1 AnswerDr. Andrea Pennington, MD, Integrative Medicine, answeredGymnema sylvestre certainly could serve as the backbone of a natural diabetes program. It has been used in India for the treatment of diabetes for more than 2,000 years. Used primarily for type 2 diabetes, its benefits extend to type l and it continues to be recommended today in India. The leaves help raise insulin levels. Gurmar, an extract of gymnema, tends to be a blood sugar balancer, lowering glucose significantly only in hyperglycemic people. It also significantly improves cholesterol and triglyceride levels.
1 AnswerNot every athlete with diabetes uses a pump. It’s a matter of personal preference. If you don’t like doing shots, and you don’t want to do more than four shots a day, I’d definitely recommend asking your doctor about an insulin pump.
There are a million ways when it comes to diabetes control. Each person needs to have what they feel is the best bag of tricks to do it properly. On the Race Across America team, we had six riders on the pump and two on Lantus. Personally, I use a combination of Lantus, Apidra (a fast-acting insulin) and the continuous glucose monitor. My co-founder, Joe Eldridge, a professional cyclist, uses the pump with Apidra and the glucose monitor. Athletes are always trying to fine tune what we do and to do it better.
A large study published in the New England Journal of Medicine demonstrated that Continuous Glucose Monitoring (CGM) therapy significantly reduced the A1C level in adult patients with type 1 diabetes without an increased risk of low blood sugar reactions -- always a concern when medicating to keep blood sugar readings on the low side. A person's A1C level is his or her average blood glucose level over three months. It makes sense that people with type 2 diabetes would get similar benefits from CGM.
1 AnswerIn the past there has definitely been a stigma associated with diabetes. Here I am, an athlete and one of the best controlled people with diabetes in the world, and I still get people who, when I’m drinking soda or eating cake, will say, “You can’t have that. You have diabetes.”
When I was younger it infuriated me, and I’d get mad and argumentative. As I’ve grown older, I realize it’s an opportunity I have to educate people. I would just suggest that if it’s possible, use it to educate your friends.
1 AnswerDuring the two- or three-hour window after strenuous exercise it’s crucial to know where your blood sugar is and do constant monitoring. It will be different today than it will be tomorrow. This is something all of our athletes with type 1 must do.
After exercise, the body is going through a lot of hormonal changes. Whatever glucose gets produced in the bloodstream to help with exercise, whatever you eat during exercise that your body doesn’t use during the event, combined with the body’s cortisol production can cause a big spike in blood sugar immediately following exercise for about an hour-and-a-half period. It’s common among all of our athletes to give a bolus immediately following exercise to prevent this post-exercise spike. (Bolus is the term we use to describe delivering insulin.)
At that point, it’s about tinkering with the right number to find out how much insulin you need. To dampen the spike, we will, the second we’re done with exercise, do a bolus of 4 units of insulin. If I want to eat, I would double the insulin I would normally do – but that’s just in that one hour period after exercise. Everyone is a little bit different. The one consistency we’ve seen is the spike immediately following exercise and the drop in blood sugar in the hour and a half post exercise.
2 AnswersNowadays, we hear about carbohydrate all the time. Foods that contain carbohydrate raise blood glucose. If you have diabetes, by keeping track of how many carbohydrates you eat and setting a limit for your maximum amount to eat, you can help to keep your blood glucose levels in your target range.
3 AnswersIntermountain Registered Dietitians, Nutrition & Dietetics, answered on behalf of Intermountain HealthcareIn years past, diabetes treatment meant strict control over your daily diet. But that's no longer the case. Thanks to newer insulin types, you and other kids with diabetes can be flexible in your eating habits. You can eat as much or as little as you need to satisfy your hunger. For you, meal planning is more about these basic principles:
- Eat a variety of foods. This is the best way to make sure you're getting the energy, vitamins, and minerals you need to grow, play, work, and stay healthy.
- Allow yourself treats once in a while -- but don't overdo it. There are no "bad foods" or "good foods" in your meal plan. But just like everybody else, you need to make healthy choices.
- Try to stick to a schedule. Have your meals and snacks at about the same time every day, and don't "graze" in between.
- Pay attention to carbohydrates (carbs) in your meals and snacks. Food is made up of three main nutrients: fat, protein, and carbohydrate. Of these, carbs have the biggest effect on your blood glucose. For this reason, you need to match your insulin intake to your carbohydrate intake ("cover" your carbs). You can do this by carefully measuring your insulin doses and counting carbs in your meals and snacks.
4 AnswersHere's how to check your blood glucose level with a glucose meter:
- After washing your hands, insert a test strip into your meter.
- Use your lancing device on the side of your fingertip to get a drop of blood.
- Gently squeeze or massage your finger until a drop of blood forms. (Required sample sizes vary by meter.)
- Touch and hold the edge of the test strip to the drop of blood, and wait for the result.
- Your blood glucose level will appear on the meter's display.
Other tips for checking:
- With some meters, you can also use your forearm, thigh or fleshy part of your hand.
- There are spring-loaded lancing devices that make sticking yourself less painful.
- If you use your fingertip, stick the side of your fingertip by your fingernail to avoid having sore spots on the frequently used part of your finger.
3 AnswersBlood glucose goals for children are looser compared to adults. For example, the target range may be 100 to 200 mg/dl. Most children under the age of 6 or 7 are not yet able to be aware of and respond to oncoming low blood glucose, and it’s very important to limit episodes of low blood glucose. Tailor goals to the age and abilities of the child and be flexible with goals as the child grows.
2 AnswersDr. Michael T. Murray, ND, Naturopathic Medicine, answeredWhen high sugar, or low fiber, starchy foods are eaten in excess, blood sugar levels rise quickly, producing a strain on blood sugar control. The body responds to the rise in blood glucose levels after meals by secreting insulin, a hormone produced by the beta cells of the pancreas (a small gland that resides at the base of the stomach). Insulin lowers blood glucose by increasing the rate that glucose is taken up by cells throughout the body. Declines in blood glucose, as occur during fasting or exercise, cause the release of glucagon, another hormone produced by the pancreas. Glucagon stimulates the release of glucose stored in the muscles and liver as glycogen. If blood sugar levels fall sharply or if a person is angry or frightened, it may result in the release of epinephrine (Adrenalin) and corticosteroids (cortisol) by the adrenal glands. These hormones provide quicker breakdown of stored glucose for extra energy during a crisis or increased need.
Ideally, these mechanisms are effective in keeping blood sugar levels within a very narrow range. Unfortunately, a great deal of Americans stress these control mechanisms through diet and lifestyle. As a result, obesity, diabetes, and other disorders of blood sugar regulation are among the most common diseases of modern society.
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