Lifestyle changes will most likely be the first suggestion your doctor makes after your type 2 diabetes diagnosis. The thought of changing your eating habits, adding exercise into an already full schedule, and monitoring your blood sugar can be overwhelming. Depending on how high your A1C is, your doctor may prescribe one of these common diabetes medications. 

Type 1 and Type 2 diabetics take different types of medication because the types respond differently to insulin. Most Type 2 diabetes patients control their diabetes through oral medication.

Not all diabetes medication is right for every patient. Your doctor prescribes the type of medication based on your symptoms and how well your diabetes is controlled. Every addition of medication to your routine comes with questions you should ask your provider if they don’t supply the answer to these questions when they suggest the medication. Your pharmacy provided printouts contain most of this information, but talking to your doctor about these questions should still be the first step.

• When and how often should you take the medication?
• What should you do if you miss a dose?
• What are the common side effects of this medication?
• Why did your provider prescribe this particular medication?
• Will Medicare, Medicaid, or your private insurance cover this medication?
• Will this medication react with any other medications I’m taking?

Below are several of the most common Type 2 diabetes medications. We included a little information about each one. You can find more about these medications rxlist.com.

Metformin

Many providers prescribe metformin as the first medication for treating Type 2 diabetes. These medications help your body become more sensitive to insulin. They also decrease the amount of sugar your intestines absorb. It comes with side effects such as weight gain and possibly low blood sugar. Metformin is in a family of drugs called biguanides and may be combined with other medications also used to treat Type 2 diabetes.

Sulfonylureas

These medications stimulate the pancreas to make more insulin. Like Metformin, the side effects may include weight gain and low blood sugar.

Meglitinides

Like Sulfonylureas, these medications stimulate your pancreas to make more insulin, but they are faster acting and the effect lasts for a shorter length of time. These medications may lower your blood sugar too much.

Thiazolidinediones

These medications work a lot like Metformin in that they make your body more sensitive to glucose. Unfortunately, they come with more serious side-effects such as an increased risk of heart failure, heart disease, and anemia. Your provider will monitor your heart function closely if you take one of these medications. The increased risk of serious side effects means it probably won’t the first medication your provider prescribes.

DPP-4 inhibitors

These medications have less of a tendency to cause low blood sugar while helping the body make more insulin. They may cause joint pain and increase your risk of pancreatitis.

GLP-1 receptor agonists

This family of drugs slows digestion and helps lower blood sugar levels. They are injectable medications versus oral medications most often used. Patients with certain heart disease or chronic kidney disease are more likely to receive these medications as they may reduce the risk of heart attack and stroke. The medications often cause weight loss and may also have side effects like nausea and an increased risk of pancreatitis.

SGLT2 inhibitors

Unlike other diabetes medications, these drugs prevent the kidney from holding on to the glucose. Instead, your body excretes the sugar through your urine. These medications may also reduce the risk of heart attack and stroke. Possible side effects include vaginal yeast infections, urinary tract infections, low blood pressure, and a higher risk of diabetic ketoacidosis. 

Insulin

Insulin was once the last resort for treating type 2 diabetes, but today it’s prescribed earlier due to its benefits. This medication must be injected. Your provider has a variety of types of insulin available, and they may prescribe a mixture of insulin types for use at different times of the day or night. 

Cost of Medications

The cost of insulin and other diabetes medication continues to rise, and Medicare, Medicaid or your insurance may not cover all these medications. Patients at Mantachie Rural Health Care may request a 340B card at the time of their appointment for discounts on prescriptions. Discounts vary, but Fulton Walmart, Mantachie Pharmacy, and Saltillo Pharmacy and Solutions accept the cards.

Improving your health relies on your partnership with your medical provider, especially when you suffer from a chronic illness such as diabetes, high blood pressure, rheumatoid arthritis among others. Your provider may be an advanced practice nurse practitioner, a family doctor or a specialist with all the initials after their names, but you know your body. When something isn’t right, it’s important for you to feel comfortable explaining all your symptoms to your provider. And it’s equally important to have a provider who listens.

Patient-doctor relationships rely on both parties to fully participate in the appointment. If you’re concerned your provider isn’t listening, try these steps to get your relationship back on track.

Write Down the Details

Many health problems have similar symptoms. Write down the dates and situations when your symptoms started, improved or worsened. Bring a list of medications you take regularly. Be willing to discuss the hard truths including any illicit drug use, the amount of alcohol you regularly consume, your mental health status, and sexual symptoms. Your provider needs the full picture to make an accurate diagnosis. If you’ve written down the details, you won’t have to rely on your own memory when you may feel rushed during an appointment.

Bring Someone with You

Illness, medication, and pain can cloud our thoughts and make it hard to remember what we wanted to say or what the doctor recommended. A trusted friend or family member can help you remember what the doctor said and ask questions you may not think to ask. They can also back you up if you don’t think the doctor is listening. It’s easier to advocate for someone else than ourselves.

Make Notes

You wrote down your symptoms and information prior to your appointment. Use that same notebook to write down what the doctor says. Most offices provide a print out of instructions, tests run and diagnoses after the appointment. It’s a great reference sheet. Make your own notes about what the doctor is saying to review later. They may help you create a list of questions for your next appointment.

Ask Questions

Sometimes medical providers use big words and acronyms that don’t make sense to the rest of us. If your provider suggests a specific test, discusses your test results or prescribes a new medication, ask for details. You may also ask how to spell any words you don’t understand. Even if the provider doesn’t explain what it means well you can do your own research after the appointment.

Do Your Research

Providers do get tired of patients who self diagnose with Dr. Google. If anyone searches through the symptom checker long enough they’ll find a chronic illness or cancer diagnosis waiting to happen. In truth, most of us don’t have these rare diseases and your search on Google can cause more alarm than is needed. Once you’ve been diagnosed though, arm yourself with information especially if you have a chronic condition. Stick to websites with varified information such as Mayo Clinic, CDC, or medical research schools. National organizations focused on your health condition may also provide up-to-date research information. You can also ask your provider where you can find more information on your condition.

Complete the Patient Survey

Most medical facilities, including ours, requests patients complete a satisfaction survey. If you’re uncomfortable confronting a provider whose bedside manner isn’t what you’d hoped it would be, you can ensure clinic management knows about the problem by completing the survey. (Another note, if your provider does an excellent job tell us about that too!)

Find An Alternative Provider

We offer this as a last resort. If your medical provider repeatedly brushes off your concerns or treats your symptoms without searching for a root cause, it might be time to search for another provider. We encourage our patients to develop a relationship with their provider, especially if they have chronic conditions. This ensures you work with a provider who understands your history. Changing providers isn’t something we take lightly, but it is an option you might want to explore if your provider isn’t giving the care you expect.

Everyone has a bad day. Sometimes a provider’s less than attentive visit has more to do with an emergency situation they may have recently managed than a lack of concern for your health. If you’ve had one bad experience with any provider, we encourage you to give them another chance before looking for care elsewhere. If you feel your current provider isn’t listening, we invite you to make an appointment with one of our providers. We strive to be your patient-centered medical home.

The story headlined WedMD, FoxNews, and CNN this week. A British teen who ate only potato chips, French fries, cold cuts, and white bread for years went blind due to his poor nutrition.

Although the boy’s food choices consisted of high-calorie carb-heavy foods, his BMI and weight stayed in the normal range. 

“But the lack of essential vitamins and minerals took its toll. Anemia set in, his bone mineral density plummeted, and his levels of vitamin B-12, vitamin D, copper and selenium all cratered,” reported WebMD.com.

His lack of nutrition first led to tiredness. Hearing and vision problems then developed before he was diagnosed with “nutritional optic neuropathy.”

The boy’s diagnosis is a rare and extreme case. It highlights the importance of a varied diet for the sake of health, not just weight. Diets limited to a few foods, especially highly-processed foods, reduce the consumption of vitamins and nutrients our bodies need to function well.

Vitamin supplements can replace some vitamins we don’t receive from our diet. However, they’re meant to be a supplement, not our sole source of vitamins. The best way to receive vitamins and nutrients is through the foods we eat. A diet of unprocessed foods, vegetables, and fruits provides benefits beyond better-controlled weight and blood glucose levels.

Picky Eaters

For parents of picky eaters, it’s tempting to give in to their preferred foods. Nutritionists encourage parents to continue offering a variety of foods and then encourage their children to try new menu items. Some children and adults experience a heightened sensitivity to certain foods and food textures. They may benefit from a visiting a nutritionist and primary care provider as a great first step to improving the variations of foods they consume.

For most children, picky eating is a phase. Others may require a combination of physician care and mental health therapy to move past their extreme picky eating. 

If you’re looking for ways to increase the variety of nutrient-dense foods in your diet, try our Witcher’s Weight Loss Warriors. This group meets every Monday and provides information on menu planning and food education. Or if you believe your or your child’s picky eating has stretched on for years and you need additional help, contact us for an appointment with one of our providers or our registered dietician. 

Do you know the difference in emotional health and mental health? We often hear the terms used interchangeably, but they refer to two different areas of a person’s health. While emotional and mental health work together, it’s possible to be strong in one area and weaker in another.

Mental Health

The way our brain processes and understands information refers to our mental health. It includes our emotional, psychological, and social well-being. Our mental health affects our relationships, how we manage stress, and how we exercise reason.

Symptoms of mental health problems affect us physically through mood changes, lack of energy, over- or under-eating, abusing drugs or alcohol, having suicidal thoughts, sleeping too much or not enough, feeling helpless, or having an inability to perform daily tasks.

Mental health disorders include bipolar disorder, depression, and schizophrenia among others.

Emotional Health

Our emotional health dictates how we react to situations and circumstances based on how our mental health interprets that information. Expressing emotion in an age-appropriate way indicates good emotional health. It requires us to manage our emotions and determine the correct response to situations.

Better Together

While mental health and emotional health refer to two different areas of our health, they work together to help us manage everyday stress. When we can process information from a situation correctly, we’re more likely to respond in an emotionally correct way. This allows us to manage difficult and even traumatic events to find solutions, develop resiliency, and learn coping skills.

Difficulties with your mental or emotional health are not cause for shame. Statistics show 1 in 5 people will experience a mental illness this year. Instability in mental or emotional health can lead to problems at work and in relationships and can lead to abuse of drugs and alcohol. 

Don’t struggle alone. Reach out for help now. Our counselors are ready to help you face your mental or emotional health struggles so you can lead a stronger, healthier life. To make an appointment call us at 662-282-4359.  

No matter how well you control your diabetes everyone has problems from time to time. One of the most common diabetes complicates is deviations in morning blood sugar. These highs or lows can cause problems throughout the day and can be caused by medications, changes in diet, exercise, or hormone levels.

Low Morning Blood Sugar

The main cause of low morning blood sugar levels (also known as hypoglycemia) in diabetic patients is an excess of background or long-acting insulin. Blood sugar levels are considered low if they dip below 70 milligrams per deciliter (mg/dL). Readings that reach 54 mg/dL and lower are cause for concern and immediate medical treatment.

Symptoms of low morning blood sugar include:

• headache
• sweating
• dry mouth
• nausea
• lightheadedness
• dizziness
• shaking
• hunger
• anxiety
• blurred vision
• pounding heartbeat

Consistently low morning blood sugar can lead to tiredness and headaches that last throughout the day. It may also reduce your awareness of low blood sugar levels which can be dangerous if those levels drop into the severe range.

If you’re experiencing low morning blood sugar levels, your first step is to visit with your medical provider. Your provider may want to adjust your insulin dosage or timing before bed. Other causes of low blood sugar may include drinking alcohol before bed, forgetting your regular bedtime snack or changing what you eat, or exercising too late in the day.

Other ways to combat low morning blood sugar include eating a bedtime snack of carbs and protein, avoiding excessive alcohol consumption, and exercising earlier in the day.

Dawn Phenomenon

On the flip side of low blood sugar levels, some diabetic patients find they wake with high blood sugar levels. Our bodies are designed to release hormones that increase blood sugar levels in the morning. This blood sugar ensures we have the energy we need to wake up and get started on our day. Bodies without diabetes release insulin to manage the excess blood sugar. Diabetic patients don’t respond to insulin the say way so you may wake up with high blood sugar.

Dawn Phenomenon may not be the only reason you’re experiencing high blood sugar levels. Other causes may include not taking enough insulin the night before, other medications, or a change in your bedtime snack. 

If your blood sugar levels are high for several mornings in a row check it during the night between 2-3 a.m. and take those numbers to your medical provider. They can help you determine if the Dawn Phenomenon is the problem and how to treat it.

Somogyi effect

The other cause of high morning is the Somogyi effect. This usually has more to do with diabetes management rather than naturally occurring hormone changes like in the Dawn Phenomenon. The Somogyi effect is caused by taking too much or too little insulin before bed or skipping your bedtime snack. If your blood sugar levels drop too low at night, your body may produce more glucose in an effort to prevent dangerously low blood sugars. The effect leaves you with high morning blood sugars, also called rebound hyperglycemia.

Before making changes to your diet, insulin doses, or other routines consult with your medical provider. They can help pinpoint the cause of your low or high blood sugar and work with you to formulate a solution. If you don’t have a provider who regularly helps you manage your diabetes, our providers are ready to assist you with management for a healthier, happier lifestyle.

Earlier this year an Indiana mom returned home with cellulitis when her family visited a resort in Tennessee. After a long day of sightseeing, she headed for the hotel hot tub. That’s when the trouble began. (Read her full story in People magazine.)

Hot tubs aren’t the only place cellulitis starts. It begins when a bacteria enters a crack or break in the skin. It happens more often on the lower leg but can start anywhere on the body.

Skin problems and the lower leg or foot area point to a common topic we discuss: diabetes. Because diabetic patients have a lowered immune system and are more likely to not notice cuts, burns or scrapes on their feet or legs they are at a higher risk for developing cellulitis. Another reason to keep checking your feet and legs every day.

Diabetic patients aren’t the only ones at an increased risk for cellulitis. Anyone with a skin injury, lowered immune system, history of cellulitis, skin conditions, chronic swelling or obesity are at an increased risk. 

Symptoms of Cellulitis 

Cellulitis usually starts out as red, swollen skin that’s warm to the touch. As the illness progresses, and as the Indiana mom found out it progresses quickly, the redness, swelling, and tenderness spreads. You may also experience fever, chills, and blisters.

Treatment

If you have any symptoms of cellulitis see your medical provider immediately. The earlier your provider begins treatment the less likely you are to develop long term complications. The mom in Indiana tried two different antibiotics and was treated in the hospital before her condition improved. She faced amputation of her leg if the antibiotics did not work.

Preventing Cellulitis

Diabetic patients should inspect their feet every day and treat any redness or sores immediately. Others who have a skin tear or condition should cover the affected areas and treat them to prevent infection. Follow your doctor’s instructions for treating surgical wounds. Good hygiene goes a long way toward protecting your skin from any type of infection.

You’ve hit the mid-afternoon slump. Your eyelids sag with drowsiness. The words on your computer screen blur a bit. You yawn every couple of minutes. You have a few options: a quick nap, rest with your eyes closed for a bit, walk around or grab that afternoon cup of joe.

While a thirty minute nap has been shown to give your mind a reboot to increase alertness, creativity and productivity, longer naps may leave you feeling groggier than before. Real restorative sleep, however, comes in the total silence of deep sleep.

Deep sleep not only recharges our mind and boosts our cognitive abilities, but it also increases our body’s ability to manage insulin. A study published in the Annals of Epidemiology reports diabetics who get less than six hours of sleep a night are three times more likely to report high blood sugar levels.

Research also links increased weight gain and obesity with less sleep.

In addition to managing your diabetes with the proper medication, diet and exercise, take a look at how your sleep schedule impacts your blood sugar levels. If you aren’t getting eight hours of sleep every night, make an effort to rethink your sleeping plan.

Need some help? We have a few tips:

• Keep regular sleep and wake routines (even on the weekends)
• Cut out caffeine and large meals late in the day.
• Schedule afternoon exercise three to four hours before bedtime.
• Turn off electronics before going to bed. Screens can trick your body into believing it’s still light outside.
• Keep your bedroom cool, dark and quiet.
• Invest in a white noise machine or run a fan to block out distracting noise.
• Don’t obsess about sleep. If you can’t sleep, read under soft light until you are sleepy but avoid turning on the television, computer or cell phone.