Tag: Diabetes

recipes

Loaded Baked Sweet Potato

Posted on by mghdiabeteseducation

These loaded baked sweet potatos from the MGH Be Fit program are a healthy addition to your game day menu.  If you’re short on time, the potatoes can be cooked in a microwave. Puncture each potato a few times with a fork and microwave on high for 10 minutes.  You can also use the microwave to steam the broccoli.  Put a little water to a microwave safe bowl and add the broccoli.  Cover and microwave for 3 to 4 minutes or until broccoli is tender.

Ingredients:

4 medium sweet potatoes or yams
3½ pounds fresh whole broccoli or 2 (16 ounce) bags of frozen broccoli
1 (15 ounce) can black beans, drained and rinsed
1 cup shredded cheddar cheese
Salsa, to taste
½ cup plain low fat Greek yogurt

Instructions:

Set oven to 400 degrees.  Bake potatoes for 45 to 60 minutes, or until easily pierced with a fork.  Remove from oven.

Cut fresh broccoli into bite-sized pieces, cutting away thick stems. Bring 1-inch of water to boil in a medium saucepan.  Add broccoli, cover and reduce heat to medium.  Cook 5 to 6 minutes or until broccoli is tender.  (If using frozen broccoli cooking time may not be as long.)

Slice each potato lengthwise and flatten slightly so it opens up like a book.  Stuff with ¼ cup beans, 2 cups broccoli, ¼ cup cheese, salsa to taste, and 2 tbsp yogurt. (The contents will be overflowing.)

Yield:  4 servings

Nutrition Information per Serving:  Calories: 400 • Protein: 25g • Sodium: 470mg • Carbohydrate: 53g • Fiber: 16g • Fat: 12g • Sat Fat: 6g

Originally published on mghbefit.com.
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recipes

Meatball Mummy Crescent Bites

Posted on by mghdiabeteseducation

trick or treat ghostCelebrate Halloween with this festive appetizer recipe from the Pediatric Diabetes Clinic

Kitchen Tools:

Knife or Pizza Cutter
Parchment paper
Large cookie sheet

Ingredients:
1 can (8 oz) refrigerated crescent dinner rolls
20 frozen cooked turkey meatballs, thawed
Ketchup or mustard
Marinara sauce (1 oz or 2 tablespoons = 4 gm Carb)

Directions:
Heat oven to 375 degrees Fahrenheit. Put piece of parchment paper on work surface (counter).  Unroll dough onto parchment paper, press out perforations to make one sealed large rectangle.  Cut into 4 small rectangles with knife or pizza cutter

Using knife or pizza cutter, cut each rectangle into 10 strips. You will have 40 strips of dough after all 4 small rectangles cut.

Wrap 2 strips of dough around each meatball to look like “bandages”.

Separate “bandages” near one end to show meatball “face”. Place wrapped meatballs on ungreased large cookie sheet.

Bake 13 to 17 minutes or until dough is light golden brown and meatballs are hot. With ketchup or mustard, draw “eyes” on mummy bites.

Serve warm with marinara sauce if desired.

Prep time: 15 min lTotal time: 30 minutes l Makes: 20 servings l Serving Size: 1 meatball l Carbs per serving: 7 grams

Recipe amended from Pillsbury.com/recipes
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Nutrition, recipes

Be Fit Basics : Mango Black Bean Salad

Posted on by mghdiabeteseducation

This easy salad recipe from the MGH Be Fit Program is a great use of the leftover grain from last night’s dinner. If you don’t have a cooked grain, substitute fresh or frozen corn kernels instead.  If you can’t find fresh mango, look for frozen cubed mango in the freezer section of your grocery store.  Dislike cilantro? Substitute another green herb, like parsley.

Ingredients:
1 mango, chopped and peeled (or about 1½ to 1¾ cups)
½ cup thinly sliced green onions (scallions), the white and green parts
½ cup cooked grain (use leftover rice, quinoa, etc.) or corn kernels
¼ cup finely chopped cilantro
2 tbsp fresh tomato salsa (or diced tomato)
1-15 ounce can low- sodium black beans, rinsed and drained
juice of 1 lime
2 tbsp olive oil
½ tsp salt (or to taste)
¼ tsp black pepper

Instructions:
In a large bowl, combine all ingredients and toss gently to mix.

Yield:  Serves 6

Nutrition Information per Serving (about 2/3 cup – nutrition information calculated with brown rice):  Calories:  160 • Protein:  5g • Sodium:  250mg
Carbohydrate: 27g • Fiber:5g • Fat: 5g • Sat Fat:1g

Recipe adapted from Cooking Light.  Originally posted on mghbefit.com
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Guest Post, My Story

My Story: Nothing Holding Me Back

Posted on by mghdiabeteseducation

By Anne-Maria

I’ve had Type 1 Diabetes for 49 years – next April will be my 50th diaversary.  When I was diagnosed in the 60’s/70’s, there wasn’t as much information about diabetes out there as there is now.  But still, having diabetes never held me back from anything I wanted to do.  I still travel, and I stayed out late in my 20’s and 30’s like any other young person would.  I strongly believe that diabetes is just a part of life.  The key is to accept it and make it part of your routine.

There are professional hockey players who have diabetes.  Gary Hall, Jr. has Type 1 Diabetes and he swam the 50-meter freestyle at the Olympics.  They didn’t let diabetes stop them; they made it work.  Put your sight on what you want to do and figure out how to do it (I just don’t know if they can send you into space yet).  People are happy to work with you if you talk to them about your needs.  When I was still in school, we went on ski trip to the Alps.  At the time, they didn’t have refrigerators in the hotel rooms so I stored my insulin in the one in the kitchen.  I got to know the kitchen staff pretty well and they were happy to accommodate me.  Nobody has ever said “no” when asked to help.

The only time my health factored into any of my life choices was when I decided not to become a physician.  Sleep is very important for me and I knew I wouldn’t be able to function with the little bit of sleep med students get.  But again, it was my choice based on what I needed to take care of my own health.  I know my body inside and out, so I know when something isn’t right and how to adapt.  When I have late meetings, I’ve learned to check my blood sugar and drink some juice before it starts so I don’t go low.

My biggest piece of advice for parents or anyone who has been diagnosed with Type 1 diabetes is:  take a deep breath and relax.  If you were diagnosed as an adult, know there’s nothing abnormal about what you have.  You can maintain your regular routine without much extra effort.  The only time I need to pay more attention to my blood sugar is when I’m sick.  I might have to take some extra time off from work to recover these days, but that could be because I’m getting older.

If you’re a parent, let your kids be kids.  Let them have fun at parties and eat a small piece of cake like the other kids (maybe take of some of the frosting first).  Don’t stress too much about what they eat.  You don’t have to make big formal meals.  Sometimes when I get home late I’ll have cereal and fruit for dinner.  Just use common sense and think about what you need to do to cover it with insulin.

 

 

 

 

 

 

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Health, Nutrition

Diabetes and A Healthy Microbiome

Posted on by mghdiabeteseducation

By Christina Badaracco, Dietetic Intern 

What Is the Microbiome?

The human microbiome includes all the bacteria, both good and bad, that live in our organs. There are actually about 10 times as many bacterial cells in the body as human cells! Bacteria play many important roles in keeping us healthy, such as protecting us from invading bad bacteria and breaking down (or fermenting) the fiber in foods like vegetables that our own bodies can’t digest.

Our microbiome includes many different types of bacteria, and more diversity is typically a sign of good health. Many diseases, such as diabetes, can reduce the diversity in our gut and create environments that are better for bacteria that produce substances that cause inflammation or other harmful effects.  In this figure you can see many of the things that cause the microbiome to become imbalanced (such as taking antibiotics or poor diet) and some of the health problems that might result.  The microbiome is such an important factor in our health that the National Institutes of Health have launched two versions of the Human Microbiome Project, granting hundreds of millions of dollars into research about the connection between changes in the human microbiome and disease.

Is there a Link Between the Microbiome and Type 2 Diabetes?

Type 2 diabetes can be caused by genetics as well as diet and lifestyle.  Eating a healthy diet (one with lots of fiber-filled fruits and veggies and low in sugar and saturated fat) and exercising regularly can help keep your microbiome healthy and might help reduce the risk of developing diabetes.  The short-chain fatty acids that good gut bacteria produce when breaking down fiber can increase your body’s metabolism and how quickly glucose in the blood is used up, which can help manage blood sugar.  A recent study showed that a diet rich in fiber could improve diabetes management because it produces the short-chain fatty acids the cells of our gut lining need to be healthy.  Fiber also reduces inflammation and keeps you feeling full, which helps with managing portion sizes and keep blood sugar steady after meals. The types of bacteria in the gut also shifted to the species that love a high-fiber diet, promoting health long into the future.

How Can I Feed a Healthy Gut Microbiome?

  • Eating a diet rich in fiber keeps your good bacteria happy. They break down molecules like cellulose found in fruits, vegetables, and whole grains.
  • Limit high-sugar and high-fat meals. Bad bacteria thrive when we eat a high-sugar and high-animal fat diet. Try to limit foods like sodas, candy, large servings of fast foods, sugary baked goods, red and processed meats.
  • Try to eat some foods with probiotics. Foods that are already broken down (or fermented) contain good bacteria that can colonize and thrive in our guts. As a bonus for people with diabetes, these bacteria have already broken down some of the glucose for you! Some examples of fermented foods include:
    • Dairy: cheese or yogurt
    • Bread: sourdough
    • Grains: injera (found in Ethiopian cuisine), idli (found in Indian cuisine), atole (found in Mexican cuisine)
    • Vegetables: sauerkraut, fermented pickles, curtido (found in Salvadoran cuisine) kimchi (found in Korean cuisine) and tempeh and miso (found in Japanese cuisine)
  • Your healthcare provider many suggest taking a probiotic supplement to increase your good gut bacteria, particularly if you have recently taken antibiotics.
Post content reviewed by Melanie Pearsall, RD, CDE
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Health

Standards of Medical Care in Diabetes 2018

Posted on by mghdiabeteseducation

By Eileen B. Wyner, NP
Bulfinch Medical Group

Eileen Wyner, NPThe American Diabetes Association (ADA) publishes guidelines each January to educate professionals about the best clinical practice for people with diabetes. Beginning in 2018 the ADA will publish updates online as they become available if new evidence or regulatory changes require immediate incorporation. The new recommendations include the areas of cardiovascular health, health technology, screening , and patient centered care. These standards are meant to provide general treatment goals for people with diabetes. They are not meant to replace clinical judgment. I am going to briefly review some of the changes this year.  A more detailed explanation of the standards can be found here.  Please remember, that these are in no way meant to replace the individual care that you are participating in with your health care team.

Section 1: Improving Care and Promoting Health in Populations

Care for people with diabetes includes assessing for financial resources, access to care, stability of housing situation, ability to access healthy food, and medication use.  Additional support for diabetes self-management can come from community health workers, navigators (who help “navigate” health insurance and claims), and lay health coaches who help with self-management.

Section 2: Classification and Diagnosis of Diabetes

Certain medical diagnoses can make A1c test results less accurate. People with conditions that affect red blood cells, such as sickle cell anemia, may get an incorrect result. It is important to use other methods to test for diagnosis and control of diabetes such as fasting and postprandial (after meal) glucose levels.

Section 3: Comprehensive Medical Evaluation and Assessment of Comorbidities

Pancreatitis is now listed as a comorbid condition (another condition a person can have along with diabetes).

Serum testosterone should be checked in men with symptoms of hypogonadism.

Section 4: Lifestyle Management and Section 6: Glycemic Targets

Both sections address the ADA recommendations for using technology to help with diabetes management.  This could include teleconference, text messages, or email. The use of continuous glucose monitoring (CGM) for people with Type 1 Diabetes should start at age 18.

Section 8: Pharmacologic Approaches to Glycemic Treatment

Recent study data has shown that all patients newly diagnosed with diabetes should be following strict lifestyle changes and start metformin. People with heart disease should consider additional medication(s) that may reduce cardiovascular events/mortality.

Section 9: Cardiovascular Disease and Risk Management

People with hypertension (high blood pressure) and diabetes should monitor their home readings to help to identify white coat hypertension and to improve medication management and following directions for taking medications. The ADA defines hypertension as blood pressure of 140 or greater /90 or greater.

Lipid management recommendations were changed to group risk in two broad categories: with heart disease and without.

Section 11: Older Adults

It is very important to individualize medical therapy in older adults to achieve the best results without any adverse reactions, such as hypoglycemia. A1c target should be adjusted for age and other medical conditio

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Nutrition

Asparagus Chickpea Quinoa Salad with Lemon Vinaigrette

Posted on by mghdiabeteseducation

Celebrate spring with this salad recipe from the MGH Be Fit program.  Leftovers work well for a quick lunch—just keep the dressing separate and add before eating, so the greens don’t wilt.  You can also add a hard-boiled egg to further increase the protein in this recipe.

Ingredients

For the lemon vinaigrette
¼ cup lemon juice
½ cup olive oil
2½ teaspoons Dijon mustard
Kosher salt and black pepper, to taste

For the salad
1 cup uncooked quinoa, rinsed and drained
1 bunch asparagus (15 to 20 spears), cut into 1-inch pieces
1 tablespoon olive oil
1 (14-ounce) can chickpeas, rinsed and drained
3 large handfuls of arugula
2 scallions, thinly sliced
½ cup crumbled feta cheese

Instructions:
To make the vinaigrette:
Place all ingredients in a small jar with a lid and shake until thoroughly combined (or whisk together in a small bowl). Taste vinaigrette; add salt and pepper as needed.

To make the salad:
In a medium saucepan over medium heat, combine the quinoa with 2 cups of water. Bring to a boil, then cover and lower the heat to a simmer. Cook for 15 minutes or until the quinoa is tender. Let sit for 5 minutes then fluff with a fork. (If your quinoa still has water in it simply strain it out.) Set aside until ready to assemble the salad.
While the quinoa is cooking, sauté asparagus in olive oil in a medium skillet over medium heat until cooked through, about 7 minutes.

To assemble the salad:
Combine the cooked quinoa with asparagus, chickpeas, arugula, and scallions. Top with vinaigrette and feta cheese.

Yield: 6 servings

Nutrition Information per Serving:
Calories: 390 • Protein: 10g • Sodium: 240mg • Carbohydrate: 31g • Fiber: 7g •
Fat: 26g • Sat Fat: 5g

Recipe adapted from Two Peas & Their Pod
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Nutrition

Eat Balanced by Pairing Your Carbs with Protein

Posted on by mghdiabeteseducation

By Lisa Keovongsa
Dietetic Intern

There is a common misconception that once a person is diagnosed with diabetes they need to cut out all carbs. This is not the case! Carbohydrates are very important because they serve as the main fuel source for the body and give the brain and muscles the energy needed to carry out daily activities. Carbs, protein, and fat all play essential roles and can be incorporated into your meals and snacks to keep you feeling your best. Also, eating carbs with protein at every meal will help manage your blood sugar and help your body best utilize the nutrients in your food.

Carbohydrate Foods
Many foods with carbohydrates raise blood sugar.  Eating carbohydrate with a protein or fat can keep your blood sugar steady.  Foods with carbohydrates include:

 Starchy vegetables*/legumes:  Pumpkin, squash, all potatoes, yucca, beans, corn

Dairy: Milk, yogurt

Grains: Breads, pastas, tortillas, rice, crackers/snack chips, cereals, quinoa

Fruit: Apples, oranges, pears, bananas, mangoes

*Non-starchy vegetables have fewer carbohydrates.  Examples of non-starchy vegetables include: Carrots, lettuce, broccoli, cabbage, tomatoes, any leafy green, cucumbers

Protein Foods
There are many options when it comes to eating protein. These foods include meats, poultry, eggs, fish, cheese, cottage cheese, nuts, nut butter, and tofu.

Why do we need to eat protein with carbs?
During digestion, the food we eat gets broken down into simple sugars that are delivered to our muscles and liver through the bloodstream.  Insulin is the “key” that “unlocks the gate” for sugar to leave the blood and enter the 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.  This can cause high blood sugar, which, if it happens consistently over time, can lead to complications.  Proteins (and fats) take longer to digest than carbs, so eating protein along with the carb slows down digestion in the stomach and absorption in the intestines. This will help slow the rate of sugar entering the bloodstream, keeping blood sugars steady and preventing blood sugar spikes (and crashes).  Check your blood sugars 2 hours after a meal to see the effects.

Snack Ideas
Pair one item from the protein list with an item on the carbs list to make a balanced snack that will keep your blood sugar in check:

Protein                                                 Carbs

Handful of nuts                                 Whole fruit (apple, ½ banana)

1 cup Greek yogurt                           5 Whole wheat crackers

2 Deli turkey slices                           1 whole grain tortilla

1 oz beef jerky                                  1 oz whole wheat pretzels

Hard-boiled egg                                1 cup regular yogurt

½ cup cottage cheese                       ¼ cup granola

1 tbsp Peanut butter                        3 cups popcorn

2 Tbsp Hummus                               ½ cup dried fruit

1 oz cheese                                       1 cup raw vegetables

Post content reviewed by Melanie Pearsall, RD, CDE
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Health, Nutrition

Insulin: Get to know me!

Posted on by mghdiabeteseducation

By Meredith Kimmish
Dietetic Intern

If you or a loved one is currently living with Type 2 Diabetes, understanding the insulin regimen your healthcare provider has prescribed may be intimidating or difficult to understand. If you sometimes wonder Why am I taking this?; When should I take this?;  or Am I doing this right? you are not alone! Many people living with diabetes use different types of insulin, inject at different times of the day, and have various eating habits. But what does this all mean to you?

First let’s learn the basics on insulin:

  • There are different types of insulin depending on how fast they work, peak times, and how long they last
  • Insulin comes in different strengths and not everyone takes the same dosage
  • Insulin cannot be taken as a pill.  It breaks down before it can be absorbed by the body. That is why it must be injected

Now that we know the basics, let’s look at the 3 features of insulin:

  • Onset– the length of time it takes for insulin to reach the bloodstream and begins its job to lower blood sugars.
  • Peak time– Time during which insulin is working at its full strength to lower blood sugar levels.
  • Duration– How long insulin lasts to lower blood sugar levels.

What Insulin are you currently taking?

  • Rapid acting– Insulins such as Humalog and Novolog have a short onset and are taken with meals (either shortly before, during or right after)
  • Intermediate acting– Insulin such as NPH has a longer onset and duration than rapid acting, so it works between meals
  • Long-Acting- Insulin such as Lantus has the longest onset time and lowers blood glucose evenly throughout the day.
  • Mixed dose– NPH insulin may be mixed with a rapid acting insulin. Mixed dose is usually only used for people with a simple insulin treatment plan.

Check with your healthcare provider and/or CDE if you have any questions about your insulin.  They will work with you on the best time to take your medications.

Checking your Blood Glucose
Insulin needs are based off many factors such as body weight, food intake, physical activity, use of certain drugs, and physical or mental stress. These factors may differ day to day, therefore It is important to check your blood glucose levels regularly. Keeping a log of your blood sugar checks is a great way to help you learn how food, exercise and activity, and stress can affect your blood sugar levels. If you see that your blood sugars are too high or too low for several days, this may be a sign that you need to change your insulin regimen.

Eating Patterns and Meal Planning
Studies have shown that having meal plans and preparations ahead of time can help manage your diabetes. Remember, there is not a standard diabetes meal plan, so create one that works best for you and your lifestyle with long term goal setting.  Having scattered meal periods throughout the day can throw your blood sugar out of whack.  Creating a regular schedule for healthy meal and snack times can help manage your blood sugars by coordinating your insulin regimen with meal times.

If you would like to schedule an appointment with a registered dietitian from Massachusetts General Hospital, call the Outpatient Nutrition Counseling at 617-726-2779.

 Post content reviewed by MGH Pharmacist and Melanie Pearsall, RD, CDE
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