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Healthy Living

DIABETES BASICS


Diabetes means that your blood glucose (blood sugar) is too high. There are two main types of diabetes. Type 1 diabetes - the body does not make insulin. Insulin helps the body use glucose from food for energy. People with type 1 need to take insulin every day. Type 2 diabetes - the body does not make or use insulin well. People with type 2 often need to take pills or insulin. Type 2 is the most common form of diabetes. Gestational diabetes - may occur when a woman is pregnant. Gestational diabetes raises her risk of getting another type of diabetes, mostly type 2, for the rest of her life. It also raises her child’s risk of being overweight and getting diabetes. Diabetes is serious. You may have heard people say they have “a touch of diabetes” or “your sugar is a little high.” These words suggest that diabetes is not a serious disease. That is not correct. Diabetes is serious, but you can learn to manage it! All people with diabetes need to make healthy food choices, stay at a healthy weight, and be physically active every day. Taking good care of yourself and your diabetes can help you feel better. It may help you avoid health problems caused by diabetes such as: •

heart disease and stroke.

eye problems that can lead to trouble seeing or going blind.

nerve damage that can cause your hands and feet to feel numb. Some people may even lose a foot or a leg.

kidney problems that can cause your kidneys to stop working.

gum disease and loss of teeth.

When your blood glucose (blood sugar) is close to normal you are likely to: •

have more energy.

be less tired and thirsty and urinate less often.

heal better and have fewer skin, or bladder infections.

have fewer problems with your eyesight, feet, and gums.


Ask your health care team what type of diabetes you have.

Learn why diabetes is serious.

Learn how caring for your diabetes helps you feel better today and in the future.

Talk to your health care team about how to manage your A1C (blood glucose or blood sugar), Blood pressure, and Cholesterol when you have diabetes. This will help lower your chances of having a heart attack, a stroke, or other diabetes problems. Here's what the ABCs of diabetes stand for: A for the A1C test (A-one-C) The A1C test shows what your blood glucose (blood sugar) has been over the last three months. The A1C goal for most people with diabetes is below 7. High blood glucose (blood sugar) levels can harm your heart and blood vessels, kidneys, feet, and eyes. B for Blood pressure. The goal for most people with diabetes is below 130/80. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease. C for Cholesterol. (ko-LES-ter-ol) The LDL goal for most people with diabetes is less than 100. The HDL goal for most people with diabetes is above 40. LDL or “bad” cholesterol can build up and clog your blood vessels. It can cause a heart attack or a stroke. HDL or “good” cholesterol helps remove cholesterol from your blood vessels. •

Ask your health care team: o

What your A1C, blood pressure, and cholesterol numbers are

o

What your ABC numbers should be

o

What you can do to reach your targets


Step 3: Manage Your Diabetes. Many people avoid the long-term problems of diabetes by taking good care of themselves. Work with your health care team to reach your ABC goals (A1C, Blood Pressure, Cholesterol): Use this self-care plan. •

Use your diabetes meal plan. If you do not have one, ask your health care team about one. o

o

o o

Make healthy food choices such as fruits and vegetables, fish, lean meats, chicken or turkey without the skin, dry peas or beans, whole grains, and low-fat or skim milk and cheese. Keep fish and lean meat and poultry portion to about 3 ounces (or the size of a deck of cards). Bake, broil, or grill it. Eat foods that have less fat and salt. Eat foods with more fiber such as whole grains cereals, breads, crackers, rice, or pasta.

Get 30 to 60 minutes of physical activity on most days of the week. Brisk walking is a great way to move more.

Stay at a healthy weight by using your meal plan and moving more.

Ask for help if you feel down. A mental health counselor, support group, member of the clergy, friend, or family member who will listen to your concerns may help you feel better.

Learn to cope with stress. Stress can raise your blood glucose (blood sugar). While it is hard to remove stress from your life, you can learn to handle it.

Stop smoking. Ask for help to quit.

Take medicines even when you feel good. Ask your doctor if you need aspirin to prevent a heart attack or stroke. Tell your doctor if you cannot afford your medicines or if you have any side effects.

Check your feet every day for cuts, blisters, red spots, and swelling. Call your health care team right away about any sores that do not go away.

Brush your teeth and floss every day to avoid problems with your mouth, teeth, or gums

Check your blood glucose (blood sugar). You may want to test it one or more times a day. Be sure to take this record to your doctor visits.


Check your blood pressure if your doctor advises.

Report any changes in your eyesight to your doctor.

Talk with your health care team about your blood glucose targets. Ask how and when to test your blood glucose and how to use the results to manage your diabetes.

Use this plan as a guide to your self-care.

Discuss how your self-care plan is working for you each time you visit your health care team.

Get Routine Care to Avoid Problems. See your health care team at least twice a year to find and treat any problems early. Ask what steps you can take to reach your goals. If you have diabetes, at each visit be sure you have a: •

blood pressure check

foot check

weight check

If you have diabetes, two times each year get: •

A1C test - it may be checked more often if it is over 7

If you have diabetes, once each year be sure you have a: •

cholesterol test

triglyceride test - a type of blood fat

complete foot exam

dental exam to check teeth and gums - tell your dentist you have diabetes

dilated eye exam to check for eye problems

flu shot

urine and a blood test to check for kidney problems

If you have diabetes, at least once get a: •

Pneumonia shot


Ask your health care team about these and other tests you may need. Ask what the results mean.

Write down the date and time of your next visit.

If you have Medicare, ask your health care team if Medicare will cover some of the costs for o

learning about healthy eating and diabetes self-care

o

special shoes, if you need them

o

medical supplies

o

diabetes medicines


Type 2 Diabetes and Pre-diabetes Type 2 diabetes is a disorder that affects the way the body uses digested food for growth and energy. Normally, the food one eats is broken down into glucose, a form of sugar. The glucose then passes into the bloodstream, where it is used by the cells for growth and energy. For glucose to reach the cells, however, insulin must be present. Insulin is a hormone produced by the pancreas, a fist-sized gland behind the stomach. Most people with type 2 diabetes have two problems: insulin resistance—a condition in which muscle, liver, and fat cells do not use insulin properly—and reduced insulin production by the pancreas. As a result, glucose builds up in the blood, overflows into the urine, and passes out of the body, never fulfilling its role as the body’s main source of fuel. About 23.6 million people in the United States have diabetes. Of those, 17.9 million are diagnosed and 5.7 million are undiagnosed. Ninety to 95 percent of people with diabetes have type 2 diabetes. Diabetes is the main cause of kidney failure, limb amputation, and new-onset blindness in American adults. People with diabetes are more likely than people without diabetes to develop and die from diseases of the heart and blood vessels, called cardiovascular disease. Adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes, and the risk for stroke is two to four times higher among people with diabetes. Pre-diabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Pre-diabetes is also called impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), depending on the test used to measure blood glucose levels. Having pre-diabetes puts one at higher risk for developing type 2 diabetes. People with pre-diabetes are also at increased risk for developing cardiovascular disease. Pre-diabetes is becoming more common in the United States. The U.S. Department of Health and Human Services estimates that about one in four U.S. adults aged 20 years or older—or 57 million people—had pre-diabetes in 2007. Those with pre-diabetes are likely to develop type 2 diabetes within 10 years, unless they take steps to prevent or delay diabetes. Who should be tested for pre-diabetes and diabetes? The American Diabetes Association recommends that testing to detect pre-diabetes and type 2 diabetes be considered in adults without symptoms who are overweight or obese and have one or more additional risk factors for diabetes. In those without these risk factors, testing should begin at age 45. Risk factors for pre-diabetes and diabetes—in addition to being overweight or obese or being age 45 or older—include the following:


• • • • • • • • •

being physically inactive having a parent, brother, or sister with diabetes having a family background that is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander giving birth to a baby weighing more than 9 pounds or being diagnosed with gestational diabetes—diabetes first found during pregnancy having high blood pressure—140/90 mmHg or above—or being treated for high blood pressure having HDL, or “good,” cholesterol below 35 mg/dL, or a triglyceride level above 250 mg/dL having polycystic ovary syndrome, also called PCOS having impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) on previous testing having other conditions associated with insulin resistance, such as severe obesity or a condition called acanthosis nigricans, characterized by a dark, velvety rash around the neck or armpits having a history of cardiovascular disease

If results of testing are normal, testing should be repeated at least every 3 years. Doctors may recommend more frequent testing depending on initial results and risk status.

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