Diabetic Care


When you have diabetes problem, the levels of blood glucose are too high. High blood glucose can cause symptoms such as blurred vision, frequent urination, increased thirst, unintended weight loss, slow healing sores, and feelings of hunger and tiredness. However, some people with diabetes do not have symptoms.

Diabetes is a serious disease. Over time, diabetes that is not well controlled causes serious damage to the eyes, kidneys, nerves, and heart.

Some women develop gestational diabetes during the late stages of pregnancy. Although this form of diabetic disease usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life.

People with diabetic health problems must take responsibility for their day-to-day care. Much of the daily care involves keeping blood glucose levels from going too high or too low. About two-thirds of people with diabetes die of heart disease, so it is also important to control blood pressure and cholesterol. This may require taking medications prescribed by a doctor.

When blood glucose levels drop too low, a condition known as hypoglycemia, a person can become nervous, shaky, and confused. Judgment can be impaired. If blood glucose falls too low, a person can faint.

A person can also become ill if blood glucose levels rise too high, a condition known as hyperglycemia. Severe diabetes may go into a coma if their blood sugar levels rise too high.

Strict control of blood glucose as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. People who take steps to control their diabetes skin problems can make a big difference in their health. If you have diabetes, stick to a diet plan, monitor your blood sugar, exercise regularly, take prescribed medication, and make healthy lifestyle choices.

Causes and Prevention

Diabetic symptoms is a serious, life-long disease. It cannot be cured, but careful control of blood sugar can prevent or delay the complications of this disease. A great deal of research is underway to find out exactly what causes diabetes and how to prevent it.

Causes

Diabetic disease prevents the body from properly converting foods into the energy needed for daily activity. Understanding how diabetes develops starts with knowing what happens when the body digests food.

When you eat, your body changes most of the food into a form of sugar called glucose. Glucose travels through the blood stream to "fuel," or feed your cells. It is the main source of fuel for your body.

For glucose to get into cells, insulin must be present. Insulin is a hormone made by the pancreas, a large organ behind the stomach.

If your body does not make enough insulin or if the insulin doesn't work the way it should, glucose can't get into your cells. It remains in your blood, while the cells are starved of energy. The level of glucose in your blood then gets too high, causing diabetes.

Over the years, high levels of glucose in the blood damage nerves and blood vessels. This can lead to complications such as heart disease and stroke, kidney disease, blindness, nerve damage, gum infections, and lower limb amputation.

There are three main forms of diabetes: type 1, type 2 and gestational diabetes. Type 1 diabetes is an autoimmune disease. An autoimmune disease occurs when the body's system for fighting infection -- the immune system -- turns against a part of the body.

In type 1 diabetes, the immune system attacks the insulin-producing cells in the pancreas and destroys them. The pancreas then produces little or no insulin.

At present, scientists do not know exactly what causes the body's immune system to attack the cells, but they believe that both genetic factors and environmental factors, such as viruses, are involved. Studies have begun to try to identify these factors and prevent type 1 diabetes in people at risk.

Type 2 diabetes -- the most common form -- is linked to obesity, high blood pressure, and high levels of bad cholesterol called triglycerides, and low levels of good cholesterol called high density lipoprotein or HDL. About 80 percent of people with type 2 diabetes are overweight. Being overweight can keep your body from using insulin properly.

When type 2 diabetes is diagnosed, the pancreas is usually producing some insulin, but not as much as needed. After several years, insulin production tends to decrease in people with type 2 diabetes.

Risk factors include:
  • Having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds.
  • Having blood pressure of 140/90 or higher, or having been told that you have high blood pressure.
Risk factors include:
  • Having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher.
  • Being inactive or exercising fewer than three times a week.
Before people develop type 2 diabetes, they usually have pre-diabetes -- a condition in which blood glucose levels are higher than normal, but not yet high enough for a diagnosis of diabetes.

People with pre-diabetes are more likely to develop diabetes within 10 years and also are more likely to have a heart attack or stroke. Pre-diabetes is common in America, according to new estimates. About 41 million people, or 40 percent of U.S. adults ages 40 to 74, have pre-diabetes.

Some women develop gestational diabetes during the late stages of pregnancy. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin.

Prevention

Diabetic symptoms tends to run in families, but other factors add to the risk of getting diabetes skin problems. For example, being overweight and under-active triggers diabetes in people who are at risk.

The two most common forms of diabetes are type 1 and type 2. In people with type 1 diabetes the body stops making insulin. Currently, there is no way to delay or prevent this form of diabetes.

Type 2 diabetes can be prevented in people who are at an increased risk for developing type 2 diabetes or have a condition called pre-diabetes. Pre-diabetes is a condition in which blood glucose levels are higher than normal but not yet high enough for a diagnosis of diabetes. People with pre-diabetes are more likely to develop diabetes within 10 years and are also more likely to have a heart attack or stroke.

That same study showed that changes in diet and exercise were especially effective in curbing the development of diabetes in older people. In fact, the development of diabetes dropped by 71 percent in adults 60 and older who were enrolled in the study.

Making modest lifestyle changes can often prevent or delay type 2 diabetes in people who are at risk. Here are some tips that may help.
  • Reach and maintain a reasonable body weight. Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. Recent studies have shown that losing even a few pounds can help reduce your risk of developing type 2 diabetes.
  • In the Diabetes Prevention Program, people who lost 5 to 7 percent of their body weight significantly reduced their risk of type 2 diabetes. So if you weigh 200 pounds, losing only 10 pounds can make a difference.
  • Make wise food choices most of the time. What you eat has a big impact on your health. By making wise food choices, you can help control your body weight, blood pressure, and cholesterol.
  • Be physically active every day. Regular exercise tackles several risk factors at once. It helps you lose weight, control your cholesterol and blood pressure, and improve your body's use insulin. People in the Diabetes Prevention Program study who were physically active 30 minutes a day 5 days a week reduced their weight and risk of type 2 diabetes. Many chose walking for exercise.
  • Take your prescribed medications. Some people need medication to help control their blood pressure or cholesterol levels. If you do, take your medicines as directed. Ask your doctor whether there are any medicines you can take to help you prevent type 2 diabetes.
  • Researchers are working hard to uncover the genetic and environmental factors that may put people at risk for obesity, pre-diabetes, and diabetes. As they learn more about the changes in the body that lead to diabetes, researchers will develop ways to prevent and cure the different stages of this disease.
  • Diabetic hypertension is often called a "silent" disease because many people have no signs or symptoms before they are diagnosed. Symptoms can also be so mild that you might not notice them. More than 5 million people in the United States have type 2 diabetes and do not know it.
Symptoms and Diagnosis

The signs of diabetes are
  • Being very thirsty.
  • Urinating often.
  • Feeling very hungry or tired.
  • Losing weight without trying.
  • Having sores that heal slowly.
  • Having dry, itchy skin.
  • Losing the feeling in your feet or having tingling in your feet
  • Having blurry eyesight.
Symptoms of diabetes type 1, which occurs most often in children and young adults, usually develop over a short period of time. The symptoms for type 2 diabetes develop more gradually.

Gestational diabetic complications develops only during pregnancy and usually disappears after delivery. However, the mother is at increased risk of getting type 2 diabetes later in life.

Doctors use the following tests to diagnose diabetes.
  • A fasting plasma glucose, or FPG test, measures your blood glucose after you have gone at least 8 hours without eating. Doctors use this test to detect diabetes or pre-diabetes.
  • An oral glucose tolerance test, or OGTT, measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a sweet beverage. Doctors use this test to diagnose diabetes or pre-diabetes. Doctors also use the oral glucose tolerance test to diagnose gestational diabetes in pregnant women.
  • In a random plasma glucose test, your doctor checks your blood glucose without regard to when you ate your last meal. This test, along with an assessment of diabetic symptoms, is used to diagnose diabetes but not pre-diabetes.
  • If any of these tests show that you might have diabetes skin problems, your doctor will need to repeat the fasting plasma glucose test or the oral glucose tolerance test on a different day to confirm the diagnosis. The fasting plasma glucose or FPG test is the preferred test for diagnosing diabetes and is most reliable when done in the morning.
  • Because type 2 diabetes is more common in older people, especially in people who are overweight, doctors recommend that anyone 45 years of age or older be tested for diabetes. If you are 45 or older and overweight, getting tested is strongly recommended.
  • Diabetes is a serious disease that can lead to pain, disability, and death. Sometimes people have symptoms but do not suspect diabetes. They delay scheduling a checkup because they do not feel sick.
  • Many people do not find out they have the disease until they have diabetes complications, such as blurry vision or heart trouble. Finding out early if you have diabetes is important because treatment can prevent damage to the body from diabetes.
Treatment and Research

Diabetes cannot be cured, but it can be controlled. Strict control of blood glucose, or blood sugar, as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes.

People with type 1 diabetes control their blood sugar with insulin injections and frequent self-monitoring of blood glucose. People with type 2 diabetes generally control their blood sugar with oral medications and, in some cases, insulin. Sometimes a person with type 2 diabetes can control blood glucose levels with diet and exercise alone.

Good control of blood glucose requires
  • following a meal plan
  • getting regular physical activity
  • taking diabetes medicine every day
  • checking blood glucose as recommended
  • monitoring your diabetes ABCs
Diet and Exercise

Follow a Meal Plan. Healthy eating is very important to lowering blood glucose levels, and people with diabetes should have their own meal plan. Ask your doctor to give you the name of a dietitian or a diabetes educator who can work with you to develop a meal plan.

In designing a meal plan, the dietitian considers the patient's weight and daily physical activity. For overweight patients, a weight loss plan is a must for proper blood glucose control. Your dietitian can help you plan meals to include foods that you and your family like to eat and that are good for you. Ask your dietitian to include foods that are heart healthy to reduce your risk of heart disease.

People with diabetic symptoms don't need to eat special foods. You can eat foods that are low in fat, salt, and sugar and high in fiber, such as beans, fruits, vegetables, and grains. Eating right will help you reach and stay at a weight that's good for your body, keep your blood glucose in a desirable range, and prevent heart and blood vessel disease.

Get Regular Physical Activity. Regular physical activity is important for people with diabetes. Taking part in a regular fitness program has been shown to improve blood glucose levels in older people whose levels are high.

Exercise is especially good for people with diabetes problems because
  • exercise helps keep weight down
  • exercise helps insulin work better to lower blood glucose
  • exercise is good for your heart and lungs
  • exercise gives you more energy
Before you begin exercising, talk with your doctor. Your doctor may check your heart and your feet to be sure you have no special problems. If you have high blood pressure or eye problems, some exercises like weightlifting may not be safe. Your health care team can help you find safe exercises.

Walking, swimming, dancing, riding a bicycle, playing baseball, and bowling are all good ways to exercise. You can even get exercise when you clean house or work in your garden.

Try to exercise almost every day for a total of about 30 minutes. If you haven't exercised lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day.

Medications

Take Your Diabetes Medicine Every Day. Insulin and diabetic complications pills are the two kinds of medicines used to lower blood glucose. You need insulin if your body has stopped making insulin or if your body doesn't make enough. Everyone with type 1 diabetes needs insulin, and many people with type 2 diabetes do, too.

Insulin can't be taken as a pill. You will give yourself shots every day or use an insulin pump. Insulin pumps are small machines that connect to narrow tubing, ending with a needle just under the skin near the abdomen. Insulin is delivered through the needle.

If your body makes insulin, but the insulin doesn't lower your blood glucose, you may need diabetes pills. Some pills are taken once a day, and others are taken more often. Ask your health care team when you should take your pills.

Self-monitoring

Check Your Blood Glucose as Recommended. The best way to find out how well you are taking care of your diabetes is to check your blood to see how much glucose is in it. If your blood has too much or too little glucose, you may need a change in your meal plan, exercise plan, or medicine.

Ask your doctor how often you should check your blood glucose. Some people check their blood glucose once a day. Others do it three or four times a day. You may check before eating, before bed, and sometimes in the middle of the night.

Your doctor or diabetes educator will show you how to check your blood using a blood glucose meter. Your health insurance or Medicare may pay for the supplies and equipment you need.
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