time now for "sunday house call." >> author of "the inner pulse." >> we want to start with something amazing. there is a stunning report on diabetes showing that 29 million people in the united states now suffer from the disease, that's up from 26 million in 2010.

one in four people with diabetes don't even know they have it. what's causing the heepidemic. >> we're losing the battle, we're gaining about 1 million diabetics a year. but it's a silent killer because you may have diabetes without even knowing it and that's the prediabetics that we're worried about. got 86 million americans are prediabetic. your is sugar level is high, not high enough to be a diabetic. but it's important to look at the symptoms. it's important to know what the symptoms are diabetes are, you have frequent urination, you're frequently thirsty, you have blurred vision, you have a wound and it takes a long time to heal. tingling in the fingers and toes.

besides your blood sugar, you should get a hemoglobin a1c. this is a record of what your -- if it's 5.7%, that's normal, if it's over 6.5, that's diabetic and we have to start treating you. >> i want to get back to, why is this happening? i still don't get it. >> i'm going to answer that in a second, but i want to emphasize david's point about the hemoglobin a1c. why is it happening? it's happening because of all of our weight gain. 2/3 of americans are overweight. one-third are obese. the pancreas produces a hormone called insulin, we take in sugar. but the bigger we are, the more insulin we need.

and that it's like a motor going faster and faster. you get to resistant to it after a while if you weigh too much. as an internist, i have to look at the other risks, high blood pressure, high cholesterol. people are at risk for heart disease, for stroke. >> it all seems to be from our lifestyle, and eating as well. >> you got to exercise, you got to eat right. we're eating way too much sugar, we're a sedentary society. if you get up and exercise every day, do some cardio, even if it's just walking, and you have change your diet choices. we talk about the mediterranean diet. >> what is that salads? >> it's fruit and vegetables, it's olive oil, it's sauces, it's fish, not a lot of meat, not a lot of processed foods, you can even have a glass of wine occasionally. >> this is a behavioral problem

that we have. we are passing on this problem to our children, about 70% of our children are heading toward diabetes and we have a huge problem. the age between 15 and 19-year-olds is the group that's on the rise with diabetic. to answer your question, is it obesity that causes diabetes or is it diabetes that cruise -- your body, your pancreas is not producing insuddenly llin. the food is cheap and you can eat a lot of these foods, as a result of obesity, your insulin doesn't work. that's why losing weight and

trying to get rid of that fat can help treat diabetes. >> that can help treated, it can help avoid it, but does it cure it? >> type 1 diabetes is an auto immune disease, it's genetic, it's not purely related to weight. type 2 is related to weight, so to answer your question, yes, i can prevent this. if i have a patient that has a high sugar and they literally exercise and drop weight, i have about a 20 to 30% chance of them never getting diabetes over the next five years. >> can you get rid of it if you get it? >> you can get rid of it if you get it, type 2. there's ho there's hope, you're not stuck with it. you can get rid of it. >> it can affect your kidneys, it can cause kidney disease.

it can cause cardiovascular disease, it can cause blindness. when you come in to dr. siegel's office, by bringing you down to closer than normal, we can fix it for you, so you don't end up having this systemic disease. $245 billion of the health care costs is going to diabetes. get out there, start losing weight, start exercising. >> i want to emphasize one point that david just made that is huge, which is the combination of lifestyle, i once had a patient that could. get his sugar under control no matter what. a nurse whispered to me, no matter what you do, he's still going to drink that strawberry soda. >> if you're over the age of 45, if you have family history of

diabetes, these are high risk groups and they should be monitored on a regular basis. the effects of diabetes can stay in your system to many, many years. >> you're talking about kids, they're not out there running around like we did, playing jump rope or whatever we did as kids. they're sitting at the computer or on the phone. >> when the parents go to these fast food restaurants, the kids are learning the same kind of behavior. and that's where you bring in -- >> i said they have not incorporated all the food, vegetables in there. >> we're going to talk about lunch programs in a few months. you know something? you can have all the lunch healthy choices as you want. but the kids are still lining up

for the soed dda and pizza. do you feel tired and run down, i'm talking about all the time? it may have to do with how you spend your time when you're awake and nothing to do with the amount of time you sleep, we'll talk about it when we come back. r about viagra. ask if your heart is healthy enough for sex. do not take viagra if you take nitrates for chest pain; it may cause an unsafe drop in blood pressure. side effects include headache, flushing, upset stomach, and abnormal vision. to avoid long-term injury, seek immediate medical help for an erection lasting more than four hours. stop taking viagra and call your doctor right away if you experience a sudden decrease or loss in vision or hearing. this is the age of taking action. viagra. talk to your doctor.

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...and a choice. take 4 advil in a day which is 2 aleve... ...for all day relief. "start your engines" new findings show lack of sleep may not be the only thing draining your energy, instead, it may have a lot to do with how well you take care of yourself during the day when you're out and about. dr. siegel, is there a magic secret to what we should where doing during the day. >> if you come to my office, the first thing i'm going to check you for is medical causes, i got to rule that out. do you have thyroid disease, do you have a problem with obesity,

depression is a huge cause of fatigue, if i get all that out of the it's not medical. i look at things like how much alcohol are you drinking, are you breaking you're cycle and waking up in the middle of the night when cthe wine wears off. >> we're talking about what we're doing during the day. >> no, exactly. are you exercising? if you exercise, if will help you a lot. there's a study that shows that if you simply cut a person's regular exercise, they increase their fatigue. are you stressed? is there anxiety. if you are stressed, it increases your fatigue, depression increases your fatigue. caffeine, i want to say one last thing, we have talked on the show, david has brought to my attention, the effects of coffee. the problem is we have too much

caffeine and you use it in stead of the the proper sleep cycle. >> there's an art of drinking coffee. you cannot drink three or four cups of coffee all the way to 11:00 p.m. and think you're going to get sleep. i drink it with no milk and sugar, i drink it black. if you're drinking four cups, you will have the medical effect of it. but you stop after 5:00 p.m. i think we're doing so many things and it's jam packed on our schedule. if you look at your parents and my parents, they were not texting all day long, we have turned into robots, we're basically not drinking enough. i basically say get your seven or eight glasses of water a day. if you're dehydrated, your heart has to work harder to pump that blood, how many times have we

spoken about sleep apnea. you may be getting 7 hours of sleep, by it's not good sleep. >> what about sleep hygiene, you need a dark room. you lie down in bed, you've got your iphone, that bright light is going to interfere. >> don't skip the breakfast. >> see, a lot of people think that because they're sleeping, they're okay, but the body is still working during the night also, so you have to all the cells and your heart is pumping, when you get up, you need to refuel and make sure, and if you don't, that's when you get really hungry, you take all of those carbohydrates, exercise, i know you work out at that place three timeses a week. >> four times. >> sunday house call has made an influence on you. >> you start with that junk food, it gives you a spike of

insulin, then sugar, then insulin. >> but it makes you feel so happy. >> only temporary. don't be an addict. only temporarily. you have that candy bar, you get happy, it wears off a. >> be careful about your coffee intake, make sure you exercise during the day and don't exercise too late at night and try to take it all down. >> i'll give you one little secret. learn how to say no. i'm telling you, this is my biggest problem, is because i want to keep everyone happy, all the patients happen, sometimes we have to learn how to say no. >> my little tip is exercise every day, stick to your routine, even if it's just walking. >> exercise is good, take the stairs. nearly every aspect of our

lives is available online. our doctors have tips on protecting your privacy. i'm m-a-r-y and i have copd. i'm j-e-f-f and i have copd. i'm l-i-s-a and i have copd, but i don't want my breathing problems to get in the way of hosting my book club. that's why i asked my doctor about b-r-e-o. once-daily breo ellipta helps increase airflow from the lungs for a full 24 hours. and breo helps reduce symptom flare-ups that last several days and require oral steroids, antibiotics, or hospital stay. breo is not for asthma. breo contains a type of medicine that increases risk of death in people with asthma. it is not known if this risk is increased in copd. breo won't replace rescue inhalers for sudden copd symptoms and should not be used more than once a day. breo may increase your risk of pneumonia, thrush, osteoporosis, and some eye problems. tell your doctor if you have a heart condition or high blood pressure before taking breo.

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p and now back to sunday house call and our weekly segment, should i worry? where we talk about everything that worries us. one viewer writes, my medical records are available online, should i worry? >> there are good things and bad things about this, the fact that medical records have come into our life has made a lot of things very easy. because simultaneously, the patients can look at their records, their labs and we can find out what's going on. in some ways it reduces the medical errors. we have 200,000 people who die from medical error every year,

the purpose is to try to control this and reduce those numbers. people can make an appointment online, it cuts down the visits to the on. the insurance companies, the pharmaceuticals and a lot of people can get their hands on it, so unfortunately, a lot of privacy goes out the door and that comes with any kind of technolo technology. don't be surprised if you find some of the very detailed information, sexually transmitted disease information can get out there to people. >> can someone take that information and use it against you somehow? >> no question. there are a lot of hackers out there. the pulmonary institute in 2013 studied that 94,000 health care organizations have had some data breaches, meaning some people have gotten ahold of records they're not supposed to have. >> what do they do with them? >> social security numbers are there, private medical

information are there, they can get your credit card information, insurance information. there is, of course, a financial concern. but there's also the privacy issue, and people in my office are very reluctant about this question. he pointed out something, though, really great. i love electronic medical records because we don't end up way duplication. if somebody does a test other than me that's on the circuit, that's on the electronic health records, i get immediate access to it. there is less duplication. if we get it interinstitutional between hospitals, it's going to be even better, but i sometimes get nervous. i'm thinking, wait a minute. this patient, everyone in the medical center has access to their information. everybody that can get on line in my medical center can get that information. >> and there's really nothing to do to avoid this. unfortunately, the government already has brought this electronic medical record. it's all over the place. and that's really the big problem. what i don't like about the electronic medical record is when i'm sitting -- i can talk to my patient.

i enjoy that doctor-patient interaction. i want to know what they look like, their facial expressions and now they're typing things and that's the part that really bothers me. we don't have much of a choice. >> when we talk about breaches, the hospital or medical centers or doctor's office can find out exactly who has gone into the computer, i imagine, and unauthorized people could be trapped. >> too late, the information is out there. >> you can't get it back. >> that is going on right now with a lawsuit of a woman who said a sexually transmitted disease she had got on line and they're trying find out who did it. >> she found out about this on facebook. she found that her information was on facebook, and by the time she wanted to control this, already thousands of people saw it. so you have to be careful. >> to david's point, you sit there, and you enter it into your computer. your patient is over here, you're looking like this and you're looking like this. it's not exactly the kind of

face time we like to have. >> we're glad we had face time with you. they're one of the most important indicators of what's going on in your body, your nails. how do you know if you have something to worry about? our doctors are going to tell us what we need to look for, coming up. phillips fiber good gummies. they're delicious, and an excellent source of fiber phillips fiber good gummies. to help support regularity. wife: mmmm husband: these are good! marge: the tasty side of fiber. from phillips. if your denture moves, it can irritate your gums. try fixodent plus gum care. it helps stop denture movement and prevents gum irritation. fixodent. and forget it.

so when was the last time you had a really good look at your nails? for most of us, it's probably been a while, but you know you may not be able to keep away from looking at your nails because it can be one of the most important indicators of what's happening in your body, dr. siegel, right? what are some of the things you can glean from what's going on in your body if you looked at my nails, my bare nails? >> we don't have to put an instrument in there, no scopes needed. we just look right at the finger nails. if they're pale, you could be anemic. if they're white, you could have

liver issues. if there is a band under your nails and it's growing and changing, i need to get you to a dermatologist because it could be melanoma. it's rare but it's a possibility. if someone has lung disease and i see their fingernails getting bluer, i think, maybe they're not getting as much oxygen as i'd like. >> how blue? >> blue-blue. they can get very blue. we're not talking bright ocean blue, but pale blue. >> what about the white marks some people get on their nails? >> the bottom line is as a doctor, you can get a tremendous amount of information. the same way a good dentist can look in someone's mouth and find out exactly what's going on with their health, a good doctor can look at the nails and find out. if you have the grooves on your nails, that's mostly inflammatory disease, mostly

psoriasis, and you want to look at what's going on. the blue, do you have emphysema, do you have respiratory disease -- >> some sort of blockage somewhere. >> she's already becoming a medical doctor. if you have vascular disease, it shows. it also could be a sign of kidney disease. now, the one that you want to know is the one that it's a mess. it's the yellow one, it's the fungus looking, it's all out of shape. you want to make sure you treat it and see a doctor for antifung antifungal. >> it's true, very hard to treat. sometimes we have to use oral medication. the other thing is stress. if someone is biting their nails, they can't sleep at night -- i'm going to show my nails -- biting your fingernails is a sign of anxiety and stress, and you have to deal with that. >> is there something about the way they grow? sometimes it seems they grow

fast, other times like they're not doing well. >> if they grow fast, that's a sign of good metabolism. >> if you see they're not growing, look at your vitamin e. vitamin e is good for your hair and your nails, and if we don't get all this information out because we speak fast, we're going to put this all on facebook. >> women should sometimes take a break from nail polish and let their nails speak to them, if you will. >> that's a good point. women who coat their fingernails, we can't take a look at it. >> also take a look at the base of the nail. a healthy nail should have a good pink color at the base of the nail. that's how you know you have a healthy one. >> next week we'll do the eyes, the ears. i bet a lot of clues are there. >> thanks, docs. good to see you. and that's going to do it for us. >> all the terrific medical

information here every sunday. as always, thank you for watching. a heated debate in one california community puts the fight over immigration reform in the national spotlight while lawmakers and president obama are at an impasse. the question remains on what to do now about the thousands and thousands of illegal immigrants, many of them children, in holding centers. a more israeli air strikes on the gaza strip overnight after early rocket attacks aimed at israel. tempers in the region reach a breaking point as they say they have a