APRIL 2014 – NEWSLETTER

Spring Fever!

By: Jessica Cook MS, RD, LD/N, CDE (Director of Education)

Spring is in the air and here at Palm Beach Diabetes and Endocrine Specialists, we have put together a great edition of Healthy Living with Diabetes Newsletter for you to enjoy and to help you spring into a healthy way of life. Maintaining a healthy lifestyle starts with your attitude, knowledge, and behaviors, so hopefully, through this newsletter, we can help you jump start into a healthy lifestyle. Thank you for taking your time to read April’s Healthy Living with Diabetes newsletter. Have a lovely spring season!

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How Many Medicines Are Needed to Treat Diabetes?

By: Kort Knudson MD

How many medicines does it take to manage diabetes? This is a question that comes up frequently. Patients may not realize that some of the medicines they are prescribed may not be directly related to control diabetes. Diabetes is a common cause of blindness, kidney disease, and peripheral vascular disease. Diabetes also contributes to heart disease, hypertension, stroke and nerve damage. In order to adequately take care of all symptoms related to diabetes, we need to address all of these body systems separately in addition to lowering blood sugar levels.

To lower blood sugars physicians usually start by prescribing metformin and may add one or two additional medicines as needed. It is seemingly more effective to use moderate doses of several medicines rather than maximum doses of a single medicine.

While using medication that helps to lower blood sugars, physicians may add treatments to reduce hypertension and high cholesterol. The average patient with diabetes uses 3 medicines to control blood pressure and 1-2 medicines to control high cholesterol.

Most patients with type 2 diabetes also have metabolic syndrome with high triglycerides and low HDL cholesterol. There are some experts who feel that treating all of the lipids with a combination of a statin and a fibrate is the best approach. If the triglycerides are especially high, fish oil capsules may help as well. There are also some experts who advocate low dose aspirin use to help lower the chance of heart attacks.

At least half of the population has low vitamin D and requires supplements even in sunny South Florida. Other supplements such as vitamin B-6, vitamin B-12, and alpha lipoic acid have been shown to help prevent nerve damage, therefore your doctor may prescribe one of this medications as well if you have a history if nerve damage or as preventative measures.

When physicians treat the whole patient with diabetes it usually requires at least 3 medicines and in some cases up to 9 or 10 medicines. The underlying goal is for the physician to prevent complications and bring overall health risks down. The expense and inconvenience of taking medicines to prevent complications far outweigh the drawbacks of waiting for problems to develop, then trying to treat them afterward. We consider our care successful if the patient can lead a completely normal life without complications for a better quality of life, even if it takes multiple medicines to reach the goal.

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Cuckoo for Coconut!

By: Jessica Cook MS, RD, LD/N, CDE (Director of Education)

Coconut is all the rage! With new introductions to the food market such as coconut infused milk, yogurt, ice cream, oil and water, one would think this tasty health fad must be true! …Not so fast! Although there are some benefits to coconut consumption, many coconut related products are very high in calories as well as fat. Specifically coconut contains high amounts of saturated fats, which have been linked with increase risk for heart disease. Let’s weigh the pros and cons of coconut!

Pros:

1. Plant-based saturated fat. Unlike saturated fats from animal products or trans-fats from processed foods, coconut is plant based making it a slightly better choice for the heart including vitamins as well as minerals such as folate, various other B-vitamins, vitamin E, vitamin C, potassium, iron, selenium, phosphorus, calcium, magnesium, copper and zinc. Using saturated fats such as coconut oil, has been shown to not be as detrimental to heart health when compared to trans-fat such as hydrogenated oils that are found in many processed foods and in some studies using coconut oil actually helped to increase levels of good cholesterol (HDL) in the bloodstream.

2. Contains lauric acid. Coconut oil contains lauric acid, which is a medium chain triglyceride (MCT). MCTs are broken down quicker in the body than long chain triglycerides (LCT) such as grape seed oil or vegetable oil, therefore are not stored as fat, but rather used for immediate energy. Lauric acid also has been shown to increase good cholesterol (HDL), however, unsaturated fats still have the best benefit of reducing overall cardiovascular health risk. Lauric acid used to prevent heart disease still has not been proven.

3. May aid in weight loss. The major reason for the recent increase in coconut popularity is partly due to several studies, which have suggested it may decrease adipose (fat) tissue on the body when compared to use of LCT due to the ability of the body to break down MCT oil quickly instead of used for fat storage. However, if you increase coconut consumption without taking calorie content into consideration it may lead to overall weight gain.

Cons:

1. High in Saturated fat. Although the saturated fat in coconut is plant based it still remains a saturated fat, which is responsible for raising bad cholesterol levels, weight gain and may lead to heart disease. Monounsaturated fats are preferred for your heart due to their ability to reduce bad cholesterol and increase good cholesterol. However, your body does need a balance of different types of fats, so if choosing to use coconut oil as a cooking source also make sure to mix it up and use monounsaturated fats such as olive oil, canola oil or soybean oil for their heart healthy benefits as well.

2. High-calorie content. Because coconut is primarily a fat, it is naturally high in calories. Coconut based products such as coconut yogurt contain about 225 calories per 6oz. serving versus low-fat dairy yogurt which is typically anywhere from 80-140 calories per 6oz. serving. Also, foods such as coconut ice cream, coconut butters and coconut milk have very high-calorie contents, which may lead to weight gain if not used in moderation.

3. Coconut water contains carbohydrates. Although coconut water may contain many benefits including high doses of the electrolytes including potassium, it also contains carbohydrates. Drinking beverages that contain carbohydrates may increase blood glucose levels as well as lead to weight gain. Many people only need electrolyte replenishing if working in the sun for several hours, after continuous vomiting or diarrhea, or if instructed by a physician, therefore stick with water instead. You will benefit much more from drinking purified water versus coconut water.

If you love the flavor of coconut, but don’t want all the calories that come with it try using any one of these great coconut products:

• Coconut flavored unsweetened almond milk
• Emeralds™ 100 calorie pack of coconut dusted almonds
• Lite coconut milk for cooking
• Dannon™ Light n Fit Greek toasted coconut yogurt
• Unsweetened shredded coconut when baking

Enjoy!

Want to lose weight?

Losing weight is as easy as 1-2-3 with our Healthy Living with Diabetes 1-2-3 program!

Here at Palm Beach Diabetes & Endocrine Specialists we offer an American Diabetes Association accredited education program, which involves registered nurses, certified diabetes educators, licensed clinical social workers, and registered dietitians under physician supervision to help you not only control your diabetes, but lose weight in the process!

Our accredited 1-2-3 program will let you attend a one-on-one visit with our education team and construct a personalized healthy meal plan as well as establish a blood sugar testing pattern specifically for you. We will also review any medications you are taking, answer questions regarding medications and take a comprehensive look at what you can do to control your health for years to come. Our 1-2-3 program also allows you to attend one of our group class sessions to gain more information on food label reading, sugar alcohols, exercise, weight loss, mindful eating and so much more!

Currently, we offer our education classes at five locations including Lake Worth, West Palm Beach, Jupiter, Wellington and Boynton Beach to best serve you within your community. Class schedules can be provided in our offices, emailed or mailed to you upon request.

If interested in scheduling your Healthy Living with Diabetes 1-2-3 program today, please contact our scheduling department at (561) 513-5100

At Healthy Living with Diabetes, we want to ensure that you are satisfied with all services received. We also would like your input on educational workshops that you would like us to offer, information you would like to read about in our Healthy Living with Diabetes Monthly Newsletter or feedback on any workshop that you may have attended.

You can contact the director of education personally by email: jcook@PBDES.COM or leave a message at (561) 513-5100. We would love to hear from you!