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Condition Resources

Welcome to MaxorPlus’ Clinical Corner!  On this page, you will find information about conditions such as high blood pressure and type 2 diabetes, including symptoms, diagnosis process, and available treatments.

The information on this page does not provide medical guidance or recommendations. If you have a questions about your personal health, contact your primary care physician.

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An infographic providing two important statistics about obesity over a blue to purple gradient background. The first statistic, pictured with an icon of 5 people with two people colored light blue and 3 people colored white to emphasize the data, is "2 out of 5 American adults are living with obesity." The second statistic, pictured with an icon of a scale, is "Obesity is the second leading cause of death in the US (behind smoking)."

Background

Obesity is a serious and chronic disease that affects both children and adults worldwide. Obesity affects overall health, increases healthcare costs, decreases productivity, and increases your risk of having many other diseases. Obesity has been linked to developing Type 2 diabetes, heart disease, high blood pressure, fatty liver disease, and certain types of cancers. There are many factors that contribute to excess weight gain including genetics, diet, eating and sleeping patterns, and physical activity levels. Some medications and disease states can also contribute to weight gain.

Risk Factors

There are many factors that play a role in a person’s risk for overweight or obesity:

  • Diet/Eating Patterns: Food and drink intake plays a large part and is a focus of lifestyle changes when trying to combat overweight or obesity.
  • Insufficient Sleep: Short sleep duration can contribute to changes in the way your body uses energy and lead to excess body weight.
  • Genetics: Scientists have identified several genes that may contribute to obesity by increasing hunger which leads to increased food intake. There has also been evidence of specific variations of a gene in families that causes a clear pattern of inherited obesity.
  • Medications: Some medications may lead to weight gain by triggering an increase in appetite or altering the way your body stores energy. Common culprits are steroids, some antidepressants, insulin, and certain antipsychotic medications.
  • Illness: People that are diagnosed with certain conditions may have a harder time managing weight which can lead to overweight or obesity. Hypothyroidism, depression, insomnia, Cushing’s Disease, and congestive heart failure are some examples.

Diagnosis

Being at a weight that is higher than what is considered healthy for a given height is described as overweight or obesity. In order to diagnose overweight or obesity, the Body Mass Index (BMI) screening tool is used. The BMI screening tool uses your weight in kilograms divided by the square of height in meters. Below is a breakdown of the classifications:

  • If your BMI is less than 18.5, it falls within the underweight range.
  • If your BMI is 18.5 to <25, it falls within the healthy weight range.
  • If your BMI is 25.0 to <30, it falls within the overweight range.
  • If your BMI is 30.0 or higher, it falls within the obesity range.

It is important to note that BMI is a screening tool, and it does not diagnose body fatness or health. A trained healthcare provider should perform assessments to evaluate overall health and risks. If you are concerned about your BMI, talk with your health care provider for guidance.

Treatment Goals

The goal of any treatment related to obesity is to reach a healthy and maintainable weight for your body type. Experts recommend losing 5 to 10 percent of your body weight within the first 6 months of treatment. Being at a healthy weight doesn’t mean following a strict diet or program for the rest of your life. By incorporating lifestyle changes like healthy eating patterns, regular physical activity, and stress management, you are much more likely to maintain your goals. Medications that can be used with lifestyle changes are also available to help aide in weight loss for those people that fit certain criteria.

  • Healthy eating plan: Reducing your daily calorie intake, choosing healthier options, eating a variety of fruits, vegetables, protein, and whole grains, and controlling portion sizes for all meals and snacks. Visit myplate.gov for healthy options and meal ideas.
  • Regular physical activity: Consult your doctor before starting a new physical activity program.Start with small goals and build over time. Healthy adults should aim for 150 minutes of physical activity a week.
  • Weight-management programs: Many include counseling sessions with lessons on how to develop healthier habits. Can be online, app-based, or in person. These help with developing plans and small goals that are manageable.
  • Weight-loss medications: Can be prescribed by your medical provider after consultation. Oral medications that are approved for weight loss are taken daily. Injectable medications are administered daily or weekly. Some medications have shown up to 15% weight loss in some people. Used in conjunction with lifestyle changes to be most effective.
FDA-Approved Drugs for Chronic Weight Management
GLP-1- Glucagon-like peptide; SC-subcutaneous
  • Bariatric surgery: An operation that makes changes to the digestive system.Intended for people that have obesity but have not been able to lose weight by other means – normally adults who have a BMI over 40 or over 35 with a serious health problem linked to obesity. This may have immediate and later-emerging side effects as well as require follow-up procedures.

Childhood Obesity Management Strategies

Childhood obesity is a serious problem in the United States, putting children at risk for poor health as they age. As a parent or caregiver, you can do a lot to help your child reach and maintain healthy weight. It is important to teach children healthy habits that will affect their health into adulthood.

  • Keep appointments with your child’s medical provider for check ups: Taking your child to the doctor for a yearly check-up (or more often if needed) will help monitor their weight. Kids grow at different rates and it is important to have their doctor involved in ensuring their weight is in range for their age and height.
  • Be a good role model: Consume healthy foods and drinks and take part in fun, active pastimes with your children.
  • Provide healthy food options: Keep healthy options in the house for snacks and drinks. Water, low-fat milk, and low-sugar drinks are good substitutions for soda and other beverages that are loaded with added sugars. Eat fast food less often. If you do visit a fast-food restaurant, encourage your child to choose healthier options, such as fruit instead of fries.
  • Teach good eating habits: Discourage eating in front of the television or computer and try to have a sit-down meal as often as possible. Don’t make your child clean his or her plate at every meal.

Resources

References

An infographic providing two important statistics about Prediabetes over a blue to purple gradient background. The first statistic, pictured with an icon of three people, is "1 in 3 American adults have prediabetes." The second statistic, pictured with an icon of a profile of human head w/ a question mark in the brain area, is "80% don't know they have prediabetes."

Background

Prediabetes is a health condition where blood sugar levels are higher than normal but not high enough to be diagnosed as type 2 diabetes. Prediabetes usually happens when the body is building resistance to insulin. Insulin is a hormone made by the pancreas, and its key role is to help cells absorb glucose (sugar). This resistance makes it hard for the cells to obtain glucose from your blood stream, causing blood sugar levels to increase. Too much glucose in your blood stream can cause damage to your organs over time and increase your risk of developing type 2 diabetes, heart disease, and stroke.

Symptoms

Usually, patients with prediabetes may not experience symptoms and have their condition go undetected until their prediabetes progresses to type 2 diabetes. One possible sign of prediabetes is darkened skin in certain areas of the body including your neck, armpits, and groin. If you notice this, be sure to reach out to your healthcare provider for further evaluation.

Risk Factors

While there aren’t many symptoms of prediabetes, there are risk factors that may increase your risk of being diagnosed:

  • Being Overweight: This is the primary risk factor for prediabetes. The more fatty tissue you have, especially around your abdomen, the more resistant your cells become to insulin.
  • Waist Size: A large waist size can indicate insulin resistance. The risk increases for men with waists over 40 inches and for women with waists over 35 inches.
  • Being 35 years or older: Although diabetes can develop at any age, the risk of prediabetes increases after age 35.
  • Sedentary lifestyle: The less active you are, the greater your risk of prediabetes.
  • Family history: Having a parent or sibling with type 2 diabetes is a risk factor.
  • Gestational diabetes: If you had diabetes while you were pregnant, both you and your child are at an increased risk of developing prediabetes.
  • Polycystic ovary syndrome: Women with this condition are at an increased risk of prediabetes.
  • Tobacco smoke or vaping: Smoking may increase insulin resistance.
  • High blood pressure: Having high levels of LDL, “bad,” cholesterol.
  • Low HDL cholesterol: This is the “good” cholesterol.
  • High triglycerides: Triglycerides are a type of fat that is found in your blood.

This Prediabtes Risk Test can be used to help you evaluate your risk.

Diagnosis

It is important to visit your doctor annually since most prediabetic patients do not experience any symptoms. Your primary care provider can diagnose by doing a simple blood test. Some of the common blood sugar level tests include fasting blood sugar test, glucose tolerance test, and A1C test.

Treatment Goals

There is good news! Although prediabetes is a serious health condition, with the proper lifestyle changes, you can delay or even prevent the progression to type 2 diabetes.

The primary goals of treating prediabetes include:

  • Prevent from progressing to type 2 diabetes.
  • Reverse prediabetes to normal blood sugar levels.
  • Minimize the chance of cardiovascular events.
  • Improve quality of life.

There are a few lifestyle changes that a person with prediabetes can make that can have a huge impact in improving their health:

  • Losing weight: Lose 5-7% of body weight.
  • Exercising daily: Add 30 minutes of activity (ex: brisk walking) into your daily routine.
  • Changing your diet: Add fruits and vegetables to your daily diet.

After talking to your doctor, you may be prescribed a medication to help manage prediabetes. The most common medication is known as metformin, and you can read more about this treatment below.

Metformin Common Side Effects

Some common side effects of metformin include:

  • Nausea and vomiting
  • Stomachache
  • Metallic taste
  • Lack of appetite

Usually, patients might experience when starting treatment and often will improve overtime. It is important to follow the direction what your doctor prescribed. Here are some ways to minimize the side effects:

  • Take metformin with or after a meal.
  • Take metformin with whole glass of water.
  • Do not drink alcohol while taking metformin.

Patient Management Strategies

Committing to a healthy lifestyle is the best way to avoid progression or reverse prediabetes. Here some of the examples:

  • Follow up with regular doctor checkups and tests such as blood lab and physical exams.
  • Report any side effects or unmanaged symptoms to your pharmacist or your doctor.
  • Decrease weight if overweight or obese.
  • Avoid cigarette smoke, heavy alcohol consumption, and recreational drugs.
  • Exercise regularly to promote healthy lifestyle (moderate-intensity physical activity at least 150 minutes/week).
  • Eat balanced, nutritional diets.

Resources

References

  • American Diabetes Association; Standards of Medical Care in Diabetes—2022 Abridged for Primary Care Providers. Clin Diabetes 1 January 2022; 40 (1): 10–38. Accessed Nov. 29, 2022
An infographic providing two important statistics about Type 2 Diabetes over a blue to purple gradient background. The first statistic, pictured with an icon of a blood glucose meter, is "1 out of 10 American Adults have diabetes." The second statistic, pictured with an icon of a group of 5 people with 1 colored light blue and the other four colored white to emphasize the data, is "1 in 5 American adults are undiagnosed."

Background

Type 2 diabetes (T2D) is the most common form of diabetes, and it means that your body doesn’t use insulin properly. Some people can control their blood glucose (blood sugar) levels with healthy eating and exercise while others may need medication to help manage their disease.

If you have type 2 diabetes, your body doesn’t respond normally to insulin, a hormone made by your pancreas that helps your cells use sugar as energy. Your pancreas senses that your cells aren’t responding to insulin so it keeps making more trying to get the cells to respond. Eventually, your pancreas can’t keep up and your blood sugar rises. High blood sugar is damaging to the body and can cause other serious problems such as heart disease, vision loss, kidney disease, high blood pressure, and many other conditions.

Symptoms

Symptoms of diabetes develop slowly over time and may be so mild that you don’t even notice them. Many people do not find out they have diabetes until they have a diabetes-related health problem such as blurry vision or heart disease. It is important to report any new symptoms to your doctor and keep all doctor appointments to increase your chances of an issue being caught early.

  • Increased thirst and urination.
  • Increased hunger.
  • Blurry vision.
  • Numbness or tingling in the feet or hands.
  • Sores that do not heal.
  • Unexplained weight loss.

Risk Factors

You can develop type 2 diabetes at any age even during childhood. There are certain risk factors that may increase your chance of being diagnosed. Many of these factors are modifiable and changes to your diet and lifestyle habits may help prevent or reverse a type 2 diabetes diagnosis.

  • Prediabetes: Blood sugar levels are higher than normal but not high enough for diabetes diagnosis.
  • Overweight or obesity: Maintaining a healthy weight lowers your risk.
  • Family history: Your genes play a role in how likely you are to have T2D.
  • Low physical activity: Living a sedentary lifestyle increase your risk of developing T2D.
  • Gestational diabetes: If you had diabetes while you were pregnant or gave birth to a baby who weighed over 9 pounds.
  • Non-alcoholic fatty liver disease: A condition where too much fat is stored in liver cells.

Diagnosis

Diagnosing diabetes can be done by simple test that can be completed at your doctor’s office. These tests should be carried out in a health care setting and usually need to be repeated on a second day to give a true diagnosis.

Glycated Hemoglobin (A1C) Test

This blood test shows your average blood sugar level for the past 2 to 3 months. An A1C reading of 6.5% or higher on two separate tests means you have diabetes. Some conditions (such as pregnancy) may alter you A1C result, and your provider may use other diagnostic tests.

Type 2 Diabetes A1C Testing Levels Table. Normal levels are less than 5.7%, Prediabetes levels are between 5.7% to 6.4%, and Diabetes levels are 6.5% or higher.

Fasting Blood Sugar Test

A blood sample will be taken after an 8 hour fast (when you don’t take in any food or sugary drinks). If your fasting blood sugar level is over 126 mg/dl on two separate tests, you may have a diabetes diagnosis.

Type 2 Diabetes Fasting Levels Table. Normal range is less than 100mg/dl, Prediabetes range is between 100 mg/dl to 125 mg/dl, and Diabetes range is 126 mg/dl or higher.

Oral Glucose Tolerance Test

This test is a two-hour test that checks your blood sugar levels before and two hours after you drink a special sweet drink. It tells the doctor how your body processes sugar.

Type 2 Diabetes Glucose Tolerance Test Levels. Normal levels are less than 140 mg/dl, Prediabetes levels are between 140 to 199 mg/dl, and Diabetes levels are 200 mg/dl or higher.

Treatment Goals

The goal of any lifestyle changes or treatment for T2D is to be able to maintain a normal blood sugar level. You may be able to manage T2D with healthy eating and being active, or your doctor may prescribe oral or injectable medications to help manage your blood sugar and avoid complications of high blood sugar levels. While medications may help, it is very important to eat a healthy diet, increase physical activity, and manage stress to help reach your goals.

There are many different types of medications that help manage blood sugar levels for people with type 2 diabetes. The chart below highlights some of the more common medications that are prescribed. Your doctor will choose the best therapy or combination of therapies to help you manage your blood sugar.

Type 2 Diabetes Treatment Medication Types. This table displays the different medication types used to treat Type 2 Diabetes: Biguanides (Metformin), Sulfonylureas (Amaryl, Glucotrol), Meglitinides (Prandin), DPP-4 inhibitors (Actos, Avandia), SGLT Inhibitors (Farxiga, Januvia), and GLP-1 Receptor Agents (Ozempic, Rybelsus, Trulicity)

Preventing Type 2 Diabetes

By implementing lifestyle changes and altering daily habits, many people can delay or prevent the onset of type 2 diabetes. The longer you have diabetes, the more likely you are to develop health problems, so delaying diabetes by even a few years will benefit your overall health. By making lifestyle changes that are manageable long term, you can significantly reduce your risk of developing type 2 diabetes.

  • Lose weight and keep it off: You may be able to delay or prevent type 2 diabetes by losing 5 to 7 percent of your starting weight. For a person who weighs 200 pounds, that is a 10 to 14 pound weight loss.
  • Increase physical activity: Work up to a goal of 30 minutes of activity 5 days a week. Be sure to talk with your doctor before starting any form of new activity and start slowly to work up to your goal over time.
  • Make healthy food and drink choices: By eating smaller portions and choosing healthier options, you can slowly work towards your weight goal. Choosing water flavored with real fruit over sugary drinks is one small tweak that can make a big difference.
  • Talk to your healthcare provider: There are many support groups, diabetes educators, and wellness trainers available online and in person throughout the United States. Be sure to reach out to your doctor or pharmacist if you need help with where to go for help getting started.

Resources

References

  • https://diabetes.org/diabetes/type-1
  • https://www.cdc.gov/diabetes/
  • Diabetes Prevention Program Research Group. Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. The Lancet Diabetes & Endocrinology. 2015;3(11):866‒875
An infographic providing two important statistics about Type 1 Diabetes over a blue to purple gradient background. The first statistic, pictured with an icon of an insulin injector pen, is "5 to 14: ages when Type 1 Diabetes is most often diagnosed." The second statistic, pictured with an icon of an insulin pump, is "5 t0 10% of diabetes diagnoses are Type 1."

Background

Type 1 diabetes (T1D), once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition. If you have type 1 diabetes, your pancreas doesn’t make insulin or makes very little insulin. Insulin is required in your body to help sugar enter the cells to be used as energy. Without insulin, blood sugar builds up in the blood stream and leads to many of the symptoms and complications of diabetes. This disease state is less common than type 2 diabetes and usually develops in children and teens, but it can happen at any age.

Type 1 diabetes is considered an autoimmune disease where the body attacks its own cells in the pancreas, making it unable to produce insulin correctly. This attack can go on for months or years before any symptoms appear. Some people have a family history that makes them more likely to develop type 1 diabetes. However, not all people with a family history will go on to develop T1D. Diet and lifestyle habits do not cause this form of the disease.

Symptoms

There are many different symptoms of T1D that may show up over time. Be sure to see your doctor if you or your child have any of the following diabetes symptoms:

  • Urinate a lot, often at night.
  • Bedwetting in children who never wet the bed.
  • Can’t quench your thirst.
  • Losing weight without trying.
  • Increase in hunger.
  • Blurry vision.
  • Numb or tingling hands or feet.
  • Very dry skin.
  • Sores that heal very slowly.
  • Nausea, vomiting, or stomach pains.

Risk Factors

Type 1 diabetes is not caused by what you eat or your lifestyle habits. It is thought to be caused by an autoimmune reaction where the body attacks itself by mistake.

  • Family history: Having a parent or sibling with the disease. Having certain genes increases the risk of type 1 diabetes.
  • Age: Usually develops in children, adolescents, and teens. T1D can be diagnosed at any age, but normally in the younger years.

Diagnosis

Diagnosing diabetes is done by simple test that can be completed at your doctor’s office. There are a few additional tests that may be completed in order to correctly diagnose type 1 diabetes.

  • Glycated hemoglobin (A1C) test: This blood test shows your average blood sugar level for the past 2 to 3 months. An A1C reading of 6.5% or higher on two separate tests means you have diabetes. Some conditions (such as pregnancy) may alter you A1C result, and your provider may use other diagnostic tests.
  • Random blood sugar test: A blood sample will be taken at a random time and may be confirmed by additional tests. A random blood sugar level of 200mg/dl or higher suggests diabetes.
  • Fasting blood sugar test: A blood sample will be taken after an overnight fast (when you don’t take in any food or sugary drinks). If your fasting blood sugar level is over 126 mg/dl on two separate tests, you may have a diabetes diagnosis.
  • Antibody test: If you are diagnosed with diabetes, your provider may run tests to check for autoantibodies in the blood. Certain types are common in type 1 diabetes. This test helps your provider determine between type 1 and type 2 diabetes.
  • Ketone urine test: Ketones are the byproducts of fat breakdown in the body. If you are diagnosed with diabetes and also have ketones in your urine, it suggests type 1 diabetes.

Treatment Goals

Type 1 diabetes means that you will be prescribed insulin to help your body better use the sugar that is in your blood stream. The goal is to keep your blood sugar levels in an acceptable range so that you decrease your risk of damage from high blood sugar levels. You will need to test your blood sugar throughout the day and inject insulin accordingly.

Testing your blood sugar can be done manually with a finger stick and blood sugar monitor. Newer products can be worn on the body and monitor your blood sugar automatically.

Different amounts of insulin may be needed throughout the day depending on what you eat, your activity level, and your blood sugar readings. There are three terms to become familiar with as you start to manage your insulin: onset, peak, and duration.

  • Onset – how long it takes for the insulin to start lowering your blood sugar.
  • Peak – how long it takes for the insulin to be at maximum strength in your body.
  • Duration –how long it continues to work in your body.

See the chart below to start to learn some of the different types of insulin available. Be sure to ask your doctor or pharmacist any questions that you may have when it comes to insulin products.

Chart that displays the different types of insulin available for Type 1 Diabetes: Rapid-acting, Regular or short-acting, Intermediate-acting, Long-acting, and Ultra-long-acting.

Managing High and Low Blood Sugar

It is common for people living with diabetes to have fluctuations in their blood sugar levels. It is important to have a plan in place in case you experience symptoms of low blood sugar (hypoglycemia) or high blood sugar (hyperglycemia).  Talk with your doctor to ensure you and your family and friends know how to treat the symptoms of high or low blood sugar.

  • Symptoms of low blood sugar (hypoglycemia)
    • Hunger
    • Fast heartbeat
    • Anxiety
    • Sweating
    • Confusion

Be sure to keep quick sources of sugar on hand to treat hypoglycemia episodes, such as fruit juice; sugar tablets; corn syrup.

  • Symptoms of high blood sugar (hyperglycemia)
    • Increased thirst and urinationBlurry visionStomach ache, nausea, vomitingSweet smelling or fruity breath
    • Shortness of breath

For a person with type 1 diabetes, hyperglycemia is best managed with a supplemental dose of insulin that is part of the person’s treatment plan.

Resources

References

An infographic providing two important statistics about High Cholesterol over a blue to purple gradient background. The first statistic, pictured with an icon of an artery with plaque, is "86 million adults suffer from high cholesterol." The second statistic, pictured with an icon of a doctor and patient consultation, "0: High cholesterol has no symptoms and requires a blood test to diagnose."

Background

Hyperlipidemia, otherwise known as high cholesterol, means that the cholesterol level in your blood is higher than the normal range. Cholesterol is a waxy, fat-like substance that is made in your liver. Everyone needs cholesterol as it is required in order for your body to make hormones and digest fatty foods. However, your body produces all of the cholesterol that it needs to function, which is why experts recommend that people eat as little dietary cholesterol (cholesterol that is found in the foods we eat) as possible while on a healthy eating plan.

Cholesterol is measured in milligrams per deciliter (mg/dl) and can be measured by a health care professional via a blood test. This test (also called a lipid panel or lipid profile) will usually check the levels of cholesterol and triglycerides in your body.

  • Low-density lipoprotein (LDL) or “bad” cholesterol: High levels of LDL cholesterol can lead to buildup in your arteries and result in heart disease or stroke.
  • High-density lipoprotein (HDL) or “good” cholesterol: High levels of HDL cholesterol can lower your risk of heart disease or stroke.
  • Triglycerides: Type of fat that your body uses for energy. High triglycerides combined with high LDL or low HDL can increase your risk of heart disease or stroke.
  • Total cholesterol: Total amount of cholesterol in your blood based on HDL, LDL, and triglycerides.

High cholesterol is defined as having a total cholesterol level above 200mg/dl. Having high cholesterol can lead to many health problems over time. It is important to work with your healthcare team to manage high cholesterol and lessen your risk of severe health issues.

Risk Factors

Hyperlipidemia has no symptoms, and there is no way to tell if you have it other than getting your cholesterol levels checked. There are risk factors that may increase your chance of developing high cholesterol. Some of these factors are out of your control, but others can be modified with lifestyle habits:

  • Age: Everyone’s risk for high cholesterol goes up with age.
  • Genetics: Some people have an inherited genetic condition called familial hypercholesterolemia (FH). This condition causes very high LDL cholesterol beginning at a young age that continue to worsen over time if not treated.
  • Type 2 diabetes: Diabetes can play a role in raising LDL cholesterol and lowering HDL cholesterol levels.
  • Obesity: Being overweight is linked to high triglyceride, high LDL, and low HDL levels.
  • Diet: Eating foods that are high in saturated fat and trans fat may contribute to high cholesterol.
  • Physical inactivity: Not getting enough physical activity can contribute to weight gain, which can lead to high cholesterol.
  • Smoking: Smoking causes damage to your blood vessels, which makes them more likely to collect fatty deposits and leading to high cholesterol levels. Smoking may also lower HDL (good cholesterol) levels.

Diagnosis

Diagnosing hyperlipidemia can only be done by getting your blood levels checked by your health care team. Talk to your doctor about how often you need to get your cholesterol levels checked.

2 column table describing the optimum levels for your cholesterol: Total should be about 150 mg/dl, LDL (bad) should be 100 mg/dl, HDL (good) should be at least 40 mg/dl in men and at least 50 mg/dl in women, and Triglycerides, which should be less than 150 mg/dl.

Treatment Goals

The goal of any lifestyle changes or medication therapy used to treat high cholesterol is to maintain cholesterol levels that are within, or close to, normal range. There are many health conditions that are affected by high cholesterol levels. Working towards maintain healthy levels may reduce your risk for heart attack, stroke, and heart disease. Talk to your doctor about your treatment options. Some people are able to maintain healthy cholesterol levels with lifestyle changes alone while others may need to add in medication to reach their goals.

  • Lifestyle Changes aka a Low Cholesterol Diet: Diet can play an important role in lowering your “bad” cholesterol and increasing your “good” cholesterol. Adding in healthier options while cutting out unhealthy saturated fats can help lower cholesterol levels. Saturated fats can be found in foods like butter, cheese, and red meats and should be limited in a healthy diet.
This table lists foods that help you lower cholesterol: HIgh fiber foods, Omega-3 fatty acids, fruits and berries, and monounsaturated fats.
  • Increase Physical Activity: Not getting enough physical activity can lead to weight gain, which increases your risk for high cholesterol. Setting a goal of being active for 30 minutes per day, 5 days a week can help you maintain your weight while keeping your heart healthy and lowering your high cholesterol risk. If you don’t currently get a lot of physical activity, talk to your doctor about a plan that would work for you. Starting slow and adding on a few minutes a week makes a difference over time!
  • Quit Smoking: Smoking harms nearly every organ in the body, including your heart and blood vessels. When you smoke, the walls of your blood vessels become damaged. This damage makes it easier for your LDL (bad) cholesterol to stick to the walls of your arteries, clogging them up. This build up, known as plaque, can break off and get into your bloodstream causing severe blockage, heart attack, or stroke. Smoking also lowers your HDL (the good cholesterol) level which normally helps clear plaque buildup from your vessel walls.

Cholesterol-lowering Medications

Many people need medication in order to help lower their cholesterol levels to a normal range. If you are prescribed a medication to help lower your cholesterol, be sure to take it as directed and report any side effects to your doctor.

This table lists common medications used to treat high cholesterol such as Statins, Ezetimibe, Bile acid sequestrants, PCSK9 inhibitors, ACP inhibitors, and Fibrates.

Resources

References

An infographic providing two important statistics about High Blood Pressure over a blue to purple gradient background. The first statistic, pictured with an icon of a heath professional taking a patient's blood pressure, is "1 in 3 adults are unaware they have high blood pressure." The second statistic, pictured with an icon of a person having chest oain, "0: Called a silent killer as people do NOT always experience symptoms."

Background

Hypertension, or high blood pressure, affects tens of millions of adults across the United States. Many people do not know they have high blood pressure as this disease state usually doesn’t show any symptoms. Hypertension can increase your risk of heart disease and stroke, which are both leading causes of death for Americans.

Blood pressure is the pressure of blood pushing against the walls of your arteries. Your blood pressure can change throughout the day based on your activity level at the time. Having blood pressure readings that are consistently over the normal range may lead to a diagnosis of hypertension. Since hypertension usually shows no symptoms, it is important to see your doctor regularly so they can monitor your blood pressure over time and take action if needed.

Risk Factors

There are many risk factors that can increase your chances of being diagnosed with high blood pressure. Many of these factors are things that you can control, while others, like your age or family history, cannot be controlled.

  • Diabetes: About 6 out of 10 people who have diabetes also have high blood pressure. A person with diabetes is about twice as likely to have high blood pressure than a person who doesn’t have diabetes
  • Unhealthy Diet: Taking too much sodium (salt) into your body as well as not eating enough potassium, a mineral that your body needs, can increase blood pressure. Drinking too much alcohol (more than 1-2 drinks per day) can also increase your risk.
  • Physical Inactivity: Regular physical activity helps keep your heart and blood vessels strong, which may help lower your blood pressure.
  • Obesity: Being overweight makes it harder for your heart to pump blood and oxygen around your body, leading to stress on your blood vessels. This can also increase your risk of heart disease and diabetes.
  • Tobacco Use: Nicotine, a chemical found in tobacco, raises blood pressure, and smoking can cause damage the heart and blood vessels.

Diagnosis

Your blood pressure consists of two numbers: the ‘top’ (systolic) number and the ‘bottom’ number (diastolic). Your systolic pressure is a measure of the pressure in your arteries when your heart beats. The diastolic pressure is a measure of the pressure in your arteries when your heart rests between beats.

For most adults, a normal blood pressure is less than 120/80 mm Hg. Your blood pressure is considered high when you have consistent systolic readings of 130 mmHg or higher or diastolic readings of 80 mmHg or higher. Talk to your healthcare provider if your blood pressure readings are consistently higher than 120/80.

Certain medications or disease states may increase or decrease your blood pressure. Talk to your doctor about what your personal blood pressure goal is.  

Treatment Goals

Managing high blood pressure may require a combination of lifestyle changes and medication. Your doctor can help you develop a plan to reach your treatment goal.

What can I do to help manage high blood pressure?

  • Set a goal of at least 150 minutes of physical activity each week.
  • Stop smoking/using tobacco products.
  • Eat a healthy diet – limiting sodium (salt) and alcohol.
  • Maintain a healthy weight.
  • Manage stress.

What if my doctor prescribes a medication to help lower my blood pressure?

  • Blood pressure medication is very common and can make a huge impact on controlling high blood pressure.
  • Be sure to take the medication as prescribed.
  • Keep all doctor appointments to monitor your progress.
  • Learn how to take your blood pressure at home if needed to help monitor your numbers.

See below for a list of some of the common types of blood pressure medications. This list is not all-inclusive and is meant to be used for informational purposes only. Talk to your doctor or pharmacist for more information on medications used to help lower blood pressure.

This table contains common medications used to treat high blood pressure including ACE inhibitors, ARBs, Beta-Blockers, Calcium Channel Blockers, and Diuretics.

Impacts to Blood Pressure Readings

Your doctor will take your blood pressure at every appointment, and you may be asked to monitor your blood pressure by taking your own measurements at home. There are a few points to keep in mind when taking your blood pressure to help you get a more accurate measurement.

  • What you ate or drank before your reading: If you drank alcohol or caffeine within 30 minutes of having your blood pressure checked, your reading may be higher.
  • What you did before your reading: If you exercised or ran into the doctor’s office to avoid being late, your blood pressure may be affected. Be sure to relax for 10-15 minutes before your reading to ensure your pressure has normalized.
  • How you sit for your reading: Crossing your legs and letting your arms hang at your sides may increase your reading. Sitting with your feet flat on the floor and your hands resting at chest height can help with a more accurate measurement.

Resources

References

An infographic providing info about how brand and generic medications are similar over a blue to purple gradient background. "Brand and Generic medications have the same active ingredients, safety, effectiveness, strength, quality, and benefits."

Background

Did you know that it takes an average of 10-15 years to develop a new brand-name drug? The process includes discovery and development, preclinical research, clinical trials, review by the Food and Drug Administration (FDA), and drug safety monitoring. Each step of this process costs money sometimes adding up into the billions of dollars before a drug can even be marketed to the public!

Generic drugs are ‘copies’ of an original brand-name drug. These products go through extensive testing and FDA review before they can be available to the public. The company making the generic product must prove that their drug provides the same clinical benefit and is as safe and effective as the brand-name medicine it duplicates.

Generic Approval Process

In order for a generic medication to be approved, the manufacturer must submit an application to the FDA that shows the generic is:

  •  “Pharmaceutically equivalent” to the brand: The generic must be the same type of product as the brand (tablet, capsule, injection, etc.). It must also use the same time release technology (e.g. extended release, long acting, immediate release).
  • Made correctly and consistently: The generic manufacturer must be able to provide evidence that their manufacturing process will produce the same product every time.
  • Same active ingredient as the brand: The active ingredient is the component that is effective against the illness or condition it is treating.
  • Correct amount of active ingredient gets into bloodstream: Same amount of drug gets to where it needs to go at about the same time as the brand product.
  • “Inactive” ingredients are safe: The parts of the generic product that do not affect how the drug works must be safe for humans. These inactive ingredients can be different from those found in the brand.
  • Drug does not break down over time: Tests must show that the generic product last for a specified amount of time in the packaging.
  • Container is appropriate: If the container the drug is shipped does not meet standards, the generic product may deteriorate faster than expected.
  • Label is same as the brand-name drug’s label: Labeling must be approved to ensure contains information for safe use.
  • Relevant patents are expired: All relevant patents and legal exclusivities must be expired in order for the generic product to be marketed.

Generic Differences

There are allowable differences in the generic product when compared to the brand-name product. The generic may differ in:

  • Inactive ingredients
  • Size
  • Shape
  • Color

None of these differences impact how the medication works in the body.

Generic Benefits

One main benefit of a generic drug is that it costs less than its brand-name counterpart. Generic manufacturers do not have to repeat costly animal and human (clinical) studies that were completed for the brand-name product. This can significantly lower the overall cost of developing a generic medication.

Multiple generic manufacturers can produce a generic medication for the same brand-name drug. When this happens, the price for the generic goes down even more.

References

An infographic providing two important statistics about Alzheimer's over a blue to purple gradient background. The first statistic, pictured with an icon of three people, is "1 in 9 adults over 65 have Alzheimer's." The second statistic, pictured with an icon of a female, is "2 out of 3 Alzheimer's patients are women."

Background

Dementia is a general term for loss of memory, language, problem-solving, and other thinking abilities that are severe enough to interfere with daily life. Alzheimer’s disease is the most common type of dementia, accounting for 60-80% of dementia cases. It is progressive, beginning with mild memory loss, leading to the loss of ability to respond to the environment.

Dementia is caused by damage to brain cells that interferes with the ability of those cells to communicate with each other correctly. Scientists are working to determine the true cause of Alzheimer’s disease. They know that high levels of certain proteins inside and outside brain cells affect the way those cells talk to each other. Clinical trials are underway that focus on lowering these proteins in an effort to slow the progression of the disease.

Symptoms

Alzheimer’s disease is not a normal part of aging. Researchers believe there isn’t one cause, but that it likely develops from multiple factors, including genetics, lifestyle, and environment.

The most prominent symptom is difficulty with memory. In addition to memory issues, people with Alzheimer’s disease may experience one or more of the following additional symptoms:

  • Trouble handling money and paying bills.
  • Decreased or poor judgement.
  • Changes in mood or personality.
  • Misplacing items and being unable to retrace steps to find the item.
  • Difficulty in remembering newly learned information.
  • Memory loss that leads to repeating the same question or getting lost in familiar places.

Risk Factors

There are risk factors that play a part when determining if a person has Alzheimer’s:

  • Age: Most people with the disease are 65 and over, although some people are diagnosed at a younger age. After age 65, the risk for Alzheimer’s doubles every 5 years.
  • Family History: Those who have a parent or sibling with the disease are more likely to develop Alzheimer’s themselves.
  • Genetics: There are certain genes that are known to be related to Alzheimer’s. While genetic testing is available to evaluate for these genes, these types of tests are cautioned against until a person has had proper counseling and understands the information. Your doctor can help you decide if genetic testing would be beneficial.

Diagnosis

There is not one specific test to determine if someone has Alzheimer’s disease. Doctors diagnose Alzheimer’s and other types of dementia based on the patient’s medical history, lab tests, and memory function evaluations. To get a more accurate diagnosis, a person may need to get images of their brain (MRI, CT, PET scan) or a test done on their cerebrospinal fluid, the fluid that cushions the brain.

It is important to contact a doctor if you suspect that you or a loved one is showing signs of dementia. Your provider can help determine if the symptoms are related to dementia or something else, like a vitamin deficiency or a side effect from a medication. Early intervention can also open the door to more opportunity for you and your family to consider future plans, enroll in clinical trials, and anticipate financial needs.

Treatment Goals

The main treatment goal for a person with Alzheimer’s disease is to improve their quality of life. There is currently no known cure for this disease. However, interventions are available that can help with maintaining brain health, managing symptoms, and slowing or delaying progression of the disease.

There are different types of medications approved for Alzheimer’s disease. Your doctor will work with you to decide if treatment would be beneficial and what type of medication would be the best therapy for you.

Cholinesterase Inhibitors & Side Effects

Examples: Aricept (donepezil), Exelon (rivastigmine), Razadyne (galantamine).

These medications are approved for the symptomatic management of mild to severe disease. Patients may see small improvements in cognition and activities of daily living with these medications. However, these drugs do not prevent or delay progression of the disease.

Common Side Effects:

  • Nausea
  • Diarrhea
  • Vomiting
  • Headache
  • Anorexia
  • Muscle cramps
  • Atopic dermatitis

NMDA Receptor Antagonists & Side Effects

Examples: Namenda (memantine).

These medications are approved for the symptomatic management of moderate to severe Alzheimer’s disease and can be used in combination with cholinesterase inhibitors. These drugs do not prevent or delay the progression of the disease.

Common Side Effects:

  • Headache
  • Dizziness
  • Confusion
  • Constipation
  • Hypertension

Anti-Amyloid Agents & Side Effects

Examples: Leqembi (lecanemab).

This class of drug is approved to help treat people with Alzheimer’s disease with mild cognitive impairment or mild dementia. This is the only class to have shown evidence of reducing clinical decline.

Common Side Effects:

  • Headache
  • Infusion-related reactions
  • Amyloid-related imaging abnormalities (ARIA

Resources

Support

Background

A woman’s body and mind go through many changes during and after pregnancy. It is normal to experience a wide range of feelings while you are pregnant and even in the few weeks after having a baby. The time after giving birth is called the postpartum period. Many women get what is known as the “baby blues” during this time. They feel sad, worried, or extremely tired in the days after giving birth. This feeling usually goes away after a few days.

If you feel sad, hopeless, anxious, or like you don’t love or care for your baby and these feelings last longer than two weeks, you may have postpartum depression. There are treatments, such as therapy and medicine, that can help you and your baby have a happy and healthy future.

Symptoms

Postpartum depression (PPD) can be treated, and the faster that you get the help that you need, the faster you can be on the road to feeling better. If you are having any of these symptoms for more than two weeks, you may need to get help. The right treatment can help with mild to severe symptoms and can lead to a recovery over time.

While the warning signs are different for every woman, some of the symptoms may include the following:

  • A loss of pleasure or interest in things you used to enjoy.
  • Eating much more, or much less, than usual.
  • Anxiety – all or most of the time – or panic attacks.
  • Feeling guilty or worthless.
  • Feeling sad and crying uncontrollably for long periods of time.
  • Feelings of not being a good mother.
  • Not being interested in the baby, family, and friends.

Risk Factors

Postpartum depression can happen to any woman. However, there are some factors that may put a woman at more of a risk of having postpartum depression. Examples2 include the following:

  • Had depression before or during pregnancy.
  • Have a family history of depression.
  • Had a difficult of traumatic birth.
  • Was abused as a child.
  • Have little to no support.
  • Are under the age of 20.
  • Have relationship problems, money worries, or experience other stressful life events.

Being open and honest about your feelings with your doctor can help you get the help you need during this time.

Diagnosis

While many women have the baby blues after childbirth, those symptoms usually go away within the 10 days after delivery.3 The baby blues may include the following:

  • Mood swings.
  • Feeling sad, anxious, or overwhelmed.
  • Having crying spells.
  • Loss of appetite.
  • Trouble sleeping.

Symptoms of postpartum depression last longer, are more severe, and may require treatment by a healthcare professional. Your doctor can diagnose and develop a plan for treatment that works best for you.

Treatment Goals

There are many kinds of treatment that can be used to help you feel better. These methods can be used alone or together. Your healthcare provider can help develop a plan that works best for you.

  • Therapy – Counseling or therapy sessions with a mental health professional can help you understand your emotions and work through challenges.
  • Support groups – Talking with others who are also dealing with postpartum depression may help. Your healthcare provider can direct you to groups in your area. The U.S. Department of Health & Human Services offers a website focused on postpartum depression at www.womenshealth.gov.
  • Self-care – Taking care of yourself during this time is important. Getting rest when you can, eating healthy foods, and asking for help when needed may help you feel better.
  • Medicine – In some cases, your provider may prescribe medicine to help you manage symptoms. Antidepressants are the most common medicine used to help lessen the symptoms of postpartum depression. Some of these can be taken while breastfeeding. Be sure to talk to your doctor or pharmacist about options.

Approved Medicines

While many antidepressants are prescribed to help with postpartum depression, there are some medicines that are approved just for this illness. Some examples include the following:

  • Zurzuvae™ (zuranolone): This is an oral capsule medicine approved to treat postpartum depression.4
  • Zulresso™ (brexanolone): This is a medicine given into the vein in a healthcare setting. It is also approved to treat postpartum depression5. Your healthcare provider will work with you to determine the best mix of treatment to help with your situation.

Sources

What does mental health parity mean?

Mental health parity means that we must treat mental health or substance use disorder (SUD) conditions the same, or better than, similar medical or surgical conditions. We will not charge you more money or limit your coverage just because a drug is used to treat a mental health or SUD condition. This is sometimes called providing mental health/SUD benefits in parity with medical/surgical benefits. Maxor follows all mental health parity laws.

What is the ‘Mental Health Parity and Addiction Equity Act’?

The Mental Health Parity and Addiction Equity Act (MHPAEA) is a law passed by the federal government in 2008. This law has expanded over the years to cover more people. There are also state laws protecting mental health parity. The laws say we cannot treat a mental health or substance use disorder (SUD) worse than similar medical conditions. This includes not charging you more money or limiting your coverage. The law does not require us to cover all mental health/SUD drugs though.

Does my plan have to follow the mental health parity laws?

Most large group plans and individual plans must follow mental health parity laws. Other plans may not have to follow these laws. Mental health parity laws are complex, so it is best to check if you are unsure. You can ask your health plan, insurance agent, plan administrator, or your human resources team.

What should be equal when it comes to my benefits?

There are many mental health and substance use disorder (SUD) benefits that should be treated equally. This includes things like financial and frequency limits. For example, your co-pays and deductibles cannot be more because you are receiving treatment for a mental health condition.

Does my pharmacy plan follow the mental health parity laws?

Yes. Maxor follows all mental health parity laws.

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