Eating Disorders - American Diabetes Association

Eating Disorders - American Diabetes Association

Diabetes and the risks of surgery

The Risks of Surgery

In addition to the normal Risks of Surgery, diabetics face additional risks when having a surgical procedure. These risks are heightened if you have had diabetes for an extended period of time, frequently have high blood sugars, or if you are a brittle (have difficulty controlling your glucose level) diabetic. Patients who have already experienced major complications from diabetes, such as neuropathy or requiring an amputation are also at higher risk.

The Risks Diabetics Face After Surgery:

• Hyperglycemia (high blood glucose) Or Hypoglycemia (low blood glucose)
• Poor wound healing, slow wound healing, weak skin and tissue at site of surgery
• Infection, including infection of the wound, pneumonia, urinary tract infection or sepsis
• Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNK)
• Diabetic Ketoacidosis (DKA)
• Electrolyte Imbalance-A condition where electrolyte levels (sodium, potassium) rise or fall significantly, which can cause significant problems with the heart and the body’s fluid levels 

What Diabetics Can Do to Be a Better Surgical Candidate

The better your control of your diabetes, the better your chances of an excellent surgical outcome. Keeping your blood glucose within the parameters your doctor recommends is key. Top-notch nutrition, including high quality protein, is also essential. Protein is an important component in the healing process and can help contribute to faster wound healing, stronger tissue at the surgical site and an increased ability to withstand the rigors of surgery.

If you aren’t already exercising but you are able, you may want to start an exercise program after checking with your doctor. Making your body stronger is going to help you better tolerate your surgery and recovery.

Try not to get overly stressed about your surgery. If you are feeling anxious about your surgery, Coping With Surgical Fear and Anxiety may help. It is important to keep stress to a minimum because both physical stress (the surgery) and emotional stress (worrying, anxiety) can work against you by elevating your blood glucose levels.

If you drink or smoke, this is the time to stop. Eliminating alcohol will help you better control your blood glucose and Quitting Smoking will help you return to breathing without oxygen or a ventilator faster.

What to Expect During Your Hospital Stay

The way your diabetes is managed at home may be very different from how it is managed in the hospital. One good example is the use of regular insulin given by IV, rather than the other types available. Most doctors, especially in the time immediately surrounding surgery, will not want oral medications or long acting types of insulin to be given. Regular insulin works within a short time, allowing the staff to have a much better idea of your glucose level. This allows them to treat elevated levels, or low levels immediately. In some cases, blood glucose testing will be done as frequently as every two hours, with medication coverage provided as needed.

Your glucose level may be maintained in a much narrower window during your hospital stay. This is because studies have shown that the better controlled blood glucose levels are, the faster the healing. If you are going to have meals during your stay at the hospital you can expect to receive diabetic meals, which are designed specifically for diabetics by the nutrition staff.

If you are having outpatient surgery, or have to report for your surgery that morning, consider bringing along your glucose meter. If the surgery is delayed for any reason, you will be able to test your glucose level as needed and notify staff as appropriate.

Talk To Your Surgeon About Your Diabetes

• Who will manage my diabetes during my hospital stay, the surgeon, my endocrinologist, my family physician?
• Who will manage my diabetes during the surgery? ("It isn’t necessary" truly is not an acceptable answer unless your surgery will be VERY fast. During surgery the anesthesia provider can give you insulin or glucose as needed to keep your blood glucose level within the acceptable range, at the request of the surgeon.)
• Should I take my insulin the morning of the surgery?
• Should I take my nighttime does of insulin?
• What would you like me to do if I have an episode of low or high blood glucose the morning of surgery? 
• When should I have my last meal/fluid prior to surgery?

Diabetes After Surgery

After surgery, the need for high quality nutrition and tight glycemic control continues. Nutrition will provide the building blocks for healing and a normal glucose level will promote a quicker return to health. Tight control of glucose levels could potentially shave days or even weeks off of your recovery period when compared to recovery times with elevated blood glucose.
Once the surgery is over and you are into your recovery phase, you will need to aggressively check for signs of infection in your healing wound, in addition to the normal checks you do (such as checking your feet for problems). If you have neuropathy, remember you may not feel pain until the infection is well established. You may want to take your temperature regularly as another way to detect infection.
Signs of a wound infection include:

• Pus or foul drainage
• Fever Greater than 101 degrees
• The incision feels hot to the touch, or is angry red
• Pain around the incision that is getting worse instead of better
• Swelling or hardening of the incision site

 

10 simple ways to keep your portions a healthy size

Most of us sit down to eat, the last thing we want to think about is portion control. But for anyone on a diet or just looking to maintain their current figure, that’s exactly what they should be doing.

Gone are the days of eating a bagel or muffin and feeling safe about its calories. In fact, researchers measured typical servings from takeout restaurants, fast food chains, and family-style eateries and found that bagels were 195 percent larger than the standard set by the United States Department of Agriculture (USDA), muffins were 333 percent bigger and cooked pasta exceeded the standard by 480 percent. Scariest of all were cookies, which were a whopping seven times the USDA recommended serving size.

Portion Control and Diet: How It Works

The first step in successful portion control is learning the correct serving size — the amount of food recommended by government agencies, such as the Dietary Guidelines for Americans put out by the USDA and Department of Health and Human Services, and the USDA Food Guide Pyramid. The serving size can usually be found by reading nutritional labels. But the portion is the amount of food or drink a person chooses to consume. In many cases, the portion eaten is larger than the serving size simply because we don’t know any better.

“Portion control is limiting what you eat,” says Mary M. Flynn, RD, PhD, chief research dietitian and assistant professor of medicine at the Miriam Hospital and Brown University in Providence, R.I. “It is being aware of how much food you are actually eating and what calories are in that serving.” 

The good news is that with a little practice, portion control is easy to do and can help people be successful in reaching and then maintaining a proper weight. 

Here are 10 simple ways to keep your portions a healthy size: 

1. Measure accurately. For foods and beverages, use gadgets like a measuring cup, tablespoon, teaspoon, or food scale. 

2. Learn how to estimate serving sizes. “‘Ballpark’ food portion sizes by estimating serving sizes in comparison to known objects,” says Rose Clifford, RD, clinical dietitian in the department of pharmacy services at the Washington Hospital Center in Washington, DC. “For example, three ounces of cooked meat, fish, or poultry is about the size of a deck of cards.” Other easy measurements to eyeball include:

• ½ cup is the size of an ice cream scoop
• 1 cup is the size of a tennis ball
• 1 ounce of cheese is the size of a domino

3. Use portion control dishware. Pick out smaller plates, bowls, cups, and glassware in your kitchen and measure what they hold. You might find that a bowl you thought held 8 ounces of soup actually holds 16, meaning you’ve been eating twice what you planned. 

4. Dish out your servings separately. Serve food from the stove onto plates rather than family-style at the table, which encourages seconds. 

5. Make your own single-serving packs. “Re-portion bulk quantities of favorite foods such as pasta, rice, and cereal into individual portions in zipper bags so that when you’re in the mood for some food you’ll instantly see the number of portions you’re preparing,” says Jennifer Nasser, RD, PhD, assistant professor in the department of biology at Drexel University in Philadelphia. 

6. Add the milk before the coffee. When possible, put your (fat-free) milk into the cup before adding the hot beverage to better gauge the amount used. 

7. Measure oil carefully. This is especially important because oil (even the healthful kinds like olive and safflower) have so many calories; don’t pour it directly into your cooking pan or over food. 

8. Control portions when eating out. Eat half or share the meal with a friend. If eating a salad, ask for dressing on the side. Dip your fork into the dressing and then into the salad.

9. Add vegetables. Eat a cup of low-calorie vegetable soup prior to eating a meal, or add vegetables to casseroles and sandwiches to add volume without a lot of calories. 

10. Listen to your hunger cues. Eat when hungry and stop when satisfied or comfortably full. “Try to gauge when you are 80 percent full and stop there,” says Clifford. “There will be more food at the next meal or snack!”

10 Ways to Fend Off Food Cravings

Here's an article i read, i guess im going to give this a try

A physiological reason, such as hunger, can have you craving food. “If you go longer than five hours without food, your blood sugar will drop and your cravings will begin,” Anding says. You can help avoid food cravings caused by hunger by not going more than five hours without eating something. If it’s time for an allowed snack, choose food low in calories and fat. Options under 50 calories include a small peach, 15 grapes, 2 cups of light microwaved popcorn, or five pretzels. 

To help fend off food cravings, every meal should include some source of lean protein, such as skinless chicken or turkey, fish, eggs, or low-fat cheese. “Protein helps to control blood sugar patterns and can help prevent food cravings,” Anding says. Foods containing protein also help you feel fuller by stimulating production of cholecystokinin (CKK), a naturally occurring appetite suppressant. And by choosing lean sources, you put a cap on calories. 

Dehydration can cause some people to crave salty foods. The solution is simple: Drink more water. An 8-ounce glass of refreshing water can also help you feel full and get your mind off your food cravings of the moment. In fact, what you think are food

cravings may actually be thirst. Quench your thirst, and the food cravings will go away, too. Keep a water bottle handy throughout the day to make it easy to satisfy your fluid needs. 

“When the craving is psychological, it is meeting a need different from hunger”.The way to combat food cravings caused by boredom, anxiety, or other emotions is by finding an activity that will take your mind off your craving without adding calories. Call a friend. Go window shopping at the mall or make a virtual visit to your favorite stores online. Tune into a ballgame. Listen to music. Read a mystery. Watch a movie.

Yes, chewing gum can help you lose weight. “Some recent studies suggest that chewing gum may reduce one’s cravings for sweets and for snacks,” Anding says. If you reach for a stick of gum, be sure it’s sugarless, with zero or only a few calories. For variety, have an assortment of flavors you like available. A bit of caution is needed, Anding warns: The sugar alcohols in sugarless gum can cause gastric distress in some people, especially if you chew an excessive amount.

  

Another way to beat food cravings when they are psychological is to replace eating with an activity you find pleasurable and emotionally satisfying, Anding says. Do something you really enjoy that doesn’t involve an intake of calories: Take a bubble bath, read a fun magazine, do your nails. Or look for options that actually burn calories, like taking a long walk with a special someone. It’s a way of being kind to yourself without sabotaging your weight-loss efforts. 

Are you eyeing a bag of barbecue potato chips? Is your food craving for a sticky caramel candy bar? You can literally wash that taste right out of your mouth. Get up, go to the bathroom, and brush your teeth with minty toothpaste. Swish with a little minty mouthwash. Floss your teeth. As a final touch, apply some peppermint lip balm. Once your mouth is feeling clean and fresh, you won’t want to spoil it with salty chips or sugary candy.

 Feel like you could down that carton of ice cream in one fell swoop? Instead of heading for the freezer, head for the front door and go for a jog around the block. The fresh air and exercise will calm you down, clear your head, and help quench any desire for overindulgence. If unpleasant weather is keeping you homebound, bound up and down the stairs for five minutes until the food craving passes. Rather than piling on the calories, you’ll be burning them. 

Research suggests that some people can become addicted to refined foods, such as white bread, white pasta, and white sugar. The more you eat, the more you want. Break the cycle. Eliminate refined foods from your diet and you could curb your food cravings. Go the extra step and refine your diet by replacing the refined foods with whole grains and fiber — eat more nuts, beans, legumes, fruits, vegetables, and whole-wheat foods. Remember that fiber makes you fuller and is great for your digestion. 

When you’re scaling back on refined sugars, be sure to target high fructose corn syrup (HFCS). HFCS is used as a sweetener in many foods, from bread to frozen dinners, because it’s inexpensive and increases shelf life. New research shows that high fructose corn syrup can be a trigger food in animals — having even a tiny amount will make them want more. Scientists are studying whether HFCS may have the same effect in humans. Read food labels carefully to see whether the foods you are eating have HFCS and avoid them if you can.