In 1961, analysis of data from the Framingham Heart Study revealed the dangers of high cholesterol levels and diabetes mellitus.

In 1977, lipid and lipoprotein values were defined as major risk factors for cardiovascular disease.

Taken all together, reversing diabetes, reducing high cholesterol and correcting high blood pressure protects against heart disease and stroke!

There are medications to control high cholesterol and hypertension. They certainly should be used while reversing type 2 diabetes. Eventually, remission of diabetes usually makes taking most of those medications less important.

To learn more about programs Herd Healthcare offers, our website is:
www.herdhealthcare.com

Cholesterol Metabolism Causing Cardiovascular Disease

Lipid and lipoprotein values, including fasting triglycerides (TG), low density lipoprotein cholesterol (LDL) and total cholesterol levels (TChol) are major risk factors for cardiovascular disease. High density lipoprotein cholesterol (HDL) is a protective factor against coronary artery disease.

Cholesterol is essential for life. It is necessary to make hormones and digestive fluid and to build cells. But it doesn’t dissolve in blood. It is carried to where it’s needed in fat molecules called lipoproteins.

Those lipoproteins vary in size, shape and density. Some high weight lipoproteins are safe carrying cholesterol to and from the cells they enter. They are called High Density Lipoproteins. More of them, low in weight are not safe because they become trapped and held in cells. They are called Low Density Lipoproteins.

Over years, more and more of the low density lipoproteins becomes lodged in cells lining the arteries, especially arteries to the heart, brain and legs. Those cells eventually can become thickened enough to obstruct the flow of blood. How soon that happens depends on the amounts of cholesterol laden low density lipoproteins circulating in blood.

Cholesterol and lipoproteins are partly absorbed from fat in food and partly created by metabolism in the wall of the intestinal tract and the liver. The more fat that gets absorbed and the longer it takes to get cleared from the blood, the more cholesterol and low density lipoprotein gets built up in the walls of the arteries.

Cholesterol And Lipid Metabolism in Diabetes

Type 2 diabetes (T2DM) is associated with changes in body weight and composition. Most adult men and women with T2DM are obese. Men weigh about 30 lb more than normal men with healthy weight and women weigh about 25 lb more. The length around the middle of the abdomen of adult men and women with T2DM is about 5 inches more than the waist circumference of normal adults with good health.

We define diabetes by the high levels of sugar circulating in the blood. We could just as accurately define diabetes by the abnormally high levels of fat (called triglycerides) and cholesterol that circulate. The high levels of triglycerides cause the liver to form and secrete large, dense fat molecules.

These large, dense fat molecules are broken into small low density lipoproteins (LDL) which carry cholesterol into cells. There’s less formation of high density lipoproteins (HDL) which carry less cholesterol in and out of cells.

Both the high levels of LDL cholesterol and the low levels of HDL cholesterol predict earlier and more severe obstructions of arteries. The result is to increase the early occurrence of heart attacks and strokes.

Weight Reduction And Lipid Metabolism

Obesity associated with T2DM develops because more sugar, fat and protein are consumed than metabolism and physical work can handle. There’s no room left in skeletal muscle or liver to store excess nutrients. The high levels of sugar and fat in the blood that persist all day and all night cause the pancreas to secrete more and more insulin. The high levels of triglycerides cause the liver to secrete more and more lipoproteins containing cholesterol.

Decreasing intake of food decreases the levels of sugar and fat enough so they can be cleared from the blood between meals and overnight. The effect of reducing intake of food enough to cause rapid loss of body weight also decreases levels of insulin, sugar, fat and cholesterol in the blood.

Investigators in Denmark tested the effect of reducing daily intake of food to amounts containing less than 1,000 kilocalories per day for 8 weeks. They studied the changes in 11 men and women with T2DM who did not require daily injections of insulin to control their diabetes.

As shown in the table, all subjects had mild T2DM with BMI > 35, fasting blood sugar of 146 mg/dL and fasting insulin levels of 176 pmol/L. (Healthy levels of fasting blood sugar are < 100 mg/dL and healthy fasting insulin levels < 50 pmol/L.)

After 8 weeks of restricted food intake, body weight fell -11%, fasting sugar levels fell -21% and triglyceride levels fell -39%. Levels of fasting insulin fell more than -50%. Levels of LDL cholesterol fell -17%.

These results indicate that food restriction to less than 1,000 kcal/day rapidly reduced the dangerous metabolic effects of excess food consumption.

Education And Coaching In Nutrition And Exercise

Reducing excess food consumption to balance daily energy requirements for metabolism and physical work is difficult. Short term studies lasting a few weeks or months show substantial improvements in T2DM. However, studies lasting several years are less effective.

The effects of intensive education and personal coaching for 12 months has been tested in several states of the U.S. Investigators in 16 Clinical Centers recruited, educated, coached and supervised nutrition and physical activity of 5,145 men and women with T2DM. Approximately 15% were using daily injections of insulin.

Averaged over 4 years, the subjects who received intensive coaching and supervision had substantially greater reductions in weight. The objective was a -7% weight loss at year 1 that was maintained for the duration of the study. Subjects were assigned 1,200 to 1,800 kcal/day depending on initial weight. Liquid meal replacements were provided free of charge. The greatest loss in weight was -8.6% achieved by the intensively coached group at the end of 12 months. After the end of intensive coaching, the average weight loss was -4.7%.

The greatest reduction in HbA1c was achieved by the intensively coached group. Here, again the reductions achieved during intensive coaching in the first year diminished during the following years. However, the reductions were maintained even when insulin injections and oral agents were reduced during the following years. More of the medications were continued in the group that was less intensively coached.

Reductions of -10% to -20% in levels of triglycerides were measured in blood samples from the most intensively coached subjects. These values were about twice the reductions measured in the group that was less intensively coached. During the years after intensive coaching, triglycerides decreased until they were about equal.

Reductions in LDL cholesterol were less than -10% and increases in HDL cholesterol were less than +10% during the first 4 years.

Greater use of lipid lowering drugs occurred during the first several years of the trial. Changes in Total cholesterol and LDL cholesterol may have been caused by the introduction of those new drugs which were not restricted during the study.

The modest -5% reduction in body weight simply was not enough to improve the management of T2DM. Reductions in body weight of -10% to -20% do decrease LDL cholesterol enough to reduce the severity of cardiovascular disease and prevent the occurrence of heart attacks and strokes.

Reductions in body weight less than -10% are not effective in reversing diabetes.

Exercise And HDL Cholesterol Metabolism

Regular endurance exercise has been shown to reduce the occurrence of cardiovascular disease. Both aerobic endurance exercise and resistance strength training have proved to be effective.

Improving HDL cholesterol levels is particularly effective during aerobic endurance training. This has been best demonstrated in subjects who have high triglyceride levels and low levels of HDL cholesterol in their blood.

This combination of lipid levels is seen most often in subjects who have a maximum waist circumference greater than 40 inches in men and 35 inches in women. T2DM also is commonly associated with abnormal waist circumference along with low levels of HDL cholesterol and high levels of triglycerides.

The effect of aerobic endurance training has been demonstrated as part of the HERITAGE Family Study conducted in Canada and the US. The subjects were 62 men approximately 42 years of age, BMI > 25, and maximum waist circumference was approximately 40 inches.

Laboratory values of prediabetes were measured in all subjects. Triglyceride values were 217 mg/dL, HDL cholesterol values were 29 mg/dl and fasting insulin levels were approximately twice the normal healthy values.

Aerobic endurance training consisted of 30 minute sessions pedaling at moderate intensity on a stationary bicycle 3 days each week for 20 weeks.

Results after 20 weeks included decrease of triglyceride values of -18% and an increase in HDL cholesterol of +18%.

Results of this study indicated improved lipid metabolism including HDL cholesterol in men with abdominal obesity and elevated triglyceride levels.

Summary

Modest weight reduction in obese patients with type 2 diabetes has a small effect on triglyceride and cholesterol metabolism.

In contrast, reversal of T2DM with body weight reduction of -10% to -20% restores lipid metabolism towards normal values. Medications for lowering LDL cholesterol continue to be important if Total cholesterol minus HDL cholesterol continues above 130 mg/dL.

Aerobic endurance exercise and resistance strength training both are effective in restoring cholesterol and lipid metabolism towards normal healthy values.

Aerobic endurance exercise is particularly effective in restoring HDL cholesterol towards normal. Resistance strength training is particularly effective in restoring insulin resistance towards normal healthy values.

Let us help you prevent and correct high triglyceride and low HDL cholesterol values by reversing type 2 diabetes.

We are pleased to share our blog articles with you, and we are always interested to hear from our readers. Our website address is: www.herdhealthcare.com

Time invested for good health reduces costs now and prolongs health and life. 

Contact us and get started. Health planning now is more important even than financial planning.

Extend Life and Good Health Years:

Reversal of Diabetes is an Astounding Investment! It immediately returns more time and saves more money than you might invest along the way. Even before Remission.

Diabetes Risk Alert is a signal about a sure thing. Diabetes Risk is not like  risk of fire or flood. If the house doesn’t get burned down or flooded out, everything is okay. Maybe for a hundred years.

Diabetes Risk absolutely predicts there will be years of disability and distress before some final event. No one knows when that will start or when that will end but it certainly will happen sooner than it would without diabetes.

We do know when the average Caucasian non-Hispanic person with diabetes can expect healthy years will be lost and when life will end. Investigators analyzed data from 3992 participants in a National Survey (NHANES 2003-10). Results showed causes of type 2 diabetes and cardiovascular disease included excess body weight as well as age and gender.

Total years of life lost for very obese men and women ranged up to 8 years. Even more striking was the loss of healthy life-years that were 2 to 4 times greater in every category. Those with type 2 diabetes, obesity and cardiovascular disease lost as much as 19 years of healthy life!

The figure shows how body weight affected the results. Weight has been presented as Body Mass Index.

• BMI 30 – 35 defines Mild Obesity. A man who is 70 inches tall in this range would weigh 220 to 240 pounds. A woman who is 66 inches tall in this range would weigh 190 to 210 pounds.
• BMI 35+ defines High-risk Obesity. High risk obesity is about 40% over ideal body weight. High risk obesity for that man would be over 240 pounds. For that woman, her weight would be over 210 pounds.

Note that men and women with high risk obesity had the greatest losses, especially losses in healthy life-years.

The figure also shows how age of onset for type 2 diabetes affected results. Note that patients who developed diabetes at a young age had the greatest losses. 

The next figure shows more clearly which categories had the greatest loss in years of life.

• At 30 years of age, obese adults of low risk had 13 years of poor health until death 7 years prematurely.

• At age 50 years, those with high-risk obesity also suffered 13 years of poor health before death 5 years prematurely.

• At age 70 years, those who escaped diabetes until their later years still had several years of poor health that could have been avoided before death 7 years prematurely.

Diabetes Risk Alert signals inevitable loss of what could have been many more years of good health. They turned into years of poor health. We just don’t know how or when that will happen. Diabetes is one of the costliest and long-lasting causes of chronic illness in the U.S.

Results are obvious. Years of enjoying good health turn into years of compromise, disability and distress.

Limitations Because of Diabetes:

Employment

Diabetes endangers ability to work. Many lose employment and can’t find a job because they can’t do the work. Diabetes also causes work loss time, job limitations and decreased productivity. This all limits earning a living as well as losing employer-sponsored healthcare insurance.

Family, Friends and Community

Limits on things to do and places to go make it difficult to enjoy being with others. It’s especially difficult for someone with severe diabetes being with children and mixing in the community.

Recreation and Entertainment

Most activities are seriously limited when places are difficult to reach and actions are hard to perform. Many complications of diabetes pretty much rule out most vigorous activities. Its becomes impossible to be in many sports or join in recreations. Also, it’s hard to get around the stadium or the playground or the beach. It even becomes difficult to walk in the park.

Improve Quality of Life:

Reversing diabetes almost immediately improves physical mobility, strength, mood and intellect.
The Look AHEAD Study included 5000 people in the U.S. who were Overweight or Obese and had Diabetes. They were treated for eight years. About half were treated with Intensive Lifestyle Intervention (ILI) and half were given standard Diabetes Self-Education (DSE). The group treated Intensively had substantially better results in controlling body weight and increasing physical activity. They also had fewer symptoms of Depression.
The figure shows the results for mental health. During the Study, the group treated Intensively (ILI), shown in the Gold bars, had many fewer symptoms of Depression. The most improvement was during the most intense treatment. Both groups drifted towards more symptoms as they became older and had less contact with their counsellors in self-management.
The next figure shows the results of physical ability to go about their daily lives. During the Study, the subjects treated Intensively (ILI), again shown in Gold bars, were better able to do what they wanted to do during the day. Again, as self-management skills drifted away, so did their quality of life.The Study did not tell us which individuals did the best. We only know that subjects in the group with Intensive Lifestyle Intervention had better quality of life than those given standard Diabetes Self-Education.

We do know that the group with Intensive treatment had higher quality of life and well as more complete reversal of their diabetes.

Diabetes Risk Alerts:

It’s obvious that diabetes is a threat to physical and mental health as well as damaging financial health. Diabetes Risk Alerts tell you when it’s urgent to avoid unwanted results.     

• Overweight/Obesity

More than 3 pounds per inch is a danger alert for diabetes.

“Track your weight—keep it in a good range.”

Waist Circumference Maximum

Another danger alert for diabetes is a maximum waist circumference that is 40 inches or more for a man and 35 inches or more for a woman.

“Diabetes Risk Alert: Pay attention to your waist size.” 

• Eyesight

Good vision is needed to pass the eye tests for keeping a driver’s license. Bleeding in the back of the eyes or early cataracts can be the first sign of diabetes.Even mild loss of vision is a major Risk Alert because diabetes is the most common cause of blindness at any age.

“Be sure to have regular eye exams.”

• Peripheral Nerve Function

Loss of sensory and motor nerve function in arms and legs make it hard to feel and handle things, to use muscles and coordinate movement. Nerve damage from diabetes can also cause pain as well as numbness. Pain caused by diabetic neuropathy is one of the most common and most distressing complications of diabetes.

“Diabetes Risk Alert:  Numbness of the skin and weakness of muscles.”

• Peripheral Vascular Disease

Poor circulation to legs and feet is a serious handicap to walking and climbing stairs. Diabetes not only affects major arteries, it also affects smaller vessels especially in the feet. Skin ulcerations occur frequently and take a long time to heal. Peripheral vascular disease is a very serious alert about complications of diabetes.

“Diabetes Risk Alert: Check your feet for breaks in the skin.”

• Memory and Mental Function

Forgetting things combined with difficulty thinking and making decisions may all be caused by diabetes. Unfortunately, diabetes may progress to cause vascular dementia and Alzheimer’s disease.  Difficulty with memory and IQ function are major risk alerts for diabetes and its complications.

“Diabetes Risk Alert: Forget things you usually remember.”

Pay Attention To Diabetes Risk Alerts:

There are no medical, surgical or mental health treatments that can match personal decision, dedication and persistence. Reaching happy, independent Golden Years depends on investment in health right now.

Contact us. We’ll help you get the Good Health Years you want.

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Good Health Planning for Retirement is more important than Financial Planning. Money can’t buy Good Health but Diabetes Remission saves Money. Contact us and we’ll get you started toward saving money.

Annual Medical Costs

Have you checked your medical expenses for 2018? Are your expenses more than you expected? The average for everybody in the USA today is more than $10,000. If you have diabetes, your expenses likely are more than twice the expenses of people with ideal weight and no diabetes.

Take a look at the figure. The orange column indicates costs on the average for everybody. Note that people who are obese pay an average of about $12,000. People with ideal body weight spend about half that amount or about $6000. Now look at the blue column at the left of the figure. People with diabetes pay almost $14,000 per year, or more than twice the amount paid by people with ideal body weight and no diabetes.

Of course, there’s been a big change in how we pay our bills for medical care. Fortunately, most people have healthcare insurance. During the past 10 years, the average individual healthcare insurance premium has gone up from $160 per month to $390 per month. That’s a three-fold increase! At the same time the deductible for individual healthcare insurance has gone up from $2000 per year to $4000. That’s a twofold increase. Since medical treatment for diabetes has risen from about $150 per month to more than $500, the additional $2000 is unavoidable expense. In addition, copayment (flat fees) or coinsurance (percent costs) is charged for every medical service after reaching the deductible.

Finally, some healthcare insurance plans are increasing rates according to pre-existing medical conditions.

Cost of Chronic Illness

We tend to think about hospitalization for acute illness, surgery and emergencies as terrible costs for medical care. Certainly, we carry healthcare insurance to help us pay for something that requires hospital care. In fact, chronic illness is far more expensive for all of us year after year. Chronic illness causes 86% of all healthcare spending. The combination of diabetes and obesity is the most expensive cause of chronic illness in the USA. The figure shows the relative costs in each major category of illness. You can see in this figure that diabetes and obesity cause medical expenses more than cardiovascular disease or cancer. Both also contribute even more to cost as major causes of cardiovascular disease, cancer and Alzheimer’s disease.

Both diabetes and obesity result from too many calories taken in and too few used for energy. Both can be corrected and would save more than 10% of total healthcare costs in the USA.

Remarkable Cost Savings with Weight Reduction

Saving money by reducing diabetes and obesity actually has been demonstrated by keeping accounts of money spent on healthcare in an HMO. During 12 months, the medical expenses for men and women with diabetes and obesity were recorded. Those who reduced their weight had less cost for medical care than those who gained weight. All of the savings were from decreased costs of anti-diabetes medications including insulin.    

                                               In the figure, we can see the amounts spent by those who lost more than 3.3% of body weight, those who had no change, and those gained more than 3.6% in body weight. Those who lost weight spent $1700 less in one year than those who gained weight.

Those who lost 5 pounds spent $600 less than those whose weight stayed the same. Those who gained 5 pounds spent $600 more. That’s $120 more or less for every pound of body weight gained or lost.
Since the time these people with diabetes were studied, the cost of diabetes medications has more than doubled. Today, the savings for reducing weight at least 5 pounds would be more than $1200. That would be $240 per pound!

Consider all the Costs of Disability and Death

In addition to costs of medical treatment, there are costs because of reduced productivity at work, at home and in the community. Those personal costs increased total cost by about 40%.
Patients with diabetes and obesity are less able to work or interact with family, friends and community. In addition to increasing total cost, intermittent and permanent disability seriously degrade quality of life.

Lifetime Medical Costs

From birth to the end of life the cost for medical treatment for everybody is about $300,000.
In the figure, you can see that treatment of diabetes increases healthcare costs by about $5,000 every year. That includes costs for treating complications of diabetes as well as treating complications of heart disease, stroke, cancer and dementia.
Here, again, overweight and obesity increase medical costs as well as contributing to the cause of diabetes, heart disease, cancer, dementia and stroke.

The $ Value of Good Health

We all know we should save money for retirement. Also, we need good health for length and quality of life after retirement. Money can’t buy health but good health saves money. Reversing diabetes provides good health and the money to enjoy long life in retirement.

One Small Request:

If you enjoyed reading this article, kindly give it a share. Your share is extremely helpful to spread our message and help more like you.

We are pleased to share our blog articles with you, and we are always interested to hear from our readers. Our website address is: www.herdhealthcare.com

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]]> https://herdhealthcare.com/diabetes-remission-saves-money-telehealth-in-texas/feed/ 0 https://herdhealthcare.com/reverse-diabetes-improve-good-health-skill-every-day/ https://herdhealthcare.com/reverse-diabetes-improve-good-health-skill-every-day/#respond Tue, 13 Nov 2018 14:36:03 +0000 https://www.diabetesriskalert.com/?p=1581 Our health behavior is predictably consistent and new health skills can be learned. Overweight/obesity diabetes remission at 50 years of age can recapture an additional 10 years of Good Health beyond age 70, prevent premature death and reduce costs for medical care at least $5,000 per year.

Start a Good Health Journal today:

Every day, do something good for your health and write it down. Start with 5 minutes a day and aim for 30. See what happens in a week, then a month.

If you don’t really like typing on the virtual keyboard of your mobile unit, you can dictate your text and take photos of records. Tap the microphone icon on the screen or in the keyboard display to activate Speech to Text.

Health Behavior is Consistent:

All our behavior is predictably consistent. What we do each day is the same every day. It’s more than just habits like brushing our teeth and combing our hair. More than how we drive to work or go shopping. We are consistent at work, in our social life, what we say to our friends, what we do for entertainment and even how we vote.

Predictably irrational is how psychologist Richard Thaler described behavioral economics.

Dr. Thaler won the 2017 Nobel Prize in Economics. His work shows that assuming people are predictably irrational is the most rational approach to studying their economic behavior. We really do know more than that! Rational or irrational, our consistent health behavior is entirely understandable. Tell me. When was the last time you did something unusual? Why change anything? After all, we made it this far!

Being consistent is something we learn by experience. Subconscious brain activity stores all our previous experience. We come to expect what worked well before will work again and we remember how. Because everybody expects us to be consistent, we do it. Very complex situations don’t bother us because we remember just what to do. Our attitudes and actions are automatic. We don’t even think about it.

When something new appears, we also know what to do. We decide whether we approve of it, whether we need it, whether we can use it, what it will cost us and whether we’ll do something about it. Some times we’ll get right with it, some times we need some persuasion and some times we flatly reject it.

We suppose we’re doing all this by deliberately thinking about it. In fact our subconscious neural networks are filtering this new information and our intentions for new action through memory of our previous experience. You can say what you intend but clearing it for new action requires more than you might expect. You get started by stating what you intend to do and when you’ll do it. Then go on with your activities of normal life and see what happens. If what you intended doesn’t happen, try something less demanding. If nothing works, go back to your source of information and find something more persuasive to get started. When you succeed, keep deliberately trying to accomplish more and more until you find your limit.

Now you’ve got something to work with. Keep trying to do more and more while you build the skill to do it consistently. Do it again, again and again. Eventually you won’t have to think about it. That’s success!

Good Health Plan Description:

Get Started:

√ Keep Good Health Journal to record daily action for good health to be reviewed week by week.
√ Manage with coaching to coordinate planning, measuring, reporting and analysis of good health skills.
√ Manage medications for control of hyperglycemia and hypertension.
√Access and process accurate, up-to-date information about overweight/obesity and diabetes.
√ Manage physical health for blood glucose, blood pressure, body weight, maximum abdominal girth, nutrition and    physical activity.
√ Manage social/professional interactions for eating, drinking, exercise and entertainment.

We’re surrounded by information about what to do. It’s in the newspapers, on TV, it’s talked about amongst family and friends.
For example, your doctor tells you what to eat and drink.

The challenge is where to start. How much is less? How much is more?

Here is where you discover how your stored memory of previous experience affects the results of what you intend to do. As you deliberately plan, train and test your skills in good health, keep a record. That way you’ll know what skills are making progress and which are blocked from progress.

The first task is deliberately recording everything. Start by setting up a Good Health Journal. Make it simple. Use something like Google Keep. On the first day of each new week, write down what you intend to do that week. Then, every day, enter anything you can count, measure or describe related to good health skills.

If you can’t think of anything, or you can’t report something at least 5 days every week, use the time to learn more about getting started. Take as many occasions on as many days as you can to read articles about advantages and benefits of preventing and reversing diabetes.

Self-Managing:

If you are self-managing your Good Health Skills, at the end of every week, review what you intended to do and what got done. For example, here’s what you might have planned and recorded in May 20-26, 2018. The result? Something recorded every day. Success!
If results for the first week were pretty easy, do it again. This time, deliberately plan and explicitly write down something a little more difficult.
If the result was records on fewer than 5 of the 7 days, see if you can figure out what was the problem. Maybe you can fix something. Start with setting an alarm to remind you about recording something every day.

Trial-Run Coaching in Texas (No Charge):

If you live in Texas and wish to start Trial-run Coaching, you can e-mail me at jaherdmd@herdhealthcare.com or call to 713-669-0271. I will reply to each email or call.
If you don’t really like typing on the virtual keyboard of your mobile unit, you can dictate your text and take photos of records. Tap the microphone icon on the screen or in the keyboard display to activate Speech to Text.
At the end of every week, take and share a screenshot of your Good Health Journal or e-mail a copy to me. I will reply with coaching tips.

Telehealth in Texas for Diabetes Prevention and Remission:

MONTH 1:Register in Texas and begin Good Health Coaching: (3rd party Services $110)
 If you live in Texas and decide to register for telehealth coaching, please call/text message me at 713-669-0271 or send an email to jakaherd@gmail.com.

     I will send you a packet of documents by US Postal Service. These documents are Requests for Information that is important for effective coaching. Please fill them out and mail them back to me at PO Box 20669, Houston, TX 77025.

      You also need a food diary account with MyFitnessPal and tests for fasting blood glucose and HbA1c from Request-A- Test.

• MyFitnessPal Premium Account Annual Fee ($50)
• Request-A-Test diabetes screen  ($60)
• Good Health Coaching 1 month (no charge )

Total  $110

We will establish telehealth technology with you for data collection, file transfer and audio/visual communication between Win PC, Android and iOS mobile devices.

 The platform includes hardware and software applications linked within Google and Office 365 ecosystems using secure end-to-end encryption over the internet including WiFi connections. It is completely and strongly HIPAA compliant for audio/visual communication as well as file transfer and data storage.

MONTH 2: Good Health Coaching:  (3rd party Equipment $80  and Refundable Deposit $50 which will be returned when performance criteria are met)

•  Equipment: $80
• Weight Watchers by Conair Body Analysis Glass Bathroom Scale ($30)
• Omron BP 710n 3 Series Blood Pressure Monitor ($30)
• Omron Pedometer HJ 321 (Aerobic Steps and 7-day storage) ($20)
  Total       $80

Refundable Deposit: $50

If you live in Texas and decide to continue coaching beyond the 1st month, you may deposit $50 in an account with DP&R. This money will be refunded at the end of 4 weeks contingent upon:

• One Photo Record of BIA/Body Wt Scale, Digital BP Device and Omron Pedometer, 
• Daily Notes and Records of Measurements in the Good Health Report 5 d/wk and a
• Virtual Coaching Session at least 1 d/wk.

MONTH 3:Managing Blood Glucose: (Refundable Deposit $100 which will be returned when performance criteria are met)

 If you live in Texas and decide to continue coaching beyond the first 2 months, you may deposit $100 in an account with DP&R. This money will be refunded at the end of 4 weeks contingent upon:

• One Photo Record of BIA/Body Wt Scale, Digital BP Device and Omron Pedometer, 
• Daily Notes and Records of Measurements in the Good Health Report 5 d/wk, 
• Full Food Records in MyFitnessPal 3 d/wk and a
• Virtual Coaching Session at least 1 d/wk.

     Objective: Before meals BG 80 to 120 mg/dL and 2hr after meals BG < 180 mg/dL

MONTHS 4 – 10: Managing Diabetes Remission: (Refundable Deposit $100 each month which will be returned when performance criteria are met)

If you live in Texas and decide to continue coaching beyond the first 3 months, you may deposit $100 in an account with DP&R at the beginning of every month. This money will be refunded at the end of 4 weeks contingent upon:

• Photo Records of BIA/Body Wt Scale, Digital BP Device and Omron Pedometer,
• Daily Notes and Records of Measurements in your Good Health Journal 5 d/wk,
• Full Food Records in MyFitnessPal 3 d/wk,
• Virtual Coaching Session at least 1 d/wk and
• Reduced Body Weight -2% in 4 wk.

     Objectives:

Before meals BG 80 to 120 mg/dL and 2hr after meals BG < 180 mg/dL, reduce HbA1c < 6.5%

Reduce BWt -2%/month (-1 to -2 lb/wk) to BWt -15%

Reduce maximum Waist Circumference <40 in for men (<35 in for women)

 Reduce BP< 120/80 mm Hg

Call Us or Contact Us:

James Alan Herd, MD

Call: 713-669-0271
Email: Jaherdmd@herdhealthcare.com
Website: www.herdhealthcare.com

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