Diabetes e-Newsletter
Issue 1: January 2010
A New Year, A New You!
Welcome!
What’s at the top of your “New Year’s Resolution” list? A few goals we hear most often are “to lose weight,” “to eat healthier,” and “to gain control of my blood sugar.” With that in mind, we thought we would add a new approach to our certified education and support program…an e-newsletter! This first issue is just the beginning of a quarterly newsletter to help you keep in touch with trends in diabetes management and with our program. You’ll see the same sections each issue, with different topics each time. We hope you enjoy and we’d love to hear your feedback!
Best of health!
Your St. Anthony's Medical Center Diabetes Education Team
Send feedback to elizabeth.glantz@samcstl.org, please title your email "e-news feedback."
Hot Topic: Estimated Average Glucose (eAG)
What is it?
Estimated average glucose, or eAG, is a new way to report your A1C. eAG tells you the average level of glucose (sugar) in your blood over the last two to three months, just like the A1C. A1C is reported as a percent (for example, 7%) and gives you a way to evaluate your overall glucose control.
Now we have a new way to report A1C, called eAG, that uses the same units you see on your meter (for example, 154 mg/dl). Just like A1C, eAG lets you know the average level of glucose in your blood over the last 2-3 months.
How is it calculated?
eAG = 28.7 x A1C – 46.7
How can you benefit?
A lower eAG means lower risk for future complications. eAG can help you to better understand your A1C level by showing you how close your blood glucose is to your goals on average. The American Diabetes Association recommends a goal A1C of less than 7%, or an eAG of less than 154, for most people. Try calculating your eAG. How close are you to this goal?
Click here for more information. If you have any questions about your eAG, contact your diabetes educator or dietitian.
Ask the Diabetes Educator
Question: Why is my blood glucose higher in the morning than when I went to bed if I haven't eaten all night?
Answer: There are many reasons that your blood glucose may be high when you haven’t eaten, especially in the morning. The most common cause is known as the “dawn phenomenon.” During the early morning hours, stress hormones are released that cause the liver to release glucose into the bloodstream to help you get up and get moving. In people with diabetes, the liver “dumps” too much sugar into the blood, inadequate insulin may be present, and muscle cells may be resistant to insulin – all causing morning blood glucose levels to rise beyond normal.
Blood glucose could also be high in the morning if your dose of insulin or pancreas-stimulating medications is too high at night; causing low blood glucose while you are asleep, then “rebound” high blood glucose the next morning as a result of glucose release from the liver. This is otherwise known as the Somogyi effect.
What can you do?
Try to meet carbohydrate goals at mealtime to help post-meal blood glucose stay on target. Exercise in the evening also can help to bring down post-meal glucose levels. You may try a bedtime snack (usually 15 grams of carbohydrate in addition to a lean protein or healthy fat is sufficient). Talk to your dietitian if you need additional help with meal planning or you may want to speak with your diabetes nurse educator or doctor about adjusting your medication doses or timing.
Please send us your diabetes question! If your question is selected, we will send you a diabetes cookbook! Your question, along with the expert's answer, will be published in our next newsletter. Please send your question to elizabeth.glantz@samcstl.org (please title your email "ask the expert") or Diabetes Education, Ask the Expert, 12700 Southfork Road, Suite 225, St. Louis, MO 63128. Deadline March 1, 2010.
Try eating this...not that
Snack foods
We’re all looking for healthy snacks that are quick, satisfying and easy to grab. Planning ahead with some of these healthier options will help you avoid the vending machine when you have a snack-attack.
Try eating…
- 12-15 baked potato chips, NOT regular potato chips
Baked chips give you the same crispy crunch and salty flavor without loads of fat and sodium.
- 3 cups of light popcorn, NOT salted pretzels
It’s not that pretzels are unhealthy, but they are a refined carbohydrate. Popcorn counts as a whole grain! And when it’s light, you lose a lot of the fat and sodium.
- One small piece of fruit, NOT fruit snacks
By eating a whole piece of fruit, you’re not adding any sugar, plus you get more fiber.
- ¼ cup unsweetened, dried fruit (like cranberries or raisins), NOT candy
Dried fruit is a concentrated version of the raw fruit – this means the sweetness is also concentrated and they’ll taste just like you’re eating candy!
- 6 ounces of plain non-fat or light yogurt, NOT ice cream
You’ll still get the creamy texture and sweetness, but far less fat (the saturated kind).
- 1 ounce (1/4 cup) of almonds or walnuts, NOT salted mixed nuts
Nuts are a fat with heart-healthy benefits. Almonds and walnuts are higher in mono- and polyunsaturated fats and are best without added salt. Just remember: a little goes a long way.
- 1 ounce of dark chocolate, NOT a candy bar
Candy bars can pack on over 200 calories and 15 grams of fat easily, not to mention upwards of 40 grams of carbohydrate! Satisfy your craving for chocolate with a small serving of antioxidant-packed dark chocolate instead.
- One no-sugar-added fudge pop, NOT a brownie
That gives you the same rich, chocolaty flavor with far fewer calories, fat, and carbs.
- 100-calorie pack, NOT cookies
A 100-calorie pack of cookies is still cookies, but at least the portion is controlled – plus, having so many in a package makes you feel like you really splurged!
- ½ English muffin with 1 tablespoon tomato sauce and 1 oz. reduced-fat mozzarella cheese, NOT frozen pizza bites
Frozen snack foods are usually high in fat, sodium, and calories and may even contain trans fats. Try this do-it-yourself option for a healthy way to enjoy pizza!
- ½ turkey sandwich on whole wheat bread, NOT a pepperoni pizza pocket-type sandwich
Turkey is a lean protein and whole wheat bread is high in fiber. Both of these nutrients will satisfy your hunger while keeping you sustained until the next meal.
- One cup of coffee with 1 tablespoon of flavored-liquid creamer, NOT a coffee shop latte
Some of your favorite coffee shop beverages can be equivalent in calories to five slices of bread (not to mention high in carbs). Who knew an afternoon pick-me-up could equal a whole meal?
And don’t forget your veggies! “More matters,” and they’re so low in carbohydrates that you probably won’t have to count them in your meal plan. Try 2 tablespoons of fat-free or low-fat dressing for dipping.
Drink plenty of water and sugar-free, calorie-free beverages. Often having an 8-ounce glass of water will curb hunger!
See the “Cooks Corner” for another healthy snack option.
Cook's Corner
Liz's Trail Mix
Trail mix can be a healthy snack option, but some versions can be high in fat and sodium. Liz’s version is a well-rounded, nutrient-packed recipe that includes healthy carbohydrates and fats that will help keep you energized and satisfied until your next meal.
Ingredients:
¼ cup raw walnut pieces, unsalted
¼ cup raw almonds (whole or slices), unsalted
¼ cup dried cranberries
1 cup Cheerios®, original
¾ cup Wheat Chex®
Instructions:
Measure all ingredients into medium-sized bowl. Stir gently until evenly mixed. Store in airtight container. Makes 5 servings of ½ cup each.
Easy snacking tip: Try measuring the serving size into individual snack bags before storing. Then when you’re ready to go, just grab a bag!
Nutrition information (per ½ cup)
Calories 145
Total Fat 8 g
Saturated Fat 0.5 g
Trans Fat 0 g
Cholesterol 0 mg
Sodium 108 mg
Total Carbohydrate 18 g
Dietary Fiber 3 g
Sugars 6 g
Protein 4 g
Vitamin A 5%
Vitamin C 8%
Calcium 6%
Iron 27%
Recommended Resources
dLife.com is an excellent resource for information and support for people with diabetes and their caregivers or families. It features sections on diabetes information and management, healthy eating (including loads of recipes), expert columns, a blog, and new community section. Information is accurate and is provided by dietitians, nurses, certified diabetes educators, and physicians. Share your stories, struggles and successes with more than 51,000 members of all ages, with all types of diabetes. And membership is FREE! Better yet, you can connect 24/7. Our favorite parts:
- Diabetic recipes. Try the recipe of the day, search, or browse by category or nutrient. There are hundreds of appetizing choices ranging from super simple to more complex to prepare. Traditional recipes are modified to fit healthy meal plans (lower in fat and sugar) while retaining the taste-factor. Nutrition analysis is done for you. You can even create your electronic recipe box by saving your favorite recipes.
- Newsletters and T.V. dLife Update and Foodstuff e-newsletters come to your email inbox while dLife Connect newsletter comes straight to your doorstep. dLife T.V. is a weekly television series, Sundays at 6 p.m. Central time on CNBC.
- Diabetes Community. A source for support and sharing through support forum and groups. You can create your own profile, post your picture, and share your story. Some fun support groups include: welcoming committee, recipe tasters, and book club.
- Food Look-Up. This is an extensive nutrition database where you can search for grocery food items and some fast food meals. Provides complete nutrition facts. Link through the “Diabetic Recipes” section.
Upcoming Opportunities
With a brand new year upon us, what better time to start working on improving your health and glucose control? We offer many opportunities to obtain the information and motivation you need to get going. If it’s been a while since you’ve seen us, we encourage you to join one of our “refresher” classes or come back for a follow-up visit. The Missouri Management Guideline recommends annual follow-up for best diabetes care.
Featured Opportunities:
Last minute sign up for February pre-diabetes class!
If you or someone you know has been diagnosed with pre-diabetes, told that your blood sugar is “a little high,” or are just interested in prevention, please join us for our newest class, “Small Steps to a Healthy Tomorrow: Preventing Type 2 Diabetes.” We still have room left in our February session: February 19 and 26 from 1–3 p.m. (you attend both sessions). Call 314-ANTHONY (268-4669) to register. Cost is $25.
“One potato, two potato, three potato, four” – a carbohydrate counting refresher class. Includes review of carbohydrate counting and meal planning in addition to advanced skills, such as dining out, adding variety, and handling holidays and parties.
Upcoming class: March 5 from 9–11 a.m. Call 314-525-4508 and press option 2 for more information or to register.
Click here for information on other educational opportunities offered by the Diabetes Education Program.
Our patients' comments
“I understand that through diet and exercise you can manage diabetes. My first A1C was 7.9% and I just had my A1C done [again] and I was shocked. It had dropped to 5.4% in three to four months. I learned a lot in the class. Thank you very much. Thanks for being there.”
Contact us
phone: 314.525.4508 fax: 314.525.4260
e-newsletter editor: elizabeth.glantz@samcstl.org
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