Power Foods to Combat Stress and Improve Emotional Health

I 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,

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

Diagnosis, high blood sugar

Pregnancy and Diabetes

Dr. Eno Nsima-Obot

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

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

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

How gestational diabetes is diagnosed

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

The cause of gestational diabetes

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

Treatment for gestational diabetes

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

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

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

Gestational diabetes and future risk of developing type 2 diabetes

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

Risks for developing gestational diabetes

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

Steps to reduce gestational diabetes

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

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

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

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

To your health and wellbeing,

chronic illness, Diagnosis

Five Physical Symptoms Women Should Never Ignore

Dr. Eno Nsima-Obot

As women, it is not unusual that we may ignore our health and wellbeing. For women living with a chronic illness such as borderline or type 2 diabetes, it is important to make our overall health and wellbeing our number one priority.

I have seen female patients who have ignored symptoms that later turned out to be very serious.

In this article I outline five common symptoms that should never be ignored. This is because contrary to ‘popular wisdom’ these symptoms may be a sign of more serious illness.

Rule of thumb is that if you experience any of these symptoms for more than a few weeks then it is time to schedule an appointment to see your healthcare provider.

1-Persistent Heartburn

Heartburn is a common complaint. It is also called ‘indigestion’, or ‘reflux’. It is caused when stomach acid moves back up the swallowing tube (called the esophagus).

There are many things that can cause heartburn. Some of the common reasons include certain foods such as spices, tomatoes. Caffeine intake, emotional stress and fat around the abdomen (abdominal obesity) are also causes of heartburn.

One uncommon symptom that may mimic heartburn but is something more serious is a heart attack!

The heart sits in the chest wall directly above the stomach and is separated by the diaphragm. The diaphragm is a muscle that separates the chest from the abdomen. It is very important in breathing. If you have a heart attack that affects the bottom of the heart that sits on the diaphragm part, it may mimic the symptoms of heartburn.

How do you know it’s not heartburn?

If you have never experienced heartburn before and right out of the blue you begin to experience this more frequently -this is a strong clue! Also if you break out in a sweat, feel your heart racing or have nausea or vomiting. Another thing to observe is if you don’t recall anything that you may have eaten that could be causing you to feel this way.

Rule of thumb when it comes to heartburn that you cannot explain, get checked out immediately. This is especially important if you have a family history of heart disease

2-Frequent vaginal yeast infections

A common reason for vaginal itching is a yeast infection called candida albicans. Candida is not sexually transmitted. It can cause a rash on the labia, itching and also a thick vaginal discharge that looks like cottage cheese.

There are many reasons why a woman may get yeast infections. This may include wearing tight underwear, stress, antibiotics, and hormonal contraceptives to name a few.

However frequent candida infections may be a hidden sign of diabetes mellitus. Yeast love sugar; the candida spores usually live in the digestive tract, but diabetes mellitus affects that acidity of the vagina and this way promotes the growth of yeast.

Rule of thumb, if you have frequent yeast infections more than 2 -3 times a year, then inform your healthcare provider. A simple fasting blood sugar is a great screening tool to find out if you have borderline or type 2 diabetes.

3-A constant dry cough

Have you ever met people who constantly have a cough and short of breath? Perhaps you or someone you know may have even gone to your doctor and been told that you have ‘allergies’. The fact is that this may be a sign of a serious lung disease called sarcoidosis.

The medical profession does not really know what causes sarcoidosis. It is common between the ages of 20 and 40 years old and can affect both men and women. It is three to four times more common in black people. If you have a family member with sarcoidosis then this increases the probability of another family member having it.

Sarcoidosis can progress from a very mild illness to a very serious illness.

Rule of thumb if you have a cough especially with shortness of breath and chest pain that persists for more than a month then I recommend that you schedule a visit with your healthcare provider.

4-A facial rash that won’t go away

Do you have a red rash around your nose and cheeks that gets worse in the summer? This could be a disease called systemic lupus erythematosus –‘lupus’ for short.

Once again this is one of those illnesses that we in the medical community really can’t pin down a definite cause for. We do know that it is an autoimmune disease. This means that the body forms compounds that literally fight itself breaking it down. These are called antibodies. Because it is an autoimmune disease it can affect literally any organ in the body. This is why it can be a challenge to diagnose.

Lupus is more common in women and recently there have been campaigns to increase the public awareness of this disease.

Rule of thumb if you have a rash with an outline that looks like the wings of a butterfly over your nose and cheeks, gets worse in the sunlight and just does not seem to go away, see your healthcare provider to get blood tests for lupus.

Lupus can show up in many ways, for more information click here

5-Constant Fatigue

Now this is a tough one. I mean as women we are built to be resilient, right?. We are super mommies, caregivers, professional women, working women. We burn the candle at both ends trying to meet each and every obligation thrust upon us. So naturally we will become fatigued right?

Well here are some additional clues that that fatigue may be a sign of something more:

Weight gain
Constipation
Feeling cold even in warm weather
Growing fuzzy fine hair on your skin
Dry brittle skin and nails
A feeling of depression

These symptoms may be due to a low active thyroid called hypothyroidism. The thyroid gland produces a hormone that is responsible for maintaining our metabolism. Hypothyroidism becomes more common in women over the age of fifty.

Rule of thumb- if you are experiencing constant fatigue that you can’t explain then you can get a simple test called TSH from your primary care provider.

Well I hope that you find this information helpful. Always remember it’s better to be safe than sorry. By tuning in to the wisdom of our bodies we can live more fulfilling lives.

Remember an ounce of prevention is worth a pound of cure.

To your health and wellbeing

Type 2 Diabetes

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

Dr. Eno Nsima-Obot

Post 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,

borderline diabetes, Type 2 Diabetes

Can You Reverse Borderline Diabetes?

Dr. Eno Nsima-Obot

Perhaps 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:

It acts to reduce the output of stored sugar from the liver
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

blood glucose monitoring, Type 2 Diabetes

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

Dr. Eno Nsima-Obot

Welcome 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,

Type 2 Diabetes

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

Dr. Eno Nsima-Obot

It 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,

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.

Diagnosis, Type 2 Diabetes

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

Dr. Eno Nsima-Obot

When 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”

Acceptance
Belief
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,

high blood sugar

How to Bring High Blood Sugar Levels Down Without Feeling Lousy

Dr. Eno Nsima-Obot

Hello and welcome back to another edition of Women Living Diabetes,

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

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

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

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

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

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

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

Here is a simple explanation as to why this happens:

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

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

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

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

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

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

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

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

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

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

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

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

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

Until next week,

To your health and wellbeing,

low blood sugar, Type 2 Diabetes

Reducing Low Blood Sugar Complications in Type 2 Diabetes

Dr. Eno Nsima-Obot

Hello and welcome back to another addition to Women Living with Diabetes

Today I am going to write about a potential complication when treating diabetes especially when using drugs. This complication is low blood sugar known by the medical term hypoglycemia.

Some drugs used to treat type 2 diabetes can cause low blood sugar levels.

Low blood sugar (hypoglycemia) is when the blood sugars drop below 70 mg/dl.

From what a lot of people living with diabetes tell me, this is one complication that they do not like to experience. And from my experience as a physician in clinical practice, once a person experiences this, they will do all they can to avoid it in the future.

Some of the things they may do in order to avoid feeling that way may include cutting down the dosage of their drugs, skipping their drugs, or eating more carbohydrates.

Symptoms of low blood sugar levels

Feeling very hungry
Nervousness
Feeling Irritated
Confusion
Slurring of speech
Sleepiness
Sweats
Light headedness or dizziness
Weakness
Anxiety
Sudden change in personality

The dangers of low blood sugar levels

Low blood sugar is especially dangerous if it occurs during sleep. Because the brain uses sugar (glucose) exclusively for energy, without enough sugar, a diabetic may slip into a coma. If this is discovered and treated early, by giving glucose, then no permanent brain damage occurs. However if the low blood sugar persists for many hours then the nerve cells in the brain could begin to suffer permanent damage. At that point it cannot be reversed.

This is why it is very important that a person living with diabetes wears a bracelet letting people know that they have diabetes.

Some causes of low blood sugar levels in a type 2 diabetes

Medications- Medications called oral hypoglycemic agents and also injectable medications like insulin are common causes of low blood sugar. Also medications called ACE-Inhibitors and ARBs can also cause this. These are commonly used to treat heart disease, hypertension and early kidney disease in type 2 diabetes.

Increased physical activity- Exercise helps to control type 2 diabetes. It does this by improving how sensitive the cells in the body are to the effects of insulin. The more sensitive the cells, the better they use insulin and so the lower the blood sugars. This is the goal of treating type 2 diabetes. However when a person with type 2 diabetes starts to exercise, it may become necessary to adjust the medications that they are taking. If this does not happen then the result may be low blood sugar levels.

Alcohol intake. Alcohol can reduce the blood sugars by affecting the way that the liver stores sugars. For this reason, it is important for someone living with diabetes type 2 to drink alcohol in moderation.

How to treat low blood sugar

If you notice a friend or relative who has type 2 diabetes start acting in a strange manner, especially if they have any of the symptoms that I have listed ACT FAST. GIVE SUGAR.

Here are some suggested ways to do this

4 ounces of regular soda not diet soda
4 ounces of fruit juice or milk
6 pieces of hard candy not no sugar candy
A tablespoon of honey
3-4 glucose tablets

Once you give them some sugar, stay with them until they become more alert. Check their blood sugars in about 15 minutes. If it is still lower than 70 mg/dl repeat with any of the things listed above. If they are able to have a conversation with you and not drowsy or unconscious, have them eat a light meal and then repeat the blood sugars again. If the blood sugars are still less than 70 mg/dl then call 911!! If at any point you notice that they are lapsing into unconsciousness, call 911.

Low blood sugar can be a very scary experience not only for a person with type 2 diabetes experiencing it but also the people witnessing it.

If you have several episodes of hypoglycemia that you don’t seem able to explain, then make an urgent appointment to discuss this with your primary care physician.

Ways to prevent hypoglycemia

Make sure that if you are taking oral hypoglycemic medications or insulin that you eat shortly after taking your medications.
Plan out regular meals throughout the day. Be sure to include snacks. Try not to stay more than 2 -3 hours without a snack or a meal. Binge eating can cause the sugar levels to fluctuate widely.
Before you exercise, check your blood sugar. It is a good idea to have a snack especially if your blood sugar is less than 100 mg/dl. Also eat a snack if you plan to exercise for longer than an hour.
Limit the amount of alcohol that you drink. If you must have an alcoholic beverage, check your blood sugars to make sure that they are not running low. If you drink alcohol try to limit it to one drink.

I hope this information is useful. As always I welcome your questions, comments, suggestions for upcoming articles.

Until next week,

Here’s to your health & wellbeing’,

Type 2 Diabetes

The relationship between obesity and increase in type 2 diabetes in teens

Dr. Eno Nsima-Obot

The number of teenagers being diagnosed with type 2 diabetes is rising. About 3,700 teens are diagnosed with type 2 diabetes every year. There was a time when only older people got type 2 diabetes. This used to be called ‘maturity onset diabetes’.

However, with changes in our lifestyle, including the rising obesity epidemic, type 2 diabetes is now being diagnosed at much younger ages.

Here are some of the reasons for the increase in type 2 diabetes in our teenage children

Decreased levels of physical activity
Let’s face it, unless a teenager is actively involved in sports, they are less likely to be physically active. These days teenagers live in a more technology-oriented world, social media, video games etc. that tends to lead to a more sedentary lifestyle. Teens should be encouraged to increase physical activity into their lives.

Increased access to fast foods
With the fast paced lives that we live in the 21^st century it is not unusual for a teenager to eat more fast foods. Fast foods are not very nutritious and so could contribute to increase body weight.

Distorted body image
Some ethnicities, such as African Americans, Native Americans and Latinos may buy into the thought that ‘thick is it’, or that they are just a little ‘overweight’. This distortion of self-image contributes to a rise in obesity and also an increase in type 2 diabetes.

Genetic Tendencies
If the parents of a teenager are obese, the chance of their children being obese is high. Obesity is related to behavior patterns. If both parents are obese, then the chances of an obese child are 66%. The risk is 50% if one parent is obese.

Lack of nutrition awareness
A lot of people do not know a lot about what makes a healthy plate. We need to become more aware of the choices we make when it comes to what we eat.

Lack of recreational space and food islands in inner cities
The lack of easy access to supermarkets that stock fresh produce in inner cities is an ongoing problem. This needs to be addressed by our policy makers if we are truly serious about making a dent in diseases caused by lifestyle choices such as type 2 diabetes. In addition, there is also shortage of adequate recreational space in inner city neighborhoods. This combined with the fear of violence associated with the inner city are also factors that contribute to the rise in obesity.

Here are some simple small steps that we can take to reduce teenage diabetes

Become a more active as a family and a community
GET MOVING and encourage your teen to get moving also! There is no short cut to increasing the level of daily physical activity. Keep it simple. Get a fitness tracker such as a fitbit® for family members. Form a team. Have each family member make it a goal to increase the number of steps they walk to 10,000 steps every day. Use social media such as twitter or Facebook to gain support from friends. More importantly make it FUN! Set up healthy competition with siblings. Even involve the dog ☺.
Pay attention to nutrition labels
Thanks to recent revisions by the US Dept. of Agriculture, food labels are becoming a lot easier to decipher. Make it a habit to read food labels and learn about the ingredients in your food. I use a rule of thumb that is pretty straightforward- if the label reads like something from my medical school biochemistry class then perhaps it’s not as healthy as it looks. ☺
Create a culture of wellness
As women, we have traditionally been the custodians of the health of our households. I believe that knowledge is the first step to personal empowerment. By becoming empowered, we can make decisions that will impact not only our personal health, but also that of our families. We need to get the right information. Information that is easy to understand. Without access to the right kind of information, people cannot make good lifestyle choices. That is the mission of this website, to provide information in an easy to understand format so that we can all collectively get into action to stave off this epidemic of diabetes and obesity.

We need to arm ourselves with this knowledge so that we can transmit this information in the healthy lifestyle choices that we make for our children.

We need to rid ourselves of the belief that just because we may have a family history of obesity, diabetes or some other chronic illness, that this is the norm and to be expected and we cannot do anything about it for our children or ourselves.

Collectively as women, mothers, aunts and matriarchs- we need to take personal responsibility for creating a culture of wellness in our families, communities and the world at large.

The time to act is NOW!

To your Health and Wellbeing,

Uncategorized

Ten Things to Bring to Your Next Doctor Visit

Dr. Eno Nsima-Obot

Tip 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,

Diagnosis

What is Polycystic Ovarian Syndrome?

Dr. Eno Nsima-Obot

Polycystic ovarian syndrome (PCOS) is a health condition in women caused by a predominance of male hormones called androgens.

The exact cause of this condition is not known, it affects about 5 million women are affected by polycystic ovarian syndrome.

PCOS affects many systems in the body. The symptoms vary between women.

Some common symptoms of PCOS include-

Obesity or overweight
Irregular menstrual cycle
Male pattern hair or balding
Obesity
Facial hair such as a beard or moustache
Infertility

Some women may have very subtle symptoms that are barely noticeable. Others may have more typical symptoms.

Polycystic ovarian syndrome (PCOS) affects about 1 in 10 to 1 in 20 million women. There is no single test available to detect PCOS.

The relationship between polycystic ovarian syndrome and insulin

Research has shown that insulin resistance may play a role in the development of polycystic ovarian syndrome. In the revised edition of my upcoming book ‘Dr. Eno’s A to Z guide to living powerfully with Diabetes’, I explain how insulin resistance as a precursor to the development of diabetes. When the body’s cells become resistant to insulin, more insulin is required to break down sugar in the body.

Too much insulin circulating in the body can cause a number of problems. In women with PCOS, insulin resistance causes an increase in the production of androgens. High levels of androgens cause acne; facial hair, irregular menses and weight gain in women with PCOS.

PCOS places a woman at risk of several serious health conditions:

More than 50% of women with PCOS develop type 2 diabetes.
Women with PCOS have a 4-7 times risk of developing a heart attack.
Women with PCOS have a higher risk of high blood pressure
There is an increased risk of a sleep disorder called sleep apnea
Higher risk of anxiety and depression
Women with PCOS have an increased risk of endometrial cancer

How is Polycystic Ovarian Syndrome (PCOS) diagnosed?

There is no single blood or diagnostic test that can be used to diagnose PCOS. A woman who suspects that she has PCOS needs to pay close attention to her body, especially if the symptoms are initially subtle. It is also important to be persistent and realize that it may require more than one visit to the doctor to get a diagnosis.

In addition to a detailed history your doctor may also need to perform some tests, which may help such as:

A pelvic examination
Weight and BMI
A pelvic ultrasound
Hormone levels

How to treat PCOS

Treatment of PCOS depends on the goals of the woman living with this condition.

For instance if the goal is to get pregnant, then using fertility medications will help. If the goal is to have more regular periods then starting on an oral contraceptive will help.

Metformin can help to reduce the chance of getting type 2 diabetes.

Ultimately, the mainstay of treatment of PCOS is making a consistent change in diet and exercise.

It does not matter how long you have been diagnosed with PCOS, what’s important is to begin to make the necessary adjustments in your lifestyle starting right now. That way you will reduce your chances of getting type 2 diabetes, heart disease and high blood pressure.

What do you think?

Do you or someone you know have PCOS? Are you ready to get into action and to take the steps necessary to reduce your risk of diabetes, heart disease and high blood pressure? I’d like to share how I may support you in one of my coaching programs. Click here to contact me.

To your Health and Wellbeing,

Type 2 Diabetes

Is There a Link Between Type 2 Diabetes and Hypertension?

Dr. Eno Nsima-Obot

So you are living with type 2 diabetes. You are doing everything your healthcare provider has recommended. You are maintaining a healthy lifestyle with diet and exercise. You are checking your blood sugars and they are within target range. Your A1C is less than 7%.

You are scheduled to see your healthcare provider for your routine visit. You’re feeling good.

“Everything looks good, it’s just that your blood pressure has been rising over the last few months”, you’re healthcare provider reports, “We are going to have to start you on blood pressure medications”

You’re bewildered. How can this be? Everything seemed to be going well. How come you’ve just been diagnosed with hypertension?

Is there a link between Type 2 Diabetes and hypertension?

YES there is a link and it is called metabolic syndrome.

Metabolic syndrome is a group of characteristics. It is not a medical illness per se. These characteristics put you at an increased risk for developing certain diseases.

These diseases include diabetes type 2, hypertension and heart disease. Metabolic syndrome is also called syndrome X and also insulin resistance syndrome.

Most clinical experts define metabolic syndrome as having three or more of any of the following:

If your waist measurement is more than 35 inches in women and 40 inches in men.
A fasting blood sugar level more than 100-125 mg/dl
High blood pressure of more than 130/85 mm hg. Or if you have already been diagnosed with hypertension (high blood pressure).
High triglyceride level of more than 150 mg/dl
A low HDL level of less than 40 mg/dl.

How common is metabolic syndrome?

More than 2/3^rd of the adult American population is either overweight or obese. The number of people with metabolic syndrome has risen just as the obesity epidemic in this country. Currently that rate is at 34% of the adult population.

The following factors put you at risk for developing metabolic syndrome:

Being overweight. In other words a BMI of more than 25. Click here for the BMI calculator
Smoking
Eating a diet that is high in carbohydrates
Smoking
Lack of exercise
Menopause
Family history of diabetes or metabolic syndrome.
Increasing age.

What health risks are associated with metabolic syndrome

People with metabolic syndrome are more likely to develop diabetes type 2
They are also at risk for developing heart disease.

How is metabolic syndrome diagnosed?

Schedule an annual physical exam with your healthcare provider. Check your weight and calculate your BMI using the BMI calculator.

Remember to get your waist measurement taken.

Have your healthcare provider do blood tests to check your fasting lipid profile and blood sugar.

For more information about knowing your numbers click here

It is always a good idea to schedule an appointment for your annual physical first thing in the morning. That way, you can go in fasting- without having eaten anything.

Please do not to take your medications if you do not eat. This will reduce your risk for hypoglycemia.

How to treat Metabolic Syndrome:

The primary goal is weight loss. Become more physically active and eat a healthy diet.

This will help to reduce your cholesterol and also keep your blood sugars in target range.

If you smoke, make a commitment to quit smoking.

High blood pressure is when your blood pressure is more than 140/90 mmhg. It is diagnosed after your healthcare provider has obtained more than 3 readings of an elevated blood pressure.

When diet and exercise fail to bring the blood pressure down to normal range, then your healthcare provider may decide to start you on medications.

The common link between high blood pressure and diabetes is metabolic syndrome. It is because of this link that a lot of people with diabetes type 2 may end up being diagnosed with high blood pressure.

The goal is to control or reduce your risk for metabolic syndrome. That way you reduce your risk of complications of diabetes.

As always, I welcome your comments, feedback and any suggestions you have for upcoming topics.

To your health and wellbeing,

Type 2 Diabetes

Why Women living with type 2 diabetes need to build a support system?

Dr. Eno Nsima-Obot

If you are a woman living with type 2 diabetes or caring for someone living with diabetes, you may notice that this can be a very stressful experience. Your life as you knew it seemed to change the instant you were diagnosed. And just like any other chronic illness, there is a lot to be learned.

It may seem that there is no clear place to turn for help on learning about how to live with a chronic illness. Your healthcare providers may have very little time in their double-booked schedules to provide additional information on how to live with diabetes. Diabetes education classes are are a great resource to have a structured curriculum. So these classes may or may not cover your own unique concerns. And then of course the Internet is filled with information overload!

Building a support network is an indispensable tool

If you are living with diabetes or any other chronic illness, do not try going it alone. As women we usually try to put on a brave face and try to do it alone. We may feel afraid to ask for support, because we have a mindset that tells us we don’t want to be a bother to anybody.

We are so used to being caregivers, that may of us have forgotten how to receive care from others.

However, a surefire way to end up stressed out and depressed is to stay with this mindset.

Living with a chronic illness can be stressful. This is why it is important to build a network of people who are there to support you.

There are many ways to build a good support network. The bottom line is you want like-minded people whose sole purpose is to support you, energize you and to raise your spirits up. Period.

The types of support

There are several types of supporters to consider. Try not to lean on just one person for support. Just like different voices in a choir, there may be many types of support that you need. Also depending on the season in your life, the types of support will also change.

Combined they should contribute a high sense of value to your life as a person living with diabetes. If you have people who are attempting to do any other than supporting you such as – convince you that you do not need to be on medication, or that your healthcare provider does not know what they are doing, or recommending some ‘off the cuff’ regimen that they saw on a late night TV infomercial- they are not the kinds of people that you need in your support network.

Below is a list of some of the types of supporters that I recommend that you have:

Emotional supporters- I call these your ‘personal cheerleading squad’. Granted they may not have the faintest idea of what your target blood sugars need to be, but one thing they are good at doing is seeing the glass half full, not half empty. And so emotional supporters are the people that you call on when you are not feeling very optimistic. When you’re doing your best to get your blood sugars under control and it just does not seem to be working well this week.

Your emotional supporters have a great sense of humor and so they help to brighten up your mood. You may even have your emotional supporters willing to go with you on visits to your healthcare providers.

Spiritual Supporters- No matter your religious inclination (or lack thereof), we all have an inkling that that there is much bigger picture than our mere individual existence. And we do not always have the answers why things happen the way they do. Your spiritual supporters are the people who keep you in tune with that bigger picture. Spiritual supporters come in different forms. Spiritual supporters may include your clergy, to a favorite spiritual verse, a special spiritual text or even a spiritual mentor.

Social supporters- this is your social support network. They could be an online social support network of other people living with type 2 diabetes. Or live groups that meet online or offline. Either way, social support networks are a great resource which could help it’s members navigate online as well as offline resources, host meetings or online chats on different topics, be a source of referrals etc. When social support networks are well run, members not only support each other, but they also learn from one another.

Healthcare support

Finally, there is the kind support that you can get from your healthcare provider. Usually this may be healthcare based information designed to highlight different aspects of living with diabetes. This kind of support may take the form of exit questions that your healthcare provider’s assistant may ask you at the end of an office visit, or a nurse calling you in between visits. Or even lifestyle coaching! When used well healthcare support provides you with a roadmap that helps you to keep your target goals in full view. By keeping your target goals in view, you are well on your way to living powerfully with diabetes.

To your Health and Wellbeing,

What do you think? Are you getting enough support right now in living with diabetes? Have you been diagnosed with borderline diabetes but don’t have enough information? Do you think online support works?

Uncategorized

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

Dr. Eno Nsima-Obot

For 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,

Uncategorized

The relationship between your family medical history and type 2 diabetes

Dr. Eno Nsima-Obot

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,

511952242dd5056a22054e09-2

blood glucose monitoring, Diagnosis, lifestyle, Type 2 Diabetes

The ABC’s of Knowing Your Diabetes Numbers

Dr. Eno Nsima-Obot

I was once admitting a patient to the hospital. He had been living with type 2 diabetes for over 15 years. Unfortunately he had developed kidney failure and so now had to be on hemodialysis.

He seemed to know how his blood sugars were doing. He even recognized that a recent infection was the reason that his blood sugars were high.

I was impressed and excited. Then I asked him this, ‘So what’s your A1C?’ ‘What’s that?’ he replied with a blank stare. I was taken aback at his response, ‘You know your glyco hemoglobin?’ I ventured again. Another blank stare. ‘Never heard of that’ he responded off offhandedly.

Here was a man who by all intents and purposes seemed actively engaged in managing his diabetes. And yet he had NEVER heard of the A1C!

So this week, I will discuss getting to know your diabetes numbers.

One of the keys to Living powerfully with diabetes is to know your numbers.

I love acronyms. They help to make learning easier. For instance in my soon to be released book, Dr. Eno’s A-Z Guide to Living Powerfully with Diabetes’ I use the letters of the alphabet to cover different topics related to type 2 diabetes.

I am going to use the simple acronym ABCs to show how to remember some diabetes numbers. The uppercase letter will be for what I’ll call actual numbers. The smaller ‘a’ will go with some of the lifestyle adjustments that need to be made as a person living with type 2 diabetes.

So here goes:

A – A1C
- activity

B – Blood sugar
- bmi

C – Cholesterol
- calories

A1C

A1C is a short name for glycosylated hemoglobin. That may sound like a mouthful, so it’s been abbreviated it to the A1C. The A1c is calculated as a percentage point. The A1C measures the average of the blood sugar levels over the prior 6- 8 weeks. The A1C measures the amount of sugars that attached to the red blood cells.

The higher the blood sugars, the higher the A1C. Typically the red blood cells live for about 120 days before they die off.

The goal is to keep the A1C less than 7%. An A1C less than 7% correlates with sugars on average less than 140 mg/dl.

How to get tested for the A1C:

You do not have to fast overnight before getting tested for the A1C. Most healthcare providers can do this test in their office; otherwise it can be done in the laboratory.

activity

I encourage everyone to try to adapt some form of physical activity. Research has shown that prolonged sitting and a sedentary lifestyle increases your risk of heart disease, cancer and diabetes by up to 40%. Research also shows that increased physical activity helps to control blood sugars.

A lot of people use the excuse of lack of time for not getting enough physical activity. Here are some creative ways to incorporate physical activity into your daily life:

Purchase a fitness tracker so that you can track your movement. When you track any activity you become more aware of that and this makes you want to do more of what you track.
Encourage your friends and colleagues to purchase fitness trackers. Have them join you in a fitness tracking challenge. A good idea would be to check with your health insurance company to see if fitness trackers are a covered benefit.
Instead of looking for a 30-45 minute block of time, how about creating three to four 10-15 minute blocks of time throughout the day?
Rather than taking the elevators, look for every opportunity to take the stairs.
Get to work 15 minutes earlier park further away and get a brisk walk.
Get up several times during your workday and do squats at your desk.
Do leg raises when you are sitting down
Spend time during your lunch break walking outdoors.
Instead of delegating that task of walking the dog to your kids, get a long leash and walk it!

Blood Sugar

It is important to keep your blood sugars within a healthy range. Depending on the treatment goals that your healthcare provider sets, you may have to check your blood sugars at home. This is known as self-monitoring of blood glucose. I’m often surprised to find patients who do not want to check their blood sugars. Perhaps they feel it is painful or they are scared stick themselves.

A healthcare provider only gets to see their patients on average 4-5 times a year. That’s every 3-4 months! Knowing your blood sugar levels gives you instant feedback as to how well you are managing your diabetes. It alerts you to a problem and you can work with your healthcare provider to make corrections.

Knowing your blood sugars is key to living powerfully with diabetes.

bmi

Currently there are more than two third of adult Americans are overweight or obese.

BMI correlates with body fat and is relatively unaffected by height. It is calculated from the weight and square of the height as follows:

BMI = body weight (in kg) ÷ stature (height, in meters) squared

Know your BMI

The definition of overweight and obesity varies by race.

According to the WHO and NHBLI guidelines, overweight for Caucasians, Hispanics and blacks is a BMI between 25 and 29.9 kg/m2.

Obesity is when the BMI of 30 kg/m2 or more.

For Asians, overweight is a BMI between 23 and 29.9 kg/m2. Obesity a BMI >30 kg/m2.

There are several apps that can help to calculate your BMI once you enter in your weight and height. You can also check with your healthcare provider on a routine visit.

Cholesterol

Cholesterol is produced in the liver. It gets transported from the liver to the cells of the body where it performs a variety of functions. If the cholesterol levels run high then there is a risk for heart disease.

It is important to know your cholesterol numbers.

You should get a fasting lipid panel as part of your routine diabetes care.

The fasting lipid panel is made up of several parts:

HDL (High Density Lipoprotein) I call it the ‘happy cholesterol’ This level should be more than 40 mg/dl. More than 60 mg/dl is excellent.
LDL (Low Density Lipoprotein) I call it the ‘lousy cholesterol’. You want to keep this as LOW as possible. The current guidelines are to get the LDL as low as 70 mg/dl.
Triglycerides – These are all the fatty substances in your blood. The goal is to keep the triglycerides less than 150 mg/dl.

calories

The amount and quality of calories that you eat plays a crucial role in how well controlled your blood sugars are going. Calories are also tied directly to how much weight you gain or lose. It’s a very simple equation.

Calories in more than calories out = gain in weight (high BMI + High blood sugars + high A1C)

Calories in less than calories out = weight loss (lower BMI + normal blood sugars + normal A1C)

Ways to monitor your calories:

A simple way to start of is to simply watch your portion sizes.
Don’t fill your plate or use a smaller plate.
Eat only till you are about 80% full. This is a principle that the Okinawans in japan use. They live into their 100s.
Increase your intake of fruits and vegetables.
Drink at least half your body weight in ounces of water per day. This helps to keep you full.
Increase the intake of fiber. This also helps control your blood sugars.

So there you have it. Know your ABCs.

As always I welcome your questions and comments.

Here’s to your Health & Wellbeing,

Uncategorized

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

Dr. Eno Nsima-Obot

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,

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Five New Year Resolutions for Healthy Blood Sugar Control in 2016

Dr. Eno Nsima-Obot

Hello!! 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?