Posts Tagged ‘Your Body’s Well Being’

Eye Care

Sunday, July 15th, 2007

There are steps you can take to avoid eye problems.

First and most important, keep your blood sugar levels under tight control. In the Diabetes Control and Complications Trial, people on standard diabetes treatment got retinopathy four times as often as people who kept their blood sugar levels close to normal. In people who already had retinopathy, the condition progressed in the tight-control group only half as often. These impressive results show that you have a lot of control over what happens to your eyes. Also, high blood sugar levels may make your vision temporarily blurry.

Second, bring high blood pressure under control. High blood pressure can make eye problems worse.

Third, quit smoking.

Fourth, see your eye care professional at least once a year for a dilated eye exam. Having your regular doctor look at your eyes is not enough. Nor is having your eyeglass prescription tested by an optician. Only optometrists and ophthalmologists can detect the signs of retinopathy. Only ophthalmologists can treat retinopathy.

Fifth, see your eye care professional if:

  • your vision becomes blurry
  • you have trouble reading signs or books
  • you see double
  • one or both of your eyes hurt
  • your eyes get red and stay that way
  • you feel pressure in your eye
  • you see spots or floaters
  • straight lines do not look straight
  • you can’t see things at the side as you used to.

When to See an Eye Care Professional

  • If you are between 10 and 29 years old and have had diabetes for at least 5 years, you should have an annual dilated eye exam.
  • If you are 30 or older, you should have an annual dilated eye exam, no matter how short a time you have had diabetes. More frequent exams may be needed if you have eye disease.
  • If you have any changes in your vision.
  • You should have a dilated eye exam if you are pregnant or planning to get pregnant.
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Smoking

Wednesday, June 13th, 2007

Tobacco has many bad health effects, particularly for people with diabetes. No matter how long you’ve smoked, your health will improve after you quit.

Nicotine, the drug in tobacco, is one of the most addictive substances known. Besides the physical addiction, many smokers also become psychologically hooked on cigarettes. So kicking the habit is hard – but worth the work. There are many methods you can try to help you quit and stay away from smoking for good.

Smoking Hurts Your Health

The best-known effect of smoking is that it causes cancer. Smoking can also aggravate many problems that people with diabetes already face, such as heart and blood vessel disease.

  1. Smoking cuts the amount of oxygen reaching tissues. The decrease in oxygen can lead to a heart attack, stroke, miscarriage, or stillbirth.
  2. Smoking increases your cholesterol levels and the levels of some other fats in your blood, raising your risk of a heart attack.
  3. Smoking damages and constricts the blood vessels. This damage can worsen foot ulcers and lead to blood vessel disease and leg and foot infections.
  4. Smokers with diabetes are more likely to get nerve damage and kidney disease.
  5. Smokers get colds and respiratory infections easier.
  6. Smoking increases your risk for limited joint mobility.
  7. Smoking can cause cancer of the mouth, throat, lung, and bladder.
  8. People with diabetes who smoke are three times as likely to die of cardiovascular disease as are other people with diabetes.
  9. Smoking increases your blood pressure.
  10. Smoking raises your blood sugar level, making it harder to control your diabetes.
  11. Smoking can cause impotence.

Why Quitting Is So Hard

People keep smoking for two reasons. First, nicotine is highly addictive. Often, a person who quits smoking goes through withdrawal. Symptoms of withdrawal include: being irritable, sweating, having headaches, diarrhea, or constipation, as well as feeling restless, tired, or dizzy. Withdrawal is usually the worst on the second day after quitting, and it gradually lessens with time.

Second, many people become psychologically tied to smoking. It is part of their daily ritual. It helps them wake up in the morning, comforts them when they are upset, and rewards them for a job well done. Smoking also has pleasurable physical effects. It relaxes people and perks them up.

These factors make it easy to smoke and hard to quit. The pleasures of smoking start within seconds of lighting up; the bad effects can take years to make themselves known. On the other hand, when you try to quit, your first experience is the bad feeling of withdrawal. Only later do you begin to enjoy the benefits of quitting, such as having more energy.

Preparing to Quit

The first step to quitting is to study your own smoking habits. What events or activities make you light up? How often do you smoke?

Once you have an idea of when and why you smoke, you can look for replacements for smoking. For example, smoking may relax you. If so, learn and practice another way to relax, such as deep breathing and relaxation exercises. If smoking gives you energy, try standing and stretching or taking a walk when you start to feel the urge to smoke. Exercise can make you more alert.

Perhaps you enjoy the feeling of holding the cigarette, lighting it, gesturing with it, and tapping off the ashes. To keep your hands busy without a cigarette, try a strand of beads, a polished stone, or a pen.

Before you quit, it’s also a good idea to plan rewards for sticking to your goal. For example, you might go to a movie to reward yourself for each week you don’t smoke. Or you might put your cigarette money into a jar and use it to buy books or CDs or clothes – or save it for a trip.

Also, set up a cheerleading squad – family or friends who will give you support. Former smokers understand what you’re going through and may be especially supportive. The more people you tell you are quitting, the more your pride will help you resist lighting up.

Finally, set a date to quit. Choose a time when you expect your life to be fairly calm. That way, stress won’t tempt you to smoke. And if you do have withdrawal symptoms, they won’t interfere with your life as much.

Be a Quitter

There are many ways to quit: cold turkey or gradually, with a group or by yourself. Talk to your health care provider about your decision to quit. He or she can help you choose the best way for you. Remember, what works for one person may not work for another. Don’t be discouraged if the first method you try fails. Another method may be the one you need to kick the habit for good.

If smoking is merely a habit for you, something that you can take or leave, cold turkey may work best for you. But if you are very dependent on cigarettes, gradually weaning yourself from cigarettes may work best.

One method that helps you quit gradually is nicotine replacement. When you wear a nicotine patch or chew nicotine gum, some of the nicotine enters your blood. The patch and gum let you taper off from the physical addiction slowly. They blunt your craving for cigarettes and reduce withdrawal symptoms.

You do not wear the patch forever. Instead, you use a series of patches with decreasing nicotine doses. After a few weeks, you’ve been weaned totally from nicotine.

Nicotine replacement is especially good for people who are physically addicted to nicotine. These are people who smoke more than 20 cigarettes a day, who have their first cigarette within 30 minutes of waking up, and who have had strong withdrawal symptoms when they tried to quit before. Research shows that a smoker who uses a patch is twice as likely to quit successfully as someone who doesn’t use a patch.

Patches aren’t perfect. They raise blood sugar levels in some people with diabetes. And you must not smoke while wearing the patch.

If you think you would find it easier to quit with a group of people, think about joining a class. Your company, health plan, or a local hospital may sponsor such courses. If not, organizations such as the Seventh-Day Adventist Church, the American Lung Association, and the American Cancer Society may run free or low-cost classes in your town. (The American Heart Association and the American Lung Association also have self-help materials.) Check your phone book for the number of the local affiliates in your area, and look in the Yellow Pages under Smokers Information & Treatment Centers. Ask what the focus of the class is. Some classes target getting you ready to quit, and others try to help you stay off cigarettes.

Hypnosis helps some people stop smoking. It is most useful for helping you avoid the things that trigger you to smoke. If you are interested in hypnosis, choose a hypnotist with a clinical degree (for example, a physician or psychologist).

Another method is acupuncture. In acupuncture, fine needles are placed in various parts of your body. For some people, acupuncture stops the craving to smoke. If it’s going to work for you, it probably will do so in seven treatments or fewer.

However you decide to quit, there are several ways to help yourself keep at it. Throw away your cigarettes, lighters, and ashtrays at work and at home to make it hard to give into the urge to smoke. At first, avoid situations in which you enjoy smoking. Give yourself the rewards you planned. When you are tempted to smoke, make a list of reasons for not smoking. For example, your breath and hair smell fresher, you are saving lots of money, you are setting an example for loved ones, you aren’t coughing like you used to, or food tastes better.

Once You’ve Quit

Once you’ve quit, the next step is to stay off. The first three months or so after quitting are the hardest time. Most people who return to smoking do so then. During those first three months, they’ve broken the physical addiction but not yet shaken their psychological dependence on cigarettes.

It often takes just one cigarette to put you back on the smoking treadmill. Have some ideas up your sleeve to fight temptation. For example, plan to take a bath, chew sugarless gum, sip some water, find something to do with your hands, or step outside for some fresh air when the urge to smoke hits you.

If you know you are going to be around smokers, be prepared. Practice an answer for when you’re offered a cigarette. Seek out nonsmokers in the group. Don’t apologize for not smoking.

If you do smoke a cigarette, then you need to renew your decision to quit. Focus on learning from your slip, not on berating yourself for it. Figure out why you slipped up and how you might avoid doing so again.

Once your body’s metabolism returns to normal, you may put on a little weight. The average is about 7 pounds. If you are worried about gaining weight, talk to your dietitian about changing your meal and exercise plans.

You also need to stay in touch with your health care provider after you quit. Your diabetes control will probably improve. If so, your health care provider may want to change your insulin dose or diabetes pill schedule. Similarly, if you are being treated for high blood pressure or high cholesterol levels, your condition may improve so much that your health care provider may want to change your treatment.

Remember – quitting smoking is probably the most important thing you can do for your health and for those around you.

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Stress

Saturday, June 2nd, 2007

Stress results when something causes your body to behave as if it were under attack. Sources of stress can be physical, like injury or illness. Or they can be mental, like problems in your marriage, job, health, or finances.

When stress occurs, the body prepares to take action. This preparation is called the fight-or-flight response. In the fight-or-flight response, levels of many hormones shoot up. Their net effect is to make a lot of stored energy – glucose and fat – available to cells. These cells are then primed to help the body get away from danger.

In people who have diabetes, the fight-or-flight response does not work well. Insulin is not always able to let the extra energy into the cells, so glucose piles up in the blood.

Many sources of stress are not short-term threats. For example, it can take many months to recover from surgery. Stress hormones that are designed to deal with short-term danger stay turned on for a long time. As a result, long-term stress can cause long-term high blood glucose levels.

Many long-term sources of stress are mental. Your mind sometimes reacts to a nondangerous event as if it were a real threat. Like physical stress, mental stress can be short term – from taking a test to getting stuck in a traffic jam. It can also be long term: from working for a demanding boss to taking care of an aging parent. In mental stress, the body pumps out hormones to no avail. Neither fighting nor fleeing is any help when the “enemy” is your own mind.

How Stress Affects Diabetes

In people with diabetes, stress can alter blood glucose levels. It does this in two ways. First, people under stress may not take good care of themselves. They may drink more alcohol or exercise less. They may forget, or not have time, to check their glucose levels or plan good meals. Second, stress hormones may also alter blood glucose levels directly.

Scientists have studied the effects of stress on glucose levels in animals and people. Diabetic mice under physical or mental stress have elevated glucose levels. The effects in people with type 1 diabetes are more mixed. While most people’s glucose levels go up with mental stress, others’ glucose levels can go down. In people with type 2 diabetes, mental stress often raises blood glucose levels.

Physical stress, such as illness or injury, causes higher blood glucose levels in people with either type of diabetes.

For some people with diabetes, controlling stress with relaxation therapy seems to help. It is more likely to help people with type 2 diabetes than people with type 1 diabetes. This difference makes sense. Stress blocks the body from releasing insulin in people with type 2 diabetes, so cutting stress may be more helpful for these people. People with type 1 diabetes don’t make insulin, so stress reduction doesn’t have this effect. Reducing stress can help people with type 1 diabetes take better care of themselves.

Some people with type 2 diabetes may also be more sensitive to some of the stress hormones. Relaxing can help by blunting this sensitivity.

It’s easy to find out whether mental stress affects your glucose control. Before checking your glucose levels, write down a number rating your mental stress level on a scale of 1 to 10. Then write down your glucose level next to it. After a week or two, look for a pattern. Drawing a graph may help you see trends better. Do high stress levels often occur with high glucose levels, and low stress levels with low glucose levels? If so, stress may affect your glucose control.

Stress and Personality

You have some control over your reaction to stress. You can learn to relax and reverse the body’s hormonal response to stress. And, of course, you may be able to change your life to relieve sources of stress.

Something else that affects people’s responses to stress is coping style. Coping style is how a person deals with stress. For example, some people have a problem-solving attitude. They say to themselves, “What can I do about this problem?” They try to change their situation to get rid of the stress.

Other people talk themselves into accepting the problem as okay. They say to themselves, “This problem really isn’t so bad after all.”

These two methods of coping are usually helpful. People who use them tend to have less blood glucose elevation in response to mental stress.

Learning to Relax

There are many ways to help yourself relax:

  • Breathing exercises. Sit or lie down and uncross your legs and arms. Take in a deep breath. Then push out as much air as you can. Breathe in and out again, this time relaxing your muscles on purpose while breathing out. Keep breathing and relaxing for 5 to 20 minutes at a time. Do the breathing exercises at least once a day.
  • Progressive relaxation therapy. In this technique, which you can learn in a clinic or from an audio tape, you tense muscles, then relax them.
  • Exercise. Another way to relax your body is by moving it through a wide range of motion. Three ways to loosen up through movement are circling, stretching, and shaking parts of your body. To make this exercise more fun, move with music.
  • Replace bad thoughts with good ones. Each time you notice a bad thought, purposefully think of something that makes you happy or proud. Or memorize a poem, prayer, or quote and use it to replace a bad thought.
  • Whatever method you choose to relax, practice it. Just as it takes weeks or months of practice to learn a new sport, it takes practice to learn relaxation.

Other Ways to Reduce Mental Stress

You may be able to get rid of some stresses of life. If traffic upsets you, for example, maybe you can find a new route to work or leave home early enough to miss the traffic jams. If your job drives you crazy, apply for a transfer if you can, or possibly discuss with your boss how to improve things. As a last resort, you can look for another job. If you are at odds with a friend or relative, you can make the first move to patch things up. For such problems, feeling stressed may be a sign that changes are called for.

Some sources of stress are never going to go away, no matter what you do. Having diabetes is one of those. Still, there are ways to reduce the stresses of living with diabetes. Support groups can help. Knowing other people in the same situation helps you feel less alone. You can also learn other people’s hints for coping with problems. Making friends in a support group can lighten the burden of diabetes-related stresses.

There are other ways to fight stress as well. Sometimes adding positive things to your life can help. You can start an exercise program or join a sports team. You can take dance lessons or join a dancing club. You can start a new hobby or learn a new craft. You can volunteer at a hospital or charity.

Dealing directly with diabetes-related stress can also help. Think about the aspects of life with diabetes that are the most stressful for you. It might be taking your medication, or checking your blood glucose levels regularly, or exercising, or eating as you should.

You can get help with any of these issues. Ask a member of your diabetes team for a referral. Sometimes stress can be so severe that you feel overwhelmed. Then, counseling or psychotherapy might help. Talking with a therapist may help you come to grips with your problems. You may learn new ways of coping or new ways of changing your behavior.

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