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 Family Medicine, answered on behalf of
    There are some claims that say vitamins and natural substances like cinnamon can be used to treat diabetes. These are not fact-based claims and following them could be dangerous. 
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    A answered
    New diabetes medicines are helping patients avoid serious complications and death, and can reduce overall healthcare spending. In one study, increased patient adherence to diabetes medicines saved $7 for every additional dollar spent on medicines. Patients with the highest level of medication adherence were significantly less likely to be hospitalized and had significantly lower total medical spending than less adherent patients.
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    A Endocrinology Diabetes & Metabolism, answered on behalf of
    Will there be a cure for diabetes?

    Will we see a vaccine to prevent diabetes or a drug to cure it in our lifetime? In this WisePatient video, endocrinologist Athena Philis-Tsimikas, MD, of Scripps Health, discusses the challenges of developing diabetes cure.

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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.
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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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    Strategies for Highs before Your Period

    • If you use insulin, gradually increase your dose. Work with your health care team to add small increments, so that insulin levels are higher the last few days of your cycle, when blood glucose levels normally rise. One to two addi­tional units of insulin may be all it takes. It will take a little trial and error to figure out the right dose for you. As soon as menstruation begins, estrogen and ­progesterone levels drop. When this happens, return to your usual dose of insulin to lower your risk of ­hypoglycemia.
    • Eat at regular intervals, when possible. This will keep your blood glucose levels from swinging too much. Large blood glucose swings could contribute to some of the emotional and physical symptoms of PMS, which may in turn make variations in blood glucose levels worse.
    • Try to avoid eating extra carbohydrates. Keep a handy ­supply of crunchy veggies—for example, celery, radishes, or cucumbers—and dip them in fat-free salsa.
    • Cut back on alcohol, chocolate, and caffeine. They can affect both your blood glucose levels and your mood.
    • Be especially careful about your sodium intake, which causes ­bloating. Use pepper, fresh or powdered garlic, lemon, cayenne pepper, or scallions to add some zing to food.
    • Try to be more physically active. Many women find that regular exercise diminishes mood swings, prevents excessive weight gain, and makes it easier to manage blood glucose levels.
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    Some sugar substitutes have calories and will affect blood glucose levels, such as fructose (a sugar, but often used in “sugar-free” products) and sugar alcohols, such as sorbitol and mannitol. Others have very few calories and will not affect blood glucose levels, such as saccharin, acesulfame-K, aspartame (NutraSweet), and sucralose (Splenda).

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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.