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November 2014.

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Features & Cover Articles 4 6

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TYPE 2 DIABETES

GLAUCOMA

It is estimated that 50% of type 2 diabetes could be prevented through better lifestyle choices.

Read about the two types and causes of diabetes.

Read about glaucoma, which is the second leading cause of blindness in North America, behind diabetes.

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Great selection of quality health and wellness products from Peoples Pharmacy.

DIABETES MANAGEMENT Take charge of your health with health products to help manage your diabetes.

LIVING WITH STRESS

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Darlene Booth provides helpful advice on managing daily stress.

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Brand new feature recipe From Company’s Coming Vegetarian Recipes.

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SPOTLIGHT ON OUR COMMUNITIES A look at Quadra Island and Chetwynd, two B.C. communities that Peoples is proud to be a member of.

Diabetes Care.

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PEOPLES DRUG MART • PEOPLES PHARMACY Community owned and operated pharmacies, proudly serving British Columbians since 1976. Peoples Pharmacists are truly committed to helping people live better lives by providing trusted and personal health care.

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TYPE 2 DIABETES

Ian Lloyd Pharmacist

In 2010, it was thought that 2.7 million Canadians The most common, and most preventable, type had some form of diabetes. That is only 2.7% of of diabetes is type 2. Type 2 diabetes occurs when the population. However, this number is expected the body doesn’t produce enough insulin or it cannot to rise to 4.2 million people (10.8%) by 2020. This properly use the insulin that it does produce. There medical condition costs the Canadian healthcare are several risk factors for developing type 2 diabetes: system about $12 billion dollars a year. Diabetes being over the age of 40, being overweight, greatly increases one’s risk of heart disease, strokes, and/or if you have a family member who has diablindness and kidney failure. betes.

While these facts might seem There are many effective treatThere are several risk factors daunting, there are some good ments for type 2 diabetes. One for developing type 2 dianumbers to follow. It is estican use insulin, prescription betes: being over the age mated that 50% of some types drugs or both. The drugs that of 40, being overweight, of diabetes could be prevented treat diabetes general do one and/or if you have a family through better lifestyle choices. of two things. They either help member who has diabetes.

This month we will discuss the the pancreas make more insulin types and causes of diabetes. “keys,” or they help to make What is diabetes? The condition of diabetes cells more sensitive to insulin; “they grease the occurs when the body does not produce, or is hinges on the door.” There are many kinds of drugs unable to properly use, insulin. Insulin is needed to help treat diabetes, so it is beyond the scope of by all cells to use glucose, which is the body’s primary this article to discuss them. If you have any spesource of energy. One analogy is that insulin is the cific questions about drugs that help treat dia“key” to open your cells “door” to let in glucose. betes, please ask your local Peoples Pharmacist.

There are many symptoms that can indicate if you Are there any ways to help prevent or treat type have diabetes: unusual thirst, frequent urination, 2 diabetes? There sure are. Two things in your weight change (gain or lose), unusual fatigue, or control are to watch your diet and exercise blurred vision. regularly. Limit all things sugary, refined and foods There are three types of diabetes. Gestational of convenience. Another way to remember this tip diabetes is a temporary condition that affects is to avoid all things white: white bread, white about 3% of all pregnancies. Type 1 diabetes potatoes, donuts, white rice, etc. A very good idea occurs when the pancreas no longer produces would be to visit a dietician or nutritionist. Many insulin. Around 10% of all cases of diabetes are local chapters of the Canadian Diabetes Association, type 1. People with type 1 diabetes require several or your local hospital, may have a nutritionist that injections of insulin daily to help control the disease. you can visit. They are an excellent resource to 4 People First Join us on

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GLAUCOMA

nerves fail first, so vision loss tends to start at the Glaucoma is a type of progressive eye damage in edges, progressing to "tunnel vision" and blindness. which optic nerve cells are damaged by excess fluid Many people don't notice this at first, and there's pressure in the eyeball. It's the second leading cause usually no pain, so glaucoma can be quite advanced of blindness in North America, behind diabetes. before it's detected. The US Glaucoma Foundation esGlaucoma often runs in families. There are several timates that only 50% people with glaucoma are types of the disease and each is caused by a different aware of the disease. disease process that tends to affect different racial Types of glaucoma are classigroups. Overall, people of African fied by what's stopping the liquid origin are more likely than CauThe US Glaucoma Foundafrom draining: casians to get glaucoma. tion estimates that only - Primary open-angle glauOther risk factors for develop50% people with glaucoma coma (POAG) is the most common ing glaucoma include being over form of glaucoma in North Amerare aware of the disease.

45 years old, having high ica, affecting about 1 in 100 people. intraocular pressure (IOP; presPeople of African descent are especially susceptible. sure inside the eye), myopia (nearsightedness), diaIt normally strikes after the age of 50. The trabecular betes, high blood pressure, and a history of an eye meshwork looks fine on examination but doesn't injury. drain properly. Some researchers believe this is beCauses cause aging makes the cells less efficient. Others The front of the eye is a D-shaped chamber in suspect a drainage problem under the eye, or which the lens and iris (the coloured part) make up another defect. In any case, pressure builds up and the straight wall, while the cornea (the surface of the the optic nerve starts to fail. Blind spots eventually eye) forms the curved wall. A gland behind the upper appear in the peripheral vision, and later in the ceneyelid fills this chamber with a clear liquid (aqueous tral "seeing" area. This damage can't be repaired. humour) that supplies the front of the eye with POAG gets steadily worse over time if it isn't oxygen and nutrients and keeps it inflated. A steady treated. supply of liquid is produced, and it drains out through - Angle-closure glaucoma is most common in a mesh of tiny holes behind the lower eyelid, called people of Asian or Inuit descent, and in women and the trabecular meshwork. farsighted people. It can be chronic or intermittent.

In glaucoma, the liquid is produced normally but Since the trabecular meshwork is located in the the trabecular meshwork can't drain it due to clogangle of the D between the iris and the cornea, anyging or some other reason. Liquid pressure builds up thing that swells the iris or pushes it forward can in the eye, pressing on the optic nerve (the nerve that close that angle, blocking the meshwork. Certain links the eye to the brain). The nerve cells are then diseases, such as diabetes or uveitis (inflammatory slowly strangled of blood, eventually dying. The outer 6 People First Join us on

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Glaucoma...Continued From Page

condition of the eye), can cause the iris to be pushed forward. Aging also tends to thicken the lens and iris, blocking liquid flow between the front and rear chambers of the eye. Pressure builds in the rear chamber (the main part of the eyeball), pushing the iris forward and closing the trabecular meshwork.

- In normal tension glaucoma, the pressure in the eye is in the normal range, yet the optic nerve is still damaged. It's believed that poor blood flow to the optic nerve makes the nerves more vulnerable.

Pressures just slightly above average can therefore damage the eye.

- Pigmentary glaucoma mostly affects younger nearsighted people. The iris, which is concave in myopia, rubs against the pigment layer that holds the eye's colour. Flakes of pigment rub off and clog the trabecular meshwork, raising pressure. Exfoliation syndrome, most common in Caucasians aged 50 and older, is similar. Flaky white material appears on the lens before falling off to clog the meshwork.

Exfoliation syndrome doesn't necessarily result in glaucoma, but it makes it six times more likely.

- Traumatic glaucoma is the result of eye injury, often appearing years after the event.

Symptoms and Complications The biggest problem with glaucoma is the lack of symptoms, since you can't feel the pressure in the eye.

Only a few people get headaches, red eye, or blurred vision. If you don't get your eyes tested regularly, the first noticeable symptom could be permanent holes in your vision. Lack of treatment of glaucoma often leads to blindness.

If you do get severe eye pain, redness, and blurred vision, it may be a symptom of an angle-closure attack. This is an acute complication in which the iris swells or moves forward to totally block the trabecular meshwork. If you are prone to angle-closure glaucoma, you're most likely to get an acute attack in the dark, because the pupil opens up in low light, making the angle smaller. In a mild attack, you may see halos around objects and slight blurring, but there's no Continued On Page 10

Flu Vaccinations Flu season is coming and Peoples Drug Mart is committed to helping you stay healthy all season long.

Getting the flu vaccination is your best defense against seasonal flu and many Peoples Drug Mart and Peoples Pharmacy locations offer convenient flu vaccination services. It’s easy and can help you beat the flu bug.

Peoples Locations That Administer Flu Vaccinations Abbotsford Ashcroft Burnaby Campbell River Chase Chetwynd Cranbrook

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Golden Kelowna West Kelowna Kitimat Lytton Mackenzie Nakusp

Nelson Penticton Port Hardy Port McNeill Quadra Island Revelstoke Richmond

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Spotlight

On Our Communities

Quadra Island Quadra Island is the largest and most populous of the Discovery Islands and lies between Vancouver Island and the mainland coast of B.C. Quadra, is home to 2700 year round residents, and is a popular destination for visitors from around the world.

Surrounded by breathtaking wilderness scenery and blessed with a mild temperate climate Quadra Island is a healthy and vibrant community which to live in or visit. One of the premier destinations in B.C. for adventure recreation and in particular for diving, hiking, mountain biking, sea kayaking and wildlife viewing. The intricate shoreline is ideal for exploration by sea kayak dotted with beaches, sheltered coves, protected channels and islets.

Photo courtesy Philip Stone

Photo courtesy Philip Stone

Photo courtesy Philip Stone

Chetwynd

Photo courtesy Maggie Gilbert/PictureBC

Photo courtesy Maggie Gilbert/PictureBC

Virgin forests, rolling hills and snow capped mountains await your senses in the district of Chetwynd. Crystal clear lakes and rivers draw outdoor enthusiasts from around the world.

The residents enjoy the outdoor splendor in this forestry, pulp, gas and ranching community.

Chetwynd has beautiful handcrafted chainsaw sculptures of indigenous animals and local scenes. These sculptures can be found outside or inside local businesses. In 2005 Chetwynd hosted the first annual Chetwynd International Chainsaw Carving Championship. Chetwynd is now drawing international attention, with carvers coming as far away as Wales, North Wales, and %apan.

Photo courtesy Maggie Gilbert/PictureBC

Proud to Support Our Communities Peoples Drug Mart believes in supporting and strengthening our local communities. Peoples Drug Mart is proud to support the ALS Society of BC and offer assistance through the Peoples Drug Mart Healthy Communities Fund. peoplesdrugmart.com People First 9

Glaucoma...Continued From Page 8

a painless 15-minute outpatient procedure. The laser is unfocused and harmless when it passes through the surface of the eye, but it concentrates its energy on the trabecular meshwork, shrinking it and reopening the holes. Many patients are able to stop using their glaucoma medications after this operation. There are other surgical procedures available if this doesn't work.

With early treatment, vision loss can be minimized or prevented. Because glaucoma isn't obvious, it's vital to get your eyes checked regularly, especially if you have any of these risk factors: family history of glaucoma African descent myopia (nearsightedness) previous eye injury high blood pressure diabetes long-term use of prednisone, cortisone, or other steroids If you are between the ages of 20 and 64 years, you should have your eyes checked every 1 or 2 years. From the age of 65 years onwards, you should have them checked every year. But if you have any of these risk factors, you should go as often as your eye care professional recommends.

pain. Extreme pain and a red, swollen eye signal a medical emergency - people can go blind rapidly if it isn't treated.

Making the Diagnosis The first thing an eye doctor will want to check is the eye's internal pressure. An air-puff tonometer can measure this without touching the eye. The doctor will also look into the eye through the transparent pupil with an ophthalmoscope. This is essential because normal tension glaucoma is missed by the eye pressure test.

Early damage from glaucoma can be detected with a visual field test. You'll be asked to spot flashing lights around the rim of your field of vision. A computer is often used to perform this test.

Treatment and Prevention Medications are available that can reduce eye pressure and prevent damage. Most are given as eye drops.

Beta-blockers (e.g., betaxolol*, levobunolol, timolol), alpha2-agonists (e.g., brimonidine), and carbonic anhydrase inhibitors (e.g., dorzolamide, brinzolamide) slow the production of eye fluid (aqueous humour), while prostaglandin analogs (e.g., latanoprost, travoprost, bimatoprost) and miotics (medications that contract the pupil, such as pilocarpine) improve drainage. Medications have to be used indefinitely, so many people with glaucoma end up opting for surgery or laser treatment.

The most common operation is laser trabeculoplasty,

All material Š 1996-2014 MediResource Inc. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition

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Ian Lloyd...Continued From Page 4

learn about diabetes and nutrition. It is easy to speak to a dietician in your own home, just dial 811. It is a toll-free call anywhere in BC. You can also communicate with one by email. Visit http://www.healthlinkbc.ca/healthyeating/ for more details.

Another diet tip is to choose foods high in fibre.

Look for ‘brown’ foods like brown bread and brown rice. Fruits, vegetables and unrefined grain cereals are excellent sources of fibre. Fibre helps all forms of diabetes in several ways. It is known to slow the emptying of the stomach and will help to slow the digestion of meals. This is good as it will prevent a large influx of sugar into the body after a meal. A more gradual increase of the after meal sugar levels will put less demand on the pancreas.

A high fibre diet has also been shown to help reduce bad cholesterol, another complication of diabetes. It may also help to prevent certain forms of cancer.

One of the best ways to help prevent and treat diabetes is through regular exercise. It has been shown that walking, for even 20 minutes three times a week, can produce benefits. Regular exercise can help to increase insulin sensitivity and use up excess blood sugar. It can also help to reduce cholesterol and blood lipids. Regular exercise also increases your energy levels and helps you sleep better. The benefit list goes on and on. Before you start any new exercise routine you should first consult your physician, to determine what level of activity is appropriate. Exercise is also a great way you lose weight. Being overweight is one of the major contributing factors for the development of type 2 diabetes and other health problems. Again you don’t need much; 20 minutes of walking three times a week is a good place to start.

Whenever you change a habit or start a new project, the hardest part is just getting started.

Walking 20 minutes a day and changing one’s diet seems easy in theory, but where does one start.

The first place to start is motivation; why start in the first place? This is the hardest part, why change anything when you can't see the problem.

Helping People Live Better Lives

We Can Help With Flu Vaccinations.

Flu season is here and most Peoples locations offer convenient on-site flu vaccination services. Talk to your Peoples Pharmacist about the benefits of an annual seasonal flu shot.

Navi Bal

Pharmacist & Owner, Kelowna

We Can Help You Better Manage Your Diabetes.

A Peoples Pharmacist can help you take control of your diabetes by providing advice on proper testing of blood sugar levels, how to analyze your readings and how to effectively manage your readings.

Andrew Hoffert

Pharmacist & Owner, Nelson

We Can Help With Medication Reviews.

Medication reviews are in-depth consultations that improve health outcomes by helping resolve any issues that may have arisen due to your medication. Ask about the medication review service.

Mike Hoenmans

Pharmacist & Owner, Scotch Creek

Ian Lloyd...Continued on Page 13

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Focus On Vitamin B Complex Aids Metabolism & Nervous System Function The 11 members of what's known as the vitamin B complex are critical nutrients for metabolism and nervous system function. Although each B vitamin has a unique role, they work together as coenzymes to metabolize food and to provide energy. B vitamins help synthesize brain chemicals that control mood and nerves. The B vitamins support the nervous system, skin, eyes, liver, and mucous membranes, and enhance energy, muscle tone and gastrointestinal health.

Many of us don't get enough B vitamins, deficiencies in folic acid, B12, and B6 are especially common.

Ensuring that your diet contains plenty of B-rich foods -- dark-green vegetables, protein from animal sources, and whole grains - is important.

Talk to a Peoples Pharmacist about the benefits of B vitamin supplements.

Going On A Winter Holiday?

Peoples has everything; from travel-size essentials to travel vaccinations - find everything you need for a healthy and safe trip.

Travel Vaccination Service Most Peoples locations conveniently administer travel vaccinations on-site.

Medications for Allergy, Stomach Relief, First Aid & Pain Relief A prepared traveller is a safe traveller.

Travel-size Toiletries Bring along your daily essentials.

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Ian Lloyd...Continued From Page 11

In most mild cases of type 2 diabetes there are no symptoms. Ponder this simple phrase, “If you don't make time for wellness now, you will be forced to spend time on sickness later.” The next step is to literally take a step, no matter how small it is. One day a week go for a walk around the block. That is it. A walk around the block might take 10 minutes. Certainly you can devote 1/10th of one percent of your weekly waking hours on bettering your health? After two weeks increase to walking twice a week. Slowly increase from there.

The same thinking can be applied to eating better. Perhaps the greatest impact can be made with snacking. Instead of reaching for your usual snack, grab an apple and a glass of water instead.

Cook a slightly smaller portion of meat and add more veggies. Instead of buying white bread or pasta, choose whole wheat next time. Cut back on the portion of dessert you serve yourself. You only need to make these changes with regular at home meals. On special occasions, feel free to treat yourself. You deserve it. Build upon the small changes you make.

There are many things people can do to help reduce their risk of developing type 2 diabetes.

These include changes in diet, regular exercise and weight loss. Weight loss is very important in the management of diabetes. Talk to your doctor or Peoples Pharmacist for more information. They might recommend that you visit a nutritionist, who can help facilitate the changes to your diet.

This is one of those times that knowledge truly can improve the quality of your life. The more you know about diabetes the healthier you can be, and stay.

Written By Ian Lloyd, Pharmacist & Chartered Herbalist

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Helping People Live Better Lives

We Can Help Reduce Everyday Strain On Your Busy Legs.

Select Peoples Drug Mart and Peoples Pharmacy locations offer compression stocking and fitting services, which help treat painful venous leg disorders.

Check with your local Peoples for this health service.

Paul Sherman

Pharmacist & Owner, Kitimat

We Can Help With Menopausal Hormone Therapy.

Select Peoples locations provide menopausal hormone therapy to help people transition through menopause more comfortably.

Talk to a Peoples Pharmacist about this health service.

Chris Dreyer

Pharmacist & Owner, Lytton

We Can Help With Medication Blister Packaging.

The Med Manager blister pack program takes the guesswork out of your daily medications.

This convenient and easy to use blister card is ideal if you are on multiple medications.

Derek Langer

Pharmacist, Courtenay

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Darlene Booth

LIVING WITH STRESS

R.H.N

What is your relationship with stress? There is a tendency to- we can change how we react to them – it’s often not personal! ward putting a negative spin on all stress but, in reality, stress 2. Listen to your body. If people, places or events ramp up is a natural by-product of living and not always avoidable. It your anxiety then weed them out of your life or limit expocan be polarized and given a positive or a negative connota- sure. When my anxiety hit an all time high, I recognized that tion; positive stress motivates and fuels excitement whereas tuning out the media helped. Throwing worry about world negative stress is draining and contributes to discomfort and economic crisis on top of my personal “financial reorganizadisease. Stress can also be described using a continuum of mild tion” was only adding more stress to an already maxed out to catastrophic but the actual experience of stress is relative situation. Sometimes you have to be an ostrich for a while and bury your head in the sand until the to an individual’s circumstance, tide turns in your favour. conditioning and perception. One 3. Self care. I have to admit that after a person’s camel straw may be another To come into a healthy lifetime of taking care of other people, person’s call to action. To come into a focussing on my own needs seemed healthy relationship with stress it is relationship with stress it kind of selfish. Then the realization came important to be mindful of our is important to be mindthat self-care actually meant I was more attitude and coping strategies. available in relationships - not less. My ful of our attitude and Many years ago, I went through a self care includes healthy nutrition, daily series life transitions that included at coping strategies. exercise, meditation, going for massage least 6 of the top 10 life stressors on and being mindful of not self medicatmost lists. It was a period of huge transformation that I could not fight - nor did I try. I remember ing with junk food, drugs or alcohol when stressors ramp up. a good friend telling me that someday I would look back on (Oh and not beating myself with a stick if I have a lapse of that period and be grateful for all that occurred. At the time I “willpower” and eat the whole bag of cookies in one sitting). was extremely doubtful and in such psychological angst that 4. Find good counsel. My persona has always been one of it was hard to believe, but I held onto those words like a lifeline. independence – a “do it myself” person but for the first time They gave me the impetus needed to get up every day and I found myself in a place where none of my old “stress bustlook for the signposts that would lead me away from pain into ing” strategies worked anymore. (Lets just say that menopause the sense of peace I craved. And it turns out that they were picked an inopportune time to arrive and was ramping up the right. In hindsight now, it was like my whole being went physical stress on top of the emotional). When locked down, through metamorphosis; I came out on the other side of stress paralyzed and unable to move forward it is helpful to talk to a much stronger and clearer than ever. Here are a few things I trusted friend or enlist the help of a professional counsellor, therapist or coach. Be open to seeing from a new perspective have learned along the way: 1. Surrender. We cannot change that which we have no con- and know that over time, with practice, new strategies will trol over. I knew enough at the time that to fight the changes become the norm.

There is no doubt that some of life’s challenges are major diswould just create more pain so I adopted the stance of “what does not kill me will make me stronger.” It also helps to focus ruptors to a personal sense of safety and well-being and will on the details we can change. If you just lost your job – do you take time to rise above. We have to remember that stress hapneed an updated resume or a whole new career direction? pens. What are you going to do with it? Sometimes a change Would it help to talk to a career counsellor? Is there a bully in of attitude can help shift a negative stress experience into a your life? While we cannot change the behaviour of other people, positive one. Good Health to You!

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Biriyani Chickpeas, creamy paneer cheese and crunchy almonds give this fragrant rice dish substantial main-dish appeal. Paneer is a fresh cheese available in the freezer or deli cheese section of many grocery stores and in specialty Indian food stores. To make this recipe vegan, simply omit the paneer.

Biriyani

Cooking oil 1 tbsp.

15 mL Chopped onion 1 cup 250 mL Garlic cloves, minced 2 2 Curry paste 1 tbsp.

15 mL 1 Dried crushed chilies ⁄4 tsp.

1 mL Can of chickpeas (garbanzo beans), 19 oz.

540 mL rinsed and drained Brown basmati rice 1 1/2 cups 375 mL Diced paneer cheese (about 1/2 inch, 1 cup 250 mL 12 mm, pieces) Can of diced tomatoes (with juice) 28 oz.

796 mL Prepared vegetable broth (or water) 11⁄2 cups 375 mL 1 Saffron threads (optional) ⁄2 tsp.

2 mL Cinnamon stick (4 inches, 10 cm) 1 1 Frozen peas, thawed 1 cup 250 mL 1 Sliced natural almonds, toasted ⁄2 cup 125 mL Chopped fresh cilantro 2 tbsp.

30 mL

Heat cooking oil in a Dutch oven on medium. Add next 4 ingredients.

Cook for about 10 minutes, stirring occasionally, until onion is browned.

Add next 3 ingredients. Heat and stir for 1 minute. Add next 4 ingredients.

Stir. Bring to a boil. Reduce heat to medium-low. Cook, covered, for about 1 hour, without lifting lid, until rice is tender.

Stir in peas. Remove from heat. Let stand, covered, for about 5 minutes until peas are heated through. Transfer to serving dish.

Sprinkle with almonds and cilantro. Makes about 8 cups (2 L).

1 cup (250 mL): 370 Calories; 13 g Total Fat (3 g Mono, 1 g Poly, 4.5 g Sat); 20 mg Cholesterol; 51g Carbohydrate; 8g Fibre Fibre;16 g Protein; 630 mg Sodium

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