Diabetes: Eating a low glycemic diet

Using a low glycemic index diet is one tool to help keep your diabetes under control. The glycemic index is a rating system for foods that contain carbohydrate. It helps you know how quickly a food with carbohydrate raises blood sugar, so you can focus on eating foods that raise blood sugar slowly.

 

Key points

• Over time, high blood sugar can harm your eyes, kidneys, nerves, and heart.
• Foods that raise blood sugar slowly have a low glycemic index. Most of the carbohydrate-rich foods that you eat with this plan should be low or medium on the glycemic index.
• Eating low glycemic foods is most helpful when used along with another eating plan for diabetes, such as carbohydrate counting. Counting carbs helps you know how much carbohydrate you're eating. The amount of carbohydrate you eat is more important than the glycemic index of foods in helping you control your blood sugar.
• People respond differently to the glycemic content of foods. The only way to know for sure how a food affects your blood sugar is to check your blood sugar before and after eating that food.
• High-glycemic foods are rarely eaten by themselves, so the glycemic index might not be helpful unless you're eating a food by itself. Eating foods together changes their glycemic index.
• Look at the overall nutrition in foods-and not just their glycemic index-when planning meals. Some low-glycemic foods, such as ice cream, are high in saturated fat and should be eaten only now and then. And some high-glycemic foods, such as potatoes, have nutrients like vitamin C, potassium, and fiber.
• You can still have high glycemic foods on this diet. Just try to eat small amounts of them to limit their effect on your blood sugar. Eating low glycemic foods along with high glycemic foods also can help keep your blood sugar from rising quickly.

What is a low glycemic diet?

The glycemic index is a way to tell how quickly foods that contain carbohydrate may raise your blood sugar.
On a low glycemic diet, you eat foods that raise your blood sugar slowly. This helps you keep your blood sugar from getting too high. This diet plan is sometimes called a "low GI" diet.

• Low glycemic foods break down slowly in your body and release sugar into the blood slowly.
• High glycemic foods break down quickly and make blood sugar rise quickly.

In general, carbohydrate raises blood sugar more quickly than other nutrients like proteins and fats. But some foods that have carbohydrate raise blood sugar more slowly than other foods with carbohydrate. For example, white bread raises blood sugar more quickly than whole-grain bread.
Foods in the index are given a number from 0 to 100. The higher the number, the higher the glycemic index. Foods are compared to glucose, which is sugar. It has a rank of 100.

• Foods that raise blood sugar quickly are high. They are rated 70 or more.
• Foods that raise blood sugar moderately are medium. They are rated 56 to 69.
• Foods that raise blood sugar slowly are low. They are rated 55 or less.

Most of the carbohydrate-rich foods that you eat on this plan should be low or medium on the index. A dietitian or certified diabetes educator can help you pick foods that you like that are low on the index. You also can look at materials from the American Diabetes Association or go to its Web site at www.diabetes.org.
Low glycemic foods include:

• Dried beans and legumes like lentils.
• Nonstarchy vegetables, such as broccoli and peppers.
• Some starchy vegetables, such as yams.
• Some whole grains and cereals, such as oatmeal and whole wheat bread.
• Many fruits, such as apples, berries, dried apricots, and cherries.

Moderate glycemic foods include:

• Apricots (fresh).
• Pineapple.
• Shredded wheat cereal.
• Spaghetti.

High glycemic foods include:

• White bread.
• Sticky rice.
• Some fruits, such as dates and watermelon.
• A few vegetables, such as some types of potatoes.

People respond differently to the glycemic content of foods. The only way to know for sure how a food affects your blood sugar is to check your blood sugar before and after you eat that food.

High-glycemic foods are rarely eaten by themselves, so the glycemic index might not be helpful unless you're eating a food by itself. Eating foods together can change their glycemic index.

Choosing a low glycemic diet doesn't mean that you can't eat any high glycemic foods. Some high glycemic foods, such as potatoes, have lots of nutrients. Just try to limit how much of these foods you eat.

You should combine a low glycemic diet with another eating plan for diabetes, such as carbohydrate counting. The glycemic index can help you know the kind of carbohydrate you're eating. Carbohydrate counting can help you know how much carbohydrate you're eating.

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

Heart Disease, Diabetes and Stroke: More Chocolate, Less Risk?

By KATIE MOISSE

A new review of previously published studies adds weight to the claim that chocolate is good for the heart.
Taken together, five of seven studies included in the review linked high chocolate consumption with a 37 percent reduction in cardiovascular disease risk, a 31 percent reduction in diabetes risk and a 29 percent reduction in stroke risk when compared to low chocolate consumption.

"Although over-consumption can have harmful effects, the existing studies generally agree on a potential beneficial association of chocolate consumption with a lower risk of cardiometabolic disorders," Adriana Buitrago-Lopez of the University of Cambridge in the U.K. and colleagues reported today in BMJ.

The findings held up even when factors such as age, diet, physical activity, body mass index and smoking were controlled for. But the review stopped short of concluding that chocolate itself makes people healthier.

"This paper merely shows us that the association between habitual intake of chocolate and lower cardiometabolic risk is 'statistically robust,'" said Dr. David Katz, director of medical studies in public health at Yale University. "But what if happier people eat more chocolate, and are at lower cardiometabolic risk because they are happier? This paper cannot address such subtleties."

The review included data collected from more than 114,000 people. But the large numbers don't prove cause and effect, Katz said. The review does, however, support chocolate as a healthful indulgence -- in moderation, of course.

This is a wonderful example of the opportunity to love food that loves us back," said Katz. "However, too much of a good thing is no longer a good thing."

Chocolate for Health: What Dose Is Best?

Katz, who has published studies on the health effects of chocolate, said the next step is to establish a therapeutic window similar to that for red wine.

"Our conclusion is that dark chocolate -- 60 percent cocoa or higher -- and liquid cocoa have clear, potential benefits in terms of overall cardiac risk, but that we don't yet know enough about optimal dosing to best use this food 'as medicine,'" Katz said.

HMC urology unit helps patients to fight incontinence

By Noimot Olayiwola/Staff Reporter
 
People who experience a sudden need to urinate followed by instant bladder contraction or involuntary loss of urine while coughing, sneezing, laughing or exercising have been advised to seek immediate medical attention as they could be having problems associated with urinary incontinence.

“We have found that many people are still finding it difficult to openly discuss that they have urinary incontinence . They need not suffer in silence. It is high time they started discussing the problems with a physician as there are a number of ways they can be assisted and protected from the psychological, physiological and sociological effects of leaking urine,” Urology consultants Dr Adralan Ghafouri and Dr Omar Isam Mohamed Ali told Gulf Times yesterday.

Both consultants working at the Dysfunction Unit of the Hamad Medical Corporation’s Urology Department, disclosed that many patients also thought it was part of normal life changes while growing older and thus did not deem it necessary to seek medical intervention.

“Statistics show that the prevalence of incontinence worldwide ranges between 4-36% with varying degrees in each country and the problem could have a really negative impact on life,” they maintained.
The department, which has recently installed a second Urodynamic machine procured for QR200,000 from a Canadian company, receives yearly between 400-450 patients, comprising both males and females.

According to Dr Ghafouri, there are different types of incontinence with the most common being stress, urge and mixed incontinence.

“Stress incontinence occurs during certain activities like coughing, sneezing, laughing, or exercising while urge incontinence involves a strong, sudden need to urinate followed by instant bladder contraction and involuntary loss of urine. In this case, you don’t have enough time between when you recognise the need to urinate and when you actually do urinate and mixed incontinence involves more than one type of urinary incontinence,” he explained.

According to him, though both women and men suffer from urinary incontinence, with women mostly suffering stress incontinence due to a number of risk factors including: being female, multiple childbirth, chronic coughing (such as chronic bronchitis and asthma), ageing, obesity and smoking.

They said factors that could lead to incontinence in men are injury to the urethral area during surgical interventions, some medications and surgery of the prostate or pelvic area.

 “The ability to hold urine and control urination depends on the normal function of the lower urinary tract, the kidneys and the nervous system. A patient must also have the ability to recognise and respond to the urge to urinate. The average adult bladder can hold over two cups (350ml-550 ml) of urine,” Dr Ghafouri explained adding that two muscles were involved in the control of urine flow: the sphincter, which is a circular muscle surrounding the urethra and the detrusor, which is the muscle of the bladder wall. 

“A person must be able to squeeze the sphincter muscle to prevent urine from leaking out and the detrusor muscle must stay relaxed so that the bladder can expand. In stress incontinence, the sphincter muscle and the pelvic muscles, which support the bladder and urethra, are weakened. The sphincter is not able to prevent urine flow when there is increased pressure from the abdomen such as when you cough, laugh, or lift something heavy,” he explained.

Dr Ali mentioned that diagnosis of the condition can be done through a number of means including physical examination of the genital, rectal and pelvic floor, pad test, urinalysis and a procedure called flowmetry.

“Treatment depends on how severe the symptoms are and how much they interfere with the patients’ everyday life.There are four major categories of treatment for stress incontinence, which are behavioural changes, medication, pelvic floor muscle training (Kegel exercise) and surgery- when every other treatment method has failed,” he explained.

“Some women may use a device called a vaginal cone along with pelvic exercises, while biofeedback and electrical stimulation may also be helpful for those who have trouble doing pelvic muscle training exercises,” he mentioned.

However, Dr Ali maintained that there were still no effective approved oral medication to treat stress incontinence and that the only available medication was to treat depression, the use of which is being discouraged due to its side effects.

He added that the Urodynamic department has recorded up to 95% success rate with the use of a simple 20 minutes procedure called “day procedure” to help patients correct stress incontinence.

Diabetes Complications and Your Skin

When it comes to avoiding diabetes complications, two seemingly contradictory principles apply: Keep the skin hydrated and keep it dry.

Let's start by explaining the importance of maintaining hydration. When blood sugar levels escalate, the skin becomes dehydrated and dry. This, in turn, may lead to irritation and cracking, common diabetes complications. And whenever skin is open and blood sugars are high, the risk of germs entering and infection occurring surges.

While hydrated skin indicates healthy skin, downright moist or sweaty skin does not. "Particularly for people who are overweight, moisture and fungus get into the folds of the skin," says diabetes educator Teresa Pearson, RN, CDE, president-elect for the American Association of Diabetes Educators.

Necrobiosis lipoidica, a rare skin disorder associated with diabetes, can develop despite proper management of glucose levels. It can appear before the diagnosis of diabetes, but it usually occurs several years after.

The disorder causes small, raised, oval, dark red or brownish-yellow lesions with a thick shiny surface and sharply defined edges. They can be itchy and painful. If the spots break open, they require medical attention.

To date, treatment has proved fairly ineffective. In some cases, necrobiosis lipoidica recedes without treatment. Although its development does not hinge on how well blood sugar levels are controlled, experts warn that high blood sugar may lead to secondary infections in the lesions.

The American Diabetes Association advises patients to minimize their risk of skin-related diabetes complications by following these guidelines:

• Keep skin clean and dry.
• Apply talcum powder to parts of the body where moisture is likely to develop.
• Avoid bathing or showering in extremely hot water.
• Prevent dry skin by using moisturizers and running a humidifier in your home during cold, dry months.
• Treat cuts immediately, avoiding use of harsh agents such as alcohol or iodine.
• See a dermatologist for unresolved skin problems.

© 2010 WebMD, LLC. All rights reserved.

Omega-3 Fish Oil Supplements for High Blood Pressure

In the past 10 years, many Americans have turned to omega-3 fish oil supplements. These supplements help boost the body's supply of marine omega-3 fatty acids. Dietary fish and fish oil supplements have many benefits for healthy people and also those with cardiovascular disease.
Omega-3 fish oil contains both docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).Omega-3 fatty acids are very important in preventing and managing cardiovascular disease.

How much omega-3 fish oil is safe?

Taking no more than 3 grams of fish oil daily is classified by the FDA as Generally Recognized As Safe (GRAS) -- with no more than 2 grams per day from supplements.

Are there side effects with omega-3 fish oil?

Side effects from omega-3 fish oil may include:

• a fishy taste in your mouth
• fishy breath
• stomach upset
• loose stools
• nausea

Taking more than 3 grams of fish oil daily may increase the risk of bleeding. Higher doses of fish oil may also compromise your immune function.
If you want to take higher doses of omega-3 fish oil supplements, talk to your doctor first. Your doctor can guide you in supplementing your diet with omega-3 fish oil. Also, your doctor can monitor all aspects of your health if you take higher doses of fish oil. Prescription supplements are also available.

Are there recommendations for taking omega-3 fish oil?

Here's what the American Heart Association (AHA) suggests:

• Eat a variety of fish (preferably fatty fish) at least twice a week. Dietary fatty fish includes tuna, mackerel, salmon, and herring.
• If you have heart disease, take 1 gram of omega-3 fish oil daily. This can be from dietary fish or supplements.
• If you have high triglycerides, take 2 to 4 grams of omega-3 fish oil a day (in consultation with your doctor.)

While omega-3 fish oil can help reduce high blood pressure, triglycerides, and sudden cardiac death, there are other important uses for omega-3 fish oil. For instance, adding omega-3 fatty acids to infant formula has shown great benefit in infant neural growth and development.

WebMD Medical Reference

SOURCES:
National Medicines Comprehensive Database: "Fish Oil."
American Heart Association: "Fish and Omega 3 Fatty Acids."
Geleijnse J.M. J Hypertens, 2002; vol 20: p 1493.
Oh R. The Journal of the American Board of Family Practice, 2005; vol 18: pp 28-36.

© 2009 WebMD, LLC. All rights reserved.

24 Foods That Can Save Your Heart

(1) Fresh Herbs

Fresh herbs make many other foods heart-healthy when they replace salt, fat, and cholesterol. These flavor powerhouses, along with nuts, berries — even coffee — form a global approach to heart-wise eating. Read on for 23 more delicious ways to fight heart disease, stroke, high blood pressure, high cholesterol, and diabetes.

Fact: Rosemary, sage, oregano, and thyme contain antioxidants.

(2) Black Beans

Mild, tender black beans are packed with heart-healthy nutrients including folate, antioxidants, magnesium for lowering blood pressure, and fiber — which helps control both cholesterol and blood sugar levels.

Tip: Canned black beans are quick additions to soups and salads. Rinse to remove extra sodium. 

(3) Red Wine and Resveratrol

If you drink alcohol, a little red wine may be a heart-healthy choice. Resveratrol and catechins, two antioxidants in red wine, may protect artery walls. Alcohol can also boost HDL, the good cholesterol.

Tip: Don't exceed one drink a day for women; one to two drinks for men – and talk to your doctor first. Alcohol may cause problems for people taking aspirin and other medications. Too much alcohol hurts the heart.

(4) Salmon Super Food

A top food for heart health, it's rich in the omega-3s EPA and DHA. Omega-3s lower risk of rhythm disorders, which can lead to sudden cardiac death. Salmon also lowers blood triglycerides and reduces inflammation. The American Heart Association recommends two servings of salmon or other oily fish a week.

Tip: Bake in foil with herbs and veggies. Toss extra cooked salmon in fish tacos and salads.

(5) Tuna for Omega-3s  

Tuna is a good source of heart-healthy omega-3s; it generally costs less than salmon. Albacore (white tuna) contains more omega-3s than other tuna varieties. Reel in these other sources of omega-3s, too: mackerel, herring, lake trout, sardines, and anchovies.

Tip: Grill tuna steak with dill and lemon; choose tuna packed in water, not oil. 

(6) Extra Virgin Olive Oil

This oil, made from the first press of olives, is especially rich in heart-healthy antioxidants called polyphenols, as well as healthy monounsaturated fats. When olive oil replaces saturated fat (like butter), it can help lower cholesterol levels. Polyphenols may protect blood vessels.

Tip: Use for salads, on cooked veggies, with bread. Look for cold-pressed and use within six months. 

(7) Walnuts

A small handful of walnuts (1.5 ounces) a day may lower your cholesterol and reduce inflammation in the arteries of the heart. Walnuts are packed with omega-3s, monounsaturated fats, and fiber. The benefits come when walnuts replace bad fats, like those in chips and cookies – and you don't increase your calorie count.

Tip: A handful has nearly 300 calories. Walnut oil has omega–3s, too; use in salad dressings. 

(8) Almonds

Slivered almonds go well with vegetables, fish, chicken, even desserts, and just a handful adds a good measure of heart health to your meals. They're chock full of vitamin E, plant sterols, fiber, and heart-healthy fats. Almonds may help lower LDL cholesterol and reduce the risk of diabetes.

Tip: Toast to enhance almonds' creamy, mild flavor. 

(9) Edamame

These green soybeans are moving beyond Japanese restaurants, where they're a tasty appetizer. They're packed with soy protein, which can lower blood triglyceride levels. A half cup of edamame also has 9 grams of cholesterol-lowering fiber — equal to four slices of whole-wheat bread.

Tip: Try frozen edamame, boil, and serve warm in the pod. 

(10) Tofu

Make soy protein the main attraction more often at dinnertime by cooking with tofu instead of red meat. You gain all the heart-healthy minerals, fiber, and polyunsaturated fats of soy — and you avoid a load of artery-clogging saturated fat.

Tip: Chop firm tofu, marinate, then grill or stir-fry, going easy on the oil. Add tofu to soups for protein with no added fat. 

(11) Sweet Potatoes

Sweet potatoes are a hearty, healthy substitute for white potatoes for people concerned about diabetes. With a low glycemic index, these spuds won't cause a quick spike in blood sugar. Ample fiber, vitamin A, and lycopene add to their heart-healthy profile.

Tip: Enhance their natural sweetness with cinnamon and lime juice, instead of sugary toppings. 

(12) Oranges

This sweet, juicy fruit contains the cholesterol-fighting fiber pectin — as well as potassium, which helps control blood pressure. A small study shows that OJ may improve blood vessel function and modestly lower blood pressure through the antioxidant hesperidin.

Tip: A medium orange averages 62 calories, with 3 grams of fiber. 

(13) Swiss Chard

The dark green, leafy vegetable is rich in potassium and magnesium, minerals that help control blood pressure. Fiber, vitamin A, and the antioxidants, lutein and zeaxanthin, add to the heart-healthy profile.

Tip: Serve with grilled meats or as a bed for fish. Saute with olive oil and garlic until wilted, season with herbs and pepper. 

(14) Carrots

The latest research on carrots shows these sweet, crunchy veggies may help control blood sugar levels and reduce the risk of developing diabetes. They're also a top cholesterol-fighting food, thanks to ample amounts of soluble fiber — the kind found in oats.

Tip: Sneak shredded carrots into spaghetti sauce and muffin batter. 

(15) Barley

Try this nutty, whole grain in place of rice with dinner or simmer barley into soups and stews. The fiber in barley can help lower cholesterol levels and may lower blood glucose levels, too.

Tip: Hulled or "whole grain" barley is the most nutritious. Barley grits are toasted and ground; nice for cereal or as a side dish. Pearl barley is quick, but much of the heart-healthy fiber has been removed. 

(16) Oatmeal

Oats in all forms can help your heart by lowering LDL, the bad cholesterol. A warm bowl of oatmeal fills you up for hours, fights snack attacks, and helps keep blood sugar levels stable over time — making it useful for people with diabetes, too.

Tip: Swap oats for one-third of the flour in pancakes, muffins, and baked goods. Use oats instead of bread crumbs in cooking. 

(17) Flaxseed

This shiny, honey-colored seed has three elements that are good for your heart: fiber, phytochemicals called lignans, and ALA, an omega-3 fatty acid found in plants. The body converts ALA to the more powerful omega-3s, EPA and DHA.

Tip: Grind flaxseed for the best nutrition. Add it to cereal, baked goods, yogurt, even mustard on a sandwich. 

(18) Low-Fat Yogurt

While low-fat dairy is most often touted for bone health, these foods can help control high blood pressure, too. Milk is high in calcium and potassium and yogurt has twice as much of these important minerals. To really boost the calcium and minimize the fat, choose low-fat or non-fat varieties.

Tip: Use milk instead of water in instant oatmeal, hot chocolate, and dried soups. 

(19) Foods Fortified With Sterols

Want the heart-healthy power of vegetables in your milk or on toast? Margarine, soy milk, or orange juice can deliver — when they're fortified with cholesterol-fighting sterols and stanols. These plant extracts block cholesterol absorption in the gut and can lower LDL levels by 10% without affecting good cholesterol.

Tip: Consume at least 2 grams of sterols a day. 

(20) Coffee

Coffee and tea may help protect your heart by warding off type 2 diabetes. Studies show that people who drink 3-4 cups a day may cut their risk by 25% — and even decaffeinated coffee works. Caution is due, however, for those who already have diabetes or hypertension; caffeine can complicate these conditions.

Tip: Choose black coffee or a non-fat latte to limit fat and calories. 

(21) Cayenne Chili Pepper

Shaking hot chili powder on food may help prevent a spike in insulin levels after meals. A small study in Australia showed that simply adding chili to a hamburger meal produced lower insulin levels in overweight volunteers.

Tip: Chili powder is a blend of five spices, while dried chili pepper comes from a single hot pepper. Both are good substitutes for salt in recipes. 

(22) Kosher Salt

This may be worth a try for people with high blood pressure. Kosher salt may give you more salty flavor with less actual salt -- and less sodium -- than if you sprinkled table salt on your food. The larger crystals impart more flavor than finely ground salt. You’ll still need to measure carefully; a teaspoon of Kosher salt has 1,120-2,000 mg of sodium, while the daily limit for most people is 1,500 mg. And in cooking, the taste advantage is lost. 

(23) Cherries

Cherries are packed with anthocyanins, an antioxidant believed to help protect blood vessels. Cherries in any form provide these heart-healthy nutrients: the larger heart-shaped sweet cherries, the sour cherries used for baking, as well as dried cherries and cherry juice.

Tip: Sprinkle dried cherries into cereal, muffin batter, green salads and wild rice. 

(24) Blueberries

The list of healthy nutrients in blueberries is extensive: anthocyanins give them their deep blue color and support heart health. Blueberries also contain ellagic acid, beta-carotene, lutein, vitamin C, folate, magnesium, potassium, and fiber.

Tip: Add fresh or dried blueberries to cereal, pancakes, or yogurt. Puree a batch for a dessert sauce.

View Slideshow: http://www.webmd.com/heart-disease/slideshow-foods-to-save-your-heart?ecd=wnl_dia_081611

© 2010 WebMD, LLC. All rights reserved.

Healthy Diet Basics for Diabetes

A diet for diabetes is really a healthy diet, controlled in calories, fat, sugar, carbohydrates, and salt. The foods that are good for controlling your blood sugar are good for everyone. Several components of your diet -- including the amounts of carbohydrate, fat, and protein that you eat -- affect your blood sugar levels. So to keep your blood sugar levels normal, you need to make healthy food choices, eat regularly without skipping meals, exercise regularly, and take the medicines your doctor prescribes.
Eating a properly balanced diet can help people with diabetes:

• Maintain a healthy weight or lose weight, if you are overweight.
• Prevent low blood glucose reactions.
• Reduce your risk of health problems caused by diabetes, such as heart disease and high blood pressure.
• Control your blood sugar levels.
• Control your cholesterol levels.

A registered dietitian can be helpful in creating an individualized meal plan that works for you. He or she can provide in-depth nutrition education to help you develop a personalized meal plan that fits with your lifestyle and activity level, and medical needs.

General Guidelines for a Diabetes Meal Plan

In general, a healthy diet is a healthy diet. The food choices you should make are those that would benefit everyone, whether or not they have diabetes. For example, eat plenty of fruits and vegetables, keep fat and sugar consumption down, and keep portions reasonable. Here are a few additional guidelines to remember:

• Eat a wide variety of foods. Having a colorful plate is the best way to ensure that you are eating plenty of fruits, vegetables, lean meats, and other forms of protein such as nuts, low fat dairy products, and whole grains/cereals.
• Maintain a healthy weight. If you are overweight, losing 5%-10% of your body weight could help improve your diabetes.
• Choose foods high in fiber such as whole grain breads, fruit, and cereal. You need 25 to 35 grams of fiber per day.
• Watch your portions. Eat only the amount of food in your meal plan. Eat about the same amount of food each day.
• Distribute meals three to five hours apart.
• Do not skip meals.
• Eat meals and snacks at regular times every day. If you are taking a diabetes medicine, eat your meals and take your medicine at the same times each day.

A Diabetes Meal Plan and Sugar

You might have heard that, as a diabetic, you shouldn't have any table sugar. While some doctors continue to promote this, many -- realizing that the average person lives in the real world and will probably indulge in a bit of sugar every now and then -- have adopted a more forgiving view. Most experts now say that small amounts of sugar are fine, as long as they are part of your overall healthy meal plan and consumed with other foods. Keep these tips in mind:

• Read food labels. Learn how to determine how much sugar or carbohydrates are in the foods that you eat.
• Substitute, don't add. When you eat a sugary food, such as cookies, cakes, or candies, substitute them for another carbohydrate or starch (for example, potatoes) that you would have eaten that day unless the sweet treat is included in your meal plan.
• Sugary foods can be fattening. Many foods, like chocolate, that have a lot of table sugar and tend to be high in calories and fat. If you are watching your weight (and most diabetics must), you need to eat these foods in moderation!
• Check your blood sugar after eating sugary foods and talk to your doctor about how to adjust your insulin if needed when eating sugars.

Sample Diabetes Meal Plan

Here's a sample meal plan that is about 1,600 calories and 208 grams of carbohydrate. Remember to drink plenty of water with each meal.

Breakfast

(360 calories, 52.5 grams carbohydrate)
1 slice toasted whole wheat toast with 1 teaspoon margarine
1/4 cup egg substitute or cottage cheese
1/2 cup oatmeal
1/2 cup skim milk
1/2 small banana

Lunch

(535 calories, 75 grams carbohydrate)
1 cup vegetable soup with 4-6 crackers
1 turkey sandwich (2 slices whole wheat bread, 1 ounce turkey and 1 ounce low-fat cheese, 1 teaspoon mayonnaise)
1 small apple

Dinner

(635 calories, 65 grams carbohydrate)
4 ounces broiled chicken breast with basil and oregano sprinkled on top
2/3 cup cooked brown rice
1/2 cup cooked carrots
1 small whole grain dinner roll with 1 teaspoon margarine
Tossed salad with 2 tablespoons low-fat salad dressing
4 unsweetened canned apricot halves OR 1 small slice of angel food cake

Snack

(Each has 60 calories or 15 grams carbohydrate. Pick two per day.)
16 fat-free tortilla chips with salsa
1/2 cup artificially sweetened chocolate pudding
1 ounce string cheese plus one small piece of fruit
3 cups "lite" popcorn

Note: If you are taking some of the newer diabetes medicines, some of these tips may not apply to you; ask your health care provider.

© 2011 WebMD, LLC. All rights reserved. 

Reversal of misfortune; can diabetes be reversed?

Reversing diabetes is a top of mind subject for anyone who has ever suffered from the onset or daily threat of this disease. While the debate continues on about whether or not the disease can be reversed, here’s what I have found (resources listed within of this blog) through various resources including an interesting article written by CNN (http://www.cnn.com/2011/HEALTH/01/28/reverse.diabetes/index.html) reporting on a middle aged man who found a way to “stave-off” the onset of Type II diabetes. 

What is diabetes?

Diabetes means simply one thing: Your blood sugar (glucose/sugar) levels are too high.  Glucose comes from the food we eat, is stored in our muscles and liver and is used by our body to slowly supply us with the energy we need throughout the day. The pancreas produces insulin, which in turn helps the glucose transfer from our blood into our cells, converting the glucose into energy. Diabetes occurs when our pancreas doesn’t produce enough insulin or our body doesn’t use the insulin produced effectively or well. When glucose builds up in our blood it can’t get into our cells. If our blood sugar/glucose levels stay too high damage can occur to our eyes, heart, kidney’s and nerves.

 

Type I versus Type II Diabetes

Type I Diabetes is typically diagnosed in childhood, defined as “insulin dependent”, and rarely (unless a miracle occurs) reversible. Simply put, your body no longer makes insulin and requires medical intervention. However, just because you are using medicine to produce the insulin you need doesn’t mean you eat or drink anything you want and/or not exercise. Maintaining a balanced diet and exercise regiment is vital for those who suffer from this disease.  The best methods to help your body handle this disease are: Avoiding processed food, refined sugar, fatty and starchy foods, while increasing lean protein, complex carbohydrates and daily exercise, along with the assistance of medicine and professional/medical advice from a diabetic specialist. Each proactive step you take will help you avoid the complications caused by this disease.   

Type II Diabetes is very different from Type I: With Type I your body doesn’t produce insulin versus Type II your body’s fat, muscle and liver cells do not use insulin properly. Type II occurs when there is too much glucose or sugar in the blood, making the body “resist” or become “insensitive” to the cells that produce insulin. In other words, our body is producing insulin (a hormone produced by the pancreas) but not at a rate that is required to breakdown the sugar/glucose in our blood which comes through the food/beverage in our diet.  When our body doesn’t produce the insulin we need to break down the sugar we’ve consumed our body suffers the consequences from the build-up of sugar in our body, which can eventually lead to loss of eye sight, limbs, etc. (http://diabetes.niddk.nih.gov/dm/pubs/type1and2/what.aspx)

Body shape/contour is a good indicator of those who are more susceptible to Type II diabetes but is not the only defining factor. Mid-section weight (belly weight) greatly affects the onset of Type II diabetes.  However, don’t think that if you aren’t overweight you aren’t susceptible to acquiring this disease.

Pre-Diabetes

The onset of diabetes is called “pre-diabetes”, typically found in Type II diabetics. The good news is this: you can help stop the progression of this disease during the initial stage/onset through nutrition and exercise. The following nutritional/exercise tips will help you get started in your process. Always seek medical/professional advice from someone who specializes in diabetes.

Proper nutrition

Type II can be a reflection of lifestyle (poor diet and exercise) but can also be a genetic pre-disposition (http://www.diabetes.org/diabetes-basics/genetics-of-diabetes.html.) In other words, your pancreas might not function properly to produce what your body needs. If caught before it becomes full blown diabetes, Type II can be treated through proper diet and exercise, possibly allowing our body to “reverse” the disease. Avoiding fatty foods, processed food, refined sugar, alcohol, etc., and choosing fresh produce (fruits, vegetables), lean protein/seafood, healthy grains, legumes, and a regular/daily exercise program can help the body become balanced, avoiding the strain on our insulin to balance excessive glucose levels. 

Some of the ways in which you can help your body to naturally heal and/or balance itself are as follows:

*Exercise – 30-45 minutes a day of aerobic exercise (walking, running, swimming, anything that requires a consistent breathing with some exertion). Cross training, body building are also helpful in restore/rebuilding the body. If you haven’t been exercising, start with what you can do now! Avoid making excuses and think of your daily 30-45 minutes of routine exercise as a gift you’re giving yourself.

*Nutrition – One way to determine what you should/shouldn’t eat to balance your glucose levels is to monitor your food/beverage intake. An easy way to do this is to monitor the Glycemic Index value for the foods you eat. Below are some resources for the GI values and charts.

*Antioxidants – Increase your daily intake of antioxidants through consuming more plant food (i.e. fruits, vegetables). Sometimes, supplements are required to meet the demand of your body’s needs. However, when possible, eat your antioxidants first through nutrition.

*Glycemic index – Monitor the food you eat using a GI chart. A helpful online resource is http://www.glycemicindex.com/. This resource allows you to input your food/beverage to determine its GI value.

GI values can be interpreted intuitively as percentages on an absolute scale and are commonly interpreted as follows: (resource http://en.wikipedia.org/wiki/Glycemic_index)

Classification	GI range	Examples
Low GI	55 or less	most fruits and vegetables, legumes/pulses, whole grains, nuts, fructose and products low in carbohydrates
Medium GI	56–69	whole wheat products, basmati rice, sweet potato, sucrose, baked potatoes
High GI	70 and above	white bread, most white rices, corn flakes, extruded breakfast cereals, glucose, maltose

 

*Foods to eat – Oats, barley, whole grains, red and sweet potatoes, fresh fruit/vegetables (limit your “watermelon” intake), Basmati and Brown rice, salads (limit the dressing to olive oil/vinegar or vinaigrette dressings), lean protein/fish (oily fish at least twice a week), low fat butter (I Can’t Believe It’s Not butter Light), olive/flax/sunflower oils.

*Foods to avoid – Fast food/preservatives, alcohol, bottled/canned juice, energy drinks, sodas (if it’s been reproduced/processed it’s not worth eating). Enriched and/or bleached bread (usually white bread but also some grain bread). Most breakfast cereals (many have hidden ingredients and added sugar and/or corn syrup). 

*Water – Half your body weight in ounces each day. Example: 150 lbs = 75 oz. Purified, distilled, or mineral water are good choices when it comes to water. Aqua Fina is my personal choice for bottled water.

*Labels – Learn to read the label on food. The USDA provides the following resource on learning how to read labels and understand what your body needs and what you are consuming through the food and beverage you consume. (http://www.fda.gov/food/labelingnutrition/consumerinformation/ucm078889.htm)

 

Quick Tips for Wellness, Copyright © 2011, All Rights Reserved  

How to measure your blood pressure

HYDERABAD: For many years, we have been told that high blood pressure as measured in your doctor’s office is harmful to your heart, kidneys and brain and could lead to heart attacks, heart failure and kidney disease. Like most things in this world, there are multiple facets to everyday life and your true blood pressure level is not as simple and easy to measure as we may think.

New and novel ways of measuring a person’s blood pressure have identified different patterns of blood pressure variation. Some of these patterns of high blood pressure are bad for a person’s health, a few being potentially worse than others, while at the opposite end of the spectrum there are some which are harmless and do not need medication. Blood pressure measurement in the physician’s office has been a longstanding and usual practice. In fact, the most common reason a patient visits a physician’s office is for management of his blood pressure. World experts in hypertension have outlined very specific guidelines for the method to be followed in measuring a person’s blood pressure. If the correct method is not utilised, then there could be inaccuracies in the blood pressure measurement.

Dos and Dont's to measure blood pressure

Very briefly, the patient whose blood pressure is to be measured should avoid tobacco, coffee and tea at least for a few hours before this is done. The person should rest for five to 10 minutes in a comfortable chair with a back-rest, feet flat on the ground. The blood pressure monitor should be placed at the level of the heart and the blood pressure cuff should be of appropriate size. Blood pressure should be measured several times at intervals of at least one to two minutes between readings/measurements. Ideally, the first blood pressure reading should be discarded and then all the subsequent readings averaged to give the person’s blood pressure measurement. Blood pressure should not be measured when a patient is anxious or under stress. It is often seen that none of these basic requirements for measuring blood are followed during general visits to the doctor. Mostly, only a single reading is taken, the person may not be given time to relax and blood pressure may be measured in a rushed manner due to lack of time. This leaves scope for much inaccuracy in blood pressure measurement and often a high reading may be obtained if the patient is tired, stressed, rushed or anxious. This will result in a person being wrongly informed that he has high blood pressure and antihypertensive medications may be started when they may not actually be necessary. What is ideally required is that a true blood pressure reading be obtained first as recommended by expert guidelines.

24 hour ambulatory blood pressuremonitoring system.

An important device that has been introduced recently and has grown in acceptance as being vital for accurate blood pressure measurement is the 24 hour ambulatory blood pressure monitoring system. This device is the size of a cell phone, is attached to a blood pressure cuff and is worn by a patient for a 24 hour period on a regular day when he goes about his usual activities and work. The 24-hour ambulatory monitor measures and records the person’s blood pressure automatically several times during the day and during the night while sleeping. These serial blood pressure measurement data are then uploaded to a computer and analysed. The average value of these 70-80 readings during the 24 hour period is now considered the most accurate blood pressure measurement for that person and is considered the gold standard for blood pressure measurement.

White Coat Hypertension vs Masked Hypertension

Several patterns of blood pressure can be noted in patients who have their blood pressure measured in their doctor’s office. A patient may have elevated high blood pressure when measured in the doctor’s office but normal blood pressure readings when measured in out-of-clinic settings, such as at home. This phenomenon is termed as white coat hypertension. Studies show that this is generally a benign condition that does not require treatment. The problem with White Coat hypertension is that, if physicians rely only on office blood pressure measurements, they may add or increase antihypertensive medications based on this, which is not necessary. Such patients with white coat hypertension often end up experiencing unwanted side effects and adverse effects related to excessive antihypertensive medications, which were not necessary in the first place.

On the other hand, there are a few patients who have normal blood pressure and appear to be well controlled on treatment for hypertension, when their blood pressure is measured in the doctor’s office. However, it is interesting to note that on 24 hour ambulatory blood pressure monitoring, these patients may actually have an elevated blood pressure average which needs to be addressed for optimal blood pressure control. This pattern of high blood pressure has been termed as Masked Hypertension, and such patients could be missed if their doctors relied only upon usual office blood pressure measurement techniques.

Measurement of 24 hour blood pressure has recently identified a new pattern of blood pressure, now termed as nocturnal hypertension. The patients who have nocturnal hypertension are relatively well controlled, but their blood pressure levels are elevated at night. Nocturnal hypertension like masked hypertension is harmful to vital organs.

Trials are underway to see if controlling night time blood pressure offers protection and preserves these organs.Careful and thorough evaluation of a patient with hypertension is fundamental in providing optimal care to those with truly elevated blood pressure.

(The author is an American Board certified nephrologist and a leading hypertension expert at Nephrology Department at Apollo Hospitals Hyderguda. He also runs Apollo’s Center for Blood Pressure Management)

Express News Service , The New Indian Express

14 Tips For Dealing With Male Incontinence

About 25 million Americans have urinary incontinence. It's estimated that three-fourths are women, but that leaves more than five million men with bladder problems. Men can have incontinence due to an enlarged prostate or prostate surgery, but other causes may play a role too. Still, men are often uninformed about the issues, and they may face challenges -- physically, socially and emotionally -- when dealing with the diagnosis. Here's what you should know about male incontinence.

It's more than post-void drips.

Most men have mild post-void drips, hence the oft-quoted, "No matter how much you shake and dance, the last two drops get on your pants." But frequent, excess leakage after urination is not normal, says William Steers, M.D., chair of the urology department and Paul Mellon professor at the University of Virginia School of Medicine, in Charlottesville. If it makes you uncomfortable, shows through your clothes or causes skin irritation, it's a form of incontinence -- and it could be a symptom of a more serious problem.

It's not uncommon.

Between 2 percent and 15 percent of men ages 15 to 64, and 5 percent to 15 percent of men over 60 who live at home (as opposed to a nursing home), have incontinence, according to the National Association for Continence (NAFC). Prostate removal for cancer treatment is one of the most common causes. "Most patients who come to see me about stress urinary incontinence are men who've had surgery for prostate cancer, nine out of 10," says Dr. Steers. (In stress incontinence, coughing and sneezing can trigger leakage).

If patients have stress incontinence and have not had prostate surgery, another condition -- such as a neurological disorder, spinal injury or diabetes -- may be to blame, says Dr. Steers.

Extra weight can be a cause.

As you age, the muscles that control bladder function start to lose strength, and weight gain can put extra pressure on the bladder. Although obesity seems to affect women more than men when it comes to bladder control, Dr. Steers says he's increasingly seeing the connection in his male patients. Cigarette smoking, heavy drinking and diabetes also increase a man's risk of bladder problems.

Prostate trouble is often to blame.

Most men experience prostate enlargement with age. It can block the urethra and cause overflow incontinence, which is the leakage of a small amount of urine, or difficulty urinating. Prostate removal due to cancer can also damage or weaken the pelvic floor muscles and nerves around the bladder, and it may cause significant leakage issues for about half of men just after surgery. One in five still has problems a year or more later. This is one reason doctors often suggest "watchful waiting" for slow-growing prostate cancers, says Dr. Steers. Delaying the surgery can also help you avoid erectile dysfunction.

Parkinson's disease and stroke can play a role.

In some men, incontinence problems can be caused by nerve damage from diabetes, a stroke, Parkinson's disease (which mostly affects men), or multiple sclerosis (which mostly affects women). In addition, men are more likely to be involved in car or motorcycle accidents, workplace injuries or active-duty combat, which puts them at higher risk for spinal cord injuries that can trigger incontinence, says Nancy Muller, Ph.D., executive director of the NAFC.

Male-geared products may help.

"Fortunately, the manufactures of adult absorbent products have recognized, finally, that the male anatomy is different from female," says Muller. "Only recently have major incontinence brands come out with gender-specific adult products." Men can find absorbent or disposable underwear, ranging from briefs to boxers, as well as compression pouches that support the urethra, in most pharmacies. For severe incontinence episodes, consider an external collection unit, which fits like a sheath over the penis and contains a collection bag (that fits inside a pair of briefs).

Surgical options exist

Men with severe stress incontinence can consider surgery if other therapies fail. Doctors can implant an artificial rubber sphincter around the urethra. The sphincter is inflated and deflated to control urine flow. Another procedure, called the bulbourethral sling (or male sling), supports the urethra with a mesh hammock.

Urge incontinence can be treated with sacral nerve stimulation, a pacemaker-like electrical stimulator that is implanted under the skin and sends signals to the sacral nerve to control bladder activity. Doctors may also recommend prostate surgery for cases of overflow incontinence caused by an enlarged prostate.

There are medications for men.

Medications for male incontinence often target the underlying cause. For example, drugs can be used to shrink an enlarged prostate or reduce symptoms of neurological disorders. If you experience urge incontinence, also known as overactive bladder, your doctor may prescribe anticholinergic or antispasmodic medications to calm the muscles in your bladder. Certain types of antidepressants are also sometimes effective for bladder problems.

Fluid intake matters.

Watching your fluid intake could help you improve incontinence symptoms, even without medication or surgery. "Sometimes we find that men are drinking full six-packs of beer, and if your resistance is already low, then that's going to cause a problem," says Dr. Steers. "If you make more urine, you stress the system."

Limiting alcohol in general, as well as caffeine and carbonated beverages, can help. Staying hydrated and drinking water when you're thirsty is always healthy, says Dr. Steers, but there's no need to aim for a certain number of glasses a day.

Some medications make it worse.

Some common medicines, such as diuretics, antihistamines and antidepressants, can cause urinary leakage, so your doctor may also look at drugs you're already taking.

Skin problems shouldn't be ignored.

Chronic leakage and post-void "after-dribble" tends to cause more skin irritation in men than in women, says Muller. "They have more problems with rashes and skin fungus, and often don't give enough attention to the perineal area around the scrotum." Moisturizers and barrier creams can keep skin from becoming too dry and inflamed. Men who use absorbent pads or products should change them every few hours to prevent infection.

Men can do Kegels too.

Kegel or pelvic floor exercises, in which you squeeze and hold the muscles you'd use to stop urination, aren't just for women. A small 2010 Italian study suggests that men who do them for one month before prostate removal surgery have less incontinence after. The NAFC recommends a set of 10 slow and 10 fast contractions, two or three times a day, gradually working up to about 80 repetitions a day. "It's just like bench presses at the gym," she says. "Doing too much too soon can actually damage the muscles, so you can't rush into it."

Men have issues some women don't.

Men can face unique physical and emotional challenges with incontinence. "For starters, women are used to wearing pads several days of the month," says Dr. Steers, "whereas a man is not socially attuned to wearing anything down there. Just the idea can be really embarrassing to them." It may also be hard to avoid situations where leakage is common, he adds. More men than women might have jobs that entail heavy lifting, for example, or friends might expect participation in sports like golf and tennis, which can put pressure on the bladder.

There are online resources for men

Only 18 percent of men versus 33 percent of women talk to their doctor about their symptoms, according to an NAFC survey of people with bladder problems. Plus, more online resources are aimed at women. (Men can, however, refer to the What Every Man Should Know section of the NAFC's site). Men who've had prostate surgery may benefit from a prostate cancer support group, which can help address a range of emotional and physical and issues. Local support groups can be found at ustoo.org.

Article from Huffington Post