By: Jessica Cook MS, RD, LD/N (Director of Education)
Summer is the season for fun outdoor activities involving the sun, sand and for all of us in South Florida extreme heat. It is important before engaging in any outdoor activities that blood sugars are under good control and always make sure to stay hydrated by drinking plenty of water. Remember to wear sunscreen and bring fast acting forms of carbohydrates such as raisins just in case you experience low blood sugar levels during outdoor activities. Be smart about your summertime fun by being prepared! Please enjoy this month’s issue of healthy living with diabetes and have a great summer season.
By: Dr. Barry Horowitz
We have had an explosion of medications to treat diabetes in the past decade. Two classes of medications that are currently available work in the incretin system, which is a hormonal system in our bodies that helps regulate our blood sugars. They are DPP-4 Inhibitors (Januvia, Onglyza and Tradjenta) and GLP-1 agonists (Byetta, Victoza and Bydureon). These medications have been very useful in improving blood sugars in our diabetic patients.
One of the concerns has been possible adverse effects of these medications on the pancreas itself. In fact, you may have seen attorney ads and news items regarding this. All of these medications have labeling to indicate an association with the occurrence of pancreatitis, which is an inflammation of the pancreas. This is based on the fact that patients who have been on these medications have gotten pancreatitis. However, no clear cause and effect have been established. It is therefore recommended that if a patient has a history of pancreatitis, that they should not take these medications and if a patient develops pancreatitis while on one of these medications, it should then be stopped.
Another concern has been a possible association with pancreatic cancer. However, there is no definitive evidence regarding this and the FDA has put out the following statement: “The FDA has not concluded these drugs may cause or contribute to the development of pancreatic cancer. At this time, patients should continue to take their medicine as directed until they talk to their health care professional.” We agree with this assessment and would suggest that you discuss any concerns with your physician.
By Monika Lambertson, MS RD LD CDE
Most of us already know about the integral role that Vitamin D plays in
bone health. But have you heard that emerging research finds Vitamin D
may help promote overall health and prevent disease? Although current
guidelines for Vit D are set at 200 IU/ day for ages birth – 50,
400 IU/day for ages 51 – 70, and 600 IU/day for ages 71+, many experts believe
these levels may not be adequate. In fact, it is estimated that as many as 75% of Americans may have inadequate Vit D levels (<30ng/ml). Active in many areas of the body, research has linked higher blood levels of Vit D (30 – 55 ng/ml) to decreased risk of several types of cancer, as well as a lower risk of autoimmune diseases (such as Type 1 diabetes, lupus, multiple sclerosis, rheumatoid arthritis, Crohn’s disease). Vit D may also reduce your risk of developing Type 2 diabetes, may help to help protect against depression as well as seasonal affective disorder, and has been linked to improved cardiovascular health.
For those who already have Type 2 diabetes, adequate Vit D levels may boost insulin sensitivity and improve blood sugar levels. If you are wondering if you may be at risk for low Vit D, consider the three sources: sun exposure, Vit D rich foods/beverages, and dietary supplements. Although 5 – 30 min of sun exposure twice weekly is probably adequate to maintain VIt D status, absorption of Vit D from the sun may be inadequate if you have darker skin, use sunscreen, or have limited sun exposure. Food sources are limited unless you regularly eat fatty fish such as salmon, tuna, mackerel, and sardines (best sources), or choose Vitamin D-fortified milk, orange juice, or margarine. Supplements are an easy way to ensure you are getting enough Vit D, but may increase your risk of toxicity. Most daily multivitamins contain an excellent source of Vit D and are usually safe to take. If you take many different supplements make sure to check the amount of Vit D contained in each supplement.
If you are concerned you may be at risk for low Vit D, speak with your physician. Given the controversy over what the ideal Vit D intake, it may be wise to err on the side of caution by including more food sources of Vit D in your diet and taking a daily multivitamin containing Vit D. More findings and updated recommendations regarding daily Vit D intake and blood levels for optimal health are sure to come in the near future.
Here at Palm Beach Diabetes & Endocrine Specialists, we offer the opportunity for you to meet one on one with a registered dietitian to discuss personal dietary preferences, gastrointestinal related issues, weight loss, individualized meal plans, carbohydrate counting, current food trends, supplements as well as grocery shopping secrets. Each meeting with a registered dietitian is one hour and is individualized to meet your specific dietary needs. Meal plans can be created for your personal calorie amounts, preferred carbohydrate intake, and specific food preferences. So if you are interested in gaining more knowledge about nutrition from an expert, consider making an appointment today!
To reserve an appointment with one of our registered dietitians today please call our scheduling department at (561) 513-5100. Most insurance plans cover nutrition therapy if you have a diagnosis of diabetes or renal disease. We look forward to seeing you soon!
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 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!