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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    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.
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    AWilliam Lee Dubois, Endocrinology/diabetes/metabolism, answered
    You can calculate sensor cost for your CGM monitor? One good way to compare overall monitor cost is to look at how the sensors compare in cost per day. To calculate the daily cost of your sensor, divide the sensor price by the number of days it’s approved to run.
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    AWilliam Lee Dubois, Endocrinology/diabetes/metabolism, answered
    Generally speaking, most CGM system manuals and user guides are simply awful. They tend to suffer from being written by engineers and legal departments, not by diabetics who have actually used them. On the bright side, none of these manuals is intended as light bedtime reading.

    Manufacturers’ manuals are more like dictionaries—reference guide books to look up the spelling of a rarely used or obscure word. However, you can generally find PDF versions of the user’s manuals and quick start guides on the web. It is a great way to get a feel for the various devices you are considering.
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    ALynn Grieger, Nutrition & Dietetics, answered
    People with diabetes face many daunting obstacles, but in my over 20 years of working as a certified diabetes educators, I think the biggest struggle is figuring out how to fit diabetes management into your life, so that diabetes doesn't take over your life. Learning how to combine regular blood glucose testing, exercise, healthy eating, medications, regular eye exams, and daily foot care can seem overhwelming and seemingly impossible. Taking a proactive approach, where diabetes self-care becomes a part of your life without taking over your life, is key for both a happy and fulfilling life, as well as a healthy life.
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    AWilliam Lee Dubois, Endocrinology/diabetes/metabolism, answered
    All CGM systems have software. Some include it as part of the package, others make you buy it. Some are desktop based. Some are web-based. Big differences come into play when you look at data filtering options.

    • Can you look just at Sundays for the last three months?
    • Can you just look at lows? 
    • Can you display your day from 6 a.m. instead of from midnight? 
    • How is the sensor data displayed?
    • Do you get nice smooth lines, or plots of crazy dots, squares, and triangles?

    Do you use a Mac? Mac users are generally screwed when it comes to medical device software. If you use a Mac you’ll probably want a web-based software, just make sure there is a way for you to get your data to the web from your system.

    Also, consider download type. Cable, infrared, RF, or Blue Tooth. What are your options? What will be easiest for you? What will work best with your computer system?
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    AWilliam Lee Dubois, Endocrinology/diabetes/metabolism, answered
    Transmitters range in size and shape from a pack chewing gum to a flattened thimble. Some are smooth and sleek, and others have sharp edges.

    It’s not how big it is, it’s how you use it, right? The transmitter is only part of the story when it comes to how much of your skin a CGM site will take up. The transmitter needs a way to connect to the sensor, and a way to stay stuck to your skin. Solutions can range from complicated plastic foundations to sticky-pads. Sometimes smaller transmitters actually take up greater area of skin landscape.
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    AWilliam Lee Dubois, Endocrinology/diabetes/metabolism, answered
    You should know the following about transmitter range before buying a CGM monitor:

    How far apart can the transmitter and monitor be before your system suffers separation anxiety?

    If they get too far apart, will the transmitter store the “lost” data? Bear in mind that telemetry range data is calculated based on naked people in empty warehouses.

    You’ll almost never get the kind of range the makers brag about.