(This is part 1 of a series on diabetes, other parts will delve into labs, testing, prevention and management of diabetes)

A recent study revealed that Thai farmers exposed to different pesticides found an association between 3 different pesticides and onset of type 2 diabetes.

According to the study, a population-based case-controlled study was conducted among residents in the Bang Rakam district of Phitsanulok Province in Thailand. Lifetime pesticide exposure and other relevant data were collected from 866 participating cases with diabetes mellitus and 1021 healthy controls. Among 35 individual brand-named pesticides investigated, they found statistically significant occurrences of type 2 diabetes with three insecticides.

3 Pesticides

A popular insecticide, trade name Sevin, (carbaryl) recently banned for homeowner use but still available for commercial application was found to have a casual association to the onset of type 2 diabetes, along with other health issues. This insecticide was pulled from consumer shelves mid 2020 but is still used on industrial crops. Another insecticide, mevinphos has been on the EPA restricted use list, but is banned in the EU, and endosulfin whiles still being used on U.S. crops is being phased out globally.

In addition, another popular pesticide, Roundup (glyphosate) may also contribute to type 2 diabetes according to a 2022 study titled “Impact of Glyphosate on the Development of Insulin Resistance in Experimental Diabetic Rats: Role of NFκB Signalling Pathways”.

What is diabetes?

Diabetes is a chronic, serious health issue facing over 10 percent of the U.S. population, and one in five people with diabetes don’t even know they have it. It is a leading cause of death due to complications, such as heart disease, stroke, blindness, kidney failure and lower limb amputation. Depending on the type of diabetes, insulin and glucose metabolism are involved.  While the link between pesticide use is a contributing factor, many other life choices and genetics play into the development of diabetes.

All diabetes is diagnosed through bloodwork, by checking glucose readings- either fasting, after meals or both. A urine dip can show high glucose levels, indicating the need for further testing via bloodwork.

Types of Diabetes

Prediabetes

Prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Approximately 96 million American adults—more than 1 in 3—have prediabetes. Of those with prediabetes, more than 80% don’t know they have it. Prediabetes puts you at increased risk of developing type 2 diabetes, heart disease, and stroke.

Insulin is key factor

 Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into cells for use as energy. If you have prediabetes, the cells in your body don’t respond normally to insulin. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes—and type 2 diabetes down the road.

Insulin, Blood Sugar, and Type 2 Diabetes

• Insulin is a key player in developing type 2 diabetes. This vital hormone—you can’t survive without it—regulates blood sugar (glucose) in the body, a very complicated process. Here are the high points:
• The food you eat is broken down into blood sugar.
• Blood sugar enters your bloodstream, which signals the pancreas to release insulin.
• Insulin helps blood sugar enter the body’s cells so it can be used for energy.
• Insulin also signals the liver to store blood sugar for later use.
• Blood sugar enters cells, and levels in the bloodstream decrease, signaling insulin to decrease too.
• Lower insulin levels alert the liver to release stored blood sugar so energy is always available, even if you haven’t eaten for a while.
• That’s when everything works smoothly. But this finely tuned system can quickly get out of whack, as follows:
• A lot of blood sugar enters the bloodstream.
• The pancreas pumps out more insulin to get blood sugar into cells.
• Over time, cells stop responding to all that insulin—they’ve become insulin resistant.
• The pancreas keeps making more insulin to try to make cells respond.
• Eventually, the pancreas can’t keep up, and blood sugar keeps rising.
• Lots of blood sugar in the bloodstream is very damaging to the body and needs to be moved into cells as soon as possible. There’s lots of insulin, too, telling the liver and muscles to store blood sugar. When they’re full, the liver sends the excess blood sugar to fat cells to be stored as body fat. Yep, weight gain. And what’s more serious, the stage is set for prediabetes and type 2 diabetes.

NOTE: Type 1 diabetes is different; it’s thought to be caused by an autoimmune reaction (the body attacks itself by mistake). People with type 1 diabetes don’t make enough insulin and need to take it to survive.

Symptoms

(Type 2 diabetics)

• Urinate (pee) a lot, often at night
• Are very thirsty
• Lose weight without trying
• Always hungry
• Blurred vision
• Have numb or tingling hands or feet
• Fatigue
• Dry skin
• Slow healing sores or injuries
• Have more infections than usual

You’re at risk for type 2 diabetes if you:

• Have prediabetes.
• Are overweight.
• Are 45 years or older.
• Have a parent, brother, or sister with type 2 diabetes.
• Are physically active less than 3 times a week.

Treatment

Treatment consists of leading a healthy lifestyle, diet, and sometimes oral medications.

Type One Diabetes

Type 1 diabetes is a disease in which autoimmune destruction of pancreatic β-cells leads to insulin deficiency.

If you have type 1 diabetes, your pancreas doesn’t make insulin or makes very little insulin. Insulin helps blood sugar enter the cells in your body for use as energy. Without insulin, blood sugar can’t get into cells and builds up in the bloodstream. High blood sugar is damaging to the body and causes many of the symptoms and complications of diabetes.

Type 1 diabetes was once called insulin-dependent or juvenile diabetes. It usually develops in children, teens, and young adults, but it can happen at any age.

Only 5-10% of people with diabetes have type 1. Currently, no one knows how to prevent type 1 diabetes, but it can be treated successfully by:

• Following your doctor’s recommendations for living a healthy lifestyle.
• Managing your blood sugar.
• Getting regular health checkups.
• Getting diabetes self-management education and support.

Symptoms

In addition to the above symptoms listed for type 2 diabetes, type 1 diabetics may also have nausea, vomiting, or stomach pains. Type 1 diabetes symptoms can develop in just a few weeks or months and can be severe.

Treatment

Treatment consists of insulin therapy and sometimes oral medication in addition to leading a healthy lifestyle.

Gestational diabetes

Gestational diabetes is a type of diabetes that can develop during pregnancy in women who don’t already have diabetes. Every year, 2% to 10% of pregnancies in the United States are affected by gestational diabetes. Managing gestational diabetes will help make sure you have a healthy pregnancy and a healthy baby.

What Causes Gestational Diabetes?

Gestational diabetes occurs when your body can’t make enough insulin during your pregnancy. Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into the cells in your body for use as energy.

During pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body’s cells to use insulin less effectively, a condition called insulin resistance. Insulin resistance increases your body’s need for insulin.

All pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before they get pregnant. They start pregnancy with an increased need for insulin and are more likely to have gestational diabetes.

• Having gestational diabetes can increase your risk of high blood pressure during pregnancy. It can also increase your risk of having a large baby that needs to be delivered by cesarean section (C-section).
• If you have gestational diabetes, your baby is at higher risk of:
• Being very large (9 pounds or more), which can make delivery more difficult
• Being born early, which can cause breathing and other problems
• Having low blood sugar
• Developing type 2 diabetes later in life
• Your blood sugar levels will usually return to normal after your baby is born.
• About 50% of women with gestational diabetes go on to develop type 2 diabetes. You can lower your risk by reaching a healthy body weight after delivery.

Who is at risk

• Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed over 9 pounds
• Overweight
• Over age of 25
• Not physically active

Symptoms

Unlike type 1 and 2 diabetes, there usually aren’t symptoms, it is usually diagnosed by urine and bloodwork.

Treatment

Depending on the severity of the diabetes, medication, lifestyle, and diet changes may be implemented.

I recently went through the process of ordering my yearly supply of prescription medicine through Jase Daily. I received my medication over the weekend and am impressed. From the ordering process to communication, every step of the way the process was streamlined and efficient. In addition, I pay out of pocket for my medication (I use a Health share program) and found the price for a whole years’ worth of medicine to be very competitive compared to my usual 90-day supply. In fact, it cost less over the year.

The packaging was secure and tamper resistant.

Once opened, I found the bottle of medication in a waterproof pouch which held the medicine and details of the transaction and prescription.

My medicine came in a clearly labeled, tamperproof bottle.

Why did I feel I needed to get an entire years’ worth of my prescription medicine?

The pandemic is over, so what’s the emergency?

If the pandemic has taught us anything is to not take anything for granted. Disrupted supply chains, medical supplies and medicines were held up in ports, diesel shortages prevented transport from the ports to pharmacies, clinics and hospitals, illness overloaded the hospitals and clinics, and on and on. Hopefully we learned to not take any part of our modern, just in time delivery for granted.

I have been a medical content writer for Jase over the past year and have researched and documented how fragile our healthcare system is. The gradual deterioration of our relationships with countries (China, and India and the threat of the dollar losing world currency status) that supply the overwhelming stock of our medications and medical supplies prompted me to act. This, along with reporting on the historic weather events of the past year-2022 and 2023 so far: record-breaking snows in Sierras, tornadoes, hurricanes, flooding in California, wildfires added to my concern.

It only takes one event, nothing even national or worldwide, to cause your supply of medicine (or even water or food for that matter) to dry up for an extended period. Having a year’s supply of my prescription gives me peace of mind and I can focus on other preparedness projects.

Our world is entering a time of massive uncertainty. Severe weather, layoffs, the pending USP strike(hopefully they will come to an agreement before the deadline of July 31^st), the ongoing threat of war, civil unrest, escalating gas prices, food insecurity ( the baby formula shortage is still ongoing) and on are more than enough reasons to be proactive and stock up.

Who is eligible to order a Jase Daily Supply?

To qualify for your years’ worth of medicine, you must meet certain requirements.

• Must be a preexisting prescription.
• Must be stable on current medications for at least 6 months.
• If hospitalized in the last 6 months, you’ll be required to explain during the order process.
• A Jase physician will determine if your Jase Daily supply will be appropriate for you.

• To safely prescribe Jase Daily medication, we require that you have been seen by a health care provider within the past 6 months.

Any day, any time even local events can cause shortages. Be proactive, not reactive. If you or your family are on long term medicines, it makes sense to stock up. Get your Jase Daily for you and your loved ones today.

(May is stroke awareness month)

Strokes, also called CVA (cardiovascular accident) affect more than 795,000 people in the United States. About 610,000 of these are first or new strokes. A stroke occurs when a clot or plaque forms and blocks blood supply to a part of the brain, or when a blood vessel in the brain bursts. The lack of oxygen to the brain can cause brain damage or death. Brain damage or death can occur within minutes.

Stroke is the number three cause of death in women; 20% of women will have a stroke in their lifetime. Stroke is the number five cause of death in men; 14-17% of men will have a stroke in their lifetime.

For both sexes stroke is a leading cause of disability. Strokes can occur at any age, however the incidence of stroke rises dramatically over age of 65.  Over 50 percent of stroke sufferers over the age of 65 have impaired mobility after the stroke.

Types of strokes

There are two types of strokes: one that blocks an artery that supplies blood to the brain (ischemic stroke) or when an artery in the brain leaks blood or ruptures (hemorrhagic stroke).

Ischemic Stroke

(About 87% of all strokes are ischemic strokes)

An ischemic stroke is when a blood clot blocks the artery leading to a portion of the brain, or atherosclerosis, which is a buildup in of fats, cholesterol and other substances in and on the artery walls called plaque hardens and narrows the arteries, which limits blood flow to tissues and organs, in this instance, blood flow to the brain.

Hemorrhagic Stroke

A hemorrhagic stroke happens when an artery in the brain leaks blood or ruptures (breaks open). The leaked blood puts too much pressure on brain cells, which damages them.

TIA (Trans ischemic attack)

TIAs are sometimes known as “warning strokes” which is a warning sign of a future stroke. It is a medical emergency, just like a stroke. More than a third of people who have a TIA and don’t get treatment have a stroke within one year. The symptoms are the same as those of an early stroke. (slurred speech, weakness visual disturbances)

Know the signs and what to do if stroke is suspected

Other signs of a stroke

(Excerpt from American Stroke Association)

• NUMBNESS or weakness of face, arm, or leg, especially on one side of the body
• CONFUSION, trouble speaking or understanding speech
• TROUBLE SEEING in one or both eyes
• TROUBLE WALKING, dizziness, loss of balance or coordination
• SEVERE HEADACHE with no known cause

What to do and what not to do if stroke suspected:

What TO DO if stroke suspected

• Call 911 immediately
• Note when you first saw symptoms of stroke
• Perform CPR if necessary

What NOT TO DO if stroke suspected

• Do not let that person go to sleep or talk you out of calling 911- A stroke is a medical emergency, many feel that if they wait it out the symptoms will pass. Many times, a stroke can make a person feel sleepy, and may try to talk you out of calling 911- that they just need to take a nap and will feel better. This could mean the difference between life and death, and even how much the person will recover. It is always better to err on the safe side and seek medical attention asap.
• Do not give them medication, food, or drinks- Depending on the type of stroke, medication should never be given unless instructed by medical personnel to do so. A patient can aspirate on food or drinks during a stroke.
• Do not drive yourself or someone else to the emergency room- unless there is no other way and no help is available, stay with the patient and wait for EMS. They are trained and carry life saving equipment with them to handle emergencies.

Stroke Risks

You are at risk of a stroke if you have:

• High blood pressure (this is the number one cause of a stroke)
• Diabetes
• Heart and blood vessel diseases- (carotid artery disease, atrial fibrillation, heart valve disease)
• Are a smoker
• High LDL cholesterol
• Viral infections or conditions that cause inflammation. Rheumatoid arthritis and systemic lupus erythematosus (SLE) showed an excess risk of stroke over the general population.
• Age: A stroke can happen at any age, but the risk is higher for babies under the age of 1 and for adults. In adults, the risk increases with age.
• Race and ethnicity: In the United States, stroke occurs more often in African American, Alaska Native, American Indian, and Hispanic adults than in white adults.
• Family history and genetics
• Anxiety, depression, and high stress levels, social isolation
• Medical conditions- bleeding disorders, kidney disease, sleep apnea, sickle cell disease
• Sedentary lifestyle
• Poor nutrition
• Illicit drug use
• Overweight

Prevention

Talk to a dietician and care provider about ways to prevent stroke. In addition:

• Maintain a healthy weight
• Diet- add colorful vegetables, healthy fats to diet
• Manage stress
• Stop smoking
• Manage blood pressure
• Get enough sleep
• Add daily physical activity if you aren’t already

Diagnosing a stroke

Depending on the symptoms, the doctor can diagnose a stroke using the following:

• Physical symptoms (FAST)
• CT or MRI imaging
• Carotid ultrasound
• Cerebral angiogram
• Echocardiogram

Treatment- ischemic and hemorrhagic stroke

(Excerpt from National Heart, Blood and Lung Institute)

Treating an ischemic stroke

Treatment for an ischemic stroke or transient ischemic (TIA) may include medicines and medical procedures.

Treatment

The main treatment for an ischemic stroke is a medicine called tissue plasminogen activator (tPA). It breaks up the blood clots that block blood flow to your brain. This medication is injected into your vein. If tPA isn’t an option an anticoagulant or blood thinning medication, such as aspirin or clopidogrel may be given.

Do not take aspirin unless directed by your care provider.

Medical procedures

A procedure to open up blocked arteries and restore blood flow to the brain may be needed. This can be done several ways.

Depending on the location, age and overall health the surgeon may perform a thrombectomy. The clot is removed from the blood vessel using a catheter inserted intd the groin and threaded to the blocked artery in the neck or vein. From there, the surgeon will use angioplasty and stenting or a device called a stent retriever to open up the blocked artery.

Angioplasty and stenting procedures use a thin tube to deliver a balloon or small mesh tube into the artery. Inflating the balloon or expanding the mesh tube clears space for blood to flow more easily to the brain.

The stent retriever is a wire mesh inside the catheter that traps the clot. The stent retriever and the blood clot are then pulled out through the tube.

If carotid artery disease caused the stroke, the doctor may perform a carotid endarterectomy, a surgery to remove plaque from the carotid artery in the neck.

Treating a hemorrhagic stroke

(Excerpt from National Heart, Blood and Lung Institute)

Hemorrhagic stroke can happen suddenly and grow worse quickly. Just as with an ischemic stroke, getting treatment as quickly as possible is essential for a full recovery. The type of treatment depends on what part of the brain is bleeding and how severe it is.

Treatment

Sometimes blood pressure medicine is given to lower the pressure and strain on blood vessels in the brain. Anticoagulant medicines are discontinued and sometimes vitamin k is administered to help coagulate the blood.

Medical procedures

Procedures may include:

Aneurysm clipping to block off the aneurysm from the blood vessels in the brain. This surgery helps stop bleeding from an aneurysm. During the procedure, a surgeon places a tiny clamp at the base of the aneurysm.

Coil embolization to block blood flow to or seal an aneurysm. The surgeon will insert a tube called a catheter into an artery in the groin. The doctor will thread the tube to the aneurysm in the brain. A tiny coil will be pushed through the tube and into the aneurysm. The coil will cause a blood clot to form, which will block blood flow through the aneurysm and prevent it from bursting again.

Rehabilitation

Rehabilitation following a stroke can take days, months or even years. The road to recover depends on many factors, such as type of stroke, if diagnosed and treated promptly, overall health, age and sex and race.

After a stroke, you may need rehabilitation to help you recover. Rehabilitation may include working with speech, physical, and occupational therapists. Your care team may also recommend medicines to manage pain, muscle spasms, or other problems as you recover. In addition, recovery can be frustrating and emotionally challenging. Be sure to talk with your care team about your feelings. The sooner you receive care, the better the outcome.

Language, speech and memory:

Language, speech and memory are often affected by a stroke. Many times, you may have words you want to speak but are unable to. Or you may be able to speak but not be able to put words together that make sense. Speech and language specialists can help you adjust and learn how to effectively communicate again.

Muscle and nerve :

A stroke may affect only one side of the body or part of one side. It can cause muscle weakness or paralysis, which can put you at risk for falling. Physical and occupational therapists can help you strengthen and stretch your muscles. They can also help you relearn how to do daily activities, such as dressing, eating, and bathing.

Bladder and bowel:

A stroke can affect the muscles and nerves that control the bladder and bowels. You may not be able to get to the bathroom in time. Medicines and a bladder or bowel specialist can help with these problems.

Swallowing and eating:

 You may have trouble swallowing after a stroke. Signs of this problem are coughing or choking during eating or coughing up food after eating. Working with a speech therapist can help overcome some of these difficulties. In some instances, a modified diet may be prescribed.

Mobility affected:

Canes, braces, grab bars, special eating utensils, wheelchairs, and other devices can make it easier to keep doing your regular activities after a stroke. Working with a physical and occupational therapist can help you achieve the optimum level of recovery you had before the stroke.

Learning how to adjust to life after a stroke can be challenging. Patient support groups provide a valuable resource that can offer not just support but can connect you with services to help you with recovery and adjusting to changes you may experience.

Talk with your doctor about local support groups for both you and any family members or caregivers that will be helping you. In addition, let your care provider know if you are experiencing depression or are having frequent mood changes (both are common). Your care provider may recommend a course of antidepressants, counselling, or other therapies to help you cope with your new way of life.