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 on behalf of
    What does my family need to know about my diabetes treatment?
    Diabetes is often called a "family" disease. In this video, Scripps Health endocrinologist Athena Philis-Tsimikas, MD, explains why it's important for family members to be involved, for both the diabetes patient and for themselves.
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    A Endocrinology Diabetes & Metabolism, answered on behalf of
    You should have several goals when you first starting monitoring your blood sugar levels, including blood sugar in the normal range, consistently, every time you check -- or at the very least, blood sugar readings in the acceptable range. Knowing how your blood sugar responds to different medications and doses, to meals, to exercise, to an overnight fast, and to the length of time between meals will help you craft a plan that is right for you. You'll find all this out with the help of your new best friend: a blood glucose monitor (also called a glucose meter), an electronic device that reads your blood sugar level. The numbers flashing on the screen of this little device let you know how well you're managing your diabetes.
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    A Endocrinology Diabetes & Metabolism, answered on behalf of
    By logging your meals, you’ll soon discover which are kindest to your blood sugar. You have quite a choice of breakfasts: eggs, cereal, peanut butter and toast, and much more. What they all have in common: the same amount of carbohydrates. Say you pick an oatmeal-based breakfast, and  two hours after eating, your blood sugar is near normal, but a waffle-based breakfast leaves your blood sugar too high. A number of factors influence blood sugar levels, so you can try those breakfasts again. If you get a similar result each time, it means the oatmeal breakfast is a keeper, and from now on you’ll skip the waffles. Pretty soon, you’ll have a great collection of blood-sugar-friendly meals that work for you.
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    At first, you think you’re just imagining it. You’re going along and everything seems fine. You’re in good spirits, eating well, getting regular workouts, and your blood glucose levels are on target most of the time. Then, for some unexplained reason, everything seems out of whack. Maybe your blood glucose levels are too high; maybe they’re too low. Then you check the calendar. Oh, yeah—it’s that time of the month.

    If you have trouble keeping your blood glucose levels on target just before your period starts, you are not alone. A survey of 200 women with type 1 diabetes showed that in the week before their periods, 27% had problems with higher-than-normal blood glucose levels and 12% had lower-than-normal blood glucose levels. Another study revealed that among women under the age of 45 who were hospitalized for diabetic ketoacidosis, half were within several days of starting their periods. A survey of more than 400 women revealed that nearly 70% experienced problems with blood glucose levels during their premenstrual period. The problem was more common among women who considered themselves to suffer from the moodiness associated with premenstrual ­syndrome (PMS).

    It’s difficult to pinpoint just how many women have problems with their blood glucose levels before menstruation. Many studies are based on surveys con­ducted after the fact and do not take physical activity and eating patterns into account.

  • 2 Answers
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    A , Pharmacy, answered
    There are about 75 different kinds of glucose monitors. They all do the same essential thing -- they let you measure your blood sugar (glucose) levels at home or when you are traveling. They work by analyzing a pinprick of blood that you put on a special strip and feed into the machine.

    All glucose meters in the United States report the results in milligrams of glucose per deciliter of blood (mg/dL). They differ in the amount of blood needed for each test, ease of use, pain associated with use, accuracy, testing speed, size, ability to store results in memory, cost of the meter, cost of the strips, special features and technical support from the manufacturer. To find a good one, start by asking your doctor for a recommendation.
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    A Family Medicine, answered on behalf of
    If you have diabetes, the results of a home blood glucose monitoring test fall into the following ranges. It’s important, however, to follow the guidelines and recommendations established by your doctor.
    • hypoglycemia (low blood sugar): a glucose reading below 70 milligrams per deciliter (mg/dL)
    • critical low: below 60 mg/dL
    • critical high: above 400 mg/dL
    • test for ketones: when your blood sugar level exceeds 250 mg/dL
    • recommended pre-meal target: 70-130 mg/dL
    • post-meal target: below 180 mg/dL when the reading is taken one to two hours after the start of a meal
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    A , Endocrinology Diabetes & Metabolism, answered
    Your blood sugar rises when you are sick because the body secretes of variety of hormone and other substances in the process of fighting infection that either raise blood sugar directly or make the body resistant to the actions of insulin. Cortisol is the body’s main “stress” hormone, and cortisol makes the body more resistant to insulin action. In other words, insulin will not lower blood sugar as well in the presence of high levels of cortisol as it does when cortisol levels are lower. This is the same reason that man-made anti-inflammatory steroids, like prednisone, which are all patterned after cortisol, will raise blood sugar. Many people who have autoimmune or inflammatory disorders will see a dramatic rise in their blood sugars when they are given prednisone. Other hormones, like adrenaline (also called epinephrine) will cause the liver to release glucose directly into the bloodstream. This is why certain asthma medications which mimic adrenaline action (a common example being albuterol) will also raise blood sugar levels.

    Think of the person who has diabetes and asthma who gets pneumonia which is severe enough to require hospitalization. Between the body’s rise in cortisol and adrenaline, and the administration of large doses of prednisone and albuterol to combat airway constriction, you can see how complex the interactions become in treating diabetes in combination with other medical problems!  
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    A Endocrinology Diabetes & Metabolism, answered on behalf of
    How often and when should I test my blood sugar?
    Depending on the medication you're taking, you may need to check your blood sugar only once a day. In this video, Ronald Tamler, MD, clinical director of the Mount Sinai Diabetes Center, discusses blood sugar testing.
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    How often you monitor your blood glucose is highly individualized. It depends on:
    • Whether you have type 1 or type 2 diabetes
    • Your blood glucose goals
    • How often you’re willing to prick your finger,
    • What supplies you can afford 
    How often you monitor also depends on your reasons for checking your blood glucose. The standard times to check your blood glucose if you have diabetes and are looking for patterns in blood glucose behavior are:
    •  before breakfast, lunch, and dinner (or an especially big snack)
    •  before you go to bed
    •  1 to 2 hours after breakfast, lunch, and dinner (or an especially big snack)
    •   at 2 or 3 a.m.
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    A , Pharmacy, answered
    In your kit you'll need a glucose meter, which measures and displays your glucose -- or blood sugar -- levels. Lancets and a lancing device will help you draw blood for the testing. Glucose test strips are needed to get your blood sugar readings. You may also want a log book to track your levels. A glucose monitor kit is available at your local pharmacy. Ask your doctor for specific directions before using one.