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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    There are lots of new diabetes medications available, and the number is growing rapidly. So it makes sense to stay informed about ones that might be right for you. New insulins are being introduced all the time, and we now have diabetes pills to help you control your blood glucose levels in different ways. There are pills that help you make more insulin, pills that control the release of glucose from your liver into your blood, pills that help your body use insulin better, and pills that slow the absorption of food. Since different medications help control glucose in different ways, many people take two or more diabetes pills to get the most benefit. Your health care provider is your best source of information about new diabetes medications, because your provider knows you and your diabetes.

    You can find information on new diabetes medications from other places as well, including publications of the American Diabetes Association, such as Diabetes Forecast, and on the ADA website (www.diabetes.org). Many pharmaceutical companies also maintain websites with information about their new products.

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    This is one time when being a skeptic is a good idea. Many times, news releases make a product sound like it will work for everyone, but in fact it may only be useful for specific conditions.

    In the United States, we have many regulations to protect us from unproved (and possibly dangerous) new treatments. The Food and Drug Administration (FDA) has strict guidelines regarding the research and testing that must be done on a new drug or therapy before it can be sold to the public.

    Many times you will read reports about a new product or drug, but it is still in the early phases of testing. Testing takes several years. If safety problems or side effects are found during the testing, the product will not be marketed.

    Your health care team may have information on new products, so you should check with them when something new is available. They will help you make a decision as to whether the new product is right for you.

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    Your insatiable appetite could be due to your diabetes. There are many reasons why people can't stop eating. Sometimes it is more mental than physical. Since eating provides an immediate satisfaction, some people eat to cope with emotional needs that have little to do with physical hunger. And because eating doesn't truly satisfy these needs, these feelings often return very quickly and the person will keep eating. If diabetes makes your life feel less satisfying, it could contribute to your problem.

    Another group of people physically can't tell when they've eaten enough. For some reason or another, their bodies don't signal that they're full and they continue to eat long after they've eaten more than they need.

    Still other people eat to protect themselves from low blood glucose. Some are so afraid of ever going low that they constantly keep their levels really high. Dealing with these natural fears can make a big difference. People who frequently go low need to adjust their diabetes management plan, not overeat. Talk to your health care provider about any issues that might be causing your overeating.

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    ASecondsCount.org answered

    The same diet that will help protect your heart and keep you healthy overall is also good for people with diabetes. In general, your diet should be nutritionally balanced, high in fiber, low in fat (especially saturated fat), and moderate-to-low in salt.

    • Load up with vegetables;
    • Choose lean meats, chicken, and fish - and prepare them by baking or broiling;
    • Choose low-fat or fat-free dairy products;
    • Avoid high-sodium processed foods and limit the salt you add to food; and
    • Enjoy some fresh fruit every day.
    As for how much you should eat of starchy foods like bread, pasta, potatoes and rice, follow the advice of your doctor and dietitian. Finally, watch the calories. Too much of any food can cause you to gain weight, and that will make it hard to control your diabetes.
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    High-fiber diets may be beneficial to you, particularly if you have high blood fats or impaired glucose tolerance. Fiber is found primarily in fruits, vegetables, beans, and cereals, such as wheat and oats. Insoluble fibers like cellulose, found in wheat bran and celery, are dense and chewy. Soluble fibers, in whole oats and green peas, are soft and rather gel-like when mixed with water. Most fiber is not absorbed by the body, so it passes out in the stool. Any compounds that are bound by fiber in the intestine are also not absorbed. Many studies have been done to determine whether fiber is beneficial. Most studies show a positive (although limited) effect on blood fats. That's why high-fiber diets usually lower blood cholesterol. Some studies (primarily in type 2 diabetes) have also shown an improvement in blood glucose levels, but this improvement is usually small. You can add high-fiber foods, such as whole grains and beans, to your meals. Another way to increase the fiber in your diet is to take a tablespoon of pseudophilin (Metamucil) before you go to sleep.

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    AStacy Wiegman, PharmD, Pharmacy, answered
    The best time to take your diabetic medication will vary depending on the medicine you're taking. For example, among pills for diabetes, some are meant to be taken before a meal, some at the first bite of a meal and some with food. Some are taken twice a day while others might be taken three times daily. Insulin may be taken as injections a few times a day or given by pump as a steady dose throughout the day. You and your doctor need to choose not only the best medications for controlling your diabetes, but also the best times to take those medications.
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    AJessica Crandall, Nutrition & Dietetics, answered on behalf of Academy of Nutrition and Dietetics

    Depending on how many calories your body needs depends on the amount of carbohydrates necessary. Usually a breakfast, lunch, and dinner has 30-60 grams of carbohydrate. Each snack should be around 15 grams of carbohydrates. Meet with a Registered Dietitian to get the exact grams of carbohydrate that are necessary to consume.


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    AEliot LeBow, CDE, LCSW, Endocrinology/diabetes/metabolism, answered

    The answer is yes, indirectly it will reduce insulin resistance and help a person reduce their hunger.

    Drinking 8 glasses of water a day appears to bring down one's blood sugars by reducing insulin resistance due to proper hydration. While at the same time the more water you drink the less hungry a person is so they tend to eat less during the day, similar to drinking a glass of water prior to eating fills the stomach causing a person who is dieting to reach satiation (fullness) sooner. 

    If your blood sugars are very high and your kidney is not able to process all the sugar, water will help remove the excess sugar and ketones out of your system.

    Drinking water is important for everyone but for diabetics, especially type 1 diabetics, it is crucial to remove excess ketones from the blood stream and reduce dehydration when blood sugars are high. 

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    AStacy Wiegman, PharmD, Pharmacy, answered
    Results of an A1C test and a blood glucose check don't always match up. The A1C test measures your average blood sugar levels over a 120-day period (the lifespan of a red blood cell). But a blood glucose check measures your blood sugar at a single moment. If your blood sugar levels were high last week, and you adjusted your diabetes treatment plan so that your blood sugar returned to normal, the A1C result may still be high, because it includes the high blood sugar levels from the previous week.

    The A1C test measures the percentage of glycated hemoglobin in your blood. Glycated hemoglobin is created when molecules of hemoglobin (the oxygen-carrying protein in your blood) attach to molecules of glucose (the sugar in your blood). The more sugar you have in your blood, the higher your percentage of glycated hemoglobin.
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    AStacy Wiegman, PharmD, Pharmacy, answered
    Work with your doctor to come up with a schedule for testing your blood sugar. Factors for you and your doctor to consider in developing your schedule include the medicines you take, when you eat and how well-controlled your blood sugar is. Many people with diabetes find that it works well for them to check blood sugar first thing in the morning, but talk with your doctor to find out what's best for you.
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