Sugar Doctor

Lowering Your A1c

Thu, 02 Oct 2025 18:37:08 GMT

It’s importa nt to understand that lowering your A1C levels is a gradual (slow) process. Your A1C, unlike a blood glucose test, measures your average blood sugar over a period of 2 to 3 months. This means, it can take up to 3 months to notice significant changes in your A1C.

1. Diet

Diet is an important factor when it comes to your blood sugar. You probably know that carbohydrates (sugars) can raise your blood sugar levels. But your body also needs a certain amount of carbs to function properly.

A tip for meeting your body’s needs while keeping carb intake under control is to eat more protein, non-starchy vegetables, and low-sugar fruits. This includes:

Nuts
Legumes, like beans and lentils
Poultry, like meat and eggs
Vegetables, like leafy greens, bell peppers, and squash
Berries
Cheese

2. Exercise

Exercise can help to lower A1C levels by jumpstarting your body’s natural insulin activity. As a general rule, doing physical activity if you have diabetes is important.

Recommendations include at least 150 minutes of moderate physical activity per week. This can be broken down into 20 to 25 minute segments of activity every day. Examples include:

Brisk walking.
Cycling.
Swimming.
Housework.
Dancing .

Major Diabetes Complications

Thu, 02 Oct 2025 18:23:37 GMT

Leaving your diabetes uncontrolled can lead to serious complications like blindness, stroke, and amputation!

Heart disease and stroke:
People with diabetes are two times more likely to have heart disease or a stroke as people without diabetes.

Blindness and other eye problems:
Damage to blood vessels in the retina (diabetic retinopathy)
Clouding of the lens (cataract)
Increase in fluid pressure in the eye (glaucoma)

Kidney disease:
High blood sugar levels can damage the kidneys and cause chronic kidney disease (CKD). If not treated, CKD can lead to kidney failure. A person with kidney failure needs regular dialysis (a treatment that filters the blood) or a kidney transplant to survive. About 1 in 3 adults with diabetes has CKD. You won’t know if you have CKD unless your doctor tests you for it.

Nerve damage (neuropathy):
One of the most common diabetes complications, nerve damage can cause numbness and pain. Nerve damage most often affects the feet and legs but can also affect your digestion, blood vessels, and heart.

Amputations:
Diabetes-related damage to blood vessels and nerves, especially in the feet, can lead to serious, hard-to-treat infections. Amputation can be necessary to stop the spread of infection.

A Full Day of Eating as a Diabetic

Thu, 02 Oct 2025 18:14:50 GMT

Have you ever wondered what a healt hy and diabetic-friendly day of eating looks like?

This sample menu has about 1,800 calories and 200 grams of carbs:

Breakfast

½ cup rolled oats (28g)

1 cup low-fat milk (13g)

2/3 medium banana (20g)

¼ cup chopped walnuts (4g)

Total carbs: 65 grams

Lunch

2 slices whole wheat bread (24g)

4 oz. low-sodium turkey meat (1g)

1 slice low-fat Swiss cheese (1g)

½ large tomato (3g)

1 TBS yellow mustard (1g)

¼ cup shredded lettuce (0g)

8 baby carrots (7g)

6 oz. plain fat-free Greek yogurt (7g)

¾ cup blueberries (15g)

Total carbs: 59 grams

Dinner

6 ounces baked chicken breast (0g)

1 cup brown rice (45g)

1 cup steamed broccoli (12g)

2 TBS margarine (0g)

Total carbs: 57 grams

Snack

1 low-fat string cheese stick (1g)

2 tangerines (18g)

Total carbs: 19 grams

The Importance of Exercise as a Diabetic

Thu, 02 Oct 2025 18:08:59 GMT

If you live with diabetes, exercising regularly can help you manage your blood sugar levels and weight. It may also help you reduce your risk of heart attack and stroke, reduce cardiovascular risk factors, and promote overall health and well-being.

Exercise can also help prevent the development of diabetes in people who have prediabetes. The American Diabetes Association (ADA) encourages people to get at least 150 minutes of moderate intensity aerobic activity per week.

The benefits of exercising are independent of weight loss. However, compliance with an exercise program has to be consistent in order to see lasting results.

If you’re sedentary and considering starting an exercise program, it’s a good idea to consult a doctor first to make sure there are no restrictions or special precautions. It’s always a good idea to start gradually and build up to your personal goal.

A combination of diet and exercise can reverse diabetes in some people. A 2020 study found that 61 percent of participants with early diabetes who underwent a highly regimented 1-year intensive lifestyle that included a low calorie diet and regular exercise no longer met the criteria for diabetes.

Preventing Diabetes Complications

Thu, 02 Oct 2025 18:04:38 GMT

A healthy lifestyle is your road map for managing diabetes, which is the key to preventing or delaying complications:

Follow a healthy eating plan.
Be physically active for at least 150 minutes a week (just 30 minutes, 5 days a week).
Manage your ABCs:
A: Get a regular A1C test to measure your average blood sugar over 2 to 3 months; aim to stay in your target range as much as possible.
B: Try to keep your blood pressure below 140/90 mm Hg (or the target your doctor sets).
C: Control your cholesterol levels.
s: Stop smoking or don’t start.
Lose weight if you’re overweight
Just a 5% to 7% weight loss lowers the risk for complications. That’s 10 to 14 pounds for someone who weighs 200 pounds.
Take medicines as instructed, and talk to your doctor if you have questions about or problems with your medicine.
Make and keep appointments with your health care team (primary care doctor, dentist, foot doctor, eye doctor, and dietitian).

The Glycemic Index

Thu, 02 Oct 2025 18:00:46 GMT

The glycemic index (or GI) is a ranking of carbohydrates on a scale from 1 to 100 according to the extent to which they raise blood sugar (glucose) levels after eating.

Foods with a high GI (equal to or greater than 70) are those which are rapidly digested, absorbed and metabolized and result in marked fluctuations in blood sugar levels.

Low GI (equal to or less than 55) carbohydrates - the ones that produce smaller fluctuations in your blood glucose and insulin levels – is one of the secrets to long-term health, reducing your risk of type 2 diabetes and heart disease. It is also one of the keys to maintaining weight loss. A low GI diet improves glucose levels, reduces insulin resistance, and improves blood cholesterol, which are all important for managing diabetes and reducing the risk of long-term complications.

The most reliable way to assess how your body is affected by certain foods is to test your blood sugar two hours after a meal.

Quick Low GI Tips:

Try to incorporate at least one low GI food at every meal.

Instead of buying bakery foods made primarily with white flour, choose grainy breads where you can see the grains, like authentic sourdoughs or stoneground wholemeal options.

Choose low GI snacks such as fresh fruit, dried fruit, nuts, and yogurt, and avoid refined flour products like cookies, crackers, and biscuits.

Most dairy products including milk and yogurt are low GI and an important source of protein and calcium.

There is no need to avoid fruit on a low GI diet. The naturally occurring sugar is bound up within the plant cell walls, which means the body has to work hard to get the sugar out for it to be absorbed. Fruit also contains other important and beneficial nutrients such as fiber, vitamins, minerals, and antioxidants. Aim for two servings of seasonal fruit a day and avoid too much fruit juice.

Switch out regular white rice for basmati or brown ric e.

Diabetic Exercises

Thu, 02 Oct 2025 17:57:02 GMT

Walking

If you have a supportive pair of shoes and a safe place to walk, you can start today. In fact, you can meet your recommended minimum target for aerobic fitness by going for a brisk 30-minute walk five days per week.

According to a 2021 review, walking can help people with diabetes lower their blood pressure, HbA1c levels, and body mass index.

Cycling

If you have lower joint pain, consider choosing low impact exercise. Cycling, for example, can help you meet your fitness goals while minimizing strain on your joints.

Swimming

Aquatic activities provide another joint-friendly exercise option. For example, swimming, water aerobics, aqua jogging, and other aquatic activities can give your heart, lungs, and muscles a workout, while putting little stress on your joints.

A 2017 review found that aquatic exercise can help lower blood sugar levels, much like land based exercise does.

Aerobic dance

Signing up for an aerobic dance or other fitness class might also help you meet your exercise goals. For instance, Zumba is a fitness program that combines dance and aerobic movements for a fast-paced workout.

A 2015 study found that women with type 2 diabetes were more motivated to exercise after taking part in Zumba classes for 16 weeks. Participants also improved their aerobic fitness and lost weight.

Climbing stairs

Going up and down stairs for 3 minutes about an hour or two after a meal is a good way to burn off blood sugar. You can do it anywhere there’s a staircase, like when you need a break from work.

Weightlifting

Weightlifting and other strengthening activities help build your muscle mass, which can increase the number of calories you burn each day. Strength training may also help improve your blood sugar control, according to the ADA.

If you want to incorporate weightlifting into your weekly exercise routine, you can use weight machines, free weights, or even heavy household objects, such as canned goods or water bottles.

Pilates

Pilates is a popular fitness program that’s designed to improve core strength, coordination, and balance. According to a 2020 study of older adult women with diabetes, it may also help improve blood sugar control.

Yoga

According to a 2016 review, yoga can help people with diabetes manage their blood sugar, cholesterol levels, and weight. It might also help lower your blood pressure, improve the quality of your sleep, and boost your mood.

Tai Chi

This ancient Chinese art uses slow, controlled movements -- along with visualization and deep breathing -- to build strength. It can also help with mobility, balance, and flexibility. This gentle exercise can also lower your stress level. It may also help prevent nerve damage in your feet.

Gardening

If the idea of traditional exercise isn’t for you, don’t worry. Time in your garden counts as both aerobic activity and strength training. It gets your blood going (since you’re walking, kneeling, and bending). It also builds muscles and helps your bones (since you’re digging, lifting, and raking). You’re also outside, where your stress levels can be lower.

Lose Weight for Good

Thu, 02 Oct 2025 17:54:39 GMT

When you have diabetes, being overweight brings added risks. Find the best strategy to keep extra weight off and stay healthy.

Break the cycle

By losing just a few pounds with healthy eating and exercise, you’ll start to feel better. You’ll have more energy. And it will get easier to manage your diabetes, all while reducing your risk of developing other related problems.

Get back to basics

The key to weight loss for most people is simply finding the right combination of exercise, healthy foods and portion control. No fad diet required.

Know why you’re eating

Emotional eating can quickly sabotage weight loss efforts. If you can pinpoint the emotions that cause you to reach for food, you can stay on track.

Stay positive

The way we frame our weight loss journey can have a big impact on progress—good or bad. Learn some positive self-talk strategies that will keep you in the right frame of mind.

Eating tips before and after Exercise

Discover a few basic tips on what and when to eat before and after exercise—and what to consider if you take diabetes medications like insulin.

Preventing Heart Disease

Thu, 02 Oct 2025 17:52:48 GMT

These lifestyle changes can help lower your risk for heart disease or keep it from getting worse, as well as help you manage diabetes:

Follow a healthy diet.
Eat more fresh fruits and vegetables, lean protein, and whole grains. Eat fewer processed foods (such as chips, sweets, and fast food) and avoid trans fat. Drink more water, fewer sugary drinks, and less alcohol.

Aim for a healthy weight.
If you’re overweight, losing even a modest amount of weight can lower your triglycerides and blood sugar. Modest weight loss means 5% to 7% of body weight, just 10 to 14 pounds for a 200-pound person.

Get active.
Being physically active makes your body more sensitive to insulin (the hormone that allows cells in your body to use blood sugar for energy), which helps manage your diabetes. Physical activity also helps control blood sugar levels and lowers your risk of heart disease. Try to get at least 150 minutes per week of moderate-intensity physical activity, such as brisk walking.

Manage your ABCs:
A: Get a regular A1C test to measure your average blood sugar over 2 to 3 months; aim to stay in your target range as much as possible.
B: Try to keep your blood pressure below 140/90 mm Hg (or the target your doctor sets).
C: Manage your cholesterol levels.
s: Stop smoking or don’t start.

Manage stress.
Stress can raise your blood pressure and can also lead to unhealthy behaviors, such as drinking too much alcohol or overeating. Instead, visit a mental health counselor, try meditation or deep breathing, get some physical activity, or get support from friends and family.

Preventing Chronic Kidney Disease

Thu, 02 Oct 2025 17:50:54 GMT

You can help keep your kidneys healthy by managing your blood sugar, blood pressure, and cholesterol levels. This is also very important for your heart and blood vessels. High blood sugar, blood pressure, and cholesterol levels are all risk factors for heart disease and stroke.

Keep your blood sugar levels in your target range as much as possible.
Get an A1C test at least twice a year, more often if your medicine changes or if you have other health conditions. Talk to your doctor about how often is right for you.
Check your blood pressure regularly and keep it below 140/90 mm/Hg (or the target your doctor sets). Talk to your doctor about medicines and other ways to lower your blood pressure.
Stay in your target cholesterol range.
Eat foods lower in sodium.
Eat more fruits and vegetables.
Be physically active.
Take your medicines as directed.

Preventing Eye Disease

Thu, 02 Oct 2025 17:46:20 GMT

You can protect your vision and lower your chance for vision loss with these steps:

Get a dilated eye exam at least once a year so your eye doctor can spot any problems early when they’re most treatable.
Keep your blood sugar levels in your target range as much as possible. Over time, high blood sugar not only damages blood vessels in your eyes, it can also affect the shape of your lenses and make your vision blurry.
Keep your blood pressure and cholesterol levels in your target range to lower your risk for eye diseases and vision loss. Also good for your health in general!
Quit smoking. Quitting lowers your risk for diabetes-related eye diseases and improves your health in many other ways too.
Get active. Physical activity protects your eyes and helps you manage diabetes.

Everything You Need to Know About an A1c

Thu, 02 Oct 2025 17:41:45 GMT

An A1C is a lab test that shows the average level of blood sugar (glucose) over the previous 3 months. It shows how well you are controlling your blood sugar to help prevent complications from diabetes.

How the Test is Performed

A blood sample is needed. Two methods are available:

Blood drawn from a vein. This is done at a lab.
Finger stick. This can be done in your health care provider's office. Or, you may be prescribed a kit that you can use at home. Results by finger stick may differ slightly from blood drawn from a vein, but in most cases can also be used to monitor your treatment.

How to Prepare for the Test

No special preparation is needed. The food you have recently eaten does not affect the A1C test, so you do not need to fast to prepare for this blood test.

How the Test will Feel

With a finger stick, you may feel slight pain.

With blood drawn from a vein, you may feel a slight pinch or some stinging when the needle is inserted. Afterward, there may be some throbbing or a slight bruise. This soon goes away.

Why the Test is Performed

Your provider may order this test if you have diabetes. It shows how well you are controlling your diabetes.

The test may also be used to screen for diabetes.

Ask your provider how often you should have your A1C level tested. Usually, testing every 3 or 6 months is recommended.

Normal Results

The following are the results when A1C is being used to diagnose diabetes:

Normal (no diabetes): Less than 5.7%
Pre-diabetes: 5.7% to 6.4%
Diabetes: 6.5% or higher

If you have diabetes, you and your provider will discuss the correct range for you. For many people, the goal is to keep the level below 7%.

The test result may be incorrect in people with anemia, kidney disease, liver disease, or certain blood disorders (thalassemia). Talk to your provider if you have any of these conditions. Certain medicines can also result in a false A1C level.

The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

An abnormal result means that you have had a high blood sugar level over a period of weeks to months.

If your A1C is 6.5% or higher and you do not already have diabetes, you may be diagnosed with diabetes.

If your level is above 7% and you have diabetes, it often means that your blood sugar is not as well controlled as would be ideal. You and your provider should determine your target A1C.

Many labs now use the A1C to calculate an estimated average glucose (eAG). This estimate may be different from the average blood sugars you are recording from your glucose meter or continuous glucose monitor. Talk to your provider about what this means. The actual blood sugar readings are usually more reliable than the estimated average glucose based on the A1C.

The higher your A1C, the higher the risk that you will develop problems such as:

Eye disease.
Heart disease.
Kidney disease.
Nerve damage.
Stroke.

If your A1C stays high, talk to your provider about how to best manage your blood sugar.

Risks

There is little risk involved with having your blood taken. Veins and arteries vary in size from one person to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks of having blood drawn are slight, but may include:

Excessive bleeding.
Multiple punctures to locate veins.
Fainting or feeling lightheaded.
Hematoma (blood accumulating under the skin).
Infection (a slight risk any time the skin is broken).

References: American Diabetes Association Professional Practice Committee; Drazin B, Aroda VR, et al. 6. Glycemic targets: standards of medical care in diabetes - 2022. Diabetes Care. 2022;45(Suppl 1):S83-S96. pubmed.ncbi.nlm.nih.gov/34964868/.

What Causes Diabetes?

Thu, 02 Oct 2025 17:35:16 GMT

Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.

Causes

Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both.

To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested and absorbed:

A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body.
An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and other cells, where it can be stored or used as fuel.

People with diabetes have high blood sugar because their body cannot move sugar from the blood into muscle and fat cells to be burned or stored for energy, and/or because their liver makes too much glucose and releases it into the blood. This is because either:

Their pancreas does not make enough insulin.
Their cells do not respond to insulin normally.
Both of the above.

There are two major types of diabetes. The causes and risk factors are different for each type:

Type 1 diabetes is less common. It can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. This is because the pancreas cells that make insulin stop working. Daily injections of insulin are needed. The exact cause of the failure to make enough insulin is unknown.
Type 2 diabetes is more common. It most often occurs in adulthood, but because of high obesity rates, children and teens are now being diagnosed with this disease. Some people with type 2 diabetes do not know they have it. With type 2 diabetes, the body is resistant to insulin and doesn't use insulin as well as it should. Not all people with type 2 diabetes are overweight or obese.

References: MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US).

Diabetes Symptoms

Thu, 02 Oct 2025 17:30:57 GMT

A high blood sugar level can cause several symptoms, including:

Blurry vision
Excess thirst
Fatigue
Frequent urination
Hunger
Weight loss

Because type 2 diabetes develops slowly, some people with high blood sugar have no symptoms.

Symptoms of type 1 diabetes develop over a short period. People may be very sick by the time they are diagnosed.

After many years, diabetes can lead to other serious problems. These problems are known as diabetes complications, and include:

Eye problems, including trouble seeing (especially at night), light sensitivity, and blindness
Sores and infections of the leg or foot, which if untreated, can lead to amputation
Damage to nerves in the body, causing pain, tingling, a loss of feeling, problems digesting food, and erectile dysfunction
Kidney problems, which can lead to kidney failure
Weakened immune system, which can lead to more frequent infections
Increased chance of having a heart attack or stroke

References: American Diabetes Association Professional Practice Committee .

Taking Care of Your Feet

Thu, 02 Oct 2025 17:28:45 GMT

Diabetes can damage the nerves and blood vessels in your feet. Th is damage can cause numbness and reduce feeling in your feet. As a result, your feet are more likely to become injured and may not heal well if they are injured. If you get a blister, you may not notice and it may get worse. Even small sores or blisters can become big problems if infection develops or they don't heal. A diabetic foot ulcer can result. Foot ulcers are a common reason for hospital stays for people with diabetes. Taking good care of your feet can help prevent diabetic foot ulcers. Untreated foot ulcers are the most common reason for toe, foot, and leg amputations in people with diabetes.

Self-care

Follow your health care provider's instructions on how to take care of your feet. Use the information below as a reminder.

Check your feet every day. Inspect the tops, sides, soles, heels, and between your toes. Look for:

Dry and cracked skin.
Blisters or sores.
Bruises or cuts.
Redness, warmth, or tenderness (often absent because of nerve damage).
Firm or hard spots .

If you cannot see well, ask someone else to check your feet.

Wash your feet every day with lukewarm water and mild soap. Strong soaps may damage the skin.

Check the temperature of the water with your hand or elbow first.
Gently dry your feet, especially between the toes.
Use lotion, petroleum jelly, lanolin, or oil on dry skin. Do not put lotion, oil, or cream between your toes.

Ask your provider to show you how to trim your toenails.

Soak your feet in lukewarm water to soften your toenails before trimming.
Cut the nails straight across. Curved nails are more likely to become ingrown.
Make sure the edge of each nail does not press into the skin of the next toe.

Do not try to cut very thick toenails by yourself. Your foot doctor (podiatrist) can trim your toenails if you are unable to. If your toenails are thick and discolored (possibly due to a fungal infection) do not trim the nails yourself. If your vision is poor or you have decreased sensation in your feet, you should see a podiatrist to trim your toenails to prevent possible injury.

Most people with diabetes should have corns or calluses treated by a foot doctor. If your doctor has given you permission to treat corns or calluses on your own:

Gently use a pumice stone to remove corns and calluses after a shower or bath, when your skin is soft.
Don't use medicated pads or try to shave or cut corns and calluses away at home.

If you smoke, stop. Smoking decreases blood flow to your feet. Talk to your provider or nurse if you need help quitting.

Do not use a heating pad or hot water bottle on your feet. Don't walk barefoot, particularly on hot pavement, hot tiles, or hot, sandy beaches. This can cause severe burns in people with diabetes because the skin does not respond normally to the heat.

Remove your shoes and socks during visits to your provider so that they can check your feet.

Shoes and Socks

Wear shoes at all times to protect your feet from injury. Before you put them on, always check the inside of your shoes for stones, nails, or rough areas that may hurt your feet.

Wear shoes that are comfortable and fit well when you buy them. Never buy shoes that are tight, not even if you think they will stretch as you wear them. You may not feel pressure from shoes that do not fit well. Blisters and sores can develop when your foot presses against your shoe.

Ask your provider about special shoes that can give your feet more room. When you get new shoes, break them in slowly. Wear them 1 or 2 hours a day for the first 1 or 2 weeks.

Change your broken-in shoes after 5 hours during the day to change the pressure points on your feet. Do not wear flip-flop sandals or stockings with seams. Both can cause pressure points.

To protect your feet, wear clean, dry socks or non-binding panty hose every day. Holes in socks or stockings can put damaging pressure on your toes.

You may want special socks with extra padding. Socks that move moisture away from your feet will keep your feet drier. In cold weather, wear warm socks, and do not stay out in the cold for very long. Wear clean, dry socks to bed if your feet are cold.

When to Call the Doctor

Call your provider right way about any foot problems you have. Do not try to treat these problems yourself. Call your provider if you have any of the following changes to any part of your foot:

Redness, increased warmth, or swelling.
Sores or cracks.
Tingling or burning feeling.
Pain.

Reference: MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US).

Cushing's Syndrome and Diabetes

Wed, 01 Oct 2025 18:50:50 GMT

Cushing syndrome is a medical condition caused by high levels of the stress hormone, cortisol, in a person’s blood. Cortisol increases a person’s blood sugars and blood pressure. One of the major complications that may trigger unmanaged Cushing’s syndrome is diabetes.

Cortisol promotes the liver to increase the levels of blood glucose. Individuals who have Cushing’s syndrome and are experiencing continually high cortisol levels might also experience blood glucose spikes. Hyperglycemia is associated with many chronic complications such as nerve damage, renal damage, heart problems, as well as bone and joint disorders.

Symptoms

Acne.
Fatty tissue that accumulates around the upper back, waist, between the face and shoulders.
Inflammation on the cheeks with red patches.
Purple or red colored stretch marks.
Thin skin which gets bruised easily.

Females might get: Thicker than the normal body and facial hair and skipped or abnormal menstrual periods.

Males might experience: Trouble in attaining erections, loss of libido, and infertility.

Causes

Excess of the hormone cortisol in a person’s body results in Cushing syndrome. Cortisol is formed in the adrenal glands and plays a key role in a person’s body. For instance, cortisol aids in:

Controlling blood pressure.
Maintains normal functioning of heart and blood vessels.
Lowers inflammation.
Stress response of the body.
Controls how the body converts food into energy.

Types of Cushing’s Syndrome

There are two types of cushing’s syndrome- exogenous and endogenous. Exogenous is caused by corticosteroid drugs while endogenous is caused by the body’s own over production.

Exogenous

Cushing syndrome may develop from consuming oral corticosteroid drugs in high doses over time. Moreover, a person is likely to develop Cushing syndrome from injectable corticosteroids. Other drugs containing cortisol can result in Cushing syndrome, particularly when consumed in high doses.

Endogenous

This problem may arise when the body produces either an excess of cortisol or an excess of adrenocorticotropic hormone (ACTH). This hormone is responsible for controlling the production of cortisol. This type of Cushing syndrome can also be associated with different tumors.

Clinical Manifestations

There is a range of metabolic changes that relate to Cushing’s syndrome such as:

Central or abdominal obesity.
Type 2 diabetes.
Dyslipidemia.
High blood pressure.
Alterations in blood glucose metabolism.

When combined, these features also constitute a metabolic syndrome. People with metabolic syndromes are at a greater risk of cardiovascular problems and stroke. In obese or overweight people or people with metabolic syndrome, too much activity of the hormonal signaling cascade causes cortisol production. This might be associated with modifications in the blood glucose metabolism, including insulin resistance. This can cause prediabetes or type 2 diabetes.

Complications of Cushing’s Syndrome

Without treatment, Cushing’s syndrome complications can include:

High blood pressure.
Bone loss.
Loss of muscle strength and muscle mass.
Type 2 diabetes.

Treatment

There are 3 main treatments for Cushing’s syndrome- surgery, radiotherapy, and medications. Studies have found that nearly 70% of people with both Cushing’s syndrome and hyperglycemia who have had curative surgery or radiation therapy saw considerably reduced levels of blood glucose.

Prediabetes

Wed, 01 Oct 2025 18:43:00 GMT

Some patients have a blood sugar level which is higher than normal but not high enough to be called diabetes. This is called pre-diabetes and can be identified by blood sugar tests. It means raised blood sugar and a higher risk of getting diabetes and heart disease. Making changes to your lifestyle can delay or even prevent the development of type 2 diabetes and reduce the risk of heart disease too. This has now been proven in several large research studies.

Heart risk: People with pre-diabetes often have high blood pressure and, are twice as likely to develop cardiovascular disease

Diabetes risk: If no action is taken, 33 out of 100 people with pre-diabetes (a third) will develop type 2 diabetes within 6 years. Doctors consider this to be a high level of risk and it is over ten times the risk of the average person getting type 2 diabetes. The risk you have now of getting diabetes is about the same as you pulling the short straw out of three straws offered to you.

What can I do to help?

You should have a blood test every 6 months to measure your blood glucose level as you are now at a higher risk of developing diabetes. Making small changes to your lifestyle to make it a healthier lifestyle will help to reduce your risk of developing diabetes.

What can I do to reduce my chances of getting diabetes and heart disease?

The good news is that for many people with pre-diabetes, diabetes can be

delayed or prevented by increasing your physical activity, making changes to what you eat and by losing weight. Keeping these changes going over time improves your overall health and reduces your heart disease risk too. Out of 100 people with pre-diabetes who make ‘healthy lifestyle’ changes, only 13 will develop diabetes (compare this with 33 out of 100 if no action is taken!). The more changes you can make the better.

Healthy Eating and Weight

If you are overweight the most important thing is to try and lose weight. The best way to do this is to follow a healthy diet and take regular exercise. In particular look at the amount of fatty and sugary foods/drinks you take.

What Is Healthy Eating?

1. Eat regularly: Have 3 meals a day. For example, breakfast, lunch, and evening meal. This will help keep your blood glucose levels steady and control your appetite.

2. Include a starchy carbohydrate food at each meal: Starchy foods include cereal, bread, pasta, rice, potatoes. High fiber options are best.

3. Eat less sugar: Too much sugar and foods containing sugar can cause the blood glucose levels to rise. It is best to replace these with lower sugar and sugar free foods instead.

4. Eat less fried and fatty foods: High fat diets are linked to heart disease and reducing your fat intake will help you lose weight.

5. Eat fruit and vegetables – 5 portions a day: All fruit and vegetables are suitable and they can be fresh, frozen or tinned in natural juice. Try to have vegetables with your evening meal and spread your fruit throughout the day.

6. Include oily fish: Oily fish contains a type of fat called omega 3, which helps protect against heart disease. You should try to have oily fish in your diet at least once a week. Examples are sardines, pilchards, salmon, mackerel, fresh tuna, herring spoons of vegetables.

7. Eat less salt: Too much salt can raise your blood pressure which can lead to stroke and heart disease. Use as little salt as possible in cooking. Use herbs and spices to flavor food instead. Avoid processed foods, tinned, packed foods, and salty meats.

8. Healthy Weight: Body weight and the risk of developing diabetes are closely linked. If you are overweight it is harder for your body to use insulin properly. A healthy weight will also help to reduce your risk of heart disease and stroke and control your blood pressure. It is better to lose a small amount of weight and keep it off, than to lose a lot of weight and regain it.

9. Limit your alcohol intake: The recommended amounts of alcohol for people with pre-diabetes and the general population are exactly the same. Alcohol is high in energy and may cause weight gain therefore sensible drinking is essential.

10. Smoking: If you smoke - quit now. Smoking greatly increases the chance of developing a serious health problem.

11. Physical activity: Increased daily activity can help you to control your weight and reduce your risk of heart disease, high blood pressure and stroke.

Changing your lifestyle can have other great benefits too!

Any amount of weight loss, healthier eating or increases in physical activity can provide other strong benefits for your health. These include:

Reduced risk of heart disease and stroke · Lower blood pressure and cholesterol
More energy
Stronger bones, muscles & joints
Physical activity can relieve stress and depression
Sleeping better
Reduced risk of some forms of cancer

Don’t despair! Remember, it often takes several attempts to change lifestyle habits, so don’t be put off if you don’t succeed at first – instead, try to learn from the experience, figure out what went wrong, then plan how to do it better. Try and try again!

Key ways to reduce your risk

1. Activity! Aim for 30 minutes of activity at least 5 days per week (this should be something that makes you breathe faster or your heart beat faster). Try 20 minutes for 3 days per week in the 1st month.

2. Lose weight! Aim for 5% weight loss over several months. Try to lose 5 pounds in 2- 3 months at first. Be realistic about your target weight, and do it in gradual steps.

3. Eat healthy food! Replace fat (especially saturated fat) with healthier options. Build up to 5 portions of fruit and vegetables each day over some months.

4. Try to stop smoking! Start by seeking professional advice and make a clear plan before setting a firm date to stop.

5. Even making small changes can help to lower risks.

The Diabetes Diet

Wed, 01 Oct 2025 18:40:40 GMT

A diabetes diet simply means eating the healthiest foods in moderate amounts and sticking to regular mealtimes. It's a healthy-eating plan that's naturally rich in nutrients and low in fat and calories. Key elements are fruits, vegetables and whole grains. In fact, this type of diet is the best eating plan for most everyone.

Why do you need to develop a healthy-eating plan?

If you have diabetes or prediabetes, your health care provider will likely recommend that you see a dietitian to help you develop a healthy-eating plan. The plan helps you control your blood sugar, also called blood glucose, manage your weight and control heart disease risk factors. These factors include high blood pressure and high blood fats.

When you eat extra calories and carbohydrates, your blood sugar levels rise. If blood sugar isn't controlled, it can lead to serious problems. These problems include a high blood sugar level, called hyperglycemia. If this high level lasts for a long time, it may lead to long-term complications, such as nerve, kidney and heart damage.

You can help keep your blood sugar level in a safe range. Make healthy food choices and track your eating habits.

For most people with type 2 diabetes, weight loss also can make it easier to control blood sugar. Weight loss offers a host of other health benefits. If you need to lose weight, a healthy-eating plan provides a well-organized, nutritious way to reach your goal safely.

What does a diet for people with diabetes involve?

A diet for people living with diabetes is based on eating healthy meals at regular times. Eating meals at regular times helps to better use insulin that the body makes or gets through medicine.

A registered dietitian can help you put together a diet based on your health goals, tastes and lifestyle. The dietitian also can talk with you about how to improve your eating habits. Options include choosing portion sizes that suit the needs for your size and activity level.

Recommended foods

Make your calories count with nutritious foods. Choose healthy carbohydrates, fiber-rich foods, fish and "good" fats.

Healthy carbohydrates

During digestion, sugars and starches break down into blood glucose. Sugars also are known as simple carbohydrates, and starches also are known as complex carbohydrates. Focus on healthy carbohydrates, such as:

Fruits.
Vegetables.
Whole grains.
Legumes, such as beans and peas.
Low-fat dairy products, such as milk and cheese.

Avoid less healthy carbohydrates, such as foods or drinks with added fats, sugars and sodium.

Fiber-rich foods

Dietary fiber includes all parts of plant foods that your body can't digest or absorb. Fiber moderates how your body digests food and helps control blood sugar levels. Foods high in fiber include:

Vegetables.
Fruits.
Nuts.
Legumes, such as beans and peas.
Whole grains.
Heart-healthy fish.

Eat heart-healthy fish at least twice a week. Fish such as salmon, mackerel, tuna and sardines are rich in omega-3 fatty acids. These omega-3s may prevent heart disease. Avoid fried fish and fish with high levels of mercury, such as cod.

'Good' fats

Foods containing monounsaturated and polyunsaturated fats can help lower your cholesterol levels. These include:

Avocados.
Nuts.
Canola, olive and peanut oils.

But don't overdo it, as all fats are high in calories.

Foods to avoid

Diabetes raises your risk of heart disease and stroke by raising the rate at which you develop clogged and hardened arteries. Foods containing the following can work against your goal of a heart-healthy diet.

Saturated fats

Avoid high-fat dairy products and animal proteins such as butter, beef, hot dogs, sausage and bacon. Limit coconut and palm kernel oils.

Trans fats

Avoid trans fats found in processed snacks, baked goods, shortening and stick margarines.

Cholesterol

Cholesterol sources include high-fat dairy products and high-fat animal proteins, egg yolks, liver, and other organ meats. Aim for no more than 200 milligrams (mg) of cholesterol a day.

Sodium

Aim for no more than 2,300 mg of sodium a day. Your health care provider may suggest you aim for a smaller amount if you have high blood pressure.

Putting it all together: Creating a plan

You may use a few different approaches to create a healthy diet to help you keep your blood sugar level within a typical range. With a dietitian's help, you may find that one or a combination of the following methods works for you:

The plate method

The American Diabetes Association offers a simple method of meal planning. It focuses on eating more vegetables. Follow these steps when preparing your plate:

Fill half of your plate with nonstarchy vegetables, such as spinach, carrots and tomatoes.
Fill a quarter of your plate with a lean protein, such as tuna, lean pork or chicken.
Fill the last quarter with a carbohydrate, such as brown rice or a starchy vegetable, such as green peas.
Include "good" fats such as nuts or avocados in small amounts.
Add a serving of fruit or dairy and a drink of water or unsweetened tea or coffee.

Counting carbohydrates

Because carbohydrates break down into sugar, they have the greatest effect on your blood sugar level. To help control your blood sugar, you may need to learn to figure out the amount of carbohydrates you are eating with the help of a dietitian. You can then adjust the dose of insulin accordingly. It's important to keep track of the amount of carbohydrates in each meal or snack.

A dietitian can teach you how to measure food portions and become an educated reader of food labels. You also can learn how to pay special attention to serving size and carbohydrate content.

Choose your foods

A dietitian may recommend you choose specific foods to help plan meals and snacks. You can choose a number of foods from lists that include categories such as carbohydrates, proteins and fats.

One serving in a category is called a choice. A food choice has about the same amount of carbohydrates, protein, fat and calories — and the same effect on your blood sugar — as a serving of every other food in that same category. For example, the starch, fruits and milk list includes choices that are all between 12 and 15 grams of carbohydrates.

Glycemic index

Some people who live with diabetes use the glycemic index to select foods, especially carbohydrates. This method ranks carbohydrate-containing foods based on their effect on blood sugar levels. Talk with your dietitian about whether this method might work for you.

A sample menu

When planning meals, take into account your size and activity level. The following menu is for someone who needs 1,200 to 1,600 calories a day.

Breakfast

Whole-wheat bread (1 medium slice) with 2 teaspoons jelly, 1/2 cup shredded wheat cereal with a cup of 1% low-fat milk, a piece of fruit and coffee.

Lunch

Roast beef sandwich on wheat bread with lettuce, tomato and mayonnaise, medium apple and water.

Dinner

Salmon, 1 1/2 teaspoons vegetable oil, small baked potato, 1 tsp margarine, 1/2 cup carrots, 1/2 cup green beans, medium dinner roll and unsweetened iced tea.

What are the results of this kind of diet?

Embracing a healthy-eating plan is the best way to keep your blood sugar level under control and prevent diabetes complications. And if you need to lose weight, you can tailor the plan to your specific goals.

Aside from managing your diabetes, a healthy diet offers other benefits too. Because this diet recommends generous amounts of fruits, vegetables and fiber, following it is likely to lower your risk of cardiovascular diseases and certain types of cancer. And eating low-fat dairy products can reduce your risk of low bone mass in the future.

Are there any risks?

If you live with diabetes, it's important that you partner with your health care provider and dietitian to create an eating plan that works for you. Use healthy foods, portion control and a schedule to manage your blood sugar level. If you don't follow your prescribed diet, you run the risk of blood sugar levels that change often and more-serious complications.

Johnny Cash & Diabetes

Wed, 01 Oct 2025 18:04:58 GMT

In the lead up to his death on September 12, 2003, it wasn't a drug overdose that ended his life, but complications from diabetes.

In 1997, Cash was diagnosed with a rare nerve disease called Shy-Drager syndrome, that has no known cause and no effective treatment. However, this was most likely an incorrect diagnosis because in his early fifties, he was diagnosed with diabetes, a disease that routinely damages nerves. His diabetes was out of control and his diet, excess weight, lack of exercise, smoking, alcohol, drugs and almost everything else he did made it worse.

His manager, Lou Robin, confirmed the cause of death in a statement issued by Baptist Hospital in Nashville. "Johnny died due to complications from diabetes, which resulted in respiratory failure," Lou Robin stated.

Only a week before his death the musician had a two-week stay at hospital due to pancreatitis.

Diabetes Symptoms and Complications

Symptoms of diabetes:

Feeling very thirsty
Peeing more frequently than usual, particularly at night
Feeling very tired
Weight loss and loss of muscle bulk
Blurred vision
High blood sugar levels can seriously damage parts of your body

Uncontrolled diabetes can lead to major complications such as eye problems, foot issues, heart attack and stroke, as well as kidney trouble.

High blood sugar levels are irritating for the blood vessels. If your blood vessels aren’t working properly, blood can’t travel to the parts of your body it needs to, meaning your nerves won’t work properly either and you’ll lose feeling in parts of your body.

Key components of good blood sugar control include not smoking, eating a healthy diet, and exercising frequently.

How to Reduce Sodium in Your Diet

Wed, 01 Oct 2025 18:01:49 GMT

Even if you never pick up the salt shaker, you might be getting more sodium than you need. That’s because more than 70% of the sodium we eat comes from prepared, packaged and restaurant foods. These foods can make it hard to control how much sodium you eat.

When shopping for food:

Choose packaged and prepared foods carefully. Compare labels and choose the product with the lowest amount of sodium per serving you can find. Different brands of the same food can have lower or higher sodium levels.
Pick fresh and frozen poultry that hasn’t been injected with a sodium solution. Check the fine print on the packaging for terms like “broth,” “saline” or “sodium solution.” Sodium levels in unseasoned fresh meats are around 100 milligrams or less per 4-ounce serving. Compare this with the same serving of prepared rotisserie chicken pre-seasoned with sodium, which can have 400 mg of sodium a serving!
Select condiments with care. For example, soy sauce, bottled salad dressings, dips, ketchup, jarred salsas, capers, mustard, pickles, olives and relish can be loaded with sodium. Look for reduced-sodium or lower-sodium versions.
Buy canned vegetables labeled “no salt added” and frozen vegetables without salty sauces. When canned and frozen veggies are added to casseroles, soups or other mixed dishes you won’t miss the salt.
Look for foods labeled with the American Heart Association’s Heart-Check mark. The Heart-Check mark designates foods that can be part of an overall healthy dietary pattern. While it doesn’t necessarily mean a product is “low sodium,” it does mean that the food meets the AHA’s sodium criteria to earn the Heart-Check mark.

You can eat foods with varying amounts of sodium and still achieve a balanced and heart-healthy diet.

When preparing food:

Use flavorful ingredients . Onions, garlic, herbs, spices, citrus juices and vinegars can add flavor in place of some, or all, of the salt.
Drain and rinse canned beans and vegetables. This can help cut the sodium by up to 40%.
Combine lower-sodium versions of food with regular versions. If you don’t like the taste of lower-sodium foods right now, try combining them in equal parts with a regular version of the same food. You’ll get less salt and probably won’t notice much difference in taste. This works especially well for broths, soups and tomato-based pasta sauces.
Cook pasta, rice and hot cereal without salt. You’ll probably add other flavorful ingredients, so you won’t miss the salt.
Grill, braise, roast, sear or sauté. These cooking methods can bring out natural flavors and reduce the need to add salt.
Enjoy high-potassium foods regularly. These include sweet potatoes, potatoes, greens, tomatoes and lower-sodium tomato sauce, white beans, kidney beans, nonfat yogurt, oranges, bananas and cantaloupe. Potassium helps counter the effects of sodium and may help lower your blood pressure.

At restaurants:

Tell them how you like it. Ask for your dish to be made without extra salt and for sauces, dressings and gravies to be served on the side.
Taste your food before adding salt. If you think it needs a boost of flavor, add freshly ground black pepper or a squeeze of fresh lemon or lime and taste it again before adding salt.
Watch out for these food words: pickled, brined, barbecued, cured, smoked, broth, au jus, soy sauce, miso or teriyaki sauce. These tend to be high in sodium. Foods that are steamed, baked, grilled, poached or roasted may have less sodium.
Control portion sizes. When you cut calories, you usually cut the sodium, too. Ask if smaller portions are available, share the meal with a friend or ask for a to-go box when you order and place half the meal in the box to eat later.

Does less salt mean bland taste?

When you use less salt, you can taste the food’s natural flavor, especially when you use cooking techniques and flavorful ingredients (see tips above) to enhance it.

Over time, your taste buds can adjust to less salt. Studies show that when people follow a lower-sodium diet, they start to prefer it, and that the foods they once enjoyed taste too salty. Try it and see for yourself!

What about salt substitutes?

There are several salt substitutes on the market that replace some or all of the sodium with potassium. Potassium salt tastes similar to sodium chloride, except when heated it can have a bitter aftertaste. Most people can try potassium salt, but certain medical conditions (like kidney disease) and medications can have implications on your body’s potassium level. Talk with your health care professional about whether a salt substitute is right for you.

What are the benefits of cutting down on sodium?

Eating less sodium can reduce your risk for high blood pressure, fluid retention, heart disease, stroke, kidney issues, osteoporosis and cancer.

If people in the U.S. consume an average 1,500 mg/day sodium, it could result in a 25.6% decrease in high blood pressure and an estimated $26.2 billion in health care savings. Another estimate projects that achieving this goal would reduce cardiovascular disease deaths from 500,000 to nearly 1.2 million over the next 10 years.