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Most Diabetes is Preventable

Several recent studies show that most cases of Type II diabetes can be prevented with the diabetic medications, metformin, or perhaps Actos (Lancet, September 29, 2006; Diabetes Care, Volume 29, 2006). An earlier study showed that lifestyle changes were even more effective in preventing diabetes than drugs (Annals of Pharmacotherapy, July 2004).

People most likely to develop diabetes have a family history of diabetes, are overweight, and store fat primarily in the belly, rather than the hips. They often have a thick neck, male pattern baldness, high blood levels of triglycerides and low levels of the good HDL cholesterol, and do not exercise. Pre-diabetes is defined as having a fasting blood sugar greater than 100 but less than 125, a one-hour-after-eating blood sugar greater than 160 but less than 200, and an HBA1c greater than 5.7 but less than 6. (HBA1c is a blood test that measures how much sugar is stuck on cells).

If pre-diabetics take medications used to treat diabetes, or change their lifestyles, they markedly reduce their chances of going on to develop diabetes. Both the prevention and treatment of diabetes involves preventing blood sugar levels from rising too high after meals. To do this, a person should avoid the foods that cause the highest rises in blood sugar levels, such as those made from flour, those with added sugar, and sugar water found in fruit juices and many soft drinks. Other recommendations are to lose weight, exercise, and eat fewer calories. If you fit the description of a person at risk for diabetes, check with your doctor and get a blood test called HBA1C. If the value is greater than 5.6, you should start your diabetic prevention regimen immediately.

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Dear Dr. Mirkin: Will wearing support stockings improve blood flow during exercise?

Elastic compression stockings have no effect whatever on exercise, according to a recent study from France (European Journal of Applied Physiology, July 2006). They neither increase nor decrease endurance, strength, speed, recovery, or blood flow to the limbs. The study did not test the increased warmth generated by compressive stockings, but many people with arthritis have difficulty exercising in the cold and feel better from the warmth generated by a snug wrapping. In hot weather, the support hose can act as a barrier to prevent heat loss, which may make you tire earlier.

Many people develop swollen feet and ankles when they stand or sit, which goes away when they lie down. People with this gravity-dependant swelling of their feet and legs often find that support stockings help to prevent fluid from collecting in their legs. While you exercise, the force of your contracting muscles keeps blood from pooling. When your leg muscles relax, the veins near them fill up with blood. When your leg muscles contract, they squeeze the veins near them and pump blood up toward your heart. The pumping action of your leg muscles exerts a strong force to empty your veins, so you will not need support hose during exercise. So you may benefit from wearing support hose when you stand around, but it is unlikely that you will need them when you exercise.

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Dear Dr. Mirkin: How can I tell when to drink during a race?

You do not need to take fluids during exercise lasting less than an hour unless the weather is very hot. However, a limiting factor in athletic events lasting more than an hour is lack of water. Lack of salt and calories can also tire you, but dehydration is the first factor to tire you during less than all-out exercise. That’s why you see runners and other athletes drinking fluids at the start of and during competition. It doesn’t make any difference what you drink during a long competition as long as you also get extra salt and calories. You need to take extra salt during competition to make you thirsty and to help you retain the fluid you consume, and you need calories to fuel your muscles.

Your drinks can be carbonated or non-carbonated, warm or cold. You can use special exercise drinks containing sugar and salt or you can drink just water and eat salted foods such as peanuts. In cool-weather competitions lasting less than an hour, you don’t need to drink because it will only slow you down without giving you added benefit. On the other hand, in hot weather or during a competition that lasts more than an hour, taking fluids, salt and calories will help you last longer.

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Recipe of the Week

Golden Lentil Soup

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June 26th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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