Holiday meals bring candy, cookies and other sweets in bountiful amounts. Most of us will chow down with a promise to return to healthy eating tomorrow. But people with diabetes must closely monitor their intake of sugar and carbohydrates at every meal.

What is diabetes? 

Aminat Ogun, MD, is a family medicine physician at OSF HealthCare. She says diabetes is a disorder that affects how your body uses blood sugar. Type 1 diabetes is when an autoimmune reaction stops your body from making insulin. Type 2 is when the body can’t recognize insulin and use it well. Gestational diabetes occurs in pregnant women.

Dr. Ogun says a sedentary lifestyle can be a big risk factor for developing diabetes, so regular exercise is important. Treatment typically involves medication and lifestyle changes.

Moderation is key 

Dr. Ogun says there’s no magic number of cookies you can eat on Christmas and walk away with no diabetes complications. Your nutrition depends on your age, sex, height, weight and more. Plus, she says the brain needs some sugar to function.

Dr. Ogun recommends small portions. Put just a couple of cookies or chocolates on your plate after the holiday meal. Don’t keep going back for more.

Mix in healthier snacks, like fruits, vegetables, nuts and legumes. Look for “whole grain” or “whole wheat” on the label. If you’re craving sugar, try yogurt with berries or an apple with peanut butter. Artificial sweeteners are another option to satisfy the sweet tooth, as Dr. Ogun says they do not raise your blood sugar level. For example, mix a sweetener powder into your water.

Dr. Ogun says if you rely on insulin, check your blood sugar level as often as your doctor advises.

“You would have discussed with your doctor the amount of carbohydrates you can take,” Dr. Ogun says. “Try to keep to that level.”

Dr. Ogun admits it may be more difficult for children not to gorge on holiday sweets. So, parents need to keep a close eye and provide motivation to eat healthy.

“If they eat a certain amount of vegetables of fruits in a day, maybe reward with a cookie or snack,” Dr. Ogun suggests.

Learn more 

Symptoms of diabetes include increased urination, increased thirst and blurred vision. More serious cases could bring nausea, vomiting and eye, heart and kidney issues. Nerve damage leading to numbness and tingling in your hands and feet known as diabetic neuropathy is also possible.

“We lose sensation in those areas. People may step on a nail and might not feel it,” Dr. Ogun says. “The issue grows and grows and leads to an ulcer, which makes wound healing harder for diabetic patients.

“That’s when we have to consider amputation,” of a foot, for example, she adds.

Diabetes can also be fatal, Dr. Ogun says.

Read about diabetes care on the OSF HealthCare website. If you have questions about this disorder or have symptoms, talk to your primary care provider.

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Diabetes: a recap

Aminat Ogun, MD, a family medicine physician at OSF HealthCare, recaps Types 1 and 2 diabetes and where Type 1.5 fits in:

• Type 1: Dr. Ogun says the body’s immune system attacks insulin-producing cells in the pancreas.
  
  “Insulin is a hormone that brings glucose from food from the blood to the body’s cells for energy. So in Type 1 diabetes, the pancreas isn’t producing insulin,” Dr. Ogun explains. “This type of diabetes is usually seen in childhood and adolescence. It’s sudden onset. Symptoms are increased urination, increased thirst, weight loss and blurry vision. A lot of these people are dependent on insulin shots.”
   
• Type 2: The pancreas is producing insulin, but the body doesn’t recognize it. Dr. Ogun says these patients are typically age 40 and up, and the disease has a gradual onset.
  
  “Management is lifestyle modifications, like a healthy diet and physical activity,” Dr. Ogun says. “And there are medications to help control blood sugar like Metformin and Jardiance®, plus insulin shots.”
   
• Type 1.5: This is also called latent autoimmune diabetes in adults (LADA).
  
  “It’s a slow progressing form of Type 1 diabetes. It’s autoimmune like Type 1, but it’s usually seen in adults,” Dr. Ogun says. Symptoms are similar to Type 2 diabetes: fatigue, nausea and vomiting. Or, Dr. Ogun says some people may have little to no symptoms.

More on Type 1.5

So, if Type 1.5 diabetes can mimic Types 1 and 2, how do providers pin down a diagnosis?

Dr. Ogun says it’s something providers are learning more about and getting better at. She says providers will take a blood sample to look at your blood glucose and antibodies. Providers can also sample your blood or urine to look at your C-peptide level. C-peptide is a byproduct of insulin production, and if it’s low it’s cause for concern.

Treatment is similar to Type 2 diabetes: oral medication or an injectable GLP-1 medication like Ozempic®.

“But eventually once the autoimmune destruction happens, the person will need regular insulin,” Dr. Ogun says. “One good thing is that if you are aware the person might have Type 1.5, starting insulin earlier is a little bit better. Maybe that can preserve some of the cells in the pancreas and preserve some pancreas function.”

Shoring up your diet and exercise can also help.

Prevention

Dr. Ogun says since Type 1.5 diabetes is an autoimmune disease, there’s no bonafide way to prevent it. She adds there is a genetic component, meaning a child of someone with Type 1.5 is at a higher risk to get in themselves.

But, Dr. Ogun says sometimes education can be the best prevention. She says she’s happy Lance Bass has spoken out. Bass is active, fit and has diabetes – a sign that it can happen to anyone, and you should be aware of the disease.

Learn more

Read more about preventing and managing diabetes on the OSF HealthCare website.

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Television host Carson Daly is the latest celebrity to try what some call sleep divorce. Couples who sleep in the same bed but are not getting that coveted seven to eight hours of shut eye will slumber with some degree of separation: in the same bed but with separate blankets, in separate beds in the same room or in separate rooms.

Daly called the move the “best thing” for his marriage during a summer episode of the Today Show.

“We both, admittedly, slept better apart,” he said.

The concept is one worth exploring for couples who are kept up by snoring, restlessness, differences in sleep schedule or other nighttime issues, says Nadeem Ahmed, MD, a pulmonologist at OSF HealthCare in Alton, Illinois.

But let’s get one thing straight.

“I don’t like the term ‘sleep divorce’ because it tends to blame other people. It’s not a good word. It brings anxiety,” Dr. Ahmed says.

“I like to use ‘sleep alliance.’ They’re working together. They’re working things out. They want to make sure it’s healthy for both bed partners and the sleep disturbances don’t affect the other partner’s life,” he says.

Have the discussion

Dr. Ahmed says he encounters sleep issues, like snoring, in his practice “almost every day,” and many people are shy about it.

Every case is different. Dr. Ahmed says couples should first talk out their sleep issues and try to find a solution. The partners could try sleeping in separate beds during the week and in the same bed on the weekend so intimacy is not completely lost. Some mattresses have different firmness, temperature and slant on each side, which can help.

If needed, the partners should talk to a pulmonologist or psychologist.

“A lot of psychologists will do similar things that a physician will do. It’s just the comfort level of the person,” Dr. Ahmed explains. “Sometimes they don’t want to go to a medical doctor for the sleep problem. They would rather talk to a psychologist.”

“The idea is to discuss it with some type of professional,” he says.

Dr. Ahmed adds that sleeping separately should be a short-term solution.

“Tell your bed partner this is an issue, and we need to address it. As opposed to just getting mad or feeling crummy or sleepy the next day,” Dr. Ahmed says, “Because it can affect your job, like if you’re a machine operator or have to drive a truck.”

A major cause

Dr. Ahmed says a big cause of the restlessness that leads to sleep alliance discussions is sleep apnea, when people stop breathing during sleep. This can lead to loud snoring or body movement in bed and crabbiness or grogginess the next day.

Dr. Ahmed says there are two types of sleep apnea: obstructive and central. Obstructive sleep apnea is a product of obesity. Central sleep apnea is associated with neurological deficits like a stroke.

“[Sleep apnea] is not fatal because our brains are hard-wired to let you go to a certain time, and then it triggers you to take a breath,” Dr. Ahmed explains.

But, if the condition is left untreated, there is a litany of possible issues: hypertension, cardiac arrhythmia, diabetes, dementia, headaches and frequent urination.

Diagnosis of sleep apnea would involve a sleep study, either in your home or at a hospital.

Treatment options include a mask and machine combination known as a CPAP or BiPAP, a mouth guard or a small device that’s implanted in your body in outpatient surgery. All those options aim to help you breathe normally and sleep peacefully.

“Along with that, we have to stress lifestyle changes,” to rid oneself of sleep apnea, Dr. Ahmed adds. “Eating healthy. Losing weight. Getting exercise.”

Over-the-counter options for better sleep include melatonin, an eye mask, earplugs, thick window curtains, a plush mattress and sheets and a white noise device like a smart speaker. Don’t eat or drink, aside from water, a couple hours before bedtime, Dr. Ahmed also advises.

Learn more

Learn more about healthy sleep on the OSF HealthCare website. If you’re having sleep problems, especially if it’s impacting your daytime life, talk to your primary care provider, a pulmonologist or a behavioral health provider.

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It can be an embarrassing ailment, but experts say it’s time to talk about it.

Urinary incontinence is when a person leaks urine by accident.

Uwais Zaid, MD, a urologist at OSF HealthCare in Alton, Illinois, says urinary incontinence can wreak havoc on a person’s social life and intimacy with partners. In other words, you can’t go out and have a good time with friends if you don’t know when you’re going to suddenly “go.”

“It can be associated with medications. It can be associated with aging,” Dr. Zaid says. “It can be associated with certain surgeries. A lot of our cancer survivors, whether they're from prostate cancer, cervical cancer, uterine cancer…they can have effects to their urinary control.

“Things as normal as having children,” Dr. Zaid adds as a cause.  “Over time [childbirths] can wreak havoc on the pelvic floor and on the urinary sphincter, and you can have urinary accidents as a result.”

While incontinence is often associated with older people, Dr. Zaid says all those precursors apply to any age.

Dr. Zaid says urinary incontinence breaks down into four groups.

• Stress: This is when the bladder sphincter does not work as well. Simple things like coughing, sneezing, laughing or bending over could provoke a release of urine.
• Urge: “When the bladder has a mind of its own,” Dr. Zaid remarks. This is when you have to go and you just can’t make it to the bathroom in time. Dr. Zaid adds that hearing or seeing certain triggers like running water or jingling of keys as you rush to enter your home might provoke urge incontinence.
• Overflow: This occurs when your bladder is full. This is the opposite of urge incontinence, Dr. Zaid says, and is associated with infections and kidney issues.
•  Functional: This applies to someone who may have normal bladder control but can’t get to the toilet in time due to physical limitations like arthritis.

A health care provider will ask you about your symptoms and health history to see which type of urinary incontinence is ailing you. Testing would typically follow. Each type of incontinence, generally, has its own treatment plan.

• Stress: A provider may recommend pelvic floor physical therapy as treatment. For women, a small device can be inserted to stop leaks. Surgery is also an option.
• Urge: You may be told to cut back on caffeinated food and drink, spicy food and alcohol. Medicine and surgery are also options.
• Overflow: “That's where we need to make sure we're not missing anything like a blockage - for women, a prolapse and for men, an enlarged prostate.” Dr. Zaid says.  “A stone in the bladder. A tumor in the bladder. And we also need to make sure the kidneys are functioning okay.”
• Functional: Since people with this type of incontinence may have a normal bladder, external solutions are necessary. For example, keeping your route to the bathroom clear of obstacles like chairs and doors. For older adults with physical limitations, have a walker handy for when the need to go arises.

Other tactics include urgency suppression, when you distract yourself from thinking about urinating. You could take long, relaxing breaths or sit completely still.

Timed voiding is when you schedule times to urinate. Dr. Zaid says this can work in both directions. If you are urinating too frequently, set a timer on your phone to go every hour. Then when you get comfortable, you can increase the time. If you are holding on to your urine too long, set a plan, get comfortable then decrease the time.

The bottom line: if something seems off about your bathroom visits or if friends or family remark “You’re sure in there a lot,” see a doctor.

“If you’re chronically wet down below, it increases your risk of fungal infections and skin breakdowns,” among other serious health issues, Dr. Zaid says.

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Gotta go? Try these six bladder tips

To paraphrase George Carlin: It’s 50% universal.

At some point in their life, many men will have to think about benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate. BPH often means the flow of urine from the bladder is blocked by the prostate gland growing inward, leading to frequent and annoying trips to the bathroom. But BPH can also lead to more serious problems of the bladder, urinary tract and kidneys.

According to the National Kidney and Urological Disease Information Clearinghouse, the most common prostate problem for men over 50 is prostate enlargement. By age 60, more than half of men have BPH, according to the American Urological Association. By age 85, the number climbs to 90%.

Luckily, BPH is treatable.

Ronan Lev, MD, is a urologist who provides care through OSF HealthCare in Alton, Illinois. His practice was recently designated as a Center of Excellence by UroLift®, an organization that introduced a quick, minimally-invasive procedure to deal with an enlarged prostate and allow for an easier recovery with fewer complications such as erectile dysfunction. The Center of Excellence designation is provided to individual physicians who have achieved a higher level of training and experience with the UroLift system. In Dr. Lev’s case, he has performed more than 200 UroLift procedures.

Dr. Lev says minimally-invasive procedures such as UroLift signal a shift in BPH strategy toward bladder preservation.

“In the past, we were very happy about symptoms relief. Everything was focused on symptoms relief. And if you said, ‘I'm feeling better, took a pill,’ that was fine for us,” Dr. Lev says. “What we learned over time is that it was causing some damage to patients because as medications were failing, their bladders were making up the difference. Because the bladder is a very, very strong muscle, and we can’t appreciate how strong our muscle is working.”

Dr. Lev’s message to men: See a doctor if something doesn’t seem right down there.

“Men have a tendency to pare down their issues and say, ‘Oh, it's not an issue. It's not a problem,’” Dr. Lev says. “But if they really think about it, I would say most men compare themselves to yesterday. They don't compare themselves to what it was a year ago. If they would think about that, they would realize that it's a lot worse than they really think.

“If we can do a procedure in the office under very mild sedation and improve your quality of life,” Dr. Lev explains. “When you're 90, every day counts, not what's going to happen in a couple of years. So we if we can improve your quality of life, that's really crucial.”

At OSF HealthCare in Alton, the UroLift procedure will be done on an outpatient basis. However, UroLift is not yet available in every community served by OSF HealthCare. You can learn more about urology and find an OSF HealthCare urologist here.

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