Diabetes Education Voices

Diabetes Education Voices Blog Announcement

After 3 years, and countless posts, the Diabetes Education Voices Blog has been discontinued. We (Amy, Barbara, and Sharlene) would like to thank all of our readers over the years. We hope that you’ve been able to get some useful information and tips from our posts. There are many wonderful resources out there to inform and support you in your diabetes journey, and we hope that you will continue living your life to the fullest!

Thanks again for all of your thoughtful comments and questions!
--Amy, Barbara, and Sharlene

(Visit www.diabetesselfcare.org for more diabetes information and self-care tips.)

PMS and its effect on your blood sugar

If you are a woman with diabetes, you may have noticed that even if you have consistent blood sugars most days of the month, there are certain times of the month where our female hormones make it even more challenging to manage your blood sugar. Have you noticed that the week prior to your period that your blood sugars run high or are hard to manage? Some women do not notice their blood sugars changing along with their menstrual cycle while others can time it like clockwork.

Fluctuating estrogen and progesterone levels can cause an increased need for insulin at different times of the month, particularly the week prior to the start of your period after ovulation. The best way to know if you are sensitive to these hormones is to keep excellent blood sugar records. You may want to test at least four times a day before and during your period to see how your hormones are affecting your sugars. I would recommend more intensive monitoring at least two months or two cycles to get a feel for how your blood sugars trend during your cycle.

Another factor during certain times of the month for many women is how premenstrual syndrome (PMS) affects your energy and food cravings. I can speak for most women that PMS can make you have an increased appetite for carbohydrate-laden foods. Then the extra carbohydrates cause a further increase in blood sugars.

In addition to keeping good records to know how the menstrual cycle hormones affect blood sugars, continuing regular exercise during this time (even when you want to cuddle up on the couch) can help decrease the insulin resistance and help insulin work more efficiently as well as improve your mood.

Talk with your doctor and diabetes educator about your blood sugar records and the patterns you have identified during your cycle to see what changes you should make in your lifestyle or medication treatment plan to have more consistent blood sugar levels all through the month.

--Amy

Metformin shown to decrease cancer rates

I recently read an article reporting that scientists are seeing evidence of less cancer in patients taking the diabetes drug Metformin, also known as glucophage! Metformin is a very common drug used in the treatment of Type 2 diabetes.

The article states that there is increasing evidence linking Metformin with reduced cancer rates. One study, from Italy, found that type 2 patients who took Metformin had overall lower cancer rates while another study from China found that Metformin actually reverses the increased cancer risk seen in patients with Type 2 diabetes that have low high-density lipoprotein (or HDL, the “good”) cholesterol.

The article goes on to say that although much more research needs to be done, various investigations “strongly suggest the users of Metformin have only about 40% of the expected incidence of breast cancer. That is huge!” reports Dr. Michael Pollack, professor of medicine and oncology at McGill University in Montreal.

The article also quotes Dr. Pamela Goodwin, professor of medicine at the University of Toronto who states that in her studies which were done on mice with aggressive forms of breast cancer, Metformin delayed the development of mammary tumors and in ongoing research by her group, early information provides evidence that women who received Metformin in early-stage breast cancer exhibited significantly less cell proliferation or growth, and significantly increased apoptosis or cancer cell death.

This is greatly significant because people with diabetes are known to have a higher rate of cancer mortality although it is still unclear as to why. Possible causes that have been discussed include the disease itself, greater exposure to insulin (which is a growth hormone), the drugs patients take to control diabetes or to factors such as the increased weight. Unfortunately, increased weight in itself is a risk factor for cancer.

This recent finding about metformin is a major breakthrough for people with diabetes and even for those without diabetes as one researcher suggested a much broader use for the drug. Metformin is a very cheap drug, costing pennies a pill and easily accessible. If it really can decrease the occurrence of cancers by almost 50% - that could be wonderful news.

Of course much more investigation needs to be done, but keep your eyes open for more information.

If you want to read more, see the February 2011 issue of Endocrine News, pg 16 or this article in Diabetes Care.

--Barbara

Mediterranean Diet for Metabolic Syndrome

Over the years, you may have heard about the healthy heart benefits of the Mediterranean diet. Well not so surprisingly, a new study has been published that shows a Mediterranean diet may also reduce the risk of Metabolic Syndrome. The study included over 500,000 people who were able to demonstrate that eating a Mediterranean diet lowered their blood pressure, blood sugar, triglycerides, and cholesterol. This study is published in the March 15 issue of the Journal of the American College of Cardiology.

Metabolic syndrome is a term used to describe a patient with elevated blood sugars, high cholesterol, high blood pressure, and obesity.This combination of health problems puts someone at higher risk for Type 2 diabetes and heart disease.

If someone has three or more of the risk factors, they are considered to have Metabolic Syndrome:

• Blood Pressure: Higher than 130/85
• Fast Blood Glucose at Pre-Diabetes Level: Equal or higher than 100 mg/dL
• Waist Circumference: 35 inches or more in women and 40 inches or more in men
• Cholesterol: HDL (good) under 40 in men and under 50 in women
• Triglycerides: Equal or higher than 150 mg/dL

With the good press Mediterranean diets have received over the years, many people are well aware of the benefits of olive oil and use it in cooking. What you may not have incorporated into your meal plan are: a variety of fresh fruits and vegetables, good omega-3 fatty acids from fish, healthy fats like nuts and olives, focusing more on vegetables and less on meat, and whole grains.

For a good summary of the Mediterranean diet, visit webmd.com. The most available and convenient foods in American are processed foods-- which contributes to the increases in Metabolic Syndrome.

Other things to keep in mind with Mediterranean lifestyle is smaller portions and active lifestyles. So how does your diet stack up to the Mediterranean lifestyle? What can you add or take away from your current way of eating that would incorporate some of the benefits of a Mediterranean way of life? Work with your dietitian and diabetes educator to come up with a healthy meal plan to help decrease some of your health risk factors.

Read more about how the Mediterranean diet can reduce the risk of metabolic syndrome.

--Amy

How do you track your blood sugar?

I just love technology! I always have...I even met my husband while selling computers for Circuit City years ago! I recently called and ordered a computer cord to download patient blood sugar monitor readings to my office computer and thought I would share with you some of the current trends in tracking blood sugar readings.

Most meters have computer cords available for purchase. Look on the back of your monitor for the toll free number to your monitor company and order the cord if you are interested in downloading your readings. Not only is this beneficial to you to help see trends in your blood sugars, I also would recommend printing them off for your diabetes educator and doctor's appointments.

Your healthcare providers may even have cords at their offices for them to save your readings and track them over time. Tracking your blood sugars on a graph visually shows why it is recommended for patients to check their blood sugar at home on a regular basis--to show trends. By just checking occasionally or isolating one reading, you miss the big picture of things. Seeing your readings on a graph can quickly show you if they tend to get higher as the day goes on or when your blood sugar usually spikes. Some software programs will show what percentage of the time your readings are "in goal range" or "above/below goal range" for you to share with your healthcare provider to make adjustments in your diabetes treatment plan.

Here is an example of some blood sugar readings I put in as a sample to a TrueTrack monitor. Their software is called TRUEmanager:

The time of day is at the bottom and the blood sugars readings are on the side. One of the benefits of graphing your blood sugars is you can adjust the time of day for your meals.

I work with several patients who have an altered schedule. They may wake at 4 a.m. or wake at 12p.m. and I adjust their meal times in the software so I can see that the blood sugar at 6 a.m. (for the patient who woke at 4 a.m.) was actually two hours after a meal rather than fasting.

If you don't want to purchase your cord or maybe one isn't available for your meter, there are several online resources for just typing in your readings and then a program graphs it.

Here's a free Blood Sugar Chart that can be used in Excel or printed out for you to write in your results. Here's a Microsoft Office free template to track your blood sugars. SugarStats.com is another online resource that has a free tracking plan and also one for purchase.

I'm a visual person, so graphing blood sugars are really helpful to me for seeing patterns or trends in the blood sugars. If you graph your blood sugars and it just looks very confusing, I would recommend making an appointment with your diabetes educator and bring your results into them. You can then work together to try to make changes in your lifestyle and diabetes care routine to get closer to your goal blood sugar range.

How do you track your blood sugars?

--Amy