Quite often, when we think of the months of November and December, we think about the holidays that occur during this time. The holiday season can be great fun gathering with family and friends. At the same time, it can be a busy, stressful time which can make it more difficult to stick to good eating habits and regular physical activity. While healthy eating and regular exercise is important for all of us, it is vital for people with diabetes.

This edition of our newsletter focuses on information and tips for diabetic patients. If you or someone you know has diabetes, we hope this information will be helpful to you.

We challenged our diabetes education coordinator, Jo Fleming, by asking her if she could give us some less known facts about diabetes that would be helpful for our readers to know. She responded with the following information:

Blood sugar testing: Only testing blood sugar first thing in the morning (fasting blood sugar) doesn’t give a complete picture of what’s going on. Since our body spends about 50% of the time (about 12 hours) in the “after eating or fed state,” testing 2 hours after eating will give you and your health care provider some valuable information toward achieving better blood sugar control.

Exercise: Exercise is the least used but often the most effective “medicine” to lower blood sugar levels. A 20-30 minute walk will lower the blood sugar right away. A longer walk (like going to the mall) 45-60 minutes will not only lower the blood sugar immediately, but cause the blood sugar to lower again hours later.

Hunger: Hunger is one of the most common symptoms of high blood sugar. When you eat your blood sugar rises which causes you to be hungry again several hours after eating. If you are eating between meals or in the evening because you are “hungry,” test your blood sugar before eating to make sure that it isn’t a high sugar causing you to want food. Eating will only make the sugar go higher.

Type 2 diabetes: Type 2 diabetes is, by far, the most common form of diabetes. People can develop type 2 diabetes at any age, even during childhood. This form of diabetes usually begins with insulin resistance, a condition in which fat, muscle, and liver cells do not use insulin properly. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in response to meals. People who are overweight and inactive are more likely to develop type 2 diabetes.

It is believed that diabetes begins long before the diagnosis is made. Studies show that diabetes may have been present 10-15 years before any signs or symptoms. For this and many other reasons, it is important to get and maintain tight blood sugar control as soon as the diagnosis of diabetes or pre-diabetes is made.

If you have diabetes or pre-diabetes, the holidays can pose special challenges. Plan ahead, make food choices wisely, and watch how much you eat. Thanksgiving means a turkey dinner with all of the trimmings for most people, and those with diabetes can certainly enjoy the meal too. Turkey is a good source of protein — just remember to remove the skin. Then choose traditional vegetables such as broccoli, cabbage, spinach, collard and turnip greens. Sweet potatoes are also high in fiber and very nutritious. Watch out for dishes loaded with butter, cheese, or cream. Whole wheat bread and cornbread are sources of fiber that are good for everyone.

Dessert can be tricky. Fresh fruit is an excellent source of fiber, vitamins, minerals and it has zero fat. Cobblers, pies and cakes are high in fat and cholesterol. If you can’t resist them, just have a small serving.

Here are a few recipes for holiday healthy appetizers, and an idea on what to do with the left over turkey. Read more.

Q & A

Q: What is type 2 diabetes? Who is at high risk for getting it and what are the symptoms?

About 90 – 95% of those diagnosed with diabetes have type 2 diabetes. This form of diabetes usually begins with insulin resistance, a condition in which fat, muscle, and liver cells do not use insulin properly. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in response to meals. Read more.

Our Diabetes Education Program Achieved Recognition
Milford Regional Medical Center’s Diabetes Education Program recently received recognition by the American Diabetes Association. Educational Recognition is a process through which programs that meet the criteria of the national standards for Diabetes Self-Management Education are formally identified for their excellent performance and high quality. The Education Recognition program has grown to become the leading quality assurance mechanism for diabetes education programs across the country.

Programs that achieve education recognition have a staff of knowledgeable health professionals who can provide state-of-the-art education about diabetes self-management for patients. The Milford Regional program incorporates one-on-one learning with certified diabetes educators, small group classes for patients and a family member, nutritional counseling with registered dietitians, and a support group for patients and family. An individual education plan is developed for each patient depending on their needs.

Jo Fleming has been coordinating the Milford Regional diabetes program for fifteen years and the program has grown dramatically during that time. In the year 2000, there were 537 patient visits for the program and in 2008 there were 2,400 patient visits. If you or a friend have been diagnosed with diabetes and would like more information about our diabetes education program, please call 508-422-2396.

Milford Medical Center has gone “Green”
We have a “green team” committee who has worked very hard over the past year to find all kinds of ways to recycle items we use, and to purchase items made of recycled materials. We have greatly reduced the use of Styrofoam by converting the entire cafeteria to biodegradable products. We only use “green” cleaning products throughout the Medical Center, and we recycle all paper, cardboard, plastic bottles, aluminum cans and batteries. We continue to develop green initiatives to support a clean environment for our community. We hope you will too.

Visiting Patients at the Medical Center During Flu Season
Due to the increased number of flu cases in Massachusetts, Milford Regional is following the Massachusetts Department of Public Health guidelines with regard to visitors. All visitors are asked to abide by the following guidelines to protect our patients from infection.

1) If you currently have flu symptoms, such as a fever, cough or sore throat, we ask that you do not visit patients.
2) Please wash your hands or use an alcohol-based hand sanitizer when entering and leaving a patient’s room.
3) Remember to cough or sneeze into a tissue or into your inner elbow. If you do use your hands, please wash them right away.
4) Patients in isolation for influenza may only receive visits that are deemed necessary for their emotional well-being and care.

Awards and Recognitions
We have two physicians on our active medical staff that recently received recognition awards.

Brian Downey, MD, cardiologist, was recently named one of the “Most Influential Doctors” by USA Today. Read more.

William Rockett, MD, general surgeon, recently received the Rx for Excellence Leaders in Quality award from the Massachusetts Medical Law Report. Read more.

See our list of Primary Care Physicians who are accepting new patients. It is important to note that not all physicians accept all insurances. Please call the physician’s office directly to find out if they accept your insurance plan.

To learn more about any one of our physicians, search here.

Doctors Who Specialize in Treating Diabetic Patients
Every 24 hours more than 4,000 adults are diagnosed with diabetes and approximately 200 people die from diabetes. Diabetes is a major cause of heart disease and stroke and a leading cause of leg and foot amputations unrelated to injury, kidney failure, and new cases of blindness in adults. However, people with diabetes can lower their risk of complications and can control their disease.

The first step is to see a physician who can evaluate your condition, and the second step is to become educated about the disease and how to effectively manage it.

Samir Malkani, MD is an endocrinologist, a physician who specializes in diagnosing and treating diseases that affect your endocrine system - your glands. Learn more about Dr. Malkani.

Hasina Hamid, MD is an internal medicine physician who has a special interest in treating diabetic patients. Learn more about Dr. Hamid.