All About Diabetes Education

11/03/2022

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28/02/2022

26/02/2022

DIABETIC FOOT (3)

Diabetic Retinopathy

It is an injury to the retina, which is virtually constant, after fifteen years of developing diabetes.

This complication should be systematically looked for in all diabetics, by a regular examination of the fundus of the eye,
supplemented, if necessary, by retinal angiography (X-ray of the vessels of the retina after injection of a dye, fluorescein).

Despite laser treatment, diabetic retinopathy remains the leading cause of blindness in Western countries.

Chronic infections

These infections have a microbial or mycotic origin. They mainly consist of urinary and gynecological infections and localized skin infections (foot, groin, ge***al area).

Their prevention requires rigorous hygiene.

In addition, non-infectious skin manifestations may occur, such as the appearance of bubbles on the limbs, or general thickening of the skin.

The diabetic foot

Diabetic Foot is a consequence of neuropathy and angiopathy. The foot, insensitive to pain and poorly vascularized, presents a high risk of infection, and any injury, even small, must be treated immediately, because it can give rise to extremely serious complications, which still too often require its amputation.

ANATOMY OF THE FOOT

Anatomical reminder:

The foot, the most distal part of the lower extremity, articulates with the leg. It includes 26 bones, 29 joints, 42 muscles and a multitude of ligaments and tendons.

The articular system of the foot is manifold, with situations encountered when walking, both on flat and uneven terrain.

Its two main functions are stability and mobility. Flexible structure, all-terrain organ, the foot adapts to forces, it represents the best example of a complete architectural system, combining strength, flexibility and stability.

Osteology

There are three groups of bones in the foot:
The seven bones of the tarsus, the five metatarsals and the phalanges.

• The talus is embedded in the tibio-fibular clamp.
• The calcaneus articulates above with the talus and anteriorly with the cuboid.

It has an extension behind the talus which forms the backbone of the heel.

• The cuboid bone, the most lateral of the anterior tars, presents at the anterior part of the plantar surface a groove for the tendon of the long fibula.
• The navicular bone and the three intermediate cuneiform bones occupy the sagittal ridge of the transverse curvature of the foot.
• The five metatarsals initiate the five rays of the foot. They form 50% of the arch of the foot, the 1st metatarsal is the hallux, it is the shortest and thickest, the 2nd metatarsal is the longest.

The base of the 5th metatarsal protrudes prominently forming a tuberosity where the tendon of the peroneus brevis is inserted.

• The phalanges are bones grouped in threes (two for hallux) each phalanx has a proximal base, a shaft and a distal head.
• The two sesamoid hallucis bones, medial and lateral, are located on the plantar surface of the metatarsophalangeal joint.
Figure 2: anterior view of the foot (5)

Vascularization of the foot

Artery

Blood supply to the foot is provided by the branches of the posterior tibial artery and the dorsal artery of the foot.

Posterior tibial artery

Enter the foot through the tarsal canal on the medial edge of the ankle, behind the medial malleolus.
The posterior tibial artery pulse can be felt on palpation midway between the medial malleolus and the heel.
A little further on, the artery divides into a small medial plantar artery and a large lateral artery.

Lateral plantar artery

Passes forward and out of the sole of the foot, at the base of the Fifth Metatarsal, curves inward, to form the deep plantar arch, which crosses the deep plane of the sole of the foot, at the level of the bases of the metatarsals and interosseous muscles.

The main branches of the deep plantar arch are:

• A digital artery intended for the lateral edge of the little toe
• Four metatarsal plantar arteries which run through the interosseous spaces. Each divides into two digital plantar arteries and the medial digital hallux artery.
• Three perforating arteries that pass between the bases of the two, three, four and fifth metatarsals to anastomose to the vessels on the posterior surface of the foot.

Medial plantar artery

Penetrates the sole of the foot through the deep side of the proximal end of the abductor hallucis muscle.
It provides a deep branch for the adjacent muscle, an anastomosis with the digital branch of the deep plantar arch, which supplies the medial edge of the hallux, a superficial branch which divides into three branches running superficially, relative to the flexor digitorum brevis toes.

Dorsal artery of the foot

It is the continuation of the anterior tibial artery. The pulse of the dorsal artery of the foot can be felt on the back of the foot, gently palpating the artery at the level of the tarsal bones. The branches of the dorsal artery of the foot include the lateral and medial tarsal branches, the arched artery, and the dorsal first metatarsal artery.
This very complex anatomy results in an unequal distribution of the richness of vascularization. There are thus:

Richly vascularized territories

• The sole and medial aspect of the foot
• The medial aspect of the other toes
• The lateral aspect of the hallux

Poorly vascularized territories

• The back of the foot
• The lateral face of the calcaneus
• The lateral aspect of the other toes
• The medial aspect of the hallux

The veins

The veins of the foot form a deep and superficial network. The deep veins are satellites of their arteries. The superficial veins are drained in a dorsal venous arch at the level of the metatarsals.

Innervation

The foot is innervated by the tibial, deep peroneal, superficial peroneal, sural nerve.
Plantar sensitivity is provided by the medial plantar nerve and lateral plantar nerve, branches of the tibial nerve, and heel sensitivity by the tibial nerve.
The superficial peroneal nerve provides sensitivity to most of the back of the foot and toes.
The tibial nerve innervates all of the intrinsic muscles of the foot except the extensor digitorum brevis, which is innervated by the deep peroneal nerve.

DIABETIC FOOT

The diabetic foot is a major public health problem, both in terms of its human cost and its social cost. Lesions of the diabetic foot are an increasingly frequent pathology and one of the main reasons for hospitalization in diabetics.

26/02/2022

DIABETIC FOOT (2)

Diabetic Neuropathy

Consecutive to an attack of the nerves. It mainly affects the lower limbs, and causes loss of sensitivity of the feet and painless ulcerations of the soles (poor plantar perforation), which can become infected.

The involvement of larger nerves, in particular inflammatory (mononeuritis), is observed less frequently, it causes a sensory or motor deficit in the body area served by the nerve.

26/02/2022

THE DIABETIC FOOT (1)

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Diabetic foot represents all skin and osteoarticular lesions, secondary to the junction of neurological and - or arterial and - or infectious complications particularly affecting the distal extremities of the lower limbs in diabetics.

The diabetic foot, responsible for great morbidity and serious disabilities, weighs heavily on society, it is a real public health problem.

Diabetes is the leading non-traumatic cause of lower limb amputation and 85% of these amputations are preceded by foot ulceration (finding that every 30 seconds a lower limb will be lost to diabetes). It is an extremely expensive complication.

This is why screening and prevention actions as well as the education of all diabetic patients are essential.

The management of the diabetic foot requires a multidisciplinary team. Its role is to respond to the following problems: early diagnosis and etiological assessment of ulcerations, medical or surgical therapeutic indications, treatment of infection, optimization of the balance of diabetes, local care, education on wound relief, prevention of recurrence.

Strict discharge of the diabetic foot is the essential reference treatment for all diabetic foot wounds at risk.

Regardless of the progress made in such a process, the treatment of foot lesions in diabetics is always difficult, marked by obstacles, failures and sometimes recurrence.

General objective

Analyze the epidemiological, clinical, therapeutic and evolutionary aspects of this complication.

Specific objective

• Investigate risk factors associated with foot damage in diabetics
• Identify the clinical aspects of the diabetic foot
• Evaluate the effectiveness of the therapeutic methods introduced

General information on diabetes

Definition

Diabetes is a chronic disease, which occurs when the pancreas does not produce enough insulin or when the body is unable to use the insulin it produces effectively. This results in an increased concentration of glucose in the blood (hyperglycemia).

Biological definition

A fasting blood sugar greater than 1.26g / l (7mmol / l) twice, taken 15 days apart, is sufficient to confirm the diagnosis.
Or symptoms of diabetes (polyuria, polydipsia, weight loss) plus blood sugar regardless of the time of the sample greater than or equal to 2g / l.

Oral induced hyperglycemia should not be requested

The glycemic values indicated here above correspond to a dosage, on venous plasma, by the specific enzymatic technique of glucose oxidase, with a normal of between 0, 7 and 1.5 g / l.

This hyperglycemia may be due either to a deficiency in insulin secretion (type 1 diabetes) or to insulin resistance (type 2 diabetes) which is practically the most common.

Classification of Diabetes

There are two main types of diabetes mellitus; type 1 and type 2 as we can find other specific varieties such as gestational diabetes appearing during pregnancy, diabetes due to genetic defects in the function of the beta cell, pancreatic diabetes, endocrinopathies, induced diabetes (drug or toxic), infections, rare forms of diabetes linked to immune system pathology and other genetic syndromes sometimes associated with diabetes.

Complications

Regardless of the type, diabetes can cause complications that affect many parts of the body and increase your overall risk of premature death.

We distinguish between acute and chronic complications:
Acute complications

Ketoacidosis
Excessive build-up of ketones in the body, the culmination of untreated insulin-dependent diabetes, with build-up of ketones in the blood, leading to acidosis.

The patient loses weight quickly, suffers from dizziness, digestive disorders, and great lassitude. Only one of these signs should alert.

In the absence of insulin treatment, the progression is into a coma.

Hyperosmolar coma

Very significant hyperglycemia with dehydration. It is a rare complication of non-insulin-dependent diabetes in the elderly.

Ketoacidosis and hyperosmolar coma require emergency hospitalization in a specialized center and are treated by massive injection of insulin.

Hypoglycemia

Very low blood sugar due to lack of sugar, is a consequence of the treatment itself or its excess compared to diet or physical exercise.

It results in sudden fatigue, a feeling of hunger, dizziness and sweating and is treated by administration of "fast" sugars by mouth if the patient is conscious or by subcutaneous injection of glucagon.

Chronic complications

They are mainly due to the alteration of blood vessels, small vessels (microangiopathy), or large vessels (macroangiopathy).

Resulting from the formation of an atheroma plaque, macroangiopathy is responsible for arteritis of the lower limbs and coronary insufficiency, aggravated in the presence of other risk factors for atheroma (arterial hypertension and hyperlipidemia, very often associated with type 2 diabetes, or smoking).

Diabetic nephropathy

Affects 50% of diabetics and results in the appearance of proteinuria (too much protein passage in the urine) progressing in the long term to renal failure.

This development is accelerated by the occurrence of arterial hypertension.

One of the main causes of end-stage renal disease is diabetes mellitus.

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25/02/2022

15 Practical Tips for Diabetes Weight Loss

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Loss of limbs is not uncommon for people who suffer from diabetes. Currently, over 70,000 amputations occur every year due to poorly managed diabetes.

Nerve damage and loss of feeling in the extremities occur commonly in diabetics over 40. Somewhere close to half of diabetics will suffer from nerve damage because of the disease.
Diabetes Mellitus, or severe high blood sugar, is the main underlying cause.

Diabetes Mellitus is just one of the many serious side effects of poor diabetes management. This results when the sufferer continually has elevated sugar spikes and struggles with diabetes weight loss.

Over time, these sugar spikes can lead to a breakdown of organ health and function. Don't let your diabetes get you! We have some of the best ways to help keep your body strong and healthy!
What Are Type One And Type Two Diabetes?

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Diabetes is a hormonal disorder or autoimmune disease that attacks the pancreas. This disease has two distinct categories based upon how the disease impacts your pancreas.

If your diabetes pretty much shuts down your pancreas, this is type one diabetes. Type one diabetes symptoms consist of frequent urination and extreme fatigue.

When left untreated, these symptoms can result in life-threatening conditions. Diabetic shock and ketoacidosis are two of the main causes of hospitalization.

These symptoms are true for type 2 diabetes as well. But, one of the main differences is type 2 does not shut down the pancreas. Rather, it is extreme or moderate insulin resistance.

One of the main differences is that type one diabetes usually causes weight loss. This is an early symptom of type one before it is treated. A common precursor to type 2 diabetes is usually obesity.
But the way in which these diseases are treated and weight is managed are similar. Weight management can be difficult even for people without this disease.

Diabetes Blood Sugar Levels And Diets

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Weight control and a healthy lifestyle are imperative for those who struggle with these diseases. Diabetes weight loss is not entirely different from weight loss for everyone else.

But, there are some issues you should be aware of before you start a weight loss journey. Diabetics suffer from high and low blood sugar levels. Diabetes blood sugar levels should be within a specific range for it to be considered healthy.

Those who suffer from hyperglycemia and hypoglycemia suffer from poor blood glucose levels. Both of these blood glucose levels have underlying causes and symptoms you need to know about.
Hypoglycemia is extremely low blood sugar levels. This can be caused by fasting or exercise. The common symptoms of hypoglycemia are high pulse and cold sweats.

When untreated, both of these blood sugar levels can damage your body. Hypoglycemia can result in passing out and fainting. Diabetics usually have a shot called glucagon which holds sugar water that can boost a diabetic's sugar level.

These are usually only used if a diabetic's sugar levels have plummeted very low. In such cases, they may be unable to drink or eat. An injection of sugar can help get them to a safe level again.
Hyperglycemia is extremely high blood sugar levels. It can be caused by changes in diet or high amounts of carbohydrates.

The common symptoms include fatigue and sweet-smelling breath.
Hyperglycemia can cause you to get diabetic ketoacidosis. This occurs when sugars in the blood accumulate to unhealthy levels. The body starts burning fat cells, which can cause kidney issues.

These blood sugar levels are extremely important to understand before starting a diet. Changes in diet can impact diabetics differently than others.

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What To Consider Before Starting A Diabetes Weight Loss Program
Weight management is not just important for diabetics. It is important for everyone. The methods of maintaining weight are not so different for diabetics as they are for non-diabetics.

Blood sugar levels are important to remember when thinking about the best path to take. There are certain fad diets that diabetics should be very cautious about.

There are diets that emphasize cutting out all carbohydrates. Low-carb diets have been shown to successfully help diabetics lose excess weight. But, how are these diets long-term?

Cutting out carbohydrates for fresh vegetables and switching from bread to whole grains is great. But, certain diets such as the ketogenic diet urge dieters to switch carbs for fats.

This is a great way to enact "ketosis" (not ketoacidosis). This means the body starts to burn excess fats when it is deprived of sugars. In moderation, this is okay.

But, for type 1 and type 2 diabetics, it is important to have a balance of both carbs and fats. Carbohydrates that come from whole grains and fiber are actually good for diabetics.

Diabetics need to be especially careful of their fat intake. This is especially true for diabetics who have suffered from the disease for many years. Diabetic veins become constricted due to the levels of sugars accumulating over time.

Excess fats, especially saturated and trans fats, will likely only worsen this issue.

Are There Special Diets For Type One And Type Two Diabetics?
Type one and type two diabetes are both commonly misunderstood.

There is no real distinction between a type one and a type two diabetic diet.

The most important factors to consider are the levels of your blood glucose over time. This is called an A1C.

Find out your A1C (average blood glucose for 3 months). This will help you see how you are doing overall. If this level is high, you run a higher risk of heart disease and stroke.

The CDC states that diabetics run a much higher risk for dangerous heart diseases. This is why high fat intake (especially saturated and trans fats) are dangerous.

These fats cause LDL cholesterol levels to elevate and should be avoided by diabetics.

Diabetes Blood Glucose And Dieting

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If you are dieting, it is really important that you understand and manage your blood sugar. Low carb diets are beneficial for diabetics. But, you need to be wary of having continuous low blood glucose levels.

Incorporating simple lifestyle changes is the best way to achieve diabetic weight control. Extreme diet and exercise changes cause your blood sugar to rise and fall erratically.

Low blood glucose levels are one of the leading causes of diabetic hospitalization. It is also one of the main causes of repeat hospitalization as a result of poor management.

Repeat returns to the hospital are common for diabetics who struggle to manage glucose. When selecting your preferred diet plan, make sure you get enough to eat.

Although unhealthy for anyone, you should never stop eating to lose weight. If you stop eating or even skip meals as a diabetic, it can have severe medical consequences.

Intermittent fasting should be avoided as well for diabetics. A missed meal can severely damage your health if you have low blood sugar and faint.

It can also throw off hormone levels and diabetic medications. The best way to manage your blood sugar levels on a diet is to continue eating a solid three meals a day.

For everyone else, dieting that urges you to stop eating can cause malnutrition. This is true for diabetics as well. It is even more severe if you are diabetic since blood sugar levels can impact nutritional intake.

With these important factors in mind, let's see what options are available for healthy weight management.

These are the top 15 tips!

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1. Eat Plenty Of Green Vegetables
Eating at least 2-3 servings of leafy green vegetables is beneficial for everyone. But, for diabetics, it can do wonders for helping you manage your blood glucose.

Leafy greens are high in fiber which helps prevent blood sugar spikes during digestion. They are also very low calorie and rich in numerous vitamins and micronutrients.

You can implement greens in your diet through smoothies and add them to standard dishes. You should avoid juices if they have high sugar levels. Since the juice is strained, the fiber is removed and can cause blood sugar spikes.

2. How To Add Leafy Greens To Your Diet

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The best way to add leafy greens to your diet is to add them fresh! Fresh leafy greens have the most nutrients with the least additives.

This is especially good for type 2 diabetes. Type 2 diabetics should try to eat foods lower in calories and fats. This is because the symptoms of type 2 diabetes can be weight gain.

Weight management is already an issue, so low-calorie and high fiber are great. Try to avoid adding them to a dish that has a lot of cheese or other fats.

3. Eat Lots Of Berries Rather Than High-Starch Fruits

Berries are a powerhouse of nutrients and antioxidants. These antioxidants are helpful in aiding in the breakdown of negative buildup in the body.

These berries not only help prevent cancer but also regulate blood sugar spikes. Berries are very low in sugar content when compared to other fruits.

High-starch fruits such as apples and bananas can cause blood sugar spikes in diabetics. They do have some fiber so they aren't bad for you and should be chosen over bread.

But, when you have the option, you should choose berries!

4. How To Add Berries To Your Diet.

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Adding berries to your diet is an easy task if you like strawberries or blueberries. If you live up north, you may struggle to find fresh and delicious berries out of season.

The best way to eat them out of season is to find a tasty frozen fruit available. Just make sure you find the unsweetened variety.

When berries are sweetened, it defeats the benefits of a low-sugar fruit. Plus, refined sugars are even worse for glucose levels than sugars derived from fruits.

5. Eat Legumes For Heart Health

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Legumes include plants such as peanuts and beans. These plants are naturally high in heart-healthy fiber and nutrients.

Naturally, they have no fat or healthy fats and are excellent to help lower bad cholesterol levels. Peanuts are an excellent snack for a diabetic since they have high protein and this helps people feel full.

But, peanuts, unlike kidney and black beans, have high amounts of fats. These fats are healthy, but still high in calories. If you are trying to lose weight, keep your legume consumption moderate!

6. How To Add Legumes To Your Diet

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Legumes can be added to a lot of dishes and add a nice boost of proteins and fiber. Peanuts can be made into delicious peanut butter spread that most in America love.

Adding beans and lentils to a dish is also relatively simple. The most popular dish with beans is chili. Chili is not really low in fats though, because it is made with oil and red meat.

One of the best ways to avoid this issue and make a healthy chili is to replace the red meat. You can find ground chicken to use instead of ground red meat. This can help you get a protein boost while avoiding a lot of the bad fats.

7. Lean Meats For Protein And Low-Carb Meals

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Like we just discussed, lean meats are a great replacement for red meats and dark meats. Dark meat is popular among some dieters who claim it has higher levels of iron.

Dark meat is important in small amounts. The best way to add it is in small amounts to soup broth. But, overall, white meat has substantial minerals and vitamins.

Lean meats can also be eaten as a snack instead of a carbohydrate snack like crackers. You can keep a few cuts of cooked white meat chicken in the fridge for a healthy and low-calorie snack.

8. How To Add More Lean Meats To Your Diet

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Add lean meats to the traditional meals you would normally add meat! Lean meats cook very similarly to fatty meats, but usually don't take as long.

You should avoid cooking these meats on high heat levels. This is the best way to cook lean meats, but try to cook on lower heat levels.

You may also want to add some herbs to the mixture for more flavor. Lean meats have less flavor than fatty meats.

9. Start Up Some Meatless Days!

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People with a plant-based diet have lower BMIs overall. This means people who follow strict or semi-strict plant-based diets tend to lose more weight and keep it off.

This is because plants have fewer calories than meat. To feel full, meat-eaters may be prone to eat higher amounts of food with higher overall calorie counts.

But, plant diets can have close to a 300-500 calorie lower intake on a day-to-day basis.

10. How To Cook Meatless And Tasty!

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Cooking meatless can be a challenge to those who aren't familiar with cooking vegetables. Adding small amounts of healthy fats (olive oil) when cooking these foods helps bring out the flavors.

Use creative herbs such as rosemary and thyme when cooking tofu. This helps give it a more authentic taste!

11. Diabetes Blood Pressure Management

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Blood pressure is a serious issue for diabetics. Diabetics suffer from a thicker blood vessel wall. This is a result of red blood cell depletion.

Therefore, diabetics need to be extra careful to avoid things such as salt and bad cholesterol. Some diabetics need to take blood pressure medication in order to prevent elevation.

But, this does not mean eating low sodium won't help! Adding a moderate workout 4-5 times a week can also help you prevent blood pressure elevation.

Studies have indicated that performing an exercise regime regularly helps lower blood pressure. Some of the best exercises for diabetics are swimming and biking.

Diabetics suffer from nerve damage in their fingers and feet. This is called diabetic neuropathy. But, avoiding high-impact exercise will help prevent this from worsening.

12. Preventing Severe Side Effects Of Diabetes Insipidus

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Diabetes insipidus is a urinary disorder caused by complications associated with diabetes. The best way to identify this disorder is frequent and extremely heavy urination.

For young children, this can be identified with constipation and fevers. This is because diabetes insipidus causes damage to the kidney and urinary system. The filtration system of your body is not functioning properly.

There are medications that help manage this issue. But, one of the ways to help deal with this disorder is to drink plenty of fluids. This disorder can negatively affect your kidneys long-term.

This issue is most commonly identified in small children and infants. Children who have a genetic predisposition usually are the ones who get this disease. But, if caught early, you can prevent the severe side effects from occurring.

Once diagnosed, take your medications as prescribed, and be sure to drink lots of electrolytes. Coconut is an excellent natural source of electrolytes that will ensure proper hydration.

13. What Foods To Avoid With Diabetes

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Mostly, diabetics should avoid foods that will negatively impact their blood glucose. Also, any foods which will exacerbate common issues associated with diabetes such as fatty foods.

Low-fat dairy is a great source of nutrients but can be unpopular for young kids. You should try to limit chocolate and vanilla milk for children since they are high in sugar.

This is just one example of how many foods that are otherwise healthy can have high sugar. Avoid added sugars as much as possible.

High fats and junk foods should also be avoided. This is true for everyone, but for diabetics, it can cause early-onset heart disease. Junk food is also high in sodium.

Sodium only makes the blood vessels get even harder and restricted. Sodium also depletes the body of fluids, which can lead to dehydration.

Severe dehydration needs to be avoided. It will only worsen ketoacidosis and other severe side effects of diabetes.


14. Lifestyle Changes For Type 2 and Type 1 Diabetes

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One of the best ways to regulate your diabetes is through lifestyle changes. Even though some forms of diabetes can not be cured yet, lifestyle changes can improve your life.

Getting active is so important for diabetics. Find a way to work out at least 20-30 minutes every day. That is, if possible. This helps regulate blood sugar and improve heart health.

If you cannot find time for this every day, try to do it as much as possible. This can be a couple of times a week at least. The most important thing is you try to do it often.

Avoid walking barefoot outside, since it may increase your chances of neuropathy. But, remember that having a good blood flow is the best way to prevent this.

Doing the best you can is what you need to keep in mind when making lifestyle changes. Don't give up!

15. Best Food Lists For Type 2 Diabetes And Type 1 Diabetes

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To help make the best food choices you can, we have put together the best food list!

Leafy greens such as kale, collard greens, and spinach
Lettuce, which is high in minerals and much-needed fluids
Carrots and celery to help regulate fat and improve organ function
Fruits that are high in fiber and low in sugar, such as berries
Low-fat dairy and yogurt

Try non-dairy alternatives but avoid high-carb varieties such as oat milk

Lean meats such as chicken and fish, which have good fats
Drink fluids that are high in electrolytes and potassium
Eat lots of red vegetables and fruits such as beets and pomegranates.

These plants help oxidize the blood and lower blood pressure
Add Acai and Goji berries to your smoothies to boost vitamin C and improve stamina

Try healthy sweetener alternatives, such as stevia and sucralose

Diabetes Weight Gain and Weight Management

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Managing your weight as a diabetic can be a daunting task. There is so much your body is demanding all at once!

Diabetes weight gain causes a decrease in stamina and your body's ability to burn fat. But, don't give up. Many diabetics suffer from these issues and are willing to help with diabetes weight loss.

The Diabetics Voice website focuses on bringing diabetics closer together! We strive to give the best information and bind us all together in mutual support.

Grandfather melts 44 lbs and fixes blood sugar with this unlikely diet hack