WPADE.org

The likelihood of developing type 2 diabetes is largely a function of what we eat, how much we exercise and most importantly, how much we weigh. More than 60% of the diabetic cases can be attributed to overweight*. (*BMI of 25-29) But losing weight can reduce the risk of diabetes and current weight has a greater impact on the risk of diabetes than previous weight. If weight is lost and kept off, risk is substantially lower. This can be achieved with physical activity. Even modest activity provides some benefit, such as walking 3 hours a week. Obviously, the faster and more frequently the exercise, the faster the weight loss. Diet is of prime importance to diabetic management. Three factors that influence diabetes are fiber, fat and glycemic index.
Fiber- slows the conversion of high glycemic index foods into glucose during digestion, thereby avoiding spikes in blood sugar levels. This in turn decreases the demand for insulin, which lowers the risk of diabetes. Foods rich in cereal fibers are bran, barley, oatmeal and whole wheat bread.
Fat- the consumption of total fat, saturated fat, non mono-unsaturated fat affected the risk of diabetes, but trans fatty acids (vegetable fats that are solid at room temperature and listed on food labels as ‘partially hydrogenated vegetable oils’) increase the risk. These are found in margarines, shortening, french fries and commercially baked products. Polyunsaturated fats (primarily from plant foods and fish sources are liquid at room temperature) reduced the risk of diabetes. These are liquid vegetable oil, oil based salad dressings, tuna and salmon.
Glycemic Index- A food with a high glycemic index can increase blood sugar rapidly, forcing the production of large amounts of insulin to counteract the glucose level. Over time, this increase in insulin production can cause diabetes. High glycemic index foods are white breads, baked potato; while low glycemic index foods are apples, beans and whole grain pastas.
Diabetes can be prevented with weight control, physical activity and a healthy diet. Women can lower their risk by 90% even with a family history of diabetes. Taking these steps is an important part of a healthy life style that helps to not only lower the risk of diabetes, but also of heart disease, cancer, stroke, arthritis and osteoporosis.
Annette Karnash
BMI-
Healthy Weight 18.5-24.9
OVerweight and at risk 25-29.9
Obese and at risk Over 30

Many of your patients maybe unhappy over having to stick themselves multiple times throughout the day. To avoid this, the Insulin-Port could perhaps be an alternative. An ice cute at the site for a few minutes will eliminate the discomfort when the quarter-sized infusion set is initially inserted. As it is inserted, a needle guides the cannula inot the subcutaneous tissue where it remains for up to three days. All shots are given into the port which delivers the insulin into the tissue through a funnel going into the cannula. This eliminates subjecting patients to multiple ‘sticks’ for up to three days. It does not interfere wit sleeping, bathing, etc., and can be used by pumpers and those taking Byetta. However, if both short and long acting insulin is injected, one hour between injections is recommended.
Annette Karnash

Stem cells are being touted as a possible cure for diabetes. The Journal of the American Medical Association (JAMA) reported that injections of stem cells taken for a patients own blood may keep type 1 diabetes in check by replacing the defective cells that cause the disease. Based on a Brazilian study, results are promising but further research is needed because the treatment involves destroying the patient’s immune system before receiving the stem cells.
Researchers at the Joslin Clinic think a simple pill may be the cure for type 2 diabetes- a simple aspirin-like class of drugs called salicylates. They have determined what they believe is a ‘master switch’ in the liver that is turned on by weight gain, leading to inflammation and disruption in the insulin process. The switch can be turned off by a salicylate class of drugs that include aspirin. Additional studies are needed before recommendations can be made. Weight loss, healthy eating and exercise are still primary in the management and prevention.
Researchers have attempted to make insulin in a pill form to prevent subjecting paitents to insulin injections, however, because the body is unable to absorb insulin in the small intestines before it is degraded in the stomach, this has not been possible. But now investigators in Taiwan are using a chemical found in shrimp to protect the drug from breaking down in the stomach. A specially treated capsule maybe capable of controlling glucose levels some day. Diabetes is still the 6th leading cause of death in the United States.
Annette Karnash

It has recently been recommended by the International Diabetes Federation that monitoring of blood sugar after meals results in better control and reduces the risk of diabetic complications more than pre meal testing. The IDF suggested that blood sugar levels be kept at 140mg/dl or less for 2 hours after eating.
Annette Karnash

Hyperglycemia can cause changes to the part of the cell that produces energy (the mitochondria) causing an increase in the free radicals which lead to diabetes complications. It is felt that taking vitamin C, especially in fruits, over a long period of time, can reduce the number of free radicals found in type 1 diabetes along with insulin. Researchers are also looking at Telmisartan, a hypotensive drug, and others that may be capable of permanently stopping the production of free radicals.
Annette Karnash