Diabetes FAQ (Frequently Asked Questions)
Dedicated to the special needs of individuals with diabetes.
What does it mean to have diabetes?
If you have just been diagnosed with diabetes, you are not alone!
Over 17 million Americans have diabetes, and each day approximately
2,200 new individuals are diagnosed.
Having diabetes
means that your body's hormone, insulin, is not doing its job. Insulin
is needed to properly use the food that you eat for energy. Most
of the food that you eat is broken down into glucose and other simple
sugars. Normally, as newly arrived glucose enters the blood stream,
your body releases insulin from the pancreas, and puts the glucose
into your cells to use as fuel.
If you lack
insulin, or your insulin is unable to function properly, the newly
arrived glucose cannot be stored and will remain in your blood stream.
Your blood glucose levels (also referred to as blood sugar levels)
will then become elevated. These abnormally high levels, left untreated,
can eventually cause damage to your eyes, heart, nerves and kidneys.
What are the different types of diabetes?
There are
several types of diabetes. The most common are type 1 and type 2.
In type 1, the pancreas makes little or no insulin. Individuals
with type 1 need insulin shots in order to stay alive. Type 1 can
occur at any age, but is usually seen in children and young adults.
With type
2 diabetes, the pancreas produces some insulin, but the amount is
either not enough or is not effective, because the body's cells
are resistant to it. Some individuals with type 2 diabetes need
insulin to regulate their blood glucose, while others respond well
to diet therapy and exercise alone, or a combination of diet, exercise
and oral medication. Type 2 can occur at any age, but is most often
seen after age 40.
What causes diabetes?
The exact cause of diabetes is unknown. Heredity may play a role in developing
both types, but is most often associated with type 2. Eating sweets
does not cause diabetes, but must be limited to help control it.
Being overweight, certain medications (ex: thyroid hormone, glucocorticoids,
etc.) and emotional and physical stress related to medical conditions
such as pregnancy, illness and surgery, can play a role in its development.
Also, for reasons not yet known, certain ethnic groups such as Native
Americans, Hispanic Americans and African Americans tend to have
a higher incidence of type 2.
What are the most common signs and symptoms of diabetes?
The warning signs of diabetes include:
- Frequent urination Blurred vision
- Unusual thirst
- Numbness or tingling in hands and feet
- Intense hunger Frequent infections
- Extreme fatigue Irritability
- Slow healing cuts/bruises
If you have any of the above symptoms, contact your doctor immediately.
Can diabetes Be Cured?
If treated
properly, your blood glucose can go down to normal levels, but diabetes
will always be part of your life. Millions of individuals live healthy
and active lives with diabetes, and you can too! Make an effort
to be involved in your treatment and learn all that you can about
diabetes.
How is diabetes treated?
Diabetes
is a serious condition. Although not curable, it is treatable. Those
who do best are the individuals who take an active role in their
own treatment. It is important to know how to manage your blood
glucose levels. Treatment includes special diets, exercise, regular
blood glucose testing and sometimes insulin injections and medication.
What makes for a diabetes-friendly diet?
There are
no bad foods. For many years, individuals with diabetes were told
to avoid foods containing sugar. Fortunately, we now know more about
how diabetes works and today's diabetic diets are creative, healthy
and allow for great variety.
Many people
can keep their blood glucose within a target range using diet alone.
Even if you need to take oral medication and/or insulin to control
your blood glucose levels, diet will always be an important part
of your treatment. What you eat, when you eat it, and how much food
you eat, affects
your blood glucose levels. The closer that you can keep your blood
glucose levels to normal, the lower your risk of developing serious
eye, kidney and nerve damage. Let's take a look at how different
foods affect your diabetes:
Carbohydrates
Starches (pastas, rice, bread, cake, potatoes, corn, etc.),
fruit and milk are high in carbohydrates. Once in your body, they break down into
your cells' preferred form of energy--glucose. Insulin is needed
to help your cells take in the glucose. With diabetes, your insulin
cannot do this task properly. A diabetic diet helps you schedule
your carbohydrate intake so that your cells can get the glucose
that they need.
Consuming
too many carbohydrate-containing foods can raise your blood glucose
way above normal; eating too few, can hurt your body by denying
it the high quality energy that it needs. Balancing your carbohydrate
intake is an important part of your diabetes treatment.
Protein
Protein is found in milk, meats, cheeses, eggs and nuts and tofu. It builds
and repairs muscles, skin and cells in your body. During digestion,
protein breaks down into amino acids which can, if necessary, be
converted to glucose. Your body's cells, however, prefer using glucose
from carbohydrates for energy.
Fat
Fat (oils,
margarine, butter, lard, etc.) supplies needed energy, carries fat-soluble
vitamins A, D, E and K in your body, and helps to maintain healthy
skin. It adds to the flavor and texture of food, but should be limited.
Fat is high in calories and too much fat in your diet can increase
your risk of heart and blood vessel disease.
What special eating habits should diabetics practice?
The timing of your meals is at least as important as what you eat.
The more that you eat at one meal, the more insulin you will need to utilize
the energy from the breakdown of those foods. If you eat smaller portions
throughout your day, you will not need as much insulin to bring down your blood sugar.
Here are some recommendations:
1) Eat at least 3 times during your day. Many people enjoy 3 small
meals and two snacks.
2) Eat each meal and snack at about the same time every day.
3) Eat the same amount at every breakfast. All lunches should be similar
in size, and dinners should be similar in size to all other dinners.
4) Do not skip meals. Carry some food with you if you think
that you will be delayed.
There are
many types of diabetic diets. Some require a lot of measuring, some
don't require any measuring at all. All are planned to provide you
with the proper balance of carbohydrates, protein and fat, along
with vitamins, minerals, fiber and other nutrients needed to keep
you healthy. A registered dietitian (RD) is specially trained to
design a diet that best suits your medical needs and lifestyle.
Exercising with diabetes: are there special considerations diabetics should take?
Exercise is a powerful tool for controlling your diabetes. It helps your
cells take in glucose and aids in keeping your blood sugar at normal
levels. Ask your doctor about the types of activity that meet your
physical needs. It is recommended that you exercise for at least
20 minutes, 3-4 times each week. Remember to begin slowly if you
haven't exercised in a long time. Even 5 minutes each day can make
a big difference in your health and your blood glucose levels.
The whys and hows of measuring blood glucose levels
T esting your own blood glucose levels help both you and your doctor
see if your treatment plan is working for you. It is very simple
to do. All you need is a drop of blood from your finger. Place it
on a special test strip and insert the strip into a glucose meter.
The glucose meter will then measure your blood glucose levels. Your
doctor will specify when and how often to do the blood testing.
Most insurances cover the purchase
of blood testing equipment, as will Medicare and Medicaid. For assistance
with purchasing supplies for testing, check the glucose meters,
control solutions, and test strips
sections of this website.
The normal
range for blood glucose is 70 - 115 mg/dl (3.85 - 6 mmol/L). Blood
glucose levels will go up immediately following a meal, but should
return to normal levels within 2 hours. Blood glucose levels of
126 mg/dl (7mmol/L) or higher, are diagnosed as diabetes. See the
section entitled "Problems" for ways to treat blood glucose
levels that are not within the normal range.
What is the purpose of urine testing in controlling diabetes?
With diabetes, your blood sugar can go way too high. This can occur if you overeat,
take too little insulin, become sick, or are under significant stress.
Under these conditions, your cells becomes starved for food and
will begin breaking down fat for energy. The byproducts of fat breakdown
are chemicals called ketones and can be extremely dangerous. They
can make you
throw up, have difficulty breathing, become extremely thirsty, and
put you into a coma.
To detect
the presence of ketones, you should test your urine. Test strips
for this purpose are available from Diabeticsupplies.md. Be sure to test
your urine if you experience the symptoms listed above and/or have
a blood glucose level of over 240 mg/dl (13 mmol/L). If you find
that your urine tests positive for ketones, call your doctor immediately.
What role do oral medications play in managing diabetes?
You may need to take diabetes pills as part of your treatment plan. These
pills work best when used with a healthy diet and regular exercise.
There are many types of pills available and they work in a variety
of ways. Some inhibit the release of glucose from your liver, slow
the absorption of glucose in your gut and enhance the absorption
of glucose in other parts of your body. Others stimulate your pancreas to produce additional
insulin and help your cells respond better to available insulin.
Your doctor will prescribe the ones that are best suited to your
needs.
All about insulin
In certain
types of diabetes, there is not enough insulin available. Insulin
shots must then be taken which help glucose enter into the cells.
The thought of giving yourself a shot can be a tough one, but know
that millions of individuals are now giving themselves insulin shots
with great ease.
Insulin
attaches to the outside of most of your body cells and allows glucose
to enter. Currently, it must be injected and cannot be put into
pill form; your digestive enzymes would destroy it before it could
begin to lower your blood glucose levels. Research, however, is
ongoing regarding new ways to take insulin. Several companies have had some success with an inhaled
form of insulin which the FDA has yet to approve.
What are the different types of insulin?
There are several types of insulin. They are classified as rapid-acting,
intermediate-acting,
and long-acting. You may be asked to combine these types depending
on your needs. Rapid-acting and short-acting insulin begin to act
very quickly after you inject them and last a short time. They are
usually taken to prevent an abnormal rise in glucose levels following
meals. Intermediate and long-acting insulin have a gradual and longer
lasting effect on blood glucose levels.
There are two popular kinds of insulin--purified pork insulin and human insulin.
Purified pork insulin acts much like the insulin made by the human
body. Human insulin is not actually from humans, but is developed
in a laboratory and is considered the most pure.
What is the proper way to handle insulin?
Insulin
should be stored in a refridgerator, but once opened, can be stored
at room temperature for easy access and comfort. Room temperature
insulin usually feels more comfortable when injected and remains
stable for 30 days after opening. When traveling, do not check your
insulin with your bags. Luggage can be lost, and storage compartments
are often extremely cold.
Inspect
the expiration date on your insulin. Do not use it beyond this date.
Examine your insulin before using. Do not use it if the color appears
abnormal or the insulin does not mix well. It is recommended that
you dispose of your needles in a sharps container made especially
for this purpose.
Your doctor
will decide which type of insulin is best for you and make sure
that you learn the correct techniques for using it.
What the most common problems diabetics run into?
High blood glucose (hyperglycemia): There may be times when your blood sugar
(glucose) levels go too high. This can happen when you are ill or
under stress, eat too much, or have too little insulin in your blood.
High blood glucose can cause headaches, blurry vision, frequent
urination, increased thirst, and dry itchy skin.
Ketones:Test your urine for ketones if you experience a blood glucose reading of over
240 mg/dl (13 mmol/L) are sick, or have any of the symptoms listed
above. Be sure to drink lots of water if you are urinating often.
It is very dangerous to become dehydrated. If your urine tests positive
for ketones, contact your doctor immediately. (See section on urine testing)
Low blood glucose: There may also be times when your blood glucose will be too low.
This can be caused by taking too much insulin, not eating enough, drinking
alcohol on an empty stomach, or exercising for an extended period.
When your blood glucose is low, you may become shaky, feel tired,
experience intense hunger, and become confused or nervous. It is important that you treat
low blood glucose immediately.
Test your blood glucose if you feel that it is too low. If it is less than
70mg/dl (less than 4 mmol/L) follow the 15/15 rule: eat or drink
something with the equivalent of 15 grams of carbohydrate and then
wait 15 minutes before retesting your blood sugar. The following
servings contain 15 grams of carbohydrate:
½ cup apple or orange juice, or
½ - 3/4 cup regular (not diet) carbonated beverage, or
5 Lifesavers candies
Infections: Infections
are common in people with diabetes. The first sign of an oncoming
infection may be elevated blood glucose. Other signs of infection
include: pain, swelling, fever, redness, a feeling of warmth in
a certain area, and a discharge. They can be very serious and can
occur without any open cut or injury. Call your doctor if you suspect
that you have an infection.
Circulation: High blood
glucose levels over an extended period of time can affect your blood
vessels. This may lead to sexual problems such as impotence, cause
kidney and vision problems and encourage the development of skin
ulcers which, if left untreated, may lead to amputation. Individuals
with diabetes are also at greater risk for heart attacks, strokes
and other cardiovascular diseases. Be sure to see both your physician
and eye doctor regularly.
Dental problems:When your
blood glucose is high, it is not unusual to get a mouth infection.
High blood glucose levels encourage bacterial growth. Brush your
teeth at least two times each day. Be aware of any bleeding or gum
soreness. Schedule regular dental exams and be sure to tell your
dentist that you have diabetes. Try to schedule your dental appointments
after mealtimes to lower your risk of low blood sugar caused by limiting your food
intake following dental work.
Foot Problems: Decreased
feeling in your feet can make it difficult to know if your feet
have been injured in any way. Early treatment of any foot injury
can prevent serious complications, such as infection which can lead
to amputation. To prevent foot problems, make certain that you wear
shoes and socks that fit properly and change your shoes at least
once during the day. Check your feet every time you remove your
shoes. Look for redness, which can occur when shoes do not fit properly.
Also look for cracks, cuts, bruises, etc. Discuss with your doctor
or podiatrist the best way to care for your feet, cut your nails,
and treat calluses.
Conclusion
Fortunately, many of the complications of diabetes can be reduced or avoided
if you take good care of your health. Diabeticsupplies.md's newsletters
and educational columns provide valuable updates on treatments and
issues related to diabetes. Bulletin boards offer
a terrific forum to share concerns with others who have diabetes.
Eating properly, exercising regularly, and following your prescribed
treatment, can help you stay healthy and enjoy all that life has to offer.
Diabetic Supplies Of America can send your diabetic supplies to you
at little or no cost with the proper insurance! Please call 1-800-555-2561 for more information.
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