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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    If you have diabetes and your blood glucose readings are consistently higher or lower than your target, or if you get a reading that is unexpectedly high or low, this could indicate a problem. Discuss with your health care team in advance what you should do if your readings are way off scale. If you detect patterns in your glucose levels that indicate a need to adjust your plan, let the team know. For example, you may find that your blood glucose levels tend to be high when you check in the morning. This could be because your body is “rebounding” from a very low blood glucose level while you sleep. Try checking your blood around 3 a.m. If you discover hypoglycemia, treat it as you normally would.
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    Choosing blood glucose goals can be easy. You can simply use the guidelines supported by the American Diabetes Association (ADA). These recommendations are based on the findings from research about preventing complications.

    ADA Blood Glucose Goals:

    Before meals: 70-130 mg/dl

    Two hours after the first bite of a meal: less than 180 mg/dl

    However, the ADA’s goals may not be easy for you to reach. Or they may not be right for you. Talk to your provider to determine the right blood glucose targets for you.

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    You should do extra blood glucose checks under the following circumstances:

    •   when you’re ill

    •   if you suspect low blood glucose

    •   before you drive (if you take insulin)

    •   when you have trouble recognizing the warning signs of
        hypoglycemia

    •   when you’re physically more active than usual

    •   if you start taking a nondiabetes medication that affects blood
        glucose levels or your ability to recognize low blood glucose warning 
        signs

    •   if you have insulin reactions at night or wake up with high blood
        glucose levels

    •   when you are changing your insulin plan, your meal plan, or your
        exercise routine

    •   when you have lost or gained weight

    •   when your levels have been outside your target range more often
        than in your range

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    Over time, you will gain confidence in your ability to manage your diabetes. You may think it’s okay to monitor less often. Beware! It’s tempting to think you can tell what your glucose level is by the way you feel. But research shows that most people cannot guess their glucose level reliably. Guessing is dangerous, especially if your blood glucose levels tend to swing with little warning.

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    If you have diabetes, sometimes you might not be feeling quite right and you don’t know why. Monitoring your blood glucose may tell you what the problem is. Maybe you’re feeling sweaty and a little shaky after a 3-mile run. Maybe you’re just tired from the workout, or maybe you’re having a low blood glucose reaction. Without monitoring, you may tend to eat because you think your blood glucose level is too low, when it is really too high. Only by monitoring your blood glucose can you tell what your body really needs.
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    People with type 2 diabetes who manage their blood glucose without medications might monitor once to four times a week, or not at all. However, checking your blood glucose levels regularly will help you keep track of your diabetes and see how all of your efforts are working. One approach is to routinely measure your fasting or pre-breakfast blood glucose levels. It can also help to check your blood glucose at different times of the day: before and after exercise, before and after meals, and at bedtime. This gives you a better idea of what is happening with your blood glucose levels.
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    If you are taking oral medications, you may decide to monitor just two times each day. Blood glucose levels in people with type 2 diabetes are often more stable over the course of a day and you may not need to monitor as often because you can’t use the results to fine-tune your dose.
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    If you have type 1 diabetes or you have type 2 diabetes and you take insulin, you need to monitor. If you have type 2 diabetes and take oral diabetes medications, check with your health care team about whether and how often you need to monitor. If you have gestational diabetes and take insulin, you need to monitor.

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    Pain medications for people with diabetes are usually safe in small doses. You don’t have to worry about taking an occasional aspirin for a headache or fever. Ibuprofen is not safe for anyone with kidney disease. People with diabetes should not take ibuprofen unless a provider advises it. This drug could cause acute renal failure in people with kidney problems.
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    Before your next illness, decide on an action plan with your health care team. Include the following:

    •  When to call the doctor.

    •  How often to monitor your blood glucose.

    •  Whether you should test your urine for ketones. Ketones are
        produced when fats instead of glucose are used for energy. Most
        commonly, this is a sign that not enough insulin is available to help
        your body break down glucose. (Less commonly, when carbohydrates
        are very restricted, ketones can appear in the blood. This is called
        starvation ketosis.) When blood glucose levels are high during illness,
        ketones can appear if extra insulin is not given. •  Medication changes that might be needed. You need to know how
        much extra insulin to take to bring down unusually high blood glucose
        levels. If you take oral diabetes medications, you need to know
        whether you should continue taking them or increase or decrease the
        dose. • Whether you need to have anti-nausea suppositories or over-the-
       counter cold or flu or cough medications on hand, which ones are
       good choices, and when to take them.

    • How to choose foods and fluids during your illness.