Each month our clients receive a nutrition education handout in addition to their meal. The goal of these handouts is to improve your nutrition knowledge and empower you to make the best dietary choices for yourself. It's important for everyone to have healthy eating habits and make sure they havet he correct dietary facts about essential nutrients. The information clients received this month is included below.

Click here for a handout in both English and Spanish.

Diabetes and You.  A quick reference guide to diabetes.

August 2020 Educational Handout
By Marycela Barron, RD, LD
There are two types of diabetes. Both types need to monitor and control their BG to lessen the inflammation in the body. Uncontrolled diabetes decreases the body's abiIity to heal wounds and build new tissue which is why it is important to check for wound frequently. 
Type 1 diabetes (TlDM) is an autoimmune disease where the body attacks itself with antibodies made against the person's own tissue. The antibodies target the beta cells of the pancreas where insulin is secreted. Insulin is needed for muscle cells to absorb BG and produce energy for life-sustaining functions. Without this source of energy the cells enter into starvation mode. People with Tl DM need insulin to survive.
Type 2 diabetes, T2DM, occurs when there is a long period of insulin resistance. The pancreas continues to produce insulin but its effectiveness is decreased. T2DM can be control led with Iifestyle changes, medications,  or a combination of both. 1.5  million people will be diagnosed with diabetes this year. That is the about the same amount of people who were living in San Antonio in 2018 according to the US Census Bureau!
Diabetes is a non-curable disease that is characterized (defined) by hyperglycemia­ elevated (high) levels of blood glucose (BG), or sugar that comes from the food you eat.
Monitoring your BG is important because it can help your doctor determine if your treatment is working and helps prevent hypoglycemia, or low BG. The body usually reacts by releasing the hormone glucagon to communicate to the liver to release glucose from its stores. However, sometimes people with Tl DM loose the abiIity to secrete glucagon in response to hypoglycemia.
Signs and symptoms to monitor for are excess thirst, sweat, and hunger. You can monitor for acanthosis nigracans (AC). This is when there is skin discoloration and texture changes often seen on the neck. This can be confused with poor hygiene but this happens due to insuIin resistance causing skin to reproduce rapidly. Another complication  includes the dawn effect where there is a sudden rise in blood glucose levels in the early morning.
Uncontrolled diabetes can lead to complications such as gastroparesis when there is damage to the nerves and muscles controlling the emptying of the stomach. You may also experience neuropathy, or the numbing and tingling of extremities caused by nerve damage. A scary event that can happen is diabetic ketoacidosis which happens when the body begins to use ketones as a source of energy and requires hospitalization to correct.
A good measure of the effectiveness of your diabetes care is following your A1c which is taken every 3-6 months and measures the amount of sugar covering the red blood cells. A good goal for adults over age 65 is an A1c less than 7.5%.
Marycela Barron, RD, LD
Reference: The American Diabetes Associations and the National Institute of Diabetes and Digestive and Kidney Disease.

Como Diabetes y Usted. Una guía sobre el diabetes. 

Augusto 2020. Por Marycela Barron, RD, LD.
Hay dos tipos de diabetes y ambos necesitan que la persona controle el nivel de glucosa sanguínea para disminuir la inflamacion en el cuerpo. La diabetes descontrolada baja la capacidad del cuerpo para sanar heridas y construir nuevo muslo y es par esto que la gente con diabetes debe de chequear con frecuencia  par nuevas heridas.
La diabetes tipo 1 es una enfermedad autoinmune en el que el cuerpo ataca a si mismo y destruye las celulas beta del  pancreas. El pancreas para de producir insulina que las muslos necesitan para absorber glucosa que usan para producir 
energía. Sin esta fuente de energfa el cuerpo empieza a estropearse. La gente con la diabetes tipo 1 necesitan  insulina para sobrevivir.
La diabetes tipo 2 es el resultado de la resistencia contra la insulina. El pancreas sigue produciendo  la insulina pero el cuerpo no la puede usar. La diabete: tipo 2 se puede manejar con cambios de estilo de vida, medicamento, o las dos.
1.5 millones de personas seran diagnosticadas condiabetes este afio. Esto es el mismo numero de personas que vivieron en San Antonio en 2018 segun la Oficina del Censo de EE. UU.!
Manteniendose al tanto de las nieveles de su glucosa sanguínea ayuda a su doctor tomar de cuenta que bien o mal esta trabajando sus terapias y ayuda a no tener hipoglicemia. Hipoglicemia  causa  que el  hfgado  saque el hormono glucag6n. Este hormono sube el nivel de glucosa sanguínea, pero a veces la gente con diabetes tipo 1 pierde esta funcion regulatoria.
Los síntomas de la diabetes son la sed, el sudor, y hambre. La apariencia de acantosis pigmentaria puede indicar que hay resistencia a la insulina en el cuerpo. La piel se mira mas oscura y se siente mas gruesa y aparece con frecuencia en el cuello. Los cambios no son por no banarse pero por los altos nieveles de insulina que causan la piel que crezca rapidamente. Altos nieveles de glucosa sanguínea por la manana es otro síntomas de diabetes.
La diabetes descontrolada puede causar gastroparesia cuando hay dano al los nervios y muslos que controlan el estomago. El dano a los nervios tambien puede causar neuropatía que causa sensaciones de dolor, punzadas, y piquetes. Una de las consecuencias mas fuertes es el ketoacidosis diabetico causada por falta de insuIina y el cuerpo convierte grasa a cetonas para usar como fuente de energía y mantener la tejida muscular. Esto se tiene que manejar en el hospital y puede causar la muerte.
El A1c se mide cada 3 a 6 meses y mide cuanta azucar cubre los celulos rojos. La meta para adultos mayor de 65 es un A1c menos de 7.5%.
Marycela Barron, RD, LD
Reference: The American Diabetes Associations and the National Institute of Diabetes and Digestive and Kidney Disease.

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