What You Should Know About Intermittent Fasting & Diabetes with Jill Weisenberger

A new study from New Zealand suggests intermittent fasting is good for someone living with Type 2 diabetes. Since then Divabetic’s social media feed is blowing up with story after story about this topic. We reached out to our friend and colleague, Registered Dietitian, Certified Diabetes Educator, Jill Weisenberger MS, RDN, CDE, CHWC, FAND to help us understand what intermittent fasting is and why or why not we might want to include it fasting in our diabetes self-management. Here’s her response:

Q: what is intermittent fasting?

Jill Weisenberger (JW): There are a variety of approaches, but they all put emphasis on restricting eating at certain times. One common version of IF is the 5:2 plan, which means to eat healthfully and normally for 5 days of the week and to restrict eating to just a few hundred calories 2 days per week. Another form of IF is to extend the overnight fast to 12 or even 16 hours.

Q: I’ve read that intermittent fasting can help with weight loss and lowering A1C. Are these outcomes realistic for people with type 2 diabetes?

JW: Some studies do show improvements in weight and blood glucose control and even insulin sensitivity. However, when these IF diets are compared to other dietary strategies for weight loss, the results aren’t so clear that one way is better than another. IF, especially the 5:2 plan, can increase the risk of hypoglycemia in anyone taking a medication that has hypoglycemia as a side effect. There may be populations in which IF is a potentially harmful, such as pregnant women, adolescents and people with eating disorders.

My limited experience with the 5:2 plan suggests that it makes daily exercise very hard.

Q: Can intermittent fasting help people with prediabetes? If so, why? If not, why?

JW: If the person with prediabetes is overweight and if IF leads to weight loss, then yes, IF can help people with prediabetes. There was one study in men with prediabetes who were instructed to eat only during 6 hours of the day and to fast for the other 18. Compared to people eating for 12 hours and fasting for 12 hours, those in the longer fasting group saw improvements in blood pressure, insulin sensitivity and beta-cell responsiveness.

Overall, I think that IF can be a tool for some people. In others, it might not be helpful at all, and in some it can be harmful. I like to discuss it in depth with my patients before they decide to give it a try. If someone wants to restrict the hours of eating, I think it’s important to let this work with the circadian rhythms, so stop eating hours before bed and fast longer during the night. I don’t suggest eating a large dinner and fasting all day.

Intermittent Fasting Calculator

Intermittent Fasting (IF) Calculator helps you cycling between Eating and Fasting: CLICK HERE

Jill Weisenberger’s comprehensive guide, ‘Prediabetes: A Complete Guide: Your Lifestyle Reset to Stop Prediabetes and Other Chronic Illnesses’ will lead you through dozens of concrete steps you can take to reduce the risk of developing type 2 diabetes and other lifestyle-related chronic diseases. Taking an individualized approach to your lifestyle “reset,” this book will allow you to choose your own path to wellness, help you gain a greater sense of wellbeing, boost your confidence in your abilities to maintain a healthful lifestyle, and potentially even help you reverse prediabetes and avoid type 2 diabetes and other chronic illnesses.

Diabetes Late Nite with music from Patti Austin

Jill Weisenberger appears on Divabetic’s Diabetes Late Nite podcast featuring music by Patti Austin. We’re talking to Jill about healthy strategies to help you deal with the “FOOD POLICE”.

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06/24/201906/24/2019

Fibromyalgia & Insulin Resistance

Researchers have noticed that metformin can also address the pain of fibromyalgia, which has provided them with a new clue about this chronic condition reports Medical News.

“We showed that most — if not all — patients with fibromyalgia can be identified by their A1c levels, which reflects average blood sugar levels over the past 2 to 3 months,” said lead researcher, Dr. Pappolla from The University of Texas Medical Branch in Galveston, TX.

When the researchers compared the A1c test results of the people with fibromyalgia with those of age-matched controls, they found that the former group had significantly higher levels of hemoglobin A1c than the latter, indicating a measure of insulin resistance.

“[People with prediabetes] with slightly elevated A1c values carry a higher risk of developing central (brain) pain, a hallmark of fibromyalgia and other chronic pain disorders,” notes Dr. Pappolla, pointing out that this link between insulin resistance and fibromyalgia has been around for a long time.

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What is Fibromyalgia?

Fibromyalgia is a chronic condition that causes abnormal pain all over the body, increased sensitivity to pain, and heightened feelings of fatigue, among other symptoms. According to the Centers for Disease Control and Prevention (CDC), fibromyalgia affects 4 million people in the United States alone, which equates to about 2% of the population

Mr. Divabetic Raises Awareness for Diabetes at the Mermaid Parade

We’re talking about ‘Diabetes & Pride’ on June’s Diabetes Late Nite podcast with musical inspiration from Ricky Martin.

This year marks the 50th anniversary of Stonewall Uprising (June 29, 1969). It is widely considered to be the single most important event leading to the gay liberation movement.

Since Ricky Martin came out in 2010, he’s been a prominent voice for LGBT rights both in the U.S. and in his native Puerto Rico. Ricky Martin said, “I just wanna be free,” upon receiving GLAAD’s Vito Russo Award, which honors gay entertainers who promote equal rights. Martin opened up his life to Vanity Fair in its April 2012 issue and spoke candidly about his twins, Matteo and Valentino, and his longtime partner, Carlos Gonzalez.

As an openly gay man, Mr. Divabetic is proud to shine the spotlight on members from the LGBTQ+ community living with diabetes. Guests include Stephen Bernstein, Greg Rubin, Maria Salazar, Maya James and the Charlie’s Angels of Outreach.

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02/23/201902/23/2019

Carson Daly’s Mother’s Heart Attack Linked to Diabetes

Recently TODAY Show’s co-host Carson Daly shared memories of his mother, who died of a heart attack in September 2017, to help raise awareness about the connection between Type 1 diabetes and cardiovascular disease.

Nearly two-thirds of people with diabetes have high blood pressure, and, according to the American Diabetes Association, people with diabetes are two to four times more likely to die of heart disease or have a stroke than people who don’t have the condition.

The connection between diabetes and heart disease starts with high blood sugar levels according to the Everyday Health website. Over time, the high glucose in the bloodstream can damage the arteries, causing them to become stiff and hard. Fatty material that builds up on the inside of these blood vessels, a condition known as atherosclerosis. This can eventually block blood flow to the heart or brain, leading to heart attack or stroke. Your risk of heart disease with diabetes is further elevated if you also have a family history of cardiovascular disease or stroke.

LOS ANGELES, CA – AUGUST 25: Carson Daly and his mother Pattie Daly Caruso arrive at the 66th Annual Primetime Emmy Awards at Nokia Theatre L.A. Live on August 25, 2014 in Los Angeles, California. (Photo by Axelle/Bauer-Griffin/FilmMagic)

“I never would have guessed that my mom was going to die of a heart attack,” writes Carson Daly. “She had some health issues — nothing in the heart. No symptoms. Never saw it coming. So I find myself this month being hyperaware about women and their health, as it pertains to the heart. Heart disease is the most common cause of death in American women. And I have been directly impacted by that.”

If you believe you are at a higher risk for heart disease, don’t despair. Learning more about the link between heart disease and diabetes can help you take steps to help protect your heart and manage your diabetes.

Start by working with your doctor to keep your blood glucose level within the target range. You can check on your efforts by having A1C tests at least twice a year; these reveal your average blood sugar level for the past three months. A normal A1C level should be below 5.7.

Join us for Clued Inn: Diabetes & Heart Health Escape Rooms! Complete either the 60 second Diabetes Risk Test or the Heart IQ Quiz and register for free for the first-ever Diabetes & Heart Health Escape Room Experience scheduled for National Diabetes Alert Day, Tuesday, March 26, 2019, 5- 10PM in New York City. Sponsored by Boehringer Ingelheim. Space Limited. BOOK NOW

11/27/2018

‘HIV and Diabetes’ on December’s Diabetes Late Nite podcast

We’re excited to announce our December edition of Diabetes Late Nite. Sara (Dr. Mandy) Wilson Reece, PharmD, CDE, BC-ADM is Vice-Chair and Associate Professor in the Department of Pharmacy Practice and will stop by the studio to talk about HIV and Diabetes while Kelly Clarkson provides musical inspiration. Join us here on Tuesday, December 4, 2018 from 6 – 7:30 PM.

Wrapped In Red, Kelly Clarkson’s holiday album, inspires us to talk about all things ‘red’ such as the iconic red ribbon worn as a symbol for the solidarity of people living with HIV/AIDS. People with HIV are more likely to have type 2 diabetes than people without HIV and some HIV medicines may increase blood glucose levels and lead to type 2 diabetes.

World AIDS Day is December 1, a fitting occasion to speak with Dr. Mandy about the link between HIV medications and diabetes prior to our podcast interview.

Q: I’ve read that some HIV medicines may increase blood glucose levels and lead to type 2 diabetes. Can you explain why could happen?

Dr. Mandy Reece: Some HIV medication cause insulin resistance with insulin deficiency which increases risk for Type 2 diabetes. Specifically, nucleoside reverse transcriptase inhibitors (NRTIs) (zidovudine, stavudine and didanosine) and protease inhibitors (indinavir and lopinavir/ritonavir) increase risk for Type 2 diabetes.

Q: Do you feel people taking HIV medicines should check their blood glucose? If so, what do you recommend?

Dr. Mandy Reece: Yes, they should check their blood glucose before they start their medication and then every few months as recommended by the U.S. Department of Health.

According to U.S. Department of Health and Human Services, it is recommended to have either fasting blood glucose or hemoglobin A1c when entering into care for HIV, initiating or modifying antiretrovial therapy and annually if glucose or A1c were in target range at least measurement. Target range is < 5.7% for hemoglobin A1c and <126 mg/dL fasting blood glucose. It is advised to have fasting blood glucose or hemoglobin A1c tested every 3 – 6 months if above target range at last measure.

(Guidelines for Use of Antiretrovial Agents in Adults and Adolescents Living with HIV. U.S. Department of Health and Human Services. https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv/3/tests-for-initial-assessment-and-follow-up. Updated October 25, 2019. Accessed November 18, 2018.

Q:Dealing with two or more chronic conditions could be complicated and time consuming. What medication organizing tips can you recommend to help make life more manageable?

Dr. Mandy Reece: Personally, my favorite tool for organizing medications is a pill box where medication is stored by day and time of day. It is easy to identify visually if medication has been taken. Many pharmacies have medical refill reminder calls which work wonderfully if you get all of your medications from the same pharmacy. Pharmacies can utilize a medication synchronization system which allows for your getting all refills at same time. Additionally, there various apps such as Round Health, Medisafe -Pill & Med Reminder and Pill Reminder – All in One would provide digital reminder system. Services such as PillPack sorts and organizes medication by dose and timing each dose with monthly delivery.

Q: With the holidays quickly approaching what advice can you give to people about managing their medications during this busy time of year?

Dr. Mandy Reece: Taking time to get organized is absolutely key. An easy way to get organized is to using a pill box or service such PillPack to organize your medications, and utilizing reminder system to follow through on taking medications. Ensure that you have at least a 10 day supply of medication on hand at all times is essential. Remember keeping your health a priority hence taking your medication during this busy season is key as it has lasting effects that you will not see or feel in the moment.

Q: Holiday travel can lead to long delays and/or missing luggage. What advice can you give to traveler’s

Dr. Mandy Reece: Always pack all of your medications in your carry bag rather than checked luggage. It is absolutely vital to have your medication available at all times.

Sara (Dr. Mandy) Wilson Reece, PharmD, CDE, CDE, BC-ADM, vice-chair and associate professor in the Department of Pharmacy Practice. ‘Dr. Mandy’ shares practical information about medications for people living with diabetes on her blog, Reece’s Pieces. Follow her on Twitter @ReecesPiecesDi and Instagram ReecesPiecesDI

Don’t miss December’s Diabetes Late Nite podcast featuring music from Kelly Clarkson’s Wrapped In Red album courtesy of SONY Music on Tuesday, December 4, 2018, 6 PM, EST.

Kelly Clarkson’s inspiring us to lend our ‘voice’ to topics such as the link between HIV medications and type 2 diabetes, how the homeless manage diabetes, great gift ideas for loved ones with diabetes, and how you can lose weight during holidays (!). Plus, one lucky listener tries their luck during Mr. Divabetic’s ‘Wrapped In Red’ Health Game challenge. Guests include Poet Lorraine Brooks, Kathy Gold RN, MSN, CDE, FAADE, Glucose Delivery Necklace co-creator Kris Maynard, Dr. Sara (Mandy) Reece, PharmD, CDE, BC=ADM, BCACP, FAADE, Maria Sakowitz, MS, RDN, LDN, CLT, Mama Rose Marie and the Charlie’s Angels of Outreach.

Diabetes Late Nite is a fast-paced, full-filled hour of diabetes education and wellness advice that encourages listeners to “laugh a little, learn a lot.”

03/23/2017

Colorful Headwraps Cover Up Climbing A1C’s Among Haitian Women

Meet the New York Haitian desiger, Paola Mathe who has been praised or making “colorful the new black” as reported by the New York Times.

Ms. Mathe is challenging the way women wear head wraps. “Why not wear a headwrap on the red carpet instead of just to cover your head to run errands?” she told NY Times reporter, Tariro Mzezewa. “It’s this beautiful, powerful accessory that promotes strength and power and culture.

Paolo Mathe is the founder of Fanm Djanm, which means “strong women” in Haitian Creole which could aptly apply to Haitian women living with diabetes who are pro-active about their health.

People living with diabetes of Haitian descent may have a tougher time managing their blood sugars than others, a study published in the journal Diabetes Care.

On average, Haitian patients’ A1C was 8.2 percent, versus 7.7 percent among African American patients, and 7.5 percent among white patients.

The A1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past 3 months.

An A1C level below 5.7 percent is considered normal. An A1C between 5.7 and 6.4 percent signals pre-diabetes. Type 2 diabetes is diagnosed when the A1C is over 6.5 percent. For many people with type 2 diabetes, the goal is to keep their three month blood sugar average (A1C levels) at or below 7 percent.

Moreover, nearly 25 percent of Haitians had an A1C level above 9 percent, which is considered poor blood-sugar management.

The reasons for the discrepancy aren’t clear, according to Dr. Varsha Vimalananda, of Boston Medical Center, and colleagues. Even after researchers accounted for factors like insurance coverage, doctor visits in the past two years and whether patients spoke English, Haitian patients were still found to be much more likely than African Americans and whites to have an A1C level above 9 percent.

This suggests that other factors are at work, according to Vimalananda’s team. One possibility, they write, is the high carbohydrate content of the traditional Haitian diet; another is that culture gaps between doctors and Haitian patients may in some cases hinder communication.

The Haitians had only about one-third of the risk of complications such as heart disease or clogged arteries in the legs. And they were roughly half as likely to have problems such as nerve or kidney damage.

LISTEN NOW: Do you like your diabetes education and empowerment flavored with pop culture? Check out our free monthly Diabetes Late Nite podcasts featuring expert advice, music, fashion, food, games and prizes.

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