Category Archives: Type 2 Diabetes

Now I have Type 2 diabetes what am I supposed to eat?

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It comes as no surprise that one of the first questions someone newly diagnosed with type 2 diabetes asks is “What am I supposed to eat?”.

Let’s face it you’ve probably heard over and over again that type 2 diabetes is a ‘disease of lifestyle’. And lifestyle commonly involves food. When it comes to the food choices we make there is a lot of emotional charge attached to that. For some, it may be the way that they have eaten since they were children and this is the only way they know how to eat. Food is a connecting force between us.

So, a common answer someone diagnosed with type 2 diabetes may receive about what to eat from their healthcare provider may sound something along the lines of ‘eat healthy portion sizes, increase fruits and vegetables, cut down on processed foods’. And all these answers are great recommendations.

You’d think it seems pretty easy right to go out there and, ‘eat healthy portions, increase your fruits and vegetables, and cut down on processed foods’. But we know that’s not really what happens.

A lot of people struggle with food choices. Perhaps that’s why we have such a growing epidemic of borderline diabetes and type 2 diabetes.

Over the course of my 20 plus years as a physician, I have encountered some really strange interpretations of what a ‘healthy diabetic diet’ means to different people. Let’s face it, the amount of information out there on the internet does not help either.

So when I address the topic of what to eat with anyone diagnosed with type 2 diabetes I start by helping them to normalize their experience. Take a deep breath. This is not a punishment for what you have done wrong. And yes, you can make a choice starting today to do things differently.

My invitation is to consider that diabetes eating is healthy eating.

I intend to give a TED talk with that title because it’s something I passionately believe. If everyone diagnosed with type 2 diabetes looked at this as a way their body was inviting them to eat healthier we wouldn’t have people walking around feeling victimized.

The great news is that by making these changes to how you eat, it is possible to halt the progression of borderline diabetes, type 2 diabetes and worsening metabolic health.

Change can be stressful. So I often start by advising you take simple small steps.

This will help bypass the gargantuan alarm signals to your primitive brain- the amygdala which ends up keeping you from making any change smack in the middle of your comfort zone.

So back to the question -where do you start?

The Mediterranean diet

The Mediterranean diet is a great starting point when it comes to making some healthy changes to what you eat. The traditional mediterranean diet attracted interest because people who were living on the Greek Island of Crete had less heart disease.

What makes up the Mediterranean diet

  • whole grains
  • fruits and vegetables
  • extra virgin olive oil
  • modest amounts of poultry, red meat and fish
  • nuts
  • legumes (beans, peas etc)
  • red wine

The Mediterranean diet has been extensively researched. Over 50 studies have shown that by eating this way there is an improvement in overall metabolic health parameters- reduced waist circumference, improvement in lipid profile, blood pressure, weight and blood sugar levels.

Functional Nutrition

Perhaps you want to go a step further and you want to develop an empowered relationship to food.

Food can be used as a powerful tool, to bring about healing. In functional medicine, we call this functional nutrition.

There are several food plans used in functional medicine, each targeting different results.

The cardiometabolic food plan is a step above the Mediterranean diet.

Features of the cardiometabolic food plan

  • low glycemic foods
  • personalized targeted calories
  • helps to balance blood sugars
  • high in fiber
  • low amount of simple sugars
  • a healthy balance of quality fats

One of the exciting aspects of the THRIVE group coaching program, will be working with clients on creating a personalized cardiometabolic food plan designed to optimize their metabolic health.

If you would like more information about joining the program, please send an email to info@doctoreno.com.

What are the first steps to take after being diagnosed with type 2 diabetes?

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In my last blog post, I shared one of the common questions I get from patients when they are first diagnosed with type 2 diabetes, “How did I get diabetes?”.

One of the reasons I became so passionate about teaching patients and clients to live healthy lives with type 2 diabetes was because of the reaction I got when I told a patient they had type 2 diabetes.

Naturally, a lot of my patients expressed their dismay. However, what I noticed was some people instantly focused on the complications they could get from diabetes, instead of how they could go on living healthy lives. I realized this may have been because this was the only side of diabetes they had ever seen. Perhaps it those people with the complications had been their friends, colleagues, relatives, people in their community etc.

And so, I made it my mission to create a shift in the beliefs people had around being diagnosed with diabetes. With time, I found that I was able to engaged my patients in focusing on how to live healthy lives.

I was excited to see this. I also realized I was sharing the same kind of information that was getting my patients motivated. 

And so that is what motivated me to write my award-winning book, “Dr. Eno’s A-to-Z Guide to Thriving with Type 2 Diabetes”.

Maybe you are like one of my patients and your healthcare provider has just diagnosed you with type 2 diabetes and sent you on your way. You are feeling overwhelmed and you have no idea where to start.

Here are some steps you can take:

Step 1- Normalize your emotions

Yes, it’s important to not let your emotions run wild. Being diagnosed with diabetes or any other chronic illness can be a life altering experience. But you do not need to let it overwhelm you. First, take a step back and deal with the overwhelm. In an earlier blog article, I went into detail about how to deal with overwhelm so that it does not become overpowering. Click here to read the full article.

Step 2- Focus on the ABCs

Once we get over the shock of a life altering diagnosis, most of us want to try to want to fix it right away. In other words, we want to get straight into action. But if we want to be successful, we need to focus on what I call the ABCs of living with any chronic illness.

The ABCs is an acronym which stands for

  1. Acceptance
  2. Belief
  3. Commitment to change.

It is important that you are aware of your ABCs before you start to get into action.

Do you accept that you have type 2 diabetes? I mean face on?  Do you know have limiting beliefs around living with a chronic illness such as type 2 diabetes? Are you like a lot of my patients who instantly went from diagnosis to complications? Perhaps you know you need to make changes, but do you know there are several stages of change? Do you know what stage of change you are and what you need to do to move forward?

Click on this link to download for FREE, the first three chapters of my award-winning book.

Step 3- Focus on taking simple small steps

You’ve gotten past the initial shock and overwhelm. You’re familiar with your ABCs and the role they will play as you set out to make healthy lifestyle choices. Now you’re going to get into action. There’s one thing you need to be aware of though. We are creatures of habit. And if we try to offset the status quo, this new change sends an alarm signal to an area in the brain called the amygdala.

The amygdala is part of our primitive brain. That’s the part of the brain that is not involved in intellectual functions such as language formation, creativity or thinking. The primitive brain functions on actions related to the survival of our species and dates back to pre-historic time. The amygdala can get stimulated by fear. So, when we decide we are going to make HUGE changes, the amygdala gets triggered and it makes us stop that new thing and go back to what is familiar.

Think about a time you’ve made a major decision that involved some change. Was it easy? Or did you have a feeling of uncertainty and found yourself going back and forth about whether or not to proceed with the change? That was probably your amygdala getting fired off.

The same thing when it comes to making changes to your lifestyle when living with diabetes. You do not want to make too many changes all at once.

Start with simple small changes that are barely noticeable.

Work with someone in your support or buddy system. Create a list of say three simple things you would like to change. Notice the small number we started with.

For example, rather than say you are going to cut out all soda drinks immediately, how about working on decreasing the amount of soda you drink by say one serving every 1-3 days?

If you are not accustomed to exercise, start by for example walking for only 5 minutes. And that may also mean walking in place.

Now the great thing about simple small steps is you can build on your success. In time you’ll look back and realize you have taken large steps.

Step 4- Build in accountability team

Being held accountable for the changes you commit to helps to create results. Remember that in order to THRIVE with type 2 diabetes or any other chronic illness, over time you are going to do a lot of things differently. The reality is that it’s not always going to be smooth sailing. We may encounter bumps on the road that may challenge our resolve and even our belief in ourselves.  Building in an accountability team can help keep you on track.

Your team does not have to be complicated. But the members of your team must be people willing to support you in making those lifestyle changes.

For instance, you could have an accountability partner you check in with to make sure you have reached your weekly exercise and movement goals. Another one who helps you make sure you’re planning your meals. Another who helps you track your blood sugars etc.

Your accountability team needs to fit your needs.

Step 5- Consider joining a group coaching program

I believe that there is a lot of power in groups. Groups bring people who have things in common together and helps them move forward toward a common goal. Groups help people to produce powerful results.

By joining a group coaching program, you will not only be held accountable, but you will also get to work through different aspects of diabetes care. Group coaching programs will help you become more empowered around the choices you make.

If you have ever wondered about how a diabetes group could help you, I invite you to join my THRIVE group coaching program.

To get started, simply send me an email at info@doctoreno.com and we will be glad to send you a link to schedule a FREE no-obligation 20 minute consultation which will help us determine if this is a fit for you.

If you would like to learn about our services, please click here.

To your health and wellbeing,

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

The Women’s Health Blog Series

Welcome to the second installment of the ‘blog post series’. Whether you are a new subscriber or just happened to stumble on this site through a google search or a referral, the blog post series is a collation of  3-4 prior posts that not only have a common theme but also provide the reader with some very important information.  

I have found this to be quite useful when I have to refer clients or people asking me questions about common topics.

Blog post 1

It is not uncommon after the age of 50 to develop a low acting thyroid. At times some of the symptoms a woman may be experiencing may be easily confused with menopausal symptoms and rightfully so. In this blog post, I provide you with information in an easy to understand format about the symptoms of thyroid disease What every woman needs to know about thyroid disease.

Blog post 2

Currently, the leading cause of liver failure and the need for liver transplant is not alcohol abuse, but a condition called non-alcoholic fatty liver disease (NAFLD). This article highlights what you need to know about NAFLD including common things that can place you at risk of developing this condition. I highly recommend that if you have ever been informed in the past by a healthcare provider that you have ‘fat in your liver’ that you take this information very seriously.

Blog post 3

We speak figuratively of how something broke our heart. But do you know that stress can literally lead to a form of heart failure and that women are at an increased risk? This article in the series highlights the impact of stress on a woman’s heart.

Blog post 4

One of the leading causes of infertility in women is polycystic ovarian syndrome (PCOS). It is closely linked to metabolic syndrome. By working closely with a functional healthcare provider, this condition is reversible.

I trust that this will provide a useful resource to reference articles on this blog.

As always I welcome your comments, questions or suggestions.

To your health and wellbeing,

How to tell the difference between type 1 and type 2 diabetes in adults

A lot of times, I come across patients who have to use insulin and aren’t quite sure whether they have Type 1 or type 2 diabetes.

I hope to be able to clarify the difference between the two, especially in an adult.

Type 1 diabetes

Type 1 diabetes is commonly called ‘juvenile onset diabetes.’ Type 1 diabetes is usually diagnosed in young children, often under the age of 5 years. Type 1 diabetes is an auto-immune disease. An auto-immune disease is when the body forms antibodies against itself.

In the case of type 1 diabetes, the body develops antibodies against the cells in the pancreas responsible for producing insulin. These are called the beta cells. When the beta cells are attacked and destroyed, the result is a rise in blood sugars. Someone with type 1 diabetes requires insulin.

During community talks as well and media appearances, I take the time to emphasize the difference between type 1 and type 2 diabetes.

It is fairly common for people to flippantly state that “Diabetes is a disease of lifestyle” without differentiating between the two.

Type 1 diabetes is not a disease of lifestyle.

Type 2 diabetes

Type 2 diabetes is different. It is not caused by a lack of insulin; instead, it is caused by a condition called insulin resistance. With insulin resistance, the cells of the body do not respond to insulin efficiently. In my book, I compare insulin resistance to the landlord changing the locks on the door to your apartment so that the key no longer works. The beta cells have to put out more insulin to overcome the resistant cells.

When someone with type 2 diabetes starts using insulin, does that mean they now have type 1 diabetes?

No. It is possible that with the ‘natural progression’ of type 2 diabetes, some people may need to start using insulin. They may also have a condition called late auto-immune diabetes of adulthood (LADA).

Individuals with LADA have a slower progression toward needing insulin than someone with type 1 diabetes.

There are also other scenarios where someone newly diagnosed with type 2 diabetes needs to be started on insulin right away. This still does not make them a type 1 diabetic.

What can happen with type 2 diabetes is that with time, the beta cells (the cells that produce insulin in the pancreas) may begin to degenerate and so cannot keep up with the production of insulin. It may be necessary to start insulin to keep blood glucose levels within the normal range and reduce the complications of diabetes.

How can you tell the difference between LADA, and Type 2 diabetes?

There are several blood tests that your healthcare provider can perform to help tell the difference between LADA and type 2 diabetes. This is particularly important as the treatments are different.

So it’s important to be pro-active when it comes to your overall health and wellbeing. Do not be afraid to ask questions.

I’ll be sharing more details in my upcoming online course, “What your doctor does not tell you about type 2 diabetes’. For more information about Type 2 diabetes, you can download a free copy of the first three chapters of my award-winning book, “Dr. Eno’s A-to-Z Guide to Thriving with Type 2 Diabetes”, by clicking here.

To your health and wellbeing,

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,

The ABCs of living with any chronic illness

 

 

 

 

A chronic illness is a prolonged illness that is not communicable and which is not expected to resolve.

Some examples of chronic illnesses are type 2 diabetes, heart disease, stroke, cancer, and arthritis.

According to the CDC, there are currently about 117 million adult American living a chronic illness.

In addition to this number, about 1 in 2 adult Americans live with one chronic illness and 1 in 4 live with at least two conditions.

Being diagnosed with a chronic illness is a life-altering experience. I know this first hand. I still remember the shock and disbelief reading my results stating the words ‘invasive cancer’.

A lot of people may have a hard time coping with the diagnosis, and they may begin to experience feelings of overwhelm, despair and even depression.

Some people may even feel they are no longer healthy.

But as with everything else in life, you choose differently by your mindset.

That is why I chose to address the mindset in the first three chapters of my recently published Amazon bestseller book ”Dr. Eno’s Guide to Thriving with Type 2 Diabetes”

Your mindset is made up of three essential aspects. I call them the ‘ABCs of living with any chronic illness.’

I not only write about these, but I used these concepts to help me thrive through my diagnosis of cancer.

So what are the ABCs?

A stands for Acceptance
B stands for Belief
C stands for commit to change

To learn more about the ABCs, download my free ebook which highlights the first three chapters of my Amazon bestseller book.

To obtain a copy of the book from Amazon, click here.

 

To your health and wellbeing,

 

 

 

 

Here are some other articles from our archives you may also like:

Five simple strategies to cope with diabetes distress

Five symptoms women should never ignore

Today’s health awareness topic: The relationship between your emotions and diabetes symptoms

 

Today’s Health Awareness Topic: How mindset affects our health when living with a chronic illness

mindset-and-chronic-illnessIn my over 20 years as a primary care physician, I have noticed a lot of patients living with a chronic illness feel that they have lost their good health. I am here to share with you that does not have to be the case.

As I highlight in my free e-book, it all starts with your mindset. This starts with the following:

  • Acceptance
  • Belief
  • Commitment

Armed with these three attributes, you can make the choice to achieve optimal health despite living with a chronic illness.

What is optimal health?  

Optimal Health is a state of harmony in the body. It is the balance and inner resilience that allows us to meet the demands of living no matter what life throws our way without being overwhelmed.

Our health is never static. Our health is always evolving. Moment by moment and day by day. Our health is the collection of our emotional, physical and spiritual states.

We are learning more and more in the medical field how interconnected our physical state and our mental and emotional states are. This is called the ‘mind-body connection.

This mind-body awareness can also help us to choose how we live with a chronic illness. 

Our body is born with the natural urge to heal itself. When we are in a balanced state this healing can happens easily. For instance, we accidentally cut our hand with a knife whilst cooking. In time the cut heals naturally.

When we disrupt the body’s natural balance, we experience disease (Dis-ease). Only a small proportion of diseases actually have a genetic basis.

Majority of the causes for disease are the result of the lifestyle choices that we make over time. I like to work off the premise that if we know better, we can do better.

Our thoughts impact our overall state of health. How we perceive living with a chronic illness determines the choices that we make. 

Caroline Myss in her best seller book Anatomy of the Spirit writes about the fact that our biography becomes our biology.

We are all living history books. Every thought that you have ever had has traveled through your body and produced a physical response- good or bad. As our lives unfold, our physical health becomes a living, breathing biography. It conveys our strengths, weaknesses, hopes and fears.

A fearful thought such as losing our job, or being diagnosed with cancer stimulates the sympathetic nervous system. It causes the release of stress hormones- adrenaline and cortisol. These hormones are responsible for fright, flight or fight. The same fright, flight or fight response occurs if we come face to face with a big grizzly bear whilst on an outdoor camping trip. The sad news is our body does not know the difference between the fear thought and the real fear of being in an endangered situation. They both produce stress in our bodies.

Research shows that sustained stress day in and day out can affect our chromosomes. Stress affects the telomeres that are located at the tip of the chromosomes. When the telomeres break off, they speed up the aging process.

Being diagnosed with a chronic illness elicits a fear response in most people. But it takes a concerted effort to create a mind shift in order to achieve optimal health

This is your responsibility not that of your healthcare provider. 

I am passionate about motivating and inspiring both patients and clients to take an active role in their overall health. It starts with their mindset.

Accept that you are responsible for every part of your life. Your physical history, relationships, every attitude and opinion that you hold or belief that you carry inside yourself, affects your biological makeup.

You may have been diagnosed with type 2 diabetes or borderline diabetes. Being sad and resigned may seem like natural emotions. But does it make it any easier.

If dealing with a chronic medical condition and your whole mindset is that of hopelessness then this only leads to further dis-ease.

Negative emotions around illness only serve to promote self-suffering

It’s time to make a choice to adapt the ‘ABCs’ of living with a chronic illness so that we can start on the way to optimal health. Accept. Believe. Commit.

If you have not already downloaded a free copy of the first three chapters of my upcoming book “Dr. Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes” click here.

Until next week, here’s to your health and wellbeing,

511952242dd5056a22054e09-2

May 2017 Awareness Topic: The Difference Between Overweight and Obesity

In the May 2017 Health Awareness Topic, I’ll discuss the difference between what it is to be obese and how this differs from being overweight. In my years of clinical practice, I have found that people do not like to describe themselves as obese. Somehow the word obese has become ‘politically incorrect’ and offensive. So people, even healthcare professionals, choose to use the word ‘overweight’ even when they really mean that a person is obese.

I recall once when I was educating a patient about the fact that her CT scan showed that she had fat in her liver and this put her at a higher risk of diabetes. She later reported me that I said she was fat!

My assertion is that if we continue to tiptoe around this issue and not address obesity for what it is we will never be able to take control of the rising obesity or type 2 diabetes and borderline diabetes epidemic. Our patients look to us to tell them the truth. Being told the truth does not have to be offensive, but it may require an uncomfortable conversation that more healthcare professionals need to get comfortable having.

The similar statistics between obesity and type 2 diabetes

If you look closely at the statistics that I started this article with you will notice that they are similar over 100 million of adult Americans are either obese or overweight. Over 100 million adult Americans have either type 2 or borderline diabetes

Body Mass Index- BMI

The body mass index (BMI) is used to define normal weight, underweight, overweight and obese conditions. For the most part, BMI correlates with the amount of fat a person has. So a higher BMI correlates with a higher risk for obesity. There are some exceptions to using the BMI exclusively. For instance a person who is muscular may have a high BMI but they are not obese.

The BMI is calculated by dividing the weight in kilograms by the height. There are many BMI calculators online. All you need to know is your height and your weight (in kilograms) and then you can plug those numbers in. For an example of a BMI calculator, click here.

Categories of BMI:

Underweight -BMI less than 18.5

Normal weight- BMI 18.5- 24.9

Overweight- BMI 25-29.9

Obesity class I 30-34.9

Obesity class II 35- 39.9

Obesity class III greater than 40

Over two-thirds of the adult population in America is either overweight or obese. Currently there are over 29 million Americans living with type 2 diabetes. There are an additional 86 million are living with borderline diabetes. The common denominator for both of these conditions is the rising obesity epidemic.

Consider this, if you have been diagnosed with borderline diabetes and commit to losing just 10% of your body weight, you can reduce your chance of developing type 2 diabetes.

The goal is to maintain a healthy and normal BMI of between 18.5 and 24.9

For people who are overweight or obese I usually get a lot of rebuttal telling me they have not had BMI in that range since they were in high school or middle school.

That’s OK. Just as it took some time to gain weight, it will also take some time to lose weight. So let’s start with that statement. You are OK.  Accept that you are overweight or obese. This statement should not be seen as  someone making a derogatory statement about you. It simply means that if you want to live a long and healthy life there is work to do. You are not alone in this obesity epidemic.  There are close to 200 million people in the United States alone. Start by developing a support system. Work closely with your healthcare professional.

Changing old habits is never easy. There are several stages to change. One thing you can start today is to start taking simple small steps every day. Taking simple small steps helps to reduce the sense of overwhelm that making big changes can cause. And because the changes seem so small in the beginning you are more likely to stick with them.

Here’s an example of a simple small step you can take on. Purchase a fitness tracker. What is the common step goal everyone says when you start counting steps? 10,000 steps! Look at that number, doesn’t ten thousand sound like a whole lot to start with? Consider this. Set a goal to walk 1000 steps on your first day. And then when you reach that goal (or exceed it) slowly increase your daily goal. Eventually you’ll reach your goal without feeling overwhelmed and along the way you’ll discover ways to increase the amount of steps you take every day.

It all starts with what I call the ABCs – Acceptance, Belief and Commitment.

For more information about the ABCs and how you can use these to start making changes in your life, you can download a free copy of the first three chapters of my upcoming book, ‘Dr Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes’ by clicking 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,

Five Simple Strategies To Cope with Diabetes Distress

diabetes distress

A lot of people living with diabetes may sometimes become overwhelmed and stressed out. From checking blood sugars, watching your diet, making time for exercise, taking medications, appointments with healthcare providers, the fear of complications, or simply whether you are doing the right thing. The list of things to know and do may seem unending. It may seem that diabetes is taking over who you are. You can’t take a break from being a diabetic. All this can place a huge emotional toll on people living with diabetes.

These mixture of emotions was first described by two psychologists and is called diabetes distress. Diabetes distress is not just depression, although research has shown that there is a higher incidence of depression in people living with diabetes. And these feelings may not be the same thing for everybody. Every person living with a chronic illness- such as type 2 diabetes-experiences it a different way.

The important thing is to pay attention to your feelings. If you are feeling overwhelmed then it may be time to speak with your healthcare provider. It is important that you have a healthcare provider who has empathy and is able to validate your feelings. Your healthcare provider should not brush off your feelings or simply suggest that you start taking medications for depression.

Not all sad feelings associated with living with a chronic illness such as diabetes is because someone is depressed.

In addition to speaking with your healthcare provider it is also a good idea to learn some ways to cope with these feelings.

Here are five simple strategies that you can learn to overcome some the feelings related to diabetes distress. You may also find that you can apply these to any area of your life.

Identify the breakdown

What is a breakdown? I’m not describing a nervous breakdown here, although to some people it may feel that way. A breakdown is an emotional response that happens when things do not go as planned. For instance let’s just say that your goal was to get your A1C less than 7% at the next visit to your healthcare provider. But this did not happen.

So, you have not reached the goal you set for yourself. State in one simple sentence what it is that you say should have happened.

For instance you could simply say, “My A1C is not less than 7%’. In this example, not getting your A1c less than 7% is the breakdown.

Identify the upset

Write out your thoughts, feelings and emotions. For some people this may be a good time to journal. Even if journaling is not your thing, simply take out a sheet of paper and write. Try not to be judgmental about what it is that you are writing down. Just take the time to write these all down.

So going back to our example, about the A1C you could write something like “I feel upset, and discouraged, because I did not get my A1C to less than 7% as I promised myself”

Upsets can keep us stuck. This is because we become judgmental about ourselves. We let this judgement mean something about us that may not be true. I suggest you keep writing your feelings down until you feel like you are no longer judging yourself. Some people may begin to feel more compassion toward themselves. This is not the same thing as making excuses.

Write out the facts surrounding this breakdown

How would a news reporter describe this breakdown? Try doing this in one sentence. So back to the situation here, “I did not get my A1C to my goal of less than 7%”

If you cannot summarize the facts of the situation in one sentence then you may still be feeling upset. If that’s the case then circle back to the upset and continue writing until you begin to feel compassion for yourself.

What you are committed to next?

Now it is time to commit to reaching your goal. It is okay to commit over and over again. Don’t feel that because you failed to reach your goal before, that you will never reach your goal. If Thomas Edison had felt that way, we would not have had the lightbulb.

When we commit to something we have the power to create something better. What are you committed to? It may be time to look at a bigger picture than simply getting your A1C less than 7%. It may be living a powerful life and thriving despite having type 2 diabetes!

Write whatever you are committed to out as a statement. For instance our goal of achieving an A1C of less than 7% may be transformed into a statement that says “I am committed to getting my A1C to less than 7% so that I can experience vibrant health and serve to inspire other people living with diabetes to reach their goals!”

Ready, set ACTION!

After completing these steps you will be inspired to get into action. There is no time like NOW to get into action. Remember what you are committed to. Do not be discouraged.

You may notice that you can use these strategies to not only deal with setbacks when it comes to living with diabetes but all aspects of your life.

So get curious and see how many other areas of your life you can get past overwhelm, feeling stuck and back into action.

To your health and wellbeing,

Today’s Health Awareness Topic: The relationship between your emotions and diabetes symptoms

 

 

 

 

People living with diabetes  may experience a wide range of emotions on a day-to-day basis. These emotions may range from initial anger, resentment, disbelief, and even denial. At times these emotions can be very intense. Sometimes these negative emotions are inappropriately directed at the healthcare provider who gave the bad news of the diagnosis.

Being diagnosed and living with type 2 diabetes does not have to be a stressful experience. Consider that contrary to popular opinion, being ‘stressed out’ does not have to be part of living with any chronic illness including type 2 diabetes.

It is predictable that over time, your emotions will wax and wane. Some days you may feel more upbeat than other days. Rest assured that you are OK. One of the first things that I do with my patients and clients is to work on getting those emotions out in the open so that we can deal with them at the outset.

You have the power to choose how your emotions impact your overall health and well being.

This is especially important if these emotions are not empowering. We all have the power to choose how our emotions impact us. I know this may sound so cliché. But really and truly this is one of the times that you get to choose and that choice directly impacts your blood sugar control. Living with diabetes is a prime example where having the power of choice impacts your overall health and blood sugar levels.

If you are constantly stressed out and angry then it’s predictable that it may be more challenging to get your blood sugars within normal range.

Stress causes the release of hormones in the body. The stress hormones are called adrenaline, noradrenaline and cortisol. These hormones help to prepare the body for ‘fight or flight’. One way that they prepare us for ‘fight or flight’ is by increasing the production of glucose from the liver stores. This is a normal stress response.

However, when you have diabetes, the last thing that you need is more sugar in your blood stream. Your body is already not able to handle the glucose that it has already!

Research has been performed on the effects of a positive mood on our overall health and well-being. On a chemical level, being happy helps to reduce stress hormones. It enhances the release of endorphins and natural serotonin both of which enhances our emotional state and enhances our well-being. If you have a positive and optimistic mindset, then you will feel more empowered in finding ways to better control your blood sugars.

The first step to living an empowered life with diabetes is to get those emotions out in the open. The next step is to deal with these emotions.

It can be challenging for healthcare providers to be able to address all the emotional concerns of our patients  living with a chronic illness. There is no  doubt the 15-minute ‘double-booked’ appointment slot may not help us to connect with our patients and understand how they are actually experiencing their disease but this discussion is important. Be certain to speak to your healthcare provider if you are feeling stressed out or overwhelmed.

Over time some people living with diabetes may begin to experience what is known as diabetes distress.  Diabetes distress is not true depression. Some patients may need the support of talk therapy. It may be helpful to work with a health coach or a psychologist.

As a professional life coach and a physician my stand is for patients and clients living with type 2 diabetes or any chronic illness to experience a vibrant wholesome life.

It is what motivated me create this platform as a way to empower women living with diabetes.

By empowering women, we empower our communities and eventually the planet.

One of the most important things to do is to deal with your mindset and your perception of living with diabetes.

In the first three chapters of the soon to be released updated version of my  book, ‘Dr. Eno’s A-Z  Guide to Living Powerfully with Diabetes’ I write about what I can best describe as the ‘ABCs of a positive mindset’.

They are:

  • A-Acceptance
  • B-Belief
  • C- Commitment to change

Yes you have the power to choose whichever way it goes. Remain committed to how your health and well-being even on days that you may not feel your best.

To take a FREE peek of the first three chapters my upcoming book, click here.

To your Health & Well-being,

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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It’s finally here! Download my free e-book to learn how to live powerful lives despite type 2 diabetes

Type 2 DiabetesPost Updated April 29 2019:

For the greater part of my career as a physician, I have always been curious about how to not only inspire my patients but also get them into action.

I noticed that when I informed a patient with type 2 diabetes, it was sometimes received with a sense of resignation. Sometimes the diagnosis was met with indignation. There were times that I had patients using words like ‘not laying claim’ to diabetes.

Well what the latter group of patients would do, was leave my office ‘not claiming diabetes’. They would be gone for a period of months and at times even years before they returned in trouble!

By this time, they had begun to manifest the complications associated with diabetes. I noticed this was particularly the case in my African American patients.

Deep down inside me I knew it did not have to be so!

With that started what would become what I have later come to articulate as my passion in clinical practice.

I could teach people to live powerfully with type 2 diabetes!

If I could dispel the myth that once you were diagnosed with diabetes that you were going to get your legs cut off, have a heart attack, end up on dialysis and then DIE, I felt I was making a difference.

My passion for sharing wellness even in chronic illness was born. Since then I have gone on to complete more than 2 years of training as a life coach with a focus on creating a higher level of wellbeing in the lives of the clients that I work with.

I have spent countless hours coordinating the care of, educating, coaching, counseling championing the efforts of the thousands of patients with type 2 diabetes whom I had the privilege of being their primary care physician.

What I have learned, more than anything it begins with mindset and creating powerful shifts.

I engaged my patients in ways to take control of diabetes and not let diabetes take control of their lives.

The more engaged my patients were, the more they saw positive results. As time went on, I began to think that it would be a great idea to write what I had taught my patients over the years and condense it into a book. I published the first edition in 2011 and decided to revise and update it this year.

It’s finally here….

In this book I will show you how to

  • Understand what is type 2 diabetes and how this is different from Type 1 diabetes.
  • Learn about type 2 diabetes in language that is easy to understand.
  • Not become a STATISTIC of the complications associated with poorly controlled diabetes.
  • Learn about tools that will allow you to better partner with your physician to enhance your wellbeing.
  • Create an unstoppable belief that motivates you to create a powerful life.

But it all starts with your mindset

The first three chapters focus on the mindset of living with a chronic illness such as type 2 diabetes. I am offering a free download in an e-book.

So click here to download the free e-book and let’s start the conversation.

To your health and wellbeing,

511952242dd5056a22054e09-2

Can You Reverse Borderline Diabetes?

prediabetes_xsPerhaps you have read articles on how in to reverse borderline diabetes. Borderline diabetes is also known as pre-diabetes. Borderline diabetes is diagnosed when the blood sugars are out of the normal healthy blood sugar range but not as high as the range used to diagnose diabetes.

Normal blood glucose levels are between 70-99 mg/dl. Essentially less than 100 mg/dl

When the blood glucose level is between 100-125 mg/dl, this is pre-diabetes or borderline diabetes.

Borderline diabetes can lead to type 2 diabetes. The common thread linking borderline diabetes and type 2 diabetes is a condition called Insulin resistance. I explain this in detail in my award-winning book ‘Dr. Eno’s A-to-Z Guide to THRIVING with Type 2 Diabetes’.  I compare the effects of insulin resistance to when a landlord changes the locks on a tenant that he no longer wants in his building. When the body’s cells become resistant to insulin, it is not able to pass into the cell to carry out its functions. So insulin gets stuck in the bloodstream where it is of no use. The cells need sugar for energy. Persistently high blood sugars in the bloodstream eventually lead to borderline or type 2 diabetes.

Strategies to reversing borderline diabetes

Diet and exercise

Research has shown that by losing just 5-7% of your current body weight can help to reverse the effects of insulin resistance and diabetes up to 60%.

Think about this- what if you were to commit to losing just 10% of your current bodyweight? You could potentially reverse the effects of living with type 2 diabetes.

In the first three chapters of my book, I write about having the right mindset. I call this the ABCs of living with type 2 diabetes.

The ABCs stand for- the Acceptance that they have diabetes (or in this case pre-diabetes); the Belief that they can make the changes that they need to make in their lives; and finally the Commitment to creating a permanent shift in their way of being.

What happens if diet and exercise do not work in reversing type 2 diabetes?

There is a medication that can help. This medication is called Metformin. Metformin is the only drug approved by the FDA for diabetes prevention.

Metformin acts in two ways to help with blood sugar control:

  1. It acts to reduce the output of stored sugar from the liver
  2. It helps to improve the sensitivity of the cells to insulin. In other words it helps to reduce insulin resistance.

Metformin can also help with weight loss.

Metformin is not without it’s side effects. One serious side effect is called lactic acidosis. This is a condition where there is a build up of a poisonous acid in the blood stream. This condition is potentially fatal.

If you are placed on metformin, it is important to have your liver and kidney function checked with blood tests at least every three months. So check with your healthcare practitioner about this. If you have any form of kidney disease then you should not be on metformin.

I am not enthusiastic about placing people with borderline diabetes on medications. I sincerely believe it is possible to reverse and even prevent borderline diabetes from progressing to type 2 diabetes.

This can be accomplished by making intensive lifestyle changes, which includes not only diet and exercise but also a change in mindset.

It starts with the ABCs of diabetes (Acceptance-Belief-Commitment).

To download a free e-book that includes the first three chapters of my book, click here.

Until next week, here’s to your health and wellbeing

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Blood Glucose Monitoring-Some Strategies to Check Blood Sugar Levels Once a Day

blood glucose monitoringWelcome back! Over the last few weeks I shared some of the lows and highs of living with type 2 diabetes. Namely hypoglycemia and hyperglycemia.

According to American Diabetes Association guidelines, normal fasting blood sugar levels range between 80-130 mg/dL. Blood sugars should also be checked after eating. This is called postprandial blood sugars. The best time to check postprandial blood sugars is  two hours after a meal. Normal postprandial blood sugar levels should be below 180 mg/dL. In order to reduce diabetes complications, it is important to try and keep blood sugars within this range.

Sometimes it may be necessary to check blood sugars several times a day in order to make the necessary adjustments to get blood sugars in the healthy range. This is usually where I would encounter a lot of resistance from my patients. They complain that testing their blood sugars several times a day is painful. Test strips cost a lot of money. Or it may be that because of their work schedule they just don’t have the time.

I found that the more I argued with my patients about monitoring their blood sugars more than once a day, the more resistant some patients became. In fact some even stopped coming in as scheduled. They would stretch out their appointments. For instance, instead of coming in every three months, they made it twice a year.

Now that can be harmful as it is a surefire way to develop complications related to diabetes!

So I had to get creative with that segment of my patients that just were not going to check their blood sugars consistently.

Well here are some strategies that I came up with. For the most part they ended up being about compromise, which I think is something that is very important if you are committed to living powerfully.

Strategy number 1-alternate checking fasting blood sugar levels with post prandial blood sugar levels

This is by far my favorite strategy. This is how it works:

On a calendar, divide the month into odd numbered and even numbered days.

On odd numbered days of the month, check your fasting blood sugar levels.

On even numbered days, check your postprandial sugar levels.  Try to vary the times that you check your postprandial levels. For instance on one day check the levels after breakfast, the next time after lunch. At another time after dinner.

This is a great way to get a general view of how your sugars run during different times of the day and not test more than once a day.

Remember to make a note of the times that you check your sugars so that your doctor can understand the trend. Some blood glucose monitors allow labeling the blood sugars also. Check your glucose monitor to see whether you can do this.

Strategy number 2- check postprandial sugars over the weekend

Here is when I would recommend this strategy:

If a patient cannot check their postprandial levels during the week due to their work schedule, then I encourage them to check the fasting levels during the week and then over the weekend, just to focus on checking their postprandial levels.

They can do this by alternating postprandial levels between breakfast, lunch and dinner over the weekend

Strategy number 3- check your blood sugars for two weeks before you see your healthcare provider

I only bring out this strategy when I am pushed to the wall. Literally I am begging a patient to work with me so that I can help them reach their blood sugar goals.

There is nothing more frustrating than not having an idea about how the blood sugars of a patient are running in between scheduled office visits. It is like shooting in the dark. You get a blood test result that is high, but you have no idea how to go about correcting it.

As I tell my type 2 diabetes patients, on average they get to see their healthcare provider between three to four times per year for routine diabetes care. What happens the remaining 361 days is left in their hands.

With blood sugars taken consistently for even two weeks before an office visit, when combined with the hemoglobin A1C most times it is much easier to spot the problem.

Why is it important to check both the fasting and postprandial blood sugar levels?

In an earlier article I shared some important numbers that a person living with diabetes needs to know. One of those numbers is the A1C also known as the glycosylated hemoglobin. The target range for the A1c is less than 6.5- 7%.  In order to achieve that goal, the fasting blood sugars are within the target range of 70-130 mg/dL. The postprandial levels also have to be consistently less than 140 mg/dL two hours after a meal.

If your A1C is high, then by keeping a log of the blood sugars, you will be able to pinpoint the problem.

For instance if the fasting blood sugar levels are within normal range, but the post prandial levels are high, then perhaps you need to adjust portion sizes.

If the fasting levels are running high, it may be that the evening medications need to be adjusted or that a late night snack needs to be cut out. Sometimes this may even mean that the nighttime medications may need to be cut down. But your physician needs to see your glucose log so that they can target the problem and create a customized plan for you.

Start today to check your blood sugars

Perhaps you are a newly diagnosed diabetic or even if you have had diabetes for some time but just never thought it important to check your blood sugars. Let’s start out fresh.

Review the instructions of your glucometer. If you do not understand how to use it then check to see whether your local pharmacist can help you. If not call your doctor’s office and schedule a visit with the nurse. Most times they can help you. Most times the machines work the same way. A few have extra ‘bells and whistles’ attached to them.

Just as I share in my upcoming book, “Dr Eno’s A-Z Guide to Living Powerfully with Type 2 diabetes”,  two of the hallmarks of living a powerful life with diabetes is being committed and persistent. If you do that you will go a long way to living free of diabetes complications.

I welcome your comments or questions so please leave them here. I’d also love to hear some of the issues that you have as a type 2 diabetic. Come over to my Facebook page and share some of your thoughts with me. It just may be a topic for an upcoming article.

Until next week Here’s to your Health and Wellbeing,

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The Importance of Your Oral Health – Type 2 Diabetes Can Hurt the Teeth and Gums

canstockphoto33393786It is important for people living with type 2 diabetes to pay attention to all aspects of their health and wellbeing. Your oral health is a very important aspect of your overall health and wellbeing.

Recent studies have shown an increased risk between poor oral health and heart disease.

The risk for heart disease increases even more when you have 2 diabetes and poor oral health.

This is because diabetes already puts you at twice the risk of heart disease than the general population. So when you add poor oral health to the mix you could more than double your risk.

The mouth contains thousands of different bacteria, fungi and viruses. Normally with proper oral hygiene and well functioning salivary glands, these do not cause any problems.

However when the mouth becomes unhealthy then a number of dental problems can set in.

The most common teeth and gum problems associated with type 2 diabetes are:

  • Tooth decay
  • gum disease
  • altered taste
  • fungal infections commonly oral thrush
  • dry mouth
  • infections

Poorly controlled Diabetes can lead to tooth decay and gum disease

When blood sugars are high, this is called hyperglycemia. Hyperglycemia can cause bacteria and fungi to thrive in the saliva. This leads to the development of plaque.

Plaque is a hard material that builds up in the mouth. It attaches to the surface and in between the teeth. It can also collect beneath the gum line. When this happens, the gums become inflamed. This is called periodontal disease.

High blood sugars can put you at a higher risk for periodontal disease. Eventually, the gum disease becomes so bad that they lose their teeth.

Here are some signs of periodontal disease. If you have any of these signs then see a dentist as soon as possible

  • gums that bleed easily
  • red swollen and painful gums
  • bad breath
  • bad taste
  • pus in between teeth or when the gums are pressed
  • gums that have been pulled away from the teeth

Diabetes can also fungal infections

Oral thrush is a fungal infection that can occur in people with diabetes type 2.

There are several reasons why you can get fungal infections in the mouth:

  • Wearing dentures
  • Cigarette smoking
  • Hyperglycemia
  • Antibiotics
  • Dry mouth

How to reduce dental problems

  • Brush your teeth twice a day with a soft toothbrush. You can also use a electric toothbrush.
  • Floss between your teeth at least once a day
  • Change your toothbrush at least every 3 months
  • Use an antimicrobial mouthwash
  • Use a toohpaste that contains floride
  • Watch for any signs of dental problems and inform your dentist
  • Quit smoking
  • Drink water regularly to keep the mouth moist

See your dentist regularly

  • Schedule an appointment twice a year to see your dentist.
  • If you have any sores or pain in your mouth be sure to let your dentist know.
  • Let your dentist know if your blood sugars are high.
  • Inform your dentist if there is any change in your medical history.
  • Do not take any oral medications that could lower your blood sugar before seeing the dentist.
  • If you are going to have dental work done and you are taking a blood thinner, be sure to let your dentist know this. The dentist may want to get a medical clearance from your primary healthcare provider if planning a dental procedure such as a root canal or deep scaling to remove plaque.

Take the time to make sure that you pay attention to health of your mouth.  That way you will not go through the pain from lost teeth.

Let’s face it dental care to replace lost teeth can be very costly. So why not invest in prevention rather than a cure?

I’d love to read your comments. Do you have any questions or suggestions for an upcoming article? Then let’s chat on my facebook page so that I can meet you.

Here’s to your health and wellbeing,

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Healthy Tip:

If you have a cold or cough, be sure to change your toothbrush. That way you will not reinfect yourself.

Also be sure to increase your intake of Vitamin C this winter season, it will help accelerate healing from colds and flu like symptoms.

When Is It Necessary to Manage Type 2 Diabetes With Insulin?

Type 2 DiabetesWhen does it become necessary to start using insulin in type 2 diabetes? Here is a familiar scenario: You have just returned from your three-month diabetes check up with your doctor. Your doctor has just told you that she will be starting you on insulin. You have been dreading this day for the last several months. The truth is your doctor, so has your doctor.

You are experiencing a mixture of emotions. Some of them are intense. This cannot be happening you think to yourself.

Maybe if your doctor had allowed you a few more weeks, you would have been able to achieve a normal blood sugar range.

Maybe you’ll get a second opinion. Or it may be time to switch your healthcare provider.

If this scenario or something similar has happened to you or to anyone that you know, I want to assure you that you are perfectly OK with experiencing all these thoughts and emotions.

It is a normal response to be resistant to change. 

Starting insulin represents a change in your life. In my over 20 years of experience as a primary care physician, I have met very few patients who were ecstatic that I was starting them on insulin.

So take a deep breath in, relax. You are fine.

This article will explain in simple terms why sometimes it may be necessary for a person living with type 2 diabetes to start on insulin.

My mission is to provide my readers with information in an easy to understand way so that they can get into action- FAST.

There is a common misconception that once a person with diabetes type 2 starts insulin that they now have type 1 diabetes. That is not the case.

There is a difference between, diabetes type 2 and type 1. The pancreas is the organ in the body responsible for producing insulin. It is located in the abdomen. In type 1 diabetes, the pancreas produces little or no insulin. People with type 1 diabetes must use insulin in order to survive. In type 2 diabetes, the pancreas is still able to produce insulin.

So how come someone diagnosed with type 2 diabetes all of a sudden needs to start using insulin?

Insulin is responsible for a variety of functions. The most important function of insulin is managing how the body uses sugars and fats.  The secretion of insulin from the pancreas varies. For instance, if you have not eaten, insulin sends a message to the fat stores in the body. The stored fat gets sent out as a form of fuel for the body to function.

In a person without diabetes, this whole process works well to maintain healthy blood sugars.

In type 2 diabetes oral medications help to stimulate the pancreas to produce more insulin. However over time, the cells in the pancreas begin to wear down and die. When this happens, the pancreas is no longer able to keep up with insulin production.

At this point, oral medications no longer work.

When I bring up the difficult subject of starting a patient on insulin, I explain to my patients that if we continue to use just pills, it’s like beating a dying racehorse.

Think about it, beating that horse to get it back in the race is not going to work. In fact I summise that the more you beat the horse, the wearier it becomes and this may even hasten it’s demise. The same thing happens with the pancreas.

When a person with type 2 diabetes starts on insulin to get healthy blood sugar control, it gives the pancreas a much needed rest.

There are times that I have had to start a patient newly diagnosed with  diabetes 2 on insulin. It is possible later on, to transition to oral medication or reduce the amount of insulin they were taking.

The human body has an amazing capacity to heal itself.

I tell this to my patients and clients all the time. The body has an innate desire to see itself healed and ‘not dis-eased’.

Insulin is known as one of the wonder drugs of science. Recent research shows the benefit of lowering blood sugars very early, in order to reduce potential complications. While oral agents may help, they do not reduce blood sugar nor A1C levels as dramatically as insulin can.

In order to live powerfully with type 2 diabetes, it is important to dispel the misconceptions that surround being placed on insulin.

No doubt this is one of the times when living with diabetes can be challenging. But it is not impossible. So do not give up on yourself.

This is when it is important to check in with your mindset.  In my soon to be released free e-book I outline the importance of mindset. This is an excerpt from the first three chapters of my upcoming book “Dr. Eno’s A-Z Guide to Powerfully Living with Diabetes”

  1. Acceptance
  2. Belief
  3. Commitment to change

Use the ABCs as an anchor. They can help you grow and stretch outside your comfort zone. As time goes on and with the natural course of type 2 diabetes, the way that you and your doctor manage type 2 diabetes will change.

So the first step begins with your acceptance of the fact that you have reached a stage in your diabetes management that you require insulin.

The next step is a belief in yourself that you will do what it takes to learn all you can about insulin therapy.

And then finally that you make a commitment to change. Change perhaps the way that you have been doing things previously. Change whatever your hangups or misconceptions were about insulin.

All of this so that you can indeed start living a powerfully as a woman living with diabetes!

To your health and wellbeing,

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