Ask Coach Beverly a Question on FaceBook Live – April 1st, 2019 at 12:00 p.m. (PST)

Almost 2000 Facebook Friends (only 40 more to go) – We are getting ready to celebrate.

In celebration of reaching this goal, she is going to have a FaceBook LIVE Q&A Session for 30 minutes on April 1^st (no fooling) from 12:00 p.m. to 12:30 p.m.

We hope you can join us to get your questions answered.

Just type in your question here, and Coach Beverly will do her best to answer your question within the half hour time frame!

But, this can only happen if we reach 2000 followers by April 1^st!

We hope to see you there and invite your friends and colleagues join our community.

With affection,

Coach Beverly and Anne

Some of my favorite people are RDs. I’ve been blessed to team teach with many inspiring, kind, knowledgeable and dynamic dietitians over a span of more than 20 years. They are trailblazers and advocates for improving the health of our communities, in both the inpatient and outpatient settings. They have the best teaching tools (who doesn’t love the rubber chicken, food samples and empty cereal boxes) and a breadth of knowledge that they freely share with patients and colleagues alike.

Dana Armstrong, RD, CDCES (pictured far left) is a leader and an innovator in the field of diabetes, nutrition, and technology. Dana is a nationally recognized speaker, consultant, and the Medical Clinic Director of the Diabetes Center/Salinas Valley Medical Clinic.

I love that Dana pushes boundaries, questions the status quo and is a fierce advocate for people living with diabetes. We love you Dana and appreciate the decades of dedication and service you have contributed to our community.

Meet Dana in person at our Diabetes Educator Course next Month. Dana teaches the Insulin Pump Workshop.
Get the latest information on insulin pumps and continuous glucose monitoring from an expert.  This workshop will answer your questions and provide valuable insights.

Learn more about the Diabetes Educator Course – Sacramento, CA

Six ways you can thank your Registered Dietitian:

1. Send a note letting them know the ways you appreciate them
2. Bring them a treat
3. Give them a hug and thank them for their good work
4. Let providers know how much they contribute to improving the health of people
5. Invite them to lunch
6. Bring them flowers

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According to the National Credentialing Board for Diabetes Educators, (NCBDE) the CDCES® Exam Content Outline will be updated starting July 1^st, 2019.

To celebrate this update, we will be basing our 2019 Questions of the Week on this content outline. (See a snippet of the NCBDE content outline to the left or click on it to see the complete outline.)

The question of the Week – March 12th, 2019

These targeted questions are designed to help assess your knowledge of the topics critical to diabetes educators.

In addition, if you are preparing to take the exam, we strongly encourage you to go through each of these sub-categories and rate your knowledge on a scale of 1-5.  Based on this self-assessment, spend the majority of your study time on the topic areas you are least comfortable with. This approach will help you become familiar with the exam content and to use your limited study time wisely.

Assessment of the Diabetes Continuum – Learning  

For this question in this series, we focus on the Assessment Section, under learning. Here is the question that addresses learning goals and needs of the learner. Good luck!

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The trend of a low-carb or even no-carb diet has been increasing in popularity over the past decade. But have we been accidentally stereotyping our favorite foods? What if we could enjoy our slices of bread and pasta after all?

Many are enticed by the promise of quick weight loss that seems to come with cutting out carbs. However, this can be tricky to stick to long-term. On average, 50% of calories consumed in the adult American diet are from carbohydrates. And the idea of cutting out carbs completely would include the fundamentals of a healthy diet like fruits, vegetables, legumes, and whole grains.

So why do all carbs seem to get a bad reputation?

Dr. David Ludwig, professor of nutrition at the Harvard School of Public Health and the co-director of the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital, sought to better understand and explain the varying types of carbs and how they can affect your health.

Bread and pasta are often demonized, however, it is much more complex than that! “When you eat a whole-kernel, minimally processed grain … they take a while to digest. Blood sugar rises relatively more gently. You produce less insulin calorie for calorie,” Ludwig explains.

“Slow” carbs like whole grains, fruits, vegetables, and legumes, take a while to digest and are often rich in nutrients like fiber, zinc, magnesium and Vitamin E. However, when you eat white bread or another carbohydrate made from refined starch, it can raise your blood sugars sending a signal to your brain to store fat and leave you hungry.

Currently, Americans are likely to lack whole grain consumption and actually exceed the recommended amount of refined grains. Fiber-rich foods, like whole grain bread, leave you feeling full for longer with their fiber, fat, and protein. You don’t have to cut out all carbs, just the highly processed or refined.

To learn more: You Don’t Have To Go No-Carb: Instead, Think Slow Carb – NPR

Today, and every day, we want to celebrate Women Luminaries

After receiving an MBA from Columbia University, she became a business growth driver and an inspiring leader using, data, digital and technology to grow revenues, increase operating income and drive transformation.

Following a thorough national search for a new CEO, the ADA found Ms. Brown to be a talented business leader with deep strategic and operational expertise, as well as significant experience in consumer engagement. At the same time, as an engineer, she is a careful, analytical thinker who values and makes data-driven decisions.

According to Ms, Brown, “All of the skills and experience that I have gained from the for-profit world have been cultivated for such a time as this. My purpose, passion and this position have aligned, and I am honored to be joining an organization as valuable as the ADA. It changes lives for the better.”

We are honored to have Ms. Brown join us as a speaker at the first annual Women Leaders Conference.

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Join us to hear more from luminaries like Tracey Brown

Women Leaders in Diabetes Conference

San Francisco, CA | May 10th, 2019 – Get fired up & Earn 7.5 CEs

Early Bird Registration Fee, Extended until March 15th: $219

The newly popularized diet, Ketogenic diet has been around for almost a century. Originally used for the treatment of epilepsy in the 1920s, this high-fat and low carbohydrate diet is becoming well known for another reason.

“There’s growing research showing that the ketogenic diet is effective for managing blood sugar in people with diabetes,” says William Yancy, MD, program director at the Duke Diet and Fitness Center in Durham, North Carolina.

However, since most studies have been conducted only over a 2-3 year period, there is no way of knowing long-term impact. Regardless, this diet’s popularity is picking up steam.

What exactly is the ketogenic (keto) diet? 

The core of the keto diet is low carbohydrate with extremely high fat content. Here is a macronutrient breakdown:

• Fat – 65 to 80% of daily caloric intake.
• Protein -15 to 25% of daily caloric intake
• Carbs – 5-15% of daily calories (about 20 to 50 gms a day)

How could this work?

Typically the body converts glucose into fuel however with the keto diet you are converting fat into ketones – which results in a state of “ketosis.” Ketosis is a “fat-burning” state and is believed to suppress appetite.

This might sound familiar to Diabetes Educators. Prior to the discovery of insulin, an extremely low-carb and high fat diet was used to manage glucose levels in those with diabetes. This has sparked interest in scientists to research the keto diet today and it’s effects on those with diabetes

What does science say?

Many healthcare professionals are reluctant to recommend fad diets. However, there is substantial research indicating the keto diet helps with weight loss, can reduce the need for medication and in some cases, gets the A1C within target range.

“…those on the keto plan reduced their A1C from 7.6 to 6.3 percent, shed 12 percent of their body weight, eliminated their need for sulfonylurea medication, and lowered or reduced their need for insulin by 94 percent. The results were published in 2018 in the journal Diabetes Therapy.”

If people are able to lower blood sugars by decreasing carb intake, this could reduce the need for diabetes medications. Changing diet can have a huge impact on medication needs and research suggests this may be a benefit of the keto diet for those with Type 2 diabetes.

The Dangers of Keto and A1c Reduction

It is important to consider the short-term safety of those switching to the keto diet, as a swift reduction carbohydrate intake can lead to hypoglycemia. To prevent blood sugar lows, close monitoring and frequent medication down adjustments are required.

Understanding the Drawbacks

Similar to any popular diet strategy, it is important to be aware of “drawbacks” as outlined below:

• Lack of nutrients. Take away whole grains, fruit, beans, and potatoes, and it’s nearly impossible to consume enough potassium for healthy blood pressure or enough fiber to stay regular.
• Cost. The diet may require participants to buy high priced items such as meat and dairy vs. low-cost items such as pasta, rice, bread and potatoes.
• Kidney. It is important to consider kidney health on a protein high diet such as keto. Health professionals need to carefully evaluate those with chronic kidney disease.
• Dehydration. Since the intake of water-binding carbs decreases, it is important to be aware of water consumption through out the day.
• Low carb diet not appropriate for pregnant or lactating women, children, those with renal disease or disordered eating or those taking SGLT2 Inhibitors.

 

Thinking Long-Term

Impact on heart health is the most-cited long term impact. Considering most calories come from fat, cardiovascular disease is a big risk.

“…people who consumed less than 40 percent of their calories from carbohydrates were significantly more likely to die from heart disease than those whose diets contained 50 to 55 percent of calories from carbs—especially if the foods that replaced those carbs were rich in animal fats and proteins.”

One way to avoid heart risk while on the keto diet, is to coach participants to be aware of which types of fats they are consuming. Encourage them to avoid bacon and butter and consume heart-healthy fats such as seeds, nuts, olives and avocados.

Although there is always a hesitation to recommending a popularized diet, the substantial research suggests that if done right, the keto diet can have positive health affects on those with diabetes.

Here is an general approach to the Keto Diet

Eat These

• avocados
• cheese
• full-fat Greek yogurt (small portions)
• chicken and turkey
• fish and shellfish
• pork and beef (small portions)
• nuts and nut butters
• sunflower and pumpkin seeds
• blackberries, strawberries
• low-carb vegetables such as: spinach, kale, and lettuce; broccoli and cauliflower
• unsweetened fortified almond milk
• olive, canola, avocado, and nut oils

Limit These

• milk, bread, pasta, cereal, beans, fruit (other than berries), root vegetables (such as carrots and potatoes), corn, alcohol

To learn more: What You Need to Know About the Ketogenic Diet – Diabetes Forecast 2019

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That’s because I’m used to the status quo, the usual diabetes conferences, and more of the same year in and year out.Then I started thinking about it more. Imagine the synergy of bringing together an amazing group of women leaders in an intimate venue to network and collaborate. How inspiring to dedicate a day to celebrating accomplishments and sparking creativity to improve care. Very quickly, it became clear to me that we need this conference.

Join us to hear the journey’s of amazing women leaders in diabetes, network, get recharged, and leave inspired to consider how you can impact change. There is something exciting that happens when a group of dynamic leaders come together to share best practice and forge new ground. We are thrilled to provide a platform that showcases women’s accomplishments in a way that everyone can learn from and gain fresh ideas. Many talented individuals have shaped and moved the diabetes profession forward. For example, chances are you know about Drs. Banting and Best, but what about Dr. Yalow? In 1977, Rosalyn Yalow, PhD was awarded the Nobel Prize in Physiology and Medicine for her work in measuring insulin in the body. I only recently heard about her work. Who knew it was a woman scientist that made this discovery? Why isn’t this common knowledge? And how can you challenge yourself to improve diabetes care no matter where you practice? No Nobel Prize is required to help one person, then the next.This conference brings together an incredible, not-to-be-missed lineup of experts, who are advancing care. The heads of ADA, CDC, JDRF, and many more women who are gifted in their field of diabetes care will come together to collaborate… with you! And you in turn, will leave the conference with a new energy and a realistic plan for change in hand. I hope you can join us and get inspired. Theresa Garnero, APRN, BC-ADM, MSN, CDCES,Co-Chair, Women Leaders in Diabetes Conference

Happy National Nutrition Month! For this newsletter, we decided to explore some popular nutrition topics discussed on social media and brought into our offices. We give a shout out to our dietitian colleagues and celebrate their unique skill set and abundant knowledge. Finally, the amazing Theresa Garnero shares insights into her motivation to co-chair the first ever “Women Leaders in Diabetes Conference.”

Click here to read our newsletter!