diet for their diabetes or asthma they would have an expert on-site to speak to complication of type 2 diabetes is Charcot Foot …
Summer 2008
n e ws
Pittsburgh Regional Initiative for Diabetes Education
2
In the News Pennsylvania Leads the Nation with Chronic Care Management Plan
A partnership of the University of Pittsburgh Diabetes Institute
3 4 5
Team Players
How would you react if your spouse was diagnosed with diabetes? Most of us would no doubt offer our loved one a support system based on taking an active part in managing his or her newly diagnosed diabetes Unfortunately, Millie Glinsky I did not have this reaction I viewed my husbands diagnosis of diabetes as a sign of my own aging I always considered diabetes a disease one gets as he or she advances in years; and I resented my husband, Mark, for falling into this category At age 55, I had no intention of declaring myself advancing in years and Marks diabetes diagnosis interfered with my perceived invincibility I am not proud to admit this, but it is the truth Fortunately, that was three years ago and my attitude has changed I decided to be a more supportive wife and help Mark manage his diabetes But, it was difficult knowing where to begin and what management approach to follow I was frightened and overwhelmed I knew Mark and I needed a plan;
and the key to helping us develop this plan was education Jill Weissberg-Benchell, Ph D, Associate Professor at Northwestern University, explains there are generally three paths a spouse takes when a loved one is newly diagnosed with diabetes:
Diabetes Complications: Charcot Arthopathy of the Foot and Ankle Pets Diabetes: Fact or Fiction?
Getting Your Child Ready for School
10 11 12 14
Diabetes Heart Disease: An Interview with Dr Robert Stenberg Diabetes Care through the Ages
Diabetes-Friendly Recipes
COME FOR A NEW ADVENTURE IN EATING
SATURDAY, AUGUST 16 12- 4PM
Fayette County Fairgrounds
The Food Network
Upcoming Events
Bring a donation of canned goods to benefit the local food bank
American Diabetes Association
DIABETES Expo
Saturday, August 23, 9 am to 5 pm David L Lawrence Convention Center For more information, call 1-800-DIABETES, ext 4608
continued on Page 6
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IN THE NEWS
Pennsylvania Leads the Nation with Chronic Care Management Plan
The word chronic means over time, conditions like diabetes, high blood pressure, heart disease, and asthma are considered chronic As part of the Governor Rendells Prescription for Pennsylvania, a group of people
were appointed to form a Commission on Chronic Care Their job is to help the governor and the state make plans for health care reform The Chronic Care Management, Reimbursement, and Cost Reduction Commission reported in February that they have been working to develop a plan to Chronic Care Commission members presenting report to Governor Rendell in Harrisburg support primary care practices in supplying and helping patients get the resources they need to care for their chronic conditions Members of the Commission represent people who work with people living with chronic conditions, such as doctors, nurses, pharmacists, and insurers You can read the entire report at wwwrxforpacom The Commission will be setting up learning collaboratives across the state They are called collaboratives because there are plans for people to work together to learn how to properly care for people with chronic diseases At the heart of the collaboratives will be primary care practices since most people get the majority of their care at their primary care doctors office Learning collaboratives provide different approaches and services for patients For example, a practice may consider hiring a dietitian This
way if a patient is asked to lose weight and follow a special diet for their diabetes or asthma they would have an expert on-site to speak to about healthy food choices Another practice may decide to work with their local pharmacist This way if a patient gets a prescription for a complex drug routine, the practice can let the pharmacist know about it and they can work together to get the right information to the patient While a few other states have begun chronic care initiatives, Pennsylvania is the first state to take into consideration the way health care providers are paid for delivering care What is significant about this report is that it comes from a whos who of Pennsylvania health care providers — from health insurance providers and hospital executives, to physicians and nurse, and labor and consumer representatives, said Governor Rendell They all agree that we must adopt a stronger, proactive approach to address chronic conditions while also addressing how we pay for chronic care services We must work together to update information systems and improve the attention we give to self-management The first collaborative is being rolled out in southeastern Pa around
Philadelphia Plans for western and central Pa are underway b
They all agree that we must adopt a stronger, proactive approach to address chronic conditions while also addressing how we pay for chronic care services We must work together to update information systems and improve the attention we give to self-management
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Diabetes Complications:
Charcot Arthopathy of the Foot and Ankle
An often misunderstood and undiagnosed complication of type 2 diabetes is Charcot Foot — a deforming and destructive condition of the bones in the foot and ankle Charcot foot presents in the same way as other conditions known to diabetic patients like cellulitis — which is why many health care providers do not always recognize this potentially devastating complication problem The key to preventing problems is early recognition of the Charcot process
How can I prevent Charcot?
Ensure that you perform a daily check for redness, swelling, cuts, or bruising on your lower limbs See a foot specialist for routine diabetic foot care on a regular basis, even if your feet and ankles do not hurt Talk to your foot specialist or medical doctor about Charcot
What is Charcot arthopathy and how
do I know if I have it?
Charcot arthopathy is a complication of diabetic neuropathy, the loss of feeling in the hands and feet Charcot first presents itself as swelling, redness, and warmth in the foot and ankle Charcot may not hurt, especially when sensation has been totally lost due to neuropathy Charcot does not improve with antibiotic medication, where as cellulitis does A diagnosis of Charcot can be made with x-rays, bone scans, and magnetic resonance imaging MRI However, Charcot is often undiagnosed because abnormalities may not be seen on an x-ray if it is early in the Charcot process Charcot arthopathy leads to unrecognized fractures and dislocations of the foot, this results in severe deformity Because the foot is deformed, ulcers develop which can become infected Severe foot infections are one of the leading causes of hospitalization in diabetic patients, and many of these patients become amputees Every 30 seconds, somewhere in the world, a patient will have an amputation because of a complication from diabetes
How can Charcot arthopathy be treated?
If diagnosed early, Charcot arthopathy can be easily treated with a non-weight bearing cast for about eight to 12 weeks If
Charcot arthopathy is not diagnosed or treated early enough, surgery or amputation may be necessary
Where can I go if I have more questions?
The UPMC Comprehensive Foot and Ankle Center CFAC, located at UPMC South Side, specializes in conditions like Charcot arthopathy and other medical problems associated with the lower extremities The CFAC offers a collaborative approach to care, combining orthopedic surgeons, podiatrists, and vascular surgeons to treat and care for patients who experience painful conditions as a result of diabetes Coupled with the expertise of the Diabetes Self-Management Education Program at UPMC South Side, the CFAC is convenient for both treatment and education of diabetic foot conditions For more information, contact the UPMC Comprehensive Foot and Ankle Center at 412-586-1531 b
By Dane K Wukich MD, Director, UPMC Comprehensive Foot and Ankle Center
Charcot arthopathy is a complication of diabetic neuropathy, the loss of feeling in the hands and feet Charcot first presents itself as swelling, redness, and warmth in the foot and ankle
If my doctor is not aware of the condition, what should I do?
Do not be afraid to talk to your physician about Charcot
arthopathy and ask him or her to do tests to rule out this condition — especially if current therapy is not changing your condition Many patients are treated for infection, gout, or blood clots because doctors are not aware of this
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Pet Diabetes: Fact or Fiction?
In 1993, I came home from work one day to discover that my 13 year old West Highland Terrier, Katie, had drunk all of the water from her water dish Being a certified diabetes educator, I knew this could be a symptom of diabetes Soon our veterinarian confirmed Katies diagnosis I had been taking care of patients with diabetes for many years and now was going to experience it on a more personal level The veterinarian prescribed NPH insulin and sent us home Katie didnt seem to mind the injections given in the scruff of her neck, and taking care of her gave me new appreciation for taking care of a family member with diabetes starts to urinate outside of their liter box An animal exhibiting these symptoms should be taken to the veterinarian immediately Most owners with a diabetic pet learn how to administer insulin This can be a trying experience for both the owner and pet Because animals can sense their
owners feelings, if the owner is nervous and unsure, its likely that that the pet will have the same reaction After some practice, administering the insulin usually is easy and becomes part of the pets daily routine Pets often dont give any indication that they even feel the injection, which is usually given in the Katie scruff of the neck, the side of the chest or belly, or the flank Education for pet owners is typically provided by a veterinarian or can be found online Animals can experience low blood glucose similar to humans This can be caused by increased activity, decreased food intake, or the wrong insulin dose Just like in humans, sometimes symptoms occur without a specific reason Symptoms may include: shaking, tremors, weakness, lethargy, staggering, restlessness, or even urgent barking Your veterinarian can recommend proper treatment techniques of low blood glucose Discuss your pets diet with the animals veterinarian There are specially formulated foods for diabetic animals, but it is not always necessary to use them Sometimes pets can maintain their regular diet Complications can and do occur Cataracts are found in diabetic dogs and frequently cause blindness Urinary
tract infections can be a problem for animals whose diabetes is not well controlled Pets, just like humans, can live a long and healthy life if their diabetes is managed properly Regular veterinarian visits are important as well as regular exercise, proper medication, and a healthy diet b
By Janis McWilliams, RN, MSN, CDE, BC-ADM, University of Pittsburgh Diabetes Institute
The Facts about Pet Diabetes
The diagnosis of diabetes in animals has been recognized for a long time In fact, pet diabetes is very similar to the diagnosis of diabetes in humans When you have diabetes, your body either doesnt make enough insulin or doesnt use the insulin properly Type 1 diabetes occurs when the pancreas does not make enough insulin In type 2 diabetes, the pancreas still makes insulin, but the insulin doesnt work right Dogs usually develop type 1 diabetes, while cats are more likely to develop type 2 For this reason, diabetic dogs must always take insulin Cats are commonly treated with a high protein diet and an insulin injection or oral medication Just like in people, cats who are overweight may improve their blood glucose control with weight loss Diabetes most frequently occurs in dogs
between the ages of seven and nine Unspayed females are at an increased risk for developing diabetes Certain breeds of dogs are at greater risk than others Symptoms in cats and dogs are very much like human symptoms: increased thirst, frequent urination, hunger, and weight loss Cat owners sometimes call the veterinarian because their cat
Symptoms in cats and dogs are very much like human symptoms: increased thirst, frequency of urination, hunger, and weight loss
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Getting Your Child Ready for School
Diabetes is a common chronic disease among school-age children The Centers for Disease Control and Prevention estimates that type 1 diabetes affects about one in every 400 to 600 young people in the United States The number of children being diagnosed with type 2 diabetes is climbing in epidemic proportions Regardless of the type of diabetes, management and careful blood glucose sugar monitoring while the child is in school is essential Establishing a diabetes management plan with school personnel, will ensure that your child with diabetes can learn and thrive in a safe environment while being included in all classroom activities The first step is for parents to openly
talk with school personnel, especially the school nurse and teacher, about their childs current diabetes management routines School nurses can advocate for the child, provide leadership in formulating a plan, and ensure that the plan is carried out Effective management plans have three key parts: training for school personnel, a medical diabetes management plan, and either a 504 Plan or Individualized Education Plan IEP can be carried out by school personnel Also list usual signs and symptoms the child has with hypoglycemia low blood sugar and hyperglycemia high blood sugar The schools back-up plans for disasters should include provisions for extended diabetes care, just as it should for any child with chronic conditions Quick reference guides for the plan can help staff identify needs and actions in the classroom setting without having to access the school nurses office for this information Provide copies of the guides to coaches and other extracurricular school staff too The Diabetes Medical Management Plan should be reviewed and updated at a minimum of once a year, or whenever revisions to the plan are needed
The Education Plan
Finally, the Education Plan, also called IEP or
504 Plan, lists what academic assistance, services, or accommodations will be made available at school to enhance the childs learning, full participation, and academic progress The plan should be highly individualized after careful assessment of the child The parents or guardians, the school nurse, the principal, and childs teacher should be present at this meeting as well as the schools special needs coordinator Parents can get guidance and advocacy from School Health Consultants in their local districts of the Pennsylvania Department of Health Similar to the medical plan, the education plan should be reviewed and revised as the childs needs change Making school seem as normal as possible for the child poses challenges, and paying attention to the childs need for privacy, or openness, should be discussed Peers can be very supportive if they understand basic diabetes concepts Working as a team, there are few barriers that cannot be overcome in helping the school age child with diabetes succeed There are great resources available to parents and schools, such as Helping the Student with Diabetes Succeed: A Guide For School Personnel produced by the National Diabetes Education Program
NDEP, a federally sponsored partnership of the National Institutes of Health, and the Centers for Disease Control and Prevention The American Diabetes Association and the Juvenile Diabetes Research Foundation websites also provide tools and information to guide parents and school personnel through the process b By Amy Uhler, RN, BC, BSN, UPMC Northwest
Training for School Personnel
All school staff members who interact with the child should receive training that explains diabetes, the childs individual diabetes needs, how to recognize diabetes emergencies, and what to do in the event of an emergency This training can occur in a variety of ways, including presentations, brief discussions, videos, and reference guides More in-depth training should be provided to a smaller group of school personnel who are involved with the child day-to-day This training is much more focused on the childs needs and should be conducted in a way that allows interaction between a qualified instructor and the staff, especially since questions about the plan and the childs needs can be discussed One or both of the childs parents or guardians should also attend so that specific parent and staff concerns
can be discussed
All school staff members who interact with the child should receive training that explains the basic concepts of diabetes, the childs individual diabetes needs, how to recognize diabetes emergencies, and what to do in the event of an emergency
The Medical Diabetes Management Plan
The Diabetes Medical Management Plan, which can have various terms for different school districts, provides details about the childs diabetes care while in school Developed in cooperation with the childs doctor and other members of the diabetes healthcare team, this plan should include emergency contact information, diabetes supplies needed, and detailed information about blood glucose monitoring , insulin administration, glucagon and other emergency treatment, exercise requirements and precautions, and meal plans The plan should also specify which aspects can be carried out by the child and which
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TEAM PLAYERS continued from Cover
The Administrative Assistant: Control is a priority for the spouse Scheduling appointments, planning healthy meals, registering for support groups and education classes, and securing gym memberships and professional trainers are just the
first steps This spouse feels he or she is more qualified than the patient to make decisions and the patient feels his or her role in self-management being diminished The Silent Partner: This spouse says, I will do whatever you want me to do Just let me know Mostly disengaged, this spouse relies on the patient to gather all the informational tools regarding diabetes self-management This spouse is unwilling to research educational opportunities and through his or her inactions prevents any opportunity for shared management Offering to support the patient when a plan is in place is the role of the silent partner The Team Player: This spouse views the management of the newly diagnosed diabetes as a collaborative effort with shared learning and information gathering Together, both spouses explore possibilities for support systems, selfmanagement classes, and nutritional education Ideas are shared, classes are attended jointly, eating patterns are discussed and compromises take place Working together, this spouse helps develop a plan that is cooperative and successful for the entire family Shared ideas are the goal of the team players
Clearly, being a team player with your spouse and
setting reasonable expectations is the most effective strategy for helping your partner meet the challenges of diabetes Here are some examples of how other couples have created healthy partnerships with their spouses
and lows of living with diabetes Diagnosed with diabetes three years before Marge, Larry pledged to change his lifestyle and looked forward to seeing the results of his new fitness program Attending self-management classes, joining a gym, and meeting the dietician to establish healthy eating patterns were steps Larry took to gain control Marge enjoyed seeing Larry committed to his workout schedule and admired his dedication to his self-management goals Progress was made and things went well for a while Then, enthusiasm was lost and Larry no longer looked forward to achieving his fitness goals with the same energy Today things are different Larry and Marge are committed to shared goals Larry is back at the gym and Marge has begun a fitness program compatible with her goals Together, theyre meeting regularly with a dietician to establish weight goals and healthier eating patterns Larry and Marge, together, have agreed that Larry will assume the grocery
Diabetes Support
Tip 1: Share activities and goals
Larry and Marge, a couple with diabetes, often take their leads from one another They know individual moods and attitudes must sometimes play a secondary role because of the impact they have on their partner Theyve learned that practicing a positive approach to diabetes management often boosts the morale of the other and usually elevates their own desire to succeed Larry and Marge have both experienced the highs
Larry and Marge
shopping and meal preparation responsibilities because he enjoys them Theyve developed personal strategies for confronting the challenges of diabetes, but theyre working together Marge and Larry both reveal renewed emotional strength and a greater motivation to succeed They are gaining confidence from each other and have become team players
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Diabetes Support Tip 2: Offer help by creating a plan together
Bettys husband, Wayne, was diagnosed with type 1 diabetes while they were engaged, 50 years ago Betty and Wayne brought different strengths to their young marriage and Betty is grateful Wayne has taken an active role in managing his diabetes She credits his chemical engineering career with helping him
approach his diabetes with precision and accuracy Betty and Wayne worked out a plan to meet the unique challenges of diabetes in the 1950s Needles had to be boiled and without the advantages of current medications or the insulin pump, Betty had little room for error in preparing and serving meals Wayne knew employers and insurance companies were reluctant to give patients a chance, and having diabetes was usually kept a secret from friends and co-workers Betty and Wayne had a shared commitment to creating a supportive and healthy home Because Betty and Wayne, in their early years together, devised a plan that worked for each of them, they were able to gain emotional strength from one another Today, Betty and Waynes children are grown with careers of their own The children have grown up with respect for Wayne who managed his diabetes with commitment and dedication; and for Betty who was steadfast in her support of him They view their parents as team players
Diabetes Support Tip 3: Adopt a healthy lifestyle for the entire family
Alissa is a can-do, matter-of-fact mother of two and nurse Her husband, Sean, a professor, was diagnosed with type 1 diabetes 10 years ago Busy and
involved, Alissa and Sean were determined to devise a plan that worked for each of them and would allow them to continue their love of camping and the outdoors Through honest discussions and a willingness to compromise, Sean and Alissa are able to maintain hectic schedules while making sure their children are raised in a loving environment Although Alissa admits that Sean is sometimes resistant to taking advice, he values Alissas health care experience Watching his mothers health decline because of poorly controlled diabetes, Sean is determined to take an active role in controlling his disease Alissa has taught Sean that even when everything is done right, blood glucose will fluctuate and that reasonable expectations must prevail Its obvious that Alissa and Sean both take an active role in managing Seans diabetes Theyre confident with the realistic plan they worked out for Sean and with the strong knowledge base that Alissa has shared with him over the years, Sean will stay in charge and keep his diabetes in control Alissa and Sean are proud their children are growing up in a home where diabetes doesnt interfere with daily goals and they view their family as team players b
By
Millie Glinsky, Indiana Regional Medical Center
Wayne and Betty
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SPECIAL EVENTS
Sponsored by
SATURDAY, AUGUST 16
Faye 
tte County Fairgrounds
12-4 PM
Come to The Great American Cookout, a new adventure in eating Featuring the Food Networks Calorie Commando Juan Carlos-Cruz, performing fantastic feats at the grill Also featuring fun inflatables, scavenger hunts, obstacle courses, cooking and exercise demos, and giveaways galore Its all free And its all coming your way So come one, come all And bring your sense of adventure
Bring a donation of canned goods to benefit the local food bank
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Learn more about Chef Juan-Carlos Cruz
As a pastry chef at Los Angeles glamorous Hotel Bel Air, Juan-Carlos Cruz created dazzling desserts for a variety of Hollywood stars including: Jack Nicholson, Will Smith, Oprah Winfrey, Jim Carrey, Joe Namath, Julia Roberts, and more Receiving high praise for his pastry creations, Juan-Carlos decided to begin his own pasty company in 2001, Pastrydudecom, which is now one of Los Angeles premiere wedding cake destinations While working for the Hotel Bel Air, Juan-Carlos was surrounded by the best ingredients and most
tempting pastry dishes He eventually gained weight, topping 280 pounds As someone who became at high risk for developing diabetes and heart disease, Juan-Carlos realized it was time for a change He appeared on the premiere season of the Discovery Health Networks Body Challenge and lost 43 lbs with an additional 17 lbs lost after the show wrapped After his television appearance, JuanCarloss attitude towards food altered as well He began running Calorie Commando Catering with the mission of providing the best heart-healthy food in Los Angeles Also, finding little relief in fad diets, he developed his own weight-loss strategies and recreated many of his favorite dishes reducing both calories and fat content He reveals the tricks of his trade in his book, The Juan-Carlos Cruz Calorie Countdown Cookbook, which delivers a five-week plan to get menus on track and teaches how to establish a weight-loss plan that you can savor for life To date, Juan-Carlos has lost a grand total of one hundred pounds and is the popular host of two Food Networks shows, Calorie Commando and Weighing In He currently resides in Los Angeles with this family and is touring the country speaking at health fairs and
conducting healthy-cooking demos b
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9
QA
Diabetes and Heart Disease:
An Interview with Dr Robert Stenberg
Diabetes has a profound effect on many different systems of the body, but certainly the cardiovascular system is one of the most severely affected Diabetes is a very powerful risk factor for coronary artery disease Diabetes contributes to several different vascular diseases including artherosclerosis, endothelial dysfunction and microvascular dysfunction It increases the likelihood of atherosclerosis the cholesterol plaque buildup within the arteries of the heart Endothelial dysfunction is a condition where the endothelial cells the lining cells of the arteries become dysfunctional and do not work properly This can contribute to spasms or contractions of the vessels, which reduce blood flow to the tissues
Interviewer: How does cholesterol affect someone with diabetes?
Dr Stenberg: Because of their increased risk of developing heart disease, it is very important for a person with diabetes to control their cholesterol levels This can be done through a combination of diet, exercise, and drug therapies
Interviewer: What are some of the other risk factors for
coronary artery disease?
Dr Stenberg: Other risk factors besides cholesterol levels include smoking and high blood pressure These risk factors may not be directly related to diabetes, but, since diabetes is such a powerful independent risk factor for CAD you should try to eliminate as many risk factors as possible The goal for high blood pressure control is more aggressive in someone with diabetes than for someone without the disease For example, a person with diabetes should keep their blood pressure levels less than 130 systolic and 80 diastolic
Dr Robert G Stenberg Medical Director
Interviewer: Can vascular disease, including microvascular disease, be reversed or treated?
Dr Stenberg: Most vascular disease problems related to diabetes are not reversible, so prevention of heart disease is important for people with diabetes It is possible to reduce some of the plaque deposits with statin or lipid-lowering drugs like Lipitor or Zocor
Interviewer: What can I do to help reduce my risk of diabetes-related complications?
Dr Stenberg: Several recent studies have proven with a fair amount of certainty that blood glucose control will reduce the end-stage complications of diabetes,
including vascular complications, kidney failure, and peripheral neuropathy
Interviewer: Is there anything we can do to prevent diabetes?
Dr Stenberg: One of the biggest risk factors for the development of type 2 diabetes is obesity As the obesity epidemic in the United States continues to increase, more and more people are being diagnosed with type 2 diabetes We are also seeing the diagnosis of type 2 diabetes become more common in children Avoiding obesity is a key factor in preventing diabetes It is also important to maintain an ideal body weight by exercising and following a healthy diet b By Kathy DeFrehn, RCVT, Conemaugh Health System
Interviewer: Is diabetes genetic?
Dr Stenberg: There are two types of diabetes Type 1, which used to be referred to as juvenile diabetes, does involve some genetic ties It is almost always related to an illness or injury that affects the pancreas ability to produce insulin Type 2 diabetes, which is caused by the bodys inability to use the insulin it produces, has a clearer genetic tie Type 2 diabetes is referred to as adult onset because, in most cases, people do not develop diabetes until later in life However, in recent years, type 2
diabetes is being diagnosed in a large amount of children and young adults due to the obesity epidemic
Conemaugh Memorial Medical Center — Johnstown, PA
Conemaugh Memorial Medical Center offers an integrated approach to heart care that spans the spectrum from prevention and diagnostic care to the latest in surgical treatments and rehabilitation Its heart program has been nationally recognized for quality and has been ranked among the top five percent in the nation and fifth in Pa for Overall Cardiac Services To learn more about the cardiac services available at Conemaugh Health System, please call the Conemaugh Nurse Connection at 1-800-587-5875
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Diabetes Care through the Ages
History of Care
3,500 years ago, a third dynasty Egyptian papyrus was some way insulin could be made and injected into listed an unknown disease in which people displayed the body? Excited about the possibility, Dr Banting symptoms of frequent urination This is believed to be went to the University of Toronto to secure a lab and the first ever mention of the epidemic that affects over funding With assistance from a graduate student, 240 million people worldwide We know it today as Charles
Best, insulin was taken from the pancreases diabetes of cows and pigs and injected in human patients Diabetes is a Greek word meaning a siphon This A teenager, Leonard Thompson was the first word illustrates one of the major symptoms of diabetes, person to receive insulin Leonard was a typical frequent urination As the second century Greek doctor diabetes patient in those days, starving, extremely said, patients passed water like a siphon They did not thin, and on the verge of death On January 11, 1922, know that frequent urination is caused by the bodys Dr Bantings pancreatic extract was injected into inability to utilize food that we eat for fuel Very little Leonard At first, no improvement was seen, but was known about diabetes until the 1900s Up until just eventually the results were astounding Leonard was 90 years ago, diabetes was known as back to looking and acting like a a death sentence as the average life healthy young man That same expectancy upon onset could be as year, insulin was given to Elizabeth little as three weeks Hughes The therapy was successful Some doctors in the early 1800s and she lived an additional 60 tried various methods to treat years, happily seeing
her own diabetes They were far from perfect children grow old In the late 1850s, a French doctor However, there was still one began telling his patients to eat large problem remaining, Dr Banting had amounts of sugar We now know neither the money nor the resources that would have made the patients to mass produce his pancreatic condition much worse extract Eli Lilly and Company did In the late 1800s, doctors stopped have the resources and were given telling people to eat high sugar diets permission to make the insulin By They began using other types of diets 1923, insulin became commercially Dr Frederick Banting to help people live longer These diets available for everyone left people reduced to skin and bones and only extended The long term results were better than anyone their life a few years at best could have ever imagined Patients went from a life In 1919, Elizabeth Hughes, daughter of a well known of starvation and pain to leading normal lives Some American politician, was diagnosed with diabetes To people have been insulin users for 80 or more years control her diabetes she was put on a special diet by now, something that would have been impossible not her doctor He told
her to eat no more than 350 to 400 so long ago calories per day As a result, three years later she was In 1982, another breakthrough with insulin was five feet tall and weighed just 45 pounds A miracle was made Eli Lilly and Company was again at work Using needed DNA technology, Lilly produced insulin identical to what the human pancreas produces This was the first The Father of Insulin ever health care product to use such technology Now items, such as insulin pumps and pens, have Dr Frederick Banting served in World War I as a been introduced to make treating diabetes as easy front line surgeon When he returned home to Ontario, as possible and there may be more breakthroughs Canada, he would begin studying what would forever on the way It may not be long before taking insulin change the treatment of diabetes becomes a painless part of your daily routine b Dr Banting was reading an article about the pancreas when an idea occurred to him What if there By Michael McDermot, University of Pittsburgh Diabetes Institute
3,500 years ago, a third dynasty Egyptian papyrus listed an unknown disease in which people displayed symptoms of frequent urination This is believed to be the first
ever mention of the epidemic that affects over 240 million people worldwide We know it today as diabetes
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11
Summer has Arrived Fire up the Grill
The warm weather draws us back to the great outdoors for fun as well as mealtimes This can offer some challenges to eating healthy and keeping your diabetes in control However, with some simple planning, you can enjoy all your favorite summer foods Grilling is a great way to cook low fat meals You can still enjoy burgers sizzling on the grill as part of a heart healthy diet if you make a few simple changes Start with lean or extra lean beef, poultry, or even venison Extra lean beef also know as 95/5 or five percent, or lean meat also know as 90/10 or 10 percent are both good options But remember, the key is portion control A three ounce patty of extra lean meat has 5 grams of total fat and less than two grams of saturated fat The cholesterol is about the same for most cuts of red meat: 95 milligrams per 3 ounces Refrigerate burger patties before cooking so that they hold their shape Then, cook thoroughly over medium heat until the burger is no longer pink in the middle Now you are ready to load your burger with lots of
healthy toppings Forgo the high fat ones such as bacon, cheese and mayo You can add moisture, flavor and nutrition by using these low calorie options: Enjoy summer salads Try different greens in place of iceberg lettuce Cut up veggies and toss with a low calorie dressing Make different salads such as tomato salads with onions and a little olive oil, green bean salads, or cucumber salads Since you have the grilled fired up, go ahead and load it with vegetables You can grill mushrooms, onions, bell peppers, zucchini, eggplant, asparagus, and more Spray veggies with non stick cooking spray and lightly coat with salt free seasoning You can wow your guests with vegetable kabobs on the grill Just assemble the veggies on the kabob stick and grill on all sides For your starch, you can grill corn on the cob and red skin potatoes As usual, portion control is the key To keep hydrated on those dog days of summer, drink ice water flavored with citrus fruit Unsweetened teas are calorie free and full of antioxidants For a shot of natural sweetness, slice in fresh fruit and refrigerate overnight My favorite is mango tea What about desserts? With all the fresh fruits available, enjoy the sweetness
of berries and melons If you cant resist, calculate in a small piece of apple pie or a berry sundae made with frozen yogurt Summer is a great time to enjoy family, friends, food, and life Make great memories this summer by eating healthy, moving more, and improving your control of diabetes When youre done moving, sit on the front porch and take in the sunset b By Judy Siebart, MS, RD, LDN, Highlands Hospital Diabetes Center
onions tomatoes all types of peppers lettuce/leafy greens salsa ketchup mustard cucumbers barbeque sauce even fruit like grilled pineapple
Serve up some healthy sides
Summer is when fruits and vegetables are at their best Whether you get them straight from the garden, local farmers markets, or the grocery stores the abundance of fresh produce makes eating well a breeze
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DIABETES-FRIENDLY RECIPES
Courtesy of Chef Juan-Carlos Cruz
Strawberry Toasted Pecan Chicken Salad
Number of Servings: 4
2 cups skinned and boned roasted chicken breast, from a store-bought rotisserie chicken cup pecans, toasted 2 cups hulled and quartered strawberries cup finely diced red onion cup finely diced celery cup finely chopped cilantro leaves 2
tablespoons balsamic vinegar 2 tablespoons olive oil 4 cups salad greens
Apple Pear Slaw
Number of Servings: 4
cup apple cider 1 tablespoon brown sugar teaspoon salt teaspoon pepper 1 cup julienned apples 1 cup julienned pear cup dried cranberries 2 cups julienned Belgium endive
1 In a small bowl, mix together the apple cider, brown sugar, salt, and pepper 2 Toss the apples, pears, and dried cranberries in the apple cider mixture until well combined 3 Evenly divide the endive among 4 plates Divide the apple mixture into 4 equal portions and top each plate of endive
Nutrition information per serving: Total fat: 0 grams Total carbohydrates: 22 grams
1 Combine chicken, pecans, strawberries, onion, celery, cilantro, vinegar, and oil Cover and marinate in the refrigerator for 1 hour Serve over salad greens
Nutrition information per serving: Total fat: 10 grams Total carbohydrates: 11 grams
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UPCOMING EVENTS
Centerville Clinics
For more information, call 724-632-6801
Diabetes Self-Management Education — Diabetes Center
Every Wed, 10 am and 2 pm Every Thu, 5:30 pm
Gaining Unlimited Information on Diabetes Education GUIDE Adult Diabetes Support
Group
Second Tue of each month, 10 am
Diabetes Support Group — Hospital Dining Room
Every Wed, 10 am Second Wed of each month, 7 pm
Annual King Coal Show
Aug 19 to 21, 6 pm to 9 pm Visit the Centerville Clinic booth for a free health screening
Indiana Regional Medical Center
For more information, call 724-357-7164
Cal U Annual Health Fair
Sept 17, 11 am to 3 pm
Diabetes Self-Management Education — Indiana Location
Three sessions beginning July 7, Aug 4, Sept 8, and Oct 6, 9 am Three sessions beginning July 9, Aug 6, Sept 3, and Oct 1, 6 pm
Conemaugh Diabetes Institute
For more information, call 814-534-6800 or 1-866-641-3828
Diabetes Self-Management Education — Lee Campus
Four sessions beginning July 7, 9 am 1 pm, and 5:30 pm Four sessions beginning Aug 11, 9 am 1 pm, and 5:30 pm Four sessions beginning Sept 8, 9 am 1 pm, and 5:30 pm Four sessions beginning Oct 13, 9 am 1 pm, and 5:30 pm
Diabetes Self-Management Education — Northern Cambria Location
Three sessions beginning Aug 1, 9 am
Diabetes Self-Management Education — Seward/ Bolivar Location
Three sessions beginning Sept 5, 9 am Individual sessions and nutrition therapy are available by appointment only
Adult
Support Group — Indiana Location
Sept 9 and Oct 14, 7 pm
Diabetes Self-Management Education — Meyersdale Medical Center
Four sessions beginning Sept 17, 1 pm and 6 pm
Uniontown Hospital
For more information and to register, call 724-430-5971
Diabetes Support Group — Lee Campus
July 10, Aug, 4, Sept 4, and Oct 2, 1 pm and 6 pm
Diabetes Self-Management Education
Every Mon in July, 9 am Every Mon in Aug, 1 pm Every Mon in Sept, 6 pm Classes are held in the Diabetes Education Center Individual sessions are available by appointment only
Diabetes Support Group — Meyersdale Medical Center
July 7, Aug 4, Sept 8, and Oct 6, 1 pm and 5:30 pm
Diabetes Support Group — Miners Medical Center
July 15, Aug 19, Sept 16, and Oct 21, 1 pm and 5:30 pm
Diabetes Support Group
Fourth Mon of each month, 2 pm
Washington Hospital
For more information and to register for classes, call 724-250-6262 or 1-800-360-5818
Lifestyle Balance Screening — Lee Campus
Aug 14 and 21, 9 am, 1 pm, and 5 pm
Life Skills Series — Washington
Four sessions beginning July 2, 7, and 31 Four sessions beginning Aug 7 and 11 Four sessions beginning Sept 4, 8, and 9
Diabetes Prevention Support Center
For more
information, call 412-383-1286 or 1-877-444-DPSC Referrals for the Group Lifestyle Balance classes are currently being accepted
Life Skills Series — Waynesburg
Four sessions beginning July 1, Aug 4, and Sept 9
Life Skills Series — Peters Township
Four sessions beginning Aug 13
Highlands Hospital
For more information, call 724-628-8008
continued
Magee-Womens Hospital of UPMC
To learn more about the services available, call 412-6414455
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pride news
UPMC Bedford
For more information, call 814-623-3588
Diabetes Self-Management Education
July 17, Aug 28, Sept 25, and Oct 23, 9 am to 4 pm
UPMC Braddock
For more information or to register for classes, call 412-636-5381
Mon 12:30 pm Tue 5 pm Wed 9 am UPMC Green Tree Outpatient Center Thu 9 am UPMC South Hills Outpatient Center Sat 9 am seasonal Individual sessions are available by appointment only
Diabetes Support Group
For more information, call 412-232-7173
Diabetes Self-Management Education
Three sessions beginning Aug 12 and Sept 9, 9 am Three sessions beginning July 9 and Oct 15, 4:30 pm Individual sessions are available by appointment only
UPMC McKeesport
For more information or to register for classes, call
412-664-3055
Diabetes Self-Management Education
Tue and Thu in July and Oct, 1 pm Tue and Thu in Sept, 6 pm Individual sessions are available by appointment only
UPMC Center for Diabetes and Endocrinology
For more information or to register for classes, call 412-586-9700
Diabetes Self-Management Education
Fri in July and Sept, 9 am to 12 pm Falk Clinic, Suite 3B
UPMC Northwest
For more information or to register for classes, call 814-676-7992
Insulin Pump Class
First Fri of each month, 9 am to 12 pm
Diabetes Self-Management Education
Four sessions beginning July 15, and Sept 16, 9 am and 6 pm Four sessions beginning Aug 12 and Oct 14, 9 am Individual sessions are available by appointment only
UPMC Horizon — Greenville
For more information, call 724-589-6163
Free Blood Glucose Screening
Every Thu, 7 am to 9 am Regional Diabetic Center
Lifestyle Balance Program
Coming Fall 2008
UPMC Passavant — Cranberry Campus
For more information or to register for classes, call 412-367-5065 To register for nutrition education, please call 412-367-6398
Diabetes Support Group
Second Mon of each month, 7 pm Meeting is held in hospital basement Individual and Group Diabetes
Self-Management Education classes are available Call 724-589-6163 for dates and times
Diabetes Self-Management Education
Four sessions beginning Sept 9, 1 pm Four sessions beginning Oct 7, 6 pm Classes are held in second floor Conference Room
UPMC Horizon — Shenango Valley
For more information, call 724-983-7160
SAVE THE DATE JOIN US
Four locations to choose from:
Blue Spruce Park
Indiana, PA SUNDAY, SEPT 21, 2008
Free Blood Glucose Screening
Every Thu, 7 am to 9 am Regional Diabetic Center
UPMC Passavant — McCandless Campus
For more information or to register for classes, call 412-367-5065 To register for nutrition education, please call 412-367-6398
Diabetes Support Group
Second Tue of each month, 1:30 pm Meeting is held in hospital conference room Individual and Group Diabetes Self-Management Education classes are available Call 724-983-7160 for dates and times
Pennsylvania Military Museum
Boalsburg, PA SUNDAY, SEPT 21, 2008
Diabetes Self-Management Education
Four sessions beginning Sept 3, 6 pm Four sessions beginning Oct 8, 1 pm
Pittsburgh Zoo PPG Aquarium
Pittsburgh, PA SUNDAY, SEPT 28, 2008
UPMC Mercy
For more information, call 412-232-5908
UPMC
Shadyside
Please contact UPMC Referral Service at 412-647-8762 option 1 to register
Twin Lakes Park
Greensburg, PA SUNDAY, SEPT 28, 2008
To Register call our office at 1-888-DIABETES 342-2383 or Visit our web-site at wwwdiabetesorg/stepout
Diabetes Self-Management Education
Classes are offered monthly during the following days and times
continued
Diabetes Self-Management Education
Aug 9 and 16, 8:30 am to 2 pm
wwwprideofpaorg
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PRIDE PROGRAM PARTNERS
UPMC Diabetes Education Sites
Childrens Hospital of Pittsburgh of UPMC 412-692-5171 Childrens Hospital of Pittsburgh of UPMC - East 412-666-3800 Childrens Hospital of Pittsburgh of UPMC - Johnstown 412-692-5171 Lions Diabetes Center at UPMC McKeesport 412-664-3055 Magee-Womens Hospital of UPMC 412-641-4455 UPMC Bedford Memorial 814-623-3588 UPMC Braddock 412-636-5381 UPMC Center for Diabetes and Endocrinology 412-586-9700 UPMC Center for Diabetes and Endocrinology Monroeville 412-858-0336 UPMC Center for Diabetes and Endocrinology South Hills 412-344-7979 UPMC Horizon - Greenville 724-589-6163 UPMC Horizon - Shenango Valley 724-983-7160 UPMC Mercy 412-232-5908 UPMC Northwest 814-676-7992 UPMC Passavant - McCandless 412-367-5065
UPMC Passavant - Cranberry 412-367-5065 UPMC St Margaret 412-784-4195 UPMC Shadyside 412-623-2458 UPMC South Side 412-488-5687 VA Pittsburgh Healthcare System 1-866-482-7488
Additional Diabetes Education Sites
Centerville Clinics, Inc
Fredericktown
The Center for Diabetes Care at Indiana Regional Medical Center
Indiana
Editor
724-632-6801
wwwcentervilleclinicscom
724-357-7164
wwwindianarmcorg
Michelle Faderewski
Conemaugh Diabetes Institute
Johnstown
Diabetes Center at Uniontown Hospital
Uniontown
814-534-6800 or 1-866-641-3828
wwwconemaughorg
724-430-5971
wwwuniontownhospitalcom
Highlands Hospital Diabetes Center
Connellsville
724-628-8008
wwwhighlandshospitalorg
PRIDE News, a publication for diabetes patients and their families
This project was sponsored by funding from the United States Air Force administered by the US Army Medical Research Acquisition Activity, Fort Detrick, Maryland, Award Number W81XWH-04-2-0030 Review of materials does not imply Department of the Air Force endorsement of factual accuracy or opinion
The Washington Hospital Diabetes Education and Management Program
Washington and Waynesburg
724-250-6262
wwwwashingtonhospitalorg
Diabetes
INSTITUTE
in partnership with UPMC
Send us your thoughts
Email pride@upmcedu, or send a note to: PRIDE News, c/o University of Pittsburgh Diabetes Institute, Ross Building, first floor, 4601 Baum Blvd, Pittsburgh, PA 15213 wwwprideofpaorg
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Source:annals.org
