Cardiovascular exercise, whether its swimming, running, walking, dancing, etc, increases your heart rate.  What does the heart use for energy again?  Oh yeah, fat.  Cardiovascular exercise can help tone you as well, but it’s major purpose is to burn fat.  HIIT, or high intensity interval training, is most effective at burning fat.  It works off of intense cardiovascular exercise to medium or mild exercise.  For example:  Sprinting for 2 minutes and jogging or walking for 2 minutes.  It keeps the muscles confused and revs up the metabolism for longer than just the work out.  This means extra toning, extra fat burning, and, my personal favorites, it’s a shorter workout (usually) and it keeps me engaged (a boring workout will shoot my motivation faster than chocolate mousse).  Cardiovascular exercise doesn’t need to be high impact either.  You can do it on a bike, some forms of yoga can be primarily cardiovascular, swim, hula-hoop, whatever gets your heart rate up!

Toning exercises build up muscle strength.  Free weights, yoga, kinesthetics, resistance training, and weight machines.  You don’t need big fancy machinery though.  Using your own body weight, soup cans, resistance bands, or some cheap weights from Target… all of these things will do the same thing!  They’ll increase your stamina and make sure that you build lean muscle (If you don’t want to get bulky, use smaller weights and more reps).  Circuit training is one of my favorite ways to tone.  It works multiple muscle structures, you can do as many or as few circuits as you want, and you can do the circuit as fast or as slow as you want.  If you’re really challenged, just remember:  stop, take a breather, and take your time.  Just get through one circuit, you can work up to two or three later.

Still not convinced?  Do you seriously want to keep shaking your Sensa instead of your booty?  Here’s some more reasons to exercise:

1. Increase your HDL (good cholesterol)
2. Decrease your LDL (bad cholesterol)
3. Decrease your blood pressure
4. Decrease your risk for Type 2 Diabetes (or manage your diabetes)
5. Increase your metabolism (Pills don’t do this, action does)
6. Increase your stamina
7. Decrease your risk for heart disease
8. Boost your mood (that’s right, a dopamine AND serotonin boost without going to the pharmacy!)
9. Boost your energy
10. Decrease your risk for osteoporosis
11. Manage arthritis
12. Decrease your risk for falls
13. Decrease your risk for stroke
14. Decrease your risk for certain types of cancer
15. Control your weight
16. Sleep better
17. Have better sex (if that’s not motivation I don’t know what is)
18. Improve your focus as you get older (Squirrel!  Let me tell you, I’ll take any help I can get…)
19. It can be soooo much fun (Jump rope and tag were my favorite childhood memories)
20. And most important:  You are 100% worth the work.

My favorite cardio and strength training exercises are Zumba, Tone It Up, and Self’s Drop 10.  They’re  fun, very positive, and have a great community!

• Zumba is done in YMCA’s, gyms, and community centers all over the US!  It’s based off Latin dancing and I have patients who pay $30 a month at the gym and I have other patients who pay $2 a class at the community center!  They even have Water Zumba for lower impact… oh yeah, and you get to dance.  How much fun is that?!  Dance party!!!  Check out the many different classes available (even for kids) and locations: http://www.zumba.com/
• Tone It Up puts out a monthly calendar and try to keep things positive.  You can get as involved or uninvolved as you want.  I love to brag about my successes and even though I am not a frequent commenter on their Facebook I always get positive feedback.  Now, some of you might have met me (especially if you’ve been coming to Mixtures for a long time), but I’m not a perky, giggly person.  I’m pretty sarcastic (I know, you’re shocked) and blunt, but when it comes to working out I really need for someone to be positive and these girls (as smiley and irritatingly happy as they are) are incredibly supportive to their followers and make a point that no matter what size your are, you are worth the work.  When I started following them I couldn’t run worth beans.  A year + later I’m running and using heavier weights and able to do all the circuits.  It’s all about building up to it.  Follow them on facebook, twitter, and their blog and watch for their free workout videos (with accompanying PDFs) and HIIT workouts: http://toneitup.com/index.php  Trust me kids, man or woman, young or old, their workouts are great for working at your own pace.
• Self magazine released in April and May a Drop 10 eating and workout program!  The eating program even includes on the go items from Subway and Starbucks!  The best part?  It allows for fun calories like french fries and ice cream and chocolate (oh my!).  The workouts include cardiovascular three times a week and toning twice a week.  Even with my insane schedule I can fit it in AND I even followed the plan on vacation!  What you need?  Weights and your cardio of choice.  The girls at Tone It Up helped arrange the program too so it’s all very positive and if you can’t do something?  Just ask them what to substitute.  You may have a hard time with some of it, but you’re worth trying SOME of it.  The down side?  You have to sign up.  The upside?  Ummm losing at least 10 pounds.  Yes please: http://www.self.com/drop10

Remember, you’re worth it!

Do you have a favorite workout, video, or trainer?  Please share with the readers!  I know you people are reading and I’m dying for some real live comments (not just the bizarre spam that I filter out daily).

Unfortunately, this isn’t entirely accurate in one way or the other.   As you will recall from the blog on carbohydrates, not all sugars are created equal.  The same is true with high fructose corn syrup and sugar (sucrose).  The main difference is how the body metabolizes fructose and sucrose.  Sucrose that we as our every day kitchen sugar is the most readily available form of energy.  The body will use it the minute it hits blood stream.  In fact, the moment that sucrose hits the tongue it is broken down into glucose for the body to use immediately.  This is why we use sucrose in diabetics to revive them during low blood sugar.  It is not only found in candy, but also in breads and fruits.

Fructose is also found in fruits, but not in such high concentrations as in soda and as a sweetening additive in so many other processed foods.  This additive that we know as “high fructose corn syrup” cannot be broken down into glucose like sucrose can.  Its simply a matter of breaking sucrose into its parts, glucose and fructose.  Since fructose is not concentrated the quantities of each, in moderation don’t cause as much of a problem.  Fructose, especially the concentrated sort, can be very dangerous in the doses that we consume it here in the United States.  Fructose must first be metabolized into fat before it can be transformed into glucose.  This is why people tell you that drinking soda is literally pouring on the pounds.  High fructose corn syrup is usually the first ingredient in soda and is often found in processed breads and sweets so instead of getting a little fructose from adding a cup of sugar to an ENTIRE batch of cookies we are drinking or eating a massive quantity of fructose from our processed foods.

How much sugar equivalents high fructose corn syrup adds! Remember what I said about concentration and quantitiy?

I want something to be noticed in what I just said.  Fructose, sucrose, and glucose are all apart of normal every day foods, but it is the quantity that makes it dangerous.  It is the quantity of everything we eat that has lead us to be a more unhealthy nation.  I’m going to say it again: “Everything in moderation!”  So go and have that popsicle on a hot day!  Have a root beer float for dessert or a ginger ale when your stomach hurts, but don’t chug down one soda after another and don’t make a habit of eating processed food every time you want a treat.  Treat yourself with some strawberries or a home made cookie.  Stay active and you can always enjoy life and your favorite treats, but do it all in moderation.

Hot Flashes:  Hot flashes are caused by the body’s inability to thermoregulate because the hormone ratio’s are off.  This can be one of the most uncomfortable symptoms of menopause because it can effect someone at social events, it can effect sleep, and its just plain annoying.  You’re hot, you’re cold, you’re hot, you’re cold.  Oh my god MAKE IT STOP!  There are a few things that can help:

1. Watch your stress levels.  High stress can set off a hot flash.  That’ll teach you to lose your temper (hee hee).
2. Watch out for certain foods.  Caffeine and high sugar diets can set off hot flashes (that makes a frappuccino a bit of a no-no).  Spicy foods can also set off a hot flash.  To a degree it will take you figuring out what your own triggers are and avoiding them, if possible.
3. Dressing in layers can help because as you warm up you can peel the layers off and as you cool down you can restore those layers.
4. Keeping a cool rag handy, especially at night for those hot flashes that pop up and wake you up.
5. If you’re looking for supplements to help, taking 400IU of vitamin E a day can help and, if not, you can always add Evening Primrose oil supplements to the mix.

Fatigue:  This is being caused by the hormone changes and those wicked hot flashes that are keeping you up at night.  It also is probably being caused because of the type of people menopausal women are.  At this point in your life you are running around taking care of your significant other, children, work, friends, the dog, and pretty much everyone else but you.

1. Remember to take 10 minutes for yourself every day at least.  Sit down and relax and take some deep breaths.
2. Remember to eat healthy because this will help with your hormone balance and energy levels and start exercising to help with hormone regulation and boost your body’s energy levels.  Yoga is GREAT for this.  Deep breathing, stretching, and some really good kinesthetics!  It’s a great workout and also helps with relaxation.  It can be that workout you can squeeze in before bedtime without winding yourself up!
3. Remember, you can’t take care of anybody if you don’t take care of yourself!

Weight Gain:  I think this one really bothers women the most.  Your whole body changes in menopause and that belly fat that you may not have ever dealt with starts to creep in.  It’s hard and its frustrating.  Your body’s hormones change and your body becomes stressed.  Stress means that your body goes into starvation mode (Damn those animal instincts) and so it begins to store fat that we really don’t need.

1. The best way to handle this is to change your lifestyle.  Stay away from refined carbohydrates.
2. Lots of fruits, lots of veggies, lean protein, fiber, and portion control.  It’s not easy.  I hammer on it a lot (Yes I can feel you glaring at me right now).
3. If you mess up for a day don’t worry.
4. If you want a naughty day, that’s okay.
5. If your husband and kids don’t like spinach, tough cookies.  If Mama ain’t happy ain’t nobody happy.
6. Get out and exercise.  Take a bike ride, go for a walk, jump rope (so much fun!), do yoga, do tai chi, but do something.

Hair Loss:  This is an imbalance in the ratio between testosterone and estrogen.  This is so frustrating because women really define their femininity by their hair.

1. Make sure you are taking a multivitamin at this point.  I don’t suggest multivitamins normally, but prenatal vitamins can be really helpful for women suffering from this problem.
2. Add in Omega-3 fatty acids.  Fish oil and chia seeds are my favorite.  If those fish burps are bothering you put your fish oil in the fridge and remember taking over 1200mg can also decrease your risk for heart disease, help your skin and your memory.

Low Libido:  This is the thing that a lot of women don’t want to talk about.  Don’t worry.  You’re still dead sexy!  Menopause can really take a toll on your energy levels (see tips above), your confidence because of your body changing (pretty dang sure that person you’re sleeping next too doesn’t look the same as the day you met them either.  Remember you’re growing old together and that’s just bloody romantic), and you may be suffering from vaginal dryness. Vaginal dryness can really make sex painful and then it’s no wonder you don’t want to get intimate.  Ouch!

1. Get those omega-3 fatty acids in your diet again.
2. Do some kegels to strengthen up (yes it counts as working out) and encourage healthy cells.
3. Lubrication helps, but so would vitamin E suppositories and Cocoa Butter suppositories.  These things can be compounded fairly easily.
4. Just don’t be embarrassed to ask and talk to your doctor and your partner!

Remember, Mixtures Pharmacy is here to answer all your questions.  We can help you find the right supplement, find a great doctor, compound your medication, and try to make menopause as easy a transition as possible.  Just remember you need to take care of YOU.

Ideas For Management:

• Food Journals:  Write down what you ate, when it was, when you took your insulin, how much you took and your blood sugars.  If you do not use insulin a food journal will still be helpful for your doctor and diabetic educator.
• Use measuring devices:  Humans are HORRIBLE at estimating quantity.  Scales are relatively inexpensive and who doesn’t have measuring cups and spoons?
• Watch your carbs:  Shoot for ONE SERVING per meal (read that nutrition label)
• Exercise:  Chart this in your journal too.  This will help you see your progress and help you figure out how it helps your blood sugars and which ones are better for your sugars.  For example: I do much better with toning workouts because they keep my blood sugars steady.  If I do too high intensity of a workout my blood sugars crash (and then I raid the fridge).  No one says you need to run or do high intensity interval training.  Just go for a walk or do some weight lifting with some soup cans.  Something is always better than nothing.
• Stick yourself:  I know it isn’t pleasant to poke yourself with your lancets or your insulin needles.  I have an uncle who doesn’t like needles and he told my Grandmother (a long time diabetic) “Oh I’d die if I had to do that all the time.”  She told him “No, you’d die if you didn’t.”  If you don’t test when your doctor wants you to test then you’re ignoring your body.  Your pancreas and liver can’t keep track of your sugars anymore so it’s time for YOU to do it.
• Read, read, read:  Knowledge is power.  Don’t believe everything you read, but take what you read and ask for help deciphering its significance.
• Communicate with your doctor and pharmacist:  We’re here to help you.  If you don’t know how to read a nutrition label, ask!  If you want to know if those FiberOne Bars really are better for you, ASK!  No one is going to make fun of you.  If something about your treatment is frustrating you, tell us.

Questions to Ask:

• How does my medication work?
• When should I take my blood sugar?
• Why should I take my blood sugar at that time?
• How am I doing?
• What can I do to lose weight?
• What can I do to my diet to help manage my blood sugar better?
• I have an injury and I don’t know how to exercise.  What can I do?
• I feel overwhelmed.  Explain what is going on.
• What are my goals?
• How do I meet my goals?
• What goal should be my biggest priority?

Resources:

• http://www.calorieking.com  This is an internet site that also has books and apps that helps you figure out serving sizes, carbs, and calories.  It contains regular food AND restaurant food!  So handy to go out to dinner!
• http://www.diabetes.org/  This is the American Diabetes Association.  It is fairly easy to navigate and contains everything from diet, to fitness, to diabetes basics.  It is an AMAZING resource.  The only thing I don’t like is that sometimes they utilize the fake sugars too much, which have been clinically shown to cause weight gain.
• http://www.livestrong.com  This has food information, recipes, getting fit tips, help with smoking cessation, apps, food journals, articles.  Lots and lots of info and ideas!
• http://www.heart.org  The American Heart Association also has health tips, recipes, and getting fit tips.

There is so much information out there!  Go out and take diabetes by the horns.  Remember, you’re the boss!!

Let’s take a trip down memory lane in the Carbohydrates Blog.  Remember that your body needs carbohydrates to function.  Sugar is what your brain needs to function.  If your blood sugar is low, then your brain has nothing to work on and it shuts down.  No brain function means unconsciousness and even organ failure.  Here is a visual (please print it out) of signs of hypoglycemia and hyperglycemia.  Hyperglycemia is marked by:

•  The Frequent Need to Urinate
• Dry Skin
• Extreme Thirst
• Hunger
• Change in Vision
• Drowsiness
• Slow Healing Wounds

If you see this happening to you or someone you know, even if they are not a diabetic, its time to test!  If the blood sugars are high for 3 days and you don’t know why its time to call the doctor.

Hypoglycemia is marked by:

• Shakiness
• Fast Heartbeat
• Dizziness
• Anxiousness
• Hunger
• Sweating
• Vision Changes
• Weakness or Fatigue
• Headache
• Irritability

If these things occur it’s time to check your blood sugar.  If it’s less than 70mg/dL it’s time to treat.  If you  can’t check your blood sugar it’s time to treat it anyway because higher blood sugar is far less dangerous than low blood sugar.  You treat by taking 3 to 4 glucose tabs, 3 to 4 hard candies (NOT sugar free), 4 oz of juice, or 1/2 a can of soda (NOT diet).  Candy bars are really not the best thing to use because the fats stop you from absorbing the sugar fast enough.  You will probably be starving when this happens, but try to not eat everything in site (this is soooo hard).  After 15 minutes retest.  If you are still low treat again.  If you have come up over 70 mg/dL then have a small meal like a sandwich. 

When any of these signs occur take your blood sugar and write it down.  These are things your doctor needs to know about.  If your blood sugar is getting low too often hypoglycemia unawareness can happen, which means that you don’t know when you become hypoglycemic.  This is extremely dangerous.  What happens if this occurs while your driving or alone?  I always tell patients who are prone to hypoglycemia to tell their friends and family members about the signs and then telling them how to handle them.  If you are constantly having hypoglycemia it is time to call the doctor.

Remember it is all about balance.  Watch your diet, exercise, and don’t over treat your diabetes.  And remember, keep a conversation going with your doctor!

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.

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!

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!

Salt isn’t necessarily bad for you.  In fact your body needs sodium in order for your heart, nerves, and muscles to work correctly.  Eating too much salt, however, can lead to kidney disease, high blood pressure, heart disease, stroke, and congestive heart failure… not to mention it can really block your weight loss goals.

Here’s the thing:  We should really be limiting our sodium intake to 1500 to 2300mg per day.  That sounds like a lot… until you find out that one teaspoon of table salt has about 2300mg of sodium and that, on average, Americans eat about 3400mg of sodium per day.  Wow!  Just to give you a little perspective, who likes Pei Wei or PF Changs?  Google their menus.  Most of their entrees contain the daily value, if not double the daily quantity of salt in one serving.  Holy cow… have you put your eggroll down yet?

So how do we watch our sodium intake?  Well, coming from a family with sodium sensitivity and heart failure I’ll tell you what I do and then share a few internet resources.  First, don’t add salt to your food if you can help it.  Salt is great for tenderizing meat, but try adding other seasonings other than salt when the food gets to the table.  Use foods that have their own salty flavor to your food.  Celery, tomatoes, and garlic are great savory examples.  Second, make fresh food and eat fresh food.  I’ve even gone so far as to make my own broth sometimes.  Eat as little processed food as possible (Am I repeating myself?  Didn’t I say this in the last few blogs?  You bet!).  Third, don’t go out to eat all the time.  Learn to love your own leftovers!  Leftovers, especially soups this time of year, are delicious the second and third days in the fridge.  They actually get better.  Also remember it doesn’t matter if your salt is pink and Himalayan or white and iodized.  Salt is salt is salt is salt so be careful! Keep a food journal to track your salt intake until you get the hang of it!

Need to eat something packaged?  That’s fine!  Remember, we love our salt and vinegar chips, but everything in moderation.  Just read your nutrition facts:

The DASH diet is a great way to eat correctly and bring your sodium intake down.  I love the Mayo Clinic website for their information:
Eating Out

Shopping and Cooking

Sample Menus

They also have lots of recipes.  Handy!!

Hopefully I’ve kicked you off in the right direction.  Now how about those New Year’s Resolutions?  Next week, just to kick everything off in the right direction I’ll be going over cleanses.  Safe?  Not safe?  What’s the right way to do one?  Stay tuned!