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.

Recently Answered

  • 1 Answer
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    AWilliam Lee Dubois, Endocrinology/diabetes/metabolism, answered
    When using a CGM system, there are only three uses for test strips:

    1) Test strips are for insulin.
    2) Test strips are for emergency sugar.
    3) Test strips are for calibration.

    Other than these three times, they have no further use and are otherwise obsolete.
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    AStacy Wiegman, PharmD, Pharmacy, answered
    A continuous glucose monitor is connected to a tiny sensor that is inserted under your skin for up to a week before it needs to be replaced. The sensor checks glucose levels in tissue fluids and transmits those numbers to a pager-like device every one to five minutes. An alarms in the monitor goes off if your blood glucose level is getting too high or too low. This minute-by-minute monitoring allows you greater control of your blood sugar levels. However, because these monitors tend to be less accurate than standard blood glucose meters, changes in diabetes treatment should not be made until the readings are confirmed by tests using a standard glucose meter.
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  • 1 Answer
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    AWilliam Lee Dubois, Endocrinology/diabetes/metabolism, answered
    Calibrate your CGM monitor when your blood sugar is steady. Or, as I like to say, calibrate in a safe harbor so your readings are accurate in rough seas.

    Don’t calibrate your monitor when you are way out of your normal range or when your BG is shifting rapidly. For one thing, your test strips aren’t as good here, and for another the delays between your fingerstick, your entry, and the calibration process all add up.
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    AWilliam Lee Dubois, Endocrinology/diabetes/metabolism, answered
    Don’t think about blood glucose numbers; think rather about the motion of blood glucose number. Direction. Speed. Duration. There is no true blood glucose measurement. It cannot really be measured and doesn’t need to be. Blood glucose does not matter. Only changes in blood glucose matter.
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    AWilliam Lee Dubois, Endocrinology/diabetes/metabolism, answered
    The first CGM was a blind device. It was mute, deaf, and dumb to the person wearing it. It watched silently in the night like some kind of sinister spy. It was not until after it was taken off your body that it gave up its secrets.

    Now the CGM species has returned to its origins. Medtronic, makers of the original blind CGM, is now making the i-Pro, a modern, sleek, higher tech version of the original blind CGM. Dexcom too, has a way to mute their monitor so that it won’t talk to the patient. Both these systems are not for you. They are for your doctor, but they give many diabetics who cannot afford full-time systems a way to peek into their bodies and see how their diabetes therapy is working for them. Ask your doctor if a blind CGM trial is right for you.
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    AWilliam Lee Dubois, Endocrinology/diabetes/metabolism, answered
    Two things you should know about calibration limits for your CGM monitor are:

    • What is the range of fingersticks the system will accept for calibration?
    • Will the system shut you down if you are above range when a calibration is required?
  • 3 Answers
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    ALaura Motosko, MSEd, RD, Nutrition & Dietetics, answered

    I recommend to begin my keeping a food journal of what, when, and how much you eat currently, along with blood glucose record keeping. Begin to note your portion size for foods in the meals that you normally eat. See how the foods you are currently eating fit into a prescribed meal plan. Find a good reference book or check out internet resources such as the US Department of Agriculture Nutrient Database site for carbohydrate and nutrient content of your diet. Carbohydrate is the nutrient that affects your blood glucose directly. Then, start to make small changes to reduce portion sizes, eat nutrient dense healthy foods and look up carbohydrate content for the foods you are eating.

    A Registered Dietitian and your health care providers specializing in diabetes can help you to gradually make lifestyle changes that work for you to control your diabetes.

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    AWilliam Lee Dubois, Endocrinology/diabetes/metabolism, answered
    You should know the following about calibration flexibility in CGM monitors:

    • How much flexibility does the system have for the environment of the calibration?
    • Can you calibrate when blood glucose levels are dropping? 
    • Can you calibrate when blood glucose levels are rising?
    • Or do you need to calibrate in calm water?
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    People without diabetes may not notice the immediate effects of choosing an extra doughnut for breakfast. Their bodies balance the extra carbohydrates by putting out more insulin.  

    But if you have diabetes, you have to do the balancing act your body used to do for you. You need to make sure that your carbohydrate intake is balanced with your insulin doses, oral medication, and physical activity to keep your blood glucose levels on target. And, by eating more nutritious meals, you may improve your overall health and lower your risk for heart disease, some cancers, and hypertension.

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    AWilliam Lee Dubois, Endocrinology/diabetes/metabolism, answered
    Some CGMs sample every minute, most sample every five minutes. How much of a difference this actually makes is debatable, but in a fast-moving low, a lot can happen in five minutes.