Living and Coping with Your Type 2 Diabetes

November 23, 2009

Many diabetics try very hard to live their lives as normal as possible. They get up every morning, test their blood sugar, take their medication, eat their breakfast, and go to work like every other working person in the world. When a diabetic person gets sick and cannot go to work, he or she must call in sick.

According to the WebMD Online Article written September 11, 2008, sick days often mean more than a runny nose and sneezing. An illness such as a cold or the flu, or any condition resulting in nausea, vomiting or diarrhea, may cause your blood sugar to increase. An infection also can raise blood sugar levels. Therefore, it is very important to test your blood sugar when you are sick. Here are some guidelines to follow when you are ill:

  • Check your blood sugar every four hours.
  • Test for ketones if your blood sugars are above 240mg/dl, or as directed by your health care provider. Ketones are a form of waste often produced in the bodies of people with type 1 diabetes when they are under stress (such as during an illness). Call your doctor if ketones are found in your urine. Depending on the degree of your illness, he or she may suggest that you go to the emergency room.
  • Check your temperature regularly.
  • Make sure you are drinking liquids if you are unable to keep down solid food. Drink one cup of liquid every hour while you are awake to prevent dehydration. If you are unable to hold down liquids, you may need to go to the emergency room or hospital.
  • Do not stop taking your insulin, even if you are unable to eat solid foods. You may need to eat or drink something with sugar in some form so that your blood sugar doesn’t drop too low. People with type 2 diabetes who are on oral medicines may need to stop taking their medicines when sick. Check with your doctor if you are unsure of what to do.
  • If you need an over-the-counter medicine to control symptoms such as cough and nasal congestion, ask your doctor or pharmacist for a list of sugar-free products that are available.

When Should I Call My Doctor?

If you have diabetes and are sick, call your doctor if:

  • Your blood sugar stays higher than 180 mg/dL or lower than 70 mg/dL.
  • You are unable to keep liquids or solids down.
  • You have a fever (temperature over 101 degrees F or 38.3 degrees C).
  • You have diarrhea or are vomiting.

What Foods Should I Eat When I’m Sick?

If you are sick and have diabetes, you should eat or drink 45 to 50 grams of carbohydrate every three to four hours to maintain your nutrition needs, to avoid ketone development and to prevent hypoglycemia.

If you can’t eat foods, you could try more easily tolerated foods, such as those listed below. Each of these items equal one carbohydrate choice.

  • 1 cup clear soup
  • 1/2 cup regular gelatin
  • 1/2 cup regular soft drink, like 7-up or Sprite
  • 1/2 Popsicle
  • 1/2 cup unsweetened applesauce
  • 1/3 cup apple juice
  • 1/2 cup sports drink, like Gatorade

Calorie-free liquids you may drink during an illness include water and 1/2 cup of broth or bouillon.

Coping With Diabetes and Stress

When you have diabetes, stress can significantly affect your ability to control the disease. If you are under stress, you may skip meals or forget to take your medicines, which will affect your blood sugar level. Learning to deal with this stress is especially important if you have diabetes.

Although you can’t completely remove stress from your life, there are several ways you can reduce it. And by learning to better cope with stress, you can help keep your diabetes under control. Here are some tips.

Fight Stress With a Positive Attitude

When things seem to be going wrong, it’s always easier to see the bad instead of the good. Find something good in each important area of your life: work, family, friends, and health. Thinking about the good can help you get through the bad times and the stress.

Be Nice to Yourself

What are your talents, abilities, and goals? Are you expecting too much from yourself? Don’t expect more of yourself than you have or are able to give.

Accept What You Cannot Change

For those stressful situations or problems that cannot be changed, develop a simple plan of action. Ask yourself the following questions:

  • “Will this be important two years from now?”
  • “Do I have control over this situation?”
  • “Can I change my situation?”

Talk to Someone About Your Stress

Don’t keep stress bottled up inside. If you don’t want to talk with a family member or close friend, there are counselors and clergy trained to provide support and insight. Ask your doctor for recommendations if you would like to see a psychologist or counselor.

Exercise to Fight Stress

The benefits of exercise in reducing stress are well known, particularly for someone with diabetes. Exercise gives you a feeling of well-being and may relieve symptoms of stress.

Take Time to Relax

Practice muscle relaxation, deep breathing, meditation, or visualization. Ask your health care provider for information and available programs.

Type 2 Diabetes and Exercise

Exercise is very important in managing type 2 diabetes. Combining diet, exercise, and medicine (when prescribed) will help control your weight and blood sugar level.

Exercise helps control type 2 diabetes by:

  • Improving your body’s use of insulin.
  • Burning excess body fat, helping to decrease and control weight (decreased body fat results in improved insulin sensitivity).
  • Improving muscle strength.
  • Increasing bone density and strength.
  • Lowering blood pressure.
  • Helping to protect against heart and blood vessel disease by lowering ‘bad’ LDL cholesterol and increasing ‘good’ HDL cholesterol.
  • Improving blood circulation and reducing your risk of heart disease.
  • Increasing energy level and enhancing work capacity.
  • Reducing stress, promoting relaxation, and releasing tension and anxiety.

How Does Exercise Affect Blood Sugar Levels?

Normally, insulin is released from the pancreas when the amount of sugar (glucose) in the blood increases, such as after eating. Insulin stimulates the liver and muscles to take in excess glucose. This results in a lowering of the blood sugar level.

When exercising, the body needs extra energy or fuel (in the form of glucose) for the exercising muscles. For short bursts of exercise, such as a quick sprint to catch the bus, the muscles and the liver can release stores of glucose for fuel. With continued moderate exercising, however, your muscles take up glucose at almost 20 times the normal rate. This lowers blood sugar levels.

But intense exercise can have the opposite effect and actually increase your blood glucose levels. This is especially true for many people with diabetes. The body recognizes intense exercise as a stress and releases stress hormones that tell your body to increase available blood sugar to fuel your muscles. If this happens to you, you may need a little bit of insulin after intense workouts.

For a variety of reasons, after exercise, people with diabetes may have an increase or a decrease in their blood sugar levels.

Is Blood Sugar Ever Too High to Exercise?

Yes. In some cases, you should hold off on exercising if your blood sugar is very high.

What Types of Exercise Is Best for Diabetes?

While most any exercise is healthy for people with diabetes, let’s look at some specific types of exercise and their benefits:

Strength Training and Type 2 Diabetes

The latest findings show that exercise such as strength training has a profound impact on helping people manage their diabetes. In a recent study of Hispanic men and women, 16 weeks of strength training produced dramatic improvements in sugar control that are comparable to taking diabetes medication. Additionally, the study volunteers were stronger, gained muscle, lost body fat, had less depression, and felt much more self-confident.

For more detail, see WebMD’s article Strength Training and Diabetes.

Aerobic Fitness and Type 2 Diabetes

Any activity that raises your heart rate and keeps it up for an extended period of time will improve your aerobic fitness. Aerobic exercise helps decrease the risk of type 2 diabetes and helps those with diabetes to better manage their blood sugar levels. Besides the health benefits, exercise is fun and boosts your mood. It’s hard to feel stressed when you’re walking fast on a treadmill or swimming laps in a pool.

Type 2 Diabetes and Exercise Tips

  • To reduce the risk of hypoglycemia if you have diabetes, follow a regular routine of exercising, eating your meals, and taking your medicines at the same time each day.
  • Prolonged or strenuous exercise can cause your body to produce adrenaline and other hormones that can counteract the effects of insulin and cause your blood sugar to rise. If you are participating in strenuous exercise (exercising at your maximum capacity) or prolonged exercise (lasting for several hours or more), your insulin and/or oral diabetic medicine may need to be changed. Talk to your health care provider about how to adjust your medicine.
  • Be careful exercising when your medicine is reaching its peak effect.
  • Depending on the time of exercise, reducing your dose of either long-acting insulin or short-acting insulin will be necessary. Your doctor can recommend how to make this adjustment.
  • Exercise with someone who knows you have diabetes and knows what to do if you have a low blood-sugar reaction.
  • Wear a medical identification tag (for example, MedicAlert) or carry an identification card that states you have diabetes.

More Diabetes-Specific Exercise Tips

The American Diabetes Association offers these basic exercise guidelines for those with diabetes:

  • Discuss with your doctor what types of exercise might be appropriate for you. Complications of diabetes such as severe eye disease and nerve damage may make some forms of exercise dangerous for you. Your doctor may also schedule a test to see how your heart responds to exercise.
  • Do not exercise if your blood sugar is greater than 250 mg/dL (milligrams per deciliter) and your ketones positive. This is an indication that you already may have a lack of insulin and exercise will only cause a greater rise in your blood sugar. Hydrate yourself and adjust your insulin as necessary, contact your health care provider.
  • Use caution when exercising if your blood sugar is greater than 300 mg/dL without evidence of ketones, exercise may help decrease your sugars, but it’s possible they will increase instead. Hydrate well prior to and after exercise and keep track of your sugars and ketones.
  • Learn the effects of various types of exercise on your blood sugar.
  • Have carbohydrate-based foods available for exercise and for the period following exercise. Add carbohydrates to your meals if you plan on doing exercise, adjust your insulin dose appropriately in anticipation of exercise.

General Exercise Guidelines and Precautions

  • If you have diabetes, check with your health care provider before you begin a an exercise program. Tell your doctor what kind of exercise you want to do so adjustments can be made to your medicine schedule or meal plan, if necessary.
  • Start slowly and gradually increase your endurance.
  • Choose an activity that you enjoy. You’ll be more likely to stick with a program if you enjoy the activity. Make exercise a lifetime commitment.
  • Consider a water exercise program. Some other exercise options include walking, riding a stationary bicycle, swimming, or muscle stretching.
  • Exercise at least three to four times per week for 20 to 40 minutes each session. Ideally, you should exercise every day. A good exercise program should include a 5- to 10-minute warm-up and at least 15 to 30 minutes of continuous aerobic exercise (such as walking or biking) or muscle stretching exercises, followed by a 5-minute cool down.
  • Wear good shoes and practice proper foot care.
  • Drink water before, during, and after exercise to prevent dehydration.
  • Do not ignore pain — discontinue any exercise that causes unexpected pain. If you continue to perform the activity while you are in pain, you may cause unnecessary stress or damage to your joints.

Should I Stop Exercising When I Reach My Ideal Weight?

Exercise is a lifetime commitment. Regardless of your weight, you should exercise at least three to four times per week for 20 to 40 minutes each session. Ideally, you should exercise every day to help manage your type 2 diabetes long-term.

WebMD Medical Reference provided in collaboration with the Cleveland Clinic

I hope the information provided in these articles is helping all my type 2 diabetes readers out there. Tomorrow’s article will be on Healthy Eating and Travel Tips. Please comment on this information so I can know whether it has been helpful to you. I would love your ideas for future articles. Take care all, I will see you tomorrow.
By Diane | Posted in Let's Learn About Diabetes, The Power of Education, Type 2 Diabetes And How To Live With It | Tagged , , | Comments (0)

7 Principles For Controlling Diabetes

November 22, 2009

What would be better than controlling your type 2 diabetes and living a long and productive life? Everyone’s body and metabolism reacts differently to diet and medicine. That’s why there are so many medications to choose from. Even though the diet exchanges are the same, your needs are unique and should be addressed individually. Your physician, nutritionist, pharmacist, eye specialist, and anyone else you might need are your team. Use this team to help you “Live Long And Prosper.”

Controlling your diabetes is so important because there are so many diseases that can negatively affect your quality of life like the ones identified here:

  • Heart disease
  • stroke
  • eye disease that can lead to a loss of vision or even blindness
  • nerve damage that may cause a loss of feeling or pain in the hands, feet, legs, or other parts of the body and lead to problems such as lower limb amputation or erectile dysfunction
  • kidney failure
  • gum disease and loss of teeth (This information is from WebMD Online article on diabetes.)

The principles that will help you control your diabetes begin with the first principle and that is:

Principle 1: Learn as much as you can about Diabetes.

There are two types of diabetes, type 1 and type 2. Type 1 diabetes happens to adolescents or pre-teen children. Their pancreas stops producing insulin. Type 1 diabetes used to be called juvenile diabetes. In addition to the insulin, people with this type of diabetes must take very good care of their bodies with the appropriate diet and working closely with their medical team to avoid complications as described above.

Individuals with type 2 diabetes generally do not know they have it. People at the highest risk for getting this disease include those that:

  • are older than 45
  • are overweight
  • have a close family member such as a parent, a brother, or a sister who has or has had diabetes
  • had diabetes during pregnancy
  • had a baby that weighed more than 9 pounds
  • are African American, Hispanic or Latino, Asian American or Pacific Islander, or American Indian
  • have high blood pressure
  • have high cholesterol or other abnormal blood fats
  • are inactive (from WebMD Online article on Diabetes)

Principle 2: Get Regular Care for Your Diabetes

If you have diabetes, it is important to

  • see your primary physician, nutritionist, eye specialist, and other members of your team regularly
  • make sure your treatment plan is working. If it is not, ask your physician to help you change it
  • ask your family, friends, and co-workers for help and support when you need it

Work with your health care team to get the best help to control your diabetes.

Ask your health care team how often you need to see them for check-ups.

Write down the date and time for your next visit.

Ask your doctor, clinic or office staff, or pharmacist to help you find resources if you have problems paying for food, medicines, and medical supplies. You should be able to get Medicare or other insurance to help you pay for diabetes supplies.

Make a list of questions and concerns you want to talk about at your next visit to your health care team. (WebMD Online Article on Diabetes)

Principle 3: Learn How to Control Your Diabetes

Diabetes affects many parts of the body. To stay healthy, it is important to know how to eat the right foods, how to be physically active, and how to look after yourself. Using the following checklist will help you learn how to control your diabetes.

How Active Are You in Controlling Your Diabetes?

Look at the list below. Check all the boxes that describe you.

I talk to my health care team about:

  • my special needs to help control my diabetes
  • ways to improve my ABC numbers: A1C,* Blood pressure, and Cholesterol
  • aspirin therapy to prevent heart problems
  • getting regular physical activity
  • quitting smoking, if needed

I learn from my doctor, diabetes educator, podiatrist, pharmacist, or dietitian how to

  • follow a meal plan to control my diabetes
  • check my feet every day
  • take my medicines as prescribed
  • check my blood glucose levels

*A1C (pronounced A-one-C) is a measure of your average blood glucose over the last three months. You should get this test at least twice a year.

I visit my

  • doctor at least twice a year
  • eye doctor each year and report any changes in vision
  • dentist twice a year
  • specialists as my doctor advises (WebMD Online Article on Diabetes)

Principle 4: Take Care of Your Diabetes ABCs

A major goal of treatment is to control the ABCs of diabetes: A1C (blood glucose average), Blood pressure, and Cholesterol. You can do this in many ways.

  • Follow a meal plan that was made for you.
  • Be active every day.
  • Take your medicine as prescribed.
  • Before taking any non-prescription medicines, vitamins, or herbal products, ask your pharmacist how they may affect your diabetes or prescription medicines.
  • Test your blood glucose on a routine basis. (WebMD Online Article on Diabetes)

Principle 5: Monitor Your Diabetes ABCs

To reduce your risk for diabetes problems such as blindness, kidney disease, losing a foot or leg, and early death from heart attack or stroke, you and your health care team need to monitor the diabetes ABCs: A1C, Blood pressure, and Cholesterol. Talk to your health care team about how to reach your target numbers.

Get the A1C Test

The A1C test is usually done by your doctor. It measures how well your blood glucose has been controlled over the last three months. This test is very important because it tells how well you are taking care of your diabetes over the long term. It should be done at least twice a year.

  • The target A1C for most people with diabetes is less than 7.

Know Your Blood Pressure

High blood pressure makes your heart work too hard. This leads to strokes and other problems such as kidney disease. Your blood pressure should be checked at every visit. You may need to check it yourself.

  • The target blood pressure for most people with diabetes is less than 130/80.

Know Your Cholesterol

LDL is the bad cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year.

  • The target LDL cholesterol for most people with diabetes is less than 100.

Keep a Record of Your Results

Keeping a record of your results helps you reach your targets. It helps you know when you and your health care team need to take extra action.

Use a record card to keep track of your ABC numbers. (WebMD Online Article on Diabetes)

Principle 6: Prevent Long-Term Diabetes Problems

People with diabetes must control their blood glucose, blood pressure, and cholesterol to prevent the problems of diabetes: heart attack, stroke, eye and kidney problems, nerve damage, impotence, foot or leg amputation, gum disease, and loss of teeth. Here are the key self-care activities to help you manage your diabetes and live a long and healthy life.

Daily

  • Follow your diabetes meal plan with the correct portion sizes. Eat a variety of foods that are high in fiber and low in fat and salt.
  • Be active every day.
  • Take medicines as prescribed. If you have questions, talk to your pharmacist or doctor about your medicines.
  • Look at your feet and wash and dry them well each day. Tell your podiatrist or health care team about any changes with your feet.
  • Check your mouth daily for gum or tooth problems. Call your dentist right away if you have problems with your teeth or gums.

As Needed

  • Test your blood glucose as prescribed by your doctor.
  • Check your blood pressure as prescribed by your doctor.
  • Reach and stay at a healthy weight.
  • Stop smoking.
  • Make sure your eyeglasses or contact lens prescription is up to date so you can see clearly. Report any changes in your vision to your health care team.

Work with your health care team to prevent diabetes problems. (WebMD Online Article on Diabetes)

Principle 7: Get Checked for Long-Term Problems and Treat Them

See your health care team regularly to check for problems that diabetes can cause. Regular check-ups help to prevent problems or find them early when they can be treated and managed well. Along with the checks of your A1C, blood pressure, and cholesterol (see Principle 5), here are some tests that you will need:

  • Triglycerides (a type of blood fat)
Get yearly
  • Dilated eye exam to check for eye problems
Get yearly
  • Foot check
Get every visit
  • Complete foot exam to check for circulation, loss of feeling, sores, or changes in shape
Get yearly
  • Urine test to check for kidney problems
Get yearly
  • Dental exams to prevent gum disease and loss of teeth
Get twice a year

PRINCIPLE 1
Learn as Much as You Can About Diabetes

PRINCIPLE 2
Get Regular Care for Your Diabetes

PRINCIPLE 3
Learn How to Control Your Diabetes

PRINCIPLE 4
Take Care of Your Diabetes ABCs

PRINCIPLE 5
Monitor Your Diabetes ABCs

PRINCIPLE 6
Prevent Long-Term Diabetes Problems

PRINCIPLE 7

Get Checked for Long-Term Problems and Treat Them  

People with diabetes who keep their blood glucose,
cholesterol, and blood pressure under control
can expect to live a long and active life.

  • The target glucose range for most people using whole blood is 80 to 120 before meals and 100 to 140 at bedtime.
  • The target glucose range for most people using plasma is 90 to 130 before meals and 110 to 150 at bedtime.

Ask your health care team what your blood glucose targets are before meals, after meals, and at bedtime and write them down. (WebMD Article on Diabetes)

Thanks to WebMD, the information identified above will help take care of whatever type of diabetes you may have. Tomorrow’s article will focus on “Living and Managing” with diabetes, so stay tuned. I really hope that these articles are helping to educate you  about a disease that is growing out of proportion in the United States right now. See you tomorrow!

By Diane | Posted in Let's Learn About Diabetes | Tagged , , | Comments (4)

Treatments for Type 2 Diabetics

November 21, 2009

Here it is, Saturday! As promised, I am continuing the series on type 2 diabetes. The information you are about to read comes from WebMD so, you can go to the website and see most or all of these facts for yourself. We are pretty much aware of the medications available to treat this form of diabetes. However, today, I’m going to present you with some alternative and complementary treatments you can add to what you are already doing. Please, Do Not Stop Taking Your Medication or Do Any Of These Treatments Without The Advice of Your Physican.

Alternative Treatments for Diabetes

Treatments for diabetes can include many elements. Conventional treatments in addition to complementary and alternative treatments are available.

A health treatment that is not classified as standard Western medical practice is referred to as complementary and alternative medicine. Complementary and alternative therapy encompasses a variety of disciplines that include everything from diet and exercise to mental conditioning and lifestyle changes. Examples include acupuncture, guided imagery, chiropractic treatments, yoga, hypnosis, biofeedback, aromatherapy, relaxation, herbal remedies, massage, and many others.

What Alternative Therapies Are Used to Treat Diabetes?

Supplements

  • Chromium has been widely publicized as therapy to improve diabetes control. Although there are several studies that support a role for chromium as beneficial in diabetes, currently there are no recommendations for its use in diabetes management.
  • Magnesium has been studied for years as a form of therapy to improve glucose control in people with diabetes. A lack of magnesium has been associated with insulin secretion abnormalities and has been associated with diabetes complications.
  • Vanadium is derived from plant sources and has been shown in a few studies to increase a person’s sensitivity to insulin. Thus far, no recommendations exist for supplementation to be given to people with diabetes.

Plant Foods

The following plant foods have been found to help people with type 2 diabetes.

  • Brewer’s yeast
  • Buckwheat
  • Broccoli and other related greens
  • Okra
  • Peas
  • Fenugreek seeds
  • Sage

Most plant foods are rich in fiber, which is beneficial for helping control blood glucose levels.

There are no clinical trials with promising results for many of the other herbs being proposed for diabetes, such as garlic, ginger, ginseng, hawthorn, or nettle. If you have diabetes and are considering taking any of these herbal substances, talk to your doctor before you take them.

Alternative Weight Loss Products for Diabetes

Since weight and diabetes are linked, many people with diabetes turn to alternative therapies that claim to help with weight loss, including:

  • Chitosan
  • Camsogia Garcinia (hydroxycitric acid)
  • Chromium
  • Pyruvate
  • Germander
  • Momordica charanta
  • Sauropus androgynus
  • Aristolochic acid

In addition, transdermal (skin patch) systems as well as oral sprays have been developed that claim to reduce appetite and facilitate weight loss. One patch system uses homeopathic amounts of 29 different compounds to reduce appetite, but no published literature is available on how effective this patch is.

Are These Herbs Safe for Diabetes?

In December of 2003, Ephedrine — also known as ma huang — became the first herbal stimulant ever banned by the U.S. Food and Drug Administration (FDA). A popular component of anti-obesity over-the-counter medications, ephedrine was found to have some benefits. However, the evidence of its ability to cause harm was far more compelling. In high doses, it has been known to cause insomnia (difficulty falling and staying asleep), high blood pressure, glaucoma, and urinary retention. This herbal supplement has also been associated with numerous cases of stroke.

Chitosan has received a great deal of recent publicity. It is derived from seashells and has the ability to bind to fat and prevent its absorption. Although it is believed to facilitate weight loss, available studies thus far have not been encouraging.

Germander, momordica charanta, sauropus androgynus, and aristolochic acid have been associated with liver disease, pulmonary disease, and kidney disease.

The other so-called “obesity remedies” listed have not been rigorously studied and those that have yielded disappointing results.

Also, a recent survey of herbal preparations for obesity found that many preparations contained lead or arsenic and other toxic metals. Some also contain other undeclared ingredients. Occasionally there was mistaken plant identity as well.

Things to Consider Before Using Herbal Products for Diabetes

When considering treating diabetes with an herbal product, you should:

  • Discuss any drugs you use, including herbal products, with your doctor before taking them.
  • If you experience side effects such as nausea, vomiting, rapid heartbeat, anxiety, insomnia, diarrhea, or skin rashes, stop taking the herbal product and notify your doctor immediately.
  • Avoid preparations made with more than one herb.
  • Beware of commercial claims of what herbal products can do. Look for scientific-based sources of information.
  • Select brands carefully. Only purchase brands that list the herb’s common and scientific name, the name and address of the manufacturer, a batch and lot number, expiration date, dosage guidelines, and potential side effects.

Reviewed by Certified Diabetes Educators in the Department of Patient Education and Health Information and by physicians in the Department of Endocrinology at The Cleveland Clinic.

Additionally, check out the Migun store in your town. The Infra red massage bed, ionic foot detoxification, foot reflexology, and other products have extensive research showing how effective they are with consistent use. Even in this economy, everyone can take advantage of the products and services at these stores and you will notice how good you feel. If you live in the Milwaukee, Wisconsin area, please visit the Health & Energy Center of Wisconsin, located at 11931 West Bluemound Road in Wauwatosa. No appointment is necessary so come in and say hello to Nadine Retzlaff. She will take wonderful care of you. Her focus is on taking care of diabetics, types 1 and 2.

Tomorrow’s article will focus on caring for yourself with type 2 diabetes. This information will come from the same article on the WebMD website, so stay tuned and learn as much as you can about this disease.

By Diane | Posted in Let's Learn About Diabetes | Tagged , | Comments (0)

More Important Information on Diabetes You Should Know

November 19, 2009

Other forms of Pre-Diabetes identified in the WebMD article include:

Impaired Fasting Glucose

A person has impaired fasting glucose (IFG) when fasting plasma glucose is 100 to 125 mg/dL. This level is higher than normal but less than the level indicating a diagnosis of diabetes.

Impaired Glucose Tolerance

Impaired glucose tolerance (IGT) means that blood glucose during the oral glucose tolerance test is higher than normal but not high enough for a diagnosis of diabetes. IGT is diagnosed when the glucose level is 140 to 199 mg/dL 2 hours after a person drinks a liquid containing 75 grams of glucose.

An estimated 57 million people over age 20 have impaired fasting glucose, suggesting that at least that many adults had pre-diabetes in 2007.

What are the scope and impact of diabetes?

Diabetes is widely recognized as one of the leading causes of death and disability in the United States. In 2006, it was the seventh leading cause of death. However, diabetes is likely to be underreported as the underlying cause of death on death certificates.

Diabetes is associated with long-term complications that affect almost every part of the body. The disease often leads to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage. Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.

Who gets diabetes?

Diabetes is not contagious. People cannot “catch” it from each other. However, certain factors can increase the risk of developing diabetes.

Type 1 diabetes occurs equally among males and females, but is more common in whites than in nonwhites. Data from the World Health Organization’s Multinational Project for Childhood Diabetes indicate that type 1 diabetes is rare in most African, American Indian, and Asian populations. However, some northern European countries, including Finland and Sweden, have high rates of type 1 diabetes. The reasons for these differences are unknown.

Type 2 diabetes is more common in older people, especially in people who are overweight, and occurs more often in African Americans, American Indians, some Asian Americans, Native Hawaiians and other Pacific Islander Americans, and Hispanic Americans. On average, non-Hispanic African Americans are 1.6 times as likely to have diabetes as non-Hispanic whites of the same age. Hispanic Americans are 1.5 times as likely to have diabetes as non-Hispanic whites of similar age. American Indians have one of the highest rates of diabetes in the world. On average, American Indians and Alaska Natives are 2.2 times as likely to have diabetes as non-Hispanic whites of similar age. Although prevalence data for diabetes among Asian Americans and Pacific Islanders are limited, some groups, such as Native Hawaiians and Japanese and Filipino residents of Hawaii aged 20 or older, are about twice as likely to have diabetes as white residents of Hawaii of similar age.

The prevalence of diabetes in the United States is likely to increase for several reasons. First, a large segment of the population is aging. Also, Hispanic Americans and other minority groups make up the fastest-growing segment of the U.S. population. Finally, Americans are increasingly overweight and sedentary. According to recent estimates, the prevalence of diabetes in the United States is predicted to reach 8.9 percent of the population by 2025.

Causes of Type 2 Diabetes

Diabetes is a number of diseases that involve problems with the hormone insulin. While not everyone with type 2 diabetes is overweight, obesity and lack of physical activity are two of the most common causes of this form of diabetes. It is also responsible for nearly 95% of diabetes cases in the United States, according to the CDC.

This will give you a better understanding of the causes of type 2 diabetes, what happens in the body when type 2 diabetes occurs, and specific health problems that increase your risk of type 2 diabetes.

In a healthy person, the pancreas (an organ behind the stomach) releases insulin to help your body store and use the sugar from the food you eat. Diabetes happens when one of the following occurs:

  • When the pancreas does not produce any insulin.
  • When the pancreas produces very little insulin.
  • When the body does not respond appropriately to insulin, a condition called “insulin resistance.”

Unlike people with type 1 diabetes, people with type 2 diabetes produce insulin; however, the insulin their pancreas secretes is either not enough or the body is unable to recognize the insulin and use it properly. This is called insulin-resistance. When there isn’t enough insulin or the insulin is not used as it should be, glucose (sugar) can’t get into the body’s cells. When glucose builds up in the blood instead of going into cells, the body’s cells are unable to function properly.

The Role of Insulin in the Cause of Type 2 Diabetes

To understand why insulin is important, it helps to know more about how the body uses food for energy. Your body is made up of millions of cells. To make energy, these cells need food in a very simple form. When you eat or drink, much of your food is broken down into a simple sugar called “glucose.” Then, glucose is transported through the bloodstream to the cells of your body where it can be used to provide the energy your body needs for daily activities.

The amount of glucose in your bloodstream is tightly regulated by the hormone insulin. Insulin is always being released in small amounts by the pancreas. When the amount of glucose in your blood rises to a certain level, the pancreas will release more insulin to push more glucose into the cells. This causes the glucose levels in your blood (blood glucose levels) to drop.

To keep your blood glucose levels from getting too low (hypoglycemia or low blood sugar), your body signals you to eat and releases some glucose from the stores kept in the liver.

People with diabetes either don’t make insulin or their body’s cells no longer are able to recognize insulin, leading to high blood sugars. By definition, diabetes is having a blood glucose level of 126 milligrams per deciliter (mg/dL) or more after an overnight fast (not eating anything).

Health Risk Factors for Type 2 Diabetes

Type 2 diabetes is believed to have a strong genetic link, meaning that it tends to run in families. Several genes are being studied that may be related to the cause of type 2 diabetes. If you have any of the following type 2 diabetes risk factors, it’s important to ask your doctor about a diabetes test. With a proper diabetes diet and healthy lifestyle habits, along with diabetes medication, if necessary, you can manage your type 2 diabetes just like you manage other areas of your life. Be sure to continue seeking the latest information on type 2 diabetes as you become your own health advocate.

Other type 2 diabetes risk factors include the following:

  • High blood pressure
  • High blood triglyceride (fat) levels
  • Gestational diabetes or giving birth to a baby weighing more than 9 pounds
  • High-fat diet
  • High alcohol intake
  • Sedentary lifestyle
  • Obesity or being overweight
  • Ethnicity: Certain groups, such as African Americans, Native Americans, Hispanic Americans, and Japanese Americans, have a greater risk of developing type 2 diabetes than non-Hispanic whites.
  • Aging: Increasing age is a significant risk factor for type 2 diabetes. The risk of developing type 2 diabetes begins to rise significantly at about age 45 years, and rises considerably after age 65 years. (WebMD Article)

Tomorrow’s article will identify whether or not you or anyone you know and love are at risk for diabetes. This will be just as important as this article and yesterdays article, so please keep reading and comment, if you will. See you tomorrow!

By Diane | Posted in Let's Learn About Diabetes | Tagged | Comments (2)

Type II Diabetes – A Preventable Disease

November 18, 2009

According to an article on the WebMD website, 23.6 million people, about 7.9% of the population have diabetes. That is  a very high percentage of people with a pancreas that does not produce any insulin (a hormone that helps the body metabolize carbohydrates, especially sugar). This is known as Type 1 Diabetes. These folks have to take insulin shots and must test their blood sugar before and after they eat, in the morning when they wake up, and at night before they go to bed. Type 1 Diabetes is not preventable.

Generally speaking, Diabetes is a disorder of metabolism — the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body.

After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

When we eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of sugar.

More specifically, Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body’s system for fighting infection (the immune system) turns against a part of the body. In diabetes, the immune system attacks the insulin-producing beta cells in the pancreas and destroys them. The pancreas then produces little or no insulin. A person who has type 1 diabetes must take insulin daily to live.

At present, scientists do not know exactly what causes the body’s immune system to attack the beta cells, but they believe that autoimmune, genetic, and environmental factors, possibly viruses, are involved. Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States. It develops most often in children and young adults, but can appear at any age.

Symptoms of type 1 diabetes usually develop over a short period, although beta cell destruction can begin years earlier. Symptoms include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue. If not diagnosed and treated with insulin, a person with type 1 diabetes can lapse into a life-threatening diabetic coma, also known as diabetic ketoacidosis.

WebMD identifies type 2 diabetes as the most common form. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and ethnicity. About 80 percent of people with type 2 diabetes are overweight.

Type 2 diabetes is increasingly being diagnosed in children and adolescents. About 3,700 people under the age of 20 were diagnosed with diabetes based on 2002-2003 data.

When type 2 diabetes is diagnosed, the pancreas is usually producing enough insulin, but for unknown reasons, the body cannot use the insulin effectively, a condition called insulin resistance. After several years, insulin production decreases. The result is the same as for type 1 diabetes — glucose builds up in the blood and the body cannot make efficient use of its main source of fuel.

The symptoms of type 2 diabetes develop gradually. Their onset is not as sudden as in type 1 diabetes. Symptoms may include fatigue or nausea, frequent urination, unusual thirst, weight loss, blurred vision, frequent infections, and slow healing of wounds or sores. Some people have no symptoms at all.

A third type of diabetes is known as gestational diabetes, which develops only during pregnancy. Like type 2 diabetes, it occurs more often in African Americans, American Indians, Hispanic Americans, and among women with a family history of diabetes. Women who have had gestational diabetes have a 20 to 50 percent chance of developing type 2 diabetes within 5 to 10 years.

A blood test,  the fasting plasma glucose test, is the preferred test for diagnosing type 1 or type 2 diabetes. It is most reliable when done in the morning. However, a diagnosis of diabetes can be made after positive results on any one of three tests, with confirmation from a second positive test on a different day:

  • A random (taken any time of day) plasma glucose value of 200 mg/dL or more, along with the presence of diabetes symptoms.
  • A plasma glucose value of 126 mg/dL or more after a person has fasted for 8 hours.
  • An oral glucose tolerance test (OGTT) plasma glucose value of 200 mg/dL or more in a blood sample taken 2 hours after a person has consumed a drink containing 75 grams of glucose dissolved in water. This test, taken in a laboratory or the doctor’s office, measures plasma glucose at timed intervals over a 3-hour period.

Gestational diabetes is diagnosed based on plasma glucose values measured during the OGTT. Glucose levels are normally lower during pregnancy, so the threshold values for diagnosis of diabetes in pregnancy are lower. If a woman has two plasma glucose values meeting or exceeding any of the following numbers, she has gestational diabetes: a fasting plasma glucose level of 95 mg/dL, a 1-hour level of 180 mg/dL, a 2-hour level of 155 mg/dL, or a 3-hour level of 140 mg/dL.

People with pre-diabetes, a state between “normal” and “diabetes,” are at risk for developing diabetes, heart attacks, and strokes. However, studies suggest that weight loss and increased physical activity can prevent or delay diabetes, as weight loss and physical activity make the body more sensitive to insulin.

All of this information is enough to absorb in one reading, so, the rest of the information will be presented in subsequent articles. Stay tuned for more information on diabetes.

By Diane | Posted in Let's Learn About Diabetes | Tagged | Comments (0)