Tags: balanced plate, blood sugar, Diabetes, healthy eating, insulin, insulin resistance, nutrition, snacks, weight gain
By Felicia Steward, Dietetic Intern
Blood Sugar Defined
Blood sugar is the measurement of the amount of glucose, or sugar, in your bloodstream. This is important because it tells us how much energy our cells and tissues are receiving from the food we eat. Some foods affect blood sugar more than others. Any food that is mostly carbohydrates will affect blood sugar levels. These include dairy (milk and yogurt), all fruits and fruit juices, starches (pasta, bread, rice, and tortillas), and starchy vegetables (corn, peas, beans, potato, and butternut squash). Eating more carbohydrates at a meal can raise blood sugar, so it’s important to think about portion size along with when we eat and what food items we choose to eat together.
Why Care About the Amount of Sugar in My Bloodstream?
Glucose provides our body with energy, and is needed for the brain to properly function and process information. Therefore, it is important that we choose foods containing small amounts of carbohydrates whenever we have a meal or a snack throughout the day so there’s enough glucose to support our tissues and cells.
When someone with diabetes eats large portions of carbohydrate-rich foods, too much sugar is released into the blood stream and, because there’s either not enough insulin or they have insulin resistance, their body is unable to use this sugar for energy effectively. It builds up in the blood stream, causing damage to the body. Over an unhealthy extended period of time, the body will eventually store much of the excess sugar as fat, which can lead to weight gain. Therefore, it is important to be aware of how the food we eat influences the amount of sugar in our bloodstream and how it affects our weight.
How is Blood Sugar Managed?
A healthy eating pattern that includes balance and portion control is an important part of managing the amount of sugar in the bloodstream. Pairing whole grain, carbohydrate-rich foods with protein and fiber helps maintain healthy blood sugar levels. Eating a meal or snack that contains foods that increase blood sugar with those that do not affect blood sugar means the glucose is absorbed slowly into the blood and prevents blood sugar from spiking too high. Paying attention to portion size will also ensure that we are providing our body with exactly what it needs each time we eat. What the body doesn’t use for energy right away can be stored as fat and cause weight gain.
Balanced Lunch Examples:
- PB&J on whole wheat bread + 1 cup carrot and celery sticks dipped in plain yogurt
- 2 cups tossed salad + 3 oz. grilled chicken + oil/vinegar dressing + 1 banana
- 3 oz. salmon + 1 cup brown rice + 1.5-2 cups cooked green beans
- 2 oz. tuna salad (with light/mayo), lettuce, and tomato on whole wheat bread + 1 small apple + 8 oz. of skim milk
Content reviewed by Melanie Pearsall, RD, CDE
Tags: appointment, Diabetes, DSME, healthcare, office visits, preparation, team
By Eileen B. Wyner, NP
Bulfinch Medical Group
A medical appointment is a really big investment. It takes time from our busy lives that may impact our employment or family commitments. It costs us financially through transportation costs, parking fees, childcare expenses and copays. It also can cause anxiety and uncertainty because of worry about the outcomes of tests (on top of all of the other things I mentioned). Even so, a medical appointment is the single best investment you can make in your healthcare. The best way to gain the most from this investment is studying the night before. That’s right, just like preparing for that all important math test it’s worthwhile to prepare for your upcoming medical appointment.
Remember, you and your health care provider are teammates working for the same goal: the best health you can achieve. Using the tips below to prepare for your appointment will help you both get the most out of your time together.
- Review your prescriptions and see if you need any refills on medications or supplies. It is also important to have updated pharmacy contact information so your prescriptions are not delayed, and check to see if you need any specialty referrals.
- Make sure that you have your updated insurance information and photo ID with you. Medical offices do not automatically receive insurance changes, so it is important to check this information at each appointment to prevent issues with bills and referrals. You can update your address and phone number at this time if they have changed since your last office visit.
- Allow plenty of time to get to your appointment and park so you are not late. We try to accommodate people who are late but sometimes it can’t be done.
- Please be patient with me if I am running late. I work very hard to keep on time because I value YOUR time, but if I have a very sick patient, I may run behind. I promise that I will still give you the time you need for your care.
- Don’t forget to bring any results from home such as blood pressure, weight, and blood sugar checks. The information I get during the office visit is just one snapshot in time; seeing it along with your home results gives me a clearer picture of your health.
- Write down any questions and concerns you want to talk about during your appointment.
- Take notes during the appointment and use the same notebook for each visit. This will help keep all of your information organized and in one place if you need to review something you’re unsure about.
I know being a patient is a full time job for many people, and it can be daunting to keep track of everything that goes into good self-care and good health. I think that preparing for your appointment, just like studying the night before the math test, can make this process less overwhelming and as successful as possible.
Tags: beets, Diabetes Education, dinner, DSME, quick and easy, recipe, weeknight meal
The addition of greens, raisins and almonds to pasta is a healthy new spin on a quick dinner. Beets are in season in Massachusetts from June to October. Beet greens are often thrown away after beets are removed. Instead, save the greens: they are a good source of many nutrients, including vitamin A, vitamin C and vitamin K. If beet greens aren’t available, you can substitute any dark green like Swiss chard or spinach.
8 ounces (1/2 of a 1-pound box) whole wheat penne pasta
¼ cup sliced almonds
1½ tbsp olive oil
1 clove garlic, minced
2 cups chopped beet greens
¼ cup raisins
3 oz goat cheese (soft variety, such as Chevre)
½ tsp salt
Black pepper to taste
Prepare pasta according to the directions on the package. While pasta is cooking, toast the almonds in a large, dry sauté pan over medium heat until they turn golden brown (about 3 minutes). Remove almonds from pan and place in a small bowl. Add olive oil to the pan and add garlic, greens and raisins. Sauté for about 3 minutes, until greens are tender and wilted. (If necessary, once greens are fully cooked, remove sauté pan from heat until pasta is cooked.)
Once pasta is cooked, reserve ½ cup of the pasta water and add it to the sauté pan with the greens. Let mixture cook for about 1-2 minutes until slightly thickened. Meanwhile, drain pasta from remaining water. Add pasta, toasted almonds, goat cheese, salt and pepper to the greens and toss to combine.
Yield: 4 servings (about 1 cup each)
Nutrition Information per Serving:
Calories: 375 • Protein: 15 g • Sodium: 380 mg • Carbohydrate: 53 g • Fiber: 7 g • Fat: 14 g Sat Fat: 4 g
Recipe adapted from Cooking Light
Tags: Diabetes, Diabetes management, Holidays, moderation, nutrition, portion size, treats
By Melanie Schermerhorn, Dietetic Intern
Most of us have heard the phrase, “everything in moderation.” Many say moderation is the key to success; for someone who has diabetes this phrase is especially true when it comes to what you eat. Moderation in relation to healthy eating habits, especially portion control, can have a huge effect on your overall health! To break the phrase “everything in moderation” down further, let’s talk about what it means. What your healthcare providers are saying is: eat a balanced diet most of the time, but do not deprive yourself of the not-so-healthy things you enjoy. In other words, it’s alright to eat them but be sure to have them less frequently and in a smaller portion.
With diabetes this is important for your blood sugar management. The goal is to not completely deny yourself things like chocolate chip cookies, but instead maintain a healthy lifestyle while still treating yourself. A tip to do this is buy smaller portion sizes, so having one small cookie won’t have as much of an effect on your blood sugar as a larger one would. Another great way to keep track of your portions is reading the labels on packages for serving sizes. Sometimes a package could be more than one serving! Sharing a baked good with a friend instead of eating the whole thing can help you consume less as well. You could make homemade treats with healthier ingredients like in the recipe below so you aren’t consuming a heavily processed carbohydrate. So aim to keep your portions in check and when it comes to sweets “Everything in moderation!”
Recipe: Healthy Banana Pancakes: Combine 1 ripe banana, 2 large eggs, and a few shakes of cinnamon in a bowl until smooth. Heat up a pan on medium heat and spray with cooking spray. Put a few spoon fulls of the “batter” into the pan. Cook until lightly brown on each side and serve.
Post content reviewed by Department of Nutrition and Food Services
Are you newly diagnosed with diabetes, or struggling to control your blood sugar? If so, DMSE/S programs can help!October 17, 2016 at 9:43 am | Posted in Announcements | Leave a comment
Tags: Diabetes, DSME, health, healthy lifestyle, Medications, nutrition
Diabetes is a chronic, complex disease. Self management is key, but what does that even mean? Where do you start? Self Management is the ‘taking of responsibility for one’s own behavior and well being.’ Living well with diabetes means you need to learn new skills and behaviors. This can seem overwhelming during an already stressful time. DSME/S programs teach you the self management skills you need to truly thrive.
You will first see a nurse or nurse practitioner (who is often usually a Certified Diabetes Educator or CDE). You will either continue to see that clinician by yourself or attend group classes with other people just like you. Group classes are a great way to learn and be supported by people who know what you’re going through. You are not alone! During appointments or classes, you will learn about important topics like nutrition, exercise, medications and more. You will also set specific behavioral goals to work towards between each visit.
Research has shown that DSME/S works. It can lower your A1C and stop complications from happening or getting worse. Attending can also improve your quality of life and keep you out of the hospital. Major organizations like the American Diabetes Association, American Association of Diabetes Educators and the Academy of Nutrition and Dietetics all believe that everyone with diabetes should have DSME/S at some time in their life.
Mass General DSME/S programs are offered at Chelsea, Revere, Charlestown, Internal Medicine Associates, Diabetes Associates and Bulfinch Medical Group. For more information, contact Jen Searl at firstname.lastname@example.org.
Tags: care team, Diabetes, Diabetes management, DSME, family, health literacy, healthy eating, my story, nutrition, Type 2 Diabetes
My grandmother is a tenacious and vibrant woman who was diagnosed with type 2 diabetes earlier this year. She had uncontrolled blood sugar levels along with other health issues and limited mobility. With no formal educational background, she doesn’t know much about diabetes or possible complications. Her low health literacy makes it difficult for her to utilize diabetes related health care resources. “There are too many rules in my diet!” she would exclaim in Twi, her native dialect. She also has low nutritional knowledge and at times would reduce her consumption of certain staple foods. She assumed that eating less of these foods would cure her body from the disease. Her daily diet in Ghana is mostly starchy and sugary foods with low nutritional benefits. One staple meal that she eats quite often is called fufu: a soft dough-like mix of cassava, plantain, and other flours served with different types of warm soups full of meat and/or fish. Fufu is relatively high in carbohydrates and has a significant and rapid effect on my grandmother’s blood sugar levels.
As my grandmother’s caregiver, I provided diabetes care management and education. My goal was to help her avoid blood sugar spikes keep her blood sugar in a healthy range before she went back to Ghana. Every day I checked her fasting blood sugar in the morning and again two hours after eating. These results were reviewed by her PCP and nurse case manager. I modified my grandmother’s meals and incorporated more green leafy vegetables, fiber-rich foods, whole-grain breads and old-fashioned oatmeal with almond milk and honey for added sweetness. I also introduced her to cooked quinoa and cauliflower rice as substitutes for fufu, white rice, and other fufu-like foods to give her meals a nutritional boost. After a meal, I would encourage her to take a walk to the local shopping plaza or to circle around the neighborhood for an hour. Despite her stubbornness and fiery temper towards changes to her diet, we were able to improve her eating habits by stressing the importance of portion control.
My grandmother does not know how to pronounce diabetes or manage her care on her own, but making sure she understood that her medications, changes to her diet, and daily walks to her favorite consignment stores are effective tools for managing her blood sugar levels were key components to her care plan. My experience as a caregiver was a wonderful opportunity to spend time with my grandmother, and it also highlighted the importance of diabetes education in following a care plan and reducing risk of complications. I also learned how that approaching care in a culturally tailored manner that respects individual preferences, opinions and ideas is necessary for reaching optimal health.
Tags: Diabetes, DSME, healthy eating, nutrition, quinoa, recipe, whole grains, Whole Grains Month
Celebrate Whole Grains Month with this easy grain salad. One serving is a good source of iron.
1 cup of water
½ cup uncooked quinoa, rinsed
3 tbsp fresh lemon juice
1 tbsp olive oil
1 tbsp honey
¼ tsp salt
¼ tsp black pepper
¾ cup fresh parsley, roughly chopped
½ cup thinly sliced celery
½ cup thinly sliced green onion
½ cup finely chopped dried apricots
¼ cup pumpkin seeds
Bring water and quinoa to a boil in a medium saucepan; cover, reduce heat and simmer for 20 minutes or until the liquid is absorbed. While the quinoa is cooking, whisk the lemon juice, olive oil, honey, salt and pepper together in a small bowl.
Fluff the quinoa with a fork and place in a bowl. Add the parsley, celery, onion, and apricots. Toss with the dressing to coat and top with pumpkin seeds.
Yield: Serves 4
Serving Size:about 2/3 cup. Nutrition Information Per Serving:
Calories: 195 calories • Protein: 5 g • Sodium: 160 mg • Carbohydrate: 33 g
Fiber: 4 g • Fat: 6 g • Sat Fat: 1 g
Recipe adapted from Cooking Light. Originally posted on mghbefit.com.
Tags: cooking, Diabetes Education, DSME, healthy eating, home cooking, vegetables
I never used to cook at home. In fact I HATED cooking. I had no confidence in the kitchen and burned everything, even toast. Time was another reason I didn’t cook often. I always thought cooking a meal had to take a ton of time; I really just wanted my food to appear in front of me. At the same time, I wanted to eat healthier but had no idea where to start or what to do with things like vegetables and spices. Then a coworker mentioned she had signed up for Plated [a subscription meal service] and suggested I give it a try. It sounded like an interesting concept, so I went for it.
What I like most is that it saves time and effort. Everything you need to make the dish is included and portioned out for you. Some recipes use ingredients I never would have bought on my own because I didn’t know how to use them, so it’s a great way to try new things. I also discovered that cooking doesn’t take up as much time as I thought. We typically cook at home 3-4 times a week (usually dinner). We’re definitely eating as a family more often, and I enjoy getting to spend time with loved ones while preparing meals.
We’ve been using Plated for about a year now and I feel much better about my cooking skills. I know if I made a recipe once I can do it again. You get to keep the recipe cards, so we’ll usually do a little experimenting the next time we make the dish. I’m eating healthier now, too. Before, I never really ate vegetables (or if I did they were just raw). I’d go into the grocery store and see all these wonderful looking vegetables but feel intimidated not knowing what to do with them. Now that I have a better idea how to cook them, I include vegetables with my meals often.
I recommend signing up for something like Plated if you don’t have much confidence with cooking. The recipes are easy and they tell you about how much time it takes to make. You’ll learn how to cook new things and different types of vegetables. My parents actually signed up for another meal delivery service, Blue Apron, because of my experience with Plated.
Tags: bug bites, Diabetes, DSME, health, mosquito, prevention, summer, zika
By Eileen B. Wyner, NP
Bulfinch Medical Group
I have lots of fond summertime memories from my childhood. We could play outside really late, Hoodsie® Cups were allowed even if it wasn’t a birthday party, and mosquito bites made me scratch so much I got the evil eye from my mother because I was so annoying. That was the extent of thought anyone gave to bug bites. So what has changed? Playing tag until dark has been replaced with my commuter rail commute and Hoodsie® Cups are too hard to find in the supermarket these days. But the biggest change is that now if I get a mosquito bite it doesn’t itch so much as cause anxiety.
Mosquitos are more than annoying. They potentially carry serious and life threatening disease. We all have to try harder to avoid being bitten. The best way to avoid bug bites and the possible illness (as well as the associated anxiety they may cause), is being informed about the recent facts concerning mosquitoes. What you need to know about illnesses spread by mosquitoes:
- West Nile Virus (WNV): This is a virus that often causes no symptoms. It is most common between the months of June and September, but people are at risk until the first frost.
- Eastern Equine Encephalitis Virus (EEE): EEE is a rare and severe mosquito transmitted virus that carries a 33% mortality rate. EEE may have no symptoms, but in some cases it can cause serious inflammation of the brain that can lead to coma. EEE is also present until the first frost.
- Chikungunya: This is a virus caused by mosquito bites that always causes some sort of symptoms; usually fever, joint pain and sometimes a rash. Chikungunya can affect people of all ages but the symptoms can be greater in the very young, the elderly, or those with chronic diseases such as heart disease and diabetes. Treatment is possible and people usually feel better within a couple of weeks. This illness has not been found in mosquitoes in the United States BUT it has been seen in many other countries including the Caribbean. People who travel to infected areas can be bitten and develop illness when they return home.
- Zika Virus: Zika has been front page news over the last few months, but it was first identified in 1947 in monkeys in Uganda. It is now frequently mentioned by the media as it has been accompanied by a rise in cases of microcephaly (a birth defect that affects the growth of the brain that is spread to the fetus during pregnancy and possibly at birth) and Guillain-Barré syndrome in South America. This past week CDC announced that infected mosquitoes have been located in parts of Miami, Florida and published guidelines for travelers to the area. Visit the CDC website for more information about Zika. The possible symptoms are very nonspecific, such as feeling tired, fever, rash, and conjunctivitis. People may be infected and not know it. There are tests available to see if Zika is the cause of the illness, but they are performed under very specialized circumstances. Ask your healthcare provider for more information. There is no treatment for Zika, but the symptoms can be treated as needed.
The best treatment for any of these viruses is PREVENTION:
- Mosquitoes breed in moist spaces. It is important to remove standing water such as watering cans, wading pools, or rubbish cans.
- Mosquitoes are known to be most active at dawn and dusk. However, Zika infected mosquitoes are mostly DAYTIME biters. It is still the best idea to make sure that window screens are intact. Close windows and use air conditioning if possible.
- Wear protective clothing (e.g. long sleeves, pant legs tucked into socks) when outside during potential peak activity hours.
- Use mosquito repellent. Products that include DEET, picaridin, oil of eucalyptus, or para-menthane-diol are appropriate to use. It is important to read the directions as many of these products are harmful to infants and children.
- Zika presents another challenge as far as prevention. Zika can be spread through sexual activity, so it is necessary to observe safe sex practices if there is any chance of infection.
This is a beautiful time of year in the Northeast and sooner than I care to think about, I’ll be worrying about ice dams. I hope that you will all join me and go outside and play. Just don’t forget to add the right clothing and some bug spray in your backpack.
Tags: commitment, Diabetes, DSME, exercise, exercise buddy, fitness, friends, routine
By Jahnelle Bray
Population Health Coordinator
One of my old coworkers made a commitment to get up early every morning to go spinning. She always had so much energy during her day I thought I’ve got to try this! When a spinning studio opened across the street, I got a group of friends together and that’s what we did. That first class was tough and I had really mixed emotions when it was over. I was sweaty and sore, but also really energized. A little while later I introduced another friend to spinning and she LOVED it. She also suggested we go to a class every week. This was great for me because it has helped me build consistency with my workouts.
If you struggle with staying in shape or sticking with exercise, finding an exercise buddy is really helpful. When you’re by yourself, it’s easy to talk yourself out of exercising or just do the bare minimum. When you make plans with someone else, you’ve made a commitment to be there and do your best. You don’t want to feel like you’re letting them down.
Your exercise buddy can push you to keep going when your muscles start to hurt. If I start to feel like I’m ready to give up, I’ll look over and see how my friends are doing. Seeing them going for it when I’m flagging really motivates me to stick with it. Thinking about the class as a group effort also helps. Everyone is there for the same reason and we’re all going to get through this together. I don’t want to be the only person not doing anything, so I tell myself if they can do it, so can I!
It was great finding someone who loved spinning as much as I do and wanted to go regularly. We have a routine now where we text each other every week to decide what day we’ll go. It’s been about a month since we started doing this, and I’m much less sore than I was after that first time! I look forward to class. It’s a chance for me to disconnect and recharge my body and mind. If I miss a week, I don’t feel my best. Working out is a great accomplishment. If you don’t finish anything else in your day, at least you’ve done that.