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:
“Only I can change my life. No one can do it for me.”
~ Carol Burnett
COME JOIN THE LCDA FORUM!
CHAT AND CONNECT WITH OTHER LCDA MEMBERS!
It may not be well known that the LCDA has a user friendly FORUM on our website, available for all members to use. After you log in, you can find the FORUM under the RESOURCES link on the main menu. You can bring up any topic you wish, ask any question and any member can reply. Please start using our forum! We want members to connect and feel the LCDA is a great place to discuss all aspects of diabetes. Of course, only G-rated, friendly language is allowed!
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
You can also find it on the LCDA website under Supplements.
World Diabetes Day + National Diabetes Month
General Diabetes Information
The World Diabetes Day, which was November 14th, was created in 1991 by the International Diabetes Federation and the World Health Organization. It became formally established by the United Nations in 2006. This years World Diabetes Day theme was “Women and Diabetes–Our Right to a Healthy Future.”
The statistics on diabetes world-wide are shocking. One out of every 10 women has diabetes. There are currently 199 million women with diabetes and is projected to increase by 2040 to 313 million (almost the entire populationof the United States). Two out of every five women with diabetes are of reproductive age, which is around 60 million women. Diabetes is the 9th leading cause of death in women globally, causing 2.1 million deaths. Women with Type 2 diabetes are nearly 10 times more likely to die of coronary artery disease than women who do not have T2DM. One out of every 7 births deals with gestational diabetes, and the IDF estimates that nearly 21 million (or, 16.2% of live births) dealt with hyperglycemia during the pregnancy, occuring in women both under and over 30 years old. Women with T1DM have an increased risk of early miscarriage of their babies, or babies born with malformation.
The main problems are that many women around the world unfortunately do not have access to diabetic supplies, education and medical care and treatment. Most of the pregnancy problems with women and diabetes occurs in low to middle income countries, where medical care may not be prevalent and access to maternal care, especially related to gestational diabetes, is non-existent or limited.
To help women in the next year these items are important:
- Get all women access to nutrition and maternal health services, especially by those knowledgeable about preventing and treating gestational diabetes. Half of all women who experience gestational diabetes go on to develop full-blown T2DM within 5-10 years. Helping women in this way protects not only the developing baby, but mom herself.
- All women world-wide should be screened for gestational diabetes during their pregnancies.
- All girls at school, and women in general, should get regular exercise.
Of course, the LCDA has serious concerns about the identification, access to supplies and education, and quality of medical care that girls, teens, women and pregnant females with prediabetes and diabetes get throughout the world. Our message of The Eight Essentials® is, we feel, with slight modifications, valuable for all people. We believe that everyday should be diabetes awareness day, for males and females, as this is a growing epidemic and crisis globally, likely affecting someone we all know and love.
Type 3C Diabetes: What is that?
General Diabetes Information
There are many established types of diabetes already delineated in medicine:
- Type 1 diabetes–an auto-immune disease destroying pancreatic beta cells causing the need for insulin (sooner or later).
- Type 2 diabetes–a disease of insulin resistance, whereby the body cells do not react to the insulin secreted by the pancreas.
- Latant Auto-immune of the Adult (LADA: Type 1.5)–an auto-immune disease of adults, where pancreatic beta cells are destroyed, but the destruction is sometimes not as quick as with Type 1 Diabetes.
- Mature Onset Diabetes of Youth (MODY)–a genetic mutation in the beta cells or in receptor cells, causing minimal or moderate elevations in glucose levels that oftentimes can be treated with sulfonylureas.
- Gestational diabetes–T2DM that occurs during a woman’s pregnancy.
So, what then is Type 3C diabetes?
Type 3C diabetes is also called pancreatogenic diabetes or Diabetes of the exocrine pancreas. The pancreas has two very different types of cells. The exocrine cells produce digestive enzymes that are secreted via ducts into the small intestine right where the stomach and gallbladder empty. The endocrine cells of the pancreas produce hormones–insulin, glucagon, amylin–that are secreted into the blood and are carried throughout the body.
Type 3C diabetes develops when the pancreas has been damaged, oftentimes due to chronic pancreatitis, a condition typically caused by alcoholism, although much less commonly an auto-immune disease or cystic fibrosis can cause it. Alcohol can cause damage to the cells of the pancreas that make digestive enzymes and secrete them into the small intestine. If this part of the pancreas is inflammed, typically for years, the inflammation can spread to the beta cells and damage them, preventing them from being able to produce and secrete insulin. 3C patients also may develop liver based insulin resistance, and lack pancreatic alpha cell glucagon production. Glucagon is a hormone that signals the liver to produce glucose. Without that hormone working, it puts them at risk of serious hypoglycemia events they cannot naturally correct.
Chronic pancreatitis occurs generally in men 30-40 years old who are alcoholics. If they develop diabetes, they are almost always misdiagnosed with T2DM. In fact, a recent study showed that only 3% of people with 3C diabetes are correctly diagnosed. This can lead to errors in treatment. People with 3C diabetes need insulin, and pancreatic digestive enzymes.
(Note: In patients with other forms of diabetes, if they are out of control for a long time, A1Cs > 7.5%, over time, the oxidative damage that occurs in the pancreas can spread to the digestive cells, and those patients will need digestive enzymes, too. A stool test called elastase-1 can diagnose low pancreatic enzyme functioning in all patients, including diabetic patients.)
How common is 3C diabetes. Well, unfortunately, alcoholism is very common in the US; 14 million adults abuse alcohol, nearly 1 in every 13 adults. The same study surprisingly found, as a result, that Type 3C is more common in adults than Type 1 (LADA). 1% of new diabetic cases in adults were Type 1, 1.6% was Type 3C, and the rest was T2DM (as expected).
Also, Type 3C seems to have much poorer glycemic control. WIthin five years around 4.9% of newly diagnosed T2DM needed to be on insulin, this study reported, while 45.8% of Type 3C patients needed insulin. Big difference!
Why is this important? Because all patients should be properly diagnosed with the type of diabetes they’ve developed. Second, good care depends on knowing the correct form of diabetes. Type 3C diabetic patients should not be given: sulfonylureas, DPP-IV inhibitors, GLP-1 agonists. Insulin is the best treatment and not typically dosed to newly diagnosed adult diabetic patients.
Type 3C will also likely suffer from serious malabsorption, due to lack of production and secretion of digestive enzymes. There are very strong prescription pancreative enzymes for these types of patients, as well as strongly supplemental enzymes as well. They do not need hydrochloric acid or pepsin. The first type of food one malabsorbs is fat, as it’s the most difficult to absorb. With malabsorbing fat, one malabsorbs Vitamin D3, Vitamin E, Vitamin A, Vitamin K, and carotenoids (strong antioxidants). Ensuring proper absorption of food is important.
Do you know someone who is an alcoholic? If so, it’s vital to get their glucose checked at least 1-2 times a year to catch the development of Type 3C diabetes, and ensure they are both properly diagnosed and thus properly treated. It may not be the most common form of diabetes, but we need to ensure all diabetic patients of all types are correctly cared for.
Ketosis Vs. Ketoacidosis
General Diabetes Information
The LCDA received a question from a member about ketosis on a low carb diet. She asked what ketone levels a diabetic patients should expect on a low carb diet. How can a diabetic patient interpret glucose and ketone levels? What are dangerous levels?
The LCDA is happy to answer questions from members! You can contact the LCDA at [email protected]
Ketones are breakdown products of fatty acids, and can be used for energy both by the body and the brain. When a diabetic person is eating very low carbohydrates, there will not be enough glucose formed from the food, so the body will turn to burning dietary fat for energy. That is ketosis and is a normal state of metabolism for those who are doing a very low carb diet, such as less than 50 grams a day, and more ketosis occurs at even the carbohydrate intake.
There is nothing unhealthy about having a body living in ketosis; many people choose to eat a Low Carb High Fat ketogenic diet, with the purpose being to be energized by ketones. Ketones can be measured both through the urine (several hours previous level) and the blood (current level of ketones in the body).
Ketosis should not be mistaken for ketoacidosis, a serious life-threatening problem. Ketoacidosis mostly happens to T1DM patients when several factors are occurring:
- There is not enough insulin in the body
- Carbohydrate levels elevate due to lack of insulin and the liver making more.
- The body starts burning fat as a result
- Too many ketones develop
- Dehydration occurs due to urination of the excess glucose, and the body loses electrolyte and other key serum substances.
- The body’s serum becomes acidic, which can cause damage and death to body cells.
Ketoacidosis is very rare in T2DM patients, and has a mortality of 2%.
Generally, a T1DM patient should check for ketones if their glucose goes over 250 mg/dL for more than a few hours, or if they are feverish or have a serious infection. The key symptoms of DKA is abdominal tenderness, fruity breath, confusion, nausea/vomiting/diarrhea, hyperventilation, frequent urinating and drinking. DKA is diagnosed with elevated glucose, elevated ketones, low potassium, blood acidity and lack of blood buffers.
There are two main times of elevated ketone:
- Starvation ketones: Elevated ketones and low glucose levels. This can also been seen in low carb keogenic diets which regulates glucose within healthy levels, and the body lives off ketones.
- Diabetic ketones: Elevated ketones and elevated glucose levels.
The key with interpreting ketones, and if they are a problem, or not, is looking at glucose levels. If they are low or within normal levels, it is either due to needing to eat more food or you are eating a low carb higher fat diet, and living off ketones mostly. If your glucose levels are elevated, yoru diet is not working well enough for you, you are breaking down carbs in your diet into glucose and are not covering them enough with insulin. If your glucose meter is showing high glucose and high ketones, you will need to inject some insulin.
Here is a chart Dr. Morstein was given the allowance to replicate in her book–it is from the book “Type 1 Diabetes” by Dr. Ragar Hanas:
Here are three possible scenarios:
- Blood glucose is slighly elevated, say between 150-200 mg/dL, urine glucose is elevated, but ketones are negative. In this case the person would need to inject corrective insulin.
- Blood glucose is low, urine glucose is negative and ketones are high: Starvation or low carb high fat ketone diet. Nothing needs to be done. If glucose is very low, use glucose tabs to increase.
- Blood glucose is very high, at or over 250 mg/dL, urine glucose is positive, and ketones are high: Insulin is absolutely required.
The above chart notes when ketones are an emergency and that is when the blood is at or over 3.0, and the urine is very dark, showest the highest level of ketone presences. If that occurs, a diabetic patient must absolutely immediately connect with their physician or must go to the emergency department of their hospital.
If a diabetic person is following a very low carb high fat ketogenic diet, they can exercise as they wish if their glucose levels are within normal levels. People exercise the best when glucose is between 80 and 150 mg/dL. One can have high ketones as a general state of affairs on that strict diet, but the key is–where is the glucose levels? If glucose levels are good, it is safe and fine to exercise.
Remember that dietary proteins do need to be covered by insulin and can raise glucose levels if not properly covered. Eating too much saturated fat can cause insulin resistance and require some more insulin than usual to cover food, as well.
One can certainly exercise following a ketogenic diet; in fact, many people feel their energy is very stable and gives them great stamina and intensity. Although it may take a few weeks for your body to adjust to ketone energized exercise, once you are “keto-adapted,” you should be able to exercise as much as you wish without a problem.
Just because conventional care says you need to eat carbs before and constantly during exercise, that is simply not true. The body can use ketones, and snacking on protein will be much more helpful to a body engaged in exercise, if you do get hungry.
If you are a T1DM and get low a lot during exercise on a low carb ketogenic diet, you probably need to reduce your insulin levels before and/or during exercise. If you wind up low, eating a glucose tab to elevate glucose is a good idea, but then figuring out if you need to eat more food, or inject less insulin is vital, so lows do not continue.
In T2DM patients, exercising on a ketogenic diet can enhance weight loss, reduce insuln resistance, and lower glucose levels. For T1DM patients, calories must be eaten to ensure weight is maintained.
The key is working with an experienced integraive physician who is knowledgeable in diabetes, ketogenic diets, and dosing insulin. Only an integrative physician has mastered that depth of comprehensive care of diabetic patients. All diabetic patients can eat ketogenic, and exercise, safely and effectively.
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
Ulta Labs: www.UltaLabTests.com/LCDA
Diamend by Priority One Supplements (created by Dr. Mona Morstein of the LCDA)–contains benfotiamine, alpha lipoic acid, at therapeutic doses and many other ingredients. Ask your comprehensive integrative practitioner to consider prescribing you Diamend.
LOW CARB RECIPES
Recipe #1 | Sauted Brussel Sprouts With Pancetta (bacon)
Cook Time: 12 minutes
Sauteed brussels sprouts are delicious when shredded and sautéed with pancetta (or bacon), garlic and oil. If you don’t think you like Brussels sprouts, I challenge you to try these! Lightly pan fried until crisp and slightly browned on the edges, this is my favorite way to cook and eat them!
* 2 oz pancetta, minced
* 2 lb brussels sprouts (weight after outer leaves and stems removed)
* 1.5 tbsp extra virgin olive oil
* 4 cloves garlic, minced or sliced thin
* kosher salt and fresh ground pepper
1. With a large sharp knife, finely shred the brussels sprouts after thoroughly washing.
2. In a deep heavy saute pan, sauté pancetta on medium-low heat until fat melts and pancetta becomes golden, about 5 minutes.
3. Add olive oil and garlic and sauté until golden.
4. Add shredded brussels sprouts, salt and pepper to taste and sauté on medium-high heat for about 5 to 7 minutes until tender crisp.
Yield: 9 servings (about 7 cups)
Serving Size: 3/4 cup
Amount Per Serving:
* Calories: 87
* Total Fat: 4g
* Protein: 3.5 g
* Carbohydrates: 9.5g
* Fiber: 4g
* Total Carb: 5.5 g
Recipe #2 | Low Carb Salmon Patties
A quick and easy meal ready in under 20 minutes. Paleo low-carb salmon patties served with a lime avocado dressing.
Total Time: 20 minutes
Prep Time: 5 minutes
Cook Time: 15 minutes
Low-Carb Salmon Patties:
* 500 g/17.5 (or so) canned salmon drained
* 2 eggs
* 50 g/1.7 oz (or so) almond meal/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 butter, lard or other oil for frying
Avocado and Lime Dip:
* 1 small avocado
* 1/4 cup mayonnaise
* 1 tbsp lime juice
* 1 clove garlic crushed
* 1 tbsp parsley or cilantro
* salt/pepper to taste
1. Place all the salmon patty ingredients (except the butter, lard or other oil) 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. Whilst 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. A serving size is 3 salmon patties plus 2 tbsp dip.
Low-Carb Salmon Patties:
* Calories 532
* Calories from Fat 352
* Total Fat 39.1g
* Total Carbohydrates 8g
* Dietary Fiber 3.7g
* Carbs to count: 4.3 g
* Protein 39.9g