Tuesday, October 26, 2010

US Population With Diabetes To Double or Triple

According to a new CDC study, as many as 1 in 3 U.S. adults could have diabetes by 2050.    This is an increase from 1 in 10 U.S. adults now.  This is indicative of the growth that is happening due to our current trends.  Let me give three ideas on how to limit your progression to diabetes (make sure you are part of the 2 in 3 that don't have diabetes).

1. Exercise Regularly -- Exercise has been shown to be one of the most effective ways to improve diabetes and also to eliminate your diabetic risk.

2. Lose Weight -- Better weight control will reduce the likelyhood of sugar spikes and insulin resistance that often present prior to a diabetic diagnosis. 

3. Eat Good Diet -- A well balanced, nutrient rich diet can reduce the abnormal sugar spikes.  In fact, it is recommended that each individual eat 4-5 small meals every day consisting of less refined sugars (donuts, cakes, ice cream, candy, soda pop, etc.)

These three points rock the current trend and should help you reduce your chance of diabetes.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
http://www.UtahFootDoc.com

Tuesday, June 29, 2010

Vitamin C May Reduce Damage From Diabetes

In a new study on Vitamin C, it was found that oxidative stress can be alleviated by antioxidant activity of vitamin C.  In fact, it helped significantly.  Although the amounts were administered through the blood stream (not by oral over-the-counter treatment), it is promising for the options at treating the complications and injuries commonly encountered in diabetes.

My findings have been similar.  As antioxidants are added to the diet, including vitamins and minerals by supplement or by diet high in fruits and vegetables, diabetic complications can improve.  These are promising findings and more is coming.

Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
http://www.UtahFootDoc.com

Tuesday, March 23, 2010

Can Nutrition Help Diabetic Complications

Many individuals that I meet with diabetes are looking for ways to not just treat, but possibly improve their risks of complications, I have compiled a list of several key factors to limit diabetic complications:

1.  Avoid Excess Alcohol -  Alcohol can rapidly increase the progression of nerve damage and associated neuropathy if consumed in excess.  Therefore, limiting alcohol consumption will decrease the risk of this nerve damage.

2.  Diets Rich In B Vitamins -  Foods rich in vitamin B12 (Fish, meat, poultry, eggs), vitamin B6 (meats, whol grains, vegetables, and nuts), vitamin B1(cereal grains, oatmeal, flax seed, brown rice, spinach, asparagus, oranges) and Folic acid (leafy vegetables, dried or fresh beans) can improve the functioning of tissues, especially nerves.

3. Well Balanced Diets - As you eat a well balanced diet (including many of the foods above), you will also consume the essential amino acids necessary to allow repair and proper functioning of nerves and blood vessels.  This reduces the risk of complications.

4. No Smoking - Smoking, although not necessarily a nutrition item, can lead to decreased circulation to the feet and hands due to the constrictive effect of nicotine.  Smoking therefore increases the risk of diabetic complications.

5. Proper Fluid Intake - A key aspect of any nutrition program should be water rich.  Consumption of sufficient water (other fluids are not as beneficial) can improve the functioning of the kidneys, improve blood flow and overall decrease diabetic complications.

If these key nutrition practices are added to regular exercise, diabetic complications will be limited and the diabetes may even be improved.  Let's work on improving your diabetes and limiting the complications...for additional information visit our Diabetes Page.

Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
http://www.utahfootdoc.com/

Tuesday, November 24, 2009

New APMA video for the Diabetic Foot

The American Podiatric Medical Association has released a new video on the Diabetic Foot, including consequences of vascular compromise (decreased blood supply) to the foot.



To view the video clip on APMA's official YouTube channel, please CLICK HERE.


Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
http://www.UtahFootDoc.com

Tuesday, August 18, 2009

Exercise Doesn't Always Help Diabetes...

Regular exercise can often improve diabetes symptoms and even improve the insulin sensitivity in a diabetic. In many studies, it has been shown to decrease the risk for diabetes type 2 and may even help someone decrease the medication use for this disease. This is accomplished through multiple mechanisms, but the best understood includes proliferation of glucose transport molecules that move to the cell membrane and bring glucose into the cells.

In a recent study, it was found that daily vitamin supplementation with vitamin C or vitamin E failed to improve insulin sensitivity when combined with exercise. It was therefore concluded that these antioxidants reduces the beneficial effects of exercise to health. Therefore, as opposed to vitamin supplementation with exercise, the natural vitamins from a diet rich in fruits and vegetables is a better combination with exercise to continue to have the health benefits of exercise.

For more information: Ristow M et al. Antioxidants prevent health-promoting effects of physical exercise in humans. Proc Natl Acad Sci U S A 2009 May 26; 106:8665. [Free full-text online] [Medline® Abstract]

Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
http://www.UtahFootDoc.com

Tuesday, May 19, 2009

Botox For Diabetic Nerve Pain

In a recent study found in Neurology (28 April 2009), a group of scientists tested the use of injections of botulinum toxin type A—better known as Botox— into the skin on top of the foot to treat neuropathy pain. In this study, 44% were noted to have significant improvement of their pain after multiple treatments with botox. The question is whether this is a good idea.

Neuropathy pain is problematic and often difficult to treat. For years, people have been told that no treatment is available. If this were truly the case, Botox would be a good option. If it is typical Botox, however, it would require recurrent treatments throughout life to maintain the relief. And there is also a large concern for risks of injecting this substance into the skin of a diabetic without normal nerve feeling.

The truth is, however, that many diabetics are finding relief from their pain from the following options:

Monochromatic Infrared Therapy (MIRE or Anodyne): Infrared light therapy provided at a regimen of 2-3 times a week for 12 treatments. This has been shown in studies to improve some in many individuals, but has also be shown to be ineffective in many individuals.

It stimulates Nitrous Oxide (NO) release from the blood cells that interactes with surrounding tissues and decreases nerve pain, stimulates vasodilation (opening of blood vessels to increase circulation), increases nerve functioning. Often it has been shown to return sensation to a previously numb foot.

Metanx: This is a prescription medical food for the dietary management of endothelial dysfunction in patients with diabetic peripheral neuropathy. Traditional over-the-counter vitamins are synthetic forms of the nutrients found in nature and must be converted to their active forms before they can actually be used by the body's cells for such vital functions as DNA production, cell reproduction and homocysteine metabolism.

B Vitamin Active Form
Folic acid L-methylfolate (2.8mg)
Vitamin B6 Pyridoxal 5'-phosphate (25mg)
Vitamin B12 Methylcobalamin (2mg)

Metanx is a unique formulation providing the active forms of folate, vitamin B6 and vitamin B12 to manage the distinct nutritional requirements of neuropathy patients who often experience numbness, tingling, and burning sensations in their feet. Per studies run by the makers of Metanx, one tablet is equivalent to taking 19 folic acid tablets (1mg each), 2 B12 tablets (1mg each), and 2 B6 tablets (25mg each). You would need to take a handful of over-the-counter tablets to equal one dose of Metanx. Metanx is given at 1 tablet twice a day.

Neuremedy: This is a medical food consisting of benfotiamine, that nourishes dysfunctional nerves allowing them to conduct impulses more normally. Since the early 1960s, benfotiamine has been used successfully to treat neuropathy in Asia and Europe. Has has extensive studies that show it to be both effective and safe. It has recently been brought to the USA for treatment of neuropathy in our population.

Adequate blood levels of the micro-nutrient thiamine (Vitamin B1) are essential for the proper functioning of the nervous system. Recent studies have shown that many people suffering from peripheral neuropathy have low plasma levels of this essential micro-nutrient. They are unable to maintain adequate plasma thiamine levels through normal dietary means, or even through most of the B complex vitamins. They need a more bioactive form of thiamine for their nerves to function properly. In populations like diabetics, the elderly or neuropathy patients from other causes, Neuremedy alleviates the symptoms of peripheral neuropathy by delivering a highly bioactive form of the micro-nutrient thiamine to where it is needed, the nerve cells. Neuremedy works by nourishing the nerves.

Due to its overall efficacy, often people will experience improvement within days of starting the treatments. It does not reduce the symptoms of neuropathy for everyone, but is definitely a viable options. Neuremdy is dosed at one capsule twice a day.

Evening Primrose Oil: This is an herbal medication consisting of an oil from a plant native to North America that has yellow flowers that bloom in the evening. This oil extract contains up to 25% of essential fatty acids including linoleic acid (LA) and gamma-linolenic acid (GLA), an essential fatty acid. Essential fatty acids are required by the body for growth and development, and must be obtained from the diet. This formulation of LA and GLA are effectively absorbed and utilized by the body. At correct dosages, it has been shown to reduce symptoms of neuropathy including numbness, tingling, pain, burning, or lack of sensation.

Evening Primrose Oil is usually dosed at 2000mg (2 grams) daily, but can be increased to 3000mg (3 grams). Precautions include some side effects that are rare and mild, and include nausea, stomach pain, and headache. Stomach pain and loose stools may be indications that the dosage is too high. There are also some reports of seizure induction if a patient has a history of seizure disorders.

For additional information, please visit our website at http://www.utahfootdoc.com/

Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
http://www.UtahFootDoc.com

Wednesday, April 1, 2009

You Can Control Diabetic Complications

On a regular basis, I talk with diabetic individuals that are scared of lose of a foot or toe. They are often told of the worst case scenarios and just told they need to be careful. My feeling has always been that education is the best way to limit further complications and problems. Therefore, I would like to provide some additional information here:

1. The best way to limit complications of diabetes (all the complications) is strict blood sugar control. You should be monitoring your blood sugar and seeking to have a A1c of 6 or lower. Spikes in blood sugar are not recommended at any time, as this provides opportunity for the complications to start. As you talk with your doctor, you can get an aggressive program to keep blood sugars managed.

2. Exercise helps control blood sugar. Exercise in a diabetic is an important part of your self care. This program should be under the direction of your physician and should include adjustments in medications as necessary, diet changes and carefully monitored exercise. Some key points include not exercising when blood sugars are highest, 30 - 60 minutes after meals and additional carbohydrates may be required to reduce hypoglycemia (low blood sugars). Talk with your doctor and get an exercise program that will work for you.

3. Examine your feet twice a day. The American Diabetes Association recommends you examine your feet daily for new areas of redness, new calluses, blisters, or skin changes. Since you are putting shoes on and taking them off, I recommend checking your feet twice a day. This provides you information on if a certain shoe or activity is causing any of these changes. If changes are noted to the feet, your feet should be checked by a foot and ankle specialist to help improve the problem before it becomes a bigger problem. As you examine your feet, you are performing the most important exercise to reduce wounds, infections and amputations.

4. Play an active part in managing your disease. No matter how good your doctor is, you are the key to good diabetic control. Learn all you can and work to reduce your diabetic foot complications (as well as other complications).

We help people on a regular basis manage foot and ankle complications of diabetes and hope by some of these simple techniques you can control your diabetic foot complications.

Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
http://www.UtahFootDoc.com