May  2018
Issue No. 92
In this issue
Control the ABCs of Diabetes

About Us  
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  A not-for-profit ministry of
Church of the Brethren Benefit Trust Inc.

Church of the Brethren Insurance Services provides the following products: dental, vision, basic life and accidental death & dismemberment, supplemental life and AD&D, dependent life and AD&D, long-term disability, short-term disability, voluntary accident insurance, and Medicare supplement for eligible Church of the Brethren employees .
Dental, vision, and Medicare supplement coverage may also be available for eligible retired Church of the Brethren employees.
For eligibility information, call Connie Sandman at 800-746-1505, ext. 3366, or contact your human resources representative.
Medical and ancillary plans (named above) may be available to Brethren-affiliated employer groups.
Long-Term Care Insurance is available for all members of the Church of the Brethren, their family and friends, and employees of Church of the Brethren-affiliated agencies, organizations, colleges, and retirement communities. 

Contact Us 
1505 Dundee Ave., Elgin, IL 60120

This month we take up a matter that we touched on in our September 2016 issue, when we focused on childhood obesity. We quoted the Mayo Clinic, "Childhood obesity is particularly troubling because the extra pounds often start children on the path to health problems that were once confined to adults, such as diabetes, high blood pressure, and high cholesterol."
The connection between obesity and diabetes, which has become a disturbing reality for children, is a serious problem for adults. Some observers are saying it has developed into a global crisis. In our main article we describe what diabetes is, how it works, and what causes it. The follow-up article details many things you can do to control, diminish or prevent diabetes.
If you have diabetes or if you want to keep yourself from developing it, one of the best things you can do is exercise. So as we move toward summer, when all sorts of outdoor activities become possible, this might be a good time to start or ramp up your exercise routine.
Another big thing to do to prevent or slow diabetes is to eat the right foods - especially a diet high in fiber. Fresh vegetables are one of the best sources of fiber, so with gardening season upon us, this would be a good time to think about growing or buying fresh produce.
Among the temptations of summer are cold drinks, ice cream, and other sugar- or carb-laden foods. Maybe nothing can do more to keep diabetes at bay than to cut down on your intake of sugar and carbohydrates. So, as you exercise and eat your veggies, try to avoid those sugary delights and empty carbs that give you so much pleasure with so little benefit to your body.
One of the things diabetes can affect is eyesight, and people with diabetes are encouraged to have regular eye exams. This is something that vision insurance provides, so it is appropriate that we are featuring vision insurance in this issue.
Finally, we hope you will be challenged by this month's brain teasers
May you enjoy the spring weather and be blessed by good health.

Old and New --
Online account information for those with BBT medical insurance coverage

2018 account information

Brethren Insurance Services recently switched medical insurance providers - to BlueCross BlueShield Highmark. For access to all your medical account information as of January 1, 2018, you can log in to
2017 account information

If you still need access to your 2017 medical insurance information, it is available through your Blue Access for Members account at until June 30, 2019.

Read this if you have a high-deductible health plan

The IRS is reversing its previous change to the annual HSA limit because stakeholders have said that implementing the $50 reduction to this limitation on HSA contributions (for an individual with family coverage under a high-deductible health plan) would impose numerous unanticipated administrative and financial burdens. The limit that had been decreased to $6,850 annually has now been increased to $6,900. 

Please click here if you need more information.

More than meets the eye

Considering vision insurance

It starts with the eyes

They say the eye is the "window to the soul." Think about that. You can take in the beauty of a stained-glass window. You can gaze into the faces of people and learn from their expressions and body language. You can read a book or watch a movie or sing the lyrics of a hymn. You can be awed by a gorgeous sunset. These are psychological and spiritual experiences, but they all start with the physical act of seeing. They start with the eyes.

Good vision and  a good life

Have you thought about how essential your eyes are to your life? Think  how your vision enables your work and your relationships. Doesn't it make sense to ensure that you have good eye care?

Preventative care for your eyes

Vision insurance is a way to support the health of your eyes. Most insurance policies pay benefits after the problem has occurred. Vision insurance is designed to prevent problems or keep them from getting worse. It encourages regular preventive care. It even supports overall good health; during an eye exam doctors pay attention to the larger health of the body, and sometimes detect other medical problems.

Taking care of your eyes is vital because sight is  essential to a  good and 
active life.

Why Brethren Insurance Services?

These are important reasons for all people to consider vision insurance. However, if you work for Church of the Brethren-affiliated employers, including churches, retirement communities, agencies, camps, and districts, your employer may purchase vision insurance through Brethren Insurance Services, using any one or all of our three plan designs.
  • Benefits for our group-sponsored plans begin immediately, unlike individual policies that may require up to a 12-month waiting period.
  • We offer three plans through EyeMed.
  • Our plans pay for both EyeMed and non-EyeMed providers (benefits are greater with an EyeMed provider).
  • All three plans provide for an eye exam every 12 months with a $10    co-pay.
  • All three plans offer one pair of lenses, contacts, or eyeglasses per person, per year.
  • If the EyeMed plan is combined with another medical plan, EyeMed will pay as a secondary insurer if your medical plan covers office visits for vision.
  • There is a 20 percent discount for lens options such as tints, U.V. treatments, anti-scratch coating, and anti-reflective coating.
  • There is a discount of 5 to 15 percent for Lasik and PRK procedures.
  • There are discounts for additional pairs of glasses or contacts once the benefit has been used.
So, give some thought to vision insurance. If you represent or work for a Church of the Brethren-affiliated employer and have questions about our programs, contact Jeremiah Thompson, Director of Insurance Operations, at 847-622-3368 or
Diabetes --- a global health crisis

No outside cause

Unlike some diseases, diabetes is not caused by an outside agent. No bacteria or viruses carry it. You cannot "catch" it. In fact, scientists don't really know what triggers it. There are three types. In type 1, the most serious, the body stops making insulin because the immune system actually attacks and destroys the cells in the pancreas that make it. Scientists don't know why, but they believe there are genetic factors.

In type 2, either the pancreas slows down its insulin production or the body does not use its insulin well because the cells resist its action. Again, scientists do not know why this happens, but they do know that both genetic and environmental factors are at play. The third type, called "gestational," develops in some women when they are pregnant, and it usually goes away after the baby is born.

It's all about insulin

As you can see, insulin is central to the reality of diabetes. You probably know of insulin as the drug taken by diabetic people, but you may not know that insulin is a hormone in the human body that is produced by the pancreas and is designed to help glucose leave the bloodstream and enter the cells.

Glucose is produced in the  small intestines where it is converted from sugars
and carbohydrates, and absorbed into the bloodstream. It travels to the cells and becomes the source of the body's energy, but it needs help to enter the cells, and that's the job of insulin, which signals each cell to activate glucose transporters that pull the glucose through the cell walls. You could say that insulin is the key that unlocks the cell so glucose can enter and become energy.
When this process is working properly, the pancreas matches the glucose entering the bloodstream with the right amount of insulin. In type 2 diabetes, the pancreas may produce less and less insulin over time, so there isn't enough to unlock the cells, and the glucose cannot get in to generate energy. In another form of type 2 diabetes, cells build up a resistance to insulin. There may be enough, but it cannot unlock the cells to allow glucose to enter. So, more and more insulin is required, and it becomes harder for cells to get the energy they need. The glucose that cannot get into the cells builds up in the bloodstream, hence there is a high blood sugar level. Energy is being wasted, and the cells lack the energy to keep the body working.


When blood sugar is high, the kidneys,  which usually help the body reabsorb  
excess glucose, cannot handle all of it. So the body has to create urine to carry the glucose away. This draws fluid from the body and causes you to be thirsty and to urinate more often. Because there is less moisture available for other parts of the body, you become dehydrated, causing dry mouth and dry itchy skin.

The changing fluid level can also make the lenses of your eyes swell and change shape, blurring your vision. High blood sugar can affect blood flow, causing nerve damage, making it harder for sores and cuts to heal, and resulting in pain and numbness in the limbs.

Type 1 symptoms can include unplanned weight loss because your body cannot get the energy it needs from your food. Sometimes in type 1, the body, because it can't get the glucose it needs, may begin to burn fat, which produces ketones that can build to an alarming level in your blood and make you sick with nausea and vomiting.

Type 2 diabetes and its globalization

People in the early stages of type 2 diabetes may not experience any of these symptoms, but the disease is progressive, and the symptoms can develop as the disease progresses. This brings us to the statistics on diabetes. Ellen Gustafson, physician and hematologist, writes, "The abundance of cheap food with low nutritional value in the Western diet has wreaked havoc on our health; in America, one third of children and two thirds of adults are overweight or obese and are more likely to develop diabetes and cardiovascular disease."

Michael Pollan writes in The Omnivore's Dilemma, "Obesity today is officially an epidemic; it is arguably the most pressing public health problem we face, costing the health care system an estimated $90 billion a year."

The 2017 National Diabetes Statistics Report asserts that 30.3 million people (9.4 percent of the U.S. population) have diabetes. Of those, 23.1 million are diagnosed and 7.2 million are undiagnosed.

Furthermore, the same report estimates there are 84.1 million people (36.9 percent) with prediabetes. This is sometimes called "borderline" diabetes and is characterized by blood sugar levels higher than they should be but not in the diabetes range. The world health organization reported that 422 million people across the globe had diabetes as of 2014.

The incidence of type 2 diabetes rises as an economy develops. Thus, it is most prevalent in developed and developing countries. The International Diabetes Foundation puts the U.S. figure even higher than the National Diabetes Statistics Report, declaring that 10.75 percent of adults suffer from type 1 or type 2 diabetes, thus asserting that the U.S has the highest incidence of any of the developed countries.

Who will develop type 2 diabetes?

People are more likely to develop type 2 diabetes if -
  • they are 45 or older
  • there is a family history
  • they are overweight
  • they have high blood pressure
  • they do not get enough physical activity
  • their HDL cholesterol is low and their triglycerides are high
  • they have already had heart disease or a stroke
  • they are women who have had gestational diabetes
There is also a higher incidence among African Americans, Alaska Natives, Native Americans, Asian Americans, Hispanic/Latino Americans, Native Hawaiians, and Pacific Islanders. (In the section that follows this article - titled "Diabetes taught me discipline and moderation" - you will find a list of the many actions you can take to impede or slow the progression of type 2 diabetes.)

About type 1

On the other hand, type 1 diabetes is a more serious and life-threatening condition. It is usually diagnosed in children and young adults, and has been known in the past as juvenile diabetes. Only 5 percent of people with diabetes have this form of the disease. Because the immune system destroys the cells in the pancreas that produce insulin, there is little or no insulin in the body available to do its necessary work.

People with type 1 diabetes require lifelong insulin therapy. The insulin cannot be taken orally because stomach enzymes will break it down, so it has to be taken by injection or with an insulin pump. There are many different types of insulin: short-acting, rapid-acting, intermediate-acting, and long-acting, and the therapy is tailored to the person. However, some of the same practices that help people with type 2 are also good for people with type 1, such as monitoring blood sugar, eating healthy foods, exercising regularly, maintaining a healthy weight, and paying close attention to carb and sugar intake.


As stated above, the treatment program for people with type 1 diabetes is regular infusions of insulin. On the other hand, people with type 2 may be able to keep it under control with diet and exercise. Those who cannot will need medication, which may be insulin or more likely will be an oral drug.

The drugs for type 2 diabetes work in various and different ways to bring blood sugar to normal levels, such as increasing insulin production by the pancreas, decreasing the amount of sugar absorbed by the intestines, improving how the body uses insulin, or other actions. Some oral medications combine more than one of these actions.

Conclusion - simple, but difficult

Though type 1 diabetes is a serious and difficult disease requiring constant attention and effort, the easier-to-manage type 2 diabetes is the bigger threat across the world. A study published in 2011 by the American Diabetes Association reported, "Type 2 diabetes is a global public health crisis that threatens the economies of all nations, particularly developing countries. Fueled by rapid urbanization, nutrition transition, and increasingly sedentary lifestyles, the epidemic has grown in parallel with the worldwide rise in obesity. Asia's large population and rapid economic development have made it an epicenter of the epidemic."

Though the disease is progressing rapidly in Asia, it is still the U.S. that has the highest incidence of type 2 diabetes. And the healthy response is quite simple and also quite difficult. Eat a better diet, get more exercise, and lose weight. These are three ways almost all of us could enhance our lives and thus reduce the chance that we might develop type 2 diabetes, or, if we have it, improve our ability to slow its progress. And these are things that many contemporary Americans find hard to do.
Control, diminish, or prevent type 2 diabetes
- Along with advice from celebrities -

Many books and articles have been written explaining how diet and exercise will help the person with type 2 diabetes, or will promote the kind of good health that will prevent it. Here are some of the things you can do. Most of these are also useful practices for maintaining general health.

"I do not love to work out, but if I stick to exercising every day and put the right things in my mouth, then my diabetes just stays in check."

Halle Berry , actress

Exercise and activity
  • Find ways to be more active each day - at least 30 minutes, 5 days a week.
  • Walk. This is something you can do almost anywhere at any time. See if you can find walking maps for your community.
  • Ride a bike, swim, and even dance.
  • Turn up the music and jam while doing household chores.
  • Use work-out videos.
  • Deliver messages in person to your co-workers instead of sending e-mails.
  • Take the stairs at your office, not the elevator.
  • Take a walk to catch up with friends rather than having lunch or using phone or e-mail.
  • March in place while you watch TV.
  • Walk in the mall if your streets are too busy or are unsafe.
  • Get off the bus one stop early and walk the rest of the way home or to work.

"I have high blood sugars, and type 2 diabetes is not going to kill me. But I just have to eat right, and exercise, and lose weight, and watch what I eat, and I will be fine for the rest of my life."
Tom Hanks , actor

How to eat and how much to eat
  • Reduce portion size as a way of controlling the amount of food you eat.
  • Drink a large glass of water 10 minutes before your meal so you feel less hungry.
  • Keep meat, chicken, turkey, and fish portions to about 3 ounces.
  • Share one dessert.
  • Use teaspoons and salad forks (small utensils) to help you take smaller bites and eat less.
  • Make less food look like more by serving your meal on a smaller plate.
  • Eat slowly. It takes 20 minutes for your stomach to send a signal to your brain that you are full.
  • Listen to music while you eat instead of watching TV (people tend to eat more while watching TV).
  • Try filling your plate with these ratios: 1/4 protein, 1/4 grains, 1/2 vegetables and fruit.

"The goal of my diet style is eating for optimal health and longevity. What greater benefit could there be than living healthfully and actively into old age with no dependence on medications and almost no risk of heart disease, diabetes or dementia?" 

Joel Fuhrman , celebrity physician and nutritionist

Getting and Preparing food
  • Grow some of your own vegetables or shop at your local farmers market for fresh, local food.
  • Make a list of foods you need to buy before you go to the store. Resist impulse buys, which are often processed and loaded with sugar.
  • Eat a healthy snack or meal before shopping for food. Do not shop on an empty stomach.
  • Buy a mix of vegetables when you go food shopping.
  • Compare food labels on packages, and choose the foods that are lower in saturated fats, trans fats, cholesterol, calories, salt, and added sugars.
  • If you cannot grow, find or afford fresh produce, buy frozen and low- sodium canned vegetables. They may cost less and keep longer than fresh ones.
  • Stir-fry, broil, or bake.
  • Cook with less oil and butter. Try using non-stick spray or low-salt broth.
  • Cook with smaller amounts of cured meats (smoked ham, turkey and bacon). They are high in salt.
  • Cook with a mix of herbs and spices instead of salt.
  • Try different recipes for baking or broiling meat, chicken, and fish.
  • Try not to snack while cooking or cleaning the kitchen.

"My diabetes is such a central part of my life ... it did teach me discipline ... it also taught me about moderation ... I've trained myself to be super-vigilant ... because I feel better when I am in control." 

Sonia Sotomayor , Judge, U.S. Supreme Court

What to eat
  • Make healthy food choices. Eat more vegetables, fruits, and whole grains. Cut back on high-fat and fried foods.
  • Consider a "Mediterranean" diet: fruits, vegetables, whole grains, fish/seafood, and one glass of wine each day.
  • Choose veggie toppings like spinach, broccoli, and peppers for your pizza.
  • Try eating foods from other countries. Many of these dishes have more vegetables, whole grains, and beans.
  • To reduce calories, choose foods with little or no added sugar.
  • Choose brown rice instead of white rice.
  • Have a big vegetable salad with low-calorie salad dressing when eating out. Share your main dish with a friend or have the other half wrapped to go.
  • Make healthy choices at fast food restaurants. Try grilled chicken (with skin removed) instead of a cheeseburger.
  • Skip the fries and chips and choose a salad.
  • Order a fruit salad instead of ice cream or cake.
  • Peel and eat an orange instead of drinking orange juice.
  • Make at least half of your grains whole grains, such as whole grain breads and cereals, brown rice, and quinoa.
  • Use whole grain bread for toast and sandwiches.
  • Stay away from processed foods and those with high-fructose corn syrup.
  • Use "healthy" sweeteners with care. Honey, maple syrup, and agave nectar are not as heavily processed as table sugar, but they are just as high in carbs (sometimes higher).
  • Eat plain yogurt, not the flavored kind, which is high in sugar.
  • Beware of dried fruit in which the drying process has concentrated the sugars. For example, a half cup of raisins has 57 grams of carbohydrates, mostly sugar, while a whole cup of grapes has only 27 grams.
  • Drink water instead of juice and soda.
  • Find a water bottle you really like (from a church or club event, favorite sports team, etc.) and drink water from it every day.
When you snack
  • Keep a healthy snack with you, such as fresh fruit, a handful of nuts, and whole grain crackers.
  • Slow down at snack time. Eating a bag of low-fat popcorn takes longer than eating a candy bar.
  • Share a bowl of fruit with family and friends.
"I am a type-2 diabetic, and they took me off medication simply because I ate right and exercised. Diabetes is not like a cancer, where you go in for chemo and radiation. You can change a lot through a basic changing of habits." 

Sherri Shepherd , comedienne, author, and TV personality.

Changing habits
  • Keep a written record of what you eat for a week. It can help you see when you tend to overeat or eat foods high in fat or calories.
  • Take time gradually to change eating and activity patterns. Try one new food or exercise a week.
  • Find ways to relax. Try deep breathing, taking a walk, or listening to your favorite music.
  • Pamper yourself. Read a book, take a long bath, or meditate.
  • Think before you eat. Don't eat when you are bored, upset, or unhappy.
  • See your internist for regular checkups.
1. Dr. Johnson has a clock on his office wall. The clock lags six minutes behind every day. After how many days will it show the right time again?

Click here for the answer

2. If five doctors can see five patients in 20 minutes, how many doctors will be needed to see 15 patients in one hour?

3. A doctor has three sons. 
His eldest son is four years older  than his second son.
The second son is four years older than the youngest son.
The youngest son is exactly half the age of the eldest.

Question: What are the sons' ages?

For Your Long-Term Care Needs
Brethren Insurance Services offers Long-Term Care Insurance all through the year
If you're interested in purchasing coverage, you should know that e ligibility for benefits is determined by the inability to meet at least two of these six activities of daily living -- bathing, eating, dressing, toileting, continence, or transferring. Cognitive impairment can also trigger benefits.
It's difficult to think about the fact that a debilitating condition or a disabling injury might leave you unable to care for yourself, or that when you reach your twilight years, the time will come when you will need some extra care. Long-term care insurance makes sure that you will get the care you need. It helps assure that the cost of your custodial care will not eat up your savings. Finally, and this is one of the best things about LTCI, it can help protect your children and other relatives from having to use their resources to care for you.
Brethren Insurance Services offers Long-Term Care Insurance for all members and employees of the Church of the Brethren and their family and friends; and also for employees of Church of the Brethren-affiliated agencies, organizations, colleges, and retirement communities and their families and friends.
If you are interested in obtaining this coverage, contact Brethren Insurance Services at or 800-746-1505 for a free, no-obligation proposal or  click here to request more information.