How do I know if I have diabetes?
I was driving in to work the other day and I was listening to Sirius satellite radio. They have a station called 'Doctor Radio' which is run by the doctors at NYU medical center. Generally, they have great topics and help teach people what to do to get the best healthcare.
There was one man who called in to this show yesterday and wasn't sure if he had diabetes. He had an LDL of 121 and a fasting blood sugar of 129. He also had a waist circumfrence of 40 and peripheral neuropathy. He wasn't on any medications for diabetes at the time and wasn't testing his blood sugars.
The doctor on the show told him that he just needed to get his waist size down to a 36 and everything would improve. I was a little angry at that comment because although weight loss is extremely important, this man already had complications starting from diabetes and didn't even know it.
SO, what does this all mean? For one, everyone should know what their numbers mean. The diagnosis of diabetes is very clear. You must have 2 fasting blood sugars of greater than 126, or a random blood test (anytime of the day) that is greater than 200. Some doctors will have their patients do a 2 hour glucose tolerance test to diagnose them that way. A fasting blood sugar of 100-126 is considered prediabetes (used to be called 'borderline diabetes').
If your blood sugar is between 100-126, this is the ONLY time you can prevent or delay this from turning into full blown diabetes. This is an extremely important time to get help with your health.
One test that many doctors do is called a hemoglobin A1c. This is a 2-3 month average of what your blood sugars have been. If your a1c is between 4-6 this is considered normal. Greater than 6 generally means that your blood sugars have been running in a range consistent with diabetes. HOWEVER, an A1C is not a diagnostic test. Diabetes is not able to be diagnosed simply with an A1c. You must have the other tests completed for a diagnosis. If one does have an A1c of greater than 6, most generally that person would have high blood sugars on a glucose tolerance test and could be diagnosed that way.
There are many doctors who do diagnose based on an A1c. I certainly don't disagree that someone with an a1c over 6 has diabetes, however, for insurance purposes, they do require the other tests.
When your doctor does your labs, discuss the results with him/her. There are many things that you can do to prevent diabetes or to keep it under control.
It is believed that diabetes could be coming on for years before diagnosis. It's important to know your numbers and talk to your doctor.
Eating healthy costs too much
I hear this so much in my practice. "It's just too costly to eat healthy."
In many cases, yes, it's true, fresh fruits and vegetables can cost more. However, this doesn't mean that eating healthy has to cost more than an extremely unhealthy diet.
Eating healthy takes work. It doesn't happen overnight, and it certainly isn't easy to change one's diet. I see people everyday who tell me how expensive it is to eat healthy. I agree that it's not cheap to eat fruits and vegetables. However, it's important to look at someone's whole diet. There's usually something in the diet that is costing lots of money that can be changed.
One example of an expensive item in people's diets is coffee. A coffee habit of going to Dunkin Donuts or Starbucks everyday can really add up, especially if you are drinking specialty drinks (not to mention the amount of calories that are in some of them).
I often see patients spending 3 dollars per day on coffee alone. Most people don't think that this is that much money until I explain that 3 dollars could be 1.5 pounds of chicken breast when it's on sale.
Some tips that I give to my patients are to buy meats and fish when they are on sale. Put them in the freezer so you'll have it on hand when you need it. Buy produce that's 'in season'. Right now, apples are very affordable. Soon, citrus will be affordable. If you are trying to buy raspberries right now, you're going to be spending a pretty large chunk of change on those. Buy canned fruits in their 'own juice', or vegetables in a can that have 'no salt added'. Frozen veggies can be purchased on sale and have a long shelf life in the freezer. Generally, these are the best ways to get your veggies at a reasonable price.
When you are shopping for fresh produce, purchase the foods that aren't already cut and washed such as lettuce. The more production that goes into a food, the more it's going to cost.
All of this sounds easy. It's not easy to change habits, however, it can be done. It may take a little more planning and a little more time, but it's well worth it in the end.
Room Service in the Hospital
SVMC is embarking on a new food delivery system for patients in this hospital. Many hospitals are trying to improve care in multiple ways. One of these ways to improve care is by improving the quality of the food that we serve to patients.
Room service 'on demand' is a new program that will be starting in January. This program will allow patients to decide when and what they want to eat. Each patient will still get the appropriate diet for them. They will be given a restaurant style menu and be allowed to order whatever they want from the menu. The great thing about this system is the fact that patients will be able to order meals when they feel like eating.
Patients no longer will get meals at specific times. They will be responsible for calling to get their own meals. If patients can't call themselves, there will be other options for them to get their meals.
This is such an exciting system. Food quality is going to improve immensely. Not only will food taste better because it will be cooked to order, but it will also arrive in a timely manner and be an appropriate temperature.
I'm very excited about this new program. There is tons of work that needs to be done before we are up and running, but we'll get there! Look for more information about room service soon!
Posts 1 2 3 4 5 6 7 8 9
