By: Director of Education – Jessica Cook MS, RD, LD, CDE
We all struggle making good food choices every day and maintaining a healthy weight, but when you have diabetes this struggle can become even more frustrating. Spending hundreds of dollars on diabetes supplies and medications, while constantly worrying about blood sugar levels, leads some to believe it is just too difficult. This compelled me to share a story about a special patient that attended our Living Well with Diabetes 1,2,3 program and gained the motivation to turn his diabetes and health around!
The Story: R.W., age 69, developed type II diabetes after life threatening brain surgery, which left him home on disability for several months. For many years R.W. had struggled with his weight. Although successful in losing weight with a conventional weight loss program, after brain surgery R.W. found that he had regained all of what he had lost going from 200lbs. to 290lbs. and unfortunately, developing diabetes. R.W. was not familiar with education for diabetes when he first visited his endocrinologist, Dr. William Kaye, but with an A1c of 9.1%, diabetes education became a major player in R.W.’s health.
The Issue: After undergoing brain surgery, R.W. was left with little to do and a lot of stress with his current medical conditions. R.W. turned to comfort foods, such as ice cream, to soothe the pain of his situation and filled the void during boredom while being home from work. It made R.W. feel good to have a couple of large bowls of ice cream and other sweets during the day. Suddenly R.W. noticed his weight climbing and blood sugars followed suit. Soon R.W. had to go from oral medications to injecting insulin in increasing doses. While R.W. struggled to find the magical medical cure for this issue, his endocrinologist had a different plan in mind, referring him to an ADA-recognized education program to help manage blood sugar control and potentially lose the weight he had gained after surgery.
The Education Plan: Dr. Kaye immediately sent R.W. to a Certified Diabetes Educator and Dietitian. R.W. learned to care about dietary intake, carb counting and exercising because it could lead to better blood glucose control. Very few people want to hear the “exercise” word, but it turned out to be very important to R.W. and not at all as painful as R.W. had initially anticipated. R.W. started by walking one mile each day and progressed to walking three miles a day along with doing simple weight exercises. Soon exercise became a new form of therapy and stress relief versus food.
The Dietitian met with R.W. to explain how to read nutrition labels on packaged foods while establishing nutrition goals and R.W. attended a diabetes education seminar, conducted by Palm Beach Diabetes & Endocrinologist’s ADA-recognized education program. R.W. learned how to monitor food intake, stress management, target blood glucose levels and evaluate nutrition values. It became clear to R.W. that he was taking better care of his home and automobile than his own body. He discovered that his comfort foods as much as he loved them, could not be consumed every day, but within moderation. R.W. followed up with regular quarterly meetings with the dietitian and she offered suggestions for healthier food substitutes to R.W.’s old comfort food favorites, portion sizing and exercise alternatives. R.W kept a simple log of what he was eating and blood glucose readings. The dietitian and certified diabetes educator held R.W. accountable at each follow up meeting while offering support and his health has improved dramatically. R.W. was able to remain successful in his journey to better health through the encouragement during his visits with the dietitian, certified diabetes educator and endocrinologist.
The Result: R.W.’s weight has dropped from 290 lbs. to 200 lbs within 19 months and his energy has substantially increased. R.W. is no longer on blood pressure medications and A1C has dropped from over 9.1% to 5.7%. R.W. was taking a total of 44 units of insulin per day and recently, due to a great A1c level, R.W. has been taken off insulin altogether!
R.W. had developed numbness in his feet and ankles that was diagnosed as neuropathy and became very concerned about eventually losing limbs to diabetes. Due to healthy eating, consuming comfort foods within moderation and weight loss R.W. also experienced a substantial reduction in discomfort and potentially reduced chances of neuropathy worsening.
R.W. realized that he must live in moderation. Treating himself to a dessert or small bowl of ice cream once in a while is ok, but everything needs to have discipline. R.W. does not keep ice cream, sweets, or other foods in the house, but if he wants something special, he will consume it when dining out or make sure he has done exercise in order to earn a treat. R.W. learned that although it may appear that other people are fortunate to be naturally healthy, it more often occurs because of their own nutritional awareness of food intake and physical discipline.
Take Home: Your diabetes educator or dietitian can teach you ways to still enjoy your favorite foods within moderation, reduce weight, blood glucose levels and diabetes complications. Checking in with an educator regularly can help you stay on target with your health goals, give suggestions to keep you motivated and provide guidance during your journey.
Before 290 lbs.
After 200 lbs. (Lost 90lbs.!)
If you would like to make an appointment, we have registered dietitians certified diabetes educators and our living well with diabetes 1-2-3 program available in all four office locations. Let us help you track blood glucose trends, learn about your diabetes medications, lower your A1c, feel better and develop a personalized meal plan to better control blood glucose levels. We also offer a healthy meal planning workshop specifically for diabetes to learn how to make fresh, healthy meals to lower you blood glucose and lose weight!
If you want to schedule an appointment for any one of our educational workshops please call (561) 513-5100 today!
It’s Time to Take Charge of Your Health!
Thank you for taking time to read our Living Well with Diabetes February 2016 Newsletter.
By: Geetanjali Kale, M.D.
What is diabetic nephropathy or diabetic kidney disease?
Both type 1 and type 2 diabetes can cause structural and functional damage to the microvasculature of the kidneys, which is referred to as diabetic nephropathy, diabetic renal disease or diabetic kidney disease. In diabetic patients, it is possible to have damage to kidneys from a cause unrelated to diabetes. It is important to make that distinction as treatment options may vary.
What causes some diabetics to develop kidney disease while some don’t?
The risk of diabetic nephropathy increases with the duration for how long a person has been diagnosed with diabetes. In a type 1 diabetes, it takes 15-20 years to start seeing kidney damage, however, the disease can be apparent within 5 to 10 years for type 2 diabetics. In general, the overall risk of diabetic nephropathy is higher in type 1 diabetes than type 2 diabetes. Also, patients with type 1 diabetes diagnosed with nephropathy very likely have coexisting eye disease or diabetic retinopathy.
How is diabetic nephropathy diagnosed?
The patient is usually asymptomatic in the initial phases of diabetic nephropathy. The disease is picked up on urine testing, which is done to look for spillage of excess micro albumin in urine due to kidney damage. American diabetes association recommends confirming abnormal microalbumin creatinine ratio on two occasions before making the diagnosis. Rarely, the disease presents as blood in urine or chronic kidney disease.
How does the disease usually progress?
Diabetic nephropathy is a progressive disease, and the disease progress can be slowed down with proper interventions. If untreated, the disease usually worsens, resulting in frank renal failure with elevated creatinine and compromised glomerular filtration rate. The rate of worsening of disease is variable ranging from months to many years before the kidneys are severely damaged. Once end stage renal disease sets in, the patient should start following up with a nephrologist. Nephrologists usually help patients navigate through renal replacement therapies such as dialysis and kidney transplant.
What treatment options are available to treat diabetic nephropathy?
Optimal control of blood glucose levels and well controlled blood pressure are primary cornerstones of treatment of diabetic nephropathy. Weight loss, protein restriction, smoking cessation and management of cholesterol are important components of treatment. There are two classes of medications proven to stabilize kidney damage. One class is of ACE inhibitors and other class is angiotensin receptor blockers. Both of these classes of medications are blood pressure lowering. Side effects of these drugs can include cough and angioedema, but the side effects are rare.
Then come join our Healthy Meal Planning Workshop!
10:00am -12:00 P.M.
1901 Flagler Drive
West Palm Beach, FL 33407
Will provide Healthy Snacks!
If interested attending this program please contact our scheduling department at (561) 513-5100 today!
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 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!