Great Smokies Medical Center of Asheville

Archive for the ‘Diabetes’ Category

Q/A: Diabetes and Cholesterol by Dr. Wilson

Sunday, September 11th, 2005

Q. Won’t eating all the cholesterol in meat and eggs cause heart disease?

A. For diabetics, carbohydrates act like a metabolic poisen. Fats, however, provide an excellent energy source for diabetics. The notion that cholesterol causes heart disease is one of the biggest medical misconceptions around. Ongoing analysis of the 53-year long Framingham Heart Study consistantly reveals that heart disease risk is lower in individuals who eat more cholesterol. We do know, however, that excess insulin and consistantly elevated blood glucose levels directly contribute to heart disease.

Again and again I have seen total cholesterol, triglycerides, and HDL (“good”) cholesterol improve beautifully on diets high in cholesterol. A high HDL cholesterol is associated witha lower risk of heart disease. Avoid “bad” fats, including margarine, commercial vegetable oils and deep fried foods. Eat more “good” fats, including olive oil, cold pressed nut and seed oils, and butter. Honor your Mom’s advice and “Eat your vegetables!”

The Carb/Mood Trap

Sunday, September 11th, 2005

Are carbs really comfort food? “Yes,” temporarily, but “no” in the long run. Eating carbs can quickly result in increased serotonin, a neurotransmitter known for its role in depression. Your body associates the resulting “high” with eating carbs, but doesn’t associate carbs with the “low” that occurs a couple of hours later. A carb craving is born as your body simply tries to recreate the high, and you are in for a ride on the mood roller coaster. The solution? Cut the carbs! Ask your GSMC physician for strategies to increase serotonin naturally for a more stable mood.

Diabetes Solution

Sunday, September 11th, 2005

The best book to guide a diabetic in using scientific dietary principles to treat or reduce complications of diabetes is written by a medical doctor and Type 1 diabetic, Richard K. Bernstein. Dr. Berstein’s Dietary Solution is one of a handful of books we have available at GSMC for our patients. It is a great gift for diabetics who want to optimize their health.

Drs. Wilson and Wright advise the following changes and additions to enhance Dr. Bernstein’s program:

* Avoid Nutrasweet (use Stevia)
* Avoid preserved meats (eat fresh)
* Avoid intake of “bad fats”, including partially hydrogenated oils on food labels (eat butter, olive oil, cold pressed nut and seed oils)
* Use nutritional supplements to optimize treatment results.

Diabetic Recipe

Sunday, September 11th, 2005

Sticky Buns?

Mix 4 cups of sugar with 6 cups of white flour. Cut in 2 sticks of margarine with a TV remote control. Slowly stir in 265 pounds of obesity. Moisten with a liter of a soda of your choice mixed with an equal volume of fruit juice. Finely chop two of your favorite candy bars and add to mixture. Sprinkle a few years of sedentary lifestyle over the entire mixture, stirring again with a remote control. Add a tincture of aging. Allow to sit on a 72 degree couch for 5 to 10 years.

Makes: One Type 2 Diabetic

Q/A: Pass or Bypass the Bread?

Sunday, September 11th, 2005

by Dr. Wright

Q.I am a Type 2 diabetic and want to know what you think about my eating the bread I love and just taking extra insulin to cover it. It would really make my life a lot easier.

A. Thanks for your great question. While Type 1 diabetics make very little or no insulin, Type 2 diabetics can make very large amounts of insulin. Their insulin is ineffective in lowering blood sugar for a variety of reasons but still circulates in the blood stream where it causes other problems. If you are already making too much insulin and eat bread (or pasta, corn cereal, potatoes or desserts), your body will make more insulin, resulting in even higher and more harmful levels of insulin. Some oral diabetic drugs in a class called sulfonyureas also result in increased insulin production. (The popular oral diabetic drugs Glucophage and Amaryl are not in this catagory.) Excess insulin, whether it is “homemade” or taken by syringe, has been shown in studies to directly contribute to obesity, high blood pressure, cancer, heart attacks and strokes. These medical conditions would in no way make your life easier.

The best way to support good health is to avoid the bread and the resulting insulin excess. Instead, maintain normal blood sugars with the least amount of insulin possible by restricting carbohydrates.

Pre-Diabetes, IFG and IGT

Sunday, September 11th, 2005

Diabetes is diagnosed by either an overnight fasting blood sugar greater than 125 milligrams per deciliter (mg/dL) or by a blood sugar of 200 mg/dL or greater two hours after an oral glucose tolerance test (GTT).

Two terms are used to describe what used to be called “borderline diabetes.”

Impaired fasting glucose (IFG) is a condition in which the fasting blood sugar is elevated between 110 and 125 mg/dL after an overnight fast butis not high enough to be true diabetes.

Impaired Glucose Tolerance (IGT) is a condition in which the blood sugar is elevated between 140 and 199 mg/dL after a two-hour glucose challenge.

Among U.S. adults 40-74 years of age, 16 million (15.6 percent) have IGT and 10 million (9.7 percent) have IFG.

If you are diagnosed with either IFG or IGT, consider yourself lucky as it is an early warning, a wake up call. Ignorance of diabetes is anything but bliss.

We screen for diabetes with a 4 hour Glucose Insulin Tolerance Test (GITT). It gives the extra advantage of knowing your insulin and sugar levels. If you’re over 40, obese, have high blood pressure, a family history of diabetes, low energy, excessive thirst or urination, or have slow healing of skin injuries, ask your doctor if you need diabetes screening.

What Are Carbs?

Sunday, September 11th, 2005

Carbohydrates consist of starches, called complex carbohydrates, and sugars, called simple carbohydrates. All carbohydrates turn to glucose through the process of digestion. Starches are found in all grains (wheat, rice, corn, rye, oats, barley, spelt), all hot and cold cereals, pasta, white and sweet potatoes, breads, crackers, bagels, etc. Sugar is found in many beverages including tea, sodas, alcoholic drinks, and sports drinks; plus, desserts, fruit juices, fruit, cakes, cookies, muffins, candy, ice cream, and many processed foods.

Diabetes, Defined

Sunday, September 11th, 2005

Defining diabetes by listing all of it’s potential complications is common but can be psychologically defeating, resulting in diabetics’ wondering why they should even bother to modify their diet and lifestyle.

We have developed a simple working defination of diabetes that emphasizes the hope found in sound diabetic treatment. And there’s a bonus: a solution is hidden in the definition.

Diabetes defined: Diabetes is the inability to burn carbohydrates efficiently for energy. Ten words.

This inability to burn carbohydrates is the only basic difference between a person who has diabetes and a person who doesn’t. It puts diabetes squarelyin the catagory of nutritional illnesses, and nutritional illnesses require nutritional treatment. The solution hidden within the definition is: If you aren’t able to burn carbohydrates for energy, don’t depend on carbohydrates for your energy needs.

Diabetes, Statistically Speaking

Sunday, September 11th, 2005

In the January 1, 2003 issue of the Journal of the American Medicel Association (JAMA), statistics from the Centers for Disease Control and Prevention (CDC) revealed that the incidence of diabetes in the United States is is increased by 61 percent since 1991. An estimated 17 million Americans (6.2 percent of the population) now have diabetes. Alabama had the highest rate of diagnosed diabetes (10.5 percent) and Minnesota the lowest (5.0 percent). North Carolina came in slightly above the national avergae at 6.4 percent, with 36 more million North Carolinians at risk for developing diabetes. CDC Director Dr. Julie L. Gerberding called these statistics “disturbing and likely even underestimated.”

Five to ten percent of all diabetics are Type 1 (childhood onset), while 90 to 95 percent are Type 2 (adult onset). The American Diabetes Association places the direct medical annual costs at $92 billion, with an additional $40 billion in indirect costs (disability, work loss, early death.)

Poorly managed diabetes has a serious health downside including 200 to 400 percent increase in stroke and heart attack risk, a sixty percent occurance of high blood pressure, and blindness of an estimated 12,000 to 24,000 people. In addition, in 1998 nearly 100,000 people were on kidney dialysis or had a kidney transplant due to diabetes, 82,000 amputations are performed annually on U.S. diabetics, and peridontal disease is prevalent in diabetics.

Well-managed diabetes need not result in these complications. A diagnosis of diabetes need not seal your fate.

Diabetes: America’s Epidemic

Monday, August 22nd, 2005

by Eileen M. Wright, M. D.

CDC statistics released in January 2003 reveal that the incidence of diabetes in the United States has increased by 61 percent since 1991. An estimated 17 million Americans are diabetic. Nationally, direct annual costs of diabetes approach $92 billion. However, the greatest cost, the loss of health, cannot be measured in dollars.

Diabetes occurs when a person is unable to efficiently burn blood sugar (glucose) for energy due to the lack of insulin or ineffectiveness of insulin. Insulin is a pancreatic hormone that transports glucose into cells to be burned for energy. Diabetics may have no symptoms whatsoever, or may have excessive thirst, frequent urination, and low energy. The complications of uncontrolled diabetes include poor circulation that can result in strokes, heart attacks, blindness, kidney failure, foot ulcers and amputations. The damage from diabetes to nerves results in peripheral neuropathy: pain, numbness, and altered sensation, particularly in the feet and legs.

There are two types of diabetes. Type 1 or childhood onset diabetes has a sudden onset and accounts for only 10 percent of diabetics, while Type 2 diabetes has a gradual onset and accounts for 90 percent of diabetics. Although it occurs most often in adulthood, Type 2 has recently even been diagnosed in children due to high dietary intake of sugar, poor nutrition, obesity, and sedentary lifestyles. Type 2 diabetics often produce excessive amounts of insulin, but are resistant to their own insulin. Since excess insulin can result in high blood pressure, vascular disease, and obesity, it becomes very important for Type 2 diabetics to control their blood sugar with diet rather than taking even more insulin.

Many people are falsely reassured when fasting blood sugars are “normal” at their annual checkup. Patients with normal fasting morning blood sugars are all too often found to have pre-diabetes or Type II diabetes on further evaluation. The most sensitive diagnostic test to identify individuals who are at risk for developing diabetes or to diagnose diabetes is the 4-hour Glucose Insulin Tolerance Test (GITT). A GITT is most useful when reviewed by a doctor familiar with its interpretation. Impaired Glucose Tolerance (IGT) and Impaired Fasting Glucose (IFG) are two pre-diabetic conditions that are also diagnosed through a GITT, providing an early warning and an opportunity for prevention. Adults over the age of 40 with a family history of diabetes, obesity, or high blood pressure should be screened for diabetes.

Diabetes is primarily a nutritional illness-a diabetic simply can’t efficiently burn carbohydrates for energy. This seemingly little glitch is responsible for all of the complications of diabetes. Nutritional illnesses need nutritional treatment. Carbohydrate restriction is the core of the nutritional treatment of diabetes. Carbohydrates, including sugar and starches-sodas, desserts, pastries, cookies, candy, sweet tea, potatoes, cereals, pasta, crackers, and bread-are metabolic poisons for diabetics.

An ounce of prevention is worth a pound of cure when it comes to diabetes. Maintaining normal blood sugars is the foundation of the successful treatment of diabetes. There is simply no magic pill to take the place of maintaining normal blood sugars through restricting carbohydrates, attaining ideal weight, and exercising. Chromium, vanadyl sulfate, magnesium, vitamin B-6, zinc, folic acid, Vitamin B-12, certain herbs, and drugs for diabetes are known to enhance insulin sensitivity, support pancreatic function, and slow or reduce complications. The good news is Type 2 diabetes is preventable. Types 1 and 2 are modifiable by lifestyle changes that can reverse, decrease, or postpone complications once thought inevitable.

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