Allergic to Christmas: Trees, Treats Can Trigger Reactions

Allergic to Christmas: Trees, Treats Can Trigger Reactions

Re-posted from an article on ABC News, written by Lauren Browne, M.D.  For the full article, click here.

christmas_allergiesThe holiday season is in full swing. And while many people around the nation gear up for a joyful time with family and friends, those with allergies prepare for an onslaught of wheezes and sneezes that can wreck the holiday fun.

“The winter holidays are a particularly difficult time for people with allergies,” said Mike Tringale, vice president of external affairs at the Asthma and Allergy Foundation of America. “There are respiratory allergies.  There are food allergies. There are skin allergies. There are eye allergies.  The list goes on.”

But with a few simple tips and tricks from the experts, surviving and thriving during the season can be easier than cooking the holiday meal. The secret to success is planning in advance, well before common food, pet, and mold allergies turn Christmas and Hanukkah into a Halloween nightmare.

The Tree

A Christmas tree is a smoking gun for people with allergies, according to Tringale. Real trees harbor mold spores that can trigger reactions, and fake trees are often stored for months or years in dusty attics and basements. They can also be coated with allergy-inducing chemicals.

“People may just assume they have a cold or cough that isn’t going away when in fact it’s from the allergens circulating in their home from the tree,” said Dr. Neeta Ogden, an allergist in New York City.

The Fix: Keep fresh trees in the home for less than two weeks and wipe the trunk thoroughly with a solution of warm water and bleach (1 part bleach to 20 parts water). Consider hosing off a fake tree outside and letting it dry before bringing it indoors. And when the holidays are over, store the fake tree with a protective air-tight covering to prevent next year’s dust mite invasion.

The Fireplace

“Fireplaces are great for Santa’s visit, but the burning wood, which can be moldy, dusty, and have chemicals, also causes respiratory symptoms,” said Dr. Marjorie Slankard, director of the allergy clinic at Columbia-New York Presbyterian Medical Center.

The wood smoke from the fire can also trigger itchy, watery eyes, a runny nose, or a scratchy throat.

The Fix: Stack your firewood outside and bring new logs in only when you are ready to use them in your fireplace or wood-burning stove. And make sure the fire burns in a well-ventilated area to avoid unnecessary smoke inhalation.

The Food

‘Tis the season of candies, cakes, and cookies. But for those with food allergies, decadent holiday parties can be a set-up for serious missteps.

Common holiday ingredients like eggs, milk, soy, and nuts abound, and can cause potentially life-threatening allergic reactions if accidentally consumed. Even if a food does not seem to contain allergens, it may have been cross-contaminated if it was prepared alongside known allergens.

Alcohol at holiday parties adds to the danger, according to Dr. Scott Sicherer of the Jaffe Food Allergy Institute at Mount Sinai School of Medicine in New York. It can lower inhibitions and increase the risk that you mistakenly eat an unsafe food.

The Fix: Ask what’s in the buffet before you eat. If you’re unsure of the ingredients of a certain food, completely avoid it. Consider making and bringing your own food to a holiday potluck. And most importantly, you should always have your emergency epi-pen ready in case of an unexpected emergency.

The Cat

Your aunt’s cat Fluffy may be adorable, but you’ll need to steer clear if you’re sensitive to the numerous allergens spread by domestic pets.

“A frequent issue is that pet-allergic individuals visit homes of relatives and friends where there are pets, which can cause nose and eye reactions as well as asthma with cough, wheezing and shortness of breath,” said Dr. Mark Dykewicz, director of allergy and immunology at Wake Forest University.

The Fix: If you’re hosting a party, clear the air of pet dander with the aid of a HEPA air filter. If possible, minimize the time that pets and guests are indoors together. But if exposure is inevitable, Dykewicz recommends taking over-the-counter antihistamines, like nasal cromolyn, 15 to 20 minutes before entering an allergic environment and every six hours thereafter, until the party ends.

The Makeup

Holiday party season inspires many women to apply make-up more frequently, but extra layers of foundation and cover-up could lead to dry and irritated skin, according to Ogden.

Not only can this “holiday skin” be socially isolating, but when compounded with cold weather, it can trigger uncomfortable eczema flares in those who suffer from the condition.

The Fix: Peoplewith sensitive skin should use only small amounts of make-up. Don’t over-cleanse and dry out the skin, but do moisturize frequently. And if you have known eczema or other serious skin conditions talk to your doctor about ways to prevent winter flares.

The Centerpieces

Strong odors from potpourri, candles, incense, and scented decor can wreak havoc on allergies and can even exacerbate asthma, according to Dr. Tara Carr, director of the adult allergy program at Arizona Health Sciences Center.

Being trapped indoors with heavily-perfumed family and friends can also make for an uncomfortable celebration.

The Fix: Besides the obvious advice to not buy products with strong odors, the best way to avoid this one is to talk to your doctor or see an allergist about preventative medications you can take for up to a week prior to exposures.

Remember, if you have an ongoing medical condition like asthma or allergies, or are taking multiple medicines, you should wear a medical ID alert.  American Medical ID offers medical bracelets for women, men and children alike.  An engraved medical ID bracelet or necklace presenting a concise overview of your conditions, allergies and medicines will alert a doctor or medic before starting treatment. Informing medical personnel about your unique medical conditions and needs will greatly aid pre-hospital care.

Celebrate a Diabetes-Friendly Christmas

Re-posted from an article by Birgit Ottermann on Health 24.  For the complete article, click here.

TRADITIONAL CHRISTMAS FOODFor many people with diabetes Christmas can be a tough time of the year - how do you resist temptation when it’s lurking around every corner?

The good news is that, with a bit of planning, you can also have fun, while keeping your blood sugar levels under control and your waistline in check.

Here’s how:

1) Eat moderately and watch your portion sizes

If you have diabetes, you don’t have to eat a different plate of food as the rest of your family. By making a few changes, opting for healthier foods and keeping the “naughty treats” at a minimum, you can also join in the fun.


“On Christmas morning it’s important to not eat a huge breakfast or even your regular breakfast,” says Liesbet Delport, dietician and co-author of the Eating for Sustained Energy low-GI low-fat cookbook series.. “Rather eat just a bit of low-GI fruit salad (not more than a cup), together with two to three heaped tablespoons of low-fat yogurt and maybe just a sprinkle of muesli, as the rest of the day a lot of food is probably going to be consumed.” 


“For lunch on Christmas day, try to eat a normal plate of food,” says Delport. “Your plate should look like this: 1/4 meat, 1/4 low-GI starch and 1/2 vegetables and/or salads.”  If there’s more than one type of meat and more than one type of starch, all the meat should still have to fit into 1/4 of your plate and so does the starch! Choose the lower GI options.

“Don’t feel tempted to have another lunch-time helping,” Delport cautions, “if you’re not hungry, just eat salad to ‘compensate’ for eating more than usual on this day. The Christmas day lunch foods are probably going to be on the menu for the next two to three days, so you won’t miss out!”


“Try to postpone the dessert until coffee time or after your Christmas afternoon nap or, even better, after a brisk walk, as blood glucose levels soar higher when too much is eaten in one sitting.”

“Strawberries and low-fat ice cream are the best choice for dessert, but if you want to have a Christmas treat, rather have a piece of lower-GI lower-fat fruit cake, with just a little bit of low-fat ice cream or low-fat low-GI custard,” says Delport.


Christmas dinner should be very small, perhaps salad or soup, vegetables, etc.

2) Make wise food choices

Choose dishes with minimal sauces and dressings, Diabetes South Africa says. Cut back on salt, remove visible fat from food, including chicken or turkey skin, and give deep-fried foods and pastries a miss.

The traditional turkey that is served for Christmas is actually a good choice of white meat, as it is low in fat (if served without the skin and if it’s roasted, not fried) and high in protein. The real culprits are the rich  gravy and stuffing that are usually served with the turkey - so, steer away from these.

3) Eat your veggies

Vegetables are an important source of nutrients for everyone. Unfortunately, it doesn’t always feature very high on the Christmas menu. Why not add some color to the table with a choice of veggies? A fresh tossed salad or steamed non-starchy veggies are not only low in carbs, they will also help you fill you up and stop you from overeating on foods high in fat.

Says Delport: “See to it that there are enough salads and/or vegetables at lunch and if you get hungry, have a helping of salad so long instead of nibbling on nuts and chocolates that might be standing around. If you have to have some of these snacks, just have a few nuts and dried fruits and try to skip the chocolates.”

4) Think about the timing of your meal

Many families eat their big festive meals a bit later than usual. For example, your Christmas lunch could only be ready by the middle of the afternoon. It’s therefore good to have a healthy snack on standby, to ensure that your blood glucose levels don’t fall too low. “If you are visiting friends or family, don’t be shy to ask for a healthy snack, to keep your blood glucose levels steady,” Diabetes UK advises.

“If you take insulin injections or a pill that lowers blood glucose, you may need to have a snack at your normal meal time to prevent a low blood glucose reaction,” the American Diabetes Association says. “You can also delay your injection until you are about to eat, however, if you are uncertain about adjusting the timing of your injections, first talk to your diabetes health care team for advice.”

5) Drink in moderation

Remember that alcohol is high in calories. “If you drink alcohol, have some dry or light wine with your meal,” says Delport. “Also stay clear of sugary, non-alcoholic drinks. Rather opt for artificially sweetened cold drinks or water.” Keep a jug of ice water flavored with lemon slices or mint leaves nearby.

6) Don’t forget to exercise

During the holidays we all tend to get lazy when it comes to exercise. However, physical activity is a good way to manage both your weight and blood glucose levels.

“If you manage diabetes without medication or insulin, a brisk walk after a meal will help reduce your blood sugar levels. Even if you manage diabetes with medication, exercise can help reduce your blood sugar, as long as you find the fine balance between high and low blood sugar. Test often during exercise,” the American Diabetes Association advises.

7) Focus on friends and family instead of food

And finally, remember that the festive season is a time to slow down and focus on your loved ones. Enjoy some quality time with family and friends, doing the things that you love best.

The American Diabetes Association recommends all persons with diabetes have a medical ID with you at all times.  Medical IDs are usually worn as a bracelet or a necklace.  Traditional IDs are etched with basic, key health information about the person, and some IDs now include compact USB drives that can carry a person’s full medical record, such as the fact that they have diabetes and use insulin. Emergency medical personnel are trained to look for a medical ID.

10 Tips to Make Winter Easier on Your Asthma

The following article was posted on Everyday Health, written by Beth W. Orenstein.  To read the complete article, click here.

October Snowstorm Hits The NortheastDon’t let the cold, dry air or a common cold worsen your asthma symptoms this winter.

Unless you love stepping outside to cold, dry air that smacks you in the face, winter (post-holidays, of course) can be a dreary season. For people with asthma, the cold weather can worsen their symptoms.

“There are two issues with winter for people with asthma,” notes Marilyn Li, MD, an allergist and immunologist with the LAC+USC Healthcare Network in Los Angeles. “One is that the air is cold and dry, and the other is people have more sinus and upper respiratory infections, either of which can trigger or worsen asthma attacks.”

To keep a handle on asthma attacks during the cold-weather months, here are 10 things you can do.

  1. Wash your hands. Properly (and frequently!) washing your hands with soap and water is one of simplest and best ways to avoid spreading or catching colds and other viruses, Dr. Li advises. Alcohol-based hand sanitizers and moist towelettes also do the trick. Also emphasize the important of good hand washing to your children to even further reduce the chances of spreading germs around your house.
  2. Get a flu shot. The Centers for Disease Control and Prevention (CDC) recommends that most people age 6 months and older get an annual flu shot to help protect against the flu virus. Having asthma won’t make you more susceptible, but if you do get the flu, the results could be more serious, even if you keep your asthma symptoms under control. “It’s important that people with asthma get the injectable form of the flu vaccine made with inactivated [killed] flu virus,” Li says. She advises that people with asthma shouldn’t get the nasal spray (FluMist) vaccine because it contains live virus. Your doctor may also recommend that you get a pneumonia vaccine for extra protection.
  3. Don’t sit by the fireplace. While sitting by the fire sounds lovely and cozy, it’s not so great for your asthma. “The more evidence we have, the more we realize that burning wood is like burning tobacco,” explains Todd Rambasek, MD, of ENT & Allergy Health Services in Cleveland. “Smoke is smoke, and smoke can irritate your lungs, especially when you have asthma.”
  4. Keep your mouth closed. If this sounds like something your mom told you as a kid, you’re not alone. But keeping your mouth closed is good for more than simply social graces — it’s better for your lungs. Ideally, you want to breathe through your nose, not your mouth, when you’re out in the cold because the nose warms up the air for the lungs, Dr. Rambasek says. Another way to warm and humidify the air you breathe is to wear a scarf or muffler over your nose and mouth. Some people find a ski mask or face mask helpful, he says.
  5. Replace filters. Your home heating system may blow dust and debris throughout your house, especially when you first start it up for the winter. It’s important to clean and replace filters before turning on your system so as not to release the debris and trigger an asthma attack. Clean and check the filters periodically throughout the heating season to avoid issues with winter asthma. Also, try to keep the temperature and humidity levels in your home consistent.
  6. Exercise indoors. On days when it’s bitterly cold outside and the wind chill makes it feel like it’s below zero, Li recommends going to the gym instead of exercising outside. “The temperatures and the humidity in the gym are less likely to cause a problem,” she says. If you still want to exercise in the fresh (albeit cold) air, choose a time of day when it might be warmer, such as the midafternoon.
  7. Warm up before working out. A recent study showed that people with asthma recover faster and have greater lung function after exercising when they are warmed up. This is important whenever you work out, but especially in winter, according to Rambasek. “Consider doing your first 20 minutes of your run on a treadmill before heading outdoors in the cold,” he says.
  8. Take steps to prevent asthma flares. Take a preventive dose of your asthma medicine before heading outside, whether to exercise, walk the dog, or run errands. “You may need a bronchodilator at least a half-hour before you’re heading out in the cold,” Rambasek says. Your inhaler will help open your airways and give you the extra protection you need.
  9. Have an asthma action plan. No matter what the season, you should always know what to do if your asthma symptoms flare. Your action plan should detail how to control your asthma over the long run and what to do if you have an asthma attack. Be sure you know when to call your doctor and when to go to the ER.
  10. Take your medications. Work with your doctor or asthma specialist to create an effective treatment plan, and continue to get regular checkups, Li says. It’s important to follow your treatment plan regardless of the time of year. Don’t let a busy work or social schedule cause you to ignore your health. If you find your asthma symptoms worsen in the cold weather, talk with your doctor about possibly changing the mediations you take and when you take them, advises Rambasek.

Keeping your asthma under control may take a little more effort in the cold of winter, but these strategies should get you through the season without worsened symptoms.

Remember, if you have an ongoing medical condition like asthma, or are taking multiple medicines, you should wear a medical ID alert.  American Medical ID offers medical bracelets for women, men and children alike.  An engraved medical ID bracelet or necklace presenting a concise overview of your conditions, allergies and medicines will alert a doctor or medic before starting treatment. Informing medical personnel about your unique medical conditions and needs will greatly aid pre-hospital care.

Ten Videos Every Senior Caregiver Should Watch

The below section is taken from the One Call Alert website blog, please click here for the original article.

Whether you are new to senior caregiving, looking for enhanced elder care training, or are looking for ways to support another caregiver, online education offers a world of opportunities. Here’s a collection of 10 great videos compiled by Melody Wilding of HealthWorks Collective that every caregiver should watch. Remember, these clips are no replacement for expert medical advice from your doctor or physician. 

  1. How to give an insulin shot – If you care for someone with diabetes, you’re probably wondering how to properly inject insulin. This video for CVS Pharmacy guides you through important steps for preparing and storing insulin and the steps to administering a shot.
  2. How to test your blood sugar – Testing blood sugar levels helps you and your loved one make informed decisions about diet, activity and even insulin dosing to most effectively manage diabetes. This video guide from shows you everything you’ll need to get starting and how to test blood glucose (sugar) levels.
  3. How to successfully manage medications – This video from the Alzheimer’s Foundation Education Series provides an emotional, real-life look at the importance of medication management. Caregivers play an invaluable role in assisting their loved ones in establishing daily routines for taking medication and communicating with healthcare providers about concerns and side effects. These lessons span beyond dementia caregiving and are useful to any caregiver with an elderly loved one living at home.
  4. How to protect your elderly loved one from fires – Does Mom or Dad forget to shut off the stove-top? For many reasons, older adults are at a higher risk of dying in a home fire. Find out how to protect your loved one with these safety tips.
  5. How to maintain balance & stay active at home – Exercise can improve a senior’s flexibility and strength, reducing risk of injury and guarding against the deleterious affects of illness or chronic disease.  Kathy Shillue of Rehabilitation Services at Beth Israel Deaconess Medical Center in Boston shows a series of exercises seniors can perform safely from the comfort of their own home.
  6. How to measure blood pressure – If you or your loved one suffers from high blood pressure, knowing how to achieve an BP accurate reading from home is essential to staying healthy and preventing problems before they start. Here physician and ConsumerReports medical expert, Marvin Lipman shows you how.
  7. How to help prevent trips and falls in home – For the elderly, trips and falls are the most common type of accident that occurs in the home. In this video, The Visiting Nurse Service of NY shows simple modifications you can make today to prevent falls and keep your loved one’s home environment a safe place.
  8. How to prevent bedsores – Bedsores, or pressure ulcers are a serious problem for many home-bound elders and are actually lesions caused by prolonged pressure to a part or side of the body. This video from LiveStrong will help you learn about treatments and symptoms.
  9. How to measure vital signs – During this video Sandi Flores, RN of Care and Compliance Group reviews step-by-step procedures for taking blood pressure, temperature, pulse, respiration, and weight. Documenting and reporting vitals signs are also addressed.
  10. How to live to 100 – To find the path to long life and health, Dan Buettner and team study the world’s “Blue Zones,” communities whose elders live with vim and vigor to record-setting age. In this absolutely fascinating TED talk, he shares the 9 common diet and lifestyle habits that keep aging people around the world spry past age 100.

One Call Alert supports caregivers by providing a lifesaving emergency alert button service for those being cared for and peace of mind for the caregiver. Whether paramedics need to be summoned or a neighbor needs to come over and give a hand, with just the push a button, One Call Alert provides instant access to the right care for the situation. One Call Alert is the medical alert service that helps caregivers to take a few hours off, relax, and sleep well at night knowing their loved one is in good hands.

Give the Gift of Peace of Mind with a Medical ID Bracelet

The greatest gift you can give yourself or others is peace of mind… and with the latest medical ID bracelets from American Medical ID, peace of mind never looked so good!


Who should wear a medical ID?

If you have ongoing medical conditions, drug or food allergies, or are taking multiple medicines, you should wear a medical ID alert – we offer medical bracelets for women and medical bracelets for men alike. An engraved medical ID bracelet or necklace presenting a concise overview of your conditions, allergies and medicines will alert a doctor or medic before starting treatment. Informing medical personnel about your unique medical conditions and needs will greatly aid pre-hospital care.

Below is a partial list of ailments or persons who should wear a medical ID:
Heart disease (angina, atrial fibrillation, pacemakers)
Blood thinners/anticoagulants (Coumadin/Warfarin)
Drug allergies (such as Penicillin)
Food allergies (such as peanut)
Insect allergies (such as bee stings)
Alzheimer`s/Dementia/Memory impairment
Ankylosing Spondylitis
Bariatric surgery patients
Blood disorders
Breathing disorders
Cerebral Palsy
Clinical trial patients
Cystic Fibrosis
Epilepsy, seizures
Hearing, sight or mentally impaired
Kidney failure
Mental health patients
Multiple Sclerosis
Parkinson`s Disease
People taking multiple medications
Rare diseases
Special needs children
Stroke risk
Surgery, transplant or cancer patients
Tourette Syndrome

Why are medical IDs critical?

Perhaps your doctor, nurse or pharmacist advised you to obtain and always wear a medical ID. Why is it important?

  • In an emergency, when you might not be able to speak for yourself, a medical ID bracelet or necklace speaks for you.
  • Symptoms of common ailments can easily be misdiagnosed. Prompt diagnosis is critical to effective treatment. A brief description of vital medical facts engraved on your medical ID ensures appropriate and timely medical care.
  • According to a published study, half of all medical errors occur because of mistakes made upon admission or discharge from the hospital.Wearing a medical ID protects against potentially harmful medical errors.
  • More than 95 percent of emergency responders look for a medical ID; more than 75 percent check for a medical ID immediately upon assessing the patient. If you`re wearing a medical ID, it won`t be missed.
  • Medical IDs can eliminate trips to the hospital, reduce unnecessary hospital admissions and prevent minor emergencies from becoming major ones. Medical IDs save lives! One day, a medical ID may save you.

CDC leads the National Diabetes Prevention Program

Nov27_PreventType2Learn more about how the National Diabetes Prevention Program can help you reduce your risk of developing type 2 diabetes.

About the Program

The National Diabetes Prevention Program encourages collaboration among federal agencies, community-based organizations, employers, insurers, health care professionals, academia, and other stakeholders to prevent or delay the onset of type 2 diabetes among people with prediabetes in the United States.

The inaugural partners of the National Diabetes Prevention Program were the YMCA and UnitedHealth Group. These partners were instrumental in starting the national program and continue to expand the reach of this evidence-based lifestyle program. CDC is enthusiastic about other organizations becoming involved in the National Diabetes Prevention Program. Most recently, Viridian Health Management, Inc. has agreed to partner with CDC and others to expand the reach of the program.

The CDC-led National Diabetes Prevention Program is an evidence-based lifestyle change program for preventing type 2 diabetes.

  • It can help people cut their risk of developing type 2 diabetes in half.
  • The Diabetes Prevention Program research study showed that making modest behavior changes helped participants lose 5% to 7% of their body weight—that is 10 to 14 pounds for a 200-pound person.
  • These lifestyle changes reduced the risk of developing type 2 diabetes by 58% in people with prediabetes.
  • Participants work with a lifestyle coach in a group setting to receive a 1-year lifestyle change program that includes 16 core sessions (usually 1 per week) and 6 post-core sessions (1 per month).

The National Diabetes Prevention Program teaches participants strategies for incorporating physical activity into daily life and eating healthy. Lifestyle coaches work with participants to identify emotions and situations that can sabotage their success, and the group process encourages participants to share strategies for dealing with challenging situations.

To find out if this program is offered in your community, click here.

The American Diabetes Association recommends all persons with diabetes have a medical ID with you at all times.  Medical IDs are usually worn as a bracelet or a necklace. Traditional IDs are etched with basic, key health information about the person, and some IDs now include compact USB drives that can carry a person’s full medical record, such as the fact that they have diabetes and use insulin. Emergency medical personnel are trained to look for a medical ID.


Have Diabetes? Wear a Medical ID!

Nov25_MedicalIDJoslin Diabetes Center recommends all people with diabetes to wear a medical alert ID bracelet or necklace.

Importance of Wearing a Medical Alert ID Bracelet with Diabetes:

 Medical alert bracelets enable rapid identification of patients with a number of illnesses, including diabetes, which can make them unable to communicate their illness to others,” according to Shamai Grossman, M.D., Director of the Cardiac Emergency Center and Clinical Decision Unit at Beth Israel Deaconess Medical Center. (Beth Israel Deaconess Medical Center is clinically affiliated with the Joslin Diabetes Center).

How They’re Beneficial for People with Diabetes:

Medical alert ID bracelets can be extremely important for people with diabetes.  Should you have a low blood glucose reaction and suddenly become confused or unresponsive, the bracelet allows immediate identification of the problem to both bystanders and paramedics.  The sooner the low blood glucose reactions can be identified, the sooner they can be treated.

Emergency department personnel also use medical alert ID bracelets to rapidly identify people with diabetes, particularly when they may not be able to express that they have diabetes on their own.  On arrival to an emergency department, one of the routine parts of the evaluation of the critically ill, unconscious, or disoriented patients is to remove their clothing to inspect the body for a cause of their sudden alteration, Grossman says.  In these situations, medical alert bracelets can be invaluable as a time saver.

Information People with Diabetes Should Put on a Medical Alert ID Bracelet:

The message on your medical alert bracelet should be concise and to the point.  “Diabetes” should be engraved boldly on one side.  The other side of the bracelet can have other information such as “insulin dependent” or “medication controlled,” he says.  Other important information can include:

  • An emergency contact number
  • The name of your physician
  • A referral to another place for more information, for example “see wallet card for a full medical history”

Tips to Help Manage Your Child’s Diabetes

Nov22_TipsChildrenManaging your child’s diabetes can be overwhelming, but Debbie Butler, L.I.C.S.W., C.D.E., Clinical Social Worker, Pediatrics and Behavioral and Mental Health in the Joslin Clinic, gives some tips on how to make it easier.

10 Tips to Help Manage Your Child’s Diabetes

  1. Parents need to take an active role in diabetes management tasks, regardless of the age of the child.
  2. Work with a health care team that is knowledgeable about pediatric diabetes. “At Joslin, we are lucky to have a large multi-disciplinary team of doctors, nurse educators, nutritionists, mental health specialists, child life specialists and other allied health professionals,” Butler says.
  3. See the health care team regularly – at least four times a year.
  4. Be honest with your health care team. Do not be afraid to tell them what is difficult for you and your child.
  5. Stay positive with your child. Tell him or her all of the things they are doing well, rather than focusing on what they need to work on.
  6. Be mindful of your facial expressions and what you say, especially when you see an out of range blood glucose.  Stress to your child that there is no “bad” blood glucose, because you want him or her to be honest about their blood glucose levels.
  7. Find time to check in with your child about diabetes management.
  8. Make sure that you talk about non-diabetes issues as well, like you do with your other children.  For example, when your children come home from school, ask them all about their day rather than just focusing on the blood glucose levels of the child with diabetes.
  9. Make sure your child does everything that he or she would have done if your child was not diagnosed with diabetes (ex. sports, sleepovers, parties, etc.).
  10. Prepare healthy foods for the entire family. A healthy mean plan for someone with diabetes is the same for someone without diabetes.

Medical alert bracelets enable rapid identification of patients with a number of illnesses, including diabetes, which can make them unable to communicate their illness to others,” according to Shamai Grossman, M.D., Director of the Cardiac Emergency Center and Clinical Decision Unit at Beth Israel Deaconess Medical Center. (Beth Israel Deaconess Medical Center is clinically affiliated with the Joslin Diabetes Center).

Thank you to the Joslin Diabetes Center for the interview.

Surviving the Holidays with Diabetes

Nov20_HolidaySurvivalParties can pose a challenge for people with diabetes. Celebrations like birthdays, anniversaries, and the holidays present a minefield of situations to navigate.  Without a little preplanning, you risk throwing your diabetes off course and sending a joyous occasion into a healthcare calamity.


New Years: You may need less basal evening insulin should you have champagne on December 31.  This would help to stave off starting the New Year with hypoglycemia.  Carry emergency glucose
tablets and a protein bar.  You might try a small snack before arriving to the party to avoid an all night graze.
Eid al-Adha (the Festival of Sacrifice and the most important feast honored by Muslims worldwide, 70 days after Ramadan): It commemorates Prophet Ibrahim’s willingness to sacrifice his son Ishmal for Allah.  It concludes with millions of Muslims taking the pilgrimage to Mecca, Saudi Arabia.  When sharing two-thirds of your meals with the poor, you will need less insulin and medication due to
limited food intake.  Consider limiting koftas.
Chinese New Year: End of January-mid-February (date varies). Traditions require people to practice various customs to promote prosperity (like sharing tangerines and oranges to symbolize abundant happiness) and ward off bad spirits (such as lighting firecrackers and wearing the color red).  It’s a week-long celebration, filled with all kinds of carbs.  Notable mention goes to a togetherness-candy tray.  Pace yourself and share money-filled red envelopes (“lay see”).
Easter: If you’re fasting for church service, you may need to reduce or hold your morning diabetes medications (check with your healthcare provider first) and pass on the chocolate bunny ears.
• Ramadan (Islamic month of fasting, dates change about 13 days earlier in each consecutive year):
People with diabetes are not required or advised to fast.  If you wish to follow tradition, get an individualized plan together with your healthcare provider to accommodate the pre-dawn to sunset fast to prevent hypo or hyperglycemia, and dehydration.
Thanksgiving: Bring a healthy choice to share, have a little of everything instead of a lot, build exercise into the day, and ask about the best medicine approach to take.
Bodhi Day (Buddah’s Enlightenment, oftentimes observed 12/8): Choose a small portion of rice and milk, count your carbs and act accordingly. Consider adding a protein.  If meditating for hours, you may need less medicine and a way to prevent dehydration.
Virgin of Guadalupe (honors the patron saint of Mexico / patroness of the Americas 12/12):
Adjust medicines to handle the several hours of morning fast followed by high carb content foods (champurrado — a hot, thick, chocolate milk with corn flour added, tamales and sweet bread). You may need less evening insulin, or to hold your morning medications until you have food, and extra quick-acting insulin to cover the extra carbs.  Bring quick acting sugar if you start to feel dizzy or low.
Hanukkah (sometimes spelled Chanukah, the Jewish festival of lights, occurring anytime between late November and late December): Enjoy the stuffed beef brisket or fowl, try baking the potato latkes instead of frying in oil or substitute with other winter vegetables. Try whole wheat challah bread instead of egg-enriched yeast and limit the honey-sweetened desserts.  Plan for extra walking
or extra medications to combat the extra carbs.
Christmas (12/25): Bring quick acting sugar with you to church (whether it be midnight or early mass) as lows can occur in the middle of a sermon.  Suggest non-food related gifts. You can also accept all neighborly gifts of baked goods to share with your friends and family. Have a snack if the main meal feast is delayed. You may need more bolus insulin to account for the big meal. Ask for a donation to be made towards diabetes research in lieu of giving you a gift.
Boxing Day (also known as St. Stephen’s Day, 12/26): Go easy on the buffet line.  Fish around for the dime in the plum pudding and limit the cream.  Other tips about alcohol and exercise apply here!
Kwanzaa (African American / Pan-African celebration, 12/26-1/1): Have the karamu (yams, sesame seeds, collard greens and hot peppers) early in the evening if you also plan to celebrate New Year’s Eve.  Factor candied yams into bolus insulin dose.  Watch alcohol intake in the passing of a communal unity cup.

Also, remember to always wear your medical ID bracelet. Even if you are attending a party with people who know about your diabetes, you should always be prepared and wear your medical ID.

The American Diabetes Association recommends all persons with diabetes have a medical ID with you at all times.  Medical IDs are usually worn as a bracelet or a necklace. Traditional IDs are etched with basic, key health information about the person, and some IDs now include compact USB drives that can carry a person’s full medical record, such as the fact that they have diabetes and use insulin.  Emergency medical personnel are trained to look for a medical ID.


Managing your Diabetes

Nov18_managediabetesAs part of our annual coverage of American Diabetes Month we’d like to provide some steps to managing your diabetes from our colleagues at the National Diabetes Education Program.  Many people avoid the long-term problems of diabetes by taking good care of themselves.

Work with your health care team to reach your ABC goals (A1C, Blood Pressure, Cholesterol): 

  • Use your diabetes meal plan.  If you do not have one, ask your health care team about one.
  • Make healthy food choices such as fruits and vegetables, fish, lean meats, chicken or turkey without the skin, dry peas or beans, whole grains, and low-fat or skim milk and cheese.
  • Keep fish and lean meat and poultry portion to about 3 ounces (or the size of a deck of cards).  Bake, broil, or grill it.
  • Eat foods that have less fat and salt.
  • Eat foods with more fiber such as whole grains cereals, breads, crackers, rice, or pasta.
  • Get 30 to 60 minutes of physical activity on most days of the week.  Brisk walking is a great way to move more.
  • Stay at a healthy weight by using your meal plan and moving more.
  • Ask for help if you feel down.  A mental health counselor, support group, member of the clergy, friend, or family member who will listen to your concerns may help you feel better.
  • Learn to cope with stress.  Stress can raise your blood glucose (blood sugar). While it is hard to remove stress from your life, you can learn to handle it.
  • Stop smoking.  Ask for help to quit.
  • Take medicines even when you feel good.  Ask your doctor if you need aspirin to prevent a heart attack or stroke.  Tell your doctor if you cannot afford your medicines or if you have any side effects.
  • Check your feet every day for cuts, blisters, red spots, and swelling.  Call your health care team right away about any sores that do not go away.
  • Brush your teeth and floss every day to avoid problems with your mouth, teeth, or gums
  • Check your blood glucose (blood sugar).  You may want to test it one or more times a day. Use the card at the back of this booklet to keep a record of your blood glucose numbers.  Be sure to take this record to your doctor visits.
  • Check your blood pressure if your doctor advises.
  • Report any changes in your eyesight to your doctor.

Actions you could take:

  • Talk with your health care team about your blood glucose targets.  Ask how and when to test your blood glucose and how to use the results to manage your diabetes.
  • Discuss how your self-care plan is working for you each time you visit your health care team.

The American Diabetes Association recommends all persons with diabetes have a medical ID with you at all times.  Medical IDs are usually worn as a bracelet or a necklace.  Traditional IDs are etched with basic, key health information about the person, and some IDs now include compact USB drives that can carry a person’s full medical record, such as the fact that they have diabetes and use insulin.  Emergency medical personnel are trained to look for a medical ID.