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CGM A Beginner's Guide

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C.G.M. (Continuous Glucose Monitoring) A Beginner’s Guide.

C.G.M. (Continuous Glucose Monitoring) A Beginner’s Guide.

C.G.M. (Continuous Glucose Monitoring) A Beginner’s Guide.

When you live with diabetes a common term you might hear is Continuous Glucose Monitoring, also known as C.G.M.  For the uninitiated to the world of diabetes management, C.G.M. might seem an overwhelmingly daunting task.  All types of questions can present you with a challenge but with a little information such as the kind laid out here can help clear up any concerns.

What is C.G.M.?

C.G.M. or Continuous Glucose Monitoring consists of a transceiver device with an attached small sensor that fits underneath the epidermal layer your skin.  C.G.M. models may vary so it will usually be placed in an area on your arm or your stomach.  This sensor measures glucose levels found in your interstitial fluid, the fluid found between your cells and is a good method of measuring sugar levels of the body.CGM Graphic

These devices persistently analyze glucose levels and sends that data to a wireless monitor nearby.  Depending on the type of device you are using and programmed settings the sensor can collect readings every 1-15 minutes.  If glucose falls too low, it will trigger an alarm on the monitoring device, usually worn on a belt clip nearby.  Some newer models are able to send collected data to a computer, smartphone, or tablet.

Who Should Use C.G.M.?

If you suffer from a lot of blood sugar highs and lows, hypoglycemia/hyperglycemia, gestational diabetes, or use an insulin pump, speak to your doctor about using a C.G.M. system.

Pros of Using C.G.M.

  • Reduces the need for traditional glucose checks by pricking of the finger, although most will need to do so on a regular basis.
  • Helps keep blood sugar levels stable.
  • Understanding exactly when your blood sugar spikes can help tremendously on keeping the condition under control.

Cons of Using C.G.M.

  • These C.G.M. systems can be costly and possibly are not covered by certain health insurance plans.
  • Accuracy may be off with these systems at the time of this writing, so traditional glucose monitoring methods are still necessary.

What’s Included in a C.G.M. System?

All available systems now are somewhat different, but will usually include a sensor and a monitoring device.  Some systems are now smartphone, tablet, and computer compatible with special software to interface with the sensor.  Some research would be necessary to learn about the numerous apps and add-ons included with their corresponding systems.  Here at US MED we offer systems from trusted brand names like Dexcom, FreeStyle, Animas, Tandem, and Eversense.

In Conclusion.

Should your health care provider suggest a Continuous Glucose Management system to help manage your diabetes or blood sugar condition, there are quite a number of options available.  Make sure to do some additional research to make sure you get a system that best fits your lifestyle. US MED has more information on C.G.M. systems below, as well as a number to call should you need additional guidance in choosing the right C.G.M. system for you.

 

 

The Effects of Smoking & Diabetes

The Effects of Smoking & Diabetes

How Smoking Impacts Diabetics

Cardiovascular Disease

Smokers have a 30-40% higher risk of developing type 2 diabetes over non-smokers.  Smoking also makes it difficult to control the disease and determine proper insulin dosage since it makes your body more resistant to insulin leading to higher glucose levels.  The more prevalent the smoking habit is, the higher the risk of type 2 diabetes becomes.  Smoking has a negative effect on every organ in your body and leads to serious complications for diabetics which include:

  • Cardiovascular disease.
  • Poor blood flow to legs and feet which can lead to infections, ulcers, and possible amputations.
  • Peripheral neuropathy (damaged nerves that cause numbness, pain, & poor coordination).
  • Many forms of cancer

As noted, smoking has damaging effects on your cardiovascular system, which can be deadly.

  • 68% of adult diabetics age 65 or older die from heart disease.
  • 16% of adult diabetics age 65 or older die from stroke.
  • Diabetics are 2-4 times more at risk of developing heart disease or stroke than non-diabetics.

Respiratory Effects

Smoking impacts the lungs negatively and can lead to:

  • Chronic bronchitis
  • Emphysema
  • Chronic obstructive pulmonary disease (COPD)
  • Other respiratory diseases

Diseases such as these lead to a higher chance of lung infections such as pneumonia, which can be even more dangerous if you are diabetic, since it would raise your blood sugar and make it harder to recover.  Diabetics are almost three times more at risk of dying from pneumonia than non-diabetics.

Eye Health

Diabetics also have a higher risk of eye disease such as:

  • Cataracts
  • Glaucoma
  • Retinopathy (a blinding eye disease)

Smoking can speed up the advancement of retinopathy and complicate matters which can lead to eventual blindness.

Lowering Your Risk

Avoiding tobacco products should be at the top of the list if you wish lower your risk of complications with diabetes, which can prove to be more difficult the longer history you have of being a smoker.  Smoking is highly addictive so you may start off with a few tips to aid in quitting such as:

  • Make a list of reasons to stop smoking.
  • Set a quit date.
  • Share quit date with loved ones to help hold you accountable.

Some find quitting cold turkey is the best way to kick the habit, others prefer decreasing cigarette intake over time is their best bet.  Another method is with the use of prescribed medications or over-the-counter aids like nicotine patches or gum, but please note that nicotine in these products will raise your blood sugar.

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10 Natural Ways to Combat Diabetes

10 Natural Ways to Combat Diabetes

10 Natural Ways to Combat Diabetes

1. Early Prevention

It’s not hard to speculate why so many people develop diabetes.  Genetics has a lot to do with it, but lack of activity will most certainly cause weight gain, increasing risk factors.  Prediabetes is on the rise, in where raised blood sugar levels are not at it’s peak yet to cause symptoms.  Excess visceral fat stores in the body and lack of activity cause cells to stop responding to insulin for absorption of sugar in the blood.  Prediabetes is seldom tested for, but it’s the most optimal time to prevent it from developing into diabetes.

2. Losing A Few Pounds

Extra weight is the main reason people have an elevated risk for type 2 diabetes today.  Weight gain could gather extra fat around organs located in your midsection which is elevated under stressful conditions due to the stress hormone, cortisol.  New studies indicate that this buildup of fat around the abdomen produces a chemical signal to your cells that instruct them to ignore insulin, reducing blood sugar absorption.  Studies have shown that losing just 7% of your body weight lowered risk of diabetes by 58% making it a more viable option than insulin-sensitizing drugs for diabetics.  Quick cardio exercises 3-5 times a week or daily 30 minute walks can be more efficient at losing weight than dieting.

3. Cut Out Sugary Drinks

Get used to only drinking water, club soda, unsweetened tea, of fat-free milk and cut out all sodas, fruit punches, or sweetened ice teas and other such beverages.  One daily serving of soda increases the risk of increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels by a whopping 44%.  Experts have speculated over the possible reasons but may have something to do with the caloric density of sugary drinks as well as the high-fat foods we tend to pair the drinks with.  Findings also show that drinking a single serving of soda daily has been correlated with being overweight.  It might have something to do with the fact that the high caloric count in the beverages are not recognized in the brain, so you don’t end up lowering food intake as a result.

4. Limit Your Inactivity

Daily activity helps reduce chances of diabetes by moving blood sugar into muscle cells and increasing cell sensitivity to insulin.  Limiting inactivity such as watching TV to 10 hours a week can cut diabetes by up to 43%.  A night at the gym or other activities such as hiking, bowling, and dancing can be great forms of “fun” exercise.

5. Reducing Food Intake

Can fast food lead to diabetes? Studies have shown that two servings per week of red meat such as the kind found in hamburgers were 26% more likely to develop metabolic syndrome.  Add a helping of fried foods such as french fries to that equation and that risk rises by another 10-25%.  These foods tend to be high in saturated & trans fats which are detrimental to lowering risks for diabetes.

6. Reduce “Bad Fats”, Increase “Good Fats”

Saturated fats like those found in fast foods like hamburgers clog arteries and increase insulin resistance.  They also cause inflammation, which is harmful to cells, along with those that manage blood sugar.  The precisely opposite effect of lowering your risk can be found the the “good fats” found in foods such as fish, olive oil, nuts, & avocados.  The lowering of saturated fat intake to 7% of total daily calories greatly reduces risk of diabetes.

7. Eat Breakfast

Research indicates that those who skip breakfast are 35-50% more likely to be overweight and/or have insulin resistance than those who do.  Overnight fasting while you sleep puts your body into “starvation mode” and your body has to compensate to keep your blood sugar levels up.  Meanwhile not having breakfast reduces insulin sensitivity as well as increasing appetite throughout the day resulting in progressive weight gain.

8. Get Help With That Depression

When depressed, it is not as likely to find yourself eating well and exercising, although the hazards don’t end there.  Studies have shown that depression changes body chemistry in such a way that it is detrimental to people at risk for diabetes.  Some women in the study have been shown to have 23% higher insulin resistance over women who were not depressed.

9. Sleep More

Constant lack of sleep will eventually lead to weight gain and reduction of insulin sensitivity.  In one research with 1,709 men, it was found that an average of 5-6 hours of sleep doubled their risk of developing diabetes.  The same result was found for women as well.

10. Body Types

Regardless of body weight, waste measurements for women exceeding 35 inches or more and men with midsections of 40 inches or more tend to have fat stores deep in the abdomen, triple the risk of diabetes.  It is not as simple as merely watching total body weight but body composition as well.

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More Than Two Types of Diabetes?

More Than Two Types of Diabetes?

More Than Two Types of Diabetes?

For the past 20 years diabetes has always been classified as either type 1 or type 2, but new revelations show that there could actually be five different types.  New research such as one found in an article out of The Lancet: Diabetes & Endocrinology suggests a need for a revision to the diabetes classification system.  According to the article, despite experts expressing a need for it, not much emphasis has been given in the expansion of classifications for specific diabetic causes and severity levels.

Diabetes seems to be the fastest growing disease worldwide and known treatments don’t seem to be slowing it down or preventing long-term complications in many patients.  One possible reason is that diabetes is diagnosed based on one factor, how glucose is metabolized, but upon closer observation it is much more complex.  Today, diabetes is classified mainly by age of diagnosis, with younger patients usually having type 1, and on whether there are antibodies or not that attack beta cells which release insulin. Those with Type 1 cannot make their own insulin while those with type 2 can produce insulin but fail to utilize it properly.

New Subgroups for Diabetes.

It has been determined that between 75% and 85% of people with diabetes are classified as type 2, recently a third subgroup has been identified in recent studies known as latent autoimmune diabetes in adults (LADA).  Researchers from the University of Gothenberg and Lund University in Sweden are now claiming that additional subgroups are necessary.  To illustrate their claim they studied medical data from almost 15,000 Swedish people with type 2 diabetes and focused on not one but six factors that were documented at time of diagnosis.

  • Age
  • Body Mass Index
  • Presence of beta-cell antibodies
  • Metabolic control levels
  • Beta-cell activity
  • Insulin resistance

From this breakdown of data, five groups with considerably different characteristics emerge.

  • Severe Insulin-Resistant Diabetes (SIRD)Highest levels of insulin resistance  and highest risk of diabetic kidney disease.
  • Severe Insulin-Deficient Diabetes (SIDD)Mostly young adults with very poor metabolic control.
  • Severe Autoimmune Diabetes (SAD)Huge overlap with current type 1 diagnosis.
  • Mild Age-Related Diabetes (MARD) & Mild Obesity-Related Diabetes (MOD)Seemingly more benign forms of diabetes.

These new classifications could help distinguish high-risk patients and help doctors in prescribing more efficient treatments.  It can also be helpful to both newly diagnosed patients as well as those who have had type 2 diabetes for a long time.  Finally, it is not yet certain whether patients can move between these categories over time or if there are other factors that can further elaborate these sub-types of diabetes even further.  More in-depth studies are necessary, but it is clear that using several different factors to form a more specific diagnosis is a step in the right direction.

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Apple Watch Detects Diabetes with 85% Accuracy

Apple Watch Detects Diabetes with 85% Accuracy

Apple Watch Detects Diabetes with 85% Accuracy

The Apple watch is not just a hi-tech fashion statement but is now able to detect diabetes with 85% accuracy, according to part of a larger DeepHeart study with Cardiogram and UCSF.  It used data from Apple Watch users and detected 462 of them as having diabetes using the watch’s built-in heart rate sensor and artificial intelligence-based algorithms.  In previous studies it was found that heart rate variability could predict incident diabetes and hypertension, thus opening up the possibility of using the watch to to detect a diabetic patient.  Other conditions were detectable as well, please see below:

With 1 in 4 adults living with undiagnosed prediabetes or diabetes, it is becoming a growing problem in the U.S. Contributing to the growing problem is mainly the pain involved with checking blood glucose levels and keep their insulin balanced.  Early detection is one of the best ways to get diabetes under control before things get more complicated.  While other efforts have been made to create glucose sensing hardware, this is the first to use ordinary heart sensors paired with A.I. based algorithms to identify diabetes with no additional hardware.

More research is being done to increase the amount of diseases detectable through heart sensors, although caution is given that those in the study were already known to have diabetes.  Anyone who believes they are diabetic should see their doctor and not rely on the watch for diagnosis.  The conclusions are promising and we will see how far these methods will improve detection of diseases with simple readily-available tools used intelligently and efficiently.

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100 Years of Insulin Treatments Save Countless Lives

100 Years of Insulin Treatments Save Countless Lives

100 Years of Insulin Treatments Save Countless Lives

The disease diabetes has been identified for thousands of years, but only in the last 100, has there been a truly life-saving treatment: Insulin.

Insulin was discovered in 1921 at the University of Toronto.

Its discovery was one of the most sensational developments in medicine, effectively treating a disease that relentlessly reduced millions to blindness, coma and death. In his book, The Discovery of Insulin, author Michael Bliss, writes that the first attempts to use insulin on the comatose diabetics created what seemed to be a miracle: Comatose patients awoke and returned to life.

Until insulin was identified, there were many different types of treatment, all mainly useless. The most effective was a extreme diet. Patients managed to live a few years longer after starting the diet, but ultimately died of starvation. Doctors who used the diet in the 1920s, were later reminded of their patients when they saw pictures of inmates at Nazi death camps. Some people managed to live on the diet long enough to raise a child, for example. But even one morsel off the diet could kill them. Bliss gives the example of a messenger boy who managed to exist on the diet until one day he couldn’t resist picking and eating a handful of cherries. He was dead in a week.

It is generally agreed that insulin was first identified by Dr. Fred Banting, but many years of research before and after by many other scientists and doctors contributed to making insulin a reality.

Making it readily available was another problem. Insulin could not have been provided in quantity to the thousands, if not millions, of people who desperately needed it without the participation of drug companies such as Eli Lilly and Connaught Laboratories, to name just two.

During the time insulin was known, but could not be manufactured in sufficient quantity, patients died, knowing a treatment existed but that it just could not be made fast enough.

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