30 Apr

Medical News Today: Ice pick headaches: Symptoms, causes, and treatment

A headache refers to pain in any region of the head. Headaches can occur on one or both sides of the head or just in a specific location.

Symptoms vary and they can present as a sharp pain, a throbbing sensation, or simply a dull ache. A headache can develop gradually or come on suddenly. They can last for a short period or for several days.

There are different types of headaches, and they are classified by cause. This article will look at one particular type of headache: The ice pick headache.

Understanding ice pick headaches

lady with heaache
A headache around the front or sides of the head with brief stabs of pain is commonly called an ice pick headache.

An ice pick headache is a type of a headache that is marked by very brief stabs of pain, most commonly in the front or sides of the head. Other names for ice pick headaches include:

  • idiopathic stabbing headache
  • jabs and jolts
  • primary stabbing headaches
  • ophthalmodynia periodica

The pain associated with ice pick headaches tends to last for a few seconds. In some people, however, it may last for up to 1 minute. A headache may also move from one area to another on either the same or opposite side of the head.

Ice pick headaches are classified as a primary stabbing headache. Primary stabbing headaches are caused by overactivity or problems with pain-sensitive structures in the head. They may occur without an identifiable cause, or they could develop from an underlying disease. Some things that are possibly related to primary stabbing headache are herpes zoster, stroke, migraine, and multiple sclerosis.

The exact cause of ice pick headaches is unknown. Chemical activity in the brain, nerves, or blood vessels surrounding the skull, or the muscles in the head and neck, can play a role in primary headaches. In some cases, people may have a gene that makes them prone to developing headaches.

Primary headaches can be triggered by certain lifestyle factors, including:

  • stress
  • changes in sleep pattern or a lack of sleep
  • poor posture
  • not eating meals at regular times
  • certain foods, including processed meats that contain nitrates

Ice pick headaches typically occur in people who get migraines. Features of migraines sometimes occur with ice pick headaches, such as sensitivity to light and sound. These headaches typically affect middle-aged people, particularly women, but can happen at any age.

In some people, ice pick headaches can also cause nausea, vomiting, and dizziness.


man with migraine
Migraines are distinct from headaches as they are a neurological disorder and are typically on one side of the head.

Migraines are recurrent attacks of moderate to severe pain. The pain can be described as throbbing or pulsing and is typically found on one side of the head.

People with migraines often complain of sensitivity to light and sounds. Many people also experience nausea and vomiting. Many factors can trigger a migraine, including:

  • anxiety
  • stress
  • lack of food or sleep
  • exposure to light
  • hormonal changes (in women)

A migraine can last for hours to days. In some cases, the pain can become so unbearable that it is disabling.
Some people may experience warning signs, such as an aura, a headache, flashes of light, blind spots, or body tingling, but this is not always the case.

Migraines are often compared to headaches, but it is important to note that a migraine is more than just a bad headache. It is actually a neurological disorder.

According to the Migraine Research Foundation, migraines are the third most prevalent and sixth most disabling illness in the world. They affect 38 million women and children in the United States. Migraines are also more common in women than men, affecting about 28 million women in America.

Similar headache disorders

There is not a specific diagnostic test for ice pick headaches. Instead, the doctor will rely on the person’s description of their symptoms.

There are a few headache disorders that are similar, and must be ruled out. These disorders include:

Paroxysmal hemicranias

This is a rare form of headache that tends to appear in adulthood. People experience symptoms, such as severe throbbing and pain, that are usually on one side of the face. This pain is typically around or behind the eye and occasionally the back of the neck.

Attacks can occur 5-40 times per day and last for 2-30 minutes. Paroxysmal hemicranias occur more often in women than in men.

Trigeminal neuralgia

This is a chronic pain condition that affects the trigeminal or fifth cranial nerve, which is one of the most widely distributed nerves in the head.

Symptoms include infrequent, sudden burning or shock-like facial pain that can last from a few seconds to 2 minutes. The attacks can occur in quick succession for up to 2 hours.

Occipital neuralgia

This rare headache disorder involves the occipital nerves. These two pairs of nerves start near the second and third bones at the top of the spine.

People generally complain of pain that starts at the base of the skull close to the nape of the neck. The pain can then spread to the area behind the eyes and to the back, front, and side of the head.

Symptoms may include continuous aching, burning, throbbing, and intermittent shocking or shooting pain. Some people even describe the pain as similar to that of a migraine or cluster headache.

Treatment and long-term care

Treating an ice pick headache can be tricky. Ice pick headaches typically do not require any treatment. The pain is so brief that medicines such as painkillers do not often help. These headaches can occur once or several times per day, at regular intervals, but never last long.

However, people who are experiencing lots of painful episodes may want to try some of the treatment options that are available. There are some drugs available that do work.

man with headache at the doctors
If a person has had a blow to the head and develops a headache then a healthcare professional should be consulted immediately.

Indomethacin is a non-steroidal anti-inflammatory medication that is successful in treating ice pick headaches. Other drug options include gabapentin, cyclooxygenase-2 inhibitors, and melatonin.

A headache can be a warning sign for something more serious, such as a stroke or meningitis. People should always seek medical help if a headache develops after a blow to the head.

A severe headache requires immediate medical attention when it is accompanied by one of the following:

  • high fever
  • numbness
  • confusion
  • trouble seeing, speaking, or walking

For the most part, people can function normally with ice pick headaches. People should see a doctor if they begin to worsen or begin to interrupt daily activities, such as working or sleeping. A doctor can review their medical history and come up with an appropriate treatment plan.

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Source: medicalnewstoday

30 Apr

Medical News Today: Best vegetables for type 2 diabetes

People with type 2 diabetes often feel left out at big family meals and at restaurants, but it should not mean having to avoid delicious food.

In fact, no food item is strictly forbidden for people with type 2 diabetes. Healthy eating for people with diabetes is all about moderation and balance.

The best vegetables for type 2 diabetes are low on the glycemic index (GI) scale, rich in fiber, or high in blood pressure-lowering nitrates.

Why choose vegetables?

[argula is good for diabetes type 2]
Arugula and other green, leafy vegetables are rich in nutrients and fiber.

When considering foods to avoid, many people with diabetes might think about sugary or high-carbohydrate foods, such as cinnamon rolls or bread. Certain vegetables, though, can also cause blood glucose problems.

The GI refers to how quickly foods cause blood sugar levels to rise. Foods high on the GI, such as most potatoes, rapidly release glucose, potentially triggering blood glucose spikes. They can also cause weight gain when eaten in excess.

Low to moderate GI vegetables, such as carrots, offer better blood glucose control, and a lower risk of weight gain.

Nitrates are chemicals that naturally occur in some vegetables. They are also used as preservatives in some foods.

Eating nitrate-rich foods, not foods processed with added nitrates, can lowerblood pressure, and improve overall circulatory health.

This means that nitrate-rich foods, such as beets, are among the best vegetables for people with type 2 diabetes who have a higher risk of cardiovascular disease. This is still true despite their high level of carbohydrates.

The key to good food management, in this instance, is to reduce carbohydrate consumption elsewhere, such as by eliminating bread or sugary snacks.

Fiber and protein are both very important in a healthful diabetes diet. Protein is vital for good health, and can help people feel fuller for longer, reducing the urge to snack and supporting weight loss. Many dark, leafy greens are rich in many vital nutrients, fiber, and contain protein.

Fiber can help control blood glucose levels.

It also supports healthy cholesterol levels, can lower blood pressure, and relieve constipation. Like protein, fiber can help people feel fuller for longer.

Many fruits and vegetables, nuts, and legumes are rich in fiber.

Best vegetables for type 2 diabetes

Eating a wide variety of foods, including a mix of the best vegetables for type 2 diabetes, can help people stay healthy while enjoying a range of meals.

Low GI: Vegetables, with GI scores less than 30, include:

Fast facts about GI values of foods

  • Frozen green peas score 39 on the GI index
  • Carrots score 41 when boiled and 16 when raw
  • Broccoli scores 10
  • Tomatoes score 15

  • artichoke
  • asparagus
  • broccoli
  • cauliflower
  • green beans
  • lettuce
  • eggplant
  • peppers
  • snow peas
  • spinach
  • celery

It is worth remembering that the GI gives a relative value to each food item, and it does not refer to an amount of sugar. The glycemic load (GL) refers to how much a person will eat in a serving.

Nitrates: Vegetables rich in nitrates include:

  • arugula
  • beets and beet juice
  • lettuce
  • celery
  • rhubarb

Protein: Daily protein recommendations depend on a person’s size, sex, activity level, and other factors. People should speak to a doctor for the best insight on what their ideal daily protein intake is.

Pregnant or lactating women, highly active people, and those with large bodies need more protein than others.

Vegetables higher in protein include:

  • spinach
  • bok choy
  • asparagus
  • mustard greens
  • broccoli
  • Brussels sprouts
  • cauliflower

Fiber: Most people need 25-38 grams (g) of fiber each day.

The American Academy of Nutrition and Dietetics recommend 25 g per day for women, and 38 g per day for men.

This recommendation varies depending on body size and similar factors.

Fiber should come from real food, not supplements. Vegetables and fruits with high fiber content include:

  • carrots
  • beets
  • broccoli
  • artichoke
  • Brussels sprouts
  • split peas
  • avocados

  • Eating vegan or vegetarian with diabetes

    Eating a vegan or vegetarian diet can prove challenging for people with diabetes. Animal products are generally the most protein-rich options, but vegans avoid dairy and other animal products.

    Some of the best vegan protein-rich options include:

    • lentils
    • beans and chickpeas
    • peas
    • almonds
    • pumpkin seeds
    • amaranth and quinoa
    • sprouted grain bread
    • soy milk

    A vegan or vegetarian person who has diabetes can eat a balanced diet. Nuts, seeds, and lentils offer high protein, often with few calories.

    Healthful diabetes meals

    Any meal that blends several of the ingredients listed above offers excellent nutrition. To keep meals healthy and flavorful, people should avoid using lots of added salt, or relying on prepackaged ingredients that are high in sodium.

    People with diabetes should watch the number of calories in their food, too. Excess calories can turn an otherwise healthful meal into something that leads to excessive weight gain.

    Some simple, healthful meals include:

    [avocado, arugula, and tomato are healthy for type 2 diabetes]
    Avocado, arugula, and tomato are healthful and delicious in a salad.
    • avocado, cherry tomato, and chickpea salad
    • hard-boiled eggs and roasted beets sprinkled with black pepper and turmeric
    • low-sodium cottage cheese spread on toasted sweet potato slices. Add black or cayenne pepper to boost the flavor
    • tofu burger patty with spinach and avocado
    • spinach salad with chia seeds, tomatoes, bell peppers, and a light sprinkling of goat cheese
    • quinoa and fruit added to unsweetened Greek yogurt with cinnamon
    • quinoa seasoned with pepper, or vinaigrette, eaten it on its own
    • almond butter on sprouted grain bread topped with avocado and crushed red pepper flakes

    Balancing less healthful foods with more nutritious ones is a way to remain healthy. For instance, eating a cookie or two per week is usually fine when balanced by a high-fiber diet rich in plants.

    People with diabetes who want to eat well should focus on a balanced overall approach to nutrition.

    There is a risk that forbidding certain foods can make them feel even more appealing, and this can lead to less control of diet choices and blood sugar over time.

    Vegetables are just one part of healthy living with diabetes.

    People should eat a wide variety of foods from all food groups, and consider eating five to seven small meals instead of three large meals. Gaps between meals can cause blood sugar levels to vary a lot through the day.

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    30 Apr

    Medical News Today: Is cheese safe for people with diabetes?

    Compared with many other foods, cheese is high in fat and calories and may not be an obvious choice for someone with diabetes. Cheese and diabetes can, however, be a healthful combination.

    Cheese lovers can enjoy a wide variety of cheeses without elevating blood sugar, raising blood pressure, or gaining weight.

    For diabetes-friendly meals or snacks, people should choose healthful cheeses and serve them with foods that are rich in fiber and low in calories.

    Can people with diabetes eat cheese?

    People with diabetes can safely eat cheese as part of a balanced, healthful diet. Just as with other foods, moderation is the key. A diet mainly consisting of cheese is unhealthy for anyone.

    When selecting cheeses, people with diabetes need to consider a few things:


    [Selection of cheeses]
    Although cheese is high in fat, it can be enjoyed in moderation by people with diabetes.

    Cheese is very high in calories and fat. Though calorie content varies among cheese varieties, people with diabetes should avoid overindulging in cheese.

    Type 2 diabetes is linked with obesity, and losing just a few pounds can reduce the risk of diabetes.

    There are several steps that people with diabetes can take to help them eat cheese without gaining weight:

    • stick to small servings
    • choose lower-calorie cheeses
    • use cheese as a source of flavor rather than as the main course

    Saturated fat

    Cheese is high in saturated fat compared with many other foods. In small quantities, saturated fat is harmless and can actually be beneficial to the body. But excessive intake of saturated fats is linked to weight gain, high cholesterol, gallbladder problems, and heart disease.

    The American Heart Association recommend a diet that contains no more than 5-6 percent saturated fat. That means that in a 2,000 calorie diet, no more than 120 calories or 13 grams (g) should come from saturated fats.

    Other experts advise no more than 10 percent of daily caloric intake, which increases the amount of saturated fat, and cheese, that a person can consume safely. People with diabetes can meet this goal by sticking to no more than one serving of cheese per day.

    The connection between saturated fat intake and heart disease is not as clear as it once seemed. An analysis of previous research found insufficient evidence linking saturated fats and heart disease.

    However, people with diabetes are already at a higher risk of heart disease. As a result, they should continue consuming only small quantities of saturated fats until research provides clearer guidelines.

    Until this time, the emphasis for people with diabetes should be to eat lots of plant-based foods that are rich in unsaturated fats.


    People with diabetes should keep their salt (sodium) intake to 2,300 milligrams (mg) per day or less. Salt can elevate blood pressure, causing or worsening diabetes-related cardiovascular problems.

    Cheese is often high in salt, and processed cheeses are the worst culprits. A 2011 study, for example, found an average salt content of 1,242 mg per 100 g in processed cheese. String cheese had an average salt content of 724 mg per 100 g.

    Will cheese affect blood sugar levels?

    Cheese has a low glycemic index (GI), which means that it releases glucose slowly and will not trigger significant blood glucose spikes. Of course, cheese is often consumed with other foods, some of which can spike blood glucose.

    A cheese platter that offers cheese, fruit, honey, and crackers can elevate blood glucose. People with diabetes should be mindful of the foods they eat along with cheese and not just the cheese itself.


    Some research suggests that people with diabetes may actually benefit from cheese.

    A 2012 study published in the American Journal of Clinical Nutrition, looked at the eating habits of 12,400 people with type 2 diabetes, and 16,800 people without diabetes. Researchers found that people who ate 55 g of cheese, about two slices per day, could lower their diabetes risk by 12 percent.

    Cheese is also high in protein. A single slice or 1 oz of Cheddar cheese contains about 7 g of protein. Protein can help people feel fuller longer, reducing the temptation to binge on unhealthful foods, or eat too many sugary carbohydrates.

    Cheese is also an excellent source of protein for vegetarian people who have diabetes.

    Best and worst cheeses

    [Block of feta cheese]
    Feta cheese contains relatively high levels of salt.

    People with diabetes should avoid processed cheeses, including single-slice packaged cheeses, string cheese, and cheese sprays. These cheeses are very high in salt, and may also contain other unhealthful ingredients.

    Other high-salt cheeses include:

    • feta
    • imported blue
    • Edam
    • halloumi

    Lower sodium alternatives include:

    • low sodium cottage cheese
    • Wensleydale
    • Emmental
    • mozzarella
    • cream cheese

    Most cheeses contain similar quantities of saturated fat, but there are exceptions. American and Monterey Jack are slightly higher in saturated fat, while provolone and mozzarella are slightly lower.

    As well as looking at the salt and saturated fat content, it is important to check out the overall nutritional value. Cheeses that are high in protein, calcium, or other minerals are particularly healthful.

    People with diabetes may wish to consider the following:

    • An ounce (oz) of provolone offers a full daily value of calcium.
    • Neufchatel tastes similar to cream cheese, but with a third of the fat content.
    • Parmesan is higher in protein than some other cheeses, boasting 8 g per serving, but with a slightly lower calorie content.
    • Fermented cheeses such as some cottage cheeses, ricotta cheese, feta, Gouda, and Cheddar provide healthful bacteria, also known as probiotics.

    Probiotics are linked to improved health. They may reduce the risk of cardiovascular disease, fight the yeast infections that people with diabetes are prone to, and improve gut health. Low salt varieties are the most healthful choice.


    It can be easy to binge on cheese, but a single serving is often quite small, about 1 oz in weight (the size of 2 dice). People should check the package for serving size, and stick to just one serving. To make a single serving feel larger, try eating it alongside other foods, especially those high in fiber.

    Some options include:

    • Cheese and sprouted grain crackers or bread: Sprouted grain foods are rich in fiber and nutrients, which can have a favorable impact on blood sugar compared to other carbohydrates.
    • Cheese on a salad instead of dressing: Many salad dressings are high in salt and calories. Cheese offers flavor and additional protein. It is particularly healthful alongside high-fiber plants, such as spinach, kale, and avocado.
    • Low-sodium cottage cheese and avocado: Avocado is rich in fiber and healthful fats, so the two foods together can stave off cravings for less healthful foods. Add black or cayenne pepper for even more flavor.

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    30 Apr

    Medical News Today: How to lower your A1C levels: A healthful guide

    An A1C blood test measures average blood sugar levels over the past 2 to 3 months.

    The American Diabetes Association (ADA) recommend the use of A1C tests to help diagnose cases of prediabetes, type 1, and type 2 diabetes. A1C tests are also used to monitor diabetes treatment plans.

    What is an A1C test?

    An A1C test measures how well the body is maintaining blood glucose levels. To do this, an A1C test averages the percentage of sugar-bound hemoglobin in a blood sample.

    A gloved hand holding an A1C test tube.
    A1C tests measure long-term regulation of blood glucose levels.

    When glucose enters the blood, it binds to a red blood cell protein called hemoglobin. The higher blood glucose levels are, the more hemoglobin is bound.

    Red blood cells live for around 4 months, so A1C results reflect long-term blood glucose levels. A1C tests are done using blood obtained by a finger prick or blood draw.

    Physicians will usually repeat A1C tests before diagnosing diabetes. Initial A1C tests help physicians work out an individual’s baseline A1C level for later comparison.

    How often A1C tests are required after diagnosis varies depending on the type of diabetes and management factors.

    Lowering A1C levels

    Many studies have shown that lowering A1C levels can help reduce the risk or intensity of diabetes complications.

    With type 1 diabetes, more controlled blood glucose levels are associated with reduced rates of disease progression. With type 2 diabetes, more controlled A1C levels have also been shown to reduce symptoms affecting the small arteries and nerves in the body. This influences eyesight and pain while decreasing complications.

    Long-term studies have also shown that early and intensive blood glucose control can reduce cardiovascular complications in people with type 1 or 2 diabetes.

    Even small changes in A1C levels can have big effects. The ADA recommend that maintaining fair control over blood glucose levels lowers the chance of diabetes complications significantly. They suggest that most people with diabetes should maintain A1C levels below 7 percent. A diagnosis of diabetes occurs with an A1C of 6.5 percent or higher on two separate occasions.

    There are many ways to help reduce or control A1C levels using a combination of physical activity and diet.

    Physical activity tips to help lower A1C levels include:

    • Getting a minimum of 150 minutes of moderate physical exercise is recommended weekly. That equates to 30 minutes at least 5 days per week.
    • Increasing activities of daily life (ADLs). These are defined as routine activities that people tend to do daily. Workout schedules are helpful, but all activity can help in lowering A1C levels.
    • Monitoring blood glucose to ensure targets are being met and changes addressed.
    • Sticking to treatment or medication plans.
    • Setting and achieving weight loss goals.
    • Tracking progress for self-motivation and physician reference.
    • Getting others involved. Lifestyle changes are often easier to adopt if other people can encourage and monitor progress.

    Nearly all foods aside from lean proteins contain some sugar. Managing sugar intake and maintaining a healthful diet is key to lowering A1C levels healthfully.

    General diet tips to lower A1C levels include:

    • controlling portion sizes
    • keeping a strict meal schedule, eating every 3-5 hours
    • eating similar sized portions at meals and snacks
    • planning meals ahead of time
    • keeping a journal of food, medication, and exercise
    • spreading out carbohydrate-rich foods throughout the day
    • choosing less processed or whole foods like whole grains, fruits, vegetables, legumes, and nuts
    • eating a balanced diet complete with healthy proteins, fats, and carbohydrates
    • seeking out the help of a registered dietitian

    Another diet tip is carbohydrate counting. The ADA define one serving of carbohydrates as 15 grams and recommend adults consume 45 to 60 grams with each meal. Increasing or decreasing intake may be necessary depending on individual needs, exercise routines, and treatment plans.

    Foods that lower A1C

    The longer food takes to digest, the slower and lesser the impact it has on blood sugar levels. Foods with simple sugars are digested much quicker and can spike blood glucose levels.

    Most blood glucose management plans focus on controlling carbohydrates, the main dietary source of glucose (sugar).

    Moderate carbohydrates

    While managing carbohydrates is important, people do not need to avoid them altogether. Carbohydrates are the body and brain’s main fuel source and contain important nutrients.

    People with diabetes can enjoy carbohydrates while maintaining healthy A1C levels as long as consumption is balanced and spread out evenly throughout the day.

    Carbohydrates are broken into sugars, starches, and fibers. Sugars contain molecules that are quickly absorbed, causing blood glucose level to spike. Starches contain sugar molecules that take longer to be broken down and absorbed, affecting blood glucose levels more evenly over time.


    Fiber is complex, and takes longer to break down, which provides more sustainable energy and decreases the spike in blood sugar. Fiber also helps flush the digestive tract.

    Natural sugar

    Less processed, natural sugars like those found in fruits, vegetables, and low-fat dairy products are recommended over added, refined sugars. Whole fruits, vegetables, and dairy products all contain far higher levels of vital nutrients than most processed foods and less sugar.

    For most fruits and vegetables, one serving of carbohydrates is about ½ cup or 4 ounces.

    Although all whole fruits and vegetables have natural sugars and nutrients, some have more than others. Many vegetables contain high levels of fiber.

    Low-sugar options

    Low-sugar fruit and vegetable options include:

    Strawberries blackberries raspberries and blueberries.
    Many berries are considered to be relatively low in sugar.
    • lemon
    • rhubarb
    • lime
    • guava
    • kiwifruit
    • cranberries, raspberries, blackberries, and strawberries
    • tangerines, nectarines, and plums
    • olives
    • avocados
    • grapefruit
    • broccoli and cauliflower
    • kale, cabbage, bok choy, and Brussels sprouts
    • lettuce
    • spinaches, collard greens, and Swiss chard
    • cucumbers and zucchini
    • tomatoes
    • mushrooms
    • celery

    Fruits and vegetables that are high in sugar should not be avoided but controlled. Many contain vital nutrients that are difficult to obtain elsewhere.


    Lactose is the sugar found in dairy products. There is typically not a huge difference in sugar amounts between full fat, reduced fat, or non-fat milk.

    Low or no-sugar dairy options include:

    • plain yogurts
    • cottage cheese
    • unsweetened creamers

    Low-sugar, dairy-free options include:

    • unflavored, fortified soy, rice, almond, flax, and coconut milk or products

    Whole grain

    Starches or complex carbohydrates include grains, starchy vegetables, and legumes and should make up most of carbohydrate consumption. For most grains and starches, half a cup contains one 15 gram serving of carbohydrates.

    While starches are better carbohydrate choices than simple sugars, not all starches are created equally.

    Whole-grain breads, cereals, pastas, and rices contain B and E vitamins, minerals, essential fatty acids, and fiber. Bleached or processed grains and cereals generally contain fewer nutrients and higher levels of sugar than whole-grain products.

    People with diabetes should be wary of products that claim to be made with or contain whole wheat. Many still have high levels of refined grains and even more added sugar.

    The best whole-grain options include:

    • whole-wheat flour
    • buckwheat or buckwheat flour
    • cracked wheat
    • whole-grain barley
    • whole rye
    • millet
    • sorghum
    • whole oats
    • brown rice
    • wild rice
    • quinoa
    • whole faro
    • popcorn
    • whole-grain corn or corn meal
    • triticale
    • amaranth

    Starchy vegetables and legumes

    Plenty of starchy vegetables and legumes also contain high levels of nutrients and fiber in their skins or pods. Some vegetables, such as root vegetables like potatoes, have much higher concentrations of starch than others. For these, consumption need be monitored more closely.

    Two parsnips.
    Parsnips, sweet potatoes, and pumpkins are all good starchy options for lowering A1C levels.

    Healthful, starchy vegetable and legume options include:

    • corn
    • green peas
    • black, lima, and pinto beans
    • butternut, acorn, and spring squash
    • pumpkin
    • parsnip
    • plantain
    • dried black-eyed or split peas
    • lentils
    • low-fat refried beans or baked beans
    • yams or sweet potatoes
    • taro
    • palm hearts
    • garlic

    Understanding A1C levels

    A1C test results are expressed as a percentage. The greater the A1C level, the greater the risk of diabetes complications.

    Physicians may also describe A1C test results in terms of average glucose, or eAG. The eAG is determined by correlating A1C values with whole numbers.

    In the United States, eAG results are reported in milligrams per deciliter (mg/dL). Based on A1C results, eAG represents average 3-month blood glucose levels.

    A1C value eAG value ADA diagnosis
    5.6 percent or less 117 mg/dl or less Normal
    5.7-6.4 percent 117-137 mg/dl Prediabetes
    6.5 percent or more 137 mg/dl Diabetes

    A1C level recommendations vary between individuals. People with more advanced diabetes will have higher A1C targets than healthy adults without diabetes. Factors like life expectancy, treatment response, and medical history also have an impact.

    A1C value eAG value ADA recommended goal for
    5.6 percent or below 117 mg/dl or below Healthy, adults without diabetes
    6.5 percent 140 mg/dl People with short-term diabetes, managed type 2 diabetes, no cardiovascular disease, long life expectancy
    7 percent or less 154 mg/dl or less Most non-pregnant adults with diabetes
    8 percent or less 183 mg/dl or less People with long-standing or severe diabetes, limited life expectancy, extensive additional health complications, or poor treatment response

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    30 Apr

    Medical News Today: Dinner ideas for people with type 2 diabetes

    Every 23 seconds, someone in the United States is diagnosed with diabetes. But although diabetes is widespread, public awareness and understanding of the disease can be limited.

    The Centers for Diseases Control and Prevention (CDC) report that 29 million Americans currently have diabetes, but a quarter of them do not know it. Another 86 million adults have prediabetes, with 90 percent of them being unaware.

    Diabetes is a serious disease that can, if uncontrolled, lead to loss of eyesight, cardiovascular problems, kidney damage, and even amputation of lower limbs. The good news is, it can be managed and these serious health problems can be avoided.

    Diet techniques for diabetes

    [Empty White Plate]
    Using the simple “diabetic plate” rule can help people with diabetes plan meals.

    The even better news is that diabetes can be managed through a combination of exercise, health care, and diet. Despite popular belief, a diet can be varied, tasty, and fulfilling.

    The “diabetic plate”

    Maintaining a consistent, well-balanced diet can help people with diabetes keep their blood sugar levels under control.

    Portion control is also important, which is where the “diabetic plate” comes in.

    Endorsed by several organizations, including the American Diabetes Association, the “diabetic plate” can be very helpful when planning dinners.

    Follow these simple steps:

    • Draw an imaginary line down the center of your plate.
    • Divide one half into two further sections, so that your plate is now divided into three.
    • Fill the biggest section with non-starchy vegetables, such as spinach, green beans, salsa, mushrooms, broccoli, or others.
    • Use proteins to fill one of the smaller sections. Good options are skinless chicken, salmon, shrimp, tempeh or tofu, eggs, and much more. Legumes can fit in either the protein or the starch section because they provide both protein and carbohydrate.
    • Grains, legumes and starchy vegetables can go in the remaining quarter. These could be corn, lima beans, sweet potatoes, quinoa, whole grain breads, and more.
    • Complete the meal with a serving of fruit, or dairy.

    Carbohydrate counting

    Carbohydrate counting is also an essential part of healthful eating for people with diabetes. The amount of carbohydrates an individual can eat in a day will vary based on health, activity level, and treatment plans.

    Knowing the carbohydrate content of foods can help individuals eat appropriate amounts at each meal or snack, and still enjoy a varied and satisfying diet.

    Glycemic index

    The glycemic index (GI) can help people with diabetes distinguish between carbs that will help or hurt their blood sugar, and can provide essential support when planning healthful dinners.

    In essence, the higher the GI rating of a food, the more rapidly it will raise blood sugar. However, this does not mean that people with diabetes should avoid all high GI foods, since some are full of nutritional value. The important thing is to balance these foods with low GI foods, and monitor portion size.

    Portion control

    Perhaps the biggest challenge to eating healthful dinners is portion control. This is particularly true when meals are eaten on the go.

    According to the National Heart, Lung, and Blood Institute, portion sizes in American restaurants have increased by 200-300 percent in the past 20 years, and may be a factor in the country’s rising obesity rates.

    These giant servings can spell trouble for people with diabetes. They should ask servers about the size of the portions. They could also ask for some of the food to be boxed up, or they could share it with friends.


    [People drinking beer]
    Alcohol must be closely monitored by people with diabetes.

    Drinking alcohol is an important part of a dining experience for many people. But people with diabetes need to be very cautious about drinking alcohol because it can seriously affect blood sugar levels.

    However, one drink per day for women and two drinks per day for men may be acceptable if consumed with food.

    People should check their blood sugars, and check with their doctor and dietitian to find out whether any amount of alcohol is acceptable within their treatment plan.

    Dinner ideas suitable for diabetes

    Following a healthful diet does not have to mean that people with diabetes have to give up their favorite foods. The key is eating appropriate amounts and making sure there is a balance between proteins, carbohydrates, and fats, with an emphasis on fiber.

    The following are classic American foods that are suitable for a person with diabetes:

    • Steak: Stick to 3 ounce (oz) portions and do not cook it in butter. Choose center-cuts for less marbling and fat. The Harvard School of Public Health and many other agencies recommend that people eat red meat no more than once per week.
    • Baked potato, or sweet potato: Skip the high-fat add-ons, such as bacon. Substitute sour cream for Greek yogurt for protein and healthy bacteria.
    • Garden salad: Add vinaigrette for taste.
    • Salmon: Baked or grilled wild salmon is a good option.
    • Steamed asparagus: Steaming is a healthful way to prepare vegetables.
    • Turkey: Roasted turkey or chicken is a good choice.
    • Corn on the cob: Avoid butter or other high-fat toppings.
    • Burgers: Simply wrap the patty in lettuce, or only eat half the bun to keep the carbohydrates in check.

    Tips for quick healthful meals

    The following tips may help people with diabetes create healthful and interesting dinners:

    • Keep a supply of frozen vegetables, low-sodium canned tomatoes, and low-sodium canned beans.
    • Consider serving salad as an entrée.
    • Remember that eggs can be for dinner, too.
    • Prepare a batch of slow-cooker chili that you can store and eat over several days.
    • Combine frozen vegetables with pasta, toss into a stir-fry, or add to a frozen whole-wheat pizza crust.
    • Make tacos with rotisserie chicken, vegetables, salsa, and non-fat Greek yogurt.

    Recipe ideas

    People with diabetes do not have to limit themselves to boring, bland foods. The following meal ideas illustrate a wide range of ideas for healthful dinners with less than 3 servings or 45 grams (g) of carbohydrates:

    • 1 cup Spanish-style brown rice mixed with pinto beans, chicken, and salsa.
    • Cod fillets with puttanesca sauce, green beans, and quinoa.
    • Tempeh or tofu stir-fry with Asian vegetable mix.
    • Caribbean red snapper, a small baked sweet potato, and vegetables.
    • North African Shakshuka.
    • Dijon chicken, baked sweet potato fries, and steamed broccoli.
    • Skillet whole-wheat or corn tortilla pizza.
    • Bean and wild rice burgers with spinach and avocado salad.
    • Asian salmon fillets, shredded cabbage and peanut ginger sauce, zucchini, and chickpea or bean noodles.
    • Shrimp tacos, using 100 percent corn tacos, pineapple salsa, jicama (yam bean), and carrot and bell pepper slaw.

    Cooking for others who have diabetes

    Although they can eat most things, people with diabetes need to ensure they keep their blood sugar, blood pressure, and cholesterol levels in their target range.

    The first step in planning healthful dinners for people with diabetes is balancing the levels of proteins, carbohydrates, and fats, while providing ample fiber.

    By using the “diabetic plate” method to plan the basic framework of a meal, it is much easier to produce healthful and flavorful options that will appeal to everyone. As well as the examples listed above, the American Diabetes Association offers an extensive listing of recipe ideas.

    Dinner options for people eating out

    People with diabetes have lots to think about when eating out:

    • How the food is prepared: People with diabetes should find out how the meat or fish is cooked. Order grilled, roasted, or baked meats, poultry, and fish, or go for a vegetarian option.
    • What is in a sauce or soup: Choose broths over cream-based soups. Ask for sauces and salad dressing to be served on the side.
    • Ratios of different ingredients: It is important to identify how the meal is balanced between vegetables and carbohydrates. Request steamed vegetables, when possible.
    • Cuts of meat used: Lean cuts of meat are best for people with diabetes.
    • Making substitutions: Instead of choosing french fries or potatoes, opt for non-starchy beans, cooked vegetables, or a salad.
    • What types of carbohydrates to choose: Always select whole grain options, such as whole-wheat bread and pasta, if possible. Legumes and fruits are higher in fiber and are great carbohydrate choices for people with diabetes.

    Foods to avoid

    There are some foods and drinks that a person with diabetes should avoid or strictly limit. These include:

    • fried foods
    • sweets
    • sweetened beverages, such as blended coffee drinks, soda, sweet tea, or juice
    • white rice and white breads
    • “loaded” anything, as in baked potatoes or nachos
    • dishes with rich sauces
    • alcoholic beverages

    Other dietary tips

    Other tips that may help a person with diabetes maintain a healthful diet include:

    • eating a variety of fruits and vegetables every day
    • increasing the amount of fiber consumed to 25-38 g per day
    • reducing sugar and salt intake found in sweetened beverages, canned foods, and processed meats
    • replacing saturated fats, such as those in red meat and butter, with mono- and polyunsaturated fats, such as those in fish and olive oil
    • using alcohol sparingly, if at all
    • aim for a low salt diet of less than 2,300 milligrams of sodium daily

    Learn your ABC

    One of the most important general tips for managing diabetes comes from the CDC, as well as other health experts, who advise people with diabetes to “know their ABCs.” This acronym helps individuals monitor measurements that are essential for keeping their diabetes in check: These include:

    • A1C test: This test measures a 3-month average of blood glucose scores, which should be less than 7.
    • Blood pressure: The targeted measurement is below 130/80.
    • Cholesterol: The targeted levels for LDL (bad cholesterol) should be below 100 and HDL (good cholesterol) should be above 40 for men and 50 for women.

    Tips to keep in mind

    When it comes to planning dinners, people with diabetes should keep the following tips in mind:

    • A measured plate: Rough amounts for the “diabetic plate” method would include 2 cups of vegetables, 3-4 oz of protein, and a half to 1 cup of complex carbohydrates.
    • Be willing to trade: Healthful dinners do not have to mean no dessert. Simply hold back on carbohydrate-rich foods, such as bread or pasta during the main part of the meal and spend the “saved” carbohydrates on a small serving of dessert. Make sure to check your blood sugar 2 hours after you eat, so you know how much the dessert raised it.
    • Add extra vegetables: Use a spiralizer to make zucchini “noodles,” try cauliflower “rice,” or use squash instead of pasta.
    • Plan a walk: Exercising after meals can reduce blood sugar because muscles remove glucose from the blood stream and don’t need insulin. This is especially helpful when you do consume the occasional sweet.
    • Check your blood sugar: The common times recommended to check blood sugar levels are first thing in the morning after fasting, and two hours after meals. This will help a person to see how well they are managing their blood sugars, and how the food they are eating is affecting them. This can help people make better choices in the future.

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    30 Apr

    Medical News Today: Home blood glucose test: How to test for diabetes at home

    Home blood glucose testing is a safe and affordable way to detect diabetes before it becomes a health issue.

    Diabetes, especially in the early stages, does not always cause symptoms. Almost half of people with the disease don’t know they have it.

    For people already diagnosed with diabetes, a simple diabetes home test is vital in the management of blood sugar levels. It could even be lifesaving.

    How to test for diabetes at home

    man checks blood sugar before breakfast
    A blood glucose test before breakfast will be the baseline for blood glucose levels.

    Home blood glucose monitoring is designed to offer a picture of how the body is processing glucose.

    A doctor might recommend testing at three different times, and often over the course of several days:

    • Morning fasting reading: This provides information about blood glucose levels before eating or drinking anything. Morning blood glucose readings give a baseline number that offers clues about how the body processes glucose during the day.
    • Before a meal: Blood glucose before a meal tends to be low, so high blood glucose readings suggest difficulties managing blood sugar.
    • After a meal: Post meal testing gives a good idea about how your body reacts to food, and if sugar is able to efficiently get into the cells for use. Blood glucose readings after a meal can help diagnose gestational diabetes, which happens during pregnancy. Most doctors recommend testing about 2 hours after a meal.

    For the most accurate testing, people should log the food they eat, and notice trends in their blood glucose readings. Whether you consume a high or low carbohydrate meal, if your blood sugar reading is higher than normal afterwards, this suggests the body is having difficulty managing meals and lowering blood glucose.

    After consulting a doctor about the right testing schedule and frequency, people should take the following steps:

    1. Read the manual for the blood glucose monitor and testing strips. In most cases, testing strips should only be inserted into the monitor immediately before a reading.
    2. Wash and dry hands.
    3. Cleanse the testing area with an alcohol swab. Some glucose monitors allow testing on the arm or another area of the body that is less sensitive.
    4. If testing on the finger, test on the side of the finger, and use different fingers with each test. Most lancets allow the user to set how far it penetrates the skin. People with thicker or drier skin should set the penetration higher.
    5. Position the finger against a firm surface, before lancing.
    6. Squeeze the finger while holding it at chest level, and allow a drop of blood to flow onto the test strip.
    7. Note the blood glucose reading and record it.

    Some people with diabetes use an alternative blood test for glycated hemoglobin (HbA1c). The testing procedure is largely the same, but will produce different readings. Sometimes known as A1c, this test provides a picture of blood sugar readings over several weeks.

    Interpreting diabetes home test results

    For most people, blood sugar readings should be as follows:

    Fasting (morning testing or before a meal)

    • Without diabetes: 70-99 milligrams per deciliter (mg/dl).
    • Target for people with diabetes: 80-130 mg/dl.

    Two hours after meals

    • Without diabetes: Below 140 mg/dl.
    • Target for people with diabetes: Below 180 mg/dl.


    • Without diabetes: 5.6 percent or lower.
    • Target for people with diabetes: 7.0 percent or lower.

    Target numbers may vary from person to person and may change over time depending on health, age, weight, and other factors. Before beginning home testing, it is important to get clear guidelines about target figures from a doctor.

    Diabetes cannot be diagnosed solely by home testing. People with unusual readings will need further testing by a doctor.

    Tests might include fasting tests, tests following consumption of a glucose solution, HbA1c tests, or a combination of these.

    Choosing a blood glucose monitor

    blood glucose monitor
    When deciding on a blood glucose monitor to purchase, a few factors should be considered.

    A blood glucose monitor, testing strips, and a lancet to draw the blood are all necessary for testing. Some testing kits offer all three, while others require purchasing each piece separately.

    People should consider the cost of testing strips as well as the monitor itself, since people with diabetes use many testing strips. Some other tips for buying a monitor include:

    • selecting one with automatic coding
    • checking insurance plans to see if the insurer only covers certain monitors
    • looking at whether the unit stores previous data
    • considering portability, since larger units can be harder to carry
    • weighing blood sample size, particularly for people who do not like pricking themselves

    Monitors that use a smaller sample size will also use a less painful stick.

    Symptoms of diabetes

    Many people with diabetes have no symptoms at all. As a result, the absence of symptoms does not necessarily mean the absence of diabetes.

    Many of the symptoms of type 1 and type 2 diabetes are the same, since both affect the body’s ability to regulate blood sugar. Those symptoms include:

    • increased hunger and thirst
    • increased urination, particularly at night
    • unexplained weight loss
    • tiredness that is not well-explained by something else, such as sleep deprivation
    • blurred vision
    • slow-healing sores, or wounds that appear to heal and then reopen
    • high blood pressure

    Pregnant women who suddenly experience these symptoms should consider the possibility of diabetes. The placenta releases hormones during pregnancy that can make it more difficult for the body to control blood sugar. Left untreated, gestational diabetes can cause a range of pregnancy complications.

    Diabetes is the seventh leading cause of death in the United States and can lead to a host of complications. These include:

    late night snacking
    Increased hunger and thirst, as well as increased urination at night, may be symptoms of diabetes.
    • cardiovascular problems, including stroke, heart attack, and blood clots
    • wounds, numbness, tingling, and even loss of feet or limbs
    • kidney failure
    • nerve damage
    • chronic headaches
    • blindness

    Early interventions can reduce the risk of severe or fatal diabetes complications. The right combination of medication and lifestyle changes may even help reverse some cases of diabetes.

    When to see a doctor

    People performing home diabetes testing who have unusually high results, particularly more than once, should see their doctors. People with diabetes whose blood sugar is poorly controlled, or whose blood sugar suddenly changes, should also consult a doctor.

    Changes in diet, medication, or both may be recommended. Diabetes can be well-controlled by managing carbohydrate intake, and exercising regularly,

    People with prediabetes are at risk for developing diabetes if blood sugar is not managed. It’s especially important for people with prediabetes to talk to their doctors, and to continue regular blood glucose monitoring.

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    30 Apr

    Medical News Today: Soy protein may improve symptoms of inflammatory bowel disease

    Researchers from Pennsylvania State University have discovered that adding soy protein to the diet alleviates symptoms associated with inflammatory bowel diseases, such as colon inflammation and the loss of gut barrier function. The mouse study could pave the way for human studies to develop effective treatment strategies for the condition.
    [products made from soybeans]
    Substituting other protein in the diet with soy protein may help to improve symptoms of inflammatory bowel disease, find researchers.

    Researchers Zachary Bitzer and Amy Wopperer, former graduate students in the Department of Food Science at Pennsylvania State University (Penn State), conducted the research alongside Joshua Lambert, associate professor of food science in the College of Agricultural Sciences, and colleagues.

    The team’s findings were published in The Journal of Nutritional Biochemistry.

    Inflammatory bowel diseases (IBD), such as Crohn’s disease and ulcerative colitis, has affected an estimated 3.1 million adults in the United States.

    Finding ways to mitigate symptoms of IBD is of importance because the chronic inflammation that characterizes the disease is a major risk factor for colon cancer. Colonic inflammation is also responsible for the loss of gut barrier function and increased gut permeability.

    Previous studies have explored the preventive effects that soybeans may have on cancer. While some studies have shown that consuming soy may reduce the risk of cancer, other studies have yielded mixed results.

    Recent studies have uncovered that soy protein has promising outcomes in animal models of IBD. However, many questions about the underlying mechanisms behind the anti-inflammatory effect remain.

    Soy protein concentrate triggered inflammation-moderating effects

    The Penn State team examined the impact of soy protein concentrate on inflammation and gut barrier function in mice in the new study. They replaced 12 percent of other sources of proteins in the diets of the mice with soy protein concentrate. The doses of soy protein concentrate substituted were equivalent to the amount that could potentially be used in humans.

    “We didn’t want to get carried away with using doses that were really high and would crowd out all the other protein that was there,” explains Bitzer. “Instead, we wanted to find a scenario that was going to fit into a more human-relevant situation.”

    The researchers found that soy protein concentrate has an antioxidant and cytoprotective effect in human bowel cells cultured in a laboratory. Furthermore, in the mice with induced IBD, substituting just 12 percent of other protein with soy protein concentrate was enough to stop body weight loss in its tracks and improve spleen swelling, reveals Lambert. This evidence indicates that soy protein concentrate might be able to moderate the severity of inflammation.

    “Soy protein concentrate mitigates markers of colonic inflammation and loss of gut barrier function in the mice with induced IBD,” says Wopperer.

    Future studies by the investigators will try to determine whether their findings could be replicated in humans. Soy protein is a readily available food ingredient that is already used as a substitute for meat. Lambert believes that because of this, human studies could be just around the corner.

    “Since it is already out there commercially, that makes it more straightforward. But practically speaking, the actual clinical studies are a little bit out of our area of expertise. I think the most likely thing to happen will be for us to try to identify a collaborator either through the Clinical Translational Science Institute on campus or with someone at the Penn State College of Medicine Inflammatory Bowel Disease Center.”

    Joshua Lambert

    Lambert and collaborators are currently evaluating whether the inflammatory-moderating effects they have observed in mouse colons are due to the soy protein or whether soy fiber may play a part. While soy protein concentrate contains around 70 percent protein by weight, it is also comprised of soybean fiber, Lambert concludes.

    Learn how soy consumption may improve survival rates in people with breast cancer.

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    30 Apr

    Medical News Today: 'Pink noise' boosts deep sleep, memory for older adults

    As we age, our quality of sleep declines. Researchers believe that this may contribute to later-life memory loss. New research, however, suggests that there may be a simple solution to this problem: “pink noise.”
    [Older adults sleeping in bed]
    Researchers say that pink noise may help to improve deep sleep quality and memory for older adults.

    Pink noise is defined as gentle, soothing sound whereby each octave possesses equal energy. In essence, pink noise is the background noise that we hear in everyday environments.

    Researchers from Northwestern University in Evanston, IL, found that when they synced pink noise to the brain waves of older adults as they slept, the sound not only enhanced their quality of deep sleep, but it also improved their memory.

    Senior author Dr. Phyllis Zee, professor of neurology at the Feinberg School of Medicine at Northwestern, and colleagues recently published their findings in the journal Frontiers in Human Neuroscience.

    Numerous studies have highlighted the importance of sleep for memory consolidation – that is, the brain’s ability to convert short-term memories into long-term memories.

    Slow-wave sleep (SWS) – more commonly referred to as deep sleep – is part of the non-rapid eye movement (NREM) sleep cycle that is considered important for memory consolidation. As we get older, however, the quality of SWS can decrease.

    Studies have shown that disruptions to NREM sleep in older age can have negative consequences for memory.

    According to Dr. Zee and team, previous research in young adults has uncovered a link between acoustic stimulation of slow-wave brain activity during sleep and improved memory. However, they note that studies using acoustic stimulation in older adults are lacking.

    Acoustic stimulation boosts SWS, memory in later life

    To address this gap in research, Dr. Zee and colleagues enrolled 13 older adults, aged between 60 and 84 years, to their study.

    All adults were subject to one night of sham stimulation and one night of acoustic stimulation, which were around 1 week apart. The acoustic stimulation incorporated pink noise that was synced to their brain waves as they slept.

    For each session, the adults completed two memory recall tests – one before they went to sleep at night, and one after they woke up the following morning.

    While memory recall improved under both conditions, the researchers found that the average improvement following acoustic stimulation was three times greater than with the sham stimulation.

    The greater improvement in memory as a result of acoustic stimulation correlated with a greater increase in the quality of SWS, which the team says emphasizes how important deep sleep is for memory consolidation, even in later life.

    Overall, the researchers believe that their findings indicate that acoustic stimulation may be an effective way to boost sleep quality and memory in older age.

    “This is an innovative, simple, and safe non-medication approach that may help improve brain health. This is a potential tool for enhancing memory in older populations and attenuating normal age-related memory decline.”

    Dr. Phyllis Zee

    However, the team concludes that further studies involving a larger number of participants are needed before acoustic stimulation can be recommended for older adults.

    “We want to move this to long-term, at-home studies,” notes first author Nelly Papalambros, of the Department of Neurology at the Feinberg School of Medicine.

    Learn how a good night’s sleep can feel as good as winning the lottery.

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    29 Apr

    Medical News Today: Polyneuropathy: Causes, symptoms, and treatment

    Polyneuropathy is when multiple peripheral nerves become damaged, which is also commonly called peripheral neuropathy.

    Peripheral nerves are the nerves outside of the brain and spinal cord. They relay information between the central nervous system (CNS), and all other parts of the body. The brain and spinal cord are part of the CNS.

    Polyneuropathy affects several nerves in different parts of the body at the same time. In cases of mononeuropathy, just one nerve is affected.

    Polyneuropathy can affect nerves responsible for feeling (sensory neuropathy), movement (motor neuropathy), or both (sensorimotor neuropathy).

    It may also affect the autonomic nerves responsible for controlling functions such as digestion, the bladder, blood pressure, and heart rate.

    Although the exact number of people with polyneuropathy is not known, the National Institute of Neurological Disorders and Stroke (NINDS) estimate that approximately 20 million people in the United States have some form of peripheral neuropathy, and most of them have polyneuropathy.

    Types of polyneuropathy

    [Polyneuropathy diagnosis]
    Neuropathy is a problem with the nerves. This can arise from numerous underlying conditions.

    There are more than 100 types of peripheral neuropathy, and most of these are polyneuropathies.

    Each type is classified according to the type of nerve damage, the underlying cause, and the symptoms that it produces.

    For example, diabetic neuropathy occurs in people with diabetes, whereas idiopathic neuropathy appears to have no known cause.

    There are three main patterns of polyneuropathy:

    • Chronic symmetrical peripheral neuropathy: Most polyneuropathies are chronic and develop over many months.
    • Multiple mononeuropathy: There is damage to at least two separate nerve areas.
    • Acute symmetrical peripheral neuropathy: This is rare. The most common cause is Guillain-Barré syndrome, a condition that can be fatal.

    Some neuropathies can take years to develop, but others become severe within hours to days of onset.

    Causes and risk factors

    A variety of medical conditions and other factors can cause polyneuropathy, including:

    • Diabetes: This can be a significant risk factor, especially if blood glucose levels are poorly controlled. One study of more than 1,400 people with type 2 diabetes found that every fifth person had diabetic neuropathy.
    • Alcohol abuse: Alcohol can damage nerve tissue, and alcohol abuse is often associated with nutritional deficiencies that contribute to neuropathy.
    • Autoimmune conditions: The immune system attacks the body, causing damage to nerves and other areas. Conditions include Sjogren’s syndrome, celiac disease, Guillain-Barré syndrome, rheumatoid arthritis, and lupus.
    • Bacterial or viral infections: Certain infections can lead to neuropathy, including Lyme disease, shingles, hepatitis B, hepatitis C, and HIV.
    • Bone marrow disorders: Examples of these include abnormal proteins in the blood, some forms of bone cancer, and lymphoma.
    • Exposure to toxins: Toxic neuropathy may be caused by exposure to industrial chemicals such as arsenic, lead, mercury, and thallium. Drug or chemical abuse is also a risk factor.
    • Hereditary disorders: Certain conditions, such as Charcot-Marie-Tooth disease, are forms of hereditary neuropathy.
    • Hypothyroidism: An underactive thyroid may lead to polyneuropathy, although this is uncommon.
    • Kidney disease: Uremic neuropathy is a form of polyneuropathy that affects 20 percent to 50 percent of people with kidney disease, according to the Center for Peripheral Neuropathy.
    • Liver disease: Research indicates that peripheral neuropathy is very common in those with cirrhosis of the liver.
    • Medications: Chemotherapy, along with some drugs used to treat HIV/AIDS, can cause neuropathy.
    • Poor nutrition: Deficiencies of vitamins B-1, B-6, B-12, and E may lead to polyneuropathy, as these are vital for nerve health.
    • Physical trauma or injury: Repetitive motion such as typing, accidents, or other injuries can damage peripheral nerves.

    Some cases of polyneuropathy have no known cause. These are known as idiopathic neuropathy.


    Polyneuropathy can produce a variety of symptoms, depending on which nerves are affected.

    Symptoms associated with sensory or motor nerve damage can include:

    [Polyneuropathy shooting pains]
    Polyneuropathy can cause shooting or burning pains in the limbs.
    • tingling
    • numbness
    • pins and needles
    • difficulty using the arms, legs, hands, or feet
    • increased pain (such as burning, stabbing, freezing, or shooting pains)
    • sleep problems due to night-time pain
    • inability to feel pain
    • extreme sensitivity to touch
    • inability to sense temperature changes
    • lack of coordination
    • increased episodes of falling
    • changes to the skin, hair, or nails
    • foot and leg ulcers
    • skin and nail infections
    • muscle weakness
    • muscle twitching

    Symptoms associated with autonomic nerve damage include:

  • heat intolerance
  • unusual sweating
  • bladder problems or incontinence
  • digestive problems
  • dizziness
  • blood pressure or pulse abnormalities
  • difficulty eating or swallowing
  • difficulty breathing
  • inability to sense temperature changes
  • lack of coordination
  • Other conditions with similar symptoms

    Fibromyalgia and polyneuropathy may have similar symptoms, but the cause of fibromyalgia is unknown.

    Similarities also exist between multiple sclerosis and peripheral neuropathy.

    Conditions associated with polyneuropathy

    There are many conditions associated with polyneuropathy, including:

    [Polyneuropathy mobility issues]
    Coordination issues and difficulties with movement are common symptoms of polyneuropathy. This may lead to further injuries.
    • amyloidosis
    • celiac disease
    • Charcot-Marie-Tooth Disease
    • diabetes
    • diphtheria
    • Guillain-Barré Syndrome
    • hepatitis B
    • hepatitis C
    • HIV/AIDS
    • kidney disease
    • hypothyroidism
    • leprosy
    • liver disease
    • Lyme disease
    • lymphoma
    • osteosclerotic myeloma
    • pernicious anemia (vitamin B-12 deficiency)
    • radiculopathy
    • rheumatoid arthritis
    • shingles
    • Sjogren’s syndrome


    Common complications associated with polyneuropathy include:

    • Falls and injury: A lack of balance and coordination, along with muscle weakness, can lead to an increase in falls and injuries sustained from falls.
    • Burns and skin damage: Numbness and an inability to feel pain or temperature changes can lead to accidental burns, cuts, and other damage to the skin.
    • Infections: Injuries, burns, and cuts, particularly on the legs and feet, can go unnoticed, leading to an increased risk of infection.


    Diagnosis is based upon medical history, a physical exam, and neurological evaluation. Depending on the person’s symptoms, tests may be ordered.

    The doctor will take a detailed review of all symptoms, lifestyle factors, and family history.

    They will also check the patient’s height, weight, pulse, blood pressure, and temperature. The heart, lungs, and abdomen may also be checked to rule out alternative physiological causes.

    Blood tests may be ordered to check for diabetes, thyroid function, immune function, nutrient deficiencies, and other factors that may cause polyneuropathy.

    There may be some simple tests to check reflexes, muscle strength, sensitivity to temperature and other sensations, coordination, and posture.

    Other tests

    Other tests that may be used in the diagnosis of polyneuropathy include:

    • MRI or CT scan: These imaging techniques look for tumors, herniated disks, or other abnormalities that may be affecting nerve function.
    • Electro-diagnostic tests: These non-invasive tests measure the electrical activity in the muscles and nerves, helping to detect nerve damage. Examples are electromyography and nerve conduction velocity.s
    • Biopsies: The doctor may remove a small portion of a nerve, or sample of the skin, to test for abnormalities in nerve function or nerve endings.


    The American Academy of Family Physicians recommend that peripheral neuropathy treatment address the underlying disease process, correct nutritional deficiencies, and aim to provide relief from symptoms.

    Available treatments include medication, medical therapies and procedures, and alternative treatments.


    Several different medications are available to treat neuropathy and its symptoms. These include:

    • Medications for associated conditions: Conditions that may be causing polyneuropathy should be managed through various treatments, including medication if recommended by a doctor. Examples include insulin for diabetes and thyroid hormones for hypothyroidism.
    • Pain medications: Over-the-counter pain relief can be beneficial for those with mild to moderate pain. These medications should not be taken on a long-term basis.
    • Prescription medications: Some antidepressants, such as a group of medications called TCAs (including amitriptilyne or nortriptilyne), can be used, and another group called SNRIs, such as duloxetine, may also help. Corticosteroid injections could possibly be used for mononeuropathies, and some seizure medications such as gabapentin or pregabalin may help.

    Medical therapies

    A variety of medical procedures are available. They include:

    [Polyneuropathy chiro treatment]
    Chiropractors can help treat the symptoms of polyneuropathy.
    • Transcutaneous electrical nerve stimulation: Electrodes send a gentle current of electricity through the skin. This can help with pain and sensitivity.
    • Plasma exchange: People with inflammatory or autoimmune conditions may benefit from this therapy. The practitioner removes blood from the body, then separates antibodies and other proteins from the blood, before returning the blood to the body.
    • Immune globulin therapy: Those with inflammatory and autoimmune conditions are given high levels of proteins to act as antibodies, which helps with immune function.
    • Physical therapy: People with muscle weakness or coordination issues may find physical therapy helpful.
    • Orthotic and other devices: Braces, canes, casts, splints, walkers, and wheelchairs may provide support and pain relief to those with neuropathy of the hands, feet, legs, and arms.

    If neuropathy is caused by pressure on a nerve, surgery may be recommended.

    Alternative treatments

    Alternative and complementary treatments may offer relief to some people with polyneuropathy. Examples include:

    However, these remedies have not been widely studied.

    Prevention and outlook

    Preventing polyneuropathy involves limiting the risk factors and managing underlying conditions.
    A person with polyneuropathy may not be able to avoid all risk factors, but some lifestyle choices may reduce the risk. These are:

    • avoiding alcohol
    • avoiding exposure to toxins, including cigarette smoke
    • limiting factors that contribute to physical trauma or injury, such as repetitive actions and restrictive positions
    • getting enough sleep and physical activity to support immune function
    • eating a balanced diet rich in vitamins and minerals
    • considering vitamin B-12 supplements if a vegan or vegetarian

    Managing underlying conditions

    Managing any underlying conditions can help to prevent the onset of the condition. Those with diabetes and other conditions related to polyneuropathy should closely follow the treatment plan devised by their doctor, as well as ensure that they attend all check-ups.


    The outlook for polyneuropathy varies and can depend on the underlying cause, which nerves are damaged and the extent of the damage.

    For some people, treating the underlying cause can lead to improvements. For others, the damage is permanent. In some cases, symptoms may get worse over time.

    When to see a doctor

    If any of the symptoms of polyneuropathy are experienced such as weakness, pain, or tingling in the hands or feet it is important to see a doctor.

    Implementing a treatment plan as soon as possible is important to manage symptoms and prevent further nerve damage.

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    Source: medicalnewstoday

    29 Apr

    Medical News Today: Diabetes and hypertension: What is the relationship?

    Hypertension, also known as high blood pressure, often affects people with type 1 and type 2 diabetes.

    The American Diabetes Association reports that from 2000 to 2012, 71 percent of adults with diabetes had a blood pressure of greater or equal to 140/90 or were taking medications to help normalize blood pressure.

    What are hypertension and diabetes

    Many people with diabetes also have hypertension, or high blood pressure. Having these conditions together can make them both worse.

    What is hypertension?

    Known the “silent killer,” hypertension usually has no signs or symptoms and many people are not aware they have it.

    [hypertension often occurs with diabetes]
    A blood pressure that is higher than 140/90 needs to be monitored, especially if it occurs with diabetes.

    High blood pressure increases a person’s risk of stroke and heart attack. It often occurs with diabetes.

    Blood pressure is measured in millimeters of mercury (mm Hg) and can be assessed using a blood pressure monitor.

    Two numbers will be produced. The first refers to the systolic blood pressure, or the highest level of the blood pressure during a heartbeat. The second, the diastolic blood pressure, points to the lowest level.

    Any blood pressure reading of less than or equal to 119/79 is considered normal.

    A reading between 120 and 139 for systolic pressure and between 80 and 89 for diastolic pressure is considered prehypertension. This is a sign of possible hypertension if a person does not take preventive steps.

    A doctor will diagnose a reading of 140/90 mm Hg or higher as high blood pressure.

    People can control hypertension with healthy lifestyle habits. These can include exercise and a low-fat, low-sodium diet. If necessary, a person with hypertension may reduce their blood pressure using medication.

    What is diabetes?

    Diabetes occurs when blood sugar increases because the body cannot use the glucose properly. This happens when there a problem with insulin levels in the blood. There are two different types of diabetes. Insulin makes it possible for body cells to absorb glucose.

    Type 1 diabetes accounts for about 5 percent of diabetes cases, according to the American Diabetes Association (ADA).

    Type 1 diabetes occurs when the body does not produce enough insulin. With the help of insulin therapy, anyone can learn to manage and live with type 1 diabetes. Symptoms include increased thirst, frequent urination, fatigue, blurred vision, and increased hunger.

    According to the ADA, type 2 diabetes accounts for at least 90 percent of all diagnosed cases of diabetes. Risk factors are family history, prior gestational diabetes during pregnancy, impaired glucose intolerance, lack of exercise, and being overweight.

    Some ethnic groups are at a higher risk of type 2 diabetes, including African Americans, Hispanics and Latinos, and Native Americans.

    Symptoms are similar to those of type 1 diabetes, but some patients may not have symptoms until their blood sugar levels reach dangerous levels. Treatment for type 2 diabetes involves diet changes, increasing physical activity, blood glucose monitoring, and oral medication or insulin injections.

    Hypertension and diabetes: The connection

    Studies have found that at least 1 in 3 patients with type 1 diabetes also have hypertension.

    When hypertension and diabetes co-exist, the effects of one disease tend to make the other worse. This makes for a deadly combination.

    Diabetes does three things that may increase blood pressure:

    • decreasing the blood vessels’ ability to stretch
    • increasing the amount of fluid in the body
    • changing the way the body manages insulin

    Hypertension and diabetes generally coexist because they share similar risk factors, including being overweight, following an unhealthy diet, and living an inactive lifestyle.

    A blood pressure reading of 140/90 is considered normal for most healthy people and those with diabetes. Patients should report any consistent blood pressure readings of 140/90 or higher to their doctors, as these may result in complications.

    Risk factors

    The combination of hypertension and diabetes can be lethal, and together they can increase the risk of a heart attack or stroke. Having both conditions also increases the risk of kidney disease and problems the blood vessels of the eyes, which could lead to blindness.

    [smoking increases the risk of diabetes and hypertension]
    Smoking increases the risk of both diabetes and hypertension

    Uncontrolled diabetes is not the only risk factor for hypertension. The chances of having a heart attack or stroke are further multiplied if other risk factors exist, in addition to diabetes.

    These include:

    • having a family history of heart disease
    • stress
    • having a high fat or high sodium diet
    • not being active
    • advanced age
    • being overweight
    • smoking
    • overconsumption of alcohol
    • low levels of potassium or vitamin D
    • having another chronic condition, such as sleep apnea, kidney disease or inflammatory arthritis

    People with diabetes should try to minimize these risks as far as possible, for example, by choosing a healthy lifestyle.


    Lifestyle factors are the best way to lower the risk of high blood pressure and to maintain normal levels. There is a wide body of evidence, which demonstrates that controlling blood pressure in people with diabetes reduces the risk of complications.

    A study in the United Kingdom (U.K.) followed 1,148 people with diabetes for several years. The participants whose blood pressure was well-controlled had a significantly reduced risk of dying from complications related to diabetes, hypertension, or both.

    Weight loss

    Losing even a small amount of weight can make a difference in bringing down blood pressure.

    The National Heart Lung and Blood Institute (NHLBI) points out that losing 10 pounds in weight can reduce blood pressure.


    People who live with both hypertension and diabetes should try to be active at least five days a week for at least 30 minutes per day. Regular activity lowers blood pressure and offers many other health benefits.

    Healthy diet choices

    People with diabetes should already be closely monitoring their diet in order to maintain blood sugar. They should also limit the amount of salt in cooking and avoid adding salt to food to help maintain blood pressure.

    Drinking alcohol in moderation

    [reduce alcohol consumption to reduce hypertension]
    Reducing alcohol consumption can help control hypertension.

    The intake of too much alcohol leads to increased blood pressure. Reducing heavy drinking to the recommended amounts of alcohol decreases the risk of hypertension.

    According to National Institute on Alcohol Abuse and Alcoholism, women should not drink more than 3 drinks on a single day or exceed a total of 7 drinks per week. Men should not drink more than 4 drinks per day and no more than 14 per week.

    Not smoking

    Nicotine in cigarettes raises blood pressure and heart rate. It also adds stress to the heart and increases the risk of heart attack and stroke.

    Smokers with diabetes have a higher risk of serious complications, including:

    • heart or kidney disease
    • retinopathy, an eye disease that may lead to blindness
    • poor blood flow in the legs and feet, which may lead to infection and even amputation
    • peripheral neuropathy, or nerve pain in arms and legs

    People who smoke should make every effort to stop.

    Treatment with medication

    Blood pressure medication is recommended if blood pressure consistently remains above 140/90 for people with diabetes, despite lifestyle changes.

    Most people with hypertension will need to keep taking blood pressure medication for the rest of their lives.

    The only exception would be for someone who blood pressure has been well controlled for significant period of time due to major lifestyle changes, such as losing a lot of weight, being consistently active or after a significant reduction in alcohol consumption.

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    Source: medicalnewstoday