HOW AN OUT OF WHACK BODY CLOCK CAN DISTURB TYPE 2S - COMPLIMENTS OF YOUR HEALTH MART PHARMACY PLEASE TAKE ONE
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COMPLIMENTS OF YOUR HEALTH MART PHARMACY - PLEASE TAKE ONE
INVESTIGATE. INFORM. INSPIRE. BLOOD SUGARS & TIME ZONES
HOW AN OUT-
OF-WHACK
BODY CLOCK
CAN DISTURB
TYPE 2S
www.DiabetesHealth.com
®
INVESTIGATE. INFORM. INSPIRE.
Publisher / Editor-in-Chief Nadia Al-Samarrie
ADVISORY BOARD
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www.DiabetesHealth.com / DIABETES HEALTH 3
®
I N V E S T I G AT E . I N F O R M . I N S P I R E .
In This Issue
8
14
18
COVER STORY 18 Sex, Depression and Type 2 16 Diabetes Health Type 2: What
21 How an Out-of-Whack Diabetes Type 2s Can Do When Blood
Sugar Soars
Body Clock Can Disturb • Depression, and type 2 diabetes
Type 2s’ are so strongly associated that
you could consider them to be
• The emergency condition most
type 2s dread is hypoglycemia,
• By the time you read this, the two aspects of the same disease. where plummeting blood sugar
massive shutdown of everyday levels can bring on a dangerous
COLUMNS
life due to COVID should be semi-conscious state, and even
closer to over. A year’s worth of Making a Difference coma or death.
pent-up energy and demand 6 Letter From the Publisher
is going to appear at airports FROM THE SUGAR HAPPY KITCHEN
• Tick, Tock, Danger from the
all over the US in the form of
hundreds of thousands of people Body Clock 26 Vegan Keto Low-Carb
eager to travel.
14 Ask Nadia Homemade Granola with 5.32
Net Carbs
• Is Soy Bad for Me?
F E AT U R E S 28 Animal -free Keto Chocolate
LIVING WELL WITH TYPE 1 & TYPE 2
10 "Leaky Gut:" Can It Be Linked Chip Cookies
8 Diabetes Health Type 1:
to Diabetes? You’re Not Bad Because You Get
• How much do diabetes and leaky a “Bad” Blood Sugar Number
gut have in common? • Managing diabetes is hard. It is
like rocket science. It is incredibly
complicated, but we have the
power to make things better and
less uncomfortable simply by
fixing things when they go wrong.
4 www.DiabetesHealth.com / DIABETES HEALTH
Making a Difference
Tick, Tock,
Danger from the Body Clock
As we learn
more about type 2 diabetes, it becomes
more
and
to perform the sexual act because of type
easier to link it to other illnesses and 2’s effect on the sexual organs. That inability
Nadia Al-Samarrie was
conditions, either as their cause or as a can, understandably, lead to depression:
not only born into a family
result. “Sex, Depression, and Type 2 Diabetes,”
with diabetes, but also
(page 18).
married into one. So, it's with the internal clock that governs
She was propelled at a many of our unconscious bodily functions, Our outstanding type 1 correspondent
young age into “caretaker including insulin production. It turns out Meagan Esler offers a great insight into how
mode,” and with her that many of the features of modern life can type 1s can deal with extreme fluctuations
knowledge of the scarcity knock a body clock out of whack---jet travel, in their blood sugar levels in “You’re Not
of resources, support, and shift work¸ artificial lighting---with the result Bad Because You Get a ‘Bad’ Blood Sugar
that processes like blood sugar control start Number,” (page 8). Meagan is a “been there
understanding for people
occurring at the wrong time. done that” reporter who knows what type
with diabetes, co-founded
1s experience and how they can deal with
Diabetes Interview–now
In our Cover Story, “How an Out-of-Whack those experiences.
Diabetes Health magazine. Body Clock Can Disturb Type 2s” (page
Nadia’s leadership 21), we take a look at just how our usually A related article by Patrick Totty is, “What
has spanned 30 years, dependable body clock can go awry, and Type 2s Can Do When Blood Sugar Soars”
establishing the magazine some ways to help fix it. (page 16), which offers proven advice about
as a preeminent consumer how to deal with blood sugar spikes.
and professional resource. Another condition that can be linked to type
2—again, either as a cause or as a result—is I answer an Oregon woman’s question
Under her management “leaky gut,” a condition where particles about whether soy is bad for her in “Ask
DiabetesHealth.Com was that shouldn’t enter the bloodstream via Nadia” (page 14). Sneak preview: No, it’s not
named " Best Diabetes Blog the intestines are allowed to get through bad.
for 2019" by Healthline and because of damage to the intestinal lining.
Diabetes Health magazines “’Leaky Gut: Can It Be Linked to Diabetes?” And speaking of food, in “From The Sugar
was named one of the top (page 10) covers current thinking about a Happy Kitchen,” we offer two Keto-friendly
10 magazines to follow condition that medical experts can’t quite animal free recipes, one for homemade
in the world for 2018 by decide is a standalone event or part of a granola (page 26) and the other for
Feedspot Blog Reader. cluster of ailments… a syndrome. chocolate chip cookies (page 28).
Another condition often associated with Here’s to an enjoyable summer!
type 2 diabetes is depression. That comes
partly from a side-effect of diabetes that Nadia Al-Samarrie, Founder, Publisher,
doesn’t often get talked about: the inability Editor-in-Chief
6 www.DiabetesHealth.com / DIABETES HEALTH
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Living Well With Type 1 & Type 2
Diabetes Health
Type 1:
You’re Not Bad
Because You Get a
“Bad” Blood Sugar
Number
Meagan Esler
And there it is. It’s an unfair shame that
follows us throughout the daily ups and
downs of life with diabetes. Our life is mea-
sured by these numbers, which sometimes
can beat us down. It’s as though we feel it
I was working in the shop I man-
age the other day when
I overheard someone say “blood sugar.”
is a considerable flaw in us that warrants
judgment by others. I explained gently that
I would never pass judgment or be mad at
When I hear that term, my ears perk up like her because of blood sugar. I told her that
my Pomeranians hearing a car door slam. if anyone understood how hard it could be
After 20+ years with type 1 diabetes, to manage blood sugars, it’s someone who
It’s an unfair shame I’m pretty sure I can hear a diabetes also lives with diabetes. We chatted about
that follows us phrase across a crowded football how difficult it can be to manage an ill-
throughout the stadium. A volunteer was talking ness where you can do the same things on
daily ups and about her blood sugar to another a different day and receive very different
volunteer. She mentioned the fact outcomes.
downs of life with
that she hadn’t eaten lunch that
diabetes. Our life is day. I quickly walked to the register, I found out that she has type 2 diabetes
measured by these where I told her that I also have dia- and takes insulin in the morning each day,
numbers, which betes. I said I’d overheard her talking a set amount, but that is it. I asked if she
sometimes can about blood sugar and that she was had a sliding scale from her doctor to help
beat us down. It’s welcome to have one of the contain- her if she needed to get particularly rough
as though we feel ers of soup that I keep in our kitchen. blood sugar down. She said she didn’t, that
She said, “No, I can’t eat. My blood she’d been on insulin for a couple of years,
it is a considerable
sugar was horrible this morning; but that her doctor hadn’t given her one. I
flaw in us that you’d be mad at me if I told you the urged her to talk to her doctor about get-
warrants judgment number”. She lowered her eyes and ting some guidance on correcting an unde-
by others. said, “It was bad. It was over 400”. sirable blood sugar safely. A 400 blood sug-
8 www.DiabetesHealth.com / DIABETES HEALTH
Living Well With Type 1 & Type 2
ar doesn’t feel good at all. It can be downright painful! People shouldn’t be
kept in the dark on properly reining their blood sugars when they go awry.
I hope people know it’s not all their fault. Managing diabetes is hard. It is
like rocket science. It is incredibly complicated, but we have the power to
make things better and less uncomfortable simply by fixing things when
they go wrong. Sure, there will be some “bad” blood sugars throughout
life with diabetes, but we can fix them! We
need the tools from our health care team Managing diabetes is
to help ourselves. hard. It is like rocket
science. It is incredibly
The volunteer and I felt comfort in talking
complicated, but we
about diabetes together. We even contin-
have the power to make
ued the chat in the backroom of the shop.
She acknowledged that she needed to things better and less
speak to her doctor and test more frequent- uncomfortable simply by
ly to feel better. I hope she does. None of us fixing things when they go
deserve to live so uncomfortably and with wrong. Sure, there will be
feeling such shame. If you don’t know what some “bad” blood sugars
to do to help regulate your blood sugars,
throughout life with
please don’t feel bad about yourself. Just
diabetes, but we can fix
talk to your doctor and tell them you need
some help. There are excellent doctors out them! We need the tools
there that can get you on the path to feel- from our health care team
ing better. to help ourselves.
www.DiabetesHealth.com / DIABETES HEALTH 9
Feature
"Leaky Gut:"
Can It Be Linked to Diabetes?
Diabetes Health Staff
body. It can cause an autoimmune reac-
“Leaky gut” is short-
hand for
tion where T cells attack and destroy the
pancreatic cells that produce insulin. Un-
what happens when the intestinal tract like type 2, where the body still produces
starts letting harmful substances and tox- insulin but is resistant to it, leaky gut is sus-
ins reach the bloodstream. pected to lead in some cases to full-blown
Leaky gut Our intestines are lined with type 1.
can cause a barrier that has extremely
inflammation small openings through which But this can work in reverse: Diabetes is an
that alters insulin nutrients can pass into the inflammatory disease that can alter the di-
levels, which bloodstream. But sometimes gestive function. Inflammation can expand
eventually affects those openings expand the diameters of the intestinal tract’s tiny
enough to allow entrance to holes and possibly lead to leaky gut. It’s
how well insulin
those harmful substances, a classic example of which came first, the
works in the
including large food particles. chicken or the egg?
body. It can cause
That creates the leak in leaky
an autoimmune gut. Other suspected causes—or at least
reaction where contributors to developing leaky gut—
T cells attack WHAT’S LG’S LINK TO TYPE include imbibing too much alcohol over
and destroy the 1 DIABETES? time, eating food that has low nutritional
pancreatic cells Leaky gut can cause inflam- value, chronic infections, diabetes (from
that produce mation that alters insulin lev- inflammation, a main feature of diabe-
insulin. els, which eventually affects tes), lupus (an autoimmune disease), and
how well insulin works in the stress.
10 www.DiabetesHealth.com / DIABETES HEALTHFeature
BETTER SAFE THAN SORRY
Even though there’s no consensus on how
to label leaky gut (see “Leaky Gut: What’s · Stress is often mentioned as one factor
in a Name?” below), there are actions that that can lead to LG.
people in danger of developing LG are ad- Each individual’s ap- Carefully
vised to take in order to avoid it: proach to managing monitor alcohol
stress will depend on consumption.
· Carefully monitor alcohol consumption. age, physical condi- Right now the rule
Right now the rule of thumb for safe tion, or tempera- of thumb for safe
drinking is two drinks a day for men (two ment. Still, there are drinking is two
beers or two 12-ounce glasses of wine) basic techniques that
drinks a day for
and one drink per day for women (one almost everybody
men (two beers
beer or one glass of wine). can learn: A walk
or two 12-ounce
around the block
glasses of wine)
· Eat food that delivers roughage, protein, (with or without a
and one drink per
fat, and low carbohydrate levels. This dog); a ride on a
means eating a cheeseburger occasion- bicycle; working a day for women (one
ally, just not as a matter of course. crossword puzzle; beer or one glass of
gardening; a con- wine).
· If you have diabetes, carefully monitor versation with an
injection times and doses. Diabetes that old friend; cutting back on the caffein-
is well managed is a much less likely to ated coffee; eating less sugar; politely
act as a prelude to LG. telling bosses and coworkers that you
www.DiabetesHealth.com / DIABETES HEALTH 11Feature
need a daily stretch of time when you
would like to not be summoned, inter- “LEAKY GUT:” IS IT A
rupted, or interrogated, which will help SYNDROME OR JUST A
everybody because it makes you more SYMPTOM?
productive.
The big question in the room is whether
Alternative Admittedly these are leaky gut is a symptom or a cause. How it’s
medical precautions that may or labeled depends on the point of view of
practitioners may not stave off LG, but the people naming and describing it.
call it “leaky gut in any case they are good
advice for most persons Physicians and alternative medicine prac-
syndrome.”
of any age or condition to titioners disagree on just how to describe
What’s the take and follow. LG. Mainstream doctors refer to it simply
difference? as “leaky gut.” Alternative medical practi-
Mainstream (Nadia Al-Samarrie’s tioners call it “leaky gut syndrome.”
healthcare Diabetes Health recipes
practitioners at www.diabeteshealth. What’s the difference? Mainstream health-
com/topic/recipe/, are care practitioners use “leaky gut” to de-
use “leaky gut”
tested meals that de- scribe a particular outcome of whatever
to describe a
liver tasty nutrition while is ailing a patient. For example, a patient
particular outcome honoring the dietary is manifesting food allergies, so her prac-
of whatever is needs of people with titioner focuses on that as the probable
ailing a patient. diabetes.)
12 www.DiabetesHealth.com / DIABETES HEALTHFeature
cause of her leaky gut. Her doctor does pain, and inflammation. It’s this large
not view her food allergies as a result of range of ailments that makes some health- Non-traditional
leaky gut. care workers consider leaky gut to be a healthcare
syndrome.
providers believe
Non-traditional healthcare providers be-
leaky gut is a
lieve leaky gut is a syndrome, a cluster Others are not so sure. Syndromes include
syndrome, a
of causes and effects that explain how a lot of ailments, which means that propo-
a range of ailments come to be. They nents of calling LG a syndrome often seem
cluster of causes
suspect that leaky gut is more than a to be including every illness or condition and effects that
symptom. They suspect that leaky gut they can think of. But that’s not the case. explain how a
might be the cause of several diseases, The medical definition of “syndrome” de- range of ailments
including celiac, Crohn’s disease, irritable scribes it as a group of signs and symptoms come to be. They
bowel syndrome, type 1 diabetes, and that occur together and characterize a par- suspect that
even autism. Other possible side effects ticular abnormality or condition. leaky gut is more
of leaky gut may be bouts of depression than a symptom.
and anxiety. Characterizing leaky gut as a syndrome is They suspect that
not there yet. But there is increasing scien- leaky gut might
But wait, there’s more: The symptoms of tific scrutiny that is intended to establish be the cause of
leaky gut are even more extensive than definite—or not definite—links to LG. This
several diseases.
the conditions listed above. They include is a topic that we will revisit from time to
diarrhea, headaches, skin problems, joint time.
www.DiabetesHealth.com / DIABETES HEALTH 13Ask Nadia
Ask Nadia:
Is Soy Bad for Me?
for breast cancer, you should err on the con-
servative side and not use soy in your diet.
Others argue that soy’s benefit for
strengthening bones and a healthy heart
outweighs the concern because the in-
Dear Nadia, creased probability of getting a tumor is
I have decided to start replacing some of my insignificant.
protein meals with soy. Is soy bad for me?
THE THYROID LINK:
Janet Many soy studies are based on consumption
Portland Oregon amounts that are unrealistic for the average
person. There is no real evidence that soy
Reach out to Dear Janet: benefits your thyroid or adversely impacts
your healthcare Soy is a high-protein alternative that vegetar- your thyroid. However, for people with io-
ians and vegans use to substitute for meat and dine deficiency, soy can add to your deficit.
professional to
dairy products—the origins of soy date back If you have hypothyroidism, soy may inter-
discuss your soy thousands of years from East Asia. fere with the medication that treats it.
consumption Another well-designed study from the
and how it may Plant-based foods are considered suitable for American Journal of Clinical Nutrition studied
impact your lowering your cholesterol and are believed the effect of realistic amounts of soy protein
medications. Other to have some benefits to a healthy heart in on hormones, including thyroid hormone. It
considerations for addition to strengthening bones. This is good found that soy had no significant impact on
news for people with osteoporosis. these hormones.
soy include adverse
reactions to Soy is also believed to lower blood sugars. SOY AND YOUR BLOOD SUGARS:
certain medicines, The Mayo Clinic reports that soy can de-
including over-the- The two most common concerns with con- crease blood sugars. Caution is necessary for
counter products suming soy products are the possible link to people who take oral medication or inject-
like ibuprofen. breast cancer and thyroid. able medication to lower their blood sugars.
THE BREAST CANCER LINK Reach out to your healthcare professional
The research is mixed about breast cancer. to discuss your soy consumption and how
Some say if you have a genetic disposition it may impact your medications. Other con-
14 www.DiabetesHealth.com / DIABETES HEALTHAsk Nadia
siderations for soy include adverse reactions
to certain medicines, including over-the-
counter products like ibuprofen.
Source:
Mayo Clinic Nadia was not only born into a family with
Effects of soy protein diabetes but also married into one. She was
propelled at a young age into “caretaker
Write to Nadia mode,” and with her knowledge of the scar-
Go to AskNadia@diabeteshealth.com to city of resources, support, and understand-
receive her unique perspective on your ing for people with diabetes, co-founded
question. Diabetes Interview, now Diabetes Health
magazine.
Disclaimer:
Nadia’s feedback on your question is in no Under her management Diabetes Health
way intended to initiate or replace your magazine was named one of the top 10
healthcare professional’s therapy or advice. magazines to follow in the world for 2018 by
Please check in with your medical team to Feedspot Blog Reader.
discuss your diabetes management con-
cerns. Nadia has been featured on ABC, NBC, CBS,
and other major cable networks. Her publica-
About Nadia: tions, medical supply business, and website
AskNadia (ranked #1 by Google), named have been cited, recognized, and published in
"Best Diabetes Blog for 2019 & 2017" by the San Francisco Chronicle, The Wall Street Jour-
Healthline. With 24 nominations, Nadia Al- nal, Ann Landers advice column, former Chrys-
Samarrie’s efforts have made her stand out ler chairman Lee Iacocca, Entrepreneur maga-
as a pioneer and leading patient advocate in zine, Houston News, Phili.com, Brand Week,
the diabetes community. Drug Topics, and many other media outlets.
www.DiabetesHealth.com / DIABETES HEALTH 15Living Well With Type 1 & Type 2
Diabetes Health
Type 2:
What Type 2s Can
Do When Blood
Sugar Soars
Patrick Totty
When you do spike, what can you do right
away to bring blood sugar levels down?
The emergency condition most
type 2s dread is hypoglycemia,
where plummeting blood sugar levels can
IMMEDIATE STEPS YOU CAN TAKE:
1. Insulin—If you are on an insulin regimen;
bring on a dangerous semi-conscious state, a bolus injection should drive numbers
and even coma or death. down fairly rapidly.
2. If you are not on insulin or don’t use
However, hyperglycemia, high-blood sugar fast-acting insulin, taking a brisk walk or
levels consistently above 240 mg/dL, can bike ride works for most people to start
be just as dangerous. Left untreated, bringing their numbers down.
Stay hydrated.
at its most extreme, high-blood sugar 3. Stay hydrated. Hyperglycemic bodies
Hyperglycemic
can induce ketoacidosis, the build- want to shed excess sugar, leading to
bodies want to up of toxic-acid ketones in the blood frequent urination and dehydration. You
shed excess sugar, and urine. It can also bring on nausea, need to drink water steadily until your
leading to frequent weakness, fruity-smelling breath, numbers drop.
urination and shortness of breath, and, as with 4. Curb your carb intake. It does not matter
dehydration. You hypoglycemia, coma. how complex the carbs in your diet are,
your body still converts them to glucose
need to drink water
However, once they’ve been diagnosed at some point. Slacking off on carb
steadily until your
with diabetes, most type 2s have taken consumption is a trackable maneuver that
numbers drop. steps to prevent or lessen the most lets you better understand how to control
dangerous effects of high-blood sugar your numbers.
levels. Their concern shifts to dealing with
unexpected, sometimes alarming spikes in PREVENTATIVE STEPS:
blood sugar levels. The symptoms of those These are extensions of the immediate steps
spikes are the classic ones we associate with listed above. By adapting them as long-
the onset of diabetes—unquenchable thirst, term practices, you lessen your chances
excessive urination, fatigue, weight loss, and of undergoing distressing hyperglycemic
headaches. episodes.
16 www.DiabetesHealth.com / DIABETES HEALTHLiving Well With Type 1 & Type 2
· Regular exercise—Although some of us
do not experience a drop in blood sugar
from exercise, the habit itself is a good
one. Exercise helps control weight and
appetite, maintain muscle strength, and though you’ve been good about taking
generate a general feeling of well-being. your medications, it is time to talk to
These are important quality-of-life factors your doctor and take a look at alternative
for type 2s. drugs. It may also be time to look at
· Shun high-carb foods. insulin.
· Reduce weight—The cliché may be old, · Insulin—If you start on insulin, you’ll be
but it is true: A reduction in body weight taking as close to a wonder drug as type
of only 5 to 7 percent can have a dramatic 2s can get. However, keep in mind what
effect on A1c’s and insulin sensitivity. It is Dr. Richard Bernstein has cautioned for
also good for the heart, which, thanks to years: Small doses are better than
the inflammatory nature of diabetes, is large, which means managing your Reduce weight—The
already under stress. disease so that you do not fall into cliché may be old, but
· Reduce stress—Stress is also an the habit of “covering” high-carb it is true: A reduction in
inflammatory. Even if your life is too indulgences with big doses of insulin. body weight of only 5
complex to allow for extended breaks · Track your patterns—The more you to 7 percent can have a
to de-stress, grabbing a few minutes know about your body’s unique
dramatic effect on A1c’s
whenever you can to relax and take your diabetic patterns, the better.
and insulin sensitivity.
mind off current problems is a little thing Knowing your patterns helps you
that can become a big help. to know not to over-react in some It is also good for the
· Revisit your prescriptions—Remember, instances or to take drastic action in heart, which, thanks to
most type 2 medications lose their others. Give yourself time to detect the inflammatory nature
effectiveness over time. That is why you your patterns—that means many of diabetes, is already
can start on metformin or a sulfonylurea finger pricks and tracking of different under stress.
but later have to add or switch to, combinations of time, exercise, and
for example, Januvia®, or Byetta®, or food to find them. However, find
Invokana®. If your control is slipping even them you will.
www.DiabetesHealth.com / DIABETES HEALTH 17Feature
Sex, Depression
and Type 2 Diabetes strongly associated that you could consider
two aspects of the same disease. But your
David Spero sex problems are probably fixable. Here is
what is going on.
Dear Diabetes Health, Your drug, Paxil, is an SSRI, which stands
I am a 55-year-old man diagnosed with type for selective serotonin reuptake inhibitor. It
2 diabetes two years ago, which made me works by keeping serotonin circulating in
depressed. The depression eventually got so your brain. This tends to improve mood, but
bad that I didn’t want to get out of bed it can cause a variety of sexual side effects.
Paxil, is an SSRI, which in the morning. My doctor referred me Why this happens is unknown, but many
to the psych clinic, where they put me causes have been suggested.
stands for selective
on Paxil (paroxetine). The medication
serotonin reuptake
is helping my depression but ruining Paxil is one of the SSRIs that are hardest on
inhibitor. It works by my sex life. I can’t get an erection, but sexuality. One study showed that 14 percent
keeping serotonin I don’t care because I’m not interested of Paxil users spontaneously reported sexual
circulating in your brain. anyway. I have no desire. However, problems. If specifically asked, however, 60
This tends to improve my wife is still interested, and she is percent said they had problems. In a Span-
mood, but it can cause upset about my lack of desire for sex. ish study, over 70 percent of women on par-
I wouldn’t say I like hurting her, and I oxetine reported sexual dysfunctions.
a variety of sexual
don’t want us to break up over this, but
side effects. Why this
the depression was awful. I don’t want Still, you can do many things to help sexual
happens is unknown, but to go back to that. What can I do? dysfunctions and loss of libido caused by
many causes have been SSRIs. Here are some of them.
suggested. -Victim of Side Effects
AN ANTIDEPRESSANT THAT BOOSTS
Dear Victim of Side Effects, SEX DRIVE
You’re in a rough situation and a common It would help if you considered switching
one. Depression and type 2 diabetes are so your antidepressant to bupropion (Well-
18 www.DiabetesHealth.com / DIABETES HEALTHFeature
butrin) or taking bupropion along with your
Paxil. A study of 30 non-depressed men and
women taking bupropion at the University
of Alabama Birmingham found significant help with erections.” And a woman there
improvements in sexual function and sat- commented, “Within a week, I noticed a
isfaction compared to placebo. A small huge increase in sexual thoughts as well
Brazilian study (20 subjects) showed highly as the physical sensation of desire. It has
significant improvements in sexual function stayed and enhances the entire experience.
in women taking bupropion. Orgasms are much more intense.
Also, there is a total lack of bad Bupropion is not
Bupropion is not an SSRI. Instead, it in- food cravings.” an SSRI. Instead,
creases levels of dopamine and norepineph- it increases levels
rine. These chemicals also raise mood, but Of course, bupropion also has side of dopamine and
without the sexual side effects. Bupropion is effects. Some are emotional: Some norepinephrine. These
now the fourth most widely prescribed an- male users reported increased chemicals also raise
tidepressant in the U.S. It is often prescribed anger and jealousy. Other possible mood, but without
along with an SSRI. effects include nausea, restless- the sexual side
ness, and changes in eating and effects. Bupropion is
Many readers on depression websites and sleeping patterns (too much or too
now the fourth most
bulletin boards are excited about bupro- little sleep or appetite.) So, as with
widely prescribed
pion. One man on Health Forum wrote, “I’ve any drug, be careful with it.
antidepressant in
been taking Wellbutrin xl for depression for
OTHER THINGS YOU CAN DO the U.S. It is often
about four weeks now, and my sex drive has
gone through the roof! Is this something I Researchers at Wayne State Uni- prescribed along with
should be concerned about?” versity Department of Psychiatry an SSRI.
interviewed 50 psychiatrist experts
A man on Revolution Health wrote, “[Well- on the sexual side effects of anti-
butrin] raised my libido some. It seems to depressants. The experts suggested
www.DiabetesHealth.com / DIABETES HEALTH 19Feature
· Switching to another antide-
pressant (ask your doctor)
Exercise, especially · Decreasing the dose of an anti- weight training seem most effective. They
strength training, depressant (again, ask) can also reduce insulin resistance.
can boost · Adding oral agents such as
sex drive and Wellbutrin, Viagra, or Cialis, or Make sure to have your testosterone level
function and fight other stimulants checked and treated if low. Low T could
depression as well. · Wearing a testosterone patch account for the depression and the sexual
problems too. It’s very common in men with
Short, intense
You can often reduce the sexual type 2.
sessions of weight side effects of SSRIs with self-
training seem most management. Consider taking Finally, if you can get your desire back, don’t
effective. They can a “drug holiday,” which Harvard let erection problems stop you from being
also reduce insulin psychiatrist Anthony Rothschild sexual. There are drugs and pumps and self-
resistance. defines as skipping your Friday management approaches to erections, and
and Saturday doses. A drug holi- a lot of good sex can be had without erec-
day improved sexual function tions. See our previous columns for specific
without increasing depression in most ideas.
study subjects. (Again, it’s a good idea to
let your doctor know.) Good luck and let us know how it goes.
Exercise, especially strength training, can David Spero, an RN columnist for Diabetes
boost sex drive and function and fight de- Health, answers questions on sex and de-
pression as well. Short, intense sessions of pression.
20 www.DiabetesHealth.com / DIABETES HEALTHFeature
How an Out-of-Whack Body
Clock Can Disturb Type 2s
Diabetes Health Staff
By the time you
read
this, the massive shutdown of everyday life
due to COVID should be closer to over. A production to handle meals and snacks, and
year’s worth of pent-up energy and demand daily activities.
is going to appear at airports all over the
U.S. in the form of hundreds of thousands of If you’re jet-lagged, maybe it’s 10 a.m. local
people eager to travel. time outside your hotel window.
But your body, still on home time, Suppose you’re a type
Suppose you’re a type 2 ready to take to is winding down insulin produc- 2 ready to take to the
the air. If you’re traveling to a different time tion because your body clock is air. If you’re traveling to
zone, although you consciously know that preparing you for sleep. Just when a different time zone,
you’re traveling hours ahead or behind your you need increased insulin for the although you consciously
home time zone, your body clock (formal day, your pancreas takes a snooze.
know that you’re traveling
scientific name: "circadian rhythm") doesn’t. Then, when you’re ready for bed,
hours ahead or behind
Travel creates jet lag, a condition in which your body clock starts sending the
your body clock continues operating as pancreas a command to ramp up your home time zone, your
though you are at home. insulin production. Since you don’t body clock (formal scientific
need much insulin during sleep, name: “circadian rhythm)
That means your organs, including the having unneeded insulin in your doesn’t. Travel creates jet
pancreas, will be functioning on a skewed system creates the threat of hypo- lag, a condition in which
schedule. For example, your body clock glycemia, a condition that anybody
your body clock continues
slows insulin production when you go to with diabetes fears.
operating as though you are
bed at night because when you’re sleeping,
you’re not eating, so there is little demand One common cause of body clocks at home.
for insulin. When you are out and about getting out of whack is shift work.
during the day, your body ramps up insulin People who work swing and night
www.DiabetesHealth.com / DIABETES HEALTH 21Feature
One treatment for the shifts have difficulty adapting to a lack SOME COMMON INDICATORS OF BODY
lack of natural light of sunlight, which skews their body CLOCK DISRUPTION
is timed exposure to clock. One treatment for the lack of These problems with sleep can be—not
natural light is timed exposure to a necessarily—indicators of circadian disrup-
a lightbox, a lamp
lightbox, a lamp that bathes the body tion:
that bathes the body
in light that mimics sunlight. The goal
in light that mimics is to treat SAD, Seasonal Affective · You wake up too early and are unable to
sunlight. The goal is Disorder, which occurs when there is fall back asleep
to treat SAD, Seasonal not enough natural sunlight to keep · You have a difficult time falling asleep
Affective Disorder, body clocks from drifting away from · You have a hard time staying asleep, and
which occurs when a healthy sleep/wake cycle. The result you often wake up several times
is listlessness, drowsiness, and some-
there is not enough
times simple sadness. An online article in Physical Health and Sleep
natural sunlight to
("Healthy Sleeping Advice") offers steps
keep body clocks Another contributor to body clock persons with diabetes can take to maintain
from drifting away problems is Obstructive Sleep Ap- healthy functioning body clocks:
from a healthy sleep/ nea, which afflicts one in four type
wake cycle. The 2 diabetes patients. The constant · Adhere to a diet that keeps blood sugar
result is listlessness, cessation of breathing followed by levels controlled
drowsiness, and
gasping for air, followed by the same · Get regular exercise
sometimes simple
sequence throughout the night, dis- · Maintain a regular sleeping schedule
rupts the body’s natural sleep cycle · Avoid stimulants like caffeine and nicotine
sadness. and becomes another contributor to close to the time before you go to bed
disrupted body clocks. (Two treat- · Sleep in a quiet, dark, cool bedroom
ments for sleep apnea include the
use of CPAP (continuous positive air- BODY CLOCK DISTRESS AFFECTS MORE
way pressure) machines and reducing THAN TYPE 2S
body weight since excess pounds can It’s not only people with type 2 diabetes
block air intake.) who disrupted body clocks can harm. Re-
22 www.DiabetesHealth.com / DIABETES HEALTHFeature
searchers now say that body clock distress
has been accepted as a leading factor in
developing type 2 diabetes among people
who have prediabetes or metabolic syn-
drome. very careful about how and when they take
their medications.
Aleksey Matveyenko, Ph.D., at the Mayo Clin-
ic in Rochester, MN, who has done extensive Here is what one diabetes expert, Rahul
research into the causes of type 2, says that Suresh, recently suggested that travelers
although such factors as high caloric intake with diabetes can avoid do to avoid ill ef-
and physical inactivity have long been asso- fects from air travel. (Suresh, affili-
So in looking
ciated with increased susceptibility to type ated with the University of Texas,
2 diabetes, “more recently circadian rhythm offered his suggestions during an at diabetes and
[body clock] disruption has been gaining American Association of Clinical disrupted body
greater appreciation as an emerging envi- Endocrinologists meeting in Flori- clocks, the question
ronmental risk factor of type 2.” da: "Diabetes Management During often becomes which
Air Travel"). condition comes first:
So in looking at diabetes and disrupted diabetes or body clock
body clocks, the question often becomes · Pack extra supplies (insulin, distress? Research has
which condition comes first: diabetes or syringes, glucose tabs, glucose
body clock distress? Research has shown meter test strips) in a carry-on shown that it can work
that it can work both ways. A confused body bag for use during flights and both ways. A confused
clock is one factor in developing type 2 dia- stopovers, and especially in the body clock is one
betes while having diabetes is one factor in event of a delay. factor in developing
generating a confused body clock. · Be aware of a flight's direction— type 2 diabetes while
east or west—how many time having diabetes is one
TRAVEL SUGGESTIONS zones you'll be passing through,
factor in generating a
It’s easy to see how type 2s can disrupt their and the time the flight will take.
confused body clock.
body clocks and the need for them to be · No need to adjust the dosage of
www.DiabetesHealth.com / DIABETES HEALTH 23Feature
A significant aspect of the diet is its recom-
mendation that eating times should cor-
relate to the body clock’s rhythms. This in-
short- or rapid-acting insulin. cludes making breakfast and lunch, the two
· Avoid the use of premixed insulins be- major meals of the day, to give your body
cause they are difficult to titrate. energy during waking hours and making
· For persons who use an insulin pump, he dinner a much smaller meal as you get clos-
recommends turning off a pump when er to going to bed. In all, the diet’s “window”
the plane is ascending or de- for eating is 12 hours each day.
A significant aspect of scending. Depressurization can
the diet is its cause a pump to overdose and Other advice is commonsensical, including
possibly cause hypoglycemia. continuing to maintain portion control and
recommendation that
Once the aircraft is in its multi- staying away from unhealthy food choices.
eating times should
hour level flight, the insulin The article also advises eating breakfast
correlate to the body pump can be turned back on. within two hours of rising.
clock’s rhythms. This
includes making breakfast DIET WHAT ABOUT TYPE 1S?
and lunch, the two major A recent Forbes magazine ar- Generally speaking, people with type 1 dia-
meals of the day, to give ticle, "Everything You Need betes run a lower risk of body clock disrup-
to Know About the Circadian tion than people with type 2 diabetes. There
your body energy during
Rhythm Diet," gives a general is no definitive reason why this is so. Still,
waking hours and making overview of the foods and tim-
it may be that the extraordinary attention
dinner a much smaller ing that experts advise work type 1s must pay to their insulin dosing and
meal as you get closer to to decrease the occurrence of diet has a beneficial, controlling effect on
going to bed. disrupted body clocks. their body clocks.
24 www.DiabetesHealth.com / DIABETES HEALTHFrom The Sugar Happy Kitchen
From the Sugar Happy Kitchen:
Animal-Free Keto Low-Carb
Homemade Granola with 5.32
Net Carbs
Nadia Al-Samarrie
the market. If you want a filling and nutri-
tious breakfast without the high carbohy-
You may have thought gra- drate sugar found in most granolas, try my
nola derived from new recipe. It is for the health-conscious
a German European country like Muesli person.
from Switzerland. Surprisingly, the origin
is from Dansville, New York, dating back to Ingredients
1863. Dr. Caleb James Jackson, a nutrition- ¼ Cup of raw unsalted pumpkin seed
ist, struggled with good health most of his ¼ Cup of raw unsalted pecans
life. Until he went to a spa that reversed his ¼ Cup of raw unsalted Brazilian nuts
physical condition with hydrotherapy. The ¼ Cup of raw unsalted hazelnuts
revival in his good health changed his pro- ¼ Cup of raw unsalted almonds nuts
fessional interest from being a farmer and ¼ Cup of raw unsalted macadamia nuts
journalist-abolitionist to becoming a physi- / Teaspoon of salt
1 8
cian. He became a vegetarian, giving up / Teaspoon of cinnamon spice
1 8
meat, coffee, tea, and alcohol. As a whole / Teaspoon of nutmeg spice
1 8
foods advocate, he developed granola at / Teaspoon of cardamom spice
1 8
the age of 52, named initially “Granula” at ½ Cup of dry coconut chips
his Jackson Health Resort. 1 Teaspoon vanilla
1 Tablespoon of Madhava Agave Five Low-
If you are tired of having eggs, bacon, or Calorie Sweetener
ham for breakfast, granola cereal is a re-
freshing alternative to dairy, soy, or meat Instructions:
products. It is high in protein and fiber. • P reheat oven to 350° Fahrenheit
My recipe has less sugar and fewer calo- • C hop all nuts and place in a bowl
ries than any other option I have seen on • A dd spices to the dry mix and stir
26 www.DiabetesHealth.com / DIABETES HEALTHFrom The Sugar Happy Kitchen
• In a bowl, separate and measure out one
tablespoon of agave low glycemic syrup. Add 1 Tablespoon of dry unsweetened
• Add the vanilla to the agave syrup and stir cranberries
• Mix dry ingredients with wet Add ¼ of unsweetened coconut milk
• In a oven safe pan- grease ½ teaspoon of Source:
coconut oil Dr. Caleb James Jackson
• Pour mixture evenly on the tray
• Bake for 10 minutes, then take out to add
the last ingredients Nutrition Facts:
• Mix ½ cup of dry unsweetened coconut Serving Size 4
flakes with the cooked granola 372 Calories, Total Fat 35.7g,
• Place pan back into the oven and bake for Saturated Fat 0g, Sodium
another 5 minutes 105.44mg, Total Carbohydrates
• Let cool before serving 9.3g, Fiber 3.98g, Total Sugar
2.71g, Protein 5.21g
To Serve
Measure ½ cup of cooked granola
www.DiabetesHealth.com / DIABETES HEALTH 27From The Sugar Happy Kitchen
From the Sugar Happy Kitchen:
Keto Animal-Free
Chocolate Chip Cookies
Nadia Al-Samarrie
ego.” I said. You can imagine how ecstatic I
This is one of my newest and
favorite recipes. I wanted
something inclusive of many diets; keto,
was when everyone gave it a thumbs up.
The sweeteners used in the recipe are an
animal-free, low-carb, and paleo. After alternative zero-carb sweetener. The flour
experimenting with different ingredients, used is low-carb flour for better glycemic
my third try was a charm. I asked people control.
on the diets mentioned above to taste my
chocolate chip cookies and to tell me the I don’t know about you. I sometimes change
truth.” Don’t worry about my feelings. Your out certain ingredients if I don’t like what
honesty means a lot more to me than my is in a recipe. In this case, how much sugar
28 www.DiabetesHealth.com / DIABETES HEALTHFrom The Sugar Happy Kitchen
Ingredients
1 ½ Cups of almond flour
½ Cup of coconut flour
you use will be subjective. I recommend
½ Cup of coconut oil
following my recipe the first time around
½ Cup of Swerve brown sugar
and make adjustments later. The reason
¼ Cup of Swerve granular sugar
being, you want to make sure you like what I
2 Tablespoon of Bob’s Egg Replacer
have created for you.
¼ Teaspoon of Anthony’s Psyllium Husk
Powder
All feedback is appreciated. If you like this
1 Teaspoon of vanilla
recipe- do share it with your friends and
½ Teaspoon of salt
family.
½ Teaspoon baking soda
½ Cup of Lily’s Dark Baking Keto Chocolate
Enjoy!!
Chips
Nadia
...continued on page30
www.DiabetesHealth.com / DIABETES HEALTH 29From The Sugar Happy Kitchen
From the Sugar Happy Kitchen:
Keto Animal-Free Chocolate Chip Cookies
...continued from page 29
Instructions
• H eat Oven to 350° Fahrenheit
•M ix sugar and coconut oil until its creamy minutes to harden the cookie
•M ix Bobs Egg Replacer with water. Two •M
akes 16 cookies
tablespoons of egg replacer to four table-
spoons of water PS- If you cannot find the ingredients in
•M ix one-half teaspoon of psyllium with your local store, you can buy them from my
three tablespoons of water pantry kitchen essentials at https://www.
•M ix the egg replacer, psyllium with the diabeteshealth.com/product-category/
wet ingredients sugar and. Then add Va- pantry-essentials/
nilla
•M ix almond flour, coconut flour, baking
soda, and salt Nutrition Facts:
• B lend the wet and dry mixture Serving Size 16
• A dd ½ cup of Lily’s Dark Baking Chocolate 8.76 net carbs per cookies
Chips 117 Calories, Total Fat 8.64g,
• O n an oven-safe pan, spray olive oil Saturated Fat 0g, Cholesterol
•W ith a cookie scooper, scoop cookie 0mg, Sodium 50.05mg, Total
dough and pat down with your palm, then Carbohydrates 9.8g, Fiber
place on an oven-safe pan. 1.04g, Total Sugar 8.31g,
• B ake for 15 minutes Protein 1.46g
• T ake out of the oven and let cool for 30
30 www.DiabetesHealth.com / DIABETES HEALTHYou can also read
