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Friday, April 27, 2012

11 Tips to Cut Your Cholesterol Fast

Got high cholesterol? Learn what you can do to lower it quickly -- starting today.

How's your cholesterol? If you think that the normal reading you got back in 2004 (or earlier) means you're in the clear, think again: Levels of the artery-clogging substance often rise with age, and cardiologists say everyone 20 or older should be screened for high cholesterol at least once every five years, with more frequent screenings for anyone deemed to be at high risk for heart disease. If it's been awhile since your last cholesterol screening, now's a good time to ask your doctor if you're due for one.

The good news? If your fasting total cholesterol level exceeds the desirable level of 200, or if your low-density lipoprotein (LDL, or "bad”) cholesterol is above 100, getting it down to a safer level could be easier than you think. In fact, with simple lifestyle modifications -- and, if necessary, drug therapy -- people often see significant reductions in cholesterol within six weeks. Get going right now, and by New Year's Eve you could be toasting your cholesterol level rather than resolving to lower it.

1. Set a target.

You know you've got to get your cholesterol number down, but how low do you need to go? That depends on several factors, including your personal and family history of heart disease, as well as whether you have cardiovascular risk factors, such as obesity, high blood pressure, diabetes, and smoking.

If your risk is deemed high, "most doctors will treat for a target LDL of less than 70," says James Beckerman, MD, a cardiologist in private practice in Portland, Oregon. If your risk is moderate, a target LDL of under 130 is generally OK, Beckerman says. If your risk is low, less than 160 is a reasonable target. "The trend now is to treat people earlier, especially if they have two or more risk factors," he says.

2. Consider medication.

Lifestyle modifications make sense for anyone with elevated cholesterol. But if your cardiovascular risk is high, you may also need to take a cholesterol-lowering drug. Michael Richman, MD, medical director of the Center for Cholesterol Management in Los Angeles, calls drug therapy "the only thing that will work fast" to lower high cholesterol. "Everyone should do the basics, like stopping smoking and losing weight," Richman tells WebMD. "But these things lower the risk only modestly. They're nothing to write home about."

Beckerman agrees. "Lifestyle modifications are important, but we should also be emphasizing the benefits of medication when appropriate," he says.

Several types of cholesterol-lowering medication are available, including niacin, bile acid resins, and fibrates. But statins are the treatment of choice for most individuals. "Statins can lower LDL cholesterol by 20% to 50%" says Pamela Peeke, MD, assistant professor of medicine at the University of Maryland School of Medicine in Baltimore.

3. Get moving.

In addition to lowering LDL "bad" cholesterol, regular physical activity can raise HDL "good" cholesterol by up to 10%. The benefits come even with moderate exercise, such as brisk walking.

Robert Harrington, MD, professor of medicine at Duke University School of Medicine in Durham, N.C., urges his patients to go for a 45-minute walk after supper.

Peeke tells WebMD, "I ask people to get a pedometer and aim for 10,000 steps a day. If you work at a desk, get up and walk around for five minutes every hour."

Whatever form your exercise takes, the key is to do it with regularity. "Some experts recommend seven days a week, although I think five days is more realistic," Richman says.

4. Avoid saturated fat.

Doctors used to think that the key to lowering high cholesterol was to cut back on eggs and other cholesterol-rich foods. But now it's clear that dietary cholesterol isn't the main culprit. "Eggs don't do all that much [to raise cholesterol]," Beckerman says. "You don't want to be throwing down six eggs a day, but recent data suggest that it's really saturated fat" that causes increases in cholesterol. And if you cooked your eggs in a slab of butter, don't overlook the fat in the butter.                                          

"One of the first things to do when you're trying to lower your cholesterol level is to take saturated fat down a few notches," says Elaine Magee, MPH, RD, the author of several nutrition books, including the forthcoming Tell Me What to Eat If I Have Heart Disease. "The second thing to do is to start eating more 'smart' fats," Magee says. She recommends substituting canola oil or olive oil for vegetable oil, butter, stick margarine, lard, or shortening while cutting back on meat and eating more fish.

5. Eat more fiber.

Fruits and vegetables, including whole grains, are good sources not only of heart-healthy antioxidants but also cholesterol-lowering dietary fiber. Soluble fiber, in particular, can help lower cholesterol. Beckerman says it "acts like a sponge to absorb cholesterol" in the digestive tract. Good sources of soluble fiber include dried beans, oats, and barley, as well as fiber products containing psyllium.

6. Go fish.

Fish and fish oil are chockablock with cholesterol-lowering omega-3 fatty acids. "Fish oil supplements can have a profound effect on cholesterol and triglycerides," Beckerman says. "There's a lot of scientific evidence to support their use." Fish oil is considered to be quite safe, but check with your doctor first if you are taking an anti-clotting medication.

Magee recommends eating fish two or three times a week. "Salmon is great, as it has lots of omega-3s," she says. But even canned tuna has omega-3s, and it's more consumer-friendly. The American Heart Association also recommends fish as the preferable source of omega-3s, but fish oil capsule supplements can be considered after consultation with your physician. Plant sources of omega-3s include soybeans, canola, flaxseeds, walnuts, and their oils, but they don't provide the same omega-3s as fish. The  biggest heart benefits have been linked to omega-3s found in fish.

7. Drink up.

Moderate consumption of alcohol can raise levels of HDL "good" cholesterol by as much as 10%. Doctors say up to one drink a day makes sense for women, up to two a day for men. But given the risks of excessive drinking, the American Heart Association cautions against increasing your alcohol intake or starting to drink if you don't already.

8. Drink green.

Magee suggests green tea as a healthier alternative to sodas and sugary beverages. Indeed, research in both animals and humans has shown that green tea contains compounds that can help lower LDL cholesterol. In a small-scale study conducted recently in Brazil, people who took capsules containing a green tea extract experienced a 4.5% reduction in LDL cholesterol.

9. Eat nuts.

Extensive research has demonstrated that regular consumption of nuts can bring modest reductions in cholesterol. Walnuts and almonds seem particularly beneficial. But nuts are high in calories, so limit yourself to a handful a day, experts say.

10. Switch spreads.

Recent years have seen the introduction of margarine-like spreads and other foods fortified with cholesterol-lowering plant compounds known as stanols.

11. Don't smoke.

Smoking lowers levels of HDL "good" cholesterol and is a major risk factor for heart disease.

By David Freeman
Reviewed on August 06, 2011

REMINDER: Blog will be moved to http://goldeneramart-healthjunction as of May 1st, 2012.

Wednesday, April 25, 2012

Diabetes and Your Feet: Dos and Don'ts of Foot Care


Having diabetes means you're more like to have problems with your feet. That's partly because diabetes can cause nerve damage, or peripheral neuropathy. Nerve damage can cause a loss of feeling in your feet, so that you may not know whether you have sores or other injuries on your feet.

Foot injuries can easily get infected and go unnoticed, leading to more serious infections and skin ulcers. Because diabetes can make infections harder to treat, these ulcers can develop into deep tissue infections. Extreme cases can lead to amputation.

Fortunately, taking care of your feet is easy if you know what to do. It's important to check your feet every day for redness, blisters, swelling, pain, cuts, or sores. If you can't easily examine your feet, use a mirror, or ask a family member or loved one to check them for you.

One of the best things you can do for your feet is to keep your blood sugar levels under control. Ask your doctor to do a full foot exam at least once a year. Here is a list of specific dos and don'ts for diabetes and foot problems that will help keep your feet as healthy as possible.

Diabetes Foot Care Tips: Dos and Don'ts

DO: Wash your feet every day with mild soap and lukewarm water. Test the water with your elbow or a thermometer (90 to 95 degrees) to make sure it’s not too hot. Carefully pat your feet dry after washing them, making sure to dry between your toes.
DON'T: Don't wash your feet in hot water. It could cause a burn.

DO: Use lotion or petroleum jelly on your feet to keep the skin smooth. Use a non-medicated powder on your feet before putting on your socks and shoes to help keep them dry.
DON'T: Don't use moisturizer between your toes.

DO: Ask your doctor if it’s safe to trim your own nails. Cut your toenails straight across to help prevent ingrown toenails. Then file your toenails so they are not sharp.
DON'T: Round off the corners of your toenails.

DO: Wear shoes whenever you’re on your feet.
DON'T: Don't walk around barefoot.

DO: Make sure your shoes fit well and have plenty of room. It’s best to shop for shoes at the end of the day, when your feet are usually at their largest.
DON'T: Don't wear shoes that feel tight.

DO: Choose shoes that are made of material that breathes, such as leather, canvas, or suede. Choose a shoe with a cushioned sole for absorbing pressure. Select shoes with laces over loafers because they provide better support.
DON'T: Don't wear sandals, high heels, flip-flops, or shoes with open or pointed toes.

DO: Replace the shoe when signs of wear become apparent, such as heels starting to wear on one side or the inner lining of the shoe is torn. Check the inside of your shoes often for gravel, rough areas, or worn lining.
DON'T: Don't keep wearing shoes that have rough areas or torn pieces inside. Toss them and get a new pair.

DO: See your podiatrist to treat any foot problems, including corns and calluses.
DON'T: Don't try to treat calluses or corns yourself with over-the-counter treatments.

DO: Always wear clean, dry socks.
DON'T: Don't wear stretch socks or socks made of nylon.

DO: Choose socks that are well-padded and change them every day.
DON'T: Don't wear socks that have an inside seam or an elastic band at the top.

DO: Wear socks to bed if you have cold feet.
DON'T: Don't use water bottles, electric blankets, or heating pads on your feet, because they could cause burns.

DO: Wiggle your toes and move your feet around several times a day to keep the blood flowing.
DON'T: Don't stand in one position for a long time or sit with your legs crossed. These positions can block blood flow to your feet.

DO: Stay active. Aim for at least 30 minutes of activity each day. Ask your doctor what type of activity is best for you.
DON'T: Don't smoke. Smoking can also reduce blood flow to your feet.

DO: Tell your doctor about any foot problems right away.
DON'T:  Don't take your feet for granted. Instead, set aside some time every day to pamper your feet and help keep them healthy.

Diabetes and Your Feet: Shoe Tips

  •  Have at least two pairs of shoes so you can wear a different pair every other day.
  • Change your shoes after 5 hours of wearing them, or sit down and remove them for a while to give your feet a break.
  • Break in new shoes slowly. Try wearing them for about an hour a day for the first few days.
  • Ask your doctor if you need special shoes that are fitted to your feet.

Reviewed by Brunilda Nazario, MD on July 01, 2011
© 2011 WebMD, LLC. All rights reserved.

Friday, April 20, 2012

Site Relocation


THANK YOU

To all of my previous visitors and those persons who follow this blog consistently. As of April 30th, 2012. you’ll be redirected to a new site. I’ll continue to provide material at blogspot but not in their entirety. I do hope that this will not prove to be an inconvenience and that your user experience will be enhanced. Your support has been appreciated. You can now view the new site at http://goldeneramart-healthjunction.com. and provide feedback as to how we may improve your user experience.

Thanks for your support
GoldenEraMart Admin

Type 2 Diabetes and Exercise


Exercise is very important in managing type 2 diabetes. Combining diet, exercise, and medicine (when prescribed) will help control your weight and blood sugar level.
Exercise helps control type 2 diabetes by:
  • Improving your body's use of insulin.
  • Burning excess body fat, helping to decrease and control weight (decreased body fat results in improved insulin sensitivity).
  • Improving muscle strength.
  • Increasing bone density and strength.
  • Lowering blood pressure.
  • Helping to protect against heart and blood vessel disease by lowering 'bad' LDL cholesterol and increasing 'good' HDL cholesterol.
  • Improving blood circulation and reducing your risk of heart disease.
  • Increasing energy level and enhancing work capacity.
  • Reducing stress, promoting relaxation, and releasing tension and anxiety.
How Does Exercise Affect Blood Sugar Levels?

Normally, insulin is released from the pancreas when the amount of sugar (glucose) in the blood increases, such as after eating. Insulin stimulates the liver and muscles to take in excess glucose. This results in a lowering of the blood sugar level.
When exercising, the body needs extra energy or fuel (in the form of glucose) for the exercising muscles. For short bursts of exercise, such as a quick sprint to catch the bus, the muscles and the liver can release stores of glucose for fuel. With continued moderate exercising, however, your muscles take up glucose at almost 20 times the normal rate. This lowers blood sugar levels.
But intense exercise can have the opposite effect and actually increase your blood glucose levels. This is especially true for many people with diabetes. The body recognizes intense exercise as a stress and releases stress hormones that tell your body to increase available blood sugar to fuel your muscles. If this happens to you, you may need a little bit of insulin after intense workouts.
For a variety of reasons, after exercise, people with diabetes may have an increase or a decrease in their blood sugar levels.

Is Blood Sugar Ever Too High to Exercise?

Yes. In some cases, you should hold off on exercising if your blood sugar is very high.

What Types of Exercise Are Best for Diabetes?

While most any exercise is healthy for people with diabetes, let's look at some specific types of exercise and their benefits:

Strength Training and Type 2 Diabetes
 
The latest findings show that exercise such as strength training has a profound impact on helping people manage their diabetes. In a recent study of Hispanic men and women, 16 weeks of strength training produced dramatic improvements in sugar control that are comparable to taking diabetes medication. Additionally, the study volunteers were stronger, gained muscle, lost body fat, had less depression, and felt much more self-confident.

Aerobic Fitness and Type 2 Diabetes
 
Any activity that raises your heart rate and keeps it up for an extended period of time will improve your aerobic fitness. Aerobic exercise helps decrease the risk of type 2 diabetes and helps those with diabetes to better manage their blood sugar levels. Besides the health benefits, exercise is fun and boosts your mood. It's hard to feel stressed when you're walking fast on a treadmill or swimming laps in a pool.

Type 2 Diabetes and Exercise Tips
  • To reduce the risk of hypoglycemia if you have diabetes, follow a regular routine of exercising, eating your meals, and taking your medicines at the same time each day.
  • Prolonged or strenuous exercise can cause your body to produce adrenaline and other hormones that can counteract the effects of insulin and cause your blood sugar to rise. If you are participating in strenuous exercise (exercising at your maximum capacity) or prolonged exercise (lasting for several hours or more), your insulin and/or oral diabetic medicine may need to be changed. Talk to your health care provider about how to adjust your medicine.
  • Be careful exercising when your medicine is reaching its peak effect.
  • Depending on the time of exercise, reducing your dose of either long-acting insulin or short-acting insulin will be necessary. Your doctor can recommend how to make this adjustment.
  • Exercise with someone who knows you have diabetes and knows what to do if you have a low blood-sugar reaction.
  • Wear a medical identification tag (for example, MedicAlert) or carry an identification card that states you have diabetes.
More Diabetes-Specific Exercise Tips

The American Diabetes Association offers these basic exercise guidelines for those with diabetes:
  • Discuss with your doctor what types of exercise might be appropriate for you. Complications of diabetes such as severe eye disease and nerve damage may make some forms of exercise dangerous for you. Your doctor may also schedule a test to see how your heart responds to exercise.
  • Do not exercise if your blood sugar is greater than 250 mg/dL (milligrams per deciliter) and your ketones positive. This is an indication that you already may have a lack of insulin and exercise will only cause a greater rise in your blood sugar. Hydrate yourself and adjust your insulin as necessary, contact your health care provider.
  • Use caution when exercising if your blood sugar is greater than 300 mg/dL without evidence of ketones, exercise may help decrease your sugars, but it's possible they will increase instead. Hydrate well prior to and after exercise and keep track of your sugars and ketones.
  • Learn the effects of various types of exercise on your blood sugar.
  • Have carbohydrate-based foods available for exercise and for the period following exercise. Add carbohydrates to your meals if you plan on doing exercise, adjust your insulin dose appropriately in anticipation of exercise.
General Exercise Guidelines and Precautions
  • If you have diabetes, check with your health care provider before you begin an exercise program. Tell your doctor what kind of exercise you want to do so adjustments can be made to your medicine schedule or meal plan, if necessary.
  • Start slowly and gradually increase your endurance.
  • Choose an activity that you enjoy. You'll be more likely to stick with a program if you enjoy the activity. Make exercise a lifetime commitment.
  • Consider a water exercise program. Some other exercise options include walking, riding a stationary bicycle, swimming, or muscle stretching.
  • Exercise at least three to four times per week for 20 to 40 minutes each session. Ideally, you should exercise every day. A good exercise program should include a 5- to 10-minute warm-up and at least 15 to 30 minutes of continuous aerobic exercise (such as walking or biking) or muscle stretching exercises, followed by a 5-minute cool down.
  • Wear good shoes and practice proper foot care.
  • Drink water before, during, and after exercise to prevent dehydration.
  • Do not ignore pain -- discontinue any exercise that causes unexpected pain. If you continue to perform the activity while you are in pain, you may cause unnecessary stress or damage to your joints.

Should I Stop Exercising When I Reach My Ideal Weight?

Exercise is a lifetime commitment. Regardless of your weight, you should exercise at least three to four times per week for 20 to 40 minutes each session. Ideally, you should exercise every day to help manage your type 2 diabetes long-term.

© 2009 WebMD, LLC. All rights reserved.

How the Blood Sugar of Diabetes Affects the Body


Diabetes mellitus leads to persistently elevated blood sugar levels. Over time, high sugar levels damage the body and can lead to the multiple health problems associated with diabetes.

But why are high blood sugars so bad for you? How much sugar in the blood is too much? And what are good sugar levels, anyway? WebMD takes a look at how your sugar level affects diabetes and your health.

Diabetes and Normal Blood Sugar Levels

At present, the diagnosis of diabetes or prediabetes is based in an arbitrary cut-off point for a normal blood sugar level. A normal sugar level is currently considered to be less than 100 mg/dL when fasting and less than 140 mg/dL two hours after eating. But in most healthy people, sugar levels are even lower.

During the day, blood glucose levels tend to be at their lowest just before meals. For most people without diabetes, blood sugar levels before meals hover around 70 to 80 mg/dL. In some, 60 is normal; in others, 90. Again, anything less than 100 mg/dL while fasting is considered normal by today's standards.

What's a low sugar level? It varies widely, too. Many people's sugar levels won't ever fall below 60 mg/dL, even with prolonged fasting. When you diet or fast, the liver keeps sugar levels normal by turning fat and muscle into sugar. A few people's sugar levels may fall somewhat lower. Without taking diabetes medicine, though, or having uncommon medical problems, it's difficult to drop sugar levels to an unsafe point.

Sugar Levels, Diabetes, and Prediabetes

Sugar levels higher than normal mean either diabetes or pre-diabetes is present.
There are several ways diabetes is diagnosed.
  • The first is known as fasting plasma glucose. A person is said to have diabetes if his or her fasting blood sugar level is higher than 126 mg/dL after not eating -- fasting -- for eight hours.
  • The second method is with an oral glucose tolerance test. After fasting for eight hours, a person is given a special sugary drink. That person is said to have diabetes if two hours after the drink he or she has a sugar level higher than 200.
  • The third way is with a randomly checked blood sugar level. If it is greater than 200, with symptoms of increased urination, thirst, and/or weight loss, that person is said to have diabetes. A fasting sugar level or oral glucose tolerance test will be needed to confirm the diagnosis.
But diabetes is not like a switch that gets turned on and off -- healthy one day, diabetic the next. Any sugar levels higher than normal are unhealthy. A blood sugar higher than normal, but not meeting the above criteria for full-blown diabetes, is called prediabetes.

Fifty seven million people in the U.S. have prediabetes. People with prediabetes are five to six times more likely to develop diabetes over time. Prediabetes also increases the risk for cardiovascular disease, although not as much as diabetes does. It's possible to prevent the progression of prediabetes to diabetes, with diet and exercise.

Sugar and Your Body

Why are high blood sugar levels bad for you? It turns out, your body doesn't have much of a sweet tooth. Glucose is precious fuel for all the cells in your body -- when it's present at normal levels. But persistently high sugar levels behave like a slow-acting poison.
  1. High sugar levels slowly erode the ability of cells in the pancreas to make insulin. The pancreas overcompensates, though, and insulin levels remain overly high. Gradually, the pancreas is permanently damaged.
  2. All the excess sugar is modified in the blood. It becomes a form that sticks to and coats bloodstream proteins, which are normally "sugar-free." Thanks to this sugary film, the proteins don't function well, can be deposited in blood vessels, and can cause damage to them.
Because high sugar levels are everywhere, the body can be damaged anywhere. Damage to blood vessels, in particular, means no area is safe from too much sugar. High sugar levels and damaged blood vessels cause the multitude of complications that can come with diabetes:
  • kidney disease or kidney failure, requiring dialysis
  • strokes
  • heart attacks
  • visual loss or blindness
  • immune system suppression, with increased risk for infections
  • erectile dysfunction
  • nerve damage, called neuropathy, causing pain or decreased sensation in the feet, legs, and hands
  • poor circulation to the legs and feet, with poor wound healing
In extreme cases, because of the poor wound healing, amputation is required.
Keeping sugar levels closer to normal can prevent many of the complications of diabetes. The American 

Diabetes Association's goals for glucose control in people with diabetes are sugar levels of 70 to 130 mg/dL before meals, and less than 180 mg/dL after meals.

Reviewed by John A. Seibel, MD on February 25, 2010
© 2010 WebMD, LLC. All rights reserved.

Shhh! We don’t talk about that

As a physical therapist with 22 years’ experience, Shona Woods has treated women of all ages who are harboring the same secret: These women suffer from incontinence and leak urine when they sneeze and cough or when they don’t get to the bathroom on time. Woods’ goal is to improve her patients’ quality of life by providing conservative treatment.

“Since we are often too embarrassed to talk about it, women don’t realize that approximately 50 percent of all women struggle with incontinence,” said Woods.

There is now an effective approach that doesn’t involve expensive medications or surgery.


Why are women reluctant to discuss this issue with their doctor when symptoms begin?

Many women assume that this is just part of getting older, and when Kegels don’t work, they belive that the only other treatment options are medications and surgery. Therefore, women wait an average of nine years before talking with their doctor. By that time, it is often affecting their quality of life. They begin to limit their activities and travel and are exhausted from getting up multiple times during the night.

How effective is physical therapy for incontinence?

It is very effective for women with Urge Incontinence. This is often described as “Gotta go-Gotta go” and sends women rushing to the bathroom day and night with the fear they might not make it in time. This is the type of incontinence seen the most. Kegels are usually not effective for Urge Incontinence. Bladder retraining teaches the bladder to resume holding a larger volume and to empty only on demand like it always used to do.

When we were born, we were not continent, but we were able to train our bladders when we were old enough to understand. I have found that no matter what age, as long as the client can understand and follow through with the program, she will often see results in the first week. On the second weekly visit, many clients have implied that they wish they had done this a long time ago.

Stress incontinence causes leaking with downward abdominal force, such as when sneezing. These symptoms are usually due to a weak pelvic floor, and when done correctly, should respond to Kegels. However, just like any other muscle group, it often takes several months to strengthen.

What else should women know about the incontinence program?

Whether a patient is being treated for Urge or Stress Incontinence, I usually need to see only her for three to five visits over a two-month period. My office is located in a private setting at the Winfield Health Care Center, across from the hospital. The program does require a prescription from your doctor and is covered by most insurance.

Lastly, I want women to know that incontinence is common, but not normal, and often responds well to conservative treatment.

“This is a quality of life issue. If a patient has urinary control problems, it will affect everyday life. If we can help people improve without having to give them more medications, then it is win-win for everyone,” said Kimberly Adams-McDarty, APRN, with Health Professionals of Winfield.

“Shona has helped patients through dietary and exercise changes, and now patients feel more empowered and in control. That is what it is all about.”

Monday, April 16, 2012

Reducing the Embarrassment of Incontinence

Tips for Coping Day to Day With Urinary Incontinence

You don't have to just live with incontinence -- simple changes like these 13 tips can help you take control.

Like it or not, urinary incontinence is a fact of life for many people. It can happen as we get older, and for women during pregnancy or after birth, even as the result of a persistent cough. What can you do to take control?
For answers, WebMD went to the American Urological Association and Craig Comiter, MD, associate professor of urology at Stanford University School of Medicine. Here are their tips on how to take matters into your own hands -- and make living with urinary incontinence a lot easier.

Which Type of Urinary Incontinence Do You Have?

Urinary incontinence (UI) is the involuntary loss of urine and "it's a common condition" in men and women of all ages, says the American Urological Association. The two main types of urinary incontinence are:
  • Stress incontinence, which can cause leakage when you cough, sneeze, exercise, laugh, or strain to lift something heavy.
  • Urge incontinence, which is an unexpected, sudden urge to urinate, one that's so strong it can be hard to reach the bathroom in time.
No matter which type of urinary incontinence you have, simple behavioral tips can help you deal day to day.

8 Quick Tips for Coping With Urinary Incontinence

1. Do Kegel Exercises. An important urinary incontinence treatment, Kegels are especially effective for women with mild symptoms, says Comiter. "I would advocate Kegel exercises as the most commonly used initial treatment."
Kegels are simple to do: Simply clench and unclench your pelvic floor muscles. Which muscles are those? Next time you pee, stop the stream of urine midway. Presto! You've just found your pelvic floor muscles and done your first Kegel.
But don't make a habit of stopping your urine when you pee, as it can actually weaken muscles. Do Kegels anywhere and everywhere else, though: while online, on hold, or in the car. Start by clenching your pelvic floor muscles for three seconds, then release for three. Repeat ten times. As you develop strength over time, aim to hold the muscles for ten seconds and release for ten.
 
2. Stick to a Pee Schedule. Don't feel like you need to go? Head to the bathroom anyway. Why? Timed urination helps keep the bladder empty, Comiter tells WebMD, and "empty bladders cannot leak." It might take a little time to discern the schedule that's best for you, but Comiter recommends starting with a timed urination every one to two hours.
 
3. Fill the Void. And don't be in a hurry when you're in the bathroom. Take your time in there and after you've finished urinating, relax a bit and then urinate again -- this practice, called double voiding, helps really empty the bladder.
 
4. Keep the Path Clear. Having accidents before you make it to the bathroom? It's time to clear your path of obstacles so you can get there faster. And then help yourself once you're there by wearing easy-to-release clothes -- think elastic waistbands and Velcro closures.

5. Cool It on the Caffeine. As much as you may love your java, or crave a cola come 3 p.m., you're doing yourself no favor by drinking caffeine-rich beverages like coffee, tea, and carbonated drinks. To help control urinary incontinence, eliminate these diuretics -- or at least cut back.
 
6. Drink Up -- But Not Too Much. Your body needs fluids, so be sure to drink enough to stay well hydrated. Drink about two quarts (eight cups) to keep your bladder and kidneys healthy.
 
7. Watch for Medication Side Effects. Talk with your physician to make sure you're not taking any prescription or over-the-counter drugs that could be making your urinary incontinence worse. If you are -- and need those medicines -- Comiter suggests you "stay close to home (near a bathroom) for a few hours after taking a diuretic" drug.
 
8. The Tampon Tip. Women can try wearing a tampon to help control leaks when they jog, run, dance or do other energetic activities. The tampon puts a bit of pressure on your urethra, helping to prevent leakage.

5 Long-Term Tips for Coping With Urinary Incontinence

Managing urinary incontinence is a long-term issue for most people. Be sure you're doing all you can to make things easier. Some long-term tips include:
 
1. Talk to Your Doctor. Don't be shy! Get your physician or urologist on your side. Your doctor can help you find the best treatment for your urinary incontinence.
 
2. Change Your Diet. A cup of coffee and juice in the morning, a soda with lunch, a few beers or glasses of wine with dinner -- it can really add up. Fluid management can be critical in controlling urinary incontinence long term. But you're body does need fluids. Before making big changes, talk to your doctor.
 
3. Lose Weight. Weight loss hasn't definitively been shown to help UI, Comiter tells WebMD, just as being overweight hasn't been shown to cause incontinence. "However, obesity can lead to diabetes, which can lead to urinary incontinence."
 
4. Quit Smoking. While obviously a health hazard, smoking isn't a strong risk factor for urinary incontinence, Comiter says. But if smoking is causing you to cough, this could be exacerbating your leakage. Chalk this one up as another reason to quit.
 
5. Medication and Surgery. Both stress incontinence and urge incontinence can be treated with medication, though behavioral therapies like the tips above are often more effective. Surgery is mainly an option for stress incontinence though -- as with medication -- it may not be the most effective initial treatment for UI. Talk with your doctor to learn more about these options.

All of these tips can help you cope with urinary incontinence, though for day-to-day management Comiter says two of the best tips are also the simplest: Kegel exercises and time urination.


"They are inexpensive, risk free, and if they work in the short term, [they] should work in the long term -- especially in patients with mild symptoms."
Reviewed By Brunilda Nazario, MD
© 2008 WebMD, LLC. All rights reserved.

 

 

Tuesday, April 10, 2012

Blood Sugar Control and Insulin

Manage Diabetes Through Diet

With both type 1 and type 2 diabetes, you can help manage your glucose level with diet.  Monitoring carbohydrates is key because carbs strongly affect your blood sugar. The best diet includes a variety of vegetables, fruits, and meats, as well as nuts, dairy, and grains. When you live with diabetes it may be a good idea to divide your food for the day evenly across three meals and healthy snacks.

Preventing High Blood Sugar After Meals

To prevent your blood sugar from soaring after meals, follow your meal plan and be aware of your diet, particularly how many carbs you eat and portion sizes.  Research shows that a high-fiber diet -- 25 to 35 grams a day -- can help reduce your risk of type 2 diabetes by controlling blood sugar.  Make sure you exercise, take your medicine, and test your blood sugar regularly.

The Good Exercise Effect

Regular, moderate exercise can positively affect blood sugar, especially with type 2 diabetes. Exercise improves your body's sensitivity to insulin and stimulates your liver and muscles to use glucose. One study found improvement in blood sugars after strength training, which usually involves lifting weights to build muscle.

Exercise Risks

While regular exercise can help control blood sugars, it can cause your sugar to drop. To help keep your levels in check, your doctor may recommend you test your blood sugar before and after exercise. If exercise makes your blood sugar dip, don't avoid exercise. Instead, have healthy snacks -- like fruit -- with you to avoid a serious drop.

Avoiding Low Blood Sugar or Hypoglycemia

Juice, fruit, hard candy, or glucose tablets are all sources of quick sugar that can help if you're feeling the effects of low blood sugar. Feeling tired, weak, or shaky are telltale signs. When your blood sugar drops, your goal should be to get at least 15-20 grams of sugar or carbs. Avoid foods with sugar in combination with fat, like chocolate. Fat can slow your body's ability to get the carbs it needs quickly enough.

Stress and Smoking Can Affect Diabetes

Many other things can affect your diabetes, including your stress level and unhealthy habits like smoking. Stress can send your blood sugar level soaring. Try yoga or meditation or find time to de-stress with a relaxing hobby. Smoking increases your chances of developing diabetes-related complications like foot problems, nerve damage, and eye, heart, vascular, and kidney disease.

Other Life Stresses That Affect Blood Sugar

  • Be cautious when drinking alcohol. If you drink, only do so if your blood sugar is stable.
  • When sick, test your blood sugar more often, stay hydrated, and try to eat regularly.
  • Travel and changes in time zones can also affect your diabetes by disrupting your schedule. Test your sugars before and after meals. Speak with your doctor about making adjustment to medication as needed.
 Follow Your Treatment Plan

It's essential to follow your treatment plan, including exercise and diet, and take your medication as directed. Type 1 diabetes is treated with insulin or an insulin pump, sometimes with another injectable medication. Type 2 is often treated with oral and/or injectable medications like insulin or drugs that help insulin work. Your doctor customizes your treatment plan with your age, body, and lifestyle in mind.

Treating Diabetes With Insulin

With diabetes, your body often doesn't make enough insulin to control blood sugars. Doctors may prescribe insulin based on how long you've had diabetes and what type you have, your blood glucose level, your overall health and lifestyle, and what other medicine you take. When you have diabetes, giving yourself insulin injections and checking your blood sugar can become a part of everyday life.

Medications That Work With Insulin

When you take insulin, you might still need help from other medications to improve your blood sugar. Oral medications for type 2 diabetes can increase insulin in the body or improve how well it works. An injectable medication for type 1 and type 2 diabetes mimics the effects of the hormone amylin. It improves blood sugar by decreasing glucose absorption after you eat and by decreasing appetite.

Tips for Injecting Insulin

When you start taking insulin, a medical professional will teach you how to inject yourself, and you'll practice with her until you're comfortable. When doing shots, rotate where you inject to avoid building up scar tissue. For example, give yourself your shot on one side of your abdomen at breakfast, the other side at lunch, and in your leg at dinner. Avoid injecting near your joints, groin, navel, middle abdomen, or scars.

Different Types of Insulin

Insulin types vary depending on how fast they work, when they peak, and how long they last. Rapid-acting, short-acting, and pre-mixed insulin are timed to meals. Long-acting and intermediate-acting are not timed to meals. The glucose-lowering effects of these insulins can last up to 24 hours.

Timing Mealtime Insulin

If you take shorter-acting and pre-mixed insulin, timing is important. It must be working in your system while food is being absorbed in order to avoid hypoglycemia. Rapid-acting insulin is taken right before or immediately after meals. Short-acting insulin is taken 30 to 60 minutes prior to meals. Pre-mixed insulin is taken twice a day before meals.

When You've Had Too Much Insulin

If you've had too much insulin, or you haven't eaten and you’re on insulin, you can become hypoglycemic. If you start experiencing symptoms -- feeling tired, weak, or shaky -- you usually can treat mild hypoglycemia by eating or drinking something with sugar, such as juice, or taking glucose tablets. Be sure to tell your doctor about your hypoglycemic episode. Sometimes the amount of insulin you take may need adjusting.

For More Control, Pumps May Help

If you're having trouble regulating your insulin and blood sugar, you may want to consider an insulin pump. They come with a programmable dose calculator to easily control your insulin dosage and help maintain steady blood sugar. No matter how you take your medication, know you can always ask your doctor for help in controlling your blood sugar. Together you can find ways to find the right balance between diet, exercise, and medication.

Getting a Better Measure of Blood Sugar Control

In addition to home glucose testing, one of the best ways to know if your diabetes is under control is to ask your doctor for an A1c test. This test can track your average blood sugar level over the past 3 months. The goal is to achieve a level of less than 6.5%. If your result is too high, your doctor may suggest medication or adjust medication you already take. Experts recommend an A1c test every 2-3 months.

Reviewed by Andrew Seibert, MD on October 21, 2011
© 2011 WebMD, LLC. All rights reserved.












Tuesday, April 3, 2012

A Healthy Type 2 Diabetes Diet

Maintaining a healthy diet is important for everyone, but it is especially important for people with diabetes. A type 2 diabetes diet and following the right meal plan can make all the difference to a person struggling to keep their blood sugar under control. But, what is the right meal plan? How much of which food group should you eat?

Along with a visit to a dietician, this guide should help answer questions you may have about diabetes and nutrition.

Carbohydrates and Fiber in a Type 2 Diabetes Diet

Carbohydrates are one of the major food categories (the others include proteins and fats) in a type 2 diabetes diet. They provide fuel for the body in the form of glucose. Glucose is a sugar that is the primary means of energy for all of the body's cells.

There are two ways to classify carbohydrates -- simple and complex. Simple carbohydrates are sugars -- like glucose, sucrose, lactose, and fructose. They are found in refined sugar and in fruits. Complex carbohydrates are the starches, which are the simple sugars bonded together chemically -- they are found in beans, nuts, vegetables, and whole grains. Complex carbohydrates are considered healthier mostly because they are digested by the body slowly, providing a steady source of energy. They also contain valuable amounts of fiber.

Carbohydrates, rather than fats or proteins, have the most immediate effect on your blood sugar since carbohydrates are broken down directly into sugar early during digestion. It is important to eat the suggested amount of carbohydrate at each meal, along with some protein and fat.

Carbohydrates are mainly found in the following food groups:
  • Fruit
  • Milk and yogurt
  • Bread, cereal, rice, pasta
  • Starchy vegetables like potatoes

What Is Carbohydrate Counting?

Carbohydrate counting is a method of meal planning that is a simple way to keep track of the amount of total carbohydrates you eat each day. It helps allow you to eat what you want. Counting grams of carbohydrate and evenly distributing them at meals will help you control your blood sugar.

Instead of following an exchange list, with carbohydrate counting you monitor how much carbohydrates (sugar and starch) you eat daily. One carbohydrate serving is equal to 15 grams of carbohydrates.

With carbohydrate counting, you plan your carbohydrate intake based on what your pre-meal sugar is and your intake or insulin dose can be adjusted. Carbohydrate counting can be used by anyone and not just by people with diabetes that are taking insulin. If you eat more carbohydrates than your insulin supply can handle, your blood sugar level goes up. If you eat too little, your blood sugar level may fall too low. These fluctuations can be managed by knowing how to count your carbohydrate intake.

A registered dietitian will help you figure out a carbohydrate counting plan that meets your specific needs. For adults, a typical plan generally includes three to four carbohydrates at each meal, and one to two carbohydrate servings as snacks.

With carbohydrate counting, you can pick almost any food product off the shelf, read the label, and use the information about grams of carbohydrates to fit the food into your type 2 diabetes meal plan.

Carbohydrate counting is most useful for people who take multiple daily injections of insulin, use the insulin pump, or who want more flexibility and variety in their food choices. However, it may not be for everyone, and the traditional method of following food exchange lists may be used instead.

How Much Fiber Should I Eat?

Fiber is the indigestible part of plant foods. It plays an important role in the digestive process as it helps move foods along the digestive tract, adding bulk to stool to help it pass through the bowel. In addition, diets high in fiber are associated with lower risks of obesity, high blood pressure, heart disease, and strokes.
Fiber also:
  • Delays sugar absorption, helping to better control blood sugar levels.
  • Binds with cholesterol and may reduce the level of 'bad' LDL cholesterol in the blood.
  • Is a good source of vitamins and minerals.
  • Helps prevent constipation and reduces the risk of certain intestinal disorders.
  • Promotes weight loss by helping to decrease caloric intake. (It adds bulk to the food we eat, making you feel fuller.)
The goal for all Americans is to consume 25 to 35 grams of fiber per day. The best way to increase fiber intake as part of your type 2 diabetes diet is to eat more of these fiber-rich foods:
  • Fresh fruits and vegetables
  • Cooked dried beans and peas
  • Whole grain breads, cereals, and crackers
  • Brown rice
  • Bran products

Fat in a Type 2 Diabetes Diet

Since diabetes increases your risk of developing heart disease, eating foods lower in fat -- especially saturated fat -- is particularly important to keep that risk as low as possible. In addition, limiting calories from fat can help you lose any extra weight, especially when combined with an exercise program.

The major contributors of saturated fats in our diet come from cheese, beef, milk, and baked items. Trans fats also contribute to the increase risk of heart disease. These fats are vegetables oils that are harder; we recognize these as solid oils. Many of these are used in baking and frying.

Here are some general guidelines for selecting and preparing low-fat foods for your type 2 diabetes diet:
  • Select lean meats including poultry, fish, and lean red meats. When preparing these foods, don't fry them. Instead, you can bake, broil, grill, roast, or boil.
  • Select low-fat dairy products such as low-fat cheese, skim milk, and products made from skim milk such as nonfat yogurt, nonfat frozen yogurt, evaporated skim milk, and buttermilk. Remember to include dairy products in your daily carbohydrate count.
  • Use low-fat vegetable cooking spray when preparing foods or consider using cholesterol lowering margarine containing stanols or sterols. Examples include "Take Control" and "Benecol."
  • Use liquid vegetable oils that contain poly- or monounsaturated fats which can help lower your 'bad' LDL cholesterol.
  • Select lower fat margarines, gravies, and salad dressings and remember to watch the carbohydrate count on condiments and dressings.
  • All fruits and vegetables are good low-fat choices. Remember to include fruit and starchy vegetables in your daily carbohydrate count.
A registered dietitian can provide more information on how to prepare and select low-fat foods.

Salt in a Type 2 Diabetes Diet

Diabetes increases your risk for high blood pressure. High levels of salt (sodium) in your diet can further increase that risk. Your health care provider or dietitian may ask you to limit or avoid these high-salt foods:
  • Salt and seasoned salt (or salt seasonings)
  • Boxed mixes of potatoes, rice, or pasta
  • Canned meats
  • Canned soups and vegetables (with salt)
  • Cured or processed foods
  • Ketchup, mustard, salad dressings, other spreads and canned sauces
  • Packaged soups, gravies, or sauces
  • Pickled foods
  • Processed meats: lunch meat, sausage, bacon, and ham
  • Olives
  • Salty snack foods
  • Monosodium glutamate or MSG
  • Soy and steak sauces

Low-Salt Cooking Tips

  • Use fresh ingredients and/or foods with no salt added.
  • For favorite recipes, you may need to use other ingredients and eliminate or decrease the salt you would normally add.
  • Try orange or pineapple juice as a base for meat marinades.
  • Avoid convenience foods such as canned soups, entrées, and vegetables; pasta and rice mixes; frozen dinners; instant cereal; and pudding, gravy, and sauce mixes.
  • Select frozen entrées that contain 600 milligrams or less of salt. However, limit yourself to one of these frozen entrées per day. Check the Nutrition Facts label on the package for sodium content.
  • Use fresh, frozen, no-added-salt canned vegetables, or canned vegetables that have been rinsed before they are prepared.
  • Low-salt canned soups may be used.
  • Avoid mixed seasonings and spice blends that include salt, such as garlic salt.

What Seasonings Can Replace Salt?

Herbs and spices are the answer to improving the natural flavors in food without using salt. Below are some mixtures to use for meats, poultry, fish, vegetables, soups, and salads.
 
Spicy Blend
2 tablespoons dried savory, crumbled
1/4 teaspoon freshly ground white pepper
1 tablespoon dry mustard
1/4 teaspoon ground cumin
2 1/2 teaspoons onion powder
1/2 teaspoon garlic powder
1/4 teaspoon curry powder
 
Saltless Surprise
2 teaspoons garlic powder
1 teaspoon basil
1 teaspoon oregano
1 teaspoon powdered lemon rind or dehydrated lemon juice
 
Herb Seasoning
2 tablespoons dried dill weed or basil leaves, crumbled
1 teaspoon celery seed
2 tablespoons onion powder
1/4 teaspoon dried oregano leaves, crumbled
A pinch of freshly ground pepper
Spicy Seasoning
1 teaspoon cloves
1 teaspoon pepper
2 teaspoons paprika
1 teaspoon coriander seed (crushed)
1 tablespoon rosemary