November is National Diabetes Month. Each week this month, we will be posting about a different topic related to Diabetes.

Did you know…

• Nearly 30 million children and adults in the United States have diabetes
• Another 86 million Americans have prediabetes and are at risk for developing type 2 diabetes
• The American Diabetes Association estimates that the total national cost of diagnosed diabetes in the United States is $245 billion

Let’s start with some basic definitions

Diabetes mellitus: a condition characterized by high blood sugar levels resulting from the body’s inability to use blood glucose for energy.  Glucose is the energy source of cells that make up your muscles and tissues.

Type 1 diabetes: in Type 1 diabetes the pancreas no longer makes insulin and therefore blood glucose cannot enter the cells to be used for energy.

Type 2 diabetes: in Type 2 diabetes, either the pancreas does not make enough insulin or the body is unable to use insulin correctly.

Prediabetes: a condition in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes. People with diabetes are at increased risk for developing Type 2 diabetes and for heart disease and stroke.

a type of diabetes mellitus that develops only during pregnancy and usually goes away upon delivery, but increases the risk that the mother will develop diabetes later. GDM is managed with meal planning, activity, and in some cases, insulin.

Definitions taken American Diabetes Association.

Gastroparesis & Diabetes

While many people know about diabetes and its connection to sugar, a little less commonly known, is the connection of gastroparesis and diabetes. Uncontrolled diabetes, especially type 1 diabetes, can lead to the development of gastroparesis. Gastroparesis is a form of neuropathy in which the stomach and intestines slow down or become less efficient at emptying. Nerves in the gastrointestinal tract become damaged and do not function properly.

Symptoms

• Nausea
• Vomiting
• Loss of appetite
• Heartburn
• Abdominal pain
• Bloating
• Constipation or diarrhea
• Erratic blood glucose levels

Nerve damage in your eyes, feet or kidneys increase changes of gastroparesis
 
Diagnosing

• Gastric Emptying Breath Test (GEBT)

Conducted over a 4 hour period after an overnight fast
Treatment

• Achieve blood glucose control
• Meal planning with a Registered Dietitian
• Some patients require medication
• Some patients require surgery
• Gastric pacemaker

Nutritional Approaches

• Small frequent meals
• Limit fiber intake
• Choose healthy fats (avocados, nuts, and olive oil)
• Drink adequate fluids between meals
• Stay physically active

Check back next week, we will be discussing the link between sleep and diabetes!

Sources:
American Diabetes Association
Stomach in Knots? Diabetic Living

With the Holidays approaching, we know this also means that we are soon to be faced with endless amounts of parties, food, and celebrations. This time of year can be hectic and stressful, resulting in some people becoming less in tune with what they are putting in their bodies. While it is important to enjoy the wonderful food and company of loved ones, this time of year does not have to be any different than the rest of the year and your healthful eating.

This is where the concept of Mindful Eating (similar to intuitive eating) comes in. Mindful eating is especially important to remember when life gets chaotic and I challenge you to practice your Mindful Eating skills this holiday season.   “Mindful Eating is allowing yourself to become aware of the positive and nurturing opportunities that are available through food selection and preparation by respecting your own inner wisdom. By using all your senses in choosing to eat food that is both satisfying to you and nourishing to your body, acknowledging your responses to food (likes, dislikes, or neutral) without judgment, and becoming aware of physical hunger and satiety cues to guide your decisions to begin and end eating you can change your relationship to food.”

Principles of Mindful Eating

1. Mindfulness is deliberately paying attention, non-judgmentally
2. Mindfulness encompasses both internal processes and external environments
3. Mindfulness is being aware of what is present for you mentally, emotionally and physically in each moment
4. With practice, mindfulness cultivates the possibility of freeing yourself of reactive, habitual patterns of thinking, feeling and acting
5. Mindfulness promotes balance, choice, wisdom, and acceptance of what is

Mindful Eating Is…

1. Allowing yourself to become aware of the positive and nurturing opportunities that are available through food preparation and consumption by respecting your own inner wisdom.
2. Choosing to eat food that is both pleasing to you and nourishing to your body by using all your senses to explore, savor and taste.
3. Acknowledging responses to food (likes, neutral or dislikes) without judgment.
4. Learning to be aware of physical hunger and satiety cues to guide your decision to begin eating and to stop eating

1. Acknowledges that there is no right or wrong way to eat but varying degrees of awareness surrounding the experience of food.
2. Accepts that his/her eating experiences are unique.
3. Is an individual who by choice, directs his/her awareness to all aspects of food and eating on a moment-by-moment basis.
4. Is an individual who looks at the immediate choices and direct experiences associated with food and eating: not to the distant health outcome of that choice.
5. Is aware of and reflects on the effects caused by unmindful eating.
6. Experiences insight about how he/she can act to achieve specific health goals as he/she becomes more attuned to the direct experience of eating and feelings of health.
7. Becomes aware of the interconnection of earth, living beings, and cultural practices and the impact of his/ her food choices has on those systems

The information from this post is from The Center for Mindful Eating. Check out their website for more information & resources.

With Halloween right around the corner, I am sure you’re kids are excited for costumes, trick-or-treating and candy! This also means that your kids may be coming home with bags full of
candy which means you are left with the task of figuring out the best way to deal with Halloween candy and your child. This post will help you in doing so!

Ellyn Satter (visit her website for lots of great information & resources), Registered Dietitian and Family Therapist, is an internationally recognized authority on eating and feeding. Ellyn Satter created the Division of Responsibility in Feeding, which discusses the role that both children and parents play in feeding children.  In summary, the Division of Responsibility in Feeding states that:

It is the parent’s responsibility to determine what the child will eat

&

It is the child’s responsibility to determine how much they will eat.

In the book, Your Child’s Weight: Helping without Harming, Ellyn Satter discusses how to deal with Halloween candy and your child. Below you will find some of the highlights:

1. Halloween can be a learning opportunity for your child

• “Work towards having your child be able to manage his own stash”. This means, for the night of and day after trick-or-treating, let your child play with their candy, count their candy, sort their candy and eat as much as they want. After two days of this, your child is allowed to have candy at meal time and snack time If your child follows the rules, then they can be in charge of their candy stash. If not, the parent is in charge of the candy stash.

2. Sugar & Behavior

• While research does not indicate that sugar affects children’s behavior or cognition, anecdotal observations have suggested otherwise. Therefore, to ensure the child is receiving nutrients from sources other than candy, it is important that the parent maintains meal and snack time structure as discussed in the Division of Responsibility.

3. Preserve the joy of Halloween

• For some children, Halloween is their favorite holiday. This makes it especially important for parents to not be overly-concerned about sugar and let your child enjoy the holiday.

Sources & more information

The Ellyn Satter Institute