On this World Diabetes Day, let’s take a look at diabetes from a historical perspective. We have come a long way with the diagnosis, treatment and tools to aid diabetes management.
Aware of the Symptoms but not the Cause….
The earliest known mention of diabetes was in 1552 BC, when Hesy-Ra, an Egyptian physician, documented frequent urination as a symptom of a mysterious disease that caused severe weight loss. Around 600 BC, Charaka, an Indian physician described the disease as “honey-urine” or “sugar cane urine”. Physicians around this period often used ants and other insects to help diagnose diabetes because they would be attracted to the area in which someone with diabetes had urinated. In 250 BC, Apollonius of Memphis coined the term “diabetes” which is Greek for “siphon”, meaning “to pass through”. At this point in time, physicians were observing that patients tended to pass more fluid than they would drink; however, they still had no idea about the cause.
In 150 AD, Arateus, a Greek physician, described diabetes as “the melting down of flesh and limbs into urine…life is short, unpleasant and painful.” In 1675, Dr. Thomas Willis of London determined if his patients had diabetes by tasting their urine. He added the word “mellitus”, meaning “honeyed” to the word diabetes. In the 1800’s, scientists developed chemical tests to detect the presence of sugar in the urine (source: www.everydayhealth.com).
Up to the early 19th century, the kidneys, stomach and liver were thought to be linked to the cause of diabetes. Then, in 1869 the islet cells of the pancreas were described in detail through a dissertation by Paul Langerhans (source: https://www.ncbi.nlm.nih.gov/pubmed/21818991). Langerhans did not hypothesize on the role of these cells but, in 1893, French histologist GE Languesse named these areas “ilots de Langerhans”. At this point in time, the insulin producing role of these cells was unknown (source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769627/ ).
A Link between the Pancreas and Diabetes…
In 1889, German physicians Joseph von Mering and Oscar Minkowski removed the pancreas from a healthy dog to study the role of the pancreas in digestion. Several days after the dog’s pancreas was removed, the doctors happened to notice a swarm of flies feeding on a puddle of the dog’s urine. When they tested the urine to determine the cause of the flies’ attraction, they found that the dog had sugar in its urine which, of course, is a sign of diabetes. Because the dog had been healthy prior to the surgery, the doctors knew that they had caused it to have diabetes by removing its pancreas. This happened by accident as diabetes was not the intention of their study. However, their research was so very important because it showed there was a link between the pancreas and diabetes (source: https://www.pbs.org/wgbh/nova/article/accidental-discoveries/). Then in 1910, Sir Edward Albert Sharpey-Schafer found that diabetes was the result of the absence of one chemical, which he named “insula”, meaning “island”, in reference to the insulin-producing cells of the pancreas, or, “Islets of Langerhans” (source: https://www.ncbi.nlm.nih.gov/pubmed/21818991).
Finally… A Discovery of the First Miracle Drug!
In 1921, the life expectancy for a person diagnosed with what was then known as “juvenile diabetes” was less than a year. Motivated by the loss of a close childhood friend to diabetes at the age of 14, Frederick Banting, an Ontario physician, left behind a medical practice to pursue research. He hypothesized that a part of the pancreas produced a substance that could treat diabetes. He and his assistant, Charles Best, began testing his theory in dogs. They removed the pancreas of dogs and then injected them with a chemical extracted from the pancreatic islets of Langerhans (insulin). They found when the dogs were given a few injections a day, their blood glucose levels would decrease and they would be healthier and stronger.
They added a chemist, J.B. Collip, to their team to begin producing more insulin to perform larger trials. Before testing their treatment in humans, both Banting and Best tried the injections on themselves to ensure that they would be safe in humans. In 1922, Leonard Thompson, a 14 year old who was close to death from diabetes at Toronto General Hospital, became the first person to receive injections of insulin to treat diabetes. He improved immediately and lived another 13 years before dying of an unrelated condition. Banting and Best made the patent available free of charge so that millions worldwide would be able to access insulin. Banting and laboratory director, J. MacLeod, received the Nobel Prize in Medicine the following year. They both shared their Prize money with others on the team who were not recognized, in particular Best and Collip (source: https://www.ncbi.nlm.nih.gov/pubmed/21818991).
We, as diabetes educators as well as a family who experiences diabetes on a daily basis (John has had Type 1 Diabetes for 28 years) we are eternally grateful for the dedication and persistence of Dr. Frederick Banting and his assistant, Charles H. Best. Today is the birthday of Dr. Banting and the reason for the recognition of the worldwide celebration & recognition of World Diabetes Day. There is much work to do in the field of diabetes, such as the extreme high cost of insulin that we are now facing as well as the epidemic of Type 2 Diabetes. However, on this day we are so grateful for the discovery of insulin. We must, as a nation, not fail to forget that Banting and Best made the patent for insulin available “free of charge” so that it would be accessible worldwide.
We wanted to recognize the photo above. Nutrition Pair, LLC purchased the rights to use this photo from the University of Toroto Archives: UTA, Frederick Grant Banting and Charles H. Best, A1978-0041/001(53). This photo really touches our hearts. Dr. Banting is on the right and his assistant, Charles Best is on the left. With them is Marjorie, one of the laboratory dogs. In fact, she was a favorite of theirs. Here is a quote from Charles Best from his Book, “The History of Insulin” (1962):
“We were both genuinely fond of the experimental dogs with which we worked…We felt strongly then, as I have always felt since, that no animal should be subjected to pain which the human experimenter would not be willing to bear himself”.
It’s Your Health. It’s Your Life. Make that change! ™
This is the easiest casserole recipe ever! There’s no slicing or chopping required & clean up is minimal. Just toss the ingredients together into a casserole dish and toss it in the oven. This is really great for busy nights. You can mix the ingredients the night before and place the dish in the oven as soon as you get in the door from work! It’s also great for the night before Thanksgiving when you are trying to get everything cleaned up, packed (if you’re traveling) & together for the Holiday!
- 1-10 oz. can Reduced Sodium Cream of Chicken (such as Campbell’s Healthy Request)
- 1 cup of water
- Non-stick cooking spray
- 1 cup long grain rice (we like Jasmine)
- 1-12.5 oz can chicken breast (drained); you may alternatively use sliced uncooked chicken breast
- 1 (12 oz.) bag frozen broccoli florets (chopped is best, if you can find it)
- ground pepper (to taste)
- 1/2 cup shredded sharp cheddar cheese
- Pre-heat oven to 375 degrees.
- Spray a 9 X 13″ casserole dish with non-stick spray. Add the can of soup and water. Stir together until mixed well.
- Add the rice, chicken, broccoli and pepper. Mix well.
- Cover mixture w/foil and place in oven. Cook for 1 hour.
- Remove from oven and top with shredded cheese. Do not cover.
- Bake an additional 5 minutes or until cheese is melted.
Makes 4 Servings
Nutrition Facts (Per Serving):
Fat: 7 gm
- Saturated Fat: 4 gm
Sodium: 540 mg
Carbohydrate: 47 gm
- Fiber: 2.5 gm
Protein: 35 gm
It’s Your Health. It’s Your Life. Make that change! ™
Begin your day with a warm bowl of oatmeal! Preparation can begin the night before to make for a quick, easy and nutritious oatmeal breakfast. The chia seeds are an excellent source of omega 3 fat and the nut butter will add more healthy fat and a good amount of protein which will help to increase satiety. Enjoy!
1/2 cup old fashioned oats
1 T chia seeds (optional)
Sweetener of choice
Dash of salt
2 T smooth nut butter of choice
1/4 cup milk of choice
The night prior or at least one hour prior to eating, combine the oats chia seeds, sweetener & salt. Mix well.
Melt the nut butter in the microwave and pour into the dry mixture and mix well. Add the milk and refrigerate at least an hour (or overnight).
Microwave mixture for 60 seconds or broil on high in toaster oven for 5-7 minutes until golden brown.
Nutrition Facts (Per 1 Serving):
Total Fat: 22 g
- Saturated Fat: 3.4 g
Cholesterol: 3 mg
Sodium: 175 mg
Potassium: 151 mg
Total Carbohydrate: 42 g
- Dietary Fiber: 11 g
- Sugars: 7 g
Protein: 18 g
Good source of Vit E, Folate and Niacin
It’s Your Health. It’s Your Life. Make That Change!
This Okra & Tomatoes recipe is so easy and so delicious! We live in the South and most people here prefer to have their okra fried and have usually not eaten it cooked any other way. Here is a healthy, delicious alternative that we often share with our clients. Okra is a low calorie vegetable high in Vitamin A, Vitamin C, B-Complex & Folate. One surprising benefit of okra is found in the phytochemical, mucilage, which aids digestion and helps to reduce constipation. Remember, the health benefits of phytochemicals cannot be bottled, they must come from the source (the plant). So….eat (and enjoy!) your fruits and vegetables!
- 1 medium onion, chopped
- 1 clove garlic, minced
- 2 T olive oil
- 1 package (16 oz frozen cut okra)
- 2 cans (14.5 oz) No Salt Added Chopped Tomatoes
- 1/2 t red pepper flakes
- pepper to taste
- In large skillet, saute onion & garlic in oil.
- Add okra, tomatoes, red pepper flakes and pepper.
- Simmer over low heat for 20 minutes.
- Serve over cooked rice with grilled or baked meat on the side (if desired).
- Calories: 84
- Total Fat: 4.9 g
- Saturated Fat: 0.7 g
- Polyunsaturated Fat: 0.5 g
- Monounsaturated Fat: 3.4 g
- Cholesterol: 0 mg
- Sodium: 9 mg
- Potassium: 380 mg
- Total Carbohydrate: 8 g
- Dietary Fiber: 3.5 g
- Sugars: 4.5 g
- Protein: 2.6 g
Excellent source of Vit A, Vit C, Vit B-Complex, Manganese & Folate
It’s Your Health. It’s Your Life. Make That Change!
Diabetes Management from a Personal & Professional Perspective
By John Lamberson of Nutrition Pair
I have always maintained that diabetes saved my life and helped me meet my wife, and colleague.
Being diagnosed with type 1 diabetes a year after graduating college was tough, but in the end, it was a good thing. Diabetes encouraged and motivated me to change careers and return to school to obtain a Master’s Degree in Nutrition and Dietetics. It was in graduate school where I was lucky enough to meet my wife Angie, and little did we know that Nutrition Pair would become our life.
One of the driving forces for me to become a registered dietitian (RD) was based on how I was counseled after my diabetes diagnosis. Unfortunately, the entire experience was not a positive one.
The dietitian working with me was adamant about how I needed to avoid certain foods and reinforced how I would have to give up many of my favorites, including pizza and orange juice. I was determined to not let diabetes control me and have used my disease to benefit my life and the lives of others.
Similarly, Angie’s road to becoming an RD was based around helping others as well. Her specific interest in diabetes came later after working in public health and ultimately seeing my experience with the disease.
Through personal and professional experiences, we understand the added responsibility one must take on to live with and manage diabetes. We quell any concerns one might have, by looking at diabetes as a “family disease.” What we mean is that diabetes management can be heavily influenced by those supporting the person with diabetes. We see the “family” as not just the client’s household members, but also the support we provide as healthcare providers.
When we counsel, we provide knowledgeable and supportive information with tools the client can use that are personal to them and meets their specific needs. Doing this also helps us to develop an individualized meal plan tailored to their favorite foods, because as RDs, food is what draws us! We believe that finding ways to enjoy your favorite foods is paramount to living with and managing diabetes.
A trusted diabetes management tool we utilize to help clients maintain enjoyment with food is low calorie sweeteners (LCS), including sucralose, which is used in the original SPLENDA® Sweeteners. SPLENDA® Sweeteners are a game changer for diabetes meal planning.
We often get asked about the safety of low calorie sweeteners. We feel confident in using and recommending SPLENDA® Brand Sweetener (sucralose), as we’ve reviewed the breadth of evidence behind it and note it has a well-documented safety profile backed by over 20 years of research. One of the most extensive review papers to date on sucralose also confirms that there are no safety concerns from extended daily use in various populations, including people with diabetes. What’s more, long-term, well-designed clinical studies also support the role of sucralose as a safe strategy to manage carbohydrate intake that does not impact blood sugar or insulin levels, which are important findings that we translate for use personally and professionally.
We use SPLENDA® Sweeteners in some of our personal recipes too. This time of year, we love to make summer oatmeal and SPLENDA® No Calorie Sweetener gives it a touch of sweetness without all the carbs and calories of sugar! SPLENDA® Sweeteners allow us to enjoy all foods together without raising my blood sugar levels, and helps me to monitor my total carbohydrate intake. I enjoy adding SPLENDA® No Calorie Sweetener, along with cinnamon, berries and dried cranberries, to my oatmeal for a little extra sweetness and flavor.
A second tool that allows us to extend our support in diabetes management is through an exciting trend in healthcare, and that is telehealth.
Consistent counseling that offers face-to-face communication is so important when working with clients who are managing their diabetes. We’ve run into problems setting up meetings, or not being able to visually see their meals and food choices. This is especially true because we are in a rural setting and some of our clients need to drive over an hour to our office. Additionally, some of our elderly clients have a difficult time traveling. To help alleviate those barriers, we use Healthie, a telehealth system, to further extend our services and support in diabetes management.
To effectively counsel for diabetes management via telehealth, here are 3 critical tips we would recommend:
- Establish Rapport
When meeting in-person is a challenge, telehealth provides a great replacement option with live video capabilities. This allows us to establish a rapport right at the initial meeting even if conducted virtually. With telehealth, we broaden our reach, helping even more clients manage their diabetes at their convenience. We also have clients share their blood glucose levels with us directly through our secured telehealth platform so we can make the appropriate dietary adjustments.
- Be Present and Mindful to Help with Active Listening Skills
Telehealth sessions can also be conducted via just audio. If that’s preferred, we do encourage clients to be in a quiet environment free from distractions. A great tip for these types of counseling sessions is to be present and focus closely on how a client answers your question. This type of approach demands that the dietitian develop their listening skills. If you cannot see the client, you cannot rely on body language and energy level as counseling ques. Remember to not only listen to what is being said, but also to how it is being said. Picking up on changes in speed of response, energy level of response and tone of voice can provide clues on how your client is really doing. Avoiding disruptions and using active listening skills are important during video sessions as well.
- Document Sharing
Telehealth gives you the ability to extend your educational tools seamlessly through document sharing. To help us illustrate our point, Healthie has a screen share feature. Clients can easily upload photos of their meals or share laboratory work. We like to utilize the SPLENDA® professional site for current diabetes management practices, as well as source education materials for our clients. Some resource we are currently using with clients include Nutrition Tips for Diabetes and recipes.
As healthcare providers, we highly recommend referring to the SPLENDA® professional site for client education resources when conducting a telehealth session for diabetes management. To learn more on how the SPLENDA® Brand can help support your clients in controlling their blood sugar levels and with weight management, request your free SPLENDA® Professionals Toolkit. You’ll receive samples, valuable coupons, recipes, along with health and safety information.
Remember, diabetes management is not a “one size fits all” approach. Meeting your clients where they are – literally, via telehealth and finding out how to adjust their dietary choices so they can reach their goals are important in achieving a balanced and successful diabetes management plan!
Nutrition Pair™ has partnered with the SPLENDA® Brand for this blog post and have been compensated. However, the opinions expressed are our own and we have not been paid to publish any positive comments.
Angie and John Lamberson are a married couple of Registered Dietitians, Certified Diabetes Educators, and Certified Integrative Health Coaches. They are co-owners of Nutrition Pair, LLC visit them at NutritionPair.com.
Payments managed by Healthie
Here is a quick & easy pierogie recipe made with spinach & tomatoes. Perfect for a Meatless Monday (or any day!). Pierogis (pronounced Pi-roh-ghees) are filled dumplings that originated in Eastern Europe. They are made with unleavened dough and can be filled with potato, sauerkraut, ground meat, cheese and/or fruits. Also, they are often served with a topping, such as melted butter, sour cream or sauteed onions.
You can make your own pierogies or buy them in the freezer section of almost any grocery store (usually near the frozen potatoes). We like Mrs. T’s brand: http://www.mrstspierogies.com (in a blue box). They are inexpensive and make very quick and easy meals. There are tons of ways to cook them! Here is one of our favorite ways to cook pierogies:
1-12 packs box of Mrs. T’s Classic Cheddar pierogies
1/2 of a 1# bag of frozen chopped spinach or 2- 10 oz. boxes frozen spinach (about 3 cups)
2 T olive oil
1 red pepper, chopped
1 small onion, chopped
2 gloves garlic, minced
1-14 oz can no salt added diced tomatoes (do not drain)
Place the spinach in a microwavable bowl and heat approximately 4-5 minutes until it no longer feels frozen. Sauté onion & red pepper garlic in olive oil in a large skillet (cast iron works well) until the onion is transparent. Add the garlic & saute for approximately minutes. Add the canned tomatoes with their water (do not drain) & the spinach. Cover the mixture and turn down the heat to low/simmer. Place the pierogies in a large bowl containing hot tap water. Allow to sit in the water for about 3 minutes. Pour off the water and re-add hot water (to warm them up) & allow to warm until they no longer feel frozen inside. Pour off the water and add the pierogies to your tomato/spinach saucepan mixture. Allow to simmer on a low temp for 5-10 minutes and then serve topped with parmesan cheese. This will make 4 servings (3 pierogies each).
- Calories: 315
- Total Fat: 9.2 g
- Saturated Fat: 1.2 g
- Polyunsaturated Fat: 0.6 g
- Monounsaturated Fat: 5.1 g
- Cholesterol: 6.0 mg
- Potassium 109 mg
- Sodium: 685 mg
- Total Carbohydrate: 52 g
- Dietary Fiber: 7 g
- Protein: 10 g
- High in both Vitamin A & Vitamin C!
It’s Your Health. It’s Your Life. Make That Change!
This Vegetarian Beer Chili is a perfect Meatless Monday recipe because it’s so easy & cooks in only 20 minutes. Add a beer for best flavor. Enjoy!
1 chopped onion
1 red pepper
1 cup chopped celery
1 cup chopped green pepper
1 cup shredded carrots
1-16 oz. bag frozen corn
2 cans beans, drained & rinsed (one can black, one can red)
12 oz fresh or jarred salsa- mild, medium, spicy- your choice!
1 can diced tomatoes (no salt added)
1-12oz. can or bottle of light beer (non-alcoholic works as well!)
1 cup wheat germ
Combine all ingredients & cook on stove top on simmer for 20 minutes or in crock pot for at least 2 hours on high. (Top with reduced fat cheese and/or reduced fat sour cream if desired). Further reduce the sodium in the recipe by rinsing the beans or choosing reduced sodium canned beans or cooked dried beans.