Kovler Dietitian Encourages You to "Get Your Plate in Shape"

Registered Dietitians play a vital role in educating the public about healthy nutrition. With alarming rises of obesity and diabetes in our country, our role is as important as ever. National Nutrition Month is dedicated to spreading our message to help people make more informed nutrition choices and develop better habits to lead healthier lives. This year the theme is “Get Your Plate In Shape.” Below are some tips on how we get our plate in shape and improve our nutrition.

1. Make ½ of your meal vegetables.
Vegetables are low in calories and are packed with fiber, vitamins and minerals. The fiber in vegetables will fill you up faster so that you won’t need as much of the higher calorie foods at your meal. Remember not to add a lot of oil, butter, margarine, or dressings to these veggies as those calories can add up quickly. Add more veggies to soups, pasta sauces and sandwiches. Frozen vegetables are just as good as fresh vegetables, so have these available in your freezer for convenience if you can’t make it to the grocery store.

2. Skip the juice.
The calories in juice can add up fast. Eight ounces of juice contains 50% more calories than if you ate the whole fruit. Eating the whole fruit is far more satisfying since the fiber and water content help to make you feel full. The whole fruit also does not spike the blood sugar as fast as juice.

3. Don’t fall victim to portion distortion.
Trade in your current plates, bowls and cups for smaller ones. A lot of us eat with our eyes…not our stomachs! Portions at restaurants can be HUGE – at least double, if not triple, the portion we should be eating. Consider asking your server for a take-home container to arrive at the same time your meal does. Before you taste your food, divide up half of it and put it the container. This way you have controlled your portions better and also have another meal for the next day. Or, order one entrée to split between you and the person you are dining with.

I’ll continue to share some easy tips throughout the rest of National Nutrition Month, and you can also visit our website for more information.  And I’d like to know…what are some of your tricks for staying healthy?

Julia Socke, RD, LDN, CDE
Registered Dietitian, Certified Diabetes Educator and Outreach Coordinator
The Kovler Diabetes Center

Kovler Welcomes a New Team Member, Recognizes Dietitian Day

Julia Socke, Registered Dietitian and Certified Diabetes Educator at the Kovler Diabetes Center

It gives me great pleasure to introduce the newest member of the Kovler team, Ms. Julia Socke, RD, LDN, CDE…a registered dietitian and certified diabetes educator. It only makes sense to make this introduction on what is also National Nutrition Month AND Registered Dietitian Day, “commemorating the dedication of RDs as advocates for advancing the nutritional status of Americans and people around the world!”

Throughout her career, Julia has worked with patients of all ages with various dietary needs. Her areas of focus include diabetes, adult and pediatric weight management and community nutrition.

“The Kovler Diabetes Center is one of the most well-respected diabetes centers in the Chicagoland area. I feel honored to be a part of such an amazing center. In the short time I’ve been at Kovler, I’ve witnessed firsthand the exceptional teamwork between our physicians, nurses, MAs, coordinators, and Certifed Diabetes Educators that makes Kovler the special place it is, ” said Julia.

As a member of our team, Julia will act as both a diabetes educator and the outreach coordinator, supporting Kovler’s satellite clinics and working with both children and adults to effectively manage their diabetes. Additionally, she will participate in various nutrition and diabetes lectures and events and is a member of both the Chicago Dietetic Association and the Academy of Nutrition and Dietetics.

Julia also enjoys spending as much time as possible with friends and family.  And as a former athlete, she stays active in organized volleyball leagues and loves trying new restaurants around Chicagoland.

You’ll be hearing from Julia throughout National Nutrition Month and beyond, as she’s an incredible resource for the diabetes community and for our patients.  On behalf of the entire Kovler crew, we welcome Julia to our team!

Peggy Hasenauer, MS, RN
Executive Director
The University of Chicago Kovler Diabetes Center

Click here to learn more about our team of educators at the Kovler Diabetes Center.

Recognizing World Kidney Day

Today is World Kidney Day, a day reserved to remind us all to preserve the health of our kidney from common disease and toxins that injure them. The most common cause of kidney failure in the world is diabetes, a disease especially prevalent in the Westernized world. About half the patients around the world on dialysis have lost kidney function because of poor blood pressure and glucose control associated with diabetes. Patients need to know that once kidney function is lost from diabetes it can’t be restored, so prevention is the order of the day.

Patients with diabetes should ask themselves the following questions, and if positive, should be especially vigilant about preserving their kidney function:

A) Does you have a family history of kidney disease?
B) Is my blood pressure above 140/90 mmHg?
C) Is my HbA1c above 7%?

If all 3 are true you are at very high risk for sustaining kidney damage and should get screened.

Photo credit: www.kidneymobile.com

That said, the National Kidney Foundation of Illinois (NKFI) is encouraging you to “Protect and Prevent on World Kidney Day.”

They are partnering with Advocate Christ Hospital, Olive Harvey College, Chicago Family Health Services and Takeda today to draw attention to the need for early prevention and screenings through the nation’s only educational mobile unit, the KidneyMobile®, a custom motor coach offering free mobile education,screening and referral services to Illinois communities.  The screeings will include: blood pressure, blood sugar, body mass index, waist circumference, urinalysis, diabetic foot checks and a blood draw to test for early signs of CKD.  (Click here to learn more about today’s event.)

The NKFI’s press release explains that, “More than 26 million Americans (that’s approximately 900,000 Illinoisans!) have CKD, and millions more are at risk but most don’t know it. CKD, the ninth-leading cause of death in the U.S., often develops slowly with few symptoms, and many people don’t realize they are sick until the disease is advanced and requires dialysis or a transplant.”

“Unfortunately, many people don’t realize that a few simple lifestyle changes may slow the progression of CKD and can reduce the chances of developing it,” said Kate O’Connor, CEO of the NKFI. “Knowing the risk factors and controlling the major ones, such as diabetes and high blood pressure, may prevent kidney failure. Regular physical activity and a diet low in fat and salt can make a big difference in reducing risk and preventing complications.”

Please be attentive to your health and preserve your kidneys.

George Bakris, MD, FASN
Professor of Medicine
Director, Hypertension Center
The Kovler Diabetes Center

The Kovler Diabetes Center is proud to support this important community initiative, and we encourage everyone to “protect and prevent” on World Kidney Day!  Click here to learn about other upcoming community events that we’re offering the diabetes community.

Start Now: Healthy Eating Strategies

In honor of National Nutrition Month, I wanted to share some healthy eating strategies that you can incorporate NOW!  Each tip is straight-forward and easy to implement.

1) Stop DRINKING your calories: Whether it’s regular soft drinks, juices, performance drinks or teas, we forget that 1 cup of any of these items can add an extra 100 calories.  A can of regular soft drink = 150 calories, 45 grams of carbs.  A typical 16 oz. glass will add an additional 50 calories and 15 grams of carbs, leading to extra calories we don’t need and an increase in blood glucose levels.

2) Do not skip meals, especially breakfast: One may think that by eliminating breakfast, we are also eliminating calories. Not true.  By eating breakfast, we BREAK the FAST and our body’s metabolism kicks into gear, meaning we will burn calories. When we do not eat, it will still think we are sleeping and not burn many at all.  In addition, our body may compensate and eat more calories throughout the day to make up what was lost, leading to possible overeating.

3) Remember CONDIMENTS have calories (and carbs) too. Always check the serving size for all condiments. 2 tablespoons of BBQ sauce = 40 – 60 calories and 10 grams of carbs; 1 tablespoon of ketchup = 15 calories and 4 grams of carbs; 1 tablespoon of tartar sauce = 60 calories and 2 grams of carbs. We tend to underestimate our servings, so know what 1 or 2 tablespoons looks like, since it’s not as much as we think. We tend to eat 3 – 4 times the actual amount, adding far more calories (and carbs) than we presumed.

4) Learn to use the Nutrition Facts label: Focus on the serving size and total carbs when carb counting. When comparing items, focus on the serving size, calories, fat and total carbs. If you don’t know what a serving size looks like, measure it at home so you can better estimate when out.

Stay tuned next week, when I’ll post a blog about food myths for people living with diabetes.  In the meantime, you can follow us on Twitter and Facebook throughout National Nutrition Month, or visit eatright.org for additional tips and resources.

Here’s to healthy eating!

Amy Hess-Fischl
Registered Dietitian, Certified Diabetes Educator, Program Coordinator of InTransit Program
The University of Chicago Kovler Diabetes Center

Love Your Loved Ones, Love Yourself

Today we celebrate Valentine’s Day…a holiday that embraces and promotes love, traditionally marked by chocolates, flowers, greeting cards and champagne.  And while the reason to recognize February 14 has certainly morphed from its original purpose established back in 496 AD, it can nonetheless be a very pleasant and cheerful holiday for most.

But Valentine’s Day has the potential to be more than just a “Hallmark Holiday.”  Why not use the occasion of expressing our love for other people to show love for yourself?  I found a couple of online resources that can help you make healthy choices…not only on February 14, but throughout the year!

If you click here, you can learn more about the CDC’s recommendations for a healthy Valentine’s Day, along with some other really great resources.

Medical News Today also explains why, if you’re going to indulge in any chocolate for the holiday, dark chocolate is the way to go.

So whether or not you have a special someone with whom to celebrate this holiday, please take the opportunity to take care of your own health!

Amy Hess-Fischl
Registered Dietitian, Certified Diabetes Educator, Program Coordinator of InTransit Program
The University of Chicago Kovler Diabetes Center

Please visit our newly enhanced website for additional resources on managing your diabetes and maintaining a healthy lifestyle.

Insulin and Body Fat: The Sleep Connection

I am excited to be a part of an innovative study that’s giving my team at the University of Chicago a fascinating glimpse into the relationship between insulin, sleep and body fat. We’ve been studying small biopsies of abdominal fat from volunteers who have taken part in sleep deprivation studies and are finding that when you’re sleep-deprived, you’re more likely to experience insulin resistance. This means that after you eat a meal, your body has to produce higher-than normal levels of insulin to handle the blood glucose levels in your bloodstream.

Eve Van Cauter, PhD

I’m collaborating on the study with Eve Van Cauter, PhD, and David Ehrmann, MD, internationally recognized researchers from the University of Chicago. Ehrmann is known for his studies on polycystic ovary syndrome, while Van Cauter conducted a range of widely published research that revealed an association between sleep deprivation and higher levels of body fat.

Normally, when insulin is released into the body, it releases a chemical that signals body cells – primarily in muscle, liver and fat tissue – to absorb glucose from the bloodstream. This process is known as insulin signaling. We’ve found that in sleep-deprived individuals, the insulin signaling process somehow goes awry, specifically at the site of fat cells.

Fat is actually your friend, but this fact gets lost sometimes in the literature. The adipose (fat) tissues are here to help you out. They’re a repository for long-term energy storage in the body. When adipose tissues can’t “do their job” and absorb blood glucose, the body senses that its own fat cells are starved for energy. It begins to resist weight loss, slowing its metabolism to conserve energy. The brain then produces chemicals leading to cravings for high-calorie foods.

David A. Ehrmann, MD

Over time, insulin resistance also progresses into diabetes and heart disease, and it’s a known risk factor for breast cancer, pancreatic cancer, lymphoma, dementia, kidney disease, nerve damage and heart attack. Why sleep deprivation causes a “short” in insulin signaling remains a mystery. While the immediate solution may be obvious – get more sleep – some individuals struggle with chronic sleep disturbances, such as periodic limb movement disorder, which leads to wakefulness throughout the night. The problems can last for years despite attempts at treatment.

I’m studying the effects of various medications on insulin-resistant individuals, in hopes of finding a drug that restores the normal insulin signaling process. We’re also looking at the effects of bariatric surgery on insulin signaling. The procedure is a drastic intervention, and somewhat of a ‘last resort’ in morbidly obese people. But we know that one to two weeks after the surgery, there’s a marked improvement in the patient’s metabolic health. A lot of patients will go off their diabetes medications, including insulin, because their own insulin levels have returned to normal. The question is, how does insulin signaling change after the surgery? At this time, that’s completely unknown.

But the studies promise to shed new light on insulin signaling at the molecular level. The insulin signaling study crosses traditional boundaries of what we think of as sleep science or clinical science. It’s an exciting new frontier, and it’s been a privilege to collaborate with Dr. Van Cauter and Dr. Ehrmann.

Matthew Brady, PhD

Matthew Brady, PhD
Associate Professor of Medicine in the Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism
The University of Chicago Medicine

Dr. Brady is a published researcher widely known for his studies on metabolism, insulin and obesity. If you’re interested in being involved in a sleep study, have type 2 diabetes and are 18 years of age or older, please call the University of Chicago at 773-795-0141 for more information.  This article originally appeared in the fall issue of Kovler Connection.  Click here to read the newsletter in its entirity.

Diabetes Initiative Inspires Physicians and Community Leaders

Dr. Arshiya Baig

A University of Chicago Medicine physician is taking special steps to help the Latino population in Chicago fight back against diabetes. Little Village is a predominantly Mexican-American neighborhood in Chicago that has a diabetes-related mortality rate higher than the national average and the average in Chicago. Arshiya Baig, MD, General Internist and Assistant Professor of Medicine at the University of Chicago Department of Medicine, has established a unique program to involve local churches in educating Latino Americans about diabetes.

“Since the church has an important role in many Latino cultures and families, working with churches to address diabetes is one method of tailoring diabetes programs to this community,” Dr. Baig said.

With community members and two partner churches — St. Agnes of Bohemia and Our Lady of Tepeyac — she launched Picture Good Health/Imagínate una Buena Salud, a bilingual, eight-week educational program. The curriculum uses an innovative technique called “photovoice” where participants receive disposable digital cameras to document their lives with diabetes. These photos are then used to guide classes in problem solving.

Participants also have access to exercise groups within the churches. The program also includes a patient navigator service that assists participants in finding a local primary care physician.

“We motivate our participants to live a healthy lifestyle and provide them with tools to do that in a fun, creative, and supportive atmosphere,” Dr. Baig said.

Louis H. Philipson , MD, PhD, Director of the Kovler Diabetes Center was a mentor to Dr. Baig. He noted that her work reaches a population that sometimes faces obstacles in receiving health care.

“Dr. Baig is doing important work to better understand the impact of diabetes in the community and to help devise ways to improve the lives of people with limited access,” he said.

In reality, much of diabetes care and management happens outside of the clinic, Dr. Baig noted. Additionally, an important aspect of the Latino culture is its emphasis on family and community. With this program, the participants can invite family members for a graduation party on the last day of class.

Participants in the "Picture Good Health" program

“The family gets to celebrate the participant’s achievements and see how much they have learned,” she said. Monica Peek, MD, General Internist and Assistant Professor of Medicine at the University of Chicago Medicine, said the project holds great promise.

“Dr. Baig’s work uses innovative, culturally-tailored approaches to address a much-needed health issue in the Mexican-American community,” Peek said. “We’re excited about her work and its ability to improve the lives of people with diabetes here in Chicago, as well as serve as a model for others throughout the country.”

The program is currently being piloted at the two partner churches to assess its impact on diabetes control. “It gives me great pride to know that my colleagues and I are working with the Hispanic community, specifically within Chicago, to improve diabetes management and awareness,” Dr. Baig said.

This article appeared in the latest edition of Kovler Connection.  For more information on Picture Good Health, please contact the study team at 773-702-0770 or read these earlier blog posts about this program.

A New Online Experience for Our Patients and the Diabetes Community

At Kovler, we strive to give our those who see us the best care, access to the latest tools and technologies, and our unwavering commitment to support their health and emotional well-being. An important component of our mission is the online experience that we provide…not only for our patients, but for the diabetes and medical community as a whole.

Recently, we asked friends, families, colleagues and co-workers to analyze our website and identify where and how we could make improvements. We also asked them to help us create another website that’s dedicated solely to  genetic forms of diabetes–Monogenic Diabetes.

After several months of digging in to each and every page of our website and collaberating with various specialists on staff to develop our genetics website, we are proud to announce our newly enhanced websites…

KovlerDiabetesCenter.org and MonogenicDiabetes.org

On our websites, you’ll find:

• Easy-to-use navigation
• Information on Kovler’s unique clinical programs, Kovler for Kids and InTransit
• Resources and an online registry for rare genetic forms of diabetes
• The latest in clinical trials for children and adults
• Kovler’s event calendar and online event registration

….and more!

Our hope is that these websites will prove to be a valuable online tool for those living with diabetes or those effected by diabetes. We realize the the virtual world is one that is constantly evolving, so our promise is to stay informed with the latest in social media, online education, and innovative uses of the internet that can help you, your families, friends, co-workers and communities. That said, we always welcome your feedback and would love to hear your comments!

All the best,
Lou Philipson, MD, PhD
Professor of Medicine and Pediatric
Director of the Kovler Diabetes Center

Please feel free to connect with us through our website, Facebook page or Twitter handle. You can also tweet Dr. Philipson personally at @lphilipson.

A New Year Brings New Online Experiences

Chances are, you’re spending a lot of your time online.  Whether it be for work, play or keeping in touch.  We realize people are also going online to research, manage and explore their health and their medical conditions, including diabetes.

A team of specialists at the Kovler Diabetes Center has been working hard over the last few months to create an enhanced online experience for our patients and for the diabetes community.  We are updating kovlerdiabetescenter.org and turning it into a more user-friendly, informative and interactive website.

The new and improved Kovler Diabetes Center website

Some highlights include:

• Information, programs and resources for infant, teen and adult patients
• The latest on our clinical trials
• Easy online registration for events
• A cleaner, more attractive layout and look

We are also pleased to announce the launch monogenicdiabetes.org.  This website will be dedicated to forms of diabetes that result from mutations in a single gene, called Monogenic Diabetes. These forms of diabetes account for about 1% – 2% of all cases in young people, and the Kovler Diabetes Center’s website is the only place where you can find comprehensive information about Monogenic Diabetes.

The new and improved Monogenic Diabetes website

Some highlights include:

• Information and resources for all types of Monogenic Diabetes
• The latest on Monogenic Diabetes clinical trials
• Easy access to the Monogenic Diabetes online registry

We will be going live with these two websites on Tuesday, January 17, 2012.  We hope you’ll enjoy our new online resources and that your experience will be a pleasant one…whether you or your loved one has diabetes, or if you want to learn more about the disease.  Please visit kovlerdiabetescenter.org and monogenicdiabetes.org and send us your feedback once you’ve had an opportunity to explore our new websites, because we will always be striving to improve and enhance the online experience to best serve the diabetes community.

Sincerely,

The University of Chicago Kovler Diabetes Center Team

We would like to know…where do you currently go online to find information and resources about type 1 and type 2 diabetes?  What do you like best about these websites?

Kovler CDE Goes the Extra Mile…Then Goes Home to Son with Diabetes

Susan McLaughlin, Registered Nurse and Certified Diabetes Educator at Kovler

When Susan McLaughlin’s son was 8 years old, he was diagnosed with type 1 diabetes, and her life changed forever.  She, like many other parents of children with diabetes, didn’t sleep well that diagnosis…for what felt like years.  She explained that, “You always have one ear out for a low blood sugar episode.”

Two years after her son’s condition was confirmed, McLaughlin – at the time, a critical care nurse – went back to school and earned her certification as a diabetes educator. Today, McLaughlin, RN, BSN, CDE, helps outpatients at the University of Chicago Kovler Diabetes Center, as well as inpatients at the University of Chicago Medical Center and at Comer Children’s Hospital.

Today, McLaughlin’s son is grown, healthy and about to enter college. But because of his diagnosis, understanding and compassion are all part of a day’s work for her.

“Parents can be overwhelmed,” she said. “It can seem like their child’s diabetes just fell out of the sky. Parents ask questions like, ‘Is my son or daughter going to be OK, and can they live a normal life?’ I can relate to their fear.”

McLaughlin also sees adults admitted to the hospital with diabetes who are often frightened.  Their diabetes has been out of control for some time, and they’re stressed, feeling sick, and maybe a little panicked.

Whether young or old, McLaughlin treats her patients with sensitivity and compassion, as well as information that can restore a sense of hope. She has extensive knowledge about medications and treatments, and works as part of the medical team to create an optimal individualized care plan during hospitalization, and when patients return as an outpatient. Before each child or adult is discharged, McLaughlin makes sure they understand the prescribed medical plan and obtain the right prescriptions. Patients are also are trained in glucometer use, insulin injection and given a nutrition and exercise plan, developed in partnership with experienced dietitians.

Kovler's Team of Certified Diabetes Educators

For McLaughlin it’s important that her patients are safe and confident when they’re treating their diabetes at home.  That’s why the Certified Diabetes Educators and/or Endocrinologists are available 24 hours a day. When newly diagnosed children go home, their parents are encouraged to call every night to speak with a Pediatric Endocrinologist until they’re comfortable managing their child’s disease.

McLaughlin explains that, “The team at the Kovler Diabetes Center is very proactive with our kids. Parents often need to ask a lot of questions, and we’re sensitive to the newness of it all and to their emotional needs. I can say, ‘I know you’re overwhelmed, and I understand your fear.’  I just want all of our Kovler patients to feel comfortable managing their diabetes and live a life that’s fulfilling.”

To learn more about our team of Certified Diabetes Educators, which includes Susan McLaughlin, Amy Hess-Fischl and Donna Prost, please visit our website or contact us.  To read this article and others, please check out our most recent edition of Kovler Connection!

Peggy Hasenauer, MS, RN
Executive Director
The University of Chicago Kovler Diabetes Center