Diabetes

Diabetes

Diabetes mellitus (MEL-ih-tus), often referred to as diabetes, is characterized by high blood glucose (sugar) levels that result from the body’s inability to produce enough insulin and/or effectively utilize the insulin. Diabetes is a serious, life-long condition and the sixth leading cause of death in the United States. Diabetes is a disorder of metabolism (the body's way of digesting food and converting it into energy). There are three forms of diabetes. Type 1 diabetes is an autoimmune disease that accounts for five- to 10-percent of all diagnosed cases of diabetes. Type 2 diabetes may account for 90- to 95-percent of all diagnosed cases. The third type of diabetes occurs in pregnancy and is referred to as gestational diabetes. Left untreated, gestational diabetes can cause health issues for pregnant women and their babies. People with diabetes can take preventive steps to control this disease and decrease the risk of further complications.

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    Diabetes is very difficult to handle alone. Having the support of loved ones will help anyone gain better control of their disease. Most of the daily care for someone with type 1 diabetes is related to stabilizing blood glucose levels. Low blood glucose levels, or hypoglycemia, can result in dizziness, sweatiness, even fainting. Make sure that both of you always have access to a fast-acting sugar. Some people with type 1 diabetes might experience such low blood sugar levels that they lose consciousness. In these cases, you'll need what's called a glucagon emergency kit available. Make sure you know how to administer the glucagon, if your friend or loved one cannot.

    When blood glucose levels are too high, also called hyperglycemia, this can cause tiredness and increased thirst. These complications can grow serious and require immediate attention. Get to know the members of the treatment team, and make sure that the treatment plan is being followed.

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    Most people use insulin and blood glucose monitoring to treat type 1 diabetes. Another option, an experimental procedure called islet transplantation, is also available. Islet cells are insulin-producing cells in the pancreas. When these cells are transplanted from a healthy pancreas, it reduces dependency on insulin treatments. In extreme cases, a pancreas transplant may be recommended. Stem cell transplants are also being studied as an additional treatment option.

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    Several different medications are used to treat type 1 diabetes, but insulin is the primary medication for this condition. Because the body is not producing sufficient insulin to survive, insulin injections are used to help stabilize blood sugar levels. Insulin cannot be taken orally; therefore, it must be administered by injection or pump. Your blood sugar is affected by many factors, including diet, activity level, medications, hormone levels, stress, and other factors, so it is very important to monitor your blood sugar level several times throughout the day.

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    Diabetes and atherosclerosis can both result in amputation. Factors that can lead to these diseases - and therefore increase your risk for amputation - are smoking, overeating, failing to exercise, and eating foods high in cholesterol and saturated fats.

    Traumatic injuries can also lead to amputation, so anyone who drives without caution, engages in combat, or operates dangerous or heavy equipment can be at higher risk.

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    AWilliam Lee Dubois, Endocrinology, Diabetes & Metabolism, answered
    Insulin is the one and only way to treat Type-1 Diabetes, regardless of age, because those of us with T-1 don’t produce any insulin ourselves. Without insulin from outside, T-1 is fatal.

    When it comes to young children, although the medication is the same, we do look at specialized delivery options. We do this simply because young children are small ecosystems. A little bit of insulin will go along way when the patient weights 32 pounds!

    Insulin syringes are made is sizes as small as 30 units total volume, which can make it easier to estimate the smaller doses children require. Additionally, two companies make ½ unit insulin pens for children; and we also have the option of insulin pumps which can deliver very small percentages of a unit of insulin for fine tuning.
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    AWilliam Lee Dubois, Endocrinology, Diabetes & Metabolism, answered

    It’s a poorly understood auto-immune disease that causes the body to mistake the insulin producing cells of the pancreas for invaders. The body’s immune system then attacks these pancreatic “beta” cells and destroys them, taking with them the body’s ability to produce insulin. As you cannot live without insulin, it’s a potentially fatal case of “friendly fire.”

    Fortunately, while complicated and stressful for both the parents and the child, it is a treatable disease.

    Note that I said treatable, not curable.

    Type 1 diabetes is controlled by taking insulin from outside the body to replace the insulin that is missing from the inside. Children will need several shots per day, or need an insulin pump to control their blood sugars; but they can live long, happy, healthy lives.

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    AWilliam Lee Dubois, Endocrinology, Diabetes & Metabolism, answered
    The very first thing you should do is check your blood sugar. Feeling light-headed can be caused by many things, but having low blood sugar is high on the list of suspects for us diabetics. If your blood sugar is low, treat it by drinking half a can of regular soda, some juice, or eating several hard candies or two spoonfuls of honey. Oh, by the way, that’s a multiple choice list, don’t eat/drink all of those!

    Low blood sugar can become a medical emergency, but it’s one you can treat yourself. About 15 minutes after you’ve taken on some sugar, please re-test your blood sugar to make sure it’s rising. It doesn’t need to be all the way back up to normal again, but it should be higher. If it’s the same or lower, take on more sugar.

    Once your blood sugar is stable, you should call your doctor, your therapy may need to be adjusted.

    If your sugar was fine and if you have a home blood pressure monitor, you should check your blood pressure. If it’s low, drink several glasses of water, and then call your doctor.

    What if your sugar and pressure are both fine and you feel like fainting? Well, something must be causing it, and you’ve ruled out the two most common and most likely causes so it’s time to break out the big guns. Yep. Call the Doc.

    That’s what your doctor is there for. Trust me, if you feel like fainting, your doctor really wants to know.
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    AWilliam Lee Dubois, Endocrinology, Diabetes & Metabolism, answered

    They don’t need to be, but if your blood sugar is high, you will heal more slowly and be at greater risk of infection.

    So the best thing you can do to protect yourself is to get your diabetes under control before you have surgery, if that’s an option. Obviously, some surgeries cannot be delayed. Anything involving the removal of cancerous tissue comes to mind as a good example; while a hip or knee replacement could probably wait a few months.

    If your blood sugar control is poor and you’ve never been able to manage it, here are some things to consider with your doc before you go under the sterilized knife: if you are opposed to taking insulin, maybe you should re-think that, even as a temporary measure. You can also modify your diet. Even if you’ve never been able to do this in the past, taking it on as part of your pre-op preparations may not seem as daunting as a for-the-res-of-your-life change.

    You should also look at ramping up the frequency of your blood sugar checks, just to make sure you have a clear picture of what’s going on in your body.

    Also make sure your medical team is in good communication with your surgical team. You’ll need to have a plan in place for when to stop your diabetes medications before the surgery and when to start them again afterwards.

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    The best approach to healthy eating is to eat a wide variety of foods. Your body requires nutrients to repair and replace proteins, tissues, and cells throughout your body and to keep you rolling along. Your body needs three important nutrients to do this: protein, carbohydrate, and fat, as well as vitamins and minerals.

    Various combinations of these nutrients are found in different foods. So, by eating a variety of foods, you are sure to get all the nutrients you need. Eating a variety of foods is much better than taking vitamin supplements because nature combines the needed nutrients in food in a way that your body can best use them.

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    AJennifer Shaw, Nutrition & Dietetics, answered

    There is nothing wrong with taking insulin while you're pregnant, and in fact, the risks of not taking it and having excessively high blood sugars can sometimes be greater than any potential risks from taking it. Insulin is a hormone your body naturally makes itself, so you already have it in your body, whether you take it or not. Some oral medications for diabetes are contraindicated during pregnancy, so if diet and exercise alone do not control blood sugars, which is often the case particularly late in the pregnancy, often insulin is the best option.