Living longer is one of the greatest benefits of leading a healthy active lifestyle and life expectancy for both men and women has continued to rise with improvements in diet, awareness and medical care. And to ensure that you are one of those helping boost future life expectancy figures we have prepared a list of 20 great tips to help with putting off the inevitability of death for as long as possible …
1. Laugh more
Research states that laughter may be beneficial to health. Laughing appears to boost the blood flow (by more than 20 per cent) and researchers say it may reduce the risk of developing heart disease. Laughing has previously been found to help fight infections, relieve hay fever, ease pain and help control diabetes. The positive effect of laughing is thought to last around 30 to 45 minutes.
2. Adjust sleeping time
Life expectancy may be reduced by sleeping more than eight hours a night. A study found that people who get only six to seven hours sleep a night live longer than those who sleep eight hours or more, or less than four hours.
3. Eat more garlic
Garlic has been referred to as ‘nature’s antibiotic’. It is a powerful cleanser of the body and regular ingestion promotes a healthy heart and circulation by lowering blood pressure and cholesterol. It also helps fight infection and can boost immunity. There is strong evidence to suggest that garlic helps with the prevention of cancers of the digestive system, including the oesophagus, stomach, colon and rectum. Those who don’t like the taste of garlic should try the odourless supplements that are available.
4. Boost your sex life
Having sex between three to four times a week is thought to reduce the risk of having a heart attack or stroke in half. During sex, the average person maintains their heart rate above 70 per cent of the maximum, making sex a wonderful CV workout! Sex reduces stress, leads to greater contentment and better sleep.
5. Drink tea
Many research studies support the view that tea is good for your health. Scientists tend to agree that tea, both black and green, may contribute positively to the promotion of health and the prevention of chronic disease. Recent research studies reveal the antioxidants in tea may inhibit the growth of cancer cells, support dental health, increase bone density and strengthen cardiovascular health. According to a study published in Circulation: The Journal of the American Heart Association, heart attack patients who were tea drinkers decreased their risk of death by up to 44 per cent, as compared to non-tea drinkers.
6. Drink red wine
Any excuse to drink more has got to be good! Recent studies show that drinking around one glass of red wine a day may have certain health benefits by protecting against certain cancers and heart disease, and can have a positive effect on cholesterol levels and blood pressure. Excessive or binge drinking, however, unfortunately doesn’t produce the same benefits.
7. Regular self examination
For women this means regularly examining their breasts, and while breast cancer is not unknown among men, males should regularly check their testicles for lumps. It is important to get to know how your body parts normally feel and look, and report any changes, such as a lump, to your doctor. More often than not, lumps prove to be benign, and these types of cancer are usually curable if they're caught early enough.
8. Have regular smears/prostate tests
Women will usually be called once every three years for a smear test, and should make sure they attend when requested. Cervical screening probably prevents thousands of deaths each year. Prostate cancer is one of the most common forms of cancer in men and is second only to lung cancer as the biggest cancer killer. There are varying viewpoints about how often men should have a test and at what age. Testing should start at the age of 50, or at the age of 40 if in high-risk groups, such as black men or those with a father, brother or son with the disease. However, if you have any concerns go and visit your doctor.
9. Monitor your bowel behaviour
Any dramatic change in bowel habits such as an increase in constipation, or passing blood should be referred to a doctor immediately. It could prove be something as simple as piles (haemorrhoids), or worse case scenario could be bowel cancer, which is important to discover as early as possible.
10. Drink more water
Most people are unaware that the recommendation is that the average person should drink around eight glasses of water a day. The human body is made up of between 55 and 75 per cent water, and is in need of constant water replenishment. An increased intake of water will greatly enhance digestion‚ nutrient absorption‚ skin hydration‚ detoxification and virtually every aspect of better health.
11. Get more friends
Research suggests that friends help people live longer. Research in the Journal of Epidemiology and Community Health says that socialising with friends is beneficial. Good friends will promise to be there for you, and their presence can actually help you live longer, researchers say. Australian scientists said having friends around in old age can do more for life expectancy than having family members around, and that friends may encourage people to look after their health, and help reduce feelings of depression and anxiety at difficult times.
12. No smoking
Everyone is aware of the potential catastrophic effect of smoking. It is better not to start at all, but the sooner a smoker quits, the better. Because the damage caused by smoking is cumulative, the longer a person smokes the greater the risk of developing a smoking-related disease, such as lung cancer or heart disease. Quitting not only saves money, but also has added health benefits. Within one year after quitting, the risk of a heart attack falls to about half that of a smoker, and within 10 years, the risk of lung cancer falls to about half that of a smoker.
13. Relax
Relaxation reduces blood pressure and helps reduce stress-related conditions such as depression. A relaxation technique such as yoga or meditation can help reduce stress levels.
14. Get a pet
Owning a pet has a surprising amount of health benefits for the owner, according to a series of studies. Ownership of a pet, particularly a dog, means people are more active. Animals are known to reduce anxiety both from the actual physical comfort from stroking them, but also because they are a distraction and something pleasant to focus on. They are also good friends to many and provide a source of amusement, making us laugh.
15. Exercise more
Exercise is known to reduce the risk of heart disease, high blood pressure, osteoporosis, diabetes and obesity. It keeps joints, tendons and ligaments flexible, and contributes to mental well-being by helping treat depression,relive stress and anxiety. Exercise also aids better sleep. Even if you are pushed for time, exercise could be gained simply by walking up stairs rather than taking the elevator, or even try walking or cycling on shorter journeys rather than taking the car.
16. Eat more fruit and vegetables
Eating plenty of fruits and vegetables can help ward off heart disease and stroke, control blood pressure and cholesterol, and prevent some types of cancer. It is recommended to eat at least five servings of fruit and vegetables a day.
17. Change job
Research suggests a strong relationship between how long people live and the nature of their jobs. According to UK Government statistics, for the period 1997-99, life expectancy at birth in England and Wales for males in the professional group was 7.4 years more than that for those in the unskilled manual groups. The gap between the social classes was smaller for women than for men, at 5.7 years.
18. Have a happy marriage
Married people tend to have better health than unmarried people. For instance, married individuals tend to be able to have lower rates of alcoholism than their unmarried counterparts because they tend to offer encouragement, support, and protection from daily problems. They are also more able to handle stress better as a result. However, studies suggest that divorcing then remarrying actually increases the risk of dying prematurely.
19. Be optimistic
People with a positive outlook on life can actually live longer. Researchers found that optimistic people decreased their risk of early death by 50 per cent compared with those who leaned more towards pessimism.
20. Eat chocolate
Chocolate contains flavanoids and antioxidants which have positive health benefits. Flavanoids aid cardiovascular health, while antioxidants are believed to prevent or delay certain damage to the body’s cells and tissues. Dark chocolate is considered best as it contains more than twice as many antioxidants as a bar of milk chocolate, and has fewer calories.
No matter how many times I have written about vaccines the subject never fails to throw a harpoon through my heart. Just to know and see innocent children everywhere being attacked by pediatric doctors from the moment they are born is enough to shake a person to ones core.
A comprehensive evaluation of eight common childhood vaccines has found that any adverse effects from vaccines are very rare or very minor. The report, issued last week by a panel of experts assembled by the Institute of Medicine (IOM), said there is no evidence that childhood vaccines cause autism, diabetes, facial palsy or episodes of asthma. They are lying because scientifically it's impossible to conclude this. Several of the chemicals or heavy metals that are in vaccines are independently known to cause severe disease.
Mercury contamination causes autism, diabetes and many other chronic diseases and is even known under certain circumstances to cause sudden death. The aluminum that is in many vaccines is not a piece of cake either and the two together are 100 times more toxic than either alone.
The IOM says that these conclusions are based on the analysis of more than 1,000 research studies in peer-reviewed journals but they forget to mention that these research studies are heavily biased. The institute had been asked by the federal government to review whether or not the eight vaccines caused specific adverse effects as claimed by people seeking redress from a national vaccine injury compensation program. The government does not like paying out money to anyone injured by vaccines and they will fight tooth and nail against the unfortunate families who have been devastated by their vaccines.
The panel did find convincing evidence, its highest category of proof, that vaccines have been linked to adverse effects, including seizures and inflammation of the brain. It also found that a chickenpox vaccine could cause pneumonia, meningitis or hepatitis years later if the virus, normally suppressed by the immune system, re-emerged after the immune system had been weakened.
Vaccines are a cornerstone of modern medicine and that cornerstone weighs heavily on the honesty and intelligence of doctors everywhere. Parents SHOULD NOT take comfort in the report's conclusions about vaccine safety. Those inclined to seek ways to have their children evade mandatory vaccinations need to be assured that they are doing the right thing and that vaccination is absolutely the worst way to protect anyone from the risk of contracting dangerous diseases.
If you want to have a healthy child, stay away from vaccines! If you want to have a healthy pregnancy stay away from any OB/GYN doctors who have not the slightest idea of what they are doing to pregnant women and their unborn children when they inject them with unnecessary and dangerous vaccines. I was talking to a woman in her eighth month of pregnancy and she said it was too late for my warnings. Then she rattled off a long string of shots her doctor had prescribed for her.
Most doctors know little to nothing about nutrition and even less about toxicology. They have rubberstamped the elite class's dependency on using chemical, heavy metal and radioactive poisons to earn fortunes.
As I have been saying, we do not need to wait for a one-world government to make our collective lives miserable. The United Nations and the World Health Organization already dictate a unified policy across the globe. When we trust the wrong people we receive consequences that cause us pain and suffering and sometimes even the death of our children. You will never catch a mainstream media report talking about vaccine deaths even though they fit right into their “rare” category. The death of a few thousand kids is just too rare to mention for these monsters who have the bloodstreams of our young in their disgusting hands.
Can We Trust?
There is no reason that we should trust the powers that be especially when it has something to do with the field of medicine. Actually we cannot trust them at all and you can tell from the following video, the powers that be do not want us to challenge their cruel consensus reality and it eventually will get to the point where they will shoot us on sight for doing so.
The president speaks of facts. Would love to hear him explain the factors about World Trade Center building number seven and how that one came down on its own footprint with hardly a scratch on its structure. But there are fools everywhere who believe their own rhetoric and even worse fools who believe in and trust the most un-trustable people and organizations.
Newborn Deaths
Babies in the United States have a higher risk of dying during their first month of life than do babies born in 40 other countries, according to a new report. In 2009, an estimated 3.3 million babies died during their first four weeks of life. How many of these babies died from the vaccines given them and from those given to their mothers when still in the womb?
Newborn deaths would probably be vastly reduced if the doctors and nurses would leave the children alone, meaning stop the use of vaccines. Many years ago the Japanese stopped vaccinating children less than two years of age and the number of sudden deaths among the newborn dropped precipitously. The one-world medical government has deliberately forgotten all about that. They've gone the opposite direction by making sure fetuses feel their boot by injecting poisons into their mothers' bloodstreams, knowing full well how much of that will settle into the woman's womb.
We live in an obscene civilization run by obscene people and institutions. We as a people have been too wimpy in front of the growing plague of leaders who have sold their souls but lose very little sleep over it. We could have used a true holy war against these people, a war where people of all religions unite against all the ones at the top who have only profanities coming out of their mouths and hearts. They are the true enemy and it is amazing how deeply they reach into everyone's lives, even to those who are still resting quietly in the wombs of their mothers.
Stefan Molyneux speaks with Casey Research Managing Director David Galland about the debt situation but this can also be applied to the medical industrial complex. Stefan: So, we are seven-tenths of the way towards fascism in the United States. I wonder if you could expand upon that. David: Well, all the elements for fascism are in place. We have a monetary system that is accountable to no one and that's a very good start. Dr. Mark: We have a medical system that is accountable to no one, not even to medical science. What can we say about a medical science that supports the poisoning of men, women and children everywhere? What can we say about pediatricians, obstetricians and oncologists that lead the field in the harm they do to their fellow humans? All of these doctors have blood on their hands because they love to use the most poisonous substances known to man. They have violated their Hippocratic Oath to do no harm.
Contemporary medicine has sunk into a terrible darkness from which it cannot return.
(NaturalNews) Ask somebody about sunscreen and you're likely to receive an earful of disinformation from a person who has been repeatedly misinformed by health authorities and the mainstream media. Almost nothing you hear about sunscreen from traditional media channels is accurate. So here's a quick guide to the 7 most important things you need to know about sunscreen, sunlight and vitamin D:
#1) The FDA refuses to allow natural sunscreen ingredients to be used in sunblock / sunscreen products
It's true: If you create a truly natural sunscreen product using exotic botanicals with powerful sunscreen properties, you will never be able to market it as a "sunscreen" product. That's because the FDA decides what can be used as sunscreen and what can't, regardless of what really works in the real world. And there are really only two natural ingredients the FDA has allowed to be sold as sunscreen: Zinc oxide and titanium dioxide.
Any other non-chemical sunscreen ingredients, if sold as "sunscreen," would be considered mislabeled by the FDA and result in your products being confiscated... even if they offer fantastic sunscreen protection!
Not surprisingly, this whole monopoly over sunscreen chemicals is designed to protect the profits of the chemical companies while marginalizing the natural product companies which could easily formulate far better solutions. I have personally spoken to the founders of several health product companies who have figured out amazing sunscreen formulations using nothing but natural botanicals, but the FDA won't let them market their products as sunscreen products!
It's just another example of the FDA standing in the way of health innovation.
#2) Nearly all conventional sunscreen products contain cancer-causing chemicals
Read the ingredients list of any sunscreen product sold at Wal-Mart, or Walgreens, or any other mainstream store. I dare ya!
You will not be able to pronounce most of the chemicals found in the ingredients list. That's because most sunscreen products are formulated with cancer-causing fragrance chemicals, parabens, harsh alcohols, toxic chemical solvents and petroleum oils. A typical sunscreen product is actually a chemical assault on your body. That's why research shows that using sunscreen actually causes more cancer than it prevents (http://www.naturalnews.com/023317_s...).
#3) In a nation where over 70% of the population is vitamin D deficiency, sunscreen actually blocks vitamin D production
Vitamin D deficiency is perhaps the most widespread vitamin deficiency in North America. According to the research, 70 percent of whites are deficient in vitamin D, and up to 97 percent of blacks are deficient (http://www.naturalnews.com/030598_v...).
Chronic vitamin D deficiency promotes cancer (http://www.naturalnews.com/031560_v...), winter flu and infections, depression, osteoporosis and hormonal imbalances. Depending on whom you believe, vitamin D alone can prevent anywhere from 50% to nearly 80% of all cancers (http://www.naturalnews.com/021892.html).
By blocking vitamin D production in the skin, sunscreen products actually contribute to cancer-promoting nutritional deficiencies.
This doesn't mean you should never wear a sunscreen product, of course. If your skin is really pale and you're planning a day on the beach in Hawaii, you will obviously benefit from some level of sun protection using a truly natural sunscreen product. But an informed health-conscious person would try to allow their skin to achieve a natural, healthy tan (yes, a tan truly is healthy if it's combined with good nutrition, see below) through sensible exposure levels that activate vitamin D production in the skin.
#4) You can boost your internal sun resistance by changing what you eat
Here's the real secret about sun exposure that no one in conventional medicine is talking about (because, as usual, they are woefully ignorant about nutrition): You can boost your internal sunscreen by eating antioxidant-rich foods and superfoods.
The supplement astaxanthin, for example, is very well known for boosting your skin's natural resistance to sunburn. Its fat-soluble carotenoids are actually transported to skin cells where they protect those cells from UV exposure.
The more natural antioxidants you have in your diet, the more sunlight your skin will be able to handle without burning. Nearly everyone mistakenly believes that a person's sunlight burn response is purely a genetic factor. They're wrong. You can radically improve your resistance to UV exposure through radical dietary changes.
I'm a great example of this, actually, as I used to burn in just 20 - 30 minutes of sunlight when I was on a junk food diet years ago. But now, as someone who eats superfoods and high-end nutritional supplements every day, I can spend hours in the sun and will only turn slightly red (which fades a few hours later and does not result in a burn or skin peeling).
Except for one time on an all-day visit to a water park, I have not worn sunscreen in over 8 years. I spend a large amount of time in the sun, and I have absolutely no concerns whatsoever about skin cancer. My skin, most people tell me, looks significantly younger than my biological age. That's not from sunscreen; it's from nutrition. Sun exposure does not make your skin "age" if you follow a high-nutritional density diet.
#5) UV exposure alone does not cause skin cancer
It is a complete medical myth that "UV exposure causes skin cancer." This false idea is a total fabrication by the ignorant medical community (dermatologists) and the profit-driven sunscreen companies.
The truth is actually more complicated: Skin cancer can only be caused when UV exposure is combined with chronic nutritional deficiencies that create skin vulnerabilities.
To create skin cancer, in other words, you have to eat a junk food diet, avoid protective antioxidants, and then also experience excessive UV exposure. All three of those elements are required. Conventional medicine completely ignores the dietary influences and focuses entirely on just one factor: Sunscreen vs. no sunscreen. This is a one-dimensional approach to the issue that's grossly oversimplified to the point of being misleading.
The medical industry, it seems, does not want people to figure out they can literally eat their way to healthier skin. It's amazing, actually: Your skin is made entirely out of the food you eat, so how could your diet not affect your skin health? Yet no one in conventional medicine -- not the dermatologists, not the doctors and not the health regulators -- has the intellectual honesty to admit that what you eat largely determines how your skin reacts to UV exposure.
#6) Not all "natural" sunscreen products are really natural
Be careful when shopping for so-called "natural" sunscreen products. While there are some good ones out there, many are just examples of greenwashing, where they use terms like "natural" or "organic" but still contain loads of synthetic chemicals anyway.
A good guide for checking on sunscreen products is the Environmental Working Group guide (EWG) at: http://www.ewg.org/skindeep/
Some of the products that are truly natural include Loving Naturals sunscreen and Badger All Natural Sunscreen. Read the ingredients labels to see for yourself. Don't use any sunscreen product containing ingredients that sound like chemicals:
Always buy unscented sunscreen unless for some reason you just enjoy coating your skin with artificial perfume chemicals. A typical sunscreen product is made with over a dozen cancer-causing fragrance chemicals, and they're absorbed right through your skin. Most sunscreens, when applied as directed, are really just toxic chemical baths that heavily burden your liver and can give you cancer.
#7) Many "chemical free" sunscreens are loaded with chemicals
Search Amazon.com for "chemical free natural sunscreen" and you'll see a listing for:
Jason Natural Cosmetics - Earth's Best Sun Block Chemical Free, 4 oz cream
Click on the product and you'll find a listing of its ingredients which includes: C12-15 Alkyl Benzoate, Caprylic/Capric Triglyceride, Sorbitan Isostearate, Sorbitan Sesquioleate, Ethylhexyl Palmitate, Ethyl Macadamiate, Calcium Starch Octenylsuccinate, Stearalkonium Hectorite
So how are those not chemicals? Ethylhexyl Palmitate is NOT a chemical? Who are these people kidding? The Amazon.com description (title) of this product is false and misleading. In all fairness, however, this product title looks like it was added into the Amazon.com system by the vendor and not the Jason company itself. But it's an example of how the information you see from online vendors can often be misleading.
Always read the ingredients of any sunscreen product before using it. Don't poison yourself with sunscreen!
Beware the disinfo minefield surrounding sunscreen products
Perhaps more with sunscreen than any other personal care product, the "official" information distributed through the mainstream media is hopelessly misleading (if not downright false). Remarkably, no one in the media or the government is even willing to admit that fragrance chemicals are bad for your health. Similarly, no one is willing to admit that the chemicals you put on your skin get ABSORBED by your skin.
Without those two truths being acknowledged right up front, the rest of whatever they say about sunscreen is worthless babble. Any honest talk about sunscreen must acknowledge the simple truth that the chemicals you put on your skin get absorbed into your skin, and that most sunscreen products are made out of a chemical cocktail of cancer-causing substances.
This is the truth about sunscreen that both the sunscreen industry and the cancer industry doesn't want you to hear. It's the dirty little secret of sunscreen: The more you use, the more you CAUSE cancer in your body! (And the more money the cancer centers make "treating" your cancer with yet more deadly chemicals known as chemotherapy.)
So buyer beware. Sunscreen products are a minefield of lies, fraud and disinformation designed to keep you ignorant of the importance of sun exposure as well as the health risks associated with using cancer-causing chemicals on your skin.
Stick with truly natural sunscreen products (when needed) and try to build up a healthy tan while consuming large quantities of superfoods and antioxidants in your diet. Consider taking astaxanthin or other fat-soluble nutrients on a regular basis. Engage in daily juicing of fresh fruits and vegetables which are loaded with living nutrients. Time your sun exposure to build up a healthy tan so that you don't need sunscreen at all. Contrary to all the misinformation we've all been fed, a healthy tan is actually a good sign that you're achieving adequate vitamin D synthesis in your own skin.
Using a laptop connected to the internet via Wi-Fi can potentially damage sperm, a study suggests.
Sperm samples placed beneath a laptop with a wireless internet connection for just four hours were found to have reduced motility and more DNA damage compared with other samples stored under the same conditions but away from the laptop.
The study, published in the journal Fertility and Sterility, collected sperm samples from 29 healthy men, aged 26 to 45. Each of the samples were then separated into two pots.
One set of samples was placed beneath a laptop connected to the internet via Wi-Fi as it downloaded information, while the other set was stored under identical conditions - including temperature - but away from the computer.
The researchers found that exposure to the laptop resulted in a significant decrease in sperm motility and a significant increase in DNA fragmentation.
Around 25 per cent of the sperm in samples exposed to the laptop stopped swimming compared with 14 per cent of those kept away from the computer.
Similarly around nine per cent of the sperm exposed to the laptop showed DNA damage compared with three per cent in the control samples.
The researchers, from Eastern Virginia Medical School and the Nascentis Centre for Reproductive Medicine in Cordoba, Argentina, suggest that the electromagnetic radiation, and not heat, given out by the laptop was the cause.
In the study, the laptop connected to Wi-FI emitted 7 - 15 times more electromagnetic radiation than background levels, they said.
"Our data suggest that the use of a laptop computer wirelessly connected to the internet and positioned near the male reproductive organs may decrease human sperm quality, they wrote.
"At present we do not know whether this effect is induced by all laptop computers connected by Wi-Fi to the internet or what conditions heighten this effect."
The scientists concluded: "The mechanisms mediating the decrease in sperm motility and DNA integrity also need further study."
Older people who are happy tend to live longer, according to new research.
A five year study of nearly 4,000 people aged 52 to 79 found that those who rated themselves the most happy had a 35 per cent lower risk of dying compared with those who were the least happy.
Past research which has investigated the links between longevity and emotional state have relied on how well people were able to recall how happy (or not) they felt in the past, and so were dependent on memory, which can decline with age.
However, in this study, researchers from University College London asked men and women aged 52 to 79 to rate their feelings of happiness or anxiety four times over the course of a single day.
After taking into account age, gender, depression, certain diseases, and health-related behaviour such as smoking and physical activity, the researchers found that people who reported feeling happiest were 35 per cent less likely to die within the next five years.
Negative emotions such as anxiety appeared to have little effect on how long someone lived.
Although the results showed that happiness is correlated with a longer life, it does not mean that feeling happy will make you live longer, the researchers said.
Nonetheless, they say the findings highlight the importance of emotional well-being among older people.
As one of the Golden Girls memorably put it: “The older you get, the better you get, unless you’re a banana.”
So there’s no need to let yourself go soft and soggy just because you’ve passed retirement.
The core tenets of any healthy lifestyle may be the same for all ages – good diet, exercise, cut down alcohol and don’t smoke. But for the older generations there are extra steps you can take to keep yourself fit well into your golden years.
And the rewards are plentiful: bags of energy, reduced risks of mobility problems and illnesses such as heart disease, stroke and cancer, not to mention an active sex life…
With The 50+ Show - the largest exhibition for mature visitors in the UK - coming to Glasgow this weekend (November 11-12) we show you how to maintain that vim and vigour for years to come:
Keep checking
Prevention is better than cure. As the Department of Health points out: "Taking full advantage of health checks and services could help keep you up and running for longer. You might be years away from worries about mobility, but accessing services now is the best way to help protect your independence in the future."
They include regular sight tests, free every two years for those in their 60s and yearly for those 70-plus. Getting your eyes checked can help catch conditions such as glaucoma – a cause of blindness if left untreated - early on.
There are also regular free screenings for cancers, such as breast checks for the over-50s and bowel checks for the over-60s.
Get fit feet
Looking after your feet is key to living an independent, active life. If you neglect them you are more likely to develop conditions such as blisters, corns and infections, plus foot problems can quickly lead to knee, hip and back pain.
Podiatrist Emma Supple says: "Go to see a professional for a foot MOT every six months and never put up with foot pain as if it is normal. Your feet shouldn’t hurt."
If you are having any problems, see your GP as they can refer you to a chiropodist or podiatrist on the NHS.
Otherwise, make sure you regularly cut and file your nails, keep skin moisturised, check for inflammation, cracks or signs of infection like nail fungus and keep your feet clean, dry, mobile and warm.
Stay immune
At 65 you can ask for a free vaccination to reduce the risk of catching flu, as well as another that offers protection against infections such as pneumonia, septicaemia and meningitis. Ask your GP for advice.
Get moving
Adults aged 65 and over spend an average minimum of 10 hours a day sitting or lying down. But inactivity can lead to higher rates of falls, obesity, depression, heart disease and more.
“As people get older and their bodies decline in function, physical activity helps to slow that decline,” says health promotion consultant Dr Nick Cavill.
Make sure you get 150 minutes’ exercise each week – and that doesn’t mean shopping, cooking or housework. The effort must be enough to increase your heart rate.
So go for brisk walks, take up water aerobics, play doubles tennis or push a lawn mower to get the blood pumping. And include muscle-strengthening activities such as yoga or pilates.
Eat well
Whatever your age, a balanced diet is important. But there are some specific tips for the over-50s:
Digestive problems can get worse with age, so eat fibre-rich foods, e.g. brown pasta, whole-grain rice and lentils.
Iron gives energy, so go for lean red meat (though no more than 70g a day), oily fish, eggs and green vegetables.
Calcium-rich foods help stave off osteoporosis, so good sources are low fat milk, cheese and yoghurt as well as soya, broccoli and cabbage.
Also cut salt to reduce blood pressure and try not to eat liver products more than once a week as it can lead to too much vitamin A, increasing the risk of bone fracture.
If your appetite is lacking, as can often happen as we get older, make sure you eat smaller meals more often and supplement them with snacks such as fruit, nuts and whole-grain toast.
Get some lovin’
It’s important to keep tabs on your relationship over 50. As circumstances change, children move out, retirement looms, relationships can suffer.
Don’t let complacency sink in – get to know your partner all over again by arranging trips out, making time to talk about your hopes for the future and taking up new pursuits together such as dancing or visiting the theatre.
And, as the NHS Live Well site notes: “Injecting a little passion into your life will put a spring in your step and keep you feeling young. Take time to enjoy and appreciate each other.”
Do something new
Don’t let life get routine and mundane - draw up a list of things you have always wanted to do or see, and try to tick at least one new thing off every few months. For instance, visit a city you’ve never been to, take up a hobby such as pottery or ballroom dancing, or enrol in evening classes or a degree course.
Get brain fit
Not going to work doesn’t mean your brain has to retire, too. Keep mentally fit by playing crosswords or Sudoku, taking up meditation, reading more and watching TV less, and learning a foreign language.
Contraceptive pill use is associated with an increased risk of prostate cancer around the world, according to new research.
A study published in the British Medical Journal Open found that countries with a high proportion of women taking the pill also had higher rates of prostate cancer.
Researchers from the University of Toronto suggest that by-products of oestrogen, excreted in the urine of women taking the pill, may have entered the water supply and contaminated the food chain, boosting the risk of prostate cancer.
The study analysed data from the International Agency for Research on Cancer (IARC) and the United Nations World Contraceptive Use report to pinpoint rates of prostate cancer and associated deaths.
This was then compared with the proportion of women using common methods of contraception for 2007 to find out if there was any link between the use of the contraceptive pill and illness and death caused by prostate cancer, in individual countries and continents as a whole.
Their calculations showed that the use of the coil, condoms, or other barrier methods was not associated with an increased risk of prostate cancer.
But use of the pill in the population as a whole was significantly associated with both the number of new cases of, and deaths from, prostate cancer in individual countries around the world, the analysis showed.
The findings were not affected by a nation's wealth.
However, the study authors stressed that the research is speculative and does not confirm cause and effect, and so definite conclusions cannot be drawn. They also added that further research was needed to look into the issue.
But they also pointed to several recent studies which have suggested that oestrogen exposure may boost the risk of prostate cancer.
Excess oestrogen exposure is known to cause cancer, and it is thought that widespread use of the Pill might raise environmental levels of endocrine disruptive compounds (EDCs) - which include by-products of oral contraceptive metabolism.
These don’t break down easily, so can be passed into the urine and end up in the drinking water supply or the food chain, exposing the general population, the authors said.
Prostate cancer is the most common male cancer in the developed world and use of the contraceptive pill has soared over the past 40 years.
The authors wrote: "Temporal increases in the incidence of certain cancers (breast, endometrial, thyroid, testis and prostate) in hormonally sensitive tissues in many parts of the industrialised world are often cited as evidence that widespread exposure of the general population to EDCs has had adverse impacts on human health."
Dreaming may help people cope with the pain of difficult memories, research suggests.
US researchers found that brain chemicals associated with stress fall during the dream phase of sleep - REM sleep - as the brain processes emotional experiences.
This shut down in stress chemistry helps to ease the pain associated with difficult memories, and acts as a type of "overnight therapy," said researchers at University of California, Berkeley.
In addition to providing clues into why we dream, the researchers say the study may help to explain some of the symptoms of post-traumatic stress disorder (PTSD), such as recurring nightmares. For people with PTSD, this overnight therapy may not be working as effectively as it should, they said.
The researchers divided 35 volunteers into two groups. Both groups were shown 150 images designed to provoke an emotional response, while a MRI scanner measured brain activity.
The first group viewed the images in the morning and in the evening, while the second group viewed them in the evening and the following morning after a full night's sleep.
The group which viewed the images after a night's sleep reported reduced emotional reactions to the images, compared with the group of non-sleepers.
In the group of non-sleepers, the MRI scans also showed less activity in the amygdala, a part of the brain that processes emotions, and more activity in the brain's pre-frontal cortex - the part associated with rational thinking.
The researchers also used electroencephalograms to record the electrical activity of the volunteers' brains as they slept. During REM sleep, certain electrical activity patterns decreased, which suggested that levels of stress neuro-chemicals in the brain were reduced.
Dr Matthew Walker, who led the study, said: "We know that during REM sleep there is a sharp decrease in levels of norepinephrine, a brain chemical associated with stress.
"By reprocessing previous emotional experiences in this neuro-chemically safe environment of low norepinephrine during REM sleep, we wake up the next day, and those experiences have been softened in their emotional strength. We feel better about them, we feel we can cope."
Repeatedly taking slightly too much paracetamol over time can lead to an overdose that is difficult to spot, but puts the person in danger of dying, researchers have warned.
Paracetamol is a widely used painkiller, and is easily available over the counter in pharmacies, supermarkets and other outlets.
If a person takes a large amount at one time it can be dangerous - if not fatal - and medical workers are trained to spot the symptoms of such overdoses, which are a common form of attempted suicide.
But now researchers have found that people who continuously take slightly too much of the drug on each occasion could be putting themselves at risk without showing any of the standard symptoms of a paracetamol overdose.
Researchers at the University of Edinburgh and the Scottish Liver Transplantation Unit looked at over 650 cases of patient admissions with paracetamol induced liver damage to the Royal Infirmary of Edinburgh over a 16 year period.
Of these, over 160 had taken a so-called "staggered" overdose, usually to relieve a range of common aches and pains, such as headaches, toothaches or muscular pains.
Study leader Dr Kenneth Simpson said that in such cases, "they haven't taken the sort of single-moment, one-off massive overdoses taken by people who try to commit suicide, but over time the damage builds up, and the effect can be fatal."
"On admission, these staggered overdose patients were more likely to have liver and brain problems, require kidney dialysis or help with breathing and were at a greater risk of dying than people who had taken single overdoses" he added.
For emergency workers the problem is that they have been trained to asses the patient's condition by taking a blood sample and finding out how much paracetamol is present. In the case of a single overdose this is helpful, but when people have been taking too much over a period of time they may have low levels of the drug in their bloodstream even though they are at a high level of risk of kidney failure and death.
"Staggered overdoses or patients presenting late after an overdose need to be closely monitored and considered for the paracetamol antidote, N-acetylcysteine, irrespective of the concentration of paracetamol in their blood," said Dr Simpson.
The study, published in the British Journal of Clinical Pharmacology, calls for more work to find new ways of assessing whether a patient can be sent home, needs medical treatment to counteract the paracetamol, or needs to be considered for a liver transplant.
Diabetes is a chronic (lifelong) disease marked by high levels of sugar in the blood.
Causes, incidence, and risk factors
Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both.
To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested:
A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body.
An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.
People with diabetes have high blood sugar. This is because:
Their pancreas does not make enough insulin
Their muscle, fat, and liver cells do not respond to insulin normally
Both of the above
There are three major types of diabetes:
Type 1 diabetes is usually diagnosed in childhood. Many patients are diagnosed when they are older than age 20. In this disease, the body makes little or no insulin. Daily injections of insulin are needed. The exact cause is unknown. Genetics, viruses, and autoimmune problems may play a role.
Type 2 diabetes is far more common than type 1. It makes up most of diabetes cases. It usually occurs in adulthood, but young people are increasingly being diagnosed with this disease. The pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to insulin. Many people with type 2 diabetes do not know they have it, although it is a serious condition. Type 2 diabetes is becoming more common due to increasing obesity and failure to exercise.
Gestational diabetes is high blood glucose that develops at any time during pregnancy in a woman who does not have diabetes. Women who have gestational diabetes are at high risk of type 2 diabetes and cardiovascular disease later in life.
Diabetes affects more than 20 million Americans. Over 40 million Americans have prediabetes (early type 2 diabetes).
There are many risk factors for type 2 diabetes, including:
Age over 45 years
A parent, brother, or sister with diabetes
Gestational diabetes or delivering a baby weighing more than 9 pounds
Patients with type 1 diabetes usually develop symptoms over a short period of time. The condition is often diagnosed in an emergency setting.
Symptoms of type 2 diabetes:
Blurred vision
Fatigue
Increased appetite
Increased thirst
Increased urination
Signs and tests
A urine analysis may be used to look for glucose and ketones from the breakdown of fat. However, a urine test alone does not diagnose diabetes.
The following blood tests are used to diagnose diabetes:
Fasting blood glucose level -- diabetes is diagnosed if higher than 126 mg/dL on two occasions. Levels between 100 and 126 mg/dL are referred to as impaired fasting glucose or prediabetes. These levels are considered to be risk factors for type 2 diabetes and its complications.
Oral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours. (This test is used more for type 2 diabetes.)
Persons with diabetes need to have their hemoglobin A1c (HbA1c) level checked every 3 - 6 months. The HbA1c is a measure of average blood glucose during the previous 2 - 3 months. It is a very helpful way to determine how well treatment is working.
Treatment
The immediate goals are to treat diabetic ketoacidosis and high blood glucose levels. Because type 1 diabetes can start suddenly and have severe symptoms, people who are newly diagnosed may need to go to the hospital.
How to test urine for ketones (type 1 diabetes only)
How to adjust insulin or food intake when changing exercise and eating habits
How to handle sick days
Where to buy diabetes supplies and how to store them
After you learn the basics of diabetes care, learn how the disease can cause long-term health problems and the best ways to prevent these problems. Review and update your knowledge, because new research and improved ways to treat diabetes are constantly being developed.
SELF-TESTING
If you have diabetes, your doctor may tell you to regularly check your blood sugar levels at home. There are a number of devices available, and they use only a drop of blood. Self-monitoring tells you how well diet, medication, and exercise are working together to control your diabetes. It can help your doctor prevent complications.
The American Diabetes Association recommends keeping blood sugar levels in the range of:
80 - 120 mg/dL before meals
100 - 140 mg/dL at bedtime
Your doctor may adjust this depending on your circumstances.
WHAT TO EAT
You should work closely with your health care provider to learn how much fat, protein, and carbohydrates you need in your diet. A registered dietician can help you plan your dietary needs.
People with type 1 diabetes should eat at about the same times each day and try to be consistent with the types of food they choose. This helps to prevent blood sugar from becoming extremely high or low.
People with type 2 diabetes should follow a well-balanced and low-fat diet.
Medications to treat diabetes include insulin and glucose-lowering pills called oral hypoglycemic drugs.
People with type 1 diabetes cannot make their own insulin. They need daily insulin injections. Insulin does not come in pill form. Injections are generally needed one to four times per day. Some people use an insulin pump. It is worn at all times and delivers a steady flow of insulin throughout the day. Other people may use inhaled insulin. See also: Type 1 diabetes
Unlike type 1 diabetes, type 2 diabetes may respond to treatment with exercise, diet, and medicines taken by mouth. There are several types of medicines used to lower blood glucose in type 2 diabetes. See also: Type 2 diabetes
Regular exercise is especially important for people with diabetes. It helps with blood sugar control, weight loss, and high blood pressure. People with diabetes who exercise are less likely to experience a heart attack or stroke than those who do not exercise regularly.
Here are some exercise considerations:
Always check with your doctor before starting a new exercise program.
Ask your doctor or nurse if you have the right footwear.
Choose an enjoyable physical activity that is appropriate for your current fitness level.
Exercise every day, and at the same time of day, if possible.
Carry food that contains a fast-acting carbohydrate in case you become hypoglycemic during or after exercise.
Carry a diabetes identification card and a cell phone in case of emergency.
Drink extra fluids that do not contain sugar before, during, and after exercise.
You may need to change your diet or medication dose if you change your exercise intensity or duration to keep blood sugar levels from going too high or low.
FOOT CARE
People with diabetes are more likely to have foot problems. Diabetes can damage blood vessels and nerves and decrease the body's ability to fight infection. You may not notice a foot injury until an infection develops. Death of skin and other tissue can occur.
If left untreated, the affected foot may need to be amputated. Diabetes is the most common condition leading to amputations.
To prevent injury to the feet, check and care for your feet every day.
With good blood glucose and blood pressure control, many of the complications of diabetes can be prevented.
Studies have shown that strict control of blood sugar, cholesterol, and blood pressure levels in persons with diabetes helps reduce the risk of kidney disease, eye disease, nervous system disease, heart attack, and stroke.
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of ketoacidosis:
Abdominal pain
Deep and rapid breathing
Increased thirst and urination
Loss of consciousness
Nausea
Sweet-smelling breath
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of extremely low blood sugar (hypoglycemic coma or severe insulin reaction):
There is no effective screening test for type 1 diabetes in people who don't have symptoms.
Screening for type 2 diabetes and people with no symptoms is recommended for:
Overweight children who have other risk factors for diabetes starting at age 10 and repeating every 2 years
Overweight adults (BMI greater than 25) who have other risk factors
Adults over 45, repeated every 3 years
To prevent complications of diabetes, visit your health care provider or diabetes educator at least four times a year. Talk about any problems you are having.
Regularly have the following tests:
Have your blood pressure checked every year (blood pressure goals should be 130/80 mm/Hg or lower).
Have your glycosylated hemoglobin (HbA1c) checked every 6 months if your diabetes is well controlled, otherwise every 3 months.
Visit your ophthalmologist (preferably one who specializes in diabetic retinopathy) at least once a year, or more often if you have signs of diabetic retinopathy.
See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.
Make sure your health care provider inspects your feet at each visit.
Diabetes Mellitus, Type 2-Definition
Type 2 diabetes is a chronic (lifelong) disease marked by high levels of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes.
Symptoms
Often, people with type 2 diabetes have no symptoms at all. If you do have symptoms, they may include:
Diabetes is caused by a problem in the way your body makes or uses insulin. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy.
When you have type 2 diabetes, the body does not respond correctly to insulin. This is called insulin resistance. Insulin resistance means that fat, liver, and muscle cells do not \respond normally to insulin. As a result blood sugar does not get into cells to be stored for energy.
When sugar cannot enter cells, abnormally high levels of sugar build up in the blood. This is called hyperglycemia. High levels of blood sugar often trigger the pancreas to produce more and more insulin, but it not enough to keep up with the body's demand.
People who are overweight are more likely to have insulin resistance, because fat interferes with the body's ability to use insulin.
Type 2 diabetes usually occurs gradually. Most people with the disease are overweight at the time of diagnosis. However, type 2 diabetes can also develop in those who are thin, especially the elderly.
Family history and genetics play a large role in type 2 diabetes. Low activity level, poor diet, and excess body weight (especially around the waist) significantly increase your risk for type 2 diabetes.
Oral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours.
Random (non-fasting) blood glucose level -- diabetes is suspected if higher than 200 mg/dL and accompanied by the classic symptoms of increased thirst, urination, and fatigue (this test must be confirmed with a fasting blood glucose test).
You should see your health care provider every 3 months. At these visits, you can expect your health care provider to::
How to recognize and treat low and high blood sugar
How to handle sick days
Where to buy diabetes supplies and how to store them
It may take several months to learn the basic skills. Always continue to educate yourself about the disease and its complications. Learn how to control and live with diabetes. Over time, stay current on new research and treatment.
SELF-TESTING
Self testing refers to being able to check your blood sugar at home yourself. It is also called self-monitoring of blood glucose (SMBG). Regular self-testing of your blood sugar tells you and your health care provider how well your diet, exercise, and diabetes medications are working.
A device called a glucometer can provide an exact blood sugar reading. There are different types of devices. Usually, you prick your finger with a small needle called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the device. Results are available in 30 - 45 seconds.
A health care provider or diabetes educator will help set up an at-home testing schedule for you. Your doctor will help you set your blood sugar goals.
Most people with type 2 diabetes only need to check their blood sugar once or twice a day.
If your blood sugar levels are under control, you may only need to check them a few times a week.
Tests may be done when you wake up, before meals, and at bedtime.
More frequent testing may be needed when you are sick or under stress.
The results of the test can be used to adjust meals, activity, or medications to keep your blood sugar levels in an appropriate range. Testing can identify high and low blood sugar levels before serious problems develop.
Keeping a record for yourself and your health care provider. This will be a big help if you are having trouble managing your diabetes.
DIET AND WEIGHT CONTROL
People with type 2 diabetes should eat at about the same times each day and try to be consistent with the types of food they choose. This helps to prevent blood sugar from becoming extremely high or low. Meal planning includes choosing healthy foods, eating the right amount of food, and eating meals at the right time. You should work closely with your doctor, nurse, and registered dietitian to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your daily lifestyle and habits, and should try to include foods that you like.
Managing your weight and eating a well-balanced diet are important. Some people with type 2 diabetes can stop taking medications after losing weight (although they still have diabetes). See: Diabetes diet
Bariatric (weight loss) surgery may be considered for very overweight patients who are not well managed with diet and medications. See:
Regular exercise is important for everyone, but especially if you have diabetes. Regular aerobic exercise lowers your blood sugar level without medication and helps burn excess calories and fat so you can manage your weight.
Exercise can help your overall health by improving blood flow and blood pressure. It decreases insulin resistance even without weight loss. Exercise also increases the body's energy level, lowers tension, and improves your ability to handle stress.
Consider the following when starting an exercise routine:
Always check with your health care provider before starting an exercise program.
Ask your health care provider whether you have the right footwear.
Choose an enjoyable physical activity that is appropriate for your current fitness level.
Exercise every day, and at the same time of day, if possible.
Monitor blood glucose levels at home before and after exercise.
Carry food that contains a fast-acting carbohydrate in case blood glucose levels get too low during or after exercise.
Wear a diabetes identification bracelet and carry a cell phone in case of emergency.
Drink extra fluids that do not contain sugar before, during, and after exercise.
You may need to modify your diet or medication if you exercise longer or more intensely, to keep blood glucose levels in the correct range.
MEDICATIONS TO TREAT DIABETES
If diet and exercise do not help maintain normal or near-normal blood glucose levels, your doctor may prescribe medication. Since these drugs help lower your blood sugar levels in different ways, your doctor may have you take more than one. These drugs may also be given along with insulin, if needed.
Some of the most common types of medication are listed below. They are taken by mouth or injection.
Biguanides (Metformin) tell the liver to produce less glucose and help muscle and fat cells and the liver absorb more glucose from the bloodstream. This lowers blood sugar levels.
Sulfonylureas (like glimepiride, glyburide, and tolazamide) trigger the pancreas to make more insulin. They are taken by mouth.
Thiazolidinediones (such as rosiglitazone) help muscle and fat cells and the liver absorb more blood sugar when insulin is present. Rosiglitazone may increase the risk of heart problems. Talk to your doctor.
Injectible medications (including exenatide and pramlintide) can lower blood sugar.
Meglitinides (including repaglinide and nateglinide) trigger the pancreas to make more insulin in response to the level of glucose in the blood.
Alpha-glucosidase inhibitors (such as acarbose) decrease the absorption of carbohydrates from the digestive tract to lower after-meal glucose levels.
If you continue to have poor blood glucose control despite lifestyle changes and taking medicines by mouth, your doctor will prescribe insulin. Insulin may also be prescribed if you have had a bad reaction to other medicines. Insulin must be injected under the skin using a syringe or insulin pen device. It cannot be taken by mouth.
Insulin preparations differ in how fast they start to work and how long they work. Your healthcare provider will determine the appropriate type of insulin to use and will tell you what time of day to use it.
More than one type may be mixed together in an injection to achieve the best blood glucose control. Usually injections are needed one to four times a day. Your doctor or diabetes educator will show you how to give yourself an injection.
Some people with type 2 diabetes find they no longer need medication if they lose weight and increase activity. When they reach their ideal weight, their own insulin and a careful diet can control their blood glucose levels.
It is not known whether hypoglycemia medications taken by mouth are safe for use in pregnancy. Women who have type 2 diabetes and take these medications may be switched to insulin during pregnancy and while breastfeeding.
MEDICATIONS TO PREVENT COMPLICATIONS
Since those with diabetes have a much higher chance of developing heart disease, kidney disease, and other medical problems, they may need to take certain medicines to treat these problems or prevent them from happening.
Statin drugs are usually the first choice to treat an abnormal cholesterol level. Aim for LDL cholesterol level less than 100 mg/dL.
Aspirin to prevent heart disease is most often recommended for persons with diabetes who:
Are 40 or older
Have a history of heart problems
Have a family history of heart disease
Have high blood pressure or high cholesterol
Smoke
FOOT CARE
People with diabetes are more likely to have foot problems. Diabetes can damage nerves, which means you may not feel an injury to the foot until a large sore or infection develops. Diabetes can also damage blood vessels.
In addition, diabetes affects the body's immune system. This decreases the body's ability to fight infection. Small infections can quickly get worse and cause the death of skin and other tissues. Amputation may be needed.
To prevent injury to the feet, check and care for your feet every day.
Drugs
Children with type 1 diabetes need daily injections of insulin to help their bodies use glucose. The amount and type of insulin required depends on the height, weight, age, food intake, and activity level of the individual diabetic patient. Some patients with type 2 diabetes may also need to use insulin injections if their diabetes cannot be controlled with diet, exercise, and oral medication. Injections are given subcutaneously, that is, just under the skin, using a small needle and syringe, an insulin pen injector, an insulin infusion pump, or a jet injector device. Injection sites can be anywhere on the body where there is a layer of fat available, including the upper arm, abdomen, or upper thigh.
Insulin may be given as an injection of a single dose of one type of insulin once a day, or different types of insulin can be mixed and given in one dose or split into two or more doses during a day. Patients who require multiple injections over the course of a day may be able to use an insulin pump that administers small doses of insulin on demand. The small battery-operated pump is worn outside the body and is connected to a cannula (a thin, flexible plastic tube) that is inserted into the abdomen called an insertion set. Pumps are programmed to infuse a small, steady infusion of insulin (called a basal dose) throughout the day, and larger doses (called boluses) before meals. Because of the basal infusion, pumps can offer many children much tighter control over their blood glucose levels and more flexibility with their diet than insulin shots afford them.
Regular insulin is fast-acting and starts to work within 15 to 30 minutes, with its peak glucose-lowering effect about two hours after it is injected. Its effects last for about four to six hours. NPH (neutral protamine Hagedorn) and Lente insulin are intermediate-acting, starting to work within one to three hours and lasting up to 18 to 26 hours. Ultra-lente is a long-acting form of insulin that starts to work within four to eight hours and lasts 28 to 36 hours. Peakless, or basal-action insulin (insulin glargine, or Lantus) starts working in 15 minutes and has a duration of between 18 and 26 hours.
Complications
After many years, diabetes can lead to serious problems with your eyes, kidneys, nerves, heart, blood vessels, and other areas in your body.
If you have diabetes, your risk of a heart attack is the same as someone who has already had a heart attack. Both women and men with diabetes are at risk. You may not even have the typical signs of a heart attack.
Nerve damage, which causes pain and numbness in the feet, as well as a number of other problems with the stomach and intestines, your heart, and other body organs (See: Diabetic neuropathy)
Foot sores or ulcers, which can result in amputation
Overweight children who have other risk factors for diabetes, starting at age 10 and repeating every 2 years
Overweight adults (BMI greater than 25) who have other risk factors
Adults over 45 every 3 years
You can help prevent type 2 diabetes by keeping a healthy body weight and an active lifestyle.
To prevent complications of diabetes, visit your health care provider or diabetes educator at least four times a year. Talk about any problems you are having.
Stay up-to-date with all your vaccinations and get a flu shot every year.
To prevent diabetes-related foot problems, you should:
Get a foot exam by your health care provider at least twice a year and learn whether you have nerve damage.
Check and care for your feet EVERY DAY, especially if you already have known nerve or blood vessel damage or current foot problems. Follow the instructions below.
Make sure you are wearing the right kind of shoes.
Diabetes Mellitus, Type 1-Definition
Type 1 diabetes is a chronic (lifelong) disease that occurs when the pancreas does not produce enough insulin to properly control blood sugar levels.
Definition
Type 1 diabetes is a chronic (lifelong) disease that occurs when the pancreas does not produce enough insulin to properly control blood sugar levels.
Losing the feeling or feeling tingling in your feet
For others, warning symptoms that they are becoming very sick may be the first signs of type 1 diabetes, or may happen when the blood sugar is very high (see: diabetic ketoacidosis):
There are several forms of diabetes. Type 1 diabetes used to be called juvenile or insulin-dependent diabetes. Type 1 diabetes can occur at any age, but it is most often diagnosed in children, adolescents, or young adults.
Insulin is a hormone produced by special cells, called beta cells, in the pancreas, an organ located in the area behind your stomach. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy. In type 1 diabetes, these cells produce little or no insulin.
Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. The body is unable to use this glucose for energy. This leads to the symptoms of type 1 diabetes.
Within 5 - 10 years, the insulin-producing beta cells of the pancreas are completely destroyed and the body can no longer produce insulin.
The exact cause is unknown, but most likely there is a viral or environmental trigger in genetically susceptible people that causes an immune reaction. The body's white blood cells mistakenly attack the insulin-producing pancreatic beta cells.
Tests & Diagnostics
Diabetes is diagnosed with the following blood tests:
Fasting blood glucose level -- diabetes is diagnosed if it is higher than 126 mg/dL on two occasions
Random (nonfasting) blood glucose level -- diabetes is suspected if it is higher than 200 mg/dL, and the patient has symptoms such as increased thirst, urination, and fatigue (this must be confirmed with a fasting test)
Oral glucose tolerance test -- diabetes is diagnosed if the glucose level is higher than 200 mg/dL after 2 hours.
Ketone testing is also used in type 1 diabetes. Ketones are produced by the breakdown of fat and muscle. They are harmful at high levels. The ketone test is done using a urine sample. Ketone testing is usually done at the following times:
Visit your ophthalmologist at least once a year, or more often if you have signs of diabetic retinopathy.
See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.
Treatments
The immediate goals of treatment are to treat diabetic ketoacidosis and high blood glucose levels. Because type 1 diabetes can come on suddenly and the symptoms can be severe, newly diagnosed people may need to stay in the hospital.
How to adjust insulin and food intake during exercise
How to handle sick days
Where to buy diabetes supplies and how to store them
INSULIN
Insulin lowers blood sugar by allowing it to leave the bloodstream and enter cells. Everyone needs insulin. People with type 1 diabetes can't make their own insulin. They must take insulin every day.
Insulin is usually injected under the skin. In some cases, a pump delivers the insulin continuously. Insulin does not come in pill form.
Insulin preparations differ in how fast they start to work and how long they last. The health care professional will review your blood glucose levels to determine the appropriate type of insulin you should use. More than one type of insulin may be mixed together in an injection to achieve the best blood glucose control.
The injections are needed, in general, from one to four times a day. People are taught how to give insulin injections by their health care provider or a diabetes nurse educator. At first, a child's injections may be given by a parent or other adult. By age 14, most children can be expected (but should not be required) to give their own injections.
People with diabetes need to know how to adjust the amount of insulin they are taking in the following situations:
When they exercise
When they are sick
When they will be eating more or less food and calories
When they are traveling
DIET
People with type 1 diabetes should eat at about the same times each day and try to be consistent with the types of food they choose. This helps to prevent blood sugar from becoming extremely high or low. (See: Diabetes diet)
The American Diabetes Association and the American Dietetic Association have information for planning healthy, balanced meals. It can help to talk with a registered dietitian or nutrition counselor.
PHYSICAL ACTIVITY
Regular exercise helps control the amount of sugar in the blood. It also helps burn excess calories and fat to achieve a healthy weight.
Ask your health care provider before starting any exercise program. Those with type 1 diabetes must take special precautions before, during, and after intense physical activity or exercise.
Always check with your doctor before starting a new exercise program.
Ask your doctor or nurse if you have the right footwear.
Choose an enjoyable physical activity that is appropriate for your current fitness level.
Exercise every day and at the same time of day, if possible.
Monitor your blood glucose levels at home before and after exercising.
Carry food that contains a fast-acting carbohydrate in case your blood glucose levels get too low during or after exercise.
Wear a diabetes identification bracelet and carry a cell phone to use in case of emergency.
Drink extra fluids that do not contain sugar before, during, and after exercise.
As you change the intensity or duration of your exercise, you may need to modify your diet or medication to keep your blood glucose levels in an appropriate range.
SELF-TESTING
Self-testing refers to being able to check your blood sugar at home yourself. Regular self-testing of your blood sugar tells you and your health care provider how well your diet, exercise, and diabetes medications are working. This is also called self-monitoring of blood glucose, or SMBG.
A health care provider or diabetes educator will help set up a testing schedule for you at home.
Your doctor will help you set a goal for what level your blood sugar should be during the day.
The results can be used to adjust meals, activity, or medications to keep blood sugar levels within an appropriate range. Tests are usually done before meals and at bedtime. More frequent testing may be needed when you are sick, under stress, or adjusting your insulin dosing.
Testing will provide valuable information so the health care provider can suggest improvements to your care and treatment. Testing will identify high and low blood sugar levels before serious problems develop.
A device called a glucometer can provide a blood sugar reading. There are different types of devices. Usually, you prick your finger with a small needle called a lancet to get a tiny drop of blood. You place the blood on a test strip and put the strip into the device. You should have results within 30 - 45 seconds.
Keeping accurate records of your test results will help you and your health care provider plan how to best control your diabetes.
The American Diabetes Association recommends keeping blood sugar levels in the range of:
80 - 120 mg/dL before meals
100 - 140 mg/dL at bedtime
FOOT CARE
Diabetes causes damage to the blood vessels and nerves. This can reduce your ability to feel injury to or pressure on the foot. You may not notice a foot injury until severe infection develops. Diabetes can also damage blood vessels. Small sores or breaks in the skin may progress to deeper skin ulcers. Amputation of the affected limb may be needed when these skin ulcers do not improve or become larger or deeper.
Hypoglycemia can develop quickly in people with diabetes. Symptoms typically appear when the blood sugar level falls below 70. If you have symptoms:
Do a blood sugar check.
If the level is low or you have symptoms of hypoglycemia, eat something with sugar: 4 ounces of fruit juice, 3 - 4 Lifesavers candies, or 4 ounces of regular soda. Overtreating a mild low blood sugar reaction can lead to problems with high blood sugar and difficult blood sugar control overall.
Symptoms should go away within 15 minutes. If the symptoms don't go away, repeat the sugar-containing food as above, and test the sugar level again. When your blood sugar is in a safer range (over 70 mg/dL), you may need to eat a snack with carbohydrates and protein, such as cheese and crackers or a glass of milk.
Ask your doctor if you need a glucagon injection kit to raise blood sugar quickly in an emergency.
MEDICATIONS TO PREVENT COMPLICATIONS
Your doctor may prescribe medications to reduce your chances of developing eye disease, kidney disease, and other conditions that are more common in people with diabetes.
An ACE inhibitor (or ARB) is often recommended as the first choice for those with high blood pressure and those with signs of kidney disease. ACE inhibitors include:
Statin drugs are usually the first choice to treat an abnormal cholesterol level. Aim for an LDL cholesterol level of less than 100 mg/dL.
Aspirin to prevent heart disease is most often recommended for people with diabetes who:
Are older than 40
Have a personal or family history of heart problems
Have high blood pressure or high cholesterol
Smoke
Complications
After many years, diabetes can lead to serious problems with your eyes, kidneys, nerves, heart, blood vessels, and other areas in your body.
If you have diabetes, your risk of a heart attack is the same as someone who has already had a heart attack. Both women and men with diabetes are at risk. You may not even have the typical signs of a heart attack.
Nerve damage, which causes pain and numbness in the feet, as well as a number of other problems with the stomach and intestines, heart, and other body organs (diabetic neuropathy)
Foot sores or ulcers, which can result in amputation
Infections of the skin, female genital tract, and urinary tract
Prevention
Currently, there is no way to prevent type 1 diabetes. There is no effective screening test for type 1 diabetes in people with no symptoms.
To prevent complications of diabetes, visit your health care provider or diabetes educator at least four times a year. Talk about any problems you are having.
Stay up-to-date with all of your vaccinations and get a flu shot every year in the fall.
Usually there are no symptoms, or the symptoms are mild and not life threatening to the pregnant woman. Often, the blood sugar (glucose) level returns to normal after delivery.
Gestational diabetes may not cause symptoms. All pregnant women should receive an oral glucose tolerance test between the 24th and 28th week of pregnancy to screen for the condition.
Treatments
The goals of treatment are to keep blood sugar (glucose) levels within normal limits during the pregnancy, and to make sure that the fetus is healthy.
WATCHING YOUR BABY
Your health care provider should closely check both you and your fetus throughout the pregnancy. Fetal monitoring to check the size and health of the fetus often includes ultrasound and nonstress tests.
A nonstress test is a very simple, painless test for you and your baby. A machine that hears and displays your baby's heartbeat (electronic fetal monitor) is placed on your abdomen. When the baby moves, its heart rate normally increases 15 - 20 beats above its regular rate.
Your health care provider can look at the pattern of your baby's heartbeat compared to its movements and find out whether the baby is doing well. The health care provider will look for increases in the baby's normal heart rate, occurring within a certain period of time.
DIET AND EXERCISE
Managing your diet can give you the calories and nutrients you need for your pregnancy, control your blood sugar (glucose) levels, and avoid the need to take medications. Regular exercise also can help keep your blood sugar under better control.
Eating a balanced diet is a key part of any pregnancy. The food you eat helps your baby grow and develop inside of you. Because every pregnancy is different, your doctor and dietitian will create a diet just for you.
The best way to improve your diet is by eating a variety of healthy foods. Your doctor or nurse will prescribe a daily prenatal vitamin. They may suggest that you take extra iron or calcium. Talk to your doctor or nurse if you're a vegetarian or are on some other special diet.
Remember that "eating for two" does not mean you need to eat twice as many calories. You usually need just 300 extra calories a day (such as a glass of milk, a banana, and 10 crackers).
Complications
Delivery-related complications due to the infant's large size
Development of diabetes later in life
Increased risk of newborn death
Low blood sugar (glucose) or illness in the newborn
Prevention
Beginning prenatal care early and regular prenatal visits helps improve the health of you and your baby. Knowing the risk factors for gestational diabetes and having prenatal screening at 24 - 28 weeks into the pregnancy will help detect gestational diabetes early.
Diabetic Ketoacidosis
Definition
Diabetic ketoacidosis is a complication of diabetes that occurs when the body cannot use sugar (glucose) as a fuel source because the body has no insulin or not enough insulin, and fat is used instead. Byproducts of fat breakdown, called ketones, build up in the body.
Symptoms
The warning signs that you are becoming very sick might include:
People with type 1 diabetes lack enough insulin, a hormone the body uses to process glucose (blood sugar) for energy. When glucose is not available, body fat is broken down instead.
As fats are broken down, acids called ketones build up in the blood and urine. In high levels, ketones are poisonous. This condition is known as ketoacidosis
Blood glucose levels rise (usually higher than 300 mg/dL) because the liver produces glucose to try to combat the problem. However the cells cannot pull in that glucose without insulin.
Diabetic ketoacidosis may lead to a diagnosis of type 1 diabetes, because it is often the first symptom that causes a person to see a doctor. It can also be the result of increased insulin needs in someone already diagnosed with type 1 diabetes. Infection, trauma, heart attack, or surgery can lead to diabetic ketoacidosis in such cases. Missing doses of insulin can also lead to ketoacidosis in people with diabetes.
People with type 2 diabetes can develop ketoacidosis, but it is rare. It is usually triggered by a severe illness. People of Hispanic and African-American ethnicity seem to be more likely to have ketoacidosis as a complication of type 2 diabetes.
Tests & Diagnostics
Ketone testing may be used in type 1 diabetes to screen for early ketoacidosis. The ketones test is done using a urine sample. Ketone testing is usually done at the following times:
The goal of treatment is to correct the high blood glucose level by giving more insulin. Another goal is to replace fluids lost through excessive urination and vomiting. You may be able to recognize the early warning signs and make appropriate corrections at home before the condition gets worse.
If ketoacidosis is severe, you will need to go to the hospital. The following will be done at the hospital:
People with diabetes should learn to recognize the early warning signs and symptoms of ketoacidosis. In people with infections or who are on insulin pump therapy, measuring urine ketones can give more information than glucose measurements alone.
Insulin pump users need to check often to see that insulin is still flowing through the tubing, and that there are no blockages, kinks, or disconnections.
Diabetes Mellitus with Hyperosmolar Coma
Definition
Diabetic hyperglycemic hyperosmolar syndrome (HHS) is a complication of type 2 diabetes that involves extremely high blood sugar (glucose) levels without the presence of ketones. Ketones are byproducts of fat breakdown.
The buildup of ketones in the body (ketoacidosis) may also occur.
This condition is usually seen in people with type 2 diabetes. It may occur in those who have not been diagnosed with diabetes, or in people who have not been able to control their diabetes. The condition may be brought on by:
Medications that lower glucose tolerance or increase fluid loss (in people who are losing or not getting enough fluid)
Normally, the kidneys try to make up for high glucose levels in the blood by allowing the extra glucose to leave the body in the urine. If you do not drink enough fluids, or you drink fluids that contain sugar, the kidneys can no longer get rid of the extra glucose. Glucose levels in the blood can become very high as a result. The blood then becomes much more concentrated than normal (hyperosmolarity).
Hyperosmolarity is a condition in which the blood has a high concentration of salt (sodium), glucose, and other substances that normally cause water to move into the bloodstream. This draws the water out of the body's other organs, including the brain. Hyperosmolarity creates a cycle of increasing blood-glucose levels and dehydration.
Risk factors include:
A stressful event such as infection, heart attack, stroke, or recent surgery
