Goodbye Coronavirus Blues!

gardening

COVID-19 knocked our lives for a loop, didn’t it?

Has your life turned sideways this spring? Ours did.

We’re all facing a grab bag of fears right now. There’s little purpose to listing those fears, since they constantly run through our minds. Let’s focus instead on the other thing we have in common—prediabetes.

Prediabetes isn’t high on that list we’re not mentioning, but it’s in that bag somewhere.

For the most part, the problem is our eating habits have taken a turn toward the unhealthy.

We used to shop regularly for fresh foods and add in canned goods as needed. We rarely brought home processed or prepared foods.

Now, like everyone else, we’re eating a lot of processed and frozen prepared foods. Plus, the carbs are just everywhere.

This weekend, it finally began to feel like we’re getting accustomed to this (hopefully temporary) new life.

Let’s support each other as we begin to make choices that steer us back toward healthy living.

If you’re older and/or have underlying conditions, reach out to a younger or healthier family member or friend and arrange for fresh food to be delivered twice a week. If you have no one to do this for you and can’t afford a frequent delivery charge, then let’s talk about other choices.

Cookies and pies and plates of spaghetti all mean comfort food for many of us, but it’s time to turn away.

We don’t want to get through the age of coronavirus to find we’ve moved from prediabetes to type 2 diabetes. Wouldn’t that be a rotten outcome!

Let’s make a pact to set aside those foods that make our blood sugar spike, and instead focus more on canned or frozen veggies, and chicken, eggs, pork, or whatever proteins we have around.

There’s another choice we can make: exercise.

Those of us with dogs can walk them. A lot.

Does the lawn need tending? We can pull weeds, dig up dead plants, rake out moss, mow the grass, and clean up the weed whacker for a go at cutting down the parts the mower can’t reach.

Plant a garden. Let’s break up the ground and map out a fresh food repository.

Let’s dust off the elliptical machine and use it, or simply get down on the floor and start stretching.

None of us should do anything new that we haven’t run by our healthcare professional. We can email their office to check on an activity, then enjoy.

We’re all in the same place. Let’s help each other get safely to the other side of this pandemic.

Looking For Carbs On Nutrition Labels

Do you want to reverse your prediabetes diagnosis?

Tracking how many carbs we consume each day is a part of getting back to normal blood sugar levels.

To count carbs in packaged foods, we have to read nutrition labels, which is boring and necessary.

For foods that are not packaged, such as single apples at the store or elephant ears at Saturday market, we find the carb count with apps or websites or books.

In this post, we’re focusing on how to find the carb count in packaged foods.

Nutrition labels are on most food packaging. Scanning the label, we’re looking for total number of servings in a container, serving size, and carb count per individual serving.

nutrition label

On our sample label we find:

Total number of servings – 8

Individual serving size – 2/3 cup

Carb count per serving – 37g

Sugars and fiber are already included on the label’s total carb count. However, for our purposes, we subtract the fiber because our bodies don’t digest it.

For us, the total carb count is 37g – 4g (fiber count) = 33g carbs per serving.

Remember that the nutritional info on the label is for an individual serving, not for all of the food in the container.

If we eat two servings, we need to increase our carb count. So, if we eat 1 1/3 cups of whatever this is, our carb count would be 66g, not 33g. 33g x 2 servings = 66g.

If we eat only half of one serving, then divide the carb count in half. In this case, carbs for 1/2 of one serving (33g) would be 16.5g.

One of the problems with this “serving size” concept is that a serving size can vary depending on the food and the manufacturer. This is why we have to read every label.

Now we know how to use a nutrition label to accurately count carbs.

It will be a hassle at first. But, once you get in the habit, it does become easier and you’ll find yourself doing it without much thought.

But do it you must, so start counting!

Rare Causes of Prediabetes

Everybody knows what causes prediabetes. It’s eating too many carbs, right? Those donuts and cookies pack on the inches and can lead to a sugary downfall.

That’s true for some, but what about the people with prediabetes who are moderate in their diet choices, or don’t have an obvious trigger? How do they end up in the mess with the rest of us?

The answer could lie in a few directions:

Monogenic diabetes (or prediabetes) makes up less than 5 percent of all reported cases of diabetes.[i]

Humans have approximately 20,500 genes.[ii] Genes are a small part of our DNA that determine things like our hair color and eye color.

Type 1 and type 2 diabetes are the result of several genes changing or mutating – they’re polygenic. In the case of monogenic diabetes, only one gene has changed or mutated.

If it’s the right one, a single mutated gene is enough to make it difficult for some bodies to create the necessary amount of insulin or to create well-functioning insulin. If the insulin can’t control the blood sugar, this can lead to prediabetes or even full-blown diabetes.

Monogenic diabetes presents itself primarily as neonatal diabetes mellitus (NDM) or maturity-onset diabetes of the young (MODY).[iii]

NDM usually occurs in babies under six months of age, although it has been diagnosed in older babies. It may be temporary, or it may be a lifelong battle.

MODY occurs in older children and even young adults. It might never move beyond a prediabetic stage, or it might be quite severe, depending on which gene has mutated.[iv]

Because such cases are rare, they’re not always properly diagnosed.[v]

If you have been diagnosed with type 1 or 2 diabetes, but you’re not ticking all the typical boxes for that diagnosis, ask your provider if genetic testing would be appropriate. Proper diagnosis of diabetes is important to find the most effective treatment options.

Schizophrenia and other severe mental illnesses may be linked to the development of prediabetes/type 2 diabetes.[vi]

The connection may be genetic, or lifestyle choices, lack of medical care, antipsychotic medication, or a host of other factors.

Medications, both prescription and over-the-counter (OTC), may be responsible for your prediabetes.[vii] A chat with the healthcare professional who prescribed your medication as well as the pharmacist who filled it, or who sold you the OTC drug, is worth your time. It could be that a different medication will provide the same benefit but not elevate your blood sugar.

Latent autoimmune diabetes in adults (LADA)[viii] is sometimes called type 1.5 diabetes, because it has characteristics of both type 1 and type 2 diabetes. Some scientists believe it’s a subtype of type 1 diabetes, while others believe it’s a stand-alone type. Because it comes on later in life, it tends to get misdiagnosed as type 2 diabetes.

Those living with LADA find that their pancreas stops producing enough insulin and eventually, months or even years after diagnosis, regular insulin shots are required.

Gestational diabetes mellitus (GDM) develops during pregnancy and generally goes away after delivery. It acts the same way in our bodies as prediabetes[ix], and puts those affected at high risk of developing full-blown diabetes at some point in life.

There are other forms or types of diabetes, including brittle diabetes, cystic fibrosis-related diabetes, chronic pancreatitis-associated diabetes, and Wolfram syndrome.

They have complicated relationships with type 1 or type 2 diabetes, or diabetes is only one of many symptoms characteristic of these conditions.

Does knowing what’s causing your prediabetes matter? Yes. If they know exactly what’s causing your prediabetes, or diabetes, your healthcare professionals have a better chance of figuring out the best treatment for you. Even if that treatment is to knock off the donut bingeing and get on a treadmill once a day.

Your primary healthcare provider has to know a lot about a lot, but it’s not easy staying on top of the details of every ailment. If you are diagnosed as prediabetic, it’s worth your time to visit a specialist in diabetic care, such as an endocrinologist.

Find out if the root cause is too many donuts, or something else. If it’s something else, the specialist will be able to determine what that something else is, and figure out the most effective treatment options for you.


[i] NIH/National Institute of Diabetes and Digestive and Kidney Diseases, Monogenic Diabetes (Neonatal Diabetes Mellitus & MODY)https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/monogenic-neonatal-mellitus-mody, (March 20, 2019).

[ii] NIH/National Human Genome Research Institute, An Overview of the Human Genome Projecthttps://www.genome.gov/12011238/an-overview-of-the-human-genome-project/,  (March 20, 2019).

[iii] https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/monogenic-neonatal-mellitus-mody.

[iv] Hormone Health Network, Monogenic Diabeteshttps://www.hormone.org/diseases-and-conditions/diabetes/types-of-diabetes/monogenic-diabetes, (March 20, 2019).

[v] The Baltimore Sun, University of Maryland School of Medicine researchers are studying a rare form of diabeteshttps://www.baltimoresun.com/health/bs-hs-monogenic-diabetes-20151203-story.html, (March 20, 2019).

[vi] Wiley Online Library, World Psychiatry Official Journal of the World Psychiatric Association (WPS), Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta-analysishttps://onlinelibrary.wiley.com/doi/full/10.1002/wps.20309, (March 20, 2019).

[vii] Diabetes In Control, 390 Drugs That Can Affect Blood Glucose Levelshttp://www.diabetesincontrol.com/drugs-that-can-affect-blood-glucose-levels/, (March 20, 2019).

[viii] American Diabetes Association, Diabetes Spectrum, Recognizing and Appropriately Treating Latent Autoimmune Diabetes in Adultshttp://spectrum.diabetesjournals.org/content/29/4/249, (March 26, 2019).

[ix] Thomas A. Buchanan, MD, email to author, March 27, 2019.