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The Healthy Blood Sugar Control Blog Series

Photo credit- Kate on Unsplash.com

Hello, and welcome!

Whether you have been following this blog for several years, or like most people you are a new subscriber, or simply just stumbled upon this site during a google search, with time there comes a challenge. The content becomes buried beneath newer content and sometimes older content is still very relevant.

I found this challenge to be an issue a couple of weeks ago as I started working with a new client on reversing his metabolic syndrome. As he fervently searched the internet or discovered some new information about his blood sugars he would send me a message.

And most times, I’d respond with a link to a blog post I had published in the past. This got me thinking if I simply sent my client to my blog how was he to know how to navigate the wealth of information contained here?

Introducing the Mini-course series

And so I have decided once a month to create a post series that highlight a short collection of blog posts that share a similar theme.

The first of this series is about healthy blood sugar control. This series consists of four blog posts designed so you can get through them easily.

You can also save these posts and refer to them in the future.

Blog post 1– Diabetes is not only about blood sugars. The ABCs of knowing your diabetes numbers- In this article, you will gain a basic understanding of what the different blood tests important to know as it relates to reducing complications and achieving healthy control of type 2 diabetes.

Blog post 2– When it comes to healthy blood sugar control, one experience any person living with Type 2 diabetes may run into is the lousy feeling they begin to experience even when their blood sugars begin to drop into the normal range. In this article, I share how to bring blood sugars down without feeling that way.

Blog post 3- Another challenge for even the seasoned individual living with Type 2 diabetes may be how to check blood sugars several times a day in order to get a better idea of “sugar spikes”. Are they first thing in the morning? Late at night? Or after a meal? This article shares ways to check your blood sugars once a day whilst still providing vital information.

Please note- this strategy should not be used if you are on insulin and have to inject several times a day.

Blog post 4- The final article in the series relates to how to reduce low blood sugar complications. Hypoglycemia is dangerous complication and should be avoided as best as possible.

I would love to read your feedback about how you’ve enjoyed the article mini-series. Also, please send me suggestions about some topics you would like to learn more about.

You can also download a free copy of my e-book which highlights 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,



How you can improve your metabolic health with this simple lifestyle hack

Hello,

Welcome back. This week I’m attending via Livestream a functional medicine conference as part of my certification program. The conference is focusing on the topic of cardiometabolic health which happens to be an area that I am passionate about.

In my last post, I highlighted information what makes up our metabolic health and why this is important to know. It’s so synchronous that the conference is on cardiometabolic health. In the coming months, I look forward to bringing you up to date information on information in this rapidly changing field particularly as it pertains to how we can use food as medicine.

As you may know, the month of February is heart disease awareness month, and Friday, February 7 was “Go red for women day” in which women were encouraged to wear red and spread awareness that heart disease accounts for more deaths in women than breast cancer.

Having good metabolic health reduces the risk of developing heart disease, by reducing risk factors related to lifestyle.

As a recap, metabolic health looks at five measurements. (The numbers parenthesis show the normal range).

• Triglycerides (normal less than 150 mg/dL)
• Waist circumference (women less than 35 inches; men less than 40 inches)
• Fasting blood sugars (less than 100 mg/dL; or A1c less than 5.7%)
• Blood pressure (less than 120/80 mm Hg)
• Body weight (BMI less than 25.0)

Tons of research shows that we can improve our overall health when we make changes to our lifestyle by improving our diet and getting more exercise. By so doing, we can also improve our metabolic health.

However, there is a simple lifestyle strategy we can add as an adjunct to diet. This strategy is called intermittent fasting.

Fasting is merely cutting out food for some time. It may be as short as a few hours in 24 hours to days and even months. When most people hear the word fasting, they feel there is no way that they can do this. They think that if they fast, they will be left feeling hungry and deprived of food. It may be true for the initial period as the body is adjusting. With time, the hunger cravings get better. Fasting requires self-discipline. But there are many benefits to fasting.

The benefits of fasting

Fasting has a myriad of proven benefits. One significant fasting benefit is that it helps to improve our metabolic health. Fasting does this by improving insulin resistance. Improved insulin resistance means that our cells become more efficient at taking in and breaking down glucose. This reduces the risk of diabetes. Fasting also helps improve the gut microbiome (more on this fascinating topic later). Fasting also helps with weight loss.

In women, fasting has also been found to have benefit when it comes to breast cancer. In a review of data between 2009-2010 of women participating in a study, they were able to determine that the longer an overnight fast, the better was blood glucose control and also reduced the risk of breast cancer.

Some other benefits of fasting include:

  • Reduces oxidative stress and cellular inflammation
  • Improves brain function
  • Fasting helps with weight management.

How to start Intermittent Fasting

There are many ways to fast. One of the easiest ones to start is intermittent fasting.
Intermittent fasting is fasting for a certain amount of time during a 24 -hour period. I often explain to patients and clients that they can easily incorporate at least a 12-hour intermittent fasting period into their lifestyle simply by leaving 12 hours between dinner and our first meal the next day. For instance, if you have dinner at 6 PM, a 12-hour intermittent fast means that you will not eat until 6 AM the following day. It’s that simple.

Now fasting will require a mindset shift, For instance, you may have a habit of having a late night snack. To be successful at intermittent fasting, you will have to give this up. Instead, try having a cup of herbal tea.

If you have diabetes type 2 and you are taking medications, do not embark on fasting without first consulting your healthcare provider. You may need to have your medications adjusted and closely monitor your blood sugars to make sure that you do not develop hypoglycemia.

There are other methods of fasting that can get more detailed and complicated and beyond the scope of this article. But start small.

Please consult your healthcare provider, or if you would like to learn more about how fasting can improve your metabolic health.

You can also schedule a free initial discovery consultation with me by sending an email to info@doctoreno.com.

Until next time,

Here’s to your health and wellbeing,

Health Awareness Topic- Is your metabolic health up to par?

According to a recent published study by the National Health and Nutrition Examination survey between 2009-2016, only 12% of Americans have good metabolic health. This means that 7 out of every 8 Americans do not have good metabolic health. These are pretty dismal numbers by all accounts.

What was concerning with this study was that even people with so called normal body weight may not have good metabolic health!  The paper goes on to warn that these implications pose a high concern for public health.

In today’s article we’ll go over what metabolic health is. Why we need to be concerned about metabolic health. How this is different from other health parameters. How we can quickly assess our metabolic health. Why we need to be concerned about it and finally what are some of the measures we can start taking to improve our metabolic health.  

What is Metabolic health?

Metabolic health is a term that is used to identify a cluster of measurements that could increase the risk of developing cardiometabolic diseases such as type 2 diabetes, heart disease, and strokes.   

Metabolic health looks at five measurements. The parenthesis show the normal range.

  • Triglycerides (normal less than 150 mg/dL)
  • Waist circumference (women less than 35 inches; men less than 40 inches)
  • Fasting blood sugars (less than 100 mg/dL; or A1c less than 5.7%)
  • Blood pressure (less than 120/80 mm hg)
  • Body weight (BMI less than 25.0)

Why metabolic health is important?

Your metabolic health is simply looking at these five measurements and comparing it to the normal range. It is letting us know your current health status as it relates to these five categories.

Why are these five measurements important? These measurements happen to be the same measurements used to determine your risk for a cluster of abnormalities called the metabolic syndrome.

If any 3 out of the 5 measurements above are abnormal, then this is called metabolic syndrome. Metabolic syndrome there is a higher risk for cardiometabolic disease is higher. To learn more about metabolic syndrome click here.

How to measure your metabolic health

Step 1 -check your weight and take your height.

I usually recommend checking your weight first thing in the morning, after you have used the bathroom and preferably with no clothes on. This gives a more accurate measure of your fasting body weight with no fluid fluctuations that could occur during the day.

Again I prefer this measurement first thing in the morning after a stretch. Stand against a door post and have a friend or family member mark the top most part of your head with a marker.

Next, plug these two numbers into a BMI  calculator.

To calculate your body mass index click here

Step 2-measure your waist circumference

Your waist is the mid-point between the tip of your hip bones and your lower midcage. If you bend to the side the crease you see is your natural waist line. Measure your waist circumference with a measuring tape at this point standing up tall and after you have completely exhaled. In women the waist circumference should be less than 35 inches and in men less than 40 inches.

Step 3 -check your blood pressure

Blood pressure can be measured with a machine called a sphygmomanometer. Most local pharmacies and even department stores have digital blood pressure machines. You can also schedule a nurse visit at your healthcare provider’s office and have your blood pressure checked there. It’s important to take a few deep breaths, sit up straight with your two feet on the ground and using the left arm. It’s a good idea to take three readings at least five minutes apart and then take use the best of the three readings.

Step 4 – have your fasting blood sugar and your fasting lipid panel checked.

You may need to schedule an appointment with your healthcare provider to have this done.

Once you have all the measurements, you’ll be better able to know your metabolic health.

Remember that knowledge is the first step to personal empowerment. Perhaps your metabolic health is not at par. That’s not really where I want to focus on right now. We already know that only 12% of Americans meet the criteria for being metabolically healthy. So, let’s not focus on the doom and gloom.

What I find reassuring when I look at this information, is that these measurements can be modified. They are called modifiable risk factors.

Modifiable means that you can do something about them.

As I point out in my award-winning book, “Dr. Eno’s A-to-Z Guide to Thriving with Type 2 Diabetes” the first three steps to dealing with any challenge are critical mindset strategies- acceptance, belief, and commitment to change.

Instinctively we know what we need to do, eat ‘healthier’ and exercise more. But if it were as simple as that why do we have an obesity epidemic?

My mission is to provide you with tools which will allow you to create a permanent shift in your way of being so that you can become more empowered in the choices you make when it comes to your overall wellbeing.

In my next article I’ll be reviewing how fasting can help improve your metabolic health.

Until next time,

To your health and wellbeing,

To download a free copy of the first three chapters of my book click here

Do you really need an annual check up?

You see your primary healthcare provider for your routine diabetes care. In fact it may seem that between seeing your primary healthcare provider and perhaps some specialists, that you spend most of your time at the doctors’ office.

So is it really necessary to also set aside separate time for an annual physical?

While preparing this blog post, I came across two articles with conflicting views. A study published in the British medical journal in 2012, found that performing annual physical examinations in otherwise healthy individuals showed no improvement in reducing either illness or death from disease. In fact it showed that there was an increase in unnecessary testing and also increased anxiety levels amongst patients who had to undergo these tests.

However another study published in the Annals of Internal medicine in 2002, shared some of the same sentiment that I have in my over 20 years as a clinician.

I like compare an annual physical to the same way most of us maintain our cars . There does not have to be anything wrong with the car, but you should change the oil, rotate the tires rotated, change the fan belt and the air filters etc. It helps improve the longevity of your vehicle. So does having an annual physical examination. Most insurance plans cover an annual physical examination, check with your insurance provider to see if this is a covered benefit for you. If it is not covered, check with your healthcare provider first. Find out what it would cost you. Sometimes a physical examination may be bundled into an affordable ‘wellness package’ which may also include basic screening laboratory tests

The annual physical examination may include

  • Screening tests such as colonoscopy, pap smears, prostate screening and mammograms
  • Blood tests to detect abnormal blood tests such as abnormal cholesterol levels, blood sugar, or thyroid levels
  • Immunizations
  • Screening for mental health issues such as depression

To make the best use of the time, I recommend that prior to your annual physical that you prepare a list of things you would like to go over with your healthcare provider. It is also a good idea to know that the recommended tests are for your age. To go over a list of recommendations you can log onto this website healthfinder.gov.

This is also the time for you and your healthcare provider to develop a deeper understanding of your unique needs. With the way our healthcare system has become so fragmented this is truly a luxury that should not be taken for granted.

Even if you are living with a chronic illness such as type 2 diabetes, let your healthcare provider know that you want to focus on ways to enhance your overall health and well being. Just because you are living with a chronic illness does not mean that this should define your very existence. In fact you should not allow that to happen. You should be proactive in choosing to focus on your overall health and not just the chronic illness.

Do not be surprised to get some push back from your healthcare provider as they may not be used to this concept. This is a good time to focus on creating a lifestyle modification program which covers good nutrition, nutritional supplementation, exercise/movement, your emotional and spiritual beliefs as well as ensuring that you are getting adequate sleep

Perhaps you have started a lifestyle modification program and you need help making lifestyle changes, ask your healthcare provider for referrals. For instance to a health coach especially if your insurance covers this. You may also want to schedule a few sessions with an exercise physiologist or a personal trainer.

Finally, the therapeutic relationship between the physician and their patient is important. The simple act of “laying hands” on a patient can be healing.

My prayer is that as physicians we never let this art die despite what the preventive health guidelines may say otherwise.

Five strategies to help relieve stress this holiday season

holiday-stress

The 2016 Holiday season is upon us. No matter your religion or creed, for the most part the end of the calendar year is always filled with lots of activity.

The holiday season is filled with lots of activities such as shopping, family gatherings, holiday parties, gift giving , etc. For some the holidays can be perceived as stressful. At times the stress can leave us feeling depleted, overwhelmed to the point that it may even rob us of experiencing the joy of the season.

I invite you to consider that it does not have to be that way. Consider that just as any other thing in your life, our default is to make up ‘a story’ about our experience of the holiday season.

In this article, I highlight five strategies to help relieve stress this holiday season. The great news about these strategies is that you can use them year round in any situation you may find yourself.

So consider the holiday season to be a playground to practice, so that you are ready to embrace challenges in 2017 with less sense of overwhelm.

Strategy number one -Schedule regular downtime

Allot times during the day when you have some ‘me time.’ I suggest a time-frame no shorter than 10 minutes and no longer than 30 minutes.

During this time, your goal is to decompress, declutter your mind, and check in with your emotions. Your downtime should be about sourcing your inner self, allowing you to refocus.

If you are feeling overwhelmed with endless activity, consider downtime as a time to ‘correct the course’. Your downtime is NOT the time to catch up on chores, get on social media, or make phone calls. This is the time to disconnect from the outside world and focus on the inside.

Come up with a list of things that source you. Here are some suggestions of things you could consider doing during your downtime

  • Read inspirational material
  • Walk in nature
  • Say affirmations
  • Prayer
  • Meditation
  • Deep breathing
  • Journaling

Enlist the support of family members and friends in honoring your downtime. Remember it is not a long period of time that you are taking off. You could even enroll them in taking some downtime for themselves as steps to support their own wellbeing and reduce stress.

Strategy number two-Express gratitude every day

The Holiday season is a great time to express and recognize gratitude.

When we express gratitude in our lives, we train our subconscious mind to focus more on the positives in life that comes our way. What we  focus on, we tend to attract more of the same into our lives.  So rather than focus on the things that cause us stress, we can choose to focus on things we are grateful for.

Start a gratitude moment first thing in the morning or at the end of your day. Take on creating a list at least five things that you are grateful for every day.

Rather than repeating the same things each day, try to come up with at different things each day.  This will train your mind to begin to notice things more. The practice of expressing and writing down things you are grateful for helps you become more mindful. This is because  you will learn to actively notice things that are going on in your life.

Another twist to the gratitude practice is to try to see if you can frame things that you initially felt were a negative experience into something positive you can be grateful for.

For instance let’s say that you in the grocery store in the check out line and it’s crowded, rather than get stressed out about the long line, consider striking up a conversation with a fellow shopper. You never know you might learn something new.

Strategy number three-Keep physically active

If you are not already physically active, there is no time like the holidays to start an exercise program. Walking is a great form of exercise. Fitness trackers are a great way to track your progress. Plus fitness trackers make great gifts. Aim for 10,000 steps or more a day as a way to keep the calories and stress away. There are other forms of exercise like resistance training, balance training. Research the different types. Perhaps you could drop in on an exercise class you’ve been wanting to attend. Get curious, get active.

Strategy number four-Boost your energy with power foods

The holiday season can get fast paced to the point that we may skip on healthy meals and binge on dessert filled calories.

One health and wellbeing strategy is to boost your energy with foods rich in antioxidants, omega 3 fatty acids and Vitamin B complex.

To read more about power foods to boost your emotional health click here.

Strategy number five-Do not forget the reason for the season.

Finally do not forget the reason for the season. Whatever your denomination, the end of the year is a time for celebration. It is a time to strengthen our relationships to one another. To celebrate our victories, without dwelling on our past mistakes.

The holidays are a time for forgiveness and letting go of past hurts. A time for being love in action. I firmly believe that’s why we have family. Consider that our relatives are our greatest teachers. And rather than be stressed at the prospect of yet another Holiday gathering with your relatives that you embrace it as a place to practice being love.

That my friends is the reason for the season. Happy Thanksgiving!!

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Power Foods to Combat Stress and Improve Emotional Health

Emotional HealthI must admit that over the past few weeks and with the recently completed U.S presidential elections I have been just a little stressed. When I am stressed out, I tend to crave foods such as sweets and salty nuts. Whether it is from long work hours or the unpredictability of social events, the body perceives stress as a threat.

When we are under any kind of stress emotional or physical, the body releases a hormone called cortisol. Cortisol is responsible for our fight or flight response. In order to fight or flee from the danger, real or perceived, our body needs energy. The source of that energy is glucose.

The pancreas receives a signal to release insulin into the bloodstream. Insulin gets taken up into the cells of the body and there causes the release of glucose. The more ‘stressed’ we become, the more cortisol is released and the more insulin to release glucose into the bloodstream for the body to use as fuel. This is why some of us like me may crave sweets when we are under stress. This is an easy source of the glucose that our cells perceive they need.
So knowing that I have this predictable pattern, I’ve come up with some power snacks. I call them superfoods, because they not only help boost my energy but also support my stress levels.

The Power Fruits: Blueberries, Mulberries and Goji fruit

Antioxidants are commonly found in fruits and vegetables. They help to reduce what is called oxidative stress on the cells in the body. The ORAC stands for Oxygen Radical Absorbance Capacity. The score measures the strength of antioxidants.

The higher the ORAC the more potent the antioxidant capacity.

Blueberries, mulberries and goji berries are power fruits that pack high ORAC score ounce for ounce. Dr. James Joseph a lead scientist at Tufts University conducted an experiment in which he fed lab animals with extracts from blueberries. Their motor coordination improved as well as their memory. Blueberries contain powerful compounds known as anthocyanins that are powerful antioxidants and anti-inflammatory agents.

An intact memory and slowing down the aging process this is bound to improve emotional wellbeing.

Blueberries also contain other compounds called Pterostilbene. You may not have heard about this compound, but perhaps you may have heard about reservatrol which is an anti aging compound that is found in grapes and hence makes drinking wine associated with healthy benefits. Well pterostilbene is more potent than reservatrol and helps to fight the buildup of fat deposits (called plaque) in the arteries.

In addition to containing antioxidants, mulberries also contain alkaloids that help to support the immune system by stimulating macrophages. They also help with a blood sugar control.
Goji berry also has a myriad of health benefits. In addition to having an antioxidant benefits, it has been known to boost energy levels.

I mix of the super fruits that in a bag and add this to a yoghurt or some quinoa as a hot cereal.

The Walnut Connection

Walnuts contain the highest amount of omega 3 fatty acids than any other nuts. These help support the brain function. They also contain protein, fiber, calcium, magnesium, phosphorus potassium plus trace mineral called manganese that is important for peak brain function among other things. According to Rebecca Woods a natural foods expert, it is best to purchase walnuts in the shell and crack them prior to eating. Due to time constraints, I purchase shelled whole walnut halves.

A burst of Vitamin B

The two B vitamins, which help enhance emotional health, are Vitamin B12 and also Vitamin B9 also known as folic acid. The B vitamins are one of the most widely used nutritional supplements for the simple fact that they are believed to boost energy. Common food sources are liver, egg yolk, milk and poultry for vitamin B 12. For folic acid, yeast, liver, leafy vegetables and whole grain cereals.

Omega 3 Fatty Acids

Omega 3 fatty oils have a variety of benefits. A diet high in omega 3 helps to control inflammation, improve lipid levels as well the brain development of babies.
Omega 3 fatty acids are commonly called ‘fish oils’. They are present in small concentrations in leafy vegetables and seeds such as walnuts, flax seed and hemp. They are more commonly found in fish such as wild Alaskan salmon, sardines, tuna and mackerel.

Omega 3 fatty acids can also be taken as a pill.

So there’s a snippet of my ‘stress reducing food kit’ that I intentionally put together.

Here are some things to think about the next time you reach for a snack:

  • What kind of foods do you crave when you are under stress?
  • What’s your relationship to food when you are under stress?
  • Can you come up with certain foods you can use foods to reduce your stress levels?

I’d love to read your comments. As always thank you for sharing.

To your health and wellbeing,

 

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Reference: The 150 Healthiest Foods on Earth, Jonny Bowden, PhD,C.N.S

Ten Things to Bring to Your Next Doctor Visit

Tips on doctor visitTip Number 1: Current Insurance card and Identification card

It is very important to always bring in the most recent copy of your insurance card to your doctor visit. This is because there may have been a change in the subscriber information that your doctor’s office requires to bill for your insurance provider. Or your doctor may need to update their billing system. Some insurance companies may require that the physician’s office have a copy of the insurance card for certain procedures.  If you have a medical card (Medicaid) usually this is updated monthly and so bringing your current medical card to your scheduled visit is strongly recommended.

Personal identification is also very important.  I am often intrigued when I see patients get offended when my front desk staff request for their identification. In an era of identity theft, think of what the long lasting implications would be if someone used your identity to obtain medical care and had several chronic medical illnesses. This could affect your ability to get life insurance. Treat your health insurance card as a credit card and do not get offended when your healthcare provider asks for ID even if they have seen you several times in the past.

Tip Number 2: List of current medications and supplements

Always keep a list of medications and their current dosages. I recommend if possible, type it out and then laminate it. If you cannot laminate it, simply type it out. Always list all supplements that you are taking.  Include any over the counter medications. This is very important, as there is always a potential for drug-drug interactions.

Tip Number 3: Always update your personal History

Your doctor needs to be aware of any new symptoms that you may be experiencing especially if you have seen another healthcare provider for the symptoms or been to the emergency room. Your primary care physician or healthcare provider should be your health advocate. This helps your provider at to determine if you need any further workup.

Tip Number 4: Update your Family Medical History

I cannot over- emphasize how important it is to keep abreast of your family medical history. If your healthcare provider is aware of your family medical history it may allow them to customize certain screening tests specifically for you. For instance if there is a family history of diabetes then your physician may decide to start screening earlier or do more detailed tests that may unmask pre-diabetes.

Tip Number 5: Write down any questions before your scheduled doctor visit

This sounds like common sense, but a lot of times, I have seen patients come in for their office visit and they can’t remember what it was that they had concerns about. They end up frustrated. Making a list of questions that you have for your doctor allows you to get the most out of your visit. Looking at your list allows you to decide what you topics or questions you feel are most important and what you think can wait till another time. Always write a list!

Tip Number 6: Always get laboratory tests or procedures done in advance

Most times tests are ordered in order to assist in making decisions about your medical care. By doing tests well in advance of your next scheduled visit, it allows time for the test to be completed, transcribed and delivered to your doctor’s office. Your healthcare provider can then review the test results ahead of your office visit. Too often, I see patients who get a blood test done on the morning of the day that they are scheduled to see their healthcare provider. This may require a return visit to review the results.

Tip Number 7: Bring a notepad to write down any instructions

I encourage patients to be their own healthcare advocates. This also allows you to be empowered in their medical care. Writing down notes during an office visit allows your physician to see that you are genuinely interested in your healthcare. Most importantly it guards against forgetting important information. Read back information that has been provided to you. This helps to retain the information.

Tip Number 8: If possible bring along a friend or a family member 

It is not uncommon to become very flustered when coming to see the doctor particularly when dealing with chronic medical illness. This is especially true as we get older. It is a very good idea to bring along a family member or a close friend. Make sure they must have your best interests and act in line with what your best wishes are. Keep them informed about all your medications, current medical condition and also other scheduled visits. The more they are aware of what is going on with you the better an advocate they can be for you

Tip Number 9: Keep a list of your immunization record 

Keep a record of your immunization records, preferably in the same list that you have your current medications. This is particularly important if you get your immunizations from several sources such as the pharmacy or a hospital. It is important to report any updates to your physician so that you do not risk being immunized twice for the same disease.

Tip Number 10: Pay your bills and copay at the time of your visit

Just as with any other business that you patronize, your doctor’s office has overhead that needs to be met. By paying your bills on time, it conveys the fact that you value your doctor and the service that (s)he provides. If you are unable to meet your full financial obligation at once, most doctors’ offices will work with their patients and work out a payment plan.


I trust that these ten tips will help you navigate the office visit with a little more knowledge so that you get the full benefit and your physician is able to provide the best care possible.

As always I welcome your comments and suggestions for future topics.

To your health and wellbeing,

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Five Tips on How to Pick a Healthcare Provider That is The Right Fit For You

unspecifiedFor someone living with type 2 diabetes or any other chronic illness, it is important to establish care with a knowledgeable healthcare provider. It is also important to have regular scheduled follow ups so that you can have your diabetes monitored.

There are different kinds of primary healthcare providers in today’s marketplace. There are what are called ‘mid level providers’. These would include nurse practitioners and physician assistants. Mid level providers typically work under the supervision of a physician.

You may need to be seen only by a physician depending on how complex your medical needs are. For example if you already have some complications associated with type 2 diabetes.  If you do end up seeing midlevel providers, a physician should see you on some office visits.

The following tips are what I would call ‘bare necessity tips’ to ensure that you are trusting your greatest asset- YOUR HEALTH- to the right provider.

Tip number one- Make sure that your doctor carries an unrestricted medical license to practice in the state. This sounds like commonsense. You can also check with the state licensing board to find out whether there have been any bad reports made against a physician.

Tip number two- Find out if your physician board certified. Board certification is an important yardstick. It is important that a physician keeps up with the current medical trends. Board certification is a standard test that determines that. Before the 1990s, board certification was done only once. It was valid for the entire professional career of a physician. But with the rapid changes of the medical landscape, currently the American Board of Medical Specialties requires re-certification every 8-10 years. Whether your doctor is board certified or not is public information. To check on the board status of your physician, click here.

Tip number three- Find out whether your physician has current malpractice insurance coverage. In some states malpractice premiums are very high, and some physicians may decide not carry malpractice insurance. However your physician should let you know this. It is a good idea to first have a conversation with a physician who has decided not carry malpractice insurance to find out why they made that choice. It’s just like driving a car without insurance. Medical malpractice insurance is the ‘cost of doing business’. You can also check to see whether there have been any malpractice claims made against the physician. If you find your physician does have a malpractice claim, have a conversation with them. This does not have to prevent you from deciding to establish care with that physician but at least you know.

Tips number four- Ensure that the physicians’ office hours are in line with your schedule. This is very important especially if you have a job that is not very flexible when it comes to taking time off during regular work hours. If you need to be at work 8 AM-5 PM and your physicians office is also open from 8-5 PM that is not a good match. If a physician’s office hours are an important factor in your decision-making, when you call, first ask the receptionist what the hours are before deciding to schedule a visit. Perhaps a doctor’s office with evening or weekend appointments may work better for you. As a person living with diabetes, you cannot afford to skip seeing your physician because you are having a difficult time keeping appointments. Having ease of access to your primary care provider will help to identify problems as they arise early. This is an important part of avoiding long-term complications.

Tip number four- Know how long it typically takes for your doctor to return your calls. I can’t tell you how often I hear this complaint as one of the reasons that patients get upset and leave a doctor. On your initial visit with your new doctor, take the time to establish reasonable expectations. For instance your doctor may have a policy that if it is not urgent; it takes up to 24 hours before they get back to you. Or they might have their nurse get back to you with and get more information before they answer your question. At other times your physician may need to see you back in their office. For example, if your sugars have been running high for some time- this may require a repeat office visit.  But it is important to know this ahead of time.

Tip number five- Know how results of tests will be communicated to you ahead of time. Does your physician send out information about test results by a letter, phone call or do they expect you to schedule a return visit? Knowing this ahead of time cuts down on any misunderstanding. Also please realize that the adage ‘no news is good news’ does not apply to your healthcare. Always expect some form of communication regarding any tests that were performed on you.

This is just a place to start, but I trust that these five tips will help you in choosing a healthcare provider.

Some Resources to look for a physician:

  • Seek out recommendations from friends and family. It’s an added benefit if they have been longtime patients of the physician.
  • Call your insurance company for a list of physicians that they contract with. Most times the insurance company has already done a lot of the screening that I listed and can answer all your questions about a particular physician.
  • Check with the state licensing board.
  • Call your local hospital to see whether they have a physician referral service.

Just like a good pair of shoes, you may have to go spend some time in your search to find the right fit for you. The important thing is to be persistent in your search. And never be afraid to leave a healthcare provider if you feel that your needs are not being met. Be proactive for health. This is what powerful living is all about.

If you have any comments or questions, come over to my Facebook page, or leave a comment below

To your health and wellbeing,

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The relationship between your family medical history and type 2 diabetes

family diabetes

On one of my recent trips to my home country of Nigeria, I had the pleasure of reconnecting with long lost relatives and I also got to meet new relatives. I was surprised to find out that some of my relatives had developed type 2 diabetes.

Which brings me to today’s topic – what is the relationship between your family medical history and the risk of developing Type 2 diabetes?

Here are some important statistics from the American Diabetes Association:

  • There is a much stronger link between type 2 diabetes and family history than in type 1 diabetes.
  • Depending on your age at the time you are diagnosed with type 2 diabetes, the risk of your child developing diabetes increases. If you are diagnosed before the age of 50, then your child has a 1 in 7 of being diagnosed with diabetes. However if you are diagnosed after the age of 50 then that risk reduces to 1 in 13.
  • The risk of developing diabetes is higher if the parent is a mother.
  • The risk of developing diabetes increased to 1 in 2 if both parents have diabetes.

Does a family history of diabetes mean that you will get diabetes?

As you can see from these statistics, there is an increased risk of developing type 2 diabetes if a parent particularly a mother has diabetes. But all hope is not lost.

Let’s go back to one of the striking statistics I listed above-

The risk of developing diabetes is higher if the parent is a mother.

This means that if a woman develops type 2 diabetes, her children have a higher risk of becoming diabetic! Type 2 diabetes is as much a disease of lifestyle as it is what resides in our genes.

This means that as a woman if you or a family member has type 2 diabetes, then you need to become pro-active in taking preventive measures.

This is why the focus of this website is on women living with type 2 diabetes.

As a physician and a lifestyle coach, my assertion is that by providing women with information on how to live healthy pro-active lives, this will go a long way to impacting the overall health of her family.

As women, we are child bearers, and have traditionally been caregivers and nurturers. We have a stake in reducing type 2 diabetes. We can do this by being more aware of how to prevent this disease in not only our families but also our communities.

It starts with becoming an informed participant in your own health and wellbeing. Knowing your genetic roots is an integral part of that. I find that a lot of people do not know their family medical history. If you are one of those people who do not know your family medical history, then it is time to do that.

Here are some practical tips on the importance of getting a detailed family medical history:

  • Write out your family history on both your parents’ side.
  • Be ready to delve deeper. Sometimes older family members may not have used the word ‘diabetes’. Sometimes it was called ‘a touch of sugar’.
  • Speak to several family members especially first-degree relatives. They may remember family members that perhaps your parents may not recall.
  • Check back frequently with family members to update their medical history. As you can see with my family history, the medical conditions of family members can change over time and it’s important that you know this.
  • Share your family history with your children so that they can be aware. This way the entire household becomes enrolled in a healthy lifestyle.
  • Remember to get your family medical history even if your parents are deceased.

What do you think?

Do you know your family history? Do you have an open discussion about your medical history with your family members? I’d love to read your thoughts and comments below.

To your Health and wellbeing,

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Today’s Health Awareness Topic: The Difference Between Type 2 Diabetes and Borderline Diabetes

According to the recent statistics in the United States there are about 86 million people living with borderline diabetes. More than half of these individuals are unaware that they have borderline diabetes. And for those who are aware of their diagnosis, a significant number do not take it seriously.

So what is borderline diabetes?

Borderline diabetes is when the fasting blood glucose level is outside of the normal range, but not quite in the range to diagnose type 2 diabetes.

What are the normal blood glucose levels?

The most common way to diagnose diabetes is to have a fasting glucose (blood sugar) level done. This is when blood is taken for testing after at least an 8 hour fast preferably a 12 hour fast. If the blood glucose levels are between 70-99 mg/dl then this is normal. Fasting glucose levels between 100-125 mg/dl are called impaired fasting glucose. This blood glucose is what defines borderline or pre-diabetes.

Another test that is now being used to diagnose diabetes or borderline diabetes is called the A1C. The A1C has been used to determine how well-controlled blood glucose levels are in someone living with diabetes. It is a test that shows what the average blood sugar levels over the past 6-8 weeks. The A1C is measured as a percent point. For someone living with type 2 diabetes, the goal is to keep the A1C less than 7.0%.

Borderline diabetes is diagnosed when the A1C is between 5.7-6.3%. If the A1c is equal to or more than 6.4% then this is type 2 diabetes.
Usually healthcare providers may want to repeat a fasting glucose level on at least one additional occasion before making a diagnosis of diabetes or borderline diabetes. However the A1C test is conclusive on one occasion.

Does Borderline diabetes have any symptoms?

There are usually no symptoms associated with borderline diabetes. So do not expect to have the common signs of diabetes.

What are the risks associated with borderline diabetes?

The main risk of borderline diabetes is going on to developing type 2 diabetes. However independent of this risk, people with pre-diabetes are at an increased risk for heart disease, strokes and high blood pressure.

Remember that the same risks that put you at risk for type 2 diabetes can also put you at risk for pre-diabetes.

What can be done to prevent borderline diabetes from becoming type 2 diabetes?

If you are diagnosed with pre-diabetes or borderline diabetes, this is the time that you need to consider making adjustments in your lifestyle. You do have to become a type 2 diabetic. You have a choice.

It is possible to reverse borderline diabetes?

The hallmark of successfully reversing pre-diabetes remains diet and exercise. If you are overweight or obese, commit to losing weight.

Research confirms that just by losing 7-10% of your current bodyweight you could reverse borderline diabetes.

Partner with your healthcare provider to get this done and set reasonable goals. Remember you are making a lifestyle change so do not depend on fad diets. Commit to increasing your physical activity through a regular exercise regimen. Include not only aerobic (cardiovascular) exercise but also strength training.

If diet and exercise are not working to bring your blood sugars to within normal range, then your healthcare provider may decide to put you on a medication called metformin. A lot of times patients become confused because they don’t quite understand why they are on medication for diabetes even though they do not have diabetes. But research shows that metformin helps to reduce the probability of developing full-blown diabetes.

So the next time that you hear someone tell you that they were just diagnosed with pre-diabetes or borderline diabetes, do them a favor and educate them about it.

Let them know that this is the time to begin to make changes in their lifestyle. Be an example for them.

Here’s to your health and wellbeing,

Five New Year Resolutions for Healthy Blood Sugar Control in 2016

New Year 2016 cardHello!! We are well into 2016. Welcome to the inaugural blog post of women living with diabetes. com.  The mission of this blog is to provide a platform to help women living with type 2 diabetes achieve optimal health and wellbeing.

Since it is early in the year 2016, I thought that a good starting place is to discuss resolutions in helping you achieve healthy blood sugars.

Let’s start by defining what a resolution is.

A resolution is defined as a firm decision to do or not to do something. 

Recent research shows that by February 9 of every year, most people have failed at their resolutions when it comes to exercise.  Close to 90% of resolutions fail by the end of the first quarter of the year.

If you are a woman committed to optimal health and wellbeing despite type 2 diabetes, then I invite you to have a more empowered relationship to not only making, but also keeping your New Year resolutions.

In professional coaching, we have an assertion that ‘how you do one thing is how you do everything’. Imagine if you are able to stick with these resolutions how that could flow over into other areas in your life.

So let’s look review five New Year resolutions that I suggest you stick with:

Learn as much as you can about type 2 diabetes

I believe that knowledge is the first step toward personal empowerment. The field of diabetes care is rapidly changing. Become curious about the latest research and information, because it can have a huge impact on your diabetes care. If you find a treatment option that you feel may benefit you, then have a discussion with your healthcare provider about this.

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. High blood sugars are linked to a much higher risk of complications from type 2 diabetes. If you commit to do whatever it takes to achieve and maintain healthy blood sugars, you will reduce the risk of complications.

Make a resolution to do whatever it takes to keep your blood sugars in a healthy range. It may be that you have to increase your physical activity, or watch your portion sizes a lot more closely. Most importantly cut out the excuses. Yes it is easy to rationalize why your blood sugars are high without making the commitment to doing anything about it. Remember how you do one thing, is how you do everything, so if you show up ready to do whatever it takes to achieve healthy blood sugars this year, think of some of the other areas in your life that you could move forward!

See your healthcare provider on a regular basis

Commit to seeing your healthcare provider on a regular basis. This is because it is important in helping not only control your blood sugars but also helping to detect any early complications. Not only should you see your healthcare provider on a regular basis, but you should also know what tests you need to have done. For instance every three months, you should have an A1C performed. This test helps to show allows how well controlled your blood sugars have been over the past 3 months.

Know your ABCs    

It is important to know your ‘diabetes ABCs’. A is for- A1C, B for Blood sugars and C for cholesterol. Have a discussion with your healthcare provider about what your target ranges should be.

According to the American Diabetes Association, the target ranges for each of these are:

·    A1C <7.0%

·    Blood sugars (fasting) 80-120 mg/dl

·    Cholesterol- LDL less than 100 mg/dl; HDL more than 60 mg/dl.

Keep up with routine health exams

Be sure to your annual physical exam, as well as routine screening tests. It is so easy when dealing with a chronic illness to often neglect looking at the whole picture which is you.    Do not leave these to chance. Living with type 2 diabetes puts you at increased risk of some other diseases such as heart disease as well as strokes as well as certain cancers.

I suggest marking a day for your annual physical examination 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 for the rest of 2016

Let’s get started!

To your Health & Wellbeing,

What do you think? Do you keep your New Year resolutions? Would making a resolution to better control your diabetes be something worth taking on? What kind of support would you need in order to keep your resolution?