“diabetes breath”

They’re not just for holiday dinners anymore. There are now good reasons to enjoy this power-packed fruit year-round. Although best known for helping to prevent urinary tract infections, cranberries — with their abundant phytonutrients, including anthocyanins — may be especially beneficial in a diabetic meal plan.

Metabolic syndrome (also referred to as syndrome X) is a set of abnormalities in which insulin-resistant diabetes (type 2 diabetes) is almost always present along with hypertension (high blood pressure), high fat levels in the blood (increased serum lipids, predominant elevation of LDL cholesterol, decreased HDL cholesterol, and elevated triglycerides), central obesity, and abnormalities in blood clotting and inflammatory responses. A high rate of cardiovascular disease is associated with metabolic syndrome.

Meglitinides. These medications work like sulfonylureas by stimulating the pancreas to secrete more insulin, but they’re faster acting, and the duration of their effect in the body is shorter. They also have a risk of causing low blood sugar, but this risk is lower than with sulfonylureas.

Gestational diabetes. If you developed gestational diabetes when you were pregnant, your risk of developing prediabetes and type 2 diabetes later increases. If you gave birth to a baby weighing more than 9 pounds (4 kilograms), you’re also at risk of type 2 diabetes.

Some mornings I walked to work fine, others I was in a bit of a daze, and on certain days walking round the office was an effort. My family were concerned about me  getting thinner and somewhat short-tempered.

Carbohydrates make your blood glucose level go up. If you know how much carbohydrates you’ve eaten, you have a good idea what your blood glucose level is going to do. The more carbohydrates you eat, the higher your blood sugar will go up.

There is also increasing evidence that nuts can improve blood sugar control in type 2 diabetes. In a Canadian study published in Diabetes Care in 2011, researchers found people with type 2 diabetes who ate 2 ounces of mixed nuts daily saw a decrease in blood sugar levels and LDL (bad) cholesterol. The study was funded in part by the International Tree Nut Council Nutrition Research Foundation and the Almond Board of California, among other supporters.

The American Diabetes Association in 1994 recommended that 60–70% of caloric intake should be in the form of carbohydrates. As mentioned above, this is controversial, with some researchers claiming that 40%[17] or less is better, while others claim benefits for a high-fiber, 75% carbohydrate diet.[18]

A dietitian can teach you how to measure food portions and become an educated reader of labels, paying special attention to serving size and carbohydrate content. If you’re taking insulin, he or she can teach you how to count the amount of carbohydrates in each meal or snack and adjust your insulin dose accordingly.

Patients with type 1 diabetes should have a diet that has approximately 35 calories per kg of body weight per day (or 16 calories per pound of body weight per day). If you have a child who has type 1 diabetes, we encourage you to read our article about meal planning for children with type 1 diabetes.

Studies in type 1 patients have shown that in intensively treated patients, diabetic eye disease decreased by 76%, kidney disease decreased by 54%, and nerve disease decreased by 60%. More recently the EDIC trial has shown that type 1 diabetes is also associated with increased heart disease, similar to type 2 diabetes. However, the price for aggressive blood sugar control is a two to three fold increase in the incidence of abnormally low blood sugar levels (caused by the diabetes medications). For this reason, tight control of diabetes to achieve glucose levels between 70 to120 mg/dl is not recommended for children under 13 years of age, patients with severe recurrent hypoglycemia, patients unaware of their hypoglycemia, and patients with far advanced diabetes complications. To achieve optimal glucose control without an undue risk of abnormally lowering blood sugar levels, patients with type 1 diabetes must monitor their blood glucose at least four times a day and administer insulin at least three times per day. In patients with type 2 diabetes, aggressive blood sugar control has similar beneficial effects on the eyes, kidneys, nerves and blood vessels.

A1C levels need to be checked between two and four times a year. Your target A1C goal may vary depending on your age and other factors. However, for most people, the American Diabetes Association recommends an A1C level below 7 percent. Ask your doctor what your A1C target is.

Jump up ^ Yang, Y; Hu, X; Zhang, Q; Zou, R (November 2016). “Diabetes mellitus and risk of falls in older adults: a systematic review and meta-analysis”. Age and ageing. 45 (6): 761–67. doi:10.1093/ageing/afw140. PMID 27515679.

Jump up ^ Asuncion, MM; Shaheen, M; Ganesan, K; Velasques, J; Teklehaimanot, S; Pan, D; Norris, K (2007). “Increase in hypoglycemic admissions: California hospital discharge data”. Ethnicity & disease. 17 (3): 536–40. PMID 17985510.

In autoimmune diseases, such as type 1 diabetes, the immune system mistakenly manufactures antibodies and inflammatory cells that are directed against and cause damage to patients’ own body tissues. In persons with type 1 diabetes, the beta cells of the pancreas, which are responsible for insulin production, are attacked by the misdirected immune system. It is believed that the tendency to develop abnormal antibodies in type 1 diabetes is, in part, genetically inherited, though the details are not fully understood.

Commit to managing your diabetes. Learn all you can about type 2 diabetes. Make healthy eating and physical activity part of your daily routine. Establish a relationship with a diabetes educator, and ask your diabetes treatment team for help when you need it.

Jump up ^ Arguedas, JA; Leiva, V; Wright, JM (Oct 30, 2013). “Blood pressure targets for hypertension in people with diabetes mellitus”. The Cochrane Database of Systematic Reviews. 10 (10): CD008277. doi:10.1002/14651858.cd008277.pub2. PMID 24170669.

^ Jump up to: a b “National Diabetes Clearinghouse (NDIC): National Diabetes Statistics 2011”. U.S. Department of Health and Human Services. Archived from the original on 17 April 2014. Retrieved 22 April 2014.

This section deals only with approaches for curing the underlying condition of diabetes type 1, by enabling the body to endogenously, in vivo, produce insulin in response to the level of blood glucose. It does not cover other approaches, such as, for instance, closed-loop integrated glucometer/insulin pump products, which could potentially increase the quality-of-life for some who have diabetes type 1, and may by some be termed “artificial pancreas”.

Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you’ll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates that you have diabetes. An A1C between 5.7 and 6.4 percent indicates prediabetes. Below 5.7 is considered normal.

If you have type 2 diabetes, the answer to this question is much less clear. Many people can keep their blood glucose in a healthy range without medications (either oral diabetes medications or insulin injections) if they lose weight and keep their weight down, are regularly physically active, and follow a meal plan that helps them keep portion sizes under control and helps them spread the amount of carbohydrate they eat at each meal throughout the day.

Just prior to having this test run, the patient must fast (nothing to eat or drink except water) for eight hours. The health care provider draws blood from the patient. Then the plasma (the fluid part of the blood) is combined with other substances to determine the amount of glucose in the plasma, as measured in mg/dL. The chart below contains the FPG test’s blood glucose ranges for prediabetes and diabetes and describes what each diagnosis means.

Watch for thirst or a very dry mouth, frequent urination, vomiting, shortness of breath, fatigue and fruity-smelling breath. You can check your urine for excess ketones with an over-the-counter ketones test kit. If you have excess ketones in your urine, consult your doctor right away or seek emergency care. This condition is more common in people with type 1 diabetes but can sometimes occur in people with type 2 diabetes.

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Jump up ^ Cox DJ, Penberthy JK, Zrebiec J, Weinger K, Aikens JE, Frier BM, Stetson B, DeGroot M, Trief P, et al. (2003). “Diabetes and Driving Mishaps: Frequency and correlations from a multinational survey”. Diabetes Care. 26 (8): 2329–34. doi:10.2337/diacare.26.8.2329. PMID 12882857.

The most exciting innovation in pump technology has been the ability to combine the pump in tandem with newer glucose sensing technology. Glucose sensors have improved dramatically in the last few years and are an option for patients to gain further insight into their patterns of glucose response to tailor a more individual treatment regimen. The newest generation of sensors allows for a real-time glucose value to be given to the patient. The implantable sensor communicates wirelessly with a pager-sized device that has a screen. The device is kept in proximity to the sensor to allow for transfer of data; however, it can be a few feet away and still receive transmitted information. Depending on the model, the screen displays the blood glucose reading, a thread of readings over time, and a potential rate of change in the glucose values. Sensors can be programmed to produce a “beep” if blood sugars are in a range that is selected as too high or too low. Some can provide a warning beep if the drop in blood sugar is occurring too quickly.

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler’s educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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