Peripheral Arterial Disease: An Overlooked Cause of Poor Wound Healing

By Jeffrey M. Levine, MD, AGSF, and Michael Cioroiu, MD, FACS, CWS

Peripheral arterial disease (PAD) of the lower limbs, in which plaque builds up in the arteries that carry blood to the legs, is an often-overlooked cause of poor wound healing, particularly in elderly individuals. While PAD affects roughly 12% to 14% of the general population, it increases with age, affecting up to 20% of patients older than 75 years. (more…)

The Challenge of Preventing Pressure Ulcers

By Jeffrey M. Levine MD, and Michael Cioroiu, MD

Pressure ulcers are breaks in the skin over boney areas, such as the heel, elbows and tailbone. They occur in people who are at special risk for skin breakdown, including:

• Patients with spinal cord injuries

• People who are bed-bound with advanced dementia or chronic debilitating neurologic disease like multiple sclerosis

• Individuals with acute illness requiring stays in the intensive care unit (more…)

Important News for Diabetic Patients with Heart Disease

The FREEDOM clinical trial, a study of 1,900 diabetic patients, just reported in the prestigious New England Journal of Medicine that diabetics with multi-vessel coronary disease who were treated with coronary artery bypass surgery (CABG) fared much better than those treated with angioplasty with drug-eluting stents (percutaneous coronary intervention, or PCI.) (more…)

The Diabetes and Alzheimer’s Connection

Diabetes is a disease that affects all ages. But as people get older it’s particularly difficult to deal with—especially because diabetics are more likely to develop dementia.

In an 11-year study of more than 1,000 people, 27% of those with diabetes developed dementia, compared to 20% of people with normal blood sugar levels. Diabetes and Alzheimer’s disease (an advanced form of dementia) are connected in ways that still aren’t completely understood. It’s thought that diabetes contributes to vascular disease, disrupting the flow of oxygen to the brain.

In the last 50 years, the number of people diagnosed has risen from 1.5 million to around 26 million, and it’s estimated that 60 million have prediabetes. So the prevalence of dementia could increase as the U.S. population ages. However, taking steps to control diabetes now may help reduce the risk of Alzheimer’s later. And that’s important because the treatment for dementia is very limited.

Reducing the risk of dementia is actually quite simple—it’s all about managing diabetes in the best possible way. Here are some steps that can help:

* Follow physician recommendations for monitoring blood glucose, cholesterol level and blood pressure.
* Eat healthy foods, including fruits and vegetables, lean meats, whole grains, and low-fat milk and cheese.
* Exercise at least 30 minutes most days of the week.
* Maintain a healthy weight. Losing weight can seriously reduce the negative effects of diabetes. Just 10 to 15 pounds can make a difference.
* Take a doctor-approved multivitamin to help fill nutrient gaps in the diet.
* Take medications on schedule. There are reminder alarms with a vibration feature for people who have trouble hearing. For people who have trouble opening small  pill containers, there are larger, easy-to-open pill containers available. Some include magnifiers for reading medicine labels. And for people with vision problems, there are blood glucose meters that “talk.”
* Keep an updated list of medications and record important information about each one.

Diabetics can significantly reduce the risk of dementia by consistently managing their disease.

For more information and help on managing the disease and caring for elderly diabetics, visit www.friedmandiabetesinstitute.com.

Can Chocolate Be Good For You?

Guest post by Simone Walters, MS, RD

Whether in the form of a hot beverage to keep the winter chill at bay or as delicious candies received as gifts for Valentine’s Day, it would seem that chocolate holds a special place in everyone’s heart this time of year—perhaps year-round if you fashion yourself a chocoholic! There have also been several reports in recent years regarding the health benefits of chocolate, music to the ears of chocolate lovers everywhere. In spite of these health benefits, it is still quite a stretch to say that chocolate is good for you. (more…)

Why Is My New Year’s Resolution the Same Every Year?

Every year at the end of December, I reflect on the past year’s highs and lows, and the goals I set and didn’t achieve along with those I did. Most of them involve going to the gym and eating better, and 90% of the time I haven’t come close to meeting them. As inconceivable as it sounds, I find myself again making the exact same New Year’s resolutions I wasn’t able to accomplish last year! Sound familiar?

Resolutions Need a Reason

Many people get stuck in this same loop, making the same New Year’s resolutions year after year: “I will work out at least three times a week,” “I will lose 10 pounds,” “I will go to sleep by midnight,” etc. Most of us enter the new year determined to achieve our goals, but the changes never last to March. Why? Because most New Year’s resolutions are emotionless and without any motivating or driving force behind them.

To change a behavior or daily habit for a week or two is easy, but it is incredibly difficult to sustain that change over a long period or for the rest of your life if you don’t have a good reason to do it (and knowing you should do it isn’t a good enough reason for most of us). We all know we should exercise and eat better, but most of us don’t do it. So, how do you make a New Year’s resolution that sticks? Make it personal and important.

How to Make and Keep Yours

If you want to change your behavior or lifestyle, here are some steps that can help you start 2013 on the right track.

1. Think of a New Year’s resolution and write it down.

Example: I want to have better blood sugar control.

2. Look at the resolution and ask yourself why it is important to you. List your reasons.

Example: I want to live a long time and watch my son graduate high school; I don’t want to lose my toes or feet; I watched my mother die from the disease and I don’t want to go through the same thing.

3.  Rate your reasons (1 being the most important, 10 the least).

Example: 1) My son’s graduation; 2) Don’t want my Mom’s end of life; 3) I want to keep my toes.

4.  Now that you have solid and important reasons to change your behavior and achieve your goal, think about how you can go about it.

Write down what you will have to change on a daily or weekly basis to make the goal work. Be very detailed.

Example:  I will put out my finger sticks by the bedside table so I can test my blood sugar as soon as I wake up. I will make an appointment with a dietitian to make a meal plan. I will keep a log of my sugars every day. I will switch from juice to diet soda.

5. Set-up some mini milestones and rewards (not food related) for when you meet them.

This will help your motivation continue through the year until it becomes routine.

Example: If my blood sugar stays below 200 for one month I will take my family ice-skating. If I keep my blood sugar below 180 for three months, I get to book my summer vacation.

Remember, you can make goals and revise goals throughout the year and use the same method to meet them. What are you waiting for? Get started on your New Year’s resolutions now and have the faith and belief that this time you are knocking them out of the ballpark!

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