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Diabetes and Neuropathy

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Gastroparesis and Diabetes: Another Aspect of Neuropathy
Posted on June 26, 2015 by Joslin Communications
This entry was posted in Complications, Diabetes Day2Day and tagged gastroparesis, neuropathy. Bookmark the permalink.
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Patients with long standing diabetes usually have some evidence of damage to the nervous system, or neuropathy. If you have neuropathy you may be familiar with pain, tingling, numbness or loss of feeling in the feet or hands (called peripheral neuropathy), but it can affect any organ system, including the stomach and its related organs.

Nerve damage associated within the gastrointestinal tract can result in the motility disorders of gastroparesis and small bowel bacterial overgrowth (SBBO). Gastroparesis is 2 to 3 times more common in type 1 diabetes than type 2 diabetes and may affect as many as 50 percent of those with type 1.

If you eat a low-fat, mixed meal your blood glucose will peak in about 1.5 hours. With normal bowel function, this peak coincides with the peak action of rapid acting insulin.

But damage to the nerves (the vagus nerve) of the gastrointestinal tract causes a loss of stomach and intestinal motor control. This can lead to a mismatch between when you digest food and glucose enters the blood stream and the action time of insulin.

If you have gastroparesis you may experience erratic blood glucose, with a pattern of low glucose readings shortly following the meal and elevated readings hours after eating.

Symptoms include nausea, early satiety, vomiting and in severe cases weight loss. Because of gastric stasis and slower bowel transit times, patients are also prone to constipation.

Gastroparesis is diagnosed by gastric emptying studies. In this test, patients are fed a meal containing a marker isotope and x-ray pictures are taken of the stomach over a 4 hour period.

Severe gastroparesis can lead to malnutrition due to continued vomiting and poor consumption of calories and protein. The goals of nutrition therapy are to prevent muscle loss, provide adequate vitamin and mineral intake, control blood glucose levels and relieve symptoms.

Nutrition recommendations include

1. Eat smaller, more frequent meals;

2. Consume more of your calories with liquids. Liquids pass more quickly than solids through the stomach;

3. Limit dietary fiber especially, for patients prone to bezoars (those are hairball like accumulations of hardened food fibers, and they can lead to obstruction of the passage from the stomach to the intestine)

4. Reduce dietary fats –especially solid fats – as they delay gastric emptying. Fats in liquid form appear better tolerated

5. Consume adequate calories to achieve or maintain a healthy weight

Other recommendations include:

1. Control of blood glucose- high levels (greater than 270 mg/dl) delay GI transit time.

2. Taking insulin after the meal or for patients using an insulin pump, use the extended action bolus.

3. Using a combination of prokinetic (movement stimulating) and antiemetic (anti nausea and vomiting) agents to improve gastric motility and control symptoms of nausea and vomiting.

For patients who do not find relief with the above measures, gastric electric stimulation can be attempted. A small pulse generator is placed under the skin and wires are attached to the stomach. The generator emits a small charge stimulating stomach emptying.

But, as always, talk to your doctor before making any changes to your diet or care.

More information about gastroparesis can be found on the NIH website.

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Cucumbers Nutritional Facts

Cucumber Nutrition Facts

More than just a way to reduce puffiness around your eyes, cucumbers also have some impressive benefits when it comes to fighting free radical damage and inflammation. They contain some powerful polyphenol compounds that can help naturally slow aging caused by oxidative stress.

After investigating the potential free radical-scavenging abilities of cucumbers, researchers from the Institute of Pharmaceutical Sciences in Haryana, India, report that within cucumbers “the presence of flavonoids and tannins in their extract, as evidenced by preliminary phytochemical screening, suggests that these compounds might be responsible for free radical scavenging and analgesic effects … Regular consumption of natural antioxidants from vegetables, fruit, tea, and herbs may contribute to a shift in balance toward an ample antioxidant status.”

One cup of cucumbers (with the peel) has about:

16 calories
Zero protein, fat, fiber or sugar
17 milligrams vitamin K (22 percent DV)
3 milligrams vitamin C (4 percent DV)
6 milligrams magnesium (4 percent DV)
152 milligrams potassium (4 percent DV)
8 milligrams manganese (4 percent DV)

9 Cucumber Nutrition Health Benefits
1. Good Source of Cancer-Fighting Antioxidants
cancer cell

Several bioactive compounds have been isolated from the nutritious cucumber, including cucurbitacins, glucosides, lignans, apigenin and flavanols like firestin. These are known to have strong cancer-fighting abilities since they can protect DNA and cells from damage due to oxidative stress. Fisetin is specifically tied to brain health and preservation of cognitive function, while cucurbitacins are known to have cancerous tumor-reducing effects.

Researchers from the University of Valencia in Spain have found that cucurbitacins antioxidants, a type of triterpene compound, can induce cancerous cell death (a process known as apoptosis). The most significant mechanisms with regard to the apoptotic effects of cucurbitacins are their ability to modify activities via nuclear factors or genes and to activate anti-tumor proteins.

This is precisely the reason why genes don’t determine your destiny: Eating plenty of high-antioxidant foods can greatly lower your risk of cancer even if it unfortunately does run in your family, making cucumbers a natural cancer treatment.
2. High in Nutrients but Low in Calories
Low in calories and high in nutrients – Dr. Axe

Cucumbers are one of the vegetables with the highest water content, which means they offer valuable vitamins and minerals, yet they’re super low in calories — with only about 16 calories per cup. Since they’re about 95 percent water, they do a good job of taking up room in your stomach and visually adding volume to meals without weighing you down.

This means you can eat more and feel satiated while still sticking to an overall healthy, low-calorie or low-carb weight loss plan. Plus, cucumber nutrition can help quench thirst and prevent the desire to snack due to dehydration.
3. Helps Detoxify the Body
detoxifying the body

Cucumbers support the digestive tract, including helping to cleanse the liver, which is our main detoxifying organ, by removing accumulated toxins and waste materials from the blood and gut. They’re also a natural diuretic food, which means they can help the body produce more urine to carry out toxins and waste.

In the process, they’re great for reducing bloating and uncomfortable water retention — one reason to fill up on cucumbers after a night of salty food or alcohol.
4. Hydrates and Soothes Skin
young healthy skin

Fresh cucumber juice has been used to naturally nourish damaged, dry or sensitive skin for centuries. According to some studies, cucumber slices or seeds applied directly to the skin gives a soothing and cooling effect against skin irritations and reduces swelling and redness. It’s even been used to naturally treat acne, scars and other blemishes.

Cucumbers also have the power to relax and alleviate pain, blotchiness and swelling following a sunburn, making for a great natural sunburn remedy. The fruit is considered a “refrigerant, haemostatic and tonic, useful in treating hyperdipsia or thermoplegia.” In other words, cucumbers help stop bleeding, reduce heat buildup associated with inflammation, quench your thirst, relieve dehydration and fight “sunstroke” all at the same time!
5. Helps Improve Heart Health
heart and cardiogram

Lignans found in cucumbers have well-documented immune-boosting, anti-inflammatory effects that are beneficial for fighting cardiovascular disease. Studies investigating the effects of consuming ligans from plant foods (including from high sources like flaxseeds or sesame seeds) have found beneficial associations with C-reactive protein levels, a lowering effect on total and low-density lipoprotein (LDL) cholesterol, and improved blood pressure levels.

Cucumbers also provide important minerals that help maintain a healthy heart, including potassium and magnesium. Potassium is linked to healthier blood pressure levels since it helps control fluids in the body, therefore low potassium intake from fruits and veggies is often correlated with poorer heart health. Magnesium-rich foods are also beneficial for blood pressure in addition to general nerve functioning, heartbeat regulation, fluid balance, better blood sugar stability and higher energy expenditure.
6. Improves Digestion and Relieves Constipation
healthy digestion

The seeds of a cucumber are known for having a healing, heat-reducing effect on the body, and they’re often used to prevent and naturally relieve constipation in traditional forms of medicine like Ayurveda. Many people suffer from magnesium deficiency without even knowing it, but cucumbers’ source of magnesium and other electrolytes can help hydrate the gut and digestive lining, which keeps you more “regular.”

Since they’re a great vegetable for juicing or making smoothies, you can try combining cucumbers with other hydrating foods — like melon, lime, avocado, celery and fennel – to create a natural anti-bloating drink.
7. Helps Alkalize the Blood
blood sugar

Cucumber nutrition includes being one of the top alkaline foods that help balance the body’s pH level and counteract the effects of an acidic diet. Limiting consumption of acid-forming foods — such as fried foods, sugar and refined carbohydrates, and eating more alkaline-forming foods instead — is beneficial for protecting your body from diseases that thrive in an acidic entrainment.

According to a report published in the Journal of Environmental Public Health, “Life on earth depends on appropriate pH levels in and around living organisms and cells. Human life requires a tightly controlled pH level in the serum of about 7. It is generally accepted that agricultural humans today have a diet poor in magnesium and potassium as well as … This results in a diet that may induce metabolic acidosis which is mismatched to the genetically determined nutritional requirements.”

A properly balanced pH level is also thought to decrease leptin levels, the main hormone connected to hunger and appetite control, as well as inflammation, the root of most diseases. Since the body is able to easily digest nutrients in liquid form, this is one reason why cucumbers are a popular ingredient in green alkalizing juices.
8. Supports Strong Bones
Anatomy Of Human Knee Joint

With 22 percent of your daily vitamin K in every cup of cucumbers, eating more cukes is a good way to help maintain bone mineral density. Vitamin K (in the form of K2) is a fat-soluble vitamin that works with other essential nutrients like calcium and magnesium to preserve strong bones. In fact, vitamin k builds bones better than calcium.

Vitamin K also supports a healthy metabolism, nutrient absorption, aids in heart health, helps with blood clotting, supports neurological function and can help protect against cancer. Yet vitamin K deficiency is common among adults and children due to a diet low in green vegetables, a low-cholesterol diet, medication use and poor absorption of nutrients.
9. Helps Prevent or Treat Headaches
Young businesswoman has splitting headache pain migraine

Traditionally, cucumbers have been used as a natural headache remedy and somewhat of a pain reducer since they fight inflammation and swelling. Headaches or migraines can be triggered by many things, including dehydration, stress, fatigue, low blood sugar and nutritional deficiencies.

Many studies show that foods high in water and magnesium like cucumbers combat headaches by balancing fluids in the body and preventing dehydration.
History of Cucumbers

The cucumber originated in India, where many varieties are still grown today. Some sources show that cucumbers have been cultivated for at least 3,000 years! They were believed to be introduced to other parts of Europe by the Greeks or Romans and today grow on just about every continent worldwide.

Records indicate that certain species of cucumbers first appeared in France in the 9th century, England in the 14th century and North America by the mid-16th century. Botanically speaking, cucumbers are actually fruits, closely related to melon, yet most people think of them as being vegetables just like tomatoes and squash (both also fruits!).
Cucumber history – Dr. Axe

Commonly known as the cucumber in English-speaking countries, this water-rich veggie goes by many names around the world — for example, khira (Hindi) and sakusa (Sanskrit). It’s found wildly in the Himalayan regions and also widely cultivated and exported throughout India, Asia and North America today.

The uses for cucumber nutrition benefits known centuries-ago included naturally remedying PMS, fighting pain, skin irritations, headaches and improving digestion since the seeds are nourishing, cleansing and have a diuretic effect. The juice from cucumbers has also long been used as a natural electrolyte booster before energy drinks like vitamin water existed. And since it has antibacterial properties and is an anti-inflammatory food, cucumbers have been used as a home remedy for acne or to reduce redness and puffiness on the skin.
How to Buy and Use Cucumbers

When it comes to choosing the best cukes, you have some options: Look for both regular cucumbers and smaller, bumpier “kirbys.” Kirbys are the kind most often used for pickles. When shopping, look for cucumbers that are bright to dark green, firm, and don’t have any soft, water-logged spots. Plan on eating the whole cucumber whenever possible, since the seeds contain important compounds and the skin is a good source of vitamin A.

Cucumber nutrition benefits are most available when you buy organic and unwaxed cucumbers (especially since you want to eat the skin). Because cucumbers are so water-dense, if they’re grown in soil contaminated with pesticides, they’ll likely hold on to a lot of chemicals, which wind up getting passed onto you. Cucumbers are on the list of the “Dirty Dozen” vegetables and fruits put together by the Environmental Working Group for this reason, so spend the extra money and buy organic cucumbers when they’re available — they still tend to be a very inexpensive veggie.

Cucumbers are often waxed to protect them from becoming bruised during shipping. Even organic cucumbers can have wax, but these are made of less harmful substances. The only wax that’s allowed on organically grown cucumbers isn’t synthetic and is free of all chemical contaminants.

When storing cucumbers, keep in mind they do best when kept in very cold temperatures. Keep them in a plastic bag in the refrigerator until you’re ready to use them, but try to have them within three to five days. You can either peel the skin if you’d like, especially if they’ve been waxed, or leave it on and give the skin a good scrub. But I wouldn’t recommend eating waxed skin if the cucumber isn’t organic.
Cucumber Recipes

Unlike most vegetables, cucumbers actually taste better when eaten raw. Because they’re so high in water, they don’t usually come out well when cooked and tend to just turn into a soggy mess.

If plain old cucumbers gets boring, try pickling them yourself in some vinegar. You can combine two regular cucumbers and toss with three tablespoons of rice vinegar, two tablespoons chopped herbs of your choice (like dill), and a pinch of sugar and salt. The longer you let them sit, the stronger taste they’ll develop, but even just 30 minutes allows them to absorb some flavor.
Secret Cucumber Detox Soup Recipe

Total Time: 5 minutes

Serves: 4

INGREDIENTS:

1 cucumber (peeled and de-seeded plus additional cuke for garnish)
1 tablespoon onion (minced)
1 avocado, peeled
1 tablespoon olive oil
1 tablespoon lemon juice
1 tablespoon apple cider vinegar
1/4 teaspoon sea salt
1/4 teaspoon chili powder
1 dash of cayenne pepper
1 cup water
paprika for garnish

DIRECTIONS:

Throw avocado, cucumber, onion, oil, lemon juice, vinegar and water in a high-powered blender.
Puree on high speed until smooth. Blend in salt, chili powder and remaining ingredients. Serve, garnishing with extra cucumber cubes and smoked paprika if desired.

Cucumber-Detox-Soup1

Creamy Cucumber Avocado Soup Recipe — This creamy cucumber avocado soup recipe is refreshing delicious and full of healthy fats.
Super Hydrator Juice Recipe — Cucumbers are combined with coconut water in this thirst-quenching, easy-to-make juice. Coconut water is considered one of nature’s most hydrating drinks. Together, this juice is low in fat and sugar and is filled with amino acids, antioxidants, enzymes, growth factors, minerals and vitamins.
Cucumber Tomato Salad Recipe — This cucumber tomato salad recipe is packed full of healthy nutrients. It’s high in silica, which is great for healthy hair, skin and nails.

Potential Concerns and Interactions of Cucumbers

Cucumbers seem to be a pretty harmless vegetable and very rarely cause allergies. As mentioned earlier, just buy organic (ideally unwaxed) cukes whenever you can to avoid high levels of chemicals.

Another thing to consider is the potential for contamination if you make your own fermented pickles. Complex microbiota are responsible for the changes observed during cucumber fermentation, and it’s possible that if your equipment or jar is contaminated with bacteria, you can become sick once eating them. Use sterile equipment whenever fermenting veggies, and buy organic produce to further limit this risk.

Dr. Axe is a Certified Nutrition Specialist, expert in Natural Medicine, a speaker for Fortune 500 Companies (Nissan, Whole Foods) and a doctor of chiropractic.
draxe.com
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