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 , Nutrition & Dietetics, answered

    The American Diabetes Association has recipes posted on their website as well as provides a list of cookbooks at:

    • http://www.diabetes.org/food-and-fitness/food/recipes/

    In addition Diabetes Health provides recipes at:

    • http://www.diabeteshealth.com/recipes/

    You can also find diabetic recipes at Diabetic Lifestyle at:

    • http://www.diabeticlifestyle.com/recipes

    The National Diabetes Education Program also has a free booklet to download from their website on tasty recipes at:

    • http://ndep.nih.gov/publications/PublicationDetail.aspx?PubId=131

     

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    A , Endocrinology Diabetes & Metabolism, answered

    Ahhhhh… now that is a tricky one! I love these kinds of questions! OK, it’s clear to me that he doesn’t check his blood sugar, and it's also clear that you understand that it’s important that he does.

    In a perfect world we’d get him on the couch with Freud and find out what his malfunction is. Of course Freud is dead. Who else can we use? Have you asked him what the issue is?

    You might have, of course. But if you haven’t asked yet, you should. There might be a good reason, or at least a reason that seems good to him. I need to remind everyone that men and women think differently, and even if you don’t agree with the other gender’s view, it doesn’t make it less valid. So if he gives you a reason that seems silly to you, you need to bite your tongue, respect his view and help him to find a solution.

    Now people don’t test for lots of reasons. A common one, is that if you haven’t been properly trained to do it, it can hurt. Hey, no one likes pain. If he’s finding the testing painful look to the lancing device. Most have variable depth settings. The perfect setting is one right between the swearing-like-a-sailor depth and the milking-the-finger-and-praying-for-blood depth. The idea is to get a small drop of blood with little or no discomfort and with little need to squeeze the finger. It may simply be that his depth is set too deeply.

    Generally, larger numbers mean deeper lancing. Now, still on the pain theme, when was the last time anyone changed the little needle in the lancing device? Oh? Back when you changed the smoke detector batteries? So the folks that sell the needles want you to use a fresh one every time. Most of us don’t, and I don’t see any need to change that often. But they will get dull and you do need the change them. It depends on how tough your hide is, but a lance can get from 5 to 25 tests.

    Another common reason that people don’t test is they haven’t been given any knowledge to use with the numbers. If he is only on oral meds he may feel he’s helpless to change his numbers. He’d not. He can study how various foods and activities change his blood sugar. It is a game. A puzzle to be solved. A battle to be won.

    And if he’s just a stubborn old coot you can resort to any of the following: appeal to sense of loyalty (do it for me); bribe him (do it for something in the bedroom); or threaten him (do it or I’m outta here).

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    A Family Medicine, answered on behalf of
    If your blood sugar level drops below 60, I recommend stopping your medication, eating a small snack, and consulting a health professional as soon as possible.  Your physician can make the appropriate changes to your medications.  Do not delay seeing a medical provider because prolonged discontinuation of a diabetes medication can have serious adverse effects.
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    A Nutrition & Dietetics, answered on behalf of
    Rice and potatoes are both carbohydrate foods. Diabetics can eat them if they limit the serving size. If you are looking for substitutions there are many choices. Whole grains like quinoa, oats, couscous, and orzo. Beans and soy products. Look for intact grains which contain fiber and lead to lower blood sugars.
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    A , Internal Medicine, answered
    In general, there are three ways to bring your A1c down, whether you have type 1 diabetes mellitus or type 2. A1c is a measurement of the average blood sugar over two months or so, so even if your blood sugar goes to normal today, the A1c will take time to come back to normal.

    The first way is through diet. By eating less sugar, and fewer calories in general, your body has to make less insulin. So, what insulin you do make (or take) can be more effective at driving down your A1c. By substituting healthy fats, protein sources, and complex carbohydrates for simple sugars and refined carbohydrates that your body rapidly processes into sugar, you can have a strong effect on bringing down blood sugar.

    The second way is to use more sugar. That means increasing exercise, as your muscles can use sugar directly as an energy source. Exercising after eating is particularly recommended to ensure you have adequate energy for your exercise (such as a brisk walk) and can keep the blood sugar from spiking after eating.

    Finally, medications can bring down your blood sugar. There are many kinds of medications for diabetes, and only your diabetes doctor or other provider can recommend the right medication for you.

    This advice is appropriate for most people, but there are some unusual situations that require very different treatments, so definitely discuss changing your diet and exercise.
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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 , 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.