Posts for the ‘Diabetes’ Category

World Diabetes Day – Why Checking Your Blood Sugar is So Important

By Alicia Kaluza, MS, RD, LN

November 14th is World Diabetes Day  – a campaign that draws awareness to the escalating health threat posed by diabetes. The number of people with diabetes has nearly quadrupled since 1980. Prevalence is increasing worldwide, due in part to increases in the number of people who are overweight, and in a widespread lack of physical activity.

If you’re one of the many people who have been diagnosed with diabetes, you may begin a process of checking blood sugars. If this is the case, your doctor may go over a lot of information, including why you should check your blood sugar, and how often. This can be overwhelming, leading to forgetting what was said. Consider bringing someone with you to the appointment, or take notes.

Checking and understanding your blood sugar level is especially important for understanding what is happening in your body. Your blood sugar levels tell you how certain foods affect your blood sugar, how well your diabetes is being managed, if there is a problem, and whether or not your current treatment is working. This simple task of checking blood sugar provides a lot of valuable information, which is why it is so important.

Poorly managed diabetes can lead to problems with your feet, hands, kidneys and eyes. Uncontrolled diabetes also increases your risk for heart disease. This is why the one action of checking your blood sugar can help provide you with the information to manage your diabetes successfully.

Here are five tips to follow to develop good habits with checking blood sugar levels and maintaining good diabetes self-care:

  1. Talk to a Certified Diabetes Educator (CDE) – they are a great resource for answering questions, teaching you how to check blood sugars, and helping navigate the overall diabetes care process. All hospitals and clinics have CDE’s on staff, as does Take Control.
  1. Create a Habit. Set alarms, place sticky notes, whatever you need to do to remember to check your blood sugar. Some people only need to check 1-2 times daily, while others may need to it check more often, such as 4-6 times per day. Whatever your doctor recommends will be based on your medications, and overall care plan. Regardless of how often you check, remember to make it a priority.
  1. Track Your Numbers. Keep a notebook, spreadsheet, app, or other form of tracking accessible to track your numbers. People who are diligent about tracking are able to modify their approach with diet and lifestyle, as well as medication if needed to ensure good control.
  1. Use Good Procedure. Rotate your testing sites and use good technique. Instead of poking the same finger in the same spot, use different fingers. Line up on the side of the finger versus the fingertip – there are less nerve endings in the side, which causes discomfort. Rotate the site to prevent less development of scar tissue, which can occur from frequent pokes in the same spot. By using the right technique you can lessen the pain and fear of checking blood sugar levels.
  1. Build a Supportive Network. Include your doctor, CDE, family, and whomever else can help you stay accountable and on track. Having diabetes is not easy, but having people to support you makes the challenges easier.

In the end, choose the methods that work for you, and you will find more success overall. If you are unsure about whether or not you should be checking your blood sugar level at all, then discuss it with your doctor. They will be able to re-evaluate your needs and help you make adjustments to your care plan as needed.



Feet First

By Madeline Del Guerra, Take Control Staff

How often do you think about your feet? Most of us don’t give them a second thought until they start to hurt, but they are an important part of our overall good health. A change in your feet can be one of the first signs of a serious health problem. Feet (and other extremities) are the first to show signs of problems in your body, because when things go wrong, our body sends blood to our internal organs and brain first. Paying attention to your feet will allow you to get to know them well, and identify any problems sooner rather than later.

Summer is a great time to take care of your feet. Since we’re often wearing flip flops or sandals, they’re easy to notice. Summer weather can be hard on feet – the hot air dries them out, walking barefoot toughens them, and the moist, sweaty environment in shoes can invite fungus.

So while your feet are front and center this summer, take some time to examine them and pamper them. The following tips will help keep your feet in good health:

1. Soak: 

Soak your feet for 10-15 minutes. Use a large bowl or a bathtub with a chair in front of it. Fill with warm/hot water and add ¼ cup of Epsom salt. Epsom salt contains magnesium, which helps reduce inflammation and pain. You can also add a couple drops of your favorite essential oil(s). Peppermint or lavender are great choices.

2. Smooth

After soaking for 10-15 minutes, use a pumice stone and gently remove any calluses and dead skin. Rub the pumice stone in a circular motion over the pad of each foot and each heel. A pumice stone will exfoliate your feet without causing any harm. I recommend the “Trim” pumice which can be purchased at Walmart for around $3.00. It’s inexpensive, and delicate on sensitive skin.

3. Examine

Examine your feet and check for any cracks, cuts, blisters, or sores. If it’s hard to bend to see your feet, place a hand mirror on the floor to check your feet. Some symptoms of larger problems include sunken or marked toenails, no toe hair, foot cramps, flaking skin, numbness, morning pain, and sores that don’t heal. If you find any of these symptoms, or signs of infection, pain, or swelling, particularly if you have diabetes, schedule an appointment with a physician or allied health professional to have them checked.

4. Moisturize

Moisturizing your feet prevents calluses and painful cracks that can lead to infection. Apply 1-2 thin coats of lotion to the top and bottom of your feet. Do not apply lotion between toes, as the moisture accumulation can lead to infection. I recommend “Miracle Foot Repair Cream” by Miracle of Aloe. It’s available at Walmart or Walgreens for about $12.00.

Unresolved foot problems have unexpected consequences. For example, if your feet hurt, you’re likely to move less, and that could lead to weight gain. If your feet hurt, you may compensate and shift your balance in a way that leads to falling or creates pain in other areas of your body. So take the time to take care of your feet, your overall health depends on it.


Triglycerides and Your Diet

A diet high in carbohydrates, especially in refined carbohydrates (like sweeteners, white flours, and other highly refined carbohydrates) can raise triglyceride levels. Triglycerides are another type of fat in the blood. When you eat, your body converts any calories that it does not immediately need into triglycerides which are stored in fat cells. As such they can provide your body with energy when necessary.

What contributes to high triglyceride levels? High triglycerides can sometimes be a sign of poorly controlled diabetes. Other things that contribute to elevated triglyceride levels are obesity, an under-active thyroid, diabetes, kidney disease, and smoking. A low intake of omega-3 fatty acids may also raise triglycerides. Additionally, some medications may raise triglyceride levels.

Why is my triglyceride level important? We are not sure how exactly high triglycerides may contribute to the hardening of arteries or thickening of artery walls. What we do know is that this hardening and thickening of artery walls raises the risk for heart disease including both strokes and heart attacks. Dr Michael Miller (University of Maryland, Baltimore) states, “We’ve known that triglycerides are linked with LDL cholesterol in that high levels of both confer a greater risk than either one alone,”. “In fact, having a high triglyceride level, above 200 mg/dL, with elevated LDL cholesterol confers about a twofold risk of heart disease. The question is how you tease out triglycerides from other risk factors, because typically people who have high triglycerides often have insulin resistance, low HDL cholesterol, and high blood pressure.”

How do I lower my triglyceride level? Diet and exercise are the cornerstones of treatment for patients with elevated triglyceride levels, according to a new scientific statement from the American Heart Association. The American Heart Association (AHA) states that a triglyceride level of <100 is optimal and improves heart health. Additionally, in May 2011 the AHA released guidelines on the treatment for high triglycerides. For patients with borderline triglyceride levels, those ranging from 150 to 199 mg/dL, experts recommend losing 5% of current body weight and limiting carbohydrates to 50% to 60% of daily caloric intake. A 5% to 10% weight reduction may result in a 20% decrease in triglycerides, an approximate 15% reduction in LDL cholesterol, and an 8% to 10% increase in HDL cholesterol. The AHA further recommends limiting added sugars to less than 10% of daily caloric intake and provides new guidance on fructose consumption, recommending that borderline patients consume less than 100 grams per day from all sources. Among individuals with borderline, high, and very high triglyceride levels, weight loss of up to 10% of body weight is recommended.

Even if people have not been diagnosed with triglycerides outside the normal range, if they eat too many simple sugars (refined grains, added sugars and alcohol) their triglycerides will increase.

A well-balanced diet high in fiber, with whole grains and containing plenty of fruits and vegetables, along with fat-free or low-fat milk and milk products, seafood, lean meats and poultry, beans, nuts and seeds will help to lower triglyceride levels. Additional tips to lower triglycerides levels include:

  • Lose weight. There is evidence that a 5-10 percent weight loss results in a 20 percent decrease in triglycerides – the amount of decrease in triglycerides are directly related to the amount of weight lost.
  • Decrease your calorie intake – this will help with weight loss and also decrease triglycerides.
  • Limit your alcohol intake to one drink daily for women and two drinks per day for men. Alcohol in high amounts increases triglyceride levels in some people. For people with very high triglycerides, abstinence from alcohol is recommended.
  • Avoid sugary and refined carbohydrates. The type of carbohydrates that you eat makes a difference – and foods that contain high amounts of simple sugars, especially fructose raise triglyceride levels.
  • Limit cholesterol intake from meat, dairy products, butter and margarine.
  • Choose healthier fats like monounsaturated fats and foods high in omega-3 fatty acids.
  • Saturated and Trans fats raise triglycerides – Eliminate trans-fats in your diet, and decrease saturated fat intake to no more than 7 percent of total daily calories. That means, for example, if you need about 2,000 calories a day, no more than 140 of them should come from saturated fats. That’s about 16 grams of saturated fats a day.
  • Physical activity plays an important role in lowering triglycerides. Work to increase your physical activity to a minimum of 150 minutes per week.

Everyone – whether or not they have high triglycerides – should focus on fiber-rich complex carbohydrates, such as vegetables and whole grains, instead of simple sugars.


Wellness Screening Lab Results

Solve the Mystery of Your Lab Results: What Do These Numbers Mean?

By Laura Del Guerra, RD, CDE

You’ve received the results from your annual or bi-annual wellness screenings, but what do they mean? Interpreting all of the numbers and categories can be confusing. We consulted a local physician to get an explanation on what wellness lab results mean, and why they are an important indicator of health:

Q: Why is it important to have your labs drawn periodically?
Depending on which tests are done, they serve as a barometer of control. Tests like the hemoglobin A1c, and others serve to indicate how well a condition is controlled, and if there might be complications from a chronic medical condition. Others like liver function and kidney tests can be used to ascertain how well your body is tolerating certain medications. For example, liver function tests are reviewed for people who are taking statin drugs (for lowering cholesterol).

Q: Once my blood is drawn and analyzed then what happens?
All results are returned to the individual. For those covered by certain insurance plans, you may get an additional letter from the company who drew that labs at your well check event recommending that you make an appointment to see your primary care provider about these results. This is especially true with results like the A1c, PSA, and lipid panel.

Q: Where can I get a description of what each test means?
Your test results contain a lot of information to assist you in understanding what your results mean. When reviewing your results you may notice an asterisk (*) next to results that fall outside the indicated range for your age and gender. You can also visit the “Lab Tests Online” web site ( run by the American Association for Clinical Chemistry (AACC). They have information on the individual tests and what your results mean. Finally, remember that your Primary Care Provider is the best person for providing you with sound information and medical advice as well as possible treatment strategies.

Q: Is it important to share these results with my Primary Care Provider?
Yes! It is extremely important to share a copy with your PCP. If you have abnormal results it’s a good idea to make an appointment to discuss your results.

Q: Is there a “best way” for me to review my lab report?
Not really. Everyone has their own method for looking through the report. There is a lot of good information on the report and nothing is left out; all the basics are there. It is a good idea to keep the reports so that you can see trends; especially for the results that are not graphed.

Q: My red/white cell counts are out of normal range. At what point should I be concerned?
It is normal for our body to respond to the environment, and white blood cell counts have to change in order to attack germs. Therefore, we expect to see a white blood cell count that might be out of the reference range due to the body’s natural response to the environment. However, if the differential is abnormal it should be reviewed with your PCP. Any abnormality in red blood cells, the MCV, hemoglobin, hematocrit, and MCHC should all be brought to the attention of your PCP.

Q: What is blood urea nitrogen (BUN)? Should I be concerned if it elevated? What causes an elevation?
BUN is one measure of how well the kidneys are able to filter waste products from your blood. The BUN value increases with age, and is often higher in men than women. Dehydration, a high protein diet, and intense exercise can cause elevations in BUN. The BUN alone does not give enough information about kidney function.

Q: What is creatinine and glomerular filtration rate (GFR)?
Creatinine is another estimate of kidney function. An elevated level may indicate that the kidney is not doing its job as a filter.
The GFR is another estimation of how well the kidneys are doing their job as filters. If the GFR is low the kidneys don’t have enough to do (not enough is being put into the filter system). It is the most sensitive estimate of whether or not the kidneys are doing what they are supposed to.

See also:

6 Ways to Raise Your HDL cholesterol
Triglycerides and Your Diet
To Statin or Not to Statin?

Diabetes Awareness Game

Get excited about TACKLING DIABETES!!!! Montana Tech is hosting a diabetes awareness event at their football game on Oct 15th, 2016 vs Carroll College. Game time in Butte is 1 pm. Join the fun, and support a GREAT cause! Sponsored by the Montana Diabetes Educator Network, the American Diabetes Association – Montana, and the Montana Diabetes Program (DPHHS).


Lifestyle Modification and Type 2 Diabetes

We were not suprised to see a recent article in Clinical Endocrinogy News stating that lifestyle modification must be the cornerstone of any management plan for people with type 2 diabetes. A new treatment algorithm published by the American Association of Clinical Endocrinology is a periodic update with a unique strategy of clarifying type 2 diabetes management. The algorithm concluded that effectively attending to basic problems — obesity, nutrition and exercise — will dramatically increase the success of any long-term treatment plan for people with type 2 diabetes, and help prevent or delay disease development in those with pre-diabetes.

The algorithm presents an easy-to-follow stepwise decision model for diagnosis, blood glucose management, and medical management — including all of the currently approved oral diabetes medications and insulins. This new iteration to the original algorithm is the first time lifestyle intervention has been a foundation for the most effective medical management.

One member of the committee that updated the algorithm was quoted as saying that appropriate focus on lifestyle modification may reduce medication dosage, and at times, eliminate the need for pharmaceutical intervention.

Read the entire article on the Clinical Endocrinolgy News web site.

Breast-Feeding Benefits for Mothers


The New York Times, Julie Glassberg photo

We often hear of the benefits of breast-feeding for babies, but an article on the New York Times Well Blog  is reporting that recent studies suggest that mothers gain even more benefits from breast-feeding than previously found. Past studies have shown that women who breast feed have a reduced risk of breast and ovarian cancers, Type 2 diabetes, and rheumatoid arthritis. There was also evidence of improved cardiovascular health, including a healthy blood pressure.

Now, recent studies found that breast feeding may protect women from a particularly vicious type of breast cancer; and that breast feeding may act as a “reset” button for metabolism, helping women who had gestational diabetes avoid becoming lifelong diabetics. The article goes into detail about the breast cancer study, as well as the research behind the diabetes findings.

Read the article here: Breast-Feeding Is Good for Mothers, Not Just Babies, Studies Suggest



Diabetes Day – Missoula

If you’re diabetic, consider attending Providence Services’ Diabetes Day in Missoula Saturday November 7th.
The program features free food, free A1c tests, information, give-aways, and speakers.

Location: St. Patrick Hospital, 500 W. Broadway, Missoula, MT 59802 in the Broadway Building Conference Center
For more information, click on the photo:


New A1c At-Home Test Kit Packaging


Diabetic participants: the company that makes the at-home A1c test kits that we use has changed their packaging. They have reduced the amount of packaging materials, making the kits more earth-friendly. The new kits will now arrive in boxes rather than tubes, and the return mailer is smaller. The process to collect your sample is the same, and instructions will still come with the kit to walk you through collecting your sample. After you collect the sample and place it in the vial, you put it back in the original box, seal it with the tape provided, add the new mailing label and mail it through the US Postal Service. There is a tracking number you can write down if you want to track it through the mail.

For more details, watch this video of how to use the new test kit: