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:
“Success is the sum of small efforts, repeated day in and day out.”
~ Robert Collier
Board Member Updates
Remember to order Dr. Morstein’s new outstanding diabetes book at Amazon: Master Your Diabetes: A Comprehensive, Integrative Approach for Both Type 1 and Type 2 Diabetes
ULTA Labs Coming to the LCDA!
The LCDA will soon have a easy to use link to ULTA LABS on our website where anyone can order very inexpensive labs. If you do not have insurance or if your insurance still leaves you with significant laboratory charges, using Ulta Labs through the LCDA will save you significant money. The LCDA set this up to enhance comprehensive diabetic laboratory testing for patient with prediabetes and diabetes, and established a few panels, but you can order any lab you wish.
Ulta Labs is a company that has arranged with SonoraQuest labs to run very affordable blood work for physicians to order for their patients, or for people to order for themselves. This is a win-win set-up for everyone involved. The LCDA does get a little money from Ulta Labs for promoting lab tests through our website, but it goes straight to the non-profit to help us grow and offer more services for our members.
If you need upcoming labs, and are worried about a large lab bill, it’s easy to check out the prices on the Ulta Labs offered through the LCDA. Keeping on track of helpful lab values means your diabetes and risk factors are reducing, reducing your worry and stress! LCDA and Ulta Labs is a good mix!
Connect to Ulta Labs here: www.UltaLabTests.com/LCDA
Diabetes Medical Updates — General Diabetes Information
New Fast Acting Insulin Approved by the FDA
The FDA has approved a new fasting acting insulin for meals/corrections called Fiasp. It is a new version of aspart/Novolog by Novo Nordisk. The new aspect is that this insulin is bound to niacinamide, vitamin B3, and as a result this seems to make the insulin much more quickly absorbed and used by the body. Fiasp claims it can be injected at the meal or within twenty minutes of eating as it begins lowering glucose 2.5 minutes after injection. Typical fast acting insulin has to be injected 15-20 minutes before the meal, so if Fiasp is truly effective injected at the meal, this would be a more convenient form of insulin. Fiasp will be offered in a pre-filled pen and a 10 ml vial of 1000 units. It is not yet approved for use in insulin pumps in the US, though. It will cost as much as Novolog.
Note: The European study confirming benefits to Fiasp lasted only two weeks. That’s not very long.
The LCDA would be wary of using this insulin with pediatric patients, since parents are not always so sure if the child will eat the food presented to them. As a result, it seems that using it with children under 10 years old, who have the highest risk of having a tantrum or simply refusing to eat food on their plate, could experience a serious low. In that regard, using Regular Novolog or Humalog with a pediatric patient makes best sense, unless the child is clearly going to eat all the food. With adults, as well, they must inject and then immediately begin eating, and not get distracted by their phone or work.
Still for typical adults, Fiasp seems like a real benefit to injecting right at the meal and covering well all meal glucose excursions.
A new ultra fast acting insulin is also being developed by the lispro/Humalog company Eli Lilly.
Glucose Meters that Connect to Smart Phones
Both Medtronic and Dexcom CGMs can connect to smart phones, helping parents keep in touch with glucose numbers of their children.
There are now three glucose meters which can do the same thing–connect to smart phones so parents can see glucose readings after children check their glucose numbers. Those meters are:
- Dario at mydario.com is a “personalized, pocket-sized all-in-one glucose meter coupled with a robust real time mobile app to manage diabetes quickly, efficiently and acccurately.” You carry a little container of the Dario mechanism and test stripes. You pull out the Dario mechanism which is inserted into your smartphones ear phone insertion, add the test strip, use the lancet device which is included in the Dario mechanism. Your glucose is measured via your smart phone. The glucose levels are saved. A hypoglycemic alert will be sent to family/friends noting where you are via a GPS location aid.
- Fora TN’G (Test N’Go) at Fora Fora TN’G is a glucose meter with Bluetooth capabilities that is very small and convenient to carry. Unfortunately, the Fora website is scant on actual usage. It connects to smart phones and information can be tracked via it, and can be downloaded for your medical practitioner. There are no automatic alerts to others. However, information can be emailed information to others, such as parents or other family members, or put up on on websites like Facebook, if one would desire to do that. Some reviews show frustration with lack of connectivity on many Android phones.
- Accuchek Aviva Connect at https://www.accu-chek.com/meters/aviva-connect-meter is a typical Accuchek meter, coming with meter, test strips and lancet and so forth, but it automatically sends test results to your Android and Apple smart phone. You need to use the app to connect the meter to your phone. You can emall text reports to anyone you wish, including sending a message–you can send to family, friends, or your medical professional. There are no medical alerts available.
For parents of pediatric diabetic patients, Dario seems the most valuable connected meter, so that immediate notifications of hypoglycemic episodes will be sent to the parents. For adults who are involved with only their own care, any of the three above seem useful.
PCPs Lack Diagnostic Acumen for Pre-Diabetes
The LCDA’s mission statement is to not only offer integrative advice for treating all types of diabetes, under the care of an integrative medical practitioner, but to also help prevent the occurrence of diabetes all throughout the world.
As a result, as reported in the J Gen Intern Med. Published online July 20, 2017, it is particularly disconcerting to read that PCPs, that is primary healthcare providers, lack the knowledge to diagnose and treat prediabetes. If a medical practitioner is not testing for prediabetes in those likely to have it, thus not diagnosing it, it obviously will not occur to the PCP to effectively treat it and prevent another case of diabetes from developing. Around 70% of prediabetes patients, that is, by far the majority, are likely to progress into actual diabetes. Studies showing that diagnosing prediabetes and then treating it can reduce the occurrence of diabetes by 27% (although the LCDA believes that using The Eight Essentials® for treatment would significantly reduce the occurrence rate).
Also, patients with pre-diabetes can already start to develop diabetic complications such as nerve damage. It’s vastly disturbing that so many conventional care physicians may indeed not be testing patients for, and thus are missing the diagnosis of, pre-diabetic patients.
In that study only 6% of the 140 primary care providers surveyes at a medical conference were able to identify 11 risk factors that should automatically trigger an analysis of a patient for prediabetes. The physician specialities quizzed were mainly family medicine, internal medicine, and pediatric-internal medicine; also 9 nurse practitioners and 1 physician’s assistant were included. 59% of the practitioners had been in practice at least 10 years.
The eleven risk factors included:
- Age 45 or older
- Body mass index of 25 kg/m2 or higher
- High blood pressure
- High triglycerides and/or cholesterol
- Heart disease
- Family history of diabetes in a first degree relative (parent, grand-parent, sibling)
- Sedentary lifestyle
- African-American race
- Asian-American race
- Latino ethnicity
- History of gestational diabetes
The statistics are pretty sad in the study! Only 17% of the medical practitioners actually knew the fasting glucose and A1C diagnostic criteria for prediabetes. The pediatric oriented physicians had a higher rating, up to 43% of them knew that very basic information.
In terms of recommended conventional care, 25% of those quizzed new that 5-7% of weight loss was a recommended target, although for most prediabetic patients, more weight loss is usually a lot more effective. 45% were aware that exercise recommendations are 150 minutes per week.
Given the diabetes epidemic in the US (and across the world), it’s scary and pathetic that so many conventional medical practitioners are not acutely aware of when to test for prediabetes and not very good at recommending treatment for it.
The LCDA is acutely aware of diagnosing prediabetes! In fact, read below to learn of a great new tests the LCDA has created through Ulta Labs.
LCDA PreDiabetes Test
Because diagnosing pre-diabetes is so vital to reducing the world-wide epidemic of diabetes, the LCDA has spent some time doing research and working with Ulta Labs to create the best prediabetes diagnostic panel anywhere.
The conventional laboratory results for diagnosing prediabetes is:
Fasting glucose: 100-125 mg/dL
After meal glucose: at or above 200 mg/dL
The LCDA does not feel that is a comprehensive enough test to truly uncover all the pre-diabetic patients that exist. After all, there are around 89 million pre-diabetic patients in the US, and it’s vital to uncover each and everyone of them to begin effective treatment reversing the pre-diabetes and absolutely preventing movement forward into actual diabetes.
As a result, the LCDA has created it’s own pre-diabetes test that will, we feel, have a huge chance of catching every pre-diabetic. Here is a description of the Type 2 Pre-Diabetes test soon to be set up at Ulta Labs. (Please make a note to check Ulta Labs by the end of the week).
First, the LCDA has to state very firmly that this Pre-diabetes test should not in any way be given to or done by a person already diagnosed with any type of diabetes. Ever. For any reason. Ever.
This is an unnecessary and potentially dangerous test to do on a patient who already has been diagnosed with diabetes. This test is only used to diagnose pre-Type 2 diabetes.
The test consists of three separate blood draws. Here is what is tested at each blood draw:
- Fasting glucose and insulin
- One hour glucose
- Two hour post-prandial glucose and insulin
Why does the LCDA add in insulin, when conventional care only measures glucose? There are good studies showing that insulin secretion after meals is an indication of insulin resistance; that is, if a lot of insulin is secreted to attempt to keep glucose levels normal, or even worse, when the glucose numbers are still elevated, this is clear indication of insulin resistance, since insulin should easily stimulated body cells to take in glucose and reduce the serum numbers. It’s helpful to know that in a lean person with no medical presentation of possible prediabetes or diabetes, he or she secretes around 30-40 units of insulin a day for all the food and drink eaten. That’s good to remember regarding the test examples below.
Medical studies validate the use of three glucose numbers, but only two insulin numbers, which is how the LCDA has set up the test. Although having three blood draws is a little inconvenient, the information gathered will easily allow a physician who specializes in diabetes to diagnose prediabetes.
The LCDA test meal for pre-diabetes is related on science and also its own innovations. Conventional testing uses a Glucola drink of 75 grams; Glucola is straight glucose. Glucose is generally not found in foods. As a result, the LCDA has created test meals of around 75 grams that rely upon refined flour, refined sugar and saturated fat—all foods that can push insulin resistance in the body. This meal will push the limits of the body’s capacity to maintain normal glucose levels and analyze the body’s secretion of insulin for that glucose regulation.
It may be disgusting to eat, but if this meal does not cause insulin resistance and a positive test for prediabetes, the person clearly does not have pre-diabetes.
Here is the six step testing process:
- Sign up for the test on the Ulta Lab website.
- Fast for 12 hours, eating no foods but drinking good amounts of water
- Go to the lab or your physician’s office to get a fasting blood draw for glucose and insulin
- Go to McDonald’s or Denny’s to eat your test meal:
- McDonald’s (this is the preferred LCDA meal challenge): Order the pancakes, but eat only one of the three served. Use 1 syrup container. Also eat a hash-brown. Drink water. Eat the meal within ten minutes.
- Gluten Free meal challenge (may not be safe for Celiac disease patients needing dedicated gluten free restaurants, but is fine for non-Celiac gluten intolerance patients): Go to Denny’s and order 1 gluten free english muffin and cover with 4 tablespoons of maple syrup. Add in one serving of hash browns. Drink water. Eat the meal within ten minutes.
- Return to the lab or your physician’s office for the one hour after meal blood draw for glucose.
- Return to the lab or your physician’s office for the two hour after meal blood draw for glucose and insulin.
If you wish, you can get the meals beforehand and stay at the lab or your physicians office the whole time, eating it there, if that is more convenient.
Here are random examples of test results than can help your integrative medical practitioner diagnose if you have no pre-diabetes, or mild, moderate or severe pre-diabetes. These examples are unique to the medical science and the experience of the physicians who make up the LCDA board, but they are still general guidelines and not set in stone. The test results can come out in so many different ways. But, using the below as typical examples, you can see how the glucose and insulin levels continue to elevate, not yet ever to diabetic numbers. Showing significant secretions of insulin while not being able to contain glucose numbers, is a necessary analysis of pre-diabetes.
For example, if a fasting glucose number is 98 mg/dL, it may be considered not prediabetes by a conventional physician and the diagnosis is missed. However, in that same patient, if the fasting insulin was also measured and was 20 mIU/L, way above the fasting normal for insulin, a physician specializing in integrative care would realize that a great deal of insulin was needed to keep the glucose at 98, and that would easily be considered a diagnosis of pre-diabetes. So, by using insulin the LCDA test will diagnose many more pre-diabetes patients.
Here are other examples:
Normal Result–No Pre-diabetes:
- Fasting glucose: 85 mg/dL
- Fasting Insulin: <9 mIU/L
- One hour glucose: <120 mg/dL
- Two hour glucose: < 110 mg/dL
- Two hour insulin: < 33 mIU/L
Abnormal Result–Mild Pre-diabetes:
- Fasting glucose: 90-99 mg/dL
- Fasting Insulin: 9-20 mIU/L
- One hour glucose: 130-150 mg/dL
- Two hour glucose: <140 mg/dL
- Two hour insulin: < 33 mIU/L
Abnormal Result–Moderate Pre-diabetes:
- Fasting glucose: 100-115 mg/dL
- Fasting Insulin: 20-30 mIU/L
- One hour glucose: 150-180 mg/dL
- Two hour glucose: <150 mg/dL
- Two hour insulin: <150 mIU/L
Abnormal Result–Severe Pre-diabetes:
- Fasting glucose: 116-125 mg/dL
- Fasting Insulin: >30 mIU/L
- One hour glucose: 180-199 mg/dL
- Two hour glucose: >150 mg/dL
- Two hour insulin: >150 mIU/L
If you or a family member or friend wonders if they are entering into pre-diabetes, this is the best test to have done to get the information needed for the most accurate diagnosis. The LCDA is delighted to lead the way in first diagnosing pre-diabetes patients so treatment following The Eight Essentials® can occur to start healing people and reducing the world-wide diabetic epidemic.
Fire Cider For Health
Essentials #1 + #7: Food + Supplementation
With fall beginning its time for people with diabetes to once more be at risk of developing the typical fall cold. Getting sick is a natural detoxification of the body, although that view is different from the conventional view that all sickness is bad. In the LCDA, following naturopathic, integrative views of sickness and health, getting an acute illness is believed to occur when toxins have developed in the body and the body uses a micro-organism, such as a virus or bacteria, to initiate a fever, nasal discharge, coughing, diarrhea to allow the body to detoxify and cleanse.
When a person becomes ill, they tend to ideally get a fever. A fever is ideal because it increases the metabolism of the body, allowing the immune system to be more active, and it creates a warmer environment that can also help kill the microorganism. The immune system is made in the bones, so people feel achy as the immune system cell production is increased. As a result, the person should go to bed, which is beneficial as the immune system is more active at rest than when a person is up and active.
Getting sick is a risk for patients with diabetes, as glucose can raise, especially with that helpful fever, and unfortunately elevated glucose levels reduce one’s immunity.
So, it is still best to prevent illness and here is one drink that may be helpful in reducing one’s risk of getting sick. There are no guarantees, but Fire Cider contains many ingredients which have been shown to stimulate the immune system, reduce inflammation, stimulate the circulation; the more the blood moves the healthier the body.
Fire Cider is an old traditional drink and when adapted, can be an important addition for the kitchen pantries of diabetic patients.
The drink is also safe for all diabetic patients, although instead of using honey in the basic recipe, the LCDA naturally suggests using one of the accepted sweeteners, such as stevia, monk fruit, chicory, xylitol or erythritol or a combination product of those.
* 1/2 cup of fresh grated organic ginger root
* 1/2 cup fresh grated organic horseradish root
* 1 medium organic onion, chopped
* 10 cloves of organic garlic, crushed or chopped
* 2 organic jalapeno peppers, chopped
* Zest and juice from 1 organic lemon
* Several sprigs of fresh organic rosemary or 2 TBSP of dried rosemary leaves
* 1 TBSP organic turmeric powder
* Organic appled cider vinegar
* Natural sweetener to taste
1. Put all the ingredients in a quart sized jar and then fill with the vinegar.
2. Put a piece of natural parchment paper or wax paper under the lid to keep the vinegar from touching the metal. Shake well. Store in a dark, cool place for one month and remember to shake daily.
3. After one month, use cheesecloth to strain out the pulp, pouring vinegar into a clean jar.
4. Squeeze as much of the liquid goodness as you can from the pulp while straining.
5. Taste and add the sweetener to taste–you may need to a bit of sweetener to make it palatable to you.
6. You can take 1-2 TBSP a day to try to prevent a cold
7. You can mix it with lemon juice, you can use it with oil in a salad, you can drizzle it on steamed vegetables, or use as a marinade for meat or tofu, you can add to soups.
8. If you feel a cold/flu coming on take 1-2 TBSP, and then repeat every 3-4 hours to help reduce it’s intensity and duration. Make sure you always connect with your medical practitioner if you start getting sick for integrative care and monitoring of your illness and your diabetes.
Books: (All are found on Amazon.com)
- Master Your Diabetes: A Comprehensive, Integrative Approach for Both Type 1 and Type 2 Diabetes. Dr. Mona Morstein
LOW CARB RECIPES
Fire Cider (above) is the First Recipe for this blog post.
Recipe #2 | Philly Cheesesteak Stuffed Portobellow Mushrooms
It doesn’t get much better than a low-carb, Philly Cheesesteak Stuffed in a Portobello Mushroom! Steak and mushrooms work so well together, so why not make stuff them with this cheesy deliciousness!
* 6 ounces thin sliced sirloin steaks
* 1/8 teaspoon kosher salt
* black pepper to taste
* cooking spray
* 3/4 cup diced onion
* 3/4 cup diced green pepper
* 1/4 cup light sour cream
* 2 tablespoons light mayonnaise
* 2 oz full fat cream cheese, softened
* 3 oz shredded mild provolone cheese (or cheese of your choice)
* 4 medium portobello mushrooms, with no cracks
1. Preheat the oven to 400F. Spray a baking sheet with oil.
2. Gently remove the stems, scoop out the gills and spray the tops of the mushrooms with oil, season with 1/8 tsp salt and fresh pepper.
3. Season steak with salt and pepper on both sides.
4. Spray a large skillet with cooking spray and heat on high, let the pan get very hot then add the steak and cook on high heat about 1 to 1 1/2 minutes on each side, until cooked through.
5. Transfer to a cutting board and slice thin, set aside.
6. Reduce the heat to medium-low, spray with more oil and saute onions and peppers 5 to 6 minutes, until soft.
7. Combine all the ingredients in a medium bowl. Transfer to the mushroom caps, about 1/2 cup each.
8. Bake in the oven until the cheese is melted and the mushrooms are tender, about 20 minutes.
Yield: 4 servings
Serving Size: 1 mushroom cap
Amount Per Serving:
* Calories: 256 Total
* Protein: 19g
* Carbohydrates: 10g
* Fiber: 4g
* Total Carbs: 6 g