that we provide to those with diabetes in. our community! Preventing Diabetes Across Generations. Power to Move Exercise Classes …
News You Can Use
On Diabetes
An Update for CHA/Ps and Village Clinics
Winter 2007
INSIDE THIS ISSUE:
How Many People in Your Village Have Diabetes and Dont Know it?
2 2 3 3 3 4 4
Keeping weight lost Children and Weight Lasers for the eye Weight loss pill approved Smoking and kidneys f/u for GDM Time management Teens
The number of AK Natives who have diabetes is increasing every year In fact, from 1990 to 2004, the number of AK Natives that have diabetes has increased by 104 In some regions this number is much, much higher
person may have higher than normal blood sugars that are causing damage in the body, but the person may not have any symptoms
to be diabetes People with prediabetes are at increased risk for heart disease, stroke, and for developing type 2 diabetes Prediabetes does not have symptoms It is important to know if you have diabetes or prediabetes so that it can be treated before it causes damage in the body For some people this may mean increasing exercise, eating healthier and losing a small amount of weight Others may also need to take medication How do you know if you someone in your family have blood sugars out of the normal range? Get screened A normal
fasting is less than 100 Any blood sugar over 100 needs to be followed up call your regional doctor
AK Area Diabetes Program
Phone: 907-729-1125 Fax: 907-729-1129 Email: tahicks@anmcorg Teresa Hicks RD, LD, CDE
In a study published in the 2006 issue of Diabetes Care, the Center for Disease What is just as worrisome, Control CDC looked at is the number of people who national survey data from 1999 to 2002 The survey have diabetes and dont know it The symptoms for randomly interviewed participants in their homes and diabetes come on very slowly Sometimes it takes did a physical exam that included a fasting blood years before a persons blood sugar values get high glucose Of all the participants in the survey found to enough to give him the symptoms most people as- have diabetes, 33 did not sociate with diabetes: such know they had the disease as being really thirsty, hav- Additionally, it was found ing to pee a lot, blurry vithat 26 of adults over age sion, and being really tired 20, had prediabetes PrediaBecause these symptoms betes is a condition of blood dont occur until a persons sugars that are higher than blood sugar is very high, a normal, but not high enough Picture on left:
Rahnia Parker, from Norton Sound CAMP Diabetes Program explains reading a label to students in Savoonga while Iditarod musher, Joe Garnie looks on Joe Garnie traveled to many of the Norton Sound region schools with CAMP staff to talk about diabetes prevention, the importance of education, and alcohol prevention Picture on right - Gussie Ivanoff and Joe Garnie demonstrate how much sugar is found in the average can of pop at the NSHC CAMP Wales-ness dance festival in Wales
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Stress and B lood Sug ar
News You Can Use
The Easiest Way to Lose Weight
Restaurants often get blamed for serving too much food, but we also need to take blame for serving ourselves too big of portions Researchers at Cornell University decided to hold an ice cream social for the university nutrition department Participants were given either a small or large bowl and a small or large spoon, and allowed to serve themselves While participants filled out questionnaires stating how much ice cream Most surprising participants given the large bowls, guessed that they had Those who were given a large bowl ate eaten the same amount of ice cream as the people given small bowls And 31 more than those given a small
bowl, regardless of the size of spoon this was the nutrition department at Those given a large spoon ate 145 Cornell University more ice cream than those given a The message here eat off your salad small spoon, regardless of the size of plate instead of your dinner plate Use bowl But the biggest difference came child-sized utensils and smaller cups when participants were given a large Research showsyou wont even bowl and a large spoon those people know you used to eat more ate 57 more than those with a small they thought they had served themselves, their actual ice cream portion was weighed bowl and small spoon
Drink Water, Lose Weight
A study presented at the annual Obesity Society meeting analyzed weight loss data on 240 overweight women who were following a diet plan Women who replaced ALL sweetened drinks with water lost 5 more pounds a year than those who did not Women who drank at least 4 cups of water a day, lost 2 MORE pounds more than dieters that didnt drink as much Weight loss is hard work, one of the easiest changes to make is a change in the type of drink you choose
Keep Lost Weight LOST
Most people who lose weight by dieting, regain the weight they lost But there is
good news Researchers have studied people who are able to MAINTAIN their weight loss over time and have a tip to pass on 314 people who had lost on average 20 of their body weight within the last 2 years were recruited to be in a study Some people were put into a control group where they simply got mailings about making healthy food changes In the study group, participants were taught to weigh themselves everyday, then make quick changes to lifestyle that included boosting activity and cutting food calories If participants gained 5 lbs or more, they were taught to use food diaries and pedometers to get quickly back on track A year and a half later, 72 of the control group gained 5 or more pounds, but only 50 of the study group did This study is an important reminder why we need to continue to follow-up and provide education for our patients who have been successful with losing weight
Chances AreHe Probably Wont Grow Out of It
After following the children for 10 years, researchers found that 60 of children who were overweight in preschool ended up being overweight by age 12, and 80 of children who were overweight during elementary school 1,042 children were followed from age ended
up being overweight by age 12 2 to 12 years Their BMI was measured 7 times in this period of time The childrens odds for becoming BMI is a measure of weight in relation overweight by age 12 were also calcuto height The children were from lated It was found that a child over many different ethnic groups and inthe 75th percentile at age 7 is 10 times come levels more likely to be an overweight adoA study done by the National Institute of Child Health and Human Development, found that overweight children usually grow to be overweight adolescents lescent, than a child in the 50th percentile This new information may change the current guidelines that say a child is at risk for overweight once they are above the 85th percentile It also provides support for the prevention of obesity at an earlier age Talk to parents early about their childrens weight
Winter 2007
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Lasers Prevent Blindness Due to Diabetes
Diabetes is the number one reason Americans go blind diabetic retinopathy If a person with diabetes controls their blood sugar and blood pressure, their risk of going blind due to diabetes is low, however some people who do control their diabetes can still suffer vision loss
Fortunately, the invention of a special laser intended for use in eyes has greatly reduced the number of people who go blind from diabetes retinopathy Diabetic reti 
nopathy happens when high blood sugar damages the small blood vessels in the eye Once the small blood vessels become damaged, the body builds new vessels that are weak When these new weak vessels try to carry blood they break easily and leak blood and cause scarring This leaking of blood and scarring can lead to blindness How do lasers treat these weak vessels? The lasers actually cauterize the leaky vessels and seal them off, preventing further vision loss Laser therapy does not TREAT blindness, it helps prevent it Once someone has gone blind from diabetes, it is too late How do your patients know if they have weak leaky blood vessels, that may cause them to go blind? Only one way a dilated eye exam from an eye doctor Diabetes Retinopathy does not have symptoms The only way to detect, treat, and prevent blindness from diabetes is to make sure your patients get a dilated eye exam from an eye doctor at ANMC or your regional hub EVERY YEAR
FDA Approves First Over-the-Counter Weight Loss Pill
People trying to lose weight
may have a new weapon to take to the battle Xenical, a prescription only diet pill, is now available over the counter in a reduced strength form The over-the-counter pill is called Alli The pill works by decreasing the amount of fat that can be absorbed from the intestine It can block about 1/4 of fat eaten That blocked fat leaves the body in the form of stools It is to be used only by adults age 18 years and older and is expected on the market this summer Of course, Alli is no magic bullet unfortunately there never is The FDA stated that the drug alone, is unlikely to be effective The drug is intended to be used with a low calorie, low-fat diet and with regular exercise It is to be taken with meals and can be taken up to 3 times a day In studies, people who lost weight through diet and exercise, lost an additional 2 to 3 pounds if they were taking Alli There are some side effects to the drug the most common include gas and diarrhea About half of the study participants had diarrhea A daily multivitamin is also recommended since some of the fat soluble vitamins can be lost Alli is not for everyone People who have had organ transplants, are on blood thinning medications and people
with diabetes need to consult with their doctor first
Kids Today
Between 1988 and 2004, childrens belly fat has increased by more than 65 among boys and almost 70 among girls An increase in belly fat is a better predictor of type 2 diabetes and heart disease than BMI The two groups of children that have had the largest percent increase in belly fat are 2 to 5 year olds 84 increase and 18 to 19 year olds 126 increase
Smoking Just Not Hard on Your Lungs
ested in stopping smoking? Have them call 1-888-842-QUIT, to talk to a registered nurse trained in tobacco cessation The number is free and open 24 hours a day, 7 days a week People who call are also eligible for free nicotine replacement therapy
People with type 2 diabetes who smoke cigarettes are more than twice as likely as non-smokers to have something go wrong with their kidneys These are the findings of a recent study published in the journal DiabeThe good news? For children and adolescents the risk for tes Care This study reindiabetes and heart disease from extra belly fat are reversible forces the importance of with weight loss from healthy lifestyle changes Talk to talking to patients about your parents about the
importance of decreasing childrens stopping smoking screen time and making healthy drink choices to maintain a Do you have a patient interhealthy weight
Gestational Diabetes After Delivery, Women Go Unchecked
Women who have gestational diabetes GDM are at high risk for developing type 2 diabetes later on All women who have had GDM should be tested for type 2 diabetes 6 weeks after delivery and again after stopping breastfeeding, using a glucose tolerance test The glucose tolerance test done after delivery is similar to the test used to check women for GDM After the woman delivers, she is asked to come to the clinic fasting, have her blood drawn, then drink a 75 gram sugary drink, and have her blood tested again 2 hours later Are your moms with GDM being tested postpartum? Try to combine the mothers GDM follow-up appointment with In a study featured in the December the babys 6 week well issue of Obstetrics and Gynecology, child visit A mom is only 45 of women with GDM are often more likely to atfollowed up postpartum Of the 45 tend a visit that checks who were tested in the study, 36 had the health of her baby than one only high blood sugars for herself
Want a Teen to Be More
Active? Then Teach Them Time Management
Researchers in Ohio looked at a new way to get teens to become more active by teaching them time management, goal setting, self monitoring, and asking for support from peers Basically the same things that help busy adults become more active their time effectively
In this research project, the kids received an exercise program once a week for eight weeks as part of their PE class Students in the study were also given instruction on goal setting, time management and monitoring The parIt is well documented that as children turn into ticipants kept logs of their activity and how Norton Sound Health Corthey spent their non-school time in 30 minute poration CAMP dietitian adolescents their activity levels start to deblocks cline This particular group of researchers Kelly Keyes displays the looked at the problem differently then usual By the end of the 8th week, students who re- Smart Choices Big Republic health campaigns Instead of just enported getting no moderate exercise fell from wards card CAMP offers at the Iditarod basketball couraging teens to become more active, they 47 to 9, and the average amount of exer- tournament asked why are teens
becoming less active? cise students got rose For every healthy choice a What the researchers found, is that as children person makes, they get a The biggest difference was found in the turned into adolescents, they also started to VERY sedentary group This group enjoyed sticker When they have take on more adult roles like working, dating tailoring their activity goals to their own per- collected six stickers, they turn the card in for a drawand driving As their lives became busier, just sonal likes and dislikes ing for a prize like adults, they often had problems managing
Spice Mix Trying to cut back on your salt? Does your food taste bland without it? Try this spice mix on meat, potatoes, rice or vegetables 2 teaspoons garlic powder 2 teaspoons dried lemon powder 1 teaspoon basil 1 teaspoon oregano 1 teaspoon ground pepper 1 teaspoon chili powder Sometimes the best cereals are the ones that have been around forever Think your village store doesnt have any healthy choices? Think again Often times the cereals that claim to be Heart Smart have more sugar than Frosted Flakes Others arent whole grain Read the nutrition facts label to be sure youre getting a healthy choice Things to
look for: the first ingredient listed should be whole grain, the cereals should have at least 3 grams of fiber, and try to keep the sugar under 5 grams, or close to it Who fits these guidelines? Cheerios, Shredded Wheat, Wheaties Read the label to find others
Source:medicalcenterofplano.com
