Paisley Prescriptions - January 2020

Diabetes

January 2020 Issue
Paisley Prescriptions


There is a surefire formula for Americans that is resulting in the rise of the dangerous disease of diabetes: Decreased exercise plus increased weight equals more and more diabetes diagnoses. There is good news and bad news when it comes to diabetes. Let’s talk bad new first: Diabetes is one of the most destructive diseases one can face. It breaks the body down, affecting vision, kidneys, nerves, gastric function, and blood circulation. It also severely increases the risks for heart disease and stroke. In other words, it negatively affects almost every body function. So whats the good news? Diabetes is controllable, and there is a lot of help out there to get you going on the right track. Speaking of tracks, one of the best ways to combat diabetes is by taking a daily brisk walk. In other words, by changing your lifestyle, you can change your trajectory of illness due to diabetes. Read on to learn more about this disease from our leading experts. 

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Can you control diabetes? 

The short answer is yes. Type 2 diabetes occurs when your cells become insulin resistant and unable to process sugar and carbs properly. Then your body starts storing the extra sugar and carbs as fat, and your fasting glucose and A1C elevates. Proper diet and exercise are foundational elements in diabetes management.

Can you control it without meds?

There are numerous things that can be done to naturally lower blood sugar levels and restore normal insulin sensitivity.

Exercise Regularly: Activities such as lifting weights, brisk walking, running, biking, dancing, swimming and hiking can help you lose weight and increase insulin sensitivity, meaning the cells are better able to use the available sugar in your bloodstream.  Exercise also helps your muscles use blood sugar for energy and muscle use.

Lower Carb Intake and Increase Fiber Intake: Many studies show that low-carb diets help reduce blood sugar levels and prevent blood sugar spikes. Fiber slows carb digestion and sugar absorption, allowing for a gradual rise in blood sugar levels instead of a spike. Constipation, which is sign of slow and poor GI tract function, is more frequent in diabetics and can be improved by regular use of probiotic and Triphala. Try cutting out the processed white bread, artificial sweeteners and increase the veggies.

Stress: Hormones such as glucagon and cortisol are secreted during stressful situations, and these hormones can cause blood sugar levels to go up. Having your hormone levels checked, including your cortisol levels can be a good way to determine where you stand. These hormones can also make the body resistant to losing weight. Incorporating exercise and relaxation techniques, such as meditation or yoga, can help reduce stress and lower blood sugar levels.

Nutrient Deficiencies: Nutrients are essential for good health, including controlling diabetes and its prevention, as well. Many commonly used medicines can decrease absorption of key nutrients like Magnesium and Vitamin B. This is especially true of common heartburn medications. Nutrient deficiencies can occur in someone who is otherwise eating fairly well-balanced meals.

The most common nutrient deficiencies include:

Magnesium, essential for bone and teeth structure and involved in over 300 enzyme reactions, including metabolism and digestive function, directly impacting diabetic patients.

Vitamin B12, essential for blood formation, brain and nerve function, as well— suboptimal levels can lead to peripheral neuropathy and is depleted by some common diabetes meds.

Vitamin D is frequently suboptimal in diabetics and has shown to directly improve insulin sensitivity.

Vitamin A helps form and maintain healthy skin, teeth, bones and cell membranes and necessary for vision and may help improve insulin sensitivity.

Vitamin C is an antioxidant that helps protect the body against free radicals and it also helps keep blood sugar levels under control.

Zinc in patients with type-2 diabetes improves insulin secretions.

When trying to optimize your health, we recommend starting with increasing veggies and fiber, stopping all artificial sweeteners, and start a regular exercise program. A comprehensive nutritional assessment can help identify your individual vitamin and mineral levels, so you can start supplements specific to your needs.

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Diane G. Bowen, MD, is owner of Golden Isles Center for Plastic Surgery, PC —1015 Arthur J. Moore Dr., SSI, with a full medical spa and on-site plastic surgery suite. 912.634.1993. Dr. Bowen is also founder and director of Centered on Wellness, at the same location.




At what age should I get checked for diabetes and what are symptoms I should look for?

The American Diabetes Association recommends testing for diabetes should begin at age 45. If results are normal, then testing should be repeated at least every three years. For people who are overweight or who have one or more risk factors for diabetes, screening should be considered at any age.

Symptoms of high blood glucose (sugar) may include blurred vision, fatigue, increased thirst, increased hunger, increased urination, and frequent infections. Some people may have no symptoms.

How does race play a role in diabetes? Can diabetes be cured?

Certain ethnic origins are at a higher risk of developing diabetes. Those include African American, Latino, Native American, Asian American, and Pacific Islander.

Currently there is no cure for diabetes. However, diabetes can be controlled. Diabetes education is important for people to learn how nutrition, medications, activity and stress impact their glucose numbers so they can be more successful in self-managing their diabetes on a daily basis.

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Sue Ullrich, RN MA.Ed CDE, is the Diabetes Program Coordinator for Southeast Georgia Health System. For more information on Southeast Georgia Health System’s diabetes education programs, visit sghs.org or call: 912.466.7000.


 

 


 

How does belly fat affect your risk for Type 2 diabetes? How does losing belly fat help?

Belly fat includes visceral fat, which is within the abdomen, as well as subcutaneous fat around the waist. Belly fat increases the risk for Type 2 diabetes. Abdominal fat (vs. gluteal) is an independent predictor of metabolic disease and mortality, even in patients with a BMI less than 25. The chance of developing metabolic syndrome (of which abnormal glucose metabolism is a part) is increased in women with a waist size over 35 inches and over 40 inches in men. Another measurement of fat distribution is the waist to hip ration which should be less than 0.8 in women and less than 1.0 in men. Belly fat loss is promoted by a combination of diet and exercise. Patients who have a BMI of greater than 25 reduce their risk of dying as long as they are fit. There are individuals who have a BMI significantly greater than 25 who have very little body fat—some college and professional football running backs are in this category.

If I’m overweight, how many pounds do I have to lose to see my sugar levels change?

Keeping near your ideal body weight is your best bet to have normal blood sugar levels. For women, an increase of BMI from 21 to 22 doubles the relative risk of diabetes; in men it takes an increase of BMI from 22 to 23.5. This amounts to about 15 pounds on average for men and women. The bottom line is, if you are diabetic, you need to lose weight to the point that your blood sugar levels normalize. In the U.S. 80 percent of cases of type 2 diabetes are due to obesity. There are cases where people who may or may not be obese develop diabetes acutely. This is often due to an underlying infection which has developed. These patients experience weight loss due to dehydration; high levels of blood glucose exceed the kidneys’ ability to handle glucose, and water is pulled out of the body by the osmotic force of glucose (since we can only excrete urine as a liquid--and not as raw glucose). The amount of weight loss can be 20 pounds or more in a manner of days. In these cases, patients also present with symptoms of extreme thirst and hunger and marked increases in urination.

I’m thin, do I get a hall pass on diabetes?

Thin people can have diabetes, so being slender doesn’t confer immunity to developing the disease. People can have type 1 diabetes regardless of their weight. Since type 1 diabetes is related to a loss of insulin producing cells in the pancreas, weight loss would not be expected to help patients with this type of diabetes, as a general rule. Thin patients who are elderly have often lost muscle mass and replaced it with fat, so weight loss wouldn’t be expected to help this group of patients, either. Weightlifting to promote the formation of more muscle mass would be a better approach in these cases.

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Harold L. Kent, MD, Bariatric & General Surgery, is owner of Georgia Coast Surgical & Med Spa; 3226-F Hampton Avenue, Brunswick, Ga. You can reach him at 912-264-9724 or check out Georgiacoastsurgical.com, Facebook: Georgia Coast Surgical Med Spa & More.

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