Now, the TV or the computer screen is not actually doing the damage but it is the time spent slumped on the couch, the types of food we tend to eat in front of the TV and the amount of food we tend to eat in front of the TV that actually causes the significant damage.

Dr. Frank Hu of the Harvard School of Public Health is the primary study author. He says, "the combination of a sedentary lifestyle, unhealthy diet, and obesity creates a 'perfect breeding ground' for type 2 diabetes and heart disease." From the over 200,000 people involved in this study, they found that every 2 hours of watching daily television increased risk of diabetes by 20% and increased risk of heart disease by 15%. The most sobering statistic is that every 2 hours of TV per day increased the risk of dying early by 13%.

From the study, Hu and his research team estimate that if 100,000 people reduce their daily TV time by 2 hours, they could prevent 176 new cases of diabetes, 38 cases of fatal cardiovascular disease, and 104 premature deaths -- every year.

Wow! That is enough motivation to hit pause on the tivo and go out for a walk right now. Here are some healthy activities you can do instead of watching TV or cruising the internet.

• Go for a walk
• Head to the gym
• Work in your yard or garden
• Take a bike ride to a park
• Browse the library and pick several good books
• Read your new, good books
• Volunteer with a local food pantry or homeless shelter
• Spend time talking with or doing chores for a neighbor that needs help
• Visit a hospital or nursing home to spend time with patients
• Organize that desk or room that has gotten a little too messy
• Learn a new skill like knitting or work on learning a new language
• Write a letter or note to a family member or friend
• Take a class at a local community college or attend free seminars and lectures
• Play a game or do a puzzle

There really are so many productive and fun things you can do instead of watching TV or spending time on the computer. And now you have every good reason, health and life, to cut back on TV.

Tradjenta makes gut hormones available by blocking an enzyme, DPP-4, that breaks down those gut hormones. That means that this medication is called a DPP-4 inhibitor. With DPP-4 out of the way, the gut hormones are able to tell the pancreas to produce more insulin.

When Tradjenta was taken along with metformin, A1c decreased by 0.6%. With a sulfonylurea, A1c dropped by 0.5%. And Tradjenta plus metformin plus a sulfonylurea caused A1c to decrease by 0.6%.

Talk to your doctor about Tradjenta (linagliptin) if:

• You have kidney problems: Tradjenta isn’t primarily excreted through the kidneys, so the dose does not need to be adjusted based on your kidney function.
• You need to lose weight: Tradjenta is not associated with weight gain.
• You have bouts with hypoglycemia: Tradjenta should not cause hypoglycemia unless you already take secretagogues.
• You do not want to deal with GI side effects: The most common side effects of Tradjenta are stuffy or runny nose or a sore throat.
• You cannot wait for your doctor to adjust your dose: Tradjenta does not need dose adjustments because there is just one dosage of the pill.
• Ask your doctor if this new medication should be added to your treatment plan if you need to lower your A1c, fasting blood sugars, and post meal blood sugars.

Brushing:

1. Tilt your tooth brush at a 45-degree angle against your gum line.
2. Then gently (you don’t need to push that hard) roll the brush away from your gum line as you move over all your teeth. Make sure you touch all the surfaces of your teeth: front, back, top or bottom, and sides.
3. Give your tongue a good brushing to get rid of lingering bacteria.
4. Brush at least 2 minutes (sing a song in your head!) twice a day with toothpaste that has an antigingival/antibacterial ingredient. You can find brands that are recommended by the American Dental Association.

Flossing:

1. Use enough floss to wrap around your finger to pull the floss taut. Having enough floss makes the process faster and more efficient.
2. Gently slide the floss between each gap between teeth. Floss up and down the sides of the teeth and then gently wrap the floss around the base (where the tooth connects to your gum line) of each tooth.
3. Get rid of debris as you move by each tooth, using a clean portion of the floss. Be gentle so you do not bruise your gums.

Dentist Checkups:

1. See your dentist every 6 months or as often as your general physician or endocrinologist advises.
2. Be sure to remind your dentist and the dental hygienist that you have diabetes. It is important that they know this so they can be more vigilant about preventive care.
3. Call your dentist or hygienist if you see any of these signs or symptoms: bleeding, red, puffy, swollen, or sore gums; if your gums are pulling away from your teeth; if you notice pus or a white substance between your teeth and gums; constant bad breath.
4. Do what your dentist and hygienist recommend. They know how you can keep your teeth and gums healthy.

Actually, snoring is a sign of obstructive sleep apnea (OSA). Obstructive sleep apnea is caused by frequent stops in breathing while you sleep. Normally, the breathing is stopped because there is an obstruction of the upper airway.

This occurs most often in overweight, middle-aged and elderly individuals. Obstructive sleep apnea results in low levels of oxygen in your blood (because you are not breathing in enough air), waking up often during the night, and being very sleepy during the day.

OSA puts you at risk for (or may be a sign that you already have) type 2 diabetes, high blood pressure, heart disease, acid reflux or adult asthma.

Diabetes: Around 80% of people living with diabetes also have OSA, and untreated OSA is associated with poorer blood glucose control. OSA might cause changes in glucose metabolism, and we also know that poor sleep patterns contribute to poor glucose control.

Heart Disease: OSA causes low oxygen levels and stress to the heart from waking up frequently in the night. This makes it harder for your heart to regulate blood flow to arteries and your brain and affects the rhythm of heartbeats, increasing your risk for heart attack and stroke.

Blood Pressure: OSA can cause your hormonal system to overwork which can elevate blood pressure at nighttime when you’re body is frequently being woken from sleep. Low levels of oxygen in your blood may also contribute to hypertension.

Acid Reflux: There is no proven relationship but improved OSA generally results in improved acid reflux.

Asthma: People who are treated for OSA report fewer incidences of asthma attacks.

Obstructive sleep apnea can be easily treated with a machine call CPAP (continuous positive airway pressure). The CPAP machine provides ventilation support so you can breathe without interruption. This prevents low levels of oxygen in your blood and helps you sleep through the night without waking up. The CPAP is an easy way to help decrease your risk for the complications above and take care of that snoring problem!

A recent study compiling data and information about exercise and mortality showed that a sedentary person’s risk for dying prematurely decreased almost 20% if that person started and sustained a walking program, 30 minutes of walking 5 times a week for several years.

Those results are not noted if the individual only continues the walking program for a short period of time. So, it is very important to pick an exercise that you can continue for the rest of your life. And having different types of exercise that you like to do is beneficial too.

Here are a few different exercises to try, but remember, don’t give up. Keep working out each week. Find things you like to do so you’ll be more likely to make exercise an integral part of your life.

• Interval Training: Try walking three minutes briskly, then walk a bit slower for three minutes, and keep repeating this pattern. You can do these intervals with any type of exercise!
• Just get out and walk, move, dance, bike, run, swim, jump, whatever you like to do that keeps you moving continuously. Don’t stop moving for an extended period of time.
• Weight training or resistance training is great for your muscles and actually helps your cardiovascular fitness. Lift weights, pull bands, move soup cans, or do body weight exercises in controlled, repetitive movements. Do 12 repetitions of each exercise a total of 8 times.

Do you still eat out weekly, not caring about the consequences of your food choices? Or have you reverted to eating at home, scared to face a large menu with confusing choices? (Is it healthy? How will it affect my blood sugar? How many calories are in that?)

Of course it is important to make the best food choices under any circumstance, but dining out can be very difficult. Being tempted by foods and desserts that you know are not in your meal plan for the day can be a big challenge. Or navigating a menu from an ethnic restaurant where you’re not sure how the menu items are prepared can thwart your good intentions.

Even though it might be difficult, diabetes does not need to prevent you from dining out occasionally or with friends for special occasions. Planning and preparing will equip you to make the best choices possible. Here are a few ideas and red flags to watch out for.

• Just because eating out is a special occasion or because the food is so much better than what you eat at home does not mean you have a license to splurge and overeat.
• Take a look around to see the dishes on the tables around you. Does something look good? Do you see that the chef has a tendency to drown the food in butter and sauces?
• Decide how much you’ll eat before the meal comes. Cut out your portion and ask for a carry out bag for the rest right away.
• Be aware of which foods contain carbs on your plate. Portion out the right amount of each food for your total carb intake. Pasta, bread, rice, dairy, fruit, starchy veggies, etc.
• Don’t forget about your vegetables and fruits. It is easy to get lost in the main entrée options, but choose healthy sides or ask what comes with your entrée.
• Order water. Drink 1 glass of water for every other beverage serving. Be smart about your beverage choices accounting for added sugar and calories.
• Don’t be scared to ask for specifics. The chef will be willing to accommodate your needs if they know you have a medical condition.
• Eat slowly and stop when you’re full. Really. You’ll enjoy yourself more, save the extra calories you’re not hungry for, and have tasty leftovers for tomorrow.

Use these cues to make the best decisions for yourself when eating these types of cuisine.

• Mexican or Tex-Mex
  • Red Flags: sour cream, crispy, stuffed, chorizo, fried, refried beans, cream sauce, extra cheese
  • Green Lights: lettuce, tomato, pico de gallo, black beans, soft corn tortillas, fajitas, grilled
• Italian
  • Red Flags: focaccia, pancetta, prosciutto, salami, alfredo, stuffed with cheese, cream sauce, breaded, white bread
  • Green Lights: whole wheat pasta, vegetables, lightly sautéed, tomato-based, herbs and spices, primavera, piccata, vinegar
• Chinese
  • Red Flags: Chinese noodles, fried, battered, breaded, crispy, sweet and sour, white rice, sweet sauce, glaze, wonton
  • Green Lights: vegetables, steamed, brown rice, light, simmered, lightly stir fry, chicken, hot and sour
• Thai
  • Red Flags: peanut sauce, coconut milk, fried, golden brown, crispy, curry sauce, mee-krob
  • Green Lights: lemon grass, lime juice, curry paste, napa cabbage, mixed vegetables, broth soup, lime sauce, sautéed
• Japanese
  • Red Flags: fried, tempura, battered, breaded, agemono, katsu, white rice
  • Green Lights: clear broth, vinegered, miso, steamed, with vegetables, grilled, on skewers, boiled
• Indian
  • Red Flags: ghee, molee (coconut), coconut milk, fritters, fried, battered, korma (cream sauce), stuffed, cream curry, basmati rice, chutney
  • Green Lights: skinless chicken, matta (peas), Indian spices, vegetables, lentils (dahl), tandoori

Take a look at this post and this post about preventing foot sores and keep reading here to learn about taking care of wounds that you do get.

1. Make sure that the wound is getting good blood flow. Circulating blood will bring antibodies to fight infection and help generate new cells for healing and closing of the wound. Propping your legs up or gently massaging the area around the wound will help blood get to your lower extremities if you have poor circulation.
2. Keep the wound clean and dry to prevent infection. Cover the wound with clean bandages and clean away visible dirt or debris with warm water and a soap or antibacterial ointment approved by your doctor. Preventing infection is crucial because your wound, however small, will not heal if it is infected.
3. Take away any pressure on the wound or the area around the wound. Place bandages so that they are not pressing on the wound or stretching the skin around the wound. Be careful to wear loose clothing or padded socks so there is not extra pressure or contact.

Your healthcare team should know about your wounds, cuts, scrapes, etc. even if you don’t think they look too serious. Your doctor can track the healing time and let you know if circulation tests are needed, if the wound needs to be thoroughly cleansed or debrided, or if antibiotics are needed before the wound gets serious.

Call your doctor immediately and maybe schedule a visit if you have one of these types of wounds on your foot, leg, hand, arm or anywhere on your body:

• Athlete's foot
• Cracking between the toes
• Sores or wounds on your feet
• Ingrown toenails
• Increasing numbness or pain
• Calluses
• Redness
• Blackening of skin
• Bunions
• Infection
• Hammer or mallet toes (when the middle joints of toes are permanently bent downward)

This means that every time a person with diabetes smokes a cigarette, they are raising their blood sugar, increasing their risk for heart disease and they are at higher risk for other diabetes complications.

Here are the main points of the study:

• Everyone should quit smoking, but people with diabetes really need to quit smoking.
• In the study, nicotine raised glucose levels in red blood cells, the same thing that happens in the human body.
• In the study, A1c increased by 8.8%-34.5% depending on the amount of exposure to nicotine.
• This means that nicotine patches and other quitting methods with nicotine should be used for a short amount of time only to quit. The nicotine replacements will still raise your blood sugar.
• Smoking increases your risk for heart disease and other diabetes complications, and smoking might be a contributor to uncontrolled diabetes.

Go ahead and read this article and then visit this website to start your road to freedom from smoking and nicotine.

---------------------------------------------------------------------------------------------------------------------------------------------------------------

“Smoking is damaging to everyone's health, but the nicotine in cigarettes may be even more deadly for people who have diabetes.

In lab experiments, researchers discovered that nicotine raised blood sugar levels, and the more nicotine that was present, the higher the blood sugar levels were. Higher blood sugar levels are linked to an increased risk of complications from diabetes, such as eye and kidney disease.

"Smoking is really harmful for diabetics. It's even more harmful to them than to a non-diabetic," said study author Xiao-Chuan Liu, an associate professor in the department of chemistry at California State Polytechnic University in Pomona. "This study should encourage diabetics to quit smoking completely, and to realize that it's the nicotine that's raising [blood sugar levels]."

For that reason, it's also important to limit the use of nicotine replacement products, such as nicotine patches, Liu said.

"If you're using them for a short period of time to quit smoking, that's OK. But, if you still have this addiction to nicotine and are using this product long-term, it will do harm. Don't use electronic cigarettes or nicotine gum for a long time. You need to stop nicotine intake," he advised.

Liu is scheduled to present his findings Sunday at an American Chemical Society meeting in Anaheim, Calif.

It was already well-established that smoking increased the risk of problems in people with diabetes, Liu said. What hasn't been clear, he said, is if there is a specific component of cigarettes that increases the risk.

To test whether or not nicotine, an addictive substance found in cigarette smoke, contributed to higher blood sugar levels, Liu and his colleagues added equal amounts of glucose (sugar) to samples of human red blood cells. They also added varying levels of nicotine to each sample of red blood cells for either one day or two days.

They then tested the hemoglobin A1C (HbA1C) levels of the samples. HbA1C is a measure of what percentage of red blood cells have glucose molecules attached to them. In diabetes management, the HbA1C -- sometimes referred to just as A1C -- test gives doctors an idea of average blood sugar levels for the past three months or so. Most people with diabetes strive for a level of 7 percent or less, based on American Diabetes Association guidelines.

The researchers found that nicotine raised HbA1C. The smallest dose increased HbA1C levels by 8.8 percent. The highest dose -- after two days of nicotine treatment -- increased blood sugar levels by 34.5 percent.

"Nicotine is a toxic substance, and our results show that nicotine caused an increase in HbA1C," said Liu. "This is important for the public to know, and for smokers to know. It's not just the cigarette smoke. If you think you can just use a nicotine replacement product indefinitely, there's still a risk, and your chances of getting complications will be a lot higher," he cautioned.

Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, said that the researchers showed that nicotine can significantly raise A1C levels in the lab, but it's important to also know if it does so in the body.

But whether or not nicotine is the specific reason that blood sugar levels are higher in smokers, he said, "Everybody -- whether they have diabetes or not -- should stop smoking. Patients with diabetes already have a much higher risk of cardiovascular disease, and smoking adds to that."

He said that using nicotine replacement products for a month or two is fine. "If nicotine replacement is used for a short period of time with smoking cessation as the goal, there's no risk. But it's not OK if someone plans to replace smoking with nicotine replacement products indefinitely," said Zonszein.”

Experts note that research presented at meetings is considered preliminary until it is published in a peer-reviewed journal.

SOURCES: Xiao-Chuan Liu, Ph.D., associate professor, department of chemistry, California State Polytechnic University, Pomona; Joel Zonszein, M.D., director, clinical diabetes center, Montefiore Medical Center, New York City; March 27, 2011, presentation, American Chemical Society meeting, Anaheim, Calif.

http://www.nlm.nih.gov/medlineplus/aboutmedlineplus.html

They put extra effort into each day than the average person and come out with more satisfaction knowing they are conquering more than the average person.

You probably know that managing diabetes can be complicated, but there are a few changes you can make with major impact.

Controlling your blood sugar is the biggest improvement you can make but a lot goes into controlling your blood sugar:

• controlling carbohydrate intake;
• possibly taking medication or insulin;
• exercising;
• checking your blood sugar regularly;
• reducing stress;
• and the list goes on.

The following simple changes will help lead to better blood sugar control along with your other treatments, but making all these changes together will give you the biggest impact on preventing complications.

Weigh Your Food for One Day Out of Every Week: This will keep you sharp in sticking with portion control, help you control your carb intake, and aid in getting to or staying at a healthy weight.

Join a Gym or Find an Exercise Accountability Partner: The financial cost of joining a gym will be motivation to get the most out of your investment and there are trainers at gyms that can help you maximize your work outs. Having someone to exercise with or who will kindly remind to workout is a great motivator and makes exercising more fun.

Test Your Blood Sugar after fasting, before eating a meal, and 2 hours after eating a meal: Knowing what your blood sugar level is at different times during the day will cause you to react, either to work to get a high reading down, a low reading up, or to congratulate yourself on a great reading in your target range. The more you check, the better you refine your habits to control your blood sugar.

Keep Up to Date with Your Doctors Visits and Tests: Schedule your regular visits to your doctor, specialists, dietitian, dentist, and anyone else that is part of your care team. Also, make sure you are up to date with your tests like A1c, kidney tests, heart check ups and more. It is important to track your progress and give your care team as much information as possible to refine your treatment plan as time goes on.

Find Out How Many Calories You Should be Eating Each Day: This might sound complicated but knowing how much energy your body needs will help you to lose weight and then maintain your healthy weight once you’re there. If you don’t know how many Calories your body needs, how do you know if you are eating too much? Knowing this number is a simple way to keep on target. (Talk with your dietitian or doctor to find out your individual Calorie goals)

Learn Which Foods are Good for Your Heart, Cholesterol, and Diabetes: There are tons of resources available for you to do a little self study or meet with a dietitian or CDE to learn which foods are better for you to choose. A little knowledge goes a long way to better health.

Drink Water: Drinking water seems like a no-brainer but many Americans do not get enough pure water each day. Choosing water over sugary drinks like cokes and sports drinks will save you calories, lower your blood sugar, and improve your overall health.

Quit Smoking: This is a big change for some people but it has one of the biggest impacts on improving your health for your diabetes, heart, circulation, lungs, and other organs.

Set Goals: New Years is not the only time to set goals. Think about areas in your life that you want to improve, not just having to do with diabetes, and write SMART goals down. This simple act will give you something specific to work towards instead of being overwhelmed with the million things you need to improve.

Be Realistic: The longer you have diabetes, the more likely you are to develop complications not because of your failure but because of the progressive nature of the disease. Don’t beat yourself up, but do everything you can to manage the disease so you don’t have any regrets.

So what do you do if your blood sugar is high when you check right before a meal? It is important to make sure that you don't cause your blood sugar to go higher and stay there longer with your next meal.

Remember that your goal should be 90-130mg/dL before a meal if you haven’t eaten since your last meal; but if you ate a snack less than 2 hours prior, your blood sugar is just fine if it is under 180mg/dL.

It is difficult to quickly fix high blood sugar if you are just about to eat, but here are a few tips and actions that can help prevent that high reading or help you bring it down so you will still be under 180mg/dL 2 hours after that meal you are about to eat.

• Take your medication or insulin
• Talk with your doctor about correction doses if you take insulin
• Talk with your doctor, dietitian, and CDE about how to handle hyperglycemia before meals
• Have a smaller morning snack
• Perhaps cut out your morning snack if your meals are only 2-3 hours apart
• Choose healthier and lower glycemic index foods for your morning snack
• Choose healthier and lower glycemic index foods for the meal you are about to eat
• Exercising before breakfast has been shown to lower blood sugar readings in the morning and into the afternoon
• Exercise before your meal
• Eat smaller meals (1-2 carb choices) at more frequent times in the day (6 times a day)
• Add in fiber to all your meals
• Try vinegar at meals which has been shown to lower glucose spikes
• Talk to your doctor or CDE about a meal plan. This will give you specific amounts of carbohydrate to eat at each meal.
• Weigh your food and be accurate with your carb counting
• Write down everything you eat and focus on making better choices tomorrow