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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    Jardiance (empagliflozin) lowers your HbA1c and blood glucose in a very interesting way – extra glucose leaves your body when you pee (or urinate). 

    The body is very good at soaking up any blood sugar in the urine back into your bloodstream. A protein located in the kidney called SGLT-2 (sodium glucose transporter) helps do this.  

    Jardiance is a type of drug called a SGLT-2 inhibitor. That means it blocks this protein, so glucose leaves your body through the urine, lowering your blood glucose level.  The amount of glucose that is removed from the body into the urine with Jardiance treatment is about equal to 40-50 sugar cubes a day.
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    A , Pharmacy, answered
    Diabetes experts don't recommend testing your urine for glucose because this method is not as accurate as checking your blood. But testing your urine for ketones can be very important in managing your diabetes. Check with your doctor to see if you need to monitor your ketone levels. You may need to do ketone urine checks if your blood glucose is more than 300 milligrams per deciliter (mg/dL) or if you're sick with the flu, a cold or a stomach bug. If you are having symptoms of high ketones -- feeling tired all the time, thirst or dry mouth, flushed skin, mental confusion, difficulty breathing or a fruity smell on your breath -- it can be a good idea to check your ketone levels.
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    A , Endocrinology Diabetes & Metabolism, answered

    Ahhhhh… now that is a tricky one! I love these kinds of questions! OK, it’s clear to me that he doesn’t check his blood sugar, and it's also clear that you understand that it’s important that he does.

    In a perfect world we’d get him on the couch with Freud and find out what his malfunction is. Of course Freud is dead. Who else can we use? Have you asked him what the issue is?

    You might have, of course. But if you haven’t asked yet, you should. There might be a good reason, or at least a reason that seems good to him. I need to remind everyone that men and women think differently, and even if you don’t agree with the other gender’s view, it doesn’t make it less valid. So if he gives you a reason that seems silly to you, you need to bite your tongue, respect his view and help him to find a solution.

    Now people don’t test for lots of reasons. A common one, is that if you haven’t been properly trained to do it, it can hurt. Hey, no one likes pain. If he’s finding the testing painful look to the lancing device. Most have variable depth settings. The perfect setting is one right between the swearing-like-a-sailor depth and the milking-the-finger-and-praying-for-blood depth. The idea is to get a small drop of blood with little or no discomfort and with little need to squeeze the finger. It may simply be that his depth is set too deeply.

    Generally, larger numbers mean deeper lancing. Now, still on the pain theme, when was the last time anyone changed the little needle in the lancing device? Oh? Back when you changed the smoke detector batteries? So the folks that sell the needles want you to use a fresh one every time. Most of us don’t, and I don’t see any need to change that often. But they will get dull and you do need the change them. It depends on how tough your hide is, but a lance can get from 5 to 25 tests.

    Another common reason that people don’t test is they haven’t been given any knowledge to use with the numbers. If he is only on oral meds he may feel he’s helpless to change his numbers. He’d not. He can study how various foods and activities change his blood sugar. It is a game. A puzzle to be solved. A battle to be won.

    And if he’s just a stubborn old coot you can resort to any of the following: appeal to sense of loyalty (do it for me); bribe him (do it for something in the bedroom); or threaten him (do it or I’m outta here).

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    A , Endocrinology Diabetes & Metabolism, answered

    The most important thing you need to do is keep your blood sugar at whatever level your doctor says is right for you. There are two tools to help you do this:

    • One is a lab test that your doctor will run every three months to see how you are doing overall

    • The other tool is literally in your hands: a small, pager-sized device called a meter

    Used properly and together, these tools can help you to better understand and control your blood sugar levels, and to fine-tune your diabetes treatment.

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    A , Cardiology (Cardiovascular Disease), answered
    If you haven’t eaten within several hours, your blood sugar levels should be between 70 and 100. A measure of 100-125 is considered prediabetic, and 126 means you’ve got diabetes. If you’ve eaten recently and your blood sugar level reads above 200, it places you among the 80 million Americans living with diabetes. As the sugar builds up in your body due to insulin resistance, it acts like shards of glass, scraping away at the walls of your arteries, leaving them severely weakened.
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    If you are an athlete with diabetes you can monitor your blood glucose with a continuous glucose monitor (CGM). A CGM can give you hundreds of readings every day without having to prick your finger, and it can tell you if your blood sugar is rising or falling. It can allow you to be physically active and have a sense of control.
     
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    A , Endocrinology Diabetes & Metabolism, answered

    Blood sugar matters, a lot, because over time high levels of blood sugar cause damage to your body. So high numbers are bad, right? Yes, but you can’t take any one number too seriously. A bad number doesn’t make you a bad person. I like to say that even bad numbers are good information. 
    That’s the secret to blood sugar testing: It’s good information. “Bad” numbers are simply good information that you need to do something about. 

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    If you take an intermediate-acting insulin, you will need to eat when
    your insulin is peaking, whether it is convenient or not. If you take one shot of long- or intermediate-acting insulin, there are several ways to get the bolus of insulin you need for meals. Some people with type 2 diabetes may be able to make enough insulin to cover the post-meal increase in blood glucose. For these people, providing the basal insulin helps their pancreas to do its job better. Another option is to take oral diabetes medications. These medications can provide the coverage needed for meals. Still another possibility is to take a combination of insulins. You can take a rapid- or short-acting insulin along with your morning shot of long acting insulin. This gives you a bolus of insulin to cover your breakfast meal. You can either use premixed insulins or mix two types of insulin in one injection.
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    A Endocrinology Diabetes & Metabolism, answered on behalf of
    Here are some common causes of blood sugar level swings:
    • High upon waking -- Your liver is releasing too much sugar at
             night, or you had a middle-of-the-night low and your body is
             overcompensating (the Somogyi phenomenon). Or a rise in
             the hormone cortisol occurs in the early morning hours is
             causing the sugar to rise (the dawn phenomenon).
    • Much higher after breakfast -- You've consumed too many carbs
             at breakfast, a common occurrence with typical American
             breakfasts (such as cereal with milk), or you've had a
             carryover from the high cortisol levels that cause the dawn
             phenomenon.
    • High all the time -- Your blood sugar is out of control; you need to
             see your doctor right away and adjust your medication and
             diet.
    • Low in the middle of the night or upon waking -- You are taking
             too much long-acting medication, or your liver may not be
             making enough sugar during periods of fasting, such as
             overnight.
    • Higher after exercise -- The adrenaline that your body makes
             during exercise is causing your sugar to rise. Usually this is
             temporary, and overall, exercise lowers blood sugars.
    • Lower during or after exercise -- You are taking too much
             medication or not consuming enough carbohydrates prior to
             exercising. Remember: if you are getting a lot of low readings,
             ask your doctor about reducing your medication rather than
             just taking in more food to avoid packing on extra pounds.
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    If you have diabetes, sometimes you might not be feeling quite right and you don’t know why. Monitoring your blood glucose may tell you what the problem is. Maybe you’re feeling sweaty and a little shaky after a 3-mile run. Maybe you’re just tired from the workout, or maybe you’re having a low blood glucose reaction. Without monitoring, you may tend to eat because you think your blood glucose level is too low, when it is really too high. Only by monitoring your blood glucose can you tell what your body really needs.