Category Archives: Uncategorized

Cross the Border for Affordable Insulin

Great article by Robin Cressman. Read the whole thing.

“Just a week before the trip [to Tijuana, Mexico], I was down to my very last vial of Humalog. It was June and I was close, but still so far, from hitting my $5,000 deductible for the year, which meant I was still paying full price out of pocket for all of my medical costs until I hit that figure. I had started the year low on supplies (a rookie mistake that I now know to avoid) and had been juggling bills from Dexcom, my doctor’s office, and my pump supplier for months, trying to only use our health savings account but often having to pull out credit cards to cover the costs. I called my pharmacy and asked to fill a single vial of Humalog, and the cost was $248.13. I hung up the phone. Instead I went to Walmart and for the first time bought vials of Novolin NPH and Regular for $24.99 each. It was those vials that were serving as my backup insulin a week later when I found myself in that pharmacy in Tijuana.”

Source: Crossing Borders to Afford Insulin – T1International

Whether it’s legal or not, I don’t know.

Steve Parker, M.D.

low-carb mediterranean diet

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Dietary Strategies for Management of Diabetic Gastroparesis

bariatric surgery, Steve Parker MD

The only picture of stomach I have

When you eat a meal, your stomach holds it there for a while then gradually releases contents into the duodenum, the first part of the small intestine. The stomach makes those releases by contraction of muscles in the wall of the stomach. Those muscles are under control of the autonomic nervous system. In some folks with diabetes, the nerves controlling the stomach muscles don’t work very well, so stomach contractions are weak. Food just sits in the stomach for too long, delaying digestion and absorption of nutrients. One result is unpredictable blood sugar levels after meals, no matter how carefully you count carb grams. The medical term for these weak stomach contractions is gastroparesis.

From Diabetes Care:

“How is diabetic gastroparesis best managed?

Consultation by an RDN [registered dietitian, I reckon] knowledgeable in the management of gastroparesis is helpful in setting and maintaining treatment goals. Treatment goals include managing and reducing symptoms; correcting fluid, electrolyte, and nutritional deficiencies and glycemic imbalances; and addressing the precipitating cause(s) with appropriate drug therapy. Correcting hyperglycemia is one strategy for the management of gastroparesis, as acute hyperglycemia delays gastric emptying. Modification of food and beverage intake is the primary management strategy, especially among individuals with mild symptoms.

People with gastroparesis may find it helpful to eat small, frequent meals. Replacing solid food with a greater proportion of liquid calories to meet individualized nutrition requirements may be helpful because consuming solid food in large volumes is associated with longer gastric emptying times. Large meals can also decrease the lower esophageal sphincter pressure, which may cause gastric reflux [heartburn], providing further aggravation.

Results from a randomized controlled trial demonstrated eating plans that emphasize small-particle-size (<2 mm) foods may reduce severity of gastrointestinal symptoms. Small-particle-size food is defined as “food easy to mash with a fork into small particle size.” High-fiber foods, such as whole intact grains and foods with seeds, husks, stringy fibers, and membranes, should be excluded from the eating plan. Many of the foods typically recommended for people with diabetes, such as leafy green salads, raw vegetables, beans, and fresh fruits, and other food like fatty or tough meat, can be some of the most difficult foods for the gastroparetic stomach to grind and empty. Notably, the majority of nutrition therapy interventions for gastroparesis are based on the knowledge of the pathophysiology and clinical judgment rather than empirical research.”

Source: Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report | Diabetes Care

Steve Parker, M.D.

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I Just Learned About Chaffles…

…at Diabetes Daily. I assume the word rhymes with waffles. From DD:

If you haven’t heard of the term “chaffle” yet, are you really living? The latest craze has taken the diabetes online community (DOC) by storm. One moment I was inquiring about what exactly a chaffle was, and the next, I found myself a golden ticket to an underground world with over 100,000 keto-crazed chaffle fanatics! What is a chaffle you ask? A chaffle is basically a cheese and egg alternative to bread, cooked in a mini (or regular, just adjust recipes accordingly) waffle maker that can be used for anything from breakfast foods straight through your after-dinner treat. It basically acts as a base to any creative concoction you can conjure up. Why are people with diabetes so excited about chaffles? Well for one, those of us who love to experiment with new low-carb options now have this new blank canvas to create from. But more importantly, this latest invention can also help keep your blood sugars in check straight from morning till night!

Click the link for recipes.

Source: 5 Chaffle Ideas to Get You from Breakfast to Dessert – Diabetes Daily

Steve Parker, M.D.

low-carb mediterranean diet

Click the pic to purchase at Amazon.com

 

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Sofia Norton Debunks 21 Weight-Loss Myths

Click the link below for her article at Kiss My Keto. The preamble:

Before we dive into the weight loss myths, it’s important to state the truth about weight loss.It’s not as simple as eating healthy and following an exercise program.

Of course, those can make a big difference, however, it doesn’t work that way for everyone.

There are so many factors that come into play when it comes to weight loss. Some of those factors include genetics, endocrine disorders, medications, insomnia, and cultural reasons.

This is why women with the polycystic ovarian syndrome may find it harder to lose weight than those who don’t have it.

So the next time you come across a trending weight loss tip, pause for a moment, and research about it to see if it’s even true. Secondly, analyze your current situation to see if this particular weight loss strategy will work for you.

Source: 21 Popular Weight Loss Myths Debunked! – Kiss My Keto

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Seniors, Preserve Your Muscle Mass as You Lose Weight

dementia, memory loss, Mediterranean diet, low-carb diet, glycemic index, dementia memory loss

“Honey, please come to the gym with me.”

We’ve known for a while that resistance training helps preserve muscle mass in younger folks during weight-loss programs. I’ve always figured the principle applied to older folks, too. Now we have proof. Average age of these study participants was 67.

From UPI.com:

Seniors who want to lose weight should hit the weight room while they cut calories, a new study suggests.

Older folks who performed resistance training while dieting were able to lose fat but still preserve most of their lean muscle mass, compared with those who walked for exercise, researchers report.

“The thought is if you lose too much lean mass, that this will exacerbate risk of disability in older adults,” said lead researcher Kristen Beavers, an assistant professor of health and exercise science at Wake Forest University in Winston-Salem, N.C. “Our findings show if your treatment goal is to maximize fat loss and minimize lean mass loss, then the resistance training is probably the way to go.”

 

 

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What’s the Best Diet For Diabetes?

From a recent Diabetes Care journal article:

“The Consensus Report highlights the role of weight management, dietary patterns, and technology-enabled tools in diabetes prevention and management. There is a clear consensus on reducing intake of added sugars, sodium, and unhealthy fats, especially trans fat, in the diet, although the panel does not recommend a “one-size-fits-all” eating plan. Instead, multiple eating patterns including the Mediterrranean diet, DASH (Dietary Approaches to Stop Hypertension) diet, and vegetarian and low-carbohydrate diets can be used for weight and diabetes management. However, the quality and food sources of the macronutrients are among the most critical factors determining the efficacy and long-term outcomes of these diets.”

Source: Nutritional Strategies for Prevention and Management of Diabetes: Consensus and Uncertainties | Diabetes Care

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8 Scientific Health Benefits of the Mediterranean Diet 

There are reasons I adapted the Mediterranean diet for folks with diabetes. the article linked below lists some of them.

“If there’s one so-called diet that is widely acclaimed for its health benefits, it’s the Mediterranean diet. In fact, U.S. News & World Report ranked the Mediterranean diet No. 1 on its 2019 41 Best Diets Overall list, citing a “host of health benefits, including weight loss, heart and brain health, cancer prevention, and diabetes prevention and control.” More of an eating pattern than a calorie-restricted diet, the Mediterranean regimen emphasizes eating lots of vegetables, fruits, nuts, legumes, seeds, and fish, with liberal use of olive oil, a moderate amount of dairy foods, and a low amount of red meat — a way of eating common in Mediterranean countries such as Spain, Italy, and Greece, noted an article published in June 2018 the journal Current Atherosclerosis Reports.”

Source: 8 Scientific Health Benefits of the Mediterranean Diet | Everyday Health

low-carb mediterranean diet

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