Wellness

[cherry]

Our hands sometimes have it rough: Harsh soaps and hot water can zap moisture and produce chapped or cracked skin. And blood glucose checks can leave fingers a little worse for wear. Read on for 12 ways to protect your skin.

1. Maintain Control 

Diabetes control can improve the state of your skin. When your blood glucose is elevated, your body flushes some of the excess sugar by urinating, says Cleveland Clinic diabetes educator Shannon Knapp, RN, BSN, CDE, who has type 1 diabetes. That gets rid of necessary fluids and can lead to dehydrated skin. By keeping your blood glucose in line, you can avoid dehydration that can cause serious health problems in addition to dry skin.

2. Moisturize Often 

Keeping skin hydrated is important because dry skin more easily breaks, providing a perfect entry for harmful bacteria. And people with diabetes are more susceptible to infection than those without. By regularly moisturizing, you can stop dry skin before it starts. Knapp says the type of moisturizer you use doesn’t make a difference—some are advertised specifically for people with diabetes, but you’re not required to use only those. Certain moisturizers may be more appropriate for daytime versus overnight, however. Ointments such as Vaseline, for instance, are oilier than lotions and creams and may leave hands too greasy for daytime use but can be helpful overnight.

3. Skip Scents 

Think twice before slathering on scented moisturizer. “You don’t want scented lotions because that can affect your blood sugar reading,” Knapp says. Testing with fragrant lotion on your fingertips can lead to falsely high readings. Of course, even if you use unscented lotion, wash your hands before checking your blood glucose. But you can skip the alcohol wipes, which can dry out skin.

4. Cover Up 

Next time you do the dishes, protect your hands by wearing dishwashing gloves. They’ll shield your skin from harsh dish soaps, which can dry out skin.

5. Lower the Heat 

Hand-washing is essential, but constantly dousing your hands in hot water can dehydrate them. Instead, wash your hands in warm water, which won’t leave skin as parched.

6. Ask for Help 

If drugstore lotions, creams, and ointments aren’t doing the trick, talk to a dermatologist. These doctors are trained in skin care and can assess your situation, troubleshoot problems, and suggest products for your skin care needs. Your dermatologist may prescribe a special cream if your skin requires it.

7. Rotate Finger Sticks 

Frequent blood glucose testing takes a toll on your skin, but good technique can prevent problems such as calluses. One  best practice is to use different fingers for blood glucose checks. “We’ve got 10 fingers and two sides to each finger,” Knapp says. “So if you want to use all of them, you have 20 spots [for] checks.”

By keeping your blood glucose on target, you can avoid a major cause of dry skin.

 By rotating through these 20 sites, you give your skin time to heal. Constantly sticking your finger in the same spot can cause trauma to the skin, which can eventually lead to a callus.

8. Stick to the Side 

To lessen your chances of developing calluses, use the sides of your fingers instead of the center. Sure, you can still get calluses on the sides of your fingertips, but you have a lower risk than if you simply use the center of the pads. Not only that, but most people find the side of the fingers a less painful place to ****** than the sensitive center.

9. Stay Sharp 

If blood glucose tests are causing problems for your skin, check your lancet. According to Knapp, using a dull lancet can increase your chances of getting callused fingers because it makes bigger breaks in the skin.

10. Pay Attention to Size 

The gauge of your lancet determines the size of the hole it creates in your skin. A higher gauge number (such as 33) creates a smaller hole and therefore causes less trauma to the skin. Still, it may be necessary to use a lower gauge if you have a hard time getting enough blood for a glucose test.

11. Keep It Shallow 

Most lancing devices have a depth setting, which controls how deep the lancet punctures the skin. By using the shallowest setting possible, you cause less damage to the skin and are less likely to develop a callus. If your fingers are already callused, however, you may need a deep setting in order to get enough blood for a glucose check.

12. Try Different Sites 

If tough skin on your fingers makes getting enough blood difficult, try using an alternate site. Some people ****** their palms or arms for blood glucose checks, using a lancing device adaptable for this purpose. But, Knapp warns, readings from alternate sites lag behind those from the fingers and are best used when glucose is steady. At times when glucose is rapidly rising (after eating or a hypo treatment) or falling (during exercise or hypoglycemia), it’s best to use finger sticks.

[cherry]

I did ask my endo about taking Vit C. It is a new study, and she hadn't heard about it ,as of yet. She said ,she really didn't know enough to give an opinion, but, taking Vit C was totally safe, and if I wanted to experiment with it, she had no objections

She also is going to put me on Januvia, she feels my stomach problems will be gone , so I am going to give it a go

I got a call from her office today ,telling me to cut back again on my Armour thyroid. That is fine by me. I think my walking, is maybe paying off. I am exactly the same weight, but, I am also smaller, than I was. My clothes fit better ,but, I weigh the same, as always

I have been having heart flutters, and am sensitive to heat, and too much thyroid, will do this

I discovered the fact scented hand cream will elevate your testing scores.( Even after washing your hands carefully). So, I make sure I test, a few hrs later, and really wash well, and wash again.

[Trinity11]

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@cherry wrote:

I did ask my endo about taking Vit C. It is a new study, and she hadn't heard about it ,as of yet. She said ,she really didn't know enough to give an opinion, but, taking Vit C was totally safe, and if I wanted to experiment with it, she had no objections

She also is going to put me on Januvia, she feels my stomach problems will be gone , so I am going to give it a go

I got a call from her office today ,telling me to cut back again on my Armour thyroid. That is fine by me. I think my walking, is maybe paying off. I am exactly the same weight, but, I am also smaller, than I was. My clothes fit better ,but, I weigh the same, as always

I have been having heart flutters, and am sensitive to heat, and too much thyroid, will do this

I discovered the fact scented hand cream will elevate your testing scores.( Even after washing your hands carefully). So, I make sure I test, a few hrs later, and really wash well, and wash again.

---

Interesting about the vitamin c @cherry. Januvia? It can cause pancreatitis. I know someone who took Januvia and ended up in the hospital. Just wanted to alert you. It also caused her severe muscle pain. 

[cherry]

Thanks @Trinity11  we did discuss it, and she feels the risk for me, is very slight. I am going to try. My bil took it, for years ,until he needed insulin

[cherry]

Portrait of girl with double exposure effect

When I was diagnosed with type 2 diabetes in 2011, I had a hard time processing it. I spent weeks, if not months, wondering how this happened to me and if I was diagnosed correctly this time. Initially, I was misdiagnosed, so the seed of doubt was planted. Over time, I accepted the fact that I have type 2 diabetes, but it was a big pill to swallow.

What nobody told me about accepting the diabetes diagnosis is that I would have to move beyond more than my own doubt and denial, but also the denial and doubt of others. Nobody told me that I would have to defend my position of accepting my diagnosis to others. That I would run into people (friends, family, and strangers) who held strong beliefs that type 2 diabetes was “curable” with diet and that my accepting the diagnosis and taking medication for it was a sign of giving up on finding the cure that they knew was out there and available. For these people (mostly people who do not have diabetes, I might add), I wasn’t searching hard enough for the cure, drinking the right teas, or eating the right combination of foods.

Related:​ How I'm Coping With My Type 2 Diabetes Diagnosis

Nobody told me that I would have an appointment with a family medicine physician who would accuse my grandparents and other immediate family members of lying about their health because she couldn’t believe that my parents have seven siblings each and none of them have diabetes nor any of their children, therefore, making me the first in the family with diabetes. For her, type 2 diabetes is genetic, period. Nobody told me how to process that assault against my entire family while looking at the same person for care, so I only knew to never return. I do hope she’s since learned through her continuing education courses that genetics is not the total sum of type 2 diabetes.

Nobody told me that as a young person with type 2 diabetes, I’d run into people who couldn’t accept that I had diabetes and encouraged me to seek a second and third opinion because for them, type 2 diabetes didn’t happen to young people. For them, my accepting the diagnosis was like taking away their utopian idea that young people are always healthy and don’t develop chronic illnesses.

Related:​ The Emotional Impact of Type 2 Diabetes

Nobody told me that I would one day share my diagnosis story in front a room of healthcare providers and a couple of them would doubt that I have type 2 diabetes and during the question and answer section of my talk, let me know that. They’d say, “I don’t think you have type 2 diabetes, you should get tested for type 1.5 because it sounds like that to me.” To them, my accepting the type 2 diagnosis meant that their textbooks and/or framed understanding of a “classic” case of a person living with type 2 diabetes is wrong.

What nobody told me is that I would have to work through my own doubt not once, but many times and over many years. Because of the last scenario mentioned above, I intend to spend the early part of 2019 trying to find out for sure that I don’t have type 1.5.

Nobody told me that I’d constantly meet people who would try to resurrect my doubt and display disappointment in my acceptance. This is exhausting. I have long since concluded that I will no longer defend myself to the people who believe in magical teas. Instead I will just ask for the number of their supplier and a free sample. This seems to work as I have not yet received a telephone number or a sample from anyone, only a promise that they will get back to me.

What nobody told me about accepting my diabetes diagnosis is that I’d constantly get questioned about it. This has made me understand why there are so many people living in denial, because it’s hard to move beyond denial when others encourage it. I wish people understood that accepting the diagnosis is already a deeply personal and emotional experience and that their expressions of doubt aren’t helpful. I often think these conversations are more about those people thinking… if it could happen to her, then it could happen to me, so they push back with disbelief. What nobody told me is that I would have to work through other people’s doubt along with my own and at times that is a lot to deal with.

[cherry]

Carb counting is one form of meal planning that can help people with diabetes manage their blood sugar levels.

Diabetes is an incurable, yet manageable, medical condition where the body's blood sugar levels are too high. This happens when there is not enough insulin in the body, or the insulin does not work properly.

Insulin is a hormone that is made by the pancreas. It helps the body to process glucose (the simplest form of sugar), which is used by the cells to create energy. When this doesn't happen, sugar stays in the bloodstream. This can lead to serious health problems.

This article explores carb counting as a meal planning method that can help people with any form of diabetes manage their blood sugar levels.

Diabetes and carbohydrates

In the United States in 2014, approximately 9 percent of Americans, totaling nearly 29 million people, were found to have diabetes. Diabetes is classified into different types and includes:

Almost one tenth of people in the U.S. have some form of diabetes.

• Type 1 diabetes: In this type, the body does not produce insulin. This is due to the body attacking its own insulin producing cells within the pancreas. It is most commonly diagnosed in children and young adults.
• Type 2 diabetes: In this type, insulin is either not made in high enough quantities or not used efficiently. This form of diabetes affects people of all ages and is the most common type.
• Gestational diabetes: Some pregnant women will develop a typically temporary form of diabetes called gestational diabetes. This raises their risk of developing type 2 diabetes later in life. Most times, once the baby is born, this form of diabetes disappears.

What happens after carbohydrates are eaten?

The digestive system breaks down the carbohydrates into sugar. This enters the bloodstream and is used by the body's cells for energy.

Typically, when the body receives the signal that sugar is in the bloodstream, the pancreas produces insulin. This aids the body's cells in using the sugar for energy and helps to keep blood sugar levels steady.

However, this doesn't happen in the bodies of people who have diabetes. These people may need to take an external form of insulin to maintain normal levels of blood sugar.

As they have a condition that affects their blood sugar levels, people with diabetes need to be cautious about how much sugar they take in on a daily basis. This is more involved than simply curbing a chocolate or ice cream craving.

Many people with diabetes need to count the number of carbohydrates in each serving of food. This is referred to as carbohydrate counting, or carb counting, and helps to control blood sugar levels.

Understanding carb-heavy foods

The main nutrients found in food include protein, fat and carbohydrates. Carbohydrates, like any other nutrient, come in healthful and unhealthful forms. People with diabetes need to take special care about which carbohydrates they eat and how regularly.

Foods such as whole grains, fruits and vegetables are full of energy producing nutrients, vitamins minerals, and fiber. These are vital for normal physical growth and development. However, carbohydrates in sugary foods and drinks offer little nutritional value.

It is important for those with diabetes to understand:

• how many carbohydrates they need on a daily basis
• how to count carbohydrates
• how to properly read a food label

Foods that contain carbohydrates include:

• Grains: Including bread, pasta, oatmeal, certain noodles, crackers, cereals, rice, and quinoa.
• Fruits: Including apples, bananas, berries, mangoes, melons, oranges, and grapefruits.
• Dairy: Including milk and yogurt.
• Legumes: Beans (including dried), lentils, and peas.
• Snacks: Cakes, cookies, candy, and other sweet dessert-type foods.
• Drinks: Juices, soft drinks, sport drinks, and sugary energy drinks.
• Vegetables: Some vegetables contain more carbohydrates than others.

Starchy and non-starchy vegetables

Not all vegetables are created equal. They can be broken down into "starchy" and "non-starchy" types. Starchy vegetables contain more carbohydrates than the non-starchy varieties.

Non-starchy vegetables are low in carbs, therefore people counting carbs can eat much more of them.

Starchy vegetables include:

• potatoes (including sweet potatoes)
• peas
• pumpkin
• butternut squash
• fresh beets

Non-starchy vegetables include:

• asparagus
• broccoli
• carrots
• celery
• green beans
• lettuce
• other salad greens
• peppers
• spinach
• tomatoes
• zucchini

Healthy sources of protein and fat

To avoid carbohydrate-heavy foods, it is important to understand which foods are healthful sources of protein and fat.

Fish, meat, poultry, many cheeses, nuts, oils and fats do not contain enough carbohydrates to be considered when carb counting.

Healthful sources of protein include:

• eggs
• whey protein
• chicken and turkey breast
• fish, including salmon, cod, and rainbow trout
• nuts, such as almonds and peanuts
• tofu and tempeh
• pumpkin seeds

Healthful sources of fat include:

• oils, such as flax, olive, virgin coconut, avocado, and hemp seed
• grass-fed butter
• avocado
• nuts and seeds

Aims of carb counting

Carb counting alone is not a substitute for seeking medical care to make sure that normal or close to normal blood sugar levels are maintained.

Many people with diabetes also need to take insulin or other medications to aid in the process, and should also regularly engage in physical activity.

The goal of carb counting is to keep blood sugar levels steady in order to:

• help those with diabetes stay healthy
• prevent complications
• improve energy levels

How carb counting works

The first step in carb counting is identifying what foods have carbohydrates and how many grams (g) per serving.

Doctors and dietitians may help people with diabetes work out how many carbohydrates they should have each day. This helps them calculate a daily total that they can stick to.

The typical range for carbohydrate intake is between 45 and 65 percent of the total calories taken in per day. After a daily calorie intake is calculated, carbohydrate percentages and servings can be worked out.

Calculating carbs

There is around 4 calories in 1 g of carbohydrate. So, to work out the number of carbohydrates per day, total calorie intake will need to be divided by 4.

Here is an example calculation based on a daily intake of 1,800 calories and 45 percent carbohydrate:

• 0.45 x 1,800 calories = 810 calories
• 810 ÷ 4 = 202.5 g of carbohydrate

Based on this calculation, a person can have approximately 200 g of carbohydrates per day. The next thing to work out is how much carbohydrate there is in a single serving of a particular food item.

When reading nutritional labels, it is important to take note of the total number of carbohydrates per serving so that these totals can be added into the total daily carbohydrate allowance.

For example, there are approximately 15 g of carbohydrate in each serving of the following foods.

A slice of bread and a teaspoon of jam both have approximately 15 grams of carbohydrates.

• 1 slice of bread
• 1/3 a cup of pasta or rice
• 1 small apple
• 1 tablespoon of jelly
• ½ cup of starchy vegetables

According to the figures used above, an individual can have 13.5 servings of these foods each day:

• 202.5 g of total carbs ÷ 15 g per serving = 13.5 servings

However, non-starchy vegetables have just 5 grams of carbohydrate per serving, which means that an individual can eat a lot more of them.

Meal suggestions

Those who are carb counting may find it challenging at first to work out carbohydrate totals in home cooked meals, and when eating out. There are some tips that can help make carb counting a little easier, such as:

• Counting mixed foods by the cup: On average, a woman's fist is the size of a 1-cup serving. For a mixed dish, this is a good way to approximate the carb totals based on cup size.
• Count tablespoons: Knowing how many grams of carbohydrates are in a tablespoon of food is helpful. People can simply count level tablespoons to create a healthful plate.
• Calculate pizza by the crust: If possible, choose a thin-crust pizza. This will save 5-10 g of carbohydrate per serving size compared to a slice of regular or pan pizza.
• Smoothies may not always be the best bet: On average, a 12 oz. smoothie actually has more carbohydrates than a regular soda if it contains juice, so should be consumed in moderation.

Getting started with carb counting

Carb counting may help many people with diabetes to maintain steady blood sugar levels. However, it is only one way to manage diabetes. In order to know how a certain food will affect blood sugar levels, a person must consider the type of carbohydrate the food contains and how much fiber is in it.

Before trying carb counting, people should always speak with a nutritionist, diabetes educator, or doctor to determine:

• whether carb counting is appropriate
• what is the recommended daily allowance for carbohydrates
• what foods are recommended

[cherry]

I would check with my Dr. before assuming you can eat 202 grams of carbs a day. That is a lot for a diabetic. Some might be able to eat that much, others will not

[cherry]

from Web MD

snip

When you have diabetes, it’s important to balance your carbs with your medication. Have too many carbs and not enough medication and your blood sugar can soar. Too few carbs and too much medication and it can crash. Neither is good.

Counting the carbs you eat at each meal or snack can help you balance them with your medications and keep your blood sugar stable.

How Many Carbs Should You Eat in Each Meal?

Half of each meal. The U.S. Department of Agriculture recommends that you get between 45% and 65% of your calories from carbs. You could think of this as half your plate at each meal can be taken up by carbs.

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Carbohydrates in grams. To be more precise, count the carbs. You can see how many grams of carbohydrates are in packaged foods by reading the nutrition facts labels. For non-packaged foods, you can look this information up online.

The Recommended Daily Allowance (RDA) for carbs is 130 grams per day. Per meal this comes to about:

• 60-75 grams of carbohydrates per meal for men
• 45-60 grams per meal for women

Carbohydrate choices. This can help you eyeball the number of carbs you’re going to eat once you know approximately how many carbs are in different foods. Using this method, you have a certain amount of “carb choices” you can have in a meal or snack.

• Men can have 4 to 5 carb choices per meal
• Women can have 3 to 4 carb choices per meal
• Whether you’re a man or woman, snacks should be 1 or 2 carb choices

So what is a "carb choice" or serving of carbs? A carb choice is an amount of food that has about 15 grams of carbs in it.

For example, 1 slice of bread is one carb choice. But 1/4 of a large baked potato is also one carb choice. So having a whole baked potato could blow your whole carb choice budget for one meal.

You can find lists of carb choices for different foods online. You can also ask a nutritionist or diabetes instructor.