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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  • 4 Answers
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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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  • 1 Answer
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    A , Endocrinology Diabetes & Metabolism, answered

    Yes. No. Sort of. Well, ok, here’s the deal. The shinbone’s connected to the thighbone, the thighbone’s connected to the…. Diabetes can cause high blood sugar, and high blood sugar can give you the munchies. So diabetes doesn’t, by itself, make you hungry. It’s the high blood sugar that can come from out-of-control diabetes that does.

    Which is crazy, if you think about it. For the most part, the human body does a really great job of maintaining a stable state using a process of small adjustments and counter-adjustments called homeostasis. In the case of blood sugar, the body normally keeps the sugar level just right by balancing little squirts of insulin from the pancreas with little squirts of sugar from the liver. If the liver is running low on its sugar stores your body will give you an advanced head’s up that you need to refuel by sending out hunger signals.

    Where things get weird is that if your blood sugar is already high, the last thing you need is more sugar (in the form of food), right? But in fact, high blood sugar does cause hunger, even though you do not need more food. This is caused largely by a miss-communication within the body’s sugar homeostasis system.

    Every cell in your body relies on sugar from the blood for food, but they need insulin to get to the sugar. It’s insulin that moves sugar from the blood to the cells. If there is not enough insulin, or if it isn’t working very well, sugar piles up in the blood while at the same time, it’s not getting into the cells where it’s needed.

    Being in a state of high blood sugar is sort of like starving to death in the Chef Boyardee warehouse because you don’t have a can opener.

    The cells don’t really realize that there is a ton of sugar just beyond their membranes; all they know is that they are not getting any and so they send out the message: let’s eat!

    The body doesn’t really know there is a ton of sugar in the blood either, so it sends the cells signals to the brain: let's eat! Perversely, the higher the blood sugar goes, the louder the signal can become. High blood sugar gives you the munchies, so you eat, which causes your blood sugar to go even higher, which causes more munchies, which

     

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    A answered
    If the corn industry/lobbying groups that advertise on TV are to be believed, then "corn syrup vs. sugar - your body can't tell the difference." So, it is bad for diabetics except in very low quantities (basically a little when you don't know it's in something might be ok but avoid it if possible). Just try to avoid sugar and corn syrup - the latter whether you're diabetic or not. 
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    A answered
    As long as you are properly managing your blood sugar levels, meal replacement (MR) shakes that contain significant fiber and relatively low sugar should be safe when used as directed. The dotFIT LeanMR Meal Replacement formula is both high in fiber, low in sugar and contains a slower releasing carbohydrate. Type 2 diabetes is generally brought on by extra weight and MRs have been shown to be helpful in losing weight and maintaining the loss. Just make sure you closely monitor your blood sugar, especially when adding a new food category to your diet. Also check with your doctor.
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    A , Nutrition & Dietetics, answered

    The kind of fruit you choose to enjoy matters little in terms of blood glucose control. Rather, it is how much fruit you choose to enjoy. Each serving of fruit contains about 15 grams of carbohydrate. For example, a serving would be one small apple, 1/2 cup canned fruit, 1/4 cup dried fruit, or 4 ounces of fruit juice.

    It is how you fit fruit into your daily meal plan that will provide the best control. As a general rule, you should get about 3 servings of carb (or 45 grams of carbohydrate) at each meal. This carb number may be more or less depending on your weight goals and drug regimen.

    Fruit is a source of carbohydrate so it will affect your blood glucose; the trick is to eat it in moderation.

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    A , Endocrinology Diabetes & Metabolism, answered

    It’s possible. Of course I’m not sure how old the child is or what you consider to be “borderline high” glucose. If I had to guess, I’m betting you have diabetes yourself and maybe noticed your kiddo was going to the bathroom a lot so you did a finger stick and got a number higher than you expected. And now you are freaking out. Yeah, I would too.

    In fact, I nearly gave myself a heart attack testing my son when he was about five years old. He clocked a 428mg/dL. After I could breathe again, I had him wash his hands and retested to find a blood sugar of 94. He had some ketchup on his fingers from the fish sticks we were eating. False alarm.

    But assuming the child’s sugar really is up, what’s up with that? Children can get two types of diabetes. Type-1, which in the old days was actually called “juvenile diabetes,” an autoimmune disease where the body attacks and kills off the body’s ability to make insulin. Kids who get this kind of diabetes get sick very quickly and their blood sugars go through the roof.

    But we are seeing more and more and more Type-2 diabetes amongst children too. Type-2 used to be viewed as a disease of middle age. It’s a type of diabetes that has a genetic component, but is triggered by a combination of age and weight. It’s characterized by a very slow onset over time.

    To be blunt, fat kids in families with diabetes are at very high risk of developing diabetes as kids. If your child is overweight and has borderline high blood sugar you need to get that kid to the doctor right away. And today, right now, you need to pour every soda in the house down the toilet. And drive thru food is forever off limits. And you need to buy smaller plates.

    The bottom line is we have two problems. The first is, for reasons we don’t understand, Type-2 in kids is more aggressive and damaging and they have to live with it for a very long time; too long. A child who gets Type-2 will likely pre-decease her parents. The second problem is we don’t have many meds that are approved for children.

    Your best therapy is to get the weight off the child. If you think adults have problems with diets, you have no idea how hard it is to get kids on a diet. But you have to be strong and do the right thing.

    You don’t want to burry your child in the future because you didn’t have the strength to say “no” to seconds today.

     

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    A , Endocrinology Diabetes & Metabolism, answered

    What a cool question! And to be honest, I really don’t know the answer, but I’m happy to speculate. Type-2 Diabetes, the most common kind, has a very strong genetic component and it’s considered normal to see many generations of one family have it. Even the less common Type-1 Diabetes may have some genetic components as well.

    So we definitely see diabetes pass from generation to generation in many families. We also see it pop up where it never was before, but of course every human is the joining of two family trees, so it’s possible to get “diabetes genes” even though neither your mother or father’s side had it.

    But as to skipping a generation. Hmmmm…. I don’t think so. Things that “skip” tend to be recessive traits, like blue eyes. In the case of blue eyes, you can carry blue jeans (so to speak) but you need to hook up with a blue-eyed person to get blue-eyed children. Diabetes genes seem to be more like the dominant kind. I think it more likely that each generation will be equally pre-disposed, but that some generations might not trigger the genes.

    Remember that having the genes for diabetes does not guarantee that you'll get it. The genetic predisposition for diabetes still has to be triggered to get the disease.

    Those triggers tend to be a magic combination of age and weight. Generally the fatter you get at a young age, the more likely you are to develop full-blown diabetes. If you had a family where the diabetes genes ran strong but one generation was more fit (or died younger) than typical, I think it is possible that diabetes wouldn’t manifest in that generation. 

    But the diabetes genes would still be there. They just wouldn’t be active, so it might appear to “skip” that generation simply because none of them developed diabetes.

    Still, I’d be willing to bet if we took a member of that generation and fattened them up enough, they’d get diabetes too.

  • 2 Answers
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    A , Pharmacy, answered
    If you have diabetes and are pregnant your A1C levels should be as close to normal as possible. Pregnant women who do not have diabetes typically have A1C levels of less than 5%, and this should be the target range for pregnant women with diabetes. The A1C test measures the percentage of glycated hemoglobin in your blood. Glycated hemoglobin is created when molecules of hemoglobin (the oxygen-carrying protein in your blood) attach to molecules of glucose (the sugar in your blood). The more sugar you have in your blood, the higher your percentage of glycated hemoglobin. The American Diabetes Association recommends a target number of 4% to 6%. The American College of Obstetrics and Gynecology recommends a target number of no higher than 6%. Talk to your doctor about the best ways to manage your blood sugar levels during pregnancy.
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  • 2 Answers
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    Typical blood glucose levels for pregnant women with diabetes are: Fasting 60-99 mg/dl, after meals 100-129 mg/dl.
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