A panel of experts found that what children drink has a big impact on overall health and development.

Kids should drink breast milk, infant formula, water and milk in early childhood – and limit their fruit juice as much as possible.

Although the type of milk varies (breast milk, skim, infant formula, etc.) the experts agree most of what children need from 0-5 years is just milk and water.

Experts recommend no more than half a cup of juice a day (whole fruit is preferred) for children between 1-5 years old, and no juice for children under 12 months.

The recommendations, released Wednesday, broke down what children through age five should drink by age:

• 0-6 Months: Breast milk or infant formula.
• 6-12 Months: Breast milk or infant formula; small amounts of plain drinking water introduced once solid foods become part of diet.
• 12-24 Months: Whole milk and plain drinking water.
• 2-5 Years: Skim or low-fat milk and plain drinking water.

These evidence-based recommendations were crafted after careful review of existing domestic and international policy statements by experts from the Academy of Nutrition and Dietetics, the America Academy of Pediatrics, the American Academy of Pediatric Dentistry, and the American Heart Association.

Read more recommendations and panelist discussion in the full news story on U.S. News.

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Canagliflozin (Invokana), an SGLT-2 Inhibitor, just received a new Food and Drug Administration (FDA) indication.

Adults with type 2 diabetes and diabetes kidney disease who take canagliflozin (Invokana) experience a reduction of:

• end-stage renal disease
• worsening kidney function
• cardiovascular death
• hospitalization for heart failure
  

This new indication is based on the results of the CREDENCE Trial, which was designed to see if canagliflozin had a renal vascular protective effect.

The trial enrolled over 4, 400 people with type 2 diabetes and GFRs between 30 and 90. The results clearly indicated several benefits.

Researchers observed a 32% risk reduction of end stage renal disease among patients who took canagliflozin (HR = 0.68), as well as a 28% risk reduction for starting dialysis, having a kidney transplant or experiencing renal death.

In a sub-group of the CREDENCE Trial, cardiovascular death for type 2 diabetes dropped by over 30% and in the CANVAS Study, there was a 33% drop in risk of hospitalization for heart failure.

Please see Oral Meds Pocketcard for side effects and precautions of canagliflozin and SGLT-2 Medications. In the most recent ADA Standards, two SGLT-2 Inhibitors, empagliflozin and canagliflozin are indicated for individuals with heart failure, chronic kidney disease and an elevated CV risk profile.

The use of these SGLT-2 Inhibitors offer hope and a new strategy to protect renal function and decrease heart disease risk in those living with diabetes.

For more information see this Helio Article on the new FDA indication for Canagliflozin.

Please see our GLP-1 Receptor Agonists and Injectibles Pocketcard for new oral GLP-1 tablet.

Get Your Updated PocketCards Here!

Download FREE Medication PocketCards on our website.

Purchase PocketCards – Updated physical PocketCards will ship out no later than October 18, 2019.

Download our FREE CDCES Coach App

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The Journal of General Internal Medicine recently surveyed nearly 300 physicians, and the findings were alarming.

Their research suggests approximately 25% of all physicians misdiagnose people who have diabetes with prediabetes instead.

Additionally, the average provider didn’t know 33% of the risk factors for prediabetes, were unfamiliar with prevention or management of the condition, and generally under-screened for it.

Only 42% of the physicians knew the correct fasting A1c to diagnose prediabetes.

Researchers from John Hopkins University recommend providing physicians with better knowledge on diabetes prevention and for insurance to cover plans that help better diagnose and treat prediabetes.

The hope is these two strategies will help with more accurate screening and earlier intervention to avoid development and progression of type 2 which can lead to kidney failure, heart disease, or stroke. Read the full study and statistics here.

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October Newsletter Now Available!

Our October Newsletter is brimming with medication updates! From Oral GLP-1 to Semaglutide and pre-filled Glucagon, we’re keeping you up to date AND updating our PocketCards. Did you know you can hire Coach Beverly to come speak in your hometown? Read this month’s Newsletter to find out how to request her time. 

October News Topics Include:

• Oral GLP-1: Easier to Stomach than Injectables?
• Canagliflozin Slows Kidney Disease and Protects the Heart
• Diabetes & Breast Cancer
• 25% Off Live Webinars
• Updated DiaBingo
• 7 Strategies to Survive Halloween

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Happy Mindful Monday! Today we’re offering a new perspective by showcasing dishes around the world. This comes from the New York Times after they interviewed 18 families around the world to see what their typical weeknight dinner is:

In Bangkok, Thailand:

Omelet with carrots, stir-fried minced pork and eggplant, and Thai sour curry with cauliflower is a common meal. Family members are expected to clean up after themselves and help cook at least one night a week.

In Gurgaon, India:

The Osan family eats around 9 p.m., normally with palak paneer (spinach with cheese), raita, kadai aloo (potatoes with onions and spices), cucumber salad and roasted chapatis.

In Rome, Italy:

The mother normally cooks for the rest of her family, and an easy weeknight meal includes saltimbocca (veal rolled with ham and sage), homemade pesto with trofie pasta, and baked tomatoes au gratin.

In Riyadh, Saudi Arabia:

The Khojandi family eats a mix of prepared and homemade foods during the weeknight. This includes smashed beans, shakshuka (eggs poached in a tomato and green pepper stew with onions and garlic), and masoob (a mix of banana, bread, dates, cream, and honey.

In Port-au-Prince, Haiti:

Many Haitian families take their main meal at midday. The Charles’ family prepares avocado, white rice, sos pwa nwa (black bean puree), beef and blue crabs marinated in orange and lime, and lalo (boiled jute leaves and chopped spinach).

In Rehovot, Israel:

The Levy family eats Yemeni soup, chicken schnitzel, chraime (white fish in tangy and spicy tomato sauce with smoked paprika and cilantro), with challah (bread) and rice.

In Paris, France:

In Paris, roasted chicken and couscous were part of an early dinner for the Devouges. Their meal ended with various cheeses (Petit Suisse, Comte, and Emmental).

In KwaZulu-Natal, South Africa:

Chakalaka (relish made with fried peppers, grated carrots, and baked beans) is a South African favorite. Ujeqe (steamed bread) and braised oxtail is a common weeknight meal.

In Western Australia:

The Opie family eats pan-fried nannygai (red snapper), broccolini, and sweet potato fries for dinnr. Their children get extra fruits and vegetables like strawberries, raspberries, snow peas, and carrots.

In Amsterdam, Netherlands:

The Henkets eat a dinner of salmon with basmati rice and broccoli and a dessert of homemade custard with fresh raspberries and berry jam.

In Lagos, Nigeria:

In Lagos, their meal revolves around the sauces. With plantain flatbreads and chicken suya, condiments include peanut butter sauce, papaya chutney, hibiscus green chile sauce, mint and spring onion oil, tamarind ginger sauc, and beet and carrot sauerkraut.

In Monterrey, Mexico:

Huevos revueltos (scrambled eggs with chorizo and onions, served with flour tortillas) is a staple, even for dinner.

In Moscow, Russia:

Liza prepares dinner for her husband and six children. While she cooks, the children and her husband are in charge of setting the table. Kotleti (beef patties with bread, egg, and onion), rice, green salad, and an eggplant, red pepper, basil salad make for a perfect weeknight meal.

In Tokyo, Japan:

Fish, rice, and miso soup are a classic Japanese meal. Yasuko cooks for her adult son a few nights a week, with mebaru (rockfish) being on the menu that night. Fresh fruit serves as dessert.

In Istanbul, Turkey:

Kofte (meatballs), lentil soup, bulgur pilaf with tomato and bell pepper, dolmas (stuffed grape leaves) and red beans in olive oil make up the Terzi family dinner. A rice pudding called sutlac with tahini and walnuts is for dessert.

In Sao Paulo, Brazil:

In Brazil, the mom cooks the meal of picadinho (beef, potato and carrot stew) with rice and salad, while the dad sets the table. The children are expected to clean up afterward.

Read full descriptions and see in-home photography from the New York Times report!

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A new study published in Nature Medicine shows just an extra kilogram of visceral fat can raise a woman’s risk of type 2 diabetes by more than seven times, compared to men, whose risk goes up by two times. This visceral fat also associated with more heart attacks, high blood pressure, and hyperlipidemia.

Research on 325,000 people in the UK Biobank cohort revealed more than 200 distinct genes influencing visceral fat, many of which are tied to how much or little a person eats or exercises.

Findings in this study were based on a simple method of estimating an individual’s amount of deep belly fat, which can be replicated in most clinics, rather than relying on the more advanced and costly diagnostic imaging techniques.

Although the gender implications of the study are interesting, a great accomplishment of the study is simplifying measurements of visceral fat to make it easier to identify people at higher risk of developing diabetes or cardiovascular disease. Read fully study results here.

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Happy Pharmacist Appreciation Day! Today is extra special since Coach Beverly fell in love with and married a Pharmacist, Kristapor Thomassian, PharmD, BCPS, over 20 years ago. He works as a critical care specialist in a local hospital and is also on the Board of Directors at Diabetes Education Services.

Pharmacists help reduce A1c 1% or greater.

We want to take today as a chance to highlight some fantastic findings from a study published in the Diabetes Spectrum on what happens when pharmacists are involved in the diabetes care and education process:

“Pharmacists are well positioned to provide comprehensive diabetes services, including basic education and counseling.”

Lisa T Meade, Rebecca C. Tart, and Hillary L. Buzby; Diabetes Spectrum 2018, Feb. 31 (1): 90-95.

With general practitioners’ limited appointment time, pharmacists are uniquely positioned to help improve diabetes education. Pharmacists’ combination of medication expertise and ability to monitor and evaluate lab results, allows them to make informed recommendations for therapies to treat hypertension, dyslipidemia, cardiovascular disease, and microvascular complications – all often seen in advanced diabetes.

In a study reviewing rural clinics in Northern California, pharmacist intervention with diabetes education resulted in an A1c reduction of 1% or greater!

Pharmacists play a vital role in the inter-professional health care team, particularly with the increasing number and complexity of medications for diabetes. Read the full study published in Diabetes Spectrum here and thank the pharmacists on your team today!

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As lifestyle coaches and diabetes specialists, we all know how important regular activity is to improve well-being, glucose levels, and overall health. Yet, keeping engaged in an ongoing activity is one of the biggest challenges most people face.

Soul line dancing might just offer an unexpected solution.

Soul line dancing – like country line dancing – is really just choreographed dance moves that you do in a group, without a partner. “It’s a sneaky way to get exercise in”

Andrea powell – soul dancing devotee

This activity offers the benefit of connecting with friends, learning a sequence of moves (that is great for brain function) and having fun. It’s an efficient way to improve cardiovascular health and keep fit.

Soul line dancing is held in local churches, gyms, community recreation and senior centers. “There is such enjoyment and that is part of music and part of rhythm, and is almost innate in humans,” say Terri Lipman, a professor in the School of Nursing at the University of Pennsylvania. Lipman is collecting data on the impact of soul dancing programs and says that the data shows that soul line dancing counts as moderate exercise.

Since soul line dancing is an exercise that is both fun and social, it creates a habit that is more likely to last for the long run!

Read more here from NPR Story: Soul Line Dancing: Come For The Fitness. Stay For The Friendships

And, if you want to learn the World Diabetes Day Flash Mob, here are the steps and a video. Just in time for National Diabetes Month in November.

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