Mix first 4 ingredients until blended; rub onto both sides of steak. Refrigerate 30 min.
Spray barbecue grate with cooking spray; heat barbecue to medium-high heat. Meanwhile, combine mangos, peppers, onions and dressing.
Grill steak 5 min.; turn. Reserve half the barbecue sauce; brush remaining barbecue sauce onto steak. Grill 4 to 6 min. or until medium doneness (160ºF). Turn steak; transfer to cutting board. Brush with reserved barbecue sauce. Let stand 5 min. before cutting across the grain into thin slices.
Meanwhile, grill tortillas 20 to 30 sec. on each side or just until crisp and grill marked, watching carefully to prevent burning.
Cut each tortilla into 4 wedges. Serve with the steak and mango relish.
Here’s a look at diabetes, a disease that affects millions of people around the world. Diabetes is characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. The disease can lead to serious complications such as blindness, kidney damage, cardiovascular disease, limb amputations and premature death. Facts: Worldwide, the number of people living with the potentially fatal disease has quadrupled since 1980, to around 422 million, according to the World Health Organization (WHO).
30.3 million people in the United States have diabetes, about 9.4% of the population. Of this number, 7.2 million (23.8%) are undiagnosed. Diabetes is the seventh leading cause of death in the United States.
Prediabetes occurs when blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes. Before developing Type 2 diabetes, people almost always have prediabetes. Research has shown that some long-term damage to the body may occur during prediabetes.
Type 1 diabetes develops when the body’s immune system destroys pancreatic beta cells, the only cells in the body that make insulin. This form of diabetes usually strikes children and young adults. Only 5-10% of people with diabetes have Type 1. Risk factors for Type 1 diabetes may be autoimmune, genetic or environmental. There is no known way to prevent Type 1 diabetes.
Type 2 diabetes occurs when the body does not produce enough insulin or the cells do not use insulin properly. Type 2 diabetes is the most common form of diabetes and in adults, it accounts for about 90% to 95% of all diagnosed cases of diabetes. It is associated with older age, obesity, family history, physical inactivity and race/ethnicity. It is more common in African Americans, Latino Americans, American Indians, Asian Americans, Native Hawaiians and other Pacific Islanders. Type 2 diabetes in children and adolescents, although still rare, is being diagnosed more frequently. Gestational diabetes is a form of glucose intolerance diagnosed during pregnancy. It affects about 4% of all pregnant women. A diagnosis of gestational diabetes doesn’t mean that a woman had diabetes before she conceived, or that she will have diabetes after giving birth.
Some types of diabetes result from genetic conditions, surgery, medications, infections and other illnesses. Such types of diabetes account for 1% to 5% of all diagnosed cases.
Complications: Adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes. The risk for stroke is two to four times higher among people with diabetes. People with diabetes are at high risk for high blood pressure
Diabetes is the leading cause of new cases of blindness among adults aged 20-74 years. Diabetes is the leading cause of kidney failure. Between 60% and 70% of people with diabetes have mild to severe forms of nervous system damage or neuropathy. US Diabetes Statistics: 1.5 million new cases are diagnosed every year in the United States. In 2015, about 84.1 million people 18 or older had pre-diabetes. About 193,000 people under 20 years old have type 1 or type 2 diabetes. $327 billion – Cost to treat diabetes in the US in 2017. Timeline: 1921 – Insulin is discovered by Drs. Frederick Banting and Charles Best. November 16, 2012 – The CDC releases a reportshowing that 18 states had a 100% or more increase in the prevalence of diabetes from 1995 to 2010. Forty-two states saw an increase of at least 50%. January 17, 2014 – For the first time, US surgeon general’s report on the health consequences of smoking includes data that indicates smoking can cause diabetes, as well as erectile dysfunction, rheumatoid arthritis, macular degeneration, ectopic pregnancies and impaired immune function. Smokers have a 30% to 40% increased risk of developing Type 2 diabetes compared with nonsmokers. May 4, 2015 – A study published in the Journal of Clinical Investigation detects a possible connection between diabetes and Alzheimer’s disease. September 28, 2016 – The Food and Drug Administration approves a so-called artificial pancreas. The first-of-its-kind device, the size of a cell phone, monitors and treats patients with type 1 diabetes, also known as juvenile diabetes. September 28, 2017 – The FDA approves the “first-ever continuous blood sugar monitoring device” that doesn’t require patients to prick their fingers for blood samples.
El Paso, Texas, is a predominantly Latino town with a big problem: diabetes.
The city is 82 percent Hispanic and more than 85,000 people have diabetes in El Paso.
The border city, with a population of more than 800,000, has long been considered one of the unhealthiest cities in America, with a high rate of obesity that saw Men’s Fitness magazine rate it as the seventh most obese city.
“Texas is one of 28 states that participate in a CDC-sponsored program to reduce obesity and other chronic diseases.
Obesity is one of the main causes of diabetes and the El Paso Diabetes Association (EPDA) says that as many as 25 percent of those stricken with the disease in El Paso don’t know they have it.
If you have diabetes, self-testing your blood sugar (blood glucose) can be an important tool in managing your treatment plan and preventing diabetes complications. You can test your blood sugar at home with a portable electronic device (glucose meter) that measures sugar level in a small drop of your blood.
Your doctor will advise you how often you should check your blood sugar level. In general, the frequency of testing depends on the type of diabetes you have and your treatment plan.
Type 1 diabetes. Your doctor may recommend blood sugar testing four to 10 times a day if you have type 1 diabetes. You may need to test before meals and snacks, before and after exercise, before bed, and sometimes during the night. You may also need to check your blood sugar level more often if you are ill, change your daily routine or begin a new medication.
Pre-Diabetic
Type 1 diabetes
Type 2 diabetes
If you take insulin to manage type 2 diabetes, your doctor may recommend blood sugar testing a few times a day, depending on the type and amount of insulin you use.Testing is usually recommended before meals and at bedtime if you’re taking multiple daily injections. You may need to test only twice daily, before breakfast and dinner if you only use a long-acting insulin. If you manage type 2 diabetes with noninsulin medications or with diet and exercise alone, you may not need to test your blood sugar daily.
What if you have a continuous glucose monitor (CGM)?
People treated with insulin, particularly those with type 1 diabetes, may also choose to use a CGM. These devices measure your blood sugar every few minutes using a sensor inserted under the skin.
Some devices show your blood sugar reading at all times on a receiver, and an alarm will go off if your blood sugar is going up or going down too quickly. Others require that you check your blood sugar by running the receiver over the sensor periodically.
Most of these devices still require finger-stick checks to calibrate the machine. Check your device’s user guide to learn if you need to check, and how often you need to do so.
Your doctor will set target blood sugar test results based on several factors, including:
Type and severity of diabetes
Age
How long you’ve had diabetes
Pregnancy status
The presence of diabetes complications
Overall health and the presence of other medical conditions
For many people who have diabetes, Mayo Clinic generally recommends the following target blood sugar levels before meals:
Between 80 and 120 milligrams per deciliter (mg/dL) for people age 59 and younger who have no other underlying medical conditions
Between 100 and 140 mg/dL for people age 60 and older, or for those who have other medical conditions, such as heart, lung or kidney disease or reduced ability to sense low blood sugar levels (hypoglycemia awareness)
For many people who have diabetes, the American Diabetes Association generally recommends the following target blood sugar levels:
Between 80 and 130 mg/dL (4.4 and 7.2 mmol/L) before meals
Less than 180 mg/dL (10.0 mmol/L) two hours after meals
Blood sugar testing requires the use of a small electronic device called a glucometer. The meter reads the amount of sugar in a small sample of blood, usually from your fingertip, that you place on a disposable test strip. Your doctor or diabetes educator can recommend an appropriate device for you.
Your doctor or diabetes educator can also help you learn how to use a meter.
Follow the instructions that come with your glucose meter. In general, here’s how the process works:
Wash and dry your hands well.
Insert a test strip into your meter.
Prick the side of your fingertip with the needle (lancet) provided with your test kit.
Gently squeeze or massage your finger until a drop of blood forms.
Touch and hold the edge of the test strip to the drop of blood.
The meter will display your blood glucose level on a screen after a few seconds.
If your meter can test blood taken from an alternate site, such as the forearm or palm, it’s important to understand that these readings may not be as accurate as readings from the fingertips, especially after a meal or during exercise when glucose levels change more frequently.
Recording your results
Talk with your doctor about how often you need to record your blood sugar results. Many devices can now be downloaded to a computer.
When you manually log your results, record the date, time, test results, medication and dose, and diet and exercise information. Bring your record of results with you to all appointments with your doctor. Talk to your doctor about what to do and when to call when you get results that don’t fall within the range of your target goals.
here are many factors that contribute to obesity and many of them vary from person to person, as they might be related to genetics, metabolism, and lifestyle habits. Weight management can be a difficult thing to embark upon yourself and requires the attention of medical professionals that can assess the contributing factors and see how.
Diabetes Healthcare
Diabetes and Exercise: What You Need To Know
Exercise can be a great tool for staving off diabetes; it can improve blood sugar, keep off weight and make you more fit. For many, exercise is another weapon against diabetes, but it is also more complicated for someone with diabetes. Here we’ll go over the basics of exercise while dieting, so you can feel […]
The marks in this booklet show actions you can take to manage your diabetes.
Help your health care team make a diabetes care plan that will work for you.
Learn to make wise choices for your diabetes care each day.
Step 1: Learn about diabetes.
What is diabetes?
There are three main types of diabetes:
Type 1 diabetes – Your body does not make insulin. This is a problem because you need insulin to take the sugar (glucose) from the foods you eat and turn it into energy for your body. You need to take insulin every day to live.
Type 2 diabetes – Your body does not make or use insulin well. You may need to take pills or insulin to help control your diabetes. Type 2 is the most common type of diabetes.
Gestational (jest-TAY-shun-al) diabetes – Some women get this kind of diabetes when they are pregnant. Most of the time, it goes away after the baby is born. But even if it goes away, these women and their children have a greater chance of getting diabetes later in life.
You are the most important member of your health care team.
You are the one who manages your diabetes day by day. Talk to your doctor about how you can best care for your diabetes to stay healthy. Some others who can help are:
dentist
diabetes doctor
diabetes educator
dietitian
eye doctor
foot doctor
friends and family
mental health counselor
nurse
nurse practitioner
pharmacist
social worker
How to learn more about diabetes.
Take classes to learn more about living with diabetes. To find a class, check with your health care team, hospital, or area health clinic. You can also search online.
Join a support group — in-person or online — to get peer support with managing your diabetes.
Read about diabetes online. Go to National Diabetes Education Program.
Take diabetes seriously.
You may have heard people say they have “a touch of diabetes” or that their “sugar is a little high.” These words suggest that diabetes is not a serious disease. That is not correct. Diabetes is serious, but you can learn to manage it.
People with diabetes need to make healthy food choices, stay at a healthy weight, move more every day, and take their medicine even when they feel good. It’s a lot to do. It’s not easy, but it’s worth it!
Why take care of your diabetes?
Taking care of yourself and your diabetes can help you feel good today and in the future. When your blood sugar (glucose) is close to normal, you are likely to:
have more energy
be less tired and thirsty
need to pass urine less often
heal better
have fewer skin or bladder infections
You will also have less chance of having health problems caused by diabetes such as:
heart attack or stroke
eye problems that can lead to trouble seeing or going blind
pain, tingling, or numbness in your hands and feet, also called nerve damage
kidney problems that can cause your kidneys to stop working
teeth and gum problems
Actions you can take
Ask your health care team what type of diabetes you have.
Learn where you can go for support.
Learn how caring for your diabetes helps you feel good today and in the future.
Step 2: Know your diabetes ABCs.
Talk to your health care team about how to manage your A1C, Blood pressure, and Cholesterol. This can help lower your chances of having a heart attack, stroke, or other diabetes problems.
A for the A1C test (A-one-C).
What is it?
The A1C is a blood test that measures your average blood sugar level over the past three months. It is different from the blood sugar checks you do each day.
Why is it important?
You need to know your blood sugar levels over time. You don’t want those numbers to get too high. High levels of blood sugar can harm your heart, blood vessels, kidneys, feet, and eyes.
What is the A1C goal?
The A1C goal for many people with diabetes is below 7. It may be different for you. Ask what your goal should be.
B for Blood pressure.
What is it?
Blood pressure is the force of your blood against the wall of your blood vessels.
Why is it important?
If your blood pressure gets too high, it makes your heart work too hard. It can cause a heart attack, stroke, and damage your kidneys and eyes.
What is the blood pressure goal?
The blood pressure goal for most people with diabetes is below 140/90. It may be different for you. Ask what your goal should be.
C for Cholesterol (ko-LESS-tuh-ruhl).
What is it?
There are two kinds of cholesterol in your blood: LDL and HDL.
LDL or “bad” cholesterol can build up and clog your blood vessels. It can cause a heart attack or stroke.
HDL or “good” cholesterol helps remove the “bad” cholesterol from your blood vessels.
What are the LDL and HDL goals?
Ask what your cholesterol numbers should be. Your goals may be different from other people. If you are over 40 years of age, you may need to take a statin drug for heart health.
Actions you can take
Ask your health care team:
what your A1C, blood pressure, and cholesterol numbers are and what they should be. Your ABC goals will depend on how long you have had diabetes, other health problems, and how hard your diabetes is to manage.
what you can do to reach your ABC goals
Write down your numbers on the record at the back of this booklet to track your progress.
Step 3: Learn how to live with diabetes.
Diabtes Management health and wellness
It is common to feel overwhelmed, sad, or angry when you are living with diabetes. You may know the steps you should take to stay healthy, but have trouble sticking with your plan over time. This section has tips on how to cope with your diabetes, eat well, and be active.
Cope with your diabetes.
Stress can raise your blood sugar. Learn ways to lower your stress. Try deep breathing, gardening, taking a walk, meditating, working on your hobby, or listening to your favorite music.
Ask for help if you feel down. A mental health counselor, support group, member of the clergy, friend, or family member who will listen to your concerns may help you feel better.
Eat well.
Make a diabetes meal plan with help from your health care team.
Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt.
Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice, or pasta.
Choose foods such as fruits, vegetables, whole grains, bread and cereals, and low-fat or skim milk and cheese.
Drink water instead of juice and regular soda.
When eating a meal, fill half of your plate with fruits and vegetables, one quarter with a lean protein, such as beans, or chicken or turkey without the skin, and one quarter with a whole grain, such as brown rice or whole wheat pasta.
Be active.
Exercise to manage diabetes
Set a goal to be more active most days of the week. Start slow by taking 10 minute walks, 3 times a day.
Twice a week, work to increase your muscle strength. Use stretch bands, do yoga, heavy gardening (digging and planting with tools), or try push-ups.
Stay at or get to a healthy weight by using your meal plan and moving more.
Know what to do every day.
Take your medicines for diabetes and any other health problems even when you feel good. Ask your doctor if you need aspirin to prevent a heart attack or stroke. Tell your doctor if you cannot afford your medicines or if you have any side effects.
Check your feet every day for cuts, blisters, red spots, and swelling. Call your health care team right away about any sores that do not go away.
Brush your teeth and floss every day to keep your mouth, teeth, and gums healthy.
Stop smoking. Ask for help to quit. Call 1-800-QUITNOW (1-800-784-8669).
Keep track of your blood sugar. You may want to check it one or more times a day. Use the card at the back of this booklet to keep a record of your blood sugar numbers. Be sure to talk about it with your health care team.
Check your blood pressure if your doctor advises and keep a record of it.
Talk to your health care team.
Ask your doctor if you have any questions about your diabetes.
Report any changes in your health.
Actions you can take
Ask for a healthy meal plan.
Ask about ways to be more active.
Ask how and when to test your blood sugar and how to use the results to manage your diabetes.
Use these tips to help with your self-care.
Discuss how your diabetes plan is working for you each time you visit your health care team.
Step 4: Get routine care to stay healthy.
See your health care team at least twice a year to find and treat any problems early.
At each visit, be sure you have a:
blood pressure check
foot check
weight check
review of your self-care plan
Two times each year, have an:
A1C test. It may be checked more often if it is over 7.
Once each year, be sure you have a:
cholesterol test
complete foot exam
dental exam to check teeth and gums
dilated eye exam to check for eye problems
flu shot
urine and a blood test to check for kidney problems
At least once in your lifetime, get a:
pneumonia (nu-mo-nya) shot
hepatitis B (HEP-uh-TY-tiss) shot
Medicare and diabetes.
If you have Medicare, check to see how your plan covers diabetes care. Medicare covers some of the costs for:
diabetes education
diabetes supplies
diabetes medicine
visits with a dietitian
special shoes, if you need them
Actions you can take
Ask your health care team about these and other tests you may need. Ask what your results mean.
Write down the date and time of your next visit.
Use the card at the back of this booklet to keep a record of your diabetes care.
If you have Medicare, check your plan.
Things to Remember:
You are the most important member of your health care team.
Follow the four steps in this booklet to help you learn how to manage your diabetes.
Learn how to reach your diabetes ABC goals.
Ask your health care team for help.
My Diabetes Care Record: Page 1
How to use the record.
First read the shaded bar across the page. This tells you:
the name of the test or check-up
how often to get the test or check-up
what your personal goal is (for A1C, blood pressure, and cholesterol)
Then, write down the date and results for each test or check-up you get. Take this card with you on your health care visits. Show it to your health care team. Talk about your goals and how you are doing.
A1C – At least twice each year
My goal: ______
Blood Pressure (BP) – At each visit
My goal: ______
Cholesterol – Once each year
My goal: ______
Date
Result
Date
Result
Date
Result
My Diabetes Care Record: Page 2
How to use the record.
Use this page to write down the date and results of each test, exam, or shot.
Each Visit
Date
Result
Once a Year
Date
Result
At Least Once
Date
Result
Foot check
Review self-care plan
Weight check
Review medicines
Dental exam
Dilated eye exam
Complete foot exam
Flu shot
Kidney check
Pneumonia shot
Hepatitis B shot
Self Checks of Blood Sugar
How to use this card.
This card has three sections. Each section tells you when to check your blood sugar: before each meal, 1 to 2 hours after each meal, and at bedtime. Each time you check your blood sugar, write down the date, time, and results. Take this card with you on your health care visits. Show it to your health care team. Talk about your goals and how you are doing.
Date
Time
Result
My blood sugar before meals: Usual goal 80 to 130* My goal: ________
My blood sugar 1-2 hours after meals: Usual goal below 180* My goal: ________
My blood sugar at bedtime: Usual goal 110 to 150* My goal: ________
* Your blood sugar goals may be different if you are an older adult (over 65) and have had diabetes a long time. They may be different if you have other health problems like heart disease, or your blood sugar often gets too low.
2 additional pairs of inserts each calendar year for custom-molded shoes.
3 pairs of inserts each calendar year for extra-depth shoes
Medicare will cover shoe modifications instead of inserts.
Your costs in Original Medicare
If your supplier accepts assignment, you pay 20% of the Medicare-approved amount, and the Part B deductible applies.
Medicare will only cover your therapeutic shoes if your doctors and suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren’t enrolled, Medicare won’t pay the claims submitted by them.
It’s also important to ask your suppliers if they participate in Medicare before you get therapeutic shoes. If suppliers are participating suppliers, they must accept assignment. If suppliers are enrolled in Medicare but aren’t “participating,” they may choose not to accept assignment. If suppliers don’t accept assignment, there’s no limit on the amount they can charge you.
Note
To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:
Other insurance you may have
How much your doctor charges
Whether your doctor accepts assignment
The type of facility
Where you get your test, item, or service
Note
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.
Diabetes can be dangerous to your feet—even a small cut can produce serious consequences. Diabetes may cause nerve damage that takes away the feeling in your feet. Diabetes may also reduce blood flow to the feet, making it harder to heal an injury or resist infection. Because of these problems, you may not notice a foreign object in your shoe. As a result, you could develop a blister or a sore. This could lead to an infection or a nonhealing wound that could put you at risk for an amputation.
Inspect your feet daily. Check for cuts, blisters, redness, swelling or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Call your doctor if you notice anything.
Bathe feet in lukewarm, never hot, water. Keep your feet clean by washing them daily. Use only lukewarm water—the temperature you would use on a newborn baby.
Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting and carefully dry between the toes.
Moisturize your feet but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking. But don’t moisturize between the toes—that could encourage a fungal infection.
Cut nails carefully. Cut them straight across and file the edges. Don’t cut nails too short, as this could lead to ingrown toenails. If you have concerns about your nails, consult your doctor.
Never treat corns or calluses yourself. No “bathroom surgery” or medicated pads. Visit your doctor for appropriate treatment.
Wear clean, dry socks. Change them daily.
Consider socks made specifically for patients living with diabetes. These socks have extra cushioning, do not have elastic tops, are higher than the ankle and are made from fibers that wick moisture away from the skin.
Wear socks to bed. If your feet get cold at night, wear socks. Never use a heating pad or a hot water bottle.
Shake out your shoes and feel the inside before wearing.Remember, your feet may not be able to feel a pebble or other foreign object, so always inspect your shoes before putting them on.
Keep your feet warm and dry. Don’t let your feet get wet in snow or rain. Wear warm socks and shoes in winter.
Consider using an antiperspirant on the soles of your feet. This is helpful if you have excessive sweating of the feet.
Never walk barefoot. Always wear shoes or slippers. You could step on something and get a scratch or cut.
Take care of your diabetes. Keep your blood sugar levels under control.
Do not smoke. Smoking restricts blood flow in your feet.
Get periodic foot exams. Seeing your foot and ankle surgeon on a regular basis can help prevent the foot complications of diabetes
