Gretchen graduated from Philadelphia College of Pharmacy and Science, The University of Scranton, and received a Doctor of Pharmacy degree from Temple University.
Gretchen has been teaching for over 25 years at Rutgers University, Keystone College, Lackawanna College, The University of Scranton, and Marywood University. She has earned certifications in Pilates, yoga, barre and teaches all three locally. She has a Wellness and Lifestyle coaching certification from Harvard University.
Gretchen resides in Scranton with her husband, Timothy Welby, MD, and has three daughters – Casey, Kate, and Caroline.
Lifestyle Medicine, is not just a fad or buzzword that is overused in a plethora of health, fitness and wellness magazines, but is actually a medical specialty. It is the practice of using diet and exercise, along with other lifestyle modifications to prevent and manage disease. Lifestyle Medicine focuses on six pillars: healthy eating, physical activity, restorative sleep, stress management, positive social connections, and avoidance of risky substances.
The American College of Lifestyle Medicine was established in 2004. Since then, its membership and outreach have grown exponentially. Lifestyle medicine is currently the fastest-growing specialty in medicine. Its primary aim is to utilize evidence-based therapeutic lifestyle interventions to prevent/control chronic diseases such as cardiovascular disease, type II diabetes, and obesity. However, new data is emerging which expands the role of Lifestyle Medicine into many other areas, including chronic low back pain, sleep, hormonal disorders, Alzheimer’s Disease, chronic inflammatory conditions, and mental health, to name a few.
Lifestyle Medicine differs from conventional medicine in that its approach is not disease specific. Following the six pillars of Lifestyle medicine improves overall health. Conventional medicine targets and treats a specific disease process with medication or surgical intervention in a reactionary approach. Lifestyle medicine prevents or reverses the disease process through behavioral and dietary changes. In a perfect world, Lifestyle medicine and Conventional medicine can be combined to achieve the best results for some patients.
A JAMA study, published in 1993, linked unhealthy lifestyles with premature death. Since this study was published, the rates of cardiovascular disease and Type II diabetes have continued to climb. Obesity rates are at an epidemic level. 70% of American adults, and 22% of children fall into overweight/obese Body Mass Index (BMI) categories. According to the American Academy of Cardiology, only 6.8% of adult Americans meet the criteria for ideal cardiometabolic health, something the Academy calls a “Population Level Code Blue.”
In 2020, the American Heart Association issued a Presidential Advisory for 2030 Impact Goals. The overall goal is to improve morbidity and mortality through preventative measures. Interventions should be targeted earlier in childhood and young adulthood, where healthy habits can be formed with greater success and maximum outcomes. For example, physical activity is well established for its positive effects on cardiovascular health. Physical activity prevents clot and plaque build-up, is antiarrhythmic, and provides hemodynamic stability. Physical activity has also been shown to have psychological, emotional, and social benefits. The American Heart Association categorizes physical activity as a Level 1 (highest) intervention for primary prevention.
Lifestyle Medicine is rooted in evidence-based findings, and its efficacy is supported in scientific literature. A study published in the New England Journal of Medicine in 2002 examined the prevention of the onset of Type II Diabetes in prediabetic patients. Patients were divided into three groups: a placebo group, a metformin group (a type 2 diabetes medication), and a lifestyle intervention group. The metformin group received daily metformin (medication intervention). The lifestyle intervention group received education and prescriptive interventions/instructions on diet, exercise, and stress reduction. Patients were followed for three years. At the end of the study period, the metformin group saw a 31% incidence reduction of type II diabetes, and the lifestyle intervention group saw a 58% incidence reduction in type II diabetes (almost double that of the medication group).
Many examples abound, highlighting the ability of lifestyle medicine interventions for healthy outcomes. The advantages of lifestyle medicine over conventional medicine interventions are numerous. Medications come with side effects. Medication costs are rising and are often not fully covered by insurance programs. Often, current medications are not completely effective for treating disease. For example, Alzheimer’s Disease treatments are lacking. The Alzheimer’s Association International Conference emphasizes healthy lifestyle interventions. They stress adopting 4 or 5 healthy lifestyle factors to reduce the risk of Alzheimer’s dementia by 60%.
Healthy eating habits do not lead to serious side effects. Lifestyle interventions are within the patients’ control and may result in cost savings, potentially lowering food and medical bills. Because lifestyle intervention involves behavioral changes, the process requires time and effort, as well as investment in education and reinforcement to sustain healthy patterns. Motivating clients to make necessary changes and stick with those changes can be the biggest challenge. A Lifestyle/Wellness Coach may be employed to start the client on their journey. The coach works with the client to make choices that are adaptable to the client while fitting within the six pillars. The role of the coach is to hold space and provide guidance for the client, but not to “fix”, “rescue,” or “judge”. Coaching sessions last 30-60 minutes. Coaches and clients may meet 10 times over 3-12 months to establish patterns.
If you, like so many others, have not achieved your health and wellness goals using traditional methods, it may be worth considering Lifestyle Medicine. Focus on healthy eating (minimizing processed foods and sugar intake), physical activity (minimum 300 minutes per week), restorative sleep (between 7-9 hours per night), stress management (controlling anxiety and depression), positive social connections (consistent interactions with friends) and avoidance of risky substances (alcohol, tobacco/nicotine, illicit drugs) have evidence-based positive outcomes to prevent, manage and reverse chronic diseases.
Sources: More information about the six pillars of Lifestyle Medicine and specific intervention outcomes can be found @Balanced Living 570 on Facebook and Instagram!
Visit your doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
A health column about sugar for Easter??? Well, maybe this information will be more appropriate next week! For those trying to lose weight or “get in shape” for the “bathing suit season,” a better understanding of the role sugar plays in your diet and overall health may be valuable. You have probably noticed a lot of attention being paid to sugar lately. Many television stars and other celebrities have shared their experiences using a “sugar cleanse” when they need to lose a few pounds and get healthier.
I have had several patients and friends tell me the same thing. For 4-6 weeks these people decide to avoid all refined sugars with the goal of losing weight and improving their health and wellness. Well, what is all the fuss about? Terms like simple sugars and simple carbs, which are purported to be bad, and complex carbs, suggested to be good, are being used ad nauseam. While medical research does not support the value of a short term “sugar cleanse,” it may have value for another reason. For example, it would be very beneficial if one engages in a “sugar cleanse” for the purpose of changing their palate with the hope of developing long term healthy eating habits, especially for those with diabetes…to be implemented AFTER the Easter candy has been consumed!
So, with this in mind, I decided to find the answers to some simple questions about the fuss over sugar. What is a simple sugar? What is a complex sugar? Which sugars are good for you?
Sugars, along with starches and fibers, are one of three types of carbohydrates (also referred to as a carb). A carb is “simple” or “complex,” based on its chemical composition and how it is processed in the body. It gets a little complicated because some foods have both simple and complex carbs. Typically, simple carbs are chemically more “simple” and basic, and therefore they are broken down more easily and serve as a quick source of energy. Some of these carbs are naturally simple (like fruit and milk) while others are processed or refined sugars such as those used in candy, soda and baked goods.
To determine if a food product has good or bad simple sugar, you must also know how much fiber, vitamins and minerals are in the food. A food with a higher sugar content combined with a low fiber, vitamin or mineral content will be worse than a food with the same sugar content but high fiber and vitamins or minerals. For example: a candy bar, which is high in sugar without fiber or vitamins or minerals, is not as healthy as a fresh orange, which contains fiber, vitamins and minerals along with its simple sugar (fructose).
Complex carbs have a more complicated chemical makeup and take more time for the body to break down for use as energy. Therefore, these are considered “good” carbs because they provide a more even distribution of energy for the body to use during activity. They cause a more consistent and gradual release of sugar into the blood stream (as opposed to peaks and valleys caused by simple carbs) and provide energy to function throughout the day. Additionally, “good” carbs have the added benefit of providing vitamins, fiber, and minerals that are missing from simple carbs.
Remember that carbohydrates fuel the body and are an important source of energy, especially for active and athletic people. However, carefully selecting the type of carb you eat is critical to peak function and performance.
Simple carbs taste great (according to our modern brain raised on simple sugars) and are easy to break down into a quick source of energy. However, the sensation of hunger is quick to return because the sugar is released and used up in the body quickly, giving the sensation of needing more.
Simple carbs are often “refined” and therefore stripped of their fiber, vitamins and minerals, which is why they are often referred to as “empty” calories.
Simple carbs lead to rapid spikes in blood sugar and insulin levels after meals. When these levels are not controlled over time, it can lead to obesity, which is ultimately related to adult-onset diabetes and high blood pressure.
Sources: www.everydayhealth.com; www.yourdictionary.com; Mayo Clinic
Visit your doctor regularly and listen to your body
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
I wish I could tell you that after turning 50, there are health issues associated with age I plan to be mindful of and address proactively. Unfortunately, that ship has sailed for me well more than a decade ago. So, I share this medical information, not only as a health professional but also as an experienced senior.
Entering the fifth decade is not all dome and gloom. Often, this decade is associated with an established family, gratifying career, good health and acquired self-confidence…realizing that life does not have to be perfect to be wonderful!
However, research tells us that as the body ages, even small changes at the cellular level can be manifested into big changes and problems over time. Nine of ten older adults have some type of chronic disease and eight of ten have more than one. But the good news is that, with a modicum of effort, most of these illnesses can be controlled or prevented, including regular doctor visits, health screening and testing, and lifestyle changes.
While it is normal to experience some weight gain is expected with age. However, uncontrolled, the average person will gain 1-2 pounds per year, leading to 11 pounds per decade, according to the National Institutes of Health. Consequently, almost 45% of Americans between 40 to 60 are obese. Obesity is associated with at least 20 chronic illnesses such as high blood pressure, heart disease, diabetes, cancer, and arthritis.
SCREEN: Body Mass Index (BMI)
TREATMENT: Diet, Exercise, Lifestyle, Medications, Surgery
With age, the flexibility of blood vessels loses elasticity and, unchecked, two out of three adults over 60 have high blood pressure. While genetics is a factor, there are a few things that you can control such as diet (salt, calories), exercise, weight, stress, and smoking.
SCREEN: Blood Pressure Test, Lab Tests, Electrocardiogram (ECG/EKG)
TREATMENT: Diet, Exercise, Lifestyle, Medications
Plaque buildup in the arteries of the heart begins in childhood and advances rapidly with age. 6-7 percent of US adults between the ages of 40 and 60. 20% of men and almost 10% of women between the ages of 60 and 80 have heart disease.
SCREEN: Blood Pressure, Cholesterol testing, Blood Sugar Testing, Imaging (ECG/MRI)
TREATMENT: Diet, Exercise, Lifestyle, Medications, Surgery
10 % of Americans have diabetes and the percent only increases with age. Diabetes is associated with many serious chronic illnesses such as heart disease, blindness, kidney disease and others.
SCREEN: Blood Test for blood sugar levels such as A1C, fasting plasma glucose test and random plasma glucose test
TREATMENT: Diet, Exercise, Lifestyle, Medications
In many cases osteoarthritis (wear and tear of joints) is often associated with age. However, lifestyle, joint injuries, inactivity, obesity and diabetes play a significant role.
SCREEN: Physical Exam, Functional Scores, Xrays, MRI, CT, US
TREATMENT: Diet, Exercise, Physical Therapy, Lifestyle, Medications (NSAID’s, Steroids, Viscosupplementation), Bracing, Surgery
Loss of bone density and strength is associated with age and certain metabolic conditions such as early menopause, thyroid disease, prolonged use of blood thinners and steroids. However, a diet rich in vitamin D, regular weight bearing exercises such as walking, jogging, dancing etc can go a long way.
SCREEN: Fracture Risk Assessment Tool (FRAX), Dual-Energy X-Ray Absorptiometry (DEXA) TREATMENT: Diet, Exercise, Physical Therapy, Lifestyle, Medications (Oral and Injection)
Losing balance with age is a common problem due to changes in the vestibular system (balance system in the brain), loss of muscle strength and joint flexibility, and compromised vision and hearing. This can often lead to falls, head injuries and fractures.
SCREEN: Timed Up and Go (TUG) Test, Morse Fall Scale
TREATMENT: Physical Therapy – Falls Prevention Program/Balance Training , Diet, Exercise, Lifestyle, Environmental Modification, Vision/Hearing Testing
Almost 10% of adults between the ages of 55 and 65 have some form of vision and/or hearing loss. This can lead to many problems such as balance and falls as well as isolation and depression.
SCREEN: Regular Hearing Tests/Vision Testing
TREATMENT: Corrective Devices
Both men and women suffer from bladder problems with age... especially frequency and control. It can impact lifestyles in many ways. Often adults fail to hydrate properly, especially when traveling, to control urgency. This can lead to other health problems.
SCREEN: Urine Analysis, PSA, Imaging, CT Urogram, Urine Cystoscopy, Ultrasound,
TREATMENT: Diet, Exercise, Lifestyle, Avoid Caffeine and heavy lifting, Medications, Surgery
As the body ages, so too do the cells that make it up. Often these cells change into cancer different parts of the body. Skin, colon, breast, prostate, lung, throat, etc. Today, however, much progress has been made for early detection and treatment.
SCREEN: Physical Exam (Skin Exams), Lab Tests (blood work, PSA), Imaging (CT, Mammography, MRI), Genetic Testing, Pap Smears, HPV Tests, Colonoscopies/Stool Tests, Multi-Cancer Early Detection (MCED)
TREATMENT: Diet, Exercise, Physical Therapy, Lifestyle, Medications, Chemotherapy, Radiation, Immunotherapy and Targeted Therapy Surgery specific to the cancer type.
Age related mental health issues are vastly unreported and diagnosed. Medical problems can contribute to mental health such as high blood sugar levels and some infections. Overall, lifestyle, environmental factors and family structure and support are particularly important.
SCREEN: No Single Test – Combination of Tools including - Neurological and Cognitive Tests, Brain Scans (CT/MRI), Blood tests, Genetic Testing
TREATMENT: Diet, Exercise, Physical Therapy, Lifestyle, (avoid excessive toxins like alcohol and nicotine), Medications, Environmental Modifications.
SOURCES: WebMD, NIH, Mayo Clinic, Alzheimer’s Association, American Cancer Society, American Heart Association, American Diabetes Association
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
Human beings were designed to move…walk, run, climb, lift, hunt, and gather. Contemporary man has suffered greatly from a technologically driven inactive and sedentary lifestyle. Inactivity is associated with many health problems; obesity, adult-onset diabetes, high blood pressure to name a few. The problems associated with lack of movement are many:
The more you move your body, the more you colon moves! A regular and consistent exercise and activity regime, results in a more consistent bowel schedule, especially with age. Healthy muscle tone in your abdominal muscles and diaphragm is also the key to moving waste through your digestive tract.
Osteoarthritis, rheumatoid arthritis and many inflammatory or auto-immune diseases can cause achy and stiff joints. However, even healthy joints can also stiffen when you don’t use them enough. Put them to work so they don't get tight and cause pain.
All muscles get weak from lack of use, including the muscles that help your lungs expand and contract as you breathe if you don’t work them out regularly. The less exercise or activity you do, the more you experience shortness of breath, even during easy daily tasks.
Physical problems are not the only complication of inactivity. A lack of movement can also increase feelings of anxiety and depression. Aerobic exercises like walking, biking, swimming, or running, have been proven to stimulate endorphins to boost and steady your mood, and even improve your self-esteem.
Many studies have found that regular movement improves energy. Exercise helps deliver oxygen and nutrients to your tissues. When you sit or are inactive, tissues are not getting the same amount of fuel they need to keep you going.
Movement stimulates your metabolism. Hyperactive people burn more calories…just by fidgeting! Even if you are not hyperactive, the more active you are, the more calories you burn each time you move.
One of the first recommendations sleep doctors make to their patients suffering from insomnia is exercise. When you keep a regular exercise routine, you fall asleep faster, and you sleep deeper once you drift off.
Regular exercise tells your body to make more chemicals called growth factors. They boost blood vessel production in your brain. The more blood that gets to your brain, the better you can think, remember, and make decisions.
Spending most of your time sitting raises your risk of heart disease, in great part due to the fact that partly you’re more likely to have high blood pressure. This is a big risk factor for heart issues like coronary artery disease and heart attack.
When physical activity is a regular part of your life, your body has an easier time keeping your blood glucose under control. Exercise can stabilize blood sugar levels and keep you out of the type 2 diabetes danger zone.
When your core muscles are weak from lack of use, they can’t support your back the way they should. This makes it much easier to tweak your back muscles during everyday movements like standing or reaching. Pilates, yoga, and other exercises that use stretching are good for building a stronger back. Schedule an appointment with a good orthopedic and sports PT.
Logically, one might think that you’d be hungry more often if you exercised more, but the opposite is usually true. Aerobic exercise like biking, swimming, walking, and running can actually decrease your appetite because it changes the levels of certain “hunger hormones” in your body.
Studies show the more moderate activity you get, the lower your chance of catching a cold or other germs. When you make exercise a habit, your immune system gets stronger.
If your skin looks duller than usual, a lack of movement may be to blame. Some studies show that moderate exercise boosts your circulation and your immune system, which helps your skin keep that youthful glow.
SOURCE: WebMD
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
According to the American Diabetes Association (ADA) and the Centers for Disease Control (CDC), 11.3% of the population in the United States or almost 37.3 million adults and children has diabetes. Unfortunately, the number keeps rising and one-third of these people are not aware that they have the disease. It will be the purpose of this column to raise the level of consciousness through education and offer recommendations for lowering blood sugar levels naturally.
Perhaps no goal is more important to a person with diabetes than maintaining a healthy blood sugar level. When managed over time, healthy blood sugar levels can slow the onset of complications associated with the disease. According to the ADA, pre-diabetes, or impaired glucose tolerance, occurs when blood glucose levels are higher than normal (110 to 125mg/dl) but below type 2 diabetes levels (126mg/dl). 54 million Americans have pre-diabetes in addition to the 20.8 million with diabetes.
While medications are effective in maintaining blood sugar levels, for those who are borderline, there are effective ways to lower your blood sugar naturally. Your physician will determine which treatment is most appropriate for your problem. Also, maintaining your ideal body weight is always important.
SOURCES: The American Diabetes Association (ADA), CDC, NIH, and Lifescript
Visit your doctor reguLlarly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM. For all of Dr. Mackarey's articles, visit our exercise forum!
November is National Diabetes Awareness Month. This column will present information regarding type 1 and type 2 diabetes and the diagnosis and symptoms of the disease. Next week, Part II will present the role of exercise in the management of the disease.
What is it?
Diabetes is a disease where the hormone insulin is not adequately produced or used by the body. Insulin is needed for cells to take up glucose after it is broken down from sugars, starches and other food that we eat. When working properly, this provides the fuel necessary for activities of daily living. While the exact cause is not completely understood, genetics is known to play a big role. However, environmental factors such as obesity and inactivity have also been found to play a large role.
According to the American Diabetes Association (ADA) and the Centers for Disease Control (CDC), 11.3% of the population in the United States or almost 37.3 million adults and children has diabetes. Unfortunately, the number keeps rising and one-third of these people are not aware that they have the disease.
A Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT) can be used to screen a person for diabetes or pre-diabetes. Due to the fact that it is easier, quicker and cheaper, the FPG is the recommended test by the ADA. A FPG test results between 110 and 125 mg/dl indicates pre-diabetes. A FPG of 126 mg/dl or higher indicates diabetes.
Type 1 diabetes occurs when the islet cells of the pancreas are destroyed and unable to produce insulin. Without insulin, the cells of the body are unable to allow glucose (sugar) to enter the cells of the body and fuel them. Without the hormone insulin, the body is unable to convert glucose into energy needed for activities of daily living. According to the ADA, 5-10% of Americans diagnosed with diabetes has type 1. It is usually diagnosed in children and young adults.
While type 1 diabetes is serious, each year more and more people are living long, healthy and happy lives. Some conditions associated with type 1 diabetes are: hyperglycemia, ketoacidosis and celiac disease. Some things you will have to know: information about different types of insulin, different types of blood glucose meters, different types of diagnostic tests, managing your blood glucose, regular eye examinations, and tests to monitor your kidney function, regular vascular and foot exams.
While symptoms may vary for each patient, people with type 1diabetes often have increased thirst and urination, constant hunger, weight loss and extreme tiredness.
Type 1 diabetes increases your risk for other serious problems. Some examples are: heart disease, blindness, nerve damage, amputations and kidney damage. The best way to minimize your risk of complications from type 1diabetes is to take good care of your body. Get regular checkups from your eye doctor for early vision problems, dentist, for early dental problems, podiatrist to prevent foot wounds and ulcers. Exercise regularly, keep your weight down. Do not smoke or drink excessively.
Type 2 is the most common type of diabetes as most Americans are diagnosed with type 2 diabetes. It occurs when the body fails to use insulin properly and eventually it fails to produce an adequate amount of insulin. When sugar, the primary source of energy in the body, is not able to be broken down and transported in the cells for energy, it builds up in the blood. There it can immediately starve cells of energy and cause weakness.
Also, over time it can damage eyes, kidneys, nerves or heart from abnormalities in cholesterol, blood pressure and an increase in clotting of blood vessels. Like type 1, even though the problems with type 2 are scary, most people with type 2 diabetes live long, healthy, and happy lives. While people of all ages and races can get diabetes, some groups are at higher risk for type 2. For example, African Americans, Latinos, Native Americans and Asian Americans/Pacific Islanders and the aged are at greater risk. Conditions and complications are the same as those for type 1 diabetes.
People with type 2 diabetes experience symptoms that are more vague and gradual in onset than with type 1 diabetes. Type 2 symptoms include feeling tired or ill, increased thirst and urination, weight loss, poor vision, frequent infections and slow wound healing.
Sources: NIH; American Diabetes Association; Harvard Health Publications
Visit your doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM. For all of Dr. Mackarey's articles, visit our exercise forum!
According to the American Diabetes Association (ADA), 32.2 million adults and children, 10.5% of the population in the United States, have diabetes. Unfortunately, one-third of these people are not aware that they have the disease. It will be the purpose of this column to raise the level of consciousness through education and offer recommendations for lowering blood sugar levels naturally.
Perhaps no goal is more important to a person with diabetes than maintaining a healthy blood sugar level. When managed over time, healthy blood sugar levels can slow the onset of complications associated with the disease. According to the ADA, pre-diabetes, or impaired glucose tolerance, occurs when blood glucose levels are higher than normal (110 to 125mg/dl) but below type 2 diabetes levels (126mg/dl). 54 million Americans have pre-diabetes in addition to the 20.8 million with diabetes.
While medications are effective in maintaining blood sugar levels, for those who are borderline, there are effective ways to lower your blood sugar naturally. Your physician will determine which treatment is most appropriate for your problem. Also, maintaining your ideal body weight is always important.
**This column is based on information from local physicians Kenneth Rudolph, MD, Gregory Borowski, MD, the American Diabetes Association L (ADA), and Lifescript
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles, visit our Health and Exercise Forum
Diabetes is a disease in which the hormone insulin is not adequately produced or used by the body. Insulin is needed for cells to take up glucose after it is broken down from sugars, starches and other food that we eat. When working properly, this provides the fuel necessary for activities of daily living. While the exact cause is not completely understood, genetics is known to play a big role. However, environmental factors such as obesity and inactivity have also been found to play a large role.
According to the American Diabetes Association (ADA), 10.5% of the population in the United States or almost 34.2 million adults and children has diabetes. Unfortunately, one-third of these people are not aware that they have the disease.
A Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT) can be used to screen a person for diabetes or pre-diabetes. Due to the fact that it is easier, quicker and cheaper, the FPG is the recommended test by the ADA. A FPG test results between 110 and 125 mg/dl indicates pre-diabetes. A FPG of 126 mg/dl or higher indicates diabetes.
Type 1diabetes occurs when the islet cells of the pancreas are destroyed and unable to produce insulin. Without insulin the cells of the body are unable to allow glucose (sugar) to enter the cells of the body and fuel them. Without the hormone insulin, the body is unable to convert glucose into energy needed for activities of daily living. According to the ADA, 5-10% of Americans diagnosed with diabetes has type 1. It is usually diagnosed in children and young adults.
While type 1 diabetes is serious, each year more and more people are living long, healthy and happy lives. Some conditions that may be associated with type 1 diabetes are: hyperglycemia, ketoacidosis and celiac disease. Some things you will have to know: information about different types of insulin, different types of blood glucose meters, different types of diagnostic tests, managing your blood glucose, regular eye examinations, and tests to monitor your kidney function, regular vascular and foot exams.
While symptoms may vary for each patient, people with type 1diabetes often have increased thirst and urination, constant hunger, weight loss and extreme tiredness.
Type 1 diabetes increases your risk for other serious problems. Some examples are: heart disease, blindness, nerve damage, amputations and kidney damage. The best way to minimize your risk of complications from type 1diabetes is to take good care of your body. Get regular checkups from your eye doctor for early vision problems, dentist, for early dental problems, podiatrist to prevent foot wounds and ulcers. Exercise regularly, keep your weight down. Do not smoke or drink excessively.
Type 2 is the most common type of diabetes as most Americans are diagnosed with type 2 diabetes. It occurs when the body fails to use insulin properly and eventually it fails to produce an adequate amount of insulin. When sugar, the primary source of energy in the body is not able to be broken down and transported in the cells for energy, it builds up in the blood. There it can immediately starve cells of energy and cause weakness. Also, over time it can damage eyes, kidneys, nerves or heart from abnormalities in cholesterol, blood pressure and an increase in clotting of blood vessels.
Like type 1, even though the problems with type 2 are scary, most people with type 2 diabetes live long, healthy, and happy lives. While people of all ages and races can get diabetes, some groups are at higher risk for type 2. For example, African Americans, Latinos, Native Americans and Asian Americans/Pacific Islanders and the aged are at greater risk. Conditions and complications are the same as those for type 1 diabetes.
People with type 2 diabetes experience symptoms that are more vague and gradual in onset than with type 1 diabetes. Type 2 symptoms include feeling tired or ill, increased thirst and urination, weight loss, poor vision, frequent infections and slow wound healing.
**This column is based on information from local physicians Kenneth Rudolph, MD, Gregory Borowski, MD and the American Diabetes Association and Harvard Health Publications
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For those trying to lose weight or “get in shape” for the New Year (number one resolution), a better understanding of the role sugar plays in your diet and overall health may be valuable. You have probably noticed a lot of attention being paid to sugar lately. Many television stars, like Ellen DeGeneres, have shared their experiences using a “sugar cleanse” when they need to lose a few pounds and get healthier. I have had several patients and friends tell me the same thing.
For 4-6 weeks these people decide to avoid all refined sugars with the goal of losing weight and improving their health and wellness. Well, what is all the fuss about? Terms like simple sugars and simple carbs, which are purported to be bad, and complex carbs, suggested to be good, are being used ad nauseam. While medical research does not support the value of a short term “sugar cleanse,” it may have value for another reason. For example, it would be very beneficial if one engages in a “sugar cleanse” for the purpose of changing their palate with the hope of developing long term healthy eating habits, especially for those with diabetes.
So, with this in mind, I decided to find the answers to some simple questions about the fuss over sugar. What is a simple sugar? What is a complex sugar? Which sugars are good for you?
Sugars, along with starches and fibers, are one of three types of carbohydrates (also referred to as a carb). A carb is “simple” or “complex,” based on its chemical composition and how it is processed in the body. It gets a little complicated because some foods have both simple and complex carbs. Typically, simple carbs are chemically more “simple” and basic, and therefore they are broken down more easily and serve as a quick source of energy. Some of these carbs are naturally simple (like fruit and milk) while others are processed or refined sugars such as those used in candy, soda and baked goods.
To determine if a food product has good or bad simple sugar, you must also know how much fiber, vitamins and minerals are in the food. A food with a higher sugar content combined with a low fiber, vitamin or mineral content will be worse than a food with the same sugar content but high fiber and vitamins or minerals. For example: a candy bar, which is high in sugar without fiber or vitamins or minerals, is not as healthy as a fresh orange, which contains fiber, vitamins and minerals along with its simple sugar (fructose).
Examples of simple carbs:
Complex carbs have a more complicated chemical makeup and take more time for the body to break down for use as energy. Therefore, these are considered “good” carbs because they provide a more even distribution of energy for the body to use during activity. They cause a more consistent and gradual release of sugar into the blood stream (as opposed to peaks and valleys caused by simple carbs) and provide energy to function throughout the day. Additionally, “good” carbs have the added benefit of providing vitamins, fiber, and minerals that are missing from simple carbs.
Examples of complex (carbs):
Remember that carbohydrates fuel the body and are an important source of energy, especially for active and athletic people. However, carefully selecting the type of carb you eat is critical to peak function and performance.
Sources: www.everydayhealth.com; www.yourdictionary.com; Mayo Clinic
Visit your doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
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