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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    A , Endocrinology Diabetes & Metabolism, answered

    Hello. I’d like to introduce you to your liver. Other than your skin, it’s the largest organ in your body.

    Your liver is a multi-tasking organ. It’s a filter. It’s a manufacturing plant for digestive juices. And it’s a giant sugar battery. Let’s talk about that last function.

    Every cell in your body, from a brain cell, to a cardiac muscle cell, to a cell in your little toe nail eats sugar. Sugar is the fuel they use to live and carry out their assorted specialized functions that keep you alive, healthy, and interesting.

    Your body’s primary source of sugar is from eating. Everything you eat, from Twinkies to t-bones, gets broken down into sugar by the body’s digestive system. Of course it isn’t practical to be eating all the time (even though some people try very hard to do just that), so the body has a storage system for extra sugar, and that’s your liver.

    When everything is working right, the liver dribbles sugar back into your blood stream as needed between meals and overnight while you sleep. When everything isn’t working right, like say, when you have diabetes, the liver may dribble too much sugar into the system overnight. This causes your morning blood sugar to be higher than your bedtime sugar even though all you have been doing is sleeping.

    Now, before you freak out on me, I want to make it clear that there’s nothing wrong with your liver. It isn’t broken, or failing. It’s just being a little over zealous in its duties.

    A very safe, effective, and cost-effective medication called metformin (a.k.a. Glucophage) will fix the problem.

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    A answered

    Vinegar -- the tart stuff in tasty vinaigrettes and marinades -- may help clamp down on blood sugar spikes from eating starchy carbs like potatoes and pasta.

    Keeping blood sugar from surging may cut down on diabetes risk in the long run. But stabilizing blood sugar can do good things instantly, too -- like stymieing hunger pangs, keeping your energy up, and keeping pounds off. To get the blood sugar benefit of vinegar, try pairing starchy foods with vinegar-based sauces or dressings. Or start a meal with a salad dressed in oil and vinegar.

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    Be aware that your blood sugar can change very quickly, becoming too high or too low. What you eat, how physically active you are, and your growing baby will change your blood sugar many times during the day. Check your blood sugar often—as directed by your doctor and any time you have symptoms. Know what blood sugar levels mean. Learn how to adjust what and when you eat, how physically active you are, and, if prescribed, how much insulin to take depending on your blood sugar tests. Check your blood sugar right away if you have symptoms. Treat low blood sugar quickly. Always carry with you a quick source of sugar, like hard candy or glucose tablets. Wear a medical alert diabetes bracelet.

    The presence of the CDC logo and CDC content on this page should not be construed to imply endorsement by the US Government of any commercial products or services, or to replace the advice of a medical professional. The mark “CDC” is licensed under authority of the PHS.
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    Blood sugar that remains high in a woman with gestational diabetes can cause her baby to grow very large (about 9 pounds or more). Being very large makes it hard for the baby to be born through the birth canal and can cause nerve damage to the baby's shoulder during birth. A very large baby has an increased chance of being overweight or obese later in life. Being overweight or obese increases the chance of also having diabetes later in life.

    Blood sugar that remains high in a pregnant woman with type 1 or type 2 diabetes can cause her baby to have the following health problems:
    • Birth defects, especially of the brain, spine, and heart
    • Increased birth weight
    • Nerve damage to the shoulder during delivery
    • Low blood sugar after birth
    • Increased chance of overweight, obesity, and/or diabetes later in life
    The presence of the CDC logo and CDC content on this page should not be construed to imply endorsement by the US Government of any commercial products or services, or to replace the advice of a medical professional. The mark “CDC” is licensed under authority of the PHS.
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    In general, it's not a good idea to start a new strenuous exercise program during pregnancy. Good exercise choices for pregnant women include walking, low-impact aerobics, swimming, or water aerobics. Activities to avoid during pregnancy are:
    • Activities that put you in danger of falling or receiving abdominal injury, such as contact sports
    • Activities that put pressure on your abdomen (exercises done while lying on your stomach)
    • Scuba diving
    • Vigorous, intense exercise, such as running too fast to carry on a conversation
    • Activities with bouncing or jolting movements (horseback riding or high-impact aerobics)
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    A , Pharmacy, answered
    If you have diabetes, your doctor may treat your pregnancy a little differently. For example, if a woman has diabetes, some doctors would prefer to deliver her baby a week or two before the due date to lower the risk of certain problems at birth. After you deliver, you should breastfeed your baby. But because breastfeeding can lower the amount of insulin your body needs, you'll need to check your blood sugar and adjust any medications accordingly. You'll also want to plan your meals and snacks carefully around breastfeeding so you don't experience very low blood sugar.
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    Unless your health care team advises you otherwise, yes. Breast milk provides the best nutrition for babies and breastfeeding is recommended for all mothers with either preexisting diabetes or gestational diabetes.
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    High blood pressure can be a sign of pre­eclampsia, a serious condition that occurs more often in women with diabetes. Preeclampsia may also lead to early delivery, often by C-section.

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    Your baby will be closely watched after birth. He or she is at risk for hypoglycemia and will have frequent blood glucose monitoring during the first 24 hours after birth. Hypoglycemia occurs because the baby has been producing enough insulin to cover the high glucose levels in the uterus. This does not mean your baby has diabetes.

    Jaundice is also common and may require therapy with lights. If your baby was delivered early or is very large for his or her age, your baby will also be evaluated for respiratory problems. It is not unusual for these babies to be in an intensive care nursery for a short time so that they can be watched very closely.

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    The following are pregnancy planning guidelines for women with type 1 and 2 diabetes. Target blood glucose goals before getting pregnant:
    • Premeal (before eating): 60-119 mg/dl
    • 1 hour after meals: 100-149 mg/dl
    Your health care provider may have you use goals such as these, but check with your own team about your specific goals.

    Along with getting your blood glucose levels in your target range, it's also important to establish a set of healthy lifestyle habits that will reduce the risk for complications and improve the health of your baby. For women with diabetes, this means an A1C as normal as possible (less than 7%), achieving or maintaining a healthy body weight, improving diet and exercise, and having a pre-pregnancy exam.

    A pre-pregnancy exam by your doctor typically includes: measuring your A1C level to make sure blood glucose levels are under control. It also will include an assessment of any complications, such as high blood pressure, heart disease, and kidney, nerve, and eye damage. If you have type 1 diabetes, your doctor will likely check the function of your thyroid.

    You should also review all you medications and supplements with your doctor to make sure they are safe to continue using with pregnancy. Drugs commonly used to treat diabetes and its complications may not be recommended in pregnancy, especially statins, angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blockers (ARBs), and most noninsulin therapies.
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