Maxy sez :Diabetes and Feminine Health: What Women Need to Know

Women with type 2 diabetes may be at greater risk of developing yeast infections or have more trouble fighting off bacterial infections. Here’s how to maintain feminine health with the disease.
By Ilene Raymond Rush       Medically Reviewed by Bhargavi Patham, MD, PDPoorly controlled blood sugar and the use of certain medications can leave women with diabetes at a greater risk of feminine health problems.Getty Images
Anyone who has experienced a yeast infection knows how unpleasant the condition can be. Abnormal vaginal discharge, itching and burning, painful intercourse and urination, and redness and swelling — any of these common symptoms can put a dent in a woman’s sex life or simply impact her daily comfort level. For women with type 2 diabetes, combating this issue and maintaining feminine health overall can be of particular concern, especially if their blood sugar is poorly controlled.

A Greater Risk of Yeast Infections

“Control of blood sugars is important for the whole body,” says Mache Seibel, MD, a gynecologist and obstetrician at Harvard Medical School in Boston. “But an area that isn’t much talked about is how elevated blood sugars seep into vaginal tissues and set up an environment that’s more favorable for yeast infections.”

Vaginal tissue contains a balance of microorganisms, like yeast and bacteria, Dr. Seibel explains, but excess sugar in the blood can fuel the growth of yeast, potentially leading to an infection.

“Think about baking bread and how yeast thrives much better when you add sugar,” says Susan Renda, CDE, doctor of nursing practice and assistant professor in the department of community–public health at Johns Hopkins University School of Nursing in Baltimore. “I tell patients, ‘You have a nice little balance in your body, but when you throw a cake and cookie party, all the yeast comes to the party and just starts to go nuts.’”

Frequent urination, which can occur when glucose levels are high and the body works to rid itself of excess sugar, can add to the problem by bringing additional sugar found in the urine to the vaginal area. Certain diabetes drugs, such as canagliflozin (Invokana, Invokamet, or Invokamet XR), an SGLT-2 inhibitor, lower blood sugars by excreting glucose in the urine, which can also add to the sugar in the vaginal area and increase the chance of mild yeast infections.

If you experience any signs of a potential yeast infection, call your doctor to confirm the diagnosis and discuss further management.

Warding Off Bacterial Infections
Women with diabetes also tend to be at a greater risk of bacterial vaginosis, a condition that occurs when there is too much of a certain bacteria in the vagina, and can increase the chance of a sexually transmitted disease (STD) developing.

Bacterial infections can produce fevers, chills, and a foul-smelling discharge from the vagina. Antibiotics are required to treat the condition.

“The normal acidic environment of the vagina provides a natural barrier to infection and irritation, since it represses the growth of bad bacteria, which prefer a less acidic environment,” says Seibel. “As long as the good bacteria count is high and the vaginal pH is acidic, bad bacteria have a very slim chance of overgrowing, making the chance of infection low.”

Seibel explains that women with diabetes tend to have a more alkaline, rather than acidic, pH, but controlling your blood sugar can help increase your acidity, thereby warding off bacterial infections. Seibel says the normal vaginal pH is about 3.5 to 4.5. Lower pH readings are considered acidic, while those that are greater than 4.5 are considered alkaline.

Diabetes can also prevent women’s bodies from healing from bacterial infections.

“When people have blood sugars over 200 mg/dL (milligrams per deciliter), they don’t heal as well, and the immune system doesn’t act the way it should against bacteria,” says Dr. Renda. For people with diabetes, the Joslin Diabetes Center, a clinic and research and education center in Boston, recommends a fasting plasma blood glucose range of between 70 and 130 mg/dL, a plasma blood glucose range of less than 180 mg/dL after meals, and a plasma glucose range of between 90 and 150 mg/dL at bedtime.

Along with problems fighting such infections, women with diabetes who get frequent yeast infections may mistakenly self-diagnose their condition and end up treating a bacterial problem with over-the-counter yeast medication rather than antibiotics.

“It’s a good idea for women with diabetes to treat themselves more carefully than the general population when it comes to vaginal health,” says Seibel. “If something doesn’t seem normal compared with when they’re feeling healthy, they should consult with a medical professional.”

Maintaining Feminine Health With Diabetes

If you have diabetes, keeping your blood sugar in check is the best way to avoid vaginal infections. To further reduce your risk of complications related to feminine health, follow these tips:

Eat yogurt with live cultures, or take tablets of Lactobacillus acidophilus, a bacteria naturally found in the vagina, to promote vaginal acidity and reduce the risk of yeast infections.
Practice good hygiene, keeping the genital area cool and dry. Warm and moist areas are more susceptible to yeast infections.
Avoid douching, as it removes healthy bacteria lining the vagina that protect against infection.
Stay well hydrated. Drinking more water can keep the vagina hydrated and the pH in balance.
Use condoms to avoid catching or spreading other infections.
Wear cotton underwear, and avoid tight-fitting or scented garments that can cause irritation or promote moisture in the vaginal area.
Avoid wearing wet bathing suits or used workout gear for longer than necessary.

Food for Thought : Should You Take an Aspirin a Day?

Aspirin can help protect some people against certain cardiovascular diseases. Learn how aspirin works, and who should, and should not, take aspirin every day.

By Eleanor Roberts, PhD                 Medically Reviewed by Pat F. Bass III, MD, MPH
A daily dose of aspirin can help prevent cardiovascular disease and many people have improved their health with this practice. But as with all medical advice, there are pros and cons.

A Brief History of Aspirin

The active ingredient in aspirin, salicylate, has been derived from sources such as willow tree bark for centuries. In the 1700s, scientists began to investigate the medicinal properties of willow bark and since the mid-1800s, salicylate has been prescribed for pain.

Aspirin’s effect as an anticoagulant — a substance that prevents blood clotting — was first recognized by a general practitioner, Lawrence Craven, MD. In 1948, he began prescribing daily aspirin, and noted that none of the patients using it had had heart attacks.

In 1989, the Physicians’ Health Study — a huge, long-term study involving 22,071 participants — published results showing that aspirin led to a 44 percent reduction in heart attack risk in people age 50 and over. Following this report, aspirin began to be routinely prescribed as a preventative measure against cardiovascular disease. Another large study by the U.S. Preventive Services Task Force showed that aspirin significantly decreased the number of all coronary events by nearly 30 percent over five years.

Aspirin and Cardiovascular Health

Blood vessel plaques develop when cholesterol and triglycerides form fatty deposits on the walls of blood vessels. This provokes an immune response in the body, which causes white blood cells to collect. Ultimately, the plaques harden and blood flow is reduced. This means that there may not be enough oxygen getting to the heart, resulting in the severe chest pain of angina.

If a plaque breaks off it can leave a wound in the blood vessel, around which platelets (disc-shaped cells that form a clot, or a “thrombus”) clump. This can lead to such restricted blood flow that little or no oxygen gets to the heart, resulting in a heart attack. If the clot breaks off and travels to the brain, it can cause a stroke.

Aspirin helps prevent blood clots in two ways: It interferes with platelet aggregation, or the clumping of platelets together, and it reduces inflammation.

Who Should Take Aspirin?

Not everyone should take aspirin, and you should only take after talking with your doctor.

Guidelines from the American Heart Association and the American College of Cardiology (AHA/ACC) recommend low-dose aspirin only for people who have had a cardiovascular event (a heart attack, angina, heart surgery, hypertension, or a stroke) or if a person is in a “high risk” category for developing a cardiovascular disease (especially those who are diabetic). As there are indications that aspirin may increase the risk side effects including a bleeding stroke, it is not recommended as a preventative measure for people who do not have cardiovascular disease unless they are in a “high risk” category.

Studies on the benefits of aspirin use in women have been mixed. Therefore recommendations on whether or not to take it may be different for women. It is up to you and your doctor to decide if the benefits outweigh the risks.

The recommended dose of aspirin for preventative measures is 75 to 162 milligrams (mg) per day. Studies have shown that taking higher doses doesn’t increase the protective benefits. However, people who have an arterial stent (a small tube designed to keep the affected part of a blood vessel open) may take a higher aspirin dosage (up to 325 mg) for up to six months, if recommended by a doctor.

Aspirin During a Heart Attack

If you think you or someone you're with is having a heart attack call 911 immediately. Emergency personnel will advise as to whether aspirin should be taken, or it may be given when you get to the hospital. This immediate use of aspirin has been shown to increase survival rates from heart attacks. For this type of emergency, non-enteric-coated aspirin is recommended as it is more quickly absorbed.

Possible Side Effects of Aspirin

Aspirin can cause a number of side effects. These include:

Increased bleeding. The most common adverse effect of aspirin is a significant increase in bleeding in the stomach, intestines, nasal vessels (nose bleeds), and skin (bruising).
Stomach problems. Aspirin decreases the secretion of mucous in the stomach, leaving it vulnerable to damage from gastric acid. Gastrointestinal side effects occur more often in older men, smokers, those with hypertension, cardiac failure, kidney problems, or stomach complaints, and those on a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen or diclofenac, a steroid, clopidogrel, or warfarin. Although some aspirin have “enteric” coatings that slow their absorption, this has not been shown to decrease bleeding problems compared to non-coated aspirin. To counteract the gastrointestinal problems, people on aspirin therapy may be prescribed an acid reducer known as a proton pump inhibitor, although dose adjustment may be needed as it can reduce the absorption of aspirin.
Aspirin allergy. Some people are allergic to aspirin, and therefore cannot take it at all.
Aspirin can be very useful to help reduce or prevent many forms of cardiovascular disease in those who already have such a problem, or are at high risk for developing one. However, they may not have such a protective effect for women, and people who aren’t at risk should not necessarily take aspirin every day.

A Proud Grand-Poppa             G .

Comedian Dick Gregory, active in U.S. civil rights movement, dies at age 84

  New York Daily News             RICH SCHAPIRO         
August  20th 2017 6:26A
Dick Gregory, the trailblazing comic and civil rights activist whose unique brand of comedy combined cutting wit and contemporary headlines, died Saturday.

He was 84.

Gregory died in Washington D.C. two days after his son revealed that he was hospitalized with a "serious but stable medical condition."

"It is with enormous sadness that the Gregory family confirms that their father, comedic legend and civil rights activist Mr. Dick Gregory departed this earth tonight in Washington, DC.," his son Christian Gregory wrote on Instagram.

Dick Gregory, comedy legend and civil rights activist, dead at 84

"The family appreciates the outpouring of support and love and respectfully asks for their privacy as they grieve during this very difficult time."

Born in St. Louis, Gregory first started performing stand-up comedy in the army in the 1950s.

His major break came in 1961 when he was spotted by Playboy founder Hugh Hefner performing before an all-white audience at the Roberts Show Bar in Chicago.

"It was the first time they had seen a black comic who was not bucking his eyes, wasn't dancing and singing and telling mother-in-law jokes," Gregory said in a 2000 Boston Globe interview. "Just talking about what I read in the newspaper."

Gregory instantly shot to fame, landing gigs at the country's top clubs and raking in as much as $25,000 a night.

At the same time, the civil rights movement was gathering momentum and Gregory bravely injected himself into the cause, trading stage performances for sit-ins and marches.

Some critics called him out for allowing his demonstrating to interfere with his comedy career.

"My career is interfering with my demonstrating," Gregory shot back.

A friend of Dr. Martin Luther King, he was shot in the leg during Los Angeles' Watts Riots in 1965 and even ran for president as a write-in candidate in 1968.

"He taught us how to laugh. He taught us how to fight. He taught us how to live," said the Rev. Jesse Jackson. "Dick Gregory was committed to justice. I miss him already. #RIP."

TV One host Roland Martin described Gregory as "honest, truthful, unflinching, unapologetically black."

"He challenged America at every turn." Martin added.

The death of the comic giant even prompted Bill Cosby to issue a rare public statement.

"His comedy showed his education, intelligence, and was inclusive of humanitarianism along with great timing," Cosby tweeted.

Dick Gregory, comedy legend and civil rights activist, dead at 84 .

Our Sincerest Condolence  to the family and friends
The PICs

Maxy sez : These are the best fruits for diabetes

By Maria Masters        Reviewed by Kelly Kennedy, R

1 .   The Best Fruits to Manage Your Blood Sugar
Warm weather means lots of luscious fruit. But if you have diabetes, you may be wondering how these seasonal treats can fit into your diet plan. According to the American Diabetes Association (ADA), fruits are loaded with vitamins, minerals, and fiber and should be a part of a diabetes-friendly diet — just keep track of them as you do with all carbs. The key is to keep an eye on portion sizes and to stay away from fruits canned in syrups or contained in other types of added sugar. If you're using the glycemic index (GI) — a measure of how foods affect your blood sugar levels — to manage your diabetes, most fruits are a good choice because they rate low on the ranking. Satisfy your sweet tooth and keep your blood sugar in check with the following fresh or frozen low-GI choices.

2 .    Berries for Antioxidants
Whether you love blueberries, strawberries, or any other type of berry, you have the go-ahead to indulge. According to the ADA, berries are a diabetes superfood because they're packed with antioxidants, vitamins, and fiber, plus they're low-GI. Three quarters of a cup of fresh blueberries has 62 calories and 16 grams (g) of carbohydrates. If you can resist the urge to just pop them into your mouth, try berries in a parfait, alternating layers of fruit with plain non-fat yogurt — it makes a great dessert or breakfast.

3. Cherries
Tart cherries are a low-GI choice and a smart addition to a diabetes-friendly diet. One cup has 78 calories and 19 g of carbs, and they may be especially good at fighting inflammation, too. Tart cherries are also packed with antioxidants, which may help fight heart disease, cancer, and other diseases. These fruits can be purchased fresh, canned, frozen, or dried. But since many canned and dried fruits contain added sugar, be sure to check the labels .

4   Peaches for Potassium
Fragrant, juicy peaches are a warm-weather treat and can also be included in your diabetes-friendly diet. Peaches contain vitamins A and C, potassium, and fiber and are delicious on their own or tossed into iced tea for a fruity twist. When you want a snack, whip up a quick smoothie by pureeing peach slices with low-fat buttermilk, crushed ice, and a touch of cinnamon or ginger.

5    Apricots for Fiber
Apricots are a sweet summer fruit staple and a wonderful addition to your diabetes meal plan. One apricot has just 17 calories and 4 g of carbohydrates. Four fresh apricots equal one serving and provide more than 50 percent of your daily vitamin A requirement. These fruity jewels are also a good source of fiber. Try mixing some diced fresh apricots into hot or cold cereal, or toss some in a salad.

6   Apples for Vitamins
An apple a day really might keep the doctor away. Toss one in your purse or tote bag if you're on the go; a small apple is a great fruit choice, with just 77 calories and 21 g carbs. Apples are also loaded with fiber and a good source of vitamin C. Don't peel your apples, though — the skins are the most nutritious part, full of antioxidants.

7  Oranges for Vitamin C
Eat one orange and you've gotten all the vitamin C you need in a day. This low-GI choice comes in at only 15 g of carbohydrates and 62 calories. Oranges also contain folate and potassium, which may help normalize blood pressure. And while you're enjoying this juicy treat, don't forget that other citrus fruits, like grapefruit, are also great choices.

8   Pears for Vitamin K and Fiber
Because pears are an excellent source of fiber and a good source of vitamin K, they make a wise addition to your diabetes meal plan. Plus, unlike most fruit, they actually improve in texture and flavor after they're picked. Store pears at room temperature until they're ripe and perfect for eating (they can then be stored in the refrigerator). Here's a tasty treat: Slice up a pear and toss it into your next spinach salad.

9   Low-Carb Kiwi
If you've never tried a kiwi, you might not know that its brown fuzzy peel hides a zesty bright green fruit. Delicious kiwi is a good source of potassium, fiber, and vitamin C. One large kiwi has about 56 calories and 13 g of carbohydrates, so it's a smart addition to your diabetes-friendly diet. Kiwis are available year-round and will last in the refrigerator for up to three weeks.

The Roving Reporter : The Heart Attack and Depression Link

 By Jennifer J. Brown, PhD

Almost nowhere is the mind-body connection more apparent than in the link between depression and heart attack.

Heart-Attack-Depression-Image-1Mental health and heart health are intimately connected when it comes to your heart. Heart disease is consistently the No.1 killer in the United States, according to the Centers for Disease Control and Prevention (CDC). Each year, about 715,000 Americans have a heart attack. And 190,000 of these are repeat heart attacks. Those who have heart attacks are more likely to become depressed, and people with depression have higher rates of heart attacks.

Current Depression and Heart Attack

Heart-Attack-Depression-Image-2One in 10 American adults surveyed by Gallup said they currently have depression or are on depression treatment. Whether or not they have had a heart attack dramatically increased their depression risk:

8 percent is the current depression rate for people who have never had a heart attack.
17 percent is the rate for people who have had a heart attack.
Heart Attack and Lifetime Depression Risk

Heart-Attack-Depression

Almost one in five U.S. adults surveyed said they had been diagnosed with depression at some point. Lifelong rates of depression rose much higher for those who had experienced a heart attack:

The Roving Reporter

The Roving Reporter : 3 Heart-Disease Treatment Breakthroughs That Are Changing Lives

By Steven Nissen, MD, Special to Everyday Health

Nearly 27 million people in the United States have heart disease. It remains the leading cause of death for both U.S. men and women. However, during the last several years, there have been some truly significant advances in heart disease treatment that are now moving quickly toward widespread availability.

After a decade of failed efforts at developing new heart drugs, two important therapeutic breakthroughs are nearing FDA approval in 2015. These overdue advancements have the potential to change the practice of medicine. They can help patients who have not benefited adequately from existing therapies.

1. A Better Drug for Heart Failure

Congestive heart failure is a common disorder characterized by a failure of the heart muscle to forcefully pump blood to the body’s tissues. Heart attacks, high blood pressure, or diseases that weaken the heart muscle are common causes. Patients often have severe shortness of breath or fatigue that limits their ability to enjoy life. This disorder is the most common reason for hospital admission among Medicare patients.

In a large clinical trial, known as Paradigm-HF, the new drug LCZ696 was used to treat heart failure, and it was highly effective. It achieved a substantial 20-percent reduction in death or repeat hospitalization compared with the best currently available therapies. Although the benefits of a reduction in deaths are self-evident, the importance of reducing readmission to the hospital should not be underestimated. Currently, 20 percent or more of patients hospitalized for heart failure are re-admitted within 30 days. This represents a significant burden for patients and the healthcare system.

LCZ696 will probably be approved this year, providing a new, promising option for the 5.7 million Americans with heart failure.

2. New Treatment for High Cholesterol

The second innovative drug therapy is known as a PSCK9 inhibitor. This class of drugs has moved from discovery to the clinic more rapidly than any cardiovascular advancement in recent memory.

The single most important risk factor for developing coronary heart disease is an elevated level of “bad” cholesterol, also known as LDL-C. Currently, the best available drugs for reducing cholesterol, statins, have been shown to lower the risk of heart attack or stroke up to 35 percent.

Statins have been available for more than 25 years and have been enormously successful at reducing the burden of heart disease. Unfortunately, some patients cannot tolerate statins or can’t take large enough dosages to adequately reduce cholesterol levels. In other cases, LDL-C is very high due to an underlying genetic cause, and even the most powerful statins cannot reduce it to safe levels.

PSCK9 inhibitors have been shown to reduce bad LDL-C by as much as 50 percent to 70 percent and demonstrated few, if any, adverse effects. Although these drugs are given by injection every two weeks or once a month, they are injected through very small needles that produce little or no pain. Patients can easily self-inject these drugs using an automated injector.

This new class of drugs appears to be well tolerated even in patients who cannot take statins due to adverse effects. The FDA is considering applications from two pharmaceutical companies for drug approval in 2015.

3. Less Invasive Surgery for Heart Valve Disease

In 2011, the FDA approved a new procedure to treat heart valve disease without a major surgical operation, known as TAVR, or transcatheter aortic valve replacement. This device is approved for patients who need an aortic valve replacement, but who are too high risk for standard open-heart surgery.

This new approach is an important advance for patients who are too ill to withstand an open-chest procedure or for older patients. In the United States, patients currently undergoing TAVR typically include people with lung or kidney disease who would be less likely to tolerate major heart surgery to replace the aortic valve. TAVR was initially performed only at large academic medical centers. It is now moving gradually toward mainstream treatment throughout the world.

A catheter (small hollow tube) is placed in the groin (femoral artery) and guided into the heart chambers using advanced imaging techniques. Through this catheter, a collapsed tissue heart valve is guided into position and placed directly inside the diseased aortic valve. Once the new valve correctly positioned, a balloon is inflated to deploy the valve, incredibly, without opening the patient’s chest.

Currently TAVR is being performed at more than 350 hospitals in the United States.

Although heart disease remains the No. 1 cause of death in the United States, these treatment breakthroughs and other developments offer new hope to patients, providing long-awaited advances that are already making a difference.

Steven Nissen, MD, is the Chairman of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at Cleveland Clinic’s Sydell and Arnold Miller Family Heart & Vascular Institute, in Cleveland, Ohio. He has more than 35 years experience as a physician and is world-renowned for his work as a cardiologist, patient advocate, and researcher.



The Roving Reporter

Maxy sez: Foods That Help and Hurt Type 2 Diabetes

By Jan Sheehan Reviewed by Lindsey Marcellin, MD, MPH

A diabetes-friendly diet is one key to effectively managing the disease. Read on to find which foods to eat, and which ones to avoid.

Healthy eating is one of the best ways to manage type 2 diabetes. Because this type of diabetes is strongly linked to excess weight, cutting calories and following the right kind of diabetes diet will go a long way toward improving your health.

One of the most important aspects of good nutrition when you have type 2 diabetes is eating meals with the right mix of carbohydrates, proteins, and fats to keep blood sugars as normal as possible throughout the day. The next step is choosing among the foods and beverages that can give you an extra edge in managing type 2 diabetes, says dietitian Beth Reardon, MS, RD, an integrative nutritionist and food researcher at Duke University Integrative Medicine in Durham, N.C.

Eat Pre-Germinated Brown Rice and Fiber

White rice has long been known to be a bad food for diabetes. Like most "white" foods, it causes blood sugar spikes. However, adding healthy whole grains and fiber to a diabetes diet may reduce the risk of complications, such as diabetic neuropathy, which is nerve damage resulting from high blood sugars. Researchers at the Medical College of Georgia found that a diet rich in pre-germinated brown rice protected animals with diabetes from this common complication. To make pre-germinated rice, you soak the rice in warm water overnight before cooking. This stimulates the rice to germinate, producing tiny shoots that are invisible, but contain chemical complexes that appear to be protective against neuropathy.

This rice is also packed with fiber, an important component for diabetes management. “Because fiber takes a long time to digest, sugars are released slowly,” Reardon says. “That helps keep blood sugar levels steady and prevents glucose spikes.”

Another way to add fiber to your diet is through beans. A recent study published in Nutrition Journal found that beans and rice eaten together prevent the blood sugar spikes caused by white rice alone.

Add Oranges and Spinach to Your Diabetes Diet

In a recent study of men and women ages 40 to 75, those with the most vitamin C in their bodies had the lowest incidence of type 2 diabetes. Oranges and orange juice are one of the best sources of vitamin C, Reardon says. Other foods with generous amounts of vitamin C are grapefruit, strawberries, and tomatoes. (If you are on a statin drug for high cholesterol, check with your doctor or pharmacist before eating grapefruit or drinking grapefruit juice, as it can cause dangerously increased levels of atorvastatin, lovastatin, and simvastatin.)

When it comes to leafy greens, just one cup of spinach contains 40 percent of your daily value of magnesium, a mineral that can help regulate blood sugar levels — important because people with type 2 diabetes frequently have low levels of magnesium. To get more of this magnesium-rich green veggie into your diet, substitute spinach for lettuce on sandwiches and in salads, Reardon suggests. Not a big fan of spinach? Nuts, beans, and low-fat diary products are also good sources of magnesium.

Drink Low-Fat Milk

Milk is loaded with calcium and vitamin D. This double whammy of essential nutrients may help in your quest to keep type 2 diabetes under control. In a 20-year study of almost 84,000 women, those who consumed the most calcium and vitamin D gained the most protection from type 2 diabetes. Just be sure it’s low- or nonfat — skim or 1 percent milk will control your intake of saturated fats and help prevent weight gain.

Spice Up Your Diabetes Diet

Several studies have documented that cinnamon can lower blood sugar levels. But for an even bigger punch of diabetes protection, sprinkle cinnamon in your morning coffee. Coffee consumption has been associated better type 2 diabetes management, possibly due to its antioxidant properties. Having both cinnamon and coffee can give you double the ammunition to fight type 2 diabetes.

A hearty bowl of curry could also help control your type 2 diabetes. That’s because turmeric, a spice used in curry, can help prevent the inflammation associated with type 2 diabetes. “Turmeric contains a chemical called curcumin, which is a natural anti-inflammatory that works as well as some anti-inflammatory drugs,” Reardon says. Curry typically contains a heaping helping of turmeric, but you can spice up other dishes with turmeric as well.

It’s just as important to steer clear of foods that can make managing type 2 diabetes more difficult, or at least eat them sparingly. First and foremost, don’t feast on foods that are high on the glycemic index (GI), which is a system that ranks foods by how they affect blood sugar. High GI foods, such as white rice, doughnuts, soda, and white bread, can cause glucose levels to skyrocket. The same goes for sweets and desserts. “Because these foods are high in carbohydrates, they can cause blood sugar levels to go up considerably,” Reardon says.

That doesn’t mean you can never have a slice of pie or a few cookies. Just be smart about eating foods that can make controlling your type 2 diabetes more challenging. Having a piece of cake with a low-carb meal (such as baked chicken and broccoli) won’t raise glucose levels as much as cake after a big pasta meal.

It’s also wise to watch your saturated fat intake when you are living with diabetes. Fatty cuts of meat and full-fat dairy raise cholesterol and promote inflammation throughout the body in both healthy people and people with type 2 diabetes. But recent research found that the effects of this inflammation may be more damaging for people with the disease. And because diabetics already have an increased risk of heart disease, consuming saturated fat in moderation is especially important. Studies have also shown that fatty foods may increase insulin resistance in women with diabetes.

Managing type 2 diabetes involves paying careful attention to what you eat. If you start with a base of good-for-you foods, building a healthy diet will be that much easier.

The Roving Reporter : Is It Healthy to Use a Vibrator?

Bringing a vibrator into the bedroom can rev your sex life, boost your bond, and more.
Curious about using a vibrator? You’re not alone. Many women turn to vibrators to achieve the big O. In fact, a study published in July 2009 in the Journal of Sexual Medicine found that 53 percent of women ages 18 to 60 have used a vibrator, and one-quarter of them have used it in the past month. Plus, those who use a vibrator regularly were more easily aroused and better able to become lubricated and achieve an orgasm.

So should you try using a vibrator? Absolutely. Here’s why it’s healthy, and how to incorporate it into your sex life — solo and with a partner.

Why It’s Healthy to Use a Vibrator

The benefits of using the battery-operated device abound. If you choose to try it solo, you can discover what turns you on without feeling any pressure or expectations from your partner, says Kristin Zeising, PsyD, a psychologist and sex therapist in San Diego. She recommends experimenting with it all over your body to discover erogenous zones you may not know about. Finding out what feels good will help you give your partner more guidance and make sex more pleasurable.

Incorporating a vibrator into your sexual repertoire can also boost your bond with your mate. “Anything that brings more pleasure to your sex life can help your relationship,” says Zeising. Plus, opening up a conversation about sex toys can foster better communication with your partner in general.
The benefits of using the battery-operated device abound. If you choose to try it solo, you can discover what turns you on without feeling any pressure or expectations from your partner, says Kristin Zeising, PsyD, a psychologist and sex therapist in San Diego. She recommends experimenting with it all over your body to discover erogenous zones you may not know about. Finding out what feels good will help you give your partner more guidance and make sex more pleasurable.

Incorporating a vibrator into your sexual repertoire can also boost your bond with your mate. “Anything that brings more pleasure to your sex life can help your relationship,” says Zeising. Plus, opening up a conversation about sex toys can foster better communication with your partner in general.

How to Bring a Vibrator Into the Bedroom Think again. According to another study published in July 2009 in the Journal of Sexual Medicine, 45 percent of men have used a vibrator, and most said they did so with their female partner. What’s more, men who used vibrators had better erectile function and were more satisfied during sex than those who didn’t.

So how can you bring up the conversation with your partner? Zeising recommends suggesting it as a way to add to the fun you’re already having. Reassure your partner that your desire to use a vibrator has nothing to do with his performance. “Remind him that he’s the one who turns you on and that the vibrator is just a tool to help you along the way,” says Zeising. And remember: You don’t have to use it during every sexual  encounter .
Think your mate will be opposed to using a vibrator? Think again..

When you’re both ready, go shopping for a vibrator together so you can find one that you’re both comfortable with. Then, play around with it to figure out what feels good, suggests Zeising. Use it on yourself or each other — and don’t be afraid to let your partner take the lead.


Thanks for stopping by ---See you in the funny papers. 

The Roving Reporter

Chicken Salad with Grapes, Honey, Almonds, and Broccoli

Time   :20 Minutes       Makes 4 to 6 servings

2     large eggs, lightly beaten
 6   (4-oz.) chicken cutlets, 1/4 to 1/2 inch thick 
1-1/2    cups seasoned breadcrumbs
 1/2     cup apple cider vinegar  2 tablespoons honey
 1    tablespoon Dijon mustard
 1/2     teaspoon kosher salt 
4    teaspoon freshly ground black pepper
 1/2     cup olive oil 
1 (5-oz.)     package spring lettuce mix 
3     cups broccoli florets 
1/2    cup halved seedless red grapes 
1/2    cup halved seedless green grapes 1/2 cup sliced honey-roasted almonds

1 .  Preheat oven to 425°. Whisk together eggs and 3 Tbsp. water in a small bowl. Dip chicken in egg mixture, and dredge in breadcrumbs, pressing firmly to adhere. Place on an aluminum foil-lined baking sheet. Bake 15 minutes or until chicken is brown and done.

 2 .  Meanwhile, whisk together vinegar, honey, Dijon mustard, salt, pepper, and olive oil. Toss together lettuce, broccoli, red grapes, and green grapes; season with salt and pepper. Top with chicken and sliced almonds; serve with vinaigrette.
Heart Healthy

Maxy sez:: Suicide and Diabetes: What Caregivers Should Know

When emotional health and diabetes collide, suicide is a real risk. Learn how to help your loved ones avoid this tragic choice.
By Madeline R. Vann, MP    Medically Reviewed by Farrokh Sohrabi, MD

As many as one in five people with diabetes think about suicide, some on a daily basis. People considering suicide don't always advertise their plans, but those with diabetes might be doing so by neglecting their diabetes management. A statewide study of patients in Texas revealed that depression and diabetes led to poor diabetes control. And although no in-depth research into diabetes and suicide exists, the study authors suggest that one sign of worsening emotional health might be giving up on the hard work of controlling diabetes.

Also of great concern, according to a study published in The Primary Care Companion to the Journal of Clinical Psychiatry, are data that suggest that people with diabetes might go so far as to commit insulin suicide, intentionally overdosing with the very medication that can help them achieve and maintain blood sugar control.

Emotional Health and Diabetes: Depression and Suicide

The connection point between diabetes and suicide is depression. About 16 percent of the general population experience depression, but the percentage is nearly doubled among those with diabetes. To better understand depression and diabetes, family medicine expert David Katerndahl, MD, and colleagues at the University of Texas Health Science Center at San Antonio looked at diabetes control and depression symptoms among 106 patients over the course of five years.
Though their research did not address suicide risk specifically, Dr. Katerndahl said, "I looked at the results from our question about how frequently patients thought about suicide over the past two weeks and found that 20 percent had thought about suicide and 6 percent thought about it daily." The results of the study show a link between depression, poor compliance with diabetes treatment, and a lower qualify of life .

"Diabetes and depression is a toxic combination," said psychologist Susan Guzman, PhD, director of clinical services for the Diabetes Behavioral Institute in San Diego. "Mortality rates in people who have both are about 2.5 times the rates in people with either or neither."

Decades of Diabetes Leading to Depression

Ed Cook, a San Diego resident, was diagnosed with diabetes 38 years ago. For much of the time, the government administrator and, after retirement, entrepreneur felt life was balanced despite his illness. But as Cook, now 66, gradually lost his vision and then his driver's license, his business, and most recently, one toe to amputation, depression infiltrated his life. A religious person, he struggled against thoughts of suicide and sought help from Guzman.

"The complications led me to severe depression," Cook admitted. He entered treatment, which included anti-depressants for a time, and he now regularly attends both therapy and support groups. "It helps to know I am not alone," he said. "Diabetes is not the end of the world."

But Cook also acknowledges that his battle is not over. Periodically, he still feels some despair as he continues to face the screenings and health assessments, such as vascular checkups, that are intended to catch complications before they do too much damage. Still, through prayer and therapy, he said, he's come to see that even now he has a role and a purpose. "I try to be an encouragement to people," he said.

This shift in attention is part of the treatment process, noted Guzman. At their worst, people with depression and diabetes may feel like a collection of flawed body parts under the thumb of the illness. But as the depression subsides, they can see that they are more than just the label and experience of diabetes.

Suicide by Insulin
Complicating the issue is the ability of people with diabetes to commit suicide using the very same tools that keep them alive. At one point, Cook floated the idea of an intentional insulin overdose to Guzman, but she pointed out that it's a permanent solution to a temporary problem, not to mention risking severe side effects from the overdose if you survive it.

How widespread is insulin suicide? According to research published in the Journal of Clinical Psychiatry, an analysis of overdose-related calls to a poison center suggested that 95 percent of insulin overdoses were deliberate. But Guzman noted that this is an area that needs more study.

Katerndahl understands how life with diabetes can look grim to patients, especially if they have seen older relatives living with some of the more severe complications of diabetes. But he said it's also important to remember that modern medicine offers many more options for disease management than the diabetes programs older relatives were following decades ago.

How Caregivers Can Help: Tips for Preventing Suicide

As a caregiver, it can be hard to tell when a loved one's blue mood turns to depression and potentially to thoughts of suicide, but often there are clues. "More than half of the time, people who complete suicide have talked about it," said Guzman.

Here are suggested actions to take:
Note any changes in self-care. Katerndahl's research supports what other studies have shown: Depression correlates with poor diabetes management compliance. If someone used to be on top of diabetes control but now makes less effort, talk to the person or the person's doctor about what's going on.
Know the risk factors for suicide. There are many risk factors for suicide, including recent unemployment, childhood traumas, social isolation, family conflict, and personality traits such as aggression, impulsivity, or shame. For people with diabetes, experiencing severe complications that require amputations or the loss of independence can also be risk factors.

Encourage substance abuse treatment. Alcohol and substance abuse both increase the risk for suicide, warned Guzman. If your loved one is struggling with an addiction in addition to diabetes and depression, investigate treatment options.
Don't argue. You have to take any talk of suicide seriously, which means getting help, not debating the matter. Trying to reason with someone who's depressed and considering suicide won't help, said Guzman. Avoid saying things like, "But you have so much to live for." Instead, sympathize with the person's concerns and offer the hope that depression treatment could ease suffering. From his own experience, Cook said that even at his worst, the people in his life who were positive and encouraging were like a lifeline.
Suggest depression screening. Doctors can (and should, argues Katerndahl) provide depression screening tools to but you can also find them online. Encourage your loved one to complete one.
Call the doctor. If you are very concerned and your loved one can't or won't get help, calling the doctor is an option. Privacy laws prevent doctors from discussing a patient's status with you, but they don't prevent you from sharing your concerns with the doctor, who might be able to find a solution.
Remove weapons. Taking away guns, knives, and even prescription medications may be necessary if you feel suicide is imminent. Limiting access to insulin might be necessary for severely depressed insulin-dependent people, with family members or doctors taking over responsibility for giving insulin.action. "Don't sit on it. You're better off talking to the patient or the physician and, if it turns out your wrong, that's fine. You don't want to end up second-guessing yourself." Your care and insistence could make the difference in your loved one's life. "Getting treated for depression was a godsend," said Cook.
"Look for any kind of warning signs," said Katerndahl, and take 
control.