The ski resorts have opened for the season, ice skating is back at Frog Pond, and it’s dark at 4:30pm – must be winter in New England. Another sure sign winter has returned: itchy skin. Dry skin (or “winter itch,” as it’s sometimes called) occurs when dry air pulls moisture from the skin, weakening the skin barrier. The body has difficulty rebuilding the barrier, which in turn leads to itchy skin. Itching leads to scratching which can invite trauma and infection.
To help keep your skin healthy this winter use warm (not hot) water when bathing, and stick to one shower/bath a day (or every other day if possible). Scented liquid soaps and body washes can be drying; therefore bar soap (such as Dove® for sensitive skin or Cetaphil®) is preferred. Use your hands to apply soap to the underarms and groin. Avoid loofahs and vigorous scrubbing. Pat dry and apply an emollient which is better absorbed immediately following bathing.
Moisturizers that come in jars are generally recommended as they’re thicker than those that come in a pump bottle. CeraVe®, Cetaphil®, Curel®, Aveeno® and Eucerin® are good moisturizers that can be purchased at any local drugstore and do not require a prescription. The bottom line is to pick something you like and stick with it! For dry hands and feet, try applying a thin layer of petroleum jelly and then wear thin cotton gloves & socks to bed, which will help lock in moisture.
Despite the best efforts to keep the skin hydrated and prevent infections, problems can still arise. Contact your healthcare provider right away if you develop painful, hot, red skin which can be accompanied by fever. Another common problem is chronic lower leg swelling (or venous stasis) caused by poor blood return back to the heart. Over time, the legs can become itchy with skin breakdown which puts the individual at greater risk for infection. If your primary provider cannot manage your skin problems, he or she can refer you to a dermatologist if necessary. We hope these simple tips will keep your skin healthy for 2015!
(Post Content reviewed by Mariko Yasuda, MD – MGH Department of Dermatology)
A quick meal couldn’t be easier—or more balanced. The fiber and protein from the beans will
keep you satisfied, without depriving your taste buds of flavor. Add a salad to round out your meal.
2-15 oz cans of cannelini, great northern or other white beans
¼ cup 0% Greek yogurt
1 tbsp olive oil
1 tsp red pepper flakes
1 tsp hot sauce, such as Frank’s Red Hot (or to taste)
2 tsp dried rosemary
Black pepper (to taste)
Blend all ingredients in food processor or blender; heat on stovetop or in microwave.
Yield: About 4 servings (1 cup each)
Nutrition Information per Serving:
Calories: 216 • Protein: 14 g • Sodium: 321 mg • Carbohydrate: 35 g • Fiber: 10.5 g
Fat: 3.5 g • Sat Fat: 0.5 g
(Recipe provided by MGH Be Fit)
Tags: chicken, Chinese Food, Diabetes, DSME, healthy, New Year, takeout
In the mood for Chinese takeout, but want to avoid the extra calories? Try this simple, healthy meal suggestion. If you don’t have a grill pan, you can use a nonstick skillet to cook the chicken. (Recipe adapted from Cooking Light)
Tags: Diabetes Education, driving, guidelines, Hypoglycemia, safety
By Eileen B. Wyner, NP
Bulfinch Medical Group
Possessing a driver’s license is a rite of passage in our society.
A driver’s license is seen as a gateway to independence and is a necessity for survival in many instances since many places in the US don’t have adequate public transportation. Driving is such a huge part of our lives, but there are instances when the ability to drive competently is also at issue. The American Diabetes Association (ADA) published a Position Statement on Diabetes and Driving in the 2014 Clinical Practice Recommendations. I would like to summarize the key points of this Position to provide an overview to help both people with diabetes and their health care providers have the best information about driving with diabetes.
The process for identifying drivers with diabetes varies from state to state, depending on what type of vehicle the driver needs to be licensed for. In some states, questions such as “Do you have any medical condition that may interfere with the safe operation of a motor vehicle?” are asked at the initial application for license. These questions may then prompt the need for further medical evaluation. There is no need for a medical examination just because the driver has diabetes. Most often a medical evaluation would be requested when there has been a documented episode of hypoglycemia while driving. Visit the ADA Website for more information on specific rules for each state.
Drivers with diabetes that are commercial drivers in interstate commerce have different rules and follow a set of uniform federal regulations. ALL drivers are subject to an examination every 2 years to update the driver’s ongoing general fitness. Drivers with diabetes managed with diet, exercise, and oral medications do not have any further requirements. Drivers who use insulin often require a more detailed medical evaluation so an exemption to drive and medical certification can be granted. Drivers for commercial motor vehicles, such as school bus drivers and vehicles that transport passengers or hazardous materials are subjected to more strict evaluations that differ state to state.
There are many factors to consider when caring for the driver with diabetes. I want to be clear: a diagnosis of diabetes or the use of oral medications or insulin does not mean that driving ability is compromised. The ADA has determined that the single most significant factor associated with collisions for drivers with diabetes appears to be a recent history of severe hypoglycemia regardless of diabetes type or treatment. The ADA Workgroup on Hypoglycemia defines severe hypoglycemia as an event that disrupts cognitive motor function and requires the assistance of another person to treat the hypoglycemic event.
The plan of assessment and care of the driver with diabetes needs to be individualized. It is important to not only review hypoglycemia awareness, but to also review the other conditions that could interfere with safe driving. These conditions may include decreased visual acuity due to retinopathy or cataracts, neuropathy that diminishes the sensation of the right foot, or sleep apnea which can result in daytime sleepiness. Drivers that have had a hypoglycemic event will need much closer evaluation and education. The driver may need re-education to address issues with mealtimes and dosing of medications (or medications may need to be adjusted altogether), further education about hypoglycemia awareness, and the best methods of treating low blood sugars. Drivers who have had episodes with severe hypoglycemia may also need to perform additional glucometer testing.
People driving for long distances should have a good supply of glucose tablets easily available in the glove compartment or in the console. A supply of snacks such as packages of cheese and peanut butter crackers or nuts should also be stored in the front of the car with the driver and checked before each trip. Drivers who feel hypoglycemia occurring while driving should pull off the road immediately, put on their blinkers, and treat with a fast acting carbohydrate. Do not resume driving until blood sugar values are normalized.
Finally, I advise that all of my patients with diabetes have a medical ID with them at all times. Symptoms of hypoglycemia may appear as if driving under the influence of alcohol or drugs, which can lead to losing precious treatment time if there is an incident where you are unable to identify yourself as having diabetes. First responders are trained to look for things like a bracelet or necklace, or a card in the wallet.
Tags: Christmas, Diabetes Education, DSME, healthy, Holidays, mind-body, mindfulness, relaxation response, stress, weight gain
The holidays are a time of fun and excitement, but they can also be a time of added stress.
While stress is a normal part of life, it can have an impact on diabetes management. Stress hormones can raise blood sugar, and prolonged stress weakens the immune system and interferes with healthy self-care routines.
Stay healthy and enjoy the season with these techniques for managing holiday stress:
- Prioritize – A common cause of holiday stress is trying to do too much at once. Focus on those things that are most important to you, and don’t be afraid to say “no” to taking on new commitments.
- Take “time out” (Find a distraction) – Take a break and do something to clear your mind. Spend time with or call friends. Engage in some other activity you enjoy (like a favorite hobby).
- Get Moving – Exercise is a known stress reducer, and sticking with your regular fitness routine can help with maintaining good blood sugar control. Small steps make a difference! Go for a walk, put on a yoga video or dance to a song on the radio.
- Relax – Mind-body activities like meditation, deep breathing or positive visualizations elicit the relaxation response, the body’s built-in counter to the stress response.
Losing or maintaining a healthy weight is another source of stress for many during the holidays. The added pressures of the holidays can also contribute to emotional or stress eating (eating for reasons other than hunger). Signs of stress eating can be turning to comfort food after a difficult day, or mindlessly munching on snacks to burn off nervous energy. The downside is many comfort foods are high in sugar (which can raise blood sugar), fat, and calories. Distracted snacking makes it easy to take in more calories than expected. Consider preparing some healthy snacks to have accessible.
The techniques above can help with coping with stress eating as well, but if you’re still craving a crunchy snack or Mom’s Mac and Cheese go ahead and have some – just do so mindfully. Keep track of portion size, and eat slowly so you can really enjoy the food’s taste and texture.
It’s not possible to avoid all stress completely, but one final thing to remember is the holiday season (and the stress that comes along with it) is temporary. Slow down and enjoy the best the season has to offer. If you’re still feeling overwhelmed or think you might be experiencing diabetes burnout, talk to your health care provider or a diabetes educator.
(Post content reviewed by the Benson-Henry Institute for Mind Body Medicine)
Tags: breakfast, Diabetes, DSME, easy, Eggs, leftovers, morning, oatmeal, Thanksgiving, weekday
They say breakfast is the most important meal of the day. Don’t skip breakfast if you’re pressed for time in the morning – instead try one easy breakfast ideas from Janelle Langlais, a dietetic intern with the MGH Department of Nutrition and Food Services.
Turkey, Butternut Squash & Nuts
3/4 cup Butternut squash
¼ cup or 10-15 almonds/walnuts/pecans sliced/chopped
1 tsp. cinnamon (as desired)
1/8th tsp. ginger (as desired)
2-3 oz. Turkey (or chicken) breast
- Combine squash, turkey (or chicken) and spices in a microwave safe dish.
- Microwave on high for 1 minute (keep an eye on things).
- Add nuts and spices.
- Enjoy with ½ cup of skim milk, soy milk or water as desired!
Calories: 365 • Carbs 22g • Protein 29g
Avocado and Egg Sandwich
1 Egg or 2 Egg Whites
2 Slices low-Carb whole wheat bread Or 1 Whole Wheat English Muffin
¼ Avocado sliced or ¼ cup Guacamole
2 slices of tomato
¼ cup spinach
1 slice low-fat cheddar/American cheese
- Microwave egg or egg whites in a microwave-safe dish for 1 minute or until egg is firm. Or conventionally cook egg in a frying pan on stove with Pam or canola oil.
- Toast English muffin or bread in toaster/toaster oven.
- Top egg with cheese, avocado slices/guacamole, add tomato and spinach.
Calories: 330 • Carbs 24g • Protein 23g
Blueberry Banana Overnight Oats
1/3 cup oats
2/3 cup Greek yogurt
1/3 cup soy milk, slightly overflowing
1/2 banana (1/3 if it’s particularly large)
1/4 cup blueberries
1/8 cup Granola and/or chopped nuts
- Mash banana and blueberries together in a bowl until blended together. Stir in oats, yogurt, and milk. Cover, and refrigerate overnight.
- In the morning, top with granola and/or walnuts, along with fresh berries/bananas, if desired.
Calories: 460 • Carbs 49g • Protein 20g
Tags: awareness, Diabetes, DSME, education, WDD
Tags: breakfast, diabetes awareness, Diabetes Education, Diabetes management, DSME, nutrition, prevention, WDD
Tags: awareness, Diabetes, Diabetes Education, DSME, fitness, November, nutrition, stress relief, WDD
Thursday, November 13 10:00 am—3:00 pm MGH Main Lobby near Coffee Central This year’s event will focus on developing a healthy lifestyle and preventive care.
- Talk to an exercise physiologist about your fitness goals.
- Ask our dietitians questions about food and nutrition.
- Learn about stress reducing techniques and get a free massage.
- Plus trivia, games and prizes!
Tags: party, salsa, snack, spices, tomato, whole wheat
Snacks should be satisfying and nutritious: this recipe works on both accounts. The spices add interest and also offer up beneficial antioxidants. You may even want to make a double batch of the chutney to freeze for when you need a quick condiment to spice up chicken or pork.
8-8″ whole wheat tortillas
2T olive oil, divided
1/4 tsp salt, plus a pinch for the chips
1 tsp cumin seeds (can substitute ground cumin, if necessary)
1 tsp mustard seeds
1 medium onion, chopped
1 T fresh ginger, peeled and minced
2 garlic cloves, minced
1 jalapeño pepper, chopped (removed seeds to decrease spiceness, if desired)
1 tsp curry power
1 tsp tumerick
2 (14.5. oz each) cans diced tomatoes, no added salt
1/3 cup raisins
2T brown sugar
Preheat oven to 400 degrees. Cut each tortilla into 8 wedges and place wedges on baking sheet. Lightly coat wedges with 1 tbsp olive oil and sprinkle with salt. Bake for about 7 minutes or until wedges are crisp and golden.
Meanwhile, heat cumin and mustard seeds in a large sauce pan until seeds become fragrant, about 2-3 minutes. Remove seeds from pan and add in remaining tablespoon of oil. Add onion, ginger, garlic and jalapeño to pan and sauté until onions become translucent; add in ½ tsp salt, curry powder, turmeric, cumin and mustard seeds. Add tomatoes and simmer for about 10 minutes; add in raisins and sugar and simmer for an additional 5-10 minutes, or until mixture thickens (If mixture starts to thicken too much simply add a little water to the pan). Cool to room temperature or refrigerate until needed and serve with toasted chips. Chutney can be made ahead of time; prepare chips the day you plan on serving them.
Yield: About 12 servings (serving size: about ¼ cup chutney and 5 chips)
Nutrition Information per Serving:
Calories: 170 • Protein: 4 g • Sodium: 310 mg • Carbohydrate: 25 g • Fiber 2.5 g • Fat: 5 g •
Sat Fat: 0.5 g