Tag Archive for: blood sugar

Health Headline: Ketogenic Diet and Type 1 Diabetes

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Researchers wanted to examine the blood sugar control of type 1 diabetics who use a very low carbohydrate, high-protein, moderate fat ketogenic diet. The diet was developed by Dr. Richard Bernstein, himself a type 1 diabetic. They used a unique study design: they requested volunteers from a Facebook group of children and adults who adhere to the Bernstein Diet. Over 300 volunteers completed an online survey about their diagnosis and diet. The diagnosis of type 1 diabetes was confirmed from medical records from a follow-up survey of medical staff.

This was a rigid ketogenic diet with no more than 30 grams of carbohydrate allowed per day. The average intake was 36 grams carbohydrate per day. The better the control of carbohydrate intake, the better the HbA1c score, with a mean of 5.7%. Remember, these were type 1 diabetics; there are many type 2 diabetics who don’t control their HbA1c that well. I think this study illustrated the potential of nutrition in affecting a disease system. One interesting aside was the healthcare professionals treating the patients seemed indifferent to the dietary approach regardless of the results.

Headline worthy? Yes, in context. Close to half the subjects did not provide access to medical personnel so the researchers relied on the initial subject surveys for information. They also had no access to any dietary records to confirm the diet. Still this was a unique way to use social media to gather information. The study has to be confirmed using traditional research design to assess the variables. But this approach examined people who live this diet on their own or with their children. That can provide insights that might be missed if the study were conceived by a group of research professionals discussing the question around a table.

What are you prepared to do today?

Dr. Chet

 

Reference: Pediatrics. 2018. doi: 10.1542/peds.2017-3349.

 

A New Approach to HbA1c

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Type 2 diabetes is a significant problem in North America and it’s spreading throughout the entire world. The treatment standard has always focused on controlling blood sugar, especially HbA1c. Normal is less than 5.7%. For most individuals, reducing the HbA1c to under 6.5% has been the goal for pharmacologic treatment.

HbA1c is a protein found on red blood cells that indicates blood glucose levels over the past 90 days. It develops when hemoglobin, a protein within red blood cells that carries oxygen throughout your body, bonds with glucose in the blood. Think of it as the sugar you ate over the last three months getting stuck to your red blood cells; the higher your HbA1c, the worse your control of your blood sugar has been. For a prediabetic, that means your days of diabetes meds and finger pricks is getting closer. For a diabetic, that opens the door to many of the worst consequences of diabetes, such as heart and kidney disease, blindness, and nerve damage.

Recently, the American College of Physicians published new guidance statements for the use of medications for controlling HbA1c. A committee of physicians examined the data behind the current standards of treatment for four of the major physician organizations including the American Diabetes Association. In the simplest terms, they wanted to know what benefits or hazards occur when treating adults with type 2 diabetes with medications. Should the goal be to get the HbA1c as low as possible with drugs? Or should the individual be part of the treatment equation?

This is an important issue and the topic for this week. I’m going to review evidence-based medicine on Thursday. You can get the entire story by listening to the Straight Talk on Health on evidence-based medicine, normally available only to Members and Insiders; I cover the entire concept of how EBM began and what it was intended to be. For those of you who haven’t chosen a membership yet, get more info here.

What are you prepared to do today?

Dr. Chet

 

Reference: Ann Intern Med. doi:10.7326/M17-0939.

 

The Science Behind Holiday Spices: Cloves

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No one has to tell us that Christmas and the New Year are coming; it’s in the air. You can smell the holiday season this time of year. This week, I’m going to cover three spices used this time of year and talk about some of the potential health benefits of each. I’m not suggesting their use makes foods healthy if they’re also high in sugar and fat—just that there’s some interesting science behind these spices.

If you prepare . . .

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The Answer to the Sugar Conundrum

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Whether you have prediabetes, type 2 diabetes, or are just concerned about the calories in the sugary treats this holiday season, what should you do? Go without and feel deprived, or indulge and pay some sort of price? Let’s take a look by beginning with a few questions.

Why do you want to reduce your sugar intake? Do you want to reduce your caloric intake? Is it because you know you have prediabetes or type 2 diabetes? Are you concerned about gaining weight over the holiday season? Once you know why you want to avoid sugar, you can start . . .

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Sugar Alternatives

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Dealing with our sweet tooth this week, let’s look at sugar alternatives that may give us better choices if we don’t want to use artificial sweeteners.

Sugar alcohols are one alternative; xylitol, sorbitol, and other sugar alcohols are often used in candies and other treats. They can be a reasonable alternative to regular sugar, but there are a few things you need to know. First, they have a pronounced aftertaste; it feels like a cool sensation. Second, they’re not calorie free but . . .

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The Sugar Conundrum

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During the holiday season, there are plenty of sugary snacks available. Candy, cookies, pies, all kinds of treats. But can something as simple as jam on toast, let alone the holiday treats, be an issue for someone with prediabetes or type 2 diabetes? With close to half of all adults afflicted with one condition or the other, any kind of sugar stops them in their tracks. I see people reading labels carefully in the grocery store and often hear the words “No good. It has sugar!” In the prediabetes and diabetes groups I . . .

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Pedelec: The Bottom Line

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I want everyone to exercise. Period. It doesn’t matter how. You can work within your physical limitations, but everyone needs to exercise. That’s why the pedelec story and research study attracted my attention. Combining what you have to do anyway—get to work—with physical activity could be just the ticket. Let’s see if this is your ticket to ride.


The Benefits

Even in a study as short as four weeks, there were some health benefits, especially for blood sugar control. For someone at risk for type 2 diabetes, which is just about everyone, it . . .

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Prediabetes: What Now?

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The messages this week have talked about the risk factors for prediabetes and how many people don’t know what they are. It’s time to change that, at least in those of you who read the messages. Please feel free to pass them along to anyone you feel might also be unaware.

How do you know if you’re actually prediabetic? It requires a blood test for a specific protein called HbA1c. This protein indicates the amount of sugar that’s been in your blood stream for the past 90 days. The number for your blood sugar might be . . .

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Keeping Track of Life’s Simple 7

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To complete American Heart Month, here’s an easy way to track your heart health called Life’s Simple 7 (LS7), developed by the American Heart Association. LS7 has been around since 2010 but it escaped my attention until recently. For those of you who like to track your progress to see how you’re doing, this is a great tool; you may remember I mentioned it last month, but I think you need the details to really understand how LS7 can work for you.

There are seven different categories of variables to track, hence the name Life’s Simple . . .

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