June 24, 2017

Discussion on Dawn Phenomenon

As a person with type 2 diabetes, the following does affect me, but most of the time I have avoided it with adjustments to my insulin.  The biggest aid has been splitting my long acting insulin into two doses per the doctors instructions.
The dawn phenomenon is a normal, natural rise in blood sugar that occurs in the early morning hours, between roughly 4 and 8 a.m. The shift in blood sugar levels happens as a result of hormonal changes in the body.
All people experience the dawn phenomenon to one level or another, which can vary day by day. People without diabetes may never notice it happening, as a normal body's insulin response adjusts for the rise without intervention.
A person with diabetes is more likely to experience symptoms from the rise in blood sugar levels, however.
How does it affect people with diabetes?
Dawn phenomenon is a normal rise in blood sugar released by the liver. The release happens as the person's body is preparing to wake for the day.
The rise in blood sugar is normally handled with insulin. For people with diabetes, insulin is not produced in high enough quantities, or the body is unable to use the insulin properly.
As a result, a person with diabetes will feel the effects of having high sugar levels in the blood.
These effects can include: faintness, nausea, vomiting, weakness, disorientation, feeling tired, and extreme thirst.
Managing the dawn phenomenon
Managing blood sugar levels is nothing new to most people with diabetes. A combination of diet, exercise, and medication often help keep the symptoms and problems under control.
In the case of dawn phenomenon, there are some additional changes that may help prevent issues caused by the spike in blood sugar.
Some steps people with diabetes can take to manage the dawn phenomenon include:
   changing medication entirely or making adjustments with a doctor on existing medication
   avoiding skipping meals or medication doses
   avoiding carbohydrates around bedtime
   taking medication closer to bedtime and not at dinner time

Other steps include eating dinner earlier in the evening. After dinner, some light physical activity, such as going for a walk, jogging, or yoga, is encouraged.

It is likely that a person with diabetes will experience high morning blood sugar levels from time to time. Occasional, mild issues from dawn phenomenon are not too worrisome. However, if the frequency becomes much more regular, then it's time to call a doctor.

If blood sugar levels spike too high as a result of dawn phenomenon, the effects can range from mild to a life-threatening medical emergency.

Some complications that a person with diabetes may experience as a result of dawn phenomenon include:
   nerve damage
   damage to blood vessels
   organ damage
   ketoacidosis, an extremely dangerous buildup of acid in the bloodstream

People who experience repeated high blood sugar levels due to dawn phenomenon should see a doctor to prevent these consequences.

Do options differ between type 1 and type 2 diabetes?

Differences in dealing with dawn phenomenon depends more on the individual person than what type of diabetes they have or what their treatment plan is.

A person with type 1 diabetes may adjust the dosage or type of insulin to account for any changes overnight. In other cases where the person wears an insulin pump, they may adjust the pump to deliver extra insulin in the morning.

June 23, 2017

Statins May Not Be Effective As We Thought

Statins, the popular cholesterol-fighting medication, might not be as effective as previously believed in protecting seniors with no history of heart disease, according to a study published Monday.

NYU Langone Medical Center researchers looked at 2,867 healthy older adults who were taking statins and found no evidence to suggest they were living any longer as a result.

This was published in JAMA Internal Medicine.

Statins are sold under the generic name Pravastatin and under brand names such as Lipitor, Crestor and Zocor.

“Our study argues that the benefits of initiating statins in older patients, particularly those over 75, may not outweigh the risks,” said lead author Dr. Benjamin Han.

Potential side effects of statins include muscle pain, liver damage and increased risk of Type 2 diabetes, according to the Mayo Clinic.

“As the number of older adults in the United States is rapidly increasing, it is more important than ever that we improve our understanding of preventative interventions in aging patients, and the possible side effects and risks that accompany them,” Han said.

Reps for the makers of Lipitor and Zocor could not be immediately reached for comment on Monday.

A spokeswoman for Crestor’s maker AstraZeneca said: “The safety and efficiency of Crestor has been well established in more than 120 ongoing or completed clinical trials involving more than 67,000 patients worldwide over the past 13 years.”

June 22, 2017

Diabetes Words and Phrases to Know

Aerobic exercise: Any rhythmic physical activity that uses large muscle groups and causes the heart and lungs to work harder than when your body is at rest. Also called cardio exercise, it’s been proven to lower blood sugar levels.

Artificial sweeteners: Also called non-nutritive sweeteners, includes low-calorie or non-caloric sweeteners or sugar substitutes.  These add a sweet flavor with fewer calories than table sugar, corn syrup, or fruit juice concentrates.  Examples include aspartame (NutraSweet and Equal), sucralose (Splenda), acesulfame potassium, neotame, and saccharin (Sweet'N Low).

Blood sugar: Also called blood glucose, this is the sugar that's in your bloodstream.  People with type 2 diabetes have too much blood sugar because insulin levels or actions aren’t working well.

Body mass index (BMI): A calculation based on your height and weight to categorize you as underweight, at a healthy weight, overweight, or obese.  BMI gives an idea of what your risks of health problems are based on your weight. You can calculate yours here.

Carbohydrates (carbs): A source of food your body uses for energy.  These include simple carbohydrates (such as honey, table sugar, and high-fructose corn syrup), as well as complex carbohydrates.  Complex carbs include starches (such as bread, pasta, rice, and potatoes) and dietary fiber (found in fruits and vegetables, nuts, and whole grains).

Carbohydrate counting: A meal-planning technique used by some people with diabetes.  It involves tracking the grams of carbohydrates in food to ensure that you don't eat more than a predetermined amount at a given meal.  You can count each serving of carbohydrates, since each serving of carbs is 15 grams.  If you choose this strategy, your doctor or diabetes educator will tell you how many total carbs to aim for in each meal or the total daily amount.

Cholesterol: A waxy substance found in your blood.  Your body naturally makes cholesterol, but it’s also found in foods that you eat (namely, animal products). Since diabetes and heart disease often go hand in hand, your doctor may want to keep closer tabs on your cholesterol levels.  She will want to make sure that your LDL ("bad") cholesterol -- which can lead to heart disease -- is not too high, and that your HDL ("good") cholesterol -- which is protective -- is high enough.

Diabetes educator: Also called a certified diabetes educator (CDE),this is a specialist who counsels people with diabetes about how to care for their condition.  Diabetes educators are often nurses, dietitians, doctors, or pharmacists.

Diabetes-friendly food: Any food that is healthy for someone with diabetes to have.  Because there are no special foods that a person with diabetes must eat, pretty much any healthy food can qualify.  Warning: Some packaged foods that aren't especially healthy may be labeled "diabetes-friendly," so always check nutrition labels.

Dietitian: Also called a nutritionist, this is an expert who is trained in the science of nutrition and advises others about healthy eating.  Some nutritionists are registered dietitians (RD or RDN); this credential means that someone has completed a higher level of training and passed a registration exam.

Endocrinologist: A doctor who specializes in diseases -- including diabetes -- that are related to hormones (such as insulin).

Fat: A nutrient you need for energy and other bodily functions. Although some fat is necessary, it's important not to overdo it.  Try to pick healthy fats (monounsaturated and polyunsaturated) over unhealthy ones (saturated and trans) as often as possible.

Fiber: A type of carbohydrate that the body can’t digest. It can’t be broken down into sugar.  You'll find it in fruit, vegetables, beans, whole grains, and nuts.  High-fiber foods tend to be bulky and require extra chewing, so they may boost your weight loss efforts by helping you feel fuller longer.  Fiber plays an important role in the digestive process, and getting enough may also help improve your blood sugar levels.

Food journaling (meal tracking): The process of writing down or otherwise recording what you eat.  Research has shown that keeping track of your food intake can help you lose weight.

Glucose tablets: Chewable sugar used by people with diabetes to raise their blood sugar quickly when it drops dangerously low (hypoglycemia).  These products come in a variety of flavors and forms such as gels, liquids, and powders, as well.  If you take a medication that makes you prone to this problem, your doctor may tell you to carry glucose tablets with you -- especially during exercise.

Hyperglycemia: An excess of sugar in the bloodstream (high blood sugar). People with high blood sugar (including those with type 2 diabetes) don't produce enough insulin, or their bodies have trouble using it.

Hypoglycemia: Blood sugar that is too low. It may cause shakiness, dizziness, confusion, or even fainting.  This problem is more common in people with type 1 diabetes, but it can happen to those with type 2 as well -- especially if you take certain medications.

Insulin: A hormone produced by the pancreas that helps the body use glucose (sugar) for energy.  People with type 2 diabetes either don't make enough insulin, or their bodies don't use it effectively.

Insulin resistance: This means that the body isn't properly using the insulin it produces.  Getting regular exercise -- both aerobic exercise and strength training-- can help with this problem.

Meal plan (meal planning): Any strategy used to map out what you're going to eat.  This term may refer to following a specific diet, or it may just indicate the process of thinking through what you plan to eat beforehand.

Metabolism: The process of converting food into the energy that allows your body to function.  People who have a fast metabolism (metabolic rate) use up calories more quickly than those with slower metabolisms.  One way you can increase your metabolism is by exercising.

Natural no-calorie sweeteners: Similar to artificial sweeteners, except these come from a natural source.  Stevia (Truvia, PureVia, etc.) is considered a natural sweetener because it comes from the stevia plant.

Obese: Refers to someone with a BMI of 30 or higher, who is carrying a large amount of excess body fat.  Too much body fat may cause or worsen health problems, including type 2 diabetes.
Overweight: Refers to someone with a BMI of between 25 and 29.9, who is carrying excess body fat.  Someone who is overweight has an increased risk of health problems such as type 2 diabetes.

Protein: A substance made up of amino acids that your body needs to function. You'll find protein in meat, poultry, fish, legumes, tofu, eggs, nuts, seeds, and dairy products.  Meats don't contain carbohydrates, so they won't raise your blood sugar.

Sodium: A mineral found in salt.  Getting too much -- as most Americans do -- can raise your blood pressure, and, in turn, raise your risk of heart attack and stroke.  Since these problems are often tied to diabetes, it's important to watch your intake.  Processed foods tend to be very high in sodium.

Starch: A type of carbohydrate found in grains, as well as in starchy vegetables such as peas, corn, beans, and potatoes.  Just like sugar (another type of carbohydrate), starch can raise your blood sugar; so it's important to pay attention to how much you're eating.

Strength training: Physical activity designed to build muscle strength or muscle mass.  Some examples include lifting free weights, working with weight machines, and exercising with resistance bands.  Also called resistance exercise, it can help make your body use insulin more effectively.

Sugar: A type of sweet-tasting carbohydrate. Includes glucose, fructose, and sucrose.

Sugar alcohols: A type of low-calorie sweetener that's often used in "diet" and "sugar-free" foods.  These usually end in "-ol."  Examples include erythritol, sorbitol, and xylitol.  Foods containing these sweeteners may still have carbs and can increase blood sugar, so be sure to check the nutrition label.  Sugar alcohols may cause stomach upset in some people.

Whole grains: Grains that have the entire grain kernel, including the nutrient-rich bran and germ.  Refined grains (such as white bread), on the other hand, have had the bran and germ removed and contain only the starchy endosperm. Whole grains have more fiber than refined ones, so they're digested more slowly and won't cause your blood sugar to rise as fast.