doctor_deena

True story - soda (and other sugar sweetened beverages) increase your risk for prediabetes, even INDEPENDENT of obesity!
There's something about added sugars, like high fructose corn syrup that disrupts our normal metabolism of sugar and fats.

So my suggestion is - stop drinking sugar sweetened beverages (especially regular soda) & drink more water instead!

Here's an interview I did with WebMD on this topic:

http://www.webmd.com/diabetes/news/20161110/daily-can-of-soda-boosts-odds-for-prediabetes-study-finds #1

For diabetes awareness month today let's talk LADA!

LADA = Latent Autoimmune Diabetes of Adulthood

This is probably a type of Diabetes that you have never heard of.

We are seeing a ton of LADA patients these days, so its important to know about it.

LADA occurs when the body make antibodies which destroy the cells of the pancreas that produce insulin. Its similar to TYPE 1 Diabetes, except it happens later in life.
Patients with LADA USUALLY need insulin at some point in their lives.
Not all patients with LADA will need insulin at the time of diagnosis, since their pancreas is still able to make insulin. LADA is sometimes called TYPE 1.5 Diabetes bc it has features of both Type 1 and Type 2 Diabetes.
Patients with LADA will need insulin once the insulin producing cells of the pancreas are fully destroyed.

LADA patients are generally greater than age 25, can be normal weight, and often times there may be a family history of diabetes (i.e. it can be genetic). The diagnosis of LADA must be made by the presence of antibodies.

Do you know anyone with LADA?

For diabetes awareness month today let's talk LADA!

LADA = Latent Autoimmune Diabetes of Adulthood

This is probably a type of Diabetes that you have never heard of.
Good thing its still Diabetes Awareness Month and I can tell you a little bit about it!

We are seeing a ton of LADA patients these days, so its important to know about it.

LADA occurs when the body make antibodies which destroy the cells of the pancreas that produce insulin. Its similar to TYPE 1 Diabetes, except it happens later in life.
Patients with LADA USUALLY need insulin at some point in their lives.
Not all patients with LADA will need insulin at the time of diagnosis, since their pancreas is still able to make insulin. LADA is sometimes called TYPE 1.5 Diabetes bc it has features of both Type 1 and Type 2 Diabetes.
Patients with LADA will need insulin once the insulin producing cells of the pancreas are fully destroyed.

LADA patients are generally greater than age 25, can be normal weight, and often times there may be a family history of diabetes (i.e. it can be genetic). The diagnosis of LADA must be made by the presence of antibodies.

Do you know anyone with LADA?

November is Diabetes Awareness Month ❤️ As a diabetes doc, I'm obviously psyched to shine light on this very important condition 👍

Most of us know at least one person w Diabetes & that's bc it's becoming more & more common.

In places like southern India its like a fad bc so many people have it!
Unfortunately now that it's so common, people started thinking it's the "norm" and don't take it seriously which has led to bad complications.

Look around you... 1 out of every 10 people around you may have type 2 diabetes!
That means likely at least one person in your extended family might develop type 2 diabetes!
This is why we need to pay attention & learn the symptoms.
Even though its so common, many people don't know they have diabetes bc they aren't screened. All it takes is a simple blood test which can change your life.

What are your questions about diabetes?

This recipe is SHD & soo pretty!

Carrots + olive oil + sprinkle of dill & salt & pepper. In the oven for 25 mins at 400.

I love carrots in the fall and winter to help boost my immune system. They also are a great source of fiber & omega fats which are great for your gut microbiome.

Hosting dinner w some med school friends tonight 💜
Check out part of our spread 😋

I love to cook w the seasons...especially for the fall :)
Of course my menu tonight has a lot of roasting!

Let the holidays begin 💙🥳 Stay tuned for these shd recipes!

Hosting dinner w some med school friends tonight 💜
Check out part of our spread 😋

I love to cook w the seasons...especially for the fall :)
Of course my menu tonight has a lot of roasting!

Let the holidays begin 💙🥳

Stay tuned for these shd recipes!

Important post before the holidays🦃🎅

Dealing w weight issues & obesity is complicated 😑

We all know weight loss is tough but maintaining ones weight loss is even harder & something you have to work on EVERY DAY for life

Why is it hard?
Its really complicated.
You might notice that no matter how much weight you lose, you end up yo-yoing back up to a certain weight most of your life.
We call this weight our body's "weight set point"-- its basically the weight that your body wants to be.
And all the hunger signals, brain reward stimuli, gut hormones, neurotransmitters, brain hormones, satiety signals, fat tissue, emotional triggers, & so much more work hard to maintain this set point.
That's why its so so easy to gain weight again.

In fact, as a weightloss doctor...I make sure I still see my pts who have lost weight (even when they are happy w their weight) every 6 months or more frequently to make sure they maintain their weightloss.
Its just so easy to fall back into bad habits...

One of the biggest reasons for weight regain after weight loss is justifying eating every extra snack, dessert or high calorie item by telling yourself --

"I can eat it today & just go on a diet later".

I do this often too especially during the holidays... but the truth is that these justifications for high calorie foods don't just happen once... they happen more often than that.. and slowly the calories add on & we gain weight AGAIN.

If you are struggling w weight regain, its important to remember that cheat meals or snacks can happen once or twice a week; anything more will lead to gaining weight & the vicious cycle starting once again.

Weight maintenance means continuing to say no to high calorie foods & practicing lifestyle changes forever to keep your weight stable.

Rybelsus is the FIRST ever ORAL GLP-1 agonist approved for treatment of Type 2 Diabetes ✔

You have probably heard of other GLP-1 agonists -- Victoza, Byetta, Bydureon, Trulicty, etc. -- which are all injectables so this is the first time this type of medication can be given as a daily pill 💊

GLP-1 agonists work to increase insulin secretion, decrease glucagon secretion, and decrease gut motility.
Many of my patients are asking me about Rybelsus, but since it was just approved earlier this month... we don't have enough "real life data" just yet; however, the drug trials prior to this medication coming to market, look very favorable.

Studies suggest that it works in acchieving good diabetes control when compared to placebo.

Studies also suggest that it works just as well as similar GLP1 agonists which are injectables to control blood sugar and help w weight loss. In fact, there is a possibilty that this drug might have fewer side effects like nausea and/or vomiting.

I am excited to be able to offer my patients an additional pill for diabetes that works... but
the limiting factor right now is costs 🤑

Rybelsus will cost $772.43 for a 30-day supply, or nearly $9,400 a year, a price point that the Danish drugmaker described as "competitive" within the GLP-1 category 😮

With so many great drugs on the market, insurers need to find ways to help cover these drugs for consumers ⚖
The better coverage ➡️ the better diabetes control ➡️ the less likely a patient will develop other diabetes-related complications or need for admissions in the hospital = less costs overall for the patient & insurance company

If patients can't find options that they want to take (like injections) they won't comply w the medication.. we need to make all diabetes meds affordable and accessible!

Thai food is my favorite & I love a good pad thai.
Since I'm trying out some new low carb recipes...
I decided to experiment one night...so here's my version of pad thai made w squoodles 💜

Its fun trying different recipes w veggie noodles...especially squoodles (made w spaghetti squash) since it doesn't even require a spiralizer! All you need is a fork to make these noodles 🍴

This recipe was super easy.. the only thing that took time was roasting the spaghetti squash for 40 mins & sauteing the veggies
I like this dish bc its low calorie, low carb, anti-inflammatory, packed w vitamin a&c, high protein (bc of the peanut butter) & so yummy. My mother in law & hubby loved it 😋

Next time, I'll try to make it with thicker cut veggie noodles similar to the padthai noodles 👍

And as always... S(imple) made w ingredients you ate familiar with if you love thai/asian food

H(ealthy)- less than 120 cals in a cup

D(elicious) - this sauce is awesome, I even froze some for the future!

How do you do your veggie noodles?

I got an awesome birthday present today -- my interview with got published 🥳

Trypanophobia, aka Needle Phobia, is a real thing. I encounter this very often amongst my patients with diabetes who inject insulin & need to check fingersticks with a needle every day (sometimes up to 8 to 10 times a day!) There are many tools to help people overcome this phobia.

Deep breathing exercises and meditation during the actual blood draws or needle sticks can be very helpful.
Even chanting & counting out loud has helped many of my patients.

I sometimes ask my patients to bring their headphones and listen to music that they love during a blood draw. Sometimes we even play music for them 😀 anything to keep them distracted!
If that doesn't work, I even offer numbing gels.

Check out this article to learn more helpful techniques.
How do you help people overcome this fear?

Today is world Osteoporosis day! I thought today would be the perfect day to talk about screening for osteoporosis.

Who should be screened for osteoporosis and when?

There are so many different recommendations regarding this. For women...should we start at 50 or 65? For men...should we start at 65 or 70?

The National Osteoporosis Foundation (NOF, International Society for Clinical Densitometry (ISCD) and US Preventive Services Task Force (USPSTF) have recommendations that are different and can be quite confusing!

My recommendations are based on changes in hormones that predispose one to bone loss.

Dr. Deena's reccs on should be screened for osteoporosis&when:

1) ALL women after age 50 should have a bone density test

2) ALL men after 70 should have a bone density test

3) With either s*x -- screening for bone disease should occur at ANY AGE if risk factors are significant -- these RFs include ✔history of fragility fracture (any fall from a standing height or less, that results in a fracture) ✔early menopause (menopause before age 50) ✔those w medical conditions associated with low testosterone in men or low estrogen in females (these conditions may include anorexia/eating disorders leading to low body weight, chronic opioid use) ✔use of medications associated with bone loss (like high dose steroids, some chemotherapy agents, etc) ✔significant smoking history ✔transgender males (women who wish to be male) on HRT with supressed levels of estrogen ✔medical conditions associated with bone loss (like anorexia, untreated hyperthyroidism, hyperparathyroidism, severe vitamin D deficiency)

If you have patients or know someone who meets any of the above parameteres, please get them screened!

The bone density test is fast and easy -- just a simple Xray that takes

I decided to have a mini bday party w fam before my actual birthday tomorrow 😀 bc tomorrow we will be celebrating in Vegas 💓🎊🥳🎉 I can't believe that another year has passed!
Days seem to fly by....and I keep reminding myself to live out every day when I can.
I don't want to ever have huge regrets, ya know?

Birthdays are bittersweet for me when I think of getting older... but its exciting to live in this amazing world & makes me appreciate all that I have & all that I wish for.
So cheers to another great year! Have a drink or healthy snack on my behalf 💋

So tonight..I made these veggie bites which were a hit & so yummy!

People couldn't believe how easy they were to make so I'm excited to share this recipe with you!

As expected from me - its SHD
1) Simple (made w 6 ingredients + spices)
2) Healthy (less than 20 cals in one)
3) Delicious - you won't believe that it's so healthy

STEPS
1) Grate up two carrots and add to bowl
2) Finely chop one onion and add to bowl
3) Finely chop up one bunch fresh parsley and add to bowl
4) Add in one cup feta cheese
5) Add in two eggs
6) Add in a teaspoon oregano
7) Add in a tablespoon cumin
8) Add in 1 cup bread crumbs
9) Add in 2 teaspoons salt and pepper
10) Add a drizzle of olive oil
11) Mix it up
12) Oil your hand and mold 2 cm balls with your hands
13) Preheat oven to 375
14) Bake until brown & crisp (20 mins depending on your oven)
15) Cool
16) Enjoy!

To me apple season means that fall is on its way & it's my favorite time of the year 🍎🌳 Nothing is better than some cool weather, the gorgeous change in foliage colors, apple cider, pumpkin everything, bonfires... yay!

I love to explore farms in new cities. This weekend was perfect weather for some apple picking in Yardley, PA.

We got lots of cameo & snap staymen apples.. they are varieties that I've never heard of or tasted before ❤

Everyone knows apples are high in fiber (w the skin)... but did you know apples have many phytonutrients to fight inflammation?

I love how apples can be used in so many ways - in sweet & savory dishes, as a snack, drink, etc.

I plan to bake a slightly healthier version of apple crisp with no butter & oatsl! I will share that recipe soon 🍰

Roasted veggies continued w maple glazed butternut squash.

This tastes like Thanksgiving in your mouth 😋& its so easy 🤸‍♀️

Made w 5 ingredients: butternut squash cubes + drizzle of evoo + a drizzle of maple syrup + sprinkle of cinnamon + sprinkle of nutmeg + s&p

Butternut squash is a great alternative to sweet potatoes bc its just as hearty & sweet.... but it's lower calorie & lower sugar & loaded w more antioxidants 👍

So SHD 😀

Enjoy!

I love this pic bc its a candid shot taken during an interview & it portrays how I really felt in the moment 😀

I feel so lucky that I love what I do every day & nothing makes me happier than health education & clearing out the pseuodoscience out there in the world of diabetes & hormone health 💓

you inspire me to want to do better things every day 😍 Rock on 💪

I love this pic bc its a candid shot taken during an interview & it portrays how I really felt in the moment 😀

I feel so lucky that I love what I do every day & nothing makes me happier than health education & clearing out the pseuodoscience out there in the world of diabetes & hormone health 💓

you inspire me to want to do better things every day 😍 Rock on 👍💪

These roasted veggies recipss might be the easiest & yummiest things you've ever made 😋

Mini portobello mushrooms w dill.

Made w s&p + dill + basil +evoo. Roasted for 30 mins!

The herbs can be fresh or dried. Either way, it tastes great 💓

More SHD recipes to come!

I celebrated the end of rotations & summer w my new fellows this weekend w a bbq at home. It was so nice to meet their families & spend time outside the hospital 🤗

In my world - Summer is for bbqs but they don't have to stop bc of the weather...
even in the winter, I use my grill pan on my stove inside... its such an easy & healthy way to cook!

If you live to grill, I hope you have one!

Even simple salt, pepper and olive oil go a long long way to grill veggies that taste delicious.

This weekend I made grilled veggies in 4 different ways....obviously SHD and w different tastes 😍

I'll share each recipe through the week 👍

I celebrated the end of rotations & summer w my new fellows this weekend w a bbq 🤗

Summer is for bbqs but they don't have to stop bc of the weather...
Even in the winter, I use my grill pan inside.. its such an easy & healthy way to cook!

Even simple salt, pepper and olive oil go a long long way!

This weekend I made grilled veggies in 4 different ways....obviously SHD and w different tastes 😍

I'll share each recipe through the week 👍

Its officially fall!
Which means time for roasted vegetables...something is just so comforting & cozy about them 🤗

I'll be sharing a lot of roasting recipes this season bc its just so SHD....and there's so much you can do w them!

I use my roasted veggies as:
-a topping to salad
-a side with a protein
-a snack
-or I even puree it down to make a soup!

Last night I made roasted butternut squash, portobello mushroom and carrots w olive oil + garlic powder + thyme + salt + pepper. Roasting took 30 mins or so.

Today I topped it onto my salad and added some black beans & feta for protein!

What do you do w your roasted veggies?

Its officially fall!

Which means time for roasted vegetables...something is just so comforting & cozy about them 🤗

I'll be sharing alot of roasting recipes these season bc its just so easy & quick..and there's so much you can do w them!

I use my roasted veggies as a:
-topping to salad
-a side with a protein
-a snack
-or I even puree it down to make a soup!

Last night I made roasted butternut sqaush, portobello mushroom and carrots w olive oil + garlic powder + thyme + salt + pepper. Roasting took 30 mins or so.

Today I topped it onto my salad and added some black beans & feta for protein!

What do you do w your roasted veggies?

I love the concept of providing a healthier option to vending machines especially in hospitals.

My biggest pet peeve 🤯 is vending machines stocked w chips, candy & junk food in hospitals... the exact opposite of what I tell my patients w Type 2 Diabetes to eat!

Most of my patients have never tried chia, flax or diff yogurts..
So I get so excited w people talking about the new things they are eating in this fridge - chia seed pudding, overnight oats, etc.
This fridge is introducing people to healthy options that that they would never have tried otherwise.

Its one step to making healthy food accessible to everyone in underserved communities....and to hungry residents in the middle of the night at the hospital 🤣