Jul

27

Diabetes is becoming more common and more of a medical problem than ever before.  I am specifically referring to type 2 diabetes, which is invariably brought on entirely by ones eating habits.  This is why it has earned the designation “adult onset diabetes”.  The “juvenile” type, or type 1, occurs at an early age for other reasons entirely.  So let’s discuss type 2, since that is the big problem and since it is entirely in your control to remedy.  Quite simply, type 2 diabetes occurs associated with obesity.  For each pound of “extra” weight one carries, risk of diabetes rises, exponentially.  As an example, someone 30 pounds overweight has a 4000% increased risk in becoming diabetic.  (This is not a typo).

Heart disease and peripheral artery disease are the biggest complications that people face with uncontrolled diabetes. Approximately 65% of death from diabetes is due to heart disease and stroke.  Peripheral artery damage or nerve damage, also from uncontrolled diabetes, can lead to foot problems that can lead to amputations. More than 60% of leg and foot amputations not related to an injury are due to diabetes.  Diabetes is the leading cause of blindness in this country. Other problems include glaucoma, cataracts and diabetic retinopathy.  Studies show that regular eye exams and timely treatment of diabetes-related eye problems could prevent up to 90% of diabetes-related blindness. Recent studies correlate metabolic syndrome with marked increase in total fructose intake in the form of high-fructose corn syrup, beverage and table sugar.  Metabolic syndrome is a name given to a group of risk factors including heart disease.  If you learn to read labels, you will find that many products now contain high fructose corn syrup.

Dizziness, a common problem in and of itself, is often associated with deregulation of sugar.  Sugar levels, both too high, and too low, will lead to dizziness. Your body does a delicate balancing act trying to maintain as steady a level of blood sugar as possible.  You can help this cause  by maintaining a healthy diet that does not cause blood sugar levels to suddenly go through the roof, or conversely, waiting all day to eat causing them to plummet.  More information on healthy eating tips can be found on my website.  Much of the dizziness which I see clinically is ether caused by or complicated by extreme variations in blood sugar levels.

Of equal importance is exercise.  Humans were not meant to be sedentary, which unfortunately, is how many Americans spend their day. Exercise should be performed at the highest level of your ability.  If you are unsure of your ability, you should discuss it with your doctor.

Jul

20

High blood pressure affects about 1 in 4 American adults and is one of the most common worldwide diseases afflicting humans.  It increases the risk of heart disease and stroke for those afflicted, so it’s important to know how to lower high blood pressure. High blood pressure, aka hypertension risk factors include obesity, drinking too much alcohol, smoking, and family history of hypertension.  Hypertension is the most important modifiable risk factor for coronary heart disease (the leading cause of death in North America), stroke (the third leading cause), congestive heart failure, end-stage renal disease, and peripheral vascular disease.

Normal blood pressure with respect to cardiovascular risk is less than 120/80 mm Hg, (however, unusually low readings should be evaluated for clinical significance as well).  Prehypertension is a new category emphasizing that patients with prehypertension are at risk for progression to hypertension and that lifestyle modifications are important preventive strategies.  Home blood pressure predicts cardiovascular events much better than do office readings and can be a useful clinical tool. Anyone with hypertension should be monitoring their own BP at home.  BP kits are available everywhere, and they are inexpensive.  If your BP readings suddenly become low, you should tell your doctor to titrate downwards your medication so that you do not become syncopal, (passing out).  The following are the ranges of BP:

Normal – Systolic, (top number) lower than 120, diastolic, (bottom number) lower than 80.

Prehypertension – Systolic 120-139, diastolic 80-99.

Stage 1 hypertension- Systolic 140-159, diastolic 90-99.

Stage 2 hypertension- Systolic equal to or more than 160, diastolic equal to or more than 100

Recommendations to lower blood pressure and thus decrease cardiovascular disease risk include the following:

  • Lose weight if overweight. Even a few extra pounds will raise blood pressure.
  • Google DASH (Dietary Approaches to Stop Hypertension) for a reasonable diet, which is rich in fruits and vegetables.
  • Limit alcohol intake to no more than 1-2 drinks/day.
  • Increase aerobic activity (30-45 min most days of the week).
  • Reduce sodium intake, learn to read nutritional information labels on products you purchase.
  • Maintain adequate intake of dietary potassium, calcium and magnesium for general health.
  • Stop smoking and reduce intake of dietary saturated fat and cholesterol for overall cardiovascular health.