This is part of a series by George Tohme, a Registered Pharmacist. George will be suggesting small actions toward a healthy lifestyle and sharing excerpts from his book.
During my pharmacy career, I have come to realize that a good majority of people with chronic diseases are making the same common mistakes that put their lives in danger. Whether people are unaware or choosing to ignore the risk, it doesn’t change the fact that the choices they are making directly affect their lifespan and their quality of life.
All of these mistakes can be totally rectified with proper awareness. This is the first in a three-part series where we'll discuss those situations along with solutions.
Knowledge is Power
Mistake #1: Not knowing enough about your condition, and seeing obstacles as a dead end instead of using the multiple solutions available to overcome them.
Solution: This is by far the most common and biggest problem facing people who get diagnosed with chronic conditions. Let’s talk about diabetes, for example. When I counsel people who have diabetes, most don’t realize that they can actually control it and that they can expect to have a natural lifespan without complications.
Instead, most people see their diagnosis as an obstacle that they won’t be able to overcome and that it’s the end of their world as they know it. People also believe that they will surely end up suffering all of the horrible complications their condition causes. But facts from landmark trials and all health organizations tell us a different story. Facts tell us that when you reclaim responsibility for your health and make the right choices then chances are you can live with almost any chronic condition, including diabetes, heart disease and COPD, and can expect a natural lifespan without complications.
Inaction or wrong actions are not options for defeating disease. It doesn’t matter what choices anyone made before the diagnosis; what will matter is what you do after the diagnosis. Your favorable and informed choices will make a tremendously positive impact to your recovery and keep your condition at bay.
For instance here’s how anyone can "defeat" (defeat as defined thoroughly in this previous article series) Type 1 or Type 2 diabetes: Take or use medications as prescribed and don’t make any changes before consulting with your doctor; monitor your blood sugar, pressure and/or cholesterol as indicated; learn how to structure your meals and snacks; make favorable food, snack and beverage choices; increase physical activity throughout the day; lose excess weight, if needed; manage stress and quit smoking. The same applies for other chronic diseases, just substituting the parameters that apply to your condition.
Small Action of The Week:
Raise your daily fiber intake to 35 grams daily. Switch to whole grain bread instead of the nutrient deficient white bread. One slice of the bread brands Oroweat or Nature Made contain 5 grams of fiber.
Keep up with "Actions of The Week" from other articles.
Lifestyle Makeover for Diabetics and Pre Diabetics
Here’s an excerpt from “Lifestyle Makeover for Diabetics and Pre Diabetics:”
Lifestyle Makeover for Diabetics and Pre Diabetics
by George F. Tohme, Pharmacist
What Is Diabetes?
Diabetes is the inability to transfer sugars in blood into the sugar-storage sites of your body, —the muscles and liver. Sugars, called carbohydrates, are found mainly in cereals, rice, bread, pastas, potatoes, milk products, fruits, fruit juices, and sweets. When we consume these foods, they pass from the stomach into the intestines and get broken down to the most basic sugar form, glucose.
Glucose (sugar) normally moves into the blood via a web of blood vessels that are connected to the intestines. When the movement of glucose into the bloodstream raises its average level above 100 points (mg/dL), it triggers the secretion of a hormone called insulin from the pancreas. When insulin is secreted into the blood, it causes the excess glucose (sugar) to be stored in muscles and liver cells. It is stored in a form called glycogen, which may be used at a later time as an immediate source of energy.
This energy is used for activities of up to 3 minutes: lifting or throwing an object, running away from danger, sprinting, stop-and-go actions such as a short walk, or any sports activity. Some people have impairment in their insulin production or in the functioning of their insulin. This insulin impairment causes the level of glucose to rapidly rise above the 100-point mark, and that is the condition we call diabetes.
High sugar levels, left untreated, can gradually cause damage to vital tissues, such as blood vessels, the nervous system, kidneys, heart, and arteries. This can cause debilitating strokes, heart disease, erectile dysfunction, loss of sensation or pain in the feet and hands leading to leg amputations, kidney failure, and blindness.
How Many Types of Diabetes are there?
There are many types of diabetes. These include types 1 and 2, gestational diabetes that develops during pregnancy, and prediabetes—a condition that may lead to diabetes.
Type 1 Diabetes
Type 1 diabetes is the condition in which someone can produce little or no insulin, due mainly to immune and genetic (inherited) defects in the pancreas. People with type 1 diabetes represent only 10% of all people diagnosed with diabetes. Type 1 can occur at a relatively young age, especially during childhood. At the time of diagnosis, people are usually of average weight, experiencing weight loss, frequent urination, blurred vision, and dry mouth, and their fasting blood sugars are way above 125 points (mg/dL).
People with type 1 diabetes have to depend on insulin use for the rest of their lives, in order to survive. Making good lifestyle choices is integral to diabetes control. Oral diabetes medications that are sensitizers (see detailed discussion of this group of drugs in Action Step 2 right after the insulin section) can be prescribed along with insulin for people with type 1, which can help reduce the amount of daily insulin used. Also leading and maintaining an active lifestyle and making favorable food choices and raising your fiber intake can all help bring diabetes under control and reduce the dose of total daily insulin (decisions about insulin dosing can only be made by your doctor).
Refer to Action Step 4 for a detailed discussion on how to start and maintain an active lifestyle and make favorable food choices.
Gestational diabetes affects some women during pregnancy and is characterized by blood sugars consistently higher than 95 points (mg/dL) in a fasting state first thing in the morning, and over 120 points 2 hours after a meal. Most women who suffer from gestational diabetes will return to having normal blood glucose levels after delivery. Up to 45% of women who develop diabetes during pregnancy may progress to having full-blown diabetes later in life unless they make favorable lifestyle choices and change their eating and activity habits. The main predisposing factors for gestational diabetes are family history of diabetes, obesity, and sedentary lifestyles. It is crucial that women at risk be identified, since high blood sugar causes fetal harm.
All women, early on in their pregnancy, who have the following criteria must be tested for high blood sugar: women who are overweight, over the age of 25, who have a family history of diabetes, those who belong to certain racial and ethnic groups other than Caucasian, those who have previously had gestational diabetes, or who have previously delivered large babies over 9 pounds.
Gestational diabetes is initially treated with lifestyle interventions such as making balanced food choices and increasing activity as described in Action Step 4. If fasting (first thing in the morning before eating) blood sugar is not brought to 95 points (mg/dL) or to 120 points 2 hours after lunch or dinner, then insulin is the ideal drug that is used. Your doctor will decide which insulin product and dose is appropriate for you. (See the discussion about insulin in Action Step 2.)
Type 2 Diabetes
Type 2 diabetes usually affects people later on in life, after the age of 25 or 30. However, Type 2 diabetes has alarmingly been plaguing children at a much younger age than ever witnessed. Kids as young as 15 and 17 who are obese and leading sedentary lifestyles and commonly seen in grocery stores shopping while riding electric scooters are now diagnosed with type 2 diabetes. About 90% of people with diabetes have type 2.
People with type 2 diabetes produce insulin from their pancreas, but due to lifestyle factors such as obesity and inactivity, the insulin is not able to perform and move the extra sugar from the blood into the muscle and liver cells, resulting in the buildup of sugar levels in the blood. This defect is referred to technically as insulin resistance. The diagnosis for type 2 diabetes is made when people have a fasting (before eating in the morning) blood sugar level of 126 points (mg/dL) and higher on 2 separate readings.
Type 2 diabetes can be hereditary. Non-Caucasians are more predisposed to getting it. But the vast majority of people get it due to inadequate lifestyle practices such overeating and s. A staggering 75% of people with diabetes are obese and inactive. This leads to the worsening of their conditions. I witness this trend every single day in my pharmacy practice. People drop off several prescriptions for diabetes, cholesterol, and blood pressure, and they sit the entire time in the pharmacy waiting area. When I counsel them about their medications and suggest they might increase the amount of daily walking, their invariable answer is, “I don’t have time.” Sometimes, they drop off their prescriptions and go food shopping. They bring back a cart full of bacon, cookies, and other packaged snacks such as popcorn, jugs of soft drinks, pretzels, butter, white bread, and let’s not forget the cigarettes!
People with type 2 diabetes may be treated with medications, either taken by mouth and/or through insulin injections, and by making favorable lifestyle choices. Medications alone without an active lifestyle will never be an efficient way to control diabetes and other chronic lifestyle-related diseases. Your doctor has many medication options from which to choose. What is important is to get diabetes under control in order to avoid deadly complications. Your health is your responsibility, and staying in close contact with your doctor and pharmacist is the only way to avoid diabetes complications and keep your diabetes under control.
The message that I bring you is this, “You are not doomed.” Certainly, you can control diabetes, but you have to be aware of some simple facts and act on them. Inaction will cause these deadly ailments to creep up on you and systematically destroy your internal organs.