Diabetes Self-Management – September 2019

DIABETES

Q UIZ Answers

1. C. It’s natural to feel a little stressed out with managing your diabetes.
   However, feeling so emotionally overwhelmed that you find yourself feel-
   ing guilty, stressed out, or in denial or overreacting to the circumstances
   of your condition may be symptoms of diabetes distress, according to
   a 2017 study in Diabetes Therapy. And the condition is surprisingly
   common. In fact, the Centers for Disease Control and Prevention report
   that 33-50% of people who have diabetes experience some form of
   diabetes distress within an 18-month period. If you’re experiencing any
   of these symptoms or feel something isn’t quite right, please make an
   appointment to discuss your symptoms with your doctor.


2. A & B. Both depression and schizophrenia are considered inde-
   pendent risk factors for developing diabetes, according to a 2011
   review article published in the Indian Journal of Endocrinology and
   Metabolism. Similarly, diabetes can also increase your risk of developing
   psychological issues such as delirium and substance abuse problems.
   Studies have shown that people who have both diabetes and a mental
   health disorder tend to have more health problems than people who
   have just one of these conditions. It’s also important to understand
   that some medications used to treat depression and schizophrenia can
   cause weight gain, and some medication used to treat schizophrenia
   can also raise blood sugar. Since both circumstances can increase your
   risk for diabetes, consider asking your doctor about how to manage
   your individual risks if you have either of these conditions.


3. B. Getting stressed out occasionally probably won’t hurt you
   long-term, but staying stressed out can elevate your blood sugar.
   (It can also alter stress hormones, although it may not necessarily
   lower them). Your best bet? Find healthy ways to manage your stress,
   such as exercising, practicing relaxation techniques such as yoga and
   meditation, or performing breathing exercises. For more information,
   visit DiabetesSelfManagement.com.


4. False. Adolescents who have diabetes are more likely to experi-
   ence stress than their peers who do not have the condition. A 2018
   study published in Diabetes Research and Clinical Practice found that
   adolescents who have type 1 diabetes must deal with the same stresses
   most teenagers encounter as well as diabetes-related stress. However,
   young adults hailing from lower-income families seemed to feel more
   stressed than those growing up in higher-income households.


5. D. You already know from previous quiz questions that chronic
   stress can raise your blood sugar. However, the way you respond to
   and manage your stress, called sense of coherence, also plays a role.
   A 2019 study in Diabetes & Metabolic Syndrome: Clinical Research and
   Reviews found that the combination of always being stressed out and
   responding poorly to the stress, or having a low sense of coherence,
   increased the risk for developing diabetes. †

Frieda Wiley, PharmD, RPh, is a Texas-based clinical pharmacist and

contract writer.

NEWS &

NOTES

LOW-CARB BREAKFAST FOR

DIABETES CONTROL

By Joseph Gustaitis

C

utting carbs at breakfast might help people with type 2

diabetes (T2D) control their blood sugar throughout

the entire day, according to a new study published in the

American Journal of Clinical Nutrition.

According to study co-author Jonathan Little, PhD,

breakfast is a “problem meal” because the biggest blood

sugar rises experienced by people with type 2 diabetes

occur after breakfast: “The large blood sugar spike that

follows breakfast is due to the combination of pronounced

insulin resistance in the morning in people with T2D and

because typical Western breakfast foods—cereal, oatmeal,

toast and fruit—are high in carbohydrates.”

For their study, the researchers, who were from the

School of Health and Exercise Science at the University of

British Columbia Okanagan, recruited 23 participants with

type 2 diabetes (average age, 59) for a two-day experiment.

On the first day, the subjects were given a breakfast very low

in carbohydrates. On the

second day, their break-

fast was much higher

in carbs, which contrib-

uted 55% of the energy

(30% came from fat and

15% from protein). On

both days, lunch and

dinner were the same.

The blood sugar levels

of the participants were

measured continuously

by a glucose monitor,

and they were asked to

report feelings of hunger

and cravings for sweet or

savory foods.

The researchers dis-

covered that eating a

low-carb, high-protein

breakfast didn’t just

lower the usual after-

breakfast blood sugar

spike; it eliminated it. The effect also lasted the entire

24-hour day. As Dr. Little described it, “We expected that

limiting carbohydrates to less than 10% at breakfast would

help prevent the spike after this meal, but we were a bit

surprised that this had enough of an effect and that the

overall glucose control and stability were improved.” The

second positive finding was that the low-carb breakfast

reduced cravings for sweets for the rest of the day while

also curbing pre-meal hunger. † Shu

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12 September/October 2019