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THE CENTER FOR METABOLIC WELLNESS
Diabetes . Prediabetes . Obesity
Cardiometabolic health is measured by a person's blood pressure, blood sugar, cholesterol, weight, and heart disease risk. In order to truly improve risk, we must be proactive and attack the underlying cause of the problem. The cause of increased cardiometabolic risk is often a decreased physiological resilience and metabolic reserve caused by chronic inflammation and insulin resistance stemming from poor lifestyle choices such as obesity, physical inactivity, stress, environmental factors, and nutrient deficiencies. Regardless of your risk level, the recommended course of treatment is often focused on drug therapies aimed at reducing an individual lab value (e.g., a statin for high LDL). This type of management is a reactive way of helping you lower your risk, but it clearly does not attack the underlying cause of the problem.
Type 1 Diabetes & Exercise
Regardless of the type of diabetes you have, regular physical activity is important for your overall health and wellness. With type 1 diabetes, it’s very important to balance your insulin doses with the food you eat and the activity that you do—even when you are doing house or yard work. Planning ahead and knowing how your blood sugar and body respond to exercise can help you keep your blood sugar from going too low or too high. PREVENTING LOWS Your blood sugar response to exercise will vary depending on: your blood sugar level before you start the intensity of the activity the length of time you are active the changes you’ve made to insulin doses Sometimes people experience a drop in blood sugar during or after exercise, so it is very important to check your blood sugar, plan ahead, and be prepared to treat hypoglycemia (low blood sugar). To learn how different types of activity affect you, you should check your blood sugar before, during and after an exercise session. Put a trial and error system into place. For example, increased activity may mean that you need to lower your insulin dose or eat some extra carbs before exercising to keep your blood sugar in a safe range. Some activities may cause your blood sugar to drop quickly while others do not. If your blood sugar is trending down before a workout, have a pre-exercise snack. Always carry a carbohydrate food or drink (like juice or glucose tabs) that will quickly raise your blood sugar. It may take a while to figure out what works best for you. If your blood sugar level is less than 100 mg/dl before you start your activity, try having a small carbohydrate snack (about 15 grams) to increase your blood sugar and reduce your risk for hypoglycemia. This is especially important if you took insulin recently and if you will be exercising for longer than 30 minutes. If you use an insulin pump, you may be able to avoid adding an extra snack by lowering your basal insulin rate during the activity. And if you have repeated problems with your blood sugar dropping during or after exercise, consult your doctor. When your blood sugar is high… Blood sugar can also run high during or after exercise, particularly when you do a high-intensity exercise that increases your stress hormone (i.e., glucose-raising hormone) levels. IFYOUR BLOOD SUGAR IS HIGH before starting exercise, check your blood or urine for ketones. If you test positive for ketones, avoid vigorous activity. If you do not have ketones in your blood or urine and you feel well, it should be fine to exercise
Diabetes, Obesity & Fatty Liver
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the United States. Individuals with obesity or diabetes mellitus (DM) have the highest risk of developing its more severe form, nonalcoholic steatohepatitis (NASH), with inflammation, hepatocyte injury, and severe fibrosis.
Is Inhaled Insulin for You
Inhaled insulin is another option for people with diabetes to control their blood sugar. It works for both type 1 and type 2 diabetes. In June 2014, the FDA approved Afrezza. It's an inhaler with pre-measured, rapid-acting insulin you use before meals. It's not for diabetes emergencies such as diabetic ketoacidosis (DKA). Common side effects of inhaled insulin are low blood sugar, a cough, and a scratchy or sore throat. If you have type 1 diabetes, you'll still need to take long-acting insulin, too, to help control your blood sugar. If you smoke or you have a lung disease, such as asthma or COPD, you shouldn't use inhaled insulin.
Mounjaro is an injectable prescription medicine that is used along with diet and exercise to improve blood sugar (glucose) in adults with type 2 diabetes mellitus. In studies with or without other diabetes medications, 75% to 90% of patients reached an A1C of less than 7%, with an average starting A1C of 7.9% to 8.6% across the 5-mg, 10-mg, and 15-mg doses. In studies with or without other diabetes medications, weight loss in adults ranged from 12 lb (5 mg) to 25 lb (15 mg)
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