Health Watch 11/2020 Telegraph/Intelligencer

Health WATCH November 2020

American Diabetes Awareness Month: Find out more about insulin resistance

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• Wednesday, November 18, 2020 • Health Watch

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Health Watch

IN THIS ISSUE 3. Cover Story: American Diabetes Month 5. Organization focuses awareness on children • Staying healthy for the holidays 6.Dear Dietitian • Open letter to my daughter 7.Dental and vision exams can detect diabetes

healthwatch HEALTH WATCH PUBLISHER Denise VonderHaar dvonderhaar@edwpub.net (618) 463-2500 — HEALTH WATCH ADVERTISING DIRECTOR Carole Fredeking carole.fredeking@hearst. com (618) 463-2500 —

HEALTH WATCH EDITOR-IN-CHIEF Jill Moon jill.moon@hearst.com (618) 208-6448 — HEALTH WATCH COORDINATOR Regina Harbison rharbison@thetelegraph. com (618) 208-6433 —

ON THE COVER: Nurse practitioner Lisa James, a diabetes educator, and Dr. Wael Girgis, for whom she works, at the Diabetes and Endocrine Care of Alton offices located in a doctors building at 2 Memorial Drive, suite 220, on the Alton Memorial Hospital campus. (John Badman | Health Watch)

• Wednesday, November 18, 2020 • 3

Celebrate American Diabetes Month with education Avoid, look out for insulin resistance

By Jill Moon

jill.moon@hearst.com

ALTON — Since November is American Diabetes Month, it’s a good reminder to brush up on diabetes education because insulin resistance could happen to anyone, but it does not always lead to diabetes if nutrition and exercise regimens are followed.

An estimated 30 million Americans have diabetes, a disease in which there is too much sugar in the bloodstream.

In addition, it is estimated there are about seven million people who have not yet been diagnosed with the disease. Diabetes occurs when the pancreas, a gland behind the stomach, does not produce enough of the hormone insulin, or the body cannot use insulin properly. Insulin helps carry sugar from the bloodstream into the cells. Once inside the cells, sugar is converted into energy for immediate use or stored for the future.

Insulin resistance occurs in some people with diabetes. The pancreas secretes insulin but the insulin has difficulty reaching the cells where it is needed. As a result, glucose (blood sugar) levels rise, and the pancreas secretes more insulin in an effort to get blood sugar into the cells where it is needed for energy. Insulin resistance plays a part in formation of diabetes and metabolic syndrome. The energy created by converted blood sugar fuels many bodily functions, but extra stored insulin and sugar can lead to belly fat.

“The problem with belly fat, it leads people to have insulin resistance, causing the pancreas to work harder and harder to produce more and more insulin,” explained nurse practitioner Lisa James, a diabetes educator with endocrinologist Dr. Wael Girgis’ office at Diabetes and Endocrine Care of Alton, a BJC Medical Group.

“In the long haul this insulin resistance causes the pancreas to go out even faster. It becomes like a dog chasing its tail. More insulin resistance causes a need for more insulin, which

For Health Watch

Nurse practitioner Lisa James, left, a diabetes educator, and Dr. Wael Girgis, for whom she works, in a portrait for Diabetes and Endocrine Care of Alton offices located in a doctors building at 2 Memorial Drive, suite 220, on the Alton Memorial Hospital campus. The photo was taken before the new coronavirus pandemic started.

cause an increase in weight and belly fat which leads to more insulin resistance.

This is truly a vicious circle.

“Insulin is a hormone, a lot of people don’t know that,” she explained.

“People think of taking insulin as really bad, but the current treatment guidelines recommend using insulin earlier, to avoid complete destruction of the pancreas, to stabilize blood sugar. That sometimes eliminates complications.”

Pancreatitis can increase risk for insulin resistance of an otherwise non-diabetic person. Pancreatitis may start suddenly and last for days, or it can occur over many years as a chronic condition.

“Pancreatitis can happen totally on its own, as inflammation or an infectious process,” James said. “It’s something that can be a wait-and-see kind of thing, depending on how much damage is done to the pancreas. It’s a sensitive organ made up of beta cells, which make insulin, and you can’t make new ones. Once they’re gone, they’re gone.

You have to keep an eye on it if you’ve See DIABETES | Page 4

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• Wednesday, November 18, 2020 • Health Watch

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Diabetes From page 3

had pancreatitis.”

Of the millions of American with diabetes, typically 10% have type 1, an autoimmune disease more common in children and young adults, although any age can have type 1, James noted. Those patients suffer from destruction of cells in the body that make insulin and they have to take insulin for the rest of their lives, as well as run the risks of related complications.

“Type 2 is on the upswing because our kids have gotten so much heavier, have poor diets, and kids aren’t as active,” said James, who primarily works with adults.

“They’re doing more sedentary things, like, gaming and computer things that aren’t active.

Those kids tend to gain weight, and it tends to be belly fat, so that sets them up for metabolic complications that range from blood pressure and lipid levels to fat levels in the blood and a whole cascade of issues.

“If people don’t control their diets, insulin can cause weight gain, and gets this dog-chasing-itstail phenomenon.”

In contrast to injectable insulin, an injectable, noninsulin medicine, Ozempic, has been found to help those with type 2 diabetes, James noted.

“It’s actually a peptide and helps reduce insulin resistance,” she said.

She also said insulin pumps, versus a once-aday injection, drip and

allow more complete, but less insulin absorption requiring less amount of insulin.

“You get tiny amounts continuously instead of a shot that has to last the whole day,” she said.

“There’s a fine balance and what we see sometimes, people eat what they want, eat a doughnut and take more insulin, which is counterproductive in the long run, creating insulin resistance,” James explained.

“The key is balancing all things — diet, exercise, medicine and monitoring, and that’s what makes diabetes hard to control. You have to do all of that. Sometimes I think having diabetes is a full-time job, then add in everyday life, stress, kids, work, and you can see why it’s hard to control and keep it in a manageable position.”

Alton Memorial Hospital (AMH) provides a formalized diabetes education program offered every month, in which each of four weeks cover a different topic, beginning with an overview, followed by nutrition, monitoring, and lastly complications.

“It’s encouraging throughout,” James said.

AMH is still offering the program with smaller groups and social-distancing measures in place. Call AMH’s Diabetes Management Center Office at 618-463-7526 for more details.

Before the COVID-19 pandemic, Alton Memorial had a very active support group that met on Thursdays, which is in the process of being transitioned to an online setting, James said.

The American Diabetes

Association also provides great resources at www. diabetes.org.

“They have really good magazines, such as Forecast, and Better Homes and Gardens has one, Diabetic Living, that has a lot of recipes,” she said.

“And technology has been a good thing for diabetes with apps now developed to help people stay on track,” she also noted. “Everyone carries a cell phone now. And now sensors and pumps are integrated into cell phone apps to help keep people connected with blood sugars, insulin delivery, exercise and food.”

Such apps include My Fitness Pal, Glucose Buddies, and many others.

James has worked with the BJC Medical Group for 15 years and graduated 33 years ago as a registered nurse. She was a diabetes educator at AMH for seven years before becoming a nurse practitioner in April with Dr. Girgis’ office.

“This was a special interest for me because I felt like I saw all these people who had these bad outcomes, and I thought, ‘I wish there was a way to help people,’” she recalled.

“Education is always the beginning steps, and it led to becoming a nurse practitioner. I was fortunate enough that Dr. Girgis allowed me to join him, and I think we make a pretty good team and enjoy working together.”

Diabetes and Endocrine Care of Alton is located at 2 Memorial Drive, suite 220, on the campus of Alton Memorial Hospital. Call 618-433-6170 for more information.

Health Watch

Diabetes organization focuses awareness on children Health Watch

November is American Diabetes Month, a time when communities across the country team up to bring attention to diabetes. This year’s focus is on taking care of youth who have diabetes.

Diabetes is one of the most common chronic conditions in school-age youth in the United States, affecting about 193,000 age 20 years old and younger.

Regardless of their age, sometimes youth who have diabetes need support with their diabetes care. That’s why it’s important to help your child or teen develop a plan to manage diabetes, and work with their health care team to adjust the diabetes self-care plan as needed.

Here are some tips to consider for your youth’s diabetes self-care plan.

• Manage blood glucose levels. Make sure your child or teen takes their medicines as prescribed, at the right time, and the right dose—even when they feel good or have reached their blood glucose, blood pressure, and cholesterol goals.

• Encourage healthy habits. Follow

a healthy eating plan (especially if your youth is taking insulin), get enough sleep, and aim for regular physical activity. Youth with type 1 diabetes should also check their blood glucose levels before, during, or after physical activity.

• Stay prepared for emergencies. A basic “go-kit” could include medical supplies and equipment (at least a week’s worth) emergency and health care professional contact lists a medication list, including doses and dosing schedules, and an allergy list. Face coverings, hand sanitizer, and disinfecting wipes may also be added to your “go-kit” during a pandemic.

• Monitor for diabetes complications. Early diagnosis and treatment can help reduce risk for heart disease, vision loss, nerve damage, and other related health problems.

• Seek mental health support.

Encourage them to connect with other youth who have diabetes. Youth may not be used to talking about feeling anxious or alone about their diabetes.

Speak with your health care team for help.

Source: National Institute of Diabetes and Digestive and Kidney Diseases

Tips for staying healthy for the holidays

By Dustin Heiser SSP Wellness For Health Watch

ALTON — The holidays will be a little different this year, but they remain a special time for celebration.

Celebrations like these often include a break from work and school and time with family (perhaps in smaller groups this year). These special times can bring with them special challenges to an individual’s physical fitness and health. On a bright side, despite some extra challenges to healthy living, some of the more common challenges might be less prominent this year.

For example, the typical challenges associated with the holiday season have often included extended travel, leading to a deficiency in movement, and possibly disruptions in sleep schedules. Travel will be less than years’ past, but other challenges remain, including excess calorie consumption and certainly increased stress levels.

But fear not. Have your heard the quote, “It’s not the destination it’s the journey?”

Here are some tips for staying healthy while

• Wednesday, November 18, 2020 • 5

celebrating the holidays this year: • Meals should be relished, not rushed.

Remember to not only enjoy your food, but enjoy the whole day of being with loved ones, and savor every bite without rushing through the meal. There are many health benefits for taking your time to chew thoroughly, and giving your body time to cue you that you are full.

• Don’t skip meals during your holiday.

It can be tempting to skip a meal in preparation for a bigger celebratory meal, in an attempt to lower your overall calorie consumption. But, more often than not, that plan backfires. It’s more common that a person becomes overly hungry after skipping a meal, and if you ignore your body’s hunger cues, you will likely ignore the cue that you are full during the larger meal.

• Plan ahead and follow through with exercise during your holiday.

When stress levels rise and more calories are consumed, combat these influxes with exercise to bring your body back to a healthier state.

Try going for a walk or hike after the family get together. Exercise not only lowers stress levels, burns calories and improves physical fitness, but also promotes higher-quality and more-restorative sleep.

Dustin Heiser B.A.,CPT, FNS is an SSP Wellness coordinator at Senior Services Plus, 2603 N. Rodgers Ave., in Alton.

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• Wednesday, November 18, 2020 • Health Watch

DEAR DIETITIAN

Insulin trouble can be halted

By Leanne McCrate For Health Watch

Dear Dietitian, My doctor says I have insulin resistance syndrome. I need to lose about 40 pounds, and the doctor said this would help my insulin resistance; otherwise, I’m likely to become diabetic. He gave me a sheet with diet information, but I need more help.

Signed, Janet Dear Janet, Insulin resistance is a condition in which the pancreas secretes insulin but has difficulty reaching

the cells where it is needed. As a result, glucose (blood sugar) levels rise, and the pancreas secretes more insulin in an effort to get blood sugar into the cells where it is needed for energy. Insulin resistance also is known as metabolic syndrome.

Researchers aren’t sure what causes insulin resistance, but genetics likely are a factor. The American Association of Clinical Endocrinologists (AACE) has established the following criteria for the diagnosis of insulin resistance: • Overweight with a body mass index (BMI) of 25 or higher

• Triglycerides of 150 mg/dL or higher • High-density lipoprotein (HDL) of less than 40 mg/dl in men or less than 50 mg/dL in women • High blood pressure • Fasting glucose of 110-126 mg/dL • Glucose level of more than 140 mg/dL 2 hours after consuming 75 grams of glucose Does this mean you automatically will develop diabetes? Thankfully, it does not, but it is time to make some lifestyle changes. The first step is exercise. When you exercise, insulin sensitivity is improved, so your muscle

An open letter to my daughter

By T.A. Bechel For Health Watch

I have mentioned relationships a lot in this column. From relationships with family and friends to those in the community; I believe this is one of the most critical areas to focus on when recovering from some ailment, whether addiction, cancer, or toxic relationships. In many cases, when we are experiencing turbulence in our life, we can sometimes push those away that love us the most and even underappreciate those we are supposed to protect and love unconditionally. There comes a time when we become more mindful of the things in life we took for granted.

The combination of being a father and in recovery has taught me a lot about the

importance of relationships and how I should treat other people, especially my children.

I share with you an open letter to my oldest daughter, Dorie.

“Dorie, I loved you from the moment you were born. I remember hearing you cry for Bechel the first time, and it felt like someone hit me directly in the middle of my chest. I had to gasp for air and tried to fight back the tears to look tough, but that didn’t work out too well. You were perfect, and I remember thinking that I would be a better father than my own, and I would get healthier for you and your mom. I wanted to be the best father so I could

help protect and love you like the way you deserved.

I mean, you didn’t ask to come into this world that is full of such a juxtaposition of beauty and chaos.

If there was a theme song for you entering the world on the tail end of winter on that sunny day in March, it would be ‘Can’t Help Falling in Love’ written by George Weiss, Hugo Peretti, and Luigi Creatore. Right now, you would look at me and say, ‘Dad, are you crying?

Stop it, don’t cry.” I would laugh and wipe away any tears. I missed so many formative years due to being sick, stubborn, and selfish.

I know I fought daily to get better and some days it felt

cells are better able to use insulin to take up glucose during and after activity.

When your muscles contract during exercise, your cells can take up glucose and use it for energy, whether insulin is available or not. Moderate exercise of 30 minutes five times a week has been shown to McCrate improve insulin sensitivity. Other benefits of regular exercise include improved mood and better sleep.

Weight loss will improve insulin resistance. Fat blocks the insulin receptors on cells, thereby preventing insulin from

bringing glucose into the cells where it belongs.

Once weight comes down, glucose can enter the cells instead of staying in the bloodstream.

When beginning a weightloss program, consider a plan that offers group support, which is an essential factor for success. If you make no other change in your diet, avoid added sugars, like those in regular soda. Opt for whole grains instead of refined carbohydrates.

Choose fresh or frozen fruits and vegetables, healthy fats such as polyunsaturated (nuts, seeds,

seed oil) and monounsaturated fats (olive or canola oil), and lean proteins.

If you need more education on your diet, consult a registered dietitian nutritionist (RDN) near you. Most insurances will cover the cost of the consultation, but contact your provider to be sure.

Until next time, be healthy!

Dear Dietitian

like Hell would win. People wished death upon me, and I started believing them.

But the thought of you and your sister crying for the first time and how beautiful and perfect you two were when you were born helped give me the strength to keep fighting like Grandma Bechel, a woman I wish you could have met, told me on numerous occasions.

‘Never give up. Sometimes we have to fight,’ she would always remind me.

You have grown into such a gorgeous young lady with a supremely bombastic personality that has already faced so much adversity. I look at you and want to help protect you from getting in a romantic relationship with someone that may do more damage than aiding in your growth.

It is a hard pill to swallow to openly admit the wrongs I committed toward others in the pursuit of self-accep-

tance and selfish desires.

It is painstaking to see the world offer you a moment of your own that brandishes such a toxic atmosphere.

I look back on my past mistakes and hope to pass on to you what NOT to let a romantic or platonic partner do to you. No one should call you a whore, a skank, a dummy, or any other oppressing terms to assert power over you, especially at such a young age. Relationships can be troublesome at times, and both parties are sometimes guilty, but I have learned many of us human beings love power so much we want to wield it over someone we think we own.

I cannot always protect you from the snafus of life (some you have to learn on your own). However, through my final days on this earth, I hope that I do my best to prepare you on how to handle many situa-

tions and be an upstanding and caring person and set your boundaries appropriately. I love you, Dorie, more than a million words written by the most talented poets.”

Time is something we keep as human beings. The universe does its thing.

Marcus Aurelius said in Meditations, “The universe is transformation, life is but an opinion.” I am only here for a short amount of time during the cycle of life. I have to make a conscious effort to meet God halfway to become a better person, a better father, and a better friend. Until next time, may we love those that we’ve taken for granted.

Leanne McCrate, RDN, LD, CNSC, is an award-winning dietitian based in St. Louis.

Her mission is to educate consumers on sound, science-based nutrition. Do you have a nutrition question? Email her today at deardietitian411@gmail. com. Dear Dietitian does not endorse any products, health programs, or diet plans.

Ty Bechel is the executive director at Amare, a nonprofit 501(C)(3), that is a non-clinical, peer-led recovery community organization that offers recovery support services, education, awareness, guidance and hope to Madison County.

Health Watch

• Wednesday, November 18, 2020 • 7

Dental, vision exams can help detect diabetes early Delta Dental of Illinois encourages preventive checkups during American Diabetes Month For Health Watch

NAPERVILLE — Diabetes is a growing problem in Illinois and across the nation.

About 1.3 million Illinois adults have diabetes.

That’s nearly 13% of the state’s population. But more than one-quarter of Illinoisans living with diabetes do not realize that they have this potentially life-threatening disease.

This November during American Diabetes Month, Delta Dental of Illinois is partnering with the American Diabetes Association to bring awareness to the growing prevalence of diabetes and risks associated with the disease.

“Diabetes is a prime example of how your oral and overall health are connected,” said Dr. Sheila Strock, vice president, dental services and science officer at Delta Dental of Illinois.

“Diabetes can increase your risk of gum disease, and gum disease can contribute to the progression of diabetes.”

Connection between oral, overall health Your mouth and eyes can show early signs of diabetes.

People with diabetes are more likely to develop periodontal (gum) disease, which can also lead to tooth loss. Gum disease can also make it harder to manage diabetes by increasing blood sugar levels.

Other oral health prob-

lems associated with diabetes include cavities, dry mouth, burning mouth syndrome, oral infections and problems tasting food.

In addition, diabetes can impact your vision by damaging small blood vessels in your retina.

“That’s why preventive checkups are so important,” Strock said. “Even if you may not be aware you have symptoms of diabetes, your dentist or optometrist may notice them during routine exams.”

An oral exam can help detect more than 120 diseases, including diabetes, that show early symptoms in the mouth and jaw.

During a regular checkup, dentists and dental hygienists remove plaque and tartar that can lead to gum disease.

Those diagnosed with diabetes may need to visit their dentist more frequently for cleanings and preventive care.

Early detection is crucial Diabetes is the seventh-leading cause of death in Illinois and the U.S. This serious chronic disease has no cure. It affects how your body turns food into energy and places you at greater risk for serious health problems, including heart disease, stroke, blindness, kidney disease and amputations.

Symptoms of diabetes include increased

thirst, extreme hunger, unexplained weight loss, frequent urination, slow-healing sores, fatigue, irritability and blurred vision.

“Illinoisans experiencing any of these symptoms should inform their physician, dentist and optometrist,” Strock said.

“Your health care providers can work together to diagnose your condition and help develop a treatment and management plan that’s best for you.”

Tips for preventing, managing diabetes Not all types of diabetes are preventable. But routine dental and vision exams can help detect diabetes early, while a healthy lifestyle can help lower blood sugar and manage the disease. Steps toward better health include: • Eating a well-balanced diet rich in fruits, vegetables and high-fiber foods like beans and whole grains.

• Exercising regularly.

• Avoiding tobacco and consuming alcohol in moderation.

• Brushing teeth twice and flossing once daily.

• Visiting the dentist regularly. Since people with diabetes are at higher risk for gum disease, they may need to visit the dentist for additional preventive care, such as more frequent cleanings.

For more tips on protecting your oral and overall health, visit www.delta dentalil.com/oral-health and www.diabetes.org.

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