USDA and HHS have unveiled the seventh edition of the US Department of Agriculture Dietary Guidelines. There were a few changes, but lacked the changes needed to be in line with many of the Medical Associations' current positions. Only two associations have welcomed the new edition and the American Heart Association has said the improvement is still lacking for bringing sodium in line for everyone.
I do not understand why some of the other medical associations have not issued statements. But if they were to issue acceptance or rejection, they might have to agree with something they wish to avoid. The American Caner Society says the new guidelines could reduce the cancer risk.
To read the full copy of the latest dietary guidelines go here. I used Adobe
Reader to save a copy to my files. The seventh edition has six chapters and 16 appendices.
The first chapter labeled Introduction explains how the dietary guidelines were developed. This may be of interest for many.
Chapter two is Balancing Calories to Manage Weight.
Chapter three is Foods and Food Components to Reduce.
Chapter four is Foods and Nutrients to Increase.
Chapter five is Building Healthy Eating Patterns.
Chapter six is Helping Americans Make Healthy Choices.
There is over 90 pages of reading, but I will say it is well organized, but short of some reasonable specifics. There are many specifics and some welcomed discussions for ethnic specifics which should make this more useable than previous editions.
Linda Van Horn, PhD, RD, LD, from Northwestern University in Chicago, Illinois, chaired the 13-member Dietary Guideline Advisory Committee. For 18 months, the committee reviewed the scientific and medical literature regarding the role of diet and nutrition in health promotion and disease prevention.
One of the features in this edition is the emphasis on managing body weight from age two to elder ages. This includes eating patterns for balanced nutrition and also for vegetarian adaptions. The report includes recommendations for all ages as well as for those at risk for chronic diseases, a real plus
The recommendation presently generating the most discussion is about salt. The American Heart Association recently lowered the maximum from 2300 milligrams to 1500 milligrams. The USDA only lowered the maximum for those age 51 and older. If we are serious in reducing obesity and hypertension then the limit for all ages should be 1500 milligrams.
There are many areas that this report should have covered, but it is the most comprehensive report issued yet by the USDA and does have something for almost everyone. There will be disagreements and groups that will find fault; however, this report should be read and understood by everyone. It is the first time national action has been addressed for obesity.
Read some of the takes on the press release and report here by Medscape and here by Medicine Net. You may also have seen parts of this on the nightly news. There is much information about the report and represents views not in the actual report.
February 4, 2011
February 2, 2011
Suggestions for Doctors
Sometimes doctors are open to suggestions from patients and other doctors will never take suggestions from patients. But I will still make suggestions as most of my doctors have not turned them away completely. Some have even admitted that they like a few of them, but don't have the time or office staff time to put them into effect. That I do understand. Now I will need to ask some questions to find out if there is something I am able to do that would be accepted.
My main suggestion has been to have a list of acceptable web sites to get patients started in their research. Also a list of books about the disease, to be in the local library or ordered on line. These would vary by disease or illness. For this discussion I am talking about diabetes and the related complications, but this will involve more then just diabetes when I get started. I have worked on lists for one doctor recently and am encouraged again after reading a blog by Dr. Fran Cogen.
Her statement in the blog of “Families often walk into their appointments with reams of Internet papers and articles strongly suggesting a certain form of treatment.” When this is what doctors see and get, it is easy to understand why they are less than happy about the internet.
Dr. Cogen has an excellent discussion about information overload and why this is sometimes not a good thing. People on information overload often become incapable of making a simple decision. They have too many ideas to digest and this causes them to not make a decision.
Dr. Cogen also does not like “the paternalistic approach in which the physician and team reverts to the 'father knows best' mantra.” Many doctors do use this and even this is not always the best or most appropriate. Often the best decisions are made from a few well thought out possibilities that are discussed with the patient and/or their advocate.
I am taking this and trying to pare down the internet resources to a few good sources to help people find information and then ask the doctors to review the list and add or subtract from this list. This is going to take some time, but I am looking forward to see what reaction I will receive from some of the different doctors with the different specialties.
Of course, the diabetes, type 2, is complete, but I have a lot to do for the rest. I do believe that people are more internet conscious and savvy than ten or more years ago and people need good information. The doctors deserve consideration and not being buried in unrelated papers that have no bearing on the subject of the visit. I may even suggest that the doctors have a book list for patients to order through them.
There will always be changes to the sources as some sites shut down and other good sites appear. New books appear all the time and while many may be good, some are far better. Some of the current books will continue to be relevant as they are updated with revisions to stay current. Each type of diabetes is different and needs its own resources.
My main suggestion has been to have a list of acceptable web sites to get patients started in their research. Also a list of books about the disease, to be in the local library or ordered on line. These would vary by disease or illness. For this discussion I am talking about diabetes and the related complications, but this will involve more then just diabetes when I get started. I have worked on lists for one doctor recently and am encouraged again after reading a blog by Dr. Fran Cogen.
Her statement in the blog of “Families often walk into their appointments with reams of Internet papers and articles strongly suggesting a certain form of treatment.” When this is what doctors see and get, it is easy to understand why they are less than happy about the internet.
Dr. Cogen has an excellent discussion about information overload and why this is sometimes not a good thing. People on information overload often become incapable of making a simple decision. They have too many ideas to digest and this causes them to not make a decision.
Dr. Cogen also does not like “the paternalistic approach in which the physician and team reverts to the 'father knows best' mantra.” Many doctors do use this and even this is not always the best or most appropriate. Often the best decisions are made from a few well thought out possibilities that are discussed with the patient and/or their advocate.
I am taking this and trying to pare down the internet resources to a few good sources to help people find information and then ask the doctors to review the list and add or subtract from this list. This is going to take some time, but I am looking forward to see what reaction I will receive from some of the different doctors with the different specialties.
Of course, the diabetes, type 2, is complete, but I have a lot to do for the rest. I do believe that people are more internet conscious and savvy than ten or more years ago and people need good information. The doctors deserve consideration and not being buried in unrelated papers that have no bearing on the subject of the visit. I may even suggest that the doctors have a book list for patients to order through them.
There will always be changes to the sources as some sites shut down and other good sites appear. New books appear all the time and while many may be good, some are far better. Some of the current books will continue to be relevant as they are updated with revisions to stay current. Each type of diabetes is different and needs its own resources.
January 29, 2011
Are You Now A Person With Diabetes?
If you read the previous blog about “Are You An Undiagnosed Person With Diabetes?”, you will want to read this about what to do if you are diagnosed with prediabetes or diabetes. If you were not diagnosed with either of these, then consider that you must continue to undergo at least an annual test for diabetes. The older you are, the more important this becomes.
If you were diagnosed with Type 2 diabetes, then you will have more than likely been put on medications and been advised to watch your diet. Hopefully your doctor will have referred you to a dietitian and maybe to a diabetes educator. These should be specializing in diabetes or they may be less than useful to you. Occasionally you will encounter a nurse that specializes in diabetes and some of the complications from diabetes including depression and cardiovascular disease, but not limited only to these.
Start reading as much information as you are able. I suggest starting with two of my blogs here and here. One is about printed materials and the other about some of the many internet sources.
Do not go into panic mode. There are many tasks to accomplish and the more knowledge you obtain the easier dealing with diabetes it will be. First, you must make a lifestyle change. Some say severe, others say to do it gradually. This will depend on you and either way this change should be considered a permanent one as this will give you the best overall means to manage diabetes and prevent or delay its complications.
Next, if you have no medical limitations, you need to start an exercise regimen in something you like doing. Please talk to your doctor before starting. Your doctor may have advice you need to follow depending on your condition and weight.
If you have prediabetes, please do not take it lightly or dismiss it, and proceed as if you have diabetes because your pancreas is not functioning properly and some damage has been done. It is still possible to delay the onset of full blown diabetes and complications for many years, but only if you take this seriously and are able to follow a regimen of nutrition and exercise.
Read this blog for more details on insulin resistance. For a discussion of prediabetes read this and my blog here.
If you were diagnosed with Type 2 diabetes, then you will have more than likely been put on medications and been advised to watch your diet. Hopefully your doctor will have referred you to a dietitian and maybe to a diabetes educator. These should be specializing in diabetes or they may be less than useful to you. Occasionally you will encounter a nurse that specializes in diabetes and some of the complications from diabetes including depression and cardiovascular disease, but not limited only to these.
Start reading as much information as you are able. I suggest starting with two of my blogs here and here. One is about printed materials and the other about some of the many internet sources.
Do not go into panic mode. There are many tasks to accomplish and the more knowledge you obtain the easier dealing with diabetes it will be. First, you must make a lifestyle change. Some say severe, others say to do it gradually. This will depend on you and either way this change should be considered a permanent one as this will give you the best overall means to manage diabetes and prevent or delay its complications.
Next, if you have no medical limitations, you need to start an exercise regimen in something you like doing. Please talk to your doctor before starting. Your doctor may have advice you need to follow depending on your condition and weight.
If you have prediabetes, please do not take it lightly or dismiss it, and proceed as if you have diabetes because your pancreas is not functioning properly and some damage has been done. It is still possible to delay the onset of full blown diabetes and complications for many years, but only if you take this seriously and are able to follow a regimen of nutrition and exercise.
Read this blog for more details on insulin resistance. For a discussion of prediabetes read this and my blog here.
January 26, 2011
Are You An Undiagnosed Person With Diabetes?
Are you a person that is undiagnosed for diabetes? If you don't know if you have diabetes and are overweight and even normal weight, please read carefully. The number of undiagnosed persons is growing every day.
About 25 percent of the adult population has already developed insulin resistance. No one knows the number that are on their way to developing Type 2 diabetes. The following are some of the symptoms that may give you some guidance that will let you learn if you should get an appointment with your doctor for a definitive check.
Depending the the source of information there are varying symptoms, but the following are good indicators. These are not the signs that are for diabetes, but for insulin resistance.
Obesity: Almost every source lists this. This is the greatest indicator of possible insulin resistance.
Hypertension: Also goes by high blood pressure, and it involves high cholesterol and high triglycerides.
High blood glucose: This means the glucose is not getting into the cells and is raising blood glucose levels.
Low blood glucose: Cells starved for food when insulin cannot escort glucose into the cells, causing prolonged periods of hypoglycemia. Hypoglycemia makes you feel agitated and jittery and the symptoms generally go away after you eat. If you get shaky when you are hungry, it may mean you have insulin resistance.
Inflammation: Inflammation is caused by high levels of insulin in the blood stream and this is the result of inflammatory compounds like C-reactive protein which in turn increases the risk of cardiovascular disease.
The other symptoms are also thought about, but not everyone includes them in the discussion. They include: fatigue, brain fogginess, intestinal bloating, sleepiness, depression, and increased weight.
According to most polls, about 25 percent of the US population has already developed insulin resistance and about another 10 percent is is not far behind. If you have doubts about where you are, please make an appointment with your doctor to confirm if you have a problem or not.
You should ask for two tests. The first if the fasting glucose test, meaning you have nothing to eat from midnight until the test is done and then you may eat. The second
test is the two-hour glucose tolerance test. Be prepared to insist on both tests if the doctor only wants one done.
Read other discussions here and here. Next blog is a suggestion of what to do with the diabetes diagnosis.
About 25 percent of the adult population has already developed insulin resistance. No one knows the number that are on their way to developing Type 2 diabetes. The following are some of the symptoms that may give you some guidance that will let you learn if you should get an appointment with your doctor for a definitive check.
Depending the the source of information there are varying symptoms, but the following are good indicators. These are not the signs that are for diabetes, but for insulin resistance.
Obesity: Almost every source lists this. This is the greatest indicator of possible insulin resistance.
Hypertension: Also goes by high blood pressure, and it involves high cholesterol and high triglycerides.
High blood glucose: This means the glucose is not getting into the cells and is raising blood glucose levels.
Low blood glucose: Cells starved for food when insulin cannot escort glucose into the cells, causing prolonged periods of hypoglycemia. Hypoglycemia makes you feel agitated and jittery and the symptoms generally go away after you eat. If you get shaky when you are hungry, it may mean you have insulin resistance.
Inflammation: Inflammation is caused by high levels of insulin in the blood stream and this is the result of inflammatory compounds like C-reactive protein which in turn increases the risk of cardiovascular disease.
The other symptoms are also thought about, but not everyone includes them in the discussion. They include: fatigue, brain fogginess, intestinal bloating, sleepiness, depression, and increased weight.
According to most polls, about 25 percent of the US population has already developed insulin resistance and about another 10 percent is is not far behind. If you have doubts about where you are, please make an appointment with your doctor to confirm if you have a problem or not.
You should ask for two tests. The first if the fasting glucose test, meaning you have nothing to eat from midnight until the test is done and then you may eat. The second
test is the two-hour glucose tolerance test. Be prepared to insist on both tests if the doctor only wants one done.
Read other discussions here and here. Next blog is a suggestion of what to do with the diabetes diagnosis.
January 24, 2011
RDA for Vitamin D Needs Change
At least I feel vindicated by what I said in my blog of December 20, 2010. Others including Dr. Miller are also pointing out more accurately the problems of the report issued by Institute of Medicine of the National Academies of Science (IOM). There are some glaring errors that punch holes in the report by IOM. These errors make me wonder how these men of science could miss this or do they simply lack the education necessary for their duties.
Harsh, yes. But these errors are serious. Even David Mendosa has told me to be careful not to take vitamin-D2, but to take vitamin-D3. What bothers me is that people will go to the doctor for a vitamin D prescription and pay the doctor fee and a higher cost for vitamin-D2, when vitamin-D3 is on the shelves and a lot cheaper.
Vitamin-D2 is much less effective in humans than vitamin-D3. D2 is largely human made and added to foods as a fortifier. Vitamin-D3 is also consumed by consuming animal based foods. So those on non-meat lifestyles, should have their doctor check their vitamin D levels and consider taking vitamin-D3 supplements.
Vitamin D, also known as calciferol, comprises a group of fat-soluble seco-sterols. The two major forms are vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). In addition to having markedly lower potency, D2 also has a significantly shorter duration of action relative to vitamin D3. Both forms of vitamin D produce similar initial rises in serum 25OHD over the first 3 days, but 25OHD continues to rise with D3 supplementation, peaking at 14 days, and serum 25OHD falls rapidly in D2 treated subjects.
I think that this statement in the American Journal of Clinical Nutrition is most effective and needs to be heeded. They say that vitamin-D2 should not be used as a nutrient suitable for supplementation or fortification.
Dr Miller's blog is well stated and has some excellent comments to read here and read his latest blog here. Jon Barron writes his understanding of the IOM study and publishing of standards here. He is very factual and reports on the errors. NOTE: The two links for Dr. Miller's information are no longer functional.
Harsh, yes. But these errors are serious. Even David Mendosa has told me to be careful not to take vitamin-D2, but to take vitamin-D3. What bothers me is that people will go to the doctor for a vitamin D prescription and pay the doctor fee and a higher cost for vitamin-D2, when vitamin-D3 is on the shelves and a lot cheaper.
Vitamin-D2 is much less effective in humans than vitamin-D3. D2 is largely human made and added to foods as a fortifier. Vitamin-D3 is also consumed by consuming animal based foods. So those on non-meat lifestyles, should have their doctor check their vitamin D levels and consider taking vitamin-D3 supplements.
Vitamin D, also known as calciferol, comprises a group of fat-soluble seco-sterols. The two major forms are vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). In addition to having markedly lower potency, D2 also has a significantly shorter duration of action relative to vitamin D3. Both forms of vitamin D produce similar initial rises in serum 25OHD over the first 3 days, but 25OHD continues to rise with D3 supplementation, peaking at 14 days, and serum 25OHD falls rapidly in D2 treated subjects.
I think that this statement in the American Journal of Clinical Nutrition is most effective and needs to be heeded. They say that vitamin-D2 should not be used as a nutrient suitable for supplementation or fortification.
Dr Miller's blog is well stated and has some excellent comments to read here and read his latest blog here. Jon Barron writes his understanding of the IOM study and publishing of standards here. He is very factual and reports on the errors. NOTE: The two links for Dr. Miller's information are no longer functional.
January 22, 2011
The Problem Side of Diabetes Forums
Since I was kind to diabetes forums, I just had to meet the bad side. When people with initials behind their name (titles) and others that must not contradict the position of their professional organizations get involved and state the position, they bring many thoughts that are not always the full truth into the discussion and leave people new to the forums wondering who is right.
I will admit I am very passionate about the issue of the medical community dismissing prediabetes. Part of the reason is from my prior blog here. The consensus does state that damage occurs earlier than previously thought. It is unfortunate that no actual determination has been made for the blood glucose levels when damage can be the most severe.
First, when a person openly disputes a doctor's request of a patient, this really upsets me. Granted in this case there is some potentially harmful information missing that those of us that posted did not ask for. In getting to the A1c of 5.7, we don't know what medications the original poster was taking. We also don't know the number of lows this person experienced, if any. We can only guess that the doctor knows the facts and when he suggests getting an A1c of 5.5 he knows that this is possible.
The medical community needs more doctors like this person and less people that quote ADA (and AADE) that A1c's of 6.5 being okay. That means that a blood glucose average of 140mg/dl which tells us that damage is being done. An A1c of 5.7 means a blood glucose reading of 117mg/dl. My reaction would be to pay attention to the doctor and ignore the rest. This is between the patient and doctor and is the individuals choice.
Having said that, there are people that should not try to get that low because they are unable to control their levels and have some dangerous lows when trying to get down below 6.0. This action needs to be done according to what the patient is capable of managing, desires to do, and if the patient keeps an open line of communication with a doctor. Even though this is on a diabetes forum, most of us suggest and most take it as such, people with titles behind their name often forget themselves and advise against doctors.
The second incident is where we seem to get a dismissal of the seriousness of prediabetes. Prediabetes is technically not diabetes, however, if the medical community continues to ignore the need to treat prediabetes with counseling and letting people know how serious this can become, they are taking a pass on their responsibilities.
There is much that can be done for people with prediabetes to assist them in taking advantage of this diagnosis and preventing the onset of diabetes. If they are medically capable they should begin exercise under a doctors direction and make some good lifestyle changes which will likely prevent diabetes for a number of years or possibly decades. Some will even prevent diabetes altogether.
For the blood glucose and A1c conversion table from the American Diabetes Association click here, and if you will be using it, bookmark the page.
I will admit I am very passionate about the issue of the medical community dismissing prediabetes. Part of the reason is from my prior blog here. The consensus does state that damage occurs earlier than previously thought. It is unfortunate that no actual determination has been made for the blood glucose levels when damage can be the most severe.
First, when a person openly disputes a doctor's request of a patient, this really upsets me. Granted in this case there is some potentially harmful information missing that those of us that posted did not ask for. In getting to the A1c of 5.7, we don't know what medications the original poster was taking. We also don't know the number of lows this person experienced, if any. We can only guess that the doctor knows the facts and when he suggests getting an A1c of 5.5 he knows that this is possible.
The medical community needs more doctors like this person and less people that quote ADA (and AADE) that A1c's of 6.5 being okay. That means that a blood glucose average of 140mg/dl which tells us that damage is being done. An A1c of 5.7 means a blood glucose reading of 117mg/dl. My reaction would be to pay attention to the doctor and ignore the rest. This is between the patient and doctor and is the individuals choice.
Having said that, there are people that should not try to get that low because they are unable to control their levels and have some dangerous lows when trying to get down below 6.0. This action needs to be done according to what the patient is capable of managing, desires to do, and if the patient keeps an open line of communication with a doctor. Even though this is on a diabetes forum, most of us suggest and most take it as such, people with titles behind their name often forget themselves and advise against doctors.
The second incident is where we seem to get a dismissal of the seriousness of prediabetes. Prediabetes is technically not diabetes, however, if the medical community continues to ignore the need to treat prediabetes with counseling and letting people know how serious this can become, they are taking a pass on their responsibilities.
There is much that can be done for people with prediabetes to assist them in taking advantage of this diagnosis and preventing the onset of diabetes. If they are medically capable they should begin exercise under a doctors direction and make some good lifestyle changes which will likely prevent diabetes for a number of years or possibly decades. Some will even prevent diabetes altogether.
For the blood glucose and A1c conversion table from the American Diabetes Association click here, and if you will be using it, bookmark the page.
January 20, 2011
Many Think of Pre-diabetes as Non-Diabetes
Diabetes forums can be an excellent learning place. Diabetes forum dlife had a good discussion about a visit to a doctors office and a subsequent call by the nurse in the office, that basically said the patient had an elevated blood glucose level and he was to watch his diet. His blood glucose test had been 126mg/dl which by current guidelines is diabetes.
This is two sided and not as black and white as many want it to be. Here is where I fault the doctors for not weighing in and explaining what pre-diabetes or diabetes actually means. Many just say, “watch your diet as your blood glucose is a little elevated”. Why is this so easy for doctors? Two answers and both equally in error.
First, they do not know what to do because they have heard that between 100 and 125 on the blood glucose scale is pre-diabetes, but they have their doubts since they have not kept up with the latest reasoning or guidelines. And second, they don't want to get their patients alarmed. Therefore they pass on the opportunity to educate a patient and help the patient get an early start on possible prevention for many years. This is where I say the doctors are doing harm.
What many doctors fail to understand that studies are finding that damage to the pancreas occurs earlier than many realize and this is the reason for the American Diabetes Association changing the diagnosis standards. Prediabetes is at least better defined for the diagnosis and treatment for women who are pregnant. Still doctors are not following the ADA.
At least the patient was asking questions and was sincere in wanting answers to understand what was going on and what to do next on the forum. This is a common occurrence as doctors are not doing their job.
What everyone needs to realize is that a fasting blood glucose reading of 125mg/dl and 126mg/dl are just numbers. They both indicate that the pancreas is in trouble and already has damage. Both are serious.
When fasting blood glucose is consistently above 99 mg/dl (5.5 mmol/L), this is considered prediabetes by the ADA in their latest Care Standards published in December 2010. This means that the pancreas is not functioning properly and the condition needs attention. Most doctor dismiss this as being something needing attention, and just tell the patient to watch their diet as blood glucose in elevated. If you get this reading, insist on getting the blood glucose reading so that at least you know how to treat it. And then, find an endocrinologist that will help.
How is the patient going to take this seriously when the medical community does not. Patients often just dismiss this as well and then in the next one to five years when the diagnosis comes back of diabetes, they are shocked and think they had done enough in reducing some sugars and doing some exercising. What they don't understand is that what they did was not a plan and the carbohydrate consumption was not controlled and the exercise may have been when they thought of it.
Both doctors and patients need to take fasting blood glucose readings of 100mg/dl to 125mg/dl (5.6 mmol/L to 6.9 mmol/L) seriously and develop and plan for treating this to prevent them from getting above the upper number. This takes planning and setting goals which must be followed seriously. The doctor needs to see the patient on a regular basis and use the HbA1c to see how good, or poorly, the patient is doing. Both should be prepared to review the plan and make adjustments.
Even if the fasting blood glucose level is 126mg/dl (7.0 mmol/L) and above, many people are still capable of controlling diabetes with nutrition and exercise. This does take commitment to this goal. Some are able to do this for years and some for a few decades. So this should be a goal. For some it will not happen because of other health problems and medical reasons that prohibit exercise. Even then, proper nutrition can be of benefit in keeping off medications.
This is two sided and not as black and white as many want it to be. Here is where I fault the doctors for not weighing in and explaining what pre-diabetes or diabetes actually means. Many just say, “watch your diet as your blood glucose is a little elevated”. Why is this so easy for doctors? Two answers and both equally in error.
First, they do not know what to do because they have heard that between 100 and 125 on the blood glucose scale is pre-diabetes, but they have their doubts since they have not kept up with the latest reasoning or guidelines. And second, they don't want to get their patients alarmed. Therefore they pass on the opportunity to educate a patient and help the patient get an early start on possible prevention for many years. This is where I say the doctors are doing harm.
What many doctors fail to understand that studies are finding that damage to the pancreas occurs earlier than many realize and this is the reason for the American Diabetes Association changing the diagnosis standards. Prediabetes is at least better defined for the diagnosis and treatment for women who are pregnant. Still doctors are not following the ADA.
At least the patient was asking questions and was sincere in wanting answers to understand what was going on and what to do next on the forum. This is a common occurrence as doctors are not doing their job.
What everyone needs to realize is that a fasting blood glucose reading of 125mg/dl and 126mg/dl are just numbers. They both indicate that the pancreas is in trouble and already has damage. Both are serious.
When fasting blood glucose is consistently above 99 mg/dl (5.5 mmol/L), this is considered prediabetes by the ADA in their latest Care Standards published in December 2010. This means that the pancreas is not functioning properly and the condition needs attention. Most doctor dismiss this as being something needing attention, and just tell the patient to watch their diet as blood glucose in elevated. If you get this reading, insist on getting the blood glucose reading so that at least you know how to treat it. And then, find an endocrinologist that will help.
How is the patient going to take this seriously when the medical community does not. Patients often just dismiss this as well and then in the next one to five years when the diagnosis comes back of diabetes, they are shocked and think they had done enough in reducing some sugars and doing some exercising. What they don't understand is that what they did was not a plan and the carbohydrate consumption was not controlled and the exercise may have been when they thought of it.
Both doctors and patients need to take fasting blood glucose readings of 100mg/dl to 125mg/dl (5.6 mmol/L to 6.9 mmol/L) seriously and develop and plan for treating this to prevent them from getting above the upper number. This takes planning and setting goals which must be followed seriously. The doctor needs to see the patient on a regular basis and use the HbA1c to see how good, or poorly, the patient is doing. Both should be prepared to review the plan and make adjustments.
Even if the fasting blood glucose level is 126mg/dl (7.0 mmol/L) and above, many people are still capable of controlling diabetes with nutrition and exercise. This does take commitment to this goal. Some are able to do this for years and some for a few decades. So this should be a goal. For some it will not happen because of other health problems and medical reasons that prohibit exercise. Even then, proper nutrition can be of benefit in keeping off medications.
January 18, 2011
Diabetes May Simplify Life's Choices
I can occasionally learn something by reading blogs of others, whether they are Type 1 or Type 2. Catherine Price at A Sweet Life dot org wrote a blog on January 17, 2011, that really hit home. I had not really thought about diabetes this way, but she is so right that I must add my thoughts as a Type 2 and with heart disease.
Yes, diabetes does make life simpler in so many ways. I go shopping for groceries with my wife and by myself. I do look for something to change the menu, but I seldom get past the label. It is easy to pick up fresh vegetables and some fresh fruits as from experience I know that the carbohydrate count is within the range I am looking for. Once in a while, it is easy to select a few of the higher carbohydrate fruits as we both like them and I can limit the portion size that I will eat.
Then we come to the packaged products. If it isn't the carbohydrate content, then it is the sodium content that rejects them. Most canned fruits and vegetables are ruled out because of the sodium levels or the carbohydrate levels. Some canned fruits and vegetables can be made acceptable by rinsing them and then soaking them in clear water and draining this liquid, thereby eliminating the liquid they were canned in.
Catherine says it very well that we would not choose to have diabetes, but it can be a blessing in disguise (I say it is a large blessing) as we eliminate many foods we would not otherwise reject. I add sodium because of heart disease which eliminates other foods. Now with the American Heart Association issuing their call to the public, health professionals, the food industry, and the government to increase efforts to lower the amount of sodium that we consume on a daily basis, we have more hope.
The AHA has issued their statement to get people to limit their sodium intake to 1500 milligrams of sodium per day. This is down from the 2300 milligrams that was their standard. Anyone concerned about heart disease and high blood pressure, the standard now is 1500 milligrams. Thank you to the AHA for their revision. Therefore, I now feel much safer with my personal upper limit being at 1200 milligrams of sodium intake.
Everyone should read their release published in Science Daily here. Now if the American Medical Association and other professionals organizations will follow their lead, we can all be healthier.
Yes, diabetes does make life simpler in so many ways. I go shopping for groceries with my wife and by myself. I do look for something to change the menu, but I seldom get past the label. It is easy to pick up fresh vegetables and some fresh fruits as from experience I know that the carbohydrate count is within the range I am looking for. Once in a while, it is easy to select a few of the higher carbohydrate fruits as we both like them and I can limit the portion size that I will eat.
Then we come to the packaged products. If it isn't the carbohydrate content, then it is the sodium content that rejects them. Most canned fruits and vegetables are ruled out because of the sodium levels or the carbohydrate levels. Some canned fruits and vegetables can be made acceptable by rinsing them and then soaking them in clear water and draining this liquid, thereby eliminating the liquid they were canned in.
Catherine says it very well that we would not choose to have diabetes, but it can be a blessing in disguise (I say it is a large blessing) as we eliminate many foods we would not otherwise reject. I add sodium because of heart disease which eliminates other foods. Now with the American Heart Association issuing their call to the public, health professionals, the food industry, and the government to increase efforts to lower the amount of sodium that we consume on a daily basis, we have more hope.
The AHA has issued their statement to get people to limit their sodium intake to 1500 milligrams of sodium per day. This is down from the 2300 milligrams that was their standard. Anyone concerned about heart disease and high blood pressure, the standard now is 1500 milligrams. Thank you to the AHA for their revision. Therefore, I now feel much safer with my personal upper limit being at 1200 milligrams of sodium intake.
Everyone should read their release published in Science Daily here. Now if the American Medical Association and other professionals organizations will follow their lead, we can all be healthier.
Subscribe to:
Posts (Atom)