Happy Thanksgiving!

Happy Thanksgiving! Have a warm and safe holiday!

Click here for important Thanksgiving safety reminders from the National Fire Protection Association!

Balancing Diabetes in the Holiday Season

The end of the year brings major holidays from a variety of backgrounds. And a large majority of these holidays will bring families around tables for some of the most impressive - and fattening - dinners of the year. While the high carb, calorie and sugary foods may be tempting and delicious, we should all limit our intake of holiday treats. This can be especially difficult for those with diabetes, as the typical holiday foods do not cater to dietary restrictions. However, you can still have a wonderful time eating with your family this holiday season. Here are some tips from the CDC to help you eat well during the holidays:

At parties and gatherings:

• You can still enjoy some of your favorite foods, just watch the portion sizes. Load your plate with good things with very small portions of the more fatty foods! 
• Watch out for "healthy" options with disguised added fats. Hams coated with glazes and vegetables packed with butter or sour cream can hide major calories. Instead, look for plain fresh vegetables and if there are no alternative options, cut the skin off of meats.
• Choose no sugar added fruit over cakes and pies. 
• In addition, if you do not know what options will be served, take the initiative to bring your own healthy options. Not only will you give yourself options, you will introduce your family to more healty choices!

In addition, If you are traveling, make sure to get a flu vaccine before you go.
Make sure travel with double your medication just in case there are traveling issues or delays. In addition, make sure you keep up with your exercise regime, and don't be tempted to skip out on them! A little management can go a long way, helping you to still fully enjoy the holidays in a healthy way!

Click here http://www.cdc.gov/features/diabetesmanagement/ to read the full list of tips provided the CDC

How Organic Is Your Wine?

Organic beverage sales make up a significant portion of organic foods sales, with wine being a contributor. For those who prefer to shop organic, organic wine may be the logical choice, but did you know there are different levels of 'organicness' in wines?



100% Organic wine is made with organic grapes. In addition there is a strict limit on the additives that go into the wine. Non-agricultural ingredients cannot account for more that 5% of the total product.

Wine made from Organic grapes must contain grapes that are 100% certified organic. While there are also specific rules on additives, they are not required to be organic.

So how do you tell the difference? Wine that is 100% organic will have the the USDA organic label on them while those made only with organic grapes will not. To learn more about the specifics of what goes into each type of organic wine and decide which is best for you, visit the USDA page: Organic Wine: Oversight, Labeling and Trade for further information. Remember, organic or not... ALWAYS in moderation!

More Resources:
USDA, Organic 101: Organic Wine

~ Enjoy your weekend! And maybe try some organic wine! ~

Diabetes and Pregnancy

By Winnie Natu, MSIV

It is important to remember that diabetes can affect people in any stage of life, including  pregnancy! Termed ‘gestational diabetes mellitus’ (GDM), it is critical we raise awareness about this topic as it can have life changing effects not only on mom, but on baby too.

What is it?

GDM is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. It usually shows up in the middle of pregnancy.  Like other types of diabetes, it occurs due to resistance to insulin, which is increased because of the different hormones the body produces and balances during pregnancy.

Am I at risk for getting it?

The most important risk factors for developing GDM are:

• Age over 30
• Family history of Type 2 diabetes
• Being overweight
• Certain ethnic backgrounds—Indian, Vietnamese, Chinese, Middle Eastern, Polynesian
• GDM in a previous pregnancy
• Previous difficulty carrying a pregnancy to term
• Previous birth of a baby weighing more than 4 kg.

How do I know if I have it?

Doctors test for GDM between 24-28 weeks of pregnancy with a glucose challenge test. One hour after drinking a glucose solution, you will have a blood test to measure your blood sugar level. If it is higher than 130 to 140 mg/dL, it means you are at risk of gestational diabetes and will need a follow-up test. This time, you will have your fasting blood sugar level measured and then you will drink another sweet drink. Your blood sugar level will be checked every hour for three hours and if at least two of the readings are higher than normal, you will be diagnosed with gestational diabetes.

How does it affect me and my baby?

GDM causes baby’s blood sugar to be very high, which means the baby is overfed and grows to be very large. This can cause problems for both mom and baby during delivery and it may be necessary to have a C-section. Because of baby’s size, he or she may be born with nerve damage or shoulder abnormalities. GDM can also raise mom’s blood pressure and cause “preeclampsia”, which might lead to the baby being born early, seizures, or a stroke. Lastly, if GDM is not well-controlled, baby can quickly develop low blood sugar after birth which can be very serious, even fatal. 

How can I prevent it?

Follow a healthy diet including foods high in iron (fully cooked red meat), folic acid (green leafys) and calcium (pasteurized dairy). Lots of fruits and veggies with only moderate carbohydrates (pasta, bread, etc.). It is crucial to maintain a healthy weight! Generally, you should gain about 2 to 4 pounds during the first three months and then 1 pound a week during the rest of your pregnancy. Engage in regular and safe exercises including walking, swimming, low intensity aerobics, or pilates.

For more user-friendly and complete information about gestational diabetes, please visit the following resources:

Mayo Clinc information on Gestational Diabetes 

Gestational diabtetes information from the CDC

Brochure created by Maters.org

Affordable Care Act Policy Briefing: Presented By Women's Way

Want to learn more about what the affordable care act means for women? Take advantage of the unique opportunity to join a conference call presented by Women's Way. By simply calling in during lunch, you have the ability to be part of an informative discussion about key provisions, medicare and medicaid advantages and disadvantages, as well as the healthcare marketplace. Time at the end will be saved for questions.

The call will be on Thursday, November 21 from 12:00-12:45 pm

Click Here for event details and instructions on connecting

To learn more about Women's Way, visit their website at http://womensway.org/

Women's Health and the AFA: Now and in the Future

By Justine Shum, MSIV

The Affordable Care Act has been getting a lot of negative press lately due to problems with its Marketplace website, but we remain hopeful that it will improve access to healthcare. The Affordable Care Act has made a lot of changes for women, particularly by increasing coverage of preventive services. With 2014 quickly approaching, here is a review of the expanded coverage that is specific to women:

Now:

• 20.4 million women with private health insurance gained expanded coverage of preventive services including mammograms, cervical cancer screenings, prenatal care, flu and pneumonia shots, and regular well-baby and well-child visits
•  Many health plans now provide full coverage of other preventive services including well-woman visits, screening for gestational diabetes, domestic violence screening, breastfeeding supplies and contraceptive services
•  24.7 million women with Medicare received coverage of preventive services including an annual well visit, personalized prevention plan, mammograms, and bone mass measurement if at risk for osteoporosis
•  Women between ages 19 and 25 who would have been uninsured now have coverage under their parent’s employer-sponsored or individually purchased health insurance plan

Coming up in 2014 & Beyond

• Insurance companies in the individual and small group markets will no longer be permitted to charge higher rates due to gender or health status
• An estimated 13.6 million women who would otherwise be uninsured will gain health coverage by 2016
•  An estimated 8.7 million women who currently pay for individual insurance will gain coverage for maternity services

Resources: 

For a full list of preventive services covered under the Affordable Care Act:

http://www.hhs.gov/healthcare/facts/factsheets/2010/07/preventive-services-list.html

Good read on why we need Obamacare: http://www.nytimes.com/2013/11/03/opinion/sunday/kristof-this-is-why-we-need-obamacare.html?_r=0

Journal Club: November

Looking for a good article to read? Our fourth year students recently shared some very interesting articles with us for WHEP Journal Club, and in addition created some great discussion.Check out these articles:

• Characteristics Associated With Differences in Survival Among Black and White Women With Breast Cancer, By: Silber and colleagues.  

• Risk of Cervical Abnormalities in Women With Inflammatory Bowel Disease: A Population-Based Nested Case-Control Study, By: Singh and colleagues 

• Patient Knowledge and Beliefs as Barriers to Extending Cervical Cancer Screening Intervals in Federally Funded Centers, By Hawkins and colleges 

• Food Security Maternal Stressors and Overweight Among Low-Income US Children- Results From the National Health and Nutrition Examination Survey (1999-2002), By: Gunderson and colleagues 

Diabetes & Heart Disease : Key Issues for Women

By: Justine Shum, MSIV

Patients with type 2 diabetes are more likely to die from heart disease compared to adults without diabetes. Adults with diabetes are also 2-4x more likely to have heart disease. In women especially, diabetes is a serious risk factor for heart disease.

Why does diabetes increase risk of heart disease?

Even patients with well-controlled diabetes are at an increased risk of heart disease. This is because patients with diabetes, especially those with type 2 diabetes, often have other comorbid conditions that increase their risk of developing heart disease. These conditions include hypertension, hyperlipidemia and obesity.

What does this mean for women with diabetes?

Women with diabetes are more likely to have heart disease. Even premenopausal women, who normally have  protection due to estrogen against heart disease, lose that protection once they develop diabetes.

Women with diabetes who have heart disease also have poorer outcomes after heart attacks. In the first year after a heart attack, women are more likely to die compared to men who have heart attacks. Women are also more likely to have a second heart attack compared to men.

What can women with diabetes do about their heart disease risk?

• Control your diabetes: A1C - measure of your average blood glucose control for the last 3 months. Measure at least twice a year. ADA recommends a A1C of 7% although your doctor will may recommend more or less stringent goals
•  Quit smoking!
• Maintain a healthy weight: Obesity is associated with insulin resistance
•  Exercise: In addition to helping to maintain a healthy weight, exercise
• Control your blood pressure: The American Diabetes Association (ADA) recommends lowering your blood pressure to 130/80 or lower
•  Lower your LDL (bad cholesterol) level and raise your HDL (good cholesterol) level: The ADA recommends a LDL level less than 100, and with therapeutic lowering agents, a goal of 70 is recommended for patients with multiple risk factors. An HDL level greater than 45 is recommended, although the higher the better!
•  Know the atypical presentation of a heart attack: Heart attack symptoms in women often are different from those experienced by men. Although chest pain remains the most common symptom, women often also experience a burning sensation in their upper abdomen as well as lightheadedness, upset stomach or sweating.

And always be sure to talk with your doctor about concerns and changes you may need to make. Remember, taking control is the first step toward prevention!

For healthy tips and resources, visit: http://www.diabetes.org/

Warning: May Contain Sexism

When going to the movies, we are used to the ratings warning us of explicit language, sexual images and violence. Now, movies in Sweden are rating movies on the basis of sexism. While this rating is meant to say nothing about the quality of a movie, it is used to display sexism in movies and promote the creation of more strong, female roles. The criteria for pass or fail is simple: Movies need to include at least two female characters that talk to each other about something other than a man. Sounds simple, but you'll be surprised what movies don't make the cut. The criteria to pass is a bit light on substance, but can make you think when it comes to your favorite movies.While some feel this is a good way to raise awareness about women's roles in films, others feel that Sweden should start making the movies it is promoting instead of rating movies that have already been released. What do YOU think?

Read the Full story
http://www.cbsnews.com/8301-202_162-57611073/sweden-theaters-bring-in-sexism-ratings-for-movies/

Visit http://bechdeltest.com/ to view a database of ratings for over 45,000 movies

A Great Visual for Pregnancy Nutrition.

MyPlate is a visual for nutrition designed by ChooseMyPlate.gov that shows the ideal composition for a meal. It can be a useful tool for people of all ages, in helping them to understand what a healthy meal looks like. Now, Oregon Health and Science University has come out with "My Pregnancy Plate" to help pregnant women visualize their recommend intake of each food group. In addition, they also answer questions and give suggestions about snacks, sweet and food safety. Check out this great resource!

To see the full version Click Here

See the original MyPate at choosemyplate.gov , the site also includes many resources for healthy living and eating!

TGIF Quote of the Week!

Happy Friday Everyone!
Here is the Quote of the Week:

Learn to be what you are, and learn to resign 
with good grace all that you are not
-Henri Frederick Amiel

This puppy is obviously not quite there yet...

Have a great weekend! Have fun and be safe if
you will be dressing up! 

“Your Diabetes To-Do List”

Written By: Renee E. Amori, MD

November is Diabetes Awareness Month, and it’s a good time to review your diabetes list of “Things to Do.”  Taking your medications, having diabetes education classes, and checking blood sugars are very important, but not the only things that people with diabetes need to remember.  Whether you have type 1 or type 2 diabetes, you have to do some regular “maintenance” to reduce your chance of having complications develop. 

Here are a few things that you should be doing as part of your regular diabetes care plan:

Have you had you had your eye exam?
Diabetes is a leading cause of vision loss.  You should have a dilated eye exam once a year

Do you check your feet daily or see a Podiatrist?
Daily foot care decreases the chance of infections, which can lead to amputations.  If you don’t know how to care for your feet, then seeing a Podiatrist for care is helpful.

Have you seen the dentist?
Regular dental visits reduce the chance of gum disease and tooth loss from high blood sugars.

Did you get your flu vaccine?
We recommend everyone with diabetes get the flu vaccine yearly.

Are you do for any other vaccine?
You may benefit from vaccines against other medical conditions.  Check with your doctor or health care provider to see if this applies to you.

It is important not only to do these things in November but all year long. Make sure your are keeping up with all of these and continue living a healthy life!