Treatment for Diabetes

1. Understanding Diabetes and Its Complications

2. Monitoring Your Glucose Levels

3. Know Your A1C numbers

4. Recognizing Hypoglycemia – Low Blood Sugar

5. The Prevention and Treatment of Hyperglycemia – High Blood Sugar

6. Insulin Therapy for Type 1 Diabetes

7. Methods of Insulin Delivery

8. Drug Therapy for Type 2 Diabetes

9. The Diabetes Diet

Diabetes is a condition that many don’t understand, including those who have been diagnosed with it. That lack of knowledge can lead to a host of complications. We will go so far as to say diabetes can be fatal. It is important to learn everything you can to take care of yourself when you are diagnosed with diabetes.

What is Diabetes?

In simple terms, diabetes is the imbalance of blood sugar in the body that throws the metabolic process into chaos. The body uses sugar, called glucose, for fuel. This fuel is used by the cells for their processes as well as to keep you moving. Burning glucose is the reason you are able to do all that you do during the day without simply dropping from sheer exhaustion. You usually can save that for the end of the day!

Carbohydrates are broken down by the body and glucose is released through the intestinal tract. The liver picks it up and stores it as glycogen until it is needed. The glucose that makes it into the bloodstream stays there waiting to be used.

The pancreas secretes a hormone called insulin that acts as a carrier for glucose.Insulin moves into the bloodstream and bonds with the glucose, carrying it to cells where it is needed. The cells allow the glucose in because it likes insulin and allows it to attach to it and release its precious cargo.

With diabetes, the body either doesn’t make enough insulin or the cells have developed sensitivity to it and won’t allow it to bind to the surface. In both cases, blood sugar rises to dangerous levels, causing several reactions, once which diabetes sufferers notice right away - fatigue from the lack of proper fuel.

Carbohydrates, Weight, and Complications

It seems we have a love-hate relationship with carbohydrates. We love to eat them but we hate the way certain ones can make our body look. We might as well glue those muffins to our waistline.

Obesity is one of the risk factors for diabetes. However, it's important to note that it’s not just the extra weight itself, but what we ate to get that extra weight. Eating carbohydrates, like breads and muffins, and other sugars causes the blood sugar to rise significantly. Remember, carbohydrates turn into sugar in the body. Keep this high carbohydrate and sugary diet up, and over time your body may not be able to produce enough insulin to counteract all of the sugar you are taking in. That can lead to a diagnosis of diabetes and future complications if you are not careful.

High levels of blood sugar can affect a variety of systems in the body. For example, these high levels of sugar can damage your nerves which is a common complication of diabetes. Damaged nerves can result in losing the feeling in the hands and feet. This nerve damage has been known to cause injury by burning on a stove, or stepping on a sharp object where the person couldn't even feel the pain until the injury was very severe. The resulting injury may take a long time to heal, another complication caused by a diabetic condition. Sadly, these injuries can lead to very serious conditions such as gangrene, and even amputation.

The complications of diabetes can also affect the kidneys. You may urinate more frequently as the body tries to rid itself of excess sugars through the urine. The kidneys are trying to handle this bombardment of sugar; a task the kidneys were not designed to do.

Your entire body can be thrown out of whack by diabetes, especially when it is uncontrolled. Refuse to be uninformed. If you are diagnosed with diabetes, ask your doctor to help you manage it to avoid dangerous complications.

Carbohydrates are broken down into glucose inside the body to use for fuel. When there is too much glucose circulating in the blood, you can develop a condition called diabetes. One way to manage your diabetes is to keep a close eye on your glucose levels, also known as your blood sugar levels.

It is important for both Type 1 and Type 2 diabetes sufferers to know their blood sugar levels throughout the day. With Type 1, the body may not produce any insulin to control the levels of sugar in the blood. With Type 2, what you eat may raise your blood sugar to a higher level than the insulin your pancreas produces can process it.

Your blood sugar number determines how well your body is processing glucose and will be an indication of how you feel throughout the day. At first, you will probably have to monitor your blood sugar levels several times until you get the hang of what your ideal glucose numbers should be.

Reasons to Monitor your Glucose Levels

There are several good reasons to monitor your blood sugar. Here are just a few:

· Prevent hypoglycemia, low blood sugar

· Prevent hyperglycemia, high blood sugar

· Keep diabetes under control and avoid any complications

· Prevent heart disease

Do those sound like good enough reasons to monitor your blood sugar? I see you're nodding. So now we will talk about how to monitor your blood sugar.

Using a Glucose Meter

People with diabetes check their blood sugar with a device called a glucose meter. It uses a small sample of blood to assess your blood sugar at the moment. This is helpful before and after meals to help you know a) how long is too long to go between meals and b) if you are eating the right foods to control your sugar levels.

There are many different glucose meters on the market these days so read the instructions for each before using it. The sample of blood is obtained by the finger stick method. Many meters have a spring-loaded needle to make it easier to prick your finger. It may seem awkward the first few times until you get used to the process. Many people avoid getting sensitive fingertips by taking blood from the side of the finger.

Here’s a quick rundown of some important steps when using a meter:

1. Clean your hands with soap and water. Swab alcohol on the area of your finger that you will be sticking.

2. Carefully prick your finger with the needle. Gently massage your finger to get the drop of blood to form. You may want to warm your hands slightly before you test. This will make the blood flow easier.

3. Place the drop of blood on the end of the testing strip.

4. Turn on your meter and slide the test strip in, then wait for the device to calculate your glucose level.

5. Reapply alcohol on a cotton ball to your finger to clean up.

Recommended blood sugar levels vary depending on who you ask. As a general guide, optimum level before meals should be between 90 and 130mg/dl. After meals, it will rise a bit to about 180mg/dl. Blood sugar levels higher than that need to be evaluated and discussed with your doctor or dietitian. It could mean you are eating too many of the wrong carbohydrates, sugary foods, or processed foods.

Monitor your blood sugar levels in the proper manner so you have the information you need to keep your diabetes controlled. Your healthy diet, regular monitoring, and routine visits to your doctor will go a long way to fighting back against the effects and complications of diabetes.

One goal of diabetes treatment is to get your blood sugar under control. Actually that is the foremost goal. When your blood sugar stays at manageable levels, then complications are are less of an issue. But, it takes time, as well as carefully following your doctor’s instructions to find the balance. One tool that doctors use is your A1C number.

What does A1C mean?

You might have heard this mentioned on commercials but weren’t sure how it correlated to diabetes. Here's a simple explanation. A glucose meter is used to determine your blood glucose level at any point throughout your day. This is important for treatment because these numbers can teach you where your diet is lacking when it comes to eating too many carbohydrates.

When you are first learning to live with diabetes, it can be both frightening and confusing. You don’t realize how important the relationship is between glucose and insulin until your body can’t perform the job properly anymore. If you have been diagnosed with Type 1 diabetes, the body never developed the process to do what it is supposed to do to the glucose. You have to provide the tool since your body doesn't automatically know what to do.

The A1C number gives a broader picture of your diabetes management for a few months at a glance. You might show good control of your diabetes this week, but still appear to have symptoms. You can test your blood sugar at any given moment and get a number that shows compliance but that may not have been the case all the time. This is where the additional testing is vital.

A1C is actually written HbA1C, read “glycated hemoglobin A1C.” Glucose is not the only thing swimming through the bloodstream. There are red blood cells, which gives blood its red color. These cells contain a protein called hemoglobin. Hemoglobin binds to iron in the blood.

Well, hemoglobin can also be bound by glucose. Remember it is sugar so it is sticky. Glucose that has been circulating for a while unused will bind to hemoglobin in the red blood cells. Since red blood cells live for about three months before they die, that sugar can stay bound for a good amount of time.

A1C Numbers

The A1C test finds those hemoglobin molecules in the red blood cells and quantifies them. The percentage of glycated (bound) hemoglobin lets the doctor know the average blood sugar over that period of time. An average glucose number is about 150mg/dl. This equals roughly seven percent on the A1C test. A percentage of eight or nine means your blood sugar has, at some point, been out of control. The test is done about four times a year.

Your doctor will use these numbers as a guide. He or she can verify blood sugar management against your glucose monitoring logs. This is not to catch you off guard but to help you better keep your diabetes under control so you don’t run into trouble in the rest of your body systems.

Keep monitoring your blood sugar using your glucose meter, but do follow up with your doctor on a routine basis for this other very important test. The more information you gather regarding your diabetes, the more likely you will maintain control and avoid complications.

Controlling blood sugar is important for diabetics. When well managed, a person with diabetes only need make a few changes to their lifestyle. But, when there are issues with fluctuating blood sugar levels, you could be at risk for complications like hypoglycemia.

What is Hypoglycemia?

Even people who have not been diagnosed as diabetic may get weak after exercise, or when they forget to eat. They may refer to this as “hypoglycemia.” Although their blood sugar may be low, it may not necessarily be actual hypoglycemia. Healthy individuals may suffer from a true case of hypoglycemia, or low blood sugar, but when diabetes is also an issue, hypoglycemia is a very serious threat.

Just like sugar in the blood can rise to high levels, blood sugar can also fall below the normal level. This is referred to as “insulin shock” and can seriously affect those with Type 1 and Type 2 diabetes who are both dependent and non-dependent on insulin. There are several reasons that the blood sugar may fall below normal:

· You forgot to eat

· You ate too little

· You exercised too much

· You drank alcohol

· You did not manage your insulin

Signs of Hypoglycemia

With hypoglycemia, there is not enough glucose in the blood to be carried to the cells for energy. Extra sugar stored in the liver as glycogen will be tapped, but after that, the body starts to go through changes. The early signs of hypoglycemia may include:

Sweating

Hunger

Trembling

Tachycardia (rapid heartbeat)

At the first sign of hypoglycemia, get some source of sugar into your body. It is recommended that diabetics take candy, glucose tablets, or a convenient carbohydrate with them to replenish their sugar if needed. These episodes are more prevalent before bed or upon waking up so keeping some form of sugar on your nightstand is a good idea.

One of the organs that rely on sugar is the brain. When the sugar levels get low, the brain has a hard time functioning normally. Prolonged, severe low levels can lead to:

· Confusion

· Disorientation

· Feeling weak

· Becoming combative

· Diabetic coma

In this hypoglycemic state, it is almost like you don’t have the energy to move, and if you could move, you wouldn't know which direction to go. If you see a diabetic person experiencing these signs, they need sugar right away and medical attention.

It may be difficult for long-time diabetics to recognize a hypoglycemic episode. They may have gotten used to feeling a certain way and don’t pay attention to the symptoms anymore. This can also happen to diabetics who haven’t been taught what to watch for in a hypoglycemia episode. That's why information is so crucial.

If you have been diagnosed with diabetes, learn everything you can about treatment and symptoms for hypoglycemia. Even if your diagnosis came many years ago, there are still things you should learn. Knowledge is power when it comes to controlling your diabetes.

One reason that an individual develops diabetes is because of the levels of sugar in the blood is higher than normal. This is called hyperglycemia and can be dangerous if left untreated.

What is Hyperglycemia?

Blood sugar levels sometimes get out of control. The high level of sugar in the blood causes problems in the rest of the body. That is the gist of diabetes. Chronic high blood sugar may cause diabetes over time, but you may also experience an acute spike in blood sugar which can have more immediate results.

Why would the blood sugar be high? One reason may be you are eating the wrong foods. Too many carbohydrates at one meal can flood the body with excess sugar that the insulin can’t handle.

Another reason is not enough insulin in the body. Your body may not produce enough insulin. Also, if a person is being monitored and treated with insulin for Type 1 diabetes, they may not be injecting enough insulin each day. For Type 2 diabetes, there could be insulin resistance in their cells.

Symptoms of Hyperglycemia

The body will try to get rid of excess sugar you ingest. One way is through the kidneys. That causes frequent urination. Because you are losing so much water from your body, you will also notice that you are thirsty more often.

Check your blood sugar. If it is way above normal, say over 200mg/dl, steps are going to have to be taken to lower it.

Treating Hyperglycemia

One way to treat it is with exercise. Yes, we did say exercise. Put that extra glucose to good use. Vigorous physical activity burns that sugar off as fuel. It can start to bring your blood sugar levels back down to normal.

A word of caution here: When there is not enough insulin to move all of the sugar that the cells need, the body can go into ketoacidosis. This is a condition were the body burns fats for energy which gives off ketones. Too many ketones are toxic to the body and it will try to get rid of them. Also, if fats are being used then sugar isn’t, and the blood sugar level will rise again.

How can you tell you have ketoacidosis? Here are some signs:

1. A fruity smell to your breath

2. Shortness of breath

3. Nausea and vomiting

Medical attention is needed right away. Ketoacidosis can lead to diabetic coma and death.

Preventing Hyperglycemia

Monitoring your glucose levels with a meter is one way to prevent this condition. When your sugar is too high, take measures to lower it safely.

Exercise (as long as ketones are not present in the urine)

Take some insulin

Monitor your diet

Reduce your stress level

Just like the sugar in your blood can get too low, it can also go sky high. The repercussions will be dangerous for your entire body. Knowing the signs and treatment of hyperglycemia will help you immediately control the outcome. Knowledge is power in the life of a person living with diabetes.

People with Type 1 diabetes often do not make enough insulin naturally to deal with the sugar that is in their bloodstream. Several methods are used in diabetes treatment and management, one method which includes insulin therapy.

What is Insulin?

In the body, insulin is a naturally-occurring hormone. It is secreted by cells in the pancreas in response to blood sugar levels. When the body needs sugar for fuel, the insulin is secreted to carry the sugar to the cells. When there is more sugar than insulin, blood sugar levels can rise above normal.

In people with Type 1 diabetes, there is a problem with the insulin production system. The body produces little or no insulin. That leaves the body vulnerable to the effects of high blood sugar; effects which may include nerve damage, eye damage, poor wound healing, and kidney damage.

There are many manners in which medicinal insulin is obtained and many types of insulin. At first, insulin was obtained from animals and processed for administering in people. Unfortunately, there was always the rejection factor which often worsened the condition. Now, insulin is obtained by harvesting pancreatic cells and creating human insulin for injection. With this source, there is less chance of rejection.

Insulin Therapy

Insulin therapy is necessary for Type 1 diabetics. It has to be administered each day and sometimes more than once a day to stop blood sugar levels from going too high and to keep sugar moving into the cells for energy. When a person is dependent on insulin, it is important to monitor several times a day. This helps to make sure the blood sugar remains stable.

Along with different sources of insulin, there are also different types of insulin:

· Regular

· Intermediate acting

· Long acting

· Rapid acting

Depending on the blood sugar management program prescribed by your doctor, you may be taking more than one type of insulin.

Onset time is important when it comes to insulin. This determines how fast it will lower the glucose levels in your blood. For instance, Rapid Acting insulin can begin to lower your blood sugar in less than fifteen minutes while Regular Onset insulin products take up to an hour to react. Regular Onset insulin is often used when your sugar is high, but not at a dangerous level, like after you have eaten a meal. It is not necessary to drop the levels quickly.

When diabetes is well managed with diet, exercise, and insulin, a Long Acting or Intermediate Acting insulin product may be appropriate. When glucose levels are well controlled over a long period of time, your doctor may put you on this type of insulin treatment program.

There is some trial-and-error expected with taking insulin. You and your doctor will carefully monitor your progress and change your treatment method as needed. This may take time, so don't worry. Follow all instructions given by your health care professional and take charge of your diabetes.

As an essential hormone in the body, insulin is secreted to control the levels of sugar in the blood. When insulin is not produced in the body, a condition known as diabetes occurs. People who have diabetes would have to inject themselves with insulin. Now, there are several methods for delivery of insulin that give diabetics options.

Insulin has peak times and a duration to consider. Peak time refers to the time when insulin becomes most effective in lowering blood sugar. Duration refers to how long the insulin will remain in your system after it is administered, continuing to do its job. For instance, a rapid acting form of insulin can take affect quickly, but may also last for another hour or two in the system. That is why the peak and duration is important when prescribing the type of insulin and the delivery system.

Injecting Insulin

This is the method most often used. It requires taking a certain dosage of insulin several times a day via a syringe and needle. The insulin is injected in the fat tissue of the body. Within the fat tissue, the insulin is more rapidly absorbed into the bloodstream.

Your doctor will discuss with you how to give yourself an insulin injection. It may be slow going at first but you will get the hang of it. You won't be left on your own to learn. Your doctor and health care team will help you learn the technique and guide you through the injection for as long as it takes. Here are a few reminders:

· Get all of your supplies together first so you can sit down, relax, and steel your nerves when it’s time.

· Wash your hands before handling insulin and any needles.

· Use sterile products. Wipe the top of your insulin bottle with an alcohol swab to clean it. Open a new syringe.

· Shake the bottle before using. Insulin can settle out of solution in the fridge. Draw up the prescribed amount of units.

· Use another alcohol swab to clean the injection site (shoulder, thigh). Pinch the skin between thumb and forefinger with one hand and inject at a 90 degree angle with the other hand. Push the needle in to the hub and push down on the plunger.

· Obtain a “sharps container” to store all of your used needles for later disposal.

Insulin Pump

Another method of delivery for Type 1 diabetics is the insulin pump. Your doctor may decide that an insulin pump will work for you. A small pump is attached to a catheter inserted in the skin, usually the abdomen. It delivers short-acting insulin throughout the day. The insulin pump makes it easier for diabetics to administer their insulin while going about their daily activities with more freedom.

There is a learning curve though. There are numbers to punch in and schedules to follow. All this will be covered in detail with your doctor. For activities like swimming, bathing, and running, you can disconnect the pump from the catheter for greater ease of motion. Again, your health care team will guide you through every step, and stick with you until you are comfortable with this method.

Insulin Spray

This is one of the newest ways that insulin is delivered. An insulin spray is mostly used for people with Type 2 diabetes. The spray works like an inhaler you might see an asthma patient use. It's important that patients have sufficient lung capacity to deliver the insulin effectively into the body. In other words, smokers need not apply.

Taking insulin for diabetes doesn't necessarily have to require a needle and syringe these days. There are now alternatives. Talk to your doctor about the choices available to control your diabetes.

For people with Type 2 diabetes, insulin therapy may not always be necessary. Type 2 diabetes is often controlled with diet, exercise, and medication. In this article you will learn about some of the medications that are prescribed to manage blood sugar in diabetics.

When your doctor tells you that you have diabetes, lifestyle changes will be one of the first things discussed. The first discussion will involve your current risk factors. These include obesity, poor diet, and a sedentary lifestyle. As you work to change your diet and incorporate a more active lifestyle, your doctor may prescribe certain medications to get you on the right track faster.

Even though Type 2 diabetics don't take insulin, they still have to monitor blood sugar to determine how well their dieting and exercise efforts are working. Sorry, you won't be able to avoid that finger pricking; it is still necessary for control.

Medications

Now, we don’t always eat what we should. If you are diabetic, the results of non-compliance can be very detrimental to your health and well-being. If you eat something that is off your diet, like a cookie, your blood sugar will usually rise in response to too much sugar moving into the blood.

Anti-Hyperglycemic Drugs

These are given orally (a relief to those who don’t like needles) to lower your blood sugar through stimulating the natural process of insulin production in the body. One such drug is metformin. Another name for it is Glucophage. It reduces the amount of glucose produced by the liver.

It also helps the cells to become more welcoming to insulin in diabetics who have developed insulin resistance. For those with risks of heart attack and stroke, this drug also helps to lower blood cholesterol levels and blood pressure. It is particularly useful for diabetics who are overweight.

Another class of drugs that help with lowering blood sugar is sulfonylurea. They work to naturally stimulate an increased production of insulin in the body. This is good for diabetics that have a limited insulin secretion that is not managing their blood sugar levels.

Precose is a diabetes management drug that works in the intestinal tract. It decreases the amount of carbohydrates that are absorbed into the intestines. Once carbs are broken down, the glucose is moved through the walls into the bloodstream where it circulates until used. When there is less sugar available to the bloodstream, then the amount of insulin the body produces can handle it.

Injectable drugs are used as a companion for Type 2 diabetics who have to use insulin. The blood sugar is not easily controlled with insulin alone so these drugs (Symlin and Byetta for example) are used for greater control.

Your doctor may use one drug, several drugs, or a combination drug to manage your diabetes. It all depends on your risk factors, any other complications with your diabetes, and how well you are controlling your diabetes with diet and exercise. All these options for treatment should be discussed with your health care professionals.

Type 2 diabetes is often treated with diet, exercise, and medication. Type 1 diabetes incorporates insulin into the equation to control blood sugar. In both cases, your doctor may place you on a special diabetes diet to help keep your blood sugar stable.

To be clear, there is not one “official” diabetes diet. Instead, we are looking at a series of guidelines set by the American Diabetes Association to help diabetics get control of their blood sugar, whether they take insulin or not. This diet also induces weight loss at the same time for diabetics who are overweight.

Before proceeding with any diet consult your doctor. He or she is a starting player on your diabetes management team, right alongside you. Your particular dietary requirements will depend on many factors:

· Your type of diabetes

· Other risk factors present (obesity, heart disease, kidney disease, high blood pressure, high cholesterol, etc.)

· The need for insulin, or not

· Management with medication, or only diet and exercise

· Sedentary lifestyle or active lifestyle

So, let’s start with the makeup of your average meal. The plate can be divided into three sections: protein, fats, and carbohydrates. Sounds pretty standard huh?

Carbohydrates are what supply the sugars that the body will use as fuel after the food is broken down.

At least 55-60 percent of your meal will be carbohydrates. And, these are not just any carbohydrates. You are encouraged to eat foods that are high in fiber and low in calories. Think vegetables, fruits, whole grains, and beans. Be sure that your food is definitely “whole grain” and not just processed white flour dressed up to look like a beneficial whole grain.

Fats are needed by the body in many capacities. The most beneficial fats are those that are poly- and mono-unsaturated. Try olive oil, canola oil, vegetable oil, and peanut oil. Omega-3 fatty acids are used by the body for heart health and immunity. Fish is a major source especially cold water fish. Aim for about 25-30 percent of your meal.

Protein is a building block in the body. All of the cells need access to protein for one reason or another. Try lean meat, fish, and dried beans, peas, and lentils. Protein, at most, needs to make up about 20 percent of your meal.

Meals are coordinated with insulin injections and timing of medications to get the most use of them. There are also snacks you can eat before bed or when you awake to keep blood sugar within normal levels. Exercise, which can lower your blood sugar, also has to be factored into the equation of eating and insulin. For the Type 2 diabetic, losing weight can bring you one step closer to possibly stopping any sort of diabetes medication for good.

If you are diabetic and need to control your blood sugar, a special diet is in order for you. There is not one single diet that qualifies as a “diabetic diet,” but the above guidelines will help you know in which direction you need to go. Your doctor and nutritionist will help you develop a plan that works for you.

** Please note every effort has been made to include accurate information, but further research and the advice of a physician is highly recommended before following any of the suggestions or ideas. The information is for information only.