Can I lower my hemoglobin A1C eating foods I like? By Sarah Morrison, RD, CD

One of the most common questions we get about diabetes management is: “Can I lower my hemoglobin A1C while I eat the foods I like?”

Our answer to this is absolutely yes! We believe that people can go beyond their diagnosis while living a happy fulfilling life, including the freedom to eat sweets and other foods, often thought of as “off limits.” Most importantly, we start with small, real-life changes that positively impact blood sugar numbers.

 

Ramey Nutrition providers encourage patients to balance macro nutrients. Having a healthy combination of carbohydrates, protein and fat at every meal is important to blood sugar management. Protein and fat play vital roles in blood sugar spikes and their longevity. Protein stimulates the release of insulin, as well as slowing the flow of sugar into the blood stream. This delayed release helps prevent sharp spikes in blood sugar. Adding healthy fats to a meal or snack also helps curb these sharp blood sugar spikes, and can help slow down the digestion and absorption of carbohydrates.

In addition to balancing macro nutrients, our patients focus on ADDING food to their menu instead of restricting foods. Adding high protein sources prior to eating high carbohydrate foods, such as having a cup of cottage cheese prior to a 5-star Italian cuisine dinner, eating a lean hamburger patty before gulping down a regular Coca-Cola, or looking for nuts in the next candy bar are all examples of balancing our favorite foods to keep control over blood sugar.

Incorporating fiber is another great tool. Fiber delays digestion, delaying the release of glucose into the bloodstream. Fiber is found in whole grains, as well as fresh fruits and vegetables. Craving waffles? Adding flaxseed to the batter or using whole wheat flour will make an impact on blood sugar numbers without the need to restrict food choices.

Making small changes in fitness is another way to control blood sugar levels while eating the foods we love. With continued moderate exercising, muscles can take up glucose at almost 20 times the normal rate. This helps lower blood sugar not only during exercise but throughout the entire day.

These few simple changes to food and the “diabetic diet” are real and impactful. They allow us to focus on the life we want to live and no longer feel restricted; it allows us to be free from our diagnosis.

World Diabetes Day 2014: 'Healthy Living' Theme Raises Awareness of Lifestyle Benefits

The theme for World Diabetes Day 2014 is "Healthy Living and Diabetes"(Getty)

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Today celebrates World Diabetes Day, a day of global awareness of the disease held annually. The theme for 2014 is Healthy Living and Diabetes – specifically focusing on how blood sugar levels can be controlled by eating a good breakfast.

It was set up in response to the rise of diabetes around the world, on the day marking the birthday of Frederick Banting, who along with Charles Best, first conceived the idea which led to the discovery of insulin in 1922.

Introduced in 1991 by the International Diabetes Federation and the World Health Organisation, the day is now an official United Nations day.

Last year, the international charity JDRF launched the Twitter campaign #TypeOnsie to raise awareness of type 1 diabetes.

What is diabetes?

Diabetes is a lifelong condition that causes a person's blood sugar level to become too high. Although diabetes is a group of metabolic diseases, there are two main types – type 1 and type 2.

High blood sugar causes frequent urination, thirst and hunger. Untreated, it can cause severe complications such as heart disease, stroke, kidney failure and damage to the eyes.

It is caused by either the pancreas not producing enough insulin, or the cells of the body not responding properly to the insulin provided.

Insulin, a hormone created in the pancreas, helps the body use glucose for energy.

How many people are affected?

In 2010, there was an estimated 3.1 million people aged 16 or over with diabetes in the United Kingdom, both diagnosed and undiagnosed.

According to the Centers for Disease Control and Prevention's National Diabetes Statistics Report in 2014, 29.1 million people or 9.3 percent of the US population had the condition.

Globally, as of 2013, there are an estimated 382 million people with diabetes worldwide, with type 2 diabetes making up about 90 percent of the cases.

What is the difference between the two types of diabetes?

In type 1 diabetes, the body's immune system attacks and destroys the cells that produce insulin. This leads glucose levels to increase, damaging the body's organs. It is known as insulin-dependent diabetes and often develops before the age of 40.

Type 2 diabetes is where the body fails to produce enough insulin, or the body's cells do not react to insulin. Often associated with obesity, it is a progressive condition and is normally treated using tablets.

Can lifestyle changes affect diabetes?

Being active and eating a balanced diet of fruit, vegetables, starchy foods, non-dairy sources of protein and dairy can be beneficial to controlling and preventing both type 1 and type 2 diabetes.

According to Diabetes UK, however, the same eating pattern is recommended for everyone – trying to eat foods low in salt, fat and sugar.

Lifestyle changes are often advised for those with a high risk of diabetes and who have been recently diagnosed with type 2. Recommendations include taking two-and-a-half hours each week of moderate physical activity, while losing weight to achieve a healthy body mass index.

Diabetes and Apple's HealthKit

Notwithstanding HealthKit’s aborted launch due to a software bug, digital health companies have jumped at the opportunity to integrate their products with Apple’s HealthKit, a hub of personal health data that consumers can display in Apple’s new Health app in iOS 8. Many are betting that the tech giant has the clout and reach to make Health an indispensable tool for patients looking to engage with their doctors outside the clinic. “It’s going to be the biggest health release ever,” says Daniel Kivatinos, a founder of electronic health record provider drchrono.

It might take some time for doctors still struggling with electronic health records to widely accept the deluge of data HealthKit brings, but many companies don’t want to be caught flat-footed. Soon after Apple announced HealthKit in June, HealthLoop went to work to integrate its software. The start-up allows doctors to check in with their patients between visits, especially post surgery, to follow their progress. Patients who underwent joint replacement, for example, can now opt to share with their doctors who prescribe HealthLoop, the number of steps they took or their temperature from trackers and blue-tooth enabled devices uploaded through HealthKit.  A lack of activity or a spike in fever, can prompt a clinician to intervene. “HealthLoop is able to wrap these streams of biometric data with clinical context,” says Jordan Shlain, founder of HealthLoop and a practicing internist.

The application of biometric data in a defined clinical context, such as hypertension or diabetes, is critical in determining the success of monitoring devices with health care providers, as well as patients who are motivated to engage because of illness. “If data comes in and is not actionable, no one is going to bother,” says Michael Blum, a cardiologist at the University of California, San Francisco, and director of its Center for Digital Health Innovation, which validates tracking devices in a clinical setting.

iHealth Labs, a subsidiary of Chinese medical equipment company Andon Health, which Apple chose as a partner to pilot HealthKit, sells FDA-approved wireless blood pressure and glucose monitors, among other tracking tools. Data from blood pressure cuffs are uploaded onto mobile devices, such as the iPhone and iPad, and are currently used in clinical studies at UCSF, and the VA Medical Center in San Francisco.

iHealth’s chief marketing officer Jim Taschetta says Apple introduced the company to electronic health records vendors Epic Systems and UK-based EMIS Group, as well as Stanford University, and Duke Medicine. To test HealthKit, Duke incorporated readings from iHealth blood pressure monitors into its Epic patient portal. Epic has integrated its MyChart with HealthKit, but it is up to its customers to decide whether they want to enable sharing. Taschetta is encouraged to see a handful of health care leaders adopt HealthKit. “The odds are in our favor to see widespread adoption,” he says.

Other companies tying into HealthKit include electronic health record providers Cerner, drchrono, and athenahealth.

Skittles Fuel Seahawk Marshawn Lynch

Seattle running back Marshawn Lynch's play on the field has become synonymous with Skittles, his candy of choice that he munches on the sidelines. 

This week, Lynch opened up about his love for the colorful candy that he says sprouted in his childhood days playing football.

"My mom used to give them to me when I was a little guy, when I first started playing football. I just kind of kept doing it. Then when I got to high school, my stomach used to get upset, and then I guess the sugar from the candy used to settle my stomach, so then I just started eating it whenever my stomach got upset," he told NFL Japan.

While Lynch's sensational Skittle-fueled runs might say the candies are working, KIRO Radio's Morning News wanted to know if there is really any medicinal or performance-enhancing value to the sweet.

Sports dietician and nutrition expert Emily Edison says there could be a few factors contributing to the Skittles' apparent effectiveness for Lynch. 

"Is there a psychological advantage from eating something that your mama gave you, that she said was magic pills, it's going to make you run faster and be stronger on the field, is there a psychological advantage to that?" Edison asks. "I think yeah, there might be."

"The other thing is, you know our athletes do need to have some sort kind of sugar or glucose coming in from food while they're playing," says Edison. "The Skittle candy does have that. It does have glucose in it, it has a little bit of fructose as well and those things together are going to give you a little extra energy on the field."

There are a few key ingredients however, when considering a good fuel for athletes, that might be missing from the candy. 

"There are two things though that the Skittles are missing that we want to really key in on, and that is sodium and potassium, as well as water. An athlete, when (they're) on the field, they definitely need to have glucose, sodium, potassium and water in order to be at their best."

Morning News host Dave Ross says it sounds like there's a hole in the market for a Skittle with these additives. 

"I'm with you," says Edison. "I think we need to reformulate the Skittle and add some salt and a little potassium and take out those artificial colors and flavors."

Little league coach and Morning News Anchor Chris Sullivan wonders whether the good merits of Skittles are enough to let his son take a handful mid-game.

Edison says while a little bit of candy is not going to hurt, there are healthier options for athletes already on the market.

"What I would recommend is looking at some other products, like an all-natural sports drink," says Edison. "We have a fantastic one right here in Seattle made by Golazo, a Seattle-based company, all natural ingredients. It has the glucose. It has the sodium and potassium, also a great hydrator. That way your athlete is getting something that includes all the ingredients they need, but it's an all-natural, healthy version."

Understanding Hypoglycemia

Eating to Prevent Low Blood Sugar

-- By  Becky Hand, Licensed & Registered Dietitian

Your body breaks down the food you eat into a type of sugar called glucose. After you eat a meal or snack, that glucose makes its way into the bloodstream, causing the level of sugar in your blood to increase. Your pancreas responds by releasing the hormone insulin, which allows glucose to leave the bloodstream and enter into body tissues (including the liver, for later use). When the sugar supplied by your last meal is more or less used up, insulin levels go back down to keep your blood sugar from falling further. In addition, stored sugar is released back into the bloodstream from the liver with the help of another hormone called glucogon. Normal levels of blood glucose levels vary depending on when levels are measured and can range from 70- 145 milligrams per deciliter. Most people’s systems are remarkably adept at maintaining a fairly steady blood sugar level.

However, for people with hypoglycemia, which technically means "low blood sugar," this process doesn't come as easily. While it is not considered a disease itself, hypoglycemia is a medical condition that has many uncomfortable symptoms. Frequent episodes of hypoglycemia can also be related to other medical diagnoses, most commonly diabetes. There are two types of hypoglycemia.

Fasting hypoglycemia occurs when you have not eaten for eight or more hours. It can be caused by certain conditions that disrupt your body’s ability to balance the levels of glucose in the blood: eating disorders, and diseases of the kidney, liver, pancreas, and pituitary or adrenal glands. Taking a high dose of aspirin may also lead to fasting hypoglycemia.

Non-fasting (reactive) hypoglycemia occurs after eating a high-carbohydrate meal or snack. If your body is unable to respond appropriately, it releases insulin too late and in excessive amounts. This causes your blood glucose levels to drop too low.

Hypoglycemia can also be caused by: 

• Diabetes. Taking too much medication, eating inappropriately, changing your exercise routine, or illness can cause low blood sugar levels in people with diabetes.
• Drinking excessive amounts of alcohol
• Prolonged exercise
• Waiting too long between meals and snacks, especially during pregnancy.
• Prolonged fasting
• Eating large amounts or the wrong types of food after certain stomach surgeries, such as gastric bypass surgery
• Diseases of the glands that produce hormones important in blood glucose control, such as the pancreas, pituitary gland, or adrenal glands. (These are rare and generally require the care of an endocrinologist.)
• Kidney failure, severe liver disease, severe congestive heart failure or severe widespread infection
• Medication interactions

Signs of hypoglycemia include weakness, nausea, hunger, headache, sweating, nervousness, mental confusion, anxiety, shakiness, drowsiness, dizziness, and trembling.

Because these symptoms are similar to many other problems, including panic attacks and stress, it's important to get appropriate testing and an accurate diagnosis from you physician. 

Eating with Hypoglycemia
The food you eat can play an important role in preventing the symptoms you experience when your blood sugars drop too low. While there are many causes of low blood sugar, the dietary recommendations are similar for all types of hypoglycemia. These general guidelines include:

• Eating three balanced meals a day with two or three planned snacks. It is important that you don’t skip meals and snacks. Try not to go any longer than 3-4 hours between eating.
• Eating the right amount of carbohydrates during each meal and snack. This helps to keep your blood glucose and insulin levels in balance. Ask your doctor for a referral to meet with a registered dietitian in your area. She can determine the correct amount of carbohydrates for you based on your health status, body size, lifestyle activities, work routine, and fitness program.
• Avoiding concentrated sugars such as white sugar, brown sugar, honey, corn syrup, and molasses. These are found in cookies, candy, cakes, pies, soft drinks, jams, jellies, ice cream and other sweets. Click here to learn more about hidden sugars.
• Eating foods high in complex carbohydrates and fiber such as whole grains, fruits, vegetables, and beans. High-fiber foods digest more slowly and help keep glucose from "dumping" into your blood stream too quickly.
• Eating a high protein food at each meal and snack. Protein-rich foods include fish, chicken, turkey, lean beef and pork, tofu, cottage cheese, cheese, yogurt, milk, eggs, peanut butter, nuts and seeds. Protein can help to maintain your blood sugar levels between meals by delaying how quickly the carbohydrate is digested.
• Achieving and maintaining a healthy body weight.
• Limiting alcohol consumption. Always include a snack when drinking an alcoholic beverage. If you drink alcohol, limit your daily intake—no more than two drinks for men and one drink for women.
• Avoiding caffeine, found in regular coffee and soda.
• Avoiding large meals.

Treating children who have diabetes

The main focus of treating diabetes in children, both type 1 and 2, is normalizing their blood sugar levels to reduce risk of long-term complications.

Along with medication, proper diet and lifestyle modifications are integral parts of treating and managing diabetes.

With children, it is often a caregiver that is fostering and administering these diabetes management techniques.

Therefore it is important for caregivers of pediatric diabetic patients to become educated about the disease and proper diet and lifestyle routines to promote with type 1 or type 2 diabetics.

While it is encouraged for both type 1 and type 2 pediatric diabetic patients to maintain a well-balanced diet, incorporating complex carbohydrates, such as whole grain bread or sweet potatoes, lean protein and plenty of fruits and vegetables throughout the day, there are several differences in their nutritional and lifestyle recommendations.

Children with type 1 diabetes should limit their consumption of concentrated sugars, such as sodas, sweet tea, candy and cake. However, to ensure proper growth and development, it is important for them to get an adequate amount of calories and balanced nutrition throughout the day.

Type 1 diabetics are also prone to low blood sugar levels, therefore it’s important for caregivers to keep juice, sodas, or candy on hand to help regulate their blood sugar levels rapidly.

Obesity is more prevalent type 2 pediatric diabetic patients, therefore diet and lifestyle modifications are not only focused on regulating blood sugar levels, but also focused on preventing weight gain, and in many cases, promoting weight loss.

Caregivers of type 2 diabetics should limit their consumption of concentrated sugars, as well as high-fat foods, such as fried or fast food, while also monitoring meal portion sizes.

Because type 2 diabetics tend to have higher blood sugar levels, maintaining a balanced diet should also be paired with at least an hour of exercise daily, which promotes lower blood sugar levels.

Consulting with a registered dietician and/or diabetes educator is recommended for diabetic patients and their caregivers to develop an individualized disease management plan.

Seahawks Quarterback Russell Wilson Battles Diabetes

RALEIGH, N.C. – Seattle Seahawks quarterback Russell Wilson announced today that he has agreed to serve as National Ambassador for CR3 Diabetes Association, Inc.  Wilson is one of the most successful college quarterbacks in history, setting two all-time NCAA records for quarterbacks while leading the Wisconsin Badgers to the Rose Bowl.

Despite his many blessings, Wilson has seen his share of pain. In 2007, his beloved father, Harrison Wilson III, suffered a series of diabetes-related strokes and was not expected to survive. Harrison, a widely respected Richmond attorney who played college football at Dartmouth, was always an inspiration to his children so they weren’t surprised when he defied the diagnosis and recovered from his stroke. Unfortunately the disease that had ravaged his body ultimately caught up with him and Mr. Harrison passed away on June 9, 2010. As he watched his father’s battle with diabetes, Wilson vowed he would do what he could to help once he reached the NFL.

The CR3 Diabetes Association, Inc.encourages people with diabetes to take control of their health by providing medical devices and supplies to those unable to afford the cost. It provides the necessary tools to monitor diabetes such as free glucose meters and testing strips while offering substantial discounts for insulin pumps and insulin pump supplies. This program allows each diabetic it assists to be a healthy candidate when a cure is developed. 

Russell was impressed with this mission when he met Charles Ray III, his wife Heather and brother-in-law Winston Ducally – the trio of diabetes sufferers who started and operate the nonprofit. “These good people help provide life-saving supplies and education to thousands of people who wouldn’t otherwise have access to these things”, said Wilson. “If I can help call attention to this critical problem we can help even more people.”

Charles Ray III has been following Wilson’s career since he was a freshman at North Carolina State and was amazed by his athletic abilities, but even more so by his character and leadership. “We are so blessed to have a young man with so much talent and heart, step up to and join with us to help save lives throughout the nation,” said Ray.

About CR3 Diabetes Association, Inc.

CR3 Diabetes Association, Inc. is a 501c3 Tax Exempt Non-Profit Organization that was established in 1998 to provide free equipment and supplies to the many uninsured or underinsured diabetics in need. Since that time the organization has provided free diabetes-care products to more than 3,000 people. According to a recent study, reported by NBC, between 1999 and 2008, the percentage of adolescents ages 12 to 19 with diabetes or prediabetes increased from 9 percent to 23 percent so we face a dire future unless we act now. With Russell Wilson’s help, our goal is to help save even more lives by assisting diabetics who otherwise wouldn’t have access to these critical supplies.

About Russell Wilson

Wilson began his collegiate football career in Raleigh at NC State University.  He became the first freshman quarterback in conference history to be selected to First-Team All-ACC and was also named the ACC Rookie of the Year (2008). In 2010, he led the Wolfpack to a 9-4 season and a win over West Virginia in the Champs Sports Bowl. 

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In 2011, Wilson graduated in just three years from NC State with a bachelor’s degree in Communications and transferred to the University of Wisconsin, where he entered the Masters in Education Leadership and Policy Analysis program.  

During his only season with the Badgers, Wilson led the team to an 11-3 record and an appearance in the Rose Bowl. Wilson received the MVP award of the Big Ten Championship Game, was named Big Ten Quarterback of the Year and voted First-Team All-Big Ten.  Wilson passed for a school record 33 touchdowns while throwing only 4 interceptions. He also set the all-time NCAA passer rating record for a single season (191.8) and the NCAA record for the most consecutive games with a touchdown pass (38).

Wilson is married to the former Ashton Meem. They reside in Seattle, where he is in competition for the starting quarterback slot for the NFL’s Seattle Seahawks. French/West/Vaughan of Raleigh, NC manages Wilson’s marketing and charitable programs.