 |
 |
 |
 |
 |
 |
 |
 |
University Medical Associates
465 N. Belair Road, Suite 2B
Evans, GA 3080
The Latest on UMA:
Information on Internal Medicine & Medical Care - Diabetes Care, Endocrine Care, and More
New Study Shows That Short Sleepers Could Have Higher Diabetes Risk
Want to sleep in? A new study by researchers at the University of Buffalo indicates that it just might be what you need to stave off diabetes.[read more]
Don't Worry, Be Happy! The Benefits Of "Mirthful Laughter," Coupled With Standard Diabetic Treatment
Laughter could save your life--a new study shows that your body responds to a happy disposition positively. This could mean that diabetics may need to treat themselves to a good laugh, as well as standard diabetic treatement.[read more]
UPDATE: IMT Scanning Comes To University Medical Associates
The physicians of UMA are pleased to announce that we now offer IMT (Intima Media Thickness) scanning of the carotid arteries. This is a rapid, inexpensive, painless means of estimating the amount of cholesterol in arteries and therefore the risk for heart attack and stroke.[read more]
University Medical Associates Doctors Voted "Best of 2008" by Augusta Magazine
University Medical Associates was recognized as a group of dedicated physicians and doctors who continues to provide compassionate, quality, and innovative care. We know that it's important to have a doctor who cares--thank you Augusta Magazine and our patients for voting our doctors the Best of Augusta![read more]
Control Or Prevent Diabetes Through Healthier Habits
(25 Mar 2009) As diabetes rates continue to rise, Department of Health Secretary Everette James stressed the need for Pennsylvanians to learn about steps they can take to prevent or delay the onset of diabetes.[read more]
Diabetics May Need More Calcium with Their Fiber
(April 1, 2009) People with Type II diabetes who are trying to bulk up on fiber may need to pay closer attention to their calcium intake as well, a small study suggests...[read more]
Patient-Physician "Connectedness" Affects Quality of Care
(March 3, 2009) A new study in Annals of Internal Medicine, however, finds that patients who are connected to a specific primary care physician are more likely to receive guideline-consistent care....[read more]
New Advice For Preventing Heart Attacks, Cardiovascular Disease
(March 30, 2009) Heart health may be better protected and maintained with more recognition to the benefits of preventive measures - especially exercise....[read more]
Don't Worry, Be Happy! The Benefits Of "Mirthful Laughter," Coupled With Standard Diabetic Treatment
Posted April 23, 2009
Laughter could save your life--a new study shows that your body responds to a happy disposition positively. This could mean that diabetics may need to treat themselves to a good laugh, as well as standard diabetic treatement.
More information from a report posted on Medical News Today from the American Physiological Society:
In earlier work, Dr. Lee Berk and his colleagues discovered that the anticipation of "mirthful laughter" had surprising and significant effects. Two hormones - beta-endorphins (the family of chemicals that elevates mood state) and human growth hormone (HGH; which helps with optimizing immunity) - increased by 27% and 87 % respectively in study subjects who anticipated watching a humorous video. There was no such increase among the control group who did not anticipate watching the humorous film. In another study, they found that the same anticipation of mirthful laughter reduced the levels of three detrimental stress hormones. Cortisol (termed "the steroid stress hormone"), epinephrine (also known as adrenaline) and dopac, (the major catabolite of dopamine), were reduced 39, 70 and 38%, respectively (statistically significant compared to the control group). Chronically released high levels of these stress hormones can be detremential to the immune system.
Lee Berk, DrPH, MPH, a preventive care specialist and psychoneuroimmunologist, of Loma Linda University, Loma Linda, CA, has paired with Stanley Tan, MD, PhD an endocrinologist and diabetes specialist at Oak Crest Health Research Institute, Loma Linda, CA, to examine the effect of "mirthful laughter" on individuals with diabetes. Diabetes is a metabolic syndrome characterized by the risk of heart attack, blindness and other neurological, immune and blood vessel complications. They found that mirthful laughter, as a preventive adjunct therapy in diabetes care, raised good cholesterol and lowered inflammation. The researchers will present their findings entitled Mirthful Laughter, As Adjunct Therapy in Diabetic Care, Increases HDL Cholesterol and Attenuates Inflammatory Cytokines and hs-CRP and Possible CVD Risk. They will present the findings at the 122nd Annual Meeting of the American Physiological Society, which is part of the Experimental Biology 2009 scientific conference. The meeting will be held April 18-22, 2009 in New Orleans.
The Study
A group of 20 high-risk diabetic patients with hypertension and hyperlipidemia were divided into two groups: Group C (control) and Group L (laughter). Both groups were started on standard medications for diabetes (glipizide, TZD, metformin), hypertension (ACE inhibitor or ARB)) and hyperlipidemia (statins). The researchers followed both groups for 12 months, testing their blood for the stress hormones epinephrine and norepinephrine; HDL cholesterol; inflammatory cytokines TNF-a IFN-? and IL-6, which contribute to the acceleration of atherosclerosis and C-reactive proteins (hs-CRP), a marker of inflammation and cardiovascular disease. Group L viewed self-selected humor for 30 minutes in addition to the standard therapies described above.
Results
The patients in the laughter group (Group L) had lower epinephrine and norepinephrine levels by the second month, suggesting lower stress levels. They had increased HDL (good) cholesterol. The laughter group also had lower levels of TNF-a, IFN-?, IL-6 and hs-CRP levels, indicating lower levels of inflammation.
At the end of one year, the research team saw significant improvement in Group L: HDL cholesterol had risen by 26 percent in Group L (laughter), and only 3 percent in the Group C (control). Harmful C-reactive proteins decreased 66 % in the laughter group vs. 26 percent for the control group.
Conclusion
The study suggests that the addition of an adjunct therapeutic mirthful laughter Rx (a potential modulator of positive mood state) to standard diabetes care may lower stress and inflammatory response and increase "good" cholesterol levels. The authors conclude that mirthful laughter may thus lower the risk of cardiovascular disease associated with diabetes mellitus and metabolic syndrome. Further studies need to be done to expand and elucidate these findings.
In describing himself as a "hardcore medical clinician and scientist," Dr. Berk says, "the best clinicians understand that there is an intrinsic physiological intervention brought about by positive emotions such as mirthful laughter, optimism and hope. Lifestyle choices have a significant impact on health and disease and these are choices which we and the patient exercise control relative to prevention and treatment."
Source:
Donna Krupa
American Physiological Society
Article URL: http://www.medicalnewstoday.com/articles/146449.php
Main News Category: Diabetes
Also Appears In: Cardiovascular / Cardiology, Hypertension, Preventive Medicine
New Study Shows That Short Sleepers Could Have Higher Diabetes Risk
Posted April 8, 2009
Want to sleep in? A new study by researchers at the University of Buffalo indicates that it just might be what you need to stave off diabetes.
New Study Shows That Short Sleepers Could Have Higher Diabetes Risk
American Heart Association report via Medical News Today:
Researchers in the US found that people they described as "short sleepers", that is those who slept less than six hours a night were nearly five times more likely to develop abnormal levels of fasting blood sugar, a condition that can lead to type 2 diabetes.
The study was the work of lead author Dr Lisa Rafalson, a National Research Service Award fellow and research assistant professor at the University at Buffalo in New York, and the findings were presented yesterday, Wednesday 11 March, during the American Heart Association's 49th Annual Conference on Cardiovascular Disease Epidemiology and Prevention which is taking place this week at the Westin Innsbruck Resort in Palm Harbor, Florida.
Rafalson and colleagues do not think there is a genetic reason behind their findings and hope that the study prompts more research into the links between sleep and diabetes.
Type 2 diabetes is the most common form and arises when the body can't use the insulin it produces, and instead of being transported into cells for use as energy, the glucose stays in the blood. This causes the pancreas to produce even more insulin, which is also not used efficiently. The condition is sometimes called insulin resistant diabetes for this reason.
Type 2 diabetes mostly arises during middle age, but teenagers and young adults are now developing it at an alarming rate.
Rafalson and colleagues carried out a matched, nested case-control study involving 1,455 participants followed for six years as part of the Western New York Health Study. They wanted to find out if the amount of sleep participants were reporting at the start of the study could predict progression from normal to impaired fasting glucose over the follow up period.
They found 91 participants whose fasting glucose levels were below 100 milligrams per decilitre (mg/dL) when they enrolled in 1996-2001, had gone up to between 100 and 125 mg/dL in follow up tests in 2003-2004.
They matched each of these 91 to three controls whose glucose levels were below 100 mg/dL at enrollment and at follow up. They also matched them by gender, race/ethnicity and year of enrollment.
The results showed that participants who slept on average less than six hours a night during the working week, when followed for six years, were 4.56 times more likely to start with normal then move to impaired fasting blood glucose levels compared to counterparts who had six to eight hours.
Rafalson said:
"This study supports growing evidence of the association of inadequate sleep with adverse health issues."
"Sleep should be assessed in the clinical setting as part of well-care visits throughout the life cycle," she added.
Rafalson said that while some research has suggested that many genes are involved in diabetes risk, and perhaps each contributes a small effect, she and her colleagues were not aware of any that predisposed people to sleep disturbance that could explain their results, and therefore it was:
"More likely that pathways involving hormones and the nervous system are involved in the impaired-sleep/fasting glucose association."
"Our findings will hopefully spur additional research into this very complex area of sleep and illness," she added.
Rafalson's co-authors were: Richard P Donahue, Michael LaMonte, Joan Dorn, Maurizio Trevisan, Saverio Stranges, and Jacek Dmochowski.
The study was sponsored by the National Institutes of Health.
American Heart Association - 12 MAR 2009
UPDATE: IMT Scanning Comes to University Medical Associates
April 3 - UMA
AUGUSTA, GA - The physicians of UMA are pleased to announce that we now offer IMT (Intima Media Thickness) scanning of the carotid arteries. This is a rapid, inexpensive, painless means of estimating the amount of cholesterol in arteries and therefore the risk for heart attack and stroke.
Cholesterol accumulation in the body’s arteries is a silent process. It occurs in multiple arteries of the body and causes no symptoms until there is critical obstruction which may result in stroke or heart attack. Until recently there has been no way to safely and painlessly estimate the body’s burden of cholesterol. Standard risk factors are helpful but leave a large number of people unidentified.
Ultrasound of the carotid has recently been identified as a painless and safe means of identifying those whose arteries show early signs of cholesterol accumulation. Identification of those at higher risk allows early aggressive treatment and a greater hope for avoiding serious problems.
Currently, IMT scanning is not coverer by insurance or Medicare. Our office will charge a flat fee of $50 for this simple procedure.
Control Or Prevent Diabetes Through Healthier Habits, Pennsylvania Health Secretary Urges
25 Mar 2009 - 2:00 PDT
As diabetes rates continue to rise, Department of Health Secretary Everette James stressed the need for Pennsylvanians to learn about steps they can take to prevent or delay the onset of diabetes.
"While we don't know the exact cause of diabetes, we do know that genetics and personal health choices can play a role in its development," said Secretary James. "Take control of your overall health by eating properly and adding moderate exercise to your daily routine. For many people, adopting these changes can delay -- or even prevent -- diabetes."
Approximately 863,000 people in Pennsylvania have diabetes and the number is growing. According to the Centers for Disease Control, the number of diabetes cases has increased by 90 percent nationally over the past decade and that has had a significant impact on our health system and its costs. The American Diabetes Association says direct costs and productivity losses associated with diabetes amounted to $174 billion in 2007.
Diabetes is a chronic disease that occurs when a person's pancreas does not produce, or stops producing, insulin resulting in Type 1 diabetes. Type 2 diabetes occurs if the body is not producing enough insulin and/or the body cannot use the insulin that is produced. Insulin is a hormone that converts sugar and starches from food into energy.
Diabetes increases an individual's risk for additional health complications and other chronic diseases such as high blood pressure, heart disease and stroke. Individuals with diabetes are also more likely than those without to suffer blindness and lower extremity amputations.
Knowledge about diabetes management is important not only for those who battle the disease but for their caregivers and loved ones as well. Individuals should know the ABCs of Diabetes - A- the A1C blood sugar test, B-blood pressure and C-cholesterol levels.
"It's important to talk with your physician about the ABCs of diabetes," added James. "Together, you can discuss steps to be taken to keep your levels normal and develop a plan that works best for you."
Pennsylvania Department of Health
http://www.state.pa.us
Diabetics May Need More Calcium with Their Fiber
April 1 - Reuters Health
NEW YORK - People with type 2 diabetes who are trying to bulk up on fiber may need to pay closer attention to their calcium intake as well, a small study suggests.
When 13 diabetics doubled their fiber intake, the study participants began to excrete less calcium in their urine -- a sign that their body's calcium absorption had declined, the researchers observed.
Fiber is known to help lower cholesterol, improve blood sugar control and maintain bowel regularity; and adults are advised to get roughly 25 grams or more each day.
But these latest findings suggest that poorer calcium absorption may the trade-off, the researchers report in the journal Diabetes Care.
"Because more calcium equals better bone health, we recommend that people on high-fiber diets talk to their physician about increasing their dietary calcium as well, in order to get the most benefit from both," senior researcher Dr. Abhimanyu Garg, of the University of Texas Southwestern Medical Center in Dallas, said in a written statement.
He added that it is important to consult a doctor or dietitian first because excessive calcium can cause kidney stones.
The findings are based on 13 middle-aged and older adults with type 2 diabetes who each consumed 50 grams of fiber per day for 6 weeks, followed by 24 grams per day over another 6-week period.
Garg's team found that when participants were on the higher-fiber diet, their calcium excretion declined. Some studies, the researchers note, have suggested that dietary fiber binds with certain minerals, forming "complexes" that cannot be absorbed.
Garg suggested that people try foods that provide both fiber and calcium, such as spinach, broccoli, figs, papaya, beans and artichokes.
SOURCE: Diabetes Care, online March 11, 2009.
Patient-Physician "Connectedness" Affects Quality of Care
March 3, 2009 - Annals of Internal Medicine
Health care in the United States is often fragmented and uncoordinated. It is common for patients to receive episodic care from different physicians. A new study in Annals of Internal Medicine, however, finds that patients who are connected to a specific primary care physician are more likely to receive guideline-consistent care than those who are connected to a practice but not a physician.
Researchers looked at 155,590 adults in a primary care network to determine which patients received most of their care from a specific physician, practice, or neither. They found that patients who were not connected to a particular physician were less likely to receive recommended care. In addition, these patients were less likely to complete recommended testing for preventive and chronic illness care.
"This study provides strong evidence for the value of having a regular doctor," said Steven Atlas, M.D., Director of Primary Care Quality Improvement at Massachusetts General Hospital, and lead author of the study.
Researchers used the term "connectedness" to describe the closeness of the relationship between a patient and an individual physician. The researchers found that patients who were connected to a physician were more likely to have health insurance, speak English, and be non-Hispanic white. However, connectedness was associated with larger disparities in screening rates than was race or ethnicity.
"The process of establishing a strong relationship with a specific physician may represent an important key to understanding disparities in care," said Dr. Atlas. "Greater insight into the role of patient- provider- or practice-level barriers to establishing a closely connected primary care relationship may lead to improved quality of care for vulnerable patients."
But according to researchers, continuity of care is a shared responsibility between physicians and patients. Even if physicians or practices treated all patients similarly, patients vary in their ability and willingness to adhere to recommendations.
According to Dr. Atlas, this study has health care policy implications as well.
"Pay-for-performance initiatives hinge on the ability to accurately assign performance measures to those practitioners who have some control over the outcome. Our study results suggest that physicians with a relatively low percentage of connected patients are likely to receive lower scores on performance measures when compared to physicians with a higher proportion of connected patients," said Dr. Atlas.
New Advice For Preventing Heart Attacks, Cardiovascular Disease
March 30, 2009 - American College of Sports Medicine
Heart health may be better protected and maintained with more recognition to the benefits of preventive measures - especially exercise, said an expert at today's American College of Sports Medicine (ACSM) Health & Fitness Summit & Exposition.
John Quindry, Ph.D., FACSM says people should be more aware of their heart attack risk factors, and fully realize the potential that preventive activity has for longevity and cardiovascular health, rather than relying solely on drug intervention. Risk factors can be divided into two segments: modifiable and non-modifiable.
Non-modifiable risk factors
- Age (45+ for males, 55+ for females)
- Family history of heart disease
Modifiable risk factors
- High blood pressure
- Diabetes
- Cigarette smoking
- High cholesterol
- Poor diet
- Sedentary lifestyle
Taking steps - literally - to alter one important risk factor, sedentary lifestyle, can act as a catalyst to cure other modifiable risk factors, according to Quindry.
"The bottom line is that to prevent heart disease, people need to be active," he said. "Research shows that exercise consistently improves heart disease related factors like diabetes, high blood pressure and other chronic conditions, so you're essentially knocking out multiple risk factors through physical activity."
Quindry added that the type of exercise performed is of little significance because, from biological and cardiovascular perspectives, the body doesn't know the difference between a session on an elliptical machine or a brisk hike.
What's more, it doesn't take a vigorous session on a treadmill to improve heart health. ACSM supports the new federal recommendation of 150 minutes/week of moderate-intensity physical activity - like taking a walk after dinner - which is easily achieved in 30 minutes/day, five days/week.
Beginning exercisers who have one or more cardiovascular risk factors are encouraged to seek exercise advice from their doctor. ACSM's Exercise is Medicine™ initiative asks physicians to review patients' physical activity programs at every visit, to make exercise a standard part of health care. The Exercise is Medicine Web site features printable exercise prescription pads that doctors can use to counsel patients on their physical activity regimens.
The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 35,000 international, national, and regional members and certified professionals are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.
Source:
American College of Sports Medicine
University Medical Associates Doctors Voted "Best of 2008" by Augusta Magazine
2008 - Augusta Magazine
Congratulations to the following doctors on being voted the Best of 2008:
Dr. Daniel H. Boone
Dr. Stanley T. Smith (Diabetes Specialist)
Dr. Barry T. Tarpley
Dr. Ruj Ujjin
Dr. Robert W. West
The following was written in Augusta Magazineby Jenna Anderson:
"One of the most precious and valuable resources available to Augusta-area residents is the availability of excellent physicians and world-class medical facilities."
"With more than six renowned hospitals, including an academic medical center, nationally-renowned burn center, major Army medical center and Veterans Administration hospital, there is no dearth of options when it comes to choosing the best healthcare provider for you and your family."
"To help you with your decision, Augusta Magazine publishes a bi-annual list of the best doctors in the CSRA as excerpted from the database of Best Doctors Inc., a company founded in 1989 by doctors affiliated with the Harvard University School of Medicine. The international database is comprised of 50,000 top medical specialists in more than 400 specialities chosen by their own peers."