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.

Recently Answered

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    “Sugar surfing” is a method that blends your ability to be reactive and proactive to control changes in blood sugar levels in response to different situations.  It’s a little like ocean surfing: the longer you sugar surf, the better you get. Where you set your personal blood sugar target zone or zones is always you or your doctor’s choice. When starting out, higher and wider ranges are always a good idea. As your skills improve, you can start to lower the target and maybe make the range narrower as you gain experience.

    A few words of caution: Don’t overdo it! It’s easy to make things too hard on yourself at first. Often, you just can’t keep blood sugars in range no matter what you do. We all have those days. Mistakes and missteps are chances to learn new things about your unique diabetes control.
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    The most common side effects of Trulicity (dulaglutide) are:
    • upset stomach
    • nausea
    These symptoms usually improve after a few weeks as your body gets used to the medication. Because of how Trulicity works, it poses little risk of causing low blood glucose (hypoglycemia). However, combining Trulicity with drugs such as insulin or sulfonylureas (glipizide, glimepiride or glyburide) may increase your risk.
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    There are several things you can do to help avoid high blood glucose levels after meals if you are on insulin:
    • Give yourself a pre-meal dose of fast-acting insulin about 20-30 minutes before you actually eat. You can give yourself about 30-40% of what you think you will need for that meal and then the rest later. This pre-meal amount, or bolus, is called “priming the pump.” It has been shown to really limit the post-meal blood sugar spike. If you wear a pump it is quite easy. However, if you are using an insulin pen you will have to give yourself two injections for the meal. 
    • Try to limit the amount of rapid-acting carbohydrates in your meal. This may be hard to do, but definitely cut out drinks with a lot of sugar calories. And, no fruit! 
    • Spread out your calorie intake as best you can. I know this seems like a pain but eat slowly and, if you can, save part of your meal for later as a snack. Mixing your rapid-acting carbohydrates with fat and protein can help as well. 
    • Try Afrezza, the inhaled insulin. It has a rapid-on rapid-off course of action that helps limit how high your glucose goes after eating. It also reduce your chances of having a delayed low blood sugar (hypoglycemia) reaction.
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    A , Pharmacy, answered
    Blood sugar levels not only vary from person to person with diabetes, but can vary in the same person from hour to hour or even more frequently. Exercising, drinking alcohol, eating and other factors can all affect your blood sugar levels. That's why keeping blood sugar under control in someone with diabetes can be tricky and may require frequent or even continuous blood glucose monitoring. If you have diabetes, talk to your doctor about the best ways to monitor your own blood sugar levels.
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    • Make sure your hands and skin are clean and dry. Soap or lotion on your skin can cause incorrect test results.

    • Puncture the skin where testing is to be done with the lancing device. If there is a problem with potential hypoglycemia, use your finger for testing.

    • Squeeze or milk out the amount of blood needed by the individual meter. With alternative sites, follow manufacturer’s instructions.

    •  Follow instructions to see if blood needs to be dropped on the test strip or if the finger or other site should be held so the strip can absorb the blood.

    • Apply firm pressure with a cotton ball or tissue to the lanced site until bleeding stops.
    • Dispose of the lancet and test strip according to local waste disposal laws
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      • Record your test results in your logbook. Make sure your name and telephone numbers are in your logbook in case you lose it.

       

       

    • 2 Answers
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      A , Endocrinology Diabetes & Metabolism, answered
      Diabetes can and will kill you if you let it, and your first line of defense is keeping your blood sugar under control. The more you test your blood sugar, the more your opportunity to control it. The more you control it, the longer and healthier your life will be. It’s a pretty simple formula, when you come right down to it.

      So how many times a day do you test your blood sugar now? It may surprise you to learn that amongst diabetics who bother to test at all (yes, a great many of our kind do not test, period) the most common frequency is once per day. If you use insulin, you really should be checking six times per day at a minimum. If you are on a pump, you should check ten times per day. Some really dedicated diabetics with either deep pockets or great insurance test 12 to 14 times per day.

      But no one tests 288 times per day, which just happens to be the minimum testing frequency of any CGM system.
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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.
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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 Nutrition & Dietetics, answered on behalf of
      Use the log book that comes with your meter to record your blood glucose readings, insulin doses, and other information. Keep this record faithfully, for at least two weeks after your diagnosis -- you'll need this information as you work with your doctor or diabetes educator to assess your treatment. After these first few weeks, your doctor may say it's okay to stop keeping this paper record.

      Tips for tracking:
      • Be consistent: Make it a habit to record each blood glucose reading and each insulin dose.
      • Be complete: Most logs have a place to write notes. Use that space to write down changes in your routine, how your feel, whether you had ketones, etc. This extra information can help your diabetes care team assess your treatment.
      • Watch for trends: Circle any blood glucose readings that are too high or too low. Can you see a pattern as to when these readings occur? (For example, do you tend to have lows after soccer practice on Tuesdays and Thursdays?) Discuss this with your care team.
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      A Endocrinology Diabetes & Metabolism, answered on behalf of
      CGMS stands for continuous glucose monitoring systems. A lot of times, it’s important for doctors to know what their patients' glucose levels are doing between finger stick testing. It's helpful to know, for example, what someone's glucose level is while he or she is asleep. A CGMS placed under the skin will measure blood sugar every five minutes for three days.

      With 72 hours of information, doctors can identify glucose patterns and manage them appropriately.