DrRubin.Com - Endocrinologist and Author of Dummies(tm) Medical Series - Article

Diagnosis of High Blood Pressure

Fri, 06 Apr 2007 19:37:08 -0700

Do I have High Blood Pressure?

When you or your doctor takes your blood pressure, two numbers are generated, a larger number, the systolic blood pressure (SBP), and a smaller number, the diastolic blood pressure (DBP), written as SBP/DBP or 120/80, for example. How do you know if yours is too high? The numbers have been clearly defined. These are the various categories that you might fall into. Remember that you should use the higher category to determine your particular level. For example, if you have normal systolic blood pressure but a diastolic blood pressure that puts you at stage 1 high blood pressure (HBP), you are considered to have stage 1 high blood pressure.

Diagnosis of Diabetes

Fri, 06 Apr 2007 19:06:07 -0700

Do I have Diabetes?

Diabetes is very clearly defined by the level of the blood sugar, which is actually called glucose. These are the criteria for making a diagnosis of diabetes:

If your plasma (the liquid part of the blood) glucose in the fasting state (you have not eaten since dinner the night before) is 126 milligrams per deciliter (mg/dl) or higher on two different occasions, you have diabetes. Using the International System of measurement, that would be 7 millimoles per liter (mmol/L).
Alternately, if your casual plasma glucose (you have eaten normally prior to being tested) is greater than 200 mg/dl (11.1 mmol/L) on two separate occasions, you have diabetes.

Aging Well

Fri, 06 Apr 2007 18:45:43 -0700

A podcast on this topic is also available. Here is the link:

http://www.drrubin.com/podcasts/Healthcast_001-Aging_Well

What are the things that should be in place by age 50 that predict that you will be alive and well at age 80 and beyond?

A major study from Harvard Medical School attempted to answer this question by following three groups of people beginning in the year 1910 and continuing through the 20th century. The results are discussed in the book, "Aging Well: Surprising Guideposts to a Happier Life from the Landmark Harvard Study of Adult Development" by George Valliant.

The Body Mass Index

Fri, 06 Apr 2007 19:01:22 -0700

The body mass index or BMI is a number that correlates your weight with your height. It is valuable because a person who is 150 pounds in
weight 62 inches tall is overweight, while a person who is 150 pounds in weight and 70 inches tall is normal. To calculate the BMI:

1) Multiply your weight in pounds by 703
2) Take that result and divide it by your height in inches
3) Take that result and divide it again by your height in inches

Using these formulas, the 62 inch tall person has a BMI of 27.4 while the 70 inch person has a BMI of 21.5.

A BMI of 20 to 25 is normal. A BMI of over 25 to 30 is overweight. A BMI of over 30 is obese.

Treatment of Hypothyroidism

Fri, 06 Apr 2007 19:51:42 -0700

Hypothyroidism means your thyroid gland is not making enough thyroid hormone for your body's needs. Most of the hormone coming out of the thyroid is thyroxine (T4) and a much smaller amount of tri-iodothyronine (T3). The vast majority of patients will do fine given just T4 since the body can convert T4 into T3 to make up for missing T3. You take enough T4 to reduce the thyroid stimulating hormone (TSH) level to normal. Changes in the level of T4 you take are checked with blood tests no more often than every 4 weeks.

The available preparations of T4 are:

Levoxyl, a brand name for thyroxine.

Treatment of Hyperthyroidism

Fri, 06 Apr 2007 19:51:30 -0700

The idea in treating hyperthyroidism is to reduce the amount of thyroid hormone in the blood to normal. There are three main ways of doing this:

Antithyroid drugs include tapazole and propylthiouricil. These block the production of thyroid hormone and reduce the autoimmune reaction that is taking place. You usually have to stay on the drug for at least a year. They can cause a reduction in white blood cells, making you more prone to infections.
Radioactive iodine (RAI) will concentrate in the thyroid gland and gradually destroy thyroid cells. Unfortunately it is not possible to know exactly how much RAI to give to just destroy enough cells to reduce thyroid hormone production to normal so most people end up with low thyroid function and have to take a pill for the rest of their lives.

Aspirin and Diabetes

Fri, 06 Apr 2007 19:09:17 -0700

If five people with diabetes read this article, chances are good that four of them will not be taking low dose aspirin to prevent heart attacks, even though it has been shown, conclusively, to do this. Aspirin makes the blood less apt to clot and cause a blockage of the arteries of the heart.

Just about every diabetic is a candidate for aspirin treatment. Diabetics benefit more than those who do not have the disease because having diabetes puts you at risk of a heart attack.

You should take between 81 and 325 milligrams daily unless you have one of the following conditions:

Ten Commandments For Excellent Diabetes Care

Sat, 07 Apr 2007 09:40:08 -0700

Follow these recommendations and you will not only avoid complications of diabetes but you will be healthier than your friends without diabetes.

Major monitoring: Make sure your doctor orders hemoglobin A1c tests, lipid profiles, and urine microalbuminuria tests at appropriate intervals
Devout dieting: Keep your calories down so your body mass index is between 20 and 25
Tenacious testing: Test your blood glucose at least four times daily if you have type 1 and twice daily with type 2 diabetes
Enthusiastic exercising: Do 30 minutes of exercise at least 5 times a week

Alcohol and Weight

Fri, 06 Apr 2007 18:48:37 -0700

In the last few weeks, I have had several new patients who came in complaining of weight gain despite not eating excessively. Over the years I have seen many similar patients. When I take a history, I often find that these patients are consuming excessive amounts of alcohol every night. These patients do not realize the calorie contribution of alcohol.

This is explained in my book, Diabetes For Dummies, but it is worth emphasizing. Alcohol has calories and you have to account for it in your diet.

The proof of the alcohol is the percent of alcohol in an ounce of the drink times 2. Wine usually contains 12.5% alcohol so it is 25 proof. Beer is usually 12 proof. Liquor is often 80 proof.

How low should my cholesterol be?

Fri, 06 Apr 2007 18:56:51 -0700

When it comes to cholesterol, except for the form called High Density Cholesterol or HDL (also known as "good cholesterol"), the lower the better. This is especially true of Low Density Cholesterol or LDL (also known as "bad cholesterol"). It was thought that an LDL of less than 100 milligrams per deciliter (mg/dl) was the goal but recent studies show that people who achieve an LDL of 70 mg/dl after a heart attack are at much lower risk of a second heart attack than those at an LDL of 100. The good news is that these goals can be achieved by anyone using modern treatments.

To calculate your 10-year risk of a heart attack (needed in the chart below), go to: