Archive for April, 2010
Don’t be surprised if you sometimes feel like there’s lots to do to manage type 2 diabetes. Here are some tips to help you keep on track:
- If you’re having trouble staying with your diabetes plan, think about what the problem may be.
- Ask yourself what you need to do to get on track. Find one step that could get you started. Choose something fairly easy.
- Find things you can do to keep the problem from happening again. Focus on your successes, not your slip-ups. Don’t beat yourself up for backsliding.
- It’s normal to feel overwhelmed with the demands of managing diabetes. Accepting that you havediabetes doesn’t mean that you have to like it.
- The more you know about diabetes, the easier it is to manage. Visit this program, whenever you need a refresher. Read books and visit respected Web sites about diabetes. Or, take a class in your community. See a diabetes educator at least once a year for more tips on living with diabetes.
- Decide what type of support you need from your family, friends, co-workers, or healthcare team. Then tell them. Odds are, they’ll be happy to help and flattered that you asked them.
- Some of the areas you might need help with aresetting goals, overcoming obstacles, and solving problems.
- Teach your family and friends about type 2 diabetes. Ask them to listen to what you think and feel, and to support you in making some healthy changes. For instance, they may want to exercise with you.
Your doctor may prescribe one or more medicines to help control your blood sugar, along with your plan to eat healthy and stay active.
Several kinds of medicines may help control blood sugar. Most people take pills while others take insulin. Some newer medicines for type 2 diabetes are injected. Your doctor will tell you which kind of medicine you need and why.
Over time, as your body changes, your doctor may make some changes in your treatment to help control your blood sugar. He or she may:
- Change your dose
- Add a new medicine or insulin
- Switch pills
Types of pills
Several types of pills are prescribed to treat type 2 diabetes:
- Alpha-glucosidase inhibitors prevent the breakdown of starches, such as bread, potatoes, and pasta in the intestine. They also slow the breakdown of some sugars. Their action slows the rise in blood glucose levels after a meal.
- Biguanides reduce the amount of sugar produced by the liver and make muscle tissue more sensitive to insulin so that sugar can be absorbed.
- DPP-4 inhibitors help improve A1C without causing low blood sugar (hypoglycemia). They work by preventing the breakdown of a naturally occurring compound in the body.
- Sulfonylureas and meglitinides stimulate the beta cells in the pancreas to release more insulin.
- Thiazolidinediones help insulin work better in the muscle and fat and also reduce the liver’s sugar production. They target insulin resistance.
Diabetes pills don’t work for everyone. Although you may find that your blood glucose levels go down when you start taking pills, your blood sugar levels may not reach the normal range.
What are the chances that diabetes pills will work for you? Your chances are good if you developed diabetes recently or have needed little or no insulin to keep your blood glucose levels near normal.
Type 2 diabetesis a chronic disease, which means that you have it for life. Although there’s no cure, you and your doctor can work together to control your blood sugar, which can help reduce your risk for type 2 diabetes complications.
Managing type 2 diabetes over months and years can mean making changes in your treatment plan. Diet and physical activity may control your blood sugar at first, but you may need to take medicine down the road. Over time, may need to change medicines, or add medicines, to keep your blood sugar under control. You may even need to use insulin
Remember, you play a major role in controlling your blood sugar and helping to prevent complications. With time, the lifestyle changes and treatments your doctor suggests can become a regular part of your routine.
Support from family, friends and your healthcare team can help you deal with diabetes long-term.
Low Blood Sugar
Low blood sugar (hypoglycemia) happens when you eat too little or not often enough, exercise more than usual, take too much of some diabetes medicine(s), or drink alcohol. Symptoms to look out for include:
- Nervousness and shakiness
- Dizziness or light-headedness
- Trouble speaking
- Feeling anxious or weak
If you have any of these symptoms, test your blood sugar. If it’s low, eat or drink a small amount of something that has sugar, like two or three glucose tablets, five or six pieces of hard candy, or 1/2 cup of fruit juice.
After 15 minutes, test again. If your blood sugar is still low, or you still have symptoms, have another serving of sugar. Wait 15 minutes and test again. If you have low blood sugar several times a week, call your doctor.
If you having symptoms but your meter shows that your blood sugar is fine, recheck your blood sugar and follow the steps above. This can happen if your meter isn’t working right.
NEVER DRIVE while you have low blood sugar or symptoms of low blood sugar.
Extreme High Blood Sugar
Extreme high blood sugar can lead to two life-threatening conditions:
Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS) is most often seen in elderly people. It is usually caused by an illness, infection, or by missing doses of your medicine. HHNS may take days or even weeks to develop. If it continues, the severe dehydration will lead to seizures, coma and eventually death.
In HHNS, blood sugar levels rise, and the body tries to get rid of the excess sugar by passing it into your urine. You will make a lot of urine at first. Later you may not have to go to the bathroom as often, and your urine becomes very dark. You may get very thirsty. Even if you are not thirsty, drink liquids. This will help keep you from getting dehydrated.
Know the warning signs:
Very high blood sugar level (over 600 mg/dL)
- Extreme thirst (although this may gradually disappear)
- Dry mouth
- Warm, dry skin that does not sweat
- High fever
- Sleepiness or confusion
- Loss of vision
- Hallucinations (seeing or hearing things that are not there)
- Weakness on one side of the body
Test your blood sugar if symptoms appear. Drink fluids if you can. Call your doctor right away.
Ketoacidosis is a serious condition that can lead to diabetic coma or even death. Ketoacidosis means dangerously high levels of ketones, which are acids that build up in the blood. They appear in the urine when your body doesn’t have enough insulin, and are a warning that your diabetes is out of control or that you are getting sick.
When to check for ketones
- When your blood glucose is more than 240 mg/dL, check every 4-6 hours
- When you are ill, check every 4-6 hours
- When you have any symptoms of ketoacidosis
Know the warning signs:
- Thirst or a very dry mouth
- Frequent urination
- High blood glucose (sugar) levels
- Constantly feeling tired
- Dry or flushed skin
- Nausea, vomiting, or abdominal pain (Vomiting can be caused by many illnesses, not just ketoacidosis. If vomiting continues for more than two hours, contact your healthcare provider.)
- A hard time breathing (short, deep breaths)
- Fruity odor on breath
- A hard time paying attention, or confusion
If you have these symptoms, test your blood sugar and your urine ketones. Call your doctor at once if:
- Your urine tests show high levels of ketones
- Your urine tests show high levels of ketones and your blood glucose level is high
- You have vomited more than twice in four hours and your urine tests show high ketones
Diet plays a significant role in controlling the diabetes. The diabetic diet may be used alone or else in combination with insulin doses or with oral hypoglycemic drugs. Main objective of diabetic diet is to maintain ideal body weight, by providing adequate nutrition along with normal blood sugar levels in blood. The diet plan for a diabetic is based on height, weight, age, sex, physical activity and nature of diabetes. While planning diet, the dietician has to consider complications such as high blood pressure, high cholesterol levels.
With respect to the above factors, a dietician will assess calories to be given, like scheming the carbohydrates, proteins, fats, type of carbohydrate, amount of fiber and so on.
Exchange meal plan is a diet program which balances the amount of carbohydrate that we intake per day. Glucose is a sugar released from carbohydrate so, if we want to control blood sugar we have to limit the consumption of simple carbohydrate. Carbohydrate foods are given as value per portion, known as the exchange. This plan helps us to decide on the type of food to be taken, the amount of food and also the time to eat. You can plan for more flexible meals as you get more knowledge about the diet for a diabetic, may be like the counting carbohydrate meal plan or constant carbohydrate. But there is no common diet that works for everyone. Nor is there any particular diet that works perfectly for any diabetic over a long period. While planning diabetes diet we should adhere to certain important factors, they are as follows:
- Fiber should be at least 1.4 oz / day
- Instead of 3 heavy meals, we should go for 4-5 small mid intervals
- Replace bakery products and fast foods by simple whole cooked cereals, and don’t eat carbohydrates 2 hours before bedtime
- Consume fresh fruit and vegetables at least 5 exchange/ day
Diabetics always need to take care of their diet and also about the food they eat. Care has to be taken because all foods contain not only carbohydrate, but also some energy value. Protein and fat available in the food are converted to glucose in the body. This glucose has some effect on the blood sugar level, which has to be taken care of. Furthermore, you needn’t have to eat only the bland boring diet. Instead, you can eat more fruits, vegetables and whole grains. All it means is that you need to select foods that are high in nutrition and low in calories.
diabetes are at increased risk for developing some cancers, and are more likely than nondiabetics to die of cancer. Now a study reports that they also have a higher risk of dying in the weeks just after cancer surgery.
The patients in the studies had both types of diabetes, though Type 2 is more common.
Their higher death rate may have resulted from problems associated with the chronic illness, like a higher risk of infections and greater risk of heart disease, said Hsin-Chieh Yeh, assistant professor of medicine and epidemiology at Johns Hopkins School of Medicine and one of the authors of the paper, published in the April issue of Diabetes Care.
“The implication of this is that diabetes care is important on top of the cancer care,” Dr. Yeh said. “When patients are diagnosed with cancer, the patient and the family and the physician think, ‘This is serious — we have to take care of the cancer part first.’ And sometimes they forget about the diabetes they have.”