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Health Department Sponsors Walking Tour of the Human Heart


The 17th Annual “ Tortoise & the Hare Dare,” a 5K walk/run, will be held on Saturday, April 5th at 9:00 a.m. at Pocomoke River State Park-Shad Landing, Snow Hill, Maryland. Registration begins at 8:30 a.m.   This is a FREE event and participants will receive T-shirts. The walk is co-sponsored by the Worcester County Health Department, Worcester County Department of Recreation & Parks, and Pocomoke River State Park with funding provided by the Maryland Department of Health and Mental Hygiene Office of Minority Health and Health Disparities.

Participation in regular physical activity has many benefits including reducing the risk of developing chronic health problems such as high blood pressure, high cholesterol, diabetes, heart disease, and certain cancers. It also helps with weight loss/maintenance of a healthy body weight, bone health, strength, stress management, and flexibility. The 17th Annual Tortoise & the Hare Dare is a great opportunity to enjoy the outdoors while getting some physical activity with friends, family, and other community residents.

After the walk, participants are encouraged to visit local health, recreation, and community exhibits This year’s event will feature the AmeriHeart Exhibit, a realistic, inflatable, human heart that participants can walk through and learn about how the heart works and how to keep it healthy. The AmeriHeart Display and exhibits will be open from 10:00 a.m.-2:00 p.m.  

Pre- registration is encouraged and participants can register by calling 410-632-0056.




Internet Resources to Help You Manage Your Diabetes

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Internet Resources to Help You Manage Your Diabetes

John Motsko, RPh, CDE
Apple Drugs Diabetes Center

Over the past several years, diabetes information on the Internet has not only increased in volume, but also in the quality of information available.   Many individuals with diabetes prefer the casual, personal use of the Internet to help them better manage their diabetes.   In this article I will describe some of the more common (and useful) websites an individual (or their partner, significant other, family member or friend) can use to better understand what diabetes is and the patient’s role in helping to manage it. Often times it’s difficult to obtain this important information simply at a physician’s appointment. The use of the resources of the Internet, plus coaching from their local diabetes educator, can assist patients very effectively in managing their diabetes

Here are a few of my favorites:

Journey for Control   (http://www.journeyforcontrol.com) is an easy to use, interactive website that allows patients to access practical tools to manage their diabetes. One of the unique features of this site is an “electronic book” under the tab of patient tools called the “go to guide”. When the “book” is accessed, the individual can actually see and hear descriptions of certain topics, such as “how does the body utilize glucose” or “what is insulin resistance”. These are short YouTube videos that explain the topics very simply and efficiently. There is also an interactive quiz at the end of each chapter of the “book”.

Calorie King (http://www.calorieking.com) is another interactive site that allows individuals to learn about the nutritional content of foods and how they affect blood sugar management and weight control. It’s a very helpful site for individuals to look up fast food products. For an additional $49 registration fee individuals can “join” and track their food intake, activity and results. If you don’t want to join, you can still look up nutritional information on different foods.

For Carbohydrate Information the USDA has a very comprehensive site listing the carbohydrate content of about 1500 different foods, including foods that may not have a “nutrition label” included with them, such as raw foods or bulk packaged foods. The list is 27 pages long, but I usually ask individuals to print it out then highlight the foods they normally eat or intend to eat. The website is under www.nutrition.gov and under the “subject tab” on the left “what’s in food-carbohydrates”.

The USDA also has a comprehensive website “Choose my Plate” (http://www.choosemyplate.gov). Again a website chocked full of information; one of the more interesting functions is the ‘Super Tracker’ tool that allows individuals to create a profile and track food intake, exercise and results.

The National Diabetes Education Program website (http://www.ndep.nih.gov) contains a variety of publications and other resources, including many publications in Spanish. This resource website is also very helpful for those involved in diabetes support, such as church groups or other community based organizations.

The American Diabetes Association’s website (www.diabetes.org) contains information on the basics of diabetes and nutrition. It’s also a site very helpful for individuals with children with diabetes. While it tends to be focus mainly on Type 1 diabetes, there are very good resources also available for the patient with Type 2 Diabetes.

The American Association of Diabetes Educator patient website (www.diabetesselfcare.org) offers another comprehensive guide to managing diabetes. The site focuses on the AADE 7- a group of 7 behaviors needed to help individuals understand and manage their diabetes. The “AADE7 Self Care Behaviors” are composed of understanding diabetes, monitoring, being active, healthy eating, medications, risk reduction, problem solving and healthy coping. Many of the AADE accredited centers use these behaviors as the basis of their education classes. The site also allows individuals to “find a diabetes educator” by searching for one by state or zip code

Another helpful website is A to Z Health (http://diabetes.atozhealth.com). This is a very helpful website that includes links, printable resources and videos, both in English and in Spanish to visually support the ideas of diabetes self-management and risk reduction.

My Fitness Pal (www.myfitnesspal.com) is a free site focusing on weight loss and fitness. It allows individuals to track food intake, activity and weight loss. In additions the site contains a large data base of foods for reference in meal planning. This site is also available as an Application on Smart Phone devices.

Speaking of Smart Phone applications, there is a large selection of health related applications available, many of them focused on diabetes.   Included among these is “GoMeals” which allows individuals to track their food intake and activity on their phone. My Fitness Pal also has a similar application for your Smart Phone. Lastly, another helpful application available on for your Smart Phone is a new product called Glooko. Glooko is an application that allows you to download your blood glucose results from your meter to your phone or Pad device. Once downloaded, the data can be viewed in several forms, such as a log book in which you can include foods eaten, activity, etc. and several very helpful graphic options that visually show blood glucose monitoring progress.   Once downloaded these report can be e-mailed or even printed out to share with your diabetes educator or health care provider. The Glooko app requires a connecting cable which is available for just about all popular meters for about $30. Visit their website (www.glooko.com) for more information or search the application icon on your phone or PAD for the free application.

As you may have heard your diabetes coach say many times, diabetes is a disease where self-management skills play the most important role in your success. The more recent Internet and Smart Phone applications can help you help yourself. Just make sure you stick to the ones that are supported by reputable organizations, not strictly advertisers. If you have a question about the site’s validity, please check with your diabetes support individual or your Certified Diabetes Educator.





Emerging Diabetes Research Being Conducted on the Eastern Shore

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Emerging Diabetes Research Being Conducted on the Eastern Shore




It is well-established that there are a myriad of benefits of regular physical activity for those with Type 2 Diabetes, including improved blood glucose regulation (reduced HbA1C)1, increased whole-body insulin sensitivity 2, and the delay or prevention of developing cardiovascular disease 3,4. Because of these benefits, in a Joint Position Statement, the American College of Sports Medicine and the American Diabetes Association recommended that Type 2 Diabetics engage in at least 150 minutes of moderate to vigorous dynamic exercise per week, spread out over 3 to 5 days 5. For individuals starting an exercise program, choosing types of physical activity that are personally enjoyable will help them stick with their program, allowing them to experience these benefits of exercise.


In addition to benefits of regular exercise, we have learned that during recovery from even a single session of aerobic exercise, humans can experience increased insulin sensitivity, although this response varies widely, depending on the exercise duration and intensity 6. During this postexercise period, humans also experience a sustained rise in blood flow to previously active skeletal muscles 7. We have recently learned that this increased blood flow is mediated by 2 receptors that can be blocked by common over-the-counter medications 8. The findings that both skeletal muscle blood flow and insulin action are increased following a bout of dynamic exercise got us thinking about how the 2 things might be related. Does the increased blood flow aide in delivery of glucose to the muscle cells? If so, is less insulin needed to escort the glucose into those cells?


We addressed those questions in a pair of research studies and found that in healthy individuals, elevated postexercise skeletal muscle blood flow was a key factor in both normal glucose delivery 9 and insulin sensitivity 10 following dynamic exercise. If postexercise blood flow plays a key role in glucose regulation in healthy individuals the potential clinical implications of the relationship between blood flow and glucose regulation following exercise in those with Type 2 Diabetes, who have impaired glucose delivery and insulin sensitivity, is substantial.


Currently, in our research laboratory at Salisbury University, we are conducting the first in a series of experiments examining postexercise blood flow and blood pressure in Type 2 Diabetics, as well as the role postexercise hemodynamics play in glucose regulation for this clinical population. We are seeking subjects to participate in this research study. Research subjects receive a free, medically supervised graded exercise test and explanation of the results, in addition to being compensated (in cash) for their time. If you or anyone you know meets the following inclusion criteria and is interested in participating in this study, please contact me at This e-mail address is being protected from spambots. You need JavaScript enabled to view it "> This e-mail address is being protected from spambots. You need JavaScript enabled to view it or 410-677-0144.


Subject inclusion criteria:

  1. You must be 20 to 60 years of age
  2. You must have been diagnosed with Type 2 Diabetes Mellitus between 6 months and 15 years from the start of the study.
  3. You must have reasonably well-controlled blood glucose levels (HbA1c ≤ 9%)
  4. You must be non-insulin-dependent
  5. You must be free of co-morbidities, including but not limited to coronary artery disease, pulmonary disease, cancer, and hypertension (blood pressure ≥ 140/90) * requiring medication (*Please see exceptions in #10).
  6. You must have a body mass index (BMI) < 35 kg/m2 (Below the level of morbid obesity)
  7. You must be a non-smoker and may not be using any illegal/recreational drugs
  8. You must be free of diabetic complications, including retinopathy, nephropathy, and autonomic and peripheral neuropathy
  9. You must not be pregnant or breast feeding
  10. You must be taking no more than 3 diabetic medications. In addition, you must be taking no other medications, other than oral contraceptives, aspirin, dyslipidemia medications (e.g., statins), ACE Inhibitors/Angiotensin II Receptor Antagonists (for renal protection etc.), and bone health supplements (e.g., calcium).

If you have any questions about participating in this research study, please let me know.


Thank you and be well.


Tri-County Diabetes Alliance – Featured Article, October 2013

Tom Pellinger, PhD, ACSM RCEP – Assistant Professor of Physiology

Salisbury University - Department of Health Sciences




1          Umpierre, D. et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. Jama 305, 1790-1799, doi:10.1001/jama.2011.576 (2011).

2          Winnick, J. J. et al. Short-term aerobic exercise training in obese humans with type 2 diabetes mellitus improves whole-body insulin sensitivity through gains in peripheral, not hepatic insulin sensitivity. J Clin Endocrinol Metab 93, 771-778, doi:10.1210/jc.2007-1524 (2008).

3          Balducci, S. et al. Effect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med 170, 1794-1803, doi:10.1001/archinternmed.2010.380 (2010).

4          Balducci, S. et al. Changes in physical fitness predict improvements in modifiable cardiovascular risk factors independently of body weight loss in subjects with type 2 diabetes participating in the Italian Diabetes and Exercise Study (IDES). Diabetes Care 35, 1347-1354, doi:10.2337/dc11-1859 (2012).

5          Colberg, S. R. et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement executive summary. Diabetes Care 33, 2692-2696, doi:10.2337/dc10-1548 (2010).

6          Boule, N. G. et al. Effects of exercise training on glucose homeostasis: the HERITAGE Family Study. Diabetes care 28, 108-114 (2005).

7          Pricher, M. P., Holowatz, L. A., Williams, J. T., Lockwood, J. M. & Halliwill, J. R. Regional hemodynamics during postexercise hypotension. I. Splanchnic and renal circulations. J Appl Physiol 97, 2065-2070 (2004).

8          McCord, J. L. & Halliwill, J. R. H1 and H2 receptors mediate postexercise hyperemia in sedentary and endurance exercise-trained men and women. J Appl Physiol 101, 1693-1701 (2006).

9          Pellinger, T. K., Simmons, G. H., Maclean, D. A. & Halliwill, J. R. Local histamine H(1-) and H(2)-receptor blockade reduces postexercise skeletal muscle interstitial glucose concentrations in humans. Appl Physiol Nutr Metab 35, 617-626, doi:10.1139/H10-055 (2010).

10        Pellinger, T. K., Dumke, B. R. & Halliwill, J. R. Effect of H1- and H2-histamine receptor blockade on postexercise insulin sensitivity. Physiological Reports 1, n/a-n/a, doi:10.1002/phy2.33 (2013).


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