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Managing Holiday Stress

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Nov graphic 11By Eloise D. Keene, MS, MPH, RD, LDN, CDE, Certified Diabetes Educator, Diabetes Management & Supplies

Coping with Stress as the Holidays Approach

You have now been on your “wellness journey” for several months. You may have conquered the addition of physical activity to your daily life, added carrots or squash as new meal choices, even gone to the doctor or had your blood / labs drawn here at work. Now, it’s time for the holidays! You can almost smell the turkey or “Tofu Turkey” and hear those jingle bells. It is an exciting time, so why do you feel so jittery and out of sorts as November and December appear on the calendar?

Holidays are supposed to be fun and joyous occasions. But for many, they bring an unusual amount of stress.

Do the children have commitments to activities and events, but you have time constraints?

Are your in-laws arriving for Thanksgiving and staying until Christmas? Will they be at your home preparing your spouse’s family’s traditional holiday meals?

Is this the busiest time of year at your job and you will be working overtime from November 1 until the New Year?

Does the excitement of holiday shopping just get you down? Who to buy for, what to buy, how much to spend on a gift? Does this mean your wallet will be empty all the way to Easter or will you say, “charge it please,” and then look at a mountain of credit card debt in the New Year?

Will you spend the holidays alone? Do you feel that preparing a celebration for one is something you cannot bear?

All of these issues and situations fill our lives with holiday stress and anxiety. The key is how you react and find a solution to manage the stress. How do you normally react to additional stress in your life? Do you find yourself eating more? Munching on one more cookie or slice of cake that work buddies or acquaintances have shared.  Maybe you find it so much more enjoyable to share holiday treats with others.

Do you find yourself accepting more glasses of eggnog or holiday cheer? Stress reduction comes with an increased intake of alcoholic beverages for some individuals. If you have experienced successful weight loss over your wellness journey, it is important to remember that alcoholic beverages are not calorie free.

Did you stop smoking on your path to wellness? Now with holiday stress, do you find yourself yearning for a cigarette? Do holiday parties have you wanting to do something with your hands and that cigarette, cigar or pipe finds its way back into your life. This can seem particularly true when one is drinking more alcoholic beverages, and for some highly stressed individuals, reaching for that smoke and a drink seem to go hand in hand at holiday parties.

Tips to Reduce and Manage Holiday Stress

Learn to say no. You do not need to attend every party nor have your child attend every event they are invited to attend. Select several or just a few and make and create holiday traditions at home.

Make gifts at home for presents. Gifts that offer time spent or activities performed may bring fonder memories than the purchase of an expensive toy.

Select a cost limit for gift purchases. This can reduce the future stress of nagging credit card bills in the New Year.

Offer and buy a gift for someone less fortunate. The idea that one is thankful for what they have and can offer happiness to another is a spiritual gift of gratitude for the giver.

Understand why having guests increases your stress. Do you feel you cannot meet their expectations; do they require you to behave differently and in a way that is uncomfortable for you thus increasing your holiday anxiety?

Does the job stress overwhelm you? Can you think of stress reducers like exercise, prayer, or meditation that will allow you to reach a happy place and combat (overcome) the work stressors?

Stress can be dealt with by emotion-focused based solutions and problem-focused solving techniques. Stress will most likely continue to build if not dealt with appropriately. Denying the problem and not confronting stress (avoidance) only allows stress to continue to build and have negative effects on health and also interfere with your individual wellness journey.

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Stress in the Workplace

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nov graphic 12By Eloise D. Keene, MS, MPH, RD, LDN, CDE, Certified Diabetes Educator, Diabetes Management & Supplies

Signs of Stress can be both Physical and Emotional 

A variety of conditions and issues can create stressful situations in the workplace. Stressors at work can be new managers, new hires, new equipment, new software programs and even a promotion.

The need to work longer hours, having specific timelines for project completion and needing additional time to learn and experiment with a new program might have one pulling their hair out or heading towards their favorite snack for comfort. How does one recognize the signs of stress and then reduce or manage that stress? How can you learn to balance the elements in your professional and personal worlds to enjoy the benefits of good health and personal fulfillment?

Stress affects the body and can contribute to the development of the following chronic conditions: hypertension, ulcers, and migraine headaches. Stress can also exacerbate existing conditions such as diabetes and heart disease.

Signs of stress can be both physical and emotional:

  • Headaches
  • High blood pressure
  • Fatigue
  • Ulcers
  • Trouble sleeping (Insomnia)
  • Excessive sweating
  • Anger
  • Nervousness
  • Irritability
  • Frustration
  • Anxiety
  • Depression

Two strategies for healthy coping of stress:

  • Emotion focused is where the individual acknowledges their feelings to relieve stress.
  • Problem focused is where an individual looks at the stress from an objective viewpoint and attempts to systematically resolve the stress.

An unhealthy coping strategy is avoidance. Avoidance is when a person refuses to address the stressful situation which may lead to health problems.

Ways to manage stress:

  • Get adequate sleep
  • Get regular physical activity or exercise
  • Eat a healthy diet
  • Practice meditation and deep breathing exercises
  • Find a support system (close friends, family members, spouses or partners)

Remember, stress does not have to beat you! Take charge and be intentional about your health!

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Fasting Safely

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spoonDuring the month of April, people of various faiths will celebrate holidays that will include religious or spiritual fasting. Lenten fasts of no meat on Fridays to the week-long and a day Passover ritual of abstaining from leaven breads, are religious practices and cultural beliefs that are followed by individuals of all ages and walks of life. Among the many who will fast are those with diabetes.

Generations of people who have Type 1, Type 2, or gestational diabetes, will celebrate their faith by limiting their intake of food, water or both items for one meal, a whole day, or even for several days.

The limitation of food or fluid intake for even just one meal can have an effect on a person with diabetes, therefore, it becomes important for those with the disease to recognize the symptoms of a potential hypoglycemic episode, to know how to adjust insulin to match carbohydrate intake, to alter physical activity and to understand how to use medical technologies to help them maintain good glucose management while they practice their religious observances.
Tips for fasting safely:
  • Always speak with your doctor or health care provider or diabetes educator before starting a fast.
  • Wear diabetes medical alert jewelry - bracelet, necklace, dog tags - at all times.
  • Keep emergency contact information on you where it can be quickly found.
  • Understand that fasting can affect medication regimes – a change in eating schedules can directly affect when medications are taken.
  • Check blood glucose more frequently.
  • Do remember for many religions, there are exemptions from participating in the fast if doing so would jeopardize the health and safety of the individual.
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A Boy and His Dog

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For the past ten months, eight-year-old Casey has had a new four-legged playmate and cuddle buddy named Beamer. Beamer isn’t a small dog by any means, but Casey’s mom, Courtney, doesn’t have any complaints. After all, Beamer is more than just her son’s best friend, he is a diabetes alert dog with the mission to help Casey stay healthy.

Casey has Type 1 diabetes, a chronic illness caused by the body’s inability to produce insulin. Insulin is a hormone that the body needs to get glucose from the bloodstream into the cells of the body. People living with the disease must maintain stable blood sugar levels to avoid low (hypoglycemia) or high (hyperglycemia) blood sugar events before they become dangerous. People living with diabetes depend on insulin therapy and other treatments to manage their condition.

Raising a child with diabetes can be challenging, to say the least. However, Casey’s family sought new ways to help manage the condition. His mom reached out to a company that trains and supplies service dogs to patients in need. Despite the costly $25,000 price tag, the family set out on a mission to purchase a service dog for Casey. They began a recycling drive by collecting cans and bottles from their community. For an entire summer, Casey hand delivered the recyclables collected and cashed them in himself. As word got out about their story, supporters started making donations. In the end, as a result of the family’s hard work and the community’s backing, they were able to make the full payment.

Beamer, their Labrador Retriever, joined the family the following May, and that’s when the fun really started. The company that provided Casey with Beamer, organized a trip to Disney for patients and their service animals. This trip helped with the adjustment phase of transitioning Beamer in to the family, which can sometimes be tough, but nothing bonds a pair like sharing a seat on the tea-cup ride at one of the most beloved theme parks in the world. Beamer joined Casey and their new friends on “the best Disney trip ever.”

Companionship is only one benefit of having a diabetes alert dog. Courtney shares that Beamer’s presence can indeed be comforting during late nights when she checks Casey’s blood sugar. Beamer’s real skill lies in noticing Casey’s lows and highs, especially during times when they are not expecting his levels to be imbalanced. Such a fail-safe can be a huge blessing to the minds and hearts of parents raising children with diabetes.

As for her advice to parents considering alert dogs for their own children, Courtney says that service dogs are a wonderful addition to the family, but they can also mean a lot of extra work. It’s important to make sure the child is on board with the extra tasks that come along with their new companion and helper.

Is a diabetes alert dog the right fit for your family? Talk to your physician and your child and spend the necessary time processing the decision. Service animals aren’t for everyone, but those willing to put in the time and work required will find themselves with an amazing new member of the family.

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New Orleans-based medical supply company seeking qualified candidates with long-term career aspirations to fill management, sales, marketing, and administrative positions.

New Orleans, LA – January 31, 2019Diabetes Management & Supplies (DMS), a recognized leader in the healthcare supply industry, is hosting a job fair and career expo on Saturday, February 9th from 8:30am – 12:00pm at the DMS office in Harahan, LA.

Candidates attending the event will be able to speak with human resources representatives and participate in on-the-spot interviews. Current job openings include: management (all departments), inside medical sales (all positions), medical document examiners, insurance verification representatives, billing and account receivables representatives, data entry/intake representatives, diabetic shoe fitter, sales and marketing representatives, and managed care representatives.

“We are excited about the growth we’ve experienced over the years and this opportunity to provide career-seekers in and around the New Orleans area with a chance to learn, grow, and excel in the healthcare industry,” said Joel Deutser, DMS Director of Human Resources. “Our goal during the event is to connect with and recruit qualified people who care about the health and well-being of individuals living with diabetes. We are offering long-term careers with management opportunities.”

DMS has been in business for over 20 years in New Orleans. Ranked as one of the nation’s largest resources for patients who have diabetes, the company provides not only medical supplies to tens of thousands of individuals, but equips healthcare professionals, patients, and caregivers with a comprehensive education program for managing the disease.

The event will be held at the company’s Harahan office located at 10 Commerce Court, New Orleans in the Elmwood Park Business Center. Candidates interested in immediate consideration should bring a resume and be prepared for in-person interviews.

To learn more, please contact Deutser at 504-875-3462 or

About Diabetes Management & Supplies

Diabetes Management & Supplies was launched in 1997 by pharmaceutical and medical device industry veteran, Cynthia Pazos. As one of the largest distributors of diabetes products and supplies in the U.S., the company is dedicated to the prompt and proper fulfillment of customer’s needs for diabetic supplies. DMS offers the most complete selection of insulin pumps, continuous glucose monitors, blood glucose monitors, test strips, insulin syringes, orthopedic shoes, and medical home equipment. Today, DMS is the largest diabetes supply company in Louisiana and ranks as one of the largest nationally, serving tens of thousands of people in all fifty states and Puerto Rico.

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Heat and Diabetes

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During the summer months and especially when it is both hot and humid it becomes extremely important to stay hydrated and limit exposure to high temperatures and the sun. Having diabetes, kidney disease and other chronic diseases that compromise fluid and electrolyte balances place individuals at greater risk for heat sensitivity and heat exhaustion or heat stroke.

These conditions may be heat exhaustion or even heat stroke or sun stroke. Heat related injuries/ conditions occur when internal body temperature rises above the normal body temperature of 98.6 degrees Fahrenheit. Heat stroke is a condition where the body’s core temperature is as high as 104 degrees Fahrenheit.

Who is at risk?

  • Individuals most prone to dehydration and heat conditions are the young, (babies and young children) and the elderly; these are those under 5 years of age and those older than 65 years of age.
  • Those who work outside during the day, especially in the hottest hours, from early morning until midday have an increased risk of heat exhaustion or heat/sun stroke.
  •  Athletes who perform intensive exercise on hot, humid summer days have the potential for heat related illnesses.
  • Even individuals taking medications for blood pressure or fluid restriction can be at risk for developing heat related conditions.

The body perspires from four places the head, hands, feet and armpits.  Sweating helps lower the body’s internal temperature. Exercising in clothing that covers these areas with helmets or shoulder pads limits the potential for sweating/ perspiring causing body temperature to rise.

Heat exhaustion is a condition that can occur from water depletion in the body.  The symptoms here can include; excessive thirst, weakness, headache or even a loss of consciousness.  The body may also be depleted of salt.  Here symptoms can include; nausea and vomiting, muscle cramps and dizziness.

Treating Heat Exhaustion:

  • Go indoors or at the very least move to a shady location.
  • Drink water to rehydrate.
  • Place cold wet cloths or ice on the back, arm pit and groin area.

A change in the individual’s responsiveness should occur. If it doesn’t, contact a health care provider, the condition could escalate to heat stroke.

Heat Stoke / sun stroke can become a fatal condition. The person may show symptoms of massive headache, rapid pulse, difficulty breathing, inability to perspire with red or flushed dry skin, hallucinations, vomiting, nausea, dizziness, lightheadedness, fainting or losing consciousness.

Treating Heat Stroke:

  • Call 911! The individual needs to get to the hospital.
  • While awaiting medical assistance, move the individual to a cooler area, preferably air conditioned.  Remove any excessive clothing and administer first aid if needed.
  • Fan air over the individual or wet the person’s body with water. A cool shower would be ideal, but a garden hose will work.
  • Place cold packs or cloths on back, arm pits, groin area to reduce internal body temperature.

Tips to avoid heat stroke or heat exhaustion:

  • Avoid drinks that contain caffeine.
  • Skip alcoholic beverages
  • Remember thirst is not a good mechanism to tell how much water one should drink.
  • Always carry with you a water bottle filled with clean fresh water.
  • Skip the workout in the hottest hours of the day.
  • Wear clothing that breathes when being out in the heat or sun.
  • If you work outside, stay well hydrated, wear a hat, and take breaks from being in the sun for extended periods of time.

Do you have more questions about this topic?

Call Diabetes Management & Supplies to speak to an educator.

888-738-7929 ext 2102

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Diabetes Disaster Preparedness

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A natural or man made disaster can have an unnerving affect on any individual.

Hurricanes, tornadoes, snowstorm and earthquakes call upon people to have a plan on hand.

Fires, gas leaks, and terrorists attacks can place a city and all its individuals in a state of rushed emergency.

When an individual has diabetes it is most important to have a plan.  Not just one single plan but also a plan for contingency action.

An individual should always have a stash of supplies ready. Test strips, batteries, pump and CGM supplies, and skin preps or alcohol pads packed in a to–go bag or plastic case by the door.

Insulin will need a way to remain cold so a container that maintains temperature should be readily available. Prescriptions for current diabetes medications should be current and placed in a plastic baggie with a pen if you currently use a local pharmacy. If your medications are at a nationwide pharmacy, one should be able to obtain medications through the computerized system of records.

It is important that the individual wear some form of identification of the disease state.  Medical ID’s are available as bracelets, necklaces, dog tags even key chains that allow others to know ones health status.

Having plenty of portable water is a must whether you are stuck in your home for several days or on an evacuation route to a safer location.   Having at least three days worth of water for the individual with diabetes is a must to reduce the potential of dehydration.

Food is always an issue if evacuation is a solution in the plan.  Snacks that match carbohydrate needs should be available for the person with diabetes. Packing a bag filled with protein snacks, carb snacks and snacks with mono-unsaturated fats like nuts can be consumed if  restaurants or food store or chains are not  nearby.  An individual with diabetes can always carry a six pack of glucose control liquid meal supplement if that restaurant which is only two miles away takes six hours to reach.

Planning ahead can be the best solution to disaster situations as it can reduce the stress of the event and help maintain blood glucose in target ranges.

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Medicare Replacing All ID Cards

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In April of 2018, the Centers for Medicare & Medicaid Services (CMS) will began replacing Medicare ID cards for 60 million Medicare beneficiaries. This is a fraud prevention initiative that removes Social Security numbers from Medicare cards to help combat identity theft and safeguard taxpayer dollars.

The new Medicare cards will use a unique and random number, which will be called your Medicare Beneficiary Identifier (MBI). The MBI will replace the Social Security number that is on the current ID cards. The new MBI numbers will consist of 11 characters and will contain a combination of numbers and uppercase letters. Beneficiaries will be instructed to safely and securely destroy their current Medicare cards and keep the new MBI confidential. The new Medicare cards and MBI will not change Medicare benefits for Medicare beneficiaries.

On  your  next supply order with Diabetes Management & Supplies, please verify that we have your correct social security number on file. Once you receive your new card, you will not need your old card any longer. There will be a 21-month transition period where providers will be able to use either the new Medicare Beneficiary Identifier (MBI) or the old Social Security-based ID number. The transition period will begin no earlier than April 1, 2018 and last through December 31, 2019.

In order to ensure that you receive your new Medicare Beneficiary Identifier (MBI) card, please ensure that Medicare has your correct address. You will not receive your new card if your address is not updated with Medicare. In order to avoid denied claims, the address that you have on file with Diabetes Management & Supplies needs to be the same address that you have on file with Medicare.

When you have received your new Medicare Beneficiary Identifier (MBI) card, please call us at 504-734- 7165 or toll free at 1-888-738-7929 to give us your new information so that we can update your file.

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What’s Your Type 2 Diabetes Risk?

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Today is American Diabetes Association® Alert Day®, and we’re asking you to encourage your employees to take the Type 2 Diabetes Risk Test. In 60 seconds, an individual can learn their risk for type 2 diabetes and access a wealth of resources that motivate them to act now and take the necessary steps to improve their health.

One in three Americans is at risk for developing type 2 diabetes, a disease that can lead to serious complications including kidney failure, heart disease, stroke, blindness, and amputations. But a type 2 diabetes diagnosis doesn’t have to be in your employee’s future—it can be prevented or delayed with healthy lifestyle changes.

Learning your risk is the first step!

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Dining out with Diabetes

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Dining out for both regular meals, breakfast, lunch or dinner or for a special occasion can be an obstacle for the individual with diabetes.  There are several tips or strategies that can be used to enjoy the eating/ dining out experience.

Know the components of a healthy diabetes modified meal plan.  Partake of your food choices by understanding the number of grams of carbohydrate, the portion size of   protein and fat that are usually the foundation of a meal.

A diner can go online and review a restaurant or a food establishment’s menu to make a selection prior to arrival at the location.

Several phone applications provide nutrition information for national restaurant chains.  Small neighborhood restaurants may also do the same.

Calorie King, the book or the app can provide listings of carbohydrates, protein, fat and sodium as well as other key nutrients and is an available tool for diner who has diabetes.

The Restaurant Experience:

One can ask for shared plate service, have the server request that the meal be split in two before it is served. You and your dining partner get half the calories and save half the cost (expense) allowing you to go dining again.

After the meal has been ordered you can ask the server to place the one half of the meal in a take home box, before the plate ever reaches the table.

During the meal, you can use the healthy plate method by visually dividing the plate in two. Filling one half with low carbohydrate vegetable choices, take the other side and fill one quarter of the plate with a lean protein choice: fish, chicken, lean beef, then fill the remaining quarter with a serving of carbohydrate.  Look for a carbohydrate choice that you have not identified as a trigger food that usually raises the blood sugar extremely high.

If this meal is a special occasion meal where a dessert or a cake may be served, eat the plate making sure it is filled with the low carbohydrate vegetable choices and then select a small size portion of the cake or dessert.

If you select the salad option do remember that the salad dressing will add calories to the meal. Acknowledge that if you choose the low fat salad dressing option it will have added carbohydrate to maintain its taste, and when choosing the low carbohydrate dressing additional fat is added.

Ask for the dressing to be placed on the side, and then you can dip each individual piece of salad into the dressing and cut down on the total amount of dressing that is used.

These simple strategies will allow an individual who has diabetes to enjoy the dining out experience.

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Ordering Supplies and Equipment

A diabetes treatment plan is very important. Make sure you know how things should work. Carefully following any medication orders and instructions is vital to your plan's success. Make sure you don't run out of supplies just as you refill prescriptions so you don't run out of medication.

Here are some ways you can let us help you reorder supplies:

At Diabetes Management & Supplies, we value the part we play on your treatment plan team and realize that winning is promoting good health.