HQ June 2013 - Diabetes

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Piedmont Healthcare Quarterly A Kings Mountain Herald, Banner News, Cherryville Eagle publication

Managing

Diabetes What to Eat & When to Eat It Juvenile Diabetes YOU in Control - Not the Diabetes Exercise, Supplements & More Can Help You Control Diabetes How Diabetes Affects Vision & Dental Health

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HQ - Managing Diabetes

June 19, 2013

Diabetes booklet talks about C.A.N.D.Y.

by MICHAEL E. POWELL When looking for an idea for her Gold Award project, Girl Scout Emily Campbell pretty much knew what she wanted to do – something involving health. That’s when she came up with the idea of C.A.N.D.Y., or Community Awareness of Nutritious, Diabetes-friendly Yummy snacks.

The CHS senior, who is looking at a career in biosciences or medicine, chose to highlight diabetes, so she devised a pamphlet and cookbook to help diabetics. “I chose diabetes as my issue of importance because of its increased occurrence in this area,� she said. “Nearly everyone I have spoken to about this project is either diabetic or knows of someone close to them who is.�

Campbell said she also noticed there was “a glaring lack of education� about this issue. “I decided to work with (registered dietician) Gudrun Novak, and Karen Bolick (a nursing fundamentals and health science classes teacher at Cherryville High School), the leader of the Junior Heart Board and Health Occupation Students of America at CHS, in order to produce pam-

phlets that talk about nutritional information pertinent to diabetics and booklets that contain recipes for relatively healthy desserts.�

Campbell has been in scouting for about 13 years, which she said is the longest anyone can remain a Girl Scout. “I am still in it, but I am essentially finished because it’s the end of the scouting year and I am pretty much done with my Girl Scout Gold Project.�

Campbell said the Girl Scout Gold Project is the highest award in Girl Scouts. “To attain this award, a Girl Scout must complete two smaller versions of this project to get a feel for this type of leadership project. After that is done, she must come up with an idea for her project, research it, fill out needed paperwork, and participate in an extensive panel interview to determine if the project should be approved. If it is, then the Girl Scout will need to connect with others around her and figure out how to take action on her issue of importance and contribute a suggested minimum of 80 hours.�

Campbell said the project is technically still ongoing since she hasn’t yet attended the needed exit interview.

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Girl Scout and CHS senior Emily Campbell and members of Girl Scout Troop 20242 working on Campbell’s Gold Project, or C.A.N.D.Y., which helps diabetics choose the proper “sweets�.

Submitted photo “It has taken me approximately 115 hours so far.�

She noted the Junior Heart Board and Health Occupation Students of America clubs, in addition to her Girl Scout Troop, helped her with her fundraiser and with assembling the booklets. “I gathered the information myself, with, of course, extensive help from Mrs. Novak.�

In the pamphlet, Campbell answers the question, “What can I do to make my diet diabetes friendly?�

The easy answer is to make it a vegetable- and fruit-heavy diet, she noted.

Nearly half of every meal should be some type of vegetable, she added. “No, it doesn’t count if that vegetable is fried!� she said.

As for fruit, it must be eaten in moderation, Campbell said. The same is true for dairy products.

Surprisingly, Campbell said in her research she found that desserts don’t necessarily have to be given up by the diabetic.

In the pamphlet she put together, she mentions most diabetics can “safely consume between 15 and 20 carbohydrates per dessert, adding they should ask their doctor or nutritionist to help them determine their specific dietary needs. “Also, don’t forget using sweeteners such as Splenda, Sweet-N-Low, Truvia, or other options, like agave nectar or stevia extracts,� she said.

Campbell said no one in her immediate family has diabetes, although quite a few in her extended family do.

“I’m not a diabetic, but I definitely have problems giving up my sweets!� she said. “In fact, that’s part of the reason that I chose to focus on the nutritional aspect of diabetes awareness and prevention. After all, who doesn’t like desserts?�

All the desserts in her small recipe book, which she handed out at the 2013 Cherry Blossom Festival in Cherryville, are roughly no more than 200 calories. She said any diabetic-friendly dessert should be no more than that. “For the most part, the lower the carbs and calories, the better off you are, whether you’re diabetic or not.�

When it comes to vegetables, she knows many may have trouble eating them, due to a various problems, such as taste and consistency. “Personally, I think that some vegetables – like Brussels sprouts – are just way too disgusting to eat, so I don’t eat them. I eat what I love: broccoli, squash, peas, etc.�

Campbell added there is no real reason to eat what you don’t love when you have so many other vegetable options to choose from. “A quick search on the Internet will usually reveal new, interesting ways of cooking vegetables that are quite delicious,� she said. “I would have to suggest trying out some new recipes and seeing what you like.

After all, you should enjoy what you eat!�

The recipes work just as well for Type I diabetics as they do for Type II diabetics, Campbell said. “The nutritional needs are usually pretty See CAMPBELL, 10

June 19, 2013

HQ - Managing Diabetes

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How to beat diabetes

By Olin Idol, ND, CNC Hallelujah Acres Our nation is currently in the midst of a chronic diabetes epidemic that threatens the health of the next generation in a way never before seen in history.

Dr. Alan Cantwell tells us that the CDC in Atlanta reports that 33% of the babies born in 2011 will be diabetic by 2050 (age 39).

We cannot overestimate the critical nature of this epidemic. Consider the words of author Joseph W. Thompson regarding the severity of the situation: “Without action on our part, this generation of children is threatened with a future of chronic disease, economic burden, and an eroding quality of life. Indeed, they may become the first generation in our nation’s history to live shorter, less healthy lives than their parents.� *There is an obvious connection between the obesity epidemic and diabetes.

As worldwide populations become more Westernized (and more obese), the incidence of diabetes skyrockets. Here in the U.S., two-thirds of adults and nearly onethird of children and teens are currently obese or overweight.1

A study by the Organization for Economic Cooperation and Development predicts that by the year 2020 nearly 75% of the American population will be overweight or obese. *This exploding epidemic has led to the shocking prediction that in less than nine years, half of all Americans will be either pre-diabetic or suffer full-blown Type 2 diabetes.2 Even with the previously noted gloomy predictions, there is hope!

Type 2 diabetes can indeed be prevented.

In fact, with moderate dietary changes it usually can be completely reversed in a very short time. Formerly called adult onset diabetes, Type 2 diabetes is increasingly being diagnosed now in younger children.

Tragically, most health care providers do not realize the significant role of diet and lifestyle to both prevent and reverse Type 2 diabetes.

The key lies in the fact that Type 2 diabetes is not really a blood sugar issue. It is disease of insulin and leptin signaling. Leptin is a critical link between obesity and diabetes.

Author Ron Rosedale, MD states in his book, The Leptin Connection, “When your body has clear leptin signaling, this hor-

mone (leptin) regulates hunger and tells your body when to store and when to burn fat.�

Ironically, due to today’s poor dietary choices, body fat can actually produce so much leptin that the brain becomes insensitive to the message to burn fat, resulting in leptin resistance.

This becomes an ever-increasing vicious cycle with a greater intake of calories, increasing fat storage, more leptin production, and greater insensitivity to leptin’s signals.

Leptin signaling plays an important role in insulin signaling, insulin resistance, and ultimately diabetes. The only known way to restore the sensitivity to leptin and insulin is through proper diet.

As the body is nourished with a primarily raw, whole food, plant-based diet (low in starches but rich in nutrients), the body fat begins to diminish, the excess production of leptin slows, and the brain once again becomes sensitive to the signal to turn off the appetite and to burn the fat.

The first few weeks of any dietary change are critical as the brain is still insensitive to leptin. As leptin sensitivity is restored, the appetite diminishes and achieving optimal body weight becomes easier, and insulin sensitivity is restored as well.

In Type 2 diabetes, the problem is not a lack of insulin production but the cell’s insensitivity to insulin and the inability of the

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HQ - Managing Diabetes

June 19, 2013

Knowing what triggers Change today for diabetes can help you a healthier future to better manage it Cleveland County YMCA

Summit Place When we hear the term “diabetic,” we most often think, “sugar.” That is partly correct.

The CDC defines diabetes as “the condition in which the body does not properly process food for use.” The pancreas, which is an organ near the stomach, produces a hormone, insulin, and the job of insulin is to transfer glucose (sugar) into the cells of our bodies. This is why many people refer to diabetes as “sugar.”

Diabetes can accelerate the aging process, and lead to many other serious health conditions, including heart disease, blindness, kidney failure, and amputation of lower extremities.

Diabetes management requires awareness. You must know what makes your sugar rise and fall. There are several key components to managing diabetes: Keep a schedule. Blood sugar is typically at its highest an hour or two after a meal, and it decreases from there. Know your body’s habits, and if something doesn’t seem right, talk with your physician right away.

Eat well-balanced meals consistently. According to Tyrone Corbitt, Executive Chef and Director of Dining Services at Summit Place of Kings Mountain, “while carbohydrates are a necessity, they must be in moderation, especially for diabetics. In Assisted Living, the dining services team provides well-balanced meals, focusing on providing sugar-free options when available. They also ensure that the proper amounts of proteins, sugars, and carbohydrates are made available to each resident. This, paired with the services provided by the Nursing Team and Medication Aides, helps our residents to better manage their diabetes.”

You should see your Primary Care Physician if you have questions about managing your diabetes.

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Type II Diabetes is a lifelong disease that requires constant attention to manage.

If you had the chance to prevent it, wouldn’t you try?

Cleveland County resident Shannon Blanton did just that. In June of 2012, Shannon joined the YMCA’s Diabetes Prevention Program through the Cleveland County Family YMCA after a visit to her doctor where she was told that her fasting blood sugar was fluctuating between 110 and 120; she had pre-diabetes. She said, “It really concerned me because I was overweight with arthritis, hyperlipidemia and hypertension. I did not want to be labeled ‘diabetic;’ I did not want one more label added to my chart. I just feared that. I knew I had to get active and reduce my body weight.”

Shannon felt she could accomplish those two things with education and counseling. She found out about the YMCA’s Diabetes Prevention Program through her local hospital who referred her to the program. The first time Shannon spoke with Becca Schweppe, MPH, RD, LDN, the Program Coordinator, “I learned about the program’s goals and what I would be expected to do to reach those goals. Long story short, I qualified and was accepted into the program.”

The YMCA’s Diabetes Prevention Program helps participants take control of their health by encouraging the adoption of habits that reduce the chance of developing Type 2 diabetes.

These new habits also improve participants’ overall health and wellbeing. Research by the National Institutes of Health has proven that programs like the YMCA’s Diabetes Prevention Program can reduce the number of cases of Type 2 diabetes by nearly 60%. To qualify for the program, participants must be at least 18 years old, overweight (BMI≥25) and at high risk for developing type 2 diabetes or have been diagnosed with pre-diabetes.

Thanks to a grant from the Kate B. Reynolds Charitable Trust, the Cleveland County Family YMCA offers the program at the Kings Mountain Family YMCA in Kings Mountain, the Dover YMCA in Shelby, and the Ruby C. Hunt YMCA in Boling Springs.

The program provides a supportive environment where participants work together in a small group to learn about healthier eating and increasing their physical activity in order to reduce their risk for developing diabetes. The program, which is led by a trained Lifestyle Coach in a classroom setting, is delivered over a 12month period, beginning with 16 weekly sessions followed by monthly maintenance. The program goals are to reduce body weight by 7% and increase physical activity to 150 minutes per week.

Shannon found the group experience to be very positive and remarked, “It’s really great to have the support of the group.” Shannon admitted that there were “a lot of ups and downs,” and at first, she thought she might quit. But, “I just couldn’t quit because of the accountability of the weekly support meetings.

The group members and the members of the Y were constantly cheering me on.

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June 19, 2013

HQ - Managing Diabetes

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HQ - Managing Diabetes

June 19, 2013

Ruppe family deals with juvenile diabetes together

by BETH BROCK When Jennifer Ruppe delivered her baby boy, Hunter, she counted his fingers and toes, and he had ten of each, so he was a normal baby and she and her husband, Greg were happy parents.

On October 23, 2010, when Hunter was three years old, something happened that changed the entire family's lives.

Hunter had been sick, and the doctor said that it seemed like an ordinary childhood virus which just needed to run its course. But the illness persisted.

Jennifer noticed that Hunter remained thirsty, to the point of drinking water directly from the dispenser on front of the refrigerator.

Her dad, who had been keeping Hunter, pointed out to Jennifer that Hunter seemed

Hunter's insulin pump with custom made holder by Mom. photos by BETH BROCK

to be losing weight. Well that seemed odd, since Hunter had gone through two gallons of milk in three days.

The next day, Jennifer called the pediatrician to get Hunter checked, and they had no well appointments, but agreed to see Hunter for a “sick� visit.

By the time they arrived at the Shelby Children's Clinic, Hunter had become unresponsive, in and out of consciousness, and his eyes were rolling back in his head.

The doctor immediately ran a regular sugar level and Hunter's level was so high it wouldn't even register on the meter. After being able to coax enough urine for a sample, it was discovered that Hunter's level measured over 600, with the normal being between 80–120.

He was rushed to the hospital, which had been alerted and IVs and insulin drips were started immediately. As soon as he was stabilized, Hunter was transferred to Levine Children's Hospital in Charlotte, where he stayed for six days.

Jennifer and Greg thought that Hunter would probably end up having to take a pill or two a day to keep his insulin levels constant, but soon discovered that the entire family's lives were going to change drastically.

For four months Hunter was given nine injections of insulin a day, then he was given an insulin pump. It was discovered that Hunter has Type I diabetes.

Jennifer sings the praises of the pediatric endocrinologist, Dr. Mark Vanderwell. She said he is an awesome doctor, who is never too busy to talk to her about any of Hunter's issues. The whole family, including grandparents, were taught how to test Hunter's insulin level and administer insulin via the pump in the correct amount. They were taught to measure every carb that goes into Hunter's body so that the insulin can be adjusted accordingly. They use a remote control in which they enter the amount of carbs

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Hunter, Jennifer, and Greg playing at the YMCA playground. eaten, and it tells them how much insulin to give. Dr. Vanderwell gave Hunter a bear, named Rufus, which shows how to use the insulin pump. A book was included with the bear.

Once Hunter started getting the insulin regulated, he began to eat and grow like crazy, making up for lost time, Jennifer says. He is now normal on the growth chart for a child his age (he turned six in April).

Last summer, before school started, Jennifer talked with Dr. Janet Anthony, principal at Grover Elementary School, about setting up a training class for everyone who would be involved with Hunter in school.

Jennifer taught them how to use the meter, and if Hunter were to be unconscious, how to administer the Glucogun, which brings hm back quickly. Normally, if he becomes drowsy, a sugar pill or a piece of hard candy is enough to get his level back to normal.

During the first week of school, Jennifer took vacation from work, and went to school at lunch to help the teachers learn how to properly work with Hunter. She says that his teachers, Mrs. Campbell and Mrs. Turner are great. Jennifer packs Hunter's lunch each day with a note in his lunchbox stating the number of carbs in his lunch, so that the teachers will know how much insulin he will need.

Jennifer's mother, Sara Towery, has been a Godsend for Hunter. “I don't know what we would have done without her,� Jennifer said. Without Sara's help, Jennifer and Greg would not have been able to hold down their jobs, which are especially needed with the never-ending medical bills.

Jennifer explained that in Type I diabetes the part of the pancreas that makes insulin dies so the pancreas cannot create any insulin. Hunter only gets insulin through his pump.

Type I diabetes is an auto-immune disease, and they watch Hunter carefully since he is more susceptible to pancreatic cancer and other diseases. They have been taught to provide a gluten free diet to Hunter as much as possible. The biggest secret to keeping Hunter healthy is keeping his numbers at the correct level and getting two checkups a year.

In school, Hunter's classmates have been helpful. They will point out to the teachers if they think he needs attention. One little girl pointed out to the teacher that “there ain't nothing wrong with him – he just has low blood pressure!� (Bear in mind these are kindergartners) Jennifer said that even though everything seems to be under control for Hunter, she still worries. One out of every 20 children who have Type I diabetes dies in their sleep, so Jennifer gets up at least once a night to check Hunter's insulin level. If it is low, she will awaken him, and have him eat.

This sometimes causes Hunter to be sleepy in school, but the teachers understand and work with him.

Jennifer would like to get together with other parents with Type I-diabetic children, and help them learn all the things she has learned in the past three years. She says a good website to learn more information about Juvenile Diabetes is JDRF.org.

June 19, 2013

HQ - Managing Diabetes

What is gestational diabetes?

by Alan Hodge Many people are familiar with Type 1 and Type 2 diabetes but not so many with gestational diabetes.

Pregnant women who have never had diabetes before but who have high blood sugar (glucose) levels during pregnancy are said to have gestational diabetes. Gestational diabetes affects the mother in late pregnancy, around the 24th week, after the baby’s body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.

Based on recently announced diagnostic criteria for gestational diabetes, it is estimated that gestational diabetes affects 18% of pregnancies. In Gaston County, over 10% of pregnancies are affected by gestational diabetes.

Lisa Clement-Bryant is diabetes manager at CaroMont Health and talked about the disease.

“We don’t know what causes gestational diabetes, but we have some clues,” she said. “The placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother’s insulin in her body. This problem is called insulin resistance. Insulin resistance makes it hard for the mother’s body to use insulin. She may need up to three times as much insulin.”

According to Clement-Bryant, controlling blood glucose in pregnancy is important for both the mother’s and baby’s health.

“Uncontrolled blood glucose can cause high blood pressure for the mother, resulting in activity restrictions or early, emergent delivery,” she said. “For the baby, high glucoses can cause a number of problems, such as macrosomia (large weight for gestational age), low blood glucose during the first hours after birth, and increased risk for developing type 2 diabetes in their lifetime. There is evidence that our increasing prevalence of gestational diabetes is adding to the increase in pediatric type 2 diabetes cases.”

Treatment for gestational diabetes aims to keep blood glucose levels normal for pregnancy. Treatment for ges-

tational diabetes always includes special meal plans and scheduled physical activity.

It also includes daily blood glucose testing.

If these treatments are not able to keep blood glucose normal, then insulin therapy should be added for the duration of pregnancy.

“At CaroMont Regional Medical Center, we have a very unique approach to helping women with gestational diabetes manage their condition,” she said. “Our Outpatient Maternal Diabetes Program accepts referrals from community obstetricians, midwives, and nurse practitioners who have diagnosed their patients with gestational diabetes. Each woman comes to a group class in which they are given an individualized meal plan and are taught how to monitor their blood glucose. The women are instructed to send each week’s glucose results to CaroMont Diabetes Center, where those results are reviewed and a weekly update is given to the referring provider. If any participant has results that are above the recommended glucose targets, they are immediately referred to Endocrinology Associates, who specializes in the treatment of diabetes in pregnancy. Our collaborative approach in treating diabetes in pregnancy has helped many women in our community produce many healthy babies.”

It’s important for expectant mothers with gestational diabetes to monitor their blood sugar levels even after the baby is born by checking with their healthcare team right after delivery and again in six weeks. Once you’ve had gestational diabetes, it’s a good idea to have your blood sugar level tested regularly. The frequency of blood sugar tests will in part depend on your test results soon after you deliver your baby.

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HQ - Managing Diabetes

June 19, 2013

Lifestyle key to managing diabetes Cleveland Regional Medical Center Diabetes Center Diabetes is a life-changing, chronic disease that requires day-to-day management.

Cleveland Regional Medical Center’s Diabetes Center can help with controlling this disease.

With education and self-awareness, people with diabetes can continue to have full and active lives. “If diabetes is diagnosed early and blood sugars are kept in relatively good control, the long-term complications are greatly diminished,” said Gudrun Novak, coordinator of the Diabetes Center.

“Medications are important, but having a good understanding of the disease and making healthy lifestyle changes are the foundation of good diabetes management.”

Novak, who is a Registered Dietitian, Licensed Dietitian Nutritionist, and Certified Diabetes Educator, emphasizes the importance of healthy eating and activity in managing and preventing diabetes. The American Association of Diabetes Educators established a set of seven self-care behaviors believed to have a positive impact on the quality of life for someone managing diabetes. Among those are healthy eating and being active. The other five behaviors are: monitoring, taking medication, problem solving, reducing risks and healthy coping.

“Of all those behaviors, I think healthy eating and being active need to be a primary focus,” said Novak. “Everyone should be doing those two things to prevent and treat diabetes, and they directly impact how much medication a person will need to treat their diabetes.”

For people at risk of developing Type 2 diabetes, changing their diet and increasing physical activity are the two things they can do to prevent or delay the onset, according to the American Diabetes Association.

Studies show that many people can prevent

Gundrun Novac, coordinator of Cleveland Regional Medical Center’s Diabetes Center, is shown here with a client. or delay the onset of Type 2 diabetes by losing 5 percent to 7 percent of their body weight through physical activity and developing healthier eating habits.

Doing those two things is easier said than done for a lot of people. “Too many people give up on eating healthy because they feel deprived and over-restricted,” said Novak. It doesn’t have to be that way, even when you have diabetes. If you have been diagnosed with diabetes, that does not mean you must give up your favorite foods or stop eating at restaurants, according to

Based on their experience, over 99% of our patients and families would recommend us.

the American Association of Diabetes Educators. There is some learning involved, however. You need to know how the foods you eat impact your blood sugar.

Carbohydrates are one of the nutrients that impact blood sugar. They can be found in bread, pasta, rice, fruits, and vegetables such as potatoes and dried beans. Sugar is a carbohydrate that people with diabetes often assume they must avoid. “People who have diabetes do not have to stay away from carbohydrates,” said Novak, “but they need to be careful of how much they eat.

We often tell our clients that carbohydrates are not the enemy.”

Novak and the other staff members in the Diabetes Center help clients understand how the foods they eat, including carbohydrates, affect blood sugar levels. By understanding these effects, clients can learn to make adjustments in what they eat, their activity levels and medication.

This is one reason physical activity is also such an important factor in managing diabetes. Being physically active isn’t just about losing weight. It can help someone with diabetes keep blood sugar levels closer to normal so they can better manage their diabetes. And being physically active doesn’t mean you have to join a gym or start a rigorous exercise plan. Choose to do something you enjoy. Walking, riding bikes, swimming, or playing with your children are all good activities. The key is to get moving, and to do some type of activity on a regular basis. Checking your blood sugar levels before and after physical activity is recommended by the American Association of Diabetes Educators because doing so will help you learn how your body responds to the activity.

For more information on preventing or managing diabetes, contact CRMC’s Diabetes Center at 980-487-3953.

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June 19, 2013

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Don’t know how to care for your body?

We’ve got a class for that!

by DAVE BLANTON A year ago Lisa Costner was taking a handful of prescription medications – for high cholesterol, acid reflux and other maladies. Now, she says, she takes none.

“My head’s clear. I have more energy,” said Costner, a cheerful 53-year-old Gastonia dental assistant, who reports that her cholesterol dropped from a dangerous 293 to just 165 in a few months.

Costner credits her transformation to a series of healthy aging classes that have taught her to eat better, exercise more and simply understand her body.

“We’re just trying to get back to good nutrition, good exercise and good results,” said Kings Mountain pharmacist Billy Wease, who developed and has taught the free classes for six years.

The classes focus on more than a dozen themes, from diabetes, exercise, weight-loss, and thyroid health. There are even classes on the benefits of eating grass-fed beef and green smoothies.

“So much of what people are eating is what I would consider junk,” said Wease, referring to American’s growing taste for fatty, fried, processed and sugary foods.

The consequences of those habits are

becoming increasingly evident. U.S. health professionals have reported an epidemic in obesity and diabetes, which can lead to heart disease, stroke, blindness and amputation.

“More than 37 percent of Americans are obese in America. In 1970, it was only 14 percent,” Wease said.

The aging and elderly population isn’t immune to the rise of cases in diabetes, said Wease, a practicing pharmacist for 22 years. Wease said the classes are popular – with about 15-20 usually in attendance. More important, his students are seeing results.

“Some of our students have been able to reduce or eliminate the medications they take,” he said, adding that patients should always consult their physicians before altering or abandoning any drug regimen. “We always work with, not against, doctors.”

Wease’s curriculum also emphasizes the use of a special kind of water that is ionized to reduce its acidity.

Wease said that low acidity in the blood promotes healing and digestion, as well as providing other general health benefits.

The classes, which are offered at Prescription Plus on King Street in Kings Mountain, will kick off the fall season in September with a lesson on healthy eating.

Can dogs get diabetes? Yes! Diabetes mellitus, sometimes called sugar diabetes, is a common disease in dogs. Golden Retrievers, German Shepherd Dogs, Miniature Schnauzers, Keeshonden, and Poodles have the highest incidence, but all breeds can be affected. Females with the disease outnumber males by three to one.

The average age of onset is 6 to 9 years.

Diabetes is a result of inadequate production of insulin by the islet cells in the pancreas. There may be a genetic predisposition for this in some dogs.

Glucose in the urine causes the diabetic animal to excrete large volumes of urine.

In turn, this creates dehydration and the urge to drink large amounts of water.

Initially, dogs who do not metabolize enough sugar have an increase in appetite

and a desire to consume more food. Later, with the effects of malnourishment, the appetite drops.

In summary, the signs of early diabetes are frequent urination, drinking lots of water, a large appetite, and unexplained loss of weight. The laboratory findings are high glucose levels in the blood and urine.

In more advanced cases there is lethargy, loss of appetite, vomiting, dehydration, weakness, and coma. Cataracts are common in diabetic dogs. Ultimately, diabetes is a disease that affects all organs. Diabetic dogs will have enlarged livers, be susceptible to infections, and often develop neurological problems if not treated.

If you suspect your dog may have diabetes visit your veterinarian.

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HQ - Managing Diabetes

June 19, 2013

CAMPBELL: diabetes booklet talks about C.A.N.D.Y. From page 2 much the same, although there is often a greater focus on weight loss with Type 2 diabetics,� she said. “That is why I included the nutritional information on each of the recipes; each diabetic’s needs are different and can vary easily.�

Campbell said the medical professionals she spoke with were very helpful and informative.

Did they have very much input into the recipes and amounts, etc.? “Gudrun Novak, RD, was extremely helpful with my project,� Campbell said. “She gave me a lot of information about diabetes, diabetics’ diets, and non-nutritive sweeteners, which really helped me create the recipes.�

As for feedback, Campbell said she has received “several positive comments� about the booklets and pamphlets and “no negative feedback, as of yet.� “I stated that it was not meant to be taken as a ‘replacement for medical advice’ because diabetic diets are not a ‘cookie cutter’ type of thing; each person has his or her own needs that should be considered.�

Campbell plans to attend Anderson University in the autumn majoring in biology and minoring in Spanish and chemistry. She has also been accepted into its honors program. “I am leaning towards becoming a cardiologist, but I am also really interested in endocrinology, so I guess we’ll just have to wait and see!�

Campbell’s mother and father helped with her project, but their help has been limited, as required by Girl Scouts. “They mostly helped me make a few decisions and run the booth at the Cherry Blossom Festival, in addition to helping with my fundraiser,� she said. “They have had little to do with my choice of careers, except to encourage me to utilize my full potential at whatever I choose to do.�

Campbell said anyone wishing to know more about diabetes or other diabetic-friendly recipes can check out the web sites that helped her: www.diabetes.org/, diabetes.webmd.com/, or www.cdc.gov/diabetes/

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BEAT DIABETES From page 3 insulin to transport glucose into the cells where it can be utilized for energy production — and saturated fats from animal source foods are primary contributors to this insulin sensitivity.

Our length of life and quality of health depend upon how efficiently our cells communicate and act in harmony. Leptin and insulin are the most important hormones that carry out this communication in relation to energy. These two hormones deliver messages about energy and, to a large extent, control metabolism and aging.

Here’s how insulin affects longevity and the risk of disease: Insulin production is largely determined by glucose and the individual cell’s sensitivity to insulin.

Lower levels of insulin are very healthy as long as the cells are sensitive to insulin’s message and allow the glucose to enter.

Animal fats in the diet tend to lower the cell’s sensitivity to the message, preventing the efficient transport of glucose into the cells.

As a result, greater amounts of insulin are produced (or supplemented with medication) in an effort to force the glucose into the cells.

These higher levels of insulin are associated with faster aging and more rapid development of diseases.

To summarize, the primary functions of insulin are transporting glucose into the cells and storing excess energy for future time of need.

Tragically, today the Standard American Diet is so loaded with processed foods and animal fats, devoid of fiber, loaded with sugars, and excessively high in calories that the average person’s insulin levels are constantly elevated and way too high to support health. The cells are constantly bombarded with insulin, leading to insulin resistance and increasing storage of fat, leading to diabetes and diseases associate with aging.

If you have Type 2 diabetes, I encourage you to work with your doctor to fully embrace a primarily raw, plant-based diet (The Hallelujah Diet; see www.hacres.com) for six weeks. Monitor your progress and you will discover the positive impact of dietary and lifestyle intervention — you will not want to go back to your old ways!

1: http://healthyamericans.org/ reports/obesity2010/Obesity2010 Report.pdf 2: http://www.lef.org/magazine/mag 2011/jul2011_An-Epidemic-ofDenial_01.htm 3: http://healthyamericans.org/ reports/obesity2010/Obesity2010 Report.pdf 4: http://www.lef.org/magazine/mag 2011/jul2011_An-Epidemic-ofDenial_01.htm

June 19, 2013

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Juvenile diabetes doesn’t have to slow you down – just ask Layla Harris!

by ELIZABETH STEWART Throughout our lives, we go down many different paths.

Layla Harris, 11, was given an extra special challenge at 2 ½. She is beating Juvenile Diabetes and mentoring through the Juvenile Diabetes Research Foundation other kids hospitalized with Type I Diabetes.

‘It’s no big deal,” says the vivacious 5th grader who doesn’t let pricking her finger 11 times a day to check her blood sugar stop her from playing softball and being a normal teenager. Aside from a few frustrations at first, it has been an amazing experience for her and her parents, Ashley and Johnny Harris and Layla’s twin sister, Abbie, and older brother, John, 13, to see how she took ownership of this challenge since the age of 3.

In November 2004 Layla was diagnosed with Juvenile Diabetes and she depends on an insulin pump to treat her disease, which eliminates the need for multiple daily shots.

Just getting the news that a child has been diagnosed with Juvenile Diabetes is unnerving at the very least and it stirs up a storm of emotions as you realize family life will change.

Layla’s family decided that the disease wouldn’t ruin her life. And Layla’s determination is an example to others.

“Our three children had a virus at the same time and that’s what doctors suspected,” said the proud Mom, continuing that because her daughters are identical twins med-

;

ical doctors could not understand why one twin could have diabetes and the other could not. The twins were 2 ½ years old at the time and John was 4.

How could Mom and Dad explain to a toddler why she had to be “pricked and stuck” and why there would be scary times because insulin is necessary for life?

“It’s a grieving process for a family,” says Mrs. Harris.

They took one day at a time.

Layla now 4 feet 3 inches tall, a blue-eyed blonde with a pony tail, weighs 75 pounds Layla Harris, left, and her twin sister, Abbie, like to play softball and enjoy practicand expertly manages her ining the sport in the yard of their home on Sharon Drive. sulin. At KM Intermediate photo by LIB STEWART School, where she is an active honor student, plays softThe insulin is pumped in her body through a tube that conball with the Lady Mountaineers and Crushers, she counts nects the device to a port on her abdomen. The pump has carbohydrates, and every bite of food that goes in her eliminated shots and needles six times a day. mouth has to be covered by insulin and she knows how Layla has been trying out a new device that she can much she needs. Her twin sister and best friend, Savannah wear on either arm, an Omni Pod, and she can bathe and Briggs, are there to help, if needed. swim with this new device. “I’m really going to like it,’’ Since age 3 Layla has worn a small, stylish pouch she says. clipped inside her pants, a device that holds the insulin and Their efforts to mentor other children paid off in 2004 reads how much she needs after her blood sugar is checked.

See HARRIS, 18

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HQ - Managing Diabetes

June 19, 2013

It’s all fun and games until un ntil someone soomeonne gets getts hurtt When you need emergency care, turn to the ERs at Cleveland Regional Medical Center and Kings Mountain Hospital. Our physicians and staff are here for you around the clock with immediate access to excellent care. For more information on any of our services, visit us at www.ClevelandCountyHealthCareSystem.org.

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HQ - Managing Diabetes

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June 19, 2013

Tasty Diabetic-Friendly Recipes *taken from Mayoclinic.com

Cranberry spritzer Serves 10 Ingredients 1 quart reduced-calorie cranberry juice 1/2 cup fresh lemon juice 1 quart carbonated water 1/4 cup sugar 1 cup raspberry sherbet 10 lemon or lime wedges Directions: Refrigerate the cranberry juice, lemon juice and carbonated water until cold.

In a large pitcher, mix together the cranberry juice, lemon juice, carbonated water, sugar and sherbet.

Pour into tall chilled glasses and garnish with a lemon or lime wedge. Serve immediately.

Nutritional analysis per serving Serving size: About 1 cup Calories 63 Sodium 21 mg Total fat 0 g Total carbohydrate 15 g Saturated fat 0 g Dietary fiber 0g Monounsaturated fat 0 g Protein trace Cholesterol 0 mg

Fruit Salsa n’ Sweet Chips Serves 10 Ingredients For tortilla crisps: 8 whole-wheat tortillas 1 tablespoon sugar 1/2 tablespoon cinnamon For fruit salsa: 3 cups diced fresh fruit, such as apples, oranges, kiwi, strawberries, grapes or other fresh fruit 2 tablespoons sugar-free jam, any flavor 1 tablespoon honey or agave nectar 2 tablespoons orange juice Directions: Preheat oven to 350 F. Cut each tortilla into 10 wedges. Lay pieces on two baking sheets.

Make sure they aren't overlapping. Spray the tortilla pieces with cooking spray.

In a small bowl, combine sugar and cinnamon. Sprinkle evenly over the tortilla wedges. Bake for 10-12 minutes or until the pieces are crisp. Place on a cooling rack and let cool.

Cut the fruit into cubes. Gently mix the fruit together in a mixing bowl. In another bowl, whisk together jam, honey and orange juice. Pour this over the diced fruit. Mix gently. Cover the bowl with plastic wrap and refrigerate for 2 to 3 hours.

Serve as a dip or topping for the cinnamon tortilla chips.

Nutritional analysis per serving Serving size: About 8 chips and 1/3 cup salsa Calories 119 Sodium 90 mg Total fat 3 g Total carbohydrate 21 g Saturated fat trace Dietary fiber 3g Trans fat 0 Sugars 3.5 g Monounsaturated fat trace Protein 2g Cholesterol 0

Whole-Grain Banana Bread

This twist on banana bread uses rice, amaranth, millet, quinoa and tapioca flours — making it safe for people with gluten sensitivity.

Serves 14 Ingredients 1/2 cup brown rice flour 1/2 cup amaranth flour 1/2 cup tapioca flour 1/2 cup millet flour 1/2 cup quinoa flour 1 teaspoon baking soda 1/2 teaspoon baking powder 1/8 teaspoon salt 3/4 cup egg substitute (or use egg whites) 2 tablespoons grape seed oil 1/2 cup raw sugar 2 cups mashed banana Directions: Preheat oven to 350 F. Prepare a 5-by9-inch loaf pan by spraying it lightly with cooking spray. Dust with a little of any of the flours. Set aside.

Mix all dry ingredients except sugar together in a large bowl. In a separate bowl, combine egg, oil, sugar and mashed banana. Mix well. Add wet mixture to dry ingredients and combine thoroughly. Spoon into loaf pan. Bake for 50 to 60 minutes.

Check for doneness with toothpick — when the toothpick is removed it shouldn't have any batter sticking to it. Remove bread from oven, cool, slice and serve.

Nutritional analysis per serving Serving size: 1 slice Calories 150 Sodium 150 mg Total fat 3 g Total carbohydrate 30 g Saturated fat 0.5 gDietary fiber 2g Trans fat 0 g Sugars 7g Monounsaturated fat 2.5 gProtein 4g Cholesterol 0 mg

Wacky Chocolate Cake Serves 20 Ingredients 3 cups whole-wheat pastry flour 1 cup sugar 3 tablespoons unsweetened cocoa powder 1/2 teaspoon salt 2 1/4 teaspoons baking soda 1 tablespoon vanilla 2 tablespoons vinegar 1/2 cup canola oil 2 cups water Directions: Preheat oven to 350 F. Put flour, sugar, cocoa powder, salt and baking soda directly into an ungreased 9-by-13-inch baking pan. Use a whisk to stir them together.

Using a spoon, make 3 separate holes in the dry mixture. Pour the vanilla into one hole. Pour the vinegar into another hole. Pour the oil into the third hole.

Microwave the water on high for 3 minutes or until it's boiling. Pour the boiling water slowly and evenly

over the ingredients in the pan. Use the whisk to mix everything together for 2 minutes. No traces of dry ingredients should remain.

Bake for 25 to 30 minutes or until a toothpick stuck in the center of the cake comes out clean. Let cake cook completely. Cut into 20 squares and serve.

Nutritional analysis per serving Serving size: 1 piece Calories 158 Sodium 201 mg Total fat 6 g Total carbohydrate 23 g Saturated fat trace Dietary fiber 2g Trans fat trace Sugars 10 g Monounsaturated fat 3 g Protein 3g Cholesterol 0

Fish Tacos Serves 4 Ingredients 12 ounces whitefish such as cod or tilapia Salt and pepper to taste (optional) 1/4 head Napa cabbage (1 1/2 cups) 1 teaspoon cumin 2 teaspoons paprika 1/2 teaspoon chili powder 1/2 small yellow onion, diced (1/4 cup) 2 tablespoons cilantro, minced 2 red Fresno peppers, diced Zest and juice of 1 lime (1/2 teaspoon zest, 1 tablespoon juice) 4 wheat tortillas (8-inch diameter), lightly grilled or toasted Directions: Season fish with salt and pepper if you like. Then bake fish at 375 F for about 20 minutes until internal temperature reaches 145 F. Or grill fish if you prefer.

Place remaining ingredients except tortillas in a mixing bowl and toss to combine. Flake and place fish on tortillas. Top with cabbage mixture and enjoy.

Nutritional analysis per serving Serving size: 1 filled tortilla Calories 197 Sodium 439 mg Total fat 5 g Total carbohydrate 19 g Saturated fat trace Dietary fiber 3.5 g Trans fat trace Sugars 0g Monounsaturated fat 1.5 gProtein 19.5 g Cholesterol 48 mg

Grilled Turkey Burgers Serves 4 Ingredients 1 pound ground turkey breast 1/4 cup dried bread crumbs 1/4 cup chopped onion 2 tablespoons fresh parsley, chopped 1 1/2 tablespoons Worcestershire sauce 1 teaspoon Tabasco (hot) sauce 4 whole-grain buns 4 slices tomato 4 slices red onion 2 bibb lettuce leaves, halved 4 tablespoons ketchup Directions: Combine the ground turkey breast,

bread crumbs, chopped onion, parsley, Worcestershire sauce and hot sauce in a large bowl. Mix well.

Divide turkey mixture into 4 equal portions and form into patties.

Prepare a hot fire in a charcoal grill or heat a gas grill or broiler (grill). Away from the heat source, lightly coat the grill rack or broiler pan with cooking spray. Position the cooking rack 4 to 6 inches from the heat source.

Grill burgers until nicely browned on both sides and heated through, about 7 minutes a side. Serve each burger on a bun topped with 1 tomato slice, 1 onion slice, 1/2 lettuce leaf and a dollop of ketchup.

Nutritional analysis per serving Serving size: 1 prepared burger including bun and toppings Calories 244 Sodium 340 mg Total fat 8 g Total carbohydrate 29 g Saturated fat 2 g Dietary fiber 4g Monounsaturated fat 2 g Protein 17 g Cholesterol 59 mg

Pizza Margherita Serves 6 Ingredients Whole-grain pizza dough: 1 teaspoon active dry yeast 3/4 cup warm water 3/4 cup whole-wheat flour 2 tablespoons barley flour 2 teaspoons gluten 1 tablespoon oats 1/2 tablespoon olive oil Toppings: 2 1/2 cups chopped spinach 2 1/2 cups sliced tomatoes 1/4 cup chopped basil 1 tablespoon minced oregano 1 tablespoon minced garlic 1 teaspoon black pepper 2 ounces fresh mozzarella Directions To make dough, dissolve yeast in warm water, let sit 5 minutes. Mix dry ingredients together. Add oil and water-yeast mixture. Knead for 10-15 minutes for best texture. An electric mixer is helpful, but not necessary.

Let dough rise in refrigerator for a minimum of 1 hour.

Preheat oven to 450 F. Roll out dough ball on floured surface to 1/4-inch thickness. Place dough on baking sheet or pizza peel. Top with spinach, tomatoes, basil, oregano, garlic, black pepper and mozzarella.

Bake for 10-12 minutes, or until cheese melts and crust is crisp.

Nutritional analysis per serving Serving size: 1 slice (1/6th of pizza) Calories 144 Sodium 83 mg Total fat 5 g Total carbohydrate 20 g Saturated fat 1 g Dietary fiber 4g Trans fat 0 g Sugars 0g Monounsaturated fat 2 g Protein 7g Cholesterol 6 mg

June 19, 2013

HQ - Managing Diabetes

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June 19, 2013

Take what your body is telling you seriously

Beautiful summer smiles

Deepak Gelot, M.D.

Invisalign Invisible Braces

Medical Director, Carolina Family Care Carolina Wellness and Cosmetic Laser Center

Diabetes is also referred to as high blood sugar. It’s a condition that affects your whole body. It’s important to keep your blood sugar controlled, because when too much sugar stays in your blood for a long time, it can damage blood vessels and nerves. Over time, constant high sugar levels can cause damage to your eyes, heart, kidneys, and nerves.

Much of the food we eat is turned into sugar in the blood for our bodies to use for energy. A hormone produced by the pancreas called insulin helps sugar in our blood to get into the cells of our bodies. If your body doesn’t make enough insulin or if the insulin doesn’t work the way it should, blood sugar can’t get into your cells and instead stays in your blood, raising your blood sugar level.

Diet and proper nutrition play an important role in the prevention and the treatment of diabetes. Eating healthy foods in the proper balanced amounts can help lower blood sugar levels and manage the symptoms of Type 2 diabetes. Balancing carbohydrates, eliminating sugars, and adding protein will help stabilize blood glucose in people with Type 2 diabetes.

Diabetics need to be aware of “good” carbs and “bad” carbs. Good carbs contain complex carbohydrates and burn slower, helping to stabilize blood glucose. Bad carbs cause insulin to spike in the blood and should be avoided. Bad carbs are found in sugar, refined white flour, corn sugar, fruits and juices. Fiber is necessary in a diabetic’s diet because it lowers blood sugar. Nuts are a diabetic super food. They contain healthy fats that are good for the body and helps slow the digestion of carbs, leading to lowering the blood sugar. Adding protein to every meal slows the release of blood sugar.

Exercise is another important part of any diabetics treatment plan. Diabetes and exercise go hand in hand, at least when it comes to managing your diabetes. Exercise can help you improve your blood sugar control, as well as boost your overall fitness and reduce your risk of heart disease and nerve damage. You should track your blood sugar before, during, and after exercise to help prevent potentially dangerous blood sugar fluctuations. For the best health benefits, 150 minutes a week of moderately intense physical activities such as fast walking, swimming or bicycling is recommended. Before starting any exercise program, get your doctors permission.

Monitoring your blood sugar levels with a meter is a good thing to do. It helps you to see how food, physical activity, and medicine affect your blood sugar levels. Using your medicines exactly as your doctor prescribes, making smart food choices and staying physically active will help keep your blood sugar levels controlled.

Take your body’s hints seriously. The earlier the condition is diagnosed the sooner the treatment can begin. Diabetes is a serious condition but with your active participation and the support of your health care team, you can manage diabetes while enjoying an active, healthy life.

For further questions feel free to contact Carolina Family Care at 704.734.0010 or wellnesscarolina@gmail.com

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Did you know that nearly one out of four orthodontic patients these days is over the age of 21? And did you know that Invisalign braces can give you straighter teeth in as little as six months to one year? “I didn’t have braces as a child,” one patient told us, “and I was afraid that getting braces as an adult would make me look unprofessional. When my dentist told me about braces that were nearly invisible, I knew I’d found the perfect solution.”

With Invisalign braces, you can have a confident and beautiful smile, without most people even realizing you’re wearing invisible braces.

A welcome alternative to braces with metal wires, this treatment uses clear, custom-molded aligners that are virtually invisible. You can remove the aligners when it’s time to eat, drink, brush or floss.

Young and Associates Family Dentist offers Invisalign clear aligners for adults as well as children.

Invisalign treatment consists of a series of aligners that change about every two weeks. Each aligner is individually manufactured with exact calculations to gradually shift your teeth into place. And since your Invisalign system is custom-made for your teeth, you know you’ll end up with a smile that truly fits.

When it comes to considering your options for a smile makeover, it’s easy to see Invisalign’s advantages.

Lumineers May be Right for You! Are you unhappy with your smile? Do you hide it because of stained or dull-looking teeth? Do you have chipped, cracked, crooked or missing teeth that make you self-conscious? Get the bright, white, and even smile you’ve always dreamed about with Lumineers porcelain veneers.

Nine out of ten Americans think an attractive smile is an important asset; threefourths of them believe an unattractive smile can hurt a person’s chances for ca-

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If your teeth are discolored, improperly aligned or misshaped, then Lumineers, porcelain veneers, may be the best solution. A porcelain veneer is an extremely thin, ceramic covering which bonds to the front of the tooth. A porcelain veneer visually improves the look of the tooth while also strengthening it.

If you’re not happy with your smile, a beautiful smile can still be yours. Advances in cosmetic dental care have made it possible for the dentist with the right training, qualifications and expertise to completely redesign your smile.

Young and Associates offer smile design expertise. You don’t have to hide your smile any longer. A straight, incredibly white, bright and beautiful smile is waiting for you. Discover how our advanced cosmetic techniques and treatments can painlessly restore the brilliance of your smile. Make an appointment today to transform your worn, stained or crooked teeth into the beautiful, natural looking smile of which you have always dreamed.

Feel free to contact us for more information at www.shelbyfamilydentist.com or 704.482.7986

June 19, 2013

HQ - Managing Diabetes

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Wise’ diabetes doesn’t control her, she controls it Credits endocrinologist with saving her life

by MICHAEL E. POWELL Connie Wise first became acquainted with the word “diabetes� as it applied to her life, in 1994. At that time, she said her doctor told her she might be “borderline diabetic.�

She said her whole life changed at that point.

Since then, she’s learned to control the disease instead of it controlling her.

Wise, 81, said when she first heard the news, she was on her way to the Holy Land – Israel – for a trip with some church friends. “I had a physical and was told then I needed to be on insulin. All I knew was I didn’t want to get started on something that I knew nothing about (insulin), so when I came back from the trip, my regular doctor started me on it,� she said.

Wise didn’t know how to regulate it and the dose her doctor suggested didn’t help with symptoms management. “As for them (the symptoms), I really didn’t know what I was looking at or feeling. Also, I was having a lot of problems. When I later went to my heart doctor for my regular checkup he said he knew somebody I needed to see.�

Wise, a Type II diabetic, was referred to the doctor she said has been her “lifesaver�, Kings Mountain endocrinologist Dr. Neeraj Ashri.

Ashri went over the nature of the disease with her and husband, Hillard. She also went to the Shelby diabetes

Deepak R. Gelot, M.D.

Crystal Skinner

clinic and learned all about “counting carbs�. One piece of advice Dr. Ashri gave her stuck with her then and is in her mind and heart still. “He told me to control my diabetes and to not let it control me.�

Wise said her new diabetes doctor told her to eat in moderation. That she didn’t have to rule out all the things she loved, but to eat them in moderation. “He said I wasn’t a machine; that I was a human being.

He said “don’t let the disease scare me to death, but do what he told me to do.�

Wise said she has tried over the last eight years to do what Ashri has told her to do. So much so, her doctor has used her progress as an example to other diabetics, young or old, of what can be done if you set your heart and mind to it. “I write down all I eat all day long. I’m on sliding scale insulin. He tells other diabetics if an 80-year-old woman can do what he’s said to do, then anyone can!�

Wise uses two insulin pens and readily admits there are times she does “foul up� and goes overboard, but she gets right back on track. She takes a dose once in the morning and once at night.

Connie said there were times early in her battle with the disease and before she began seeing Ashri, when she was blacking out. In one incident she passed out in the floor of her home and woke up with medical and fire responders, as

Connie Wise discovered she was a Type II diabetic in 1994 as she prepared to go on a tour of the Holy Land. photo by MICHAEL POWELL

well as her children, all looking down at her, making sure she was all right. She doesn’t remember passing out, See WISE’, 20

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CHANGE: today for a healthier future From page 4 Each week, I would lose just a little bit and that really motivated me. I felt so much better after I started exercising and eating less.” Weekly session topics range from healthy eating and physical activity to stress management, overcoming negative thoughts, and ways to stay motivated.

Shannon stuck to the program goals and was very committed to tracking her food intake. She said, “I tracked everything I put in my mouth except my tooth brush and dental floss.”

Shannon is incredibly proud of her success and hard work and says, “At the end of the 16 weeks, I had achieved the goals of the program with 7% weight loss, 150 minutes of physical activity each week, and I was able to attend all 16 classes without missing a single class. I feel so blessed. My blood pressure is more favorable, I have no acid reflux, and I no longer ride in carts when I shop. I now proudly walk and push my buggy.”

Shannon went back to her doctor, and he was so excited, he asked, “How did you do it?” Shannon says, “My fasting blood glucose was 94 and my doctor wrote me a note that just said ‘Excellent!’ I am enjoying activity. Now that I am almost 30 pounds lighter, my knee pain has improved by

80%.”

Shannon is now in the maintenance portion of the program and has set another 7% weight loss goal. She happily exclaims, “I will be there by June, I just know it!” As she reflects on her long-term goals, Shannon adds, “This will be a permanent change for me. This program has worked so well for me that I want to tell others about it and be an advocate for diabetes prevention.”

Qualifying for the YMCA’s Diabetes Prevention Program is as simple as knowing your score on the quiz below. Individuals who have already been diagnosed with either type 1 or Type 2 diabetes do not qualify for this program. If you score a 9 or higher, then you may be at risk for pre-diabetes or diabetes and may qualify for the program. (This does NOT mean you have diabetes. You will need a blood test to confirm if you have diabetes.)

Classes are continually forming at all of the Cleveland County Family YMCA local branches. Thanks to our funding from Kate B. Reynolds Charitable Trust, we are able to offer the program at a reduced price. Participants also receive a 16-week trial YMCA membership during their time in the program. Contact Becca Schweppe at 704-669-3631 (bschweppe@clevecoymca.org) for more information.

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Layla Harris, 11, demonstrates how she checks her blood sugar. Since age 2 ½ she has stuck her finger a total of 36,135 times. photo by LIB STEWART

HARRIS: juvenile diabetes doesn’t slow her down From page 11 when the family sponsored a cookbook at Resurrection Lutheran Church, where the twins were in pre-school. All proceeds went to the Juvenile Diabetes Research Foundation.

Other good things have happened.

The nursing experience Ashley Harris learned with her daughter led to a decision to return to nursing school. Mrs. Harris is a nurse in the Emergency Room/Diabetic Center at Cleveland Regional Medical Center in Shelby and teaches newly-diagnosed patients how to manage the disease. Since 2012 she has worked with patients referred by medical doctors and her newest little friend is a six-year-old boy the Harris twins call “cool.” They give other families compassion and assurance the disease demands.

“We really focused on our daughter learning how to take control of managing her insulin 100 percent,” said Mrs. Harris. “If she maintains her insulin dosage, eats right, and exercises it will cut down on any complications as she get older. If there is a low reading, Layla knows what to do.”

Layla has already decided what her goal will be as a grown-up. She wants to teach elementary-age children. She and her twin sister are best buddies and plan to attend the same college. Both girls are busy. They enjoy school, Central United Methodist Church, and playing with friends. They were recently selected Miss Poppy by American Legion Auxiliary Unit 155 and have already asked a friend to drive them in his red convertible in the 2013 Christmas parade as representatives of the organization.

The Harris children are grandchildren of Mal and Shirley Brutko and Jean Arthur Harris and the late Ollie Harris, Jr. They are the great-grandchildren of the late Senator J. Ollie Harris and Mrs. Harris and the late Mr. and Mrs. J.H. Arthur.

The twins love what they do and do what they love. Their brother, John, is shy about having his picture but they all agreed that Layla deserves the limelight.

June 19, 2013

HQ - Managing Diabetes

19

Are You Pre-Diabetic?

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Some estimates show up to 60 million adults in the United States that are.

Diabetes is a disease in which the body does not produce or properly use insulin, a hormone that is needed to convert sugar, starches and other food into energy. The cause of diabetes is still unknown; however, genetics and factors such as obesity play a role.

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HQ - Managing Diabetes

June 19, 2013

WISE: diabetes doesnʼt control her From page 17

Diabetes among leading causes of blindness Joshua Ziebell, OD Gaston Eye Associates What if I told you to look around in your immediate vicinity; look at the faces of children, adults and elders around you. Take it all in by looking at the smiles, the sometimes furrowed brows. Look into their eyes. Now imagine that nearly one in every 3 of those individuals you see right now has a potentially blinding disease. If not now, they are at an ever-increasing risk of developing this disease over their lifetime.

It is diabetes. It is also one of the leading causes of blindness in our Western civilization. That needs to be emphasized, because it has been called the disease of the affluent nations. And yes, if you are over 65, you will have a 1 in 3 chance of developing this disease and a 5-7% risk of losing vision.

To put some additional salt in the wound of realization, here are some figures: $245 Billion in total costs of diagnosis and treatment in the US and $69 Billion in lost productivity. Those figures are with “B” as in Billions. Another “B” word that brings with it apprehension and fear is blindness. Diabetes affects the small blood vessels of the body, causing a weakness to the walls of blood vessels and thereby allowing cracks to develop.

Out of these cracks leak blood and proteins that accumulate in the retina causing vision loss. Should these lesions go undetected and untreated, the result being permanent vision loss.

A logical follow-up question should be – what can I do about it? How can I avoid being a statistic? By the way, there are an additional 79 million individuals that are “prediabetic” which means their body is trying to tell them to do something different, or medical intervention will no longer become an option; for those that do not find time for exercise will sooner or later find time for illness.

I urge caution when saying you are a “Diet Controlled” diabetic. Let’s not kid ourselves. It is BECAUSE of your diet that you are being followed closely by your medical provider. So, beware of what you eat. Begin an exercise program – your body will respond. This is a disease that can be reversed if your lifestyle can be changed. Expecting a different outcome yet continuing to do exactly the same thing is one definition of insanity.

Talk with your eye doctor and your general practitioner today. It is so very true, a quote by our beloved Benjamin Franklin who just so happened to invent the bifocal; “an ounce of prevention is worth a pound of cure.”

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about her day.

She and her husband are members of Cherryville First Presbyterian Church. She also credits the prayers and friendship of the church members for helping her along with this as well.

Wise said if she was able to give new diabetics advice it would be to find a good endocrinologist and follow through with what he or she says.

“If you’re not going to follow through with what the doctor says, then don’t waste your time or money, or his time or money,” she said. “It’s costly to be a diabetic!”

Another thing she advises to change is eating habits. Again, she said all things in moderation.

As for weight gain and loss, or exercise regimens, Wise said that should be up to one’s doctor or medical professional.

One of the big “no-no’s” for diabetics is smoking.

“There are too many things that can go wrong with diabetics, like heart attacks, strokes, and such,” she said.

For Wise, there is always something more she, or other diabetics, can do to help themselves.

“I need to get out and walk more; be a little more critical of what I eat, things like that.”

At the end of the day, she said it all comes down to living in moderation and not going “overboard” with anything.

“We need to all slow down and realize that we’re not in control (of our lives), that God is in control!”

however. She just remembers waking up and seeing them all there.

Wise said she doesn’t know of anyone in her family, past or present, who has diabetes. She believes hers came about due to weight gain and a sedentary lifestyle.

“I worked at Cherryville Area Ministries (CAM) and was working 50 to 60 hours a week with no exercise, eating just anything at lunch time. I didn’t take care of myself!”

Wise said her sugar numbers have a tendency to be low. She carries fast-acting orange-flavored glucose tablets with her whenever she feels her sugar getting low.

“I don’t go anywhere without them,” she said.

The Wises, married 62 years and both retired, aren’t big breakfast eaters, Connie said. They split the difference and eat “brunch”. She said she could, nowadays, “easily be a vegetarian”, she loves them so much.

“When you’re retired you don’t have anything you really need to get up early in the morning for anyway,” she said, laughing.

Unlike many diabetics Wise said she doesn’t remember experiencing the routine problems most diabetics do, such as frequent urination, dizziness, dry mouth, and such.

“I do have some problems with neuropathy though, and have some leg problems,” she said, adding her doctor watches them “like a hawk.”

Connie said Dr. Ashri told her when he first met her that she was going to have to watch herself and monitor herself, he couldn’t do it and no one else could either.

“He was very honest with me,” Wise said. “It was a sobering experience! But I was glad for his honesty because it opened my eyes about what I needed to be doing.”

Wise said even though she worked at CAM, it was on a volunteer basis. Her real job was that of a housewife, a full-time job, especially with three children.

A Bob Jones University Connie Wise looks at her two insulin pens. She grad, she learned about doesn’t go anywhere without them. They, along with being a missionary of sorts her lifestyle change, help her manage diabetes and live there at college, and noted a full life in which she controls her diabetes; it doesn’t she feels she is still a miscontrol her. sionary today, seeking to do photo by MICHAEL POWELL God’s work as she goes

June 19, 2013

HQ - Managing Diabetes

Helping our children stay healthy, happy

By Paula Vess Regional Marketing Group SHELBY – It’s no secret that America is suffering an obesity epidemic among children, and many parents may be overwhelmed on just what to do to help.

Professional help is available. At the Shelby Children’s Clinic, Amy Buttrick, RD, LDN, a registered dietician, works with children and adolescents who are overweight or obese. “I am seeing more obese children than ever,� she said. “Children who were classified as overweight a few years ago, and have made little to no change in their habits, are now obese or close to it.�

In North Carolina, about 34 percent of children ages 10 to 17 fall into the overweight or obese category, according to a 2009 report from the N.C. Department of Health and Human Services. But the problem is nationwide. In 2010, more than one third of American children and adolescents were classified as overweight or obese, according to the Centers for Disease Control and Prevention. “Obesity is a major health care concern that has increased to epidemic levels across the country and locally,� said Chris Cerjan, MD, a pediatrician and the medical director at Shelby Children’s Clinic. “Cleveland County is fortunate to have a resource like Amy Buttrick.�

Why the concern? “Although the immediate problems that children encounter such as sleep issues, fatigue, joint pains, and self-esteem issues are important, the long term consequences are

even more dramatic,� said Dr. Cerjan.

Some experts believe the life expectancy of the next generation may actually decline due to health problems related Amy Buttrick to obesity.

RD, LDN “Pediatricians have seen a rise in high cholesterol, high blood pressure, and even adult onset diabetes in children,� he continued. On average, about half of the children Buttrick works with have elevated triglycerides (a type of fat transported through the bloodstream), elevated LDL levels (commonly known as “bad cholesterol�), or both.

These elevated levels increase their risk for heart disease.

Many of the children who visit Buttrick also have difficulties sleeping. Sleeping on their stomachs is uncomfortable because of their size, so they often end up sleeping on their backs. The extra weight in their abdomen pushes against the lungs, causing breathing problems, including sleep apnea. “It’s a vicious cycle. They don’t sleep well; they feel tired in school, and they don’t feel like being active when they get home,� said Buttrick.

Her work with these children and adolescents and their parents helps them break that cycle. Families who are referred to Buttrick by their pediatrician or primary See CHILDREN, 23

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HQ - Managing Diabetes

June 19, 2013

The role digestion and nutrition play in diabetes Billy Wease Prescriptions Plus Diabetes is defined as a group of metabolic diseases in which a person has high blood sugar, either because thepancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced. Not only is the result elevated blood sugar but a host of other bodily functions become impaired.

One of those important bodily functions that become affected by diabetes is digestion. The digestive process is basic to existence because it is the means by which the body assimilates the nutrition from the food consumed to then nourish the cells for their ever important tasks. A disruption in the digestive process can have dire consequences so we shall look at the normal digestive process and see how diabetes can be prevented with the help of key principles.

The Normal Digestive Process The process of digestion actually starts the second your fork enters your mouth.

With help from the enzyme amylase found in saliva, the carbohydrates in your food start to be broken down into smaller particles which is crucial to relieving the bur-

den it puts on the small intestine. That is why it is so important to completely chew your food and eat slowly! Once swallowed those particles make their way down the esophagus and into the stomach by way of peristalsis, a series of wave-like muscle contractions that move food to different processing stations along the GI tract.

Next, the stomach calls its hydrochloric acid into action along with enzymes secreted from the pancreas to further digest the proteins in that meal. After a few hours, the digested food is ready for its next destination, the intestines. The small intestine begins the job of sorting the components of food.

Bile from the liver dissolves fat and juices in the intestinal lining continuing the breakdown of the food into macronutrients: carbohydrates, proteins and fats. Micronutrients of the food, vitamins and minerals, absorb into the blood stream from the small intestine. What is left moves through the remainder of the intestines and exits the body within approximately 24 hours as long as there are no disruptions along the way.

Digestion Compromised By Diabetes The process of digestion is an involuntary action performed by the nervous sys-

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tem of the body. Unfortunately, the nerves of a diabetic person are damaged by the continual elevation of blood sugar.

T h i s causes digestion to be impaired and can result in heartburn, diarrhea and constipation- just to name a few. When digestion is not working properly, the nutrients in food are not absorbed as they should be.

Not only does diabetes cause impairment with the metabolism of sugars but also the metabolism of fats and proteins.

Ironically, many diabetic people are overweight from excess blood sugar while the cells in their body are literally starving and emaciated. The excess blood sugar or glucose cannot be delivered to the cells for the energy needed and is therefore stored in the liver contributing to weight gain, toxicity and rising acidity.

Enzyme Therapy for Diabetes Supplementing with broad spectrum plant based enzymes is beneficial to anyone suffering from indigestion and a dysfunctional GI tract but especially to those with diabetes. Since the body is not breaking down and absorbing nutrients properly, enzymes aid in assisting that process and relieving the burden put on the pancreas and intestines.

In addition, digestive enzymes may improve circulation, which is often poor in diabetics, boost the immune system, decrease inflammation, help the transportation of nutrients throughout the body, eliminate waste products and enhance overall wellness. Digestive enzymes may be also useful for gastroparesis, a complication of diabetes. Gastroparesis is characterized by symptoms like heartburn, belching, bloating, nausea and changes in bowel movement pattern.

Digestive enzymes, particularly

protease may help prevent kidney complications of diabetes, and all enzymes may help prevent nerve damage caused by this condition.

Another crucial enzyme that is most often deficient in someone with diabetes is the lipase enzyme. Lipase is responsible for fat digestion and metabolism. Diabetics are deficient in lipase, which is required for optimum cell permeability, which includes the production of insulin and its transport inside the cell. Insulin is suppressed in proportion to the amount of undigested fat (triglycerides) in the blood. If fat can be digested, insulin metabolism can be improved. Because cell membranes are made up of cholesterol, which is a fat, lipase will also help make the membranes more flexible and allow the membrane to function normally again.

Diabetes Prevention Probiotics and digestive enzymes work hand in hand for complete breakdown and utilization of the nutrients consumed. New research is revealing a link between obesity and poor micro floral gut environments which suggest that supplementation may even help to reduce weight- a major contributor to Type 2 diabetes.

With diabetes comes a host of complications such as yeast infections triggered by high blood sugar levels, skin conditions, a lower immune system and more. This “good bacteria� will help to colonize and maintain balance of the micro-organisms in the gut. They not only build the immune system but also help to quench inflammaSee DIGESTION, 23

June 19, 2013

HQ - Managing Diabetes

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CHILDREN: helping them stay healthy, happy From page 21 care physician spend time learning about healthy nutrition and the importance of physical activity. “The treatment (for childhood obesity) is really lifestyle modifications including improving nutrition and exercise,� said Dr. Cerjan. “It is easy to get caught up in the latest fad diet, or over focus on the trendy quick loss micronutrient,� he continued. “Amy is able to explain simple weight loss strategies in everyday language. Even small changes can get people moving in the right direction. She also promotes overall healthy lifestyle changes instead of just focusing on the number of pounds.�

Buttrick teaches families about food portion sizes, healthy food choices, recommended daily servings for different food groups and more. Most families visit her for six sessions lasting about one hour.

She hopes what she teaches them will last a lifetime. “The big thing is to change the environment in their house,� she said. “I start by asking parents to get rid of all the junk food and sugary drinks. It’s a big change for parents, too. It’s hard, but it’s important to change the environment around the child and begin to promote healthy habits.�

Changing that environment means making sure the kitchen is stocked with healthy choices for every meal and snacks.

To help parents, Buttrick provides grocery lists, recipes and healthy snack ideas.

Food is only half of the equation,

though. Adding physical activity into the child’s day is just as important. Buttrick encourages families to find something active to do between 5 p.m. and 8 p.m. when the tendency, upon arriving home, is to sit on the couch and turn on the television. “I tell parents I’m asking them to contribute three hours a day to prevent a life threatening illness. We talk about easy, free ways to be active such as walking around the yard, using walking tracks at schools or the YMCA, even an empty church parking lot,� said Buttrick. “The important thing is to get the kids out of the house and do something active at least four days a week.�

In addition, she connects families with programs in the community to allow them access to playgrounds, walking tracks, pools and structured activities. She also teaches the children how to move more at home, including some simple, one-minute exercises.

Buttrick stresses that it’s very important for families to make changes together, especially for younger children. They do what’s familiar, what they see their parents do. “If mom and dad aren’t motivated to go for a walk or swap the snack cake for an apple, the kids won’t be motivated either,� she said.

About the professionals: Christopher Cerjan, MD is board certified by the American Board of Pediatrics.

Dr. Cerjan received his medical degree from the Medical College of Georgia. He completed his residency at Carolinas Med-

ical Center with a specialty in pediatrics.

Amy H. Buttrick RD, LDN works as a registered dietitian at the Shelby Children’s Clinic. She received her BS degree in Exercise and Sport Science from East Carolina University, and received a Certificate of Training in Childhood and Adolescent Weight Management from the American Dietetic Association. In addition

to working with overweight and obese children, Buttrick also assists families with issues such as infant feeding disorders, problems transitioning to table foods, and children with Crohn’s disease, food allergies, or celiac disease.

For more information on the nutrition services provided at the Shelby Children’s Clinic call 980-487-2100.

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DIGESTION: nutrition play a role in diabetes From page 22 tion which is another culprit associated with diabetes as well as heart disease and obesity.

It is vitally important when searching for the right probiotic supplement to find one that is pH stabilized with multiple strains of flora. We know our stomach is a very acidic environment which is worsened with diabetes so consuming a refrigerated, unstabilized probiotic will not provide the full benefits due to the live cultures not being able to tolerate the heat and acidity of the stomach and GI tract.

Probiotics can go a long way in helping you take care of yourself, manage certain diabetes complications, helping you recover faster and keeping your immune system functioning properly when taken in the right forms.

Making sure the diabetic patient is get-

ting ample whole food vitamin and minerals in the cells daily is critical to help the body efficiently use the sugar and insulin.

Research shows that the typical diabetic patient is deficient in the B family of vitamins as well as magnesium and others.

Many prescription drugs that are commonly given to diabetics can deplete these crucial vitamins and minerals as well. Supplementation with the proper whole food vitamins and minerals can improve the energy and sugar levels of many diabetic patients.

The World Health Organization anticipates that by 2030, over 360 million people will have diabetes. That is a staggering number when there is ample evidence to support that it’s mainly caused by diet.

It’s time to take a closer look at the foods we consume and how our bodies digest and break that food down for the nourishment of our cells.

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HQ - Managing Diabetes

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