Q: What’s the best meal schedule for a diabetic? When should snacks be included?
A: I recommend eating a meal or snack every four to five hours. This allows enough time for your blood sugar to come back down to a healthy baseline after eating, but it’s frequent enough to help you manage your appetite and keep hunger pangs at bay, which is especially important if you’re trimming calories to lose a few pounds. In general, you can meet this guideline by eating breakfast, lunch, a mid-afternoon snack, and dinner, evenly spaced throughout your day. At all meals and snacks, combine a small to moderate amount of high-quality carbohydrates (vegetables, fruit, whole grains, beans/lentils) with a good dose of lean protein from foods like skinless turkey or chicken, egg whites, seafood, low-fat dairy, or beans/lentils (beans and lentils count as both a carb and a protein). The protein helps slow your body’s absorption of carbs and prevent spikes in your blood sugar. Here’s an example of an A+ day of eating designed for optimal blood-sugar control.
Breakfast:
Egg-white omelet with vegetables (spinach, mushrooms, peppers and/or onions)
One orange
Coffee with skim milk
Lunch:
2 cups hearty, low-sodium soup (lentil, black bean or minestrone) topped with ¼ cup shredded
reduced-fat cheese
Crunchy red-pepper sticks
Water
Snack:
Nonfat yogurt
1 apple
Dinner:
Homemade shrimp-and-broccoli stir-fry
¾ cup cooked brown rice
Zero-calorie seltzer
After Dinner:
Handful of almonds or pistachio nuts
Cup of decaf or herbal tea
Thursday, December 22, 2011
Wednesday, December 21, 2011
Stop the Progress of Prediabetes
You can prevent this precursor to type 2 diabetes from developing into full-blown disease.
Nearly 24 million American adults are living with diabetes, according to figures released last month by the International Diabetes Federation. But what may be even more alarming is that there are also about 79 million Americans with a condition known as prediabetes — and many aren't aware of it.
Prediabetes means that while your blood sugar levels are higher than normal, that level isn’t high enough to warrant a diabetes diagnosis. However, a prediabetes diagnosis means it is time for action to prevent diabetes.
"In simple terms, there is a gap between what we call diabetes, which is a fasting blood sugar of 126 and above, and normal, which is less than 100 fasting," explains Vivian Fonseca, MD, a professor of medicine and pharmacology and chief of endocrinology at Tulane University Health Sciences Center in New Orleans. "In between, you have impaired fasting glucose. If you do a glucose tolerance test, and you are in the gap, you have prediabetes. You are at risk for getting diabetes in the future and you are also at risk for heart disease."
Research has also found that prediabetes may be more common in men than in women.
Type 2 Diabetes: Prevention
If you are told your blood sugar is abnormally high, you’ve just had a red flag waved in front of you. You’re being warned that unless you make some changes in your life today, your future will probably include a diabetes diagnosis.
"Walking 30 minutes a day and reducing weight by 5 percent can decrease the risk [of getting type 2 diabetes] by 60 percent over three years," says Dr. Fonseca. While there are medications that have the same effect, lifestyle change is less expensive and has fewer side effects, Fonseca says.
Cutting your weight is crucial. "One of the links with obesity is that fat induces a mild low-grade inflammation throughout the body that contributes to heart disease and diabetes," Fonseca explains. Without making any changes, you could develop type 2 diabetes within 10 years of first developing prediabetes.
Type 2 Diabetes: Who Should be Tested?
Prediabetes is a "silent" condition, says Fonseca. While some people may experience symptoms of diabetes such as fatigue or increased urination, most people’s blood sugar rises without any outward signs at all. This means you might not know you need to be tested for prediabetes — and even if you are screened, your doctor might not give you all the information you need to prevent it.
For these reasons, diabetes experts developed criteria for those who should be tested. The American Diabetic Association recommends that any adult age 45 or older should be tested for diabetes and prediabetes.
The ADA also recommends that any adult under age 45 who is overweight and has at least one of the following risk factors should be tested:
Family history (especially parent or sibling with diabetes) Physically inactive lifestyle Native American, African-American, or Hispanic heritage Prior gestational diabetes diagnosis Birth of a baby over nine pounds in weight High blood pressure or treatment for high blood pressure Polycystic ovarian syndrome (PCOS) diagnosis Dark, velvety rash around the armpits or neck History of heart disease If your test reveals that you have prediabetes, you should be tested again in one to two years, depending on your doctor’s recommendations.
Type 2 Diabetes: Types of Tests
There are two tests used to screen for diabetes and prediabetes:
Fasting plasma glucose: a test of your blood after you haven’t eaten for eight hours (usually overnight) Oral glucose tolerance test: a comparison of your blood taken first after eight hours without food (fasting) and then two hours later after you have consumed a sugary drink given to you by the lab technician. If you fit the screening criteria listed above, make an appointment to get tested as soon as possible. It could be the first step toward preventing the development of type 2 diabetes.
Nearly 24 million American adults are living with diabetes, according to figures released last month by the International Diabetes Federation. But what may be even more alarming is that there are also about 79 million Americans with a condition known as prediabetes — and many aren't aware of it.
Prediabetes means that while your blood sugar levels are higher than normal, that level isn’t high enough to warrant a diabetes diagnosis. However, a prediabetes diagnosis means it is time for action to prevent diabetes.
"In simple terms, there is a gap between what we call diabetes, which is a fasting blood sugar of 126 and above, and normal, which is less than 100 fasting," explains Vivian Fonseca, MD, a professor of medicine and pharmacology and chief of endocrinology at Tulane University Health Sciences Center in New Orleans. "In between, you have impaired fasting glucose. If you do a glucose tolerance test, and you are in the gap, you have prediabetes. You are at risk for getting diabetes in the future and you are also at risk for heart disease."
Research has also found that prediabetes may be more common in men than in women.
Type 2 Diabetes: Prevention
If you are told your blood sugar is abnormally high, you’ve just had a red flag waved in front of you. You’re being warned that unless you make some changes in your life today, your future will probably include a diabetes diagnosis.
"Walking 30 minutes a day and reducing weight by 5 percent can decrease the risk [of getting type 2 diabetes] by 60 percent over three years," says Dr. Fonseca. While there are medications that have the same effect, lifestyle change is less expensive and has fewer side effects, Fonseca says.
Cutting your weight is crucial. "One of the links with obesity is that fat induces a mild low-grade inflammation throughout the body that contributes to heart disease and diabetes," Fonseca explains. Without making any changes, you could develop type 2 diabetes within 10 years of first developing prediabetes.
Type 2 Diabetes: Who Should be Tested?
Prediabetes is a "silent" condition, says Fonseca. While some people may experience symptoms of diabetes such as fatigue or increased urination, most people’s blood sugar rises without any outward signs at all. This means you might not know you need to be tested for prediabetes — and even if you are screened, your doctor might not give you all the information you need to prevent it.
For these reasons, diabetes experts developed criteria for those who should be tested. The American Diabetic Association recommends that any adult age 45 or older should be tested for diabetes and prediabetes.
The ADA also recommends that any adult under age 45 who is overweight and has at least one of the following risk factors should be tested:
Family history (especially parent or sibling with diabetes) Physically inactive lifestyle Native American, African-American, or Hispanic heritage Prior gestational diabetes diagnosis Birth of a baby over nine pounds in weight High blood pressure or treatment for high blood pressure Polycystic ovarian syndrome (PCOS) diagnosis Dark, velvety rash around the armpits or neck History of heart disease If your test reveals that you have prediabetes, you should be tested again in one to two years, depending on your doctor’s recommendations.
Type 2 Diabetes: Types of Tests
There are two tests used to screen for diabetes and prediabetes:
Fasting plasma glucose: a test of your blood after you haven’t eaten for eight hours (usually overnight) Oral glucose tolerance test: a comparison of your blood taken first after eight hours without food (fasting) and then two hours later after you have consumed a sugary drink given to you by the lab technician. If you fit the screening criteria listed above, make an appointment to get tested as soon as possible. It could be the first step toward preventing the development of type 2 diabetes.
Monday, December 19, 2011
Why Are My Feet Hurting When I Walk?
Q: My feet have started to hurt a lot — so much that when I wake up in the morning I cannot walk barefoot for at least the first 20 minutes. I can't be on my feet too much anymore without pain. What might be causing this, and what can I do to get some relief?
A: What you are describing sounds like a painful condition known as plantar fasciitis. This is a situation where there is inflammation of the soft tissue along the sole of your foot, all the way from your heel to your toes. It may be caused by high-impact exercise, structural problems such as being flat-footed, arthritis, or ill-fitting shoes. It is also more common in people with diabetes. The most characteristic symptom of plantar fasciitis is severe shooting or burning pain in the feet in the morning. The pain typically improves after some movement, only to recur after periods of prolonged rest or intense activity.
Preventive measures include always wearing shoes that fit well, stretching in the morning, afternoon and evening and before any exercise, limiting high-impact exercises, and maintaining ideal body weight, as obesity does predispose to plantar fasciitis. The key is to exercise carefully rather than eliminating exercise altogether. Treatment includes surgical and nonsurgical approaches, though surgery is a last resort and is rarely necessary. Night plints, orthotics, and physical therapy may hasten your recovery, but if the condition is left untreated, it will not resolve itself. In severe cases, injections with steroids or treatment with ultrasound may be warranted.
A: What you are describing sounds like a painful condition known as plantar fasciitis. This is a situation where there is inflammation of the soft tissue along the sole of your foot, all the way from your heel to your toes. It may be caused by high-impact exercise, structural problems such as being flat-footed, arthritis, or ill-fitting shoes. It is also more common in people with diabetes. The most characteristic symptom of plantar fasciitis is severe shooting or burning pain in the feet in the morning. The pain typically improves after some movement, only to recur after periods of prolonged rest or intense activity.
Preventive measures include always wearing shoes that fit well, stretching in the morning, afternoon and evening and before any exercise, limiting high-impact exercises, and maintaining ideal body weight, as obesity does predispose to plantar fasciitis. The key is to exercise carefully rather than eliminating exercise altogether. Treatment includes surgical and nonsurgical approaches, though surgery is a last resort and is rarely necessary. Night plints, orthotics, and physical therapy may hasten your recovery, but if the condition is left untreated, it will not resolve itself. In severe cases, injections with steroids or treatment with ultrasound may be warranted.
Sunday, December 18, 2011
Foot Anatomy: Your Amazing Feet
Despite delicate foot anatomy, your feet are able to take a pounding every day. Help them go the distance by identifying and correcting common foot problems, from corns and calluses to Athlete's foot and hammertoes.
The human foot has 42 muscles, 26 bones, 33 joints, and at least 50 ligaments and tendons made of strong fibrous tissues to keep all the moving parts together … plus 250,000 sweat glands. The foot is an evolutionary marvel, capable of handling hundreds of tons of force — your weight in motion — every day. The foot’s myriad parts, including the toes, heel, and ball, work in harmony to get you from one place to another. But the stress of carrying you around puts your feet at high risk of injury, more so than other parts of your body.
Many foot problems, including hammertoes, blisters, bunions, corns and calluses, heel spurs, claw and mallet toes, ingrown toenails, toenail fungus, and athlete’s foot, can develop due to neglect, ill-fitting shoes, and simple wear and tear. Your feet also can indicate if your body is under threat from a serious disease. Gout, for instance, will attack the foot joints first.
Foot Problems: Athlete's Foot
Caused by a fungus that likes warm, dark, and moist environments like the areas between the toes or on the bottoms of the feet, athlete’s foot can inflame the skin and cause a white, scaly rash with a red base. The athlete’s foot fungus also causes itching, burning, peeling, and sometimes a slight odor; the infection can also migrate to other body parts. You can avoid athlete’s foot (also called tinea pedis) by keeping your feet and toes clean and dry and by changing your shoes and socks regularly. Over-the-counter antifungal creams or sprays can be used to treat athlete’s foot. If these remedies do not work, however, you may need to see a podiatrist and ask about prescription-strength medication.
Foot Problems: Hammertoes
If your second, third, or fourth toe is crossed, bent in the middle of the toe joint, or just pointing at an odd angle, you may have what’s called a hammertoe. Hammertoes are often caused by ill-fitting shoes. Early on, wearing inserts or foot pads can help reposition your toe, but later it becomes fixed in the bent position. Pain then sets in and you may need surgery. Because hammertoes are bent, corns and calluses often form on them.
Foot Problems: Blisters
It’s this simple: If your shoes fit well, you won't have blisters. Soft pockets of raised skin filled with clear fluid, blisters are often painful and can make walking difficult. It’s important not to pick at them. Clean the area thoroughly, then sterilize a sewing needle and use it to open the part of the blister located nearest to the foot’s underside. Drain the blister, slather with antibiotic ointment, and cover with a bandage. Follow these same care steps if a blister breaks on its own.
Foot Problems: Bunions
A bunion is a crooked big-toe joint that sticks out at the base of the toe, forcing the big toe to turn in. Bunions have various causes, including congenital deformities, arthritis, trauma, and heredity. A bunion can be painful when confined in a shoe, and for many people, shoes that are too narrow in the toe may be to blame for the formation of bunions. Surgery is often recommended to treat bunions, after conservative treatment methods like over-the-counter pain relievers and footwear changes fail.
Foot Problems: Corns and Calluses
Corns and calluses form after repeated rubbing against a bony area of the foot or against a shoe. Corns appear on the tops and sides of your toes as well as between your toes. Calluses form on the bottom of the foot, especially under the heels or balls, and on the sides of toes. These compressed patches of dead skin cells can be hard and painful. To relieve the pain, you may want to try placing moleskin or padding around corns and calluses. Don’t try to cut or remove corns and calluses yourself — see a podiatrist for care.
Foot Problems: Plantar Fasciitis and Heel Spurs
It’s common for doctors to confuse heel spurs and plantar fasciitis when a patient comes to them with heel pain. Heel spurs are found in 70 percent of patients with plantar fasciitis, but these are two different conditions. Plantar fasciitis is a painful disorder in which the tissue that connects the ball of the foot to the heel – the fascia – becomes inflamed. Heel spurs are pieces of bone that grow at the heel bone base and often develop after you’ve had plantar fasciitis. The heel spurs themselves are not painful; it’s the inflammation and irritation caused by plantar fasciitis that can hurt. Heel spurs are often seen on X-rays of patients who do not have heel pain or plantar fasciitis.
Foot Problems: Claw Toes and Mallet Toes
Claw toe causes all toes except the big toe to curl downward at the middle of the joints and curl up at the joints where the toes and the foot meet. Calluses and corns may often form when someone has claw toes. While tight shoes can be blamed for claw toes, so can nerve damage to the feet (from diabetes or other conditions), which weakens foot muscles.
With mallet toes, the last joint of the toe bulges, and a painful corn will grow near the toenail. Generally the second toe is affected because it’s the longest. Injuries and arthritis are among the causes of mallet toe.
Foot Problems: Gout
Gout is a type of arthritis caused by a build-up of uric acid in joint tissues and joint fluid, which happens when the body is unable to keep uric acid levels in check. One of the first places for this build-up to occur is in the big toe joint — temperature-wise, the toes are the body’s coolest parts, and uric acid crystallizes with temperature changes. You’ll know a gout attack when it happens: The toe will get warm, red, and swollen and will be painful to even the slightest touch. The best way to prevent a gout attack is to learn to identify triggers, including high-purine foods, red meat, seafood, and alcohol. Applying ice, keeping hydrated, and staying bed may help, too.
Foot Problems: Ingrown Toenails
The right way to clip toenails — straight across — is key to foot health. If you don’t cut them properly, the corners or sides of the nail can dig into skin and become ingrown. Other causes of ingrown toenails include shoe pressure, a fungus infection, and even poor foot structure. When you cut your toenails, use larger toenail clippers and avoid cutting nails to short, as this can also cause ingrown toenails or infection.
Foot Problems: Toenail Fungus
Toenail fungus can give nails an unattractive, deformed appearance. It can alter the nail’s color and spread to other nails, even fingernails. Avoiding toenail fungus is difficult, especially if you walk through wet areas where people tend to go barefoot, such as locker rooms and swimming pools. People with chronic conditions, such as diabetes or immune deficiency diseases like HIV, are especially vulnerable and may want to keep their shoes on.
The human foot has 42 muscles, 26 bones, 33 joints, and at least 50 ligaments and tendons made of strong fibrous tissues to keep all the moving parts together … plus 250,000 sweat glands. The foot is an evolutionary marvel, capable of handling hundreds of tons of force — your weight in motion — every day. The foot’s myriad parts, including the toes, heel, and ball, work in harmony to get you from one place to another. But the stress of carrying you around puts your feet at high risk of injury, more so than other parts of your body.
Many foot problems, including hammertoes, blisters, bunions, corns and calluses, heel spurs, claw and mallet toes, ingrown toenails, toenail fungus, and athlete’s foot, can develop due to neglect, ill-fitting shoes, and simple wear and tear. Your feet also can indicate if your body is under threat from a serious disease. Gout, for instance, will attack the foot joints first.
Foot Problems: Athlete's Foot
Caused by a fungus that likes warm, dark, and moist environments like the areas between the toes or on the bottoms of the feet, athlete’s foot can inflame the skin and cause a white, scaly rash with a red base. The athlete’s foot fungus also causes itching, burning, peeling, and sometimes a slight odor; the infection can also migrate to other body parts. You can avoid athlete’s foot (also called tinea pedis) by keeping your feet and toes clean and dry and by changing your shoes and socks regularly. Over-the-counter antifungal creams or sprays can be used to treat athlete’s foot. If these remedies do not work, however, you may need to see a podiatrist and ask about prescription-strength medication.
Foot Problems: Hammertoes
If your second, third, or fourth toe is crossed, bent in the middle of the toe joint, or just pointing at an odd angle, you may have what’s called a hammertoe. Hammertoes are often caused by ill-fitting shoes. Early on, wearing inserts or foot pads can help reposition your toe, but later it becomes fixed in the bent position. Pain then sets in and you may need surgery. Because hammertoes are bent, corns and calluses often form on them.
Foot Problems: Blisters
It’s this simple: If your shoes fit well, you won't have blisters. Soft pockets of raised skin filled with clear fluid, blisters are often painful and can make walking difficult. It’s important not to pick at them. Clean the area thoroughly, then sterilize a sewing needle and use it to open the part of the blister located nearest to the foot’s underside. Drain the blister, slather with antibiotic ointment, and cover with a bandage. Follow these same care steps if a blister breaks on its own.
Foot Problems: Bunions
A bunion is a crooked big-toe joint that sticks out at the base of the toe, forcing the big toe to turn in. Bunions have various causes, including congenital deformities, arthritis, trauma, and heredity. A bunion can be painful when confined in a shoe, and for many people, shoes that are too narrow in the toe may be to blame for the formation of bunions. Surgery is often recommended to treat bunions, after conservative treatment methods like over-the-counter pain relievers and footwear changes fail.
Foot Problems: Corns and Calluses
Corns and calluses form after repeated rubbing against a bony area of the foot or against a shoe. Corns appear on the tops and sides of your toes as well as between your toes. Calluses form on the bottom of the foot, especially under the heels or balls, and on the sides of toes. These compressed patches of dead skin cells can be hard and painful. To relieve the pain, you may want to try placing moleskin or padding around corns and calluses. Don’t try to cut or remove corns and calluses yourself — see a podiatrist for care.
Foot Problems: Plantar Fasciitis and Heel Spurs
It’s common for doctors to confuse heel spurs and plantar fasciitis when a patient comes to them with heel pain. Heel spurs are found in 70 percent of patients with plantar fasciitis, but these are two different conditions. Plantar fasciitis is a painful disorder in which the tissue that connects the ball of the foot to the heel – the fascia – becomes inflamed. Heel spurs are pieces of bone that grow at the heel bone base and often develop after you’ve had plantar fasciitis. The heel spurs themselves are not painful; it’s the inflammation and irritation caused by plantar fasciitis that can hurt. Heel spurs are often seen on X-rays of patients who do not have heel pain or plantar fasciitis.
Foot Problems: Claw Toes and Mallet Toes
Claw toe causes all toes except the big toe to curl downward at the middle of the joints and curl up at the joints where the toes and the foot meet. Calluses and corns may often form when someone has claw toes. While tight shoes can be blamed for claw toes, so can nerve damage to the feet (from diabetes or other conditions), which weakens foot muscles.
With mallet toes, the last joint of the toe bulges, and a painful corn will grow near the toenail. Generally the second toe is affected because it’s the longest. Injuries and arthritis are among the causes of mallet toe.
Foot Problems: Gout
Gout is a type of arthritis caused by a build-up of uric acid in joint tissues and joint fluid, which happens when the body is unable to keep uric acid levels in check. One of the first places for this build-up to occur is in the big toe joint — temperature-wise, the toes are the body’s coolest parts, and uric acid crystallizes with temperature changes. You’ll know a gout attack when it happens: The toe will get warm, red, and swollen and will be painful to even the slightest touch. The best way to prevent a gout attack is to learn to identify triggers, including high-purine foods, red meat, seafood, and alcohol. Applying ice, keeping hydrated, and staying bed may help, too.
Foot Problems: Ingrown Toenails
The right way to clip toenails — straight across — is key to foot health. If you don’t cut them properly, the corners or sides of the nail can dig into skin and become ingrown. Other causes of ingrown toenails include shoe pressure, a fungus infection, and even poor foot structure. When you cut your toenails, use larger toenail clippers and avoid cutting nails to short, as this can also cause ingrown toenails or infection.
Foot Problems: Toenail Fungus
Toenail fungus can give nails an unattractive, deformed appearance. It can alter the nail’s color and spread to other nails, even fingernails. Avoiding toenail fungus is difficult, especially if you walk through wet areas where people tend to go barefoot, such as locker rooms and swimming pools. People with chronic conditions, such as diabetes or immune deficiency diseases like HIV, are especially vulnerable and may want to keep their shoes on.
Friday, December 16, 2011
Shin Pain While Walking
Q: I love walking, but when I walk at a fast pace my shins really start to hurt. What can I do to stop the pain?
A: First, make sure your walking shoes have good arch support, since shin splints often happen because of a fallen arch or flat feet. Also, try to avoid walking hills until you've walked on a flat surface for at least five minutes. This will warm up your shins so they don't become overstressed.
If you want to strengthen your shins, here's an easy towel exercise you can do! Sit in a chair, your feet bare, and place a rolled-up towel just in front of your toes. Grab the towel between your toes and your forefeet and unroll it, flexing the arches of your feet at the same time. Try to do this for 15 to 30 seconds every other day. It will help you keep up the good work and stay fit.
A: First, make sure your walking shoes have good arch support, since shin splints often happen because of a fallen arch or flat feet. Also, try to avoid walking hills until you've walked on a flat surface for at least five minutes. This will warm up your shins so they don't become overstressed.
If you want to strengthen your shins, here's an easy towel exercise you can do! Sit in a chair, your feet bare, and place a rolled-up towel just in front of your toes. Grab the towel between your toes and your forefeet and unroll it, flexing the arches of your feet at the same time. Try to do this for 15 to 30 seconds every other day. It will help you keep up the good work and stay fit.
Thursday, December 15, 2011
Is Stress Raising My Blood Sugar?
Q: I have a really stressful job. I find that when I test my blood sugar at work or in the evening after work that my levels are markedly higher than on the days I don't work. I take my food to work with me, so my diet doesn't change from day to day. Is it the stress that is boosting my levels?
A: Is your physical activity level also the same during both times? If not, the difference may be simply because you are burning more calories during your off-work days. But if your diet and activities are similar during your on- and off-work days, it is possible that occupational stress is the cause of your higher sugar levels. Psychological stress from a demanding job or other life situations has been implicated in high glucose levels in otherwise healthy individuals. This is true especially among those who have limited social support or who have little authority to make changes at their job.
We are also learning that in people with diabetes, stress complicates glucose control. The mechanism for this is twofold. First, some individuals eat more while under stress, which then raises their sugar level. Second, during stressful times the body produces hormones as a survival mechanism to ensure that there is enough energy to respond to the particular stressor. These hormones facilitate the breakdown of stored fat and glycogen. In this process, glycogen is converted into glucose, increasing its concentration in the blood. These hormones also affect blood pressure, heart rate, and the immune system.
Stress reduction is one of the key elements of diabetes management. Unfortunately, there is no specific method that works for everyone. I recommend consulting your doctor or a psychologist to find what works for you.
A: Is your physical activity level also the same during both times? If not, the difference may be simply because you are burning more calories during your off-work days. But if your diet and activities are similar during your on- and off-work days, it is possible that occupational stress is the cause of your higher sugar levels. Psychological stress from a demanding job or other life situations has been implicated in high glucose levels in otherwise healthy individuals. This is true especially among those who have limited social support or who have little authority to make changes at their job.
We are also learning that in people with diabetes, stress complicates glucose control. The mechanism for this is twofold. First, some individuals eat more while under stress, which then raises their sugar level. Second, during stressful times the body produces hormones as a survival mechanism to ensure that there is enough energy to respond to the particular stressor. These hormones facilitate the breakdown of stored fat and glycogen. In this process, glycogen is converted into glucose, increasing its concentration in the blood. These hormones also affect blood pressure, heart rate, and the immune system.
Stress reduction is one of the key elements of diabetes management. Unfortunately, there is no specific method that works for everyone. I recommend consulting your doctor or a psychologist to find what works for you.
Wednesday, December 14, 2011
Wardrobe Malfunctions: Are Your Clothes Causing You Pain?
From skinny jeans to sky-high stilettos, your clothing, shoes, and accessories may be a source of chronic pain that no amount of style will alleviate.
What's causing your chronic pain? Turns out, it could be your wardrobe.
A number of chronic pain issues can be traced to what you wear. The problem is most common in women — a whopping 88 percent wear shoes that are too small for them — but men can be fashion pain victims too. Among the high-style culprits are ultratight skinny jeans and mega pursesthat border on suitcase size. We've scoured the racks for some of the common clothing choices that cause chronic pain – and we've researched some painless alternatives.
Toe Pressure: High Heels and Pointy Shoes
Stilettos and other dramatic styles may be fashionable, but they are waging war on your feet on a daily basis, says Neil M. Scheffler, MD, a podiatrist at Sinai Hospital in Baltimore, Md. The result can ultimately be chronic pain. “High heels place the foot in a ‘toe-down’ position with the heel up, which puts a great deal of pressure on the front of the foot, mainly on the metatarsal bones,” he says. This creates short-term discomfort and can lead to long-term pain and other problems. “With continued wearing of high heels, the Achilles tendon shortens, creating an imbalance that can lead to foot deformities as well as postural symptoms.”
Flimsy Support: Flip-Flops and Flats
Considering the problem with high heels, you might think that wearing flip-flops or other flats would be the proper course of action for pain management, but these styles can cause pain in other ways. “Because flip-flops have no support for the foot, mechanical disorders are exaggerated,” says Dr. Scheffler. “Flip-flops are notorious for causing heel and arch pain called plantar fasciitis.” Instead, Scheffler suggests wearing running shoes. “I explain to my patients that to run 26-plus miles in a marathon, you need a great shoe,” he says. “Why not use this technology for everyday footwear?” Running shoes are supportive, give great cushioning, have adequate toe room, and are often available in varying widths, he adds.
Excess Baggage: Heavy Purses and Bags
Chiropracter Brett Winchester, an instructor at Logan College of Chiropractic in Chesterfield, Mo., has noticed a dangerous trend when it comes to women’s handbags and chronic pain. “With larger purses, many women are tempted to carry more items, which adds stress to the neck and shoulder areas,” he says. “We recommend a reasonably sized purse that can be draped across the shoulders and allows the arms to swing freely for walking.” For pain management or prevention, center the weight of the purse in the middle of your back or chest to balance your center of gravity.
Sciatica in Your Pocket: Men's Wallets
If you’re a man looking for easy pain treatment, simply take your wallet out of your back pocket whenever you are sitting, says Dr. Winchester. Sitting on your wallet creates a two-fold pain problem. “First, the wallet can put direct pressure on the sciatic nerve,” he says. “Second, it can create a pelvic unleveling, which can prompts imbalances throughout the body. Such problems can become prevalent among men who commute for long periods of time.”
Too Tight: Skinny Jeans
You may think you look good in stylish clothing choices like skinny jeans, miniskirts, and other tight clothing, but you might not like the long-term chronic pain that can result from wearing them. “There are reported cases of these jeans causing a nerve disorder called lateral femoral cutaneous nerve entrapment, though this would be considered rare,” says Winchester. “Other issues these jeans can create include the lack of hip extension. In human gait the hip is designed to have a certain amount of extension and flexion.” Skinny, tight jeans can hamper this motion, which can create pain problems in the lower back.
Unfit for the Job: Bras
Women can do themselves a favor when it comes to pain management or, better yet, prevention, by simply taking the time to find a bra that fits them well. Winchester says bras that fit poorly can create chronic pain problems in several ways. “Ill-fitting bras cause deep grooves in the shoulder area and can rub on the lower part of the rib cage,” he explains. “Most noticeably, an ill-fitting bra can also affect cosmetic appearance and everyday activities.” The pain management solution is simple: “Buying bras is like buying shoes,” says Winchester. “They must be tried on in the store first before purchasing. Specialty stores that only sell bras are usually great places to make an informed purchase.”
What's causing your chronic pain? Turns out, it could be your wardrobe.
A number of chronic pain issues can be traced to what you wear. The problem is most common in women — a whopping 88 percent wear shoes that are too small for them — but men can be fashion pain victims too. Among the high-style culprits are ultratight skinny jeans and mega pursesthat border on suitcase size. We've scoured the racks for some of the common clothing choices that cause chronic pain – and we've researched some painless alternatives.
Toe Pressure: High Heels and Pointy Shoes
Stilettos and other dramatic styles may be fashionable, but they are waging war on your feet on a daily basis, says Neil M. Scheffler, MD, a podiatrist at Sinai Hospital in Baltimore, Md. The result can ultimately be chronic pain. “High heels place the foot in a ‘toe-down’ position with the heel up, which puts a great deal of pressure on the front of the foot, mainly on the metatarsal bones,” he says. This creates short-term discomfort and can lead to long-term pain and other problems. “With continued wearing of high heels, the Achilles tendon shortens, creating an imbalance that can lead to foot deformities as well as postural symptoms.”
Flimsy Support: Flip-Flops and Flats
Considering the problem with high heels, you might think that wearing flip-flops or other flats would be the proper course of action for pain management, but these styles can cause pain in other ways. “Because flip-flops have no support for the foot, mechanical disorders are exaggerated,” says Dr. Scheffler. “Flip-flops are notorious for causing heel and arch pain called plantar fasciitis.” Instead, Scheffler suggests wearing running shoes. “I explain to my patients that to run 26-plus miles in a marathon, you need a great shoe,” he says. “Why not use this technology for everyday footwear?” Running shoes are supportive, give great cushioning, have adequate toe room, and are often available in varying widths, he adds.
Excess Baggage: Heavy Purses and Bags
Chiropracter Brett Winchester, an instructor at Logan College of Chiropractic in Chesterfield, Mo., has noticed a dangerous trend when it comes to women’s handbags and chronic pain. “With larger purses, many women are tempted to carry more items, which adds stress to the neck and shoulder areas,” he says. “We recommend a reasonably sized purse that can be draped across the shoulders and allows the arms to swing freely for walking.” For pain management or prevention, center the weight of the purse in the middle of your back or chest to balance your center of gravity.
Sciatica in Your Pocket: Men's Wallets
If you’re a man looking for easy pain treatment, simply take your wallet out of your back pocket whenever you are sitting, says Dr. Winchester. Sitting on your wallet creates a two-fold pain problem. “First, the wallet can put direct pressure on the sciatic nerve,” he says. “Second, it can create a pelvic unleveling, which can prompts imbalances throughout the body. Such problems can become prevalent among men who commute for long periods of time.”
Too Tight: Skinny Jeans
You may think you look good in stylish clothing choices like skinny jeans, miniskirts, and other tight clothing, but you might not like the long-term chronic pain that can result from wearing them. “There are reported cases of these jeans causing a nerve disorder called lateral femoral cutaneous nerve entrapment, though this would be considered rare,” says Winchester. “Other issues these jeans can create include the lack of hip extension. In human gait the hip is designed to have a certain amount of extension and flexion.” Skinny, tight jeans can hamper this motion, which can create pain problems in the lower back.
Unfit for the Job: Bras
Women can do themselves a favor when it comes to pain management or, better yet, prevention, by simply taking the time to find a bra that fits them well. Winchester says bras that fit poorly can create chronic pain problems in several ways. “Ill-fitting bras cause deep grooves in the shoulder area and can rub on the lower part of the rib cage,” he explains. “Most noticeably, an ill-fitting bra can also affect cosmetic appearance and everyday activities.” The pain management solution is simple: “Buying bras is like buying shoes,” says Winchester. “They must be tried on in the store first before purchasing. Specialty stores that only sell bras are usually great places to make an informed purchase.”
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