Diabetic Live

Diabetes And Your Skin: It is estimated that at least one third of diabetics will suffer from a skin disorder following a diabetic diagnosis. Some suggest skin problems may be the first indicator to a primary physician that there may be an issue greater than a dermatological disorder.

Bacterial and fungal issues are a fairly common issue for diabetics, but the skin disorders do not stop there. Itching of the lower legs is another common issue diabetics face. This is typically the result of problems with circulation and can often be remedied with skin cream.

A Blood Vessel Top Three
There are three primary skin disorders that affect diabetics and each stem from issues related to alterations in the smallest blood vessels of the legs.

• Necrobiosis Lipoidica Diabeticorum. It is often diabetic women who will develop this condition. Raised blood vessels create sore red bumps on the legs that may develop into a scab-like area. As long as the skin does not break open no medical care may be required.
• Diabetic Dermopathy. Similar to age spots in appearance these flaky patches do not itch and require no treatment.
• Atherosclerosis. Legs that are shiny and have no hair are hallmarks of this skin disorder. It is caused by thickening arteries in the legs of diabetics. Since circulation is a problem for diabetics there are fewer infection fighting white cells to ward off potential problems. Feet tend to become cold and patients often discover changes to their toenails.

Other Skin Disorders
Most of the following skin issues are directly related to diabetes that is out of control. When patients get their blood sugar under control many of these issues tend to go away.

• Acanthosis Nigricans. These darkened skin patches are generally found in diabetics who are overweight and can cause knuckles, elbows and knees to be affected. Weight loss is the best remedy.
• Eruptive Xanthomatosis & Bullosis Diabeticorum. These are blisters that are not generally painful and will heal by themselves.
• Disseminated Granuloma Annulare. May appear a bit like ring worm in either skin tone or various shades of red. Medication is required to manage this skin disorder.
• Digital Sclerosis. A thickening and tightening of skin in Type 1 diabetics. In advanced cases can spread to other areas of the body causing stiff finger, knee or elbow joints.

Skin Care Tips
The American Diabetes Association provides some information on taking care of your skin when you also live with diabetes.

• Keep skin clean and dry. Use talcum powder in areas where skin touches skin, such as armpits and groin.
• Avoid very hot baths and showers. If your skin is dry, don’t use bubble baths. Moisturizing soaps may help. Afterward, use a standard skin lotion, but don’t put lotions between toes. The extra moisture there can encourage fungus to grow.
• Prevent dry skin. Scratching dry or itchy skin can open it up and allow infection to set in. Moisturize your skin to prevent chapping, especially in cold or windy weather.
• Treat cuts right away. Wash minor cuts with soap and water. Do not use Mercurochrome antiseptic, alcohol, or iodine to clean skin because they are too harsh. Only use an antibiotic cream or ointment if your doctor says it’s okay. Cover minor cuts with sterile gauze. See a doctor right away if you get a major cut, burn, or infection.
• During cold, dry months, keep your home more humid. Bathe less during this weather, if possible.
• Use mild shampoos. Do not use feminine hygiene sprays.
• See a dermatologist (skin doctor) about skin problems if you are not able to solve them yourself.
• Take good care of your feet. Check them every day for sores and cuts. Wear broad, flat shoes that fit well. Check your shoes for foreign objects before putting them on.

Diabetes In The News: With diabetes viewed as something close to an epidemic there are significant studies being conducted that are designed to provide better treatment options as well as new methods for ongoing care. This article is dedicated to some of the more recent studies and their findings. We will look at what some are doing to manage health cares costs associated with diabetes and other stories related to diabetes and its management.

Diabetics and Saliva
Researchers in both Oregon and India have been researching the possibility of using a saliva sample to help diagnose diabetes in patients. This research is also exploring the possibility of using a similar test to monitor blood glucose.

One of the stated purposes of the research was to find a non-invasive way to monitor the progress of a diabetic. Some feel that the use of standard blood glucose ‘pin prick’ tests make it undesirable for many diabetics to accurately monitor their blood sugar levels.

It should be noted that many in the medical community do not view this as a significant enough prospect to abandon traditional blood glucose tests.

Lowering Costs Associated With Diabetic Care
An insurance company (UnitedHealthcare) is offering savings of up to $500 for those who are diabetic and participate in “blood sugar checks, routine exams and wellness coaching”.

The company indicates it will provide the savings through free prescriptions and testing supplies. The presumed concept is that encouraging managed care will result in fewer costs associated with long-term diabetic care.

An Indicator of Heart Health in Diabetic Men
Erectile Dysfunction (ED) is being claimed as an important indicator of potential heart issues among men who also have diabetes. There seems to be evidence that blood vessels damaged by diabetes within the heart can contribute to ED. Cholesterol reducing drugs can help reduce the risk of heart issues. Interestingly Viagra also seems to provide some benefit to heart health as the drug was initially tested as a heart health aid.

Food Consumption
Researchers at Brigham Young University (BYU) suggest that if cutting calories is a discipline you can live with then you have the potential of better long-term health. Once past middle age your daily caloric needs decrease. Whether it’s simply a matter of habit or felt need most individuals will eat roughly the same amount of food throughout their lives. Lance Davidson who has followed this case carefully was quoted as saying, “Because the body’s energy requirements progressively decline with age, energy intake must mirror that decrease or weight gain occurs.” The weight gain described is a primary contributor to onset diabetes.

The Air We Breathe
The Ohio State University Medical Center conducted research that seems to point to a connection between high air pollution levels and an increase in the development of onset diabetes. It is argued that with as little as six months of exposure to high levels of air pollution the ingestion of air particulates, “exaggerates insulin resistance and fat inflammation.”

The fat inflammation mentioned in the study appears to be blamed for increasing obesity, which often leads to diabetes. One more shocking note from this report states, “221 million people [are] expected to suffer from [Type 2 diabetes] in 2010, a 46 percent increase compared to 1995.”

While there are significant advancements that are coming at a rapid pace there is still a long way to go. Education and discipline are often keys to success in diabetes care management.

Diabetics in Profile – Male Performers: In this column we would like to take a look at the lives of several well-known individuals who just happened to live with diabetes. The intent of this article is to provide encouragement for those who think life may have passed them by following a diagnosis of diabetes.

Elvis Presley – not only the King of Rock and Roll, but also a diabetic. He kept this part of his life relatively quiet. Those who knew about the role of diabetes in Presley’s life rarely commented on it. The prevailing belief was that this legend pursued life with such vitality that it didn’t seem important to bring it up. Presley’s death in 1977 does not indicate diabetes was a contributing factor.

Bret Michaels – the front man for the rock group Poison, Michaels has had diabetes since he was six years old. He has taken thousands of insulin shots and has even passed out on stage due to issues with his blood sugar, but Michaels is passionate about not allowing diabetes to incapacitate him. He simply does when he needs to do to get it under control.

Johnny Cash – the “Man in Black” lived with diabetes and suffered from complications during the 1990’s and early in the new millennium. He died from complications of the disease in 2003. He will be known for fusing multiple musical styles into a rockabilly/country sound that no one has dared duplicate.

David Crosby – a legend of folk rock Crosby has been entertaining audiences since 1963. He has also lived with diabetes and in 1993 endured a liver transplant. While often controversial Crosby has continued his musical pursuits.

Jerry Garcia – front man for the Grateful Dead, Garcia had seen millions of dollars in ticket sales and engaged in solo and collaborative work. It is believed Garcia was in a diabetic coma when he suffered a fatal heart attack in 1995.

Mark Collie – a rising star in the 1990’s Collie has used his elevated national platform to bring attention to diabetes. His own status as a diabetic has helped fuel passion for his involvement in the “Mark Collie Celebrity Motorsports Festival For Diabetes Cure”. He is also a regular volunteer for the American Diabetes Association. Collie’s career has included acting in several television shows.

Nick Jonas – a meteoric rise in popularity for the band Jonas Brothers has meant lots of touring and multiple recording sessions. Jonas discovered in 2005 that he had Type 1 diabetes. By 2007 Jonas was sharing his story with others and continues to try and raise awareness of the disease. He wears an insulin pump to regulate insulin delivery.

James Brown – having every right to give up Brown refused. He’s been called the hardest working man in show business. He was stillborn, but one of his aunts refused to let him go. She kept blowing into his lungs until he started breathing on his own. Brown grew up in a very poor family. He dropped out of school and was caught trying to steal a car. Time in prison allowed him to reorganize his priorities and music was rotated to the top of the list. His career took off, but he struggled with tax issues and the death of a son. He would spend another two years in prison, but would return once again to his music prior to his death.

This is a short list of popular male performers who live/lived with diabetes. Hopefully their successes encourage you to engage life in the midst of coping with your disease.

The Vietnam War and Diabetes: the U.S. Department of Veteran Affairs (VA) confirmed a link between military service in Vietnam and a higher instance of Type 2 diabetes also known onset diabetes or diabetes mellitus.

What this means in practical terms is that the nearly 3 million service personnel that served in Vietnam during 1962 and 1975 may be eligible for a variety of services and benefits from the U.S. Government if they have developed diabetes since their deployment to Vietnam.

Why was this alteration made? The use of Agent Orange has everything to do with the probable link between military service and onset diabetes. Agent Orange was used to kill ground cover making it much more difficult for the enemy to find hiding places. This herbicide unleashed a litany of long-term health complications including diabetes mellitus, cancer and a variety of less severe illnesses for service personnel. The VA confirms the use of some 20 million gallons of Agent Orange and other herbicides in Vietnam. It also indicates health issues were common among service personnel returning from the Asian country following the war.

A statement from the VA reads, “Military veterans who served in Vietnam who now have Type 2 Diabetes are eligible for presumptive service-connected disability compensation and health care connected with this condition through the VA. Service in the waters offshore or in the air does not qualify a veteran unless there is proof that he or she set foot on land in Vietnam. For most veterans who served in Vietnam, their service is clearly shown on their military discharge papers (DD-214). Veterans with qualifying service should obtain a detailed statement from their treating doctor that they are being treated for diabetes, as a successful VA claim could entitle them to compensation for diabetes.”

Once a military health case file has been created and accepted Vietnam War veterans will have justification for additional claims related to the care of their diabetes and a compliment of compensation benefits.

Health care benefits include medical care and prescription drugs related to the care of diabetes at no cost to qualified veterans.

The following is a list of health issues the VA presumes may be related to direct service in Vietnam during the war.

• Chloracne (must occur within 1 year of exposure to Agent Orange)
• Non-Hodgkin’s lymphoma
• Soft tissue sarcoma (other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma)
• Hodgkin’s disease
• Porphyria cutanea tarda (must occur within 1 year of exposure)
• Multiple myeloma
• Respiratory cancers, including cancers of the lung, larynx, trachea, and bronchus
• Prostate cancer
• Acute and subacute transient peripheral neuropathy (must appear within 1 year of exposure and resolve within 2 years of date of onset)
• Type 2 diabetes
• Chronic lymphocytic leukemia

What does the term ‘presumed’ mean in this context?

In relation to military service the term ‘presumed’ means that the VA will automatically assume the above conditions were the result of your involvement in the military if all conditions are met in the qualifying process. They presume this even if the actual reasons for the disease were not related to direct military involvement.

This revision in policy regarding the above illnesses was dated November 13th, 2008.

You can visit your regional VA or call them for more specific information about this presumptive coverage and related benefits. Additional information can be found at the following link: http://www.vba.va.gov/bln/21/benefits/Herbicide/

ADA Legislative Recommendations for the 111th Congress: The 111th Congress is taking place as of this writing. With a new President and many new congressmen and senators in office there will be a concerted push by the American Diabetes Association (ADA) to convince lawmakers to place a high priority on diabetes.

Let’s take a look at some of the issues the ADA believes to be important during this congressional cycle.

Research and Prevention
The ADA is lobbying for more than $23 million in additional funding for research and prevention projects as directed by the National Institute of Heath (NIH) and the Center for Disease Control (CDC). ADA acknowledges the difficulties associated with the current economic environment, but suggest that this increase is in direct proportion to the growth in new cases of the disease. Many of the proposed programs work at prevention on a local level. The ideas is that by spending funds on prevention there may be less need to spend money on future treatments.

Specific Research Using Stem Cells
Believing that stem cell research holds great promise for the potential cure of Type 1 and the improvement of Type 2 diabetes the ADA is urging congress to work toward greater funding of research related to the bioethical study of stem cells. The ADA has said, “Stem cell research allows scientists to better explore how to control and direct stem cells so they can grow into other cells, such as insulin-producing beta cells found in the pancreas.” Further, “The Association strongly supports legislation that would expand federal funding for embryonic stem cell research.”

Health Care Coverage
The ADA remains a strong proponent of meaningful health care coverage for those who live with diabetes. The American Diabetes Association indicates it will, “Oppose legislation that would it make it more difficult for individuals with diabetes to have the tools needed to manage the disease.” The opposite is also true as the ADA remains in strong support of any way the congress can exercise its role to enhance coverage for diabetics.

Maintain the Course on Medicaid
In tough economic times many in congress are asking for cuts in Medicaid. While the ADA may understand the need for fiscal diligence they also seem anxious to see congress to take a long-term approach to managed care. By denying existing diabetics the supplies they need for managed care it is the belief of the ADA that there will more significant costs in the long run related to vision loss, amputations and kidney failure among diabetics. The ADA mentions S. 755, which would be a powerful prevention step as a part of Medicaid. They believe that while there are costs involved in preventative medicine it may actually decrease the long-term financial burden.

Medicare Assistance
Individuals who qualify for Medicare can take advantage of a “Welcome to Medicare” visit that allows specific screenings at no cost. This is provided within the first six months of sign up and can be very useful in defining issues of importance in long-term managed care including, but not limited to, diabetes. The ADA remains in strong support of this program.

Gestational Diabetes
The ADA is in support of legislation that would seek to help medical personnel, “Understand and reduce the incidence of gestational diabetes.” Studies point out that as many as eight out of every one hundred pregnant women will be diagnosed with gestational diabetes. Many of those women will eventually be diagnosed with Type 2 diabetes. The hope is that by better understanding and treating gestational diabetes the better the odds are that it can either be avoided or it’s present and future complications minimized.

Diabetes And The Liver: The American Diabetes Association (ADA) indicates the greatest incidence of liver disease is found among those who also have diabetes. More than 12% of those who have diabetes will die from complications involving their liver, yet it is rare to hear the issue raised in mainstream discussions. This article will seek to explore the relationship between diabetes and liver health.

ADA reports indicate the following as a primary list of liver issues common among diabetics.

• Abnormal liver enzymes
• NAFLD
• Cirrhosis in diabetes
• Hepatocellular carcinoma in diabetes
• Acute liver failure
• Hepatitis C in diabetes

Let’s take a look at each of these individually.

Abnormal Liver Enzymes – This is a sign physicians often review when diagnosing liver disease among those who abuse alcohol, but increasingly it is also a sign of potential liver damage due to onset diabetes. This condition can also be accelerated when using cholesterol-reducing medications or various NSAID based medications.

NAFLD – This abbreviation stands for non-alcoholic fatty liver disease. The treatment for this disease is often the exact same treatment as properly maintained blood glucose in Type 2 diabetics. One of the most radical forms of this disease is non-alcoholic steatohepatitis (NASH). This condition is usually discovered when a doctor is working to treat or diagnose a separate condition. Confirmation of this disorder can take several months and will only be properly diagnosed once a liver biopsy is conducted.

Cirrhosis In Diabetes – It is increasingly common for liver issues to be evident in diabetic patients. Interestingly a diagnosis of cirrhosis may be a precursor to a diagnosis of diabetes. The combination of the two medical issues is increasingly discovered in tandem.

Hepatocellular Carcinoma In Diabetes – This form of liver cancer seems to indicate that the presence of diabetes can contribute a 2-3-fold increase in the potential of development. Reports indicate that diabetes is a risk factor apart from any other existing medical history.

Acute Liver Failure – This diagnosis indicates a rapid deterioration of the functionality of the liver. It can be common in diabetics to also see an accompanying renal (kidney) failure.

Hepatitis C In Diabetes – When Hep C is diagnosed it is not uncommon to discover diabetes is close behind. It isn’t crystal clear whether Hepatitis C contributes to onset diabetes or if the diabetes worked to create and environment for Hepatitis C. Science Daily reports, “Patients who have chronic hepatitis C with advanced fibrosis have twice the risk of developing liver cancer if they also have diabetes.”

The truth is there is debate over the proverbial topic of which came first, the chicken or the egg. In this case it’s a question of whether liver issues precede diabetes or if diabetes works to create an environment conducive to the development of liver disorders.

What is known is that many of these disorders can be held in check. When it comes to prevention of liver disease in diabetics the Mayo Clinic offers the following steps.

• Tight control of blood sugar levels
• Maintaining a healthy weight
• Reducing high cholesterol
• Avoiding excessive consumption of alcohol

A recent government finding concluded that Type 2 diabetic patients had 80% more liver fat than non-diabetic counterparts in their same age groups. This finding is significant in demonstrating the link between diabetes and chronic liver ailments. Obesity may contribute to onset diabetes, but its continued existence can lead to additional and very serious liver complications.

Diabetics In Profile – Female Performers: Some of the most talented women in music history live with diabetes. These women entertainers have not allowed Type 1 or Type 2 diabetes stop them from making memorable music for their fans. Let’s take a look at some of these standouts.

Ella Fitzgerald. Fourteen Grammy awards and 200 albums to her credit Fitzgerald is an icon in the realm of jazz music. It may seem she had everything going for her, but her parents split shortly after she was born, she was placed in an orphanage and her mother passed away when she was fifteen. Two years later at the age of seventeen Ella made her singing debut and she never seemed to stop. Her last original album was in 1989 and she lost both her sight and legs to diabetes, passing away in 1996. She is remembered more for who she was that the disease she lived with.

Mama Cass Elliot. A member of the folk group the Mamas and Papas, Elliot also had a very successful solo career, She died before reaching her 33rd birthday the result of an apparent heart attack. Elliot also lived with diabetes. She participated in eight albums over six years and had concluded two highly successful concerts in London just before she passed away.

Patti LaBelle. In 1995 Patti was diagnosed with diabetes. She has used her star status to bring hope to others with the disease. She is a spokesperson for the American Diabetes Association and has also appeared in advertising for blood glucose meters. She continues an R&B singing career that started in 1962.

Peggy Lee. Louis Armstrong, Dean Martin and Ella Fitzgerald all said that Peggy Lee was one of their favorite vocalists. She was nominated or awarded for her work on the big screen as well as her music. She passed away in 2002 from diabetes complications. She was 81. Peggy Lee started singing in 1941 and continued into the early 1990’s

Pump Girls. This is a pop music group that formed based on the common thread of diabetes. Each member suffers from Type 1 diabetes and the pump in their name presumably refers to their insulin pumps. This group is very active in support of diabetes organizations like Juvenile Diabetes Research Foundation, American Association of Diabetes Educators, American Diabetes Association, and the PADRE Foundation.

Aretha Franklin. This artist has always encouraged others to give her some R-E-S-P-E-C-T. For the most part this hasn’t been a problem for a woman who has wowed audiences for several decades. Her passion for music has led to eighteen Grammy’s, her own record label and a Presidential Medal of Freedom. In 2009 she is set to deliver a long awaited new CD.

Della Reese. This singer/actor was discovered by another diabetic by the name of Mahlia Jackson. She has recorded dozens of albums – the most recent in 2006. She was diagnosed with Type 2 diabetes after being rushed to the hospital from the set of her hit television show, “Touched by an Angel”. Reese received several Grammy nominations for her singing and continues to use her talents as a way to help spread information about diabetes.

All of these women worked through moments of despair in order to come to terms with the fact they had dreams they still believed in and work they had yet to accomplish. Diabetes isn’t a death sentence and the lives represented above demonstrate there’s still a lot of living yet to do.

Diabetic News Briefs: There have always been warnings against smoking when you are pregnant. A new study not only supports that notion, but also indicates that when you smoke while carrying a child you may be unintentionally increasing the likelihood that your child may develop diabetes later in life.

Research spearheaded by Geneva University Hospitals, Switzerland show that studies on rats indicates an alteration in the genes of developing embryos.

1. The rat embryos whose mother was placed in an environment filled with nicotine gained weight faster than rat embryos in a non-nicotine environment. These rats were less effective at loosing that fat following birth.
2. The rat embryos in the nicotine group also had alterations to the way their pancreas cells were formed.

The end result seems to be that smoking can cause a two-fold scenario that may place children at risk for Type 2 diabetes. Exposed rat pups had marked abnormalities in the cells that produce insulin. The research seems to suggest that there may be environmental hazards that contribute to the development of diabetes as a contributor independent from family genetics.

Meanwhile, Dr Francis Ofei, a medical doctor at the Department of Medicine and Therapeutics of the Korle-Bu Teaching Hospital indicates that energy drinks have been found to contribute to diabetes among the people he serves in Ghana.

Information may be less wide spread in this country where many doctors believe a large number of citizens may be undiagnosed diabetics.

The reason Dr. Ofei suggests energy drinks are a contributor to diabetes is the high calories and popularity of the drinks. These drinks also feature high carbs, which may also contribute to the findings.

Finally, a recent report indicates, “Diabetes has reached near-epidemic proportions in the UAE and Saudi Arabia, with nearly one out of every five individuals suffering from diabetes in the UAE. In Saudi Arabia, the prevalence is expected to rise to between 40-50% by 2020.”

The reason for the expected rise is a deficiency in health care. The report states a lack of care may be due to, “systemic deficiencies, regulatory changes and socio-economic factors.”

There are pharmaceutical companies that are working to bring their medicinal offerings to Saudi Arabia and the United Arab Emirates. According to the World Health Organization (WHO), “In Saudi Arabia, almost one Saudi in four beyond the age of 30 has diabetes mellitus costing the government $800 per month.”

Arabnews.com says, “To do nothing in the face of the emerging crisis, to ignore its seriousness, or to dismiss its impact is foolhardy and irresponsible.”

Further ArabNews.com suggests the following approaches to dealing with the diabetic crisis in the Middle East.

• Increased national awareness of diabetes.
• Greater recognition of the human, social and economic burden of diabetes.
• Recognition of the fact that diabetes is becoming a health priority.
• Implementation of cost-effective strategies to prevent diabetes complications.
• Affordable public-health strategies for the prevention of diabetes itself.
• Recognition of “special needs” groups (diabetes in children, the elderly, diabetes during pregnancy).

These suggestions are something every country has or will have to face in dealing with the growing problem of diabetes.

There seems to be a three-stage phase in dealing with diabetes.

1. Recognize it is an issue.
2. Make information a first response.
3. Develop strategies to cope with current issues and minimize future incidence of the disease.

This report dealt with new findings in medical research as well as diabetic issues facing various countries in our world. The sharing of research and information remains a key to finding better ways to mange this global crisis.

Diabetes: Prevention Attention: Sometimes it can be the simple thought starters that can help us make meaningful changes in our health. If you want to prevent diabetes in your own life or the lives of those you love most the following list from the National Diabetes Educational Program (NDEP is a government agency) might just spark some creative options in health.

• Keep meat, poultry and fish portions to about 3 ounces
• Try not to snack while cooking or cleaning the kitchen.
• Try to eat meals and snacks at regular times every day.
• Eat breakfast everyday.
• Use broth and cured meats in small amounts. They are high in sodium.
• Share a single dessert.
• When eating out, have a big vegetable salad, then split an entrée with a friend.
• Stir fry, broil, or bake with non-stick spray or low-sodium broth and cook with less oil and butter.
• Drink a glass of water 10 minutes before your meal to take the edge off your hunger.
• Make healthy choices at fast food restaurants.
• Listen to music while you eat instead of watching TV.
• Eat slowly
• Eat a small meal.
• Make less food look like more by serving your meal on a salad plate.
• Turn up the music and jam while doing household chores.
• Deliver a message in person to a co-worker instead of e-mailing.
• Take the stairs to your office.
• Catch up with friends on a regular basis during a planned walk.
• March in place while you watch TV.
• Park as far away as possible from your favorite store at the mall.
• Get off of the bus one stop early and walk the rest of the way home or to work.
• Try getting one new fruit or vegetable every time you grocery shop.
• Low-fat macaroni and cheese can be a main dish.
• Cook with a mix of spices instead of salt.
• Find a water bottle you really like and drink water from it wherever and whenever you can.
• Always keep a healthy snack with you.
• Choose veggie toppings like spinach, broccoli, and peppers for your pizza.
• Try different recipes for baking or broiling meat, chicken and fish.
• Try to choose foods with little or no added sugar.
• Gradually work your way down from whole milk to 2% milk until you’re drinking and cooking with fat-free (skim) or low-fat milk and milk products.
• Eat foods made from whole-grains such as—whole wheat, brown rice, oats, and whole-grain corn—every day.
• Don’t grocery shop on an empty stomach. Make a list before you go to the store.
• Read food labels.
• Slow down at snack time. Eating a bag of low-fat popcorn takes longer than eating a slice of cake.
• Try keeping a written record of what you eat for a week. It can help you see when you tend to overeat or eat foods high in fat or calories.
• Try one new activity or food a week.
• Find mellow ways to relax—try deep breathing, take an easy paced walk, or enjoy your favorite easy listening music.
• Try not to eat out of boredom or frustration
• Honor your health as your most precious gift.

Keep this list handy and find two ways each day to make positive changes in your lifestyle. This can serve to prevent diabetes or manage it better. You can do it – this list can help you accomplish your goals.