A patient-centered approach should be used to guide the choice of pharmacologic agents. Considerations include efficacy, hypoglycemia risk, history of atherosclerotic cardiovascular disease, impact on weight, potential side effects, renal effects, delivery method (oral versus subcutaneous), cost, and patient preferences. E
. Dietary fat acutely increases glucose concentrations and insulin requirements in patients with type 1 diabetes: implications for carbohydrate-based bolus dose calculation and intensive diabetes management. Diabetes Care 2013;36:810–816
To determine a person’s blood sugar levels, blood tests may be taken after not eating for 8 hours, 2 hours after a meal, or at both times. Some people may also take a glucose tolerance test, which requires the patient to drink a sugary liquid and get blood tests afterward.
The most common symptoms are related to hyperglycemia (high blood sugar levels), especially the classic symptoms of diabetes: frequent urination and thirst. Fatigue related to dehydration and eating problems can also be related to high blood sugars.5,6
Screening is also recommended for people who are under 45 and overweight if there are other heart disease or diabetes risk factors present, such as a sedentary lifestyle, a family history of type 2 diabetes, a personal history of gestational diabetes or blood pressure above 140/90 millimeters of mercury (mm Hg).
In addition to the problems with an increase in insulin resistance, the release of insulin by the pancreas may also be defective and suboptimal. In fact, there is a known steady decline in beta cell production of insulin in type 2 diabetes that contributes to worsening glucose control. (This is a major factor for many patients with type 2 diabetes who ultimately require insulin therapy.) Finally, the liver in these patients continues to produce glucose through a process called gluconeogenesis despite elevated glucose levels. The control of gluconeogenesis becomes compromised.
Diabetes is manifested through symptoms such as constant thirst, sudden weight loss, blurred vision, numbness of the feet, swollen gums, etc. If you notice any of these symptoms, we suggest you visit your doctor as soon as possible.
Your doctor may suspect you have diabetes if you have some risk factors for diabetes, or if you have high levels of blood sugar in your urine. Your blood sugar (also called blood glucose) levels may be high if your pancreas is producing little or no insulin (type 1 diabetes), or if the body is not responding normally to insulin (type 2 diabetes).
How would you know if you had urinary tract infection (UTI)? Take the Urinary Tract Infection in Adult Quiz to learn the causes, symptoms, and treatments for infection that can affect your kidneys, ureters, bladder, and urethra.
Unlike many other health conditions, the incredible thing about type 2 diabetes is that it can be controlled and reversed with lifestyle changes. Ultimately, diabetes management is all about monitoring your blood sugar and keeping it as stable as possible. While everything we eat eventually breaks down into glucose, some foods raise blood sugar faster than others.
Many research studies have shown that meals which contain sugar do not make the blood sugar rise higher than meals of equal carbohydrate levels which do not contain sugar. However, if the sugar-containing meal contains more carbs, the blood sugar levels will go up.
Dr. Sivitz emphasizes the importance of being active, eating a healthy diet, and having a good understanding of the role that carbohydrates play. He recommends eating healthy carbs, such as nonstarchy vegetables, fruits, legumes, whole grains, and nonfat dairy products. A certified diabetes educator or a registered dietitian can help personalize your diet and teach you strategies to control your blood sugar. Depending on your desired blood sugar range and weight loss goals, recommendations for foods, carbohydrate intake, and portion sizes may vary. Regardless, if you have diabetes, it will be important to count carbs in your diet because, while not off limits, they can lead to blood sugar spikes when overeaten.
Some of the risk factors for getting diabetes include being overweight or obese, leading a sedentary lifestyle, a family history of diabetes, hypertension (high blood pressure), and low levels of the “good” cholesterol (HDL) and elevated levels of triglycerides in the blood.
Alpha lipoic acid is an antioxidant that helps turn glucose into fuel for the body. It effectively improves insulin sensitivity and reduces symptoms of diabetic neuropathy, such as weakness, pain and numbness that’s caused by nerve damage. Although we make alpha lipoic acid and it can be found in some food sources, like broccoli, spinach and tomatoes, taking an ALA supplement will increase the amount that circulates in your body, which can be extremely beneficial when trying to reverse diabetes naturally. (15)
Home monitoring There are a variety of easy-to-use home monitors on the market with which patients can test their blood sugar. If you are managing diabetes with the help of a home monitor, be sure to learn what results are too high and too low for you. Consult with your health care provider to learn what to do when your results are outside that target range.
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.
One serving in a category is called a “choice.” A food choice has about the same amount of carbohydrates, protein, fat and calories and the same effect on your blood glucose — as a serving of every other food in that same category. So, for example, you could choose to eat half of a large ear of corn or 1/3 cup of cooked pasta for one starch choice.
In general, women live longer than men do because they have a lower risk of heart disease, but when women develop diabetes, their risk for heart disease skyrockets, and death by heart failure is more likely in women than in men. Another study also found that in people with diabetes, heart attacks are more often fatal for women than they are for men. Other examples of how diabetes affects women differently than men are:
Studies funded by the National Institutes of Health (NIH) have demonstrated that face-to-face training programs designed to help individuals with type 1 diabetes better anticipate, detect, and prevent extreme BG can reduce the occurrence of future hypoglycemia-related driving mishaps. An internet-version of this training has also been shown to have significant beneficial results. Additional NIH funded research to develop internet interventions specifically to help improve driving safety in drivers with type 1 diabetes is currently underway.
You may eat normally and constantly feel hungry, yet continue to lose weight. This can be seen with type 1 diabetes. If your body isn’t getting enough energy from the foods that you eat, it will break down other energy sources available within the body. This includes your fat and protein stores. When this happens, it can cause you to lose weight.
Cinnamon has the ability to lower blood sugar levels and improve your sensitivity to insulin. A study conducted at Western University of Health Sciences in Pomona, Calif. found that the consumption of cinnamon is associated with a statistically significant decrease in plasma glucose levels, LDL cholesterol and triglyceride levels. Cinnamon consumption also helped increase HDL cholesterol levels. (13)
A big question for people who want to eat few carbs and not much meat: How do beans fit in? As a mix of protein, fat, and carbs, they are sort of a perfect food, but they do have a lot of carb content, usually from 20 to 40 grams per cup, depending on the type.
The treatment goals are related to effective control of blood glucose, blood pressure and lipids, to minimize the risk of long-term consequences associated with diabetes. They are suggested in clinical practice guidelines released by various national and international diabetes agencies.