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.

Interview clips

Previous coverage

OSF HealthCare blog entries on diabetes

OSF HealthCare Newsroom stories on diabetes

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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Migraines are a part of life for many. From stress to dehydration to a woman’s menstrual cycle and even more serious issues such as a stroke, the headaches can pop up often. And they’re something you should know how to manage.

Amber Oberheim, APRN, a primary care provider at OSF HealthCare, says migraines can often be treated with ibuprofen (Advil is a common brand name) or naproxen (Aleve), plus lifestyle changes including better sleep. But, an online search will also yield plenty of non-medicinal, at-home remedies. Experts will remind you that these aren’t cure-alls. But it’s important to know what works and what doesn’t.

Myth vs. fact

• A cold or warm cloth on the head and neck: Stick to cold, Oberheim says.
  
  “One of the theories for why migraines happen is vasodilation, or increased blood flow to your brain,” Oberheim explains. “So we talk about using a cold compress over your eyes, on the back of your neck or at the top of your head. That cold sensation constricts blood vessels, thereby decreasing blood flow.”
  
  Oberheim adds that there are even migraine caps that stay in the freezer until use. Those are available over the counter at retail outlets.
   
• Rest and deep breathing: Oberheim says there’s no guarantee that your migraine will be gone when you wake up from a nap. But, she says rest and deep breathing can’t hurt. Take a break in a cool, dark room, and avoid screens and loud noises.
   
• Caffeine: It’s good general advice to ingest caffeine in moderation for heart and mental health. But, Oberheim says a soda might help with that headache.
  
  “We look at medications in Excedrin Migraine [pills]. Caffeine is one of them,” Oberheim says. “Caffeine has been proven to be effective sometimes in early management of migraine headaches.”
   
• Supplements: There’s a lot to choose from in this aisle of the pharmacy. And experts warn that you should choose with provider guidance since supplements aren’t regulated like others under the eye of the United States Food and Drug Administration. However, Oberheim says some research has shown that taking vitamin B2 (also called riboflavin) and magnesium daily can help with the number of migraines.
   
• Massaging your head: It’s a tactic some of us learned when we were kids. Massaging your temples (the area between your eyes and the top of your ears) could help with head pain.
  
  “I don’t think there’s any data that would support that. I think it’s more of a comfort,” Oberheim says. “When you’re experiencing pain and you can have a sensation that’s not pain somewhere on your body, it might help lessen the pain.”
  
  For example, Oberheim says when her patients are getting a blood draw through an IV in their elbow, a provider might scratch their upper arm (between the point of pain and the brain) to “confuse” the pain signal and lessen the discomfort. The same logic applies to rubbing your head during a migraine.
   
• Taking a shower: It depends, Oberheim says.
  
  “I could see if stress or muscle tension is creating a headache. Taking a warm shower or bath to relax might help,” Oberheim says. “However, if we’re thinking about a classic migraine with the theory of increased blood flow to the brain, taking a hot bath or shower might actually make it worse.
  
  “It never hurts to try, but I think it’s going to be patient-specific,” she adds.

When in doubt

Oberheim says some people have a history of migraines and know how to manage them. But if the headaches suddenly increase in frequency or intensity, you should see a health care provider. Also, talk to a provider if you have questions about starting or changing at-home treatment. The provider can determine what works for you. You don’t want new medications to negatively interact with drugs you’re already on, for example.

“Often, a migraine can last for longer than a typical headache. It can be accompanied by symptoms like nausea, light sensitivity and noise sensitivity,” Oberheim says, warning of the dangers if migraines are not treated quickly. “There are certain types of migraines that can also affect your vision.”

Temporary decreased function of your limbs is another rare, but possible side effect, Oberheim says.

Learn more

Read more about how to spot and treat a migraine on the OSF HealthCare website.

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Shingles.

It’s a word that stings just coming out of your mouth. And it’s certainly an illness you want to avoid.

There are time-tested treatments for the disease that’s associated with chickenpox – namely an effective vaccine. But new research from the University of Pennsylvania and New York University (NYU) gives hope to people who have suffered eye complications from shingles.

“It’s promising,” says Fred Burke, MD, an emergency medicine physician who provides care at OSF HealthCare.

Shingles basics

Dr. Burke says shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. Chickenpox is common in children, who typically suffer from a blistering rash for four to seven days.

“That virus will lie dormant in the nerve cells of the body. For some unknown reason, it gets activated later in life,” causing shingles, Dr. Burke says. “Generally, that’s in people 50 and over. You’ll get a localized blistering rash. It’s painful. It can last for three to five weeks. We treat it with antiviral medication.”

Catching the disease early is key.

“If the rash has already crusted over, the antiviral medication won’t be effective,” Dr. Burke says. “You can treat the pain, but you have to just ride it out.”

You’re not contagious at that point, Dr. Burke says, but you’ll want to rest.

Aside from older adults, people with a compromised immune system – for example, someone with cancer or a transplanted organ – are at a higher risk for shingles. The disease spreads through the air – like when you cough on someone – or by direct contact.

In some cases, the pain from shingles can linger for months or years, Dr. Burke says. It’s called neuropathic pain, and there’s medicine available for that too. Meningitis and facial paralysis are other shingles complications.

Shingles can also impact the eyes, causing redness, swelling, itching and impaired vision. This is called herpes zoster ophthalmicus (HZO).

“We treat that with antiviral medication. We consult an ophthalmologist because the person may also need steroids,” Dr. Burke says. “It’s good to treat this quickly because it can lead to vision loss.”

Treating eye complications

That’s where the new research comes in.

Elisabeth J. Cohen, MD, a professor of ophthalmology at NYU, did the study after she was impacted by shingles-related vision loss. The research looked at the antiviral treatment valacyclovir, which is typically short term.

“The researchers showed that using valacyclovir for a year can decrease the risk of new or worsening eye disease by 26 percent at 18 months after initiating treatment. Patients treated with valacyclovir also were 30 percent less likely than those not receiving the treatment to have multiple HZO flare-ups at a year or a year-and-a-half later,” a news release announcing the research results says.

“I was very, very impressed,” Dr. Burke says after reading the results.

Importance of vaccines

Like any new research, more study is needed of long-term use of valacyclovir. In the meantime, Dr. Burke says vaccines for chickenpox and shingles are 90% effective.

The United States Centers for Disease Control and Prevention says children under 13 should get two doses of the chickenpox vaccine – one at 12 to 15 months and the other at four to six years. People 13 and older who never got chickenpox or the vaccine should also get two doses 28 days apart.

But be warned: Dr. Burke says if you don’t get chickenpox as a child, you can still get shingles as an adult.

“It’s the same virus,” that’s associated with both ailments, he says. “So if you catch it from someone [as an adult], you’ll probably get chickenpox first. And you could get shingles later.”

Meanwhile, Dr. Burke says the two-shot shingles vaccine is for healthy people 50 and older and people 19 and older who are immunocompromised.

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She was about to become a statistic in a polio epidemic and battle a disease that still impacts her in 2024.

Though polio is nearly eradicated today thanks to childhood vaccinations, both the disease and the shots have garnered headlines lately. This month, Paul Alexander, who spent much of his life in an iron lung, passed away at age 78. And the state of Illinois is combating a measles outbreak, reminding us of the importance of vaccines.

Kemnetz’s story

Kemnetz says the week she got her headache that led to a polio diagnosis was a painful blur.

“All my senses were on high alert,” she says. “The littlest sound was like somebody stomping next to my ear. We had a little night light. I couldn’t even stand to have it on.”

On Sunday, the family doctor made a house call and immediately called for an ambulance. Kemnetz wound up at Mercy Hospital in Urbana, Illinois (now OSF HealthCare Heart of Mary Medical Center). That next month, she says, was also a blur. Among other things, doctors upon her arrival performed a spinal tap to examine Kemnetz’s spinal fluid. She also recalls waking up one day with doctors preparing to put her in an iron lung to help her breathe.

“I screamed at my parents not to put me in that. I was terrified,” Kemnetz says.

After leaving the hospital, Kemnetz got more treatment near her home before spending over a year at a hospital in New York. There, she reprogrammed her leg muscles to work through repetitious exercises. It’s what we know today as physical therapy. Eventually, she returned to a mostly normal life and a career in real estate.

Polio then vs. now

Albert England, MD, an infectious disease physician at OSF HealthCare, says polio has been around “for a long time.” There’s even evidence of ancient Egyptians having it, he says. The disease is caused by a virus that “invades the nervous system and can cause total paralysis in a matter of hours,” according to the World Health Organization (WHO). Other symptoms are flu-like, including fever, difficulty breathing, fatigue, headache, vomiting, a stiff neck and pain in the arms or legs.

Dr. England says today, doctors use ventilators to help sick people who can’t breathe. But back in 1952, the iron lung – which Kemnetz got acquainted with – was the help available for people with polio.

“It produced negative pressure around the patient, allowing the lungs to expand and contract regularly,” Dr. England explains.

“It was like having CPR 24/7,” Kemnetz says of lying in the tube. “So uncomfortable.”

Kemnetz also gave blood to help develop a polio vaccine, the number one way we have come to fight that disease and many others. It’s a topic she’s passionate about today.

“We have to save the children,” she says.

The United States Centers for Disease Control and Prevention (CDC) says children should get four doses of the polio vaccine as a part of routine childhood vaccinations. The CDC says while it’s rare, adults who know or suspect they did not get the shots as kids should get them as adults. Adults who are at an increased risk of getting the disease, such as working in a laboratory where the virus may be present, can get a booster shot.

“The vaccine prevents illness by developing antibodies,” Dr. England explains.

Kemnetz today

In 1985, Kemnetz developed post-polio syndrome, a disorder that weakens the nerves and muscles. She says her hands “look nice,” but everyday tasks like writing, eating or shuffling cards are tough.

“There are just not as many neurons providing the strength the people need,” Dr. England says of post-polio syndrome.

But, after being told in 1952 that walking, having children and living a long life was unlikely, Kemnetz is counting her blessings. Among them are the chances to recount her life story with her children and grandchildren.

“I think I thumbed my nose at them pretty good,” she quips about her prognosis back then. “The word ‘can’t’ isn’t in my vocabulary.”

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Telemedicine – seeing a provider by video from home – is a common and useful part of today’s health care landscape. But as Amer Alshekhlee, MD, points out, it’s sometimes not fast. A person will commonly book a virtual appointment days or weeks out.

So how can telemedicine play a critical role when millions of brain cells are at stake in a matter of minutes?

Enter telestroke. It’s a concept in use throughout OSF HealthCare. At OSF HealthCare Saint Anthony’s Health Center in Alton, Illinois, the strategic affiliation between OSF and SSM Health allows telestroke to be seamless. Dr. Alshekhlee, the stroke program director at DePaul Hospital in nearby Bridgeton, Missouri, is one of the doctors who sees people virtually when they come to the OSF Saint Anthony’s Emergency Department with a suspected stroke.

“We see patients quickly. We triage them from hospital to hospital. That provides very quick treatment,” Dr. Alshekhlee says.

“We’ll have a video encounter,” he adds. “We examine the patient. Talk to them and their family. Make a decision on what kind of treatment and where.”

Providers will ask about when symptoms started and their severity. They will likely have the patient demonstrate the BEFAST acronym, a standard way to spot stroke symptoms. Providers will look for problems or abnormalities in balance, eyes, face, arms and speech. The “T” in BEFAST stands for time. In other words, if there is evidence of issues in B through S, it’s “time” to take quick action.

“We have a scale. We score the person, and for example, say ‘these stroke symptoms look very bad’. Then we have to really act on that patient.”

That could mean a transfer to a hospital better equipped to treat stroke. Again, providers will tell you time is of the essence. For example, if you start treatment at the Emergency Department within 4½ hours of the onset of symptoms, you may be able to take Tenecteplase, a blood clot-busting agent that experts say could become the gold standard for stroke care.

On the flip side, for each minute a stroke goes untreated, the brain loses around 2 million cells it cannot recover. Strokes can also have life-altering consequences like vision, walking and swallowing difficulties. They can take years off your life and put you at risk of another stroke.

Learn more about stroke care on the OSF HealthCare website.

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Nearly 800,000 Americans suffer a stroke each year.

Strokes can have life-altering consequences like vision, walking and swallowing difficulties. They also rank in the top five killers of Americans. For each minute a stroke goes untreated, the brain loses around 2 million cells it cannot recover.

“Getting to the hospital quickly – within four and a half hours of your onset of symptoms – is important,” says Leslie Ingold, a registered nurse and stroke coordinator with OSF HealthCare.

A cutting-edge stroke drug rolled out at OSF HealthCare is already turning the tide for people.

Tenecteplase (TNKase ®) can be used in people experiencing a stroke and who meet certain criteria, such as a specific blood pressure, history of brain bleeds, medications taken at home and how quickly they arrived at the emergency department. TNKase is a clot-busting agent that stands to become the gold standard of this type of care, Ingold says.

“It has a lower cost. It’s something providers can mix much, much quicker,” Ingold says. “And it’s given quickly in an IV push over five to 10 seconds, and we’re done.”

TNKase also does a better job than its predecessor at finding and breaking up clots, and there’s a lower risk of bleeding.

“The quicker we can get oxygen flowing back into that brain tissue, the better recovery the person is going to have,” Ingold says.

Why it’s important

The most common type of stroke, an ischemic stroke (also sometimes called an embolic stroke), is when a clot forms and travels to the brain. When watching for one, remember the acronym B.E.F.A.S.T.

• B is for balance: Watch for sudden loss of balance.
• E is for eyes: Check for vision loss or eyes looking askew.
• F is for face: Look for droopiness or an uneven smile.
• A is for arm: Is one arm weak or numb?
• S is for speech: Watch for slurred, slow speech or no speech. Ask the person to repeat a simple sentence.
• T is for time. It’s the conclusion to the checklist. Time to call 9-1-1 if someone has these symptoms, even if they go away.

Another type of stroke, a hemorrhagic stroke, is when a blood vessel breaks and blood seeps into brain tissue. Ingold says hemorrhagic strokes are typically caused by a traumatic injury, like falling and hitting your head. Uncontrolled high blood pressure is also a cause.

For either type, when you arrive at the hospital, a provider will take some pictures of your brain and decide the best treatment option.

Prevention

Up to 80% of strokes are preventable, Ingold says. Prevention goes back to what any doctor will tell you is key for a healthy life: control your blood pressure, cholesterol and diabetes through diet and exercise. Avoid tobacco, alcohol and drugs. If you have an irregular heartbeat, known as atrial fibrillation, see your cardiologist regularly and follow their instructions. And get established with a primary care provider, too.

Ingold says a stroke takes 3.75 years off a person’s life, on average. And if you have a stroke, you have a 25% chance of having another one.

“We always tell people they really need to be on top of their treatment,” Ingold says. “The signs and symptoms of a possible second stroke may not be the same as the first. In fact, they could be completely different. It just depends on what part of the brain the stroke affects.”

Learn more

Read about stroke care on the OSF HealthCare website.

Previous coverage

OSF HealthCare Newsroom stroke stories
OSF HealthCare stroke blogs

According to the American Optometric Association, one in four school-age children has a vision disorder. While children are required to get an eye exam before entering kindergarten, Dr. Mike Endris, an OSF HealthCare pediatrician in Bloomington, Illinois says kids could benefit from vision screenings even earlier.

“Vision loss and vision deficits are one of the most common ailments in childhood, and oftentimes there are no symptoms, and screening is the best way to detect these problems,” explains Dr. Endris.

The process of screening, however, can be a challenge; young children are not able to navigate eye charts or articulate vision issues they are experiencing. Dr. Endris says there is a simple solution, and all it takes is an iPhone. He and his Bloomington colleagues use a digital screening platform called GoCheck Kids for this purpose.

GoCheck Kids is a photoscreening test performed at the well-child visit. A photo of the child’s eyes is taken using an iPhone with attached hardware. The GoCheck Kids technology then alerts the provider of any possible vision issues, sometimes in less than a minute.

“It can assess for differences in vision, whether that would be nearsightedness or farsightedness,” Dr. Endris says. “It can estimate for weakness in one eye compared to the other, as well as look for things like a red reflex in the pupil. That can be a sign of a more serious underlying disease. And it can also check to see if our eyes are in alignment.”

The most common vision abnormalities in children are nearsightedness, farsightedness, amblyopia (lazy eye) or astigmatism. Signs of eye health issues in kids can include frequent rubbing of the eyes, squinting, tilting or turning of the head to look at objects, or noticeable wandering eyes. 

Dr. Endris continues, “If our automatic read from this device picks up on any issue at all, it is then reviewed by an ophthalmologist, which is a medical doctor who specializes in the eye. If they concur and see that there is some abnormality present, then we would start a referral.”

Dr. Endris and his team have used this technology for nearly a year and provide vision screenings for kids as young as 12 months old. He says early detection of vision abnormalities can make a huge impact on a child’s development, physically, academically and emotionally.

“Vision problems are common and we know that, in general, it's better to treat them earlier than later. We know that not only is it important for the success of academics, but also kids that have amblyopia have recently been found to have a higher incidence of anxiety and depression. Whether that's truly from their vision or not, we'll see. But again, it's ever so critical to screen for these, both by asking parents questions about their child's vision as well as using a photo screen or device,” urges Dr. Endris.

If you notice your child struggling with vision issues contact their pediatrician or a pediatric optometrist. If you don’t have a pediatrician visit osfhealthcare.org to find one near you.

Interview Clips - Dr. Mike Endris

B-Roll Clips - GoCheck Kids