Diabetes

Numbers for health

Optimal Operating Conditions – Live your Healthiest Life

Posted on by Michelle Fritsch, Pharm.D.
Numbers for health
Know your optimal operating conditions

What are your optimal operating conditions? How often do you change the oil in your car? How warm/cool do you keep your home? How often do you change your furnace filter? When do you change your car’s tires?

I find we tend to be more aware of these guidelines for our cars and homes than we do for our bodies. Perhaps it is more clearly communicated how to care for your car or your home.

Most people find a temperature of 72 degrees Fahrenheit to be comfortable. Your car’s tires were designed to perform best when driving at the speed limit. You car’s oil is designed to lubricate the moving parts of your engine for 3500 miles (up to 7-10,000 if synthetic).

Our bodies have been designed to operate BEST within certain parameters. Do you know the numbers that will help keep you most healthy? Here are a few.

Your Best Numbers for your Heart

Why are your blood pressure and pulse checked every visit to your doctor? It is because there is an optimal range to help your heart stay in top performance.

Pulse 60-90 bests per minute

Blood pressure under 140/90 without being dizzy

When your heart beats in this range, it is able to fill with the right amount of blood with each beat. It can also send out to the body the right amount of blood with each pump. If your heart pumps too slowly, there might not be enough blood per pump to get enough to all of the other parts of the body. Similarly, when the heart pumps too fast, each squirt is just a small amount of blood rather than a full load. Those small quick squirts don’t get enough blood throughout the body where it is needed.

When your blood pressure is too high, it makes your heart work extra hard. Think about a body builder gradually increasing his muscle mass. If he tries to lift too much weight all of a sudden without working up to that weight, he is likely to hurt himself. He could even rip or harm a muscle to the point his weight lifting days are over. When your blood pressure shoots up quickly or it stays high over time, you move from a strong heart muscle to an injured heart muscle. A heart attack is destruction of part of the muscle wall. Once part of the heart is no longer working correctly, the rest of heart has trouble doing its work. It has to compensate for the wounded part.

Your Best Numbers for your Sugar

At least yearly during your physical, your doctor checks your blood sugar. Sugar (technical term glucose) is essential ‘food’ for your cells. Now, sugar doesn’t just come from eating sugary, sweet food. It is the result of your body breaking down other foods into usable cell ‘food’. There are a lot of other ways the body stores, releases, and breaks down sugar. Also, insulin is what helps that sugar ‘food’ get into the cell. Your body works best when your sugar is in the optimal range, and you have the right amount of insulin to keep it in that range.

Blood glucose 60-110 mg/dL if you do not have diabetes. (Your goal might be a bit higher if you have diabetes – talk with your doctor).

A1c (glycosylated hemoglobin – this gives an indication of your blood sugar over the last 90 days)

4-5.6% if you do not have diabetes

5.7-6.4% your doctor will talk with you about ways to make changes with your diet and exercise to avoid diabetes

less than 6.5% goal for well-controlled diabetes

just over 6.5% for some people with diabetes

– your doctor will help decide your best goal

When your blood sugar is too low, you get dizzy, shaky, sick to your stomach, you sweat, and it is hard to think clearly. When your blood sugar is too high, it causes damage throughout your body. Uncontrolled blood sugar can lead to poor kidney function, blindness, and loss of feeling in your hands and feet and other parts of your body. Also, type 2 diabetes is linked with high cholesterol, heart disease, stroke, high blood pressure, and being overweight.

Your Best numbers for your Weight

Your weight is also checked with nearly all doctor visits. Extra weight is hard on a lot of parts of your body. It creates more work for your hips, your knees, your ankles, and your feet. You are more likely to have diabetes. There are more cells to feed, beyond what your body was intended to feed. Your risk of heart attack and stroke go up. Your risk of falls goes up.

Your ideal weight is linked with your height. There are two best ways to determine if your weight is in a healthy range. One deals with your total weight. The other pertains to where you carry your extra weight.

Body Mass Index (BMI) – you can calculate your BMI here. It is based on your height.

Your BMI should be between 18.5 and 24.9

Waist Circumference – see this link to learn how to measure your waist circumference.

Women should be less than 35 inches

Men should be less than 40 inches

Can you live with numbers that are outside the normal range? Yes, you can. There will be consequences, though. When we live outside of the optimal range, systems don’t function as efficiently. They don’t operate like they were designed to operate.

Note, medications can help with these numbers. And, in all of these circumstances, our daily choices are also important to maintain optimal operating conditions. What we eat, how much we sit, how we exercise, and how we control our stress are also important in staying in these goal ranges. So, you have a lot of ability to help control your numbers!

Please contact us at Meds MASH to learn more about how to stay in your optimal operating conditions! You can reach us at 410-472-5078 or www.medsmash.com/contact.

BIBLICAL APPLICATION

Our body will function best when it can operate at optimal numbers. God designed our bodies and these healthy parameters. God has given us optimal operating guidelines for our spiritual life, too.

This struck me hard this week while I was reading Numbers. [I’ll admit, I don’t love reading some of the Bible chapters like Numbers. They can be dry and tedious. I have accepted the challenge of reading the Bible in a year. I highly encourage you to do this. You can start any time. So many insights jump out each time.]

While reading Numbers it hit me how God REPEATEDLY told the Israelites exactly what He was going to do and what He wanted them to do. He guided them with when to move, when to stay, and where to go. He provided the food while they were in the desert with few food sources. He explained before they reached each place who they would conquer and how He would make that happen.

If they had just listened, things would have been so much easier for them. That time in the desert could have been focused on worship and praise and relaxation waiting for all the wonderful things that they were promised.

Instead, they were impatient, untrusting, and impressionable. They were easily pulled away from God’s message and onto the opinions, concerns, or temptations presented by other people.

[If you’re a Veggie Tales fan, remember the peas in Josh and the Big Wall? They said, ‘silly children’ when addressing the children of God.] Silly children!

Numbers 14:11 ESV

And the Lord said to Moses, “How long will this people despise me? And how long will they not believe in me, in spite of all the signs that I have done among them?

We sit here and read about their mistakes and wonder how they could have been so dense. Through Moses, God spelled out what they needed to do in great detail. It was very clear. What were they thinking?

Then, I remember my own thoughts, actions, impatience, lack of trust, and how gullible I can be. Who am I to judge? Because Jesus died for us and removed the rules of the Hebrew Bible, our access to God is so much easier! We really have no excuse.

Galatians 3:13 ESV

Christ redeemed us from the curse of the law by becoming a curse for us—for it is written, “Cursed is everyone who is hanged on a tree”—

We don’t have to obey the tedious rules and sacrifices of the Hebrew people. Christ removed all of those rules and barriers between God and us. You have a straight link to the creator of the universe through Christ. Day by day, minute-by-minute God will guide you if you just ask.

I’ve mentioned before, my day is entirely different, less stressful, more productive, and more peaceful when I give it all to Christ. So, you’d think I would do that every day. Duh! If I give it to Christ it is an incredible day. If I get into a rush, too busy, too much too do, no time to slow down, then the whole day stays rushed and stressful.

John 16:33 ESV

I have said these things to you, that in me you may have peace. In the world you will have tribulation. But take heart; I have overcome the world.”

I encourage you to consider this week how God is calling you to live. How does your ready access and potential relationship with Him change everything? If you look in the Bible, we are given the exact recipe for a life of peace and love. It’s our own decisions, impatience, lack of trust, and distractibility that takes us off that path.

2 Thessalonians 3:16 ESV

Now may the Lord of peace himself give you peace at all times in every way. The Lord be with you all.

Blessings,

Michelle

Image source: Medline Plus, National Institutes of Health, U.S. Department of Health and Human Services.

Advertisement
Newer diabetes options

Are You TOO Sweet? Newer Options for Diabetes

Posted on by Michelle Fritsch, Pharm.D.
Newer diabetes options
Newer diabetes medications to consider if you’re too sweet.

Do you remember when the treatment options for your type 2 diabetes were medicines that could make your blood sugar too low – oral medicine or insulin? The available options would also make you gain weight.

Those treatments are still available, and now there are improved versions of each. So, if you and your doctor and your healthcare team haven’t talked about options recently, now might be the time. The experts in the field, using the information from the latest studies, release guidelines. The latest guidelines from the American Diabetes Association have tables that provide comparisons between the options. These tables make a nice display to help you have a conversation with your doctor about which options might work best for you.

Those early medication options mentioned before would either help your pancreas release more insulin or would be an extra source of insulin.

Newer diabetes medication options

Here are ways other, newer medicines help control your diabetes:

  • control how your liver stores extra glucose (sugar) and when and how it lets it back out
  • control how your kidneys let your glucose out in your urine
  • impact how sugar is absorbed from the food you eat
  • mimic hormones that control how your body responds to sugar and insulin
  • slow down the rate food moves through your body keeping you feeling full longer
  • increasing how a cell responds to insulin

The body has many different steps in the way it handles the food you eat and how that food is turned from sugar into energy for your cells. Now, with these newer options, your diabetes can be treated with medicines that address more than one of those steps.

Combinations of medications can help control your diabetes more than one way at a time. Also, when you use combinations of medicines, you can usually use a lower dose. This helps cut down on side effects.

New insulin options

If a combination of medicines you take by mouth don’t help you reach your diabetes control goals, there are new insulins. The old insulins were dosed either around meals or twice a day. There are now basal insulins. These are dosed just once per day. They then provide some support to control your blood sugar all day and all night. Then, when you eat, your blood sugar does not climb as high.

Often, people who have been taking higher and higher doses of oral medicines find they can be on lower doses. The basal insulin helps decrease the need for so much oral medicine.

And, like we said before, using several different medicines helps you use lower doses of each. This is often easier to tolerate than high doses of one or two medicines.

NOTE, this information is all for type 2 diabetes. If you have type 1 you need insulin therapy only because your pancreas has quit working. The insulin is absolutely required. The oral medicines mentioned above won’t control your diabetes.

We have much more we can tell you about diabetes and treatment options. For more information, please contact us at www.medsmash.com/contact or call at 410-472-5078.

BIBLICAL APPLICATION

Diabetes (and other medical conditions) can be best treated with medication using different mechanisms. Treat different parts of the condition from all directions for the most comprehensive care.

I have been embarking on some new (to me) techniques for Bible study. Wow, there are so many ideas and methods out there! I am intrigued by all of the different ways we can approach the same scripture. And, as only God could do, I learn something different every time. Part of the reason I keep learning new things from the same scripture is that I am different every time I read it. The things happening in my life, the things that are exciting me, the things that are concerning me, the things happening with my friends and family are different. This changes my perspective. Also, my moods change. That can definitely impact how I approach anything I read or hear.

Then, there are all of these techniques and approaches I have been reading about. Some are obvious, and some, to me, seem really innovative. Here are some that I have been trying to incorporate:

  • When reading a small bit of scripture, read it over and over emphasizing a different word each time to see how that changes the meaning.
  • Research the history at the time it was written. Historical context helps to understand the culture and surrounding events.
  • Write down in a journal (or I write in the margins) insights, events, or ideas you get from that verse or chapter. (Date it so you can see it later. Often I find it strikes me a completely different way the next time I read it because I’m in a different frame of mind in different circumstances.)
  • Consider how the scripture you’re reading could be incorporated into your life today.
    • Sometimes this is an action, sometimes an new idea, sometimes a reflection on how great is our God, sometimes a prayer, sometimes a question to ponder.
  • Put yourself in the scripture. Try to imagine being there at that time. How did it probably look, sound, feel. How might you have gotten there? What are you probably wearing? Who else is there?
  • Read about the author of that chapter of the Bible. What do we know about that person? What was their perspective?
    • I like the Life Application Bible. It has information at the start of each chapter to start answering these questions. It has helped me dig a lot deeper and understand more concepts. There are application tidbits on each page.
  • Where else is this theme, story, or concept in the Bible?
  • Listen to the Bible being read to you. There are many online apps that include an audio version. Especially if you like to learn through hearing, this is a great method.
  • Read the same scripture as a friend and talk about it. Or better yet, talk about it in a Bible study group. I am always amazed at how we can read the very same thing and have completely different insights.

No doubt, there are many more.

God gave us his Word to be an integral part of our life.

2 Timothy 3:16-17 ESV

All Scripture is breathed out by God and profitable for teaching, for reproof, for correction, and for training in righteousness, that the man of God may be competent, equipped for every good work.

God’s Word can be a huge source of answers when you’re feeling lost, alone, hurt, confused.

Psalm 119:105 ESV

Your word is a lamp to my feet and a light to my path.

There’s not just one right way to study scripture. Like a combination of meds approach to diabetes, try a combination approach to reading your Bible.

Hebrews 4:12-13 MSG

 God means what he says. What he says goes. His powerful Word is sharp as a surgeon’s scalpel, cutting through everything, whether doubt or defense, laying us open to listen and obey. Nothing and no one is impervious to God’s Word. We can’t get away from it—no matter what.

My prayer is you’ll find it exciting and refreshing to try all sorts of new ways to get into your Bible. There is a never-ending amount of great information in there. It is always pertinent.

Blessings,

Michelle

I have diabetes – let the pills fix it!

Posted on by Michelle Fritsch, Pharm.D.
ID-10093880
Diabetes – let the pills fix it

 

Medications to treat diabetes have revolutionized the treatment of this condition. The number of people with diabetes has been increasing for many years. So, a lot of emphasis has been put on finding new treatments. The number of new types of medications to treat diabetes has greatly increased even in the last five years. This is GREAT news!

So, with all of these new and the older tried and true treatments, diabetes is in good control, right? Surely with all of these options, diabetes is a problem of the past.

Unfortunately, it’s more complex than that. The same things that are causing this increase in number of people with diabetes need to be at the core of the treatment. So what are these things?

At the core of diabetes management

The primary link to the growing number of people with diabetes is the growth of the population. I’m not referring to number of people, I’m referring to SIZE of people.

Obesity has been on the rise. As a population we have gained significant weight. This is one of the main risk factors for diabetes. It is also a risk factor for high blood pressure, high cholesterol, heart disease, and stroke.

So, besides medications to treat diabetes, changes in diet, exercise, and weight are key parts of treatment. Diet and exercise changes are the best way to manage weight. They are not always the most fun and certainly not the easiest. There are all sorts of ‘quick fix’ schemes for weight management that sound very enticing. But, after all is considered, none of these are as safe or effective as true, daily, positive changes in food and movement.

Daily changes

Move every day. Spend less time in a chair and more walking, participating in dance or games, cleaning, or doing other things that are active.

Diet changes are best made in moderation. Sudden, huge diet changes are very hard to sustain. A few simple changes can make a big different. Try some of these:

  • Avoid second helpings
  • Eat a bit smaller portions
  • Cut back on white bread, crackers, pasta
    • Replace with those with higher grain content
  • Eat some more vegetables in place of bread and sweets
  • Eat some more fruit in place of sweets

It is important to make changes that you can make new habits. Keep up these gradual changes over time.

Be good to yourself. If you occasionally slip and fall back in old habits, pick yourself up, forgive yourself, and try again. As you adopt healthier habits, your weight decreases, and you move more, you will start to feel better and more energetic. That will made it easier to continue to make positive changes.

If you want to talk about more details aobut how you can start making these changes, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Just as it is tempting to let pills fix medical health, it is tempting to let Sunday church fix our spiritual health.

If you go to church most Sundays, you have all you need for spiritual growth and development, right?

Peter had some very insightful instruction about spiritual growth.

1 Peter 2:1-5 ESV

So put away all malice and all deceit and hypocrisy and envy and all slander. Like newborn infants, long for the pure spiritual milk, that by it you may grow up into salvation— if indeed you have tasted that the Lord is good. As you come to him, a living stone rejected by men but in the sight of God chosen and precious, you yourselves like living stones are being built up as a spiritual house, to be a holy priesthood, to offer spiritual sacrifices acceptable to God through Jesus Christ.

I encourage you to read the rest of this chapter of 1 Peter.

2 Peter 1:5-8 ESV

For this very reason, make every effort to supplement your faith with virtue, and virtue with knowledge, and knowledge with self-control, and self-control with steadfastness, and steadfastness with godliness, and godliness with brotherly affection, and brotherly affection with love. For if these qualities are yours and are increasing, they keep you from being ineffective or unfruitful in the knowledge of our Lord Jesus Christ.

2 Peter 3:18 ESV

But grow in the grace and knowledge of our Lord and Savior Jesus Christ. To him be the glory both now and to the day of eternity. Amen.

Another verse with some instruction about spiritual growth is:

2 Timothy 3:16-17 ESV

All Scripture is breathed out by God and profitable for teaching, for reproof, for correction, and for training in righteousness, that the man of God may be competent, equipped for every good work.

Growing in your faith is a lifelong quest. With each new thing you learn, your perspective changes and you realize there is so much more to learn.

Sundays, church, and fellowship are incredibly important! And so are all of the other ways you spend time with God and the Bible and other growth opportunities.

Blessings,

Michelle

Sugar, Pressure, and Lipids…Oh My! Metabolic Syndrome

Posted on by Michelle Fritsch, Pharm.D.

Slide1Do you have diabetes, or have you been told you have pre-diabetes? Are you overweight, especially around your midsection? Do you have high blood pressure? Do you have high cholesterol? Did you know they often go hand-in-hand? As a group they are called ‘metabolic syndrome’.

Metabolic Syndrome

This term describes a collection of medical conditions that each impacts the other. These conditions have many negative effects on your body. The primary risks have to do with your possibility of heart disease and stroke.

Risk factors

The biggest risk factor seems to be weight. Our population as a whole has been gaining weight over the last several years. As that has occurred, the number of people with diabetes has rapidly climbed. The number of people with metabolic syndrome has also climbed. Family history of high blood pressure, diabetes, heart disease, and/or high cholesterol also increases your risk of developing these conditions.

Treatment

No matter what medications are used, DIET and EXERCISE are key components of treatment. In particular, less fat, salt, sugar, carbohydrates, and overall calories can help you control this syndrome. Simple carbohydrates are foods like white bread, white pasta, sweets, honey, and fruits.

There have been many new types of medications to treat diabetes in recent years. This is great news if you have type 2 diabetes! The different types of medication help control your blood sugar in different ways. So, you might find that more than one medication is used.

The situation is similar with high blood pressure. There are several different types of medications to lower blood pressure.  These impact the blood pressure from different mechanisms. Using more than one can better lower blood pressure in some patients.

The best type of cholesterol medication depends on which parts of the lipid profile are to be treated. Which are selected is also impacted by liver function.

In addition to those medicines, often a low-dose aspirin is added to further lower risk for heart attack or stroke.

So, if you have metabolic syndrome, you are probably taking several different medications. You also hopefully monitor parts of the syndrome at home – blood pressure and/or blood sugars.

If you would like to better understand your medication regimen, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

There are multiple different types of medications that approach the control of some medical conditions from different angles. Similarly, there are multiple ways to worship. In what ways do you worship the Lord?

Colossians 3:14-17 ESV

And above all these put on love, which binds everything together in perfect harmony. And let the peace of Christ rule in your hearts, to which indeed you were called in one body. And be thankful. Let the word of Christ dwell in you richly, teaching and admonishing one another in all wisdom, singing psalms and hymns and spiritual songs, with thankfulness in your hearts to God. And whatever you do, in word or deed, do everything in the name of the Lord Jesus, giving thanks to God the Father through him.

John 4:24 ESV

God is spirit, and those who worship him must worship in spirit and truth.”

Psalm 95:6 ESV

Oh come, let us worship and bow down; let us kneel before the Lord, our Maker!

Isaiah 12:5 ESV

“Sing praises to the Lord, for he has done gloriously; let this be made known in all the earth.

Worship is so much more than going to church on Sunday. God wants you to get to know Him and to worship in multiple ways. Fully experience the glory and joy of God!

Blessings,

Michelle

Weight – Less of you might mean less in your medicine cabinet

Posted on by Michelle Fritsch, Pharm.D.

…or at

Medicine doses should be adjusted with weight loss
Medicine doses should be adjusted with weight loss

least lower doses.

Healthy weight loss can lead to decreased doses

Unhealthy weight loss can, too. Actually, sudden, unexpected, or drastic weight loss can be even more hazardous. If it is unplanned please talk with your doctor right away.

Fat loving (lipophilic) medicines distribute throughout all of the extra weight in our bodies. The medication finds places to travel and stay stored in all of these fatty areas. Once we lose fat, it takes a lower dose to get the same effect. If the dose is not changed with weight loss, the same dose you have taken for years can actually be toxic. Rather than being stored in the fat, the amount of medicine stays in your blood where it has more effect. I have seen several cases where someone was getting more confused, more sleepy, having more difficulty thinking with no change in their medicine regimen. Upon further analysis, we found they had lost several pounds over the past several months with no reduction in medicine dose. So talk with your doctor as you lose weight to double check doses of meds.

Medical conditions related to weight

There are also several medical conditions that are related to your weight, especially excess weight. For many people diabetes, high blood pressure, and high cholesterol are found when the person is overweight. They get worse with increased weight. If that person then loses weight, those medical conditions can get better. The need for medicines to control these conditions can go down as the body is better able to manage the blood sugar, blood pressure, and cholesterol on its own. This means the number and doses of medicines might also need to be decreased. Blood pressure medicine doses that are too high can lead to dizziness, especially with standing, and falls. Diabetes medicine doses that are too high can lead to low blood sugar, confusion, dizziness, sweating, or even passing out. Cholesterol medicine doses that are too high might increase risk of side effects like liver damage or muscle pain.

If you have diabetes, high blood pressure, or high cholesterol and have lost at least five pounds, ask your doctor if you could take fewer medicines or lower doses.

What are other benefits of weight loss?

Data has shown that a 5% weight loss can help prevent high blood pressure. It can also help control your blood pressure, your diabetes, and your cholesterol. So, if you weigh 200 pounds, this would be a 10 pound weight loss. This can be accomplished through diet and exercise. Fast weight loss fad diets are NOT the diets of choice. Eating healthy foods, vegetables, fruits, and low-fat options are the safest diet changes. Also, exercise does not mean running a marathon tomorrow. Increased movement several times each day can have a huge positive benefit.

I had one patient once who took this message to heart. He gradually changed his diet and started walking. None of his changes were extreme. Over time, he lost weight. We were able to remove EIGHT medicines from his regimen as his own body resumed control of his conditions. Not everyone will have results this dramatic, but small changes can have big positive impacts.

For more information about healthy weight loss and associated medicine reductions, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

In line with these thoughts about the positive benefits of weight loss, consider the benefits of guilt loss! How much of your daily activity is influenced by guilt? Do ayou feel worthy, accepted, loved, precious, and good enough? Or, do doubts cast a shadow over you? Do feelings of guilt or shame impact your confidence and your attitude? Are you as positive and hopeful s you could be?

If you could shed guilt and shame, can you even imagine how much lighter your load would be? Think how much freer you would be to rejoice and praise and live the life you were meant to live!

Here are some of the thoughts in the Bible about guilt.

Romans 8:1 ESV

There is therefore now no condemnation for those who are in Christ Jesus.

Romans 3:23 ESV

For all have sinned and fall short of the glory of God,

Romans 5:1 ESV

Therefore, since we have been justified by faith, we have peace with God through our Lord Jesus Christ.

Rather than being burdened and weighed down by guilt, consider this offer from Jesus.

Matthew 11:28-30 ESV

Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.”

The past is gone. You are forgiven! You do not need to carry around this guilt and shame. Shed it and see how good you can feel!

2 Corinthians 5:17 ESV

Therefore, if anyone is in Christ, he is a new creation. The old has passed away; behold, the new has come.

Ephesians 4:22-24 ESV

To put off your old self, which belongs to your former manner of life and is corrupt through deceitful desires, and to be renewed in the spirit of your minds, and to put on the new self, created after the likeness of God in true righteousness and holiness.

Blessings,

Michelle

Image Source:  National Center for Complementary and Integrative Health; National Institutes of Health; U.S. Department of Health and Human Services