On Wednesday, February 19th, we enjoyed hearing about "The Care and Feeding of Diabetes." Our speaker was Brent McFadden, PharmD, from Brent's Pharmacy and Diabetes Care. Brent's talk included a discussion of the physiology of diabetes as well as dietary and life-style considerations for those having been diagnosed with the disease. Diabetes is actually a group of diseases, which affect how the body handles the fuel necessary for the function of cells in the body or brain - glucose. There are two primary types of diabetes, Type I and Type 2. Type I is usually diagnosed at an earlier age, is an auto immune condition, having a genetic susceptibility and results in the patient being dependent on the hormone, insulin. Type 2 is diagnosed later in life and may be the result of a sedentary lifestyle, high blood pressure, poor lifestyle choices or previous diagnosis of gestational diabetes. The Type 2 diabetic may still produce insulin but not in amounts sufficient for daily living, or the body is not able to utilize what insulin is being produced and must be supplemented.

Brent talked about the condition of pre-diabetes which can exist and be managed for some period of time. But it may eventually convert to Type 2 diabetes. Diagnosis of any of the three types is dependent on evaluation of symptoms and results of one's blood sugar levels through various tests. The most usual and definitive test might be said to be the glycated hemoglobin or Hgb A1c blood test because the results are not influenced by a recent glucose response. Instead, the test reflects a two to three month "glucose load" which has been carried by red blood cells. A consistent below 5.7% is normal - 5.7 to 6.4 means pre-diabetes and 6.5 or higher on two separate tests is diagnostic of diabetes. Maintenance at 7% or below is a goal for known diabetics.

Diabetes in any of its forms is a manageable disease but demands compliance in maintaining a healthy lifestyle to ward off the possible long-term effects to the body. The best approach for optimum health includes:

• Exercise - at least 30 minutes per day, five days a week
• Medication - oral meds or insulin delivered by various routes and frequency
• Diet - portion control of nutritious, high fiber foods low in saturated fats, sweets and refined carbohydrates. There is no definitive "Diabetic Diet."

One in four Americans has diabetes and many do not know they are at risk. Diabetes is the leading cause of lower limb amputations and blindness. It is a disease that has become more prevalent in great part because of our Western lifestyles of inactivity in an industrialized society and obesity due to poor dietary choices and consumption of large portions of over-refined foods. It is never too late to do something good for yourself by choosing to live healthy.

You can listen to the audio of Brent's presentation here. You can download a copy of Brent's PowerPoint presentation here.