| Litvin Centers for Diabetes Newsletter |
Volume 33
November, 2008 |
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Dear Patients & Colleagues,
I would like to wish all of our readers a warm welcome to this Fall Edition of our newsletter. The purpose of the newsletter is to keep the reader informed about current and new developments in the ever-expanding field of diabetes, as well as to inform you about new developments in our own Litvin Centers of Diabetes (LCD).
Most important, is our recent acceptance of a Certificate of Recognition by the American Diabetes Association and National Committee for Quality Assurance on Achievement of Recognition of Delivery of Quality Diabetes Care. This award was given to approximately 20 practices in all of New Jersey and The Litvin Centers for Diabetes is proud to be included in that short list.
Furthermore, we would like to remind you that nutrition and podiatry consults are available in both locations and acupuncture service in our Ft. Lee location. We plan to initiate monthly PM meetings with a clinical diabetes educator and we are restarting our in-office nuclear exercise stress testing for screening our patients for potential heart disease.
We are also considering a class by a Chef/MD about diabetes-cooking which would involve cooking and eating a whole meal. Please let us know if you're interested so arrangements can be made by taking our quick Survery, click here.
Sincerely,
Dr. Litvin |
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Recent Diabetes News
Fewer Diabetic Women than Men Achieve Target Goals
In a study looking at 211 under-served inner-city and rural patients, researchers from Temple University found that diabetic women carry a greater risk of developing heart complications and death following an acute heart attack, than do either diabetic men or women without diabetes. Upon reviewing the medical charts of these high-risk women, researchers found that targets for good control of diabetes, blood pressure, and cholesterol were not achieved in this group as compared to the other two groups, despite being equally medicated. Regardless of the reason, diabetic women seem to be at unexplained higher risk for heart disease.
Insulin Treatment and Alzheimer's
In a study from Mt. Sinai Hospital in NYC, researchers examining the brains of 148 Alzheimer patients half of whom also had diabetes, found that patients with diabetes who took both insulin and oral anti-diabetic medications had significantly less Alzheimer pathology than those who were either not medicated or did not take insulin. Insulin seems to have a beneficial effect on brain tissue in Alzheimer-prone individuals. This may serve as another reason not to shy away from insulin in the elderly diabetic.
Skin Temperature and Shoes as Culprits in Foot Ulcers
Foot ulcers are one of the most common precursors to the more than 100,000 diabetic-related amputations performed in the US annually. Patients with neuropathy and /or peripheral vascular disease are at greatest risk for developing foot ulcers, and they are the group that should be examined carefully. Since the office visit is typically short, most of the responsibility lies with the patient. About 20% of foot ulcers are triggered by ill-fitting shoes, mainly among women. Medicare patients may take advantage of a program which provides for therapeutic footwear and insoles for patients who are at risk. Other signs which may precede an ulcer include pain, loss of function, edema, redness, and local heat. These may go unnoticed in patients with neuropathy. Of all the signs, heat may be easiest to identify. A long-armed handheld infrared skin thermometer called TempTouch (www.temp-touch.com) may help in that respect. Patients who detect a temperature difference of more than 4 degrees in corresponding sites of the two feet, should alert their physician. |
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Medication, Gadgets & Lifestyle Info
Vitamin C Levels and Diabetes
Plasma Vitamin C levels show a strong inverse relationship with the risk of developing diabetes. People with the highest levels had a 62% lower chance of developing diabetes. Vitamin C seems to be a good marker for fruit and vegetable consumption, because in Western diets it is its main source. High fruit and vegetable consumption may reflect other life-style issues, however regardless of the potential complexity, it seems to be prudent to increase consumption of fresh produce.
Real-Time Blood Ketone Monitoring
Ketones are of course implicated in diabetic ketoacidosis, which in type 1 diabetic patients is a catastrophic event necessitating an emergency room visit. Monitoring real-time blood ketones significantly reduces visits to the emergency room, and is much superior to testing for ketonuria with urine dipsticks. A handheld device marketed by Abbott/MediSense (Percision Xtra) is able to measure both blood glucose and ketones. Early detection is key to prevention, and therefore in patients with a blood glucose exceeding 300 mg/dL, it is recommended to check ketones. Elevated ketones mandate more insulin with more fluids, along with close follow up. Please ask me for the device.
Free 2008 Diabetes Pocket Guide
The National Diabetes Education Program is offering a reference card with lists of current recommendations on diagnosis and treatment of prediabetes and diabetes, treatment goals, and a diabetes management schedule. Call 888-693-6337 for a free copy.
Free Booklet for Pregnant Diabetic Women
The National Institute of Diabetes and Digestive and Kidneys Diseases is offering a publication "For Women with Diabetes: Your Guide to Pregnancy". This booklet outlines a diabetes care plan, and includes forms for recording glucose levels, food intake, medication, and physical activity. To order call 800-860-8747 or visit http://diabetes.niddk.nih.gov/dm/pubs/pregnancy.
Living Your Best Life: Diabetes & Insulin
The Hormone Foundation has created its first patient video which follows 4 people with diabetes as they live their lives to the fullest while taking insulin. This 25-minute video can be viewed on the Foundation's Web site at www.hormone.org/bestlife. |
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Cuisine Corner
Quinoa and Black Bean Salad:
Quinoa (pronounced KEEN-wah), is a high-protein grain that was eaten by the Incas and is currently a staple in some African countries. It is a pale yellow disk-shaped whole grain with a nutty flavor. It is widely sold in the health-food stores, and is naturally gluten-free.
Ingredients: 1 ½ cups quinoa; 1 can (15 ounces) black beans, rinsed and drained; 1 ½ tablespoons red wine vinegar; 1 ½ cups frozen corn; ¾ cup chopped green bell pepper; 1 medium tomato, chopped; 4 green onions 9green and white parts), chopped; ¼ cup finely chopped fresh cilantro; ¼ cup fresh lime juice; ½ teaspoon salt; ¼ teaspoon black pepper; 1 ¼ teaspoons ground cumin; ¼ cup olive oil.
Directions: Bring 3 cups of water to a boil in a two-quart saucepan. Add quinoa and bring back to a boil. Cover and cook over medium heat for about 12 minutes or until the quinoa has absorbed all of the water. Remove from heat and fluff. Let cool slightly. While the quinoa is cooking, toss beans with vinegar, corn, green pepper, tomato, green onions, and cilantro in a large bowl. In a small bowl, whisk together lime juice, salt, black pepper, cumin, and oil. Add the cooled quinoa to the vegetables and drizzle the dressing over salad. Toss to combine. This salad may be made on day ahead, covered, and chilled.
Preparation time : 20 minutes. Cooking and cooling time : 30 minutes. Yield: 11 servings. Serving size: about ¾ cup. Per serving: Calories: 170; Carbs: 26 g; Protein: 5 g ; Fat: 6 g; Saturated fat: 1 g; Cholesterol: 0 mg; Fiber: 4 g; Sodium: 190 g.
Exchanges per serving: 2 starch, 1 fat Carbohydrate choices: 2.
Recipe taken from Diabetes Self-Management July/August 2008 | |