I happen to enjoy the look on my patients face when I tell them that 4 ounces of orange juice is 75 calories and turns into 4 teaspoons of sugar (over 1 tablespoon!), or that the avocado they are eating as part of their healthy weight loss plan may be healthy (and it is filled with monounsaturated fats – the most heart healthy fat!), but every 2 tablespoons have 45 calories and is considered one fat serving.   One patient this week was so excited to learn about nutrition.  She has been successfully cutting back on portion sizes and fats but didn’t realize some of the hidden calories and how quickly they can add up.  She was surprised to learn that 3,500 calories equal ONE POUND and ………….if you reduce your caloric intake by 500 calories a day, for one week, you will lose that pound!

It’s so easy!  She was eating 1/2 an avocado.  If 2 tablespoons has 45 calories how many calories in 1/2 of the avocado?  Too many!  One piece of cheese is 100 calories, 15 almonds is 100 calories, 6 ounces of juice is 100 calories, 8 ounces of skim milk is 90 calories, 4-6 crackers is 100 calories – and there you have it – your lost pound.

The moral of the story is:  calories add up when you don’t think about them.

©2009 Do It Yourself Diabetes with Marci Sloane. All Rights Reserved.

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This week is also the final week to cast your vote in our Diabetes Educator of the Year Contest. We have five great finalists who all dedicate their lives to fighting the diabetes epidemic, so if you have not done so yet, please take a few moments to read the biographies and vote for your favorite. The winner will get a luxurious weekend at the Boca Raton Resort & Club in Boca Raton, Florida so it’s a quick and easy way you can help us express our appreciation for these dedicated professionals.

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©2009 Keeping Diabetes Management Affordable. All Rights Reserved.

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Although she has only lost a few pounds in the past month or two, more importantly, she has changed her eating patterns, and is thinking about her food choices differently.  She started out eating many sweets whether it be at home or when she dined out.  She had “stopped eating bread” but – of course, as she later would find out, that’s not as evil a food as we are made to believe.  Her first step was controlling the “sweet-eating” –  a huge accomplishment and her biggest challenge.  It has simmered down and she now has sweet cravings less frequently.  At our most current visit, she admitted that she is more accepting of her diabetes and is ready to take the next step – not rewarding herself with food!

His HbA1c (3-month blood sugar average) was 7.3% (not terrible, but we can get that number down to under 7% or even 6.5%) and his random blood sugar was 154 mg/dL.  By the end of the hour-long session (or maybe a little longer – I can’t resist helping people!), I made it clear that he could OF COURSE continue to have his sweets……….but moderately.  I knew, his wife knew and he knew – and admitted – that he loves his sweets and won’t/can’t give them up.  I suggested alternatives and foods/snacks to add to his sweet list and he seemed satisfied with those recommendations.  We’ll see when he returns in a few weeks.

My second 88 year old patient was a woman.  She lives on her own and is very intelligent and pleasant.  She no longer drives and was dropped off by a friend an hour earlier than our appointment.  Her dilemma was why her fasting blood glucose was high and the rest of her day was running quite normal.  After speaking with her and finding out her routine, it was clear that she has the Somogyi Effect.  What’s this – you might ask!?!  High morning (fasting) blood sugars – before you eat or drink anything – is the result of either (Dawn Phenomenon: hormones encouraging hepatic glucose release (in English: the liver kicks out sugar into the bloodstream) or a Somogyi Effect: rebound effect.  If you go to sleep with your blood sugar higher than it is in the morning,  and you’re not a sleep walker or sleep eater, you are probably getting lower blood sugar during the night and your liver spares you by sending out glucose into the bloodstream.  This is very nice of your liver except it becomes too generous and you wind up with high blood sugar, first thing in the morning.

My patient ate her dinner at 6:00 pm and took her diabetes medication and then ate nothing until the next morning.  Her bedtime glucose was 100 mg/dL and was dropping in the middle of the night.  I suggested that she have a bedtime snack of protein and carbs (a few crackers and low-fat cheese or a fruit and some nuts or even a Glucerna or Extend drink or snack bar or chips made for people with diabetes).  The other option was to speak to her doctor to lower her medication since this was a pattern with her and she didn’t want to eat more – she was trying to lose some weight.

Anyway, seeing these older patients is so inspiring for me.  Sure, some folks get old and lose their mental and physical abilities.  And then there are some, like these two lovely people, who prove that getting old is not all that bad.

This week’s product spotlight features 3 cookbooks by Marlene Koch, RD. These books offer a wide variety of recipes for any type of meal or event. Also included in this week’s spotlight are 3 mouth watering fruit spreads by Walden Farms. Read about all of our featured products.

Do you enjoy parfaits? Do you enjoy cheesecake parfaits even better? Learn how to make Blueberry Cheesecake Parfaits. This recipe has only 185 calories 20 grams of carbs.

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Marlene Koch will provide health tips and advice monthly in the “Cooking with Marlene” section of Destination Diabetes. Marlene’s reputation has earned her the opportunity to appear on television, magazines, and the radio.

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