Wine and Diabetes

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Wine is becoming increasingly popular in many places. Many are even learning to like wine in place of beer. This can be a good thing for wine loving diabetics, if we can exercise the discipline to stop after several ounces.

Most people who drink beer do not stop at one or two where as most people who drink wine do. (According to certain stats, anyway) Since beer has more carbohydrates than your average red or dry white wine, the wine lover is going to have less of an impact on their blood sugar.

What if you don’t like wine? Be glad! Because diabetics really don’t need it. To those who don’t have perfect health, alcohol is just a system aggravator, throwing off the balance even more. But, that lady down the street with diabetes drinks wine all the time you say? Well, chances are, her health could improve big time. Don’t be fooled. A lot of diabetics don’t take care of themselves the way they should.

For those of you who have pretty good diabetes control and health and cannot stay away from beloved wine, well, a dry wine is probably your best bet-and certainly just one glass at a time.

When I used to drink wine I would have one 5 oz glass and I’d always have it with food. I would test my blood sugar before and after dinner to keep an eye out. The wine that didn’t raise my sugar so much was Chardonnay in case you are wondering.

We hear a lot about resveratrol, the anti-aging chemical found in red wine. Problem is, you could get a lot more resveratrol from a pill than a glass of wine. And that glass of wine gives you alcohol.

Another thing to point out is if you are the type that can stop drinking when you want, you have a big advantage towards those who cannot. If you cannot, you really shouldn’t be drinking. I tend to do most things in extremes so I am not big on drinking. If I don’t have a drink I’m fine. If I have one I want another. So, I just don’t start. How about you? Which category do you fall in? And if you drink wine, what type works best for you? Do you just have one glass? These questions are good to think about if you are a diabetic and want to drink wine and stay healthy


The Connection in Between Diabetic Issues and Your PH Balance

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Ask any individual who continues to be diagnosed with diabetes plus they can tell you how frustrating, annoying, and frightening the situation is. On the surface it looks like a relatively tame condition, exactly where you might be simply needed to maintain monitor and regulate your sugar intake. Diabetic issues, however, is extremely severe, as you’ll find a variety of ailments which can stem from diabetic issues, some of that are deadly. To get a really extended time, understanding diabetic issues continues to be a mystery. Researchers believed that they understood why heavyset people had been at far more chance for diabetic issues, but then you will find people who are thin who also contain the issue, which has manufactured it very tough for researchers to pin down what causes the condition.

One particular point that definitely variables into diabetes could be the acid in your body. Think about your body a quite huge cocktail. There are numerous issues mixed into the cocktail to produce your human body operate correctly. You could have to possess the correct amount of every compound in buy being healthful. It’s essential that you just balance body pH amounts to provide your system what it wants. Once you have as well very much or as well small of something, things go incorrect inside body. Acid is one particular important ingredient inside the entire body that several people ignore, but which often can lead to a host of troubles if the volume inside body is not balanced.

The kidneys are accountable for removing acidic residues in the fluids in the body so that you can keep the pH sense of balance inside the entire body. If you could have as well much acid within the body, the kidneys ought to operate even more challenging to have the sense of balance right, which signifies which they start off to miss issues, such as the sugar in the blood, as the kidneys also filter excessive sugar out on the blood likewise. This can strain the kidneys to ensure they’re unable to accomplish their job effectively. It can even generate a condition referred to as acidosis. pH amounts, with men and women that have this situation, are a critical matter.

Consequently of problems like these, many experts now are studying the connection among acid and diabetic issues, in hopes that when the pH is balanced inside the body, a person who have been diagnosed as a diabetic may well have a very much simpler time controlling their problem. To date, most studies have recommended that a balanced pH diet and the correct supplements might place several about the correct monitor.


Insulin Injection Omission – Demographic and disease factors. Part 3

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Study strengths and limitations

Strengths of the study include the large sample of diabetic patients drawn from a general population and the fact that the sample was weighted to be nationally representative. However, patients volunteer for the panel from which respondents were drawn and may not be representative of all patients (e.g., they may be more adherent with their treatment regimens).

Limitations of the study include the fact that there was no objective measure of insulin use (e.g., pharmacy records). Moreover, while our measure of insulin omission was very specific (i.e., skipping injections that respondents knew they should take), it is possible that some respondents included injections they did not skip intentionally, but rather simply forgot to take. Respondents might also have included scheduled injections that were appropriately skipped because a meal was not eaten or blood glucose levels were very low. This could explain (at least in part) the association between following a healthy diet and fewer skipped injections. More disciplined eating behavior reduces meal skipping, which is an often-cited reason for skipping insulin injections. This is consistent with the fact that the relationship between our diet measure and insulin omission is present only among individuals with type 1 diabetes where closer matching of food and insulin is required.

Finally, our study probably underestimated the level of insulin nonadherence in this population because it did not capture instances in which patients took an injection but gave less than the amount of insulin they knew was needed for optimal glucose control.

Clinical implications

Our findings make clear that while most patients did not report regular omission of insulin injections, a substantial number did. Thus, our findings suggest that it is important to identify patients who omit insulin and to be aware of the potential risk factors identified here. Lack of personal resources (especially income) is one potential warning sign. Although much attention has been focused on insulin omission among adolescents with type 1 diabetes, our findings suggest that among adults, individuals with type 2 diabetes are at higher risk. Patients who are not adhering to other elements of the treatment regimen, especially diet, also may be at risk for insulin omission. For patients who report injection-related problems (interference with daily activities, injection pain, and embarrassment), providers should consider recommending strategies and tools for addressing these problems to prevent insulin omission. This may contribute to improved treatment adherence and consequent clinical outcomes.


Insulin Injection Omission – Demographic and disease factors. Part 2

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The associations of insulin injection omission with other health conditions were examined. Surprisingly, history of depression was not associated with insulin omission; this contradicts findings from studies of general adherence and of insulin omission among adolescents. However, because current depression was not assessed, any concurrent association was likely to be lost. Others have shown that depression symptom scores fluctuate substantially over relatively short periods of time; individuals with elevated depression symptoms at a given point in time are likely to not report elevated symptoms 6 months later. In addition, depression symptoms across the whole range of severity symptoms have been shown to predict regimen adherence more powerfully than diagnosed depression. Being disabled was associated with less insulin omission; this may be due to a variety of reasons, including their receiving more assistance with care, or making a greater effort to compensate for poor health.

Two aspects of patients’ treatment regimens were associated with increased insulin omission—respondents who took more injections each day and those who did not follow a healthy diet were more likely to skip injections. That dietary nonadherence is associated with insulin nonadherence is not surprising. More frequent injection omission among individuals taking more injections could reflect the frequently reported finding that more complex regimens are associated with lower levels of adherence. It might also be that the impact of skipping a shot is reduced among individuals who take more shots.
Insulin and injection-related factors

Our study suggests that insulin omission is affected by the perceived burden of insulin therapy (i.e., having to plan one’s life around insulin injections and feeling that the insulin regimen interferes with activities of daily living such as social activities, work-related activities, and family care-giving responsibilities). We offer one caveat regarding our findings; we do not believe that the behavior of planning one’s day around insulin injections actually increases the level of insulin injection omission, but we do believe that feeling that one has to plan around one’s injections is associated with higher frequency of skipping insulin injections one should take. That is, when there is a conflict between scheduling of treatment and life activities, one can either plan one’s activities in a way that reduces this conflict or deal with the conflict by ignoring treatment needs. Reducing the perceived burden of insulin injections may require more effort from health care providers. As we have suggested elsewhere, providers must find out what the specific issues are for each patient and work with that patient to develop solutions that will work for him or her.

We note that the measure of interference with eating and exercise was significantly associated with insulin injection omission until interference with activities of daily living was entered into the model (results not shown). Thus, while interference with eating and exercise might be part of the burden of insulin therapy, interference with other aspects of daily living had a more substantial association with insulin omission.

Our study suggests that insulin omission may be affected by the immediate experience of injecting insulin as painful and embarrassing (but not dissatisfaction with time needed, ease of use, or skin inflammation/bruising). There are numerous device-related strategies for reducing pain and embarrassment, including insulin pens, finer gauge needles, injection ports, needleless injectors, and other injection assistance devices. However, we have found that patients do not feel that their health care providers are giving them adequate assistance in managing these problems, even when they raise the issue with their providers.

We note that the measure of negative affect toward injections was significantly associated with insulin omission until dissatisfaction with injection embarrassment and pain were entered into the model (results not shown). This suggests that addressing pain and embarrassment may reduce not only insulin omission, but also the emotional burden of injections, thereby enhancing psychological well-being. It is interesting that worry about hypoglycemia did not predict intentional omission of insulin injections, even though worry about hypoglycemia was high in the study population. This suggests that patients may address this worry by eating more or lowering insulin doses rather than by skipping injections altogether.


Insulin Injection Omission – Demographic and disease factors

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We found that respondents with higher household income, but not individuals with more education, were less likely to skip insulin injections they knew they should take. This may reflect easier access to medications and supplies among individuals with higher income, but it is also likely that higher socioeconomic status is associated with more access to diabetes education, higher health literacy, greater control over one’s daily routines, and better problem-solving skills. Our study appears to be among the first to identify an association between socioeconomic status and insulin omission. Future research should seek to identify potential mediators of this relationship, i.e., what links lower socioeconomic status to insulin omission.

Contrary to earlier reports, we found no racial/ethnic differences in intentional insulin omission. This may be because we did not have enough nonwhite respondents to examine the different racial/ethnic groups separately. Alternatively, this may be due to our controlling for income and education in the analysis, thereby eliminating the confounding of race/ethnicity with socioeconomic status.

Much prior research has suggested that intentional insulin omission is common among female adolescents with type 1 diabetes, serving as a weight control strategy and sometimes linked to eating disorders. We found that students (who were younger than nonstudents) were more likely to skip injections they knew they should take, but this behavior was not more common among women than it was among men. We found no overall association between age and intentional insulin injection omission among patients with type 1 diabetes, suggesting that patients with type 1 diabetes “age-out” of this behavior by early adulthood, when they complete their education. Ascertaining the validity of this interpretation would require following youth with type 1 diabetes as they age into adulthood to determine change in rate of insulin omission.

Our finding that, among individuals with type 2 diabetes, older respondents were less likely to skip insulin injections is consistent with earlier studies. This suggests that there are parallel aging-out processes among individuals with type 1 and type 2 diabetes, but in type 2 diabetes, this process takes place later in the life course (almost all people with type 2 diabetes are diagnosed as adults). Ascertaining the validity of this interpretation would require following adults with type 2 diabetes as they age to determine change in rate of insulin omission.

Having type 2 diabetes was itself associated with higher levels of intentional omission of insulin injections. The beta for this variable (0.226) was approximately twice the size of the unadjusted eta (0.095), reflecting the fact that controlling for confounding factors (such as age and number of daily injections) revealed a stronger underlying association. The independent association of type 2 diabetes with increased insulin omission may reflect the fact that patients with type 2 diabetes have a residual insulin response, reducing the immediate consequences of omitting an injection. Thus, these individuals may feel less vulnerable to the effects of skipping insulin injections they know they should take. Interestingly, whereas duration of diabetes was associated with the frequency of insulin injection omission, regression analysis revealed that duration of diabetes did not make an independent contribution to this behavior. That is, although insulin omission may be less common among individuals with longer duration of diabetes, this is likely a function of other factors such as age and type of diabetes rather than of duration per se.