To achieve reliable results in an OGT test you have to satisfy certain criteria and follow certain instructions.
If you are a pre-diabetic, your blood sugar can be brought down to normal levels with simple lifestyle modifications.
If you are a diabetic, your goal is to maintain your blood sugar within the target range specified for you by your doctor. Healthalyze can determine optimal times for you to test your blood sugar and remind you when to go for a screening. Gestational DiabetesGestational diabetes is a form of type 2 diabetes, usually temporary, that appears during pregnancy. Genetic FactorsResearchers have found at least 18 genetic locations, labeled IDDM1 - IDDM18, which are related to type 1 diabetes. Hyperglycemic Hyperosmolar Nonketonic Syndrome (HHNS)Hyperglycemic hyperosmolar nonketonic syndrome (HHNS) is a serious complication of diabetes that involves a cycle of increasing blood sugar levels and dehydration, without ketones. Kidney Damage (Nephropathy)Kidney disease (nephropathy) is a very serious complication of diabetes.
The early and more common type of this disorder is called nonproliferative or background retinopathy. To achieve good blood sugar control, patients and parents of children must undergo some training. Diabetes mellitus type ii – medical disability guidelines, Diabetes mellitus (diabetes) is a metabolic disorder characterized by abnormally high levels of a simple sugar (glucose) in the blood (hyperglycemia) as a result of. 1650 x 1275 · 277 kB · png, INSULIN ALGORITHM FOR TYPE 2 DIABETES MELLITUS IN CHILDREN 200 x 153 · 4 kB · jpeg, Simplified scheme for the pathophysiology of type 2 diabetes mellitus. Diabetes mellitus type 2: diagnostic criteria, Diabetes mellitus type 2 discussion diagnostic criteria. Diabetes: symptoms diabetes mellitus, Learn type 1 2 diabetes (diabetes dellitus) symptoms including increased urination, thirst, weight loss, fatigue, nausea, vomiting, skin. My former co-worker Spike, fun in that good “Keep Austin Weird” kind of way, taught me many things. Blood sugar – wikipedia, the free encyclopedia, The blood sugar concentration or blood glucose level is the amount of glucose (sugar) present in the blood of a human or animal.
What causes high blood sugar and what harm can it do to my, Question: what causes high blood sugar and what harm can it do to my body?
The blood sugar solution – the ultrahealthy program for, "want to end blood sugar problems without drugs?
Zero-calorie sweeteners may trigger blood sugar risk by, High blood sugar ends up being stored as fat. Pre-diabetes is a condition in which blood-glucose levels are marginally higher than normal but not high enough for the diagnosis of diabetes. Still, there is positive news if you have pre-diabetes you can reduce your risk of getting diabetes. Impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) or borderline diabetes are the other names for prediabetes. Diabetes mellitus is a condition in which the pancreas no longer produces enough insulin or cells stop responding to the insulin that is produced, so that glucose in the blood cannot be absorbed into the cells of the body. The most common form of diabetes is Type II, It is sometimes called age-onset or adult-onset diabetes, and this form of diabetes occurs most often in people who are overweight and who do not exercise. The causes of diabetes mellitus are unclear, however, there seem to be both hereditary (genetic factors passed on in families) and environmental factors involved. In Type II diabetes, the pancreas may produce enough insulin, however, cells have become resistant to the insulin produced and it may not work as effectively. Diabetes mellitus is a common chronic disease requiring lifelong behavioral and lifestyle changes. Several blood tests are used to measure blood glucose levels, the primary test for diagnosing diabetes. Random blood glucose test — for a random blood glucose test, blood can be drawn at any time throughout the day, regardless of when the person last ate.
Fasting blood glucose test — fasting blood glucose testing involves measuring blood glucose after not eating or drinking for 8 to 12 hours (usually overnight). Oral glucose tolerance test — Oral glucose tolerance testing (OGTT) is the most sensitive test for diagnosing diabetes and pre-diabetes. Oral glucose tolerance testing is routinely performed at 24 to 28 weeks of pregnancy to screen for gestational diabetes; this requires drinking a 50 gram glucose solution with a blood glucose level drawn one hour later.
When diet, exercise and maintaining a healthy weight aren’t enough, you may need the help of medication.
The most widely used form of insulin is synthetic human insulin, which is chemically identical to human insulin but manufactured in a laboratory. Advice patient about the importance of an individualized meal plan in meeting weekly weight loss goals and assist with compliance.
Assess patients for cognitive or sensory impairments, which may interfere with the ability to accurately administer insulin. Review dosage and time of injections in relation to meals, activity, and bedtime based on patients individualized insulin regimen. Instruct patient in the importance of accuracy of insulin preparation and meal timing to avoid hypoglycemia. Advise patient to assess blood glucose level before strenuous activity and to eat carbohydrate snack before exercising to avoid hypoglycemia. Assess feet and legs for skin temperature, sensation, soft tissues injuries, corns, calluses, dryness, hair distribution, pulses and deep tendon reflexes. Advice patient who smokes to stop smoking or reduce if possible, to reduce vasoconstriction and enhance peripheral flow. In some people, the fasting blood sugar may be normal, but blood sugar rises rapidly after eating and fall slowly.
If you are not a diabetic or pre-diabetic, get yourself screened at appropriate intervals with an FBS or HbA1c test to keep track of your sugar levels. It can also help you track your blood sugar and recommend lifestyle modifications to manage your condition.
Insulin is a hormone that is involved in regulating how the body converts sugar (glucose) into energy. The IDDM1 region contains the HLA genes that encode proteins called major histocompatibility complex. With this condition, the tiny filters in the kidney (called glomeruli) become damaged and leak protein into the urine. People with diabetes face a higher risk for influenza and its complications, including pneumonia. The results are given in percentages and indicate a person’s average blood glucose levels over the past 2 - 3 months. The earliest manifestation of kidney disease is microalbuminuria, in which tiny amounts of a protein called albumin are found in the urine. The patient and doctor must determine the amount of insulin used -- it is not automatically calculated. With modest weight loss and moderate physical activity, you can prevent altogether and return to normal glucose levels or slow down the development of type 2 diabetes. Type II is considered a milder form of diabetes because of its slow onset (sometimes developing over the course of several years) and because it usually can be controlled with diet and oral medication.
Symptoms of Type II diabetes can begin so gradually that a person may not know that he or she has it.
It is best managed with a team approach to empower the client to successfully manage the disease.
The body’s primary energy source is glucose, a simple sugar resulting from the digestion of foods containing carbohydrates (sugars and starches). It is used to monitor blood glucose control in people with known diabetes, but is not normally used to diagnose diabetes. However, the OGTT is not routinely recommended because it is inconvenient compared to a fasting blood glucose test. The person then drinks a 75 gram liquid glucose solution (which tastes very sweet, and is usually cola or orange-flavored). For women who have an abnormally elevated blood glucose level, a second OGTT is performed on another day after drinking a 100 gram glucose solution.
These medications, such as repaglinide (Prandin), have effects similar to sulfonylureas, but you’re not as likely to develop low blood sugar. Metformin (Glucophage, Glucophage XR) is the only drug in this class available in the United States.
These drugs block the action of enzymes in your digestive tract that break down carbohydrates.
These drugs make your body tissues more sensitive to insulin and keep your liver from overproducing glucose. By combining drugs from different classes, you may be able to control your blood sugar in several different ways. Two samples are used commonly, a fasting blood sample and another 2 hours after drinking the glucose water. These people may not be able to handle sugar as normal people do, and are said to have impaired glucose tolerance.
People with type 1 diabetes need to take daily insulin shots and carefully monitor their blood glucose levels.Type 1 diabetes is much less common than type 2 diabetes. Type 1 diabetes is considered an autoimmune disorder that involves:Beta cells in the pancreas that produce insulin are gradually destroyed. It is often triggered by a serious infection or another severe illness, or by medications that lower glucose tolerance or increase fluid loss (especially in people who are not drinking enough fluids).Symptoms of HHNS include high blood sugar levels, dry mouth, extreme thirst, dry skin, and high fever. Everyone with diabetes should have annual influenza vaccinations and a vaccination against pneumococcal pneumonia.Urinary Tract Infections. Microalbuminuria is also a marker for other complications involving blood vessel abnormalities, including heart attack and stroke.People with diabetes should have an annual microalbuminuria urine test. This requires an initial learning period, including understanding insulin needs over the course of the day and in different situations and knowledge of carbohydrate counting. Sometimes pre-diabetes can be reverse with weight loss that comes from healthy eating and more physical activity. If you are over 45 years and over weight, particularly large waist size, then you are at risk of developing pre diabetes and even diabetes. The treatment includes changes in diet, oral medications, and in some cases, daily injections of insulin. The consequences of uncontrolled and untreated Type II diabetes, however, are the just as serious as those for Type I.
In Type I diabetes, the immune system, the body’s defense system against infection, is believed to be triggered by a virus or another microorganism that destroys cells in the pancreas that produce insulin. As part of the team the, the nurse plans, organizes, and coordinates care among the various health disciplines involved; provides care and education and promotes the client’s health and well being.
Glucose from the digested food circulates in the blood as a ready energy source for any cells that need it.
The blood glucose level is measured before, and at one, two, and three hours after drinking the solution. Everyone with type 1 diabetes and some people with type 2 diabetes must take insulin every day to replace what their pancreas is unable to produce. One of its chief failings is that it doesn’t mimic the way natural insulin is secreted.
It works by inhibiting the production and release of glucose from your liver, which means you need less insulin to transport blood sugar into your cells. That means sugar is absorbed into your bloodstream more slowly, which helps prevent the rapid rise in blood sugar that usually occurs right after a meal. Side effects of thiazolidinediones, such as rosiglitazone (Avandia) and pioglitazone hydrochloride (Actos), include swelling, weight gain and fatigue. Other chromosomes and genes continue to be identified.Most people who develop type 1 diabetes do not have a family history of the disease. HHNS can lead to loss of consciousness, seizures, coma, and death.HypoglycemiaTight blood sugar (glucose) control increases the risk of low blood sugar (hypoglycemia).
Urine tests showing microalbuminuria (small amounts of protein in the urine) are important markers for kidney damage.Diabetic nephropathy is the leading cause of end-stage renal disease (ESRD).
If these processes affect the central portion of the retina, swelling may occur, causing reduced or blurred vision.If the capillaries become blocked and blood flow is cut off, soft, "woolly" areas may develop in the retina's nerve layer. Women with diabetes face a significantly higher risk for urinary tract infections, which are likely to be more complicated and difficult to treat than in the general population.Hepatitis. Frequent blood testing is very important, particularly during the training period.Insulin pumps are more expensive than insulin shots and occasionally have some complications, such as blockage in the device or skin irritation at the infusion site.
This form is also called noninsulin-dependent diabetes, a term that is somewhat misleading. Other symptoms may include sudden weight loss, slow wound healing, urinary tract infections, gum disease, or blurred vision. Insulin is a hormone or chemical produced by cells in the pancreas, an organ located behind the stomach.
Unfortunately, insulin can’t be taken in pill form because enzymes in your stomach break it down so that it becomes ineffective. But newer types of insulin, known as insulin analogs, more closely resemble the way natural insulin acts in your body. Second-generation sulfonylureas such as glipizide (Glucotrol, Glucotrol XL), glyburide (DiaBeta, Glynase PresTab, Micronase) and glimepiride (Amaryl) are prescribed most often.
One advantage of metformin is that is tends to cause less weight gain than do other diabetes medications.
Most doctors prescribe two drugs in combination, although sometimes three drugs may be prescribed. Type 1 diabetes can occur at any age, but it usually first develops in childhood or adolescence. In type 2 diabetes, the body does not respond properly to insulin, a condition known as insulin resistance. Evidence suggests that both a genetic predisposition and environmental factors, such as a viral infection, are involved.
The odds of inheriting the disease are only 10% if a first-degree relative has diabetes and, even in identical twins, one twin has only a 33% chance of having type 1 diabetes if the other twin has it. Patients with ESRD have 13 times the risk of death compared to other patients with type 1 diabetes. Patients with diabetes are at increased risk for contracting the hepatitis B virus, which is transmitted through blood and other bodily fluids.
In spite of early reports of a higher risk for ketoacidosis with pumps, more recent studies have found no higher risk.Supplementary Drugs for HyperglycemiaPramlintide (Symlin) is an injectable drug that is used to help control postprandial hyperglycemia, the sudden increase in blood sugar after a meal.
Many people with Type II diabetes can control the condition with diet and oral medications, however, insulin injections are sometimes necessary if treatment with diet and oral medication is not working.
It is not unusual for Type II diabetes to be detected while a patient is seeing a doctor about another health concern that is actually being caused by the yet undiagnosed diabetes. Insulin bonds to a receptor site on the outside of cell and acts like a key to open a doorway into the cell through which glucose can enter. For that reason, many people inject themselves with insulin using a syringe or an insulin pen injector,a device that looks like a pen, except the cartridge is filled with insulin. The most common side effect of sulfonylureas is low blood sugar, especially during the first four months of therapy. Possible side effects include a metallic taste in your mouth, loss of appetite, nausea or vomiting, abdominal bloating, or pain, gas and diarrhea. Although safe and effective, alpha-glucosidase inhibitors can cause abdominal bloating, gas and diarrhea. The thiazolidinedione troglitzeone (Rezulin) was taken off the market in March 2000 because it caused liver failure.
Newer medications, such as Glucovance, which contains both glyburide and metformin, combine different oral drugs in a single tablet.
Children are more likely to inherit the disease from a father with type 1 diabetes than from a mother with the disorder.Genetic factors cannot fully explain the development of diabetes. In this more severe condition, new abnormal blood vessels form and grow on the surface of the retina. Exposure to the virus can occur through sharing finger-stick devices or blood glucose monitors. Pramlintide is injected before meals and can help lower blood sugar levels in the 3 hours after meals.
Insulin also helps move glucose (blood sugar) into cells, where it can be stored and used for energy.
Some of the glucose can be converted to concentrated energy sources like glycogen or fatty acids and saved for later use.
Others may use an insulin pump, which provides a continuous supply of insulin, eliminating the need for daily shots. You’re at much greater risk of low blood sugar if you have impaired liver or kidney function. These effects usually decrease over time and are less likely to occur if you take the medication with food. If your doctor prescribes these drugs, it’s important to have your liver checked every two months during the first year of therapy. For the past several decades, the number of new cases of type 1 diabetes has been increasing each year worldwide. Symptoms of kidney failure may include swelling in the feet and ankles, itching, fatigue, and pale skin color. Adults newly diagnosed with type 1 or type 2 diabetes should get hepatitis B vaccinations.DepressionDiabetes doubles the risk for depression. For patients with diabetes, A1C is measured periodically every 2 - 3 months, or at least twice a year. A doctor uses the results from a creatinine blood test to calculate the glomerular filtration rate (GFR).
Pramlintide is used in addition to insulin for patients who take insulin regularly but still need better blood sugar control.
When there is not enough insulin produced or when the doorway no longer recognizes the insulin key, glucose stays in the blood rather entering the cells. A rare but serious side effect is lactic acidosis, which results when lactic acid builds up in your body. Contact your doctor immediately if you experience any of the signs and symptoms of liver damage, such as nausea and vomiting, abdominal pain, loss of appetite, dark urine, or yellowing of your skin and the whites of your eyes (jaundice).
Patients who are at risk for hypoglycemia should carry some sugar product, or an emergency glucagon injection kit, in case an attack occurs. VirusesSome research suggests that viral infections may trigger the disease in genetically susceptible individuals.Among the viruses under scrutiny are enteric viruses, which attack the intestinal tract. Usually the condition is manageable, but, occasionally, it can be severe or even life threatening, particularly if the patient fails to recognize the symptoms, especially while continuing to take insulin or other hypoglycemic drugs. The outlook of end-stage renal disease has greatly improved during the last four decades for patients with type 1 diabetes, and fewer people with type 1 diabetes are developing ESRD.NeuropathyDiabetes reduces or distorts nerve function, causing a condition called neuropathy.
Major hemorrhage or retinal detachment can result, causing severe visual loss or blindness.
While finger prick self-testing provides information on blood glucose for that day, the A1C test shows how well blood sugar has been controlled over the past several months.In general, most adult patients with diabetes should aim for A1C levels below or around 7%. Pramlintide and insulin are the only two drugs approved for treatment of type 1 diabetes.Pramlintide is a synthetic form of amylin, a hormone that is related to insulin.
These may not always be related to diabetes medications, but your doctor will need to investigate all possible causes. Beta-blocking medications, which are often prescribed for high blood pressure and heart disease, can mask symptoms of hypoglycemia.Risk Factors for Severe Hypoglycemia. The American Diabetes Association recommends that patients with type 1 diabetes have an annual comprehensive eye exam, with dilation, to check for signs of retina disease (retinopathy).
Side effects may include nausea, vomiting, abdominal pain, headache, fatigue, and dizziness. Lactic acidosis is especially likely to occur if you mix this medication with alcohol or have impaired kidney function.
Epidemics of Coxsackie virus, as well as mumps and congenital rubella, have been associated with type 1 diabetes.Risk FactorsType 1 diabetes is much less common than type 2 diabetes, consisting of only 5 - 10% of all cases of diabetes. In terms of sexual health, diabetes may cause decreased vaginal lubrication, which can lead to pain or discomfort during intercourse.Women with diabetes should also be aware that certain types of medication can affect their blood glucose levels.
Patients with type 1 diabetes have an increased risk of severe low blood sugar (hypoglycemia) that may occur within 3 hours following a pramlintide injection.
Patients are also encouraged to wear a medical alert ID bracelet or necklace that states they have diabetes and that they take insulin.Patients with Type 1 Diabetes Living Longer and Healthier LivesRates of serious complications among people with type 1 diabetes have decreased over the past several decades. Nevertheless, like type 2 diabetes, new cases of type 1 diabetes have been rising over the past few decades. Hypoglycemia unawareness is a condition in which people become accustomed to hypoglycemic symptoms.
It is a common complication for nearly half of people who have lived with type 1 or type 2 diabetes for more than 25 years. In addition to a comprehensive eye exam, fundus photography may be used as a screening tool. This drug should not be used if patients have trouble knowing when their blood sugar is low or have slow stomach emptying (gastroparesis).Treatment of ComplicationsHigh Blood Pressure and Heart DiseaseAll patients with diabetes and high blood pressure should adopt lifestyle changes.
While type 2 diabetes has been increasing among African-American and Hispanic adolescents, the highest rates of type 1 diabetes are found among Caucasian youth.Type 1 diabetes can occur at any age but usually appears between infancy and the late 30s, most typically in childhood or adolescence.
The most serious consequences of neuropathy occur in the legs and feet and pose a risk for ulcers and, in unusually severe cases, amputation. Long-term use (more than 2 years) of birth control pills may increase the risk of health complications.Diabetes and Pregnancy. Fundus photography uses a special type of camera to take images of the back of the eye.Screening for Neuropathy.
These include weight reduction (when needed), following the Dietary Approaches to Stop Hypertension (DASH) diet, smoking cessation, limiting alcohol intake, and limiting salt intake to no more than 1,500 mg of sodium per day.High Blood Pressure Control.
A type 1 diabetes diet is designed to provide maximum nutrition, while limiting sugar, carbohydrates, and sodium.
It affects about 25% of patients who use insulin, nearly always people with type 1 diabetes. Peripheral neuropathy usually starts in the fingers and toes and moves up to the arms and legs (called a stocking-glove distribution).
All patients should be screened for nerve damage (neuropathy), including a comprehensive foot exam. In such cases, hypoglycemia appears suddenly, without warning, and can escalate to a severe level. Studies indicate that high blood sugar levels (hyperglycemia) can affect the developing fetus during the critical first 6 weeks of organ development. These antibodies are referred to as autoantibodies because they attack the body's own cells -- not a foreign invader. Patients who lose sensation in their feet should have a foot exam every 3 - 6 months to check for ulcers or infections.Screening for Thyroid Abnormalities.
At the point when insulin production bottoms out, however, type 1 diabetes usually appears suddenly and progresses quickly.
Even a single recent episode of hypoglycemia may make it more difficult to detect the next episode.
Therefore, it is important that women with pre-existing diabetes (both type 1 and type 2) who are planning on becoming pregnant strive to maintain good glucose control for 3 - 6 months before pregnancy.It is also important for women to closely monitor their blood sugar levels during pregnancy. Blood tests for these autoantibodies can help differentiate between type 1 and type 2 diabetes.Screening Tests for ComplicationsScreening Tests for Heart Disease. The most beneficial fall into the following categoriesDiuretics rid the body of extra sodium (salt) and water. Within 20 minutes after a meal insulin rises to its peak level.Insulin enables glucose to enter cells in the body, particularly muscle and liver cells. With vigilant monitoring and by rigorously avoiding low blood glucose levels, patients can often regain the ability to sense the symptoms. Patients with diabetes should be aware of other warning signs of a heart attack, including sudden fatigue, sweating, shortness of breath, nausea, and vomiting.Rapid heart ratesLightheadedness when standing up (orthostatic hypotension)Diabetic gastroparesis is a type of neuropathy that affects the digestive track. All patients with diabetes should be tested for high blood pressure (hypertension) and unhealthy cholesterol and lipid levels and given an electrocardiogram. Patients should meet with a professional dietitian to plan an individualized diet within the general guidelines that takes into consideration their own health needs.Healthy eating habits, along with good control of blood glucose, are the basic goals, and several good dietary methods are available to meet them. However, even very careful testing may fail to detect a problem, particularly one that occurs during sleep.Symptoms.
General dietary guidelines for diabetes recommend:Carbohydrates should provide 45 - 65% of total daily calories.
Like ACE inhibitors and ARBs, certain calcium channel blockers (diltiazem and verapamil) can reduce urine protein loss caused by diabetic kidneys.Nearly all patients who have diabetes and high blood pressure should take an ACE inhibitor (or ARB) as part of their regimen for treating their hypertension. Without proper diet, exercise, and insulin therapy, a person with type 1 diabetes could suffer adverse health effects. However, during the past several decades, the rate of serious complications among people with diabetes has been decreasing, and more patients are living longer and healthier lives.
Mild symptoms usually occur at moderately low and easily correctable levels of blood glucose. The result of this damage is that the digestive system takes too long at time to move and empty food. Health complications associated with this type of diabetes include: vision problems high blood pressure, which increases risk for heart attack, stroke, and poor circulation kidney damage nerve damage skin sores and infections, which can cause pain and may lead to tissue death Following proper dietary guidelines can help mitigate the difficulties of type 1 diabetes, keep your health free from complications, and make your life better overall.
There are two important approaches to preventing complications from type 1 diabetes:Good control of blood glucose and keeping glycosylated hemoglobin (A1C) levels below or around 7%.
Undigested food and the delay in stomach emptying can cause blood glucose levels to rise, and make diabetes more difficult to control. The changes in estrogen and other hormonal levels that occur during perimenopause can cause major fluctuations in blood glucose levels. In addition to secreting digestive enzymes, the pancreas secretes the hormones insulin and glucagon into the bloodstream.
This approach can help prevent complications due to vascular (blood vessel) abnormalities and nerve damage (neuropathy) that can cause major damage to organs, including the eyes, kidneys, and heart.Managing risk factors for heart disease. Heart attacks account for 60% of deaths in patients with diabetes, while strokes account for 25% of such deaths. Symptoms of gastroparesis include heartburn, nausea, abdominal bloating, feeling full after eating only a small amount of food, and vomiting of undigested food several hours after a meal.Blood sugar control is an essential component in the treatment for neuropathy.
Women with diabetes also face an increased risk of premature menopause, which can lead to higher risk of heart disease.Specific Problems for Adolescents with Type 1 DiabetesLack of Blood Glucose Control.
The release of insulin into the blood lowers the level of blood glucose (simple sugars from food) by enhancing glucose to enter the body cells, where it is metabolized. Blood glucose control helps the heart, but it is also very important that people with diabetes control blood pressure, cholesterol levels, and other factors associated with heart disease.Diabetic KetoacidosisDiabetic ketoacidosis (DKA) is a life-threatening complication caused by a complete (or almost complete) lack of insulin. Diabetes affects the heart in many ways:Both type 1 and 2 diabetes accelerate the progression of atherosclerosis (hardening of the arteries). Studies show that tight control of blood glucose levels delays the onset and slows progression of neuropathy.
Patients with diabetes should monitor their carbohydrate intake either through carbohydrate counting or meal planning exchange lists.Fats should provide 25 - 35% of daily calories.
A nutritionist or dietitian can help you come up with meal plans, and create a diet that works for you in the long term. If blood glucose levels get too low, the pancreas secretes glucagon to stimulate the release of glucose from the liver. Adolescents with diabetes are at higher risk than adults for ketoacidosis resulting from noncompliance. Ketones are byproducts of fat breakdown that build up in the blood and appear in the urine. This can lead to coronary artery disease, heart attack, or stroke.In type 1 diabetes, high blood pressure (hypertension) usually develops if the kidneys become damaged. Lowering triglycerides, losing weight, reducing blood pressure, and quitting smoking may help prevent the onset of neuropathy.Foot Ulcers and AmputationsAbout 15% of patients with diabetes have serious foot problems. Young people who do not control glucose are also at high risk for permanent damage in small vessels, such as those in the eyes.Eating Disorders. Up to a third of young women with type 1 diabetes have eating disorders and under-use insulin to lose weight.
Children with diabetes are also at risk for hypertension.Impaired nerve function (neuropathy) associated with diabetes also causes heart abnormalities. The consequences of both poor circulation and peripheral neuropathy make this a common and serious problem for all patients with diabetes. Limit trans-fats (hydrogenated fat found in snack foods, fried foods, and commercially baked goods) to less than 1% of total calories.Protein should provide 12 - 20% of daily calories, although this may vary depending on a patient’s individual health requirements. Extreme stages of diabetic ketoacidosis can lead to coma and death.For some people, DKA may be the first sign that someone has diabetes. Atherosclerosis is a disease of the arteries in which fatty material is deposited in the vessel wall, resulting in narrowing and eventual impairment of blood flow. Diabetes is responsible for more than half of all lower limb amputations performed in the U.S.
In type 1 diabetes, it usually occurs when a patient is not compliant with insulin therapy or intentionally reduces insulin doses in order to lose weight. Severely restricted blood flow in the arteries to the heart muscle leads to symptoms such as chest pain.
Most amputations start with foot ulcers.People with diabetes who are overweight, smokers, and have a long history of diabetes tend to be at most risk.
Having a well-stocked kitchen or carrying healthy snacks with you can cut down on unnecessary sugar, carbohydrates, sodium, and fat that can spike blood sugar. People who have the disease for more than 20 years and are insulin-dependent are at the highest risk.
Reducing sodium can help lower blood pressure and decrease the risk of heart disease.Healthy Weight ControlWeight gain is a potential side effect of intense diabetic control with insulin. Related conditions that put people at risk include peripheral neuropathy, peripheral artery disease, foot deformities, and a history of ulcers. To maintain blood sugar levels, dont skip meals, and try to eat around the same time each day. Foot ulcers usually develop from infections, such as those resulting from blood vessel injury.
Widespread screening of patients to identify those at higher risk for diabetes type 1 is not recommended.Oral Glucose Tolerance TestThe oral glucose tolerance test (OGTT) is more complex than the FPG and may overdiagnose diabetes in people who do not have it. On the other hand, studies suggest that more than one-third of women with diabetes omit or underuse insulin in order to lose weight.
Numbness from nerve damage, which is common in diabetes, compounds the danger since the patient may not be aware of injuries. Some doctors recommend it as a follow-up after FPG, if the latter test results are normal but the patient has symptoms or risk factors of diabetes. Eating disorders are especially dangerous in patients with diabetes and can increase the risk for diabetic ketoacidosis. Ketoacidosis is a significant complication of insulin depletion and can be life threatening.ExerciseAerobic exercise has significant and particular benefits for people with type 1 diabetes. Charcot foot or Charcot joint (medically referred to as neuropathic arthropathy) is a degenerative condition that affects the bones and joints in the feet.
It increases sensitivity to insulin, lowers blood pressure, improves cholesterol levels, and decreases body fat. Early changes appear similar to an infection, with the foot becoming swollen, red, and warm.
Fruits Fruits are natural sources of sugar and should be counted as carbohydrates if youre using a diet plan.
The bones may crack, splinter, and erode, and the joints may shift, change shape, and become unstable. It typically develops in people who have neuropathy to the extent that they cannot feel sensation in the foot and are not aware of an existing injury.
Instead of resting an injured foot or seeking medical help, the patient often continues normal activity, causing further damage.Retinopathy and Eye ComplicationsDiabetes accounts for thousands of new cases of blindness annually and is the leading cause of new cases of blindness in adults ages 20 - 74. Because patients with diabetes may have silent heart disease, they should always check with their doctors before undertaking vigorous exercise.Warning on Dietary SupplementsVarious fraudulent products are often sold on the Internet as “cures” or treatments for diabetes.
People with diabetes are also at higher risk for developing cataracts and certain types of glaucoma.
The US Food and Drug Administration (FDA) and Federal Trade Commission (FTC) warn patients with diabetes not to be duped by bogus and unproven remedies.TreatmentInsulin is essential for control of blood glucose levels in type 1 diabetes. Good blood glucose control is the best way to prevent major complications in type 1 diabetes, including those that affect the kidneys, eyes, nerve pathways, and blood vessels.
These include: most green leafy vegetables asparagus beets carrots celery cucumber onions peppers sprouts tomatoes Always choose fresh or frozen vegetables without added salt or sauces. It is important to manage heart disease risk factors that might develop as a result of insulin treatment.A diet plan that compensates for insulin administration and supplies healthy foods is extremely important. The basal component of the treatment attempts to provide a steady amount of background insulin throughout the day. Insulin glargine offers the most consistent insulin activity level, but other intermediate and long-acting forms may be beneficial when administered twice a day.
Carbohydrates can come in the form of beans, starchy vegetables, fruit juices, pasta, or bread. Short-acting insulin delivered continuously using a pump is proving to a very good way to provide basal rates of insulin.Mealtime insulin administration. Snacks are often necessary.Insulin requirements vary depending on many non-nutritional situations during the day, including exercise and sleep.
Injections of insulin under the skin ensure that it is absorbed slowly by the body for a long-lasting effect.
The timing and frequency of insulin injections depend upon a number of factors:The duration of insulin action. Insulin lispro (Humalog) and insulin aspart (Novo Rapid, Novolog) lower blood sugar very quickly, usually within 5 minutes after injection.
This rapid action reduces the risk for hypoglycemic events after eating (postprandial hypoglycemia).
Fruits, vegetables, nuts, and other foods travel easily and are great to have on hand when you need them. Optimal timing for administering this insulin is about 15 minutes before a meal, but it can also be taken immediately after a meal (but within 30 minutes).
Fast-acting insulins may be especially useful for meals with high carbohydrates.Regular Insulin. Regular insulin begins to act 30 minutes after injection, reaches its peak at 2 - 4 hours, and lasts about 6 hours. Regular insulin may be administered before a meal and may be better for high-fat meals.Intermediate Insulin. Lente (insulin zinc) is another intermediate insulin that peaks 4 - 12 hours and lasts up to 18 hours.Long-Acting (Ultralente) Insulin. Regimens generally include combinations of short and longer-acting insulins to help match the natural cycle. For example, one approach in patients who are intensively controlling their glucose levels uses 3 injections of insulin, which includes a mixture of regular insulin and NPH at dinner. Another approach uses 4 injections, including a separate short-acting form at dinner and NPH at bedtime, which may pose a lower risk for nighttime hypoglycemia than the 3-injection regimen.Insulin Pens. Newer, prefilled pens (Humulin Pen, Humalog) are disposable and allow the patient to dial in the correct amount.Insulin PumpsAn insulin pump can improve blood glucose control and quality of life with fewer hypoglycemic episodes than multiple injections. The pumps correct for the “dawn phenomenon” (sudden rise of blood glucose in the morning) and allow quick reductions for specific situations, such as exercise.
Many different brands are available.The typical pump is about the size of a beeper and has a digital display.
Some are worn externally and are programmed to deliver insulin through a catheter in the skin or the abdomen. They work by administering a small amount of insulin continuously (the basal rate) and a higher dose (a bolus dose) when food is eaten.Although learning to use the pump can be complicated at first, most patients find over time that the devices are fairly easy to use.
Adults, adolescents, and school children use insulin pumps and even very young children (ages 2 - 7 years) may be able to successfully use them. The catheter at the end of the insulin pump is inserted through a needle into the abdominal fat of a person with diabetes.
Dosage instructions are entered into the pump's small computer, and the appropriate amount of insulin is then injected into the body in a calculated, controlled manner.
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