BY: DIRECTOR OF EDUCATION – JESSICA COOK MS, RD, LD, CDE
Many of our patients with diabetes take medications to control blood glucose levels. When blood glucose levels remain high despite medication use, dosages may need to be increased in order to lower blood glucose levels effectively. Our physicians at Palm Beach Diabetes and Endocrine Specialists (PBDES) also provide other services to help patients lower blood glucose levels without increasing medications! What is the secret to lower blood glucose levels without medication increase? Diabetes Education. Here at PBDES we have a full team of certified diabetes educators to teach patients easy steps to lowering blood glucose levels without medication increases. Most insurance plans cover 2 visits every year with a registered dietitian, 2 visits every year with a certified diabetes educator and Group classes on healthy eating and blood sugar management every year!
Our education team has helped countless patients lose weight, reduce blood glucose levels, reduce medication use, feel better and some patients have even discontinued medication use with basic lifestyle changes. Our education team can also provide help for feelings of depression due to diabetes, stress management or diabetes burn out. At PBDES you have your very own diabetes care team all year round to keep you motivated, successful and healthy! So why not make an appointment with one of our diabetes educators to learn ways to reduce blood glucose levels easily, safely and without extra medication! Call (561) 513-5100 to schedule your appointment today!
Thank you for taking time to read our Living Well with Diabetes August 2015 Newsletter. Enjoy!
BY: GARY PEPPER, M.D.
The views and opinions expressed here are those of the author and may not reflect the opinions of your health professional. Please consult your own doctor before embarking on any new exercise routine.
Lack of energy and inability to lose weight are constant challenges for many people and are every day complaints encountered in the doctor’s office. Studies show that almost everyone can find some relief from these problems by accessing the healing properties of physical activity. In my experience, mentioning the need for “more exercise” often results in rolling of the eyes, sighing, shrugging, snorting or worse yet, the hundred yard stare. Yes, we all know exercise is important but who has the energy for that? It seems like a vicious cycle. What is surprising is that when done correctly, exercise can actually improve energy with the additional advantage of promoting weight loss, and restoring tone and stamina. It is helpful to remember that the human body was designed for a lot more physical activity and a lot less food than we are privileged to experience in present day life. It therefore takes will power and knowledge to maintain the environment required for optimal health. Here are eight steps to get in the swing of regular exercise. Some suggestions may surprise you.
1. Check with your doctor first. Make sure you are medically ready to embark on a new exercise program. Those with heart, lung or orthopedic issues will need special advice. Diabetics particularly should inquire whether adjustments are needed because exercise can lower requirements for some medications particularly insulin.
2. Stretch. Personally I don’t believe in the “restless leg” syndrome. I believe most of these symptoms are a natural way muscles express the need to stretch and move. If you are familiar with dogs or cats you will recognize the signals they give when their body requires exercise. So it is with our muscles. Muscles are machines that need maintenance, and the tendency is to take them for granted. Careful stretching will help restore elasticity to the muscles preparing them for exertion. Proper stretching will minimize injury and feels good. Yoga is the art of stretching and is a wonderful way to begin your journey to better physical and mental health. There are many good resources which explain simple steps to safely begin a stretching routine.
3. Start slowly. Muscle strength deteriorates quickly with inactivity. The resiliency of the muscle also declines making injury much easier. Starting a new exercise routine requires a surge of motivation so the natural tendency is to overdo it at the beginning. This results in pain and injury and an early end to your good intentions.
4. Do less than you feel you can do. When starting a program, frequent, shorter duration exercise is preferable to engaging in the “weekend warrior” approach. Often, within the first few minutes of exercise it may seem easier than you imagined. Determination grows and unless you have a preset limit you may push harder than you should. Pain and injury result. I often advise 10 to 20 minutes of walking three times per week to start and not to try to increase for at least a few weeks. I disagree with the gym proverb “no pain, no gain” unless your goal is to be a competitive athlete. Pain is nature’s way of saying stop what you are doing. Once discomfort is occurring I believe you are reaching your body’s limit. It is more productive to ask yourself, “Will I want to come back and do this tomorrow?” rather than “How much can I do today?” In this way injury will be avoided as the muscles adapt to the new stresses placed on them. Muscles are unique in their ability to enlarge and strengthen with use, a process known as hypertrophy. This takes time so be patient as your body adapts.
5. Schedule, schedule, schedule. Modern life is demanding, hectic and stressful. Waiting for the perfect time to exercise can result in no exercise at all. Most of the things you do fit into some preset routine. If you don’t consciously set aside time to exercise the likelihood is that you will never find the right moment. Unavoidably, things come up and some exercise sessions will be missed but this should be viewed as only a momentary set back. For those who have the option, walking at lunch time or immediately after work may be the best times. Once home after work, chores and other commitments make finding exercise time very difficult.
6. Every little bit helps. When exercise is recommended by the doctor, the image of sweating in a gym for an hour, comes to mind. This is incorrect. To get exercise you just need a good pair of shoes and motivation. For most, 20 minutes of walking 3 times a week is a great initial goal and doesn’t require a gym membership or expensive equipment. If you can’t make a full exercise session, ten minutes is still better than no minutes. It’s a bit like putting pennies in a piggy bank. It adds up. An exception may be dog walking. While walking the dog is better than no exercise, typically it is the dog that walks the owner. Stopping every few steps while the dog does whatever, does little to help restore physical fitness.
7. Ice is nice. Ice is a natural anti-inflammatory. No matter how careful we are, doing exercise will frequently result in some muscular pain. Using an ice pack for a few minutes on sore muscles after exercise can provide great relief. Be sure not to give yourself frost bite! Anti-inflammatory drugs such as ibuprofen when used sparingly also offer good relief but check with your doctor if they are safe for you.
8. Maintenance can be a bore, so keep it interesting. Let’s say you have been exercising regularly for 6 months and are making progress. The routine can be getting boring and if the weight isn’t dropping as fast as you like there is a tendency to skip exercise sessions more and more. Keeping motivated is hard. Mix up the types of exercise to keep it fresh. If you are a walker or jogger try mixing in bike riding. Swimming is a great addition to a program although it requires more time and resources. Exercise with a friend or family member or join an exercise group to relieve boredom and this may also help you set new goals. Finally, don’t forget to reward yourself for your efforts. Each of us can imagine some little treat or item we would like so set an achievement goal which will earn you the reward. It takes creativity and determination but chances are you will be healthier, stronger, thinner, more energetic and more relaxed if you can add exercise to your life.
The information presented here is for educational use only and is not intended as medical advice. Be sure to check with your own health provider before starting any new exercise routines.
BY: GAIL STARR LCSW, CDE
Dementia and Alzheimer’s Disease are frightening topics to discuss. No one wants to lose themselves, their relationships or their ability for self-care. These conditions are affecting millions of people in the U.S. and around the world. Why is dementia being discussed in an article on Diabetes? It appears that as the elderly population increases, so does Diabetes and Dementia/Alzheimer’s Disease. Is there a connection?
Ongoing research is finding a link between high blood sugars and Alzheimer’s. A study, published in the American Journal of Psychiatry, reviewed 62 research studies to look for conditions that could indicate the risk of mild cognitive impairment (MCI) worsening to dementia. The study included 16,000 participants. Researchers, led by Gill Livingston of University College, London, found that “diabetes seems to make it more likely that MCI will progress to dementia.”
One of the reasons may be due to damaged blood vessels in the brain caused by high blood sugars compromising blood flow. Also, MCI may occur as a result of the complex ways that type 2 diabetes affects the ability of the brain to use glucose and how it responds to insulin. Studies have shown that even people with pre-diabetes, a condition where sugars are higher than normal but not high enough to be diagnosed, are at greater risk for developing dementia. Ongoing research continues to focus on confirming the link between diabetes and Dementia or Alzheimer’s Disease, but it appears that the link is real.
It also appears that if high blood sugars can cause dementia then controlling them could help lower the risk of developing it. Research has shown that working with a health care team, and using the knowledge learned, can be an effective strategy to avoid, reduce or delay complications of high blood sugars. While there is currently no cure for dementia, we know that the risk can be lowered. Following your health care team’s plan by eating healthfully (fruits, vegetables, whole grains, lean meats, healthy fats), keeping active (which includes 30 minutes of exercise 5 days per week), not smoking, and losing weight may be the factors needed for staying healthy in mind and body. In order for people to make changes in their lives, they need a motivation. Reducing the risk for dementia may be the motivation needed for people to change their attitude toward self-care.
To make an appointment with our diabetes education team to lower your blood sugars and possibly prevent the onset of dementia or Alzheimer’s disease please call (561) 513-5100 today!
Come learn how to plan healthy meals for diabetes, weight loss and heart health!
Join us at our healthy meal planning refresher class in West Palm Beach.
We hold classes every month which include how to plan healthy meals, weight
loss, tips on grocery shopping as well as dining out, healthy substitutions and more!
If you have tried losing weight on your own without success why not try our Healthy Meal Planning with Diabetes Refresher Course to help you get back on track with your weight loss goals. If interested attending this program please contact our scheduling department at (561) 513-5100 today!
At Healthy Living with Diabetes we want to ensure that you are satisfied with all services received. We also would like your input on educational workshops that you would like us to offer, information you would like to read about in Healthy Living with Diabetes Monthly or feedback on any workshop that you may have attended. You can contact the director of education personally by email jcook@PBDES.COM or leave a message at (561) 513-5100. We would love to hear from you!