November 2016 Edition - Health Matters

Prediabetes? Not That Sweet!

You may know that diabetes is one of the risk factors of cardiovascular disease. Did you know that pre-diabetes, if left untreated can increase your risk of developing type 2 diabetes, heart disease and stroke? According to the CDC, 86 million American adults have prediabetes. This means 1 out of 3 have prediabetes and 9 out of 10 with prediabetes do not know they have this medical condition. What is the difference between diabetes and prediabetes? “Diabetes is a disease when your fasting blood glucose is higher than 126mg/dl and non-fasting blood glucose is over 200mg/dl. This is due to either low insulin hormone production in the pancreas with type 1 diabetes or improper use of normal insulin production with type 2 diabetes,” states Venkata Yerramilli, MD, Family Practice Physician at the NCH Physician Group in Bonita Springs. A person has prediabetes if fasting blood glucose is more than 100mg/ dl and less than 125mg/dl or impaired glucose tolerance test showing 140 -199mg/dl after an oral glucose challenge or Hemoglobin A1C level 5.7 -6.4%. Individuals with prediabetes may not have any symptoms. “The good news is when prediabetes is diagnosed early and treated appropriately the development of type 2 diabetes can be prevented,” says Yerramilli. What are the risk factors for prediabetes? Risk factors include a family history of type 2 diabetes among parents and siblings and being overweight which is defined as having a Body Mass Index, (BMI), above 25.

“For women, additional risk factors include, a history of diabetes during pregnancy or the baby’s birth weight of more than 9 pounds. A history of poly cystic ovary syndrome, (PCOS) is also a risk factor for developing prediabetes,” explains Yerramilli. Certain ethnic groups including American Indians, Hispanics, African-Americans and Asian populations are at higher risk. Prediabetes, What is A1C? Hemoglobin A1c or glycated hemoglobin is the measure of the percentage of hemoglobin in red blood cells that is coated with sugar. The normal range is between 4.3- 5.6% What are the complications of

prediabetes and diabetes? About 30% of people with prediabetes will end up with type 2 diabetes over a 10 year period. Diabetes is a serious condition leading to heart attacks, strokes and kidney failure. Diabetes can cause certain vascular complications leading to amputations and vision loss. It can also lead to risk of infections and delays in wound healing. According to Dr. Yerramilli, “If you are in a high risk category for prediabetes consult your physician for testing and diagnosis. Your physician will develop a treatment plan appropriate for you that may include medical management and lifestyle modifications. Education is key in managing prediabetes.” Venkata Yerramilli, MD

LIFESTYLE CHANGES INCLUDE: √ Maintain a healthy weight √ Eat a healthy, low calorie, and low carb diet with portion control √ Decrease sugary drinks √ Be physically active

Venkata Yerramilli, MD, NCH Physician Group is accepting new patients at 3302 Bonita Beach Road, Suite 170 in Bonita Springs. Call (239) 624-1050 to make an appointment.

NCH Orthopedic Program a National Leader in Quality Care For Total Hip and Knee Replacement

So, you’ve been told you should consider knee or hip replacement surgery? You’re not alone. In the United States, more than 600,000

said Erin Raney, BSN, RN, CNML, Nurse Manager of NCH Orthopedic Services. In seeking Joint Commission Gold Seal of Approval certification, the staff aimed for excellence in reducing surgical site infections, minimizing patient falls, improving patient satisfaction (through patients’ ratings) and increasing pre-operative patient education attendance. As a result of the certification process, surgical care was improved, the length of stay fell below the national average, the incidence of potential post-operative complications (such as infections, falls, deep vein thrombosis, pulmonary embolism, respiratory issues, increased swelling in the surgical area) fell below the national average, and the team attained the highest scores for patient satisfaction for pain management and for overall surgical experience and post- operative recovery. Several hours after joint replacement surgery, patients

are evaluated and assessed by physical therapists, and individualized rehabilitation sessions are provided. The facility’s newest program, “Let’s Get Moving,” starts rehabilitation on the day after surgery with the intention of getting patients moving to reduce the risk of post-operative complications. “The program also helps patients to attain independence and gets them back to home within two to three days after surgery,” explained Raney. A “Mobility Planner” provided at the patient’s bedside allows them to track distance walked from day of surgery, note exercises completed, whether they were able to sit in a chair for meals and distance walked with a friend or nursing staff. “We have dedicated orthopedic units and state-of-the- art private rooms,” said Graziano, adding that NCH is a community-based, patient-oriented hospital where the patient comes first.

knee replacement surgeries and more than 300,000 hip replacement surgeries are performed each year. With an aging population working longer and rising rates of obesity, those numbers are expected to explode in the next two decades. If you or a loved one is considering surgical options to improve mobility and quality of life, selecting the right facility to perform the procedure is critical. You can’t do better than to choose an accredited hospital, such as NCH, that boasts two dedicated orthopedic units carrying the Joint Commission Gold Seal of Approval – a certification that ensures excellence across the entire patient care experience. The non-profit, independent Joint Commission measures a health care organization’s commitment to meeting stringent qualityperformance standards and is recognized throughout the United States as the premier symbol of quality in joint- related health care. NCH Orthopedic Program is currently working on recertification for another two years. “This certification demonstrates to the community that we have a higher standard of care for patients and are committed to providing exceptional care and improving patient outcomes,” said Suzanne Graziano, MSN, RN, ONC, NE-BC, CNAT, Director of NCH Orthopedic Services. “We have an excellent track record in regard to quality, compared to national standards,” she added. “The NCH Orthopedics Program has a dedicated interdisciplinary team of healthcare professionals who collaborate and provide outstanding care to our patients,”

Reasons to choose NCH Orthopedic Unit for your total knee or total hip replacement • Joint Commission Gold Seal of Approval certification. • Demonstrated commitment to quality and patient satisfaction. • Two hour presurgery class for patients and family. • Proactive postsurgery pain management program. • Interdisciplinary, collaborative team approach from presurgery to postsurgery care. • Dedicated orthopedic units and dedicated professional team. • State-of-the-art private rooms. • “Let’s get Moving” postsurgery mobilization program.

• Postsurgery physical therapy evaluation. • Individualized rehabilitation sessions.

For more information about NCH Orthopedic Services, contact Suzanne Graziano at (239) 624-3916. To learn more about the Joint Commission visit

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