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by Meghana Kumar, MD

Sugar Free Assortment, 17.75 oz bag | Russell Stover

You’ve seen the aisles of enticing desserts aimed for people with diabetes in the grocery store – puddings, chocolate bars, cookies. Can you really indulge in these products guilt free?

These sweets tend to be sweetened with artificial sweeteners, like Splenda, Stevia, and aspartame. Artificial sweeteners have been linked with obesity, appetite stimulation, and glucose intolerance as well, though not nearly to the same extend as regular sugar. They can also cause bloating, diarrhea, and abdominal pain, especially when consumed in excess.

Remember that sugar-free doesn’t necessarily mean carbohydrate-free – it often simply means that the product contains no added sugar. In other words, carbohydrates come in more forms than refined white sugar. A sugar-free vanilla pudding (Jello single-serve cup) still has 10 grams of carbs, stemming from the dairy contents. While better than the 25 grams in a regular pudding, it may still impact your blood sugar and certainly is not a license to eat without inhibition. One Voortman’s sugar-free chocolate chip cookie contains 14 grams of carbohydrates (coming from flour), but no added sugars. This distinction is especially important for people who need to count and dose insulin for carbohydrates precisely.

Calorie and saturated fat content often do not differ significantly between sugar-free chocolate and regular desserts. For example, a chocolate bar still has fat and calories from milk and cocoa butter. So keep in mind that, carbs aside, there are usually healthier choices than highly processed sugar-free snacks – fresh fruits, a scoop of cottage cheese, carrot sticks and hummus, etc.

Some people may find moderation with regular desserts to be a more satisfying and equally healthy choice. For instance, 2 pieces of Hershey’s Dark Chocolate Nuggets with almonds have 10 grams of carbs, whereas 3 pieces of Hershey’s sugar-free Special Dark chocolates have 13 grams of carbs. If you can stop yourself at one or two pieces, then the former may be a preferable option.  

In short, don’t just rely on advertising (the people who design food packaging are savvy!) – look at the nutritional labels and make the decision for yourself about whether a food item is a healthy choice or not.

Novo Nordisk is offering a free 90-day supply of insulin to those who have lost health insurance due to the COVID-19 pandemic AND has expanded their patient assistance program for discounted insulin. Ask your endocrinologist for more information to see if you may qualify.

Letal Garber, MS, RD, LD

Diabetes and Covid-19: What you need to know and tips on management

During a time of uncertainty, it’s easy to get stressed or panicked. Our practice stands by our philosophy that knowledge is power; the more informed you are, the better chances of a good outcome. Our goal is to propagate safety and minimize fear during this difficult time.

Here’s what we know about the connection of Covid-19 and Diabetes:

  1. People may be infected with the virus up to two weeks before developing symptoms.
  2. The most common symptoms are fever, fatigue, and cough.
  3. Most people recover from the virus, but the disease can be more dangerous to those who have chronic conditions such as Diabetes.
  4. This is especially true with pre-existing complications secondary to uncontrolled Diabetes, which could mean increased risk of infection and difficulty with healing due to poor circulation.
  5. If Diabetes is well managed, your risk of getting severely sick from Covid-19 is about the same as the general population.

Here’s what you can do to reduce your risk:

  1. General:
    1. Follow government and state guidelines for dealing with Covid-19.
    1. Do your part by staying home, wash hands, avoid touching your face, sneeze in tissues or your elbow, and sanitize commonly used surfaces.
    1. Practice social distancing and minimize contact with others.
      1. Keep your appointments by scheduling virtual visits! We are now offering telemedicine appointments with a simple click of a button. You can join the virtual appointment by clicking on the link sent to you via email or text. For those of you with upcoming appointments, if you don’t hear from us first, give us a call to change the visit to a virtual meeting.
  2. Medication Management:
    1. Make sure you maintain a stockpile of oral medications and/or insulin and keep these properly stored.
    1. Also keep enough inventory of testing supplies (test strips, lancets), ketone strips, alcohol wipes, glucose tablets and/or sugar-containing fluids such as juice for low blood sugars.
    1. You may want to ask for 90-day prescriptions with refills versus the typical 30-day prescription.
    1. Ask your insurance if they contract with mail order pharmacies to reduce need to leave the house.
    1. If you’re having difficulty affording your medication, investigate patient assistance programs and resources such as InsulinHelp.org. If you’re running low on insulin and/or can’t afford insulin, don’t go without it. Wal-Mart has mealtime and 24-hour insulin that doesn’t require a prescription, just ask your provider.
    1. Keep a stock of broth, jello, electrolyte drinks, canned or frozen foods in the event of acute illness.
  3. Lifestyle Management:
    1. Monitor your blood sugars regularly and send in your blood sugar data to your provider for adjustment of your medications.
    1. Aim for 3 balanced meals per day with lean protein such as beans, chicken, fish, nuts/seeds, complex carbs (whole wheat pasta, baked potato, peas), and many vegetables. Stay hydrated with water.
    1. Limit high carb snacks, chips, dessert and beverages and fried foods.
    1. Engage in “joyful movement” most days of the week (30 minutes of moderate activity 5 times per week at minimum). Think about what activities you enjoy: walking, aerobics, biking and stick to it!
    1. Practice self-care in order to manage stress and improve mental health. Be intentional about finding ways to relax whether it’s reading a new book, practicing a new skill, or simply listening to calming music.

We can’t change the fact that this pandemic has impacted the world. What we can change is the extent to which we inform ourselves and make choices that improve our wellbeing. Stay informed, calm, safe, and healthy and we hope to hear from you soon!