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General » diabetes awareness

  • Insulin Resistance & Prediabetes by Dr. Mariela Glandt Insulin Resistance & Prediabetes by Dr. Mariela Glandt

    Posted on by Anabelle Savion

    Insulin resistance and prediabetes occur when the body becomes insensitive to insulin.

    What is insulin?

    Insulin is a hormone made by the pancreas that helps glucose in your blood enter cells in your muscle, fat, and liver, where it’s used for energy. Glucose comes from the food you eat or it’s made by the liver when we are fasting. When glucose levels rise after you eat, your pancreas releases insulin into the blood, allowing the sugar to enter the cells and allowing the blood glucose levels to go back down to normal.

     

    What is insulin resistance?

    Insulin resistance is when cells in your muscles, fat, and liver don’t respond well to insulin and can’t easily take up glucose from your blood. Insulin resistance causes are highly correlated with abdominal fat (visceral fat). There are people that can handle a great deal of fat and don’t get sick, while there are others have less fat cells and therefore can contain limited amounts of fat. When the fat cells are overstuffed with fat, the fat starts sending a clear message that it does not have room for any more sugar.  This is called insulin resistance, and what it is essentially suggesting is that the body does not want any more sugar to come in. However, the pancreas must clear the high sugar from the blood and hence it makes more insulin to help glucose enter your cells. As long as your pancreas can make enough insulin to overcome your cells’ weak response to insulin, your blood glucose levels will stay in the healthy range. 

     

    Are there any problems with having insulin resistance, as long as glucose levels are in the normal range?

    Having normal sugar levels can be deceiving, giving a sense that there is no problem. However, high insulin levels, even with normal sugars, can be a problem. In the short run, high insulin levels make us hungry and make us gain weight. High insulin levels are also associated with hypertension and with dyslipidemia. In the long run, we know that high insulin levels are associated with higher rates of coronary artery disease, stroke, and cancer.

    What is prediabetes?

    When the pancreas is not able to keep up with the extra demand placed on it, then prediabetes sets in. This means your blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. One in every 3 adults has pre-diabetes. People with prediabetes have up to a 50 percent chance of developing diabetes over the next 5 to 10 years. Fortunately, type 2 diabetes can be prevented.

    What are the symptoms of insulin resistance and prediabetes?

    Insulin resistance and prediabetes usually have no symptoms. Unfortunately, doctors do not routinely check for insulin levels and diagnosed insulin resistance through other proxies. The presence of hypertension, high triglycerides, low HDL cholesterol, high uric acid, and fatty liver are all signs of insulin resistance. A HbA1c above 5.7 already points to insulin resistance. A HbA1c of 6.5 already defines diabetes.

    How can we reverse insulin resistance?

    Insulin resistance symptoms can be reversed by starting to decrease the levels of insulin in the blood. As insulin levels drop, then the body starts to respond better to insulin. The best and fastest way to drop insulin levels is by decreasing the ingestion of food that raises insulin levels. The foods that most raise insulin are carbohydrates such as sugars, but also less obvious sugars such as pasta, rice, bread, pizza, potatoes, sweet potatoes, fruits, corn, and legumes.

    Besides food, other things will help improve insulin resistance. This includes sleeping better, exercising, and decreasing emotional stress. So, if you are trying to figure out how to reverse insulin resistance naturally, those are some ways to go.

    Other things that may contribute to insulin resistance include certain medicines, such as glucocorticoids, some antipsychotics, and some medicines for HIV.

    Dr. Mariela Glandt is an endocrinologist specialized in Diabetes. She has recently opened the Glandt Center for Diabetes Care, a state of the art clinic in Tel Aviv.

     

     

     

     

    Insulin resistance and prediabetes occur when the body becomes insensitive to insulin.

    What is insulin?

    Insulin is a hormone made by the pancreas that helps glucose in your blood enter cells in your muscle, fat, and liver, where it’s used for energy. Glucose comes from the food you eat or it’s made by the liver when we are fasting. When glucose levels rise after you eat, your pancreas releases insulin into the blood, allowing the sugar to enter the cells and allowing the blood glucose levels to go back down to normal.

     

    What is insulin resistance?

    Insulin resistance is when cells in your muscles, fat, and liver don’t respond well to insulin and can’t easily take up glucose from your blood. Insulin resistance causes are highly correlated with abdominal fat (visceral fat). There are people that can handle a great deal of fat and don’t get sick, while there are others have less fat cells and therefore can contain limited amounts of fat. When the fat cells are overstuffed with fat, the fat starts sending a clear message that it does not have room for any more sugar.  This is called insulin resistance, and what it is essentially suggesting is that the body does not want any more sugar to come in. However, the pancreas must clear the high sugar from the blood and hence it makes more insulin to help glucose enter your cells. As long as your pancreas can make enough insulin to overcome your cells’ weak response to insulin, your blood glucose levels will stay in the healthy range. 

     

    Are there any problems with having insulin resistance, as long as glucose levels are in the normal range?

    Having normal sugar levels can be deceiving, giving a sense that there is no problem. However, high insulin levels, even with normal sugars, can be a problem. In the short run, high insulin levels make us hungry and make us gain weight. High insulin levels are also associated with hypertension and with dyslipidemia. In the long run, we know that high insulin levels are associated with higher rates of coronary artery disease, stroke, and cancer.

    What is prediabetes?

    When the pancreas is not able to keep up with the extra demand placed on it, then prediabetes sets in. This means your blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. One in every 3 adults has pre-diabetes. People with prediabetes have up to a 50 percent chance of developing diabetes over the next 5 to 10 years. Fortunately, type 2 diabetes can be prevented.

    What are the symptoms of insulin resistance and prediabetes?

    Insulin resistance and prediabetes usually have no symptoms. Unfortunately, doctors do not routinely check for insulin levels and diagnosed insulin resistance through other proxies. The presence of hypertension, high triglycerides, low HDL cholesterol, high uric acid, and fatty liver are all signs of insulin resistance. A HbA1c above 5.7 already points to insulin resistance. A HbA1c of 6.5 already defines diabetes.

    How can we reverse insulin resistance?

    Insulin resistance symptoms can be reversed by starting to decrease the levels of insulin in the blood. As insulin levels drop, then the body starts to respond better to insulin. The best and fastest way to drop insulin levels is by decreasing the ingestion of food that raises insulin levels. The foods that most raise insulin are carbohydrates such as sugars, but also less obvious sugars such as pasta, rice, bread, pizza, potatoes, sweet potatoes, fruits, corn, and legumes.

    Besides food, other things will help improve insulin resistance. This includes sleeping better, exercising, and decreasing emotional stress. So, if you are trying to figure out how to reverse insulin resistance naturally, those are some ways to go.

    Other things that may contribute to insulin resistance include certain medicines, such as glucocorticoids, some antipsychotics, and some medicines for HIV.

    Dr. Mariela Glandt is an endocrinologist specialized in Diabetes. She has recently opened the Glandt Center for Diabetes Care, a state of the art clinic in Tel Aviv.

     

     

     

     

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  • Diabetes and Nutrition Diabetes and Nutrition

    Posted on by Anabelle Savion

     


    Diabetes is a disease characterized by high blood sugar level in blood, but cholesterol level is also commonly elevated, along with disturbances in protein metabolism. The reason for high blood sugar level is due to a deficit of insulin. Therefore the sugars fail to enter the cells and storage depots (like liver and fat cells). 

    Many individuals who have diabetes are overweight, but not all. Thus one single diet would not work for everyone.

     

    Count your carbs

    Dietary planning has never been an easy task in diabetes and is best done with the help of a qualified dietitian, as every person has different needs. In Caucasians, the majority of those who have diabetes are either overweight or obese, but for other ethnic groups, things are entirely different.

    There are certain principles in diet planning that work for most people. Two relevant terms that have to be understood are glycemic index and glycemic load. Everyone knows that in diabetes simple sugars must be avoided and one should consume complex carbohydrates. Reason for it being that simple sugars get absorbed very quickly resulting in sugar spikes, meaning they have high glycemic index. Complex carbs are foods with low glycemic index; these are food products in which sugars are digested and broken at a slow pace. Consequently, the body has time to absorb and utilize them, an example of a fruit with low glycemic index is apple. You can find more about foods that are low in the glycemic index here.

    Knowing the glycemic index would not help unless a person understands another concept called glycemic load. It indicates the amount of sugar in a product. Some products may have fast absorbing sugars in low quantity thus being safe (low glycemic load). Just think about a small piece of watermelon which is high in water content with a small amount of fast absorbing sugars (thus it has a high glycemic index but very low glycemic load and is safe to consume in diabetes in right quantity).

    Therefore, when taking any food, you have to multiply glycemic index with the glycemic load. Simply stated, limit the carbs and calories, do not eat fast absorbing carbs too much, take the carbs wisely (distributed in smaller sizes during the day).

    The good food

    Diabetes is about being careful about carbs and calories, but a proper diet is much more than carbs. A balanced diet must be rich in good fats (monounsaturated and polyunsaturated fats). Some of the excellent sources of such good fats are almonds, avocados, walnuts, canola, olives and olive oil, and fatty fish.

    Omega-3 fatty acids (walnuts and fatty fish being the rich source) are worth mentioning, as they are good for blood vessels, brain, heart, and skin.

    A fiber-rich diet is another way to improve your skin, heart and general health. Include lots of fresh fruits and vegetables, nuts, and whole grains in food.

    Finally, limit the trans fats, saturated fats, and sodium intake in the diet, and keep hydrated by increasing fluid intake.

    10 tips for eating well with diabetes

    1. Always eat at a fixed time: this is especially true if you are on insulin, this helps to titrate the dose of insulin better, and avoid too much variance in sugar levels.
    2. Eat slow absorbing carbs: like oatmeal or muesli.
    3. Cut on fats: use virgin olive oil, drink low-fat milk, bake the food rather than frying.
    4. Eat five times a day: instead of eating heavy food twice or thrice daily, better divide it into five portions.
    5. Eat beans: lentils, baked beans, chickpeas, are rich in fiber and do not raise blood glucose much.
    6. Eat fish regularly.
    7. Avoid sugar: avoid any sugary drinks, use sweetener in tea or coffee.
    8. Cut down on salt: it raises blood pressure and increases the risk of heart disease, high salt intake is also harmful to your kidneys.
    9. Drink sensibly: drink alcohol in limits, and avoid having alcohol more often than once a week.
    10. Finally, remember that most diabetes foods don’t help. They are expensive and yet with unproven benefit. Thus learn more about the foods that are safe with diabetes and plan.

       

       


      Diabetes is a disease characterized by high blood sugar level in blood, but cholesterol level is also commonly elevated, along with disturbances in protein metabolism. The reason for high blood sugar level is due to a deficit of insulin. Therefore the sugars fail to enter the cells and storage depots (like liver and fat cells). 

      Many individuals who have diabetes are overweight, but not all. Thus one single diet would not work for everyone.

       

      Count your carbs

      Dietary planning has never been an easy task in diabetes and is best done with the help of a qualified dietitian, as every person has different needs. In Caucasians, the majority of those who have diabetes are either overweight or obese, but for other ethnic groups, things are entirely different.

      There are certain principles in diet planning that work for most people. Two relevant terms that have to be understood are glycemic index and glycemic load. Everyone knows that in diabetes simple sugars must be avoided and one should consume complex carbohydrates. Reason for it being that simple sugars get absorbed very quickly resulting in sugar spikes, meaning they have high glycemic index. Complex carbs are foods with low glycemic index; these are food products in which sugars are digested and broken at a slow pace. Consequently, the body has time to absorb and utilize them, an example of a fruit with low glycemic index is apple. You can find more about foods that are low in the glycemic index here.

      Knowing the glycemic index would not help unless a person understands another concept called glycemic load. It indicates the amount of sugar in a product. Some products may have fast absorbing sugars in low quantity thus being safe (low glycemic load). Just think about a small piece of watermelon which is high in water content with a small amount of fast absorbing sugars (thus it has a high glycemic index but very low glycemic load and is safe to consume in diabetes in right quantity).

      Therefore, when taking any food, you have to multiply glycemic index with the glycemic load. Simply stated, limit the carbs and calories, do not eat fast absorbing carbs too much, take the carbs wisely (distributed in smaller sizes during the day).

      The good food

      Diabetes is about being careful about carbs and calories, but a proper diet is much more than carbs. A balanced diet must be rich in good fats (monounsaturated and polyunsaturated fats). Some of the excellent sources of such good fats are almonds, avocados, walnuts, canola, olives and olive oil, and fatty fish.

      Omega-3 fatty acids (walnuts and fatty fish being the rich source) are worth mentioning, as they are good for blood vessels, brain, heart, and skin.

      A fiber-rich diet is another way to improve your skin, heart and general health. Include lots of fresh fruits and vegetables, nuts, and whole grains in food.

      Finally, limit the trans fats, saturated fats, and sodium intake in the diet, and keep hydrated by increasing fluid intake.

      10 tips for eating well with diabetes

      1. Always eat at a fixed time: this is especially true if you are on insulin, this helps to titrate the dose of insulin better, and avoid too much variance in sugar levels.
      2. Eat slow absorbing carbs: like oatmeal or muesli.
      3. Cut on fats: use virgin olive oil, drink low-fat milk, bake the food rather than frying.
      4. Eat five times a day: instead of eating heavy food twice or thrice daily, better divide it into five portions.
      5. Eat beans: lentils, baked beans, chickpeas, are rich in fiber and do not raise blood glucose much.
      6. Eat fish regularly.
      7. Avoid sugar: avoid any sugary drinks, use sweetener in tea or coffee.
      8. Cut down on salt: it raises blood pressure and increases the risk of heart disease, high salt intake is also harmful to your kidneys.
      9. Drink sensibly: drink alcohol in limits, and avoid having alcohol more often than once a week.
      10. Finally, remember that most diabetes foods don’t help. They are expensive and yet with unproven benefit. Thus learn more about the foods that are safe with diabetes and plan.

         

        Read more

      1. Diabetes and Prevention Diabetes and Prevention

        Posted on by Anabelle Savion

         diabetes prevention


        Diabetes is a heterogeneous chronic metabolic disorder that is characterized by elevated blood sugar levels, along with metabolic disturbances of all fuel providing compounds. All this happens either due to insulin resistance or deficit.  Disturbances of fat and protein metabolism in diabetes are as frequent as disturbances of glucose metabolism.

        Causes of diabetes are not fully understood. The family history of diabetes or genetics is a predisposing factor, but specific environmental factors like obesity, sedentary lifestyle and wrong kind of diet serve as triggering factors.

        Type 1 diabetes is a chronic autoimmune condition and is difficult to prevent. However preventing type 2 diabetes is possible with dietary and lifestyle changes.

        What happens in diabetes?

        Insulin is a hormone that is required by our body for energy generation and anabolic processes. In the deficit of insulin, our body cells are not able to properly use glucose for their energy needs; glucose fails to enter the muscles, liver and other cells of the body. In insulin deficit, all the construction processes in body slow down.

        Elevated glucose and disturbances of fat metabolism are harmful to the blood vessels. Thus diabetes is characterized by so-called macro and microvascular diseases. It is seen as damage to kidneys, eyesight, heart disease, increase in cases of stroke, neuropathies (damaged nerves), slower healing of wounds.

        Skin is one organ which becomes susceptible to infections. Due to a loss of sensation of limbs, chances of injury to extremities are elevated. Once injured, owing to neuropathies, inadequate blood supply, and persistent infections, healing process becomes painfully slow. In some individual’s chronic ulcers of limbs persist for months or even years. Infection of lower limbs is one of the leading non-traumatic causes of amputations.

        Preventing diabetes

        Diabetes is primarily a disease of lifestyle. Thus one of the most effective ways to stop this disorder is weight loss, dietary measures, and regular exercise.

        Weight loss: modern research shows that even 5-10% reduction in body weight (in obese people), may reduce the risk of developing diabetes by several times.

        Dietary measures: cutting back on refined carbs and sugary drinks will help maintain stable blood sugar levels and reduce the risk for diabetes. A registered dietitian (RD) or certified diabetes educator (CDE) can help create meal plans. The goal of the meal plan is to control blood glucose level and keep it in the healthy, normal range. 

        Regular exercise: a sedentary lifestyle has often been named are the number one killer of the 21st century. There is increasing evidence that sedentary lifestyle is causing more diseases than all other factors. Diabetes prevention studies carried out in the US, Europe, and Asian nations have shown that 150 minutes of aerobic exercise a week decreases the risk of developing diabetes by 50-70%. The minimum recommendation is of exercising at least 30 minutes five times a week.

         

        Skincare in diabetes

        Skin diseases in diabetes occur due to peripheral neuropathy causing loss of sensation, autonomic neuropathy leading to the dry and flaky skin, and inadequate blood supply due to diseased blood vessels. In diabetes, even a small scratch may get infected, because of elevated blood glucose level and slow down of the healing process, skin infections and ulcers are challenging to cure.

        Individuals living with diabetes have to take better care of their skin. It is recommended that people who have diabetes should check their feet on a daily basis, and should pay particular attention to the skincare, by regularly using hydrating agents along with anti-infective properties. Non-chemical based, natural creams and lotions may be especially beneficial in prevention and treatment of skin problems.

        Thus to prevent dry and cracked skin, it is highly recommended that a person uses moisturizer on a daily basis, not just any moisturizer, but one with anti-inflammatory and anti-microbial properties that can prevent the infection, help in healing the damage that has already occurred and can prevent or treat inflammation and swelling. Products based on natural ingredients are preferred as they are less irritating to skin on regular use.

         

         

         

         diabetes prevention


        Diabetes is a heterogeneous chronic metabolic disorder that is characterized by elevated blood sugar levels, along with metabolic disturbances of all fuel providing compounds. All this happens either due to insulin resistance or deficit.  Disturbances of fat and protein metabolism in diabetes are as frequent as disturbances of glucose metabolism.

        Causes of diabetes are not fully understood. The family history of diabetes or genetics is a predisposing factor, but specific environmental factors like obesity, sedentary lifestyle and wrong kind of diet serve as triggering factors.

        Type 1 diabetes is a chronic autoimmune condition and is difficult to prevent. However preventing type 2 diabetes is possible with dietary and lifestyle changes.

        What happens in diabetes?

        Insulin is a hormone that is required by our body for energy generation and anabolic processes. In the deficit of insulin, our body cells are not able to properly use glucose for their energy needs; glucose fails to enter the muscles, liver and other cells of the body. In insulin deficit, all the construction processes in body slow down.

        Elevated glucose and disturbances of fat metabolism are harmful to the blood vessels. Thus diabetes is characterized by so-called macro and microvascular diseases. It is seen as damage to kidneys, eyesight, heart disease, increase in cases of stroke, neuropathies (damaged nerves), slower healing of wounds.

        Skin is one organ which becomes susceptible to infections. Due to a loss of sensation of limbs, chances of injury to extremities are elevated. Once injured, owing to neuropathies, inadequate blood supply, and persistent infections, healing process becomes painfully slow. In some individual’s chronic ulcers of limbs persist for months or even years. Infection of lower limbs is one of the leading non-traumatic causes of amputations.

        Preventing diabetes

        Diabetes is primarily a disease of lifestyle. Thus one of the most effective ways to stop this disorder is weight loss, dietary measures, and regular exercise.

        Weight loss: modern research shows that even 5-10% reduction in body weight (in obese people), may reduce the risk of developing diabetes by several times.

        Dietary measures: cutting back on refined carbs and sugary drinks will help maintain stable blood sugar levels and reduce the risk for diabetes. A registered dietitian (RD) or certified diabetes educator (CDE) can help create meal plans. The goal of the meal plan is to control blood glucose level and keep it in the healthy, normal range. 

        Regular exercise: a sedentary lifestyle has often been named are the number one killer of the 21st century. There is increasing evidence that sedentary lifestyle is causing more diseases than all other factors. Diabetes prevention studies carried out in the US, Europe, and Asian nations have shown that 150 minutes of aerobic exercise a week decreases the risk of developing diabetes by 50-70%. The minimum recommendation is of exercising at least 30 minutes five times a week.

         

        Skincare in diabetes

        Skin diseases in diabetes occur due to peripheral neuropathy causing loss of sensation, autonomic neuropathy leading to the dry and flaky skin, and inadequate blood supply due to diseased blood vessels. In diabetes, even a small scratch may get infected, because of elevated blood glucose level and slow down of the healing process, skin infections and ulcers are challenging to cure.

        Individuals living with diabetes have to take better care of their skin. It is recommended that people who have diabetes should check their feet on a daily basis, and should pay particular attention to the skincare, by regularly using hydrating agents along with anti-infective properties. Non-chemical based, natural creams and lotions may be especially beneficial in prevention and treatment of skin problems.

        Thus to prevent dry and cracked skin, it is highly recommended that a person uses moisturizer on a daily basis, not just any moisturizer, but one with anti-inflammatory and anti-microbial properties that can prevent the infection, help in healing the damage that has already occurred and can prevent or treat inflammation and swelling. Products based on natural ingredients are preferred as they are less irritating to skin on regular use.

         

         

         

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