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HEALTH TYPE 2 DIABETES: PREVENTION LIES IN DIET, EXERC ISE 24 Vero Beach 32963 / September 25, 2014 Your Vero Beach Newsweekly ™ Your Vero Beach Newsweekly ™ HEALTH The American Diabetes Association reports that 25 percent of Americans over the age of 60 now have diabetes, but a leading local physician still believes the disease is preventable. Diabetes is a well-documented disease. Type 2 is the most common; it is tied to family history, being overweight, and an inactive lifestyle. Type 2 generally has its onset later in adulthood. Most people, even those with no vested interest, know there is also Type 1 diabetes, usually diagnosed in children and young adults. In Type 1, the body makes little or no insulin. In Type 2, the body makes insulin, but doesn’t use it the right way. Dr. Deepti Sadhwani, a physician of internal and bariatric medicine who established Quality Health Care in Sebastian 15 years ago where she treats many diabetic patients, believes that Type 2 diabetes can be prevented with diet and exercise. “Carbohydrates are the biggest culprit,” Sadhwani says, “Our bodies don’t know what to do with them, so they are stored ‘for later’. Unless we are going to run a marathon, later 25 HEALTH Type 2 diabetes: Prevention depends on diet, exercise By MARIA CANFIELD Correspondent Vero Beach 32963 / September 25, 2014 never comes, carbohydrates become fat, and carrying that extra weight increases the risk for Type 2 diabetes.” Dr. Sadhwani is also concerned about popular misconceptions that people have about different kinds of foods and their ties to diabetes. For example, there is a popular misconception that all fruits and vegetables are good for you and can’t do any harm. The truth is that all fruits and vegetables are not created equal, as some are high in carbohydrates and should be avoided, such as grapes, bananas, pears, apples, corn, potatoes and carrots. If Type 2 diabetes is diagnosed, treatment involves oral medication (insulin injections in severe cases), avoidance of fatty and sugary foods, and consistent exercise – five days a week, at least 30 minutes each time. Diabetes affects many body systems and parts and can contribute to many other related conditions, all of them potentially serious and warranting close and constant examinations by medical professionals, but one body part that is at particular risk from diabetes is the foot. Many bad things can happen to the feet because of diabetes, but there are measures people can take that can help prevent problems. Diabetes doubles the risk of foot conditions, as it causes damage to blood vessels and peripheral nerves. Alarmingly, 60 percent of all lower limb amputations are a result of diabetes. Two of the most serious conditions are Peripheral Artery Disease (PAD) and Peripheral Neuropathy, and both are diabetes-related. PAD is the narrowing of arteries outside of the brain and heart, resulting in decreased oxygen flow to hands and feet. Severe cases can result in ulcers and tissue death (gangrene). In Peripheral Neuropathy, damage to the peripheral nerves decreases sensation in legs and feet, making it more difficult to feel injuries – the feet can’t effectively send information to the brain. Other common foot-related problems include: • Dryness, due to dysfunction of the nerves that control oil and moisture, which can cause skin to peel and crack. • Calluses, which are potentially dangerous for diabetics because they can hide a developing ulcer. • Ulcers, most commonly on the ball of the foot or on the bottom of the toe, which can lead to infection. • Poor circulation, which can make feet less able to fight infection. Dr. Sadhwani says that preventative foot care is a critical component of all treatment plans, and that annual foot exams are essential. “Physicians should look for signs of neuropathy,” she says, “as well as checking the skin for corns, blisters, and calluses, all of which can lead to infection.” Some specific guidance on at-home care, courtesy of the American Diabetes Association: • Check feet regularly for red spots, swelling, and blisters. Don’t forget to check between the toes (blisters and infections can start there) and the soles – if necessary, use a mirror or ask someone to help. • Wash your feet every day, and dry carefully, especially between toes. • Keep your skin soft and smooth by rubbing a thin coat of lotion on the tops and bottom; diabetics often have dry skin, which can crack and peel, allowing germs to enter. • Trim toenails straight across and use an emery board to smooth the edges. • Always wear shoes and socks; shoes should be comfortable, with a smooth lining. • Protect feet from hot and cold; don’t put your feet in hot water, and never use hot water bottles, heating pads, or electric blankets – you can burn your feet without realizing it. • Keep blood flowing to your feet – put your feet up when you can, wiggle your toes often, don’t cross your legs for long periods of time. • Don’t smoke, as smoking decreases blood flow and negatively affects circulation. In addition, Dr. Sadhwani emphasizes the importance of exfoliation (removal of dead skin) as a way to prevent the growth of bacteria and possible infection; it can be done with a washcloth, pumice stone, or loofah. Diabetes is a serious disease, which can affect many other parts of the body as well. While foot problems may be more evident, diabetes also affects other parts of the body, including eyes and kidneys. That’s why annual exams are critical for diabetics. Patients should also be diligent about getting flu and pneumonia shots to prevent infections, and keep close tabs on their blood pressure. Dr. Sadhwani is passionate about education to both prevent diabetes – and treat it properly if it manifests itself; she says it’s the most important prevention tool we have. Anyone with diabetes, or concerned about developing it, should seek guidance and information from his or her physician, and talk specifically about diet. While diet advice for diabetics is widely available on the internet, it is often contradictory. Your physician is still your best bet! 26 Vero Beach 32963 / September 25, 2014 Your Vero Beach Newsweekly ™ HEALTH Dentists don't want plastic beads in your toothpaste By Abby Phillip Washington Post The tiny plastic beads found in many popular toothpaste brands are approved by regulators, but dentists are becoming increasingly alarmed that the beads could cause more dental hygiene problems than they solve. Polyethylene plastic beads became all the rage in personal care products – including toothpastes, face washes and body scrubs – a few years ago. And the Food and Drug Administration says they're safe. But the beads do not disintegrate and are not biodegradable, and dentists are concerned that they're getting stuck in the tiny crevices between the teeth and gums. "They’ll trap bacteria in the gums which leads to gingivitis, and over time that infection moves from the gum into the bone that holds your teeth, and that becomes periodontal disease," dentist Justin Phillip said, according to Phoenix ABC affiliate KNXV. "Periodontal disease is scary.” The beads are similar to the slightly larger exfoliating beads the Illinois legislature banned this year because the products can't be sifted out of the water supply and can end up in large bodies of water, where they can harm marine life. But that same substance is in widespread use in toothpaste products, including a variety of Crest products such as Crest 3D White and Crest ProHealth. And according to Crest, the product is really used only to provide color to toothpaste. Months ago, Texas-based dental hygienist Trish Walraven sounded the alarm on her personal blog about the harm she has seen done to her patients – and even her children. She urged her patients to stop using the products. "Polyethylene plastic is in your toothpaste for decorative purposes only," Walraven wrote. "This is unacceptable not only to me, but to many, many hygienists nationwide. We are informing our patients." In response, Crest said in a statement this week that it has begun phasing out microbeads from its products, a process that will be completed by March 2016. A spokesman for the company told the Post that he decision was made "months ago" in response to "changing consumer and dental professional preferences." "While the ingredient in question is completely safe, approved for use in foods by the FDA, and part of an enjoyable brushing experience for millions of consumers with no issues, we understand there is a growing preference for us to remove this ingredient. So we will," the company said in a statement to KNXV. "We currently have products without microbeads for those who would prefer them. We have begun removing microbeads from the rest of our toothpastes, and the majority of our product volume will be microbeadfree within six months." The American Dental Association, which endorses some Crest products, stands behind the beads, citing a lack of clinical evidence questioning their safety. "The American Dental Association’s (ADA) Council on Scientific Affairs, on an ongoing basis, monitors and evaluates the safety of all ADA SealAccepted products," the association said in a statement this week. "If the council’s evaluation determines sufficient scientific evidence exists that an ADA Seal-Accepted product poses a health risk, the council has the authority to withdraw the Seal from that product." At this time, clinically relevant dental health studies do not indicate that the Seal should be removed from toothpastes that contain polyethylene microbeads."