NEW YORK (Reuters) – People with diabetes may be more likely to also develop Parkinson's disease - and this seems particularly true for younger patients, a new study suggests.
The findings, published online by the journal Diabetes Care, add to evidence linking diabetes and Parkinson's. One recent report said that U.S. adults with diabetes had a slightly higher risk of developing Parkinson's over a 15-year period, compared to nondiabetics.
Neither study, however, proves that diabetes itself causes Parkinson's.
Instead, researchers think it's more likely that the two disorders share some common underlying causes.
The new findings are from Denmark, where researchers compared close to 2,000 adults with Parkinson's disease and nearly 10,000 people the same age but without the disease (the "control" group).
Overall, 6.5 percent of the Parkinson's patients had diabetes for at least 2 years before they were diagnosed with the movement disorder. By comparison, just 5 percent of people in the control group had diabetes for at least 2 years.
Overall, the study found, having diabetes was linked to a roughly one-third higher risk of developing Parkinson's. That was after the researchers accounted for participants' age and sex, and any diagnoses of emphysema - which was considered a proxy for heavy smoking. (Studies have found cigarette smokers to be at lower risk of Parkinson's, for reasons that are not clear.)
In particular, diabetes was related to a higher risk of developing Parkinson's before the age of 60 -- which is about the average age at diagnosis.
Exactly what the findings mean is unclear, according to the researchers, who were led by Dr. Eva Schernhammer of Harvard Medical School in Boston.
But they say that for now, the "most plausible" explanation would be that diabetes and Parkinson's have some of the same biological underpinnings.
One possibility is continuous low-level inflammation throughout the body, which is suspected of contributing to a number of chronic diseases by damaging cells. There might also be a common genetic susceptibility.
However, even if people with diabetes have a relatively bigger risk of Parkinson's, that does not mean it is a high risk. For example, the recent U.S. study that tracked patients for 15 years involved nearly 289,000 older adults. The proportion of people who eventually developed Parkinson's disease was 0.8 percent among diabetics and 0.5 percent among nondiabetics - less than 1 percent in either case.
The researchers on that study said that people with diabetes should simply continue to do the things already recommended for their overall health -- eating a well-balanced diet and getting regular exercise.
More studies are needed, they said, to understand why diabetes is related to a higher Parkinson's risk, and what, if anything, can be done about it.
Diabetes arises when the body can no longer properly use the blood-sugar-regulating hormone insulin. Parkinson's occurs when movement-regulating cells in the brain die off or become disabled, leading to symptoms like tremors, rigidity in the joints, slowed movement and balance problems.
Researchers say it's possible that something about diabetes -- like a problem regulating insulin -- might somehow contribute to Parkinson's. But that remains unproven.
SOURCE: http://bit.ly/fWbB3u Diabetes Care, online March 16, 2011.
Showing posts with label controling diabetes. Show all posts
Showing posts with label controling diabetes. Show all posts
Thursday, September 15, 2011
Sunday, April 3, 2011
Easy Steps to Reduce Diabetes Risk
From walking more to getting your blood sugar checked, you can reduce your chances of getting diabetes by following just a few easy steps.
Being overweight, not getting enough physical activity, and constantly being stressed out are all strong risk factors for type 2 diabetes. These are problems that many people face, but the good news is that you can make a few simple changes to your life to create a diabetes prevention program and reduce your diabetes risk.
Think diabetes prevention at the start of every day. “Eat a breakfast of protein and complex carbohydrates,” says Suzanne Steinbaum, DO, a cardiologist and director of Women and Heart Disease at Lenox Hill Hospital in New York City. “Eating a meal like this prevents the sugar highs and lows that often come with a breakfast of simple carbohydrates and sugars, like a bagel or a donut, which can cause those feelings of fatigue and lethargy that make you crave sugar again to increase your energy.”
Fred Pescatore, MD, an author and physician who practices nutritional medicine in New York City, says one of your best overall strategies for diabetes prevention is to steer clear of most foods that are white — white bread, white rice, and white pasta top the list. “These simple carbohydrates can cause blood sugar to spike even more than regular sugar,” he says. “This may lead to a blood sugar dip, resulting in additional sugar cravings. Avoiding white foods will help to stop this vicious cycle.”
One of the biggest causes of diabetes in this country is overeating that leads to obesity. A basic strategy for avoiding overeating is to reduce your portions by using smaller dishes than you usually would for all your meals, according to Dr. Steinbaum. “Rather than worrying about servings, pay attention to cups and tablespoons,” she says. “To help with this, instead of using a large dinner plate, use a salad plate for dinner.”
Most people think it’s okay to drink soda as long as they stick to diet soda instead of the regular sugary kind. But Steinbaum cautions that water might be the better choice for diabetes prevention. “Studies have shown that even diet soda can increase the incidence of metabolic syndrome, a pre-diabetic condition associated with insulin resistance,” she says.
A basic lifestyle strategy to assist with diabetes prevention is to keep a detailed food journal. You can use paper or a Web site or mobile phone application like My Calorie Counter, but whatever you choose, don’t spare any details. “If you write down everything you eat, you are less apt to overeat or to unconsciously pick at food or ‘graze,’” says Steinbaum. “It also lets you look back at what you’ve eaten, so you can more easily modify your behavior.”
Some people get frustrated by constantly monitoring a scale while trying to lose weight. Steven Joyal, MD, author of What Your Doctor May Not Tell You About Diabetes, says that measuring your waistline might be a better way to foster diabetes prevention. “Greater than 40 inches for men or greater than 35 inches for women means you’re at an increased risk,” he says.
Remember that inactivity is a diabetes cause and activity is a key to diabetes prevention. When it comes to exercise, some people use time constraints or other commitments as excuses not to work out. If you think that not doing a long workout means you shouldn’t bother at all, Dr. Joyal respectfully begs to differ. “A power-packed, yet short-duration exercise program of 12 minutes every other day can have a tremendous impact on your body,” he says.
Another simple way to fit more diabetes prevention strategies into your everyday, daily routine is to find ways to add more activity to everything you do. For example, when you pull into a parking lot, Dr. Pescatore suggests parking as far away from your destination as possible and walking the rest of the way. “Walking burns calories, builds muscle, and utilizes blood sugar,” he says. Other steps include taking the stairs instead of the elevator and doing sit-ups, push-ups, or even stretches while watching TV.
Stress is a risk factor for type 2 diabetes. So while focusing on eating less and exercising more, it’s important not to overlook stress reduction. “Take a yoga class, try meditation, and set boundaries around family and friends,” says Robyn Webb, MS, food editor of Diabetes Forecast magazine and author of 13 cookbooks published by the American Diabetes Association. “Seek professional therapy for issues in your life that you feel you need help with.”
Finally, if you have a family history of diabetes or are at risk, you should get your blood checked once a year to truly know your status. Pescatore says the two most important tests your doctor should perform are checking your hemoglobin A1C levels and your fasting insulin levels. If you commit to making all the previous suggestions, your efforts should show in your lab results.
Being overweight, not getting enough physical activity, and constantly being stressed out are all strong risk factors for type 2 diabetes. These are problems that many people face, but the good news is that you can make a few simple changes to your life to create a diabetes prevention program and reduce your diabetes risk.
Think diabetes prevention at the start of every day. “Eat a breakfast of protein and complex carbohydrates,” says Suzanne Steinbaum, DO, a cardiologist and director of Women and Heart Disease at Lenox Hill Hospital in New York City. “Eating a meal like this prevents the sugar highs and lows that often come with a breakfast of simple carbohydrates and sugars, like a bagel or a donut, which can cause those feelings of fatigue and lethargy that make you crave sugar again to increase your energy.”
Fred Pescatore, MD, an author and physician who practices nutritional medicine in New York City, says one of your best overall strategies for diabetes prevention is to steer clear of most foods that are white — white bread, white rice, and white pasta top the list. “These simple carbohydrates can cause blood sugar to spike even more than regular sugar,” he says. “This may lead to a blood sugar dip, resulting in additional sugar cravings. Avoiding white foods will help to stop this vicious cycle.”
One of the biggest causes of diabetes in this country is overeating that leads to obesity. A basic strategy for avoiding overeating is to reduce your portions by using smaller dishes than you usually would for all your meals, according to Dr. Steinbaum. “Rather than worrying about servings, pay attention to cups and tablespoons,” she says. “To help with this, instead of using a large dinner plate, use a salad plate for dinner.”
Most people think it’s okay to drink soda as long as they stick to diet soda instead of the regular sugary kind. But Steinbaum cautions that water might be the better choice for diabetes prevention. “Studies have shown that even diet soda can increase the incidence of metabolic syndrome, a pre-diabetic condition associated with insulin resistance,” she says.
A basic lifestyle strategy to assist with diabetes prevention is to keep a detailed food journal. You can use paper or a Web site or mobile phone application like My Calorie Counter, but whatever you choose, don’t spare any details. “If you write down everything you eat, you are less apt to overeat or to unconsciously pick at food or ‘graze,’” says Steinbaum. “It also lets you look back at what you’ve eaten, so you can more easily modify your behavior.”
Some people get frustrated by constantly monitoring a scale while trying to lose weight. Steven Joyal, MD, author of What Your Doctor May Not Tell You About Diabetes, says that measuring your waistline might be a better way to foster diabetes prevention. “Greater than 40 inches for men or greater than 35 inches for women means you’re at an increased risk,” he says.
Remember that inactivity is a diabetes cause and activity is a key to diabetes prevention. When it comes to exercise, some people use time constraints or other commitments as excuses not to work out. If you think that not doing a long workout means you shouldn’t bother at all, Dr. Joyal respectfully begs to differ. “A power-packed, yet short-duration exercise program of 12 minutes every other day can have a tremendous impact on your body,” he says.
Another simple way to fit more diabetes prevention strategies into your everyday, daily routine is to find ways to add more activity to everything you do. For example, when you pull into a parking lot, Dr. Pescatore suggests parking as far away from your destination as possible and walking the rest of the way. “Walking burns calories, builds muscle, and utilizes blood sugar,” he says. Other steps include taking the stairs instead of the elevator and doing sit-ups, push-ups, or even stretches while watching TV.
Stress is a risk factor for type 2 diabetes. So while focusing on eating less and exercising more, it’s important not to overlook stress reduction. “Take a yoga class, try meditation, and set boundaries around family and friends,” says Robyn Webb, MS, food editor of Diabetes Forecast magazine and author of 13 cookbooks published by the American Diabetes Association. “Seek professional therapy for issues in your life that you feel you need help with.”
Finally, if you have a family history of diabetes or are at risk, you should get your blood checked once a year to truly know your status. Pescatore says the two most important tests your doctor should perform are checking your hemoglobin A1C levels and your fasting insulin levels. If you commit to making all the previous suggestions, your efforts should show in your lab results.
Wednesday, March 16, 2011
Healthy Snacking With Type 2 Diabetes
You might not have to forgo that afternoon snack if you have type 2 diabetes, but you may have to change what you eat.
Having a quick bite to eat in the afternoon or before bed is a habit many people might not think twice about. However, after someone is diagnosed with type 2 diabetes, it seems like every eating habit gets scrutinized, including snacks. Since adjusting lifestyle factors like diet and exercise are among the first steps in managing type 2 diabetes, snacking in a healthy and controlled way can help manage the disease.
Living with Type 2 Diabetes: Should I Snack?
Not everyone with type 2 diabetes should snack regularly. Snacking patterns should be tailored to an individual’s preferences, schedule, and medication. For example, someone taking insulin can use a snack to help prevent a drop in blood sugar between meals. Someone else might have a snack while preparing dinner, to relieve hunger and keep from overeating before dinner is ready. Snacking in general can help spread out food intake over the course of a day, helping to lower blood lipids and glucose for people with type 2 diabetes.
Living with Type 2 Diabetes: Choosing the Right Snack
Choosing the right snack along with the right scheduling is equally important. Here are some tips for selecting that perfect snack:
Choose quality. Lorena Drago, MS, a registered dietitian and diabetes educator with the American Association of Diabetes Educators, has a catchy way to remember the important criteria for a good snack: “I tell my patients to mind their Ps and Qs — P stands for portion and Q for quality.” Keeping snack portion sizes small is important, but so is choosing quality, healthy snacks. For example, three crackers with one slice of cheese is a better-quality snack than a chocolate bar.Get educated. Educate yourself about basic nutrition components like carbohydrates, fat, and protein so that you are comfortable reading nutrition labels. Drago advises choosing snacks with “staying power,” those that will prevent you from eating too much later in the day. Drago recommends snacks with some fat and some protein, to slow food absorption and keep you feeling full longer. Stay away from foods heavy in carbohydrates, like sugary desserts.Plan ahead. Plan snacks in advance to make sure healthy choices are available and to prevent overeating. Living with Type 2 Diabetes: The Dark Side of Snacking
There's more content below this advertisement. Jump to the content.
Snacking can work against you if you take it too far. Thomas Wolever, MD, PhD, professor of nutritional sciences at the University of Toronto, says that research shows that when people with type 2 diabetes eat six meals a day, instead of three, they tend to overeat and, in turn, gain weight, which overcomes any potential benefit of managing blood glucose and lipids.
Since weight control is often a primary concern for people with type 2 diabetes, snacking carefully and strategically is very important. Some diabetics may have a hard time stopping after eating one handful of tasty cashews — a tightly restricted eating schedule might work better for these people.
People with type 2 diabetes should examine their own lifestyle, personality, and medication before deciding whether snacking is a healthy approach for tackling their diabetes. Diabetes educators can help you make these decisions and offer suggestions for how to fit different approaches into your lifestyle. The best snacking pattern for you is a custom plan that will fit comfortably into your lifestyle and help keep your type 2 diabetes under control.
Having a quick bite to eat in the afternoon or before bed is a habit many people might not think twice about. However, after someone is diagnosed with type 2 diabetes, it seems like every eating habit gets scrutinized, including snacks. Since adjusting lifestyle factors like diet and exercise are among the first steps in managing type 2 diabetes, snacking in a healthy and controlled way can help manage the disease.
Living with Type 2 Diabetes: Should I Snack?
Not everyone with type 2 diabetes should snack regularly. Snacking patterns should be tailored to an individual’s preferences, schedule, and medication. For example, someone taking insulin can use a snack to help prevent a drop in blood sugar between meals. Someone else might have a snack while preparing dinner, to relieve hunger and keep from overeating before dinner is ready. Snacking in general can help spread out food intake over the course of a day, helping to lower blood lipids and glucose for people with type 2 diabetes.
Living with Type 2 Diabetes: Choosing the Right Snack
Choosing the right snack along with the right scheduling is equally important. Here are some tips for selecting that perfect snack:
Choose quality. Lorena Drago, MS, a registered dietitian and diabetes educator with the American Association of Diabetes Educators, has a catchy way to remember the important criteria for a good snack: “I tell my patients to mind their Ps and Qs — P stands for portion and Q for quality.” Keeping snack portion sizes small is important, but so is choosing quality, healthy snacks. For example, three crackers with one slice of cheese is a better-quality snack than a chocolate bar.Get educated. Educate yourself about basic nutrition components like carbohydrates, fat, and protein so that you are comfortable reading nutrition labels. Drago advises choosing snacks with “staying power,” those that will prevent you from eating too much later in the day. Drago recommends snacks with some fat and some protein, to slow food absorption and keep you feeling full longer. Stay away from foods heavy in carbohydrates, like sugary desserts.Plan ahead. Plan snacks in advance to make sure healthy choices are available and to prevent overeating. Living with Type 2 Diabetes: The Dark Side of Snacking
There's more content below this advertisement. Jump to the content.
Snacking can work against you if you take it too far. Thomas Wolever, MD, PhD, professor of nutritional sciences at the University of Toronto, says that research shows that when people with type 2 diabetes eat six meals a day, instead of three, they tend to overeat and, in turn, gain weight, which overcomes any potential benefit of managing blood glucose and lipids.
Since weight control is often a primary concern for people with type 2 diabetes, snacking carefully and strategically is very important. Some diabetics may have a hard time stopping after eating one handful of tasty cashews — a tightly restricted eating schedule might work better for these people.
People with type 2 diabetes should examine their own lifestyle, personality, and medication before deciding whether snacking is a healthy approach for tackling their diabetes. Diabetes educators can help you make these decisions and offer suggestions for how to fit different approaches into your lifestyle. The best snacking pattern for you is a custom plan that will fit comfortably into your lifestyle and help keep your type 2 diabetes under control.
Saturday, March 5, 2011
Can Diabetes Be Cured?
Q: I'm 47 years old and was recently diagnosed with diabetes. I'm about 25 pounds overweight and lead a sedentary lifestyle, but I'm starting a diet and an exercise program. Will my diabetes go away if I lose weight, watch my diet, and exercise regularly?
— Mary, Kansas City
A: It is wonderful that you are changing your lifestyle to become healthier! This will benefit you greatly, not only in controlling your blood sugar but also in improving your cholesterol levels, strengthening your bones, and improving your heart function. These changes come with a long list of health benefits, but whether they will allow you to stop taking medicines completely depends on several factors:
The primary cause of your diabetes
The length of time that you had undiscovered, or "hidden," diabetes
The length of time you've had diagnosed diabetes
How well your pancreas is functioning, including how much insulin it is producing, and the extent of insulin resistance associated with excess weight
As you probably know, the cause of diabetes among most adults is twofold. It's caused by insulin resistance resulting from excess weight, and inadequate insulin production in the pancreas. These two causes are also interrelated. Many people whose diabetes is primarily the result of excess weight and insulin resistance can potentially reduce their glucose levels by losing a significant amount of weight and controlling their sugar levels through diet and exercise alone. This assumes that their pancreas is still producing an adequate amount of insulin.
A good number of diabetics, however, have the illness but don't know it for at least five years before diagnosis. This is crucial because over time, the insulin-producing cells in the pancreas decline in function. Often, by the time a patient is diagnosed, a critical number of cells have stopped producing insulin entirely. There is no way to reverse this. If your diabetes is diagnosed early in the disease process, however, aggressive management may help you prevent further loss of function in those cells. This means maintaining your fasting glucose levels below 100mg/dl and your after-meal (two hours after) levels below 140 mg/dl. This is the same for morning and evening glucose levels.
It is also entirely possible for some people to control their blood glucose with diet alone. I have a few patients who have been able to do so. All are producing adequate insulin, have lost weight or are within their ideal body-weight range, and watch their diets.
— Mary, Kansas City
A: It is wonderful that you are changing your lifestyle to become healthier! This will benefit you greatly, not only in controlling your blood sugar but also in improving your cholesterol levels, strengthening your bones, and improving your heart function. These changes come with a long list of health benefits, but whether they will allow you to stop taking medicines completely depends on several factors:
The primary cause of your diabetes
The length of time that you had undiscovered, or "hidden," diabetes
The length of time you've had diagnosed diabetes
How well your pancreas is functioning, including how much insulin it is producing, and the extent of insulin resistance associated with excess weight
As you probably know, the cause of diabetes among most adults is twofold. It's caused by insulin resistance resulting from excess weight, and inadequate insulin production in the pancreas. These two causes are also interrelated. Many people whose diabetes is primarily the result of excess weight and insulin resistance can potentially reduce their glucose levels by losing a significant amount of weight and controlling their sugar levels through diet and exercise alone. This assumes that their pancreas is still producing an adequate amount of insulin.
A good number of diabetics, however, have the illness but don't know it for at least five years before diagnosis. This is crucial because over time, the insulin-producing cells in the pancreas decline in function. Often, by the time a patient is diagnosed, a critical number of cells have stopped producing insulin entirely. There is no way to reverse this. If your diabetes is diagnosed early in the disease process, however, aggressive management may help you prevent further loss of function in those cells. This means maintaining your fasting glucose levels below 100mg/dl and your after-meal (two hours after) levels below 140 mg/dl. This is the same for morning and evening glucose levels.
It is also entirely possible for some people to control their blood glucose with diet alone. I have a few patients who have been able to do so. All are producing adequate insulin, have lost weight or are within their ideal body-weight range, and watch their diets.
Thursday, February 17, 2011
Can Diabetes Affect Your Mood?
Q: My husband has type 2 diabetes, which is now being controlled by medicine. I find that he is sometimes particularly irritable or even mean, which is very out of character for him. Is this common with type 2 diabetes, or with high or low readings?
— Amanda
A:It is great that you are seeking a better understanding of your husband’s illness. Diabetes is a disease that not only affects individuals but also those close to them. As a result, those who have good family support in the care of their diabetes do much better in managing their illness.
There are a few reasons for behavioral changes like those you see in your husband among people with diabetes. One is the effect of abnormally low glucose levels in the bloodstream. The other reason is depression, which can be triggered by the diagnosis of diabetes, the burden of daily management, and fear of complications.
Low glucose levels can cause symptoms including impaired judgment, anxiety, moodiness, belligerence, fatigue, apathy, confusion, dizziness, blurred vision, and a lack of coordination. I would advise your husband to check his sugar levels at the times when he is irritable. If his mood is indeed due to low glucose levels, the symptoms will improve if he raises his blood sugar, for example, by drinking orange juice or taking glucose tablets. It is also important to consult with his doctor to adjust his medicines or dietary intake.
On the other hand, your husband’s irritability can be a manifestation of depression. Many people with depression are undiagnosed and thus do not receive the necessary counseling and treatment. Also, depression symptoms vary from person to person, which can make it difficult to diagnose. Signs such as lack of sleep, overeating or lack of appetite, poor concentration, and other symptoms help in the diagnosis of depression.
In any case, depressed individuals have difficulty with the demands of daily diabetes care. This turns into a cycle of poor glucose control leading to depression, and depression causing further glucose abnormality.
There are other reasons that can cause behavioral changes like those you describe. Your husband’s doctor might shed better light on these possibilities.
— Amanda
A:It is great that you are seeking a better understanding of your husband’s illness. Diabetes is a disease that not only affects individuals but also those close to them. As a result, those who have good family support in the care of their diabetes do much better in managing their illness.
There are a few reasons for behavioral changes like those you see in your husband among people with diabetes. One is the effect of abnormally low glucose levels in the bloodstream. The other reason is depression, which can be triggered by the diagnosis of diabetes, the burden of daily management, and fear of complications.
Low glucose levels can cause symptoms including impaired judgment, anxiety, moodiness, belligerence, fatigue, apathy, confusion, dizziness, blurred vision, and a lack of coordination. I would advise your husband to check his sugar levels at the times when he is irritable. If his mood is indeed due to low glucose levels, the symptoms will improve if he raises his blood sugar, for example, by drinking orange juice or taking glucose tablets. It is also important to consult with his doctor to adjust his medicines or dietary intake.
On the other hand, your husband’s irritability can be a manifestation of depression. Many people with depression are undiagnosed and thus do not receive the necessary counseling and treatment. Also, depression symptoms vary from person to person, which can make it difficult to diagnose. Signs such as lack of sleep, overeating or lack of appetite, poor concentration, and other symptoms help in the diagnosis of depression.
In any case, depressed individuals have difficulty with the demands of daily diabetes care. This turns into a cycle of poor glucose control leading to depression, and depression causing further glucose abnormality.
There are other reasons that can cause behavioral changes like those you describe. Your husband’s doctor might shed better light on these possibilities.
Saturday, February 5, 2011
Motivating a Teen With Type 1 Diabetes
Q: My 16-year-old son is having difficulty staying motivated to consistently take care of his diabetic needs like checking his blood sugar often and keeping a log book. His doctor hospitalized him at the start of school to establish better control — his first hospitalization since diagnosis with type 1 10 years ago. He is active in sports, likes to stay up late, eats only 15 to 30 carbs for breakfast, and is on a regimen of Lantus twice daily and Humalog for meals and highs (injections, no pump.) His last A1c was 10.3. Do you have suggestions for helping him be motivated to care for himself?
— Janelle
A:
That's a tough situation indeed. Many of my colleagues who care for teenaged patients have similar moments of exasperation. As you know so well, the teen years are filled with layers of complexities for kids themselves and their families. There are many issues that become priorities in any teenager's life, among them the challenges presented by their own growth and development. These issues become even more complicated for a teenager with diabetes.
Adolescence is a time of great change, and with physical growth come greater insulin requirements. And with rebellion, experimentation and the need for peer acceptance comes greater non-adherence. In addition, while trying to find and assert their own identity, teens become less reliant on mom and dad. The challenge for parents is equally great and the solutions, unfortunately, are usually time-consuming and labor-intensive.
Your son is doing certain things for which he should be congratulated, including getting involved in sports, carbohydrate counting and injecting his insulin several times a day. These are feats that many of my adult patients do not accomplish. Motivating your son further might require one or more of the following:
1.Understanding his attitude towards frequent glucose checks and his coping and problem-solving skills will help you in identifying specific ways to help him change his behavior.
2.Assessing his knowledge-base about the need to check his sugar levels and his knowledge of glucose and insulin balance during athletic engagements can identify gaps, which can be easily addressed.
3.Understanding his priorities and academic responsibilities and showing empathy to these daily challenges can help you provide a structure that is conducive to checking blood glucose levels and diabetes self-management.
4.Exploring the barriers of checking his sugar level at school, as well as the challenges he might face from his peers about having diabetes, doing frequent glucose checks and injecting insulin, might uncover issues that he finds difficult to discuss. Since you live in a small town, there might not be many other kids living with diabetes. Perhaps your son can connect with other kids with diabetes via the Internet for peer support. A good place to start is the American Diabetes Association.
5.More importantly, understanding your communication pattern with your son and assessing its effectiveness will help you find a happy medium between too much involvement and too little engagement. Empathy is important, but so is leaving him room to make his own decisions. In other words, asking him how he can meet the challenge of good glucose control might also be more effective than telling him to make a specific change in his behavior.
6.When exploring these areas, you should enlist the help of your son's doctor as well as a psychologist or diabetes educator in your area. In addition, if you find that there are barriers at school that prevent your son from checking glucose, you should involve the school and teachers. Some teens like taking leadership roles in teaching others about diabetes, advocating for students with diabetes and organizing groups. This gives them the motivation for also managing their diabetes better. Teachers can be recruited to stage such a forum for your son and perhaps other teens. Other possible venues you might explore include religious organizations, social clubs, and community fitness centers.
Finally, this might be time to consider the insulin pump, which many teens like because it allows them better control. I wish you much luck and hope you will write back with further questions or to tell us how you and your son are doing.
— Janelle
A:
That's a tough situation indeed. Many of my colleagues who care for teenaged patients have similar moments of exasperation. As you know so well, the teen years are filled with layers of complexities for kids themselves and their families. There are many issues that become priorities in any teenager's life, among them the challenges presented by their own growth and development. These issues become even more complicated for a teenager with diabetes.
Adolescence is a time of great change, and with physical growth come greater insulin requirements. And with rebellion, experimentation and the need for peer acceptance comes greater non-adherence. In addition, while trying to find and assert their own identity, teens become less reliant on mom and dad. The challenge for parents is equally great and the solutions, unfortunately, are usually time-consuming and labor-intensive.
Your son is doing certain things for which he should be congratulated, including getting involved in sports, carbohydrate counting and injecting his insulin several times a day. These are feats that many of my adult patients do not accomplish. Motivating your son further might require one or more of the following:
1.Understanding his attitude towards frequent glucose checks and his coping and problem-solving skills will help you in identifying specific ways to help him change his behavior.
2.Assessing his knowledge-base about the need to check his sugar levels and his knowledge of glucose and insulin balance during athletic engagements can identify gaps, which can be easily addressed.
3.Understanding his priorities and academic responsibilities and showing empathy to these daily challenges can help you provide a structure that is conducive to checking blood glucose levels and diabetes self-management.
4.Exploring the barriers of checking his sugar level at school, as well as the challenges he might face from his peers about having diabetes, doing frequent glucose checks and injecting insulin, might uncover issues that he finds difficult to discuss. Since you live in a small town, there might not be many other kids living with diabetes. Perhaps your son can connect with other kids with diabetes via the Internet for peer support. A good place to start is the American Diabetes Association.
5.More importantly, understanding your communication pattern with your son and assessing its effectiveness will help you find a happy medium between too much involvement and too little engagement. Empathy is important, but so is leaving him room to make his own decisions. In other words, asking him how he can meet the challenge of good glucose control might also be more effective than telling him to make a specific change in his behavior.
6.When exploring these areas, you should enlist the help of your son's doctor as well as a psychologist or diabetes educator in your area. In addition, if you find that there are barriers at school that prevent your son from checking glucose, you should involve the school and teachers. Some teens like taking leadership roles in teaching others about diabetes, advocating for students with diabetes and organizing groups. This gives them the motivation for also managing their diabetes better. Teachers can be recruited to stage such a forum for your son and perhaps other teens. Other possible venues you might explore include religious organizations, social clubs, and community fitness centers.
Finally, this might be time to consider the insulin pump, which many teens like because it allows them better control. I wish you much luck and hope you will write back with further questions or to tell us how you and your son are doing.
Saturday, January 22, 2011
Are Sports Drinks Safe for Diabetics?
Q: I am working outside this week as a volunteer for a sports event. The temperature is about 110 degrees. We are constantly given sports drinks to replenish our electrolytes. As a diabetic, is it safe for me to drink these?
— Nancy
A: While it is important to prevent dehydration and replace electrolytes that you might lose through excessive sweating, you must also consider the amount of carbohydrates and calories that you are consuming throughout the day. Below is information on some common sports drinks. You can see the difference in the amount of carbohydrates and calories.
Gatorade: 50 calories, 14 carbohydrates (grams)
Mountain Dew Sport: 95 calories, 24 carbohydrates (grams)
All Sport: 70 calories, 19 carbohydrates (grams)
Rehydrate: 40 calories, 10 carbohydrates (grams)
Performance: 100 calories, 25 carbohydrates (grams)
So for example, if you consume four 8-oz bottles of Gatorade, you have taken in 200 calories and 56 grams of carbohydrates — and those values double if you are drinking 16-oz bottles. The calories and carbohydrates can add up quickly, causing high sugar levels.
The best practice is to look at each brand’s calorie and carbohydrate counts and the number of drinks that you are consuming a day to determine if it is within your daily caloric and carbohydrate requirements. It's also a good idea to supplement sports beverages with plain water.
— Nancy
A: While it is important to prevent dehydration and replace electrolytes that you might lose through excessive sweating, you must also consider the amount of carbohydrates and calories that you are consuming throughout the day. Below is information on some common sports drinks. You can see the difference in the amount of carbohydrates and calories.
Gatorade: 50 calories, 14 carbohydrates (grams)
Mountain Dew Sport: 95 calories, 24 carbohydrates (grams)
All Sport: 70 calories, 19 carbohydrates (grams)
Rehydrate: 40 calories, 10 carbohydrates (grams)
Performance: 100 calories, 25 carbohydrates (grams)
So for example, if you consume four 8-oz bottles of Gatorade, you have taken in 200 calories and 56 grams of carbohydrates — and those values double if you are drinking 16-oz bottles. The calories and carbohydrates can add up quickly, causing high sugar levels.
The best practice is to look at each brand’s calorie and carbohydrate counts and the number of drinks that you are consuming a day to determine if it is within your daily caloric and carbohydrate requirements. It's also a good idea to supplement sports beverages with plain water.
Saturday, December 25, 2010
7 Easy Lunches for Type 2 Diabetes
Sticking to your diabetes diet at lunchtime is easier than you think. Here's a week's worth of ideas to keep your midday meal interesting and healthy.
If breakfast is the most neglected meal of the day, lunch can often be the most hurried. Fast-food restaurants and food courts often prevail over more healthy options because we lead such hectic lives. But they don't have to be your only option — and, in fact, they shouldn't be your first choice if you have type 2 diabetes.
In general, try to pack your own lunch whenever possible — the health benefits can be enormous. Short on prep time? Put these quick and nutritious lunch ideas on your diabetes menu to fill you up and keep your blood sugar in check.
1. Salads
Salad should be a part of your lunch menu if you have diabetes. You can create a different salad every day of the week by varying your toppings. Try grilled chicken, shrimp, or fish, but avoid heaping on a lot of fattening ingredients, such as bacon bits and heavy cheeses.
Salads with lots of raw vegetables are best, including carrots, cucumbers, radishes, celery, and spinach. Sprinkle nuts or seeds on top, add a few dried cranberries, and garnish with some avocado chunks to give it zip. Always choose low-fat or fat-free salad dressings or, for a change, flavored vinegars.
2. Sandwiches
There's more content below this advertisement. Jump to the content.
As with salads, there are many ways to spice up a sandwich. Start with whole-grain bread or a whole-wheat tortilla. Add lean meat, such as turkey, ham, or grilled chicken; layer on your choice of veggies; add mustard, low-fat mayo, or hummus to the mix — and you have a filling and tasty lunch. Stay away from greasy chips, French fries, and other fattening sides. Instead choose fruit, a few pretzels, or carrot and celery sticks to complement your meal.
3. Hearty Soups
Soup can be a good option for lunch, with many healthy choices to consider. Chicken noodle, chicken and rice, and tomato (made without cream) are all good soup choices. Others include butternut squash, gazpacho and other chunky vegetable varieties, miso, and pasta and bean soups. Avoid cream-based soups and chowders. Remember, soup freezes well. You can make a large batch and freeze it in individual containers; with a microwave you have a nearly instant lunch.
4. Pasta
As long as you choose whole-grain pasta, you can eat all types of noodles, such as penne, angel hair, or spaghetti. Top it with a healthy tomato sauce, then add chicken, shrimp, or turkey meatballs and a variety of vegetables. Add a crisp salad and you have a healthy and filling lunch.
5. Pizza
Pizza can be a good choice &mash; in moderation. Choose a thin-crust variety, ask for light cheese, and include vegetables as the topping instead of fatty meats like pepperoni.
6. Tuna, Chicken, and Shrimp Salads
When you make these protein-based mixes, you can control the mayonnaise and the good-health factor. Choose low-fat mayonnaise, and not too much of it. Add fiber and bulk with chopped celery, diced bell pepper, and chopped onions to taste. Serve on whole-grain bread or scoop onto a bed of lettuce.
7. Veggie Stir-Fry
For a more exotic lunch, go for a bowl of vegetable stir-fry and brown rice. Avoid the fast-food version, which can be high in fat and sodium, and make it yourself by sautéing the vegetables with a healthy cooking spray and soy sauce. Prepare it the night before for dinner, making enough to bring leftovers for lunch.
More Healthy Lunch Tips for Type 2 Diabetes
To better control type 2 diabetes, keep these tips in mind:
Choose low-fat or fat-free salad dressings and watch how much you use.
Pick whole-grain bread over white bread.
Practice portion control.Follow the diabetes food pyramid: Eat more grains, beans, and starchy vegetables and less fats, sweets, and alcohol. In between and equally divided are protein choices, non-starchy vegetables, fruit, and milk and dairy products.
Choose lean protein sources, such as turkey, ham, chicken, lean roast beef, and fish.
Avoid fried foods.
Stay away from fatty chips and mayonnaise-based salads, like potato salad. Complement your meal with sliced carrots and celery or fruit salad.
If you are craving a sweet after lunch and fresh fruit just won't do, reach for sugar-free, fat-free frozen yogurt. Be careful of sorbets and sherbets that are loaded with sugar.
Avoid sugary beverages; drink water and tea instead.
Consult with a certified diabetes educator or registered dietitian to get more lunch ideas. How much and what types of food you should eat varies, depending on your specific needs — a dietitian can help create a meal plan that is right for you.
If breakfast is the most neglected meal of the day, lunch can often be the most hurried. Fast-food restaurants and food courts often prevail over more healthy options because we lead such hectic lives. But they don't have to be your only option — and, in fact, they shouldn't be your first choice if you have type 2 diabetes.
In general, try to pack your own lunch whenever possible — the health benefits can be enormous. Short on prep time? Put these quick and nutritious lunch ideas on your diabetes menu to fill you up and keep your blood sugar in check.
1. Salads
Salad should be a part of your lunch menu if you have diabetes. You can create a different salad every day of the week by varying your toppings. Try grilled chicken, shrimp, or fish, but avoid heaping on a lot of fattening ingredients, such as bacon bits and heavy cheeses.
Salads with lots of raw vegetables are best, including carrots, cucumbers, radishes, celery, and spinach. Sprinkle nuts or seeds on top, add a few dried cranberries, and garnish with some avocado chunks to give it zip. Always choose low-fat or fat-free salad dressings or, for a change, flavored vinegars.
2. Sandwiches
There's more content below this advertisement. Jump to the content.
As with salads, there are many ways to spice up a sandwich. Start with whole-grain bread or a whole-wheat tortilla. Add lean meat, such as turkey, ham, or grilled chicken; layer on your choice of veggies; add mustard, low-fat mayo, or hummus to the mix — and you have a filling and tasty lunch. Stay away from greasy chips, French fries, and other fattening sides. Instead choose fruit, a few pretzels, or carrot and celery sticks to complement your meal.
3. Hearty Soups
Soup can be a good option for lunch, with many healthy choices to consider. Chicken noodle, chicken and rice, and tomato (made without cream) are all good soup choices. Others include butternut squash, gazpacho and other chunky vegetable varieties, miso, and pasta and bean soups. Avoid cream-based soups and chowders. Remember, soup freezes well. You can make a large batch and freeze it in individual containers; with a microwave you have a nearly instant lunch.
4. Pasta
As long as you choose whole-grain pasta, you can eat all types of noodles, such as penne, angel hair, or spaghetti. Top it with a healthy tomato sauce, then add chicken, shrimp, or turkey meatballs and a variety of vegetables. Add a crisp salad and you have a healthy and filling lunch.
5. Pizza
Pizza can be a good choice &mash; in moderation. Choose a thin-crust variety, ask for light cheese, and include vegetables as the topping instead of fatty meats like pepperoni.
6. Tuna, Chicken, and Shrimp Salads
When you make these protein-based mixes, you can control the mayonnaise and the good-health factor. Choose low-fat mayonnaise, and not too much of it. Add fiber and bulk with chopped celery, diced bell pepper, and chopped onions to taste. Serve on whole-grain bread or scoop onto a bed of lettuce.
7. Veggie Stir-Fry
For a more exotic lunch, go for a bowl of vegetable stir-fry and brown rice. Avoid the fast-food version, which can be high in fat and sodium, and make it yourself by sautéing the vegetables with a healthy cooking spray and soy sauce. Prepare it the night before for dinner, making enough to bring leftovers for lunch.
More Healthy Lunch Tips for Type 2 Diabetes
To better control type 2 diabetes, keep these tips in mind:
Choose low-fat or fat-free salad dressings and watch how much you use.
Pick whole-grain bread over white bread.
Practice portion control.Follow the diabetes food pyramid: Eat more grains, beans, and starchy vegetables and less fats, sweets, and alcohol. In between and equally divided are protein choices, non-starchy vegetables, fruit, and milk and dairy products.
Choose lean protein sources, such as turkey, ham, chicken, lean roast beef, and fish.
Avoid fried foods.
Stay away from fatty chips and mayonnaise-based salads, like potato salad. Complement your meal with sliced carrots and celery or fruit salad.
If you are craving a sweet after lunch and fresh fruit just won't do, reach for sugar-free, fat-free frozen yogurt. Be careful of sorbets and sherbets that are loaded with sugar.
Avoid sugary beverages; drink water and tea instead.
Consult with a certified diabetes educator or registered dietitian to get more lunch ideas. How much and what types of food you should eat varies, depending on your specific needs — a dietitian can help create a meal plan that is right for you.
Friday, December 24, 2010
When to Test Children for Diabetes
Q: My husband is a type 1 diabetic, and we didn't know that until he went for a physical and the doctor said his body was in "ketosis" (shutting itself down). We didn't expect that since he looked healthy, and we didn't recognize any symptoms except frequent urination. At what age should we have our three children (ages 13, 15, and 16) checked? Are there more obvious signs in children? Do you recommend any particular diet as a starting point for better eating? Sorry for the many questions, I am just trying to keep my info straight. Thank you very much in advance for your time in answering this. Have a great day.
— Christina, Kansas
A:
These are all great questions. Discovering that you or a loved one has type 1 diabetes can be overwhelming — and troubling to parents who worry that their children are at risk of developing the disease. How wonderful that you are thinking about trying to prevent that from happening!
There isn't a definitive answer to your question regarding early screening. First of all, even though your husband has type 1 diabetes, it does not mean that your children will invariably develop the disease. In fact, very few children of diabetic parents do. The bad news is that we do not have a way to determine who will and who won't. Second, even when we know the specific inherited tendencies for diabetes, there are many factors in the environment that are yet undiscovered triggers. If we knew these factors, we might then be able to work on reducing their influence. Third, we do not know the rate at which a person who carries the genetic risk actually develops diabetes. They may develop the disease early or it may take many years for diabetes to establish a foothold. Fourth, we do not have an effective treatment or preventive measure to stave off type 1 diabetes among those who are at greatest risk of developing it.
In light of all these factors, the best way to move forward is to do the following:
Make sure your children get regular checkups and talk to your pediatrician about new developments in early diagnosis and prevention efforts. There are ongoing studies, the results of which will teach us more about how to proceed. There might also be research projects that your children might participate in that may give them access to genetic and immunology tests not available to the general public. These tests can give you a better idea of your children's specific odds of developing diabetes.Have your children undergo blood glucose tests starting now, biannually or annually, to prevent severe symptoms such as ketosis from being the stimulus for a diagnosis.
Watch out for the following signs and symptoms: excessive thirst, frequent urination, weight loss, fatigue, or blurred vision; and much less common signs of ketosis, including nausea and vomiting, abdominal pain, lethargy, and decreased alertness and rapid breathing. These are the same signs and symptoms as in adults.While there are no specific dietary supplements or diet recommendations, a healthy lifestyle and maintaining a healthy weight will help in general. Specific recommendations depend on your children's caloric needs, activity level, and preferences. I frequently tell my patients that their first loyalty is to nutrition — making sure they have adequate nutrients (i.e., vitamins, minerals, and protein intake) necessary for survival. In the children's case, it is important to take their growth and developmental needs into account. You might consult a dietitian for specific suggestions.
Finally, coping with a diabetic parent can be a frightening experience for children. I would advise that you and your husband normalize the daily routines of his care, which include home blood glucose testing, doctor's visits, diet and exercise regimens, insulin injections, and discussing the symptoms of high and low sugar levels. This way, you can avoid crises and show your children that diabetes is a condition that can be managed as long as you take care of yourself. This knowledge will help them a great deal in the event that they are someday diagnosed with diabetes, however small the odds may be. Best wishes to you and your husband and children. I hope all goes well.
— Christina, Kansas
A:
These are all great questions. Discovering that you or a loved one has type 1 diabetes can be overwhelming — and troubling to parents who worry that their children are at risk of developing the disease. How wonderful that you are thinking about trying to prevent that from happening!
There isn't a definitive answer to your question regarding early screening. First of all, even though your husband has type 1 diabetes, it does not mean that your children will invariably develop the disease. In fact, very few children of diabetic parents do. The bad news is that we do not have a way to determine who will and who won't. Second, even when we know the specific inherited tendencies for diabetes, there are many factors in the environment that are yet undiscovered triggers. If we knew these factors, we might then be able to work on reducing their influence. Third, we do not know the rate at which a person who carries the genetic risk actually develops diabetes. They may develop the disease early or it may take many years for diabetes to establish a foothold. Fourth, we do not have an effective treatment or preventive measure to stave off type 1 diabetes among those who are at greatest risk of developing it.
In light of all these factors, the best way to move forward is to do the following:
Make sure your children get regular checkups and talk to your pediatrician about new developments in early diagnosis and prevention efforts. There are ongoing studies, the results of which will teach us more about how to proceed. There might also be research projects that your children might participate in that may give them access to genetic and immunology tests not available to the general public. These tests can give you a better idea of your children's specific odds of developing diabetes.Have your children undergo blood glucose tests starting now, biannually or annually, to prevent severe symptoms such as ketosis from being the stimulus for a diagnosis.
Watch out for the following signs and symptoms: excessive thirst, frequent urination, weight loss, fatigue, or blurred vision; and much less common signs of ketosis, including nausea and vomiting, abdominal pain, lethargy, and decreased alertness and rapid breathing. These are the same signs and symptoms as in adults.While there are no specific dietary supplements or diet recommendations, a healthy lifestyle and maintaining a healthy weight will help in general. Specific recommendations depend on your children's caloric needs, activity level, and preferences. I frequently tell my patients that their first loyalty is to nutrition — making sure they have adequate nutrients (i.e., vitamins, minerals, and protein intake) necessary for survival. In the children's case, it is important to take their growth and developmental needs into account. You might consult a dietitian for specific suggestions.
Finally, coping with a diabetic parent can be a frightening experience for children. I would advise that you and your husband normalize the daily routines of his care, which include home blood glucose testing, doctor's visits, diet and exercise regimens, insulin injections, and discussing the symptoms of high and low sugar levels. This way, you can avoid crises and show your children that diabetes is a condition that can be managed as long as you take care of yourself. This knowledge will help them a great deal in the event that they are someday diagnosed with diabetes, however small the odds may be. Best wishes to you and your husband and children. I hope all goes well.
Tuesday, December 14, 2010
Diabetes is the 6th leading cause of death in the United States
LANGLEY AIR FORCE BASE, Va. - Diabetes is the sixth leading cause of death in the United States, claiming more than 180,000 victims annually. Part of the debilitation of diabetes is the effect the disease has on feet, resulting in painful sores, immobility and potential amputation. However, with attention and preventative measures, some effects may possibly be avoided.
According to Maj. Hjalmar Contreras, 633d Medical Group podiatrist, diabetic foot infections are the most common reason for hospital admissions among diabetic patients, accounting for 25 percent of all diabetic admissions.
“Without proper care, diabetic patients may develop ulcers on their feet, which occur in 15 percent of diabetic patients,” said Contreras.
Diabetes affects the feet in two ways: contributing to vascular disease and damaging nerves. Vascular disease impairs circulation, creating an oxygen deficiency in tissues. This deficiency could result in poor healing, infections and even gangrene. Symptoms of vascular disease include changes in the skin of the feet, such as lack of hair or thinning of skin, absent peripheral pulses and arterial Doppler abnormalities.
“Diabetes and smoking pose the greatest risk of peripheral vascular disease,” said Contreras, noting that PVD is 30 times more prevalent in diabetic patients.
Diabetes also damages the three nerve systems -- autonomic, sensory and motor -- resulting in a loss of feeling in the feet. This condition is known as diabetic neuropathy. Symptoms of neuropathy include a loss of protective sensation, dry flaky skin and foot deformities.
Most of the aforementioned conditions can be avoided or limited by prevention, said Contreras. To help prevent complications from diabetes, follow these 10 guidelines:
1. Inspect your feet daily. Check for cuts, scrapes, bruises or blisters.
2. Never soak your feet. There’s little way of knowing what may be in the water, and contaminants may irritate or cause infections. Wash your feet in lukewarm water, and carefully dry between toes.
3. Moisturize your feet. Use lotions and creams. Do not use petroleum jelly, and do not apply any topical solution between toes.
4. Cut toenails straight across, leaving the front edge. Don’t pull or rip off nail edges.
5. Never use chemical corn removers on your feet. These may cause blisters, burning holes in the skin. Never cut calluses with razors -- use a pumice stone instead.
6. Change your socks daily. Keep socks clean and dry, and avoid tight socks and stockings.
7. Never walk barefoot. Check the insides of your shoes daily.
8. Avoid smoking.
9. Wear shoes that fit. Tip: leather shoes easily adapt to feet and may provide more comfort.
10. Get annual check-ups.
“Controlling your glucose levels decreases chances of foot problems by 50 percent,” added Contreras.”While developing complications from diabetes may not be completely avoidable, practicing sound prevention measures will greatly diminish the chances of problems occurring.”
According to Maj. Hjalmar Contreras, 633d Medical Group podiatrist, diabetic foot infections are the most common reason for hospital admissions among diabetic patients, accounting for 25 percent of all diabetic admissions.
“Without proper care, diabetic patients may develop ulcers on their feet, which occur in 15 percent of diabetic patients,” said Contreras.
Diabetes affects the feet in two ways: contributing to vascular disease and damaging nerves. Vascular disease impairs circulation, creating an oxygen deficiency in tissues. This deficiency could result in poor healing, infections and even gangrene. Symptoms of vascular disease include changes in the skin of the feet, such as lack of hair or thinning of skin, absent peripheral pulses and arterial Doppler abnormalities.
“Diabetes and smoking pose the greatest risk of peripheral vascular disease,” said Contreras, noting that PVD is 30 times more prevalent in diabetic patients.
Diabetes also damages the three nerve systems -- autonomic, sensory and motor -- resulting in a loss of feeling in the feet. This condition is known as diabetic neuropathy. Symptoms of neuropathy include a loss of protective sensation, dry flaky skin and foot deformities.
Most of the aforementioned conditions can be avoided or limited by prevention, said Contreras. To help prevent complications from diabetes, follow these 10 guidelines:
1. Inspect your feet daily. Check for cuts, scrapes, bruises or blisters.
2. Never soak your feet. There’s little way of knowing what may be in the water, and contaminants may irritate or cause infections. Wash your feet in lukewarm water, and carefully dry between toes.
3. Moisturize your feet. Use lotions and creams. Do not use petroleum jelly, and do not apply any topical solution between toes.
4. Cut toenails straight across, leaving the front edge. Don’t pull or rip off nail edges.
5. Never use chemical corn removers on your feet. These may cause blisters, burning holes in the skin. Never cut calluses with razors -- use a pumice stone instead.
6. Change your socks daily. Keep socks clean and dry, and avoid tight socks and stockings.
7. Never walk barefoot. Check the insides of your shoes daily.
8. Avoid smoking.
9. Wear shoes that fit. Tip: leather shoes easily adapt to feet and may provide more comfort.
10. Get annual check-ups.
“Controlling your glucose levels decreases chances of foot problems by 50 percent,” added Contreras.”While developing complications from diabetes may not be completely avoidable, practicing sound prevention measures will greatly diminish the chances of problems occurring.”
Tuesday, December 7, 2010
Fearful of Complications
Q: I've had type 1 diabetes since I was a kid (I'm now 42). It's well controlled, but lately I'm starting to be really anxious about complications. What can I do to save myself from all the scary things that can happen to me as I get older?
– Brooke
A: Let me start by congratulating you on controlling your blood sugar — it is extremely important to your health. The discipline with which you've controlled your type 1 diabetes thus far, and close collaboration with your doctor, will surely help reduce your risk of worrisome complications.
Over the last several years, a number of studies have shown us that diabetes-related complications are the consequence of both poor glucose control and conditions such as high blood pressure and high cholesterol. The latter are associated with advancing age, genetic risk, and an unhealthy lifestyle. As long as you continue to control your blood sugar, with close follow-up from your doctor, then concentrating on lifestyle factors is the best way to improve your odds of avoiding complications.
As you grow older, regular exercise and ideal body weight maintenance become increasingly important components of diabetes care, blood pressure control, and lipid (cholesterol) management. Having a sustained normal or near-normal glucose level, blood pressure below 120/80, and a low cholesterol level (low-density lipoprotein level below 100 mg/dl) will stave off bad outcomes.
Besides home glucose monitoring, keep track of your glycosylated hemoglobin (hemoglobin A1c) level. Levels below 7 percent are associated with reduced complications — I prefer maintaining this level closer to 6 percent. Other risk factors you can change through exercise and a healthful diet include a high triglyceride level and a reduced level of high-density lipoprotein (HDL-C). A triglyceride level below 150 mg/dl and an HDL-C level above 40 mg/dl are associated with better health outcomes.
As an adult over age 40, you might be able to take daily aspirin, which considerably reduces cardiovascular risk. Do seek the advice of your doctor on this and other specific treatment and monitoring recommendations. Most important, if you use tobacco, stop. Quitting smoking is the single most critical step you will ever take toward preventing many of the diabetes-related complications.
– Brooke
A: Let me start by congratulating you on controlling your blood sugar — it is extremely important to your health. The discipline with which you've controlled your type 1 diabetes thus far, and close collaboration with your doctor, will surely help reduce your risk of worrisome complications.
Over the last several years, a number of studies have shown us that diabetes-related complications are the consequence of both poor glucose control and conditions such as high blood pressure and high cholesterol. The latter are associated with advancing age, genetic risk, and an unhealthy lifestyle. As long as you continue to control your blood sugar, with close follow-up from your doctor, then concentrating on lifestyle factors is the best way to improve your odds of avoiding complications.
As you grow older, regular exercise and ideal body weight maintenance become increasingly important components of diabetes care, blood pressure control, and lipid (cholesterol) management. Having a sustained normal or near-normal glucose level, blood pressure below 120/80, and a low cholesterol level (low-density lipoprotein level below 100 mg/dl) will stave off bad outcomes.
Besides home glucose monitoring, keep track of your glycosylated hemoglobin (hemoglobin A1c) level. Levels below 7 percent are associated with reduced complications — I prefer maintaining this level closer to 6 percent. Other risk factors you can change through exercise and a healthful diet include a high triglyceride level and a reduced level of high-density lipoprotein (HDL-C). A triglyceride level below 150 mg/dl and an HDL-C level above 40 mg/dl are associated with better health outcomes.
As an adult over age 40, you might be able to take daily aspirin, which considerably reduces cardiovascular risk. Do seek the advice of your doctor on this and other specific treatment and monitoring recommendations. Most important, if you use tobacco, stop. Quitting smoking is the single most critical step you will ever take toward preventing many of the diabetes-related complications.
Subscribe to:
Posts (Atom)
