Talking to a counselor or therapist may help you cope with the lifestyle changes that come with a type 2 diabetes diagnosis. You may find encouragement and understanding in a type 2 diabetes support group. Although support groups aren't for everyone, they can be good sources of information. Group members often know about the latest treatments and tend to share their own experiences or helpful information, such as where to find carbohydrate counts for your favorite takeout restaurant. If you're interested, your doctor may be able to recommend a group in your area.
A random blood sugar of greater than 11.1 mmol/l (200 mg/dl) in association with typical symptoms or a glycated hemoglobin (HbA1c) of ≥ 48 mmol/mol (≥ 6.5 DCCT %) is another method of diagnosing diabetes. In 2009 an International Expert Committee that included representatives of the American Diabetes Association (ADA), the International Diabetes Federation (IDF), and the European Association for the Study of Diabetes (EASD) recommended that a threshold of ≥ 48 mmol/mol (≥ 6.5 DCCT %) should be used to diagnose diabetes. This recommendation was adopted by the American Diabetes Association in 2010. Positive tests should be repeated unless the person presents with typical symptoms and blood sugars >11.1 mmol/l (>200 mg/dl).
Aspirin should be used as secondary prophylaxis in all diabetic people with evidence of macrovascular disease, and it should be strongly considered as primary prevention in diabetic subjects with other risk factors for macrovascular disease, such as hypertension, cigarette smoking, dyslipidemia, obesity, and albuminuria (macro or micro).228 Because of the platelet defects associated with diabetes, it is recommended that the dose of aspirin should be 300 mg per day,228–230 although the American Diabetes Association’s position statement (http://www.diabetes.org/DiabetesCare/supplement198/s45.htm) advocates a dose of 81 to 325 mg enteric-coated aspirin per day. If the patient cannot tolerate aspirin, then clopidogrel231 can be used.
In type 2 diabetes (adult onset diabetes), the pancreas makes insulin, but it either doesn't produce enough, or the insulin does not work properly. Nine out of 10 people with diabetes have type 2. This type occurs most often in people who are over 40 years old but can occur even in childhood if there are risk factors present. Type 2 diabetes may sometimes be controlled with a combination of diet, weight management and exercise. However, treatment also may include oral glucose-lowering medications (taken by mouth) or insulin injections (shots).
Hyperglycemia (ie, random blood glucose concentration of more than 200 mg/dL or 11 mmol/L) results when insulin deficiency leads to uninhibited gluconeogenesis and prevents the use and storage of circulating glucose. The kidneys cannot reabsorb the excess glucose load, causing glycosuria, osmotic diuresis, thirst, and dehydration. Increased fat and protein breakdown leads to ketone production and weight loss. Without insulin, a child with type 1 diabetes mellitus wastes away and eventually dies due to DKA. The effects of insulin deficiency are shown in the image below.
One of the key factors in Joslin’s treatment of diabetes is tight blood glucose control, so be certain that your treatment helps get your blood glucose readings as close to normal as safely possible. Patients should discuss with their doctors what their target blood glucose range is. It is also important to determine what your goal is for A1C readings (a test that determines how well your diabetes is controlled over the past 2-3 months). By maintaining blood glucose in the desired range, you’ll likely avoid many of the complications some people with diabetes face.
Can diabetes be prevented? Why are so many people suffering from it now over decades past? While there will never be anyway to possibly avoid genetic diabetes, there have been cases where dietary changes could perhaps have been made to delay or prevent the ailment from further developing. Doctors report that obesity plays a role, as well as activity levels, and even overall mental health often can be common threads of pre-diabetic patients.
Doctors can monitor treatment using a blood test called hemoglobin A1C. When the blood glucose levels are high, changes occur in hemoglobin, the protein that carries oxygen in the blood. These changes are in direct proportion to the blood glucose levels over an extended period. The higher the hemoglobin A1C level, the higher the person's glucose levels have been. Thus, unlike the blood glucose measurement, which reveals the level at a particular moment, the hemoglobin A1Cmeasurement demonstrates whether the blood glucose levels have been controlled over the previous few months.
Which came first: the diabetes or the PCOS? For many women, a diagnosis of polycystic ovary syndrome means a diabetes diagnosis isn’t far behind. PCOS and diabetes are both associated with insulin resistance, meaning there are similar hormonal issues at play in both diseases. Fortunately, managing your PCOS and losing weight may help reduce your risk of becoming diabetic over time.
People with full-blown type 2 diabetes are not able to use the hormone insulin properly, and have what’s called insulin resistance. Insulin is necessary for glucose, or sugar, to get from your blood into your cells to be used for energy. When there is not enough insulin — or when the hormone doesn’t function as it should — glucose accumulates in the blood instead of being used by the cells. This sugar accumulation may lead to the aforementioned complications.