Gastroparesis Awareness Month

This month, we’re shedding light on a health condition you may be at risk of developing if you’ve been diagnosed with type 1 or 2 diabetes. Gastroparesis (also referred to as “delayed gastric emptying”) is a disorder that disrupts the movement of food from your stomach to your small intestine.

Out of 100,000 people, about 10 men and 40 women may suffer from gastroparesis, adding up to about 5 million people throughout the United States. Although gastroparesis is rare, you may be more likely to develop it based on certain factors.

Diabetes, certain cancer treatments, and any surgery that may have injured your vagas nerve may contribute to an increased risk of developing this disorder. Out of these factors, diabetes is the most commonly-identified cause.

A few different symptoms may indicate signs of gastroparesis, including a feeling of fullness in your stomach before or after finishing a normal-sized meal, stomach pain or discomfort, or nausea.

The first doctor you may see when you start to present symptoms of gastroparesis is your primary care physician. This doctor may then refer you to a gastroenterologist if they believe those symptoms may indicate gastroparesis.

When diagnosing you with gastroparesis, a doctor conducts a physical exam, measures stomach emptying, and takes your medical history into consideration. These factors, in addition to your symptoms, complications, and most likely cause help determine the best course of treatment for you. If diabetes is determined to be the cause of your gastroparesis, your doctor will focus on helping you control your blood glucose levels.

You can also tackle your symptoms from a dietary angle by reducing fat and fiber intake, avoiding tough-to-chew foods as well as carbonated and alcoholic beverages, and increasing your intake of water and liquids containing glucose and electrolytes. Light physical activity after each meal can also be helpful for stimulating your digestive processes, relieving feelings of fullness and allowing you to process food more easily.

Are you suffering from symptoms that may be signs of gastroparesis? Schedule an appointment with a gastroenterologist at Jamaica Hospital Medical Center by calling (718) 206-6742.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

How Is Type 2 Diabetes Treated?

Type 2 diabetes is a disease that occurs when blood glucose or blood sugar levels are abnormally high. It is the most common type of diabetes affecting approximately 29 million people living in the United States.

Type 2 diabetes impairs cells in the body from properly using insulin-a hormone produced by the pancreas that aids in regulating blood glucose levels. This impairment can lead to other serious health problems such as vision loss, kidney, or heart disease.

Symptoms of Type 2 diabetes may take years to present. It is common for individuals to have the disease and not know that they have it.  Symptoms may include frequent urination, increased thirst, increased hunger, blurred vision, unexplained weight loss, fatigue, tingling or numbness in the hands and feet, as well as slow-healing wounds.

There is no cure for Type 2 diabetes; however, the disease can be managed successfully with medications. According to the Centers for Disease Control and Prevention (CDC), “…your doctor may prescribe insulin, other injectable medications, or oral diabetes medicines to help manage your blood sugar and avoid complications.”

Lifestyle habits such as eating a healthy diet, exercising, and consistently monitoring blood glucose levels are also beneficial in managing your diabetes.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Learn The Facts About Diabetes

Diabetes is a treatable, but not curable, disease in which the body either develops a resistance to insulin or cannot successfully use all the foods it takes in because of a defect in the production of insulin. Insulin is a hormone created in the pancreas, an organ found near the stomach. It acts as a key to allowing glucose into our cells. Glucose is created during digestion and is needed as a fuel for the body to perform many activities.

Scientists are not certain why diabetes affects some people and not others, but there is strong evidence that heredity, diet, activity level, and ethnicity play an important role.

Diabetes is the leading cause of blindness, kidney disease, nerve damage, and non-traumatic amputations, and the fourth leading cause of death in the United States. It is essential to be under the regular care of a physician when diagnosed with the disease, as diabetics have an increased risk of heart disease and stroke and are also prone to infection and slow-healing wounds.

What Are The Risk Factors For Diabetes?

  • You are at risk of developing diabetes if you:
  • Are overweight
  • Are over the age of 45
  • Have poor dietary habits
  • Do not exercise regularly
  • Are a woman who has experienced gestational diabetes
  • Are a woman who has delivered a baby weighing more than nine pounds at birth
  • Are of African American decent
  • Are of Hispanic decent
  • Have a family history of diabetes

What Are The Types Of Diabetes?

Type I
Type I is also called insulin dependent diabetes because the body does not produce insulin in sufficient quantities, if at all. In this form of diabetes, people are required to take insulin every day by injection. It is seen mostly in children and young adults, though not exclusively. It affects 10% of the diabetic population.

Type II
This more common form of the disease affects the greatest number of people.  Almost 90% of people with diabetes have this type. Type II has also been called the non-insulin dependent form of the disease because it can often, though not always, be managed without taking insulin. Many people do well with oral medications, strict diets, exercise, and close monitoring by a physician.

Gestational Diabetes
This form of the disease can develop during pregnancy. It will often go away after the pregnancy is completed. It is believed to be caused by the hormonal changes that take place during pregnancy. It is a risk factor for developing the disease later in life.

 Some common symptoms of diabetes include:

  • Frequent urination
  • Constant thirst
  • Dramatic weight loss
  • Constant hunger
  • Tingling or numbness in the feet or hands   
  • Blurred vision
  • Frequent feeling of fatigue

It is important to discuss any symptoms with your physician as soon as they are noticed. The above lists some warning signs and they all need not be present. Further testing is necessary to make an accurate diagnosis.

Diabetes isn’t necessarily painful, and that is why it is often not diagnosed until major symptoms develop.

Depending on the type of diabetes and its severity, treatment plans will vary and must be tailored to the individual’s specific needs. Medications include daily injections of insulin and/or oral agents, strict diet, regular glucose monitoring, an exercise plan, and regular medical examinations.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Diabetes Prevention

According to the Centers for Disease Control and Prevention(CDC), “Approximately 88 million American adults—more than 1 in 3—have prediabetes. Of those with prediabetes, more than 84% don’t know they have it. Prediabetes puts you at increased risk of developing type 2 diabetes, heart disease, and stroke.”

Pre-diabetes is a silent health condition that has no symptoms and is almost always present before you develop type 2 diabetes.

It is a condition in which blood glucose levels are higher than normal, but not high enough to be classified as full-blown diabetes. If you haven’t visited your doctor, a good way to see if you are at increased risk for pre-diabetes is to take the American Diabetes Association’s (ADA) Diabetes risk test by visiting https://www.diabetes.org/risk-test

Those who should be screened for pre-diabetes include overweight adults age 45 and older, or those who are under age 45 and has one or more of the following risk factors:

  • Habitually physically inactive
  • Overweight or obese
  • Have previously been identified as having impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)
  • Have a family history of diabetes
  • Are members of certain ethnic groups (including Asian, African-American, Hispanic or Native American)
  • Have had gestational diabetes or have given birth to a child weighing more than 9 pounds
  • Have elevated blood pressure
  • Have elevated cholesterol
  • Have polycystic ovary syndrome
  • Have a history of vascular disease

That said, if you have pre-diabetes, your risk of developing type 2 diabetes can be reduced by a sustained modest weight loss and increased moderate-physical activity, such as walking 30 minutes a day.

Through weight loss and increased physical activity, a dietitian may direct you on how to make food choices that cut down on the amount of fat and carbohydrates by:

  • Eating more foods that are broiled and fewer foods that are fried
  • Decrease the amount of butter you use in cooking
  • Eat more fish and chicken
  • Eat more meatless meals
  • Re-Orient your meals to reflect more vegetables and fruit

If you have symptoms such as increased thirst, frequent urination, fatigue and blurred vision, you may have crossed from pre-diabetes to type 2 diabetes.

Jamaica Hospital Medical Center now offers a free and innovative approach to treat patients who are at risk for developing diabetes. The Diabetes Prevention Program (DPP) was developed by the National Institute of Health and is aimed at managing the health of individuals with either prediabetes or borderline diabetes.

These meetings are facilitated by “Lifestyle Coaches” who are specially trained and certified Jamaica Hospital Patient Navigators with strong interpersonal and group facilitation skills.For more information about eligibility or to sign up for the Diabetes Prevention Program, please visit  https://jamaicahospital.org/pre-diabetes/ or  call 718-206-8494.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Understanding How Diabetes Can Affect Your Digestion

Nausea and vomiting are two unpleasant feelings that most everyone has encountered at some point in their life, but for many diabetics, these are symptoms that they live with every day as a result of a condition known as diabetic gastroparesis.

Gastroparesis, also known as delayed gastric emptying, is a known complication of both the type 1 and type 2 forms of diabetes.  It occurs because high blood glucose levels associated with diabetes often leads to nerve damage throughout the body.  One such nerve is the vagus nerve. It controls the movement of food from the stomach into the small intestine. When it is damaged, food cannot move as quickly through the digestive system because the stomach muscles aren’t working well or stop working completely.  When undigested food remains in the stomach for too long it can lead to a variety of problems such as bacterial overgrowth and the build-up of hardened, solid masses.

It is estimated at as many as 50% of all people living with diabetes develop some level of gastroparesis during their lifetime, but symptoms can vary greatly from person to person.

The most common symptoms associated with diabetic gastroparesis include:

  • Nausea after eating
  • Vomiting after eating
  • Fullness after eating small amount of food
  • Bloating
  • Pain in the upper section of your stomach
  • Lack of appetite
  • Heartburn
  • Unexplained weight loss

Diabetic gastroparesis can affect lead to many complications including dehydration and malnutrition. It can also make it hard for someone with diabetes to manage their blood sugar levels as well as maintain a healthy weight.

Unfortunately, there is no cure for gastroparesis, but there are some medications that have shown temporary relief. There are also some alternative food delivery methods available, such as feeding tubes and IV nutritional therapy for those with severe symptoms.

The best way to reduce the symptoms of diabetic gastroparesis involves adjusting your lifestyle through:

  • Maintaining a low fat / low fiber diet
  • Drinking plenty of water
  • Reducing stress levels
  • Quitting smoking
  • Avoiding alcohol and carbonated beverages
  • Eating small meals and chewing your food slowly
  • Taking walks after meals

It is also recommended that you talk to your doctor about any medications you are taking as they can also worsen gastroparesis symptoms.

If you would like to make an appointment with a diabetes specialist at Jamaica Hospital’s Ambulatory Care Center, please call 718-206-7001.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Can Diabetes Affect Your Sense of Hearing?

More than 30 million Americans have diabetes, a disease that inhibits the body’s ability to produce and manage insulin appropriately, causing glucose to build up in the bloodstream instead of feeding hungry cells.

If you have diabetes, you should be aware of how it can impact your hearing as research has indicated that diabetics have a higher probability of developing hearing loss than those without the disease.

diabets and hearing loss, Jamaica Hospital

Multiple studies in recent years have examined the relationship between diabetes and hearing loss. In one study conducted by the National Institute of Health (NIH) those with diabetes were found to be more than twice as likely to have mild to moderate hearing loss than those without the disease. A separate study published by the Clinical Endocrinology and Metabolism analyzed the results of more than 20,000 participants and concluded that diabetics were more likely to have hearing loss than those without the disease, regardless of their age.

While researchers are uncertain as to exactly how diabetes negatively impacts our sense of hearing, most believe that high blood glucose levels cause damage to the small blood vessels in the inner ear.

Our inner ears are lined with hair cells called stereocilia. These hairs cells are responsible for translating the noise our ears collect into electrical impulses, which are then sent to the brain where we process them into recognizable sounds.  Like other parts of the body, these hair cells require good circulation to function. If damaged, these cells cannot regenerate and hearing loss would be permanently affected.

With a higher likelihood of developing hearing loss, it is recommended that diabetics take certain precautions to avoid damaging these cells, including:

  • Turning down the volume on personal electronic devices and limiting the use of devices that require headphones or earbuds
  • Protecting your ears from excessive noise with earplugs if you engage in noisy hobbies or attend loud events.
  • Incorporating an appropriate amount of exercise into your daily routine. Even a moderate amount improves circulation and blood flow.
  • Maintaining an appropriate weight. Excessive weight makes it more difficult for your heart to pump blood effectively to all parts of your body, including your ears.

Most importantly, you should schedule a hearing evaluation regularly with your doctor if you have diabetes.

To speak to a doctor about how to better manage your diabetes, please call 718-206-7001.

 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Diabetes and the Myths that go with it.

Diabetes is a serious illness. It affects 30 million people in the United States. There are many facts that we know about the disease, and not surprisingly, many myths associated with it as well.

 

 

Some of these myths include:

  • You can catch diabetes from someone else. False  Diabetes is not contagious
  • People with diabetes catch more colds and other illnesses. False. Diabetics aren’t any more at risk for catching a cold than anyone else.
  • People with diabetes can’t eat sugar. False. Sugar should be consumed in small quantities as part of a balanced meal.
  • Only overweight  people get diabetes. False. A  person can be slim, medium build or heavy and still be a diabetic.
  • People who have diabetes shouldn’t drive. False. People with diabetes can do  anything a person who doesn’t have diabetes does.
  • Type II diabetes is not as serious as Type I. False. Every form of diabetes is to be taken seriously. It is just treated differently.
  • Nobody in my family has diabetes therefore I won’t get it. False. While it does run in families, anyone is at risk regardless of family history.
  • Borderline diabetes is not real diabetes. False. It may only mean you are at higher risk of developing diabetes.
  • Eating fruit is bad for diabetes. False. Fruit should be eaten in small portions. Excessive amounts may cause a problem because fruit contains carbohydrates.

Speak to your physician if you would like to clarify the facts about diabetes and your ability to do things. You can schedule an appointment with a physician at Jamaica Hospital by calling 718-206-6742.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Neuropathy

According to the Centers for Disease Control and Prevention, 25.8 million people in the United States have diabetes. Typically, 60 to 70 percent of people with diabetes have some sort of nerve problems, know as neuropathy.

Neuropathy is a shorter term for peripheral neuropathy, meaning nerve damage in the peripheral nervous system. Neuropathy from diabetes can damage the nerves in your hands, arms, feet and legs. This condition can cause pain, numbness and weakness. Depending on the degree of neuropathy, and how long you have been a diabetic, nerve problems can occur in every organ system, including the digestive tract, heart and reproductive organs.

The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathy also appears to be more common in people who have issues with controlling their blood glucose, have high blood pressure and are overweight.

Symptoms of diabetic neuropathy vary depending on the nerves affected and develop gradually over the years. Symptoms may include:

  • Trouble with balance
  • Numbness and tingling of extremities
  • Abnormal sensation to a body part (Dysesthesia)
  • Diarrhea
  • Erectile dysfunction
  • Urinary incontinence
  • Vision changes
  • Burning or electric pain in extremities

When treating diabetic neuropathy, a nutritionist may recommend healthier food choices and exercise to help lower your glucose and glycohemoglobin levels. Additionally, analgesics and low doses of antidepressants can be prescribed for pain relief, burning and tingling.

If you are a diabetic and have been experiencing symptoms of neuropathy, Jamaica Hospital Medical Center’s Ambulatory Care Center and Department of Nutrition can help. Call 718-206-7001 to get the process started.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

The History of Diabetes Testing

Diabetes was recognized as far back as 1500 BC by Egyptian scientists. In 600 BC scientists later noted that ants seemed to be particularly drawn to the urine of people with diabetes. The earliest documented diagnosis of the disease was during the middle ages when Chinese, Indian and Egyptian scientists tested the urine of people thought to have diabetes by tasting it for a sweet distinctive taste.

The first clinical exam for diabetes was performed by a doctor named Karl Tommer in 1841 who tested urine with acid hydrolysis which broke up the disaccharides into monosaccharides and then after the addition of other chemicals results in a reaction forming if sugar is present.

In 1850 Hermann von Fehling was able to expand on Trommer’s work to quantify the results. Later in the 19th century, Frederick Pavy developed tablets that when added to the urine would show if there was glucose in the urine. In 1907 Stanley Benedict was able to refine Fehling’s test. In 1913 Ivar Bang discovered a way to test the blood for glucose.

In the 1940’s urine test strips were developed that would change colors depending on the amount of glucose was in the urine. In more modern times,  test strips were introduced in 1964 that could check the blood for sugar and the first glucometer that was able to test blood samples for elevated sugar was developed in 1970. Another test for diabetes was developed in the mid 1970’s and it tested for hemoglobin A1c.

Glucose testing has now progressed to the point where blood sugar can be determined by a sensor that can measure it through the skin, with no need to take a drop of blood.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Healthy eating for people with diabetes

For people with diabetes, maintaining a healthy diet is crucial.  Although eating well-balanced meals is strongly encouraged, it is important to pay close attention to the carbohydrate portion of foods consumed as they become glucose when digested.

Glucose is a sugar needed to help our cells and organs function properly. In healthy individuals, the level of glucose within the blood is controlled so that it does not become too high or too low.  However, in people with diabetes, the body is unable to keep the glucose levels within the normal range. Frequent high levels of glucose within the blood is responsible for the complications that go along with diabetes including an increased risk for heart attacks, strokes, nerve damage, kidney damage, and many other problems.

To avoid the development of these complications and to help maintain normal glucose levels, people with diabetes should include foods that have low glycemic levels such as whole wheat bread, barley, carrots or lentils in their diets. Food such as white rice, white bread, pretzels or potatoes rank highly on the glycemic index and should be kept to a minimum or eliminated.

The glycemic index is a scale from 0-100 that gives us an idea of blood sugar response from a particular food. In general, foods that rank 55 or less are considered to have low glycemic levels and foods that rank 70 or more are high.  Anything in between these numbers is moderate.

While having diabetes doesn’t mean you have to follow a specific diet, it does mean you should remain mindful of what you eat.  Here are some recommended tips you can follow to help you along the way:

– Try to avoid or cut down on sweet drinks. Sugary drinks such as juice, soda, and energy drinks are very high in sugar and easily absorbed by the body so they will cause your blood sugar to go high quickly.

– Protein and fat in foods can lower the glycemic index (making it better for your blood sugar), but be careful you’re not eating too much because they are also rich in calories and can cause weight gain.

-Foods with polyunsaturated or monounsaturated fats such as lean meat, avocados, fish, and whole grain wheat are much better for you than food that contains saturated or transfats such as doughnuts, fried foods, and salami.

To schedule an appointment to speak with a doctor about managing your diabetes, please call the Jamaica Hospital Department of Family Medicine  at 718-206-6942.

Wesley Cheng D.O. Family Medicine

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.