MY NEWSLETTER

Fall 2015/Winter 2016

DR EDELMAN’S CORNER Blinded CGM... Give Me A Break

Inside Continuous glucose monitoring (CGM) has been around for a decade and, according to me, it is the single greatest advance for people with type 1 PAGE 3 Smart Patients since the discovery of , which was almost a century ago! For those of you who don’t know about it, CGM allows a person with dia- PAGE 4 Tresiba and Toujeo betes to have a blood sugar reading every five minutes, 24/7, with trend arrows to show which direction the blood sugar is going and sounds an PAGE 6 In Memory: alert for impending highs and dangerous lows. CGM has already improved Joseph F. Kunz the lives of thousands of infants, chil- if the glucose value is extremely high or dren, and adults living with diabetes, as dangerously low. You will not see trend PAGE 7 well as their loved ones. There are two arrows and are unable to see how food, Puracyn CGM devices currently on the market, exercise, stress, and other factors affect the Dexcom G5 and Medtronic Enlite. your diabetes control. The CGM, which PAGE 8 These devices have traditionally been used ends up being a loaner unit, is returned to Eating Better: for folks with type 1 diabetes; however, the clinic or doctor’s office and the data We Need A Plan! they will soon be used to a much greater is downloaded there. When you see that extent by people with type 2 diabetes! HCP again (whenever that will be), you PAGE 9 While it may seem obvious to use go over the results in retrospect, hoping Case of the Month an unblinded CGM, many healthcare to find trends and patterns in order to providers (HCP) use blinded CGM. This make therapeutic decisions in your diabe- PAGE 10 is where the person with diabetes wears tes management. The Game Changer a CGM device for three to five days but I just do not understand the concept cannot see any of the glucose values. around blinding a person with diabetes PAGE 11 Additionally, no alarms will go off even from their results in real-time. Why Eating Well CONTINUED ON PAGE 2 Special Acknowledgements

Board of Directors Steven V. Edelman, MD Founder and Director, TCOYD Sandra Bourdette Co-Founder and Executive Director, TCOYD Edward Beberman Christine Beebe Audrey Finkelstein Margery Perry Daniel Spinazzola Andrew Young

Contributing Authors DR EDELMAN’S CORNER FROM PAGE 1 Tricia Santos Cavaiola, MD Steven V. Edelman, MD would you not want to see your numbers? they do, they are not permanent because Chef Robert Lewis Why would you not want to be alerted to life is not that consistent. Also, I love the Robyn Sembera highs or lows? Why would you not want Hawthorn Effect! If someone changes J. Todd Walker, MD to see the effects of how different types their daily habits for the better by seeing and amounts of food affect your glucose his or her glucose values in real time day TCOYD Team values? Why would you not want to see and night…then they may not need a Steven V. Edelman, MD how exercise affects your diabetes control? new or insulin dose Founder and Director Are our lives so predictable that those adjustment! I could go on and on. Sandra Bourdette three days of blinded CGM represent the If you ask me, there is no role for Co-Founder and Executive Director norm and we never have days where our blinded CGM except for formal clinical Michelle Feinstein, CPA meals and activities are different than usu- research studies that must evaluate the Chief Financial Officer al? Do we really love to prick our fingers a true affect of a medication on a person Jennifer Braidwood zillion times a day? I just do not get it! with diabetes without any confounding Vice Executive Director Do you want to know what the influences. Real time unblinded CGM is Jill Yapo HCPs say who use blinded CGM…none the standard of care for type 1 diabetes Director of Operations of whom have diabetes themselves? They right now and will soon become a valu- Michelle Day say that real-time unblinded CGM is able asset for people with type 2 diabetes Director of Meeting Services more expensive than a short-term blind- as well. I can guarantee you that there is Robyn Sembera ed session. For example, they say that not one HCP who has diabetes and who Manager of Continuing Medical Education “patients” will not know what to do with uses a blinded CGM on him or herself. Sarah Severance the results, and may do ourselves harm by Blinded CGM…Give me a break! Manager of Events and Fundraising overreacting and giving too much insulin. Collin Stephens They say that the technology is “too Manager of Health Fairs and Marketing much” for many folks with diabetes. They MyTCOYD Newsletter refer to the Hawthorne Effect, where Robyn Sembera Editor in Chief if we see the results, we will change our Sarah Severance and Jennifer Braidwood behavior based on the glucose values and Assistant Editors the HCP will not know the isolated effect Leah Roschke Design of adding a new medication or changing the insulin dose. MyTCOYD Newsletter is offered as a paid I strongly disagree with these subscription of Taking Control Of Your Diabetes. thought processes. None of their ar- All material is reviewed by a medical advisory board. guments hold water with me or with The information offered is not intended to constitute medical advice or function as a substitute for the services the majority of HCPs and people with of a personal physician. On the contrary, in all matters diabetes. Everyday is different for a Steven Edelman, MD involving your health, TCOYD urges you to consult person with diabetes, so trends and Founder and Director your caregiver. ©2016 All rights reserved. patterns may not show up and, even if Taking Control Of Your Diabetes

2 MY TCOYD NEWSLETTER, VOL 53 TCOYD IN MOTION Smart Patients THE NEW TCOYD ONLINE COMMUNITY The goal of Smart Patients is to help patients and families learn from each other in a safe, peer-to-peer community. The community isn’t meant to replace in-person learning, but to complement it. As TCOYD conference participants, consider Smart Patients to be an opportunity to continue your conversations after the confer- ence. What did you learn? What new questions do you have? What inspired you to reevaluate your diabetes management? Questions and ideas from the Smart Patients diabetes community can also serve as feedback to TCOYD to make the conferences even better.

We at Smart Patients believe that pa- conversations within our virtual walls. tients are the most underutilized resource We know living with diabetes is not in medicine. The patient experience is easy. Regardless of type, treatment, or I’m still awed often overlooked and we want to change technology, the very nature of diabetes that. By providing a safe place online includes the unfair truth that the only almost daily by for patients to share, interact, and learn consistent thing about diabetes is its from each other, we are helping create a inconsistency. The good news is that we the combination community of patients who can improve know living with diabetes can be a little care for themselves and others. bit easier if you have help. The in-person of knowledge and The stories we share will strengthen opportunities provided by TCOYD are a bonds among community members by fantastic example of the power of peer- providing support and understanding. to-peer support. Smart Patients provides kindess that is By helping people affected by diabetes a chance for those moments of support to discuss emotions, treatments, news, and extend beyond each TCOYD conference shared here. more, Smart Patients can foster lasting and create a new dynamic for interactions A SMART PATIENT relationships. One thing we continually within the diabetes community. hear from Smart Patients members is that When you’re ready, we invite you to their initial fears are alleviated almost join the Smart Patients diabetes communi- immediately after participating in the ty. Visit www.smartpatients.com/diabetes.

Fit2Me Support Program Helps Patients Manage Type 2 Diabetes

t’s not too late to kick start your 2016 Unlike some diet, exercise, and from digital coaches who resolutions for proactive diabetes diabetes trackers that record past activity, can help users through the I management and Fit2Me™ can help. Fit2Me focuses on establishing healthy process of improving their Since each person with type 2 diabetes habits in planning for the future, instead health and fitness while is unique, this interactive resource from of just tracking calories consumed and celebrating successes along AstraZeneca offers the tools to navigate burned. This free online program focuses the way. your personal journey with the condition on four key areas of diabetes management With more than 10,000 while helping to establish easy-to-main- – food, activity, treatment information, diabetes-friendly recipes CONTINUED ON PAGE 12 tain healthy habits. and support – and offers encouragement

TAKING CONTROL OF YOUR DIABETES 3 ASK YOUR PHARMACIST Toujeo and Tresiba BY TRICIA SANTOS CAVAIOLA, MD

Did you know that insulin has been around since the 1920’s? Although insulin sometimes gets a bad rap, to this day, it is still one of the best medications we have to treat diabetes. Despite the fact that insulin has been around for so long, the current insulin medications are not perfect. However, two new were approved in 2015, Toujeo and Tresiba, which may offer some advantages.

Basal Insulin Each of these new medications is a basal insulin, which is necessary in all patients with type 1 diabetes and some pa- tients with type 2 diabetes. The main purpose of basal insu- lin is to control glucose levels in the “fasting state”, which is overnight and in between meals. Therefore, the ideal basal insulin should have a steady effect throughout the day and night. Basal insulin should also last a full 24 hours in every patient. You wouldn’t want your basal insulin to run out before your next dose is due! Both Toujeo and Tresiba are longer-acting basal insulins compared to the other available long-acting insulins, which do not last 24 hours in every patient. Toujeo and Tresiba will allow for more flexibility in the timing of the dose and they also appear to be more “steady” throughout the 24 hours with fewer peaks and valleys. Let’s look at each of them in a little more detail.

Toujeo® ( U-300) Insulin Toujeo is not actually “new.” It simply is three times more concentrated than insulin glargine (Lantus), so you can inject a smaller volume of insulin to get the same effect. Most of the insulin available today comes in a U-100 concentration, including Lantus (glargine U-100). This means there are 100 units in 1 milliliter of fluid. Toujeo is more concentrated with 300 units in 1 milliliter of fluid. It is therefore called glargine U-300. Why is this import- ant? It turns out that the volume of insulin injected can change the way the insulin works. For patients with type 2 diabetes on large doses of insulin (over ~200 units a day), the lower volume in the concentrated Toujeo works better. Some clinical trials comparing Lantus (glargine U-100) and Toujeo (glargine U-300) showed fewer ups and downs, less hypoglycemia and less weight gain in patients taking Toujeo. Toujeo was FDA approved in 2015 and is currently

available for use. CONTINUED ON NEXT PAGE

4 MY TCOYD NEWSLETTER, VOL 53 ARTICLE PROVIDED BY LIFESCAN, INC

Tresiba® () ® Tresiba, a new , has been on the Get a OneTouch Verio Meter market in Europe since 2013. Tresiba comes in a traditional U-100 concentration and a at no charge! more concentrated U-200 formulation. In clinical trials, Tresiba was associated with ® decreased hypoglycemia (especially at night.) Meet the OneTouch Verio Meter. In most studies, weight gain was similar when comparing Tresiba with Lantus. A flexible Helps you better understand your dosing schedule can be used in patients on results, without any extra work. Tresiba, which also lasts more than 24 hours, and in the new FlexTouch pen, one can re- Ask your doctor for a prescription ceive a dose of up to 160 units at a time (it is for OneTouch Verio® test strips not uncommon for some users with type 2 to use that much basal insulin). What this means and bring this coupon to your is that you don’t have to take your dose at the pharmacy to receive your same time every day. For example, you could OneTouch Verio® meter at take your dose Sunday morning at 7:00am, and then again at 11:00am on Monday. no charge! Tresiba also comes in a 70/30 premixed formulation called Ryzodeg, with 70 percent insulin degludec and 30 percent and is often used with the largest meal of the Attention Pharmacist: day in people with type 2 diabetes. Tresiba Please submit this claim to Patient Choice®. You will then receive your is also being studied in combination with reimbursement plus a dispensing fee. For any questions regarding on- Victoza, a GLP-1 receptor agonist. Victoza line processing, please call the Help Desk at 1-800-422-5604. No claim is another injectable medication approved for can be submitted for reimbursement to Medicare, Medicaid, or any the treatment of type 2 diabetes. This com- other payer for the OneTouch® Meter received from this offer. This card bination medication would come as a single is good for one fill only and cannot be combined with other offers. daily injection in a prefilled pen. Tresiba was Patient may not receive a duplicate meter. Limit one meter per patient. FDA approved in 2015 and is expected to hit Offer good while supplies last. Void where prohibited by law. Please re- shelves in early 2016. move identification number from patient profile after claim has been Are these new insulins easy to use processed. This offer from LifeScan, Inc is available to all patients and and right for you? may be redeemed wherever OneTouch Products are sold. Offer only Toujeo and Tresiba offer exciting new treat- valid for legal residents of the United States. Void where prohibited or ment options for patients using basal insulin. restricted by law. Available while supplies last. Limit one per patient. Both medications are approved for use in Qualifying conditions may apply.© LifeScan, Inc. LFS-15-5112B 10/15 type 1 and type 2 diabetes. They both come in prefilled pens; the Toujeo SoloStar pen and the Tresiba FlexTouch pen. These medica- To redeem for a OneTouch Verio ® meter tions may have some benefits over traditional Bin 004682 basal insulin including less hypoglycemia, less RxPCN CN weight gain, and more stable, long-lasting Group ID# LVARV472 effects beyond 24 hours. Lastly, flexible dosing offers a new opportunity in basal insulin ID# NOCHARGEMETR use. This is an exciting time for new insulin formulations and more are on the way in the CARD EXPIRES 03/31/16 future! © 2015 LifeScan, Inc.

TAKING CONTROL OF YOUR DIABETES 5 GIVING BACK In Memory of Joseph F. Kunz Leaving a Legacy with TCOYD BY ROBYN SEMBERA

oseph Kunz, deemed the, “Diabetic youngest granddaughter Oliviah, who of TCOYD. Guru Dad,” was a long-time also has type 1 diabetes. Joseph and Ol- Joseph had requested that in lieu of JTCOYD conference goer, a type 1 iviah spent a lot of time together having flowers for his memorial service, dona- diabetic for 45 years, friend and patient fun, but also comparing CGM numbers, tions be made to TCOYD. Everyone at of Dr. Edelman’s. Joseph ended his battle blood sugars, counting carbohydrates, TCOYD would like to reach out and with cancer on October 31, 2015 and will sharing the same day-to-day struggles, offer a very warm thank you to The Kunz be greatly missed by Dr. Edelman and the same fears, and the same hopes for a and Ali families for generously setting up the entire TCOYD staff. Even though cure. the “In Memory of ” donation fund for he resided in Phoenix, AZ, Joseph would Joseph’s regular attendance at the Joseph Kunz. We greatly appreciate the make a monthly trip to see Dr. Edelman San Diego TCOYD conferences with a donations and, more importantly, appreci- at the San Diego VA clinic. few members of his beautiful family— ate the friendship we were able to gain Joseph will be remembered for wife Marie, daughter Ashley, son-in-law from Joseph and his family. many wonderful qualities including his Hany, and granddaughter Oliviah— P.S. Oliviah was also featured in the bright spirit, positive attitude, the light always left a sense of love and warmth Spring 2015 edition of the my TCOYD he brought into his friends and families in all of our hearts. Joseph was always so newsletter, so check her out, lives, and for a very special bond with his grateful, positive, and an active supporter she’s quite a cutie!

If you would like to donate to TCOYD in honor of Joseph, please email [email protected] with “Joseph Kunz” in the subject.

MEET THE TCOYD BOARD MEMBER SERIES WILL CONTINUE IN THE NEXT EDITION!

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6 MY TCOYD NEWSLETTER, VOL 53 PRODUCT THEATER Prepare to Get Back to Freedom

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The First Step for Your Next Step. The Power of Preparation Utilizing an advanced hypochlorous at Your Fingertips technology in an over-the-counter Directions for Use formula, Puracyn® Plus is wound care • Apply Puracyn® Plus directly to your for whatever life hands you. From minor wounds, burns, scrapes, or cuts to flush wounds and sores to minor burns and away dirt and debris lacerations, Puracyn® Plus is easy to • Continue application until the wound use and works with your body’s natural is thoroughly cleaned healing mechanisms to get you back • If a dressing or bandage is used, on the path to doing what you love. saturate it with Puracyn® Plus and Clear the Way for apply directly over wound Optimal Healing Conditions • Flush the wound with Puracyn® Plus The healing process typically begins in and apply a freshly moistened dressing the inner tissue layers and expands to as needed. the surface layer of the skin. In normal Puracyn® Plus is intended for the wound healing, cleansing and irrigation management of minor skin wounds are critical steps needed to minimize the including minor lacerations, minor risk of complications (such as infection). abrasions, minor irritations, minor Irrigating a wound helps to remove dirt cuts, minor burns, and intact skin, in and debris while avoiding trauma to addition to moistening and lubricating the wound bed and minimizes the risk absorbent wound dressings. of complications that might affect the wound and the healing process. Puracyn® Plus is as Safe as it is Effective • Non-toxic and non-irritating • Contains no steroids or antibiotics • Contains no alcohol or iodine • Won’t harm healthy tissue • Environmentally friendly— no special disposal required

Puracyn® Plus is wound care for life. Visit www.puracynplus.com to learn more.

TAKING CONTROL OF YOUR DIABETES 7 TAKING CONTROL

Eating Better: Why planning ahead We Need a Plan! makes all the difference CHEF ROBERT LEWIS THE HAPPY DIABETIC & d LIFE COLUMNIST ARTICLE PROVIDED BY d LIFE Just think...starting next week, you can come home from work feeling excited to cook and eat the amazing meals you have taken a little time to prepare. By planning ahead, you will provide healthy meals for yourself and your family… and hallelujah! You won’t have to stress about what the heck you should fix for dinner!

Anyone can become a great meal planner. Your old way is to plan tonight’s 5:30 dinner at 4:45, which means you might resign to road tripping to your favorite fast food joint. Trust me, I know the feeling. You come home from work tired and lacking the energy and enthusiasm to plan, shop for, and cook a healthy and happy meal. At some point however, we have to stand our culinary ground and come to terms with the fact that, to take responsibility, we need to plan in advance. Meals that happen when we roll the dice for dinner usually prioritize convenience and end up being more expensive and less healthy. Menu planning can be a simple process, so let me show you how. In learning to eat healthily, I have discov- ered how to turn ordinary ingredients into something extraordinary. Here are three simple Happy Diabetic meal-planning tips. Ready, set, go!

#1 – Plan to cook and eat at home often.

OK…I admit it. I like to eat out, too. But, having worked for most of my career in restaurants, I can tell you that you should only trust yourself and your mama to prioritize good health. Restaurants are becoming better at paying attention to nutritional information, and that is good, but pleasing your pallet and handling your credit card are undeniably still the primary focus

8 MY TCOYD NEWSLETTER, VOL 53 of a restaurateur. You have to be a little defensive when CASE OF THE MONTH

GASTROPARESIS AND THE G5 it comes to eating in a restaurant. Be #3 - Prep meals and ingredients aware that portion sizes are completely ahead of time. CLARITY APP whacked-out. When the restaurant com- Another reason meal plans fall apart BY STEVEN V. EDELMAN, MD mercials on TV feature the grilled shrimp is because real life crowds the time swimming in butter and the all-beef fried Steve is a 60 year old male with type 1 needed to prepare those meals we want taco smothered in cheddar cheese, you diabetes for 45 years. He also has gas- to eat. I like to take some time on need to shake yourself from the trance troparesis and it is not uncommon for the weekend, when I have a few extra and say, “That meal is not for me!” You him to go to bed with a very good blood minutes, to prep some of my meals can make food at home that is delicious sugar level (140 to 180mg/dl), but then and snacks for the week. For example, and far more responsible! Healthy plan- his CGM ‘high alert’ will go off several I like to buy 3-5 lbs. of chicken breasts ning and eating belongs to only you, and hours later with his values in the mid at a time – a far greater quantity than as you further develop your skills in the 200’s. Since he has the Dexcom G5, the I need for one meal, but which elimi- kitchen you won’t even miss those high Clarity phone application will not only nates multiple trips to the grocery store. caloric restaurant meals! show a summary of his numbers but I’ll marinate, season, and bake or grill will also give an estimated A1c value. As the lot. After they cool, I’ll slice and #2 – Write down your meal plans. you can see, his download via the cloud bag them, 4-8 oz. per freezer baggy. shows that he does have a pattern of For me a Sunday day off works best. I Now I’ve got portioned cooked chicken nighttime highs and his estimated A1c is turn off the TV for ½ hour and grab my ready to go. For what, you ask? Chicken 7.4%. It turns out that this calculation of iPad and/or a piece of paper and a pencil. soup, chicken tacos, chicken enchila- the estimated A1c is extremely accurate I put on some of my favorite music, das, Mediterranean Chicken of Love as it is based on thousands of numbers assemble my favorite cookbooks and web (a favorite recipe in my Cook Fresh, throughout the day and night. The Clarity sites, and go to work! I think about my Live Happy cookbook!), a broccoli and download also shows Steve’s best day, week ahead, my work schedule, and the mushroom chicken bake, chicken chili, which is kind of a cool way to give kudos people that I will share meals with. For chicken salad with avocado, chicken to folks, like Steve, who are really trying example, I am meeting friends on Tues- fajitas, Olive and Garlic Chicken of to get their numbers in range. day evening, so I know on that night I Love… you get the idea. Even the will need to cook a simple meal as I won’t littlest bit of food preparation can put So...what can Steve do to correct his have much time. Or, maybe I can cook a you ahead of the cooking curve, and nighttime highs? little extra on Monday to have leftovers if/when that unexpected glitch in the 1) Try not to eat late. Anyone living with to eat on Tuesday. Let’s see…what fresh schedule occurs at meal time, you will gastroparesis should eat as early as pos- produce do I already have on hand? I be SO pleased that you worked ahead. take a quick inventory of my staples and Good job, me! the spices in the pantry. Then, with the I hope you’ve found these tips and steps artistry of Picasso, I start to visualize inspiring and helpful on your journey colorful plates and write down the list of to healthy and convenient cooking at ingredients I will gather on my shopping home – Bon Appetit! trip. Remember: If it isn’t written down it doesn’t exist. Make time for planning ahead! With the artistry of Picasso, I start to visualize colorful plates and write down the list of ingredients I will gather on my shopping trip. Remember: If it isn’t written down it doesn’t CONTINUED ON PAGE 12 exist. Make time for planning ahead!

TAKING CONTROL OF YOUR DIABETES 9 LIVING WELL

The Game Changer BY J. TODD WALKER, MD Back in my glory days as a football player at Texas Tech University we referred to a “game changer” as a play that changed the course and outcome of a game. With nearly 150 plays each game – one or two game changing plays are able to make a tremendous impact. One game changing play I will never forget was the game winning touchdown pass against the number one ranked team in the country, The University of Texas Longhorns, as time expired. That was a game changer.

t the age of 26, not too long after cose monitor gave me 480 readings every finishing up my football career, day without having to prick my finger. It DIABETES GAME CHANGERS A I was diagnosed with type 1 told me if my sugars were rising or falling. diabetes. At that time I had no idea how It also allowed me to get back to being tough this opponent was going to be. physically active like I used to be and gave Continuous As a strong football player who had been me that sense of control back in my life. The in difficult games and overcame numer- insulin pump eliminated the need to give glucose monitor ous injuries, I felt invincible. I was also injections, allowed me to feel socially com- a 4th year medical student on my way fortable giving myself insulin, and greatly to becoming an orthopaedic surgeon. I increased flexibility with meals and exercise. 1 remember thinking there was nothing The inhalable insulin gave me the added that could take me down or defeat me! benefit of super fast acting insulin and peace Insulin pump My endocrinologist put me on insulin of mind knowing it would be out of my and I was ready to celebrate another vic- system within an hour. tory. I thought I was winning the game Although these three game changing components have had a hugely positive 2 and stayed on the same regimen for the next two years. As time passed, however, impact on my diabetes management, I have Fast-acting I began to realize I wasn’t winning my a long way to go and I know it’s going to inhalable battle. I was slowly losing the game with take a lot of practice to get to the top of my insulin increasing feelings of not being in control diabetes game. But, never have I felt more of my body, my sugars, or my new feel- in control and empowered to face any oppo- ings of anxiety. I was an elite athlete, now nent than I do now with my game changers. 3 physician, who could not control my own I’m taking control of my diabetes. body or workout with the intensity or en- durance I used to have, and it profoundly affected me. My opponent was outplaying me both physically and mentally. I felt helpless and was in desperate need of that “game changer.” Shortly after moving to San Diego, a friend and colleague of mine, Dr. Porter, told me about the charming Dr. Steven Edelman who introduced me to three game changers; a continuous glucose monitor, an insulin pump, and fast acting inhalable insulin. The continuous glu-

10 MY TCOYD NEWSLETTER, VOL 53 EATING WELL

Pork Tenderloin with Apple-Onion Chutney FROM

Servings 2 1. Trim fat from pork. Cut meat in half crosswise. Place each piece, cut side (4-ounce pork and down, between two pieces of plastic wrap. Pound lightly with the flat side of 1⁄2 cup chutney each) a meat mallet to 1⁄2-inch thickness. Remove plastic wrap. Sprinkle meat with carb. per serving 24 g the thyme and pepper. START TO FINISH 30 minutes 2. Lightly coat an unheated large nonstick skillet with nonstick cooking spray. Add pork. Cook over medium-high heat for 6 to 9 minutes or until done 1 8-ounce piece pork tenderloin (145°F), turning once. Transfer pork to a plate. Cover; keep warm. 1⁄8 teaspoon dried thyme, crushed 3. For chutney, in the same skillet cook onion about 4 minutes or until tender, 1⁄8 to 1⁄4 teaspoon black pepper stirring occasionally. Stir in apple slices, the water, vinegar, honey, salt, and 3⁄4 cup thinly sliced onion cumin (if desired). Bring to a boil; reduce heat. Simmer, uncovered, for 8 ounces apples, cored and sliced 4 to 5 minutes or until the liquid is almost evaporated and the apples are ten- 1⁄4 cup water der, stirring occasionally. Return pork to skillet; heat through. Divide pork and 2 tablespoons cider vinegar chutney between two serving plates. 1 teaspoon honey Per serving: 219 cal., 2 g total fat (1 g sat. fat), 73 mg chol., 344 mg sodium, 24 g carb. 1⁄4 teaspoon salt (4 g fiber, 17 g sugars), 25 g pro. Exchanges: 1 vegetable, 1 fruit, 3 lean meat. 1⁄8 teaspoon ground cumin (optional) For more great recipes, visit DiabeticLivingOnline.com

Diabetic Living, © Meredith Corporation. All rights reserved. Used with permission.

TAKING CONTROL OF YOUR DIABETES 11 Nonprofit Org US Postage Mark Your Calendar P A I D San Diego CA Join Us in a City Near You Permit no 1 2016 Conference & Health Fair Schedule education. motivation. empowerment. February 20 Anchorage, Alaksa 1110 Camino Del Mar Suite B March 5 Sacramento, California Del Mar CA 92014 April 16 Memphis, Tennessee April 30 Honolulu, Hawaii May 21 Washington, DC June 18 San Antonio, Texas August 27 Native American Corning, California October 1 San Diego, California November 19 Orlando, Florida

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FIT2ME PROGRAM FROM PAGE 3 CASE OF THE MONTH FROM PAGE 9 Fit2Me encourages people to reach based on criteria from the American Di- their personal health goals through in- sible so that when bedtime comes around abetes Association, Fit2Me allows people teractive games, team challenges, and re- most of the food in the stomach as been to choose their favorite ingredients, wards. It provides treatment and appoint- pushed out into the small intestine for cuisines, and fitness activities to build a ment reminders, A1C and blood sugar absorption into the blood stream. customized lifestyle plan. For example, trackers, and a personalized treatment 2) Try not to stuff himself at the dinner if a Fit2Me member doesn’t like mush- kit that includes information about type table. When the stomach is rooms or red meat, Fit2Me will omit any 2 diabetes and treatment options from stretched with a lot of volume, it con- recipes with those ingredients from his or AstraZeneca. Fit2Me also offers access tracts even more than usual, so food just her plan. Fit2Me also offers 500 physical to external health resources like type 2 sits in the stomach for a longer period of activities and focused exercises, most with diabetes-trained nurses, certified diabetes time. The food in the stomach doesn’t get instructional videos. Digital coaches can educators, and assistance verifying insur- absorbed, and won’t contribute to raising help patients create a personal activity ance coverage. blood glucose levels until it leaves the program, no matter what their activity Visit Fit2Me.com to learn more or stomach. level may be. to register today for free to create your 3) If he is on a pump, he should use customized type 2 diabetes lifestyle plan. the square wave or dual wave bolus feature, which basically stretches out the Fit2Me encourages people premeal dose of insulin over an extended peri- to reach their personal health od of time (30 to 90 minutes) versus all at once. 4) Consider taking a medication to help his goals through interactive stomach have better contractions. games, team challenges, and 5) Check out the TCOYD book for an excel- rewards. Visit Fit2Me.com to lent chapter on how diabetes can affect the learn more and register. stomach.

12 MY TCOYD NEWSLETTER, VOL 53