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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  • 2 Answers
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    A , Endocrinology Diabetes & Metabolism, answered
    “Excursion” simply means fluctuations in your blood sugar, but the term is usually used when talking about how much the blood sugar numbers change with meals. Doctors will say that your meal-related “excursions” shouldn’t be more than a certain number. For example, I often tell my patients that an excursion of no more than 40 to 60 mg/dL glucose with a meal indicates very good control. An example would be a person whose pre-meal number is around 90 with a rise to about 140 maximum after eating. That would qualify as an “excursion” of 50 points -- pretty close to the kind of change you would see in someone without diabetes. The concept is also helpful in knowing whether someone has a problem with blood sugar control primarily in the fasting setting or after eating. 

    For example, let’s say a person takes a combination of long- and short-acting insulin and she has a hemoglobin A1c of 8.5. She needs to do better, but should there be adjustment to the long-acting insulin, the short-acting insulin or both? Well, if the fasting or pre-meal glucose levels are high (let’s say around 220) but the meal-related excursions are typically only around 50 mg/dL (from about 220 to about 270 on average), then you know that the fast-acting insulin doses are generally correct, but the long-acting insulin dose is too low. If the person took enough long-acting insulin to get the fasting sugar down to around 100, then with meals that 50 point excursion would be just about perfect.
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    A , Emergency Medicine, answered
    A review of 6 studies that included over 95,000 men and women (including over 4,000 people with diabetes) showed that aspirin reduced the risk of nonfatal heart attacks by about 12%.

    This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor. 
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    In Sugar Nation, author Jeff O'Connell makes an irrefutable case that lifestyle changes are critical in combating a diagnosis of prediabetes or diabetes. While manipulating dietary choices is the logical place to begin in diabetes management, he stresses the importance of exercise as an essential element in combating the disease. "Along with a low-carb eating plan, a gym membership is the most potent antidote to type 2 diabetes," writes O'Connell.

    He speaks with experts who identify high-intensity interval exercise (HIIT) as the preferred workout regimen to affect insulin sensitivity. HIIT is a style of training where you "alternate bursts of intense cardio exercise, like sprinting, with a more relaxed pace." While HIIT training demands greater exertion, it's also a workout that can be completed in shorter time than traditional cardio workouts.

    James Timmons, PhD, a university researcher who studied HIIT's influence on diabetics, told the writer: "The intense contractions that fatigue muscle really break down carbohydrate stores in muscle as well. The muscles then become much more responsive to insulin as they attempt to replenish these stores." As O'Connell sums up: "[T]he latest studies suggest that the blood sugar benefits of high-intensity training don't just meet those of longer, steady-pace cardio sessions -- they exceed them."

    Research has also found that exercise can deliver enormous benefits to diabetics even when sufferers fail to reach their weight-loss goals. "In the Diabetes Prevention Program, those subjects who didn't hit their target weight loss, yet did hit their target for exercise, still had a 44% reduction in diabetes risk relative to a placebo group."

    Whatever type of workout program you engage in, do it as regularly as you would take a medication for diabetes. It's that powerful.
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    Jardiance (empagliflozin) is a medicine that can help people with type 2 diabetes stay in control of their blood glucose levels. When starting Jardiance, you can expect: 
    • a moderate drop in your HbA1c level (0.5%-1%, depending on your baseline)
    • a moderate decrease in your fasting plasma glucose of 30 mg/dL
    • to lose about three to six pounds, or 2.5%-5% of your body weight 
    • a small but significant lowering of the top (systolic) number of your blood pressure reading (about 2-4 mmHg)
    Researchers noticed these improvements in clinical trials. Your results on the drug may be even better. The bottom line is that if you want to have better diabetes control and lose weight without low blood sugar (hypoglycemia), Jardiance may be a good option for you.
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    A , Emergency Medicine, answered
    Your doctor will need to test your kidney function before starting treatment. If you have severe kidney impairment or end-stage renal disease (ESRD), you should not take an SGLT2 inhibitor.

    If you have severe liver impairment, you should not take canagliflozin. Other SGLT2 inhibitors may also not be good options for you.

    If you have bladder cancer, you should not take dapagliflozin. If you have had bladder cancer in the past, dapagliflozin may not be a good option for you.

    If you are pregnant, planning to become pregnant, or may be pregnant, SGLT2 inhibitors may not be good options for you. It is not known if they are safe for pregnant women.

    You should not take an SGLT2 inhibitor if you are breastfeeding. 

    ​​​​​​This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor. 
  • 6 Answers
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    A answered
    Who is a candidate for diabetes treatment?
    Diabetes treatment includes more than the supplies from your pharmacist. In this video, Michelle Lalick, RN, BSN, CDE, of Mercy Health, explains that treatment can also include a specific diet and exercise plan.

    Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.
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    If you have type 2 diabetes, Trulicity (dulaglutide) combined with a healthy diet and exercise can help you better control your blood sugar level. Proper blood glucose control is important to prevent long-term complications of diabetes such as damage to blood vessels and nerves. 

    However, Trulicity is not recommended as the first medication to treat diabetes. Metformin or Glucophage is usually tried first. 

    Trulicity typically leads to a significant decrease in HbA1c, especially when coupled with other diabetes medications like metformin. The drug is taken once a week. This may be preferred if you have difficulty remembering to take your current medication or you want more flexibility. 

    Before taking Trulicity, it is important to tell your doctor if you have:
    • a history of severe gastrointestinal (GI) disease
    • a personal or family history of thyroid cancer 
    As always, it’s important to let your provider know of all prescription, over-the-counter and herbal medications you are taking.
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    A answered
    The American Diabetes Association (ADA) recommends the following treatment goals (your goals may differ, depending on your health history):
    • Hemoglobin A1c: Less than 7 percent
    • Blood sugar before a meal (preprandial plasma glucose): 70-130 mg/dL
    • Blood sugar 1-2 hours after a meal (postprandial plasma glucose): Less than 180 mg/dL
    • Blood pressure: Lower than 130/80 mm Hg
    • LDL (bad) cholesterol: Less than 100 mg/dL
    • HDL (good) cholesterol: Over 40 mg/dL for men; over 50 mg/dL for women
    • Triglycerides: Less than 150 mg/dL

    With regular monitoring every 2-3 months, you and your doctor can check whether your treatment plan is helping you meet these goals and can make adjustments as needed.

    Good diabetes care should also include steps to maintain oral/dental health, eye health, kidney health, mental health, and foot health through self-care, regular checkups, and, when necessary, appropriate treatment.

  • 1 Answer
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    A , Emergency Medicine, answered
    Some people with diabetes can benefit from taking low dose aspirin (75 to 162 mg a day). This includes people with cardiovascular disease or a higher risk of it. The risk is higher in people over age 50 with diabetes and at least 1 other major risk factor for cardiovascular disease. Major risk factors include high blood pressure, high cholesterol, too much protein in the urine, smoking, or a family history of cardiovascular disease.

    Aspirin is not recommended for men or women under age 50 who have no other major risk factors for cardiovascular disease. 

    This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor.
  • 1 Answer
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    A , Alternative & Complementary Medicine, answered

    There is no one-size-fits-all program for diabetics or for nondiabetics seeking to be as healthy as they can be. But there are some basics that everyone should heed. Among them are:

    -Get and maintain a positive attitude.

    -Do not smoke.

    -Reduce your consumption of refined sugar.

    -Cut loose heavy drinking - or you may need to abstain from alcohol.

    -Do not eat supersize meals.

    -If you eat meat, eat lean meat and less meat.

    -Eat more fruits and veggies.

    -Drink lots of water.

    -Reduce your stress level.

    -Laugh, laugh, and laugh!

    -Get off your butt and move! I don’t care if it’s swimming, walking, or mopping. Just get up and move. Trust me, your hair can handle it!