Diabetes Archive

Ask the doctors

Q. I'm trying to eat less sugar. Can you offer any tips that can help?

A. First, congratulations. Cutting down your consumption of sugar can help protect your health in the long term. Sugar-heavy diets have been linked to health conditions, including obesity, diabetes, and heart disease. Most Americans eat far too much sugar. A U.S. government health and diet survey from 2015–16 found that the average American eats about 17 teaspoons of sugar a day. The Dietary Guidelines for Americans recommend eating no more than the equivalent of 12 teaspoons of sugar a day, and the American Heart Association suggests no more than the equivalent of six teaspoons per day. To cut down on your sugar consumption, your first goal should be to focus on incorporating more whole, unprocessed foods into your daily diet. Eating more of these foods can crowd out processed sources of added sugars in your diet.

In the journals

Scientists continue to explore the right balance of carbohydrates and fat in people's diets. But for overweight or obese older adults, a recent study found that a low-carbohydrate, high-fat diet might offer special health benefits. The results were published online Aug. 12, 2020, by Nutrition and Metabolism.

Researchers asked 40 obese adults, ages 60 to 75, to follow an eight-week diet in which 10% of calories came from carbs, 25% from protein, and 65% from fat. Carb sources included leafy greens, non-starchy vegetables, some fruit, and high-fiber grains. Protein intake consisted of eggs, fish, pork, and poultry. Fat-containing foods included olive oil, coconut oil, nut oils, nut butter, cheese, coconut milk, and avocados.

When diet and exercise are not enough for a person with diabetes to manage their blood sugar, one or more medications may be needed. Adding a second medication can offer additional benefits beyond blood sugar control, but the benefits and risks of these newer classes of drugs must be weighed for each person.

On call

Q. My blood pressure stays low. Sometimes it drops so low, it causes dizziness and weakness. What causes this?

A. Of the possible causes of low blood pressure, two are at the top of my list. First, I would review your medications. Drugs prescribed to treat high blood pressure and heart disease are the ones that most often cause this side effect. Reducing the dose with your doctor's approval may be all you need.

Drinking no more than four or five 8-ounce cups of coffee per day—equal to about 400 milligrams of caffeine—helps people get the drink's health benefits with a lower risk of caffeine side effects like anxiety and nervousness.

News briefs

A modest uptick in the amount of fruit and vegetables you eat can help ward off type 2 diabetes, according to a study published online July 8, 2020, by The BMJ. From a much larger study involving some 340,000 people from eight European countries, scientists selected 9,754 participants who were newly diagnosed with diabetes over a decade. Researchers compared the fruit and vegetable intakes of these people to those of about 13,000 participants who remained diabetes-free during the study period. Researchers also measured blood levels of seven key plant-derived nutrients, including vitamin C and brightly colored antioxidant pigments called carotenoids. People with the highest intakes of fruit and vegetables and the highest blood levels of the plant-derived nutrients were 25% to 50% less likely to get diabetes during the study period, compared with those who ate the least of these food groups or had the lowest nutrient levels. Even better, it didn't take a whole lot of extra green, red, yellow, and orange on the plate to make a dent in diabetes risk. The equivalent of only two-thirds of a medium apple or just over one-third of a cup of mixed fruit each day offered protection.

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In the journals

Not only can regular leg stretching help reduce cramps and muscle strains, it also may be another way to protect against heart disease and stroke. A study published online July 1, 2020, by The Journal of Physiology found that performing simple leg stretches can help improve blood flow throughout the body.

Researchers split 39 healthy people into two groups. One group didn't do any stretching. The other group performed four types of leg stretches five times a week for 12 weeks. The stretches focused on the hip, knee, and ankle. Each stretch was done for 45 seconds with a 15-second recovery. Afterward, the researchers found that the arteries in the lower legs of the stretching group had better blood flow and less stiffness. The stretching group also had lower blood pressure at the end of the study compared with their initial readings.

News briefs

Eating a diet high in foods tied to inflammation — such as processed meat, sweets, and refined grains — is associated with many health problems, including an increased risk for colon cancer, heart disease, stroke, or diabetes. A Harvard study published online May 7, 2020, by Gastroenterology found another potential risk: Crohn's disease, a condition characterized by areas of inflammation throughout the large and small intestines. Researchers evaluated 30 years' worth of self-reported diet information from more than 208,000 men and women. Diets were scored based on foods that promote inflammation. Compared with people who had the lowest inflammatory diet scores, people with the highest scores had a 51% higher risk for developing Crohn's disease. The risk for Crohn's doubled among people who went from a low- to a high-inflammatory diet during the study. The study is observational and doesn't prove that an inflammatory diet causes Crohn's disease. But with so many other risks associated with foods that promote inflammation, it's important to eat as many foods that fight inflammation as possible. In other words, focus on whole, unprocessed foods with no added sugar — such as vegetables, fruits, whole grains, legumes (beans, lentils), fish, poultry, nuts, seeds, a little bit of low-fat dairy, and olive oil.

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News briefs

First it was certain blood pressure and heartburn drugs; now some medications used to treat type 2 diabetes are being recalled because of cancer concerns. The FDA warned in late May and early June 2020 that some lots of extended-release metformin may contain unacceptable levels of N-nitrosodimethylamine (NDMA), a possible cancer-causing chemical. At least five manufacturers are now issuing voluntary recalls of the medications. But if you take extended-release metformin, don't just stop on your own. Not all extended-release metformin products are affected by the voluntary recalls, and stopping any medication that controls blood sugar can be very dangerous. The FDA advises that you check in with your doctor or pharmacist. Ask if your medication is affected by the recall; if so, ask if you should switch to another version of the drug.

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