Diabetic Information~Foods To Avoid

Foods to Avoid or Limithttp://www.betterfamilyhealth.org/treatment-of-diabetes.htmlSuitable Alternatives

High in Sugar
sugar, honey
spreads : jam, marmalade, syrups, nutellasweet drinks : cordial, soft drink, flavoured mineral water, tonic water, fruit juice drinks, ordinary flavoured milk, milkshakessweet wine/sherry, port, liqueurs, ordinary beerconfectionary : lollies, cough lollies, chocolate (ordinary/diabetic/carob), muesli/health bars
Use Stevia (0 calories) instead, tablet or liquid artificial sweetenerlow joule jam/marmalade, Promite, Vegemite, meat/fish pastelow joule cordial/soft drink, plain mineral/soda water, pure fruit juice (limit to 1 small glass a day), coffee, tea, herbal teas, Green tea is highly antioxidant
dry wine or spirit (1 to 2 drinks a day)
low joule pastilles
sweet biscuits (eg cream, chocolate, shortbread), cakes, donuts, iced buns, sweet pastries, crispbreads, Cruskits, wholemeal crackers, wheatmeal or coffee biscuits, scones, ‘no added sugar’ fruit loafRice crackers or biscuits
sweet desserts : ordinary jelly, fruit in sugar syrup, fruit pies, cheesecakes, puddings, ordinary flavoured yoghurt or ice-cream, ice-cream toppingslow joule jelly, fresh or tinned/stewed fruit without added sugar, plain or diet-lite ‘no added sugar’ yoghurt, plain ice-cream (1 scoop occasionally), low joule ice-cream topping
sweet cereals : some mueslis, Nutrigrain, Cocopops, Honey Smacks, Sugar Frosties, Weetbix, All-BranPorridge

High in Fat
mayonnaise, oily dressings, cream sauces, fatty gravies, sour creamlow joule dressings, vinegar, lemon juice, low joule Gravox, plain yoghurt, Olive Oil based dressings
fat on meat, chicken skin, fatty meats (sausages, bacon, salami)deep-fried foods, pies/pastriesVegetable oils are now considered unhealthy oils (including peanut oil)lean cuts of meat with skin and fat removedfoods cooked without fat, or with a minimal amount of coconut, olive, avacado, flaxseed or nut oils
snack foods : crisps, corn chipslarge amounts of margarine, oil, cream, peanut butter, drippingnuts, raw vegetables, fruit, plain popcornlimit to 3-6 teaspoons a day, preferably butter, moderate amounts of lard & ghee

Do you think you will find it difficult to commit to a healthier diet as a treatment of diabetes, here is a powerful and pragmatic suggestion in this Ted.com video from Graham Hill, founder of Treehugger.com – Be a weekday vegetarian.

Here is a list of the Best Antioxidants and Free Radical Scavengers that you should be taking as dietary supplements daily as recommended by Dr David Perlmutter, author of ‘Grain Brain’:

  • Tumeric
  • DHA Omega 3
  • B complex vitamins (including Vitamin B12)
  • Vitamin C & D
  • Bacopa
  • Brocolli
  • Alpha-Lipoic acid 300 (ALA)
  • Ashwagandha
  • Resveratrol
  • Milk Thistle
  • Green Tea
  • Probiotics
  • Coenzyme Q10 (coq10)

These nutritional supplements reduce oxidative stress on your brain and body, thus protecting your health.

Dr. Mercola Interviews Dr. David Perlmutter, Author of Grain Brain

Natural health expert and Mercola.com founder Dr. Joseph Mercola interviews Dr. David Perlmutter about the implications of diet to Alzheimer’s risk.

Here is a list of the Best Antioxidants and Free Radical Scavengers that you should be taking as dietary supplements daily as recommended by Dr David Perlmutter, author of ‘Grain Brain’:

  • Tumeric
  • DHA Omega 3
  • B complex vitamins (including Vitamin B12)
  • Vitamin C & D
  • Bacopa
  • Brocolli
  • Alpha-Lipoic acid 300 (ALA)
  • Ashwagandha
  • Resveratrol
  • Milk Thistle
  • Green Tea
  • Probiotics
  • Coenzyme Q10 (coq10)

These nutritional supplements reduce oxidative stress on your brain and body, thus protecting your health.

Thank you for reading 🙂


Non-Perishable Foods For People With Diabetes

18 of the Best Non-Perishables for People with Diabetes

If you have diabetes, you may be concerned about eating well while keeping physical distance, also known as social distancing, or self-quarantining.

Keeping non-perishable foods on hand can be a great way to minimize your trips to the store and ensure that you have all the ingredients you need to make nutritious meals.

Notably, numerous frozen or shelf-stable foods have a minimal effect on your blood sugar levels. You may even already have some in your pantry or freezer.

Here are 18 of the best non-perishables for people with diabetes.

dry chickpeas in a glass jar

1. Dried or canned chickpeas

Chickpeas are popular in numerous dishes. While they contain carbs, they’re also rich in fiber, protein, and fat — all of which help minimize their overall effect on your blood sugar levels (1Trusted Source).

You can use these tasty legumes to make hummus or falafels. What’s more, they make a filling meat alternative and can be added to soups, salads, and stir-fries.

If stored in a cool, dark pantry, dried chickpeas keep for up to 3 years.

2. Canned tomatoes

Canned tomatoes can flavor numerous dishes, including soups and stews.

These savory, red fruits are also rich in antioxidants, such as lycopene, which may promote heart health. Plus, they’re fairly low in carbs, so they only affect your blood sugar levels minimally (2, 3Trusted Source).

Canned tomatoes can be used in cooking or to make sauces. Canned veggies typically don’t expire for several years after purchase.

3. Peanut butter

Peanut butter is an inexpensive source of healthy protein, fat, and fiber — and it has few carbs (4Trusted Source).

It’s a great way to make a snack more filling. You can add it to toast or crackers, blend it into a smoothie, or use it as a dip for apples or baby carrots. It’s likewise great in savory dishes like Thai-inspired stir-fry.

Just be sure to choose natural peanut butter brands that don’t contain added sugar, as sugary foods negatively affect blood sugar control.

After opening, peanut butter lasts for about 1 year.

4. Pistachios

pistachios in a bowl

Pistachios are a tree nut that packs healthy protein and fat. They’re also rich in fiber, making them a great snack for people with diabetes (5Trusted Source).

They serve as a crunchy addition to salads and can be crushed to make breading for fish or chicken.

Pistachios last for about 6 months in your pantry, although refrigeration greatly extends their shelf life.

5. Canned salmon

Canned salmon is rich in omega-3 fatty acids, which benefit your brain and fight inflammation (6Trusted Source).

Moreover, this fish is packed with protein and has no carbs. Canned salmon also contains some bones, which are safe and edible — and provide a calcium boost (7Trusted Source).

You can use canned salmon on salads or in salmon patties. It typically doesn’t expire until 2 years after purchase.

6. Seed crackers

Seed crackers are crackers made from a variety of seeds, such as sesame, flax, and chia seeds.

Seeds serve as a healthy source of fat and fiber, which help slow these crackers’ effects on your blood sugar levels (8Trusted Source, 9Trusted Source, 10Trusted Source).

They can be paired with peanut butter or cheese as a snack, or included in a light meal like chicken salad or soup.

If kept tightly sealed and stored in a pantry or fridge, seed crackers should last for about 1 month.

7. Chia seeds

Chia seeds are tiny black or white seeds. They boost digestive health because they’re rich in soluble fiber and form a gel in your gut. This helps slow digestion and prevent rapid blood sugar spikes (11Trusted Source).

Chia seeds add crunch to salads and smoothies. You can also use them to make chia pudding, a delectable treat that’s delicious with fresh fruit.

These seeds last up to 4 years in your pantry.

8. Frozen berries

mixed frozen berries

Berries like raspberries are relatively low in sugar and high in fiber compared with other fruits like bananas or apples, so they affect your blood sugar levels to a lesser extent (12Trusted Source, 13Trusted Source, 14Trusted Source).

Additionally, berries are packed with health-boosting nutrients and antioxidants (15Trusted Source).

Frozen berries can be used in smoothies, cooking, and baking, and they last up to 1 year in the freezer — although you’ll want to check them on occasion for freezer burn.

9. Frozen cauliflower

Cauliflower is a versatile ingredient that can replace mashed potatoes, rice, and even certain pastas like macaroni. Its mild flavor makes it a great substitute for these starchy carbs.

Plus, it boasts a very low carb count (15Trusted Source).

Frozen cauliflower can last for up to 1 year in the freezer but should be checked for freezer burn often.

Virtual doctor visits with Novant Health

10. Quinoa

Quinoa is a chewy whole grain with a taste and texture similar to that of brown rice. However, it has more protein and fiber — and fewer total carbs — than brown rice, making it ideal for people with diabetes (16Trusted SourceTrusted Source17Trusted SourceTrusted Source).

Quinoa lasts for about 6 months to 1 year if properly stored in a sealed container in your pantry.

11. Canned mushrooms

Canned mushrooms, which taste milder than fresh varieties, give a nutrient boost to endless dishes. They’re particularly popular in soups and stir-fries.

Mushrooms are fiber-rich and low in carbs, so they affect your blood sugar negligibly. Some varieties, including the white button, contain ergothioneine, an amino acid that has antioxidant properties and may aid blood sugar management (18Trusted Source, 19Trusted Source).

Canned mushrooms usually don’t expire until 2 years after purchase.

12. Canned or frozen spinach

cooking frozen spinach in pan

Given that spinach contains very few carbs and calories, you can eat a large quantity with a minimal effect on your blood sugar levels (20Trusted Source).

You can cook it as a side or add it to soups, stir-fries, and many other dishes to increase your intake of fiber, antioxidants, and provitamins A and K.

Canned spinach lasts up to 4 years, while frozen spinach keeps for up to 1 year.

13. Canned chicken

Canned chicken is fairly lean, rich in protein, and contains almost no carbs. It’s also convenient, as it’s fully cooked and ready to eat (21Trusted Source).

You can use it in soups, salads, and casseroles in the same way as you would use cooked chicken that’s shredded or cubed. It also makes for easy chicken salad.

Canned chicken lasts up to 4 years.

14. Dark chocolate

Dark chocolate is a great treat for people with diabetes — and the darker the better, as chocolate with a higher cocoa content tends to pack less added sugar. Cocoa is also rich in fiber and healthy fats.

For instance, just 3 squares (30 grams) of 78% dark chocolate offers 14 grams of fat, 3 grams of protein, and 4 grams of fiber — with only 11 grams of carbs (22Trusted Source).

You can eat it on its own or include it in numerous desserts. A dark chocolate bar keeps for up to 4 months in your pantry, but freezing it extends its shelf life.

15. High protein pasta

High protein pasta are usually made from legumes, such as black beans or chickpeas, instead of wheat.

Legumes contain carbs but boast more fiber and protein than wheat, making high protein pastas a better choice for people with diabetes (23Trusted Source24Trusted Source).

You can replace regular pasta with a high protein variety in any recipe. It lasts dry for up to 6 months.

16. Protein powder

a scoop of protein powder

Most protein powders are low in carbs and added sugars while providing hefty doses of protein. They’re also quick and convenient.

Whey protein is derived from cow’s milk, so if you prefer a plant-based option, you can use soy or pea protein powder.

Protein powder is a great addition to smoothies, protein shakes, and desserts. It typically lasts for up to 1 year if sealed and stored in a cool, dry place.

17. Shelf-stable milk

Shelf-stable milk, whether dairy or plant-based, is always good to have on hand.

Although cow’s milk is slightly higher in carbs than some nondairy alternatives, it has protein and fat — unless it’s skim — that reduce its effects on your blood sugar. Alternatively, some plant-based milk like unsweetened almond milk contain few carbs to begin with (25Trusted Source, 26Trusted Source).

If you opt for plant milk, make sure to buy varieties without added sugar.

Both shelf-stable and plant-based milks can be used in various recipes, such as protein-rich smoothies, soups, and baked goods. They last unopened for several months but should be refrigerated after opening.

18. Olive oil

Olive oil is rich in anti-inflammatory compounds, and consuming it regularly may help you manage your blood sugar levels (27Trusted Source).

Olive oil is pure fat, so it contains no carbs to affect your blood sugar levels. However, it’s high in calories, so you should use it in moderation (28Trusted Source).

It’s a popular cooking oil and ideal for vinaigrettes, dressings, and dips.

Meal planning tips

Keeping blood sugar levels consistent is an important consideration for people with diabetes.

Since carbs affect your blood sugar levels more than protein and fats, your meals and snacks should all contain roughly the same number of carbs.

The number of carbs that you need or can tolerate depends on many factors, including your body size, activity level, insulin sensitivity, and calorie needs.

While the best way to determine the right amount for your needs is to consult a knowledgable healthcare provider, here are some examples of a single serving of some carb-rich foods (29Trusted Source):

  • 1/3 cup (about 50 grams) of rice or pasta
  • 1/2 cup (117 grams) of oatmeal or grits
  • 1 slice of bread
  • 1 small tortilla or dinner roll
  • 6 crackers
  • 1/2 cup (80 grams) of potatoes or sweet potatoes, cooked
  • 1 piece of fruit or 1 cup (144 grams) of berries
  • 1 cup (240 mL) of milk

Try to include protein and fat in each meal or snack to help keep you full and prevent your blood sugar levels from rising quickly (30Trusted Source).

Before making any large changes to your diet, consult your healthcare provider so that they can properly adjust your medications and insulin dosages if needed.


If you have diabetes, you should try to keep your carb intake consistent across all your meals and snacks.

Sample meals

Here is a sample 3-day meal plan using the non-perishable foods featured in this article.

Day 1

  • Breakfast: morning quinoa with chia seeds and frozen berries
  • Lunch: soup with chickpeas and canned tomatoes
  • Snack: dark chocolate and pistachios
  • Dinner: high protein pasta with chicken, plus sauce made from canned tomatoes, spinach, and mushrooms

Day 2

  • Breakfast: protein shake with whey powder, shelf-stable milk, and peanut butter
  • Lunch: chicken salad with seed crackers
  • Snack: roasted chickpeas
  • Dinner: salmon patties, quinoa, and green beans

Day 3

  • Breakfast: savory cauliflower “oatmeal” with spinach and mushrooms, plus 1 cup (240 mL) of milk
  • Lunch: high protein pasta tossed with olive oil, chickpeas, and spinach
  • Snack: smoothie with berries, shelf-stable milk, and peanut butter
  • Dinner: falafel and sautĂ©ed spinach


This 3-day sample meal plan can serve as a starting point for your own meal planning using these non-perishable and frozen foods.

The bottom line

Several non-perishable or frozen foods are great to have on hand if you have diabetes.

These foods not only minimally affect your blood sugar levels but can also be combined in numerous ways to make scrumptious meals and snacks.

Thank you for reading 🙂

Diabetes, Blood Pressure Meds, and COVID -19…

What to Know About Diabetes, Blood Pressure Meds and COVID-19

Medical experts say it’s key to not stop your medications without talking to your physician. Getty Imageshttps://www.healthline.com/health-news/can-common-diabetes-blood-pressure-meds-make-covid-19-worse-what-we-know?slot_pos=article_1&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=diabetes&utm_content=2020-04-09&apid=10209075
  • The concern began after a study in The LancetTrusted Source stated that ibuprofen boosts the angiotensin-converting enzyme 2 (ACE2), which may facilitate and worsen COVID-19.
  • The World Health Organization warned most patients to stick with acetaminophen. Now they say they do not advise against using ibuprofen.
  • Most cardiologists advise patients to stay on their medications.

Could people on certain medications for hypertension, cardiovascular disease, and diabetes be at risk for experiencing COVID-19 more severely?

The question raises more concerns about which medications may make COVID-19 worse in some people. It follows reports that ibuprofen could do more harm than good in patients with COVID-19.CORONAVIRUS UPDATESStay on top of the COVID-19 outbreak

Understanding the theory

The concern began after a study in The LancetTrusted Source stated that ibuprofen boosts the angiotensin-converting enzyme 2 (ACE2), which may facilitate and worsen COVID-19.

As a result, the World Health Organization (WHO) originally warned most patients to stick with acetaminophen, which is also known as paracetamol. Now they say they do not advise against using ibuprofen.

The study explained that COVID-19 binds to ACE2 in order to target cells. Patients likely have increased ACE2 expression if they’re treated with ACE inhibitors, angiotensin II type I receptor blockers (ARBs) and thiazolidinediones. Those drugs are commonly taken by those with cardiovascular disease, hypertension, and diabetes. Ibuprofen can also increase ACE2, the study noted.

Cardiovascular, diabetes drugs in question as well

While media reports focused on ibuprofen, many did not highlight the other drug warnings in the journal article.

“We therefore hypothesize that diabetes, cardiovascular disease, and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19,” the authors wrote. They said patients with cardiac diseases, hypertension, or diabetes who use drugs that increase ACE2 could be at higher risk for severe COVID-19 and, therefore, should be monitored.

In a separate article, lead author Dr. Michael Roth-Chiarello, who heads up a pulmonary cell research unit at the University Hospital of Basel in Switzerland, said that there needs to be more research into the use of ACE inhibitors in those with COVID-19. He did not respond to a request for comment.

Doctors: Evidence lacking

So, are patients on some hypertension, cardiovascular disease, and diabetes drugs at risk for more severe COVID-19?

This speculation about the safety of ACE or ARB treatment in relation to COVID-19 “does not have a sound scientific basis or evidence to support it,” Jared Van Hooser, assistant professor in the department of pharmacy practice and pharmaceutical sciences at the University of Minnesota College of Pharmacy and a clinical pharmacist at St. Luke’s Mount Royal Medical Clinic, told Healthline.

“Should people be aware that there is a possibility COVID-19 could be more severe in those with hypertension, cardiovascular disease, or diabetes? Yes, they should be aware, but the research is not definitive,” Van Hooser said.

The Council on Hypertension of the European Society of Cardiology has stated there’s a lack of any evidence supporting harmful effects of ACE and ARB with regard to COVID-19.

“[We] strongly recommend that physicians and patients should continue treatment with their usual antihypertensive therapy because there is no clinical or scientific evidence to suggest that treatment with ACEi or ARBs should be discontinued because of the COVID-19 infection,” the organization said in a statement.

Further research is needed to evaluate interactions between ACE inhibitor drugs and the virus that causes COVID-19. Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, has expressed support for further research in this area.

“There have been worse COVID-19 in patients on treatment for some chronic diseases like hypertension, but it’s impossible right now to separate whether this is due to the underlying disease versus the drugs being used,” explained Dr. Otto O. Yang, a professor of infectious diseases at the David Geffen School of Medicine at UCLA, told Healthline.

Rory Remmel, Ph.D., a professor at the University of Minnesota College of Pharmacy, cited the BMJ report that said patients taking lisinopril or angiotensin receptor blocking agents such as losartan could have increased ACE2 Trusted Source in the lungs. ACE2, the study authors noted, could make COVID-19 worse.

But there’s a flip side.

“Interestingly, losartan is one of the medically approved drugs that is being tested for treatment of COVID-19 on the theory that it will block viral entry,” he told Healthline. The virus binds to ACE2, but losartan blocks ACE2 from entering cells — making it a potential therapy.

Dr. James Louis Januzzi, a cardiologist at Massachusetts General Hospital, said people need to be careful about getting medical advice from anyone other than their own doctors.

“Don’t believe the misinformation that is going on out there,” he said. “Everyone is scared and wants to provide rapid, useful information to people.”

“Unless and until prospective randomized data are available, people should not assume anything they read is true, and they should speak to their physician if they have questions,” Januzzi added.

Stay on your meds, doctors warn

Most cardiologists — including the American Heart Association, American College of Cardiology, and Heart Failure Society of America — advise patients to stay on their medications.

“People should not stop taking their medications unless directed by a healthcare professional,” Van Hooser said. “We want to avoid a knee-jerk reaction to something that does not have evidence or very limited evidence.”

Concerned about taking these medications and getting COVID-19? Dr. Michael Miller, a cardiologist, and professor at the University of Maryland School of Medicine, said to stay on your medications and talk to your doctor about concerns.

“We are not recommending that our patients stop taking these medications,” he told Healthline.

The only way a doctor would recommend stopping the medication is if the patient has complications from COVID-19, Miller said.

“However, if they develop COVID-19 and have complications that result in significant hypotension, ACE inhibitors will almost invariably be temporarily discontinued,” he noted.

Stay on your medications, Januzzi echoed.

“It actually could be harmful to stop these meds abruptly,” Januzzi said. “To be explicitly clear, we have no good, prospective comparative data to suggest taking drugs like ACE inhibitors is harmful or beneficial relative to COVID-19 infection.”

Thank you for reading 🙂

Diabetes~ Inhaled Insulins, Are They Safe To Use During Coronavirus?

As the entire world is combating an unprecedented outbreak of the viral respiratory disease COVID-19, you may be wondering if it’s safe to continue taking inhalable insulin. Could it compromise your lungs? Or be rendered ineffective if you become sick?

People may be concerned because research shows that respiratory infections are more severe in those with diabetes.

We queried some of the country’s top experts and learned a lot in the process.

The short answer is that there’s no reason not to use inhalable insulin unless you are ill to the point of experiencing “acute respiratory distress” that requires hospitalization.

But there’s a lot more to know on this topic as well — including what weakens your lungs most, information on the newest inhalable insulin product under development, and how inhalable medications might be key to fighting the COVID-19 outbreak.

MannKind’s Afrezza ‘not impacted’  

There is currently only one brand of inhalable insulin on the market, Afrezza, from Southern California-based MannKind Corp. The drug has been shown to be extremely effective, and quite safe in both clinical trials and real-world use since its launch in 2015.

We asked Mike Castagna, CEO of MannKind, about the interplay of colds and flu with using the Afrezza inhaler. “We don’t have any evidence that there’s an issue with absorption, and there’s no evidence that it exacerbates respiratory issues. The powder is not sitting in the lungs, but rather goes through the lungs like oxygen,” he says.

Official word from the company is: “In clinical studies, absorption of Afrezza was not impacted by upper respiratory infection (which typically includes scratchy or sore throat, sneezing, cough and runny nose).”

While Afrezza users often experience a cough at the outset of use, Castagna says they regularly work through colds and flu without issues. Some Afrezza users who experience a lot of mucus, or an extreme cough, may opt to switch to injectable insulin during the worst part of their illness, but “that’s up to you and your doctor. We don’t see absorption issues in Afrezza in upper respiratory infections,” he says.

While the predictions for COVID-19 spread are scary — up to half the U.S. population may get the viral disease — thankfully the huge majority of those cases are expected to clear up after relatively mild symptoms, including runny nose, headache, fever, and diarrhea. Experts confirm that people with diabetes are no more or less likely to contract the illness. But if they do get sick, the consequences can be more severe and exceptional care needs to be taken to keep glucose levels under control.

“I don’t want to minimize the concerns people with diabetes may have. If you have good (glucose) control, most people will be fine. If you don’t have good control, that’s when we worry,” says Castagna.

He reminds us that we all need additional insulin when we’re sick, due to the stress on the body. But generally, he says, “We don’t recommend any changes to people’s insulin management due to coronavirus — unless you are in respiratory distress. Then you should contact your doctor and get into a clinic as soon as possible.”

An expert weighs in

John Patton, one of the nation’s premier experts in inhalable medication science, is a veteran of the team that developed the world’s first inhalable insulin, Exubera, from Pfizer. He is a co-founder and now board member of Aerami, a start-up developing a new formulation of inhaled insulin (details below).

“That’s actually the most common safety question on inhaled insulin — what happens when you get cold or flu?” Patton tells Diabetes Mine. “Pfizer actually ran trials where they gave people rhinovirus to do testing. We did not find that episodic lung diseases or infections were cause for concern.”

Once that first inhalable insulin product was out on the market, “all kinds of people got the flu and there was never a serious adverse event associated with having the flu. Of course, we don’t know how many people reverted to injections when they were sick,” he says.

(Note that Exubera was pulled from the market in 2007, for business reasons having nothing to do with negative health outcomes.)

Patton makes a point of noting that when sick, you need to manage blood glucose carefully, to avoid going into diabetic ketoacidosis (DKA).

Whose lungs are at highest risk?

The people who appear to be at “enormous risk” of developing worst-case-scenario COVID-19 are smokers, whose lungs are filled with high loads of tar, Patton says.

Vaping is also suspected to make COVID-19 cases worse, although there is no solid data on this yet.

A gender gap is also emerging, where more men are being infected and dying of COVID-19 than women. One theory is that this is tied to significantly higher rates of smoking among men than women across the world. But the LA Times reports that other factors may be at play, such as a theory that the hormone estrogen may have “specific protective powers” against this virus.

Access to Afrezza should remain smooth

MannKind is also not expecting any product shortages due to the outbreak, despite the fact that they manufacture the product in Connecticut, which is currently 12th on the list of hardest-hit states.

“We have months of inventory on hand. We’re making another batch as we speak,” Castagna tells DiabetesMine. “We’re taking measures to secure safety, of workers and the product, at our factories.”

A company alert issued on March 25 reminds patients and doctors that “pharmacies can order additional supplies from wholesalers with expected delivery within 1-2 days, as usual.” They also note that patients can receive Afrezza by mail-order, and that many insurance companies are allowing 90-day refills during this time.

A healthy market for Afrezza?

The company has had difficulty gaining traction with Afrezza, because so many doctors and patients still just don’t know it’s an option, Castagna says. They currently have a user base of 6,000 to 7,000 individuals, half with type 1 diabetes and half with type 2. They don’t have specific stats on age groups but do know that 20 percent of their users are on Medicare, so presumed older; and 80 percent are on Medicaid or private insurance, which implies younger users.

Although they started out targeting type 2s, they’re now shifting almost 100 percent of their energy towards the type 1 market, a decision that was made in January 2020. Castagna points out that they now have 20 to 30 people on staff who live with type 1 diabetes themselves.

Basically, they want to prioritize their resources where they can have the most impact, he says. And people with type 1 are most keenly tuned in to achieving better time-in-range, fewer hypoglycemic episodes, and less sleep disruption. Data presented at the February 2020 ATTD international diabetes technology conference showed a 1.6 percent reduction in A1C and significant reduction of hypos using Afrezza versus injected insulins.

Castagna says they’re seeing increased demand for the product every week, “and we don’t anticipate any slowdown, other than the fact that people won’t be seeing their doctors in the coming weeks, so that will slow down prescriptions overall.”

They’re apparently achieving 70 percent approval on prior authorizations “within hours,” he says, as their CoverMyMeds program has been quite effective.

As far as COVID-19 concerns go, Castagna adds:” We’ve had zero calls as of last week from HCPs (healthcare providers) on this issue. But our reps are equipped to answer questions.”

“We don’t want people running around scared, saying, ‘I’ve got to get off my Afrezza.’ We don’t see any indication for that
 A large majority of people will get COVID-19 but a large majority will not have symptoms strong enough to warrant a change in their insulin.”

If you use Afrezza and have questions, you can contact their Customer Service at 818-661-5047 or guide@mannkindcorp.com.

New inhalable insulin from Aerami

Aerami Therapeutics

We also connected with North Carolina-based Aerami Therapeutics (formerly Dance Pharmaceuticals), which is working on a next-generation inhalable insulin product.

Theirs is a fine mist aerosol formulation instead of a powder, delivered by their new inhaler device called AFINA. It will have built-in Bluetooth capability to track data and integrate with apps and platforms. The company has completed seven early stage trials to date and is now looking for a partner for their phase 3 study design with the Food and Drug Administration.

They are also working on an inhalable GLP-1 drug, which would be the first needle-free option for that type 2 diabetes drug.

About the new coronavirus, Aerami COO Timm Crowder says: “We’re seeing acute respiratory issues now with this virus which are pretty unique. It’s probably not something people have put a lot of thought into. Is this the new normal

But he says their inhalable drug formulation should be perfectly safe and effective for those with “normal” cold and flu symptoms — perhaps even more so than Afrezza.

“Ours is a soft liquid, that’s shown no cough, and been very gentle on the lungs in trials. Our high peripheral deposition (HPD) insulin droplets go into the deepest part of the lungs. Even with congestion, you’re not typically going to see mucus in that part of the lung,” Crowder explains.

The AFINA inhaler is a small black square device outfitted with a light that blinks to alert the user as to how effective their inhalation technique is. It comes with a small dropper vial full of insulin mist, which has to be used to fill the inhaler before each mealtime (bolus-only) dose.

The big differentiators for this product are its precise delivery, those small droplets that go into the deep lungs, and “breath actuation,” meaning the ability to let users know how well they are absorbing the product, Crowder says.

“With our device, the aerosol droplets are only generated when the inhalation is in target range, shown by the flow sensor on the device — in other words, only when the patient inhales properly. If they’re not inhaling appropriately, the device will glow yellow, showing that no dose is being delivered. They either need to slow down or speed up their inhalation technique.”

“Also, our dosing is extremely targeted. We can control precisely where the droplets go,” he adds.

They’re not yet providing a projected launch date, and are still determining basics like whether a spirometry lung capacity test will be required to get a prescription for this inhaler (as is the case with Afrezza), or whether they will mainly target type 1 or type 2 diabetes. Human clinical trials will determine all that, Crowder says.

Despite the current worldwide respiratory virus crisis, the overall promise of inhalable medications to effectively treat conditions free of needles is huge, Crowder says.

Inhalable treatments for COVID-19?

It’s important to note that on March 17, Afrezza maker MannKind announced that the company will be shifting its pipeline to also work on three potential COVID-19 treatments with development partners. These aim to reduce replication of the virus in the lungs and delay the “inflammation cascade” that leads to acute respiratory distress syndrome. These will be in the form of dry powder inhalers that deliver the medication directly into the lungs.

Expert Patton, who is now also co-founder of iPharma, an “International Inhalation Center of Excellence” that helps develop and test new medical inhalation products, tells us that with the current COVID-19 pandemic, “people with ideas for therapies are coming out of the woodwork.”

Patton points to a paper just published by the University of California, San Francisco and international scientists listing 72 molecules that could have an impact on treating the novel coronavirus. (Among the substances listed is the diabetes drug metformin, we noticed.) Patton lauds this as “remarkable work” but cautions that this may lead to a potentially dangerous explosion of off-label use of these molecules: “People aren’t going to wait for clinical trials.”

Case in point: Just a few days ago, a man died in Arizona after self-medicating with what he thought was an experimental substance that could combat the new coronavirus that causes COVID-19.

Patton also notes that most of the ideas for new COVID-19 therapies are oral or injection prototypes, which could have toxic properties. “Ideally, they should be inhaled,” he says.

“Local lung delivery has always had extraordinarily strong potential. It offers targeted delivery, that can lower overall dose and raise the effect on the cells you want to target.”

A classic example is newer inhaled steroids used for asthma or COPD; he says. Oral or injected steroids can be quite toxic, especially in children. “They’re essentially going through the whole body. But with inhaled medications, you get targeted treatment, that only impacts the affected cells. It’s like with some drugs that can kill cancer, but they will also kill you,” Patton explains.

The benefits of inhaled steroids are enabling a high concentration of the drugs to reach only the impacted areas of the body, reducing adverse side effects and allowing for smaller, more effective dosing.

Patton is not alone in believing that inhalation devices can have a huge impact on improving healthcare.

But of course, with the cautionary note: “If you have irritated lungs or lungs that are sensitive, there’s just a physical irritation that happens with anything — even good things that are not toxic, like mother’s milk.”

The bottom line, according to Patton, is: “If you are really sick and coughing, you may not want to inhale anything.” But if your lungs are otherwise healthy, there’s no inherent danger in it

Call your primary care provider and discuss symptoms before visiting a healthcare facility or click below to find a local provider. If this is an emergency, call 911, and tell the operator you have COVID-19.


Thank you for reading 🙂

Mushrooms and Diabetes~ Hmm

Are Mushrooms Good for People with Diabetes?

Given that diabetes is characterized by high blood sugar levels, following a healthy diet that helps manage blood sugar is essential to treatment (1Trusted Source).

However, that can be easier said than done, and people with diabetes may find it difficult to decide which foods to eat and avoid.

Mushrooms are low in carbs and sugar and considered to have anti-diabetic properties.

This article explains why mushrooms are an excellent choice if you have diabetes.

A pack of mushrooms


There are many types of mushrooms, including the traditional button or white mushroom, shiitake, portobello, and oyster mushrooms to name a few.

Despite their varying appearance and taste, they all have similar nutritional profiles, which are characterized by low sugar and fat contents.

One cup (70 grams) of raw mushrooms provides the following (2Trusted Source):

  • Calories: 15
  • Carbs: 2 grams
  • Sugar: 1 gram
  • Protein: 2 grams
  • Fat: 0 grams
  • Vitamin B2or riboflavin: 22% of the Daily Value (DV)
  • Vitamin B3, or niacin: 16% of the DV
  • Selenium: 12% of the DV
  • Phosphorus: 5% of the DV

Mushrooms are rich in selenium and certain B vitamins. B vitamins are a group of eight water-soluble vitamins that’s strongly linked to improved brain function. Meanwhile, selenium is a potent antioxidant that plays a key role in thyroid function (3Trusted Source4Trusted Source).


Mushrooms are a low calorie, low carb food that can be enjoyed on a diabetes-friendly diet. They also provide high amounts of selenium and certain B vitamins.

Glycemic index and glycemic load of mushrooms

The glycemic index (GI) and glycemic load (GL) are two classification systems that help evaluate how carb-containing foods affect blood sugar.

They are both popular strategies and widely used in the treatment of chronic diseases like diabetes (5Trusted Source6Trusted Source7Trusted Source).

The GI method ranks foods on a scale of 0–100 and tells you how they may affect your blood sugar levels by assigning them into three categories (8Trusted Source):

  • low GI: 1–55
  • medium GI: 56–69
  • high GI: 70–100

Foods with a low GI will likely raise your blood sugar levels at a slower pace. In contrast, those with a high GI will cause them to spike.

Alternatively, foods can be categorized by their GL, which takes into account a food’s GI, as well as its carb content and serving size. It’s determined by multiplying the GI by the carb content of a specific serving size and dividing the result by 100 (9Trusted Source).

The GL system also classifies food into three categories (10Trusted Source):

  • low GL: 10 and under
  • medium GL: 11–19
  • high GL: 20 and above

Similarly, to GI, a low GL tells you that a portion of food only slightly affects your blood sugar levels, whereas a high GL indicates a more significant effect.

Although mushrooms are technically fungi, they are considered white vegetables — like onions and garlic — with a low GI of 10–15 and a GL of less than 1 per cup (70 grams), meaning that they won’t spike your blood sugar levels (11).


Mushrooms are considered a low GI and low GL food, meaning that they won’t spike your blood sugar levels.

Potential benefits for people with diabetes

Mushrooms may benefit certain types of diabetes.

Research shows that consuming a diet rich in vegetables like mushrooms and other vitamin-rich foods may help protect against gestational diabetes, which affects approximately 14% of pregnancies worldwide and affects both the mother and child (12Trusted Source13Trusted Source14Trusted Source15Trusted Source).

Thanks to their high vitamin B content, mushrooms may also protect against decreased mental function and dementia in older adults with vitamin B deficiencies, as well as those with diabetes who take the drug metformin to control their blood sugar levels (16Trusted Source, 17Trusted Source).

In addition to B vitamins, the main bioactive compounds in mushrooms —polysaccharides — may have anti-diabetic properties.

Research in animals with type 2 diabetes shows that polysaccharides may lower blood sugar levels, improve insulin resistance, and reduce pancreatic tissue damage (18Trusted Source, 19Trusted Source, 20Trusted Source, 21Trusted Source).

Plus, the soluble fiber beta glucan â€” one of the types of polysaccharides found in mushrooms — slows digestion and delays the absorption of sugars, thus controlling your blood sugar levels after a meal (22Trusted Source, 23Trusted Source, 24Trusted Source).

Polysaccharides may also lower blood cholesterol levels, which in turn may reduce the risk of heart disease and stroke associated with unmanaged diabetes (25Trusted Source, 26Trusted Source, 27Trusted Source).

That said, more research is needed to better understand how the B vitamins and polysaccharides in mushrooms may benefit people with diabetes.


The B vitamins and polysaccharides in mushrooms may aid the management and prevention of diabetes and its complications. However, more human research is needed to confirm this.

Adding mushrooms to your diet

Given the wide variety of mushrooms, there are plenty of ways to add them to your diet, including eating them raw, grilled, roasted, sautéed, or in a sauce or soup.

If you’re looking for new and tasty ways to add them to your meals, try this low carb mushroom and cauliflower rice skillet.

For this recipe you need the following:

  • 1.5 cups (105 grams) of mushrooms, sliced
  • 1.5 cups (200 grams) of cauliflower rice
  • 1 cup (30 grams) of spinach
  • 1/4 cup (40 grams) of onion, chopped
  • 1 tbsp of olive oil
  • 1 celery stick, sliced
  • 1 small garlic clove, minced
  • 3 tbsp (45 ml) of vegetable broth
  • Salt, pepper, and soy sauce to taste

Place a large skillet over medium heat and add the olive oil. Add the onions and celery and cook for 5 minutes. Then add the garlic and cook for a few seconds.

Next, add the mushrooms and sautĂ© until cooked. Then add the cauliflower rice and the rest of the ingredients — minus the spinach — and cook until soft. Lastly, add the spinach and season with salt and pepper before serving.

This recipe serves two and makes a great addition to your lunch or dinner.


Mushrooms are a versatile and tasty ingredient and adding them to your meals allows you to take advantage of their benefits.

The bottom line

Mushrooms are safe to eat if you have diabetes, as their low GI and GL content won’t spike your blood sugar levels.

Also, their vitamin B and polysaccharide content may offer additional health benefits that are of relevance for people with diabetes, including improved blood sugar and cholesterol control.

Aside from their anti-diabetic properties, mushrooms can add flavor to your dishes without any extra carbs and calories

Thank you for reading 🙂

Things That Happen When Your Diabetes Goes Untreated

When you hear “diabetes,” your mind likely jumps to problems with producing insulin and regulating blood sugar. And that’s definitely a key part of this chronic disease, which affects nearly 1 in 10 Americans, according to the Centers for Disease Control and Prevention (CDC). But that’s also just the tip of the iceberg.

“Diabetes is like termites, in that it causes slow, hidden, but significant damage in the body,” says Osama Hamdy, M.D., Ph.D., director of the Inpatient Diabetes Program at the Joslin Diabetes Center in Boston. “Most patients with type 2 diabetes die from a heart attack,” Dr. Hamdy says, “but because the disease doesn’t have many symptoms, people tend to take it lightly.”

And evidence continues to mount that diabetes affects every system in the body, wreaking havoc if it’s not well managed. Learn more below about the side effects of diabetes and how you can protect yourself from complications. (The good news: Most can be avoided by following the treatment plan set out by your doctor.)

1) High blood pressure and cholesterol

When you have type 2 diabetes, your body can’t properly use insulin, a hormone that regulates blood sugar. In turn, your HDL (or “good”) cholesterol lowers, and your levels of harmful blood fats called triglycerides rise. Insulin resistance also contributes to hardened, narrow arteries, which in turn increases your blood pressure.

As a result, about 2 of 3 people with diabetes also have hypertension—a risk factor for stroke, heart disease, and trouble with thinking and memory. Failing to control high blood pressure and high cholesterol, either with diet and exercise alone or by adding medications, accelerates the rate at which all your other complications progress, says Robert Gabbay, M.D., Ph.D., chief medical officer at Joslin Diabetes Center in Boston.

2) Brain health issues

“It appears that people with diabetes have some abnormalities of blood flow control to the brain,” explains Helena Rodbard, M.D., an endocrinologist based in Maryland. “And this appears to be correlated with a more rapid loss of mental function with age,” she says, including the ability to plan, organize, remember things, prioritizes, pay attention, and get started on tasks.

To protect your brain health, you’ll want to stay active physically and mentally, logging at least 30 minutes of exercise a day and keeping your mind stimulated. “Read, socialize, work, and play games that challenge your intellect,” Dr. Rodbard says. “Keep a positive, optimistic attitude—don’t permit yourself to become depressed.”

3) Gum disease

People with diabetes are more likely to develop periodontal disease, an infection of the gum and bone that can lead to painful chewing problems and tooth loss. “This is due in part to elevated blood sugar that modifies the collagen in all of our tissues,” Dr. Rodbard says. “It’s also due to a slight increase in susceptibility to infections of all kinds.”

On the other hand, gum disease—specifically inflammation of the gums or development of deep abscesses—can raise blood sugar and make diabetes harder to control, according to Dr. Hamdy. To prevent periodontitis, brush and floss daily and consider using a mild antiseptic mouthwash to knock out any lingering plaque.

4) Sex difficulties

Many men with diabetes will experience some level of erectile dysfunction (ED) in their lifetime. “ED can be psychological or due to reduced testosterone,” Dr. Hamdy says, noting that low testosterone is common among people with diabetes, especially if they’re obese. “However, in patients with a long duration of diabetes, changes in blood vessels and nerve supply to the penis could be the cause.” If you have diabetes, are over age 40, and have been having trouble with your male equipment, see your doctor.

Middle-aged and older women with diabetes also tend to have sexual issues, according to a study of nearly 2,300 women published in Obstetrics & Gynecology, likely because nerve damage can impair lubrication and the ability to achieve orgasm.

5) Hearing loss

While we all lose some hearing as we age, hearing loss is twice as common in people with diabetes compared to those without the condition, according to the CDC. Diabetes may lead to hearing loss by damaging the small blood vessels and nerves in the inner ear, the CDC says.

The best way to protect your hearing is to keep your blood sugar levels in check, Dr. Rodbard says. In fact, in a study from Henry Ford Hospital in Detroit, older women with uncontrolled diabetes had more hearing loss than women the same age who had well-controlled diabetes. The CDC also suggests getting your hearing checked every year and avoiding other causes of hearing loss, like exposure to loud noises, when possible.

6) Skin infections

Having diabetes spikes your risk for all kinds of skin issues, including bacterial infections such as boils and urinary tract infections, fungal infections, and itching. “Fungal infections, especially yeast infections, are so common that they may even be the first sign of diabetes in someone who hasn’t yet been diagnosed,” Dr. Hamdy says.

In some cases, skin infections can be tied to obesity, because there are “moist places between skin folds that may breed bacteria and fungi, including candida,” Dr. Rodbard says.

Unfortunately, several diabetes medications increase the risk of fungal infections of the genitalia, Dr. Hamdy says, because they enhance glucose excretion in urine, fueling the growth of bacteria and fungus. Controlling blood sugar levels helps with prevention, but once you have an infection, seek out the usual treatments: over-the-counter antifungal vaginal creams and suppositories, to be used as directed.

7) Obstructive sleep apnea

This potentially serious sleep disorder, in which the throat muscles intermittently relax and block the airway during sleep, affects around 50% of people with diabetes, Dr. Hamdy says, especially those who are obese and have a collar size of more than 17 for men and 16 for women.

The most obvious sign of obstructive sleep apnea (OSA) is audible snoring. Unfortunately, like gum disease, “sleep apnea may worsen diabetes control,” Dr. Hamdy says, possibly because the two conditions share risk factors. Treatment for OSA may involve using a device to keep your airway open at night or wearing a mouthpiece that thrusts your jaw forward. In severe cases, surgery can help by altering the structure of the nose, mouth, or throat.

8) Vision problems

Roughly 1 in 3 people with diabetes older than age 40 have diabetic retinopathy or damage to the light-sensitive tissue at the back of the eye. This happens because elevated blood glucose levels over time harm the eye’s delicate blood vessels, a process that can begin as early as 7 years before diagnosis.

The good news is, treating these problems early can reduce the risk of blindness by 95%, per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

9) Kidney failure

Over time, high blood glucose thickens and scars the nephrons, tiny structures within the kidneys that filter your blood. About 7% of the time, you’ll already have protein leaking into your urine—an early sign of kidney problems—by the time you receive a type 2 diabetes diagnosis.

About half of those who don’t take steps to control their diabetes will sustain kidney damage within 10 years, and 40% of those will progress to kidney failure, a condition requiring either dialysis or a kidney transplant, says Betul Hatipoglu, M.D., an endocrinologist at the Cleveland Clinic.

10) Neuropathy

About half of people with type 2 diabetes will develop neuropathy, the most common diabetes complication. At first, you might have no symptoms or feel a mild tingling or numbness in your hands or feet, says Dr. Gabbay. But eventually, this form of nerve damage can cause pain, weakness, and digestive troubles as it strikes the nerves that control your gastrointestinal tract.

In addition to managing your blood sugar, being physically active, eating a healthy diet, and keeping up with recommended medications can help prevent diabetes-related nerve damage, the NIDDK says.


Thank you for reading 🙂

Diabetes And Corona Virus

Here’s what you need to know:

People with diabetes are not more likely to get COVID-19 than the general population.

The problem people with diabetes face is primarily a problem of worse outcomes, not greater chance of contracting the virus. In China, where most cases have occurred so far, people with diabetes had much higher rates of serious complications and death than people without diabetes—and generally we believe that the more health conditions someone has (for example, diabetes and heart disease), the higher their chance of getting serious complications from COVID-19. We expect the death rate to decline over time as we get better at detecting and treating this specific virus.

People with diabetes do face a higher chance of experiencing serious complications from COVID-19.

In general, people with diabetes are more likely to experience severe symptoms and complications when infected with a virus.If diabetes is well-managed, the risk of getting severely sick from COVID-19 is about the same as the general population.

When people with diabetes do not manage their diabetes well and experience fluctuating blood sugars, they are generally at risk for a number of diabetes-related complications. Having heart disease or other complications in addition to diabetes could worsen the chance of getting seriously ill from COVID-19, like other viral infections, because your body’s ability to fight off an infection is compromised.

Viral infections can also increase inflammation, or internal swelling, in people with diabetes. This is also caused by above-target blood sugars, and both could contribute to more severe complications.

When sick with a viral infection, people with diabetes do face an increased risk of DKA (diabetic ketoacidosis), commonly experienced by people with type 1 diabetes. DKA can make it challenging to manage your fluid intake and electrolyte levels—which is important in managing sepsis. Sepsis and septic shock are some of the more serious complications that some people with COVID-19 have experienced.

COVID-19 is different from the seasonal flu.

COVID-19 is proving to be a more serious illness than seasonal flu in everyone, including people with diabetes. All of the standard precautions to avoid infection that have been widely reported are even more important when dealing with this virus.

Recommended safety precautions are the same as for flu, such as frequent hand washing and covering coughs and sneezes with a tissue or your elbow. The CDC does not recommend the use of face masks by people who are not infected.

We encourage people with diabetes to follow the guidance of the CDC and to review how you manage sick days—preparing for a sick day can make it easier.

The risks are similar for people with type 1 and type 2 diabetes.

In general, we don’t know of any reason to think COVID-19 will pose a difference in risk between type 1 and type 2 diabetes. More important is that people with either type of diabetes vary in their age, complications and how well they have been managing their diabetes.

People who already have diabetes-related health problems are likely to have worse outcomes if they contract COVID-19 than people with diabetes who are otherwise healthy, whichever type of diabetes they have.

Manufacturers are not reporting that COVID-19 is impacting access to insulin and other supplies.

Leading manufacturers are reporting that COVID-19 is not having an impact on their current manufacturing and distribution capabilities for insulin and other supplies at this time. We are continuing to monitor the situation and will provide updates should anything change. If you are struggling to pay for insulin or know someone who is, the ADA has resources to help—visit InsulinHelp.org.

If COVID-19 is spreading in your community, take extra measures to put distance between yourself and other people to further reduce your risk of being exposed to this new virus. Stay home as much as possible.

Before you get sick, make a plan:

Gather your supplies:

  • Phone numbers of your doctors and healthcare team, your pharmacy and your insurance provider
  • List of medications and doses (including vitamins and supplements)
  • Simple carbs like regular soda, honey, jam, Jell-O, hard candies or popsicles to help keep your blood sugar up if you are at risk for lows and too ill to eat
  • If a state of emergency is declared, get extra refills on your prescriptions so you do not have to leave the house
    • If you can’t get to the pharmacy, find out about having your medications delivered
  • Always have enough insulin for the week ahead, in case you get sick or cannot refill
    • If you are struggling to pay for insulin or know someone who is, the ADA has resources to help—visit InsulinHelp.org
  • Extra supplies like rubbing alcohol and soap to wash your hands
  • Glucagon and ketone strips, in case of lows and highs
  • Have enough household items and groceries on hand so that you will be prepared to stay at home for a period of time

Talk to your health care team about the following:

  • When to call your doctor’s office (for ketones, changes in food intake, medication adjustments, etc.)
  • How often to check your blood sugar
  • When to check for ketones
  • Medications you should use for colds, flu, virus, and infections
  • Any changes to your diabetes medications when you are sick

Take everyday precautions:

  • Avoid close contact with people who are sick
  • Take preventive actions:
    • Clean your hands often
    • Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
    • If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
    • To the extent possible, avoid touching high-touch surfaces in public places–elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
    • Wash your hands after touching surfaces in public places.
    • Avoid touching your face, nose, eyes, etc.
    • Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)
    • Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
    • Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.

Watch for emergency warning signs:

If you develop emergency warning signs for COVID-19 get medical attention immediately. In adults, emergency warning signs include:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

If you feel like you are developing symptoms, call your doctor:

Pay attention for potential COVID-19 symptoms including fever, dry cough and shortness of breath. If you feel like you are developing symptoms, call your doctor.

When you call:

  • Have your glucose reading available
  • Have your ketone reading available
  • Keep track of your fluid consumption (you can use a 1-liter water bottle) and report
  • Be clear on your symptoms (for example: are you nauseated? Just a stuffy nose?)
  • Ask your questions on how to manage your diabetes

If you do get sick, know what to do:

Here are some common tips, which may vary for each person:

  • Drink lots of fluids. If you’re having trouble keeping water down, have small sips every 15 minutes or so throughout the day to avoid dehydration.
  • If you are experiencing a low (blood sugar below 70 mg/dl or your target range), eat 15 grams of simple carbs that are easy to digest like honey, jam, Jell-O, hard candy, popsicles, juice or regular soda, and re-check your blood sugar in 15 minutes to make sure your levels are rising. Check your blood sugar extra times throughout the day and night (generally, every 2-3 hours; if using a CGM, monitor frequently).
  • If your blood sugar has registered high (BG greater than 240mg/dl) more than 2 times in a row, check for ketones to avoid DKA.
  • Call your doctor’s office immediately, if you have medium or large ketones (and if instructed to with trace or small ketones).
  • Be aware that some CGM sensors (Dexcom G5, Medtronic Enlite, and Guardian) are impacted by Acetaminophen (Tylenol). Check with finger sticks to ensure accuracy.
  • Wash your hands and clean your injection/infusion and finger-stick sites with soap and water or rubbing alcohol.

Know your rights:

A reminder: If you have diabetes, you have legal rights that do not go away during a health crisis like COVID-19.

  • Even in a pandemic, you have the right to reasonable accommodations at work, which could include medical leave or alternate work arrangements.
  • Your child’s Section 504 Plan should include accommodation for extra sick days without penalty. This would apply if your child is sick or if you choose to keep him or her home from school to avoid contagion with COVID-19.
  • People with diabetes who are incarcerated or in police custody are entitled to appropriate and adequate medical care, and their medical needs may change during infectious disease outbreaks.

If you are concerned you are being treated unfairly because of your diabetes, contact us to seek help from our Legal Advocacy team.

For more information, please call 1-800-DIABETES (800-342-2383).Related pagesPlanning for Sick Days

Partner sites

American Diabetes Association


1995 – 2020. American Diabetes AssociationÂź. All rights reserved.

Thank you for reading 🙂

Diabetic Lasagna Recipe

Diabetic Lasagna Recipe Prep Time 10 mins Cook Time 1 hr Total Time 1 hr 10 mins   This easy Diabetic Lasagna Recipe is delicious, hearty and healthy. Made with ground turkey and fat-free ricotta. Perfect for an easy weeknight dinner idea. Course: Entree Servings: servings Calories: 291 kcal Author: Tiffany Bendayan Ingredients

  • 1 1/2 lbs ground turkey breast
  • 1 large onion chopped
  • 2 cloves garlic minced
  • 28 oz can of crushed tomatoes with NO SALT ADDED
  • 3-4 leaves basil chopped
  • 1 teaspoon dried oregano
  • 9 sheets of Whole Wheat Lasagna Noodles
  • 15 oz fat-free ricotta cheese
  • 1 egg
  • 2 cups part skim mozzarella cheese shredded
  • 2 teaspoons olive oil
  • Salt + Pepper


  1. Preheat oven to 350 degrees Fahrenheit
  2. Cook noodles according to package instructions*
  3. Drain and place in cold water to stop the cooking process
  4. In a large skillet, heat the olive oil
  5. Add the onions and saute until softened
  6. Add garlic, 1/2 teaspoon of oregano and half of the basil
  7. Add the ground turkey and cook while breaking up the big pieces into little ones
  8. Drain excess liquid and add salt and pepper
  9. Add the tomatoes and cook until the mixture starts boiling. Remove from heat
  10. In another bowl, mix the ricotta cheese, egg, salt, pepper and the other half of the basil
  11. Drain noodles
  12. Place 3 noodles in a 9×13″ rectangular baking pan in a way they cover the bottom of the pan
  13. Add 1/2 of the turkey mixture. Spread evenly
  14. Add 1/2 of the ricotta mixture. Spread evenly
  15. Sprinkle some cheese
  16. Cover with 3 more lasagna noodles
  17. Spread the remaining turkey mixture
  18. Spread the remaining ricotta mixture
  19. Sprinkle some more cheese
  20. Cover with 3 more lasagna noodles
  21. Sprinkle with remaining cheese and dried oregano
  22. Spray a piece of aluminum foil with nonstick spray
  23. Cover lasagna with foil
  24. Bake covered for 45 minutes
  25. Remove foil and bake for 10 minutes
  26. Broil for 2 more minutes or until the top is brown
  27. Remove from oven and let it rest for about 10 minutes before serving
  28. Enjoy!

Recipe Notes

*omit this step if using oven ready noodles Nutrition Facts Diabetic Lasagna Recipe Amount Per Serving (1 serving) Calories 291 Calories from Fat 54 % Daily Value*Fat 6g9%Saturated Fat 2g13%Cholesterol 74mg25%Sodium 437mg19%Potassium 492mg14%Carbohydrates 30g10%Fiber 1g4%Sugar 5g6%Protein 29g58%Vitamin A 325IU7%Vitamin C 8.3mg10%Calcium 299mg30%Iron 2.5mg14% * Percent Daily Values are based on a 2000 calorie diet.

Thank you for reading 🙂