Diabetes in Nigeria: Impact, Challenges, Future Directions Ogonna Oguejiofor, Charles Odenigbo and Chikezie Onwukwe.
Diabetes Education: Strategy For Improving Diabetes Care In Nigeria T H Raimi, O C Alebiosu, J O Adeleye, W O Balogun, B A Kolawole, O B Familoni, R T Ikem, O F Adesina, O Odusan, S A Oguntona, T Olunuga, and O Ogunsemi
Camel Milk Has Beneficial Effects on Diabetes Mellitus: A Systematic Review
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DO I REALLY NEED TO WORRY ABOUT MY HIGH CHOLESTEROL?
DO I REALLY NEED TO WORRY ABOUT MY HIGH CHOLESTEROL?
By Maureen Salamon
The Answer Is the Same for Anyone with High Cholesterol. Though some health issues are easy to ignore, high cholesterol, particularly high LDL levels (the “bad cholesterol”) is not one of them. Cholesterol problems can affect anyone. Monitoring cholesterol levels is crucial because individuals with unhealthy cholesterol levels typically do not develop specific symptoms.
Overview
High cholesterol, which is defined as a total cholesterol level greater than 240 milligrams per decilitre (mg/dL), is much more common than very low levels.
The target cholesterol level for a normal, healthy adult is below 200 mg/dL, while levels between 200 mg/dL and 239 mg/dL are considered borderline high. Current guidelines recommend that healthy adults check their cholesterol levels at least once every five years.
Individuals with elevated total cholesterol or LDL levels have a significantly increased risk of developing heart disease, which is the number one cause of death in the United States. Approximately 25.6 million adults have diagnosed with heart disease annually, resulting in 650,000 deaths each year.
It would seem that cholesterol has been demonized with good reason, yet our bodies cannot live without the soft, waxy stuff. Cholesterol is present in every cell and promotes hormone production, digestion, and the conversion of sunlight into vitamin D. Approximately 75% of the cholesterol present in the blood is produced by the liver, while the remaining cholesterol present is derived from the diet.
Diagnosis
Several tests are used to evaluate cholesterol levels in the blood. The simplest test measures total cholesterol, which is the combined levels of LDL (“bad cholesterol), HDL (“good cholesterol”), and triglycerides (the main form of body fat). A lipid profile test, which is performed after 12 hours of fasting, provides a detailed breakdown of cholesterol levels by lipid type (LDL, HDL, and triglycerides).
Current healthy cholesterol level guidelines recommend:
LDL (“bad cholesterol”): Levels below 100 mg/dL are considered healthy. Levels above 190 mg/dL are unhealthy.
HDL (“good cholesterol”): Levels above 60 mg/dL are healthy. Levels below 40 mg/dL are unhealthy.
Triglycerides: Levels below 150 mg/dL are healthy. Levels above 500 mg/dL are unhealthy.
HDL cholesterol — the “good cholesterol” — works like a clean-up crew in the bloodstream by ferrying “bad cholesterol” (LDL) to the liver for safe disposal. That means higher HDL levels are good for the heart.
Causes
Maintaining a healthy level of cholesterol is important for maintaining a healthy heart. According to the National Cholesterol Education Program (NCEP), an initiative of the National Heart, Lung, and Blood Institute, high total cholesterol levels are particularly dangerous for individuals who smoke. Additionally, individuals who are diabetic or obese, or have low HDL cholesterol, high blood pressure, or a family history of heart disease, should strive to maintain healthy cholesterol levels.
Approximately 7 in every 1,000 adults suffer from familial hypercholesterolemia, a genetic condition that can elevate cholesterol levels to two times the normal level.
In addition to lifestyle and overall health, age is also a risk factor for developing high cholesterol. Older individuals, particularly men over 45 years of age and women over 55 years of age, are more likely to see their cholesterol levels increase because their bodies are not as efficient at processing and excreting cholesterol. In fact, men with high cholesterol levels often have their first heart attack when they are between 40 to 50 years of age.
However, even young people are not immune to the dangers of high cholesterol. Researchers have found that fatty plaques of cholesterol can actually begin forming well before adulthood, leading to narrowed arteries and, potentially, a heart attack or stroke.
Lifestyle Changes
In most cases, changes in diet and increased exercise are the first response to lowering high cholesterol levels.
The NCEP recommends getting at least 30 minutes of exercise every day. Other recommended strategies include avoiding saturated fats and cholesterol and maintaining a healthy weight. Obesity often leads to elevated total cholesterol levels because excess body fat can increase the concentration of cholesterol and triglycerides in the blood.
Foods to Avoid
Foods to avoid if you have high cholesterol levels include white bread, white potatoes, and white rice, whole-fat dairy products, and any highly processed sugars or flours.
Foods that have been shown to reduce cholesterol include fatty fish, walnuts and other nuts, oatmeal, psyllium (and other soluble fibres) and foods fortified with plant sterols or stanols.
Medications
However, if lifestyle changes alone are not effective, your doctor may prescribe a particular class of drugs known as statins, which help reduce LDL and triglyceride levels and increase HDL levels. Statins, the most widely prescribed class of cholesterol-lowering drugs, act by inhibiting cholesterol production within the liver. Your doctor may prescribe one of many available statin medications: Lipitor (atorvastatin), Zocor (simvastatin), Mevacor (lovastatin), Lescol (fluvastatin), Crestor (rosuvastatin) or Pravachol (pravastatin).
Sources:
“High Blood Cholesterol: What You Need to Know.” NHLBI. Jun 2005. National Institutes of Health.
“Heart Disease.” National Centre for Health Statistics. 31 Dec 2007. Centres for Disease Control. 27 Feb 2008.
“Lifestyle Changes and Cholesterol.” American Heart Association. Oct. 26, 2015.
Fallon Jr., L. Fleming. “Hypercholesterolemia.” Health AtoZ, Gale Encyclopedia of Medicine. 2006. The Gale Group.
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HOW TO MANAGE BLOOD SUGAR SPIKES AFTER MEALS
HOW TO MANAGE BLOOD SUGAR SPIKES AFTER MEALS
If you’re trying to manage diabetes, you already know it’s important to keep track of your blood sugar levels. But how do you handle a spike that comes after you eat? It’s called “postprandial” blood glucose, and if you take some simple steps, you can get it under control and help avoid health problems.
Why You Should Keep an Eye on It
When your blood sugar is high, you can get symptoms like a foggy-headed feeling that makes it hard to focus or think clearly. Your energy may also take a dive, and you may feel nervous or moody.
If your levels go too low, you could even pass out. In the long run, if your blood sugar stays up, you could be at risk for heart disease, stroke, kidney disease, or other problems.
How to measure your spikes
The American Diabetes Association (ADA) recommends you check your blood sugar levels right before mealtime with a blood sample from a finger stick. Then do it again 1 to 2 hours after that first bite of food.
Keep this up for a week or so. Write down the time and the blood sugar number. Make a note of anything you think might affect your levels, like medicine or exercise. And don’t forget to log exactly what you ate, along with portion sizes and a number of carbs.
What are levels too high after a meal? Experts vary on what the number should be, but the ADA says a general goal is a blood sugar level under 180 mg/dL, 1 to 2 hours after a meal. Talk to your doctor about what you should aim for, and don’t adjust your medicine without speaking to him first.
How to Manage After-Meal Spikes
Get medicine that works for you. The right insulin or medication program can make a big difference. In general, to cover after-meal spikes, those that kick in quickly and for a short time are a better choice than ones that work slowly over a long period. Your doctor can explain your options.
Keep blood sugar in check before meals. That way, even if it goes up after you eat, it won’t be so dramatic.
Watch what you eat. Limit sweets, white bread, rice, pasta, and potatoes. They tend to trigger post-meal spikes.
The type of fat you eat may play a role, as well. One study shows you may be able to curb blood sugar spikes after you eat if you skip foods with lots of butter and choose a meal made with a little olive oil instead.
Eat breakfast every morning. Even when you’re in a hurry to get out the door, don’t be tempted to skip it. A study shows that folks with diabetes who don’t eat breakfast get higher blood sugar spikes after lunch and dinner.
The ideal morning meal? It might just be one that’s packed with protein. A small study shows that when people ate a 500-calorie breakfast that was 35% protein, their post-meal blood sugar levels were lower than those who started their day with high-carb food. But check with your doctor to see what’s right for you.
Go for an after-dinner walk. It’s a healthy habit for everyone, but if you have diabetes, it’s also a good way to burn extra glucose from a meal.
WebMD Medical Reference
Reviewed by Melinda Ratini, DO, MS on September 09, 2016