Education for Diabetes

Dr Edelman, MD Endocrinologist, discusses family tendencies to get diabetes and other diabetes risk factors. Find out how Liberty Medical can help you manage your diabetes: bit.ly

Dr. Richard M. Moe, MD, PhD, Preventive Cardiologist with Cardiovascular Consultants of Saint Lukes Mid America Heart Institute, explains what type of exercise, diet and lifestyle changes you must make to lower your risk for developing Coronary Artery Disease. Two types of activity include aerobic and anaerobic. Anaerobic is the type that we typically can’t maintain for a long period of time, such as heavy weight lifting. Aerobic is physical activity that we can sustain for an extended time frame, such as walking. We are most interested in aerobic activity if we are trying to maintain heart health. Exercise can help reduce risk for heart disease. It can help with blood pressure control, blood sugar control, cholesterol control, stress control, overall maintenance of heart structure and function, maintaining suppleness of the large arteries we have, and it can give a sense of relief and confidence. Often, exercise is linked to helping to control depression, which often has a relation to heart disease. The average American today needs some sustained aerobic activity, less dietary saturated fat, and should utilize fish and/or fish oil in the diet and a baby aspirin regularly. A consistent exercise program, similar to cardiac rehab or a daily setting with camaraderie is good for any diabetic patient. These help the patient to take accountability and can influence continued exercise and diet. The diabetic patient has a higher potential to develop coronary disease. Type 2 …

Copyright (c) 2008 Katie Kelley

Depression is a severe and often debilitating condition that affects millions of individuals nationwide. However, now depressed patients must also watch for a new risk of developing type 2 diabetes on top of their current condition. Recently, a study published in the Diabetes Research and Clinical Practice from the University of Alberta found that depressed patients have a 30 percent increased risk of also developing type 2 diabetes as well.

Lauren Brown, the lead author of the study, researched the history of 2,400 individuals who had been diagnosed with depression. According to Brown, patients taking both selective serotonin re-uptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) are at the most risk for developing type 2 diabetes.

While the study needs further research to better understand the relationship between antidepressants and developing type 2 diabetes, it is important that patients of depression as well as diabetes receive educational information on both conditions and the link to better assess and treat their potential illnesses, according to the study.

What are TCAs and SSRIs?

Tricyclic antidepressants are used to treat abnormalities involving neurotransmitters serotonin, norepinephrine and dopamine, according to the Mayo Clinic. The TCAs “inhibit the reabsorption of serotonin and norepinephrin” and block certain cell receptors. TCAs were first introduced to the market in the 1960s and remained a top treatment of depression among patients through the 1980s until the development of SSRIs. Common side effects that have been associated with TCAs include:

* constipation, urinary retention

* drowsiness and dizziness

* dry mouth

* blurred vision

* impaired sexual function

* increased heart rate

* headache

* increased appetite, weight gain

* weakness

* low blood pressure or increased heart rate

* nausea

According to the Mayo Clinic, patients of TCAs may have issues with their blood sugar levels, but the drug has never been linked directly to having caused diabetes.

Health Insite, an initiative by the Australian government, describes SSRIs as a group of antidepressants that activate nerve cells within the brain to regulate serotonin levels. Some of the most common SSRI side effects include the following, according to the Harvard Medical School:

* insomnia

* rashes

* headaches

* joint and muscle pain

* diarrhea, nausea or upset stomach

* potential risk of stomach or uterine bleeding

* diminished sexual interest/desire

* impaired sexual function

* suicide and increased suicidal thinking

Patients are advised to discuss any sudden change in moods, and, with the increased risk of developing diabetes, patients taking both SSRIs and TCAs should consult their physician if weight gain or loss begins to affect moods.

What Determines A Type 2 Diabetes Diagnosis?

Individuals who feel they may suffer from type 2 diabetes will likely receive one or all of the following tests, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDD):

* fasting plasma glucose test

* oral glucose tolerance test

* random plasma glucose test

It is important to know the signs and symptoms of diabetes in order to receive diagnosis and treatment of the condition immediately, as the condition can worsen if left untreated. The American Diabetes Association (ADA) reported the following diabetes symptoms for individuals to watch for:

* frequent urination

* extreme hunger

* blurry vision

* irritability

* extreme thirst

* increased fatigue

* unexplained weight loss

It is extremely important for patients suffering from depression to contact a medical professional if they feel they may suffer from type 2 diabetes as well. If diagnosed with type 2 diabetes, it is important to become aware of the potential risks involved with consuming type 2 diabetes medications such as Avandia.

One such drug is Avandia, which has been linked to heart disease and bone fracture among patients; the drug was approved for market in 1999 from GlaxoSmithKline. Individuals who have suffered from complications related to Avandia should receive a free consultation from a pharmaceutical attorney regarding their condition and the side effects that have caused additional harm to an individual. Avandia patients may be eligible for earning monetary compensation because of the side effects caused by the drug, which may be irreversible.

Developing Gestational Diabetes during pregnancy carries a 15 to 60 percent chance of developing Non-Insulin Dependent (Type II) after pregnancy within a 5 to15 year period of time.  It is important to determine the significant risk factors that lead to Type II diabetes as this disease has reached epidemic proportions around the world.  From 1994 to 2002, the incidence of gestational diabetes doubled to now involve 7 percent of pregnancies.  This has an increased  maternal and neonatal morbidity which includes but is not limited to elevated blood pressure, preeclampsia, eclampsia, placental abruption, maternal kidney disease, increased susceptibility to premature delivery, increased incidence of C-sections, uterine infection, bacteria in the blood, maternal death, fetal macrosomia (large infant) hypoglycemia of the infant, prematurity of the lungs even late in the third trimester, increased risk or neonatal infection, hyperbilirubenemia, intrauterine fetal death, and perinatal mortality.  

By knowing the risk factors that lead to a higher incidence of gestational diabetes, there is hope to be able to prevent them before, during, or after the pregnancy in order to reduce the complications mentioned above associated with the immediate problems with gestational diabetes.

When patients are diagnosed with Non-insulin dependent diabetes, there are a host of complications and risk factors that occur:  increased risk of heart, peripheral vascular, kidney, eye, and neurologic diseases such as heart attacks, angina, pain in legs when walking (claudication , kidney failure,  blindness, stroke, transient ischemic attack, loss of balance when walking and unable to feel feet due to peripheral nerve damage.

Several  studies show three factors  that lead to highest risk for women developing Type II diabetes after having gestational diabetes in pregnancy:

1) BMI  (Basal Metabolic Index) > 27

Patients have a 4 to 8 fold chance of developing Type II diabetes whose BMI is greater than 27

2) Developing gestational diabetes before 24 weeks gestation

Patients who develop gestational diabetes after 24 weeks have less chance of developing Type II diabetes.  The fetal placenta is responsible for abnormal glucose intolerance after 24 weeks  

3) Use of insulin to control the blood sugars in pregnancy

Insulin  use in pregnancy means  the mother has less ability to produce an adequate amount of insulin during stress (excessive sugar loads, viral or bacterial infections, ect.)

Measures must be in place to prevent, reduce, and or treat each risk factor.

Regarding prevention, reduction, or treating a BMI of greater than 27 requires a comprehensive approach  involving  psychological, environmental, nutritional, and exercise.

1)  Eating minimal amounts of calories is noted to increase longevity. This is because obesity leads to chronic diseases such as cancer, hypertension, heart disease, diabetes, and arthritis. One must learn to eat frequent small meals. Eating 5 to 7 small meals throughout the day will increase the metabolism by 10 to 12 percent. Increasing the portion of protein and reducing the amount of carbohydrates will reduce insulin demand that is needed to metabolize sugars in the body.  Patients must reduce breads, pasta, and sweets.  Patients must increase fiber intake, brown rice, sweet potatoes, nuts, and non-starchy vegetables.

2) Exercise. One must engage is some form of exercise 30 minutes to 1 hour a day.  Swimming, walking, riding bicycles, stationary bicycle, treadmill, weightlifting, rowing, stair climber, etc, are examples of exercises that will build muscle and help increase the uptake of sugars into muscle which in turn decreases the demand for insulin and reduces glucose resistance.   Increase in one pound of muscle leads to an increase of 50 calories a day being burned.   

3) Supplements  known to increase glucose utilization in diets.

a. Cinnamon

b. Bitter melon

c. Cane sugar

d. Alpha Lipoic Acid

e. Chromium Piccolinate

In summary, Type II diabetes leads to serious illness and disease left untreated.   Gestational Diabetes during pregnancy predicts a high incidence of developing Type II Diabetes within a few years.  Knowing the risk factors that lead to Type II diabetes after Gestational Diabetes and the ways to reduce or prevent these factors from occurring, will help to reduce the incidence of this detrimental disease.

Dr Edelman, MD Endocrinologist, discusses family tendencies to get diabetes and other diabetes risk factors. Find out how Liberty Medical can help you manage your diabetes: bit.ly

A national study chaired by Gary Foster at Temple University’s Center for Obesity Research and Education (CORE) has found that school-based interventions can help reduce various risk factors for type 2 diabetes in children.

The World Health Organization estimates that at least 180 million people have diabetes. Ninety percent have what’s called Type 2 diabetes, caused by the body’s ineffective use of insulin. Researchers have focused in recent years on a hormone derived from fat cells, called adiponectin, which is shown to lower the risk of diabetes. VOA’s Melinda Smith reports that scientists now hope this could improve the treatment of diabetes or even prevent it altogether.

Some folk are at higher danger than others of developing diabetes. Any individual with a household story of diabetes has increased danger. Diabetes too occurs more often in Native Americans, Hispanic Americans, and African Americans.

Because it tends to run in families, the major risk factor for type 1 diabetes appears to be genetics. The risk of developing type 2 diabetes increase progressively as body fat increases, especially around the midsection. Compared to a normal-weight person, an obese person can have 40 times the risk of type 2 diabetes. Most, but not all, people diagnosed with type 2 diabetes are obese when the diagnosis is made.

In new years, scientists have recognized a clump of danger factors dubbed Syndrome X. Like diabetes, Syndrome X involves impaired uptake of glucose by cells, but it too includes higher blood force and higher blood levels of insulin, fat, and cholesterol. Combined, these factors increase the danger of character 2 diabetes and eye disease by several fold. As many as 30 percent of grownup males and 15 percent of postmenopausal women have Syndrome X.

Contrary to popular though, high sugar or high carbohydrate intake does not by itself cause diabetes. In fact, current dietary recommendations for individuals with diabetes emphasize diets rich in complex carbohydrate (including fiber) and low in fat. Although in the past, dietary treatment of diabetes eliminated simple sugars from the diet, current recommendations allow individuals with diabetes include moderate amounts of simple sugars in their diet as long as sugar intake dose not contribute to excess energy intake and obesity.

The best prevention for both type 2 diabetes due to obesity and Syndrome X is healthful diet and regular exercise. Reducing excess body fat will improve glucose tolerance and reduce related risk factors for heart disease. Regular exercise will improve carbohydrate and lipid metabolism and increase insulin sensitivity. In addition, exercise improves blood flow to the extremities, bringing blood pressure down to normal levels and reducing risk of heart disease.

Who is at greater risk for type 1 diabetes?

People with high blood pressure

People with a family history of diabetes

People who are overweight

People who do not exercise regularly

People with low HDL or high tri-glyceride levels in blood

Certain racial and ethnic groups (e.g., African American, Hispanic Americans, Asian and Pacific Islanders, and Native Americans)

Woman who have had gestational diabetes, a form of diabetes that occurs in about 4 percent or pregnancies, or who have had a baby who weighed 8 pounds or more at birth.

Incidence of Type II diabetes and Impaired Glucose Tolerance (IGT) is rising around the world. According to the International Diabetes Federation, 7 million people develop diabetes each year, at the rate of 2 people every 10 seconds! It is believed that up to 50% of people with diabetes are undiagnosed, and in some less developed countries, that number could be as high as 80%. This amazing number can be attributed to the slow onset of type II diabetes. People may not notice the progression of their symptoms, which include tiredness, thirst, constant hunger, frequent urination, blurred vision, weight loss, weakness, repeated infections and poor wound healing. Another factor that may contribute to the rise in type II diabetes cases is increased affluence. Increased income to spend on food, cars and other labor saving appliances leads to a fatter, less active society- two of the key factors that contribute to type II diabetes. This disease can have many serious complications if not managed, but many people do not understand how serious it is. Why? Because many people with diabetes look healthy. Yet, late diagnosis or poor management can lead to deterioration of vision and blindness, kidney damage and failure, angina and heart attacks, painful feet and paralysis, and foot ulcers and poor circulation to the legs and feet- the result of which can be amputation.

ARE YOU AT RISK?

            People with diabetes do not make insulin, or it does not work the way it should. In healthy people, insulin works with the food you eat to deliver glucose to your cells for energy. People with diabetes have high blood glucose levels, because the insulin is not facilitating transport of glucose into your cells. This explains the symptoms and complications of diabetes: your body does not have the energy to perform its necessary tasks! While there is a genetic susceptibility, studies have also noted that dietary composition, physical activity, and low birth weight contribute to the onset of type II diabetes.

People at risk are:

·         Over 40 years old

·         Have (or have had) a blood relative with diabetes

·         Have (or have had) diabetes during pregnancy

·         Don’t exercise regularly, or have a sedentary lifestyle

·         Are obese (waist measurement over 100cm for men, 95 cm for women)

·         Have high blood pressure or take blood pressure medication

·         Have a history of heart attack, angina, paralysis, stroke

·         Women with polycystic ovary syndrome who are obese (cysts on ovaries, irregular periods, problems with excess facial and body hair and acne)

·         Have previously had abnormal blood glucose levels (impaired glucose tolerance or impaired fasting glucose)

·         Were born in Southern Europe, the Middle East, South East Asia; are Polynesian or Asian Indian

·         Have two or more of the following symptoms:

1.      excessive urination

2.      constant thirst

3.      unexplained weight loss

4.      numbness or tingling in legs or feet

5.      blurred vision

6.      constant fatigue

7.      itching skin or frequent skin infections

Diabetes claims the lives of one person every 10 seconds, and people with type II diabetes die an average of 5-10 years earlier than those without it. Don’t let this disease claim any more lives! UP TO 80% OF TYPE II DIABETES IS PREVENTABLE AND MANAGEABLE BY LOSING WEIGHT, INCREASING ACTIVITY AND EATING A HEALTHY DIET! If you are at risk, see your doctor for a blood test!

For more information about diabetes, its symptoms and risk factors, visit The American Diabetes Association website at www.diabetes.org or Societa Italiana di Diabetologia www.siditalia.it/.  For more information about what is being done to combat diabetes, the search for a cure, and ways to donate, visit www.idf.org.

Eating a higher-fiber diet is important to optimum health for a variety of reasons. High fiber diet has been prove to lower cholesterol level in the blood, control your blood sugar levels, improve slow digestion, prevent cancer and prevent constipation. Fiber can actually help us to eat less and lose excess weight.

According to researchers, eating more fiber is associated with reduced the risk of type 2 diabetes.

A recent study from Slone Epidemiology Center at Boston University followed 40,000 African American women over eight years and looked at their dietary habits while noting the development of type 2 diabetes within the group. The researchers found that the more high fiber cereals consumed, the lower the risk for diabetes in the women.

“Increasing cereal fiber in the diet may be an effective means of reducing the risk of type 2 diabetes, a disease that has reached epidemic proportions in black women,” concludes Dr. Supriya Krishman, lead author on the study published in the November 2007 issue of Archives of Internal Medicine.

An earlier report from Harvard School of Public Health in Boston found similar results with data from more than 286,000 women who had participated in the Nurses’Health Studies and other research programs. During the 12 to 18 year follow up, approximately 11,000 women were diagnosed with type 2 diabetes, but the women who ate more whole grain foods were less likely to develop the disease.

The authors report that just two servings a day of whole grains were associated with a 21% decrease in the risk for diabetes. They suggest that these studies “consistently support increasing whole grain consumption for the prevention of type 2 diabetes.”

In general, try to increase the fiber in your diet. By eating more fiber rich foods, such as whole grains, vegetables, beans, nuts, seeds and high fiber fruits, you can not only  lose weight, but also decrease your risk of diabetes, colon cancer, hemorrhoids, high cholesterol, and heart disease.