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Clickcomplications button updated: September 16, 2013

Diabetes Information

The word diabetes simply means increased urine production.  Diabetes mellitus on the other hand implies a condition where the increased urine is caused by high levels of glucose (sugar).


TYPES OF DIABETES MELLITUS
Type 1 diabetes
Type 1a diabetes.  When one refers to type 1 diabetes, it generally means type 1a diabetes.  In This type of diabetes the body’s immune system fails to recognize the insulin producing β-cells as a part of self.  Therefore, the immune system attacks these cells resulting in a decrease in or a complete failure in the production of insulin. Since insulin is required for glucose to get into the body cells and glucose is the primary source of energy, insulin treatment is required for survival. Type 1a diabetes generally occurs in younger individuals.

Type 1b diabetes.  This type of diabetes generally refers to a lack of insulin because of some physical destruction of the insulin producing cells.  This can occur from pancreatitis, cancer, trauma or other causes.

LADA.  Latent Autoimmune Diabetes of Adults. 
This is a slow onset type 1 diabetes.  Some people call it type 1 1/2.  LADA differs from typical type 1 diabetes in that it is very slow in onset and may not appear until the person is well into adulthood. People with this form of diabetes may be successfully treated with pills for a while but will sooner than later require insulin treatment.

Type 2 diabetes. 
This is the most common form of diabetes.  Approximately 95% of the people with a diagnosis of diabetes will have type 2 diabetes.  It generally begins with what is called insulin resistance.  The person has enough insulin but it doesn't work very well.  As the body attempts to compensate for the insulin resistance, there may even be a temporary excess of insulin.  This disease generally starts after age 35 but there are increasing numbers of adolescents developing type 2 diabetes. People with type 2 diabetes are generally obese and frequently have a family history of diabetes. Risk factors for developing this disease include:

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People with type 2 diabetes can generally be initially treated with lifestyle changes and pills.  Eventually, however, pills fail to work because type 2 diabetes is progressive.  The insulin producing β-cell eventually fails. Pills are not effective enough to control diabetes if the pancreas is not producing sufficient amounts of insulin.  Therefore, more than 85% of people with type 2 diabetes will eventually end up with insulin therapy.

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Thirsty Sweating

Symptoms of high blood glucose

  • Fatigue.
  • Frequent trips to the bathroom.
  • Increased thirst.
  • Blurred vision.
  • Weight loss.
  • Increased appetite.
  • Agitation.

Symptoms of low blood glucose hypoglycemia

  • Excessive sweating.
  • Shaking.
  • Dizziness.
  • Hunger.
  • Fatigue.
  • Irrational behavior.
  • Blurred vision.
  • Headache.
  • Unconsciousness


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What to do (and don’t do) for Type 2

If you have recently been diagnosed with type 2 diabetes, here is an approach we recommend for patients. These suggestions are also good for those with long standing type 2 diabetes
What to do (and don’t do) for Type 2.

Don't be in DENIAL.
The Merriam-Webster dictionary defines denial as a psychological defense mechanism in which confrontation with a personal problem or with reality is avoided by denying in the existence of the problem or reality. Denial in diabetes leads to poor control which leads to complications (in the long run), the bad news.
Grab the bull by the horns and control the diabetes before it controls you. To do so can reduce your risk of problems to a level of anyone without diabetes with your age and situation, the good news.

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Do face the facts
Diabetes is a lifelong proposition. It will not go away, you may go on vacation but your diabetes will not; there is no cure (yet). There are a number of approaches that reduce the outward signs of diabetes, including bariatric surgery. But none offer a CURE.
Almost everything that happens to you will affect the diabetes.
Diabetes will affect almost everything that happens to you.
Examples: Food, Exercise (or lack thereof), psychological stress, depression, physical stress, medications, alcohol, illness, menstruation, menopause, pregnancy, testosterone lack, high blood pressure, thyroid problems,  and any other things that affect body hormones.

Do know where you are with your diabetes
Check blood glucose (sugar). Consult your health care provider about how often. The American Diabetes Association recommends that testing should be done in the following situations:

  1. When taking insulin
  2. When pregnant
  3. If having a hard time controlling your blood glucose levels
  4. If having low blood glucose levels
  5. If having low blood glucose levels without the usual warning signs
  6. If you have urine ketones from high blood glucose levels.

Your sugar after a meal is just as or more important than the first thing in the morning. At least some of your tests should be after a meal (2 hours). The American Diabetes Association (ADA) indicates a target of less than 180 after a meal. We think less than 140 is much better. The target before a meal is 70-130.
Get A1c test every 3-6 months (ADA target less than 7%).

Other targets for those of us with diabetes

  1. LDL or “Bad Cholesterol”: less than 100
  2. HDL or “Good Cholesterol”: Men >40; Women >50
  3. Triglycerides: less than 150 mg/dl (there is a typo on the ADA web site indicating >150mg/dl)

Take your prescribed medicine regularly.

Eat sensibly
Here are a few general principles.
How much you eat is much more important than what you eat.
Fast Carbohydrates (e.g. starch, bread and fruit) have an immediate and marked effect on blood glucose (sugar).
Slow carbohydrates, those high in fiber and low in total carbohydrate content have a slower and less marked effect on blood glucose.
Protein has an effect on blood glucose but to a lesser extent than carbohydrates.
Fat has an effect on blood glucose, primarily by providing calories and increasing blood fatty acid levels. This prevents insulin from working effectively.

Some general guidelines.
Consult your health care providers before starting this.
Have no more than two servings of FAST carbohydrate per meal. Serving examples: 1/3 cup rice Pork and Beans, Mac and Cheese, 1/2 cup potatoes or pasta, one slice of bread or one roll.
No limit on slower carbohydrate such as raw vegetables, cooked leafy vegetables, broccoli, asparagus.
Eat nothing that is boiled in oil (fried).
No limit on lean meat, chicken or seafood.
Exercise as much as is approved by your heart care provider
Limit snacks to 1 or 2 per day. Examples: Yoplait Light Yogurt (19gm Carb, 100 calories), 2 cookies.

If you fall off the wagon, its only human, get back on, the wagon is moving very slowly!

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