28 Jun Living Well with Diabetes Newsletter – June 2017
In the Summer Heat Stay Hydrated!
By: Director of education – Jessica Cook MS, RD, LD, CDE
Summer in South Florida usually means brutally high temperatures! High heat levels can not only lead to distorted blood sugar levels, but also dehydration. Staying hydrated is important for brain health, electrolyte balance, metabolism, blood sugar levels, but may also aid in weight loss, prevention of urinary tract infections, kidney stones and constipation. Here are some tips to stay hydrated in the Summer heat:
1. Drink 8-16oz. of water when you first wake up. Most people are slightly dehydrated in the morning due to lack of fluids for the past 6-10hrs.
2. Drink 8-16oz. plain water before each meal, which may aid in helping you feel full and lose weight.
3. Add fruit to your water such as lemon, orange or lime slices to add flavor. Or try soaking 1 cup of strawberries or melon in a 64oz. container of water overnight. Discard the fruit in the morning and you have naturally flavored fruit water.
4. Avoid beverages with added sugars such as Gatorade, lemonade, sweet tea, sweetened coffee drinks or milk, which may elevate blood sugar levels leaving you more dehydrated.
5. If you’re not a water fan, try sparkling waters that lack artificial sweeteners and sodium such as Lacroix. Artificial sweeteners may be damaging to kidney health, so limit or reduce your use gradually and eventually switch to plain or sparkling water.
To learn more about diabetes, health and weight loss call 561-659- 6336 ext 8012 to schedule an appointment with a certified diabetes educator today. Please enjoy our June 2017 Living Well with Diabetes Newsletter.
Glucagon–like peptide-1 (GLP-1) receptor agonists
By: Paul Casanova-Romero, M.D., M.P.H., F.A.C.P., F.A.C.E., E.N.C.U.
The prevalence of type 2 diabetes is increasing at an astounding rate. While all agents in the diabetes armamentarium provide patients the benefit of glucose reduction, numerous options, have undesirable effects, which include weight gain and hypoglycemia, potentially limiting their overall. Additionally, the therapeutic longevity of some agents, may be shortened due to their mechanism of action of enhancing insulin secretion, and the natural beta cell (cells that produce your insulin) burnout that ensues in long standing type 2 diabetes. Glucagon-like peptide-1 (GLP-1) receptor agonists represent a unique approach to the treatment of diabetes, with benefits extending outside glucose control, including positive effects on weight, blood pressure, cholesterol levels, and beta cell function. They mimic the effects of the hormone GLP-1, which is released from the intestine in response to food intake.
How are they given?
Given as an injection into the fat under your skin.
How do they work?
Their effects include increasing insulin secretion, decreasing glucagon release, increasing satiety, and slowing gastric emptying. Help your pancreas to make more insulin: insulin helps to lower blood glucose. Lower the amount of glucose made by your liver. Help to slow down the breakdown of your food: this slows down increases in blood glucose.
What are the benefits?
Modest weight loss. May make you feel less hungry and more full. There is a low risk of hypoglycemia (blood glucose that is too low) with GLP-1 receptor agonists. Hypoglycemia can cause tiredness, weakness, nervousness, shakiness, confusion, fast heartbeat, problems with vision, and fainting or seizures GLP-1 receptor agonists are available in a variety of forms, including twice-daily injections, once-daily injections, and once-weekly injections. There are currently four approved GLP-1 receptor agonists in the United States: exenatide, liraglutide, albiglutide, and dulaglutide. A fifth agent, lixisenatide, is available in combination with insulin glargine.
What are the side effects?
Most common: diarrhea, nausea, itching at the injection site, vomiting, headache, indigestion and constipation. Also possible: thyroid tumors, including cancer, were seen in rats and mice in studies during the medication testing process, inflammation of the pancreas (acute pancreatitis), hypoglycemia if taken with a sulfonylurea or insulin, kidney problems (renal impairment) and allergic reactions.
Overall, these are effective agents for patients with type 2 diabetes, who are either uncontrolled on metformin or intolerant to metformin. GLP-1 receptor agonists are effective agents for the treatment of type 2 diabetes, offering many advantages over other agents, including weight loss, potential beta cell protection, and low risks of hypoglycemia.
The New MiniMed 670G Hybrid Closed Loop Insulin Pump
By: Ines Cobo RN, CDE
Medtronic has launched the first Hybrid Closed Loop Insulin Pump. This closed loop therapy uses an automated dosing algorithm (pattern) that determines how much insulin to give as micro-doses that can be delivered as often as every 5 minutes. These automated micro-doses replace basal insulin delivery and target sensor glucose values to 120 mg/dl which is preset in the system, with the ability to be set at a temporary target of 150 mg/dl by the user. These micro-doses delivered in Auto Mode are referred to as Auto Basal (continuous insulin drip.) In addition, the system requires the patient to use the bolus (insulin taken at meals) feature to enter grams of carbohydrate and finger stick blood glucose values before meals. When the system is in Auto Mode, the Algorithm is controlling the delivery of basal insulin. When the algorithm determines that sensor glucose levels are not responding as expected or when the system’s safety delivery limits have been reached, the user will be alerted that they are no longer in Auto Mode. At this point, the pump will default to Manual Mode, delivering the patient’s pre- programmed basal rates. The goal of the hybrid closed loop therapy is to keep the user in Auto Mode as much of the time as possible. When the system exits Auto Mode for any reason, the therapeutic goal is to resolve the issue and resume Auto Mode as quickly as possible, so that the person can spend more time in desirable blood glucose ranges.
If you have questions regarding the 670G MiniMed Hybrid Closed Loop Insulin Pump talk to your endocrinologist at your next visit or speak with a certified diabetes educator at 561-659- 6336 ext 8012.
Want to Slim Down and Gain Energy thisSummer?
Then come to Our Living Well with Diabetes 1,2,3 Program!
Learn foods to help you lose weight, balance blood sugars, gain energy and how to eat out without adding extra pounds!
Now at 3 Convenient Locations!
Tuesday July 11 th 10am-12pm
Temple Israel 1901 N. Flagler Drive
West Palm Beach, FL 33401
Wednesday July 12 th 5:30-7:30pm
550 Heritage Drive, Suite 150
Jupiter FL, 33458
Wednesday July 19th 10am-12pm
Brookdale 8220 Jog Rd.
Boynton Beach, FL 33472
Will provide Healthy Snacks!
**May bring one guest free of charge!
If interested attending this program please contact our scheduling department at (561) 659-6336 Extension 8001 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) 659-6336 ext. 8012. We would love to hear from you!