To Your Health! A SPECIAL SECTION OF THE RIVERTOWNS ENTERPRISE
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OCTOBER 6, 2017
Prediabetes now and in your future By LAURIE SULLIVAN
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rediabetes is silent and could be lurking when we least expect it. But the risk factors are clear. Prediabetes, the precursor to Type 2 diabetes, can happen to people with specific risk factors, including being overweight especially with a lot of abdominal fat, and those of us given to inactivity or at least not getting enough exercise. Genetics and family history play a huge role in being predisposed in developing prediabetes, as do certain ethnic groups. According to the Mayo Clinic’s website, people with prediabetes don’t process sugar (glucose) properly anymore. As a result, sugar accumulates in the bloodstream, instead of doing its normal job of fueling the cells that make up muscles and other tissues. According to the site, insulin comes from, the pancreas, a gland located behind the stomach. Your pancreas secretes insulin into your bloodstream when you eat. To cut to the chase, when you have prediabetes the process of processing glucose in the pancreas begins to work improperly. Instead of fueling cells, sugar builds up in your bloodstream and high blood sugar occurs when your pancreas doesn’t make enough insulin or your cells become resistant to the action of insulin or both. This is reason enough to take action if you are at risk, even if you feel fine.
Prevention solutions Dr. Jeffrey Powell is chief of endocrinology at Northern Westchester Hospital and an endocrinologist at CareMount, an outpatient clinic in Mount Kisco. He sees patients with prediabetes and diabetes conditions and those with glandular and other hormonal issues. When treating patients with prediabetes he recommends lifestyle changes to be of the upmost importance. That includes diet management and exercise. There are some medications that could also be prescribed, but Dr. Powell believes patients should try lifestyle changes first. If someone is prediabetic and fails to improve their blood sugars, “We would use some diabetes medicine.”
Internists sometimes refer patients to Powell, but often he sees patients for unrelated issues and it turns up. “If patients have a first-degree relative or many second-degree relatives [with diabetes], you should screen,” he said. Someone who is overweight or had gestational diabetes when they were pregnant should also be tested. Dr. Powell said most people try to modify their diet and exercise. He said because prediabetes has no symptoms it’s hard to get people to change their dietary habits and physical exercise “if they’re not feeling any different.” They may also have high blood pressure as well. “I think if they know someone who has dia-
betes and seen the effects it of it, they are more likely to do something about their own issues,” Dr. Powell said. In addition to family history and genetics, he stressed that those of African American, Latino and Native American descent are more predisposed to getting diabetes. There may be a higher incidence of being overweight. Dr. Powell said there are a couple tests to screen for prediabetes, including a fasting glucose or oral glucose tolerance test and hemoglobin A 1 C, showing the range of normal values, prediabetes values and diabetes values. Continued on page 9A
Happy feet make life much more sweet
INSIDE
By MAJA TARATETA
5A Sleep: How to get what you need..........2A Reducing knee and hip pain without surgery, prescriptions................. 3A Pain, mystery symptoms: autoimmunity is on the rise...................... 4A Good relationships are key to maintaining good health...................... 5A Auditory therapies for brain health.......... 6A Opioid Crisis: Collaboration needed for addiction treatment............... 8A Top 5 Diet Tips...................................... 10A Endpaper: Got a symptom? Don't wait to get help like I did..............12A
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h, my aching dogs!” It’s an expression that signifies that feet are tired, sore or in serious pain. The reasons behind foot ailments are many. Bunions, ingrown toenails, fungus, plantar fasciitis, hammer toes, warts, deformities and sports injuries top the lists of reasons that patients are running — well, limping — to the podiatrist’s office. But many don’t go right away. “People accept their foot pain,” said Dr. Ryan Minara, DPM, a podiatrist at the Center for Pediatric Care & Sports Medicine in Manhattan and White Plains. “They feel foot pain is natural and their feet should hurt. To some extent this is true — feet can often feel tired. But pain is a sign that something is wrong that should be addressed.” Podiatrists are doctors who specialize in
and treat conditions of the foot, ankle and related structures of the leg. They complete four years of medical school training and currently three years of residency. They can be board certified. And they are on the front lines of diagnosing and treating the feet of patients of all ages and with a variety of other medical issues. “Everything begins with the foot you inherit and how it functions after that,” said Dr. Stuart Bernstein, DPM, who has a practice in Manhat-
tan and Hastings-on-Hudson. “You need to look at feet though the lens of foot mechanics, or as I like to call it, the lost art of podiatry.” A self-described conservative, holistic podiatrist, Dr. Bernstein believes that many foot ailments can be traced to the way patients walk and the shoes they wear. “You can get an infection from a bad pedicure or cutting your nail the wrong way,” he said. “But the usual reason that people don’t get better is their way of walking.” Believing that some doctors are overly eager to perform surgeries on patients rather than investigate biomechanics, Bernstein said he has decided to focus his practice on making custom orthotics to help people’s feet function better. Dr. Bernstein prescribes orthotics for many foot concerns, even bunions. “You can put an orthotic in a shoe, walk a different way, and the bunion can feel Continued on page 13A