After a 2 week break due to Memorial Day, we reconvened at the Center at Spring Street for class 3, but had a role reversal.  My teaching partner, Mandel, did the powerpoint presentation and education lesson about fats and salt while I cooked!

I added to the education lesson, clarifying that the ABCs of diabetes stand for A1c, Blood pressure, and Cholesterol and pointing out that people with diabetes and hypertension are more likely to be salt sensitive, among other things.

For the cooking demonstration, I made Sautéed yellow squash and snow peas in the electric frying pan and Classic Caesar salad.  The hot dish used a minimal amount of oil and many herbs.  I made sure I knew what nutrients the vegetables were good sources of and delved into those benefits while cooking.  The Caesar salad was made from a plain Greek yogurt base for some bite, but no raw egg or anchovy paste.  Very light and tasty if not exactly what they’d serve at Caesar’s Palace!  Mandel had baked a Buttermilk chocolate cake at home using brown sugar Splenda and that was served to all as well.  These recipes are all in the Dining with Diabetes cookbook, at class we give copies of all recipes used, then at the last class, we give them a cookbook that includes everything.

After class, one participant hung around and asked me if I knew what hydrogenation meant (we had taught about trans fats in class), I said sure, “it means the liquid oil was bombarded with hydrogen molecules through some kind of process and became more solid.”  She went on to explain that she was a retired high school chemistry teacher and she taught Mandel and me a thing or two! She said “you are both a carbon, you each have 4 places to bond, head, each hand, and feet,” and then had me hold Mandel’s hand. “Now you have 3 places left to bond,” so we could bond to another carbon on both sides and hydrogen top and bottom.  Then she had us hold both hands (like playing London Bridge), and said “now you have a double bond, you only have 2 other places to bond, one place for the next carbon and one hydrogen. So you will be an unsaturated link.” It was like a light bulb going off for the first time!!  I knew about this but never really “saw” it until I acted it out! I gave her a hug, she was a great teacher!

I taught the second class yesterday. 17 participants showed up!  I focused on carbohydrates, sweeteners, and interpreting food labels.  I brought in 2 boxes of cereal, bowls, food models, and measuring cups.  I had 2 participants pour what they thought was 1 cup of cereal into a bowl and then we measured to see how much it really was.  Later, when explaining how to use the food label, we figured out how much carbohydrate was in each bowl and they were quite impressed with the difference.

My site supervisor, Jill, came in all the way from State College, she had spent the night locally and was at the center early enough to help Mandel and I set up and complete A1c tests on a few more participants.  She observed my presentation, added a comment about xylitol, and participated in the physical activity portion with the group, and helped serve samples of the recipes Mandel demonstrated too.

After the program, Jill and I sat and talked awhile about the program, my practicum goals, and how to attain some of them.  I’m interested in how this education program contributes to the principal study by Joslin and the Centers for Medicaid and Medicare Services.  I’m excited about how I am offering this education program in the community, apart from an institutional setting which is my usual teaching setting and how the outcomes may differ.  I asked about spending time at the office at State College and Jill offered that I could meet with Julie Cooper, the data manager and see how the data base was set up and how the data is compiled and analyzed.

We also discussed offering this program a second time, and in the evening for those who work, which I am on board to do, but had thought it would be in the fall.  Upon thinking about logistics since both Mandel and I have school age kids with after-school activities, I’m considering doing an early evening program starting in mid-summer so it will be done except for the follow-up class before the kids’ school year starts again.

Did I mention I’m getting paid for this practicum?? About the same rate as my regular job, certainly helps offset tuition!!

Interesting business, figuring out my way around this blog site. My first post last week was not attached to “me” I guess because I wasn’t yet listed as a participant.

My Dining with Diabetes group has met twice now! Last Monday was the initial meeting, we did HbA1c fingerstick tests (with 5 minute waits for results), blood pressures (with the help of a local nurse from a home care company), PAR-Q forms (physical activity readiness), consent forms and pre-assessment surveys on 17 people. Most people pricked their own fingers but I helped a few as this class is open to those with diabetes, prediabetes, and spouses, partners, relatives, or friends who may not have diabetes. Everyone’s data is collected, if they consent to it. I can do fingersticks because the state of PA licensure for dietitians does not address it or restrict it and it is within the scope of practice of an advanced practice RD and CDE. The center staff assisted with directions and paperwork and brought us coffee too! We had a short presentation at the end about the scope of diabetes in the US and PA, about the study, and the aim of the education program.

Yesterday was the first official education session including diabetes risk and important monitoring tests for health maintenance including A1c, BP, eGFR, LDL, and eye exams.  I added to the powerpoint presentation in explaining more about the reasons for the tests, anecdotes about my clients over the years with diabetes, & basic guidance on how some medications work in the body and affect these parameters.  I fielded questions about many things, from amputations to hypoglycemia.  I moved on to physical activity and played 10 minutes of Joslin’s “Keep Moving Keep Healthy with Diabetes” DVD. Engaging music and 2 people on screen, one doing the exercise seated in a chair and the other standing, marching, stepping, reaching, and stretching got most of the class moving whether they could easily stand or not.  We all got warmed up.  Then, my education partner, Mandel, distributed recipes and did a cooking demonstration that she had prepped while I was speaking.  She made a spinach and strawberry salad, a green bean side dish, and a vegetable frittata.  Meanwhile, I collected A1c’s on new attendees, and some able bodied participants helped pass out small sample plates of the food.  As we finished up, we finished data collection for the new people, and measured waist circumference on those who volunteered.  This is a measurement that the study no longer collects, but I decided to investigate on a small sample.  Part of my motivation is that doing such a measurement seems like an invasion of personal space and made me a little uncomfortable.  I looked at this video a few times and went ahead with it.

https://www.youtube.com/watch?v=jyL8UfGZMJE

Surprisingly, I wasn’t uncomfortable, perhaps because I explained what I was going to do and why WC is important with respect to health risk.

Whew, what a whirlwind. So far so good, next week my site supervisor will travel 2 hours to come and observe and I’ll start getting some photos taken.  I’m going to cook one week too, stay tuned!