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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    APhRMA answered
    Today in the United States, 23.6 million children and adults, or nearly 8 percent of the population, have diabetes, a disease in which the person’s body does not produce or correctly use insulin.  Insulin is a hormone that helps change glucose (sugar) and other foods into energy. New cases of diabetes have risen more than 90 percent among adults over the last 10 years, and since 1987 the number of deaths from the disease has risen by 45 percent, according to the U.S. Centers for Disease Control and Prevention and the American Diabetes Association.

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    AWilliam Lee Dubois, Endocrinology, Diabetes & Metabolism, answered

    First and foremost, what type of diabetic you are determines your medication future. If you’re a Type-1 like me, you can stop taking your meds when you die. Yeah. No kidding on that one. T-1s produce no insulin, and without taking insulin shots we don’t last too long.

    If you have gestational diabetes you can generally stop taking your meds after giving birth to your baby, but exactly how long after you give birth can vary quite a bit so you and your doctor should have a plan in place in advance. Generally, if you are on insulin for gestational diabetes, you’ll stop right away, if you are on pills you’ll probably keep taking them for a few weeks.

    If you’re a Type-2 Diabetic, things are more complicated. Don’t get depressed on me, but know that diabetes is both chronic and progressive. That means it’s permanent and gets worse over time. And that means diabetic medications are very likely a permanent and progressing part of your life. Not only is it unlikely that you’ll ever get to stop them, but most likely you’ll need both higher quantities and more prescriptions over time.

    That said, there may be a loophole. If you’re very much over weight, sedentary (fancy medical word for couch potato), and have a horrible diet there’s an opportunity for you to either reduce or get off diabetic medications entirely by making radical changes to your life.

    As you improve your diet, start losing weight, and start exercising more, you’ll need less and less medication to keep your blood sugars normal. Will you get to the point of actually being able to stop all your diabetic meds? It’s possible.

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    ALeon Books, Family Medicine, answered on behalf of MDLIVE
    The best way to control your diabetes is to try to eat and take your medication at about the same time every day. If this is not possible due to your schedule discuss it with your doctor or a certified diabetes educator. They can help you work out a plan to coordinate your meals and medication and still get good control of your diabetes.
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    AStacy Wiegman, PharmD, Pharmacy, answered
    There are several things you can do to prepare your skin when using a glucose monitor kit. Before starting, make sure that you have all the supplies needed to check your blood sugar level. You will need your meter, glucose test strips, lancets and a lancing device. You may also want your log book to track your levels. To get ready, clean your skin with alcohol or wash it with soap and water. Make sure your skin is dry before pricking yourself with the lancet.

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    AStacy Wiegman, PharmD, Pharmacy, answered
    In your kit you'll need a glucose meter, which measures and displays your glucose -- or blood sugar -- levels. Lancets and a lancing device will help you draw blood for the testing. Glucose test strips are needed to get your blood sugar readings. You may also want a log book to track your levels. A glucose monitor kit is available at your local pharmacy. Ask your doctor for specific directions before using one.

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    AStacy Wiegman, PharmD, Pharmacy, answered

    If you have diabetes, your doctor or clinician will show you how to check your blood sugar -- or glucose -- levels with a glucose monitor. To use this device, you poke your finger with a lancet and lancing device, and squeeze a drop of blood onto a glucose test strip. Depending on different brands or models, some require more blood samples than others. The blood glucose test strips will then be inserted into the blood glucose meter. There are chemicals on the strip that react with your blood sample that will estimate the amount of sugar in your blood.

    Generally, the manufacturer of glucose meters specifically designed their blood glucose test strips for their meters. You may also need to check to see if your meter is 'coded" to match a particular batch of diabetes test strips. In this case you would have to enter a code number into the meter or by inserting a code chip. Some diabetes test strips have the coding built in. Each time you open a new vial of test strips, you would have to "code' your meter. Remember to store your strips in their original container away from heat, humidity because temperature and exposure to air can all affect strips.

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    Some researchers believe that when a virus infects a body, it might somehow change the structure of the antigens on the surface of the islet cells. If this occurs, then the altered antigen might appear to be foreign to the immune system, and a person’s own insulin-producing islet cells might be destroyed.

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    Everyone is born with a set of instructions that tells the cells in your body how to grow, live, and function. These instructions lie in the particular chemical sequence of units known as bases, which make up the DNA in every cell in your body. Each cell in your body contains 46 chromosomes, which are made up of DNA and protein. Each DNA strand is like a long string that contains millions of bases. Along the strand lie the genes, unique segments of DNA that tell your cells what kind of protein to make. But just as books sometimes contain typographical errors, so too does the sequence of DNA. If there is a mistake, or mutation, in the DNA within a gene, then a faulty protein may be made that can’t do its job. Scientists are trying to determine how mistakes in specific genes cause diabetes. If mutated genes occur in germ cells—the eggs and sperm—then the DNA mutations can be passed on from generation to generation.

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    The risk factors associated with type 1 or type 2 diabetes are different. For both type 1 and type 2 diabetes, having a family history of diabetes puts you at a higher risk for developing the disease than a person with no family history of diabetes. However, many people with type 1 diabetes have no known family history of the disease. Type 1 diabetes is more common among whites than among members of other racial groups. In contrast, members of American Indian, African American, and Hispanic ethnic groups are at higher risk for developing type 2 diabetes.
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    Maturity-onset diabetes of the young (MODY) usually affects young adults, but can also affect teens and children. It can be misdiagnosed as type 1 in younger patients. Adults with MODY develop diabetes at a younger age than most type 2 patients and do not tend to be overweight or sedentary. In the past, people with MODY were often told they had a form of type 2 diabetes. We now know that MODY is caused by a genetic mutation that leads to impaired insulin secretion. Insulin resistance, which is often found in type 2 diabetes, does not usually occur in MODY. If you have MODY, you may be able to manage your blood glucose levels through diet and exercise alone, at least for a while. However, therapies that work for people with type 2 diabetes do not always work for people with MODY. You may have more success with insulin therapy or oral agents that stimulate insulin secretion.