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Healthy Living & Eating with Diabetes

Insulin Therapy: How to Avoid Unhealthy Weight Gain

5/8/2023

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Author: Chantelle van der Merwe

Registered Dietitian (SA). PGDip Diabetes Management (UK). Combining creativity and expertise to manage diabetes through nutrition.

I have seen many patients on insulin therapy who struggle with weight gain. Insulin therapy can be a lifesaver for individuals with diabetes, but it can also lead to weight gain if not managed properly. If you are on insulin therapy and want to avoid weight gain, here are some practical tips you can follow:
  1. Track your calorie intake: Overeating can contribute to weight gain. Fear of hypoglycemia and regular hypoglycemic events are common culprits that lead to overeating. Remember, too much insulin can cause blood sugar levels to drop too low, leading to hunger and cravings for high-calorie foods. It is essential to track your calorie intake and ensure that you are consuming the right amount of calories to reach your goals with better diabetic control and fat loss. Your registered dietitian can help you calculate the amounts you require per day of not only calories but also protein, fat, and carbs.
  2. Track your total carbohydrate intake: Your overall carbohydrate intake is just as important as managing your overall energy intake. Your risk of hypoglycemia will increase when you inject too much insulin for the amount of carbohydrates that you consumed. Your registered dietitian can assist with calculating an appropriate insulin-to-carbohydrate ratio for you, in addition to developing a personalized nutrition plan that is suitable for your health needs and goals. Regular monitoring of your blood sugar levels and keeping a food diary with the amount of insulin injected with each meal will help your health care providers greatly in making necessary adjustments to your treatment
  3. Choose low-glycemic index foods: Foods with a low glycemic index (GI) should be an important part of your meal plan. Lower GI foods promote a slow, steady increase in blood glucose levels. This can contribute to more stable blood glucose control. Remember, the portion of your carbohydrate foods, even if low GI, needs to be controlled to match your recommended calorie intake for weight control, and your insulin dose needs to be matched with the amount of carbohydrates you consume for better glucose control as well.
  4. Exercise regularly: Some individuals on insulin therapy may have insulin resistance, which means that their cells do not respond to insulin effectively. This can result in higher insulin doses being required to regulate blood sugar levels, which can contribute to weight gain over time. Regular exercise can help reduce insulin resistance and promote weight loss. Consult your doctor before engaging in any exercise program.
  5. Prioritize good sleep: Poor sleep quality and duration are associated with increased levels of the stress hormone cortisol, which causes insulin resistance. Improving sleep quality and duration may have important implications for improving insulin sensitivity and glycemic control in individuals on insulin therapy.
  6. Stress management: Chronic stress has also been linked to the development of insulin resistance. Take steps to manage stress effectively to promote better glycemic control and weight management.

In conclusion, it is essential to manage your insulin therapy carefully and work with your healthcare team to adjust your treatment to meet your needs. Proper management of insulin therapy, combined with a healthy diet, regular physical activity, good sleep, and appropriate stress management, can help prevent excessive weight gain in people with diabetes on insulin therapy. Remember to regularly test your blood glucose levels, keep a food diary, and follow the recommendations of your healthcare team. With these tips, you can successfully manage your weight and improve your overall health while on insulin therapy.
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Why Weight Gain Can Occur on Insulin Therapy

5/8/2023

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Author: Chantelle van der Merwe

Registered Dietitian (SA). PGDip Diabetes Management (UK). 

If you've been experiencing unwanted weight gain and struggling to find the root cause, you may be surprised to learn that your insulin levels could partially be to blame. This is because when a person takes insulin, their body begins absorbing glucose again, and any excess glucose that is not immediately used for energy is converted into fat. 

There are several factors that can influence how much weight a person may gain while on insulin therapy. These include age, sex, height, the amount of insulin used with each meal, the level of insulin resistance, genetic makeup, family history, ethnicity, and diet and exercise habits.

Additionally, a person who takes insulin for diabetes may be gaining weight if they eat more due to concerns about developing hypoglycemia, or low blood sugar. Hypoglycemia can occur if a person takes too much insulin or skips a meal, and can cause symptoms such as dizziness, confusion, and shakiness. To prevent hypoglycemia, some people may eat more food or consume more carbohydrates than they normally would, which can lead to weight gain.
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It's important to note that weight gain is not a reason to stop taking insulin therapy. Insulin is a life-saving medication for people with diabetes, and stopping or adjusting insulin therapy without medical supervision can have serious consequences. Instead, it's important to work with a healthcare provider and a registered dietitian to develop a plan that manages blood sugar levels effectively while also addressing weight concerns. This may involve adjustments to insulin doses, changes in diet and exercise habits, and other strategies to support overall health and well-being.
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Insulin Therapy & Weight Gain

5/8/2023

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Author: Chantelle van der Merwe

Registered Dietitian (SA). PGDip Diabetes Management (UK).  Crafting diabetes nutrition plans that are both science-driven and practically designed.

Insulin is essential in managing elevated blood glucose levels, and it is a powerful treatment Type-1 diabetes and Type-2 diabetes to help control blood sugar. However, insulin therapy comes with side effects, and weight gain is one of the most commonly expressed concerns from individuals who use insulin. 

As a registered dietitian, I want to assure you that gaining weight while on insulin does not have to be inevitable. By taking a few steps, you can maintain a healthy weight while using insulin.

First, focus on consuming nutrient-dense foods with balanced macronutrients. Eating a variety of fruits, vegetables, whole grains, and lean protein sources can help keep you satisfied and nourished while managing blood sugar levels. Additionally, reducing portion sizes and avoiding calorie-dense foods can make a difference in managing weight.

Physical activity is also a crucial factor in managing weight while on insulin. Regular exercise helps improve insulin sensitivity and glucose uptake by muscles, which helps in blood sugar management. Aim to engage in moderate-intensity physical activity such as brisk walking, cycling, or swimming for at least 30 minutes a day.

Lastly, it's essential to work closely with your healthcare team to adjust your insulin doses and regimen as needed to manage your blood sugar levels effectively. Remember, weight management is not a one-size-fits-all approach, and working with a registered dietitian or diabetes educator can help tailor a plan to your unique needs.
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By making simple changes in your diet, engaging in physical activity, and working with your healthcare team, you can manage your weight while on insulin therapy. Don't let the fear of weight gain deter you from the life-saving benefits of insulin therapy.
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How to Lower your HbA1C Levels: Better Overall Blood Glucose Control

5/6/2023

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Author: Chantelle van der Merwe

Registered Dietitian (SA). PG Dip Diabetes Management (UK).  Simplifying diabetes nutrition, one plate at a time.

If you have diabetes, you've probably heard of hemoglobin A1C, glycosylated hemoglobin, HbA1c or just “A1C” before. A1C levels play a huge role in how diabetes is managed, and it's also used to diagnose diabetes and prediabetes. A1C is a blood test that provides information about your average blood sugar levels over the past three months. Your diabetes care team use this number to gauge how things are going and if and how to tweak your diabetes treatment plan. In most cases, an A1C of less than 7% is recommended. To lower A1C levels, you can take medication, but lifestyle measures are effective, too.

What you eat and how much of it you consume can have a significant impact on your blood sugar control, which, in turn, affects your A1C levels. But with so many conflicting opinions about the "best" diet for diabetes, it can be challenging to figure out what to eat. The truth is, there is no one-size-fits-all approach to nutrition when it comes to managing diabetes. Contrary to popular belief, the American Diabetes Association does not prescribe a specific eating plan for people with diabetes. Instead, they recognize that various eating patterns, including lower-carb, vegetarian, DASH, and Mediterranean diets, can all be beneficial.

To determine what approach will work best for you, it's essential to meet with a registered dietitian who has experience working with people who have diabetes. Your doctor can refer you to a qualified dietitian who can help you create a personalized nutrition plan that takes into account your unique health needs, lifestyle, and preferences.

In the meantime, there are several steps you can take to help lower your A1C levels. For example, consider reducing your intake of processed and high-sugar foods and increasing your consumption of whole, nutrient-dense foods like vegetables, fruits, whole grains, lean proteins, and healthy fats. Portion control is also critical, as consuming too much of any food can lead to elevated blood sugar levels.
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While there is no one "perfect" diet for managing diabetes, following a balanced, nutrient-dense eating plan and working with a registered dietitian can help you achieve optimal blood sugar control and lower your A1C levels.

Here are seven practical pointers:
  1. Come up with a plan: Getting into the habit of eating three meals a day, and possibly some snacks, is a great way to get started on controlling A1C levels. In addition, aiming to eat your meals at about the same times each day will make it easier to stabilize your blood sugars. Try not to skip meals or delay eating your meals as much as possible.
  2. Be carb choosey: Eating refined and processed carbs has been linked to an increased risk of diabetes, heart disease, inflammation and obesity. The carbs to focus on are unrefined, meaning, they retain their fiber, vitamins, minerals, and other plant-based compounds that are beneficial to your health.
  3. Focus on fiber: Eating plenty of fiber is key for helping manage blood sugars, as fiber helps slow down the absorption of glucose in your bloodstream. High-fiber foods include fruits, vegetables, whole grains, nuts, and seeds.
  4. Mind your portions: Portion control is important because eating too much of anything can cause your blood sugars to rise. Try measuring your food with measuring cups or a food scale to make sure you're eating appropriate portion sizes.
  5. Keep moving: Exercise is great for helping to manage blood sugars, as it helps your body use insulin more effectively. Walking, cycling, swimming, dancing, and strength training are all great options.
  6. Take your meds: If your healthcare provider has prescribed medication for you, it's important to take it as prescribed. Missing doses or taking too much can cause your blood sugars to rise.
  7. Test your blood sugars: Checking your blood sugars regularly can help you see how your A1C levels might be affected by certain foods or activities. Be sure to follow your healthcare provider's advice on when and how often to check.
Remember, it's important to work with your healthcare team, including your registered dietitian, to help you navigate the blurry lines and you with an individualized diabetes treatment plan that works for you and your lifestyle. 
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Don't Delay Optimized Diabetes Management: The Importance of Taking Action NOW!

4/30/2023

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Author: Chantelle van der Merwe

​Registered Dietician (SA) PG Dip Diabetes Management (UK) . All about simplifying and individualizing nutritional therapy for diabetes management

Diabetes is a chronic condition that affects millions of people worldwide. Sadly, the dangers of uncontrolled diabetes become notable when it is too late, and severe damage has been done to almost every body system. The good news is that managing diabetes is possible with the right information, tools, and support.

One of the most critical aspects of diabetes management is monitoring blood sugar levels. Regular monitoring allows you to see how well you are managing your blood sugar levels and make adjustments to your diet, exercise routine, and medication as needed.

Knowing your blood sugar targets is also crucial for effective diabetes management. As we discussed in a previous post, for individuals with type 2 diabetes, the general recommended fasting/pre-prandial blood glucose target is 4.0 to 7.0 mmol/L, and the post-meal/post-prandial blood glucose target is 5.0 to 10 mmol/L.

In addition to monitoring blood sugar levels and knowing your targets, it is also essential to understand what foods contain carbohydrates and how much you can eat. Carbohydrates have the most significant impact on blood sugar levels, so it is crucial to manage your carbohydrate intake to maintain healthy blood sugar levels. Knowing how much is an appropriate portion for carbohydrates is also vital. Your registered dietitian can provide guidance on these matters and help you develop a meal plan that is tailored to your individual needs and preferences.

It is essential to work with your healthcare team to manage your diabetes effectively. If your blood sugar levels are not optimal, do not wait for your next scheduled appointment. Contact your healthcare team as soon as possible to discuss adjustments to your treatment plan.

Uncontrolled hyperglycemia can cause damage to many of the body's organs, leading to disabling and life-threatening health complications such as cardiovascular diseases, nerve damage, kidney damage, and eye disease. However, appropriate management of diabetes can delay or prevent these serious complications altogether.
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Managing diabetes can be challenging, but it is essential to take responsibility for your health and work with your healthcare team to achieve optimal blood sugar control. Regular monitoring, understanding your targets and carbohydrate intake, and working with your healthcare team can help you manage your diabetes effectively and reduce the risk of developing diabetes-related complications.
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Don't fall victim: Why It's Crucial to Seek Diabetes Nutrition Advice from a Registered Dietitian

4/25/2023

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Author: Chantelle van der Merwe

Registered Dietician (SA) PG Dip Diabetes Management (UK) . Saving those with diabetes one post at a time, from fake diabetes treatment quacks! ​

There is nothing that infuriates me more than “hogwash, quackery” info out there given by non-registered individuals, taking advantage of vulnerable desperate persons who are trying to manage their diabetes better and who grasp at every last empty promise. 

As someone living with diabetes, you are likely bombarded with various pieces of advice and recommendations for managing your condition. With the abundance of information available online and in social media, it can be challenging to determine what is legitimate and what is not.
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One thing that can make the situation worse is non-registered individuals peddling their own treatments and concoctions to vulnerable people. This type of misinformation and quackery can not only be frustrating, but it can also be dangerous, especially when it comes to managing a chronic condition like diabetes.

That's why it's important to seek advice and guidance from registered healthcare professionals, such as registered dietitians. In South Africa, for example, dietitians must be registered with the Health Professions Council of South Africa (HPCSA) to practice legally.

Being registered with a professional council means that dietitians clinical practices are regulated (like your GP) and they are required to attend continuous professional development courses every year. This ensures that they are up-to-date with the latest evidence-based practices and guidelines. As a result, they are better equipped to provide accurate and safe medical nutrition advice.

What does this mean for you as a person living with diabetes? It means that you can trust the advice and recommendations provided by registered dietitians. It also means that you have recourse in case you encounter an unethical or unprofessional dietitian.

If you have any concerns about the practice of a registered dietitian, you can report them to the HPCSA. The council will investigate the matter and take disciplinary action if necessary. This level of accountability and regulation is not available with non-registered individuals, meaning you’ll have a much harder time holding them liable and reporting them to a council. 

So, when it comes to managing your diabetes, it's crucial to seek advice from trusted healthcare professionals. Registered dietitians are one such group of professionals who can provide you with accurate and reliable medical nutrition advice. Remember to always verify the qualifications of the person providing you with advice and seek professional help when needed.

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    Chantelle vd Merwe RD (SA)
    Post Grad. Diabetes Management (UK)

    Dietitian dedicated to making diabetes management simple,
    ​realistic, and sustainable.

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"So happy and thankful to Chantelle to have had her be part of my journey, without her I would not have been as successful as I was." - Gayle , diagnosed with Gestational Diabetes 

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Chantelle is amazing at understanding exactly where you are, and adjusting treatment accordingly. Her compassion and patience is amazing, and I genuinely feel that she partners with me in my nutrition and health" - Danielle , wanted help with weight loss 

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The sympathy, empathy she works with is phenomenal. It just motivates you to talk to someone that understand your challenge. I am on my path to lose 30kg, it is surely not happening overnight. However, my journey with Chantelle is making every centimeter I lose absolutely worth to take on the next one to shake off." - Sonja, wanted help with weight loss post heart attack 

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