Fruit consumption and diabetes

sliced fruits on tray
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Patients frequently ask me if as a diabetic, is it safe to ready fruit. It’s not a simple question to answer. I received an update from Medical News that answers this question very nicely. The short answer is, yes, got can safely consume fruit add a diabetic. However, all things in moderation.  In general, if you are diabetic, you should be aware of calories.  You want to avoid fruits with a high glycemic index.   Otherwise, you do want fruit as part of your diet.  You also want to incorporate vegetables as well.

If your looking for ways and reasons to incorporate fruits and vegetables in your diet, please check out one of my favorite sites Nutrition Facts

Thank you for stopping by!

 

 

 

 

Insomnia #3: What Happens When you Sleep

white bed linen
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The Awake Brain

Your brain is designed to work in cycles. In the morning, your brain is in its it’s full functional state. Your sensory organs are fully engaged, allowing for sight, hearing, touch, taste and scent. Your eyes will operate normally, and your blink reflex (the response to a fast moving object coming towards your face) is active. You are also in complete control of your motor cortex, so you have full control of your muscles, allowing for normal movements.

Your heart beat is on an automatic system but gets outside input from the vagus nerve. Your heart rate will rise when physical demand requires more blood flow. Your breathing is automatic as well. You can override the automatic breathing cycle yourself by doing something like meditation or breath holding. Your respiratory system will go back to your default automatic program as soon as your conscious brain moves on to something else.

During the awake state, your digestive system is ready to work, and particularly during the day hours the stomach, small intestines, and colon work in coordination to digest for and extract nutrients as well as eliminate waste.

The Drowsy Brain

You begin to register the sensation of feeling sleepy when your blood pressure begins to drop. Your heart rate will also begin to slow down. Your ability to form new memories decreases, and any new information that reaches your brain will not be stored. The electrical activity in your brain begins to change as well which can be seen on an EEG. This corresponds to an alteration in your eyes, which will start an automatic slow back and forth movement.

Light Sleep

N2 or light sleep will follow the first stage of sleep. The electrical activity of the brain will continue to change, reflecting a lower amplitude of activity on EEG’s. The eyes will stop moving at this point, tending to stay in one place. Breathing is now automatic. When your awake, if you hold your breath, you will get a strong urge to breathe within a few seconds due to your body’s mechanism to respond to elevated carbon monoxide levels in the blood stream. In N2 sleep, your body may not do this. You will spend about half of the night in this stage of sleep.

N3 sleep

In this deeper stage of sleep, brain activity continues to slow even more. Your brain will cycle between N2 and N3 several times throughout the night. The body is even less responsive to rises in carbon dioxide in the blood stream than in the lighter stages of sleep.

REM sleep

REM, or Rapid Eye Movement, is the necessary sleep stage that allows for true rest. It is during this phase that the all motor control is frequently lost; This is the stage of sleep when dreams occur.

Waking up

After going through several cycles of sleep throughout a night, your body will prepare to wakes itself. In the early morning hours, your blood sugar will rise. This effect can become exaggerated in diabetics, leading to the Dawn Phenomenon, or early morning high blood sugars despite being in a fasting state. The cycle starts again

Sleeping is a complex process, and as you can see, there are many steps in the process to ensure a good night’s sleep. I frequently discuss an abbreviated form of the the sleep process with patients because many people don’t realize that the highly coordinated process is deeply disrupted with alcohol, several medications, as well as bad habits such as ruminating at bed time.

Once again, I am so appreciative for readers that stop by to read my blog. Being a practicing physician, many of these important topics I often rush through, so it’s nice to spend a little more time on issues.

In my next insomnia post, I will start delving deeper into how to analyze your sleep issue and approaches to deal with them.

Resources:

Goldman, L., & Schafer, A. I. (2016). Goldman-Cecil medicine. Retrieved June 2, 2018.

Why I won’t touch your cell phone…it’s basically a bodily fluid

Cell phones can add an amazing dimension to healthcare. Whereas patient used to tell me about a rash that’s now gone, now a savvy patient can snap a picture from their cell phone that I can use to make a diagnosis. Patients can keep track of blood sugars, blood pressures, activity levels, migraine attacks, sleep, etc on their cell phones. They are social tools, their with you at every outing, capturing awesome pictures and updating your social media.

They are filthy. Literally.

In a study, cultures from cell phones were found to grow Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphlococcus aureus, Enterococcus feacalis, and Bacillius¹

 

Just for kicks and giggle:

Escherichia coli and Enterococcus feacalis are coliform bacteria…yep….they’re in your poop.

Pseudomonas aeruginosa causes serious skin and blood stream infections.

Its for this reason that:

If I’m seeing you as a patient in the clinic, I will do everything possible not to handle your phone.

Before I touch your cell phone, I will wear gloves as if handling any other bodily fluid.

Keeping your phone clean:

Some studies show that a case on your cell phone can reduce the amount of bacteria.

You can reduce the amount of bacterial contamination by wiping the phone down with diluted rubbing alcohol.

I personally use commercially available eyeglass cleaner wipes once or twice a day.

While patients are not suprised to see me put on gloves for a variety of reasons, I’m now gloving up to touch your personal electronics.

Thanks for reading! I appreciate all the readers that stop by an spend a few minutes here.

  1.  Akinyemi, K. O., Atapu, A. D., Adetona, O. O., & Coker, A. O. (2009). The potential role of mobile phones in the spread of bacterial infections. The Journal of Infection in Developing Countries,3(08). doi:10.3855/jidc.556

 

Ginger

via Ginger | NCCIH

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The National Center of Complementary and Integrative Health recently sent out an email about ginger.  I thought this would be a good excuse to get back to my blog.

I frequently recommend using ginger to patients.   There are ginger supplements available in many forms, but its pretty easy to find raw ginger root in the grocery store produce aisle.  I use raw ginger in stir fry or make a “tea” (herbal infusion) with hot water, ginger root and water.

Ginger is a great remedy for motion sickness, Meniere’s Disease,  or morning sickness.  Simply inhaling the spicy scent gives  you instant relief.

I often recommend ginger to help stabilize blood sugars. Ginger has been shown to reduce A1c (blood sugar average) and fasting blood sugars in diabetics.¹

Ginger essential oil  has a much longer shelf life than the root, and its easy to carry when you travel.  One very strong recommendation is that ginger is a “hot” oil, meaning it has a lot of kick.  I strongly recommend diluting essential oil in a carrier oil if your going to use it topically.

 

 

1. The Effects of Ginger on Fasting Blood Sugar, Hemoglobin A1c, Apolipoprotein B, Apolipoprotein A-I and Malondialdehyde in Type 2 Diabetic Patients. (n.d.).

Resource for High Deductible/Uninsured Patients

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via MDsave – Feels Better Already

 

I was reminded today of this excellent resource for patients who have high deductibles of don’t have insurance.  MDsave.com is a free service that can assist you if you are needing labs, x-rays or other medical procedures.  Although the procedures are still expensive, you can save a lot of money on necessary medical care.

Prostate Cancer Screening and Men’s Health

Photo from wordpress...representation of male patient afte he finds out there will be no prostate exam.
Photo from wordpress…representation of male patient afte he finds out there will be no prostate exam.

I see both male and female patients. Women are accustomed to some sort of yearly exam, typically related to women’s health.

I’ve found over my years of practice that men typically present at the ages of 30, 40, or 50 wondering what is required of their health. Unlike women, the average healthy man may not have a specific need for a physician. It’s not unusual for a male patient to go over 20 years without seeing a physician. After going so long without seeing a physician naturally, they are very nervous about the prospect of meeting a physician and getting a rectal exam immediately.

These medical headlines are extremely helpful. The current recommendations are that for the majority of men, prostate cancer is not recommended.

My approach is education. Every man should be aware of symptoms of prostate enlargement, such as frequent urination or trouble emptying the bladder. Men should also be prepared discuss issues with sexual health, as any issues with having an erection could signal issues with cardiovascular disease. Checking PSA or performing a prostate exam won’t be necessary UNLESS a patient wants to do this. Patients that want a more rigorous screening exam have the option once we discuss the risks and benefits it prostate screening.

Internal Medicine News

KHN Morning Briefing