Diabetic Neuropathy: Preventing And Reversing The Damage
Imagine living with the haunting possibility that one day, you may lose all feeling in your feet and that this lost sensation could ultimately lead to ulceration, infection, and even amputation of your unsalvageable limbs. This grim but very real condition is called diabetic peripheral neuropathy (DPN), and according to the National Institute of Diabetes and Digestive and Kidney Disease 60-70 percent of diabetics suffer some kind of nerve damage. That means as the number of type 2 diabetics continues to spiral out of control, we are facing a growing population suffering from pedal disasters like these. What’s tragic is that with all we now know about diabetes, many of these conditions are preventable and largely reversible when they do occur. To help you prevent DPN or reverse the damage if you are already suffering, in today’s blog I will review some of the issues that lead to the onset of the condition and outline some simple dietary measures and supplements you can take to properly support your feet and reverse the damage. Sadly, these conditions typically begin with one major medical assumption: Diabetes can be controlled by medicine alone. Controlling Diabetes with Medication: Can it Be Done? In my opinion, one of the biggest misconceptions in modern medicine is the assumption that diabetes can be controlled by medication alone. The truth is that it simply can’t be. Somehow our culture has developed this fantasy that people can eat anything they want, do no exercise, and any health complications will be resolved with a few pills or injections. Nothing could be further from the truth. On the surface it may appear that diabetes can be successfully treated with pharmaceuticals. Fasting blood sugar and hemoglobin A1C levels both seem to improve. And while these a Continue reading >>
Type 2 Diabetes And Alcohol: Proceed With Caution
Alcohol can worsen diabetes-related nerve damage.(RON CHAPPLE STOCK/CORBIS)Hoping for a beer at the ball game, or a glass of wine with dinner? If you have type 2 diabetes, that's probably OK as long as your blood sugar is under control, you don't have any complications that are affected by alcohol (such as high blood pressure), and you know how the drink will affect your blood sugar, according to the American Diabetes Association. An alcohol-containing drink a day might even help your heart (though if you don't already drink, most experts say that's not a reason to start). In moderation, alcohol may cut heart disease risk According to a study by researchers at the Harvard School of Public Health, women with type 2 diabetes who drank relatively small amounts of alcohol had a lower heart-disease risk than those who abstained. A second study found that men with diabetes had the same reduction in heart risk with a moderate alcohol intake as non-diabetic men. In general, the recommendations for alcohol consumption for someone with type 2 diabetes are the same as anyone else: no more than two drinks per day for men and no more than one drink per day for women. (Make sure to measure: A drink serving is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor such as scotch, gin, tequila, or vodka.) People with diabetes who choose to drink need to take extra care keeping food, medications, alcohol, and blood sugars in balance. Janis Roszler, RD, a certified diabetes educator in Miami, Fla., recommends: Mixing alcoholic drinks with water or calorie-free diet sodas instead of sugary (and calorie- and carbohydrate-laden) sodas and other mixers. Once you have had your drink, switch to a non-alcoholic drink, such as sparkling water, for the rest of the evening. Make sure yo Continue reading >>
Does Drinking Diet Soda Increase Your Blood Sugar?
If you're watching your blood sugar levels, you're probably aware that drinking regular soda can quickly cause your blood sugar levels to spike due to the large amounts of easily absorbed sugars it contains. But you might not be aware that diet soda may also have an effect on your blood sugar levels, although research in this area isn't conclusive. Drinking diet soda by itself isn't likely to cause spikes in your blood sugar levels. A study published in "Diabetes Care" in December 2009 found that drinking diet soda had the same effect on blood sugar and insulin levels as drinking carbonated water. When consumed along with carbohydrates in the form of glucose, however, the diet soda did increase the amount of a substance called GLP-1 in the blood that may delay stomach emptying and minimize the effect of the carbohydrates on after-meal blood sugar levels, although more research is needed to verify this effect. Fasting Blood Sugar Consuming diet soda at least once a day was associated with an increased fasting blood sugar level and a higher waist circumference compared to not consuming any soda, according to a study published in "Diabetes Care" in April 2009. This translated to a 67 percent higher chance of developing type-2 diabetes and a 36 percent higher risk for metabolic syndrome. Another study, published in the "American Journal of Clinical Nutrition" in April 2012, compared the effects of drinking diet soda on people following either a healthier diet or a typical Western diet and found that people following the healthier diet had a lower risk for metabolic syndrome than those following the Western diet. In addition, the study indicated that drinking diet soda sometimes, but not always, increased the risk for metabolic syndrome somewhat even when following the healt Continue reading >>
Now Let’s Talk Lower A1c
JARDIANCE is a prescription medicine used along with diet and exercise to lower blood sugar in adults with type 2 diabetes, and also to reduce the risk of cardiovascular death in adults with type 2 diabetes who have known cardiovascular disease. JARDIANCE is not for people with type 1 diabetes or for people with diabetic ketoacidosis (increased ketones in the blood or urine). Dehydration. JARDIANCE can cause some people to have dehydration (the loss of body water and salt). Dehydration may cause you to feel dizzy, faint, light-headed, or weak, especially when you stand up. You may be at a higher risk of dehydration if you: have low blood pressure, take medicines to lower your blood pressure, including water pills (diuretics), are on a low salt diet, have kidney problems, are 65 years of age or older. Ketoacidosis (increased ketones in your blood or urine). Ketoacidosis is a serious condition and may need to be treated in the hospital. Ketoacidosis may lead to death. Ketoacidosis occurs in people with type 1 diabetes and can also occur in people with type 2 diabetes taking JARDIANCE, even if blood sugar is less than 250 mg/dL. Stop taking JARDIANCE and call your doctor right away if you get any of the following symptoms, and if possible, check for ketones in your urine: nausea, vomiting, stomach-area (abdominal) pain, tiredness, or trouble breathing. Serious urinary tract infections. Serious urinary tract infections can occur in people taking JARDIANCE and may lead to hospitalization. Tell your doctor if you have symptoms of a urinary tract infection such as a burning feeling when passing urine, a need to urinate often or right away, pain in the lower part of your stomach or pelvis, or blood in the urine. Sometimes people also may have a fever, back pain, nausea or vomit Continue reading >>
Understanding Fpg, Ppg, And A1c
When it comes to diabetes, there are a lot of numbers and initials to remember. So, maybe your health care provider has mentioned these terms to you and you weren’t exactly sure what they meant. Or, maybe they are brand new to you. Either way, understanding what FPG, PPG, and A1C mean can be very important when you are trying to reach your blood sugar goals. A1C measures how well your blood sugar has been controlled over the past 2 to 3 months. It also gives you an idea of how well your overall diabetes care plan is working. Your health care provider will be checking your A1C on a regular basis. FPG is your “fasting plasma glucose (sugar)”. This is your blood sugar when you have been “fasting” (not eating) for at least 8 hours. You may be checking this in the morning when you wake up. PPG is your “postprandial plasma glucose (sugar)”. This is your blood sugar level about 1 to 2 hours after you eat. It measures blood sugar spikes that happen after you eat. What do these numbers have in common? Your A1C tells you how well your PPG and your FPG have been controlled over the past 2 to 3 months. Or, to put it another way, A1C control=FPG control & PPG control. Why are these numbers important? To help measure how you are doing with your diabetes care, your health care provider will set a goal for what your A1C should be and will measure A1C every 2 to 3 months in most cases or at least twice a year if you are meeting your treatment goals. Your A1C gives you a good idea of your blood sugar control over time. In general, your goal is to keep your blood sugar level as close to your goal as possible. This can help reduce the risk of some diabetes-related problems, like problems with the eyes (diabetic retinopathy), and the nerves in places like the hands and feet (n Continue reading >>
Endocrinology Frequently Asked Questions
In this section are answers to questions about endocrine-related diseases. There are separate sections for diabetes, weight management, pituitary problems and bone problems. Questions about Diabetes Questions about Pituitary Problems Questions about Bones What is hemoglobin A1c? This is a type of blood test. A hemoglobin A1c percentage is important because it is the only way to know how well patients are controlling their diabetes over time. Based on blood tests taken over a period of two or three months, doctors can estimate patients' average blood sugar levels. The goal for most diabetics is an A1c of less than 7%. This is roughly equivalent to an average blood sugar level of about 150 mg/dl. An A1c of 9% indicates an average blood sugar level of about 210 mg/dl. Here's how blood sugar works in the body. Glucose (blood sugar) circulates in the blood after food is absorbed in the intestine. A small amount normally combines with the hemoglobin molecule (A1c). Hemoglobin is the red-colored protein in red blood cells that carries oxygen to the rest of the body. It operates in direct proportion to the amount of glucose in the blood. The glucose remains with the hemoglobin molecule until the individual's red blood cells die - usually between two and three months. When the patient's blood is analyzed for hemoglobin A1c, the resulting value number provides an estimate of the level of glucose over that time period. How do I properly treat a low blood sugar reaction? Should I eat a chocolate bar to bring my sugar back up? Chocolate is not usually the best choice because the fat in it slows down the absorption of the sugar. Treat a low blood sugar reaction with some type of fast-acting sugar, such as glucose tabs, four ounces of juice, four ounces of nonfat milk or a half can of Continue reading >>
Drinking Wine Is Linked To A Lower Risk Of Diabetes
TIME Health For more, visit TIME Health. Drinking alcohol—especially wine—every few days may help protect against type 2 diabetes, suggests a new study published in the journal Diabetologia. People in the study who drank three to four days a week were about 30% less likely to develop diabetes than those who drank less than once a week. This isn’t the first study to find a link between drinking moderately—having up to 7 drinks a week for women and up to 14 drinks a week for men—and a reduced diabetes risk, compared to not drinking at all. (Heavy drinking, however, is known to increase the risk of diabetes.) For the new study, researchers analyzed data from more than 70,000 healthy Danish adults who were surveyed about their health and drinking habits around 2007. They tracked them for five years to see who developed type 2 diabetes. People who had the lowest risk for diabetes were those who drank alcohol at moderate—and slightly more than moderate—levels. Men who drank 14 drinks a week had a 43% lower risk of diabetes than men who did not drink at all; women who drank nine drinks a week had a 58% reduced risk. TIME Health Newsletter Get the latest health and science news, plus: burning questions and expert tips. View Sample Sign Up Now The timing of those drinks also mattered. Drinking three to four days a week was linked to the biggest risk reduction. For women, very infrequent drinking (less than one day a week) was also associated with slightly lower diabetes rates, compared to being a lifetime abstainer. “For the same total weekly amount of alcohol, spreading it out on more days is better than drinking it all together,” said lead author Janne Tolstrup, professor of epidemiology and intervention research at the University of Southern Denmark’s Nati Continue reading >>
Is It Safe To Mix Metformin And Alcohol?
If you’re taking metformin to treat your diabetes, you may be wondering how this drug affects your ability to drink safely. Drinking alcohol can affect your diabetes symptoms directly, but there are additional risks if you drink alcohol with metformin. This article gives you information on how alcohol interacts with metformin and also how drinking alcohol can affect your diabetes. With any medicine you take, you should be aware of interactions that can happen if you use other substances. Metformin and alcohol can interact to increase your risk of harmful effects. You are at much greater risk of these effects if you frequently drink a lot of alcohol or you binge drink (drink a lot in short periods). These effects include an extremely low blood sugar level, called hypoglycemia, and a condition called lactic acidosis. Hypoglycemia Drinking alcohol while you’re taking metformin may cause extremely low blood sugar levels. Some symptoms of low blood sugar levels can be similar to symptoms of having too much alcohol. These include: drowsiness dizziness confusion Tell the people who are with you while you drink that you have diabetes. They can help you watch for these symptoms. If you or the people around you notice these symptoms, stop drinking and eat something right away to help increase your blood sugar level. If your symptoms of hypoglycemia are severe, such as losing consciousness, and you do not have a glucagon hypoglycemia rescue kit, someone with you should call 9-1-1. A glucagon hypoglycemia rescue kit includes human glucagon (a natural substance that helps balance your blood sugar level), a syringe to inject it, and instructions. You can use this kit for severe hypoglycemia when eating food will not help. If you are not familiar with this kit, talk to your doctor Continue reading >>
Hemoglobin A1c Test (hba1c)
Hemoglobin A1c, often abbreviated HbA1c, is a form of hemoglobin (a blood pigment that carries oxygen) that is bound to glucose. The blood test for HbA1c level is routinely performed in people with type 1 and type 2 diabetes mellitus. Blood HbA1c levels are reflective of how well diabetes is controlled. The normal range for level for hemoglobin A1c is less than 6%. HbA1c also is known as glycosylated, or glycated hemoglobin. HbA1c levels are reflective of blood glucose levels over the past six to eight weeks and do not reflect daily ups and downs of blood glucose. High HbA1c levels indicate poorer control of diabetes than levels in the normal range. HbA1c is typically measured to determine how well a type 1 or type 2 diabetes treatment plan (including medications, exercise, or dietary changes) is working. How Is Hemoglobin A1c Measured? The test for hemoglobin A1c depends on the chemical (electrical) charge on the molecule of HbA1c, which differs from the charges on the other components of hemoglobin. The molecule of HbA1c also differs in size from the other components. HbA1c may be separated by charge and size from the other hemoglobin A components in blood by a procedure called high pressure (or performance) liquid chromatography (HPLC). HPLC separates mixtures (for example, blood) into its various components by adding the mixtures to special liquids and passing them under pressure through columns filled with a material that separates the mixture into its different component molecules. HbA1c testing is done on a blood sample. Because HbA1c is not affected by short-term fluctuations in blood glucose concentrations, for example, due to meals, blood can be drawn for HbA1c testing without regard to when food was eaten. Fasting for the blood test is not necessary. What Are Continue reading >>
The 30 Days No Alcohol Experiment: Part 1 (what Happens When You Quit Alcohol Cold Turkey).
It was in a podcast episode last month with James Swanwick that a crazy thought entered my mind. During the podcast (yeah, this is a mouthful) “How Quitting Alcohol Helped Today’s Guest Lose 30 Pounds, Make More Money, Attract Better Friends And Lovers, And Got A Job Hosting SportsCenter on ESPN (And Your Formula For Reducing or Quitting Alcohol)”… …I asked James if he actually got any blood testing before and after quitting alcohol. He said no (but he wished he had). So after I recorded the podcast, I e-mailed the good folks at WellnessFX, and said, “Hey look – it would be an incredibly interesting experiment to take some guy or girl who is drinking alcohol pretty liberally and to test their blood biomarkers, then have them quit alcohol for 30 days, and then re-test – just to see what happens inside your body when you quit alcohol for 30 days.” Within about 5 minutes, I got an e-mail back. They said, “Let’s do it.” Get The Low Carb Athlete - 100% Free!Eliminate fatigue and unlock the secrets of low-carb success. Sign up now for instant access to the book! Not only that, but WellnessFX graciously offered their flagship $198 “Baseline Package”, which includes an advanced biomarker analysis and an intuitive health dashboard to track the results. My next task? Find a willing, drinking victim who would not only give up alcohol for 30 days, but would do it between the celebratory holiday time frame of Thanksgiving to Christmas day and be willing to have all their health results publicly released here on BenGreenfieldFitness.com. In other words, they’d need to not only sober up cold turkey, but also be a glutton for some pretty serious self-control under intense public scrutiny. ———————————— How To Find A Crazy Person Who Continue reading >>
10 Facts About The Hba1c (a1c) Blood Test
If you are a diabetic or have recently been diagnosed, then you will be familiar with the HbA1C test. It is one of the most effective methods of monitoring glucose control in diabetes management. Insurance companies may also request this test before covering a diabetic and there is good reason that it is the test of choice these days. It is not a snapshot of your blood glucose levels at the time of taking the blood sample. Rather it gives you an idea of your blood glucose levels over a period of a few months. Measures glucose in blood cells Most other glucose tests measure the amount of glucose circulating in your blood or being passed out in the urine at the time when the sample was collected. It can change within hours. However, an A1c measures the changes in your red blood cells that arises with high blood glucose levels. It measures what is known as glycated hemoglobin which is within red blood cells. Hemoglobin is the important compound in red blood cells that carries oxygen through the bloodstream. When the glucose levels are high, it combines with the hemoglobin over time to form glycated hemoglobin. No fasting before test necessary Eating or drinking before most glucose tests can affect the results. For this reason these tests are done early in the morning before a person has their first meal. However, fasting is not necessary for an HbA1c. It can be done anytime during the day, before or after a meal, and still give an accurate result. The HbA1c test indicates the glucose levels over weeks and months, and does not change over hours and days. Even drinking a sugary drink before the test will not affect the result. No other preparation is required prior to the test. Nevertheless it is important to follow your doctor’s orders. Shows levels between 2 to 3 months Continue reading >>
Drunk Versus Diabetes: How Can You Tell?
Dispatch calls your EMS unit to the side of a roadway, where police officers have detained a driver on suspicion of driving under the influence of alcohol intoxication. You find the female driver handcuffed in the back seat of a police cruiser. She is screaming profanities and hitting her head against the side window. An officer tells you that she was weaving in and out of traffic at highway speed, and it took several minutes to pull her over. She was noncooperative and it took several officers to subdue her. She sustained a laceration to her head, which the officers want you to evaluate. The woman continues to swear at you as you open the car door. You note that she is diaphoretic and breathing heavily. You can smell what appears to be the sour, boozy smell of alcohol, even though you are not close to her. You can see that the small laceration near the hairline on her right forehead has already stopped bleeding. Her speech is slurred and she appears to be in no mood to be evaluated. The police officers are ready to take her down to the station to be processed for driving under the influence. Sound familiar? It should — this is a scene that is played out often in EMS systems. While it may seem initially that these incidents are not medical in nature, they really deserve close attention by the EMS personnel. In this article we will focus on the challenges of evaluating a patient who is intoxicated versus a patient who is experiencing an acute diabetic emergency. There have been numerous instances where EMS providers have exposed themselves to serious liability secondary to medical negligence. Let's take a closer look. Diabetes Diabetes is a serious disease that affects nearly 29 million people in the United States . Advances in diabetic care have resulted in an impr Continue reading >>
Yale School Of Medicine
Part of becoming an adult means making responsible decisions. It is a known fact that some people (with our without diabetes) choose to drink alcohol and/or do drugs. While we are certainly not encouraging the use of alcohol or drugs, it is important for a person with diabetes to be well educated on how alcohol and drugs can impact blood sugar and diabetes management so that smart and safe choices are made. What You Need to Know About Drinking Alcohol Alcohol is a "Legal Depressant" and causes the following: Significant increase in risk of hypoglycemia (your liver is busy processing alcohol and is not as good at putting out stored sugar when you blood sugar starts to drop) Impaired judgment and unable to make good decisions (short-term) Impaired coordination and reaction time (short term) Impaired vision (short term) Chronic liver disease, liver failure (long term) Increased risk for heart disease and stroke (long term) Increased risk of some cancers (long term) Overall it is SAFEST not to drink; however if you do drink know this: Do not bolus for alcohol Use sugar free mixers Never drink on an empty stomach and always eat while drinking Limit to 1 or 2 drinks in total Test blood glucose throughout Ensure that friends are aware of both drinking and diabetes Consume bedtime snack (do not bolus) or put on a temp rate (for pumpers) What You Need to Know about Tobacco & Nicotine Damages small blood vessels and can lead to kidney and nerve disease. People with diabetes are already at risk for this damage and therefore your risk is MUCH higher if you have diabetes and smoke cigarettes. Can increase your blood sugars and make diabetes more difficult to manage. Can increase your risk for heart attacks and strokes. Use in men can lead to impotence. DO NOT START SMOKING OR USING Continue reading >>
Nutrition Therapy For Diabetes: Effectiveness, Carbohydrates, And Alcohol: Effectiveness & Outcomes From Mnt For Diabetes
Please confirm that you would like to log out of Medscape.If you log out, you will be required to enter your username and password the next time you visit. Log out Cancel Box 1. Academy of Nutrition and Dietetics Evidence Review Summary Statements Used to Write Medical Nutrition Therapy Recommendations and the Nutrition Practice Guidelines For Type 1 and Type 2 Diabetes in Adults. Franz MJ, Horton ES Sr, Bantle JP et al. Nutrition principles for the management of diabetes and related complications. Diabetes Care 17(5), 490518 (1994). Bantle JP, Wylie-Rosett J, Albright AL et al.; American Diabetes Association. Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care 31(Suppl. 1), S61S78 (2008). Franz MJ, Powers MA, Leontos C et al. The evidence for medical nutrition therapy for Type 1 and Type 2 diabetes in adults. J. Am. Diet. Assoc. 110(12), 18521889 (2010). American Diabetes Association. Standards of medical care in diabetes 2012. A position statement of the American Diabetes Association. Diabetes Care 35(Suppl. 1), S11S63 (2012). Dyson PA, Kelly T, Deakin T et al. Diabetes UK Nutrition Working Group. Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes. Diabet. Med. 28(11), 12821288 (2011). Franz MJ. The evidence is in: lifestyle interventions can prevent diabetes. AJLM 1, 113121 (2007). Look AHEAD Research Group. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with Type 2 diabetes: four-year results of the Look AHEAD trial. Arch. Intern. Med . 179, 15661575 (2010). Wheeler ML, Dunbar SA, Jaacks LM et al. Macronutrients, food groups, and eating patterns in the management of diabetes: a systematic r Continue reading >>
Association Between Alcohol Intake And Hemoglobin A1c In The Korean Adults: The 2011-2013 Korea National Health And Nutrition Examination Survey
Abstract Although alcohol consumption is commonly encountered in clinical practice, few studies have investigated the clinical significance of alcohol intake on the use of the hemoglobin A1c (HbA1c) level. This study was performed to investigate the association between alcohol intake and HbA1c level in the general population. Among the 24,594 participants who participated in the 2011–2013 Korea National Health and Nutrition Examination Survey (KNHANES), 12,923 participants were analyzed in this study. We excluded diabetic patients currently taking antidiabetes medication. We compared the HbA1c level and proportions of patients with an HbA1c level of ≥5.7%, ≥6.1%, and ≥6.5% according to the fasting plasma glucose (FPG) concentration range and the amount of alcohol intake. The average amounts of daily alcohol intake were categorized into three groups: 0 g/day, <30 g/day, ≥30 g/day. Results The mean HbA1c level was 5.65%, and the mean FPG concentration was 95.3 mg/dl. The percentages of patients with an HbA1c level of ≥5.7%, ≥6.1%, and ≥6.5% were 42.6%, 13.4%, and 4.5%, respectively. The average amount of alcohol intake was 12.3 g/day. The percentages of subjects with alcohol intake 0, <30, and ≥ 30 g/day were 16.5%, 69.7%, and 13.8%, respectively. There was a significant positive relationship between alcohol intake and FPG concentration (P < 0.001), the prevalence of impaired fasting glucose (P < 0.001), and the prevalence of diabetes (P < 0.001). However, there was no significant relationship between the alcohol intake and HbA1c level. Overall, the adjusted HbA1c levels decreased across alcohol intake (5.70% ± 0.01%, 5.66% ± 0.01%, and 5.55% ± 0.01%) after adjustment for confounding factors such as age, sex, FPG concentration, college graduation, smo Continue reading >>
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- Type 1 diabetes as common in adults as children, but many adults misdiagnosed