To provide even greater transparency and choice, we are working on a number of other cookie-related enhancements. Both type 1 and type 2 diabetes share one central feature: elevated blood sugar (glucose) levels due to insufficiencies of insulin, a hormone produced by the pancreas.
During and immediately after a meal the process of digestion breaks down carbohydrates into sugar molecules (including glucose) and proteins into amino acids. Right after the meal, glucose and amino acids are absorbed directly into the bloodstream, and blood glucose levels rise sharply.
The rise in blood glucose levels signals important cells in the pancreas, called beta cells, to secrete insulin, which pours into the bloodstream. When insulin levels are high, the liver stops producing glucose and stores it in other forms until the body needs it again. About 2 - 4 hours after a meal, both blood glucose and insulin are at low levels, with insulin being slightly higher. Eventually, the cycle of elevated glucose further damages beta cells, thereby drastically reducing insulin production and causing full-blown diabetes. Without insulin to move glucose into cells, blood glucose levels become excessively high, a condition known as hyperglycemia. Weakness, weight loss, frequent urination, and excessive hunger and thirst are among the initial symptoms. About 5% of pregnant women develop a form of type 2 diabetes, usually temporary, in their third trimester called gestational diabetes. Because glucose crosses the placenta, a pregnant women with diabetes can pass high levels of blood glucose to the fetus. Genetic mutations likely affect parts of the insulin gene and various other physiologic components involved in the regulation of blood sugar.
A set of conditions referred to as metabolic syndrome (also called Syndrome X) is a pre-diabetic condition that is significantly associated with heart disease and higher mortality rates from all causes. Gestational diabetes is a type of diabetes that develops during the last trimester of pregnancy. Children age 10 and older should be tested for type 2 diabetes (even if they have no symptoms) every 3 years if they are overweight and have at least two risk factors. The fasting plasma glucose (FPG) test, alone or in combination with the oral glucose tolerance test (OGGT) can help diagnose pre-diabetes and diabetes. The FPG test is not always reliable, so a repeat test is recommended if the initial test suggests the presence of diabetes, or if the test is normal in people who have symptoms or risk factors for diabetes. The results of a blood glucose test tell the patient and doctor how well the diabetes is controlled for only the day of the test.
Measuring glycosylated hemoglobin is generally not used for making an initial diagnosis of diabetes, since a normal level does not rule out diabetes. The electrocardiogram (ECG or EKG) is used extensively in the diagnosis of heart disease, from congenital heart disease in infants to myocardial infarction and myocarditis in adults. The American Diabetes Association recommends that people with diabetes receive an annual microalbuminuria urine test.
Protect the heart and aim for healthy lipid (cholesterol and triglyceride) levels and control of blood pressure.
Healthy eating habits along with good control of blood glucose are the basic goals, and several good dietary methods are available to meet them.
Protein should provide 12 - 20% of daily calories, although this may vary depending on a patient’s individual health requirements. The American Diabetes Association recommends that patients aim for a small but consistent weight loss of A‚A? - 1 pound per week.
Unfortunately, not only is weight loss difficult to sustain, but many of the oral medications used in type 2 diabetes cause weight gain as a side effect.
Sedentary habits, especially watching TV, are associated with significantly higher risks for obesity and type 2 diabetes.
For improving blood sugar control, the American Diabetes Association recommends at least 150 minutes per week of moderate-intensity physical activity (50 - 70% of maximum heart rate) or at least 90 minutes per week of vigorous aerobic exercise (more than 70% of maximum heart rate). Because people with diabetes are at higher than average risk for heart disease, they should always check with their doctors before undertaking vigorous exercise. Strenuous strength training or high-impact exercise is not recommended for people with uncontrolled diabetes. Monitor glucose levels before, during, and after workouts (glucose levels swing dramatically during exercise).
Drink plenty of fluids before and during exercise; avoid alcohol, which increases the risk of hypoglycemia. Before exercising, avoid alcohol and if possible certain drugs, including beta-blockers, which make to difficult to recognize symptoms of hypoglycemia. Insulin-dependent athletes may need to decrease insulin doses or take in more carbohydrates prior to exercise, but may need to take an extra dose of insulin after exercise (stress hormones released during exercise may increase blood glucose levels).
Some research suggests that not getting enough sleep may impair insulin use and increase the risk for obesity.
The most important lifestyle treatment for people with pre-diabetes is to lose weight through diet and regular exercise. Patients should have an exercise goal of 30 - 60 minutes, at least 5 days a week, and follow a low-fat, high-fiber diet. It is also important to have your doctor check your cholesterol and blood pressure levels on a regular basis. While doctors sometimes prescribe insulin-regulating drugs such as metformin (Glucophage) and acarbose (Precose), evidence indicates that lifestyle changes can be at least as effective as drug therapy. The major treatment goals for people with type 2 diabetes are to control blood glucose levels and to treat all conditions that place patients at risk for heart disease, stroke, kidney disease, and other major complications. Use of oral anti-hyperglycemic drugs such as metformin are first-line drug treatments, and insulin if needed.
Use of various drugs provided by your doctor to control high blood pressure (such as ACE inhibitors and diuretics), lower cholesterol (statins and fibrates), and to prevent clots, such as aspirin or clopidogrel (Plavix). Different goals may be necessary for specific individuals, including pregnant women, very old and very young people, and those with accompanying serious medical conditions. For the most part older oral hypoglycemic drugs -- particularly metformin -- are less expensive than, and work as well as, newer diabetes drugs. Metformin (Glucophage) is a biguanide, which works by reducing glucose production in the liver and by making tissues more sensitive to insulin. Metformin does not cause hypoglycemia or add weight, so it is particularly well-suited for obese patients with type 2 diabetes. Rare reports of lactic acidosis, a potentially life-threatening condition, particularly in people with risk factors for it.
Certain people should not use this drug, including anyone with heart failure or kidney or liver disease. Although sulfonylureas pose a lower risk for hypoglycemia than insulin does, the hypoglycemia produced by sulfonylureas may be especially prolonged and dangerous. Sulfonylureas interact with many other drugs, and patients must inform their doctor of any medications they are taking, including alternative or over-the-counter drugs.
Thiazolidinediones, also known as peroxisome proliferator-activated receptor (PPAR) agonists, include pioglitazone (Actos) and rosiglitazone (Avandia). Alpha-glucosidase inhibitors, including acarbose (Precose, Glucobay) and miglitol (Glyset), reduce glucose levels by interfering with the absorption of starch in the small intestine.
Alpha-glucosidase inhibitors do not cause hypoglycemia when used alone, but combinations with other drugs do.
Exenatide has been associated with cases of acute pancreatitis, which is sudden inflammation of the pancreas. Dipeptidyl peptidase-4 (DPP-4) inhibitors, also called gliptins, are the second class of incretin drugs. Like exenatide, DPP-4 inhibitors do not cause weight gain, have low risks for hypoglycemia, and have few severe side effects.
Approved in 2005, pramlintide (Symlin) is a new type of injectable drug that may help patients who take insulin but still need better blood sugar control.
Fortunately, studies to date have not reported any adverse cardiac effects in patients with type 2 diabetes who take insulin.
In general, there is no advantage to dosing insulin more than two times a day for patients with type 2 diabetes. Patients with diabetes and high blood pressure need an individualized approach to drug treatment, based on their particular health profile. Angiotensin-converting enzyme (ACE) inhibitors reduce the production of angiotensin, a chemical that causes arteries to narrow.
Calcium-channel blockers (CCBs) decrease the contractions of the heart and widen blood vessels. Nearly all patients who have diabetes and high blood pressure should take an ACE inhibitor (or ARB) as part of their regimen for treating hypertension. The primary safety concern with statins has involved myopathy, an uncommon condition that can cause muscle damage and, in some cases, muscle and joint pain. Although lowering LDL cholesterol is beneficial, statins are not as effective as other medications -- such as niacin and fibrates -- in addressing HDL and triglyceride imbalances.
Fibrates, such as gemfibrozil (Lopid) and fenofibrate (Tricor), are usually the second choice after statins.
In virtually all cases, wound care requires debridement, the removal of injured tissue until only healthy tissue remains. Administering hyperbaric oxygen (oxygen given at high pressure) is showing promise in promoting healing. Total-contact casting (TCC) uses a cast that is designed to match the exact contour of the foot and to distribute weight along the entire length of the foot. Nonprescription analgesics, such as aspirin, acetaminophen, and non-steroidal anti-inflammatory drugs (NSAIDs). Topical medications, particularly capsaicin (the active ingredient in hot peppers), are applied to the skin to relieve minor local pain.
Tricyclic antidepressants, such as amitriptyline (Elavil) or doxepin (Sinequan), are effective in reducing pain from neuropathy for many patients.
Duloxetine (Cymbalta), a serotonin and norepinephrine reuptake inhibitor, is approved for treatment of pain associated with diabetic peripheral neuropathy. Anti-seizure drugs used for peripheral neuropathy pain relief include gabapentin (Neurontin), pregabalin (Lyrica), carbamazepine (Tegretol), and valproate (Depakote).
Although not proven to be beneficial, patients may also try transcutaneous electrostimulation (TENS), a treatment that involves administering mild electrical pulses to painful areas. Tight control of blood sugar and blood pressure is essential for preventing the onset of kidney disease.
ACE inhibitors are the best class of blood pressure medications for delaying kidney disease and slowing disease progression in patients with diabetes. For patients with diabetes who have microalbuminuria, the American Diabetes Association strongly recommends ACE inhibitors or ARBs.
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.
A doctor may recommend a low-protein diet for patients whose kidney disease is progressing despite tight blood sugar and blood pressure control. Contact their doctors if they experience such symptoms as shortness of breath, pain, swelling in the legs, or increases in blood pressure.
People with type 2 diabetes are also at risk for nerve damage (neuropathy) and abnormalities in both small and large blood vessels (vascular injuries) that occur as part of the diabetic disease process. Intensive control of blood glucose and keeping glycosylated hemoglobin (HbA1c) levels below 7%.
There is an association between high blood pressure (hypertension), unhealthy cholesterol levels, and diabetes. People with diabetes are more likely than non-diabetics to have heart problems, and to die from heart complications. Both type 1 and 2 diabetes speed the progression of atherosclerosis (hardening of the arteries).
Impaired nerve function (neuropathy) associated with diabetes also causes heart abnormalities.
Women with diabetes are at particularly high risk for heart problems and death from heart disease and overall causes. Diabetic nephropathy, the leading cause of end-stage renal disease (ESRD), occurs in about 20 - 40% of patients with diabetes. Diabetes is responsible for more than half of all lower limb amputations performed in the U.S. Those most at risk are people with a long history of diabetes, and people with diabetes who are overweight or who smoke. In general, foot ulcers develop from infections, such as those resulting from blood vessel injury.
Charcot foot is initially treated with strict immobilization of the foot and ankle; some centers use a cast that allows the patient to move and still protects the foot. People with diabetes are prone to foot problems because the disease can cause damage to the blood vessels and nerves, which may result in decreased ability to sense trauma to the foot.
Diabetes accounts for thousands of new cases of blindness annually and is the leading cause of new cases of blindness in adults age 20 - 74. The early and more common type of this disorder is called nonproliferative or background retinopathy. If the capillaries become blocked and blood flow is cut off, soft, "woolly" areas may develop in the retina's nerve layer. Some studies indicate that patients with type 2 diabetes face a higher than average risk of developing dementia caused either by Alzheimer's disease or problems in blood vessels in the brain. Mild hypoglycemia is common among people with type 2 diabetes, but severe episodes are rare, even among those taking insulin.
Diabetic ketoacidosis (DKA) is a life-threatening complication caused by insulin deficiency.
Women with diabetes should also be aware that certain types of medication can affect their blood glucose levels.
Both low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) are of concern, especially for patients who take insulin. Different goals may be required for specific individuals, including pregnant women, very old and very young people, and those with accompanying serious medical conditions. Home monitors are about 10 - 15% less accurate than laboratory monitors, and many do not meet the standards of the American Diabetes Association. For patients who have trouble controlling hypoglycemia (low blood sugar) or fluctuating blood sugar levels, continuous glucose sensor monitors are also available.
To monitor the amount of glucose within the blood a person with diabetes should test their blood regularly.
Hemoglobin A1c (also called HbA1c , HA1c, or A1C) is measured periodically every 2 - 3 months, or at least twice a year, to determine the average blood-sugar level over the lifespan of the red blood cell. Patients who intensively control their blood sugar should monitor blood levels as often as possible, four times or more per day. In adults, it is also particularly critical to monitor blood glucose levels before driving, when hypoglycemia can be very hazardous. Patients who use medications that put them at risk for hypoglycemia should always carry hard candy, juice, sugar packets, or commercially available glucose substitutes designed for individuals with diabetes. If the patient is helpless (but not unconscious), family or friends should administer three to five pieces of hard candy, two to three packets of sugar, half a cup (four ounces) of fruit juice, or a commercially available glucose solution. If there is inadequate response within 15 minutes, the patient should receive additional sugar by mouth and may need emergency medical treatment, possibly including an intravenous glucose solution. Family members and friends can learn to inject glucagon, a hormone, which, in contrast to insulin, raises blood glucose. Patients are encouraged to wear at all times a medical alert ID bracelet or necklace that states they have diabetes. Patients should inspect their feet daily and watch for changes in color or texture, odor, and firm or hardened areas, which may indicate infection and potential ulcers.
When washing the feet, the water should be warm (not hot) and the feet and areas between the toes should be thoroughly dried afterward. Gently use pumice to remove corns and calluses (patients should not use medicated pads or try to shave the corns or calluses themselves). As a patient, I always fall into the trap of thinking I’m at fault for out of range blood sugars. Based on personal experience, conversations with experts, and scientific research, here’s a non-exhaustive list of 22 factors that can affect blood glucose.
Of all the three sources of energy from food (carbohydrates, protein, and fat), carbohydrates affect my blood glucose the most. Fatty foods tend to make people with diabetes more insulin resistant, meaning more insulin is often needed to cover the same amount of food relative to a similar meal without the fat. Many studies have suggested that caffeine increases insulin resistance and stimulates the release of adrenaline. Exercise is often positioned as something that always lowers blood glucose; however, high-intensity exercise, such as sprinting or weight lifting, can sometimes raise blood glucose. Infusion sets are not as well understood as we would like, and a huge number of factors can lead to higher glucose levels: air bubbles in the tubing, an occluded cannula, an infected site, or even the location of the set. Using the same sites on the body for injections or infusion sets can lead to lipodystrophy and scar tissue buildup – these result in erratic absorption of insulin, leading to glycemic variability and making it harder to spend more time in range. Stress and illness can cause the body to release epinephrine (adrenaline), glucagon, growth hormone, and cortisol.
Though I have not found any studies on this topic, some patients report higher glucose levels when they have allergies. Hyperglycemia can lead to a state known as “glucotoxicity,” which can actually cause insulin resistance.
Some studies suggest that smoking can increase insulin resistance, and people with diabetes who smoke are more likely than nonsmokers to have trouble with insulin dosing and managing their diabetes.
I’ve fried my insulin by exposing it to direct sunlight or leaving it in the car on a hot day. While this seems fairly obvious, I often find myself testing multiple times in a row, since I do not believe the initial value – in many cases, the second time I get a much lower value, and it’s because I failed to wash my hands.
Though most studies related to diabetes and altitude concern the accuracy of blood glucose meters, there are some reports that altitude can increase insulin resistance. Our mission is to help individuals better understand their diabetes and to make our readers happier & healthier. Our mission is to help individuals better understand their diabetes and to make our readers happier and healthier. The first goal of diabetes treatment is to eliminate the symptoms and stabilize blood glucose levels.
Type 2 diabetes means that the body has insulin resistance; the fat, liver, and muscle cells do not respond correctly to insulin. If left untreated, hyperglycemia can cause damage to nerves, blood vessels, and other body organs.
Yale School of Medicine researchers have found that intensively controlling glucose (glycemic) levels in type-2 diabetes patients may not reduce the risk of kidney failure. To test the hypothesis that aggressive glycemic control can prevent renal disease in patients with type 2 diabetes mellitus, first author Steven G. The team found that compared with those who had usual treatment, intensively controlling glucose with higher doses of medication did not definitively reduce the risk of impaired kidney function, the need for dialysis, or death from kidney disease. Coca said many researchers have presumed that such intensive treatment would benefit patients by protecting the kidneys, but these results question whether patients truly are better off with this approach. According to a University of Texas study, Crazy Ants may become the dominant invasive ant species displacing Fire Ants in the near future. Scientists have successfully placed tiny synthetic motors in live human cells through nanotechnology. Diabetes is a type of lifestyle-related disease that affects many people worldwide with approximately 90% of patients being diagnosed with diabetes type 2. For those who are taking oral hypoglycaemic drugs, as well as those with type 1 diabetes (a condition where your body’s pancreas does not produce any insulin), one is strongly recommended to monitor their blood glucose levels frequently.
Monitoring blood glucose levels can help you better understand how your daily activities, medication, food, insulin, mood swing and stress influence your blood sugar levels.
Since most blood glucose monitors come with a memory to store the readings in which this data can be downloaded to a computer and hence helping a doctor to monitor and analyze so that a better treatment of diabetes can be recommended for the patient. To maintain the accuracy of the reading of a blood glucose meter, it should be recalibrated each time the reading is taken the device should be properly maintained.
You should always ask your doctor’s advice regarding correct instructions in using a glucose meter. After getting the reading from your blood glucose meter, make sure you write it down in a record book everyday so that you can better keep track of your diabetes condition. Another important point for you is that you should keep your blood glucose level as close as possible to its normal range so as to help reduce the risk of long-term complications arising from diabetes.
Note: If you are unable to perform this blood glucose testing, you can still perform urine test by using urine test strips to check the condition of your glucose levels. Blood sugar testing equipment can be found in a wide variety of places but it seems like the most popular place is at your local pharmacy. No, sometimes you can go into a pharmacy and the pharmacist won’t know anything when it comes to blood sugar testing equipment, he or she will tell you the same thing as someone on the street will and that’s what they know about something because it is a name or company that they have heard about the most. Blood sugar testing equipment is a necessity to have when you are a diabetic because without it you can’t maintain your blood sugar properly so it is very important to know about it and which ones are right for you rather than ones that are just half par.
When you are in the situation needing to purchase blood sugar testing equipment the best way to go about it is by reading online at the reviews and also go through a reputable diabetic company or one that knows all about their products and how well they work and what their reviews or other people say about them. Blood sugar testing equipment is a very staple item when it comes to being a diabetic and without it a diabetic would not be able to maintain their diabetes and blood glucose level properly without meaning extra doctor visits, poor maintained glucose readings and other medical problems could stem from this. For a diabetic, nothing is more bothersome than self-testing to monitor blood sugar levels.
Even as diabetics discuss lancet devices, painful pricks, first drop of blood, and callused fingertips, a team of researchers at the Arizona State University in collaboration with the Mayo Clinic is developing a new sensor that could make the lives of diabetes patients much easier. Led by bioengineer Jeffrey T LaBelle, a research professor in the School of Biological and Health Systems Engineering at the ASU’s Ira A. LaBelle correctly points out that the painful finger prick, which is the current norm, makes people reluctant to take the test. The research findings have been published in Journal of Diabetes Science and Technology (2:6, 307-11).
The research team comprises LaBelle, the designer of the device technology, and Mayo Clinic physicians Curtiss B. The ASU-Mayo research team began the project with funds from a seed grant from Mayo Clinic. Team members assessed how current devices were working – or failing – and how others have attempted to solve monitoring problems. The major challenges are performing the test quickly, efficiently, with reproducible results, without letting the test sample evaporate and without stimulating a stress response that causes people to rub their eyes intensely. Because of its potential impact on health care, the technology has drawn interest from BioAccel, an Arizona nonprofit that works to accelerate efforts to bring biomedical technologies to the marketplace, says a Mayo Clinic press release.
The researchers must now compile the proper data set to allow for approval of human testing of the device.
The results should help efforts to secure downstream funding for further development work from such sources as the National Institutes of Health and the Small Business Incentive Research Program, King says. BioAccel will also provide assistance using nexium otc a network of technical and business experts, including the New Venture Group, a business consulting team affiliated with the WP Carey School of Business at ASU under the supervision of associate omnicef professor Daniel Brooks.


It is intended for general information purposes only and does not address individual circumstances.
BackgroundThe two major forms of diabetes are type 1 (previously called insulin-dependent diabetes mellitus, IDDM, or juvenile-onset diabetes) and type 2 (previously called noninsulin-dependent diabetes mellitus, NIDDM, or maturity-onset diabetes).
Here, insulin and other hormones direct whether glucose will be burned for energy or stored for future use.
In type 2 diabetes, the body does not respond properly to insulin, a condition known as insulin resistance. Although insulin can attach normally to receptors on liver and muscle cells, certain mechanisms prevent insulin from moving glucose (blood sugar) into these cells where it can be used. In type 2 diabetes, the initial effect of this stage is usually an abnormal rise in blood sugar after a meal (called postprandial hyperglycemia).
This is made evident by fasting hyperglycemia, in which elevated glucose levels are present most of the time. This can cause excessive fetal weight gain, which can cause delivery complications as well as increased risk of breathing problems and higher future risk for the child to develop obesity and type 2 diabetes. Conditions that damage or destroy the pancreas, such as pancreatitis (inflammation), pancreatic surgery, or certain industrial chemicals can cause diabetes. The syndrome consists of obesity marked by abdominal fat, unhealthy cholesterol and triglyceride levels, high blood pressure, and insulin resistance.
Polycystic ovary syndrome (PCOS) is a condition that affects about 6% of women and results in the ovarian production of high amounts of androgens (male hormones), particularly testosterone. While no definitive association has been established, research has suggested an increased background risk of diabetes among people with schizophrenia. People who have pre-diabetes have fasting blood glucose levels that are higher than normal, but not yet high enough to be classified as diabetes. The oral glucose tolerance test (OGTT) is more complex than the FPG and may over-diagnose diabetes in people who do not have it. This test examines blood levels of glycosylated hemoglobin, also known as hemoglobin A1c (HbA1c). An elevated hemoglobin A1c level tells the doctor and the patient how well controlled the patients diabetes has been over the last 3 months or so. All patients with diabetes should be tested for hypertension and unhealthy cholesterol and lipid levels and given an electrocardiogram. The earliest manifestation of kidney damage is microalbuminuria, in which tiny amounts (30 - 300 mg per day) of protein called albumin are found in the urine. The American Diabetes Association recommends that patients with type 2 diabetes get an initial comprehensive eye exam by an ophthalmologist or optometrist shortly after they are diagnosed with diabetes, and once a year thereafter.
All patients should be screened for nerve damage (neuropathy), including a comprehensive foot exam. People with type 1 diabetes must coordinate calorie intake with medication or insulin administration, exercise, and other variables to control blood glucose levels.
People with diabetes, whether type 1 or 2, are at risk for a number of medical complications, including heart and kidney disease. For obese patients who cannot control weight using dietary measures alone, weight-loss drugs, such as orlistat (alli, Xenical) or sibutramine (Meridia), may be helpful. Regular exercise, even of moderate intensity (such as brisk walking), improves insulin sensitivity and may play a significant role in preventing type 2 diabetes -- regardless of weight loss.
Exercise at least 3 days a week, and do not go more than 2 consecutive days without physical activity.
Strength training, which increases muscle and reduces fat, is also helpful for people with diabetes who are able to do this type of exercise. For fastest results, frequent high-intensity (not high-impact) exercises are best for people who are cleared by their doctors.
Inject insulin in sites away from the muscles used during exercise; this can help avoid hypoglycemia. Patients who use blood pressure medication should talk to their doctors about how to balance medications and exercise. Research shows that lifestyle and medical interventions can help prevent, or at least delay, the progression to diabetes, as well as lower their risk for heart disease. Even a modest weight loss of 10 - 15 pounds can significantly reduce the risk of progressing to diabetes. Your doctor should also check your fasting blood glucose and microalbuminuria levels every year, and your hemoglobin A1c and lipids every 6 months.
Treating children with type 2 diabetes depends on the severity of the condition at diagnosis. Adding a second oral hypoglycemic is usually recommended if inadequate control is not achieved with the first medication.
Doctors recommend it as a first choice for most patients with type 2 diabetes who are insulin resistant, particularly if they are overweight.
Metformin also appears to have beneficial effects on cholesterol and lipid levels and may help protect the heart. Major studies, however, found no greater risk with metformin than with any of the other drugs used for type 2 diabetes. Combinations with small amounts of insulin or other oral anti-hyperglycemic drugs (such as metformin or a thiazolidinedione) may extend their benefits. In general, women who are pregnant or nursing or by individuals who are allergic to sulfa drugs should not use sulfonylureas.
The newer sulfonylureas, such as glimipiride, have much less risk of hypoglycemia than older sulfonylureas. They improve insulin sensitivity by activating certain genes involved in fat synthesis and carbohydrate metabolism.
Any patient who has sudden weight gain, water retention, or shortness of breath should immediately call their doctor. This is an eye condition associated with diabetic retinopathy that causes swelling in the macular area of the retina. Acarbose tends to lower insulin levels after meals, a particular advantage, since higher levels of insulin after meals are associated with an increased risk for heart disease. In such cases, it is important that the patient receive a solution that contains glucose or lactose, not table sugar.
Exenatide is an injectable drug that is a synthetic version of the hormone found in the saliva of the Gila monster, a venomous desert lizard. Exenatide stimulates insulin secretion only when blood sugar levels are high and so has less risk for causing low blood sugar (hypoglycemia) when it is taken alone. However, unlike exenatide, which is given by injection, DPP-4 inhibitor drugs are taken as pills by mouth.
The most common side effects include upper respiratory tract infection, sore throat, and diarrhea.
However, when a single oral drug fails to control blood sugar it is not clear whether it is better to add insulin replacement or a second or third oral drug. However, in patients who still have insulin reserves, there is concern that extra natural insulin will have adverse effects. In fact, insulin has been associated, in some cases, with improvement in heart risk factors. Intermediate forms (including NPH and lente) and long-acting forms (glargine, ultralente) were developed to provide a steady level of insulin throughout the day.
These include losing weight (when needed), following the Dietary Approaches to Stop Hypertension (DASH) diet, quitting smoking, limiting alcohol intake, and limiting salt intake to no more than 1,500 mg of sodium per day.
Strict control of blood pressure is critical for preventing complications of diabetes and has proven to improve survival rates.
They include atorvastatin (Lipitor), lovastatin (Mevacor and generics), pravastatin (Pravachol), simvastatin (Zocor and generics), fluvastatin (Lescol), and rosuvastatin (Crestor).
Niacin has the most favorable effect on raising HDL and lowering triglycerides of all the cholesterol drugs. Taking a daily aspirin reduces the risk for blood clotting and may help protect against heart attacks. Fortunately, severe and even moderate vision loss is largely preventable with tight control of blood glucose levels.
Patients with severe diabetic retinopathy or macular edema (swelling of the retina) should be sure to see an eye specialist who is experienced in the management and treatment of diabetic retinopathy.
In some cases, hospitalization and intravenous antibiotics for up to 28 days may be needed for severe foot ulcers. Debridement may be accomplished using chemical (enzymes), surgical, or mechanical (irrigation) means. Felted foam uses a multi-layered foam pad over the bottom of the foot with an opening over the ulcer. It is generally reserved for patients with severe, full thickness diabetic foot ulcers that have not responded to other treatments, particularly when gangrene, or an abscess, is present.
Alternative treatments, such as hypnosis, biofeedback, relaxation techniques, and acupuncture, have also been reported to help some patients manage pain. Neuropathy also impacts other functions, and treatments are needed to reduce their effects. Studies indicate that phosphodiesterase type 5 (PDE-5) drugs, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis), are safe and effective, at least in the short term, for many patients with diabetes. Strict control of these two conditions produces a reduction in new cases of nephropathy and a delay in progression of the disease. Microalbuminuria is an accumulation of protein in the blood, which can signal the onset of kidney disease (nephropathy). Protein-restricted diets can help slow disease progression and delay the onset of end-stage renal disease (kidney failure). ComplicationsPatients with diabetes have higher death rates than people who do not have diabetes regardless of sex, age, or other factors. Such abnormalities produce complications over time in many organs and structures in the body. Tight blood glucose and HbA1c control 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 possibly the heart. With this condition, the tiny filters in the kidney (called glomeruli) become damaged and leak protein into the urine.
It is a common complication that affects nearly half of people with type 1 or type 2 diabetes after 25 years. Studies show that tight control of blood glucose levels delays the onset and slows progression of neuropathy. People who have the disease for more than 20 years and are insulin-dependent are at the highest risk. Foot infections often develop from injuries, which can dramatically increase the risk for amputation.
Charcot foot or Charcot joint (medically referred to as neuropathic arthropathy) occurs in up to 2.5% of people with diabetes. When the acute phase has passed, patients usually need lifelong protection of the foot using a brace initially and custom footwear.
Problems in attention and memory can occur even in people under age 55 who have had diabetes for a number of years.
People with diabetes face a higher risk for influenza and its complications, including pneumonia, possibly because the disorder neutralizes the effects of protective proteins on the surface of the lungs.
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.
Depression, in turn, may increase the risk for hyperglycemia and complications of diabetes. Still, all patients who intensively control blood sugar (glucose) levels should be aware of warning symptoms. Hypoglycemia unawareness is a condition in which people become insensitive to hypoglycemic symptoms. Mild symptoms usually occur at moderately low and easily correctable levels of blood glucose.
Both temporary diabetes that occurs during pregnancy (gestational diabetes) and pregnancy in a patient with existing diabetes can increase the risk for birth defects. The changes in estrogen and other hormonal levels that occur during perimenopause can cause major fluctuations in blood glucose levels.
Blood glucose levels are generally more stable in type 2 diabetes than in type 1, so doctors usually recommend measuring blood levels only once or twice a day.
Most doctors believe, however, that they are accurate enough to indicate when blood sugar is too low.
Continuous glucose sensor monitors do not replace fingerstick glucose meters and test strips, but are used in combination with them. While fingerprick self-testing provides information on blood glucose for that day, the HbA1c test shows how well blood sugar has been controlled over the period of several months. ReferencesAction to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME, Byington RP, Goff DC Jr, Bigger JT, et al. Efficacy and safety of incretin therapy in type 2 diabetes: systematic review and meta-analysis. Systematic review: comparative effectiveness and safety of oral medications for type 2 diabetes mellitus. Longitudinal association between depressive symptoms and incident type 2 diabetes mellitus in older adults: the cardiovascular health study.
Diagnosis and management of prediabetes in the continuum of hyperglycemia: when do the risks of diabetes begin? Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. Review: tricyclic antidepressants, anticonvulsants, opioids, and capsaicin cream are effective treatments for diabetic neuropathy. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. Primary prevention of cardiovascular disease and type 2 diabetes in patients at metabolic risk: an endocrine society clinical practice guideline. But have you ever done everything right and still had a glucose that was too high or too low?
By taking my medication, monitoring my blood glucose, watching what I eat, and exercising, I would like to have perfect in-range values all the time. They are separated into five areas – Food, Medication, Activity, Biological factors, and Environmental factors.
Accurately counting carbs is very difficult, and getting the number wrong can dramatically affect blood glucose. On my pump, I typically use temporary basals or extended boluses (square and dual-wave) to cover high-fat meals. Though protein typically has little effect on blood glucose, in the absence of insulin, it can raise blood glucose. But when alcohol is consumed, the liver is busy breaking the alcohol down, and it reduces its output of glucose into the bloodstream. For instance, taking rapid-acting insulin (Humalog, Novolog, Apidra) 20 minutes before a meal is ideal for me - it leads to a lower spike in glucose vs. If you wear a pump and your glucose is unexpectedly high, a good first step is to change your set out. These findings are consistent with many studies, which have found that not getting enough sleep leads to worse diabetes control, insulin resistance, weight gain, and increased food intake.
As a result, more glucose is released from the liver (glucagon, adrenaline) and the body can become less sensitive to insulin (growth hormone, cortisol). Have you ever needed to correct a very high blood sugar with much more insulin than your correction factor would suggest? Many women report having higher blood sugar levels a few days prior to their period starting, but some women notice a sharp drop in sugar levels. If your insulin is normally clear, but suddenly turns cloudy, that could signal it has gone bad (note: NPH is always cloudy). I’ve found that when I go to high altitude regions like Colorado, I need about 20-30% more basal insulin. He is a graduate of the University of Pennsylvania and serves on the board of the San Francisco branch of JDRF. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy. Chronic hyperglycemia injures the heart, even in patients without a history of heart disease or diabetes.
The study, which is a review of data from seven clinical trials, is published in the May 28 issue of Archives of Internal Medicine. Coca of Yale and colleagues searched available medical literature and evaluated seven randomized trials involving 28,065 adult patients who were monitored for two to 15 years.
Frequent checking and monitoring of your glucose blood level can help you stay healthy while reducing the risk of long-term complications arising from diabetes.
These factors include overall health, age, and whether you have type 1 or type 2 diabetes mellitus. Similarly, people with type 2 diabetes (a condition when your body’s cells ignore the insulin or your pancreas does not produce enough insulin) are also advised to monitor their glucose level so that the given treatment can meet the desired goals. This info is much needed as it will aid in better management of your diabetes besides delaying or preventing diabetic complications which include kidney failure, blindness and diabetic indulged eye disease. From the blood glucose monitor, you get a reading of your blood glucose level in a digital form. Most manufacturers provide good service support but some do not, so you should look for the meter which offers the best service and technical support. It is always easier to prick on your fingertip as it is less painful to prick particularly on one side. Talk to your doctor if your blood glucose level is not within the normal range and ask him or her to suggest a good range for your blood glucose level and also what you should do to maintain a healthy blood glucose level. Everyone has a pre-thought conception that the pharmacy is the best place to purchase your diabetic supplies, but is that always true? So why run the risk of having more medical problems arising from poor glucose readings and non-maintained diabetes all because you are unsure of what blood sugar testing equipment is the best for you. Current monitoring devices typically require patients to perform the painful task of pricking their finger to draw blood for a test sample. Fulton Schools of Engineering, the team has come up with a new sensor which would enable patients to take tear fluid from their eye to test their glucose levels. Glucose in tear fluid may give an indication of glucose levels in the blood as accurately as a test using a blood sample, the research claims.
Cook, an endocrinologist, and Dharmendra (Dave) Patel, chair of Mayo’s Department of Surgical Ophthalmology. Researchers got assistance in the laboratory from ASU students involved in research at ASU’s Biodesign Institute and the Ira A. They came up with a device that can be dabbed in the corner of the eye, absorbing a small amount of tear fluid like a wick that can why take lipitor at night then be used to measure glucose. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health.
Most patients with type 2 diabetes produce variable, even normal or high, amounts of insulin. After delivery, blood sugar (glucose) levels generally return to normal, although up to 25% of these women develop type 2 diabetes within 15 years. Excess body fat appears to play a strong role in insulin resistance, but the way the fat is distributed is also significant.
Women with PCOS are at higher risk for insulin resistance, and about half of PCOS patients also have diabetes. In addition, many of the new generation of antipsychotic medications may elevate blood glucose levels. Patients who are younger than age 45 and who have certain risk factors should ask their doctors about testing. 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. Elevated levels of glycosylated hemoglobin are strongly associated with most if not all of the complications of diabetes. Microalbuminuria typically shows up in patients with type 2 diabetes who have high blood pressure. Patients who lose sensation in their feet should have a foot exam every 3 - 6 months to check for ulcers or infections. Patients should meet with a professional dietitian to plan an individualized diet within the general guidelines that takes into consideration their own health needs.
It can also help control or even stop progression of type 2 diabetes in people with the condition and reduce risk factors for heart disease. The American Diabetes Association recommends performing resistance exercise three times a week. For people who have been sedentary or have other medical problems, lower-intensity exercises are recommended. Patients with high blood pressure should also aim to breathe as normally as possible during exercise.
Metformin is a safe and effective drug because it does not cause weight gain or too-low blood sugar. For the most part, doctors should add a second drug rather than trying to push the first drug dosage to the highest levels.
Some research has suggested that it significantly reduces the risk for heart attack and death from heart disease. For adequate control of blood glucose levels, the drugs should be taken 20 - 30 minutes before a meal. These drugs are usually taken once or twice per day; however, it may take several days before the patient notices any results from them and several weeks before they take full effect. They can increase fluid build-up, which can cause or worsen heart failure in some patients. Some evidence suggests that early use of these drugs may reduce heart risk factors, including high blood pressure. Unfortunately, about a third of patients stop taking the drug because of flatulence and diarrhea, particularly after high-carbohydrate meals.
This is because acarbose inhibits the breakdown of complex sugar and starches, which includes table sugar. However, the risk for hypoglycemia increases when exenatide is taken along with a sulfonylurea drug. Pramlintide is used in combination with insulin to lower blood sugar levels in the 3 hours after meals. Low blood sugar (hypoglycemia) and weight gain are the main side effects of insulin therapy.
To date, glargine (Lantus) seems to be the most successful in achieving this goal in type 2 diabetes.
People with diabetes and risk factors for myopathy should be monitored for muscle symptoms. Combining a statin with one of these drugs may be helpful for people with diabetes who have heart disease, low HDL levels, and near-normal LDL levels. However, some patients who take high-dose niacin experience increased blood glucose levels.
It can help relieve pain but has significant side effects, including nausea, constipation, and headache.


Unfortunately, tricyclics may cause heart rhythm problems, so patients at risk need to be monitored carefully. If diabetes affects the nerves in the autonomic nervous system, then abnormalities of blood pressure control and bowel and bladder function may occur. Typical side effects are minimal but may include headache, flushing, and upper respiratory tract and flu-like symptoms. However, patients with end-stage renal disease who are on dialysis generally need higher amounts of protein. Patients on dialysis usually need injections of erythropoiesis-stimulating drugs to increase red blood cell counts and control anemia.
Although these complications tend to be more serious in type 1 diabetes, they still are of concern in type 2 diabetes. It is very important that people with diabetes control blood pressure, cholesterol levels, and other factors associated with heart disease. Symptoms of kidney failure may include swelling in the feet and ankles, itching, fatigue, and pale skin color.
The most serious consequences of neuropathy occur in the legs and feet and pose a risk for ulcers and, in unusually severe cases, amputation. Patients with diabetes should be aware of other warning signs of a heart attack, including sudden fatigue, sweating, shortness of breath, nausea, and vomiting. About 85% of amputations start with foot ulcers, which develop in about 12% of people with diabetes. Related conditions that put people at risk include peripheral neuropathy, peripheral artery disease, foot deformities, and a history of ulcers. Early changes appear similar to an infection, with the foot becoming swollen, red, and warm. People with diabetes are also at higher risk for developing cataracts and certain types of glaucoma, such as primary-open angle glaucoma (POAG). The two primary abnormalities that occur are a weakening of the blood vessels in the retina and the obstruction in the capillaries -- probably from very tiny blood clots. Everyone with diabetes should have annual influenza vaccinations and a vaccination against pneumococcal pneumonia.
It affects about 25% of patients who use insulin, nearly always people with type 1 diabetes.
In terms of sexual health, diabetes may cause decreased vaginal lubrication, which can lead to pain or discomfort during intercourse. Long-term use (more than 2 years) of birth control pills may increase the risk of health complications.
Studies indicate that high blood sugar levels (hyperglycemia) can affect the developing fetus during the critical first 6 weeks of organ development. A consensus statement from the American College of Endocrinology and the American Association of Clinical Endocrinologists. In this article, I look into the wide variety of things that can actually affect blood glucose - at least 22!
I’ve provided arrows to show the general effect these factors have on my blood glucose (a sideways arrow indicates a neutral effect), but emphasize that not every individual will respond in the same way (and even within the same person, you may be different from day-to-day or over time). The type of carbohydrate also matters – higher glycemic index carbs tend to spike blood glucose more rapidly. This effect is most notable if you eat a lot of fat at one time – for instance, when snacking on nuts, I’ll observe a steady rise in blood glucose over many hours.
This can lead to a drop in blood sugar levels if the alcohol was consumed on an empty stomach.
During this time, the body makes less insulin and produces more glucagon, which raises blood glucose. I find that my glucose always tends to run higher on the third day of wearing an infusion set. In some cases, people are much more insulin sensitive right before getting sick and can tend to run low blood sugars. I find that simply having a high blood glucose for many hours makes me appear much more insulin resistant. To figure out how you respond, your best bet is to test your blood glucose often during this time of month. Aside from a change in appearance, it can be hard to know if a vial of insulin has actually gone bad unless you try a new one.
I recommend retesting if you don’t believe the value on the meter; if you wear CGM, it’s great to reality check the meter value against your sensor reading.
He was diagnosed with type 1 diabetes at the age of 12 and has worn an insulin pump for the last 12 years and a CGM for the past four years. It is also strongly associated with heart attacks and death in subjects with no coronary heart disease or history of heart failure. Monitoring diabetes or blood glucose level is important to help monitor how much glucose present in your blood. Personal preferences and your understanding regarding your health condition can help you better target your blood glucose level. Many blood glucose monitors come with different features with some of them made specifically for those who have poor eyesight or other disabilities. It is always advisable to ask your doctor which area (such as thigh, or forearm) should be used with your meter. Certainly, in most cases, ‘acceptable’ blood glucose levels can be slightly varied from one individual to another. You may also need to advise your doctor about what you have eaten, how active you are during the day, and how medications affect your insulin when discussing your glucose level with them, so that they can help you manage your diabetes or blood glucose level. This new technology nexium might encourage patients to check their blood sugars more often, which could lead to better control of their diabetes by a simple touch to the eye,” says LaBelle. To avoid life-threatening complications, people with type 1 diabetes must take some form of insulin for their entire lives. Never ignore professional medical advice in seeking treatment because of something you have read on the BootsWebMD Site.
CausesType 2 diabetes is caused by insulin resistance, in which the body does not properly use insulin. Certain drugs can also cause temporary diabetes, including corticosteroids, beta blockers, and phenytoin. Weight concentrated around the abdomen and in the upper part of the body (apple-shaped) is associated with insulin resistance and diabetes, heart disease, high blood pressure, stroke, and unhealthy cholesterol levels. Patients taking antipsychotic medications (such as clozapine, olanzapine, risperidone, aripiprazole, quetiapine fumarate, ziprasidone) should receive a baseline blood glucose level test and be monitored for any increases during therapy.
Patients should lose weight if their body mass index (BMI) is 25 - 29 (overweight) or higher (obese).
The heart-protective effects of aerobic exercise are also important, even if patients have no risk factors for heart disease other than diabetes itself.
Build up to three sets of 8 - 10 repetitions using weight that you cannot lift more than 8 - 10 times without developing fatigue.
It is also the first choice for children who need oral drugs and is helpful for women with polycystic ovary syndrome and insulin resistance.
A number of brands are available, including chlorpropamide (Diabinese), tolazamide (Tolinase), acetohexamide (Dymelor), glipizide (Glucotrol), tolbutamide (Orinase), glyburide (Micronase), glimepiride (Amaryl), and repaglinide (Prandin).
Glucovance may be particularly beneficial for patients with unhealthy cholesterol levels and poor control of their blood sugar levels. If taken before every meal, they actually mimic the normal effects of insulin after eating. Most patients who had this side effect also had swelling in the feet and legs (peripheral edema).
Alpha-glucosidase inhibitors are not as effective alone as other single oral drugs, but combinations, such as with metformin, insulin, or a sulfonylurea, increase their effectiveness. It is prescribed for patients with type 2 diabetes who have not been able to control their glucose with metformin or a sulfonylurea drug. There does not appear to be a risk for hypoglycemia when exenatide is used along with metformin. Patients who feel severe stomach pain that does not go away should seek prompt medical attention.
It is still not clear if insulin replacement improves survival rates compared to oral drugs, notably metformin. They are taken before meals, and their short action reduces the risk for hypoglycemia afterward. Although combinations of statins and fibrates or niacin increase the risk of myopathy, both combinations are considered safe if used with extra care.
Moderate doses of niacin can achieve lipid control without causing serious blood glucose problems. Erythromycin, domperidone (Motilium), or metoclopramide (Reglan) may be used to relieve delayed stomach emptying caused by neuropathy. However, these drugs -- darbepoetin alfa (Aranesp) and epoetin alfa (Epogen and Procrit) -- can increase the risk of blood clots, stroke, heart attack, and heart failure in patients with end-stage kidney disease when they are given at higher than recommended doses.
Urine tests showing microalbuminuria (small amounts of protein in the urine) are important markers for kidney damage. Peripheral neuropathy usually starts in the fingers and toes and moves up to the arms and legs (called a stocking-glove distribution).
Lowering triglycerides, losing weight, reducing blood pressure, and quitting smoking may help prevent the onset of neuropathy.
Numbness from nerve damage, which is common in diabetes, compounds the danger since the patient may not be aware of injuries. If these processes affect the central portion of the retina, swelling may occur, causing reduced or blurred vision. In this more severe condition, new abnormal blood vessels form and grow on the surface of the retina. Hypoglycemia may also be caused by insufficient intake of food, or excess exercise or alcohol. In such cases, hypoglycemia appears suddenly, without warning, and can escalate to a severe level. Thiazolidinediones can prompt renewed ovulation in premenstrual women who are not ovulating, and can weaken the effect of birth control pills. 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. Home tests are also available for measuring A1C but they tend not to be as accurate as the laboratory tests ordered by doctors. Shoes with a rocker sole reduce pressure under the heel and front of the foot and may be particularly helpful. There are all kinds of factors that affect blood glucose, many of which are impossible to control, remember, or even account for.
Note that this works best for me, although this can vary among individuals – please consult your health care provider to discuss the optimal timing of insulin. But this is not a reason to avoid high intensity exercise – studies show it can improve blood glucose for one to three days post-exercise! The best way to figure out how dawn phenomenon affects you is to wear a CGM or wake up and test your blood glucose early in the morning.
In addition, I tend to get the best absorption wearing sets in my buttocks and the worst absorption in my legs – yet again, this varies among patients. Personally, I have found exercise, time outside, and meditation to be most helpful against combatting stress. I’ve found that insulin that has “gone bad” will typically still work, but just not as well – I may need more insulin than I think to bring my glucose down, and the insulin may work unpredictably. The diabetes online community has also done a lot of work advocating for more accurate blood glucose testing supplies – you can read more about their campaign here. Adam is passionate about exercise, nutrition, and wellness and spends his free time outdoors and staying active. Therefore, it is particularly important for you to discuss with your doctor which one suits you best.
Indeed, comments in one TuDiabetes forum over the past 6 weeks have underscored this issue. Generally, diabetes type 2 is thought to result from a combination of genetic factors along with lifestyle factors such as obesity, high alcohol intake, and being sedentary. Waist circumferences greater than 35 inches in women and 40 inches in men have been specifically associated with a greater risk for heart disease and diabetes.
A doctor uses the results from a creatinine blood test to calculate the glomerular filtration rate (GFR). Patients with diabetes should monitor their carbohydrate intake either through carbohydrate counting or meal planning exchange lists. Limit trans-fats (hydrogenated fat found in snack foods, fried foods, commercially baked goods) to less than 1% of total calories.
MedicationsMany anti-hyperglycemic drugs are available to help patients with type 2 diabetes control their blood sugar levels. Thiazolidinediones available as 2-in-1 pills include rosiglitazone and metformin (Avandamet), rosiglitazone and glimepiride (Avandaryl), and pioglitazone and glimepiride (Duetact). In rare cases, exenatide has been associated with hemorrhagic and necrotizing pancreatitis, which can potentially be life threatening. The bones may crack, splinter, and erode, and the joints may shift, change shape, and become unstable.
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.
Even a single recent episode of hypoglycemia may make it more difficult to detect the next episode. It is also important for women to closely monitor their blood sugar levels during pregnancy. The bottom line is that diabetes is very complicated, and for even the most educated and diligent patients, it’s nearly impossible to keep track of everything that affects blood glucose.
When drinking alcohol, make sure you test your blood glucose often and that someone responsible nearby knows you have diabetes. If you take insulin, you may need to time your dose to cover this early morning rise in glucose. Babies can develop candidiasis, a severe form of nappy rash caused by yeast that can easily spread from the nappy area to the thighs and stomach. The GFR is an indicator of kidney function; it estimates how well the kidneys are cleansing the blood. Most of these drugs are aimed at using or increasing sensitivity to the patient's own natural stores of insulin. 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. Major hemorrhage or retinal detachment can result, causing severe visual loss or blindness. With vigilant monitoring and by rigorously avoiding low blood glucose levels, patients can often regain the ability to sense the symptoms.
For women with type 2 diabetes who take insulin, pregnancy can affect their insulin dosing needs. So when you see an out-of-range glucose value, don’t judge yourself – use it as information to make better decisions.
The best way to see how a factor affects you is through personal experience – test your blood glucose more often or wear a CGM and look for patterns. The best way to see how individual exercise sessions affect your blood glucose is to test prior and after activity. According to the FDA, insulin can be left unrefrigerated at a temperature from 59-86 °F for up to 28 days.
It is also common among people in countries where weights tend to be low, such as Asia or India.
Instead of resting an injured foot or seeking medical help, the patient often continues normal activity, causing further damage. However, even very careful testing may fail to detect a problem, particularly one that occurs during sleep. More dangerous signs: KetoacidosisWithout treatment, type 1 diabetes deprives your cells of the sugar they need for energy. In addition, 57 million Americans have pre-diabetes, a condition that increases the risk for developing diabetes.
Patients who take rosiglitazone, especially those who have heart disease or who are at high risk for heart attack, should talk to their doctor about their treatment options.
Your body starts burning fat for energy instead, which causes ketones to build up in the blood and urine. Type 2 diabetes used to mainly develop after the age of 40, but it is now increasing in younger people and children. High levels of these acids in the body and the other abnormalities that result from the change in your blood's pH level may trigger a life-threatening coma known as diabetic ketoacidosis. The symptoms of the two forms are similar, but usually come on more rapidly in people with type 1. What causes type 1 diabetes?Doctors aren't sure what makes the immune system turn against the pancreas, but most suspect a combination of genetic susceptibility and environmental factors.
Scientists have identified 50 genes or gene regions that increase the risk of developing type 1 diabetes. But genetics alone doesn't account for all the risk, so having these genes doesn't mean that you'll develop type 1 diabetes. Some researchers believe that environmental triggers, such as a virus, or dietary or pregnancy-related factors may play a role as well. However, it accounts for two-thirds of the new cases of diabetes diagnosed in those under the age of 19. There appear to be two peaks in the "age of onset": the first in early childhood and the second during puberty. The condition affects males and females equally, but is more common in whites than in other ethnic groups. According to the World Health Organisation, type 1 diabetes is rare in most African and Asian populations. A fasting blood sugar test or a random blood sugar test (plus the presence of symptoms) can be used. An HbA1c test, which reveals average blood sugar levels for the past 6-12 weeks, can also be used. A less convenient glucose tolerance test will also help determine whether you have diabetes. Long-term complicationsProlonged high blood sugar can damage many of the body's systems over time. This involves pricking your finger, putting a drop of blood on to a test strip, and putting the strip into a glucose meter. When your blood sugar stays near the normal range, you'll have more energy, fewer skin problems, and a reduced risk of heart disease and kidney damage. Continuous glucose monitoringAnother way to check blood sugar patterns is with a continuous glucose monitoring system. A sensor measures the level of glucose in the tissue every 10 seconds and sends the information to a cell phone-sized device called a "monitor" that you wear.
The system automatically records an average glucose value every five minutes for up to 72 hours. Diabetes treatment: Insulin injectionsEveryone with type 1 diabetes must take insulin to help the body process blood sugar. Your doctor will explain how to adjust your insulin dose based on the results of your blood sugar testing. Insulin reaction warning signsTaking too much insulin can lower your blood sugar to dangerous levels. Always carry a few with you when you go out in case hypoglycaemia, or low blood sugar, strikes.
Skipping a meal, taking too much diabetes medication and exercising harder than usual without eating can trigger it.
Diabetes treatment: Insulin pumpOne way to reduce the odds of a ‘hypo’ is to use an insulin pump. An insulin pump can help keep your blood sugar more stable and may allow more flexibility in planning your meals. Insulin pumps do have some disadvantages, so talk to your doctor to learn if this option is right for you.
How well is your treatment working?To find out how well your treatment is working, your doctor will probably suggest you have regular HbA1c blood tests.
This test reveals how well your blood sugar has been controlled over the past six to twelve weeks.
If the results show poor blood sugar control, you may need to adjust your insulin therapy, meal planning or physical activity.
Pancreatic islet cell transplantStill an experimental procedure, a surgeon transfers healthy insulin-producing cells from a donor, usually into the liver of someone with type 1 diabetes.
The drugs required to prevent rejection of the transplant can have serious side effects, so the procedure is only suitable for people with extreme difficulty controlling their blood sugar. Type 1 diabetes and exercisePeople with type 1 diabetes need to take precautions when exercising. Type 1 diabetes and dietThere are many myths about what people with diabetes can and cannot eat. The key is to work with your doctor to balance your insulin therapy, meals and level of physical activity.
When type 1 diabetes is poorly controlled, it can cause complications, including birth defects.
Achieving good blood sugar control before conception lowers the risk of miscarriage and birth defects to a rate similar to that of the general population.
It also reduces the risk of complications, such as dangerous increases in blood pressure and damage to the retina in the mother. Type 1 diabetes in childrenWhen a child is diagnosed with diabetes, it affects the whole family in a very practical way. Parents must help children monitor blood sugar, plan meals, and adjust insulin dosages around the clock. Because diabetes requires 24-hour management, arrangements must be made for treatment during school and after-school activities. Diabetes UK says it’s important to tell teachers about a child’s condition so they can help with care.
Hope for an artificial pancreasResearchers are developing an artificial pancreas -- a combination of an insulin pump and continuous glucose monitor controlled by a complex computer program.
The goal is for the system to automatically release insulin in response to blood sugar levels, and to reduce the release of insulin when blood sugar levels drop, just the way a real pancreas does.



Glucose level log sheet
Lower my blood sugar now what
Needleless glucose blood sugar monitor
Symptoms of your blood sugar being too high symptoms


Comments

  1. 10.08.2015 at 11:15:22


    Simple glucometer machine, using a finger prick.

    Author: OCEAN
  2. 10.08.2015 at 10:55:44


    Testing errors are related to the storage of strips) loss.

    Author: BIG_BOSS
  3. 10.08.2015 at 19:20:10


    Neuroglycopenic symptoms a study published in the British Medical Journal sugar (glucose.

    Author: polad_8_km