16 Feb Living Well with Diabetes Newsletter – February 2017
National Heart Health Month
By: Director of education – Jessica Cook MS, RD, LD, CDE
February is national heart health month, so you may have been seeing women going red for heart disease awareness. That is because heart disease is not only the number one killer of women in the United States, but heart disease is also the number one chronic complication of diabetes. Diabetes increases your risk of high cholesterol and blood pressure, which may lead to stroke, heart attack or peripheral artery disease. That is why when seeing your endocrinologist, certified diabetes educator or registered dietitian you may find yourself discussing your heart health.
Keeping your heart healthy not only starts with well managed blood sugars but also these simple steps:
- Stop smoking. Smoking leads to poor circulation, increased blood pressure and creates free radicals in the blood leading to cancer. Smoking with diabetes can accelerate complications leading to heart disease, kidney disease and neuropathy at a quicker rate.
- Increase activity. Increasing physical activity can lower blood sugars, blood pressure, cholesterol and weight. Even a small amount of activity 10-15min. can cause a heart healthy effect, but aiming for 30 minutes at least 3 days per week will significantly reduce your risk of heart disease and can help shed pounds!
- Lower cholesterol. Eating high fiber foods such as berries, apples, oats, nuts, seeds, vegetables, beans and whole grains can lower cholesterol and body fat mass. Also limiting high cholesterol foods such as ice cream, butter, cheese, bacon, sausage and fried foods can also help reduce weight and cholesterol levels.
- Lower blood pressure. Limiting high sodium food items such as canned or frozen foods, restaurant food items, cured meats, chips, crackers and other processed foods may help lower blood pressure if you are salt sensitive. Adding foods such as vegetables, watermelon, tomatoes, avocados and low fat yogurt can also help to lower blood pressure.
Our education team has helped countless patients lose weight, reduce blood glucose levels, reduce medication use and feel better. If you want to schedule an appointment for any one of our educational workshops please call 561-659-6336 ext 8001.
Thank you for taking time to read our Living Well with Diabetes February 2017 Newsletter and have a Happy Valentine’s Day!
Diabetes & Your Circulation
By: Paul Aoun, D.O., Ph.D.
Diabetes impacts almost every organ in the body; the circulatory system is one where the disease leaves its greatest marks. Circulatory complications from diabetes are generally divided into two broad categories, micro- and macro-vascular. Microvascular refers to small arteries such as the ones supplying the eyes, kidneys, and nerves. Macrovascular complications are changes seen in large vessels of the heart, brain, and limbs.
The risk of microvascular complications, i.e. retinopathy, neuropathy, and/or nephropathy, appears to rise as the blood sugar goes up and it is difficult to predict who will develop what and when. Some could even have sugar-related changes in small arteries starting in the pre-diabetes stage. As such, tight sugar control, when safely achieved without precipitating hypoglycemia (sugars below 70 mg/dL), is recommended to help reduce either the development of, and/or the progression of existing micro-vascular disease.
Diabetes increases also the risk of macrovascular complications such as heart disease, stroke, dementia, and peripheral vascular diseases. While improving sugar levels reduces injury to small vessels, researchers have been debating whether tight sugar control, in itself, has the same positive impact on large vessels. Several studies have suggested that lessening macrovascular complications requires going beyond just fixing blood sugars and involves a multidisciplinary approach and a comprehensive strategy that includes at its core healthier lifestyle choices and physical activity as permitted and tolerated, in addition to, blood pressure, cholesterol, and weight control and smoking cessation for those who smoke. The anticipated gains from various medications such as aspirin, statins, and certain blood pressure meds reported to be beneficial in diabetics with vascular complications must be weighed against their potential risks, adverse events, and long term safety.
Aside from “how” best to reduce vascular complications of diabetes, the question of “when” to start applying the above-stated strategies is as important, if not of more importance. This is particularly true in relation to macrovascular disease which predates the diagnosis of diabetes by 10, or more, years Macrovascular disease is often fueled by unhealthy lifestyle choices, limited physical activity, and resultant weight gain and insulin resistance. The damage progresses if these unhealthy choices are sustained but could regress if the tide is turned and healthier choices are adopted and sustained.
Although divided into two broad categories, micro- and macrovascular complications often overlap and may brew underneath the surface without manifesting in clinical symptoms until later on in the course of the disease. For example, one could have eye or kidney problems from diabetes without experiencing visual or urinary changes. Also, a person with underlying heart problems may not experience any chest pain or other symptoms of heart disease. It is, therefore, crucial to maintain proper follow up with the respective physicians to identify any changes early on.
In summary, as medical research continues to advance and novel ways to reduce circulatory complications of diabetes get explored, it is crucial to not lose focus of the one modifiable factor that governs in some, the onset of, and drives in many, the progression of diabetes: lifestyle choices. Although genetics set the stage in certain cases, the course of the disease could be largely altered by the choices you make. Also, keep in mind that many of the preventable complications of diabetes, i.e., balance problems from neuropathy or visual issues from retinopathy, are life-altering ones and could impact your independence, activities of daily living, and quality of life. So, start early, stay the course, and if you have diabetes don’t let diabetes have you!
Introducing the Freestyle Libre Pro
By: Ines Enriquez-Cobo, RN, CDE
The Freestyle Libre Pro Flash Glucose Monitoring System is a professional continuous glucose monitoring (CGM) device indicated for detecting blood sugar trends, patterns and glucose level excursions above or below the desired range. These trends and patterns facilitate therapy adjustments in people with diabetes 18 and older. The system is intended for use by health care professionals, not approved for personal use and requires a prescription.
The Libre Pro sensor continually measures and stores blood glucose levels for up to 14 days. After the sensor has been worn for up to 14 days, the doctor will download and review the data from the sensor. The data will give information about how glucose levels are trending throughout the day and night. This will help the doctor to personalize the patient’s treatment plan.
While wearing the sensor the patient will continue to monitor blood sugars as recommended by the healthcare professional, maintain a daily log of glucose readings, meals, exercise and diabetes medications and/or insulin.
The sensor is water resistant and can be worn while bathing, showering, or swimming within 3 feet no longer than 30 minutes. For MRI, CT scan, X-ray, or a diathermy treatment sensor must be removed.
The Freestyle Libre Pro is now available at all locations in Palm Beach Diabetes And Endocrine Specialists, ask your doctor at your next visit about how continuous glucose monitoring can benefit your treatment today.
Looking for New Information in Diabetes Care?
Then come join our FREE Diabetes Support Group!
Wednesday February 22nd
5:30 -7:00 P.M.
Flagler Waterview Building
1515 N. Flagler Drive, Suite 430
West Palm Beach, FL 33401
Will provide Healthy Snacks!
Dr. Barry Horowitz will provide a presentation followed by a question and answer segment to answer many of diabetes health related questions.
And registered dietitian Jessica Cook will discuss the benefits of plant based diets.
**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!