Month: June 2019

Diabetes diagnosis? Here’s how to commit to success

A new diabetes diagnosis can feel overwhelming. It is important for patients to become committed to the new self-care regimen that diabetes requires. This Q&A with offers some tips on how to get started.

What is diabetes? How is it managed?

Insulin, a hormone in our bodies, keeps our blood glucose (sugars in the blood) at a healthy level. Diabetes is a condition where there is a lack of insulin or the insulin isn’t working well, and too much glucose collects in the blood.

There are two types of diabetes. In Type 1 diabetes, the body cannot create insulin. This condition typically occurs earlier in life and is best managed by an endocrinologist. In Type 2 diabetes, the body develops a relative lack of or resistance to insulin. This usually occurs later in life and can be due to many things, but most often, the cause is an overabundance of fat tissue and being overweight or obese.

Diabetes is controlled with medications, by monitoring your blood sugars and by making lifestyle changes in diet, exercise and weight management.

How can a patient start to understand a type 2 diabetes diagnosis?

Your doctor and care team will guide your care and can point you to classes and support groups. I also recommend the great resources at the American Diabetes Association website as a way to get started.

It’s also easier to be motivated when you understand the value of making certain lifestyle changes. These changes all play a role in keeping you healthy and your diabetes under control:

  • Losing weight (decreasing excess body mass and fat cells) allows your body to regulate blood sugar more efficiently.
  • Eating healthier and reducing your intake of carbohydrates and refined sugars decreases the amount of blood sugar the body must regulate.
  • Increasing cardiovascular exercise burns calories and increases the body’s metabolism, empowering it to use up any excess sugar that might turn into fat tissue.

It sounds easy to feel overwhelmed! How does a patient commit to these new demands of self-care?

It’s not easy, but these demands become manageable (and natural) once you realize that these lifestyle changes will result not only in better blood sugar control, but also prevent the development of many other health conditions, leading to a healthier and happier you. I encourage my patients to take an active role in their care by doing some research, being disciplined with their medications and lifestyle, and asking questions when needed.

Any tips for the best way to partner with your primary care provider?

Your primary care doctor should help you understand the state of your diabetes—Is it controlled? uncontrolled? Is diabetes currently affecting other parts of my body?—and give you the tools and education to help manage it.

A good way to help your doctor is to keep a log of the foods you eat throughout the day and the activities you do. This way, your doctor can cater their advice to your particular situation. For example, if you tell your doctor that you eat pasta five times per week, he or she can make specific recommendations as to how much pasta or the type of pasta you should be eating. This will be more useful than a general instruction to “reduce your carbohydrate intake.”

Ask your primary care doctor what other care you might need. This might involve vaccines, annual eye and dental exams, foot care—all important for preventing and monitoring complications from diabetes.

What are some signs that a patient should seek medical help?

While lowering the blood sugar to normal levels is important in diabetes, blood sugar that is too low (hypoglycemia) can be dangerous and even deadly. It’s important to watch for signs of hypoglycemia such as shaking, lightheadedness, nausea and sweating—and if you develop them, check your blood sugar levels right away. If they are low, follow the plan that your doctor and you have created to address this situation. If hypoglycemia happens regularly, let your doctor know right away right away so they can adjust your treatment.

Dr. Jay Estrada, Internal Medicine, Pacific Medical Centers Lynnwood

Pacific Medical Centers
Primary and specialty care at nine PacMed clinics.
You can find diabetes care and classes at our Lynnwood, Northgate and Canyon Park clinics.

The most common reasons for clinic visits during the summer

Take precautions as hot weather returns

Warm weather and longer days will bring many Pacific Northwest residents outside this summer for pool parties, barbeques and more. However, increased time outdoors can lead to more urgent care or emergency room visits, as preventable issues including sports and swimming-related injuries significantly increase in the summer months.

Dr. Xiulian Chen with Pacific Medical Centers has outlined the most common reasons why patients end up unexpectedly in the doctor’s office or ER during summer months, as well as what can be done to ensure you and your loved ones stay safe and healthy this summer.

1. Heat-related illnesses

Heat rash: Heat rash is a rash caused by the blockage of sweat ducts. Other names for heat rash are “sweat rash” or “prickly heat.” While heat rash is more common in young children, it can happen to anyone. Often, heat rash looks like tiny bubbles or red dots/pimples on the skin. However, heat rash can sometimes appear as skin colored dots. The most common areas to develop heat rash are on the neck, chest, head or armpits. The best course of treatment is to cool down the skin and stay dry.

To avoid developing heat rash, I recommend wearing loose fitting cotton clothing, so the skin can breathe. Taking a cool bath or wiping sweat with a cool towel will also help. Generally, heat rash resolves in a few days. However, if the rash is associated with significant irritation or itching, or the skin begins to swell or emit pus, you should seek medical attention.

Sunburn: It is important to remember that being outside during the beautiful summer months can come with the danger of sunburn, even if it appears cloudy outside, and those with fair skin are more sensitive to sun damage.

Mild sunburn is generally skin redness accompanied by irritation. However, more severe cases of sunburn can cause painful blisters. Sunburn also increases the long-term risk for skin cancers. Most sunburn symptoms typically resolve in a few days. However, if the sunburn develops severe blistering and pain, go see your doctor.

Sunburn can be prevented by adhering to the following:

  • Avoid afternoon sun
  • Avoid excessive amount of time spent in the sun
  • Wear protective clothes and a hat
  • Apply sunscreen with at least SPF 15 and reapply as instructed on the product label

Heat exhaustion: Heat exhaustion occurs when a person’s internal temperature rises and causes the following symptoms:

  • Nausea
  • Fatigue
  • Racing heart
  • Muscle cramps
  • Lightheadedness

When heat exhaustion does occur, it is important to move to a cooler place, dampen your clothes, or take a cool shower and try to sip water.

Heat stroke: If a person’s internal temperature rises above 103 Fahrenheit or higher, heat exhaustion can lead to heat stroke. The symptoms of heat stroke include:

  • Headache
  • Confusion
  • Agitation
  • Rapid breathing
  • Racing heart

In the situation of heat stroke, the person should be immediately transported to a hospital.

To prevent heat-related illnesses, I recommend wearing loose fitting, light colored, and breathable clothing and be sure to drink extra fluids if you know you are going to be active outdoors. Also, if possible, try to remain in the shade while outdoors this summer.

2. Food poisoning and gastroenteritis

Summer is the peak season for food borne illness and gastroenteritis, as warm temperatures can cause bacteria to grow on food products. It is also more common to cook outside in the summer, where refrigeration is less available. Cooking outside also makes it harder for us to ensure cooking utensils and surfaces remain clean, as our hands allow bacteria to spread on both utensils and food.

Common symptoms of food poisoning include:

  • Abdominal pain
  • Diarrhea
  • Vomiting
  • Fever
  • Headache
  • Lightheadedness

These symptoms can range from mild to severe, with mild symptoms usually going away within a few days.

The important part of the treatment for food poisoning and gastroenteritis is to increase oral hydration with fluids that contain electrolytes. In severe cases, if you are unable to consume fluids by mouth, you will need to go to the hospital for intravenous fluids.

To prevent foodborne illness, it is important to refrigerate any food that can spoil easily. I recommend storing prepared food in your refrigerator or cooler if possible and avoid keeping food in the heat for long periods of time. Other helpful tips include thorough washing of hands and cooking utensils and to separate your raw meat and fish from other foods.

3. Swimming-related injuries and drowning

Who doesn’t enjoy jumping into cool water and having some fun in the summer? Unfortunately, drowning does happen very often in the summer and is the second most common cause of death in children by unintentional injury during the summer months. Given this, it is extremely important to supervise children closely. If you are going to have a pool party this summer, make sure you have designated an adult to watch the kids in the pool. Parents often get distracted while socializing with other adults and are not always able to pay close attention to their children. By ensuring children are constantly monitored, the chances of drowning are extremely slim.

4. Sports injuries

Common sports-related injuries include injuries from playing football, frisbee, soccer, tennis or hiking. Sprained ankles, sprained wrists, or broken bones are the reasons behind many urgent care clinic visits during the summer months in the Pacific Northwest. Treatment for sports-related injuries usually consists of RICE (Rest, Ice, Compression and Elevation). If you believe you have incurred a sports injury this summer, be sure to go to your doctor’s office to ensure the injury does not worsen.

5. Insect bites and diseases

Another common occurrence during the summer months is insect bites and diseases, including mosquito and tick-borne diseases. In addition to causing allergic reactions, mosquitoes can also spread bacteria and cause more serious infections. An easy way to prevent insect bites and diseases this summer is to wear insect repellent when you are outside.

While tick-borne diseases are not common in Washington, they are present in other states. If you plan on traveling this summer, be sure to wear tick repellent, as well as search for ticks when you are in the woods, brush or grassy places. It also helps to wear long sleeve shirts and pants while outdoors to ensure insects do not have access to your skin.

For more information about summer safety, check out the CDC website where you will find a lot of practical and useful information. Have a fun and safe summer!

Dr. Xiulian Chen is a family medicine physician at PacMed.