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DOWNLOADTHIS ISSUEON YOURMOBILE DEVICEFROM THEAPP STORE!R HFO LTR EAVE HO ’S ONIP EN TIFL M SECOWFREESIMMERANDSERVETry thesethreenew stewrecipesALSOFALL 2017WIC: 912141SKIN CARE TIPSWORKOUT TECHNOLOGYFIND THE RIGHT DOCTOR
Fall 2017 CONTENTS63diabetes Wire5diabetes 1016fitness MATTERS7body SHOP12pop QUIZ13health SMARTS15living HEALTHYRead the latest researchon surgical options, fatty fish,and moreLearn the role your pancreasplays in controlling blood sugarFind out how technology canhelp with your workouts8713SIMMERANDSERVEThese skin conditions arecommon for those with type 2diabetesTest your knowledge aboutfoot careTry these three new stew recipesGet tips for finding theright doctor15Gain a better understanding ofroutine tests, exams, and shotsCover: Photography by Rick LozierFood styling by Charlie WorthingtonPlus: Look for this icon to get more information at WebMD.com.Fall 2017Health Information from1
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diabetesWirePercentage of type 2 diabetes-relateddeaths that could have been preventedby a healthy diet.Source: JAMAIT TAKES TWONeed some extra helpwith your blood sugar?Get your spouse on board.When couples take onactivities together thatcould help control bloodsugar—such as planninghealthy meals or workingout—the spouse withtype 2 diabetes hasbetter glycemic controlthan in couples thatdon’t commit to healthychoices together.Source: Journal of Marital andFamily Therapy5,300GETTY IMAGESNUMBERof new cases oftype 2 diabetesin kids ages 10 to19 every year inthe U.S. That’sup from 3,800cases per year adecade ago.Source: JAMASURGERY SUCCESSFor people who are obese, bariatric surgery might be more effective intreating type 2 diabetes than medication and diet. Researchers assigned150 people with type 2 diabetes and a body mass index of 27 to 43 to dietand medication or one of two weight loss surgeries: gastric bypass or sleevegastrectomy. Five years later, 5% of those in the medicine-only group hadachieved their blood sugar goals. About 25% of those in the surgery groupshad improved or eliminated their diabetes. They had lower blood sugar andcholesterol, greater weight loss and quality of life, and used less insulin.Source: New England Journal of MedicineFall 2017Health Information from3
THE POWEROF ASPIRINBRING ON THE FATTY FISHOver time, too much sugar in your blood from type 2 diabetescan damage your eyes and possibly lead to vision loss. Eating twoservings of fatty fish per week, such as salmon and tuna, could slashrisk for this complication in half. Researchers tracked the diets of3,482 adults with type 2 diabetes for six years. Those who took in500 milligrams of omega-3 fatty acids per day—the equivalent of twoservings of fatty fish per week—were 48% less likely to develop eyeconditions during the six-year study.Source: JAMA5% 10%GETTY IMAGEStoFall 2017Women who have type 2diabetes may be at greaterrisk of developing breastcancer. An aspirin a daycould reduce that risk.Researchers analyzed 10years of health records fornearly 150,000 womenwith diabetes. Those whotook 75 to 165 milligramsof aspirin each day were18% less likely to developbreast cancer over the10-year study period thanthose who didn’t.Source: Journal of Women’s HealthPercentage of body weight loss that couldimprove your blood sugar control and reducethe amount of medication you need. That’sjust 10 to 20 pounds for a 200-pound person.Source: CDCHealth Information from4
diabetesASK YOURDOCTORCould I benefitfrom medicationsthat stimulate thepancreas to produceinsulin? Medicationssuch as sulfonylureasand meglitinides arerecommended only if yourpancreas is capable ofproducing insulin.Can I live without a pancreas? Some people can.But they need daily insulininjections and digestiveenzyme supplements tomake up for the missingorgan. Pancreas transplants are available, usuallyfor patients with type 1diabetes, but they areless common than otherorgan transplants, saysendocrinologist FernandoOvalle, MD.Can I improve insulinresistance? Scientistsdon’t fully understand whatcauses insulin resistance.But in some cases exerciseand weight loss can makeyour cells more responsiveto insulin.GETTY IMAGESWhich symptomsindicate a problem withmy pancreas? Pancreaticdiseases can be toughto diagnose becausethey may come with fewsymptoms. But these mayinclude mid-back pain,upper abdominal pain,nausea, and diarrhea.Search for Picture of thePancreas at WebMD.com.Fall 2017ThePancreasLearn more about this oftenoverlooked organBY ERIN O’DONNELLChances are you didn’t give your pancreas muchthought—until you were diagnosed with type 2diabetes. This long, flat, spongy organ is hiddendeep in the upper abdomen between the stomachand spine.“People don’t necessarily give the pancreasthe respect it deserves,” says endocrinologistFernando Ovalle, MD, director of the University ofAlabama at Birmingham’s Multidisciplinary Comprehensive Diabetes Clinic. “But it’s an extremelyimportant organ.” Despite its low-key reputation,the pancreas plays two key functions: controllingblood sugar and assisting digestion.Most of the pancreas is devoted to making andpumping out enzymes that help your body digestfood. These include protease, designed to breakdown protein; lipase, which digests fats; and amylase, which attacks carbohydrates. A much smallerportion of the pancreas is dedicated to producinghormones such as insulin and glucagon, whichregulate blood sugar levels.These hormones are made in the pancreas insmall clusters of cells called the Islets of Langerhans and then released into the blood stream. Onecell type found in the islets, the beta cell, senses theamount of sugar in the blood and then makes andreleases insulin. The insulin acts like a key, opening glucose channels in the body’s cells so they cantake up glucose for energy.In people with type 2 diabetes, cells stopresponding as well to insulin, a condition knownas insulin resistance, leaving sugar locked out ofthe cells and circulating in the blood stream. Thebeta cells sense the increase in blood glucose levelsand release more and more insulin. “But sooner orlater the pancreas cannot keep up with the bloodglucose,” and fails to produce enough insulin,Ovalle says. This scenario triggers diabetes. Insome cases, a condition known as chronic pancreatitis, or long-term inflammation of the pancreas,can cause diabetes by damaging the organ’sinsulin-producing cells.Some medications for type 2 diabetes stimulatebeta cells in the pancreas to produce more insulin.These drugs include sulfonylureas, which you takeonce or twice a day, usually before meals, and meglitinides, taken three times a day before each meal.Ovalle notes that unlike other organs in theabdomen, such as the kidneys or the liver, much isstill unknown about the pancreas, and by extension, diabetes. “We’ve been able to classify liverand kidney diseases very well through biopsies,”he explains. “We cannot do that with the pancreasbecause it is not as accessible,” he says, and removing samples of the pancreas to study them elevatesa person’s risk for pancreatitis, a potentially lifethreatening condition.Researchers are currently considering waysto repair or replace the pancreas in patients withdiabetes; one area of study involves transplantinghealthy Islets of Langerhans from a donor pancreas into people with diabetes.REVIEWED BY BRUNILDA NAZARIO, MD, WEBMD LEAD MEDICAL DIRECTORHealth Information from5
fitness MATTERSTech GeniusASK YOURDOCTOREnlist technology to help you getthe most out of your workoutsBY KARA MAYER ROBINSONReady to invest ingadgets, gizmos, orcoaches? Your doctorcan help you makethe right choices.Can I count ondiabetes gear likeCGMs and smartglucometers to readmy levels accurately?How can I use mydiabetes data todevelop my fitnessplan?What factors mayimpact my workoutroutine? Is it helpfulto log my meals andthe time of day whenI work out?GETTY IMAGESWhat goals shouldI strive for with thehelp of an onlinecoach?Search for the articleHealthy Apps for YourWorkout Trackerat WebMD.com.Fall 2017Your diabetes toolbox is aboutto bulk up.“The medical technologyfield has been booming,” saysdiabetes coach and speakerDaniele Hargenrader, CPT. Aslew of new high-tech gear andgadgets won’t just help youmanage your blood sugar. Theycan also streamline your fitnessprogram, says Hargenrader.Take a look:Continuous glucose monitorsContinuous glucose monitors(CGMs) are wearable devicesthat track your glucose levelsand send real-time feedbackto a receiver or smartphone.Hargenrader recommendspairing a CGM with a smartwatch, which is easy to glanceat when you’re moving andsweating. “While you’re running, you can look at your wristand see your blood sugar,” saysHigh-tech clothingIf you wear an insulin pump andthe hassle of carrying it detersyou from hitting the gym, hightech threads may be just whatthe doctor ordered.“A lot of clothing linesnow have pockets for insulinpumps. You can tuck themaway and they’re hidden,”says Hargenrader. PocketInnerwear, for example, hasan entire line of insulin-pumpwear, she notes.You can also stash glucosetablets, gel, or your cell phoneinto tank tops, running shorts,and other clothing with builtin gear pockets.Mobile resources“Online coaching is a huge tool,”says Hargenrader, who runscoaching sessions via GoogleHargenrader. If your levels gettoo high or low, you can quickly Hangouts and Skype. An onlinecoach can create a personalizedadjust your activity.program, set goals, and check inwith you regularly.Smart glucometersSome companies, likeHigh-tech glucometers fromLivongo and One Drop, havecompanies like Dario, Livongo,experts on call. If you haveand One Drop simplify bloodquestions or need support, yousugar testing with disposablesend a message through yourtest strips and portability. Youcan also use them for insight on smartphone app, then a certified diabetes educator respondsexercising safely.You upload your glucometer within 24 hours.You’ll also find peer supportreadings into your smartphoneand log details, like what you eat, online. Try joining a Facebookdiabetes fitness group, a chatwhen you eat, and what timeroom, or a support group at theyou worked out, into an app.Then you get insight into which Diabetes Hands Foundation’sfactors impact your levels. “You website, tudiabetes.org.It’s an exciting time, sayscan look back and see whatyour blood sugar was. Then you Hargenrader, who has lived withdiabetes for 26 years. “Technolcan adjust what you do,” saysogy has allowed me to take myHargenrader. For example, ifyour levels are best after a small fitness to another level,” shesays. “There are a lot of options.meal, you can eat somethingThey’re game-changers.”before your next workout.REVIEWED BY MICHAEL SMITH, MD, CPT, WEBMD CHIEF MEDICAL DIRECTORHealth Information from6
body SHOPSKINSMARTSWhat’s the best wayto fight infections thatcause skin problems?Try these tips.Check your feetand any areas ofyour body that getdamp and sweatyevery day.Use moisturizer ondry skin daily to keepit from crackingand itching.Don’t try to treatskin infectionsat home withover-the-counterproducts, becausethey may not bestrong enough.If you think youhave an infectionanywhere onyour body, callyour doctor.ProtectYour SkinIf you have diabetes, diligentskin care is crucialBY BRENDA CONAWAYDiabetes gives you a good reason to pamperyour skin. You’re more prone to skin problemslike dryness. And because diabetes raisesyour chances of infection, even a minor skincondition can become a more serious problem.This guide will fill you in on common skinconditions linked to diabetes and how to preventthem—or care for yourself if you do get them.Skin conditionsDiabetic dermopathyThis appears as light brown, scaly, round spotson the shins. They look a lot like age spots butare caused by changes in the small blood vessels.“It’s more of a cosmetic issue and doesn’t reallyrequire treatment,” says Margo S. Hudson, MD,an instructor at Harvard Medical School.Disseminated granuloma annulareThis causes red, red-brown, or skin-coloredraised rings or arcs on the skin. They’re likely toshow up on your fingers, ears, or lower legs, butcan also appear on the trunk of your body. Yourdoctor can prescribe a cortisone skin cream oranother treatment.GETTY IMAGESDigital sclerosisAbout one-third of people with type 1 diabeteshave this condition. It can make the skin on theback of the hands thick, waxy, and tight. Yourfinger joints may become stiff and hard to move.Search for the slideshowWhat Your Skin SaysAbout Your Health atWebMD.com.Fall 2017You can also get it on your forehead and toesand, more rarely, your elbows, knees, or ankles.To treat it, get your blood sugar under control.Acanthosis nigricansWith this condition, the skin on your neck,armpits, or groin thickens and becomes brownor tan. “People think it’s dirt and wonder whythey can’t clean it off,” Hudson says. Insulinresistance causes it, and it’s most likely if youare overweight. Treatment includes losingweight and taking diabetes drugs, which helpthe body use insulin better.Skin infectionsBacterial skin infections are common withdiabetes, says Betul Hatipoglu, MD, of theEndocrinology and Metabolic Institute atCleveland Clinic in Ohio. “It can be as simple asa boil in the armpit or on the face, infection ofthe hair follicles, or infection of the nail bed,”she says.Fungal infections are common, too, she says.You are most likely to have them in areas thatget hot and sweaty, including under the breasts,between fingers and toes, in the armpits, in thegroin area, and around the tip of the penis, ifyou are an uncircumcised man.REVIEWED BY BRUNILDA NAZARIO, MD, WEBMD LEAD MEDICAL DIRECTORHealth Information from7
BY Kerri-Ann JenningsREVIEWED by Hansa Bhargava, MDSTIR THE POT WITH THESE STEW RECIPESA bubbling pot of fragrant, hearty stew is sure to warm the chilliest fall days.And while we have you covered with three new recipes to try, all follow asimple formula you can adapt based on what you have on hand. Start with aDutch oven (or any heavy-bottomed pot with a lid) and a drizzle of oil, thenadd aromatics, a protein, more veggies, and enough liquid to cover. Simmeruntil you’re ready for dinner.8 Health Information fromFall 2017P H OTO G R A P H Y: R I C K LOZ I E R ; F O O D S T Y L I N G : C H A R L I E W O R T H I N G TO NWebMD Senior Medical Director
MOROCCAN EGGPLANT STEW WITH GREEN CHICKPEASThis cinnamon-laced stew is chock-full of veggie goodness. If you can find themin the freezer section, try green chickpeas, which are picked earlier than theyellow ones you’re used to and have fewer carbohydrates per cup. Serve withwhole-wheat couscous, and top with plain yogurt, toasted sliced almonds, and apoached egg for extra protein. SERVES 62 tbsp olive oil1 onion, diced1 tbsp grated fresh ginger2 tsp cinnamon3 garlic cloves, minced1 tsp cumin seeds1 tsp paprika1 tsp sea salt1 medium eggplant, cut into 1-inch chunks2 tbsp tomato paste3 cups vegetable stock1 14-oz can crushed tomatoes2 cups frozen green chickpeas(or 1 14-oz can of regular chickpeas,drained and rinsed)½ cup golden raisinsZest from 1 lemonOPTIONAL FOR GARNISHToasted sliced almondsPlain yogurtFresh chivesChopped cilantroHeat a Dutch oven or large saucepan overmedium-high heat. Add olive oil. Whenolive oil has warmed, add onion and sautéfor several minutes. Add ginger, cinnamon,garlic, cumin, paprika, and salt and cookfor another minute. Add eggplant andtomato paste and stir. Cook for severalminutes, and stir to keep from sticking. Addvegetable stock and tomatoes and simmeruntil eggplant is tender. Add chickpeas, raisins,and lemon zest and cook several minutes untilheated through. If you like, garnish with almonds,yogurt, chopped cilantro, and/or fresh chives.Nutrition info (stew only): 216 calories, 8 g protein, 33 gcarbohydrate, 6 g fat (1 g saturated fat), 0 mg cholesterol, 495mg sodium, 9 g fiber, 11 g sugar; calories from fat: 26%Fall 2017Health Information from9
PORK, HOMINY, ANDTOMATILLO STEWUsing ground pork makes thisflavorful stew easy to prepare, whilehominy helps add some extra body.SERVES 42 tbsp canola oil1 medium white onion, chopped1 green bell pepper, diced1 pound ground pork tenderloin1 jalapeño, seeds removed, minced2 tsp no-salt-added chile powder1 teaspoon cumin2 cloves of garlic, minced¼ tsp salt1 pound tomatillos, husks removed,chopped¼ cup cilantro leaves and stems,minced2 cups low-sodium chicken stock1 (14- to 15-oz) can hominy, drainedand rinsedOPTIONAL FOR SERVINGCotija cheeseCilantroSearch for the article5 Food Hacks forDiabetes at WebMD.com.Heat oil in a Dutch oven over medium-high heat.Add onion and green pepper and sauté for severalminutes until onion is translucent. Add pork,jalapeño, chile powder, cumin, garlic, and salt andcook for a couple of minutes until pork begins tobrown. Add tomatillos and cilantro, then chickenstock. Reduce heat to medium-low, partially coverand simmer until tomatillos are fully cooked, at least20 minutes. Add hominy and heat through. If youlike, top with cotija and/or cilantro to serve.Nutrition info (stew only): 331 calories, 35 g protein, 21 gcarbohydrate, 10 g fat (1 g saturated fat), 74 mg cholesterol, 611mg sodium, 3 g fiber, 5 g sugar; calories from fat: 52%10 Hea
Try these three new stew recipes. 8. Cover: Photography by Rick Lozier. Food styling by Charlie Worthington. 6. 13 15. 7. 3. diabetes. Wire. Read the latest research on surgical options, fatty fish, and more . 5. diabetes. 101. Learn the role your pancreas plays in controlling blood sugar . 6. fitness. MATTERS . Find out how technology can help .
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Start food cooking. Bring liquid to a boil. Medium High Hold a rapid boil. Quickly brown or sear food. Medium Maintain a slow boil. Fry or sauté foods. Cook soups, sauces and gravies. High simmer or simmer without lids. Medium Low Stew or steam food. Simmer. Low Keep food warm. Melt chocolate or butter. Low simmer using lids. Dual/Triple Elements
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