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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