Diabetes e-Newsletter
Issue 2: April 2010

Spring into Action!

Shake out your rugs and dust off those cobwebs. It’s springtime and that means it’s time for renewal! Take a look around your home – are your cupboards filled with junk food? Is your medicine cabinet stocked with expired supplies? Spring cleaning does not have to apply only to your household chores. This e-news issue is dedicated to providing you with ideas to refresh your lifestyle, environment, and attitude as we spring into action for springtime!

Best of health!
Your St. Anthony's Medical Center Diabetes Education Team

Hot Topic: Two New Medications Enter the Diabetes Market

Two medications recently were approved by the FDA (Food and Drug Administration) to treat diabetes: Onglyza, a DPP4 inhibitor, and Victoza, a GLP-1 receptor agonist. Both medications are the second in their respective classes.

Onglyza (saxagliptin), from Bristol-Myers Squibb, was approved in July 2009 and belongs to the class of medications called DPP4 inhibitors. DPP4 inhibitors work by increasing the levels of natural hormones in the body called incretins. Incretins decrease the blood sugars by increasing utilization of sugar by the body, mainly through increasing insulin production in the pancreas and by reducing the production of sugar by the liver. Onglyza is used along with diet and exercise to control high blood sugar in adults with type 2 diabetes. To learn more, visit www.onglyza.com.

Victoza (liraglutide), from NovoNordisk, is a glucagon-like peptide (GLP-1) receptor agonist approved in January 2010. It is indicated as an addition to diet and exercise to improve glycemic control in adults with type 2 diabetes. It is an injectable, taken once daily with a pre-filled pen. Victoza works to stimulate the release of insulin from the pancreas when blood glucose levels are elevated, while suppressing meal time production of sugar by the liver. The mechanism of blood glucose lowering also involves a delay in gastric emptying, which increases the feeling of fullness with meals leading to decreased food consumption and weight loss. To learn more, visit www.victoza.com.

Talk to your doctor to see if either medication may be right for you.

Ask the Diabetes Educator:

Spring clean your medicine cabinet

Question: What’s the right way to dispose of expired medications?

Answer: Medications – prescribed, over-the-counter, and/or herbs and supplements – can play an important role in treating certain conditions or diseases. However, medications and testing supplies cannot be thrown out like everyday garbage: they must be taken with care and disposed of safely.

Unused portions of medications must be disposed of properly to avoid harm to people, pets, and the water supply. Most should not be flushed down the toilet. Make sure to follow specific disposal instructions on the drug label or product insert. If no disposal instructions are given, follow these steps:

Take tablets, pills, and/or capsules out of their original containers and place in a sealable plastic bag.

• Add liquid medications to the bag.
• Add a small amount of water.
• Mix with an undesirable substance such as used coffee grounds, sawdust, or cat litter.
• Place the sealed plastic bag in the regular household trash container.
• Destroy any personal information printed on labels before tossing your medication containers.

You can also find these guidelines at www.whitehousedrugpolicy.gov >publications>letter P>Proper Disposal of Prescription Drugs. You can watch a short demonstration video at www.smarxtdisposal.net.

Some medications or medical supplies are not as effective after a certain amount of time, even if the expiration date has not yet occurred. Be aware of expiration dates printed on the manufacturer’s labels. Tubes of creams or ointments usually have it stamped on the crimped edge.

Certain brands of glucose test strips may not give an accurate reading if opened for more than 90 days. The expiration date printed on the test strip label is valid only if never opened. When you open a container of strips, use a permanent marker to write the date on the label so you’ll know how much time has passed. Insulin products also have time limitations ranging from 14 to 42 days, depending on the particular type of insulin and if dispensed in a pen device or vial.

If you have additional questions, the instructions inside the product packaging or your pharmacist can give you storage information for medications and supplies. Safety is key to helping you stay healthy!

Please send us your diabetes question! If your question is selected, we will send you a gift! 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 May 1, 2010.

Eat This Instead

Spring clean your pantry

March was National Nutrition Month, an entire month dedicated to recognizing the importance of good nutrition. This year’s theme was “Nutrition from the Ground Up,” and focused on getting back to the basics of healthy eating by choosing a variety of basic, nutrient-rich foods. What better time than springtime to get started refreshing your diet? To simplify healthy eating, give your pantry and fridge a spring cleaning.

Start by taking inventory. It is not necessary to throw food away (unless it is expired), but you should try to whittle away less healthy choices and replace them with healthier options the next time you grocery shop. Meal time is a lot easier when you have basic ingredients on hand at all times. Basics include whole grains, fresh and frozen fruits and vegetables, low-fat or fat-free dairy products, lean meats, fish, dried beans and nuts. Read on to find tips for making healthy replacements in your household.

Try stocking your pantry and fridge with…

• Whole wheat pasta and brown rice instead of “white” pasta and rice
  Whole grains are healthier than refined grains because they contain more fiber, protein, vitamins and minerals.
• Whole grain cereal instead of sugar-sweetened cereals
  Even if whole grain cereals have more calories and carbohydrates, they pack more nutrition. Look at the ingredients list on the package and make sure that the first ingredient is “whole.”
• Whole grain crackers instead of snack chips
  Chips tend to be high in fat and lacking in fiber that is found in whole grains.
• Frozen vegetables instead of canned vegetables
  Canned vegetables contain loads of sodium, which is not found in fresh or plain, frozen vegetables.
• Fruits that are fresh, frozen, or canned in juice instead of fruits canned in syrup
  Added sugars, like those found in syrup, are a source of “empty calories” (calories without nutrition).
• Fat-free (skim) milk instead of soda
  Soda is a source of only sugar and calories, while milk provides calcium, vitamin D, and protein in addition to calories.
• Fat-free yogurt or pudding instead of ice cream
  Fat-free dairy products are healthier alternatives because they contain no saturated fat, which raises cholesterol.
• Lean cuts of meat and fish instead of higher-fat cuts of meat
  Leaner meats like chicken, turkey, fish, beef sirloin, and pork tenderloin contain less saturated fat and calories. That’s good for the waistline and cholesterol levels.
• Dried beans and lentils instead of meat
  Try to incorporate beans as a meat-substitute a couple times per week. They are an excellent protein source without the fat found in meats.
• Low-fat cheese instead of regular cheese
  Cheeses are high in saturated fat, but those labeled “light” or “made with 2% milk” have been reduced in fat. Make sure to still be mindful of portion size.
• Olive oil instead of butter
  Olive oil contains unsaturated fats, the kind that can lower cholesterol, while butter contains saturated fat.
• Raw nuts or natural peanut butter instead of salted or sugar-coated nuts
  These healthy sources of fat make filling additions to meals and snacks. Just remember, a little goes a long way.

The key to good nutrition is building from the ground up by focusing on the basics. Change does not have to be dramatic to make a difference, so start slowly and give yourself a good foundation to build upon. Make an appointment with your registered dietitian if you need help with meal planning.

To learn more about National Nutrition Month, click here.

Cook's Corner

Judy’s Texas Caviar

Here’s a simple recipe that uses basic ingredients from your pantry. This quick and healthy dish can be served as a fresh appetizer or side perfect for springtime picnics outside.

Ingredients:
15 ounce can great northern beans, drained and rinsed
15 ounce can pinto beans, drained and rinsed
15 ounce can black eyed peas, drained and rinsed
15 ounce can black beans, drained and rinsed
15 ounce can corn, drained and rinsed (or 2 cups frozen corn, thawed)
1 large green bell pepper, chopped
1 large red bell pepper, chopped
1 large sweet onion, chopped
¾ cup apple cider vinegar
1 cup Splenda Granulated ®
½ cup canola oil

Instructions:
Combine beans, peppers and onions in a large bowl. In a small bowl, whisk together vinegar, Splenda, and oil. Pour over bean mixture. Cover and refrigerate for at least one hour. Makes about 13 cups. May be served with tortilla or corn chips or eaten as a side dish.

Make it even healthier:
Purchase lower sodium canned beans. A typical can of beans has about 450 mg of sodium per serving, with three to four servings per container. Canned beans labeled “low-sodium” or some that are organic have less than 100 mg sodium per serving. Quite a difference! Eating a diet that is low in sodium helps to control blood pressure.

Nutrition information (per ¼ cup)
Calories 52
Total Fat 2g
Saturated Fat 0g
Trans Fat 0g
Sodium Varies depending on brand of canned goods
Carbohydrate 7g
Fiber 2g
Protein 2g

Recommended Resources

Diabetes magazines

Are you looking for support, inspiration, motivation, updates on diabetes research, or meal ideas and recipes? There are several high quality consumer magazines for people with diabetes.

A one-year American Diabetes Association membership for $28 includes 12 issues to Diabetes Forecast. This longtime favorite includes articles on the latest scientific research, new technology, recipes, and more. Other benefits of membership include a network of diabetes support and information, notification of upcoming community events, research news, annual resource guide for diabetes supplies, and more. Go to www.diabetes.org and click “Join ADA” for more information (or call 800-806-7801). Go to www.forecast.diabetes.org for more information on the magazine. A free trial issue is offered!

Diabetes Self-Management is published bimonthly and features departments such as “What Your Doctor is Reading,” “Supermarket Smarts,” and “Diabetes Resources.” Visit www.diabetesselfmanagement.com or call 800-234-0923 to subscribe. Save 50% if you subscribe via the Internet!

Diabetes Health is published bimonthly and contains a wide variety of topics. A recent issue highlighted Kris Freeman (a member of the United States cross country team), an update on the development of an oral insulin spray called Oral-lyn, and gastric banding, a type of weight loss surgery done as an outpatient procedure. Visit www.diabeteshealth.com for more information or call customer service at 415-883-1990.

Diabetic Cooking is published bimonthly and features a wide variety of tasty, carb-friendly recipes, along with pertinent nutrition articles and healthy eating tips. Ask us for a coupon for a free trial issue! Visit www.diabeticcooking.com or call 800-777-5582 to subscribe.

To obtain a past sample issue of any of these publications, please contact Mary Lawrence at mary.lawrence@samcstl.org.

Upcoming Opportunities

Spring is here, and it’s time to get out of the house again!  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 Diabetes Management Guideline recommends annual follow-up for best diabetes care.

Featured Opportunities:

Target: Take Aim for Your Best Control – “Refresher” class
This class is intended for those who have had previous diabetes education, but need to brush up on skills or get re-motivated.  The class includes a review of diabetes management, recognizing carbohydrates in the meal plan, detecting blood sugar patterns, and more!  April 16 from 1-3 p.m.  Call 314-525-4508 and press option 2 for more information and to register.

May 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."  May 10 and 12 from 4-6 p.m. (you attend both sessions).  Call 314-ANTHONY (268-4669) to register.  Cost is $25.

May Support Group: Dining out in South County
Please join us as we discuss ways to make your local dining experience healthier – featuring menus and special offers from restaurants right here in our neighborhood!  May 20 at 7 p.m.  Call 314-ANTHONY (268-4669) to register.  Meetings are free to the public and held in the conference room/dining room at the Hyland Education & Training Center.

Click here for information on other educational opportunities offered by the Diabetes Education Program.

Our patients' comments

“I no longer test positive for a high glucose after meals nor does any glucose show up in my urine. I believe by altering my diet and increasing exercise I have come out of the diabetes threat [of complications].”

“The staff at Diabetes Education was extremely professional. They explained diabetes thoroughly and answered all my questions completely. Thank you - I am not as scared anymore.”

“My physician is not at SAMC, but I am going to highly recommend he refer patients to the program. I wish I had gone through these classes a lot earlier.”

Contact us

phone: 314.525.4508    fax: 314.525.4260
e-newsletter editor: elizabeth.glantz@samcstl.org