Diabetes Health Talk

Mediterranean Fruit

Choose whole-grain, high-fiber foods. Try a grain like barley for a new taste.

Eat plenty of vegetables and fruits. Shoot for a rainbow of colors.

If you drink alcohol, stick to 1 or 2 drinks at the most.

Ditch the salt shaker. Try fresh herbs and spices.

Avoid trans fat, which is found in many pastries, cakes, french fries, crackers and other processed foods and packages. Also, limit intake of foods high in saturated fat and cholesterol.

Choose non-fat dairy, and have several “meatless meals” every week. Use beans, veggie burgers, lentils and other sources of vegetarian protein.

eople with diabetes also can reduce their risk for having a heart attack, stroke, and other complications by following the ABCs of diabetes:

A: Average Glucose - A1C (a measure of average blood glucose). Most people with diabetes should get an A1C test at least twice a year, which measures how well blood glucose has been controlled over the past 2-3 months. The goal for most people with diabetes is an A1C less than 7%, which is an estimated average glucose of less than 154 mg/dl.

B: Blood Pressure - People with diabetes should have a target blood pressure of less than 130/80 mmHg.

C: Cholesterol - LDL (bad) cholesterol should be below 100 mg/dl; HDL (healthy) cholesterol should be above 40 mg/dl for men and 50 mg/dl for women; triglycerides should be below 150 mg/dl.

By following these Diabetic and heart healthy hints and tips, you’ll be giving your body the proper nutrients it needs.

Broccoli lovers, know this: Your favorite veggie is loving you right back, with ample amounts of this stroke-stomping, diabetes-deterring nutrient — vitamin C.

High blood levels of vitamin C could cut stroke risk by as much as 42 percent and reduce your odds of developing type 2 diabetes by a whopping 62 percent.

“C” the Stats
Yep, that’s exactly what happened in two recent studies involving middle-aged and older adults. As blood levels of C went up, risks went down. Researchers suspect that the vitamin’s strong antioxidant qualities may be the reason for its protective effects. And there’s no better way to raise your blood levels of C than to start filling your body with C-rich winter foods like broccoli, brussels sprouts, and oranges.

One Vital Vitamin

Slashing stroke and diabetes risk is just part of what vitamin C does. Here are a few of its many other roles:

Sight saver. Along with beta carotene, vitamin E, and zinc, C lowers the odds of age-related macular degeneration

Breath buddy. Your lungs love vitamin C.

Does Your Gum Have Vitamin C?

Snapping and popping gum remain image busters — just ask Britney Spears watchers. But here’s a good excuse for discreet chewing: less blood at the dentist’s office.

If your gums bleed a lot during cleaning — a sign of subpar dental health — your dentist may urge you to floss more. But chew gum more? It could help. In a recent study, gum chewers experienced less gingivitis-like bleeding than nonchewers, but only if their gum of choice was enriched with vitamin C. Better yet, they didn’t have to chew for a long time to get the benefit.

Dentists have been concerned that too much direct contact between tooth enamel and vitamin C leads to a breakdown in tooth structure, but there was no problem with erosion in this study. And gum chewers didn’t need to chew long — only for about 15 minutes — to release nearly all of the vitamin C in their sample gum. But they did chew daily — about five times each day, in fact — to achieve the benefits.

The Earth Times: When Yolanda Myers was diagnosed with diabetes at age 17, she was living a lifestyle similar to many Americans – a lifestyle high in calories and low on exercise. As an African-American woman, Myers was at an increased risk for diabetes, high blood pressure and chronic kidney disease. Now, at age 39, she suffers from all three.

Her diabetes and high blood pressure led to kidney failure, and she must now rely on dialysis to perform the functions of her kidneys. Diabetes is the number one contributor to chronic kidney disease, accounting for 44 percent of new cases, according to the American Diabetes Association.

In recognition of the American Diabetes Association’s designation of November as “American Diabetes Month,” Fresenius Medical Care North America, operator of the nation’s leading network of dialysis facilities, encourages people to discuss their health history with family members, especially in regard to diseases like type 2 diabetes and high blood pressure, which can often be prevented or controlled.

While discussing health problems may not seem like exciting dinner conversation, doctors and health researchers stress the importance of prevention and early detection in dealing with these conditions.

“Because families typically gather at the holidays, it’s a good time to have frank discussions about family illnesses, such as diabetes and high blood pressure. If you can show your nieces and nephews, for example, how diabetes has affected your own health, you may be able to influence them to maintain healthier lifestyles,” said Kathryn McDougall, R.N., M.S., C.D.E and Fresenius’ Director of Quality Initiatives.

Fresenius Medical Care offers a free Treatment Options Program to inform at-risk patients and their families about chronic kidney disease and treatments. Sessions are free and open to the public. Call 1-866-4-DIALYSIS (1-866-434-2597) to locate the Fresenius Medical Care facility nearest you.

Though Myers’ mother and aunt would both develop diabetes years later, she didn’t know at a young age how the disease would impact her own life. She couldn’t predict that, by age 38, she would suffer nine mini-strokes, endure eight medical procedures on her eyes, lose a leg to infection and would require dialysis three days a week to stay alive.

But Myers, who lives outside Nashville, Tenn., now has a positive outlook. She is determined to spare her 14-year-old daughter and 12-year-old son from a similar fate by discussing their family’s history of these conditions and by encouraging her children to live a healthy lifestyle.

“I talk to my kids about everything,” Myers said. “I told them that I lost a leg from diabetes. And I tell them to have everything in moderation. I don’t want this to happen to them.”

Updated guidance published in the current issue of the American Society of Hypertension’s (ASH) Journal of Clinical Hypertension addresses the urgent need for physicians to take a more integrated, individualized approach to treating hypertension (high blood pressure) in patients with diabetes by treating the intricacies of each patient profile, rather than focusing on the disease in isolation. Early initiation of medications that block the renin angiotension system (ACE inhibitors or ARBs) coupled with either thiazide-like diuretics or calcium antagonists are needed to maintain BP <130/80 mmHg. Additionally, more frequent patient follow-up is recommended.

While the fundamentals of treatment and blood pressure goals remain unchanged, the authors emphasize that early detection of risk factors unique to each patient and earlier, more aggressive treatment be implemented. Follow-up visits after each medication adjustment should occur within 2-3 weeks as opposed to 4-8 weeks, and immediate referral to an ASH-certified clinical hypertension specialist should occur if repeated attempts to achieve blood pressure goal fails. Achieving and sustaining blood pressure goal earlier during treatment has been shown
retrospectively in many clinical trials to have an impact on stroke risk. Thus, such an approach is necessary to stop the cardiovascular event rates and stroke death toll from spiraling even further out of control.

Hypertension affects more than 70 million Americans and is the most prevalent risk factor for cardiovascular and kidney disease. More than 75% of adults with diabetes have hypertension or are using antihypertensive medications. If implemented, this new guidance will potentially lead to better control of blood pressure, blood sugar and blood fats, all major risk factors for cardiovascular events if they are not properly managed.

“We know that mortality increases by more than 7-fold when hypertension is present in patients with diabetes,” said George Bakris, MD, president-elect of the American Society of Hypertension, co-author of the Position Paper and professor, University of Chicago School of Medicine. “Because of their increased cardiovascular risk, these patients require an integrated therapeutic intervention that, in addition to blood pressure control, should include glycemic and lipid control and antiplatelet therapy. It is imperative that we attack all risk factors simultaneously and manage the profile of each patient type more vigilantly.”

The guidance from the American Society of Hypertension is offered in a series of recommendations, accompanied by a modified treatment algorithm. Of note, the guidance draws attention to the fact that treatment of blood pressure in people with diabetes must also focus on reducing proteinuria if present. Proteinuria refers to an excessive amount of protein in the urine and may be a sign of impending kidney failure and/or a precursor to stroke and other potentially life-threatening cardiovascular events. The guidance emphasizes the importance of early identification and management of proteinuria as part of its more integrative approach to patient management.