Observations On Diabetes from our Community Health Intern

Though difficult (since time and money are drastically lacking), One of our missions is to teach students who are interested in primary care the joy of developing a professional relationship with a patient and the power of detective work as we discuss with each patient the different possibilities of what is causing their health challenge.

To make sure no one is falling asleep or studying for physics exams while in the rooms I have requested that the students send in a paragraph of their learning. We also have a community health intern, Nora Provencal, who sees the world a bit differently than the pre-med students. We will present to you some of those student essays.

                                                                                  - Husna R. Baksh, MD

November is Diabetes Awareness month. Today we saw a diabetic 91 year old patient. This patient noticed her blood sugars fluctuating week by week and she was concerned about it. A clinical staff member stated that “blood sugars will fluctuate based on what you eat. If a patient eats out one week , then eats a lot of healthy foods and salad the following week, the blood sugar during the second week will show a significant decrease”. In an ideal world we would eat low glycemic index foods**which would help the sugar levels in our bodies stabilize (to prevent low or high blood sugar events).”
These changes in our blood sugar (glucose) levels can affect our blood vessels on a MICROvascular level (where oxygen is “fed” to the body) . When we have a multitude of such changes or a VERY high or VERY low blood sugar reading we may ultimately get MACROvascular changes (heart attack and strokes).
This is why Healthy Steps does the bike stress test (one of the few doctor’s offices in the area which focuses on this evaluation). The bike stress test looks at the ability of the body to use oxygen well during activity. As a matter of fact, athletes use this test to improve their ability to perform better during activity. This test can give Healthy Steps VERY early clues to MICROvascular disease so that they can PREVENT or DELAY the onset/worsening of MACROvascular disease such as Heart attack, strokes and their consequences (paralysis, blindness, inability to express yourself or understand others etc.). GO Healthy Steps!
                                                    -Nora Adjah- Provencal, Salisbury University, Community Health Intern
**Low Glycemic Foods are foods which the body digests slowly, resulting in a controlled rise in blood sugar levels versus High glycemic foods which lead to a rapid rise in blood sugar . Examples of high glycemic foods are white carbohydrates (cakes, pastries, rice, bread, sodas, fruit juices etc). Some types of low glycemic index foods are: leafy vegetables, legumes, sweet potatoes, whole grains etc.
Nora Adjah-Provencal Community Health Intern, Salisbury University

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