Posted in diabetes, food, Health, news

Doctors May Fail to Recognize Type 1.5 Diabetes

A form of diabetes, having features that overlap with both Type 1 and Type 2 diabetes, has been given the name, Type 1.5 Diabetes.  Researchers suggest that Latent Autoimmune Diabetes in Adults (LADA), may comprise 10% of the diabetic population, and require insulin treatment be instituted earlier than in those previously diagnosed with Type 2 diabetes, because they may have an autoimmune etiology (seen in Type 1 diabetics)…… hence a Diabetes Type 1.5.

Type I vs. Type II vs. Type 1.5 Diabetes

Type I Diabetes, previously called insulin dependent or Juvenile diabetes, occurs when the pancreas doesn’t produce insulin, possibly from the immune system destroying the cells that produce the hormone. When this occurs there is rapid weight loss and death could occur if the cells don’t get the sugar they need.  Insulin has to be administered regularly.

Type II Diabetes, previously called non-insulin dependent or adult-onset diabetes,  occurs in those who began with a fully functioning pancreas but as they age the pancreas produces less insulin, called insulin deficiency, or the insulin produced meets resistance.  This is the fastest growing type of diabetes in both children and adults.

So Type 1.5 Diabetes may develop after childhood, as a working pancreas may, during adulthood, become damaged by the body’s immune system or, suggested by some, a virus.  Those with Type 1.5 diabetes therefore may not be obese, may have had difficulty managing their blood sugar by diet and exercise alone, and may need assistance with insulin supplementation.  If medical providers don’t recognize this early, and appropriate treatment is delayed, a patient may suffer multiple health issues and risks the longer their blood glucose levels are uncontrolled.

What is Diabetes?

Diabetes is a disease in which the body doesn’t utilize and metabolize sugar properly.  When we consume food, its broken down into proteins, nutrients, fats, water, and sugar. These components are necessary for cell growth and function.  They get absorbed in the small intestine and make it to the blood stream.   In order for a cell to utilize sugar, it needs the hormone insulin to help guide it in.  It’s similar to a key that fits in the keyhole of the “door” of the cell, opening it up so sugar can enter.  Insulin is produced in the pancreas, an organ that receives signals when one eats to release insulin in preparation of the sugar load coming down the pike.

Diabetes Explained

So I imagine our mouth like a waiting room, the blood stream like a hallway, and the cells of the body the rooms along the hallway.  Insulin is the key to open the cells’ “doors” allowing sugar to enter.  If the sugar does not get in, it stays in the bloodstream “hallway” and doesn’t feed the cell.  Weight loss occurs, and individuals may become more thirsty as the sugar in the blood makes it fairly osmotic, something the body wants to neutralize, reduce.  The kidneys are going to want dump the excess sugar, so to do so, one would urinate more, again causing thirst.  So when a diabetic loses weight, urinates more frequently and becomes thirsty, you now understand why.

Complications of Diabetes

Cardiovascular disease – Sugar is sticky, so it can easily add to atherosclerotic plaques.

Blindness – high sugar content draws in water to neutralize and small blood vessels in the eye can only take so much fluid before they burst.  Moreover, high blood sugar weakens blood vessels.

Kidney disease – the kidneys work overtime to eliminate the excess sugar. Moreover, sugar laden blood isn’t the healthiest when they themselves need nourishment.

Infections – pathogens love sugar. Its food for them.  Moreover blood laden with sugar doesn’t allow immune cells to work in the most opportune environment.

Neuropathy – nerves don’t receive adequate blood supply due to the diabetes-damaged blood flow and vessels, hence they become dull or hypersensitive causing diabetics to have numbness or pain.

Dementia – as with the heart and other organs, the brain needs healthy blood and flow.  Diabetes has been found to increase risk of Alzheimer’s as well.

What is insulin resistance?

Insulin resistance, if using our hallway and door analogy, is as if someone is pushing against the door the insulin is trying to unlock. As we know, those with obesity are at higher risk for diabetes, hence fat can increase insulin resistance.  It’s also been associated with an increase in heart disease.

Blood sugar numbers

If your fasting blood sugar (glucose) is greater than 126 mg/dl, or your non fasting blood sugar is greater than 200 mg/dl, you may be considered diabetic.  Pre-diabetes occurs when the fasting blood sugar is between 100 and 125 mg/dl.  If ignored, and the sugar rises, pre-diabetics may go on to develop diabetes.

 

dmp-blood-sugar-levels-chart

SOURCE DIABETESMEALPLANS.COM

 

Preventing/Controlling Diabetes

1/3 of American adults are currently pre-diabetic.  Experts predict 1/3 of US Adults will be diabetic by the year 2050.  Although genetics plays a big role, decreasing ones sugar intake and maintaining an active lifestyle can help ward of diabetes.

Foods high in sugar and carbohydrates increase one’s risk, so a diet rich in vegetables and lean meats is preferred.

For more information, visit http://www.diabetes.org/.

 

Can Diet Soda CAUSE Diabetes?

 

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in food, Health, news

E. Coli Romaine Lettuce Outbreak Declared “Over” by FDA

The FDA has disclosed a new E. coli romaine lettuce outbreak, that has supposedly ended.

23 people from 12 states have become ill due to this recent outbreak of E. coli. 

No deaths have been reported.

The Shiga toxin-producing E. coli O157:H7 sickened 23 people and hospitalized 11 between the dates July 12 and September 8th, with cases occurring in Arizona, Florida, Georgia, Illinois, Maryland, North Carolina, Nevada, New York, Oregon, Pennsylvania, and South Carolina, with the majority of cases in California.

The FDA emphasizes that they believe the outbreak is over.  However many wonder why they this wasn’t disclosed earlier.

The CDC did appear to begin its investigation earlier this Fall, and forward their concerns to the FDA, but jointly the disclosure didn’t come until now.

On their website, the FDA reports the following:
Today, the U.S. Food and Drug Administration is sharing news of a recent E. coli O157:H7 outbreak, involving 23 illnesses, that was likely associated with romaine lettuce. No deaths were reported. The active investigation has reached its end and the outbreak appears to be over. The FDA and the U.S. Centers for Disease Control did not identify actionable information for consumers during this investigation. Additionally, when romaine lettuce was identified as the likely source of the outbreak, the available data at the time indicated that the outbreak was not ongoing and romaine lettuce eaten by sick people was past its shelf life and no longer available for sale. The FDA is communicating details about the outbreak at this time to help ensure full awareness by the public and to highlight the ongoing importance of industry actions to help ensure the safety of leafy greens. Federal health officials do not believe there is a current or ongoing risk to public health.
CDC notified the FDA of this illness cluster in mid-September 2019 and the agency promptly initiated a traceback investigation. The FDA, CDC, along with state and local partners, investigated the illnesses associated with the outbreak. A total of 23 people infected with the outbreak strain of E. coli O157:H7 were reported from 12 states: Arizona (3), California (8), Florida (1), Georgia (1), Illinois (2), Maryland (1), North Carolina (1), Nevada (1), New York (1), Oregon (1), Pennsylvania (2) and South Carolina (1). Eleven people were hospitalized and no deaths were reported. Illnesses started on dates ranging from July 12, 2019 to Sept. 8, 2019. No illnesses were reported after CDC began investigating the outbreak on Sept. 17, 2019.
Investigators were sent to visit farms located in California’s central coast region which were identified through the traceback investigation. They collected and tested many environmental samples, and the outbreak strain was not identified. While romaine lettuce is the likely cause of the outbreak, the investigation did not identify a common source or point where contamination occurred. Since the outbreak strain was not detected in samples collected from farms during the traceback investigation, and there have been no new cases since Sept. 8, 2019, the outbreak appears to be over.
The FDA remains committed to improving the safety of leafy greens and traceability from farm to fork.

Symptoms of E. coli poisoning can occur anywhere from 1-10 days after ingestion.

They include:

  • Nausea
    Vomiting
    Diarrhea, may be bloody
    Fever
    Chills
    Body Aches
    Abdominal Cramps

And if progresses, can cause

  • Shortness of Breath
    Nose bleeds
    Anemia
    Dehydration
    Seizures
    Renal Failure
    Death

Exposure to E. coli may occur from exposure to contaminated foods (from human or animal waste) or undercooked meats.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in children, food, Health, news

Child Goes “Blind” From Junk Food Diet: The Growing Malnourishment Epidemic

A case report in Annals of Internal Medicine describes a teen who went “blind” from a junk food diet.

A 14 year-old boy described as a “fussy eater” presented to his doctor with fatigue after years of eating meals rich in fries, white bread, chips and processed meat.  He was told to take supplements when they found him to be iron and B12 deficient but progressively over the next 3 years he began to suffer from vision loss.  Upon lab testing he was found to be deficient in iron, copper, selenium, Vitamin D and Vitamin B 12. And upon further testing was found to suffer from optic neuropathy.

He was further treated with supplements and now is under the care of specialists including nutritionists and eating disorder specialists.

His condition stabilized but reportedly he still has deficits such as blind spots  in the middle of his vision (central scotomata), rendering him “legally blind.”

This wasn’t the first case of nutritional optic neuropathy.

optic neuropathy.jpg

Above is a picture of the fundi of a 28 year-old male who suffered from central vision loss as a result of his diet which consisted of heavy alcohol use.  The progression of his disease has stabilized with intervention but he too has had to learn to adapt to his central scotomata.

Our eyes need vitamins such as A, a variety of B’s, C, E, and omega-3 fatty acids to name a few.  Vitamin D is crucial for bone health and for protection against diabetes and cancer.

Most fast food is rich in carbohydrates, fats, salt and preservatives, and lacking in rich nutrients and amino acids.

So comes the question, are the majority of our youth “malnourished?”

Unless our children are eating diets rich is fruit, vegetables, whole grains, protein, dairy and health fats, they could be at risk of not receiving vital nutrition.

vitamins.png

Vitamin supplementation helps but may not satisfy all the nutritional needs of a growing child.  Hence in addition to the millions of children who suffer from malnourishment due to poverty, millions more are expected to suffer similarly as a result of poor diet choices.

This is a developing story.

 

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in food, Health, news

Most Americans Don’t Realize They’re Speaking Yiddish

If you ever had to nudge someone to get off their tush and fix a glitch….then you’ve yodelled some good ole Yiddish.

Yiddish is a language most commonly spoken by Ashkenazi Jews. Its roots are believed to have originated in 1250 when Jews began to migrate to the German Rhine Valley and then east to Central and Eastern Europe.

It’s a mixture of languages including Hebrew, German, Aramaic, Slavic and Romance languages.

As opposed to Aramaic, the language of learning, and Hebrew, the language of prayer, Yiddish was the common, regular day-to-day language.

Yiddish became very popular where millions spoke it by the early 1900’s.  After the Holocaust, however, its use dropped drastically.  However many words and phrases are still spoken strong in multiple countries, and some have even been adopted as mainstay vernacular.

Take America, for example. The following words are used ubiquitously, with few knowing of their Yiddish roots.

  • nudge – came from noodge, to pester, nag, bore
  • bagel – comes from beygl, a ringed bread food
  • lox – from laks, salmon
  • blintz – crepe
  • glitch – a small malfunction
  • -nik – someone aligned with a movement such as Beatnik
  • klutz – someone who’s clumsy
  • slob – one who is unkempt
  • tush – from tuchas, buttocks

and that’s just a bissel (small amount) of it. A full comprehensive list of Yiddish words can be found here.

So next time your buddy invites you over for a bagel and lox, get off your tush, schlep over there, and schmooze a little.

 

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

 

 

 

 

Posted in food, Health, news

How to Prevent Your Next Shart

You think you’re safe. Tummy’s grumbling, gas a bubbling, and you want to let it out.  A coworker leaves their desk and you have a moment of freedom.  Assuming the other coworkers aren’t short of 20 feet downwind, you attempt to let the gas out, easy and quietly.  But instead..no sound, no air….but a warm mushy, wet feeling takes over.  Your shorts become heavy and woah…you’re soiled and so is your suit.  What happened??? You’ve just become a victim of a shart…….

 

What is a Shart?

Made famous in the 2004 comedy, Along Came Polly, “shart” combines the words “S$%t” and “Fart”.  Medically speaking, it’s when you pass stool instead of passing gas.

It may be a sign of gastrointestinal illness if happening frequently but usually its a rare occurrence, with negative consequences from a social perspective.

 

How can we tell if we’re about to Shart?

Fortunately sharting is predictable, but the signs are subtle.

Usually the fart prior to the shart is not very gassy. It’s usually small and you feel like you need to poop soon.  If you forget and minutes later try to pass gas, poop will come out instead.

Most sharts involve wetter stool, since passing a constipated rock is not that easy and triggers the rectal sphincter to tighten a bit prior to passing.  So if your stool is running loose, you may be more inclined to shart if you pass gas.

 

How can we prevent a Shart?

Firstly, have good bowel health. Eat foods that form stool that is firm but not hard.

bristol

Per this Bristol Stool Chart, types 4-5 are ideal.

Secondly try to stay on a predictable stooling cycle. If you have a bowel movement each morning before going to work, you hopefully should be less likely to need to poop during your shift.

Thirdly, eat a balanced diet that helps you have regular bowel movements and avoid foods that give you gas.

Fourthly, you can wear extra padding like I do…..

 

padding

 

Finally, go to the bathroom when you feel the need to pass gas.  If you’re sitting on a toilet, you’ll plop rather than shart, and your pants will thank ya.

 

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

 

Posted in food, Health, news

Death Reported After Eating Five Day Leftover Pasta

The death of a 20 year-old Belgium student who ate leftover pasta has gotten attention this week from a report published in the Journal of Clinical Microbiology.

“A.J” had eaten spaghetti and tomato sauce that was prepared 5 days earlier and left at room temperature. Within 30 minutes he began feeling ill with abdominal pain, headache and nausea and vomiting.  Later that evening he had diarrhea and when his parents went to check on him the following morning he was found dead.

A post-mortem exam suspected he passed away within hours at approximately 4 am as a result of Bacillus cereus poisoning.

Dr. Bernard on a YouTube video highlighting the case report states he went into acute liver failure.

B. cereus bacteria reproduce quickly at room temperature and can produce an emetic toxin that causes illness within 30 minutes.

food-safety-illness-bacillus-cereus

Leftover food safety

To help avoid food poisoning, the USDA recommends the following:

  • Be aware of the “Danger Zone” in which bacteria can grow on food between the temperatures of 40 – 140 degrees F.
  • Refrigerate food within 2 hours, one hour if outside temperature is above 90 degrees.
  • Perishables should be kept refrigerated at 40 degrees F or colder
  • Wrap leftovers thoroughly to retain moisture and keep other bacteria out.
  • Throw out leftovers after 3-4 days. Food can be safely frozen for 3-4 months.
  • Cook food thoroughly. Red meat to 145 degree F, Ground meat to 160 degree F and poultry to 165 degree F.
  • Reheat food to 165 degrees.
  • Cool food quickly so food doesn’t stay hot in the refrigerator cultivating more bacteria. Divide food up into smaller containers to allow a speedier cool.
  • When in doubt throw it out.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

 

 

Posted in food, Health, news

Reusable Water Bottles Harbor Poop Bacteria

A study out of Brazil finds reusable water bottles to be as filthy as a toilet seat.

In this small study, researchers sampled 30 water bottles used by people at the gym and compared them to unused, new water bottles. They found the following:

  • 83% had bacterial contamination
  • 27% contained Staph. aureus
  • 17% contained E. coli

among other contaminants.

STAPHYLOCOCCUS-AUREUS.jpg

Staphlococcus aureus

 

Although Staph. aureus and E. coli occur naturally in human orifices such as the nose and colon respectively, both have been implicated in multiple diseases.

 

E-coli.jpg

E. coli

 

This echos a 2016 study published by Treadmill Reviews which compared straw top to slide top to squeeze top to screw top reusable bottles and found the slide top design to be the worst in contamination.

 

water bottles.jpg

Study author, Dr. Gilmar Weber Senna of the Federal University of State of Rio de Janeiro told Runner’s World, 

“We tested in a real-world scenario, by surprise, asking for [bottles of] those who were arriving at the gym at those particular days……. We did this to avoid an intentional over-cleaning.”

Medical experts believe steel, metal or glass bottles may provide better protection against harboring pathogens.  Studies need to determine which water canister is the safest.

For now, clean the bottle out regularly, wash your hands before grabbing it, and watch where you set it……

 

dw sketch.jpg

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.