Agave: The Real Deal – Diabetes Daily Voices

For those of you that haven’t heard of agave, agave syrup (also known as agave nectar) is known to be sweeter than both sugar and honey making it a common substitute to sweeten recipes. While this product of the Tropical Americas and South Africa may seem hip and new to you, it’s been part of traditional Mexican and Latin American diets for years. You can read about DiabetesMine’s take on Agave, too!

Agave and Diabetes
To control blood sugar levels, a diabetic must use a combination of diet, medication, and exercise. The Glycemic Index (GI) has played a huge role in helping people with diabetes choose foods wisely as it indicates how a food will affect their glucose levels. Unless you’re trying to raise your blood sugar purposely, a diabetic would generally avoid foods with a high GI as it will raise glucose levels significantly.

Because of their low GI properties, agave syrup products have become very popular among diabetics lowering their blood sugar levels. While ideally this would be a great tactic for choosing diabetic-friendly substitutes for sugar and honey, natural foods are still significantly unregulated in the US. Depending on manufacturer and manufacturing processes, some brands of syrup could potentially have higher GIs than others, making it an especially risky choice for diabetics trying to keep their glucose levels low. Because of this and other findings, both the FDA and the Glycemic Research Institute have expressed their concerns about agave syrup being labeled as diabetic-safe.

So Should I Cross Agave off of my Grocery List? 
Not necessarily. I believe that agave nectar can be consumed as long you keep the following in mind:

  • Read all product labels carefully
  • Enjoy like other sweeteners, in moderation
  • Choose brands that are minimally refined
  • Choose brands that have the lowest GI possible
  • Before making any drastic changes to your diet, be sure to consult your nutritionist or doctor. I cannot stress this enough! While the internet can be a valuable resource for information, it is no substitute to consulting a professional.

For other information, tips, and articles on managing your diabetes, I encourage you to check out my website at


“What Is the Glycemic Index?” All About Agave. N.p., n.d. Web. 17 Aug. 2012. .

Zelman, Kathleen M., MPH, RD, LD. “The Truth About Agave.” WebMD. WebMD, 2010. Web. 17 Aug. 2012. .



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Fact or fiction you decide..

This is so funny!


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  1. I always think if someone asks me if I’m wearing a pager, I’m going to answer, “Yeah, I’m trying to bring it back, you got a problem with that?”

    You could also tell someone you are a doctor, but that is most likely a horrible idea. And very fraudulent!


  2. Hahaha this is great! I totally have a slew of makeup bags that I used for D-supplies in my purse!


  3. You’re cute:) I never thought of myself as badass, but I do have grown men tell me they could never give themselves shots.


  4. I just ditched the black meter case for the cutest makeup clutch! I’m still using injections and found the perfect insulated bag from GraniteGear to keep my insulin cool in this hot Colorado summer. I love bags!


  5. I absolutely love you, Kim! DHugs! ❤


  6. This totally brought a smile to my face… Love it! An addition from my end: Not being a bag-lover myself, as I have one “boring” black meter case, it’s a bright side bonus that Suzi can actually get as many bags and purses as she wants and use “carrying my D-stuff” around as an excuse. So, yes -> That’s awesome, too! :))


  7. You are too cute and too funny!
    Thanks for the smiles this evening!!


  8. This is hysterical. I especially like the comment about throwing dirty test strips at weddings instead of rice. LOL!


  9. Kim, I was thinking of Adele when you said, “do my business and be left alone!”


  10. So, umm… what does it say about me that when my old standard-issue black meter pouch got all tattered and frayed, I called up the manufacturer and asked for a replacement? (And they asked me to send the old one back!). But, yeah, there is something bad-ass about showing someone my infusion or CGM site to someone and saying “Yeah, I did that myself, and I’ll probably do it again tomorrow”, just to see their reaction.


  11. Thanks for the smiles and giggles 🙂


  12. Stop being so cute. Or don’t. Or whatever. Love this.


  13. Im getting ready to go to a wedding.. strip confetti here I come!


1HappyDiabetic Diabetes Blog –


25…. Not a big number, yet not a small number. It is a significant number for me this December as this is the year I celebrate 25 years with diabetes. I don’t actually know or remember the day I was diagnosed with diabetes. I know it was in December 1986, after my mother’s birthday on the 10th and before Christmas. I remember the way the hospital smelled, that I was put on the children’s ward even though at age 13 I felt I should be on the adult ward, and I remember the doctor telling my parents to go buy me a case of diet sodas from the gift shop as I needed to drink a ton of fluids for my blood sugar to come down.  I remember the doctors talking to my parents as if I was not there, telling them I would not live to age 30 and I would never have children.  I remember feeling very alone and very scared as visiting hours ended and I was left in a room by myself.  I remember thinking that my life was over before it had a chance to begin.


When I look back at that scared 13 year old girl, I think about how I began my diabetic journey feeling like it didn’t matter what I did, no matter the good or bad choices, I was  doomed.  I look back over some of the choices I made or avoided and I wonder how it might have been different if I hadn’t been diagnosed with diabetes mellitus, AKA  type 1 diabetes.  I think about all the things I was afraid to try doing because I used diabetes as my excuse.  Then I think about the fact that I would not be the awesome person I am today if I had not gotten that diagnosis so many years ago.  I wouldn’t have been forced to be so tough and resilient.  


Not many people know all the details of my journey with this chronic condition.  Some of the details are ugly and some of them are magical.    Although I can be cynical about many things, I am also a hopeful person who always can see the possibilities.  I still hope for a cure someday.  I still get excited when I see another diabetic following their dreams and they don’t let diabetes stop them.  I still am here, chasing my own dreams, not letting diabetes define what I can’t do.  I can do anything I want, I just have to plan and prep a bit more than a non diabetic.  And I am a pretty good planner after 25 years of practice :)


So as we say goodbye to 2011, let’s all remember, it’s all about your attitude!   I think I will go have a cupcake to celebrate all that is possible with diabetes in my life.

For all of those like me that are celebrating their 25 years of diabetes – Well done!


By: Michael Aviad


Shakshuka is a traditional North African dish that is wildly popular in Israel.  You can find shakshuka on the menu in just about every café in Tel Aviv.  Shakshuka is generally eaten as a breakfast food, but makes a good meal at any time of the day. There are many shakshuka variation – some are spicer than others, some add sausage, some add cheese. 

Traditionally, shakshuka comes with a serving of bread to soak up the sauce.  As you can imagine, since I’m a serious low-carb dieter, I skip the bread altogether.  I don’t find that I miss the bread, as the dish is quite heavy on its own and very satisfying.

This dish is about as versatile as it gets – you can add more tomatoes if you like, make it spicy or mild.  Whatever you decide, you can be sure it will be delicious.


5-6 Medium tomatoes, chopped

1 Medium onion, finley chopped

2 medium red bell peppers, chopped

2-3 hot peppers (use cayenne, jalapeños, Anaheim or any other according to your taste) 

3 garlic cloves, crushed and chopped

½ cup olive oil

1½ tablespoons tomato paste

½ cup water

½ teaspoon cumin

salt to taste

1 tablespoon chopped parsley



Heat oil in a large frying pan over medium-high heat. Add onions and pepper and cook, stirring occasionally, until soft and starting to brown, about 6 minutes. Add garlic and cumin and cook, stirring frequently, until garlic is soft, about 2 more minutes.

Add the tomatoes, tomato paste, and half a cup of water. Reduce heat to medium, cover and cook, for 15 minutes, stirring occasionally. Add salt and stir.

Crack eggs over sauce so that eggs are evenly distributed across pan. Cover pan and cook until yolks are just set, about 5 minutes.

Sprinkle shakshuka with parsley and serve.


Serves: 2-3


Variation: Sprinkle ½ a cup of feta cheese on top of the shakshuka before serving.




Pregnancy and Diabetes – Its all about the preparation

Written by Gary Scheiner MS, CDE

What you do before conceiving can make all the difference.

By Gary Scheiner MS, CDE

Think about the last thing you had to do that was really important.  Perhaps it was making a key presentation at a business meeting.  Or taking a major exam.  Or running in a big race.  Or maybe just keeping your dignity during the first dance at your wedding.  In all likelihood, what helped you get through it successfully was the preparation you put in.  Training, studying, practicing, and basically “doing your homework” are all forms of preparation.  And preparation is what gives most people the confidence and skills necessary to perform even under the most difficult circumstances.



Now, it’s time for the performance of a lifetime.  Bringing a new life into the world.


Sure, women with diabetes can conceive and go on to deliver healthy, beautiful babies.  But before you start preparing the baby’s room and making lists of possible names, there is some preparation of your own that you need to tend to.


(Modest) Tightening of BG Control


During the first four to eight weeks of pregnancy, the baby’s major organs develop and the body begins to take shape.  It is during this phase that serious birth defects can occur – particularly involving the brain/nervous system and heart/circulatory system.  Paradoxically, most women don’t even realize that they are pregnant until this early developmental phase is almost if not completely over.


Elevated blood glucose levels during the early developmental phase greatly increase the risk for fetal defects and malformation.  For this reason, it is essential that blood glucose be under reasonably tight control at the time of conception.  Ideally, A1c should be as low as possible (without experiencing too many hypoglycemic events), but certainly below 7%, prior to conceiving.  This will give your baby the best chance possible for healthy development.


In fact, the chances for conceiving in the first place may hinge on your blood glucose control.  High glucose levels can cause problems with the endometrial lining of the uterus.  If this lining is unstable, the fertilized egg may not “nest” properly, and the baby will never have a chance to develop.



Weight Control


Women who are extremely overweight (BMI greater than 30*) should receive counseling on weight loss before conceiving.  Carrying excessive body fat increases the risk for hypertension, insulin resistance, pre-eclampsia and a more complicated delivery.  The need for a Casaerean procedure is also much more common in women who are overweight.


Weight loss diets are generally not recommended during pregnancy due to the risk of malnutrition for the unborn child, so the time to lose weight is before conceiving.  Losing 5-10% of body weight through a sensible nutrition and exercise program can produce significant health benefits for you and your future baby, and may also increase your chances for becoming pregnant.


* To calculate your body mass index, go to



Medication Review


If you have type-2 diabetes that is treated with oral medications, or type-1 and use medications in addition to insulin, you may need to discontinue the medications prior to conceiving.  Most oral diabetes medications will be passed along to the developing baby and may pose a risk.  Certain other medications, including ACE inhibitors (for blood pressure and/or kidney protection) and statins (for cholesterol control), are also considered unsafe during pregnancy and should be discontinued prior to conceiving.  In other words, before you even think about becoming pregnant, speak to your physician about all of the medications you take and whether any should be halted.


Also, talk to your doctor about starting prenatal vitamins along with a folic acid supplement.  Many prenatal vitamins lack sufficient folic acid for preventing birth defects (generally 400-800 mg daily).  It is usually a good idea to start both folic acid and prenatal vitamins three months prior to conceiving.


 Medical Care/Screenings


Make sure you’re up to date on your immunizations.  Contracting a serious illness during any phase of pregnancy may cause you to lose your baby.  Thyroid levels should also be checked before conception.  Hypothyroidism is very common in people with diabetes, and the baby’s nervous system can be affected if your thyroid level is too low.  If you already have thyoid disease, your dose of thyroid medication may need to be increased during pregnancy.


Carrying a baby places particular strain on the small blood vessels of the eyes and kidneys.

Be sure to have a comprehensive eye exam (including a dilated retinal screening) prior to conceiving.  Any pre-existing blood vessel problems in the retina should be treated prior to conception, since eye disease can worsen quickly during pregnancy.  Likewise, have your kidney function checked by measuring the amount of protein (microalbumin) in your urine.  Significant kidney problems may make you a poor candidate for pregnancy.



Ask any painter, what’s the most important part of the job… the answer will always be “the preparation”.  The same can be said about having a healthy baby.  Just take a few basic steps to prepare for pregnancy:  Get the blood sugars in good control, work to achieve a healthy weight, cut out potentially harmful medications, and receive the necessary medical screenings.  It can make all the difference in the world!



Note:  Gary Scheiner MS, CDE is owner and clinical director of Integrated Diabetes Services, a private practice specializing in blood glucose regulation and advanced self-management training for people with type-1 diabetes. A portion of his practice focuses on pregnancy and type-1 diabetes.  He and his staff of CDEs offer their services remotely via phone and the internet for clients throughout the world.  A devoted husband and father of four, Gary has had type-1 diabetes for 25 years and makes extensive use of both pump and CGM technology.  For more information, visit, or call 877-735-3648.

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