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Too much sweat, not enough chlorine: A summertime reference to understand diabetes.

If you’re diabetic you’re probably familiar with the term hemoglobin A1c. However, if your doctor is concerned you’re “prediabetic” meaning you’re knocking on the door of type 2 diabetes, then this is a lab value you need to understand. 

When you are diagnosed with diabetes, it means you have too much blood glucose (sugar) floating around in your system and your body isn’t able to create enough insulin to combat all the sugar you’re consuming. Think of your body like a pool. People with sunscreen (carbs that get broken down into sugar) and sweat (sugar) are getting in the pool making it cloudy. The pool has chloride (your insulin) to fight the sunscreen and sweat so that the pool stays nice and clear despite all the people in and out BUT when all the chlorine storage is depleted (type 1 diabetes) or there are just too many people in the pool and the chlorine demand can’t keep up (type 2 diabetes) and the sweaty, sunscreened...

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Concussions

With the onset of warm weather and the spring soccer season, I am bracing for the recurrent questions regarding concussions.  Such is the life of a dad physician cheering from the sidelines. Though it is true that the fast pace, aggressive play, and frequent hard contact of soccer are a set up for this injury, many other mechanisms can be at play.  Most associate concussions with high impact, high velocity incidents; however, even less forceful traumas can be the cause, particularly when sudden and rapid head movement is also associated.  This knowledge is important:  1) we need be vigilant that, though helmets are helpful in reducing fractures and some contact forces upon vital structures, they do not add full protection against shearing forces and resulting injuries; 2) we must be observant with even less forceful injuries, such as an elbow to the head, standing up an hitting your head on a low beam, or a fall even when no obvious impact occurs, to give a...

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