HEALTHY CONNECTIONS - November 2019

Volume 1, Edition 9

M i l l e n n i u m P h y s i c i a n G r o u p ’s

HEALTHYConnections ConnectingYou to a Healthier Life

November/December 2019 • National Diabetes Awareness Month

What we have in store in this edition:

What’s in a Number? Defining A1C Diabetes and You – Dr. Abarca Selva is Passionate about Preventing and Treating Diabetes Healthy Holiday Eating

Type 2 Diabetes – How it Happens

Diabetic Eye Exam – Why It’s Important

Time Change in the Sunshine State

Your Connection to a Healthier Life

For more information about Millennium Physician Group, visit www.MillenniumPhysician.com or call (844) CALL-MPG.

with Dr. Salerno

Englewood Medical Center Opens!

Welcome to Millennium’s Healthy Connections! November is National Diabetes Awareness Month! In this edition, we bring you our expert panel of physicians on the importance of understanding your A1C, diabetic eye exams, healthy holiday eating and so much more!

Diagnosing and Monitoring through the A1C Blood Test

A1C Test Results Diabetes

6.5% or higher Written By: Aschanti Abarca Selva, MD

This relatively simple blood test can tell you a lot. The A1C test is used to not only diagnose but also treat diabetes. The results give you the picture of your average blood sugar level over the past two to three months. The higher the levels, the greater your risk of developing diabetes and complications. Your

doctor will tell you how often you need the A1C test, but usually you’ll have the test at least twice a year if you’re meeting your treatment goals. If you're not meeting your goals or you change treatments, you might need to get an A1C test more often. It does not take the place of daily blood sugar monitoring, if not the A1C gives you an idea of how your blood sugar levels are trending over time. This test can help physicians answer the important question of whether your intervention or treatment is headed in the right direction.

Type 2 Diabetes and You More than 30 million Americans have diabetes.

That’s about 1 in 10, and a great majority have adult onset or type 2 diabetes. That means most of the people who are living with diabetes could have avoided it. I’m passionate about preventing and treating diabetes because it is

Prediabetes 5.7 to 6.4%

Normal

Below 5.7 %

Millennium’s Dr. Aschanti Abarca Selva is Passionate about Preventing and Treating Diabetes

a multi-organ, system damaging disease that can cause terrible complications, which are all preventable through patient education, moderation and medication compliance. This is a great time "to be a diabetic" because we have so many wonderful choices of medications and monitoring that allow for optimal control of the disease.

What I’d really like people with diabetes to know is that this is a serious metabolic disease, and they need to take care of themselves.

Unfortunately, some patients don’t believe the disease is affecting them because they don’t see anything "wrong happening on the outside." And initially they might not see any major

physical signs or symptoms, meanwhile the disease is mining their bodies from head to toe.

It’s sad that more and more people are becoming diabetic, and they're being diagnosed younger and younger. In fact, many believe this disease is reaching epidemic proportions. As a society, we have become more sedentary; people don't want to exercise or might not have time to. They order in or eat out because they don’t want to spend the little time they do have cooking a healthy meal at home. Good outcomes in life always require time and effort. It’s the same with our health, more so if we belong to a group that is "at higher risk" for certain conditions. And that’s why I get so much enjoyment out of what I do.

Helping people understand the importance of being engaged in their own health is powerful when you know you’ve made a difference and get to see the results: a healthier person!

Healthy Holiday Eating for Diabetics… and Everyone Else, Too! The holiday season has arrived! Although it’s a wonderful time to gather with friends and family, don’t let the celebrations spoil all your hard work and healthy eating. The holidays run from November to January. That could mean lots of extra calories if you’re not careful! Remember to enjoy the treats but find the proper balance to remain healthy. Your focus should be on friends and family, not food!

ONE DRINK IS: 12 fluid ounces (fl. oz.) of beer 5 fl. oz. of wine 1½ fl. oz. of 80-proof distilled spirits 1 fl. oz. of 100-proof distilled spirits

Good Tips for Everyone

Good Tips for Diabetics

Keep Your Routine: Try to eat meals close to your usual times. If a meal will be served late, eat a small snack first. Distribute your carbohydrate intake throughout the day and don’t skip meals!

Learn About Carbohydrates: You should know how certain foods affect your blood sugars. If you want to indulge in a sweet treat, cut back on other carbs like potatoes, rice, or bread. There are mobile tools and cell phone apps available to help with carb counts.

Be Prepared: Ask the host what will be served, so you can establish a plan. Better yet, offer to bring a healthy dish. If you’re eating at a restaurant, look at the menu and nutritional information ahead of time, so you will be ready to make appropriate decisions.

Make Good Choices: Limit the number of servings of starchy foods on your plate. Choose fruits and vegetables served raw, grilled or steamed. Enjoy your favorite holiday treats but take small portions. Eat slowly and really savor the taste and texture.

Move Your Body: If you do not have time for a long workout, break exercise into 10-15-minute periods. After a meal, taking a walk with family and friends is always a great idea. Really enjoy your time together!

Sleep: Lack of sleep can make it hard to control blood sugar. Make sure you find time to sleep, too. Seven to eight hours is always recommended.

Test More Often: If you’re eating food you usually don’t eat, or if you’re eating off schedule, test your sugars more often to ensure your numbers are in range and to help better guide your choices.

Be Kind: It’s OK to fall off track. If you have an unhealthy meal, try to make better choices next time. No food should be considered off limits, so long as you’re controlling portion size and eating a balanced meal.

Think About Drinks: Stick to calorie-free drinks, like water, tea or seltzer instead of punch or mixed drinks. Plus, keeping well-hydrated can stave off hunger and make you feel fuller longer.

If you do choose to drink alcohol, limit the amount and have it with food. Try to understand how alcohol affects your sugars.

Type 2 Diabetes – How it Happens Type 2 diabetes most often develops in people over age 45, but more and more children, teens, and young adults are also developing it.

Causes: Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into the cells in your body for use as energy. If you have type 2 diabetes, cells don’t respond normally to insulin; this is called insulin resistance. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes and type 2 diabetes.

Prediabetes – a Warning You Should Heed: Prediabetes means a person has elevated blood sugar levels. This condition can lead to type 2 diabetes and even heart disease. The good news is lifestyle changes can prevent or delay the development of adult onset, type 2 diabetes. There are many factors you can control to prevent Diabetes. You have a greater chance of developing prediabetes if you: Are 45 or older Are Black, Hispanic/Latino, American Indian, Asian American, or Pacific Islander Have a parent, brother or sister with diabetes Are overweight Are physically inactive Have high blood pressure or take medicine for high blood pressure Have low HDL cholesterol and/or high triglycerides Had diabetes during pregnancy Have been diagnosed with Polycystic Ovary Syndrome

Symptoms: If you have any of the following symptoms, see your doctor about getting your blood sugar tested: Urinate a lot, often at night Extreme thirst Weight loss, without trying Extreme hunger Blurred vision Numbness or tingling in the hands or feet Extreme fatigue Dry skin Sores that are slow to heal More infections than usual

Long-term goals for people with diabetes: Manage cholesterol

Stop smoking Keep eyes healthy Prevent foot problems Manage chronic stress Maintain a healthy weight Journal blood sugar levels

Complications: Heart disease and stroke Blindness and other eye problems (retinopathy) Nerve damage (neuropathy) Kidney disease (can advance to end stage renal disease requiring dialysis) Amputations Gum disease Depression Lazy stomach (gastroparesis)

The Importance of an Annual Diabetic Eye Exam with Dr. Bruce Lipschutz As you are checking your list of things to finish up before the end of the year, don't forget to schedule your eye exam. The American Diabetes Association recommends an annual eye exam for everyone with diabetes because the metabolic disease can affect vision.

In fact, a majority of diabetics – both type 1 and type 2 – who’ve had diabetes for 20 years or more have been affected by diabetic retinopathy, which occurs when the blood vessels in the retina become damaged. The

retina is the light-sensitive area in the back of the eye, and a dilated eye exam is the only way to detect problems. Millennium Internal Medicine Physician Dr. Bruce Lipschutz says it’s essential to catch eye disease early in diabetics because it’s treatable.

“Vision loss can happen when diabetic retinopathy is found too late. Additionally, if diabetes is not under control, or if you have lived with diabetes for a long time, there is a higher risk of this eye disease,” says Dr. Lipschutz. "Chronically elevated glucose levels affect blood vessels all over the body, including the heart, kidney, and the small arteries of the retina. These blood vessels can

bleed or clot, compromising those vessels," adds Dr. Lipschutz.

"High sugars can also cause more blood vessels to grow within the retina leading to poor functioning vision and vision loss.

Patients can decrease diabetic eye changes by controlling their sugar." Dr. Lipschutz also stressed that annual vision checks with monitoring could assess continuous changes from one visit to another. There are no symptoms in the early stages of diabetic retinopathy. Even if you do not detect a problem, it is crucial to see a vision specialist every year. Regular treatment will slow the progression of the condition.

The Time Change and

…with Millennium Sleep Specialist Dr. Edward Salerno In early November, we set our clocks back and found that hour of sleep we lost eight months earlier when Daylight Saving Time began. With our feet now firmly planted back in Eastern Standard Time, don’t you feel more rested?

Well…

“Light therapy can help. Use of a lightbox has been shown to help people feeling the effects of lack of sunlight. We know light helps delay or advance sleep cycles, too. You can pick one up online and place it right next to your bed.

It mimics daylight and can lift your mood, alleviating symptoms,” explains Dr. Salerno.

“Although gaining an hour of sleep is beneficial,” says Millennium Sleep Specialist Dr. Edward Regardless, even in the Sunshine State, many Salerno, “your body adjusts quickly to the change people have strong feelings about the time change. In fact, the Florida legislature passed – within about one to two weeks.” the Sunshine Protection Act last year, doing Dr. Salerno says those who have the most to away with Daylight Standard Time. But that gain from this extra hour of sleep are teens, change needs to be approved by Congress and whose Circadian Rhythm – the 24-hour cycle of has stalled in Washington. According to a press physiological processes we all live by – does not release from Senator Marco Rubio’s office earlier this year, the following are some reasons why confirm to early school start times. permanent Daylight Saving Time is preferred: With the time change, the sun is rising earlier.

Reduction in car crashes and car According to the clock, around 7:15 am on accidents involving pedestrians (and average throughout the winter months. That wildlife). would have been 8:15 old time. Of course, the same goes for sunset, with nighttime coming Reduced risk for cardiac issues, stroke around 5:30 pm on December 21 – the shortest and seasonal depression. day of the year. These early night falls can make Reduction in the number of robberies you sad, as in Seasonal Affective Disorder kind (by 27 percent). of SAD. “Seasonal Affective Disorder is a type of depression that relates to the change of seasons, Benefits to the economy (apparently but it isn’t that common in Florida,” says Dr. economic activity drops when the Salerno. clocks are moved back).

We are lucky in the Sunshine State. We have about two more hours of sunlight than more northern latitudes across the US, but if the time change does affect your mood or sleep, there is something you can do.

Reduction in childhood obesity and increased physical fitness.

Benefits to the agricultural economy.

Reduced energy usage

Healthy Connections didn’t run all this information by Sleep Specialist Dr. Salerno. We just asked him what he thought of the time change: “I’d just do away with it, I prefer one set time zone to reduce confusion and stress on people,” he said in his interview. Dr. Salerno says he’s also in favor of later school start times to get them more in line with biological clocks of teens.

“In general, we’re a sleep-deprived nation. Seven to eight hours of sleep a night are important for memory, health and immunity.”

Amount of Daylight Around the U.S. During Winter

Millennium’s Brand-New

Englewood Medical Center Now Open Millennium’s Englewood Medical Center opened for business Monday, November 4. The state-of-the-art, 20,000 square foot building at 3000 McCall Road is the first we designed and built from the ground up and with our patients in mind.

Drs. Jack Baron, Todd Chace, Ramon De Leon, David Gooding, Lynette Llerena and Rhoniel Perdigon call this new facility home. Patients can also take advantage of a lab, imaging center and walk-in center on site. With all these services available, Millennium is excited to be able to provide a comprehensive and coordinated approach to healthcare.

At Millennium, we believe in streamlining processes and reducing barriers to healthcare for our patients; and at this new Englewood Medical Center, patients could have all their

medical needs taken care of at one, modern, pleasing center. By providing the right care at the right time in the right setting, we will be our patents’ connection to a healthier life.

So far, the Englewood team is seeing approximately 150 patients a day; that’s about 100 established patients that are being seen for their primary-care needs, and about 50 more that are being treated at the walk-in center for more urgent needs.

Additionally, we will be building on the services we are now offering. We know there is a need for specialists in the community; we will be adding neurology and endocrinology in January, along with CT imaging capability.

That is also when we plan on having our grand opening and ribbon cutting, so stay tuned.

Your Connection to a Healthier Life Thank you for reading!

To learn more about Millennium Physician Group visit www.MillenniumPhysician.com or call (844) CALL-MPG to schedule an appointment today!