High Cholesterol Treatment

If you have high lipoproteins and thus high cholesterol, your doctor will work with you to target your levels with dietary and drug treatment. Depending on your risk factors for heart disease, your target goals may differ for lowering your LDL cholesterol.
Diet: The National Cholesterol Education Program has created dietary guidelines.
NCEP dietary guidelines
Total fat - Less than 30% of calories
Saturated fat - Less than 7% of calories
Polyunsaturated fat - Less than or equal to 10% of calories
Monounsaturated fat - Approximately 10-15% of calories
Cholesterol - Less than 200 milligrams per day
Carbohydrates - 50-60% of calories
The new guidelines are more stringent than previous ones, mandating more restriction on saturated fat and dietary cholesterol.
Some people are able to reduce fat and dietary cholesterol with vegetarian diets. Dean Ornish and his colleagues have shown the value of a very strict fat-reduction diet in unblocking coronary arteries. Whether these dietary restrictions are realistic for most Americans is debatable. Moreover, such a diet also reduces HDL and raises triglyceride levels.
Stanol esters can be included in the diet and may reduce LDL by about 14%. Products containing stanol esters include margarine substitutes (marketed as brand names Benecol and Take Control).
People with higher triglycerides may benefit from a diet that is higher in monounsaturated fat and lower in carbohydrates, particularly simple sugars. A common source of monounsaturated fat is olive oil.
Activity: Although exercise has little effect on LDL, aerobic exercise may improve insulin sensitivity, HDL, and triglyceride levels and may thus reduce your heart risk. People who exercise and control their diet appear to be more successful in long-term lifestyle modifications that improve their heart risk prof

Diabetic Eye Disease Treatment

If the patient controls their weight, eats a proper diabetic diet, exercises regularly, monitors blood sugars, and takes the prescribed diabetic medications, the chances of developing serious problems due to diabetes mellitus decrease dramatically.
If the patient has diabetic eye disease and is experiencing serious visual problems, almost all treatment will require the care provided by an ophthalmologist.

Diabetic Foot Care

A person with diabetes should do the following:
Foot examination: Examine your feet daily and also after any trauma, no matter how minor, to your feet. Report any abnormalities to your physician. Use a water-based moisturizer every day (but not between your toes) to prevent dry skin and cracking. Wear cotton or wool socks. Avoid elastic socks and hosiery because they may impair circulation.
Eliminate obstacles: Move or remove any items you are likely to trip over or bump your feet on. Keep clutter on the floor picked up. Light the pathways used at night - indoors and outdoors.
Toenail trimming: Always cut your nails with a safety clipper, never a scissors. Cut them straight across and leave plenty of room out from the nailbed or quick. If you have difficulty with your vision or using your hands, let your doctor do it for you or train a family member how to do it safely.
Footwear: Wear sturdy, comfortable shoes whenever feasible to protect your feet. To be sure your shoes fit properly, see a podiatrist (foot doctor) for fitting recommendations or shop at shoe stores specializing in fitting people with diabetes. Your endocrinologist (diabetes specialist) can provide you with a referral to a podiatrist or orthopedist who may also be an excellent resource for finding local shoe stores. If you have flat feet, bunions, or hammertoes, you may need prescription shoes or shoe inserts.
Exercise: Regular exercise will improve bone and joint health in your feet and legs, improve circulation to your legs, and will also help to stabilize your blood sugar levels. Consult your physician prior to beginning any exercise program.
Smoking: If you smoke any form of tobacco, quitting can be one of the best things you can do to prevent problems with your feet. Smoking accelerates damage to blood vessels, especially small blood vessels leading to poor circulation, which is a major risk factor for foot infections and ultimately amputations.
Diabetes control: Following a reasonable diet, taking your medications, checking your blood sugar regularly, exercising regularly, and maintaining good communication with your physician are essential in keeping your diabetes under control. Consistent long-term blood sugar control to near normal levels can greatly lower the risk of damage to your nerves, kidneys, eyes, and blood vessels

Food To Fight Diabetes

Diabetes is on the rise. The Centers for Disease control in the US predicts that an American born in 2000 has a one in three chance of becoming diabetic.

The food you eat plays a crucial role in your health. Certain foods can even help in the prevention and treatment of diabetes. In diabetes, the cells of the body cannot get the sugar they need. Glucose, a simple sugar, is the body's main fuel. It is present in the blood even if you don’t eat any sugary foods, because the foods we eat are broken down into glucose. A hormone called insulin signals the body’s cells to let glucose in. In people with diabetes, glucose cannot get into the cells where it is needed.
People with type 1 diabetes do not have enough insulin to signal the cells to let in glucose, so it builds up in the blood stream. People with type 2 diabetes or who are at high risk for diabetes are said to be insulin resistant, meaning that while there is enough insulin present, the cells aren’t paying very close attention to the signal. Being above one’s healthy weight and choosing a fatty diet increase the likelihood of insulin resistance. Both types of diabetes are reaching epidemic proportions: An average American born in 2000 has a one in three chance of developing diabetes, according to the Centers for Disease Control.
Low-fat, fiber-rich diets built from legumes, vegetables, whole grains, and fruits help individuals avoid diabetes and control blood sugar levels. Such diets can also prevent complications in people who already have diabetes.
Choosing the right foods can make a world of difference to your health. Look for delicious, minimally processed foods from plant sources. Here are ten tasty choices for the prevention and management of diabetes:
Steamed Artichokes – Serve this beautiful vegetable upright on a plate with rice wine vinegar as a dipping sauce. Artichokes are low in calories, nearly fat free, and delicious. They’re also rich in fiber, which slows down the absorption of natural sugars from the starchy foods we eat and has been shown to reduce insulin resistance.
Hummus Dip with Baby Carrots – Hummus is a hearty dip made from chickpeas, sesame seed paste, garlic, and lemon. Chickpeas provide protein and fiber, while sesame seeds are a great source of vitamin E. Vitamin E is an antioxidant that can help protect and improve circulation in the eyes. Use carrots to dip with and get double the eye- and anti-oxidant protection from the beta-carotene in the carrots. People with diabetes frequently develop eye problems, particularly diabetic retinopathy, or damage to the retina. This can lead to a gradual loss of vision.
Old-Fashioned or Irish Oats with Fresh Strawberries – Here’s a breakfast that fills you up without filling you out. It’s also a good source of vitamin C, vitamin B6, and soluble fiber. Vitamin C is an antioxidant and a potent eye protector, while vitamin B6 may help prevent diabetic retinopathy (retina damage). Soluble fiber, in addition to helping keep blood sugar under control, can help lower blood cholesterol levels. People at risk for diabetes—and those already coping with it—have a high risk for heart disease. Therefore, it’s important to choose meals that decrease cholesterol levels.
Quinoa Tabouli – This protein-rich whole grain can help head off those carbohydrate cravings with a healthy choice. Some individuals crave muffins, cookies, cakes, and white bread—all foods that raise blood sugar levels unnecessarily. Tasty and healthier whole-grain foods can satisfy the need for carbohydrates.
Mushroom Barley Soup – Barley has the lowest glycemic index of any grain, and mushrooms are tasty and magnesium-rich. Magnesium helps maintain nerve cells and may also play a role in preventing diabetic retinopathy (retina damage).
Edamame (boiled fresh soybeans in the pod) – A delicious, hearty, protein- and fiber-rich snack that is fun to eat and chock-full of disease-fighting phytosterols (a plant compound that can lower cholesterol, among other things). Look for fresh edamame at your local farmer’s market, or check the frozen vegetable case in the supermarket. Most kids love them.
Fruity Spinach Salad – An attractive salad decorated with sunflower seeds, oranges, sweet red pepper, and cucumbers and flavored with raspberry vinaigrette fat-free dressing makes a delicious first course or side dish. Spinach is great for magnesium; sunflower seeds provide vitamin E, selenium, and magnesium; and oranges and red peppers are good sources of vitamin C. Selenium is an important antioxidant. This mineral protects the cells of the heart and blood vessels from damage, which is important because of diabetes’ strong association with heart disease.

Diabetes Care

Diabetes care: 10 ways to avoid diabetes complications

Here are 10 ways to take an active role in diabetes care and enjoy a healthier future.
1. Make a commitment to managing your diabetes.
Members of your diabetes care team — doctor, diabetes nurse educator and dietitian, for example — will help you learn the basics of diabetes care and offer support and encouragement along the way. But it's up to you to manage your condition. After all, no one has a greater stake in your health than you.
Learn all you can about diabetes. Make healthy eating and physical activity part of your daily routine. Maintain a healthy weight. Monitor your blood sugar level, and follow your doctor's instructions for keeping your blood sugar level within your target range. Don't be afraid to ask your diabetes treatment team for help when you need it.
2. Schedule yearly physicals and regular eye exams.
Your regular diabetes checkups aren't meant to replace yearly physicals or routine eye exams. During the physical, your doctor will look for any diabetes-related complications — including signs of kidney damage, nerve damage and heart disease — as well as screen for other medical problems. Your eye care specialist will check for signs of retinal damage, cataracts and glaucoma.
3. Keep your vaccines up-to-date.
High blood sugar can weaken your immune system, which makes routine vaccines more important than ever. Ask your doctor about:
Flu vaccine. A yearly flu vaccine can help you stay healthy during flu season, as well as prevent serious complications from the flu.
Pneumonia vaccine. Sometimes the pneumonia vaccine is a one-shot deal. If you have diabetes complications or you're age 65 or older, you may need a five-year booster shot.
Other vaccines. Stay up-to-date with your tetanus shot and its 10-year boosters, and ask your doctor about the hepatitis B vaccine. Depending on the circumstances, your doctor may recommend other vaccines as well.
4. Take care of your teeth.
Diabetes may leave you prone to gum infections. Brush your teeth at least twice a day, floss your teeth once a day, and schedule dental exams at least twice a year. Consult your dentist right away if your gums bleed or look red or swollen.
5. Pay attention to your feet.
High blood sugar can damage the nerves in your feet and reduce blood flow to your feet. Left untreated, cuts and blisters can become serious infections. To prevent foot problems:
Wash your feet daily in lukewarm water.
Dry your feet gently, especially between the toes.
Moisturize your feet and ankles with lotion.
Check your feet every day for blisters, cuts, sores, redness or swelling.
Consult your doctor if you have a sore or other foot problem that doesn't start to heal within a few days.

6. Keep your blood pressure and cholesterol under control.
Like diabetes, high blood pressure can damage your blood vessels. High cholesterol is a concern, too, since the damage is often worse and more rapid when you have diabetes. When these conditions team up, they can lead to a heart attack, stroke or other life-threatening conditions.
Eating healthy foods and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. Sometimes medication is needed, too.
7. Take a daily aspirin.
Aspirin interferes with your blood's ability to clot. Taking a daily aspirin can reduce your risk of heart attack and stroke — major concerns when you have diabetes. In fact, daily aspirin therapy is recommended for most people who have diabetes. Ask your doctor about daily aspirin therapy, including which strength of aspirin would be best.
8. Don't smoke.
If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications, including heart attack, stroke, nerve damage and kidney disease. In fact, smokers who have diabetes are three times more likely to die of cardiovascular disease than are nonsmokers who have diabetes, according to the American Diabetes Association. Talk to your doctor about ways to stop smoking or to stop using other types of tobacco.
9. If you drink alcohol, do so responsibly.
Alcohol can cause either high or low blood sugar, depending on how much you drink and if you eat at the same time. If you choose to drink, do so only in moderation and always with a meal. Remember to include the calories from any alcohol you drink in your daily calorie count.
10. Take stress seriously.
If you're stressed, it's easy to abandon your usual diabetes care routine. The hormones your body may produce in response to prolonged stress may prevent insulin from working properly, which only makes matters worse. To take control, set limits. Prioritize your tasks. Learn relaxation techniques. Get plenty of sleep.
Above all, stay positive. Diabetes care is within your control. If you're willing to do your part, diabetes won't stand in the way of an active, healthy life

Diabetes more tests_diagnosis

Diabetes Screening Tests One of the ways to screen for diabetes in symptomless individuals is to measure blood sugar levels after fasting; more than 126 milligrams of blood sugar per deciliter of blood (126 mg/dL) is considered an abnormal value. Another way to screen for or further diagnose diabetes is to give an oral glucose tolerance test. A series of blood samples is taken before and after swallowing a liquid that contains glucose. A blood-sugar reading that remains at or above 200 mg/dL two hours after drinking the glucose solution indicates inadequate production of insulin and, therefore, diabetes. Values between 127 and 199 mg/dL indicate a "glucose intolerance" state. Glucose levels have to be abnormal on more than one occasion before a diagnosis of glucose intolerance or diabetes is made. Most persons detected with abnormal glucose tolerance do not proceed to frank diabetes, especially if they pay attention to maintaining recommended weight, diet and exercise. The most accurate diagnostic test of whether diabetes is truly active or to gauge how well any therapy is proceeding is measurement of glycosylated hemoglobin (Hemoglobin A-1C) or similar glycosylated proteins such as fructosamine. These tests are important because they accurately reflect the effects of high blood sugar levels resulting in glucose binding to blood vessel proteins, where much of the damage caused by diabetes occurs. Furthermore, since blood glucose levels fluctuate during any day, they are a better indication of how high average blood sugar has been over several weeks preceeding the test. They are not, however, suitable as screening tests.

Causes of Diabetes

Diabetes mellitus occurs when the pancreas doesn't make enough or any of the hormone insulin, or when the insulin produced doesn't work effectively. In diabetes, this causes the level of glucose in the blood to be too high.
In Type 1 diabetes the cells in the pancreas that make insulin are destroyed, causing a severe lack of insulin. This is thought to be the result of the body attacking and destroying its own cells in the pancreas - known as an autoimmune reaction.
It's not clear why this happens, but a number of explanations and possible triggers of this reaction have been proposed. These include:
infection with a specific virus or bacteria;
exposure to food-borne chemical toxins; and
exposure as a very young infant to cow's milk, where an as yet unidentified component of this triggers the autoimmune reaction in the body.
However, these are only hypotheses and are by no means proven causes.
Type 2 diabetes is believed to develop when:
the receptors on cells in the body that normally respond to the action of insulin fail to be stimulated by it - this is known as insulin resistance. In response to this more insulin may be produced, and this over-production exhausts the insulin-manufacturing cells in the pancreas;
there is simply insufficient insulin available; and
the insulin that is available may be abnormal and therefore doesn't work properly.
The following risk factors increase the chances of someone developing Type 2 diabetes:
Increasing age;
obesity; and
physical inactivity.
Rarer causes of diabetes include:
Certain medicines;
pregnancy (gestational diabetes); and
any illness or disease that damages the pancreas and affects its ability to produce insulin e.g. pancreatitis.