Low-glycemic diet seen to reverse diastolic dysfunction of diabetes

Vienna, Austria - A diet that was short on carbohydrates and long on protein, given to diabetic patients engaged in a supervised exercise and weight-loss program, appeared not only to cut proinsulin levels and postprandial glucose and triglyceride levels, it seemed to improve LV diastolic function [1].

In the study that compared the "low-carb" diet to a traditionally recommended low-fat diet, the one designed to flatten out resulting insulin and glucose curves also allowed them to take far fewer oral diabetes medications and apparently cut both systolic and diastolic pressures. The low-fat diet had no apparent effect on diastolic function or med use or on blood pressures.

Prof Helene von Bibra

On the other hand, the two diets led to about the same declines in weight and waist circumference and lipoprotein-cholesterol levels, reported Prof Helene von Bibra (Technical University Munich, Germany) here at the Prediabetes and the Metabolic Syndrome 2013 Congress.

Many patients with insulin resistance, diabetes, or both have subclinical diastolic dysfunction, with severe prognostic implications if it becomes symptomatic, von Bibra reminded heartwire. About 65% of the 32 patients in the study had abnormal diastolic function as defined echocardiographically by low early diastolic myocardial velocity. That measure in most cases nearly normalized after the low-carb diet, but not after the low-fat diet, she said.

Of 32 overweight or obese diabetic patients (mean body-mass index, 34) without cardiac disease who were engaged in a "rehabilitation program in order to lose weight" that included two hours of supervised aerobic exercise per day, half followed a low-glycemic diet (25% carbohydrate, 45% fat, 30% protein) and the other half a low-fat diet (55% carbohydrate, 25% fat, and 20% protein) for three weeks. The diets provided the same amount of calories. Those on the low-fat diet then switched to the low-glycemic diet for an additional two weeks. Cardiac function by echo and metabolic parameters were assessed daily before and after a 400-kcal breakfast.

From baseline to three weeks, patients on the low-carb diet reduced their use of conventional oral antidiabetic medication by 86%. Those on the low-fat diet reduced them by only 6% by the end of three weeks, but intake went down another 57% by the end of their two-week low-glycemic diet phase. "And still they had improvements in glucose," von Bibra said. Medications other than oral ones for diabetes, such as antihypertensive drugs, were not changed in anyone during the study.

Laboratory and echo changes in overweight/obese diabetic patients assigned to low-glycemic (n=16) and low-fat (n=16) diets

Initial assigned diet	Baseline	3 wk	2 wk after crossover to low-carb	p
Low-glycemic
Triglycerides (mg/dL)	150	111	—	<0 .005="" br="">
Postprandial glucose (mg/dL)	141	125	—	<0 .04="" br="">
E' (cm/s)	9.5	10.4	—	<0 .03="" br="">
Low-fat
Triglycerides (mg/dL)	208	194	138	<0 .003="" 3="" baseline="" br="" vs="" wk="">
Postprandial glucose (mg/dL)	168	137	127	<0 .008="" baseline="" br="" vs="">
E' (cm/s)	10.8	10.7	11.4	<0 .02="" 3="" br="" vs="" wk="">

E'=early diastolic myocardial velocity by tissue-Doppler echocardiography

The gains in diastolic function probably were not independently related to the associated blood-pressure reductions; rather, she proposed, they reflected improvements in myocardial energy utilization on the low-glycemic diet. Insulin resistance can lead to diastolic dysfunction via several pathways, she noted, but the most prominent seems to be myocardial energy deficiency secondary to microvascular dysregulation and mitochondrial imbalances of glucose vs fat oxidation.

APRIL 22, 2013 Steve Stiles

Nike SportsVision Golf!

Did you know that all of the Skyvision Centers doctors are golfers? Dr. Kaye has actually competed in some of the biggest Cleveland golf events. All of our doctors know the importance of protecting their eyes from UV light. But what about performance? Can a pair of sunglasses make you see BETTER on the golf course?

You bet! The Nike Max Tint SportsVision series of sunglass lenses are designed to only let the most important wavelengths of light make it to your eyes for your special sport. The Nike Golf lens is a purple lens that makes the white golf ball "POP"  against the green background of a golf course so that you can follow your shots better.

The other big advantage of wavelength management is how the Nike Golf Lens allows a golfer to see contours on both the fairways and the greens. Dr. Kaye wears his all the time and feels he can see the breaks on the greens much better when he is wearing his Nikes!

Skyvision Centers is the leading provider of Nike Max Tint sports lenses in Cleveland. Let the doctors and our optical staff fit you with the perfect pair of Nike Golf lenses so that you an improve your game!

Know the Dry Eye Facts

You’ve been staring at your computer and sifting through paperwork for hours. Your eyes begin to feel gritty, sore and tired. You could be among the 30 million Americans that suffer from dry eye disease, and not even know it. Since dry eye symptoms can mimic many other syndromes, sufferers frequently go undiagnosed and often don’t realize what they are afflicted with. Additionally, many people confuse dry eye symptoms with seasonal allergies or the common cold. It is imperative to know the facts; and we have made it easy for you with our dry eye fact sheet.

So, why is being aware of dry eye disease important, you ask? Well, if dry eye is left untreated or undetected, it can be much more than just a bothersome and uncomfortable condition. Untreated, excessive dry eye disease can damage the eye’s delicate tissues and disrupt the cornea, which can ultimately lead to vision impairment or even loss. Permanent scarring on the ocular surface and frequent eye infections can also be a result of undetected dry eye disease. Do not take eye hydration for granted!

In every practice, there are hundreds, perhaps even thousands, of patients who suffer from some form of ocular dryness. In fact, dry eye disease is the number one reason for eye doctor visits. And while we can’t change the fact that we have dry eye disease, we can limit the environmental factors that aggravate symptoms. Being aware of potential dry eye triggers and becoming familiar with recognizing the symptoms can be exceedingly beneficial.

With so much to know, and so little time to read literature on the topic, how can one be more knowledgeable regarding the proper protocol to detect, ease and avoid dry eye symptoms? Further, who are the unlucky individuals more likely to be plagued with dry eye disease? Know the answers to these questions and the most common do’s and do not’s of dry eye disease to lessen your risk before the problem progresses. Proactively reduce your chances of developing or worsening dry eye symptoms by printing or sharing this child-friendly, educational dry eye fact sheet! Know the basics, your eyes will thank you!

Always see an Accredited Dry Eye doctor for a regular eye examination, or if you think you may have dry eye disease.

September 6, 2012 by All About Dry Eye 

Using Eye Makeup

Follow these tips to keep your eyes healthy as well as beautiful:

• Throw away eye makeup after three months. Infection-causing bacteria grow easily in creamy or liquid eye makeup. If you develop an eye infection, immediately toss all of your eye makeup.
• Never share eye makeup, and when sampling makeup in stores use only fresh applicators and samples that have not been contaminated by multiple users. (The safest choice is to avoid store samples altogether.)
• If you tend to be allergic, introduce only one new eye makeup or care product at a time. If there is no reaction, add another new product, and so on. If you notice an allergic reaction, find out what the ingredients are and let your doctor know. Avoid products that contain untested or harmful chemicals.
• Before applying makeup, be sure your face and eyelids are very clean. Always apply makeup outside the lash line, away from the eye, to avoid blocking the oil glands of the upper or lower eyelid. These glands secrete oil that protects the eye’s surface. Never apply makeup while in a moving vehicle.
• Do not separate your mascara-clumped lashes with sharp items.
• If you tend to have dry eyes, avoid metallic/glitter, powder or other makeup that flakes. Flakes can get into the tear film and increase your eyes’ irritation. Glitter eye makeup is a common cause of corneal irritation or infection, especially in contact lens users.
• Remove all eye makeup at night before sleeping, especially mascara that can stick to the lashes. Brush a clean cotton swab along the base of the eyelashes to remove all makeup remnants. If you use eye makeup remover, avoid getting it in your eyes and thoroughly rinse remover off your eyelids.

If you have eye surgery, do not wear makeup around the eye until your ophthalmologist tells you it is safe to do so, and then use only fresh, new makeup.

Eye Tips for Teenagers

Exercise

Our eyes need good blood circulation and oxygen intake, and both are stimulated by regular exercise. Regular exercise also helps keep our weight in the normal range, which reduces the risk of diabetes and diabetic retinopathy. Remember to use sun safety and protective eye wear when enjoying sports and recreation.

No Smoking

Avoiding smoking, or quitting, is one of the best investments you can make in your long-term health. Even though old age seems a long way off, smoking as a teenager can increase your risks for cataracts as well as for cardiovascular diseases that indirectly influence our eyes’ health. Smoking increases the risk of severe vision loss people with other eye diseases as well. 

Decorative Contact Lenses

Decorative contact lenses, including circle lenses, are a potentially dangerous trend among teenagers and young adults. These cosmetic lenses are designed to change the appearance or color of the eye. These decorative lenses can be bought in stores and online without a prescription.

Buying any decorative contact lenses, including circle lenses, without a prescription is hazardous to your eye health. Pain and swelling are frequently caused by improperly fitted, over-the-counter lenses. More serious problems can include corneal abrasions and blinding contact lens-related infections. All contact lenses are medical devices that require a prescription, proper fitting by an eye care professional and a commitment to proper contact lens care by the wearer.

Info - courtesy of EyeSmart

Eye Health Tips for High School and College Students

Students face special challenges to the eyes when they are under academic performance pressure. 

Lack of sleep, prolonged computer use and long hours studying make for tired eyes that are dry, 
scratchy and achy. 


Prolonged computer use contributes to eye fatigue because you blink less frequently. Less
blinking significantly reduces lubrication in the eye making it feel tired, scratchy and “dry” as a
result. Also eyes are not designed for prolonged focus on a single object, such as the computer.
Remedy: place a note on the computer screen as a reminder to blink and to look away from the
screen and focus on objects in the distance. Looking out a window (20 – 20 – 20 rule: for every
20 minutes of computer work, look away for 20 seconds, and focus on a scene or object at least
20 feet away) is a good break for the eyes. The key is to give your eyes a rest.

“Dry eye” is a common feeling from not giving your eyes enough rest while some people just
naturally do not produce enough tears to keep their eyes healthy and comfortable. Some common
symptoms of dry eye are stinging and burning to the eyes, scratchiness, excessive eye irritation
from smoke or wind and excessive tearing. Remedy: If you have occasional symptoms of dry
eye, you should try eye drops called artificial tears. These are similar to your own tears and help
lubricate the eyes and maintain moisture. For persistent “dry eye,” see your SkyVision doctor.

Contact Lenses and Sleep Deprivation 

When a contact-lens wearer stays awake studying for 18-20 hours or more with their contacts in,
it’s almost the equivalent of sleeping with contacts in, something that Eye M.D.s warn against.
Prolonged wearing of your contact lenses is a problem for people who wear regular hydrogen
lenses, since traditional hydrogels are relatively less permeable to oxygen than newer alternatives
like silicone hydrogels. The eye needs oxygen to keep it healthy. Without regular exposure to
oxygen, the eye’s cornea can become inflamed and the vision blurry. Prolonged contact lens use
can even lead to infections or corneal ulcers that in the worst case can permanently damage
vision.

Sometimes students fall asleep without knowing it (with their contacts in), while studying.
Remedy: Alternate wearing contact lenses with use of eyeglasses during long study periods.
Also, students with irregular sleep patterns can wear contact lenses made of silicon hydrogen, a
new material with improved oxygen permeability, which may reduce risk of infection and
discomfort.

Make sure you have a current prescription for your spare eyeglasses! 

For more information about contact lenses and proper contact care guidelines ask one of the SkyVision doctors.

This article reprinted with permission from the American Academy of Ophthalmology's EyeSmart 
Campaign (www.geteyesmart.org).

AN INDEPENDENT LASIK INFORMATION RESOURCE - ARSC

Do you wear glasses or contact lenses? 

                                                             

 Have you been thinking about LASIK? 

We found a new, independent resource that provides very high quality information about LASIK and some other eye surgeries.  The American Refractive Surgery Counsel (www.americanrefractivesurgerycounsel.org) provides a website with good, solid, independent information about LASIK. 

The ARSC website does not promote any individual LASIK surgeon or practice.  There is a refractive surgery checklist which you can use to evaluate your options.  In addition, there is a blog that posts updates about interesting stories about LASIK.

We think the American Refractive Surgery Counsel website is a very nice resource for those people thinking about LASIK surgery.  We encourage you to give it a look!

FDA clears iPhone vision test

The FDA has granted Class II prescription-only 510(K) clearance for an iPhone-enabled vision test. 

The software, called myVisionTrack, was developed by Vital Art and Science. The FDA clearance applies to the software when run on an iPhone 4S.

Vital Art and Science has developed the test for patients with serious degenerative eye conditions such as diabetic retinopathy (DR) and age-related macular degeneration (AMD), who will be able to use it to monitor their vision regularly at home. The software compares results to previous results, and can automatically alert a physician if a significant change has occurred, so the physician can respond with an appropriate therapy in a timely way. As the product is developed, the company also plans to enable it to send patients’ results to their EHRs in a safe, HIPAA-compliant way.

According to President Mike Bartlett, the company hopes to have a downloadable app version of the platform eventually. But because the software is only currently cleared for prescription use, the initial form factor will probably be to distribute pre-loaded iPhones to patients.

“Right now we’re looking for collaboration opportunities like clinical drug trials,” he told MobiHealthNews. “In all of the clinical drug trials [for degenerative eye diseases], all of the data is being collected in the clinic. We want to enable them to collect data as often as hourly or daily instead of every month or so. Because of the nature of vision problems, we expect the first big deployments will be done by the drug companies.”

The company is already in talks with Novartis, makers of Lucentis, which is prescribed for DR and AMD. Novartis funded a clinical trial of myVisionTrack. Bartlett hopes the software will be prescribed along with drugs like Lucentis and paid for by patients’ health plans.

The app runs a test called shape discrimination hyperacuity (SDH), which is licensed from the Retina Foundation of the Southwest, whose research showed it to be one of the most likely vision tests to work on an electronic device. This is partly because, unlike the famous Snelling test typically used in opthamologist offices, the SDH is distance insensitive, which means patients using it at home can hold it at any natural distance from their faces without effecting the accuracy. In two different clinical trials, Vital Art and Science found the test to be equal to or better than a Snelling test in terms of accuracy. In the test, patients are repeatedly presented with three shapes and have to tap the one that looks different.

Bartlett believes over-the-counter clearance is something that will come along for diagnostic apps, once they’ve become more commonplace.

“We felt from the beginning we wanted to develop the regulatory approved version,” said Bartlett. “The one that’s going to be used and trusted by doctors.”

By: Jonah Comstock | Apr 8, 2013

Spring Means Baseball Season for Kids too . . . . Expert Pitches Safety Tips for Young Baseball Players

It's a great youth sport, but beware the possible injuries, doctor advises

 -- Baseball is one of the safest sports for children, but even so there are potential risks that can result in serious injury, an expert warns.

"All kids should be involved in physical activity, and baseball is a great, safe way to get kids exercising, help them develop eye/hand coordination, deepen concentration skills and learn how to work as a team," Dr. Jerold Stirling, a pediatric sports medicine specialist at Loyola University Health System, said in a Loyola news release.

"Still, parents and coaches need to be attentive to ensure all players and fans are safe during the game," added Stirling, who is also chair of the department of pediatrics at Loyola University Chicago Stritch School of Medicine.

Eye injuries are a common hazard. Baseball is one of the leading causes of the nearly 40,000 eye injuries that occur from sports and recreational activities each year in the United States, according to background information in the news release.

"Children are especially vulnerable to eye injury because they don't have the same depth perception," Stirling explained. "Be especially careful if your child wears glasses. Make sure they wear protective lenses and consider a face shield for the batting helmet."

Eye injuries are most likely to occur when a batter is hit by a wild pitch, Stirling pointed out. He said coaches and parents should teach batters to turn their backs toward the ball and their heads away from the ball. This is especially important at younger ages, when pitching is more erratic.

Age 5 is the ideal time for a child to start playing baseball as part of a T-ball team, he noted.

"A child's hand/eye coordination and ability to concentrate really start to develop at age 5, and that can play a role in keeping kids safe while playing a game," Stirling said.

He also noted that pitchers and catchers are the players most likely to suffer injuries. "Pitchers tend to have more shoulder and elbow injuries due to overuse. Catchers tend to encounter the most traumas with foul balls being hit off their body and painful collisions at home plate," Stirling said.

In order to prevent injuries in young pitchers, it's important to teach them proper technique and to keep an eye on their pitch count, Stirling said. Children younger than 14 should not throw curve balls, and sliders should not be thrown until a pitcher is 16 or older, he advised.

More information

The Nemours Foundation offers safety tips for young baseball players.

Copyright © 2012 HealthDay. All rights reserved.

Maintaining Good Eye Health

Don't take your eye health for granted. Protect your eyesight with these six tips:

1. Eat for Good Vision

Protecting your eyes starts with the food on your plate. Studies have shown that nutrients such as omega-3 fatty acids, lutein, zinc, and vitamins C and E may help ward off age-related vision problems such as macular degeneration and cataracts. Regularly eating these foods can help lead to good eye health:

• Green, leafy vegetables such as spinach, kale, and collards
• Salmon, tuna, and other oily fish
• Eggs, nuts, beans and other non-meat protein sources
• Oranges and other citrus fruits or juices

Eating a well-balanced diet also helps you maintain a healthy weight, which makes you less likely to get obesity-related conditions such as type 2 diabetes. Diabetes is the leading cause of blindness in adults. It makes glaucoma and cataracts more likely. 

2. Quit Smoking for Better Eyesight

Smoking makes you more likely to get cataracts, optic nerve damage, and macular degeneration. If you've tried to quit smoking before and started smoking again, keep trying. Studies show that the more times you try to quit smoking, the more likely you are to succeed.  

3. Wear Sunglasses for Good Vision

The right kind of sunglasses will help protect your eyes from the sun's ultraviolet (UV) rays.

Too much UV exposure makes you more likely to get cataracts and macular degeneration.

Choose sunglasses that block 99% to 100% of both UVA and UVB rays. Wraparound lenses help protect your eyes from the side. Polarized lenses work well to help reduce glare when driving.

If you wear contact lenses, some offer UV protection. It's still a good idea to also wear sunglasses for more protection, including of your eyelids.

4. Use Safety Eyewear at Home, at Work, and While Playing Sports

If you work with hazardous or airborne materials at work or home, wear safety glasses or protective goggles every time.

Certain sports such as ice hockey, racquetball, and lacrosse can also lead to eye injury. Wear eye protection (such as helmets with protective face masks or sports goggles with polycarbonate lenses) to shield your eyes.

5. Look Away From the Computer for Good Eye Health

Staring at a computer screen can cause:

• Eyestrain
• Blurry vision
• Difficulty focusing at a distance
• Dry eyes
• Headaches
• Neck, back, and shoulder pain

Protect your eye health by taking the following steps:

• Make sure your glasses or contact lens prescription is up-to-date and adequate for computer use. 
• Some people may need glasses to help with contrast, glare, and eye strain when using a computer.
• Position your computer so that your eyes are level with the top of the monitor. This allows you to look slightly down at the screen.
• Try to avoid glare on your computer from windows and lights. Use an anti-glare screen if needed.
• Choose a comfortable, supportive chair. Position it so that your feet are flat on the floor.
• If your eyes are dry, blink more.
• Every 20 minutes, rest your eyes by looking 20 feet away for 20 seconds. At least every two hours, get up and take a 15-minute break.

6. Visit Your Eye Doctor Regularly

Everyone, even young children, should get their eyes examined regularly. It helps you protect your sight and make sure that you are seeing your best.

Eye exams can also find some eye diseases, such as glaucoma, that have no symptoms. It's important to find these conditions in their early stages, when they're easier to treat. Depending on your eye health needs, you can see either an optometrist or an ophthalmologist for a comprehensive eye exam. Ophthalmologists are medical doctors who specialize in eye care. They can provide general vision care, treat eye diseases, and perform eye surgery. Optometrists have had four years of specialized training after college. They provide comprehensive primary eye care and treat the most common eye diseases. They do not perform eye surgery.

A comprehensive eye exam may include:

• Discussing your personal and family medical history
• Taking vision tests to see if you have nearsightedness, farsightedness, astigmatism (a curved cornea that blurs vision), or presbyopia (age-related vision changes)
• Tests to see how well your eyes work together
• Eye pressure and optic nerve tests to determine if you have glaucoma
• External and microscopic examination of your eyes before and after dilation

You may also need other tests or procedures, depending upon your particular case.

© 2013 WebMD, LLC. All rights reserved.

Invest in Protective Eyewear for Sports

Health Tip: 

Make sure they fit and work properly

SkyVision Centers docs are big into fitness and sports.   They concur with all recommendations regarding eye injury prevention . . . .

(HealthDay News) -- Wearing protective eye gear when playing sports can help prevent serious eye injuries.

Guidelines when selecting protective eyewear:

• Buy your eye guards at an optical store or sports store, and make sure someone familiar with your eyes and the sport you play fits you for the guards.
• Make sure your eyewear comes with the correct lenses, which should be held securely in place.
• Purchase eye guards that offer cushion or padding along the bridge of the nose and eyebrows to avoid cuts or damage to the face.

SkyVision Docs can help you and any family members pick out the right protective eyewear for your best protection.

Copyright © 2012 HealthDay. All rights reserved.

Corneal Ulcers: Why Contact Lens Wearers Need Glasses!

What do you think is the biggest risk for really bad infections in contact lens wearers? Give up? The answer is not owning a pair of glasses! That's right, the biggest risk factor for developing a corneal ulcer, as very serious infection, is not having a pair of glasses to wear when your eyes are a little uncomfortable with your contacts, or to give your eyes a break from your contacts.

There are almost 71,000 cases of what eye doctors call ulcerative keratitis each year in the United States. Contact lens wearers are TEN TIMES as likely to get this than non-wearers. There seems to be an increased risk from wearing your contact lenses when you sleep, and wearing contact lenses that you buy from a fashion store is dangerous, too!

Here's a very typical story of how NOT having glasses causes a problem. You have a very high, very strong prescription, and your vision without glasses or contacts is very poor. One of your eyes starts to get red and sore, but you don't have glasses so you just keep wearing your contact lens. Pretty soon...UH OH!...you have a corneal ulcer. Now you CAN'T wear your contacts, but you still don't have a pair of glasses and you're stuck.

Dr. White always says that the first cardinal rule of contact lens wear is to have a back-up pair of glasses, because you never know. Don't let yourself get caught in a bind. Make sure you own a pair of glasses in addition to your contacts!