Jump up ^ Cox DJ, Gonder-Frederick LA, Julian D, Clarke W (1994). “Long-term follow-up evaluation of blood glucose awareness training”. Diabetes Care. 17 (1): 1–5. doi:10.2337/diacare.17.1.1. PMID 8112183.
Glucagon is a hormone that causes the release of glucose from the liver (for example, it promotes gluconeogenesis). Glucagon can be lifesaving and every patient with diabetes who has a history of hypoglycemia (particularly those on insulin) should have a glucagon kit. Families and friends of those with diabetes need to be taught how to administer glucagon, since obviously the patients will not be able to do it themselves in an emergency situation. Another lifesaving device that should be mentioned is very simple; a medic-alert bracelet should be worn by all patients with diabetes.
Prednisone and diabetes: What is the connection? Prednisone is a steroid used to treat autoimmune disorders, but it can also affect how the body reacts to insulin. Learn more in this article. Read now
Jump up ^ Selvin E, Steffes MW, Zhu H, Matsushita K, Wagenknecht L, Pankow J, Coresh J, Brancati FL (2010). “Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults”. N. Engl. J. Med. 362 (9): 800–11. doi:10.1056/NEJMoa0908359. PMC 2872990 . PMID 20200384.
The serving-size guideline for seafood is the same for meat and poultry: 3 ounces. Even though fish might be more expensive than other protein sources, preparing it at home rather than ordering it in a restaurant keeps the cost down.
Though it may be transient, untreated gestational diabetes can damage the health of the fetus or mother. Risks to the baby include macrosomia (high birth weight), congenital heart and central nervous system abnormalities, and skeletal muscle malformations. Increased levels of insulin in a fetus’s blood may inhibit fetal surfactant production and cause respiratory distress syndrome. A high blood bilirubin level may result from red blood cell destruction. In severe cases, perinatal death may occur, most commonly as a result of poor placental perfusion due to vascular impairment. Labor induction may be indicated with decreased placental function. A Caesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia, such as shoulder dystocia.
Jump up ^ Voltarelli JC, Couri CE, Stracieri AB, et al. (2007). “Autologous nonmyeloablative hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus”. JAMA. 297 (14): 1568–76. doi:10.1001/jama.297.14.1568. PMID 17426276.
No. Natural therapies such as deep abdominal breathing, progressive muscle relaxation, guided imagery, and biofeedback can help relieve stress. And emotional stress affects your blood sugar levels. So learning to relax is important in managing your diabetes.
Nausea and vomiting. When your body resorts to burning fat, it makes “ketones.” These can build up in your blood to dangerous levels, a possibly life-threatening condition called diabetic ketoacidosis. Ketones can make you feel sick to your stomach.
Some women with diabetes wonder if it’s safe to become pregnant. The good news is that you can have a healthy pregnancy after being diagnosed with type 1 or type 2 diabetes. However, it’s important to manage your condition before and during pregnancy to avoid complications.
People around the world are eating low-carbohydrate diets to treat their diabetes. But all plant foods, other than seeds, are carbs. So what can you eat? Is it all animal products, or are there other options?
McCulloch DK, Hayward RA, et al. Screening for type 2 diabetes mellitus. Up to Date. Aug. 7, 2017. Accessed Jan. 21, 2018 at https://www.uptodate.com/contents/screening-for-type-2-diabetes-mellitus#H18058884
Second, can affect a person’s thinking process, coordination, and state of consciousness. This disruption in brain functioning is called neuroglycopenia. Studies have demonstrated that the effects of neuroglycopenia impair driving ability. A study involving people with type 1 diabetes found that individuals reporting two or more hypoglycemia-related driving mishaps differ physiologically and behaviorally from their counterparts who report no such mishaps. For example, during hypoglycemia, drivers who had two or more mishaps reported fewer warning symptoms, their driving was more impaired, and their body released less epinephrine (a hormone that helps raise BG). Additionally, individuals with a history of hypoglycemia-related driving mishaps appear to use sugar at a faster rate and are relatively slower at processing information. These findings indicate that although anyone with type 1 diabetes may be at some risk of experiencing disruptive hypoglycemia while driving, there is a subgroup of type 1 drivers who are more vulnerable to such events.
Aside from the financial costs of diabetes, the more frightening findings are the complications and co-existing conditions. In 2014, 7.2 million hospital discharges were reported with diabetes as a listed diagnosis. Patients with diabetes were treated for major cardiovascular diseases, ischemic heart disease, stroke, lower-extremity amputation and diabetic ketoacidosis.
The total daily calories are evenly divided into three meals (with snacks for youth with type 1 diabetes). Over the past two years the ADA has lifted the absolute ban on simple sugars for people with diabetes. Small amounts of simple sugars are now allowed when consumed with a complex meal.
According to About.com, a half-cup serving of firm tofu contains 10 grams of protein, 5 grams of fat, and only 2 grams of carbohydrates. In addition to tofu, a number of soy products like tempeh and miso contain a lot of protein and few carbs.
Meanwhile, saturated fats and trans fats can harm your heart and overall health, according to the American Heart Association. To spot trans fats, look for the term “hydrogenated” on labels of processed foods, such as packaged snacks, baked goods, and crackers. “I always tell my clients to double-check the ingredient list to make sure they don’t see any partially hydrogenated oil in their food products,” Massey says.
Regular blood testing, especially in type 1 diabetics, is helpful to keep adequate control of glucose levels and to reduce the chance of long term side effects of the disease. There are many (at least 20+) different types of blood monitoring devices available on the market today; not every meter suits all patients and it is a specific matter of choice for the patient, in consultation with a physician or other experienced professional, to find a meter that they personally find comfortable to use. The principle of the devices is virtually the same: a small blood sample is collected and measured. In one type of meter, the electrochemical, a small blood sample is produced by the patient using a lancet (a sterile pointed needle). The blood droplet is usually collected at the bottom of a test strip, while the other end is inserted in the glucose meter. This test strip contains various chemicals so that when the blood is applied, a small electrical charge is created between two contacts. This charge will vary depending on the glucose levels within the blood. In older glucose meters, the drop of blood is placed on top of a strip. A chemical reaction occurs and the strip changes color. The meter then measures the color of the strip optically.
Even with careful management, blood sugar levels can sometimes change unpredictably. With help from your diabetes treatment team, you’ll learn how your blood sugar level changes in response to food, physical activity, medications, illness, alcohol, stress — for women, fluctuations in hormone levels.
Diabetes is a chronic condition associated with abnormally high levels of sugar (glucose) in the blood. Insulin produced by the pancreas lowers blood glucose. Absence or insufficient production of insulin, or an inability of the body to properly use insulin causes diabetes.
In patients with metformin contraindications or intolerance, consider an initial drug from another class depicted in Fig. 8.1 under “Dual Therapy” and proceed accordingly. When A1C is ≥9% (75 mmol/mol), consider initiating dual combination therapy (Fig. 8.1) to more expeditiously achieve the target A1C level. Insulin has the advantage of being effective where other agents may not be and should be considered as part of any combination regimen when hyperglycemia is severe, especially if catabolic features (weight loss, ketosis) are present. Consider initiating combination insulin injectable therapy (Fig. 8.2) when blood glucose is ≥300 mg/dL (16.7 mmol/L) or A1C is ≥10% (86 mmol/mol) or if the patient has symptoms of hyperglycemia (i.e., polyuria or polydipsia). As the patient’s glucose toxicity resolves, the regimen may, potentially, be simplified.
For people who take insulin or another blood glucose-lowering medication that can cause hypoglycemia, eat some food when drinking alcohol. A cautionary note to people with type 1 diabetes: Significant alcohol intake can cause hypoglycemia a number of hours later, so regularly check blood sugar levels when you drink.
“For people with diabetes who don’t respond to oral medications or non-insulin injectables, insulin can be started as a long-acting preparation once a day,” Sivitz says. Short-acting insulin may be added before meals if long-acting insulin alone isn’t effective enough.
Fig. 8.2 outlines these options, as well as recommendations for further intensification, if needed, to achieve glycemic goals. If a patient is still above the A1C target on premixed insulin twice daily, consider switching to premixed analog insulin three times daily (70/30 aspart mix, 75/25 or 50/50 lispro mix). In general, three times daily premixed analog insulins have been found to be noninferior to basal-bolus regimens with similar rates of hypoglycemia (62). If a patient is still above the A1C target on basal insulin plus single injection of rapid-acting insulin before the largest meal, advance to a basal-bolus regimen with ≥2 injections of rapid-acting insulin before meals. Consider switching patients from one regimen to another (i.e., premixed analog insulin three times daily to basal-bolus regimen or vice-versa) if A1C targets are not being met and/or depending on other patient considerations (60,61). Metformin should be continued in patients on combination injectable insulin therapy, if not contraindicated and if tolerated, for further glycemic benefits.
It is wonderful that you are changing your lifestyle to become healthier! This will benefit you greatly, not only in controlling your blood sugar but also in improving your cholesterol levels, strengthening your bones, and improving your heart function. These changes come with a long list of health benefits, but whether they will allow you to stop taking medicines completely depends on several factors:
Because the symptoms of low blood sugar alert you to the problem, not having any symptoms requires that you be especially vigilant. Remember: Frequent monitoring is the only way to know if you are low and need to take corrective action.
If you have positive experience with the methods described here, please leave comments below, hit the “recommend” button, post on Facebook and Twitter, and forward this post to everyone you know! If you don’t have experience yet, but are thinking about it or have other questions, please reach out and I will help.
— Kathie Madonna Swift, MS, RD, LDN, is owner of Swift Nutrition, author of The Inside Tract: Your Good Gut Guide to Great Digestive Health, and a member of the Dietitians in Integrative and Functional Medicine practice group of the Academy of Nutrition and Dietetics.
SI: That was my moment of truth, if you will. I thought, it doesn’t make any sense. What we are telling people to do, the message to pre-diabetics today in America is “Don’t you worry. You’re getting fit but you have to eat a little less, eat a little healthier and exercise a little more everything will be just fine.” Well I had been doing that freaking 20 years.