Archive for Understanding Diabetes
Good blood sugar control today will reduce the risk of damage to kidneys and other organs tomorrow.
The kidneys filter waste products from your blood and keep fluids in your body balanced. Having diabetes puts you at a greater risk for developing kidney disease also called diabetic nephropathy. This complication is also called diabetic kidney disease. It is a progressive kidney disease caused by damage to the tiny blood vessels in the kidneys that are used to filter waste from the blood.
High blood glucose, sometimes paired with high blood pressure, slowly damages the kidneys. High blood sugar makes the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak and useful protein is lost in the urine.
People living with type 1 and type 2 diabetes can experience kidney complications. Chronic hyperglycemia, excess blood sugar, is the primary cause of the disease. In type 1 diabetes, hyperglycemia starts in the first decades of life and is usually the only recognized cause of nephropathy. With type 2 diabetes, to the contrary, hyperglycemia starts near middle-age, usually when the kidneys have already suffered the long‐term consequences of aging and of other recognized promoters of chronic renal injury such as arterial hypertension, obesity, high cholesterol, and smoking.
Early detection of kidney damage is important, but there might not be noticeable symptoms in the early stages. It’s important to have regular urine tests to find kidney damage early because early kidney damage might be reversed.
Later in the progression, swelling in your body is a primary symptom. The feet and legs are key areas where swelling will be seen as kidneys become damaged.
Keeping blood sugar as close to normal as possible is the first step to preventing kidney disease. Control your blood pressure by checking it on a regular basis and following your doctor’s recommendations for acceptable levels. Finally, don’t use tobacco because it narrows your blood vessels including the already tiny ones working deep inside your kidneys.
Educating individuals on best ways to avoid this and other diabetes complications is a goal of self-management courses. If you need help developing a strategy to avoid complications or face other challenges, Diabetes Management & Supplies can assist with diabetes self-management and education services. For more information, call our Education Department at 1-888-738-7929 or email firstname.lastname@example.org.
The holiday season may help bring attention to a rarely-discussed diabetes symptom: depression. Whether emphasized by SAD (Seasonal Affective Disorder) or just noticed in contrast to the festive season, depression may be one sign of diabetes or a flag that one’s diabetes is not in good control.
The American Diabetes Association explains that people with diabetes are at a greater risk to depression and the complications of poorly controlled blood sugars are very similar to the symptoms of depression.
Spotting depression in yourself or someone you love is an important step to countering depressions effects. The signs include:
- Loss of pleasure: You no longer take interest in doing things you used to enjoy.
- Change in sleep patterns: You have trouble falling asleep, you wake often during the night, or you want to sleep more than usual, including during the day.
- Early to rise: You wake up earlier than usual and cannot to get back to sleep.
- Change in appetite: You eat more or less than you used to, resulting in a quick weight gain or weight loss.
- Trouble concentrating: You can’t watch a TV program or read an article because other thoughts or feelings get in the way.
- Loss of energy: You feel tired all the time.
- Nervousness: You always feel so anxious you can’t sit still.
- Guilt: You feel you “never do anything right” and worry that you are a burden to others.
- Morning sadness: You feel worse in the morning than you do the rest of the day.
- Suicidal thoughts: You feel you want to die or are thinking about ways to hurt yourself.
You should contact your doctor if you see any three of these signs. Taking action can affect both your mental and physical well-being.
This month (November) is Diabetes Awareness Month, a time set aside to education and inspire those living with a form of diabetes and those who can take steps to reduce their risk of the preventable conditions associated with diabetes.
Diabetes is not a single disease. It is group of similar conditions that fall into the same category because the symptoms and effects on the body may be similar. The most common types of diabetes in our presence society are Type 1 Diabetes, Type 2 Diabetes and Gestational Diabetes. Understanding what they have in common, how they differ and the associated risk factors is crucial to raising awareness and encouraging prevention, when possible.
Type 1 Diabetes accounts for only 5 – 10 percent of all cases, and used to be called juvenile diabetes. Three-quarters of people who develop type 1 are under the age of 18, and most others are under 40 years old, but older adults develop it as well.
The cause of Type 1 Diabetes is unknown. Most experts believe it is an autoimmune disorder, which is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue. With Type 1 Diabetes, an infection or some other trigger causes the body to destroy the cells in the pancreas that make insulin.
This condition can be passed down through families. In fact, in most cases of Type 1 Diabetes, people inherit risk factors from both parents. Such factors appear to be more common in whites, who have the highest rate of type 1 diabetes.
The pathway to developing Type 1 Diabetes can take years. In studies that followed relatives of people with Type 1 Diabetes, researchers found that relatives who later developed diabetes had certain auto-antibodies in their blood for years.
Type 2 Diabetes is the most common form of diabetes, accounting for 90 – 95 percent of all cases. It used to be called adult-onset diabetes, but, unfortunately, both children and adults develop this kind of diabetes. Many people think of it as the kind of diabetes that does not require insulin. However, about half of people with type 2 diabetes will eventually need insulin. This is because the pancreas produces less and less insulin over time, so it must be injected to meet the body’s needs.
The causes of Type 2 Diabetes are not completely understood, but it almost always starts with insulin resistance. So what contributes to this insulin resistance? Here are some of the most common risk factors:
- Family history of diabetes
- Growing older – your risk increases as you age
- History of gestational diabetes
- Lack of exercise
- Member of a high-risk ethnic group, such as:
- African American
- Asian American or Pacific Islander
- Hispanic American
- Native American
- Overweight or obese
Gestational Diabetes is diabetes that develops while you are pregnant. Gestational diabetes is still diabetes, which means your blood sugar levels are abnormally high. That excess sugar crosses the placenta and can make your baby grow too large and lead to problems with your pregnancy and delivery.
The causes of Gestational Diabetes have not been determined, but the many hormonal changes during pregnancy contribute to what is called insulin resistance – which is your body not using the insulin that your pancreas produces.
For more on these forms of diabetes, visit the Diabetes Management & Supplies Learning Center.
People living with diabetes are given a host of numbers in reports from their doctor’s visits. Those numbers are very important, but should be paired with the information that can be gained every day through home monitoring of blood sugar.
Blood sugar testing is very important because it helps you manage your diabetes on a day-to-day basis. Blood sugar numbers help you to understand and take control of your diabetes.
Tools used at home to test and monitor blood sugar levels include blood glucose meters and Continuous Glucose Monitoring devices. Speaking with your doctor or another member of your diabetes treatment team will help you decide which monitoring method is best for you.
When and how many times to test your levels each day will vary from person to person so you should follow the specific testing schedule your physician has established with you. Many schedules may call for once-daily testing while others require two or more testing time that might be before or after meal.
Daily blood sugar levels plus lab reports are just two tools needed to develop a road map to diabetes management success. Knowing those numbers tells you where you are, but goals represent where you would like to be.
A lab report crucial to your goal-setting is your A1C level also known as hemoglobin A1C or HbA1c. The A1C is a common test for type 1 and type 2 diabetes. It measures how well diabetes is managed over a period of time instead of just one instance. An A1C reading of 6.5 is the usual indicator of a diabetes diagnosis.
A1C test recommendations
- Every 6 months when you are meeting treatment goals and have stable blood sugars.
- Every 3 months when therapy has changed or if you are not meeting blood sugars targets.
- Used by physician to allow for timely decisions on therapy changes.
- In-home testing may be done with across the counter testing device called A1C Now®. See this at www.a1cnow.com
When setting goals, it is important to strive for noted, but reasonable change. Home testing may be recorded each day, but it might take three to six months to evaluate the big picture and see true progress or regression. Be very patient and don’t expect to drive your averages down or up like the numbers on a scale. Slow and steady not only wins the race, but it also provides a safe playing field for your diabetes treatment plan.
Carbohydrates, when broken down, turn into sugar. Too many carbs at one time can cause your blood sugar to go too high. The amount of carbs that you should eat at one meal depends on the individual. Contact a diabetes educator or a dietician for a customized meal plan.
The American Diabetes Association (ADA) has a simple principle that explains all carbohydrates are created equal: A carb is a carb is a carb! It is important to understand that sucrose (table sugar) and other sugars do not create a more harmful effect on blood sugar and they are not absorbed more rapidly than starches. The totalamount of carbohydrates eaten will have more of an effect on blood sugar levels than the source of the carbohydrate.
A healthy eating regimen doesn’t just help control blood sugar. It also can have a positive effect on other conditions like obesity, hypertension and heart disease.
Diabetes Management & Supplies offers diabetes self-management and diabetes education services. For more information on specific nutrition needs or to enroll in group or individual sessions, call our Education Department at 1-888-738-7929 or email email@example.com.
The term “insulin” is easily associated with diabetes. While many people may consider it to be only a diabetes drug, it is a natural substance produced by the body. The pancreas is a small organ that creates insulin. The cells in the body need blood glucose (sugar) from carbohydrates for energy, but blood sugar can’t go directly into the cells without some help.
Enter insulin – the key that unlocks the cell door.
When you eat, blood sugar rises as the food provides a new stream of energy. The beta cells in the pancreas get a signal to release insulin into the blood. Insulin then attaches to the cells and allows the sugar to be absorbed and used for fuel.
Insulin is important to keep balance in the bloodstream. It keeps blood sugar levels from getting too high, preventing a condition called hyperglycemia. If also keeps blood sugar levels from being too low, preventing a condition called hypoglycemia.
In people with type 1 diabetes, the pancreas does not produce insulin so they will need to take insulin injections to keep blood glucose levels under control. People with type 2 diabetes also can use injected insulin to control blood sugar. Insulin is often used with pills to treat type 2 diabetes.
The latest treatment trend involved inhaled insulin. First, insulin is made into a powder form. The tiny particles of insulin would then be put inside of an inhaler similar to that used by people with asthma. The fine powder is then inhaled into lungs and eventually is released into the bloodstream. This process is still being perfected, but you can read more in our earlier blog item: FDA approval opens door for inhaled insulin.
The diabetes educators at Diabetes Management & Supplies can help take the guess-work out of your medication and treatment plan. For more information on insulin delivery or training needs, call our Education Department at 1-888-738-7929.
Our bodies work best when the sugar in our blood is balanced with insulin. Our cells need insulin to be able to use the sugar for fuel. Diabetes is the result of the body not making any or enough insulin. If the sugar isn’t soaked up into the cells, it collects in the blood. High levels of blood sugar will hurt organs like the heart, brain, eyes and kidneys.
When diet and exercise are not enough to control blood sugars, medications can help achieve good control. Some drugs help your body make more insulin or better use your own insulin. Insulin can be injected and taken as a drug. Taking insulin helps or replaces your own insulin.
Over time, your diabetes changes. As your state of health changes, your medications may also change. You may need more drugs or other combinations to stay healthy.
Both oral and injectable medicines can be used to help people living with diabetes. Oral medicine, pills taken by mouth, work on specific organs to stimulate insulin development, help the body burn sugars better or have other functions. Injectable medicines are injected into the body with various devices or instruments. Insulin is the first injectable that might come to mind, but other injectable medicines include Byetta, Victoza or Symlin.
No matter which drug or combinations of drugs you take, it is important to closely follow doctor’s orders and seek help or ask questions if you are unsure about your daily regimen.
The diabetes educators at Diabetes Management & Supplies can help take the guess-work out of your medication and treatment plan. For more information on specific medication or training needs, call our Education Department at 1-888-738-7929.
Blood sugar levels are tested in your doctor’s office, but that is not enough. Blood sugar changes not only from day to day. It changes from hour to hour. Some people run high in the morning and others at night. Certain foods might cause a spike. A long walk may drop levels too low.
Glucose monitors are machines that measure blood sugar from finger sticks. Continuous glucose monitors are worn on the body. They records several readings a day without finger sticks.
Why test your blood sugar?
- Tell how well you’re reaching health goals
- Know how diet and exercise affect blood sugar levels
- Know how other factors, such as illness or stress, affect blood sugar levels
- See the effect of diabetes drugs on blood sugar levels
- Know when blood sugars are too high or low
To get a full picture of your diabetes, you need regular monitoring. Testing often will show problem areas and how your levels react to certain foods. A blood sugar reading might be an early warning sign in sudden illness.
Another method of monitoring blood glucose is Continuous Glucose Monitoring or CGM. A CGM automatically takes several blood sugar readings throughout the day, sends alerts for extreme readings and feeds those levels to the insulin pump. The goal would be blood sugar control that is consistently stable.
The CGM reads blood sugar levels every one to five minutes and shows whether a person’s blood sugar is rising or falling. Combining CGM with insulin pump therapy can provide a method to monitor and manage blood glucose levels. The information obtained can also help to fine-tune the pump settings.
The American Heart Association offers these tools to help you understand the importance of monitoring and staying as healthy as possible:
- Diabetes-Friendly Recipes. Recipes to satisfy cravings – sweet, savory or somewhere in between.
- My Diabetes Health Assessment. Having type 2 diabetes greatly increases your risk of having a heart attack or stroke. Learn your 10-year risk and ways you can lower it.
- Diabetes Quiz. Take this short quiz to learn the facts about diabetes.
The diabetes educators at Diabetes Management & Supplies can help take the guess-work out of your monitoring needs. For more information on specific monitoring or insulin delivery needs, call our Education Department at 1-888-738-7929.
Insulin pump use is becoming more popular and a national group of diabetes experts are calling for more consistency in how pumpers are trained and educated to use their devices.
There is a need for everyone connected to insulin pump use to get on the same page according to new guidance from the American Association of Clinical Endocrinologists (AACE).
The group of diabetes specialists acknowledges that pumps have become more sophisticated, and in order to get the best benefit, training programs should be developed.
The statement, published in Endocrine Practice, is an update to an earlier guidance from 2010 and offers recommendations for patients with both type 1 and type 2 diabetes on pump therapy.
Insulin pumps are small computerized devices that deliver insulin in two ways:
- In a steady measured and continuous dose (the “basal” insulin)
- As a surge (“bolus”) or an extra amount of insulin taken to cover an expected rise in blood glucose, often related to a meal or snack, at your direction, around mealtime.
The diabetes educators at Diabetes Management & Supplies can help you decide if pump therapy is right for you and help take the fear out of using an insulin pump.
They can also provide insulin pump training on all major insulin pumps. Working with your doctor, the educators can also help pumpers improve their control by helping them fine tune pump settings and avoid fluctuations in blood glucose as well as other pump and infusion site issues.
In addition to pump therapy, our educators can also teach people with diabetes how to use a CGM. For more information on specific monitoring or insulin delivery needs, call our Education Department at 1-888-738-7929.
Also see: Survey offers insight on pump therapy