Sep 8, 2018 | Healthy Tips
By Yasmine Ali, MD
The International Agency for Research on Cancer (IARC), a part of the World Health Organization (WHO), came out definitively with a report on cancer-causing processed meats, stating that such meats definitely can cause colorectal cancer. They have also stated that red meat in general “probably” causes cancers such as colon, pancreatic, and prostate cancer.
Given that obesity is a risk factor for a number of different cancers, it is helpful to do all you can to decrease your risk.
Below are five foods to avoid, based on the report.
- Hot Dogs
According to the IARC press release, “Processed meat refers to meat that has been transformed through salting, curing, fermentation, smoking, or other processes to enhance flavour or improve preservation.”
Hot dogs are listed as one example of processed meat that can cause cancer. Specifically, the IARC classified processed meat as “carcinogenic [cancer-causing] to humans, based on sufficient evidence in humans that consumption of processed meat causes colorectal cancer.”
According to the IARC, a little over the equivalent of one hot dog per day is enough to increase the risk of colorectal cancer by 18%.
- Beef Jerky
Beef jerky also falls into processed meat group and was listed as a specific example in the IARC press release as a processed meat that can cause cancer.
The IARC press release regarding the recent findings stated that IARC experts “considered more than 800 studies that investigated associations of more than a dozen types of cancer with the consumption of red meat or processed meat in many countries and populations with diverse diets.”
The IARC Working Group found that “the most influential evidence came from large prospective cohort studies conducted over the past 20 years.”
- Sausage
Sausage is another kind of processed meat that was given as an example in the IARC press release as being cancer-causing.
The IARC has stated that “each 50-gram portion of processed meat eaten daily increases the risk of colorectal cancer by 18%.”
The IARC further noted that “the consumption of meat varies greatly between countries, with from a few percent up to 100% of people eating red meat, depending on the country, and somewhat lower proportions eating processed meat.”
- Ham
Ham is a processed meat that is not only carcinogenic due to its processed nature but has also been linked to high blood pressure and other cardiovascular diseases because of its very high sodium content.
Other processed deli meats, such as pastrami, salami, pepperoni, and the like, present the same cancer-causing risk.
- Corned Beef
Corned beef was also one of the examples listed by the IARC as a processed meat linked to colorectal cancer.
The IARC further noted that “most processed meats contain pork or beef, but processed meats may also contain other red meats, poultry … or meat by-products such as blood.”
Other examples of processed meat listed in the IARC press release included canned meat and meat-based preparations and sauces.
Article Sources :
Nagle CM, Wilson LF, Hughes MC, et al. Cancers in Australia in 2010 Attributable to the Consumption of Red and Processed Meat. Aust N Z J Public Health. 2015; 39:429-33.
Amiano P, Chamosa S, Etxezarreta N, et al. Unprocessed Red Meat and Processed Meat Consumption and Risk of Stroke in the Spanish Cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC). Eur J Clin Nutr 2015 Sep 30. [Epub ahead of print]
5 FOODS THAT CAN CAUSE CANCER
Sep 7, 2018 | Healthy Tips
Overview
An enlarged heart (cardiomegaly) isn’t a disease, but rather a sign of another condition.
The term “cardiomegaly” refers to an enlarged heart seen on any imaging test, including a chest X-ray. Other tests are then needed to diagnose the condition causing your enlarged heart.
You may develop an enlarged heart temporarily because of a stress on your body, such as pregnancy, or because of a medical condition, such as the weakening of the heart muscle, coronary artery disease, heart valve problems or abnormal heart rhythms.
Certain conditions may cause the heart muscle to thicken or one of the chambers of the heart to dilate, making the heart larger. Depending on the condition, an enlarged heart may be temporary or permanent.
An enlarged heart may be treatable by correcting the cause. Treatment for an enlarged heart can include medications, medical procedures or surgery.
Symptoms
In some people, an enlarged heart causes no signs or symptoms. Others may have these signs and symptoms:
- Shortness of breath
- Abnormal heart rhythm (arrhythmia)
- Swelling (oedema)
When to see a doctor
An enlarged heart is easier to treat when it’s detected early, so talk to your doctor if you have concerns about your heart.
If you have new signs or symptoms that might be related to your heart, make an appointment to see your doctor.
Seek emergency medical care if you have any of these signs and symptoms, which may mean you’re having a heart attack:
- Chest pain
- Discomfort in other areas of the upper body, including one or both arms, the back, neck, jaw, or stomach
- Severe shortness of breath
- Fainting
Causes
An enlarged heart can be caused by conditions that cause your heart to pump harder than usual or that damage your heart muscle. Sometimes the heart enlarges and becomes weak for unknown reasons (idiopathic).
A heart condition you’re born with (congenital), damage from a heart attack or an abnormal heartbeat (arrhythmia) can cause your heart to enlarge. Other conditions associated with an enlarged heart include:
- High blood pressure.Your heart may have to pump harder to deliver blood to the rest of your body, enlarging and thickening the muscle.
High blood pressure can cause the left ventricle to enlarge, causing the heart muscle eventually to weaken. High blood pressure may also enlarge the upper chambers of your heart (atria).
- Heart valve disease. Four valves in your heart keep blood flowing in the right direction. If the valves are damaged by conditions such as rheumatic fever, a heart defect, infections (infectious endocarditis), connective tissue disorders, certain medications or radiation treatments for cancer, your heart may enlarge.
- Disease of the heart muscle (cardiomyopathy).As this thickening and stiffening of heart muscle progress, your heart may enlarge to try to pump more blood to your body.
- High blood pressure in the artery connecting your heart and lungs (pulmonary hypertension).Your heart may need to pump harder to move blood between your lungs and your heart. As a result, the right side of your heart may enlarge.
- Fluid around your heart (pericardial effusion).Accumulation of fluid in the sac (pericardium) that contains your heart may cause your heart to appear enlarged on a chest X-ray.
- Low red blood cell count (anaemia).Anaemia is a condition in which there aren’t enough healthy red blood cells to carry adequate oxygen to your tissues. Untreated, chronic anaemia can lead to a rapid or irregular heartbeat. Your heart must pump more blood to make up for the lack of oxygen in the blood.
- Thyroid disorders. Both an underactive thyroid gland (hypothyroidism) and an overactive thyroid gland (hyperthyroidism) can lead to heart problems, including an enlarged heart.
- Excessive iron in the body (hemochromatosis).Hemochromatosis is a disorder in which your body doesn’t properly metabolize iron, causing it to build up in various organs, including your heart. This can cause an enlarged left ventricle due to the weakening of the heart muscle.
- Rare diseases that can affect your heart, such as amyloidosis.Amyloidosis is a condition in which abnormal proteins circulate in the blood and may be deposited in the heart, interfering with your heart’s function and causing it to enlarge.
Risk factors
You may have a greater risk of developing an enlarged heart if you have any of the following risk factors:
- High blood pressure.Having a blood pressure measurement higher than 140/90 millimeters of mercury puts you at an increased risk of developing an enlarged heart.
- A family history of enlarged hearts or cardiomyopathy.If an immediate family member, such as a parent or sibling, has had an enlarged heart, you may be more susceptible to developing the condition.
- Blocked arteries in your heart (coronary artery disease).With this condition, fatty plaques in your heart arteries obstruct blood flow through your heart vessels, which can lead to a heart attack. When a section of heart muscle dies, your heart has to pump harder to get adequate blood to the rest of your body, causing it to enlarge.
- Congenital heart disease. If you’re born with a condition that affects the structure of your heart, you may be at risk of developing an enlarged heart.
- Heart valve disease. The heart has four valves — aortic, mitral, pulmonary and tricuspid — that open and close to direct blood flow through your heart. Conditions that damage the valves may cause the heart to enlarge.
- Heart attack. Having a heart attack increases your risk of developing an enlarged heart.
Complications
The risk of complications from an enlarged heart depends on the part of the heart that is enlarged and the cause.
Complications of an enlarged heart can include:
- Heart failure.One of the most serious types of enlarged heart, an enlarged left ventricle increases the risk of heart failure. In heart failure, your heart muscle weakens, and the ventricles stretch (dilate) to the point that the heart can’t pump blood efficiently throughout your body.
- Blood clots.Having an enlarged heart may make you more susceptible to forming blood clots in the lining of your heart. If clots enter your bloodstream, they can block blood flow to vital organs, even causing a heart attack or stroke. Clots that develop on the right side of your heart may travel to your lungs, a dangerous condition called a pulmonary embolism.
- Heart murmur.For people who have an enlarged heart, two of the heart’s four valves — the mitral and tricuspid valves — may not close properly because they become dilated, leading to a backflow of blood. This flow creates sounds called heart murmurs. Although not necessarily harmful, heart murmurs should be monitored by your doctor.
- Cardiac arrest and sudden death.Some forms of an enlarged heart can lead to disruptions in your heart’s beating rhythm. Heart rhythms too slow to move blood or too fast to allow the heart to beat properly can result in fainting or, in some cases, cardiac arrest or sudden death.
Prevention
Tell your doctor if you have a family history of conditions that can cause an enlarged heart, such as cardiomyopathy. If cardiomyopathy or other heart conditions are diagnosed early, treatments may prevent the disease from worsening.
Controlling risk factors for coronary artery disease — tobacco use, high blood pressure, high cholesterol and diabetes — helps to reduce your risk of an enlarged heart and heart failure by reducing your risk of a heart attack.
You can help reduce your chance of developing heart failure by eating a healthy diet and not abusing alcohol or using illicit drugs. Controlling high blood pressure with diet, exercise and possibly medications also prevents many people who have an enlarged heart from developing heart failure.
Diagnosis
If you have symptoms of a heart problem, your doctor will perform a physical exam and order tests to determine if your heart is enlarged and to find the cause of your condition. These tests may include:
- Chest X-ray.X-ray images help your doctor see the condition of your lungs and heart. If your heart is enlarged on an X-ray, other tests will usually be needed to find the cause.
- This test records the electrical activity of your heart through electrodes attached to your skin. Impulses are recorded as waves and displayed on a monitor or printed on paper. This test helps your doctor diagnose heart rhythm problems and damage to your heart from a heart attack.
- This test for diagnosing and monitoring an enlarged heart uses sound waves to produce a video image of your heart. With this test, the four chambers of the heart can be evaluated.
Your doctor can use the results to see how efficiently your heart is pumping, determine which chambers of your heart are enlarged, look for evidence of previous heart attacks and determine if you have congenital heart disease.
- Stress test.A stress test, also called an exercise stress test, provides information about how well your heart works during physical activity.
An exercise stress test usually involves walking on a treadmill or riding a stationary bike while your heart rhythm, blood pressure and breathing are monitored.
- Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI).In a cardiac CT scan, you lie on a table inside a doughnut-shaped machine called a gantry. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest.
In a cardiac MRI, you lie on a table inside a long tube-like machine that uses a magnetic field and radio waves to produce signals that create images of your heart.
- Blood tests. Your doctor may order blood tests to check the levels of certain substances in your blood that may point to a heart problem. Blood tests can also help your doctor rule out other conditions that may cause your symptoms.
- Cardiac catheterization and biopsy. In this procedure, a thin tube (catheter) is inserted in your groin and threaded through your blood vessels to your heart, where a small sample (biopsy) of your heart, if indicated, can be extracted for laboratory analysis.
The pressure within the chambers of your heart can be measured to see how forcefully blood pumps through your heart. Pictures of the arteries of the heart can be taken during the procedure (coronary angiogram) to ensure that you don’t have a blockage.
Treatment
Treatments for an enlarged heart focus on correcting the cause.
Medications
If cardiomyopathy or another type of heart condition is to blame for your enlarged heart, your doctor may recommend medications. These may include:
- Diuretics to lower the amount of sodium and water in your body, which can help lower the pressure in your arteries and heart
- Angiotensin-converting enzyme (ACE) inhibitors to lower your blood pressure and improve your heart’s pumping capability
- Angiotensin receptor blockers (ARBs)to provide the benefits of ACE inhibitors for those who can’t take ACE inhibitors
- Beta-blockers to lower blood pressure and improve heart function
- Anticoagulants to reduce the risk of blood clots that could cause a heart attack or stroke
- Anti-arrhythmic to keep your heart beating with a normal rhythm
Medical procedures and surgeries
If medications aren’t enough to treat your enlarged heart, medical procedures or surgery may be necessary.
- Medical devices to regulate your heartbeat.For a certain type of enlarged heart (dilated cardiomyopathy), a pacemaker that coordinates the contractions between the left and right ventricle may be necessary. In people who may be at risk of serious arrhythmias, drug therapy or an implantable cardioverter-defibrillator (ICD) may be an option.
ICDs are small devices — about the size of a pager — implanted in your chest to continuously monitor your heart rhythm and deliver electrical shocks when needed to control abnormal, rapid heartbeats. The devices can also work as pacemakers.
If the main cause of your enlarged heart is atrial fibrillation, then you may need procedures to return your heart to a regular rhythm or to keep your heart from beating too quickly.
- Heart valve surgery. If your enlarged heart is caused by a problem with one of your heart valves or it has caused heart valve problems, you may have surgery to repair or replace the affected valve.
- Coronary bypass surgery. If your enlarged heart is related to coronary artery disease, your doctor may recommend coronary artery bypass surgery.
- Left ventricular assist device (LVAD).If you have heart failure, you may need this implantable mechanical pump to help your weakened heart pump. You may have an LVAD implanted while you wait for a heart transplant or, if you’re not a heart transplant candidate, as a long-term treatment for heart failure.
- Heart transplant. If medications can’t control your symptoms, a heart transplant may be a final option. Because of the shortage of donor’s hearts, even people who are critically ill may have a long wait before having a heart transplant.
Lifestyle and home remedies
There are ways to improve your condition, even though you can’t cure it. Your doctor may recommend the following lifestyle changes:
- Quit smoking.
- Lose excess weight.
- Limit salt in your diet.
- Control diabetes.
- Monitor your blood pressure.
- Get modest exercise, after discussing with your doctor the most appropriate program of physical activity.
- Avoid or eliminate alcohol and caffeine.
- Try to sleep eight hours nightly.
Preparing for your appointment
If you think you may have an enlarged heart or are worried about your heart disease risk because of your family history, make an appointment with your doctor. If you have heart disease, your doctor may refer you to a heart specialist (cardiologist).
Here’s some information to help you prepare for your appointment.
What you can do
- Be aware of any pre-appointment restrictions. When you make the appointment, ask if there’s anything you need to do in advance, such as restrict your diet or fast before tests.
- Write down your symptoms, including ones that may seem unrelated to coronary artery disease.
- Write down key personal information, including a family history of heart disease, stroke, high blood pressure or diabetes, and major stresses or recent life changes.
- Make a list of all medications, vitamins or supplements you’re taking.
- Take a family member or friend along, if possible. Someone who accompanies you may remember something you missed or forgot.
- Write down questions to ask your doctor.
Preparing a list of questions will help you make the most of your time with your doctor. For heart disease, some basic questions to ask your doctor include:
- What is likely causing my symptoms or condition?
- What are other possible causes for my symptoms or condition?
- What tests do I need?
- What’s the best treatment?
- What foods should I eat or avoid?
- What’s an appropriate level of physical activity?
- Are there restrictions I should follow?
- How often should I be screened for heart disease? For example, how often do I need a cholesterol test?
- I have other health conditions. How can I best manage them together?
- Should I see a specialist?
- Should my children be screened for this condition?
- Is there a generic alternative to the medicine you’re prescribing?
- Are there brochures or other printed materials I can take? What websites do you recommend?
Don’t hesitate to ask other questions.
What to expect from your doctor?
Your doctor is likely to ask you questions, including:
- When did your symptoms begin?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- What is your typical diet?
- Do you drink alcohol? How much?
- Do you smoke?
- Are you physically active? How often do you exercise?
- Have you been diagnosed with other conditions?
- Do you have a family history of heart disease?
Enlarged heart
Sep 6, 2018 | Healthy Tips
How Much Is Too Much?
The American Heart Association recommends no more than 6 teaspoons (25 grams) of added sugar a day for women and 9 teaspoons (36 grams) for men. But the average American gets way more: 22 teaspoons a day (88 grams). It’s easy to overdo. Just one 12-ounce can of regular soda has 10 teaspoons of sugar — and no nutritional benefit.
Harm: Weight Gain
Sugar-sweetened beverages are a big source of added sugars for Americans. If you drink a can of soda every day and don’t trim calories elsewhere, in three years you’d be 15 pounds heavier. Putting on too much weight can lead to problems like diabetes and some cancers.
Harm: Heart Disease
One in 10 Americans gets 1/4 or more of their daily calories from added sugar. If you eat that much, one study found that you’re more than twice as likely to die from heart disease than someone who gets less than half as much. It’s not clear why. It could be that the extra sugar raises your blood pressure or releases more fats into the bloodstream. Both can lead to heart attack, stroke, and other heart diseases.
Harm: Diabetes
Sugary drinks, in particular, can boost your odds for type 2 diabetes. That can happen because when sugar stays in your blood, your body may react by making less of the hormone insulin, which converts the food you eat into energy. Or the insulin doesn’t work as well. If you’re overweight, dropping even 10-15 pounds can help you manage your blood sugar.
Harm: High Blood Pressure
Usually, salt gets the blame for this condition, also called hypertension. But some researchers say another white crystal — sugar — may be a more worrisome culprit. One way they believe sugar raises blood pressure is by making your insulin levels spike too high. That can make your blood vessels less flexible and cause your kidneys to hold onto water and sodium.
Harm: High Cholesterol
Sugary diets are bad for your heart, regardless of how much you weigh. They can:
Raise your so-called “bad” (LDL) cholesterol and lower the “good” (HDL) kind.
Hike blood fats called triglycerides and hinder the work of an enzyme that breaks them down.
Harm: Liver Disease
Most packaged foods, snacks, and drinks are sweetened with fructose, a simple sugar from fruits or veggies like corn. Your liver turns it into fat. If you regularly pump fructose into your body, tiny drops of fat build up in your liver. This is called non-alcoholic fatty liver disease. Early diet changes can reverse it. But over time, swelling and scarring can damage your liver.
Harm: Cavities
You know sugar rots your teeth. How? It feeds the bacteria in your mouth, which leave behind acid that wears away your tooth enamel. Sugary drinks, dried fruits, candy, and chocolate are common offenders. Sour candies are among the worst. They’re almost as acidic as battery acid! If you eat tart treats, rinse your mouth with water afterward or drink some milk to neutralize the acid.
Harm: Poor Sleep
Too much sugar during the day can mess with your blood glucose levels and cause energy spikes and crashes. You may struggle to stay awake at work or doze off in class at school. In the evenings, a bowl of ice cream or cookies can pump you with sugar that can wake you up at night. It also can cut short the time you’re in deep sleep. So you may not wake up feeling refreshed.
Possible Harm: ADHD
It’s a common perception that sugar worsens the symptoms of attention deficit hyperactivity disorder. But the link is unproven. More studies knock down the theory that sugar causes or worsens ADHD than support it. We don’t know exactly what leads to ADHD, but your genes probably play a large role.
Harm: Mood Problems
Feeling down? Your sweet tooth may be part of the problem. Several studies have linked sugar and mental health problems. One of the latest showed that men who ate more than 66 grams of sugar a day — almost double what’s recommended — were 23% more likely to be diagnosed with anxiety or depression than men who ate 40 grams or less. Too much sugar could fuel depression through swelling, or inflammation, in your brain, which is more common in people with depression.
Harm: Gout
You may know that you can get this painful arthritis from eating too much red meat, organ meats, and lobster. The same goes for fructose. When your body breaks it down, it releases a chemical called purines. That can make uric acid build up in your blood, which in turn forms hard crystals in your big toe, knees, and other joints.
Harm: Kidney Stones
You get these when chemicals in your pee turn into solid crystals. Your body flushes out some kidney stones without much pain. Others can get stuck in your kidney or another part of your plumbing and block urine flow. Too much fructose — from table sugar, high-fructose corn syrup, or processed foods — raises your chances for kidney stones.
Harm: Aging
Sugary drinks may add years to your biological age. DNA called telomeres cap the end of your chromosomes to protect them from damage. Longer is better. Shortened telomeres may go hand in hand with age-related diseases like diabetes. One study found that people who drink 20 ounces of soda a day have shorter telomeres. Researchers figure that’s like adding more than 4 years to the age of your cells.
12 WAYS TOO MUCH SUGAR HARMS YOUR BODY
Sep 6, 2018 | Healthy Tips
CAN YOU REVERSE TYPE 2 DIABETES?
By Sonya Collins; Reviewed by Michael Dansinger, MD
It sounds too good to be true: reversing type 2 diabetes through exercise and healthy eating.
While certain lifestyle changes are key to managing diabetes, whether you can actually turn back time so that it’s like you never had diabetes is a different matter. That depends on how long you’ve had the condition, how severe it is, and your genes.
Make Changes That Count
“The term ‘reversal’ is used when people can go off medication but still must engage in a lifestyle program in order to stay off,” says Ann Albright, PhD, RD. She’s the director of diabetes translation at the CDC.
Shedding extra pounds and keeping them off can help you better control your blood sugar.
For some people, reaching a healthier weight will mean taking fewer medications, or in rarer cases, no longer needing those medications at all.
Losing 5% to 10% of your body weight and building up to 150 minutes of exercise a week may help you to slow or stop the progress of type 2 diabetes.
“If you sit [inactive] most of the day, 5 or 10 minutes is going to be great,” Albright says. “Walk to your mailbox. Do something that gets you moving, knowing that you’re looking to move towards 30 minutes most days of the week.”
The Proof
In one study, people with type 2 diabetes exercised for 175 minutes a week, limited their calories to 1,200 to 1,800 per day and got weekly counselling and education on these lifestyle changes.
Within a year, about 10% got off their diabetes medications or improved to the point where their blood sugar level was no longer in the diabetes range and was instead classified as prediabetes.
Results were best for those who lost the most weight or who started the program with less severe or newly diagnosed diabetes. Fifteen percent to 20% of these people were able to stop taking their diabetes medications.
Don’t Blame Yourself
If you make changes to your diet and exercise routine, and your diabetes doesn’t improve, it’s not your fault, Albright says.
“The earlier in the course of the [condition] that you make these changes, the more likely you are to stack the deck in your favour that you won’t progress,” Albright says.
Your weight and lifestyle aren’t the only things that matter. Your genes also influence whether you get type 2 diabetes. Some thin people are living with type 2 diabetes, too.
Still, your weight and lifestyle are things you can change, and they are important parts of your overall health.
Know the Goal
What you’re aiming for: your best health, not someone else’s. Diet and exercise alone will control diabetes for some people. For others, a combination of medication and healthy habits will keep them at their best.
“If you have been able to manage on lifestyle intervention [or changes] alone, continue to do that. If you need to go on medication, do what’s necessary [for] your health,” Albright says. “You need to take advantage of the treatment that’s going to keep your blood sugar, blood pressure, and cholesterol in check.”
CAN YOU REVERSE TYPE 2 DIABETES?
Sep 6, 2018 | Healthy Tips
Reference Reviewed by Michael Dansinger, MD
When you have diabetes, you need to worry about other health conditions, too. The longer you have the disease — into your 50s and beyond — the greater you are at risk for problems with your feet, your vision, your heart, your kidneys, and more.
This is why it’s crucial to see your doctor often: He’ll make sure that you have your diabetes under control, and he’ll see if other health problems are cropping up. You’ll probably need to visit his office every 3 months unless he tells you to come less often. (Some people who have their diabetes well under control may only need to visit the doctor every 6 months.)
These tests will help make sure you aren’t at risk of further health problems:
Blood Sugar Test
Your doctor needs to know how well you control your blood sugar levels. He’ll give you an A1c test, which shows your average over the past 3 months. If you have it under control, he may only need to do this test every 6 months. If you’re still getting there, you’ll need to be tested every 3 months. You should aim for an A1c level of around 7% or less to avoid more health problems.
Get it done: Every 3 to 6 months
Blood Pressure Check
People with diabetes are more likely to have high blood pressure, which raises your chances of getting heart disease. Your doctor should check your blood pressure at every office visit. If it’s too high, he may suggest lifestyle changes or prescribe a drug to help lower it. You want your readings to be below 130/80.
Get it done: Every time you see your doctor
Weight
If you’re overweight, your doctor may talk to you about your diet and exercise plan. Those extra pounds can make it harder to manage your blood sugar. Losing weight can help lower your blood pressure and your risk of heart disease. It doesn’t have to be a drastic change; your health can improve if you lose even 10 or 15 pounds.
Get it done: Every time you see your doctor
Foot Exam
Foot problems are common with diabetes, so you and your doctor need to stay on top of your foot health. You should carefully wash, dry, and inspect your feet at home every day. Nerve damage in your feet and legs can keep you from noticing when you hurt yourself. Your doctor will want to check them at each office visit.
People with diabetes also may have blood flow problems, which makes it harder for foot wounds to heal. A tiny cut, sore, or blister could grow into a foot ulcer that’s tricky to treat. If it gets severely infected, your foot or leg may need to be removed.
Get it done: Every time you see your doctor
Dental Check-up
Don’t neglect your mouth. When you have diabetes, you’re at greater risk of gum disease. It’s more likely when your blood sugar is out of whack. Even if you have it under control through brushing, flossing and rinsing with an antiseptic mouthwash, you should still see your dentist for checkups to make sure your mouth is healthy.
Get it done: Every 6 months
Kidney Test
You’re more likely to have kidney disease when you have diabetes, so your doctor will want to monitor them. He’ll test your urine to make sure your kidneys are working like they should. If you have kidney disease, treating it early can keep it from getting worse.
Get it done: Every year
Cholesterol Test
High cholesterol levels can lead to heart disease. Your doctor will check them at least yearly to make sure they’re in a healthy range. He can prescribe medicine to lower your cholesterol if you need it.
Get it done: Every year
Eye Exam
People with diabetes are at greater risk of vision problems. You’re more likely to have trouble with your eyes if your blood sugar or blood pressure levels are too high. To keep tabs on your vision and eye health, see an eye doctor at least yearly for a thorough exam. He’ll dilate your pupils to see whether you have any problems.
Get it done: Every year
GETTING OLDER? GET THESE TESTS.
Aug 21, 2018 | Healthy Tips
Reviewed by Nayana Ambardekar, MD.
People who have diabetes often have poor sleep habits, including difficulty falling asleep or staying asleep. Some people with diabetes get too much sleep, while others have problems getting enough sleep. According to the National Sleep Foundation, 63% of American adults do not get enough sleep needed for good health, safety, and optimum performance.
There are several causes of sleep problems for people with type 2 diabetes, including obstructive sleep apnea, pain or discomfort, restless legs syndrome, the need to go to the bathroom, and other problems associated with type 2 diabetes.
Sleep Problems and Type 2 Diabetes
Sleep Apnea
Sleep apnea involves pauses in breathing during sleep. The periods of stopped breathing are called apneas, which are caused by an obstruction of the upper airway. Apneas may be interrupted by a brief arousal that does not awaken you completely — you often do not even realize that your sleep was disturbed. Yet if your sleep was measured in a sleep laboratory, technicians would record changes in the brain waves that are characteristic of awakening.
Sleep apnea results in low oxygen levels in the blood because the blockages prevent air from getting to the lungs. The low oxygen levels also affect brain and heart function. Up to two-thirds of the people who have sleep apnea are overweight.
Sleep apnea alters our sleep cycle and stages of sleep. Some studies have linked altered sleep stages with a decrease in growth hormone, which plays a key role in body composition such as body fat, muscle, and abdominal fat. Researchers have found a possible link between sleep apnea and the development of diabetes and insulin resistance (the inability of the body to use insulin).
Peripheral Neuropathy
Peripheral neuropathy, or damage to the nerves in the feet and legs, is another cause of sleep disruption. This nerve damage can cause a loss of feeling in the feet or symptoms such as tingling, numbness, burning, and pain.
Restless Legs Syndrome
Restless legs syndrome is a specific sleep disorder that causes an intense, often irresistible urge to move your legs. This sleep disorder is often accompanied by other sensations in the legs such as tingling, pulling, or pain, making it difficult to fall asleep or stay asleep.
Hypoglycemia and Hyperglycaemia
Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) can affect sleep in those with diabetes. Hypoglycemia may occur when you have not eaten for many hours, such as overnight, or if you take too much insulin or other medications. Hyperglycaemia occurs when the sugar level rises above normal. This may happen after eating too many calories, missing medication, or having an illness. Emotional stress can also cause your blood sugar to rise.
Obesity
Obesity, or too much body fat, is often associated with snoring, sleep apnea, and sleep disturbance. Obesity increases the risk of sleep apnea, type 2 diabetes, heart disease, hypertension, arthritis, and stroke.
How Are Sleep Problems Diagnosed?
Your doctor will ask you about your sleep patterns, including whether you have trouble falling or staying asleep, are sleepy during the day, have difficulty breathing while asleep (including snoring), have pain in your legs, or move or kick your legs while sleeping.
Your doctor may refer you to a sleep specialist who may do a special sleep study called a polysomnogram to measure activity during sleep. The results of the sleep study can help your doctor make an accurate diagnosis and prescribe an effective and safe treatment.
How Are Sleep Problems Treated in Type 2 Diabetes?
There are several treatments for sleep problems in people with diabetes, depending on the condition:
Sleep Apnea
If you are diagnosed with sleep apnea, your doctor may suggest that you lose weight to help you breathe more easily.
Another potential treatment is continuous positive airway pressure (CPAP). With CPAP, patients wear a mask over their nose and/or mouth. An air blower forces air through the nose and/or mouth. The air pressure is adjusted so that it is just enough to prevent the upper airway tissues from collapsing during sleep. The pressure is constant and continuous. CPAP prevents airway closure while in use, but apnea episodes return when CPAP is stopped or is used improperly.
Peripheral Neuropathy
To treat the pain of peripheral neuropathy, your doctor may prescribe simple pain relievers such as aspirin or ibuprofen, antidepressants such as amitriptyline, or anticonvulsants such as gabapentin (Gralise, Neurontin), tiagabine (Gabitril) or topiramate (Topamax). Other treatments include carbamazepine (Carbatrol, Tegretol), pregabalin (Lyrica), lidocaine injections, or creams such as capsaicin.
Restless Legs Syndrome
Various medications are used to treat restless legs syndrome, including dopamine agents, sleeping aids, anticonvulsants, and pain relievers. Your doctor may also prescribe iron if you have low iron levels.
There are also several medications that treat insomnia, including:
Over the counter drugs such as antihistamines including diphenhydramine (such as Benadryl). These drugs should be used short-term and in conjunction with changes in sleep habits.
Medications used to treat sleep problems such as eszopiclone (Lunesta), suvorexant (Belsomra), zaleplon (Sonata), and zolpidem (Ambien).
Benzodiazepines are an older type of prescription medicine that causes sedation, muscle relaxation, and can lower anxiety levels. Benzodiazepines that were commonly used for the treatment of insomnia include alprazolam (Xanax), diazepam (Valium), estazolam (ProSom), flurazepam, lorazepam (Ativan), temazepam (Restoril), and triazolam (Halcion)
Antidepressants such as nefazodone and very low doses of doxepin
How Can I Improve my Sleep?
In addition to medications, recommendations to improve sleep are:
Learn relaxation and breathing techniques.
Listen to a relaxation or nature sounds CD.
Get regular exercise, no later than a few hours before bedtime.
Don’t use caffeine, alcohol, or nicotine in the evening.
Get out of bed and do something in another room when you can’t sleep. Go back to bed when you’re feeling drowsy.
Use the bed only for sleeping and sexual activity. Don’t lie in bed to watch TV or read. This way, your bed becomes a cue for sleeping, not for lying awake.
Are There Other Links Between Sleep and Type 2 Diabetes?
People who have poor sleep habits are at greater risk of becoming overweight or obese and developing type 2 diabetes, according to several studies. Chronic sleep deprivation may lead to insulin resistance, which can result in high blood sugar and diabetes.
Some studies show that chronic sleep deprivation can affect hormones that control appetite. For example, recent findings link inadequate sleep with lower levels of the hormone leptin, which helps control the metabolism of carbohydrates. Low levels of leptin have been shown to increase the body’s craving for carbohydrates regardless of the number of calories consumed.
WebMD Medical Reference
TYPE 2 DIABETES AND SLEEP
