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You’ve heard a lot about
Outsulin? © TM
Indications and Limitations of Use
Afrezza® is a man-made rapid-acting inhaled insulin breathed in through your lungs and is used to control high blood sugar in adults with type 1 and type 2 diabetes. Afrezza® is available by prescription only. • Afrezza® is not for use in place of long-acting insulin. Afrezza® must be used with long-acting insulin in people who have type 1 diabetes. • Afrezza® is not for use to treat diabetic ketoacidosis. • It is not known if Afrezza® is safe and effective for use in people who smoke. Afrezza® is not for use in people who smoke or have recently stopped smoking (less than 6 months). • It is not known if Afrezza® is safe and effective in children under 18 years of age.
Important Safety Information
What is the most important information I should know about Afrezza®? Afrezza® can cause serious side effects including: • Sudden lung problems (bronchospasms). Do not use Afrezza® if you have long-term (chronic) lung problems such as asthma or chronic obstructive pulmonary disease (COPD). Before starting Afrezza®, your healthcare provider will perform a detailed medical history, physical examination, and will give you a breathing test (called spirometry) to check how your lungs are working. Who should not use Afrezza®? Do not use Afrezza®: • During episodes of low blood sugar (hypoglycemia). • If you have chronic lung problems such as asthma or COPD. • If you are allergic to regular human insulin or any of the ingredients of Afrezza® as this may cause a significant and severe allergic reaction.
What should I tell my healthcare provider before using Afrezza®? Before using Afrezza®, tell your healthcare provider about all your medical conditions, including if you: • Have lung problems such as asthma or COPD. • Have or have had lung cancer. • Are using any inhaled medications. • Smoke or have recently stopped smoking. • Have kidney or liver problems. • Are pregnant, planning to become pregnant, or are breastfeeding. Afrezza® may harm your unborn or breastfeeding baby. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, or herbal supplements. Before you start using Afrezza®, talk to your healthcare provider about low blood sugar and how to manage it. How should I use Afrezza®? • Read the detailed Instructions for Use that comes with your Afrezza®. • Take Afrezza® exactly as your healthcare provider tells you to, including how much Afrezza® to use and when to use it. • Know the strength of Afrezza® you use. Do not change the amount of Afrezza® you use unless your healthcare provider tells you to. • Take Afrezza® at the beginning of your meal. • Check your blood sugar levels. Ask your healthcare provider what your blood sugar level should be and when you should check your blood sugar levels. • Keep Afrezza® and all medicines out of reach of children. Your dose of Afrezza® may need to change because of: • Change in level of physical activity or exercise, weight gain or loss, increased stress, illness, change in diet, or because of other medicines you take.
Mealtime insulin has an OUTsulin part
Medical professionals often focus on how quickly mealtime insulin goes IN and handles blood sugar spikes that can happen when you eat. It’s time for another discussion: how quickly it leaves the body, which you can think of OUTsulin. as OUT
Afrezza® is a rapid-acting mealtime insulin • Reaches maximum effect in about 53 minutes • Can stay active for up to 3 hours. By then your blood sugar returns to near premeal levels
• Goes to work quickly (12-15 minutes rapid absorption rate)
Afrezza® is inhaled insulin. And yes, the Afrezza® inhaler is this size. You could be using fewer needles every day.
That’s why you can appreciate the OUTsulin side of Afrezza®: insulin that does its job and then leaves. For more information, visit Afrezza.com.
Could Afrezza® be right for you? Ask your doctor.
What should I avoid while using Afrezza®? While using Afrezza® do not: • Drive or operate heavy machinery, until you know how Afrezza® affects you. • Drink alcohol or use over-the-counter medicines that contain alcohol. • Smoke. What are the possible side effects of Afrezza®? Afrezza® may cause serious side effects that can lead to death including: • Low blood sugar (hypoglycemia). Signs and symptoms of low blood sugar include: • Dizziness or light-headedness, sweating, confusion, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability or mood change, hunger. • Decreased lung function. Your healthcare provider should check how your lungs are working before you start Afrezza®, 6 months after you start using it, and yearly after that. • Lung cancer. In studies of Afrezza® in people with diabetes, lung cancer occurred in a few more people who were taking Afrezza® than in people who were taking other diabetes medications. There were too few cases to know if lung cancer was related to Afrezza®. If you have lung cancer, you and your healthcare provider should decide if you should use Afrezza®. • Diabetic ketoacidosis. Talk to your healthcare provider if you have an illness. Your Afrezza® dose or how often you check your blood sugar may need to be changed. • Severe allergic reaction (whole body reaction). Get medical help right away if you have any of these signs or symptoms of a severe allergic reaction: © 2016 MannKind Corporation. All rights reserved. US.AFR.08.16.12 Afrezza and the Afrezza and MannKind logos are registered trademarks, and the INsulin and OUTsulin avatars are copyrights and trademarks of MannKind Corporation.
• A rash over your whole body, trouble breathing, a fast heartbeat, or sweating. • Low potassium in your blood (hypokalemia). • Heart failure. Taking certain diabetes pills called thiazolidinediones (TZDs) with Afrezza® may cause heart failure in some people. This can happen even if you never had heart failure or heart problems before. If you already have heart failure it may get worse while you take TZDs with Afrezza®. Your healthcare provider should monitor you closely while you are taking TZDs with Afrezza®. Tell your healthcare provider if you have any new or worse symptoms of heart failure including: • Shortness of breath, swelling of your ankles or feet, sudden weight gain. Treatment with TZDs and Afrezza® may need to be changed or stopped by your healthcare provider if you have new or worse heart failure. Get emergency medical help if you have trouble breathing, shortness of breath, fast heartbeat, swelling of your face, tongue, or throat, sweating, extreme drowsiness, dizziness, confusion. The most common side effects of Afrezza® are low blood sugar (hypoglycemia), cough, sore throat, headache, diarrhea, tiredness and nausea. These are not all the possible side effects of Afrezza®. Call your doctor for medical advice about side effects. You are encouraged to report negative side effects of all prescription drugs to the FDA. Visit www.fda.gov/ medwatch or call 1-800-FDA-1088. Please see the Brief Summary of Prescribing Information on the following page.
Summary of Information for Patients about Afrezza® (insulin human) Inhalation Powder: This is a brief summary of important information about Afrezza® (uh-FREZZ-uh) and is not comprehensive. Please read the Medication Guide and Instructions for Use that come with Afrezza® before you start taking it and each time you get a refill because there may be new information. To learn more about Afrezza® talk with your healthcare provider or pharmacist. The FDA approved product labeling, including boxed WARNING, can be found at www.afrezza.com/afrezza.pdf or by calling 1-877-323-8505. What is Afrezza®? Afrezza® is a man-made rapid-acting inhaled insulin breathed in through your lungs and is used to control high blood sugar in adults with type 1 and type 2 diabetes. Afrezza® is available by prescription only. • Afrezza® is not for use in place of long-acting insulin. Afrezza® must be used with long-acting insulin in people who have type 1 diabetes. • Afrezza® is not for use to treat diabetic ketoacidosis. • It is not known if Afrezza® is safe and effective for use in people who smoke. Afrezza® is not for use in people who smoke or have recently stopped smoking (less than 6 months). • It is not known if Afrezza® is safe and effective in children under 18 years of age. What is the most important information I should know about Afrezza®? Afrezza® can cause serious side effects including: • Sudden lung problems (bronchospasms). Do not use Afrezza® if you have long-term (chronic) lung problems such as asthma or chronic obstructive pulmonary disease (COPD). Before starting Afrezza®, your healthcare provider will perform a detailed medical history, physical examination, and will give you a breathing test (called spirometry) to check how your lungs are working. Who should not use Afrezza®? Do not use Afrezza®: • During episodes of low blood sugar (hypoglycemia). • If you have chronic lung problems such as asthma or COPD. • If you are allergic to regular human insulin or any of the ingredients of Afrezza® as this may cause a significant and severe allergic reaction. See the end of this summary of information for a complete list of ingredients in Afrezza®. What should I tell my healthcare provider before using Afrezza®? Before using Afrezza®, tell your healthcare provider about all your medical conditions, including if you: • Have lung problems such as asthma or COPD. • Have or have had lung cancer. • Are using any inhaled medications. • Smoke or have recently stopped smoking. • Have kidney or liver problems. • Are pregnant, planning to become pregnant, or are breastfeeding. Afrezza® may harm your unborn or breastfeeding baby. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, or herbal supplements. Before you start using Afrezza®, talk to your healthcare provider about low blood sugar and how to manage it. How should I use Afrezza®? • Read the detailed Instructions for Use that comes with your Afrezza®. • Take Afrezza® exactly as your healthcare provider tells you to, including how much Afrezza® to use and when to use it. • Know the strength of Afrezza® you use. Do not change the amount of Afrezza® you use unless your healthcare provider tells you to. • Take Afrezza® at the beginning of your meal. • Check your blood sugar levels. Ask your healthcare provider what your blood sugar level should be and when you should check your blood sugar levels. • Keep Afrezza® and all medicines out of reach of children.
Your dose of Afrezza® may need to change because of: • Change in level of physical activity or exercise, weight gain or loss, increased stress, illness, change in diet, or because of other medicines you take. What should I avoid while using Afrezza®? While using Afrezza® do not: • Drive or operate heavy machinery, until you know how Afrezza® affects you. • Drink alcohol or use over-the-counter medicines that contain alcohol. • Smoke. What are the possible side effects of Afrezza®? Afrezza® may cause serious side effects that can lead to death including: • Low blood sugar (hypoglycemia). Signs and symptoms of low blood sugar include: • Dizziness or light-headedness, sweating, confusion, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability or mood change, hunger. • Decreased lung function. Your healthcare provider should check how your lungs are working before you start Afrezza®, 6 months after you start using it, and yearly after that. • Lung cancer. In studies of Afrezza® in people with diabetes, lung cancer occurred in a few more people who were taking Afrezza® than in people who were taking other diabetes medications. There were too few cases to know if lung cancer was related to Afrezza®. If you have lung cancer, you and your healthcare provider should decide if you should use Afrezza®. • Diabetic ketoacidosis. Talk to your healthcare provider if you have an illness. Your Afrezza® dose or how often you check your blood sugar may need to be changed. • Severe allergic reaction (whole body reaction). Get medical help right away if you have any of these signs or symptoms of a severe allergic reaction: • A rash over your whole body, trouble breathing, a fast heartbeat, or sweating. • Low potassium in your blood (hypokalemia). • Heart failure. Taking certain diabetes pills called thiazolidinediones (TZDs) with Afrezza® may cause heart failure in some people. This can happen even if you never had heart failure or heart problems before. If you already have heart failure it may get worse while you take TZDs with Afrezza®. Your healthcare provider should monitor you closely while you are taking TZDs with Afrezza®. Tell your healthcare provider if you have any new or worse symptoms of heart failure including: • Shortness of breath, swelling of your ankles or feet, sudden weight gain. Treatment with TZDs and Afrezza® may need to be changed or stopped by your healthcare provider if you have new or worse heart failure. Get emergency medical help if you have trouble breathing, shortness of breath, fast heartbeat, swelling of your face, tongue, or throat, sweating, extreme drowsiness, dizziness, confusion. The most common side effects of Afrezza® are low blood sugar (hypoglycemia), cough, sore throat, headache, diarrhea, tiredness and nausea. These are not all the possible side effects of Afrezza®. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 (1-800-332-1088). General information about the safe and effective use of Afrezza®. Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use Afrezza® for a condition for which it was not prescribed. Do not give Afrezza® to other people, even if they have the same symptoms that you have. It may harm them. What are the ingredients in Afrezza®? Active ingredient: human insulin Inactive ingredients: fumaryl diketopiperazine, polysorbate 80 ©2016 MannKind Corporation. All rights reserved. US.AFR.08.16.14 AFREZZA is a registered trademark of MannKind Corporation.
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PAST TO PRESENT
Vital and game-changing diabetes milestones
Paleo? Vegan? Gluten-free? Could one work for you?
MANAGEMENT IN MOTION
Three generations talk diabetes fitness, management and more
Making lifestyle changes may help in other ways
8 10 12 18 26
LIVING WITH DIABETES
Facts about the disease that affects 29 million U.S. adults
Contents NOVEMBER 2016
28 30 34 36 38
BREAK THE LINK
Prevent the disease from leading to other ailments
EDITORIAL DIRECTOR Jeanette Barrett-Stokes email@example.com CREATIVE DIRECTOR Jerald Council firstname.lastname@example.org MANAGING EDITOR Michelle Washington email@example.com
PARTNERS IN HEALTHY LIVING
ADA and CVS Pharmacy join forces for you
MAKING THINGS BETTER
Research improves quality of life for Type 1 and Type 2 patients
Tips to save money despite rising insulin costs
EDITORS Elizabeth Neus Hannah Prince Sara Schwartz Tracy L. Scott DESIGNERS Miranda Pellicano Gina Toole Saunders Ashleigh Webb Lisa M. Zilka CONTRIBUTING WRITERS Karen Asp, Claudia M. Caruana, Jim Dillon, Sandra Gordon, Cindy Kuzma, Peggy J. Noonan ADVERTISING VP, ADVERTISING Patrick Burke | (703) 854-5914 firstname.lastname@example.org ACCOUNT DIRECTOR Justine Madden | (703) 854-5444 email@example.com FINANCE BILLING COORDINATOR Julie Marco
TRUE AND FALSE
Separate diabetes fact from fiction
View our interactive edition! Visit usatoday-studiog.com/diagnosis-diabetes-2016
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Living with Having diabetes can be life-changing. But many of the nearly 30 million American adults diagnosed with the disease know that despite the challenges, it can be managed properly and even inspire positive life changes. Those with TYPE 1 diabetes, typically diagnosed during childhood or the teen years, do not produce the hormone insulin, which the body depends on to move glucose (a form of sugar) from the bloodstream into the cells to create energy. Those with Type 1 will need to receive daily insulin injections for the rest of their lives following the initial diagnosis. Those with TYPE 2, the more common of the two, accounting for 95 percent of those diagnosed, can make insulin, but the cells aren’t able to process it as well as they should. While the condition may be treated through weight loss and exercise, medication may be necessary and some might eventually need insulin injections. Athough those diagnosed are
at a greater risk of developing additional health issues, including heart disease, stroke and kidney failure, by maintaining healthy and balanced diets, engaging in regular physical activity and working with physicians to track blood glucose levels, they can live a long, healthy life. NOVEMBER is National Diabetes Awareness Month, and we’ve packed this issue with the latest advice on nutrition and fitness, tips on how lifestyle adjustments can have big benefits and how to keep diabetes from leading to other health issues. We share profiles of people living with diabetes and detail an exclusive partnership between CVS Pharmacy and the American Diabetes Association designed to promote awareness and make managing the disease easier. Whether you’ve been newly diagnosed or have been living with the disease for years, our goal is to arm you with information that will help you live — and thrive — with diabetes.
MILESTONES Key dates shape diabetes history
First century A.D.
Though Egyptian doctors first referenced the disease centuries earlier, it’s Greek physician Araetus of Cappodocia who coins the term “diabetes” and accurately describes the condition.
French researcher Jean De Meyer creates the term “insulin” to describe internal secretions of the pancreas; loss of these secretions, he hypothesizes, causes diabetes.
Scottish surgeon John Rollo expands on Dobson’s work and creates the first diet designed to control diabetes.
French mathematician/ philosopher Blaise Pascal invents the precursor of the modern syringe.
English scientist Matthew Dobson uses experiments to link sugar in the urine to diabetes.
Scottish physician Alexander Wood invents the first medical syringe.
CLOCKWISE: WIKIMEDIA COMMONS; THE INDIANAPOLIS STAR; AMERICAN DIABETES ASSOCIATION; JOHN SOARES/JOSLIN DIABETES CENTER; DEKA RESEARCH & DEVELOPMENT CORP. ; GETTY IMAGES; GETTY IMAGES; ASCENSIA DIABETES CARE; BERN HARRISON, BAYER HEALTHCARE LLC; BANTING AND BEST DIABETES CENTRE; WELLCOME LIBRARY, LONDON
Testing dogs and cattle at the University of Toronto, Canadian physician Frederick Banting and assistant Charles Best develop insulin. Biochemist James Collip joins the team and develops a way to purify the extract to use in humans.
1916 Inspired by relatives with the disease, Dr. Elliott Joslin, (whose work would lead to the creation of the Joslin Diabetes Center) publishes the first textbook on diabetes, The Treatment of Diabetes Mellitus, now in its 14th edition. Two years later, he publishes Diabetic Manual for the Mutual Use of Doctor and Patient, the first patient handbook.
Early 1920s 1922
Banting and project supervisor John Macleod receive the Nobel Prize for Medicine or Physiology for the discovery of insulin. Indianapolisbased Eli Lilly and Company begins producing the first commercial insulin.
Leonard Thompson, 14, becomes the first person to receive insulin. Weighing just 65 pounds and dying from diabetes, he receives injections at Toronto General Hospital that save his life. He dies in 1935.
Clinician research Harold H worth d the first measure sensitivi enables to tell th ence be the two diabete
Joslin Diabetes Center, which helped create the current blueprint for the diagnosis, treatment and prevention of diabetes, is founded at Harvard Medical School.
The American Diabetes Association is founded.
n and her Himsdevelops t test to e insulin ity, which s doctors he differetween o types of es.
Doctors perform the first human pancreas transplant at the University of Minnesota; the patient lives insulinfree for two months before dying of complications.
Future Segway inventor Dean Kamen develops the first wearable insulin pump (previous versions were the size of a backpack); they hit the market in 1976.
Researchers report that more children are developing Type 2 diabetes.
In 2014, health insurance plans cannot deny coverage for pre-existing conditions, including diabetes â€” part of the Affordable Care Act signed by President Obama in 2010, which made health care coverage available for all Americans.
Simple testing of urine for glucose using special strips begins to become more common. (Later strips would test the blood.) Oral medications for diabetes begin to hit the market.
Veterans Administration researchers Solomon Berson and Rosalyn Yalow discover that people treated with cattle-based insulin (common at the time) can create antibodies to it, leading to the development of human-based insulin.
Ames Company introduces the first glucose meter.
Type 2 diabetes found to be more common among African Americans, Mexican Americans and Native Americans than among Caucasians.
Joslin researcher Mary-Elizabeth Patti finds that poor prenatal nutrition in mice permanently damaged functioning insulinproducing cells in the motherâ€™s pancreas, which put its offspring at risk of diabetes.
SOURCE: USA TODAY RESEARCH
Paleo, vegan and gluten-free â€“ which best fits your diabetes care plan? B Y C I N D Y KU Z M A
Vegan DIET: Unlike vegetarians, vegans avoid all animal foods, including meat, dairy, eggs, honey, gelatin and fish. Because the diet can be low in artery-clogging saturated fat, this way of eating can work well for people who already have heart disease, says dietitian Toby Smithson, a spokesperson for the Academy of Nutrition and Dietetics and author of Diabetes Meal Planning and Nutrition for Dummies.
GARDEN GOODNESS Experts recommend 3 to 5 servings of vegetables daily
MEANS: Vegans should include plenty of non-starchy vegetables such as leafy
BENEFITS: According to the American Diabetes Association, the high fiber in this diet naturally helps you to feel full for a longer time after meals and may help reduce overall calorie intake. DIAGNOSIS: DIABETES
Dark, leafy greens are low in calories and carbs, giving them superfood status Citrus fruits contain soluble fibers, excellent for your diet
greens, cucumbers or broccoli to control your intake and blood glucose. Because this diet has a lot of carbohydrates, careful meal-planning is necessary. Then thereâ€™s the matter of protein. Non-animal sources lack one or more of the essential building blocks called amino acids, which form proteins. So, your daily diet should include protein from a wide variety of sources, including beans, soy foods, nuts, lentils and quinoa.
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Most people with diabetes should get at least 30 percent of their calories from carbohydrates.
DIET: Based on habits of prehistoric humans, this diet stresses whole — not processed — foods, says dietitian Kelly Schmidt, who has Type 1 diabetes and is the author of What’s the Deal with Primal Eating and the Paleo Diet? MEANS: Your grocery cart should be loaded with vegetables, fruits, nuts,
−Toby Smithson, dietitian
seeds and high-quality proteins — think wild seafood, grass-fed beef and pasture-raised pork. For instance, one study found two grams per day of chia seeds increased the effectiveness of blood sugar-lowering medicines in people with Type 2 diabetes. Leave out foods your paleolithic ancestors didn’t hunt or gather, such as dairy, sugar, soy, lunchmeat and snack foods, Schmidt says.
TRY THIS Make to-go salads the night before to ensure healthy eating
BENEFITS: A study published in the journal Cardiovascular Diabetology indicates that improved blood-glucose control and lower blood pressure and cholesterol are among the short-term benefits for people with Type 2 diabetes who eat paleo.
Gluten-free DIET: The gluten-free diet has become trendy, even among people for whom it’s not a medical necessity. Type 1 diabetes often goes hand-in-hand with celiac disease, an autoimmune condition in which your body’s defenses turn against your own small intestine. MEANS: The only treatment? Avoiding gluten, a protein present in wheat, barley and rye. That means omitting some cereals, breads, and crackers.
BENEFITS: Avoiding gluten should eliminate the uncomfortable abdominal pains, fatigue, weight gain and other symptoms that often accompany celiac disease. For those who do drop gluten, the major concern is carbs, Smithson says. “Many of the special gluten-free products — such as cereals, breads, and crackers — are higher (in carbs) than their gluten-containing comparisons.” So, keep close tabs on your intake to keep your blood glucose in check.
Delectable Dishes GINGERED FRIED RICE Serves 6
Serves 4 1 1 ¼ ½ ¼ 4
T. trans-fat-free margarine T. olive oil cup all-purpose flour tsp. salt, divided tsp. ground black pepper, divided 4-ounce boneless, skinless chicken breasts, pounded to ¼-inch thickness ½ cup cherry preserves 2 T. balsamic vinegar 2 T. slivered almonds, toasted In a large nonstick skillet, heat the margarine and oil over medium heat until margarine melts. In a shallow dish or pie plate, combine the flour, ¼ teaspoon salt and 1/8 teaspoon black pepper. Dredge the chicken breasts in flour and sauté until golden brown on each side and cooked through, about 5 minutes on each side. Remove the chicken to a serving platter and keep warm. In a small saucepan, heat the cherry preserves and balsamic vinegar until warm. Season chicken breasts with remaining salt and pepper, top with cherry sauce and sprinkle with toasted almonds. NUTRITION INFO: 354 calories, 10 g fat (1 g saturated fat) 72 mg cholesterol, 28 g protein, 36 g carbohydrates, 1 g fiber, 337 mg sodium, 32 mg calcium, 25 percent calories from fat.
Recipes from Heart Smart Cookbook: Third Edition by the Detroit Free Press and the Henry Ford Health System 6 DIAGNOSIS: DIABETES
T. trans-fat-free margarine, divided cup onion, diced garlic clove, peeled and minced T. minced gingerroot cup broccoli florets, cut into small, ½-inch pieces cup grated carrots cup diced celery egg whites cups cooked brown rice T. reduced-sodium soy sauce tsp. brown sugar tsp. ground mustard tsp. ground ginger tsp. garlic powder tsp. ground black pepper cup thinly sliced green onion
In a large nonstick skillet over medium heat, melt 1 tablespoon plus 2 teaspoons margarine. Sauté the onion, garlic and gingerroot until fragrant, about 3 minutes. Add the broccoli, carrots and celery and continue to sauté an additional 5 to 8 minutes. Remove vegetable mixture from skillet and set aside. In the same skillet, add the remaining 1 teaspoon of margarine and cook and stir the egg whites over medium heat until completely set. Add vegetable mixture back to the skillet with the cooked rice. In a small bowl, whisk together the soy sauce, brown sugar, ground mustard, ground ginger, garlic powder and ground black pepper. Add the sauce to the skillet and combine until heated through. Serve topped with green onions. NUTRITION INFO: 126 calories, 3 g fat, 0 mg cholesterol, 4 g protein, 20 g carbohydrates, 2 g fiber, 241 mg sodium, 31 mg calcium, 21 percent calories from fat.
SUSAN TUSA/DETROIT FREE PRESS; KIMBERLY P. MITCHELL/DETROIT FREE PRESS
CHICKEN WITH CHERRY BALSAMIC GLAZE
2 ½ 1 1 ¾ ½ ½ 2 2 2 1 ½ 1 /8 1 /8 1 /8 1 /3
Enjoy a Sweet Sugar-Free Holiday The American Heart Association recommends no more than 24 grams/100 calories of added sugar for women and 36 grams/150 calories for men daily*
Frozen Hot Chocolate A LOW-SUGAR TWIST ON A FALL FAVORITE! 83 CALORIES PER SERVING
1 cup instant dry milk 2 tsp. SugarLeaf ® 4 Tbsp. cocoa, unsweetened 1 cup milk 6 drops SweetLeaf ® Liquid Stevia Chocolate Sweet Drops™ 3 cups ice Whipped cream (optional)
Stir dry milk, SugarLeaf , and unsweetened cocoa in a small bowl until completely mixed. Add ingredients to blender in the following order: milk, Chocolate Sweet Drops™, dry mix. Blend for 5 seconds. ®
Add ice and blend for 30 seconds until smooth. Pour into a short glass. If desired, top with whipped cream. Serves 4. NUTRITION FACTS PER 1 SERVING: Calories 83, Total Fat 3g, Cholesterol 10mg, Sodium 59mg, Total Carbohydrate 11g, Dietary Fiber 2g, Protein 5g (does not include optional topping)
SweetLeaf Sweet Drops™ ®
Zero calories or carbs No artificial ingredients Delicious sweet taste Adds flavor and sweetness to food and beverages Non-glycemic response
SweetLeaf Stevia Sweetener & Organic Stevia Sweetener
SweetLeaf Water Drops™ No sugars or artificial sweeteners Four tasty fruit-flavored blends Enhances still or sparkling water Adequate hydration is vital to body and brain health Non-glycemic response
No artificial ingredients Non-GMO verified Zero carbs or calories Non-glycemic response Tastes great in coffee or sprinkled on fruit or cereal *Source: American Heart Association website, July 2016.
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Every recipe can be a SweetLeaf recipe! Use our Conversion Chart or Calculator at
MANAGEMENT IN MOTION
From adolescence through adulthood, use exercise to control your diabetes BY C I N D Y KU Z M A
O GETTY IMAGES; ILLUSTRATIONS: MIRANDA PELLICANO
ne of the most effective diabetes treatments comes not in a pill or a shot, but through a dose of motion. A well-rounded fitness program includes aerobic, strengthening, flexibility and balance-building movements. This potent combination controls blood glucose and improves health at any age. However, the top priorities for physical activity shift as the years pass. On the following pages, we outline workouts for different age groups, and we talk to three individuals, ranging from age 17 to 72, who share how they are effectively managing their day-today challenges and living well.
SHARING THEIR STORIES: McGuire Ray Hayes
S. Epatha Merkerson
Diabetes MANAGEMENT IN MOTION
Start a cardio habit for long-term weight control B Y C I N D Y KU ZM A
future, so we need to make sure we incorporate exercise,” says Amy Hess-Fischl, certified diabetes educator at the University of Chicago Kovler Diabetes Center. Team sports provide ample activity for adolescents. For non-athletes, steady-state aerobic moves such as walking on a treadmill, biking or using an elliptical work well,
Hess-Fischl says. One warning: Teens with diabetes must learn to avoid hypoglycemia, or low blood glucose, during exercise. They typically need to adjust meals and medications, then check blood-glucose levels during workouts, games or practices. Work with your child and his or her health care team to develop a plan.
Any endurance sport requires you stay hydrated. So, if you’re biking, make sure you drink plenty of liquids. DIAGNOSIS: DIABETES
oung people with diabetes need an hour a day of moderate aerobic activity to stay healthy — more if they want to shed pounds. And with about 1 in 5 U.S. teens considered obese, managing weight has become more critical. “We know kids who are sedentary now are going to be obese adults in the
MANAGEMENT IN MOTION
Familiar with the disease already affecting close relatives, this teen knew what to expect BY KA R E N A S P
ILLUSTRATION BY MIRANDA PELLICANO
lthough his three so there’s an extra check in sisters had been place. diagnosed with Type Hayes tries to stay away 1 diabetes, McGuire from soda and candy, but Ray Hayes didn’t worry about he generally eats what his chances of developing he wants. He plays a few the disease. His siblings’ different sports just for fun diagnoses had come at ages but not any one all the time. 3, 4 and 11, so at 14, he He plays basketball and MCGUIRE RAY HAYES figured he had escaped the baseball, snowboards and Current age: 17 family trend. Then, he came rides his bike with his family Age diagnosed: 14 down with what he thought members who, he credits for was a cold or the flu. their support. He also frequently needed to get up at night “When we went to diabetes camp this summer, to go to the bathroom and was unusually thirsty. I noticed that the main point was to meet other He asked his mom to check his blood using one kids with Type 1 diabetes,” says Hayes, who of his sister’s blood-sugar kits, and his fears were attends with his siblings. “Even though camp confirmed. A doctor later verified the results. was a great experience, I didn’t need it for that “I was scared, sad and upset,” says the reason, as I have three people in my house who Colorado Springs teen. “Even though I knew completely understand.” how to care for diabetes, I knew my life would He does acknowledge, however, that it can be forever changed, and I was going to have to be tough to deal with people who don’t do shots, watch what I ate and check my blood understand. He adds he tries to take a light and sugars all the time.” humorous approach to his diabetes and often Hayes started using an insulin pump six months jokes about it. after his diagnosis, something he considers an While Hayes was initially embarrassed about advantage. “Not having to do shots every time having diabetes, which affected how he managed you want to eat is awesome,” he says. it, he urges other teens not to be. “You didn’t do He also uses a glucose monitoring system, anything wrong; don’t let it define you but do which provides his blood-glucose levels every five take charge of it,” he advises. And find support, minutes. he adds. “There are lots of kids out there with His mom even follows his blood-sugar levels Type 1 diabetes so you’re not alone. Seek them (as well as his sisters’) on an accompanying app out if you need support, which is so important.”
Diabetes MANAGEMENT IN MOTION
Add intervals and strength training to your routine B Y C I N D Y KU ZM A
ness, blood sugar and weight benefits about 50 percent of the time. Also key: adding musclestrengthening moves two to three times per week. “You don’t have to go to the gym,” says exercise physiologist Sheri Colberg-Ochs, author of The 7 Step Diabetes Fitness Plan. “Exercises using your body weight are perfectly fine, such as wall push-ups, planks
and lunges.” Resistance training preserves the strength needed for daily activities and keeps your blood glucose in check. Muscles use glucose for energy and act as a storage tank for extra fuel — so the more brawn you have, the less sugar enters your bloodstream, notes Jacqueline Shahar, an exercise physiologist at Joslin Diabetes Center.
ardio remains important for a strong heart and a slim waistline. Adults should aim for 30 minutes most days of the week. Crunched for time? Try high-intensity interval training — short bursts of accelerated effort followed by rest periods. Research published in the International Journal of Sports Medicine found this method produced fit-
MANAGEMENT IN MOTION
Accepting the Challenge When diagnosed with the disease that blinded her grandmother, this actress took action BY KA R E N A S P
ILLUSTRATION BY MIRANDA PELLICANO
ou might know S. a management plan that included Epatha Merkerson as diet, exercise and medication. hospital administrator Her first major change? Choosing Sharon Goodwin healthier foods. on NBC’s Chicago Med or “I was eating more like a child previously as Lt. Anita Van when I was diagnosed,” she S. EPATHA MERKERSON Buren on the iconic drama Law says about her junk-food habit. Current age: 63 & Order before its years-long She also began planning meals Age diagnosed: 49 run ended. What you may not in advance and learning about know is that Merkerson has proper serving sizes. Type 2 diabetes. That’s why She then tested different she urges others to join her in America’s Diabetes exercises to figure out what worked best for her. She Challenge, an educational program that encourages tried several activities, including cycling and hot yoga people with Type 2 diabetes to work with their but eventually found she most enjoyed taking a brisk doctors to set and reach their blood sugar goals. walk several times a week. Although prior to her own diagnosis, Merkerson Most importantly, though, Merkerson has kept a wasn’t a stranger to diabetes — her grandmother close eye on her blood sugar. She checks it twice a lost her sight to it; her father died from complications day and tracks it every three months when she sees from Type 2 diabetes and her uncle had a lower limb her doctor to make sure her plan is still working. She amputation as a result — she wasn’t well versed also logs her progress to check that she’s staying on about the symptoms or lifestyle habits that would track. prevent it. Merkerson, who splits her time between Chicago “As an African American, I knew Type 2 diabetes and New York City, concedes that having Type 2 was a significant health concern among our diabetes is challenging. Making lifestyle changes community, but I was unaware of the signs and and breaking bad habits as an adult isn’t easy, but symptoms, let alone that I might be displaying her personal support system has been a tremendous them,” she says. Constant thirst and frequent help. urination are two early symptoms. “Having supportive people in my life has helped She also wasn’t the healthiest she could be. She’d me stay motivated and proactive,” she adds. put on weight and wasn’t exercising or paying close As difficult as the disease can be to live with, attention to her diet. So when she attended a health Merkerson says it’s manageable, especially if you’re fair and was told her blood-sugar levels were high, being proactive. she was spurred to action. “My diagnosis was a “Keep your doctor involved and never hesitate wake-up call,” she says. “I knew I had to start making to ask questions,” says the Emmy Award-winning serious changes to my lifestyle to take control of actress. “The more you know about your condition, my health.” the more you can do to manage it, or as I like to say, Merkerson began working with her doctor to create if you know better, you can do better.”
Diabetes MANAGEMENT IN MOTION
Fight against falls with these exercises B Y C I N D Y KU ZM A
exercise routine counters these effects, says exercise physiologist Sheri ColbergOchs. Yoga and tai chi address all these issues in a single series of movements. Add a balance challenge — such as standing on one leg — or strengthening exercises using resistance bands. Older adults should aim for 150 minutes of daily aerobic exercise and two to three
days of strengthening per week, diabetes educator Amy Hess-Fischl says. The complications of diabetes shouldn’t deter you from exercise, but might require modifications to your routine, Colberg-Ochs says. For instance, if you have retinopathy, steer clear of bending over or lifting heavy weights, to avoid further damage to your eyes.
alling is a concern for anyone experiencing the fatigue, dizziness or fluctuating blood-sugar levels sometimes associated with diabetes. However, for seniors, the injuries sustained are often more serious and it can take much longer to heal than for younger counterparts. Fortunately, the right
MANAGEMENT IN MOTION
Step by Step Drastic weight loss followed a diagnosis that wasn’t so sweet BY KA R E N A S P
ILLUSTRATION BY MIRANDA PELLICANO
alk about a weather. whopper of Today, Mazzella a wake-up has gotten his call: When condition under Donald Mazzella control so much of Ridgefield, N.J., that his blood sugar, innocently attended a which he reads health fair, the mournful regularly, hovers face on the nurse around 6.5, the who’d tested his blood lowest percentage DONALD MAZZELLA told him everything he at which one is Current age: 72 needed to know. He diagnosed with Age diagnosed: 55 immediately went to his diabetes, according doctor, who delivered to the Mayo Clinic. the Type 2 diabetes He’s also nixed diagnosis. the two tablespoons of sugar he used to Truth is, the verdict didn’t surprise him. dump in his coffee and made smart food Mazzella knew he was susceptible to it. choices like switching from regular soda After all, his mother, two aunts and his to diet. grandmother also had diabetes. Another important change he adopted: Yet his overindulged sweet tooth — he reading food labels. “We always read practically poured the sugar dish into his ingredient labels on everything now, daily cups of coffee — had caught up especially because there’s so much sugar with him. He went on a regimen of pills, in foods these days, and too much sugar, including a drug called Victoza, which especially the granulated kind, will kill he credits with helping him lose almost you,” he says. 30 pounds, and began a daily walking If there’s one piece of advice he wants program, largely spurred on by his wife. to pass along, it’s a simple tip: “Go to “She really wanted me to live,” he says. your doctor at least once a year and get The couple began walking a mile a day your blood-sugar levels tested so you can six days a week, a habit they continue. establish a baseline,” says Mazzella, who While they mainly walk outside, they walk advises that it’s also important to find a indoors at a mall or store during inclement doctor you feel comfortable working with.
Fringe Benefits The steps you take to control your diabetes can help you in other ways, too
ILLUSTRATIONS BY ASHLEIGH CORRIN
BY PEGGY J. NOONAN
EXERCISE uLowers blood pressure as effectively as many medications taken to control hypertension. uDecreases the risk of dying from cardiovascular disease.
uImproves your chances of surviving your first heart attack. uHelps reduce LDL (bad) and increase HDL (good) cholesterol in your blood. cdc.gov/ cholesterol/ldl_hdl.htm
WEIGHT LOSS/MANAGEMENT uReduces your risk of joint damage and arthritis pain by lowering the load your joints must carry. Every 1 pound you lose takes 4 pounds of stress off your knees. u”Improves fitness,” says Barry A. Franklin, director of cardiac rehabilitation program and exercise laboratories
at William Beaumont Hospital in Michigan. “As the weight goes down, the fitness goes up.”
uReduces your waist size. “Abdominal fat is far more dangerous” to your diabetes and cardiovascular or heart health than fat around the hips and thighs, Franklin notes.
ILLUSTRATIONS BY ASHLEIGH CORRIN
SLEEP uCuts your chances of developing hypertension when you get more than six hours a night — ideally, seven to nine hours is better. It also may cut nighttime blood pressure spikes.
uBalances hunger hormones that regulate appetite and food intake, Franklin says. People who sleep fewer than four hours a night are 73 percent more likely to be obese, he adds.
Breaking the Links Those with diabetes can avoid these commonly associated diseases B Y SA N D R A G O R D O N
Smoking cigarettes narrows blood vessels, leading to high blood pressure and increasing the risk of fatal heart attacks in people with diabetes by 52 percent, according to a study in the online journal BMJ Open. Abdominal or central obesity â€” for women, having a waist larger than 35 inches; for men, 40 inches or more â€” can lead to the buildup of bad cholesterol in blood vessel walls, and in turn cause elevated blood pressure. High blood pressure can lead to heart disease or stroke, the top cause of death among those with diabetes. Taking aspirin can help decrease risk. Researchers suggest eating more fiberrich foods such as beans, vegetables and oat bran. DIAGNOSIS: DIABETES
OSTEOARTHRITIS There is a high occurrence of osteoarthritis, a deterioration of joint cartilage, among those diagnosed with diabetes, a report in the journal Rheumatic & Musculoskeletal Diseases found. Obesity or high blood sugar may be the cause.
TIPS To decrease risk of heart disease, try limiting your intake of saturated fats. Exercise will help ease symptoms of osteoarthritis, strengthening joints and lessening pain. To prevent kidney failure, closely monitor blood sugar levels after meals.
KIDNEY FAILURE Diabetes is the leading cause of kidney disease. About 10 percent to 40 percent of adults with diabetes will eventually experience kidney failure, according to the National Institute of Diabetes and Digestive and Kidney Diseases. To decrease your risks of developing the disease, Margaret EckertNorton, a nurse practitioner and certified diabetes educator in New York, suggests checking your blood sugar an hour or two after daytime meals and once before going to bed. After a week or so, show your data to your doctor, who can determine whether medication adjustment is necessary.
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Diabetes NEWS & INFO
CVS, ADA work together to boost awareness, funding and resources
hether you are craving sugar-free sweets or are in need of glucose tablets, CVS Pharmacy, the exclusive drug store for the American Diabetes Association’s Partner in Healthy Living Initiative, hopes to top the list of go-to retailers for those living with diabetes. In May, the two juggernauts announced their partnership and the effort’s goal to advance the research, prevention, care and
treatment of diabetes, says Judy Sansone, a senior vice president and chief merchant at CVS Health. At nearly 8,000 CVS locations in the U.S., customers can benefit from helpful resources in-store and online (cvs.com/diabetes-care), including discounts on products such as glucose meters as well as diabetes testing at the pharmacy’s MinuteClinics. “Customers can now turn to CVS Pharmacy as their one-stop shop for all things diabetes,” says Sansone.
Though just months old, the project “has been extremely well-received by our customers,” she adds. “The ultimate success of this program will be based on the number of individuals that we reach and positively impact,” Sansone says. “The impact could come in the form of something as simple as a customer saving a few dollars on diabetes products, to something greater, like providing the guidance and information an individual needs to live a healthier life
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Diabetes NEWS & INFO
demonstrate good corporate citizenship.
CVS Pharmacy is committed to becoming a onestop shop for all things diabetes.
with diabetes.” ADA’s chief development and stewardship officer Corey Gordon agrees. “The American Diabetes Association hopes the Partner in Healthy Living initiative will provide valuable health information to the millions of CVS customers to help them effectively manage their diabetes. In addition, we hope collaborations such as this one will elevate the focus on diabetes, and make it easier for patients and caregivers to access disease management resources.” In addition to serving customers, the partnership also supports CVS Pharmacy employees’ participation in awareness events and diabetes fundraising. And getting people involved — financially and otherwise — is a major component of the initiative. The collaboration is an example of how health care
of employees experience a greater sense of satisfaction and increased loyalty to companies that invest in the community. – Mollye Rhea, president and founder of For Momentum LLC
corporations and nonprofits can try to make life easier for those with chronic illnesses while boosting awareness and funding. Another benefit is the goodwill such partnerships generate among employees and consumers as both groups favor companies that
It makes good business sense for health care companies like CVS and nonprofits like the ADA to work together because the relationship can be mutually beneficial, says Mollye Rhea, president and founder of For Momentum LLC, a cause marketing firm in Atlanta. The nonprofit gets an opportunity to raise awareness and funds, while the company gets an endorsement from the nonprofit, access to its research and the chance to boost sales among a key customer group, Rhea says. Such projects also allow a company to show it is socially responsible, which more employees have come to expect, Rhea says. “Ninety percent of employees express a greater sense of loyalty when they work for a company that does good things in the community,” Rhea says. Another cause marketing expert, Bruce Burtch, says that when nonprofits, for-profits, educational or governmental organizations want to promote the greater good, nothing provides as much economic and social benefit as a good partnership. “Nothing else even comes close,” Burtch says in an August 2014 webinar on Third Sector Today, a website for nonprofit professionals.
PHOTOS COURTESY OF CVS PHARMACY
A Simple Diet for Better Blood Sugar Control
Here are the findings: • Children were twice as likely to understand a Low Glycemic exchange diet. • Twice as many parents in the Low Glycemic diet group said their children had no difﬁculties selecting their own meals. • After 12 months, twice as many children on the Low Glycemic diet had acceptable HbA1c values than those in the carbohydrate exchange diet group. • The carbohydrate exchange diet was associated with inferior blood sugar control and quality of life measures.
(Even Kids Find It Easy to Follow!)
Yes, a clinical study* of children with Type 1 diabetes compared a Low Glycemic diet, that is a more ﬂexible approach and considers a carbohydrate’s impact on blood sugar, to the traditional carbohydrate exchange diet that counts all carbs the same. The study revealed kids understood the Low Glycemic diet twice as much and had less difﬁculty selecting their meals...and that makes them happier.
To learn more download The Low Glycemic Guide for Better Blood Glucose Control. Shop Fifty50 Foods’ full line of Low Glycemic products at fifty50foods.com, they will put a smile on your face!
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Diabetes NEWS & INFO
What’s new in research and treatments TYPE 1
AUTOMATED INSULIN PUMP
An FDA-approved hybrid closed-loop insulin pump is on its way to individuals with Type 1 diabetes. Medtronic’s MiniMed 670G system automatically monitors blood-sugar levels and simplifies the delivery of insulin to patients. The device, which closes the loop between a traditional insulin pump and a continuous glucose monitor, uses sophisticated algorithms to determine how much insulin a patient needs. Previously, patients would have to enter data gathered by computerized monitors into a pump. The new technology releases insulin on its own when a sensor attached to the patient’s body determines that it’s needed; this largely eliminates the need for manual injections several times daily. Patients must still enter the amount of carbohydrates they eat at each meal. The newly approved TYPE 1 “artificial pancreas system” even works overnight so Most often diagnosed in users don’t have to wake children and for a blood-sugar reading. teens. The company hopes to start rolling out the device, Requires approved for patients 14 lifelong insulin and older, in spring 2017. treatments.
For years, doctors have advised those with Type 2 diabetes to manage their weight, in part, by spending 30 minutes per day working out, primarily walking. Now, new research suggests that dividing that half hour into multiple walks can have a positive effect on how insulin is used by the body. A study conducted by researchers at the University of Otago in New Zealand found that when patients with Type 2 diabetes walked for 10 minutes after each meal, their blood-sugar levels were lower than their counterparts who exercised in 30-minute blocks. “Advice to walk after meals when blood sugars are high provides a greater reduction in blood sugar than advice to walk where the timing is not specified,” says Andrew Reynolds, the study’s lead author. TYPE 2 Of the 41 patients who were observed in two-week Most often diagnosed in intervals, blood-sugar levels adulthood. of those who walked after meals decreased 12 percent Managed by on average compared with medication those whose walk didn’t and a healthy correlate with a mealtime. lifestyle.
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Diabetes NEWS & INFO
Experts suggest ways to offset rising insulin costs B Y SAN D RA G ORD O N
ood health, of course, is priceless. But managing insulin-dependent diabetes? That’s a pricey proposition. There have been 24 price increases between 2002 and 2013, says William Herman, professor of internal medicine and epidemiology at the University of Michigan and co-author of a study published in the Journal of the American Medical Association in April. Health insurance certainly helps defray the cost, but there is no generic form of insulin available as an alternative to the brand name options that can cost anywhere from $26 to $300 per 10 milliliter vial. (Typically, two to three vials a month are needed.) While it may be tempting or seem cost-effective to stretch insulin by skipping injections or taking smaller doses, to manage your diabetes well and minimize the risk of complications, it’s important to fill your prescriptions promptly and use as directed. “The amount of insulin you use should match the amount of insulin your body needs,” says Robert Lash, an endocrinologist and chairman of the clinical affairs committee at the Endocrine Society. Too little insulin can lead to hyperglycemia (high blood sugar), which can lead to nerve, kidney, eye the amount that a milor blood vessel damage. Too much liliter of injectable insulin insulin can cause hypoglycemia increased from 2002 (low blood sugar), which can cause to 2013, from $4.34 to dizziness, fainting, coma or $12.92. other problems.
SWITCH INSULIN TYPES
Synthetic insulin analogs mimic the body’s natural pattern of insulin release. “The insulin analogs are probably a little safer ... and potentially a little more effective” for people with Type 1 diabetes, Herman says. But human insulin, an older form that’s not been modified, sells for much less and can be just as effective for managing Type 2 diabetes.
ASK FOR ASSISTANCE
Contact the customer service department of your insulin manufacturer and ask whether the company offers a pharmaceutical assistance program.
CHECK YOUR DRUG FORMULARY
This is essentially a list of prescription drugs (both brand name and generic) maintained by medical professionals. Health insurance companies, hospitals and health systems use the formulary to indicate what is covered by your health plan. You might find injectable insulin with a cheaper co-pay.
CHANGE INJECTION METHODS
Insulin pens are convenient to carry, but they’re more expensive per insulin unit. To reduce costs, switch to a vial and syringe.
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Diabetes A FEW HEALTHY NOTES
Myths Facts uA positive attitude and
keeping active play key roles in managing diabetes. uInjections to treat
diabetes are not always necessary. Blood-sugar meters, insulin pens and oral medications do not require shots. uCompared with the
general population, AfricanAmericans are at higher risk of developing diabetes.
uIf you have diabetes, your
immune system puts you at a higher risk for catching colds and other illnesses than others. Not really, but contracting an illness on top of diabetes (example: flu, pneumonia) can complicate your management regimen. uSweets are a no-no.
Combined with a healthy dose of exercise and eaten in small portions, desserts are fine. uObesity is the major cause
of diabetes. There are many risk factors — weight, genetics and diet — that contribute to this complicated disease.
uExercise helps control
diabetes, but it has to be balanced with diet and insulin medication.
Figures uThe minimum daily recommended
dietary allowance for protein consumption is 0.36 grams per pound of body weight. That’s 46 grams per day for the average woman who exercises a bit, and 54 grams for a sedentary 150-pound woman. uThe U.S. Department of Agriculture
recommends consuming no more than 2,300 milligrams of sodium per day. uOne slice of American cheese
contains between 330 and 460 milligrams of sodium. uNearly 90 million American adults
SOURCES: HEALTHLINE; AMERICAN DIABETES ASSOCIATION; CENTERS FOR DISEASE CONTROL AND PREVENTION
are prediabetic. About 90 percent of them are unaware.
Can science potentially make drinking safer?
Alcohol has been an iconic part of human culture. This icon however comes with consequences for those who are diabetic. Effects, such as fluctuating blood sugar levels, could pose serious risk to your well-being and may deter you from enjoying this tradition. What if there was a way to lessen these effects without forfeiting the enjoyment? Vapshot was designed with this in mind, using only 1/60th of the alcohol and sugar of a 1oz shot. Vapshot could be the libation of choice for the health conscious! Want to know more? Check out the science behind Vapshot at: http://www.vapshot.com
The Diabetes Sentry is worn on the wrist, intended for use by diabetics that experience nocturnal hypoglycemia. The device alerts the individual via an audible alarm if one or both symptoms of hypoglycemia are present, an increase in perspiration or a decrease in skin temperature.
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Bachelor of Science in Allied Health Bachelor of Science in Clinical Laboratory Science Bachelor of Science Major in Radiation Therapy Master of Science in Clinical Affairs Master of Science in Clinical Regulatory Affairs Master of Science in Complementary & Integrative Healthcare Master of Science in Health Informatics We invite you to visit our website at www.nu.edu for the enrollment application process