Is intermittent Fasting Good for Weight Loss?

Over the past decade, intermittent fasting, also known as time restricted fasting, has gained popularity as a way to lose weight and mitigate health risks. Some of this is true, however as with all things that seem too good to be true there are a few things that intermittent fasting can do and a few things it can’t do.

Before you jump on the intermittent fasting bandwagon for either health or weight loss related reasons there are a few things to consider. It is true that intermittent fasting can help lower insulin levels and regulate blood sugar. It can help with appetite suppression and accelerate healing and lower inflammation. However, intermittent fasting isn’t for everyone. As far as weight loss is concerned, consistent lifestyle changes over a period of time, along with time restricted eating schedule has proven to help with weight reduction.

Terms

Leptin– Leptin is known as the appetite suppressant hormone. It is secreted by fat cells in response to an increase in insulin. In a healthy feedback loop, leptin decreases hunger.

InsulinInsulin is released by beta cells in the pancreas in response to increased blood glucose levels. In a healthy feedback loop, insulin acts like a gatekeeper by attaching to cells and allowing glucose into the cell, thereby providing energy to the cell.

GhrelinGhrelin, also known as the hunger hormone, is primarily secreted in the stomach and gastrointestinal when your stomach is empty. It tells your brain you are hungry. It also regulates insulin secretion and has a role in reducing energy expenditure. Research continues to discover many other roles that ghrelin plays in the body.

Incretin- Incretin hormones are gut peptides that are secreted after nutrient intake and stimulate insulin secretion together with hyperglycemia. GIP (glucose-dependent insulinotropic polypeptide) und GLP-1 (glucagon-like peptide-1) are the known incretin hormones from the upper (GIP, K cells) and lower (GLP-1, L cells) gut.

The healthy leptin insulin feedback loop

In a healthy feedback loop, insulin levels rise due to food intake (which increases blood glucose), triggering fat cells to release leptin. Leptin reduces appetite. In turn, less or no food is eaten, resulting in lower blood glucose, which stabilizes insulin levels.

The unhealthy feedback loop

Persistent high levels of leptin cause cells to not be receptive to the effects of leptin. You continue to be hungry. The leptin, which is stored in your fat cells, doesn’t respond to feelings of satiety and you continue to be hungry. Insulin resistance is caused by persistent high levels of insulin. Cells don’t have gatekeepers(insulin)that allow glucose(energy) into the cell. This results in high circulating blood glucose levels.

 

Understanding the body weight thermostat

In a healthy feedback loop, the body weight thermostat sets the metabolism by the balance of the insulin-leptin feedback loop. Leptin goes up (reduce hunger) in response to rising insulin levels. This in turn lowers insulin levels because you aren’t eating. In this example, healthy body weight is maintained.

However, the body weight thermostat can malfunction. This happens when increased insulin levels- insulin levels that are increased over a period of months or years, cause insulin resistance. This results in weight gain.

Intermittent fasting/time restricted eating can balance insulin and blood sugar levels- if done right

Insulin is a primary driver of weight gain in many individuals. Correcting the imbalance through diet, exercise, reduced stress, and good quality sleep can reverse insulin and leptin resistance. It takes time, perseverance, education and planning to achieve optimum health and weight.

Talk with your healthcare provider before starting any time restricted fasting. Children, endurance athletes, underweight people, and women who are trying to conceive, pregnant, or breastfeeding should avoid intermittent fasting.

Fasting benefits and considerations

How and when to fast

Research shows that a 16 hour fast with 8 hour eating schedule provides the body with enough time to reset insulin levels, reduce inflammation and help the body turn fat into energy in a process called ketosis. However, it can take a while to get to that eating window. Many people start with a 10 hour fast and gradually work up to the 16/8 schedule. However, there are many ways to do intermittent fasting. Some do alternate days fasting, others have a more time restrictive fasting window. It all depends on your schedule and health status.

There are many benefits to intermittent fasting. During a state of fasting the body has energy to repair since energy isn’t being used for digestion. In addition, human growth hormone (HGH) increases dramatically, which can facilitate fat burning. Inflammatory markers, which cause many health-related problems, such as heart disease and diabetes. Increases levels of BDNF, a brain hormone called brain-derived neurotrophic factor, in which a deficiency has been implicated in depression and other psychiatric illnesses.

Fasting increases OGT enzyme

New research out of Yale University discovered an enzyme (OGT) produced in the hypothalamic region of the brain regulates the body’s homeostatic set point body weight and lipid metabolism. The enzyme, OGT, significantly increased after 24 hour fasting period in mice, leading researchers to speculate this enzyme may have use in obesity prevention.

Intermittent fasting, cortisol, and stress

Any type of stress the body experiences- whether emotional or physical increases cortisol levels.

Cortisol prepares your body to deal with stressful situations by diverting resources, such as blood sugar or glucose, to give your body the energy it needs to respond to a stressor or crisis. Cortisol raises blood sugar levels, even during periods of fasting. This can lead to storing more fat, Once the body adjusts to time restricted eating, many of these stressors will more than likely start to disappear.

Intermittent fasting and thyroid hormones

The thyroid gland, releases several hormones that regulate metabolism. Intermittent fasting can lower T3 and T4 levels, which can actually lead to weight gain. This is usually solved by a gradual lengthening of the fasting period. Since the thyroid hormone needs glucose to convert from inactive to active hormones (T4 to T3) the transition to using ketones as fuel (which form after extended time of fasting) can be a challenge. Seek professional guidance when dealing with thyroid dysfunction, either hypo or hyperthroid.

Effects of Intermittent Fasting on reproductive hormones

Hypothalamic Kisspeptin neurons and their receptors are involved with puberty and reproductive hormone regulation. During fasting, these hormones are decreased and can affect fertility.

- Brooke Lounsbury, RN

Medical Content Writer

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I subscribed to Netflix over New Year's Eve to watch the viral movie "Leave the World Behind". The movie is loosely based on a 2020 novel written by Rumaan Alam. I hold an amateur (ham) radio license, have trained in Ares (Amateur Radio Emergency System), was a home...

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What is Insulin Resistance?

To understand what insulin resistance is, we first need to look at what insulin is and what it does.

Insulin is a hormone that is secreted by beta cells of the pancreas. The pancreas is located under the left rib cage and extends slightly to the right. The pancreas releases insulin in response to consuming carbohydrate rich foods, especially when high in simple sugars.

The lock and key gatekeeping loop

Once insulin is released into the bloodstream, it travels to cells throughout the body where it binds to special cell receptors called glucose transporters. These cell receptors act as the gatekeeper for glucose to enter the cells. Once insulin binds to these receptors it “unlocks” the cell, allowing glucose to enter the cell, providing energy for the cell. Depending on what part of the body they are located in, there are 14 different glucose transporters that have been identified. These transporters are responsible for signaling the pancreas to stop releasing insulin when no longer needed. This is called a feedback loop.

The image below shows how one of the receptors does its job- GLUT4 transport receptor

Defective or decreased insulin receptors causes insulin resistance (AKA impaired insulin sensitivity).

Mild insulin resistance (fasting glucose of 100–125 milligrams per deciliter and/or an A1C of 5.7% to 6.4%) is usually caused by decreased insulin receptors. This is also called prediabetes. About 34% of middle-aged adults in the U.S. fall in this category.

Severe insulin resistance, also known as type 2 diabetes, (fasting insulin levels above 50–70 μU/mL or levels that exceed 350 μU/mL after an oral glucose tolerance test) is caused by both decreased insulin receptors and defective receptors.  

The development of insulin resistance typically increases insulin production (hyperinsulinemia) so your body can maintain healthy blood sugar levels. Elevated levels of insulin can result in weight gain, which, in turn, makes insulin resistance worse.

When blood glucose is excessive, the body converts it into glycogen where it is stored mostly in muscle and liver for energy when glucose isn’t readily available. When the glycogen stores are needed, enzymes release and convert the glycogen back to readily available glucose for the cells to use.

Signs of insulin resistance

(In addition to high insulin levels, and elevated blood glucose testing levels)

There is no definite test for insulin resistance that is affordable and easy to test– most testing is done in research facilities. Instead, practitioners rely on a series of labs to determine insulin resistance.

  • High triglyceride levels.
  • High LDL (bad cholesterol)
  • Low HDL (good cholesterol)
  • Hardening of the arteries (atherosclerosis)
  • High blood pressure (hypertension)
  • Metabolic syndrome or insulin resistance syndrome is a group of conditions- obesity, high blood pressure, high blood triglycerides, low levels of HDL cholesterol and insulin resistance that raise your risk of coronary heart disease, stroke, and other serious complications.

Causes of insulin resistance

Insulin resistance can affect anyone, and it can be temporary especially if you are under stress or taking corticosteroid medication.

Other risk factors include: (taken from CDC website)

  • overweight or obesity
  • age 45 or older
  • a parent, brother, or sister with diabetes
  • African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander American ethnicity
  • physical inactivity
  • health conditions such as high blood pressure and abnormal cholesterol levels
  • a history of gestational diabetes
  • a history of heart disease or stroke
  • polycystic ovary syndrome, also called PCOS
  • certain medicines, such as glucocorticoids NIH external link, some antipsychotics, and some medicines for HIV
  • hormonal disorders, such as Cushing’s syndrome and acromegaly
  • sleep problems, especially sleep apnea

How to reverse insulin resistance

Check with your care provider before starting any lifestyle or dietary changes

  • Increase physical activity- any activity that gets heart rate up increases insulin sensitivity.
  • Consider intermittent fasting– In conjunction with a healthy diet, stress reduction, and physical activity, intermittent fasting has proven to increase insulin sensitivity and regulate glucose metabolism
  • Lower carbohydrate intake- Talk with your care provider or a dietician about ways to lower carbohydrate intake. Work with them to put together a workable, realistic meal plan
  • Reduce stress-In addition to avoiding stressful situations, and media that may prove upsetting try deep breathing exercises– proven to reduce stress and anxiety.
  • Get good quality sleep- Practice sleep hygiene– shut off blue light emitting screens, turn off wifi (known to decrease melatonin production and increase norepinephrine- the fight or flight hormone- production)

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

Leave the World Behind- Leave This Movie Behind

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I subscribed to Netflix over New Year's Eve to watch the viral movie "Leave the World Behind". The movie is loosely based on a 2020 novel written by Rumaan Alam. I hold an amateur (ham) radio license, have trained in Ares (Amateur Radio Emergency System), was a home...

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Antibiotics don’t kill viruses; they kill bacteria, mold, or parasites. They are lifesaving drugs when the need arises. However, overuse has led to antibiotic-resistant strains of bacteria that used to be effective with an appropriate antibiotic. Nowadays, we are...

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

Cellulitis can be Life Threatening

If no medical care is available-Do all members of your family have a Jase Case?

Melissa Gilbert of Little House on the Prairie, recently posted on Instagram that she had to go to the hospital. 2 days prior, an insect bit her arm. The bite had turned red, swollen, and hot to touch. Her doctor told her to go to the ER, where she was diagnosed with cellulitis. She was put on a IV of antibiotics, Benadryl and Acetaminophen.

Years back, when I worked in a family practice clinic, I received a phone call from one of our patients, a single mom, who was camping with her 4 children outside of Disneyland. (Back then they had camping, more affordable than the hotels.) She had just spent the last 3 days going to the local walk-in clinic where she received IV antibiotics for cellulitis. She went on to tell me that she had saved for years to go on this vacation with her kids by selling Avon to finance the trip. The last Avon order had come in right before her trip. In her excitement to get orders to her customers she ripped open the box, and in doing so cardboard fibers lodged under her thumb. She removed the fibers, but the area had remained very red and swollen. She ignored the injury and went on the planned vacation, where she ended up seeking medical attention for what seemed at the time like a minor injury.

What is cellulitis and what to do if medical attention isn’t readily available?

Cellulitis is a serious infection that spreads to surrounding tissue from a break in the skin. It usually occurs around the arms and legs but can be found in other areas of the body as well. Group A Streptococcus (S. pyogenes), is the most common bacteria that causes cellulitis; however, staphylococcus bacteria can also cause cellulitis.

The bacteria enter through breaks in the skin through:

  • Cuts, bites (insect, spider animal)
  • Tattoos, piercings
  • Chronic skin conditions that compromise skin integrity and the protective barrier- eczema, athletes foot
  • Chickenpox, shingles-blisters pop which leaves skin vulnerable to infection
  • Chronic edema in lower extremities resulting in skin breakdown
  • Injection drug use and
  • Puncture wounds

Symptoms include

  • Area surrounding the wound – redness, swelling, pain and areas are warm to touch
  • Malaise, fatigue
  • In more advanced cases fever, swollen lymph glands, and elevated white blood cell count
  • If untreated it can lead to sepsis, amputation and even death.
  • Redness and swelling usually spreads rapidly-within hours

How diagnosed

Diagnosis is usually through patient history and inspection of the affected area. Wound cultures, etc. are not indicated unless unusual pathogens are suspected.

What if you suspect cellulitis?

Cellulitis can spread rapidly, within a matter of hours. If medical care is available, don’t delay. If caught in time, oral antibiotics can stop the spread in most cases. Warm compresses can help bring infection fighting cells to the area. Apply moist, warm compresses for 20 minutes up to 5 times a day along with seeking medical care.

If in doubt if cellulitis and symptoms (pain, swelling, redness) are mild: Take a marker and draw a line around the edge of the red, swollen area. Check every hour. If the redness spreads outside the boundary, seek immediate medical attention. In addition, if there is any change, necrosis (dead tissue, sometimes black) or any other types of skin breakdown, fever, chills, confusion, dizziness, seek immediate medical attention.

The following images are courtesy of NHS

TESTIf no medical care is available-Do all members of your family have a Jase Case?

Melissa Gilbert of Little House on the Prairie, recently posted on Instagram that she had to go to the hospital. 2 days prior, an insect bit her arm. The bite had turned red, swollen, and hot to touch. Her doctor told her to go to the ER, where she was diagnosed with cellulitis. She was put on a IV of antibiotics, Benadryl and Acetaminophen.

Years back, when I worked in a family practice clinic, I received a phone call from one of our patients, a single mom, who was camping with her 4 children outside of Disneyland. (Back then they had camping, more affordable than the hotels.) She had just spent the last 3 days going to the local walk-in clinic where she received IV antibiotics for cellulitis. She went on to tell me that she had saved for years to go on this vacation with her kids by selling Avon to finance the trip. The last Avon order had come in right before her trip. In her excitement to get orders to her customers she ripped open the box, and in doing so cardboard fibers lodged under her thumb. She removed the fibers, but the area had remained very red and swollen. She ignored the injury and went on the planned vacation, where she ended up seeking medical attention for what seemed at the time like a minor injury.

What is cellulitis and what to do if medical attention isn’t readily available?

Cellulitis is a serious infection that spreads to surrounding tissue from a break in the skin. It usually occurs around the arms and legs but can be found in other areas of the body as well. Group A Streptococcus (S. pyogenes), is the most common bacteria that causes cellulitis; however, staphylococcus bacteria can also cause cellulitis.

The bacteria enter through breaks in the skin through:

  • Cuts, bites (insect, spider animal)
  • Tattoos, piercings
  • Chronic skin conditions that compromise skin integrity and the protective barrier- eczema, athletes foot
  • Chickenpox, shingles-blisters pop which leaves skin vulnerable to infection
  • Chronic edema in lower extremities resulting in skin breakdown
  • Injection drug use and
  • Puncture wounds

Symptoms include

  • Area surrounding the wound – redness, swelling, pain and areas are warm to touch
  • Malaise, fatigue
  • In more advanced cases fever, swollen lymph glands, and elevated white blood cell count
  • If untreated it can lead to sepsis, amputation and even death.
  • Redness and swelling usually spreads rapidly-within hours

How diagnosed

Diagnosis is usually through patient history and inspection of the affected area. Wound cultures, etc. are not indicated unless unusual pathogens are suspected.

What if you suspect cellulitis?

Cellulitis can spread rapidly, within a matter of hours. If medical care is available, don’t delay. If caught in time, oral antibiotics can stop the spread in most cases. Warm compresses can help bring infection fighting cells to the area. Apply moist, warm compresses for 20 minutes up to 5 times a day along with seeking medical care.

If in doubt if cellulitis and symptoms (pain, swelling, redness) are mild: Take a marker and draw a line around the edge of the red, swollen area. Check every hour. If the redness spreads outside the boundary, seek immediate medical attention. In addition, if there is any change, necrosis (dead tissue, sometimes black) or any other types of skin breakdown, fever, chills, confusion, dizziness, seek immediate medical attention.

The following images are courtesy of NHS

If no medical care is available-TESTDo all members of your family have a Jase Case?

Melissa Gilbert of Little House on the Prairie, recently posted on Instagram that she had to go to the hospital. 2 days prior, an insect bit her arm. The bite had turned red, swollen, and hot to touch. Her doctor told her to go to the ER, where she was diagnosed with cellulitis. She was put on a IV of antibiotics, Benadryl and Acetaminophen.

Years back, when I worked in a family practice clinic, I received a phone call from one of our patients, a single mom, who was camping with her 4 children outside of Disneyland. (Back then they had camping, more affordable than the hotels.) She had just spent the last 3 days going to the local walk-in clinic where she received IV antibiotics for cellulitis. She went on to tell me that she had saved for years to go on this vacation with her kids by selling Avon to finance the trip. The last Avon order had come in right before her trip. In her excitement to get orders to her customers she ripped open the box, and in doing so cardboard fibers lodged under her thumb. She removed the fibers, but the area had remained very red and swollen. She ignored the injury and went on the planned vacation, where she ended up seeking medical attention for what seemed at the time like a minor injury.

What is cellulitis and what to do if medical attention isn’t readily available?

Cellulitis is a serious infection that spreads to surrounding tissue from a break in the skin. It usually occurs around the arms and legs but can be found in other areas of the body as well. Group A Streptococcus (S. pyogenes), is the most common bacteria that causes cellulitis; however, staphylococcus bacteria can also cause cellulitis.

The bacteria enter through breaks in the skin through:

  • Cuts, bites (insect, spider animal)
  • Tattoos, piercings
  • Chronic skin conditions that compromise skin integrity and the protective barrier- eczema, athletes foot
  • Chickenpox, shingles-blisters pop which leaves skin vulnerable to infection
  • Chronic edema in lower extremities resulting in skin breakdown
  • Injection drug use and
  • Puncture wounds

Symptoms include

  • Area surrounding the wound – redness, swelling, pain and areas are warm to touch
  • Malaise, fatigue
  • In more advanced cases fever, swollen lymph glands, and elevated white blood cell count
  • If untreated it can lead to sepsis, amputation and even death.
  • Redness and swelling usually spreads rapidly-within hours

How diagnosed

Diagnosis is usually through patient history and inspection of the affected area. Wound cultures, etc. are not indicated unless unusual pathogens are suspected.

What if you suspect cellulitis?

Cellulitis can spread rapidly, within a matter of hours. If medical care is available, don’t delay. If caught in time, oral antibiotics can stop the spread in most cases. Warm compresses can help bring infection fighting cells to the area. Apply moist, warm compresses for 20 minutes up to 5 times a day along with seeking medical care.

If in doubt if cellulitis and symptoms (pain, swelling, redness) are mild: Take a marker and draw a line around the edge of the red, swollen area. Check every hour. If the redness spreads outside the boundary, seek immediate medical attention. In addition, if there is any change, necrosis (dead tissue, sometimes black) or any other types of skin breakdown, fever, chills, confusion, dizziness, seek immediate medical attention.

The following images are courtesy of NHS

If no medical care is available-TESTDo all members of your family have a Jase Case?

Melissa Gilbert of Little House on the Prairie, recently posted on Instagram that she had to go to the hospital. 2 days prior, an insect bit her arm. The bite had turned red, swollen, and hot to touch. Her doctor told her to go to the ER, where she was diagnosed with cellulitis. She was put on a IV of antibiotics, Benadryl and Acetaminophen.

Years back, when I worked in a family practice clinic, I received a phone call from one of our patients, a single mom, who was camping with her 4 children outside of Disneyland. (Back then they had camping, more affordable than the hotels.) She had just spent the last 3 days going to the local walk-in clinic where she received IV antibiotics for cellulitis. She went on to tell me that she had saved for years to go on this vacation with her kids by selling Avon to finance the trip. The last Avon order had come in right before her trip. In her excitement to get orders to her customers she ripped open the box, and in doing so cardboard fibers lodged under her thumb. She removed the fibers, but the area had remained very red and swollen. She ignored the injury and went on the planned vacation, where she ended up seeking medical attention for what seemed at the time like a minor injury.

What is cellulitis and what to do if medical attention isn’t readily available?

Cellulitis is a serious infection that spreads to surrounding tissue from a break in the skin. It usually occurs around the arms and legs but can be found in other areas of the body as well. Group A Streptococcus (S. pyogenes), is the most common bacteria that causes cellulitis; however, staphylococcus bacteria can also cause cellulitis.

The bacteria enter through breaks in the skin through:

  • Cuts, bites (insect, spider animal)
  • Tattoos, piercings
  • Chronic skin conditions that compromise skin integrity and the protective barrier- eczema, athletes foot
  • Chickenpox, shingles-blisters pop which leaves skin vulnerable to infection
  • Chronic edema in lower extremities resulting in skin breakdown
  • Injection drug use and
  • Puncture wounds

Symptoms include

  • Area surrounding the wound – redness, swelling, pain and areas are warm to touch
  • Malaise, fatigue
  • In more advanced cases fever, swollen lymph glands, and elevated white blood cell count
  • If untreated it can lead to sepsis, amputation and even death.
  • Redness and swelling usually spreads rapidly-within hours

How diagnosed

Diagnosis is usually through patient history and inspection of the affected area. Wound cultures, etc. are not indicated unless unusual pathogens are suspected.

What if you suspect cellulitis?

Cellulitis can spread rapidly, within a matter of hours. If medical care is available, don’t delay. If caught in time, oral antibiotics can stop the spread in most cases. Warm compresses can help bring infection fighting cells to the area. Apply moist, warm compresses for 20 minutes up to 5 times a day along with seeking medical care.

If in doubt if cellulitis and symptoms (pain, swelling, redness) are mild: Take a marker and draw a line around the edge of the red, swollen area. Check every hour. If the redness spreads outside the boundary, seek immediate medical attention. In addition, if there is any change, necrosis (dead tissue, sometimes black) or any other types of skin breakdown, fever, chills, confusion, dizziness, seek immediate medical attention.

The following images are courtesy of NHS

What if no immediate medical care is available?

Cellulitis can quickly become life threatening. Early intervention can mean the difference between life and death.

  • Monitor all skin breaks including scrapes, cuts, insect bites – If you have young children be sure to inspect their skin on a regular basis. Look for the signs of skin infections that may possibly lead to cellulitis.
  • Maintain hygienic practices – Group A streptococcus is spread through direct contact with infected fluid/material or droplets or when coughing. Wear disposable gloves when cleansing wound, double bag all dressings and dispose of in garbage. Avoid contact with wound drainage or other fluids from area. Wash your hands thoroughly using soap and water. There is some discussion that cellulitis isn’t contagious, however always err on the side of caution and use gloves and wash hands .
  • Draw an outline with a marker around any area you have doubts about. Check hourly for redness, swelling, change in appearance of skin, blisters, necrosis (blackened skin in and surrounding skin break).
  • If redness or swelling is noted outside the marked area, contact your care provider for instructions.
  • If a care provider is not available for consult, follow the instructions in your Jase Case for skin infections/cellulitis. Doxycycline, included in the Jase Case is one of the most effective antibiotics for cellulitis.

Given all the instability in the world, while the infrastructure is still in place, prioritize and consider what would happen if the medical system went down, even for a week. Take advantage of Jase Daily and get your year supply of prescriptions and order Jase Case for every member of your family if you haven’t done so yet.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

Leave the World Behind- Leave This Movie Behind

Leave the World Behind- Leave This Movie Behind

I subscribed to Netflix over New Year's Eve to watch the viral movie "Leave the World Behind". The movie is loosely based on a 2020 novel written by Rumaan Alam. I hold an amateur (ham) radio license, have trained in Ares (Amateur Radio Emergency System), was a home...

Does Your Sore Throat Need an Antibiotic?

Does Your Sore Throat Need an Antibiotic?

Antibiotics don’t kill viruses; they kill bacteria, mold, or parasites. They are lifesaving drugs when the need arises. However, overuse has led to antibiotic-resistant strains of bacteria that used to be effective with an appropriate antibiotic. Nowadays, we are...

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

Drugs That Affect Blood Sugar and Hypoglycemia- A Medical Emergency

Medications can be lifesaving; however, many have unwanted effects. Almost every drug class has medications that can affect blood sugars and even mask high and low glucose levels. From blood pressure meds to inhalers, steroids, antibiotics, antifungals and diuretics, the likelihood of you or someone you know using a drug that affects glucose levels.  There are too many to list. Below are just a few examples:

A few of the many drugs that increase blood sugar (hyperglycemia): (NIH database)

  • Alcohol (decreases blood sugar after several hours of excessive intake)
  • Antibiotics (Dapsone, Rifampin)
  • Antidepressants (Zyprexa, risperdal, Clozaril, Seroquel, Abilify, Geodon, lithium)
  • Beta-2 stimulators (Proventil, Alupent, Serevent, Foradil, Brethine, Theo-Dur)
  • Corticosteroids (Prednisone, Decadron, DepoMedrol)
  • Dilantin (phenytoin)
  • Estrogens (Premarin, hormone replacement therapy)
  • Fluconazole
  • Heart and blood pressure medications (amiodarone, beta blockers(non insulin dependent diabetics), calcium channel blockers, catapress, diuretics)
  • Oral contraceptives (Birth control pills)
  • Niacin or nicotinic acid
  • Thiazide diuretics
  • Thyroid hormones (Synthroid, Levothroid)

If on a continuous glucose monitor acetaminophen (Tylenol) interferes with sensors resulting in a false low glucose reading and should be avoided.

A few of the drugs that decrease blood sugar (hypoglycemia): (NIH database)

  • Alcohol (acute excess amounts)
  • Aspirin and other salicylates in larger doses
  • Cibenzoline and quinidine (heart arrhythmia drugs)
  • Indomethacin (Indocin)
  • Levofloxacin
  • Trimethoprim-sulfamethoxazole
  • Metformin when used with sulfonylureas
  • Heart and blood pressure medications (ACE inhibitors, beta blockers, Norpace, Quinidine)

One common drug that masks low blood sugar

If diabetic (especially insulin dependent) and taking beta blockers the symptoms of low blood sugar may not be apparent. Beta blockers block the effects of norepinephrine. Norepinephrine, along with epinephrine are released into the bloodstream during hypoglycemic episode. In turn the release of these hormones causes the early symptoms of hypoglycemia such as tremor, sweating, rapid heartbeat, and anxiety. If diabetic and taking beta blockers monitor glucose levels closely even when you don’t have signs of low blood sugar.

Signs of low blood sugar (below 70 mg/dL or less)

Low blood sugar, especially in a diabetic, can be more dangerous and even a medical emergency if not treated in time.

Common signs of low blood sugar are:

  • Fast heartbeat
  • Shaking
  • Sweating
  • Nervousness or anxiety
  • Irritability, anger or confusion
  • Dizziness
  • Hunger

During sleep, low blood sugar symptoms may include sweaty sheets and sometimes nightmares

Signs of severe low blood sugar (below 54 mg/dL or by symptoms listed below)- Medical emergency

  • Loss of coordination
  • Difficulty speaking or slurred speech
  • Blurry or tunnel vision
  • Inability to eat or drink
  • Muscle weakness
  • Drowsiness

If left untreated hypoglycemia can result in coma, seizures and in rare cases, death

Causes of Low Blood Sugar

There are many reasons why for low blood sugar, including:

  • Taking too much insulin and/or not taking it on time
  • Not eating enough carbs after taking insulin
  • Poor diet- not eating a balanced protein, carbs and fat diet
  • The amount and timing of physical activity.
  • Drinking alcohol.
  • Hot and humid weather.
  • Unexpected changes in your schedule.
  • Spending time at a high altitude.
  • Going through puberty
  • Menstruation
  • On medication that causes low blood sugar
  • Severe liver or kidney disease
  • Severe infection
  • Advanced heart disease
  • Pancreatic or adrenal tumors
  • Drinking alcohol at night

What to do if you or someone you know has low blood sugar. The CDC website has tips on managing and treating hypoglycemia:

The 15-15 Rule

For low blood sugar between 55-69 mg/dL, raise it by following the 15-15 rule:

Have 15 grams of carbs and check your blood sugar after 15 minutes. If it’s still below your target range, have another serving. Repeat these steps until it’s in your target range. Once it’s in range, eat a nutritious meal or snack to ensure it doesn’t get too low again.

These items have about 15 grams of carbs:

  • 4 ounces (½ cup) of juice or regular soda.
  • 1 tablespoon of sugar, honey, or syrup.
  • Hard candies, jellybeans, or gumdrops (see food label for how much to eat).
  • 3-4 glucose tablets (follow instructions).
  • 1 dose of glucose gel (usually 1 tube; follow instructions).

Tips to keep in mind:

  • It takes time for blood sugar to rise after eating. Give some time for treatment to work. Following the 15-15 rule helps.
  • Young children usually need less than 15 grams of carbs, especially infants and toddlers. Ask your doctor how much your child needs.
  • You should avoid eating a carbohydrate with lots of fiber, such as beans or lentils, or a carb that also has fat, such as chocolate. Fiber and fat slow down how fast you absorb sugar.
  • Check your blood sugar often when lows are more likely, such as when the weather is hot or when you travel.

Treating Severely Low Blood Sugar- (below 55mg/dL)

Not treatable by 15-15-15 rule

Make sure your family members, friends, and caregivers know your signs of low blood sugar so they can help treat it if needed.

You also may not be able to check your own blood sugar or treat it by yourself, depending on your symptoms.

Injectable glucagon is the best way to treat severely low blood sugar. A glucagon kit is available by prescription. Speak with your doctor to see if you should have a kit. Be sure to learn how and when to use it. Let family members and others close to you know where you keep the glucagon kit and make sure they’ve been trained in how to use it too.

It’s important to contact a doctor for emergency medical treatment immediately after receiving a glucagon injection. If a person faints (passes out) due to severely low blood sugar, they’ll usually wake up within 15 minutes after a glucagon injection. If they don’t wake up within 15 minutes after the injection, they should receive one more dose.

When the person is awake and able to swallow:

  • Feed the person a fast-acting source of sugar (regular soft drink or fruit juice).
  • Then, have them eat a long-acting source of sugar (crackers and cheese or a sandwich with meat).
  • It’s also important that friends, family, co-workers, teachers, coaches, and other people you may be around often know how to test your blood sugar and treat severely low blood sugar before it happens.

A medical ID, usually a bracelet or necklace, can be critical in keeping you safe and healthy. Emergency medical technicians are trained to look for a medical ID when caring for someone who can’t speak for themselves.

When To Call 911

If any of the following happens, your friend, relative, or helper should call 911:

  • You pass out and no glucagon is available.
  • You need a second dose of glucagon.
  • You had glucagon but are still confused.
  • Your blood sugar stays too low 20 minutes after treatment or doesn’t respond to your usual treatments.
  • Or call 911 anytime you are concerned about your severely low blood sugar.

After You Have Low Blood Sugar

If your low blood sugar was mild (between 55-69 mg/dL), you can return to your normal activities once your blood sugar is back in its target range.

After you have low blood sugar, your early symptoms for low blood sugar are less noticeable for 48 to 72 hours. Be sure to check your blood sugar more often to keep it from getting too low again, especially before eating, physical activity, or driving a car.

 

If you used glucagon because of a severe low (54 mg/dL or below), immediately call your doctor for emergency medical treatment. If you have had lows several times close together (even if they’re not severe), you should also tell you doctor. They may want to change your diabetes plan.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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Medical Preparedness – Diabetes

Do you have an extra glucometer in your supplies?

A chronic condition such as diabetes can be life threatening if our fragile medical supply chain is disrupted and medication or supplies to test are not available. Having adequate supplies- an extra glucometer with test trips, batteries, and solution should be in every diabetic’s medical kit. Whether you are type 1, 2 or gestational diabetic having the extra glucometer and supplies is vital. Nowadays, glucometers there are so many high-tech glucometers- ones that use a thin needle under the skin and read glucose levels every few minutes and alert user if levels are out of range, to blood free sensors that use flashing light to take glucose readings- and even more. Even though technology is wonderful, relying on it can be dangerous. Glucometers can fail by giving incorrect readings or stop working altogether. It is important to have another glucometer, preferably one that isn’t as high tech to measure the reading against or in case of altogether failure. In addition, make sure you have an adequate supply of medication- both oral and injectable insulin (along with supplies) in case these drugs aren’t available for an extended period of time. Aim for at least 6-month supply of drugs and supplies. Even more would be better.

Always check with the diabetic and observe for symptoms of hypo/hyperglycemia. If glucose readings are within normal limits established by their care provider but they exhibit symptoms of poor glucose control, retake glucose with alternate glucometer. Contact primary care provider or healthcare professional if needed.

Diabetes testing and lab values

The following are excerpts from the CDC website:

Tests for Type 1 Diabetes, Type 2 Diabetes, and Prediabetes

A1C Test

The A1C test measures your average blood sugar level over the past 2 or 3 months. An A1C below 5.7% is normal, between 5.7 and 6.4% indicates you have prediabetes, and 6.5% or higher indicates you have diabetes.

Fasting Blood Sugar Test

This measures your blood sugar after an overnight fast (not eating). A fasting blood sugar level of 99 mg/dL or lower is normal, 100 to 125 mg/dL indicates you have prediabetes, and 126 mg/dL or higher indicates you have diabetes.

Glucose Tolerance Test

This measures your blood sugar before and after you drink a liquid that contains glucose. You’ll fast (not eat) overnight before the test and have your blood drawn to determine your fasting blood sugar level. Then you’ll drink the liquid and have your blood sugar level checked 1 hour, 2 hours, and possibly 3 hours afterward. At 2 hours, a blood sugar level of 140 mg/dL or lower is considered normal, 140 to 199 mg/dL indicates you have prediabetes, and 200 mg/dL or higher indicates you have diabetes.

Random Blood Sugar Test

This measures your blood sugar at the time you’re tested. You can take this test at any time and don’t need to fast (not eat) first. A blood sugar level of 200 mg/dL or higher indicates you have diabetes.

5 things you can do to improve blood sugar – prediabetic or diabetic

  1. Get moving

Exercise of any form contributes to overall health and is a valuable tool in managing glucose levels. Even a brisk walk has benefits. If you haven’t been exercising, take it slow and easy. The key is to be consistent. If walking, aim for at least 30 minutes a day 5 days a week. Studies reveled that walking 30 minutes a day reduced blood sugar readings by 25 percent. Once you have mastered this, consider HIIT- high intensity interval training-short bursts of intense exercise alternated with low intensity recovery periods. Studies show that this form of exercise has the more powerful effect on glucose control than other forms of exercise. Consult with your primary care provider before embarking on any new exercise regimen.

  1. Reduce stress

High stress hormones prevent the pancreas from producing insulin. When under stress, stress hormones such as glucagon and epinephrine are released and reduce glucose uptake in the muscle. When this happens, more glucose is circulating in the blood, causing hyperglycemia. Ways to manage and reduce stress include journaling, exercise, meditate, connect with others, and my personal favorite, deep breathing. Johns Hopkins Medicine has a good video on deep breathing and stress reduction.

  1. Follow diabetic diet and consider intermittent fasting (IF)- only under the supervision of a healthcare professional

If you are prediabetic or type 2 diabetic intermittent fasting- when you eat in a restricted time frame- for example eat 8 hours and fast 16- has proven health benefits, including the ability to lower blood sugar and in some cases reverse diabetes and insulin resistance (Insulin resistance is when muscles, fat, and liver cells don’t respond well to insulin and can’t easily take up glucose from your blood.)

There are downsides to intermittent fasting. If you are taking medication to lower blood glucose IF could potentially cause a hypoglycemic episode. In addition, with type 1 diabetics, IF can cause hyperglycemia and hypoglycemia.

  1. Get good quality sleep- at least 7 hours a night

Too little sleep can affect glucose levels by:

  • Increasing insulin resistance.
  • Make you hungrier the next day and reduce how full you feel after eating and causes the hunger hormone grehlin to increase
  • Make you more likely to reach for junk foods—those that are high in carbs and sugar.
  1. Stay hydrated and don’t get overheated

Dehydration can lead to an increase in blood glucose because the blood is more concentrated.

Also, extreme heat can cause blood vessels to widen, which in turn causes insulin to absorb more quickly, leading to low blood sugar.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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Popular Pesticide That Was Recently Banned Associated With Type 2 Diabetes

(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.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

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I subscribed to Netflix over New Year's Eve to watch the viral movie "Leave the World Behind". The movie is loosely based on a 2020 novel written by Rumaan Alam. I hold an amateur (ham) radio license, have trained in Ares (Amateur Radio Emergency System), was a home...

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Join Our Newsletter

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