You Want To Know!
As a member of the LCDA, you should be proud knowing you are taking a proactive lead in healing the prediabetes or diabetes of yourself or a loved one or a patient. And, you have come to the right organization. By learning about The Eight Essentials, and how to bring positive changes to your diet, lifestyle, supplementation, you will learn information that may help you reverse prediabetes and can help you to reverse or control diabetes.
New Expert Interviews!
The low carb diet is the foundation diet for people who have prediabetes or diabetes. The LCDA promotes a nutritional, fun, tasty way to implement the diet.
The LCDA knows that change can be difficult! That is why we are here to help make sense of diabetes and help educate you about how simple life changes can have profound effects on your health and on reversing and controlling your diabetes. We know that you may start only dipping your toes into the water of healing. We are here to lend hope, support and offer answers and confidence in your success.
Quote of the Day:
“Health is the greatest gift, contentment the greatest wealth, faithfulness the best relationship.”
Board Member Updates
Dr. Jody Stanislaw and Dr. Mona Morstein were interviewed to be part of the exciting upcoming The Diabetes Summit®, highlighting how to use integrative medicine to help treat/reverse/control diabetes, established and moderated by Dr. Brian Mowll. Advertising for this informative Summit will begin March 19th, so mark your calendar to check your email for how to register!
Dr. Brian Mowll is a new LCDA board member. Dr. Mowll runs The Diabetes Summit and is an functional physician with a specialty in diabetes. You can check out more about Dr. Mowll here. We are happy to have him on the LCDA board!
Zippora Karz shares her diabetes wisdom this month in the newsletter.
Innovative Diabetes Labs
General Diabetes Information
Some Lab Tests To Consider Having Your Physician Order
If you have diabetes, you are well aware that your physician has your fasting glucose, hemoglobin A1C, and lipids drawn at least once a year and maybe every three months. Those are very standard tests and are helpful for analysis on how well you’re doing in terms of glucose control and cholesterol and triglyceride control.
However, there are some other tests to consider having drawn to help you know how your body is doing and to help maximize your ability to control your glucose levels:
Fasting C-peptide — Insulin is a curly molecule made up of several different peptides. To become insulin, first, the d-peptide breaks away. Then, the c-peptide–there is an equal amount of c-peptides for every insulin molecule the pancreas produces and secretes. We measure the c-peptide because it can tell us how much insulin you are making, and if you have insulin antibodies, or ever injected insulin into you, measuring insulin can be inaccurate. We never develop antibodies to the c-peptide molecule, however, so it is always a good lab test.
The fasting c-peptide can be high, indicating insulin resistance, or normal, or low, and if very low, it can mean insulin needs to be likely be given. This test is valuable for many diabetic patients:
- The honeymooning T1DM patient, ensuring that enough insulin is still being made
- Early T1DM on insulin, to see if insulin is still being secreted, so less has to be injected, or if it is too low, that all insulin must be injected.
- T2DM on insulin, to see if the pancreas is healthy enough to potentially allow the patient to stop injecting insulin.
- Long term uncontrolled T2DM patient, to see if enough damaged has happened to their pancreas, requiring the initiation of insulin.
C-peptide can also be measured after a meal, to check on if the pancreas can secrete enough insulin for food intake, but it’s most commonly done fasting.
- Normal range for c-peptide is 1.1-4.4 ng/mL
- Below 1.0 you may need to start basal insulin
- Below 0.5 you will very likely need to be on basal and bolus insulin
- Above 4.4 you are insulin resistant but still producing plenty of insulin
Glycomark test — The Glycomark test measures 1,5Androglucitol (15AG). In non-diabetic patients, serum levels and urinary excretion of 15AG remain constant, and the kidney’s reabsorb almost 100% of it, so in general a serum draw should find high levels of 15AG. However, hyperglycemia can cause the kidneys to mistakenly excrete the 15AG as it excretes the extra glucose. Thus, lower levels of 15AG on serum tests correlates with glucose elevation spikes in the last two weeks. It can be very helpful in helping to learn where glucose has been, especially after eating, if there have been any significant spikes.
A Glycomark test is a great addition to an A1C, as it does help learn if there have been glucose spikes causing a lower Glycomark reading, especially if you are not using a CGMS machine.
Glycomark test may not be accurate in a pregnant woman, end-stage renal disease, if the stomach was surgically removed, liver cirrhosis, if you are on steroids such as prednisone, if you are on IV food, or if there is continual glucose in your urine. Three Chinese botanicals: polygala, tenuifolia and senega syrup may cause elevated 15AG readings.
- Normal range for Glycomark is >10 ng/mL
- Slightly abnormal range: 6-10
- Very abnormal range: <6
Fibrinogen — The main reason now poorly controlled diabetic patients in the US die is from cardiovascular disease. Cardiovascular disease has many components to it, but continual elevated glucose levels can cause inflammation in the body and increase the risk for developing clotting–those can lead to and promote the development of atherosclerosis, and the risk of heart attack or stroke. Conventional care usually just studies cholesterol, a poor marker for risk of cardiovascular disease, unless a young patient with diabetes has already had a heart attack or stroke.
Fibrinogen is a serum marker for making clots. If it is elevated, you are at higher risk for producing the kind of blood clots that may lead to a crisis situation. There are natural ways to reduce fibrinogen, so it is a good marker to check at least once per year.
HS-CRP (high sensitivity c-reactive protein) — HS-CRP is a marker for inflammation in the body and can be associated with increased risk of cardiovascular disease, since inflammation is an etiological factor for damaged blood vessels and the development of atherosclerosis. The HS-CRP value picks up more inflammation, especially at lower levels, and can indicates chronic inflammation. Inflammation can drive insulin resistance, dementia/Alzheimer’s, fatty liver, and other situations associated with poorly controlled diabetes. This should be checked yearly in diabetic patients.
Integrative physicians are well aware of these tests and check them in patients. Check out the LCDA’s physician section here to see if an LCDA recommended integrative physician is near you.
Alpha Lipoic Acid
Essential #7: Diabetic Supplements
The LCDA believes that many supplements are valuable to diabetic patients for many different reasons. Some replace nutrients they may be deficient in. Some help regulate glucose or insulin, or help lower appetite. Some are antioxidants, or anti-inflammatories. Some help with energy, some with mood. Some help lower blood pressure, or help prevent complications, and protect organs from being damaged by high glucose numbers.
One of the most excellent supplements for diabetic patients to consider taking is Alpha Lipoic Acid (ALA), also known as Lipoic Acid. ALA an antioxidant that is made in each cell of the human body. While most antioxidants work either in a water or fatty tissues, ALA is soluble in both water and fat so has a more widespread act of protection in the body. ALA quences reactive oxygen species (damaging molecules), chelates metal ions, helps other antioxidants–such as Vitamin C, Vitamin E, and glutathione–get recharged and work again. ALA can signal NRf-2, which the body uses to signal the need for antioxidant formation. It can also inhibit the activation of pro-inflammatory chemicals. Since it works on so many body areas, it is highly recommended all diabetic patients take it who can swallow the capsules.
ALA comes in two isomers, R-ALA and S-ALA, but only the R-ALA form is active in cells. If you buy a supplement that says Alpha Lipoic Acid 300 mg per capsule, it will contain 150 mg of both R-ALA and S-ALA, so you will only get half the antioxidant effect, and the S-ALA can prevent the activity of the R-ALA. If you buy a product that says it is R-ALA 300 mg per capsule, then all the ALA will be actively protecting you. Thus, look for supplements that say they contain only R-ALA.
ALA can also be found in some diabetic friendly foods such as spinach, broccoli, tomatos, brussel sprouts, rice bran, as well as organ meats such as heart, liver and kidney. Ideally, ensure the meats are organic so the detoxifying liver and kidney organs do not contain drugs, hormones and environmental toxins in them.
ALA has been shown in good medical studies that it might help:
- Prevent and treat diabetic kidney disease
- Prevent and treat diabetic neuropathy
- Prevent and treat diabetic retinopathy
- Lower glucose numbers
- Reduce insulin resistance
- Reduce A1Cs
- Prevent vascular dysfunction
- Protect a fatty liver
- Protect a damaged pancreas.
- Initiate general antioxidation effect throughout the whole body.
R-ALA is generally well handled by patients–it can be dosed through IVs, but most patients take it orally. It may, though rarely, cause stomach upset. Capsules should never be opened, but swallowed whole. A good daily dose of R-ALA could be from 300-1200 mg, but 600 mg/day is a very acceptable middle dose.
Check with your integrative physician about R-ALA if you are not already taking it. Your integrative physician will know the best type and correct dose appropriate to you and your diabetes.
LCDA Board Member Zippora Karz’s Diabetes Wisdom
Introduction by Dr. Mona Morstein
The LCDA board is honored to have a non-physician T1DM advocate for patients with diabetes. We have learned so much about T1DM from Zippora, and how backward and awkward diabetes medical care was 30 years ago. We have the highest respect for Zippora for essentially learning to treat herself, figuring out how to eat, how to use insulin, how to match her activity with her diabetes. We can all learn a lesson of perseverance, hope and success from Zippora Karz. Please enjoy reading some of her life lessons. Also, please check the resources section right after this article to find the two books Zippora has written; one about her life journey dancing with diabetes, and one for children with T1DM.
I was a young member of the New York City ballet, already dancing starring roles like the Sugarplum Fairy in the Nutcracker. Then in 1987 at the age of 21, my 3rd year in the company, I was diagnosed with diabetes. My world came crashing down. It took me years too find the right diagnosis (I was first diagnosed as type 2, then later type 1), the right protocol, the best way to eat and to take care of my body. I would go on to be promoted to soloist years after my diagnosis. I had many ups and downs and learned many things through the years that helped me keep dancing and living my dream. And above all, find a level of health with diabetes.
A few things have helped me through the years.
- I had to learn to deal with the perfectionist part of my personality, the part that was trying to be perfect. I was putting an enormous amount of pressure on myself, not only to be the dancer I once was, but trying to hide the moment to moment ups and downs with my blood sugar levels. I was so fearful that I would be judged, roles would be taken away, I lived in constant anxiety. I had to learn to value my health above all else. That I was doing the best I could, and while I might not achieve my original potential as a dancer, I was achieving my new potential as a dancer with diabetes. My best had to be good enough. Once I was able to learn to hold myself like I would hold a crying child, to be there for myself rather than blame and hate myself for what was happening, my anxiety calmed. My sleep improved as well as my ability to make better food choices. And, my ability to stop eating when I felt nourished. And even if I didn’t stop when I thought I should, I learned not to obsess on my failing. Basically I learned self love and compassion.
- At every stage of my 30 plus years with diabetes I have found myself needing to eliminate some food I previously loved. Whether it was the macrobiotic counselor telling me I had to stop eating dairy, my own discovery early on that carbs raised my sugars (no bread), and even my recent food sensitivity test saying some of my favorite healthy foods were causing an inflammatory response. Eliminating a food I love and crave has never been easy. I resist, I deny, I complain. I go through emotions of feeling like I can’t do it. But, I always did and do, and I always come out the other side no longer craving or needing that particular food.
My advice today is rather than focus on what is being eliminated, start by focusing on adding foods. Try to identify what it is you crave. For some it is salty, others sweet, and others fatty. For some it’s a combination. Then try to choose the healthiest version of what you are craving that won’t spike your blood sugar levels. Stable blood sugars mean less out of control hunger and cravings, and healthier foods nourish the body and help satiate your cells and cravings. Identify what the craving is and choose the healthiest alternative of that craving!!
Trust me, I know it’s not as easy as being told what to eat, and then following those directions.
When your blood sugars are off, so is your psychology and your cravings.
As an example, if you crave fatty and sweet, try something with coconut butter. I like the crunch with my fatty and sweet, so coconut butter with nuts is my go to craving. Add agave, or stevia to food if you crave sweet. Add celtic or himalayan sea salt if you crave salty. I find adding sauces, like, pesto sauce to whatever I am eating adds the element of creamy that I crave. Adding nuts and seed adds the cruncy and chewy.
In fact I add coconut to many of my meals. Avocados, nuts and seeds, and organic protein. That way I’m focusing on nourishing with foods I enjoy. Then when I want more food, it’s more of the same foods, not foods I should not be having. When your body is nourished you will find yourself craving less of the fast acting sugars. And if you find yourself not being able to resist, my advice is to add some slow acting fat and protein to what you are eating. That will keep your sugars more stable and help you make better choices and feel better overall.
Dance taught me how to give my heart and soul to everything I did. It taught me to take chances even when that meant falling down. It taught me, when I did fall, to get up, move on, and even shine. It taught me to value every moment; it taught me that journeys are as important as results; it taught me how to keep my balance. Dance taught me about being in the company of people: how to fit in and how to stand out, how to be dramatic and grandiose one moment, subtle and understated the next. It taught me to let go, to let the moment take over and allow the magic to happen. Most importantly, dance taught me how to transcence my limitations and transform myself.
Books by ZIppora Karz–highly recommended!
- The Sugarless Plum–For dancer Zippora Karz, a rising young star with the famed New York City Ballet, being diagnosed with diabetes could easily have ended all her dreams. See how Zippora rose about her diabgnosis to become a highly praised soloist dancer: Can buy here.
- Ballerina Dreams–This is the story of ZIppy, a young girl who falls in love with ballet. With hard work she dances all the way to her pointes and the leading role in the performance. But then ZIppy learns she has T1DM. What about her ability to dance now?: Can buy here.
LOW CARB RECIPES
Recipe #1 | Low Carb Salmon Patties
A quick and easy meal ready in under 20 minutes. Low-carb salmon patties served with a lime avocado dressing.
Total Time: 20 minutes
Prep Time: 5 minutes
Cook Time: 15 minutes
Salmon Patty Ingredients:
* 1 lb tinned/canned salmon drained
* 2 eggs – medium
* 1/2 cup almond flour (see notes)
* 2 tbsp parsley chopped
* 1 tbsp dill chopped
* 1 tbsp lemon juice
* 1 small onion diced
* 1 clove garlic crushed
* 1 tsp paprika
* 1/2 tsp cumin
* 1/2 tsp turmeric
* salt/pepper to taste
* 2 tbsp ghee, lard or duck fat, avocado, peanut or sesame oil for frying
Avocado and Lime Dip Ingredients:
* 1 small avocado
* 1/4 cup mayonnaise
* 1 tbsp lime juice
* 1 clove garlic crushed
* 1 tbsp parsley or cilantro
* salt/pepper to taste
Low-Carb Salmon Patties:
1. Place all the salmon patty ingredients (except the ghee, lard or duck fat) in a large mixing bowl and combine.
2. Scoop some of the salmon mixture into a 1/4 cup measuring cup. With the back of a spoon, press the mixture into the cup to pack it tightly. Turn the measuring cup over onto a plate. Repeat to make 12 patties.
3. Heat the oil in the frying pan and cook the salmon patties on a gentle heat. Cook on each side for 4-5 minutes and use a spatula to flip them. TOP TIP – If a patty does not release when you try to flip it, cook a little longer until it is crispy and ready to flip.
Avocado and Lime Dip:
1. While the patties are cooking, prepare the avocado dip. Place all the ingredients in a blender. Process until smooth. Spoon into a serving dish.
1. Place 3 low-carb salmon patties on a bed of salad with the avocado and lime dip on the side, or drizzled over the top.
2. Cooked salmon patties can be stored in an airtight container in the fridge for up to 3 days.
Almond flour can be replaced with 2 tbsp coconut flour.
Makes 12 salmon patties. Four serving sizes of 3 salmon patties plus 2 tbsp dip.
Amount Per Serving: (3 patties + dip)
* Calories 532
* Calories from Fat 352
* Protein 39.9 gm
* Total Carbohydrates 8gm
* Dietary Fiber 3.7gm
* Net Carbs: 4.3 gm
Recipe #2 | Fat Head Dough Calzones
Incredible keto Fat Head dough calzones that are healthy and gluten free. Perfect for low-carb healthy lunch boxes .
Total Time: 25 minutes
Prep Time: 15 minutes
Cook Time: 10 minutes
Fat Head Dough:
* 1 and 3/4 cups grated cheese (mozzarella is the best or Edam/mild cheese)
* 3/4 cups almond meal/flour
* 2 tbsp cream cheese
* 1 egg – medium
* 1 pinch salt to taste
* 1/2 tsp dried rosemary/ garlic or other flavourings optional
* 1 cup bolognese meat (see recipe below)
* 1/2 cup grated cheese (mozzarella is the best)
Fat head Dough:
1. Mix the shredded/grated cheese and almond flour/meal in a microwaveable bowl. Add the cream cheese. Microwave on HIGH for 1 minute.
2. Stir then microwave on HIGH for another 30 seconds.
3. Add the egg, salt, rosemary and any other flavourings, mix gently.
4. Place the dough in between 2 pieces of baking parchment/paper and roll out as shown in the pictures above.
1. Remove the top piece of paper. Cut the Fat Head dough into circle shapes using a glass tumbler or mug.
2. Place the circle of dough into the calzone press. Place 1 or 2 teaspoons of spaghetti bolognese into the centre, add some grated/shredded cheese, then close the calzone press gently. After the first calzone, you will know whether to add more or less to the calzones. Each calzone press is slightly different.
3. Place each meat and cheese filled calzone on a lined baking dish, bake at 180C/350F for 20 minutes, or until golden brown and crispy.
* Fat Head pastry can also be made by replacing the almond meal/flour with 1/4 cup (4 tbsp) coconut flour.
* If the mixture hardens and becomes difficult to work with, pop it back in the microwave for 10-20 seconds to soften again but not too long or you will cook the egg.
* If you do not have a microwave, you can gently melt the cheeses together in a saucepan.
Yield: 12 calzones
Amount Per Serving: 1 calzone
* Calories 97
* Calories from Fat 85
* Total Fat 9.4g
* Protein 7.1 g
* Total Carbohydrates 2.5g
* Dietary Fiber 0.9g
* Net Carbs: 1.6 g
Recipe #3 | Bolognese Meat
Total time: 35 minutes
Prep time: 15 minutes
Cook time: 20 minutes
* 1 onion finely chopped
* 2 cloves garlic crushed
* 1 lb ground beef
* 1 lb can chopped tomatoes
* 1 tbsp dried rosemary
* 1 tbsp dried oregano
* 1 tbsp dried sage
* 1 tbspy dried basil
* 1 tbsp dried marjoram
* Salt and pepper to taste
1. In a large saucepan. gently fry the onion and garlic in oil until softened but not over cooked.
2. Add the mince/ground beef and continue to fry stirring continuously to break up the mince/ground beef. Fry until all the meat is cooked and browned.
3. Add the herbs, seasoning and tomatoes.
4. Stir then simmer for 15 minutes, then divide into 12 servings and add to calzone middle.
* Total fat: 17 g
* Protein: 30 g
* Total carbs: 13 g
* Fiber: 4 g
* Net Carbs: 9