Insulin Basics

  • There are different types of insulin depending on how quickly they work, when they peak, and how long they last.
  • Insulin is available in different strengths; the most common is U-100.
  • All insulin available in the United States is manufactured in a laboratory, but animal insulin can still be imported for personal use.

Inside the pancreas, the hormone insulin is made in the beta cells, which are part of the Islets of Langerhans. These islets also have alpha cells, which make glucagon, as well as delta cells. With each meal, beta cells release insulin to help the body use or store the blood sugar it gets from food.

In the beta cells, insulin is created first as a big molecule called “proinsulin.” Proinsulin is broken into two pieces: insulin and C-peptide. C-peptide is important especially when determining treatment because it can be used to measure how much insulin a person is making. The more C-peptide a person has, the more insulin they are making. This can help a provider determine how much insulin to prescribe.

In people with type 1 diabetes, the pancreas no longer makes insulin. The beta cells have been destroyed and they need insulin shots to use glucose from meals.

People with type 2 diabetes make insulin, but their bodies don’t respond well to it. Some people with type 2 diabetes need diabetes pills or insulin shots to help their bodies use glucose for energy.

Insulin cannot be taken as a pill because it would be broken down during digestion just like the protein in food. It must be injected into the fat under your skin for it to get into your blood. In some rare cases insulin can lead to an allergic reaction at the injection site. Talk to your doctor if you believe you may be experiencing a reaction.

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Influence of cinnamon on glycemic control

A recent randomized clinical trial published in July in the Journal of Endocrine Society found that 500mg #cinnamon supplementation (300mg cinnamon extract + 200mg Cinnamomum burmannii powder), 3x per day, for 12 weeks improved glucose control in a small sample of adults with pre-diabetes. From a similar baseline of fasting plasma glucose (FPG), FPG rose after 12 weeks with placebo but remained stable with cinnamon supplementation, leading to a statistically significant mean between-group difference of 5 mg/dL.

Cinnamon supplementation was also found to improve glucose tolerance and safely tolerated by study participants.

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#RCT

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How an RDN can help with Diabetes

Diabetes affects the body’s ability to make or properly use insulin. This leads to high blood glucose (sugar) in the blood. Maintaining a healthy blood sugar level is key to managing diabetes. Choosing nutritious foods and watching portion sizes can help you control blood sugar levels. And, a registered dietitian nutritionist, or RDN, can help you learn how to get the nutrients you need.

What Is Medical Nutrition Therapy?

RDNs treat diabetes with medical nutrition therapy, called MNT. MNT includes a nutrition diagnosis as well as therapeutic and counseling services to help you manage diabetes. Many insurance plans cover these services. Medicare Part B covers MNT for diabetes and kidney disease. If you have private insurance, check with your individual plan for specific coverage details. An RDN who meets certain requirements can provide these services.

An RDN can discuss a variety of nutrition approaches to help you manage diabetes. For example, carbohydrate counting, simplified meal plans, healthy food choices, exchange lists and behavior strategies. One study found that three to six months after MNT, HgA1c was reduced. Plus, research shows that meeting regularly with an RDN helps manage weight, improves cholesterol levels, decreases the need for medicines and reduces risk for other diseases.

Why a Registered Dietitian Nutritionist?

RDNs are the food and nutrition experts. They have completed multiple levels of training established by the Accreditation Council for Education in Nutrition and Dietetics. Some RDNs are generalists — they have knowledge about a variety of nutrition subjects. Others have a specialty interest or an advanced credential. An RDN who is a Certified Diabetes Educator, or CDE, educates people with diabetes on how to manage their condition and improve their health outcomes.

How Do RDNs Help?

An RDN figures out what therapy is best for you and works with you on short- and long-term plans. People with diabetes need to understand how foods and nutrition affect their bodies to successfully manage the disease. RDNs provide detailed information about how to eat and practical tips for addressing daily challenges. A dietitian can put together a daily meal plan that considers your individual food preferences, level of physical activity and lifestyle choices.

What Should I Expect?

The length of a visit with an RDN may vary. Learning to manage diabetes is complicated so you may need four to five visits across three to six months. Also, yearly follow-ups are recommended. At these visits you learn new information about diabetes and nutrition.

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Can you eat fruit if you have diabetes?

Fragrant, fuzzy peaches. Juicy watermelon. Tart berries. There’s nothing like fresh-picked fruits available at a farmers market or produce stand near you.

If you have diabetes, you might be a little wary of nature’s candy. “But don’t be scared of fruit,” says dietitian Kim Pierce, RD.

Here are 10 things to know about making fruit part of a diabetes-friendly diet.

Fruit is healthy

Yes, it’s a carbohydrate. And yes, the body processes carbs into sugars. But you need healthy carbs to fuel your brain and red blood cells, Pierce says.

Plus, fruit is packed with vitamins, minerals, fiber and antioxidants. “Fruit contains nutrients that can lower your risk of cancer and heart disease,” she adds. “You should eat some every day.”

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Survey reveals how hypoglycemia is referred to, treated in real world

People with diabetes reported identifying and treating “low” and “hypo” at relatively high blood glucose levels, and that symptoms of hypoglycemia changed over time, according to survey results.

“Compared to published hypoglycemia categories, people living with diabetes who responded to our survey reported they treat, feel and worry about hypoglycemia at higher levels, and they don’t use the same terminology to describe or talk about hypoglycemia,” Jane K. Dickinson, RN, PhD, CDCES, program director and lecturer at Teachers College Columbia University, told Healio.

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Folate Supplementation Linked To Reduced Risk Of Diabetes

Recent research has reported that proper dietary Intake of folate in young adulthood to be inversely associated with diabetes incidence in midlife among Americans. Researchers have published the findings in Diabetes Care. A recommendation supported by the American Diabetes Association is for women with preexisting diabetes to consume 400 micrograms of folic acid daily if they are capable of becoming pregnant, and to increase their consumption to 600 micrograms of folic acid daily if they are pregnant or planning to become pregnant.

Previous studies have shown homocysteine is associated with a higher risk of diabetes. Folate, which reduces homocysteine, is promising for the prevention and treatment of diabetes. Jie Zhu et al, associated with the Nutrition and Foods Program, Texas State University, had carried out a study to prospectively examine intakes of folate, vitamin B6, and vitamin B12 concerning diabetes incidence in a large U.S. cohort.

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Carbs are bad…

A diabetes educator clarifies information and myths about carbohydrates. Here are her 3 steps to managing your carb intake. 

So, you have recently been diagnosed with diabetes. Somehow, everyone becomes an expert and begins telling you that carbohydrates (carbs) are the devil and that they ‘should be avoided’. At least that is what you think you heard.

I am here to clarify some information, dispel some myths and, hopefully, make your life with diabetes a bit easier.

Human physiology has not changed in 10,000 years or so. The food we eat whether we hunt for it, forage, buy, or prepare it, is digested into molecules your body needs for fuel. The primary fuel your body produces is (drumroll….) GLUCOSE. There is nothing wrong with this. It’s our fuel and it’s how we roll. The brain and central nervous system utilize glucose without the requirement of insulin to make it available. The rest of the body burns glucose too but needs insulin present to let it into the cells.

We are very efficient mammals. We can create glucose out of ANY kind of macronutrient; protein, fat, carbs. Carbohydrates convert to glucose with 90-100% efficiency because this is what they are supposed to do. Therefore, carbs (sugars, starches, fibers) can affect blood glucose values fast and furious. Remember, protein and fat CAN convert to glucose as well but it is not their primary functions. When they do have to convert, it is a slow, inefficient process and not without potential consequences.

Carbs are not the devil. Some of the highest nutrient dense superfoods are complex carbs that grow on earth.

Here are 3 steps to managing your carb intake for optimal energy and blood sugar management.

Identify 

We have to speak the same language. What kind of foods count as carbs? Anything that comes from a grain (barley, rye, oats, wheat, spelt, quinoa), all fruit, milk, yogurt, desserts (even if it is sugar-free, it does NOT mean carb-free), beans, legumes and starchy vegetables such as peas, potatoes, corn and winter squash.

ALL of these foods can fit into a healthy meal plan. Look at your plate and identify your carb sources. Point them out, “yep, yep, nope”. Just identify.

Quantify

This is where most people get lost. 4 quarters equals $1.00, right? A standard serving of a carb source has a carb count. A serving is not a portion. Please re-read that. For example: 1/3 cup of rice has about 15g of carb. One scoop of rice on your plate may very well be 4 times that quantity. Therefore, your rice may be 60g, not the 15g in the carb apps or books. Know your quantities and do the math!

Quality

Better quality means more complex carbs that digest slower and keep you fuller, longer. The hack here comes down to intact, unadulterated fiber content, ie. carbs that grow on Earth (beans, legumes, vegetables and fruits with peels if possible, whole grains). The higher the natural fiber, the lower the glycemic effect because the fiber slows down digestion and absorption. You will still need to quantify so watch the portions.

So before you decide that carbs are the devil, remember to make sure you know what to count as carbs, be accountable for the amount you are actually eating and choose the highest quality you can afford. Those 3 simple steps will always get you back on track when the nutrition messages begin to blur.

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