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The PEAK - September

Published on
September 1, 2024
Contributors
Dr Matthew Johnson
DO
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Welcome to The PEAK!

The PEAK, or “Patient Education And Knowledge,” is the monthly newsletter for Free Range Direct Primary Care. This newsletter will hopefully provide you with evidence-based medical knowledge as well as updates regarding the practice.

Practice Updates

NEW PATIENTS: My office is accepting new patients! Currently, I can see them in 1-2 days for a new patient appointment. If you know of anyone in need of a primary care doctor, please send them my way!

APPOINTMENTS: If you are in need of an appointment, please schedule here. You may also call or email and I can get you on the schedule.

MEDICATION REFILLS: Please text/call (434-337-5934) or email (drjohnson@frdpc.com) with medication refill requests. I will get them to your pharmacy as soon as possible.

In this issue…

  • What are the warning signs of diabetes?
  • Supplements: What does the evidence say?
  • September is “Healthy Aging” Month

What are the warning signs of diabetes?

Warning signs of diabetes can vary depending on the type of diabetes and the severity of hyperglycemia. The American Diabetes Association (ADA) identifies several key symptoms that are indicative of diabetes:

1. Polyuria (frequent urination): This is often one of the earliest signs and is due to the osmotic diuresis caused by high blood glucose levels.[1-2]

2. Polydipsia (increased thirst): This occurs as a result of dehydration from polyuria.[1-2]

3. Unexplained weight loss: Despite increased hunger (polyphagia), weight loss can occur due to the body's inability to utilize glucose properly, leading to the breakdown of fat and muscle for energy.[1-2]

4. Polyphagia (increased hunger): This is due to the body's cells being starved of glucose.[1-2]

5. Blurred vision: High blood glucose levels can cause changes in the shape of the lens in the eye, leading to vision problems.[1-2]

6. Fatigue: This results from the body's inability to use glucose for energy efficiently.[3]

7. Slow-healing sores or frequent infections: High blood glucose levels can impair the body's ability to heal and fight infections.[3]

In addition to these symptoms, specific signs can be more prominent in certain types of diabetes. For instance, type 1 diabetes often presents with more acute and severe symptoms such as diabetic ketoacidosis (DKA), characterized by nausea, vomiting, abdominal pain, and rapid breathing. Type 2 diabetes symptoms tend to develop more gradually and may include tingling or numbness in the hands or feet (diabetic neuropathy) and sores that do not heal well.[4-5]

Recognizing these warning signs is crucial for early diagnosis and management of diabetes to prevent acute complications like DKA and long-term complications such as retinopathy, nephropathy, and cardiovascular disease.[1-2]

If you have questions or are experiencing any of these concerns, please schedule an appointment with Dr. Johnson. The sooner the diagnosis, the sooner we can get you on a treatment plan and path for improvement.

References

https://naturalforce.com/blogs/nutrition/do-i-need-to-take-vitamins

Supplements: Do we need them? What does the evidence say?

The evidence on dietary supplements is mixed and varies significantly depending on the specific supplement and the health outcome in question.

Muscle Mass and Strength: According to a review in the European Journal of Nutrition, supplements such as nitrate and caffeine have sufficient evidence supporting their acute beneficial effects on muscle strength. Long-term consumption of creatine, protein, and polyunsaturated fatty acids consistently increases or preserves muscle mass and strength. However, evidence for other popular supplements like branched-chain amino acids and β-Hydroxy-β-methylbutyrate is mixed or unclear.[1]

Cardiovascular Disease and Cancer: The US Preventive Services Task Force, as reviewed in JAMA, found that vitamin and mineral supplementation generally offers little to no benefit in preventing cardiovascular disease and cancer. Notably, beta carotene was associated with an increased risk of lung cancer and cardiovascular mortality. Multivitamins showed a small benefit in reducing cancer incidence, but the evidence had important limitations.[2]

General Health Benefits: A systematic review in the Journal of Parenteral and Enteral Nutrition concluded that, with the possible exceptions of vitamin D and omega-3 fatty acids, there is no substantial data supporting the widespread use of dietary supplements in Westernized populations. Some supplements may even be harmful.[3]

Athletic Performance: The International Olympic Committee (IOC) consensus statement, published in the British Journal of Sports Medicine, indicates that only a few supplements, such as caffeine, creatine, specific buffering agents, and nitrate, have good evidence of performance benefits. However, the response to these supplements can vary widely among individuals.[4]

In summary, while certain supplements like creatine, protein, and omega-3 fatty acids have specific benefits, the overall evidence does not support the widespread use of dietary supplements for general health improvement, and some may pose risks.

References

September is Healthy Aging Month: What are the evidence—based recommendations for healthy aging?

Evidence-based guidelines for healthy aging emphasize a multifaceted approach that includes physical activity, nutrition, cognitive engagement, social interaction, and preventive healthcare measures.

Physical Activity: Regular physical activity is crucial for maintaining muscle function, cardiorespiratory fitness, and overall functional capacity. The International Exercise Recommendations in Older Adults (ICFSR) highlight the importance of both structured exercise and general physical activity for preventing chronic diseases, improving mobility, mental health, and quality of life, and reducing mortality. Exercise should be individualized and can include aerobic, resistance, balance, and flexibility training.[1]

Nutrition: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins is essential. The American Heart Association recommends the Mediterranean diet, which has been shown to reduce cardiovascular risk factors and outcomes in older adults. Adequate intake of vitamins and minerals, particularly vitamin D, is also important for maintaining bone health and reducing the risk of cardiovascular mortality.[2]

Cognitive and Emotional Health: Engaging in cognitively stimulating activities, managing cardiovascular risk factors, and maintaining social interactions are key strategies for promoting cognitive health and preventing dementia. Regular physical activity, a heart-healthy diet, smoking cessation, and managing metabolic syndrome are also endorsed by major health organizations.[3]

Preventive Healthcare: Regular screenings and preventive measures, such as vaccinations and fall prevention strategies, are critical. The US Preventive Services Task Force recommends interventions like exercise for strength and balance, home environment modifications, and vitamin D supplementation for fall prevention in older adults.[4]

Social Engagement: Maintaining social connections and participating in community activities can enhance emotional well-being and reduce the risk of depression and cognitive decline.[5]

In summary, healthy aging is best supported by a comprehensive approach that includes physical activity, proper nutrition, cognitive and social engagement, and preventive healthcare measures. These strategies are supported by guidelines from various health organizations and are essential for maintaining functional ability and quality of life in older adults.

References

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