Recipe: Vanilla Yogurt with Pear Compote

Today I have a fun recipe idea for you from Margie Sobil - she tried this with her support group at the Greenfield office, and it was a big hit. 

She suggests trying this as a dessert to serve to guests - they might appreciate its lightness, and it looks very elegant served in individual dishes. 

Recipe: (Lower Carb) Vanilla Yogurt with Pear Compote

Ingredients:
- Large 32-oz container of plain, fat free greek style yogurt
- 8 teaspoons (or 8 packets) of stevia/Truvia or Splenda
- 2 teaspoons vanilla extract
- 4-6 medium apples, pears, or other fruit of your choice
- 1 Tbs lemon juice
- 1/4 cup raisins or craisins
- cinnamon or nutmeg to taste

Combine the yogurt, vanilla, and 6 teaspoons of the stevia or other non-caloric sweetener.

Cut fruit into chunks and stew/cook covered with a little water and the lemon juice.  

Add cinnamon, nutmeg to taste. 

When almost finished, add craisins and remaining stevia.  Refrigerate overnight.

Divide yogurt into 6 serving of about 2/3 cup. Top yogurt with about 1/3 cup of the compote. 

Total carbohydrates = about 25-30g total carbs per serving. You will feel like you are having a gourmet dessert! 

November is American Diabetes Month... And the start of the holiday season for many of us!

According to the American Diabetes Association:

• Nearly 30 million children and adults in the United States have diabetes.
• Another 86 million Americans have pre-diabetes and are at risk for developing type 2 diabetes.
• The total national cost of diagnosed diabetes in the United States is $245 billion.

For more info visit: http://www.diabetes.org

Don't forget we at VMG are here for diabetes education, nutrition, and medical services through the holiday season! Please let us know how we can help.

In the meantime, holiday meals and treats don't have to get you off track if you plan ahead. If it's important to you to savor a special holiday dessert this season, try these strategies for fitting it into your plan:

Here are some "Sweet Tips" for the holidays:

• Choose what special treat to eat ahead of time, and stick to your plan 
• Choose a small serving size 
• Decrease the other carbohydrates in your meal to keep your total within goal 
• Try replacing up to half the sugar with a sugar substitute when baking 
• Or, try cutting down on sugar and increasing cinnamon, nutmeg, or vanilla instead 
• For sweet cravings at home, try frozen grapes or baked apples 
• Savor your serving slowly, and then send the leftovers home with someone else! 

Do you have other strategies that help you enjoy the holidays in moderation? Please share in the comments section below!

New FREE Support Group! (Plus Halloween Carb Counting)

The Diabetes Team at Valley Medical Group is excited to announce a new FREE Diabetes Support Group in our Northampton (Florence) office. 

The group will meet on the 2nd Wednesday of every month starting November 11th, from 5:30 -7 pm. 

The group is open to anyone - no need to sign up.

 Our first support group will feature a food demonstration to prepare you for the holidays!!

 We are looking forward to offering support and connections with you, your family and our community. If you have any questions or concerns you are welcome to contact Bonnie Grenier at 413-262-2838 or bgrenier@vmgma.com

And to get you started thinking about your strategy for navigating the holiday season, let's start with Halloween! Here are the nutrition facts for some of the most popular Halloween candies you might encounter this week, thanks to Diabetes Forecast Magazine: 

Candy	Calories	Fat (g)	Carbs (g)
Snickers, fun size	80	4	10.5
Snickers, mini	43	1.6	4.4
3 Musketeers, fun size	63	2	11
3 Musketeers, mini	24	0.7	5
Skittles Original, fun size mini	60	0.5	14
Butterfinger, fun size	100	4	15
Butterfinger, mini	45	2	7.25
Candy Corn, 1 oz.	100	0	25.6
Milky Way, fun size	80	3	12
Milky Way, mini	38	1.6	6
Almond Joy, snack size	80	4.5	10
Almond Joy, mini	67	3.6	8
Hershey's Kiss, 3 pieces	67	4	8.3
Kit Kat, snack size	70	3.6	9
Kit Kat, mini	18	2	5.6
Reese's Peanut Butter Pumpkin	170	10	18
Twix, fun size	80	4	10
Twix, mini	50	2.6	6.6
Peanut M&M's, fun size	90	5	10.5
M&M's, fun size	73	3.3	10.6
York Peppermint Patty	140	2.5	31
York Peppermint Patty, mini	50	1	11
Tootsie Roll	23	0	4.6
Charms Blow Po	60	0	17
Jolly Rancher	23	0	5.6
Smarties roll	25	0	6

Nutrition information is shown per piece of candy or per bag for appropriate items (such as M&M's).

Source: http://www.diabetesforecast.org/2010/oct/carb-counts-for-halloween-candy.html

Good News for Fidgeters

By now, I'm guessing you've heard about the health effects of sitting. Those of us logging hours in front of computers, TV's, and sitting in cars on long commutes have an increased risk of:

• heart disease
• diabetes
• cancer
• anxiety
• death (!)

Sitting has been said to increase your risk of heart disease just as much as smoking! And in the research I've seen, this is even if you exercise for an hour at the gym before you go home.

But I have some encouraging news for you: it seems that even small efforts to move more can make a big difference.

For example, as this article explains, there is research to show that some of these health risks are lower in people who fidget.

And this one shows that even a two minute walk each hour can offset these drawbacks.

Encouraging, right? You don't need to start running races to undo all that time in your chair. Here are some more suggestions to stay moving throughout the day:

• If you have a laptop or other portable device, put a shelf or a small table on top of your desk so you have the option to alternate sitting and standing throughout the day
• Walk down the hall to speak to a coworker, rather than sending an email
• Get up to refill your water bottle (two goals in one!)
• Go the long way around to the copier or to the bathroom - bonus points if you can go up one set of stairs and down another on your way
• When tidying up the house, make a trip up or down the stairs for each item you put away
• Stand up, walk in place, or do simple stretches during each commercial break
• Pace or walk in place while on the phone, brushing your teeth, or waiting for the microwave

What other suggestions do you have for fitting a little bit more movement into your day? Let us know in the comments section below!

VMG is now on Social Media!

Did you know VMG is now on social media?

You can now find (and "like"!) Valley Medical Group at:

Facebook - https://www.facebook.com/valleymedgroup

Twitter- https://twitter.com/valleymedgroup

Thanks,

From the VMG Diabetes Team

Back to School with Diabetes

Are you caring for a child with diabetes?

Here are some things to think about while getting ready for the first day of school:

1. Communicate clearly with teachers.

Joslin posted their advice last week, advising that you discuss symptoms of hyper- and hypo-glycemia, and when the child should go to the nurse's office. You may also want to clearly outline what the child needs to be allowed to do in the classroom, such as checking blood sugars or carrying snacks.

Depending on the child's age, you may need to emphasize that your child may not be able to tell the teacher when he or she is having a low.

2. Do your homework.

Work with your child's doctor to update your Diabetes Medical Management Plan (DMMP). You can use the DMMP to draft an Individualized Education Plan (IEP) with the school, clearly outlining the school's responsibilities and who should be trained - this includes the teacher, the school nurse, and depending on the age of the child, possibly other staff such as the bus driver.

http://www.cdc.gov/features/diabetesinschool/

3. Be prepared.

The CDC offers this list of suggestions for packing a diabetes kit for your child's backpack:

• Blood glucose (sugar) meter, testing strips, lancets, and extra batteries for the meter.
• Ketone testing supplies.
• Insulin and syringes/pens.
• Antiseptic wipes.
• Water.
• For children who wear an insulin pump, backup insulin and syringes/pens in case of pump failure,
• All children on insulin need glucose tablets or other fast-acting glucose snacks (a carbohydrate that will raise blood sugar levels relatively quickly when eaten). Here are examples of fast-acting snacks that provide about 10 to 15 grams of carbohydrate:
• 3-5 pieces of hard candy.
• 4-6 ounces of regular (non-diet) soda.
• 4-6 ounces of orange juice.
• 2 tablespoons of raisins.
• 8 ounces of nonfat or low-fat milk.

http://www.cdc.gov/features/diabetesinschool/

4. Stay healthy and active as a family 

The back-to-school season can be a stressful time, but it's important to keep up with all your family's healthy habits, including:

• Packing or encouraging healthy balanced breakfasts, lunches, and snacks
• 60 minutes of physical activity per day - especially if you can do activities together, such as walking or bike riding together after school
• Limiting screen time
• Staying up to date on doctor appointments and vaccinations

Is there anything else you have learned from experience about getting ready for this fall? Please let us know in the comments section below!

For more information, check out:
http://www.cdc.gov/features/diabetesinschool/
http://blog.joslin.org/2013/08/back-to-school-tips-for-diabetes-management-teacher-edition/

Two News Items

Good Morning! 
Two news items were brought to my attention by VMG Diabetes team members recently that I thought I should share with you. It's kind of a good news/bad news situation. 

Let's do the bad news first: the FDA has issued a drug warning for the diabetes medications Invokana (canagliflozin), Farxiga (dapagliflozin), and Jardiance (empagliflozin). These are a group of medications called SGLT2 inhibitors. 

The warning is being issued because 20 patients being treated with these medications were hospitalized with Diabetic Ketoacidosis (DKA). You might have heard of DKA happening to people with type I diabetes, and being associated with very high blood sugars. These cases were unusual because these were people with Type 2 diabetes, with relatively normal blood sugars. 

If you are taking one of these medications, you are not advised to stop taking it without speaking to your provider, but do be on the lookout for the symptoms of DKA, which the FDA lists as: difficulty breathing, nausea, vomiting, abdominal pain, confusion, and unusual fatigue or sleepiness. You can read the full FDA warning here. 

photo from Weill Cornell Medical College's article

Today's good news? Changing the order in which you eat your meal may help improve blood sugar control! A recent study out of Weill Cornell Medical College found that eating protein and vegetables before carbohydrates resulted in lower post-meal blood sugars and insulin levels in people with type 2 diabetes on oral medications. 

They emphasize that more research is needed to confirm the finding and to explain why exactly this works, but I don't think it can hurt to try it out for yourself!

Any other big diabetes news you've noticed in the past couple weeks? Let us know in the comments section below!

Looking for Weight Loss Inspiration?

For those of you who may be trying to lose weight, I want to share some of my favorite online resources for inspiration, information, and support.

If you are a smartphone user, you probably already know there are many apps available to help you on your weight loss journey - maybe too many. These are the ones that I have seen the most people succeed with:

• Fooducate or Shopwell: Scan barcodes while shopping – these apps will help you make healthy choices.
• Myfitnesspal or LoseIt: Track your intake to meet daily calorie or nutrient goals
• HealthyOut Healthy Meal Finder: Search for the healthiest restaurant or takeout food options

If you are looking for trustworthy information, recipes, or community, these are some websites that you might want to try:

• CalorieKing.com: Find the facts on almost any food!
• Sparkpeople.com: A combination of an online food diary, informative articles, and a supportive online community.
• Mayo Clinic Recipes: Large database of healthy recipes from a trustworthy source
• Oldways: Not strictly for weight loss, this collection of Mediterranean Diet recipes may help you include more heart-healthy choices in your weight loss meal plan

My favorite weight loss resources of all, however, have always been first-person accounts of real life experiences. I think these blogs are inspiring, funny, and very helpful. If you have all the information you need, but could use a boost from a real person's story, check out these blogs: 

• Authentically Emmie: Cheerful and positive, documents the author’s journey down from 455 pounds.
• Prior Fat Girl: Honest advice from a writer who has maintained her weight loss
• Does this Blog Make Us Look Fat: Very funny take on weight loss, with some very good advice
• Can You Stay for Dinner?: Heartfelt personal story of weight loss and the author’s struggle with emotional eating and body image. Also includes many wonderful recipes!
• Cranky Fitness: This blogger doesn’t like to exercise either, but does it anyway.
• Roni’s Weigh: Inspirational story of weight loss, with lots of helpful tips.

Do you have any favorite online resources to share? Let us know in the comments section below! 

Update on Artificial Sweeteners - Plus Summer Beverage Ideas!

Lately, the question I hear most often is "what is the best artificial sweetener? And is it true that regular sugar is actually healthier for me?

If you have diabetes, you know that one of the first thing your healthcare providers will suggest is to reduce or eliminate sweetened beverages from your diet. Artificial sweeteners such as aspartame, saccharin, or sucralose have been commonly recommended as safe sugar alternatives for people trying to lose weight or manage diabetes. 

The problem is, the research has been mixed. Some studies show they help with weight loss. Other research suggests they cause weight gain, "metabolic derangement", and/or insulin resistance by "tricking" the brain. (Studies here, here, and here.)

Now, a new study may have uncovered the mechanism. This article from NPR explains the findings of the new study: 

"What we find is that a subgroup [four of the seven people] developed significant disturbances in their blood glucose even after short-term exposure to artificial sweeteners," Elinav says.

"For example, results of a glucose tolerance test found that some individuals' blood sugar temporarily shot up to levels that are characterized as pre-diabetic within just a few days of introducing the artificial sweetener.

And how it's happening may be even more surprising. Their experiments showed that artificial sweeteners can alter the mix of bacteria in the guts of mice and people in a way that can lead some to become glucose intolerant.”

Amazing! And alarming. But drinking sugar- or corn-syrup-sweetened beverages was not helping us, either. So what to do? Here are some ideas:

1. Flavor your water with:

• Lemon, lime, or orange slices
• Cucumber
• Fresh mint
• Frozen berries
• 1 oz fruit juice

2. Try seltzer - but avoid club soda, which has added sodium. Plain seltzer could be flavored with the ideas above, or there are many sodium-free unsweetened flavored options to choose from!

3. Make your own iced tea with black, green or herbal teas. Stevia is a safe sweetener to add if desired, or you could add some fruit or mint to these, too!

4. Iced coffee - order plain/black and add your own stevia and skim milk. Try adding natural flavors such as vanilla extract or cinnamon. 

5. Try low sodium V8 or no-salt added vegetable juices. You can add tabasco/hot sauce, curry powder, or lemon/lime juice for extra flavor

Do you have any other fun beverage ideas? Let us know in the comments section below!

Enjoy, and happy summer!

Safe Fasting with Diabetes

Whether it is for religious purposes or fad diets, people with diabetes often have questions about fasting. With Ramadan starting next week, let's review some strategies for safely fasting with diabetes.

A recent article in Diabetes Forecast outlines the challenges of fasting with diabetes, and offers recommendations and some examples: click here for the full article.

The article notes that fasting doesn't just put you at risk of low blood sugars. Blood sugars can also rise too high during a fast, because the liver can release glucose into the bloodstream.

Most medical professionals do not recommend fasting as part of any weight loss plan or diet. It can put you in unnecessary danger, and may not lead to any lasting weight loss.

Many religious observances such as Ramadan involve fasting from sunrise to sundown, breaking the fast only in the evening. However, most religious leaders seem to agree that safety comes first, and allow for exceptions for anyone with medical reasons for being unable to fast.

If you decide to fast:
- consult with your provider about which medications to take or to stop during your fast
- check your blood sugars more frequently
- keep a source of fast-acting carbohydrates handy, such as juice or glucose tablets, in case of a low
- if your blood sugar drops too low, break the fast

In the article, a teenager with type 1 diabetes offers the advice to follow the spirit of the fast by limiting intake to bland, sick-day type foods such as toast. By avoiding rich or sweet foods, she feels that she is able to participate in the meaning of the experience, without putting herself in danger. I think that sounds like a wonderful compromise.

I'd encourage you to check out the article at http://www.diabetesforecast.org/2014/10-oct/safe-fasting-with-diabetes.html.

If you have any advice or experiences to share, please do so in the comments section below!

Carb Counting the Cookout

Summer cookout season is starting, so I thought I would offer a few tips to help you count your carbs and keep your blood sugars on track all summer long, without missing any of the fun.

1. Remember Key Carb Exchanges

A few key 15 gram carb servings can be used to estimate the carb content of a wide variety of dishes. For example, knowing that 1/2 cup of potato is around 15g of carb might help you to estimate the carb content of a similar size portion of potato salad or fries. Here are a few more that I use all the time to help me "guesstimate": 

15 grams of carbs is: 

- 1/2 of a hamburger or hot dog bun

- 1/3 cup of pasta or rice

- 1/2 of a large corn-on-the-cob

- 1/2 cup of beans (but only 1/3 cup of baked beans with the sugary sauce!)

- 9-13 potato or tortilla chips

- 1 1/4 cups of watermelon cubes

- 1/2 cup of ice cream

2. Use Your Hands

When you can't use a measuring cup to check your portion size, try comparing what's on your plate to these visuals: 

your palm = 1/2 cup

your fist = 1 cup

your thumb = 1 tablespoon

your thumb tip = 1 teaspoon

3. Don't Forget to Count the Condiments...

1 tablespoon ketchup = 5g carb

1 tablespoon of barbeque sauce = 7g carb

4. ... And the Beverages

8 oz lemonade = 25g carb

1 can (12oz) soda/soft drink = 35g carb

5. Avoid The "Fillers" 

Social gatherings and special seasonal foods are important to all of us, and you don't want to miss Aunt So-and-So's amazing famous dish. But at most of these events, there are many other foods you have all the time or that are just not that exciting. It's different for everyone - some people skip the boring white hamburger buns so they can have macaroni salad; others wait all year for that one taste of white bread. But be mindful and have a strategy - choose what you really love, savor it, and skip the rest. 

6. Contribute Something Healthy

I like to volunteer to bring something healthy and lower in carbs, so I know there will be something I can have a larger portion of that will be filling. Chances are, others will appreciate this too. Try bringing something like a green salad or a chopped salad with beans that will be filling, colorful, and healthy. 

Don't forget to have fun and enjoy the season!

VMG's Diabetes Services

Happy spring (finally!)!

Are you taking advantage of these VMG services to help you manage your diabetes? Confused about what these mean? We offer: 

Endocrinology:

To help you manage your diabetes, analyze your blood sugar levels and develop a regimen of lifestyle changes and medicines which are right for you.

Diabetes Education in an Individual or Group Setting:

To help you understand your diabetes and your treatment plan, including help with blood sugar monitoring, medications, insulin, and more. Focused on practical and personalized goal setting.

Nutrition Therapy:

One-on-one education, support, and goal setting. Incorporating all your medical and lifestyle needs into a practical and personalized plan.

Support Groups: 

We offer free support groups for both diabetes and weight loss, led by our diabetes educators and nutritionists! These are a great opportunity to connect with others in a fun, informal setting. These vary by center - check HERE for current dates/times. 

We also recommend taking advantage of these VMG services: 

Eye Care

Comprehensive eye examinations

Foot Care

Diabetes foot care from a podiatrist

Behavioral Health

Psychiatrists, psychologists, social workers and therapists to help you navigate the social and emotional stressors of managing diabetes

Physical Therapy

Physical therapists to help you prepare for increasing your physical activity and establishing a program of exercise for you to complete independently 

Questions or feedback - our contact information is listed in the "meet our educators" tab - please let us know how we can help you!

National Nutrition Month: Wrap-Up

Thanks to all who participated in our National Nutrition Month activities! We had four prize winners in all four centers, and 4 UMass students who volunteered their time to staff our tables and offer healthy creative food samples and recipes. It was a great month!

Before we get too far away from March I wanted to share some info about one more awesome phytochemical with you - LUTEIN!

Lutein is a type of phytochemical called a carotenoid. It concentrates in the macula of the eye, and research shows it can actually prevent or slow macular degeneration! Macular degeneration is a leading cause of blindness in the elderly. 

Lutein's antioxidant power can also help reduce the risk of heart disease and certain types of cancer. 

Fill up on these (mostly green leafy) vegetables to get your lutein and protect your eyes: 

collard greens
kale
spinach
broccoli
Brussels sprouts
lettuces
artichokes

For more information, recipes, and more visit: http://www.fruitsandveggiesmorematters.org/

Recipe: Cauliflower Rice!

This week's recipe comes from Margie Sobil - she made this last week with her Diabetes Support Group and they enjoyed it both ways!

Cauliflower Rice

This makes a wonderful side dish on its own, or could be used any way you'd use rice. For example, I have served stew, chili, or saucy curry over a spoonful of this "rice", and I have used it in stuffed peppers or cabbage rolls as part of the filling instead of rice. 

This helps to make your meal lower in total carbohydrates, even if you have a big heaping spoonful (or two). It adds a lot of fiber and volume, without a lot of calories.

Ingredients: 
1 head raw cauliflower
1 yellow onion
olive oil 
salt, pepper, garlic, herbs or spices to taste

Chop the cauliflower in a food processor until it is approximately the size and texture of rice:

Dice the onion. Saute onion in a pan with olive oil for a few minutes, then add the cauliflower "rice" to the pan. Saute until slightly softened. Flavor to taste. 

In the support group we tried making it two ways. One recipe used salt, pepper and garlic powder. The other used about a tsp of curry powder. You could invent many more ways to use this versatile dish - share in the comments section if you come up with any more yummy variations!!

National Nutrition Month Update: Week 1

If you forgot to fill out our National Nutrition Month quiz this week, don't forget you have 3 more weeks to enter the drawing for a prize!! The display is in or near the waiting room of all 4 VMG centers this whole month.

Our theme this year is Health Benefits of Fruits and Veggies. Nutrition is about a lot more than calories and weight loss.

Here were some of the highlights of this week's quiz:

Resveratrol:

Resveratrol is an antioxidant found in red wine. It is a type of phytochemical called a polyphenol. Some people attribute the health benefits of the Mediterranean Diet to this compound. In studies, resveratrol has been shown to be anti-inflammatory, and may help lower the risk of heart disease, cancer, and asthma!

Food sources: red wine, peanuts, grape skin and grape juice



Quercetin: 

Quercetin is the main flavonoid in most of our diets - it lowers the risk of asthma, heart disease, and lung cancer!

Food sources: onions, apples, broccoli, cranberries, and grapes



Anthocyanidins:

Anthocyanidins are antioxidants found in blue/purple and red fruits and vegetables that improve blood vessel health!

Food sources: blueberries, blackberries, plums, cranberries, raspberries, red onions, red potatoes, radishes, strawberries

Of course, it's not important that you remember these names and categories. The point is that a wide variety of compounds are found in fruits and vegetables that have wide-ranging benefits on health and longevity! And there are different types in all the different colors of produce, so when you are planning your meals, see how many different colors you can include! That will go a long way toward improving and protecting your health.


This info is thanks to: www.pbhfoundation.org. For more information, check out their website!

March is National Nutrition Month!

In keeping with our various wellness initiatives throughout the year at VMG, we hope you’ll join us by participating in our National Nutrition Month event. This year the National Nutrition Month theme is:  “Bite Into a Healthy Lifestyle.”

At Valley Medical, we are focusing our NNM theme on the “Health Benefits of Eating Fruits and Vegetables”.

Watch for the display table in the lobby of each health center. Both VMG staff and patients are invited to participate. There will be a new quiz and a new prize each week in all 4 centers! 

Quiz topics will focus on recognizing the antioxidants in various fruits and vegetables, and the specific health benefits to us when we eat foods that contain these antioxidants.


New this year: we have 4 students from the Nutrition Department at UMass who will be volunteering in each center once during the month, and offering taste testing and information to staff and patients. We will let you know when they will be here, so you can drop by and say hello.

We hope you will find the time to participate! Enjoy and good luck!

Warning about Supplements

A new study on supplements has revealed that 4 out of 5 supplements sold at stores like Walmart, Target, or GNC contained none of the herb listed on the label. Can you believe that? NONE. 

We already knew that supplements are not as carefully regulated as prescription drugs and are not tested for efficacy by the FDA. 

But most of these supplements contained mainly fillers like rice and houseplants!!

Read full articles describing the study: here and here.

Hopefully this will help improve supplement regulation - but in the meantime, maybe just stay out of the supplement aisle altogether!

Bottom line: don't waste your money, and don't risk your health. 

Update from the Diabetes Support Group

Hi all! Today Margie Sobil, our nutritionist in Greenfield, has an update about the Diabetes Support Group. Also below - a quick easy alternative to sugary grocery store fruit-flavored yogurts!

The diabetes support group is in its 3rd year now! We continue to combine a mixture of activities at the meetings:

•          member sharing and support
•           Tips, skills building and new ideas
•           Recipes and food demos

At some of our recent meetings, we all got a chance to practice a variety of chair exercises thanks to Ann Marie (great for many of us who feel confined to home during this time of year of being snow-bound) and we looked at the Diabetes Blog on the Valley Medical Group website- where we got to see our favorite VMG volunteer (from our support group)- Ann Marie.

 Some comments from participants about the group: 

“What I like about this group is the sharing of ideas and having a place to talk about what is working, and the challenges.  I get help for myself, and sometimes it just feels good to offer some  ideas and help someone else.” 

“I like the food samplings and new recipe ideas- it helps me to know I can expand my food options and know that I am eating something that is healthy for me without overdoing the carbs”

AND, we have been learning creative/tasty tips for lower carb food items  that are simple to prepare. 
Zucchini and summer squash spaghetti spirals,  sautéed and combined with whole wheat pasta, to create a low carb spaghetti that everyone loved.  We also learned that 2 oz dry pasta on the box (40-45 grams of carbs) is about 1 cup cooked- something everyone had to admit has always been a mystery to figure out.

But today I want to share this easy way to make a healthy alternative to grocery store fruit-flavored yogurts. After looking at a variety of yogurt containers, we learned that there are only about 6-7 grams of carbs in a container of plain yogurt.  Many people in the group eat flavored Greek yogurt- the “light” Greek style yogurt has only about 9 grams of carbs, while the sweetened yogurt has about 20 grams.  Once we figured out the difference between sweetened yogurt (20 grams) and the plain (6 grams) = 12 grams, we learned that 12 grams sugar is equal to 3 teaspoons of added sugar.  

Instead try this, for almost 2x as much food as fruit flavored cups, without all the sugar: 

• 1 cup frozen berries (strawberries, blueberries and blackberries) thawed in microwaveable bowl
• Pulse with small blender or chopper
• mix berry mixture. 3/4 cup plain Greek style yogurt and 1 packet stevia or Splenda. 
• Mix and enjoy. 
• Carb count: approx 20 grams carbs

At 22 grams of carbs (minus a few grams of fiber from the fruit)- we got a serving of yogurt and real fruit for roughly the same amount of carbs as a sugar sweetened yogurt.  Not only that- but everyone, even the most skeptical members of the group- had to admit that it was DELICIOUS!!!!

So, if you haven’t been to the group for a while, or if you would like to give it a try- come any month- 2^nd Tuesday.  Our next meeting is Tuesday March 10, 5:30-7:00 p.m.  Feel free to call Margie with any questions at (413) 992-7392.

Guest Post: Are You Ready For an Emergency?

After yesterday's storm, Dr. Stuart Chipkin has a few reminders for you all about being prepared for an emergency. Thanks Dr. Chipkin!

Whenever the snow starts falling or the electricity fails, I can count on several phone calls from patients who “all of a sudden” realize they don’t have glucose test strips or other supplies to help with their diabetes.  It’s completely understandable- we all think “Oh, I’ll run out and get those tomorrow”, or “the weather will only be bad for a day or so- I won’t have a problem”.  But any weather that can limit your ability to travel or suddenly put you without electricity can “snowball” (OK- maybe I intended that pun) into a much bigger problem. 

And I recommend all patients have a Medical ID (bracelet, necklace, even a tattoo!) in case they are unable to respond when initially found (again, independent of weather- could be in a car accident or brought into an Emergency room).

Listed below are some things you should think about to make sure that you are prepared for having diabetes during severe weather:

•  A week’s worth of medication
• Glucose tablets or gel if you are at any risk for having low blood sugars.  If you have had reactions without symptoms, you should find out about having a Glucagon emergency kit as long as someone at home will learn how to use it.
• For those on an insulin pump- have extra supplies including:
• Cartridges, infusion sets, prep wipes and batteries
• Extra sensors (if appropriate) and chargers
• Non-pump insulin options (see #4) in case of a pump failure;
• If you are on insulin injections, make sure and have enough:
• Insulin pens and pen needles OR insulin vials and syringes- both short and long acting
• Extra alcohol wipes;
• Consider having something in which to discard insulin syringes, needles and lancets (e.g., an empty hard plastic detergent bottle with cap)
• Glucose measurement supplies including:
• Extra meter
•  Lancet device and lancets
• Alcohol wipes
• Test strips and batteries
• For patients with type 1 diabetes, I encourage you to have urine ketone test strips (independent of bad weather)-  these are good to have if you have several high blood sugars to see if you are getting to the point that you need to consider going to the Emergency room;
• Other general information to have:
• Copy of your recent medical records including current medications and doses

You should think about having something to put all these things in- a container (maybe even waterproof) that may also have a place for a cold pack for insulin.

For more information, visit either:

http://www.diabetesforecast.org/2012/aug/how-to-stockpile-for-emergencies.html

http://www.nj.gov/health/fhs/documents/diabetes_disaster_guidelines.pdf

Guest Post: A Reluctant Diabetic

Hi everybody! Today I am thrilled to share a story from a VMG patient. Anne Marie Meltzer has been an amazing volunteer for our diabetes program, including helping with diabetes support groups at our GHC office. Thanks, Anne Marie!!

Annual Physical February 2012.  I complained of tingling and numbness in my fingers, toes and nose.  I thought it was due to weakness resulting from a small stroke I had in 2009.  I also gained 25 pounds but thought that was also due to the stroke and inactivity.  My MD, Ross Midler, decided to do and A1C to rule out Diabetes.  It came back high – Type II Diabetes. I was put on a 500mg of Metformin.

This hit me hard, as it was not expected.  When I was young, I lost a friend to kidney failure resulting from Diabetes and I knew this disease as a killer.  I withdrew into a deep sadness.  When my MD recommended Diabetes Education, I rolled my eyes and reluctantly attended the sessions.  I am highly independent and I don’t like to be told how to live my life.  I got angry and decided to take control – I wasn’t going to let this disease take away my life. 

How I eat is a challenge. I adjusted the regimen of carbs to even out my food intake over six small meals a day.  I keep low carb snacks in my car and purse, and I have learned to order wisely in restaurants.

I cook my foods from scratch, sometimes including bread, and eat no processed foods because I am allergic to a preservative used in pre-made food.  Under these circumstances, counting carbohydrates can be difficult. I also have intermittent attacks of Gastroparesis, my stomach does not empty and bloats. I change what I eat when this flares up - low residue foods, liquids, and very little or no fiber.  The two diets are not compatible and my blood glucose fluctuates.

I began to exercise again and trained to be certified to teach strength and balance classes to older people.  This keeps me in shape – I cannot say that I am too tired to exercise because I am teaching the classes.

My A1C now remains between 6.1 and 6.5 and I have lost 22 pounds.  I have learned to listen to what my body is telling me, although I admit I sometimes cheat.