Diabetes is not an easy disease to control.  Your blood sugar will be up, it will be down.  If you’re stressed or sick you could eat a salad for lunch your blood sugar may still be at 300.  It’s annoying and frustrating.  My dad says (and pardon the language, but the honesty is key) that diabetes is a “Goddamn guessing game.”  There will be times when you want to throw your meter across the room and where it feels like anything you try is futile.  Doing something is better for you then simply giving up.  Remember,  the blood sugar is important to protect your organs, so doing something is better than giving up and doing nothing at all.

The biggest struggle that most diabetics have is with high blood sugar and there are two schools of thought.  One school says that you can eat whatever you want and just cover with insulin and medication.  I think this is mostly bogus.  Eating whatever we want is what has gotten us into this epidemic in the first place.  Non-diabetics shouldn’t even eat whatever they want, whenever they want.  I’m tossing that school into the trash.  The other school of thought says that you should modify your life to match your blood sugar.  If your blood sugar is high at lunch time it just makes more sense to have a salad or some soup instead of a sandwich.  If your blood sugar is high at dinner, maybe dessert really isn’t the best idea.  Okay, stop it.  I can feel you glaring at me.  I am not saying you can never have dessert or your favorite sandwich.  Having a slice of your best friends birthday cake is a-okay in my book.  It’s life and you are allowed to have fun, but fun comes at a cost, whether you’re a diabetic or not.  If you eat simple carbs your blood sugar will go up.  That is just how it is.  Now, you’re pouting.  Stop it, it isn’t the end of the world and there is something you can do.

Exercise is so important.  Life is busy and exhausting and there are so many excuses to not exercise.  Trust me, I’ve used them all, but it’s about putting yourself first.  The goal is to exercise 30 minutes five times a week.  That’s the GOAL, but, remember, 20 minutes is better than 0 minutes.  You don’t need to go to the gym.  You don’t even need workout equipment.  Go into your kitchen and grab some soup cans.  Do some bicep curls!  Do something.  Walk around the couch while you’re watching tv and then step it up a notch!  Do some jump roping or jumping jacks.  Exercise makes your blood sugar go down.  As long as you have some insulin in your system your body will suck up those carbs up like a 6 year old on a Mountain Dew.  What does that mean?  Lower blood sugar means that your body isn’t getting maimed by sugar crystals and it means you can afford to have a little fun!  Yum!

Most diabetics have the hardest time with their blood sugars in the morning.  That means that whatever you ate the night before isn’t getting worked off.  There are a few things that could be going on there.  First, you could be eating and then sitting around before going to bed.  That is SOOO relaxing, but very naughty for the blood sugar (Yoga is also relaxing… just saying ).  The other thing that could be happening is that you could be eating too many carbs with your meals.  It is fairly normal in our American culture to have multiple carbs with our meals.  As a diabetic it is so important to try to limit the carbohydrates to a single serving and to attempt to make sure that the carbohydrates are high in fiber (these are complex carbs and your best friend).  Instead of potatoes and a slice of bread with dinner, why not try some long grain wild rice (or jasmine rice is lovely), which is much higher in fiber and amazingly easy to season.  Yum!  Try switching to whole wheat pasta and skipping the garlic bread.  What about garlic chicken instead?  Delicious! 

Hyperglycemia is the awkward elephant in the room.  It is frustrating and often makes you feel defeat you.  Don’t let it defeat you.  Take that frustrated energy and move it into something positive and active.  Hell, take that anger and do some shadow boxing.  Do some kick boxing.  Go for a walk.  Put your favorite song on your stereo and dance  until you can’t dance anymore.  You’re worth it.  Diabetes doesn’t have to be Hell.  It doesn’t have to be a death sentence.  You can be diabetic AND fabulous.  Just don’t be afraid to try.

So a couple weeks ago we talked about the difference between Type 1 and Type 2 diabetes.  We talked about what puts us a risk for getting the different types of diabetes.  But what about your risk factors if you already have diabetes?  What about ways to prevent or even cure your diabetes?  Nothing like a little motivation to move you in the right direction eh?

First a little recap:

Type 1 Diabetes is caused when your body attacks your pancreas and can no longer make insulin.  You become insulin dependent.  This is linked mostly to genetics and bad luck, but an unhealthy lifestyle has been shown to accelerate the process.

Type 2 Diabetes is caused when the body cannot can not utilize the insulin that the body makes and when the body cannot make enough insulin to compensate.  The most common causes are weight, poor diet, with genetics also playing a factor.

So, as a diabetic, what are some complications and what puts you at risk for these complications?

First let’s talk about why a lot of these complications happen.  Most of them occur because of high blood sugar.  Do me a little favor, grab a sugar packet from the break room or a teaspoon of sugar from your kitchen.  Rub some sugar between your fingers (now go wash your hands).  Sugar is sharp!  It’s crystal and when it is in your blood it is still a very tiny microscopic little ninja star.  When your blood sugar is high your blood goes from a teaspoon of sugar in your tea to simple syrup.  That is a lot of sugar running around and that little ninja star becomes a wire scrub brush.  And that brush is running through your veins honey.  Yikes!

So the major risk you hear about the most as a diabetic is cardiovascular disease.  This is very complicated, but let’s at least tackle some of the simple concepts.  When you want to paint your bookshelf what do you do first?  You sand that baby down!  This takes off protective coatings and creates tiny imperfections in the wood.  This means the new paint can stick to the surface!  Now lets apply this concept to your blood vessels.  The excess sugar in your blood scuffs up the inside of your blood vessels.  Now that the inside of your vessels are texturized the cholesterol that is also located in your blood grabs a hold and sticks.  Your blood vessels then narrow giving you chest pain, blocking off blood to your heart and brain and putting you at high risk for stroke and heart attack.  This, of course, is made worse the longer your blood sugar is elevated (because your body has no time to heal) and when your cholesterol is elevated this puts you even more at risk for cardiovascular disease.

Something else that you might be doing to your body, but you might not feel is kidney damage, or nephropathy.  Your kidney has little tiny blood vessels where waste from the body is filtered out.  Remember that scrub brush?  You are doing two different things to your poor kidneys:  First, the scrub brush is poking holes in your filtering system so you are losing blood and vital nutrients.  Second, the sugars are scarring up the vessels making it harder for the kidneys to filter, thus causing a backup of waste into your body.  Yuck!

Cancer is another risk factor that increases, especially with Type 2 diabetes.  There are still studies being done to try to pinpoint the cause, but it may have to do with the risk factors that cancer and Type 2 diabetes have in common, like obesity.

Neurological problems have also been linked to diabetes.  Alzheimer’s has been correlated to high blood sugars and may be related to the scuffing up of vessels around the neurons, but also to genetics surrounding Type 2 diabetes and Alzheimer’s.

High blood sugar can also cause some very unattractive problems (and there is nothing wrong with being diabetic, but let’s look fabulous and healthy being one).  High blood sugar gives you dry mouth.  Dry mouth lets the naughty bacteria running rampant around your mouth.  High blood sugar erodes the blood vessels.  This means that the body’s ability to heal is diminished.  This means that your skin will suffer, your mouth will suffer (nobody likes hillbilly mouth), and so will your feet!  All these things put you at risk for massive bacterial infections and amputation.  I’ve had family members who needed both legs amputated from uncontrolled diabetes.  The amputations don’t heal well, they hurt, they become infected, and they take a huge emotional toll on the diabetic and their family.

Eye damage can also be devastating.  The blood vessels in your eye are so teeny tiny that when those sugar crystals travel through them and cause damage the eye and it’s nerves don’t get the blood and nutrients that you need.  This means that the eyes begin to die and blindness becomes a real risk.

The greatest complaint I get from my patients is about the pain and numbness that they begin to feel in their fingers, toes, legs, and arms.  We’ve already talked about how high blood sugar destroys blood vessels and destroys nerves causing blindness.  The same thing happens to the nerves over the rest of your body.  Those starving nerves can tingle, burn, and eventually die leaving no feeling in those limbs.  Neuropathy also effects sexual health and can cause erectile dysfunction in men and sexual dysfunction in women.

So this all sounds pretty scary.  Coming from a family of diabetics some of this makes diabetes sound like a death sentence, but this does not have to be the case.  Whether you are a Type 1 or Type 2 diabetic be healthy.  Exercise, watch your blood sugar, and your weight.  No one wants you to look like Twiggy (eww) and you’re never going to perfect blood sugar all the time, but trying and shooting for being healthy makes all the difference.  If you are a Type 2 diabetic then shooting for being healthy can also be your cure.  Just remember kids:  It’s never too late to get healthy, but we always have to deal with the consequences of our actions.  Just don’t lose hope!

It’s a new year with new resolutions and I’m sure none of us have been perfect, but trying is what matters.  I’m a firm believer that knowledge is power and the best way to succeed is to know as much as you can.  Diabetes is a very big issue.  Projections have showed that 52% of the population could have diabetes or pre-diabetes by the year 2020!  That’s only eight years away folks.  Now, I’m not here to judge anyone.  Trust me, I understand that sometimes genetics is a beast that looms over your shoulder and sometimes you just want to give up.  There are at least three generations of late onset type I diabetics in my family and the odds are not on my side.  Depending on the kind of diabetes you see in your family there are tests that can be run and things that you can do to prevent the diabetes (or at least slow it down).  If you are already a diabetic and you are wondering how these new year’s diets all fit into your life it’s time to touch on that too.  This is waaaaaaaaaaaaaaay too much information to do in one blog.  I don’t want your eyes to glaze over and I promise it’s going to be good stuff so I really want you to take it all in.  So this is the first blog in the series.  Let’s talk about diabetes, the difference between Type I, Type II, and the emerging definition of Type III.

Diabetes Mellitus (DM), no matter what type you have, is a dysfunction of a hormone, insulin, in the body.  Insulin is the hormone that helps your cells absorb glucose (a sugar your body needs to function).  The best way to think about insulin is that it is the taxi that delivers glucose into the cell.  Depending on what is going on with the taxi, this helps you understand what the difference in the kind of diabetes you have.

Type I DM is often known as juvenile diabetes because the majority of patients diagnosed with Type I are between the ages of 4 years of age and in their early 20′s.  This term, however, is not being used any longer because there are patients with Type I that are diagnosed in their 30′s and 40s (and sometimes later).  Also, in the current state of affairs, just because a child has diabetes, does not necessarily mean that they are Type I diabetics.  So, what really distinguishes a Type I diabetic from the other types?  This is a autoimmune mediated disease where antibodies attack the pancreatic beta-cells and, sometimes, the insulin hormone itself.  Okay, WHAT?  Now in plain ol’ English:  Type 1 diabetes is caused when the body decides it doesn’t like the cells that make insulin in an organ called the pancreas and sometimes doesn’t like the insulin either.  This is equivalent to the body’s antibodies blowing up the taxi station and the taxis so that glucose cannot get inside the cells.  Now that’s what I call bio-terrorism.  Now, here is the good news: if you know that this type of diabetes runs in the family there is a very simple lab test that can be run to test for the antibodies.  This can sometimes help catch the disease before it gets ugly, but not everyone produces these antibodies, just the majority.  Sometimes you can’t predict if you’re going to get Type I DM.  It can be caused by genetics, but also environment, a virus, or even poor eating.  And remember what I mentioned before.  Just because you are over 30 doesn’t mean you’re out of the woods.  LADA, or Latent Autoimmune Diabetes of the Adult, occurs in people over the age of 30!

Type II DM is more often than not associated with obesity and poor eating.  This is true, but individuals at a healthy weight can also get Type II (although their chances are much less likely).  Type II diabetes is caused by peripheral insulin resistance and by the beta cells inability to make enough insulin to cover the high glucose that is already present in the body.  All overweight individuals suffer from insulin resistance, but only when a person’s beta cells are unable to produce enough insulin does the patient have Type II DM.  So in English:  The body is unable to absorb the sugars into it’s cells and the pancreas just can’t spit out enough insulin to overcome the resistance.  This is equivalent to the taxis not being able to get the glucose into the cells and the taxi station not being able to supply enough taxis to meet the  demands of the body.  Type II diabetes does have a genetic link (some of the mutations can be screened for), but there is more than just genes involved.  People who do not do some sort of exercise, are overweight, have high blood pressure, polycystic ovarian syndrome, or just eat meals high in simple carbohydrates put themselves at high risk for Type II diabetes.  Unlike Type I diabetes there is usually a way to prevent the onset or to simply get rid of the Type II DM altogether (more on that later).

Type III DM is not truly recognized, but people studying the occurrence describe it as a mix of Type I and Type II DM.  Not only has the body destroyed it’s ability to make insulin it is also resistant to absorbing the insulin injected.  This means the patient must use super high doses of insulin to moderately bring down their blood glucose.

If you already have diabetes or pre-diabetes (no matter the type) the words you most likely hear from the doctor are “blood glucose levels” and “A1C.”  I suspected since these numbers are thrown around so much that the average patient would at least be able to tell me what their goal is or what those numbers mean, but in my experience only a few patients actually understand the numbers and the acronyms and tell me what they mean.  This means there is a distinct lack of communication going on between the patient and the doctor, so let me clear some of this up for you:

Blood Glucose Levels:  These are measurements read from the blood by a laboratory or by your glucose monitor to tell you how sugar is in your blood and much insulin to inject or what foods to eat less of.  For example, if your blood sugar is reading 200 it is probably not the right time to have a burger or eat some ice cream.  A fasting blood glucose level (the level taken after not eating for 6 hours) should be less than 125.  If it is between 100 and 125 then pre diabetes is a concern.

A1C:  Your A1C is measured, normally, by your laboratory although there are machines available to the general public for home monitoring.  This lab helps figure out an approximate 3 month average of blood sugars.  Most people have a goal of less than 7, but if you are 65 or older the American Geriatric Society suggests an A1C of less than 8.  Testing your A1C more than once every 3 months is not recommended (and to be honest the home test kits are kind of expensive and not as accurate at the lab).

I know this is a lot of information so take it in.  Ask questions.  Read the article a few times and remember that another blog will be appearing soon to discuss more about risk factors and prevention.  And just remember, Mixtures Pharmacy doesn’t just compound, we also take care of your regular medications, including your diabetic supplies so if you have questions about your diabetes and treatments just call or stop by and let us know!

We’ve all heard how important a good detox can be for jump-starting a diet, cleaning the colon, as well as general body health.  These things are all true, but the sort of detoxifying regimen and the length of the detoxifying regimen is what is most important.  Remember, the way to lose weight and to keep your body healthy is to eat a clean nutritious diet.  Lots of fresh foods, plenty of fiber, lean protein, and good fats.

The cleanse I hear most people talking about is the Master Cleanse.  It consists of a laxative tea or water with 2 teaspoons of salt every morning and at least ten days of a lemonade made with water, lemon juice, maple syrup, and cayenne pepper.  I know of no medical professional who approves of this cleanse.  It contains only simple sugars.  There are no essential fats, proteins, or fiber (which is the colon’s toothbrush), although, since you do not eat anything for ten days and take laxatives each morning it can be no wonder why your system is cleaned out, but you are entirely at risk for being malnourished.

There are some wonderful cleanses out there that can be used as a meal supplement.  Used along with a healthy diet these cleanses can help jumpstart your weight loss clean out your old habits while you’re bringing in your new habits.  Our favorite at Mixtures is made by a company called Metagenics.  Metagenics has a cleanse called the UltraClear RENEW cleanse.  It contains good fats, proteins, and fiber and is lower in sodium.  It is a perfect meal supplement to take to work and keep you going.  It will help cleans your liver (your body’s toxin filter), your colon (without the harshness of diarrhea), and has been shown to help with neuron function.  Xymogen Opticleanse is another brand that provides the same benefits and is also available at Mixtures!

Another great detox that I love for the morning is green tea mixed with Yogi Tea’s detox tea.  It is my favorite when I’ve eaten too much salt.  If tea is difficult there are other tablet forms of detox (like Metagenics AdvaClear.  Metagenics makes a great deal of effort to make their products as hypoallergenic as possible and they are of extremely high quality.  If you stop by Mixtures, or call, we can set you on the right track to make your resolutions come true.

Remember to detox correctly you must support adequate nutrition.  Nutrition keeps your body in balance which balances your hormones and, therefore, your metabolism.  See our blogs on carbohydrates, fats, proteins, and sodium to help guide you through the new year.  If you have questions please tweet, facebook, or comment and we’ll see what we can do to help!