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

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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?
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    Many people with diabetes find that it helps not to think of their meal plan as a “diet.” After all, no one could “follow a diet” for the rest of their lives. If you are on a diet, it’s easy to go off your diet. And once off, it’s even easier to stay off. “Well, I’ve already blown my diet for today, so another slice of cheesecake won’t hurt,” you might think. But that will only make matters worse. Instead, think of your meal plan as a new way of eating. But in planning for that new way of life, make sure you work with your dietitian to develop a plan you can stick with. If your goal is to lose pounds, a low-calorie diet may look good on paper, but if you can’t stick to it, it won’t do any good. In working out your nutrition plan, your dietitian or diabetes educator can work with you to achieve your goals. 

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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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    For many people with diabetes, food is the biggest struggle. The millions of us who have ever tried a “diet” know how hard it is to change how we eat. Diabetes is filled with food myths. Most people need help knowing what’s true and what’s not about diabetes and food. Your time and money will be well spent if you decide to get some education from a registered dietitian or a certified diabetes educator.

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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?