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November is National Diabetes Month, and with cases of the disease at an all-time high in the U.S., individuals must do everything they can to stay healthy. Learn more about diabetes prevention and also how to stop prediabetes in its tracks with these five helpful tips. Diabetes is a disease that is increasingly making its way into the public consciousness, and not in a good way. In fact, according to USA Today, diabetes has a greater health impact on Americans than heart disease, substance use disorder or COPD, with 30.3 million Americans diagnosed with the illness — and many more who are at risk for developing it. And those with prediabetes are at risk for developing type 2 diabetes in 10 years or less, according to the Mayo Clinic. The American Medical Association notes that 4 million U.S. adults have prediabetes. Check out the American Diabetes Association’s prediabetes risk test. The good news: There are ways to manage — and even reverse — prediabetes. Renown’s Certified Diabetes Educator Stephen Compston, RD, LD, CDE, shares five steps for managing blood sugar and also avoiding an eventual diagnosis. How to Prevent Diabetes Eat healthy foods. Plan meals that limit (not eliminate) foods that contain carbohydrates, which raise your blood sugar. Carbohydrates include starches, fruits, milk, yogurt, starchy vegetables (corn, peas, potatoes) and sweets. “Substitute more non-starchy vegetables into your meals to stay satisfied for fewer carbohydrates and calories,” Compston says. Exercise. Blood sugar is the body’s basic energy source. When you exercise, you are lowering your blood sugar. “People with prediabetes usually want to stay off of medication, so they must add something to their normal regimen that lowers blood sugar,” Compston says. “In this case, exercise is medicine.” Lose weight. A small decrease in your weight can drastically decrease your risk of developing diabetes in the future. The Diabetes Prevention Program study showed that a 7 percent decrease in body weight (14 pounds for a 200 pound person) can reduce a person’s risk of developing the disease by 58 percent. Get more rest. Studies link sleep issues to an increased risk of insulin resistance. It can also make it harder to lose weight. Thus, people that don’t get adequate sleep are at an increased risk for developing type 2 diabetes. See your doctor regularly. Schedule an appointment with your primary care provider at least once a year so you can track your health together. “A regular check-up and lab work can help identify what your blood sugars are doing so you and your doctor can develop a good plan for delaying the onset of diabetes,” Compston says.

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While there used to be three basic treatment options for cancer -- surgery, radiation and chemotherapy, or a combination of the three -- there's a fourth option: clinical trials. Here, a Renown patient shares her successful battle with ovarian cancer, aided by a clinical trial. Shari Flamm's battle with ovarian cancer began in 2011. She was experiencing prolonged bleeding, irregular thyroid levels and anemia and was scheduled to undergo a hysterectomy. Before the surgery, her gynecologist ran routine tests to check for cancer as a precautionary measure. All tests were negative for cancer, expect her CA 125 test. A CA 125 test measures the amount of the protein CA 125 (cancer antigen 125) in the blood. In some cases, a CA 125 test may be used to look for early signs of ovarian cancer in women with a very high risk of the disease. In most laboratories, the normal level is 0 to 35 units/ml. Flamm's CA 125 level was 121. As Flamm can attest, early diagnosis played a key role in her battle with ovarian cancer. September is Gynecologic Cancer and Ovarian Cancer Awareness Month – an important time to learn the signs, symptoms and risk factors of this type of cancer so your doctor can diagnosis the disease as early as possible. Ovarian Cancer: Round One Despite the elevated CA 125 results, her doctor recommended they move forward with the hysterectomy. But when surgery began, doctors discovered a mass. She had stage 4 cancer. The procedure was halted, the mass was biopsied and she was immediately seen by Dr. Peter Lim of the The Center of Hope. Following diagnosis, Flamm underwent surgery with Dr. Lim to remove the cancer, which had spread to part of diaphragm, spleen, colon and other organs. Three months after surgery, Flamm had recovered enough to start six rounds of chemotherapy in her hometown of Carson City. She continued working at a doctor's office during her treatment, and was grateful for Dr. Lim’s ability to co-manage her care so she could stay close to work and family. “To me, chemo was the scariest part because I didn’t like feeling sick,” Flamm says. Thankfully, her body responded well to the treatments and she was back to the things she loved. “I stated working out at the gym, even if it was only for 10 minutes,” she says. She also stayed positive by spending time with her grandchildren, attending a San Jose Sharks hockey game, going for walks and enjoying concerts. Ovarian Cancer: Round Two In November 2014, Flamm had a cancer check-up. That’s when doctors discovered three cancerous tumors. For this round, Flamm choose another treatment option -- clinical trials at Renown Institute for Cancer. Clinical trials are the studies that test whether drugs work, and inform doctors' decisions about how to treat their patients. Flamm participated in a clinical trial that featured oral-targeted therapy stronger than IV chemotherapy. The hope was for the drug to shrink her tumors, however the result was stabilization -- meaning the lumps weren’t growing or spreading. The best part of the clinical trial, Flamm says, was the constant monitoring. Between the CT scans every six weeks, a heart scan every three months and monthly doctor visits, she was confident that if the cancer started growing or spreading, her healthcare team would catch it right away. For Flamm, the benefits of the clinical trial included less hair loss, less fatigue and more time to focus on what’s important in her life -- her family. “I decided I wasn’t going to be that sick grandma on the couch with cancer,” Flamm says. After taking the oral medication for one year, Flamm developed a rash and discontinued treatment due to discomfort. Clinical Trials, Setbacks and Survival In June 2016, two of the three tumors began to grow and had to be surgically removed. Despite the setback, Flamm was determined to maintain a positive outlook. "You have to stay positive because cancer feeds off anger, depression and stress," Flamm says. Flamm was released to go home with clear margins, meaning the tumors were removed and are surrounded by a rim of normal tissue that does not have cancerous cells. Flamm says her outlook on life has changed drastically since her first cancer diagnosis. “Your whole mentality changes when cancer disturbs your life," Flann says. "The things that weren’t important, are now ever so important. I’m a lot calmer now,” Flamm says.

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