Martha Jefferson Hospital
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Diabetes
Reversing Insulin Resistance
Have you heard of insulin resistance? Perhaps in relationship to pre-diabetes? It is a condition that occurs when certain cells in the body, especially in the liver and muscles, lose their sensitivity to insulin. There is resistance to insulin. Since the cells are not taking up as much insulin as usual, more insulin is needed to help keep your glucose levels in the normal range. And that means the pancreas eventually will not be able to keep up with making enough insulin.
Risk Factors for Insulin Resistance:
- family history
- lack of activity
- excess weight
How best to reduce your risk for insulin resistance:
- modest weight loss of 10-15 lb.
- 150 minutes of exercise per week, with no more than 2 days off between
- eat less saturated fats and trans fats
- focus on filling up your plate with three-quarters filled up with plant foods
Insulin resistance can lead to pre-diabetes and then type 2 diabetes. Since the pancreas has to compensate for your body’s inability to efficiently use insulin, it has to work even harder by making more insulin to get the job done. And this is stressful wear-and-tear on the pancreas.
Check Out Your Glucose
For 25 years, the American Diabetes Association has set aside today – Diabetes Alert Day – to help folks learn if they are at risk for developing the most common type of diabetes, type 2. It is a growing epidemic in this country – well, actually worldwide because it is so closely connected to obesity. We want an early diagnosis of diabetes, since early treatment means delaying or avoiding complications such as heart disease, blindness, kidney disease, and stroke.
Are you at risk for developing diabetes? These put you at risk….. excess weight, age, and having a family history of diabetes.
If you have been diagnosed with pre-diabetes, it does not mean that you will develop type 2 diabetes any time soon. It really depends what you do with your lifestyle habits:
make changes in your diet with a modest amount of unrefined carbohydrate foods, lose weight if you need to, and enjoy regular exercise. Follow the 30/5 exercise rule: 30 minutes of exercise, 5 days a week.
Friday, March 29
Diabetes Resources: www.stopdiabetes.org and 1-800-DIABETES.
Get Nutrition Help!
Making lifestyle changes for better health? There is help! If you have Pre-Diabetes or Diabetes:
- One-on-one nutrition counseling session with a Registered Dietitian or diabetes education with a Certified Diabetes Educator.
- Attend Diabetes Education Classes to help learn how to manage your diabetes. YOU are in charge.
- Attend our Ins and Outs of Pre-Diabetes seminar to work on diabetes prevention.
- Attend a monthly Diabetes Support Group session.
- Take advantage of my FREE Diabetes Supermarket Smarts Class at Giant Foods. (434) 654-7009 for more info.
Making lifestyle changes for better health? There is help! If you have Heart issues:
- Attend the Food for Thought healthy-heart nutrition class.
- Come to my FREE Heart Healthy Supermarket Smarts class at Giant Foods.
- We teach a Get Cholesterol DOWN seminar monthly.
- How about one-on-one nutrition counseling session with a Registered Dietitian.
- Try out the MJH Heart-to-Heart Support Group meeting. More info. at (434) 654-7009.
Making lifestyle changes for better health? There is help! If you have Weight Management issues:
- It can help to meet regularly with a Registered Dietitian to develop a healthy, balanced approach to eating well rather than “dieting”.
- For those who have had bariatric surgery, plan to attend our twice monthly Support Group sessions.
- There are plenty of online resources and support at Wt. Watchers, Spark People, and My Fitness Pal.
- Are you are a member at a gym? Ask about their workout classes geared towards folks working on weight loss.
Other health issues where a Registered Dietitian might be able to offer some guidance with your food choices:
- gastrointestinal (acid reflux, celiac disease, IBS, Crohn’s Disease, gastroparesis)
- allergies such as soy or dairy
- iron deficiency
- eating disorders
Our Nutrition and Diabetes Education Department will get a referral from the MD office. And YOU can call insurance to see if there is coverage. There is more coverage in disease prevention than ever before, so it is worth checking it out.
Prevent Pre-Diabetes
It’s such a growing problem world-wide that I want to discuss pre-diabetes at the beginning of this new year. It you have pre-diabetes, then you join 79,000,000 Americans. Worldwide, diabetes experts predict that 470 million will have pre-diabetes by year 2030!!! IF you have pre-diabetes and don’t do something NOW, you will probably develop type 2 diabetes within 10 years. So, let’s get into action NOW!!
Even with pre-diabetes there can be early signs of chronic kidney disease, diabetic retinopathy and vascular disease. You’ll want your glucose numbers to be in good control (fasting glucose is 70-99 mg/dl).
What lab values put you in the pre-diabetes range?
- Fasting glucose: 100-125 mg/dl and/or and
- A1C of 5.7-6.4%
Lifestyle changes that can reverse pre-diabetes:
- weight loss in midsection,
- moderate intake of minimally processed carbohydrate foods,
- drinking sugar-free, carb-free beverages, and
- daily physical activity of at least 30 minutes
Usually two things are going on in pre-diabetes: the pancreas does not produce sufficient insulin and there is insulin resistance from the tummy fat. Fortunately lifestyle changes are often the only thing that needs to happen to get glucose readings back to the normal range. How cool is that???
Sleep Well. ZZZZZZ…
How do you sleep at night? Sleeping well and adequately is so very important health-wise. A recent study found that weight loss, especially in the belly, in obese or overweight individuals with type 2 diabetes or pre-diabetes improved the quality of their sleep. Isn’t that interesting?
Common sleep problems in folks:
- sleep apnea
- insomnia
- restless sleep
- often sedatives are used to help with sleep.
Chronic sleep problems can lead to:
- high blood pressure
- irregular heartbeats
- increased risk of having a heart attack or stroke
Even a modest 15 lb. weight loss makes a difference in sleep. And in the study it did not matter if folks lost weight by just making changes in their diet, or a combo with added exercise, there was a sleep benefit.
Sleep health – that means sleeping restfully and long enough – is important for physical as well as mental health. Sleep well…..and losing weight might help you to do just that!
Know When Glucose is High
Okay, so you have type 2 diabetes. And as you know, it is important to keep your glucose well-controlled. That means aim for a glucose reading under 130 mg/dl before a meal and less than 180 mg/dl two hours after a meal. Now, if you get certain physical symptoms, your body might be telling you that your glucose is not in good control.
Symptoms of HIGH blood glucose:
- excessive thirst and urination
- unintentional weight loss
- an increase in frequency of infections
- slow healing of cuts
- dry and/or itchy skin
- blurry vision
- headaches
- overall fatigue
Having a high blood glucose reading is not normal, so the body does rebel in different ways. You might even experience diarrhea or constipation. Your family and friends may also notice that you are a bit irritable when glucose is out of control.
If you have diabetes, be in tune to when things do not feel right physically. Use your glucose meter to test your glucose if things seem off. You need to know where you stand, and then decide with your doctor how you are going to treat those high readings.
Regulating Glucose Levels: Avoid the Highs and Lows
Millions diabetes, and they work hard to keep their blood glucose levels in a safe range. But for some, they have high and low blood glucose readings that are troublesome, and even dangerous. It’s important to keep those glucose levels on an even keel.
Symptoms of LOW blood glucose:
- weak, shaky, dizzy
- a headache
- anxiety
- sweating
- unusual behavior
What can happen if glucose levels are low frequently?
- elevated blood pressure
- you may become unaware that the blood glucose is dropping – this can be very dangerous!
Health problems with running HIGH Glucose levels:
- frequent yeast infections
- urinary tract infections
- nerve damage
- eye problems (retinopathy)
Consistently having high or low blood glucose readings is not physically good for your body. It takes a toll when this goes on for months and even years. It is never too late to get those glucose levels back to the normal and safe range by
- making lifestyle changes in diet and exercise,
- taking any prescribed diabetes medications,
- seeing your physician as scheduled,
- and then learning all you can about diabetes.
Check out the many diabetes-related classes that Martha Jefferson offers. Call Health Connection at (434) 654-7009.
Breakfast to Fight Off Diabetes?
We know that type 2 diabetes is running rampant in the world. Millions of folks either have pre-diabetes or type 2 diabetes. We also talk about the importance of breakfast. So, are the two connected – type 2 diabetes and eating breakfast? A recent study published in the American Journal of Clinical Nutrition suggests YES!
The study included 29,000 men who were followed for 16 years. Researchers tracked diets, exercise habits and disease rates.
- The results: skipping breakfast = 21% higher risk of developing diabetes.
Why would breakfast reduce type 2 diabetes risk? Researchers believethat perhaps…
- Eating breakfast first thing may help stabilize blood glucose levels.
- Skipping breakfast can result in “make-up” eating later in the day with glucose spikes, and an overworking pancreas trying to keep up by producing more insulin. Phew! It gets pooped and wears out!
Don’t fret. Breakfast is as easy as 1-2-3:
- Protein – eggs; nuts and nut butters; reduced-fat milk, cheese and yogurt; turkey bacon.
- Starch – whole-grain cereal, bread, tortilla and English muffins; potatoes, dried beans.
- Fruit – fresh, frozen or light-packed canned.
Easy ideas to make breaskfast happen:
- Grilled cheese sandwich on whole-grain bread
- Peanut butter and banana slices on English muffin
- Frozen blackberries on oatmeal
- Hearty chicken and wild rice soup (why not?)
- Baked potato with reduced-fat cheese
New Diabetes A1C Guidelines
The American Diabetes Association is releasing new guidelines for the treatment of type 2 diabetes. The bottom line is that the patient needs to work with their doctor to figure out the best treatment plan. One size does not fit all.
The A1C Guidelines have changed:
- 5.5 or less if you do not have diabetes
- 6.0-6.5 if you have diabetes but no heart disease and few episodes of low blood glucose
- less than 7.0 if you have diabetes and other health issues
Bottom line- your A1C goal needs to be decided with you and your doctor.
Lifestyle treatment for type 2 diabetes is still suggested first:
- enjoy a healthy diet with moderate carbohydrate intake
- lose 5-10% of body weight if overweight
- exercise for 2½ hours/week
Treatment may also include medications. Metformin is a first-line medication. Other meds can be added of needed. Again, this is a decision to make with your doctor.
The new guidelines for treatment of type 2 diabetes focus on YOU the patient, other health conditions you have, your lifestyle, level of motivation and ability to make changes. Each person is different in what they can or cannot do. The bottom line is to have good control of your type 2 diabetes to reduce your risk of complications such as early heart disease or kidney failure.
Prevent Diabetes
Last Tuesday was National Diabetes Alert Day, sponsored by the American Diabetes Association. It is a “one-day wake-up” call to assess your risk for developing type 2 diabetes. With 26 million Americans who have diabetes, and another 79 million with pre-diabetes (or, one-third of all adults!), it is really important to take this disease seriously and work to prevent it.
Risk Factors for Type 2 Diabetes:
- overweight and sedentary
- over age 45
- having a family history of type 2 diabetes
- certain ethnic populations: African-Americans, Hispanics, Native Americans and Asian Americans
Protect Yourself From Type 2 Diabetes:
- have your glucose levels tested
- enjoy a daily 30-minute walk
- eat healthy most of the time
- lose weight or stay lean
All of this is especially important if you’re over 65: Because 1 in 4 Americans over the age of 65 has type 2 diabetes.
You can take a diabetes risk test and gather some great information at www.diabetes.org or at www.stopdiabetes.com. And think about coming to my FREE Supermarket Smarts class for folks with pre-diabetes or type 2 diabetes. The calendar is available at www.marthajefferson.org or you can call MJH Health Connection at (434) 654-7009.
