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  • 1. 4 Doctor in the House: William Polonsky Yes, you can live a long and healthy life with diabetes! 6 CVS Minute Clinic Take advantage of a FREE offer for people with diabetes from CVS MinuteClinic 9 Inspirational Words to Live By: Never let diabetes slow you down Learn how one woman uses her creativity to inspire herself and others to maintain a positive attitude. 10 Educator’s Corner: Patti Geil Discover the proven power of insulin for your good health This publication is brought to you by Roche, the maker of ACCU-CHEK products. ACCU-CHEK, ACCU-CHEK 360° and ACCU-CHEK SPIRIT are trademarks of Roche. All other product names and trademarks are the property of their respective owners. © 2011 Roche. 346-50238-1011 Winter 2011/2012 C NTENTS accu-chekconnect.com • Subscribe today! Sign up for your complimentary 1-year online subscription at accu-chek.com/subscribe. Don’t let diabetes get in the way of living your life to its fullest Editor’s Letter Having diabetes doesn’t automatically mean you’re sentenced to live a miserable, terrible life because of complications. As our doctor in the house reminds us, “Well-managed diabetes is the leading cause of nothing.” With the right attitude, your own good efforts and good diabetes care, you have the power to live a long, healthy and happy life with few or no problems. In this edition of ACCU-CHEK® Connect Discoveries, you’ll learn new ways to get inspired, stay motivated and keep your spirits soaring throughout the winter months. Plus, you’ll discover how to make positive, lasting lifestyle changes that can help you gain better perspective and control of your blood sugar. Our diabetes educator will also explain why making the move to insulin may be the best choice for optimizing your health. And as you’ve come to expect and enjoy, you’ll find pages devoted to the topics you truly love—food and recipes, fitness and exercise, daily life and well-being—along with practical tips, fresh insights and different perspectives from others who share this journey with you. We hope you enjoy reading this issue and are able to find the strength, the will and the determination inside to take positive steps to ensure a bright and fulfilling future. Dannielle Patterson Editor in Chief 2 Breakfast 1 cup sliced strawberries 1 6-oz container no sugar added, fat-free yogurt 2 Golden Applesauce Muffins * 1 cup hot tea 1 serving Hearty Oatmeal for One* 1 cup fat-free milk 1 serving Hot and Spicy Omelet ‡ 2 slices whole-wheat toast 2 tsp light margarine 2 tsp 100% fruit spread 1 cup Berry and Banana Blend* 1 cup hot tea ¾ cup bra ½ cup fat 1 English 2 tsp ligh 2 tsp 100% 1 cup coff Lunch 1 serving Chicken Minestrone ‡ 6 saltine crackers 1 medium banana 1 cup fat-free milk ⅔ cup spaghetti noodles ½ cup Spunky Spaghetti Sauce * 1 serving Quick Garlic Buns * 2 cups chopped lettuce and tomato 1 Tbsp olive oil and vinegar 1 Chocolate Peanut Butter Drop * 12 oz iced tea (Fast Food) 1 small chili with 4 crackers 1 side salad with 1 packet light dressing 1 small diet soda 1 turkey s turkey br wheat bre ½ cup Sas 1 cup car 2 Tbsp fa dressing 1 medium 12 oz zero Dinner 1 Grilled Asian Pork Kabob * 1 cup Crunchy Oriental Coleslaw * 1 serving Rich Chocolate Fudge Cake * 12 oz iced tea 3 oz Turkey Breast with Raspberry Salsa ‡ 1 cup Carrots, Onions and Potatoes * ½ cup Southern Style Green Beans * 1 roll 1 tsp light margarine 1 Pumpkin Bar * 1 cup Sunday Afternoon Split Pea Soup * 1 serving Gran’s Country-Style Cornbread * 1 Personal Fruit Parfait * 1 cup fat-free milk 1 Individu Sliced tom (½ small cucumbe 1 Tbsp Ve 1 slice Fre 1 tsp ligh 1 Rainbow 12 oz iced Snack ¾ oz pretzels 8 oz sugar-free lemonade 1 medium apple 1 leftover Golden Applesauce Muffin * 1 cup fat-free milk ½ cup fat sugar-free chocolate Seven–Day Day 1 Day 2 Day 3 * Recipe available from Diabetes Meals on $7 a Day—or Less! American Diabetes Association, 2007 ‡ Recipe available from ACCU-CHEK Recipe Box www.accu-chek.com/us/inner-circle/inner-circle-home-page.html 17 grapes 6 almonds 1 low-sugar granola bar Snack 3 cups po The only diabetes TV show! Every Sunday on CNBC, 7:00pm ET, 4:00pm PT or anytime on dLife.com. Tune into dLifeTV every week. Each week dLifeTV brings news and information to people like you trying to manage diabetes every day, stay on track and remain positive. You’ll be inspired by stories of real people doing amazing things, educated by our diabetes experts and tantalized by the dishes of dLife Chef Michel Nischan. Make a date to watch every Sunday. November 20 Dr. Powell & Carroll Paxton: Moving to Insulin Carroll Paxton thought he was doing all the right things to control his diabetes, but he still struggled with an A1C of 10%. Tune in to see Carroll’s inspiring journey to lower his A1C level to 5.6%. December 4 The McGrath Family: Inevitability Tammy McGrath’s father suffered complications from uncontrolled diabetes. When her son, Aiden, was diagnosed with type 1, she feared he would share the same fate. See how Tammy’s family fights feelings of inevitability and works to instill a sense of self-care in Aiden. Every Sunday on CNBC, 7:00 pm ET 4:00 pm PT or anytime on dLife.com. 14 When the weather outside is frightful, exercising indoors can be delightful! Lift your spirits and lower your blood sugar by staying fit and active with fun and frugal indoor physical activities 16 Get Connected Online Find the support and encouragement you need during the holidays by reaching out to the diabetes online community 18Craving a better mood? Boost your mood and bring a little sunshine to your dinner plate with delicious, healthy, feel-good foods 20 Sometimes is the best medicine Get and stay on the path of happiness with these five starters 22 Healthy Holiday Eating— It’s All Part of the Plan Create a before- and after-holiday meal plan to help you stay on track and keep your blood sugar in control with a special 7-day planner Laughter Your feedback is important. Visit us at accu-chek.com/feedback or write to us at: Roche Attn: ACCU-CHEK Connect Discoveries Feedback 9115 Hague Rd., Building VV Indianapolis, IN 46250-0457 2 3 ,
  • 2. Doctor in the House | William Polonsky, PhD, CDE Yes, you can! Live a long and healthy life with diabetes? Be a medal winner! The Joslin Diabetes Center in Boston gives out medals annually to people who have been living well with diabetes for 50 years or longer. In the past 20 years, the number of medals awarded each year has more than tripled. You can be a medal winner, too! Well-controlled diabetes is the leading cause of . . . nothing! If you’re feeling frightened and hopeless about diabetes, remember this: while poorly controlled diabetes is the leading cause of many serious problems, well-controlled diabetes is the leading cause of… nothing! In the past, we didn’t have adequate tools for managing diabetes effectively, and many people had no idea how to take good care of their diabetes health. As a result, complications were more common. But with today’s medical advances and your good efforts, living a long and healthy life with few or no complications is certainly possible. Lowering your risk with good control You can dramatically lower your risk for complications by working with your doctor to keep your blood sugar, blood pressure and cholesterol levels in a safe range. In fact, you may find that a diabetes- friendly lifestyle that includes regular activity and healthy eating can even extend your life. As renowned physician Sir William Osler said, “To live a long and healthy life, develop a chronic disease and take good care of it.” For most people, being diagnosed with diabetes is a sobering moment. It’s a sign of our mortality and a reminder that we can’t live forever. This can lead to profound discouragement and depression. But for others, the moment of diagnosis serves as a wake-up call, a positive opportunity to transform their health and their life. Which type of person would you prefer to be? Think diabetes is a death sentence? Whether you have type 1 or type 2 diabetes, there’s one negative belief that’s more worrisome than any other: If you believe that diabetes is a death sentence, you’re likely to be in trouble. Like many people, you may be convinced that having diabetes means you’re doomed to suffer from terrible complications (heart disease, kidney problems, blindness or amputations). If you think complications are inevitable, no matter what you do, then you won’t be motivated to make positive lifestyle changes, take medications or check your blood sugar levels. You might feel this way because you remember a friend or family member who had serious problems. One of my patients, Roberta, said, “I watched diabetes take my mom piece by piece. That’s just what it does. I hope I die before that happens to me.” Hearing stories like these, who wouldn’t get discouraged about their own diabetes care? Or perhaps you already have diabetes complications. You may think there’s nothing you can do to stop them from getting worse. But nothing could be further from the truth! Did you know? A 1% drop in your A1C lowers your risk of having diabetes-related complications by 37%1 The ACCU-CHEK 360° View tool has been proven to lower A1C when used together with a doctor.2 Turn to page 7 to try it today. 1 Stratton, Adler A, Neil H, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405‒412. 2 Polonsky WH, et al. Structured self-monitoring of blood glucose significantly reduces A1C levels in poorly controlled, noninsulin-treated type 2 diabetes: results from the Structured Testing Program study. Diabetes Care. 2011;34(2):262–267. 54
  • 3. Date Time InsulinDose EnergyLevel* Activity** BloodSugar 2 hrs. after breakfast Before breakfast 2 hrs. after lunch 2 hrs. after dinner Before lunch Before dinner Before bed/ overnight H IH HG HGOOLOL WW BLOOD SUGAR RANGE WARNING:Donotadjustyourprescribedoralmedication orinsulintherapywithoutfirstconsultingyourdoctor. Whatis yourenergy level? *ENERGYLEVEL 1 VeryLow 3 Moderate 4 Somewhat High 5 VeryHigh 12345123451234512345123451234512345 2 hrs. after breakfast Before breakfast 2 hrs. after lunch 2 hrs. after dinner Before lunch Before dinner Before bed/ overnight 12345123451234512345123451234512345 2 hrs. after breakfast Before breakfast 2 hrs. after lunch 2 hrs. after dinner Before lunch Before dinner Before bed/ overnight 12345123451234512345123451234512345 Date >300 mg/dL 261-300 mg/dL 221-260 mg/dL 181-220 mg/dL 141-180 mg/dL 111-140 mg/dL2 81-110 mg/dL2 51-80 mg/dL <50 mg/dL 2 Somewhat Low Date Carbmealsize SMLor#ofgramsSMLor g SMLor gSMLor g SMLor g SMLor g SMLor g SMLor gSMLor g SMLor g After- Meal Goal Fasting/ Before- Meal Goal Whatdidyoudiscoveraboutyourbloodsugarpatternsbyusingthistool? BringthisformandyourACCU-CHEK® metertothe nextappointmentwithyourhealthcareprovider. PATIENTNAME&AGE PATIENTPHONE ORALDIABETESMEDICATIONSDOSETIMES/DAYDOCTORNAME DOCTORPHONE INSULINNAME(BASAL/BOLUS)INSULIN/CORRECTIVE CARBRATIODOSEUNITS B L D **ACTIVITY walkeddog, 10minutes, 10AM Example: Date Time InsulinDose EnergyLevel* Activity** BloodSugar 2 hrs. after breakfast Before breakfast 2 hrs. after lunch 2 hrs. after dinner Before lunch Before dinner Before bed/ overnight H IH HG HGOOLOL WW BLOOD SUGAR RANGE WARNING:Donotadjustyourprescribedoralmedication orinsulintherapywithoutfirstconsultingyourdoctor. Whatisyour energylevel? *ENERGYLEVEL 1 VeryLow 3 Moderate 4 Somewhat High 5 VeryHigh 12345123451234512345123451234512345 2 hrs. after breakfast Before breakfast 2 hrs. after lunch 2 hrs. after dinner Before lunch Before dinner Before bed/ overnight 12345123451234512345123451234512345 2 hrs. after breakfast Before breakfast 2 hrs. after lunch 2 hrs. after dinner Before lunch Before dinner Before bed/ overnight 12345123451234512345123451234512345 Date >300 mg/dL 261-300 mg/dL 221-260 mg/dL 181-220 mg/dL 141-180 mg/dL 111-140 mg/dL1 81-110 mg/dL1 51-80 mg/dL <50 mg/dL 2 Somewhat Low Date Carbmealsize SMLor#ofgramsSMLor g SMLor gSMLor g SMLor g SMLor g SMLor g SMLor gSMLor g SMLor g After- Meal Goal Fasting/ Before- Meal Goal MinuteClinic diabetes monitoring services are conveniently available to help provide you the care you need in between visits to your doctor. The diabetes monitoring services are available 7 days a week, including weekday evening hours, and no appointment is necessary. MinuteClinic walk-in medical clinics are located in select CVS/pharmacy stores across 25 states and the District of Columbia. Get the answers you need Following your exam, the MinuteClinic nurse practitioner or physician assistant will sit down to discuss your results with you, answer any questions you may have and provide you with recommendations to help you stay in control of your diabetes. A comprehensive visit summary will also be provided to your doctor via e-mail or fax with your permission. And if you don’t have a doctor, the MinuteClinic practitioner will help you find one in your area who is accepting new patients. Struggling to lower your A1C? Offer valid while supplies last. Limit 1 per customer. Must be age 18 and over. Restrictions apply. Package not available in MA or MD. Future services may be covered by your health insurance co-pay. Consult your healthcare insurance provider before your next visit. 1 Polonsky WH, et al. Structured self-monitoring of blood glucose significantly reduces A1C levels in poorly controlled, noninsulin- treated type 2 diabetes: results from the Structured Testing Program study. Diabetes Care. 2011;34(2):262-267. The Diabetes Monitoring Made Easy™ service includes: • A1C and blood glucose test • Blood pressure check • Body mass index (BMI) • Cholesterol screening • Comprehensive foot exam • Microalbumin test (kidney function) • Review of lifestyle factors Having trouble making sense of your blood sugar numbers? Looking for a convenient way to monitor diabetes more effectively? Now you can turn to your neighborhood MinuteClinic, the medical clinic inside CVS/pharmacy, for help. 6 Take advantage of this FREE offer! MinuteClinic, along with Roche, the maker of ACCU-CHEK products, is offering this free service ($79 reg. price) beginning April 1, 2012, while supplies last. This service includes the ACCU-CHEK 360° View tool—proven to lower A1C when used with a doctor.1 To find a location near you, visit minuteclinic.com.
  • 4. •Providesyouwithaquicksnapshotofyourbloodsugarpatterns •Helpsyoutrackyourbloodsugarnumbers,mealsizesandenergyandactivitylevelsatspecifictimesoverjust3days •Useitwhenyouwanttoseehowfood,exercise,medications,evenstressorillnesscanaffectyourbloodsugarthroughout thedayortopinpointwhattoworkonfirst Takeyourcompletedtooltoyourhealthcareprovidertotalkaboutthepatternsyousee. Bydrawingalinethroughthe recordedresults,youcaneasily identifytrendsinbloodsugar. Out-of-rangebloodsugarvaluescanindicateaneed forbetterbloodsugarcontrolandmightsuggestthe needtoadjustand/orchangetherapy. ProventolowerA1Cwhenusedtogetherwithadoctor2 1 AmericanAssociationofClinicalEndocrinologistsTaskForceforDevelopingaDiabetesComprehensiveCarePlan.AmericanAssociationofClinicalEndocrinologists medicalguidelinesforclinicalpracticefordevelopingadiabetesmellituscomprehensivecareplan.EndocrPract.2011;17(suppl2):S1-S52. 2 PolonskyWH,etal.Structuredself-monitoringofbloodglucosesignificantlyreducesA1Clevelsinpoorlycontrolled,noninsulin-treatedtype2diabetes:resultsfromthe StructuredTestingProgramstudy.DiabetesCare.2011;34(2):262-267. ACCU-CHEKandACCU-CHEK360°aretrademarksofRoche.©2011Roche.348-49970-0611 Experiencewhat’spossible. Instructionstopatient: Completethisformover 3consecutivedays. Fillinthedatesforthedaysyouwill trackyourbloodsugarresults. Step1 Testyourbloodsugarusingyour ACCU-CHEKmeteratthetimesshown foreachday. Step2 Inthe“Time”row,enterthetime youchecked. Step3 Basedonyournormaleatinghabits, describeyourcarbmealsizeby circlingSmall,MediumorLargeor byenteringthe#ofgrams. Step4 Enteryourinsulindoseinthe“Insulin Dose”row.Thiscanbeyourcorrective doseorfooddoseorthecombination. Step5 Rateyourenergylevelonascaleof 1(verylow)to5(veryhigh)andcircle thatscorehere. Step6 Enterthetypeofactivityyouperformed alongwiththelengthandtimeofday (e.g.,vacuuming,20min.,10AM). Step7 Graphyourbloodsugarlevel (fromStep8)byplacinganXinthe correspondingrowofthechart.Thenconnect theXs.Youcanalsoaddanotenextto theXsthatareoutofrangetoremind yourselfwhatwashappeningatthetime. Step9 Inthe“BloodSugar”row,enteryour bloodsugarnumber. Step8 Toprintadditionalcopiesofthistool, visitaccu-chekconnect.com. 9 iagnosed with type 1 diabetes at age 22 in 1941, Heartha Whitlow has never let the challenges of living with diabetes slow her down or put a damper on her positive spirit. As a former chemist, an artist, a photographer and a poet who cherishes each day—even with diabetes—Heartha has witnessed dramatic changes in the world since growing up in Texas during the 1920s. Deemed a trailblazer in many avenues of her life, Heartha has been on an insulin pump since 1996 and is proud to be a shining example that diabetes doesn’t have to slow you down, get you down or shorten your life. “All you need is determination and a positive attitude,” she says with a smile. Today, she can’t imagine life without her blood sugar meter and her pump. “No doubt I would not still be around if it were not for this pump,” she says. “With the pump, I can make very small corrections as I need them—and give small or large boluses for the food I eat.” Her advice to others with diabetes? “Take more readings than they tell you to, and you’ll be able to better evaluate your dosages and your basal settings. This also lessens stress!” With diabetes taking up a smaller part of her life, she spends considerable time at the Box Factory for the Arts, a local building in St. Joseph, Michigan, that houses the Heartha Whitlow Gallery, named in her honor as one of the founding members. As an on-the-go lady who’s always been interested in sharing expressions of beauty, Heartha isn’t about to let diabetes diminish the beauty she sees in life or put the brakes on her active lifestyle…even 70 years after her diagnosis. Inspirational Words to Live By Heartha Whitlow uses her creative pallette to inspire herself and others to maintain a positive attitude. Her portrait was painted by Robert R. Williams, an artist at the Box Factory for the Arts. 9 All you need is determination and a positive attitude Never let diabetes slow you down D
  • 5. Educator’s Corner | Patti Geil, MS, RD, FADA, CDE You’ve just been told you need to start taking insulin. If you’re like many people with diabetes, you’re probably drowning in a sea of emotions. 10 11 of insulin for your good healththediscover most likely, one of them is fear—fear of needles, fear of side effects, fear that your diabetes is now more serious. Another one is guilt: Have I failed at managing my diabetes? Does the fact that I haven’t always followed my healthcare provider’s advice mean the disease has won? Set aside your fear and guilt If your doctor feels you need to begin insulin injections, take a moment to set aside your fear and guilt. Then prepare yourself to take advantage of a powerful, proven medication that reduces your risk for diabetes complications, enabling you to lead a longer, healthier life. It’s more common than you might think You probably know that healthy eating, physical activity and taking oral medications are the basics for treating type 2 diabetes. But did you know that most people with type 2 diabetes will likely benefit from going on insulin at some point in their life? This is due to the progressive loss of the body’s ability to make insulin or to use it effectively.
  • 6. Rapid-acting insulin (e.g., lispro or aspart) Short-acting insulin (e.g., regular insulin) Intermediate-acting insulin (e.g., NPH and lente) Should be injected about 10 minutes before mealtime. (Used in insulin pumps) Should be taken 30 to 60 minutes before a meal. Should be taken up to 1 hour prior to a meal. The proven power of insulin While other oral medications can be added, insulin therapy is the most powerful and proven choice for lowering blood sugar when control cannot be achieved with the basics. In fact, insulin lowers A1C on average by 1.5%‒3.5%, compared to oral medications, which lower it 1% on average.1 Once you understand the natural progression and treatment of type 2 diabetes, you’ll find that beginning insulin and increasing your dose over time is a lot like wearing glasses. When your vision isn’t as sharp as it used to be, you begin wearing glasses. If things become blurry, your prescription will change. No fear, no guilt, just a natural progression and course of correction in the pursuit of good health. Most people with type 2 diabetes will likely benefit from going on insulin at some point in their life. Understanding the side effects When beginning insulin therapy, it’s important to understand its side effects. Insulin and modest weight gain often go hand in hand. As you begin taking insulin, your body becomes more efficient. This allows more sugar to enter your cells, where it can accumulate as fat instead of being wasted in your urine. With lifestyle counseling, careful adjustment of your insulin dose and more exercise, you may be able to help offset any weight gain you experience. A second, more serious side effect is hypoglycemia (low blood sugar, below 70 mg/dL). Early symptoms include hunger, shakiness, nervousness and sweating. Without treatment, hypoglycemia can lead to severe low blood sugar symptoms, such as mood changes, drowsiness, seizures and coma. If you’re experiencing lows, be sure to tell your healthcare provider. He or she may adjust your insulin to help you maintain smooth blood sugar control. As always, your blood sugar results should guide treatment decisions. Be sure to work with your healthcare provider to help determine which insulin fits you best. Have it your way People with type 1 and some people with type 2 diabetes control their blood sugar by taking insulin injections one or more times a day. The most common delivery methods include using a vial and syringe or the more convenient choice of an insulin pen. But sometimes, a single injection or multiple daily injections may not provide the exact amount of insulin your body needs. That’s where insulin pump therapy can help. For people with type 1 diabetes, insulin pump therapy is proven to lower A1C and reduce the risk of having lows.2 Insulin pump therapy can also be used by those with type 2 or gestational diabetes. The most often cited benefits of being on insulin pump therapy include being able to: • Deliver a precise amount of insulin around the clock, just like your pancreas • Take extra insulin for meals or high blood sugars • Increase the flexibility of your diabetes management—fits your schedule What’s in it for you? Insulin is recognized as the most effective medicine for controlling blood sugar. Better sugar control has important immediate and long-term benefits, such as more energy, clearer thinking, improved emotional well-being and a reduced risk for diabetes complications. Now that you’re more familiar with the benefits of taking insulin, isn’t it time you take advantage of its therapeutic power and overcome your reluctance to give it a try? 1 Nathan D, et al. Medical management of hyperglycemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy: A consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2009;32:193-203. 2 Bode BW, et al. Diabetes management in the new millennium using insulin pump therapy. Diabetes Metab Res. 2002;18(suppl 1):S14-S20. 12 13 Different insulin for different needs There are many types of insulin to treat diabetes. They’re classified by how fast they start to work and how long their effects last. In general, your insulin injection should coordinate with when you want to eat. The time between your insulin shot and meals may vary depending on your insulin type. Long-acting insulin (e.g., Lantus® or detemir) Covers basic insulin needs for about one full day. For people with type 1 diabetes, insulin pump therapy is proven to lower A1C and reduce the risk of going low.2
  • 7. exercising indoors weather outside is frightful, When the can be delightful! our local weatherman may be calling for a foot of snow, bone-chilling arctic winds and slippery roads, but that’s no excuse to sprout eyes and turn into a couch potato. Instead of hibernating like a bear, waiting for spring to arrive, fall and winter are the perfect time to keep up the momentum you’ve built up over the warm-weather days. As studies have shown, exercising in the winter can play a big role in relieving the depression, stress and anxiety you may feel—which may also help lower your blood sugar levels. To help stave off potential diabetes complications, it’s important that you get your blood sugars under control. Exercising on a consistent basis throughout the winter may keep you in a safe, healthy range. To get your heart pounding, your blood pumping and your body moving, try adding one or two of these simple, easy-to-do indoor physical activities to your daily routine. Each offers a fun and frugal way to burn calories, increase your endurance and keep your stamina and mood levels at their peak. Before you know it, those winter blahs will be a thing of the past. Before that next laugh-out-loud sitcom or action-thriller movie starts, take advantage of the commercial breaks in between to: • Jog on the treadmill • Do a quick yoga, tai chi or Pilates session • Clean up the house • Go up and down the stairs • Do jumping jacks, crunches, lunges, push-ups, sit-ups, squats, bicep curls or leg lifts Turn on your favorite music from the past and present, crank up the volume and dance up a storm. Get your groove on and work up a sweat, by yourself or with some friends, at your indoor dance party. Jump roping is a safe exercise for people of all fitness levels. It’s a low-impact aerobic activity that can help improve overall muscle tone. For an indoor exercise that is both fun and beneficial, try jump roping to keep winter workout boredom away. Think the Hula-Hoop is just for kids? Think again. This core-strengthening workout can help you develop coordination and improve your spinal flexibility, while massaging your belly as it circles your body. Plus, it also benefits your midsection without the grunt work of crunches. It may take some practice, but why not give it a whirl? Today’s interactive video games make it easy to get in a high-intensity workout right in your family room or living room. Games like Dance Dance Revolution (DDR), Xtreme Fit®, Wii Fit Plus, EA Sports Action and others allow you to combine fun and fitness. It doesn’t take a lot of effort or financial commitment on your part to stay motivated, lift your spirits or have fun while staying fit and active during the cold winter months. Just get off the couch and get moving! Take a Tv timeout Bottom line 1514
  • 8. Here are some ways that you can get connected with others online: Find a community TuDiabetes.com diabetesdaily.com childrenwithdiabetes.com Get involved diabetessocmed.com diabetestalkfest.com diabeteshandsfoundation.org Find inspiration living-in-progress.com diabetesstories.com accu-chek.com/microsite/heroes/ index.html#/intro Search for support accu-chekdiabeteslink.com diaboogle.com thediabetesresource.com If you start feeling isolated this season, just remember that you’re not alone. Everyone experiences a touch of the holiday blues from time to time. So if it begins to happen, don’t hesitate to reach out to the diabetes online community to find the support you need. FPO Activities and Interests Basic Information Interests Friendship Family Eggnog About me Baker Dog Lover Type 1 diabetes Loves life accu-chek.com/microsite/heroes/ index.html#/intro 16 17 Fond memories and nostalgia fill the air, as do the tantalizing smells of the seemingly endless variety of sugary, high-calorie holiday sweets. Everywhere you turn, the temptation grows stronger—making the holidays a stressful and isolating time for people with diabetes. While most people can freely enjoy the festive foods that often accompany family gatherings, they don’t always understand diabetes and the challenges you face with eating these foods. Sometimes the opposite is true—they think they know the ins and outs of diabetes better than they actually do, offering misguided advice. Or they don their “diabetes police” badges and try to arrest you for what you are or aren’t eating. Although it may seem hard to find the support you need, today’s social media sites and, in particular, the diabetes online community (DOC) are there for you. These connections serve to offer inspiration, peer-to-peer advice and encouragement, reminding you that you’re not alone in dealing with the challenges you face. Diabetes communities, blogs and forum boards are great places to start connecting to and learning about the DOC. The atmosphere is inclusive, and the free advice comes from a place that is trustworthy and relatable. You can always find a kindred spirit who’s willing to lend an attentive ear. Facebook and Twitter are two well-known, high-traffic areas where you and others with diabetes can come together. These channels can be a fun way to connect, share your ideas, post photos and learn more about others who have diabetes. They can also provide platforms for ongoing discussions and ways for you to reach out and help others in times of need. The holidays can be a wonderful, almost magical time to spend with your family and friends. C nnectedOnlineto find the support you need during the holidays Get
  • 9. Salmon For an instant mood lift, give salmon a try. Odds are you’ll be happier for it, as studies have shown that those who don’t eat fish regularly are prone to feeling depressed. For an extra “helping of healthy happiness,” try coating the salmon with crushed hemp seeds, which contain all 9 essential amino acids and are a rich source of protein, vitamin E and phytonutrients. better mood? Craving a Add a little sunshine to your dinner plate with these healthy, feel-good foods It’s easy to feel like a holiday Grinch when dealing with life’s everyday stressors. But did you know that you may be able to boost your mood and your energy level simply by filling your plate with feel-good foods? It’s not only easy; you’ll feel better for it too. 19 Food for thought and your feelings Nutritional scientists discovered long ago that natural chemicals found in the foods we eat have the power to change our moods. How? Simply put, food influences the chemicals in our brains (serotonin, melatonin and dopamine) and changes the way they act. This creates an instant mood-lifting effect. Chasing the winter blues away with every bite Fall and winter typically mean darker, drearier and much colder days. For many people with diabetes, this can trigger seasonal depression, causing one’s mood to nosedive. That’s where eating good-mood foods like the following may help keep you on an even keel and bring a little extra flavor and sunshine to your dinner plate. Walnuts Long thought of as brain food because of their wrinkled, bilobed appearance, walnuts contain a significant amount of omega-3s, which are an important part of cell membranes and are vital for brain cells to function well. They also rank higher than other nuts in terms of antioxidants, which help protect cells from damage. 18 Mushrooms exposed to UV light Studies have found that people with vitamin D deficiency have a greater risk of depression than those with normal levels. One food packed with vitamin D is mushrooms that have been exposed to UV light. This process naturally boosts their vitamin D level. One cup of these mushrooms contains 100% of the recommended daily allowance of this important vitamin. Oatmeal Quick, convenient and delicious, oatmeal is proven to lower cholesterol, reduce high blood pressure and lessen the risk of heart disease and some cancers. Its soluble fiber also helps slow down sugar absorption in your blood, which may help reduce mood swings. To add some excitement to oatmeal, try mixing in chopped nuts or fresh, frozen or dry fruits. Medjool dates You’re probably familiar with the instant pick-me-up of sugar. You also know how quickly you can come crashing down from its momentary high—leaving you feeling grumpy. A healthier way to satisfy your sweet cravings is medjool dates. Rich and creamy in texture, they’re also super sweet to the taste. Yet unlike a candy bar, dates are loaded with fiber, vitamins, minerals and antioxidants. Tea Tea, especially green tea, may also play a role in mood. One study found that drinking 4 or more cups of green tea a day lowered the risk of developing signs of depression among elderly Japanese. After water, tea is one of the most hydrating fluids. Simply staying well-hydrated may improve mood and attention.
  • 10. A happier, Happiness can be defined in many different ways. For some, it’s waking up feeling hopeful about the new day and going to bed feeling satisfied with what has transpired. For others, it’s taking time out to find pleasure in life’s little moments. But in reality, happiness isn’t anything more than an attitude. While having a happy attitude has many emotional and spiritual benefits, it also has many important life-enhancing, physiological benefits. Being happy can help reduce the harmful stress hormones that raise your blood sugar levels. In fact, it can also boost your immune system, defending you from a host of ailments and illnesses. And according to the studies done by the Diabetes Research Institute, people who are happy and laugh more are less likely to develop heart problems than those who rarely crack a smile. That’s pretty significant when you consider that heart disease is the number one cause of death for people with diabetes. Did you know? Laughter Sometimes is the best medicine 5. Take time to enjoy life’s healthier you 2120 How you look at the world is a direct reflection on how you feel and act. Instead of focusing on the negative aspects of managing your diabetes, turn your sights on all the positive things you’re doing, and you’ll be surprised at how good you feel. Nothing saps the joy and promise of a new day more than the thought of having to do something you’re simply not passionate about. Directing your talents, desires and passion to things you absolutely love doing may lead you to a future as big, bright and wonderful as you dreamed it. 2. what you do It’s often said that you can’t put a price tag on the value of good health. But investing wisely in a healthy future by taking good care of your diabetes—monitoring your blood sugar regularly, taking your medications as directed, problem-solving around how the things you do are connected to blood sugar and following your doctor’s recommendations—can increase your shares of happiness tenfold. 3. Strive for positive attitude better health Love Five ways to stay on the Path of Happiness 1. Develop and maintain a Joining a support group offers a great way to get the emotional support, inspiration and personal insights of others who are managing their diabetes successfully. It’s also an opportunity to meet others who share your same interests, hobbies and desire to live a rich, joy-filled life. power of pals Special moments 4. Discover the Whether it’s waking up to the first snowfall of the season, sitting down to a festive family dinner, curling up with a warm blanket and a good book or laughing out loud to a bloopers reel, taking time out to find pleasure in the small things of life can bring joy, happiness and laughter to your world.
  • 11. 4 Doctor in the House: William Polonsky Yes, you can live a long and healthy life with diabetes! 6 CVS Minute Clinic Take advantage of a FREE offer for people with diabetes from CVS MinuteClinic 9 Inspirational Words to Live By: Never let diabetes slow you down Learn how one woman uses her creativity to inspire herself and others to maintain a positive attitude. 10 Educator’s Corner: Patti Geil Discover the proven power of insulin for your good health This publication is brought to you by Roche, the maker of ACCU-CHEK products. ACCU-CHEK, ACCU-CHEK 360° and ACCU-CHEK SPIRIT are trademarks of Roche. All other product names and trademarks are the property of their respective owners. © 2011 Roche. 346-50238-1011 Winter 2011/2012 C NTENTS accu-chekconnect.com • Subscribe today! Sign up for your complimentary 1-year online subscription at accu-chek.com/subscribe. Don’t let diabetes get in the way of living your life to its fullest Editor’s Letter Having diabetes doesn’t automatically mean you’re sentenced to live a miserable, terrible life because of complications. As our doctor in the house reminds us, “Well-managed diabetes is the leading cause of nothing.” With the right attitude, your own good efforts and good diabetes care, you have the power to live a long, healthy and happy life with few or no problems. In this edition of ACCU-CHEK® Connect Discoveries, you’ll learn new ways to get inspired, stay motivated and keep your spirits soaring throughout the winter months. Plus, you’ll discover how to make positive, lasting lifestyle changes that can help you gain better perspective and control of your blood sugar. Our diabetes educator will also explain why making the move to insulin may be the best choice for optimizing your health. And as you’ve come to expect and enjoy, you’ll find pages devoted to the topics you truly love—food and recipes, fitness and exercise, daily life and well-being—along with practical tips, fresh insights and different perspectives from others who share this journey with you. We hope you enjoy reading this issue and are able to find the strength, the will and the determination inside to take positive steps to ensure a bright and fulfilling future. Dannielle Patterson Editor in Chief 2 Breakfast 1 cup sliced strawberries 1 6-oz container no sugar added, fat-free yogurt 2 Golden Applesauce Muffins * 1 cup hot tea 1 serving Hearty Oatmeal for One* 1 cup fat-free milk 1 serving Hot and Spicy Omelet ‡ 2 slices whole-wheat toast 2 tsp light margarine 2 tsp 100% fruit spread 1 cup Berry and Banana Blend* 1 cup hot tea ¾ cup bra ½ cup fat 1 English 2 tsp ligh 2 tsp 100% 1 cup coff Lunch 1 serving Chicken Minestrone ‡ 6 saltine crackers 1 medium banana 1 cup fat-free milk ⅔ cup spaghetti noodles ½ cup Spunky Spaghetti Sauce * 1 serving Quick Garlic Buns * 2 cups chopped lettuce and tomato 1 Tbsp olive oil and vinegar 1 Chocolate Peanut Butter Drop * 12 oz iced tea (Fast Food) 1 small chili with 4 crackers 1 side salad with 1 packet light dressing 1 small diet soda 1 turkey s turkey br wheat bre ½ cup Sa 1 cup car 2 Tbsp fa dressing 1 medium 12 oz zero Dinner 1 Grilled Asian Pork Kabob * 1 cup Crunchy Oriental Coleslaw * 1 serving Rich Chocolate Fudge Cake * 12 oz iced tea 3 oz Turkey Breast with Raspberry Salsa ‡ 1 cup Carrots, Onions and Potatoes * ½ cup Southern Style Green Beans * 1 roll 1 tsp light margarine 1 Pumpkin Bar * 1 cup Sunday Afternoon Split Pea Soup * 1 serving Gran’s Country-Style Cornbread * 1 Personal Fruit Parfait * 1 cup fat-free milk 1 Individ Sliced tom (½ small cucumbe 1 Tbsp Ve 1 slice Fre 1 tsp ligh 1 Rainbo 12 oz iced Snack ¾ oz pretzels 8 oz sugar-free lemonade 1 medium apple 1 leftover Golden Applesauce Muffin * 1 cup fat-free milk ½ cup fat sugar-fre chocolate Seven–Day Day 1 Day 2 Day 3 * Recipe available from Diabetes Meals on $7 a Day—or Less! American Diabetes Association, 2007 ‡ Recipe available from ACCU-CHEK Recipe Box www.accu-chek.com/us/inner-circle/inner-circle-home-page.html 17 grapes 6 almonds 1 low-sugar granola bar Snack 3 cups po Seasoned Pan-Fried Catfish Instructions 1. In a shallow dish, combine potato flakes, seasoned salt, and pepper. Dip catfish fillets in beaten egg, then coat well with seasoned potato mixture. 2. Place in a large nonstick skillet coated generously with cooking spray, and cook over medium heat until fillets are golden, about 8–10 minutes. 3. Spray remaining uncooked side of fillets with cooking spray, turn over, and continue cooking until golden and fish flakes easily with a fork (about 8–10 more minutes). Turn only once during cooking. Grilled Asian Pork Kabobs Instructions 1. Preheat grill to medium heat. 2. In a small bowl, whisk together sauce ingredients. Set aside. 3. Push onto each skewer in the following order: 1 pork cube, 4 slices pineapple, 1/4 onion, 1 pork cube, 1 tomato, and 1 mushroom. 4. Brush kabobs with half of sauce. 5. Grill covered over medium heat for 15–20 minutes, or until pork is cooked through and no longer pink (turn kabobs to allow for even cooking); baste with remaining sauce halfway through. Nutritional Information Per Serving Calories 155 Protein 16 g Carbs 5 g Fat 7 g Cholesterol 100 mg Sodium 250 mg Fiber 0 g Nutritional Information Per Serving Calories 147 Protein 13 g Carbs 21 g Fat 2 g Cholesterol 30 mg Sodium 491 mg Fiber 1 g Cinnamon French Toast Instructions 1. In a shallow dish, whisk together egg and egg whites, milk, vanilla and cinnamon. Dip each slice of bread quickly in egg mixture to coat one side, flip over with fork and quickly coat other side. 2. Place in large nonstick skillet coated generously with cooking spray and warmed over medium heat. Cook until golden, turn over, and continue cooking until other side is golden. If cooking French toast in 2 batches, recoat skillet with cooking spray between batches. Nutritional Information Per Serving Calories 194.2 Total Carbs 29 g Dietary Fiber 3.9 g Sugars 6.4 g Total Fat 5.6 g Saturated Fat 3 g Unsaturated Fat 2.6 g Potassium 331 mg Protein 8.7 g Sodium 67.9 mg It’s all part of the planEating around the holidays can be a stressful and nerve-wracking time, with all the office parties, festive buffets and family gatherings you’re invited to. Even with the best of intentions, it’s easy to give in to your cravings for holiday treats and sweets, piling your plate high with extra helpings of calories and carbs. As always, be sure to talk with your healthcare provider before making any adjustments to your medications, physical activity and meal plans. But before you begin restricting yourself from a little holiday indulgence, plan ahead and create a before- and after-holiday meal plan. It can help you stay on track, keep your blood sugar levels near target and regulate your mood too. To help you get started, here’s a 7-day meal planner that you can put into action. Healthy Holiday Eating
  • 12. Breakfast 1 cup sliced strawberries 1 6-oz container no sugar added, fat-free yogurt 2 Golden Applesauce Muffins * 1 cup hot tea 1 serving Hearty Oatmeal for One* 1 cup fat-free milk 1 serving Hot and Spicy Omelet ‡ 2 slices whole-wheat toast 2 tsp light margarine 2 tsp 100% fruit spread 1 cup Berry and Banana Blend* 1 cup hot tea ¾ cup bran flake cereal ½ cup fat-free milk 1 English muffin 2 tsp light margarine 2 tsp 100% fruit spread 1 cup coffee 1 slice Cinnamon French Toast * 1 tsp light margarine 1 Tbsp maple syrup 2 slices turkey bacon ½ cup unsweetened apple juice ½ cup unsweetened pineapple juice 1 serving Cinnamon Coffee Cake * 1 cup fat-free milk 1 cup tomato juice 1 serving Scrambled Eggs in Crisp Potato Skins ‡ 2 slices turkey bacon 1 cup coffee Lunch 1 serving Chicken Minestrone ‡ 6 saltine crackers 1 medium banana 1 cup fat-free milk ⅔ cup spaghetti noodles ½ cup Spunky Spaghetti Sauce * 1 serving Quick Garlic Buns * 2 cups chopped lettuce and tomato 1 Tbsp olive oil and vinegar 1 Chocolate Peanut Butter Drop * 12 oz iced tea (Fast Food) 1 small chili with 4 crackers 1 side salad with 1 packet light dressing 1 small diet soda 1 turkey sandwich (2 oz leftover turkey breast on 2 slices whole- wheat bread with 1 tsp mustard) ½ cup Sassy Sweet Potato Chips * 1 cup carrot and celery sticks 2 Tbsp fat-free ranch-style dressing 1 medium apple 12 oz zero-calorie flavored water 1 Gourmet Grilled Cheese Sandwich * 1 oz baked tortilla chips ½ cup mandarin oranges canned in own juice 12 oz diet soda 1 serving Chicken Shrimp Creole ‡ 1 medium pear 1 cup Apple-Raspberry Tea Sparkler * 1 cup leftover Sunday Afternoon Split Pea Soup * 6 saltine crackers 1 slice fat-free American cheese 1 serving Simple Strawberry Shortcake * 1 cup fat-free milk Dinner 1 Grilled Asian Pork Kabob * 1 cup Crunchy Oriental Coleslaw * 1 serving Rich Chocolate Fudge Cake * 12 oz iced tea 3 oz Turkey Breast with Raspberry Salsa ‡ 1 cup Carrots, Onions and Potatoes * ½ cup Southern Style Green Beans * 1 roll 1 tsp light margarine 1 Pumpkin Bar * 1 cup Sunday Afternoon Split Pea Soup * 1 serving Gran’s Country-Style Cornbread * 1 Personal Fruit Parfait * 1 cup fat-free milk 1 Individual Meat Loaf ‡ Sliced tomato and cucumber (½ small tomato, ¼ medium cucumber) 1 Tbsp Versatile Vinaigrette * 1 slice French bread 1 tsp light margarine 1 Rainbow Parfait * 12 oz iced tea 1 serving Marilyn’s Spicy “Fried” Chicken * 1 serving Green Bean Stir-Fry * 1 medium ear corn on the cob 1 tsp light margarine 1 serving Spiced Raisin Bread Pudding * 12 oz iced tea 3 oz Seasoned Pan-Fried Catfish * ½ cup Carrot and Orange Salad ‡ ½ cup Garden Vegetable Scramble * 1 roll 1 tsp light margarine 1 serving Simple Strawberry Shortcake * 1½ cups Tempting Turkey Pot Pie * 2 cups lettuce, tomato, cucumber and carrot salad 1 Tbsp Versatile Vinaigrette * 1 Banana Split Parfait * 12 oz iced tea Snack ¾ oz pretzels 8 oz sugar-free lemonade 1 medium apple 1 leftover Golden Applesauce Muffin * 1 cup fat-free milk ½ cup fat-free, sugar-free chocolate pudding 1 cup Do-It-Yourself Drinkable Yogurt* 3 cups air-popped popcorn 2 tsp light margarine, melted 1 cup Tropical Slushy * Seven–Day Meal Plan Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Available at amazon.com Meal plan selections provided by Patti Geil, MS, RD, FADA, CDE * Recipe available from Diabetes Meals on $7 a Day—or Less! American Diabetes Association, 2007 ‡ Recipe available from ACCU-CHEK Recipe Box www.accu-chek.com/us/inner-circle/inner-circle-home-page.html 17 grapes 6 almonds 1 low-sugar granola bar Snack 1 small fresh orange 1¼ cups watermelon 3 cups popcorn 1 oz trail mix Cinnamon French Toast ACCU-CHEK Connect Discoveries Ingredients 1 egg + 2 egg whites 1/2 cup fat-free (skim) milk 1/4 tsp vanilla extract 1/8 tsp cinnamon 8 slices bread Butter-flavored cooking spray Prep Time 45 minutes Cook Time 15 minutes Servings 8 Seasoned Pan-Fried Catfish ACCU-CHEK Connect Discoveries Ingredients 1/2 cup instant potato flakes 1/2 tsp seasoned salt 1/8 tsp ground black pepper 4 twelve-oz boneless, skinless catfish fillets 1 medium egg, beaten Butter-flavored cooking spray Prep Time 30 minutes Cook Time 20 minutes Servings 4 Grilled Asian Pork Kabobs ACCU-CHEK Connect Discoveries Ingredients Sauce 2 Tbsp reduced-sodium soy sauce 1/4 cup ketchup 2 Tbsp packed brown sugar 1/4 tsp garlic powder 2 Tbsp cold water 4 eight-inch bamboo skewers, soaked in water for 30 minutes Kabob 8 oz. raw lean pork, cut into eight 1 1/2-inch cubes 4 pineapple rings canned in juice, each cut into 4 equal-size pieces 1 small red onion (~3 oz), cut into 4 pieces 4 cherry tomatoes (or 1 small tomato cut into 4 pieces) 4 mushrooms Prep Time 30 minutes Cook Time 20 minutes Servings 4
  • 13. Seasoned Pan-Fried Catfish Instructions 1. In a shallow dish, combine potato flakes, seasoned salt, and pepper. Dip catfish fillets in beaten egg, then coat well with seasoned potato mixture. 2. Place in a large nonstick skillet coated generously with cooking spray, and cook over medium heat until fillets are golden, about 8–10 minutes. 3. Spray remaining uncooked side of fillets with cooking spray, turn over, and continue cooking until golden and fish flakes easily with a fork (about 8–10 more minutes). Turn only once during cooking. Grilled Asian Pork Kabobs Instructions 1. Preheat grill to medium heat. 2. In a small bowl, whisk together sauce ingredients. Set aside. 3. Push onto each skewer in the following order: 1 pork cube, 4 slices pineapple, 1/4 onion, 1 pork cube, 1 tomato, and 1 mushroom. 4. Brush kabobs with half of sauce. 5. Grill covered over medium heat for 15–20 minutes, or until pork is cooked through and no longer pink (turn kabobs to allow for even cooking); baste with remaining sauce halfway through. Nutritional Information Per Serving Calories 155 Protein 16 g Carbs 5 g Fat 7 g Cholesterol 100 mg Sodium 250 mg Fiber 0 g Nutritional Information Per Serving Calories 147 Protein 13 g Carbs 21 g Fat 2 g Cholesterol 30 mg Sodium 491 mg Fiber 1 g Cinnamon French Toast Instructions 1. In a shallow dish, whisk together egg and egg whites, milk, vanilla and cinnamon. Dip each slice of bread quickly in egg mixture to coat one side, flip over with fork and quickly coat other side. 2. Place in large nonstick skillet coated generously with cooking spray and warmed over medium heat. Cook until golden, turn over, and continue cooking until other side is golden. If cooking French toast in 2 batches, recoat skillet with cooking spray between batches. Nutritional Information Per Serving Calories 194.2 Total Carbs 29 g Dietary Fiber 3.9 g Sugars 6.4 g Total Fat 5.6 g Saturated Fat 3 g Unsaturated Fat 2.6 g Potassium 331 mg Protein 8.7 g Sodium 67.9 mg
  • 14. accu-chekconnect.com 1 Polonsky WH, et al. Structured self-monitoring of blood glucose significantly reduces A1C levels in poorly controlled, noninsulin-treated type 2 diabetes: results from the Structured Testing Program study. Diabetes Care. 2011;34(2):262-267. ACCU-CHEK and ACCU-CHEK 360° are trademarks of Roche. © 2011 Roche. This publication is brought to you by Roche, the maker of ACCU-CHEK® products. how to lower your 1 ACCU-CHEK® 360° View tool Proven to lower A1C when used together with a doctor1 Look for the ACCU-CHEK 360° View tool inside the ACCU-CHEK Aviva meter kit.