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Type 2 diabetes, formerly known as adult-onset diabetes, is on the rise for adults and children in the United States. Although genetics play a role, you can take steps today to lower your risk of developing this life-altering condition. Michael Raymund Gonzales, MD with Renown Endocrinology answered our questions about Type 2 diabetes and gave us some useful tips for prevention. What effect does diabetes have on the body? And who’s most at risk? First, it’s important to know the difference between the two most common types of diabetes: Type 1 diabetes is the result of the body’s inability to make insulin, which is a hormone your body needs to be able to use sugar, or glucose, for energy. Type 1 is not preventable, and people who have it were either born with it or they developed it later in life due to an autoimmune process that attacked the pancreas that went unrecognized. Type 2 diabetes occurs when the body makes the insulin hormone, but it might not make enough or work well enough for the body to use sugar for energy. This is called insulin resistance. This condition usually develops later in life but is preventable with proper diet, exercise and weight loss. However, due to the obesity epidemic, type 2 diabetes is occurring more often in younger individuals.  Diabetes hurts the body’s ability to break down glucose, so rather than it being used for energy, glucose stays in the bloodstream, which can cause problems. But with early detection and the help of your doctor, diabetes can be managed so that complications are avoided. Left unmanaged, however, diabetes can affect major organs and lead to heart and blood vessel disease, nerve damage, kidney damage, eye damage, skin conditions and more. Type 2 diabetes also results from risk factors that you can’t control, including your family history, race and age. However, there are a few risk factors that you can watch out for, such as being overweight, inactivity, diet choices, having high blood pressure and high cholesterol and triglycerides.

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Cost-saving isn’t the only reason to enroll in a Medicare Advantage Plan. One of the main reasons Medicare beneficiaries in Nevada join a Senior Care Plus Medicare Advantage Plan is for the care coordination services. The Senior Care Plus Care Coordination team helps members navigate what can be a complex healthcare system. Care coordination is a popular and extremely important service for members because keeping members healthy is the number one goal. One way they help reach this goal is to encourage members to participate in a no-cost, comprehensive health assessment. At this Quick Start Health Assessment, members meet with a geriatric specialist – a provider who specializes in the care of seniors – to discuss the 4 Ms: Mentation – Thinking, memory and mental health Medications – Understanding your medication Mobility – Staying physically active What Matters to You – Let your provider know what is important to you – examples could be family, health and independence The results of this detailed visit are then shared with the member’s primary care provider, so a customized care plan can be developed. This is a free service for Senior Care Plus members, along with an annual wellness visit and an annual physical exam. Care Team Approach – Laying the Foundation to Improve Health Health assessments and annual visits are offered so Renown Health providers can build relationships to improve care. This approach, also known as the Building Relationships to Improve Care or BRIC Model, is the care model used across Renown Health. “What’s special about this care model is that it really puts our patients at the center of their care,” says Savannah Gonsalves, a registered nurse with Senior Care Plus. “Members have their providers and nurses, Senior Care Plus personal assistants, case managers, and within the BRIC Model, they’re all talking to one another and putting the focus on the patient to meet needs.” Personal Assistants – A Unique Connection to Each Member A team of personal assistants is available to help members coordinate care by: Scheduling a member’s appointments Answering a member’s benefits questions Helping navigate care – these are experts in both health insurance and healthcare Answering questions about medications Working with providers to coordinate a member’s care The Senior Care Plus personal assistants are one of the most popular services that the Medicare Advantage plan offers. Each personal assistant has a direct phone line so members can call them to ask questions. “After my hip surgery my personal assistant, Megan checked in on me every day,” recalls Janelle, a Senior Care Plus member. “She made sure that I was doing alright and that I didn’t need anything. She just let me know that she was there for me.” To Learn More Senior Care Plus is the largest Medicare Advantage Plan in northern Nevada. They offer $0 plans with low co-pays with access to Renown Health and Teladoc Virtual Visits that cover you nationwide. To learn more about Medicare Advantage plans and to see if you qualify, visit SeniorCarePlus.com or call 775-982-3158 to speak to an enrollment specialist.

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With more than 29 million adult Americans having high cholesterol, it’s important to know the facts. We asked Jayson Morgan, MD, a cardiologist with Renown Institute for Heart and Vascular Health, explains the numbers, the risk factors and how to maintain healthy levels. What is cholesterol? There are two types: Low-density lipoprotein (LDL) cholesterol, also known as the “bad” variety, because it can eventually build up within the walls of your blood vessels and narrow the passageways. High-density lipoprotein (HDL), also known as the “good” variety, because it helps remove other forms of cholesterol from the bloodstream. In adults, total cholesterol is considered high if it is more than 200 mg/dL. If the total is more than 200 or if high-density lipoprotein (HDL) levels are less than 40, your heart and brain may not be getting as much oxygen-rich blood as they need. This puts you at greater risk of heart attack and stroke. HDL levels greater than 60 mg/dL can actually lower your risk. What are the risk factors for high levels? Diet high in saturated fat Excess body weight Lack of exercise Smoking Family history Age (as people age, they are more prone to high levels) How often should someone get their numbers checked, and what kind of test is done? The American Heart Association recommends all adults age 20 or older have their cholesterol checked every four to six years. Those with cardiovascular disease or who are at higher risk of it may need their levels and other risk factors assessed more often. Your primary care provider can perform the test, along with assessing your other risk factors to help determine a treatment plan if necessary. The test will likely be one you will need to fast for, meaning no food, beverages or medications for around nine to 12 hours. Your healthcare provider will let you know if, and for how long, to fast. A simple blood test is all that’s needed to get your levels. What are some ways to lower “bad” cholesterol and raise “good” cholesterol? To achieve healthier levels, people should: Eat a heart-healthy diet: Choose healthier fats, eliminate trans fats, eat foods rich in omega-3 fatty acids and increase soluble fiber. Increase physical activity: Exercise on most days of the week. Quit smoking: If you smoke, it’s time to stop. Quitting smoking will improve HDL “good” cholesterol levels. Lose weight: Losing as little as five to 10 percent of your weight can improve cholesterol levels. Drink alcohol only in moderation. And finally, if lifestyle changes aren’t enough, your care provider might recommend medication to help lower your numbers. Renown Institute for Heart & Vascular Health For optimal heart health, the American Heart Association encourages you to “Know Your Numbers” which include: blood pressure, body mass index (BMI), cholesterol and fasting blood sugar, by scheduling a visit with your doctor. These numbers are critical in assessing your current risk for heart disease and stroke. Find a Cardiologist

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Maintaining a healthy weight has many benefits: among those is improved heart health. If you’re trying to eat right as well as become healthier, nutrition experts say you might want to consider a plant-based diet. Plants provide air to breathe, beauty in our surroundings — and just may be a viable solution to your weight-loss goals. According to the Centers for Disease Control and Prevention, more Americans than ever are overweight: Today, 7 in 10 Americans are classified as “obese” or “overweight,” and childhood obesity rates are growing rapidly. So experts encourage would-be dieters to look to plants as a source of daily inspiration. “When you slowly and consistently expand your daily food choices to include more plant-based options, you will feel fuller, have more energy and lose weight,” says Lynice Anderson, director of Renown’s Healthy Heart Program. But according to a recent study from the U.S. Centers for Disease Control and Prevention, just 1 in 10 adults eats enough vegetables and only 12 percent get the recommended amount of fruit daily. The same study notes that eating a diet rich in fruits and vegetables daily can help reduce the risk of many leading causes of illness and death, including heart disease, type 2 diabetes, some cancers and obesity. Plant Foods = Foods with Fiber One of the overwhelming health benefits of plant-based foods: fiber. A study published in a recent issue of the Annals of Internal Medicine suggests that something as simple as aiming to eat 30 grams of fiber each day can help you lose weight, lower your blood pressure and improve your body’s response to insulin just as effectively as a more complicated diet. Fiber contains no calories and comes in two forms: soluble, which dissolves in water, and insoluble, which doesn’t dissolve. Both are important for different reasons. The soluble fiber found in oats, fruits and beans forms a gel-like substance and helps to lower blood cholesterol and blood sugar levels. Insoluble fiber found in fruit skins, green beans and cauliflower goes through your intestines relatively intact providing “bulk” and improving bowel-related health problems. “My fiber champion is chickpeas, also known as garbanzo beans,” says Renown Chef Chris Wyatt. “They are high in fiber, low in fat, low sodium and have zero cholesterol. Not only do they not contain any cholesterol, chickpeas work to remove cholesterol from your body. It’s a win-win.” Snacks That Are Part of a Plant-Based Diet Looking for the best sources of fiber from the plants and trees in your life? Here are the best options, according to this CDC fact sheet: Fruits Raspberries, 1 cup: 8.0 grams of fiber Pear, with skin, 1 medium: 5.5 grams of fiber Apple, with skin, 1 medium: 4.4 grams of fiber Strawberries (halved), 1 1⁄4 cup: 3.8 grams of fiber Banana, 1 medium: 3.1 grams of fiber Orange, 1 medium: 3.1 grams of fiber Veggies Artichoke, cooked, 1 medium: 10.3 grams of fiber Peas, cooked, 1 cup: 8.8 grams of fiber Broccoli, boiled, 1 cup: 5.1 grams of fiber Turnip greens, boiled, 1 cup: 5.0 grams of fiber Sweet corn, cooked, 1 cup: 4.2 grams of fiber Brussels sprouts, cooked, 1 cup: 4.1 grams of fiber Potato; with skin, baked, 1 medium: 2.9 grams of fiber Carrot, raw, 1 medium: 1.7 grams of fiber Renown Health Improvement Programs | Appointments: 775-982-5073  Renown Health offers a number of educational and support programs to help people overcome the challenges presented through various health conditions and to aid in creating and adopting a healthy lifestyle. To get an assessment of your dietary needs, schedule a consultation with one of Renown’s registered dietitians, who can help with: Diabetes Programs Medical Weight Management Nutrition Programs Make an Appointment

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