Digestive System

Diabetes

What is diabetes?

Diabetes is a medical condition that affects the body’s ability to produce or use insulin. It also affects blood sugar levels.

The three types of diabetes are type 1, type 2 and gestational diabetes. Type 1 diabetes affects the body’s ability to produce insulin. Type 2 diabetes affects the body’s ability to use insulin well. Gestational diabetes impacts the body’s ability to use blood sugar during pregnancy.

The cause of type 1 diabetes is not understood and at this time is not preventable. However, people trying to avoid type 2 diabetes may be able to engage in lifestyle changes that lower their risk.

Measuring your blood sugar levels frequently (4 times a day, or more) is important to see how well your levels are controlled. The goal is to keep fasting blood sugar levels (the levels after an overnight fast), under 140 mg/dL and preferably closer to the 70 to 120 mg/dL range.

Measuring your blood glucose levels will give you necessary information. If your levels are too high, you may need to modify your diet, and medications (if you take any).

Symptoms of diabetes:

  • Frequent urination, often at night
  • Excessive thirst
  • Unexplained weight loss
  • Extreme hunger
  • Blurry vision
  • Numbness or tingling hands or feet
  • Fatigue
  • Dry skin
  • Slow healing of sores
  • Increased infections

You can experience the above symptoms in addition to high blood sugar levels if you’ve been diagnosed with diabetes and it is not well controlled.

If you are experiencing any of the above symptoms, getting a blood test is the only way to confirm if you have diabetes. Contact your primary care physician to make an appointment.

Eat Healthy

  • Avoid foods that are high in unhealthy fats and cholesterol in favor of fresh foods and whole-grain carbohydrate choices
  • Avoiding processed and pre-packaged foods can help.
  • Portion control is often an important aspect of eating a healthy diet. By limiting excessive portions, people can cut calories resulting in weight loss

Exercise

  • Exercise is an important part of the weight-loss plan for people trying to prevent type 2 diabetes
  • Engaging in at least 30 minutes of physical activity five days a week can help
  • However, people who don’t currently exercise may need to start in smaller intervals—this can include three 10-minute exercise sessions each day

Quit Smoking

  • If you have type 2 diabetes and you smoke, it is not too late to quit smoking
  • Quitting smoking may make it easier to manage your diabetes
  • Studies have found insulin to be more effective at lowering blood sugar levels just eight weeks after quitting smoking
  • If you are looking to get your diabetes under control, or are simply looking to quit for other health reasons, talk to your doctor about your options and/or call the “quitline” at 1-800-QUIT-NOW (1-800-784-8669)

If you have diabetes, you should do the following every year. All of these recommended treatments are covered by AHDI in our Standards of Care.

  • Two visits to your doctor per year (more often if your blood sugars are not well controlled) *
  • Two Glycohemoglobin (Hemoglobin A1c) tests per year
  • One Creatinine per year
  • One Lipid Panel per year
  • One Urine Albumin/Creatinine ratio or other tests for early kidney disease per year (if no kidney disease or treatment for early diabetic kidney disease)

*Seniors: If you need assistance finding a health plan that will help you seek the care you need in the management of your diabetes, please visit our division dedicated to senior care

If you need additional resources to help manage your diabetes, visit the American Diabetes Association website.

Prediabetes

What is prediabetes?

There are no clear symptoms of prediabetes so you may have it and not know it. But before people develop type 2 diabetes, they almost always have prediabetes—where blood sugar levels that are higher than normal but not yet high enough to be diagnosed as diabetes.

For some people with prediabetes, early treatment, and moderate lifestyle changes can return blood sugar levels to a normal range, effectively preventing or delaying type 2 diabetes. With prediabetes, there are simple steps you can take to change things, such as adapting your food choices and increasing your daily physical activity to lose weight, if needed.

Your pancreas produces and sends insulin to your blood when you eat, and when your blood sugar level starts to drop, the pancreas slows down the release of insulin into your blood.

Prediabetes causes this process to lose its efficiency, and sugar builds up in your bloodstream.

This happens because:

  • Not enough insulin is produced by your pancreas
  • Your cells don’t allow as much sugar in because they become resistant to insulin

Prediabetes doesn’t usually have any signs or symptoms.

One possible sign of prediabetes is darkened skin on certain parts of the body. Affected areas can include the neck, armpits, and groin.

Classic signs and symptoms that suggest you’ve moved from prediabetes to type 2 diabetes include:

  • Frequent urination, often at night
  • Excessive thirst
  • Unexplained weight loss
  • Extreme hunger
  • Blurry vision
  • Numbness or tingling hands or feet
  • Fatigue
  • Dry skin
  • Slow healing of sores
  • Increased infections

You can experience the above symptoms in addition to high blood sugar levels if you’ve been diagnosed with diabetes and it is not well controlled.

If you are experiencing any of the above symptoms, getting a blood test is the only way to confirm if you have prediabetes. Contact your primary care physician to make an appointment.

Eat Healthy

  • Avoid foods that are high in unhealthy fats and cholesterol in favor of fresh foods and whole-grain carbohydrate choices
  • Avoiding processed and pre-packaged foods can help
  • Portion control is often an important aspect of eating a healthy diet. By limiting excessive portions, people can cut calories resulting in weight loss

Exercise

  • Exercise is an important part of the weight-loss plan for people trying to prevent prediabetes
  • Engaging in at least 30 minutes of physical activity five days a week can help
  • However, people who don’t currently exercise may need to start in smaller intervals—this can include three 10-minute exercise sessions each day

Quit Smoking

  • If you have prediabetes and you smoke, it is not too late to quit smoking
  • Quitting smoking may make it easier to manage your prediabetes
  • Studies have found insulin to be more effective at lowering blood sugar levels just eight weeks after quitting smoking
  • If you are looking to get your prediabetes under control, or are simply looking to quit for other health reasons, talk to your doctor about your options and/or call the “quitline” at 1-800-QUIT-NOW (1-800-784-8669)

If you have prediabetes, we recommend you seek the following treatments every year. All of these recommended treatments are covered by AHDI in our Standards of Care.

  • One visit to your doctor per year *
  • One Fasting Blood Sugar or Glycohemoglobin test (Hgb A1c) per year
  • One Lipid Panel per year

*Seniors: If you need assistance finding a health plan that will help you seek the care you need in the management of your diabetes, please visit our division dedicated to senior care

If you need additional resources to help manage your diabetes, visit the American Diabetes Association website.

Crohn's Disease

What is Crohn’s Disease?

Crohn’s Disease—less commonly known as Regional Enteritis—is an lifelong inflammatory bowel disease that causes your digestive tract to swell and become irritated.

While the cause of Crohn’s Disease is currently unknown, researchers do believe that it may be linked to an autoimmune reaction (when your immune system attacks the healthy cells in your body). Crohn’s Disease can also run in families, meaning that there may be a genetic cause.

See your doctor if you have persistent changes in your bowel habits or if you have any of the signs and symptoms of Crohn’s disease, such as:

  • Abdominal pain
  • Blood in your stool
  • Nausea and vomiting
  • Diarrhea lasting more than two weeks
  • Unexplained weight loss
  • Fever in addition to any of the above symptoms

Family history of the disease

Having a parent, child, or sibling with the disease puts you at higher risk.

Smoking

This may double your risk of developing Crohn’s disease.

Taking certain medicines

Antibiotics, birth-control pills, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, may increase your chances of developing Crohn’s.

These may slightly increase your chance of developing Crohn’s.

A high-fat diet

This may also slightly increase your risk of Crohn’s.

The pain that Crohn’s patients feel tends to be crampy. It often appears in the lower right abdomen but can happen anywhere along the digestive tract. “It depends on where that inflammatory process is happening,” says Nana Bernasko, DNP, gastroenterology expert with the American Gastroenterological Association.

Pain is common in people with Crohn’s disease and can significantly impact quality of life. Over time, Crohn’s disease may cause scarring in the lining of the intestinal tract (called adhesions and strictures) that can lead to painful obstructions. Ongoing inflammation along with ulcers and abscesses in the intestines are common causes of pain.

Sometimes pain is the only sign that the disease is progressing and that a different treatment may be needed.

If you experience the following, call 911 or visit the emergency room:

  • Are experiencing severe bleeding from the rectum
  • Are having severe and constant abdominal pain
  • Are noticing a sudden, unusual change in alertness

Avoid NSAIDs

Nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen (Advil) or naproxen (Aleve) can impair the ability of the GI tract to protect and heal itself and can precipitate a flare. If you are having pain, take acetaminophen (Tylenol) instead of NSAIDs.

Quit smoking

Smoking is a strong risk factor for developing Crohn’s disease and can also set off a disease flare. Quitting smoking is strongly associated with fewer flares, decreased medication requirements, and reduced risk of surgery.

Reduce stress

Although stress does not directly cause Crohn’s disease, it does strongly impact IBD symptoms. Many people with Crohn’s disease find the regular use of stress management and stress reduction techniques to be helpful. These can include meditation, deep breathing, biofeedback, yoga, and cognitive behavioral therapy.

Simplify your diet

There is no specific diet that prevents or cures Crohn’s disease, but you may identify specific foods that tend to worsen your symptoms. Keeping a food journal can help you make these connections. There are also several general principles that help most patients feel better when they are experiencing a flare:

  • Eliminate dairy
  • Avoid greasy and fried food
  • Limit foods that are high in fiber, such as raw vegetables and whole grains
  • Avoid foods that tend to cause gas (beans, cruciferous vegetables)
  • Limit your diet to well-cooked vegetables
  • Minimize caffeine and alcohol; they may make symptoms worse during a flare

If you have Crohn’s Disease we recommend you see your doctor every year. Recommended treatments are covered by AHDI in our Standards of Care.

If you need additional resources to help manage your Crohn’s Disease, visit the Crohn’s and Colitis Foundation’s website https://www.crohnscolitisfoundation.org/

Ulcerative Colitis

What is Ulcerative Colitis?

Ulcerative Colitis is a chronic disease affecting the lining of the colon (large intestine). Sign and symptoms of the disease may vary in severity and duration, but often are associated with periods of diarrhea, lower abdominal pain and blood and mucus in the stools.

The cause of the disease is currently unknown, but genetics may be a contributing factor.

Ulcerative colitis also affects other areas of the body, such as the skin, liver, and joints.

Flare-ups are common and treatment is usually aimed at bringing about remission (periods without symptoms or disease activity). Complications may include poor nutrition, anemia, electrolyte imbalances, and arthritis. There is an increased risk of colon cancer for patients with a long history of the disease.

Abnormal immune response, genetics, microbiome, and environmental factors all contribute to ulcerative colitis.

Research suggests that ulcerative colitis could be triggered by an interaction between a virus or bacterial infection in the colon and the body’s immune response.

Typically, the cells and proteins that make up your immune system protect you from infection.

A normal immune response would cause temporary inflammation to combat an illness or infection. The inflammation would then go away once you are healthy and free of the illness.

In ulcerative colitis patients, the inflammation persists long after the immune system should have finished its job. The body continues to send white blood cells into the lining of the intestines, where they produce chronic inflammation and ulcers.

Experiencing diarrhea and bloody stools are two of the earliest symptoms of Ulcerative Colitis. Reach out to your primary care urgently if you are experiencing these signs of the condition.

Ulcerative colitis can occur at any age, though most people are diagnosed in their mid-30s.

  • Men and women are equally likely to be affected, but older men are more likely to be diagnosed than older women
  • The risk of developing ulcerative colitis is between 1.6 percent and 30 percent if you have a first-degree relative with the disease
  • It is not possible to confidently predict which, if any, family members will develop ulcerative colitis, even though there is an increased risk of IBD based on family history
  • Ulcerative colitis can affect people of any racial or ethnic group

Belly pain from ulcerative colitis can feel crampy, like a charley horse in your gut. It can happen before a bowel movement or while you’re going.

Other parts of your body might hurt as well. Some people with the disease have sore joints. Others’ eyes hurt when they look at bright lights.

If you experience the following, call 911 or visit the emergency room:

  • Severe stomach pain
  • High fever
  • Severe diarrhea
  • Heavy rectal bleeding

Skip the dairy aisle

There’s no firm evidence that diet causes ulcerative colitis. But certain foods and beverages can aggravate your signs and symptoms, especially during a flare-up.

Say no to fiber

In general, high-fiber foods, such as fresh fruits and vegetables and whole grains, are excellent sources of nutrition. However, if you have ulcerative colitis, these foods may make your symptoms worse.

Eat small meals

You may feel better if you eat five or six small meals a day. Just be sure to plan small, healthy, balanced meals, rather than snacking without thinking throughout the day.

Be smart about beverages

Drink plenty of liquids every day. Water is your best bet.

Manage stress

Stress may make your symptoms worse and may trigger flare-ups. Exercise may help reduce tension and keep your bowels functioning well.

If you have Ulcerative Colitis we recommend you see your doctor every year, but more frequently during seasons of disease activity. Recommended treatments are covered by AHDI in our Standards of Care.

If you need additional resources to help manage your Ulcerative Colitis, visit the Chron’s and Colitis Foundation’s website at https://www.crohnscolitisfoundation.org/