Notice: Principles for Good Diabetes Care

These principles, or steps, will help you manage your diabetes and live a long and active life. Every person who has diabetes has different needs. Talk to your health care team about a treatment plan that is best for you. Diabetes affects almost every part of the body and good diabetes care requires a team of health care providers. They include doctors, diabetes educators, nurses, dietitians, pharmacists, mental health workers, eye specialists, foot specialists, dentists, and social workers. Print out and take this information with you when you visit your doctor or other members of your team to talk about your treatment plan.

Taking good care of diabetes can lower the chances of getting:

• heart disease
• stroke
• eye disease that can lead to a loss of vision or even blindness
• nerve damage that may cause a loss of feeling or pain in the hands, feet, legs, or other parts of the body and lead to problems such as lower limb amputation or erectile dysfunction
• kidney failure
• gum disease and loss of teeth

As you read through this information, look for things with a  to help you take action to control your diabetes.

Principle 1: Learn as Much as You Can About Diabetes

The more you know about diabetes, the better you can work with your health care team to manage your disease and reduce your risk for problems. You should know what type of diabetes you have. If you do not know, ask your doctor whether you have type 1 or type 2 diabetes.

Principle 2: Get Regular Care for Your Diabetes

see your health care team regularly

make sure your treatment plan is working. If it is not, ask your health care team to help you change it

ask your family, friends, and co-workers for help and support when you need it

Work with your

Principle 3: Learn How to Control Your Diabetes

Diabetes affects many parts of the body. To stay healthy, it is important to know how to eat the right foods, how to be physically active, and how to look after yourself. Using the following checklist will help you learn how to control your diabetes.

Principle 4: Take Care of Your Diabetes ABC's

A major goal of treatment is to control the ABCs of diabetes: A1C (blood glucose average), Blood pressure, and Cholesterol. You can do this in many ways.

Follow a meal plan that was made for you.

Be active every day.

Take your medicine as prescribed.

Before taking any non-prescription medicines, vitamins, or herbal products, ask your pharmacist how they may affect your diabetes or prescription medicines.

Test your blood glucose on a routine basis.

Principle 5: Monitor Your Diabetes ABCs

To reduce your risk for diabetes problems such as blindness, kidney disease, losing a foot or leg, and early death from heart attack or stroke, you and your health care team need to monitor the diabetes ABCs: A1C, Blood pressure, and Cholesterol. Talk to your health care team about how to reach your target numbers.

Principle 6: Prevent Long-Term Diabetes Problems

People with diabetes must control their blood glucose, blood pressure, and cholesterol to prevent the problems of diabetes: heart attack, stroke, eye and kidney problems, nerve damage, impotence, foot or leg amputation, gum disease, and loss of teeth. Here are the key self-care activities to help you manage your diabetes and live a long and healthy life.

Principle 7: Get Checked for Long-Term Problems and Treat Them

See your health care team regularly to check for problems that diabetes can cause. Regular check-ups help to prevent problems or find them early when they can be treated and managed well. Along with the checks of your A1C, blood pressure, and cholesterol (see Principle 5), here are some tests that you will need:

• Triglycerides (a type of blood fat) Get yearly
• Dilated eye exam to check for eye problems Get yearly
• Foot check Get every visit
• Complete foot exam to check for circulation, loss of feeling, sores, or changes in shape Get yearly
• Urine test to check for kidney problems Get yearly
• Dental exams to prevent gum disease and loss of teeth Get twice a year

Diabetes Facts and Myths

The bad news is that yes, Indians are more prone to diabetes in their later years. This is primarily due to a drastic change in lifestyle and dietary habits. Blame it on westernization and a little help from your own genes! But the good news is that you can still try and avoid the big D. To begin with, get exercising. Your mother's told you this, your doctor tells you this all the time and so does your wife/girlfriend. Well, they are right. Squeeze in at least half an hour of cardiovascular activity daily like running or swimming and you are halfway there.

Now comes the more important step — watch what you eat. This time, do not listen to your mother or girlfriend, and start cutting down on simple carbs. This means white bread, pasta and white rice. Remember, carbs mean sugar and you need to keep the sugar level of your blood stable all day. Don't go all paranoid but just keep a count of what you eat and start replacing things. For example, switch to sweet potatoes or use brown rice instead of white rice.

As far as possible avoid sugar and try other sweeteners in beverages. Eat as much fresh fruits and vegetables as they have natural sweeteners and enough fibre to keep your system healthy. If you are a non-vegetarian, control your intake of red meat and replace it as much as possible with fish. And please switch to more frequent and smaller meals a day rather than just the three big ones.

The golden rule is this — Keep a tab on what you eat, squeeze in enough exercise to counter it and you are good to go!

Diabetes care: 15 ways to avoid diabetes complications

Diabetes is a disease which happens when the amount of insulin produced by pancreas is reduced quantitatively which results in the increase of sugar in blood and the access sugar eliminates outside through urine.

Here are 10 ways to take an active role in diabetes care and enjoy a healthier future.

1. Make a commitment to managing your diabetes.

Members of your diabetes care team — doctor, diabetes nurse educator and dietitian, for example — will help you learn the basics of diabetes care and offer support and encouragement along the way. But it's up to you to manage your condition. After all, no one has a greater stake in your health than you.

Learn all you can about diabetes. Make healthy eating and physical activity part of your daily routine. Maintain a healthy weight. Monitor your blood sugar level, and follow your doctor's instructions for keeping your blood sugar level within your target range. Don't be afraid to ask your diabetes treatment team for help when you need it.

2. The use of fenugreek (methi) in food is beneficial for diabetic patients. Sprouted methi or one tsp of its powder may be taken daily.

3. Don't smoke.

If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications, including heart attack, stroke, nerve damage and kidney disease. In fact, smokers who have diabetes are three times more likely to die of cardiovascular disease than are nonsmokers who have diabetes, according to the American Diabetes Association. Talk to your doctor about ways to stop smoking or to stop using other types of tobacco.

4. Keep your blood pressure and cholesterol under control.

Like diabetes, high blood pressure can damage your blood vessels. High cholesterol is a concern, too, since the damage is often worse and more rapid when you have diabetes. When these conditions team up, they can lead to a heart attack, stroke or other life-threatening conditions.

Eating healthy foods and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. Sometimes medication is needed, too.

5. The diabetic patients may take the chapatti made up of wheat flour mixed with gram, soyabean and fenugreek (methi).

6. Schedule yearly physicals and regular eye exams.

Your regular diabetes checkups aren't meant to replace yearly physicals or routine eye exams. During the physical, your doctor will look for any diabetes-related complications — including signs of kidney damage, nerve damage and heart disease — as well as screen for other medical problems. Your eye care specialist will check for signs of retinal damage, cataracts and glaucoma.

7. Keep your vaccines up to date.

High blood sugar can weaken your immune system, which makes routine vaccines more important than ever. Ask your doctor about:

• Flu vaccine. A yearly flu vaccine can help you stay healthy during flu season as well as prevent serious complications from the flu.
• Pneumonia vaccine. Sometimes the pneumonia vaccine requires only one shot. If you have diabetes complications or you're age 65 or older, you may need a five-year booster shot.
• Hepatitis B vaccine. The Centers for Disease Control and Prevention (CDC) currently recommends hepatitis B vaccination if you haven't previously been vaccinated against hepatitis B and you're an adult aged 19 to 59 with type 1 or type 2 diabetes. The most recent CDC guidelines advise vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you're age 60 or older and have diabetes and haven't previously received the vaccine, talk to your doctor about the whether it's right for you.
• Other vaccines. Stay up to date with your tetanus shot and its 10-year boosters. Depending on the circumstances, your doctor may recommend other vaccines as well.

8. Take care of your teeth.

Diabetes may leave you prone to gum infections. Brush your teeth at least twice a day, floss your teeth once a day, and schedule dental exams at least twice a year. Consult your dentist right away if your gums bleed or look red or swollen.

9. All the sweet products, preserved and packed food products, smoking, chewing of Tobacco and consumption of alcohol is completely prohibited for diabetic patients.

10. Pay attention to your feet.

High blood sugar can damage the nerves in your feet and reduce blood flow to your feet. Left untreated, cuts and blisters can lead to serious infections. To prevent foot problems:

• Wash your feet daily in lukewarm water.
• Dry your feet gently, especially between the toes.
• Moisturize your feet and ankles with lotion.
• Check your feet every day for blisters, cuts, sores, redness or swelling.
• Consult your doctor if you have a sore or other foot problem that doesn't start to heal within a few days.

11. Consider a daily aspirin.

Aspirin reduces your blood's ability to clot. Taking a daily aspirin can reduce your risk of heart attack and stroke — major concerns when you have diabetes. Ask your doctor whether daily aspirin therapy is appropriate for you, including which strength of aspirin would be best.

12. A diabetic patient should examine his blood sugar at the regular interval to ensure that it is in control.

13. If you drink alcohol, do so responsibly.

Alcohol can cause low blood sugar, depending on how much you drink and whether you eat at the same time. If you choose to drink, do so only in moderation and always with a meal. Remember to include the calories from any alcohol you drink in your daily calorie count.

14. Take stress seriously.

If you're stressed, it's easy to neglect your usual diabetes care routine. The hormones your body may produce in response to prolonged stress may prevent insulin from working properly, which only makes matters worse. To take control, set limits. Prioritize your tasks. Learn relaxation techniques. Get plenty of sleep.

15. Regular long walks are beneficial for diabetic patients.

Above all, stay positive. Diabetes care is within your control. If you're willing to do your part, diabetes won't stand in the way of an active, healthy life.

Types of Diabetes Medicines

Diabetes medicines come in several forms.

Insulin

If your body no longer makes enough insulin, you'll need to take it. Insulin is used for all types of diabetes. Your doctor can help you decide which way of taking insulin is best for you.

Taking injections. You'll give yourself shots using a needle and syringe. The syringe is a hollow tube with a plunger. You will put your dose of insulin into the tube. Some people use an insulin pen, which looks like a pen but has a needle for its point.

Using an insulin pump. An insulin pump is a small machine about the size of a cell phone, worn outside of your body on a belt or in a pocket or pouch. The pump connects to a small plastic tube and a very small needle. The needle is inserted under the skin and stays in for several days. Insulin is pumped from the machine through the tube into your body.

Using an insulin jet injector. The jet injector, which looks like a large pen, sends a fine spray of insulin through the skin with high-pressure air instead of a needle.

What does insulin do?

Insulin helps keep blood glucose levels on target by moving glucose from the blood into your body's cells. Your cells then use glucose for energy. In people who don't have diabetes, the body makes the right amount of insulin on its own. But when you have diabetes, you and your doctor must decide how much insulin you need throughout the day and night.

What are the possible side effects of insulin?

Possible side effects include

• low blood glucose (for more information, see Insert N)
• weight gain

How and when should I take my insulin?

Your plan for taking insulin will depend on your daily routine and your type of insulin. Some people with diabetes who use insulin need to take it two, three, or four times a day to reach their blood glucose targets. Others can take a single shot. Your doctor or diabetes educator will help you learn how and when to give yourself insulin.

Types of Insulin

Each type of insulin works at a different speed. For example, rapid-acting insulin starts to work right after you take it. Long-acting insulin works for many hours. Most people need two or more types of insulin to reach their blood glucose targets.

Look at the list of types of insulin on Insert C. Check off the names of the kinds of insulin you take. Then print and write the names of your insulins under My Insulins in the chart on Insert A.

Diabetes Pills

Along with meal planning and physical activity, diabetes pills help people with type 2 diabetes or gestational diabetes keep their blood glucose levels on target. Several kinds of pills are available. Each works in a different way. Many people take two or three kinds of pills. Some people take combination pills. Combination pills contain two kinds of diabetes medicine in one tablet. Some people take pills and insulin.

Your doctor may ask you to try one kind of pill. If it doesn't help you reach your blood glucose targets, your doctor may ask you to

• take more of the same pill
• add another kind of pill
• change to another type of pill
• start taking insulin
• start taking another injected medicine

If your doctor suggests that you take insulin or another injected medicine, it doesn't mean your diabetes is getting worse. Instead, it means you need insulin or another type of medicine to reach your blood glucose targets. Everyone is different. What works best for you depends on your usual daily routine, eating habits, and activities, and your other health conditions.

For information about the different kinds of pills and what they do, see the inserts. You'll see the brand name and the generic name-the scientific name-for each medicine. Find your diabetes pills and check off the names. Then print and write the names of your diabetes pills under My Pills and Injected Medicines in the chart on Insert A.

Injections Other Than Insulin

In addition to insulin, two other types of injected medicines are now available. Both work with insulin-either the body's own or injected-to help keep your blood glucose from going too high after you eat. Neither is a substitute for insulin.

See the cards in the pocket of this booklet for more information about these injected medicines. Check off the kinds you take. Then write the names of your injected medicines under My Pills and Injected Medicines in the chart on Insert A.

What do I need to know about side effects of medicines?

A side effect is an unwanted problem caused by a medicine. For example, some diabetes medicines can cause nausea or an upset stomach when you first start taking them. Before you start a new medicine, ask your doctor about possible side effects and how you can avoid them. If the side effects of your medicine bother you, tell your doctor.

Blood glucose levels and medicines in people with diabetes

Blood glucose levels go up and down throughout the day and night in people with diabetes. High blood glucose levels over time can result in heart disease and other health problems. Low blood glucose levels can make you feel shaky or pass out. But you can learn how to make sure your blood glucose levels stay on target-not too high and not too low.

What makes blood glucose levels go too high?

Your blood glucose levels can go too high if

• you eat more than usual
• you're not physically active
• you're not taking enough diabetes medicine
• you're sick or under stress
• you exercise when your blood glucose level is already high

Some diabetes medicines can also lower your blood glucose too much. Ask your doctor whether your diabetes medicines can cause low blood glucose.

Medicines for My Diabetes

Ask your doctor what type of diabetes you have and write down your answer.

• Medicines for Type 1 Diabetes

Type 1 diabetes, once called juvenile diabetes or insulin-dependent diabetes, is usually first found in children, teenagers, or young adults. If you have type 1 diabetes, you must take insulin because your body no longer makes it. You also might need to take other types of diabetes medicines that work with insulin.

• Medicines for Type 2 Diabetes

Type 2 diabetes, once called adult-onset diabetes or noninsulin-dependent diabetes, is the most common form of diabetes. It can start when the body doesn't use insulin as it should, a condition called insulin resistance. If the body can't keep up with the need for insulin, you may need diabetes medicines. Many choices are available. Your doctor might prescribe two or more medicines. The ADA recommends that most people start with metformin, a kind of diabetes pill.

• Medicines for Gestational Diabetes

Gestational diabetes is diabetes that occurs for the first time during pregnancy. The hormones of pregnancy or a shortage of insulin can cause gestational diabetes. Most women with gestational diabetes control it with meal planning and physical activity. But some women need insulin to reach their target blood glucose levels.

• Medicines for Other Types of Diabetes

If you have one of the rare forms of diabetes, such as diabetes caused by other medicines or monogenic diabetes, talk with your doctor about what kind of diabetes medicine would be best for you.

Treatment of Type 1 diabetes

Symptoms

These symptoms may be the first signs of type 1 diabetes, or may occur when the blood sugar is high:

• Being very thirsty
• Feeling hungry
• Feeling tired or fatigued
• Having blurry eyesight
• Losing the feeling or feeling tingling in your feet
• Losing weight without trying
• Urinating more often

For other people, these warning symptoms may be the first signs of type 1 diabetes, or they may happen when the blood sugar is very high (see: diabetic ketoacidosis):

• Deep, rapid breathing
• Dry skin and mouth
• Flushed face
• Fruity breath odor
• Nausea or vomiting, inability to keep down fluids
• Stomach pain

Low blood sugar (hypoglycemia) can develop quickly in people with diabetes who are taking insulin. Symptoms usually appear when the blood sugar level falls below 70 mg/dL. Watch for:

• Headache
• Hunger
• Nervousness
• Rapid heartbeat (palpitations)
• Shaking
• Sweating
• Weakness

Treatment

Because type 1 diabetes can start quickly and the symptoms can be severe, people who have just been diagnosed may need to stay in the hospital.

If you have just been diagnosed with type 1 diabetes, you should probably have a check-up each week until you have good control over your blood sugar. Your health care provider will review the results of your home blood sugar monitoring and urine testing. Your provider will also look at your diary of meals, snacks, and insulin injections.

As the disease gets more stable, you will have fewer follow-up visits. Visiting your health care provider is very important so you can monitor any long-term problems from diabetes.

You are the most important person in managing your diabetes. You should know the basic steps to diabetes management:

• How to recognize and treat low blood sugar (hypoglycemia)
• How to recognize and treat high blood sugar (hyperglycemia)
• Diabetes meal planning
• How to give insulin
• How to check blood glucose and urine ketones
• How to adjust insulin and food when you exercise
• How to handle sick days
• Where to buy diabetes supplies and how to store them

INSULIN

Insulin lowers blood sugar by allowing it to leave the bloodstream and enter cells. Everyone with type 1 diabetes must take insulin every day.

Insulin is usually injected under the skin. In some cases, a pump delivers the insulin all the time. Insulin does not come in pill form.

Insulin types differ in how fast they start to work and how long they last. The health care provider will choose the best type of insulin for you and will tell you at what time of day to use it. More than one type of insulin may be mixed together in an injection to get the best blood glucose control. You may need insulin shots from one to four times a day.

Your health care provider or diabetes nurse educator will teach you how to give insulin injections. At first, a child's injections may be given by a parent or other adult. By age 14, most children can give their own injections.

People with diabetes need to know how to adjust the amount of insulin they are taking:

• When they exercise
• When they are sick
• When they will be eating more or less food and calories
• When they are traveling

DIET AND EXERCISE

People with type 1 diabetes should eat at about the same times each day and try to eat the same kinds of foods. This helps to prevent blood sugar from becoming too high or low. See also:

Diabetes diet

Snacking when you have diabetes

The American Diabetes Association and the American Dietetic Association have information for planning healthy, balanced meals. It can help to talk with a registered dietitian or nutrition counselor.

Regular exercise helps control the amount of sugar in the blood. It also helps burn extra calories and fat to reach a healthy weight.

Ask your health care provider before starting any exercise program. People with type 1 diabetes must take special steps before, during, and after intense physical activity or exercise. See also: Diabetes and exercise

MANAGING YOUR BLOOD SUGAR

Checking your blood sugar levels at home and writing down the results will tell you how well you are managing your diabetes. Talk to your doctor and diabetes educator about how often to check.

A device called a glucometer can read blood sugar levels. There are different types of devices. Usually, you prick your finger with a small needle called a lancet to get a tiny drop of blood. You place the blood on a test strip and put the strip into the device. You should have results in 30 - 45 seconds.

Keep a record of your blood sugar for yourself and your doctor or nurse. This will help if you have problems managing your diabetes. You and your doctor should set a target goal for your blood sugar levels at different times during the day. You should also plan what to do when your blood sugar is too low or high.

Low blood sugar is called hypoglycemia. Blood sugar levels below 70 mg/dL are too low and can harm you.

FOOT CARE

Diabetes damages the blood vessels and nerves. This can make you less able to feel pressure on the foot. You may not notice a foot injury until you get a severe infection.

Diabetes can also damage blood vessels. Small sores or breaks in the skin may become deeper skin sores (ulcers). The affected limb may need to be amputated if these skin ulcers do not heal or become larger or deeper.

To prevent problems with your feet:

• Stop smoking if you smoke.
• Improve control of your blood sugar.
• Get a foot exam by your health care provider at least twice a year and learn whether you have nerve damage.
• Check and care for your feet every day, especially if you already have known nerve or blood vessel damage or current foot problems.
• Make sure you are wearing the right kind of shoes.

PREVENTING COMPLICATIONS

Your doctor may prescribe medications or other treatments to reduce your chances of developing eye disease, kidney disease, and other conditions that are more common in people with diabetes.

Treatments for Insulin Resistance

Some natural treatments may help fight insulin resistance, a health condition known to raise your risk of type 2 diabetes and heart disease. In people with insulin resistance, the body fails to respond properly to insulin (a hormone that plays a key role in using blood sugar for energy). The body produces more and more insulin to help blood sugar (or "glucose") enter cells, but excess glucose builds up in the bloodstream and, in turn, promotes the onset of diabetes. But by pairing certain natural treatments with essential lifestyle changes, you may be able to protect against insulin resistance.

While the presence of specific genes appears to increase your odds of developing insulin resistance, some lifestyle factors (such as being overweight and not exercising regularly) could also raise your risk for this condition. Many people with insulin resistance also show signs of metabolic syndrome (a cluster of health problems known to increase your risk of diabetes and heart disease, including high blood pressure, high cholesterol, and excess weight around your waist).

Working with your doctor to manage any major health issues should be your first step in addressing insulin resistance. In fact, by working out regularly, following a healthy diet, and maintaining a healthy weight, you may be able to reverse insulin resistance and reduce your risk of diabetes and other chronic illnesses. There's also some evidence that getting sufficient sleep may help improve your insulin response. In addition, preliminary research suggests that the following natural treatments may offer some benefit when it comes to combating insulin resistance:

1) Omega-3 Fatty Acids

Following a diet high in omega-3 fatty acids (a type of healthy fat found naturally in oily fish like salmon and sardines) may help fight insulin resistance, according to a 2008 study of 12 older adults. After eating 720 grams of fatty fish weekly and 15 ml of sardine oil daily, study members showed an improvement in insulin sensitivity (as well as a decrease in inflammation).

2) Ashwagandha

Ashwagandha may help improve insulin sensitivity and normalize blood sugar levels, a 2008 study on rats shows. Often touted as an adaptogen, ashwagandha is widely used in ayurveda (the traditional medicine of India).

3) Fenugreek

In a 2009 study on mice, scientists discovered that 4-hydroxyisoleucine (a fenugreek-derived amino acid) may help stimulate the secretion of insulin, reduce insulin resistance, and decrease blood sugar levels. However, a 2009 research review found that there is very limited human-based evidence to support the use of fenugreek in diabetes management.

Should You Use Natural Remedies for Insulin Resistance?

Due to a lack of scientific support, it's too soon to recommend the use of natural treatments for insulin resistance. If you're interested in using any type of natural treatment to manage or prevent insulin resistance, make sure to consult your physician.

Sources: web

Treatments for Type 2 Diabetes

According to the American Diabetes Association, nearly 21 million people in the United States have diabetes, with about 90 to 95% having type 2 diabetes. Sugar, in the form of glucose, is the main source of fuel for body cells. The hormone insulin allows glucose in blood to enter cells. In type 2 diabetes, either the body doesn't produce enough insulin or cells are resistant to effects of insulin.

As a result, glucose builds up in the blood instead of entering cells, which causes cells to be deprived of energy. If high glucose levels in the blood persist, it may damage the eyes, heart, kidneys, or nerves.

Natural Remedies for Type 2 Diabetes

There are some natural treatments that are being explored for type 2 diabetes. If you are interested in trying a natural treatment in addition to standard treatment, be sure do so only under the close supervision of a qualified health professional. If diabetes is not properly controlled, the consequences can be life-threatening. Also inform your physician about any herbs, supplements, or natural treatments you are using, because some may interact with the medications you are taking and result in hypoglycemia unless properly coordinated. Consider keeping track of your herbs, vitamins, and supplements with the Supplement Diary and giving your doctor a copy.

1) Ginseng

Although there are several different types of ginseng, most of the promising studies on ginseng and diabetes have used North American ginseng (Panax quinquefolius). Those studies have shown that North American ginseng may improve blood sugar control and glycosylated hemogobin (a form of hemoglobin in the blood used to monitor blood glucose levels over time) levels.

2) Chromium

Chromium is an essential trace mineral that plays an important role in carbohydrate and fat metabolism and helps body cells properly respond to insulin. In fact, studies have found low levels of chromium in people with diabetes.

There are many promising studies suggesting chromium supplementation may be effective, but they are far from conclusive. For example, a small study published in the journal Diabetes Care compared the diabetes medication sulfonylurea taken with 1,000 mcg of chromium to sulfonylurea taken with a placebo. After 6 months, people who did not take chromium had a significant increase in body weight, body fat, and abdominal fat, whereas people taking the chromium had significant improvements in insulin sensitivity.

Another study published in the same journal, however, examined the effect of chromium on glycemic control in insulin-dependent people with type 2 diabetes. People were given either 500 or 1,000 mcg a day of chromium or a placebo for six months. There was no significant difference in glycosylated hemoglobin, body mass index, blood pressure, or insulin requirements across the three groups.

3) Magnesium

Magnesium is a mineral found naturally in foods such as green leafy vegetables, nuts, seeds, and whole grains and in nutritional supplements. Magnesium is needed for more than 300 biochemical reactions. It helps regulate blood sugar levels and is needed for normal muscle and nerve function, heart rhythm, immune function, blood pressure, and for bone health.

Some studies suggest that low magnesium levels may worsen blood glucose control in type 2 diabetes. There is also some evidence that magnesium supplementation may help with insulin resistance. For example, a study examined the effect of magnesium or placebo in 63 people with type 2 diabetes and low magnesium levels who were taking the medication glibenclamide. After 16 weeks, people who took magnesium had improved insulin sensitivty and lower fasting glucose levels.

High doses of magnesium may cause diarrhea, nausea, loss of appetite, muscle weakness, difficulty breathing, low blood pressure, irregular heart rate, and confusion. It can interact with certain medications, such as those for osteoporosis, high blood pressure (calcium channel blockers), as well as some antibiotics, muscle relaxants, and diuretics.

4) Cinnamon

A couple of studies have found that cinnamon improves blood glucose control in people with type 2 diabetes. In the first study, 60 people with type 2 diabetes were divided into six groups. Three groups took 1, 3 or 6 g of cinnamon a day and the remaining three groups consumed 1, 3 or 6 g of placebo capsules. After 40 days, all three doses of cinnamon significantly reduced fasting blood glucose, triglycerides, LDL cholesterol, and total cholesterol.

In another study, 79 people with type 2 diabetes (not on insulin therapy but treated with other diabetes medication or diet) took either a cinnamon extract (equivalent to 3 g of cinnamon powder) or a placebo capsule three times a day.

After four months, there was a slight but statistically significant reduction in fasting blood glucose levels in people who took the cinnamon (10.3%) compared with the placebo group (3.4%), however, there was no significant difference in glycosylated hemoglobin or lipid profiles. 

5) Zinc

The mineral zinc plays an important role in the production and storage of insulin. There is some research showing that people with type 2 diabetes have suboptimal zinc status due to decreased absorption and increased excretion of zinc.

Food sources of zinc include fresh oysters, ginger root, lamb, pecans, split peas, egg yolk, rye, beef liver, lima beans, almonds, walnuts, sardines, chicken, and buckwheat.

6) Aloe Vera Gel

Although aloe vera gel is better known as a home remedy for minor burns and other skin conditions, recent animal studies suggest that aloe vera gel may help people with diabetes.

A Japanese study evaluated the effect of aloe vera gel on blood sugar. Researchers isolated a number of active phytosterol compounds from the gel that were found to reduce blood glucose and glycosylated hemoglobin levels. 

Type 2 diabetes Mellitus Treatment

Treatment must be individualized on the basis of the type of diabetes and specific needs of each patient. However, certain general principles of management can be outlined for hyperglycemic states of different types. 

1. Type 2 diabetes

The most common type of diabetic patient is obese, is non-insulin-dependent, and has hyperglycemia because of insensitivity to normal or elevated circulating levels of insulin. 

(1) Weight reduction

Treatment is directed toward achieving weight reduction, and prescribing a diet is only one means to this end. Behavior modification to achieve adherence to the diet - as well as increased physical activity to expend energy - is also required. Cure can be achieved by reducing adipose stores, with consequent restoration of tissue sensitivity to insulin, but weight reduction is hard to achieve and even more difficult to maintain with our current therapies. The presence of diabetes with its added risk factors may motivate the obese diabetic to greater efforts to lose weight. 

(2) Hypoglycemic agents

If the patient is not able to achieve target glycemic control with weight management and exercise, then pharmacologic therapy is indicated. The choice of initial agent depends on a number of factors, including comorbid conditions, adverse reactions to the medications, ability of the patient to monitor for hypoglycemia, drug cost, and patient and physician preferences. Metformin is advantageous because apart from lowering glucose without the risk of hypoglycemia, it also lowers triglycerides and promotes some modest weight loss. The drug, however, cannot be used in patients with renal failure, and gastrointestinal side effects develop in some patients at even the lowest doses. Thiazolidinediones improve peripheral insulin resistance and lower glucose without causing hypoglycemia. They also have been reported to improve nonalcoholic fatty liver disease, have beneficial effects on the lipid profile and some other cardiovascular risk factors, decrease microalbuminuria, and reduce neointimal tissue hyperplasia after coronary artery stent placement. These drugs, however, can cause fluid retention and are contraindicated in patients with heart failure. 

They also very commonly increase weight, which patients find distressing, affecting adherence. The drugs are also contraindicated in patients with active liver disease and in patients with liver enzymes ≥ 2.5 times the upper limit of normal. Sulfonylureas have been available for many years and their use in combination with metformin is well established. They do, however, have the propensity of causing hypoglycemia and weight gain. The α-glucosidase inhibitors have modest glucose lowering effects and have gastrointestinal side effects. Exenatide has a lower risk of hypoglycemia than the sulfonylureas and promotes weight loss. However, it needs to be given by injection, causes nausea, and is contraindicated in patients with gastroparesis. Exenatide is also expensive and lacks long-term safety data.

For most obese patients with mild type 2 diabetes, metformin is the first-line agent. If it proves to be inadequate, then a second agent should be added. In those patients where the problem is hyperglycemia after a carbohydrate rich meal (such as dinner), then a short-acting secretagogue before meals may suffice to get the glucose levels into the target range. Patients with nonalcoholic fatty liver disease or microalbuminuria may be candidates for one of the thiazolidinediones. Subjects who are very concerned about weight gain may benefit from a trial of exenatide. If two agents are inadequate, then a third agent is added, although data regarding efficacy of such combined therapy are limited. Experienced clinicians have found that instead of maximizing the dose of each agent before adding another agent, some patients are more tolerant of submaximal combinations of drugs. Insulin therapy should be instituted if combination of oral agents (and exenatide) fail to restore euglycemia. Weight-reducing interventions should continue and may allow for simplification of this regimen in the future. 

When the combination of oral agents (and exenatide) fail to achieve euglycemia in patients with type 2 diabetes, various insulin regimens may be effective. There is no consensus about how insulin therapy should be instituted. One proposed regimen is to continue the oral combination therapy and then simply add a bedtime dose of NPH or long-acting insulin analog (insulin glargine or insulin detemir) to reduce excessive nocturnal hepatic glucose output and improve fasting glucose levels. If the patient does not achieve target glucose levels during the day, then daytime insulin treatment can be initiated. A convenient insulin regimen under these circumstances is a split dose of 70/30 NPH/regular mixture (or Humalog Mix 75/25 or NovoLogMix 70/30) before breakfast and before dinner. If this regimen fails to achieve satisfactory glycemic goals or is associated with unacceptable frequency of hypoglycemic episodes, then a more intensive regimen of multiple insulin injections can be instituted as in patients with type 1 diabetes. Metformin principally reduces hepatic glucose output and the thiazolidinediones improve peripheral insulin resistance, so it is a reasonable option to continue these drugs when insulin therapy is instituted. The sulfonylureas also have been shown to be of continued benefit. Thus, the continued use of the oral drugs may permit the use of lower doses of insulin and simpler regimens. There is no data on the continued administration of exenatide under these circumstances.

20 WEEKS PREGNANT

You're halfway there! And in case you don't believe 20 weeks is a milestone worth celebrating, consider that it's longer than a semester at college—or any relationship you had in high school. Congrats! This is also the week your bambino is able to flash you on the sonogram, revealing what exactly he or she is packing. Why not celebrate with a bottle of sparkling grapefruit juice? It's not as sexy as champagne, but it's got bubbles, and that counts for something, right?

Your Body

Stretch marks are the battle scars of pregnancy. Think of those tiny lines on your belly, breasts and butt with pride, not embarrassment. They're caused by your skin stretching to accommodate your growing belly—a necessary evil!

The truth is stretch marks are difficult if not impossible to avoid. But, hey, even if cocoa butter isn't a wonder cure, it sure does feel good going on ... especially if your partner does it for you! And it makes you smell like a freshly baked chocolate cake! And the good news? A dermatologist can help lessen the appearance of stretch marks after your pregnancy. 

And it doesn't stop there. Other skin changes like acne and rashes are also common while pregnant. So if you're breaking out all over, you're not alone and it will go away.

If you haven't already had one, your health care provider may recommend that you receive an ultrasound, a diagnostic test that uses sound waves to create an image. An ultrasound can determine the size and position of the fetus, and any structural abnormalities of bones and organs that are visible by this time. Depending on the position of the fetus, the sex can usually be determined by now. During an ultrasound, the umbilical cord, placenta, and amniotic fluid can also be examined. Talk to your health care provider about the risks and advantages of this test.

Your Baby

You're halfway there! Twenty weeks into your pregnancy, your baby has grown significantly from that first dividing cell and now weighs about 11 ounces (312 grams) and measures about 6.3 inches (16 cm) from crown to rump. The baby is taking up increasing room in your uterus, and continued growth will put pressure on your lungs, stomach, bladder, and kidneys.

Under the vernix caseosa (a protective, waxy coating), your baby's skin is thickening and developing layers. Hair and nail growth continue.

This is the week most women get that ever-important gender-revealing ultrasound. If your baby isn't shy, the genitals can be clearly seen at this point. Will the baby pee standing up or sitting down? Well, that depends on how you potty train—but if you're interested, you could leave the appointment knowing if you're carrying a boy or a girl. Other highlights this week:

Your baby has established sleep patterns akin to a newborn now. Many babies even have a favorite sleep position already. Some snooze with their chins resting on their chests, while others nap with their head flung back. Many babies at this age fall into noticeable cycles of sleep and activity, so you may know before she arrives whether you have a night owl or an early bird.

If your baby is a boy, the testes have begun descending from the pelvis into the scrotum. If it's a girl, her uterus is completely formed and the rest of her "parts" are in development. (Is that TMI?) 

From this point forward, your baby will put most of her energy into gaining weight and, not coincidentally, so will you! Right now your baby weighs approximately 10½ ounces and is about 6½ inches long, about the size of a can of Red Bull (which has way too much caffeine for a pregnant woman to be drinking). 

16 WEEKS PREGNANT

Funny how everyone who's never been pregnant assumes all the changes you're going through are just located in your uterus. Nobody mentions the stuffy nose, the itchy skin, the sciatica, the outbursts of emotion. But just remember that all the funky things your body is doing are leading up to the big payoff of snuggling up with that little muffin in just a few months

Your Body

Between weeks 16 and 18 of pregnancy, your health care provider may offer you a second trimester screening test (known as the multiple marker test or triple screen), which measures the levels of alpha-fetoprotein (AFP), a protein produced by the fetus, and the pregnancy hormones hCG and estriol in the mother's blood. It's called a quadruple screen (or quad screen) when the level of an additional substance, called inhibin-A, is also measured.

If you have already done a blood test and/or ultrasound in the first trimester (first trimester screening test), then the results of the two tests together is called an integrated screening test. The results of these tests can tell moms whether their babies are at risk for (not whether they have) neural tube defects such as spina bifida or chromosomal abnormalities such as Down syndrome.

An abnormal result does not necessarily mean that your baby has a problem — but it may mean more testing is required. Talk to your health care provider about the risks and advantages of these tests.

No, you don't have a new superpower, although it'll feel like it because you're able to smell pizza, burnt toast or a pulled-pork sandwich from miles away. Your heightened sense of smell isn't the only new trick your nose is doing. You're probably noticing some extra nasal congestion and maybe even some nosebleeds to go along with it. 

Clearly your sense of smell is in overdrive, so try to avoid walking past the BBQ Pit or Curry Emporium. 

While pregnancy-related nasal congestion is annoying, it shouldn't cause any problems and will go away after the baby is born. If you're getting a lot of nosebleeds, it could be because your partner keeps cheaping out on theater tickets, buying seats located in the top row of the balcony. Either that or it could be an indication of high blood pressure, so check with your medical provider. 

But enough about your nose. Let's talk about your ever-enlarging ta-tas. Your boobs might still be tender, especially your nipples, and they're continuing to grow, grow, grow. You may even be able to squeeze a little colostrum (nutrient rich pre-milk milk) out of your boobs at this point. (If you can even touch your nipples without writhing in pain, that is.)

Your Baby

Your baby is already mugging for the camera as she practices all sorts of facial expressions, such as squinting, yawning and grimacing, which will come in handy when you introduce her to pureed spinach. Check out what else is happening in utero:

You're just getting comfortable with being a new mom, but you're actually on the road to being a grandma. If your baby is a girl, her uterus is fully developed and the ovaries already hold primitive egg cells. Did that just make you feel a thousand years old, or what? 

Your baby's skin is still translucent and wrinkly, not unlike an old man's, but more fat will soon accumulate under the dermas to plump her out. If you could peer inside right now, you'd be able to see all of her veins under her skin. And speaking of veins, your baby's heart now pumps about 25 quarts of blood per day, and she hasn't even seen Orlando Bloom yet! Also, her eyes are now locked and loaded at their final destination, facing forward rather than to the sides. 

This is the week women get an amniocentesis, if their doc recommends it. In addition to supplying doctors with a boatload of info about the baby's health, amnios are also more than 99 percent accurate in determining what version of baby you'll be having. So if you want to know and you're getting an amnio, now's a great time to find out for sure.

Your baby now weighs about 3.9 ounces (110 grams) and measures about 4.7 inches (12 cm) in length from crown to rump. Your baby can hold his or her head erect, and the development of facial muscles allows for a variety of expressions, such as squinting and frowning.

12 WEEKS PREGNANT

If you've kept the news of your pregnancy in a lockbox so far, now is a good time to break the news ... likely by shouting, "I'm pregnant!" at all your friends and family and probably several strangers. Try to tell people in person when possible and then prepare to be assaulted with hugs and hands groping at your belly. But be kind: They're doing it out of love and curiosity. And, hey, you're pregnant! It's all good!

Your Body

Has anyone told you that you have that "pregnant glow"? It's not just the joy you may feel because you're having a baby — there's a physiological reason for smoother, more radiant skin during pregnancy. Increased blood volume and pregnancy hormones work together to give you that glow. The greater blood volume brings more blood to the blood vessels and hormones increase oil gland secretion, resulting in a flushed, plumper, smoother skin appearance. Sometimes, though, the increased oil gland secretion can cause temporary acne.

You can barely brush your teeth without gagging so the mere thought of visiting the dentist may make you retch. Still, healthy teeth and gums are especially important during pregnancy as poor dental care can lead to a variety of problems such as pregnancy-related gingivitis and periodontal disease, neither of which sound like any fun at all. Plus, poor dental health during pregnancy has been associated with premature and low-birth-weight babies. 

Book an appointment, but be sure to let your dentist know you're expecting, so you can avoid dental X-rays. If you notice strange lumps on your gums, don't worry. It's just another perk of being preggo. Many women develop harmless, non-cancerous oral tumors when pregnant. 

Your Baby

Baby's face is looking more human as his eyes have moved to the front of his head and his ears are in place. Hooray! Other amazing fetal highlights this week: 

Your baby is able to swallow this week and practices on the amniotic fluid he or she floats in. (And you thought baby food was kind of nasty!) And in case you're wondering how your kid can breathe in all that fluid, here's your answer: Fetuses get oxygen from the blood pumped into their bodies by the placenta and don't breathe with their lungs. Mystery solved!

This is kind of gross, albeit fascinating, so feel free to skip ahead: Your baby's intestines are well under way, but they aren't all where you'd expect them to be. Instead of all being locked away in the body cavity, some are dangling on the outside, in the umbilical cord. Ewwww.

Don't forget to put a baby nail file on your registry—your little nugget's finger- and toenails are forming this week. The chin and nose are also becoming more defined. 

Junior has doubled in size over the past two weeks and now weighs almost ½ ounce. He's also now around 2 ½ inches long, about the length of your pinky finger or a Vienna sausage, which, in a few months, will be indistinguishable from one another. 

Your baby's brain continues to develop, and tiny fingernails and toenails start to form. Vocal cords are formed this week, which is the last of your first trimester.

Your baby's kidneys are functioning! After swallowing amniotic fluid, your baby will now be able to pass it out of the body as urine. And the intestines will make their way into the abdomen, since there is room for them now.

4 WEEKS PREGNANT

Is it? Could it be? Yep. At the very end of this week, which also bizarrely marks the end of your first month of pregnancy, you'll miss your period. And the ride of your life will begin.

Your Body

This week your baby continues to implant in your uterus, burying itself deep within the endometrium. Once implanted, your baby starts to produce a hormone called human chorionic gonadotropin (hCG), which helps to maintain the lining of the uterus. It also sends a signal to the ovary to stop releasing an egg each month, which stops your monthly periods. Some women experience slight cramping and spotting of blood during this week while implantation is taking place, and they may mistake this for a period, as it often occurs around the time their monthly period was due.

hCG is the hormone that is measured in pregnancy tests. This week a pregnancy test will probably be able to detect your pregnancy! hCG also causes the symptoms of pregnancy, which can appear this week. Fatigue, tingling or aching breasts, or nausea might lead you to believe your period will be starting any day because the first pregnancy symptoms resemble premenstrual syndrome (PMS). But by the end of this week, your expected period will not take place. Your pregnancy is well on its way!

Once Mini Me or He implants in your uterus and that placenta starts to grow, your heart starts beating more quickly. You might be putting in an extra 15 beats per minute (even when Taye Diggs isn't onscreen). Until your blood volume catches up to all that extra pumping (which it won't do for a number of weeks), you're likely to feel tired most of the time. Sounds like a good reason to schedule a siesta! 

A lot of that extra blood is heading straight for your breasts, resulting in tenderness and the tendency for your nipples to show ... through your down jacket. (Another early pregnancy sign: Your cervix is softening and changing color. But if this is something you're able to notice on your own, we don't want to know about it.)

Your Baby

Four weeks into your pregnancy, your baby (called an embryo) consists of two layers of cells — the epiblast and the hypoblast — that will eventually develop into all of your baby's organs and body parts. Two other structures that develop at this time are the amnion and the yolk sac. The amnion, filled with amniotic fluid, will surround and protect the growing embryo. The yolk sac will produce blood and help to nourish the embryo until the placenta takes over that role.

Your microscopic embryo is already hard at work this week creating the placenta, umbilical cord and the basics of his or her body.

The embryo is now made of three layers that will transform into the different parts of your baby's body. The endoderm, or inner layer, will become your baby's intestines, liver and lungs. The middle layer, or mesoderm, will become your baby's heart, sex organs, muscles, bones, and kidneys, and the ectoderm, or outermost layer, will develop into your baby's hair, skin, eyes, and nervous system. Believe it or not, your baby is already starting to look like a tiny little being (not necessarily a human being) complete with a head, a mouth opening and a primitive brain and heart.

By the end of this week, your baby measures about 1/25 inch long, about the size of a period (like the one at the end of this sentence, not the one you just missed).

Sugar and Desserts and Diabetes

If you have diabetes, it doesn't mean you will never have birthday cake or pumpkin pie again. With a little planning, you can have a small serving of your favorite dessert. It's best to save the sweets for special occasions so you don't miss out on the more nutritious foods your body needs. But don't worry, you can include sweet treats on special occasions and still manage your diabetes well.

The myth that sugar causes diabetes is commonly accepted by many people. Research has shown that it isn't true. Eating sugar has nothing to do with developing type 1 diabetes.

The biggest dietary risk factor for developing type 2 diabetes is simply eating too much and being overweight — your body doesn't care if the extra food comes from cookies or beef, it is gaining weight that is the culprit.

In the past, people with diabetes were told to completely avoid sugar. Experts thought that eating sugar would raise blood glucose levels very high.

Research around this issue has shown that while the type of carbohydrate can affect how quickly blood glucose levels rise, the total amount of carbohydrate you eat affects blood glucose levels more than the type. Now experts agree that you can substitute small amounts of sugar for other carbohydrate containing foods into your meal plan and still keep your blood glucose levels on track.

That doesn't mean you can eat all the sugar you may want. Most sweets contain a large amount of carbohydrate in a very small serving. So you need to be sure to have a small serving.

Saving sweets for a special occasion is the most healthful way to eat so you focus your meal plan on the most nutrient dense foods such as vegetables, beans, whole grains, fruit, non-fat dairy, fish and lean meats.

If you tend to overeat on sweets, don't buy them. Instead, plan to have dessert when you are away from home. Split the dessert with a friend to keep yourself on track.

Most sweeteners have calories and carbohydrates. Examples are:

Table sugar (also called white sugar or sucrose)

Raw sugar

Cane sugar

• Sugar cane syrup
• Beet sugar
• Honey
• Brown sugar
• Molasses
• Fructose
• Maple syrup
• Cane sugar
• Agave nectar
• Confectioners sugar
• Powdered sugar
• turbinado
• high fructose corn syrup (also called corn sugar)
• rice syrup or brown rice syrup

The key to keeping your blood glucose levels on target is to substitute small portions of sweets and sweeteners for other carb-containing foods in your meals and snacks.

Carb-containing foods include (but are not limited to):

• bread
• tortillas
• rice
• crackers
• cereal
• fruit
• juice
• milk
• yogurt
• potatoes
• corn
• peas.

For many people, having about 45 to 60 grams at meals is about right. Serving sizes make a difference. To include sweets in your meal, you can cut back on the other carb-containing foods at the same meal.

For example, if you'd like to have cookies with your lunch, you need to substitute for another carb-containing food. If your lunch is a turkey sandwich with two slices of bread, here are the steps you would take to make the substitution:

Your first step is to identify the carb foods in your meal. Bread is a carb.

You decide to swap two slices of regular bread for two slices of low-calorie bread (with ½ the carbohydrate) and have the cookies—it's an even trade.

Your total amount of carbohydrate remains the same for the meal.

Diabetes symptoms

Diabetes often goes undiagnosed because many of its symptoms seem so harmless. Recent studies indicate that the early detection of diabetes symptoms and treatment can decrease the chance of developing the complications of diabetes.

Type 1 Diabetes

Frequent urination

Unusual thirst

Extreme hunger

Unusual weight loss

Extreme fatigue and Irritability

Type 2 Diabetes*

Any of the type 1 symptoms

Frequent infections

Blurred vision

Cuts/bruises that are slow to heal

Tingling/numbness in the hands/feet

Recurring skin, gum, or bladder infections

*Often people with type 2 diabetes have no symptoms

Diet for Diabetes

As with all foods, you need to work the diabetes superfoods into your individualized meal plan in appropriate portions.All of the foods in our list have a low glycemic index or GI and provide key nutrients that are lacking in the typical western diet such as:

• calcium
• potassium
• fiber
• magnesium
• vitamins A (as carotenoids), C, and E.

There isn't research that clearly points to supplementation, so always think first about getting your nutrients from foods. Below is our list of superfoods to include in your diet.

• Beans

Whether you prefer kidney, pinto, navy or black beans, you can't find better nutrition than that provided by beans. They are very high in fiber giving you about 1/3 of your daily requirement in just a ½ cup and are also good sources of magnesium, and potassium.

They are considered starchy vegetables but a ½ cup provides as much protein as an ounce of meat without the saturated fat. To save time you can use canned beans, but be sure to drain and rinse them to get rid of as much sodium as possible.

• Dark Green Leafy Vegetables

Spinach, collards, kale – these powerhouse foods are so low in calories and carbohydrates, you can't eat too much.

• Citrus Fruit

Grapefruit, oranges, lemons and limes. Pick your favorites and get part of your daily dose of soluble fiber and vitamin C.

• Sweet Potatoes

A starchy vegetable packed full of vitamin A and fiber. Try in place of regular potatoes for a lower GI alternative.

• Berries

Which are your favorites: blueberries, strawberries or another variety? Regardless, they are all packed with antioxidants, vitamins and fiber. Make a parfait alternating the fruit with light, non-fat yogurt for a new favorite dessert.

• Tomatoes

An old standby where everyone can find a favorite. The good news is that no matter how you like your tomatoes, pureed, raw, or in a sauce, you're eating vital nutrients like vitamin C, iron, vitamin E.

• Fish High in Omega-3 Fatty Acids

Salmon is a favorite in this category. Stay away from the breaded and deep fat fried variety... they don't count in your goal of 6-9 ounces of fish per week.

• Whole Grains

It's the germ and bran of the whole grain you're after.  It contains all the nutrients a grain product has to offer. When you purchase processed grains like bread made from enriched wheat flour, you don't get these. A few more of the nutrients these foods offer are magnesium, chromium, omega 3 fatty acids and folate.Pearled barley and oatmeal are a source of fiber and potassium.

• Nuts

An ounce of nuts can go a long way in providing key healthy fats along with hunger management. Other benefits are a dose of magnesium and fiber.Some nuts and seeds, such as walnuts and flax seeds, also contain omega-3 fatty acids.

• Fat-free Milk and Yogurt

Everyone knows dairy can help build strong bones and teeth. In addition to calcium, many fortified dairy products are a good source of vitamin D. More research is emerging on the connection between vitamin D and good health.

Some of the above list can be tough on the budget depending on the season and where you live. Look for lower cost options such as fruit and vegetables in season or frozen or canned fish. Foods that every budget can live with year round are beans and rolled oats or barley that you cook from scratch.