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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    Islet transplantation is a procedure that involves moving the islets from a donor pancreas into a person whose pancreas has stopped producing insulin. Beta cells in the islets make the insulin that the body needs for using blood glucose.
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    The evidence of a link between exposure to Agent Orange (or dioxin, the problematic contaminant in Agent Orange) and diabetes is modest. Most of the association between Agent Orange and diabetes comes from studies of people who lived near or worked at manufacturing plants that produced large quantities of Agent Orange dioxin. In those cases, there appears to be some relationship between Agent Orange exposure and increased insulin resistance, the precursor to type 2 diabetes.
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    When you finish the blood glucose check, write down your results and review them to see how food, activity and stress affect your blood glucose. Take a close look at your blood glucose record to see if your level is too high or too low several days in a row at about the same time. If the same thing keeps happening, it might be time to change your plan. Work with your doctor or diabetes educator to learn what your results mean for you. This takes time. Ask your doctor or nurse if you should report results out of a certain range at once by phone.
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    Some people with type 1 diabetes experience a brief remission called the "honeymoon period." During this time, their pancreas may still secrete some insulin. Over time, this secretion stops and, as this happens, the child will require more insulin from injections. The honeymoon period can last weeks, months, or even up to a year or more.
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    A fasting blood glucose (FBG) test is a check of a person's blood glucose level after the person has not eaten for 8 to 12 hours (usually overnight). This test is used to diagnose prediabetes and diabetes. It is also used to monitor people with diabetes.
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    Conventional therapy is a term used in clinical trials where one group receives treatment for diabetes in which A1C and blood glucose levels are kept at levels based on current practice guidelines. However, the goal is not to keep blood glucose levels as close to normal as possible, as is done in intensive therapy. Conventional therapy includes use of medication, meal planning, and exercise, along with regular visits to healthcare providers.
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    There are many meters to choose from. Some meters are made for those with poor eyesight. Others come with memory so you can store your results in the meter itself. The American Diabetes Association does not endorse any products or recommend one meter over another. If you plan to buy a meter, here are some questions to think about:
    • What meter does your doctor or diabetes educator suggest? They may have meters that they use often and know best.
    • What will it cost? Some insurance companies will only pay for a certain meter. Call your insurance company before you purchase a meter and ask how to get a meter and supplies. If your insurance company does not pay for blood glucose checking supplies, rebates are often available toward the purchase of your meter. You still have to consider the cost of the matching strips and lancets. Shop around.
    • How easy is the meter to use? Methods vary. Some have fewer steps than others.
    • How simple is the meter to maintain? Is it easy to clean? How is the meter calibrated (set correctly for the batch of strips you are using)?
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    Autonomic neuropathy affects the autonomic nerves, which control the bladder, intestinal tract, and genitals, among other organs. There are a number of treatments for damage to nerves that control body systems. For example, a dietitian can help you plan meals if you have nausea or feel full after eating a small amount. Some medications can speed digestion and reduce diarrhea. Problems with erections can be treated with medications or devices.
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    Experts testing meters in the lab setting found them accurate and precise. That's the good news. The bad: meter mistakes most often come from the person doing the blood checks. For good results you need to do each step correctly. Here are some other things that can cause your meter to give a poor reading:
    • Dirty meter
    • Meter or strip that's not at room temperature
    • Outdated test strip
    • Meter not calibrated (set up for) the current box of test strips
    • Blood drop that is too small
    Ask your health care team to check your skills at least once a year. Error can creep in over time.
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    Although the A1C test is an important tool, it can't replace daily self-testing of blood glucose for those who need it. A1C tests don't measure your day-to-day control. You can't adjust your insulin on the basis of your A1C tests. That's why your blood sugar checks and your log of results are so important to staying in effective control.
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