightseeing- and walking. More activity than usual may put you at risk for hypoglycemia. Carry a source of glucose at all times. If you use insulin, a lower dose may be necessary.
Carry your passport, credit cards, letter from your doctor, and money on you at all times (Dyment recommends using a wallet pouch you can keep under your clothing). If you're traveling with a lot of cash, consider leaving some in your suitcase. "I split (my money) up to make sure that, if for some reason I was mugged, I have backup," says Brian Phelps, 48, who often travels for work.
Load your supplies into a bag that you wear across the front of your body- not in a backpack. Backup meds and supplies left in your room are generally safe at reputable hotels, but not when left at hostels or campsites.
Invest now in travel preparation and gain more time to kick back and enjoy your journey. It might be the difference between relaxing with a glass of wine in Paris and waiting in line at the hospital for more insulin.
If you are a diabetic and do not currently see a podiatrist for diabetic foot care, call our office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Doctor in CT
Podiatrist In Bristol, CT
Visit our website, friend and like our page on Facebook, and follow our tweets on Twitter. 

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