Sunday, May 27, 2012

Sitting Too Much? You Might Be At Risk For Diabetes

Prolonged periods of sitting may increase the risk of Type 2 diabetes in women, a new study finds.
In the study, a woman's likelihood of having risk factors for diabetes, such as insulin resistance and chronic inflammation, increased with the more time she spent sitting. No such link was found in men.
Even women who engaged in moderate or vigorous physical activity were at an increased risk for early signs of diabetes if they were also sedentary for long periods of time, the study found.
"If these results are replicated, they have implications for lifestyle recommendations, public health policy, and health behavior interventions, as they suggest that enabling women to spend less time sitting is an important factor in preventing chronic disease," the researchers wrote in the January issue of American Journal of Preventative Medicine.
Thomas Yates, of the University of Leicester in the United Kingdom, and colleagues analyzed information from about 500 people living in the U.K. who attended a diabetes screening program. Participants reported how much time they spent sitting on a weekday in the last seven days. The researchers collected blood samples to test for diabetes risk factors.
On average, women said they spent five hours a day sitting, while men said they spent six hours a day sitting. 
For women, prolonged sitting was linked with insulin resistance and high levels of markers of inflammation, including c-reactive protein (CRP) and interluken-6 (IL-6). 
The strength of the association decreased when the researchers took into account the woman's body mass index (BMI), indicating that obesity might explain part of the link. The researchers said it may be that hormones released from fat tissue are detrimental to the body's metabolism. 
The study was limited in that participants reported their own sitting time, which may not be accurate and could affect the results, the researchers said. 
If you have diabetes and do not currently see a podiatrist for your diabetic foot care, call our office to make an appointment
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Doctor in CT
Podiatrist in Bristol, CT
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Sunday, May 20, 2012

Type 2 Diabetes in Children and Teens

From Time.Com, published 4/30/2012
Type 2 diabetes, the kind linked with obesity, progresses much faster and is harder to treat in children than . adults, according to the disappointing results of a new study that sought to determine the best treatment for the disease in obese teens.
The study, the largest to examine Type 2 diabetes treatment in youth, looked at the effectiveness of several methods to manage blood sugar levels in newly diagnosed teens aged 10 to 17. The research found that nearly half of all participants failed to maintain stable blood sugar levels over the four-year study, and 1 in 5 suffered serious complications as a result.
The findings are troubling for teens' health since obesity and diabetes rates are increasing nationwide. Uncontrolled diabetes can increase the risk for serious health problems, including heart disease, vision loss, nerve problems, amputations, and kidney failure.
Type 2 diabetes- once referred to as adult-onset diabetes- was rarely seen among children before the 1990s. But as American children and teens started getting fatter, related cases of diabetes began to rise. Today, Type 2 diabetes is still uncommon in children (Type 1, or juvenile, diabetes affects more youths), but the disease continues to increase at an alarming rate: between 2002 and 2005, there were about 3,600 new cases of Type 2 diabetes in children and teens a year.
For the new study, released by the New England Journal of Medicine, researchers followed 699 overweight and obese teens who had recently been diagnosed with diabetes. Most of the participants were from low-income families; 40% were Hispanic, 33% black, 20% white, 6% American Indian, and fewer than 2% were Asian.
All of the participants were started off on metformin, the standard oral medication for Type 2 diabetes, to normalize their blood sugar levels. They were then divided into three treatment groups to maintain blood sugar control. One group continued to use metformin alone; another used metformin along with an intensive diet, exercise, and weight-loss program; the third used metformin plus another drug, Avandia.
Failure rates were high for all three treatment groups. About half the teens in the metaformin group failed to keep their blood sugar down, 39% failed in the group using metformin plus Avandia, and 47% failed in the diet and exercise group.
"It's frightening how severe this metabolic disease is in children," study author Dr. David M. Nathan, director of the diabetes center at Massachusetts General Hospital told the New York Times. "I fear that these children are going to become sick earlier in their lives than we've ever seen before."
The authors could only speculate why diabetes is so hard to treat in children and teens, but it could be due to rapid growth and hormone changes during puberty.
So what can be done? Obviously, the best treatment is prevention: "Don't get diabetes in the first place," researcher Dr. Phil Zeitler of the University of Colorado Denver told the Associated Press.
However, it will take a concerted national effort to help keep children from the increasing risk. In an editorial  accompanying the study, Dr. David Allen of the department of pediatrics at the University of Wisconsin School of Medicine and Public Health, in Madison, wrote:
Fifty years ago children did not avoid obesity by making healthy choices; they simply lived in an environment that provided fewer calories and included more physical activity for all. Until a healthier "eat less, move more" environment is created for today's children, lifestyle interventions like that in the... study will fail. The stark message from... study is that, tomorrow and beyond, public-policy approaches- sufficient economic incentives to produce and purchase healthy foods and to build safe environments that require physical movement- and not simply the prescription of more and better pills will be necessary to stem the epidemic of type 2 diabetes and its associated morbidity.
In terms of immediate treatment, when the usual drugs fail, daily insulin shots may be needed. The researchers note that adding Avandia to metformin is not recommended for children or teens because the drug has been linked to an increased risk of heart attack and stroke in adults, and the U.S. Drug and Food Administration has severely restricted its use. Other oral medications for diabetes haven't been studied or approved for use in children.
"A single pill or single approach is not going to get the job done," study author Mitchell Geffner of the Children's Hospital Los Angeles told the AP.
If your child or teen suffers from Type 2 diabetes, call to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Doctor in CT
Podiatrist in Bristol, CT
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Sunday, May 13, 2012

Diabetes in Men and Women: Not the Same

Not only is today Mother's Day, but it also starts National Women's Health week, from May 13th to the 19th.
We can always count on moms, sisters, wives, girlfriends, and other women in our lives to be there for us, and we want them to stay healthy (Men too, of course, but we'll get to that next month!).
But diabetes can be especially tough on women. For starters, it affects both mothers and their unborn babies. Studies also show women with diabetes are at higher risk for developing heart disease, kidney disease, and depression than men- despite the fact that women typically have longer life expectancies.
This information may be concerning, but we also know a lot about how to stave off many of these complications. Let's address some popular questions about how diabetes affects women.
1. Are there any diabetes medications that have side effects unique to women?
Yes, the oral medications classified as thiazolidnediones (TZDs) may cause women who are not ovulating and haven't gone through menopause to begin ovulating again, enabling them to conceive. Also, oral contraceptives may be less effective when taking this medication.
2. Is there a special time table that women with diabetes should follow for medical check-ups such as gynecological exams?
Check-ups should be performed on a regular, consistent basis to ensure that your diabetes is not negatively affecting your reproductive organs. Your health care provider will determine how often you should schedule your visits, depending on your overall health.
3. Can women with diabetes breastfeed their babies?
Unless your healthcare team advises you otherwise, yes! Breast milk provides the best nutrition for babies and breastfeeding is recommended for all mothers, whether you have preexisting diabetes or gestational diabetes.
4. I had gestational diabetes. How soon after having my baby should I get my blood glucose rechecked?
Gestational diabetes is estimated to develop in 18 percent of all pregnancies. Get your blood glucose checked about six to eight weeks after delivery. Like 90 percent of women with gestational diabetes, your levels will probably return to normal right after your baby is born. However, you still run the risk of developing Type 2 diabetes later on. In fact, studies have shown women who have had gestational diabetes are at risk (of up to 60 percent) for developing diabetes in the next 10 to 20 years.
5. What are the benefits and risks of hormone replacement therapy (HRT)? 
The benefits of HRT are decreased risk of osteoporosis, hot flashes, and vaginitis (infections). The risks while using estrogen are increased incidence of breast cancer and uterine cancer. However, when estrogen and progesterone are administered together and in correct doses, the risk of uterine or endometrial cancer is actually reduced.
6. Will menopause affect my diabetes?
Yes. The changes in the levels and balances of your hormones may lead to out-of-control blood glucose levels. Women with diabetes are also at risk of developing premature menopause and consequently, increased risks of cardiovascular disease.
So if you're a woman with diabetes, be sure to take care of yourself by making healthy lifestyle choices and getting proper medical care. If you know someone who has diabetes or is known to be at risk, be sure they do the same. Your support and understanding can make all the difference.
If you are women with diabetes and you do not currently see a podiatrist for diabetic foot care, call our office for an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Doctor in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow our tweets on Twitter
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Friday, May 11, 2012

Diabetic Recipe of the Week: Malaysian Shrimp With Pineapple

4 servings
Serving Size: 1 cup
Preparation Time: 25 minutes
Cooking Time: 18 minutes

2 tsp. canola oil
1 onion, thinly sliced
3 garlic cloves
1 tsp. ground cumin
1 tsp. turmeric
1 tsp. ground coriander
1/8 to 1/4 tsp. red pepper flakes
2 Tbsp. lite soy sauce
1 Tbsp. brown sugar
1/3 cup lite coconut milk
1 lb. large shrimp, peeled and deveined
2 cups fresh pineapple chunks
2 scallions, thinly sliced

1. In a wok or deep heavy pan, warm the oil over medium-high heat. Add the onions and garlic, and stir-fry for about 5 minutes until onions begin to soften. Add the cumin, turmeric, coriander, and red pepper flakes. Stir fry for 2 minutes.
2. Combine the soy sauce, brown sugar, and coconut milk. Add to the wok, lower the heat, cover, and simmer for 5 minutes.
3. Add the shrimp to the sauce. Simmer uncovered for 3 to 4 minutes until shrimp are almost cooked through. Add the pineapple and scallions and cook 1 minute.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Doctor in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow our tweets on Twitter
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Friday, May 4, 2012

Recipe of the Week: Green Beans With Sunflower Seeds

Serves 6
Serving Size: 1/2 cup
Prep Time: 20 minutes

1lb. fresh green beans
1 cup of water
1/4 cup chopped onion
2 clove garlic, minced
1/2 tsp. salt
1/8 tsp. black pepper
1 pinch crushed red pepper flakes
2 Tbsp. sunflower seeds, shelled
1 tsp. fresh chopped oregano

1. Snap the ends off the green beans. If they are very young, leave the beans whole; if they are large cut them into 2 inch pieces.
2. Place the beans in a saucepan; add water, onion, garlic, salt and peppers.
3. Cover and bring to a boil; reduce the heat to a simmer and cook for 8 minutes, until the beans are crisp tender; drain.
4. Toss with sunflower seeds and oregano.
Richard E. Ehle, DPM 
Connecticut Foot Care Centers
Diabetic Foot Doctor in CT
Podiatrist in CT
Visit our website, friend and like our page on Facebook, and follow our tweets on Twitter
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Wednesday, May 2, 2012

Diabetic Support Group

Bristol Hospital is pleased to offer two different support groups for those facing diabetes. The morning support group is not only for those with diabetes, but their family and friends as well. The meetings are facilitated by Karen Cornell, LCSW and meets at the Bristol Hospital Center for Diabetes (Dr. Vijay Joshi's office) from 11AM to noon. Meeting dates are:
*May 22: Demystifying Motivation
*June 26: Diabetes Super Foods
*July 24: Updating Your Coping Skills
*August 28: Carbohydrate Management
Research shows that ongoing support is necessary for continued and effective diabetes management. For patients whose schedules make it impossible to attend our monthly day support group, the Bristol Hospital Center for Diabetes is starting an evening group complete with weigh-ins and forums on diabetes management. Get control of your diabetes in an interactive, social setting. Meeting times are from 6:30-7:30. Instructors: Miles Everett, RD, RN, CDE, and Katherine Kreh, RD.
*May 2
*June 6
*July 11
*August 1
Both support groups are free. The Bristol Hospital Center for Diabetes is located at 102 North Street, behind Best Cleaners, Bristol, CT. Call 860-940-6300 for more information.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Doctor in CT
Podiatrist in Bristol, CT
Visit our website, friend and like our page on Facebook, and follow our tweets on Twitter
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