Borderline diabetes, also called prediabetes, is a condition that develops before someone gets type 2 diabetes. It’s also known as impaired fasting glucose or glucose intolerance. It basically means your blood sugar levels are higher than normal, but they’re not quite high enough to be considered diabetes.

During the prediabetes phase, your pancreas usually still produces enough insulin in response to ingested carbohydrates. The insulin is less effective at removing the sugar from the bloodstream, though, so your blood sugar remains high. This condition is called insulin resistance.

If you have prediabetes, you should know you’re not alone. In 2015, it was estimated that 84.1 million people age 18 and older had the condition. That’s 1 in 3 Americans.

Having prediabetes doesn’t mean you’ll definitely develop diabetes. It is a warning of what could lie ahead, however. People with prediabetes have a 5 to 15-fold higher risk for type 2 diabetes than someone with normal blood sugar levels. Those chances increase if you don’t make any healthy changes to your diet or activity habits.

Early warning signs:
“Prediabetes is not pre-problem,” says Jill Weisenberger, MS, RD, CDE, and author of “Diabetes Weight Loss Week by Week.”

Someone with insulin resistance in its early stages can develop type 2 diabetes if it continues long enough. Only 10 percent of people with prediabetes even know they have it because they don’t display any symptoms.

“Often, people consider these symptoms part of their normal day, so they’re ignored,” says Toby Smithson, RDN, CDE, a spokesperson for the Academy of Nutrition and Dietetics and co-author of “Diabetes Meal Planning and Nutrition for Dummies.”

Borderline diabetes risk factors:
 Any of these risk factors can increase your chances of developing prediabetes:
•being overweight or obese
•being inactive
•high blood pressure
•high cholesterol
•having a close family member with type 2 diabetes
•giving birth to a baby weighing more than 9 pounds

Determining if you have borderline diabetes:
Prediabetes can be a silent condition, so getting a regular wellness checkup is important for early detection. If you think you might have borderline diabetes, discuss your concerns with your doctor.

If your doctor is concerned you may have prediabetes, they’ll most likely perform a hemoglobin A1c (HbA1c) test or an oral glucose tolerance test (OGTT).  HbA1c is an indicator of your blood sugar patterns over the last two to three months, so it’s often a better overall picture than a single fasting blood sugar check. An HbA1c level between 5.7 and 6.4 indicates prediabetes.

By Dr. David Brownstein

Potassium is a major intracellular cation — a positively charged ion. The average human body contains 245 grams of potassium, about 95 percent of which is found inside cells.  Potassium is found in a variety of foods, including:

1. Avocados
2. Bananas
3. Cantaloupe
4. Leafy green vegetables
5. Mango
6. Melon
7. Papaya
8. Prunes
9. Winter squash
10. Yams

Nuts, legumes, seeds, and peanut butter are also good sources, and dairy products may contain some potassium. More than 85 percent of the potassium in food is absorbed.  Potassium is necessary for the contraction of smooth muscles as well as skeletal and cardiac muscle.

It helps increase the excitability of nerve tissue, and is also important for regulating electrolyte and pH balance.  In addition, potassium also helps regulate the adrenal hormones, particularly aldosterone.  Much like the other electrolytes, I have found that a vast majority of my patients are deficient in potassium.

The reference range for potassium is 3.5 to 5.3 mmol/L. However, the optimal range is from 4.5 to 5.0 mmol/L.  This reference range is drawn from the serum, meaning that it is a measure of extracellular potassium. But remember, most potassium is found inside the cells. 

To better assess potassium levels, I suggest getting a measure of red blood cell potassium. The range for red blood cell potassium is 90 to 111 mmol/L with an optimal level greater than 100 mmol/L.

Patients taking diuretics are often deficient in potassium, and are frequently prescribed potassium pills with the diuretic medication.  Potassium deficiencies can also be common in patients who suffer with diarrhea or very loose stools.  Too much potassium can occur in patients with kidney failure and result in arrhythmias that can lead to death.

http://www.newsmax.com/Health/DavidBrownsteinMD/red-blood-cells-potassium-arrhythmias/2017/10/31/id/823246/

Dr. David Brownstein Bio

APS Pharmacy makes no claims of efficacy.  Always consult your physician for medical advice.

Is peanut butter good for you? Is almond butter better? I get these questions from my clients all the time, mostly because there’s a lot of different and conflicting information out there. For quite some time, peanuts have been tossed aside by many health and wellness enthusiasts and experts—partially, I think, because traditional peanut butter for decades has been laden with trans fats and added sugar (yep, that partially or fully hydrogenated oil on the label of your peanut butter—those are trans fats). However, there are other reasons that health experts and enthusiasts might suggest that you try almond butter over peanut butter, and there are also a few reasons that peanut butter may be your best choice, too.

Here's what you need to know:

1. Peanuts aren't actually a nut.

Peanuts belong to the legume family and for many of my clients, legumes are a major issue for easy digestion (other members of the legume family include chickpeas, soybeans, lentils, and peas, to name a few).  Because peanuts are a member of the legume family, many with bloating and gas issues from other legumes may also experience the same with peanuts and peanut products. For these people, almonds and other tree nuts (cashews, walnuts included) may be a better choice.

2. Peanuts can be a source of mold and other fungi.

Peanuts (and many other nuts in general) can be a host for mold and other fungi as well as bacteria. The worst type of mold that peanuts may carry, aflatoxin, is a carcinogen and can even be deadly in large quantities; the good news is the USDA does offer some regulation and controls for peanuts having more than 20 parts per million and inspects for obvious mold (though it's not perfect, it does help). It seems that peanuts grown in warmer parts of the country may be more risky, and it also seems that dry roasting (without the shell) may help to somewhat reduce risk of bacteria and molds on the nuts. Though large companies that produce peanuts and peanut products seem to have the least toxicity (JIF, Skippy, etc.), there are negatives to these ones as well (primarily, the high trans-fat content and added sugars). Avoiding the DIY peanut butter station at the local grocery can help as often these machines are not cleaned and may be more of a source for aflatoxin and other similar ones. There can also be traces of other molds and fungi that can cause sensitivities, making peanuts cause an allergy-like response (even in people who aren't technically allergic). Always buy organic, and store your nuts (even non-peanuts) in the fridge so no further mold forms.

3. For some, peanut butter is much easier to tolerate than other nuts.

Many of my clients with tummy troubles, like gassiness and bloating, actually find that sometimes peanuts are easier to tolerate. If you’ve traditionally had trouble stomaching almond butter, you may want to try peanuts/peanut butter. But be mindful of volume—start small and, of course, buy organic.

4. Peanuts are a low FODMAP food.

Though almonds and other tree nuts are also low FODMAP in small quantities (less than 10), peanuts have a larger portion size on the FODMAP diet (a count of about 32), so can make for a better and more satisfying snack with better tolerance in some cases. The key, though, is watching your portioning. Less is always more!

The conclusion?

I like both peanuts and tree nuts (like almonds), in small quantities of course. I interchangeably use them in recipes and on my oatmeal and in smoothies personally. But no matter what nut or nut butter I buy, it’s always organic, and I always keep my nuts and nut butters in the fridge, too, to prevent the delicate fats from turning rancid—especially if I’m not going to be using them super quickly.

If you’re unsure which is better for you (and you know you don't have anaphylaxis to any nuts), try small amounts (less than one tablespoon) of each and see which agrees with you better. Sometimes it’s about total volume consumed, but trying small amounts can help you identify which works better.

 By Isabel Smith, R.D.,CDN 

https://www.mindbodygreen.com/articles/is-peanut-butter-bad-for-you