28 Apr Living Well with Diabetes Newsletter – April 2017
Spring Is Here!
By: Director of education – Jessica Cook MS, RD, LD, CDE
For many people Spring feels like a sense of rebirth, which could involve spring break traveling, spring cleaning or getting ready for new blossoms in your garden. For people with diabetes you still need to pay attention to blood sugars, activity, food intake and paying attention to these aspects of diabetes never changes. But when was the last time you met with a diabetes educator who can talk to you about the food you are eating on a regular basis, discuss what to do when your sugar is too high or too low or how to get your supplies in an easier, cheaper way?
Then maybe it’s time for a spring refresher course to get blood sugars back on target, feel better, have more energy and save money on diabetes supplies! Currently at Palm Beach Diabetes and Endocrine Specialists we have a team of certified diabetes educators, registered dietitians and healthy meal planning sessions for people with diabetes that can help you achieve your goals. Call 561-659-6336 ext 8012 to schedule an appointment today.
Pease enjoy our April 2017 Living Well with Diabetes Newsletter.
By: Jaime Steinsapir, M.D., Ph.D., F.A.C.P., F.A.C.E.
The metabolic syndrome is defined as the simultaneous presence of metabolic risk factors for both type 2 diabetes and cardiovascular disease (abdominal obesity, hyperglycemia, dislipidemia and hypertension). Current criteria from the National Cholesterol Education Program defines metabolic syndrome as the presence of any three of the following five traits:
- Abdominal obesity: waist circumference in men equal or above 102 cm (40 in) and obesity – related in women equal or above 88 cm(35in)
- Serum triglycerides above 180 mg/dl or drug treatment for elevated triglycerides.
- Serum high density lipoprotein (HDL) cholesterol below 40 mg/dl in men and below 50 mg/dl in women or drug treatment for low HDL cholesterol.
- Blood pressure equal or above 130/85 or drug treatment for elevated blood pressure.
- Fasting plasma glucose (FPG) equal or above 100 mg/dl or drug treatment for elevated blood glucose. In addition, although no formal definition of metabolic syndrome include glycated hemoglobin (A1C), abnormal A1C (5.7 to 6.4) is increasingly accepted and used to define impaired glycemia in patients with metabolic syndrome.
The metabolic syndrome is becoming increasingly common. Using data from the National Health and Nutrition Examination Survey (NHANES III) 1999 to 2002 data base, 34.5 % of participants met criteria for metabolic syndrome described above, compared with 22% in NHANES III (1988 to 1994). The metabolic syndrome increases the risk for the incidence of cardiovascular disease and all cause mortality. The increased risk appears to be related to risk factor clustering or insulin resistance associated with the metabolic syndrome rather than simply to obesity. The metabolic syndrome has also been associated with several obesity – related disorders including: fatty liver disease, liver cholangiocarcinoma, chronic kidney disease, polycystic ovarian syndrome, sleep disorders, including obstructive sleep apnea, hyperuricemia and gout. Obesity is associated with resistance to the effects of insulin on glucose and fatty acid utilization, often leading to type 2 diabetes mellitus. Insulin resistance, the associated high levels of insulin in the blood and hyperglycemia contribute to an abnormal lipid profile, hypertension and vascular inflammation, all of which may lead to the development of atherosclerotic cardiovascular disease.
Physicians have two major therapeutic goals in treating patients with metabolic syndrome:
- Treat the underlying cause (overweight/obesity and physical inactivity) by intensifying weight management and increasing physical activity.
- Treat the cardiovascular risk factors if they persist despite lifestyle modification (treatment of hypertension, cessation of smoking, glycemic control in patients with diabetes, and lowering of serum cholesterol).
Clinical trials have shown that lifestyle modifications can significantly reduce the risk of development of type 2 diabetes. They also reduce the levels of risk factors for cardiovascular disease in patients at increased risk.
In the Diabetes Prevention Program (DPP) from the National Institutes of Health, 3234 obese persons with impaired fasting glucose or impaired glucose tolerance were randomly assigned to one of the following groups: Patients who made intensive lifestyle changes with the aim of reducing weight by 7% through a low fat diet and exercise for 150 minutes per week. Patients treated with metformin plus information on diet and exercise. Patients given placebo plus information on diet and exercise.
After 3 years of follow up, intensive lifestyle modifications or metformin decreased significantly the risk of developing diabetes.
The metabolic syndrome was present in 53% of participants in The Diabetes Prevention Program at baseline. In the remaining 1523 subjects, both intense lifestyle modifications and metformin therapy reduced the risk of developing the metabolic syndrome.
The prevalence of the metabolic syndrome is high among obese children and adolescents, and increases with the severity of the obesity and with central adiposity, in particular. The incidence of self reported cardiovascular disease has been observed to be more common in adults who exhibited metabolic syndrome traits as children than in those who did not.
Genetic predisposition, lack of exercise and body fat distribution all affect the likelihood that a given obese person will become overtly diabetic or develop cardiovascular disease. Diabetes Prevention Programs are also being developed in children and adolescents. The adoption of these programs will certainly help to decrease morbidity and mortality associated with diabetes and cardiovascular disease.
**If you are at risk for type 2 diabetes and would like to join our pre-diabetes seminar Tuesday June 20th from 10:00AM – 12:00PM please call 561-659-6336 ext 8012.
By: Gail Starr LCSW, CDE
Now that Passover and Easter are behind us, literally as well as figuratively, it is time to get back on track to “healthy.” No beating up on one’s self, no self-recriminations, no giving up because of a holiday. Just remember that today is the first day of the rest of your life and that it’s time to get the ego, the adult part of your mind, back in control. But how?
The first thing needed is a strong motivation. There are many reasons to get back in control. Feeling better is one. High blood sugar is another reason which can make people tired, lethargic, achy, thirsty and itchy. Blood sugars that go up and down, can make moods labile too. Having hope for a longer life can be beneficial in getting the behaviors better. Having hope for a better quality of life can be a source of change. If thoughts about the self, though, aren’t enough to help you chart the course, then maybe your love for others can.
We have two more holidays coming up which are Mother’s Day and Father’s Day. People are always trying to find the perfect present for their parents and parents are always trying to find the right present for their children. How does the “gift of one’s self” sound? How does staying healthy for your children sound to you? Diabetes is inherited and your children many have the gene. How about choosing to be the role model for your children? What a gift that could be!!
How does the gift of “less worry” sound? This can be a present for both parents and children.
Having better blood sugars help to keep relationships on a more even keel. People who love you will be less angry if you are doing things that keep your blood sugars in a healthier place. And believe it or not, you may love yourself better too. And that could be the best gift of all ….. a gift to yourself of a better, healthier, happier life.
No one chooses to have diabetes, but we can choose what to do about it. We just celebrated holidays that told the stories of miracles. Why not be the miracle in your family and choose to live healthfully!
Looking for Meal Ideas to Manage your Diabetes?
Then come to Our Healthy Meal Planning for Diabetes Workshops!
Now at 3 Convenient Locations!
Tuesday May 9th 10am-12pm
Temple Israel 1901 N. Flagler Drive
West Palm Beach, FL 33401
Wednesday May 10th 5:30-7:30pm
550 Heritage Drive, Suite 150
Jupiter FL, 33458
Wednesday May 17th 10am-12pm
Brookdale 8220 Jog Rd.
Boynton Beach, FL 33472
Will provide Healthy Snacks!
**May bring one guest free of charge!
If interested attending this program please contact our scheduling department at (561) 659-6336 Extension 8001 today!
At Healthy Living with Diabetes we want to ensure that you are satisfied with all services received. We also would like your input on educational workshops that you would like us to offer, information you would like to read about in Healthy Living with Diabetes Monthly or feedback on any workshop that you may have attended. You can contact the director of education personally by email jcook@PBDES.COM or leave a message at (561) 659-6336 ext. 8012. We would love to hear from you!