One of the most serious chronic complications of diabetes mellitus is a condition known as diabetic nephropathy. Which, if you break down the term into nephro and pathy literally means kidney disease that occurs secondary to diabetes. And it’s actually pretty common as it eventually affects about 20 to 40 of all individuals with diabetes, including both type I and type II. In this tutorial, let’s talk about the mechanism underlying the cause of diabetic nephropathy and how individuals with diabetes develop the condition. So diabetic nephropathy is a chronic complication.
Of diabetes mellitus. Meaning, it usually has a slow progression over decades after the initial diagnosis of diabetes. And to give you an overview of what happens, an insulin deficiency due to the diabetes results in hyperglycemia, which then causes hypertension and kidney dysfunction. This kidney function is actually then further worsened by the hypertension. And ultimately, all of this results in kidney failure, which can have very severe and potentially even life threatening complications, such as anemia, electrolyte imbalances, such as metabolic acidosis, and heart arrhythmias. Now, before we dive into the mechanism.
Of diabetic nephropathy, let’s briefly review the structure of the glomerulus in the kidney, by bringing in a diagram here. So, the glomerulus is the portion of the kidney where blood is initially filtered. So blood enters the glomerulus over here, through this afferent arterial, and then leaves the glomerulus through the efferent arterial. And you can remember this, that it leaves through the efferent arterial for E for exit, or efferent. And while the blood is within the glomerulus, there’s this advanced filtration system, which we’ll talk about more in a minute.
And the filtered fluid that exits the blood is known as a filtrate and it collects in Bowman’s space before it enters into the tubules of the nephron where further reabsorption and secretion occurs before it exits the kidney into the ureters as urine. Now, one last structure to point out in this diagram is this vessel coming off the efferent tubule, here. Now, this vasculature actually wraps around the tubules of the nephron, and contributes to the reabsorption and secretion of solutes. Now, to add to this diagram, let’s imagine we took a cross section of this glomerulus,.
And looked at it on its end. And it would look a little bit something like this. Now, we can use this diagram here to better depict some of the important structures within the glomerulus. So here you can see the capillary vessels, and each of them I’ve drawn in here a little red blood cell to help remind you that it’s a blood cell. And as you can see, these vessels are surrounded by a few additional structures that we couldn’t really appreciate in that first diagram. So these are the structures that contribute.
To the three layered filtration system of the glomerulus. The first layer is that of the vascular endothelium. So the endothelial cover, the inside of the blood vessel, so the capillary wall, there. And then the second layer is the glomerular basement membrane, or GBM for short, which is a specialized basement membrane that surrounds the vascular endothelium. And then the last filtration layer is the visceral epithelium, which is also known as the podocytes. Now, in between all these capillaries here is the mesangium, which is comprised of cells known conveniently as.
Mesangial cells. And they produce a collagen network that structurally supports all of these capillaries and it’s across this space that filtration occurs within the glomerulus of the kidney. So how exactly does diabetes, a problem with insulin deficiency, result in kidney damage Well, the answer includes multiple compounding factors. Now, the first component is an increased pressure state within the nephron. And this is due to two mechanisms. And the first is hypertension, which is a common comorbidity associated with diabetes mellitus. So hypertension or high blood pressure results in an increased pressure throughout.
The entire arterial vascular system. And this includes the afferent arterial of the glomerulus. So, to think about how this increases the pressure within the glomerulus, let’s think about a simple garden hose. So, in the middle of the garden hose, there’s a hole. And as water flows through the hose, a small amount of water will leak out through this hole. But if we open up the spigot all the way this is going to increase the pressure of the water traveling through the hose, and intuitively, this change is going to result.
In more water leaking from the hole here in the center and that’s because there’s increased pressure forcing it out of the hole. Now this is similar to what occurs in the glomerulus. The hypertension increases the pressure, just like turning on that spigot, which in return increases the filtration rate of the glomerulus, which can be thought of as that leakiness from the hole in the garden hose. Now, the other mechanism contributing to this high pressure state, is something known as vasoconstriction of the efferent arterial. Which is just a fancy way of saying.
That this blood vessel constricts or gets smaller in diameter. So, to understand why this occurs, we need to briefly review the reninangiotensinaldosterone system, or RAAS, for short. So renin is a hormone that’s secreted by the kidneys in response to decreased renal profusion, or low blood flow to the kidney. This is a sign of low fluid volume throughout the body. So in the response to a low fluid volume, renin has a cascade of effects in order to maintain blood pressure as well as volume status. And one of these effects is constriction.
Of the efferent arterial, which then maintains this pressure within the glomerulus in the presence of a decreased renal profusion. So once again, let’s go back to this garden hose to understand this a little bit better. Now, instead of turning up the spigot, as we did before, what do you think would happen if you were to kink the hose on the other side of the hole Once again, intuitively, this is going to increase the pressure behind the kink and subsequently will increase the rate at which water leaks out the hole.
So once again, this is similar to what occurs in the glomerulus in response to activation of this reninangiotensinaldosterone system. There’s a constriction of the efferent arterial to build up pressure within the glomerulus to maintain the necessary filtration and therefore, it will increase the filtration rate even further. But why exactly is this happening If I just said that individuals with diabetes often have increased renal profusion due to the hypertension, then why is a low pressure system such as the reninangiotensinaldosterone system activated And this is a good question,.
And the answer is not exactly intuitive. For some reason, the underlying physiology of diabetes, specifically the hyperglycemia, results in a direct intrarenal or within the kidney activation of this reninangiotensinaldosterone system. And subsequently, efferent vasial constriction independent of the volume status of the individual and therefore increases the glomerular filtration rate. So how does this increased pressure relate to diabetic nephropathy Well, as the pressure within the glomerulus increases, this results in a process known as mesangial expansion. The increased pressure results in trauma and damage to the mesangium of the glomerulus.
And in response to this damage, the mesangial cells respond by secreting cytokines that produce inflammation, as well as oxygen free radicals that result in endothelial dysfunction, and all of this kind of combines into hypertrophy and matrix accumulation within the mesangium, which is known as mesangial expansion. And as you can see over here on the right, as the mesangium expands, the spaces, or what are known as the fenestrations between the podocyte foot processes expand. Now, this has two effects. First, it decreases the surface area available within the glomerulus for filtration,.
And second, the dilation of the fenestrations causes the filtration system to be leaky, and larger molecules such as proteins are filtered out of the blood in the kidney. Then, the last factor contributing to diabetic nephropathy is a combination of the previously mentioned factors. And this is ischemia. As I mentioned earlier, the blood vessels supplying the tubules of the nephron come off of the efferent arterial, and vasoconstriction of this arterial from the intrarenal activation of the reninangiotensinaldosterone system decreases this blood flow. And in addition, the cytokines and free radials.
Produced from the barotrauma to the mesangium further damage the nephron vasculature. And over time these processes result in ischemia, or cell death, and atrophy of the vasculature that supports the glomerulus, as well as the tubules. So this will decrease the kidney’s ability to filter blood, and is ultimately what will lead to kidney failure in diabetic nephropathy. So as you can see, there are many different mechanisms that are going to contribute to the progression of kidney failure in individuals with diabetes mellitus. However, it’s important to note that they are all directly associated.
Diabetic nephropathy Clinical presentation treatment
Voiceover Diabetic nephropathy is one of the most common and serious chronic complications associated with diabetes mellitus. In this tutorial, let’s discuss how the mechanisms underlying diabetic nephropathy correlate with the clinical presentation as well as the treatment of the disease. Now fortunately the mechanisms underlying diabetic nephropathy, directly correlate with the clinical presentation. And the first clinical finding of the disease is somewhat paradoxically an increased kidney filtration rate or glomerular filtration rate. So, diabetic nephropathy, if you break down the term into nephro and pathy literally means kidney disease caused by diabetes.
Now typically kidney disease is marked by a decreased filtration rate, so why is it that the first clinical stage of diabetic nephropathy is that of an increased glomerular filtration rate Well recall that the earliest mechanism contributing to diabetic nephropathy is an increased pressure state, over here in blue. And this is due to hypertension and efferent vasoconstriction. So let’s use a common garden hose to help illustrate how this increased pressure state will ultimately result in an increased glomerular filtration rate. So, imagine you have this garden hose and it has a small hole in the middle of it.
So first you’re gonna open up the spigot and increase the pressure and flow through the hose. Intuitively, this is going to increase the rate at which water is leaking from the hole in the hose. Next, you partially kink off the end of the hose distal to the hole, and once again this is gonna further increase the rate at which water leaks from the hose. This is essentially what’s occurring in the glomerulus with the hypertension representing the opening up of the spigot and increasing the pressure before the glomerulus,.
In front of the glomerulus, and the efferent vasoconstriction representing the kinking off of the hose, which causes this back pressure. Both of which are going to increase the filtration rate. This stage of diabetic nephropathy is most commonly asymptomatic, so it goes typically unnoticed. However, it’s going to set the stage for the next clinical step of diabetic nephropathy and that is detectable proteinuria. And what proteinuria is is protein in the urine. So this increased pressure state causes trauma on the mesangium, in the middle of the glomerulus here.
And it results in mesangial expansion, which is this second mechanism of diabetic nephropathy. Now as the mesangium expands, this also increases the size of these fenestrations or spaces between the podocyte foot processes, so let’s go back and look real closely at these fenestrations and watch how they increase in size. Now, these podocyte fenestrations are a component of the glomerular filtration mechanism. So, let’s think of these podocyte foot processes as a coffee filter. A proper coffee filter is porous enough to allow for the water to flow through,.
But will retain the coffee grounds within the filter. This is because the molecules of water are much smaller than the size of the coffee ground, so over time the coffee pot is gonna fill just with the coffee but no coffee grounds. Now imagine if the coffee filter was replaced with a cooking strainer, which has considerably larger pores. If you were to try and use a cooking strainer as a coffee filter, when you pour the hot water through, it’s not gonna work because the pores of this cooking strainer are much larger.
Both the coffee as well as the grounds are gonna start to spill through and you’re gonna end up with coffee grounds in your coffee. So in the glomerulus, the fenestrations between these podocyte foot processes are kind of like coffee filters and normally in the filtration of blood no proteins or large molecules are allowed though. However, with mesangial expansion these fenestrations become much larger and when filtration occurs they become leaky, and they allow for molecules, such as proteins, to be spilled out into the urine. So this is what causes the detectable proteinuria.
In diabetic nephropathy. One of these proteins is albumin. Urine tests are available to detect the presence of albumin in the urine, so frequently individuals with diabetes will have routine screening to test for this albumin or for protein in their urine, which is a sign that they may be developing diabetic nephropathy or kidney disease due to diabetes. Then the next clinical stage of diabetic nephropathy is that of a decreased glomerular filtration rate. So you can see that we’ve gone from an increased glomerular filtration rate, then to a decreased glomerular filtration rate.
So what exactly causes this Well, recall that part of the reason for this mesangial expansion is the release of cytokines which cause inflammation and oxygen free radicals. Now, these cytokines and oxygen free radicals damage the mesangium, resulting in the mesangial expansion. However, they don’t just damage the mesangium. They damage the cells throughout the tubules as well as the vasculature that supports the nephron. Now in addition to the cytokines and oxygen free radicals, this vasculature is further damaged by this efferent vasoconstriction here. Which is one of the causes of that increased pressure state.
And this combination of damage from decreased blood flow and cytokines and oxygen free radicals results in ischemia and atrophy of this vasculature. As this vasculature kind of dies off, it no longer can support the tubules of the nephron, so the nephron itself begins to die off as well, and so there’s a decreased ability to filter the blood. Now initially this occurs in just a small percentage of the nephrons in the kidney, and the kidney’s able to compensate, but eventually over time if this diabetic nephropathy is not treated, a large enough number.
Of nephrons throughout the kidney are gonna die off, and it’s gonna be detected as a decreased filtration rate. The kidney’s no longer able to keep up with the dying off of nephrons. If this is present, this decreased filtration rate is present for more than three months in a row, then it’s known as chronic kidney disease. As it continues to progress, eventually it will become a permanent decrease, which is then known as endstage renal disease. Now that we have a better understanding of the mechanisms that cause diabetic nephropathy.
And how they correlate with the clinical presentation, let’s just briefly touch on how diabetic nephropathy is treated. This is, once again, gonna be directly correlated to the underlying mechanisms. So, the most important thing in diabetic nephropathy is to treat the underlying diabetes. This is because the hyperglycemia associated with diabetes is the cause of this increased pressure state, so if you can treat the diabetes, you can prevent the increased pressure state, which will then prevent the cascade of effects leading to diabetic nephropathy. However, if this increased pressure state.
Does start to occur, the next step is to treat the pressure. And what I mean by that is treat the hypertension. So if you can decrease the blood pressure, that goes into the afferent arteriole here, you’ll decrease this increased pressure state. In addition, one of the most common medications to treat blood pressure are known as ACE inhibitors. Now ACE inhibitors stands for angiotensin converting enzyme inhibitor and angiotensin is one of the hormones in that reninangiotensinaldosterone system that results in the efferent vasoconstriction. So by treating the blood pressure with an ACE inhibitor,.
You’re also going to decrease this vasoconstriction to further decrease this pressure state within the glomerulus. These two treatments should be occurring regardless of whether or not an individual with diabetes is in any of these clinical stages of diabetic nephropathy. So these are not only treatments, but they’re also good for preventing the progression of diabetic nephropathy before someone even enters this first clinical stage. However, if someone does develop diabetic nephropathy and it unfortunately progresses far enough to have this decreased glomerular filtration rate and they end up in endstage renal disease,.
NDEP Preventing Type 2 Diabetes
There’s several things to find out about your health history in terms of Type 2 Diabetes. The first is, is there a history of Type 2 Diabetes in the family Is there anyone in the family who has Type 2 Diabetes now Are there people in the family who have been told they’re at highrisk for developing Diabetes or that they need to lose weight or be more active in order to prevent Diabetes People from certain racial and ethnic populations including African Americans, HispanicsLatinos, American Indians and Alaska Natives, Asian Americans or Pacific Islanders, also have a higher risk for.
Developing type 2 diabetes. And then the other question is to find out if your mother had Gestational Diabetes during her pregnancy. If the answer to any of those questions is yes, talk to your doctor about getting tested for PreDiabetes and Diabetes. music We know from the Diabetes Prevention Program and other studies that in fact there are things that people can do who are at highrisk to prevent or delay the onset of Type 2 Diabetes. For example, they can lose a modest amount of weight, become moderately physically active.
For example, walk 30 minutes five days a week, and make healthier food choices. And those things can go a long way to lowering their risk, and therefore delay or prevent Type 2 Diabetes. music It sounds easy to say lose a modest amount of weight, become moderately physically active, make healthier food choices, but we all know that it’s not that easy. Making changes in lifestyle is one of the hardest things that people do. One of the strategies that we know that works and helps is to involve the whole family in preventing Diabetes.
So think about how as a family you can be more active, make healthier food choices and support each other in those efforts to live a healthy and long life. music I think the first thing to realize is that change doesn’t happen with one giant sweep of willpower. So one of the strategies that we know that is effective is to take a big change and break it down into steps. So make it as simple as in order to be more active, in order to begin to lose weight, what is one thing I can do this week that.
Will help me to make a step towards that goal So for example, if you want to be more active maybe you need to start simply by looking at your schedule and finding a good time to exercise. Maybe you need to start with just a walk around the block. Maybe you need to look at do I have the right shoes and the right time and the right equipment that I need So break it down into doable steps figure out what the barriers might be and strategies to overcome those barriers.
Two of the resources that we have available here are, are first of all the Small Steps.Big Rewards because we know that by making a series of small steps you do in fact reap big rewards in the prevention effort. And second, Your Game Plan, which really helps you to think through stepbystep, what do I want to do and how can I get it done Both of those tools are designed to help you think about what do I want to accomplish and how can I break it down into steps that I can then achieve and then take another step.
Treatment Options for Charcot Foot Babak Kosari, MD
Charcot foot is a neuropathic foot disease that is sometimes seen in patients with diabetes. The prevention of further joint destruction and foot deformity is the primary initial aim in treatment of charcot’s foot. Dr. Babak Kosari of Valley Presbyterian Hospital tells us about this disease and how critical it is to have it treated promptly and correctly. It’s a condition that affects diabetics. Now it’s an end stage type of a condition where once you start developing a charcot foot, your disease process has gone on for a long time your neuropathy or lack of sensation in the lower extremity which is one of the.
Conditions that happens with over 40 of diabetics. The bones in the foot, they start to demineralize. In other words the calcium, the minerals, the get less and less the bone becomes weak and it starts to crack just by standing or walking. Now if you have a minor trauma that exacerbates it. Eventually what happens, the arch of the foot starts to collapse and the foot changes the shape and then you develop this what’s called technically Bag of Bones and these are tiny fractures that happens in the bones of the foot of the diabetic patient.
It’s a very very serious condition when it happens for a diabetic. In the initial phase, it goes untreated, unnoticed again primarily because the patient doesn’t feel pain. The disease process is very complicated, there are many theories about it. One of them is that the nerve endings that supply sensation to the arteries, they don’t function well. So the signal goes to open up the vessels the rush of blood comes into the foot and the rush of blood demineralizes the bone, weakens the bone. The treatment involves a team process we have a foot surgeon, we have the vascular surgeon, we have the endocrinologist,.
Primary physician, all these have to come together and develop a plan. The point is to prevent all this, once it happens the game changes. Then you get into first trying to stabilize this process because these bones are breaking. The patient is walking, they’re working, they’re doing things they’re weight bearing and they’re not realizing that this foot is actually collapsing slowly, slowly, slowly and if you take photographs from day one to day thirty, the drastic change in the foot. This is not a reversible type of a condition.
What we do is in severe cases, we do reconstruction of the foot. It’s a very complicated surgery, it involves metal frames that go from the foot to the leg. It’s a long recovery and it has many facets to postop care and education you know education for a long term. The first preventative treatment for these types of patients is education. You want your patient to know about what to look for, they have to have a comprehensive plan of care which routinely involves being checked by a foot specialist for types of foot changes that.
Normally we don’t think about. For example a small callus, you know we have calluses on our hands and our feet but that callus for a diabetic patient underneath is a very significant finding underneath, what’s happening in the bones is very crucial. Xrays, different imaging studies, just watching the patient walk, how they’re walking, the biomechanics of the foot, the types of shoes that they wear, the type of activity, their lifestyle, all these come into effect and my biggest weapon against all this is educating my patient as to what to look for. It’s a preventable condition but it has to be caught early and.
Education is the key. How many high school football players sustain a concussion each year 25,000, 50,000, 75,000 or 100,000 The answer when we return. Join the American Health Journal on Facebook. Search for American Health Journal. How many high school football players sustain a concussion each year The answer is over 100,000. The CDC also reports that 62 of these injuries occur during practice, not during games. Now with the latest information on cancer treatment here’s our reporter Lora Windsor. According to the American Cancer Society, more than one and a half million people in the United States are diagnosed.
PreDiabetes and Diabetes Prevention, Screening and Risk Factors
For prevention of diabetes the best thing is to make sure you’re at a healthy weight. You want to eat healthy foods and and really keep seeing your your primary care doctor to make sure that you are staying healthy so that they can do routine monitoring of your blood and keeping you accountable for your healthy weight and healthy lifestyle. So a prediabetic basically means that a patient is their blood sugar is somewhat high, sometimes it’s high sometimes it’s not. It it kind of fluctuates between a normal range. A lot of.
Times it depends on what they’re they’ve eaten, if they’ve eaten really high sugary foods or or high in carbohydrates, their blood sugar will probably likely a lot higher than say a normal person’s blood sugar after that meal. And but yet it’s not so high that it’s causing problems yet. Diabetes will will affect your kidneys, will affect your heart, whereas prediabetes you you might be on the road to that but not quite there and that’s that prediabetes and before is really what where we would like to catch our patients. If you are a prediabetic.
You can definitely change your lifestyle and get out of that category. A lot of times, it it has to do with just changing your lifestyle, changing your your eating habits and changing your exercise habits or start exercising. Possibly just losing a few pounds will be enough to get you out of that range of prediabetes. There are a few different ways that we can screen for and diagnose diabetes. The most common one is a Hemoglobin A1c. This is a blood test that can be performed that will kind of give us an average of what a patient’s.
Blood sugar has been doing over a three to four month time period. We do use it for screening as well. Sometimes we’ll see that a patient is borderline or prediabetic and we can start to take more intense preventative actions to help prevent that patient from going onto becoming diabetic. Risk factors for diabetes would include if you have a family history of diabetes. Also, if you are overweight you are more likely to become diabetic. If you have a poor diet, if you eat high sugary foods or high carbohydrate foods, you’re going to.
How Can A Proper Diet Help My Peripheral Neuropathy Dr. Jason Meyer DC Reviews Your Questions
Dr. Jason Lawrence Meyer is a chiropractor who runs the World of Wellness Chiropractic Offices in Fort Worth and Arlington, TX. wowhealthcenters Integrative medicine which is also called integrated medicine or integrative health, combines alternative medicine with evidencebased medicine. Proponents claim that it treats the whole person , focuses on wellness and health rather than on treating disease, and emphasizes the patientphysician relationship. The Defining Principles of Integrative Medicine 1. Patient and practitioner are partners in the healing process. 2. All factors that influence health, wellness, and disease are taken into consideration,.
Including mind, spirit, and community, as well as the body. 3. Appropriate use of both conventional and alternative methods facilitates the body’s innate healing response. 4. Effective interventions that are natural and less invasive should be used whenever possible. 5. Integrative medicine neither rejects conventional medicine nor accepts alternative therapies uncritically. 6. Good medicine is based in good science. It is inquirydriven and open to new paradigms. 7. Alongside the concept of treatment, the broader concepts of health promotion and the prevention of illness are paramount. 8. Practitioners of integrative medicine should exemplify its principles and commit themselves.
To selfexploration and selfdevelopment. World of wellness is a group of medical offices specializing in functional medicine, natural wellness and prevention. We offer integrated services providing fabulous bodywork in a fun and upbeat environment. our highly trained staff including Dr. Jason Meyer DC offer services such as natural medicine, pain relief, rehabilitation, therapy, massage, weightloss, nutrition, allergy testing, allergy management, arthritis relief, pain management, headache relief, and more, our mission statement and corporate purpose is to help people in the country become happier and healthier through natural healthcare. We are fully staffed with medical doctors,.
Nurse practitioners, chiropractors such as Dr. Jason Lawrence Meyer and licensed massage therapists and we are dedicated to help you obtain optimum wellness. Have you explored the World of wellness Fort Worth functional medicine World of Wellness would like to show you how optimizing your health and wellness can, in turn, eliminate any chronic pain that you may suffer from. Dr. Jason Meyer and Our team invites you to pay us a visit at our Fort Worth natural wellness clinic, where you will receive focused attention from a whole team of medical professionals.
We pride ourselves in working closely with each patient, explaining to them the potential sources of their pain and how that pain can be eliminated. World of Wellness provides Fort Worth and Arlington wellness and prevention that helps hold off chronic pain. Through our allnatural methods, we are able to treat a wide variety of ailments, including, but certainly not limited to Low back pain Migraine headaches Sciatica Neuropathy Neck pain Sports injuries Allergies Weight loss What makes our Fort Worth Chiropractic and functional medicine so effective is that we use natural methods of treatment instead of introducing harsh chemicals or subjecting.
The body to painful surgical procedures. Prescription medication might take away your pain, but not without a price. Many of these powerful medications can cause damage to other parts of your body. This is why our wellness clinic in Fort Worth shies away from using these drugs. The experienced staff at our functional medicine clinic in Fort Worth TX is truly unique. We staff a whole team of medical professionals who specialize in various areas of health and wellness. This means all of our resources are together under one roof. Many traditional.
Doctors will refer patients to other specialists because they are not equipped to handle certain treatments. Keeping our patients in one facility ensures strong communication and lets you garner the advantages of working with an entire team of professionals rather than just one doctor. We want to meet with you and open your eyes to a new way of reducing or eliminating your chronic pain. World of Wellness offers free consultation appointments. Make an appointment now and see what our Fort Worth functional medicine methods can do for you. Dr. Jason Meyer D.C. Jason Meyer Chiropractor.
Inspirational Tutorial, the Diabetes Prevention Program
I’ve worked in Indian Country for almost 25 years now. This is a program that is vital to our communities its without a doubt in my opinion one of the best programs that we’ve ever had. It changes lives and I’m proud to be a part of it I’ve been apart from the very beginning we wrote the grant we came to our first grantee meeting we worked as a team of folks we collaboratively work together to design the program I’m real proud of it and i’ve seen the results of it.
I’m really honored to be a part of designing the tail end of this now when we get the modules together and we share it with the other tribes and the rest of the country so they can benefit from what we’ve learned no matter what we look like what size we are where we come from that when we really understand what this disease is doing to our people we all have that same hope we wanna see a future without this disease a future with out threat this taking our children or taking our lives.
And the Diabetes Prevention Program gives us that hope this program is lifechanging it’s community changing its it changes the way that families and individuals think it’s what’s needed in the next step of creating healthy communities and health or healthy tribes so I knew this was important we put a lot of time into getting where we are it been super successful each individual person I mean chronic diseases have been prevented not just diabetes but hypertension and obesity So it just seems the logical next step is that you would.
Disseminate the information to make it as easy for other people to follow we’re providing them with lifechanging education that will help them and their families to better know how to prevent diabetes many of them did not do any type of exercise but because of the program they’re involved with their families again so it’s not just about the person that’s in the program the whole family is impacted by our program being part of the Diabetes Prevention Program It really was something that was very close to my heart just due to the things that have.
Happened to family members regarding diabetes it was something that at that time I really wanted to find a position and find an area of work where I could focus on prevention and it came at the right time and for me to work with my tribe in doing this has meant the world to me Diabetes prevention is actually so much more than just losing weight it provides skills for people to really change their lives and eat healthier and move more to where they feel better and to where they really feel good about themselves. Our tribes are very proud of.
The work that’s been done and more importantly its it’s saving the lives of people and its information it needs to be shared with everybody not just tribal communities but all our partners across the state federally and it’s really important that we get to the end we get the toolkit finished and present it in a manner that folks can understand that it’s easy to follow and DPP really is it’s a successful tool and the toolkit is something that will really help your team or help native communities prevent diabetes.
I can tell you now having been through the program this program has changed the way that our tribal leaders our elders think about health care healthcare is a number one priority for our tribe at this point the Diabetes Program the prevention program is white basically sparked that and in light of the the transformation changes in the country in everything happening we’re huge part that in our community and our state and this program has really become the results are so astonishing that folks from the Argonian from the organ health science university from local hospitals all call us up and.
Ask if we’ll come and share what we know the knowledge that the tribe has gained from our very small input and to reducing the the diabetes epidemic the obesity epidemic and our tribe’s proud of that but they’re more proud that this has changed our community this is change the way our families eat and how they exercise together we have a garden now it’s really really blossomed into something huge and the tribe’s very proud of that so we will be maintaining the Diabetes Prevention Program i’d like this toolkit to empower our Native American people.
Diabetes Treatment New Diabetes Treatment For Reversing Your Diabetes Naturally
Diabetes Treatment New Diabetes Treatment For Reversing Your Diabetes Naturally tinyurll6mdeo4 Diabetes Treatment New Diabetes Treatment For Reversing Your Diabetes Naturally Diabetes Treatment New Diabetes Treatment For Reversing Your Diabetes Naturally If you or a loved one is suffering with type 1 or type 2 diabetes or even prediabetes, I’m about to tell you something you have never heard before no more needles, no more confusion, no more fear, no more embarrassment. Diabetes Treatment New Diabetes Treatment For Reversing Your Diabetes Naturally You are about to learn a little known, but 100 scientifically proven way to reverse.