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By admin, March 27, 2010 8:47 am

The feeling of being on “pins and needles” is wonderful — if it describes how children feel when looking forward to a birthday party or adults when anticipating a special vacation. But where diabetes patients are concerned, those words often are used to describe a painful chronic condition, calleddiabetic peripheral neuropathy, that results from damage to nerves (typically in the hands, arms, feet and legs) caused by elevated blood sugar. Affecting about 60% of people with type 1 and type 2 diabetes, neuropathy is the leading cause of diabetes-related hospital admissions and amputations, and it is not curable — so finding any information about how to prevent it or slow its progression is valuable.

Is there a connection?

Now a study from the University of Michigan has uncovered a crucial clue that helps identify patients most at risk for neuropathy progression. Researchers analyzed data from 427 people with diabetes and early-stage neuropathy using advanced technology to measure the amount of damage to patients’ peripheral nerves at the beginning of the study and again one year later. The surprising finding was that those whose neuropathy got worse over the year were the same ones who also had elevated levels of triglycerides, a type of fat in the blood. In fact, having elevated triglycerides was a more accurate predictor of neuropathy progression than other factors such as blood sugar or high levels of cholesterol.

What Does this Mean for Your Health?

I spoke with study coauthor Kelli A. Sullivan, PhD, assistant research professor in neurology at University of Michigan Medical School. She told me that people with type 2 diabetes frequently have elevated triglycerides primarily because they are so often overweight, which is known to be associated with high triglycerides. The study’s findings could be a crucial indicator to doctors that they should monitor triglyceride levels in overweight or obese diabetic patients as closely as they do blood sugar.

Fortunately, there are ways to bring elevated triglyceride levels down into a normal range. Lifestyle habits have a strong impact on normalizing triglycerides — this includes shedding excess pounds and having a healthy diet that limits fats and sugars… not smoking… and moderate alcohol consumption, especially red wine. Exercise is a must, says Dr. Sullivan, as demonstrated in a 2006 Italian study that showed regular long-term aerobic exercise improved neuropathy in early stages. And since having more muscle mass benefits nerve tissue as well, strength training is helpful too.

Source(s):

Kelli A. Sullivan, PhD, assistant research professor, department of neurology, University of Michigan Medical School, Ann Arbor.

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By admin, March 2, 2010 9:55 am

If you have diabetes and heart disease — and many Americans do, or will, since the two tend to go hand in hand — it is important to be aware of special considerations regarding your treatment, especially when it comes to invasive heart procedures.

Heart surgery causing conflicts with diabetics

A Landmark Study

Surprisingly, there is no clear consensus on how to treat diabetic patients with heart disease. That, coupled with concern about the exorbitant cost of treating diabetes (it now accounts for one out of every five federal health-care dollars spent), led researchers to undertake the Bypass Angioplasty Revascularization Investigation (BARI 2D) trial, which is a comparative effectiveness study of two different treatments for diabetic patients with heart disease.

In the five-year randomized, clinical trial of 2,368 diabetics with heart disease at 49 sites in six countries, researchers compared optimal medical therapy (medications and lifestyle counseling) with the same plus surgery to see which worked best in preventing a cardiovascular event and/or early death. These patients were generally considered to be at low risk for heart attack and stroke based on the extent of their coronary artery disease and symptoms, such as their degree of angina (chest pain), when the study began. The “optimal medical therapy” (e.g., medications such as beta-blockers and statins) was given to all participants to control blood pressure and cholesterol, and participants were also counseled, as appropriate, to quit smoking and/or lose weight, notes William E. Boden, MD, FACC, clinical chief of the division of cardiovascular medicine and professor of medicine and preventive medicine at the University at Buffalo Schools of Medicine & Public Health.

For the group that received medical therapy plus surgery, half the participants were randomly assigned to either undergo stent angioplasty or coronary-artery bypass grafting (CABG).

Over the five-year period following the intervention, Dr. Boden and his colleagues found that…

• There was little or no difference in outcome between those who underwent angioplasty versus only optimal medical therapy — angioplasty patients had a 10.8% death rate, compared with a 10.2% death rate among those on optimal medical therapy.
• In the bypass group — which included individuals with more severe heart disease — surgery was more effective than optimal medical therapy. Bypass recipients had a 22.4% chance of having a heart attack or stroke or dying in the next five years, compared with 30.5% of participants who only took medications.

These results were published in the June 2009 issue of The New England Journal of Medicine.

High Tech is Not Always the Answer

We’re often inclined to believe that high-tech devices and interventions are superior, Dr. Boden observes. This is not always the case — sometimes conservative medical therapy is more effective, since it is less invasive and therefore less dangerous, and it costs less, too. The BARI 2D results confirm that intensive medical (non-surgical) therapy can be an effective first line of treatment for diabetics with heart disease, particularly for those with less severe disease.

Source(s):

William E. Boden, MD, FACC, clinical chief, division of cardiovascular medicine, professor of medicine and preventive medicine, University at Buffalo Schools of Medicine & Public Health, medical director, cardiovascular services, Kaleida Health chief of cardiology, Buffalo General and Millard Fillmore Hospitals, Buffalo, New York.

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By admin, February 2, 2010 8:03 am

It can be hard living with diabetes, especially with the many eating restrictions that you could encounter. Instead of letting this overtake your life discover some great gourmet cooking recipes that are diabetic friendly.

A diagnosis of diabetes is a wake-up call that it’s time to make some lifestyle changes, such as losing weight, getting regular exercise and choosing a nutritious, well-balanced diet. But to many of the 24 million diabetics in this country, the mere thought of eliminating sweets and many processed foods from their diet connotes endless meals of flavorless, bland and boring foods. Can diabetics eat healthfully and also make it enjoyable? The answer is a resounding “yes,” says Chris Smith, author of The Diabetic Chef’s Year-Round Cookbook (American Diabetes Association). Smith uses fresh, seasonal ingredients to create healthy, interesting meals full of flavor for diabetics and everyone else at the table, while reducing the salt, sugar and fat that many have come to rely upon to add taste.

HEALTHY EATING FOR DIABETICS

Healthy options that will work with your diabetes.

Just like the rest of us, people with diabetes should eat nutritious meals that are low in fat (especially saturated and trans fat), moderate in salt and very sparing with sugar, while emphasizing whole grains, vegetables and fruit. However, because diabetics are at a greater risk for life-threatening complications such as hypertension, heart disease and stroke, it’s particularly important that they keep blood glucose control while maintaining normal levels of blood pressure and blood lipids (cholesterol). It can be challenging to do all that while still preparing food that is flavorful and appealing. I asked The Diabetic Chef to share his secrets for preparing foods appropriate for people with diabetes that are delicious enough for everyone to want to eat. Here are some of his best secrets…

HERBS & SPICES ARE ESSENTIAL

Liven up your meals with garden-fresh herbs, many of which are available year-round, even in supermarkets. Fresh herbs are densely packed with flavor. You can use herbs in a variety of ways throughout the seasons.

• Fine herbs, such as thyme, oregano, dill, basil and chives, are usually available in the spring and summer. These should be added as a finish (at the end of the cooking process) to release their delicate flavors and aromatic qualities. “Use fresh basil with summer tomatoes and olive oil for pasta, or as a finish to a tomato sauce,” said Smith. “Use chives as a delicate finish to soups, salads and sauces.”
• Hearty herbs (rosemary, sage), available year-round, can be added earlier on in the cooking process. Use them with stews, soups and crockpot dishes. They can withstand the heat of cooking without losing flavor and, in fact, the longer they’re cooked, the more mellow and flavorful they are, says Smith.
• Dried herbs are dehydrated, so must be rehydrated in cooking — for instance, think of homemade tomato sauce. When using dried oregano and basil, the sauce has much more flavor the following day because the flavor of the dried herbs fully blooms and combines with the other ingredients.

“Herb” typically describes the leaves of a plant, while spices are derived from any other part — including the root, seeds, bark or buds. Spices can be used to create a medley of flavors and can be evocative of different types of ethnic cuisines. “Spices bring great diversity to food,” said Smith.

OTHER TIPS FOR HEALTHFUL EATING

Overall, Smith points out that healthful eating is a matter of practicing what he calls “Nutritional MVP,” which stands for moderation… variety… and portion control.

From his cookbook, another suggestion is to learn how to do template cooking. Template cooking is taking one recipe and adapting it in different ways by using the same cooking method but substituting different ingredients, said Smith. “It gives you the freedom to be creative, which is the essence of good cooking.” It also brings much-needed diversity to meals, so you are not forever serving the same old thing. One example of a template recipe is the Simple Chicken Breast (see below). “There are only seven ingredients in this recipe but you can vary it with fresh, seasonal ingredients,” said Smith. “For instance, in springtime you can exchange the olive oil for sesame oil and use lemon grass rather than garlic to create an Asian flavor. In summer, substitute fresh cilantro for the rosemary.”

Try different cooking techniques to bring out the essence of foods.

• Grill, broil, roast, sauté or steam food to enhance flavor without added fat or salt. Slow-roast vegetables with a drizzle of olive oil in a 400 degree oven to bring out their true flavors. Many develop a natural sweetness when roasted. Season with garlic or add herbs to vary the taste. Rather than sautéing garlic or onions with butter or oil before adding them to soups or stews, try roasting in the oven.
• Marinate foods in a few ingredients. “The herbs, lemon and spice in the Simple Chicken Breast recipe create a vibrant flavor, and the extra virgin olive oil allows the herbs and spices to reach their full bouquet,” said Smith.
• Sear meat (brown on both sides in a pan for a few minutes before placing it in the oven) to enhance flavor without adding extra fat or salt. “Any kind and cut of meat can be seared,” said Smith.

Pair dishes with colorful sides. Instead of a plate full of brown items such as chicken and rice, liven up your plate with deeply colored fruits and vegetables that add variety and important phytonutrients (components of fruits and vegetables that are thought to promote health) to your diet. (For more on this topic, see Daily Health News, February 19, 2009.)

Keep the pantry stocked with these healthy ingredients.

• Oils: extra-virgin olive oil, sesame oil, canola oil and grapeseed oil.
• Vinegars: balsamic, champagne, rice and aged sherry vinegar.
• Essential spices: cayenne pepper, chili powder, cinnamon, mustard, nutmeg, paprika and pepper.
• Essential dry herbs: bay leaves, dill, basil, oregano, rosemary, thyme and sage.
• Other essential products: chicken, vegetable and beef broth, dried beans, whole gluten-free grains such as quinoa and amaranth.
• Essential fresh ingredients: lemons, limes, oranges, garlic, onions, shallots, carrots, tomatoes, potatoes, mushrooms, butter (salt free), sour cream (fat free), eggs, hard cheeses (Parmesan and Romano), mustard (grain, Dijon), capers and olives.

Template Recipe: Simple Chicken Breast

Serves four.
Serving Size: 1 Breast Half

4 chicken breasts
1 Tbsp extra-virgin olive oil
1 Tsp dried rosemary
1 Tsp poultry seasoning
1 Tsp salt-free lemon pepper
1 Tbsp minced garlic
½ Tsp red pepper flakes
Cooking spray

• In medium bowl, combine all ingredients and place chicken breasts in it. Cover and refrigerate 1 hour.
• Preheat oven to 375°F.
• Preheat sauté pan to medium-high heat. Spray pan with cooking spray. Add chicken breast to pan and sear to desired color, about 10 seconds, then turn over and sear other side.
• When both sides are seared, remove chicken from pan and place in a baking dish or cookie sheet. Do not cover. Place in oven. Cook meat until it is done, at 165°F internal temperature. When chicken is done, remove from oven and let rest for two to four minutes.

For more tips from Smith go to: www.TheDiabeticChef.com.

Source(s):

Chris Smith, The Diabetic Chef, is an executive chef working in the healthcare field. A graduate of the prestigious Culinary Institute of America, Smith has also worked as a chef at the four-star Le Cirque restaurant in Manhattan. He is author of two cookbooks,Cooking With the Diabetic Chef and The Diabetic Chef’s Year-Round Cookbook (both from American Diabetes Association). He lectures widely about cooking for people with diabetes. www.TheDiabeticChef.com.

Take the time to look through all your meal options and get exactly what you want. Make sure that you include one of the Medifast Coupons so that you can get a great discounted price on your next Medifast Diet Plan.

Reprinted with the permission of:
Bottom Line Publications/Daily Health News
Boardroom Inc.
281 Tresser Blvd., 8th Floor
Stamford, CT 06901
www.BottomLineSecrets.com

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By admin, January 29, 2010 2:26 pm

We’ve long considered most cases of diabetes a lifestyle disease, associated with poor diet and a lack of exercise, but now researchers have found that other factors beyond heredity may also play a role, specifically environmental ones. I spoke with one of the leading researchers in this area, Ana Navas-Acien, MD, PhD, assistant professor and researcher at the Johns Hopkins Bloomberg School of Public Health at Johns Hopkins University, about how environmental toxins impact the development of diabetes and what we can do to protect ourselves.

Is your drinking water dangerous? Find out now

IS IT SAFE TO DRINK THE WATER?

In one recent study, scientists found that arsenic, a naturally occurring element in the environment that results when minerals dissolve in rocks and soil, was related to the prevalence of type 2 diabetes. This is potentially very important, since an estimated 8% of public water supplies in the US have levels of inorganic arsenic higher than the safety standard established by the Environmental Protection Agency (EPA), which is 10 micrograms per liter. Previous research has linked exposure to this heavy metal with bladder, lung, kidney and skin cancer, as well as other health problems. To determine the relationship between arsenic and diabetes, Dr. Navas-Acien and her team of collaborators analyzed data from 788 adults age 20 and older whose urine was tested for traces of this toxin.

They found that …

• Participants with type 2 diabetes had a 26% higher arsenic level than people who did not have the disease.
• Those with the highest levels of arsenic were more than three times as likely to have diabetes than those with the lowest levels. Drinking water can be contaminated with arsenic in some mining areas and in areas with inappropriate arsenic waste disposal… also, air pollution can be an additional source of arsenic exposure in certain areas.

The theory is that inorganic arsenic may contribute to diabetes by interfering with insulin sensitivity. When the body’s cells are exposed to both insulin and arsenic, they absorb less blood glucose than when exposed to insulin alone and, of course, impaired ability to manage glucose is a hallmark of diabetes. Inorganic arsenic may also contribute to diabetes by encouraging inflammation. (Note: Inorganic arsenic is distinct from arsenobetaine, an organic arsenic compound often found in seafood that is not believed to pose health risks.)

These findings were published in the August 20, 2008, issue of the Journal of the American Medical Association. Further research is necessary to confirm the causal role of arsenic in diabetes development.

PESTICIDES AND DIABETES

Pesticides are also being implicated as a possible factor in increasing rates of diabetes, Dr. Navas-Acien told me. Scientists at the US National Institutes of Health looked into the incidence of diabetes in workers who applied pesticides on farms and in other agricultural settings. They found that workers who used chlorinated pesticides for more than 100 days over the course of their lifetimes faced a significantly higher risk of diabetes. The associations between particular pesticides and diabetes ranged from a 20% to 200% jump in risk. Also, scientists at University of Cambridge in the UK have noted the need for more research on a possible link between persistent organic pollutants (POPs, a chemical group that includes many pesticides) and the risk of type 2 diabetes. Although POPs such as DDT have been banned, they persist in our environment, slowly biodegrading and entering the food supply. Other environmental chemicals, such as brominated flame retardants used in a range of consumer products, from electronic equipment to clothing, or bisphenol A, found in plastics, may be associated with the development of diabetes as well.

WHILE WE WAIT FOR MORE INFORMATION…

While researchers continue to study what role environmental toxins may play in susceptibility to type 2 diabetes, it is important to do what we can to limit exposure to those we know are potentially dangerous. Reasonable steps to take to protect yourself and your family include…

• Ask your water utility company for a water quality report. You can also review independent tests on bottled water brands at the National Resources Defense Council (NRDC) Web site,www.nrdc.org/water/drinking/bw/appa.asp.
• Filter your tap water before drinking. Reverse osmosis filters are effective at removing arsenic, but pitcher filters and water softeners are not.
• Go green. For example, instead of deadly pesticides, use pest-resistant grasses to manage your lawn. Read more about “integrated pest management” (IPM) athttp://www.epa.gov/pesticides/factsheets/ipm.htm… replace chemical-laden cleaning products in your home with green brands such as Seventh Generation (http://www.seventhgeneration.com/).

While the jury is still out on any direct causal relationship between environmental toxins and diabetes, there is a strong suggestion of such links. This just adds more to the already long list of health risks you may be able to avoid altogether by living life as naturally and healthfully as possible.

Source(s):

Ana Navas-Acien, MD, PhD, assistant professor, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.

Take the time to look through all your meal options and get exactly what you want. Make sure that you include one of the Medifast Coupons so that you can get a great discounted price on your next Medifast Diet Plan.

Reprinted with the permission of:
Bottom Line Publications/Daily Health News
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281 Tresser Blvd., 8th Floor
Stamford, CT 06901
www.BottomLineSecrets.com

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By admin, January 5, 2010 5:42 pm

Understanding the side effects of statin is important for everyone and as you get older it is something you are going to become more familiar with. Take the time to see what we’ve put together for you so you can have a better understanding of the statin side effects, beware it is real and shocking!

Sometimes it seems as if everyone over age 50 takes statins — women and men, middle aged and elderly, and lots of people whose cholesterol levels are barely a blip over normal. In fact, lipid-regulating drugs are among the most common prescriptions in this country — but their side effects are a troubling but seldom acknowledged issue, even by the doctors prescribing them. Beatrice A. Golomb, MD, PhD, at the University of California, San Diego, a leading researcher in this area, recently published a review analyzing nearly 900 studies on the many problems associated with statin use. Not only is this the most complete analysis ever published, her paper also explains why some people are at higher risk for problems than others.

SIDE EFFECTS

Based on patient reports, the number-one statin side effect, which is also the most recognized, concerns adverse effects on muscles including muscle pain, fatigue and weakness. (There is also an association with a rare but potentially devastating muscle condition called rhabdomyolysis, which causes severe muscle damage that can produce toxins that can eventually lead to renal dysfunction and possibly death.)

Understand the statin side effects now

Second on the list is cognitive problems, including some that are dementia-like. Third place goes to peripheral neuropathy, which causes tingling, pain and numbness in the feet and hands. Other side effects are less frequent but wide ranging, from blood-glucose increases to sleep disruption and atrial fibrillation, as well as — and this should get some attention — sexual dysfunction.

It’s widely known that statins decrease coenzyme Q10, harming the mitochondria, which are the power producers in our cells. Dr. Golomb says this explains why people at highest risk for statin side effects are those who already have conditions that adversely affect mitochondria function — high blood pressure, diabetes, thyroid problems or simply being older. CoQ10 is helpful in minimizing mitochondrial damage, which is obviously especially important for people with these pre-existing conditions — but as noted, statins deplete this coenzyme. Dr. Golomb noted that this may be why statins aren’t as helpful for people who are over 70 or so.

Observational studies indicate that 10% to 30% of people taking statins will likely experience side effects, and that women seem to be at higher risk than men. Are you wondering why these problems aren’t frequently reported in clinical trials on statins? According to Dr. Golomb, one reason is because participants selected for such studies tend to exclude those most likely to have side effects — such as people who take other medications along with those who have other health problems. Pharmaceutical companies pour millions of dollars into clinical trials, which are designed to, as Dr. Golomb puts it, “showcase the benefits” of the drugs. However, there are no corresponding interest groups to make sure that the other side also gets heard — and people at higher risk for side effects are not excluded from taking the drugs once they are on the market. Keep in mind that one-fifth of all fully tested drugs put on the market are ultimately withdrawn or receive a black box warning. The reason: Once a larger and broader population takes a drug over a longer period of time, potential problems not shown in clinical trials will surface.

With so many people taking statins, it’s particularly important to be alert to problems that develop after you start taking these drugs. Side effects can become progressively worse, so it’s vital to investigate any possible ones immediately — by stopping the drug to see if the problem reverses or stops. The good news is that many side effects are at least partially reversible, says Dr. Golomb. Potency of the statin increases the risk of side effects, so be especially suspicious if problems develop when you are taking a high dose. Taking less may be a solution, if you and your doctor feel you really need to be on statins.

Source(s):

Beatrice Golomb, MD, PhD, University of California, San Diego.

Take the time to look through all your meal options and get exactly what you want. Make sure that you include one of the Medifast Coupons so that you can get a great discounted price on your next Medifast Diet Plan.

Reprinted with the permission of:
Bottom Line Publications/Daily Health News
Boardroom Inc.
281 Tresser Blvd., 8th Floor
Stamford, CT 06901
www.BottomLineSecrets.com