Diabetes Awareness

A Mediaplanet Guide to Diabetes Management and Prevention

Diabetes Awareness Caron Butler The daughter of this NBA veteran is thriving in the face of type 1 diabetes with the help of JDRF

The Medtronic insulin pump makes life easier for MLB player Jordan Hicks A registered dietitian dispels myths around gestational diabetes NOVEMBER 2020 | FUTUREOFPERSONALHEALTH.COM

2020

1.6 MILLION AMERICANS LIVE WITH

TYPE 1 DIABETES jdrf.org

An Independent Supplement by Mediaplanet to USA Today

THE NUMBER OF YOUTH WITH

T1D COULD

TRIPLE

BY 2050

The American Diabetes Association Calls for Unity During American Diabetes Month The American Diabetes Association advocates for unity and equity, launching its #WeStandGreaterThan diabetes campaign.

their #WeStandGreaterThan campaign, hosting live cooking demos and virtual workouts among other activities.

“We’ll be focusing on nutrition and wellness the week of November 16-21,” Brown said.

ovember is American Diabetes Month, and the American Diabetes Association is raising awareness by encouraging healthy lifestyles, community engagement, and improved access to medical services.

“People with diabetes can do more than just survive; they can thrive,” said Tracy Brown, CEO of the American Diabetes Association (ADA).

“The ADA encourages everyone to manage their diabetes by incorporating the right balance of nutrition, physical activity, and mental health management.”

For the month of November, the ADA will be raising awareness online through @MEDIAPLANETUSA

Diabetes during the pandemic The coronavirus pandemic has raised new health concerns for people living with diabetes. Forty percent of COVID-19-related deaths have been people living with diabetes, according to a report from the CDC. “This is why the American Diabetes Association continues to advocate for increased COVID-19 testing within local communities that need it the most,” @FUTUREOFPERSONALHEALTH

Brown said. “With increased testing, more people will know if they have contracted the virus and can take the proper precautions for a safe and speedy recovery.”

Because of the increased risk for people with diabetes, Brown stressed the precautions that should be taken to prevent the spread of COVID19. “If you begin to feel symptoms, take it seriously and call your doctor. We urge everyone to continue social distancing, washing their hands often, and properly wearing masks whenever out in public.”

COVID-19 has made regular in-person check-ups more difficult, but Brown said that shouldn’t prevent people from

speaking with their doctor.

“Many practices are offering telemedicine appointments as a safe alternative for routine appointments,” she said.

“We should not wait until complications set in. We must tackle them head on.”

Addressing health inequities Diabetes disproportionately affects Black and Latino communities, which are 50 percent more likely to be diagnosed with diabetes than non-Hispanic whites. “The ADA is determined to raise awareness around the health inequities that exist within these communities and the disproportionate impact that COVID-19 has had on all peo-

ple with diabetes,” Brown said.

Advocating for these communities is one of ADA’s top priorities. “We’re advocating for states to extend healthcare coverage to those who’ve lost their jobs,” Brown said. “We need to eradicate the co-pay for insulin that millions are struggling to pay for in order to stay healthy during this pandemic, and we need to bring COVID19 testing into these highrisk communities in order to inform and stop the spread of this virus. If these actions aren’t taken immediately, we will continue to see devastating impacts and increased numbers and outcomes for millions of Americans.” n Ross Elliott

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PLEASE RECYCLE

Publisher Isabel Carretero, Katherine McNerney, Richard Sparano Business Developer Mac Harris Managing Director Luciana Olson Lead Designer Tiffany Pryor Designer Celia Hazard Lead Editor Mina Fanous Copy Editor Sydney Scott Partnerships and Distribution Manager Jordan Hernandez Director of Sales Stephanie King Director of Product Faye Godfrey Cover Photo Mia Butler All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve USA Today.

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“It definitely works for me and it’s made my life easier,” he says, explaining he no longer needs to self-administer insulin through pens. “This is connected to me.”

While he had heard of pumps before, Hicks didn’t use them because he thought they were too complicated. “I thought it was more responsibility, when it’s actually less,” he says. “I don’t want to remember life without it.”

Hicks would tell others with diabetes to do their research and ask questions about technology options, and to not be afraid of technology being more responsibility. “You just need to trust it,” he says.

St. Louis Cardinals Pitcher Jordan Hicks On Managing His Type 1 Diabetes

T

hat’s the Xbox identity he chose for himself — it gives him a warrior mentality. Diabetic Phenom is now a larger brand he’s launching to spread awareness and empower those living with diabetes. Known for throwing baseballs over 100 mph, Hicks is meeting the challenge of diabetes with the same intensity. “Whatever I want to do, I’m going to get it done,” he says.

Hicks was diagnosed with type 1 diabetes back when he was 17. At the time, he told his mother he wasn’t feeling well, he had lost 30 pounds in three months,

PHOTO: CHANDLER HENRY

St. Louis Cardinals relief pitcher Jordan Hicks calls himself the “diabetic phenom.”

had dry mouth, and frequent urination.

His doctor suspected diabetes and sent the high school junior to the emergency room where he spent the next five days getting his glucose levels stabilized.

A treatment regimen He didn’t let the diagnosis hold him back.

He started using insulin pens for daily injections and soon gained his weight back and grew stronger. He continued to play high school baseball and was drafted by the Cardinals in 2015.

When he was in the minor leagues, Hicks was a starting pitcher and had to

check his blood sugar every inning. At times his blood sugar would spike or go down very quickly. He was always monitoring his condition, including being prepared with snacks and insulin pens.

Then, when Hicks had Tommy John surgery on his elbow in June 2019, his doctor recommended getting his diabetes under control by using an insulin pump.

That’s when the pitcher started using the Medtronic insulin pump system.

The discreet wearable device delivers insulin through a tube directly into his body. The pump delivers insulin to Hicks based on what his body needs.

Off season The 24-year-old opted out of playing major league baseball in 2020 due to COVID-19.

Having diabetes is a pre-existing condition and makes him high-risk. Hicks says the team and fellow players were respectful and supported his decision.

“It was just a tough decision for me, but I ended up thinking it was the best thing for my health and my career,” says Hicks.

Hicks is eager to get back on the mound. During the off-season, he’s working out and throwing several days a week.

He’s eating healthy meals too, with a focus on protein.

He’s focused on being his best self and inspiring others.

“I’m just trying to be a voice for people that have this condition and give them an example to look up to,” he says.

He also encourages kids and adults to find their passion: “Just keep living every single day and grinding for that,” he says. “Thrive to be a better person than you were the day before.” n Kristen Castillo

To learn more, visit www. medtronicdiabetes.com/ASK.

Important Safety Information: Successful operation of insulin infusion pumps required adequate vision and hearing to recognize alerts and alarms. Rx required.

Please visit http://www.medtronicdiabetes.com/about/safety.html for additional details.

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Innovations in Diabetes Treatment Are on the Horizon Brian Heald, SVP and head of product at LifeScan, discusses improvements in diabetes care.

What is the biggest focus for diabetes researchers in 2021?

Supporting diabetes management using intelligent, personalized solutions that result in health population management. At LifeScan, we are focused on addressing the challenge patients share: how to manage their diabetes and reduce the mental burden.

What is the best way for people to manage their diabetes during this pandemic?

Always follow the safety precautions and the direction of your healthcare provider.

Test your blood glucose and take your medications, make healthy food choices, and include regular physical activity. Use blood glucose meters and digital tools, like the OneTouch Reveal® app, to make it easy to share results and get insights.

How can people recently diagnosed with diabetes ensure they are prioritizing their health?

Think of managing diabetes as taking steps to enhance your health. See blood glucose test results as information to help you understand what to do next, rather than a “pass/fail.”

Our latest innovation, the OneTouch Verio Reflect® meter, gives you personalized guidance, insight, and encouragement right on screen so you can take action.

How is technology changing the patient experience for those with diabetes?

The future for people with diabetes will be simple solutions that anticipate their needs, make supportive recommendations, and create real-time access points for needed insights. The OneTouch® family of products from LifeScan is defined by simplicity, accuracy, and trust — and on the leading edge of this new future.

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How Your Diet Impacts Gestational Diabetes Rebecca Ditkoff, a registered dietician, talks about misconceptions around gestational diabetes mellitus (GDM) and how people can ensure their health during pregnancy.

What are some common misconceptions about gestational diabetes?

Diet misconceptions: • “You need to avoid carbohydrates.” Carbohydrates are still an important part of a healthy diet for you if you’ve been diagnosed with GDM; however, monitoring how much and what you pair carbohydrates with is key for maintaining healthy blood sugars.

• “Fruit (such as bananas) are too high in sugar to eat.” Pair fruit with a protein.

• “You need to stay away from sweets.” You can enjoy dessert mindfully and can try to pay attention to additional fat and protein content to help balance blood sugars.

General GDM misconceptions: • “Having GDM means you will have a large baby.” There is an increased risk of having a large baby with gestational diabetes, but changes to control the blood sugar can help lower the risk.

• “Having GDM means there will automatically be delivery complications.” A woman with GDM is at no higher risk than a woman without “official” gestational diabetes.

If proper diet, lifestyle, and medications are implemented and blood sugar levels are well-controlled, the risk for complications should be lowered.

What are a few key foods that pregnant women should be incorporating into their diet, whether they are living with gestational diabetes or not?

Eggs: Eggs are an excellent source of many nutrients commonly lacking in a prenatal diet. An important and often overlooked nutrient found in eggs is choline, which is extremely vital to a baby’s brain development and in the prevention of birth defects.

Foods rich in folate.

Vegetables: It is important to incorporate more of the non-starchy vegetables that provide vitamins, minerals, and antioxidants while being low in carbohydrates. Dark leafy greens are especially important and provide a good source of folate.

Foods rich in fiber: Fiber helps to keep your bowels running smoothly, lowers cholesterol, helps you feel fuller longer, and is also crucial for maintaining optimal blood sugar levels.

Fatty fish such as salmon: Omega-3 fatty acid is critical for optimal brain and vision development.

How will a woman know if she has gestational diabetes?

For most women, gestational diabetes doesn’t cause noticeable symptoms. Increased thirst and more frequent urination are possible symptoms.

GDM screening is a standard test provided during routine prenatal doctor visits. Most pregnant women have a glucose screening test between 24 and 28 weeks of pregnancy.

The test may be done earlier if you have a high glucose level in your urine during your routine prenatal visits or if you have a high risk for diabetes.

Beyond diet, how can women care for themselves physically, mentally, and emotionally after a gestational diabetes diagnosis?

Without adequate support, the wrong information, or no information at all, the diagnosis of gestational diabetes can feel overwhelming and scary.

Therefore, seeking professional help from a registered dietitian or certified diabetes educator is an important first step.

Additionally, if you have been diagnosed with gestational diabetes, the most important thing is to be gentle with yourself and not beat yourself up. For both physical and mental health, it is important to think about ways outside of diet to care for yourself that can impact your blood sugar control such as sleep hygiene, activity levels, and stress management.

Last, research has shown us that moms who maintain overall normal blood sugar levels, despite a GDM diagnosis, have no higher risk than women without the diagnosis. n

Keep Your Appointment, Keep Your Feet

if a patient does not develop sepsis, the five-year mortality rate after a diabetic limb amputation is higher than the five-year mortality rate for many cancers.

Fear of exposure to COVID-19 is driving Americans to avoid routine diabetes care — and resulting in life- and limb-threatening complications.

S

ince the onset of the pandemic, I have seen some of the sickest patients of my career — and these are not patients who are suffering from COVID19. These are patients with severe diabetic wounds, gangrene, and even risk of sepsis.

These patients are afraid they will contract COVID-19 in a healthcare facility, and as a result, they are avoiding regular care and even ignoring injuries and infections.

Diabetes risks People with diabetes are classified as high-risk for COVID19, and our national healthcare experts have appropriately cautioned high-risk patients to limit their potential exposure. Those cautions do not extend to avoiding regular care for diabetes.

Patients who have been stuck at home have become more sedentary and often have become lax in their diets. They have neglected to track their A1C levels, and

many are risking their feet and, in fact, their lives by putting off routine foot care.

I have patients who were treating wounds on their own at home before finally coming into my office when it was too late to save their feet. Once a wound becomes infected, there is very real risk that the tissue will die (what we refer to as gangrene), which can lead to an amputation. There is also a risk for sepsis, a deadly systemic infection. And even

Proper foot care During the pandemic, people with diabetes should stay active and in control by getting proper exercise and nutrition and tracking blood sugar levels. They should stay alert by doing daily foot exams (a caregiver or family member can help) and protecting the feet with shoes, even around the house. And above all, they should stay in contact with their diabetes care team and reach out to their podiatrist if they notice a wound, injury, or other changes to their feet.

Healthcare providers are taking significant precautions to prevent the spread of COVID-19 in their offices. I

wear a face shield and mask when treating patients, and I require my patients to wear masks and follow hand hygiene protocols as well. We do temperature checks for all employees, patients, and guests entering the office, and we require social distancing.

Physicians’ offices are limiting the number of patients in the office at any given time and following disinfection guidelines for surfaces and equipment. Depending on your condition, you may even be able to take advantage of telehealth options.

With the many safeguards and options in place, the risk of seeking medical attention is much lower than the risk of putting it off. Do not neglect your regular care out of fear of COVID-19. Keep your appointment and keep your feet. n Priya Parthasarathy, DPM, Foot and Ankle Specialists of the Mid-Atlantic

So they can get back to living.

Over 34 million people have diabetes in the US, and over 5 million will develop a foot wound.

Medela is joining efforts with healthcare professionals every day to help improve the patient experience and make a stressful situation easier.

During Diabetes Awareness Month, we want to extend our gratitude to these healthcare professionals who work tirelessly to support their patients with chronic and complex wounds.

www.medelahealthcare.us

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Vanessa Rissetto Registered Dietitian

French Onion Macaroni and Cheese Recipe Nutritionist Vanessa Rissetto shares her healthier alternative to regular mac and cheese for you to try this Thanksgiving.

Ingredients 5 tbsp butter, divided, plus more room temp. for brushing 2 large yellow onions, thinly sliced Pinch of Kosher salt 8 oz cavatappi or other short curly pasta 2 tbsp all-purpose flour 2 1/2 cups whole milk 1 cup grated fontina cheese 2 1/2 cups grated Gruyère 1 cup shredded sharp white cheddar 1 tsp Dijon mustard Pinch of cayenne pepper 1 tsp fresh thyme leaves, plus more for garnish Directions 1. Preheat oven to 350 degrees. Brush 4 to 6 ramekins (depending on size) or small ovenproof baking dishes with butter. Alternatively, brush one large baking dish with butter.

2. In a large skillet, melt 3 tablespoons of the butter over medium heat. Add the onions and a pinch of salt and cook, stirring occasionally until they are golden, about 30 minutes.

3. Cook pasta in a large pot of boiling salted water, following package directions until al dente. Drain pasta.

4. In a medium saucepan, melt the remaining 2 tablespoons butter over medium-high heat. Add flour and cook, stirring, for 1 minute. While whisking, slowly pour in milk until combined. Bring to a boil and reduce heat to medium. Simmer, stirring, until sauce is thickened, about 6 minutes. Stir in fontina, 1 cup of the Gruyère, and cheddar until cheese is melted. Remove from heat.

5. Stir in the pasta, caramelized onions, Dijon, thyme, and cayenne. Season with salt and pepper.

6.

Divide mixture among ramekins and top each ramekin with the remaining Gruyère. Bake until sauce is bubbly around the edges, about 20 minutes.

7. Switch oven to broil and broil until cheese is golden, about 2 minutes. Garnish with more thyme before serving.

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Eat These 3 Food Groups to Balance Blood Sugar Blood sugar balance may seem like a difficult thing to achieve, but there are actually three things you can eat daily to make balancing your blood sugars a lot easier than you’d think.

But before we dive into those three things, let’s look at why we should be concerned about balancing our blood sugars.

Find a balance Your body’s blood sugar level changes quite frequently throughout the day in response to a number of different things: • What you eat • How you move your body • What your stress levels are • Your body’s hormone levels And it can change pretty quickly, too. Blood sugars that are too high or too low can lead to low energy levels, reduced sex drive, brain fog, sugar cravings, and many other unwanted side effects.

So, it’s safe to say that it’s worth the time to make sure we’re eating in a way that promotes blood sugar balance.

The three food groups To balance blood sugars, you should focus on adding fat, fiber, and protein to your plate every time you eat.

All food is made up of some combination of carbohydrates, protein, and fat. And there are three main types of carbohydrates we eat: sugar, fiber, and starch. Sugar is considered a simple carbohydrate, while fiber and starch are considered complex carbohydrates.

Our bodies process simple carbohydrates (sugar) the quickest. Simple carbohydrates are great for a quick energy boost, but if you are not eating anything else with them, you may see a rapid rise in blood sugar level and then a rapid fall (a sugar crash). You also will most likely not be as satisfied and get hungry again sooner because the food is digested pretty quickly. For example, an apple with peanut butter will most likely keep you more satisfied than an apple by itself.

It takes our bodies longer to digest fat, fiber, and protein than it does sugar.

So if you are eating fat, fiber, and protein at each meal

or snack, your body takes a bit longer to digest your food. This means you will have a more steady supply of nutrients to your bloodstream, and your food will stay in your stomach longer.

In other words, you will feel satisfied for longer and have more stable energy levels.

Making a plate So how do you put this into practice? Here’s an example.

Let’s say you want to enjoy a piece of toast or a bagel. By themselves, these things likely don’t have a lot of fat, fiber, and protein. They’re all easy-to-digest simple carbs.

But if you took that piece of toast or bagel and added some avocado (for fat and fiber) and an egg (for fat and protein), you’d have a much more blood sugar-friendly meal in front of you.

So the next time you sit down to eat, think about adding those three things: fat, fiber, and protein. Both your blood sugar levels and your energy levels will thank you. n Mary Ellen Phipps, MPH, RDN, LD, Founder, milkandhoneynutrition.com; Author, “The Easy Diabetes Cookbook”

The Girl Who Won’t Back Down From Type 1 Diabetes Despite a diagnosis of type 1 diabetes, Gia won’t give up on leading her life.

PHOTO: COURTESY OF T HE BUTLER FAMILY

M

y daughter Gia had just started playing organized sports.

A leading scorer in basketball like her dad, a 14-year NBA veteran, she loved the game.

Until there was a change.

Gia was lethargic. She vomited every day, was always thirsty, and started wetting the bed. I thought she was simply fending off a bug.

But one day, her teacher suggested that something more serious might be happening.

I shared Gia’s symptoms with her teacher, who told me they were similar to those her son had experienced when he was Gia’s age.

That’s when she asked if Gia had ever had a glucose test. She had, but not recently. I made a same-day appointment for Gia to have one.

A day to never forget It was March 1, 2019. I sat in the doctor’s office with Gia. Her doctor broke the news: Gia had type 1 diabetes (T1D).

My heart sank. How could I have forgotten my aunt? She was diagnosed with T1D as a teenager. At that moment, I knew: Gia would live with the burden of T1D, too.

Continuing to thrive March 2020 marked Gia’s oneyear “diaversary” — just in time for the start of the pandemic. I

Oral Corticosteroids and Diabetes: Understanding the Risks Oral corticosteroids could increase your risk of diabetes. Here’s how to take the proper precautions.

One of the best defenses doctors have against severe asthma are oral corticosteroids (OCS).

This life-saving wonder drug can stop an asthma flare in its tracks by quickly reducing inflammation in the lungs and airways. It’s effective, easy to take, and affordable.

On the other hand, it’s also a very strong medicine that should be used sparingly and wisely. Overuse or long-term use of OCS can lead to harmful side effects — including weight gain and high blood sugar that can trigger or worsen diabetes.

Steroid-induced diabetes Oral corticosteroids can increase your blood sugar levels and affect how your body reacts to insulin, the hormone that controls blood sugar levels. In certain patients, this can lead to what’s called steroid-induced diabetes.

Symptoms of steroid-induced diabetes can emerge 1-2 days after beginning a course of OCS. They include dry mouth and thirst, fatigue, unintentional weight loss, nausea, and vomiting, frequent urination, blurred vision, or tingling or loss of feeling in the hands or feet.

Diabetes prevention

have been sleep-deprived with worry as Gia’s telemedicine appointments do not offer regular A1C checks.

These tests tell you what someone’s average blood sugar levels are from the past 2-3 months, which is one indication of how well-managed someone’s T1D is.

Without these, we’re uncertain as to how successfully we are managing her T1D. However, I love homeschooling because I can closely monitor her blood sugar levels every day.

Gia misses her school friends and her old routine. She enjoys riding bikes, swimming, and shooting hoops with her dad

and sisters more often. She has also discovered a love of sharing the story of her T1D journey on social media.

The silver lining Gia is the strongest person in our family. Despite the burdens of T1D and the pandemic, she wakes up with a wide, toothy smile. As a family, we couldn’t be prouder of her.

In JDRF, we found community. We have connected with other T1D families and newly diagnosed families seeking reassurance that their child can live life to the fullest — like Gia. n Andrea Butler, T1D Mom, Wife of Caron Butler

If you’re taking OCS and are at risk for steroidinduced diabetes, monitor your blood sugar levels regularly during treatment. Talk with your doctor about how to manage diabetes, including insulin treatment.

Blood sugar levels typically return to normal when a course of oral corticosteroids is finished.

However, if you continue to experience symptoms, you should be evaluated for type 2 diabetes, especially if you have pre-existing risk factors for the disease.

If you need two or more courses of OCS in a 12-month period, this is a sign of poor asthma control and you should speak with your doctor about taking medications with fewer side effects.

Gary Fitzgerald, Allergy & Asthma Network

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