Health, Medicine & Nutrition
Type 2 Diabetes and Complications PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Dr. Sanjay Gupta   
Monday, 08 December 2014 12:55
For people with type 2 diabetes, uncontrolled blood sugar levels pose a serious health risk with a range of potential complications.

According to the U.S. Centers for Disease Control and Prevention, diabetes is the leading cause of kidney failure, new blindness, and leg and foot amputations unrelated to injury. It’s a major cause of heart disease, stroke, and nerve damage. Poor blood sugar control may also raise the risk for Alzheimer’s disease.

If you have type 2 diabetes, your body doesn’t use insulin properly to convert glucose into energy. As a result, blood sugar levels become elevated. This buildup of glucose, known as hyperglycemia, can damage blood vessels and vital organs. The A1C blood test is commonly used to see how well, on average, a patient’s blood sugar level has been managed over the past two to three months.

“A person’s A1C level is an excellent marker of complications,” said Joel Zonszein, MD, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City. “If you have a lower number, you’ll be healthier.” The American Diabetes Association recommends an A1C of 7 percent, or an average glucose level of 145 milligrams per decileter (mg/dL).

The following are three common types of complications that can occur when diabetes isn’t properly controlled over time.

Eye Damage (Retinopathy)

Diabetic retinopathy is the leading cause of new-onset blindness in adults. It occurs when blood vessels of the retina swell and leak fluid into the macula, where focusing occurs. The result, known as macula edema, causes blurred vision. A more serious form of eye complication, called proliferative retinopathy, occurs when new blood vessels form in the retina to replace damaged ones. Scar tissue can develop and cause the retina to become detached.

Fortunately, “this kind of damage doesn’t happen overnight,” said Stephanie Marioneaux, an ophthalmologist in Chesapeake, Va., and a clinical spokesperson for the American Academy of Ophthalmology. Vision loss can be prevented if the blood vessel damage is caught early enough through regular eye exams.

“If we’re seeing damage in the retina that means their blood sugar has been elevated for a while,” said Dr. Marioneaux.

Nerve Damage (Neuropathy)

When hyperglycemia damages blood vessels that feed oxygen and nutrients to the nerves, it can result in nerve damage or neuropathy. Common signs include tingling, pain, or numbness in the feet and hands.

Patients may develop blisters or sores on their feet that can spread infection to the bone and cause tissue death. These infections are very hard to treat and can result in amputation.

“If people are experiencing the numbness and tingling, they should be checking their feet regularly for any sores or wounds and get them seen by a doctor before they get infected,” said Priscilla Hollander, MD, an endocrinologist at the Baylor Endocrine Center in Dallas.

While A1C is “a great tool,” Betul Hatipoglu, MD, an endocrinologist at the Cleveland Clinic, said it’s not a replacement for daily blood sugar monitoring. “Keeping it level can decrease chances of terrible complications that could potentially cause you to lose your limbs,” said Dr. Hatipoglu.

Kidney Disease (Nephropathy)

Diabetes is the leading cause of chronic kidney disease in the United States. “About 10 percent of people with type 2 diabetes will develop [it],” said Dr. Hollander.

High blood sugar levels compromise the kidneys’ ability to properly filter waste products in the blood. Protein that’s useful to the body leaks into the urine, while wastes start to collect in the blood. Left untreated, this can lead to kidney, or renal, failure requiring a machine to filter the blood (known as dialysis) or a kidney transplant.

According to Hollander, it usually takes about 10 years for diabetic kidney disease to manifest, and it can be caught in the early stages. A simple urine test can detect excess protein in the urine. Other signs to look for include frequent urination, weight gain, and ankle swelling.

“The incidence is improving,” said Hollander. “And we’ve made a lot of progress by controlling blood pressure, which plays a big role in furthering kidney damage.”

For anyone with type 2 diabetes, as Dr. Zonszein points out, “the sooner you can catch that your blood glucose hasn’t been under control, the better you can prevent these complications.”

Last Updated: 04/24/2014

 
What to Do If You Have Hyperglycemia PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Everyday Health   
Thursday, 04 December 2014 11:42

Hyperglycemia is the technical term for when blood-glucose levels (or blood-sugar levels) are too high because the body isn't properly using or doesn't make the hormone insulin. The symptoms of hyperglycemia develop slowly, over a period of hours or even days. Hyperglycemia doesn’t even cause symptoms until glucose levels are significantly high  — above 200 milligrams per deciliter (mg/dL), or 11 millimoles per liter (mmol/L). The longer blood-glucose levels stay high, the more serious the symptoms become.

Symptoms of hyperglycemia include:
  • Blood glucose over 200 mg/dL
  • More urine output than usual
  • Increased thirst
  • Dry skin and mouth
  • Decreased appetite, nausea, or vomiting
  • Fatigue, drowsiness, or lethargy

If hyperglycemia goes untreated, it can cause:

  • Fruity-smelling breath
  • Nausea and vomiting
  • Abdominal pain
  • Shortness of breath
  • Dry mouth
  • Weakness
  • Confusion
  • Buildup of toxic acids (called ketones) in your blood and urine
  • Coma

The dangerously high blood-glucose levels of hyperglycemia can result from:

  • Not taking enough insulin
  • An illness such as a cold or the flu
  • An infection
  • Eating too much
  • Excessive stress
  • Taking certain medications

How to Avoid Hyperglycemia

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To avoid episodes of hyperglycemia, take your usual insulin exactly as prescribed by your doctor (do not skip a dose!) and eat regular, balanced meals.

Next Step: How to Treat Low Blood Sugar

 
Profile by Sanford opens retail location in Davenport PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Shawn Neisteadt   
Wednesday, 03 December 2014 14:58

Program offers research-based method for weight management

DAVENPORT, Iowa – Profile by Sanford is now open at 3010 E. 53rd Street in Davenport. This is the second store Iowa.  The Hawkeye state’s first Profile store is in Clive and opened in July.

Profile launched in Sioux Falls, South Dakota, opening its first store front in November 2012. Today, it has 16 locations in five states with several more planned openings by the end of 2014.

Profile was designed using a large body of clinical research to ensure a sustainable means to healthy weight loss. A clinical and scientific advisory board comprised of Sanford Health physicians and researchers oversaw the development of the Profile system.  Sanford Health is the largest, rural, not-for-profit health care system in the United States.

“This state-of-the-art weight-loss system has brought clinically-proven results to communities across the Dakotas, Minnesota and Nebraska,” said local store manager Justin Roberson. “I’m eager to see the results this nutritional program will have here in Davenport.”

The rapidly growing Profile system utilizes meal-replacement products, nutritionally complete food and qualified health coaches. In addition to members consuming both Profile-produced and grocery-store food, coaches develop customized plans for their clients and offer advice on nutrition, exercise and behavior.

Profile continues to focus on program advancements through the launch of new food products, such as three new pizza varieties available this fall. Profile is also on the cutting edge of technology, expanding to better assist members with measuring daily activity. A new fitness tracker will provide additional measurable data that will be helpful to members and coaches in helping to monitor progress toward goals.

In addition to face-to-face meetings, coaches are able to efficiently track members’ progress through the use of smart wireless technology. Each member is outfitted with wireless devices to measure progress, including tools to track body weight, measurement and blood pressure. These devices automatically upload to a secure server, where members and coaches can monitor improvement on the web or mobile applications. Printed options are also available to members.

According to the Centers for Disease Control and Prevention, more than 60 percent of the U.S. population is considered overweight or obese.

To learn more, visit profileplan.net or call (877) 373-6069.


About Sanford Health
Sanford Health is an integrated health system headquartered in the Dakotas and is now the largest, rural, not-for-profit health care system in the nation with locations in 126 communities in nine states. In addition, Sanford Health is in the process of developing international clinics in Ghana, Mexico and China.

Sanford Health includes 43 hospitals, 140 clinic locations and 1,360 physicians in 81 specialty areas of medicine. With more than 26,000 employees, Sanford Health is the largest employer in North Dakota and South Dakota. The system is experiencing dynamic growth and development in conjunction with nearly $1 billion in gifts from philanthropist Denny Sanford. These gifts are making possible the implementation of several initiatives, including global children's clinics, multiple research centers and finding cures for type 1 diabetes and breast cancer. For more information, visit sanfordhealth.org.

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How to Lose 20 Pounds PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Madeline Vann, MPH   
Wednesday, 03 December 2014 13:53
A focused strategy will help you reach your weight-loss goal. Counting calories and getting active will help.

Search online and you’ll find dozens of Web sites promising to tell you exactly how to lose 20 pounds (or more), often with hyped-up claims of speedy success, like losing the weight in 30 days or “just six weeks!” The reality is that losing 20 pounds is an achievable goal if you apply proven strategies, such as counting calories. This approach may take a bit longer than those miracle diets, but it will actually work and help you develop healthy habits to keep the weight off, and even lose more, if that’s your goal.

“Having a realistic weight goal makes good sense,” says dietitian Jenna Anding, PhD, RD, of the department of nutrition and food science in the Texas A&M System at College Station. “Eliminating 500 calories a day can help promote a one-pound-per-week weight loss. Increasing physical activity can also help promote weight loss.”

In order for counting calories to work, you will have to do a little math (it’s okay to cheat and use a calculator). If you want to lose 1 pound a week (it is safe to lose up to 2 pounds a week or 1 percent of your body weight, if you weigh more than 200 pounds), that means you need to cut out or burn through exercise about 500 calories a day. But remember not to eat less than 1,200 calories daily, so that your body doesn’t retreat into starvation mode. A reduction of at least 500 calories a day means you could lose a pound every week or 20 pounds in about five months.

Here are four diet truths to help you achieve your goals:

  • Cutting out sweet drinks is non-negotiable. Sweet tea, soda, and flavored and sweetened milks, waters, and coffees all have to go. Drink plain water, low-fat milk, and sugar-free drinks instead. A study of 810 adults between 25 and 79 years old showed that after 18 months, those who cut out sweet drinks had greater weight loss than those who cut down on food calories. One possible reason: While your body lets you know when it is full of food, there is no way for your body to tell you when you’ve maxed out on liquid calories.
  • Physical activity helps counting calories. Being physically active burns calories while it improves your overall health. Aim for 30 minutes a day most days of the week. A brisk 30- to 45-minute walk burns 100 to 200 calories. If you can burn 200 calories through exercise, you only have to cut out 300 calories in food or drink to reach your daily calorie-cutting goal.
  • Strategically eating less drops weight. A study of 811 overweight people who participated in four popular diets found that whether diets were low-fat, high-protein, or a combination didn’t matter — weight-loss success depends on cutting out calories. In fact, you can continue to eat filling portions if you simply replace high-calorie foods with low-calorie foods that contain a lot of water, such as fruits and vegetables. A study of 97 obese women who ate either a low-fat diet or a low-fat diet with additional fruits and vegetables found that those who emphasized fruits and veggies lost up to five pounds more.
  • Journaling leads to success. Counting calories is easier if you write down (or type in) what you eat, including serving sizes and details such as condiments you may have added. “Research has shown that exercise and journaling really make a difference in long-term weight management,” says Gail Curtis, assistant professor at Wake Forest University Health Sciences in Winston-Salem, N.C. A detailed journal will help you identify your successes and pinpoint where you can cut additional calories or replace high-calorie foods with low-calorie ones.

With dedicated work you can apply these truths to lose 20 pounds in 20 weeks or less. So get moving!

 
Can Cinnamon Help Treat Diabetes? PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Diana Rodriguez, Everyday Health   
Wednesday, 03 December 2014 13:47
Several studies have investigated the effects of cinnamon on blood sugar, but the results are mixed.

There are medications available to help manage type 2 diabetes and lower blood sugar levels. A diabetes-friendly diet and regular exercise can also help to keep type 2 diabetes under control. But some researchers suspect that there could be a more natural source of blood sugar control to help manage diabetes: cinnamon.

Some studies have investigated the effect of cinnamon on blood sugar levels, but there aren't enough of them or enough carefully compiled results — or consistency in those results — to draw hard and fast conclusions yet. "There's not very much research on it," explains Philip A. Kern, MD, an endocrinologist and director of the Barnstable Brown Diabetes and Obesity Center at the University of Kentucky College of Medicine in Lexington. But there is potential.

The studies that have tried to measure the effects of cinnamon on blood sugar levels in type 2 diabetes have been small and not well controlled. In general, a reliable study is one that is large (at least 500 to 1000 patients), has patients randomly assigned to different groups, and is double blind — meaning neither the researchers nor the subjects know who is getting the treatment. That type of detailed and careful research just hasn't been done on the subject of cinnamon’s role in diabetes, says Dr. Kern, adding that the results of the small studies that have been conducted "are all over the place."

"Some say that the cinnamon does lower blood sugar or improves some other measure — some studies report a benefit, and some studies don't report a benefit," says Kern. His initial reaction was dubious, he admits, but after studying what little research is available, the effects of cinnamon are "probably something deserving of a larger study."

For instance, one study suggests that cinnamon may be effective in lowering blood sugar levels because it has a similar effect on the body as insulin, the hormone that people with type 2 diabetes produce in insufficient amounts. 

Cinnamon: A Dash or a Dollop?

The amount of cinnamon needed to produce a positive effect is unclear. In some of the clinical trials, diabetic patients were given about 1 gram of cinnamon in a capsule — that amount of pure cinnamon is about the size of the tip of your pinkie finger.

Swallowing that much cinnamon powder would be downright painful (and probably not taste very good), so Kern says you shouldn't try to ingest cinnamon on your own in an effort to lower blood sugar. You also shouldn't chow down on a big cinnamon bun or sip a cinnamon latte, thinking you're getting a health benefit — even if additional research concludes that cinnamon is of benefit in lowering blood sugar and managing diabetes, Kern says you're still not getting a free pass for the sugar and calories.

So what's the take-away message? Kern believes it's not so much that people with diabetes should eat more cinnamon, but that "maybe [it] has a property that might be beneficial." He adds, "If you could figure out exactly what it is about cinnamon, you could design a drug that would target that beneficial property.”

So, Kern says, if anything does come of cinnamon as a blood sugar-lowering agent, the recommendations for patients with diabetes will be in the form of a new medication that has captured the properties of cinnamon, not necessarily dietary changes.

For more diabetes news, follow @diabetesfacts on Twitter from the editors of @EverydayHealth.

 
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