Diabetes: Managing Your Condition

Diabetes is a condition where people don't produce enough insulin, or their cells don't respond properly to insulin. Insulin is an important hormone produced by the pancreas that moves glucose, a type of sugar, into the body's cells from the blood. Once inside the body's cells, glucose is used as a source of energy. If insulin isn't available or doesn't work correctly to move glucose from the blood into cells, glucose will stay in the blood. Blood sugar levels will then increase.

In Canada, almost 3.4 million people have diabetes, and about 20% to 40% of those with the condition are unaware that they have it. According to Diabetes Canada, 5 million people in Canada will have diabetes by the year 2025.

There are 3 main kinds of diabetes: type 1 diabetes, type 2 diabetes, and gestational diabetes. Type 1 diabetes is usually diagnosed in children and adolescents, and occurs when the pancreas cannot make insulin. Everyone with type 1 diabetes needs to take insulin on a daily basis. It’s estimated that around 10% of all people with diabetes have type 1.

Type 2 diabetes occurs when the pancreas does not make enough insulin or the body does not use insulin properly. It usually occurs in adults, although in some cases, children may be affected. People with type 2 diabetes are treated with lifestyle changes (diet and exercise) and may require diabetes medications or insulin. Approximately 90% of all people with diabetes have type 2. Type 2 diabetes is very closely linked to body weight and obesity, which can increase the risk of complications from diabetes.

Gestational diabetes is a temporary type of diabetes that is first diagnosed during pregnancy. About 2% to 4% of pregnancies are affected by gestational diabetes. If a woman has gestational diabetes, both she and her baby have a higher risk of developing diabetes later on.

Diabetes Canada estimates that at least 5.7 million Canadians (22%) are living with prediabetes. A person with prediabetes has blood sugar (glucose) levels that are higher than normal but not high enough to be diagnosed with type 2 diabetes. As in type 2 diabetes, the body produces insulin, but there may be less of it, or the body does not use insulin properly. Not everyone with prediabetes will go on to develop type 2 diabetes, however many people will.

Studies have shown that keeping blood sugar levels as close to the normal range as possible can help prevent the long-term health problems associated with diabetes, such as nerve damage, kidney disease, and blindness. Whichever type of diabetes you have, you'll need to measure your blood sugar regularly and follow a treatment plan to keep your blood sugar under control. Your doctor and pharmacist can show you how to monitor blood sugar levels. See our disease database articles on diabetes for more information.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Diabetes-Managing-Your-Condition

Management is different for type 1 and type 2 diabetes.

Managing type 1 diabetes involves:

• taking insulin as recommended on a daily basis (through injections or an insulin pump) so that your body can regulate your blood sugar levels
• following your doctor's advice about regulating your carbohydrate intake and getting appropriate exercise
• monitoring your blood sugar levels regularly. Blood glucose monitors, flash glucose monitoring systems and continuous glucose monitoring systems are very convenient for this purpose.
• monitoring A1C, which measures your blood sugar control over time. Your doctor will do this test every 3 months (or every 6 months if your blood sugar is consistently controlled) to see how effectively you're managing your blood sugar levels.

Your dose of insulin will be tailored to your individual needs based on several factors, including your age, lifestyle, meal plan, and activity level. The goal is to try to maintain blood sugar levels as close to normal as possible.

Managing type 2 diabetes involves:

• eating healthy meals and snacks
• weight control and regular exercise
• taking diabetes medications and/or insulin, if prescribed
• monitoring your blood sugar levels regularly
• monitoring A1C

If you have type 2 diabetes, your doctor may prescribe oral (taken by mouth) or injectable medications. There are many kinds of diabetes medications. All of them work differently, but each lowers blood glucose. Ask your doctor which medication or combination of medications is most appropriate for you.

Eating an appropriate, well-balanced diet and exercising regularly is especially important in managing type 2 diabetes. Read more about this in "Nutrition and exercise to control diabetes" in this health feature.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Diabetes-Managing-Your-Condition

Controlling diabetes is closely linked to diet and lifestyle.

Healthy eating

• Smart food choices help keep blood sugar, weight, and cholesterol in better control. Focus on eating a variety of healthy foods each day, including vegetables, fruits, whole grains, and protein foods. Limit the amount of highly processed foods you eat.
• The amounts of fat, carbohydrate (fruits, vegetables, breads and grains) and protein (meat, fish, milk, nuts) you eat depend on your calorie needs and goals for weight control. A healthy diet usually includes eating plenty of vegetables and fruit (about half of your plate), protein foods, and whole grain foods.
• Always read the labels to help guide your choices. Prepare meals and snacks containing little-to-no added sugar, salt, or saturated fat. Try to read the fine print!
• Just one alcoholic beverage on an empty stomach can lower your blood sugar drastically. Sip drinks slowly and always drink alcohol with some carbohydrate containing foods in your stomach. Limit yourself to no more that 2 standard drinks a day for women and 3 standard drinks a day for men. Be careful when consuming liqueurs, coolers, and certain mixes which have high sugar content.
• Enjoy sweets in moderation: People with diabetes don't have to avoid sugar all together. You can still enjoy a cookie, a piece of cake, or chocolate every now and then. Talk to your health care professional about how to safely incorporate sweets into your diet.

Exercising

• Exercise usually lowers blood sugar. It can improve your blood sugar control and improve your health and energy.
• Ask your doctor about the right kind of exercise for you. Get a check-up if you're starting out, and avoid overdoing it. Gradually increasing your levels of physical activity helps prevent injuries while maintaining your enthusiasm to continue exercising.
• Check blood sugar levels before and after you exercise. This helps avoid low blood sugar. Monitoring your blood sugar can help determine how different types of activities affect sugar levels.
• Try walking, swimming, and light weight-lifting exercises for physical activity.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Diabetes-Managing-Your-Condition

How often people living with diabetes should test their blood glucose levels will depend on factors like the medications that they take and their overall blood glucose level control. Diabetes Canada recommends that people with diabetes who are using insulin once a day should check their blood glucose levels at least once daily at different times throughout the week. People who use insulin more than once a day should check their blood glucose levels at least 3 times per day, and include a mix of readings taken both before and after eating. Depending on their blood glucose level control, those who are not taking insulin might be asked to check their blood glucose levels every 1 to 3 months, when they're feeling sick, or in situations where their blood glucose levels may rise, such as if they're taking steroid medications. It's best to clarify with your doctor or primary health care provider if you're not sure how often you should be checking your blood glucose levels.

A blood glucose monitor, flash glucose monitor, or continuous glucose monitor can be used to test blood glucose at home and to determine whether blood glucose levels are in the target range. Many types of glucose meters and monitors can be obtained at pharmacies. Testing glucose levels helps put the person with diabetes in control and be more active in managing their condition. Using glucose monitors to determine the effects of certain foods on blood glucose levels can also help a person with diabetes to choose appropriate foods more carefully.

A person with diabetes should talk with their diabetes educator or pharmacist about which model of glucose meter is appropriate for them. Anyone using a glucose meter should receive proper training so that they can test their blood glucose levels properly.

Ask a diabetes educator about:

• how and where to draw blood
• how to use lancets and dispose of them
• the size of the drop of blood needed and where to draw blood
• the type of blood glucose strips to use
• how to check if the meter is accurate
• how to clean the meter

If you're using a flash glucose monitor or continuous glucose monitor, there are other considerations to keep in mind. Ask your diabetes educator about information relating to topics such as applying or replacing your sensors and how to obtain your blood glucose readings.

If a person with diabetes experiences symptoms of hypoglycemia (i.e., low blood glucose), they should check their blood glucose immediately. Common symptoms of low blood sugar include trembling, sweating, confusion, anxiety, and nausea. If a meter is not immediately available, the symptoms should still be treated with the following guidelines:

• Eat or drink a fast-acting carbohydrate (15 g):
• 3 to 5 glucose tablets (the exact amount will depend on the glucose content per tablet of the brand you have; check to make sure you are aware of this amount and take enough to make up 15 g of glucose)
• 2/3 cup (150 mL) of juice or regular soft drink
• 1 tablespoonful (15 mL) honey
• 15 g fast acting sugar (e.g., 6 Life Savers® or 2 rolls Rocket Candy)
• 3 teaspoons (15 mL) or 3 packets of table sugar dissolved in water
• Wait 15 minutes, then check blood glucose again. If it is still low (below 4.0 mmol/L), treat with additional carbohydrates (repeat step 1), wait 15 minutes and check again.
• Once the blood sugar reading is above 4.0 mmol/L and hypoglycemia has been reversed, if the next meal is more than one hour away, or if the person is going to be active, they should eat a snack containing starch and protein, such as a slice of bread with a piece of cheese or crackers with 2 tablespoons of peanut butter. If an individual is planning on driving after treating a low, ensure that they wait until their blood sugar is above 5.0 mmol/L before they start driving. The brain requires up to 40 minutes to recover before it is considered safe to drive.
• Certain people at risk of severe hypoglycemia may be advised by their doctor to carry a prefilled 1 mg glucagon injection and make it readily available for emergency situations. Symptoms of severe hypoglycemia include difficulty speaking and unconsciousness. Glucagon is used to increase blood glucose levels rapidly.

Do-it-yourself tests for ketones are useful during times of illness when blood glucose levels can be unpredictable. Ketones are potentially dangerous acids that build up in your blood when you lack insulin. Ketone buildup is much more common if you have type 1 diabetes. Talk to your doctor or primary health care provider about how to test for ketones and develop a sick-day plan for diabetes.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Diabetes-Managing-Your-Condition