Anyone with a body mass index higher than 25, regardless of age, who has additional risk factors, such as high blood pressure, a sedentary lifestyle, a history of polycystic ovary syndrome, having delivered a baby who weighed more than 9 pounds, a history of diabetes in pregnancy, high cholesterol levels, a history of heart disease, and having a close relative with diabetes.
Diabetes can go into remission. When diabetes is in remission, you have no signs or symptoms of it. But your risk of relapse is higher than normal.1 That’s why you make the same daily healthy choices that you do for active type 2 diabetes.
Guava (scientific name Psidium guajava) has been used in East Asia for diabetes possibly for centuries. Several studies from Japan found that guava leaf tea also reduces cholesterol and insulin levels in mice and rats. You can make tea with the leaves or buy guava tea online
The classic oral glucose tolerance test measures blood glucose levels five times over a period of three hours. Some physicians simply get a baseline blood sample followed by a sample two hours after drinking the glucose solution. In a person without diabetes, the glucose levels rise and then fall quickly. In someone with diabetes, glucose levels rise higher than normal and fail to come back down as fast.
Jump up ^ Segal-Isaacson CJ; Carello E; Wylie-Rosett J (October 2001). “Dietary fats and diabetes mellitus: is there a good fat?”. Curr Diab Rep. NLM.NIH.gov. 1 (2): 161–69. doi:10.1007/s11892-001-0029-3. PMID 12643112.
— Constance Brown-Riggs, MSEd, RD, CDE, CDN, is the national spokesperson for the Academy of Nutrition and Dietetics, specializing in African American nutrition, and author of the African American Guide to Living Well With Diabetes and Eating Soulfully and Healthfully With 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.
Diabetes can also result from other hormonal disturbances, such as excessive growth hormone production (acromegaly) and Cushing’s syndrome. In acromegaly, a pituitary gland tumor at the base of the brain causes excessive production of growth hormone, leading to hyperglycemia. In Cushing’s syndrome, the adrenal glands produce an excess of cortisol, which promotes blood sugar elevation.
According to the National Institutes of Heath (NIH), close to one-third of women with diabetes do not know they have the disease. It is recommended that screening for adults of both genders be done in those over the age of 45 who are overweight or obese and who have one of the risk factors listed above.
Again, the choice of drug is an individual one. In the case of sulphonylureas, the choice depends on daily dosing and the level of side effects. These drugs are associated with weight gain and hypoglycemia.2
Eating right and exercising more often is good for everyone. But it’s especially important for people with type 2 diabetes because they often have more body fat than they should. When people put on too much body fat, it’s because they’re eating more calories than they use each day. The body stores that extra energy in fat cells. Over time, gaining pounds of extra fat can lead to obesity and diseases related to obesity, like type 2 diabetes.
Your doctor may want to perform periodic blood tests to determine your blood sugar levels. This will help determine how well you’re managing the disease. If you take medication, these tests will help gauge how well it’s working.
Pramlintide (Symlin) was the first in a class of injectable, anti-hyperglycemic medications for use in addition to insulin for type 1 diabetes or type 2 diabetes. Pramlintide, the active ingredient in Symlin, is a synthetic analog of human amylin, a naturally occurring neuroendocrine hormone synthesized by pancreatic beta-cells that helps control glucose after meals. Similar to insulin, amylin is absent or deficient in person with diabetes. When used with insulin, amylin can improve glycemic control and has additional benefits that cannot be realized with insulin alone.
Keep your immunizations up to date. High blood sugar can weaken your immune system. Get a flu shot every year, and your doctor will likely recommend the pneumonia vaccine, as well. The Centers for Disease Control and Prevention (CDC) also recommends the hepatitis B vaccination if you haven’t previously received this vaccine and you’re an adult age 19 to 59 with type 1 or type 2 diabetes. The CDC advises vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older, have diabetes and haven’t previously received the vaccine, talk to your doctor about whether it’s right for you.
^ Jump up to: a b c Barnard ND, Cohen J, Jenkins DJ, et al. (2006). “A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes”. Diabetes Care. 29 (8): 1777–83. doi:10.2337/dc06-0606. PMID 16873779. Lay summary – News-Medical.Net (2006-08-08).
For most patients, metformin (Glucophage, Glucophage XR) will be initial therapy, but insulin may be required short-term for patients who present with excessively high blood sugar. Metformin is a preferred initial drug therapy because it rarely leads to weight gain or hypoglycemia (low blood sugar), is available generically and therefore is cost- effective, and has been shown to have a positive effect on LDL cholesterol.
As with any healthy eating program, a diabetic diet is more about your overall dietary pattern rather than obsessing over specific foods. Aim to eat more natural, unprocessed food and less packaged and convenience foods.
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Overview: The premise of this program is learning how to manage real food decisions in real-life situations. “It’s structured like a four-legged table, and each leg — food, behavior change, activity, and support — is essential for success,” says Stephanie Rost, M.S., RD, of Weight Watchers International. A new two-week Simple Start feature helps you eat right and lose weight without a focus on tracking food points. Meetings, plus extensive online and smartphone tools, help you stay on track. Membership in the program averages less than $10 a week.
A rapid-acting inhaled insulin (Afrezza) is also FDA-approved for use before meals. It must be used in combination with long-acting insulin in patients with type 1 diabetes and should not be used by those who smoke or have chronic lung disease. It comes as a single dose cartridge. Premixed insulin is also available for people who need to use more than one type of insulin.
Bariatric surgery. Although it is not specifically considered a treatment for type 2 diabetes, people with type 2 diabetes who also have a body mass index higher than 35 may benefit from this type of surgery. People who’ve undergone gastric bypass have seen significant improvements in their blood sugar levels. However, this procedure’s long-term risks and benefits for type 2 diabetes aren’t yet known.
Don’t replace saturated fat with sugar. Many of us replace saturated fat such as whole milk dairy with refined carbs, thinking we’re making a healthier choice. Low-fat doesn’t mean healthy when the fat has been replaced by added sugar.
Syda Productions/shutterstock”It’s not like you wake up one day and all of a sudden you’re thirsty, hungry, and [going to the bathroom] all the time,” says Melissa Joy Dobbins, RD, a certified diabetes educator in Illinois and a spokesperson for the American Association of Diabetes Educators. “It picks up gradually.” Indeed, “most people are unaware that they have diabetes in its early or even middle phases,” says Aaron Cypess, MD, assistant professor of medicine at Harvard Medical School and staff physician at Joslin Diabetes Center. Just because you’re not keyed in doesn’t mean you’re immune from problems associated with diabetes, he adds. The longer you go without controlling diabetes, the greater your risk for heart disease, kidney disease, amputation, blindness, and other serious complications. “We recommend that people with risk factors for diabetes, such as a family history or being overweight, get evaluated on a regular basis,” Dr. Cypess says. If you’ve been feeling off, talk your doctor about getting a simple blood test that can diagnose the disease. And pay attention to these subtle signs and symptoms of diabetes.
A healthy breakfast should include one or more servings of a high-fiber whole grain food, a good source of low-fat protein or dairy (such as 8 ounces of fat-free milk), and a serving of fruit. Work with a registered dietitian or diabetes educator to determine the best foods and portions for you.