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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  • 8 Answers
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    AToby Smithson, Nutrition & Dietetics, answered on behalf of Academy of Nutrition and Dietetics
    With diabetes, you need to balance the amount of carbohydrates you eat with your body’s ability to use it. Spread out the amount of carbohydrate you eat evenly throughout the day, preferably every 4 hours. Remember one carbohydrate serving is equal to 15 grams of carbohydrates. The following are some general guidelines for carbohydrate choices at meals (these may change depending on your personal goals): Women can generally have 3-4 carbohydrate choices per meal. Men can have 4-5 choices. Make an appointment with a Registered Dietitian so she/he can personalize your meal plan taking into consideration your food preferences, medications, and activity schedule. You can find a dietitian in your location at www.eatright.org

    Remember the following foods contain carbohydrates, starches, starchy vegetables (Squash, potatoes, corn, beans, peas), milk and yogurt, fruits, and sweets/desserts.

    Healthy food choices also include fresh fruits and vegetables that are high in nutrients and fiber and low in sodium. Choose whole grains such as oats, barley, whole-grain wheat, buckwheat, quinoa, or rye.
    Other suggestions:
    • Include a healthy protein choice at every meal
    • Choose high fiber foods to help control blood sugar
    • Limit simple sugars and concentrated sweets
    • Select healthy choices from each food group:
    • Follow a low-fat, low-cholesterol diet
    • Bake, broil, or grill your meat instead of frying
    • Season your food with fresh or dried herbs and spices instead of salting it; Measure out carbohydrate food servings at least once a month to make sure you are eating the correct portion size; Be aware that breaded meats and vegetables have carbohydrates in them!
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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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    AJanis Jibrin, MS, RD, Nutrition & Dietetics, answered on behalf of The Best Life
    There is no one-size-fits-all carb prescription; some people can handle more at a meal than others. How many carbs you're allowed each day is tied to your daily calorie needs, which, in turn, are based on genetics, whether you need to lose weight, and how much exercise you're getting. Obviously, the more calories you burn through physical activity and the faster your inherent metabolism, the more calories you can consume and still stay at a healthy weight or lose weight.
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    AKristy L. France, Cardiology, answered on behalf of Honor Society of Nursing (STTI)
    Drinking water can lower blood sugar levels by diluting the amount of glucose (sugar) in the blood stream.
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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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    High blood glucose before a meal tells you that your liver is making too much glucose and needs to be told to slow down! The signal it needs is insulin. Because it takes time for insulin to be absorbed from the skin and additional time to reduce the liver's glucose production, we suggest that you take your usual dose of insulin and wait 60–90 minutes (instead of the usual 30–45 minutes) to eat. This will allow your blood glucose level to fall toward the normal range before you eat, giving the insulin a "head start." The goal is not to become low before eating but to regain control over high blood glucose. An alternative is to take lispro insulin 15–30 minutes before your meal, which should lower your blood glucose more rapidly than regular insulin.

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    Most health care professionals recommend that a woman with pre-existing diabetes (both type 1 & type 2) who becomes pregnant monitor her blood glucose levels up to 8 times daily. In terms of your day-to-day routine, you should probably monitor: before each meal, 1 or 2 hours after each meal, at bedtime, occasionally at 2 or 3 a.m.

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    The oral medications classified as thiazolidinediones (TZDs), which are often prescribed for type 2 diabetes, may cause women who are not ovulating and haven't gone through menopause to begin ovulating again, enabling them to conceive. Also, oral contraceptives may be less effective when you are taking TZDs.