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Can you recommend a good renal/diabetic diet?
last updated:
Fri, 3/15/2013 4:25 PM

A Carbohydrate Consistent diet is the best for Diabetes.  

If you are on Dialysis and your labs levels are abnormal, then your Potassium, Sodium or Phosphorus may need to be restricted while your Protein needs to be increased. If you are not on Dialysis, your protein will need to be restricted with the possibility of Potassium, Sodium and Phosphorus to be restricted also--all while keeping the Carbohydrates consistent.

We recommend meeting with a dietitian to learn how to combine the Carbohydrate Consistent diet with the restricted diet that renal issues involve.

(Answer provided by Stacy Baumeister RD, LDN at Methodist University Hospital) 

Registered Dietitians can provide Medical Nutrition Therapy related to blood pressure, blood sugar, preventive care, gluten free needs and some GI disorders, food allergy, decreased kidney function, weight loss/gain and more.

Most insurances cover the cost of nutrition therapy at the request of your physician. Check with your insurance company to find out if your plan covers classes, and talk to your doctor about providing a written request.

More Information:
Contact Amanda Carmichael, BS, RD, LDN, 901.516.6357
Fax physicians requests: 901.937.3334

Type 2 Diabetes and Sleep Apnea
last updated:
Fri, 6/15/2012 8:39 AM

The majority of patients with type 2 diabetes also have obstructive sleep apnea (OSA), which is the most common type of sleep apnea and occurs when an airway is blocked or has narrowed during sleep.  While these two conditions are irrefutably linked, it is difficult to determine which one induces the other. A better understanding of the relationship may have important health implications for patients of either condition.

The interactions between obesity, OSA and type 2 diabetes are extremely complex and involve multiple pathways. Obstructive sleep apnea is associated with alterations in glucose metabolism and therefore places patients at an increased risk of developing type 2 diabetes.  Because sleep apnea increases stress on the body, blood sugar levels rise, which makes it very important for patients with type 2 diabetes to have OSA treated.  Undiagnosed OSA may interfere with lifestyle treatments for diabetes.

While it is uncertain where the relationship originates and which condition induces the other, acknowledging the link between type 2 diabetes and OSA enables health professionals to better inform and treat patients.

If you suffer from type 2 diabetes and have trouble sleeping, consult your physician or contact the Methodist Sleep Disorders Center directly by calling 901-683-0044 to determine you best treatment option.

This information is provided by Methodist Healthcare and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.


Diabetes Foot Care
last updated:
Wed, 12/08/2010 3:17 PM

When you have diabetes, proper foot care is very important. Poor foot care with diabetes can lead to serious health problems, including possibly having to remove the foot or leg (amputation).It's important to understand the connection between diabetes and foot care. As a person with diabetes, you are more vulnerable to foot problems because diabetes can damage your nerves and reduce blood flow to your feet. By taking proper care of your feet, most serious health problems associated with diabetes can be prevented.

  • Wash and Dry Your Feet Daily
  • After washing, use lotion on your feet to prevent cracking. Do not put lotion between your toes.
  • Examine Your Feet Each Day
  • Take Care of Your Toenails
  • Check the tops and bottoms of your feet. Have someone else look at your feet if you cannot see them.
  • Check for dry, cracked skin.
  • Look for blisters, cuts, scratches, or other sores.
  • Check for redness, increased warmth, or tenderness when touching any area of your feet.
  • Check for ingrown toenails, corns, and calluses.
  • If you get a blister or sore from your shoes, do not "pop" it. Apply a bandage and wear a different pair of shoes.
  • You may want a podiatrist (foot doctor) to cut your toenails.
  • If you have Medicare your doctor can prescribe diabetic shoes and Medicare will cover the cost.
  • Be careful when exercising
  • Walk and exercise in comfortable shoes.
  • Do not exercise when you have open sores on your feet.
  • Protect your feet with shoes and socks
  • Never go barefoot. Always protect your feet by wearing shoes or hard-soled slippers or footwear.

Your health care provider should examine your feet at each visit. In addition, see your health care provider if you have any of the following problems with your feet:

  • Athlete's foot
  • Sores or wounds on your feet
  • Ingrown toenails
  • Increasing numbness or pain
  • Calluses
  • Redness
  • Blackening of skin
  • Bunions
  • Infection
  • Hammer toes (when the middle joint of toes is permanently bent downward)
  • Footwear Test: make sure your shoes fit properly.

Use this simple test to see if your shoes fit correctly:

  1. Stand on a piece of paper. (Make sure you are standing and not sitting, because your foot changes shape when you stand.)
  2. Trace the outline of your foot.
  3. Trace the outline of your shoe.
  4. Compare the tracings: Is the shoe too narrow? Is your foot crammed into the shoe? The shoe should be at least 1/2 inch longer than your longest toe and as wide as your foot.

The best way to manage your diabetic feet are to keep your blood sugars monitored and your blood sugars under control. When your blood sugar is out of control you are at risk of developing diabetic ulcers and skin problems. Make sure you take care of your feet. Proper foot care is very important. Just remember that more than 60% of nontraumatic lower leg amputations occur in people with diabetes. Many times if care was taken with the proper foot care, the amputation may have been prevented.


Dawn Caldwell is a Physical Therapist in Memphis, Tennessee with Methodist Healthcare. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Call 888.777.5959 for more information.

Heart Disease Prevention
last updated:
Fri, 11/05/2010 10:24 AM

Weight gain and and an inactive lifestyle can influence heart diseases. These also increase the risk of high blood pressure, diabetes and increased blood cholesterol levels, which increases the risk of heart disease. Knowing how to maintain or lose weight and also to maintain cardiac (heart) fitness is important.

Tips on Calories:

  1. The formula for losing or gaining weight is generally simple. If you burn more calories than you take in, you'll lose weight because the calories are used up and your body begins burning fat instead. If you take in more calories than you burn, the extra calories are converted to fat and are stored in the body.
  2. Use up at least as many calories as you take in.   
  3. Find out how many calories you should be eating and drinking to maintain your weight. 
  4. Don’t eat more calories than you know you can burn up every day. 
  5. Increase the amount and intensity of your physical activity to match the number of calories you take in. 
  6. Regular physical activity can help you maintain your weight, keep off weight that you lose and help you reach physical and cardiovascular fitness. 
  7. For weight maintenance, aim for at least 30 minutes of moderate physical activity every day. If you can’t do at least 30 minutes at one time, you can add up 10-minute sessions throughout the day.

Tips on Physical Activity:

  1. Being active brings many benefits for your heart and your health.
  2. Regular exercise improves blood pressure and blood sugar levels
  3. It also reduces risk for diabetes, osteoporosis, obesity, depression, and colon and breast cancer
  4. Try to live an active lifestyle: incorporate as much physical movement into your usual daily activities as you can. For example, decide to take the stairs instead of riding the elevator; try not to drive to a nearby shop, and instead try walking to the shop. 
  5. How much activity do you need?  At least 30 minutes of moderate physical activity on most, if not all, days of the week. For losing weight, 30 to 60 minutes moderate physical activity is required on most days.


Dr. Santhosh K.G. Koshy, DM, FACC, FSCAI is the Director of Interventional Cardiology and Director of UT services at Methodist Healthcare and the University of Tennessee Health Sciences Center in Memphis, Tenn. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Call 888.777.5959 for more information.

10 Steps to Better Sleep
last updated:
Tue, 11/02/2010 10:25 AM

In today’s busy, 24/7 society, many of us fail to allocate sufficient time or attention to our sleep. Healthy sleep is a fundamental aspect of our physical, emotional and spiritual well-being. When sleep problems occur, the impact on our quality of life is significant and we may experience problems with alertness, productivity, safety, mood regulation, and physical health. 

The following Ten Steps to Better Sleep provide a good place to begin assessing sleep health:

  1. Make sleep a priority in your life. Establish a consistent sleep/wake schedule that provides adequate sleep every night. Most adults function best with 7-9 hours of sleep. Teens and young adults generally require 8.5-9.5 hours per night.
  2. Avoid activities or habits that work against good sleep: avoid caffeine after 3-4 p.m., avoid strenuous exercise in the evening, and avoid stressful activities such as paying bills or emotional family discussions during the 2 hours prior to bedtime.
  3. Maximize your exposure to bright light in the morning and minimize your exposure to bright light in the evening. Bright light has a significant impact on timing and quality of sleep and alertness.
  4. Discuss concerns regarding medication side effects that involve sleep with your healthcare provider. Certain medications may cause daytime sleepiness or affect ability to fall asleep or stay asleep at night.
  5. Avoid using alcohol to help fall asleep. Alcohol may help hasten sleep onset but it also fragments or disrupts nighttime sleep.
  6. Learn how to recognize sleep problems in your life. For example, excessive daytime sleepiness can present with difficulty focusing or completing tasks, irritability, poor memory, and difficulty with brief “lapses” or micro-sleeps.
  7. Insomnia (difficulty falling asleep or staying sleep) is a common sleep problem that can occur due to many different factors. Discuss insomnia concerns with your healthcare provider and seek help from a sleep specialist if initial interventions do not help.
  8. Breathing problems such as loud habitual snoring, or gasp-like sounds during sleep may signal the presence of a sleep disorder called obstructive sleep apnea (OSA). OSA is an important medical disorder that can be associated with a variety of other chronic health problems such as high blood pressure, diabetes, obesity, stroke, chronic headache, and depression. This problem requires evaluation in a sleep center, followed by development of a treatment plan.
  9. Drowsiness while driving is a potentially life-threatening problem. Recognize and acknowledge your drowsiness, and avoid driving when you are sleep deprived or if you are experiencing drowsiness due to medication effects or a sleep disorder.
  10. If you or a family member is struggling with a chronic sleep problem, gather information by keeping a calendar or sleep log, and seek help by consulting with your primary care provider or a sleep specialist!


Merrill S. Wise, M.D. is a neurologist and Board-certified sleep medicine specialist affiliated with the Methodist Healthcare Sleep Disorders Center. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Please call the Sleep Disorders Center for more information at 901.683.0044.


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Methodist Healthcare is an integrated health care delivery system, dedicated to the art of healing through our faith-based commitment to minister to the whole person. 1211 Union Avenue, Memphis, Tennessee 38104 • (901) 516-7000