Tips to Improve Insulin Resistance – Part 2

Western diets typically lack certain nutrients, such as magnesium, calcium, fiber, and potassium. These nutrients are especially important to maintain blood sugar levels. So, people with insulin resistance should seek out foods rich in these ingredients.

It's possible to enjoy foods from every food group even with insulin resistance. Understanding which foods increase blood sugar and which support insulin sensitivity is key.

The following foods help to support insulin sensitivity:

• non-starchy vegetables, such as broccoli and peppers
• high-fiber foods, such as beans and whole grains
• protein-rich foods, including lean meats, fish, and nuts
• foods rich in omega-3 fatty acids, such as salmon
• antioxidant foods, such as berries
• sweet potatoes, which are lower GI than other potatoes
• water, especially as a substitute for sweetened drinks
• unsweetened teas

Certain foods are more likely to raise blood sugar. These foods should be limited or avoided to help maintain a steady blood sugar level:

• sweetened beverages, including fruit juices, soda, and fountain drinks
• alcohol, particularly beer and grain alcohol, especially in large quantities
• grains, whether refined or whole, may worsen insulin sensitivity in some people
• starchy vegetables, such as potatoes, pumpkin, corn, and yams
• processed snacks and boxed foods
• excessive sugary sweets, such as cupcakes, ice cream, or chocolate bars
• white bread, rice, pasta, and flour, which is lower in fiber than whole grain
• dairy from cows, especially milk
• fried foods, even if the food is otherwise healthful
• foods high in saturated fats, including chocolate, butter, and salt pork

It's possible to sometimes eat foods on this list and still improve insulin sensitivity. The key is to limit these foods, and to replace them with more healthful options as often as possible.

By sticking to a diet rich in fiber and plants while being low in added sugars, it's possible to steadily improve insulin sensitivity. Daily exercise is also an important factor. These lifestyle changes can reduce the risk of type 2 diabetes, cardiovascular disease, and other health conditions.

Research shows ethnic and genetic factors may increase the risk of insulin resistance. However, lifestyle factors also make a big difference.

Making positive changes to lifestyle can greatly decrease the risk of insulin resistance.

Diet affects insulin resistance in at least two ways. Firstly, consuming too many calories whether from too much fat, sugar, or alcohol can make people gain weight. This increases the risk of insulin resistance.

Secondly, different food types affect insulin resistance. Some foods increase the risk and some foods reduce it.

Being overweight makes insulin resistance much more likely. People with lots of fat around their middle, in particular, are at an even greater risk. This is because fat secretes hormones and other substances that may interfere with insulin.

Excess fat around the waist is also linked to chronic inflammation. This can trigger a wide range of health problems, including insulin resistance.

Not getting enough exercise can affect the way insulin regulates glucose. Physical activity plays an important role in keeping blood sugar levels steady. It is a great idea to do light exercise after meals because exercise causes the muscles to use up glucose and they don't need insulin. This lowers blood sugar levels.

A number of other lifestyle factors affect insulin resistance, including:

• smoking
• sleep issues
• older age
• use of steroids

Tips to Improve Insulin Resistance – Part 1

Insulin resistance makes it harder for glucose to be absorbed. Insulin is produced in the pancreas and is a hormone that helps the body absorb glucose, keeping blood sugar levels in balance.

Insulin resistance causes problems for muscles, fat, and the liver, as they need glucose (sugar). Over time, insulin resistance can cause high blood sugar levels and damage cells.

Insulin resistance can lead to type 2 diabetes. People with insulin resistance are often diagnosed with prediabetes. They may need extra checks to make sure they don't develop diabetes.

Diet and other lifestyle choices can increase the risks related to insulin resistance. Making diet changes can reduce insulin insensitivity. This reduces the risk of type 2 diabetes and the health problems that go with it.

Glucose is a vital source of energy for the body. However, many of the body's cells can't absorb glucose on their own. The pancreas secretes insulin into the bloodstream. It joins up with glucose, and travels to the body's cells, where it attaches to insulin receptors. Insulin allows the cells to absorb glucose, making sure that:

• blood sugar levels remain at a safe level
• muscle, fat, liver, and other cells are able to get energy

Insulin resistance makes cells less sensitive to insulin. This means the body has to produce more insulin to keep blood sugar levels healthy.

If the pancreas is unable to keep up with the increased demand for insulin, blood sugar levels go up. When this happens, cells can't use all of the excess glucose in the blood. This leads to type 2 diabetes.

The pancreas releases insulin to help the body absorb glucose and maintain healthy blood sugar levels.

Following a healthful diet plan, such as the Mediterranean Diet, can improve insulin sensitivity.

This diet recommends eating lots of seasonal plant-based foods, having fruit as a dessert, and olive oil as the main source of fat. Fish, poultry, and dairy products should be eaten in moderation. It also advises people to have a very small amount of red meat and a little wine during meals.

How many calories you have each day should be based on weight loss goals and body size. Larger people need more calories, while smaller people need fewer calories. Generally, 2,000 calories per day is a healthy average to maintain weight.

The Mediterranean Diet is just one option for healthful eating. Other diet plans offer more specific ways to improve symptoms of insulin resistance.

One of the simplest ways to tackle insulin resistance is to eat foods with a low glycemic index (GI).

Low GI foods are digested slowly and don't produce as many blood sugar spikes. The difference between low GI and other foods is particularly noticeable when it comes to carbohydrates. Carbohydrates that have a high GI can cause blood sugar spikes and put more demand on the pancreas to make insulin.

As such, eating low GI foods is a good way to maintain balanced blood sugar levels.

Solutions for Depression

I had hoped that I would not have depression again, but after radiation for prostate cancer, depression comes and goes. This article keeps reminding me of my depression and why I dislike some doctors. Exercise, magnets, therapy, antidepressants, diets, herbs, music, and several other activities have all been tried and have shown success in the treatment of depression.

A recent study published in JAMA Internal Medicine reveals that that one out of every six people in the US has taken psychiatric drugs, and the great preponderance of those prescriptions are for antidepressants or anti-anxiety pills. The study found a significant increase in the use of antidepressants since 2009, when we wrote a blog post revealing that one in 10 people had taken antidepressants, a fact that we found alarming at that time. Now that statistic has risen to one out of every 8.5 individuals, with another one out of every 12 on sister drugs for anxiety. The majority of such prescriptions (85%) were refilled at least three times in the study year, meaning that these depressive crises and anxious states are not short-lived, one-shot deals.

As extraordinary as these numbers appear, they probably underestimate the actual numbers of people on antidepressant and anti-anxiety drugs, since the data relies on self-reporting from the 37,421 respondents, and you can bet that many were reluctant to reveal that they took such medications. It’s also interesting to note that the one in six figure represents an average for all subgroups, with twice as many women as men taking such drugs, and twice as many whites as other races. Among those over the age of 65, nearly one in every four people is on an antidepressant or anti-anxiety medication.

Exercise works just as well or even better than pharmaceuticals for alleviating depression and anxiety. So why on earth don’t doctors just prescribe exercise instead of prescribing the pills with dangerous side effects? Maybe it’s not just because they’re lazy or indoctrinated, but because they don’t want to encourage noncompliance. The sad truth is that when depression is severe, patients often can’t muster the energy to start exercising, or to take a class, or to even call a friend. One of the symptoms of depression can be a kind of catatonia where doing anything that requires energy feels overwhelming. Depression famously takes to bed and wants to stay there.

Depression is famous for seeking short-term comfort, and for many depressed people, the thought of avoiding chocolate, wine, coffee, cupcakes and so on is just too much to bear.

In other words, depression and anxiety crave short-term, no-sweat solutions and pharmaceuticals seem to suit the bill. Patients are willing to deal with side effects and with health risks in hope of finding some fast relief. And while the efficacy of antidepressant pills may be dismal for many patients, some do find they get a significant mood lift from them. Likewise, anti-anxiety medications often work fast, fueling continuing demand for them. Theoretically, prescription drugs might work as a short-term bridge until the patient is stabilized enough to switch to something that actually enhances health (like exercise), instead of continuing on medications that could potentially destroy it. (The problem, of course, is that the switch over doesn’t happen. Rather, the doctor writes out another prescription refill, leaving the patient to continue the same old unhealthy routines.)

I have been fortunate to avoid antidepressants and my depression does not last for long periods of time. I have only had one doctor try to prescribe an antidepressant and when I refused, he insisted. I told him that I would not fill the prescription as I had other ways to help my depression and prevent myself from developing severe depression. I did tell him that if that did happen, I would let him know and consider taking an antidepressant.

Medicare Putting More Diabetics at Risk

A new survey from the American Association of Diabetes Educators (AADE) found that Medicare’s Competitive Bidding Program (CBP) significantly reduced beneficiary choice and access to commonly used diabetes testing supplies. The lack of choice forces beneficiaries to switch to unfamiliar or unsuitable testing systems, and can have dire health consequences.

AADE’s survey is the latest in a continuous round of reports by AADE and others pointing out the inherent problems with the CBP. Last year, a National Minority Quality Forum report showed a direct link to increases in mortality and complications, inpatient admission and supplier costs. The unintended consequences from switching testing supplies results in diminished or ceasing altogether of blood sugar testing, leading to an increased risk for complications such as blindness, kidney damage, cardiovascular disease and lower-limb amputations.

The new survey reinforces AADE secret shopper surveys done in 2011 and 2013 showing the same downward trend in availability and access.

“Evidence continues to show that the competitive bidding process is failing people with diabetes and putting them at unnecessary risk,” said Kellie Antinori-Lent, a diabetes clinical nurse specialist at the University of Pittsburgh Medical Center. “Patient safety and choice must come first.”

Key findings from the survey include:

• The number of manufacturers making diabetes testing supplies (DTS) available under National Mail Order (NMO) has fallen 50 percent since the start of the Competitive Bidding Program (CPB)
• The number of diabetes testing systems available under NMO is less than half the number available in 2009 before the CPB started
• Many suppliers do not offer models covering 50 percent of the market share of the DTS
• Suppliers do not provide consistent information about inventory to customers

The Centers for Medicare and Medicaid Services (CMS) established the competitive bidding program for mail-order suppliers of diabetes testing equipment in January 2011. Soon after, widespread anecdotal reports suggested that the suppliers were denying access to the specific brands and types of equipment promised to be available on Medicare.gov. The most recent study showed some improvements, finding fewer discrepancies between the information provided on Medicare.gov and what is available to consumers.

To ensure beneficiary safety and well-being, a complete review of the program is necessary. AADE applauds the recent announcement by CMS to delay Round 2019 of the Competitive Bidding Program in hopes that the process can be overhauled to reflect evidence based data and best practices. Beneficiaries should have access to their preferred testing supplies, directed by their healthcare team.

Older Women Using Statins at Higher Risk of Diabetes

Even though this study is from Australia, it still applies to older women in the United States. According to a University of Queensland (UQ) study, older Australian women taking cholesterol-lowering statins face a significantly increased risk of developing diabetes.

UQ School of Public Health researcher Dr Mark Jones said women over 75 faced a 33 per cent higher chance of developing diabetes if they were taking statins. The risk increased to over 50 per cent for women taking higher doses of statins.

"We found that almost 50 per cent of women in their late seventies and eighties in the study took statins, and five per cent were diagnosed with new-onset diabetes," Dr Jones said.

"Statins are highly prescribed in this age group but there are very few clinical trials looking at their effects on older women.

"The vast majority of research is on 40- to 70-year-old men."

Statins, a class of drugs that lower cholesterol in the blood, are prescribed to reduce the incidence of cardiovascular events such as heart attacks and strokes.

"What's most concerning was that we found a 'dose effect' where the risk of diabetes increased as the dosage of statins increased.

"Over the 10 years of the study most of the women progressed to higher doses of statins," Dr Jones said.

"GPs and their elderly female patients should be aware of the risks.

"Those elderly women taking statins should be carefully and regularly monitored for increased blood glucose to ensure early detection and management of diabetes."

The research was based on prescription and survey data from 8372 women born between 1921 and 1926 who are regularly surveyed as part of the Women's Health Australia study (also known as the Australian Longitudinal Study on Women's Health).

The research is published in Drugs and Ageing.

Avoid Diabetes Scams

This FDA warning came a little late for me, but at least I deleted the attempts to put false information comments on one of my blogs. The person was claiming that he was cured of type 1 diabetes and was willing to provide the information for a “fee.” When it didn't post the first time, it was repeated exactly twice more and then he must have realized that comments were moderated and he stopped. The only thing I could conclude was that since I am using insulin, he must have felt that I was a type 1 and did not believe I was a type 2. I get this quite often from people that believe if you are using insulin, you must be a person with type 1 diabetes.

Next, he went to my profile page, emailed me the same message, and did asked why I would not approve any of his comments. This showed his arrogance as far as I was concerned and told me that he did not have type 1 diabetes to begin with and was just pushing a product to separate money from me. I may not always be the brightest bulb in the lot, but I am not stupid, and this joker really ticked me off.

The FDA warning can be read here. I will quote a part of it:

“Sound Too Good To Be True? Then it's probably a scam. Watch out for these and similar red flags:

• "Lowers your blood sugar naturally!"
• "Inexpensive therapy to fight and eliminate type II diabetes!"
• "Protects your eyes, kidneys, and blood vessels from damage!"
• "Replaces your diabetes medicine!"
• "Effective treatment to relieve all symptoms of diabetes!" 
• "Natural diabetes cure!"

As the number of people diagnosed with diabetes continues to grow, illegally marketed products promising to prevent, treat, and even cure diabetes are flooding the marketplace.

“Products that promise an easy fix might be alluring, but consumers are gambling with their health. In general, diabetes is a chronic disease, but it is manageable. And people can lower their risk for developing complications by following treatments prescribed by health care professionals, carefully monitoring blood sugar levels, and sticking to an appropriate diet and exercise program.”

Even with the FDA monitoring things, people with diabetes will not listen, but will continue to believe in a miracle cure. Even recently, I had a fellow person with type 2 diabetes ask why the doctors continue to hide the cure. When I said the doctors are not the ones to blame, he snorted and said we can't expect them to expose the cure, because then they won't have patients to treat.

Yet, these are the people that will buy the scams and blame the doctors when they receive harm, even if their doctors warned them against the scam.

Sodium Use Rising in People with High BP

According to a study scheduled for presentation at the American College of Cardiology's 66th Annual Scientific Session, researcher say that despite recommendations to limit sodium intake to support a heart-healthy lifestyle, daily sodium intake significantly increased in Americans with high blood pressure from 1999-2012.

The study found people with high blood pressure consumed an average of 2,900 milligrams of sodium per day in 1999 and 3,350 milligrams per day in 2012, for an overall average daily sodium intake of 3,100 milligrams during the 14-year study period. That's more than twice the 1,500 milligram daily maximum recommended for people with high blood pressure in dietary guidelines issued by the U.S. Department of Health and Human Services and U.S. Department of Agriculture since 2005.

The increase appears to be driven by rising sodium intake among Hispanics and African-Americans, groups that historically showed lower sodium intake levels compared to whites but whose sodium consumption matched that of whites by the end of the study period. Groups with the lowest sodium intake included those with more advanced forms of heart disease such as a history of heart attack or stroke.

The researchers analyzed data from the National Health and Nutrition. Excess sodium consumption increases the risk of heart disease because it draws additional water into the bloodstream, raising the volume, and consequently, the pressure, of the blood as it flows through blood vessels. This increased blood pressure creates strain on the heart and cardiovascular system.

Elena Dolmatova, MD, a resident at Rutgers New Jersey Medical School and the study's lead author states, "We need to find a way to address this so that the message actually gets to people. People shouldn't wait until they have a heart attack before taking action to limit sodium."

Dolmatova and her colleagues extracted the records of 13,000 people participating in the survey between 1999-2012 who indicated they had been diagnosed with high blood pressure. People in the sample were an average age of 60 and slightly more than half were men.

The team then analyzed the sodium intake of these 13,000 study participants based on questionnaires that provided a snapshot of their daily food intake. The analysis revealed that daily sodium intake increased among people with high blood pressure by more than 14 percent overall from 1999-2012. Intake increased by 26 percent and 20 percent among Hispanic and African-American participants, respectively, compared to 2 percent in white Americans. White participants had the highest overall sodium intake across the study period and a markedly higher intake than other racial groups at the start of the study, but showed little change in sodium intake over time. All racial groups reported roughly the same daily sodium intake by 2012.

In general, men reported higher sodium intake than women, although both men and women increased their sodium intake over the course of the study at roughly the same rate.

Relative to all people with high blood pressure, those with the lowest sodium intake were people who had experienced a heart attack or stroke, were taking blood pressure medications, or who had diabetes, obesity or heart failure.

Although these findings suggest people with worse health conditions are likely more motivated to take dietary recommendations seriously, the researchers emphasized that reducing sodium intake is important for anyone with high blood pressure.

"For many diseases, lifestyle modification is the first and most effective step in treatment," Dolmatova said. "There are [many] medications for hypertension, but they all come at a cost and have side effects; we [the medical community] have to focus more effort on educating people to successfully implement these lifestyle modifications and thus decrease the use of medications."

U.S. dietary guidelines recommend a daily maximum of 1,500 milligrams of sodium for people with high blood pressure or a high risk of developing it, and a daily maximum of 2,300 milligrams (the amount in one teaspoon of table salt) for most other people. Since the majority of the typical American's daily sodium intake comes from prepared or processed foods, experts recommend cutting down on processed foods or switching to low-sodium or sodium-free products to reduce sodium intake. Other recommendations include selecting less salty items at restaurants, using less salt when cooking at home and tasting food before adding salt at the table.

One limitation of this retrospective study is that it relied on self-reporting by participants to measure both high blood pressure and dietary intake. In addition, because authors analyzed the data during the 12-year period from 1999 to 2012, the study does not reflect any dietary changes that might have occurred since the latest U.S. dietary guidelines were released in 2016.

Dolmatova will present the study, "Dietary Sodium Intake among United States Adults with Hypertension, 1999-2012," on Sunday, March 19, at 12:30 p.m. ET at the Prevention Moderated Poster Theater, Poster Hall C at the American College of Cardiology's 66th Annual Scientific Session in Washington. The meeting runs March 17-19.