City of Columbus, GA Focus on Health, 7 Oct 2016

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From YouTube: Focus on Health Diabetes

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Description

A

Welcome to another program and focus on health. We're going to be back at other end of this commercial about a topic. I want to tell you what a surprise you pretty much faces. Everybody see you after the commercial I'm.

B

Gloria Weston smart, the director for keep Columbus beautiful and.

C

I'm Michelle mang with the Columbus consolidated government public works department, we're getting ready for our annual hazardous household waste. Electronic recycling.

D

Event, it'll be hell, October, the first at the old recycling center we will be collecting paint.

E

Paint solvents lawn care, chemicals, hall, cleaning products, automotive products, such as nano freezing car batteries, computers.

F

Printers fax machines, copiers consumer.

G

Electronics, kalpa survivor this hazardous material from our landfills. Do your part to help dilute, don't miss it? Each.

H

Year, more than 350 million pairs of shoes are tossed in our landfills, taking about a thousand years to decompose, so don't throw them out, donate them instead drop them off on these dates at these locations and we'll send them to developing countries around the world. It keeps them from taking up space in our landfills and helps provide Footwear to those who really could use it. Our goal, 1200 bags of shoes of all sizes, got a pair.

H

You can spare brought to you by the keep Columbus beautiful Commission and the W LTZ NBC 38 c WG am a diverse power. Community green initiative.

A

Welcome to the program focus on health. It's my pleasure to come in here to you talk about a subject that everybody knows that I'm interested in so that the tease you might have. Guess it's about diabetes and pre-diabetes and took my right. I have the diabetes educator to say, embraer she's, going to look into that camera over there and tell you everything about herself hi.

I

Pops thanks for letting me be here today again. My name is Anne Blair I am a nurse practitioner and board certified in diabetes management. I am serving as the director for diabetes services at Columbus, Regional and here today, to just really highlight some important principles. Around diabetes will look a little bit at prevalence, will look a little bit about diagnosing and some of the management opportunities right and the educational opportunities that we have throughout the community and.

A

Looking at camera tunnel about your classes, how often in a number to reach you, we.

I

Have a class the second saturday of every month at Midtown, Medical Center, the class starts around 9am were over or finished about 11 30 ish, it's really a foundational level class. It's intended to build! You know at some point. It's again the second saturday of the month, Midtown Medical, Center, 9 a.m. to about 1130am no.

A

I

Cost to register and call 706 three two one, three, seven, four one and you will maybe get voicemail but I will get back with whoever calls with any questions that.

A

Sounds good. We've got a lot of information on diabetes. We want two moves lickety-split, but all this information is good. We'd go to the first slide, please next there we go that one right. There talk about some of these statistics. Can you see that in no.

I

I'm no, but just to really point out. This is data from the CDC, the Centers for Disease Control and its data from jun 2014, when looking at prevalence of diabetes throughout the United States and as you can see, there are a lot of Americans who are walking with diabetes done with prediabetes, almost 29 million with diabetes and looking at the numbers for those with pre-diabetes. You know we're talking about 86 million with pre-diabetes, so add them together.

I

It's a lot of individuals walking with elevated blood, glucose or blood, sugars or varying levels of insulin, resistance right.

A

If we see from the slide that a lot of people are really really really affected, with diabetes or pre-diabetes, can we go to the next slide? Please yeah.

I

And looking at prevalence among different ethnicities, this is actually again a continuation of the data from the CDC and it really points out the prevalence. You know within the different ethnic populations right.

A

And now just it's staggering when you go when you go to think about it, how on the prevalence rate for round this year, you see that african-americans are 13.2 percent, followed by no actually the Native Americans at 15.9, followed by african-americans and then Hispanic. So that's kind of l'armée. Yes,.

I

And again, you know looking at as you even open the show talking about just how diabetes impacts us in so many different ways, either directly or indirectly. Even if we're not walking with diabetes or pre-diabetes, the chances are pretty high that we know somebody embarking.

A

I

Related to somebody walking with it, let's.

A

Go to the next slide. Look at some of the values. Here we go like to speak to this here. Yeah.

I

Now this is actually looking at. What's considered a normal blood sugar versus that pre-diabetes range versus.

F

I

Of diabetes, now a diagnosis is not always going to be made off of one reading per se. I.

G

H

I

Variables, but this actually, you know, shows us that a fasting blood sugar I get up in the morning, Ivan had anything to eat or drink or I. Go have that lab work at my physicians office that fasting blood sugar what's considered normal, is less than 99 right.

A

I

We look at a you, know: 100, you know point up to the 125, because the diagnosis is made off of a fasting of 126. Yes,.

D

I

Pops, you and I've been in. You know the medical arena for a while, and you remember back when it was a 140 that.

H

Was a diagnostic.

I

H

I

126 we have found and I say we. Research has found that people with 126 or greater in a fasting state or just as likely to develop those complications as an.

A

I

At 140 or greater so criteria was modified. Let's.

A

Go to the next slide impact so.

I

This actually looks at the direct and indirect costs associated with diabetes, again continuation of data from the CDC. So we could see that you know it's very costly to the.

E

H

I

Not only you know, costly to the nation, but to the individual.

A

Individually is it but now when you go to think about the rising cost of health care, it is very impactful, absolutely.

I

Absolutely next.

A

Slide please so.

I

This is um one of the things that pops in you and I were talking about at the beginning. You know when we think of diabetes, and so often you know it's not always the Association. We need to recognize, for example, I'm in the hospital setting and the majority of patients that come into the hospital are coming in with a complication of their diabetes, comorbid.

A

I

Absolutely and my interest in diabetes actually sparked I was with a cardiologist in the community for 10 years and actually saw that there was a common denominator. She knows that we served, and that was that.

A

Was to come in pretty much the card.

I

Diabetes and the heart disease, so you can see you know diabetes, uncontrolled now, let's specify if we don't control it, it will control us.

A

But what I like to stress and is the fact that, even though diabetes affects every organ system in the body from the eyes to the kidneys, at the same time, through education for educating diabetes, educators like you and doing all the things that they're supposed to do eating correctly, monitoring their blood sugars, taking the medication on time, it's one of the most easily manageable condition. Absolutely.

I

And you said something that I'm very proud to hear. You say you said: eating. Diet is a whole letter word. That is just we want to talk about better nutrition. We.

A

H

About meal planning to.

A

I

About how to take any situation and make it work for our good, that's.

A

Examine you know.

I

We got the holidays coming up well, what about 1am Suzie makes red velvet cake. Well, obviously, we can't eat the whole red velvet cake, but we can learn.

A

How to balance exactly or not what it is, is it best balance.

I

Absolutely next.

A

Slide please good goals of hemoglobin, a1c and glucose control right.

I

So what I've got on this slide is really just an overview of those things that we need to be aware of that. We need to know. You know when we're with our health care team. What's my a 1c and what isn't anyone seen a1c? Actually, it's a hemoglobin a1c. You know to be exact and more specific, but it's a three-month average of where the blood sugar has been, but we need to know the different aspects of management.

I

Where does glucose monitoring come in where, and you know what do I do when I'm ill or sick and I'm on medication? How do I recognize what are called acute complications that low blood sugar, hypo or hyper.

B

I

You know immunizations, you know talking to our health care team, even as an adult. We need immunization.

A

One of the things that I'm plated should mention is T. It is team and what I like what I've seen over the years and you've seen is that it's grown into that that that the individual first of all is the head of the team. Absolutely.

I

A

And key player and uses all the health care professionals to accomplish their wellness and that's why I'm glad that you say emphasis on Chi.

I

It is a team effort and are reaching goals. You know again, we we need to recognize that it is a team effort, but ultimately we are the ones that are responsible for the outcomes. We can't blame the dog. We can't blame the cat. We can't blame anybody because ultimately we're the ones making decisions, but.

E

I

Here's my thing: pops people have to know what decisions to make I'm.

F

Still, we know we.

I

Don't know and.

F

I

Someone's given the tools, then you know I can give you stories about people who were making major changes, but those changes were not in the right direction. You're.

A

Ready question they.

I

Didn't know and.

A

That's what education comes absolutely.

I

A

Slide please so.

I

What are the goals alrighty.

A

This is what we're talking about right.

I

And these are you know, criteria or you know, recommendations of course set through various professional organizations, the American Diabetes Association American Medical American Association clinical endocrinologist. These are guidelines, but this is looking at that a1c and ultimately, if I have diabetes, my goal is for that to be at seven percent or less ideally,.

H

I

On the other hand, as a clinician, if I've got an older person or somebody who has multiple medical issues or I'm concerned about risk for Falls or for whatever reason, I may still, you know, of course, not strive for a seven I need reasonable control, but maybe not as tight. You.

A

I

Someone, you know without those risk factors and.

A

That's where the team concept consciously.

I

It's very individualized: it's not a one-size-fits-all pops, so.

A

We go to the next line, we see what a major thing and it's glucose monitoring. Yes,.

I

And that day to day monitoring that we may be doing and again, you have to work with your health care team to come up with really what's the best for you, you know when I have a patient that I'm starting on a new medication or they're implementing some lifestyle changes focusing on meal planning activity, maybe their newly diagnosed I'm trying to establish a pattern. Well, I'm going to have them monitor a little more often than once we get them. You know more, you know situated if.

A

You well and that's an xt reason why individuals need to have to education.

I

A

Needs to be a team effort, absolutely.

I

A

I

That monitoring as the tool that it is you.

A

Spoke about hypoglycemia, yes,.

I

Yes, hypo, that is that feeling, even if we don't have diabetes, if we've ever exerted ourselves to the degree where oh, my gosh, I'm so hungry and I'm shaking well, that likely was low. We burned off the fuel we had, but people who are on medication for managing their blood sugar are at higher risk for this hypoglycemia.

A

Happy so it's kind of good to know the symptoms are shaking the sweating, dizziness hunger and paired.

I

Behind that can say that I'm having a low and I need to use that meter that I have to monitor your mom.

A

I

If I don't have my monitor, then it's safer if I'm having those symptoms and I'm on a medication to treat it. So we need to know what is hypo and what do we do about it? Should we have it? Those are important pieces. So this next slide actually talks more specifically about treating hypo because next slide.

A

I

Have lowes, they are often it's a frightening thing. Instead of coming from that low to a more reasonable level, people tend to over-consume.

F

H

A

I

Now they're high and they got to come back down, go.

A

Go go yeah, so we always.

I

Say the rule of 15 15 grams of a rapid-acting carbohydrate like three glucose tablets, 324 glucose tablets or a tablespoon of honey jam or jelly or four ounces of juice. Those are options to correct, but we got to remember. We need to recheck in 15 minutes idea.

A

Where you go and then.

I

You know follow-up, but making.

A

Sure good lot of good information here that they ads are given next slide. Please.

I

So, oh this, oh good.

A

ah You didn't you get some good slide. Cuz, you don't know how. Often when I go into the homes, I will see a diabetic walking around in bare feet. So let's just cover this yeah. This is good right here. My.

I

Kids, just really are tired of me telling them about not walking barefoot, but especially when we think about with diabetes. We very often see issues with circulation exactly.

A

I

And you know a little blister, a little corn or a little callous that you know we decide to remedy on ourself with that over-the-counter product, whatever it may be, can lead to a major mass. So we need to practice. You know daily foot inspections, looking for rend areas, look for potential issues and making sure we communicate with our health care team. If we identify an issue, I chicks.

A

I

Eye examinations: we need to have those eyes examined now. Blurred vision is an acute complication of high blood sugar, hyperglycemia.

E

I

I very often would see people that were experiencing these episodes of blurred vision and they perceive that that was the blindness associated with the diabetes. But you know again. This is where that healthcare team discussion comes into play, but recognizing that blurred vision is actually a symptom that that blood sugar could be high. That's.

A

I

I would see patients pops that were referred from their eye doctor because they found that they had them yeah after spending hundreds on glasses, kidney.

A

I

Looking at the kidneys- and you know the again health care team would absolutely run blood. Excuse me not blood. Well, absolutely they do do blood tests, but.

B

I

Urine collections for the 24 hour protein.

F

Sugar I'm just.

I

Looking at a urine specimen to see if an individual had protein in their urine but again just like the eye exams, those kidney exams.

A

I

Function, those are again things that your health care team will assess. You.

A

Keep using that buzz word that I'm and his team. I love that next slide, please so.

I

A

Sit turn. Oh, my yeah.

I

Now, sick day, you absolutely want to have a plan with the health care team, because, especially if you're on insulin and I've seen a lot of people with type 1 diabetes come into the hospital with what's referred to as diabetic ketoacidosis, because they really didn't have a good sick day plan. Or you know, when you're diagnosed with diabetes. You know, there's so much information that you are given that you know it's hard to process all at one point.

I

So what I really encourage my patients is when we get a sick day plan to put that in the medicine cabinet, big.

A

Build are you so.

I

That when I am sick, I can retrieve that and say: oh, this is what I need to do. I've got to stay hydrated I've got to that is.

A

Excellent and that way it's.

I

Individualized and.

A

You want to send these are the kinds of things that you actually learn by coming to your classes, because I'm going to be honest with you, I never thought about. That's an excellent idea. Okay, let's go to the next slide. This is not a good stuff here. Immunizations well,.

I

Like I said, pops here comes flu season right, you're.

A

F

I

Know we got to look at what immunizations might be a good fit for me because, like anything, it's not always for everyone. You're.

A

I

Working with that health care team I don't want to seem so redundant, don't.

B

Know I would if such it right.

H

You know we got to.

F

I

F

I

Know really looking at don't do I need to get the new pneumonia vaccine do I need you know any of these other immunizations. The CDC actually has some guidelines for the hepatitis vaccine for people with diabetes. um So there's you know, there's different. You know and.

A

I notice, there's other things on here, which is one of my big things. Is smoking against smoking, smoking, cessation a lot of people, don't know how that impacts? That's huge from.

I

A health perspective Hume.

A

I

One thing I see when I talk a lot about smoking. Cessation is telling patients telling people I serve. Do you want to pay? Raise I mean it absolutely. How much do those things cause? That's.

A

Exactly right, you.

I

Know not only for my health, but you know so there's that physical, but there's that financial component and then again even a lot of people, don't realize that secondhand smoke and what impact it has.

A

Just as harmful, absolutely it's just as harmful, so there's a lot of little things here that go along with it and dental care. Well,.

I

You know dental caries anytime, you.

A

I

We actually are at at a higher risk. um You know if we have diabetes. Even you know, for issues with our dental. um You.

A

Know your care.

I

With art, you know, with our teeth, I'll meet you we're.

A

Going to take a break here and we're going to come back right after the next commercial, with all this good information, that n is giving us see the commercial I'm.

B

Gloria Weston, smarter director for keep Columbus beautiful and.

C

I'm Michelle mang with the Columbus cansada, a government public works department, we're getting ready for our annual hazardous household waste. Electronic recycling.

D

Event, it'll be hell, October, the first at the old recycling center we will be collecting paint.

E

Paint solvents lawn care, chemicals, all cleaning products, automotive products, such as nano freezing car batteries, computers.

F

Printers fax machines, copiers consumer.

G

Electronics help us to divert this hazardous material from our landfills. Do your part to help those dome? Is it each.

H

Year, more than 350 million pairs of shoes are tossed in our landfills, taking about a thousand years to decompose, so don't throw them out, donate them instead drop them off on these dates at these locations and we'll send them to developing countries around the world. It keeps them from taking up space in our landfills and helps provide footwear to those who really could use it. Our goal, 1200 bags of shoes all sizes got a pair.

H

You can spare brought to you by the keep Columbus beautiful Commission and the W LTZ NBC 38 c WG am at the first power community green initiative. Welcome.

A

Back to focus on else with an and in and what you're looking at camera Chris, let me tell you something and I like what you're saying all the things that you say it or very important, I love that emphasis. You can't say it any more better than team, but if you're looking at there and let everybody know how they can reach you and about your class.

I

Again, we have a class a second saturday of every month at Midtown medical center. It's actually in the conference center at Midtown, Medical Center. You can call 7063, 21, 37, 41 and leave your information. I will follow up with you or you can go to the columbus regional website and actually get information specific to our class and other classes. Fantastic.

A

Okay: let's talk about basic guidelines for healthy eating next slide. Please well.

I

Pops one of the big things is that there are no forbidden foods. That's a big thing say.

A

That again for no forbidden there, we go the.

I

Focus and I mentioned you know, being redundant with the team approach, but it is so true, but during my class I always make sure I let my participants know that I'm intentionally being redundant when I say we need to have a focus on balance. That's.

A

Exactly moderation, exactly consistency.

I

So we need again to learn how to work those occasional treats like aunt Susie's ray I. Don't even have an aunt Susie.

D

Yes, I, but red.

F

I

Cake at the holiday, but- and you know that's one thing to want to say about the holidays: we have to keep the holiday the holiday, how many times I've seen people make the holiday October thirty-first through January. Second, look.

A

H

Then they say: oh.

I

I've gained all this weight over the holidays. Well because we tend to make that holiday almost of what two month period. My.

A

Period so keep.

I

The holiday the holiday- and you know we need to enjoy that. But but again we need to focus on that balance, at moderation, the consistency and when, yes, there are foods that really don't have a lot of nutritional value. But.

F

Education, you know occasion.

I

Those can be worked in the meal plan, but they need to be learned. Artificial.

A

Sweeteners, artificial.

I

Sweeteners they are approved from the FDA. You can see that they're listed, but again you got to get into moderation here. That's.

A

Exactly you know, and.

I

Too much even even a good thing: it's not always a good thing. So really looking at my plate, I know.

A

Next slide, please, this is, and this is my favorite. This is what I use to lose weight and end to how should I say when I look at the plate. I know exactly how I'm supposed to this is an excellent tool. Right here sit. So can we speak about this absolutely.

I

What you can see is taken a play and think that when you were younger even with me, I mean what were we always taught if it's in front of you eat.

A

It eat it, that's exactly. We.

I

Gotta look at the size of the plates, too. I mean if you look at the plates way back compared to some of them now I mean you know. Portion size is very.

A

Much it's important.

I

But, as you can see, if you take a plate, divide it down the middle and then on one half divide that again what you're seeing is a balance. So you know again there's opportunity. Everybody is at a different point. We need to understand what foods have the greater effect on blood sugar and we we need to learn. You know what is considered a portion or reasonable. I would see over the years I've seen people. That would say you know I don't eat a lot, but it's true.

I

They don't need a lot, but they eat a lot of what they eat. So we need.

A

H

I

And looking at protein and the carbs, but then looking at those fruits and the vegetables.

A

People looking at the non non starchy vegetables and we're going to cover that like that, because that's extremely important and people see I only get a couple of sweet potatoes in it. It's a big difference between and start yet non-starchy, so that pair for that plate is non starchy. Fruit and vegetables. Yeah.

I

Not so you got your fruits and you've got your non starchy.

F

H

I

Your broccoli or.

H

Cauliflower you.

I

Know, onions, peppers, your cucumbers, so people very often and again until you know you don't know that those you know those beans, those peas, those lentils. Those are starchy vegetables, which are considered carbohydrates,.

F

Exactly and carbohydrates,.

I

You know that's the thing about a diet, pops, it's like! Oh, don't eat this car, don't know any carbs dhoni, you know or don't eat protein. Or you know it's you've got to get the balance. Gotta.

A

Get no new that Trent.

I

Group should be excluded from my meal plan. Alrighty.

A

Let's see now next slide, please think we got the next slide coming up.

I

Okay, so this is looking at those grains. This is looking at carbohydrates and when you look at carbs, which are those macronutrients, larger nutrients that make up um you know your your breads starches, so.

B

I

Bread, pasta, rice, cereal, oatmeal, tortillas crackers, those are carbohydrate sources and again this non-starchy vegetables versus starchy. Knowing the difference, the starchy vegetables are carbohydrates, but fruit. Fruit is a carbohydrate source and we need to recognize that so looking at the next slide. Next.

A

Slide please you.

I

Know you can absolutely you know, get a feel for what's considered starchy very.

A

Starchy vegetable, big difference, it's a and how.

I

It affects so our next slide. I think feeds into the fruits, and you know I would oh absolutely getting ahead of myself, but recognizing that very often people are so misled by sugar, free or no sugar added labels.

G

I

Got to learn to focus on carbohydrate.

A

That all successfully total causes the key right.

I

So this is what our side here we're looking at now,.

A

And this is when I saw this in your presentation. I was extremely happy because you know I've had individuals come on and they don't stress labels. This is where all I think anyway, because this is what I use. This is where it all begins when I'm at the store shopping taking time for the labels, I'm so glad that you did this. So let's speak a little bit about this. Let's take some time about this. Okay.

I

So let's talk about those people in the store that so often are so overwhelmed by they look at that label and go oh. My right.

A

I

Do I go I've been in the store, I've seen people at a honor I'll looking at a label and I go hit a few other owls on come back. They're still.

A

Looking at the label, I figure.

I

Out what to look at.

A

Right, that's why this is good.

I

What we look at because there is a lot of information, so you got to start somewhere right.

A

I

Do we start we look at what's considered the serving size of the particular food right.

A

I

It's a cup, a half a cup, one slice, two slices whatever, maybe but looking at what that serving size is and then what I try to get people to move to next is looking at what is the total carbohydrate.

C

I

Learning how to adjust and focus in on that right.

A

I

There is a lot of content and we do focus a lot on looking at labels because most of the foods that we consume our package exactly.

A

I

Have a label so making sense of that label and not to be overwhelmed, because when we get overwhelmed, then we say: oh, my I, just I can't deal with.

A

This gift, you get frustrated so.

I

Just understanding how to where's my start point and then building from there again laying the foundation on which we can build. But.

A

But really those labels are extremely extremely extremely important. Can we go to the next slide? Please tips to get the most from our carbohydrates.

I

People so often and I was just as guilty. We drink so.

H

F

Of our calories right, you've.

I

Got to be careful about beverages and our beverage options, and you know really looking at the fact that you know gatorades and power aids, and you know those different beverage options that we recognize or think. Oh, this is a nutritional supplement. We got there's a lot of sodium in there not sufficient.

A

I

May have the glucose, of course, I know, there's some that have lower carbohydrate, but being careful of that, you know regular soft drink and not realizing how much of an impact that has looking at juices. You know we associate juice, I was oh, you know this is a natural. This is this is.

F

A healthy option, but.

I

Think about what we said if my blood sugar is low, I can correct that low with four ounces is used, so.

A

I

Blood glucose is high or trying to get control of it and I'm drinking lots of.

F

Where's it going sky.

A

I

Looking at our beverage options- and you know again, focusing in on portion sizes, you go out to a restaurant I'm getting ahead of myself. But if you know the portion size is going to be generous and you eat. Everything in front of you like I was right, can I have to go box, but.

H

Half of a to-go.

A

I

You even start that's.

A

Exactly but there's a lot.

I

Of little tricks to this, but really at all begins into you know getting that understanding of what is a carb and what's considered a serving, and how do I balance it.

A

Out balance it out: let's go to the next slide. Oh here we go. This is talking more about the choice. Yes,.

I

This is just a build on. You know, looking at the different options and finding ways to try to reduce you know the amount of carbohydrate consumed and you know building in even to looking at the proteins and the fat and looking at added fat. You know, for example, maybe I have that nice. You know salad and I'm drowning it with a lot of high-fat dressing. Oh.

A

My don't know how many times I've seen it I know you've seen it as well. Oh.

I

My gosh yeah and you know: what can we well? You know people say all so you're telling me I can't have my dressing, no, absolutely not, but what can we do to try to reduce hallam bring when you go out to the restaurant or even at home, put your dressing on the side and then take your salad and dip it to get the taste but not to over-consume, because it's just drowning in it, the baked potato that I get okay, the butter can I, have it on the side, and then you control.

I

What you add that.

A

Is- and you know, you've given a lot of excellent chips, that, of course, someone in your your occupation would give that I hadn't thought about that's another thing, because I have under what someone very close, that it will drown it to potato and butter mm-hmm.

I

A

And really, if you ordered on sighs and you can gauge right.

I

You can tell much, and it fat itself at the time doesn't have a huge effect on my blood sugar, but that has double the calories exactly.

A

I

The other thing is recognizing that a lot of people with diabetes, they also have high lipids or cholesterol.

A

I

You know that added fat you know can contribute, of course, to increase in those levels but indirectly to we know that a high fat meal plan absolutely can have a indirect effect on insulin, resistance.

A

Resistance so which.

I

Is in the majority of people that are walking with diabetes and pre-diabetes I'm.

A

Going to make sure that this friend of mine at tubes into this, what you're talking about what they would dividual I serving of butter at all, because he definitely needs it. This is good. I'm often asked this here. This is a very.

I

Good looking at though the oils and when you think of a saturated, those are those that really increase my risk for heart disease and clogging up my arteries if it gets hard at room temperature. Oh.

A

I

Saturated saturated.

A

I

When I am making a selection in using different oils, these are you know better options. You know again, not the saturation is what we roll.

A

Oliver, oil corn, oil, soybean oil and peanut oil- I'm often asked that so I'm really glad when I saw this in a presentation down the other evening. I said this is really a good one. Let's go to the next slide. Please.

A

And we go, this is still for other eating choices, so.

I

One of the things to and looking at you know decreasing my fats and and whatnot. We need to recognize that you know that baking boiling broiling grilling it's a little bit. You know healthier options and.

H

Trying everything sure so.

I

Looking at opportunities to decrease my fried foods, that's an important component- and you know just again: I really want to emphasize the fact that we need to understand how to moderate all things.

H

A

H

I

What are those things that are going to have the greater effect on my blood sugar and how do I balance them out, but I need to recognize that protein and fat are part of my new.

A

Integral part- and we gotta balance.

I

That out as well right.

A

Right: okay: let's go to the next slide, these flat fat free products when possible, such as sour cream, yeah.

I

A

Salad dressing: this is all what you're talking about, though,.

I

A

The lower fat fun.

I

But again not to be misled because of that sugar, free or no sugar added label, you know and that individualization diabetes meal planning, pre-diabetes, better nutrition. However, you want to focus on it. It's not going to be a cut and dry. It's not going to be the same for everybody. There's a lot of individualization sure.

A

I

I have one person who may be willing to go with maybe instead of whole milk, maybe skim milk.

A

I

I may have another person that says no I'm not doing that, but I'm willing to maybe go with a lower fat. One.

A

I

For my mayonnaise or my salad dressing, or what not like personally I, don't like the fat free products well,.

C

H

Rather, balance.

I

H

Some other way.

I

So that's where it's got to be and individualize. You know, but.

A

That's also it where the education comes in it from someone like you where, because the average person really in all reality, they don't they don't they don't have the freedom to really think outside the box or the or the knowledge to know that they can do that and that's why a lot of them are lifestyle changes. When people try to do it, they're resistant to it and they give up right.

I

A

Don't know that they, just like you said you don't you don't have to do skin you just other things that you can.

I

You can balance it out. You can balance it out. It's like anything until you know you don't know. That's.

A

Exactly right: let's go to the next slide. ah We touched about plates and portion size next slide. We talked about eating. Let's go to sweetness.

I

Rechargeable sweeteners, yeah.

A

And let's go to and we talked about drink he's, okay, this! Let's talk about how exercise? Okay.

I

A

Talk about that's right, you.

I

Know sometimes, like diet, people go. Oh what you know we got to do a little more than we're doing. Obviously,.

B

I

Know incorporating and I'm so proud of the the regimen that you shared that you're.

A

I

But it's like medication on the counter it truly is. It helps to lower my level of stress right.

A

I

Resistance, it helps with my blood pressure, I mean there's so many benefits, but you've got to work with a health care team. You know to really come up with a plan and just to begin. If I park, my car a few spaces further from the door when I go to church or to the grocery store. You.

A

Can get some exercise actually.

I

Improving if I'm watching my favorite TV show like watching this, show right right.

A

I

Up beside my chair is burning, more fuel walking in place is burning more fuel, not.

A

I

Sitting in a chair, I'm confined to check your.

A

Isn't running back and.

I

A

I

Just got to start moving a little bit more so.

A

We've got to add exercise. I think the guidelines is gold is 30 minutes 2 times 5 times a week, and you want to something like you're saying sitting in the chair, doing something like this here. Even with your legs moving side to side absolutely.

I

Oh this is these recommendations are from the DPP, which is a landmark trial, that it's referred to: DPP, diabetes prevention plan, okay,.

A

I

This is again a huge you know, undertaking that the government I mean NIH CDC everybody's involved, with really putting this plan out right.

A

I

This plan we actually at Columbus Regional, are going to launch a diabetes prevention plan program with the Georgia Department of Public Health. That's based off of the DPP. These.

E

Guidelines are.

I

Actually from the DPP, because it benefit is shown, so people can be over well I got to do that that many times a week. No, you got to start where you are there.

A

And you gotta start.

I

And build and do it safely, because not everybody needs to be doing the same thing that someone else. We got a look.

A

At that are customized it to yourself. Absolutely I can have you looking at camera right. There also tell them, so you can tell them again how they can get in touch with you to get all this good information and to be a part of a team effort where they can wear their the captain of the team, but they can call them. Professionals, like you, become.

I

Tell me how they can do. You can call us at seven. Oh six, three two one, three, seven, four one and you know leave me your name, your contact, information and a message, and we will get back with you. You can also go to the Columbus Regional website or boot, and you can get information there. Good.

A

Well and we're going to wrap this up, I want an to come back again because you see all the good information that she's given AI mean a lot of fantastic information, but I want her to come back also because, let me tell you something: nutritious is the key. You are what you put in your mouth. You are what you eat now, you see all the good information she's given AI wanted to come back and talk on some other nutrition.

A

Other topics- I'll celiac, sprue with and other people, are confused about one Crohn's specific things, a wealth of information she wants to get the community healthy and you can do it welcome again to our focus on help. We glad that you had an opportunity to watch this program. Did all this good information I'll see you again next month, god bless you.