Category Archives: high blood sugar

How did I get type 2 diabetes?

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Being diagnosed with type 2 diabetes can be a very overwhelming experience. Naturally, those newly diagnosed may have a lot of questions. But one of the most common questions I get asked is ‘how did I get diabetes?’

 A lot number of people may not have a full understanding of how certain factors as well as lifestyle can put them at a higher risk for developing type 2 diabetes.

 In a recent post -summit survey I performed, several participants responded they wanted to learn more about type 2 diabetes. 

For those people who do not have diabetes, this information is still beneficial. It will help you to know what your risk and begin now to make healthy lifestyle changes.

 Insulin and the pancreas

The pancreas is an organ located in the abdomen. It produces a hormone called insulin. Insulin helps the cells in the body to use sugar as energy.

In type 2 diabetes, the cells of the body begin to resist the effects of insulin. This condition is called Insulin Resistance.

I like to use the metaphor of a landlord who changes the locks to the house on his tenant.

In this metaphor, the tenant is blood sugar.  Insulin controls the lock to the house. With insulin resistance, the tenant cannot open the lock, with the insulin.

Insulin resistance is usually present in the body at least five years before type 2 diabetes is diagnosed.

Who is at risk of developing type 2 diabetes?

 Here are some of the things you should know that increases the chances of developing type 2 diabetes:

  • Family History: A big reason why people develop diabetes is genetic. If you have a first degree relative with diabetes, like a parent, sister, brother,  then your chance of getting diabetes goes up five to ten times. So it is crucial to know your family history.
  • Ethnic Groups: Type 2 diabetes is common in certain races such as African Americans, Hispanics, Asians, and Native Americans. So just by being of a certain race puts you at an increased risk.
  • Pregnancy: 3-5% of pregnant women can develop diabetes in pregnancy, also known as gestational diabetes. The difference is that once the baby is born, diabetes goes away.

If you had diabetes while you were pregnant, you are at risk of developing diabetes later on in life. Make sure that after your pregnancy, you have regular medical check-ups. Your healthcare provider will need to monitor your blood sugars closely.

  • Environmental Toxins:  Environmental toxins which can increase the risk of type 2 diabetes have been coined diabetogens. Exposure to toxins such as pesticides, arsenic, as well as ambient air pollution, to name a few, can all increase the risk of type 2 diabetes through several mechanisms.

Ongoing exposure to the toxin load increases our risk of developing type 2 diabetes.

  • Medications: Some medications can cause diabetes. Usually, this happens to people who were already at risk for developing diabetes.

One of the common drugs that can cause diabetes is steroids. Steroids are used to treat many medical conditions such as transplant patients, chronic lung disease, rheumatoid arthritis, and other autoimmune diseases to name a few.

According to the National Kidney Foundation up to 20% of patients after a kidney transplant may develop diabetes.

There are some other commonly used medications which can elevate blood sugars.

These include-

  • Statin medications -used to treat high cholesterol.
  • Thiazide diuretics -used to treat high blood pressure.
  • Beta-blockers
  • Transplant rejection medications such as tacrolimus
  • edications used to treat anxiety and/or depression.

Speak with your healthcare provider if you are concerned about any medications you are on. Do not discontinue any medications by yourself.

It is possible that the benefits of being on the medication may outweigh your risk of developing diabetes.

Trust that your healthcare provider has your best interests at heart.

If you do not feel this about your healthcare provider, then perhaps you need to search for a new one!

For more information on how to pick a healthcare provider that is the right fit for you, click here.

To download a FREE copy of the first three chapters of my award winning book which explains more about type 2 diabetes, click here.

Here’s to your Health & Wellbeing,

Some proven benefits of the ketogenic diet, but is it right for everyone?

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I recall when I first started hearing the buzz around going “keto” “ketogenic” ketolife” I was very skeptical. With the roll of my eyes I dismissed it as a soon to be done fad that would blow over. But it didn’t.

After my community talks, I’d have a few people stop by and ask my thoughts on going “keto”. Again, my response would be I thought it was just another fad and would pass away. And oh by the way if you happened to be someone living with type 2 diabetes, this probably was not for you!

How wrong I was on both counts especially the latter.  

Well you know the saying “what you resist persists”?  Keto has persisted. And now it’s becoming mainstream.

The ketogenic diet was developed almost a 100 years ago- in the 1920s- by a faith healer who was trying to help children with epilepsy. There was some success with this diet intevention at the time. However, when drugs were developed for the treatment of epilepsy it fell out of favor.

How does the ketogenic diet work?

The ketogenic diet works by converting the body’s source of predominant fuel from carbohydrates to fats which are the source of ketone bodies predominantly beta hydroxybutyrate. This leads to an increase in the production of energy source -ATP.  

The ketogenic diet is now being used to treat a host of diseases and conditions. In the article below I list some of the benefits of a ketogenic diet.

Improved insulin resistance and reduced inflammation

By utilizing fats as a source of fuel versus carbohydrates there is less need for insulin. This leads to less insulin resistance. Insulin resistance is the hallmark of type 2 diabetes. There is research showing the benefits of a ketogenic diet to reverse pre-diabetes or type 2 diabetes. Insulin resistance is also associated with more inflammation because of an increase in free radical production. Inflammation is linked to a host of chronic diseases such as auto-immune diseases, arthritis, thyroid disease, bowel disorders, mental and cognitive decline (type 3 diabetes). Less insulin resistance=less inflammation, which allows the body to heal.

Improved Fat Burning leading to weight loss
By definition, being in a state of ketosis means you’re burning fat for energy. If you have excess body fat, you’ll be able to burn it at a much more efficient rate. This trend can lead to weight loss. The advantage of using fat as fuel, is that you do not have as much hunger cravings as when you are using carbohydrates as a main source of fuel.

Mood stabilizing effects
A ketogenic diet changes the energy matrix of the body. In the brain, a ketogenic diet helps to modulate mood by not only a reduction in inflammation but also changes in monoamine oxidase levels, GABA transmission, as well as mitochondrial biogenesis.

Improved Energy
Increased energy from a ketogenic lifestyle is due to a combination of factors including less inflammation, upregulation of mitochondrial biogenesis, more ATP per molecule of ketone and more stable blood sugar.

Improved Mitochondrial Biogenesis &Anti-aging
Our bodies are trained to use glucose (sugar) as a natural source of energy.  Our mitochondria are the energy powerhouse of our bodies. With aging, we tend to have less efficient mitochondria. The ketogenic diet helps to stimulate new and stronger mitochondria. Because mitochondria have such a profound impact on energy production, inflammation levels and gene expression (and therefore an overall function of the body), promoting mitochondrial health can be of great benefit when it comes to anti-aging.

How do you know you’re in ketosis?

There are a number of kits on the market which can help you to detect when you are in ketosis. Kits that measure blood levels are more accurate than urine test strips.

How do you know if keto is right for you?

Despite it’s popularity a ketogenic diet may not be safe for everyone. Despite a plethora of websites offering do it yourself keto plans and diets, I highly recommend that you invest in working closely with a qualified healthcare professional who is well versed on what to look out for if you have any of the following conditions:

  • Type 2 diabetes
  • Very high blood triglycerides
  • Severe depression
  • Older adults
  • Cancer
  • Cognitive decline such as alzheimer’s type dementia
  • Certain gene snps such as ApoE4

The next thing to consider is – how long do you need to be on a ketogenic diet?

The reality is that maintaining ketosis for prolonged periods of time can be a challenge for most.

In summary, a ketogenic diet can be a useful tool for helping to improve metabolic health. Be sure to use it under the supervision of a qualified healthcare practitioner who will be able to customize it to your unique goals as well as determine a safe duration of therapy.

To your health and wellbeing,

Scientific citations

A low carbohydrate ,ketogenic diet to treat type 2 diabetes

Veech RL. The therapeutic implications of ketone bodies: the effects of ketone bodies in pathological conditions: ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism.

Peer-reviewed papers from Virta health on ketogenic diet and type 2 diabetes reversal

Five Strategies to help you reach healthy blood sugar control in the New Year

Happy 2019! I trust you are off to a great start. It is great to be back to blogging after such a long time. As I shared in an earlier newsletter, late summer we had some challenges upgrading the platform and then as the holidays approached, I had a rather grueling work schedule, in addition to a brief media blitz in Wisconsin. I am currently writing to you whilst on a much-needed vacation in Nigeria.

This is a re-purposed article from an older blog article. I like to start the new year highlighting New Year resolutions.

Now that we are in a New Year, we can press the reset button and set some New Year resolutions to reach your healthy blood sugar goals.

What is a resolution?

A resolution is a firm decision to do or not to do something. Research has shown that close to 90% of resolutions fail by the end of the first quarter of the year.

If you are committed to thriving with type 2 diabetes, then consider developing an empowered relationship to resolutions. Remember you are not just a person living with type 2 diabetes.

Here are Five New Year Resolutions to start with:

It all begins with the ABCs

In my award-winning book, “Dr. Eno’s A-to-Z Guide to thriving with Type 2 Diabetes”, the first three chapters focused on what I started calling the ABCs. The ABCs is an acronym which stands for A-Acceptance, B-Belief and C-Commitment to change.

No matter what challenges you may be dealing with, whether it is learning to live with a chronic illness such as type 2 diabetes, or simply deciding to make a new year resolution it all begins with your ABCs.

The reason many New Year resolutions fail, is because we tend to avoid change by making excuses. First is the need to accept some things need to change. Next is developing a belief that you can make changes. The final step is making a commitment to improve. To download a free e-book of the first three chapters of my book, click here.

Learn all there is to learn about type 2 diabetes

I continue to emphasize that knowledge is the first step toward personal empowerment. The field of diabetes care is rapidly changing. Become curious about the latest information particularly as it may pertain to diabetes care. Search for reputable sources of information.

If you find a treatment option that you feel may work for you, then be sure to have a discussion with your healthcare provider about this. Remember that there are several ways to treat diabetes, however, making changes to your lifestyle is the foundation for reaching healthy blood sugars. So this year, make a commitment to taking stock of your current lifestyle. Look for ways that you can make some changes. Always remember to start with small changes and then build on them. With time small changes can create significant shifts in your overall health and wellness.

Do what it takes this year to achieve and maintain healthy blood sugars. There may be times when your blood sugars get out of control. This can be very discouraging. At times some people living diabetes may become discouraged and resigned. The thing to keep in mind is that uncontrolled blood sugars are associated with a higher risk of complications. So if you commit to doing whatever it takes to achieve and maintain healthy blood sugars, you will reduce the risk of complications. It may mean, increasing the amount of physical activity, watching portion sizes a lot more closely, and cutting out the excuses.

See your healthcare provider on a regular basis.

Early in the year is an excellent time to look at your calendar and schedule visits with your healthcare provider as well as any specialists on a regular basis are vital in helping to detect any early complications. Not only should you see your healthcare provider on a regular basis, but also I suggest that you even know what kinds of testing you need to have done. For instance every three months, you should have an A1C performed. This test allows your healthcare provider as well as you to know how well controlled your blood sugars have been. For tips on how to choose a healthcare provider

Know your “ABC numbers.”

The ABCs stand for another acronym. It is essential to know your ABC numbers. This means- A1C, Blood sugars and cholesterol. Have a discussion with your healthcare provider about what your target ranges are.

Your numbers are based on guidelines recommended by the American Diabetes Association:

  • A1C <7.0 %
  • Blood sugars (fasting) 80-120 mg/dl
  • Cholesterol- LDL (think bad lousy cholesterol) less than 100 mg/dl; HDL (think good happy cholesterol) more than 60 mg/dl.

Keep up with routine health exams.

Once a year schedule an annual physical exam, as well as routine screening tests. Do not leave these to chance. This is because type 2 diabetes increases your risk of some other diseases such as heart disease as well as strokes as well as certain cancers.

I suggest marking this on your calendar early in the year. Perhaps you may want to pick your birthday month, for instance, to get all your routine medical exams done.

So there you have it. Five New Year resolutions to get the year off to a robust start in achieving healthy blood sugars.

My New Year resolution is to create more consistent content for this platform as well as online and in-person programs that can help you reach your goals of thriving by helping you to improve your metabolic health.

So let’s get started! Click here to download the free e-book of the first three chapters of my book. And if you would like to purchase a copy of my book, click here.


To your Health & Wellbeing,

Health Awareness Topic- What every woman needs to know about fatty liver disease

 

 

 

 

 

 

It was a routine request for a preoperative consultation in the hospital.
I cheerfully introduced myself to my 33-year-old female patient. She had presented to the emergency room with upper abdominal pain. She had an ultrasound of her abdomen performed which revealed inflammation of her gallbladder. She was scheduled to have surgery the following day.

I briefly read the ultrasound report I noticed an additional abnormality. I asked her to tell me about herself. She had a history of high blood pressure otherwise considered herself healthy. She did not drink alcohol but consumed several cans of soda a day. She had a twin sister recently diagnosed with type 2 diabetes. Her mother who was present in the room, also had type 2 diabetes. It seemed to be coming together in my mind.

I assured her that I thought she would do well with the surgery, however, that I had found a slight concern on the ultrasound. The ultrasound showed that she had fat in her liver. I explained to her what this meant and some of the things in her history that had put her at risk for this happening. I shared with her that because she was obese with a history of high blood pressure as well as having a family history type 2 diabetes mellitus she was at increased risk of developing type 2 diabetes herself.

So what is fatty liver disease?

My patient had is a condition called non-alcoholic fatty liver disease, commonly called fatty liver disease. Fatty liver disease is becoming more common with some studies showing that up it affects up to 46% of adult Americans. It is more common in women. It usually develops between 40 and 50 years of age, although there are some young people in their teens being diagnosed with fatty liver disease. Many people do not know that they have fatty liver disease. Up to 2-3% of people have a more condition called nonalcoholic steatohepatitis (NASH). NASH can progress to advanced liver disease called cirrhosis.

Some Conditions associated with fatty liver disease

  • Obesity– more than 70% of people with fatty liver disease are obese. Of more concern is abdominal obesity. The waist circumference is a measure of fat in the abdominal cavity. Measuring the waist circumference helps to determine abdominal obesity. A waist circumference (over 31.5 inches in women and 37 inches in men). Fat can accumulate around organs as well as inside organs such as the liver. Fat cells produce harmful substances increase inflammation in the body and can lead to chronic illness. In the liver the fat cells can cause inflammation called nonalcoholic steatohepatitis (NASH) and can eventually lead to a condition called cirrhosis.
  • Type 2 diabetes – Up to 75% of people with fatty liver disease have type 2 diabetes
  • Metabolic syndrome– Metabolic syndrome is not a disease, but a collection of symptoms. Metabolic syndrome increases the risk for type 2 diabetes, hypertension and heart disease. Click here to read more about an article I wrote about metabolic syndrome and the link between type 2 diabetes and hypertension.
  • High triglycerides– Between 20-80% of people with fatty liver disease have high triglycerides.
  • Exposure to certain toxins and drugs– some medications that are used to treat medical conditions can cause fatty liver disease. These include steroids (prednisone and hydrocortisone, methyl prednisolone) amiodarone, tamoxifen

What are the signs or symptoms of fatty liver disease?

Unfortunately most people with fatty liver disease do not have any symptoms. At other times a routine blood test performed by your healthcare provider might show abnormal liver enzymes which may be a clue that there may be some inflammation in the liver .

How do you to treat fatty liver disease?

The good news is that if addressed early, fatty liver disease is reversible. Here are some things you can do:

  • Weight loss- If you have been informed by your healthcare provider that you have fatty liver disease, please take this seriously. Lose weight. Lose weight gradually. Rapid weight loss has been found to worsen fatty liver disease. Do not just look at this as a ‘weight loss plan’, rather look at ways to improve your lifestyle. Work with your healthcare provider to create a lifestyle plan that works for you and allows you to thrive.
  • Eliminate high fructose corn syrup- High fructose corn syrup is a manufactured chemical sweeter that is present in a lot of foods. It is very common in soda as well as several other processed foods including salad dressing and even ketchup. There are some studies that show a relationship between high fructose corn syrup and liver disease.
  • Reduce processed foods. Increase fruits and vegetables- processed foods contain a lot of simple carbohydrates. These simple carbohydrates get turned into sugar. Excess sugar gets taken up into the liver and converted to fat. Reduce simple sugars and increase the amount of fruits and vegetables in your diet. This way you are getting more fiber, vitamins, minerals and powerful nutrients that have healing properties.
  • Treat diabetes – If you have been diagnosed with type 2 diabetes or borderline diabetes get this treated.

This is the time to focus on making healthy lifestyle changes. If left untreated, fatty liver disease could progress and cause severe damage to the liver. Be proactive. This is your life. I want to see more women thrive into their older years rather than suffer from the effects of chronic illness. If you would like more information about working with me click here.

To your health and wellbeing,

Seven Tips People Living With Diabetes Mellitus Type 2 Can Use to Make the Most of an Office Appointment with Their Healthcare Provider

Diabetes MellitusFor some people living with diabetes mellitus type 2, an appointment with their healthcare provider, particularly a doctor, can be overwhelming.

When I was in a primary care practice, I often told my patients that for the most part they had an average of four to six office appointments a year. The typical primary care visit is limited to only 15 minutes. So you need to prepare ahead of time to make the most of the appointment.
Here are seven tips you can use to make the most of your office appointment. If you use all these tips, you will get the most out of every visit to the doctor.

Tip Number 1: Take a Long Record of Your Blood Sugars

Make a habit of keeping a record of your blood sugars. Keep it simple. You do not need fancy computer software. All you need is a small notebook. You can get this at any office supply or drug store. Divide each page of the notebook into at least two columns.

The first column is for the date and time that you check your blood sugars. The second column is to a record of your blood sugar levels.

Some people do not like to prick their fingers to check their blood sugars. I’ve shared in an article some tips on how to check your sugars once a day. Over the period of a week you be able to trend of how your blood sugars are running.

By keeping a log of your blood sugars, it helps provide important feedback for you as well as your healthcare provider. For instance if your blood sugars suddenly begin to run high or low, you can pinpoint the exact time this happened. Perhaps you were sick, had started an exercise program or went on vacation and over-indulged in food. All this information can help you and your healthcare provider to make important decisions regarding your diabetes management.

Tip Number 2: Take Along Your Glucometer

When I was in an office based practice, I liked to look over the blood sugar readings on my patients’ glucometers. A number of the new generation glucometers provide a lot of valuable information. For instance some machines average the sugars over say a 14-30 day period. Others may average the blood sugars before and after meals. This is a great teaching tool for diabetic patients. It allows them to see how their blood sugars affects their overall health and wellbeing.

Tip Number 3: If Your appointment is First Thing in the Morning Do Not Eat Breakfast

Take advantage of an early morning appointment with your healthcare provider and arrive ‘fasting’. Nowadays, a lot of healthcare providers perform blood tests in their offices to check blood sugar, A1C and lipid profile. For more information on the importance of knowing your numbers, click here.

Tip Number 4: Always Carry a Snack

Has this ever happened to you? You are at the doctor’s office and the wait time is longer than you planned. But you had taken your medications earlier on in the day. Next you begin to experience the ‘bottoming out’ sensation as your sugars take a nose-dive.

Next thing you know it you’re being carted into a waiting ambulance to the emergency room!

I advise people living with diabetes to always carry around a piece of ‘hard candy’. I also recommend meal replacement bars such as glucerna. So always be sure to take a snack along with you wherever you go.

Tip Number 5: Keep a Journal and Take This Along to Your Visit

Living powerfully with diabetes requires that you do things a little differently than the crowd. Keeping a journal or a diary is one of those things. A lot of times, a journal is for your personal use. However at times it may help your healthcare provider to detect why your sugars may be running high or low.

There are several ways you can choose to journal. For instance, you can keep a food journal. If you keep a record of what you eat, you may notice there are certain foods that make your blood sugars go up.

This gives you a good idea of knowing what foods to reduce or what to take out of your diet completely.
You may find out that stress affects your blood sugars. Some people may prefer to journal and record their blood sugars in the same book. Decide what works for you and just do it.

Tip Number 6: Be Prepared to Take Off Your Shoes and Socks

Foot care is a very important aspect of diabetes care. Inspecting the feet helps to prevent or detect early foot infections, which could lead to other complications. I always insisted on looking at the feet of all my diabetic patients at least every 2-3 months.

It is also important to make sure that you have sensation on the bottom of your feet.

Your physician can perform a very simple test called a fine filament test on your feet. This is a simple instrument and as there name suggests a thin filament. If you do not feel the filament being pressed on the bottom of your feet, you may be developing a complication called diabetic neuropathy. This is when the nerves are damaged and you can no longer feel your feet. The danger is that you could step on a nail for instance and not know because you could not feel it.

Diabetic neuropathy is one of the leading causes of amputations in people living with diabetes mellitus. So make sure that your doctor performs this test on your feet every three months.

Tip Number 7: Be Prepared for Change

In diabetes type 2 is a disease that has the potential to change over time. Regimens that worked earlier on may not work so well as the disease advances. As time goes on it may get harder to control your blood sugars. So be prepared for change.

For example you may have been on a medication for a long time and your blood sugars had been well controlled. All of a sudden your blood sugars start running high. Your doctor may decide to add another medication or even insulin. Always believe that your healthcare provider has your best interest at heart.

I know that there are a lot of skeptics out there about the pharmaceutical industry. Research is being conducted to develop new drugs, which may help preserve the function of the pancreas.
To reduce the potential complications of type 2 diabetes follow your doctor’s advice. In the first three chapters of my upcoming book, “Dr Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes” I address three strategies that are important in order to embrace change. To download a free copy of my e-book that covers this, click here.

As always I welcome your comments and suggestions about more topics you would like to learn about.
To your health & wellbeing,

How Type 2 Diabetes Can Affect The Skin

diabetesType 2 diabetes affects many organs in the body. The skin is one of the largest organs in the body. There are several skin conditions that can happen just because of diabetes. For the most part very few of these skin conditions are life threatening. More importantly, a lot of these conditions may show up when the blood sugars are not well controlled.

These skin conditions can be very frustrating, especially for women living with diabetes. By knowing about these conditions will allow you to become a more vigilant. It also helps to hasten healing if you should get any one of these.

Acanthosis Nigricans

This skin condition gives the skin the appearance of soft velvety wart like growth. It is usually seen at the back of the neck, the armpits, beneath the breasts, the flexure surface of the elbow.

It is typically seen in those who are  overweight or obese.

There are other conditions that can cause this skin condition, but usually acanthosis nigricans is a warning sign of  insulin resistance. Insulin resistance can eventually lead to diabetes.

I take the time to point this out to my patients. Especially patients who do not have diabetes. This is a great time to start making lifestyle changes.

Scleroderma diabeticorum

This is a skin condition that causes the skin of the back and the upper neck to become very thick.

The treatment for this is to get the blood sugars well controlled.

Lotions can be applied that will help to soften the skin.

Vitiligo

In vitiligo, the skin loses it’s pigment and causes white patches. Vitiligo is an autoimmune disease. Vitiligo is more common in type 1 diabetes. It is very important to use a sunscreen, to reduce the risk of developing skin cancer.

Vitiligo is treated with skin lightening creams to try to even out the appearance. Some people even attempt to tattoo back in pigment into the white areas.

Eruptive Xanthomatosis

These are lumpy yellow deposits of fat beneath the skin. It is usually an indication that cholesterol and triglyceride levels are high.

Once blood sugars and the cholesterol are better controlled then these may disappear.

Digital Sclerosis

Tight waxy skin on the back of hands, the toes and also the forehead. This condition happens more commonly in people with type 1 diabetes and can cause the hands to become stiff.

Just as in most of the other skin conditions we have discussed thus far, the treatment is to normalize the blood sugars.

Disseminated Granuloma Annulare

Raised oval patches that are either skin colored or red or brown. They usually occur on parts of the body away from the trunk such as the legs or the ears.

In addition to controlling the blood sugars, there are several ways to treat this condition. So please be sure to see your healthcare provider.

Diabetic Blisters (Bullosis Diabeticorum)

These blisters may be large but are usually large and look like burns. They are not painful. They can occur on the fingers, feet, and hands and even sometimes on the forearms.

The treatment is to get the blood sugars within control. They heal by themselves within a few weeks. It’s important to keep them clean.

Necrobiosis lipoidica diabeticorum

This is caused by fat and collagen accumulating beneath the skin. Most times these lesions happen on the legs. The overlying skin then gets thin and can break down easily especially when exposed to injury. It can also get itchy.

It is important to see your primary care physician especially if the lesions break open as it may take a longer time to heal.

Allergic reactions

Allergic reactions that can cause rashes and bumps can also occur in type 2 diabetes. It is even possible to develop an allergic reaction to a particular type of insulin. So be very observant and if this happens inform your physician.

Bacterial infections

These can happen especially when blood sugars are not well controlled. The common culprit is staphylococcus aureus. This can cause boils, folliculitis or impetigo. There is a particular strain of Staphylococcus called MRSA (Methicillin Resistant Staphylococcus Aureus).

It is very important to treat MRSA early and promptly. So be sure to bring any boils to the attention of your physician.

Fungal Infections

These are usually caused by candida (yeast) organisms. Women with borderline or full-blown diabetes may also be at risk of vaginal candidiasis. Fungi can affect various body parts. For instance between the toes it can cause athlete’s foot. It is very important to make sure that the webs between the toes are kept dry to prevent athlete’s foot, as this could become an entry point for bacterial infections. Fungi can also infect the toenails causing the nails to become dark and discolored. This is called onychomycosis. In the groin it can cause a jock itch.

There is a potentially fatal fungal infection that is very common in diabetes called Mucormycosis. This fungus invades the nasal passage and then can spread to the eye and brain.

If you have a ‘sinus infection’ that does not seem to be getting better, especially associated with eye pain, and fever should be evaluated immediately by a physician.

It is important to get evaluated and treated for these skin conditions. Your healthcare provider may refer you to a dermatologist. This is a doctor who specializes in skin diseases.

As you can see from this article, in addition to treating these skin diseases, it is also important to get the sugars under good control.

As with any other complication associated with diabetes, I like to emphasize the importance of prevention rather than treatment.

You may be experiencing difficulty getting your blood sugars under control. Do not despair. It starts with your mindset. You have control over how you choose to live with a chronic illness.

To learn more about this click here to download a free copy of the first three chapters of my upcoming book.

Be persistent. Stay the course.

To your Health and Wellbeing,

Seven Tips On How to Maintain Healthy Blood Sugars During The Holiday Season

holiday-feast

I recall a number of years ago, when a patient left my office based practice and sent me a very nasty note three months later. She expressed how disappointed she was that I was not a person of my word. I had assured her that due to the fact that her blood sugars were well controlled and her A1C was less than 7% that I would attempt to wean her off some, if not all her medications.

The catch was that at the time that this discussion was going on, the holiday season was also upon us. I had made a mental note to address this in the New Year, as I hate to see anyone fail due to no fault of his or her own.
I should have educated my patient on what it was that I intended to accomplish and my reasoning.

For people living with type 2 diabetes, this is one of the more challenging times of the year. Blood sugar levels may gradually begin to rise with each holiday party. And with that, the A1C rises.

By following these seven simple steps, you can survive the holiday season and come out a winner ready to embrace 2017 as you live powerfully!

Tip number 1- Plan your meals

In order to keep blood sugars within a normal range, planning your meals is very important at this time of the year.

Here’s a simple tip-If you know that you are going to be out at a holiday party later on in the day, consider having a light snack just before leaving home. That way you are less hungry and less likely to go for the sweets that will cause your sugars to rise.

Also consider cutting down on the portion sizes of your earlier meals. Be careful if you are on insulin or an oral hypoglycemic agent not to cut down too low so that you do not experience hypoglycemia.

Tip number 2- Increase your amount of fiber intake

Fiber is a complex carbohydrate. The average American diet contains a low level of fiber. Most nutritionists recommend a daily fiber intake of up to 35G.

Studies have shown that by increasing the amount of fiber in the diet can help control blood glucose levels. This is especially if it is soluble fiber. An example of soluble fiber is oatmeal.

Fruits and vegetables are all good sources of fiber. By making a conscious choice to increase the amount of fiber rich foods in your diet will get you to your goal of maintaining a normal blood sugar range throughout the holiday season and beyond.

Tip number three- Plan to incorporate physical activity

The Winter & Holiday season is traditionally the time when the average American gains between 7-10 lbs. Studies have shown that people living with type 2 diabetes can achieve normal blood sugar range by increasing physical activity. During the winter months make an effort to maintain some form of physical activity. Choose an exercise regimen that is easy to follow.  As always be sure to see your physician before starting out on an exercise program. So if you have not already scheduled your annual physical, now is a great time to go ahead and do so.

Tip number four- Drink enough water

There are a myriad of benefits to drinking water. The important thing in a type 2 diabetic is to maintain good kidney function. Drinking water may also keeps you feeling full and so help with weight loss. The traditional recommendation has always been 8 glasses of water a day. However something else to consider is drinking half of your body weight in ounces. So if you weigh 170 lbs. that equals 85 ounces of water a day.

Tip number five- be consistent with monitoring your blood sugars

This is not the time of the year to slack off testing your blood sugar levels.  It is not the time to stick your head in the sand and rationalize that your blood sugar levels are going to be high and there’s nothing you can  do about it anyway. Your mindset is very important. If you have not been checking your blood sugar levels regularly, this is the time to start. By regularly checking your blood sugar levels,  you get instant feedback. Living powerfully with diabetes, requires that you have an awareness attached to action. High blood sugar levels just do not happen to you. You can make the necessary adjustments in your lifestyle in order to control your blood sugars.

Tip number six- Keep all scheduled appointments with your healthcare providers

This is the time to make your healthcare provider aware of any challenges that you may be encountering during the holiday season. That way you both can explore ways to better control your blood sugar levels.

Depending on your A1C, your healthcare provider may decide to adjust your medications. This is a much better option than starting out the New Year with high A1c levels and blood sugar levels out of control. Sometimes it can take more than 6 months to normalize the blood sugars.

Tip number seven- Enlist the support of family and friends

I have written in a previous article about the importance of a support network. Now more than ever is the time of the year to enlist the support of family and friends. Want to get started in an exercise program? Call up a workout buddy. Not sure how to handle ‘Aunt Martha’s’ three layer chocolate cake? Have a family member share a portion with you. It takes teamwork to make the dream work. Do not be afraid to ask for support. Sometimes just knowing there is someone else looking out for you is what makes the world of difference.

I’d love to read your comments and any other strategies that you may have in place to ensure that you keep your diabetes type 2 sugar levels normal this holiday season and beyond.

Until next week,

Here’s to your Health & Wellbeing,

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Pregnancy and Diabetes

Gestational DiabetesDiabetes in pregnancy is called gestational diabetes. Women who develop gestational diabetes usually did not have either borderline or type 2 diabetes before they got pregnant.

According to the centers for disease control, gestational diabetes occurs in about 9.2% of pregnancies. Just like type 2 diabetes, the incidence of gestational diabetes is rising.

Women with gestational diabetes usually do not have any symptoms. This is why it is important to screen for it in all pregnant women.

 

How gestational diabetes is diagnosed

Gestational diabetes is usually diagnosed after 24 weeks of pregnancy. If diabetes is diagnosed before 24 weeks, more than likely this is type 2 diabetes. Your healthcare provider will order a test called the oral glucose tolerance test. For more information about the oral glucose tolerance test, click here.

 

The cause of gestational diabetes

Gestational diabetes is felt to be caused by insulin resistance just as in type 2 diabetes. The high levels of insulin cross the placenta into the baby. The excess insulin converts glucose into fat. Babies born to women with gestational diabetes usually have a high birth weight of over 9 lbs. This is because they are large. This can lead to the baby getting injured as it is being delivered through the birth canal. If the baby is too large to be delivered naturally it may have to be delivered by cesarean section. Cesarean section is major surgery and just like any surgical procedure there are inherent risks to both the mother and the child. A woman who has a cesarean section may have to have another cesarean section in future pregnancies.

 

Treatment for gestational diabetes

 Women with gestational diabetes will need to be monitored very closely by an obstetrician who specializes in high-risk pregnancies. This is to prevent complications to the mother as well as the unborn child. Sometimes these appointments may be on a weekly basis as the pregnancy advances. It is important to know when these appointments are and to keep them.

Diet and moderate exercise are usually the first steps to treating gestational diabetes. If a woman has not been physically active before getting pregnant this is not the time to start a vigorous exercise program. Starting a walking program is a good idea, however it is important she speak with her healthcare professional prior to starting any physical activity.

If diet and exercise do not get control the blood sugars, then it may be necessary to start on medications. A lot of women are started on insulin because it allows for better control of insulin. It is also important that to check blood sugars frequently when pregnant with diabetes. Just as in type 1 or type 2 diabetes this can be taught and will need to be done at home several times a day. It is important to inform your healthcare provider if the blood sugars are not in the target range.

 

Gestational diabetes and future risk of developing type 2 diabetes

Gestational diabetes usually resolves after pregnancy. However women who have had gestational diabetes have an increased risk of developing type 2 diabetes. There is also a chance for recurrence in future pregnancies.

Risks for developing gestational diabetes

 

  • Certain ethnic groups such as African Americans, Latina, or Native Americans
  • Having borderline diabetes
  • Being overweight or obese
  • Family history of type 2 diabetes
  • Being over the age of 25 years

 

Steps to reduce gestational diabetes

 Just as in type 2 diabetes prevention is the key. Taking preventive steps does not reduce the risk of developing gestational diabetes to zero, but it is still a step to having a pregnancy with few complications and delivering a healthy baby.

Here are a few steps every woman planning a pregnancy can take to reduce her risk of developing gestational diabetes

 

  • Try to get as close as possible to your ideal body weight prior to getting pregnant.
  • Start an exercise program. I am a proponent of walking as a simple form of exercise. If you are planning to get pregnant now may not be the time to start training for a marathon, but it is easy to start walking. Purchase a fitness tracker and commit to walking 10,000 steps a day.
  • Eat more fresh fruit and vegetables. These contain nutrients rich in antioxidants, is a good source of fiber. Fiber helps with weight control. Fruits and vegetables are also a good source of folic acid that is necessary to prevent birth defects and support a healthy pregnancy. Juicing is an excellent way to get a variety of fruits and vegetables into your diet.
  • Get an annual physical. Inform your healthcare provider that you are planning a pregnancy and they may order some blood tests such as a fasting glucose, lipid profile and blood chemistry. For instance if you find out through blood tests that you have borderline diabetes, you can take some pro-active measures prior to getting pregnant.

 

Diabetes in pregnancy affects both a woman’s health as well as the health of her unborn baby. To avoid complications, it is important to seek medical care during pregnancy and to follow the advise of your healthcare professional.

To your health and wellbeing,

 

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How to Bring High Blood Sugar Levels Down Without Feeling Lousy

high blood sugarHello and welcome back to another edition of Women Living Diabetes,

Last week I wrote about low blood sugars also known as hypoglycemia. Today I am going to discuss the other extreme- high blood sugar levels. This is also known as hyperglycemia. Hyperglycemia can be as equally a challenging to treat.

‘But doctor I feel perfectly fine even though I have high blood sugars. In fact I feel really lousy when my blood sugar levels are normal. So this must be normal for my body’

I cannot tell you how many times I have heard that statement or something similar. One of the things I emphasize to all my patients is the importance of achieving normal blood sugars.

The American Diabetes Association recommends the fasting normal blood sugar should be between 70–130 mg/dL for fasting blood (3.9-7.2 mmol/L). Two hours after eating the blood sugar level should be less than 180 mg/dL (10 mmol/L).

Some people with type 2 diabetes begin to feel like they have low blood sugar levels even though they may be in the normal range. In other words their body tricks them into feeling this way. Next they eat to counteract the feelings and their blood sugars rise.

High blood sugar levels can lead to complications of type 2 diabetes.

So why do some people with diabetes feel ‘bad’ when their sugars are in normal blood sugar range?

Here is a simple explanation as to why this happens:

Every human body has a set ‘thermostat’. This thermostat is set to a range for each person. Everyone has a set level that his or her body systems function at.

For instance, the normal fasting blood sugar level is a range, between 70 to 99 mg/dL.  This normal range spans about 20 points. Which means it is going to be different numbers in that range for different people. But so as long as the blood sugar levels are in that range they are considered normal.

In type 2 diabetes, one of the things that happens is that the body reset it’s thermostat to a higher blood sugar level. So instead of functioning with blood sugars between 70 and 99 mg/dL, the body makes an attempt to function at a higher blood sugar level.

By the time diabetes symptoms set in, the blood sugars are usually well over 180 mg/dL.

This is why it is important to screen for diabetes early.

So now the body has reset it’s thermostat. Think about it like an air-conditioning system. If the thermostat is set at 73 degrees then the system does not come on until the temperature rises above 73 degrees and then it cools the room down till it is below 73 degrees and then turns off.

In the case of a person living with type 2 diabetes, the ‘blood sugar thermostat’ has been reset to a higher level.

Now here comes an ambitious healthcare provider such as myself. ☺ Our goal is to achieve normal blood sugars. Because we know from research that with normal blood sugars, the complications of type 2 diabetes are reduced.

However, as the blood sugar levels begin to come down with treatment, the body sends out alarm signals. These alarm signals feel just like low blood sugar (hypoglycemia). As I explained in my recent article, hypoglycemia is a very scary feeling for someone living with type 2 diabetes. Once they experience it once, most diabetics will usually do everything they can to avoid experiencing again.

So how can you bring your blood sugars down to target range without feeling lousy?

  • Keep a log of your blood sugar levels. You may need to check your blood sugars several times a day to see if there is a pattern.
  • Discuss your concerns with your healthcare provider. Remember open communication produces better outcomes.
  • Your healthcare provider may decide to bring the sugars to normal range slowly. This way the body ‘thermostat’ resets itself slowly without sending out those alarm signals.
  • If you feel that your blood sugars are dropping low, check the levels first before deciding to eat something. This serves a purpose of reassuring you what the level is. Most times the blood levels are still outside of range.
  • Do not to skip a meal. Try to eat smaller more frequent meals.

Remember that your goal is to achieve normal blood sugar levels. This requires that you are committed to your health and wellbeing.

As always I welcome any questions or comments that you have. If you have found this information useful, please share it with someone else.

Until next week,

To your health and wellbeing,

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