Diabetes Complications

Diabetes Complications

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    A , Endocrinology Diabetes & Metabolism, answered

    Assuming you have type 1 diabetes or type 2 diabetes on insulin, you need to be careful about exercising if you have ketones. Ketones in diabetes usually indicate that you don't have enough insulin. As a result, your body can't use glucose for fuel, so it starts to burn fat, and that forms ketones. If ketones build up in the blood, it can lead to a serious condition called diabetic ketoacidosis (DKA), which requires immediate medical treatment. Exercising when you have ketones may make the situation worse and also put you at risk for DKA. So, in general, if you want to exercise, check your blood glucose. If your glucose is above 250 mg/dl, check for ketones. If ketones are present, don't exercise, and follow your sick day guidelines. I you don't have these; contact your healthcare provider or diabetes educator for instructions.

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    Your body has a normal mechanism that wakes you up and gives you energy to start the day. Your body responds to this wake-up call of the growth hormones. These hormones depress the activity of insulin, allowing blood glucose to rise between around 4 and 8 a.m. This is called the dawn phenomenon. The dawn phenomenon can be one reason for blood glucose readings and ketone levels that are high when you wake up.

    If high morning blood glucose levels seem to occur mysteriously and you have diabetes, discuss the problem with your health care team and talk about the best way to treat it. You may need to eat less food at breakfast or the night before or increase your pre-breakfast or evening insulin dose.

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    A , Healthcare, answered
    I had this problem for a six week period in my life when I was training for the Race Across America in 2007. I could wake up with a blood sugar of 80, and the second I got moving or put anything into my body – if I drank a cup of coffee – my blood sugar would be 200. It was extremely frustrating. I was doing a lot of insulin to compensate for anything I ate in the morning. It’s about working with the doctor to find out how much you need to increase your basal rate from 3 a.m. to 7 a.m. to get the metabolism moving faster so the dawn phenomenon is less problematic. When I was having the dawn phenomenon I was averaging 22 hours a week on a bike, and it was a lot of intensity. I kept making adjustments until I go it right.

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    A , Pharmacy, answered
    When ketones show up in your urine, it's a sign that your diabetes may be getting out of control. Ketones are acids that your body produces when it is not getting enough fuel to function properly. Your body gets fuel by a process that starts with turning the food you eat into sugar (glucose) in your bloodstream. Your pancreas then produces a hormone called insulin, which helps move the glucose from your blood into your cells to be used for fuel. With diabetes, your body either doesn't produce enough insulin or doesn't respond normally to the insulin you do have, so it can't use glucose efficiently. The glucose is just flushed out of your body in your urine. Since you can't use glucose for fuel, it starts using fat instead -- and the fat-burning process produces the acids known as ketones.
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    A , Cardiology (Cardiovascular Disease), answered
    Type 2 diabetes (the kind associated with being overweight) increases the risk of Alzheimer’s, probably by increasing inflammation or arterial aging, but also because too much of the hormone insulin in the brain can stimulate beta-amyloid buildup. In fact, Alzheimer’s is now being called type 3 diabetes by some people.
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    Diabetes and hearing loss are two of America's most widespread health concerns. Nearly 26 million people in the U.S. have diabetes, and an estimated 34.5 million have some type of hearing loss.

    The numbers are similar -- is there a link?

    Yes, says the National Institute of Health (NIH). In fact, the NIH has found that hearing loss is twice as common in people with diabetes as it is in those who don't have the disease. Also, of the 79 million adults thought to have prediabetes, the rate of hearing loss is 30% higher than in those with normal blood sugar.

    Hearing depends on small blood vessels and nerves in the inner ear. Researchers believe that, over time, high blood glucose levels can damage these vessels and nerves, diminishing the ability to hear.
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    A answered

    Everyone experiences a little hearing loss with age. But in people with diabetes, hearing loss is often worse, especially if the disease isn't well-controlled. In fact, according to the American Diabetes Association, the rate of hearing loss is 30% higher in people with diabetes than it is in people without diabetes. That's because hearing relies on small blood vessels and nerves in the inner ear. High glucose levels can damage those vessels and nerves, which weakens hearing. Ask your doctor for a hearing test if you're having trouble.

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    A diabetic coma can occur for one of three reasons: diabetic ketoacidosis is triggered when toxic acids called ketones are formed as fat stores break down; diabetic hyperosmolar syndrome when blood sugar gets too high and the sugar passes into the urine; and hypoglycemia where your blood sugar level is extremely low. Diabetic coma is treatable but treatment is determined by the cause of the coma. Once sugar levels are stabilized, the person will usually regain consciousness.

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    Symptoms of a diabetic coma include labored breathing, breath that smells fruity, nausea and vomiting, excessive thirst, dry mouth, flushed skin, confusion, and loss of consciousness.

    A person suffering from insulin shock may experience a tingling sensation in the mouth, hands or other body part. Symptoms of insulin shock also include physical weakness, headaches, abdominal pain, labored breathing, a rapid heartbeat, tremors and irritability.

    A person with symptoms of either diabetic coma or insulin shock should seek prompt medical attention. (This answer provided for NATA by the Southern Connecticut State University Athletic Training Education Program)
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    A diabetic coma is treated according to the cause of the coma. If blood sugar is too low, glucose will be administered intravenously, along with thiamin to avoid complications from a sudden influx of sugar. If the blood sugar levels are too high, you will be given insulin, and minerals like potassium and sodium to restore cell function. Total consciousness is usually restored with these treatments.