Ayurveda the Science of Life
In addition to visits to your primary care provider, find out if visits to other members of your health care team (see Chapter 13) are covered and under what conditions. Some carriers will provide coverage for routine physicals but will not cover visits to a dietitian, for example. You may recognize that treating your diabetes is a team effort, but not all insurance carriers provide this coverage.
Now what Your diabetes care provider may already use a team approach and may already be in contact with other team members. If they are not already in touch, make sure all team members know about everyone else on your team. Ask your health care team to consult with each other whenever appropriate. Be sure that they have each other's phone numbers and addresses. If you are making any lifestyle adjustments quitting smoking, starting a weight loss diet, or taking up jogging, for example make sure you notify all team members. Remember, your health care team is there to help you manage your diabetes. They can provide a wealth of information and the resources you need to make the decisions that affect your health. But you are the one who ultimately makes the decisions and puts your health care plan into action.
The key thing is to get going on improving your health now. Don't wait another day to begin to do the things that can prolong your life and increase its quality at the same time. You don't want to regret your life the way poor George Burns did. When a beautiful girl walked into his hotel room and said, I'm sorry, I must be in the wrong room, he told her, No, you're not in the wrong room. You are just 40 years too late.
Screening mammography has been shown to reduce breast cancer mortality and is recommended by clinical practice guidelines for all women between the ages of 50 and 69 years. With current antidiabetic treatment, many patients with diabetes do not have additional comorbidity and thus may benefit from screening, yet in several countries diabetes may adversely affect attendance to screening mammography. Beckman et al. 38 found that American diabetic patients were less likely to undergo screening mammography, probably due to compromised attitude of their primary care physicians to preventive medicine and to high costs of mammography. Lipscombe et al. 39 investigated mammography rates in a large Canadian cohort, consisting of 69,168 women with diabetes and 663,519 women without diabetes. Although all patients were fully insured, diabetic patients had about one-third lower chances to perform screening mammography. On the other hand, a study from the UK revealed an attendance of more than 80...
Obese patients should aim to achieve some weight reduction by adopting a healthy lifestyle with a combination of correct diet and regular exercise. Weight reduction should be gradual and need not reach ideal body weight to improve glycaemic control. Patients should be encouraged to take a balanced, nutritionally correct diet and reduce their intake of simple sugars and fat. Unsaturated fat should be substituted by monounsaturated or poly-unsaturated types. Although the optimal dietary composition is unknown, a diet composed of 15-20 of total energy intake as protein, 25-30 as fat, 50-60 as complex carbohydrate and less than 10 as simple sugars is a generally accepted recommendation (European Diabetes Policy Group 1999 IDF Asian-Pacific Type 2 Diabetes Policy Group 1999 National Health and Medical Research Council of Australia 1992).
The ADA review found that there was inadequate evidence to support use of herbal medicine or mineral supplements in the treatment of diabetes. If you decide to use them, buy your supplements from reputable suppliers those with USP (United States Pharmacopeia) or NF (National Formulary) labels are preferred (see Resources). The National Nutritional Foods Association good-manufacturing practices (NNFA GMP) and ConsumerLab.com also test the quality of herbal and dietary supplements.
Diabetes mellitus (diabetes) is a disease of worldwide significance and increasing prevalence. Plant materials have played an important role in the traditional treatment of diabetes, particularly the type II (non-insulin-dependent) form. In many regions of the world, herbal remedies continue to be more accessible and affordable than conventional drugs and represent the first line of treatment available to a diabetes patient. Concurrently, within societies with well-developed, modern health care systems, demand is growing for herbal remedies to complement prescribed, modern therapies for many diseases, including diabetes. The extent to which various antidiabetic plants have been studied differs widely. For some (e.g., fenugreek, bitter melon, or gymnema Gymnema sylvestre R. Br. ), detailed studies in humans, animals, and in vitro have resulted in the isolation of active compounds with recognizable modes of action. An interesting finding is that plants typically have more than one...
Antidiabetic activity (Palanichamy et al., 1988) Part of an ayurvedic formula hyponida that has antihyperglycemic and antioxidant activity (Babu and Prince, 2004) Reported to have antidiabetic activity but Hussain et al. (2004) showed it did not stimulate insulin secretion
To work together as a team, you must be able to communicate with your fellow health care team members. It's not always easy to communicate, especially when you're feeling nervous, worried, or under pressure. Sometimes people can feel intimidated by health care professionals. However, just remember that they are there to help you. But to best help you, they need to know what is on your mind. Only you can tell them how you are feeling and what special concerns you might have. Here are a few tips for establishing a smooth line of communication between you and your health care professional Share the conversation. Begin the visit by telling your provider what you hope to accomplish and what you want him or her to know. Your provider cannot read your mind or guess what problems you may have. If the vocabulary becomes too technical or the concepts too complex and you don't understand, speak up. Ask for an explanation of anything you don't understand. Write down any information or...
A stepwise therapeutic approach for ED is shown in Table 10. An algorithm for treatment of ED has been suggested by the Second International Consultation on Erectile and Sexual Dysfunctions (Fig. 2) (100). The initial management should advise the patient to reduce or treat possible risk factors such as obesity, hypertension, hyperlipidemia, or smoking and to optimize glycemic control. However, no studies are available to show that improvement in glycemic control will exert a favorable effect on ED. In fact, the VA CSDM Study could not demonstrate an effect of intensive diabetes therapy maintained for 2 years on ED in type 2 diabetic men (119). Healthy lifestyle factors are associated with maintenance of erectile function in men. A controlled study evaluated the effect of weight loss and increased physical activity on erectile and endothelial functions in obese men. Men randomly assigned to the intervention group received detailed advice about how to achieve a...
Women who have had gestational diabetes are at greater risk for getting diabetes again. They have a 2 in 3 chance of developing gestational diabetes during future pregnancies. Also, their risk of developing type 2 diabetes 5 to 15 years after they had gestational diabetes rises to between 40 and 60 percent, compared with about a 15 percent risk in the general population. Obesity increases the risk of getting type 2 diabetes after having gestational diabetes to a 3 in 4 chance. Women who have had gestational diabetes can reduce their risk of developing diabetes closer to a 1 in 4 chance by keeping a healthy body weight (see Chapter 1).
Today, diabetology is no longer satisfied to keep diabetics in reasonably good health, but also addresses everything that may affect the individual's quality of life and, from this standpoint, sexuality cannot fail to occupy a role of primary importance. In the diabetic male, it is sexuality in the narrowest sense, namely what is conventionally designated 'potentia coeundi', that is compromised and it is precisely in relation to that situation that a comprehensive overview of this condition can provide the diabetic patient with the answer he seeks.
The alignment of IFG and the corresponding intermediate category based on the oral glucose tolerance test impaired glucose tolerance (IGT) in predicting the future development of type 2 diabetes. The proposed new diagnostic threshold is derived from receiver-operator characteristic curves of the different levels of fasting plasma glucose that predict the development of diabetes. The optimal cut-point (optimising the sum of sensitivity and specificity) was between 5.2 and 5.7 mmol L 6 . A secondary, but equally important consideration was to increase the proportion of individuals with IGT identified as having IFG. With the previous definition (6.1-6.9) 18 only 29 of individuals with IGT also have IFG. Lowering the diagnostic threshold to 5.5 mmol L would increase this proportion to 69 . Identification of patients with IGT is important from the perspective of preventive medicine, as this is the group where intervention studies have proven effective in preventing progression to diabetes...
Women with a history of GDM are an ideal group to target, not only because of their own heightened risk of future diabetes (97,98) but to ensure a healthy lifestyle within the family unit, hence reducing the risk of obesity and future diabetes in the children also.
As you start to choose your health professionals, it may help to listen to the experience of other people with diabetes. Consider the stories of James and Helen, decades apart in age, but sharing an initial sense of confusion and a little fear about finding quality care for diabetes. After the interview, take time to reflect on it. How did it feel Were you comfortable with the practitioner Did he or she seem concerned about you as an individual Was the provider willing to work with you to achieve your health goals Did you feel free to express your feelings Did you feel that he or she
The debate still rages over mercury amalgam fillings. No one disputes the extreme toxicity of mercury compounds and mercury vapor. The ADA feels that mercury amalgam fillings are safe because they do not vaporize or form toxic compounds to a significant degree. Opponents cite scientific studies that implicate mercury amalgams as disease causing. Many dentists advocate mercury amalgam fillings simply because they are accepted by the ADA, which they believe protects them from malpractice litigation. Why risk your health and life on their opinions Remember everything corrodes and everything seeps, so amalgams must too.
Keeping a record of SMBG test results is vital. You and your health-care professionals use this information to make safe adjustments to your diet, exercise plan, and insulin or oral hypoglycemic pills. Make sure your SMBG test record includes any unusual events, such as illness, stress, and changes in exercise or activity level.
The message here is that the most important thing you can do to fight type 2 diabetes is to modify your diet and lifestyle. You may require medications eventually as well, but your most important weapon against type 2 diabetes is your choosing to live a healthy lifestyle (exercise and diet) It is important that people with diabetes not make any changes to their treatments or adjust their blood glucose targets without speaking to their healthcare team. In addition to blood glucose control, people with diabetes can reduce their overall cardiovascular risk by controlling their blood pressure and cholesterol levels and by adopting a healthy lifestyle that includes quitting smoking.
If you are anything like I was when I was diagnosed, you want quick easy answers about what to eat and how to get healthy. I can tell you what works well for me, and others I have worked with, but understanding it will take some time and study on your part. I recommend you start with this book, then go to Diabetic-Diet-Secrets.com, bookmark the site and visit it often until you have a clear understanding of what makes a healthy diabetic diet and you feel confident in planning a healthy meal
Some people just don't believe they have diabetes. They don't see why they need to follow a diabetes care plan. Other people understand in their minds that they have diabetes, but still do not follow their care plans. These are forms of denial. It can take time to overcome denial, but the sooner you accept your diagnosis and begin learning about your diabetes, the sooner you'll achieve independence and good health under your care plan. Many people with diabetes will go through a time of grieving . It is normal to grieve over the loss of your healthy self when first diagnosed with diabetes or when a complication occurs. With time and support from family, health-care providers, religious leaders, and friends, you will be able to resolve your grief.
An individual with diabetes can, in general, lead a normal, healthy, and long life. Looking after yourself and learning about your diabetes provide the best chance to do this. Your doctor and the other members of the health-care team (made up of doctors, nurses, dietitians, and chiropodists) are there to advise you and to provide the information, support, and technology for you to look after yourself and live your life in the way you choose. It is important for you to know what your health-care providers should provide to help you reach these goals and what you should do.
Unfortunately, there has also been a tendency to treat adherence and metabolic control as interchangeable constructs. Health care providers have been known to assess patients' compliance and measure therapeutic success based solely on biological measures, such as HbA1c levels. The literature has not only failed to document a direct relationship between adherence and metabolic control (4-6), but even when patients have followed their program reasonably, often there is far less than perfect control. Health care providers must take into consideration the numerous factors that influence or inhibit an individual's behaviors in maintaining good health. Also, measures of an individual's health should never be limited to metabolic ones. Psychosocial outcomes, such as quality of life, are equally, if not more, important in assessing a person's well-being.
They say their mother, Henrietta, carefully taught them how to care for themselves so they could stay healthy. The doctor prescribed the diet I should be on, and my mother was most careful about sticking to it, Robert Cleveland says. There were very few carbohydrates, a quart and a half of milk every day, and there were lots of vegetables and proteins. 3
Keep in mind that a healthy meal plan for you is just a healthy meal plan. You don't have to worry about following some strange diet involving weird foods that no one else in your family will want to touch. You will be developing a healthy living strategy that will benefit all the members of your household. Often, family members will not even realize that they are eating a diabetes meal plan.
Consult with your health care team in advance to know how much additional rapid- or short-acting insulin you may need. drinking plenty of water. This helps to prevent dehydration. avoiding exercise. Exercise just causes more fat-burning because there isn't any insulin. If you continue to exercise, you could counteract the effects of taking extra insulin. Unlike glucose levels, ketone levels aren't given in exact units like mg or dl. Instead, the side of the vial reads from zero and trace to small, moderate, and large. Some brands just score with + signs. Ask your health care team in advance what to do when you have moderate to large ketones. They may ask that you call right away or try taking additional insulin first. Be sure
Try not to exercise when your insulin injection is peaking. If you use rapid-acting or regular insulin, this would mean to avoid exercising within the first 1 to 2 hours after injecting it. Remember that exercise increases blood flow, which speeds up how fast your insulin goes to work. If your exercise is going to be of moderate to high intensity or you're going to be working out at a more moderate intensity but for a longer time than usual, think about decreasing the insulin dose that will be working while you exercise. Ask your health care team for guidance.
The control group subjects were also given general advice about healthy lifestyle at their annual visits to the study clinic. An oral glucose tolerance test was done annually and if either fasting or 2-h glucose values reached diabetic levels a confirmatory oral glucose tolerance test was performed. The study endpoint, type 2 diabetes, was only recorded if the second test also reached diabetic levels otherwise the subjects continued with their randomized treatment. The subjects in the control group were given general verbal and written diet and exercise information at baseline and at subsequent annual visits, but no specific individually tailored information.
Claims that suggest that foods or food components have an impact on health - in improving good health or a condition related to a disease - have been called health claims.5,10 An important subgroup of claims are disease-risk reduction claims. They state that a food or its component may help to reduce the risk of a disease. Examples of such claims include 'Adequate intake of calcium may help to reduce the risk of osteoporosis', 'Adequate intake of folate by women may reduce the risk of having children with neural tube defect', 'Food low in fat and cholesterol can help to reduce the risk of coronary heart disease'.
Another question is why has the incidence of type 2 diabetes increased so rapidly Considerable epidemiological evidence points to excess caloric intake and physical inactivity as the major reasons. There is no room here to discuss the problem of obesity and overweight in people with established CHD. Obesity and overweight are obviously associated with a clustering of CHD risk factors and weight reduction results in favourable changes in the risk factor profile of most individuals. However, it is also obvious that weight reduction efforts have met with limited success in the general population and that the treatment of obesity is complex and difficult. There is no reason (and no published data) to believe that the situation is different among patients with CHD. In addition, there are controversies regarding the efficacy, benefits and consequences of high-carbohydrate or low-fat or very low-fat or high-protein diets, all of which have been proposed as the best way to reduce weight....
Vitamins and minerals are essential to your health. Although they do not give you energy, they do assist in energy-yielding reactions and promote body growth and development. Vitamins and minerals are vital for human function, each one playing a different role. Read on to find out what select vitamins and minerals do and where you can find them Whole foods are the preferred source of important vitamins and minerals for your health. Always look to foods first, before considering a supplement. If you have questions about vitamins, minerals, or nutrition supplements, talk to your doctor or Registered Dietician.
While the cost-effectiveness of community screening has yet to be tested, it could be argued that this approach would serve to enhance public awareness about both T2D and CVD and help to encourage healthy living at a population level in terms of diet and exercise. From a commonsense standpoint, there is much to be said in support of population health initiatives with Government backing linked to positive incentives (e.g. cheaper healthy foods, free use of community leisure facilities), but this would require significant investment of time and resources in a relatively healthy generation in an attempt to prevent morbidity and mortality several decades in the future, a concept that is unlikely to be welcomed by politicians whose careers depend on being re-elected at 4-year intervals.
Matyka et al. (46), on the other hand, found differences in hypoglycemic symptom responses when comparing healthy older men, aged 60 to 70, with younger men, aged 22 to 26. During clamp studies, neuroendocrine responses for the two groups were similar. However, symptoms began earlier in the younger men and were more intense (46). Measures of psychomotor coordination deteriorated earlier in the older subjects and to a greater degree (46). The usual 10 to 20 mg dL plasma glucose difference between the subjective awareness of hypoglycemia and the onset of cognitive dysfunction was lost in the older men (46). This altered counterregulatory effect may contribute to the altered cognitive response to reductions in blood glucose. A lower glycemic threshold to hypoglycemia would be problematic in older persons. This would further limit the time available to self-treat and thereby increasing the risk of developing severe hypoglycemia (44,46). Additionally, in the older patient these...
The goals of dietary advice are to achieve and maintain good health and quality of life, with avoidance and management of short-term symptoms, including hypoglycaemia and freedom from the long-term complications of the disease, for as long as possible. Evidence available from America from the Diabetes Control and Complications Trial in Type 1 diabetes (11) and also from the United Kingdom Prospective Diabetes Study in Type 2 diabetes (12) suggests that normalisation of metabolic markers like blood glucose levels and management of blood pressure constitute key aims. There needs to be a balance between the attainment of objectives of care and the demands that they may impose on the individual person with diabetes.
In the United States, the schools or day care centers that receive public funds are legally required to provide training to school staff on treating diabetes. The ADA has literature for teachers and child-care providers. Your health-care team can also help ensure that the staff members at your child's school are adequately trained. The degree of supervision by the staff of the school will vary with your child's age and abilities.
When you are diagnosed with a chronic illness like diabetes, you may go through a period of grief because of the loss of good health. The diagnosis can be overwhelming there is a lot of information that you need to grasp you have to learn about carbohydrates, calories, exercise, weight management, and checking blood glucose levels. You may need to take oral medications or inject insulin. You may also have some or all of these questions Be proactive about your health care
If you take oral diabetes medications, you cannot assume that your health will be fine when you exercise if you take sulfonylureas, nateglinide, or repaglinide, you can get low glucose levels with exercise. Prepare for this by taking your meter and some glucose tablets or juice with you. If hypoglycemia occurs when you exercise, talk to your doctor about reducing the dose of your sulfonylurea medication.
If you have diabetes, you know how high health care costs are. Not only do you have to pay for routine care, but you also have to be prepared for the unexpected. Medical care is expensive for everyone these days, making health insurance an absolute must. Diabetes can make health care even more expensive even if you have insurance. So getting the best insurance coverage possible is critical, not only for your pocketbook, but also for your health. Throughout the course of your life, your career, and your diabetes, you need to periodically evaluate your health insurance situation. Ask yourself if your needs are being met. If you are unhappy with your current situation, evaluate the options. But don't be too quick to jump ship. Any change in your health insurance coverage requires careful evaluation. You need to make sure that any new situation provides the health care coverage you need. There may also be times when you want to make changes in your life. Maybe you want to switch jobs,...
If you are seeing your diabetes care provider or other health care professional for the first time, you will most likely be asked to provide a medical history. The forms and questionnaires may vary, but all will want the same basic information. Although many questions may refer to matters that you consider private, it is important to answer honestly and trust that your health care team will maintain confidentiality. how old were you when you contracted mumps ask that a questionnaire be mailed to you in advance. That way, you can answer all the questions more accurately and at a leisurely pace. The more complete and correct the picture you provide, the better your health care will be. care not to criticize you. What is important is achieving good health.
If you or your health care team suspect that you have hypoglycemia unawareness, you need to establish some safety nets Discuss your hypoglycemic episodes with your health care team so you can look for patterns to use as warning cues. Educate more of the people you're with every day about hypoglycemia and how to help you. Treatment. If you think you are having a hypoglycemic reaction, you need to check your blood glucose level. Talk to your health care team about the blood glucose level at which One way to gauge how much glucose to take during a hypoglycemic reaction is to do a glucose check. When your blood glucose is about 100 mg dl or less, eat or drink your favorite fast-acting sugar. Wait 15 minutes, then recheck. Did your blood glucose rise 25, 30, or 50 mg dl, or more This will give you an idea of how to treat your hypoglycemia. You'll be less likely to overtreat low blood glucose if you can predict how much your treatment will increase blood glucose. Ask your health care team...
Adopting an intensive management program does not happen overnight. It works better if you have the help and support of your family and your health care team. Intensive diabetes management takes commitment on your part. If you find that your current diabetes plan interferes with living the kind of life you would like, you may be more likely to stick with an intensive program. When you and your health care team decide to forge ahead, they will probably recommend that you attend classes or a series of training sessions to learn how to make adjustments in your diet, exercise, and insulin doses.
Whether you have type 1 or type 2 diabetes or gestational diabetes, the goal of diabetes care is the same to keep blood glucose as close as possible to that of a person without diabetes. For many people with diabetes, getting normal blood glucose levels (like a person without diabetes) just isn't realistic or even desirable. For instance, if you are elderly and live alone, you may be more concerned with preventing severe low blood glucose than avoiding long-term complications. Talk with your health care
It is very important to make sure that you understand what your health-care professionals are saying to you and to speak up when you do not understand because they are being either too vague or using medical 'jargon' or technical language with which you are not familiar. Good communication is critical if you are to be satisfied with your care, and a number of studies have linked 'satisfaction with treatment' to a good understanding of what was said during the consultation, which in turn leads to the likelihood of being able to follow your
As we have discussed, successful lifestyle change that leads to weight loss involves more than just changing your diet. In fact, diets alone don't work for permanent weight loss. But you will need to learn to manage and plan your eating how you eat, where you eat, why you eat, what you eat, and when you eat. It's a long-term commitment to your health, not a short-term test of your willpower. That means getting rid of the diet mentality. A diet does not sound permanent. It suggests an element inserted 134, into your life rather than the consistent long-term change in
A market is like a huge menu set up to entice you. Most markets are set up in the same way. This setup is not by accident. It's arranged to encourage you to buy. What people buy on the impulse of the moment is often the most calorie-concentrated and expensive food that is least appropriate for them. You'll find that all the perishable food is arranged around the perimeter of the market. The high-calorie foods are in the aisles in the middle of the store. Unless you want to take the long way around, you must go through those aisles to get to the meat, milk, fruit, and vegetables. You pass the loose candies, the cookies, the high-sugar cereals, and all the other no-nos. If you prepare a list and buy only from the list, you won't purchase any of those foods. Walking into the market hungry and without a list is dangerous for your health.
Until very recently, bottled salad dressings didn't offer much in the way of flavor unless they were full of fat, salt, sugar, and other no-nos for a diabetic diet. Some of the newer light dressings have improved flavor, are less detrimental to your health, and are convenient. But there's really no substitute for making dressings yourself. And believe it or not, the process is pretty simple.
In this book, you find everything of importance that you need to know to help your child (or yourself, if you're an adult patient) live a long and healthy life with type 1 diabetes (or T1DM for short). If you don't read about something in one of the chapters on diagnosis and treatment, it's unlikely that it plays an important role in diabetes care. So if you hear about some great breakthrough in T1DM and it isn't in this book, consider it a myth until proven otherwise. You can even drop me an e-mail and tell me about it at diabetes drrubin.com. I'm happy to either confirm or deny it.
Eat about the same amount and type of carbohydrate every day, at about the same time in relation to when you take your insulin or oral diabetes medication dose. Learn how to make adjustments from your health care team. For example, if your blood glucose check shows a level higher than your target range, take a small supplemental dose of rapid-acting or regular insulin, skip a snack, or if mealtime is coming up, eat less than usual. Getting extra exercise can also help sometimes. Increase your dose of rapid-acting or regular insulin (or plan to get some extra exercise) when you know you'll be eating more carbohydrates than usual. Take less insulin if you plan to eat less than usual. Learn how to make these adjustments from your health care team.
So how is type 1 diabetes different from type 2 diabetes (T2DM) The central problem in T2DM isn't a lack of insulin but insulin resistance in other words, the body resists the normal, healthy functioning of insulin. Before the development of T2DM, when a person's blood glucose is still normal, the level of insulin is abnormally high because the person is resistant to the insulin and therefore more is needed to keep the glucose normal.
Consider having a snack before going to sleep for the night. If you use an insulin pump, you may want to disconnect it during lovemaking to avoid going low. The length of time you can safely keep the pump off without an injection depends on how active you are. Ask your health care team for advice about this. more attention, and there is more help available. If you are having any problems related to sexual issues and you want help, talk to your health care team. If you don't feel comfortable talking with your provider, perhaps you need to find a health care professional with whom you do feel comfortable discussing personal matters.
In order to help your child to live a long, healthy life free of complications of T1DM, you need a number of skills under your belt. You pick up these skills primarily from the diabetes specialist, the diabetes educator, and the dietitian, but the other professionals listed in the previous section also contribute to your education. i Setting goals to promote health, and problem solving for daily living (Chapters 14 and 15)
Prevention efforts may start with promotion of healthy lifestyle and appropriate screening in those at higher risk individuals 45 years of age and those with a BMI 25 kg m2 (22). Screening should also be considered for people who are 9 lb or were diagnosed with gestational diabetes, hypertension, low HDL cholesterol, high triglycerides, women with polycystic ovarian syndrome, IGT, or IFG on previous testing, other clinical conditions associated with insulin resistance (e.g., severe obesity and acanthosis nigricans), and history of cardiovascular disease (CVD). Repeat testing may be carried out at 3-year intervals. Overweight and obesity are strongly linked to the development of T2D and can complicate its management. Moderate weight loss improves glycemic control and reduces CVD risk. Therefore, weight loss is an important therapeutic strategy in all overweight or obese individuals who have T2D. All patients with diabetes should be encouraged to maintain a healthy lifestyle by...
Pregnancy puts stress on any woman's body. This is why it is so important that you and your health care team keep a close watch on your health before and throughout your pregnancy. But here's the good news When women with type 1 diabetes who have been pregnant are compared to women with type 1 diabetes who have never been pregnant, about the same number of women in each group show signs of diabetes complications. Being pregnant doesn't seem to raise your risk for complications over your lifetime. Mother's Health. Before becoming pregnant, you need a thorough physical exam. Any problems that could jeopardize your health or that of your baby will be assessed. These problems include high blood pressure, heart disease, and kidney, nerve, and eye damage. If you have any of these complications, they need to be treated before you try to conceive. Even kidney transplant recipients who are otherwise healthy have had babies. Your A1C level will be measured, as well as your thyroid function, if...
In 2002, the Institute of Medicine recommended at least one hour of exercise daily for good health and weight. This was based on numerous studies of the effects of exercise on health. This amount shouldn't be taken as an upper limit, though. If you want to do more, that's fine, but don't do less. An hour (not an apple) a day keeps the doctor away
The role of smoking in causing lung disease is well known. But smoking is even more risky for people with diabetes. Over time, smoking damages your heart and circulatory system by narrowing your blood vessels. When blood flow to cells is restricted, the cells in your body can die. This damage can lead to heart disease, impotence, and amputation. Coupled with the already high risk for people with diabetes, the effect can be devastating. If you smoke now, talk to the members of your health care team about strategies that can help you quit.
Of the three components of an educational package, attitudinal learning is more difficult to attain than is knowledge or skills acquisition. For example, the difficulty in getting people to modify their diet, level of exercise and other lifestyle factors is well recognized, even in people with knowledge about what constitutes a healthy lifestyle (Searle and Ready 1991). Health professionals who fail to understand the value of rehabilitation also require education, to counteract nihilistic attitudes. It is important that such people come to understand that neither old age nor diabetes is a barrier to successful rehabilitation. As stated eloquently by Roald Dahl (1975) 'It is possible for anyone, given a lot of guts and a bit of luck, to overcome gigantic misfortunes and terrible illness.'
The accepted, tried-and-true treatment for type 2 diabetes is a balance of diet and exercise. Even if you need medications, healthy eating and exercise habits continue to be key in caring for your type 2 diabetes. Most people with type 2 diabetes are advised to lose weight and improve their physical fitness. This can help to lower the body's resistance to insulin. The severity of type 2 diabetes can be greatly reduced by maintaining a healthy body weight. Even a modest weight loss 10 pounds can have benefits. By building a healthy lifestyle around a low-fat, well-rounded diet and regular exercise, it is possible to decrease body weight and insulin resistance. Exercise helps by taking some glucose from the blood and using it for energy during a workout, an effect that lasts even beyond the workout. Healthy eating, especially watching the amount of food eaten, helps glucose levels stay lower. As your level of physical fitness improves with regular exercise, so does your body's...
Gymnema silvestre is a plant found in India and Africa that is promoted as a glucose-lowering agent as part of an alternative medical treatment called Ayurvedic medicine. Gymnema silvestre has never been tested in a controlled study in humans. One statement in its advertising is, For most people, blood sugar lowers to normal levels. No evidence exists that this is the case.
Blood pressure control is critical for the prevention of both microvascular and mac-rovascular complications of diabetes. The goal should be to have blood pressure measurements consistently below 130 80. Sometimes you may find that the blood pressure is high only when you see a doctor or when you see a particular doctor (a phenomenon called white-coat hypertension). If this is the case, ask to have your blood pressure measured when you see other doctors, or buy a home blood pressure machine and use those blood pressure measurements as a guide to treatment. Blood pressure is often easier to control than blood glucose levels, and controlling blood pressure is just as beneficial to your health. You doctor may not routinely recommend measuring blood pressure at home unless there is a suggestion that you have white-coat hypertension or symptoms that might be due to low or high blood pressure.
When deciding upon treatment for an elderly patient with diabetes, you first have to consider the individual. Does this person have a low life expectancy Or is this person physiologically young, with the possibility of living for 15 or 20 more years If the patient is only 65 years old and in relatively good health, he or she has a life expectancy of at least 18 more years plenty of time to develop complications of diabetes, especially macrovascular disease, eye disease, kidney disease, and nervous system disease (see Chapter 5). That person may require more intensive diabetes care than someone who is older and has worse overall health.
The focus of this chapter is MNT in pregnancy complicated by preexisting diabetes. However, the value of preconception counseling in women with preexisting diabetes cannot be ignored. All women with diabetes should receive MNT counseling prior to and throughout pregnancy, ideally provided by a registered dietitian who is well versed in diabetes and pregnancy. The role of the dietitian is to assess nutrition knowledge and determine a meal plan approach based on individual preferences to meet MNT goals of (1) providing adequate calories and nutrients that are important for optimal maternal and fetal outcomes and good glycemic control to minimize pregnancy complications, (2) balancing food, activity, and insulin doses to achieve adequate weight gain and to meet glucose goals to maximize perinatal outcomes, and (3) promoting healthy lifestyle behaviors that will contribute to lifelong health.
Individuals with diabetes must manage their blood glucose levels through the careful balance of food, exercise, and medication. Blood glucose monitoring is an essential component to good health. It is the only way of making sure blood glucose levels are maintained within your child's target range. Because it is extremely important for your child to be able to monitor his or her own blood glucose levels and respond to levels that are too high or too low as quickly as possible, you may want your child to check his or her blood glucose levels and promptly treat wherever he or she is at school or during a school-related activity. Whether this is appropriate depends on your child's age, level of experience and skill, and personal preference. Your child's immediate access to diabetes equipment and self-care is important so that symptoms don't get worse and so that she or he doesn't miss valuable classroom instruction or other school activities.
Was a magic formula to tell you how to arrive at the right blood glucose level. Instead, you'll need to discover how each of these factors affects your blood glucose level. Knowing how much to eat, how much to exercise, and how much insulin or medication to take is not always easy. You are likely to feel frustrated at times. Look to your health care team for support. They can also help you learn to understand the meaning of your self-monitoring results and what to do about them.
Go ahead and lose some pounds and start an exercise program or increase it if you already do something, Not only will you prevent diabetes if you don't have it already or decrease the damage it does if you do, but your health in general will take a giant step in a positive direction.
Think of your insulin as an insurance agent, who lives in San Francisco (which is your pancreas) but travels from there to do business in Seattle (your muscles), Denver (your fat tissue), Los Angeles (your liver), and other places. This insulin insurance agent is insuring your good health.
The first step is to choose blood glucose targets for your pregnancy. The targets given in the box on page 370 are an example. Talk to your health care team about how to personalize blood glucose target ranges to your health and your lifestyle. In the first trimester, targets are designed to help you minimize the risk of birth defects or miscarriage. In the second and third trimesters, the targets will help to prevent your baby from growing too large. If you have trouble staying in the range, or if you have frequent or severe hypoglycemia, talk to your health care team about revising your treatment plan or your targets.
Diabetes management is much more than blood glucose readings. And data management systems can do much more than store blood glucose readings. These systems can store many test results and information on time, date, insulin doses, exercise, and food intake. Some will store or calculate grams of carbohydrate in food and insulin doses. Some even have built-in alarm clocks. Some systems can load all of these data into your or your health care team's computer while others are part of the meter. PDA systems are also available. Surprisingly, data management systems don't cost too much more than regular meters. These systems can give you a detailed picture of your overall diabetes management plan. Before you buy a system, check to see if your health care team uses or recommends one system over another. Also call the manufacturer's toll-free number and ask them exactly what you will be getting. They should be willing to answer any questions you may have. You can also buy computer programs or...
Will probably interpret the question as to how much sport or exercise they do. According to the Allied Dunbar National Fitness Survey (Activity and Health Research, 1992) 75 per cent of the participants knew that exercise is good for your health, but many people do not recognize that they can look to their everyday life to find ways to be more active without the need to engage in formal exercise if they do not wish to. Working from an understanding of the perspective and lifestyle of the obese or type 2 diabetic individual is therefore important in supporting their efforts to increase their physical activity. This is especially important since they will commonly view exercise and sport participation as unattainable and not desirable, as they may have had bad previous experiences of exercise and sport.
You'll talk with your doctor about what kind of medicine you need and how much you should take. You'll also agree on a target blood glucose range and blood pressure and cholesterol targets. Your doctor will do tests to be sure that your blood glucose, blood pressure, and cholesterol are staying on track and that you're staying healthy. Ask your doctor if you should take aspirin every day to help prevent heart disease. questions if you don't understand something. After all, it's your health
Epidemiologic studies suggest that individuals who are obese and historically sedentary are at the highest risk for Type 2 diabetes and are thus the best targets for physical activity interventions. Since intense exercise is not likely to be feasible or popular in these individuals, interventions will probably be more successful if they focus on lower intensity activities. Unfortunately, lower intensity physical activities are the most difficult to measure. Fortunately, the assessment of physical activity has made considerable progress in the last half century, enhancing the understanding of the relationship between exposure to different levels of physical activity and risk for a wide range of diseases. Because of the contribution of physical activity assessment tools, physical activity is now regarded as one of the fundamental behaviors necessary for a healthy lifestyle. It is likely that any improvement in the accuracy of these tools will only enhance the ability to observe true...
The Balance of Good Health (see Figure 2) shows the types and proportion of foods you need to eat to achieve a well-balanced and healthy diet. It is based on the five commonly accepted food groups. It shows that you do not have to give up the foods you most enjoy for the sake of your health. A healthy eating pattern includes the correct balance of foods from the four main food groups every day, plus an allowance for extras from the fats and fatty sugary foods group. All your nutritional needs will be met if you choose foods in these proportions. Remember, however, that everything you eat - snacks as well as meals - counts towards the balance of what you eat. The basic message is The balance of good health The balance of good health
The intervention studies discussed above were carried out in a number of ethnic groups and populations. Although none have been carried out in Australian Aborigines there is no reason to believe that the possibility of improving metabolic parameters and preventing Type 2 diabetes in Aboriginal populations both in Australia and other developed countries would be any less. The studies to date have been focused on people with IGT who are already at increased risk of Type 2 diabetes. There are no data available from any population as to whether community-wide programmes encouraging healthy diet and exercise can successfully reduce the incidence of Type 2 diabetes. However, given the potential benefits of healthy lifestyle programmes in influencing risk factors for a range of non-communicable diseases, including Type 2 diabetes, coronary heart disease, stroke and certain cancers (11,30), there are strong grounds for advocating a strengthening of such programmes in Aboriginal communities...
Ou will be surprised at how easy it is to eliminate meat and dairy and substitute with something just as delicious. Sometimes the food will taste different, so you have to try different vegetable products to see what works best. You may even find that the taste of the food when vegetable sources are used is better than when animal sources are used. It takes getting used to, but the advantages for your health are worth the effort.
If goal setting is to succeed, therefore, the goals need to flow from you and be an expression of what you require to solve a particular problem. The goals need to come from you and be owned by you. This canbe particularly challenging, as people sometimes want to set goals that are far too ambitious to be achievable. In other circumstances people want to set goals that are not compatible with established guidelines or with what the diabetes care team believe is the best course. However, your health-care professionals will ensure that you understand the disadvantages and benefits of your decisions, and will emphasise the likely consequences of your choices. In the end, however, you are responsible for, and in control of, the choices you make about your own diabetes self-care.
The logic of profit underlying integrated agroindustry planet-wide has turned food into goods just like any others. If food is good to sell, the logic of profit concludes that only those who can afford food will eat, in an equation ruled by budget rather than by need. There is a direct relation between the creation of profit and the creation of nutrition pathologies. In no way can small local producers compete with the world's agroindustry as a consequence, products manufactured in developed countries reach the farthest corners of the planet, on the basis of price, prestige, and biological security, homogenizing the taste for certain foods and decreasing the diversity of foods. Such nutritional invasion does not promote health but instead profit. In the global culture the market that historically was used to organize the interchange has become the legitimizing factor of society the market society that endows nutritional culture with one single meaning profit. Then, those who eat are...
Establishing such relationships requires effort and commitment. A great many factors will determine your ability to feel comfortable with your health-care team including your personality, your health-care professionals' personality and philosophy regarding treatment, and more. You will probably look for a series of cues in order to answer important questions that you will have on your mind, such as 'Do they listen to me ', 'Do they seem to care about people ', 'Are they concerned about my agenda and my concerns ', 'Do they appear knowledgeable about diabetes ', 'Will they be able to answer my questions '.
The idea behind intensive diabetes management is to keep your blood glucose levels as close to normal as possible. If you decide that intensive management is for you, you will want to choose blood glucose goals as close to those of people without diabetes as is reasonable and safe for you. It's a group decision that you, your family, and your health care team need to make together. One piece of information that came out of the DCCT is that even if you set goals that seem reasonable, they can be hard to reach. The DCCT goals for people in the intensive management group were to have near-normal blood glucose levels before and after meals and at bedtime. Most people just couldn't consistently reach these goals. No matter how hard you and your health care team work, it is difficult to keep blood glucose levels close to those found in people without diabetes.
To check for heart and blood vessel disease, your health care team will do some tests. At least once a year, have a blood test to see how much cholesterol is in your blood. Your health care provider should take your blood pressure at every visit. Your provider may also check the circulation in your legs, feet, and neck. Ask your health care team whether you should take an aspirin every day. Blood pressure levels tell how hard your blood is pushing against the walls of your blood vessels. Your pressure is given as two numbers The first is the pressure as your heart beats and the second is the pressure as your heart relaxes. If your blood pressure is higher than your target, talk with your health care team about changing your meal plan, exercising, or taking medicine.
By keeping daily records of your blood glucose checks, you can tell how well you're taking care of your diabetes. Show your blood glucose records to your health care team. They can use your records to see whether you need changes in your diabetes medicines or in your meal plan. If you don't know what your results mean, ask your health care team.
In places like Chicago where you can smell the air as you approach the city, it is wiser to keep your windows shut. You can't breath the industrial soup all day and night and expect to stay healthy. Of course, it all enters the houses anyway. Central air conditioning and a plain carbon filter at the furnace location (see Sources) may be the best solution in spite of blowing dust around the house. Keep the vents to the bedrooms closed to reduce the air turbulence there but leave the cold air return open. Clean the vents in other rooms each week along with floors and carpets by pulling up the grating and reaching down the passage as far as possible.
Medical Nutrition Treatment In The Management Of Type Diabetes Goals of Nutrition Therapy for Type Diabetes
Nutritional management aims to help optimize metabolic control and reduce risk factors for chronic complications of diabetes. This includes the achievement of blood glucose and glycosylated hemoglobin (HbA1c) levels as close to normal as is safely possible, and lipid and lipoprotein profiles, as well as blood pressure values, that may be expected to reduce the risk of macrovascular disease. Individual nutritional needs and the quality of life of the person with diabetes also have to be considered when defining nutritional objectives (7-10,14,16,36). The nutritional recommendation for an individual patient should include practical advice regarding appropriate food choices and quantities. However, it should be stressed that nutritional recommendations for people with type 2 diabetes are similar to those aimed at the population as a whole for the promotion of good health and the prevention of metabolic disorders and vascular complications. Thus, the food for persons with diabetes should...
Of course, the goals mentioned previously are guidelines only. Discuss your needs with your health care team to create a plan that will work for you. Your target glucose levels may change over time. For instance, you could find it harder and harder to detect hypoglycemia. This would call for increasing your target range and perhaps new training at recognizing your symptoms.
One of the most important tools in your diabetes toolbox is also the most overlooked. The low-tech logbook may not look like much, but it will help you and your health care team understand your blood glucose levels and will alert you to any red flags that could signal a serious problem. Everyone gets a free logbook when buying a new meter. Many pharmacies don't carry logbooks because the meter manufacturers provide them to health care professionals instead. Ask your health care team You may want a lot of room to write in your logbook. Consider buying a spiral-bound notebook or using a loose-leaf notebook, where you can add pages as needed, to jot down extra notes. You may find it useful to have extra space to record different symptoms and situations that could be relevant to your health. Your logbook is an important tool for looking for patterns in your blood glucose control, so be sure that it is easy to use. Notebooks also offer lots of room to write for people whose fingers might...
As a first step, each family member needs to understand what diabetes is, how it is managed, and how to handle emergencies. There is lots of help available. Books, magazines, pamphlets, libraries, support groups, on-line message boards and chat rooms, and medical professionals can all be of assistance. Take a family member with you to some of your health care appointments. By keeping a running list of questions or issues with which they may be concerned, your family can get answers to their questions firsthand. Many diabetes education programs encourage family members to attend. The more information they have, the more they can help you and learn to integrate your diabetes management plan into the daily family routines. Your family can also help with your eating plan. For many people, this is the most difficult adjustment to make after being diagnosed with diabetes. You may want to change some of the foods you eat and when you eat them. It will help you tremendously if the members of...
The main risk is of hypoglycaemia (see Chapter 10). Every patient on glucose-lowering treatment (whether tablets or insulin) must be taught how to recognize and treat hypoglycaemia. They should also know how to adjust their treatment to reduce the risk of further hypoglycaemia. Patients with varied timetables, varied meals, and varied exercise and those who have problems being careful with their diabetes are particularly at risk of hypoglycaemia, as are the very young and elderly. Any patient who has had one hypoglycaemic attack is likely to have more. Some patients will be unable to achieve a normal glucose without hypoglycaemia. In this case you must work together towards the best compromise between safety now and good health long term.
Interventions and it was difficult to generalize the findings. One study examined the effect of dietary education aimed at young children, 3-9 years old. A significant reduction in prevalence of overweight and obesity was reported in the group of children who were given 'multimedia' information regarding healthy eating which included the use of qualified staff to underline health messages (Simonettei et al., 1986). No significant changes were seen in the control group and also in a group of children who were given written information only. Four long-term studies examined the effect of a combination of dietary education and physical activity interventions. The results of these have been disappointing. The APPLES study in the UK assessed the impact of a school-based intervention including teacher training, modification of school meals and action plans tackling physical activity in the school curriculum (Sahota et al., 2001). Six hundred and thirty four children aged 7-11 years old took...
Observational studies just look at the association between vitamin E status (either in the diet or in blood samples) and clinical measures of heart disease such as myocardial infarction (MI) or stroke. These studies are summarized in Table 4.1 and generally support the idea that vitamin E helps prevent heart disease. Observational studies do not, however, show cause and effect and have many major limitations. For example, people who are health conscious in general may exercise, maintain an ideal body weight, have a low-fat diet, and also take vitamin E supplements. In this case, vitamin E consumption is just a marker for a healthy lifestyle.
Some blood glucose meters store 10 or 20 or over 1,000 test results. This saves you from having to write the results down each time, but you will still have to see if there are any patterns in your blood glucose readings by charting out the results. Make sure to show the members of your health care team the results of your monitoring. Let them know if you are pleased or not with the results and what you want to do to change your results. Sometimes you will be faced with an unexpectedly high or low reading. Try to figure out what could have caused it. You might already know why the reading could be higher than usual. If you have a series of high or low results that you can't explain, contact your health care team. As you get the hang of monitoring, you will come to know what to expect your readings to be at certain times of the day. If your readings are consistently higher or lower than your target, or if you get a reading that is unexpectedly high or low, this could indicate a...
Randomized to either an active intervention (metformin or diet exercise) or the control group. Metformin, a standard anti-diabetic medication, and diet exercise reduced the risk of incident diabetes however, the risk reduction was much greater for participants in the diet exercise group than for participants in the metformin group. Similarly, investigators of the Finnish Diabetes Prevention Study reported that healthy lifestyle modification (i.e., diet and exercise) could reduce the risk for incident diabetes. Furthermore, participants with the highest compliance to the diet and exercise regimen had the lowest risk of incident diabetes (102). Taken together, these two studies provide conclusive evidence that lifestyle modification (diet exercise) is an effective therapeutic strategy. Earlier, we discussed findings supporting the notion that T2DM and insulin-resistant conditions in the absence of diabetes impair memory and other cognitive functions (13-16) and that effectively treating...
When your child is diagnosed with type 1 diabetes, he may experience a wide range of emotions, such as shock, sadness, anger, and denial. Having these initial emotions is perfectly normal, but your child needs to accept the diagnosis eventually in order to take charge of his treatment and start living a healthy life. You can use the information in the following sections to show your child that he's not alone in dealing with type 1 diabetes and to help him develop positive coping skills.
To manage T1DM, you and your child have to do so much on a daily basis, and so little of it seems to have an immediate effect. The positive belief that what you're doing is helpful to your child in the long-run is what keeps you doing it. The power of positive thinking is an important tool that helps you do everything you must do for your child, knowing that your efforts will bear fruit in the form of a long and healthy life. I discuss the details of coping with T1DM positively in Chapter 6.
As you and your health care team design your diabetes care plan, you'll need to set some big picture goals. Any kind of diabetes treatment should be able to help you meet the basic diabetes management goals listed above. The methods you use to meet these treatment goals almost always include some form of meal and exercise planning and may also include a medication plan (see table on page 32). When you sit down with members of your health care team to plan your treatment, be sure to consider the following
No matter how long and confusing is the list of symptoms a person has, from chronic fatigue to infertility to mental problems, I am sure to find only two things wrong they have in them pollutants and or parasites. I never find lack of exercise, vitamin deficiencies, hormone levels or anything else to be a primary causative factor. So the solution to good health is obvious
People with type 2 diabetes have plenty of insulin in their bodies (unlike people with type 1 diabetes), but their bodies respond to the insulin in abnormal ways. Those with type 2 diabetes are insulin-resistant, meaning that their bodies resist the normal, healthy functioning of insulin. This resistance, combined with not having enough insulin to overcome the insulin resistance, causes type 2 diabetes.
Two bowel movements a day are the minimum necessary for good health. The first one should be in the morning. The morning cup of water, drunk at the bedside has the magical ability to move the bowels. Cold water may fail. But the water effect only works in the early morning. Waiting until after breakfast may not work. Notice the energy lift your loved one gets from this most primitive body cleanse. Take advantage of this to exercise them. Go immediately for the morning walk. This might be the only time of day they can enjoy their walk.
This book is one small step in that direction. I had to find answers for myself. I am not a farmer, food manufacturer, drug manufacturer, medical practitioner, researcher, politician or otherwise entangled in the web that has created this international problem. I am one lonely voice in the wilderness seeking answers and willing to share what I find with others. There are no big dollars in trying to get people to make healthy choices so I will never get rich. If I can get a few people to make healthy choices I may have done some good. If each of us then helps a couple more get healthy we are contributing to the betterment of our communities. If enough of us get involved in wanting a healthier world we will have a movement. If the movement quits buying unhealthy foods, the food companies would listen and give us healthy foods. I know this is an impossible dream but we have to start somewhere and I chose to start with myself and ask you to join me.
This part takes you on the road to long life and great health as you incorporate the needs of being a person with diabetes into the rest of your life. It begins by showing you all aspects of a healthy lifestyle and continues by focusing on food and its importance to you. When you cook for a person with diabetes (either yourself or a loved one), you must keep some special considerations in mind, but this part shows you that a diet for diabetes is an excellent diet for anyone. We guide you around the kitchen and take you to the supermarket to find out about meal-enhancing ingredients, as well as the ones to bypass as you navigate the aisles.
Which of the following has your health care team (doctor, nurse, dietician, or diabetes 3. Which of the following has your health care team (doctor, nurse, dietician, or diabetes 5. Which of the following has your health care team (doctor, nurse, dietician, or diabetes 10. Which of the following has your health care team (doctor, nurse, dietician, or diabetes educator) advised you to do Please check all that apply
You should expect your primary physician to have a decent working knowledge of diabetes. Chapter 7 describes the proper way to follow a person with diabetes. The various tests are essential to your health, and the primary physician must know which ones to order and when to send you to a specialist because your needs are beyond his or her expertise.
A person's weight loss goals are often based upon other personal considerations, such as appearance. As you set your weight loss expectations, keep in mind that the amount you need to lose to improve your health is probably different from (and likely less than) how much you'd need to lose to bring you to your pre, Calculate Your Own Weight Loss Goal_
Your mate may worry when the decisions you make about caring for yourself seem wrong. He or she may fear the consequences of what will happen, either in an emergency situation or down the road, if you neglect your health. Maybe you feel that your spouse is nagging too much. Maybe your spouse feels that you are deliberately undermining his or her efforts to sup- You might need help learning to communicate. Admitting to this is a sign of strength, not a weakness. Confide in your friends. Speak with your spiritual counselor. Consider seeking the help of professional counselors who are trained in coping strategies for people with chronic disease. Your health care professional or local ADA office may be able to help you find the skilled professional you need to talk to.
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