The Sentinel: Diabetes

Health & Wellness |
Ask your healthcare provider if a CT calcium screen is right for you

by Tim Ditman
OSF Healthcare

Ash Al-Dadah, MD

URBANA - Here’s something new to bring up the next time you visit your health care provider: Should I undergo a CT calcium score screen to take stock of my heart health? It’s not for everybody, but it could mean the difference between a long, healthy life and finding yourself on an operating table.

“The number one killer in the United States is heart disease,” says Ash Al-Dadah, MD, an interventional cardiologist at OSF HealthCare. “We have to do a better job.

“This calcium scoring is a screening where we may say ‘Hey, you need to exercise more’ or ‘Hey, we just found out you have high blood pressure. Let’s control that.’ or ‘Hey, you’re a smoker. Maybe you need to quit that,’” he adds. “We go after the risk factors that precipitate and lead to heart disease. It’s a wake-up call. Getting ahead of things so you’re not coming in with a heart attack and damage to the heart muscle. At that point, it’s too late.”

The screening

Dr. Al-Dadah says the 15-minute or so, non-invasive procedure is similar to other CT [computed tomography] scans. “A fancy X-ray,” he calls it. You lie down, and a doughnut-looking device surrounds you and takes pictures of your heart.

“The arteries in our heart are supposed to be flesh and appear gray [on the imaging]. As we roll the body through the scan, we want to see all gray,” Dr. Al-Dadah explains. “But if there’s hardening and plaque formation in the arteries, it will light up as white. That’s because plaque as it ages forms calcification. There are calcium deposits.”

You could be told you’re at low, medium or high risk. Or, providers may look at the results based on your age compared to the typical amount of plaque found in a person of that age.

Put simply: “It’s one way to measure risk for heart disease,” Dr. Al-Dadah says. “The most common heart disease is blocked arteries, leading to a risk for heart attacks and other issues.”Cardiologists and radiologists have a scoring system based on how much plaque is found.

Next steps

Dr. Al-Dadah says if your screen comes back with red flags, you’ll want to see a cardiologist to discuss next steps. That could mean more tests, especially if you have daily symptoms like chest pain or shortness of breath:

A stress test, where you walk and run on a treadmill while providers see how your heart functions.
A coronary angiogram, which provides more comprehensive images of your arteries.
Or, a provider could recommend you get another CT calcium screen in a few years.

Plaque in heart

Other treatment options for milder cases: “Even if your cholesterol level is normal, I could still put you on a medication class called statins. Statins reduce plaque thickness. They stabilize the plaque and reduce the risk for heart attack,” Dr. Al-Dadah outlines.

“I could put you on aspirin. Aspirin will dramatically reduce the risk for a heart attack if you have significant plaque,” he adds.

One other outcome of note: Though rare, Dr. Al-Dadah says your CT calcium screen could come back OK, but you could still have a heart issue soon after. No screening is a silver bullet to keep you 100% healthy, in other words. That’s why it’s important to follow your provider’s recommendations and practice healthy habits, like eating a balanced diet, exercising and ditching the cigarettes.

For me?

Who is this screening intended for? Dr. Al-Dadah says it’s often done on people aged 40 to 65 or people with a family history of heart disease. But, anyone can and should ask their provider about it.

“If you’re 75 and have diabetes,” for example, Dr. Al-Dadah says. “You’re going to have a lot of calcification in the arteries. But it does not signify blockages. It’s just hardening of the arteries that comes with age. But if you’re younger and have that calcification, that’s a marker for risk of heart disease and heart attack.”

10 Health recommendations for the new year

Ready to quit smoking in 2025? Ask your doctor for resources and guidance for quitting tobacco and nicotine.

Photo: Lil Artsy/PEXELS

StatePoint - Looking to improve your health in 2025 and beyond? Check out these recommendations from the American Medical Association:

Make nutritional tweaks: Reduce your intake of sugar-sweetened beverages and processed foods, especially those with added sodium and sugar. Drinking sugary beverages, even 100% fruit juices, is associated with a higher mortality risk, according to a study published in JAMA Network Open. Drink water and choose nutritious, whole foods including fruits, vegetables, whole grains, nuts and seeds, low-fat dairy products, and lean meats and poultry.

Get active: A recent study published in JAMA found that putting down the TV remote and going for a walk can improve healthy aging—highlighting the importance of small everyday habits. Adults should get at least 150 minutes a week of moderate-intensity activity, or 75 minutes a week of vigorous-intensity activity.

Get up-to-date: Get your vaccines in advance of respiratory virus season—including the annual flu vaccine and the updated 2024-2025 COVID-19 vaccine for everyone six months and older, as well as pregnant people. People 65 and older and those who are moderately or severely immunocompromised should receive a second dose of the 2024-2025 COVID-19 vaccine six months later.

RSV can be dangerous for older adults. The Centers for Disease Control and Prevention recommend those 75 and older, and 60 and older at high risk for severe RSV, get vaccinated. Immunizations are also available to protect babies from getting very sick from RSV. This is important because RSV is the leading cause of infant hospitalization nationwide.

If you have questions, speak with your physician and review trusted resources, including GetMyFluShot.org. You can also reduce the spread of respiratory viruses by covering coughs and sneezes, frequently washing your hands, wearing masks, improving air quality, and staying home if you are sick.

Get screened: Make an appointment for preventive care, tests and screenings to help your doctor spot certain conditions before they become more serious.

Know your blood pressure numbers: Visit ManageYourBP.org to understand your blood pressure numbers and take necessary steps to get hypertension under control. Doing so will reduce your risk of heart attack and stroke. If checking your blood pressure at home, visit ValidateBP.org to see if your device has been tested for accuracy.

Learn your type 2 diabetes risk: Take a 2-minute self-screening test at DoIHavePrediabetes.org. Steps you take now can help prevent or delay the onset of type 2 diabetes, which carries a higher risk of heart disease, kidney disease and vision loss.

Drink only in moderation: If consuming alcohol, do so in moderation as defined by the U.S. Dietary Guidelines for Americans—up to one drink per day for women and two drinks per day for men, and only by adults of legal drinking age.

Quit tobacco and nicotine: Ask your doctor for resources and guidance for quitting tobacco and nicotine. Declare your home and car smoke-free to eliminate secondhand smoke exposure.

Follow dosage instructions: When taking prescription opioids or other medications, store them safely to prevent diversion or misuse, and properly dispose of any leftover medication. If you’re prescribed antibiotics, take the full course to prevent antibiotic resistance—a serious public health problem.

Manage stress: Good mental health is part of good overall health. Get sufficient sleep (at least 7.5 hours per night), exercise and ask for help from a mental health professional when you need it.

More health resources and tips can be found by visiting ama-assn.org.

“The best way to address the post-holiday doldrums is to do something good for your health,” said Bruce A. Scott, M.D., president of the AMA. “Even small, positive choices you make now can have a big impact on your long-term wellbeing.”

New Year - New Diet: Be wary of fad diets on social media

by Tim Ditman
OSF Healthcare

SAVOY - Among the New Year’s resolutions worldwide, many people have pledged to find and stick with a healthy diet. But there’s a lot more to it than just grabbing every “reduced fat” item off the grocery store shelf.

Karen Whitehorn, MD, an OSF HealthCare internal medicine physician, hears questions all the time about diets. Her first question back is usually: what do you want out of your diet? Do you want to be healthy? Lose weight? Manage a medical condition? Sort through the details, and you’ll find the best option.

Exploring the popular options

U.S. News and World Report each year consults a panel of medical and nutrition experts to rank the best diets. The Mediterranean diet topped the list. Dr. Whitehorn says this diet is based on the eating habits of people who live near the Mediterranean Sea. It’s a plant-based diet, incorporating fruits, vegetables, whole grains, brown rice and seafood.

An added benefit: recent research shows the Mediterranean diet could reduce dementia risk.

Dr. Karen Whitehorn
OSF HealthCare Internal Medicine

“The Mediterranean diet is actually pretty easy to follow. But you need to make sure you have the right food in your home,” Dr. Whitehorn says. “It might be a little more difficult during the winter to get fresh fruits and vegetables. If you can’t, frozen is OK. Canned is OK. But we recommend you rinse the canned food first to decease some of the salt.”

Number two on the U.S News list is a plan Dr. Whitehorn recommends often: dietary approaches to stop hypertension, or the DASH diet. It recommends foods that are low in sodium and high in magnesium and potassium.

Some people may incorporate fasting into their diet. Dr. Whitehorn says fasting, when done in consultation with a medical expert, can work. But she’s hesitant to recommend it broadly.

“Our bodies need nutrients every couple hours. So to not eat anything for 12 hours can cause other problems,” Dr. Whitehorn says. “If you’re diabetic and don’t eat for 12 hours, your blood sugar could drop too low. Then when you eat, it could go too high.”

Avoid misinformation and fads

Watch out for fad diets on social media, Dr. Whitehorn says. Remember the saying: if it’s too good to be true, it probably is.

“Fad diets are not consistent. They’re not healthy. They don’t provide you the nutrients you need. If it requires you to take a pill or drastically reduce your calories, it’s not really a healthy diet. It can only be followed in the short term.”

On the contrary, working out a diet plan with your health care provider has a better chance of achieving long term results.

“A healthy diet gives you the energy you need to do everyday activities,” Dr. Whitehorn says. “It has been shown to increase your life expectancy. And it helps prevent chronic medical problems like high blood pressure, diabetes, cancer and heart disease.”

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Multiple studies show diabetes medication may help with long COVID

by Terri Dee
Illinois News Connection

CHICAGO - COVID-19 cases do not make news headlines much anymore but many people who experienced it can have persistent symptoms long after the infection.

A new study reveals a prescription drug used for another chronic illness shows promising results in reducing COVID's aftereffects. Metformin is what doctors often prescribe for managing Type 2 diabetes. The study said taking Metformin within a week of the onset of COVID-19 symptoms showed a 53% lower risk of symptoms lasting longer-term.

Dr. Jacob Teitelbaum, internist and fibromyalgia specialist at Washington University in St. Louis, said the result of studies on 9 million people, with and without diabetes, revealed how the medication works.

"It turns out that Metformin acts like 'birth control' for COVID," Teitelbaum explained. "It suppresses the viral replication, keeps it from getting in cells, and basically, it's like the virus hits a red light."

According to the Centers for Disease Control and Prevention, Illinois is one of eight states where COVID infections are growing or likely growing. Some "long COVID" symptoms are dizziness, digestion problems, chest pain and thirst. Teitelbaum cautioned Metformin is not a cure for COVID and if taken in moderation, is safe and well tolerated.

A review published in Nature Medicine looks at the economics of using Metformin. It notes long COVID has affected more than 400 million people globally, costing $1 trillion a year, and suggested more than half of cases were preventable had Metformin been administered.

Teitelbaum pointed out the drug is inexpensive and he wants patients to take a more proactive role in their health.

"Doctors are just learning about it," Teitelbaum emphasized. "There's nobody paying to get this information to physicians, which (means) you're going to have to be the one as a patient to get this research to your doctor and to ask them. This is how doctors will hear about the studies."

The CDC has found American Indians and Alaska Natives are about 3.5 times more likely to experience long COVID. The likelihood for people who identify as Hispanic or Black is 2.5 times.

Too much Halloween sugar can lead to a scary future with diabetes

Photo: Denny Müller/Unsplash

KEWANEE - Halloween is here, and many Americans are looking forward to venturing out for Halloween festivities and trick-or-treating with kids. While the holiday is all in good fun, one aspect of Halloween that experts have warned about for years is the overconsumption of candy and other high-sugar sweets.

According to the American Heart Association, kids ages two to 18 should have less than 25 grams (or about six teaspoons) of added sugar daily. Eating too much added sugar at an early age is linked to high blood pressure, type 2 diabetes, obesity, and increased risk for heart disease. Sara Umphfleet, RD, LDN, is a registered dietitian at OSF HealthCare Saint Luke Medical Center in Kewanee, Illinois. She says some of our favorite treats are often harboring more sugar than we might expect.

“There is a sugar model I like to use. It talks about things like the amount of sugar in half a cup of Jell-O, for example – and there is a lot of sugar in Jell-O (about 16 grams). Same with the amount of sugar that is in something like just one Pop-Tart (about 14 grams), and you get two in a bag. A big one is soda which has a lot of extra added sugar in it (about 39 grams). And these aren’t natural sugars like from apples and oranges and bananas. These are sugars that are added. Hershey’s candy bars are another example with a lot of sugar (about 24 grams),” explains Umphfleet.

However, according to Fortune, the average child consumes about three cups of sugar on Halloween alone, which is about 144 teaspoons and nearly 27 times the recommended daily amount. Furthermore, every year Americans purchase nearly 600 million pounds of candy for Halloween festivities and trick-or-treaters.

If you haven’t bought Halloween candy yet this year, Umphfleet recommends an alternative route.

“I typically recommend offering things like bubbles or bouncy balls – some of those little trinkets you can find at the dollar store instead of giving candy out. You also think of food allergies and they are going to get candy from a lot of neighbors and friends – so try to do something different,” says Umphlfeet.

You do not need to completely forego the Halloween candy. But if you do let your kids indulge, Umphfleet recommends doing so in moderation, as too much sugar on even just one day can result in increased exhaustion and headaches – or a “sugar crash.”

“I recommend to give them a couple pieces of candy and then putting the rest away. They definitely don’t need to be eating all of the candy the night of Halloween. And then offer it usually in the afternoons rather than at night time when they are getting ready for bed and less active. You don’t want all of that sugar to sit in their gut,” Umphfleet explains.

It is also important to make sure your child is drinking enough fluids on Halloween in between the festivities and candy consumption – but make sure their beverage of choice is not full of sugar. When it comes to hydration, plain old fashioned water remains the best option.

“It is very important to stay hydrated and get those beverages in, but try to stick to the sugar-free beverages. Choose 100% fruit juice rather than juice that has 10% juice which has a lot of extra added sugar. Also look on food labels to avoid things with high fructose corn syrup, so things like soda,” advises Umphfleet.

While you don’t necessarily need to skip sugary treats altogether, Umphfleet emphasizes that you should not let your kids deter too far from their normal daily eating habits on Halloween. Enjoy a piece of candy or two, and spend some time over the holiday weekend enjoying other Halloween traditions as well, such as watching a Halloween movie, looking at local decorations, and carving pumpkins.

Diabetes is a silent killer because people tend to ignore symptoms

Photo: Sweet Life/Unsplash

by Shelli Dankoff
OSF Healthcare

Evergreen Park - During the winter months there is typically a spike in seasonal illnesses such as common colds, flu, and pneumonia. While there are tips and tricks forkeeping seasonal illnesses at bay, they are sometimes unavoidable. And for those with other health conditions a simple cold can be so much more than that.

According to the American Diabetes Association (ADA), when someone who has diabetes gets sick with things like colds or the flu, the illness and stress cause their body to release hormones that raise blood sugar (blood glucose) levels, making it harder to keep their blood sugar in their target range. The ADA adds that while having diabetes in and of itself does not necessarily make someone more likely to get a cold or the flu, it does raise the chances of getting seriously sick. Some people may not even know they have diabetes until a severe illness occurs.

“If you have poorly controlled or undiagnosed diabetes and develop symptoms of something like the flu, you will have increased risk factors of severe illness. I would encourage those people to get quickly examined at an urgent care or their primary physician,” says Mohammed Khan, M.D., an OSF HealthCare family medicine physician.

The National Institutes of Health (NIH) says that nearly a third of people with diabetes do not know they have it, and someone can go years before getting a diagnosis. The reason diabetes can fly under the radar is because the symptoms can be minor, especially early on.

“When patients have certain symptoms like more frequent urine and going to the restroom more often, losing weight, having lack of energy, having dry mouth, feeling thirsty and drinking more often, having recurrent infections like skin and urine infections – those are the things that indicate a screening for diabetes,” explains Dr. Khan.

He adds, “People who have diabetes sometimes ignore the symptoms and think they are not affected which is why it is a silent killer. The body is getting destroyed from the inside and many do not notice it unless you go to regular health exams or are screened for it. Diabetes is also one of the most common causes for chronic kidney disease. For a lot of people who develop problems like kidney failure or needing dialysis, the root cause for that most of the time is diabetes.”

Dr. Khan advises people who do have diabetes to keep it under control as best as possible, as well-controlled diabetes helps manage seasonal illnesses when they do occur. However, serious illness can still occur.

“With diabetes, your immune system goes down which is a risk factor. If you have diabetes, you want to make sure you are fully vaccinated and get the flu shot and are up to date on COVID vaccinations. If they are at a higher risk factor due to age and are in the age group to receive the pneumonia vaccination, we encourage get that as well, Dr. Khan advises.

The Centers for Disease Control and Prevention (CDC) recommends a pneumonia shot for anyone age two or older who, because of chronic health problems (such as diabetes) or age, has a greater chance of getting pneumonia, and urges all eligible individuals who are six months and older to get their annual flu shot.

If you have diabetes, have a kit on hand with the following items in it: A glucose meter, extra batteries, supplies for your insulin pump or continuous glucose monitor, ketone test strips, a week’s worth of glucose-lowering medication (but don’t store these longer than 30 days before use), glucose tabs or gels, and flu or cold medications that won’t disrupt your diabetes management.

If you do end up with a seasonal illness, keep track of your symptoms and let your primary doctor know if they get worse. If your symptoms become severe or unmanageable, go to the nearest urgent care or emergency department.

If you have not been diagnosed with diabetes but are exhibiting any possible signs and symptoms, make an appointment with your doctor.

New government act to limit the cost of insulin for people on Medicare starting in January

Last month was National Diabetes Awareness Month. With almost 1.3 million Illinoisans diagnosed with the disease, people with diabetes make up 10% of the population, and another 3.4 million people have prediabetes, according to the American Diabetes Association.