New Supplement To Reduce Diabetes Risk During Pregnancy

A new small pilot study says that myo-insitol supplements may help protect women at risk for gestational diabetes.
Previous studies have shown that myo-insitol may restore fertility in polycystic ovary syndrome, but this is the  first evidence it may reduce the number of gestational diabetes cases, says lead author Dr. Rosario D'Anna.
Women who are overweight or obese or have a family history of diabetes are at risk for gestational diabetes, which affects 10 percent of pregnancies. Those with the condition have trouble controlling their carbohydrates, which therefore leads to high blood sugar.
"Undiagnosed and untreated gestational diabetes can cause large for gestational diabetes babies, which may lead to delivery complications," says Dr. D'Anna, who is at the Department of Obstetrics at University Hospital in Messina, Italy.
220 pregnant women with a family history of Type 2 diabetes were part of the study. Half of the women were given two grams of myo-insitol supplements twice a day along with the recommended amount of folic acid. The other women were given just the folic acid from the end of the first trimester.
Myo-insitol is available in the United States without a prescription and costs $10 for 60 650 millograms. It is also found in fruits, nuts, grains, and meats, but not in high concentrations.
Of those who took the myo-insitol, just six percent developed gestational diabetes, compared to 15 percent who took just the folic acid. None of the babies in the myo-insitol group met criteria for being overweight, but seven babies in the folic acid group did, weighing more than eight pounds, 13 ounces.
Even though these results are positive, it doesn't mean the supplement works or is safe. "The results are promising, but we would need a larger trial and a broader group of women before we could recommend this supplement," says Dr. Wanda Nicholson, who studies gestational diabetes at the University of North Carolina at Chapel Hill.
Even though their blood sugar levels usually return to normal after pregnancy, women need to continue to diet and exercise. "Up to 50 percent of women in general who are diagnosed with gestational diabetes can develop Type 2 diabetes in the next five to 10 years," says Nicholson.
Dr. Donald Coustan of the Division of Maternal-Fetal Medicine at Women and Infants Hospital of Rhode Island in Providence says, "There's really nothing currently recommended to prevent gestational diabetes" other than maintaining a healthy weight before getting pregnant.
The number of women getting the condition has been rising for the last 10 years. "There's great concern that we're going to be inundated with patients with gestational diabetes," says Coustan.
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, like our page on Facebook, and follow my tweets on Twitter.

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Diabetic Recipe of the Week: Garlic-Spiked Hash Browns

Serves: 6
Serving Size: 2/3 cup
Ingredients

1 Tbsp. extra virgin olive oil
2 tsp. unsalted butter (divided)
1 cup chopped red onion
2 large garlic cloves, minced
3 medium Yukon gold or red potatoes, boiled with peel, chilled, and diced (1/2-inch cubes, about 4 cups)
3/4 tsp. sea salt
1/4 tsp. ground cayenne red pepper
1/4 cup roughly chopped fresh Italian parsley
2 Tbsp. finely chopped fresh chives
Preparation
1. Heat the oil and 1 tsp. butter in a large nonstick skillet over medium-high heat. Saute the onion for 3 minutes, then add garlic and saute for 1 minute.
2. Add the potatoes and cook for 5 minutes, or until potatoes are lightly browned, turning occasionally. Remove from heat and stir in the remaining butter. Sprinkle evenly with salt and red pepper. Stir in parsley and chives.
This recipe is from Diabetes Forecast Magazine 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, like our page on Facebook, and follow my tweets on Twitter.

Diabetic Foot Ulcers Linked To Risk of Death

We've always said that diabetic foot ulcers and wounds are nothing to ignore, and now there's an even bigger reason to get them looked at.
Last fall researchers from St. George's, University of London published findings in Diabetologia stating that those with diabetic foot ulcers are at a higher risk of dying prematurely than those without the condition. The study was the largest analysis of diabetes and the link between foot ulcers.
Diabetes can damage a person's blood vessels and nerves, especially when they are a poorly controlled diabetic. This in turn leads to neuropathy, when you have a diminished, or no sensation in your extremities. A person with diabetes is less likely to notice cuts, scrapes, abrasions, or injuries that can turn into ulcers and wounds.
The study included 17,830 patients with diabetes- 3,095 with foot ulceration and 14,735 without, investigating how diabetic foot ulcers affected a person's chance of dying earlier. They found that those with a history of foot ulceration had a higher death rate than those without. There were an extra 58 deaths per 1,000 people each year with foot ulceration.
The study included patient records for eight studies published between 2006 and 2011 and conducted in Europe, America, Australia, and Southeast Asia. Patients were followed from two years to 10 years.
Those with foot ulcerations showed more cardiovascular risk factors, like high blood pressure, and were more likely to die from complications. Half of the additional deaths were due to heart attack or stroke. This was not investigated in this particular study, but is an area of further research, as there is potentially a link between infections and complications of foot ulcers.
Robert Hinchliffe, of St. George's, who co-led the study, said, "Our research, which is the largest and therefore most reliable study to date, shows that people with diabetes who have foot ulcers are at considerably higher risk of an earlier death compared to those patients without. We suspect that this may be due in part to the effect of infections among those with foot ulcers and the greater co-existence of cardiovascular disease and foot ulcers with diabetes although the reasons are not entirely clear."
The researchers say this calls for a two-pronged approach for those with diabetes: enhanced foot ulceration screening, as early detection and treatment may curtail some of the complications; and more intensive control of blood pressure and cholesterol among those with foot ulcers.
The current recommendations are to control your blood sugar, wearing socks to prevent foot ulcers, self-checking for abrasions, and getting a complete foot exam at least once a year.
Professor Kausik Ray, who co-led the research, said, "Our result warrant further investigation as to whether even greater control of risk factors such as blood pressure, blood glucose, and early preventative screening can further reduce mortality among those with foot ulcers. There is likely an unmet potential to reduce deaths in this group."
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, like our page on Facebook, and follow my tweets on Twitter.

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Diabetic Recipe of the Week: Rhubarb Applesauce

Servings: 8
Serving Size: 1/2 cup
Ingredients

2 lbs. tart cooking apples, peeled, cored, and cut into quarters (scant 8 cups; try Jonagold, Northern Spy, or Gravenstein)
1 1/2 cups red rhubarb (1 or 2 stalks), cut into small pieces
1/4 cup water
1 Tbsp. lemon juice
1/4 cup Splenda granular or to taste
Preparation
1. Add the apple slices, rhubarb pieces into a heavy-bottomed sauce pan. Pour in the water and lemon juice. Heat on medium, stirring often. Cook until the apples and rhubarb are soft, about 35 minutes. Stir in the Splenda granular. Store in the refrigerator.
This recipe is from Diabetes Forecast Magazine 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, like our page on Facebook, and follow my tweets on Twitter.

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New Guidelines For Children With Diabetes

Childhood obesity is on the rise and pediatricians are looking for any way to help it from reaching an epidemic. Pediatricians released in January new guidelines for managing weight-related diabetes amongst children.
Children have been diagnosed with Type 1 diabetes for a long time now, but pediatricians are seeing an increase in the number of children diagnosed with Type 2 diabetes. Almost a third of all diabetes cases in children are now Type 2 cases, which generally happens later in life, around the age of 40. "We're seeing it much more than we did before," says Dr. Janet Silverstein, co-author of the new American Academy of Pediatrics guidelines on diabetes and professor of pediatrics at the University of Florida. "Many pediatricians were never trained in managing Type 2 diabetes because it isn't a disease we used to see. It was a disease of adulthood. But as we're seeing more obesity in kids, we're seeing adult diseases in childhood."
The Academy decided that since they were seeing more patients with this disease they needed to have clear, consistent advice on how to treat them. These guidelines are the first of their kind for children ages 10 to 18 and were developed in conjunction with the American Diabetes Association, the Pediatric Endocrine Society, the American Academy of Family Physicians, and the Academy of Nutrition and Dietetics. The group's first recommendation is to screen all obese children for diabetes, then figure out what type they have.
The importance between diagnosing Type 1 and Type 2 will be the treatment plan, especially when it comes to insulin. Many children who have Type 2 diabetes do not need insulin and will instead be treated with medication that increases their sensitivity to it. Doctor will also highly recommend lots of exercises, as much as an hour a day. Screen time, both computers, television, and other devices, should be limited as well, unless it is related to schoolwork. If doctors aren't initially sure what type of diabetes their patient has, they should start all children off with insulin, as those with Type 1 will always need it.
Dr. Rubina Heptulla, chief of the division of pediatric endocrinology and diabetes at Children's Hospital at Montefiore in the Bronx, sees up to three children a week who are newly diagnosed with diabetes. About half have Type 2 diabetes and she says this is a pediatric epidemic. "I did not see this as a resident or fellow. We would not have had these guidelines 10 years ago because there were not many cases. Now these guidelines are very relevant," says Dr. Heptulla, who was not involved with creating the new guidelines.
In the guidelines pediatricians recommend parents take a large role in combating their child's disease, by regulating diet and exercise, as these simple measures can sometimes reverse the condition. "The way to make a difference is before they develop diabetes," says Dr. Heptulla.
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, like our page on Facebook, and follow my tweets on Twitter.

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Diabetic Recipe of the Week: Carrot Apricot Muffins

Makes: 12 muffins
Serving: 1 muffin
Cooking Time: 36 minutes
Preparation Time: 25 minutes
Ingredients

1/4 cup raw, unsalted sunflower seeds
2 Tbsp. sesame seeds
1 3/4 cup all-purpose flour
2 tsp. baking powder
1/2 tsp. baking soda
1 tsp. cinnamon
3/4 tsp. ground ginger
1 cup low-fat buttermilk
1/4 cup light olive oil
1/2 cup Splenda brown sugar blend
1 large egg
3 large carrots, peeled and shredded
1/3 dried apricots, finely chopped
Preparation
1. Preheat the oven to 375 degrees. Coat a nonstick 12-cup muffin tin with cooking spray.
2. Spread the sunflower seeds and sesame seeds onto a baking sheet. Bake the seeds for about 3 to 4 minutes until lightly toasted. Remove from the oven. Keep the oven on.
3. In a large bowl, combine the flour, baking powder, baking soda, cinnamon, and ground ginger.
4. In a separate bowl, whisk together the buttermilk, oil, Splenda, and egg until well combined. Make a well in the center of the dry ingredients and add the egg mixture. Stir until just combined.
5. Fold in the sunflower and sesame seeds, shredded carrots, and apricots.
6. Spoon the batter into the prepared muffin tin and bake for about 25 to 30 minutes until a toothpick inserted into the center comes out clean. Let the muffins cool 5 minutes in the pan and then turn them inside out onto a cooling rack.
This recipe is from Diabetes Forecast magazine 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, like our page on Facebook, and follow my tweets on Twitter.

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6 Exercises For People With Diabetes

When was the last time you went for a walk, hit the gym, or swam in the pool? Most Americans don't get enough exercise and it's even more crucial for those with diabetes to get the recommended amount of exercise each week. Just 39 percent of those with type 2 diabetes diabetes participate in some form of exercise, compared to 58 percent of Americans without the disease. According to Sheri Colberg-Ochs, PhD. a professor of exercise science at Old Dominion University in Norfolk Virginia, exercise can increase insulin production, keep blood sugars in check, help you lose weight, and improve balance.
Here are six easy exercise routines any diabetic can work into their daily life.

1. Walking. "Walking is easy for people to do. All you need is a good pair of shoes and somewhere to go. Walking is probably one of the most prescribed activities for people with type 2 diabetes." says Colberg-Ochs. To get the maximum benefit, brisk walk three days a week for 150 minutes. Try to avoid going more than two days without walking. 
2. Tai chi. Tai chi has been practiced for centuries and is a series of movements done in a slow and relaxed way for 30 minutes. This form of exercise is perfect for those with diabetes because it provides fitness and stress release in one. Tai chi helps improve balance and may reduce nerve damage.
3. Weight tarining. "I can't say enough about the benefits of weight training, not just for people with diabetes but for everyone," says Colberg-Ochs. "If you lose muscle mass, you have a lot harder time maintaining your blood sugar." Weight training should be done twice a week and should include from five to 10 different types of lifting involving all major muscle groups. Work your way up to doing three to four sets of each exercise, with each exercise having 10 to 15 repetitions. 
4. Yoga. Yoga can help reduce lower body fat, fight insulin resistance, and improve nerve function, and like tai chi, is also a stress reducer. "When stress levels go higher, so do your blood sugar levels," says Colberg-Ochs. The good thing about yoga is that you can do it as often as you like. "The more the better," adds Colberg-Ochs.
5. Swimming. Swimming is ideal for those with type 2 diabetes because it doesn't put any stress on your joints. "Being buoyed by the water is less stressful for you," says Colberg-Ochs. For your feet, swimming is also the least stressful and special shoes can be made to prevent scraped feet and prevent slipping. 
6. Stationary bicycling. Stationary bikes are great for type 2 diabetics because you can ride the bicycle indoors and never have to worry about the weather. Bicycling also improves blood flow to your legs and burns lots of calories to keep your weight at a manageable target. 

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, like our page on Facebook, and follow my tweets on Twitter.

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Diabetic Recipe of the Week: Tandori Chicken

Makes: 6 servings
Serving Size: about 5 oz., with bone
Preparation Time: 10 minutes
Marinating Time: 6 to 24 hours
Cooking Time: 30 minutes

Ingredients
2 lbs. skinless chicken drumsticks
2 Tbsp. fresh lemon juice
1 1/4 nonfat plain yogurt
1/2 large onion, chopped
1 Tbsp. paprika
2 tsp. garam masala spice blend
1 garlic clove, minced
1 tsp peeled, fresh grated ginger
1 tsp. ground coriander
1/2 tsp. turmeric
1 tsp. cayenne pepper
1/4 tsp. salt
A few drops of red food coloring (optional)
1 fresh lime, cut into wedges
Preparation
1. Using a sharp knife, cut 2 diagonal slashes through both sides of each chicken drumstick, cutting through to the bone. These deep cuts allow the marinade to penetrate.
2. Place the chicken drumsticks in a shallow baking dish. Sprinkle lemon juice over the chicken, coating well. Refrigerate the chicken, covered, for 20 minutes.
3. For the marinade, add the yogurt, onion, paprika, gasam masala, garlic, ginger, coriander, turmeric, cayenne pepper, salt, and red food coloring, if desired, to a food processor or blender. Process until smooth.
4. Pour the marinade over the chicken and coat well. Marinade the chicken, covered, in the refrigerator for at least 6 hours (up to 24 hours).
5. When ready to cook, preheat the oven to 450 degrees. Line a broiler pan with foil. Coat the foil with cooking spray. Remove the chicken from the marinade pan (the chicken should be lightly coated with marinade) and place in broiler pan. Discard the excess marinade.
6. Roast the chicken for 20 to 25 minutes, or until a meat thermometer registers 160 degrees when inserted into the meatiest part of a drumstick. Turn the oven to broil, and broil the chicken for 5 minutes or until just lightly browned, turning once. Serve the chicken with fresh lime wedges.
This recipe is from Diabetes Forecast magazine 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, like our page on Facebook, and follow my tweets on Twitter.

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