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Groundbreaking Research Shows Low-Glycemic
High-Protein Nutrition
How to Regain and Glucose Health
Healthy Blood Sugar
and Lose Weight In a 2017 study by Kerstin Kempf and a
group of German researchers, a
One answer to healthy blood sugar levels is found in 12-week telemedical lifestyle
high-protein low-glycemic nutrition. intervention (TeLiPro) was carried out in
patients with advanced type 2 diabetes.1
People who live with diabetes want better options for getting
a handle on their blood sugar, especially their HbA1c levels. It included weekly phone calls by
trained diabetes educators who talked
The problem is that, even when we do try to eat right about diet, exercise, and options for
and exercise, our bodies still need extra help from our overall lifestyle changes.
metabolism to light the fires of our glucose-burning furnace
that’s necessary for weight loss. For the first 12 weeks, the TeLiPro group
also received a low-glycemic high-
Knowing this, in 1985 German holistic therapist protein dietary supplement — in place
Hubertus Trouillé developed a low-glycemic high-protein of three meals a day for the first week,
formula to be used as nutritional therapy by his patients two meals a day for weeks 2 to 4, then
living with diabetes and slow metabolism. one meal a day for weeks 5 to 12.
After following his dietary advice, Trouillé discovered that the The results? The HbA1c levels in the
formula not only helped his patients increase metabolism but LGHP diet group were, on average,
also regain glycemic control and lose weight. reduced by 1.1, from 8.4% to 7.3%.
Today, his unique formula, called Almased, has been In this group, there were also significant
scientifically studied for over 30 years. reductions in fasting blood glucose,
body weight, body mass index, blood
pressure, cardiovascular risk factors,
and requirements for diabetes
medications — a 20% lower need for
medications and a nearly 50% reduction
in insulin needs.
Study results show the Mean Weight Loss (kg) Weight Reduction
Almased participants experienced: Control
Weight loss Increased quality of life ATlemliaPsreod
Healthy HbA1c Healthy blood sugar Time (Weeks)
Reduced hunger Weight loss
1.Kempf K, et al. Efficacy of the telemedical lifestyle intervention program TeLiPro in advanced stages of type 2 diabetes: A randomized controlled trial. Diabetes
Care. 2017 Jul;40(7):863–871.
2.Lean M, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet.
2017;391(10120):541–551.
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These improvements were even seen What makes Almased so different?
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Made from high-quality Supported by over 30 years
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studies, with other diets, that have had Glycemic Index score.
some success, such as the 2017 DiRECT All essential amino acids.
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Results are not typical. Individual results may vary based on starting weight and program adherence.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
••• SPRING 2021 •••
Features At The Table
24 New Diabetes Tools 38 Step Into Spring
This year has seen many Delicious, no-fuss recipes
new devices, drugs and for a healthful breakfast.
resources for diabetes Plus, seafood, beef and
introduced to the U.S. yogurt collections.
market.
The Dose
28 Health in the
Palm of Your Hand 9 News & Notes
Learn about some top apps 13 Quiz
to improve health and 15 Product Spotlight
diabetes care in 2021. 16 Ask Away
17 Curmudgeonly Athlete
32 Give Hearing Aids
A Chance Healthy Living
The proper hearing aids can
help greatly improve day- 18 The Right Moves
to-day life. Find out about 20 Weighty Matters
the latest technology. 21 Smart Smarter Smartest
22 Food for Thought
34 Top Picks: Diabetes-
Friendly Foods In Every Issue
These options provide
nutrition, taste great and 4 Editor’s Note
will fit nicely into your 63 Recipe Index
diabetes eating plan. 64 Final Countdown
On the cover: Honey-Mustard
Salmon. For a list of all the delicious
recipes in this issue, see page 63.
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••• EDITOR’S NOTE •••
Editorial Director,Wellness Division Food Editor
Diane Fennell Lorena Drago, MS, RDN, CDN, CDCES
ART & PRODUCTION
Senior Designer
Scott Brandsgaard
SALES & MARKETING
Senior Media Solutions Manager Marketing Director
Bob Beucler Tim Doolan
[email protected] Senior Marketing Associate
Tommy Goodale
Client Services
[email protected] Content Marketing Supervisor
Anthony Buzzeo
CUSTOMER SERVICE
[email protected] (855) 367-4813
EDITORIAL BOARD
Dear Readers, Pamela Allweiss, MD, MPH Jeanne L. Rosenthal, MD
CDC Division of DiabetesTranslation Attending Surgeon, Retinal Service,
Spring is in the air! If you’re looking for tools that NewYork Eye and Ear Infirmary, NewYork, NewYork
can help you get a fresh start on your diabetes Amy P. Campbell, MS, RD, LDN, CDCES
management routine, you’ve come to the right place. Boston, Massachusetts Gary Scheiner, MS, CDCES
Interested in learning about devices and medications Owner and Clinical Director, Integrated Diabetes Services,
that have recently hit the market? Turn to “New Diabetes Robert S. Dinsmoor
Tools” (page 24). Curious about apps that can help you South Hamilton, Massachusetts Wynnewood, Pennsylvania
manage your meal plan, improve your sleep, bolster your
mental health and more? Check out “Tech to the Rescue” David E. Goldstein, MD Sheri Setser-Legg, MS, RD, LD, MLDE, CDCES
(page 22) and “Health in the Palm of Your Hand” (page Professor Emeritus, University of Missouri Diabetes Education Service Coordinator
28). Seeking fare that can stabilize your blood sugar Health Science Center, Columbia, Missouri
and satisfy your taste buds? Read our roundup of “Top UK HealthCare Barnstable Brown Diabetes Center,
Picks: Diabetes-Friendly Foods” (page 34), selected by Laura Hieronymus, University of Kentucky, Lexington, Kentucky
a diabetes educator and registered dietitian. No matter DNP, MSEd, MLDE, BC-ADM, CDCES, FADCES
what you seek, you’re sure to find something that can Associate Director, Education & Quality Services, Bernard P. Shagan, MD
help simplify your regimen and improve your health! UK HealthCare, Barnstable Brown Diabetes Center, Director, Diabetes Education Center,
Monmouth Medical Center, Long Branch, New Jersey
If you’ve recently found yourself cranking up University of Kentucky, Lexington, Kentucky
the volume on the TV or asking others to repeat Richard M. Weil, MEd, CDCES
themselves, you’ll want to learn more about another Jeff Plumer, Vice Chair, JDRF International Exercise Physiologist and Director, Mount Sinai St. Luke’s
type of technology that can improve your health and Board of Directors Weight Loss Program, Mount Sinai St. Luke’s Hospital,
quality of life: hearing aids. Studies show that hearing
loss is twice as common in people with diabetes, and William H. Polonsky, PhD, CDCES NewYork, NewYork
hearing impairment can impact both quality of life and Assistant Clinical Professor,
cognitive function. To learn about types of hearing aids Department of Psychiatry, Susan Weiner, MS, RDN, CDCES, CDN, FADCES
on the market, along with how to choose and use a Owner, SusanWeiner Nutrition, PLLC, Long Island, NewYork
device, see “Give Hearing Aids a Chance” (page 32). University of California, San Diego
Stephen Z. Wolner, DDS
Another common but not frequently discussed NewYork, NewYork
concern in people with diabetes is pain and stiffness
in joints. In “Freely Movable Joints” (page 18), learn In Memoriam Dr. Lois Jovanovic, 1947-2018
about some common issues that affect the joints, and
find several exercises that can be done in just a few *Please note: The Certified Diabetes Educator (CDE) credential has transitioned to Certified Diabetes Care and Education
minutes to help keep them healthy and limber. Specialist (CDCES).
We hope these pages help guide you toward a happier VP, Circulation Strategy O P E R AT I O N S Accounting Director
and healthier year ahead. Be well and happy spring! Jason Pomerantz Amanda Joyce
Senior Client Services & Operations Lead
All the best, Operations Director Andrea Palli Accounts Payable Associate
Cheyenne Corliss Tina McDermott
Diane Fennell Operations & Human Resources Coordinator
Editorial Director, Wellness Division Toni Eunice Accounts Receivable Associate
Wayne Tuggle
Client Services
Darren Cormier
Audience Development Analyst DIGITAL OPERATIONS WordPress Developer
Ryan Gillis David Glassman
Senior Digital Designer
Mike Decker
EXECUTIVE
Chairman & CEO Chief Operating Officer SVP, Sales & Strategic Partnerships Content Director
Jeffrey C. Wolk Courtney Whitaker Stuart Crystal Matt Martinelli
In memory of Susan Fitzgerald, COO, 1966-2018
Newsstand Distribution Weekly Retail Service
Diabetes Self-Management, Spring 2021, Volume 38, Number 1. Diabetes Self-Management (ISSN 0741-6253) (USPS SHUTTERSTOCK
003-865) is published quarterly by Madavor Media, LLC, 35 Braintree Hill Office Park, Suite 101 Braintree, MA 02184.
Periodicals postage paid at Boston, MA and at additional mailing offices. Copyright © 2021 Madavor Media, LLC. U.S.
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All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, elec-
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Statements and opinions expressed in this publication are those of the authors and not necessarily those of the publishers
or advertisers. The purpose of this magazine is to provide readers with accurate and up-to-date medical information. It is
not intended to provide medical advice on personal health matters, which should be obtained directly from a physician.
We regret that we are unable to respond to inquiries about personal health matters.
We sometimes make our list of subscribers available to carefully screened organizations whose products and activities
may interest you. While many subscribers find this type of information valuable, some prefer not to receive unsolicited
mail. Please contact our customer service department at (855) 367-4813 if you do not wish to receive such mailings.
Photographs contained in this magazine are for illustration purposes only.
For customer service or subscription information, please call (855) 367-4813.
4 DiabetesSelfManagement.com • Spring 2021
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••• DiabetesSelfManagement.com •••
FREE DOWNLOAD
WEEK OF: ______________
BLOOD MEDICINES FOODS OTHER*
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Managing High Blood Glucose Diabetes Logbook
When you were diagnosed with diabetes, your doctor probably told you Want to keep track of your blood
that your blood glucose levels were too high. Indeed, high blood glucose, or glucose readings to help you better
hyperglycemia, is the hallmark of diabetes. Get our tips for managing high manage your condition? With our free
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PHYSICAL FITNESS NUTRITION RECIPE
Circulation Exercises Is Almond Milk Good Greek Salad
Need help improving your for Diabetes? Crunchy and refreshing, this authen-
circulation? Try these simple tic low-carb recipe is the perfect
movements at home, the office Before you head to the supermarket complement to any Mediterranean-
or your desk to help relax your to stock up on almond milk, it’s themed meal. Fresh tomatoes, cu-
heart, improve blood flow and feel important to evaluate the various cumber, onion, Kalamata olives and
refreshed. types, as not all are healthy choices. Feta cheese serve as the base, all
Learn about the pros and cons of this topped with a homemade dressing.
bit.ly/CirculationExercises plant milk for people with diabetes.
bit.ly/LowCarbGreekSalad
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INTERACT WITH US Get more news, tools and recipes all month long! NEWSLETTER
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6 DiabetesSelfManagement.com • Spring 2021
For adults with type 2 diabetes (T2D), along with diet and exercise, once-daily RYBELSUS® can help lower blood sugar
Wake Up to the Possibilities of Reaching Your A1C Goal
RYBELSUS® is proven to lower RYBELSUS® may help you RYBELSUS® does not increase
blood sugar and A1C lose some weight the risk of major cardiovascular
(CV) events such as heart attack,
In a 6-month study of people with an average While not for weight loss, in the same 6-month
starting A1C of 8%, the majority of people study, people with an average starting weight stroke, or deathb
taking RYBELSUS® reached an A1C of of 195 pounds lost up to 8 poundsa:
less than 7%a: aIn a 6-month study looking at A1C with 703 adults with T2D
• 5 pounds on 7 mg of RYBELSUS® comparing 7 mg RYBELSUS® and 14 mg RYBELSUS® with a
• Nearly 7 out of 10 people on 7 mg of RYBELSUS® • 8 pounds on 14 mg of RYBELSUS® sugar pill when both were added to diet and exercise.
• Nearly 8 out of 10 people on 14 mg of RYBELSUS® • 3 pounds on a sugar pill bIn a cardiovascular safety study, 3183 adults with T2D and
• About 3 out of 10 people on a sugar pill a high risk of CV events were treated with either 14 mg
While many people in medical studies lost weight, some RYBELSUS® or a sugar pill in addition to their usual diabetes
did gain weight. and CV medications.
If eligible, you may pay as little Textd RESULTS to 44535
as $10 for a 30-day prescriptionc to learn more about RYBELSUS®
What is Rybelsus®? Before using Rybelsus®, tell your healthcare cause low blood sugar, such as a sulfonylurea or
provider if you have any other medical insulin. Signs and symptoms of low blood
Rybelsus® (semaglutide) tablets 7 mg or 14 mg conditions, including if you: sugar may include: dizziness or lightheadedness,
is a prescription medicine for adults with type 2 blurred vision, anxiety, irritability or mood changes,
diabetes that along with diet and exercise may • have or have had problems with your pancreas or sweating, slurred speech, hunger, confusion or
improve blood sugar (glucose). kidneys drowsiness, shakiness, weakness, headache, fast
heartbeat, and feeling jittery
• Rybelsus® is not recommended as the first choice of • have a history of vision problems related to your
medicine for treating diabetes diabetes • kidney problems (kidney failure). In people
who have kidney problems, diarrhea, nausea, and
• It is not known if Rybelsus® can be used in people • are pregnant or plan to become pregnant. It is vomiting may cause a loss of fluids (dehydration),
who have had pancreatitis not known if Rybelsus® will harm your unborn which may cause kidney problems to get worse. It
baby. You should stop using Rybelsus® 2 months is important for you to drink fluids to help reduce
• Rybelsus® is not for use in people with type 1 before you plan to become pregnant. Talk to your your chance of dehydration
diabetes and people with diabetic ketoacidosis healthcare provider about the best way to control
your blood sugar if you plan to become pregnant • serious allergic reactions. Stop using Rybelsus®
• It is not known if Rybelsus® is safe and effective for or while you are pregnant and get medical help right away, if you have any
use in children under 18 years of age symptoms of a serious allergic reaction including
• are breastfeeding or plan to breastfeed. itching, rash, or difficulty breathing
Important Safety Information Breastfeeding is not recommended during
treatment with Rybelsus® The most common side effects of Rybelsus® may
What is the most important information I include nausea, stomach (abdominal) pain, diarrhea,
should know about Rybelsus®? Tell your healthcare provider about all the decreased appetite, vomiting, and constipation.
Rybelsus® may cause serious side effects, medicines you take, including prescription and Nausea, vomiting, and diarrhea are most common
including: over-the-counter medicines, vitamins, and herbal when you first start Rybelsus®.
supplements. Rybelsus® may affect the way some
• Possible thyroid tumors, including cancer. medicines work and some medicines may affect the Please see Brief Summary of Prescribing
Tell your healthcare provider if you get a lump way Rybelsus® works. Information on adjacent page.
or swelling in your neck, hoarseness, trouble
swallowing, or shortness of breath. These may be What are the possible side effects of Rybelsus®? cCommercially insured patients only. Offer valid for up to
symptoms of thyroid cancer. In studies with rodents, six 30-day fills. Eligibility and other restrictions apply.
Rybelsus® and medicines that work like Rybelsus® Rybelsus® may cause serious side effects, dMessage and data rates may apply. Check with your mobile
caused thyroid tumors, including thyroid cancer. It including: service provider. Message frequency will be based on your
is not known if Rybelsus® will cause thyroid tumors selections. Text HELP to 44535 for help. Text STOP to 44535 to
or a type of thyroid cancer called medullary thyroid • inflammation of your pancreas (pancreatitis). quit. See Terms and Conditions of Use at RYBELSUS.com.
carcinoma (MTC) in people Stop using Rybelsus® and call your healthcare
provider right away if you have severe pain in your See cost and savings info at
Do not use Rybelsus® if: stomach area (abdomen) that will not go away, RYBELSUS.com, and ask your healthcare
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• you or any of your family have ever had MTC, or from your abdomen to your back provider about RYBELSUS® today.
if you have an endocrine system condition called
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ingredients in Rybelsus® • low blood sugar (hypoglycemia). Your risk
for getting low blood sugar may be higher if you
use Rybelsus® with another medicine that can
RYBELSUS® is a registered trademark of Novo Nordisk A/S.
Novo Nordisk is a registered trademark of Novo Nordisk A/S.
© 2020 Novo Nordisk All rights reserved. US20RYB00495 September 2020
Brief Summary of information about RYBELSUS® (semaglutide) tablets How should I take RYBELSUS®?
• Take RYBELSUS® exactly as your healthcare provider tells you to.
Rx Only
This information is not comprehensive. • Take RYBELSUS® by mouth on an empty stomach when you first wake up.
• Talk to your healthcare provider or pharmacist
• Visit www.novo-pi.com/rybelsus.pdf to obtain the FDA-approved product labeling • Take RYBELSUS® with a sip of water (no more than 4 ounces).
• Call 1-833-GLP-PILL
• Do not split, crush or chew. Swallow RYBELSUS® whole.
Read this Medication Guide before you start using RYBELSUS® and each time you
get a refill. There may be new information. This information does not take the place • After 30 minutes, you can eat, drink, or take other oral medications.
of talking to your healthcare provider about your medical condition or your treatment. RYBELSUS® works best if you eat 30 to 60 minutes after taking RYBELSUS®.
What is the most important information I should know about • If you miss a dose of RYBELSUS®, skip the missed dose and go back to your
RYBELSUS®? regular schedule.
RYBELSUS® may cause serious side effects, including:
• Possible thyroid tumors, including cancer. Tell your healthcare provider • Talk to your healthcare provider about how to prevent, recognize and manage low
blood sugar (hypoglycemia), high blood sugar (hyperglycemia), and problems
if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or you have because of your diabetes.
shortness of breath. These may be symptoms of thyroid cancer. In studies with
rodents, RYBELSUS® and medicines that work like RYBELSUS® caused thyroid What are the possible side effects of RYBELSUS®?
tumors, including thyroid cancer. It is not known if RYBELSUS® will cause thyroid
tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in RYBELSUS® may cause serious side effects, including:
people.
• See “What is the most important information I should know about
• Do not use RYBELSUS® if you or any of your family have ever had a type of RYBELSUS®?”
thyroid cancer called medullary thyroid carcinoma (MTC), or if you have an
endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 • inflammation of your pancreas (pancreatitis). Stop using RYBELSUS®
(MEN 2). and call your healthcare provider right away if you have severe pain in your
stomach area (abdomen) that will not go away, with or without vomiting.
What is RYBELSUS®? You may feel the pain from your abdomen to your back.
RYBELSUS® is a prescription medicine used along with diet and exercise to improve
blood sugar (glucose) in adults with type 2 diabetes. • changes in vision. Tell your healthcare provider if you have changes in vision
• RYBELSUS® is not recommended as the first choice of medicine for treating during treatment with RYBELSUS®.
diabetes. • low blood sugar (hypoglycemia). Your risk for getting low blood sugar may
be higher if you use RYBELSUS® with another medicine that can cause low blood
• It is not known if RYBELSUS® can be used in people who have had pancreatitis. sugar, such as a sulfonylurea or insulin. Signs and symptoms of low blood
sugar may include:
• RYBELSUS® is not for use in patients with type 1 diabetes and people with
diabetic ketoacidosis. • dizziness or light-headedness • blurred vision
It is not known if RYBELSUS® is safe and effective for use in children under 18 years • anxiety, irritability, or mood changes • sweating
of age.
• slurred speech • hunger • confusion or drowsiness
Do not use RYBELSUS® if:
• you or any of your family have ever had a type of thyroid cancer called medullary • shakiness • weakness • headache
thyroid carcinoma (MTC) or if you have an endocrine system condition called • fast heartbeat • feeling jittery
Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• kidney problems (kidney failure). In people who have kidney problems,
• you are allergic to semaglutide or any of the ingredients in RYBELSUS®. diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration) which
may cause kidney problems to get worse. It is important for you to drink fluids to
Before using RYBELSUS®, tell your healthcare provider if you have any help reduce your chance of dehydration.
other medical conditions, including if you:
• have or have had problems with your pancreas or kidneys. • serious allergic reactions. Stop using RYBELSUS® and get medical help
right away, if you have any symptoms of a serious allergic reaction including
• have a history of vision problems related to your diabetes. itching, rash, or difficulty breathing.
• are pregnant or plan to become pregnant. It is not known if RYBELSUS® will The most common side effects of RYBELSUS® may include nausea,
harm your unborn baby. You should stop using RYBELSUS® 2 months before stomach (abdominal) pain, diarrhea, decreased appetite, vomiting and constipation.
you plan to become pregnant. Talk to your healthcare provider about the best Nausea, vomiting and diarrhea are most common when you first start RYBELSUS®.
way to control your blood sugar if you plan to become pregnant or while you are
pregnant. Talk to your healthcare provider about any side effect that bothers you or does not go
away. These are not all the possible side effects of RYBELSUS®.
• are breastfeeding or plan to breastfeed. Breastfeeding is not recommended during
treatment with RYBELSUS®. Call your doctor for medical advice about side effects. You may report side effects to
FDA at 1-800-FDA-1088.
Tell your healthcare provider about all the medicines you take, including
prescription and over-the-counter medicines, vitamins, and herbal supplements. How should I store RYBELSUS®?
RYBELSUS® may affect the way some medicines work and some medicines may • Store RYBELSUS® at room temperature between 68°F and 77°F (20°C to 25°C).
affect the way RYBELSUS® works. • Store in a dry place away from moisture.
Before using RYBELSUS®, talk to your healthcare provider about low • Store tablet in the original pack.
blood sugar and how to manage it. Tell your healthcare provider if you are • Keep the tablet in the pack until you are ready to take it.
taking other medicines to treat diabetes, including insulin or sulfonylureas. • Keep RYBELSUS® and all medicines out of the reach of children.
Know the medicines you take. Keep a list of them to show your healthcare provider
and pharmacist when you get a new medicine. Revised: 01/2020
Manufactured by: Novo Nordisk A/S, DK-2880 Bagsvaerd, Denmark
RYBELSUS® is a registered trademark of Novo Nordisk A/S.
© 2020 Novo Nordisk US20RYB00078 2/2020
••• THE DOSE ••• News & Notes
CPAP Tied to Lower
Glucose Levels
BY QUINN PHILLIPS
SHUTTERSTOCK Most people with diabetes are betes. These clinical trials all com- which simply look at outcomes based
familiar with several factors that pared a standard treatment for sleep on what treatments people are already
can raise their blood glucose levels— apnea—continuous positive airway receiving—since people who are more
including high-carbohydrate meals, pressure (CPAP), which uses a machine motivated to treat their sleep apnea
inadequate physical activity, and not to support breathing while you sleep— effectively may also be more motivated
taking insulin or other medications as with either a sham CPAP treatment (a to control their diabetes.
prescribed or directed. In some peo- machine that does nothing to support
ple, psychological or physical stress breathing) or no treatment at all. The signs of sleep apnea aren’t
can also raise blood glucose levels. always clear to a person with the con-
The researchers found that com- dition, since you may not be woken up
Ongoing research is also identifying pared with either a sham treatment by its symptoms. But a partner who
other health conditions that can con- or no treatment, CPAP lowered par- sleeps with you may notice that your
tribute to higher blood glucose levels ticipants’ HbA1c (a measure of long- breathing stops for longer than usual,
in people with diabetes. One of those term blood glucose control) by an or that you snore loudly. It’s worth
conditions is obstructive sleep apnea average of 0.32%. The treatment also noting, though, that not everyone
(OSA), in which the airways temporar- led to improvements in fasting blood who snores has sleep apnea, and not
ily get blocked during sleep, stopping glucose and blood pressure. While everyone with sleep apnea snores.
a person’s breathing for a period of the differences in HbA1c and fast-
time. Sleep apnea has been associated ing blood glucose weren’t huge in Many people with sleep apnea wake
with a number of bad health outcomes, absolute terms, they were found to up with a dry mouth or headache.They
and a new study suggests that it’s be statistically significant and could, may also experience fatigue or mood
particularly bad for people with dia- over time, lead to improved outcomes swings during the day, since the condi-
betes—but that effectively treating it in people with diabetes. tion can interfere with getting enough
can help people with diabetes achieve restful sleep. The consequences of this
better blood glucose control. It’s notable that all of the clinical fatigue can be significant, potentially
trials included in the analysis were leading to lower productivity, falling
The study, published in the journal randomized, meaning that partici- asleep at work and even falling asleep
Diabetes, Obesity and Metabolism, was pants didn’t know what treatment they while driving.
an analysis of seven previous clinical would receive when they enrolled. This
trials that included 691 participants means the results are more reliable If you suspect that you could have
with both sleep apnea and type 2 dia- than those of observational studies— sleep apnea, talk to your doctor about
getting tested for the condition. DSM
Spring 2021 • DiabetesSelfManagement.com 9
••• THE DOSE ••• News & Notes
Hot Baths May Improve
Glucose Control in Type 2
BY QUINN PHILLIPS
Most people with type 2 diabetes 2 diabetes. The results of the ques- HbA1c—with average HbA1c levels SHUTTERSTOCK
are aware of some basic recom- tionnaire were then compared with of 7.10%, 7.20% and 7.36% in each
mendations for keeping blood glucose health-related measures taken as part of the three bath-taking groups, from
levels under control—such as taking of their regular appointments at the the most to the fewest baths.
medications as prescribed, getting outpatient unit of the hospital.
enough physical activity and follow- After adjusting for age and sex,
ing a healthy diet. But a new study Based on their responses in the frequency of baths was also indepen-
highlights a potential tool for blood questionnaire, participants were dently linked to BMI, with an average
glucose management that isn’t men- divided into three groups: those who BMI of 25.5, 26.0 and 26.7 in each
tioned very much: taking hot baths. took four or more baths per week, those bath-taking group from most to few-
who took one to four baths per week, est baths. Lower blood pressure was
The new study suggests that regu- and those who took less than one bath also independently tied to greater
lar heat exposure may have a benefi- per week. On average, participants bath frequency after adjusting for age,
cial effect on blood glucose control, took a bath 4.2 times per week, with sex and the number of blood pressure
as noted in a summary on the study an average duration of 16 minutes. drugs participants took.
from the journal Diabetologia. While
previous studies have shown health The researchers found that taking The researchers concluded that
benefits associated with heat ther- more baths per week was associated “daily heat exposure through hot-tub
apy—such as hot tubs and saunas—in with lower HbA1c (a measure of long- bathing has beneficial influences on
people with diabetes in controlled term blood glucose control), lower cardiovascular risk factors in patients
settings, the latest study is the first body weight, smaller waist circumfer- with type 2 diabetes.” While the effect
to look at the impact of real-world ence and lower blood pressure. Even of taking hot baths on your blood glu-
bath-taking habits in a large group after adjusting for factors like age, cose control may be minimal, those
of people with diabetes. sex, body-mass index (BMI, a mea- benefits still appear to be real—and
sure of body weight that takes height the potential for additional benefits
For the study, researchers at into account), and use of insulin and like lower blood pressure and a lower
Kohnodai Hospital in Japan gave a oral diabetes drugs, they found that body weight may further reduce your
questionnaire on bath-taking habits there was still a small but significant risk for health complications related
to nearly 1,300 patients with type link between baths per week and to diabetes. DSM
10 DiabetesSelfManagement.com • Spring 2021
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••• THE DOSE ••• News & Notes
Diabetes
Drugs to
Combat
COVID-19?
BY JOSEPH GUSTAITIS
Can drugs used to treat diabe- tor agonists and SGLT2 inhibitors. researchers are seriously looking at SHUTTERSTOCK
tes help fight the COVID-19 According to M. Regina Castro, MD, are the sodium glucose cotransporter
pandemic? A growing number of 2 (SGLT2) inhibitors. SGLT2 inhibitors
researchers think so and are actively of the Mayo Clinic, GLP-1 receptor inhibit the proteins in the kidneys
pursuing studies into the matter. agonist diabetes drugs “mimic the that promote returning glucose into
action of a hormone called glucagon- the blood. This causes blood sugar
There are good reasons to think like peptide 1. When blood sugar levels to discharge into the urine, thereby
the medications might be effective start to rise after someone eats, these lowering the amount of glucose in
in COVID treatment. At a recent drugs stimulate the body to secrete the blood. Four SGLT2 inhibitors
Heart in Diabetes (virtual) meeting, more insulin. The extra insulin helps are currently available: canagliflozin
Mikhail Kosiborod, MD, pointed out lower blood sugar levels.”Well-known (Invokana), dapagliflozin (Farxiga),
that COVID-19 is not just a viral dis- GLP-1 receptor agonist drugs include empagliflozin (Jardiance) and ertug-
ease—it’s also both a systemic disease dulaglutide (brand name Trulicity), liflozin (Steglatro). The main reason
(that is, it affects the entire body, not exenatide (Byetta, Bydureon), sema- researchers think these medications
just a part of it) and a cardiometabolic glutide (Ozempic, Rybelsus), lixisena- might help COVID patients is because
disease. (A cardiometabolic disease tide (Adlyxin) and liraglutide (Victoza). they help many of the processes dam-
is one that combines cardiovascular At the Heart in Diabetes meeting, Man- aged by viruses. According to Husain,
risk with metabolic problems, such as soor Husain, MD, proposed that GLP-1 “We already know that SGLT2s pro-
insulin resistance and diabetes. Car- receptor agonist diabetes drugs might vide organ protection.” Studies have
diometabolic diseases tend to share be used to treat the COVID-caused vas- previously demonstrated that they are
common risk factors). cular complications that excessively of value in treating heart failure and
affect diabetes patients. A Canadian kidney disease as well as diabetes.
COVID-19 strikes the same body initiative called the SEMPATICO trial Kosiborod is leading a research team
systems that cardiometabolic dis- has recently been established to test that is conducting a trial called DARE-
ease does, which might explain why the effectiveness of semaglutide in 19, which has enrolled about 900
the virus often affects people with lowering the death rate among certain participants to study the potential of
diabetes and other cardiometabolic COVID patients, as well as their need dapagliflozin in safely and effectively
diseases more severely. Two classes for cardiorespiratory support, such treating people with COVID who are
of diabetes medications are of special as a ventilator. at risk of serious complications. DSM
interest in the war on COVID-19:
glucagon-like peptide 1 (GLP-1) recep- The other diabetes drugs COVID
12 DiabetesSelfManagement.com • Spring 2021
QUIZ Thanks to
BetterWOMAN, I’m
DIABETES winning the battle for
AND WALKING
Bladder Control.
BY LISA CANTKIER
Frequent nighttime trips to the bathroom,
When you have a busy schedule, finding time embarrassing leaks and the inconvenience of
for physical fitness can be challenging. Why constantly searching for rest rooms in public–
not consider something as simple as walking? It can for years, I struggled with bladder control
provide more positives than many of us may realize. problems. After trying expensive medications
(Before starting a new fitness program, consult with with horrible side effects, ineffective exercises
your healthcare provider to ensure it is safe for you.) and uncomfortable liners and pads, I was
ready to resign myself to a life of bladder leaks,
1. To achieve any health benefits, you need to par- isolation and depression. But then I tried BetterWOMAN®.
ticipate in higher-intensity activities at least once When I first saw the ad for BetterWOMAN, I was skeptical. So
many products claim they can set you free
or twice a week in addition to walking. from leaks, frequency and worry, only to
deliver disappointment. When I finally tried
l True l False BetterWOMAN, I found that it actually works!
It changed my life. Even my friends have
2. People with diabetes who walk every day for 30 noticed that I’m a new person. And because
it’s all natural, I can enjoy the results without
to 60 minutes can obtain which benefits? the worry of dangerous side effects. Thanks to
l A. Improved glucose control. BetterWOMAN, I finally fought bladder control
l B. Improved cardiovascular fitness. problems and I won!
l C. Improved weight control.
l D. All of the above. ALL NATURAL
3. Walking is associated with which of the follow- Clinically-Tested Herbal Supplement
ing in people with diabetes? • Reduces Bladder Leaks*
l A. Decreased A1C levels. • Reduces Bathroom Trips*
l B. Reduced body-mass index.
l C. Lowered diastolic blood pressure. • Sleep Better All Night*
l D. All of the above. • Safe and Effective
• Costs Less than Traditional Bladder Control Options
• Live Free of Worry, Embarrassment,
and Inconvenience
4. Which of the following statements is correct? Better Products
l A. Moderate exercise such as brisk walking by itself for Better Aging!
can reduce the risk of type 2 diabetes. Tested. Natural.
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SHUTTERSTOCK l True l False *These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat,
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See page 14 for answers.
••• THE DOSE ••• News & Notes
QUIZ ANSWERS See page 13 for questions. UNDIAGNOSED LIVER
DISEASE COMMON IN T2
1. False. In a study published in the journal Diabetes
Care, researchers found that it is not necessary to do BY QUINN PHILLIPS
a lot of strenuous exercise to reap health benefits—
even small increases in physical activity can help. The Liver dysfunction in type 2 diabetes can go beyond the
study authors noted that walking regularly is “one of organ’s role in regulating blood glucose levels. People
the best things you can do for [your] health.” with type 2 diabetes are at increased risk for nonalco-
holic fatty liver disease (NAFLD), a condition in which
2. D. People with diabetes who walk every day for 30 to abnormally large amounts of fat build up in the organ.
60 minutes (all at once or in smaller chunks) can enjoy While this condition doesn’t tend to cause symptoms by
improved glucose control, cardiovascular fitness and itself, it increases the risk of inflammation and structural
weight management. Exercise helps the muscles absorb changes (fibrosis and cirrhosis) in the liver that can reduce
blood glucose, preventing it from building up in the liver function over time and possibly lead to liver cancer.
bloodstream. A study in Diabetologia indicated that
walking after meals is particularly beneficial for glucose But according to a recent study, some of the most
control. With respect to heart health, a review in Current commonly used markers of liver function aren’t actually
Opinion in Cardiology noted that“increased walking vol- very good at predicting liver damage in people with type
ume is associated with reduced cardiovascular mortality 2 diabetes.
and events among those diagnosed with diabetes.”Last
but not least, walking regularly burns calories, which can The research recruited 564 adults with type 2 diabetes
help with weight management. and without a previous diagnosis of NAFLD. All of them
underwent laboratory testing to screen for liver fibrosis,
3. D. A meta-analysis looking at the impact of walk- which included common blood tests as well as an imaging
ing on blood glucose control and other cardiovascu- test known as vibration-controlled transient elastography.
lar risk factors in type 2 diabetes published in PLOS Based on these screening tests, participants suspected
One showed that this activity is associated with a of having substantial fibrosis underwent a liver biopsy
decreased A1C (a measure of glucose control over the to confirm the diagnosis.
previous two to three months), along with reduced
body-mass index (BMI, a measure of weight relative to Based on the imaging test, about 22% of participants
height) and lower diastolic blood pressure. were found to have some stage of suspected fibrosis in
their liver. But two of the blood tests often used to screen
4. A. A joint position statement from The American for liver disease—aspartate aminotransferase (AST) and
College of Sports Medicine and the American Diabe- alanine aminotransferase (ALT)—weren’t very good at
tes Association notes that regular physical movement indicating this suspected damage. Among the participants
reduces the risk of type 2 diabetes. The researchers con- with signs of fibrosis in their imaging tests, 71% had a
cluded that“exercise plays a major role in the prevention normal AST result, and 62% had a normal ALT result.
and control of insulin resistance...type 2 diabetes and
diabetes-related health complications.”A review in the Based on these findings, the researchers recommended
World Journal of Diabetes found that“Walking for at least adding imaging tests to screening for NAFLD in people with
30 min[utes] per day was shown to reduce the risk of type 2 diabetes—since other tests may not pick up signs
type 2 diabetes by approximately 50%.” of the condition. They also emphasized the importance of
screening in the first place, since even though none of the
5. True. In the recent CARDIA Study, which analyzed study participants had a previous diagnosis of liver disease,
data from 1,923 middle-aged participants, those who almost one in four showed signs of the condition. DSM
walked the most steps per day over an average of
nine years had a 43% lower risk of diabetes and a 31%
lower risk of high blood pressure, compared to those
who took the fewest steps. In women, every 1,000
additional steps were associated with a 13% reduced
risk of becoming obese. DSM
Lisa Cantkier is a writer and educator specializing in nutri- Liver fibrosis
tion and health. She is coauthor of The Paleo Diabetes Diet
Solution. Email her at [email protected]. SHUTTERSTOCK
14 DiabetesSelfManagement.com • Spring 2021
••• THE DOSE ••• Product Spotlight
Cool New Products to Try
BY AMY CAMPBELL, MS, RD, LDN, CDCES
HoMedics SoundSpa White Noise Machine
Sleep is vitally important to overall good health, as well as managing
diabetes and lowering your risk of heart disease. If you toss and
turn at the slightest shift in sound, give the HoMedics SoundSpa
white noise machine a try. This little machine will do wonders for
masking sudden changes in sound, such as a truck rumbling by or
a dog barking. Choose from six therapeutic sound options—White
Noise, Thunder, Ocean, Rain, Summer Night and Brook—that you
can set on an auto-off timer to conserve energy. An added benefit:
HoMedics White Noise Sound Machine is lightweight and portable,
so it can go where you go, easily fitting into your purse, bag or
suitcase. A good night’s sleep is finally within reach!
homedics.com
Bulbhead Egg Sitter Support Cushion
Spending more time at home means you might be sitting a lot more than
usual. And sitting for long periods of time can put a lot of pressure on
your tailbone and hips, which, in turn, can lead to lower back pain and
sciatica. If you’re dealing with this, it’s time to give the Egg Sitter Support
Cushion a try. This cushion’s unique honeycomb design absorbs your
weight and takes pressure off sensitive areas, all the while supporting
your spine and allowing air to circulate (no hot sticky cushion here!). Give
your backside some well-deserved comfort with this innovative cushion.
bulbhead.com
AZO Urinary Tract Infection Test Strips
People with diabetes can be prone to having UTIs (urinary tract infections) due
to high blood sugars and certain medications. Left untreated, UTIs can lead to
more serious conditions, like a kidney infection. If you think you may have a UTI,
AZO Urinary Tract Infection Test Strips can save time and help you get the right
treatment faster. With AZO test strips, you take a UTI test at home and then call
your healthcare provider with the results. These strips are the same test that
many doctor’s offices use to measure leukocytes (white blood cells) and nitrites
in your urine. Plus, you get a result in just two minutes. The strip’s clean grip
handle is sanitary and easy to use, and results are easy to read, too.
azoproducts.com
Spring 2021 • DiabetesSelfManagement.com 15
••• THE DOSE ••• Ask Away
Estimated
A1C,
Seated
Exercise
BY GARY SCHEINER, MS, CDCES
QI have had type 1 diabetes for 12 weeks. How many weeks of data cycle), as well as participating in chair SHUTTERSTOCK
21 years and recently started did you look at when getting the A1C exercise classes (which are available
to use a continuous glucose moni- estimate from your device? Certain both online and on DVDs). Water
tor (CGM). The average glucose on CGM software programs default to exercise may also be a good option,
my device is close to 150 mg/dl, the last two weeks of data. If your as the buoyancy of the water can
which corresponds with an A1C average tightened up over the past provide nice support, not to mention a
of roughly 7.0%. Last week, I had two weeks, the estimated A1C would “cushion” in case you accidentally tip
an A1C test, and my result was be lower than the actual A1C. over. Water options include walking,
8.1%. Why such a difference? doing laps with a kickboard or taking
QI am 68 years old and have water fitness classes.
AThis is something that many type 2 diabetes. Unfortunately,
people wonder about. There I also have a serious hernia that You can perform many forms of
are several possible explanations. causes me to lean back and lose strength training in a seated posi-
my balance while walking. Now, tion using elastic resistance bands
1. The A1C result generated by the I’m so out of shape that I can’t stay or household objects (cans, bottles,
blood test could be wrong. There are on my feet for long before tiring. I rolls of coins, etc.) as weights. Exer-
a number of things that can produce know that exercise is good for me, cises that can be performed on a
a false result, including iron defi- but what, if anything, could I do to chair or bed or the floor include
ciency or other types of anemia, low get back into shape? shoulder (overhead) presses, front
red blood cell count, kidney disease, arm raises, bicep curls, chest flies,
a recent blood donation and slow AKudos to you for not giving shrugs, leg curls, leg extensions,
recycling of red blood cells. up! Many people with (and abdominal crunches and back
without) diabetes have difficulty extensions. Directions for perform-
2. The CGM could be wrong. exercising in a standing position. ing these and other strength exer-
Overall, most CGM systems tend to Conditions such as poor circula- cises can be found online or with
underestimate glucose levels more tion in the legs, painful neurop- the guidance of a trainer at your
than they overestimate. CGMs also athy (nerve damage), arthritis, local gym. Check with your doctor
tend to run low for extended peri- back problems, balance issues and before adopting any new exercises
ods of time after a person recov- various joint ailments can make to ensure they’re a good fit for you,
ers from hypoglycemia (low blood certain types of physical activity and enjoy your workout! DSM
glucose), even though their blood difficult. The good news is that there
sugar may have returned to normal are many good “non-weight-bear- Gary Scheiner, MS, CDCES, has lived
quickly. Even when using a system ing” options—activities that don’t with type 1 diabetes for 30 years and
that does not require calibration, it require you to be on your feet. was named Diabetes Educator of the
is still important to perform finger- Year 2014 by the Association of Dia-
sticks on a regular basis to verify that Seated cardio (aerobic) exercise betes Care & Education Specialists.
your CGM is performing properly. options include using a stationary
bike (upright or recumbent), a rowing Have a question about diabetes?
3. They could both be cor- machine or an arm ergometer (arm Email [email protected].
rect. Remember, the A1C reflects the
average glucose over the past eight to
16 DiabetesSelfManagement.com • Spring 2021
••• THE DOSE ••• Curmudgeonly Athlete
Exercise Recovery
BY ROBERT S. DINSMOOR
SHUTTERSTOCK An important aspect of exercising chance to recover. So, here are some Also, alcohol can interfere with pro-
for health is knowing when not widely accepted tips to help you make tein metabolism and the body’s ability
to exercise—that is, when to take a the most of your workout and fully to build muscle.
break. This lesson was painfully driven recover from exercise.
home to me after paddleboarding fol- Get adequate protein. Your body
lowing a long hike following a stint of TIPS FOR EXERCISE RECOVERY can’t repair muscle tears without it.
yardwork that involved lifting heavy Get enough sleep. During sleep,
patio stones. (I knew how to “use my the body releases growth hormone, Be careful about which painkill-
core,” so I was all set—right? Wrong!) which allows muscles to recover and ers you take. While many athletes
I found myself hobbling around pain- grow. Sleep is essential to a healthy scarf down nonsteroidal antiinflam-
fully for several weeks afterward with body and mind, and it aids in recov- matory drugs (NSAIDS) like popcorn,
bursitis of the hip.At the risk of putting ery from exercise. medicines like aspirin, ibuprofen and
my bruised ego on display, listening naproxen may actually interfere with
to people say, “Slow down, everybody, Drink plenty of water. We can exercise recovery. Inflammation is
so Rob can catch up!” was almost as lose a lot of fluids during a workout, part of the body’s natural recovery
bad as the bursitis. so it’s important to avoid dehydration. process. If you need a painkiller,
Water is also essential to help remove consider acetaminophen instead of
Everyone needs periods of recovery metabolic waste products from your NSAIDs. Some exercise experts rec-
after heavy exercise, especially when bloodstream. While there are a lot of ommend ice baths instead of pills.
it involves weight training or other athletes out there touting sports drinks
resistance training. There is a rule of like Gatorade, most health experts say Massage, anyone? Although
thumb that says you should skip at plain water is enough. And, of course, there is not much solid evidence that
least one day between exercising the people with diabetes should be aware massage aids in muscle repair, it
same muscle groups, and more than that many sports drinks can raise their can reduce muscle soreness after a
one day might be even better as you blood sugar levels. workout. Using foam rollers can help
get older. There’s a reason for this. remove any knots in the muscles and
When we engage in weightlifting or Avoid post-exercise alcohol. Does connective tissue.
other forms of strength training, we’re a beer after a workout help you rehy-
essentually tearing the muscle fibers, drate? No, sorry. If anything, alcohol BE IN IT FOR THE LONG HAUL
which become stronger and bulkier as does just the opposite. It can increase I tend to look at life as a marathon
they recover—that is, if they’re given a your need to urinate, which—you rather than a sprint, so there’s ample
guessed it—promotes dehydration. time to slow down when you need to.
It will help you in the long run. DSM
Spring 2021 • DiabetesSelfManagement.com 17
••• HEALTHY LIVING ••• The Right Moves
Freely Movable Joints
Exercises for staying limber
BY LAUREL DIERKING, MED, NASM, 700-ERYT
Joints are the areas in the body where in their range of motion, we are more SHOULDER SWIMMERS
two or more bones meet, keeping the likely to strain, sprain and tear joint and Standing normally, make as
skeleton together and helping to allow muscle tissue. These injuries are com- big a circle as you possibly
movement. They are configured to be mon in older adults, as with age we lose can with one arm, forward,
supple but stable, consisting of cartilage the elasticity and hydration within our up and around, allowing
(tissue that covers the bone), synovial joints, especially in the shoulders, knees your trunk to rotate as
membrane (which lubricates and encap- and hips. Athletes in certain sports are you reach back (similar to
sulates the joint), ligaments (tissues that also largely susceptible to these types of a single-arm backstroke).
connect bone to bone), tendons (tissues injuries due to continuous impact. Make five rotations front
that connect muscle to bone) and bursas to back and five rotations
(sacs that cushion friction). These impor- However, injuries do not just occur back to front. Repeat on the
tant structures allow us to safely absorb from being tight and inflexible. Many other side.
impact from movements such as walking, injuries also occur due to hypermobility.
jogging and jumping. This is characterized by the ability to take HURDLE STEPS
joints beyond what is considered a normal Stand near a wall or desk for
The mobility of our joints can affect range of motion. This can cause—and be support. Take one knee as
our quality of life. The largest joints in caused by—weak muscles surrounding far up as you can and rotate
the body, the ball-and-socket joints of a particular joint and may lead to joint the leg up and around as if
the shoulders and hips, should be supple pain or discomfort after some activities. you are stepping backward
enough to reach, stretch and extend Hypermobility can be genetic, but in large over a tall hurdle. Return
the body to meet an object but strong part, it is more directly due to lifestyle the leg forward the same
enough to brace the body when we lift and activity habits. Overstretching, in way. Repeat five to 10 times
an item overhead onto a high shelf or combination with little or no strength on each side.
to catch ourselves after stumbling. The training, can lead to hypermobility and
hinge joints of the knees and elbows chronically loose joints. WIDE-LEG TOE REACH
ideally extend through their full range of Stand with your feet
motion so that we can transition properly Just as it is important to maintain comfortably wide apart
through each gait cycle when walking, strength in each muscle of the body, it is and your arms in a “T”
jogging or running. The pivot joints of critical to keep our joints mobile, moving shape. Exhale as you bend
the wrists and ankles allow us to move each one individually and intentionally. at the waist and reach your
the outermost portion of our extremities Take five minutes to try these simple right hand toward your
dynamically. Without the appropriate exercises, either first thing in the morn- left foot or shin. Inhale as
harmonious balance of flexibility and ing, during a short work break or before you return to standing and
stability within the joints, our quality getting into bed. DSM immediately reach to the
of movement is affected, whether it be opposite side. Repeat 10
when sitting, standing or moving. Laurel Dierking, MEd, NASM, touches on each side.
700-ERYT, is a movement specialist
One of the most important benefits with a concentration in yoga, strength
of having freely movable joints is injury conditioning, exercise physiology and
prevention. Hypomobility is character- postural restoration. With 10 years of
ized by being restricted in our range extensive experience, Dierking seeks
of motion in a particular joint. A lack of to enhance self-awareness by guiding
stretching and excessive strength train- individuals through mindful movement,
ing can be primary causes of limited joint functional training, body awareness
movement. If our joints are more fixed and breath work.
18 DiabetesSelfManagement.com • Spring 2021
AARON ASHLEY
Spring 2021 • DiabetesSelfManagement.com 19
••• HEALTHY LIVING ••• Weighty Matters
Tech for Weight Control
BY DR. NICOLA DAVIES, PHD
T echnology has integrated itself • The MyNetDiary app can help ers can additionally be set to send SHUTTERSTOCK
into every aspect of our lives and, you log your meals, drinks and you reminders, prompting you to
as much as we might not like to admit snacks. You can also set up your own complete your daily goals.
it, most of us would be lost without personalized targets and weight-loss
our digital devices. While the reliance plan, with the app encouraging you CONNECT WITH PROFESSIONALS
on gadgets can be unhealthy, used to stay on track by offering tailored With a smartphone app, you always
the right way, technology can help advice to help you reach your goals. have access to your nutrition and
you meet your health goals, including activity tracking data, making it sim-
weight management. • The Fooducate app contains a pler to keep an accurate and up-to-
comprehensive library of nutrition date log of your progress. It also makes
CONTROL PORTIONS data, allowing you to scan your food it easier to share your data with your
Controlling your portion sizes can labels and quickly gather information healthcare provider. As an example,
help you maintain a healthy weight about what you are eating. The app Glooko is a diabetes management
and stabilize your blood sugar levels. even suggests healthier alternatives. platform that creates a digital logbook
A device such as the Smart Diet Scale, of information that you can share with
a high-tech food scale, can help you MOTIVATION TO MOVE your physician or diabetes specialist
measure your portion sizes and track With wearable technology such as for review and analysis.
carbohydrate, fat, calorie and protein the Fitbit, you can track your daily
content, so that you can monitor your activity levels and exercise using the THE FUTURE OF DIABETES TECH
nutrition intake via the corresponding power of an accelerometer (a tool that Watch this space—technology is set
smartphone app. measures movement). Some Fitbit to make your diabetes and weight
models even have heart rate monitor- management goals easier to track
TRACK CARBS AND CALORIES ing capabilities to ensure you get the and achieve! DSM
Whether you need to lose some weight most out of your workout.
or maintain your current weight, Dr. Nicola Davies, PhD, health
tracking your calorie and carbohy- Wearable gadgets can also share psychology, is author of I Can Beat
drate intake accurately can help you information and challenges with your Obesity! Finding the Motivation,
succeed. Fortunately, technology has friends on social media, helping to Confidence and Skills to Lose Weight
made the process much easier: keep you motivated when working and Avoid Relapse.
toward a specific weight-management
or exercise goal. Some activity track-
20 DiabetesSelfManagement.com • Spring 2021
••• HEALTHY LIVING ••• Smart Smarter Smartest
Nuts and Seeds
BY LEA ANN HOLZMEISTER, RD, CDCES
Nuts and seeds are an important decreases the risk of heart disease. and flaxseeds. Choose varieties that
part of a healthful diet. With the Nuts and seeds also provide essen- are unsalted or lightly salted and keep
adaptability to be made into butters, track of your portions. A 1-ounce
pastes, flours or cooking oils, they tial vitamins and minerals, such as serving of most nuts or three table-
are versatile in recipes, and they can vitamin E and magnesium, as well spoons of seeds contains 150 to 200
also be eaten alone as a satisfying as fiber and protein. The healthi- calories. To reap the benefits of these
snack food. And what’s more, they est options are those that contain foods without adding extra calories,
are good for you. These foods contain higher amounts of polyunsaturated replace less-healthful snacks such
healthy fats, and most varieties help fats (as opposed to saturated fats), as potato chips or pastries with nuts
lower LDL (“bad”) cholesterol, which including walnuts, macadamia nuts, and seeds. DSM
hazelnuts, pecans, sunflower seeds
FAT SAT FAT SODIUM CARBS FIBER PROTEIN
(g) (g) (mg) (mg)
SERVING CALORIES (mg) (mg)
15 2
SMART 1 oz 170 16 1.5 0 5 36
1 oz 170 16 1.5 0 6 25
Planters Mixed Nuts, Unsalted 1 oz 170 15 2 40 6 2 5
Planters NUT•rition, Raw Mixed Nuts, Unsalted 1 oz 170 15 1.5 45 5 2 6
Planters NUT•rition Essential Nutrients Mix 1 oz 170 14 1.5 35 5 3 6
Planters Mixed Nuts, Lightly Salted 1 oz 160 16 1.5 0 6 25
Planters NUT•rition Heart Healthy Mix 1 oz 170 40 6 2 5
Target Good & Gather Raw Mixed Nuts, Unsalted 14 2
Target Good & Gather Raw Mixed Nuts, Lightly Salted 1 oz 166 14 1.5 2 6 27
1 oz 170 14 2 0 8 36
SMARTER 3 tbsp 156 21 3 3 6 35
1 oz 204 11 2.5 1 4 22
Peanuts, Unsalted 3 tbsp 150 12 2 5 3 29
Pistachios, Unsalted 1 oz 157 19 4 3 9 15
Sesame Seeds, Unsalted 1 oz 186 1 4 24
Macadamias, Unsalted 14 1
SHUTTERSTOCK Pumpkin Seeds, Unsalted 1 oz 164 17 1 0 6 46
Cahsews, Unsalted 1 oz 178 20 2 0 5 34
Brazil Nuts, Unsalted 1 oz 196 14 1 0 4 33
3 tbsp 174 18 2 0 2 1 11
SMARTEST 1 oz 185 15 0 1 4 24
3 tbsp 153 11 1 3 6 36
Almonds, Unsalted 3 tbsp 174 6 15 12 6
Hazelnuts, Unsalted
Pecans, Unsalted
Hemp Seeds, Unsalted
Walnuts, Unsalted
Sunflower Seeds, Unsalted
Chia Seeds, Unsalted
Spring 2021 • DiabetesSelfManagement.com 21
••• HEALTHY LIVING ••• Food For Thought
Tech to the Rescue
Apps and devices to help with food and fitness
BY ALISON MASSEY, MS, RD, LDN, CDCES
T ools to help us meet our food and I’M LOOKING FOR SOME HELP The first step in choosing is to SHUTTERSTOCK
fitness goals have been around WITH IMPROVING MY FOOD identify how you would like to use
for decades. While technology may CHOICES. WHICH APPS DO YOU the app to change your eating hab-
have changed the type of assistance SUGGEST TO YOUR CLIENTS? its or behaviors. Next, determine if
that is available for the kitchen or you want an app with basic func-
gym, remember that any tool is help- How useful someone finds a particular tionality or something that has the
ful only if it is actually used regularly. app is largely based on that person’s option to customize features to your
Don’t let your food and fitness tech goals and the purpose of the app. specifications or preferences. Lastly,
collect dust—if a specific item isn’t When it comes to food and nutrition remember that you might need to try
being used frequently, evaluate why apps, I typically divide them into three a few apps before you find the right
it isn’t meeting your needs and think different categories: one for you.
about trying something else. This
piece provides some guidance on food • Macronutrient/calorie tracking Here is a quick list of a few apps
and fitness technology to consider • Nutrition guidance (all available on Android and iOS) to
adding to your routine. • Cooking/dining/shopping consider within each category when
you start your search.
22 DiabetesSelfManagement.com • Spring 2021
MACRONUTRIENT/CALORIE features include a daily meal log, are also interested in fitness.
TRACKING APPS recipes and health articles. Premium Fitbit, Inc., fitbit.com
Calorie Counter & Diet Tracker upgrade available for low-carb, keto
This app tracks food and workouts, and diabetes profiles. Endomondo A fitness trainer that will
providing features such as a food Fooducate, Ltd., fooducate.com track all kinds of activity—including
database, calorie counter, exercise walking, running, biking and kayaking—
demonstrations and health articles. COOKING/DINING/ providing motivational feedback and
It also includes internal social SHOPPING APPS allowing users to set goals and connect
networking capabilities. SideChef Home cooks receive access with friends in the network.
SparkPeople, sparkpeople.com in this app to more than 18,000 step- Endomondo.com, endomondo.com
by-step recipes, a meal-planning
Calorie Mama AI: Meal Planner & tool and the ability to purchase RunKeeper Create running goals and
Food Macro Counter An app that ingredients directly through Walmart receive a training program or custom-
analyzes photos users have taken and Amazon Fresh. build your own with this app. It also
of their food to calculate and track SideChef, sidechef.com integrates with other fitness trackers
nutrition information. Users can then such as MyFitnessPal and Fitbit so
evaluate their eating habits against Instacart Shop online and get you can easily assess your progress.
their specific nutrition goals. groceries delivered in as little as ASICS Digital, Inc., runkeeper.com
Azumio, Inc., caloriemama.ai one hour. This app provides a list of
participating stores that are available Strong Record weight and repeti-
Carb Manager: Keto Diet Tracker in your zip code. tions during your exercise routine.
& Macros Counter Designed for Instacart, instacart.com The app serves as a diary and pro-
those following a ketogenic or low- vides suggestions to modify future
carbohydrate lifestyle, this app allows ShopList Categorize your shopping exercise routines.
users to enter food, water intake list with this app and add specific Strong Fitness PTE, Ltd., strong.app
and exercise for assessment against weights and measurements of foods
defined goals. Enhanced functionalities required to help reduce food waste. FITNESS WITH A GAMING
are also available. Kamiku Apps, ourshoplist.es COMPONENT
Wombat Apps, LLC, carbmanager.com Zombies, Run! Want to integrate a
Food Network Kitchen With recipes, story of a post-apocalyptic world into
NUTRITION GUIDANCE APPS video guides and the ability to order your workout? Zombies, Run! is part
CalorieKing A database of thousands ingredients directly, this app provides story and part game, challenging you
of foods that can be used to assess the users with access to their favorites to increase the speed of your run.
nutrition facts associated with each from Food Network chefs. Six to Start, zombiesrungame.com
food item. Discovery Digital Ventures, LLC,
CalorieKing.com, calorieking.com foodnetwork.com FITNESS ROUTINES
J&J Official 7 Minute Workout
Carb Counting With Lenny WHICH TRACKERS AND DEVICES This app provides exercise routines
Designed for children, this app has ARE THE BEST FOR IMPROVING that can help you get fit without
simple features to help users learn to FITNESS? long time commitments. Workouts
count carbohydrates. Game elements There are so many choices when using body resistance eliminate the
of the program help with engagement it comes to physical activity track- need for additional equipment. Each
and learning. ers, devices and apps—the best one workout is customized based on
Medtronic, Inc., lenny-diabetes.com for improving fitness is the one that selected preferences.
you will use the most. Regardless of Johnson & Johnson Health & Well-
Ate—The Mindful Food Journal whether you’re looking for something ness Solutions, Inc., 7minuteworkout.
and Photo Diary A mindful photo- to provide a workout routine or a tool jnj.com
based food journaling app that doesn’t that simply allows you to track your
track calories but rather is designed own fitness regimen, there is an option Fitocracy Fitness Community Use
to create awareness of eating habits, available to meet your needs and help this app to customize workouts, track
behaviors and feelings. Premium you achieve your goals. fitness and set goals, as well as connect
features available. with others in the fitness community.
Ate (formerly YouAte), youate.com TRACKING MILEAGE OR Fitocracy, fitocracy.com
FITNESS ROUTINE
Fooducate This app uses a rating Fitbit These apps and devices track Alison Massey, MS, RD, LDN, CDCES,
system to evaluate foods based on activity, record workouts, log food and is a registered dietitian and certified
their nutrients and ingredients. Other help users connect with friends who diabetes educator in Maryland.
Spring 2021 • DiabetesSelfManagement.com 23
New Diabetes Tools
Despite a global pandemic, the past year has seen many new devices,
drugs and resources for diabetes introduced to the U.S. market
BY QUINN PHILLIPS
T he year 2020 wasn’t a normal one for to change up their diabetes management or treat- SHUTTERSTOCK
healthcare, to say the least. The global ment in this environment.
COVID-19 pandemic has changed the way
doctors and patients interact throughout the United But even though you might have missed them,
States, with many turning to telemedicine for rou- a variety of devices and drugs for diabetes were
tine visits, including those related to diabetes. It introduced in 2020. Here’s what you should know
stands to reason that many people were reluctant about these new tools, along with drug and device
label changes that were made to existing products.
24 DiabetesSelfManagement.com • Spring 2021
HYBRID CLOSED-LOOP SYSTEMS CONTROL-IQ
Control-IQ MINIMED
Tandem Diabetes Care 770G
(877) 801-6901
tandemdiabetes.com Spring 2021 • DiabetesSelfManagement.com 25
WHAT IT DOES Tandem’s Control-IQ technology works with
the company’s t:slim X2 insulin pump and the Dexcom G6
continuous glucose monitor (CGM) to automatically adjust
insulin delivery in response to predicted glucose levels.
The company reports that study participants using the
technology achieved in-range glucose levels 71% of the
total time, compared with 59% for those using a similar
setup without the new technology.
AVAILABILITYIf you’re interested in using a t:slim X2 pump to
take advantage of Control-IQ technology, visit tandemdiabetes.
com and click on the “get a pump”button to see your options.
MiniMed 770G
Medtronic
(800) 646-4633
medtronicdiabetes.com
WHAT IT DOES The MiniMed 770G system automatically
adjusts background insulin delivery every five minutes
based on real-time glucose readings. It also connects
with a smartphone to let you see your glucose and insulin
trends over time. This system is approved for adults and
children with type 1 diabetes ages 2 and above, based on
a study that showed favorable results in children along
with adolescents and adults.
AVAILABILITY Visit medtronicdiabetes.com and click on
the MiniMed 770G product page (by clicking on the “learn
more” or “for parents” button), where you can fill out an
online form to get started using the system.
CONTINUOUS GLUCOSE MONITORING FREESTYLE
(CGM) SYSTEM LIBRE 2 iCGM
FreeStyle Libre 2 iCGM
Abbott
(855) 632-8658
freestylelibre.us
WHAT IT DOES The FreeStyle Libre 2 system is approved
for adults and children ages 4 and above and uses a sensor
that lasts up to 14 days to continuously monitor glucose
levels. It now has optional real-time glucose alarms and also
lets you scan your glucose level in one second rather than
using a finger-stick test for confirmation in many situations.
AVAILABILITY Visit freestylelibre.us and click on the
“start now” button to learn about options for starting on
the system or talk to your doctor about the benefits of
continuous glucose monitoring.
MINIMED MIO PUMP INFUSION SET
ADVANCE
MiniMed Mio Advance
LYUMJEV Medtronic
(800) 646-4633
QUTENZA medtronicdiabetes.com
SULLI THE WHAT IT DOES The MiniMed Mio Advance is compatible
DIABETES with all current Medtronic insulin pumps in the United
GURU States and is designed to require fewer insertion steps.
26 DiabetesSelfManagement.com • Spring 2021 The new infusion set allows one-hand insertion to permit
greater flexibility and access to more potential insertion sites
on the body. It also uses a fully hidden needle at all steps.
AVAILABILITY Talk to your doctor or pharmacist about
using the MiniMed Mio Advance if you’re a Medtronic
insulin pump user. You can also buy infusion sets online
at medtronicdiabetes.com.
NEW DRUGS/FORMULATIONS
Lyumjev (insulin lispro-aabc)
Lilly
(800) LillyRx (545-5979)
lyumjev.com
WHAT IT DOES Lyumjev is a fast-acting mealtime insulin
used to control high blood sugar in adults with type 1 and
type 2 diabetes that has been shown in studies to reduce
HbA1c (a measure of long-term glucose control) and to
reduce blood sugar spikes following meals. It’s available
in both vials and insulin pens.
AVAILABILITY Learn more about switching to Lyumjev
at lyumjev.com or talk to your doctor about whether this
new insulin formulation is right for you.
Gimoti (metoclopramide)
Evoke Pharma
(833) 4-GIMOTI (444-6684)
gimotirx.com
WHAT IT DOES Gimoti is a nasal spray formulation of the
drug metoclopramide, designed to help relieve symptoms
of diabetic gastroparesis (delayed stomach emptying). It
may be especially helpful since gastroparesis can cause
nausea and vomiting, and oral versions of the drug may
not be well tolerated or effective in many people.
AVAILABILITY Talk to your doctor about taking Gimoti if
you experience symptoms of gastroparesis or have been
diagnosed with the condition.
Trijardy XR (empagliflozin/linagliptin/metformin
HCl extended release tablets)
Boehringer Ingelheim, Lilly
(800) 243-0127
trijardyxr.com
WHAT IT DOES This three-drug combination tablet (empa-
gliflozin, linagliptin and metformin) is aimed at adults
with type 2 diabetes who would otherwise need to take
multiple pills. It’s taken once daily and should be used
along with diet and exercise to control glucose levels.
AVAILABILITY Talk to your doctor about taking Trijardy
XR if you already take one or more oral drugs for type 2
diabetes and your glucose control still isn’t ideal.
PEN NEEDLE DRUG LABEL CHANGES
Unifine SafeControl Fiasp (insulin aspart)
Owen Mumford Novo Nordisk
(770) 977-2226 (800) 727-6500
unifinesafecontrol.com rapidactinginsulin.com/fiasp.html
WHAT IT DOES The Unifine SafeControl pen needle is REASON FOR LABEL CHANGE Fiasp insulin is now
designed with both safety and full-dose delivery in mind. approved for children ages 2 and above, in addition
It features a manual push tab for one-hand operation of to the original approval for adults.
the safety mechanism, a guard to cover the needle after
injection, and a visual safety indicator. Trulicity (dulaglutide)
AVAILABILITY Visit the product page at unifinesafecontrol. Lilly
com and click on the “get in touch” button to learn more (800) LillyRx (545-5979)
about getting started, or talk to your doctor or pharmacist. trulicity.com
NEUROPATHY TREATMENT REASON FOR LABEL CHANGE Trulicity is now approved
to include the option of once-weekly doses of 3.0 mg/0.5
Qutenza (capsaicin 8% patch) ml and 4.5 mg/0.5 ml, in addition to the originally
Averitas Pharma approved 0.75 mg/0.5 ml and 1.5 mg/0.5 ml. As a
(877) 900-6479 prescription medicine, Trulicity is for adults with type
qutenza.com 2 diabetes and used to improve blood glucose. It’s also
approved to reduce the risk of major adverse cardiovas-
WHAT IT DOES Qutenza is a patch that delivers capsaicin, cular events (such as stroke or heart attack) in adults
a chemical derived from chili peppers, to provide relief with type 2 diabetes who have established cardiovas-
from diabetic nerve pain in your feet. It’s applied by your cular disease or multiple cardiovascular risk factors.
doctor and is effective for up to three months.
AVAILABILITY Talk to your doctor about Qutenza as a treat- Invokana, Invokamet, Invokamet XR
ment option if you experience pain from diabetic neuropathy. (canagliflozin, canagliflozin-metformin,
canagliflozin-metformin extended release)
VOICE-ACTIVATED RESOURCE Janssen
(877) 468-6526
Sulli the Diabetes Guru invokana.com
Roche Diabetes Care
(800) 858-8072 REASON FOR LABEL CHANGE A boxed warning about
accu-chek.com the risk of amputation has been removed since new data
shows that this risk is lower than was once believed.
WHAT IT DOES Sulli the Diabetes Guru is a voice assistant
that can answer your questions about nearly any aspect Farxiga (dapagliflozin)
of diabetes, including diet, exercise, medications and AstraZeneca
glucose monitoring. You can ask any question, get lifestyle (855) 3FARXIGA (332-7944)
tips, go through Sulli’s step-by-step support guide, or set farxiga.com
diabetes-related reminders.
AVAILABILITY Sulli the Diabetes Guru is available on REASON FOR LABEL CHANGE Farxiga is now approved
Amazon Alexa devices and Google Assistant. to treat a type of heart failure (reduced ejection frac-
tion HF, or HFrEF) in addition to its original approval
for adults with type 2 diabetes.
Spring 2021 • DiabetesSelfManagement.com 27
Health in the SHUTTERSTOCK
Palm of Your Hand
Apps to improve your diabetes care
BY ALISON MASSEY, MS, RD, LDN, CDCES
28 DiabetesSelfManagement.com • Spring 2021
urrently there are more relevant diabetes data, such as Sugar.IQ Diabetes Assistant
carbohydrates, medications, blood Medtronic
C than 300,000 health- glucose values and more. It inte- medtronicdiabetes.com/products/
related apps available, grates with many different devices sugar.iq-diabetes-assistant
with a variety specifically devel- to enable automated data transfer,
oped to help with diabetes manage- including some of the Accu-Chek Designed to work with
ment. And, indeed, now more than product line. the Guardian Connect
ever, people are looking to technol- CGM device, this iOS
ogy to help them stay connected to DIABETES MANAGEMENT app helps with track-
their healthcare providers, interact COMPANION ing glucose levels and
with the wider diabetes commu- assessing insulin, food and daily rou-
nity, and keep track of their health- BlueLoop tines to improve understanding of
related metrics. MyCareConnect diabetes management.
blueloop.mycareconnect.com
Whether you’re looking for DIABETES EDUCATION AND
a way to store data and create An app that connects COMMUNITY CONNECTION
reports, integrate your health and with an online service
diabetes devices, improve your and allows kids, their Beyond Type 1 Diabetes
sleep and mental health, or more, family and school per- Mighty Networks
you can find an app to meet that sonnel to share real- beyondtype1.org
need. Learn about a few in this time diabetes information. Reports
roundup of some of the top apps are easily shared with clinicians. This app is a social
that can help improve your health BlueLoop is free and used to track community for any-
and diabetes care in 2021. metrics like blood glucose, insulin one impacted by type
and information on meals. 1 diabetes, including
BLOOD GLUCOSE patients, caregivers,
MANAGEMENT TRACKING iHealth Gluco-Smart family members and loved ones. Find
iHealth Labs, Inc. peer support, ask questions and get
Glucose Buddy Diabetes Tracker ihealthlabs.com connected to others. The commu-
Azumio, Inc. nity also offers a dedicated space for
glucosebuddy.com This is the compan- Spanish-speakers.
ion app to the iHealth
Built to track blood glucometer. When the Glucagon
glucose, A1C, medica- glucometer and app Eli Lilly and Company
tions, weight, blood are synced, informa- lillyglucagon.com
pressure and carbohy- tion on diabetes metrics and behav-
drate intake, this app iors are easily logged. Historical Created to provide
also provides a 12-week Diabetes data can be viewed for monitoring step-by-step guid-
Education Plan. It integrates with and analysis, and the app also has ance on administer-
Dexcom and Apple devices. reminder functionality. ing glucagon, this app
includes optional audio
mySugr — Diabetes Tracker Log One Drop: Transform Your Life instructions. Users can record expi-
mySugr GmbH One Drop ration dates of their glucagon kit to
mysugr.com onedrop.today receive reminder notifications when
the kit is nearing expiration.
Designed as a diabe- One Drop is a free,
tes logbook, this app award-winning app Diabetes Self-Management
features a personal- for people with dia- Madavor Media
ized dashboard to betes. Track glucose, diabetesselfmanagement.com
collect and analyze meals, meds and
more. Set helpful reminders and Download this app to
sync health data. Subscribe to a purchase the latest
Digital Membership to message a digital issue or digital
coach, receive AI-powered glucose back issues of Diabe-
predictions and access interactive tes Self-Management
educational content. magazine.
Spring 2021 • DiabetesSelfManagement.com 29
MENTAL AND COGNITIVE HEALTH & MEDICATION SLEEP
HEALTH
Withings Health Mate Calm—Meditate, Sleep, Relax
Headspace: Meditation & Sleep Withings Calm.com, Inc.
Headspace for Meditation, withings.com calm.com
Mindfulness and Sleep
headspace.com Health Mate is a fitness, Guided meditations,
activity and health sleep stories, breathing
Learn meditation and tracker app that inte- programs, stretching
mindfulness skills with grates with many of exercises and relaxing
this app to improve the Withings devices, music are available
stress management, including their watches, scales, blood through this app to help improve
sleep and mind-body pressure monitors and sleep tracking sleep habits. Calm meditation and
health. Features include a daily video mat. It provides personalized, easy-to- sleep sessions are connected to the
series, Move Mode workouts, a guided understand data that can be shared Apple Health app.
meditation series for kids and con- with your healthcare provider.
centration-boosting music. Sleep
GoodRx: Prescription Drugs, Bending Spoons
Lumosity: Brain Training Discounts & Coupons App bendingspoons.com
Lumos Labs, Inc. GoodRx
lumosity.com goodrx.com Establish a regular
bedtime routine, lis-
This app provides fun Compare prescription ten to bedtime stories,
and interactive science- drug prices across participate in sleep
based brain-training pharmacies, find meditations or lis-
games that test mem- GoodRx pharmacy or ten to relaxing sleep/white noise
ory, logic, math skills manufacturer coupons sounds through this app for a more
and problem-solving capabilities. and discounts, read savings tips and restful slumber.
Detailed progress tracking is included. set up refill reminders and savings
Lumosity scientists and designers alerts for your prescriptions with Sleep Cycle: Sleep Analysis and
also work with university researchers this app. Upgrading to GoodRx Gold Smart Alarm Clock
around the world to help with advanc- provides additional savings at any Sleep Cycle AB
ing the understanding of brain health. participating GoodRx Gold pharmacy. sleepcycle.com
MindDoc: Depression & Anxiety Pill Reminder & Medication This app includes a SHUTTERSTOCK
MindDoc Health Tracker — Medisafe smart alarm clock that
mymoodpath.com Medisafe analyzes sleep patterns
medisafeapp.com to wake you up in your
Designed to monitor lightest phase of sleep.
mental health disor- This app functions as It also detects sleep disturbances such
ders like depression, a manager and pill as snoring, sleep talking, coughing and
anxiety and eating reminder for medica- other sounds, and provides a detailed
disorders, this app tions, vitamins and sup- sleep analysis. Premium upgrade fea-
includes personalized recommen- plements. Additional tures include relaxing sleep sounds
dations, psychological courses and features include the integration of and a story library.
mindfulness exercises. It checks in metrics from other health apps, such
on users three times a day, “learning” as blood pressure or blood glucose Alison Massey, MS, RD, LDN, CDCES,
from responses to generate relevant levels, report sharing, coupons and is a registered dietitian and certified
insights and resources. time zone reminders for traveling. diabetes educator in Maryland.
30 DiabetesSelfManagement.com • Spring 2021
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GIVE HEARING AIDS A CHANCE
BY ROBERT S. DINSMOOR
A n estimated 48 million people kidneys and other body parts, it may you might think that other people are SHUTTERSTOCK
in the United States have some damage the vessels in and leading to mumbling, or you might have trouble
degree of hearing loss, and studies the inner ear as well. Diabetes may following conversations, especially in
show that hearing loss is twice as also affect the auditory nerves in the crowded rooms. Other people may
common in people with diabetes as in same way that it impacts nerves in the start to complain that you’re not lis-
those without it. Scientists don’t know hands, feet and elsewhere throughout tening, that you always ask them to
exactly how diabetes contributes to the body. repeat themselves, or that you turn
hearing loss, but they suspect that, the volume on the TV up too loud.
just as prolonged high blood glucose You may not even be aware that If any of this sounds familiar, you
damages blood vessels in the eyes, you have hearing loss, especially if should speak with your primary care
it has occurred gradually. However,
32 DiabetesSelfManagement.com • Spring 2021
physician or ear, nose and throat specific direction while tuning out Why I Love My
doctor (also known as an ENT, or background noise. (This option is very Latest Hearing Aids
otolaryngologist). handy for speaking across the table
from someone at a noisy restaurant, I’ve written about hearing aids
Some cases of hearing loss are very for example.) Wireless connectiv- in the past, talking about how
straightforward to treat: Sometimes, ity available on some models allows my latest ones were better than
removal of ear wax or other blockages users to sync up their hearing aids the previous ones. Here are some
may immediately improve hearing. with Bluetooth-compatible devices, not-so-high-tech changes that
If an acute ear infection causes the such as cellphones, music players have made my latest pair so much
hearing loss, antibiotics may greatly and televisions. easier to use:
improve the situation. Surgery may
be used to treat hearing loss from a Choosing a hearing aid • Most models now have built-in
head trauma, damage from chronic If you’re considering getting a hearing batteries that can be charged
ear infections, or chronic fluid build- aid, the first step is to visit an audiolo- overnight. I simply place my
up in the inner ear. gist in your area. (Proximity is impor- hearing aids in a charging base,
tant, as you may need to return to where they recharge while I sleep.
Types of hearing aids your audiologist frequently for adjust- No worrying about batteries. Plus,
In some cases, getting the proper hear- ments.) The audiologist can help you the charging station, which I keep
ing aids can greatly improve a per- choose a device based on your degree on my dresser, is a very convenient
son’s day-to-day life. There are many of hearing loss, how unnoticeable you place for them to “live,” and so I’m
different types of hearing aids on the want it to be, your finances and other much less likely to lose them.
market, but they all share three basic considerations. Also, ask whether
components—a microphone that picks you’ll have a trial period, which would • Many models also now use
up sound, an amplifier that makes it give you a chance to try it out and see Bluetooth technology, which has
louder, and a receiver that transmits whether it’s working for you. Ideally, a number of benefits. They can
these amplified sounds into the ear. the hearing aids should come with a sync up with smartphones, so I
warranty that covers parts and any can manage their settings such
The two main types of hearing aids labor. Find out how many return visits as volume with a few taps. I can
are analog hearing aids and digital to the audiologist, if any, are covered hear phone conversations directly
hearing aids. Analog hearing aids, by the price of the hearing aids. If through my hearing aids. I can play
which are generally less expensive they’re not covered, get an idea of music from my iPhone directly
and have simple volume controls, how much the office visits will cost. into my hearing aids. If I wanted, I
electronically amplify sounds. This could even attach a Bluetooth unit
technology is becoming less common. What if you have hearing loss in to my TV to feed the sound directly
Digital hearing aids are more sophis- both ears? If cost is a major concern, into the hearing aids.
ticated, converting sound waves into you may opt to get only one hearing
digital signals, providing a duplicated aid, but most audiologists recommend • If I do lose my hearing aids, I
and amplified version of the origi- getting a set of two in these cases. can use my hearing aid app to find
nal sound. Digital hearing aids can them. It displays a map showing
be adjusted for different patterns of Using your hearing aid where I am and where they are—
hearing loss, as well as various set- A hearing aid won’t restore your hear- even if they’re miles away.
tings and situations. ing to normal—it can only amplify
sounds. There’s also a learning curve • I don’t have to clean out my
Hearing aids also come in differ- that goes with a new hearing aid. It hearing aids anymore. Instead of
ent styles: In-the-canal (ITC) and actually takes time to get used to the being carried through a hollow
completely-in-the-canal (CIC) hearing amplified sounds. That includes other plastic tube, the sound is carried
aids fit partly or fully into a person’s people’s speech, which can sound through a wire within a plastic
ear and are harder to see. In-the- much different when certain frequen- tube. If the hearing aid becomes
ear (ITE) hearing aids fit completely cies are amplified. Consonants, for blocked, I can replace the earbud,
inside the ear. Behind-the-ear (BTE) example, can sound very different the piece that goes into my ear
or “mini” behind-the-ear (mini BTE) through a hearing aid. canal and, if necessary, the filter
hearing aids sit primarily behind the that keeps gunk from the earbud
ear, with a plastic ear mold fitting If you suspect that you have hear- from blocking the sound. Both the
inside the outer ear and directing ing loss, you owe it to yourself to earbud and the filter are cheap
the sound into the ear canal. Some- look into hearing aids. Even if you pieces that I replace once a month
times, the hearing aid is connected don’t think you’re missing much, and twice a month, respectively.
to a narrow tube leading into the ear you might be surprised by how much
canal. Some hearing aids include they can improve your hearing—and Spring 2021 • DiabetesSelfManagement.com 33
directional microphones, which help your life. DSM
people hear sounds coming from a
TOP PICKS
Diabetes-Friendly Foods
BY AMY CAMPBELL, MS, RD, LDN, CDCES
Quinn White Cheddar Banza Cavatappi Yo Mama’s Marinara Icelandic Provisions
& Sea Salt Microwave Pasta is a no-no when Sauce Plain Skyr
Popcorn you have diabetes, right? How about a great-tasting Sure, yogurt is great, but
Who doesn’t love popcorn, Wrong! You can eat pasta, sauce to top off that cavata- have you tried skyr? Skyr
let alone cheese popcorn? and if you choose Banza ppi? Trying to find a pasta is a thick and creamy cul-
Quinn White Cheddar & Sea Cavatappi, you’ll worry sauce that isn’t loaded with tured product that just so
Salt Microwave Popcorn even less about the car- sugar and other less-than- happens to be full of protein
is made with organic pop- bohydrate. That’s because desirable ingredients can be (even more than its Greek
corn and sunflower oil and this pasta is made with like searching for a needle in cousin, as it turns out).
flavored with aged white chickpeas, making it 25% a haystack. Meet Yo Mama’s Plain Icelandic Provisions
cheddar and sea salt, mak- lower in carb than regular Marinara sauce. What you Skyr is delicious, healthy
ing this a snack you’ll reach wheat pasta. It’s got nearly see is what you get: toma- and has an amazing 17
for time and time again. two times the protein and toes, onions, basil, olive oil, grams of protein—all with
Plus, this tasty treat is glu- three times the fiber as oregano, black pepper and a 0 grams of added sugar.
ten free, non GMO and con- regular pasta, as well. And touch of salt. What you don’t Perfect with fresh fruit or
tains none of those suspect it’s gluten free! Did we men- get: sugar, gluten, GMOs blended into your favorite
preservatives, artificial fla- tion that it looks, cooks and and preservatives. Just like smoothie recipe or simply
vors and additives found in tastes like regular pasta? mama would make.And you as-is. It’s that good!
other brands of microwave can’t beat the carbs—just 5
popcorn. One serving (2 ounces) has grams per serving! One serving (5.3 ounces) has
190 calories and 32 grams of 120 calories and 8 grams of
One serving (3 cups) has carbohydrate. One serving (½ cup) has carbohydrate.
170 calories and 13 grams of 60 calories and 5 grams of
carbohydrate. eatbanza.com carbohydrate. icelandicprovisions.com
quinnsnacks.com yomamasfoods.com SHUTTERSTOCK
34 DiabetesSelfManagement.com • Spring 2021
If you’re looking for some new snack ideas or have been
searching high and low for lower-carbohydrate products, look no
further. Here’s a lineup of food products that provide nutrition,
taste great, and will fit nicely into your diabetes eating plan.
Harvest Snaps Lightly Green Giant Riced Otto’s Cassava Flour Dave’s Killer Bread
Salted Green Pea Snack Veggies If you’ve been searching for Powerseed Thin-Sliced
Crisps If you’re cutting carbs or a grain-free/nut-free flour Bread seems to be at the
You might have hated peas following a gluten-free diet, that actually tastes good, top of everyone’s “do not
when you were a kid, but rice and other grains may be your search ends right eat” list these days. “Too
you’re going to love Har- off-limits. But never fear, it’s now. Otto’s Cassava Flour many carbs!” bread detrac-
vest Snaps Green Pea Snack veggies to the rescue! Green is made from cassava (aka tors claim. That’s really
Crisps. Made from whole- Giant Riced Veggies, that is. yucca), a root vegetable that, not true, though, espe-
some green peas, these Choose from a wide assort- when dried and ground up, cially if you go for Dave’s
crunchy baked snacks are a ment of varieties, including makes a perfect alternative Killer Bread Powerseed
far cry from traditional potato broccoli, risotto medley and to wheat flour. This flour is Thin-Sliced. Bursting with
and corn chips that provide cauliflower medley. They’re 100% cassava, which means wholesome goodness from
mainly fat and salt. Harvest 100% vegetables and 0% no fillers, gums, additives whole wheat, flaxseeds,
Snaps contain 5 grams of added ingredients (including or gluten. Just use 3/4 cup pumpkin seeds, sesame
fiber and 5 grams of protein, sodium and gluten), preser- of Otto’s Cassava Flour for seeds, rolled oats and more,
so they’re filling as well as vatives, flavorings and artifi- every 1 cup of all-purpose this bread will leave you
scrumptious. And they rate cial colors. Best of all, they’ll flour in your favorite reci- satisfied without the blood
low on the sodium scale, with save you a ton of work—no pes and start baking to your sugar spike later on. This
only 75 milligrams of sodium peeling and chopping. Just heart’s content. bread slays it!
per serving. cook, eat and enjoy!
One serving (¼ cup) contains One serving (1 slice) contains
One serving (22 pieces) One serving (½ to 1 cup) 110 calories and 28 grams of 60 calories and 12 grams of
contains 130 calories and 16 contains 20 to 50 calories and carbohydrate. carbohydrate.
grams of carbohydrate. 4 to 12 grams of carbohydrate
(depending on the variety). ottosnaturals.com daveskillerbread.com
harvestsnaps.com
greengiant.com
Spring 2021 • DiabetesSelfManagement.com 35
TOP PICKS These foods are
nutritious, delicious
Diabetes-Friendly Foods
and fit well into a
diabetes eating plan.
KIND Cranberry SunButter No Sugar RxSugar GG Exceptional Fiber
Almond Bar Added Sunflower Just because you have dia- Scandinavian Fiber
You know all too well Butter betes doesn’t mean you Crispbread
what happens at 3 o’clock Not everyone can or can’t enjoy the taste of Does a cracker exist that
in the afternoon: You’re chooses to eat peanut but- something sweet. If you’re isn’t loaded with carbs,
sapped of energy and it ter. And almond butter is off looking for a substitute for gives you a decent amount
takes every ounce of effort limits for people with tree sugar but aren’t sure of of fiber, and actually tastes
to stay awake. But rather nut allergies. No worries, the best choice, consider good? GG Exceptional Fiber
than head for the vending though, because there’s RxSugar. This sweetener is Scandinavian Fiber Crisp-
machine or raid the kitchen SunButter No Sugar Added made with allulose, a low- bread does all this, as a
for something that will only Sunflower Butter. The key calorie sugar that’s naturally matter of fact, and more.
send your blood sugar sky- ingredient is sunflower found in small amounts in Weighing in at only 20 calo-
rocketing, why not reach seeds that are roasted foods like figs and raisins. ries and 20 milligrams of
for a KIND Bar instead? and ground into a creamy, RxSugar looks like sugar, sodium per cracker, this
Better yet, reach for a KIND smooth “butter” that is tastes like sugar and even crispbread is tasty plain
Cranberry Almond Bar. free from peanuts, tree behaves like sugar—yes, or topped with your favor-
With the right balance of nuts, soy, sugar, milk, eggs, you can cook and bake ite nut butter, a boiled egg,
carb, protein and fat (and wheat, fish and shellfish with it. Best of all, it’s zero some avocado or a spread
let’s not forget the fiber), (whew!). All that you’ll find calories and won’t cause of cream cheese. It makes a
this gluten-free bar will sat- in this spread are roasted blood sugar surges (that’s perfect, filling snack when
isfy your sweet tooth and sunflower seeds and a bit right—even though allulose those horrible hungries
give you the energy that you of salt. Spread it on bread, has calories, it’s not metabo- strike.
need to power through that use it as a dip, bake with it lized by the body). RxSugar
afternoon slump. Thanks or simply eat it straight out is Non-GMO Project Verified, One serving (1 cracker)
to KIND Bar, you got this! of the jar (it’s that good!). Keto Certified, Gluten-Free contains 20 calories and 6
Certified, FODMAP Friendly, grams of carbohydrate.
One serving (1 bar) contains One serving (2 tablespoons) Kosher Certified and plant-
160 calories and 19 grams of contains 210 calories and 4 based/vegan, so it fits right ggbrancrispbread.com
carbohydrate. grams of carbohydrate. into any eating plan.
Amy Campbell, MS, RD,
kindsnacks.com sunbutter.com One serving (1 teaspoon) LDN, CDCES, is a registered
contains 0 calories and 4 grams dietitian, certified diabetes
of carbohydrate. care and education specialist,
and CDE Lead at Good
therxsugar.com Measures, LLC.
36 DiabetesSelfManagement.com • Spring 2021
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••• AT THE TABLE ••• No-Fuss Breakfasts
Step Into
Spring
BY LORENA DRAGO, MS, RDN, CDN, CDCES
What is your favorite meal of the day?
Mine is breakfast! I must confess that I
am baffled when people tell me that they skip
breakfast or that theirs is just a cup of coffee
or tea. One of the most common excuses for
skipping breakfast is lack of time. When we
are rushed getting everyone ready in the
morning, breakfast often takes a back seat.
But preparing it in batches the night before
when possible makes it easy to pack and go.
With these delicious, no-fuss recipes, you’ll
never want to skip the most important meal
of the day again.
Once you’ve set the stage with a healthful
breakfast, why not keep up the momentum
for the rest of your meals? Whether you’re
looking for a delicious dinner or a simple
snack, you’ll find something you love in our
seafood, beef and yogurt collections. Enjoy!
OUR RECIPES 30 minutes or less. Others require short ▲ FI HIGH-FIBER RECIPE ▼ LC LOW-CARB RECIPE SHUTTERSTOCK
preparation times followed by long 5g or more of fiber per serving 15g or less of carbs per serving
Like everyone, you’re busy— cooking times. We’ve also included
and we keep that in mind symbols to help you more easily find ▼ LF LOW-FAT RECIPE ▼ LS LOW-SODIUM RECIPE
when we select recipes. Many those recipes especially high in fiber, 3g or less of fat per serving 140mg or less of sodium per serving
of them can be prepared in low in fat, carbohydrates and sodium.
38 DiabetesSelfManagement.com • Spring 2021
Banana-Pineapple
Breakfast Shake
4 SERVINGS | 1 CUP
▼ LF | ▼ LS
CAL 140 | FAT 1G | SAT FAT 1G | PROTEIN
8G | CARBS 27G | CHOL 2MG | FIBER 1G |
SODIUM 95MG
DIETARY EXCHANGE: 1½ FRUIT, ½ MILK
2 cups plain fat-free yogurt
1 can (8 ounces) crushed pineapple
in juice, undrained
1 ripe medium banana
8 packets sugar substitute
1 teaspoon vanilla extract
1/8 teaspoon ground nutmeg
1 cup ice cubes
1. Combine yogurt, pineapple, banana,
sugar substitute, vanilla, nutmeg and ice
in blender. Process until smooth.
2. Pour into 4 glasses. Serve immediately.
TIP This recipe is perfect
for a brunch or
special meal. Make as many
batches as you need to serve
the family.
▲ FI HIGH-FIBER | ▼ LF LOW-FAT | ▼ LC LOW-CARBOHYDRATE | ▼ LS LOW-SODIUM Get more delicious diabetes-friendly recipes at
DiabetesSelfManagement.com/recipes
Spring 2021 • DiabetesSelfManagement.com 39
••• AT THE TABLE ••• No-Fuss Breakfasts
Quick Breakfast Blintzes
4 SERVINGS | 2 BLINTZES
CAL 231 | FAT 6G | SAT FAT 3G | PROTEIN 10G | CARBS 34G | CHOL 35MG |
FIBER 4G | SODIUM 183MG
DIETARY EXCHANGE: 2 BREAD/STARCH, ½ FAT, ½ FRUIT, ½ MEAT
1 teaspoon unsalted butter pears; cook and stir 3 to 4 minutes,
1/4 teaspoon ground cinnamon or until warmed and tender.
1/4 teaspoon ground nutmeg 2. Add vanilla to ricotta cheese;
2 ripe but firm Bartlett pears, stir well to lighten. Place crêpes on
peeled and cut into 1/2-inch sheet of waxed paper sprinkled with
1 cubes 1 teaspoon powdered sugar. Spoon
11/2 teaspoon vanilla extract ricotta cheese mixture down center
cups reduced-fat ricotta of crêpes. Spoon pears over cheese;
8 cheese roll up and place on microwave-safe
3 8-inch packaged thin crêpes serving plates.
teaspoons powdered sugar,
3. Microwave each serving sepa-
divided
rately on high 20 to 30 seconds, or
Ground cinnamon
until warm.
(optional)
1. Melt butter in 10-inch nonstick 4. Place powdered sugar in fine
skillet over medium heat. Stir cin- mesh strainer; shake over crêpes.
namon and nutmeg into butter. Add Sprinkle with cinnamon, if desired.
Get more delicious diabetes-friendly recipes at
DiabetesSelfManagement.com/recipes
40 DiabetesSelfManagement.com • Spring 2021
Berry Oatmeal With Vanilla Sweet Cream
4 SERVINGS | ½ CUP OATS, ¼ CUP SWEET CREAM AND ½ CUP BERRIES
▲ FI | ▼ LF | ▼ LS
CAL 150 | FAT 2G | SAT FAT 1G | PROTEIN 5G | CARBS 30G | CHOL 8MG | FIBER 5G | SODIUM 120MG
DIETARY EXCHANGE: 1 BREAD/STARCH, ½ FAT, 1 FRUIT
2 cups water 11/2 cups fresh or frozen 2. Meanwhile, combine Sweet Cream
1 cup quick-cooking oats blueberries, thawed ingredients (half-and-half, sugar
1 tablespoon pourable sugar substitute, vanilla extract, almond
1/2 cup fresh or frozen extract) in medium bowl.
substitute* raspberries, thawed
1/2 teaspoon ground cinnamon 3. To serve, spoon equal amounts of
1/8 teaspoon salt 1. Bring water to a boil in large oatmeal in each of 4 parfait glasses
3/4 cup fat-free half-and-half saucepan over high heat. Stir in oats, or shallow bowls, pour Sweet Cream
3 tablespoons pourable sugar then reduce heat to medium and over oatmeal, and top with berries.
cook, uncovered, 2 minutes, or until
substitute* thickened. Remove from heat, stir in *Note: This recipe was tested using
1/2 teaspoon vanilla extract 1 tablespoon sugar substitute, cin- sucralose-based sugar substitute.
1/2 teaspoon almond extract namon and salt.
▲ FI HIGH-FIBER | ▼ LF LOW-FAT | ▼ LC LOW-CARBOHYDRATE | ▼ LS LOW-SODIUM Spring 2021 • DiabetesSelfManagement.com 41
••• AT THE TABLE ••• No-Fuss Breakfasts
Cherry-Orange Oatmeal
4 SERVINGS | ¾ CUP OATMEAL
▼ LF | ▼ LS
CAL 150 | FAT 2G | SAT FAT 1G | PROTEIN 4G | CARBS 39G | CHOL 0MG | FIBER 3G | SODIUM 6MG
DIETARY EXCHANGE: 1 BREAD/STARCH, 1½ FRUIT
1 can (11 ounces) mandarin 1 tablespoon unsweetened cocoa sugar substitute in medium microwav-
able bowl. Microwave on high 2 minutes.
orange segments in light syrup, powder Stir; microwave 4 minutes.
drained, divided 2 tablespoons sugar substitute* 3. Divide mixture evenly among four
serving bowls. Garnish with reserved
1 cup fresh pitted cherries or 1. Set aside eight orange segments and oranges and cherries
frozen dark, sweet cherries, four cherries for garnish.
divided *Note: This recipe was tested with
sucralose-based sugar substitute.
2 cups water 2. Combine water, remaining orange
1 cup old-fashioned oats segments and cherries, oats, cocoa and
TIP Oats are a staple in many homes, and with good reason.
They are a whole grain that pairs deliciously with fruit,
nuts, seeds and milk. Oats are also inexpensive, easy to prepare
and delicious. Their health benefits include lowering LDL, or “bad,”
cholesterol. Did you know that oats additionally can play a role
in blood sugar regulation? They have repeatedly been shown to
improve blood glucose levels after meals, as well as insulin levels.
They are also a good source of plant protein. One cup of cooked oats
contains 10 grams of protein—2 more grams than a glass of milk.
42 DiabetesSelfManagement.com • Spring 2021
Peanut Butter
Cereal Bars
40 SERVINGS | 1 BAR
▼ LF | ▼ LC | ▼ LS
CAL 66 | FAT 3G | SAT FAT 1G |
PROTEIN 1G | CARBS 10G | CHOL
2MG | FIBER 1G | SODIUM 54MG
DIETARY EXCHANGE: ½ BREAD/
STARCH, ½ FAT
Nonstick cooking spray
3 cups mini marshmallows
3 tablespoons butter or
margarine
1/2 cup reduced-fat peanut
butter
3 1/2 cups crisp rice cereal
1 cup quick oats
1/3 cup mini semisweet
chocolate chips
1. Spray 13x9-inch baking pan
with nonstick cooking spray.
2. Combine marshmallows and
butter in large microwavable bowl.
Microwave on high 15 seconds;
stir. Microwave 1 minute; stir until
marshmallows are melted and
mixture is smooth. Add peanut
butter; stir. Add cereal and oats;
stir until well coated. Spread
into prepared pan. Immediately
sprinkle chocolate chips on top;
lightly press into cereal mixture.
3. Cool completely in pan. Cut into
40 bars to serve.
TIP To make spreading the
cereal mixture easier
and cleanup a snap, lightly spray
your spoon with nonstick cooking
spray before stirring these bars.
▲ FI HIGH-FIBER | ▼ LF LOW-FAT | ▼ LC LOW-CARBOHYDRATE | ▼ LS LOW-SODIUM Get more delicious diabetes-friendly recipes at
DiabetesSelfManagement.com/recipes
Spring 2021 • DiabetesSelfManagement.com 43
••• AT THE TABLE ••• No-Fuss Breakfasts
Scrambled Egg Burritos
4 SERVINGS | 1 BURRITO WITH 1 TABLESPOON PLUS 1 TEASPOON SALSA
CAL 192 | FAT 5G | SAT FAT 3G | PROTEIN 13G | CARBS 23G | CHOL 10MG | FIBER 2G | SODIUM 423MG
DIETARY EXCHANGE: 1 BREAD/STARCH, 1 VEGETABLE, 1½ MEAT
Nonstick cooking spray 1. Spray medium nonstick skillet with cooking spray. Heat
1 medium red bell pepper, chopped over medium heat. Add bell pepper, green onions and red
5 green onions, sliced pepper flakes; cook and stir 3 minutes, or until vegetables
1/2 teaspoon red pepper flakes are crisp-tender.
1 cup cholesterol-free egg substitute or 8 egg 2. Add egg substitute to vegetables. Reduce heat to low.
whites Cook and stir 3 minutes, or until set. Sprinkle with cilantro.
1 tablespoon chopped fresh cilantro or parsley 3. Stack tortillas and wrap in paper towels. Microwave on
4 8-inch flour tortillas
1/2 cup (2 ounces) shredded low-sodium reduced-fat high 1 minute, or until tortillas are hot.
Monterey Jack cheese 4. Place one-fourth egg mixture on each tortilla. Sprinkle
1/3 cup salsa with 2 tablespoons cheese. Fold sides over to enclose fill-
ing. Serve with salsa.
44 DiabetesSelfManagement.com • Spring 2021
Scrambled Egg and Red Pepper Pockets
2 SERVINGS | 1 PITA HALF
CAL 155 | FAT 6G | SAT FAT 3G | PROTEIN 8G | CARBS 17G | CHOL 113MG | FIBER 3G | SODIUM 285MG
DIETARY EXCHANGE: 1 BREAD/STARCH, ½ FAT, 1 MEAT
1 egg 1. Whisk egg, egg whites, milk, salt, 3. Evenly spread inside of each pita
2 egg whites if desired, and black pepper in small half with remaining 1 teaspoon but-
1 tablespoon fat-free (skim) milk bowl until well blended. ter. Spoon egg mixture into pita halve.
1/8 teaspoon salt (optional)
1/8 teaspoon black pepper 2. Spray medium skillet with non- Note: An ideal breakfast includes
stick cooking spray. Add 1/2 teaspoon lean protein, complex carbohydrates
Nonstick cooking spray butter; heat over medium heat. Add and a little bit of fat. This recipe in-
11/2 teaspoons unsalted butter, onion; cook and stir 3 to 5 minutes, cludes all of the important aspects
or until lightly browned. Pour egg for a nutritious meal; it’s filling
softened and divided mixture into skillet; sprinkle with red enough to get you through the morn-
3 tablespoons minced red onion peppers. Stir gently, lifting edge to ing. Plus, it’s fast and easy to make,
2 tablespoons diced jarred roasted allow uncooked portion to flow un- even on the run!
derneath. Continue cooking until set.
red pepper (blot before dicing)
1 whole-wheat pita bread round,
cut in half crosswise
TIP If you’ve shied
away from eggs,
it may be time to give them
another try. One egg has
6 grams of protein. And
while many people discard
the yolk over cholesterol
concerns, the 2015-2020
Dietary Guidelines for
Americans removed the
prior recommendation to
limit dietary cholesterol to
300 milligrams per day. The
reason? The relationship
between dietary cholesterol
and blood cholesterol has
been found to be weak.
So think again before you
discard that yolk! It is a
great source of choline,
which can improve
memory both in developing
babies during pregnancy as
well as later in life. The yolk
also contains nearly half
the protein and a higher
proportion of the egg’s
vitamins than the white.
▲ FI HIGH-FIBER | ▼ LF LOW-FAT | ▼ LC LOW-CARBOHYDRATE | ▼ LS LOW-SODIUM Get more delicious diabetes-friendly recipes at
DiabetesSelfManagement.com/recipes
Spring 2021 • DiabetesSelfManagement.com 45
••• AT THE TABLE ••• Sizzling Seafood
Baked Fish With Tomatoes & Herbs
4 SERVINGS
▼ LC
CAL 150 | FAT 4G | SAT FAT 1G | PROTEIN 24G | CARBS 4G | CHOL 42MG | FIBER 1G |
SODIUM 360MG
DIETARY EXCHANGE: 1 VEGETABLE, 3 MEAT
Nonstick cooking spray 1. Preheat oven to 350°F. Coat 12x8-inch
4 lean white fish fillets (about 1 glass baking pan with nonstick cooking
pound), such as orange roughy spray.
or sole 2. Arrange fish fillets in pan; drizzle 2
2 tablespoons plus 2 teaspoons tablespoons lemon juice over fillets and
sprinkle with paprika. Cover with foil; bake
lemon juice, divided 18 minutes, or until opaque in center and
1/2 teaspoon paprika flakes easily when tested with fork.
1 cup finely chopped seeded
tomatoes
2 tablespoons capers, rinsed and 3. Meanwhile, in medium saucepan, com-
bine tomatoes, capers, parsley, remaining
drained
2 tablespoons finely chopped fresh 2 teaspoons lemon juice, basil, oil and salt.
Five minutes before fish is done, place
parsley
saucepan over high heat. Bring to a boil.
11/2 teaspoons dried basil
Reduce heat and simmer 2 minutes, or
2 teaspoons olive oil
until hot. Remove from heat.
1/4 teaspoon salt
4. Serve fish topped with tomato mixture.
TIP Fish is just what the
doctor ordered! The
American Heart Association
and the 2015-2020 Dietary
Guidelines for Americans
both recommend eating
up to 8 ounces of nonfried
seafood per week. The goal
is to consume at least 250
milligrams per day of the
omega-3 fatty acids EPA
and DHA to help with brain
function and heart health.
Go through these seafood
recipes, and I am sure you
will find one or two that will
be a family winner!
46 DiabetesSelfManagement.com • Spring 2021
Skillet Fish With Lemon Tarragon “Butter”
2 SERVINGS
▼ LF | ▼ LC
CAL 125 | FAT 3G | SAT FAT 1G | PROTEIN 22G | CARBS 1G | CHOL 60MG | FIBER 1G | SODIUM 291MG
DIETARY EXCHANGE: 3 MEAT
2 teaspoons reduced-fat margarine bowl. Blend well with fork; set aside.
4 teaspoons lemon juice, divided
1/2 teaspoon grated lemon peel 2. Coat 12-inch nonstick skillet with cooking spray.
1/4 teaspoon prepared mustard Heat over medium heat until hot.
1/4 teaspoon dried tarragon leaves
1/8 teaspoon salt 3. Drizzle fillets with remaining 2 teaspoons lemon
juice. Sprinkle one side of each fillet with paprika.
Nonstick cooking spray Place fillets in skillet, paprika side down; cook 3
2 lean white fish fillets (4 ounces each),* minutes. Gently turn and cook 3 minutes longer,
or until opaque in center and flakes easily when
rinsed and patted dry tested with fork. Place fillets on serving plates; top
1/4 teaspoon paprika with margarine mixture.
1. Combine margarine, 2 teaspoons lemon juice, *Note: Cod, orange roughy, flounder, haddock,
lemon peel, mustard, tarragon and salt in small halibut and sole can be used.
▲ FI HIGH-FIBER | ▼ LF LOW-FAT | ▼ LC LOW-CARBOHYDRATE | ▼ LS LOW-SODIUM Get more delicious diabetes-friendly recipes at
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Spring 2021 • DiabetesSelfManagement.com 47
••• AT THE TABLE ••• Sizzling Seafood
Fish Tacos With Cilantro Cream Sauce
4 SERVINGS | 2 TACOS
▲ FI
CAL 309 | FAT 10G | SAT FAT 3G | PROTEIN 28G | CARBS 29G | CHOL 72MG | FIBER 5G | SODIUM 347MG
DIETARY EXCHANGE: 2 BREAD/STARCH, 3 MEAT
1/2 cup reduced-fat sour cream 1 green bell pepper, cut into in large nonstick skillet over medium
heat. Add fish; cook, turning gently, 3
1/4 cup chopped fresh cilantro strips to 4 minutes, or until fish is opaque in
center. Transfer to plate.
11/4 teaspoons ground cumin, 8 corn tortillas, warmed
3. Add bell peppers to skillet; stir-fry
divided 4 limes, cut into wedges 6 to 8 minutes, or until tender. Return
fish to skillet, adding remaining 1/2
1 pound skinless tilapia, mahi- teaspoon hot pepper sauce; toss with
mahi or other firm white fish 1. For Cilantro Cream Sauce, combine bell peppers and cook just until heated
sour cream, cilantro and 1/4 teaspoon through.
fillets
1 teaspoon chipotle hot pepper cumin in small bowl. Refrigerate until 4. Spoon mixture into warm tortillas.
needed. Serve with Cilantro Cream Sauce and
sauce, divided lime.
1 teaspoon garlic salt 2. Cut fish into 1-inch chunks; toss
2 teaspoons canola or with 1/2 teaspoon hot pepper sauce,
vegetable oil remaining 1 teaspoon cumin and
1 red bell pepper, cut into strips garlic salt in medium bowl. Heat oil
Get more delicious diabetes-friendly recipes at
DiabetesSelfManagement.com/recipes
48 DiabetesSelfManagement.com • Spring 2021
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