News & Announcements

Jan 18

Diabetes Texas is now Diabetes Center of Wellness. Please check out our new website!

Jan 18

As of January 18, 2022, we are proud members of Privia Medical Group!

Dec 9

Clearing the air around Diabetes

Diabetes is a disease that affects millions of Americans, and that number continues to rise. With such a complex disease, there are many myths surrounding it. Today we take a look at some of the most common diabetes myths and explain why they are wrong. Get the facts here.

Eating sugar causes diabetes.
It’s commonly believed that sugar “causes” diabetes. Although elevated blood sugar levels play a significant role in diabetes, sugar isn’t a direct cause of diabetes. A diet high in sugar leads can lead to obesity and weight gain, which are risk factors of type 2 diabetes.

When it comes to developing type 2 diabetes, there are multitudes of factors that lead to the developing the disease.

For those with type 1 diabetes, the story is a bit more complicated. Scientists are still unsure why some people develop type 1 diabetes and why others do not. To read more on the differences between type 1 and type 2 diabetes click here.

Type 2 diabetes only affects people with obesity.
This myth is just flat wrong. Although being overweight is a risk factor for developing type 2 diabetes, it is not the only one. Age, ethnicity, physical activity, and family history are also risk factors for developing diabetes. With anything as complicated as type 2 diabetes, no one factor is the cause. The Center for Disease Control and Prevention (CDC) estimated in a 2020 diabetes report that 11% of those with type 2 diabetes are neither overweight nor obese.

People with diabetes can’t eat sugar.
A major step in successfully managing diabetes is monitoring blood glucose levels. If eaten as a part of a healthy meal plan, sweets can be enjoyed by people with diabetes. The key to eating sugary treats is to have a very small portion and to save them for special occasions. Working with your physician and Certified Diabetes Educator (CDE) will help you determine an individualized meal plan that covers your goals and your food preferences.

People with diabetes go blind and lose their legs.
It is true that unmanaged diabetes can progress and lead to blindness or amputations. This is because continually high blood sugar levels can damage the nerves. However, this is avoidable when diabetes is managed properly.

Diabetic neuropathy often occurs in the legs and feet, but can also affect nerves of the digestive system, urinary tract, blood vessels, and even the heart. If nerve damage progresses far enough in the legs and feet, it can lead to amputation.

Diabetic retinopathy is nerve damage that occurs in the eye as a result of mismanaged diabetes.

Again, when diabetes is managed properly, nerve damage can be avoided.

The CDC estimate that 11.7% of adults with diabetes have some level of vision impairment. Lower-extremity amputation occurs in around 0.56% of people with diabetes in the U.S.

People with diabetes shouldn’t be active.
People with diabetes are actually encouraged to get more active and exercise, so this is bunked.

For some, there may be some limitations for what they can do, especially if they are experiencing issues with arthritis. Here are a few resources for ideas on how to get more active. We also have guides for starting a new exercise routine. If you have any questions about what activities you should avoid specifically, speak with your physician, or get in touch with our clinic.

Diabetes is contagious.
Diabetes cannot be caught by another person. Diabetes is a non-communicable illness meaning it cannot be passed on from sneezing, touching, or any other person-to-person contact.

Dec 9

Issue Description

It’s summertime and the sun is out. It’s the perfect time of year to go out and get some outdoor exercising. But these activities don’t have to be intense or strenuous. They can be at your pace and relaxing. We’ve compiled a list of a few great outdoor activities to get you active and burn calories, but are also low-intensity and self-paced. A few things to remember when enjoying these fun summer activities:

• Stay hydrated.
• Stay cool.
• Wear sunscreen.
• Wear proper shoes.

Go for a Walk on a Nature Trail

Walking on a nature trail offers you a chance to be outdoors and burn calories. It also gives you a chance to unplug from devices and calm your mind, which helps to lower stress. Unlike running, walking can be done at a slower pace, and still burn a substantial amount of calories.

An added of walking outside, as opposed to being on a treadmill, is improved mental well-being. Evidence shows that time spent in the sun can reduce feelings of depression.

Go for a Bike Ride

Bike riding is a low-impact activity that allows you to train your muscles and build your endurance. It’s a versatile workout that can be done indoors on a stationary bike, or outdoors on a traditional bike. It’s a fun way to be able to get active and workout, without having to worry about added stress to your joints.

Go Kayaking

Kayaking is an amazing water activity that combines cardio and resistance training. Like the other activities on this list, it can be done at your own pace, is relaxing, and has the added benefit of being outdoors. For many who enjoy this sport, the appeal of being on the water is the calming effect on the mind.

With kayaking, you also have the added bonus of exercising not just your lower body, but your core, arms, and back as well. It is also a low-impact activity. If you don’t own a kayak, there are many places near the water that rent them out.

Outdoor Yoga

The benefits of yoga are numerous, and doing it outside just adds to that. Yoga is a great way to increase your flexibility, your strength and reduce stress. It also doesn’t require equipment or a special facility to do it.

Dec 9

The glycemic index (GI) is a measurement used to determine how much a specific carbohydrate-containing food will increase glucose levels. GI categories are broken down into low, medium, and high. Foods are assigned to these categories based on how much they raise blood sugar compared to how much pure glucose raises the blood sugar level.

Category	Range
Low	1 to 55
Medium	56 to 69
High	70 and higher

The glycemic index is a great tool for understanding how your body metabolizes food. However, there are some limitations.

Limitations of the Glycemic Index

1. Serving size: GI values do not factor in how much of a food you are eating in every meal, but are based on a typical serving size of a particular item.
2. Nutritional information: Glycemic index does not give you nutritional details of food (such as total fat or protein).
3. GI values can change: The GI value of food can change depending on how it is cooked, processed, and even can change based on what it’s eaten with.
4. Incomplete GI database: The glycemic index database is comprised of foods that have been researched specifically for their effects on blood glucose. However, this database does not include all foods available.
5. GI values are a range: GI values aren’t always exact and can come in a range for some foods. This can make it difficult to determine what category a particular food item belongs to.

Quick GI Food Guide To Follow

Low Glycemic Index Foods

1. Non-starchy vegetables: broccoli, cauliflower, cucumber, spinach, mushrooms, onion, lettuce, brussels sprouts
2. Whole grains: barley, rye, wild rice, wheat pasta, farro, bulgur
3. Legumes: lentils, black beans, chickpeas, kidney beans, green beans, pinto beans
4. Fruits: grapefruit, apples, apricots, peaches, plums, tomatoes, strawberries, raspberries

High Glycemic Index Foods

1. Starchy vegetables: potatoes, parsnips, canned/frozen corn, winter squash
2. Bread: white bread, bagels, whole grain bread,
3. Fruits: dried dates, watermelon, pineapple, over ripe bananas
4. Cereals: breakfast cereals, instant oatmeal, cream of wheat, grits
5. Snacks: candy, crackers, chips, cookies, donuts, pretzels, pastries, cakes

Foods With No Glycemix Index

1. Meat: beef, bison, deer, lamb, pork
2. Poultry: chicken, turkey, duck, goose
3. Seafood: tuna, salmon, shrimp, sardines, anchovies, mackerel
4. Oils: olive oil, coconut oil, avocado oil, vegetable oil, oils that are liquid at room temperature
5. Nuts and Seeds: sunflower seeds, almonds, peanuts, pecans, hazelnuts, walnuts

Summary

A low glycemic diet may help you manage your blood sugar levels, managing cholesterol, and losing weight, however, the GI does come with some limitations. For best results, speak to a doctor about your ideal diet and what techniques you should use for managing your diabetes.

Dec 9

Fruits are a healthy part of a balanced diet, both as a snack and as part of a meal. They provide important nutrients such as fiber, vitamin c, potassium, and so much more. Fresh fruits are low in fat, sodium, and calories. However, fruits aren’t all created equally. Some fruits are high in sugar and can cause blood glucose to spike. In this article, we’ll explore what foods to avoid, and which ones to eat as you manage your diabetes.

Background

If you stroll through any grocery store across America, the first thing you’ll be greeted with is the fresh produce aisle, and there’s a reason why. On a subconscious level, fresh fruits and vegetables act as an invitation to eat. Biologically speaking, our brains are hardwired to seek out the bright colors and sweet aromas that come from these edibles. Today, supermarkets provide easy access to food, but before grocery stores, early humans had to rely on their senses to determine if food found in the wild should be eaten. Over time, we’ve come to associate healthy foods with colors, scents, and even taste.

Fruits by definition are the seed-bearing structure of flowering plants. Their bright colors, delicious tastes, and sweet aromas helped to attract animals (and humans), entice them to eat, and then help spread the seeds to make sure new plants would grow. Seedless fruits do exist, but in nature, these were fruits that had not been fertilized (in the reproductive sense of the word).

Fruit to Avoid or Limit if You Have Diabetes

It’s a common misconception that those with diabetes have to avoid fruits due to their sugar content. However, the sugar found in fresh fruits isn’t the same as sugars that you’ll find in processed foods and sugary snacks. Free sugars, also known as refined sugars, are sugars that are added to foods. These sugars have a huge effect on your glucose levels, while sugars in fruits do not have as great of an effect. With that being said, there is still in effect, and as such, fruits should be counted towards your carbohydrates, according to the ADA. There are also some fruits that should be kept in moderation because they are higher in sugar than others.

Fruits with a high glycemic index:

• Watermelons
• Dried dates
• Pineapples
• Overly ripe bananas
• Mangos
• Raisins
• Figs
• Lychees

Fruit to Eat if You Have Diabetes

Fruits with a low glycemic index:

• Blueberries
• Tart cherries
• Strawberries
• Peaches
• Apples
• Pears
• Kiwi
• Avocado
• Tomatoes

Fruits and Fruit Products to Completely Avoid

We’ve included the list below of fruits and fruit products to completely avoid. These often times contain added sugars and can lack many of the nutrients that make fruits healthy.

• Fruit juices
• Sweetened fruits
• Dried fruits with added sugar

Summary

Eating fruits are a healthy way to curve sugar cravings and to add important nutrients to a person’s diet. Although fruits do contain sugar, fresh fruits do not contain free sugars, which can affect a person’s glucose levels. They also contain high amounts of fiber, which aids in digestion and helps regulate the absorption of sugar.

Dec 9

Getting Educated On Diabetes

If you’re reading this, chances are you or someone close to you has recently been diagnosed with diabetes. First and foremost, great job with seeking information on diabetes. You’ve taken the first steps towards successful diabetes management.

Below you’ll find a collection of several blogs that will help you learn about the basics of diabetes and tips for proper management.

Diabetes Basics

The difference between type 1 and type 2.
In this blog, we breakdown the big differences between type 1 and type 2 diabetes. You’ll be introduced to terms such as blood glucose and insulin, as well as be introduced to some of the complications associated with diabetes. Click here to read the full blog.

The basics of A1C testing.
Here we give you a quick guide to understand A1C tests, as well as a reference chart for A1C levels. This will come in handy for understanding ongoing glucose testing. Check that out here.

What is Insulin?
Insulin will be a word you will hear often. It’s the hormone that helps regulate your body’s glucose. Understanding what it is and its importance will aid you in your diabetes management. Get the facts.

Healthy Eating For Diabetes

A quick guide to the plate method.
Healthy management is not only about what you eat but how much you eat as well. Having a strategy for quick portion control will make planning your meals so much easier. That’s where the plate method comes in. Check out this quick eating guide on the plate method.

Deciphering the food label.
Along with portion control, you also have to understand what is in the food you’re eating. That’s where the nutrition labels come in. However, these labels don’t come with instructions and can be overwhelming to read. We’ve put together a breakdown of how to read your food labels, and how these nutrients factor into your diet. Continuing reading.

“Healthy” foods that aren’t so healthy if you’re diabetic.
Armed with your new facts on reading nutrition labels and portion control, you may be asking yourself, “What about healthy snacks?”. We’ve put together a quick list of some common “health” foods that you will want to AVOID! But don’t worry, we also have a guide for foods to incorporate as well.

Foods to help maintain and lower your blood sugar.
Variety is the spice of life. That’s one of the things that makes eating so enjoyable. Dieting gets a bad rap for being boring, which can make it harder to stay disciplined. We’ve put together a shortlist of foods to incorporate into your healthy eating journey. The goal here is to give you a good starting point as this list is by no means exhaustive. Read to the end for some additional tips for lowering your blood sugar.

The Diabetes Community

Being diagnosed with diabetes can sometimes be scary and overwhelming in the beginning, and we understand that. At Diabetes Center of Wellness, our philosophy is that by focusing on healthy living as a whole, diabetes management will become easier for our patients. Your mental health is just as important as knowing your A1C number. Below you’ll find a few of our blogs on diabetes, stress and mental health.

May is Mental Health Month!
Individuals living with diabetes sometimes feel stressed or powerless about managing their diabetes. In this post about mental health month, we dive into diabetes distress and give you some strategies for stress management. Click here for more.

Get moving and active!
The benefits of exercise are numerous. A workout routine can aid in maintaining a healthy weight, increasing your energy, and reduce stress. Learn about some of the benefits of working out, and how it can lower your blood sugar, as well as some ideas on how often you should exercise.

Dec 9

Overview

Diabetic retinopathy is a complication caused by diabetes that is caused by damaged blood vessels in the back retina. The retina is the light-sensitive portion of the back of your eye. If diabetic retinopathy worsens, you may experience blurred vision or even vision loss.

In its early stages, diabetic retinopathy may have mild symptoms, no symptoms at all. It also can develop in anyone with type 1 or type 2 diabetes. With regular screenings, any damage can be found early on and your vision can be preserved.

Symptoms

If you are in the early stages of diabetic retinopathy, you may not experience any symptoms. However, as the condition progresses, symptoms may include:

1. Spots or dark strings appearing in your vision (floaters)
2. Blurred vision
3. Fluctuating vision
4. Impaired color vision
5. Dark or empty areas in your vision
6. Vision loss

Usually this symptoms will be present in both eyes.

Causes

Over time, the build-up of excess sugar can cause blockage to the tiny blood vessels of the retina, preventing fresh blood and nourishment for it. As a result, your eye will try and grow new blood vessels to feed the eye. These new blood vessels are not as strong or as effective as the original blood vessels and are prone to leaks and ruptures. This can negatively impact your vision.

Risk factors

Anyone with diabetes is at risk of developing diabetic retinopathy. Risk factors that increase the likelihood of this condition include:

1. High blood pressure
2. High cholesterol
3. How long you have had diabetes – the longer you have diabetes, the greater your risk
4. Poor blood sugar level management
5. Pregnancy
6. Tobacoo use
7. Being African-America, Hispanic, or Native American

Prevention of Diabetic Retinopathy

You can’t always prevent this condition. However, with regular eye exams at Diabetes Center of Wellness, good control of your blood sugar and blood pressure, and early intervention for retinal problems can help prevent severe vision loss. The key is detecting it early.

If you have diabetes, take these steps to help lower your risk of developing diabetic retinopathy.

1. Properly manage your diabetes. Make healthy and physical activity the norm, and follow your doctors recommend treatment instructions.
2. Consistently monitor your blood sugar levels. Work with your doctor to determine how frequently you need to test your blood sugar. During times of stress or sickness, you may need to test your blood sugar more often.
3. Pay attention to vision changes. As stated previously, you may not experience symptoms in the early stages of diabetic retinopathy. If anything changes with your vision – such as blurry, spotty, or hazy vision develops – notify your doctor immediately. This could be the signs of this condition progressively getting worse.
4. Schedule regular vision tests with Diabetes Center of Wellness, or your diabetes care provider. It is of the upmost importance that you have vision tests done by your diabetes care provider, even if you see an eye doctor regularly.

Diabetes is not an automatic sentence for vision loss, but it does put you at risk. Protect your eyes and your vision by taking an active role in your diabetes management.

Dec 9

Deciphering a nutrition label

Understanding the nutritional information of what you’re eating is crucial to successfully managing diabetes. But nutrition labels can sometimes seem like gibberish. But don’t fear because we’re here to help. We’re going to breakdown each section of the nutrition label so you can make the right choices for your diet.

Serving size
The serving size is the standard amount of a particular food, such as a cup, and is what all the nutritional information on the label is based on. It’s a good way to compare the nutritional value of different foods. Keep in mind, that this is not a suggestion on how much you should eat. That would be a suggested portion. For more information on portion control, read our blog on the plate method.

Calories
Calories are the amount of energy that food provides your body to function. Getting with your doctor or nutritionist will help you determine the appropriate amount of calories for you to eat a day.

Total carbohydrate
Total carbohydrates are the total amount of sugar, starch, and fiber in what you’re eating. Below is a breakdown of each individual carb count. For carb counting, it is important to use the total grams. More information on the basics of carbs can be found here.

Added Sugar
Added sugar is a newly required section on nutrition labels. This lets you know how much sugar is added during processing versus sugar that occurs naturally in your food. To maintain a healthy diet, you will want to avoid foods high in sugar and highly processed foods, as well as adding foods that can help lower your blood sugar levels. Learn more about foods that help lower blood sugar levels.

Fiber
This is the part of plant-based foods that your body doesn’t digest, or only partially digests. Fiber helps to regulate appetite and can help you maintain a healthy blood sugar level. Fruits, vegetables, beans, and whole grains are all a good source of fiber. The amount of fiber you need is based on your age and gender, with healthy adults needing an average of 25 to 38 grams of fiber a day.

Fats
Total fat tells you how much fat is in one serving of the food. With fats, there is a difference between healthy and unhealthy fats. In general, you want to avoid trans fats, reduce your saturated fats, and eat foods rich in unsaturated fats. We have a two-part series on fats that will educate you further on the subject. Start with part 1 to learn about the types of fat to avoid.

Sodium
Sodium, better known as salt, tells you how much salt can be found in your food. Although salt doesn’t affect blood sugar, it can cause high blood pressure and heart disease if you consume too much of it. With sodium, you have to be careful and understand that you cannot always taste how salty something is. Some foods, like salad dressings and processed foods, have hidden salt or masked the taste. The general recommendation for daily sodium intake is 2,300 milligrams (mg). If you have high blood pressure, or at risk, speak to your doctor to find out what is the right amount for you.

List of ingredients
Knowing what ingredients are in your food can be helpful for your overall health management. The ingredients list is ordered by weight, with the first ingredient being the highest amount in the food.

Percent Daily Values (%DV)
The Percent Daily Values of each nutrient provides you with the daily percent of each nutrient the food provides you based on a 2,000 calorie per day diet.

Dec 9

Good ole November. The leaves are changing colors, the weather is cooling off, and many families are preparing for cheerful holidays, pumpkin-spiced everything, and of course Thanksgiving dinner. Covid-19 may change how big our Thanksgiving celebrations are this year, however, the foods we enjoy will still be making their usual appearance. Celebrations like these can make it very tempting to eat foods that we know are bad can negatively impact our blood sugar levels, so we’ve included some foods below that you should avoid, and some alternatives, as well as some food strategies to help you stay disciplined while still enjoying the holidays.

Foods to Limit	Foods to Enjoy
Canned cranberry sauce	Whole-wheat, veggie-filled stuffing
Sweet potatoes/ yams with marshmallow topping	Whole grain bread
White bread and processed flours	Lean meats
Mashed Potatoes	Roasted vegetables
Plain store-bought stuffing	Sweet potatoes with meringue
Desserts	Homemade cranberry sauce sweetened with stevia

Smart Eating Strategies For Thanksgiving

Portion Control: Being able to eyeball how much food you should be eating is key for just everyday eating. Check out our really easy guide to the Plate Method for a helpful way of controlling your portions.

Skip the appetizers: Most appetizers are high in carbs. If you’re hungry and can’t wait until dinner time, opt for crudite and other low-calorie, low-carb options.

Go for the turkey: Turkey is a great source of carb-free lean protein, and is high in other nutrients as well. Just make sure to limit the gravy, as it can be high in carbs and fat.

Dec 9

What is Juvenile Diabetes?

Juvenile Diabetes is the previous name given to type 1 diabetes or insulin-dependent diabetes. Unlike type 2 diabetes, juvenile diabetes usually appears during childhood or adolescence, hence the name. Both types of diabetes are chronic diseases that affect the way your body regulates glucose. Glucose, or blood sugar, is the fuel that your body’s cells use for energy. Insulin, a hormone produced by the body, is used to transport glucose into the cells. Diabetes occurs when your body can no transport sugar into the cells. In type 1 diabetes, this is because your body doesn’t produce insulin. With type 2 diabetes, your body doesn’t respond as well as it should to insulin and eventually doesn’t produce enough insulin. Both forms can inevitably lead to chronically high blood sugar levels if left unchecked.

Symptoms of Juvenile Diabetes

One of the early signs of diabetes in children is increased urination and thirst. Increased blood sugar causes your body to pull fluid from tissues. This causes your child to be constantly thirsty and increasing the need to use the restroom. Below are a few more signs of juvenile diabetes.

• Changes in vision
• Fatigue
• Fruity smelling breath
• Extreme hunger and unexplained weight loss
• Unusual behavior

Dec 9

Medtronic Issues Recall For Insulin Pump

Pump Models:

• MiniMed 630G Insulin Pump (MMT-1715)
• MiniMed 670G Insulin Pump (MMT-1780)

*the pump model number can be found directly on the bottom or on the back of the device

Issue Description

The MiniMed 600 series insulin pump is designed with a pump retainer ring to lock the reservoir in the insulin pump. There have been reported incidents of a loose reservoir that can no longer be locked into the pump. The reservoir can become loose due to a broken or missing retainer ring that prevents a proper lock. The retainer ring can be broken, for example, as a result of dropping or bumping your pump on a hard surface.

If the reservoir is not properly locked into the pump, it could lead to over or under-delivery of insulin, which then results in hypoglycemia or hyperglycemia.

Actions Required by Patients

1. Examine the retainer ring on your pump for any damages.
2. If the reservoir does not lock into the pump or the retainer ring is loose, damaged or missing, discontinue using the insulin pump and revert to a back-up plan of manual insulin injections per your doctor’s recommendations. Do not insert the reservoir back into your pump while connected because you could mistakenly give yourself a large insulin bolus.
3. Go to www.medtronicdiabetes.com/pumpring or contact Medtronic 24-Hour Technical Support line at 1-877-585-0166.
4. If your reservoir is properly locking in place by the retained ring, continue to use your pump.

Dec 9

What is an Insulin Pump

An insulin pump is a small device that is attached to your body and delivers insulin through a tube called an Infusion Set. This small electronic device is about that size of a smartphone and can discreetly attach to your clothing, or fits in your pocket. Insulin pumps are a very discreet way of receiving insulin therapy. Insulin pumps replace the need for frequent injections by delivering insulin continuously 24 hours a day.

How Does the Medtronic Diabetes Insulin Pump Work?

What Are The Benefits of Insulin Pump Therapy?

A diabetes insulin pump is a convenient way to manage your day to day diabetes treatment. Other advantages an insulin pump may provide over multiple daily injections include:

• better HbA1c Control
• fewer hypoglycemic events
• reduction in glycemic variability

Are You a Current Patient and Need Help With Your Insulin Pump?

Are you currently a Diabetes Center of Wellness Patient and need help with your diabetes insulin pump? Contact Medtronic Directly for the fastest response time.

Technical Support: 1-877-585-0166

Dec 9

Nana Mainoo, PharmD Candidate, and Jonathan Ogurchak, PharmD, CSP

Across the globe, the term “lockdown” will continue to linger in the minds of many people for a long time. The coronavirus disease 2019 (COVID-19) pandemic and associated lockdown coupled with a stay at home restrictions have ushered the world into an era in which social distancing has forced many to avoid congregating.

The resulting effect is the loss of jobs (temporary and permanent), fewer working hours, changes in work schedules and environment, parents becoming home teachers, and canceled events such as weddings, parties, and funerals. These are trying and difficult moments, as the most exciting aspects of the busy and stressful lifestyles people, tend to lead have been taken away by COVID-19.

Day in and day out, the news on the internet, television, and radio has been alarming. The death toll continues to rise, as state and federal officials (despite their efforts to keep calm) have made it clear that COVID-19 is an uncharted challenge. The uncertainty surrounding the pandemic breeds stress and anxiety, which may lead to depression in many people.

For many who would generally be considered as healthy, the level of anxiety may not be as high as people living with chronic diseases or those on medications that affect their immune systems. People living with chronic diseases generally have a higher tendency to express depression-like symptoms.1 For these people, being locked down could compound their plight, as social isolation and loneliness can also lead to depression.

In order to manage these increased pressures, improving and maintaining brain health is a necessity that cannot be taken for granted. People should conduct self-mental health checks from time to time. Signs of depression include some of these symptoms lasting most days for more than 2 weeks:

• feelings of sadness, tearfulness, emptiness, or hopelessness
• anger, irritability, or frustration
• loss of interest or pleasure in most or all normal activities
• fatigue, tiredness, and lack of energy
• sleeping too little or too much
• changes in appetite, including eating too little or too much
• anxiety, agitation or restlessness2

Some useful ways to manage pandemic stress are taking deep breaths, stretching, exercising, meditation, eating healthy, getting plenty of sleep, and avoiding drugs and alcohol. In addition to the allopathic or prescription medications given by doctors to manage depression or any associated mental disorder stemming from this pandemic, there are integrative medicines, as well as health and wellness modalities, that can be used to improve mental health.

Some health and wellness modalities like acupuncture, art therapy, yoga, light therapy, music therapy, relaxation therapy, and Tai Chi can be helpful in reducing stress and maintaining improving brain health in the wake of the lockdown. Foods and supplements rich in essential fatty acids like fish oil (omega-3 fatty acids), DHA (docosahexaenoic acid), EPA (eicosatetraenoic acid), folic acid, vitamins C and E, Ginkgo (Ginkgo biloba), saffron (Crocus sativus) and turmeric (Curcuma longa) can help in maintaining mental health.3

Among the many natural medicines that may be used in managing depression, St. John’s wort is the best-known natural antidepressant. It works similarly to conventional antidepressants by inhibiting the reuptake of serotonin, norepinephrine, and dopamine.

It also appears to affect other neurochemicals such as glutamate and gamma-aminobutyric acid (GABA).4 Despite its proven efficacy St. John’s wort induces cytochrome P450 3A4 enzymes responsible for breaking down of medicines in the body. More than 50% of drugs on the market are affected by the CYP34 enzyme. This does not make St. John’s wort the best candidate for treating or managing depression as it has the tendency to interact with a long list of conventional drugs.5

Anyone who is taking or has the intention to take a product containing St John’s wort must first have a discussion with a pharmacist. COVID-19 may have exerted its negative impact on the lives of many but it is important for all to ensure that our brains stay healthy in a healthy body.

About the Authors

Nana Mainoo will graduate from the Nova Southeastern College of Pharmacy in the spring of 2021.
Jonathan Ogurchak, PharmD, CSP, is the founder and CEO of STACK, a pharmacy compliance management software, and serves as a preceptor for a virtual Advanced Pharmacy Practice Experiential Rotation for specialty pharmacy, during which this article was composed.

References

1. Pryce CR, Fontana A. Depression in Autoimmune Diseases. Curr Top Behav Neurosci. 2017; 31:139‐ doi:10.1007/7854_2016_7
2. https://creakyjoints.org/living-with-arthritis/coronavirus-isolation-loneliness-chronic-illness-patients/?gclid=Cj0KCQjwlN32BRCCARIsADZ-J4tgtyroDiNUXlYJFcnrrHrn8Px_s7gWb8JvushrzaE1OkIKNRzC3Z4aAjkDEALw_wcB
3. http://naturaldatabase.therapeuticresearch.com.ezproxylocal.library.nova.edu/ce/CECourse.aspx?cs=naturalstandard&s=ND&pm=5&pc=19-105
4. Singer A, Wonnemann M, Muller WE. Hyperforin, a major antidepressant constituent of St. John’s wort, inhibits serotonin uptake by elevating free intracellular Na+1. J Pharmacol Exp Ther 1999; 290:1363-8.
5. Morales AJ, Haubrich RH, Hwang JY, et al. The effect of six months treatment with a 100 mg daily dose of dehydroepiandrosterone (DHEA) on circulating sex steroids, body composition and muscle strength in age-advanced men and women. Clin Endocrinol (Oxf)1998; 49:421-32.

Dec 9

When you’ve got diabetes, the most important thing to do is to keep your blood sugar in check. Creating a diabetes-friendly diet can be challenging. To help make it easier, we’ve listed 4 healthy foods to avoid if you have diabetes.

Gluten-Free Foods

Gluten has had a lot of media attention, leading many to opt for gluten-free food options. However, gluten-free food does not always mean healthier food. Gluten is a protein from wheat that adds volume and elasticity to certain foods. Gluten-free foods, on the other hand, lack this protein and tend to be denser and higher in carbohydrates per serving than conventional foods.

Sports Drinks

Sports drinks like Gatorade have been shown to help very active people to stay hydrate and aid in athletic performance. However, they can be a high source of calories and added sugars which diabetics should avoid. For active people with diabetes, opt for water during your workout or low-calorie sports drinks.

Fruit Smoothies

Fruit smoothies, even the freshly blended organic ones, can be a huge source of excess sugar and carbs. They also remove healthy fiber that helps to regulate blood sugar and slow digestion.

Dried Fruits

It’s hard for us to add these tasty snacks to our list of healthy foods to avoid if you’re diabetic, but we have to. Dried fruits may seem healthy but can wreak havoc on your blood sugar levels. When fruits a dried, the process results in water loss that concentrates the nutrients and sugars of the fruit. To put this in perspective, a cup of grapes contains 27 grams of carbs, while one cup of raisins (dried grapes) contains 115 grams of carbs. If you have diabetes, stick to fresh, low-sugar berries or small apples.

Dec 9

Prediabetes is when your blood sugar level is higher than it should be but not high enough for you to be diagnosed with type 2 diabetes. It’s estimated that 84 million people over the age of 20 in the U.S. are prediabetic, but 90% don’t know that they have it.

If you are prediabetic, the good news is that you can still make lifestyle changes to prevent yourself from progressing to type 2 diabetes.

Symptoms

Prediabetes symptoms can be hard recognize or completely absent. For those who do experience symptoms, you may notice that:

• You’re a lot thirstier
• Frequent urination
• Blurry vision
• Increased fatigue

Although these symptoms are rare, there are risk factors that can make you more likely to become prediabetic and eventually diabetic without the right changes.

Risk Factors for Prediabetes

The exact cause for prediabetes is unknown, but family history and genetics appear to play an important role. We do know that prediabetics start losing the ability to properly process sugar (glucose). This causes blood sugar to increase, instead of being used by the cells of their body for energy. You can learn more about blood sugar and insulin here.

Other than family history and genetics, other known risk factors include:

• Weight
• Diet
• Age
• Exercise
• Tobacco use
• High cholesterol
• Race

Prediabetes Prevention

When it comes to preventing prediabetes from progressing into type 2 diabetes, a lot of it comes down to lifestyle choices. Race, age, and family history are out of our control. Choosing to eat right, exercise regularly, and not smoking are all in our control, and will help promote overall better health. Even if you have a family history of diabetes, just reducing your weight by 5-10% and exercising regularly can help prevent prediabetes and type 2 diabetes.

Dec 9

May is Mental Health Awareness Month. May 2020 also means that we’ve officially been in a global pandemic for 3 months now due to COVID-19. During this time, maintaining a positive mental state can be difficult given the current state of the world, and the uncertainty that comes with it. Compounding that stress with diabetes can make things worse and increases stress. Having a positive mental state can help you be more successful at managing diabetes. Keep reading to learn about how diabetes can cause mood swings and find out some useful tips you can do at home to help manage your stress.

Mood Swings and Diabetes

Diabetes is a disease in which the body doesn’t process sugar properly. For those with diabetes, rapid changes in blood sugar can occur and these fluctuations can cause severe mood changes and physical effects. Some signs that a person with diabetes may have high blood sugar levels include feeling nervous, fatigue or low energy, difficulty thinking clearly, and even anxiety.

Conversely, a person experiencing low blood sugar levels may experience low mood, confusion, aggression and irritability, and even hunger. Oddly enough, some diabetics experience a slightly euphoric feeling similar to being mildly drunk. During this type of event, the body will often release adrenaline to try and convert any available glycogen in the liver back into glucose to boost sugar levels. When this happens, the fight-or-flight response lends itself to the feeling of irritability.

When it comes to the effects of blood sugar on mood, these feelings usually resolve themselves once blood sugar levels return to a normal range. However, diabetes can lead to a mental health condition that some doctors refer to as diabetes distress.

Diabetes Distress, Depression, and Anxiety

Individuals living with diabetes sometimes feel stressed or powerless about managing their diabetes. This can sometimes lead to diabetes distress. Diabetes distress is a poor mental health state commonly associated with feelings of guilt or fear, and the stigma associated with having diabetes. It’s not uncommon for those living with diabetes to become stressed with the burden of managing diabetes properly. Some patients even report developing stress from fear that they will be treated differently by their friends and family.

Diabetes distress shares similar characteristics of depression and anxiety, however, it is not considered a mental disorder.

Stress Management Tips

• Pause and breathe. This may seem simple, but active deep breathing releases “feel good” neurotransmitters in your brain, elevating your mood. It also gives you a moment to collect your thoughts and think through what may be bothering you.
• Take breaks from COVID-19 content and other content that may contribute to negative feelings. Keep in mind that your thoughts and feelings can be influenced by what you watch, read, and listen to. Removing stressful content may help to improve your mood.
• Make time to sleep and exercise. Regular exercise and restful sleep are vital to general wellbeing.
• Reach out and connect to family and friends, and we don’t mean on social media. During the stay-at-home order, it may be difficult to see your loved ones, and feelings of isolation may promote stress. Pick up the phone and call them or FaceTime with them. You may be amazed at the effect a good conversation can have on your mood.
• Seek help if you’re feeling overwhelmed or unsafe. Talking to a professional that you don’t know on a personal level may make it easier and more comfortable for you to work through your feelings without fear of being judged.

The above tips are a good place to start from if you’re more stressed than normal. However, if you feel that what your feeling more serious, or your feelings have been persisting, please contact a professional. Your mental health is just as important as your physical health.

At Diabetes Center of Wellness, we specialize in helping our patient better understand their body and how it is affected by diabetes. We teach proper management and help you form the right habits to make diabetes just a detail of your life, and not the focal point. For information on becoming a patient, contact our office today.

Dec 8

Diabetes is a group of chronic diseases that stem from blood glucose levels becoming too high. Glucose, sugar, comes from the food you eat being metabolized. Insulin, a hormone produced by your pancreas, shuttles glucose from the blood and into your cells to use as energy. There are two major types of diabetes; Type 1 and Type 2. There is another type of diabetes, gestational diabetes, but we won’t be discussing that today.

Type 1 diabetes: No insulin production

Type 1 diabetes, also known as insulin-dependent diabetes (previously known as juvenile-onset diabetes), is an autoimmune condition. For those with type 1 diabetes, antibodies from their own body begin to attack their pancreas. The pancreas eventually becomes so damaged that it can no longer produce insulin.

Another way type 1 diabetes develops is due to faulty beta cells in the pancreas, which are responsible for producing insulin. Type 1 diabetes is typically attributed to a genetic predisposition. Treatment for type 1 diabetes involves insulin injections.

Type 2 Diabetes: The most common form

Nearly all cases of diabetes, about 95% of diagnosed adults, is type 2. It’s estimated that 26 million American adults have been diagnosed with type 2 diabetes, and that number is growing. Historically, type 2 diabetes was almost exclusively seen in adults. However, as more and more children become overweight and obese, the number of children and teenagers developing type 2 diabetes has rapidly grown.

With type 2 diabetes, the pancreas can produce insulin, however, it is either not enough or the body’s cells have developed insulin resistance. With insulin resistance, the pancreas must work harder to produce more insulin in an attempt to reduce blood sugar levels. People who are obese, or 20% over their ideal body weight, are at a particularly high risk of developing type 2 diabetes. Increased fat contributes to insulin resistance.

Diabetes is a life-long disease

There is no cure for diabetes. For those with type 2 diabetes, exercise, weight management, and proper nutrition can help manage type 2 diabetes. But this requires a commitment to series lifestyle changes. For many diagnosed with type 2 diabetes, the disease does progress, unfortunately, and diabetes medication becomes necessary.

Whether you have type 1 diabetes, or type 2, properly managing the disease is important. Mismanaging can result in serious complications including:

• Diabetic Retinopathy – damage to tiny blood vessels in the eyes
• Neuropathy – nerve damage
• Nephropathy – kidney damage
• Increased risk of heart disease
• Increased risk of stroke

Bottom Line

Diabetes is a chronic disease that requires discipline to keep in check. At Diabetes Center of Wellness, our goal is to help educate all our patients on how to best manage their diabetes while maintaining a high quality of life. Your happiness is just as important as your A1C number. If you have been diagnosed with any form of diabetes, or you are prediabetic, contact our office today. We can help you get on the right track to a healthy, happy life.

Dec 8

What is the A1C Test?

The A1C test is a blood test used to diagnose type 2 diabetes and prediabetes. This is also the primary tool for diabetes management. A1C testing measures how much your hemoglobin is coated with sugar. Hemoglobin is the red protein found in the blood that is responsible for transporting oxygen throughout the body. Other names for the A1C test are hemoglobin A1C, HbA1c, glycated hemoglobin, or glycohemoglobin test. The A1C results are reported as a percentage that represents the level of blood sugar. The higher the percentage, the higher your blood sugar (glucose) levels.

A1C Results by the Numbers

Diagnosis*	A1C Level
Normal	below 5.7%
Prediabetes	5.7% to 6.4%
Diabetes	below 5.7%

*Any test used to diagnose diabetes requires confirmation with a second measurement unless there are clear symptoms of diabetes.

Prediabetics are at risk of developing type 2 diabetes. In the prediabetic range, the higher the A1C number, the greater the risk of developing diabetes.

Bottom Line
An A1C is a valuable tool that allows Endocrinologists the ability to monitor and track blood sugar levels. For prediabetics, an A1C test and positive lifestyle changes can help to prevent diabetes by altogether, greatly improving the individuals quality of life. For those with diabetes, an A1C testing is a convenient tool for monitoring and managing diabetes.

Dec 8

Insulin Is A Hormone Produced By The Pancreas.
Insulin is a hormone produced by the pancreas. A hormone is simply a substance produced by the body to regulate and control one or more functions in the body. Insulin’s job is to guide sugar from the bloodstream and into individual cells. It’s so useful that it, or something similar, can be found all throughout nature in other animals. In humans, if the pancreas fails to produce insulin at all, you’re said to have type 1 diabetes. If your pancreas can actually produce insulin, but you have acquired insulin resistance, you have type 2 diabetes.

Therapeutic Insulin
The pancreas is not the only way to receive insulin. This hormone was first synthesized by Dr. Frederick Banting nearly a century ago. Originally, it was first developed by grinding up animal pancreases to be then distilled and used as medicine. Over the last few decades, technology has made it possible to produce large amounts of insulin, in various forms, using yeast or E.Coli. Our understanding of insulin has even lead to the ability to create forms of insulin that can behave differently in the body. For example, we can vary the “strength” of insulin and even control how fast it acts in the body.

The beauty of insulin as a medicine is that humans tolerate synthesized insulin with almost no side effects. There’s no toxic dose so it is simple and safe to use.

Why Does Insulin Need To Be Injected?
Insulin does have to be injected, but why? Insulin is a hormone, but it is also a protein. This means that if you swallow it, as in pill form, your body will treat it like food. It will go through your normal digestive process and be destroyed by your stomach fluids. By injecting it, we bypass digestion, and it is able to do its job.

However, there are other forms of insulin that are being experimented with. One of these is a patch. Unfortunately, this mode of delivery has a large challenge to overcome, mainly, that insulin is a very large molecule. This makes it difficult for insulin to be absorbed through the skin. Scientists are currently working on a way to help insulin pass easier through the skin and into the bloodstream.

Dec 8

What is healthy eating? This is a question that gets thrown around a lot, and has many different answers, depending on who you ask.

Defining Healthy Eating

In general, eating healthy is eating what your body needs – not too much or too little of one type of food or beverage. To elaborate, our bodies require a variety of nutritents to function properly. These include essential nutrients (things the body cannot produce on its own such as vitamins), protein, healthy fats, etc. But it doesn’t stop there. Equal in importance to what we eat, is the amounts and propotions of those foods.

Increased Portion Sizes Lead to Weight Gain

There are many diets in circulation that promise that “eating this superfood” will cause you to drop weight overnight, or drinking this weight-loss tea will speed up your metablism. Many of these methods work, or don’t work, to varying degrees. However, one thing that is a sure fire way to maintain a heathly weight is by controling your portions.

In the last few decades, the amount of calories we consume per meal has skyrocketed. For example, a serving size amount of popcorn at the movies has increased from 270 calories to a whopping 630 calorie tub. That tub of popcorn contains nearly 1/3 of the daily recommended calorie intake. Access to cheaper and larger amounts of food have help lead to increases in weight gain, high-blood pressure, and type 2 diabetes in many adults.

For those with diabetes, maintaining a healthy weight is not an option, it’s a requirement. Besides counting carbs, and monitoring sugar intake, those with diabetes can benefit from eating lower fat, high-fiber foods, and eating portion sizes that offer just enough calories required to maintain a healthy weight. But what is a fast & convenient way of making sure you’re eating healthy portions and a properly balanced meal? Enter the Plate Method.

The Plate Method

The Plate Method is an easy, visual way of balancing your meal and keeping your portions in control. In summary, you divide your plate into 2 halves, with one-half further divided into quarters.

1. Half the plate is filled with nonstarchy vegetables, like broccoli or cauliflower.
2. One-quarter of the plate is filled with a starchy vegetable such as corn or potatoes, or can a grain such as rice.
3. The remaining quarter of the plate is filled with a protein such as lean meats, fish, or other protein sources.

Dec 8

As a diabetic, your body does not metabolize sugar properly. If you’re a type 1 diabetic, you may have been born without the ability to produce enough insulin. As a type 2 diabetic, overtime your body may have become insulin resistant, or damage to the pancreas has caused your body’s production of insulin to decrease. At any rate, managing glucose levels is important. The most direct to manage your blood sugar levels by monitoring what you eat. Earlier this year, we wrote a blog giving you some quick tips for maintaining a healthier diet. Today, we are sharing with you 5 Foods That Help To Lower Blood Sugar! Read until the end to learn about a few more things you can do to help maintain proper glucose levels.

Best Foods For Maintaining A Healthy Blood Sugar Level

Incorporate the following foods in to your diet to help you maintain healthy glucose levels:

Sweet potatoes
Sweet potatoes are a delicious starchy food that is high in nutrition but registers a low GI score. These orange vegetables are high in fiber and are a great substitute for regular potatoes, which are high on the GI chart.

All though there is no conclusive evidence that eating sweet potatoes alone will lower your blood sugar levels, sweet potatoes are a healthy alternative to everyday fast metabolizing carbs.

Whole wheat
For diabetics, pasta and bread are typically the first things to be given up during a diet change. However, by substituting 100 percent stone-ground whole wheat or pumpernickel bread, you may be able to fill that sandwich craving without sacrificing your A1Cs. These substitutes are not only delicious but both clock in at 55 or less on the GI scale.

Foods made from white flour are highly processed and have had the fibrous out shells of the grains removed. Whole wheat on the hand, has this shell intact and as such, introduces much-needed fiber into your diet that can help to slow digestion and stabilize blood sugar.

Coldwater fish
In general, fish and other meats do not register on the GI charts because they do not contain carbohydrates. However, when selecting your proteins, keep in carbs aren’t the only macro we’re concerned with. Increased fat can lead to obesity and insulin resistance. Fish, such as salmon, cod, and haddock, are healthy sources of protein. Incorporating quality sources of protein with your meals will help also help with portion control. More on that below.

Legumes
Legumes come in a wide variety of sizes, colors, flavors, and textures. But one thing is consistent; they are very low on the GI chart. A 2012 study found that incorporating legumes into your diet improved glycemic control and lowered the risk of coronary heart disease in people with type 2 diabetes. Legumes are high in fiber, complex carbohydrates (the good kind) and a good source of protein. A word of caution, READ THE LABELS! Some legume products, especially those found in boxes, contain added sugars and starches in the forms of sauces or marinades. When in doubt, opt for buying your legumes in bulk and cook them yourself.

Yogurt
Most unsweetened yogurts have a GI score below 50. In a study conducted on dairy consumption and risk of type 2 diabetes, researchers found that in general, dairy consumption was not associated with type 2 diabetes risks. However, this study also concluded that yogurt may be the only dairy product that can actually lower your risk of type 2 diabetes.

Additional strategies for maintaining and lowering your blood sugar levels

Along with eating the right foods, there are other lifestyle choices that you can make that will help to improve not only your blood sugar levels but your overall health too. These include:

1. exercising regularly
2. not skipping meals
3. eating smaller portions (checkout our blog on the plate method for easy portion control)
4. drinking plenty of water and staying hydrated
5. managing and reducing stress
6. maintaining a healthy body weight

At Diabetes Center of Wellness, we specialize in helping our patient better understand their body and how it is affected by diabetes. We teach proper management and help you form the right habits to make diabetes just a detail of your life, and not the focal point. Let us help you live a normal and active life. For information on becoming a patient, contact our office today.

Dec 8

Cardio? Pilates? Lifting Weights? Gym memberships? The idea of starting a workout routine can be pretty intimidating. However, exercising offers a host of benefits for anyone who starts, especially for those with type 2 diabetes. A consistent workout routine can help make managing diabetes easier.

Exercising For Diabetes Control

When it comes to diabetes managment, there’s more to it than eating right. You have to get active. Exercise has serious benefits for diabetics. A regular exercise routine can help increase energy levels, control glucose levels, improve heart health, and promote emotional well-being. Unless specified by your doctor, those with diabetes can and should have a regular exercise routine.

How Does Exercise Lower Blood Sugar?

When you exercise, you subject your body to an increased workload. This increased workload signals to your body that it needs to adapt, and this adaptation is the key to exercising’s metabolic benefits. But what are those benefits?

First, when you exercise, your body requires more energy. As a result, your body becomes more sensitive to insulin. This increase in insulin sensitivity allows your blood cells to better abosorb the sugar in your bloodstream and use it for energy. Second, exercising stimulates your muscles to abosorb and use sugar as energy, even without insulin. Overtime, the overall affect of these two processes can contribute to lower A1C levels.

How Often Should I Exercise?

For those starting on a new workout regiment, one of the most common questions is “How often should I exercise?”. The American Diabetes Association (ADA) has created a recommended and easy to follow guide for creating a workout plan.

1. Have at least two and a half hours of moderate to vigours intensity physical activity per week (i.e., brisk walking, swimming, water aerobics, or jogging). That’s a little over 20 minutes a day.
2. At least two to three sessions of resistance training per week. Resistance exercises are those that help to strengthen muscles. These sessions can include things like lifting weights, doing push-ups, or even using resistance bands.
3. Don’t go more than two days in a row without physical activity.
4. Incorporate flexibility exercises like yoga or pilates into your weekly routine. These have the added bonus of helping with tight and achy joints or muscles.
5. Break up your sitting time every 30 minutes during the day. If you have a desk job, this is perfect for getting the blood flowing and adds a burst of energy to your day.