Diabetes experts feel that these blood glucose monitoring devices give patients a significant amount of independence to manage their disease process; and they are a great tool for education as well. It is also important to remember that these devices can be used intermittently with fingerstick measurements. For example, a well-controlled patient with diabetes can rely on fingerstick glucose checks a few times a day and do well. If they become ill, if they decide to embark on a new exercise regimen, if they change their diet and so on, they can use the sensor to supplement their fingerstick regimen, providing more information on how they are responding to new lifestyle changes or stressors. This kind of system takes us one step closer to closing the loop, and to the development of an artificial pancreas that senses insulin requirements based on glucose levels and the body's needs and releases insulin accordingly - the ultimate goal.
Diabetes is among the leading causes of kidney failure, but its frequency varies between populations and is also related to the severity and duration of the disease. Several measures to slow down the progress of renal damage have been identified. They include control of high blood glucose, control of high blood pressure, intervention with medication in the early stage of kidney damage, and restriction of dietary protein. Screening and early detection of diabetic kidney disease are an important means of prevention.
The most common complication of treating high blood glucose levels is low blood glucose levels (hypoglycemia). The risk is greatest for older people who are frail, who are sick enough to require frequent hospital admissions, or who are taking several drugs. Of all available drugs to treat diabetes, long-acting sulfonylurea drugs are most likely to cause low blood glucose levels in older people. When they take these drugs, they are also more likely to have serious symptoms, such as fainting and falling, and to have difficulty thinking or using parts of the body due to low blood glucose levels.
Hypoglycemia means abnormally low blood sugar (glucose). In patients with diabetes, the most common cause of low blood sugar is excessive use of insulin or other glucose-lowering medications, to lower the blood sugar level in diabetic patients in the presence of a delayed or absent meal. When low blood sugar levels occur because of too much insulin, it is called an insulin reaction. Sometimes, low blood sugar can be the result of an insufficient caloric intake or sudden excessive physical exertion.
5. Signs and symptoms ofhyperglycemiaandhypoglycemia, and measures to take when they occur. (See accompanying table.) It is important for patients to become familiar with specific signs that are unique to themselves. Each person responds differently and may exhibit symptoms different from those experienced by others. It should be noted that the signs and symptoms may vary even within one individual. Thus it is vital that the person understand all reactions that could occur. When there is doubt, a simple blood glucose reading will determine the actions that should be taken.
The roots of type 2 diabetes remain in insulin resistance and pancreatic failure, and the blame for the current diabetes epidemic lies in an overall dietary pattern emphasizing meat, dairy products, and fatty foods, aided and abetted by sugary foods and beverages, rather than simply in sugar alone. A diet emphasizing vegetables, fruits, whole grains, and legumes and avoiding animal products helps prevent diabetes and improves its management when it has been diagnosed.
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An article published in November 2012 in the journal Global Public Health found that countries with more access to HFCS tended to have higher rates of the disease. Though it’s likely that these countries’ overall eating habits play a role in their populations’ diabetes risk, a study published in February 2013 in the journal PLoS One found limiting access to HFCS in particular may help reduce rates of the diagnosis.
Louis B. Malinow, MD is an MDVIP-affiliated physician that's been practicing in Baltimore for more than 20 years. He's board certified in Internal Medicine, a certified Hypertension Specialist and a Diplomate of the American Board of Clinical Lipidology. Dr. Malinow graduated from the University of Maryland School of Medicine and completed his residency at Stanford University Hospital in Stanford, CA. Dr. Malinow is one of the only physicians in Maryland that specializes in both high blood pressure and high cholesterol management. He is also a member of the prestigious Alpha Omega Alpha medical honor society and is recognized by Best Doctors and Top Doctor by U.S. News & World Report and Baltimore Magazine. Dr. Malinow has appeared on numerous news programs advocating for preventive care and wellness.
While poor vision is hardly uncommon—more than 60 percent of the American population wears glasses or contacts, after all—sudden changes in your vision, especially blurriness, need to be addressed by your doctor. Blurry vision is often a symptom of diabetes, as high blood sugar levels can cause swelling in the lenses of your eye, distorting your sight in the process. Fortunately, for many people, the effect is temporary and goes away when their blood sugar is being managed.
There are a number of medications and other health problems that can predispose to diabetes. Some of the medications include: glucocorticoids, thiazides, beta blockers, atypical antipsychotics, and statins. Those who have previously had gestational diabetes are at a higher risk of developing type 2 diabetes. Other health problems that are associated include: acromegaly, Cushing's syndrome, hyperthyroidism, pheochromocytoma, and certain cancers such as glucagonomas. Testosterone deficiency is also associated with type 2 diabetes.
Type 1 diabetes has some connection to your family genes, but that doesn't mean you'll get it if one of your parents had it. "Since not all identical twins get diabetes, we do think that exposure to an additional environmental factor may trigger an immune response that ultimately causes destruction of the insulin-producing cells of the pancreas," says Dr. Sarah R. Rettinger, an endocrinologist with Providence Saint John's Health Center in Santa Monica, California.
Originally described in approximately 30% of patients with type 1 diabetes mellitus, limited joint mobility occurs in 50% of patients older than age 10 years who have had diabetes for longer than 5 years. The condition restricts joint extension, making it difficult to press the hands flat against each other. The skin of patients with severe joint involvement has a thickened and waxy appearance.
The good news is that if you have diabetes, you have a great amount of control in managing your disease. Although it can be difficult to manage a disease on a daily basis, the resources and support for people with diabetes is endless. It's important for you to receive as much education as possible so that you can take advantage of all the good information that is out there (and weed out the bad).
Although there are dozens of known type 1 genes, about half of the risk attributable to heredity comes from a handful that coordinate a part of the immune system called HLA, which helps the body recognize nefarious foreign invaders, such as viruses, bacteria, and parasites. Type 1 diabetes is an autoimmune disease, in which the body's own immune system destroys the cells in the pancreas that produce insulin, so perhaps it is no surprise that immunity genes are involved. Other autoimmune diseases share the HLA gene link, which may be why people with type 1 are more likely to develop additional autoimmune disorders.
All children with type 1 diabetes mellitus require insulin therapy. Most require 2 or more injections of insulin daily, with doses adjusted on the basis of self-monitoring of blood glucose levels. Insulin replacement is accomplished by giving a basal insulin and a preprandial (premeal) insulin. The basal insulin is either long-acting (glargine or detemir) or intermediate-acting (NPH). The preprandial insulin is either rapid-acting (lispro, aspart, or glulisine) or short-acting (regular).
There is strong evidence that the long-term complications are related to the degree and duration of metabolic disturbances.2 These considerations form the basis of standard and innovative therapeutic approaches to this disease that include newer pharmacologic formulations of insulin, delivery by traditional and more physiologic means, and evolving methods to continuously monitor blood glucose to maintain it within desired limits by linking these features to algorithm-driven insulin delivery pumps for an “artificial pancreas.”
Diabetes develops when the body can't make any or enough insulin, and/or when it can't properly use the insulin it makes. For some people with diabetes, the body becomes resistant to insulin. In these cases, insulin is still produced, but the body does not respond to the effects of insulin as it should. This is called insulin resistance. Whether from not enough insulin or the inability to use insulin properly, the result is high levels of glucose in the blood, or hyperglycemia.
Get to Know Your Medications: If you have diabetes, it is important to know and understand what your medications do. This can help to keep blood sugars controlled and prevent low and high blood sugars. Certain medicines need to be taken with food, or they will cause your blood sugar will drop. There are so many diabetes medications out there. Being your own advocate can help you. Make sure to tell your doctor if your medications are too expensive or if they are causing any side effects. If your medication regimen is not working for you, odds are your doctor can find a new medicine that might work better.
There are other factors that also fall into the category of environmental (as opposed to genetic) causes of diabetes. Certain injuries to the pancreas, from physical trauma or from drugs, can harm beta cells, leading to diabetes. Studies have also found that people who live in polluted areas are prone to type 2, perhaps because of inflammation. And an alternate theory of insulin resistance places the blame on damage caused by inflammation. Age also factors into type 2; beta cells can wear out over time and become less capable of producing enough insulin to overcome insulin resistance, which is why older people are at greater risk of type 2.
Type 2 diabetes is usually associated with being overweight (BMI greater than 25), and is harder to control when food choices are not adjusted, and you get no physical activity. And while it’s true that too much body fat and physical inactivity (being sedentary) does increase the likelihood of developing type 2, even people who are fit and trim can develop this type of diabetes.2,3
In this health topic, we discuss hyperglycemic hyperosmolar nonketotic syndrome (HHNS), an extremely serious complication that can lead to diabetic coma and even death in type 2 diabetes. This serious condition occurs when the blood sugar gets too high and the body becomes severely dehydrated. To prevent HHNS and diabetic coma in type 2 diabetes, check your blood sugar regularly as recommended by your health care provider; check your blood sugar more frequently when you are sick, drink plenty of fluids, and watch for signs of dehydration.