The best host of a party knows the wants and needs of those attending their party. Looking back on previous generations, we seem to have forgotten a lot about how to make a good party. Sometimes it's just easier to throw a few things together and hope for the best. But truly, it shouldn't be that way.
Designing a dinner party is more than merely putting food on the table on pretty plates. It means learning and caring about the people coming to enjoy a few hours of time with you. This is basic human interaction at its finest. Human interaction over food is an elemental thing and something every culture does. We share food as a way of showing nurturing, appreciation and giving. That's why we feel good when doing it. However, in modern times, many times, we find ourselves a bit stressed out over the timing of things and the trips to the tore and all the preparation...it becomes something different and uncomfortable. It doesn't have to be that way. Nor does it have to be something thrown together without a care. So where's the balance?
Paying a little bit of attention to who is attending and what their backgrounds are and whether they might have special food needs is important in planning and making people comfortable at your table. It also shows that you cared enough to pay attention and then put it into action for the event. Let's use Diabetes as an example of a person who might have special needs at a dinner party. I say "might" because technically speaking, a person with diabetes does not require special foods! But making foods available that provide a rounder and broader spectrum of choices is important.
Whether you are the host with diabetes or hosting for a guest with diabetes, having a well rounded array of foods is important. It should be important for all guests, but when diabetes is involved, it becomes a bit more of a focus. Making sure that not every food offering from appetizer to dessert contains carbohydrate would be a good start. Then seeing that there are tasty choices that enable everyone to enjoy themselves without making statements about what is good for diabetes or not. The person with diabetes is the only one responsible for their choices and no one else. The foods presented should just be there to offer the choices. These would include food like vegetables for dipping; cheese assortments; smoked salmon or beef tenderloin; antipasto salad; vegetable frittatas; shrimp cocktail.
It's a warm moment when you realize that your guests are comfortable and pleased with their visit. Mostly it's about caring about each other and sharing some special times. Seeing that those around you appreciate the extra effort and realize you cared enough to plan for them, makes those moments even more meaningful.
Linda Yerardi MS, RD, LDN, CDE
Director of Diabetes Education The Diabetes Center at Mercy Medical Center in Baltimore, MD
Sick and Tired 01/07/2008
Sometimes we feel sick and sometimes tired and sometimes it's both or more! It also seems that the Winter months bring with them certain complications: the cold and flu as one example. All of us try to avoid it and do our best to stay healthy and practice good hygiene in order to avoid the contaminates that seem to lurk almost everywhere. I even know those who become borderline obsessive and compulsive at this time of year when it comes to avoiding "germs". But the fact is that even the most fastidious person with OCD (regarding hygiene) can be exposed and react to the flu and many of the "colds" that come along at this time of year. Your best defense is, of course, hand washing and getting the flu shot.
People with diabetes experience elevated blood glucose (BG) when they become sick or have an infection. The flu is no exception. So, it makes sense that people with diabetes would benefit from yearly flu shots. Keeping up with good oral hygiene is also a good idea because infections in the mouth can cause BG to rise also. Good oral hygiene is also important in warding off colds and any other bacteria that might try to invade your body through your mouth.
There are some ways that you can add to the daily rituals of maintaining health. Naturally, good nutrition is important because a healthier body is more able to utilize its defense/immune system to fight off invading germs. This means focusing on including lots of fruits and vegetables (citrus fruits and green leafy veggies are a good start). I usually recommend fruits as snacks and veggies with lunch and dinner daily as a good way to include these foods. This makes sense for people with diabetes since fruit contains carbohydrate. Juices are not a great idea because of the high carb content. Staying well hydrated is essential, so trying sugar-free flavored waters, seltzers, sodas, decaf teas or other warm beverages are better choices.
Lastly, sleep is important whenever you're starting to feel sick or run down. Sleep is a vital part of the immune system's maintenance. Do your best to see that you get adequate sleep, especially when you're feeling stress. Sickness is stressful on the body. Be good to your body and give it a rest. If it's dealing with diabetes in addition to the million other things it's trying to do everyday, then a little extra rest will likely reap great rewards. Your immune system and your whole body is telling you something when it's sick and tired. Listen to it and give it what it needs. Eat healthful foods, keep hands and mouth clean and get some sleep. Sounds like a good New Year’s Resolution to me!
Linda Yerardi MS, RD, LDN, CDE
Director of Diabetes Education The Diabetes Center at Mercy Medical Center in Baltimore, MD
10/30/2007 Candy Doesn’t have to be Scary!
Halloween can be a scary day on many levels. For people with diabetes it can pose to be more of a scary problem. You’ve probably heard of insulin resistance or impaired glucose tolerance but some patients report that they have impaired sweets resistance also! That might NOT be a clinical term but to those who admit to having this condition, it causes problems on holiday’s, such as Halloween, Thanksgiving and religious holiday’s.
Let me first say that there is no candy that’s off limits. It’s about the carbs and how you use them. This is another case of how size matters…portion size. Due to the high amounts of sugar and fat in most popular and favorite candies, particularly the Halloween candy assortments, it is important to know that all is available to someone with or without diabetes. The focus should always be on the quantity of carbs and fat and its relationship to the resulting BG. If candy is how you want to use your carbs then it is your choice.
The role of fat is important in sweets and candy because it can delay the rise in glucose over time. In other words, it might take longer for the Snickers bar (for example) to fully digest and raise BG to its fullest capacity because it contains nuts and more fat than, let’s say, gummy bears. So instead of Blood Glucose rising faster it might take an hour or so longer for higher fat foods (not just sweets) to make its greatest peak in Blood Glucose. That could be why people report that pizza gives them a high Blood Glucose long after they expected it. The more high fat toppings on the pizza, the more the total fat rises for that meal. Logically, the higher the fat content, the longer is the delay of the rise in Blood Glucose. Don't forget also that as the fat content rises, so does the calorie content.
The problem with candy is the fact that people tend to overeat it on certain occasions. In the months ahead, there are many of these notorious occasions. Is dark chocolate better than milk chocolate? Is sugar-free candy better for people with diabetes? It's all a matter of taste...and carb content and whether you prefer to have the potato with dinner (for instance) or the chocolate for dessert. Trading carbs and calories and making personal choices are the cornerstones of diabetes management, even during the holiday season.
Knowing how many carbs you are eating is important whether you are taking a flat amount of insulin or medication to lower blood glucose or whether you’re counting the carbs in order to determine how much insulin to take (such as with the use of a pump or if you are using an insulin-to-carb ratio for dosing). All people managing diabetes need to be aware of their carb intake in order to manage diabetes most effectively.
Halloween is a scary time, especially to those with diabetes. So much candy and so little insulin!
Ms. Linda Yerardi, MS, RD, LDN, CDE, is a diabetes nutrition educator at Mercy Medical Center in Baltimore, MD. She is also a consulting dietitian for small businesses, clinics and special groups. If you would like to share your thoughts on Linda’s column please e-mail
08-27-2007 Moving On
Moving is not an easy procedure. Yet, this time of year so many people are moving that it’s hard not to comment on it. Just think about how many things can go wrong in a move and then add diabetes management to that list. It’s tough to manage diabetes under uncertain circumstances and moving is a big problem.
In many circles, it is acknowledged that a move is a life-changing event. Whether you’re moving across country or down the street, it’s a life change and it has a lot of significance psychologically, emotionally and physically. The challenge of diabetes management further complicates this change in so many ways.
First of all, a person with diabetes needs to make sure that their diabetes care will be well-managed wherever they are moving. Finding a Primary Care Physician and/or a Diabetes Care Team is the first question for your physician before the move. Referrals are great when they come form someone you already know and respect. So getting information from your present Team or Doctor is a good place to start.
Next is the challenge of the stress, fast foods, eating on the run, increased physical labor (for some) and the actual moving day itself. Make sure all your prescriptions are up to date and that you have all the medications and gear to do blood glucose checks all along the way. It’s easier to take the gear with you than to try and get it once you’re there. Also, making sure that insulin stays cool and doesn’t freeze or get too hot is vital. Packing all your supplies separately and as a carry bag is your best bet. By checking BG often, you are better equipped to help yourself before BG gets out of control or even goes too low. It’s always better to be proactive than reactive.
Some of the best foods to keep around for travel include: crackers and peanut butter; pretzels, diet beverages and water to maintain good hydration; fruits that transport well (like bananas, apples, pears, grapes, oranges); nuts; whole wheat crackers. Airport food can be disastrous yet many fast food restaurants offer healthy alternatives that are worth considering. Once you’ve moved into your new place, it’s important to place a priority on your diabetes management, remembering that stress and fatigue pose issues of control. Checking blood glucose more often is even more essential when under stress. So even though you’re moving on with life, remember that your diabetes moves right along with you.
Ms. Linda Yerardi, MS, RD, LDN, CDE, is a diabetes nutrition educator at Mercy Medical Center in Baltimore, MD. She is also a consulting dietitian for small businesses, clinics and special groups. If you would like to share your thoughts on Linda’s column please e-mail
06-26-2007 On the Road Again...
Most of us just can’t wait to get back on the road to vacation again. It is that time of year. Kids are out of school and parents are going crazy trying to find ways to keep their families entertained. Parents and children alike are enjoying the freedom that comes without a schedule; however, we all know schedules are necessary and extremely helpful in diabetes management. Finding new ways to make summer freedom and excitement fit in with diabetes management can present a challenge.
Whether it’s by plane, train or automobile, lots of us are heading out for day trips, weekend trips or week long adventures to different places. Snacking often accompanies these travels, which can take hours in a vehicle to reach the destination. Often times these trips include eating out in restaurants and fast-food places an awful lot. Losing control over food preparation means that accurate carbohydrate counting can become even more difficult.
Here are some tips to follow when traveling or on vacation:
- Pack snacks that fit into your present food plan. Examples of this would be: low fat pretzels or raw veggies and lunchbox size dips; single serving 100 calorie pack snack foods; Sugar-free gum; nuts in their shells; Ready made salads with low fat dressings; individual cottage cheese and fruit packs.
- Choose lower fat and lower calorie foods for 2 out of your 3 meals a day, so you can still indulge a bit, but not gain as much weight because of it.
- Remember to include fruits and vegetables in with meals/snacks so that extra fiber helps keep you feeling fuller for a bit longer.
- Drink plenty of calorie-free/sugar-free fluids, especially if flying on a plane (to maintain adequate hydration).
- Buy snack foods when you are not hungry and keep them handy so stops are limited and choices are more suitable to your health needs.
- Research some favorite chain restaurants online to see what foods in their Nutrition Facts Label meet your food likes and also your carb needs. This can be done ahead of time, allowing you better awareness and knowledge of what to choose that won’t compromise your Blood Sugar control.
- Bring some really good distractions along such as, books, magazines, word puzzles, video games, movies, books on CD, etc…that will occupy your attention so that you don’t decide to eat when bored! That’s always a big one. Eating shouldn’t become a pastime.
Ms. Linda Yerardi, MS, RD, LDN, CDE, is a diabetes nutrition educator at Mercy Medical Center in Baltimore, MD. She is also a consulting dietitian for small businesses, clinics and special groups. If you would like to share your thoughts on Linda’s column please e-mail
5-29-2007 We All Scream for Ice Cream!
Just using my children as an example, I can easily say that ice cream is a favorite treat, especially in the Summer. Unfortunately, it’s also one that they find hard to resist when we’re driving past a specialty shop. And these products are not inexpensive either. One stop at a specialty ice cream shop can easily run up a $10 tab. If you multiply that by 12 weeks of Summer and to the tune of a few trips a week, it can easily add up and equal a substantial amount of cash. That could be a costly love affair, indeed!
Speaking of costs, consider how much it would cost in calories and carbohydrates to eat ice cream on a regular basis. While ice cream is a great food in many ways, it has a high price in terms of fat content, calories and carbohydrates. Choosing an ice cream is almost complicated at times when you consider the many options of flavors, brands, combinations, toppings, etc…it’s enough to make you dizzy. So, look at the labels for the serving size (usually ½ cup is one serving) and the calorie content (which can vary quite a bit) and always check the total carbohydrates per serving before making a decision of which one is right for you.
There are some great lower fat versions of some favorite flavors out there. The texture is the same and the flavor is fabulous. Low-fat and lower carbohydrate ice cream does not translate into poor quality. The food industry has come a very long way in making more quality products that are lower in fat, calories and carbohydrate over the past 10 years. By all means, try a few and find one you like. That way you can still enjoy a good old American favorite food of Summer without all of the consequences of the higher fat and carbohydrate versions. It’s just another way to stay cool while managing your diabetes.
Ms. Linda Yerardi, MS, RD, LDN, CDE, is a diabetes nutrition educator at Mercy Medical Center in Baltimore, MD. She is also a consulting dietitian for small businesses, clinics and special groups. If you would like to share your thoughts on Linda’s column please e-mail
25-April-2007 Nothing in Life is Free
Whoever said that there are free foods didn't qualify the statement. Foods can be "free" in many ways and in many portions, depending on your point of origin. If someone was referring to fat in foods, then certain foods are free in large quantities. If a person is considering calories then there are a lot of foods that are free of calories also. When talking about foods free in carbohydrates, then there are a bit more limited foods available. However, in diabetes education we often refer to some "free" foods as foods to fall back on if all the allotted carbs have been utilized. Most important is to remember the boundaries with foods. Over-eating carb-free and/or fat-free foods can result in unexpected high blood glucose levels. Therefore, it's important to know and understand what you're eating.
So often I have patients ask me what they can eat in unlimited amounts, as if there is some miracle food that is a combination of promoting health and providing high volume eating without any ramifications at all! Calories and carbs are two different things (as we've discussed on this site before). So it makes sense then that no foods can be eaten in unlimited quantities without some kind of issue - whether it be excess calories and therefore excess weight gain, or elevated blood cholesterol or elevated blood glucose. The key thought here is that people shouldn't be deceived by advertising that promotes foods, supplements or herbs that make this claim. Nor should people with diabetes think that it's OK to frequently eat unusually high amounts of protein or fat based upon the fact that they don't raise blood glucose. That's unhealthy practice as well.
The best advice would be to enjoy all foods. When necessary to use lower carb foods or calorie free products or additional protein foods (to add fullness, satiety or satisfaction at a meal or in between meals), do so in moderation. As examples for these additions or substitutions, I have the following suggestions: Nuts (whichever you like - except the honey roasted), vegetables (non-starchy kinds- could also have them with dip), deli meats, flavored waters and hot beverages (coffee, tea, herbal teas - sweetened with artificial sweeteners), cheese (sticks, slices, etc...), pickles, sugar-free gelatin, candies, and frozen popsicles (beware of sugar alcohols). Most of these can be eaten in combination to make yummy and healthy snacks. Consider peanut butter or lowfat cream cheese on celery. Or a handful of cashews on a plate with slices of your favorite cheese and a decaf, freshly brewed coffee (enhanced with hazelnut artificially sweetened syrup).
Many commonly eaten foods are available to you everyday that are free of carbs that can easily be a part of your meals or snacks to satisfy both your hunger and your appetite. Some things are not free in large quantities, such as condiments like ketchup, barbeque sauce, honey mustards, salad dressings (certain kinds). Reading food labels for both portion size and total carbohydrates can be the key in keeping carbs under control at certain meals. Consider the food label your price tag when eating. It tells you the cost in carbohydrates as you calculate the value of your choices. Knowledge allows you the freedom of choice in diabetes, as in most things in life.
Ms. Linda Yerardi, MS, RD, LDN, CDE, is a diabetes nutrition educator at Mercy Medical Center in Baltimore, MD. She is also a consulting dietitian for small businesses, clinics and special groups. If you would like to share your thoughts on Linda’s column please e-mail
21-Feb-2007 The Lowdown on Low’s
As most people with diabetes know, planning is essential for good blood glucose control. When taking a trip for even a day, many factors must be considered. This can be especially critical for those using insulin. Probably the most frequent problems arise when people are ill prepared or if there is a change in plans, such as the following scenario: A day trip out of town on a business trip where there will be a series of meetings and (hopefully) a meal or two...unpredictable at best. There are almost an infinite number of things that could come between you and good blood glucose maintenance.
So what are the basic guidelines? Here’s what I tell my patients:
1. Always have extra snacks on hand. Never leave home without a snack so certainly extras should be stored for the unexpected circumstances that life always brings! One late train or plane and you could be facing a hypoglycemic situation. Remember that waiting for symptoms of a low BG is not a good, reliable measure. You always need to bring your glucose meter to verify the low and treat it appropriately and without creating a rebounding high BG.
2. Be sure to treat a low with the Rule of 15 - Use 15 grams of carbohydrate and re-check BG 15 minutes later to verify that it’s back in normal range (above 70). If it’s not over 70 then treat it again, in the same way, and check it 15 minutes later again. In other words, repeat as needed. Using glucose tablets (read the package- use as many is needed for approximately 15 grams) or use 4 oz. Juice or soda (any kind except a sugar-free beverage). Those are the two simplest means of access to glucose.
3. Keep glucose available wherever you are. Better said, carry it with you no matter where you go. The tablets work great for that - keep them in your car glove box; jacket pockets; briefcase; purse; baby bag; backpack; gym bag...you get my point.
4. Keep a Glucagon kit available for emergency purposes.
5. Be sure to wear some form of Medical Identification specifying your medical condition(s).
In the event that a meal is missed, such as an extended meeting that leaves you in a very compromising position (choosing between work and/or personal health), well I suggest education. If explaining, in simple terms, to the people around you that you have diabetes and need a snack to hold you over till the meeting’s end is not possible, then all the more reason to have glucose tablets available for the entire meeting. But under most ordinary circumstances, and considering the rising rate of diabetes, most people understand your needs. When explained, most people will respond favorably and with empathy. Chances are that they know someone with diabetes and understand your dilemma.
All in all, traveling with diabetes can be tricky at times, no doubt. But the key to success is education and preparation. If you know what to do and are prepared (even a bit over-prepared) you will feel more comfortable and confident about your actions when undesirable situations present themselves.
Ms. Linda Yerardi, MS, RD, LDN, CDE, is a diabetes nutrition educator at Mercy Medical Center in Baltimore, MD. She is also a consulting dietitian for small businesses, clinics and special groups. If you would like to share your thoughts on Linda’s column please e-mail
22-Jan-2007 In a Heart Beat...
It can be disheartening to know that just by having diabetes your risk for heart disease increases. In fact, coronary artery disease accounts for 50% - 60% of all deaths in patients with diabetes. The incidence of coronary artery disease is equivalent for men and women in people with diabetes which is not true for people without diabetes. In the general population, men have a greater risk for heart disease than women.
But, take heart! There’s a lot you can do to improve your chances and to reduce your risks. Leading a healthy lifestyle is vital. That means quitting smoking (if you still smoke), keeping a low fat eating style, increasing your cardiovascular exercise, maintaining an A1C under 7% and implementing a relaxation program. All the pieces of the coronary health puzzle should fit into place to produce a healthier heart and a stronger feeling of well-being. This concept might not come as a big surprise, but it is a major way to improve overall health and reduce your chances of having a heart attack in the future. While you’ve probably heard all this before, many studies do actually show that these lifestyle changes are the most effective way of helping your heart.
Whatever your eating lifestyle, there are many ways of reducing your fat intake. As a dietitian, I can attest to the fact that most Americans can benefit from reducing their total fat intake. Just by reducing all the fats you eat by 50 % (cutting it in half) you can improve your eating plan. Changing from fried foods to baked, grilled or broiled and limiting convenience foods would be a good first step. Limiting snack foods like chips, crackers and cookies, which also contribute a lot of unnecessary carbohydrates and calories as well as fat, would be another good step. Then by replacing some of those high fat, high calorie snacks with more whole grains, more low-fat dairy products, fresh fruits and vegetables and being careful about food portions will help in meeting these goals, also.
Most of us don’t think about our food choices on a regular basis, but we should. What we put into our bodies is what the body uses as its building blocks for repairing tissues, generating energy and fueling our metabolism, maintaining our daily physical needs, and much more - all the ingredients for keeping your body functioning optimally. It’s time to take these lifestyle changes to heart by focusing more on our foods, exercise routines and relaxation techniques. Your heart will love it!
Ms. Linda Yerardi, MS, RD, LDN, CDE, is a diabetes nutrition educator at Mercy Medical Center in Baltimore, MD. She is also a consulting dietitian for small businesses, clinics and special groups. If you would like to share your thoughts on Linda’s column please e-mail
