Q: I have Type 2 diabetes and am having trouble getting my A1cs to stay below 7%. I exercise, eat pretty wisely and take my medication. What else can I try? — Elsie R.,Weehawken, New Jersey A: It can be a challenge to effectively control or reverse Type 2 diabetes, but it’s doable and aiming for an A1c of 6.5% is a great goal. Diet, of course, matters enormously — and eliminating highly processed foods is step number one. Then upping your fruit, vegetable and 100% whole grain intake is next. A few cups of coffee daily help, too. Daily physical activity, along with your meds, is also essential. Plus, there are some quirky approaches that you might adopt that could make all the difference.
Mind-body practices like meditation, Qigong, yoga and mindfulness-based stress reduction help control blood sugar levels, according to a study from the Keck School of Medicine of USC. Yoga, for example brought down A1cs by 1% — and while that might seem slim, metformin, the most commonly taken medication for Type 1 diabetes, reduces A1cs by an average of 1.1%. And, more yoga, more reduction. So add it and/or another mind-body practice to your weekly routine.
Another unexpected method: Combating loneliness. A study found that loneliness doubles the risk of developing diabetes — perhaps because of associated sedentary habits and comfort eating, depression, insomnia and elevated levels of the stress hormone cortisol, which promotes insulin resistance.Whatever the cause, the same triggers can persist post-diagnosis, worsening outcomes. I suggest trying to increase connections with friends and family, volunteering in a local charity, joining a hobby-club and/or taking yoga classes.
One more tip. A four-year study looked at three groups of people with Type 2 diabetes taking metformin plus insulin-boosting sitagliptin, liraglutide, or glimepiride and a fourth group taking metformin and long-acting insulin glargine U-100. Insulin glargine and liraglutide performed the best of four medications. Ask your doctor if medication changes might be beneficial for you.
*** Q: I want to boost my good HDL cholesterol level. I’ve lowered the lousy one LDL — with a statin. What do you suggest? — Frank J., Iowa City, Iowa A: HDL is a complex blood fat that shows up in a family of particles that contain lipids, cholesterol and proteins called apolipoproteins. These various HDL particles do different things: Some remove LDL from the blood and vessel walls and shuttle it to the liver for a fast exit from the body. Other forms of HDL don’t pay any attention to LDL and some even transfer cholesterol the wrong way — into particles of LDL. That’s why everyone focuses on lowering LDL and apolipoprotein B, instead of raising HDL. (Statins taken to lower LDL and apolipoprotein B don’t do much to improve HDL.)
So what causes low HDL levels? Beta blockers, anabolic steroids, progestins, and benzodiazepines, like Valium and Xanax, can depress them. So can being overweight and smoking. Fortunately, there are several lifestyle choices, in addition to quitting smoking and maintaining a healthy weight, that boost HDL to heart-loving levels.Give these three a try.
— A lower carb diet (less than 50 grams a day) that’s high in unsaturated fats and low in saturated fat raises HDL twice as much as a high carb diet does, according to a study in the American Journal of Clinical Nutrition. Fifty grams of carbs equals 4 cups of cherry tomatoes, two large zucchini, and three large red peppers or a bowl of plain oatmeal and two slices of whole wheat bread.
— Extra virgin olive oil is also an HDL booster according to a 2006 study in the Annals of Internal Medicine. And purple foods such as eggplant, black plums, black and red grapes, black beans, radishes, contain powerful antioxidants called anthocyanins in their colorful pigment that may raise HDL.
— Strength training, high-intensity interval training and aerobics are all beneficial as well. (Best to do each of them over the course of a week and keep it up).
Health pioneer Michael Roizen, M.D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers. His next book is “The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow.” Do you have a topic Dr. Mike should cover in a future column? If so, please email questions@Great-AgeReboot.com.


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