Jan
01
2007

Prevent Type 2 Diabetes With Diet And Moderate Exercise

By | Diabetes, Hormones, Nutrition, Prevention

The almost epidemic proportions of Type 2 diabetes has raised grave concern, but healthcare providers agree that adult onset diabetes is not just a disease that strikes out of the blue. Patient education remains a basic concern, as there are factors that predispose people to the disease. There are known risks for those who are overweight and when inactivity is the main lifestyle. Family history plays a role and ethnic origin can make the patient more vulnerable to the development of diabetes. Population groups at risk are African-Americans, Native Indians, Pacific Islanders, Hispanic-Americans and Asian-Americans. There is a stage which is known as pre-diabetes. The blood glucose level is elevated, but it is not high enough that the condition is labeled as a full-blown diabetes. The good news is that with screening of the blood sugar the first signs of elevation can be detected with a blood sugar monitor at home. This way this condition can be picked up and the progression to diabetes can be avoided with proper diet and exercise.

In a large study of the Diabetes Prevention Program people who lost 7 % of their body weight and exercised 150 minutes per week cut their risk of developing type 2 diabetes by 58%. For patients in the age group over 60 the risk was reduced by 70%.

Prevent Type 2 Diabetes With Diet And Moderate Exercise

Diabetics need exercise and a proper diet

It is important that all persons who are at risk are screened. The laboratory tests involve fasting overnight, after which the fasting glucose levels are checked. A glucose tolerance test is the second test. After overnight fasting the patient receives a glucose-rich drink and blood sugar levels are monitored afterwards to establish how well the glucose is metabolized. These tests are inexpensive and are usually covered by health insurance.

More information about:

1. Diabetes type 2: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

2. Exercise (fitness): http://nethealthbook.com/health-nutrition-and-fitness/fitness/

Reference: Dec. 25, 2006/January 1, 2007 issue of U.S. News & World Report, page 55

Last edited November 2, 2014

Jan
01
2006

Prevent Foot Problems In Diabetics

By | Diabetes, Hormones, Prevention, Skin Disorders

Diabetes has reached epidemic proportions in North America. Two million Canadians (about 20 million in the US) have diabetes, and the number is expected to rise dramatically. At one time or another about 15-20% of patients with diabetes will need hospitalization with a diabetic foot complication. The conditions, which are of concern, are diabetic foot ulcers, severe infection and circulation problems in fingers and feet (peripheral circulation). Health budgets are stretched, as the cost of treating a single foot ulcer has been estimated at $2,183, so the total cost over the lifetime of current diabetics will exceed $650 million (about 6.5 billion $ in the US). Foot ulcers appear like a small item considering the fact that the need for amputation of a lower extremity is the next severe problem that can arise. The average patient who undergoes a below knee amputation will spend 84 days in hospital and another 38 days in rehabilitation.
To prevent the development of foot ulcers, it is important to screen diabetic patients for predisposing factors like the loss of protective sensation in the feet (diabetic neuropathy) as well as structural changes resulting in areas of increased pressure. A study conducted in southwestern Ontario found that only 15% of patients with type 2 diabetes were screened to identify those at risk for foot ulcers. Screening is the first step, after which a podiatrist will have to take over. Footwear prescribed by a podiatrist can be an avenue of prevention, but ongoing podiatric care as well. The small number of diabetic foot screenings shows that podiatric medicine has not been used as a tool to recognize and treat diabetic foot problems.

Prevent Foot Problems In Diabetics

Prevent Foot Problems In Diabetics

The proactive approach of seeking the input of a podiatrist early will translate into significant benefits for the patient with type 2 diabetes.

More information on complications of diabetes:  http://nethealthbook.com/hormones/diabetes/complications-diabetes/

Reference: Parkhurst Exchange, December 2005, page 162

Last edited October 30, 2014

Aug
01
2005

Tight Blood Sugar Control In Diabetics Cuts Heart Disease

By | Diabetes, Heart Disease

Successful treatment of type 1 diabetes in the past usually meant compliance in taking insulin shots and paying attention to a diabetic diet. Since the arrival of specific lab tests like the HbA1c levels, patient education has become more sophisticated: it is not enough to just be on shots, eat sensibly and otherwise hope for the best. As a result, it is a must for patients to monitor their glucose levels closely.
Research that was presented at the American Diabetes Association during the 65th annual scientific session spelled out the benefits very clearly: strict control of glucose levels helps patients with type 1 diabetes to decrease the risk of stroke and cardiovascular disease by 57%!

It has been known that tight glucose control helped to reduce diabetic nephropathy (kidney disease) and diabetic retinopathy (eye disease) in diabetics, but this is the first time that controlling glucose levels has been associated with cardiovascular disease, reports the main investigator, Dr.David Nathan from, director of the diabetes center at Massachusetts General Hospital in Boston. He also reported that every 1% reduction in HbA1c (glycosated hemoglobin) correlated with a 20% reduction in cardiovascular risk for the diabetes type 1 patient.

These findings are significant, as the risk reduction is larger than seen in any other trials, like administering medication (statins) or placing stents.

Tight Blood Sugar Control In Diabetics Cuts Heart Disease

Tight Blood Sugar Control In Diabetics Cuts Heart Disease

A similar risk reduction may also occur in patients with type 2 diabetes, but at this point no specific research on this group is available. In the meantime it is of great importance to any patient with type 1 diabetes.

More information about:

1. Diabetes treatment: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/treatment-type-2-diabetes/

2. Heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

Reference: The Medical Post, July 5,2005,page1, 58.

Last edited October 29, 2014

Apr
01
2005

One Shot For Better Blood Sugar Control

By | Diabetes

People with permanent health conditions face the need for lifelong medications, and patients with type 2 diabetes see insulin shots as part of an everyday routine. There are different types of insulin, which helps in tailoring the medication to the needs of the patient.
It is old news that a new type of insulin under the name insulin glargin can be used for the treatment of type 1 diabetes. The news of a study just published in February is, that also patients with type 2 diabetes benefit from insulin glargin. Often the standard treatment with diabetes drugs does not provide optimal control of blood sugar levels.
371 type 2 diabetes patients with inadequate diabetes control who were not supplemented with insulin were part of a 24-week clinical trial in Bremen, Germany, headed by Dr. Hans U. Janka.

The patients received an antidiabetic combo consisting of sulfonylurea and metformin. These patients were randomly picked, and they received a morning dose of glargine insulin injection along with the antidiabetic medication. Others did not receive the oral medication, but were administered twice-daily injections of NPH insulin. Patients were monitored for the level of glycosylated hemoglobin (= HbA1c), which is the best indicator for diabetes control. The improvements in laboratory tests were more pronounced in the group that received the combination between an oral antidiabetic and glargine injection. In addition 46% reached HbA1c levels of 7% or less, which is excellent long-term blood sugar control, as compared to only 29% of the NPH insulin group. Fasting blood sugar levels also showed improvement. There is a risk of patients becoming hypoglycemic. Again, the risk was significantly lower in those who were on the glargin combination, than those who were on the NPH insulin.

One Shot For Better Blood Sugar Control

One Shot For Better Blood Sugar Control

These results show that one single injection, which is added to the oral medication, can help type 2 diabetes patients, whose condition has been poorly controlled. Glargine insulin has been approved in Canada already in 2002, but due to supply problems it is only now expected to be on the pharmacy shelves soon.

More information on treatment of diabetes with insulin: http://nethealthbook.com/hormones/diabetes/treatment-diabetes-insulin/

Reference: National Review Of Medicine, March 15,2005,page22

Last edited October 28, 2014

Mar
01
2005

Metabolic Syndrome Threatens Mental Functioning

By | Health, Hormones, Mental Health

It used to be called syndrome of hyperinsulinism or syndrome X, but in the meantime the term Metabolic Syndrome stands for a derailment of the metabolism, which manifests itself in excessive weight, type 2 diabetes, high blood pressure and inflammatory processes in the body. The condition, which is largely preventable by healthy lifestyle choices, also paves the way for heart disease, stroke, arthritis and some cancers.
A study from the University of California at San Francisco by Dr. Kristine Yaffe points to yet another health problem that results from the metabolic syndrome and which mars the “golden years” of a large number of seniors: lack of cognitive function, short term memory loss, and forms of dementia.
The study was based on 2632 participants with an average age of 74 years. The likelihood to develop cognitive impairment was 20% higher in those participants of the study who had metabolic syndrome. Things were getting worse, if patients had metabolic syndrome and laboratory tests showed high inflammation with elevated blood levels of interleukin 6 and the C- reactive protein test: the likelihood to develop cognitive impairment rose to 66%.

Metabolic Syndrome Threatens Mental Functioning

Metabolic Syndrome Threatens Mental Functioning

So much for the bad news. The good news, however, is that lifestyle can be a powerful armor in the prevention of disability and disease.

Reference: The Medical Post, January 25,2005, page 45

Last edited October 27, 2014

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Jan
01
2005

Doctor Recommended Diet Against Obesity

By | Diabetes, Health, Heart Disease, Nutrition, Weight loss

After overindulging over the holidays, new years resolutions often have diets and life style choices high on the list.
These concerns are not something new. Doctors have had concerns about heart disease, diabetes, bulging waistlines and elevated cholesterol. For over three decades there have been concerns that elevated insulin levels may be associated with heart disease, and the constellation of symptoms was called “syndrome X” and later the “insulin resistance syndrome”.

Most recently the evils that are associated with body fat have been called the “metabolic syndrome”.The problem has assumed epidemic proportions: by 2001, 30% of US adults were considered obese with a body mass index of over 30, and 50% were overweight with a body mass index over 25. The form of type 2 diabetes (the adult onset of the disease) is predicted to double in the next 20 years. Physicians are reporting that they are seeing increasing numbers of children who are obese and suffer of type 2 diabetes. The major concern with an accumulation of body fat is the area of the abdomen (think of the “apple shape” with fat around the abdomen). This visceral fat tissue is not just innocently sitting there stopping you from closing buttons and zippers. It is very metabolically active and the substances it releases are a threat to your health. These fat cells secret pro-inflammatory substances called “cytokines.”

They also form substances that influence blood-clotting, factors that increase insulin resistance, substances like angiotensin, which are signing responsible for high blood pressure as well. Among the host of damaging substances is also the C-reactive protein, which is recognized as a risk factor for heart disease.

Doctor Recommended Diet Against Obesity

Doctor Recommended Diet Against Obesity

There is only one solution: to reduce the risk, excessive weight has to be shed. A sensible diet to achieve that goal has to contain less saturated fat, more fiber, and low glycemic index carbohydrates. Proper dietary habits are only one part. The other as important measure is life style intervention, which includes 2.5 to 3 hours of moderate exercise per week.
Many of the current diets promise weight loss without compromising health. All of them promote weight loss, provided they are strictly adhered to.
The high protein diets (Atkins, Protein Power Plan) are useful for rapid initial weight loss, however due to the overload of protein long term use is highly questionable. Kidney dysfunction as a consequence is a threat to health and no benefit at all!
Moderate carbohydrate diets, moderate fat, as well as moderate protein will remain the answer for long-term life style changes. It is also of significance that the glycemic index of carbohydrates plays a major role. Food intake, which favors carbohydrates with a low glycemic index, is associated with less heart disease. It has also been documented that insulin levels are more stable. Low glycemic carbohydrates include most vegetables, beans, lentils, as well as fruit like apples, pears and oranges. In contrast, high glycemic carbohydrates result in a fast insulin release, which ultimately leads to insulin resistance. Among these items are potatoes, crackers and other flour products, rice, puffed or flaked breakfast cereals, and tropical fruit (papayas, pineapple, melons).

For short-term dieters, it is an option to embark on any of the current diets without deleterious effects, no matter whether they are high-carb or low-carb. But at this point only the diets with moderate carbohydrates have shown to have some benefits on heart health.
Ultimately the wiser choice is to consume foods with a low to moderate glycemic index, by increasing the intake of vegetable proteins and oils and by choosing increased servings of vegetables and fruit instead of highly processed items. So, when you next walk through your supermarket, remember that most of the good stuff is in the periphery, namely the area where all the fresh, unprocessed or minimally processed foods are found.

More info about Mediterranean diet: http://nethealthbook.com/news/mediterranean-diet-benefits-us-workers/

Reference: Metabolic Syndrome Rounds, Oct. 2004, Vol. 2, Issues 8, St. Michael’s Hospital, University of Toronto/On/Canada

Last edited October 27, 2014