New guidelines for Type 2 diabetes; food, mood and attitude
Q: Is it true that there are new treatment guidelines for Type 2 diabetes? My wife was recently diagnosed, and I want to know what they are. - Lester G., Columbus, Ohio
A: Yes, there are new guidelines, or a realignment of guidelines, and there are a few things you and your wife need to talk to her endocrinologist about.
The big shift is that doctors are being told to approach their Type 2 diabetes care plan by starting with an evaluation of each diagnosed patient's heart health, because cardiovascular disease (heart attack and stroke) is the No. 1 cause of death for people with diabetes. While metformin remains the recommended first-line treatment for Type 2 diabetes, there are two types of therapies that are emerging as the go-to drugs for managing long-term heart health and blood glucose levels: sodium-glucose cotransport-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists.
One caution: The Food and Drug Administration has issued a warning about SGLT2 inhibitors, because from March 2013 to May 2018, they found five women and seven men were hospitalized (one died) with what's known as necrotizing fasciitis of the genitals (flesh-eating bacteria) because of taking the meds. (1.7 million people received prescriptions for SGLT2 inhibitors in 2017). Going forward, a warning label will be placed on the medication. So ask the doctor about the risks and benefits for your wife.
As for the emphasis on cardiovascular health, that's terrific. But it doesn't depend on medicines alone! She should make sure to get 10,000 steps daily, lose 10 percent of her body weight if she is overweight, avoid all added sugars and syrups, sat and trans fats and highly processed foods. You can reverse Type 2 diabetes with a healthful lifestyle, then neither of you will have to worry about the potential side effects of Type 2 diabetes medications.
Q: My husband and I weigh about the same, are both 45 and about the same height and weight (5 feet, 8 inches, and 150 pounds). Should we eat the same kinds and amounts of foods? - Shirley D., St. Joseph, Missouri
A: Height and weight are not the only criteria that determine how much and what foods you should eat. Your nutritional needs are also influenced by your activity level, age and your gender.
Are you active? While a 45-year-old sedentary woman who is 5 feet, 8 inches tall and weighs 150 pounds may burn 1,934 calories a day or less, an active woman with the same stats can consume 2,445 calories and maintain her weight. (An active man with the same stats - 2,752 calories.) So you want to tailor what you eat to your activity level and your desired weight.
Are you in perimenopause or menopause? That often ushers in weight gain. So you want to change what and when you eat. Smart steps: Wait 13 or more hours between dinner and breakfast; eat a lean-protein, fresh fruit and 100-percent-whole-grain breakfast; and never have dinner (light and lean) later than 8 p.m.
Are you happy? A study published in Nutritional Neuroscience found that women's brains require an especially nutrient-rich diet to achieve maximum happiness and mental health. Seems as men and women evolved, their brains developed anatomical and functional differences that influence susceptibility to mental disease. The bottom line is, "women need a larger spectrum of nutrients to support mood, compared to men," and many are not getting them. That, the researchers suggest, may explain why women are more prone to depression and anxiety than men are.
So it's important that women (and men too!) avoid highly processed foods, added sugars and additives that can alter gut bacteria and the nutritional balance in the body. They need to make sure they get iron-rich food (premenopause especially), like chicken, turkey, fish, kale, spinach, beans and lentils; folate-rich citrus fruits, leafy greens, beans and peas; calcium-rich, nonfat dairy, sardines, tofu and dark leafy greens; and vitamin D from fatty fish like salmon and all varieties of mushrooms.
Distributed by King Features Syndicate, Inc.
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