Type 2 Diabetes – Do You Have Diabetes?

It’s this simple: people with Type 2 diabetes even in the early stages, show several common indicators of this condition. They include:

  • more than usual urination paired with an extreme thirst,
  • exhaustion,
  • weight gain or sometimes weight loss,
  • numbness and tingling in your hands or feet,
  • patches of dark skin in the folds and creases of your body,
  • slow to heal wound infections,
  • frequent bladder and vaginal infections, and
  • blurry vision.

Type 2 diabetes begins decades before a diagnosis is made, with an increasing resistance to insulin. This increasing resistance is the result of:

  • genetics,
  • weight gain… especially abdominal fat,
  • decreased activity, and
  • aging.

Signs and symptoms come on gradually and are not immediately identifiable, causing most people to not even think they need to take any action to overcome them. There are, however, disease warning signs.

Most people would agree Type 2 diabetes goes hand-in-hand with being overweight or obese. In fact, up to 90 per cent of all diabetes cases are Type 2, and at least 80 per cent of those are found in people who are overweight. Statistics show the incidence of obesity and Type 2 diabetes is increasing rapidly world-wide, through all cultures.

When one is obese or overweight, the cells tend to resist insulin, which is also true among diabetics. The major site of insulin resistance is the muscle tissue, which normally uses more than 80 per cent of the glucose taken into the body. Due to this resistance, the body’s insulin levels actually begins to rise. This leads to high levels of insulin and glucose in the bloodstream… this is usually when your doctor will make a diagnosis of Type 2 diabetes.

Don’t wait until you actually receive a diagnosis of Type 2 diabetes. By the time your doctor tells you you have diabetes, you have had it for several years in the form of pre-diabetes. If you are:

  • carrying excess weight in the abdominal area,
  • high blood pressure,
  • abnormal levels of triglycerides and LDL cholesterol,

don’t hesitate to take these signs seriously. You could also have high blood sugar levels because insulin cannot carry glucose into your cells, leaving glucose in your bloodstream. A fasting glucose test result of 110 mg/dL (6.1 mmol/L) or higher may be a symptom of insulin resistance. A glucose tolerance test of 140 mg/dL (7.8 mmol/L) could also indicate you have insulin resistance.

Do not hesitate to ask your doctor to give you the guidelines to prevent the development of full-blown Type 2 diabetes. The good news is anyone receiving a pre-diabetes diagnosis can take steps to prevent the development of full-blown diabetes.

The best approach is to change your lifestyle by:

  • reducing the amount of food you eat,
  • making changes in some of the foods you eat, and
  • increasing physical activity.

Nutrition: Talk to your doctor and insist on being referred to a dietitian. A dietitian will guide you on how to implement nutrition guidelines to help you reverse pre-diabetes. With the right changes in your eating plan, pre-diabetes can be reversed.

Physical Activity: This is as simple as walking briskly most days of the week… this will help with your goal of preventing full-blown diabetes. Moderate exercise actually helps your cells become more effective in using your blood sugar.

Losing 5 percent of your body weight with increased physical activity will postpone your progression to full-blow diabetes.

Don’t forget… for any Type 2 diabetes, or pre-diabetes plan to work you have to stick with it!

Category: Diabetes / Tags: , ,

Paula Deen’s Diabetes Dilemma

Paula Deen is a well known American cook specializing in many delicious foods. Unfortunately, the reason many of the food items are considered irresistible is because of the extremely high fat, sugar, and salt content in all the recipes. Criticism reached an all time high in early 2012 when Paula Deen announced that she had been diagnosed with Type 2 diabetes years earlier. The reason the diagnoses has become so controversial is because one of the leading causes of Type 2 is an unhealthy high calorie diet. In addition, diabetes is known to be one of the most silent killers out there. This is because without regular testing, many people are unaware they have diabetes until they end up in a potentially deadly situation.

Many celebrities and fans criticize Paula Deen for continuing to advertise her high-calorie recipes even after the diagnosis. Many believe that, had her diet been healthier, she never would have developed the condition. While it’s impossible to say that for sure, it’s not too late for others to prevent or even stop diabetes now with the proper diet and lifestyle change. Having diabetes is serious enough and rather than putting blame on Paula Deen or anyone with the misfortune of living with the disease, it’s more important to help stop diabetes now with these simple tips.

The key step in diabetes is to be aware of your risks. Like most medical conditions, anyone can get diabetes, but certain groups of people are at a much higher risk of developing it. Those who are overweight, consume large amounts of saturate fats, have family members with diabetes, even those who were premature as a baby are all at an increased risk.

For those who are at risk of developing diabetes, it’s important to schedule regular doctor visits to monitor the situation and stop diabetes now. Doctors can now test for a condition known as pre-diabetes, meaning that while the person isn’t completely diabetic, they will likely develop the condition within the next ten years if their lifestyle doesn’t change.

Those who refuse to take care of themselves, either by refusing to get regular checkups or simply not living healthy, can face complications that can be life changing and even fetal. For example, it’s not uncommon for those with diabetes to have trouble with their eyesight and feet. If a patient refuses acknowledge these risks, it can result in blindness or even amputation.

Life style changes that can stop diabetes now include dietary changes, such as consuming less carbs and scaling back on unhealthy foods. Any white food, such as bread and rice, should also be swapped for whole wheat versions. Foods that are high in saturate fats, such as takeout, should also be avoided.

Exercising is also highly recommended since those who are overweight are typically at the highest risk of developing the condition, as was the case with Paula Deen. Light exercise, such as walking, swimming, or cycling are often recommended to help get weight under control and improve body functions. These exercises are also easy enough to do so that even those who are overweight will be able to workout without feeling overwhelmed.

On the other hand, isometric exercises, (exercises where a contraction is held without joint movement) should be avoided as it can cause unhealthy spikes in blood pressure levels. Since many people with diabetes already struggle with keeping their blood pressure under control, it’s recommended that isometric exercises be put on hold until the diseases is better managed.

Category: Diabetes / Tags: , ,

Diabetes, Cholesterol and the Statins

Cardiovascular disease, or CVD, is the leading cause of death among Type 2 diabetics living in the United States.

CVD is a general term which refers to people with blockage of the heart’s blood vessels (also known as coronary artery disease or CAD), blockage in the vessels of the leg (peripheral vascular disease or PVD), and blockage of the carotid arteries (the blood vessels supplying the brain).

Diabetes alone is a risk factor for CVD, increasing your risk 2-4 fold.

Another very important risk factor for cardiovascular disease is your LDL cholesterol.

When your doctor tells you he/she is obtaining a blood sample to “check your cholesterol” or “measure your lipids”, they may check your total cholesterol, LDL cholesterol, HDL cholesterol and total triglycerides.

If all four measurements are included, it is called the “lipid profile”.

The blood test is typically obtained after an 8-12 hour overnight fast.

Although the LDL and HDL cholesterol may be further divided into sub-fractions (basically good and bad subtypes of the LDL and HDL), this level of sophisticated testing is rarely performed.

Given the association of elevated LDL-cholesterol (or LDL-c) levels and CVD, LDL is known as the “bad cholesterol”.

Since diabetes alone is a risk factor for CVD, the LDL-c goals are lower in diabetics.

In diabetics without known CVD, the goal LDL-c is <100 mg/dl (2.6 mmol/l). In a non-diabetic without known CVD, the goal LDL-c is <130 (3.4 mmol/l)

In diabetics with documented CVD, the goal LDL-c is typically <70 mg/dl (1.8 mmol/l).

Unless a person already has clinical evidence of CVD, or has cholesterol levels which are markedly elevated, lifestyle modifications are the first step in the management of an elevated LDL-c.

If lifestyle changes aren’t successful, medications are initiated.

The timing between the initiation of lifestyle changes and medical therapy will vary for each person, but is typically 90 days.

Statins are the most common class of drugs used to lower LDL cholesterol levels.

Available statins include simvastatin (Zocor), atorvastatin (Lipitor), lovastatin (Mevacor), pravastatin (Pravachol), atorvastatin (Lipitor) and rosuvastatin (Crestor).

Except for rosuvastatin, all statins are available as generics.

The statins work by inhibiting HMG-CoA reductase. This is an enzyme which is important in cholesterol synthesis.

Inhibition of the enzyme leads to an increased number of LDL receptors on the liver cells.

This leads to increased clearance of LDL from the circulation, and lower LDL-c levels in the blood.

All statins will:

1)Reduce LDL-c levels significantly

Atorvastatin and Rosuvastatin appear to be most effective at LDL-c reduction with a 51-55% reduction at maximum doses.

For every 39 mg/dl your LDL-c is lowered, your risk of a major CVD event is reduced 25%.

LDL-c lowering is dose dependent.

2)Lower triglyceride levels modestly

Atorvastatin and Rosuvastatin appear to be most effective with an 18%-28% reduction.

Triglyceride benefits are most significant if you have high baseline triglycerides.

3)Raise HDL-c levels mildly

Your HDL-c levels are typically raised 5-10% with statins.

Simvastatin 40 mg appears to be the most effective

Additional beneficial effects may include reduced inflammation, stabilization of atherosclerotic plaques (the build-up of cholesterol in the blood vessels), and reduction of clot size.

Although statins are safe, side effects may occur.

These include:

1)Muscle-related side effects

Muscle pain is one of the most common complaints among statin users.

The estimated prevalence of this complaint is 2-10%.

Symptoms are most common during the first months of therapy, but may occur at any time.

Higher statin doses are associated with a greater risk of muscle symptoms.

Lower statin doses, or alternate day dosing, may reduce muscle related complaints.

Changing the statin brand may also eliminate symptoms.

In the majority of people, discontinuation of the statin will result in resolution of all muscle related complaint.s

Although some people believe adding coenzyme-Q will prevent or reduce muscle symptoms (the rationale is that statins lower coenzyme-Q levels), studies supporting this are conflicting.

“Myopathy” is typically defined as a >10x increase in muscle enzymes (CPK) associated with muscle weakness and pain.

Among current statins, the risk of myopathy ranges from 1.6-3.4 cases per 10,000 patient years. The risk is greatest if you use high doses of simvastatin.

Rhabdomyolysis is a very rare (1 case for every 10 million prescriptions), but serious complication of statin use.

In rhabdomyolysis, myoglobin released from severe muscle breakdown can damage the kidneys.

Rhabdomyolysis risk is increased with several commonly used drugs such as gemfibrizol (Lopid) and erythromycin. Make sure you review potential medication interactions with your physician.

Simvastatin has the greatest risk of medication interaction due to its metabolism pathway.

Pravastatin and rosuvastatin have the lowest risk of muscle related complications.

2)Liver-related side effects

Liver test elevations are typically asymptomatic, reversible, and dose related. The abnormalities are typically seen during the first 12 weeks of treatment.

If your liver tests are only mildly elevated (<2-3x), your physician may decide to continue therapy.

The FDA recently recommended that the recommendation for routine liver function testing be removed.

The incidence of liver failure is the same as the general population.

3)Diabetes

Recently, several studies reported an increased risk of Type 2 diabetes among statin users.

The risk was greatest at the highest medication doses.

The reason for this increased risk is unknown.

Because of these findings, the FDA recently added a warning label to the statins that they can raise sugar and HA1c levels.

There is currently no data to suggest that statins play a significant role in raising your sugar levels if you already have diabetes.

4)Memory changes

This is an area of ongoing investigation, with a history of conflicting studies

Although the diabetes and memory findings are concerning, risk must always be balanced with benefit.

In a person at high risk for CVD, the benefits of statin therapy (reduced frequency of heart attacks and strokes) typically outweigh the risks.

The risk-benefit relationship is important, even if you have diabetes.

Make sure you review this with your physician before making any changes in therapy.

If LDL goals aren’t reached using lifestyle changes and statins, combination therapy with other medications such as niacin, ezetamide and the fibrates are an option.

The decision to begin any medication is a serious one.

Review information that is available so you can make an informed decision.

Become involved in your care.

Make a difference in your life starting today.

Category: Diabetes / Tags: , ,
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