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Living Well with Diabetes Newsletter – March 2017

31 Mar Living Well with Diabetes Newsletter – March 2017

National Nutrition Month!

By: Director of education – Jessica Cook MS, RD, LD, CDE

March is national nutrition month, so you may have seen many registered dietitians promoting their services to help you get your nutrition in check. Registered dietitians may help you with weight loss goals, meal planning, carbohydrate counting, learning ways to manage your blood sugar through food or helping navigate food allergies. Registered dietitians can also help educate you on calorie, sodium, fat, protein and carbohydrate requirements while teaching heart healthy or diets specifically for kidney disease. Dietitians can help manage disease through choosing healthy food items, supplements and aid in losing weight.

Currently at Palm Beach Diabetes and Endocrine Specialists we have a team of certified diabetes educators and registered dietitians that can help you achieve your goals. Call 561-659-6336 ext 8012 to schedule an appointment today.

Pease enjoy our March 2017 Living Well with Diabetes Newsletter.

Progression of Type 2 Diabetes

By: Kort Knudson, M.D., F.A.C.E.

Type 2 diabetes is still in a somewhat mysterious condition. We do not know exactly what happens to the beta cells in the pancreas that make them less able to make insulin. On the other hand, extensive research has given us a much better understanding about how diabetes develops and progresses. There is a defect in the beta cell which causes it to produce less insulin. This defect appears to be genetic so we look for other members of the family who have diabetes. Twenty percent of the time, the defect appears to be a new mutation that occurs for the first time in the individual who develops diabetes. It does appear that stressing the pancreas brings out this tendency to develop diabetes.

Most people who develop diabetes have some insulin resistance. This is usually related to a sedentary lifestyle and obesity. There is a demand for large amounts of insulin to keep the blood sugar normal. In patients who are susceptible, this can lead to diabetes. In our modern Western culture with more obesity and less exercise we are seeing diabetes develop more frequently and at younger ages.

The first defect that can be detected is usually insulin resistance, which tends to remain constant throughout the person’s life. The second defect that can be detected is progressive loss of the ability to make insulin. This is probably, as mentioned earlier, due to a genetic defect in the beta cell. It can be detected about 10 years before the onset of diabetes. There is approximately 4% per year loss of the ability to make insulin. This is usually manifested initially by loss of “first phase” of insulin secretion. The spike of insulin that occurs as soon as somebody eats is blunted, so that the sugar after a meal may be higher than normal.

After about 10 years of progressive loss of insulin we start seeing the blood sugars remain elevated throughout the day. This occurs when there has been approximately 50% loss of insulin production capacity. The A1c rises to 6.5% and this is when we diagnose diabetes.

The insulin producing capacity of the beta cell continues to decline by an average of 4 percent per year. In some people the decline is more gradual and in others it is much more rapid. The net result of these changes is that type 2 diabetes tends to be progressive. Each person has a different balance between insulin resistance and insulin producing capacity. By 6 years after developing diabetes many people aren’t able to produce adequate insulin to control their blood sugars with only oral medications and may need to use insulin injections.

Treatment of type 2 diabetes reflects the balance in the individual person of insulin resistance and insulin deficiency. It is always useful to start treating high blood sugars with lifestyle changes. A diet that promotes weight loss and has reduced carbohydrates can be very effective at all stages of diabetes. Exercise even in small amounts can have a large effect on insulin resistance.

The medications that are used for diabetes effect insulin resistance or insulin secretion ability or sugar absorption from the intestines. We usually start with 1 or 2 medications that have complementary effects and then may need to add a third or fourth type of medication and eventually add insulin. The average person with type 2 diabetes uses 3 or 4 different classes of medications.

The consequences of diabetes out of control can be severe, however the good news is that almost everyone can be well controlled with an appropriate combination of lifestyle changes and medications. The treatment of hyperglycemia will change as the diabetes progresses. The goal is to keep the blood sugars normal over the years even as we adjust the medications periodically.


Benefits of Plant Based Diets For Treating Diabetes

By: Jessica Cook MS, RD, LD, CDE

There are many methods to treat diabetes such as exercise, medications, weight loss, but also diet plays a major role in blood sugar management. There are many diets that can be used to treat diabetes such as the paleo diet, south beach diet, low carb diets, atkins, etc., but some of the most effective diets to help lower blood glucose levels are plant based diets. Plant based diets are diets that eliminate meat meaning beef, chicken, turkey, pork and any items made with meat such as gravies, soups, bacon seasoned items, any food made with lard, etc. There are different types of plant based diets such as vegetarian or vegan.

Vegetarian diets may include fish, eggs or dairy products while eliminating meat, while vegan diets eliminate any food item made from an animal, including honey, and any item made with eggs or dairy products. While many cultures used plant based diets, most people know these benefits from The China-Oxford-Cornell Study on Dietary, Lifestyle and Disease Mortality Characteristics in 65 Rural Chinese Counties as known as “The ChinaStudy.” This study examined mortality rates from chronic diseases as well as 48 forms of cancer from 367 different variables in 65 counties in China, and correlated them with dietary surveys and blood work from 6,500 people from western countries. It concluded that countries with a high consumption of animal-based foods and processed refined carbohydrate foods were more likely to have higher death rates from various types of cancer and chronic diseases such as cardiovascular disease as well as diabetes, while the opposite was true for countries that ate more plant foods.

In addition, Long-term cohort studies indicate that whole-grain consumption reduces the risk of both type 2 diabetes and heart disease. Nuts, high fiber foods such as oats, seeds, barely and soy products in a vegetarian diet can reduce serum lipid levels and post prandial blood glucose levels. These plant food components may have a very significant impact on cardiovascular disease, one of the major complications of diabetes. Substituting soy or other vegetable proteins for animal protein may also reduce the risk of developing kidney disease in type 2 diabetes. Diets that include carotenoids, which are found in colorful vegetables, provide protection from macular degeneration and a diet that includes lutein, a particular antioxidant found in spinach, provides protection from cataracts. Since people with diabetes have higher chances of retinopathy (eye disease) protecting your eyes with controlled blood sugars and nutrients may help prevent this development as well.

Lower rates of colorectal cancer are associated with the consumption of plants high in fiber, such as beans, leafy vegetables and whole grains. While higher rates of colorectal cancer are associated with processed meat such as salalmi, pepperoni, bologna, sausage, bacon, hot dogs, ribs, liverwurst, etc. Also, lower rates of breast cancer are seen in women who consume less animal products, specifically casein from dairy products.

Benefits of plant based diets include:

  •  Reduced cholesterol and saturated fat intake
  •  Reduced blood pressure
  •  Weight loss
  •  Reduced blood sugars
  •  Reduced inflammation
  •  Less hormone and antibiotic exposure due to eliminating animal products

Ways to increase plants in your diet:

  • Try Meatless Mondays!
  • Increase salad intake at meals
  • Make satisfying vegetable soups
  • Try making vegan protein smoothies with pea protein or brown rice protein powder, veggies, fruit and almond milk
  • Choose dairy free alternative cheeses, yogurt, etc. Such as Kite Hill, Silk,
  • Go Veggie, etc.
  • Replace crackers with veggies for your favorite dips such as hummus!
  • Look for meatless alternatives
  • Garden Products – Non GMO, Organic Soy
  • Tofu, seitan or Tempeh
  • Lentils or beans versus meat

And yes you can get protein in a plant based diet from:

  • Beans or Lentils
  • Quinoa
  • Tofu or Edamame
  • Tempeh or Seitan
  • Nuts and Seeds
  • Vegan protein powders
  • Vega One
  • Plant Fusion
  • Hemp protein powder, Brown Rice protein powder or Pea protein powder
  • Almond butter, Peanut butter or powdered peanut butter
  • Sunflower seed butter
  • Chia seeds, Hemp seeds or Flaxseeds
  • Steel cut oats or oats

It I important to have your doctor check you periodically or vitamin D, B-12, iron and anemia if choosing a vegan lifestyle. If you have any questions or would like to meet with a registered dietitian to develop a plant based meal plan please call 561-659- 6336 ext 8012 or email

Looking for Meal Ideas to Manage your Diabetes?

Then come to Our Healthy Meal Planning for Diabetes Workshops!

Now at 3 Convenient Locations!

Tuesday April 11 th 10am-12pm


Temple Israel 1901 N. Flagler Drive

West Palm Beach, FL 33401

Wednesday April 12 th 5:30-7:30pm


550 Heritage Drive, Suite 150

Jupiter FL, 33458

Wednesday April 19t 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!

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