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Lark

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Transforming healthcare through artificial intelligence

Aug 02

Prediabetic

What does it mean if you learn that you are prediabetic? Is it big news? Is it just “one more thing” that your doctor will be hounding you about? Prediabetes means that you are at higher risk for developing type 2 diabetes, but there is more to the story. In many ways, prediabetes is largely what you make of it.Your experience being prediabetic can depend on:How well you take care of it at home.The way your Your attitude towards self-management and treatment.If you are prediabetic, you need to know what that means so you can take care of yourself as best possible. If you are not prediabetic, it is still relevant because chances are good that you know one or more people who are. What Is “Prediabetic?”First things first: what does it mean to be prediabetic? It means that your blood sugar, or blood glucose, is higher than normal, but not as high as it is in diabetes. The changes in your body that lead to higher blood sugar can begin to happen years before your blood sugar starts to increase enough to become prediabetic. Carbohydrates, Insulin, and Blood GlucoseYou may have heard of all of these, but what is their relationship to each other, and what do they have to do with you and your prediabetes? Carbohydrates are in foods and some beverages. When you eat or drink, your body breaks them down into a type of sugar called glucose, which goes into your bloodstream. When everything is healthy, your pancreas releases a hormone called insulin. Insulin helps the cells of your body take up glucose from the blood, which lowers your blood glucose level back down. In prediabetes, you have developed insulin resistance. The cells of your body are more resistant to insulin, or less insulin sensitive. They have trouble taking up glucose from your bloodstream. For a while, your pancreas can produce more insulin to compensate, but only for so long. Eventually, the system breaks down and your blood sugar starts to rise. This is when prediabetes can be diagnosed. If the condition progresses, you can develop type 2 diabetes. Prediabetes TestsYour doctor likely told you that you are prediabetic after you took one or more blood tests. These are the tests that can be used to diagnose prediabetes.[1]FBG (fasting blood glucose): Your FBG is a measure of how much glucose is in your blood after an overnight or 8-hour fast. A prediabetic FBG value is 100 to 125 mg/dl.A1c (glycated hemoglobin): The A1c test shows how high or low your blood sugar has been, on average, over the past three months. A prediabetic A1c is 5.7 to 6.4%.OGTT (oral glucose tolerance test). The OGTT shows whether your body has trouble processing glucose, as you drink a solution with 75 grams of glucose and get your blood sugar tested after 2 hours. A prediabetes OGTT value is 140 to 199 mg/dl.If your first prediabetes test comes back positive, your doctor may order a repeat test is for confirmation that you have prediabetes. Values higher than the values for prediabetes show that you may have diabetes. Why Did You Get Prediabetes?Many people have prediabetes. Who gets it, and why? Why did you get prediabetes?Some of the risk factors for prediabetes are genetic or non-modifiable. You are at higher risk if you have family members with type 2 diabetes, you are at least 45 years old, or you have high cholesterol or blood pressure. Pacific Islanders, African Americans, Native Hawaiians, Latino/Hispanics, and Native Americans are also at higher risk.Certain risk factors for prediabetes are modifiable. They are also risk factors for diabetes. It is not too late to work on reducing these risk factors if you have any of them.Being overweight or obese. For perspective, that is a weight of 145 lb. (overweight) or 174 lb. (obese) if your height is 5’4”, or a weight of 179 lb. (overweight) or 215 lb. (obese) if your height is 5’11”.[2]Being physically inactive. The recommendation for exercise for the general public and if you have prediabetes is to get at least 150 minutes per week of aerobic activity, such as walking, dancing, playing basketball, or cycling. Having high blood pressure or cholesterol levels. You may not be able to completely control these, but you can eat healthy and follow your doctor’s advice to manage them.  Prediabetic vs. DiabeticThe conditions may be similar, but there is a world of difference between prediabetes and diabetes. These are some of the differences.  SymptomsYou are unlikely to get symptoms of prediabetes, but you may get diabetes symptoms if your prediabetes progresses to type 2 diabetes. [3] The symptoms can include poor wound healing, blurred vision, numbness in your hands and feet, fatigue, hunger, excessive thirst, increased urination, and weight loss. Do not wait until these symptoms occur before you take action! ManagementA major difference between being prediabetic and diabetic is how you manage it. While your management plan for both should include a healthy diet and regular activity, diabetes management can also include:Daily blood glucose testing up to 5 or more times a day.Medications, including injectable insulin.Extra appointments with dentists, eye doctors, and podiatrists.Monitoring for kidney disease and other complications. Prediabetic TreatmentCompared to treatment for diabetes, prediabetic treatment often places a greater emphasis on lifestyle changes than on medications and testing. You may need prescription medications as well, but injectable insulin and daily blood sugar testing are not common with prediabetes. DietThe best prediabetic diet can help you lose weight, if you are overweight or obese. It can guide you towards making healthier choices, as some foods are better for lowering blood or increasing insulin sensitivity, while other foods tend to raise blood sugar or increase insulin resistance.Weight loss can be one of the most effective treatments you do if you are overweight or obese, and you do not need to lose massive amounts of weight to gain benefits. In one study, each kilogram, or 2.2 lb., that diabetic participants lost was linked to a reduced risk for diabetes of 16%.[4]  Many experts agree that losing 5 to 10% of your body weight can have substantial benefits.[5]You can lose weight by making small changes to your regular diet. For example:Reduce portion sizes of higher-calorie foods. For example, cut your regular dessert in half, and order a half-portion at restaurants (or pack up half before you start eating).Fill up on low-calorie foods. For example, start your meal with a broth-based, chunky, vegetable soup or salad, pile your dinner plate high with steamed vegetables, and include raw vegetables between meals.Make substitution for higher-calorie foods. For example, top pasta with marinara sauce instead of alfredo sauce, snack on fresh instead of dried fruit, and use mustard instead of mayo on sandwiches.You can support blood sugar control by choosing certain foods over others. General guidelines for a healthy diet include:Choosing water or decaffeinated tea or coffee instead of sugar-sweetened beverages such as soda, energy drinks, and sports drinks.Increasing dietary fiber by upping the vegetables and legumes, and choosing whole grains instead of refined.Limiting processed meat and fatty red meat.Eating more fish, reduced-fat dairy products, and plant-based proteins.Limiting sugar-sweetened foods, such as cookies and cakes, ice cream, and candy.Limiting fried foods, such as French fries, fried chicken, doughnuts, and onion rings.Since blood glucose is related to carbohydrates, it makes sense that selecting your carbohydrates carefully can affect your blood sugar.[6] The glycemic index diet is based on the fact that some types of carbohydrates spike your blood sugar more and faster than others. Any fat or protein that you eat with those carbohydrates also affects the glycemic response. To follow a low-glycemic diet, consider both the glycemic index of foods, using a glycemic index list, as well as the amount of carbohydrates they have. In general, these guidelines can help you follow a low-glycemic diet.Choose high-fiber carbohydrates, while limiting simple sugars and refined starches.Include a source of healthy fat and lean protein when you have a meal or snack with carbohydrates.Choose less processed foods when you can.Keep portions in check, with a goal of 15 to 45 grams of carbohydrates per meal. ExerciseExercise is another pillar of prediabetic treatment. Both aerobic exercise and resistance, or strength-training, exercise, increase insulin sensitivity and help with weight control.[7] The Centers for Disease Control and Prevention (CDC) recommends at least 150 minutes per week of aerobic activity, plus strength training two to three times per week. Consider the following:Aerobic activities get your heart rate up continuously and get you out of breath enough that you cannot sing a song, but not so much that you cannot speak a word.Examples include walking, cycling, hiking, playing basketball, and gardening: activities that.Strength training can includeWhen strength training, aim to hit all of your muscle groupsBe sure to get your doctor’s approval before starting an exercise program. Diabetes Prevention in PrediabetesThe Diabetes Prevention Program (DPP) is recognized by the CDC as an effective way to lower type 2 diabetes risk if you have prediabetes. In a clinical trial, prediabetic patients who were part of the DPP had a 58% lower risk of developing diabetes than patients who were in a control group.[8] Compared to a control group, the risk among patients who took a prediabetes medication (metformin) was 31% lower. The bottom line is that lifestyle changes in the DPP were effective, and even more effective than medication, in preventing or delaying the onset of type 2 diabetes.The DPP:Promotes healthy weight, activity, and other lifestyle changes to lower type 2 diabetes risk if you have prediabetes.Includes a curriculum with 26 lessons that you can take over the course of a year.Offers strategies for handling real-life challenges, such as eating out, getting off track, managing stress, and grocery shopping.You can find out if you are eligible for and sign up for Lark DPP. The program is digital and available all the time on your smartphone, and it may be covered by your health insurance. Your Lark health coach is ready to chat with you anytime about your meals, mood, activity, and more.If you are prediabetic, find out all you can about your options and getting treatment. You can lower your risk for type 2 diabetes, and your effort will be well worth it. References1. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance2. https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi_tbl.htm3. https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1370926/5. https://www.webmd.com/diabetes/ss/slideshow-prediabetes-recommendations6. http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/understanding-carbohydrates/glycemic-index-and-diabetes.html7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745733/8. https://www.nejm.org/doi/10.1056/NEJMoa012512?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dwww.ncbi.nlm.nih.gov

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Nov 21

Obesity and Prediabetes

Obesity and prediabetes have a lot in common. They are both widespread. Over 2 out of 3 Americans are obese or overweight, and 1 out of 3 have prediabetes.They both raise diabetes risk.They are both likely to be largely in your hands.Obesity and prediabetes go hand in hand, and you can turn that relationship into a good thing. If you are carrying around extra pounds, you can lower your risk for prediabetes and diabetes by losing weight. Obesity Attacks Your BodyObesity has far less to do with how you look and what size clothing you wear than about your health. Fat cells do not just puff out your jeans and give you a muffin top. Instead, they act like harmful little enemies to your body. Fat, especially around your midsection, changes your body. It can:[1]Cause unhealthy inflammationIncrease harmful oxidative stress.Alter your hormone balance.Obesity and the changes it causes are linked to many of the most common chronic conditions, including:Heart disease.Hypertension.Stroke.Kidney disease.Certain types of cancer.Alzheimer’s disease.Diabetes.  Obesity and Prediabetes and Your Diabetes RiskFat cells are working behind the scenes to hurt your body. One of their sneaky tricks is to increase insulin resistance, and insulin resistance is the cause of prediabetes and type 2 diabetes. As excess body weight increases, you are more likely to have increasing insulin resistance and the development of high blood sugar – first at prediabetic levels and then in diabetes.   Is it really that simple? Is obesity really that closely related to diabetes? In many cases, yes. Prediabetes does have other risk factors, but obesity is one of the strongest and most consistent. It is no coincidence that Consider these astonishing numbers. Compared to having a so-called “normal” body mass index (BMI) under 25, your risk for diabetes is:[2]1.6 times as high if your BMI is 25-29.9 (Overweight).3 times as high if your BMI is 30-34.9 (Class 1 Obesity).6 times as high if your BMI is 30-34.9 (Class II Obesity).Nearly 12 times as high if your BMI is 30-34.9 (Class III Obesity). How Obesity Comes…and How to Chase It AwayWeight gain and weight loss are related to calorie balance. You take in calories from foods and many beverages. You expend, or burn, calories, by using them for staying alive (think breathing, digesting food, and keeping your heart beating) and for activity.You can:Maintain your weight: balance the calories in with calories out.Lose weight: Burn more than you eat.Gain weight: take in more calories than you need.How many calories lead to obesity? Every time you take in an extra 3,500 calories, you can expect to gain about 1 lb. of weight. When you burn off about 3,500 extra calories, you can expect to lose about 1 lb. of weight. That works out to 500 calories per day for 1 pound a week, 250 calories daily for ½ lb. per week, or 120 calories per day for 1 lb. a month.For context…A large blueberry muffin has 500 calories.A 20-oz. bottle of soda, juice, or coffee beverage has 250 calories.A 2-tablespoon serving of creamy salad dressing has 120 calories.A Little Weight Loss Goes a Long WayHow many “extra pounds” are you carrying around? 25 lb.? 50 lb? Don’t worry. There is great news for those of us who may have had trouble with weight loss in the past. You do not have to turn your body into that of a supermodel. You do not have to hit someone else’s “goal” weight. The amount of weight you have to lose to gain health benefits is…about a pound.  If you are prediabetic and obese, each pound you lose can lower your diabetes risk by over 5%. Each kilogram (2.2. lb.) you lose lowers risk by 16%. If you can lose 5 to 7% of your body weight, or 9 to 13 lb. if you weigh 180 lb., you can lower your risk for diabetes by over 50%! Bucking the Trend – How to Lose Weight for GoodWeight loss has the reputation of being difficult. You may agree if you are among the half of Americans who are trying to lose weight at any one time, or if you are among the vast majority of adults who have tried 1 or 5 or 10 diets in the past, or if you are at a loss for how to achieve weight loss.It does not have to be so hard. Check these two top-tip lists to become an instant weight loss expert when it comes to health, obesity, and diabetes.List 1. Skip These 10 Weight Loss MistakesEliminating entire food groups. It is not healthy or sustainable.Cutting out your favorite foods. Having a little treat, occasionally, may help you stick with your healthy lifestyle for longer.Confusing “healthy” with “good for weight loss.” They are often similar, but not always.Failing to include parties, restaurants, and the rest of “life” in your plan.Drinking your calories. You can hundreds or more calories without realizing it if you drink beverages with calories.Taking a short-term view. Your weight loss will end if your “diet” ends. Your weight control will continue if your “healthy lifestyle” keeps up.Using cookies, bars, or shakes instead of nutritious and filling foods.Comparing your weight loss to that of others. You do your job, and your body will follow. Everyone is unique.Following extreme diets incorrectly. “Low-carb” can turn into “high-fat and high-calorie,” while “low-fat” could turn into “high-sugar and high-calorie.” Neither of those will help with weight loss!Forgetting to read labels for calorie counts.List 2. Top 10 Weight Loss SecretsEat more vegetables. Raw vegetables and salad greens are especially filling and low in calories.Drink more water. It is a calorie-free way to suppress hunger and prevent energy drops from dehydration.Include lean proteins at most meals and snacks. Beans, poultry, egg whites, fish, tofu, cottage cheese, and plain yogurt are all nutritious and filling. Use a smaller plate. It helps you naturally take smaller portions.Trim the fat, literally. Trim visible fat from meat and remove poultry skin before cooking it to save on calories.Trim the fat, figuratively. Cut back on “extras” by taking half or less of your usual amount of high-calorie add-ons such as butter on bread or vegetables or mayonnaise on a sandwich.Plan for unprocessed snacks. Fruit, vegetables, yogurt, cottage cheese, and hard-boiled eggs are more filling and lower-calorie than processed snacks such as granola and enery bars, pretzels, and chips.Track your food with a health coaching app. Food logging is linked to weight loss and prevention of weight gain.Go halves when it comes to higher-calorie foods. For example, have only half your usual amount of pasta and instead, have a side salad.Make small swaps. For example, have zucchini noodles (“zoodles”) instead of spaghetti, or baked carrot fries instead of French fries. Skip “healthy” Finally, here are some practical changes you can make. Choose one each day to build up a 250-calorie deficit and lose about ½ lb. per week.List 3. 10 Ways to Lose ½ lb. per WeekHave a mini-bagel with ½ cup cottage cheese instead of a large bagel with 2 oz. cream cheese.Swap a 20-oz. soda for water.MeatCookingRestaurantBrothnot cream soupSalad tipHave 1 oz. of unsweetened dark chocolate instead of 1 cup of chocolate ice cream.Have ¾ cup of bran flakes instead of granola.Referencehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5507106/https://dmsjournal.biomedcentral.com/articles/10.1186/1758-5996-6-50

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Nov 14

Scalability Failures with the In-Person Diabetes Prevention Program

The Diabetes Prevention Program is recognized by the Centers for Disease 
 Control and Prevention (CDC) as an effective way to prevent or delay type 2 
 diabetes among individuals with prediabetes or high type 2 diabetes risk. 
 The DPP has been shown to lower 3-year diabetes risk by over 50%.

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Nov 06

November is Diabetes Awareness Month

November is Diabetes Awareness Month. November, 2018. Will it be the month 
 that saves your life? Will it save your family members and friends? It may 
 turn out to be a life-saving for millions of Americans because November is 
 National Diabetes Awareness Month.

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